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Capital IconMinnesota Legislature

HF 1571

as introduced - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:52am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - as introduced

Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 1.39 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 2.35 2.36 2.37 2.38 2.39 2.40 2.41 2.42 2.43 2.44 2.45 2.46 2.47 2.48 2.49 2.50 2.51 2.52 2.53
3.1 3.2
3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32
3.33 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30
4.31 4.32 4.33 4.34 4.35 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 5.35 5.36 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18
6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 6.33 6.34 6.35 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18
7.19 7.20 7.21 7.22 7.23 7.24
7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 7.34 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18
8.19
8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31
8.32 8.33 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14
9.15 9.16 9.17 9.18 9.19 9.20 9.21
9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8
10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 10.34 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21
11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32 11.33 11.34 11.35
12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20
12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30
12.31 12.32 12.33 12.34 13.1 13.2 13.3 13.4 13.5 13.6
13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 13.31 13.32 13.33 13.34 13.35 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8
14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26
14.27 14.28 14.29 14.30 14.31 14.32 14.33 14.34 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 15.33 15.34 15.35 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 16.34 16.35 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 17.34 17.35 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 18.33 18.34 18.35 18.36 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 19.32 19.33 19.34 19.35 19.36 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32 20.33 20.34 20.35 20.36 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22
21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 21.33 21.34 21.35 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 22.33 22.34 22.35 22.36 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22
23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 23.33 23.34 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 24.33 24.34 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 25.33 25.34 25.35 25.36 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 26.33 26.34 26.35 26.36 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 27.33 27.34 27.35 27.36 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8
28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 28.33 28.34 28.35 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 29.32 29.33 29.34 29.35 29.36 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 30.31 30.32 30.33 30.34 30.35 30.36 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 31.33 31.34 31.35 31.36 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 32.33 32.34 32.35 32.36 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 33.33 33.34 33.35 33.36 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12
34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 34.32 34.33 34.34 34.35 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 35.32 35.33 35.34 35.35 35.36 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33 36.34 36.35 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19
37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 37.32 37.33 37.34 37.35 38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 38.33 38.34 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 39.33 39.34 39.35 39.36 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25 40.26 40.27 40.28 40.29 40.30 40.31 40.32 40.33 40.34 40.35 40.36 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 41.33 41.34 41.35 41.36 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 42.32 42.33 42.34 42.35 42.36 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 43.32 43.33 43.34 43.35 43.36 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 44.32 44.33 44.34 44.35 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 45.32 45.33 45.34 45.35 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 46.32 46.33 46.34 46.35 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 47.32 47.33 47.34 47.35 47.36 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 48.32 48.33 48.34 48.35 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 49.31 49.32 49.33 49.34 49.35 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 50.32 50.33 50.34 50.35 50.36 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32 51.33 51.34 51.35 51.36 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 52.31 52.32 52.33 52.34 52.35 52.36 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 53.32 53.33 53.34 53.35 53.36 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 54.32 54.33 54.34 54.35 54.36 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 55.34 55.35 55.36 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32 56.33 56.34 56.35 56.36 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 57.31 57.32 57.33 57.34 57.35 57.36 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 58.32 58.33 58.34 58.35 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 59.32 59.33 59.34 59.35 59.36 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18
60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 60.32 60.33 60.34 60.35 61.1 61.2 61.3 61.4
61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 61.33 61.34 61.35 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25
62.26 62.27 62.28 62.29 62.30 62.31 62.32 62.33 62.34 62.35 63.1 63.2 63.3 63.4
63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13
63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 63.32
64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 64.32 64.33 64.34 64.35 64.36 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 65.32 65.33 65.34 65.35
66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 66.32 66.33 66.34 66.35 67.1 67.2 67.3 67.4 67.5 67.6 67.7
67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16
67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 67.33 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24
68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 68.34 68.35 69.1 69.2 69.3 69.4 69.5 69.6
69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 69.33 69.34 69.35 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32 70.33 70.34 70.35 71.1 71.2
71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29 71.30 71.31 71.32 71.33 71.34 71.35 72.1 72.2 72.3 72.4 72.5
72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 72.33 72.34 72.35 73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20
73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 73.32 73.33 73.34 73.35 74.1 74.2
74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12
74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 74.33 74.34 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9
75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32 75.33 75.34 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14
76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 76.33
76.34 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11
77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20
77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 77.32 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21
78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30
78.31 78.32 78.33 78.34 79.1 79.2
79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10
79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 79.32 79.33 79.34
80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21
80.22 80.23 80.24 80.25
80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12
81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22
81.23 81.24 81.25 81.26 81.27 81.28
81.29 81.30 81.31 81.32 81.33 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11
82.12
82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 82.32 82.33 82.34 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 83.31 83.32 83.33 83.34 84.1 84.2 84.3
84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 84.31 84.32 84.33
84.34 84.35 84.36 85.1 85.2 85.3 85.4 85.5
85.6 85.7
85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25
85.26
85.27 85.28 85.29 85.30 85.31 85.32 85.33 86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28 86.29 86.30 86.31 86.32 86.33 86.34 86.35 86.36 86.37 86.38 86.39 86.40 86.41
86.42 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30
87.31 87.32 87.33 87.34 87.35 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26
88.27
88.28 88.29 88.30 88.31 88.32 88.33 88.34 88.35 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 89.32 89.33 89.34 89.35 89.36 90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23
90.24
90.25 90.26 90.27 90.28 90.29 90.30 90.31
90.32 90.33 90.34 91.1 91.2 91.3 91.4 91.5 91.6 91.7
91.8 91.9 91.10 91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 91.32 91.33 91.34 91.35 92.1 92.2
92.3
92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16
92.17
92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 92.32 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10
93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29
93.30
93.31 93.32 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22
94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 94.31 94.32 94.33 94.34 94.35 95.1 95.2 95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31 95.32 95.33 95.34 95.35 95.36 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20
96.21
96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 96.33 96.34 96.35 97.1 97.2 97.3 97.4 97.5 97.6 97.7
97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 97.32 97.33 97.34 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22
98.23
98.24 98.25
98.26 98.27
98.28 98.29 98.30 98.31 98.32 98.33 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21
99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 99.30 99.31 99.32 99.33 99.34 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15
100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 100.32 100.33 100.34 100.35 101.1 101.2 101.3 101.4 101.5 101.6
101.7 101.8 101.9 101.10 101.11 101.12 101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25
101.26 101.27 101.28 101.29 101.30 101.31 101.32 101.33
102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14
102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 102.32 102.33 102.34 102.35 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 103.34 103.35 103.36 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12
104.13 104.14 104.15 104.16
104.17 104.18
104.19 104.20 104.21 104.22
104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 104.33 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 105.32 105.33 105.34 105.35 105.36 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 106.33 106.34
106.35 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 107.33 107.34
107.35
108.1 108.2 108.3 108.4 108.5 108.6 108.7
108.8 108.9
108.10 108.11
108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22
108.23
108.24 108.25 108.26 108.27 108.28 108.29 108.30 108.31 108.32 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21
109.22
109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 109.33 110.1 110.2 110.3 110.4 110.5 110.6 110.7
110.8
110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33 110.34 111.1 111.2 111.3
111.4
111.5 111.6
111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14
111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32 111.33 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14
112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31
112.32 112.33 112.34 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 113.32 113.33 113.34 113.35 113.36 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 114.33 114.34 114.35
115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14
115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 115.32 115.33 115.34 115.35 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 116.32 116.33 116.34 116.35
117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 117.33 117.34 117.35 117.36 118.1 118.2
118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 118.33 118.34 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 119.33 119.34 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 120.33 120.34 120.35 120.36 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8
121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 121.32 121.33
121.34 122.1
122.2 122.3 122.4 122.5 122.6 122.7
122.8 122.9
122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19
122.20
122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 122.31 122.32 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32 123.33 123.34 123.35 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 124.32 124.33 124.34 124.35 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32
125.33
125.34 126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15
126.16
126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 126.33 126.34 126.35 127.1 127.2 127.3 127.4
127.5
127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16
127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 127.32 127.33 127.34 128.1 128.2 128.3
128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 128.32 128.33 128.34 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 129.33 129.34 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24
130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 130.33 130.34 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16
131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31 131.32 131.33 131.34 131.35 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28
132.29 132.30 132.31 132.32 132.33 132.34 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 133.31 133.32 133.33 133.34 133.35 133.36 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 134.32 134.33 134.34 134.35 134.36 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 135.33
135.34 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 136.32 136.33 136.34 136.35 136.36 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 137.33 137.34 137.35 137.36 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 138.33 138.34 138.35 138.36 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 139.33 139.34 139.35 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 140.33 140.34 140.35 140.36 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 141.32 141.33 141.34 141.35 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 142.33 142.34 142.35 142.36 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14
143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32 143.33 143.34 143.35 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 144.33 144.34 144.35 144.36 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 145.33 145.34 145.35 145.36 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 146.33 146.34 146.35 146.36 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 147.33 147.34 147.35 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 148.32 148.33 148.34 148.35 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 149.32 149.33 149.34 149.35 149.36 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 150.32 150.33 150.34 150.35 150.36 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 151.32 151.33 151.34 151.35 151.36 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19
152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33 152.34 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 153.32 153.33 153.34 153.35 153.36 153.37 153.38 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 154.34 154.35 154.36 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 155.34 155.35 155.36 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 156.33 156.34 156.35 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 157.33 157.34 157.35 157.36 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31
158.32 158.33 158.34 158.35 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 159.32 159.33 159.34 159.35 159.36 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15
160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 160.33 160.34 160.35 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 161.33 161.34 161.35 161.36 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 162.32 162.33 162.34 162.35 162.36 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 163.31 163.32 163.33 163.34 163.35 163.36 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14
164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22
164.23
164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 164.33 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 165.32 165.33 165.34 165.35 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9
166.10
166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 166.32
166.33
167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20
167.21
167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 167.32 167.33 167.34 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 168.32 168.33 168.34 168.35 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32 169.33
169.34
170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10
170.11
170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 170.34
171.1
171.2 171.3 171.4 171.5 171.6 171.7 171.8
171.9
171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21
171.22
171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 171.32 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15
172.16
172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 172.33 172.34 172.35 173.1 173.2 173.3
173.4
173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30
173.31
173.32 173.33 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9
174.10
174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26
174.27
174.28 174.29 174.30 174.31 174.32 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11
175.12
175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26
175.27
175.28 175.29 175.30 175.31 175.32 175.33 176.1 176.2
176.3
176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30
176.31
176.32 176.33 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20
177.21
177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 177.32 177.33 177.34 177.35 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8
178.9
178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 178.33 178.34 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19
179.20
179.21 179.22 179.23 179.24 179.25 179.26 179.27
179.28
179.29 179.30 179.31 179.32 180.1 180.2 180.3
180.4
180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21
180.22
180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 180.32 180.33 181.1 181.2
181.3
181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27
181.28
181.29 181.30 181.31 181.32 181.33 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8
182.9
182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 182.32 182.33 182.34 182.35 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23
183.24
183.25 183.26 183.27 183.28 183.29 183.30
183.31
183.32 183.33 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12
184.13
184.14 184.15 184.16 184.17 184.18 184.19 184.20
184.21
184.22 184.23 184.24 184.25 184.26
184.27
184.28 184.29 184.30 184.31
185.1
185.2 185.3 185.4 185.5 185.6 185.7 185.8
185.9
185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 185.32 185.33 185.34 186.1 186.2
186.3
186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18
186.19
186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 186.32 186.33 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 187.32
187.33
187.34 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10
188.11 188.12
188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 188.32 188.33 188.34 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10
189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29
189.30 189.31 189.32 189.33 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31
190.32 190.33 190.34 190.35 190.36 190.37 190.38 190.39 191.1 191.2 191.3 191.4
191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 191.32 191.33
191.34 191.35 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10
192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18
192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31
192.32 192.33 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9
193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23
193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 193.32
193.33 193.34 194.1 194.2 194.3 194.4 194.5
194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27
194.28 194.29 194.30 194.31 194.32
194.33 194.34 195.1 195.2 195.3 195.4
195.5 195.6 195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19
195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28
195.29 195.30 195.31 195.32 195.33 196.1 196.2
196.3 196.4
196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 196.32 196.33 196.34 197.1 197.2 197.3 197.4
197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28
197.29 197.30 197.31 197.32 197.33 197.34 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14
198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26
198.27
198.28 198.29 198.30 198.31 198.32 198.33 198.34 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8
199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 199.33 199.34 199.35 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 200.33 200.34 200.35 200.36 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21
201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 201.32 201.33 201.34 201.35 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13
202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 202.33 202.34 203.1 203.2 203.3 203.4 203.5
203.6 203.7
203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28
203.29
203.30 203.31 203.32 203.33 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19
204.20 204.21
204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 204.32 204.33
204.34
205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15
205.16
205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 205.33 205.34 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 206.32 206.33 206.34 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23
207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 207.32 207.33 207.34 207.35 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 208.32 208.33 208.34 208.35 208.36 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29
209.30 209.31 209.32 209.33 209.34 209.35 210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 210.31 210.32 210.33 210.34 210.35 210.36 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31 211.32 211.33 211.34 211.35 211.36 212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 212.31 212.32 212.33 212.34 212.35 212.36 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14
213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 213.31 213.32 213.33 213.34 213.35 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 214.32 214.33 214.34 214.35 214.36 215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15
215.16 215.17
215.18 215.19 215.20
215.21 215.22 215.23
215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 215.32 215.33
216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10
216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19
216.20 216.21 216.22 216.23 216.24 216.25
216.26 216.27 216.28 216.29 216.30 216.31 216.32 216.33 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32 217.33 217.34 217.35 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17
218.18
218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 218.32 218.33 218.34 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13
219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 219.30 219.31 219.32 219.33 219.34 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27 220.28 220.29 220.30 220.31 220.32 220.33 220.34 220.35 220.36 221.1 221.2 221.3 221.4 221.5 221.6
221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 221.29 221.30 221.31 221.32 221.33 221.34 221.35 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 222.33 222.34
222.35 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 223.33 223.34 223.35 223.36 224.1 224.2 224.3 224.4 224.5 224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 224.32 224.33 224.34 224.35 224.36 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19 225.20 225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 225.32 225.33
225.34 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20
226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 226.33 226.34 226.35 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26
227.27 227.28 227.29 227.30 227.31
227.32 227.33 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28
228.29 228.30 228.31 228.32 228.33 228.34 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 229.33 229.34 229.35 229.36
230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 230.31 230.32 230.33 230.34 230.35 230.36
231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8
231.9 231.10 231.11 231.12 231.13 231.14
231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 231.32 231.33 231.34 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 232.33 232.34 232.35 232.36 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 233.32 233.33 233.34 233.35 233.36 234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 234.34 234.35 234.36 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30
235.31
235.32 235.33 235.34 235.35 236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13 236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 236.31 236.32 236.33 236.34 236.35 236.36 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18 237.19 237.20 237.21 237.22 237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 237.33 237.34 237.35 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 238.33 238.34 238.35 239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 239.31 239.32 239.33
239.34 240.1 240.2 240.3 240.4 240.5 240.6
240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16
240.17 240.18 240.19 240.20 240.21
240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 240.31 240.32 240.33 241.1 241.2 241.3 241.4 241.5 241.6 241.7
241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26
241.27 241.28 241.29 241.30 241.31 241.32 241.33
242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28
242.29
242.30 242.31 242.32 242.33 242.34 242.35 243.1 243.2 243.3 243.4 243.5 243.6 243.7
243.8 243.9 243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28
243.29 243.30 243.31 243.32 243.33 244.1 244.2
244.3 244.4 244.5 244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14 244.15 244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27
244.28 244.29 244.30 244.31 244.32 244.33 244.34 245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21 245.22 245.23
245.24 245.25 245.26 245.27 245.28 245.29 245.30 245.31 245.32 245.33 245.34 245.35 246.1 246.2 246.3 246.4 246.5 246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27
246.28 246.29 246.30 246.31 246.32 246.33 247.1 247.2 247.3 247.4 247.5 247.6 247.7
247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 247.31 247.32 247.33 247.34 247.35 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9
248.10 248.11 248.12 248.13 248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 248.32 248.33 249.1 249.2 249.3 249.4 249.5 249.6
249.7 249.8 249.9 249.10 249.11 249.12 249.13 249.14 249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31
249.32 249.33 249.34 250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10
250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30 250.31 250.32 250.33 250.34 250.35 251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18
251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 251.32 251.33 251.34 251.35 252.1 252.2 252.3 252.4 252.5 252.6 252.7 252.8 252.9 252.10 252.11 252.12
252.13 252.14 252.15 252.16 252.17 252.18 252.19 252.20
252.21 252.22 252.23 252.24 252.25 252.26 252.27 252.28 252.29 252.30 252.31 252.32 252.33 252.34 253.1 253.2 253.3 253.4 253.5 253.6
253.7 253.8 253.9 253.10 253.11 253.12 253.13 253.14 253.15 253.16 253.17 253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25 253.26 253.27 253.28 253.29
253.30 253.31 253.32 253.33 253.34 254.1 254.2 254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30 254.31 254.32 254.33 254.34 254.35 254.36 255.1 255.2
255.3 255.4 255.5 255.6 255.7 255.8 255.9 255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28 255.29 255.30 255.31 255.32
255.33 255.34 256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22 256.23 256.24 256.25 256.26 256.27 256.28 256.29
256.30 256.31 256.32 256.33 256.34 256.35 257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18 257.19 257.20 257.21 257.22 257.23 257.24
257.25 257.26 257.27 257.28 257.29 257.30 257.31 257.32 257.33 257.34 257.35 258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28 258.29 258.30 258.31 258.32 258.33 258.34 258.35 259.1 259.2 259.3 259.4
259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13 259.14 259.15 259.16 259.17 259.18 259.19 259.20 259.21 259.22 259.23 259.24
259.25 259.26 259.27 259.28 259.29
259.30 259.31 259.32 259.33 260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8
260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17
260.18 260.19 260.20 260.21 260.22 260.23 260.24 260.25 260.26
260.27 260.28 260.29 260.30 260.31 260.32 260.33 261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25
261.26
261.27 261.28 261.29 261.30 261.31 261.32 261.33
261.34 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 262.31 262.32 262.33 262.34 262.35 263.1 263.2
263.3 263.4 263.5 263.6 263.7 263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23
263.24 263.25 263.26 263.27 263.28 263.29 263.30 263.31 263.32 263.33 263.34 264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14 264.15 264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24
264.25 264.26 264.27 264.28 264.29 264.30 264.31 264.32 264.33 264.34 264.35 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22
265.23 265.24 265.25 265.26 265.27 265.28
265.29 265.30 265.31 265.32
266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19 266.20 266.21 266.22 266.23 266.24 266.25
266.26 266.27
266.28 266.29 266.30 266.31 266.32 266.33 267.1 267.2 267.3 267.4 267.5
267.6 267.7
267.8 267.9 267.10
267.11 267.12
267.13 267.14 267.15
267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 267.32 268.1 268.2 268.3 268.4
268.5 268.6
268.7 268.8 268.9 268.10 268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18 268.19
268.20 268.21 268.22 268.23 268.24 268.25 268.26
268.27 268.28 268.29 268.30 268.31 268.32 268.33 269.1 269.2
269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18
269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31
269.32 269.33 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11 270.12
270.13 270.14 270.15 270.16 270.17 270.18 270.19 270.20 270.21 270.22
270.23 270.24 270.25 270.26 270.27 270.28
270.29 270.30 270.31 270.32 270.33 271.1 271.2
271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12
271.13 271.14 271.15 271.16 271.17 271.18 271.19
271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32 271.33
272.1 272.2 272.3 272.4 272.5 272.6 272.7
272.8 272.9 272.10 272.11 272.12 272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24
272.25 272.26 272.27 272.28 272.29 272.30 272.31 272.32 272.33 272.34
273.1 273.2 273.3
273.4 273.5
273.6 273.7 273.8 273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 273.31 273.32 273.33 273.34 273.35 274.1 274.2 274.3
274.4 274.5 274.6 274.7 274.8 274.9 274.10 274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18 274.19 274.20 274.21 274.22
274.23 274.24 274.25 274.26 274.27
274.28 274.29 274.30 274.31 274.32 274.33 274.34 274.35 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17 275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25 275.26 275.27 275.28 275.29 275.30 275.31 275.32 275.33 275.34 275.35 275.36 275.37 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18
276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 276.32 276.33 276.34 276.35 276.36 276.37 276.38 277.1 277.2 277.3 277.4
277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14
277.15 277.16 277.17 277.18
277.19 277.20 277.21 277.22 277.23 277.24
277.25 277.26 277.27 277.28 277.29 277.30
278.1 278.2 278.3 278.4 278.5 278.6 278.7
278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 278.31 278.32 278.33
279.1 279.2 279.3 279.4 279.5 279.6
279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18
279.19 279.20 279.21 279.22 279.23 279.24
279.25 279.26 279.27 279.28 279.29 279.30 279.31 279.32 279.33 280.1 280.2 280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 280.31 280.32 280.33 280.34 280.35 280.36 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10 281.11 281.12 281.13 281.14
281.15 281.16 281.17 281.18 281.19 281.20 281.21
281.22 281.23 281.24 281.25 281.26 281.27 281.28 281.29 281.30 281.31 281.32
281.33 282.1 282.2 282.3 282.4 282.5
282.6
282.7 282.8 282.9
282.10
282.11 282.12 282.13 282.14
282.15
282.16 282.17 282.18 282.19
282.20
282.21 282.22 282.23 282.24 282.25
282.26
282.27 282.28 282.29 283.1 283.2
283.3
283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16
283.17
283.18 283.19 283.20 283.21 283.22 283.23
283.24
283.25 283.26 283.27 283.28 283.29 283.30 283.31 283.32 284.1 284.2 284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12 284.13 284.14 284.15 284.16 284.17 284.18 284.19 284.20 284.21 284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 284.30 284.31 284.32 284.33 284.34 284.35 284.36 284.37 284.38 284.39 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11
285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 285.31
285.32 285.33 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28
286.29 286.30 286.31 286.32 286.33
287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27
287.28
287.29 287.30 287.31 287.32 287.33 287.34
288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17 288.18 288.19 288.20 288.21 288.22 288.23 288.24
288.25
288.26 288.27 288.28 288.29 288.30 288.31 288.32 288.33 288.34 288.35
289.1
289.2 289.3 289.4
289.5 289.6 289.7 289.8 289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23
289.24 289.25 289.26 289.27
289.28 289.29 289.30 289.31 289.32 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12 290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 290.30 290.31 290.32 290.33 290.34 290.35 290.36 291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15 291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24 291.25 291.26 291.27 291.28 291.29 291.30 291.31 291.32 291.33 291.34 291.35 291.36 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28 292.29 292.30 292.31 292.32 292.33 292.34 292.35 292.36 293.1 293.2 293.3 293.4 293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22 293.23 293.24 293.25 293.26 293.27 293.28 293.29 293.30 293.31 293.32 293.33 293.34 293.35 293.36 293.37 293.38 294.1 294.2 294.3 294.4 294.5 294.6 294.7 294.8 294.9 294.10 294.11 294.12 294.13 294.14 294.15 294.16 294.17 294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 294.30 294.31 294.32 294.33 294.34 294.35
294.36 294.37 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 295.32 295.33 295.34 295.35 296.1 296.2 296.3 296.4 296.5
296.6 296.7 296.8 296.9 296.10
296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29 296.30 296.31 296.32 296.33 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14 297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31 297.32 297.33 297.34 297.35 297.36 298.1 298.2 298.3 298.4 298.5 298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27
298.28 298.29 298.30 298.31 298.32 298.33 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 299.31 299.32 299.33 299.34 299.35 299.36 300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15 300.16 300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27
300.28 300.29 300.30 300.31 300.32 300.33 300.34 301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17 301.18 301.19 301.20 301.21 301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 301.31 301.32 301.33 301.34 301.35 301.36 302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12 302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21 302.22 302.23 302.24
302.25 302.26 302.27 302.28 302.29 302.30 302.31 302.32 302.33 302.34 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10 303.11 303.12 303.13 303.14 303.15 303.16 303.17 303.18 303.19 303.20 303.21 303.22 303.23 303.24 303.25 303.26 303.27 303.28 303.29 303.30 303.31 303.32
303.33 303.34 303.35 304.1
304.2 304.3
304.4 304.5 304.6 304.7 304.8 304.9 304.10 304.11 304.12 304.13 304.14 304.15 304.16 304.17 304.18 304.19 304.20 304.21 304.22 304.23 304.24 304.25 304.26 304.27 304.28
304.29 304.30 304.31 304.32 304.33 304.34 305.1 305.2 305.3 305.4 305.5 305.6 305.7 305.8 305.9 305.10 305.11 305.12 305.13
305.14 305.15 305.16 305.17 305.18 305.19 305.20 305.21 305.22 305.23 305.24 305.25 305.26 305.27 305.28 305.29 305.30 305.31 305.32 305.33 305.34 305.35 306.1 306.2 306.3 306.4 306.5 306.6 306.7 306.8 306.9 306.10 306.11 306.12 306.13 306.14 306.15 306.16 306.17 306.18 306.19 306.20 306.21 306.22 306.23 306.24 306.25 306.26 306.27 306.28 306.29 306.30 306.31 306.32 306.33 306.34 306.35 307.1 307.2 307.3 307.4 307.5 307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16 307.17 307.18 307.19 307.20 307.21 307.22 307.23 307.24 307.25 307.26 307.27 307.28 307.29 307.30 307.31 307.32 307.33 307.34 307.35 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 308.32 308.33 308.34 308.35 308.36 309.1 309.2 309.3 309.4 309.5
309.6 309.7 309.8 309.9
309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19
309.20 309.21 309.22 309.23 309.24 309.25 309.26
309.27 309.28 309.29 309.30 309.31 309.32 310.1 310.2 310.3 310.4 310.5 310.6 310.7 310.8 310.9 310.10 310.11 310.12 310.13 310.14 310.15 310.16 310.17 310.18 310.19 310.20 310.21 310.22 310.23 310.24 310.25 310.26 310.27 310.28 310.29 310.30 310.31 310.32 310.33 310.34 310.35 310.36 311.1 311.2 311.3
311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 311.32 311.33 311.34 311.35 312.1 312.2 312.3 312.4 312.5 312.6 312.7 312.8 312.9 312.10 312.11 312.12 312.13 312.14 312.15 312.16 312.17 312.18 312.19 312.20 312.21 312.22 312.23 312.24 312.25 312.26 312.27 312.28 312.29 312.30 312.31 312.32 312.33 312.34 312.35 313.1 313.2 313.3 313.4 313.5 313.6 313.7 313.8 313.9 313.10 313.11 313.12 313.13 313.14 313.15 313.16 313.17 313.18 313.19 313.20 313.21 313.22 313.23 313.24 313.25 313.26 313.27 313.28 313.29 313.30 313.31
313.32 313.33 313.34 314.1 314.2 314.3 314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18 314.19 314.20 314.21 314.22
314.23 314.24 314.25 314.26 314.27 314.28 314.29 314.30 314.31 314.32 314.33 314.34 314.35 315.1 315.2 315.3 315.4 315.5 315.6 315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16 315.17 315.18 315.19 315.20 315.21
315.22 315.23 315.24 315.25 315.26 315.27 315.28
315.29 315.30 315.31 315.32 315.33 315.34 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8 316.9 316.10 316.11 316.12 316.13 316.14 316.15 316.16 316.17 316.18 316.19 316.20 316.21 316.22
316.23 316.24 316.25 316.26 316.27 316.28 316.29 316.30 316.31 316.32 316.33 316.34 316.35 317.1 317.2 317.3 317.4 317.5 317.6 317.7 317.8 317.9 317.10 317.11 317.12
317.13 317.14 317.15 317.16 317.17 317.18 317.19 317.20 317.21 317.22
317.23 317.24 317.25 317.26 317.27 317.28 317.29 317.30 317.31
317.32 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10 318.11 318.12 318.13 318.14 318.15 318.16 318.17 318.18 318.19 318.20 318.21 318.22 318.23 318.24 318.25 318.26 318.27 318.28 318.29 318.30 318.31 318.32 318.33 318.34 318.35 318.36
319.1 319.2 319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10 319.11 319.12 319.13 319.14
319.15 319.16 319.17 319.18 319.19 319.20 319.21 319.22 319.23 319.24 319.25 319.26 319.27 319.28 319.29 319.30 319.31
319.32 319.33 319.34 320.1 320.2 320.3 320.4 320.5 320.6 320.7 320.8 320.9 320.10 320.11 320.12 320.13 320.14 320.15 320.16 320.17 320.18 320.19 320.20 320.21 320.22 320.23 320.24 320.25 320.26 320.27 320.28 320.29 320.30
320.31 320.32 320.33 320.34 320.35 321.1 321.2 321.3 321.4 321.5 321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17
321.18 321.19 321.20 321.21 321.22 321.23 321.24 321.25 321.26 321.27
321.28 321.29 321.30 321.31 321.32 321.33 321.34 322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14
322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28
322.29 322.30 322.31 322.32 322.33 323.1 323.2 323.3 323.4 323.5 323.6 323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18
323.19 323.20
323.21 323.22 323.23 323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 323.32 323.33 323.34 323.35 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10 324.11 324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20 324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 324.32 324.33 324.34 324.35 324.36 325.1 325.2 325.3 325.4 325.5 325.6
325.7 325.8 325.9 325.10 325.11
325.12 325.13 325.14 325.15 325.16 325.17 325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25 325.26
325.27 325.28 325.29 325.30 325.31 325.32
326.1 326.2 326.3 326.4
326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13 326.14
326.15 326.16 326.17 326.18 326.19 326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 326.30
326.31 326.32 327.1 327.2 327.3 327.4 327.5
327.6 327.7 327.8 327.9 327.10
327.11 327.12 327.13 327.14 327.15 327.16 327.17 327.18 327.19 327.20 327.21
327.22 327.23 327.24 327.25 327.26 327.27 327.28 327.29 327.30 327.31 327.32 327.33 328.1 328.2 328.3 328.4 328.5 328.6 328.7 328.8 328.9 328.10 328.11 328.12 328.13 328.14 328.15
328.16 328.17 328.18 328.19 328.20 328.21
328.22 328.23 328.24 328.25 328.26 328.27 328.28 328.29 328.30 328.31 328.32 328.33 329.1 329.2 329.3 329.4
329.5 329.6 329.7 329.8 329.9 329.10 329.11 329.12 329.13 329.14 329.15 329.16 329.17
329.18 329.19
329.20 329.21 329.22 329.23 329.24 329.25 329.26 329.27 329.28 329.29 329.30 329.31 329.32 329.33 329.34 330.1 330.2 330.3 330.4
330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15
330.16 330.17 330.18 330.19 330.20 330.21 330.22 330.23 330.24 330.25
330.26 330.27 330.28 330.29 330.30 330.31
330.32 331.1 331.2 331.3 331.4
331.5 331.6 331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15
331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25
331.26 331.27 331.28 331.29 331.30 331.31
331.32 332.1 332.2 332.3 332.4
332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17
332.18 332.19 332.20 332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 332.31 332.32 332.33 332.34 333.1 333.2 333.3 333.4 333.5 333.6 333.7 333.8 333.9 333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17 333.18 333.19 333.20 333.21 333.22 333.23 333.24 333.25 333.26 333.27 333.28 333.29 333.30 333.31 333.32 333.33 333.34 333.35 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18
334.19 334.20 334.21 334.22 334.23 334.24 334.25 334.26 334.27 334.28 334.29 334.30 334.31 334.32 334.33 334.34 334.35 335.1 335.2
335.3 335.4 335.5 335.6
335.7 335.8
335.9 335.10 335.11 335.12 335.13 335.14 335.15 335.16
335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28 335.29 335.30 335.31 335.32
336.1 336.2 336.3 336.4 336.5 336.6 336.7 336.8 336.9 336.10 336.11 336.12 336.13 336.14 336.15 336.16 336.17 336.18 336.19
336.20 336.21 336.22
336.23 336.24
336.25 336.26
336.27 336.28 336.29 336.30 336.31 336.32 336.33 337.1 337.2 337.3 337.4 337.5 337.6 337.7 337.8 337.9 337.10 337.11 337.12 337.13 337.14 337.15 337.16 337.17 337.18 337.19 337.20 337.21
337.22 337.23 337.24 337.25 337.26 337.27 337.28 337.29
337.30 337.31 337.32 337.33 338.1 338.2
338.3 338.4 338.5 338.6 338.7 338.8
338.9 338.10 338.11 338.12 338.13 338.14 338.15 338.16 338.17 338.18 338.19 338.20 338.21
338.22 338.23 338.24 338.25 338.26 338.27 338.28 338.29 338.30 338.31 338.32 338.33 339.1 339.2 339.3 339.4 339.5 339.6 339.7 339.8 339.9 339.10 339.11 339.12 339.13 339.14 339.15 339.16 339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29 339.30 339.31 339.32 339.33 339.34 339.35 339.36 340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21
340.22 340.23
340.24 340.25
340.26 340.27 340.28 340.29 340.30 340.31 340.32 340.33 340.34 340.35 341.1 341.2
341.3 341.4 341.5 341.6 341.7 341.8 341.9 341.10 341.11 341.12 341.13 341.14 341.15
341.16 341.17 341.18 341.19 341.20 341.21 341.22 341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 341.32 341.33 341.34 341.35 341.36 342.1 342.2 342.3 342.4 342.5 342.6 342.7 342.8 342.9 342.10 342.11 342.12 342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20 342.21 342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31 342.32 342.33 342.34 343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14 343.15 343.16 343.17 343.18 343.19 343.20 343.21 343.22 343.23 343.24 343.25 343.26 343.27 343.28 343.29 343.30 343.31 343.32 343.33 343.34 343.35 344.1 344.2 344.3 344.4 344.5 344.6 344.7 344.8 344.9 344.10 344.11 344.12 344.13 344.14 344.15 344.16 344.17 344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 344.31 344.32 344.33 344.34 344.35 345.1 345.2 345.3 345.4 345.5 345.6 345.7 345.8 345.9 345.10 345.11 345.12 345.13 345.14 345.15 345.16 345.17 345.18 345.19 345.20 345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 345.29 345.30 345.31 345.32 345.33 346.1 346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20 346.21 346.22 346.23 346.24 346.25 346.26 346.27 346.28 346.29 346.30 346.31 346.32 346.33 346.34 346.35 346.36 347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10 347.11 347.12 347.13 347.14 347.15 347.16 347.17 347.18 347.19 347.20 347.21 347.22 347.23 347.24 347.25 347.26 347.27 347.28 347.29 347.30 347.31 347.32 347.33 347.34 347.35 348.1 348.2 348.3 348.4 348.5 348.6 348.7 348.8 348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16 348.17 348.18 348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 348.29 348.30 348.31 348.32 348.33 348.34 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 349.31 349.32 349.33 349.34 350.1 350.2 350.3 350.4 350.5 350.6 350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25 350.26 350.27 350.28 350.29 350.30 350.31 350.32 350.33 350.34 350.35 351.1 351.2 351.3 351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21 351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 351.31 351.32 351.33 351.34 351.35 352.1 352.2 352.3 352.4 352.5 352.6 352.7 352.8 352.9 352.10 352.11 352.12 352.13 352.14 352.15 352.16 352.17 352.18 352.19 352.20 352.21 352.22 352.23 352.24 352.25 352.26 352.27 352.28 352.29 352.30 352.31 352.32 352.33 352.34 352.35 353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9 353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21 353.22 353.23 353.24 353.25 353.26 353.27 353.28 353.29 353.30 353.31 353.32 353.33 353.34 353.35 353.36 354.1 354.2 354.3 354.4 354.5 354.6 354.7 354.8 354.9 354.10 354.11 354.12 354.13 354.14 354.15 354.16 354.17 354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30 354.31 354.32 354.33 354.34 354.35 355.1 355.2 355.3 355.4 355.5 355.6 355.7 355.8 355.9 355.10 355.11 355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 355.32 355.33 355.34 356.1 356.2 356.3 356.4 356.5 356.6 356.7 356.8 356.9 356.10 356.11 356.12 356.13 356.14 356.15 356.16 356.17 356.18 356.19 356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28 356.29 356.30 356.31 356.32 356.33 356.34 356.35 357.1 357.2 357.3 357.4 357.5 357.6 357.7 357.8 357.9 357.10 357.11 357.12 357.13 357.14 357.15 357.16 357.17 357.18 357.19 357.20 357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 357.30 357.31 357.32 357.33 357.34 357.35 358.1 358.2 358.3 358.4 358.5 358.6 358.7 358.8 358.9 358.10 358.11 358.12 358.13 358.14 358.15 358.16 358.17 358.18 358.19 358.20 358.21 358.22 358.23 358.24 358.25 358.26 358.27 358.28 358.29 358.30 358.31 358.32 358.33 358.34 359.1 359.2 359.3 359.4 359.5 359.6 359.7 359.8 359.9 359.10 359.11 359.12 359.13 359.14 359.15 359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23 359.24 359.25 359.26 359.27 359.28 359.29 359.30 359.31 359.32 359.33 359.34 359.35 360.1 360.2 360.3 360.4 360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12 360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20 360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29 360.30 360.31 360.32 360.33 360.34
361.1 361.2 361.3 361.4 361.5 361.6 361.7 361.8 361.9 361.10 361.11 361.12 361.13 361.14 361.15 361.16 361.17 361.18 361.19 361.20 361.21 361.22 361.23 361.24 361.25 361.26 361.27 361.28 361.29 361.30 361.31 361.32 361.33 361.34 361.35 361.36 361.37 362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9 362.10 362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28 362.29 362.30 362.31 362.32 362.33 362.34 362.35 363.1 363.2 363.3 363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13 363.14 363.15 363.16 363.17 363.18 363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 363.28 363.29 363.30 363.31 363.32 363.33 363.34 363.35 364.1 364.2 364.3 364.4 364.5 364.6 364.7 364.8 364.9 364.10 364.11 364.12 364.13 364.14 364.15 364.16 364.17
364.18 364.19 364.20 364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29 364.30 364.31 364.32 365.1 365.2 365.3 365.4 365.5 365.6 365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27 365.28 365.29 365.30 365.31 365.32 365.33 365.34 365.35 366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14 366.15 366.16 366.17 366.18 366.19 366.20
366.21 366.22 366.23 366.24 366.25 366.26 366.27 366.28 366.29 366.30 366.31 366.32 366.33 366.34 367.1 367.2 367.3 367.4 367.5
367.6
367.7 367.8 367.9
367.10
367.11 367.12 367.13 367.14 367.15 367.16 367.17 367.18 367.19
367.20 367.21 367.22 367.23 367.24 367.25 367.26 367.27 367.28 367.29 367.30 367.31 367.32 368.1 368.2 368.3 368.4 368.5 368.6 368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15 368.16
368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25 368.26
368.27 368.28 368.29 368.30 368.31 368.32 368.33 368.34 369.1 369.2
369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11
369.12 369.13 369.14 369.15 369.16 369.17 369.18 369.19 369.20
369.21 369.22 369.23 369.24 369.25 369.26 369.27 369.28 369.29 369.30 369.31 369.32 369.33 370.1 370.2
370.3 370.4 370.5 370.6 370.7 370.8 370.9 370.10 370.11 370.12 370.13 370.14 370.15 370.16 370.17 370.18 370.19 370.20 370.21 370.22 370.23 370.24 370.25 370.26 370.27 370.28 370.29 370.30 370.31 370.32 370.33 370.34 370.35 371.1 371.2 371.3 371.4 371.5 371.6 371.7 371.8 371.9 371.10 371.11 371.12 371.13 371.14 371.15 371.16 371.17 371.18 371.19 371.20 371.21 371.22 371.23 371.24 371.25 371.26 371.27 371.28 371.29 371.30 371.31 371.32 371.33 371.34 371.35 372.1 372.2 372.3 372.4 372.5 372.6 372.7 372.8 372.9 372.10 372.11 372.12 372.13 372.14 372.15 372.16 372.17 372.18 372.19 372.20 372.21 372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29 372.30 372.31 372.32 372.33 372.34 372.35 373.1 373.2 373.3 373.4 373.5 373.6 373.7 373.8 373.9 373.10 373.11 373.12 373.13 373.14 373.15 373.16 373.17 373.18 373.19 373.20 373.21 373.22 373.23 373.24 373.25 373.26 373.27 373.28 373.29 373.30 373.31 373.32 373.33 373.34 373.35 373.36 374.1 374.2 374.3 374.4 374.5 374.6 374.7 374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20 374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28 374.29 374.30 374.31 374.32 374.33 374.34 375.1 375.2 375.3 375.4 375.5 375.6 375.7 375.8 375.9 375.10 375.11 375.12 375.13 375.14 375.15 375.16 375.17 375.18 375.19 375.20 375.21 375.22 375.23 375.24 375.25 375.26 375.27 375.28 375.29 375.30 375.31 375.32 375.33 375.34 375.35 376.1 376.2 376.3 376.4 376.5 376.6 376.7 376.8 376.9 376.10 376.11 376.12 376.13 376.14 376.15 376.16 376.17 376.18 376.19 376.20 376.21 376.22 376.23 376.24 376.25 376.26 376.27 376.28 376.29 376.30 376.31 376.32 376.33 376.34 376.35 376.36 377.1 377.2 377.3 377.4 377.5 377.6 377.7 377.8 377.9 377.10 377.11 377.12 377.13 377.14 377.15 377.16 377.17 377.18 377.19 377.20 377.21 377.22 377.23 377.24 377.25 377.26 377.27 377.28 377.29 377.30 377.31 377.32 377.33 377.34 378.1 378.2 378.3 378.4 378.5 378.6 378.7 378.8 378.9 378.10 378.11 378.12 378.13 378.14 378.15 378.16 378.17 378.18 378.19 378.20 378.21 378.22 378.23 378.24 378.25 378.26 378.27 378.28 378.29 378.30 378.31 378.32 378.33 378.34 378.35 378.36 379.1 379.2 379.3 379.4 379.5 379.6 379.7 379.8 379.9 379.10 379.11 379.12 379.13 379.14 379.15 379.16 379.17 379.18 379.19 379.20 379.21 379.22 379.23 379.24 379.25 379.26 379.27 379.28 379.29 379.30 379.31 379.32
379.33
379.34 380.1 380.2 380.3 380.4 380.5 380.6 380.7 380.8 380.9 380.10 380.11 380.12 380.13 380.14
380.15 380.16 380.17 380.18 380.19 380.20 380.21 380.22 380.23 380.24 380.25 380.26 380.27 380.28 380.29 380.30 380.31 380.32 380.33 380.34 381.1 381.2 381.3 381.4 381.5 381.6 381.7 381.8 381.9 381.10 381.11 381.12 381.13 381.14 381.15 381.16 381.17 381.18 381.19 381.20 381.21
381.22 381.23 381.24 381.25
381.26 381.27 381.28
381.29 381.30 381.31
381.32 382.1 382.2 382.3 382.4
382.5 382.6 382.7

A bill for an act
relating to state government; establishing the governor's budget for health and
human services; amending provisions related to continuing care, child care,
Minnesota family investment program, adult supports, program integrity, child
support, licensing, health care programs including MinnesotaCare, medical
assistance and general assistance medical care, state-operated services, the
Department of Health, chemical and mental health, health-related fees, and
correctional state employees retirement plans; establishing the Protecting
Children and Strengthening Families Act; establishing Northstar Care for
Children; establishing and increasing fees; creating work groups; requiring
reports; appropriating money; amending Minnesota Statutes 2008, sections
16A.725, subdivision 3; 62J.692, subdivision 7; 103I.208, subdivision 2;
119B.02, subdivision 5; 119B.09, subdivision 7; 119B.12, subdivision 1;
119B.13, subdivisions 1, 6; 125A.744, subdivision 3; 144.0724, subdivisions
2, 4, 8, by adding subdivisions; 144.121, subdivisions 1a, 1b; 144.122;
144.1222, subdivision 1a; 144.1501, subdivisions 2, 5; 144.226, subdivision
4; 144.72, subdivisions 1, 3; 144.9501, subdivisions 22b, 26a, by adding
subdivisions; 144.9505, subdivisions 1g, 4; 144.9508, subdivisions 2, 3, 4;
144.97, subdivisions 2, 4, 6, by adding subdivisions; 144.98, subdivisions 1,
2, 3, by adding subdivisions; 144.99, subdivision 1; 144A.46, subdivision
1; 145.986, subdivision 5; 148.108; 148.6445, by adding a subdivision;
148D.180, subdivisions 1, 2, 3, 5; 148E.180, subdivisions 1, 2, 3, 5; 153A.17;
156.015; 157.15, by adding a subdivision; 157.16; 157.22; 176.011, subdivision
9; 245.4885, subdivision 1; 245A.03, by adding a subdivision; 245A.10,
subdivisions 2, 3, 4, 5, by adding subdivisions; 245A.11, by adding a subdivision;
245C.03, subdivision 2; 245C.04, subdivision 3; 245C.10, subdivision 3, by
adding a subdivision; 246.50, subdivision 5, by adding subdivisions; 246.51, by
adding subdivisions; 246.511; 246.52; 246B.01, by adding subdivisions; 252.43;
252.46, by adding a subdivision; 254A.02, by adding a subdivision; 254A.16, by
adding a subdivision; 254B.03, subdivision 3; 256.01, subdivision 2b, by adding
a subdivision; 256.045, subdivision 3; 256.969, subdivisions 2b, 3a; 256.975,
subdivision 7; 256.991; 256B.04, subdivisions 14, 16; 256B.055, subdivision
12; 256B.056, subdivisions 3b, 3c, 3d, 10; 256B.057, subdivisions 3, 9;
256B.0575; 256B.0595, subdivisions 1, 2; 256B.0621, subdivision 2; 256B.0625,
subdivisions 6a, 7, 8, 8a, 8b, 9, 13e, 17, 19a, 19c, 26, 41, 47, by adding
subdivisions; 256B.0651; 256B.0652; 256B.0653; 256B.0654; 256B.0655,
subdivision 4; 256B.0657, subdivisions 2, 6, 8; 256B.0911, subdivisions 1, 1a, 3,
3a, 4a, 5, 6, 7, by adding subdivisions; 256B.0913, subdivision 4; 256B.0915,
subdivisions 3e, 3h, 5, by adding a subdivision; 256B.0917, by adding a
subdivision; 256B.092, subdivision 8a, by adding a subdivision; 256B.0944, by
adding a subdivision; 256B.0945, subdivision 4; 256B.0947, subdivision 1;
256B.15, subdivisions 1a, 1h, 2, by adding subdivisions; 256B.199; 256B.37,
subdivisions 1, 5; 256B.437, subdivision 6; 256B.441, by adding subdivisions;
256B.49, subdivisions 12, 13, 14, 17, by adding a subdivision; 256B.501,
subdivision 4a; 256B.5012, by adding a subdivision; 256B.69, subdivisions
5a, 5c, 5f; 256B.761; 256D.03, subdivisions 3, 4; 256D.06, subdivision 2;
256D.09, subdivision 6; 256D.46; 256D.49, subdivision 3; 256G.02, subdivision
6; 256I.03, subdivision 7; 256I.05, subdivision 1a; 256J.20, subdivision 3;
256J.21, subdivision 2; 256J.24, subdivisions 3, 4, 5a, 10; 256J.37, subdivision
3a, by adding a subdivision; 256J.38, subdivision 1; 256J.45, subdivision 3;
256J.53, subdivision 2; 256J.575, subdivision 3; 256J.621; 256J.626, subdivision
6; 256J.751, by adding a subdivision; 256J.95, subdivision 12; 256L.01,
subdivisions 1a, 3a, 4, 5, by adding a subdivision; 256L.02, subdivisions 1,
3; 256L.03, subdivisions 1, 1a, 1b, 3, 5; 256L.04, subdivisions 1, 1a, 2, 8, 10,
13; 256L.05, subdivisions 3, 3a, 3b, 3c, 5; 256L.06, subdivision 3; 256L.07,
subdivisions 2, 3, 5, 7, by adding subdivisions; 256L.09, subdivision 2; 256L.11,
subdivisions 1, 2a, 6; 256L.12, subdivisions 6, 9; 256L.15, subdivision 1, by
adding subdivisions; 256L.17, by adding a subdivision; 257.85, subdivisions 2, 5,
6; 259.67, by adding subdivisions; 260B.441; 270A.09, by adding a subdivision;
295.58; 297I.05, subdivision 5; 327.14, by adding a subdivision; 327.15; 327.16;
327.20, subdivision 1, by adding a subdivision; 352.72, subdivision 1; 352.90;
352.91, subdivisions 1, 3h; 352.93, subdivisions 1, 2a, 4, by adding a subdivision;
356.30, subdivision 1; 393.07, subdivision 10; 501B.89, by adding a subdivision;
518A.53, subdivisions 1, 4, 10; 518A.60; 519.05; 604A.33, subdivision 1;
609.232, subdivision 11; 626.5572, subdivisions 6, 21; Laws 2003, First Special
Session chapter 14, article 13C, section 2, subdivision 1, as amended; Laws 2005,
First Special Session chapter 4, article 8, section 66; Laws 2008, chapter 358,
article 3, section 8; proposing coding for new law in Minnesota Statutes, chapters
156; 246B; 254A; 254B; 256; 256B; proposing coding for new law as Minnesota
Statutes, chapters 256N; 256O; repealing Minnesota Statutes 2008, sections
16A.724; 62U.08; 62U.10, subdivision 4; 103I.112; 144.9501, subdivision 17b;
148D.180, subdivision 8; 246.51, subdivision 1; 246.53, subdivision 3; 256.82,
subdivisions 2, 3, 4, 5; 256.962, subdivisions 1, 2, 5, 7; 256.969, subdivisions 26,
27; 256.983; 256B.057, subdivision 2c; 256B.0655, subdivisions 1, 1a, 1b, 1c,
1d, 1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 13; 256B.071, subdivisions 1, 2,
3, 4; 256B.0951; 256B.19, subdivision 1d; 256B.431, subdivision 23; 256B.76,
subdivision 4; 256I.06, subdivision 9; 256J.626, subdivision 7; 256L.02,
subdivision 3; 256L.04, subdivisions 7, 9; 256L.05, subdivision 1b; 256L.07,
subdivisions 1, 6, 7; 256L.09, subdivisions 2, 4, 5, 6; 256L.11, subdivision 7;
256L.15, subdivisions 2, 3, 4; 257.85; 259.67, subdivisions 1, 2, 3, 3a, 4, 5, 6,
7, 8, 9, 10; 295.581; 327.14, subdivisions 5, 6; 352.91, subdivisions 2, 2a, 3c,
3d, 3e, 3f, 3g, 3i, 4a, 4b, 5; Laws 1988, chapter 689, section 251; Laws 2005,
chapter 10, article 1, sections 56; 57; Laws 2005, First Special Session chapter 4,
article 8, sections 61; 67; 69; 74; 75; Laws 2007, chapter 147, article 5, sections
28; 32; 33; article 13, section 2; Laws 2008, chapter 358, article 3, sections 8; 9;
10; 11; 14; Minnesota Rules, parts 4626.2015, subpart 9; 9100.0400, subparts 1,
3; 9100.0500; 9100.0600; 9500.1243, subpart 3; 9500.1261, subparts 3, 4, 5, 6;
9560.0071; 9560.0081; 9560.0082; 9560.0083; 9560.0091; 9560.0093, subparts
1, 3, 4; 9560.0101; 9560.0102; 9560.0521, subparts 7, 10; 9560.0650, subparts
1, 3, 6; 9560.0651; 9560.0652; 9560.0653; 9560.0654; 9560.0655; 9560.0656;
9560.0657; 9560.0665, subparts 2, 3, 4, 5, 6, 7, 8, 9.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

CONTINUING CARE

Section 1.

Minnesota Statutes 2008, section 144.0724, subdivision 2, is amended to
read:


Subd. 2.

Definitions.

For purposes of this section, the following terms have the
meanings given.

(a) "Assessment reference date" means the last day of the minimum data set
observation period. The date sets the designated endpoint of the common observation
period, and all minimum data set items refer back in time from that point.

(b) "Case mix index" means the weighting factors assigned to the RUG-III
classifications.

(c) "Index maximization" means classifying a resident who could be assigned to
more than one category, to the category with the highest case mix index.

(d) "Minimum data set" means the assessment instrument specified by the Centers for
Medicare and Medicaid Services and designated by the Minnesota Department of Health.

(e) "Representative" means a person who is the resident's guardian or conservator,
the person authorized to pay the nursing home expenses of the resident, a representative
of the nursing home ombudsman's office whose assistance has been requested, or any
other individual designated by the resident.

(f) "Resource utilization groups" or "RUG" means the system for grouping a nursing
facility's residents according to their clinical and functional status identified in data
supplied by the facility's minimum data set.

new text begin (g) "Activities of daily living" means grooming, dressing, bathing, transferring,
mobility, positioning, eating, and toileting.
new text end

new text begin (h) "Nursing facility level of care determination" means the assessment process
that results in a determination of a resident's or prospective resident's need for nursing
facility level of care as established in subdivision 11 for purposes of medical assistance
payment of long-term care services for:
new text end

new text begin (1) nursing facility services under section 256B.434 or 256B.441;
new text end

new text begin (2) elderly waiver services under section 256B.0915;
new text end

new text begin (3) CADI and TBI waiver services under section 256B.49; and
new text end

new text begin (4) state payment of alternative care services under section 256B.0913.
new text end

Sec. 2.

Minnesota Statutes 2008, section 144.0724, subdivision 4, is amended to read:


Subd. 4.

Resident assessment schedule.

(a) A facility must conduct and
electronically submit to the commissioner of health case mix assessments that conform
with the assessment schedule defined by Code of Federal Regulations, title 42, section
483.20, and published by the United States Department of Health and Human Services,
Centers for Medicare and Medicaid Services, in the Long Term Care Assessment
Instrument User's Manual, version 2.0, October 1995, and subsequent clarifications made
in the Long-Term Care Assessment Instrument Questions and Answers, version 2.0,
August 1996. The commissioner of health may substitute successor manuals or question
and answer documents published by the United States Department of Health and Human
Services, Centers for Medicare and Medicaid Services, to replace or supplement the
current version of the manual or document.

(b) The assessments used to determine a case mix classification for reimbursement
include the following:

(1) a new admission assessment must be completed by day 14 following admission;

(2) an annual assessment must be completed within 366 days of the last
comprehensive assessment;

(3) a significant change assessment must be completed within 14 days of the
identification of a significant change; and

(4) the second quarterly assessment following either a new admission assessment,
an annual assessment, or a significant change assessment, and all quarterly assessments
beginning October 1, 2006. Each quarterly assessment must be completed within 92
days of the previous assessment.

new text begin (c) In addition to the assessments listed in paragraph (b), the assessments used to
determine nursing facility level of care include the following:
new text end

new text begin (1) preadmission screening completed under section 256B.0911, subdivision 4a,
by a county, tribe, or managed care organization under contract with the Department
of Human Services; and
new text end

new text begin (2) a face-to-face long-term care consultation assessment completed under section
256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care organization
under contract with the Department of Human Services.
new text end

Sec. 3.

Minnesota Statutes 2008, section 144.0724, subdivision 8, is amended to read:


Subd. 8.

Request for reconsideration of resident classifications.

(a) The resident,
or resident's representative, or the nursing facility or boarding care home may request that
the commissioner of health reconsider the assigned reimbursement classification. The
request for reconsideration must be submitted in writing to the commissioner within
30 days of the day the resident or the resident's representative receives the resident
classification notice. The request for reconsideration must include the name of the
resident, the name and address of the facility in which the resident resides, the reasons for
the reconsideration, the requested classification changes, and documentation supporting
the requested classification. The documentation accompanying the reconsideration request
is limited to documentation which establishes that the needs of the resident at the time of
the assessment justify a classification which is different than the classification established
by the commissioner of health.

(b) Upon request, the nursing facility must give the resident or the resident's
representative a copy of the assessment form and the other documentation that was given
to the commissioner of health to support the assessment findings. The nursing facility
shall also provide access to and a copy of other information from the resident's record that
has been requested by or on behalf of the resident to support a resident's reconsideration
request. A copy of any requested material must be provided within three working days of
receipt of a written request for the information. If a facility fails to provide the material
within this time, it is subject to the issuance of a correction order and penalty assessment
under sections 144.653 and 144A.10. Notwithstanding those sections, any correction order
issued under this subdivision must require that the nursing facility immediately comply
with the request for information and that as of the date of the issuance of the correction
order, the facility shall forfeit to the state a $100 fine for the first day of noncompliance, and
an increase in the $100 fine by $50 increments for each day the noncompliance continues.

(c) In addition to the information required under paragraphs (a) and (b), a
reconsideration request from a nursing facility must contain the following information: (i)
the date the reimbursement classification notices were received by the facility; (ii) the date
the classification notices were distributed to the resident or the resident's representative;
and (iii) a copy of a notice sent to the resident or to the resident's representative. This
notice must inform the resident or the resident's representative that a reconsideration of the
resident's classification is being requested, the reason for the request, that the resident's
rate will change if the request is approved by the commissioner, the extent of the change,
that copies of the facility's request and supporting documentation are available for review,
and that the resident also has the right to request a reconsideration. If the facility fails to
provide the required information with the reconsideration request, the request must be
denied, and the facility may not make further reconsideration requests on that specific
reimbursement classification.

(d) Reconsideration by the commissioner must be made by individuals not involved
in reviewing the assessment, audit, or reconsideration that established the disputed
classification. The reconsideration must be based upon the initial assessment and upon the
information provided to the commissioner under paragraphs (a) and (b). If necessary for
evaluating the reconsideration request, the commissioner may conduct on-site reviews.
Within 15 working days of receiving the request for reconsideration, the commissioner
shall affirm or modify the original resident classification. The original classification
must be modified if the commissioner determines that the assessment resulting in the
classification did not accurately reflect the needs or assessment characteristics of the
resident at the time of the assessment. The resident and the nursing facility or boarding
care home shall be notified within five working days after the decision is made. A decision
by the commissioner under this subdivision is the final administrative decision of the
agency for the party requesting reconsideration.

(e) The resident classification established by the commissioner shall be the
classification that applies to the resident while the request for reconsideration is pending.new text begin
If a request for reconsideration applies to an assessment used to determine nursing facility
level of care under subdivision 4, paragraph (c), the resident shall continue to be eligible
for nursing facility level of care while the request for reconsideration is pending.
new text end

(f) The commissioner may request additional documentation regarding a
reconsideration necessary to make an accurate reconsideration determination.

Sec. 4.

Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision
to read:


new text begin Subd. 11. new text end

new text begin Nursing facility level of care. new text end

new text begin (a) For purposes of medical assistance
payment of long-term care services, a recipient must be determined, using assessments
defined in subdivision 4, to meet one of the following nursing facility level of care criteria:
new text end

new text begin (1) the person needs the assistance of another person or constant supervision to
begin and complete at least four activities of daily living;
new text end

new text begin (2) the person needs the assistance of another person or constant supervision to begin
and complete toileting, transferring, or positioning and the assistance cannot be scheduled;
new text end

new text begin (3) the person has significant difficulty with memory, using information, daily
decision making, or behavioral needs that require intervention;
new text end

new text begin (4) the person has had a previous qualifying nursing facility stay of at least 90
days; or
new text end

new text begin (5) the person is determined to be at risk for nursing facility admission or
readmission through a face-to-face long-term care consultation assessment as specified
in section 256B.0911, subdivision 3a, 3b, or 4d, by a county, tribe, or managed care
organization under contract with the Department of Human Services. The person is
considered at risk under this clause if the person currently lives alone or will live alone
upon discharge and also meets one of the following criteria:
new text end

new text begin new text end

new text begin (i) the person has experienced a fall resulting in a fracture;
new text end

new text begin (ii) the person has been determined to be at risk of maltreatment or neglect,
including self-neglect; or
new text end

new text begin (iii) the person has a sensory impairment that substantially impacts functional ability
and maintenance of a community residence.
new text end

new text begin (b) The assessment used to establish medical assistance payment for nursing facility
services must be the most recent assessment performed under subdivision 4, paragraph
(b), that occurred no more than 90 calendar days before the effective date of medical
assistance financial eligibility determination. In no case shall medical assistance payment
for long-term care services occur prior to the date of the determination of nursing facility
level of care.
new text end

new text begin (c) The assessment used to establish medical assistance payment for services
provided under sections 256B.0915 and 256B.49 and alternative care payment for services
provided under section 256B.0913 must be the most recent face-to-face assessment
performed under subdivision 4, paragraph (c), clause (2), that occurred no more than 60
calendar days before the effective date of financial eligibility determination.
new text end

Sec. 5.

Minnesota Statutes 2008, section 144.0724, is amended by adding a subdivision
to read:


new text begin Subd. 12. new text end

new text begin Appeal of nursing facility level of care determination. new text end

new text begin A resident or
prospective resident whose level of care determination results in a denial of long-term care
services can appeal the determination as outlined in section 256B.0911, subdivision 3a,
paragraph (h), clause (7).
new text end

Sec. 6.

Minnesota Statutes 2008, section 245A.03, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin Licensing moratorium. new text end

new text begin (a) The commissioner shall not issue an
initial license for child foster care licensed under Minnesota Rules, parts 2960.3000 to
2960.3340, or adult foster care licensed under Minnesota Rules, parts 9555.5105 to
9555.6265, under this chapter for a physical location that will not be the primary residence
of the license holder for the entire period of licensure. If a license is issued during this
moratorium, and the license holder changes the license holder's primary residence away
from the physical location of the foster care license, the commissioner shall revoke the
license according to section 245A.07. Exceptions to the moratorium include:
new text end

new text begin (1) foster care settings that are required to be registered under chapter 144D;
new text end

new text begin (2) foster care licenses replacing foster care licenses in existence on the effective
date of this section and determined to be needed by the commissioner under paragraph (b);
new text end

new text begin (3) new foster care licenses determined to be needed by the commissioner under
paragraph (b) for the closure of a nursing facility, ICF/MR, or regional treatment center;
new text end

new text begin (4) new foster care licenses determined to be needed by the commissioner under
paragraph (b) for persons requiring hospital level of care; or
new text end

new text begin (5) new foster care licenses determined to be needed by the commissioner for the
transition of people from personal care assistance to the home and community-based
services.
new text end

new text begin (b) The commissioner shall determine the need for newly licensed foster care homes
as defined under this subdivision. As part of the determination, the commissioner shall
consider the availability of foster care capacity in the area which the licensee seeks to
operate, and the recommendation of the local county board. The determination by the
commissioner must be final. A determination of need is not required for a change in
ownership at the same address.
new text end

new text begin (c) The commissioner shall study the effects of the license moratorium under this
subdivision and shall report back to the legislature by January 15, 2011.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end

Sec. 7.

Minnesota Statutes 2008, section 245A.11, is amended by adding a subdivision
to read:


new text begin Subd. 8. new text end

new text begin Community residential setting license. new text end

new text begin (a) The commissioner shall
establish provider standards for residential support services that integrate service standards
and the residential setting under one license. The commissioner shall propose statutory
language and an implementation plan for licensing requirements for residential support
services to the legislature by January 15, 2011.
new text end

new text begin (b) Providers licensed under chapter 245B, and providing, contracting, or arranging
for services in settings licensed as adult foster care under Minnesota Rules, parts
9555.5105 to 9555.6265, or child foster care under Minnesota Rules, parts 2960.3000 to
2960.3340; and meeting the provisions of section 256B.092, subdivision 11, paragraph
(b), must be required to obtain a community residential setting license.
new text end

Sec. 8.

Minnesota Statutes 2008, section 252.43, is amended to read:


252.43 COMMISSIONER'S DUTIES.

The commissioner shall supervise county boards' provision of day training and
habilitation services to adults with developmental disabilities. The commissioner shall:

(1) determine the need for day training and habilitation services under section 252.28;

(2) deleted text beginapprove payment rates established by a county under section 252.46, subdivision
1
;
deleted text end

deleted text begin (3)deleted text end adopt rules for the administration and provision of day training and habilitation
services under sections 252.40 to 252.46 and sections 245A.01 to 245A.16 and 252.28,
subdivision 2
;

deleted text begin (4)deleted text endnew text begin (3)new text end enter into interagency agreements necessary to ensure effective coordination
and provision of day training and habilitation services;

deleted text begin (5)deleted text endnew text begin (4)new text end monitor and evaluate the costs and effectiveness of day training and
habilitation services; and

deleted text begin (6)deleted text endnew text begin (5)new text end provide information and technical help to county boards and vendors in their
administration and provision of day training and habilitation services.

Sec. 9.

Minnesota Statutes 2008, section 252.46, is amended by adding a subdivision
to read:


new text begin Subd. 1a. new text end

new text begin Day training and habilitation rates. new text end

new text begin The commissioner shall establish
a statewide rate-setting methodology for all day training and habilitation services. The
rate-setting methodology must abide by the principles of transparency and equitability
across the state. The methodology must involve a uniform process of structuring rates for
each service and must promote quality and participant choice.
new text end

Sec. 10.

new text begin [256.0281] INTERAGENCY DATA EXCHANGE.
new text end

new text begin The Department of Human Services, the Department of Health, and the Office of the
Ombudsman for Mental Health and Developmental Disabilities may establish interagency
agreements governing the electronic exchange of data on providers and individuals
collected, maintained, or used by each agency when such exchange is outlined by each
agency in an interagency agreement to accomplish the purposes in clauses (1) to (4):
new text end

new text begin (1) to improve provider enrollment processes for home and community-based
services and state plan home care services;
new text end

new text begin (2) to improve quality management of providers between state agencies;
new text end

new text begin (3) to establish and maintain provider eligibility to participate as providers under
Minnesota health care programs; and
new text end

new text begin (4) to meet the quality assurance reporting requirements under federal law under
section 1915(c) of the Social Security Act related to home and community-based waiver
programs.
new text end

new text begin Each interagency agreement must include provisions to ensure anonymity of individuals,
including mandated reporters, and must outline the specific uses of and access to shared
data within each agency. Electronic interfaces between source data systems developed
under these interagency agreements must incorporate these provisions as well as other
HIPPA provisions related to individual data.
new text end

Sec. 11.

Minnesota Statutes 2008, section 256.975, subdivision 7, is amended to read:


Subd. 7.

Consumer information and assistance; senior linkage.

(a) The
Minnesota Board on Aging shall operate a statewide information and assistance service
to aid older Minnesotans and their families in making informed choices about long-term
care options and health care benefits. Language services to persons with limited English
language skills may be made available. The service, known as Senior LinkAge Line, must
be available during business hours through a statewide toll-free number and must also
be available through the Internet.

(b) The service must deleted text beginassistdeleted text endnew text begin provide long-term care options counseling by assistingnew text end
older adults, caregivers, and providers in accessing information about choices in long-term
care services that are purchased through private providers or available through public
options. The service must:

(1) develop a comprehensive database that includes detailed listings in both
consumer- and provider-oriented formats;

(2) make the database accessible on the Internet and through other telecommunication
and media-related tools;

(3) link callers to interactive long-term care screening tools and make these tools
available through the Internet by integrating the tools with the database;

(4) develop community education materials with a focus on planning for long-term
care and evaluating independent living, housing, and service options;

(5) conduct an outreach campaign to assist older adults and their caregivers in
finding information on the Internet and through other means of communication;

(6) implement a messaging system for overflow callers and respond to these callers
by the next business day;

(7) link callers with county human services and other providers to receive more
in-depth assistance and consultation related to long-term care options;

(8) link callers with quality profiles for nursing facilities and other providers
developed by the commissioner of health; and

(9) incorporate information about housing with services and consumer rights
within the MinnesotaHelp.info network long-term care database to facilitate consumer
comparison of services and costs among housing with services establishments and with
other in-home services and to support financial self-sufficiency as long as possible.
Housing with services establishments and their arranged home care providers shall provide
deleted text begin information to the commissioner of human services that is consistent with information
required by the commissioner of health under section 144G.06, the Uniform Consumer
Information Guide
deleted text endnew text begin price and other information requested by the commissioner of human
services regarding rents and services. The commissioners of human services and health
shall align the data elements required by this section, and section 144G.06, the Uniform
Consumer Information Guide, to provide consumers standardized information and ease
of comparison of long-term care options
new text end. The commissioner of human services shall
provide the data to the Minnesota Board on Aging for inclusion in the MinnesotaHelp.info
network long-term care database.

(c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness
of the statewide information and assistance, and submit this evaluation to the legislature
by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps
in service delivery, continuity in information between the service and identified linkages,
and potential use of private funding to enhance the service.

Sec. 12.

Minnesota Statutes 2008, section 256B.0625, subdivision 6a, is amended to
read:


Subd. 6a.

Home health services.

Home health services are those services specified
in deleted text beginMinnesota Rules, part 9505.0295deleted text endnew text begin sections 256B.0651 and 256B.0653new text end. Medical
assistance covers home health services at a recipient's home residence. Medical assistance
does not cover home health services for residents of a hospital, nursing facility, or
intermediate care facility, unless the commissioner of human services has deleted text beginpriordeleted text end authorized
skilled nurse visits for less than 90 days for a resident at an intermediate care facility for
persons with developmental disabilities, to prevent an admission to a hospital or nursing
facility or unless a resident who is otherwise eligible is on leave from the facility and the
facility either pays for the home health services or forgoes the facility per diem for the
leave days that home health services are used. Home health services must be provided by
a Medicare certified home health agency. All nursing and home health aide services must
be provided according to sections 256B.0651 to deleted text begin256B.0656deleted text endnew text begin 256B.0653new text end.

Sec. 13.

Minnesota Statutes 2008, section 256B.0625, subdivision 7, is amended to
read:


Subd. 7.

Private duty nursing.

Medical assistance covers private duty nursing
services in a recipient's home. Recipients who are authorized to receive private duty
nursing services in their home may use approved hours outside of the home during hours
when normal life activities take them outside of their home. To use private duty nursing
services at school, the recipient or responsible party must provide written authorization in
the care plan identifying the chosen provider and the daily amount of services to be used at
school. Medical assistance does not cover private duty nursing services for residents of a
hospital, nursing facility, intermediate care facility, or a health care facility licensed by the
commissioner of health, except as authorized in section 256B.64 for ventilator-dependent
recipients in hospitals or unless a resident who is otherwise eligible is on leave from the
facility and the facility either pays for the private duty nursing services or forgoes the
facility per diem for the leave days that private duty nursing services are used. Total hours
of service and payment allowed for services outside the home cannot exceed that which is
otherwise allowed in an in-home setting according to sections 256B.0651 and deleted text begin256B.0653deleted text end
to 256B.0656. All private duty nursing services must be provided according to
the limits established under sections 256B.0651 and 256B.0653 to 256B.0656. Private
duty nursing services may not be reimbursed if the nurse is the foster care provider of
a recipient who is under age 18.

Sec. 14.

Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to
read:


Subd. 8.

Physical therapy.

Medical assistance covers physical therapynew text begin, as
described in section 148.65,
new text end and related services, including specialized maintenance
therapy. Services provided by a physical therapy assistant shall be reimbursed at the
same rate as services performed by a physical therapist when the services of the physical
therapy assistant are provided under the direction of a physical therapist who is on the
premises. Services provided by a physical therapy assistant that are provided under the
direction of a physical therapist who is not on the premises shall be reimbursed at 65
percent of the physical therapist rate.

Sec. 15.

Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to
read:


Subd. 8a.

Occupational therapy.

Medical assistance covers occupational therapynew text begin,
as described in section 148.6404,
new text end and related services, including specialized maintenance
therapy. Services provided by an occupational therapy assistant shall be reimbursed at
the same rate as services performed by an occupational therapist when the services of
the occupational therapy assistant are provided under the direction of the occupational
therapist who is on the premises. Services provided by an occupational therapy assistant
that are provided under the direction of an occupational therapist who is not on the
premises shall be reimbursed at 65 percent of the occupational therapist rate.

Sec. 16.

Minnesota Statutes 2008, section 256B.0625, subdivision 19a, is amended to
read:


Subd. 19a.

Personal care assistant services.

Medical assistance covers personal
care assistant services in a recipient's home. To qualify for personal care assistant services,
new text begin a recipient must require assistance and be determined dependent in two activities of daily
living as defined in section 256B.0659.
new text endRecipients or responsible parties must be able
to identify the recipient's needs, direct and evaluate task accomplishment, and provide
for health and safety. Approved hours may be used outside the home when normal life
activities take them outside the home. To use personal care assistant services at school,
the recipient or responsible party must provide written authorization in the care plan
identifying the chosen provider and the daily amount of services to be used at school.
Total hours for services, whether actually performed inside or outside the recipient's
home, cannot exceed that which is otherwise allowed for personal care assistant services
in an in-home setting according to sections 256B.0651 deleted text beginand 256B.0653deleted text end to 256B.0656.
Medical assistance does not cover personal care assistant services for residents of a
hospital, nursing facility, intermediate care facility, health care facility licensed by the
commissioner of health, or unless a resident who is otherwise eligible is on leave from
the facility and the facility either pays for the personal care assistant services or forgoes
the facility per diem for the leave days that personal care assistant services are used.
All personal care assistant services must be provided according to sections 256B.0651
deleted text begin and 256B.0653deleted text end to 256B.0656. Personal care assistant services may not be reimbursed if
the personal care assistant is the spouse or deleted text beginlegaldeleted text end new text beginpaid new text endguardian of the recipient or the
parent of a recipient under age 18, or the responsible party or the foster care provider
deleted text begin of a recipient who cannot direct the recipient's own care unless, in the case of a foster
care provider, a county or state case manager visits the recipient as needed, but not less
than every six months, to monitor the health and safety of the recipient and to ensure the
goals of the care plan are met. Parents of adult recipients, adult children of the recipient
or adult siblings of the recipient may be reimbursed for personal care assistant services,
if they are granted a waiver under sections 256B.0651 and 256B.0653 to 256B.0656
deleted text end.
Notwithstanding the provisions of section deleted text begin256B.0655, subdivision 2, paragraph (b), clause
(4)
deleted text endnew text begin 256B.0659new text end, the deleted text beginnoncorporate legaldeleted text endnew text begin unpaidnew text end guardian or conservator of an adult, who
is not the responsible party and not the personal care provider organization, may be
deleted text begin granted a hardship waiver under sections 256B.0651 and 256B.0653 to 256B.0656, to bedeleted text end
reimbursed to provide personal care assistant services to the recipientnew text begin if the guardian or
conservator meet all criteria for a personal care assistant according to section 256B.0659
new text end,
and shall not be considered to have a service provider interest for purposes of participation
on the screening team under section 256B.092, subdivision 7.

Sec. 17.

Minnesota Statutes 2008, section 256B.0625, subdivision 19c, is amended to
read:


Subd. 19c.

Personal care.

Medical assistance covers personal care assistant services
provided by an individual who is qualified to provide the services according to subdivision
19a and sections 256B.0651 deleted text beginand 256B.0653deleted text end to 256B.0656, deleted text beginwhere the services have a
statement of need by a physician,
deleted text end provided in accordance with a plan, and deleted text beginaredeleted text end supervised
by deleted text beginthe recipient ordeleted text end a qualified professional. deleted text beginThe physician's statement of need for personal
care assistant services shall be documented on a form approved by the commissioner and
include the diagnosis or condition of the person that results in a need for personal care
assistant services and be updated when the person's medical condition requires a change,
but at least annually if the need for personal care assistant services is ongoing.
deleted text end

"Qualified professional" means a mental health professional as defined in section 245.462,
subdivision 18
, or 245.4871, subdivision 27; or a registered nurse as defined in sections
148.171 to 148.285, or a licensed social worker as defined in section 148B.21. deleted text beginAs part
of the assessment, the county public health nurse will assist the recipient or responsible
party to identify the most appropriate person to provide supervision of the personal
care assistant.
deleted text end The qualified professional shall perform the duties deleted text begindescribeddeleted text end new text beginrequired new text endin
deleted text begin Minnesota Rules, part 9505.0335, subpart 4deleted text endnew text begin section 256B.0659new text end.

Sec. 18.

Minnesota Statutes 2008, section 256B.0651, is amended to read:


256B.0651 HOME CARE SERVICES.

Subdivision 1.

Definitions.

(a) deleted text begin"Activities of daily living" includes eating, toileting,
grooming, dressing, bathing, transferring, mobility, and positioning
deleted text endnew text begin For the purposes of
sections 256B.0651 to 256B.0656 and 256B.0659, the terms in paragraphs (b) to (g)
have the meanings given
new text end.

new text begin (b) "Activities of daily living" has the meaning given in section 256B.0659,
subdivision 1, paragraph (b).
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end "Assessment" means a review and evaluation of a recipient's need for home
care services conducted in personnew text begin as required in section 256B.0911new text end. deleted text beginAssessments for home
health agency services shall be conducted by a home health agency nurse. Assessments
for medical assistance home care services for developmental disability and alternative care
services for developmentally disabled home and community-based waivered recipients
may be conducted by the county public health nurse to ensure coordination and avoid
duplication. Assessments must be completed on forms provided by the commissioner
within 30 days of a request for home care services by a recipient or responsible party.
deleted text end

deleted text begin (c)deleted text endnew text begin (d)new text end "Home care services" deleted text beginmeans a health service, determined by the commissioner
as medically necessary, that is ordered by a physician and documented in a service plan
that is reviewed by the physician at least once every 60 days for the provision of home
health services, or private duty nursing, or at least once every 365 days for personal care.
Home care services are provided to the recipient at the recipient's residence that is a
place other than a hospital or long-term care facility or as specified in section 256B.0625
deleted text endnew text begin
means medical assistance covered services that are home health agency services, including
skilled nurse visits; home health aide visits; physical therapy, occupational therapy,
respiratory therapy, and language-speech pathology therapy; private duty nursing; and
personal care assistance
new text end.

new text begin (e) "Home residence" means a residence owned or rented by the recipient either
alone, with roommates of the recipient's choosing, or with an unpaid responsible party
or legal representative; or a family foster home where the license holder lives with the
recipient and is not paid to provide home care services for the recipient.
new text end

deleted text begin (d)deleted text endnew text begin (f)new text end "Medically necessary" has the meaning given in Minnesota Rules, parts
9505.0170 to 9505.0475.

deleted text begin (e) "Telehomecare" means the use of telecommunications technology by a home
health care professional to deliver home health care services, within the professional's
scope of practice, to a patient located at a site other than the site where the practitioner
is located.
deleted text end

new text begin (g) "Ventilator-dependent" means an individual who receives mechanical ventilation
for life support at least six hours per day and is expected to be or has been dependent on a
ventilator for at least 30 consecutive days.
new text end

Subd. 2.

Services covered.

Home care services covered under this section and
sections deleted text begin256B.0653deleted text endnew text begin 256B.0652 new text end to 256B.0656new text begin and 256B.0659new text end include:

(1) nursing services under deleted text beginsectiondeleted text endnew text begin sectionsnew text end 256B.0625, subdivision 6anew text begin, and
256B.0653
new text end
;

(2) private duty nursing services under deleted text beginsectiondeleted text endnew text begin sectionsnew text end 256B.0625, subdivision
7
new text begin, and 256B.0654new text end;

(3) home health services under deleted text beginsectiondeleted text endnew text begin sectionsnew text end 256B.0625, subdivision 6anew text begin, and
256B.0653
new text end
;

(4) personal care assistant services under deleted text beginsectiondeleted text endnew text begin sectionsnew text end 256B.0625, subdivision
19a
new text begin, and 256B.0659new text end;

(5) supervision of personal care assistant services provided by a qualified
professional under deleted text beginsectiondeleted text endnew text begin sectionsnew text end 256B.0625, subdivision 19anew text begin, and 256B.0659new text end;

deleted text begin (6) qualified professional of personal care assistant services under the fiscal
intermediary option as specified in section 256B.0655, subdivision 7;
deleted text end

deleted text begin (7)deleted text endnew text begin (6)new text end face-to-face assessments by county public health nurses for services under
deleted text begin sectiondeleted text endnew text begin sectionsnew text end 256B.0625, subdivision 19anew text begin, and 256B.0659new text end; and

deleted text begin (8)deleted text endnew text begin (7)new text end service updates and review of temporary increases for personal care assistant
services by the county public health nurse for services under deleted text beginsectiondeleted text endnew text begin sectionsnew text end 256B.0625,
subdivision 19a
new text begin, and 256B.0659new text end.

Subd. 3.

Noncovered home care services.

The following home care services are
not eligible for payment under medical assistance:

deleted text begin (1) skilled nurse visits for the sole purpose of supervision of the home health aide;
deleted text end

deleted text begin (2) a skilled nursing visit:
deleted text end

deleted text begin (i) only for the purpose of monitoring medication compliance with an established
medication program for a recipient; or
deleted text end

deleted text begin (ii) to administer or assist with medication administration, including injections,
prefilling syringes for injections, or oral medication set-up of an adult recipient, when as
determined and documented by the registered nurse, the need can be met by an available
pharmacy or the recipient is physically and mentally able to self-administer or prefill
a medication;
deleted text end

deleted text begin (3) home care services to a recipient who is eligible for covered services under the
Medicare program or any other insurance held by the recipient;
deleted text end

deleted text begin (4) services to other members of the recipient's household;
deleted text end

deleted text begin (5) a visit made by a skilled nurse solely to train other home health agency workers;
deleted text end

deleted text begin (6) any home care service included in the daily rate of the community-based
residential facility where the recipient is residing;
deleted text end

deleted text begin (7) nursing and rehabilitation therapy services that are reasonably accessible to a
recipient outside the recipient's place of residence, excluding the assessment, counseling
and education, and personal assistant care;
deleted text end

deleted text begin (8) any home health agency service, excluding personal care assistant services and
private duty nursing services, which are performed in a place other than the recipient's
residence; and
deleted text end

deleted text begin (9) Medicare evaluation or administrative nursing visits on dual-eligible recipients
that do not qualify for Medicare visit billing.
deleted text end

new text begin (1) services provided in a nursing facility, hospital, or intermediate care facility with
exceptions in section 256B.0653;
new text end

new text begin (2) services for the sole purpose of monitoring medication compliance with an
established medication program for a recipient;
new text end

new text begin (3) home care services for covered services under the Medicare program or any other
insurance held by the recipient;
new text end

new text begin (4) services to other members of the recipient's household;
new text end

new text begin (5) any home care service included in the daily rate of the community-based
residential facility where the recipient is residing;
new text end

new text begin (6) nursing and rehabilitation therapy services that are reasonably accessible to a
recipient outside the recipient's place of residence, excluding the assessment, counseling
and education, and personal assistance care; or
new text end

new text begin (7) Medicare evaluation or administrative nursing visits on dual-eligible recipients
that do not qualify for Medicare visit billing.
new text end

Subd. 4.

deleted text beginPriordeleted text end Authorization; exceptions.

All home care services above the limits
in subdivision 11 must receive the commissioner's deleted text beginpriordeleted text end authorizationnew text begin before services
begin
new text end, except when:

(1) the home care services were required to treat an emergency medical condition
that if not immediately treated could cause a recipient serious physical or mental disability,
continuation of severe pain, or death. The provider must request retroactive authorization
no later than five working days after giving the initial service. The provider must be able
to substantiate the emergency by documentation such as reports, notes, and admission or
discharge histories;

(2) deleted text beginthe home care services were provided on or after the date on which the recipient's
eligibility began, but before the date on which the recipient was notified that the case was
opened. Authorization will be considered if the request is submitted by the provider
within 20 working days of the date the recipient was notified that the case was opened;
deleted text endnew text begin
a recipient's eligibility lapse from medical assistance has been retroactively reinstated
and an authorization for home care services is completed based on the date of a current
assessment, eligibility, and request for authorization;
new text end

(3) a third-party payor for home care services has denied or adjusted a payment.
Authorization requests must be submitted by the provider within 20 working days of the
notice of denial or adjustment. A copy of the notice must be included with the request;

(4) the commissioner has determined that a county or state human services agency
has made an error; or

(5) deleted text beginthe professional nurse determines an immediate need for up to 40 skilled nursing
or home health aide visits per calendar year and submits a request for authorization within
20 working days of the initial service date, and medical assistance is determined to be
the appropriate payer.
deleted text endnew text begin if a recipient enrolled in managed care experiences a temporary
disenrollment from a health plan, the commissioner shall accept the current health plan
authorization for personal care assistance services for up to 60 days. The request must
be received within the first 30 days of the disenrollment. If the recipient's reenrollment
in managed care is after the 60 days and before 90 days, the provider shall request an
additional 30-day extension of the current health plan authorization, for a total limit of
90 days from the time of disenrollment.
new text end

deleted text begin Subd. 5. deleted text end

deleted text begin Retroactive authorization. deleted text end

deleted text begin A request for retroactive authorization will be
evaluated according to the same criteria applied to prior authorization requests.
deleted text end

Subd. 6.

deleted text beginPriordeleted text end Authorization.

new text begin(a) new text endThe commissioner, or the commissioner's
designee, shall review the assessment, deleted text beginservice update,deleted text end request for temporary services,
deleted text begin request for flexible use option,deleted text end service plan, and any additional information that is
submitted. The commissioner shall, within 30 days after receiving a complete request,
assessment, and service plan, authorize home care services as deleted text beginfollows:deleted text endnew text begin provided in this
section.
new text end

deleted text begin (a) Home health services.deleted text end new text begin(b) new text enddeleted text beginAlldeleted text end Home health services deleted text beginprovided by a home health
aide
deleted text endnew text begin including skilled nurse visits and home health aide visitsnew text end must be deleted text beginpriordeleted text end authorized
by the commissioner or the commissioner's designee. deleted text beginPrior deleted text endAuthorization must be based
on medical necessity and cost-effectiveness when compared with other care options.
new text begin The commissioner must receive the request for authorization of skilled nurse visits and
home health aide visits within 20 working days of the start of service.
new text endWhen home health
services are used in combination with personal care and private duty nursing, the cost of
all home care services shall be considered for cost-effectiveness. deleted text beginThe commissioner shall
limit home health aide visits to no more than one visit each per day. The commissioner, or
the commissioner's designee, may authorize up to two skilled nurse visits per day.
deleted text end

deleted text begin (b) Ventilator-dependent recipients.deleted text end new text begin(c) new text endIf the recipient is ventilator-dependent, the
monthly medical assistance authorization for home care services shall not exceed what the
commissioner would pay for care at the highest cost hospital designated as a long-term
hospital under the Medicare program. For purposes of this paragraph, home care services
means all new text begindirect care new text endservices provided in the home that would be included in the payment
for care at the long-term hospital. deleted text begin"Ventilator-dependent" means an individual who
receives mechanical ventilation for life support at least six hours per day and is expected
to be or has been dependent for at least 30 consecutive days.
deleted text endnew text begin Recipients who meet the
definition of ventilator dependent and the EN home care rating and utilize a combination
of home care services are limited up to a total of 24 hours of home care services per day.
Additional hours may be authorized when a recipient's assessment indicates a need for two
staff to perform activities. Additional time is limited to four hours per day.
new text end

Subd. 7.

deleted text beginPriordeleted text end Authorization; time limits.

new text begin(a) new text endThe commissioner or the
commissioner's designee shall determine the time period for which deleted text begina priordeleted text endnew text begin annew text end authorization
shall be effective deleted text beginand, if flexible use has been requested, whether to allow the flexible use
option
deleted text end. If the recipient continues to require home care services beyond the duration of
the deleted text beginpriordeleted text end authorization, the home care provider must request a new deleted text beginpriordeleted text end authorization.
A personal care provider agency must request a new personal care assistant services
assessment, or service update if allowed, at least 60 days prior to the end of the current
deleted text begin priordeleted text end authorization time period. The request for the assessment must be made on a form
approved by the commissioner. deleted text beginUnder no circumstances, other than the exceptions
in subdivision 4, shall a prior
deleted text endnew text begin Annew text end authorization new text beginmust new text endbe valid deleted text beginprior to the date the
commissioner receives the request or
deleted text end for new text beginno new text endmore than 12 months.

new text begin (b)new text end A recipient who appeals a reduction in previously authorized home care
services may continue previously authorized services, other than temporary services
under subdivision 8, pending an appeal under section 256.045. The commissioner must
provide a detailed explanation of why the authorized services are reduceddeleted text begin in amount from
those requested by the home care provider
deleted text end.

Subd. 8.

deleted text beginPriordeleted text end Authorization requests; temporary services.

The agency nurse,
deleted text begin thedeleted text end independently enrolled private duty nurse, or county public health nurse may request
a temporary authorization for home care services deleted text beginby telephonedeleted text end. The commissioner may
approve a temporary level of home care services based on the assessment, and service
or care plan information, and primary payer coverage determination information as
required. Authorization for a temporary level of home care services including nurse
supervision is limited to the time specified by the commissioner, but shall not exceed
45 daysdeleted text begin, unless extended because the county public health nurse has not completed the
required assessment and service plan, or the commissioner's determination has not been
made
deleted text end. The level of services authorized under this provision shall have no bearing on a
future deleted text beginpriordeleted text end authorization.

Subd. 9.

deleted text beginPriordeleted text end Authorization for foster care setting.

new text begin(a) new text endHome care services
provided in an adult or child foster care setting must receive deleted text beginpriordeleted text end authorization by the
deleted text begin departmentdeleted text endnew text begin commissionernew text end according to the limits established in subdivision 11.

new text begin (b) new text endThe commissioner may not authorize:

(1) home care services that are the responsibility of the foster care provider under
the terms of the foster care placement agreement and administrative rules;

(2) personal care assistant services when the foster care license holder is also
the personal care provider or personal care assistant deleted text beginunless the recipient can direct the
recipient's own care, or case management is provided as required in section 256B.0625,
subdivision 19a
deleted text end;new text begin or
new text end

deleted text begin (3) personal care assistant services when the responsible party is an employee of, or
under contract with, or has any direct or indirect financial relationship with the personal
care provider or personal care assistant, unless case management is provided as required
in section 256B.0625, subdivision 19a; or
deleted text end

deleted text begin (4)deleted text endnew text begin (3)new text end personal care assistant and private duty nursing services when the deleted text beginnumberdeleted text end
deleted text begin of foster care residentsdeleted text endnew text begin licensed capacitynew text end is greater than four deleted text beginunless the county responsible
for the recipient's foster placement made the placement prior to April 1, 1992, requests
that personal care assistant and private duty nursing services be provided, and case
management is provided as required in section 256B.0625, subdivision 19a
deleted text end.

deleted text begin Subd. 10. deleted text end

deleted text begin Limitation on payments. deleted text end

deleted text begin Medical assistance payments for home care
services shall be limited according to subdivisions 4 to 12 and sections 256B.0654,
subdivision 2
, and 256B.0655, subdivisions 3 and 4.
deleted text end

Subd. 11.

Limits on services without deleted text beginpriordeleted text end authorization.

A recipient may receive
the following home care services during a calendar year:

(1) up to two face-to-face assessments to determine a recipient's need for personal
care assistant services;

(2) one service update done to determine a recipient's need for personal care assistant
services; and

(3) up to nine new text beginface-to-face new text endskilled nurse visits.

Subd. 12.

Approval of home care services.

The commissioner or the
commissioner's designee shall determine the medical necessity of home care services, the
level of caregiver according to subdivision 2, and the institutional comparison according to
subdivisions 4 to 12 and sections 256B.0654, subdivision 2, and deleted text begin256B.0655, subdivisions
3 and 4
deleted text endnew text begin 256B.0659new text end, the cost-effectiveness of services, and the amount, scope, and duration
of home care services reimbursable by medical assistance, based on the assessment,
primary payer coverage determination information as required, the service plan, the
recipient's age, the cost of services, the recipient's medical condition, and diagnosis or
disability. The commissioner may publish additional criteria for determining medical
necessity according to section 256B.04.

Subd. 13.

Recovery of excessive payments.

The commissioner shall seek
monetary recovery from providers of payments made for services which exceed the limits
established in this section and sections 256B.0653 to 256B.0656. This subdivision does
not apply to services provided to a recipient at the previously authorized level pending an
appeal under section 256.045, subdivision 10.

new text begin Subd. 14. new text end

new text begin Referrals to Medicare providers required. new text end

new text begin Home care providers that
do not participate in or accept Medicare assignment must refer and document the referral
of dual-eligible recipients to Medicare providers when Medicare is determined to be the
appropriate payer for services and supplies and equipment. Providers must be terminated
from participation in the medical assistance program for failure to make these referrals.
new text end

new text begin Subd. 15. new text end

new text begin Quality assurance for program integrity. new text end

new text begin The commissioner shall
maintain processes for monitoring ongoing program integrity including provider standards
and training, consumer surveys, and random reviews of documentation.
new text end

new text begin Subd. 16. new text end

new text begin Oversight of enrolled providers. new text end

new text begin The commissioner shall establish
an ongoing quality assurance process for home care services. The commissioner has
the authority to request proof of documentation of meeting provider standards, quality
standards of care, correct billing practices, and other information. Failure to provide access
and information to demonstrate compliance with laws, rules, or policies must result in
suspension, denial, or termination of the provider agency's enrollment with the department.
new text end

Sec. 19.

Minnesota Statutes 2008, section 256B.0652, is amended to read:


256B.0652 deleted text beginPRIORdeleted text end AUTHORIZATION AND REVIEW OF HOME CARE
SERVICES.

Subdivision 1.

State coordination.

The commissioner shall supervise the
coordination of the deleted text beginpriordeleted text end authorization and review of home care services that are
reimbursed by medical assistance.

Subd. 2.

Duties.

(a) The commissioner may contract with or employ deleted text beginqualified
registered nurses and
deleted text end necessary deleted text beginsupportdeleted text end staff, or contract with qualified agencies, to
provide home care deleted text beginpriordeleted text end authorization and review services for medical assistance
recipients who are receiving home care services.

(b) Reimbursement for the deleted text beginpriordeleted text end authorization function shall be made through the
medical assistance administrative authority. The state shall pay the nonfederal share.
The functions will be to:

(1) assess the recipient's individual need for services required to be cared for safely
in the community;

(2) ensure that a deleted text beginservicedeleted text endnew text begin carenew text end plan that meets the recipient's needs is developed
by the appropriate agency or individual;

(3) ensure cost-effectiveness new text beginand nonduplication new text endof medical assistance home care
services;

(4) recommend the approval or denial of the use of medical assistance funds to pay
for home care services;

(5) reassess the recipient's need for and level of home care services at a frequency
determined by the commissioner; and

(6) conduct on-site assessments when determined necessary by the commissioner
and recommend changes to care plans that will provide more efficient and appropriate
home care.

(c) In addition, the commissioner or the commissioner's designee may:

(1) review new text begincare new text endservice plans and reimbursement data for utilization of services that
exceed community-based standards for home care, inappropriate home care services,
medical necessity, home care services that do not meet quality of care standards, or
unauthorized services and make appropriate referrals within the department or to other
appropriate entities based on the findings;

(2) assist the recipient in obtaining services necessary to allow the recipient to
remain safely in or return to the community;

(3) coordinate home care services with other medical assistance services under
section 256B.0625;

(4) assist the recipient with problems related to the provision of home care services;

(5) assure the quality of home care services; and

(6) assure that all liable third-party payers includingnew text begin, but not limited to,new text end Medicare
have been used prior to medical assistance for home care servicesdeleted text begin, including but not
limited to, home health agency, elected hospice benefit, waivered services, alternative care
program services, and personal care services
deleted text end.

(d) For the purposes of this section, "home care services" means medical assistance
services defined under section 256B.0625, subdivisions 6a, 7, and 19a.

Subd. 3.

Assessment and deleted text beginpriordeleted text end authorization processnew text begin for persons receiving
personal care assistance and developmental disabilities services
new text end.

deleted text beginEffective January 1,
1996,
deleted text end For purposes of providing informed choice, coordinating of local planning decisions,
and streamlining administrative requirements, the assessment and deleted text beginpriordeleted text end authorization
process for persons receiving both home care and home and community-based waivered
services for persons with developmental disabilities shall meet the requirements of
sections 256B.0651 and 256B.0653 to 256B.0656 with the following exceptions:

(a) Upon request for home care services and subsequent assessment by the public
health nurse under sections 256B.0651 and 256B.0653 to 256B.0656, the public health
nurse shall participate in the screening process, as appropriate, and, if home care
services are determined to be necessary, participate in the development of a service plan
coordinating the need for home care and home and community-based waivered services
with the assigned county case manager, the recipient of services, and the recipient's legal
representative, if any.

(b) The public health nurse shall give deleted text beginpriordeleted text end authorization for home care services
to the extent that home care services are:

(1) medically necessary;

(2) chosen by the recipient and their legal representative, if any, from the array of
home care and home and community-based waivered services available;

(3) coordinated with other services to be received by the recipient as described
in the service plan; and

(4) provided within the county's reimbursement limits for home care and home and
community-based waivered services for persons with developmental disabilities.

(c) If the public health agency is or may be the provider of home care services to the
recipient, the public health agency shall provide the commissioner of human services with
a written plan that specifies how the assessment and deleted text beginpriordeleted text end authorization process will be
held separate and distinct from the provision of services.

Sec. 20.

Minnesota Statutes 2008, section 256B.0653, is amended to read:


256B.0653 HOME HEALTH AGENCY deleted text beginCOVEREDdeleted text end SERVICES.

Subdivision 1.

deleted text beginHomecare; skilled nurse visitsdeleted text endnew text begin Scopenew text end.

deleted text begin "Skilled nurse visits" are
provided in a recipient's residence under a plan of care or service plan that specifies a level
of care which the nurse is qualified to provide. These services are:
deleted text end

deleted text begin (1) nursing services according to the written plan of care or service plan and accepted
standards of medical and nursing practice in accordance with chapter 148;
deleted text end

deleted text begin (2) services which due to the recipient's medical condition may only be safely and
effectively provided by a registered nurse or a licensed practical nurse;
deleted text end

deleted text begin (3) assessments performed only by a registered nurse; and
deleted text end

deleted text begin (4) teaching and training the recipient, the recipient's family, or other caregivers
requiring the skills of a registered nurse or licensed practical nurse.
deleted text end new text begin This section applies to
home health agency services including, home health aide, skilled nursing visits, physical
therapy, occupational therapy, respiratory therapy, and speech language pathology therapy.
new text end

Subd. 2.

deleted text beginTelehomecare; skilled nurse visitsdeleted text endnew text begin Definitionsnew text end.

deleted text begin Medical assistance
covers skilled nurse visits according to section 256B.0625, subdivision 6a, provided via
telehomecare, for services which do not require hands-on care between the home care
nurse and recipient. The provision of telehomecare must be made via live, two-way
interactive audiovisual technology and may be augmented by utilizing store-and-forward
technologies. Store-and-forward technology includes telehomecare services that do not
occur in real time via synchronous transmissions, and that do not require a face-to-face
encounter with the recipient for all or any part of any such telehomecare visit. Individually
identifiable patient data obtained through real-time or store-and-forward technology must
be maintained as health records according to sections 144.291 to 144.298. If the video
is used for research, training, or other purposes unrelated to the care of the patient, the
identity of the patient must be concealed. A communication between the home care nurse
and recipient that consists solely of a telephone conversation, facsimile, electronic mail, or
a consultation between two health care practitioners, is not to be considered a telehomecare
visit. Multiple daily skilled nurse visits provided via telehomecare are allowed. Coverage
of telehomecare is limited to two visits per day. All skilled nurse visits provided via
telehomecare must be prior authorized by the commissioner or the commissioner's
designee and will be covered at the same allowable rate as skilled nurse visits provided
in-person.
deleted text end new text begin For the purposes of this section, the following terms have the meanings given.
new text end

new text begin (a) "Assessment" means an evaluation of the recipient's medical need for home
health agency services by a registered nurse or appropriate therapist that is conducted
within 30 days of a request and as specified Code of Federal Regulations, title 42, section
484.1 to 494.55.
new text end

new text begin (b) "Home care therapies" means occupational, physical, and respiratory therapy
and speech-language pathology services provided in the home by a Medicare certified
home health agency.
new text end

new text begin (c) "Home health agency services" means services delivered in the recipient's home
residence, except as specified in section 256B.0625, by a home health agency to a recipient
with medical needs due to illness, disability, or physical conditions.
new text end

new text begin (d) "Home health aide" means an employee of a home health agency who meets
the requirements of Code of Federal Regulations, title 42, sections 484.1 to 494.55, and
completes medically oriented tasks written in the plan of care for a recipient.
new text end

new text begin (e) "Home health agency" means a home care provider agency who is
Medicare-certified satisfying the requirements of Code of Federal Regulations, title 42,
sections 484.1 to 494.55.
new text end

new text begin (f) "Occupational therapy services" mean the services defined in section 148.6402.
new text end

new text begin (g) "Physical therapy services" mean the services defined in section 148.65.
new text end

new text begin (h) "Respiratory therapy services" mean the services defined in chapter 147C and
Minnesota Rules, part 4668.0003, subpart 37.
new text end

new text begin (i) "Speech-language pathology services" mean the services defined in section
148.512.
new text end

new text begin (j) "Skilled nurse visit" means a professional nursing visit to complete nursing tasks
required due to a recipient's medical condition that can only be safely provided by a
professional nurse to restore and maintain optimal health.
new text end

new text begin (k) "Store-and-forward technology" means telehomecare services that do not occur
in real time via synchronous transmissions such as diabetic and vital sign monitoring.
new text end

new text begin (l) "Telehomecare" means the use of telecommunications technology via
live, two-way interactive audiovisual technology which may be augmented by
store-and-forward technology.
new text end

new text begin (m) "Telehomecare skilled nurse visit" means a visit by a professional nurse to
deliver a skilled nurse visit to a recipient located at a site other than the site where the
nurse is located and is used in combination with face-to-face skilled nurse visits to
adequately meet the recipient's needs.
new text end

Subd. 3.

deleted text beginTherapies through home health agenciesdeleted text endnew text begin Home health aide visitsnew text end.

deleted text begin (a) Medical assistance covers physical therapy and related services, including specialized
maintenance therapy. Services provided by a physical therapy assistant shall be
reimbursed at the same rate as services performed by a physical therapist when the
services of the physical therapy assistant are provided under the direction of a physical
therapist who is on the premises. Services provided by a physical therapy assistant that are
provided under the direction of a physical therapist who is not on the premises shall be
reimbursed at 65 percent of the physical therapist rate. Direction of the physical therapy
assistant must be provided by the physical therapist as described in Minnesota Rules, part
9505.0390, subpart 1, item B. The physical therapist and physical therapist assistant may
not both bill for services provided to a recipient on the same day.
deleted text end

deleted text begin (b) Medical assistance covers occupational therapy and related services, including
specialized maintenance therapy. Services provided by an occupational therapy assistant
shall be reimbursed at the same rate as services performed by an occupational therapist
when the services of the occupational therapy assistant are provided under the direction of
the occupational therapist who is on the premises. Services provided by an occupational
therapy assistant under the direction of an occupational therapist who is not on the
premises shall be reimbursed at 65 percent of the occupational therapist rate. Direction
of the occupational therapy assistant must be provided by the occupational therapist as
described in Minnesota Rules, part 9505.0390, subpart 1, item B. The occupational
therapist and occupational therapist assistant may not both bill for services provided
to a recipient on the same day.
deleted text end

new text begin (a) Home health aide visits must be provided by a certified home health aide
using a written plan of care that is updated in compliance with Medicare regulations.
A home health aide shall provide hands-on personal care, perform simple procedures
as an extension of therapy or nursing services, and assist in instrumental activities of
daily living as defined in section 256B.0659. Home health aide visits must be provided
in the recipient's home.
new text end

new text begin (b) All home health aide visits must have authorization under section 256B.0652.
The commissioner shall limit home health aide visits to no more than one visit per day
per recipient.
new text end

new text begin (c) Home health aides must be supervised by a registered nurse or an appropriate
therapist when providing services that are an extension of therapy.
new text end

new text begin Subd. 4. new text end

new text begin Skilled nurse visit services. new text end

new text begin (a) Skilled nurse visit services must be
provided by a registered nurse or a licensed practical nurse under the supervision of a
registered nurse, according to the written plan of care and accepted standards of medical
and nursing practice according to chapter 148. Skilled nurse visit services must be ordered
by a physician and documented in a plan of care that is reviewed and approved by the
ordering physician at least once every 60 days. All skilled nurse visits must be medically
necessary and provided in the recipient's home residence except as allowed under section
256B.0625, subdivision 6a.
new text end

new text begin (b) Skilled nurse visits include face-to-face and telehomecare visits with a limit of
up to two visits per day per recipient. All visits must be based on assessed needs.
new text end

new text begin (c) Telehomecare skilled nurse visits are allowed when the recipient's health status
can be accurately measured and assessed without a need for a face-to-face, hands-on
encounter. All telehomecare skilled nurse visits must have authorization and are paid at
the same allowable rates as face-to-face skilled nurse visits.
new text end

new text begin (d) The provision of telehomecare must be made via live, two-way interactive
audiovisual technology and may be augmented by utilizing store-and-forward
technologies. Individually identifiable patient data obtained through real-time or
store-and-forward technology must be maintained as health records according to sections
144.291 to 144.298. If the video is used for research, training, or other purposes unrelated
to the care of the patient, the identity of the patient must be concealed.
new text end

new text begin (e) Authorization for skilled nurse visits must be completed under section
256B.0652. A total of nine face-to-face skilled nurses visits per calendar year do not
require authorization. All telehomecare skilled nurse visits require authorization.
new text end

new text begin Subd. 5. new text end

new text begin Home care therapies. new text end

new text begin (a) Home care therapies include the following:
physical therapy, occupational therapy, respiratory therapy, and speech and language
pathology therapy services.
new text end

new text begin (b) Home care therapies must be:
new text end

new text begin (1) provided in the recipient's residence after it has been determined the recipient is
unable to access outpatient therapy;
new text end

new text begin (2) prescribed, ordered, or referred by a physician and documented in a plan of care
and reviewed, according to Minnesota Rules, part 9505.0390;
new text end

new text begin (3) assessed by an appropriate therapist; and
new text end

new text begin (4) provided by a Medicare-certified home health agency enrolled as a Medicaid
provider agency.
new text end

new text begin (c) Restorative and specialized maintenance therapies must be provided according to
Minnesota Rules, part 9505.0390. Physical and occupational therapy assistants may be
used as allowed under Minnesota Rules, part 9505.0390, subpart 1, item B.
new text end

new text begin (d) For both physical and occupational therapies, the therapist and the therapist's
assistant may not both bill for services provided to a recipient on the same day.
new text end

new text begin Subd. 6. new text end

new text begin Noncovered home health agency services. new text end

new text begin The following are not eligible
for payment under medical assistance as a home health agency service:
new text end

new text begin (1) telehomecare skilled nurses services that is communication between the home
care nurse and recipient that consists solely of a telephone conversation, facsimile,
electronic mail, or a consultation between two health care practitioners;
new text end

new text begin (2) the following skilled nurse visits:
new text end

new text begin (i) for the purpose of monitoring medication compliance with an established
medication program for a recipient;
new text end

new text begin (ii) administering or assisting with medication administration, including injections,
prefilling syringes for injections, or oral medication setup of an adult recipient, when,
as determined and documented by the registered nurse, the need can be met by an
available pharmacy or the recipient or a family member is physically and mentally able
to self-administer or prefill a medication;
new text end

new text begin (iii) services done for the sole purpose of supervision of the home health aide or
personal care assistant;
new text end

new text begin (iv) services done for the sole purpose to train other home health agency workers;
new text end

new text begin (v) services done for the sole purpose of blood samples or lab draw or Synagis
injections when the recipient is able to access these services outside the home; and
new text end

new text begin (vi) Medicare evaluation or administrative nursing visits required by Medicare;
new text end

new text begin (3) home health aide visits when the following activities are the sole purpose for the
visit: companionship, socialization, household tasks, transportation, and education; and
new text end

new text begin (4) home care therapies provided in other settings such as a clinic, day program, or as
an inpatient or when the recipient can access therapy outside of the recipient's residence.
new text end

Sec. 21.

Minnesota Statutes 2008, section 256B.0654, is amended to read:


256B.0654 PRIVATE DUTY NURSING.

Subdivision 1.

Definitions.

deleted text begin (a) "Assessment" means a review and evaluation of a
recipient's need for home care services conducted in person. Assessments for private duty
nursing shall be conducted by a registered private duty nurse. Assessments for medical
assistance home care services for developmental disabilities and alternative care services
for developmentally disabled home and community-based waivered recipients may be
conducted by the county public health nurse to ensure coordination and avoid duplication.
deleted text end

deleted text begin (b)deleted text endnew text begin (a)new text end "Complex deleted text beginand regulardeleted text end private duty nursing care" meansdeleted text begin:
deleted text end

deleted text begin (1) complex care is private dutydeleted text end nursingnew text begin servicesnew text end provided to recipients who are
ventilator dependent or for whom a physician has certified that deleted text beginwere it not for private
duty nursing
deleted text end the recipient deleted text beginwould meetdeleted text endnew text begin meetsnew text end the criteria for inpatient hospital intensive
care unit (ICU) level of caredeleted text begin; and
deleted text end

deleted text begin (2) regular care is private duty nursing provided to all other recipientsdeleted text end.

new text begin (b) "Private duty nursing" means ongoing professional nursing services by a
registered or licensed practical nurse including assessment, professional nursing tasks, and
education, based on an assessment and physician orders to maintain or restore optimal
health of the recipient.
new text end

new text begin (c) "Private duty nursing agency" means a medical assistance enrolled provider
licensed under chapter 144A to provide private duty nursing services.
new text end

new text begin (d) "Regular private duty nursing" means nursing services provided to a recipient
who is considered stable and not at an inpatient hospital intensive care unit level of care,
but may have episodes of instability that are not life threatening.
new text end

new text begin (e) "Shared private duty nursing" means the provision of nursing services by a
private duty nurse to two recipients at the same time and in the same setting.
new text end

Subd. 2.

new text beginAuthorization; new text endprivate duty nursing services.

(a) All private duty
nursing services shall be deleted text beginpriordeleted text end authorized by the commissioner or the commissioner's
designee. deleted text beginPriordeleted text end Authorization for private duty nursing services shall be based on
medical necessity and cost-effectiveness when compared with alternative care options.
The commissioner may authorize medically necessary private duty nursing services in
quarter-hour units when:

(1) the recipient requires more individual and continuous care than can be provided
during a new text beginskilled new text endnurse visit; or

(2) the cares are outside of the scope of services that can be provided by a home
health aide or personal care assistant.

(b) The commissioner may authorize:

(1) up to two times the average amount of direct care hours provided in nursing
facilities statewide for case mix classification "K" as established by the annual cost report
submitted to the department by nursing facilities in May 1992;

(2) private duty nursing in combination with other home care services up to the total
cost allowed under section 256B.0655, subdivision 4;

(3) up to 16 hours per day if the recipient requires more nursing than the maximum
number of direct care hours as established in clause (1) and the recipient meets the hospital
admission criteria established under Minnesota Rules, parts 9505.0501 to 9505.0540.

(c) The commissioner may authorize up to 16 hours per day of medically necessary
private duty nursing services or up to 24 hours per day of medically necessary private duty
nursing services until such time as the commissioner is able to make a determination of
eligibility for recipients who are cooperatively applying for home care services under
the community alternative care program developed under section 256B.49, or until it is
determined by the appropriate regulatory agency that a health benefit plan is or is not
required to pay for appropriate medically necessary health care services. Recipients
or their representatives must cooperatively assist the commissioner in obtaining this
determination. Recipients who are eligible for the community alternative care program
may not receive more hours of nursing under this section and sections 256B.0651,
256B.0653, deleted text begin256B.0655, anddeleted text end 256B.0656new text begin, and 256B.0659new text end than would otherwise be
authorized under section 256B.49.

new text begin Subd. 2a. new text end

new text begin Private duty nursing services. new text end

new text begin (a) Private duty nursing services must
be used:
new text end

new text begin (1) in the recipient's home or outside the home when normal life activities require;
new text end

new text begin (2) when the recipient requires more individual and continuous care than can be
provided during a skilled nurse visit; and
new text end

new text begin (3) when the care required is outside of the scope of services that can be provided by
a home health aide or personal care assistant.
new text end

new text begin (b) Private duty nursing services must be:
new text end

new text begin (1) assessed by a registered nurse on a form approved by the commissioner;
new text end

new text begin (2) ordered by a physician and documented in a plan of care that is reviewed by the
physician at least once every 60 days; and
new text end

new text begin (3) authorized by the commissioner under section 256B.0652.
new text end

new text begin Subd. 2b. new text end

new text begin Noncovered private duty nursing services. new text end

new text begin Private duty nursing
services do not cover the following:
new text end

new text begin (1) nursing services by a nurse who is the foster care provider of a person who
has not reached 18 years of age;
new text end

new text begin (2) nursing services to more than two persons receiving shared private duty nursing
services from a private duty nurse in a single setting; and
new text end

new text begin (3) nursing services provided by a registered nurse or licensed practical nurse who is
the recipient's legal guardian or related to the recipient as spouse, parent, or child whether
by blood, marriage, or adoption except as specified in section 256B.0652, subdivision 4.
new text end

Subd. 3.

Shared private duty nursing deleted text begincaredeleted text end option.

(a) Medical assistance
payments for shared private duty nursing services by a private duty nurse shall be limited
according to this subdivision. deleted text beginFor the purposes of this section and sections 256B.0651,
256B.0653, 256B.0655, and 256B.0656, "private duty nursing agency" means an agency
licensed under chapter 144A to provide private duty nursing services.
deleted text endnew text begin Unless otherwise
provided in this subdivision, all other statutory and regulatory provisions relating to
private duty nursing services apply to shared private duty nursing services. Nothing in
this subdivision shall be construed to reduce the total number of private duty nursing
hours authorized for an individual recipient.
new text end

deleted text begin (b) Recipients of private duty nursing services may share nursing staff and the
commissioner shall provide a rate methodology for shared private duty nursing. For two
persons sharing nursing care, the rate paid to a provider shall not exceed 1.5 times the
regular private duty nursing rates paid for serving a single individual by a registered nurse
or licensed practical nurse. These rates apply only to situations in which both recipients
are present and receive shared private duty nursing care on the date for which the service
is billed. No more than two persons may receive shared private duty nursing services
from a private duty nurse in a single setting.
deleted text end

deleted text begin (c)deleted text endnew text begin (b)new text end Shared private duty nursing deleted text begincaredeleted text end is the provision of nursing services by a
private duty nurse to twonew text begin medical assistance eligiblenew text end recipients at the same time and in
the same setting.new text begin This subdivision does not apply when a private duty nurse is caring for
multiple recipients in more than one setting.
new text end

new text begin (c)new text end For the purposes of this subdivision, "setting" means:

(1) the homenew text begin residencenew text end or foster care home of one of the individual recipientsnew text begin as
defined in section 256B.0651
new text end; deleted text beginor
deleted text end

(2) a child care program licensed under chapter 245A or operated by a local school
district or private school; deleted text beginor
deleted text end

(3) an adult day care service licensed under chapter 245A; or

(4) outside the home new text beginresidence new text endor foster care home of one of the recipients when
normal life activities take the recipients outside the home.

deleted text begin This subdivision does not apply when a private duty nurse is caring for multiple
recipients in more than one setting.
deleted text end

new text begin (d) The private duty nursing agency must offer the recipient the option of shared or
one-on-one private duty nursing services. The recipient may withdraw from participating
in a shared service arrangement at any time.
new text end

deleted text begin (d)deleted text endnew text begin (e)new text end The recipient or the recipient's legal representative, and the recipient's
physician, in conjunction with the deleted text beginhome health caredeleted text endnew text begin private duty nursingnew text end agency, shall
determine:

(1) whether shared private duty nursing care is an appropriate option based on the
individual needs and preferences of the recipient; and

(2) the amount of shared private duty nursing services authorized as part of the
overall authorization of nursing services.

deleted text begin (e)deleted text endnew text begin (f)new text end The recipient or the recipient's legal representative, in conjunction with the
private duty nursing agency, shall approve the setting, grouping, and arrangement of
shared private duty nursing care based on the individual needs and preferences of the
recipients. Decisions on the selection of recipients to share services must be based on the
ages of the recipients, compatibility, and coordination of their care needs.

deleted text begin (f)deleted text endnew text begin (g)new text end The following items must be considered by the recipient or the recipient's
legal representative and the private duty nursing agency, and documented in the recipient's
health service record:

(1) the additional training needed by the private duty nurse to provide care to
two recipients in the same setting and to ensure that the needs of the recipients are met
appropriately and safely;

(2) the setting in which the shared private duty nursing care will be provided;

(3) the ongoing monitoring and evaluation of the effectiveness and appropriateness
of the service and process used to make changes in service or setting;

(4) a contingency plan which accounts for absence of the recipient in a shared private
duty nursing setting due to illness or other circumstances;

(5) staffing backup contingencies in the event of employee illness or absence; and

(6) arrangements for additional assistance to respond to urgent or emergency care
needs of the recipients.

deleted text begin (g) The provider must offer the recipient or responsible party the option of shared or
one-on-one private duty nursing services. The recipient or responsible party can withdraw
from participating in a shared service arrangement at any time.
deleted text end

(h) deleted text beginThe private duty nursing agency must document the following in the
health service record for each individual recipient sharing private duty nursing care
deleted text endnew text begin
The documentation for shared private duty nursing must be on a form approved by
the commissioner for each individual recipient sharing private duty nursing. The
documentation must be part of the recipient's health service record and include
new text end:

(1) permission by the recipient or the recipient's legal representative for the
maximum number of shared nursing deleted text begincaredeleted text end hours per week chosen by the recipientnew text begin and
permission for shared private duty nursing services provided in and outside the recipient's
home residence
new text end;

deleted text begin (2) permission by the recipient or the recipient's legal representative for shared
private duty nursing services provided outside the recipient's residence;
deleted text end

deleted text begin (3) permission by the recipient or the recipient's legal representative for others to
receive shared private duty nursing services in the recipient's residence;
deleted text end

deleted text begin (4)deleted text endnew text begin (2)new text end revocation by the recipient or the recipient's legal representative deleted text beginofdeleted text endnew text begin fornew text end the
shared private duty nursing deleted text begincare authorization, or the shared care to be provided to others in
the recipient's residence, or the shared private duty nursing services to be provided outside
deleted text endnew text begin
permission, or services provided to others in and outside
new text end the recipient's residence; and

deleted text begin (5)deleted text endnew text begin (3)new text end daily documentation of the shared private duty nursing services provided by
each identified private duty nurse, including:

(i) the names of each recipient receiving shared private duty nursing services
deleted text begin togetherdeleted text end;

(ii) the setting for the shared services, including the starting and ending times that
the recipient received shared private duty nursing care; and

(iii) notes by the private duty nurse regarding changes in the recipient's condition,
problems that may arise from the sharing of private duty nursing services, and scheduling
and care issues.

deleted text begin (i) Unless otherwise provided in this subdivision, all other statutory and regulatory
provisions relating to private duty nursing services apply to shared private duty nursing
services.
deleted text end

deleted text begin Nothing in this subdivision shall be construed to reduce the total number of private
duty nursing hours authorized for an individual recipient under subdivision 2.
deleted text end

new text begin (i) The commissioner shall provide a rate methodology for shared private duty
nursing. For two persons sharing nursing care, the rate paid to a provider must not exceed
1.5 times the regular private duty nursing rates paid for serving a single individual by a
registered nurse or licensed practical nurse. These rates apply only to situations in which
both recipients are present and receive shared private duty nursing care on the date for
which the service is billed.
new text end

Subd. 4.

Hardship criteria; private duty nursing.

(a) Payment is allowed for
extraordinary services that require specialized nursing skills and are provided by parents
of minor children, spouses, and legal guardians who are providing private duty nursing
care under the following conditions:

(1) the provision of these services is not legally required of the parents, spouses,
or legal guardians;

(2) the services are necessary to prevent hospitalization of the recipient; and

(3) the recipient is eligible for state plan home care or a home and community-based
waiver and one of the following hardship criteria are met:

(i) the parent, spouse, or legal guardian resigns from a part-time or full-time job to
provide nursing care for the recipient; deleted text beginor
deleted text end

(ii) the parent, spouse, or legal guardian goes from a full-time to a part-time job with
less compensation to provide nursing care for the recipient; deleted text beginor
deleted text end

(iii) the parent, spouse, or legal guardian takes a leave of absence without pay to
provide nursing care for the recipient; or

(iv) because of labor conditions, special language needs, or intermittent hours of
care needed, the parent, spouse, or legal guardian is needed in order to provide adequate
private duty nursing services to meet the medical needs of the recipient.

(b) Private duty nursing may be provided by a parent, spouse, or legal guardian who
is a nurse licensed in Minnesota. Private duty nursing services provided by a parent,
spouse, or legal guardian cannot be used in lieu of nursing services covered and available
under liable third-party payors, including Medicare. The private duty nursing provided
by a parent, spouse, or legal guardian must be included in the service plan. Authorized
deleted text begin skilleddeleted text end nursing servicesnew text begin for a single recipient or recipients with the same residence andnew text end
provided by the parent, spouse, or legal guardian may not exceed 50 percent of the total
approved nursing hours, or eight hours per day, whichever is less, up to a maximum of
40 hours per week.new text begin A parent or parents, spouse, or legal guardian shall not provide more
than 40 hours of services in a seven-day period. For parents and legal guardians, 40 hours
is the total amount allowed regardless of the number of children or adults who receive
services.
new text end Nothing in this subdivision precludes the parent's, spouse's, or legal guardian's
obligation of assuming the nonreimbursed family responsibilities of emergency backup
caregiver and primary caregiver.

(c) A parent or a spouse may not be paid to provide private duty nursing care ifnew text begin:
new text end

new text begin (1)new text end the parent or spouse fails to pass a criminal background check according to
chapter 245Cdeleted text begin, or ifdeleted text endnew text begin;
new text end

new text begin (2)new text end it has been determined by the home deleted text beginhealthdeleted text endnew text begin carenew text end agency, the case manager, or
the physician that the private duty nursing deleted text begincaredeleted text end provided by the parent, spouse, or legal
guardian is unsafenew text begin; or
new text end

new text begin (3) the parent, spouse, or legal guardian do not follow physician ordersnew text end.

new text begin (d) For purposes of this section, "assessment" means a review and evaluation of a
recipient's need for home care services conducted in person. Assessments for private duty
nursing must be conducted by a registered nurse.
new text end

Sec. 22.

Minnesota Statutes 2008, section 256B.0655, subdivision 4, is amended to
read:


Subd. 4.

deleted text beginPriordeleted text end Authorizationnew text begin; personal care assistance and qualified
professional
new text end.

deleted text begin The commissioner, or the commissioner's designee, shall review the
assessment, service update, request for temporary services, request for flexible use option,
service plan, and any additional information that is submitted. The commissioner shall,
within 30 days after receiving a complete request, assessment, and service plan, authorize
home care services as follows:
deleted text end

deleted text begin (1)deleted text endnew text begin (a)new text end All personal care assistant services deleted text beginanddeleted text endnew text begin,new text end supervision by a qualified
professional, deleted text beginif requested by the recipient,deleted text endnew text begin and additional services beyond the limits
established in section 256B.0652, subdivision 11,
new text end must be deleted text beginpriordeleted text end authorized by the
commissioner or the commissioner's designee new text beginbefore services begin new text endexcept for the
assessments established in deleted text beginsectiondeleted text endnew text begin sectionsnew text end 256B.0651, subdivision 11new text begin, and 256B.0911new text end.new text begin
The authorization for personal care assistance and qualified professional services under
section 256B.0659 must be completed within 30 days after receiving a complete request.
new text end

new text begin (b)new text end The amount of personal care assistant services authorized must be based on
the recipient's home care rating.new text begin The home care rating shall be determined by the
commissioner or the commissioner's designee based on information submitted to the
commissioner identifying the following:
new text end

new text begin (1) total number of dependencies of activities of daily living as defined in section
256B.0659;
new text end

new text begin (2) number of complex health-related functions as defined in section 256B.0659; and
new text end

new text begin (3) number of behavior descriptions as defined in section 256B.0659.
new text end

new text begin (c) The methodology to determine total time for personal care assistance services for
each home care rating is based on fiscal year 2007 data from the personal care assistance
program. Each home care rating has a base level of hours assigned. Additional time is
added through the assessment and identification of the following:
new text end

new text begin (1) 30 additional minutes for a dependency in each critical activity of daily living
as defined in section 256B.0659;
new text end

new text begin (2) 30 additional minutes for each complex health-related function as defined in
section 256B.0659; and
new text end

new text begin (3) 30 additional minutes for each behavior issue as defined in section 256B.0659.
new text end

new text begin (d) A limit of 96 units of qualified professional supervision may be authorized for
each recipient receiving personal care assistance services. A request to the commissioner
to exceed this total in a calendar year must be requested by the personal care provider
agency on a form approved by the commissioner.
new text end

deleted text begin A child may not be found to be dependent in an activity of daily living if because
of the child's age an adult would either perform the activity for the child or assist the
child with the activity and the amount of assistance needed is similar to the assistance
appropriate for a typical child of the same age. Based on medical necessity, the
commissioner may authorize:
deleted text end

deleted text begin (A) up to two times the average number of direct care hours provided in nursing
facilities for the recipient's comparable case mix level; or
deleted text end

deleted text begin (B) up to three times the average number of direct care hours provided in nursing
facilities for recipients who have complex medical needs or are dependent in at least seven
activities of daily living and need physical assistance with eating or have a neurological
diagnosis; or
deleted text end

deleted text begin (C) up to 60 percent of the average reimbursement rate, as of July 1, 1991, for care
provided in a regional treatment center for recipients who have Level I behavior, plus any
inflation adjustment as provided by the legislature for personal care service; or
deleted text end

deleted text begin (D) up to the amount the commissioner would pay, as of July 1, 1991, plus any
inflation adjustment provided for home care services, for care provided in a regional
treatment center for recipients referred to the commissioner by a regional treatment center
preadmission evaluation team. For purposes of this clause, home care services means
all services provided in the home or community that would be included in the payment
to a regional treatment center; or
deleted text end

deleted text begin (E) up to the amount medical assistance would reimburse for facility care for
recipients referred to the commissioner by a preadmission screening team established
under section 256B.0911 or 256B.092; and
deleted text end

deleted text begin (F) a reasonable amount of time for the provision of supervision by a qualified
professional of personal care assistant services, if a qualified professional is requested by
the recipient or responsible party.
deleted text end

deleted text begin (2) The number of direct care hours shall be determined according to the annual cost
report submitted to the department by nursing facilities. The average number of direct care
hours, as established by May 1, 1992, shall be calculated and incorporated into the home
care limits on July 1, 1992. These limits shall be calculated to the nearest quarter hour.
deleted text end

deleted text begin (3) The home care rating shall be determined by the commissioner or the
commissioner's designee based on information submitted to the commissioner by the
county public health nurse on forms specified by the commissioner. The home care rating
shall be a combination of current assessment tools developed under sections 256B.0911
and 256B.501 with an addition for seizure activity that will assess the frequency and
severity of seizure activity and with adjustments, additions, and clarifications that are
necessary to reflect the needs and conditions of recipients who need home care including
children and adults under 65 years of age. The commissioner shall establish these forms
and protocols under this section and sections 256B.0651, 256B.0653, 256B.0654, and
256B.0656 and shall use an advisory group, including representatives of recipients,
providers, and counties, for consultation in establishing and revising the forms and
protocols.
deleted text end

deleted text begin (4) A recipient shall qualify as having complex medical needs if the care required is
difficult to perform and because of recipient's medical condition requires more time than
community-based standards allow or requires more skill than would ordinarily be required
and the recipient needs or has one or more of the following:
deleted text end

deleted text begin (A) daily tube feedings;
deleted text end

deleted text begin (B) daily parenteral therapy;
deleted text end

deleted text begin (C) wound or decubiti care;
deleted text end

deleted text begin (D) postural drainage, percussion, nebulizer treatments, suctioning, tracheotomy
care, oxygen, mechanical ventilation;
deleted text end

deleted text begin (E) catheterization;
deleted text end

deleted text begin (F) ostomy care;
deleted text end

deleted text begin (G) quadriplegia; or
deleted text end

deleted text begin (H) other comparable medical conditions or treatments the commissioner determines
would otherwise require institutional care.
deleted text end

deleted text begin (5) A recipient shall qualify as having Level I behavior if there is reasonable
supporting evidence that the recipient exhibits, or that without supervision, observation, or
redirection would exhibit, one or more of the following behaviors that cause, or have the
potential to cause:
deleted text end

deleted text begin (A) injury to the recipient's own body;
deleted text end

deleted text begin (B) physical injury to other people; or
deleted text end

deleted text begin (C) destruction of property.
deleted text end

deleted text begin (6) Time authorized for personal care relating to Level I behavior in paragraph
(5), clauses (A) to (C), shall be based on the predictability, frequency, and amount of
intervention required.
deleted text end

deleted text begin (7) A recipient shall qualify as having Level II behavior if the recipient exhibits on a
daily basis one or more of the following behaviors that interfere with the completion of
personal care assistant services under subdivision 2, paragraph (a):
deleted text end

deleted text begin (A) unusual or repetitive habits;
deleted text end

deleted text begin (B) withdrawn behavior; or
deleted text end

deleted text begin (C) offensive behavior.
deleted text end

deleted text begin (8) A recipient with a home care rating of Level II behavior in paragraph (7), clauses
(A) to (C), shall be rated as comparable to a recipient with complex medical needs under
paragraph (4). If a recipient has both complex medical needs and Level II behavior, the
home care rating shall be the next complex category up to the maximum rating under
paragraph (1), clause (B).
deleted text end

Sec. 23.

new text begin [256B.0659] PERSONAL CARE ASSISTANCE PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For the purposes of this section, the terms defined in
paragraphs (b) to (p) have the meanings given unless otherwise provided in text.
new text end

new text begin (b) "Activities of daily living" means grooming, dressing, bathing, transferring,
mobility, positioning, eating, and toileting.
new text end

new text begin (c) "Behavior" means a category to determine the home care rating and is based on
the criteria found in this section.
new text end

new text begin (d) "Complex health-related functions" means a category to determine the home care
rating and is based on the criteria found in this section.
new text end

new text begin (e) "Critical activities of daily living" means transferring, mobility, eating, and
toileting.
new text end

new text begin (f) "Dependency in activities of daily living" means a person requires assistance to
begin and complete one or more of the activities of daily living.
new text end

new text begin (g) "Health-related functions" means functions that can be delegated or assigned
by a licensed health care professional under state law to be performed by a personal
care assistant.
new text end

new text begin (h) "Instrumental activities of daily living" means activities to include meal planning
and preparation; basic assistance with paying bills; shopping for food, clothing, and
other essential items; performing household tasks integral to the personal care assistance
services; communication by telephone and other media; and traveling and participating
in the community.
new text end

new text begin (i) "Managerial official" has the same definition as Code of Federal Regulations,
title 42, section 455.
new text end

new text begin (j) "Qualified professional" means a professional providing supervision of personal
care assistance services and staff as defined in section 256B.0625, subdivision 19c.
new text end

new text begin (k) "Personal care assistance provider agency" means a medical assistance enrolled
provider that provides or assists with providing personal care assistance services and
includes personal care assistance provider organizations, personal care assistance choice
agency, class A licensed nursing agency, and Medicare-certified home health agency.
new text end

new text begin (l) "Personal care assistant" or "PCA" means an individual employed by a personal
care assistance agency who provides personal care assistance services.
new text end

new text begin (m) "Personal care assistance care plan" means a written description of personal
care assistance services developed by the personal care assistance provider according
to the service plan.
new text end

new text begin (n) "Responsible party" means an individual who lives with and is capable of
providing the support necessary to assist the recipient to live in the community.
new text end

new text begin (o) "Self-administered medication" means medication taken orally, by injection or
insertion, or applied topically without the need for assistance.
new text end

new text begin (p) "Service plan" means a written summary of the assessment and description of the
services needed by the recipient.
new text end

new text begin Subd. 2. new text end

new text begin Personal care assistance services; covered services. new text end

new text begin (a) The personal
care assistance services eligible for payment include services and supports furnished
to an individual, as needed, to assist in:
new text end

new text begin (1) activities of daily living;
new text end

new text begin (2) health-related functions;
new text end

new text begin (3) assistance with behavior needs; and
new text end

new text begin (4) instrumental activities of daily living.
new text end

new text begin (b) Activities of daily living include the following covered services:
new text end

new text begin (1) dressing, including assistance with choosing, application, and changing of
clothing and application of special appliances, wraps, or clothing;
new text end

new text begin (2) grooming, including assistance with basic hair care, oral care, shaving, applying
cosmetics and deodorant, and care of eyeglasses and hearing aids. Nail care is included,
except for recipients who are diabetic or have poor circulation;
new text end

new text begin (3) bathing, including assistance with basic personal hygiene and skin care;
new text end

new text begin (4) eating, including assistance with hand washing and application of orthotics
required for eating, transfers, and feeding;
new text end

new text begin (5) transfers, including assistance with transferring the recipient from one seating or
reclining area to another;
new text end

new text begin (6) mobility, including assistance with ambulation, including use of a wheelchair.
Mobility does not include providing transportation for a recipient;
new text end

new text begin (7) positioning, including assistance with positioning or turning a recipient for
necessary care and comfort; and
new text end

new text begin (8) toileting, including assistance with helping recipient with bowel or bladder
elimination and care including transfers, mobility, positioning, feminine hygiene, use of
toileting equipment or supplies, cleansing the perineal area, inspection of the skin, and
adjusting clothing.
new text end

new text begin (c) Health-related functions include the following covered services:
new text end

new text begin (1) range of motion and passive exercise to maintain a recipient's strength and
muscle functioning;
new text end

new text begin (2) assistance with self-administered medication as defined by this section, including
reminders to take medication, bringing medication to the recipient, and assistance with
opening medication under the direction of the recipient or responsible party;
new text end

new text begin (3) interventions for seizure disorders, including monitoring and observation; and
new text end

new text begin (4) other activities considered within the scope of the personal care service and
meeting the definition of health-related functions under this section.
new text end

new text begin (d) A personal care assistant may provide health-related functions associated with
the complex health-related function needs of a recipient if the tasks meet the definition
of health-related functions under this section and the personal care assistant is trained
by a qualified professional and demonstrates competency to safely complete the task.
Delegation of health-related functions and all training must be documented in the personal
care assistance care plan and the recipient's and personal care assistant's files.
new text end

new text begin (e) For a personal care assistant to provide the health-related functions of
tracheostomy suctioning and services to recipients on ventilator support there must be:
new text end

new text begin (1) delegation and training by a registered nurse, certified or licensed respiratory
therapist, or a physician;
new text end

new text begin (2) utilization of clean rather than sterile procedure;
new text end

new text begin (3) specialized training about the health-related functions and equipment, including
ventilator operation and maintenance;
new text end

new text begin (4) individualized training regarding the needs of the recipient; and
new text end

new text begin (5) supervision by a qualified professional who is a registered nurse.
new text end

new text begin (f) A personal care assistant may observe and redirect the recipient for episodes
where there is a need for redirection due to behaviors. Training of the personal care
assistant must occur based on the needs of the recipient, the personal care assistance care
plan, and any other support services provided.
new text end

new text begin (g) Instrumental activities of daily living under subdivision 1, paragraph (h), include
accompanying a recipient to obtain medical diagnosis or treatment when assistance is
required by the recipient during the appointment.
new text end

new text begin Subd. 3. new text end

new text begin Noncovered personal care assistance services. new text end

new text begin (a) Personal care
assistance services are not eligible for medical assistance payment under this section
when provided:
new text end

new text begin (1) by the recipient's spouse, parent of a recipient under the age of 18, paid legal
guardian, licensed foster provider, or responsible party;
new text end

new text begin (2) in lieu of other staffing options in a residential or child care setting;
new text end

new text begin (3) solely as a child care or babysitting service; or
new text end

new text begin (4) without authorization by the commissioner or the commissioner's designee.
new text end

new text begin (b) The following personal care services are not eligible for medical assistance
payment under this section when provided in residential settings:
new text end

new text begin (1) when the provider of home care services who is not related by blood, marriage,
or adoption owns or otherwise controls the living arrangement, including licensed or
unlicensed services; or
new text end

new text begin (2) when personal care assistance services are the responsibility of a residential or
program license holder under the terms of a service agreement and administrative rules.
new text end

new text begin (c) Other specific tasks not covered under paragraph (a) or (b) that are not eligible
for medical assistance reimbursement for personal care assistance services under this
section include:
new text end

new text begin (1) sterile procedures;
new text end

new text begin (2) injections of fluids and medications into veins, muscles, or skin;
new text end

new text begin (3) instrumental activities of daily living without a dependency in at least two
activities of daily living;
new text end

new text begin (4) home maintenance or chore services;
new text end

new text begin (5) homemaker services not an integral part of assessed personal care assistance
services needed by a recipient;
new text end

new text begin (6) application of restraints or implementation of procedures under section 245.825;
new text end

new text begin (7) instrumental activities of daily living for children under the age of 18; and
new text end

new text begin (8) assessments for personal care assistance services by personal care assistance
provider agencies or by independently enrolled registered nurses.
new text end

new text begin Subd. 4. new text end

new text begin Assessment for personal care assistance services. new text end

new text begin (a) An assessment as
defined in section 256B.0911 must be completed for personal care assistance services.
new text end

new text begin (b) The following limitations apply to the assessment:
new text end

new text begin (1) a person must be assessed as dependent in an activity of daily living based
on the person's need, on a daily basis, for:
new text end

new text begin (i) cueing and constant supervision to complete the task; or
new text end

new text begin (ii) hands-on assistance to complete the task.
new text end

new text begin (2) an adult may not be found to be dependent in an activity of daily living because
of individual choices; and
new text end

new text begin (3) a child may not be found to be dependent in an activity of daily living if because
of the child's age an adult would either perform the activity for the child or assist the child
with the activity. Assistance needed is the assistance appropriate for a typical child of
the same age.
new text end

new text begin (c) Assessment for complex health-related functions must meet the criteria in
this paragraph. During the assessment process, a recipient qualifies as having complex
health-related functions if the recipient has one or more of the interventions that are
ordered by a physician, specified in a personal care assistance care plan, and found in
the following:
new text end

new text begin (1) tube feedings requiring:
new text end

new text begin (i) a gastro/jejunostomy tube; or
new text end

new text begin (ii) continuous tube feeding lasting longer than 12 hours per day;
new text end

new text begin (2) wounds described as:
new text end

new text begin (i) stage III or stage IV;
new text end

new text begin (ii) multiple wounds;
new text end

new text begin (iii) requiring sterile or clean dressing changes or a wound vac; or
new text end

new text begin (iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require
specialized care;
new text end

new text begin (3) parenteral therapy described as:
new text end

new text begin (i) IV therapy more than two times per week lasting longer than four hours for
each treatment; or
new text end

new text begin (ii) total parenteral nutrition (TPN) daily;
new text end

new text begin (4) respiratory interventions including:
new text end

new text begin (i) oxygen required more than eight hours per day;
new text end

new text begin (ii) respiratory vest more than one time per day;
new text end

new text begin (iii) bronchial drainage treatments more than two times per day;
new text end

new text begin (iv) sterile or clean suctioning more than six times per day;
new text end

new text begin (v) dependence on another to apply respiratory ventilation augmentation devises
such as BiPAP and CPAP; and
new text end

new text begin (vi) ventilator dependence under section 256B.0652;
new text end

new text begin (5) insertion and maintenance of catheter including:
new text end

new text begin (i) sterile catheter changes more than one time per month;
new text end

new text begin (ii) clean self-catheterization more than six times per day; or
new text end

new text begin (iii) bladder irrigations;
new text end

new text begin (6) bowel program more than two times per week requiring more than 30 minutes to
perform each time;
new text end

new text begin (7) neurological intervention including:
new text end

new text begin (i) seizures more than two times per week and requiring significant physical
assistance to maintain safety; or
new text end

new text begin (ii) swallowing disorders diagnosed by a physician and requiring specialized
assistance from another on a daily basis; and
new text end

new text begin (8) other congenital or acquired diseases creating a need for significantly increased
direct hands-on assistance and interventions in six to eight activities of daily living.
new text end

new text begin (d) An assessment of behaviors must meet the criteria in this paragraph. A recipient
qualifies as having a need for assistance due to behaviors if the recipient's behavior requires
assistance at least four times per week and shows one or more of the following behaviors:
new text end

new text begin (1) physical aggression towards self, others, or property that requires immediate
response of another;
new text end

new text begin (2) increased vulnerability due to cognitive deficits or socially inappropriate
behavior; or
new text end

new text begin (3) verbally aggressive and resistive to care.
new text end

new text begin Subd. 5. new text end

new text begin Service and support planning. new text end

new text begin (a) The assessor, with the recipient or
responsible party, shall review the assessment information and determine referrals for
other payers, services, and community supports as appropriate.
new text end

new text begin (b) The recipient must be referred for evaluation, services, or supports that are
appropriate to help meet the recipient's needs including, but not limited to, the following
circumstances:
new text end

new text begin (1) when there is another payer who is responsible to provide the service to meet
the recipient's needs;
new text end

new text begin (2) when the recipient qualifies for assistance with behaviors under this section,
a referral into the mental health system for a mental health diagnostic and functional
assessment must be completed;
new text end

new text begin (3) when the recipient is eligible for medical assistance and meets medical assistance
eligibility for a home health aide or skilled nurse visit;
new text end

new text begin (4) when the recipient would benefit from an evaluation for another service; and
new text end

new text begin (5) when there is a more appropriate service to meet the assessed needs.
new text end

new text begin (c) The reimbursement rates for public health nurse visits that relate to the provision
of personal care assistance services under this section and section 256B.0625, subdivision
19a
, are:
new text end

new text begin (1) $210.50 for a face-to-face assessment visit;
new text end

new text begin (2) $105.25 for each service update; and
new text end

new text begin (3) $105.25 for each request for a temporary service increase.
new text end

new text begin (d) The rates specified in paragraph (c) must be adjusted to reflect provider rate
increases for personal care assistance services that are approved by the legislature for the
fiscal year ending June 30, 2000, and subsequent fiscal years. Any requirements applied
by the legislature to provider rate increases for personal care assistance services also
apply to adjustments under this paragraph.
new text end

new text begin (e) Effective July 1, 2008, the payment rate for an assessment under this section and
section 256B.0651 shall be reduced by 25 percent when the assessment is not completed
on time and the service agreement documentation is not submitted in time to continue
services. The commissioner shall reduce the amount of the claim for those assessments
that are not submitted on time.
new text end

new text begin Subd. 6. new text end

new text begin Service plan. new text end

new text begin The service plan must be completed by the assessor with the
recipient and responsible party on a form determined by the commissioner and include
a summary of the assessment with a description of the need, authorized amount, and
expected outcomes and goals of personal care assistance services. The recipient and
the provider chosen by the recipient or responsible party must be given a copy of the
completed service plan. The recipient or responsible party must be given information by
the assessor about the options in the personal care assistance program to allow for review
and decision making.
new text end

new text begin Subd. 7. new text end

new text begin Personal care assistance care plan. new text end

new text begin (a) Each recipient must have a current
personal care assistance care plan based on the service plan in subdivision 21 that is
developed by the qualified professional with the recipient and responsible party. A copy of
the most current personal care assistance care plan is required to be in the recipient's home
and in the recipient's file at the provider agency.
new text end

new text begin (b) The personal care assistance care plan must have the following components:
new text end

new text begin (1) start and end date of the care plan;
new text end

new text begin (2) recipient demographic information, including name and telephone number;
new text end

new text begin (3) emergency numbers and procedures, including a backup plan;
new text end

new text begin (4) name of responsible party and instructions for contact;
new text end

new text begin (5) description of the recipient's individualized needs for assistance with activities of
daily living, instrumental activities of daily living, health-related tasks, and behaviors; and
new text end

new text begin (6) dated signatures of recipient or responsible party and qualified professional.
new text end

new text begin (c) The personal care assistance care plan must have instructions and comments
about the recipient's needs for assistance and any special instructions or procedures
required. The month-to-month plan for the use of personal care assistance services is part
of the personal care assistance care plan. The personal care assistance care plan must
be completed within the first week after start of services with a personal care provider
agency and must be updated as needed when there is a change in need for personal care
assistance services. A new personal care assistance care plan is required annually at the
time of the reassessment.
new text end

new text begin Subd. 8. new text end

new text begin Communication with recipient's physician. new text end

new text begin The personal care assistance
program requires communication with the recipient's physician about a recipient's assessed
needs for personal care assistance services. The commissioner shall work with the state
medical director to develop options for communication with the recipient's physician.
new text end

new text begin Subd. 9. new text end

new text begin Responsible party; generally. new text end

new text begin (a) "Responsible party" means an
individual who lives with and is capable of providing the support necessary to assist the
recipient to live in the community.
new text end

new text begin (b) A responsible party must be 18 years of age, actively participate in planning and
directing of personal care assistance services, and attend all assessments for the recipient.
new text end

new text begin (c) A responsible party must not have a direct or indirect financial interest in care
provided to the recipient and must not be the:
new text end

new text begin (1) personal care assistant;
new text end

new text begin (2) home care provider agency staff; or
new text end

new text begin (3) county staff acting as part of employment.
new text end

new text begin (d) A licensed family foster parent who lives with the recipient may be the
responsible party as long as the foster parent does not also have a direct or indirect
financial interest in the provision of personal care assistant services.
new text end

new text begin (e) A responsible party is required when:
new text end

new text begin (1) the person is a minor according to section 524.5-102, subdivision 10;
new text end

new text begin (2) the person is an incapacitated adult according to section 524.5-102, subdivision
6, resulting in a court-appointed guardian; or
new text end

new text begin (3) the assessment according to section 256B.0911 determines that the recipient is in
need of a responsible party to direct the recipient's care.
new text end

new text begin (f) There may be two persons designated as the responsible party for reasons such as
divided households and court-ordered custodies. Each person named as responsible party
must meet the program criteria and responsibilities including living with the recipient at
the time they are serving as the responsible party.
new text end

new text begin (g) The recipient or the recipient's legal representative shall appoint a responsible
party if necessary to direct and supervise the care provided to the recipient. The
responsible party must be identified at the time of assessment and listed on the recipient's
service agreement and personal care assistance care plan.
new text end

new text begin Subd. 10. new text end

new text begin Responsible party; duties; delegation. new text end

new text begin (a) A responsible party with a
personal care assistance provider agency shall enter into a written agreement, on a form
determined by the commissioner, to perform the following duties:
new text end

new text begin (1) live with the individual who is receiving personal care assistance services;
new text end

new text begin (2) be available while care is provided in a method agreed upon by the individual
or the individual's legal representative and documented in the recipient's personal care
assistance care plan;
new text end

new text begin (3) monitor personal care assistance services to ensure the recipient's personal care
assistance care plan is being followed; and
new text end

new text begin (4) review and sign personal care assistance time sheets after services are provided
to provide verification of the personal care assistance services.
new text end

new text begin Failure to provide the support required by the recipient must result in a referral to the
county common entry point.
new text end

new text begin (b) Responsible parties who are parents of minors or guardians of minors or
incapacitated persons may delegate the responsibility to another adult who is not the
personal care assistant during a temporary absence of at least 24 hours but not more
than six months. The person delegated as a responsible party must be able to meet the
definition of the responsible party, except that the delegated responsible party is required
to reside with the recipient only while serving as the responsible party. The responsible
party must ensure that the delegate performs the functions of the responsible party, is
identified at the time of the assessment, and is listed on the personal care assistance
care plan. The responsible party must communicate to the personal care assistance
provider agency about the need for a delegate responsible party, including the name of the
delegated responsible party, dates the delegated responsible party will be living with the
recipient, and contact numbers.
new text end

new text begin Subd. 11. new text end

new text begin Personal care assistant; requirements. new text end

new text begin (a) A personal care assistant
must meet the following requirements:
new text end

new text begin (1) be at least 18 years of age with the exception of persons who are 16 or 17 years
of age with these additional requirements:
new text end

new text begin (i) supervision by a qualified professional every 60 days; and
new text end

new text begin (ii) employment by only one personal care assistance provider agency responsible
for compliance with current labor laws;
new text end

new text begin (2) be employed by a personal care assistance provider agency;
new text end

new text begin (3) enroll with the department as a non-pay-to provider after clearing a background
study. Before a personal care assistant provides services, the personal care assistance
provider agency must initiate a background study on the personal care assistant under
chapter 245C, and the personal care assistance provider agency must have received a
notice from the commissioner that the personal care assistant is:
new text end

new text begin (i) not disqualified under section 245C.14; or
new text end

new text begin (ii) is disqualified, but the personal care assistant has received a set aside of the
disqualification under section 245C.22;
new text end

new text begin (4) be able to effectively communicate with the recipient and personal care
assistance provider agency;
new text end

new text begin (5) be able to provide covered personal care assistance services according to the
recipient's personal care assistance care plan, respond appropriately to recipient needs,
and report changes in the recipient's condition to the supervising qualified professional
or physician;
new text end

new text begin (6) not be a consumer of personal care assistance services;
new text end

new text begin (7) maintain daily written records including, but not limited to, time sheets under
subdivision 12;
new text end

new text begin (8) complete standardized training as determined by the commissioner before
completing enrollment. Personal care assistant training must include successful completion
of the following training components: basic first aid, vulnerable adult, child maltreatment,
OSHA universal precautions, basic roles and responsibilities of personal care assistants
including information about assistance with lifting and transfers for recipients, emergency
preparedness, fraud issues, and completion of time sheets. Included with the basic training
is a need for the personal care assistant to demonstrate competency of ability to understand
and provide assistance. Personal care assistant training and orientation must be completed
within the first seven days after the services begin and be directed to the needs of the
recipient and the recipient's personal care assistance care plan; and
new text end

new text begin (9) be limited to providing and being paid for up to an amount of hours per month of
personal care assistance services that is determined by the commissioner regardless of
the number of recipients being served or the number of personal care assistance provider
agencies enrolled with.
new text end

new text begin (b) A legal guardian may be a personal care assistant if the guardian is not being paid
for the guardian services and meets the criteria for personal care assistants in paragraph (a).
new text end

new text begin (c) Persons who do not qualify as a personal care assistant include parents and
stepparents of minors, spouses, paid legal guardians, foster care providers, staff of a
residential setting, or anyone who has a direct or indirect financial interest in the service
delivery.
new text end

new text begin Subd. 12. new text end

new text begin Documentation of personal care assistance services provided. new text end

new text begin (a)
Personal care assistance services for a recipient must be documented daily, on a form
approved by the commissioner by each personal care assistant, and kept in the recipient's
home for the current month of service. The completed form must be submitted on a
monthly basis to the provider and kept in the recipient's health record.
new text end

new text begin (b) The activity documentation must correspond to the personal care assistance care
plan and be reviewed by the qualified professional.
new text end

new text begin (c) The personal care assistant time sheet must be on a form approved by the
commissioner documenting time the personal care assistant provides services in the home.
The following criteria must be included in the time sheet:
new text end

new text begin (1) full name of personal care assistant and individual provider number;
new text end

new text begin (2) provider name and telephone numbers;
new text end

new text begin (3) full name of recipient;
new text end

new text begin (4) consecutive dates, including month, day, and year, and arrival and departure
time with a.m. or p.m. notations;
new text end

new text begin (5) signatures of recipient or the responsible party;
new text end

new text begin (6) personal signature of the personal care assistant;
new text end

new text begin (7) any shared care provided, if applicable;
new text end

new text begin (8) a statement that it is a federal crime to provide false information on personal
care service billings for medical assistance payments; and
new text end

new text begin (9) dates and location of recipient stays in a hospital, care facility, or incarceration.
new text end

new text begin Subd. 13. new text end

new text begin Qualified professional; qualifications. new text end

new text begin (a) The qualified professional
must be employed by a personal care assistance provider agency and meet the definition
under section 256B.0625, subdivision 19c. Before a qualified professional provides
services, the personal care assistance provider agency must initiate a background study on
the qualified professional under chapter 245C, and the personal care assistance provider
agency must have received a notice from the commissioner that the qualified professional:
new text end

new text begin (1) is not disqualified under section 245C.14; or
new text end

new text begin (2) is disqualified, but the qualified professional has received a set aside of the
disqualification under section 245C.22.
new text end

new text begin (b) The qualified professional shall perform the duties of training, supervision, and
evaluation of the personal care assistance staff and evaluation of the effectiveness of
personal care assistance services. The qualified professional shall:
new text end

new text begin (1) develop and monitor with the recipient a personal care assistance care plan based
on the service plan and individualized needs of the recipient;
new text end

new text begin (2) develop and monitor with the recipient a monthly plan for the use of personal
care assistance services;
new text end

new text begin (3) review documentation of personal care assistance services provided;
new text end

new text begin (4) provide training and ensure competency for the personal care assistant in the
individual needs of the recipient; and
new text end

new text begin (5) document all training, communication, evaluations, and needed actions to
improve performance of the personal care assistants.
new text end

new text begin (c) The qualified professional shall complete the provider training with basic
information about the personal care assistance program approved by the commissioner
within six months of the date hired by a personal care assistance provider agency.
Qualified professionals who have completed the required trainings as an employee with a
personal care assistance provider agency do not need to repeat the required trainings if they
are hired by another agency, if they have completed the training within the last three years.
new text end

new text begin Subd. 14. new text end

new text begin Qualified professional; duties. new text end

new text begin (a) All personal care assistants must
be supervised by a qualified professional or in a joint supervision relationship with the
recipient or the responsible party.
new text end

new text begin (b) Through direct training, observation, return demonstrations, and consultation
with the staff and the recipient, the qualified professional must ensure and document
that the personal care assistant is:
new text end

new text begin (1) capable of providing the required personal care assistance services;
new text end

new text begin (2) knowledgeable about the plan of personal care assistance services before services
are performed; and
new text end

new text begin (3) able to identify conditions that should be immediately brought to the attention of
the qualified professional.
new text end

new text begin (c) The qualified professional shall evaluate the personal care assistant within the
first 14 days of starting to provide services for a recipient. The qualified professional shall
evaluate the personal care assistance services for a recipient through direct observation of
a personal care assistant's work:
new text end

new text begin (1) at least every 90 days thereafter for the first year of services; and
new text end

new text begin (2) every 120 days after the first year of service, or whenever needed for response to
a recipient's request for increased supervision of the personal care assistance staff.
new text end

new text begin (d) Communication with the recipient is a part of the evaluation process of the
personal care assistance staff.
new text end

new text begin (e) At each supervisory visit, the qualified professional shall evaluate personal care
assistance services including the following information:
new text end

new text begin (1) satisfaction level of the recipient with personal care assistance services;
new text end

new text begin (2) review of the month-to-month plan for use of personal care assistance services;
new text end

new text begin (3) review of documentation of personal care assistance services provided;
new text end

new text begin (4) whether the personal care assistance services are meeting the goals of the service
as stated in the personal care assistance care plan and service plan;
new text end

new text begin (5) a written record of the results of the evaluation and actions taken to correct any
deficiencies in the work of a personal care assistant; and
new text end

new text begin (6) revision of the personal care assistance care plan as necessary in consultation
with the recipient or responsible party, to meet the needs of the recipient.
new text end

new text begin (f) The qualified professional shall complete the required documentation in the
agency recipient and employee files and the recipient's home, including the following
documentation:
new text end

new text begin (1) the personal care assistance care plan based on the service plan and individualized
needs of the recipient;
new text end

new text begin (2) a month-to-month plan for use of personal care assistance services;
new text end

new text begin (3) changes in need of the recipient requiring a change to the level of service and the
personal care assistance care plan;
new text end

new text begin (4) evaluation results of supervision visits and identified issues with personal care
assistance staff with actions taken;
new text end

new text begin (5) all communication with the recipient and personal care assistance staff; and
new text end

new text begin (6) hands-on training or individualized training for the care of the recipient.
new text end

new text begin (g) The documentation in paragraph (f) must be done on agency forms.
new text end

new text begin (h) The services that are not eligible for payment as qualified professional services
include:
new text end

new text begin (1) direct professional nursing tasks that could be assessed and authorized as skilled
nursing tasks;
new text end

new text begin (2) supervision of personal care assistance completed by telephone;
new text end

new text begin (3) agency administrative activities;
new text end

new text begin (4) training other than the individualized training required to provide care for a
recipient; and
new text end

new text begin (5) any other activity that is not described in this section.
new text end

new text begin Subd. 15. new text end

new text begin Flexible use. new text end

new text begin (a) "Flexible use" means the scheduled use of authorized
hours of personal care assistance services, which vary within a service authorization
period covering no more than six months, in order to more effectively meet the needs and
schedule of the recipient. Each 12-month service agreement is divided into two six-month
authorization date spans. No more than 75 percent of the total authorized units for a
12-month service agreement may be used in a six-month date span.
new text end

new text begin (b) Authorization of flexible use occurs during the authorization process under
section 256B.0652. The flexible use of authorized hours does not increase the total
amount of authorized hours available to a recipient. The commissioner shall not authorize
additional personal care assistance services to supplement a service authorization that
is exhausted before the end date under a flexible service use plan, unless the assessor
determines a change in condition and a need for increased services is established.
Authorized hours not used within the six-month period must not be carried over to another
time period.
new text end

new text begin (c) A recipient who has terminated personal care assistance services before the end
of the 12-month authorization period must not receive additional hours upon reapplying
during the same 12-month authorization period, except if a change in condition is
documented. Services must be prorated for the remainder of the 12-month authorization
period based on the first six-month assessment.
new text end

new text begin (d) The recipient, responsible party, and qualified professional must develop a
written month-to-month plan of the projected use of personal care assistance services that
is part of the personal care assistance care plan and ensures:
new text end

new text begin (1) that the health and safety needs of the recipient are met throughout both date
spans of the authorization period; and
new text end

new text begin (2) that the total authorized amount of personal care assistance services for each date
span must not be used before the end of each date span in the authorization period.
new text end

new text begin (e) The personal care assistance provider agency shall monitor the use of personal
care assistance services to ensure health and safety needs of the recipient are met
throughout both date spans of the authorization period. The commissioner or the
commissioner's designee shall provide written notice to the provider and the recipient or
responsible party when a recipient is at risk of exceeding the personal care assistance
services prior to the end of the six-month period.
new text end

new text begin (f) Misuse and abuse of the flexible use of personal care assistance services resulting
in the overuse of units in a manner where the recipient will not have enough units to meet
their needs for assistance and ensure health and safety for the entire six-month date span
may lead to an action by the commissioner. The commissioner may take action including,
but not limited to: (1) restricting recipients to service authorizations of no more than one
month in duration; (2) requiring the recipient to have a responsible party; and (3) requiring
a qualified professional to monitor and report services on a monthly basis.
new text end

new text begin Subd. 16. new text end

new text begin Shared services. new text end

new text begin (a) Medical assistance payments for shared personal
care assistance services are limited according to this subdivision.
new text end

new text begin (b) Shared service is the provision of personal care assistance services by a personal
care assistant to two or three recipients, eligible for medical assistance, who voluntarily
enter into an agreement to receive services at the same time and in the same setting.
new text end

new text begin (c) For the purposes of this subdivision, "setting" means:
new text end

new text begin (1) the home residence or family foster care home of one or more of the individual
recipients; or
new text end

new text begin (2) a child care program licensed under chapter 245A or operated by a local school
district or private school.
new text end

new text begin (d) Shared personal care assistance services follow the same criteria for covered
services as subdivision 2.
new text end

new text begin (e) Noncovered shared personal care assistance services include the following:
new text end

new text begin (1) services for more than three recipients by one personal care assistant at one time;
new text end

new text begin (2) staff requirements for child care programs under chapter 245C;
new text end

new text begin (3) caring for multiple recipients in more than one setting;
new text end

new text begin (4) additional units of personal care assistance based on the selection of the option;
and
new text end

new text begin (5) use of more than one personal care assistance provider agency for the shared
care services.
new text end

new text begin (f) The option of shared personal care assistance is elected by the recipient or the
responsible party with the assistance of the assessor. The option must be determined
appropriate based on the ages of the recipients, compatibility, and coordination of their
assessed care needs. The recipient or the responsible party, in conjunction with the
qualified professional, shall arrange the setting and grouping of shared services based
on the individual needs and preferences of the recipients. The personal care assistance
provider agency shall offer the recipient or the responsible party the option of shared or
one-on-one personal care assistance services or a combination of both. The recipient or
the responsible party may withdraw from participating in a shared services arrangement at
any time.
new text end

new text begin (g) Authorization for the shared service option must be determined by the
commissioner based on the criteria that the shared service is appropriate to meet all of the
recipients' needs and their health and safety is maintained. The authorization of shared
services is part of the overall authorization of personal care assistance services. Nothing
in this subdivision must be construed to reduce the total number of hours authorized for
an individual recipient.
new text end

new text begin (h) A personal care assistant providing shared personal care assistance services must:
new text end

new text begin (1) receive training specific for each recipient served; and
new text end

new text begin (2) follow all required documentation requirements for time and services provided.
new text end

new text begin (i) A qualified professional shall:
new text end

new text begin (1) evaluate the ability of the personal care assistant to provide services for all of
the recipients in a shared setting;
new text end

new text begin (2) visit the shared setting as services are being provided at least once every six
months or whenever needed for response to a recipient's request for increased supervision
of the personal care assistance staff;
new text end

new text begin (3) provide ongoing monitoring and evaluation of the effectiveness and
appropriateness of the shared services;
new text end

new text begin (4) develop a contingency plan with each of the recipients which accounts for
absence of the recipient in a share services setting due to illness or other circumstances;
new text end

new text begin (5) obtain permission from each of the recipients who are sharing a personal care
assistant for number of shared hours for services provided inside and outside the home
residence; and
new text end

new text begin (6) document the training completed by the personal care assistants specific to the
shared setting and recipients sharing services.
new text end

new text begin Subd. 17. new text end

new text begin Shared services; rates. new text end

new text begin The commissioner shall provide a rate system for
shared personal care assistance services. For two persons sharing services, the rate paid
to a provider must not exceed one and one-half times the rate paid for serving a single
individual, and for three persons sharing services, the rate paid to a provider must not
exceed twice the rate paid for serving a single individual. These rates apply only when all
of the criteria for the shared care personal care assistance service have been met.
new text end

new text begin Subd. 18. new text end

new text begin Personal care assistance choice option; generally. new text end

new text begin (a) The
commissioner may allow a recipient of personal care assistance services to use a fiscal
intermediary to assist the recipient in paying and account for medically necessary covered
personal care assistance services. Unless otherwise provided in this section, all other
statutory and regulatory provisions relating to personal care assistance services apply to a
recipient using the personal care assistance choice option.
new text end

new text begin (b) Personal care assistance choice is an option of the personal care assistance
program that allows the recipient who receives personal care assistance services to be
responsible for the hiring, training, and firing of personal care assistants. This program
offers greater control and choice for the recipient in who provides the personal care
assistance service and when the service is scheduled. The recipient or the recipient's
responsible party must choose a personal care assistance choice provider agency as
a fiscal intermediary. This personal care assistance choice provider agency manages
payroll, invoices the state, is responsible for all payroll related taxes and insurance, and is
responsible for providing the consumer training and support in managing the recipient's
personal care assistance services.
new text end

new text begin Subd. 19. new text end

new text begin Personal care assistance choice option; qualifications; duties. new text end

new text begin (a)
Under personal care assistance choice, the recipient or responsible party shall:
new text end

new text begin (1) recruit, hire, and terminate personal care assistants and a qualified professional;
new text end

new text begin (2) develop a personal care assistance care plan based on the assessed needs
and addressing the health and safety of the recipient with the assistance of a qualified
professional as needed;
new text end

new text begin (3) orient and train the personal care assistant with assistance as needed from the
qualified professional;
new text end

new text begin (4) supervise and evaluate the personal care assistant with the qualified professional;
new text end

new text begin (5) monitor and verify in writing and report to the personal care assistance choice
agency the number of hours worked by the personal care assistant and the qualified
professional;
new text end

new text begin (6) engage in an annual face-to-face reassessment to determine continuing eligibility
and service authorization; and
new text end

new text begin (7) use the same personal care assistance choice provider agency if shared personal
assistance care is being used.
new text end

new text begin (b) The personal care assistance choice provider agency shall:
new text end

new text begin (1) meet all personal care assistance provider agency standards;
new text end

new text begin (2) enter into a written agreement with the recipient, responsible party, and personal
care assistants;
new text end

new text begin (3) not be related to the recipient, qualified professional, or the personal care
assistant; and
new text end

new text begin (4) ensure arm's-length transactions with the recipient and personal care assistant.
new text end

new text begin (c) The duties of the personal care assistance choice provider agency are to:
new text end

new text begin (1) be the employer of the personal care assistant and the qualified professional for
employment law and related regulations including but not limited to purchasing and
maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
and liability insurance, and submit any or all necessary documentation including, but not
limited to, workers' compensation and unemployment insurance;
new text end

new text begin (2) bill the medical assistance program for personal care assistance services and
qualified professional services;
new text end

new text begin (3) request and complete background studies that comply with the requirements for
personal care assistants and qualified professionals;
new text end

new text begin (4) pay the personal care assistant and qualified professional based on actual hours
of services provided;
new text end

new text begin (5) withhold and pay all applicable federal and state taxes;
new text end

new text begin (6) verify and keep records of hours worked by the personal care assistant and
qualified professional;
new text end

new text begin (7) make the arrangements and pay taxes and other benefits, if any; and comply with
any legal requirements for a Minnesota employer;
new text end

new text begin (8) enroll in the medical assistance program as a personal care assistance choice
agency; and
new text end

new text begin (9) enter into a written agreement as specified in subdivision 20 before services
are provided.
new text end

new text begin Subd. 20. new text end

new text begin Personal care assistance choice option; administration. new text end

new text begin (a) Before
services commence under the personal care assistance choice option, and annually
thereafter, the personal care assistance choice provider agency, recipient, or responsible
party, each personal care assistant, and the qualified professional shall enter into a written
agreement. The agreement must include at a minimum:
new text end

new text begin (1) duties of the recipient, qualified professional, personal care assistant, and
personal care assistance choice provider agency;
new text end

new text begin (2) salary and benefits for the personal care assistant and the qualified professional;
new text end

new text begin (3) administrative fee of the personal care assistance choice provider agency and
services paid for with that fee, including background study fees;
new text end

new text begin (4) grievance procedures to respond to complaints;
new text end

new text begin (5) procedures for hiring and terminating the personal care assistant; and
new text end

new text begin (6) documentation requirements including, but not limited to, time sheets, activity
records, and the personal care assistance care plan.
new text end

new text begin (b) Except for the administrative fee of the personal care assistance choice provider
agency as reported on the written agreement, the remainder of the rates paid to the personal
care assistance choice provider agency must be used to pay for the salary and benefits for
the personal care assistant or the qualified professional.
new text end

new text begin (c) The commissioner shall deny, revoke, or suspend the authorization to use the
personal care assistance choice option if:
new text end

new text begin (1) it has been determined by the qualified professional or public health nurse that
the use of this option jeopardizes the recipient's health and safety;
new text end

new text begin (2) the parties have failed to comply with the written agreement specified in
subdivision 20;
new text end

new text begin (3) the use of the option has led to abusive or fraudulent billing for personal care
assistance services; or
new text end

new text begin (4) the department terminates the personal care assistance choice option.
new text end

new text begin (d) The recipient or responsible party may appeal the commissioner's decision in
paragraph (c) according to section 256.045. The denial, revocation, or suspension to
use the personal care assistance choice option must not affect the recipient's authorized
level of personal care assistance services.
new text end

new text begin Subd. 21. new text end

new text begin Requirements for initial enrollment of personal care assistance
provider agencies.
new text end

new text begin (a) All personal care assistance provider agencies must provide, at the
time of enrollment as a personal care assistance provider agency in a format determined
by the commissioner, information and documentation that includes, but is not limited to,
the following:
new text end

new text begin (1) the personal care assistance provider agency's current contact information
including address, telephone number, and e-mail address;
new text end

new text begin (2) proof of surety bond coverage in the amount of $50,000 or ten percent of the
provider's payments from Medicaid in the previous year, whichever is less;
new text end

new text begin (3) proof of fidelity bond coverage in the amount of $20,000;
new text end

new text begin (4) proof of workers' compensation insurance coverage;
new text end

new text begin (5) a description of the personal care assistance provider agency's organization
identifying the names of all owners, managerial officials, staff, board of directors, and the
affiliations of the directors, owners, or staff to other service providers;
new text end

new text begin (6) a copy of the personal care assistance provider agency's written policies and
procedures including: hiring of employees; training requirements; service delivery;
and employee and consumer safety including process for notification and resolution
of consumer grievances, identification and prevention of communicable diseases, and
employee misconduct;
new text end

new text begin (7) copies of all other forms the personal care assistance provider agency uses in
the course of daily business including, but not limited to:
new text end

new text begin (i) a copy of the personal care assistance provider agency's time sheet if the time
sheet varies from the standard time sheet for personal care assistance services approved
by the commissioner, and a letter requesting approval of the personal care assistance
provider agency's nonstandard time sheet;
new text end

new text begin (ii) the personal care assistance provider agency's template for the personal care
assistance care plan; and
new text end

new text begin (iii) the personal care assistance provider agency's template and the written
agreement in subdivision 20 for recipients using the personal care assistance choice
option, if applicable;
new text end

new text begin (8) a list of all trainings and classes that the personal care assistance provider agency
requires of its staff providing personal care assistance services;
new text end

new text begin (9) documentation that the personal care assistance provider agency and staff have
successfully completed all the training required by this section; and
new text end

new text begin (10) disclosure of ownership, leasing, or management of all residential properties
that is used or could be used for providing home care services.
new text end

new text begin (b) Personal care assistance provider agencies shall provide the information specified
in paragraph (a) to the commissioner at the time the personal care assistance provider
agency enrolls as a vendor or upon request from the commissioner. The commissioner
shall collect the information specified in paragraph (a) from all personal care assistance
providers beginning upon enactment of this section.
new text end

new text begin (c) All personal care assistance provider agencies shall complete mandatory training
as determined by the commissioner before enrollment as a provider. Personal care
assistance provider agencies are required to send all owners, qualified professionals
employed by the agency, and all other managerial officials to the initial and subsequent
trainings. Personal care assistance provider agency billing staff shall complete training
about personal care assistance program financial management. This training is effective
upon enactment of this section. Any personal care assistance provider agency enrolled
before that date shall, if it has not already, complete the provider training within 18 months
of the effective date of this section. Any new owners, new qualified professionals, and new
managerial officials are required to complete mandatory training as a requisite of hiring.
new text end

new text begin Subd. 22. new text end

new text begin Annual review for personal care providers. new text end

new text begin (a) All personal care
assistance provider agencies shall resubmit, on an annual basis, the information specified
in subdivision 21, in a format determined by the commissioner, and provide a copy of the
personal care assistance provider agency's most current version of its grievance policies
and procedures along with a written record of grievances and resolutions of the grievances
that the personal care assistance provider agency has received in the previous year and any
other information requested by the commissioner.
new text end

new text begin (b) The commissioner shall send annual review notification to personal care
assistance provider agencies 30 days prior to renewal. The notification must:
new text end

new text begin (1) list the materials and information the personal care assistance provider agency is
required to submit;
new text end

new text begin (2) provide instructions on submitting information to the commissioner; and
new text end

new text begin (3) provide a due date by which the commissioner must receive the requested
information.
new text end

new text begin Personal care assistance provider agencies shall submit required documentation for
annual review within 30 days of notification from the commissioner. If no documentation
is submitted, the personal care assistance provider agency enrollment number must be
terminated or suspended.
new text end

new text begin (c) Personal care assistance provider agencies also currently licensed under
Minnesota Rules, part 4668.0012, as a class A provider or currently certified for
participation in Medicare as a home health agency under Code of Federal Regulations,
title 42, part 484, are deemed in compliance with the personal care assistance requirements
for enrollment, annual review process, and documentation.
new text end

new text begin Subd. 23. new text end

new text begin Enrollment requirements following termination. new text end

new text begin (a) A terminated
personal care assistance provider agency, including all named individuals on the current
enrollment disclosure form and known or discovered affiliates of the personal care
assistance provider agency, is not eligible to enroll as a personal care assistance provider
agency for two years following the termination.
new text end

new text begin (b) After the two-year period in paragraph (a), if the provider seeks to reenroll
as a personal care assistance provider agency, the personal care assistance provider
agency must be placed on a one-year probation period, beginning after completion of
the following:
new text end

new text begin (1) the department's provider trainings under this section; and
new text end

new text begin (2) initial enrollment requirements under subdivision 21.
new text end

new text begin (c) During the probationary period the commissioner shall complete site visits and
request submission of documentation to review compliance with program policy.
new text end

new text begin Subd. 24. new text end

new text begin Personal care assistance provider agency; general duties. new text end

new text begin A personal
care assistance provider agency shall:
new text end

new text begin (1) enroll as a Medicaid provider meeting all provider standards, including
completion of the required provider training;
new text end

new text begin (2) comply with general medical assistance coverage requirements;
new text end

new text begin (3) demonstrate compliance with law and policies of the personal care assistance
program to be determined by the commissioner;
new text end

new text begin (4) comply with background study requirements;
new text end

new text begin (5) verify and keep records of hours worked by the personal care assistant and
qualified professional;
new text end

new text begin (6) pay the personal care assistant and qualified professional based on actual hours
of services provided;
new text end

new text begin (7) withhold and pay all applicable federal and state taxes;
new text end

new text begin (8) make the arrangements and pay unemployment insurance, taxes, workers'
compensation, liability insurance, and other benefits, if any;
new text end

new text begin (9) enter into a written agreement under subdivision 21 before services are provided;
new text end

new text begin (10) report suspected neglect and abuse to the common entry point according to
section 256B.0651; and
new text end

new text begin (11) provide the recipient with a copy of the home care bill of rights at start of service.
new text end

new text begin Subd. 25. new text end

new text begin Personal care assistance provider agency; background studies.
new text end

new text begin Personal care assistance provider agencies enrolled to provide personal care assistance
services under the medical assistance program shall comply with the following:
new text end

new text begin (1) owners who have a five percent interest or more and all managerial officials are
subject to a background study as provided in chapter 245C. This applies to currently
enrolled personal care assistance provider agencies and those agencies seeking enrollment
as a personal care assistance provider agency. Managerial official has the same meaning
as Code of Federal Regulations, title 42, section 455. An organization is barred from
enrollment if:
new text end

new text begin (i) the organization has not initiated background studies on owners and managerial
officials; or
new text end

new text begin (ii) the organization has initiated background studies on owners and managerial
officials, but the commissioner has sent the organization a notice that an owner or
managerial official of the organization has been disqualified under section 245C.14,
and the owner or managerial official has not received a set aside of the disqualification
under section 245C.22;
new text end

new text begin (2) a background study must be initiated and completed for all qualified
professionals; and
new text end

new text begin (3) a background study must be initiated and completed for all personal care
assistants.
new text end

new text begin Subd. 26. new text end

new text begin Personal care assistance provider agency; communicable disease
prevention.
new text end

new text begin A personal care assistance provider agency shall establish and implement
policies and procedures for prevention, control, and investigation of infections and
communicable diseases according to current nationally recognized infection control
practices or guidelines established by the United States Centers for Disease Control and
Prevention, as well as applicable regulations of other federal or state agencies.
new text end

new text begin Subd. 27. new text end

new text begin Personal care assistance provider agency; ventilator training. new text end

new text begin The
personal care assistance provider agency is required to provide training for the personal
care assistant responsible for working with a recipient who is ventilator dependent. All
training must be administered by a respiratory therapist, nurse, or physician. Qualified
professional supervision by a nurse must be completed and documented on file in the
personal care assistant's employment record and the recipient's health record. If offering
personal care services to a ventilator-dependent recipient, the personal care assistance
provider agency shall demonstrate the ability to:
new text end

new text begin (1) train the personal care assistant;
new text end

new text begin (2) supervise the personal care assistant in ventilator operation and maintenance; and
new text end

new text begin (3) supervise the recipient and responsible party in ventilator operation and
maintenance.
new text end

new text begin Subd. 28. new text end

new text begin Personal care assistance provider agency; required documentation.
new text end

new text begin Required documentation must be completed and kept in the personal care assistance
provider agency file or the recipient's home residence. The required documentation
consists of:
new text end

new text begin (1) employee files, including:
new text end

new text begin (i) applications for employment;
new text end

new text begin (ii) background study requests and results;
new text end

new text begin (iii) orientation records about the agency policies;
new text end

new text begin (iv) trainings completed with demonstration of competence;
new text end

new text begin (v) supervisory visits;
new text end

new text begin (vi) evaluations of employment; and
new text end

new text begin (vii) signature on fraud statement;
new text end

new text begin (2) recipient files, including:
new text end

new text begin (i) demographics;
new text end

new text begin (ii) emergency contact information and emergency backup plan;
new text end

new text begin (iii) medical assistance service plan;
new text end

new text begin (iv) personal care assistance care plan;
new text end

new text begin (v) month-to-month service use plan;
new text end

new text begin (vi) all communication records;
new text end

new text begin (vii) start of service information, including the written agreement with recipient; and
new text end

new text begin (viii) date the home care bill of rights was given to the recipient;
new text end

new text begin (3) agency policy manual, including:
new text end

new text begin (i) policies for employment and termination;
new text end

new text begin (ii) grievance policies with resolution of consumer grievances;
new text end

new text begin (iii) staff and consumer safety;
new text end

new text begin (iv) staff misconduct; and
new text end

new text begin (v) staff hiring, service delivery, staff and consumer safety, staff misconduct, and
resolution of consumer grievances; and
new text end

new text begin (4) time sheets for each personal care assistant along with completed activity sheets
for each recipient served.
new text end

new text begin Subd. 29. new text end

new text begin Transitional assistance. new text end

new text begin Notwithstanding any contrary provision in
this section, the commissioner, counties, and personal care assistance providers shall
work together to provide transitional assistance for recipients and families to come into
compliance with the new live-in responsible party requirements of this section, and
ensure that services are prohibited from being provided by the housing provider. The
commissioner and counties shall provide this assistance until July 1, 2010.
new text end

Sec. 24.

Minnesota Statutes 2008, section 256B.0911, subdivision 1, is amended to
read:


Subdivision 1.

Purpose and goal.

(a) The purpose of long-term care consultation
services is to assist persons with long-term or chronic care needs in making long-term
care decisions and selecting options that meet their needs and reflect their preferences.
The availability of, and access to, information and other types of assistancenew text begin, including
assessment and support planning,
new text end is also intended to prevent or delay certified nursing
facility placements and to provide transition assistance after admission. Further, the goal
of these services is to contain costs associated with unnecessary certified nursing facility
admissions. new text beginLong-term consultation services must be available to any person regardless
of public program eligibility.
new text endThe deleted text begincommissionersdeleted text end new text begincommissioner new text endof human services deleted text beginand
health
deleted text end shall seek to maximize use of available federal and state funds and establish the
broadest program possible within the funding available.

(b) These services must be coordinated with deleted text beginservicesdeleted text end new text beginlong-term care options
counseling
new text endprovided under section 256.975, subdivision 7, and deleted text beginwith services provided by
other public and private agencies in the community
deleted text end new text beginsection 256.01, subdivision 24, for
telephone assistance and follow up and
new text endto offer a variety of cost-effective alternatives
to persons with disabilities and elderly persons. The county new text beginor tribal new text endagency providing
long-term care consultation services shall encourage the use of volunteers from families,
religious organizations, social clubs, and similar civic and service organizations to provide
community-based services.

Sec. 25.

Minnesota Statutes 2008, section 256B.0911, subdivision 1a, is amended to
read:


Subd. 1a.

Definitions.

For purposes of this section, the following definitions apply:

(a) "Long-term care consultation services" means:

deleted text begin (1) providing information and education to the general public regarding availability
of the services authorized under this section;
deleted text end

deleted text begin (2) an intake process that provides access to the services described in this section;
deleted text end

deleted text begin (3) assessment of the health, psychological, and social needs of referred individuals;
deleted text end

deleted text begin (4)deleted text end new text begin(1) new text endassistance in identifying services needed to maintain an individual in the
deleted text begin least restrictivedeleted text end new text beginmost inclusive new text endenvironment;

deleted text begin (5)deleted text end new text begin(2) new text endproviding recommendations on cost-effective community services that are
available to the individual;

deleted text begin (6)deleted text end new text begin(3) new text enddevelopment of an individual's new text beginperson-centered new text endcommunity support plan;

deleted text begin (7)deleted text end new text begin(4) new text endproviding information regarding eligibility for Minnesota health care
programs;

new text begin (5) face-to-face long-term care consultation assessments, which may be completed
in a hospital, nursing facility, intermediate care facility for persons with developmental
disabilities (ICF/DDs), regional treatment centers, or the person's current or planned
residence;
new text end

deleted text begin (8) preadmissiondeleted text end new text begin(6) federally mandated new text endscreening to determine the need for
a deleted text beginnursing facilitydeleted text end new text begininstitutional new text endlevel of carenew text begin under section 256B.0911, subdivision 4,
paragraph (a)
new text end;

deleted text begin (9) preliminarydeleted text end new text begin(7) new text enddetermination of deleted text beginMinnesota health care programsdeleted text end new text beginhome and
community-based waiver service
new text endeligibility new text beginincluding level of care determination new text endfor
individuals who need deleted text begina nursing facilitydeleted text end new text beginan institutional new text endlevel of carenew text begin as defined under
section 144.0724, subdivision 11, or 256B.092
new text end, new text beginservice eligibility including state plan
home care services identified in section 256B.0625, subdivisions 6, 7, and 19, paragraphs
(a) and (c), based on assessment and support plan development
new text endwith appropriate referrals
deleted text begin for final determinationdeleted text end;

deleted text begin (10)deleted text end new text begin(8) new text endproviding recommendations for nursing facility placement when there are
no cost-effective community services available; and

deleted text begin (11)deleted text end new text begin(9) new text endassistance to transition people back to community settings after facility
admission.

new text begin (b) "Long-term options counseling" means the services provided by the linkage
lines as mandated by sections 256.01 and 256.975, subdivision 7, and also includes
telephone assistance and follow up once a long-term care consultation assessment has
been completed. Long-term care options counselors shall:
new text end

new text begin (1) for individuals not eligible for case management under a public program or
public funding source, provide interactive decision support whereby consumers, family
members, or other helpers are supported in their deliberations to determine appropriate
long-term care choices in the context of the consumer's needs, preferences, values, and
individual circumstances including implementing a community support plan:
new text end

new text begin (2) provide Web-based educational information and collateral written materials to
familiarize consumers, family members, or other helpers with the long-term care basics,
issues to be considered, and the range of options available in the community;
new text end

new text begin (3) provide long-term care futures planning defined as providing assistance to
individuals who anticipate having long-term care needs to develop a plan for the more
distant future; and
new text end

new text begin (4) provide expertise in benefits and financing options for long-term care including
Medicare, long-term care insurance, tax or employer-based incentives, reverse mortgages,
private pay options, and ways to access low or no-cost services or benefits through
volunteer-based or charitable programs.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end "Minnesota health care programs" means the medical assistance program
under chapter 256B and the alternative care program under section 256B.0913.

new text begin (d) "Lead agencies" means counties or a collaboration of counties, tribes, and health
plans administering long-term care consultation assessment and support planning services.
new text end

Sec. 26.

Minnesota Statutes 2008, section 256B.0911, is amended by adding a
subdivision to read:


new text begin Subd. 2b. new text end

new text begin Certified assessors. new text end

new text begin (a) Beginning January 1, 2011, each lead agency
shall have certified assessors who have completed training and certification process
determined by the commissioner in subdivision 2c. Certified assessors shall demonstrate
best practices in assessment and support planning including person-centered planning
principals and have a common set of skills that must ensure consistency and equitable
access to services statewide.
new text end

new text begin (b) Certified assessors are persons with a minimum of a bachelor's degree in social
work, nursing with a public health nursing certificate, or other closely related field with at
least one year of home and community-based experience or a two-year registered nursing
degree with at least three years of home and community-based experience that have
received training and certification specific to assessment and consultation for long-term
care services in the state.
new text end

Sec. 27.

Minnesota Statutes 2008, section 256B.0911, is amended by adding a
subdivision to read:


new text begin Subd. 2c. new text end

new text begin Assessor training and certification. new text end

new text begin The commissioner shall develop
curriculum and a certification process to begin no later than January 1, 2010. All existing
lead agency staff designated to provide the services defined in subdivision 1a must be
certified by December 30, 2010. Each lead agency is required to ensure that they have
sufficient numbers of certified assessors to provide long-term consultation assessment and
support planning within the timelines and parameters of the service by January 1, 2011.
Certified assessors are required to be recertified every three years.
new text end

Sec. 28.

Minnesota Statutes 2008, section 256B.0911, subdivision 3, is amended to
read:


Subd. 3.

Long-term care consultation team.

(a) new text beginUntil January 1, 2011, new text enda long-term
care consultation team shall be established by the county board of commissioners. Each
local consultation team shall consist of at least one social worker and at least one public
health nurse from their respective county agencies. The board may designate public
health or social services as the lead agency for long-term care consultation services. If a
county does not have a public health nurse available, it may request approval from the
commissioner to assign a county registered nurse with at least one year experience in
home care to participate on the team. Two or more counties may collaborate to establish
a joint local consultation team or teams.

(b) The team is responsible for providing long-term care consultation services to
all persons located in the county who request the services, regardless of eligibility for
Minnesota health care programs.

new text begin (c) The commissioner shall allow arrangements and make recommendations that
encourage counties to collaborate to establish joint local long-term care consultation
teams to ensure that long-term care consultations are done within the timelines and
parameters of the service. This includes integrated service models as required in section
256B.0911, subdivision 1, paragraph (b).
new text end

Sec. 29.

Minnesota Statutes 2008, section 256B.0911, subdivision 3a, is amended to
read:


Subd. 3a.

Assessment and support planning.

(a) Persons requesting assessment,
services planning, or other assistance intended to support community-based living,
including persons who need assessment in order to determine new text beginpersonal care assistance
services, private duty nursing services, home health agency services,
new text endwaiver or alternative
care program eligibility, must be visited by a long-term care consultation team new text beginon or after
January 1, 2011, a certified assessor
new text endwithin deleted text beginten workingdeleted text end new text begin15 calendar new text enddays after the date on
which an assessment was requested or recommended. new text beginFace-to-face new text endassessments must be
conducted according to paragraphs (b) to deleted text begin(i)deleted text endnew text begin (k)new text end.

(b) The county may utilize a team of either the social worker or public health nurse,
or both, new text beginafter January 1, 2011, lead agencies shall use a certified assessor new text endto conduct the
assessment in a face-to-face interview. The consultation team members must confer
regarding the most appropriate care for each individual screened or assessed.

(c) The deleted text beginlong-term care consultation team must assess the health and social needs of
the person
deleted text endnew text begin assessment must be comprehensive and include a person-centered assessment
of the health, psychological, functional, environmental, and social needs of referred
individuals and provide information necessary to develop a support plan that meets the
consumers needs
new text end, using an assessment form provided by the commissioner.

(d) The deleted text beginteam must conduct thedeleted text end assessment new text beginmust be conducted new text endin a face-to-face
interview with the person being assessed and the person's legal representative, deleted text beginif applicabledeleted text endnew text begin
as required by legally executed documents, and other individuals as requested by the
person, who can provide information on the needs, strengths, and preferences of the
person necessary to develop a support plan that ensures the person's health and safety, but
who is not a provider of service or has any financial interest in the provision of services
new text end.

(e) The deleted text beginteam must provide thedeleted text end person, or the person's legal representative, new text beginmust
be provided
new text endwith written recommendations for deleted text beginfacility- ordeleted text end community-based servicesdeleted text begin.
The team must document
deleted text end new text beginor institutional care that include documentation new text endthat the most
cost-effective alternatives available were offered to the individual. For purposes of
this requirement, "cost-effective alternatives" means community services and living
arrangements that cost the same as or less than deleted text beginnursing facilitydeleted text endnew text begin institutionalnew text end care.

(f) If the person chooses to use community-based services, the deleted text beginteam must provide
the
deleted text end person or the person's legal representative new text beginmust be provided new text endwith a written community
support plan, regardless of whether the individual is eligible for Minnesota health care
programs. deleted text beginThedeleted text end new text beginA new text endperson may request assistance in deleted text begindeveloping a community support plan
deleted text endnew text begin identifying community supports new text endwithout participating in a complete assessment.new text begin Upon
a request for assistance identifying community support, the person must be transferred
or referred to the services available under sections 256.975, subdivision 7, and 256.01,
subdivision 24, for telephone assistance and follow up.
new text end

(g) The person has the right to make the final decision between deleted text beginnursing
facility
deleted text endnew text begin institutionalnew text end placement and community placement after the deleted text beginscreening team's
recommendation
deleted text endnew text begin recommendations have been providednew text end, except as provided in subdivision
4a, paragraph (c).

(h) The team must give the person receiving assessment or support planning, or
the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:

(1) the need for and purpose of preadmission screening if the person selects nursing
facility placement;

(2) the role of the long-term care consultation assessment and support planning in
waiver and alternative care program eligibility determination;

(3) information about Minnesota health care programs;

(4) the person's freedom to accept or reject the recommendations of the team;

(5) the person's right to confidentiality under the Minnesota Government Data
Practices Act, chapter 13;

(6) the long-term care consultant's decision regarding the person's need for deleted text beginnursing
facility
deleted text endnew text begin institutionalnew text end level of carenew text begin as determined under criteria established in section
144.0724, subdivision 11, or 256B.092
new text end; and

(7) the person's right to appeal the decision regarding the need for nursing facility
level of care or the county's final decisions regarding public programs eligibility according
to section 256.045, subdivision 3.

(i) Face-to-face assessment completed as part of eligibility determination for
the alternative care, elderly waiver, community alternatives for disabled individuals,
community alternative care, and traumatic brain injury waiver programs under sections
256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more
than 60 calendar days after the date of assessment. The effective eligibility start date
for these programs can never be prior to the date of assessment. If an assessment was
completed more than 60 days before the effective waiver or alternative care program
eligibility start date, assessment and support plan information must be updated in a
face-to-face visit and documented in the department's Medicaid Management Information
System (MMIS). The effective date of program eligibility in this case cannot be prior to
the date the updated assessment is completed.

Sec. 30.

Minnesota Statutes 2008, section 256B.0911, subdivision 4a, is amended to
read:


Subd. 4a.

Preadmission screening activities related to nursing facility
admissions.

(a) All applicants to Medicaid certified nursing facilities, including certified
boarding care facilities, must be screened prior to admission regardless of income, assets,
or funding sources for nursing facility care, except as described in subdivision 4b. The
purpose of the screening is to determine the need for nursing facility level of care as
described in paragraph (d) and to complete activities required under federal law related to
mental illness and developmental disability as outlined in paragraph (b).

(b) A person who has a diagnosis or possible diagnosis of mental illness or
developmental disability must receive a preadmission screening before admission
regardless of the exemptions outlined in subdivision 4b, paragraph (b), to identify the need
for further evaluation and specialized services, unless the admission prior to screening is
authorized by the local mental health authority or the local developmental disabilities case
manager, or unless authorized by the county agency according to Public Law 101-508.

The following criteria apply to the preadmission screening:

(1) the county must use forms and criteria developed by the commissioner to identify
persons who require referral for further evaluation and determination of the need for
specialized services; and

(2) the evaluation and determination of the need for specialized services must be
done by:

(i) a qualified independent mental health professional, for persons with a primary or
secondary diagnosis of a serious mental illness; or

(ii) a qualified developmental disability professional, for persons with a primary or
secondary diagnosis of developmental disability. For purposes of this requirement, a
qualified developmental disability professional must meet the standards for a qualified
developmental disability professional under Code of Federal Regulations, title 42, section
483.430.

(c) The local county mental health authority or the state developmental disability
authority under Public Law Numbers 100-203 and 101-508 may prohibit admission to a
nursing facility if the individual does not meet the nursing facility level of care criteria or
needs specialized services as defined in Public Law Numbers 100-203 and 101-508. For
purposes of this section, "specialized services" for a person with developmental disability
means active treatment as that term is defined under Code of Federal Regulations, title
42, section 483.440 (a)(1).

(d) The determination of the need for nursing facility level of care must be made
according to criteria new text beginestablished in section 144.0724, subdivision 11, and 256B.092,
using forms
new text enddeveloped by the commissioner. In assessing a person's needs, consultation
team members shall have a physician available for consultation and shall consider the
assessment of the individual's attending physician, if any. The individual's physician must
be included if the physician chooses to participate. Other personnel may be included on
the team as deemed appropriate by the county.

Sec. 31.

Minnesota Statutes 2008, section 256B.0911, subdivision 5, is amended to
read:


Subd. 5.

Administrative activity.

The commissioner shall minimize the number
of deleted text beginforms required in the provision of long-term care consultation services and shall
limit the screening document to items necessary for community support plan approval,
reimbursement, program planning, evaluation, and policy development
deleted text endnew text begin business processes
required to provide the services in this section and shall implement integrated solutions
to automate the business processes to the extent necessary for community support plan
approval, reimbursement, program planning, evaluation, and policy development
new text end.

Sec. 32.

Minnesota Statutes 2008, section 256B.0911, subdivision 6, is amended to
read:


Subd. 6.

Payment for long-term care consultation services.

(a) The total payment
for each county must be paid monthly by certified nursing facilities in the county. The
monthly amount to be paid by each nursing facility for each fiscal year must be determined
by dividing the county's annual allocation for long-term care consultation services by 12
to determine the monthly payment and allocating the monthly payment to each nursing
facility based on the number of licensed beds in the nursing facility. Payments to counties
in which there is no certified nursing facility must be made by increasing the payment
rate of the two facilities located nearest to the county seat.

(b) The commissioner shall include the total annual payment determined under
paragraph (a) for each nursing facility reimbursed under section 256B.431 or 256B.434
according to section 256B.431, subdivision 2b, paragraph (g).

(c) In the event of the layaway, delicensure and decertification, or removal from
layaway of 25 percent or more of the beds in a facility, the commissioner may adjust
the per diem payment amount in paragraph (b) and may adjust the monthly payment
amount in paragraph (a). The effective date of an adjustment made under this paragraph
shall be on or after the first day of the month following the effective date of the layaway,
delicensure and decertification, or removal from layaway.

(d) Payments for long-term care consultation services are available to the county
or counties to cover staff salaries and expenses to provide the services described in
subdivision 1a. The county shall employ, or contract with other agencies to employ, within
the limits of available funding, sufficient personnel to provide long-term care consultation
services while meeting the state's long-term care outcomes and objectives as defined in
section 256B.0917, subdivision 1. The county shall be accountable for meeting local
objectives as approved by the commissioner in the biennial home and community-based
services quality assurance plan on a form provided by the commissioner.

(e) Notwithstanding section 256B.0641, overpayments attributable to payment of the
screening costs under the medical assistance program may not be recovered from a facility.

(f) The commissioner of human services shall amend the Minnesota medical
assistance plan to include reimbursement for the local consultation teams.

(g) The county may bill, as case management services, assessments, support
planning, and follow-along provided to persons determined to be eligible for case
management under Minnesota health care programs. No individual or family member
shall be charged for an initial assessment or initial support plan development provided
under subdivision 3a or 3b.

new text begin (h) The commissioner shall develop an alternative payment methodology for
long-term care consultation services that includes the funding available under this
subdivision, and sections 256B.092 and 256B.0659. In developing the new payment
methodology, the commissioner shall consider the maximization of federal funding for
this activity.
new text end

Sec. 33.

Minnesota Statutes 2008, section 256B.0911, subdivision 7, is amended to
read:


Subd. 7.

Reimbursement for certified nursing facilities.

(a) Medical assistance
reimbursement for nursing facilities shall be authorized for a medical assistance recipient
only if a preadmission screening has been conducted prior to admission or the county has
authorized an exemption. Medical assistance reimbursement for nursing facilities shall
not be provided for any recipient who the local screener has determined does not meet the
level of care criteria for nursing facility placementnew text begin in section 144.0724, subdivision 11,new text end or,
if indicated, has not had a level II OBRA evaluation as required under the federal Omnibus
Budget Reconciliation Act of 1987 completed unless an admission for a recipient with
mental illness is approved by the local mental health authority or an admission for a
recipient with developmental disability is approved by the state developmental disability
authority.

(b) The nursing facility must not bill a person who is not a medical assistance
recipient for resident days that preceded the date of completion of screening activities as
required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed
resident days in the nursing facility resident day totals reported to the commissioner.

Sec. 34.

Minnesota Statutes 2008, section 256B.0913, subdivision 4, is amended to
read:


Subd. 4.

Eligibility for funding for services for nonmedical assistance recipients.

(a) Funding for services under the alternative care program is available to persons who
meet the following criteria:

(1) the person has been determined by a community assessment under section
256B.0911 to be a person who would require the level of care provided in a nursing
facilitynew text begin according to the criteria established in section 144.0724, subdivision 11new text end, but for
the provision of services under the alternative care program;

(2) the person is age 65 or older;

(3) the person would be eligible for medical assistance within 135 days of admission
to a nursing facility;

(4) the person is not ineligible for the payment of long-term care services by the
medical assistance program due to an asset transfer penalty under section 256B.0595 or
equity interest in the home exceeding $500,000 as stated in section 256B.056;

(5) the person needs long-term care services that are not funded through other state
or federal funding;

(6) the monthly cost of the alternative care services funded by the program for
this person does not exceed 75 percent of the monthly limit described under section
256B.0915, subdivision 3a. This monthly limit does not prohibit the alternative care
client from payment for additional services, but in no case may the cost of additional
services purchased under this section exceed the difference between the client's monthly
service limit defined under section 256B.0915, subdivision 3, and the alternative care
program monthly service limit defined in this paragraph. If care-related supplies and
equipment or environmental modifications and adaptations are or will be purchased for
an alternative care services recipient, the costs may be prorated on a monthly basis for
up to 12 consecutive months beginning with the month of purchase. If the monthly cost
of a recipient's other alternative care services exceeds the monthly limit established in
this paragraph, the annual cost of the alternative care services shall be determined. In this
event, the annual cost of alternative care services shall not exceed 12 times the monthly
limit described in this paragraph; and

(7) the person is making timely payments of the assessed monthly fee.

A person is ineligible if payment of the fee is over 60 days past due, unless the person
agrees to:

(i) the appointment of a representative payee;

(ii) automatic payment from a financial account;

(iii) the establishment of greater family involvement in the financial management of
payments; or

(iv) another method acceptable to the lead agency to ensure prompt fee payments.

The lead agency may extend the client's eligibility as necessary while making
arrangements to facilitate payment of past-due amounts and future premium payments.
Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
reinstated for a period of 30 days.

(b) Alternative care funding under this subdivision is not available for a person
who is a medical assistance recipient or who would be eligible for medical assistance
without a spenddown or waiver obligation. A person whose initial application for medical
assistance and the elderly waiver program is being processed may be served under the
alternative care program for a period up to 60 days. If the individual is found to be eligible
for medical assistance, medical assistance must be billed for services payable under the
federally approved elderly waiver plan and delivered from the date the individual was
found eligible for the federally approved elderly waiver plan. Notwithstanding this
provision, alternative care funds may not be used to pay for any service the cost of which:
(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
to participate in the federally approved elderly waiver program under the special income
standard provision.

(c) Alternative care funding is not available for a person who resides in a licensed
nursing home, certified boarding care home, hospital, or intermediate care facility, except
for case management services which are provided in support of the discharge planning
process for a nursing home resident or certified boarding care home resident to assist with
a relocation process to a community-based setting.

(d) Alternative care funding is not available for a person whose income is greater
than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
year for which alternative care eligibility is determined, who would be eligible for the
elderly waiver with a waiver obligation.

Sec. 35.

Minnesota Statutes 2008, section 256B.0915, subdivision 3e, is amended to
read:


Subd. 3e.

Customized living service rate.

(a) Payment for customized living
services shall be a monthly rate deleted text beginnegotiated anddeleted text end authorized by the lead agency within the
parameters established by the commissioner. The payment agreement must delineate the
deleted text begin services that have been customized for each recipient and specify thedeleted text end amount of each
new text begin component service included in the recipient's customized living new text endservice deleted text beginto be provideddeleted text endnew text begin
plan
new text end. The lead agency shall ensure that there is a documented need deleted text beginfor alldeleted text end new text beginwithin the
parameters established by the commissioner for all component customized living
new text endservices
authorized. deleted text beginCustomized living services must not include rent or raw food costs.
deleted text end

new text begin (b) new text endThe deleted text beginnegotiateddeleted text end payment rate must be based on new text beginthe amount of component new text endservices
to be providednew text begin utilizing component rates established by the commissioner. Counties and
tribes shall use tools issued by the commissioner to develop and document customized
living service plans and rates
new text end.

deleted text begin Negotiateddeleted text endnew text begin (c) Component servicenew text end rates must not exceed payment rates for
comparable elderly waiver or medical assistance services and must reflect economies of
scale. new text beginCustomized living services must not include rent or raw food costs.
new text end

deleted text begin (b)deleted text end new text begin(d) new text endThe individualized monthly deleted text beginnegotiateddeleted text endnew text begin authorizednew text end payment for new text beginthe
new text endcustomized living deleted text beginservicesdeleted text endnew text begin service plannew text end shall not exceed deleted text beginthe nonfederal share, in effect
on July 1 of the state fiscal year for which the rate limit is being calculated,
deleted text endnew text begin 50 percentnew text end
of the greater of either the statewide or any of the geographic groups' weighted average
monthly nursing facility rate of the case mix resident class to which the elderly waiver
eligible client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,
less the maintenance needs allowance as described in subdivision 1d, paragraph (a), until
the July 1 of the state fiscal year in which the resident assessment system as described
in section 256B.438 for nursing home rate determination is implemented. Effective on
July 1 of the state fiscal year in which the resident assessment system as described in
section 256B.438 for nursing home rate determination is implemented and July 1 of each
subsequent state fiscal year, the individualized monthly deleted text beginnegotiateddeleted text endnew text begin authorizednew text end payment
for the services described in this clause shall not exceed the limit deleted text begindescribed in this clausedeleted text end
which was in effect on June 30 of the previous state fiscal year deleted text beginand which has been
adjusted by the greater of any legislatively adopted home and community-based services
cost-of-living percentage increase or any legislatively adopted statewide percent rate
increase for nursing facilities
deleted text endnew text begin updated annually based on legislatively adopted changes to
all service rate maximums for home and community-based service providers
new text end.

deleted text begin (c)deleted text end new text begin(e) new text endCustomized living services are delivered by a provider licensed by the
Department of Health as a class A or class F home care provider and provided in a
building that is registered as a housing with services establishment under chapter 144D.

Sec. 36.

Minnesota Statutes 2008, section 256B.0915, subdivision 3h, is amended to
read:


Subd. 3h.

Service rate limits; 24-hour customized living services.

new text begin(a) new text endThe
payment rates for 24-hour customized living services deleted text beginisdeleted text end new text beginare new text enda monthly rate deleted text beginnegotiated anddeleted text end
authorized by the lead agency within the parameters established by the commissioner
of human services. The payment agreement must delineate the deleted text beginservices that have been
customized for each recipient and specify the
deleted text end amount of each new text begincomponent service included
in each recipient's customized living
new text endservice deleted text beginto be provideddeleted text endnew text begin plannew text end. The lead agency
shall ensure that there is a documented need new text beginwithin the parameters established by the
commissioner
new text endfor all new text begincomponent customized living new text endservices authorized. The lead agency
shall not authorize 24-hour customized living services unless there is a documented need
for 24-hour supervision.

new text begin (b) new text endFor purposes of this section, "24-hour supervision" means that the recipient
requires assistance due to needs related to one or more of the following:

(1) intermittent assistance with toileting or transferring;

(2) cognitive or behavioral issues;

(3) a medical condition that requires clinical monitoring; or

(4) other conditions or needs as defined by the commissioner of human services.
The lead agency shall ensure that the frequency and mode of supervision of the recipient
and the qualifications of staff providing supervision are described and meet the needs of
the recipient. deleted text beginCustomized living services must not include rent or raw food costs.
deleted text end

new text begin (c) new text endThe deleted text beginnegotiateddeleted text end payment rate for 24-hour customized living services must be
based on new text beginthe amount of component new text endservices to be providednew text begin utilizing component rates
established by the commissioner. Counties and tribes will use tools issued by the
commissioner to develop and document customized living plans and authorize rates
new text end.

deleted text begin Negotiateddeleted text endnew text begin (d) Component servicenew text end rates must not exceed payment rates for
comparable elderly waiver or medical assistance services and must reflect economies
of scale.

new text begin (e) new text endThe individually deleted text beginnegotiateddeleted text endnew text begin authorizednew text end 24-hour customized living payments,
in combination with the payment for other elderly waiver services, including case
management, must not exceed the recipient's community budget cap specified in
subdivision 3a.new text begin Customized living services must not include rent or raw food costs.
new text end

new text begin (f) The individually authorized 24-hour customized living payment rates shall not
exceed the 95 percentile of statewide monthly authorizations for 24-hour customized
living services in effect and in the Medicaid management information systems on March
31, 2009, for each case mix resident class under Minnesota Rules, parts 9549.0050
to 9549.0059, to which elderly waiver service clients are assigned. When there are
fewer than 50 authorizations in effect in the case mix resident class, the commissioner
shall multiply the calculated service payment rate maximum for the A classification by
the standard weight for that classification under Minnesota Rules, parts 9549.0050 to
9549.0059, to determine the applicable payment rate maximum. Service payment rate
maximums shall be updated annually based on legislatively adopted changes to all service
rates for home and community-based service providers.
new text end

new text begin (g) Notwithstanding the requirements of paragraphs (d) and (f), the commissioner
may establish an alternative payment rate system for 24-hour customized living services
by applying a single hourly rate for direct services provided in establishments, which
meet the following criteria:
new text end

new text begin (1) 24-hour customized living services must be provided in a shared living unit; and
new text end

new text begin (2) the unit is licensed as an adult foster care for no more than five residents or
licensed as a board and lodge facility with no more than ten residents.
new text end

Sec. 37.

Minnesota Statutes 2008, section 256B.0915, subdivision 5, is amended to
read:


Subd. 5.

Assessments and reassessments for waiver clients.

new text begin(a) new text endEach client
shall receive an initial assessment of strengths, informal supports, and need for services
in accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
client served under the elderly waiver must be conducted at least every 12 months and at
other times when the case manager determines that there has been significant change in
the client's functioning. This may include instances where the client is discharged from
the hospital.new text begin There must be a determination that the client requires nursing facility level of
care as defined in section 144.0724, subdivision 11, at initial and subsequent assessments
to initiate and maintain participation in the waiver program.
new text end

new text begin (b) Regardless of other assessments identified in section 144.0724, subdivision
4, as appropriate to determine nursing facility level of care for purposes of medical
assistance payment for nursing facility services, only face-to-face assessments conducted
according to section 256B.0911, subdivisions 3a and 3b, that result in a nursing facility
level of care determination will be accepted for purposes of initial and ongoing access to
waiver service payment.
new text end

Sec. 38.

Minnesota Statutes 2008, section 256B.0915, is amended by adding a
subdivision to read:


new text begin Subd. 10. new text end

new text begin Waiver payment rates; managed care organizations. new text end

new text begin The
commissioner shall adjust the elderly waiver capitation payment rates for managed care
organizations paid under section 256B.69, subdivisions 6a and 23, to reflect the maximum
service rate limits for customized living services and 24-hour customized living services
under subdivisions 3e and 3h for the contract period beginning January 1, 2010. Medical
assistance rates paid to customized living providers by managed care organizations
under this section shall not exceed the maximum service rate limits determined by the
commissioner under subdivisions 3e and 3h.
new text end

Sec. 39.

Minnesota Statutes 2008, section 256B.0917, is amended by adding a
subdivision to read:


new text begin Subd. 14. new text end

new text begin Essential community supports grants. new text end

new text begin (a) The purpose of the essential
community supports grant program is to provide targeted services to persons 65 years and
older who need essential community support, but whose needs do not meet the level of
care required for nursing facility placement under section 144.0724, subdivision 11.
new text end

new text begin (b) Within the limits of the appropriation and not to exceed $400 per person per
month, funding must be available to a person who:
new text end

new text begin (1) is age 65 or older;
new text end

new text begin (2) is not eligible for medical assistance;
new text end

new text begin (3) would otherwise be financially eligible for the alternative care program under
section 256B.0913, subdivision 4;
new text end

new text begin (4) has received a community assessment under section 256B.0911, subdivision 3a
or 3b, and does not require the level of care provided in a nursing facility;
new text end

new text begin (5) has a community support plan; and
new text end

new text begin (6) has been determined by a community assessment under section 256B.0911,
subdivision 3a or 3b, to be a person who would require provision of at least one of the
following services, as defined in the approved elderly waiver plan, in order to maintain
their community residence:
new text end

new text begin (i) caregiver support;
new text end

new text begin (ii) homemaker;
new text end

new text begin (iii) chore; or
new text end

new text begin (iv) a personal emergency response device or system.
new text end

new text begin (c) The person receiving any of the essential community supports in this subdivision
must also receive service coordination as part of their community support plan.
new text end

new text begin (d) A person who has been determined to be eligible for an essential community
support grant must be reassessed at least annually and continue to meet the criteria in
paragraph (b) to remain eligible for an essential community support grant.
new text end

new text begin (e) The commissioner shall allocate grants to counties and tribes under contract with
the department based upon the historic use of the medical assistance elderly waiver and
alternative care grant programs and other criteria as determined by the commissioner.
new text end

Sec. 40.

Minnesota Statutes 2008, section 256B.092, subdivision 8a, is amended to
read:


Subd. 8a.

County concurrence.

(a) If the county of financial responsibility wishes
to place a person in another county for services, the county of financial responsibility shall
seek concurrence from the proposed county of service and the placement shall be made
cooperatively between the two counties. Arrangements shall be made between the two
counties for ongoing social service, including annual reviews of the person's individual
service plan. The county where services are provided may not make changes in the
person's service plan without approval by the county of financial responsibility.

(b) When a person has been screened and authorized for services in an intermediate
care facility for persons with developmental disabilities or for home and community-based
services for persons with developmental disabilities, the case manager shall assist that
person in identifying a service provider who is able to meet the needs of the person
according to the person's individual service plan. If the identified service is to be provided
in a county other than the county of financial responsibility, the county of financial
responsibility shall request concurrence of the county where the person is requesting to
receive the identified services. The county of service may refuse to concur if:

(1) it can demonstrate that the provider is unable to provide the services identified in
the person's individual service plan as services that are needed and are to be provided;new text begin or
new text end

(2) in the case of an intermediate care facility for persons with developmental
disabilities, there has been no authorization for admission by the admission review team
as required in section 256B.0926deleted text begin; ordeleted text endnew text begin.
new text end

deleted text begin (3) in the case of home and community-based services for persons with
developmental disabilities, the county of service can demonstrate that the prospective
provider has failed to substantially comply with the terms of a past contract or has had a
prior contract terminated within the last 12 months for failure to provide adequate services,
or has received a notice of intent to terminate the contract.
deleted text end

(c) The county of service shall notify the county of financial responsibility of
concurrence or refusal to concur no later than 20 working days following receipt of the
written request. Unless other mutually acceptable arrangements are made by the involved
county agencies, the county of financial responsibility is responsible for costs of social
services and the costs associated with the development and maintenance of the placement.
The county of service may request that the county of financial responsibility purchase
case management services from the county of service or from a contracted provider
of case management when the county of financial responsibility is not providing case
management as defined in this section and rules adopted under this section, unless other
mutually acceptable arrangements are made by the involved county agencies. Standards
for payment limits under this section may be established by the commissioner. Financial
disputes between counties shall be resolved as provided in section 256G.09.

Sec. 41.

Minnesota Statutes 2008, section 256B.092, is amended by adding a
subdivision to read:


new text begin Subd. 11. new text end

new text begin Residential support services. new text end

new text begin (a) Upon federal approval, there is
established a new service called residential support that is available on the CAC, CADI,
DD, and TBI waivers. Existing waiver service descriptions must be modified to the extent
necessary to ensure there is no duplication between other services. Residential support
services must be provided by vendors licensed under category community residential
setting as defined in section 245A.11, subdivision 8.
new text end

new text begin (b) Residential support services must meet the following criteria:
new text end

new text begin (1) providers of residential support services must own or control the residential site;
new text end

new text begin (2) the residential site must not be the primary residence of the license holder;
new text end

new text begin (3) the residential site must have a designated program supervisor responsible for
program oversight, development, and implementation of policies and procedures;
new text end

new text begin (4) the provider of residential support services must provide supervision, training,
and assistance as described in the person's community support plan; and
new text end

new text begin (5) the provider of residential support services must meet the requirements of
licensure and additional requirements of the person's community support plan.
new text end

new text begin (c) Providers of residential support services that meet the definition in paragraph (a)
must be registered using a process determined by the commissioner beginning July 1, 2009.
new text end

Sec. 42.

Minnesota Statutes 2008, section 256B.37, subdivision 1, is amended to read:


Subdivision 1.

Subrogation.

Upon furnishing medical assistance new text beginor alternative
care services under section 256B.0913
new text endto any person who has private accident or health
care coverage, or receives or has a right to receive health or medical care from any
type of organization or entity, or has a cause of action arising out of an occurrence that
necessitated the payment of medical assistance, the state agency or the state agency's agent
shall be subrogated, to the extent of the cost of medical care furnished, to any rights the
person may have under the terms of the coverage, or against the organization or entity
providing or liable to provide health or medical care, or under the cause of action.

The right of subrogation created in this section includes all portions of the cause
of action, notwithstanding any settlement allocation or apportionment that purports to
dispose of portions of the cause of action not subject to subrogation.

Sec. 43.

Minnesota Statutes 2008, section 256B.37, subdivision 5, is amended to read:


Subd. 5.

Private benefits to be used first.

Private accident and health care coverage
including Medicare for medical services is primary coverage and must be exhausted before
medical assistance deleted text beginisdeleted text endnew text begin or alternative care services are new text end paid for medical services including
home health care, personal care assistant services, hospice, new text beginsupplies and equipment, new text endor
services covered under a Centers for Medicare and Medicaid Services waiver. When a
person who is otherwise eligible for medical assistance has private accident or health care
coverage, including Medicare or a prepaid health plan, the private health care benefits
available to the person must be used first and to the fullest extent.

Sec. 44.

Minnesota Statutes 2008, section 256B.437, subdivision 6, is amended to read:


Subd. 6.

Planned closure rate adjustment.

(a) The commissioner of human
services shall calculate the amount of the planned closure rate adjustment available under
subdivision 3, paragraph (b), for up to 5,140 beds according to clauses (1) to (4):

(1) the amount available is the net reduction of nursing facility beds multiplied
by $2,080;

(2) the total number of beds in the nursing facility or facilities receiving the planned
closure rate adjustment must be identified;

(3) capacity days are determined by multiplying the number determined under
clause (2) by 365; and

(4) the planned closure rate adjustment is the amount available in clause (1), divided
by capacity days determined under clause (3).

(b) A planned closure rate adjustment under this section is effective on the first day
of the month following completion of closure of the facility designated for closure in the
application and becomes part of the nursing facility's total operating payment rate.

(c) Applicants may use the planned closure rate adjustment to allow for a property
payment for a new nursing facility or an addition to an existing nursing facility or as an
operating payment rate adjustment. Applications approved under this subdivision are
exempt from other requirements for moratorium exceptions under section 144A.073,
subdivisions 2 and 3
.

(d) Upon the request of a closing facility, the commissioner must allow the facility a
closure rate adjustment as provided under section 144A.161, subdivision 10.

(e) A facility that has received a planned closure rate adjustment may reassign it
to another facility that is under the same ownership at any time within three years of its
effective date. The amount of the adjustment shall be computed according to paragraph (a).

(f) If the per bed dollar amount specified in paragraph (a), clause (1), is increased,
the commissioner shall recalculate planned closure rate adjustments for facilities that
delicense beds under this section on or after July 1, 2001, to reflect the increase in the per
bed dollar amount. The recalculated planned closure rate adjustment shall be effective
from the date the per bed dollar amount is increased.

new text begin (g) For planned closures approved after June 30, 2009, the commissioner of human
services shall calculate the amount of the planned closure rate adjustment available under
subdivision 3, paragraph (b), according to paragraph (a), clauses (1) to (4).
new text end

Sec. 45.

Minnesota Statutes 2008, section 256B.441, is amended by adding a
subdivision to read:


new text begin Subd. 59. new text end

new text begin Single-bed payments for medical assistance recipients.
new text end

new text begin Notwithstanding Minnesota Rules, part 9549.0070, subpart 3, beginning on October 1,
2009, the commissioner shall allow a single-bed payment rate for any medical assistance
recipient residing in a single-bed room regardless of having physician's orders for a
single-bed room. The amount of the single-bed payment shall be 110 percent of the
payment rate for the individual recipient. This subdivision does not affect the use of the
single-bed election under Minnesota Rules, part 9549.0060, subpart 11.
new text end

Sec. 46.

Minnesota Statutes 2008, section 256B.441, is amended by adding a
subdivision to read:


new text begin Subd. 60. new text end

new text begin Rebasing not to be implemented. new text end

new text begin Notwithstanding subdivisions 53 and
55, for rate years beginning on October 1, 2009, and after, no rate adjustments shall be
implemented under this section. For rate years beginning October 1, 2009, and after,
nursing facility rates shall be determined under section 256B.434.
new text end

Sec. 47.

Minnesota Statutes 2008, section 256B.49, subdivision 12, is amended to read:


Subd. 12.

Informed choice.

Persons who are determined likely to require the
level of care provided in a nursing facility new text beginas determined under sections 256B.0911 and
144.0724, subdivision 11,
new text endor hospital shall be informed of the home and community-based
support alternatives to the provision of inpatient hospital services or nursing facility
services. Each person must be given the choice of either institutional or home and
community-based services using the provisions described in section 256B.77, subdivision
2
, paragraph (p).

Sec. 48.

Minnesota Statutes 2008, section 256B.49, subdivision 13, is amended to read:


Subd. 13.

Case management.

(a) Each recipient of a home and community-based
waiver shall be provided case management services by qualified vendors as described
in the federally approved waiver application. The case management service activities
provided will include:

(1) assessing the needs of the individual within 20 working days of a recipient's
request;

(2) developing the written individual service plan within ten working days after the
assessment is completed;

(3) informing the recipient or the recipient's legal guardian or conservator of service
options;

(4) assisting the recipient in the identification of potential service providers;

(5) assisting the recipient to access services;

(6) coordinating, evaluating, and monitoring of the services identified in the service
plan;

(7) completing the annual reviews of the service plan; and

(8) informing the recipient or legal representative of the right to have assessments
completed and service plans developed within specified time periods, and to appeal county
action or inaction under section 256.045, subdivision 3new text begin, including the determination of
nursing facility level of care
new text end.

(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including
assessments, reassessments, and care plan development.

Sec. 49.

Minnesota Statutes 2008, section 256B.49, subdivision 14, is amended to read:


Subd. 14.

Assessment and reassessment.

(a) Assessments of each recipient's
strengths, informal support systems, and need for services shall be completed within
20 working days of the recipient's request. Reassessment of each recipient's strengths,
support systems, and need for services shall be conducted at least every 12 months and at
other times when there has been a significant change in the recipient's functioning.

(b) new text beginThere must be a determination that the client requires a hospital level of care or a
nursing facility level of care as defined in section 144.0724, subdivision 11, at initial and
subsequent assessments to initiate and maintain participation in the waiver program.
new text end

new text begin (c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
appropriate to determine nursing facility level of care for purposes of medical assistance
payment for nursing facility services, only face-to-face assessments conducted according
to section 256B.0911, subdivisions 3a, 3b, and 4d, that result in a hospital level of care
determination or a nursing facility level of care determination must be accepted for
purposes of initial and ongoing access to waiver services payment.
new text end

new text begin (d) new text endPersons with developmental disabilities who apply for services under the nursing
facility level waiver programs shall be screened for the appropriate level of care according
to section 256B.092.

deleted text begin (c)deleted text end new text begin(e) new text endRecipients who are found eligible for home and community-based services
under this section before their 65th birthday may remain eligible for these services after
their 65th birthday if they continue to meet all other eligibility factors.

Sec. 50.

Minnesota Statutes 2008, section 256B.49, is amended by adding a
subdivision to read:


new text begin Subd. 22. new text end

new text begin Residential support services. new text end

new text begin For the purposes of this section, the
provisions of section 256B.092, subdivision 11, are controlling.
new text end

Sec. 51.

new text begin [256B.4912] HOME AND COMMUNITY-BASED WAIVERS;
PROVIDERS AND PAYMENT.
new text end

new text begin Subdivision 1. new text end

new text begin Provider qualifications. new text end

new text begin For the home and community-based
waivers providing services to seniors and individuals with disabilities, the commissioner
shall establish:
new text end

new text begin (1) agreements with enrolled waiver service providers to ensure providers meet
qualifications defined in the waiver plans;
new text end

new text begin (2) regular reviews of provider qualifications; and
new text end

new text begin (3) processes to gather the necessary information to determine provider
qualifications.
new text end

new text begin By July 2010, staff that provide direct contact, as defined in section 245C.02, subdivision
11, that are employees of waiver service providers must meet the requirements of chapter
245C prior to providing waiver services and as part of ongoing enrollment. Upon federal
approval, this requirement must also apply to consumer-directed community supports.
new text end

new text begin Subd. 2. new text end

new text begin Rate-setting methodologies. new text end

new text begin The commissioner shall establish
statewide rate-setting methodologies that meet federal waiver requirements for home
and community-based waiver services for individuals with disabilities. The rate-setting
methodologies must abide by the principles of transparency and equitability across the
state. The methodologies must involve a uniform process of structuring rates for each
service and must promote quality and participant choice.
new text end

Sec. 52.

Minnesota Statutes 2008, section 256B.5012, is amended by adding a
subdivision to read:


new text begin Subd. 8. new text end

new text begin ICF/MR rate decreases effective July 1, 2009. new text end

new text begin The commissioner shall
decrease each facility reimbursed under this section operating payment adjustments
equal to 3.0 percent of the operating payment rates in effect on June 30, 2009. For each
facility, the commissioner shall implement the rate reduction, based on occupied beds,
using the percentage specified in this subdivision multiplied by the total payment rate,
including the variable rate but excluding the property-related payment rate, in effect on
the preceding date. The total rate reduction shall include the adjustment provided in
section 256B.502, subdivision 7.
new text end

Sec. 53. new text beginCOLA COMPENSATION REQUIREMENTS.
new text end

new text begin Effective July 1, 2009, providers who received rate increases under Laws 2007,
chapter 147, article 7, section 71, as amended by Laws 2008, chapter 363, article 15,
section 17, and Minnesota Statutes, section 256B.5012, subdivision 7, for state fiscal years
2008 and 2009 are no longer required to continue or retain employee compensation or
wage-related increases required by those sections.
new text end

Sec. 54. new text beginAGING AND DISABILITY SERVICES FOR ADULTS.
new text end

new text begin (a) The commissioner of human services shall form a work group with counties, in
consultation with other stakeholders, to develop recommendations and priorities for the
portion of funding to be allocated to counties for aging and disability services for adults.
This funding must be transferred from the Children and Community Services Act (CCSA)
distribution beginning July 1, 2011, and the CCSA distribution of county social services
block grant funds beginning January 1, 2011.
new text end

new text begin (b) Starting January 1, 2011, funding for aging and disability services for adults
must be governed under the CCSA under Minnesota Statutes, chapter 256M, pending final
enactment of the legislation in paragraph (d).
new text end

new text begin (c) The work group's recommendations must include:
new text end

new text begin (1) identification of the priorities and targeted activities for this funding; and
new text end

new text begin (2) the funding allocation method to counties that must be effective January 1, 2011.
new text end

new text begin (d) The commissioner shall draft legislation for the 2010 legislative session that is
necessary for the implementation of this funding allocation method. This allocation shall
thereafter be referred to as the "Protecting Adults Act."
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 55. new text beginPROVIDER RATE AND GRANT REDUCTIONS.
new text end

new text begin (a) The commissioner of human services shall decrease grants, allocations,
reimbursement rates, or rate limits, as applicable, by 3.0 percent effective July 1, 2009, for
services rendered on or after that date. County or tribal contracts for services specified
in this section must be amended to pass through these rate reductions within 60 days of
the effective date of the decrease and must be retroactive from the effective date of the
rate decrease.
new text end

new text begin (b) The annual rate decreases described in this section must be provided to:
new text end

new text begin (1) home and community-based waivered services for persons with developmental
disabilities or related conditions, including consumer-directed community supports, under
Minnesota Statutes, section 256B.501;
new text end

new text begin (2) home and community-based waivered services for the elderly, including
consumer-directed community supports, under Minnesota Statutes, section 256B.0915;
new text end

new text begin (3) waivered services under community alternatives for disabled individuals,
including consumer-directed community supports, under Minnesota Statutes, section
256B.49;
new text end

new text begin (4) community alternative care waivered services, including consumer-directed
community supports, under Minnesota Statutes, section 256B.49;
new text end

new text begin (5) traumatic brain injury waivered services, including consumer-directed
community supports, under Minnesota Statutes, section 256B.49;
new text end

new text begin (6) nursing services and home health services under Minnesota Statutes, section
256B.0625, subdivision 6a;
new text end

new text begin (7) personal care services and qualified professional supervision of personal care
services under Minnesota Statutes, section 256B.0625, subdivisions 6a and 19a;
new text end

new text begin (8) private duty nursing services under Minnesota Statutes, section 256B.0625,
subdivision 7;
new text end

new text begin (9) day training and habilitation services for adults with developmental disabilities
or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
additional cost of rate adjustments on day training and habilitation services, provided as a
social service under Minnesota Statutes, section 256M.60;
new text end

new text begin (10) alternative care services under Minnesota Statutes, section 256B.0913;
new text end

new text begin (11) the group residential housing supplementary service rate under Minnesota
Statutes, section 256I.05, subdivision 1a;
new text end

new text begin (12) semi-independent living services (SILS) under Minnesota Statutes, section
252.275, including SILS funding under county social services grants formerly funded
under Minnesota Statutes, chapter 256I;
new text end

new text begin (13) community support services for deaf and hard-of-hearing adults with mental
illness who use or wish to use sign language as their primary means of communication
under Minnesota Statutes, section 256.01, subdivision 2; and deaf and hard-of-hearing
grants under Minnesota Statutes, sections 256C.233 and 256C.25; Laws 1985, chapter 9;
and Laws 1997, First Special Session chapter 5, section 20;
new text end

new text begin (14) physical therapy services under Minnesota Statutes, sections 256B.0625,
subdivision 8, and 256D.03, subdivision 4;
new text end

new text begin (15) occupational therapy services under Minnesota Statutes, sections 256B.0625,
subdivision 8a, and 256D.03, subdivision 4;
new text end

new text begin (16) speech-language therapy services under Minnesota Statutes, section 256D.03,
subdivision 4, and Minnesota Rules, part 9505.0390;
new text end

new text begin (17) respiratory therapy services under Minnesota Statutes, section 256D.03,
subdivision 4, and Minnesota Rules, part 9505.0295;
new text end

new text begin (18) consumer support grants under Minnesota Statutes, section 256.476;
new text end

new text begin (19) family support grants under Minnesota Statutes, section 252.32;
new text end

new text begin (20) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917,
and 256B.0928;
new text end

new text begin (21) disability linkage line grants under Minnesota Statutes, section 256.01,
subdivision 24; and
new text end

new text begin (22) housing access grants under Minnesota Statutes, section 256B.0658.
new text end

new text begin (c) A managed care plan receiving state payments for the services in this section
must include these decreases in their payments to providers effective on January 1
following the effective date of the rate decrease.
new text end

Sec. 56. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin Subdivision 1. new text end

new text begin Renumbering of Minnesota Statutes, section 256B.0652,
authorization and review of home care services.
new text end

new text begin (a) The revisor of statutes shall
renumber each section of Minnesota Statutes listed in column A with the number in
column B.
new text end

new text begin Column A
new text end
new text begin Column B
new text end
new text begin 256B.0652, subdivision 3
new text end
new text begin 256B.0652, subdivision 14
new text end
new text begin 256B.0651, subdivision 6, paragraph (a)
new text end
new text begin 256B.0652, subdivision 3
new text end
new text begin 256B.0651, subdivision 6, paragraph (b)
new text end
new text begin 256B.0652, subdivision 4
new text end
new text begin 256B.0651, subdivision 6, paragraph (c)
new text end
new text begin 256B.0652, subdivision 7
new text end
new text begin 256B.0651, subdivision 7, paragraph (a)
new text end
new text begin 256B.0652, subdivision 8
new text end
new text begin 256B.0651, subdivision 7, paragraph (b)
new text end
new text begin 256B.0652, subdivision 14
new text end
new text begin 256B.0651, subdivision 8
new text end
new text begin 256B.0652, subdivision 9
new text end
new text begin 256B.0651, subdivision 9
new text end
new text begin 256B.0652, subdivision 10
new text end
new text begin 256B.0651, subdivision 11
new text end
new text begin 256B.0652, subdivision 11
new text end
new text begin 256B.0654, subdivision 2
new text end
new text begin 256B.0652, subdivision 5
new text end
new text begin 256B.0655, subdivision 4
new text end
new text begin 256B.0652, subdivision 6
new text end

new text begin (b) The revisor of statutes shall make necessary cross-reference changes in statutes
and rules consistent with the renumbering in paragraph (a). The Department of Human
Services shall assist the revisor with any cross-reference changes. The revisor may make
changes necessary to correct the punctuation, grammar, or structure of the remaining text
to conform with the intent of the renumbering in paragraph (a).
new text end

new text begin Subd. 2. new text end

new text begin Renumbering personal care assistance services. new text end

new text begin The revisor of statutes
shall replace any reference to Minnesota Statutes, section 256B.0655 with section
256B.0659, wherever it appears in statutes or rules. The revisor shall correct any cross
reference changes that are necessary as a result of this section. The Department of Human
Services shall assist the revisor in making these changes, and if necessary, shall draft a
corrections bill with changes for introduction in the 2010 legislative session. The revisor
may make changes to punctuation, grammar, or sentence structure to preserve the integrity
of statutes and effectuate the intention of this section.
new text end

Sec. 57. new text begin REPEALER.
new text end

new text begin (a) Minnesota Statutes 2008, sections 256B.19, subdivision 1d; and 256B.431,
subdivision 23,
new text end new text begin are repealed effective May 1, 2009.
new text end

new text begin (b) new text end new text begin Laws 1988, chapter 689, section 251, new text end new text begin is repealed effective July 1, 2009.
new text end

new text begin (c) new text end new text begin Minnesota Statutes 2008, section 256B.0951, new text end new text begin is repealed effective July 1, 2009.
new text end

new text begin (d) new text end new text begin Minnesota Statutes 2008, sections 256B.0655, subdivisions 1, 1a, 1b, 1c, 1d,
1e, 1f, 1g, 1h, 1i, 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, and 13; and 256B.071, subdivisions 1,
2, 3, and 4,
new text end new text begin are repealed.
new text end

ARTICLE 2

MFIP/CHILD CARE

Section 1.

Minnesota Statutes 2008, section 119B.09, subdivision 7, is amended to read:


Subd. 7.

Date of eligibility for assistance.

(a) The date of eligibility for child
care assistance under this chapter is the later of the date the application was signed; the
beginning date of employment, education, or training; the date the infant is born for
applicants to the at-home infant care program; or the date a determination has been made
that the applicant is a participant in employment and training services under Minnesota
Rules, part 3400.0080, or chapter 256J.

(b) Payment ceases for a family under the at-home infant child care program when a
family has used a total of 12 months of assistance as specified under section 119B.035.
Payment of child care assistance for employed persons on MFIP is effective the date of
employment or the date of MFIP eligibility, whichever is later. Payment of child care
assistance for MFIP or DWP participants in employment and training services is effective
the date of commencement of the services or the date of MFIP or DWP eligibility,
whichever is later. Payment of child care assistance for transition year child care must be
made retroactive to the date of eligibility for transition year child care.

new text begin (c) Notwithstanding paragraph (b), payment of child care assistance for participants
eligible under section 119B.05 may only be made retroactive for a maximum of six
months from the date of application for child care assistance.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2009.
new text end

Sec. 2.

Minnesota Statutes 2008, section 119B.12, subdivision 1, is amended to read:


Subdivision 1.

Fee schedule.

In setting the sliding fee schedule, the commissioner
shall exclude from the amount of income used to determine eligibility an amount for
federal and state income and Social Security taxes attributable to that income level
according to federal and state standardized tax tables. The commissioner shall base the
parent fee on the ability of the family to pay for child care. The fee schedule must be
designed to use any available tax credits.

PARENT FEE SCHEDULE. The parent fee schedule is as follows, except as noted
in subdivision 2:

Income Range (as a percent of the state
median income, except at the start of the
first tier)
Co-payment (as a percentage of adjusted
gross income)
0-74.99% of federal poverty guidelines
$0/month
75.00-99.99% of federal poverty guidelines
$5/month
100.00% of federal poverty
guidelines-27.72%
deleted text begin 2.61% deleted text end new text begin 2.69%
new text end
27.73-29.04%
deleted text begin 2.61% deleted text end new text begin 2.69%
new text end
29.05-30.36%
deleted text begin 2.61% deleted text end new text begin 2.69%
new text end
30.37-31.68%
deleted text begin 2.61% deleted text end new text begin 2.69%
new text end
31.69-33.00%
deleted text begin 2.91% deleted text end new text begin 3.00%
new text end
33.01-34.32%
deleted text begin 2.91% deleted text end new text begin 3.00%
new text end
34.33-35.65%
deleted text begin 2.91% deleted text end new text begin 3.00%
new text end
35.66-36.96%
deleted text begin 2.91% deleted text end new text begin 3.00%
new text end
36.97-38.29%
deleted text begin 3.21% deleted text end new text begin 3.31%
new text end
38.30-39.61%
deleted text begin 3.21% deleted text end new text begin 3.31%
new text end
39.62-40.93%
deleted text begin 3.21% deleted text end new text begin 3.31%
new text end
40.94-42.25%
deleted text begin 3.84% deleted text end new text begin 3.96%
new text end
42.26-43.57%
deleted text begin 3.84% deleted text end new text begin 3.96%
new text end
43.58-44.89%
deleted text begin 4.46% deleted text end new text begin 4.59%
new text end
44.90-46.21%
deleted text begin 4.76% deleted text end new text begin 4.90%
new text end
46.22-47.53%
deleted text begin 5.05% deleted text end new text begin 5.20%
new text end
47.54-48.85%
deleted text begin 5.65% deleted text end new text begin 5.82%
new text end
48.86-50.17%
deleted text begin 5.95% deleted text end new text begin 6.13%
new text end
50.18-51.49%
deleted text begin 6.24% deleted text end new text begin 6.43%
new text end
51.50-52.81%
deleted text begin 6.84% deleted text end new text begin 7.05%
new text end
52.82-54.13%
deleted text begin 7.58% deleted text end new text begin 7.81%
new text end
54.14-55.45%
deleted text begin 8.33% deleted text end new text begin 8.58%
new text end
55.46-56.77%
deleted text begin 9.20% deleted text end new text begin 9.48%
new text end
56.78-58.09%
deleted text begin 10.07% deleted text end new text begin 10.37%
new text end
58.10-59.41%
deleted text begin 10.94% deleted text end new text begin 11.27%
new text end
59.42-60.73%
deleted text begin 11.55% deleted text end new text begin 11.90%
new text end
60.74-62.06%
deleted text begin 12.16% deleted text end new text begin 12.52%
new text end
62.07-63.38%
deleted text begin 12.77% deleted text end new text begin 13.15%
new text end
63.39-64.70%
deleted text begin 13.38% deleted text end new text begin 13.78%
new text end
64.71-66.99%
deleted text begin 14.00% deleted text end new text begin 14.42%
new text end
67.00%
ineligible

A family's monthly co-payment fee is the fixed percentage established for the
income range multiplied by the highest possible income within that income range.

Sec. 3.

Minnesota Statutes 2008, section 119B.13, subdivision 1, is amended to read:


Subdivision 1.

Subsidy restrictions.

(a) Beginning July 1, deleted text begin2006deleted text endnew text begin 2009new text end, the
maximum rate paid for child care assistance in any county or multicounty region under the
child care fund shall be the rate for like-care arrangements in the county effective deleted text beginJanuary
1, 2006, increased
deleted text endnew text begin July 1, 2008, decreased new text end by deleted text beginsixdeleted text endnew text begin threenew text end percent.

deleted text begin (b) Rate changes shall be implemented for services provided in September 2006
unless a participant eligibility redetermination or a new provider agreement is completed
between July 1, 2006, and August 31, 2006.
deleted text end

deleted text begin As necessary, appropriate notice of adverse action must be made according to
Minnesota Rules, part 3400.0185, subparts 3 and 4.
deleted text end

deleted text begin New cases approved on or after July 1, 2006, shall have the maximum rates under
paragraph (a), implemented immediately.
deleted text end

deleted text begin (c)deleted text end new text begin(b) new text endEvery year, the commissioner shall survey rates charged by child care
providers in Minnesota to determine the 75th percentile for like-care arrangements in
counties. When the commissioner determines that, using the commissioner's established
protocol, the number of providers responding to the survey is too small to determine
the 75th percentile rate for like-care arrangements in a county or multicounty region,
the commissioner may establish the 75th percentile maximum rate based on like-care
arrangements in a county, region, or category that the commissioner deems to be similar.

deleted text begin (d)deleted text end new text begin(c) new text endA rate which includes a special needs rate paid under subdivision 3 or under a
school readiness service agreement paid under section 119B.231, may be in excess of the
maximum rate allowed under this subdivision.

deleted text begin (e)deleted text end new text begin(d) new text endThe department shall monitor the effect of this paragraph on provider rates.
The county shall pay the provider's full charges for every child in care up to the maximum
established. The commissioner shall determine the maximum rate for each type of care on
an hourly, full-day, and weekly basis, including special needs and disability care.

deleted text begin (f)deleted text end new text begin(e) new text endWhen the provider charge is greater than the maximum provider rate allowed,
the parent is responsible for payment of the difference in the rates in addition to any
family co-payment fee.

deleted text begin (g)deleted text end new text begin(f) new text endAll maximum provider rates changes shall be implemented on the Monday
following the effective date of the maximum provider rate.

Sec. 4.

Minnesota Statutes 2008, section 119B.13, subdivision 6, is amended to read:


Subd. 6.

Provider payments.

(a) Counties or the state shall make vendor payments
to the child care provider or pay the parent directly for eligible child care expenses.

(b) If payments for child care assistance are made to providers, the provider shall
bill the county for services provided within ten days of the end of the service period. If
bills are submitted within ten days of the end of the service period, a county or the state
shall issue payment to the provider of child care under the child care fund within 30 days
of receiving a bill from the provider. Counties or the state may establish policies that
make payments on a more frequent basis.

(c) deleted text beginAll billsdeleted text end new text beginIf a provider has received an authorization of care and been issued a
billing form for an eligible family, the bill
new text endmust be submitted within 60 days of the last
date of service on the bill. A county may pay a bill submitted more than 60 days after
the last date of service if the provider shows good cause why the bill was not submitted
within 60 days. Good cause must be defined in the county's child care fund plan under
section 119B.08, subdivision 3, and the definition of good cause must include county
error. A county may not pay any bill submitted more than a year after the last date of
service on the bill.

new text begin (d) If a provider provided care for a time period without receiving an authorization
of care and a billing form for an eligible family, payment of child care assistance may only
be made retroactively for a maximum of six months from the date the provider is issued
an authorization of care and billing form.
new text end

deleted text begin (d)deleted text end new text begin(e) new text endA county may stop payment issued to a provider or may refuse to pay a
bill submitted by a provider if:

(1) the provider admits to intentionally giving the county materially false information
on the provider's billing forms; or

(2) a county finds by a preponderance of the evidence that the provider intentionally
gave the county materially false information on the provider's billing forms.

deleted text begin (e)deleted text end new text begin(f) new text endA county's payment policies must be included in the county's child care plan
under section 119B.08, subdivision 3. If payments are made by the state, in addition to
being in compliance with this subdivision, the payments must be made in compliance
with section 16A.124.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective October 1, 2009.
new text end

Sec. 5.

Minnesota Statutes 2008, section 256J.20, subdivision 3, is amended to read:


Subd. 3.

Other property limitations.

To be eligible for MFIP, the equity value of
all nonexcluded real and personal property of the assistance unit must not exceed $2,000
for applicants and $5,000 for ongoing participants. The value of assets in clauses (1) to
(19) must be excluded when determining the equity value of real and personal property:

(1) a licensed vehicle up to a loan value of less than or equal to deleted text begin$15,000deleted text endnew text begin $7,500new text end. deleted text beginIf the
assistance unit owns more than one licensed vehicle, the county agency shall determine the
loan value of all additional vehicles and exclude the combined loan value of less than or
equal to $7,500.
deleted text end The county agency shall apply any excess loan value as if it were equity
value to the asset limit described in this sectiondeleted text begin,deleted text endnew text begin. If the assistance unit owns more than
one licensed vehicle, the county agency shall determine the vehicle with the highest loan
value and count only the loan value over $7,500,
new text end excluding: (i) the value of one vehicle
per physically disabled person when the vehicle is needed to transport the disabled unit
member; this exclusion does not apply to mentally disabled people; (ii) the value of special
equipment for a disabled member of the assistance unit; and (iii) any vehicle used for
long-distance travel, other than daily commuting, for the employment of a unit member.

new text begin The county agency shall count the loan value of all other vehicles and apply this
amount as if it were equity value to the asset limit described in this section.
new text endTo establish the
loan value of vehicles, a county agency must use the N.A.D.A. Official Used Car Guide,
Midwest Edition, for newer model cars. When a vehicle is not listed in the guidebook,
or when the applicant or participant disputes the loan value listed in the guidebook as
unreasonable given the condition of the particular vehicle, the county agency may require
the applicant or participant document the loan value by securing a written statement from
a motor vehicle dealer licensed under section 168.27, stating the amount that the dealer
would pay to purchase the vehicle. The county agency shall reimburse the applicant or
participant for the cost of a written statement that documents a lower loan value;

(2) the value of life insurance policies for members of the assistance unit;

(3) one burial plot per member of an assistance unit;

(4) the value of personal property needed to produce earned income, including
tools, implements, farm animals, inventory, business loans, business checking and
savings accounts used at least annually and used exclusively for the operation of a
self-employment business, and any motor vehicles if at least 50 percent of the vehicle's use
is to produce income and if the vehicles are essential for the self-employment business;

(5) the value of personal property not otherwise specified which is commonly
used by household members in day-to-day living such as clothing, necessary household
furniture, equipment, and other basic maintenance items essential for daily living;

(6) the value of real and personal property owned by a recipient of Supplemental
Security Income or Minnesota supplemental aid;

(7) the value of corrective payments, but only for the month in which the payment
is received and for the following month;

(8) a mobile home or other vehicle used by an applicant or participant as the
applicant's or participant's home;

(9) money in a separate escrow account that is needed to pay real estate taxes or
insurance and that is used for this purpose;

(10) money held in escrow to cover employee FICA, employee tax withholding,
sales tax withholding, employee worker compensation, business insurance, property rental,
property taxes, and other costs that are paid at least annually, but less often than monthly;

(11) monthly assistance payments for the current month's or short-term emergency
needs under section 256J.626, subdivision 2;

(12) the value of school loans, grants, or scholarships for the period they are
intended to cover;

(13) payments listed in section 256J.21, subdivision 2, clause (9), which are held
in escrow for a period not to exceed three months to replace or repair personal or real
property;

(14) income received in a budget month through the end of the payment month;

(15) savings from earned income of a minor child or a minor parent that are set aside
in a separate account designated specifically for future education or employment costs;

(16) the federal earned income credit, Minnesota working family credit, state and
federal income tax refunds, state homeowners and renters credits under chapter 290A,
property tax rebates and other federal or state tax rebates in the month received and the
following month;

(17) payments excluded under federal law as long as those payments are held in a
separate account from any nonexcluded funds;

(18) the assets of children ineligible to receive MFIP benefits because foster care or
adoption assistance payments are made on their behalf; and

(19) the assets of persons whose income is excluded under section 256J.21,
subdivision 2
, clause (43).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 6.

Minnesota Statutes 2008, section 256J.24, subdivision 5a, is amended to read:


Subd. 5a.

Food portion of MFIP transitional standard.

The commissioner
shall adjust the food portion of the MFIP transitional standard deleted text beginby October 1 each year
beginning October 1998
deleted text endnew text begin as needednew text end to reflect deleted text beginthe cost-of-livingdeleted text end adjustments to the food
deleted text begin Stampdeleted text endnew text begin supportnew text end program. The commissioner shall deleted text beginannuallydeleted text end publish deleted text beginin the State Registerdeleted text end
the transitional standard for an assistance unit of sizes one to tennew text begin in the State Register
whenever an adjustment is made
new text end.

Sec. 7.

Minnesota Statutes 2008, section 256J.24, subdivision 10, is amended to read:


Subd. 10.

MFIP exit level.

The commissioner shall adjust the MFIP earned income
disregard to ensure that most participants do not lose eligibility for MFIP until their
income reaches at least deleted text begin115deleted text endnew text begin 110new text end percent of the federal poverty guidelines in effect deleted text beginin
October of each fiscal year
deleted text endnew text begin at the time of the adjustmentnew text end. The adjustment to the disregard
shall be based on a household size of three, and the resulting earned income disregard
percentage must be applied to all household sizes. The adjustment under this subdivision
must be implemented deleted text beginat the same time as the October food stamp ordeleted text endnew text begin whenever there is anew text end
food support deleted text begincost-of-livingdeleted text end adjustment deleted text beginisdeleted text end reflected in the food portion of MFIP transitional
standard as required under subdivision 5a.

Sec. 8.

Minnesota Statutes 2008, section 256J.37, subdivision 3a, is amended to read:


Subd. 3a.

Rental subsidies; unearned income.

(a) deleted text beginEffective July 1, 2003,deleted text end The
county agency shall count deleted text begin$50deleted text end new text begin$100 new text endof the value of public and assisted rental subsidies
provided through the Department of Housing and Urban Development (HUD) as unearned
income to the cash portion of the MFIP grant. The full amount of the subsidy must be
counted as unearned income when the subsidy is less than deleted text begin$50deleted text endnew text begin $100new text end. The income from
this subsidy shall be budgeted according to section 256J.34.

(b) The provisions of this subdivision shall not apply to an MFIP assistance unit
which includes a participant who is:

(1) age 60 or older;

(2) a caregiver who is suffering from an illness, injury, or incapacity that has been
certified by a qualified professional when the illness, injury, or incapacity is expected
to continue for more than 30 days and prevents the person from obtaining or retaining
employment; or

(3) a caregiver whose presence in the home is required due to the illness or
incapacity of another member in the assistance unit, a relative in the household, or a foster
child in the household when the illness or incapacity and the need for the participant's
presence in the home has been certified by a qualified professional and is expected to
continue for more than 30 days.

(c) The provisions of this subdivision shall not apply to an MFIP assistance unit
where the parental caregiver is an SSI recipient.

(d) Prior to implementing this provision, the commissioner must identify the MFIP
participants subject to this provision and provide written notice to these participants at
least 30 days before the first grant reduction. The notice must inform the participant of the
basis for the potential grant reduction, the exceptions to the provision, if any, and inform
the participant of the steps necessary to claim an exception. A person who is found not to
meet one of the exceptions to the provision must be notified and informed of the right to a
fair hearing under section 256J.40. The notice must also inform the participant that the
participant may be eligible for a rent reduction resulting from a reduction in the MFIP
grant and encourage the participant to contact the local housing authority.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective February 1, 2010.
new text end

Sec. 9.

Minnesota Statutes 2008, section 256J.37, is amended by adding a subdivision
to read:


new text begin Subd. 11. new text end

new text begin Treatment of Supplemental Security Income. new text end

new text begin Effective March 1,
2010, the county shall reduce the cash portion of the MFIP grant by up to $125 for an
MFIP assistance unit that includes one or more Supplemental Security Income (SSI)
recipients who reside in the household, and who would otherwise be included in the MFIP
assistance unit under section 256J.24, subdivision 2, but are excluded solely due to the
SSI recipient status under section 256J.24, subdivision 3, paragraph (a), clause (1). If
the SSI recipient or recipients receive less than $125 of SSI, only the amount received
must be used in calculating the MFIP cash assistance payment. This provision does not
apply to relative caregivers who could elect to be included in the MFIP assistance unit
under section 256J.24, subdivision 4, unless the caregiver's children or stepchildren are
included in the MFIP assistance unit.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 10.

Minnesota Statutes 2008, section 256J.53, subdivision 2, is amended to read:


Subd. 2.

Approval of postsecondary education or training.

(a) In order for a
postsecondary education or training program to be an approved activity in an employment
plan, the deleted text beginplan must include additional work activities if the education and training
activities do not meet the minimum hours required to meet the federal work participation
rate under Code of Federal Regulations, title 45, sections 261.31 and 261.35
deleted text endnew text begin participant
must be working in unsubsidized employment at least 20 hours per week
new text end.

(b) Participants seeking approval of a postsecondary education or training plan
must provide documentation that:

(1) the employment goal can only be met with the additional education or training;

(2) there are suitable employment opportunities that require the specific education or
training in the area in which the participant resides or is willing to reside;

(3) the education or training will result in significantly higher wages for the
participant than the participant could earn without the education or training;

(4) the participant can meet the requirements for admission into the program; and

(5) there is a reasonable expectation that the participant will complete the training
program based on such factors as the participant's MFIP assessment, previous education,
training, and work history; current motivation; and changes in previous circumstances.

new text begin (c) The hourly unsubsidized employment requirement may be reduced for intensive
education or training programs lasting 12 weeks or less when full-time attendance is
required.
new text end

new text begin (d) Participants with an approved employment plan in place on July 1, 2009, which
includes more than 12 months of postsecondary education or training, must be allowed
to complete that plan provided that hourly requirements in section 256J.55, subdivision
1, are met.
new text end

Sec. 11.

Minnesota Statutes 2008, section 256J.575, subdivision 3, is amended to read:


Subd. 3.

Eligibility.

(a) The following MFIP deleted text beginor diversionary work program (DWP)deleted text end
participants are eligible for the services under this section:

(1) a participant who meets the requirements for or has been granted a hardship
extension under section 256J.425, subdivision 2 or 3, except that it is not necessary for
the participant to have reached or be approaching 60 months of eligibility for this section
to apply;

(2) a participant who is applying for Supplemental Security Income or Social
Security disability insurance; and

(3) a participant who is a noncitizen who has been in the United States for 12 or
fewer months.

(b) Families must meet all other eligibility requirements for MFIP established in
this chapter. Families are eligible for financial assistance to the same extent as if they
were participating in MFIP.

(c) A participant under paragraph (a), clause (3), must be provided with English as a
second language opportunities and skills training for up to 12 months. After 12 months,
the case manager and participant must determine whether the participant should continue
with English as a second language classes or skills training, or both, and continue to
receive family stabilization services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 12.

Minnesota Statutes 2008, section 256J.621, is amended to read:


256J.621 WORK PARTICIPATION CASH BENEFITS.

(a) Effective October 1, 2009, upon exiting the diversionary work program (DWP)
or upon terminating the Minnesota family investment program with earnings, a participant
who is employed may be eligible for work participation cash benefits of deleted text begin$75deleted text endnew text begin $50new text end per
month to assist in meeting the family's basic needs as the participant continues to move
toward self-sufficiency.

(b) To be eligible for work participation cash benefits, the participant shall not
receive MFIP or diversionary work program assistance during the month and the
participant or participants must meet the following work requirements:

(1) if the participant is a single caregiver and has a child under six years of age, the
participant must be employed at least 87 hours per month;

(2) if the participant is a single caregiver and does not have a child under six years of
age, the participant must be employed at least 130 hours per month; or

(3) if the household is a two-parent family, at least one of the parents must be
employed an average of at least 130 hours per month.

Whenever a participant exits the diversionary work program or is terminated from
MFIP and meets the other criteria in this section, work participation cash benefits are
available for up to 24 consecutive months.

(c) Expenditures on the program are maintenance of effort state fundsnew text begin under
a separate state program
new text end for participants under paragraph (b), clauses (1) and (2).
Expenditures for participants under paragraph (b), clause (3), are nonmaintenance of effort
funds. Months in which a participant receives work participation cash benefits under this
section do not count toward the participant's MFIP 60-month time limit.

Sec. 13.

Minnesota Statutes 2008, section 256J.626, subdivision 6, is amended to read:


Subd. 6.

Base allocation to counties and tribes; definitions.

(a) For purposes of
this section, the following terms have the meanings given.

(1) "2002 historic spending base" means the commissioner's determination of
the sum of the reimbursement related to fiscal year 2002 of county or tribal agency
expenditures for the base programs listed in clause (6), items (i) through (iv), and earnings
related to calendar year 2002 in the base program listed in clause (6), item (v), and the
amount of spending in fiscal year 2002 in the base program listed in clause (6), item (vi),
issued to or on behalf of persons residing in the county or tribal service delivery area.

(2) "Adjusted caseload factor" means a factor weighted:

(i) 47 percent on the MFIP cases in each county at four points in time in the most
recent 12-month period for which data is available multiplied by the county's caseload
difficulty factor; and

(ii) 53 percent on the count of adults on MFIP in each county and tribe at four points
in time in the most recent 12-month period for which data is available multiplied by the
county or tribe's caseload difficulty factor.

(3) "Caseload difficulty factor" means a factor determined by the commissioner for
each county and tribe based upon the self-support index described in section 256J.751,
subdivision 2
, clause (6).

deleted text begin (4) "Initial allocation" means the amount potentially available to each county or tribe
based on the formula in paragraphs (b) through (d).
deleted text end

deleted text begin (5)deleted text end new text begin(4) new text end"Final allocation" means the amount available to each county or tribe based
on the formula in paragraphs (b) deleted text beginthrough (d), after adjustment by subdivision 7deleted text endnew text begin and (c)new text end.

deleted text begin (6)deleted text end new text begin(5) new text end"Base programs" means the:

(i) MFIP employment and training services under Minnesota Statutes 2002, section
256J.62, subdivision 1, in effect June 30, 2002;

(ii) bilingual employment and training services to refugees under Minnesota Statutes
2002, section 256J.62, subdivision 6, in effect June 30, 2002;

(iii) work literacy language programs under Minnesota Statutes 2002, section
256J.62, subdivision 7, in effect June 30, 2002;

(iv) supported work program authorized in Laws 2001, First Special Session chapter
9, article 17, section 2, in effect June 30, 2002;

(v) administrative aid program under section 256J.76 in effect December 31, 2002;
and

(vi) emergency assistance program under Minnesota Statutes 2002, section 256J.48,
in effect June 30, 2002.

(b) The commissioner shalldeleted text begin:
deleted text end

deleted text begin (1) beginning July 1, 2003, determine the initial allocation of funds available under
this section according to clause (2);
deleted text end

deleted text begin (2) allocate all of the funds available for the period beginning July 1, 2003, and
ending December 31, 2004, to each county or tribe in proportion to the county's or tribe's
share of the statewide 2002 historic spending base;
deleted text end

deleted text begin (3) determine for calendar year 2005 the initial allocation of funds to be made
available under this section in proportion to the county or tribe's initial allocation for the
period of July 1, 2003, to December 31, 2004;
deleted text end

deleted text begin (4) determine for calendar year 2006 the initial allocation of funds to be made
available under this section based 90 percent on the proportion of the county or tribe's
share of the statewide 2002 historic spending base and ten percent on the proportion of
the county or tribe's share of the adjusted caseload factor;
deleted text end

deleted text begin (5) determine for calendar year 2007 the initial allocation of funds to be made
available under this section based 70 percent on the proportion of the county or tribe's
share of the statewide 2002 historic spending base and 30 percent on the proportion of the
county or tribe's share of the adjusted caseload factor; and
deleted text end

deleted text begin (6) determine for calendar year 2008 and subsequent years the initial allocation ofdeleted text endnew text begin
allocate
new text end funds to be made available under this section based 50 percent on the proportion
of the county or tribe's share of the statewide 2002 historic spending base and 50 percent
on the proportion of the county or tribe's share of the adjusted caseload factor.

(c) With the commencement of a new or expanded tribal TANF program or an
agreement under section 256.01, subdivision 2, paragraph (g), in which some or all of
the responsibilities of particular counties under this section are transferred to a tribe,
the commissioner shall:

(1) in the case where all responsibilities under this section are transferred to a tribal
program, determine the percentage of the county's current caseload that is transferring to a
tribal program and adjust the affected county's allocation accordingly; and

(2) in the case where a portion of the responsibilities under this section are
transferred to a tribal program, the commissioner shall consult with the affected county or
counties to determine an appropriate adjustment to the allocation.

deleted text begin (d) Effective January 1, 2005, counties and tribes will have their final allocations
adjusted based on the performance provisions of subdivision 7.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2010.
new text end

Sec. 14.

Minnesota Statutes 2008, section 256J.751, is amended by adding a
subdivision to read:


new text begin Subd. 2a. new text end

new text begin County performance standards. new text end

new text begin (a) For the purpose of this section, the
following terms have the meanings given:
new text end

new text begin (1) "Caseload reduction credit" (CRC) means the measure of how much the
Minnesota TANF caseload, including the separate state program caseload, has fallen
relative to the federal fiscal year 2005 caseload based on caseload data from October
1 to September 30.
new text end

new text begin (2) "TANF participation rate target" means a 50 percent participation rate reduced by
the CRC as calculated by the Department of Human Services.
new text end

new text begin (b) A county or tribe shall negotiate a multiyear improvement plan with the
commissioner if the county or tribe does not:
new text end

new text begin (1) achieve the TANF participation rate target or a five percentage point improvement
over the county or tribe's previous year's TANF participation rate under subdivision 2,
clause (7), as averaged across 12 consecutive months for the most recent year for which
the measurements are available; or
new text end

new text begin (2) perform within or above its range of expected performance on the annualized
three-year self-support index under subdivision 2, clause (6).
new text end

new text begin (c) A county or tribe that has successfully negotiated an improvement plan must
provide a semiannual report indicating that the plan has been implemented, the impact of
the plan, and any anticipated changes to the plan.
new text end

Sec. 15.

Minnesota Statutes 2008, section 256J.95, subdivision 12, is amended to read:


Subd. 12.

Conversion or referral to MFIP.

(a) If at any time during the DWP
application process or during the four-month DWP eligibility period, it is determined that
a participant is unlikely to benefit from the diversionary work program, the county shall
convert or refer the participant to MFIP as specified in paragraph (d). Participants who are
determined to be unlikely to benefit from the diversionary work program must develop
and sign an employment plan. deleted text beginParticipants who meet any one of the criteria in paragraph
(b) shall be considered to be unlikely to benefit from DWP, provided the necessary
documentation is available to support the determination.
deleted text end

(b) A participant whodeleted text begin:deleted text endnew text begin meets the eligibility requirements under section 256J.575,
subdivision 3, must be considered to be unlikely to benefit from DWP, provided the
necessary documentation is available to support the determination.
new text end

deleted text begin (1) has been determined by a qualified professional as being unable to obtain or retain
employment due to an illness, injury, or incapacity that is expected to last at least 60 days;
deleted text end

deleted text begin (2) is required in the home as a caregiver because of the illness, injury, or incapacity,
of a family member, or a relative in the household, or a foster child, and the illness, injury,
or incapacity and the need for a person to provide assistance in the home has been certified
by a qualified professional and is expected to continue more than 60 days;
deleted text end

deleted text begin (3) is determined by a qualified professional as being needed in the home to care for
a child or adult meeting the special medical criteria in section 256J.561, subdivision 2,
paragraph (d), clause (3);
deleted text end

deleted text begin (4) is pregnant and is determined by a qualified professional as being unable to
obtain or retain employment due to the pregnancy; or
deleted text end

deleted text begin (5) has applied for SSI or SSDI.
deleted text end

(c) In a two-parent family unit, deleted text beginboth parents must bedeleted text endnew text begin if one parent isnew text end determined
to be unlikely to benefit from the diversionary work program deleted text beginbeforedeleted text endnew text begin,new text end the family unit
deleted text begin candeleted text endnew text begin mustnew text end be converted or referred to MFIP.

(d) A participant who is determined to be unlikely to benefit from the diversionary
work program shall be converted to MFIP and, if the determination was made within 30
days of the initial application for benefits, no additional application form is required.
A participant who is determined to be unlikely to benefit from the diversionary work
program shall be referred to MFIP and, if the determination is made more than 30
days after the initial application, the participant must submit a program change request
form. The county agency shall process the program change request form by the first of
the following month to ensure that no gap in benefits is due to delayed action by the
county agency. In processing the program change request form, the county must follow
section 256J.32, subdivision 1, except that the county agency shall not require additional
verification of the information in the case file from the DWP application unless the
information in the case file is inaccurate, questionable, or no longer current.

(e) The county shall not request a combined application form for a participant who
has exhausted the four months of the diversionary work program, has continued need for
cash and food assistance, and has completed, signed, and submitted a program change
request form within 30 days of the fourth month of the diversionary work program. The
county must process the program change request according to section 256J.32, subdivision
1
, except that the county agency shall not require additional verification of information
in the case file unless the information is inaccurate, questionable, or no longer current.
When a participant does not request MFIP within 30 days of the diversionary work
program benefits being exhausted, a new combined application form must be completed
for any subsequent request for MFIP.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective March 1, 2010.
new text end

Sec. 16. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2008, section 256J.626, subdivision 7, new text end new text begin is repealed.
new text end

ARTICLE 3

ADULT SUPPORTS

Section 1.

Minnesota Statutes 2008, section 256D.06, subdivision 2, is amended to
read:


Subd. 2.

Emergency need.

new text begin(a) new text endNotwithstanding the provisions of subdivision 1, a
grant of emergency general assistance shall, to the extent funds are available, be made to
an eligible single adult, married couple, or family for an emergency need, deleted text beginas defined in
rules promulgated by the commissioner,
deleted text end where the recipient requests temporary assistance
not exceeding 30 days if an emergency situation appears to exist new text beginunder criteria adopted by
the county agency
new text endand the individual or family is ineligible for MFIP or DWP or is not a
participant of MFIP or DWPnew text begin and whose annual net income is no greater than 200 percent
of the federal poverty level for the previous calendar year
new text end. If an applicant or recipient
relates facts to the county agency which may be sufficient to constitute an emergency
situation, the county agency shall, to the extent funds are available, advise the person of the
procedure for applying for assistance according to this subdivision. An emergency general
assistance grant is available to a recipient not more than once in any 12-month period.

new text begin (b) new text endFunding for an emergency general assistance program is limited to the
appropriation. Each fiscal year, the commissioner shall allocate to counties the money
appropriated for emergency general assistance grants based on each county agency's
average share of state's emergency general expenditures for the immediate past three fiscal
years as determined by the commissioner, and may reallocate any unspent amounts to
other counties.

new text begin (c) No county shall be allocated less than $1,000 for the fiscal year.
new text end

new text begin (d) Should an emergency be declared as provided in section 12.31, the commissioner
may immediately reallocate unspent funds without regard to the other provisions of this
section to meet the emergency needs. The emergency reallocation must be excluded from
calculations for subsequent allocations as provided in paragraphs (b) and (c).
new text end

new text begin (e)new text end Any emergency general assistance expenditures by a county above the amount of
the commissioner's allocation to the county must be made from county funds.

Sec. 2.

Minnesota Statutes 2008, section 256D.09, subdivision 6, is amended to read:


Subd. 6.

Recovery of overpayments.

(a) If an amount of general assistance or
family general assistance is paid to a recipient in excess of the payment due, it shall be
recoverable by the county agency. The agency shall give written notice to the recipient of
its intention to recover the overpayment.

(b) new text beginExcept as provided for interim assistance in section 256D.06, subdivision
5,
new text endwhen an overpayment occurs, the county agency shall recover the overpayment
from a current recipient by reducing the amount of aid payable to the assistance unit of
which the recipient is a member, for one or more monthly assistance payments, until
the overpayment is repaid. All county agencies in the state shall reduce the assistance
payment by three percent of the assistance unit's standard of need in nonfraud cases and
ten percent where fraud has occurred, or the amount of the monthly payment, whichever is
less, for all overpayments.

(c) In cases when there is both an overpayment and underpayment, the county
agency shall offset one against the other in correcting the payment.

(d) Overpayments may also be voluntarily repaid, in part or in full, by the individual,
in addition to the aid reductions provided in this subdivision, to include further voluntary
reductions in the grant level agreed to in writing by the individual, until the total amount
of the overpayment is repaid.

(e) The county agency shall make reasonable efforts to recover overpayments to
persons no longer on assistance under standards adopted in rule by the commissioner
of human services. The county agency need not attempt to recover overpayments of
less than $35 paid to an individual no longer on assistance if the individual does not
receive assistance again within three years, unless the individual has been convicted of
violating section 256.98.

new text begin (f) Establishment of an overpayment is limited to 12 months prior to the month of
discovery due to an agency error and six years prior to the month of discovery due to a
client error or an intentional program violation determined under section 256.046.
new text end

Sec. 3.

Minnesota Statutes 2008, section 256D.46, is amended to read:


256D.46 EMERGENCY deleted text beginMINNESOTA SUPPLEMENTALdeleted text end AID.

Subdivision 1.

Eligibility.

deleted text beginA county agency must grant emergency Minnesota
supplemental aid, to the extent funds are available, if the recipient is without adequate
resources to resolve an emergency that, if unresolved, will threaten the health or safety
of the recipient. For the purposes of this section, the term "recipient" includes persons
for whom a group residential housing benefit is being paid under sections 256I.01 to
256I.06.
deleted text endnew text begin Recipients of Minnesota supplemental aid who have emergent need may apply
for emergency general assistance medical care under section 256D.06, subdivision 2.
new text end

deleted text begin Subd. 2. deleted text end

deleted text begin Income and resource test. deleted text end

deleted text begin All income and resources available to the
recipient must be considered in determining the recipient's ability to meet the emergency
need. Property that can be liquidated in time to resolve the emergency and income,
excluding an amount equal to the Minnesota supplemental aid standard of assistance, that
is normally disregarded or excluded under the Minnesota supplemental aid program must
be considered available to meet the emergency need.
deleted text end

deleted text begin Subd. 3. deleted text end

deleted text begin Payment amount. deleted text end

deleted text begin The amount of assistance granted under emergency
Minnesota supplemental aid is limited to the amount necessary to resolve the emergency.
An emergency Minnesota supplemental aid grant is available to a recipient no more
than once in any 12-month period. Funding for emergency Minnesota supplemental
aid is limited to the appropriation. Each fiscal year, the commissioner shall allocate to
counties the money appropriated for emergency Minnesota supplemental aid grants based
on each county agency's average share of state's emergency Minnesota supplemental aid
expenditures for the immediate past three fiscal years as determined by the commissioner,
and may reallocate any unspent amounts to other counties. Any emergency Minnesota
supplemental aid expenditures by a county above the amount of the commissioner's
allocation to the county must be made from county funds.
deleted text end

Sec. 4.

Minnesota Statutes 2008, section 256D.49, subdivision 3, is amended to read:


Subd. 3.

Overpayment of monthly grants and recovery of ATM errors.

new text begin(a) new text endWhen
the county agency determines that an overpayment of the recipient's monthly payment
of Minnesota supplemental aid has occurred, it shall issue a notice of overpayment
to the recipient. If the person is no longer receiving Minnesota supplemental aid, the
county agency may request voluntary repayment or pursue civil recovery. If the person is
receiving Minnesota supplemental aid, the county agency shall recover the overpayment
by withholding an amount equal to three percent of the standard of assistance for the
recipient or the total amount of the monthly grant, whichever is less.

new text begin (b) Establishment of an overpayment is limited to 12 months prior to the month of
discovery due to an agency error and six years prior to the month of discovery due to a
client error or an intentional program violation determined under section 256.046.
new text end

new text begin (c) new text endFor recipients receiving benefits via electronic benefit transfer, if the overpayment
is a result of an automated teller machine (ATM) dispensing funds in error to the recipient,
the agency may recover the ATM error by immediately withdrawing funds from the
recipient's electronic benefit transfer account, up to the amount of the error.

new text begin (d) new text endResidents of deleted text beginnursing homes, regional treatment centers, anddeleted text end new text beginlicensed residential
new text endfacilities deleted text beginwith negotiated ratesdeleted text end shall not have overpayments recovered from their personal
needs allowance.

Sec. 5.

Minnesota Statutes 2008, section 256I.03, subdivision 7, is amended to read:


Subd. 7.

Countable income.

"Countable income" means all income received by an
applicant or recipient less any applicable exclusions or disregards. For a recipient of any
cash benefit from the SSI program, countable income means the SSI benefit limit in effect
at the time the person is in a GRH deleted text beginsetting less $20deleted text end, less the medical assistance personal
needs allowance. If the SSI limit has been reduced for a person due to events occurring
prior to the persons entering the GRH setting, countable income means actual income less
any applicable exclusions and disregards.

Sec. 6.

Minnesota Statutes 2008, section 256J.38, subdivision 1, is amended to read:


Subdivision 1.

Scope of overpayment.

new text begin(a) new text endWhen a participant or former participant
receives an overpayment due to agency, client, or ATM error, or due to assistance received
while an appeal is pending and the participant or former participant is determined
ineligible for assistance or for less assistance than was received, the county agency must
recoup or recover the overpayment using the following methods:

(1) reconstruct each affected budget month and corresponding payment month;

(2) use the policies and procedures that were in effect for the payment month; and

(3) do not allow employment disregards in section 256J.21, subdivision 3 or 4, in the
calculation of the overpayment when the unit has not reported within two calendar months
following the end of the month in which the income was received.

new text begin (b) Establishment of an overpayment is limited to 12 months prior to the month of
discovery due to agency error and six years prior to the month of discovery due to client
error or an intentional program violation determined under section 256.046.
new text end

Sec. 7.

Minnesota Statutes 2008, section 393.07, subdivision 10, is amended to read:


Subd. 10.

Food stamp program; Maternal and Child Nutrition Act.

(a) The local
social services agency shall establish and administer the food stamp program according
to rules of the commissioner of human services, the supervision of the commissioner as
specified in section 256.01, and all federal laws and regulations. The commissioner of
human services shall monitor food stamp program delivery on an ongoing basis to ensure
that each county complies with federal laws and regulations. Program requirements to be
monitored include, but are not limited to, number of applications, number of approvals,
number of cases pending, length of time required to process each application and deliver
benefits, number of applicants eligible for expedited issuance, length of time required
to process and deliver expedited issuance, number of terminations and reasons for
terminations, client profiles by age, household composition and income level and sources,
and the use of phone certification and home visits. The commissioner shall determine the
county-by-county and statewide participation rate.

(b) On July 1 of each year, the commissioner of human services shall determine a
statewide and county-by-county food stamp program participation rate. The commissioner
may designate a different agency to administer the food stamp program in a county if the
agency administering the program fails to increase the food stamp program participation
rate among families or eligible individuals, or comply with all federal laws and regulations
governing the food stamp program. The commissioner shall review agency performance
annually to determine compliance with this paragraph.

(c) A person who commits any of the following acts has violated section 256.98 or
609.821, or both, and is subject to both the criminal and civil penalties provided under
those sections:

(1) obtains or attempts to obtain, or aids or abets any person to obtain by means of a
willful statement or misrepresentation, or intentional concealment of a material fact, food
stamps or vouchers issued according to sections 145.891 to 145.897 to which the person
is not entitled or in an amount greater than that to which that person is entitled or which
specify nutritional supplements to which that person is not entitled; or

(2) presents or causes to be presented, coupons or vouchers issued according to
sections 145.891 to 145.897 for payment or redemption knowing them to have been
received, transferred or used in a manner contrary to existing state or federal law; or

(3) willfully uses, possesses, or transfers food stamp coupons, authorization to
purchase cards or vouchers issued according to sections 145.891 to 145.897 in any manner
contrary to existing state or federal law, rules, or regulations; or

(4) buys or sells food stamp coupons, authorization to purchase cards, other
assistance transaction devices, vouchers issued according to sections 145.891 to 145.897,
or any food obtained through the redemption of vouchers issued according to sections
145.891 to 145.897 for cash or consideration other than eligible food.

(d) A peace officer or welfare fraud investigator may confiscate food stamps,
authorization to purchase cards, or other assistance transaction devices found in the
possession of any person who is neither a recipient of the food stamp program nor
otherwise authorized to possess and use such materials. Confiscated property shall be
disposed of as the commissioner may direct and consistent with state and federal food
stamp law. The confiscated property must be retained for a period of not less than 30 days
to allow any affected person to appeal the confiscation under section 256.045.

(e) deleted text beginFood stamp overpayment claims which are due in whole or in part to client
error shall be established by the county agency for a period of six years from the date of
any resultant overpayment.
deleted text endnew text begin Establishment of a food stamp overpayment is limited to 12
months prior to the month of discovery due to an agency error and six years prior to the
month of discovery due to a client error or an intentional program violation determined
under section 256.046.
new text end

(f) With regard to the federal tax revenue offset program only, recovery incentives
authorized by the federal food and consumer service shall be retained at the rate of 50
percent by the state agency and 50 percent by the certifying county agency.

(g) A peace officer, welfare fraud investigator, federal law enforcement official,
or the commissioner of health may confiscate vouchers found in the possession of any
person who is neither issued vouchers under sections 145.891 to 145.897, nor otherwise
authorized to possess and use such vouchers. Confiscated property shall be disposed of
as the commissioner of health may direct and consistent with state and federal law. The
confiscated property must be retained for a period of not less than 30 days.

(h) The commissioner of human services may seek a waiver from the United States
Department of Agriculture to allow the state to specify foods that may and may not be
purchased in Minnesota with benefits funded by the federal Food Stamp Program. The
commissioner shall consult with the members of the house of representatives and senate
policy committees having jurisdiction over food support issues in developing the waiver.
The commissioner, in consultation with the commissioners of health and education, shall
develop a broad public health policy related to improved nutrition and health status. The
commissioner must seek legislative approval prior to implementing the waiver.

Sec. 8. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2008, section 256I.06, subdivision 9, new text end new text begin is repealed.
new text end

new text begin (b) new text end new text begin Minnesota Rules, parts 9500.1243, subpart 3; and 9500.1261, subparts 3, 4, 5,
and 6,
new text end new text begin are repealed.
new text end

ARTICLE 4

PROGRAM INTEGRITY

Section 1.

Minnesota Statutes 2008, section 119B.02, subdivision 5, is amended to read:


Subd. 5.

Program integrity.

For child care assistance programs under this
chapter, the commissioner shall enforce the requirements for program integrity and fraud
prevention investigations under sections 256.046, 256.98, and deleted text begin256.983deleted text endnew text begin 256.9832new text end.

Sec. 2.

Minnesota Statutes 2008, section 256.045, subdivision 3, is amended to read:


Subd. 3.

State agency hearings.

(a) State agency hearings are available for the
following:

(1) any person applying for, receiving or having received public assistance, medical
care, or a program of social services granted by the state agency or a county agency or
the federal Food Stamp Act whose application for assistance is denied, not acted upon
with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
claimed to have been incorrectly paid;

(2) any patient or relative aggrieved by an order of the commissioner under section
252.27;

(3) a party aggrieved by a ruling of a prepaid health plan;

(4) except as provided under chapter 245C, any individual or facility determined by
a lead agency to have maltreated a vulnerable adult under section 626.557 after they have
exercised their right to administrative reconsideration under section 626.557;

(5) any person whose claim for foster care payment according to a placement of the
child resulting from a child protection assessment under section 626.556 is denied or not
acted upon with reasonable promptness, regardless of funding source;

(6) any person to whom a right of appeal according to this section is given by other
provision of law;

(7) an applicant aggrieved by an adverse decision to an application for a hardship
waiver under section 256B.15;

(8) an applicant aggrieved by an adverse decision to an application or redetermination
for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;

(9) except as provided under chapter 245A, an individual or facility determined
to have maltreated a minor under section 626.556, after the individual or facility has
exercised the right to administrative reconsideration under section 626.556; deleted text beginordeleted text end

(10) except as provided under chapter 245C, an individual disqualified under sections
245C.14 and 245C.15, on the basis of serious or recurring maltreatment; a preponderance
of the evidence that the individual has committed an act or acts that meet the definition
of any of the crimes listed in section 245C.15, subdivisions 1 to 4; or for failing to make
reports required under section 626.556, subdivision 3, or 626.557, subdivision 3. Hearings
regarding a maltreatment determination under clause (4) or (9) and a disqualification under
this clause in which the basis for a disqualification is serious or recurring maltreatment,
which has not been set aside under sections 245C.22 and 245C.23, shall be consolidated
into a single fair hearing. In such cases, the scope of review by the human services referee
shall include both the maltreatment determination and the disqualification. The failure to
exercise the right to an administrative reconsideration shall not be a bar to a hearing under
this section if federal law provides an individual the right to a hearing to dispute a finding
of maltreatment. Individuals and organizations specified in this section may contest the
specified action, decision, or final disposition before the state agency by submitting a
written request for a hearing to the state agency within 30 days after receiving written
notice of the action, decision, or final disposition, or within 90 days of such written notice
if the applicant, recipient, patient, or relative shows good cause why the request was not
submitted within the 30-day time limitdeleted text begin.deleted text endnew text begin; or
new text end

new text begin (11) any person with an outstanding debt resulting from receipt of public assistance,
medical care, or the federal Food Stamp Act who is contesting a setoff claim by the
Department of Human Services or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request setoff of a refund under chapter 270A against
the debt.
new text end

(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or
(10), is the only administrative appeal to the final agency determination specifically,
including a challenge to the accuracy and completeness of data under section 13.04.
Hearings requested under paragraph (a), clause (4), apply only to incidents of maltreatment
that occur on or after October 1, 1995. Hearings requested by nursing assistants in nursing
homes alleged to have maltreated a resident prior to October 1, 1995, shall be held as a
contested case proceeding under the provisions of chapter 14. Hearings requested under
paragraph (a), clause (9), apply only to incidents of maltreatment that occur on or after
July 1, 1997. A hearing for an individual or facility under paragraph (a), clause (9), is
only available when there is no juvenile court or adult criminal action pending. If such
action is filed in either court while an administrative review is pending, the administrative
review must be suspended until the judicial actions are completed. If the juvenile court
action or criminal charge is dismissed or the criminal action overturned, the matter may be
considered in an administrative hearing.

(c) For purposes of this section, bargaining unit grievance procedures are not an
administrative appeal.

(d) The scope of hearings involving claims to foster care payments under paragraph
(a), clause (5), shall be limited to the issue of whether the county is legally responsible
for a child's placement under court order or voluntary placement agreement and, if so,
the correct amount of foster care payment to be made on the child's behalf and shall not
include review of the propriety of the county's child protection determination or child
placement decision.

(e) A vendor of medical care as defined in section 256B.02, subdivision 7, or a
vendor under contract with a county agency to provide social services is not a party and
may not request a hearing under this section, except if assisting a recipient as provided in
subdivision 4.

(f) An applicant or recipient is not entitled to receive social services beyond the
services prescribed under chapter 256M or other social services the person is eligible
for under state law.

(g) The commissioner may summarily affirm the county or state agency's proposed
action without a hearing when the sole issue is an automatic change due to a change in
state or federal law.

Sec. 3.

new text begin [256.9832] STATE WELFARE FRAUD INVESTIGATIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Program established. new text end

new text begin Effective July 1, 2009, the commissioner of
human services shall establish a welfare fraud investigative unit to investigate allegations
of recipient fraud in welfare programs with a state or federal funding component and
quickly terminate benefits to ineligible recipients. Counties that received grants under
Minnesota Statutes 2008, section 256.983, for the fraud prevention investigation project
must use state investigators to investigate possible welfare fraud effective with termination
of their grants. The commissioner shall develop a process for counties that did not
participate in the former fraud prevention investigation project to begin use of state
investigators.
new text end

new text begin Subd. 2. new text end

new text begin Relationship to county criminal welfare fraud investigative units.
new text end

new text begin An investigation resulting in discovery of facts that appear to merit the involvement of
the criminal justice system are to be referred to the county human services director or
designee for further referral to the county criminal justice system, or may be referred
directly to the county criminal justice system. The commissioner of human services must
be notified of the disposition of these cases within six months of referral. If the criminal
justice system has not acted on the referral or declined to act, the commissioner has the
option to pursue further action on those cases.
new text end

new text begin Subd. 3. new text end

new text begin County agency responsibilities. new text end

new text begin State welfare fraud investigators shall
have unrestricted access to human services records as needed to conduct an investigation.
County agencies have 30 days after receipt of investigative findings to notify the
commissioner of effect on eligibility. County agencies shall calculate overpayments
identified through an investigation and establish a formal claim for repayment within 45
days of discovery.
new text end

new text begin Subd. 4. new text end

new text begin Department responsibilities. new text end

new text begin The commissioner shall establish training
programs for state investigators, county welfare case workers, and supervisory staff. The
commissioner shall develop operational guidelines, forms, and reporting mechanisms,
which must be used by county agencies. The commissioner shall develop a process
to ensure county cooperation with making appropriate referrals for welfare fraud
investigations. An individuals's application or redetermination form for public assistance
benefits, including child care assistance programs and medical care programs, must
include an authorization by the individual for the release and sharing of information and
documentation between third parties and investigators who are conducting welfare fraud
investigations. The authorization for release and sharing of information is effective for
six months after public assistance benefits have ceased.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 1, 2009.
new text end

Sec. 4.

Minnesota Statutes 2008, section 270A.09, is amended by adding a subdivision
to read:


new text begin Subd. 1b. new text end

new text begin Department of Human Services claims. new text end

new text begin Notwithstanding subdivision 1,
any debtor contesting a setoff claim by the Department of Human Services or a county
agency whose claim relates to a debt resulting from receipt of public assistance, medical
care, or the federal Food Stamp Act shall have a hearing conducted in the same manner as
an appeal under sections 256.045 and 256.0451.
new text end

Sec. 5. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2008, section 256.983, new text end new text begin is repealed effective November 1, 2009.
new text end

ARTICLE 5

CHILD SUPPORT

Section 1.

Minnesota Statutes 2008, section 518A.53, subdivision 1, is amended to
read:


Subdivision 1.

Definitions.

(a) For the purpose of this section, the following terms
have the meanings provided in this subdivision unless otherwise stated.

(b) "Payor of funds" means any person or entity that provides funds to an obligor,
including an employer as defined under chapter 24 of the Internal Revenue Code,
section 3401(d), an independent contractor, payor of worker's compensation benefits or
unemployment benefits, or a financial institution as defined in section 13B.06.

(c) "Business day" means a day on which state offices are open for regular business.

(d) new text beginThe term new text end"arrears" deleted text beginmeans amounts owed under a support order that are past duedeleted text endnew text begin
as used in this section has the meaning provided in section 518A.26
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 1, 2010.
new text end

Sec. 2.

Minnesota Statutes 2008, section 518A.53, subdivision 4, is amended to read:


Subd. 4.

Collection services.

(a) The commissioner of human services shall prepare
and make available to the courts a notice of services that explains child support and
maintenance collection services available through the public authority, including income
withholding, and the fees for such services. Upon receiving a petition for dissolution of
marriage or legal separation, the court administrator shall promptly send the notice of
services to the petitioner and respondent at the addresses stated in the petition.

(b) Either the obligee or obligor may at any time apply to the public authority for
either full IV-D services or for income withholding only services.

(c) For those persons applying for income withholding only services, a monthly
service fee of $15 must be charged to the obligor. This fee is in addition to the amount of
the support order and shall be withheld through income withholding. The public authority
shall explain the service options in this section to the affected parties and encourage the
application for full child support collection services.

(d) If the obligee is not a current recipient of public assistance as defined in section
256.741, the person who applied for services may at any time choose to terminate either
full IV-D services or income withholding only services regardless of whether income
withholding is currently in place. The obligee or obligor may reapply for either full IV-D
services or income withholding only services at any time. Unless the applicant is a
recipient of public assistance as defined in section 256.741, a $25 application fee shall be
charged at the time of each application.

(e) When a person terminates IV-D services, if an arrearage for public assistance as
defined in section 256.741 exists, the public authority may continue income withholding,
as well as use any other enforcement remedy for the collection of child support, until all
public assistance arrears are paid in full. Income withholding shall be in an amount equal
to 20 percent of the support order in effect at the time the services terminateddeleted text begin.deleted text endnew text begin, unless the
support order includes a specific monthly payback amount. If the support order includes a
specific monthly payback amount, income withholding shall be in the specific amount
ordered. The provisions of this paragraph apply to all support orders in effect on or before
January 1, 2010, and to all support orders in effect after January 1, 2010.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 1, 2010.
new text end

Sec. 3.

Minnesota Statutes 2008, section 518A.53, subdivision 10, is amended to read:


Subd. 10.

Arrearage order.

(a) This section does not prevent the court from
ordering the payor of funds to withhold amounts to satisfy the obligor's previous arrearage
in support order payments. This remedy shall not operate to exclude availability of other
remedies to enforce judgments. The employer or payor of funds shall withhold from
the obligor's income an additional amount equal to 20 percent of the monthly child
support or maintenance obligation until the arrearage is paiddeleted text begin.deleted text endnew text begin, unless the support order
includes a specific monthly payback amount. If the support order includes a specific
monthly payback amount, income withholding shall be in the specific amount ordered.
The provisions of this paragraph apply to all support orders in effect on or before January
1, 2010, and to all support orders in effect after January 1, 2010.
new text end

(b) Notwithstanding any law to the contrary, funds from income sources included
in section 518A.26, subdivision 8, whether periodic or lump sum, are not exempt from
attachment or execution upon a judgment for child support arrearage.

(c) Absent an order to the contrary, if an arrearage exists at the time a support
order would otherwise terminate, income withholding shall continue in effect or may be
implemented in an amount equal to the support order plus an additional 20 percent of the
monthly child support obligation, until all arrears have been paid in full.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 1, 2010.
new text end

Sec. 4.

Minnesota Statutes 2008, section 518A.60, is amended to read:


518A.60 COLLECTION; ARREARS ONLY.

(a) Remedies available for the collection and enforcement of support in this chapter
and chapters 256, 257, 518, and 518C also apply to cases in which the child or children
for whom support is owed are emancipated and the obligor owes past support or has an
accumulated arrearage as of the date of the youngest child's emancipation. Child support
arrearages under this section include arrearages for child support, medical support, child
care, pregnancy and birth expenses, and unreimbursed medical expenses as defined in
section 518A.41, subdivision 1, paragraph (h).

(b) This section applies retroactively to any support arrearage that accrued on or
before June 3, 1997, and to all arrearages accruing after June 3, 1997.

(c) Past support or pregnancy and confinement expenses ordered for which the
obligor has specific court ordered terms for repayment may not be enforced using drivers'
and occupational or professional license suspension, new text beginand new text endcredit bureau reporting, deleted text beginand
additional income withholding under section 518A.53, subdivision 10, paragraph (a),
deleted text end
unless the obligor fails to comply with the terms of the court order for repayment.

(d) If an arrearage exists at the time a support order would otherwise terminate
and section 518A.53, subdivision 10, paragraph (c), does not apply to this section, the
arrearage shall be repaid in an amount equal to the current support order until all arrears
have been paid in full, absent a court order to the contrary.

(e) If an arrearage exists according to a support order which fails to establish a
monthly support obligation in a specific dollar amount, the public authority, if it provides
child support services, or the obligee, may establish a payment agreement which shall
equal what the obligor would pay for current support after application of section 518A.34,
plus an additional 20 percent of the current support obligation, until all arrears have been
paid in full. If the obligor fails to enter into or comply with a payment agreement, the
public authority, if it provides child support services, or the obligee, may move the district
court or child support magistrate, if section 484.702 applies, for an order establishing
repayment terms.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective April 1, 2010.
new text end

ARTICLE 6

PROTECTING CHILDREN AND STRENGTHENING FAMILIES ACT

Section 1.

new text begin [256N.01] CITATION.
new text end

new text begin Sections 256N.01 to 256N.09 may be cited as the "Protecting Children and
Strengthening Families Act," hereafter the "act." This act defines public child welfare
policy, sets state priorities, creates accountability mechanisms for achieving improved
outcomes for children and families, and establishes a fund to address the safety,
permanency, and well-being needs of children and adolescents who come to the attention
of the county as a result of a report of child maltreatment pursuant to section 626.556 or
are otherwise the responsibility of the county.
new text end

Sec. 2.

new text begin [256N.02] PUBLIC POLICY.
new text end

new text begin Subdivision 1. new text end

new text begin General. new text end

new text begin The legislature hereby declares that the public policy
of the state is:
new text end

new text begin (1) first and foremost, children should be safe from harm and protected from abuse
and neglect;
new text end

new text begin (2) children should be maintained safely in their homes whenever possible and
appropriate;
new text end

new text begin (3) when the ability of parents to keep their children safe is compromised it is in
the public interest to intervene early and provide services that promote parents' protective
capacities, mitigate risks of harm, and strengthen and support parents in their care giving
roles;
new text end

new text begin (4) children should grow up in safe, permanent and nurturing homes and, when it is
not possible for their parents to provide safety and permanency, alternative permanency
options must be made available to children as quickly as possible;
new text end

new text begin (5) whenever possible, alternative permanency options should be with children's
relatives or kin in order to maintain family relationships and preserve connections with
their communities and culture; and
new text end

new text begin (6) once permanency is achieved, children and their families should receive the
services and supports necessary to maintain safe, stable, and permanent homes.
new text end

new text begin Subd. 2. new text end

new text begin Racial disparities in child welfare. new text end

new text begin It is further the policy of the state to
reduce racial disparities and disproportionality that exists in the child welfare system by:
new text end

new text begin (1) identifying and addressing structural factors contributing to inequities in
outcomes;
new text end

new text begin (2) identifying and implementing promising and evidence-based strategies to reduce
racial disparities in treatment and outcomes;
new text end

new text begin (3) using cultural values, beliefs and practices of families, communities and tribes to
shape family assessment, case planning, case service design, and case decision making
processes;
new text end

new text begin (4) using placement and reunification strategies that maintain, honor, and support
relationships and connections between parents, siblings, children, kin, and significant
others, giving priority to kinship placements when placement is necessary; and
new text end

new text begin (5) supporting families in the context of their communities and tribes so as to safely
divert them away from the child welfare system, whenever possible.
new text end

Sec. 3.

new text begin [256N.03] PUBLIC PRIORITIES.
new text end

new text begin A broad continuum of services and a reform of practice are necessary across
Minnesota to keep children safe from abuse and neglect, prevent the trauma associated
with removing a child from their family home, and provide families with the necessary
supports and services to protect and nurture their children. Successful implementation
of state policy must result in improved outcomes for children and families and must be
measured by:
new text end

new text begin (1) improved timeliness to initial investigations;
new text end

new text begin (2) increased monthly caseworker visits;
new text end

new text begin (3) reduced out-of-home placements;
new text end

new text begin (4) reduced re-entry;
new text end

new text begin (5) reduced recidivism;
new text end

new text begin (6) reduced number of children aging out of foster care without achieving
permanency;
new text end

new text begin (7) improved rate of relative care;
new text end

new text begin (8) improved stability in foster care; and
new text end

new text begin (9) reduced racial and ethnic disparities and disproportionality.
new text end

Sec. 4.

new text begin [256N.04] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin For the purposes of sections 256N.01 to 256N.09, the terms
defined in this section have the meanings given them.
new text end

new text begin Subd. 2. new text end

new text begin Adoptive care. new text end

new text begin "Adoptive care" means care to an adopted special needs
child under section 259.67.
new text end

new text begin Subd. 3. new text end

new text begin Child protection investigation. new text end

new text begin "Child protection investigation" means
fact gathering by the child welfare agency related to the current safety of the child and the
risk of subsequent maltreatment that determines whether child maltreatment occurred and
whether child protective services are needed.
new text end

new text begin Subd. 4. new text end

new text begin Children services. new text end

new text begin "Children services" means services provided or
arranged for by county boards for infants, children, and adolescents and may include,
but are not limited to: child protection investigation, family assessment response,
family-based crisis services, family foster care, family preservation services, foster care,
independent living services, permanency services, postpermanency support services,
reunification services, subsidized guardianship, and support for at-risk families.
new text end

new text begin Subd. 5. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of human
services or the commissioner's designee.
new text end

new text begin Subd. 6. new text end

new text begin County board. new text end

new text begin "County board" means the board of county commissioners
in each county.
new text end

new text begin Subd. 7. new text end

new text begin Family assessment response. new text end

new text begin "Family assessment response" means a
comprehensive assessment of child safety, risk of subsequent maltreatment, and family
strengths and needs that is applied to a child maltreatment report that does not allege
substantial child endangerment. Family assessment response includes assessing the need
for services and may include the provision of time-limited services.
new text end

new text begin Subd. 8. new text end

new text begin Family-based crisis services. new text end

new text begin "Family-based crisis services" means
services provided to a family in the home, within 24 hours of referral, to help the family
resolve a relationship crisis to prevent placing a child outside of the home.
new text end

new text begin Subd. 9. new text end

new text begin Foster care. new text end

new text begin "Foster care" means 24-hour substitute care in a family home
or facility licensed under Minnesota Rules, chapter 2960, for children placed away from
their parents or guardian and for whom a responsible social services agency has placement
and care responsibility pursuant to a court order or voluntary placement agreement. Foster
care includes an emergency placement of a child in the home of a relative who has not yet
completed the licensure process. Services are provided to children who are in immediate
need of out of home placement until a plan of care is established.
new text end

new text begin Subd. 10. new text end

new text begin Family preservation services. new text end

new text begin "Family preservation services" means
services designed to maintain children in the home or in an outside setting, if needed to
help the family resolve personal, family, or situational problems. These services are
provided to prevent placement of a child outside of the home or so that a child can be
returned home from placement.
new text end

new text begin Subd. 11. new text end

new text begin Guardianship assistance. new text end

new text begin "Guardianship assistance" means financial
support to relatives who accept permanent and legal custody of a related child as a result
of a permanency proceeding under section 260C.317.
new text end

new text begin Subd. 12. new text end

new text begin Human services board. new text end

new text begin "Human services board" means a board
established under section 402.02; Laws 1974, chapter 293; or Laws 1976, chapter 340.
new text end

new text begin Subd. 13. new text end

new text begin Independent living services. new text end

new text begin "Independent living services" means
individual or group services designed to assist youth, ages 14 through 20, who are in
out-of-home placement, to prepare them for independent living. Eligible youth can
receive services until their 21st birthday. Services include an independent living skills
assessment and the development of an independent living plan by a case manager.
Services may include training in daily living skills, service coordination, educational and
career assistance, driver's education or transportation use, and the funding of activities
that promote self-reliance and self-esteem.
new text end

new text begin Subd. 14. new text end

new text begin Permanency services. new text end

new text begin "Permanency services" means services designed
to plan for and finalize a safe and legally permanent alternative home for the child within
the timelines of section 260C.201, subdivision 11, when a child cannot return to the parent
or guardian from whom they were removed. It also includes considering other permanent
alternative homes for a child, preferably through adoption or transfer of permanent legal
and physical custody of the child. Concurrent permanency planning and family group
decision-making are included as permanency services.
new text end

new text begin Subd. 15. new text end

new text begin Postpermanency support services. new text end

new text begin "Postpermanency support services"
means services designed to improve the likelihood that a child who has been in
out-of-home placement will be able to remain in their permanency situation, whether that
is reunification with their families, transfer of permanent legal and physical custody to a
relative, or in a finalized adoption.
new text end

new text begin Subd. 16. new text end

new text begin Reunification services. new text end

new text begin "Reunification services" means services,
including family group decision-making, provided to a child and their legal caregiver to
facilitate the safe return of the child to the home. Specific services are provided by the
local agency with legal responsibility pursuant to a court order or voluntary placement
agreement, and are in the out-of-home placement plan.
new text end

new text begin Subd. 17. new text end

new text begin Services for at-risk families. new text end

new text begin "Services for at-risk families" means
voluntary services that are designed to reduce the likelihood of any future maltreatment
for families who have a maltreatment report that is not accepted under section 626.556,
are self referred or referred by a community provider, or who are on the Minnesota family
investment program under chapter 256J.
new text end

Sec. 5.

new text begin [256N.05] USE OF FUNDS.
new text end

new text begin Funds under this act may be used to provide services under this act, or other services
needed based on an individualized assessment of the child and family. Funds must be
directed in the following order of priority:
new text end

new text begin (1) family assessment response, time-limited targeted services and child protection
investigations;
new text end

new text begin (2) support for at-risk families;
new text end

new text begin (3) postpermanency support services;
new text end

new text begin (4) independent living services;
new text end

new text begin (5) family support and family preservation services;
new text end

new text begin (6) family-based crisis services;
new text end

new text begin (7) reunification services;
new text end

new text begin (8) permanency services; and
new text end

new text begin (9) foster care.
new text end

Sec. 6.

new text begin [256N.06] DUTIES OF COMMISSIONER OF HUMAN SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin General supervision. new text end

new text begin In order to achieve the goals of this act,
the commissioner shall allocate funds, provide assistance, evaluate the performance of
counties, and ensure accountability for achieving improved outcomes for children and
families.
new text end

new text begin Subd. 2. new text end

new text begin Allocation of funds. new text end

new text begin Each year the commissioner shall allocate available
funds to each county with an approved plan according to section 256N.07 and meeting the
requirements under this act. Funds must be allocated according to section 256N.08.
new text end

new text begin Subd. 3. new text end

new text begin Assistance. new text end

new text begin The commissioner shall:
new text end

new text begin (1) provide training, technical assistance, and other supports to each county to
assist in needs assessment, planning, monitoring of outcomes and service quality, and
implementation of program improvement plans;
new text end

new text begin (2) request waivers from federal programs as necessary to implement this act; and
new text end

new text begin (3) have authority under sections 14.055 and 14.056 to grant a variance to existing
state rules as needed to eliminate barriers to achieving desired outcomes.
new text end

new text begin Subd. 4. new text end

new text begin Accountability. new text end

new text begin (a) The commissioner shall maintain a quality assurance
system that measures county performance on federal and state outcome measures and
performance items regarding child safety, permanency, and well being and determine the
status of the public priorities identified in 256N.03. Performance measures may include:
new text end

new text begin (1) timeliness to initial investigation;
new text end

new text begin (2) monthly caseworker visits;
new text end

new text begin (3) rate of entry into foster care;
new text end

new text begin (4) rate of re-entry;
new text end

new text begin (5) rate of recidivism;
new text end

new text begin (6) number of children aging out of foster care without achieving permanency;
new text end

new text begin (7) rate of relative care;
new text end

new text begin (8) foster care stability; and
new text end

new text begin (9) other federal or state performance measures.
new text end

new text begin Performance measures may be modified by the federal Department of Health and
Human Services or the commissioner. The quality assurance system must support
and measure continuous quality improvement and work with counties to develop and
implement program improvement plans in any areas in which the county is not in
substantial conformity with federal and state performance standards.
new text end

new text begin (b) The commissioner shall:
new text end

new text begin (1) use data collection, evaluation of outcomes, and the review and approval of
county plans to supervise county performance in the delivery of services to children
and families;
new text end

new text begin (2) specify requirements for reports, including fiscal reports to account for funds
distributed; and
new text end

new text begin (3) adjust allocations to a county based on the commissioner's determination
regarding county performance under the act.
new text end

new text begin (c) The following steps must be taken when the commissioner has determined that a
county has failed to meet performance standards and address the priorities under this act,
or failed to develop and implement a program improvement plan:
new text end

new text begin (1) the commissioner shall notify the county, by mail, of the standards which the
county has not achieved;
new text end

new text begin (2) the county has 60 days from notification to develop a program improvement plan
and submit it to the commissioner for approval; and
new text end

new text begin (3) if the county fails to demonstrate achievement or fails to implement a program
improvement plan approved by the commissioner, the commissioner may withhold the
county's share of state or federal funds under this act. The commissioner may withhold
future allocations until the county has achieved the standards applicable to the program
or has developed and implemented a program improvement plan. If a county does not
achieve standards to develop and implement a program improvement plan for more than
six consecutive months, the commissioner may reallocate the withheld funds to counties
that have achieved standards or are working to achieve them.
new text end

Sec. 7.

new text begin [256N.07] PLAN.
new text end

new text begin Subdivision 1. new text end

new text begin Plan submitted to commissioner. new text end

new text begin Effective January 1, 2011, and
each two-year period thereafter, each county shall have a biennial plan approved by the
commissioner that addresses the public policy and priorities of this act in order to receive
funds. The plan may be combined with other plans required by the commissioner and
counties may submit multicounty or regional plans.
new text end

new text begin Subd. 2. new text end

new text begin Contents. new text end

new text begin The plan must be completed in a form prescribed by the
commissioner. The plan must include:
new text end

new text begin (1) strategies the county must implement to keep children safe in their own homes
and support families in the context of their communities and tribes so as to safely divert
them away from the child welfare system, whenever possible;
new text end

new text begin (2) strategies the county must engage in to address each of the public priorities
identified in section 256N.03;
new text end

new text begin (3) strategies that the county must engage in to maintain connections between family
members and significant others, giving priority to kinship placements, when placement is
necessary;
new text end

new text begin (4) strategies that address disparities in out-of-home placement for African-American
and American Indian children in their county and other populations of children
disproportionately represented, and when placement is necessary the strategies that must
be employed to maintain children's familial and cultural connections;
new text end

new text begin (5) performance targets on state and federal indicators measuring outcomes of child
safety, permanency, and well-being;
new text end

new text begin (6) strategies the county must implement to achieve the performance targets,
including specification of how funds under this section and other community resources
must be used to achieve desired performance targets; and
new text end

new text begin (7) a description of the county's process to solicit public input and a summary of
that input.
new text end

new text begin Subd. 3. new text end

new text begin Timelines. new text end

new text begin The preliminary plan must be submitted to the commissioner
by October 15, 2010, and October 15 of every two years thereafter.
new text end

new text begin Subd. 4. new text end

new text begin Public comment. new text end

new text begin The county board shall determine how citizens in the
county will participate in the development of the plan and provide opportunities for
such participation. The county shall allow a period of no less than 30 days prior to the
submission of the plan to the commissioner to solicit comments from the public on the
contents of the plan.
new text end

new text begin Subd. 5. new text end

new text begin Commissioner's responsibilities. new text end

new text begin The commissioner shall, within 60
days of receiving each county plan, inform the county if the plan has been approved.
If the plan is not approved, the commissioner shall inform the county of any revisions
needed for approval.
new text end

Sec. 8.

new text begin [256N.08] GRANT ALLOCATION.
new text end

new text begin Subdivision 1. new text end

new text begin Determination. new text end

new text begin The commissioner shall annually determine whether
a county has met the requirements under this act. In making this determination, the
commissioner shall consider factors addressed by the county in its plan under section
256N.07, whether the county fully participated in the state quality assurance process, and
actual county performance on measures of child safety, permanency, and well-being. The
commissioner shall continue to measure and monitor performance, and counties shall
continue to develop and employ appropriate strategies and procedures to continuously
improve their services and outcomes. Performance standards for these measures must be
determined by the commissioner in consultation with counties, and must include those
prescribed by the federal Department of Human Services and those unique to the state.
new text end

new text begin Subd. 2. new text end

new text begin Grant formula. new text end

new text begin (a) Beginning July 10, 2011, counties shall receive the
same allocation as was received the previous year under chapter 256M proportionately
to state Children and Community Services Act and federal Title XX funds that are
attributable to children services as determined by the commissioner. Allocations must be
comprised of both state appropriations under this act and federal Title XX funds, except
for Title XX funds allocated for administrative purposes and migrant day care. Beginning
July 10, 2012, the amount of money allocated to counties must first be allocated in
amounts equal to each county's guaranteed floor according to subdivision 3 provided they
meet the requirements under subdivision 1, and second, any remaining available funds
must be allocated as provided in paragraphs (b) to (f).
new text end

new text begin (b) Beginning July 10, 2012, ninety percent of remaining funds must be allocated
proportionally to counties based on the previous year's allocation and ten percent must be
allocated by the following formula:
new text end

new text begin (1) 50 percent of the funds must be allocated based on the county's performance on
the state and federal standards and the public priorities identified in section 256N.03 as
determined by the commissioner for that county;
new text end

new text begin (2) 30 percent of the funds must be allocated based on the county's percentage
share of the number of accepted maltreatment reports in the most recent calendar year
available as determined by the commissioner;
new text end

new text begin (3) ten percent of the funds must be allocated based on the county's percentage share
of the number of reports of family assessments and services to at-risk families, as defined
by section 256N.04, subdivisions 7 and 17, in the most recent calendar year available
as determined by the commissioner; and
new text end

new text begin (4) ten percent of the funds must be allocated based on the average monthly
caseloads in each county in the Minnesota family investment program in the most recent
calendar year available as determined by the commissioner.
new text end

new text begin (c) Beginning July 10, 2013, 70 percent of remaining funds must be allocated
proportionally to counties based on the previous year's allocation and 30 percent must be
allocated by the following formula:
new text end

new text begin (1) 50 percent of the funds must be allocated based on the county's performance on
the state and federal standards and the public priorities identified in section 256N.03 as
determined by the commissioner for that county;
new text end

new text begin (2) 30 percent of the funds must be allocated based on the county's percentage
share of the number of accepted maltreatment reports in the most recent calendar year
available as determined by the commissioner;
new text end

new text begin (3) ten percent of the funds must be allocated based on the county's percentage share
of the number of reports of family assessments and services to at-risk families, as defined
by section 256N.04, subdivisions 7 and 17, in the most recent calendar year available
as determined by the commissioner; and
new text end

new text begin (4) ten percent of the funds must be allocated based on the average monthly
caseloads in each county in the Minnesota family investment program in the most recent
calendar year available as determined by the commissioner.
new text end

new text begin (d) Beginning July 10, 2014, 40 percent of remaining funds must be allocated
proportionally to counties based on the previous year's allocation and 60 percent must be
allocated by the following formula:
new text end

new text begin (1) 50 percent of the funds must be allocated based on the county's performance on
the state and federal standards and the public priorities identified in section 256N.03 as
determined by the commissioner for that county;
new text end

new text begin (2) 30 percent of the funds must be allocated based on the county's percentage
share of the number of accepted maltreatment reports in the most recent calendar year
available as determined by the commissioner;
new text end

new text begin (3) ten percent of the funds must be allocated based on the county's percentage share
of the number of reports of family assessments and services to at-risk families, as defined
by section 256N.04, subdivisions 7 and 17, in the most recent calendar year available
as determined by the commissioner; and
new text end

new text begin (4) ten percent of the funds must be allocated based on the average monthly
caseloads in each county in the Minnesota family investment program in the most recent
calendar year available as determined by the commissioner.
new text end

new text begin (e) Beginning July 10, 2014, ten percent of remaining funds must be allocated
proportionally to counties based on the previous year's allocation and 90 percent must be
allocated by the following formula:
new text end

new text begin (1) 50 percent of the funds must be allocated based on the county's performance on
the state and federal standards and the public priorities identified in section 256N.03 as
determined by the commissioner for that county;
new text end

new text begin (2) 30 percent of the funds must be allocated based on the county's percentage
share of the number of accepted maltreatment reports in the most recent calendar year
available as determined by the commissioner;
new text end

new text begin (3) ten percent of the funds must be allocated based on the county's percentage share
of the number of reports of family assessments and services to at-risk families, as defined
by section 256N.04, subdivisions 7 and 17, in the most recent calendar year available
as determined by the commissioner; and
new text end

new text begin (4) ten percent of the funds must be allocated based on the average monthly
caseloads in each county in the Minnesota family investment program in the most recent
calendar year available as determined by the commissioner.
new text end

new text begin (f) Beginning July 10, 2015, 100 percent of remaining funds must be allocated
by the following formula:
new text end

new text begin (1) 50 percent of the funds must be allocated based on the county's performance on
the state and federal standards and the public priorities identified in section 256N.03 as
determined by the commissioner for that county;
new text end

new text begin (2) 30 percent of the funds must be allocated based on the county's percentage
share of the number of accepted maltreatment reports in the most recent calendar year
available as determined by the commissioner;
new text end

new text begin (3) ten percent of the funds shall be allocated based on the county's percentage share
of the number of reports of family assessments and services to at-risk families, as defined
by section 256N.04, subdivisions 7 and 17, in the most recent calendar year available
as determined by the commissioner; and
new text end

new text begin (4) ten percent of the funds must be allocated based on the average monthly
caseloads in each county in the Minnesota family investment program in the most recent
calendar year available as determined by the commissioner.
new text end

new text begin Subd. 3. new text end

new text begin Guaranteed floor. new text end

new text begin The guaranteed floor portion of funds must be 25
percent of the total allocation. Each county must be allocated a guaranteed floor based on
the population of the county under age 19 years as compared to the state as a whole as
determined by the most recent data from the state demographer's office. When the amount
of funds available for allocation is less than the amount available in the previous year,
each county's allocation must be reduced in proportion to the reduction in the statewide
funding, to establish each county's guaranteed floor.
new text end

new text begin Subd. 4. new text end

new text begin Payments. new text end

new text begin Calendar year state allocations under subdivision 1 must be
paid to counties on or before July 10 of each year. Federal Title XX funds must be
allocated as permissible under federal law and regulations.
new text end

Sec. 9.

new text begin [256N.09] DUTIES OF COUNTY BOARDS.
new text end

new text begin Subdivision 1. new text end

new text begin Responsibilities. new text end

new text begin The county or human services board of each
county are responsible for administration and funding of children services in order to
achieve the public policy and priorities identified in sections 256N.02 and 256N.03. The
county board shall use funds under this act to support the strategies identified in its plan
under section 256N.07.
new text end

new text begin Subd. 2. new text end

new text begin Reports. new text end

new text begin The county shall provide necessary reports and data as required
by the commissioner.
new text end

new text begin Subd. 3. new text end

new text begin Exemption from liability. new text end

new text begin The state of Minnesota and the county in
the implementation and administration of services under this act must not be liable
for damages, injuries, or liabilities sustained through the purchase of services by the
individual, the individual's family, or the authorized representative under this section.
new text end

new text begin Subd. 4. new text end

new text begin Fees for services. new text end

new text begin The county may establish a schedule of fees based upon
clients' ability to pay to be charged to recipients of children services. Payment, in whole or
in part, for services may be accepted from any person except that no fee may be charged to
persons or families whose adjusted gross household income is below the federal poverty
level. When services are provided to any person, including a recipient of aid administered
by the federal, state, or county government, payment of any charges due may be billed to
and accepted from a public assistance agency or from any public or private corporation.
new text end

new text begin Subd. 5. new text end

new text begin Denial, reduction, or termination of services due to fiscal limitations.
new text end

new text begin Before a county denies, reduces, or terminates services to an individual, the county shall
notify the individual and the individual's guardian in writing of the reason for the denial,
reduction, or termination of services and their right to a fair hearing under section 256.045
and that the county will, upon request, meet to discuss alternatives before services are
terminated or reduced.
new text end

Sec. 10. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 1 to 9 are effective January 1, 2011.
new text end

Sec. 11. new text beginREVISOR'S INSTRUCTION.
new text end

new text begin The revisor shall renumber section 256M.20, subdivision 3, as 256.01, subdivision
29, paragraph (a), and section 256M.20, subdivision 4, as section 256.01, subdivision 29,
paragraph (b), and correct any internal cross references resulting from this renumbering.
The revisor shall make any necessary technical, grammatical, or punctual changes to
accomplish this renumbering.
new text end

ARTICLE 7

NORTHSTAR CARE FOR CHILDREN

Section 1.

Minnesota Statutes 2008, section 256.991, is amended to read:


256.991 RULES.

The commissioner of human services may promulgate rules as necessary to
implement sections 256.01, subdivision 2; deleted text begin256.82, subdivision 3;deleted text end 256.966, subdivision 1;
256D.03, subdivisions 3, 4, 6, and 7; and 261.23. The commissioner shall promulgate
rules to establish standards and criteria for deciding which medical assistance services
require prior authorization and for deciding whether a second medical opinion is required
for an elective surgery. The commissioner shall promulgate rules as necessary to establish
the methods and standards for determining inappropriate utilization of medical assistance
services.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2011.
new text end

Sec. 2.

Minnesota Statutes 2008, section 256J.21, subdivision 2, is amended to read:


Subd. 2.

Income exclusions.

The following must be excluded in determining a
family's available income:

(1) payments for basic care, difficulty of care, and clothing allowances received for
providing family foster care to children or adults under Minnesota Rules, parts 9555.5050
to 9555.6265, 9560.0521, and 9560.0650 to 9560.0655, and payments received and used
for care and maintenance of a third-party beneficiary who is not a household member;

(2) reimbursements for employment training received through the Workforce
Investment Act of 1998, United States Code, title 20, chapter 73, section 9201;

(3) reimbursement for out-of-pocket expenses incurred while performing volunteer
services, jury duty, employment, or informal carpooling arrangements directly related to
employment;

(4) all educational assistance, except the county agency must count graduate student
teaching assistantships, fellowships, and other similar paid work as earned income and,
after allowing deductions for any unmet and necessary educational expenses, shall
count scholarships or grants awarded to graduate students that do not require teaching
or research as unearned income;

(5) loans, regardless of purpose, from public or private lending institutions,
governmental lending institutions, or governmental agencies;

(6) loans from private individuals, regardless of purpose, provided an applicant or
participant documents that the lender expects repayment;

(7)(i) state income tax refunds; and

(ii) federal income tax refunds;

(8)(i) federal earned income credits;

(ii) Minnesota working family credits;

(iii) state homeowners and renters credits under chapter 290A; and

(iv) federal or state tax rebates;

(9) funds received for reimbursement, replacement, or rebate of personal or real
property when these payments are made by public agencies, awarded by a court, solicited
through public appeal, or made as a grant by a federal agency, state or local government,
or disaster assistance organizations, subsequent to a presidential declaration of disaster;

(10) the portion of an insurance settlement that is used to pay medical, funeral, and
burial expenses, or to repair or replace insured property;

(11) reimbursements for medical expenses that cannot be paid by medical assistance;

(12) payments by a vocational rehabilitation program administered by the state
under chapter 268A, except those payments that are for current living expenses;

(13) in-kind income, including any payments directly made by a third party to a
provider of goods and services;

(14) assistance payments to correct underpayments, but only for the month in which
the payment is received;

(15) payments for short-term emergency needs under section 256J.626, subdivision
2
;

(16) funeral and cemetery payments as provided by section 256.935;

(17) nonrecurring cash gifts of $30 or less, not exceeding $30 per participant in
a calendar month;

(18) any form of energy assistance payment made through Public Law 97-35,
Low-Income Home Energy Assistance Act of 1981, payments made directly to energy
providers by other public and private agencies, and any form of credit or rebate payment
issued by energy providers;

(19) Supplemental Security Income (SSI), including retroactive SSI payments and
other income of an SSI recipient, except as described in section 256J.37, subdivision 3b;

(20) Minnesota supplemental aid, including retroactive payments;

(21) proceeds from the sale of real or personal property;

(22) state adoption assistance payments under section 259.67, new text beginadoption assistance
payments under chapter 256O,
new text endand up to an equal amount of county adoption assistance
payments;

(23) state-funded family subsidy program payments made under section 252.32
to help families care for children with developmental disabilities, consumer support
grant funds under section 256.476, and resources and services for a disabled household
member under one of the home and community-based waiver services programs under
chapter 256B;

(24) interest payments and dividends from property that is not excluded from and
that does not exceed the asset limit;

(25) rent rebates;

(26) income earned by a minor caregiver, minor child through age 6, or a minor
child who is at least a half-time student in an approved elementary or secondary education
program;

(27) income earned by a caregiver under age 20 who is at least a half-time student in
an approved elementary or secondary education program;

(28) MFIP child care payments under section 119B.05;

(29) all other payments made through MFIP to support a caregiver's pursuit of
greater economic stability;

(30) income a participant receives related to shared living expenses;

(31) reverse mortgages;

(32) benefits provided by the Child Nutrition Act of 1966, United States Code, title
42, chapter 13A, sections 1771 to 1790;

(33) benefits provided by the women, infants, and children (WIC) nutrition program,
United States Code, title 42, chapter 13A, section 1786;

(34) benefits from the National School Lunch Act, United States Code, title 42,
chapter 13, sections 1751 to 1769e;

(35) relocation assistance for displaced persons under the Uniform Relocation
Assistance and Real Property Acquisition Policies Act of 1970, United States Code, title
42, chapter 61, subchapter II, section 4636, or the National Housing Act, United States
Code, title 12, chapter 13, sections 1701 to 1750jj;

(36) benefits from the Trade Act of 1974, United States Code, title 19, chapter
12, part 2, sections 2271 to 2322;

(37) war reparations payments to Japanese Americans and Aleuts under United
States Code, title 50, sections 1989 to 1989d;

(38) payments to veterans or their dependents as a result of legal settlements
regarding Agent Orange or other chemical exposure under Public Law 101-239, section
10405, paragraph (a)(2)(E);

(39) income that is otherwise specifically excluded from MFIP consideration in
federal law, state law, or federal regulation;

(40) security and utility deposit refunds;

(41) American Indian tribal land settlements excluded under Public Laws 98-123,
98-124, and 99-377 to the Mississippi Band Chippewa Indians of White Earth, Leech
Lake, and Mille Lacs reservations and payments to members of the White Earth Band,
under United States Code, title 25, chapter 9, section 331, and chapter 16, section 1407;

(42) all income of the minor parent's parents and stepparents when determining the
grant for the minor parent in households that include a minor parent living with parents or
stepparents on MFIP with other children;

(43) income of the minor parent's parents and stepparents equal to 200 percent of the
federal poverty guideline for a family size not including the minor parent and the minor
parent's child in households that include a minor parent living with parents or stepparents
not on MFIP when determining the grant for the minor parent. The remainder of income is
deemed as specified in section 256J.37, subdivision 1b;

(44) payments made to children eligible for deleted text beginrelative custodydeleted text end new text beginguardianship new text endassistance
under deleted text beginsection 257.85deleted text endnew text begin chapter 256Onew text end;

(45) vendor payments for goods and services made on behalf of a client unless the
client has the option of receiving the payment in cash;

(46) the principal portion of a contract for deed payment; and

(47) cash payments to individuals enrolled for full-time service as a volunteer under
AmeriCorps programs including AmeriCorps VISTA, AmeriCorps State, AmeriCorps
National, and AmeriCorps NCCC.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2011.
new text end

Sec. 3.

Minnesota Statutes 2008, section 256J.24, subdivision 3, is amended to read:


Subd. 3.

Individuals who must be excluded from an assistance unit.

(a) The
following individuals who are part of the assistance unit determined under subdivision 2
are ineligible to receive MFIP:

(1) individuals who are recipients of Supplemental Security Income or Minnesota
supplemental aid;

(2) individuals disqualified from the food stamp or food support program or MFIP,
until the disqualification ends;new text begin and
new text end

(3) children deleted text beginon whose behalfdeleted text endnew text begin eligible for Northstar Care for Children under chapter
256O when the caregiver receives
new text end federal, state or local foster carenew text begin; guardianship
assistance; or adoption assistance
new text end payments deleted text beginare madedeleted text endnew text begin for themnew text end, except as provided in
sections 256J.13, subdivision 2, and 256J.74, subdivision 2deleted text begin; anddeleted text endnew text begin.new text end

deleted text begin (4) children receiving ongoing monthly adoption assistance payments under section
259.67.
deleted text end

(b) The exclusion of a person under this subdivision does not alter the mandatory
assistance unit composition.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2011.
new text end

Sec. 4.

Minnesota Statutes 2008, section 256J.24, subdivision 4, is amended to read:


Subd. 4.

Individuals who may elect to be included in the assistance unit.

(a) The
minor child's eligible caregiver may choose to be in the assistance unit, if the caregiver
is not required to be in the assistance unit under subdivision 2. If the eligible caregiver
chooses to be in the assistance unit, that person's spouse must also be in the unit.

(b) Any minor child not related as a sibling, stepsibling, or adopted sibling to the
minor child in the unit, but for whom there is an eligible caregiver may elect to be in
the unit.

(c) A deleted text beginfoster caredeleted text end provider deleted text beginof a minor child who isdeleted text end receiving deleted text beginfederal, state, or
local foster care maintenance payments
deleted text endnew text begin benefits for a child eligible for Northstar Care
for Children under chapter 256O
new text end may elect to receive MFIP if the provider meets the
definition of caregiver under section 256J.08, subdivision 11. If the provider chooses to
receive MFIP, the spouse of the provider must also be included in the assistance unit with
the provider. The provider and spouse are eligible for deleted text beginassistancedeleted text endnew text begin MFIPnew text end even if the only
minor child living in the provider's home is receiving deleted text beginfoster care maintenance paymentsdeleted text endnew text begin
benefits from Northstar Care for Children
new text end.

(d) The adult caregiver or caregivers of a minor parent are eligible to be a separate
assistance unit from the minor parent and the minor parent's child when:

(1) the adult caregiver or caregivers have no other minor children in the household;

(2) the minor parent and the minor parent's child are living together with the adult
caregiver or caregivers; and

(3) the minor parent and the minor parent's child receive MFIP, or would be eligible
to receive MFIP, if they were not receiving SSI benefits.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2011.
new text end

Sec. 5.

new text begin [256O.001] CITATION.
new text end

new text begin Sections 256O.001 to 256O.270 may be cited as the "Northstar Care for Children
Act." Sections 256O.001 to 256O.270 establish Northstar Care for Children, which
authorizes certain benefits to support children in need who are served by the Minnesota
child welfare system and who are the responsibility of the state of Minnesota, local county
social service agencies, or tribal social service agencies under section 256.01, subdivision
14b. A child eligible for the benefit has experienced a child welfare intervention that has
resulted in the child being placed away from the child's parents' care and is receiving
foster care services under chapter 260B, 260C, or 260D or is in the permanent care of
relatives through a transfer of permanent legal and physical custody, or in the permanent
care of adoptive parents.
new text end

Sec. 6.

new text begin [256O.01] PUBLIC POLICY.
new text end

new text begin (a) The legislature hereby declares that the public policy of this state is to keep
children safe from harm and to ensure that when children suffer harmful or injurious
experiences in their lives, appropriate services are immediately available to keep them safe.
new text end

new text begin (b) Children do best in permanent, safe, nurturing homes with long-term
relationships with adults. Whenever safely possible, children are best served when they
can be nurtured and raised by their parents. Where services cannot be provided to allow a
child to remain safely at home, an out-of-home placement may be required. When this
occurs, reunification should be sought if it can be accomplished safely. When it is not
possible for parents to provide safety and permanency for their children, an alternative
permanent home must quickly be made available to the child, drawing from kinship
sources whenever possible.
new text end

new text begin (c) Minnesota understands the importance of having a comprehensive approach to
temporary out-of-home care and to permanent homes for children who cannot be reunited
with their families. It is critical that stable benefits be available to caregivers to ensure
that the child's needs can be met whether the child's situation and best interests call for
temporary foster care, transfer of permanent legal and physical custody to a relative, or
adoption. Northstar Care for Children focuses on the child's needs and strengths, and
the actual level of care provided by the caregiver, without consideration for the type of
placement setting. In this way, caregivers are not faced with the burden of making specific
long-term decisions based upon competing financial incentives.
new text end

Sec. 7.

new text begin [256O.02] DEFINITIONS.
new text end

new text begin Subdivision 1. new text end

new text begin Scope. new text end

new text begin For the purposes of sections 256O.001 to 256O.270, the
terms defined in this section have the meanings given them.
new text end

new text begin Subd. 2. new text end

new text begin Adoption assistance. new text end

new text begin "Adoption assistance" means financial support,
medical coverage, or both, provided under agreement with the legally responsible agency
and the commissioner to the parents of an adoptive child whose special needs would
otherwise make it difficult to place the child for adoption, to assist with the cost of caring
for the child.
new text end

new text begin Subd. 3. new text end

new text begin Assessment. new text end

new text begin "Assessment" means the process under section 256O.240 by
which is determined the benefits an eligible child may receive under section 256O.250.
new text end

new text begin Subd. 4. new text end

new text begin At-risk child. new text end

new text begin "At-risk child" means a child who does not have a
documented disability but who is at risk of developing a physical, mental, emotional, or
behavioral disability based on being related within the first or second degree to persons
who have an inheritable physical, mental, emotional, or behavioral disabling condition,
or from a background which has the potential to cause the child to develop a physical,
mental, emotional, or behavioral disability. The disability that the child is at risk of
developing must be likely to manifest during childhood. A high-risk child under section
259.67 is considered an at-risk child.
new text end

new text begin Subd. 5. new text end

new text begin Basic rate. new text end

new text begin "Basic rate" means the maintenance payment made on behalf
of a child to support the costs caregivers incur to meet a child's needs consistent with the
care parents customarily provide, including: food, clothing, shelter, daily supervision,
school supplies, child's personal incidentals, reasonable travel to the child's home for
visitation, and transportation needs associated with providing the listed items.
new text end

new text begin Subd. 6. new text end

new text begin Caregiver. new text end

new text begin "Caregiver" means the foster parent of a child in foster care
who meets the requirements of emergency relative placement, a licensed foster parent
under chapter 245A, or approved by the tribe; the relative custodian; or the adoptive parent
who has legally adopted a child.
new text end

new text begin Subd. 7. new text end

new text begin Child-placing agency. new text end

new text begin "Child-placing agency" means an agency licensed
under section 245A.03, subdivision 1, clauses (2) and (3).
new text end

new text begin Subd. 8. new text end

new text begin Commissioner. new text end

new text begin "Commissioner" means the commissioner of human
services.
new text end

new text begin Subd. 9. new text end

new text begin County board. new text end

new text begin "County board" means the board of county commissioners
in each county.
new text end

new text begin Subd. 10. new text end

new text begin Disability. new text end

new text begin "Disability" means a professionally documented physical,
mental, emotional, or behavioral impairment that substantially limits one or more major
life activity. Major life activities include, but are not limited to: thinking, walking,
hearing, breathing, working, seeing, speaking, communicating, learning, developing and
maintaining healthy relationships, safely caring for oneself, and performing manual tasks.
The nature, duration, and severity of the impairment must be used in determining if the
limitation is substantial.
new text end

new text begin Subd. 11. new text end

new text begin Foster care. new text end

new text begin "Foster care" means foster care as described either in section
260B.007, subdivision 7, or 260C.007, subdivision 18.
new text end

new text begin Subd. 12. new text end

new text begin Guardianship assistance. new text end

new text begin "Guardianship assistance" means financial
support, medical coverage, or both, provided under agreement with the legally responsible
agency and the commissioner to a relative who has received permanent legal and physical
custody of a child, to assist with the cost of caring for the child.
new text end

new text begin Subd. 13. new text end

new text begin Human services board. new text end

new text begin "Human services board" means a board
established under section 402.02; Laws 1974, chapter 293; or Laws 1976, chapter 340.
new text end

new text begin Subd. 14. new text end

new text begin Legally responsible agency. new text end

new text begin "Legally responsible agency" means the
Minnesota agency that is assigned responsibility for placement, care, and supervision
of the child through a court order, voluntary placement agreement, or voluntary
relinquishment. These agencies include both local social service agencies under section
393.07 and tribal social service agencies authorized in section 256.01, subdivision 14b,
and Minnesota tribes when legal responsibility is transferred to the tribal social service
agency through a Minnesota district court order.
new text end

new text begin Subd. 15. new text end

new text begin Maintenance payments. new text end

new text begin "Maintenance payments" means the basic
rate plus any supplemental difficulty of care rate under Northstar Care for Children. It
specifically does not include the cost of initial clothing allowance, payment for social
services, or administrative payments to a child-placing agency.
new text end

new text begin Subd. 16. new text end

new text begin Permanent legal and physical custody. new text end

new text begin "Permanent legal and
physical custody" means permanent legal and physical custody ordered by a Minnesota
juvenile court under section 260C.201, subdivision 11, or for children under tribal
court jurisdiction, similar provision under tribal code which means that the individual
responsible for the child has responsibility for the protection, education, care, and control
of the child and decision making on behalf of the child.
new text end

new text begin Subd. 17. new text end

new text begin Reassessment. new text end

new text begin "Reassessment" means an update of the previous
assessment through the process under section 256O.240 for a child who has been
continuously eligible for this benefit.
new text end

new text begin Subd. 18. new text end

new text begin Relative. new text end

new text begin "Relative" as described in section 260C.007, subdivision 27,
means a person related to the child by blood, marriage, or adoption, or an individual who
is an important friend with whom the child has resided or had significant contact. For an
Indian child, relative includes members of the extended family as defined by the law or
custom of the Indian child's tribe or, in the absence of law or custom, nieces, nephews,
or first or second cousins, as provided in the Indian Child Welfare Act of 1978, United
States Code, title 25, section 1903.
new text end

new text begin Subd. 19. new text end

new text begin Relative custodian. new text end

new text begin "Relative custodian" means a person to whom
permanent legal and physical custody of a child has been transferred under section
260C.201, subdivision 11, or for children under tribal court jurisdiction, a similar
provision under tribal code which means that the individual responsible for the child has
responsibility for the protection, education, care, and control of the child and decision
making on behalf of the child.
new text end

new text begin Subd. 20. new text end

new text begin Supplemental difficulty of care rate. new text end

new text begin "Supplemental difficulty of care
rate" means the supplemental rating, if any, as determined by the legally responsible
agency or the state, based upon an assessment under section 256O.240. The supplemental
rate supports activities consistent with the care a parent would provide a child with special
needs and not the equivalent of a purchased service. The rate considers the capacity
and intensity of the activities associated with parenting duties provided in the home to
nurture the child, preserve the child's connections, and support the child's functioning in
the home and community.
new text end

Sec. 8.

new text begin [256O.200] NORTHSTAR CARE FOR CHILDREN.
new text end

new text begin Subdivision 1. new text end

new text begin Eligibility. new text end

new text begin A child is eligible for Northstar Care for Children if
the child is eligible for:
new text end

new text begin (1) foster care under section 256O.210;
new text end

new text begin (2) guardianship assistance under section 256O.220; or
new text end

new text begin (3) adoption assistance under section 256O.230.
new text end

new text begin Subd. 2. new text end

new text begin Assessments and agreements. new text end

new text begin A child eligible for Northstar Care for
Children shall receive an assessment under section 256O.240. For a child eligible for
guardianship assistance or adoption assistance, negotiations with caregivers and the
development of a written, binding agreement must be conducted under section 256O.240.
new text end

new text begin Subd. 3. new text end

new text begin Benefits and payments. new text end

new text begin A child eligible for Northstar Care for Children
is entitled to benefits specified in section 256O.250, based primarily on assessments,
negotiations, and agreements under section 256O.240. Although paid to the caregiver,
these benefits are considered benefits of the child rather than of the caregiver.
new text end

new text begin Subd. 4. new text end

new text begin Shared cost of care. new text end

new text begin The cost of Northstar Care for Children must be
shared among the federal government, state, counties of financial responsibility, and
certain tribes as specified in section 256O.260.
new text end

new text begin Subd. 5. new text end

new text begin Administration and appeals. new text end

new text begin The commissioner and legally responsible
agency shall administer Northstar Care for Children according to section 256O.270. The
notification and fair hearing process is defined in section 256O.270.
new text end

new text begin Subd. 6. new text end

new text begin Transition. new text end

new text begin Provisions for the transition to Northstar Care for Children are
specified in sections 256O.240, subdivision 13, and 256O.270, subdivisions 2 and 7 to
10. Additional provisions for children in foster care are specified in section 256O.210,
subdivision 5; for children in relative custody assistance under section 257.85 are specified
in section 256O.220, subdivision 8; and for children in adoption assistance under section
259.67 are specified in section 256O.230, subdivision 14.
new text end

Sec. 9.

new text begin [256O.210] FOSTER CARE ASSISTANCE ELIGIBILITY.
new text end

new text begin Subdivision 1. new text end

new text begin General eligibility requirements. new text end

new text begin This section establishes the
eligibility for benefits when children are placed in foster care.
new text end

new text begin (a) A child that meets the requirements of subdivision 2 on or after January 1, 2011,
is eligible for the benefit.
new text end

new text begin (b) The benefit to the child under Northstar Care for Children, if any, is determined
under sections 256O.240 and 256O.250.
new text end

new text begin (c) When a child is eligible for additional services, subdivisions 3 and 4 govern
the co-occurrence of program eligibility.
new text end

new text begin (d) The child's benefit is individually assessed and the information assessment is
used to determine future eligibility for guardianship assistance and adoption assistance,
if needed.
new text end

new text begin (e) The county of financial responsibility, or, for children in the American Indian
Child Welfare Initiative, the responsible tribal social service agency authorized in section
256.01, subdivision 14b, shall make a title IV-E eligibility determination for all foster
children in Northstar Care for Children. To be eligible for title IV-E foster care, a child
must also meet any additional criteria specified in section 472 of the Social Security Act.
new text end

new text begin Subd. 2. new text end

new text begin Placement in foster care. new text end

new text begin To be eligible for Northstar Care for Children,
all of the following criteria must be met:
new text end

new text begin (1) the child is placed away from the child's legal parents or guardian and a legally
responsible agency has placement authority and care responsibility;
new text end

new text begin (2) the legally responsible agency has authority to place the child with a voluntary
placement agreement or a court order, consistent with section 260C.001, 260B.175, or
260D.01, or continued eligibility consistent with section 260C.451; and
new text end

new text begin (3) the child is placed in an emergency relative placement under section 245A.035,
a licensed foster family setting, foster residence setting, or treatment foster care setting
licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or a family foster home
approved by a tribal agency.
new text end

new text begin Subd. 3. new text end

new text begin Minor parent. new text end

new text begin A child who is a minor parent in placement with the
minor parent's child in the same home is eligible for the benefit. The benefit is limited
to the minor parent unless the legally responsible agency has separate legal authority
for placement of the minor parent's child.
new text end

new text begin Subd. 4. new text end

new text begin Excluded activities. new text end

new text begin The basic and supplemental difficulty of care
payments represent costs for activities similar in nature to those expected of parents and do
not cover services rendered by the licensed foster parent or facility or any administrative
cost. The county of financial responsibility, or, for children in the American Indian Child
Welfare Initiative, the responsible tribal social service agency authorized in section
256.01, subdivision 14b, may pay a fee for specific services provided by the licensed
foster parent or facility. Any foster parent or residence setting must be able to distinguish
the service from the daily care of the child, as assessed in the universal assessment under
section 256O.240. Administrative costs or fees are not part of this benefit.
new text end

new text begin Subd. 5. new text end

new text begin Transition from pre-2011. new text end

new text begin All children in family foster care who are the
financial responsibility of local social service agencies under section 393.07 or tribal
social service agencies authorized in section 256.01, subdivision 14b, are eligible for
Northstar Care for Children. All eligible foster children must be assessed according to
section 256O.240 and then transitioned into Northstar Care for Children according to
the process in section 256O.270.
new text end

Sec. 10.

new text begin [256O.220] GUARDIANSHIP ASSISTANCE ELIGIBILITY.
new text end

new text begin Subdivision 1. new text end

new text begin General eligibility requirements. new text end

new text begin (a) To be eligible for guardianship
assistance, there must be a judicial determination under section 260C.201, subdivision 11,
paragraph (c), that a transfer of permanent legal and physical custody to a relative or, for
a child under tribal jurisdiction, a similar provision under tribal code which means that
the individual responsible for the child has responsibility for the protection, education,
care, and control of the child and decision making on behalf of the child, is in the child's
best interest. Additionally, a child must:
new text end

new text begin (1) have been removed from the child's home pursuant to a voluntary placement
agreement or court order;
new text end

new text begin (2)(i) have resided in foster care for at least six consecutive months in the home
of the prospective relative custodian; or
new text end

new text begin (ii) have received an exemption from the requirement in item (i) from the court based
on a determination that an expedited move to permanency is in the child's best interest;
new text end

new text begin (3) meet the judicial determination regarding permanency requirements in
subdivision 2;
new text end

new text begin (4) meet the applicable citizenship and immigration requirements in subdivision
3; and
new text end

new text begin (5) have been consulted regarding the proposed transfer of permanent legal and
physical custody to a relative, if the child has attained 14 years of age or is expected to
attain 14 years of age prior to the transfer of permanent legal and physical custody.
new text end

new text begin (b) In addition to the requirements in paragraph (a), the child's prospective relative
custodian or custodians must meet the applicable background study requirements in
subdivision 4.
new text end

new text begin (c) The legally responsible agency shall make a title IV-E guardianship assistance
eligibility determination for each child. To be eligible for title IV-E guardianship
assistance, a child must also meet any additional criteria specified in section 473(d) of
the Social Security Act. A child who meets all eligibility criteria, except those specific
to title IV-E guardianship assistance, is entitled to guardianship assistance paid through
state funds.
new text end

new text begin Subd. 2. new text end

new text begin Judicial determinations regarding permanency. new text end

new text begin To be eligible for
guardianship assistance, the following judicial determinations regarding permanency must
be made for the child prior to the transfer of permanent legal and physical custody:
new text end

new text begin (1) a judicial determination that reunification and adoption are not appropriate
permanency options for the child; and
new text end

new text begin (2) a judicial determination that the child demonstrates a strong attachment to the
prospective relative custodian and the relative custodian has a strong commitment to
caring permanently for the child.
new text end

new text begin Subd. 3. new text end

new text begin Citizenship and immigration status. new text end

new text begin (a) A child must be a citizen of the
United States or otherwise eligible for federal public benefits according to the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, in order to
be eligible for title IV-E guardianship assistance.
new text end

new text begin (b) A child must be a citizen of the United States or meet the qualified alien
requirements as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, as amended, in order to be eligible for state-funded
guardianship assistance.
new text end

new text begin Subd. 4. new text end

new text begin Background study. new text end

new text begin (a) A background study must be completed on each
prospective relative custodian. If a background study on the prospective relative custodian
was previously completed under section 245A.04 for the purposes of foster care licensure,
that background study may be used for the purposes of this section, provided that the
background study is current at the time of the application for guardianship assistance.
If the background study reveals:
new text end

new text begin (1) a felony conviction at any time for child abuse or neglect;
new text end

new text begin (2) spousal abuse;
new text end

new text begin (3) a crime against children, including child pornography;
new text end

new text begin (4) a crime involving violence, including rape, sexual assault, or homicide, but not
including other physical assault or battery; or
new text end

new text begin (5) a felony conviction within the past five years for physical assault, battery, or a
drug-related offense,
new text end

new text begin the prospective relative custodian is prohibited from receiving title IV-E guardianship
assistance payments on behalf of an otherwise eligible child.
new text end

new text begin (b) An otherwise eligible prospective relative custodian who possesses one of the
felony convictions in paragraph (a) may receive state-funded guardianship assistance
payments on behalf of an otherwise eligible child if the court has made a judicial
determination that:
new text end

new text begin (1) the legally responsible agency has thoroughly reviewed the felony conviction
and has considered the impact, if any, that the conviction may have on the child's safety,
well-being, and permanency;
new text end

new text begin (2) the conviction likely does not pose a current or future safety risk to the child;
new text end

new text begin (3) there is no other available permanency resource that is appropriate for the
child; and
new text end

new text begin (4) the proposed transfer of permanent legal and physical custody is in the child's
best interest.
new text end

new text begin Subd. 5. new text end

new text begin Residency. new text end

new text begin A child placed in the state from another state or a tribe outside
the state is not eligible for state-funded guardianship assistance through the state. A child
placed in the state from another state or a tribe outside of the state may be eligible for title
IV-E guardianship assistance through the state if all eligibility factors are met and there is
no state agency that has responsibility for placement and care of the child.
new text end

new text begin Subd. 6. new text end

new text begin Exclusions. new text end

new text begin A child with a guardianship assistance agreement under
Northstar Care for Children is not eligible for the MFIP child-only grant under section
256J.88.
new text end

new text begin Subd. 7. new text end

new text begin Termination. new text end

new text begin (a) A guardianship assistance agreement terminates in any
of the following circumstances:
new text end

new text begin (1) the child reaches the age of 18;
new text end

new text begin (2) the commissioner determines that the relative custodian is no longer legally
responsible for support of the child;
new text end

new text begin (3) the commissioner determines that the relative custodian is no longer providing
financial support to the child;
new text end

new text begin (4) death of the child; or
new text end

new text begin (5) the relative custodian requests termination of the guardianship assistance
agreement in writing.
new text end

new text begin (b) A relative custodian is considered no longer legally responsible for support of
the child in any of the following circumstances:
new text end

new text begin (1) permanent legal and physical custody of the child is transferred to another
individual;
new text end

new text begin (2) death of the relative custodian;
new text end

new text begin (3) enlistment of the child in the military;
new text end

new text begin (4) marriage of the child; or
new text end

new text begin (5) emancipation of the child through legal action of another state.
new text end

new text begin Subd. 8. new text end

new text begin Transitioning in from pre-2011. new text end

new text begin Effective December 31, 2010, all relative
custody assistance agreements under section 257.85 must terminate. A child who has a
relative custody assistance agreement executed on the child's behalf under section 257.85
on or before November 24, 2010, is eligible for Northstar Care for Children beginning
January 1, 2011, provided that all parties have signed the guardianship assistance
agreement on or before that date. All eligible children shall be assessed according to
section 256O.240 and transitioned into Northstar Care for Children according to the
process in section 256O.270. Effective November 25, 2010, a child who meets the
eligibility criteria for guardianship assistance in subdivision 1, may have a guardianship
assistance agreement negotiated on the child's behalf according to section 256O.240,
and the effective date of the agreement is January 1, 2011, or the date of the court order
transferring permanent legal and physical custody, whichever is later.
new text end

Sec. 11.

new text begin [256O.230] ADOPTION ASSISTANCE ELIGIBILITY.
new text end

new text begin Subdivision 1. new text end

new text begin General eligibility requirements. new text end

new text begin (a) To be eligible for adoption
assistance, a child must:
new text end

new text begin (1) be determined to be a child with special needs, according to subdivision 2;
new text end

new text begin (2) meet the applicable citizenship and immigration requirements in subdivision
3; and
new text end

new text begin (3)(i) meet the criteria outlined in section 473 of the Social Security Act; or
new text end

new text begin (ii) have had foster care payments paid on the child's behalf while in out-of-home
placement through the county or tribe, and be either under the guardianship of the
commissioner or under the jurisdiction of a Minnesota tribe and adoption according to
tribal law is the child's documented permanency plan.
new text end

new text begin (b) In addition to the requirements in paragraph (a), the child's adoptive parent or
parents must meet the applicable background study requirements in subdivision 4.
new text end

new text begin (c) The legally responsible agency shall make a title IV-E adoption assistance
eligibility determination for each child. A child who meets all eligibility criteria, except
those specific to title IV-E adoption assistance, shall receive adoption assistance paid
through state funds.
new text end

new text begin Subd. 2. new text end

new text begin Special needs determination. new text end

new text begin (a) A child is considered a child with special
needs under this section if all of the following criteria in paragraphs (b) to (d) are met.
new text end

new text begin (b) There has been a determination that the child cannot or should not be returned to
the home of the child's parents as evidenced by:
new text end

new text begin (1) a court-ordered termination of parental rights;
new text end

new text begin (2) a petition to terminate parental rights;
new text end

new text begin (3) a consent to adopt accepted by the court under sections 260C.201, subdivision
11, and 259.24;
new text end

new text begin (4) in circumstances when tribal law permits the child to be adopted without a
termination of parental rights, a judicial determination by tribal court indicating the valid
reason why the child cannot or should not return home;
new text end

new text begin (5) a voluntary relinquishment under section 259.25 or 259.47 or, if relinquishment
occurred in another state, the applicable laws in that state; or
new text end

new text begin (6) the death of the legal parent.
new text end

new text begin (c) There exists a specific factor or condition because of which it is reasonable to
conclude that the child cannot be placed with adoptive parents without providing adoption
assistance as evidenced by:
new text end

new text begin (1) a determination by the Social Security Administration that the child meets all
medical or disability requirements of title XVI of the Social Security Act with respect to
eligibility for Supplemental Security Income benefits;
new text end

new text begin (2) a documented physical, mental, emotional, or behavioral disability not covered
under clause (1);
new text end

new text begin (3) membership in a sibling group being adopted at the same time by the same parent;
new text end

new text begin (4) adoptive placement in the home of a parent who previously adopted another child
born of the same mother or father for whom they receive adoption assistance; or
new text end

new text begin (5) documentation that the child is an at-risk child according to subdivision 7.
new text end

new text begin (d) A reasonable but unsuccessful effort has been made to place the child with
adoptive parents without providing adoption assistance as evidenced by:
new text end

new text begin (1)(i) a documented search for an appropriate adoptive placement; or
new text end

new text begin (ii) a determination by the commissioner that such a search would not be in the best
interests of the child; and
new text end

new text begin (2) a written statement from the identified prospective adoptive parents that they are
either unwilling or unable to adopt the child without adoption assistance.
new text end

new text begin (e) To meet the requirement of a documented search for an appropriate adoptive
placement under paragraph (d), clause (1), item (i), the placing agency minimally shall:
new text end

new text begin (1) give consideration as required by section 260C.212, subdivision 5, to placement
with a relative;
new text end

new text begin (2) for an Indian child covered by the Indian Child Welfare Act, comply with the
placement preferences identified in the Indian Child Welfare Act and the Minnesota Indian
Family Preservation Act; and
new text end

new text begin (3) review all families approved for adoption who are associated with the placing
agency.
new text end

new text begin If the review of families associated with the placing agency results in the identification
of an appropriate adoptive placement for the child, the placing agency must provide
documentation of the placement decision to the commissioner as part of the application
for adoption assistance. If two or more appropriate families are not approved or available
within the placing agency, the agency shall locate additional prospective adoptive families
by registering the child with the state adoption exchange, as defined in section 259.75. If
registration with the state adoption exchange does not result in an appropriate family for
the child, the agency shall employ other recruitment methods as outlined in recruitment
policies and procedures prescribed by the commissioner, to meet this requirement.
new text end

new text begin (f) The requirement for a documented search for an appropriate adoptive placement
including a review of all families approved for adoption that are associated with the
placing agency, registration of the child with the state adoption exchange, and additional
recruitment methods must be waived if:
new text end

new text begin (1) the child is being adopted by a relative;
new text end

new text begin (2) the child is being adopted by foster parents with whom the child has developed
significant emotional ties while in the foster parents' care as a foster child; or
new text end

new text begin (3) the child is being adopted by a family that previously adopted a child of the
same mother or father;
new text end

new text begin and the court determines that adoption by the identified family is in the child's best interest.
For an Indian child covered by the Indian Child Welfare Act, a waiver must not be granted
unless the placing agency has complied with the placement preferences identified in the
Indian Child Welfare Act and the Minnesota Indian Family Preservation Act.
new text end

new text begin (g) Once the placing agency has determined that placement with an identified family
is in the child's best interest and made full written disclosure about the child's social and
medical history, the agency must ask the prospective adoptive parents if they are willing to
adopt the child without adoption assistance. If the identified family is either unwilling
or unable to adopt the child without adoption assistance, they must provide a written
statement to this effect to the placing agency to fulfill the requirement to make a reasonable
effort to place the child without adoption assistance, and a copy of this statement shall be
included in the adoption assistance application. If the identified family desires to adopt
the child without adoption assistance, they must provide a written statement to this effect
to the placing agency and the statement shall be maintained in the permanent adoption
record of the placing agency. For children under the commissioner's guardianship, the
placing agency shall submit a copy of this statement to the commissioner to be maintained
in the permanent adoption record.
new text end

new text begin Subd. 3. new text end

new text begin Citizenship and immigration status. new text end

new text begin (a) A child must be a citizen of the
United States or otherwise eligible for federal public benefits according to the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, in order to
be eligible for title IV-E adoption assistance.
new text end

new text begin (b) A child must be a citizen of the United States or meet the qualified alien
requirements as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, as amended, in order to be eligible for state-funded adoption
assistance.
new text end

new text begin Subd. 4. new text end

new text begin Background study. new text end

new text begin (a) A background study under section 259.41 must be
completed on each prospective adoptive parent. If the background study reveals:
new text end

new text begin (1) a felony conviction at any time for child abuse or neglect;
new text end

new text begin (2) spousal abuse;
new text end

new text begin (3) a crime against children, including child pornography;
new text end

new text begin (4) a crime involving violence, including rape, sexual assault, or homicide, but not
including other physical assault or battery; or
new text end

new text begin (5) a felony conviction within the past five years for physical assault, battery, or a
drug-related offense,
new text end

new text begin the adoptive parent is prohibited from receiving title IV-E adoption assistance on behalf of
an otherwise eligible child.
new text end

new text begin (b) A prospective adoptive parent who possesses one of the felony convictions in
paragraph (a) may receive state-funded adoption assistance on behalf of an otherwise
eligible child if the court has made a judicial determination that:
new text end

new text begin (1) the legally responsible agency has thoroughly reviewed the felony conviction
and has considered the impact, if any, that the conviction may have on the child's safety,
well-being, and permanency;
new text end

new text begin (2) the conviction likely does not pose a current or future safety risk to the child;
new text end

new text begin (3) there is no other available permanency resource that is appropriate for the
child; and
new text end

new text begin (4) the adoptive placement is in the child's best interest.
new text end

new text begin Subd. 5. new text end

new text begin Residency. new text end

new text begin A child placed in the state from another state or a tribe outside
the state is not eligible for state-funded adoption assistance through the state. A child
placed in the state from another state or a tribe outside of the state may be eligible for title
IV-E adoption assistance through the state of Minnesota if all eligibility factors are met
and there is no state agency that has responsibility for placement and care of the child.
new text end

new text begin Subd. 6. new text end

new text begin Exceptions and exclusions. new text end

new text begin Payments for adoption assistance must
not be made to a biological parent of the child or a stepparent who adopts the child.
Direct placement adoptions under section 259.47 or the equivalent in tribal code are
not eligible for state-funded adoption assistance. A child who is adopted by the child's
legal custodian or guardian is not eligible for state-funded adoption assistance. A child
who is adopted by the child's legal custodian or guardian may be eligible for title IV-E
adoption assistance if all required eligibility factors are met. International adoptions are
not eligible for adoption assistance unless the adopted child has been placed into foster
care through the public child welfare system subsequent to the failure of the adoption,
and all required eligibility factors are met.
new text end

new text begin Subd. 7. new text end

new text begin Documentation. new text end

new text begin (a) Documentation must be provided to verify that a child
meets the special needs criteria in subdivision 2.
new text end

new text begin (b) Documentation of the disability is limited to evidence deemed appropriate by
the commissioner.
new text end

new text begin (c) To qualify as being an at-risk child, the placing agency shall provide to the
commissioner one or more of the following:
new text end

new text begin (1) documented information in a county or tribal social service department record or
court record that a relative within the first or second degree has a medical diagnosis or
medical history, including diagnosis of a significant mental health or chemical dependency
issue, which could result in the child's development of a disability during childhood;
new text end

new text begin (2) documented information that while in the public child welfare system, the child
has experienced three or more placements with extended family or different foster homes
that could affect the normal attachment process;
new text end

new text begin (3) documented evidence in a county or tribal social service department record that
the child experienced neglect in the first three years of life or sustained physical injury,
sexual abuse, or physical disease that could have a long-term effect on physical, emotional
or mental development; or
new text end

new text begin (4) documented evidence in a medical or hospital record, law enforcement record,
county or tribal social service department record, court record, or record of an agency
under a contract with a county social service agency or the state to provide child welfare
services that the birth mother used drugs or alcohol during pregnancy which could later
result in the child's development of a disability.
new text end

new text begin Subd. 8. new text end

new text begin Termination. new text end

new text begin (a) An adoption assistance agreement terminates in any
of the following circumstances:
new text end

new text begin (1) the child attains the age of 18, unless an extension according to subdivisions 10
to 13 are applied for by the adoptive parents and granted by the commissioner;
new text end

new text begin (2) the commissioner determines that the adoptive parents are no longer legally
responsible for support of the child;
new text end

new text begin (3) the commissioner determines that the adoptive parents are no longer providing
financial support to the child;
new text end

new text begin (4) death of the child; or
new text end

new text begin (5) the adoptive parents request termination of the adoption assistance agreement
in writing.
new text end

new text begin (b) An adoptive parent is considered no longer legally responsible for support of the
child in any of the following circumstances:
new text end

new text begin (1) parental rights to the child are legally terminated;
new text end

new text begin (2) permanent legal and physical custody or guardianship of the child is transferred
to another individual;
new text end

new text begin (3) death of the adoptive parent;
new text end

new text begin (4) enlistment of the child in the military;
new text end

new text begin (5) marriage of the child; or
new text end

new text begin (6) emancipation of the child through legal action of another state.
new text end

new text begin Subd. 9. new text end

new text begin Death of adoptive parent or adoption dissolution. new text end

new text begin (a) The adoption
assistance agreement ends upon death or termination of parental rights of both of the
adoptive parents, in the case of a two-parent adoption, or the sole adoptive parent, in the
case of a single-parent adoption, but the child maintains eligibility for state-funded or title
IV-E adoption assistance in a subsequent adoption if the following criteria are met:
new text end

new text begin (1) the child is determined to be a child with special needs as described in
subdivision 2;
new text end

new text begin (2) the subsequent adoptive parents reside in the state of Minnesota; and
new text end

new text begin (3) no state agency outside the state has responsibility for placement and care of the
child at the time of the subsequent adoption.
new text end

new text begin (b) According to federal regulations, if the child had a title IV-E adoption assistance
agreement prior to the death of the adoptive parents or dissolution of the adoption, and a
state agency outside of the state of Minnesota has responsibility for placement and care of
the child at the time of the subsequent adoption, the state of Minnesota is not responsible
for determining whether the child meets the definition of special needs, entering into the
adoption assistance agreement, and making any adoption assistance payments outlined in
the new agreement.
new text end

new text begin (c) According to federal regulations, if the child had a title IV-E adoption assistance
agreement prior to the death of the adoptive parents or dissolution of the adoption, the
subsequent adoptive parents reside outside of the state of Minnesota, and no state agency
has responsibility for placement and care of the child at the time of the subsequent
adoption, the state of Minnesota is not responsible for determining whether the child
meets the definition of special needs, entering into the adoption assistance agreement, and
making any adoption assistance payments outlined in the new agreement.
new text end

new text begin Subd. 10. new text end

new text begin Extension, past age 18. new text end

new text begin Under certain limited circumstances, a child may
qualify for extension of the adoption assistance agreement beyond the date the child attains
age 18. An application for extension must be completed and submitted by the adoptive
parent at least 90 days prior to the date the child attains age 18, unless the child's adoption
is scheduled to finalize less than 90 days prior to that date, in which case the application
for extension must be completed and submitted with the adoption assistance application.
The application for extension shall be made on forms established by the commissioner and
shall include documentation of eligibility as specified by the commissioner.
new text end

new text begin Subd. 11. new text end

new text begin Extension based on a continuing physical or mental disability. new text end

new text begin (a)
Extensions based on a child's continuing physical or mental disability must be applied for
prior to the date the child attains age 18. The commissioner must not grant an extension on
this basis if an extension based on continued enrollment in a secondary education program
or being a child whose adoption finalized after age 16 was previously granted for the child.
new text end

new text begin (b) A child is eligible for extension of the adoption assistance agreement to the date
the child attains age 21 if the following criteria are met:
new text end

new text begin (1) the child has a mental or physical disability upon which eligibility for adoption
assistance was based which warrants the continuation of assistance;
new text end

new text begin (2) the child is unable to obtain self-sustaining employment due to the
aforementioned mental or physical disability; and
new text end

new text begin (3) the child needs significantly more care and support than what is typical for an
individual of the same age.
new text end

new text begin Subd. 12. new text end

new text begin Extension based on continued enrollment in a secondary education
program.
new text end

new text begin (a) If a child does not qualify for extension based on a continuing physical or
mental disability, or a parent chooses not to apply for an extension on that basis, the
adoptive parents may make an application for continuation of adoption assistance based
on enrollment in a secondary education program.
new text end

new text begin (b) If a child is enrolled full time in a secondary education program or a program
leading to an equivalent credential, the child is eligible for extension to the expected
graduation date or the date the child attains age 19, whichever is earlier. If a child receives
a school-based extension and at any time ceases to be enrolled in a full-time secondary
education program or a program leading to an equivalent credential, the adoptive parents
must notify the commissioner and the agreement must terminate.
new text end

new text begin (c) Extensions based on continuation in a secondary education program must be paid
from state funds only, unless the child meets the extension criteria in subdivision 13.
new text end

new text begin Subd. 13. new text end

new text begin Extension for children whose adoption finalized after age 16. new text end

new text begin A
child who attained the age of 16 prior to finalization of the child's adoption is eligible
for extension of the adoption assistance agreement to the date the child attains age 21
if the child is:
new text end

new text begin (1) completing a secondary education program or a program leading to an equivalent
credential;
new text end

new text begin (2) enrolled in an institution which provides postsecondary or vocational education;
new text end

new text begin (3) participating in a program or activity designed to promote or remove barriers to
employment;
new text end

new text begin (4) employed for at least 80 hours per month; or
new text end

new text begin (5) incapable of doing any of the activities described in clauses (1) to (4) due to a
medical condition, which incapability is supported by regularly updated information in
the case plan of the child.
new text end

new text begin Subd. 14. new text end

new text begin Transitioning in from pre-2011. new text end

new text begin A child who has an adoption assistance
agreement executed on their behalf under section 259.67 on or before November 24, 2010,
is eligible for Northstar Care for Children beginning January 1, 2011, provided that all
parties have signed the renegotiated adoption assistance agreement on or before that date.
The adoption assistance agreement of eligible children whose adoptive parents decide to
opt in to Northstar Care for Children must be renegotiated according to the process in
section 256O.270. All eligible children whose adoptive parents decide to renegotiate
their adoption assistance agreement under Northstar Care for Children must be assessed
according to section 256O.240 and then transitioned into Northstar Care for Children
according to the process in section 256O.270. Effective November 25, 2010, a child
who meets the eligibility criteria for adoption assistance in subdivision 1 may have an
adoption assistance agreement negotiated on their behalf according to section 256O.240,
and the effective date of the agreement is January 1, 2011, or the date of the court order
finalizing the adoption, whichever is later.
new text end

Sec. 12.

new text begin [256O.240] ASSESSMENTS AND AGREEMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Assessment. new text end

new text begin Every child eligible under sections 256O.210,
256O.220, and 256O.230 must be assessed to determine the benefits the child may receive
under section 256O.250 according to the tool, process, and requirements specified in
subdivision 2. A child eligible for guardianship assistance under section 256O.220 or
adoption assistance under section 256O.230 who is determined to be an at-risk child
must be assessed at level A under section 256O.250, subdivision 1. All other children
shall be assessed at the basic level, level B, or one of ten supplemental difficulty of care
levels, levels C to L.
new text end

new text begin Subd. 2. new text end

new text begin Commissioner to establish the assessment tool, process, and
requirements.
new text end

new text begin Consistent with sections 256O.001 to 256O.270, the commissioner
shall establish the tool to be used and the process to be followed, including appropriate
documentation and other requirements, when conducting the assessment of children
entering or continuing in Northstar Care for Children. The assessment tool must take
into consideration the needs of the child and the ability of the caregiver to meet the
child's needs.
new text end

new text begin Subd. 3. new text end

new text begin Child care component of the assessment. new text end

new text begin (a) The assessment tool
established under subdivision 2 must include consideration of the caregiver's need
for child care according to this subdivision. Prior to including consideration of the
caregiver's need for child care on the child's assessment, prospective adoptive parents or
relative custodians shall apply to the child care assistance program under chapter 119B.
Foster parents are not required to apply to the child care assistance program to have the
caregiver's need for child care considered as part of the foster child's assessment.
new text end

new text begin (b) The child's assessment must include consideration of the caregiver's need for
child care if all the following criteria are met:
new text end

new text begin (1) the child has not attained the age of 13;
new text end

new text begin (2) all available adult caregivers are employed or attending training or educational
programs;
new text end

new text begin (3) the caregiver has applied for the child care assistance program under paragraph
(a); and
new text end

new text begin (4) child care assistance under chapter 119B is not received for the child.
new text end

new text begin Consideration of the caregiver's need for child care may be included on the child's
assessment for caregivers who are wait-listed for child care assistance or are eligible for
child care assistance but choose not to receive it.
new text end

new text begin (c) The level determined by the balance of the assessment must be adjusted based on
the number of hours of child care needed each week due to employment or attending a
training or educational program as follows:
new text end

new text begin (1) less than ten hours or if the caregiver is participating in the child care assistance
program under chapter 119B, no adjustment;
new text end

new text begin (2) ten to 19 hours, increase one level;
new text end

new text begin (3) 20 to 29 hours, increase two levels;
new text end

new text begin (4) 30 to 39 hours, increase three levels; and
new text end

new text begin (5) 40 or more hours, increase four levels.
new text end

new text begin (d) When the child attains the age of 13, the level shall revert to the level assessed
for the child prior to any consideration of the caregiver's need for child care.
new text end

new text begin Subd. 4. new text end

new text begin Timing of initial assessment. new text end

new text begin For an eligible child entering Northstar
Care for Children who is not part of the transition group under subdivision 13, the initial
assessment must be completed within 30 days of placement for children in foster care and
prior to the establishment of a guardianship assistance or adoption assistance agreement
on behalf of the child, if an initial assessment is required under subdivision 5.
new text end

new text begin Subd. 5. new text end

new text begin Completing the assessment. new text end

new text begin (a) The assessment must be completed in
consultation with the child's caregiver. Face-to-face contact with the caregiver is not
required to complete the assessment.
new text end

new text begin (b) For foster children eligible under section 256O.210, the initial assessment must
be completed by the county of financial responsibility or, for children in the American
Indian Child Welfare Initiative, the responsible tribal social service agency authorized
in section 256.01, subdivision 14b, within 30 days of the child's placement in foster
care. Reassessments must be completed by the legally responsible agency according to
subdivision 7. If the foster parent is unable or unwilling to cooperate with the assessment
process, the child must be assessed at the basic level, level B under section 256O.250,
subdivision 3. Notice to the foster parent must be provided as specified in subdivision 9.
new text end

new text begin (c) For children eligible for guardianship assistance under section 256O.220, a
new assessment is required as part of the negotiation of the guardianship assistance
agreement if:
new text end

new text begin (1) the child is determined to be an at-risk child;
new text end

new text begin (2) the child was not placed in foster care with the proposed relative custodian
immediately prior to the negotiation of the guardianship assistance agreement under
subdivision 10; or
new text end

new text begin (3) any requirement for reassessment under subdivision 7 is met.
new text end

new text begin If a new assessment is required prior to the effective date of the guardianship assistance
agreement, the new assessment must be completed by the county of financial responsibility
or, for children in the American Indian Child Welfare Initiative, the responsible tribal
social service agency authorized in section 256.01, subdivision 14b. If reassessment
is required after the effective date of the guardianship assistance agreement, the new
assessment must be completed by the commissioner or the commissioner's designee. If
the proposed relative custodian is unable or unwilling to cooperate with the assessment
process, the child must be assessed at the basic level, level B under section 256O.250,
subdivision 3, unless the child is known to be an at-risk child, in which case, the child
must be assessed at level A under section 256O.250, subdivision 1. Notice to the proposed
relative custodian must be provided as specified in subdivision 9.
new text end

new text begin (d) For children eligible for adoption assistance under section 256O.230, a new
assessment is required as part of the negotiation of the adoption assistance agreement if:
new text end

new text begin (1) the child is determined to be an at-risk child;
new text end

new text begin (2) the child was not placed in foster care with the prospective adoptive parent
immediately prior to the negotiation of the adoption assistance agreement under
subdivision 10; or
new text end

new text begin (3) any requirement for reassessment under subdivision 7 is met.
new text end

new text begin If a new assessment is required prior to the effective date of the adoption assistance
agreement, it must be completed by the county of financial responsibility or, for children
in the American Indian Child Welfare Initiative, the responsible tribal social service
agency authorized in section 256.01, subdivision 14b. If there is no county of financial
responsibility and the child is not in the American Indian Child Welfare Initiative, or the
financially responsible agency is not a county social service or tribal agency in the state,
the assessment must be completed by the agency designated by the commissioner. If
reassessment is required after the effective date of the adoption assistance agreement, it
must be completed by the commissioner or the commissioner's designee. If the prospective
adoptive parent is unable or unwilling to cooperate with the assessment process, the child
must be assessed at the basic level, level B under section 256O.250, subdivision 3, unless
the child is known to be an at-risk child, in which case, the child shall be assessed at level
A under section 256O.250, subdivision 1. Notice to the prospective adoptive parent must
be provided as specified in subdivision 9.
new text end

new text begin Subd. 6. new text end

new text begin Approval of assessments and reassessments. new text end

new text begin Each legally responsible
agency shall designate one or more staff to examine and approve completed assessments
and reassessments. The staff person approving the assessments and reassessments must
not be the case manger or staff member completing the forms. The new rate is effective
the calendar month that the assessment is approved or the effective date of the agreement,
whichever is later.
new text end

new text begin Subd. 7. new text end

new text begin Timing of reassessments and requests for reassessments. new text end

new text begin For an eligible
child, reassessments must be completed within 30 days of any of the following events:
new text end

new text begin (1) for a child in continuous foster care, six months since completion of the last
assessment;
new text end

new text begin (2) for a child in continuous foster care, at a change of placement location;
new text end

new text begin (3) for a child in foster care, at the request of the legally responsible agency;
new text end

new text begin (4) at the request of the commissioner; or
new text end

new text begin (5) at the request of the caregiver under subdivision 8.
new text end

new text begin Subd. 8. new text end

new text begin Caregiver requests for reassessments. new text end

new text begin (a) For an eligible child, a
caregiver may initiate a reassessment request in writing to the county of financial
responsibility, or, for children in the American Indian Child Welfare Initiative, the
responsible tribal social service agency authorized in section 256.01, subdivision 14b,
for foster care cases, or the commissioner, or the commissioner's designee for adoption
assistance and guardianship assistance cases. The written request must include the
reason for the request and the name, address, and contact information of the caregivers.
For an eligible child with a guardianship assistance or adoption assistance agreement,
the caregiver may request a reassessment if at least six months have elapsed since any
previously requested review. A caregiver for a foster child may request reassessment in
less than six months with written documentation that there have been significant changes
in the child's needs that necessitate an earlier reassessment.
new text end

new text begin (b) A caregiver may request a reassessment of an at-risk child for whom a
guardianship assistance or adoption assistance agreement has been executed if the
caregiver has written professional documentation that the potential disability upon which
eligibility for the agreement was based has manifested itself.
new text end

new text begin (c) If the reassessment cannot be completed within 30 days of the caregiver's request,
the agency responsible for reassessment shall notify the caregiver of the reason for the
delay and a reasonable estimate of when the reassessment can be completed.
new text end

new text begin (d) If the child's caregiver is unable or unwilling to cooperate with the reassessment,
the child must be assessed at level B under section 256O.250, subdivision 3, unless the
child has an adoption assistance or guardianship assistance agreement in place and is
known to be an at-risk child, in which case, the child shall be assessed at level A under
section 256O.250, subdivision 1. Within 60 days of the caregiver demonstrating they are
able or willing to cooperate with the assessment or reassessment process, the reassessment
for the child must be completed.
new text end

new text begin Subd. 9. new text end

new text begin Notice for caregiver. new text end

new text begin (a) The agency responsible for completing the
assessment shall provide the child's caregiver with written notice of the initial assessment
or reassessment.
new text end

new text begin (b) Initial assessment notices must be sent within 15 days of completion of the initial
assessment and must minimally include the following:
new text end

new text begin (1) a summary of the completed child's individual assessment used to determine
the rating;
new text end

new text begin (2) statement of rating and benefit level;
new text end

new text begin (3) statement of the circumstances under which the agency shall reassess the child;
new text end

new text begin (4) procedure to seek reassessment;
new text end

new text begin (5) notice that the caregiver has the right to a fair hearing review of the assessment
and how to request a fair hearing, consistent with section 256.045, subdivision 3; and
new text end

new text begin (6) name, telephone number, and, if available, electronic address of a contact person
at the responsible agency or state.
new text end

new text begin (c) Reassessment notices must be sent within 15 days of the completion of the
reassessment and must minimally include the following:
new text end

new text begin (1) a summary of the completed child's individual assessment used to determine
the new rating;
new text end

new text begin (2) any change in rating and its effective date;
new text end

new text begin (3) procedure to seek reassessment;
new text end

new text begin (4) notice that if a change in rating results in a reduction of benefits, the caregiver
has the right to a fair hearing review of the assessment and how to request a fair hearing
consistent with section 256.045, subdivision 3;
new text end

new text begin (5) notice that a caregiver who requests a fair hearing of the reassessed rating within
ten days may continue at the current rate pending the hearing, but the agency may recover
any overpayment; and
new text end

new text begin (6) name, telephone number, and, if available, electronic address of a contact person
at the responsible agency or state.
new text end

new text begin Subd. 10. new text end

new text begin Agreements. new text end

new text begin (a) In order to receive guardianship assistance or adoption
assistance benefits, a written, binding agreement on a form approved by the commissioner
must be established prior to finalization of the adoption or a transfer of permanent legal
and physical custody. The agreement must be negotiated with the caregivers according
to subdivision 11. The caregivers and the commissioner or the commissioner's designee
must sign the agreement. A copy of the signed agreement must be given to each party.
Termination or disruption of the preadoptive placement or the foster care placement
preceding assignment of custody makes the agreement with that family void.
new text end

new text begin (b) The agreement must specify the following:
new text end

new text begin (1) duration of the agreement;
new text end

new text begin (2) the nature and amount of any payment, services, and assistance to be provided
under such agreement;
new text end

new text begin (3) the child's eligibility for Medicaid services;
new text end

new text begin (4) the terms of the payment;
new text end

new text begin (5) eligibility for reimbursement of nonrecurring expenses associated with adopting
or obtaining permanent legal and physical custody of the child, to the extent that the
total cost does not exceed $2,000 per child;
new text end

new text begin (6) that the agreement must remain in effect regardless of the state of which the
adoptive parents or relative custodians are residents at any given time;
new text end

new text begin (7) provisions for modification of the terms of the agreement; and
new text end

new text begin (8) the effective date of the agreement.
new text end

new text begin (c) The effective date of the guardianship assistance agreement is the date of the
court order that transfers permanent legal and physical custody to the relative.
new text end

new text begin (d)(1) For a child who receives Supplementary Security Income (SSI), Retirement,
Survivors, and Disability Insurance (RSDI), veteran's benefits, railroad retirement benefits,
or black lung benefits, the effective date of the adoption assistance agreement is the date
that the adoption is finalized.
new text end

new text begin (2) For a child who does not receive SSI, RSDI, veteran's benefits, railroad
retirement benefits, or black lung benefits, and who has been in the prospective adoptive
parents' home as a foster child for at least six consecutive months prior to adoption
placement, the effective date of the agreement is the date of adoptive placement or the
date that the agreement is signed by all parties, whichever is later.
new text end

new text begin (3) For a child who does not receive SSI, RSDI, veteran's benefits, railroad
retirement benefits, or black lung benefits, and who has been in the prospective adoptive
parents' home as a foster child for less than six consecutive months prior to adoptive
placement, the effective date of the agreement is the date that the child has resided in the
prospective adoptive parents' home as a foster child for at least six consecutive months
or the date the adoption is finalized, whichever is earlier.
new text end

new text begin Subd. 11. new text end

new text begin Negotiation of the agreement. new text end

new text begin (a) A monthly payment is provided
as part of the adoption assistance or guardianship assistance agreement to support the
care of children who have manifested special needs. The amount of the payment made
on behalf of children eligible for guardianship assistance or adoption assistance is
determined through agreement between the relative custodian or the adoptive parent and
the commissioner or the commissioner's designee, using the assessment tool established
by the commissioner in subdivision 2 and the associated benefit and payments in section
256O.250. The assessment tool establishes the monthly benefit level for a child in foster
care. The monthly payment under a guardianship assistance agreement or adoption
assistance agreement may be negotiated up to the monthly benefit level under foster care.
In no case may the amount of the payment under a guardianship assistance agreement or
adoption assistance agreement exceed the foster care maintenance payment which would
have been paid during the month if the child with respect to whom the guardianship
assistance or adoption assistance payment is made had been in a foster family home
in the state. The income of the relative custodian or adoptive parent must not be taken
into consideration when determining eligibility for guardianship assistance or adoption
assistance or the amount of the payments under section 256O.250. With the concurrence
of the relative custodian or adoptive parent, the amount of the payment may be adjusted
periodically using the assessment tool established by the commissioner in subdivision 2
and the agreement renegotiated under subdivision 12 when there is a change in the child's
needs or the family's circumstances.
new text end

new text begin (b) The guardianship assistance or adoption assistance agreement of a child who
is identified as an at-risk child must not include a monthly payment unless and until the
potential disability manifests itself, as documented by an appropriate professional, and
the commissioner authorizes commencement of payment by modifying the agreement
accordingly. A relative custodian or adoptive parent of an at-risk child with a guardianship
assistance or adoption assistance agreement may request a reassessment of the child under
subdivision 8 and renegotiation of the guardianship assistance or adoption assistance
agreement under subdivision 12 to include a monthly payment, if the caregiver has written
professional documentation that the potential disability upon which eligibility for the
agreement was based has manifested itself. Documentation of the disability must be
limited to evidence deemed appropriate by the commissioner.
new text end

new text begin (c)(1) The initial amount of the monthly guardianship assistance payment must be
equivalent to the foster care rate in effect at the time that the agreement is signed less
any offsets in section 256O.250, subdivision 8, or a lesser negotiated amount if agreed
to by the prospective relative custodian and specified in that agreement, unless the child
is identified as an at-risk child.
new text end

new text begin (2) An at-risk child must be assigned level A according to section 256O.250
and there shall be no monthly guardianship assistance payment unless and until the
potential disability manifests itself, as documented by an appropriate professional, and
the commissioner authorizes commencement of payment by modifying the agreement
accordingly.
new text end

new text begin (d)(1) For a child in foster care with the prospective adoptive parent immediately
prior to adoptive placement, the initial amount of the monthly adoption assistance payment
must be equivalent to the foster care rate in effect at the time that the agreement is signed
less any offsets in section 256O.250, subdivision 8, or a lesser negotiated amount if agreed
to by the prospective adoptive parents and specified in that agreement, unless the child
is identified as an at-risk child.
new text end

new text begin (2) An at-risk child must be assigned level A according to section 256O.250 and there
must be no monthly adoption assistance payment unless and until the potential disability
manifests itself, as documented by an appropriate professional, and the commissioner
authorizes commencement of payment by modifying the agreement accordingly.
new text end

new text begin (3) For children who are in the guardianship assistance program immediately prior
to adoptive placement, the initial amount of the adoption assistance payment must be
equivalent to the guardianship assistance payment in effect at the time that the adoption
assistance agreement is signed or a lesser amount if agreed to by the prospective adoptive
parent and specified in that agreement.
new text end

new text begin (4) For children who are not in foster care placement or the guardianship assistance
program immediately prior to adoptive placement or negotiation of the adoption assistance
agreement, the initial amount of the adoption assistance agreement must be determined
using the assessment tool and process in this section and the corresponding payment
amount in section 256O.250.
new text end

new text begin Subd. 12. new text end

new text begin Renegotiation of the agreement. new text end

new text begin (a) A relative custodian or adoptive
parent of a child with a guardianship assistance or adoption assistance agreement may
request renegotiation of the agreement when there is a change in the needs of the child
or in the family's circumstances. When a relative custodian or adoptive parent requests
renegotiation of the agreement, a reassessment of the child must be completed. If the
reassessment indicates that the child's level has changed, the commissioner or the
commissioner's designee and the caregiver shall renegotiate the agreement to include a
payment with the level determined through the reassessment process. The agreement
must not be renegotiated unless the commissioner and the caregiver mutually agree to
the changes. The effective date of any renegotiated agreement must be determined by
the commissioner.
new text end

new text begin (b) A relative custodian or adoptive parent of an at-risk child with a guardianship
assistance or adoption assistance agreement may request renegotiation of the agreement to
include a monthly payment, if the caregiver has written professional documentation that
the potential disability upon which eligibility for the agreement was based has manifested
itself. Documentation of the disability must be limited to evidence deemed appropriate by
the commissioner. Prior to renegotiating the agreement, a reassessment of the child must
be conducted according to subdivision 8. The reassessment must be used to renegotiate
the agreement to include an appropriate monthly payment. The agreement shall not be
renegotiated unless the commissioner and the caregiver mutually agree to the changes.
The effective date of any renegotiated agreement shall be determined by the commissioner.
new text end

new text begin Subd. 13. new text end

new text begin Transition assessments. new text end

new text begin (a) For a child who might transition into
Northstar Care for Children under section 256O.210 subdivision 5; 256O.220, subdivision
8; or 256O.230, subdivision 14, initial transition assessments must be completed between
May 1, 2010, and December 31, 2010.
new text end

new text begin (b) Transition assessments for a child in foster care completed between May 1,
2010, and August 31, 2010, must be considered valid under subdivision 7 until April 1,
2011, and those completed between September 1, 2010, and December 31, 2010, must be
considered valid under subdivision 7 until July 1, 2011.
new text end

new text begin (c) Children with relative custody assistance agreements under section 257.85 that
are effective prior to May 1, 2010, shall have initial transition assessments completed
between May 1 and December 31, 2010. Children with relative custody assistance
agreements between May 1, 2010, and November 24, 2010, shall have an initial transition
assessment completed as the agreement is being established in conjunction with the
supplemental maintenance needs assessment and other required relative custody assistance
paperwork under section 257.85.
new text end

new text begin (d) Children with adoption assistance agreements negotiated under section
259.67 and submitted to the commissioner for review and approval on or before April
30, 2010, who might transition into Northstar Care for Children, shall have initial
transition assessments completed by August 31, 2010. Children with adoption assistance
agreements negotiated under section 259.67 and submitted to the commissioner for
review and approval between May 1, 2010, and November 24, 2010, shall have an initial
transition assessment completed in conjunction with the supplemental maintenance needs
assessment and other required adoption assistance paperwork under section 259.67.
new text end

new text begin (e) If the child's caregiver is unable or unwilling to cooperate with the initial
transition assessment process, the child shall be assessed at the basic level, level B under
section 256O.250, subdivision 3, unless the child is known to be an at-risk child, in
which case the child shall be assessed at level A under section 256O.250, subdivision 1.
Within 60 days of the caregiver indicating they are able or willing to cooperate with the
assessment process, the commissioner or the commissioner's designee shall complete a
reassessment for the child.
new text end

new text begin (f) If the child's caregiver cannot be located to complete the initial transition
assessment process according to the time frames outlined in this section, the child shall
be assessed at the basic level, level B under section 256O.250, subdivision 3, unless the
child is known to be an at-risk child, in which case the child shall be assessed at level A
under section 256O.250, subdivision 1. Within 60 days of locating the caregiver, the
commissioner or the commissioner's designee shall complete a reassessment for the child.
new text end

Sec. 13.

new text begin [256O.250] BENEFITS AND PAYMENTS.
new text end

new text begin Subdivision 1. new text end

new text begin Benefits. new text end

new text begin There are three potential benefits available under Northstar
Care for Children: medical assistance, basic payment, and supplemental difficulty of care
payment. An eligible child receives medical assistance under subdivision 2. An eligible
child receives the basic payment under subdivision 3, except for those assigned level A
because they are determined to be at-risk children in guardianship assistance or adoption
assistance. An eligible child may receive an additional supplemental difficulty of care
payment under subdivision 4, as determined by the assessment under section 256O.240.
new text end

new text begin Subd. 2. new text end

new text begin Medical assistance. new text end

new text begin Eligibility for medical assistance under this chapter
continues to be determined according to section 256B.055.
new text end

new text begin Subd. 3. new text end

new text begin Basic monthly rate. new text end

new text begin For the period January 1, 2011, to June 30, 2012, the
basic monthly rate is according to the following schedule:
new text end

new text begin Ages 0-5
new text end
new text begin $500 per month
new text end
new text begin Ages 6-12
new text end
new text begin $625 per month
new text end
new text begin Ages 13 and older
new text end
new text begin $750 per month.
new text end

new text begin Subd. 4. new text end

new text begin Difficulty of care supplemental monthly rate. new text end

new text begin For the period January 1,
2011, to June 30, 2012, the difficulty of care supplemental monthly rate is according to
the following schedule:
new text end

new text begin level B
new text end
new text begin none
new text end
new text begin level C
new text end
new text begin $60 per month
new text end
new text begin level D
new text end
new text begin $120 per month
new text end
new text begin level E
new text end
new text begin $180 per month
new text end
new text begin level F
new text end
new text begin $240 per month
new text end
new text begin level G
new text end
new text begin $300 per month
new text end
new text begin level H
new text end
new text begin $360 per month
new text end
new text begin level I
new text end
new text begin $420 per month
new text end
new text begin level J
new text end
new text begin $480 per month
new text end
new text begin level K
new text end
new text begin $540 per month
new text end
new text begin level L
new text end
new text begin $600 per month.
new text end

new text begin A child assigned level B is still eligible for basic monthly rate under subdivision 3.
new text end

new text begin Subd. 5. new text end

new text begin Daily rates. new text end

new text begin The commissioner shall establish prorated daily rates to
the nearest cent for the monthly rates under subdivisions 3 and 4. Daily rates must be
routinely used when a partial month is involved for foster care, guardianship assistance,
and adoption assistance.
new text end

new text begin Subd. 6. new text end

new text begin Revision. new text end

new text begin By April 1, 2013, for fiscal year 2013, and by each subsequent
April 1 for each subsequent fiscal year, the commissioner shall review and revise the
rates under subdivisions 3, 4, and 5 based on United States Department of Agriculture
Estimates of the Cost of Raising a Child, published by the United States Department of
Agriculture, Agricultural Resources Service, Publication 1411. The revision must be the
average percentage by which costs increase for the age ranges represented in the United
States Department of Agriculture Estimates of the Cost of Raising a Child. The monthly
rates must be revised to the nearest dollar and the daily rates to the nearest cent.
new text end

new text begin Subd. 7. new text end

new text begin Home and vehicle modifications. new text end

new text begin A child who is eligible for an adoption
assistance agreement based on the child's physical disability or a child who is eligible
for a guardianship assistance agreement who possesses a physical disability must have
reimbursement of home and vehicle modifications necessary to accommodate the child's
physical disability included as part of the negotiation of the agreement under section
256O.240, subdivision 11. The total of all modifications must not exceed $25,000 and the
modifications must be requested during the first six months that the adoption assistance or
guardianship assistance agreement is in effect. The type and cost of each modification
must be preapproved by the commissioner. The type of home and vehicle modifications is
limited to those specified by the commissioner. The commissioner shall ensure that the
modifications are necessary to incorporate the child into the family and that the cost
is reasonable. Application for and reimbursement of modifications must be completed
according to a process specified by the commissioner.
new text end

new text begin Subd. 8. new text end

new text begin Child income or income attributable to the child. new text end

new text begin (a) A monthly
adoption assistance or guardianship assistance payment must be considered income and
resource attributable to the child and must be inalienable by any assignment or transfer
and exempt from garnishment under the laws of the state.
new text end

new text begin (b) When a child is placed into foster care, any income and resources attributable
to the child must be handled according to sections 252.27 and 260C.331 or 260B.331, if
applicable to the child being placed.
new text end

new text begin (c) Consideration of income and resources attributable to the child must be part of
the negotiation process in section 256O.240, subdivision 11. In some circumstances, the
receipt of other income on behalf of the child may impact the amount of the monthly
payment received by the adoptive parent or relative custodian on behalf of the child
through Northstar Care for Children. Supplemental Security Income (SSI), Retirement,
Survivors, and Disability Insurance (RSDI), veteran's benefits, railroad retirement benefits,
and black lung benefits are considered income and resources attributable to the child.
new text end

new text begin Subd. 9. new text end

new text begin Treatment of Supplemental Security Income. new text end

new text begin If a child placed in
foster care receives benefits through Supplemental Security Income (SSI) at the time of
foster care placement or subsequent to placement in foster care, the county of financial
responsibility, or, for children in the American Indian Child Welfare Initiative, the
responsible tribal social service agency authorized in section 256.01, subdivision 14b,
may apply to be the payee for the child for the duration of the child's placement in foster
care. If a child continues to be eligible for SSI after finalization of the adoption or transfer
of permanent legal and physical custody and is determined to be eligible for a payment
under Northstar Care for Children, a permanent caregiver may choose to receive payment
from both programs simultaneously. If the payment under Northstar Care for Children
is a title IV-E payment, the permanent caregiver is responsible to report the amount of
the payment to the Social Security Administration and the SSI payment will be reduced
by the amount of the payment under Northstar Care for Children, as required by the
Social Security Administration.
new text end

new text begin Subd. 10. new text end

new text begin Treatment of RSDI, veteran's benefits, railroad retirement benefits,
and black lung benefits.
new text end

new text begin (a) If a child placed in foster care receives RSDI, veteran's
benefits, railroad retirement benefits, or black lung benefits at the time of foster care
placement or subsequent to placement in foster care, the county of financial responsibility,
or, for children in the American Indian Child Welfare Initiative, the responsible tribal
social service agency authorized in section 256.01, subdivision 14b, may apply to be
the payee for the child for the duration of the child's placement in foster care. If it is
anticipated that a child will be eligible to receive RSDI, veteran's benefits, railroad
retirement benefits, or black lung benefits after finalization of the adoption or assignment
of permanent legal and physical custody, the permanent caregiver shall apply to be the
payee of those benefits on the child's behalf. The monthly amount of the other benefits
must be considered an offset to the amount of the payment the child is determined eligible
for under Northstar Care for Children.
new text end

new text begin (b) If a child becomes eligible for RSDI, veteran's benefits, railroad retirement
benefits, or black lung benefits after the initial amount of the payment under Northstar
Care for Children is finalized, the permanent caregiver shall contact the commissioner
to renegotiate the payment under Northstar Care for Children. The monthly amount of
the other benefits must be considered an offset to the amount of the payment the child is
determined eligible for under Northstar Care for Children.
new text end

new text begin (c) If a child ceases to be eligible for RSDI, veteran's benefits, railroad retirement
benefits, or black lung benefits after the initial amount of the payment under Northstar
Care for Children is finalized, the permanent caregiver shall contact the commissioner to
renegotiate the payment under Northstar Care for Children. The monthly amount of the
payment under Northstar Care for Children must be the amount the child was determined
to be eligible for prior to consideration of any offset.
new text end

new text begin (d) If the monthly payment received on behalf of the child under RSDI, veteran's
benefits, railroad retirement benefits, or black lung benefits changes after the adoption
assistance or guardianship assistance agreement is finalized, the permanent caregiver shall
notify the commissioner as to the new monthly payment amount, regardless of the amount
of the change in payment. If the monthly payment changes by $75 or more, even if the
change occurs incrementally over the duration of the term of the adoption assistance
or guardianship assistance agreement, the monthly payment under Northstar Care for
Children must be renegotiated to reflect the amount of the increase or decrease in the
offset amount. Any subsequent change to the payment must be reported and handled in
the same manner. A change of monthly payments of less than $75 is not a permissible
reason to renegotiate the adoption assistance or guardianship assistance agreement under
section 256O.240, subdivision 12.
new text end

new text begin Subd. 11. new text end

new text begin Treatment of child support and MFIP. new text end

new text begin (a) If a child placed in foster
care receives child support, the child support payment may be redirected to the county of
financial responsibility, or, for children in the American Indian Child Welfare Initiative,
the responsible tribal social service agency authorized in section 256.01, subdivision
14b, for the duration of the child's placement in foster care. In cases where the child
qualifies for Northstar Care for Children by meeting the adoption assistance eligibility
criteria or the guardianship assistance eligibility criteria, any court-ordered child support
must not be considered income attributable to the child and must have no impact on the
monthly payment.
new text end

new text begin (b) Consistent with section 256J.24, children eligible for and receiving a payment
from Northstar Care for Children are excluded from a MFIP assistance unit.
new text end

new text begin Subd. 12. new text end

new text begin Payments. new text end

new text begin (a) Payments to caregivers under Northstar Care for Children
must be made monthly.
new text end

new text begin (b) The county of financial responsibility, or, for children in the American Indian
Child Welfare Initiative, the responsible tribal social service agency authorized in section
256.01, subdivision 14b, shall pay foster parents for eligible children in foster care.
new text end

new text begin (c) The commissioner shall pay caregivers for eligible children in guardianship
assistance and adoption assistance. Payments must commence when the commissioner
receives the required documentation from the court, the legally responsible agency, or the
caregiver. In guardianship assistance or adoption assistance cases, monthly payments must
be prorated according to subdivision 5 based on the effective date of the agreement.
new text end

new text begin Subd. 13. new text end

new text begin Effect of benefit on other aid. new text end

new text begin Payments received under this section shall
not be considered as income for child care assistance under chapter 119B or any other
financial benefit. Consistent with section 256J.24, all children receiving a maintenance
payment under Northstar Care for Children are excluded from any MFIP assistance unit.
new text end

new text begin Subd. 14. new text end

new text begin Waivered service plans. new text end

new text begin A child in foster care may qualify for home and
community-based waivered services, consistent with section 256B.092 for developmental
disabilities, or section 256B.49 for community alternative care, community alternatives
for disabled individuals, or traumatic brain injury waivers. A waiver service must not be
substituted for the foster care program. When the child is eligible for waivered services
and eligible for this benefit, the local social service agency must assess and provide basic
and supplemental difficulty of care rates as determined by the universal assessment under
section 256O.240. If it is determined that additional services are needed to meet the child's
needs in the home that is not or cannot be met by the foster care program, the need would
be referred to the waivered service program.
new text end

new text begin Subd. 15. new text end

new text begin Overpayments. new text end

new text begin The commissioner has the authority to collect any
amount of foster care, adoption assistance, and guardianship assistance paid to a
caregiver in excess of the payment due. Payments covered by this subdivision include
basic maintenance needs payments, supplemental difficulty of care payments, and
reimbursement of home and vehicle modifications under subdivision 7. Prior to any
collection, the commissioner or the commissioner's designee shall notify the caregiver in
writing, including:
new text end

new text begin (1) the amount of the overpayment and an explanation of the cause of overpayment;
new text end

new text begin (2) clarification of the corrected amount;
new text end

new text begin (3) a statement of the legal authority for the decision;
new text end

new text begin (4) information about how the caregiver can correct the overpayment;
new text end

new text begin (5) if repayment is required, when the payment is due and a person to contact to
review a repayment plan;
new text end

new text begin (6) a statement that the caregiver is entitled to a fair hearing review by the
department; and
new text end

new text begin (7) the procedure for seeking the review in clause (6).
new text end

new text begin Subd. 16. new text end

new text begin Payee. new text end

new text begin For adoption assistance and guardianship assistance cases,
the payment may only be made to the adoptive parent or relative custodian specified
on the agreement. If there is more than one adoptive parent or relative custodian, both
parties must be listed as the payee unless otherwise specified in writing according to
policies outlined by the commissioner. In the event of divorce or separation of the
caregivers, a change of payee may be made in writing according to policies outlined by
the commissioner. If both caregivers are in agreement as to the change, it may be made
according to a process outlined by the commissioner. If there is not agreement as to the
change, a court order indicating the party who is to receive the payment is needed before a
change can be processed. If the change of payee is disputed, the commissioner may
withhold the payment until agreement is reached. A noncustodial caregiver may request
notice in writing of review, modification, or termination of the adoption assistance or
guardianship assistance agreement. In the event of the death of a payee, a change of payee
consistent with sections 256O.220 and 256O.230 may be made in writing according
to policies outlined by the commissioner.
new text end

new text begin Subd. 17. new text end

new text begin Notification of change. new text end

new text begin (a) Parents or relative custodians who have an
adoption assistance agreement or guardianship assistance agreement in place shall keep
the agency administering the program informed of the parent's or custodian's address and
circumstances which would make them ineligible for the payments or eligible for the
payments in a different amount.
new text end

new text begin (b) For the duration of the agreement, the adoptive parent or relative custodian
agrees to notify the agency administering the program in writing within 30 days of the
following changes:
new text end

new text begin (1) change in the family's address;
new text end

new text begin (2) change in the legal custody status of the child;
new text end

new text begin (3) child's completion of high school, if this occurs after the child attains age 18;
new text end

new text begin (4) date of termination of the parental rights of the adoptive parent, transfer of
permanent legal and physical custody to another person, or other determination that the
adoptive parent or relative custodian is no longer legally responsible for support of the
child;
new text end

new text begin (5) date the adoptive parent or relative custodian is no longer providing support to
the child;
new text end

new text begin (6) date of death of the child;
new text end

new text begin (7) date of death of the adoptive parent or relative custodian;
new text end

new text begin (8) date the child enlists in the military;
new text end

new text begin (9) date of marriage of the child;
new text end

new text begin (10) date the child becomes an emancipated minor through legal action of another
state;
new text end

new text begin (11) separation or divorce of the adoptive parent or relative custodian;
new text end

new text begin (12) change of the caregiver's employment or educational enrollment status, if the
child has not attained age 13 and the child care component of the assessment under section
256O.240, subdivision 2, was used to determine the assessment level; and
new text end

new text begin (13) residence of the child outside the home for a period of more than 30 consecutive
days.
new text end

new text begin Subd. 18. new text end

new text begin Termination notice for caregiver. new text end

new text begin The responsible agency must provide
a child's caregiver written notice of termination of payment. Termination notices must be
sent at least 15 days before the final payment or in the case of an unplanned termination,
the notice is sent within three days of the end of the payment. The written notice must
minimally include the following:
new text end

new text begin (1) the date payment will end;
new text end

new text begin (2) the reason payments will end and the event that is the basis to terminate payment;
new text end

new text begin (3) a statement that the provider is entitled to a fair hearing review by the department
consistent with section 256.045, subdivision 3;
new text end

new text begin (4) the procedure to request a fair hearing; and
new text end

new text begin (5) name, telephone number, and, if available, an electronic contact address of a
contact person at the county or state.
new text end

Sec. 14.

new text begin [256O.260] FEDERAL SHARE, STATE SHARE, LOCAL SHARE.
new text end

new text begin Subdivision 1. new text end

new text begin Federal share. new text end

new text begin For the purposes of determining a child's eligibility
under title IV-E of the Social Security Act for a child in foster care, the county of
financial responsibility or, for children in the American Indian Child Welfare Initiative,
the responsible tribal social service agency authorized in section 256.01, subdivision 14b,
shall use the eligibility requirements outlined in section 472 of the Social Security Act.
For a child who qualifies for guardianship assistance or adoption assistance, the county of
financial responsibility or, for children in the American Indian Child Welfare Initiative,
the responsible tribal social service agency authorized in section 256.01, subdivision 14b,
shall use the eligibility requirements outlined in section 473 of the Social Security Act.
In each case, the agency paying the maintenance payments must be reimbursed for the
costs from the federal money available for this purpose.
new text end

new text begin Subd. 2. new text end

new text begin State share. new text end

new text begin The commissioner shall pay the state share of the maintenance
payments as determined under subdivision 4, and an identical share of the pre-Northstar
Care adoption assistance program under section 259.67. The commissioner may transfer
funds into the account if a deficit occurs.
new text end

new text begin Subd. 3. new text end

new text begin Local share. new text end

new text begin The county of financial responsibility under section 256G.02
or tribal social service agency authorized in section 256.01, subdivision 14b, at the
time of placement for foster care or finalization of the agreement for guardianship
assistance or adoption assistance, shall pay the local share of the maintenance payments as
determined under subdivision 4, and an identical share of the pre-Northstar Care adoption
assistance program under section 259.67. The county of financial responsibility under
section 256G.02 or tribal social service agency authorized in section 256.01, subdivision
14b, shall pay the entire cost of any initial clothing allowance, child-placing agency
administrative payments, or other support services it authorizes, except as provided under
other provisions of law. In cases of federally required adoption assistance where there is
no county of financial responsibility, or, for children in the American Indian Child Welfare
Initiative, the responsible tribal social service agency authorized in section 256.01,
subdivision 14b, as provided in section 256O.240, subdivision 5, the commissioner shall
pay the local share.
new text end

new text begin Subd. 4. new text end

new text begin Nonfederal share. new text end

new text begin The commissioner shall establish a percentage share
of the maintenance payments, reduced by federal reimbursements under title IV-E of the
Social Security Act, to be paid by the state and to be paid by the county of financial
responsibility under section 256G.02 or tribal social service agency authorized in section
256.01, subdivision 14b. These state and local shares shall initially be calculated based
on the ratio of the average appropriate expenditures made by the state and all counties
and tribal social service agencies authorized in section 256.01, subdivision 14b, during
state fiscal years 2008, 2009, and 2010. For purposes of this calculation, appropriate
expenditures for the counties and tribal social service agencies shall include basic and
difficulty of care payments for foster care, not including any initial clothing allowance,
child-placing agency administrative payments, child care, or other ancillary expenditures,
reduced by federal reimbursements. For purposes of this calculation, appropriate
expenditures for the state must include adoption assistance and relative custody assistance,
reduced by federal reimbursements. For each of the periods January 1, 2011, to June
30, 2012, and fiscal years 2013 and 2014, the commissioner shall adjust this initial
percentage of state and local shares to reflect the relative expenditure trends during state
fiscal years 2008, 2009, and 2010. The fiscal year 2014 set of percentages must be used
for all subsequent years.
new text end

new text begin Subd. 5. new text end

new text begin Adjustments for proportionate shares among legally responsible
agencies.
new text end

new text begin For children who transition into Northstar Care for Children under section
256O.270, subdivision 7, and for children on the pre-Northstar Care adoption assistance
program under section 259.67, the commissioner shall adjust the expenditures by each
county or tribal social service agency so that its relative share is proportional to its foster
care expenditures as determined under subdivision 4 for state fiscal years 2008, 2009, and
2010 compared with similar costs of all county or tribal social service agencies.
new text end

Sec. 15.

new text begin [256O.270] ADMINISTRATION.
new text end

new text begin Subdivision 1. new text end

new text begin Responsibilities. new text end

new text begin (a) The county of financial responsibility or,
for children in the American Indian Child Welfare Initiative, the responsible tribal
social service agency authorized in section 256.01, subdivision 14b, shall determine
the eligibility for Northstar Care for Children for children in foster care under section
256O.210, and for those children determined eligible, shall further determine each child's
eligibility for title IV-E of the Social Security Act.
new text end

new text begin (b) Subject to commissioner approval, the legally responsible agency shall determine
the eligibility for Northstar Care for Children for children in guardianship assistance under
section 256O.220 and children in adoption assistance under section 256O.230, and for
those children determined eligible, shall further determine each child's eligibility for title
IV-E of the Social Security Act.
new text end

new text begin (c) The legally responsible agency is responsible for the administration of Northstar
Care for Children for children in foster care, and for assisting the commissioner with the
administration of Northstar Care for Children for children in guardianship assistance and
adoption assistance by conducting assessments, reassessments, negotiations, and other
activities as specified by the commissioner under subdivision 2.
new text end

new text begin Subd. 2. new text end

new text begin Procedures, requirements, and deadlines. new text end

new text begin The commissioner shall
specify procedures, requirements, and deadlines for the administration of Northstar Care
for Children according to sections 256O.001 to 256O.270, including for transitioning
children into Northstar Care for Children under subdivision 7. The commissioner shall
periodically review all such procedures, requirements, and deadlines, including the
assessment tool and process under section 256O.240, in consultation with counties, tribes,
and representatives of caregivers and may alter them as needed.
new text end

new text begin Subd. 3. new text end

new text begin Administration of title IV-E programs. new text end

new text begin The title IV-E foster care,
guardianship assistance, and adoption assistance programs shall operate within the statutes
and rules set forth by the federal government in the Social Security Act and Code of
Federal Regulations.
new text end

new text begin Subd. 4. new text end

new text begin Reporting. new text end

new text begin The commissioner shall specify required fiscal and statistical
reports under section 256.01, subdivision 2, paragraph (q), and other reports as necessary.
new text end

new text begin Subd. 5. new text end

new text begin Promotion of programs. new text end

new text begin The commissioner or the commissioner's
designee shall actively seek ways to promote the guardianship assistance and adoption
assistance programs, including informing prospective relative custodians of eligible
children of the availability of guardianship assistance and prospective adoptive parents of
eligible children under the commissioner's guardianship of the availability of adoption
assistance. All families who adopt children under the commissioner's guardianship must
be informed as to the adoption tax credit.
new text end

new text begin Subd. 6. new text end

new text begin Appeals and fair hearings. new text end

new text begin (a) A caregiver has the right to appeal to the
commissioner pursuant to section 256.045 when eligibility for Northstar Care for Children
is denied, and when payment or the agreement for eligible child is modified or terminated.
new text end

new text begin (b) A relative custodian or adoptive parent has additional rights to appeal to
the commissioner under section 256.045. The rights include when the commissioner
terminates or modifies the guardianship assistance or adoption assistance agreement or
when the commissioner denies an application for guardianship assistance or adoption
assistance. A prospective relative custodian or adoptive parent who disagrees with a
decision by the commissioner prior to transfer of permanent legal and physical custody or
finalization of the adoption may request review of the decision by the commissioner or
may appeal the decision under section 256.045. A guardianship assistance or adoption
assistance agreement must be signed and in effect prior to the court order that transfers
permanent legal and physical custody or the adoption finalization, however in some cases,
there may be extenuating circumstances as to why an agreement was not entered into prior
to the finalization of permanency for the child. Caregivers who believe that extenuating
circumstances exist in the case of the caregiver's child may request a fair hearing.
Caregivers have the responsibility of proving that extenuating circumstances exist.
Caregivers are required to provide written documentation of each eligibility criterion at
the fair hearing. Examples of extenuating circumstances include: relevant facts regarding
the child were known by the placing agency and not presented to the caregiver prior to
transfer of permanent legal and physical custody or finalization of the adoption, failure by
the commissioner or the commissioner's designee to advise potential caregivers about the
availability of guardianship assistance or adoption assistance for children in the state foster
care system. If an appeals judge finds through the fair hearing process that extenuating
circumstances existed and that the child met all eligibility criteria at the time the transfer
of permanent legal and physical custody was ordered or the adoption was finalized, the
effective date and any associated federal financial participation must be retroactive to
the date of the request for a fair hearing.
new text end

new text begin Subd. 7. new text end

new text begin Transition; timelines; assessments. new text end

new text begin (a) All eligible children shall
participate in an initial assessment under section 256O.240, subdivision 3.
new text end

new text begin (b) All children in foster care, relative custody assistance, or adoption assistance are
eligible for Northstar Care for Children as specified in sections 256O.210, 256O.220, and
256O.230. All children in foster care or receiving relative custody assistance under section
257.85 on December 31, 2010, must be transitioned into Northstar Care for Children as of
January 1, 2011. Children in adoption assistance under section 259.67 on December 31,
2010, whose caregivers sign no later than November 24, 2010, an agreement to transition
to Northstar Care for Children as provided under sections 256O.230 and 256O.240 must
be added to Northstar Care for Children as of January 1, 2011. A child receiving adoption
assistance under section 259.67 whose caregivers sign an agreement to transition to
Northstar Care for Children as provided under sections 256O.230 and 256O.240 between
December 1, 2010, and March 31, 2011, must be added to Northstar Care for Children
for the first calendar month at least 31 calendar days after the date of the signing of the
agreement. A child receiving adoption assistance under section 259.67 whose caregivers
do not sign an agreement to transition to Northstar Care for Children by March 31, 2011,
must remain on the pre-Northstar Care adoption assistance program under section 259.67
until the child is no longer eligible for the program.
new text end

new text begin Subd. 8. new text end

new text begin Transition; distribution of program information. new text end

new text begin Between May 1, 2010,
and June 30, 2010, all foster parents with a child placed in the foster parents' home, relative
custodians with executed or signed relative custody assistance agreements, adoptive
parents with executed or signed adoption assistance agreements, and preadoptive parents
with a preadoptive placement in the parents' home shall receive written information about
Northstar Care for Children. Foster parents with a child placed in the foster parents' home
between July 1, 2010, and December 31, 2010, shall receive written information about
Northstar Care for Children at the time of the child's placement. Relative custodians
who sign a relative custody assistance agreement and prospective adoptive parents who
sign an adoption assistance agreement subsequent to June 30, 2010, shall receive written
information about Northstar Care for Children no later than when the relative custody
assistance agreement or the adoption assistance agreement is signed by the caregiver.
new text end

new text begin (1) The legally responsible agency shall mail, electronically distribute, or personally
provide foster parents with placed children with written information about Northstar
Care for Children.
new text end

new text begin (2) The agency responsible for providing the relative custody assistance payment
shall mail, electronically distribute, or personally provide relative custodians with relative
custody assistance agreements with written information about Northstar Care for Children
when the relative custodians' mail or email address is known. The responsible social
service agency shall make reasonable efforts to locate relative custodians with signed or
executed relative custody assistance agreements whose mail or email address is known.
new text end

new text begin (3) For cases where the adoption assistance agreement is executed or submitted to
the commissioner for review and approval prior to May 1, 2010, the commissioner shall
mail or electronically distribute information about Northstar Care for Children to the
adoptive parent. The commissioner shall make reasonable efforts to locate the adoptive
parent whose mail or email address is unknown. For cases where the adoption assistance
agreement is executed or submitted to the commissioner for review on or after May 1,
2010, and on or before November 24, 2010, the responsible social service agency shall
mail, electronically distribute, or personally provide preadoptive parents with written
information about Northstar Care for Children.
new text end

new text begin (4) Information must minimally include a summary of the provisions of the new
program, an overview of the assessment process, the transition time frame, and actions
required by the foster parent, relative custodian, or adoptive parent during the transition
period, including the procedure to opt in to Northstar Care for Children and renegotiate
the adoption assistance agreement for adoption assistance cases.
new text end

new text begin Subd. 9. new text end

new text begin Transition; renegotiation of adoption assistance agreements. new text end

new text begin Adoptive
parents shall provide written notice to the commissioner of the adoptive parents' intent
to renegotiate their adoption assistance program or remain on the pre-Northstar Care
adoption assistance program according to section 259.67 within 60 days of receiving
the written notice in subdivision 8. The commissioner may extend this time frame if
it is determined that the adoptive parent has good cause to warrant extension of this
consideration period. If adoptive parents decide to opt in to Northstar Care for Children,
the adoptive parents' adoption assistance agreement must be renegotiated according to
section 256O.240, subdivision 10. If an adoptive parent would like to opt in to Northstar
Care for Children, but does not believe that the assessment under section 256O.240 was
completed accurately, the adoptive parent shall indicate this in writing to the commissioner
and must be given an extension of the consideration period while a reassessment is
completed. The commissioner may not extend the time frame to renegotiate adoption
assistance agreements after March 31, 2011. All adoption assistance agreements under
Northstar Care for Children for children transitioning from the adoption assistance
program under section 259.67 must be renegotiated and signed by all parties no later than
March 31, 2011. The commissioner may establish additional requirements or deadlines
for implementing the transition.
new text end

new text begin Subd. 10. new text end

new text begin Effective date of payment rates. new text end

new text begin The new rates for payment under
Northstar Care for Children must be determined under section 256O.250 and effective
according to the timelines in subdivision 7, paragraph (b).
new text end

new text begin Subd. 11. new text end

new text begin Purchase of child-specific adoption services. new text end

new text begin The commissioner may
reimburse the placing agency for appropriate adoption services for children eligible under
section 259.67, subdivision 35.
new text end

Sec. 16.

Minnesota Statutes 2008, section 257.85, subdivision 2, is amended to read:


Subd. 2.

Scope.

The provisions of this section apply to those situations in which
the legal and physical custody of a child is established with a relative or important friend
with whom the child has resided or had significant contact according to section 260C.201,
subdivision 11
, by a district court order issued on or after July 1, 1997,new text begin and on or before
November 24, 2010,
new text end or a tribal court order issued on or after July 1, 2005,new text begin and on or
before November 24, 2010,
new text end when the child has been removed from the care of the parent
by previous district or tribal court order.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2009.
new text end

Sec. 17.

Minnesota Statutes 2008, section 257.85, subdivision 5, is amended to read:


Subd. 5.

Relative custody assistance agreement.

(a) A relative custody assistance
agreement will not be effective, unless it is signed by the local agency and the relative
custodian no later than 30 days after the date of the order establishing permanent legal and
physical custody,new text begin and on or before November 24, 2010,new text end except that a local agency may
enter into a relative custody assistance agreement with a relative custodian more than 30
days after the date of the order if it certifies that the delay in entering the agreement was
through no fault of the relative custodiannew text begin and the agreement is signed and in effect on or
before November 24, 2010
new text end. There must be a separate agreement for each child for whom
the relative custodian is receiving relative custody assistance.

(b) Regardless of when the relative custody assistance agreement is signed by the
local agency and relative custodian, the effective date of the agreement shall be the date of
the order establishing permanent legal and physical custody.

(c) If MFIP is not the applicable program for a child at the time that a relative
custody assistance agreement is entered on behalf of the child, when MFIP becomes
the applicable program, if the relative custodian had been receiving custody assistance
payments calculated based upon a different program, the amount of relative custody
assistance payment under subdivision 7 shall be recalculated under the Minnesota family
investment program.

(d) The relative custody assistance agreement shall be in a form specified by the
commissioner and shall include provisions relating to the following:

(1) the responsibilities of all parties to the agreement;

(2) the payment terms, including the financial circumstances of the relative
custodian, the needs of the child, the amount and calculation of the relative custody
assistance payments, and that the amount of the payments shall be reevaluated annually;

(3) the effective date of the agreement, which shall also be the anniversary date for
the purpose of submitting the annual affidavit under subdivision 8;

(4) that failure to submit the affidavit as required by subdivision 8 will be grounds
for terminating the agreement;

(5) the agreement's expected duration, which shall not extend beyond the child's
eighteenth birthday;

(6) any specific known circumstances that could cause the agreement or payments
to be modified, reduced, or terminated and the relative custodian's appeal rights under
subdivision 9;

(7) that the relative custodian must notify the local agency within 30 days of any of
the following:

(i) a change in the child's status;

(ii) a change in the relationship between the relative custodian and the child;

(iii) a change in composition or level of income of the relative custodian's family;

(iv) a change in eligibility or receipt of benefits under MFIP, or other assistance
program; and

(v) any other change that could affect eligibility for or amount of relative custody
assistance;

(8) that failure to provide notice of a change as required by clause (7) will be
grounds for terminating the agreement;

(9) that the amount of relative custody assistance is subject to the availability of state
funds to reimburse the local agency making the payments;

(10) that the relative custodian may choose to temporarily stop receiving payments
under the agreement at any time by providing 30 days' notice to the local agency and may
choose to begin receiving payments again by providing the same notice but any payments
the relative custodian chooses not to receive are forfeit; and

(11) that the local agency will continue to be responsible for making relative custody
assistance payments under the agreement regardless of the relative custodian's place of
residence.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2009.
new text end

Sec. 18.

Minnesota Statutes 2008, section 257.85, subdivision 6, is amended to read:


Subd. 6.

Eligibility criteria.

new text begin(a) new text endA local agency shall enter into a relative custody
assistance agreement under subdivision 5 if it certifies that the following criteria are met:

(1) the juvenile court has determined or is expected to determine that the child,
under the former or current custody of the local agency, cannot return to the home of
the child's parents;

(2) the court, upon determining that it is in the child's best interests, has issued
or is expected to issue an order transferring permanent legal and physical custody of
the child; and

(3) the child either:

(i) is a member of a sibling group to be placed together; or

(ii) has a physical, mental, emotional, or behavioral disability that will require
financial support.

When the local agency bases its certification that the criteria in clause (1) or (2) are
met upon the expectation that the juvenile court will take a certain action, the relative
custody assistance agreement does not become effective until and unless the court acts as
expected.

new text begin (b) After November 24, 2010, no new relative custody assistance agreements shall
be executed. Agreements that were signed on or before November 24, 2010, and were not
in effect because the proposed transfer of permanent legal and physical custody of the
child did not occur on or before November 24, 2010, must be renegotiated according to
the terms of Northstar Care for Children in chapter 256O.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2009.
new text end

Sec. 19.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 11. new text end

new text begin Purpose and general eligibility requirements. new text end

new text begin (a) The purpose of the
adoption assistance program is to help make adoption possible for children who would
otherwise remain in foster care.
new text end

new text begin (b) To be eligible for adoption assistance, a child must:
new text end

new text begin (1) be determined to be a child with special needs, according to subdivision 12;
new text end

new text begin (2) meet the applicable citizenship and immigration requirements in subdivision
13; and
new text end

new text begin (3)(i) meet the criteria outlined in section 473 of the Social Security Act; or
new text end

new text begin (ii) have had foster care payments paid on the child's behalf while in out-of-home
placement through the county or tribe, and be either under the guardianship of the
commissioner or under the jurisdiction of a Minnesota tribe, with adoption in accordance
with tribal law as the child's documented permanency plan.
new text end

new text begin (c) In addition to the requirements in paragraph (b), the child's adoptive parents must
meet the applicable background study requirements outlined in subdivision 14.
new text end

new text begin (d) The legally responsible agency shall make a title IV-E adoption assistance
eligibility determination for each child. Children who meet all eligibility criteria except
those specific to title IV-E adoption assistance shall receive adoption assistance paid
through state funds.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 20.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 12. new text end

new text begin Special needs determination. new text end

new text begin (a) A child is considered a child with
special needs under this section if all of the requirements in paragraphs (b) to (g) are met.
new text end

new text begin (b) There has been a determination that the child cannot or should not be returned to
the home of the child's parents as evidenced by:
new text end

new text begin (1) a court-ordered termination of parental rights;
new text end

new text begin (2) a petition to terminate parental rights;
new text end

new text begin (3) a consent to adopt accepted by the court under sections 260C.201, subdivision
11, and 259.24;
new text end

new text begin (4) in circumstances when tribal law permits the child to be adopted without a
termination of parental rights, a judicial determination by tribal court indicating the valid
reason why the child cannot or should not return home;
new text end

new text begin (5) a voluntary relinquishment under section 259.25 or 259.47 or, if relinquishment
occurred in another state, the applicable laws in that state; or
new text end

new text begin (6) the death of the legal parent.
new text end

new text begin (c) There exists a specific factor or condition because of which it is reasonable to
conclude that the child cannot be placed with adoptive parents without providing adoption
assistance as evidenced by:
new text end

new text begin (1) a determination by the Social Security Administration that the child meets all
medical or disability requirements of title XVI of the Social Security Act with respect to
eligibility for Supplemental Security Income benefits;
new text end

new text begin (2) a documented physical, mental, emotional, or behavioral disability not covered
under clause (1);
new text end

new text begin (3) membership in a sibling group being adopted at the same time by the same parent;
new text end

new text begin (4) adoptive placement in the home of a parent who previously adopted another child
born of the same mother or father for whom they receive adoption assistance; or
new text end

new text begin (5) documentation that the child is a high-risk child, according to subdivision 17.
new text end

new text begin (d) A reasonable but unsuccessful effort must have been made to place the child
with adoptive parents without providing adoption assistance as evidenced by:
new text end

new text begin (1)(i) a documented search for an appropriate adoptive placement; or
new text end

new text begin (ii) a determination by the commissioner that such a search would not be in the best
interests of the child; and
new text end

new text begin (2) a written statement from the identified prospective adoptive parents that they are
either unwilling or unable to adopt the child without adoption assistance.
new text end

new text begin (e) To meet the requirement of a documented search for an appropriate adoptive
placement under paragraph (d), clause (1), item (i), the placing agency minimally must:
new text end

new text begin (1) give consideration, as required by section 260C.212, subdivision 5, to placement
with a relative;
new text end

new text begin (2) for an Indian child covered by the Indian Child Welfare Act, comply with the
placement preferences identified in the Indian Child Welfare Act and the Minnesota Indian
Family Preservation Act; and
new text end

new text begin (3) review all families approved for adoption who are associated with the placing
agency.
new text end

new text begin If the review of families associated with the placing agency results in the
identification of an appropriate adoptive placement for the child, the placing agency must
provide documentation of the placement decision to the commissioner as part of the
application for adoption assistance.
new text end

new text begin If two or more appropriate families are not approved or available within the placing
agency, the agency shall locate additional prospective adoptive families by registering the
child with the State Adoption Exchange, as required under section 259.75. If registration
with the State Adoption Exchange does not result in an appropriate family for the child,
the agency shall employ other recruitment methods, as outlined in recruitment policies and
procedures prescribed by the commissioner, to meet this requirement.
new text end

new text begin (f) The requirement for a documented search for an appropriate adoptive placement
under paragraph (d), including review of all families approved for adoption that are
associated with the placing agency, registration of the child with the State Adoption
Exchange, and additional recruitment methods, must be waived if:
new text end

new text begin (1) the child is being adopted by a relative;
new text end

new text begin (2) the child is being adopted by foster parents with whom the child has developed
significant emotional ties while in their care as a foster child;
new text end

new text begin (3) the child is being adopted by a family that previously adopted a child of the
same mother or father; or
new text end

new text begin (4) the court determines that adoption by the identified family is in the child's best
interest.
new text end

new text begin For an Indian child covered by the Indian Child Welfare Act, a waiver must not be
granted unless the placing agency has complied with the placement preferences identified
in the Indian Child Welfare Act and the Minnesota Indian Family Preservation Act.
new text end

new text begin (g) Once the placing agency has determined that placement with an identified family
is in the child's best interest and made full written disclosure about the child's social
and medical history, the agency must ask the prospective adoptive parents if they are
willing to adopt the child without adoption assistance. If the identified family is either
unwilling or unable to adopt the child without adoption assistance, they must provide a
written statement to this effect to the placing agency to fulfill the requirement to make
a reasonable effort to place the child without adoption assistance, and a copy of this
statement shall be included in the adoption assistance application. If the identified family
desires to adopt the child without adoption assistance, the family must provide a written
statement to this effect to the placing agency and the statement must be maintained in the
permanent adoption record of the placing agency. For children under the commissioner's
guardianship, the placing agency shall submit a copy of this statement to the commissioner
to be maintained in the permanent adoption record.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 21.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 13. new text end

new text begin Citizenship and immigration status. new text end

new text begin (a) A child must be a citizen of the
United States or otherwise eligible for federal public benefits according to the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996, as amended, in order to
be eligible for title IV-E adoption assistance.
new text end

new text begin (b) A child must be a citizen of the United States or meet the qualified alien
requirements as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, as amended, in order to be eligible for state-funded adoption
assistance.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 22.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 14. new text end

new text begin Background study. new text end

new text begin (a) A background study under section 259.41 must
be completed on each prospective adoptive parent. If the background study reveals:
new text end

new text begin (1) a felony conviction at any time for child abuse or neglect;
new text end

new text begin (2) spousal abuse;
new text end

new text begin (3) a crime against children, including child pornography;
new text end

new text begin (4) a crime involving violence, including rape, sexual assault, or homicide, but not
including other physical assault or battery; or
new text end

new text begin (5) a felony conviction within the past five years for physical assault, battery, or a
drug-related offense,
new text end

new text begin the adoptive parent is prohibited from receiving title IV-E adoption assistance on behalf of
an otherwise eligible child.
new text end

new text begin (b) A prospective adoptive parent who possesses one of the felony convictions in
paragraph (a) may receive state-funded adoption assistance on behalf of an otherwise
eligible child if the court has made a judicial determination that:
new text end

new text begin (1) the legally responsible agency has thoroughly reviewed the felony conviction
and has considered the impact, if any, that the conviction may have on the child's safety,
well-being, and permanency;
new text end

new text begin (2) the conviction likely does not pose a current or future safety risk to the child;
new text end

new text begin (3) there is no other available permanency resource that is appropriate for the
child; and
new text end

new text begin (4) the adoptive placement is in the child's best interest.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 23.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 15. new text end

new text begin Residency. new text end

new text begin A child placed in the state from another state or a tribe outside
of the state is not eligible for state-funded adoption assistance through the state. A child
placed in the state from another state or a tribe outside of the state may be eligible for title
IV-E adoption assistance through the state of Minnesota if all eligibility factors are met
and there is no state agency that has responsibility for placement and care of the child.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 24.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 16. new text end

new text begin Exceptions and exclusions. new text end

new text begin Payments for adoption assistance shall
not be made to a biological parent of the child or a stepparent who adopts the child.
Direct placement adoptions under section 259.47 or the equivalent in tribal code are
not eligible for state-funded adoption assistance. A child who is adopted by the child's
legal custodian or guardian is not eligible for state-funded adoption assistance. A child
who is adopted by the child's legal custodian or guardian may be eligible for title IV-E
adoption assistance if all required eligibility factors are met. International adoptions are
not eligible for adoption assistance unless the adopted child has been placed into foster
care through the public child welfare system subsequent to the failure of the adoption
and all required eligibility factors are met.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 25.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 17. new text end

new text begin Documentation. new text end

new text begin Documentation must be provided to verify that a child
meets the special needs criteria outlined in subdivision 12.
new text end

new text begin (a) Documentation of a disability is limited to evidence deemed appropriate by
the commissioner.
new text end

new text begin (b) To qualify as being a high-risk child, the placing agency must provide to the
commissioner one or more of the following:
new text end

new text begin (1) documented information in a county or tribal social service department record
or court record that a relative within the first or second degree of the child has a medical
diagnosis or medical history, including diagnosis of a significant mental health or
chemical dependency issue, which could result in the child's development of a disability
during childhood;
new text end

new text begin (2) documented information that while in the public child welfare system, the child
has experienced three or more placements with extended family or different foster homes
that could affect the normal attachment process;
new text end

new text begin (3) documented evidence in a county or tribal social service department record
that the child experienced neglect in the first three years of life, or sustained physical
injury, sexual abuse, or physical disease that could have a long-term effect on physical,
emotional, or mental development; or
new text end

new text begin (4) documented evidence in a medical or hospital record, law enforcement record,
county or tribal social service department record, court record, or record of an agency
under a contract with a county social service agency or the state to provide child welfare
services that the birth mother used drugs or alcohol during pregnancy which could later
result in the child's development of a disability.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 26.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 18. new text end

new text begin Termination. new text end

new text begin (a) An adoption assistance agreement shall terminate in
any of the following circumstances:
new text end

new text begin (1) the child attains the age of 18, unless an extension as outlined in subdivisions 20
to 23, is applied for by the adoptive parents and granted by the commissioner;
new text end

new text begin (2) the commissioner determines that the adoptive parents are no longer legally
responsible for support of the child;
new text end

new text begin (3) the commissioner determines that the adoptive parents are no longer providing
financial support to the child;
new text end

new text begin (4) death of the child; or
new text end

new text begin (5) the adoptive parents request termination of the adoption assistance agreement
in writing.
new text end

new text begin (b) An adoptive parent is considered no longer legally responsible for support of the
child in any of the following circumstances:
new text end

new text begin (1) parental rights to the child are legally terminated;
new text end

new text begin (2) permanent legal and physical custody or guardianship of the child is transferred
to another individual;
new text end

new text begin (3) death of the adoptive parent;
new text end

new text begin (4) enlistment of the child in the military;
new text end

new text begin (5) marriage of the child; or
new text end

new text begin (6) emancipation of the child through legal action of another state.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 27.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 19. new text end

new text begin Death of adoptive parent or adoption dissolution. new text end

new text begin (a) The adoption
assistance agreement ends upon death or termination of parental rights of both the adoptive
parents in the case of a two-parent adoption, or the sole adoptive parent in the case of a
single-parent adoption, but the child maintains eligibility for state-funded or title IV-E
adoption assistance in a subsequent adoption if the following criteria are met:
new text end

new text begin (1) the child is determined to be a child with special needs as outlined in subdivision
12;
new text end

new text begin (2) the subsequent adoptive parents reside in Minnesota; and
new text end

new text begin (3) no state agency outside of Minnesota has responsibility for placement and care
of the child at the time of the subsequent adoption.
new text end

new text begin (b) According to federal regulations, if the child had a title IV-E adoption assistance
agreement prior to the death of the adoptive parents or dissolution of the adoption, and a
state agency outside of the state of Minnesota has responsibility for placement and care of
the child at the time of the subsequent adoption, the state of Minnesota is not responsible
for determining whether the child meets the definition of special needs, entering into the
adoption assistance agreement, and making any adoption assistance payments outlined in
the new agreement.
new text end

new text begin (c) According to federal regulations, if the child had a title IV-E adoption assistance
agreement prior to the death of the adoptive parents or dissolution of the adoption, the
subsequent adoptive parents reside outside of the state of Minnesota, and no state agency
has responsibility for placement and care of the child at the time of the subsequent
adoption, the state of Minnesota is not responsible for determining whether the child
meets the definition of special needs, entering into the adoption assistance agreement, and
making any adoption assistance payments outlined in the new agreement.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 28.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 20. new text end

new text begin Extension, past age 18. new text end

new text begin Under certain limited circumstances a child
may qualify for extension of the adoption assistance agreement beyond the date the
child attains age 18. An application for extension must be completed and submitted by
the adoptive parent at least 90 days prior to the date the child attains age 18, unless the
child's adoption is scheduled to finalize less than 90 days prior to that date in which
case the application for extension must be completed and submitted with the adoption
assistance application. The application for extension must be made according to policies
and procedures prescribed by the commissioner, including documentation of eligibility,
and on forms prescribed by the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 29.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 21. new text end

new text begin Extension based on a continuing physical or mental disability. new text end

new text begin (a)
Extensions based on a child's continuing physical or mental disability must be applied
for prior to the date the child attains age 18 and according to the requirements under
subdivision 20. The commissioner must not grant an extension on this basis if an extension
based on continued enrollment in a secondary education or being a child whose adoption
finalized after age 16 was previously granted for the child.
new text end

new text begin (b) A child is eligible for extension of the adoption assistance agreement up to the
date the child attains age 21 if the following criteria are met:
new text end

new text begin (1) the child has a mental or physical disability upon which eligibility for adoption
assistance was based which warrants the continuation of assistance;
new text end

new text begin (2) the child is unable to obtain self-sustaining employment due to the
aforementioned mental or physical disability; and
new text end

new text begin (3) the child needs significantly more care and support than what is typical for an
individual of the same age.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 30.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 22. new text end

new text begin Extension based on continued enrollment in a secondary education
program.
new text end

new text begin (a) If a child does not qualify for extension based on a continuing physical or
mental disability or a parent chooses not to apply for such extension, the adoptive parents
may make an application for continuation of adoption assistance based on enrollment in
a secondary education program.
new text end

new text begin (b) If a child is enrolled full-time in a secondary education program or a program
leading to an equivalent credential, the child is eligible for extension to the expected
gradation date or the date the child attains age 19, whichever is earlier. If a child receives
a school-based extension and at any time ceases to be enrolled in a full-time secondary
education program or a program leading to an equivalent credential, the adoptive parents
are responsible to notify the commissioner and the agreement must terminate.
new text end

new text begin (c) Extensions based on continuation in a secondary education program must be paid
from state funds only, unless the child meets the extension criteria outlined in subdivision
23.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 31.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 23. new text end

new text begin Extension for children whose adoption finalized after age 16. new text end

new text begin A child
who attained the age of 16 prior to finalization of their adoption is eligible for extension of
the adoption assistance agreement to the date the child attains age 21 if the child is:
new text end

new text begin (1) completing a secondary education program or a program leading to an equivalent
credential;
new text end

new text begin (2) enrolled in an institution which provides postsecondary or vocational education;
new text end

new text begin (3) participating in a program or activity designed to promote or remove barriers to
employment;
new text end

new text begin (4) employed for at least 80 hours per month; or
new text end

new text begin (5) incapable of doing any of the activities described in clauses (1) to (4) due to a
medical condition, which incapability is supported by regularly updated information in
the case plan of the child.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 32.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 24. new text end

new text begin Adoption assistance certification. new text end

new text begin The placing agency shall certify a
child as eligible for adoption assistance according to policies and procedures, and on
forms, prescribed by the commissioner. Professional documentation must be submitted
with the certification, and when applicable, the supplemental adoption assistance needs
assessment, to establish eligibility for the amount of payment requested. This form must
be submitted with the adoption assistance agreement under subdivision 25.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 33.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 25. new text end

new text begin Adoption assistance agreement. new text end

new text begin (a) In order to receive adoption
assistance benefits, a written, binding agreement on a form approved by the commissioner
must be established and completed by the placing agency prior to finalization of the
adoption. The agreement must be negotiated with the parents, in the case of a two-parent
adoption, or the adoptive parent, in the case of a single-parent adoption, as required in
subdivision 26. The parents, an approved representative from the placing agency, and
the commissioner or the commissioner's designee must sign the agreement prior to the
effective date of the adoption decree. The adoption assistance certification and agreement
must be granted or denied by the commissioner no later than 15 working days after receipt.
A fully executed copy of the signed agreement must be given to each party. Termination
or disruption of the preadoptive placement preceding adoption finalization makes the
agreement with that family void.
new text end

new text begin (b) The agreement must specify the following:
new text end

new text begin (1) duration of the agreement;
new text end

new text begin (2) the nature and amount of any payment, services, and assistance to be provided
under such agreement;
new text end

new text begin (3) the child's eligibility for Medicaid services;
new text end

new text begin (4) the terms of the payment;
new text end

new text begin (5) eligibility for reimbursement of nonrecurring expenses associated with adopting
the child, to the extent that the total cost does not exceed $2,000 per child;
new text end

new text begin (6) that the agreement must remain in effect regardless of the state of which the
adoptive parents are residents at any given time;
new text end

new text begin (7) provisions for modification of the terms of the agreement; and
new text end

new text begin (8) the effective date of the agreement.
new text end

new text begin (c) The agreement is effective the date of the adoption decree.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 34.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 26. new text end

new text begin Negotiation of the agreement. new text end

new text begin (a) A monthly payment is provided
as part of the adoption assistance agreement to support the care of a child who has
manifested special needs. The amount of the payment made on behalf of a child eligible
for adoption assistance is determined through agreement between the adoptive parents
and the commissioner or the commissioner's designee. The agreement shall take into
consideration the circumstances of the adopting parents and the needs of the child being
adopted. The income of the adoptive parents must not be taken into consideration when
determining eligibility for adoption assistance or the amount of the payments under
subdivision 28. At the written request of the adoptive parents, the amount of the payment
in the agreement may be renegotiated when there is a change in the child's needs or the
family's circumstances.
new text end

new text begin (b) The adoption assistance agreement of a child who is identified as a high-risk child
must not include a monthly payment unless and until the potential disability manifests
itself, as documented by an appropriate professional, and the commissioner authorizes
commencement of payment by modifying the agreement accordingly. An adoptive parent
of a high-risk child with an adoption assistance agreement may request a renegotiation of
the adoption assistance agreement under subdivision 27 to include a monthly payment,
if the parent has written professional documentation that the potential disability upon
which eligibility for the agreement was based has manifested itself. Documentation of the
disability shall be limited to evidence deemed appropriate by the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 35.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 27. new text end

new text begin Renegotiation of the agreement. new text end

new text begin (a) An adoptive parent of a child
with an adoption assistance agreement may request renegotiation of the agreement when
there is a change in the needs of the child or in the family's circumstances. When an
adoptive parent requests renegotiation of the agreement, a reassessment of the child
must be completed. If the reassessment indicates that the child's level has changed,
the commissioner or the commissioner's designee and the parent shall renegotiate the
agreement to include a payment with the level determined appropriate through the
reassessment process. The agreement must not be renegotiated unless the commissioner
and the parent mutually agree to the changes. The effective date of any renegotiated
agreement must be determined by the commissioner.
new text end

new text begin (b) An adoptive parent of a high-risk child with an adoption assistance agreement
may request renegotiation of the agreement to include a monthly payment, if the parent
has written professional documentation that the potential disability upon which eligibility
for the agreement was based has manifested itself. Documentation of the disability must
be limited to evidence deemed appropriate by the commissioner. Prior to renegotiating
the agreement, a reassessment of the child must be conducted. The reassessment must
be used to renegotiate the agreement to include an appropriate monthly payment. The
agreement must not be renegotiated unless the commissioner and the adoptive parent
mutually agree to the changes. The effective date of any renegotiated agreement must be
determined by the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 36.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 28. new text end

new text begin Benefits and payments. new text end

new text begin (a) Eligibility for medical assistance for children
receiving adoption assistance is as specified in section 256B.055.
new text end

new text begin (b) The basic maintenance payments must be made according to the following
schedule for all children except those eligible for adoption assistance based on high risk of
developing a disability:
new text end

new text begin Birth through age five
new text end
new text begin up to $247 per month
new text end
new text begin Age six through age 11
new text end
new text begin up to $277 per month
new text end
new text begin Age 12 through age 14
new text end
new text begin up to $307 per month
new text end
new text begin Age 15 and older
new text end
new text begin up to $337 per month
new text end

new text begin A child must receive the maximum payment amount for the child's age, unless a lesser
amount is negotiated with and agreed to by the prospective adoptive parent.
new text end

new text begin (c) Supplemental adoption assistance needs payments, in addition to basic
maintenance payments, are available for a child whose disability necessitates care,
supervision, and structure beyond that ordinarily provided in a family setting to persons
of the same age. These payments are related to the severity of a child's disability and
the level of parenting required to care for the child, and must be made according to the
following schedule:
new text end

new text begin Level I
new text end
new text begin up to $150 per month
new text end
new text begin Level II
new text end
new text begin up to $275 per month
new text end
new text begin Level III
new text end
new text begin up to $400 per month
new text end
new text begin Level IV
new text end
new text begin up to $500 per month
new text end

new text begin A child's level shall be assessed on a supplemental maintenance needs assessment form
prescribed by the commissioner. A child must receive the maximum payment amount for
the child's assessed level, unless a lesser amount is negotiated with and agreed to by
the prospective adoptive parent.
new text end

new text begin (d) Reimbursement for special nonmedical expenses is available to all children
except those eligible for adoption assistance based on high risk of developing a disability.
Reimbursements under this paragraph will be made only after the adoptive parents
document that an application for the applicable service was denied by the local social
service agency, community agencies, local school district, local public health department,
the parent's insurance provider, or the child's Medicaid program. Reimbursements must
be made according to the policies and procedures prescribed by the commissioner and
are limited to:
new text end

new text begin (1) child care;
new text end

new text begin (2) respite care;
new text end

new text begin (3) camping program;
new text end

new text begin (4) home and vehicle modifications;
new text end

new text begin (5) family counseling;
new text end

new text begin (6) postadoption counseling;
new text end

new text begin (7) services to children under age three who are developmentally delayed;
new text end

new text begin (8) specialized communication equipment; and
new text end

new text begin (9) burial expenses.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 37.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 29. new text end

new text begin Child income or income attributable to the child. new text end

new text begin If a child for whom a
parent is receiving adoption assistance is also receiving Supplemental Security Income
(SSI) or Retirement, Survivors, Disability Insurance (RSDI), the certifying agency shall
inform the adoptive parents that the child's adoption assistance must be reported to the
Social Security Administration.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 38.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 30. new text end

new text begin Payments. new text end

new text begin (a) Payments to parents under adoption assistance must
be made monthly.
new text end

new text begin (b) Payments must commence when the commissioner receives the adoption decree
from the court, the legally responsible agency, or the parent. Payments must be made
according to policies and procedures prescribed by the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 39.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 31. new text end

new text begin Overpayments. new text end

new text begin (a) The commissioner has the authority to collect any
amount of adoption assistance paid to a parent in excess of the payment due. Payments
covered by this subdivision include basic maintenance needs payments, supplemental
maintenance needs payments, and reimbursements of nonmedical expenses under
subdivision 28. Prior to any collection, the commissioner or designee shall notify the
parent in writing, including:
new text end

new text begin (1) the amount of the overpayment and an explanation of the cause of overpayment;
new text end

new text begin (2) clarification of the corrected amount;
new text end

new text begin (3) a statement of the legal authority for the decision;
new text end

new text begin (4) information about how the parent can correct the overpayment;
new text end

new text begin (5) if repayment is required, when the payment is due and a person to contact to
review a repayment plan;
new text end

new text begin (6) a statement that the parent has a right to a fair hearing review by the department;
and
new text end

new text begin (7) the procedure for seeking such a review.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 40.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 32. new text end

new text begin Payee. new text end

new text begin For adoption assistance cases, the payment may only be made to
the adoptive parent specified on the agreement. If there is more than one adoptive parent,
both parties must be listed as the payee unless otherwise specified in writing according
to policies and procedures prescribed by the commissioner. In the event of divorce or
separation of the parents, a change of payee may be made in writing according to policies
and procedures prescribed by the commissioner. If both parents are in agreement as to
the change, it may be made according to a process prescribed by the commissioner. If
there is not agreement as to the change, a court order indicating the party who is to receive
the payment is needed before a change can be processed. In the event of the death of the
payee, a change of payee consistent with subdivision 19 may be made in writing according
to policies and procedures prescribed by the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 41.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 33. new text end

new text begin Notification of change. new text end

new text begin (a) An adoptive parent who has an adoption
assistance agreement in place shall keep the agency administering the program informed
of the parent's address and circumstances which would make them ineligible for the
payments or eligible for the payments in a different amount.
new text end

new text begin (b) For the duration of the agreement, the adoptive parent agrees to notify the agency
administering the program in writing within 30 days of the following changes:
new text end

new text begin (1) change in the family's address;
new text end

new text begin (2) change in the legal custody status of the child;
new text end

new text begin (3) child's completion of high school, if this occurs after the child attains age 18;
new text end

new text begin (4) date of termination of the parental rights of the adoptive parent, transfer of
permanent legal and physical custody to another person, or other determination that the
adoptive parent is no longer legally responsible for the support of the child;
new text end

new text begin (5) date the adoptive parent is not longer providing support to the child;
new text end

new text begin (6) date of death of the child;
new text end

new text begin (7) date of death of the adoptive parent;
new text end

new text begin (8) date the child enlists in the military;
new text end

new text begin (9) date of marriage of the child;
new text end

new text begin (10) date the child becomes an emancipated minor through legal action of another
state;
new text end

new text begin (11) separation or divorce of the adoptive parent; and
new text end

new text begin (12) residence of the child outside the home for a period of more than 30 consecutive
days.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 42.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 34. new text end

new text begin Termination notice for parent. new text end

new text begin The commissioner shall provide the
child's parent written notice of termination of payment. Termination notices must be sent
at least 15 days before the final payment or in the case of an unplanned termination,
the notice is sent within three days of the end of the payment. The written notice must
minimally include the following:
new text end

new text begin (1) the date payment will end;
new text end

new text begin (2) the reason payments will end and the event that is the basis to terminate payment;
new text end

new text begin (3) a statement that the parent has a right to a fair hearing review by the department
consistent with section 256.045, subdivision 3;
new text end

new text begin (4) the procedure to request a fair hearing; and
new text end

new text begin (5) the agency name and address to which a fair hearing request must be sent.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 43.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 35. new text end

new text begin Reimbursement of costs through purchase of service. new text end

new text begin (a) Subject
to policies and procedures prescribed by the commissioner and the provisions of this
subdivision, a child-placing agency licensed in Minnesota or any other state, or local
or tribal social services agency shall receive a reimbursement from the commissioner
equal to 100 percent of the reasonable and appropriate cost of providing child-specific
adoption services. Adoption services under this subdivision may include child-specific
recruitment, child-specific training and home studies for prospective adoptive parents,
and placement services.
new text end

new text begin (b) An eligible child must have a goal of adoption, which may include an adoption
according to tribal law, and meet one of the following criteria:
new text end

new text begin (1) is a ward of the Minnesota commissioner of human services or a ward of a
Minnesota tribal court under section 260.755, subdivision 20, who meets one of the
criteria under subdivision 12, paragraph (b), and one of the criteria under subdivision 12,
paragraph (c), clauses (1) to (5); or
new text end

new text begin (2) is under the guardianship of a Minnesota-licensed child-placing agency who
meets one of the eligibility criteria under subdivision 12, paragraph (b), and one of the
criteria in subdivision 12, paragraph (c), clauses (1) to (4).
new text end

new text begin (c) A child-placing agency licensed in Minnesota or any other state shall receive
reimbursement for adoption services it purchase for or directly provides to an eligible
child. Tribal social services shall receive reimbursement for adoption services it purchases
for or directly provides to an eligible child. A local social services agency shall receive
reimbursement only for adoption services it purchases for an eligible child.
new text end

new text begin (d) Before providing adoption services for which reimbursement is sought under this
subdivision, a reimbursement agreement, on the forms prescribed by the commissioner,
must be signed by the commissioner. No reimbursement under this subdivision must
be made to an agency for services provided prior to signatures by all required parties
on a reimbursement agreement. Separate reimbursement agreements must be made for
each child and separate records must be kept on each child for whom a reimbursement
agreement is made. Reimbursement shall not be made unless the commissioner of
human services agrees that the reimbursement costs are reasonable and appropriate. The
commissioner may spend up to $16,000 for each purchase of service agreement per
child. Only one agreement per child is allowed, unless an exception is granted by the
commissioner and agreed to in writing by the commissioner prior to commencement of
services. Funds encumbered and obligated under such an agreement for the child remain
available until the terms of the agreement are fulfilled or the agreement is terminated.
new text end

new text begin (e) The commissioner shall make reimbursement payments directly to the agency
providing the service if direct reimbursement is specified by the purchase of service
agreement and if the request for reimbursement is submitted by the local or tribal social
services agency along with verification on a form prescribed by the commissioner that
the service was provided.
new text end

new text begin (f) The commissioner shall set aside an amount not to exceed five percent of the
total amount of fiscal year appropriation from the state of Minnesota for the adoption
assistance program to reimburse placing agencies for adoption services. When adoption
assistance payments for children's needs exceed 95 percent of the total amount of fiscal
year appropriation from the state of Minnesota for the adoption assistance program, the
amount of reimbursement available to placing agencies for adoption services is reduced
correspondingly.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 44.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 36. new text end

new text begin Indian children. new text end

new text begin A child certified as eligible for adoption assistance
under this section who is protected under the Federal Indian Child Welfare Act of 1978
should, whenever possible, be served by the tribal governing body, tribal courts, or a
licensed Indian child-placing agency.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 45.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 37. new text end

new text begin Administration responsibilities. new text end

new text begin (a) Subject to commissioner approval,
the legally responsible agency shall determine the eligibility for adoption assistance under
this section, and for those children determined eligible, shall further determine each child's
eligibility for title IV-E of the Social Security Act.
new text end

new text begin (b) The legally responsible agency is responsible for assisting the commissioner with
the administration of the adoption assistance by conducting assessments, reassessments,
negotiations, and other activities as specified by the commissioner under this section.
new text end

new text begin (c) The certifying agency shall notify an adoptive parent of a child's eligibility
for Medicaid in their state of residence. The certifying agency shall refer the adoptive
parent to apply for Medicaid in the financial office in their county of residence. The
certifying agency shall inform adoptive parents of the requirement to comply with the
rules of the applicable Medicaid program.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 46.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 38. new text end

new text begin Procedures, requirements, and deadlines. new text end

new text begin The commissioner shall
specify procedures, requirements, and deadlines for the administration of adoption
assistance in accordance with this section. As needed, the commissioner shall review all
procedures, requirements, and deadlines, including the designated forms, in consultation
with counties, tribes, and representatives of parents, and may alter them as needed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 47.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 39. new text end

new text begin Administration of title IV-E programs. new text end

new text begin The title IV-E adoption
assistance program shall operate within the statute and rules set forth by the federal
government in the Social Security Act and Code of Federal Regulations.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 48.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 40. new text end

new text begin Reporting. new text end

new text begin The commissioner shall specify required fiscal and statistical
reports under section 256.01, subdivision 2, paragraph (q), and other reports as necessary.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 49.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 41. new text end

new text begin Promotion of programs. new text end

new text begin The commissioner or the commissioner's
designee shall actively seek ways to promote the adoption assistance program, including
informing prospective adoptive parents of eligible children under the commissioner's
guardianship of the availability of adoption assistance. All families who adopt children
under the commissioner's guardianship must be informed as to the adoption tax credit.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 50.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 42. new text end

new text begin Appeals and fair hearings. new text end

new text begin (a) A prospective adoptive parent has the
right to appeal to the commissioner under section 256.045 when eligibility for adoption
assistance is denied, and when payment or the agreement for an eligible child is modified
or terminated.
new text end

new text begin (b) An adoptive parent has additional rights to appeal to the commissioner under
section 256.045. These include when the commissioner terminates or modifies the
adoption assistance agreement or when the commissioner denies an application for
adoption assistance. A prospective adoptive parent who disagrees with a decision by the
commissioner prior to finalization of the adoption may request review of the decision
by the commissioner, or may appeal the decision under section 256.045. An adoption
assistance agrement must be signed and in effect prior to the court order that finalizes the
adoption; however, in some cases, there may be extenuating circumstances as to why an
agreement was not entered into prior to the adoption finalization. An adoptive parent who
believes that extenuating circumstances exist in the case of an adoption finalizing prior to
entering of an adoption assistance agreement may request a fair hearing. Parents have
the responsibility of proving that extenuating circumstances exist. Parents are required to
provide written documentation of each eligibility criterion at the fair hearing. Examples
of extenuating circumstances include: relevant facts regarding the child were known by
the placing agency and not presented to the parent prior to finalization of the adoption, or
failure by the commissioner or the commissioner's designee to advise a potential parent
about the availability of adoption assistance for a child in the state foster care system. If
an appeals judge finds through the fair hearing process that extenuating circumstances
existed and that the child met all eligibility criteria at the time the adoption was finalized,
the effective date and any associated federal financial participation shall be retroactive to
the date of the request for a fair hearing.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 51.

Minnesota Statutes 2008, section 259.67, is amended by adding a subdivision
to read:


new text begin Subd. 43. new text end

new text begin No new executions of adoption assistance agreements. new text end

new text begin After November
24, 2010, no new adoption assistance agreements must be executed under this section.
Agreements that were signed on or before November 24, 2010, and were not in effect
because the adoption finalization of the child did not occur on or before November 24,
2010, must be renegotiated according to the terms of Northstar Care for Children under
section 256O.001 to 256O.270. Agreements signed and in effect on or before November
24, 2010, must continue according to the terms of this section and applicable rules for
the duration of the agreement, unless the adoptive parents choose to renegotiate their
agreement in accordance with the terms of Northstar Care for Children. After November
24, 2010, this section and associated rules must apply to a child whose adoption assistance
agreements were in effect on or before November 24, 2010, and whose adoptive parents
have chosen not to renegotiate their agreement according to the terms of Northstar Care
for Children.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 52.

Minnesota Statutes 2008, section 260B.441, is amended to read:


260B.441 deleted text beginCOST,deleted text end PAYMENTnew text begin FOR FOSTER CARE, RESIDENTIAL
PLACEMENT, AND CLOTHING ALLOWANCE
new text end.

new text begin Subdivision 1. new text end

new text begin Responsibility for placement costs. new text end

deleted text beginIn addition to the usual
care and services given by public and private agencies, the necessary cost incurred by
the commissioner of human services in providing care for such child shall be paid by
the county committing such child which, subject to uniform rules established by the
commissioner of human services, may receive a reimbursement not exceeding one-half of
such costs from funds made available for this purpose by the legislature during the period
beginning July 1, 1985, and ending December 31, 1985. Beginning January 1, 1986, the
necessary cost incurred by the commissioner of human services in providing care for
the child must be paid by the county committing the child.
deleted text end new text beginChapter 256O establishes
the responsibility for cost and payment for eligible children placed in family foster
care settings or in permanent placement with a relative custodian or adoptive parent.
Responsibility for placement costs and payment in any other setting is with the county,
consistent with chapter 256G, or the tribes authorized in section 256.01, subdivision 14b.
new text end

new text begin Subd. 2. new text end

new text begin Federal title IV-E. new text end

new text begin Foster care maintenance payments under title IV-E of
the Social Security Act are defined in subdivisions 4 and 5 and section 256O.020. Every
effort must be made to establish a child's eligibility for title IV-E, using the criteria in the
Social Security Act, United States Code, title 42, sections 670 to 676. Payment of title
IV-E funds in Northstar Care for Children is specified in section 256O.260. In all other
circumstances, the county or tribal agency authorized in section 256.01, subdivision 14b,
responsible for payment of the maintenance costs must be reimbursed from the federal
funds available for the purpose.
new text end

new text begin Subd. 3. new text end

new text begin Child resources. new text end

deleted text beginWhere suchdeleted text endnew text begin When anew text end childnew text begin in foster carenew text end is eligible to
receive a grant of deleted text beginMinnesota family investment programdeleted text endnew text begin Retirement, Survivors, and
Disability Insurance (RSDI),
new text end or Supplemental Security Income for the aged, blind, and
disabled, or a foster care maintenance payment under title IV-E of the Social Security Act,
United States Code, title 42, sections 670 to 676, the child's needs shall be met through
these programs.

new text begin Subd. 4. new text end

new text begin Group residential maintenance payments. new text end

new text begin When a child is placed in
a group residential setting, foster care maintenance payments are payments made on
behalf of a child to cover the cost of providing food, clothing, shelter, daily supervision,
school supplies, child's personal incidentals, and transportation needs associated with
providing the items listed, including transportation to the child's home for visitation.
Daily supervision in group residential settings includes routine day-to-day direction
and arrangements to ensure the well-being and safety of the child. It may also include
reasonable costs of administration and operation of the facility.
new text end

new text begin Subd. 5. new text end

new text begin Initial clothing allowance. new text end

new text begin An initial clothing allowance must be available
to all children eligible for Northstar Care for Children under section 256O.210 and foster
children placed in group residential settings based on the child's individual needs during
the first 60 days of the initial placement. The agency shall consider the parent's ability
to provide for the child's clothing needs and the residential facility contracts. A clothing
allowance must be approved that is consistent with the child's needs. The amount of
the initial clothing allowance must not exceed the monthly basic rate for the child's age
group under section 256O.260.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2011.
new text end

Sec. 53. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2008, sections 256.82, subdivisions 2, 3, 4, and 5; and
257.85,
new text end new text begin are repealed effective January 1, 2011.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2008, section 259.67, subdivisions 1, 2, 3, 3a, 4, 5, 6, 7, 8, 9,
and 10,
new text end new text begin are repealed effective July 1, 2009.
new text end

new text begin (c) new text end new text begin Minnesota Rules, parts 9560.0521, subparts 7 and 10; 9560.0650, subparts 1, 3,
and 6; 9560.0651; 9560.0652; 9560.0653; 9560.0654; 9560.0655; 9560.0656; 9560.0657;
and 9560.0665, subparts 2, 3, 4, 5, 6, 7, 8, and 9,
new text end new text begin are repealed effective January 1, 2011.
new text end

new text begin (d) new text end new text begin Minnesota Rules, parts 9560.0071; 9560.0081; 9560.0082; 9560.0083;
9560.0091; 9560.0093, subparts 1, 3, and 4; 9560.0101; and 9560.0102,
new text end new text begin are repealed
effective July 1, 2009.
new text end

ARTICLE 8

LICENSING

Section 1.

Minnesota Statutes 2008, section 245A.10, subdivision 2, is amended to
read:


Subd. 2.

County fees for background studies and licensing inspections.

(a) For
purposes of family and group family child care licensing under this chapter, a county
agency may charge a fee to an applicant or license holder to recover the actual cost of
background studies, but in any case not to exceed $100 annually. A county agency may
also charge a license fee to an applicant or license holder not to exceed $50 for a one-year
license or $100 for a two-year license.

(b) A county agency may charge a fee to a legal nonlicensed child care provider or
applicant for authorization to recover the actual cost of background studies completed
under section 119B.125, but in any case not to exceed $100 annually.

(c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):

(1) in cases of financial hardship;

(2) if the county has a shortage of providers in the county's area;

(3) for new providers; or

(4) for providers who have attained at least 16 hours of training before seeking
initial licensure.

(d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
an installment basis for up to one year. If the provider is receiving child care assistance
payments from the state, the provider may have the fees under paragraph (a) or (b)
deducted from the child care assistance payments for up to one year and the state shall
reimburse the county for the county fees collected in this manner.

(e) For purposes of adult foster care deleted text beginand child foster caredeleted text end licensing under this
chapter, a county agency may charge a fee to a corporate applicant or corporate license
holder to recover the actual cost of background studies. A county agency may also charge
a fee to a corporate applicant or corporate license holder to recover the actual cost of
licensing inspections, not to exceed $500 annually.

(f) Counties may elect to reduce or waive the fees in paragraph (e) under the
following circumstances:

(1) in cases of financial hardship;

(2) if the county has a shortage of providers in the county's area; or

(3) for new providers.

Sec. 2.

Minnesota Statutes 2008, section 245A.10, subdivision 3, is amended to read:


Subd. 3.

Application fee for initial license or certification.

(a) For fees required
under subdivision 1, an applicant for an initial license or certification issued by the
commissioner shall submit a deleted text begin$500deleted text endnew text begin $750new text end application fee with each new application required
under this subdivision. The application fee shall not be prorated, is nonrefundable, and
is in lieu of the annual license or certification fee that expires on December 31. The
commissioner shall not process an application until the application fee is paid.

(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license
to provide services at a specific location.

(1) For a license to provide deleted text beginwaivereddeleted text endnew text begin residential-based habilitationnew text end services to
persons with developmental disabilities deleted text beginor related conditionsdeleted text endnew text begin under chapter 245Bnew text end, an
applicant shall submit an application for each county in which the deleted text beginwaivereddeleted text end services
will be provided.

(2) For a license to provide new text beginsupported employment, crisis respite, or
new text endsemi-independent living services to persons with developmental disabilities deleted text beginor related
conditions
deleted text endnew text begin under chapter 245Bnew text end, an applicant shall submit a single application to provide
services statewide.

(3) For a license to provide independent living assistance for youth under section
245A.22, an applicant shall submit a single application to provide services statewide.

Sec. 3.

Minnesota Statutes 2008, section 245A.10, subdivision 4, is amended to read:


Subd. 4.

License deleted text beginor certificationdeleted text end fee for deleted text begincertain programsdeleted text endnew text begin a child care centernew text end.

deleted text begin (a)deleted text endnew text begin Anew text end child care deleted text begincenters and programs with a licensed capacitydeleted text endnew text begin centernew text end shall pay an annual
nonrefundable license deleted text beginor certificationdeleted text end fee based on the following schedule:

Licensed Capacity
Child Care Center
License Feenew text begin Fiscal Year
2010
new text end
deleted text begin Other Programdeleted text end
License Feenew text beginFiscal
Year 2011 and
thereafter
new text end
1 to 24 persons
deleted text begin $225 deleted text end new text begin $295
new text end
deleted text begin $400 deleted text end new text begin $360
new text end
25 to 49 persons
deleted text begin $340 deleted text end new text begin $410
new text end
deleted text begin $600 deleted text end new text begin $475
new text end
50 to 74 persons
deleted text begin $450 deleted text end new text begin $520
new text end
deleted text begin $800 deleted text end new text begin $585
new text end
75 to 99 persons
deleted text begin $565 deleted text end new text begin $635
new text end
deleted text begin $1,000 deleted text end new text begin $700
new text end
100 to 124 persons
deleted text begin $675 deleted text end new text begin $745
new text end
deleted text begin $1,200 deleted text end new text begin $810
new text end
125 to 149 persons
deleted text begin $900 deleted text end new text begin $970
new text end
deleted text begin $1,400 deleted text end new text begin $1,035
new text end
150 to 174 persons
deleted text begin $1,050
deleted text end new text begin $1,120
new text end
deleted text begin $1,600 deleted text end new text begin $1,185
new text end
175 to 199 persons
deleted text begin $1,200
deleted text end new text begin $1,270
new text end
deleted text begin $1,800 deleted text end new text begin $1,335
new text end
200 to 224 persons
deleted text begin $1,350
deleted text end new text begin $1,420
new text end
deleted text begin $2,000 deleted text end new text begin $1,485
new text end
225 or more persons
deleted text begin $1,500
deleted text end new text begin $1,570
new text end
deleted text begin $2,500 deleted text end new text begin $1,635
new text end

deleted text begin (b) A day training and habilitation program serving persons with developmental
disabilities or related conditions shall be assessed a license fee based on the schedule in
paragraph (a) unless the license holder serves more than 50 percent of the same persons
at two or more locations in the community. Except as provided in paragraph (c), when a
day training and habilitation program serves more than 50 percent of the same persons in
two or more locations in a community, the day training and habilitation program shall pay
a license fee based on the licensed capacity of the largest facility and the other facility
or facilities shall be charged a license fee based on a licensed capacity of a residential
program serving one to 24 persons.
deleted text end

deleted text begin (c) When a day training and habilitation program serving persons with developmental
disabilities or related conditions seeks a single license allowed under section 245B.07,
subdivision 12, clause (2) or (3), the licensing fee must be based on the combined licensed
capacity for each location.
deleted text end

Sec. 4.

Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision
to read:


new text begin Subd. 4a. new text end

new text begin License fee for an adult day care center. new text end

new text begin An adult day care center
licensed under Minnesota Rules, parts 9555.9600 to 9555.9730, shall pay an annual
nonrefundable license fee based on the following schedule:
new text end

new text begin Licensed Capacity
new text end
new text begin License Fee Fiscal
Year 2010
new text end
new text begin License Fee Fiscal Year
2011 and thereafter
new text end
new text begin 1 to 24 persons
new text end
new text begin $930
new text end
new text begin $1,460
new text end
new text begin 25 to 49 persons
new text end
new text begin $1,130
new text end
new text begin $1,660
new text end
new text begin 50 to 74 persons
new text end
new text begin $1,330
new text end
new text begin $1,860
new text end
new text begin 75 to 99 persons
new text end
new text begin $1,530
new text end
new text begin $2,060
new text end
new text begin 100 or more persons
new text end
new text begin $1,730
new text end
new text begin $2,260
new text end

Sec. 5.

Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision
to read:


new text begin Subd. 4b. new text end

new text begin License fee for day training and habilitation program. new text end

new text begin (a) A day
training and habilitation program licensed under chapter 245B to provide services to
persons with developmental disabilities shall pay an annual nonrefundable license fee
based on the following schedule:
new text end

new text begin Licensed Capacity
new text end
new text begin License Fee Fiscal
Year 2010
new text end
new text begin License Fee Fiscal Year
2011 and thereafter
new text end
new text begin 1 to 24 persons
new text end
new text begin $925
new text end
new text begin $1,430
new text end
new text begin 25 to 49 persons
new text end
new text begin $1,125
new text end
new text begin $1,630
new text end
new text begin 50 to 74 persons
new text end
new text begin $1,325
new text end
new text begin $1,830
new text end
new text begin 75 to 99 persons
new text end
new text begin $1,525
new text end
new text begin $2,030
new text end
new text begin 100 to 124 persons
new text end
new text begin $1,725
new text end
new text begin $2,230
new text end
new text begin 125 to 149 persons
new text end
new text begin $1,925
new text end
new text begin $2,430
new text end
new text begin 150 to 174 persons
new text end
new text begin $2,125
new text end
new text begin $2,630
new text end
new text begin 175 to 199 persons
new text end
new text begin $2,325
new text end
new text begin $2,830
new text end
new text begin 200 to 224 persons
new text end
new text begin $2,525
new text end
new text begin $3,030
new text end
new text begin 225 or more persons
new text end
new text begin $3,025
new text end
new text begin $3,530
new text end

new text begin (b) A day training and habilitation program licensed under chapter 245B must
be assessed a license fee based on the schedule in paragraph (a) unless the license
holder serves more than 50 percent of the same persons at two or more locations in the
community. Except as provided in paragraph (c), when a day training and habilitation
program serves more than 50 percent of the same persons in two or more locations in a
community, the day training and habilitation program shall pay a license fee based on the
licensed capacity of the largest facility and the other facility or facilities must be charged a
license fee based on a licensed capacity of a residential program serving one to 24 persons.
new text end

new text begin (c) When a day training and habilitation program serving persons with developmental
disabilities seeks a single license allowed under section 245B.07, subdivision 12, clause (2)
or (3), the licensing fee must be based on the combined licensed capacity for each location.
new text end

Sec. 6.

Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision
to read:


new text begin Subd. 4c. new text end

new text begin License fee for residential program serving persons with
developmental disabilities.
new text end

new text begin A residential program licensed under chapter 245B whether
certified as an intermediate care facility for persons with developmental disabilities or not
shall pay an annual nonrefundable license fee based on the following schedule:
new text end

new text begin Licensed Capacity
new text end
new text begin License Fee Fiscal
Year 2010
new text end
new text begin License Fee Fiscal Year
2011 and thereafter
new text end
new text begin 1 to 24 persons
new text end
new text begin $1,000
new text end
new text begin $1,600
new text end
new text begin 25 to 49 persons
new text end
new text begin $1,200
new text end
new text begin $1,800
new text end
new text begin 50 to 74 persons
new text end
new text begin $1,400
new text end
new text begin $2,000
new text end
new text begin 75 or more persons
new text end
new text begin $1,600
new text end
new text begin $2,200
new text end

Sec. 7.

Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision
to read:


new text begin Subd. 4d. new text end

new text begin License fee for program providing crisis respite. new text end

new text begin (a) In fiscal year
2010, a program licensed to provide crisis respite services for persons with developmental
disabilities under chapter 245B shall pay an annual nonrefundable license fee of $1,600.
new text end

new text begin (b) In fiscal year 2011 and thereafter, a program licensed to provide crisis respite
services for persons with developmental disabilities under chapter 245B shall pay an
annual nonrefundable license fee of $2,000.
new text end

Sec. 8.

Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision
to read:


new text begin Subd. 4e. new text end

new text begin License fee for program providing residential-based habilitation
services.
new text end

new text begin (a) In fiscal year 2010, a program licensed to provide residential-based
habilitation services for persons with developmental disabilities under chapter 245B
shall pay an annual nonrefundable license fee that is based on a base rate of $715 plus
$50 times the number of clients served on the first day of August of the current license
year. State-operated programs are exempt from the license fee under this paragraph and
paragraph (b).
new text end

new text begin (b) In fiscal year 2011 and thereafter, a program licensed to provide residential-based
habilitation services for persons with developmental disabilities under chapter 245B shall
pay an annual nonrefundable license fee that is based on a base rate of $1,000 plus $70
times the number of clients served on the first day of August of the current license year.
new text end

Sec. 9.

Minnesota Statutes 2008, section 245A.10, is amended by adding a subdivision
to read:


new text begin Subd. 4f. new text end

new text begin License fee for program providing semi-independent living services
or supported employment services.
new text end

new text begin (a) In fiscal year 2010, a program licensed to
provide semi-independent living services for persons with developmental disabilities
under chapter 245B or supported employment services for persons with developmental
disabilities under chapter 245B shall pay an annual nonrefundable license fee of $1,250.
new text end

new text begin (b) In fiscal year 2011 and thereafter, a program licensed to provide semi-independent
living services for persons with developmental disabilities under chapter 245B or
supported employment services for persons with developmental disabilities under chapter
245B shall pay an annual nonrefundable license fee of $2,000.
new text end

Sec. 10.

Minnesota Statutes 2008, section 245A.10, is amended by adding a
subdivision to read:


new text begin Subd. 4g. new text end

new text begin License fee for residential program serving persons with physical
disabilities.
new text end

new text begin A residential program licensed under Minnesota Rules, parts 9570.2000 to
9570.3400, to serve persons with physical disabilities shall pay an annual nonrefundable
license fee based on the following schedule:
new text end

new text begin Licensed Capacity
new text end
new text begin License Fee Fiscal
Year 2010
new text end
new text begin License Fee Fiscal Year
2011 and thereafter
new text end
new text begin 1 to 24 persons
new text end
new text begin $713
new text end
new text begin $1,025
new text end
new text begin 25 to 49 persons
new text end
new text begin $913
new text end
new text begin $1,225
new text end
new text begin 50 to 74 persons
new text end
new text begin $1,113
new text end
new text begin $1,425
new text end
new text begin 75 to 99 persons
new text end
new text begin $1,313
new text end
new text begin $1,625
new text end
new text begin 100 to 124 persons
new text end
new text begin $1,513
new text end
new text begin $1,825
new text end
new text begin 125 or more persons
new text end
new text begin $1,713
new text end
new text begin $2,025
new text end

Sec. 11.

Minnesota Statutes 2008, section 245A.10, is amended by adding a
subdivision to read:


new text begin Subd. 4h. new text end

new text begin License fee for residential programs serving adults with mental
illness.
new text end

new text begin (a) In fiscal year 2010, a residential program licensed under Minnesota Rules,
parts 9520.0500 to 9520.0670, to serve adults with mental illness shall pay an annual
nonrefundable license fee of $2,450.
new text end

new text begin (b) In fiscal year 2011 and thereafter, a residential program licensed under Minnesota
Rules, parts 9520.0500 to 9520.0670, to serve adults with mental illness shall pay an
annual nonrefundable license fee of $4,400.
new text end

Sec. 12.

Minnesota Statutes 2008, section 245A.10, is amended by adding a
subdivision to read:


new text begin Subd. 4i. new text end

new text begin License fee for a children's residential program. new text end

new text begin (a) In fiscal year 2010,
a children's residential program licensed under Minnesota Rules, chapter 2960, shall pay
an annual nonrefundable license fee of $2,450.
new text end

new text begin (b) In fiscal year 2011 and thereafter, a children's residential program licensed under
Minnesota Rules, chapter 2960, shall pay an annual nonrefundable license fee of $4,400.
new text end

Sec. 13.

Minnesota Statutes 2008, section 245A.10, is amended by adding a
subdivision to read:


new text begin Subd. 4j. new text end

new text begin License fee for programs licensed to provide drug or chemical
dependency treatment.
new text end

new text begin (a) A program licensed under Minnesota Rules, parts 9530.6405
to 9530.6505 or 9530.6510 to 9530.6590, to provide drug or chemical dependency
treatment shall pay an annual nonrefundable license fee based on the following schedule:
new text end

new text begin Licensed Capacity
new text end
new text begin License Fee Fiscal
Year 2010
new text end
new text begin License Fee Fiscal Year
2011 and thereafter
new text end
new text begin 1 to 24 persons
new text end
new text begin $755
new text end
new text begin $1,035
new text end
new text begin 25 to 49 persons
new text end
new text begin $955
new text end
new text begin $1,235
new text end
new text begin 50 to 74 persons
new text end
new text begin $1,155
new text end
new text begin $1,435
new text end
new text begin 75 to 99 persons
new text end
new text begin $1,355
new text end
new text begin $1,635
new text end
new text begin 100 to 124 persons
new text end
new text begin $1,555
new text end
new text begin $1,835
new text end
new text begin 125 or more persons
new text end
new text begin $1,755
new text end
new text begin $2,035
new text end

new text begin (b) In fiscal year 2010, if a license issued to a program under Minnesota Rules, parts
9530.6405 to 9530.6505, does not have a stated licensed capacity, the drug or chemical
dependency treatment program shall pay an annual nonrefundable license fee based on a
licensed capacity of one to 24 persons for fiscal year 2010.
new text end

new text begin (c) In fiscal year 2011 and thereafter, if a license issued to a program under Minnesota
Rules, parts 9530.6405 to 9530.6505, does not have a stated licensed capacity, the drug or
chemical dependency treatment program shall pay an annual nonrefundable license fee
based on a licensed capacity of one to 24 persons for fiscal year 2011 and thereafter.
new text end

Sec. 14.

Minnesota Statutes 2008, section 245A.10, is amended by adding a
subdivision to read:


new text begin Subd. 4k. new text end

new text begin License fee for independent living assistance for youth. new text end

new text begin A program
licensed to provide independent living assistance for youth under section 245A.22, shall
pay an annual nonrefundable license fee of $2,000.
new text end

Sec. 15.

Minnesota Statutes 2008, section 245A.10, is amended by adding a
subdivision to read:


new text begin Subd. 4l. new text end

new text begin License fee for private agencies that provide child foster care or
adoption services.
new text end

new text begin A private agency licensed under Minnesota Rules, parts 9545.0755
to 9545.0845, to provide child foster care or adoption services shall pay an annual
nonrefundable license fee of $400.
new text end

Sec. 16.

Minnesota Statutes 2008, section 245A.10, subdivision 5, is amended to read:


Subd. 5.

deleted text beginLicense ordeleted text endnew text begin Mental health center or mental health clinicnew text end certification fee
deleted text begin for other programsdeleted text end.

deleted text begin (a) Except as provided in paragraphs (b) and (c), a program without
a stated licensed capacity shall pay a license or certification fee of $400.
deleted text end

deleted text begin (b)deleted text end A mental health center or mental health clinic requesting certification for
purposes of insurance and subscriber contract reimbursement under Minnesota Rules,
parts 9520.0750 to 9520.0870, shall pay a certification fee of $1,000 per year. If the
mental health center or mental health clinic provides services at a primary location with
satellite facilities, the satellite facilities shall be certified with the primary location without
an additional charge.

deleted text begin (c) A program licensed to provide residential-based habilitation services under the
home and community-based waiver for persons with developmental disabilities shall pay
an annual license fee that includes a base rate of $250 plus $38 times the number of clients
served on the first day of August of the current license year. State-operated programs are
exempt from the license fee under this paragraph.
deleted text end

Sec. 17.

Minnesota Statutes 2008, section 245A.10, is amended by adding a
subdivision to read:


new text begin Subd. 7. new text end

new text begin Human services licensing revenue and appropriations. new text end

new text begin Effective July
1, 2011:
new text end

new text begin (1) departmental earnings collected under subdivisions 3, 4 to 4l, and 5 shall be
deposited in the state government special revenue fund; and
new text end

new text begin (2) the direct appropriation to the department for licensing activities in subdivisions
3, 4 to 4l, and 5 shall be transferred from the general fund to the state government special
revenue fund.
new text end

Sec. 18.

Minnesota Statutes 2008, section 245C.10, is amended by adding a
subdivision to read:


new text begin Subd. 8. new text end

new text begin Private agencies. new text end

new text begin The commissioner shall recover the cost of conducting
background studies under section 245C.33 for studies initiated by private agencies for the
purpose of adoption through a fee of no more than $70 per study charged to the private
agency. The fees collected under this subdivision are appropriated to the commissioner for
the purpose of conducting background studies.
new text end

ARTICLE 9

HEALTH CARE

Section 1.

Minnesota Statutes 2008, section 62J.692, subdivision 7, is amended to read:


Subd. 7.

Transfers from the commissioner of human services.

deleted text begin (a) The amount
transferred according to section 256B.69, subdivision 5c, paragraph (a), clause (1), shall be
distributed by the commissioner annually to clinical medical education programs that meet
the qualifications of subdivision 3 based on the formula in subdivision 4, paragraph (a).
deleted text end

deleted text begin (b) Fifty percent of the amount transferred according to section 256B.69, subdivision
5c
, paragraph (a), clause (2), shall be distributed by the commissioner to the University of
Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40. Of
the remaining amount transferred according to section 256B.69, subdivision 5c, paragraph
(a), clause (2), 24 percent of the amount shall be distributed by the commissioner to
the Hennepin County Medical Center for clinical medical education. The remaining 26
percent of the amount transferred shall be distributed by the commissioner in accordance
with subdivision 7a. If the federal approval is not obtained for the matching funds under
section 256B.69, subdivision 5c, paragraph (a), clause (2), 100 percent of the amount
transferred under this paragraph shall be distributed by the commissioner to the University
of Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40.
deleted text end

deleted text begin (c) The amount transferred according to section 256B.69, subdivision 5c, paragraph
(a), clauses (3) and (4), shall be distributed by the commissioner upon receipt to the
University of Minnesota Board of Regents for the purposes of clinical graduate medical
education.
deleted text end

new text begin (a) Of the amount transferred under section 256B.69, subdivision 5c, paragraph (a),
clauses (1) to (4), $21,714,000 must be distributed as follows:
new text end

new text begin (1) $2,157,000 must be distributed by the commissioner to the University of
Minnesota Board of Regents for the purposes described in sections 137.38 to 137.40;
new text end

new text begin (2) $1,035,360 must be distributed by the commissioner to the Hennepin County
Medical Center for clinical medical education;
new text end

new text begin (3) $17,400,000 must be distributed by the commissioner to the University of
Minnesota Board of Regents for purposes of medical education;
new text end

new text begin (4) $1,121,640 must be distributed by the commissioner to clinical medical
education dental innovation grants under subdivision 7a; and
new text end

new text begin (5) the remainder of the amount transferred under section 256B.69, subdivision 5c,
clauses (1) to (4), must be distributed by the commissioner annually to clinical medical
education programs that meet the qualifications of subdivision 3 based on the formula
in subdivision 4, paragraph (a).
new text end

Sec. 2.

Minnesota Statutes 2008, section 125A.744, subdivision 3, is amended to read:


Subd. 3.

Implementation.

Consistent with section 256B.0625, subdivision 26,
school districts may enroll as medical assistance providers or subcontractors and bill
the Department of Human Services under the medical assistance fee for service claims
processing system for special education services which are covered services under chapter
256B, which are provided in the school setting for a medical assistance recipient, and for
whom the district has secured informed consent consistent with section 13.05, subdivision
4
, paragraph (d), and section 256B.77, subdivision 2, paragraph (p), to bill for each type
of covered service. School districts shall be reimbursed by the commissioner of human
services for the federal share of individual education plan health-related services that
qualify for reimbursement by medical assistance, minus up to five percent retained by the
commissioner of human services for administrative costsdeleted text begin, not to exceed $350,000 per
fiscal year
deleted text end. The commissioner may withhold up to five percent of each payment to a
school district. Following the end of each fiscal year, the commissioner shall settle up with
each school district in order to ensure that collections from each district for departmental
administrative costs are made on a pro rata basis according to federal earnings for these
services in each district. A school district is not eligible to enroll as a home care provider
or a personal care provider organization for purposes of billing home care services under
sections 256B.0651 and 256B.0653 to 256B.0656 until the commissioner of human
services issues a bulletin instructing county public health nurses on how to assess for the
needs of eligible recipients during school hours. To use private duty nursing services or
personal care services at school, the recipient or responsible party must provide written
authorization in the care plan identifying the chosen provider and the daily amount
of services to be used at school.

Sec. 3.

Minnesota Statutes 2008, section 256.01, subdivision 2b, is amended to read:


Subd. 2b.

Performance payments.

deleted text begin(a)deleted text end The commissioner shall develop and
implement a pay-for-performance system to provide performance payments to eligible
medical groups and clinics that demonstrate optimum care in serving individuals
with chronic diseases who are enrolled in health care programs administered by the
commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any
federal matching money that is made available through the medical assistance program
for managed care oversight contracted through vendors, including consumer surveys,
studies, and external quality reviews as required by the federal Balanced Budget Act of
1997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external
quality review. Any federal money received for managed care oversight is appropriated
to the commissioner for this purpose. The commissioner may expend the federal money
received in either year of the biennium.

deleted text begin (b) Effective July 1, 2008, or upon federal approval, whichever is later, the
commissioner shall develop and implement a patient incentive health program to provide
incentives and rewards to patients who are enrolled in health care programs administered
by the commissioner under chapters 256B, 256D, and 256L, and who have agreed to and
have met personal health goals established with the patients' primary care providers to
manage a chronic disease or condition, including but not limited to diabetes, high blood
pressure, and coronary artery disease.
deleted text end

Sec. 4.

Minnesota Statutes 2008, section 256.01, is amended by adding a subdivision
to read:


new text begin Subd. 18a. new text end

new text begin Public Assistance Reporting Information System. new text end

new text begin (a) Effective July
1, 2009, the commissioner shall comply with the federal requirements in Public Law
110-379 in implementing the Public Assistance Reporting Information System (PARIS) to
determine eligibility for all individuals applying for:
new text end

new text begin (1) health care benefits under chapters 256B, 256D, and 256L; and
new text end

new text begin (2) public benefits under chapters 119B, 256D, 256I, and the supplemental nutrition
assistance program.
new text end

new text begin (b) The commissioner shall determine eligibility under paragraph (a) by performing
data matches, including matching with medical assistance, cash, child care, and
supplemental assistance programs operated by other states.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 5.

Minnesota Statutes 2008, section 256.969, subdivision 2b, is amended to read:


Subd. 2b.

Operating payment rates.

In determining operating payment rates for
admissions occurring on or after the rate year beginning January 1, 1991, and every two
years after, or more frequently as determined by the commissioner, the commissioner shall
obtain operating data from an updated base year and establish operating payment rates
per admission for each hospital based on the cost-finding methods and allowable costs of
the Medicare program in effect during the base year. Rates under the general assistance
medical care, medical assistance, and MinnesotaCare programs shall not be rebased to
more current data on January 1, 1997, January 1, 2005, deleted text beginanddeleted text end for the first 24 months of the
rebased period beginning January 1, 2009new text begin, and for the first three months of the rebased
period beginning January 1, 2011
new text end. The base year operating payment rate per admission is
standardized by the case mix index and adjusted by the hospital cost index, relative values,
and disproportionate population adjustment. The cost and charge data used to establish
operating rates shall only reflect inpatient services covered by medical assistance and shall
not include property cost information and costs recognized in outlier payments.

Sec. 6.

Minnesota Statutes 2008, section 256.969, subdivision 3a, is amended to read:


Subd. 3a.

Payments.

(a) Acute care hospital billings under the medical
assistance program must not be submitted until the recipient is discharged. However,
the commissioner shall establish monthly interim payments for inpatient hospitals that
have individual patient lengths of stay over 30 days regardless of diagnostic category.
Except as provided in section 256.9693, medical assistance reimbursement for treatment
of mental illness shall be reimbursed based on diagnostic classifications. Individual
hospital payments established under this section and sections 256.9685, 256.9686, and
256.9695, in addition to third party and recipient liability, for discharges occurring during
the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
inpatient services paid for the same period of time to the hospital. This payment limitation
shall be calculated separately for medical assistance and general assistance medical
care services. The limitation on general assistance medical care shall be effective for
admissions occurring on or after July 1, 1991. Services that have rates established under
subdivision 11 or 12, must be limited separately from other services. After consulting with
the affected hospitals, the commissioner may consider related hospitals one entity and
may merge the payment rates while maintaining separate provider numbers. The operating
and property base rates per admission or per day shall be derived from the best Medicare
and claims data available when rates are established. The commissioner shall determine
the best Medicare and claims data, taking into consideration variables of recency of the
data, audit disposition, settlement status, and the ability to set rates in a timely manner.
The commissioner shall notify hospitals of payment rates by December 1 of the year
preceding the rate year. The rate setting data must reflect the admissions data used to
establish relative values. Base year changes from 1981 to the base year established for the
rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
1. The commissioner may adjust base year cost, relative value, and case mix index data
to exclude the costs of services that have been discontinued by the October 1 of the year
preceding the rate year or that are paid separately from inpatient services. Inpatient stays
that encompass portions of two or more rate years shall have payments established based
on payment rates in effect at the time of admission unless the date of admission preceded
the rate year in effect by six months or more. In this case, operating payment rates for
services rendered during the rate year in effect and established based on the date of
admission shall be adjusted to the rate year in effect by the hospital cost index.

(b) For fee-for-service admissions occurring on or after July 1, 2002, the total
payment, before third-party liability and spenddown, made to hospitals for inpatient
services is reduced by .5 percent from the current statutory rates.

(c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Mental health services within diagnosis related groups 424 to 432, and
facilities defined under subdivision 16 are excluded from this paragraph.

(d) In addition to the reduction in paragraphs (b) and (c), the total payment for
fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 6.0 percent
from the current statutory rates. Mental health services within diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
Notwithstanding section 256.9686, subdivision 7, for purposes of this paragraph, medical
assistance does not include general assistance medical care. Payments made to managed
care plans shall be reduced for services provided on or after January 1, 2006, to reflect
this reduction.

(e) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2008, through June 30, 2009, made
to hospitals for inpatient services before third-party liability and spenddown, is reduced
3.46 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
paragraph. Payments made to managed care plans shall be reduced for services provided
on or after January 1, 2009, through June 30, 2009, to reflect this reduction.

(f) In addition to the reductions in paragraphs (b), (c), and (d), the total payment for
fee-for-service admissions occurring on or after July 1, 2009, through June 30, 2010, made
to hospitals for inpatient services before third-party liability and spenddown, is reduced
1.9 percent from the current statutory rates. Mental health services with diagnosis related
groups 424 to 432 and facilities defined under subdivision 16 are excluded from this
paragraph. Payments made to managed care plans shall be reduced for services provided
on or after July 1, 2009, through June 30, 2010, to reflect this reduction.

(g) In addition to the reductions in paragraphs (b), (c), and (d), the total payment
for fee-for-service admissions occurring on or after July 1, 2010, made to hospitals for
inpatient services before third-party liability and spenddown, is reduced 1.79 percent
from the current statutory rates. Mental health services with diagnosis related groups
424 to 432 and facilities defined under subdivision 16 are excluded from this paragraph.
Payments made to managed care plans shall be reduced for services provided on or after
July 1, 2010, to reflect this reduction.

new text begin (h) In addition to the reductions in paragraphs (b), (c), (d), (f), and (g), the total
payment for fee-for-service admissions occurring on or after July 1, 2009, made to
hospitals for inpatient services before third-party liability and spenddown, is reduced
3.0 percent from the current statutory rates. Facilities defined under subdivision 16 are
excluded from this paragraph. Payments made to managed care plans shall be reduced for
services provided on or after January 1, 2010, to reflect this reduction.
new text end

new text begin (i) In addition to the reductions in paragraphs (b) and (h), the total payment for
fee-for-service admissions occurring on or after July 1, 2009, made to hospitals for mental
health services within diagnosis-related groups 424 to 432 before third-party liability and
spenddown, is reduced 5.2 percent from the current statutory rates. Facilities defined under
subdivision 16 are excluded from this paragraph. Payments made to managed care plans
shall be reduced for services provided on or after January 1, 2010, to reflect this reduction.
new text end

Sec. 7.

Minnesota Statutes 2008, section 256B.04, subdivision 14, is amended to read:


Subd. 14.

Competitive bidding.

(a) When determined to be effective, economical,
and feasible, the commissioner may utilize volume purchase through competitive bidding
and negotiation under the provisions of chapter 16C, to provide items under the medical
assistance program including but not limited to the following:

(1) eyeglasses;

(2) oxygen. The commissioner shall provide for oxygen needed in an emergency
situation on a short-term basis, until the vendor can obtain the necessary supply from
the contract dealer;

(3) hearing aids and supplies; and

(4) durable medical equipment, including but not limited to:

(i) hospital beds;

(ii) commodes;

(iii) glide-about chairs;

(iv) patient lift apparatus;

(v) wheelchairs and accessories;

(vi) oxygen administration equipment;

(vii) respiratory therapy equipment;

(viii) electronic diagnostic, therapeutic and life-support systems;

(5) nonemergency medical transportation level of need determinations, disbursement
of public transportation passes and tokens, and volunteer and recipient mileage and
parking reimbursements; and

(6) drugs.

(b) Rate changes under this chapter and chapters 256D and 256L do not affect
contract payments under this subdivision unless specifically identified.

(c) The commissioner may deleted text beginnotdeleted text end utilize volume purchase through competitive bidding
and negotiation for special transportation services under the provisions of chapter 16C.

Sec. 8.

Minnesota Statutes 2008, section 256B.056, subdivision 3b, is amended to read:


Subd. 3b.

Treatment of trusts.

(a) A "medical assistance qualifying trust" is a
revocable or irrevocable trust, or similar legal device, established on or before August
10, 1993, by a person or the person's spouse under the terms of which the person
receives or could receive payments from the trust principal or income and the trustee
has discretion in making payments to the person from the trust principal or income.
Notwithstanding that definition, a medical assistance qualifying trust does not include:
(1) a trust set up by will; (2) a trust set up before April 7, 1986, solely to benefit a person
with a developmental disability living in an intermediate care facility for persons with
developmental disabilities; or (3) a trust set up by a person with payments made by the
Social Security Administration pursuant to the United States Supreme Court decision in
Sullivan v. Zebley, 110 S. Ct. 885 (1990). The maximum amount of payments that a
trustee of a medical assistance qualifying trust may make to a person under the terms of
the trust is considered to be available assets to the person, without regard to whether the
trustee actually makes the maximum payments to the person and without regard to the
purpose for which the medical assistance qualifying trust was established.

(b) new text beginExcept as provided in paragraphs (c) and (d), new text endtrusts established after August 10,
1993, are treated according to section 13611(b) of the Omnibus Budget Reconciliation
Act of 1993 (OBRA), Public Law 103-66.

new text begin (c) For purposes of paragraph (d), a pooled trust means a trust established under
United States Code, title 42, section 1396p(d)(4)(C).
new text end

new text begin (d) A beneficiary's interest in a pooled trust is considered an available asset unless
the trust provides that upon the death of the beneficiary or termination of the trust during
the beneficiary's lifetime, whichever is sooner, the department receives any amount in
excess of reasonable administrative fees remaining in the beneficiary's trust account up to
the amount of medical assistance benefits paid on behalf of the beneficiary.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for pooled trust accounts established
on or after July 1, 2009.
new text end

Sec. 9.

Minnesota Statutes 2008, section 256B.056, subdivision 3c, is amended to read:


Subd. 3c.

Asset limitations for families and children.

A household of two or
more persons must not own more than deleted text begin$20,000deleted text end new text begin$6,000 new text endin total net assets, new text beginplus $200 for
each additional legal dependent,
new text endand a household of one person must not own more than
deleted text begin $10,000deleted text end new text begin$3,000 new text endin total net assets. In addition to these maximum amounts, an eligible
individual or family may accrue interest on these amounts, but they must be reduced to
the maximum at the time of an eligibility redetermination. The value of assets that are
not considered in determining eligibility for medical assistance for families and children
is the value of those assets excluded under the AFDC state plan as of July 16, 1996, as
required by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996
(PRWORA), Public Law 104-193, with the following exceptions:

(1) household goods and personal effects are not considered;

(2) capital and operating assets of a trade or business up to $200,000 are not
considered;

(3) one motor vehicle is excluded for each person of legal driving age who is
employed or seeking employment;

(4) one burial plot and all other burial expenses equal to the supplemental security
income program asset limit are not considered for each individual;

(5) court-ordered settlements up to $10,000 are not considered;

(6) individual retirement accounts and funds are not considered; and

(7) assets owned by children are not considered.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2010.
new text end

Sec. 10.

Minnesota Statutes 2008, section 256B.056, subdivision 3d, is amended to
read:


Subd. 3d.

Reduction of excess assets.

Assets in excess of the limits in subdivisions
3 to 3c may be reduced to allowable limits as follows:

(a) Assets may be reduced in any of the three calendar months before the month
of application in which the applicant seeks coverage bydeleted text begin:
deleted text end

deleted text begin (1) designating burial funds up to $1,500 for each applicant, spouse, and MA-eligible
dependent child; and
deleted text end

deleted text begin (2)deleted text end paying deleted text beginhealth servicedeleted text end bills new text beginfor health services that are new text endincurred in the retroactive
period for which the applicant seeks eligibility, starting with the oldest bill. After assets
are reduced to allowable limits, eligibility begins with the next dollar of MA-covered
health services incurred in the retroactive period. Applicants reducing assets under this
subdivision who also have excess income shall first spend excess assets to pay health
service bills and may meet the income spenddown on remaining bills.

(b) Assets may be reduced beginning the month of application bydeleted text begin:
deleted text end

deleted text begin (1)deleted text end paying bills for health services new text beginthat are incurred during the period specified in
Minnesota Rules, part 9505.0090, subpart 2,
new text endthat would otherwise be paid by medical
assistancedeleted text begin; anddeleted text endnew text begin. After assets are reduced to allowable limits, eligibility begins with the
next dollar of medical assistance covered health services incurred in the period. Applicants
reducing assets under this subdivision who also have excess income shall first spend excess
assets to pay health service bills and may meet the income spenddown on remaining bills.
new text end

deleted text begin (2) using any means other than a transfer of assets for less than fair market value as
defined in section 256B.0595, subdivision 1, paragraph (b).
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for requests for medical assistance
submitted on or after July 1, 2009.
new text end

Sec. 11.

Minnesota Statutes 2008, section 256B.056, subdivision 10, is amended to
read:


Subd. 10.

Eligibility verification.

(a) The commissioner shall require women who
are applying for the continuation of medical assistance coverage following the end of the
60-day postpartum period to update their income and asset information and to submit
any required income or asset verification.

(b) The commissioner shall determine the eligibility of private-sector health care
coverage for infants less than one year of age eligible under section 256B.055, subdivision
10
, or 256B.057, subdivision 1, paragraph (d), and shall pay for private-sector coverage
if this is determined to be cost-effective.

(c) The commissioner shall verify assetsnew text begin, including capital and operating assets of a
trade or business,
new text end and income for all applicants, and for all recipients upon renewal.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2011.
new text end

Sec. 12.

Minnesota Statutes 2008, section 256B.057, subdivision 3, is amended to read:


Subd. 3.

Qualified Medicare beneficiaries.

A person who is entitled to Part A
Medicare benefits, whose income is equal to or less than 100 percent of the federal
poverty guidelines, and whose assets are no more than deleted text begin$10,000 for a single individual
and $18,000 for a married couple or family of two or more
deleted text endnew text begin the maximum resource
level applied for the year for an individual or an individual and the individual's spouse
according to United States Code, title 42, section 1396d(p)(1)(C)
new text end, is eligible for medical
assistance reimbursement of Part A and Part B premiums, Part A and Part B coinsurance
and deductibles, and cost-effective premiums for enrollment with a health maintenance
organization or a competitive medical plan under section 1876 of the Social Security Act.
Reimbursement of the Medicare coinsurance and deductibles, when added to the amount
paid by Medicare, must not exceed the total rate the provider would have received for the
same service or services if the person were a medical assistance recipient with Medicare
coverage. Increases in benefits under Title II of the Social Security Act shall not be
counted as income for purposes of this subdivision until July 1 of each year.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2010.
new text end

Sec. 13.

Minnesota Statutes 2008, section 256B.057, subdivision 9, is amended to read:


Subd. 9.

Employed persons with disabilities.

(a) Medical assistance may be paid
for a person who is employed and who:

(1) meets the definition of disabled under the supplemental security income program;

(2) is at least 16 but less than 65 years of age;

(3) meets the asset limits in paragraph (c); and

(4) effective November 1, 2003, pays a premium and other obligations under
paragraph (e).

Any spousal income or assets shall be disregarded for purposes of eligibility and premium
determinations.

(b) After the month of enrollment, a person enrolled in medical assistance under
this subdivision who:

(1) is temporarily unable to work and without receipt of earned income due to a
medical condition, as verified by a physician, may retain eligibility for up to four calendar
months; or

(2) effective January 1, 2004, loses employment for reasons not attributable to the
enrollee, may retain eligibility for up to four consecutive months after the month of job
loss. To receive a four-month extension, enrollees must verify the medical condition or
provide notification of job loss. All other eligibility requirements must be met and the
enrollee must pay all calculated premium costs for continued eligibility.

(c) For purposes of determining eligibility under this subdivision, a person's assets
must not exceed $20,000, excluding:

(1) all assets excluded under section 256B.056;

(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans,
Keogh plans, and pension plans; and

(3) medical expense accounts set up through the person's employer.

(d)(1) Effective January 1, 2004, for purposes of eligibility, there will be a $65
earned income disregard. To be eligible, a person applying for medical assistance under
this subdivision must have earned income above the disregard level.

(2) Effective January 1, 2004, to be considered earned income, Medicare, Social
Security, and applicable state and federal income taxes must be withheld. To be eligible,
a person must document earned income tax withholding.

(e)(1) A person whose earned and unearned income is equal to or greater than 100
percent of federal poverty guidelines for the applicable family size must pay a premium
to be eligible for medical assistance under this subdivision. The premium shall be based
on the person's gross earned and unearned income and the applicable family size using a
sliding fee scale established by the commissioner, which begins at one percent of income
at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income
for those with incomes at or above 300 percent of the federal poverty guidelines. Annual
adjustments in the premium schedule based upon changes in the federal poverty guidelines
shall be effective for premiums due in July of each year.

(2) Effective January 1, 2004, all enrollees must pay a premium to be eligible for
medical assistance under this subdivision. An enrollee shall pay the greater of a deleted text begin$35deleted text end new text begin$50
new text endpremium or the premium calculated in clause (1).

(3) Effective November 1, 2003, all enrollees who receive unearned income must
pay deleted text beginone-half of onedeleted text end new text begin2.5 new text endpercent of unearned income in addition to the premium amount.

(4) Effective November 1, 2003, for enrollees whose income does not exceed 200
percent of the federal poverty guidelines and who are also enrolled in Medicare, the
commissioner must reimburse the enrollee for Medicare Part B premiums under section
256B.0625, subdivision 15, paragraph (a).

(5) Increases in benefits under title II of the Social Security Act shall not be counted
as income for purposes of this subdivision until July 1 of each year.

(f) A person's eligibility and premium shall be determined by the local county
agency. Premiums must be paid to the commissioner. All premiums are dedicated to
the commissioner.

(g) Any required premium shall be determined at application and redetermined at
the enrollee's six-month income review or when a change in income or household size is
reported. Enrollees must report any change in income or household size within ten days
of when the change occurs. A decreased premium resulting from a reported change in
income or household size shall be effective the first day of the next available billing month
after the change is reported. Except for changes occurring from annual cost-of-living
increases, a change resulting in an increased premium shall not affect the premium amount
until the next six-month review.

(h) Premium payment is due upon notification from the commissioner of the
premium amount required. Premiums may be paid in installments at the discretion of
the commissioner.

(i) Nonpayment of the premium shall result in denial or termination of medical
assistance unless the person demonstrates good cause for nonpayment. Good cause exists
if the requirements specified in Minnesota Rules, part 9506.0040, subpart 7, items B to
D, are met. Except when an installment agreement is accepted by the commissioner,
all persons disenrolled for nonpayment of a premium must pay any past due premiums
as well as current premiums due prior to being reenrolled. Nonpayment shall include
payment with a returned, refused, or dishonored instrument. The commissioner may
require a guaranteed form of payment as the only means to replace a returned, refused,
or dishonored instrument.

Sec. 14.

Minnesota Statutes 2008, section 256B.0575, is amended to read:


256B.0575 AVAILABILITY OF INCOME FOR INSTITUTIONALIZED
PERSONS.

new text begin Subdivision 1. new text end

new text begin Income deductions. new text end

When an institutionalized person is determined
eligible for medical assistance, the income that exceeds the deductions in paragraphs (a)
and (b) must be applied to the cost of institutional care.

(a) The following amounts must be deducted from the institutionalized person's
income in the following order:

(1) the personal needs allowance under section 256B.35 or, for a veteran who
does not have a spouse or child, or a surviving spouse of a veteran having no child, the
amount of an improved pension received from the veteran's administration not exceeding
$90 per month;

(2) the personal allowance for disabled individuals under section 256B.36;

(3) if the institutionalized person has a legally appointed guardian or conservator,
five percent of the recipient's gross monthly income up to $100 as reimbursement for
guardianship or conservatorship services;

(4) a monthly income allowance determined under section 256B.058, subdivision
2
, but only to the extent income of the institutionalized spouse is made available to the
community spouse;

(5) a monthly allowance for children under age 18 which, together with the net
income of the children, would provide income equal to the medical assistance standard
for families and children according to section 256B.056, subdivision 4, for a family size
that includes only the minor children. This deduction applies only if the children do not
live with the community spouse and only to the extent that the deduction is not included
in the personal needs allowance under section 256B.35, subdivision 1, as child support
garnished under a court order;

(6) a monthly family allowance for other family members, equal to one-third of the
difference between 122 percent of the federal poverty guidelines and the monthly income
for that family member;

(7) reparations payments made by the Federal Republic of Germany and reparations
payments made by the Netherlands for victims of Nazi persecution between 1940 and
1945;

(8) all other exclusions from income for institutionalized persons as mandated by
federal law; and

(9) amounts for reasonable expenses new text beginas defined in subdivision 2, new text endincurred for
necessary medical or remedial care for the institutionalized person that are not deleted text beginmedical
assistance covered expenses and that are not
deleted text end subject to payment by a third party.

deleted text begin Reasonable expenses are limited to expenses that have not been previously used as a
deduction from income and are incurred during the enrollee's current period of eligibility,
including retroactive months associated with the current period of eligibility, for medical
assistance payment of long-term care services.
deleted text end

For purposes of clause (6), "other family member" means a person who resides
with the community spouse and who is a minor or dependent child, dependent parent, or
dependent sibling of either spouse. "Dependent" means a person who could be claimed as
a dependent for federal income tax purposes under the Internal Revenue Code.

(b) Income shall be allocated to an institutionalized person for a period of up to three
calendar months, in an amount equal to the medical assistance standard for a family
size of one if:

(1) a physician certifies that the person is expected to reside in the long-term care
facility for three calendar months or less;

(2) if the person has expenses of maintaining a residence in the community; and

(3) if one of the following circumstances apply:

(i) the person was not living together with a spouse or a family member as defined in
paragraph (a) when the person entered a long-term care facility; or

(ii) the person and the person's spouse become institutionalized on the same date, in
which case the allocation shall be applied to the income of one of the spouses.

For purposes of this paragraph, a person is determined to be residing in a licensed nursing
home, regional treatment center, or medical institution if the person is expected to remain
for a period of one full calendar month or more.

new text begin Subd. 2. new text end

new text begin Reasonable expenses. new text end

new text begin (a) For the purposes of subdivision 1, paragraph
(a), clause (9), reasonable expenses are limited to expenses that have not been previously
used as a deduction from income and are incurred:
new text end

new text begin (1) during the enrollee's current period of eligibility including retroactive months
associated with the current period of eligibility for medical assistance payment of
long-term care services; or
new text end

new text begin (2) within three months before the effective date of the period of eligibility identified
in subdivision 1, paragraph (b), clause (3), item (i).
new text end

new text begin (b) For expenses incurred during the period identified in paragraph (a), clause (1),
reasonable expenses do not include:
new text end

new text begin (1) expenses for services or equipment covered under chapter 256B by medical
assistance or a home and community-based waiver; or
new text end

new text begin (2) any additional expenses for services and equipment otherwise covered under
chapter 256B.
new text end

new text begin (c) For expenses incurred during the period identified in paragraph (a), clause (2),
reasonable expenses do not include any amount incurred for long-term care services
during a period of ineligibility due to uncompensated transfers, or long-term care facility
expenses incurred without a timely preadmission screening under section 256B.0911.
new text end

Sec. 15.

Minnesota Statutes 2008, section 256B.0595, subdivision 1, is amended to
read:


Subdivision 1.

Prohibited transfers.

(a) For transfers of assets made on or before
August 10, 1993, if an institutionalized person or the institutionalized person's spouse has
given away, sold, or disposed of, for less than fair market value, any asset or interest
therein, except assets other than the homestead that are excluded under the supplemental
security program, within 30 months before or any time after the date of institutionalization
if the person has been determined eligible for medical assistance, or within 30 months
before or any time after the date of the first approved application for medical assistance
if the person has not yet been determined eligible for medical assistance, the person is
ineligible for long-term care services for the period of time determined under subdivision
2.

(b) Effective for transfers made after August 10, 1993, an institutionalized person, an
institutionalized person's spouse, or any person, court, or administrative body with legal
authority to act in place of, on behalf of, at the direction of, or upon the request of the
institutionalized person or institutionalized person's spouse, may not give away, sell, or
dispose of, for less than fair market value, any asset or interest therein, except assets other
than the homestead that are excluded under the Supplemental Security Income program,
for the purpose of establishing or maintaining medical assistance eligibility. This applies
to all transfers, including those made by a community spouse after the month in which
the institutionalized spouse is determined eligible for medical assistance. For purposes of
determining eligibility for long-term care services, any transfer of such assets within 36
months before or any time after an institutionalized person requests medical assistance
payment of long-term care services, or 36 months before or any time after a medical
assistance recipient becomes an institutionalized person, for less than fair market value
may be considered. Any such transfer is presumed to have been made for the purpose
of establishing or maintaining medical assistance eligibility and the institutionalized
person is ineligible for long-term care services for the period of time determined under
subdivision 2, unless the institutionalized person furnishes convincing evidence to
establish that the transaction was exclusively for another purpose, or unless the transfer is
permitted under subdivision 3 or 4. In the case of payments from a trust or portions of a
trust that are considered transfers of assets under federal law, or in the case of any other
disposal of assets made on or after February 8, 2006, any transfers made within 60 months
before or any time after an institutionalized person requests medical assistance payment of
long-term care services and within 60 months before or any time after a medical assistance
recipient becomes an institutionalized person, may be considered.

(c) This section applies to transfers, for less than fair market value, of income
or assets, including assets that are considered income in the month received, such as
inheritances, court settlements, and retroactive benefit payments or income to which the
institutionalized person or the institutionalized person's spouse is entitled but does not
receive due to action by the institutionalized person, the institutionalized person's spouse,
or any person, court, or administrative body with legal authority to act in place of, on
behalf of, at the direction of, or upon the request of the institutionalized person or the
institutionalized person's spouse.

(d) This section applies to payments for care or personal services provided by a
relative, unless the compensation was stipulated in a notarized, written agreement which
was in existence when the service was performed, the care or services directly benefited
the person, and the payments made represented reasonable compensation for the care
or services provided. A notarized written agreement is not required if payment for the
services was made within 60 days after the service was provided.

(e) This section applies to the portion of any asset or interest that an institutionalized
person, an institutionalized person's spouse, or any person, court, or administrative body
with legal authority to act in place of, on behalf of, at the direction of, or upon the request
of the institutionalized person or the institutionalized person's spouse, transfers to any
annuity that exceeds the value of the benefit likely to be returned to the institutionalized
person or institutionalized person's spouse while alive, based on estimated life expectancy
as determined according to the current actuarial tables published by the Office of the
Chief Actuary of the Social Security Administration. The commissioner may adopt rules
reducing life expectancies based on the need for long-term care. This section applies to an
annuity purchased on or after March 1, 2002, that:

(1) is not purchased from an insurance company or financial institution that is
subject to licensing or regulation by the Minnesota Department of Commerce or a similar
regulatory agency of another state;

(2) does not pay out principal and interest in equal monthly installments; or

(3) does not begin payment at the earliest possible date after annuitization.

(f) Effective for transactions, including the purchase of an annuity, occurring on or
after February 8, 2006, by or on behalf of an institutionalized person who has applied for
or is receiving long-term care services or the institutionalized person's spouse shall be
treated as the disposal of an asset for less than fair market value unless the department is
named a preferred remainder beneficiary as described in section 256B.056, subdivision
11
. Any subsequent change to the designation of the department as a preferred remainder
beneficiary shall result in the annuity being treated as a disposal of assets for less than
fair market value. The amount of such transfer shall be the maximum amount the
institutionalized person or the institutionalized person's spouse could receive from the
annuity or similar financial instrument. Any change in the amount of the income or
principal being withdrawn from the annuity or other similar financial instrument at the
time of the most recent disclosure shall be deemed to be a transfer of assets for less than
fair market value unless the institutionalized person or the institutionalized person's spouse
demonstrates that the transaction was for fair market value. In the event a distribution
of income or principal has been improperly distributed or disbursed from an annuity or
other retirement planning instrument of an institutionalized person or the institutionalized
person's spouse, a cause of action exists against the individual receiving the improper
distribution for the cost of medical assistance services provided or the amount of the
improper distribution, whichever is less.

(g) Effective for transactions, including the purchase of an annuity, occurring on
or after February 8, 2006, by or on behalf of an institutionalized person applying for or
receiving long-term care services shall be treated as a disposal of assets for less than fair
market value unless it is:

(i) an annuity described in subsection (b) or (q) of section 408 of the Internal
Revenue Code of 1986; or

(ii) purchased with proceeds from:

(A) an account or trust described in subsection (a), (c), or (p) of section 408 of the
Internal Revenue Code;

(B) a simplified employee pension within the meaning of section 408(k) of the
Internal Revenue Code; or

(C) a Roth IRA described in section 408A of the Internal Revenue Code; or

(iii) an annuity that is irrevocable and nonassignable; is actuarially sound as
determined in accordance with actuarial publications of the Office of the Chief Actuary of
the Social Security Administration; and provides for payments in equal amounts during
the term of the annuity, with no deferral and no balloon payments made.

(h) For purposes of this section, long-term care services include services in a nursing
facility, services that are eligible for payment according to section 256B.0625, subdivision
2
, because they are provided in a swing bed, intermediate care facility for persons with
developmental disabilities, and home and community-based services provided pursuant
to sections 256B.0915, 256B.092, and 256B.49. For purposes of this subdivision and
subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient
in a nursing facility or in a swing bed, or intermediate care facility for persons with
developmental disabilities or who is receiving home and community-based services under
sections 256B.0915, 256B.092, and 256B.49.

(i) This section applies to funds used to purchase a promissory note, loan, or
mortgage unless the note, loan, or mortgage:

(1) has a repayment term that is actuarially sound;

(2) provides for payments to be made in equal amounts during the term of the loan,
with no deferral and no balloon payments made; and

(3) prohibits the cancellation of the balance upon the death of the lender.

In the case of a promissory note, loan, or mortgage that does not meet an exception
in clauses (1) to (3), the value of such note, loan, or mortgage shall be the outstanding
balance due as of the date of the institutionalized person's request for medical assistance
payment of long-term care services.

(j) This section applies to the purchase of a life estate interest in another person's
home unless the purchaser resides in the home for a period of at least one year after the
date of purchase.

new text begin (k) This section applies to transfers into a pooled trust that qualifies under United
States Code, title 42, section 1396p(d)(4)(C), by:
new text end

new text begin (1) a person age 65 or older or the person's spouse; or
new text end

new text begin (2) any person, court, or administrative body with legal authority to act in place
of, on behalf of, at the direction of, or upon the request of a person age 65 or older or
the person's spouse.
new text end

Sec. 16.

Minnesota Statutes 2008, section 256B.0595, subdivision 2, is amended to
read:


Subd. 2.

Period of ineligibilitynew text begin for long-term care servicesnew text end.

(a) For any
uncompensated transfer occurring on or before August 10, 1993, the number of months
of ineligibility for long-term care services shall be the lesser of 30 months, or the
uncompensated transfer amount divided by the average medical assistance rate for nursing
facility services in the state in effect on the date of application. The amount used to
calculate the average medical assistance payment rate shall be adjusted each July 1 to
reflect payment rates for the previous calendar year. The period of ineligibility begins
with the month in which the assets were transferred. If the transfer was not reported to
the local agency at the time of application, and the applicant received long-term care
services during what would have been the period of ineligibility if the transfer had been
reported, a cause of action exists against the transferee for the cost of long-term care
services provided during the period of ineligibility, or for the uncompensated amount of
the transfer, whichever is less. The uncompensated transfer amount is the fair market
value of the asset at the time it was given away, sold, or disposed of, less the amount of
compensation received.

(b) For uncompensated transfers made after August 10, 1993, the number of months
of ineligibility for long-term care services shall be the total uncompensated value of the
resources transferred divided by the average medical assistance rate for nursing facility
services in the state in effect on the date of application. The amount used to calculate
the average medical assistance payment rate shall be adjusted each July 1 to reflect
payment rates for the previous calendar year. The period of ineligibility begins with the
first day of the month after the month in which the assets were transferred except that
if one or more uncompensated transfers are made during a period of ineligibility, the
total assets transferred during the ineligibility period shall be combined and a penalty
period calculated to begin on the first day of the month after the month in which the first
uncompensated transfer was made. If the transfer was reported to the local agency after
the date that advance notice of a period of ineligibility that affects the next month could
be provided to the recipient and the recipient received medical assistance services or the
transfer was not reported to the local agency, and the applicant or recipient received
medical assistance services during what would have been the period of ineligibility if
the transfer had been reported, a cause of action exists against the transferee for that
portion of long-term care services provided during the period of ineligibility, or for the
uncompensated amount of the transfer, whichever is less. The uncompensated transfer
amount is the fair market value of the asset at the time it was given away, sold, or disposed
of, less the amount of compensation received. Effective for transfers made on or after
March 1, 1996, involving persons who apply for medical assistance on or after April 13,
1996, no cause of action exists for a transfer unless:

(1) the transferee knew or should have known that the transfer was being made by a
person who was a resident of a long-term care facility or was receiving that level of care in
the community at the time of the transfer;

(2) the transferee knew or should have known that the transfer was being made to
assist the person to qualify for or retain medical assistance eligibility; or

(3) the transferee actively solicited the transfer with intent to assist the person to
qualify for or retain eligibility for medical assistance.

(c) For uncompensated transfers made on or after February 8, 2006, the period
of ineligibility:

(1) for uncompensated transfers by or on behalf of individuals receiving medical
assistance payment of long-term care services, begins the first day of the month following
advance notice of the deleted text beginpenaltydeleted text end periodnew text begin of ineligibilitynew text end, but no later than the first day of the
month that follows three full calendar months from the date of the report or discovery
of the transfer; or

(2) for uncompensated transfers by individuals requesting medical assistance
payment of long-term care services, begins the date on which the individual is eligible
for medical assistance under the Medicaid state plan and would otherwise be receiving
long-term care services based on an approved application for such care but for the
deleted text begin application of the penaltydeleted text end periodnew text begin of ineligibility resulting from the uncompensated
transfer
new text end; and

(3) cannot begin during any other period of ineligibility.

(d) If a calculation of a deleted text beginpenaltydeleted text end period new text beginof ineligibility new text endresults in a partial month,
payments for long-term care services shall be reduced in an amount equal to the fraction.

(e) In the case of multiple fractional transfers of assets in more than one month for
less than fair market value on or after February 8, 2006, the period of ineligibility is
calculated by treating the total, cumulative, uncompensated value of all assets transferred
during all months on or after February 8, 2006, as one transfer.

new text begin (f) A period of ineligibility established under paragraph (c) may be eliminated if
all of the assets transferred for less than fair market value used to calculate the period of
ineligibility, or cash equal to the value of the assets at the time of the transfer, are returned
within 12 months after the date the period of ineligibility begins. A period of ineligibility
must not be adjusted if less than the full amounts of the transferred assets or the full cash
values of the transferred assets are returned.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for periods of ineligibility established
on or after July 1, 2009.
new text end

Sec. 17.

Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:


new text begin Subd. 3g. new text end

new text begin Chiropractic services. new text end

new text begin Chiropractic services are not covered.
new text end

Sec. 18.

Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:


new text begin Subd. 3h. new text end

new text begin Podiatric services. new text end

new text begin Podiatric services are not covered.
new text end

Sec. 19.

Minnesota Statutes 2008, section 256B.0625, subdivision 8, is amended to
read:


Subd. 8.

Physical therapy.

Medical assistance covers physical therapy and related
services, including specialized maintenance therapynew text begin for eligible recipients under 21 years
of age
new text end. Services provided by a physical therapy assistant shall be reimbursed at the same
rate as services performed by a physical therapist when the services of the physical
therapy assistant are provided under the direction of a physical therapist who is on the
premises. Services provided by a physical therapy assistant that are provided under the
direction of a physical therapist who is not on the premises shall be reimbursed at 65
percent of the physical therapist rate.

Sec. 20.

Minnesota Statutes 2008, section 256B.0625, subdivision 8a, is amended to
read:


Subd. 8a.

Occupational therapy.

Medical assistance covers occupational therapy
and related services, including specialized maintenance therapynew text begin for eligible recipients
under 21 years of age
new text end. Services provided by an occupational therapy assistant shall be
reimbursed at the same rate as services performed by an occupational therapist when the
services of the occupational therapy assistant are provided under the direction of the
occupational therapist who is on the premises. Services provided by an occupational
therapy assistant that are provided under the direction of an occupational therapist who is
not on the premises shall be reimbursed at 65 percent of the occupational therapist rate.

Sec. 21.

Minnesota Statutes 2008, section 256B.0625, subdivision 8b, is amended to
read:


Subd. 8b.

Speech language pathology and audiology services.

Medical assistance
covers speech language pathology and related services, including specialized maintenance
therapynew text begin for eligible recipients under 21 years of agenew text end. Medical assistance covers audiology
services and related services. Services provided by a person who has been issued a
temporary registration under section 148.5161 shall be reimbursed at the same rate
as services performed by a speech language pathologist or audiologist as long as the
requirements of section 148.5161, subdivision 3, are met.

Sec. 22.

Minnesota Statutes 2008, section 256B.0625, subdivision 9, is amended to
read:


Subd. 9.

Dental services.

Medical assistance covers dental servicesnew text begin for children
under 21 years of age and pregnant women
new text end. Dental services include, with prior
authorization, fixed bridges that are cost-effective for persons who cannot use removable
dentures because of their medical condition.

Sec. 23.

Minnesota Statutes 2008, section 256B.0625, subdivision 13e, is amended to
read:


Subd. 13e.

Payment rates.

(a) The basis for determining the amount of payment
shall be the lower of the actual acquisition costs of the drugs plus a fixed dispensing fee;
the maximum allowable cost set by the federal government or by the commissioner plus
the fixed dispensing fee; or the usual and customary price charged to the public. The
amount of payment basis must be reduced to reflect all discount amounts applied to the
charge by any provider/insurer agreement or contract for submitted charges to medical
assistance programs. The net submitted charge may not be greater than the patient liability
for the service. The pharmacy dispensing fee shall be $3.65, except that the dispensing fee
for intravenous solutions which must be compounded by the pharmacist shall be $8 per
bag, $14 per bag for cancer chemotherapy products, and $30 per bag for total parenteral
nutritional products dispensed in one liter quantities, or $44 per bag for total parenteral
nutritional products dispensed in quantities greater than one liter. Actual acquisition
cost includes quantity and other special discounts except time and cash discounts.
Effective July 1, 2008, the actual acquisition cost of a drug shall be estimated by the
commissioner, at average wholesale price minus deleted text begin14deleted text end new text begin15 new text endpercent. The actual acquisition
cost of antihemophilic factor drugs shall be estimated at the average wholesale price
minus 30 percent. The maximum allowable cost of a multisource drug may be set by the
commissioner and it shall be comparable to, but no higher than, the maximum amount
paid by other third-party payors in this state who have maximum allowable cost programs.
Establishment of the amount of payment for drugs shall not be subject to the requirements
of the Administrative Procedure Act.

(b) An additional dispensing fee of $.30 may be added to the dispensing fee paid
to pharmacists for legend drug prescriptions dispensed to residents of long-term care
facilities when a unit dose blister card system, approved by the department, is used. Under
this type of dispensing system, the pharmacist must dispense a 30-day supply of drug.
The National Drug Code (NDC) from the drug container used to fill the blister card must
be identified on the claim to the department. The unit dose blister card containing the
drug must meet the packaging standards set forth in Minnesota Rules, part 6800.2700,
that govern the return of unused drugs to the pharmacy for reuse. The pharmacy provider
will be required to credit the department for the actual acquisition cost of all unused
drugs that are eligible for reuse. Over-the-counter medications must be dispensed in the
manufacturer's unopened package. The commissioner may permit the drug clozapine to be
dispensed in a quantity that is less than a 30-day supply.

(c) Whenever a generically equivalent product is available, payment shall be on the
basis of the actual acquisition cost of the generic drug, or on the maximum allowable cost
established by the commissioner.

(d) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider or the amount established for Medicare by the United States Department of
Health and Human Services pursuant to title XVIII, section 1847a of the federal Social
Security Act.

(e) The commissioner may negotiate lower reimbursement rates for specialty
pharmacy products than the rates specified in paragraph (a). The commissioner may
require individuals enrolled in the health care programs administered by the department
to obtain specialty pharmacy products from providers with whom the commissioner has
negotiated lower reimbursement rates. Specialty pharmacy products are defined as those
used by a small number of recipients or recipients with complex and chronic diseases
that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis
C, growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms
of cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, high-cost therapies, and therapies that require complex care. The
commissioner shall consult with the formulary committee to develop a list of specialty
pharmacy products subject to this paragraph. In consulting with the formulary committee
in developing this list, the commissioner shall take into consideration the population
served by specialty pharmacy products, the current delivery system and standard of care in
the state, and access to care issues. The commissioner shall have the discretion to adjust
the reimbursement rate to prevent access to care issues.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from July 1, 2008.
new text end

Sec. 24.

Minnesota Statutes 2008, section 256B.0625, subdivision 17, is amended to
read:


Subd. 17.

Transportation costs.

(a) Medical assistance covers transportation costs
incurred solely for obtaining emergency medical care or transportation costs incurred
by eligible persons in obtaining emergency or nonemergency medical care when paid
directly to an ambulance company, common carrier, or other recognized providers of
transportation services.

(b) Medical assistance covers special transportation, as defined in Minnesota Rules,
part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
transportation, or private automobile.

The commissioner may use an order by the recipient's attending physician to certify that
the recipient requires special transportation services. Special transportation includes
driver-assisted service to eligible individuals. Driver-assisted service includes passenger
pickup at and return to the individual's residence or place of business, assistance with
admittance of the individual to the medical facility, and assistance in passenger securement
or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers
must obtain written documentation from the health care service provider who is serving
the recipient being transported, identifying the time that the recipient arrived. Special
transportation providers may not bill for separate base rates for the continuation of a trip
beyond the original destination. Special transportation providers must take recipients to
the nearest appropriate health care provider, using the most direct route available. The
maximum medical assistance reimbursement rates for special transportation services are:

(1) $17 for the base rate and deleted text begin$1.35deleted text end new text begin$1.95 new text endper mile for services to eligible persons
who need a wheelchair-accessible van;

(2) deleted text begin$11.50deleted text end new text begin$8.50 new text endfor the base rate and $1.30 per mile for services to eligible persons
who do not need a wheelchair-accessible van; and

(3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
services to eligible persons who need a stretcher-accessible vehicle.

Sec. 25.

Minnesota Statutes 2008, section 256B.0625, subdivision 26, is amended to
read:


Subd. 26.

Special education services.

(a) Medical assistance covers medical
services identified in a recipient's individualized education plan and covered under the
medical assistance state plan. Covered services include occupational therapy, physical
therapy, speech-language therapy, clinical psychological services, nursing services,
school psychological services, school social work services, personal care assistants
serving as management aides, assistive technology devices, transportation services,
health assessments, and other services covered under the medical assistance state plan.
Mental health services eligible for medical assistance reimbursement must be provided or
coordinated through a children's mental health collaborative where a collaborative exists if
the child is included in the collaborative operational target population. The provision or
coordination of services does not require that the individual education plan be developed
by the collaborative.

The services may be provided by a Minnesota school district that is enrolled as a
medical assistance provider or its subcontractor, and only if the services meet all the
requirements otherwise applicable if the service had been provided by a provider other
than a school district, in the following areas: medical necessity, physician's orders,
documentation, personnel qualifications, and prior authorization requirements. The
nonfederal share of costs for services provided under this subdivision is the responsibility
of the local school district as provided in section 125A.74. Services listed in a child's
individual education plan are eligible for medical assistance reimbursement only if those
services meet criteria for federal financial participation under the Medicaid program.

(b) Approval of health-related services for inclusion in the individual education plan
does not require prior authorization for purposes of reimbursement under this chapter.
The commissioner may require physician review and approval of the plan not more than
once annually or upon any modification of the individual education plan that reflects a
change in health-related services.

(c) Services of a speech-language pathologist provided under this section are covered
notwithstanding Minnesota Rules, part 9505.0390, subpart 1, item L, if the person:

(1) holds a masters degree in speech-language pathology;

(2) is licensed by the Minnesota Board of Teaching as an educational
speech-language pathologist; and

(3) either has a certificate of clinical competence from the American Speech and
Hearing Association, has completed the equivalent educational requirements and work
experience necessary for the certificate or has completed the academic program and is
acquiring supervised work experience to qualify for the certificate.

(d) Medical assistance coverage for medically necessary services provided under
other subdivisions in this section may not be denied solely on the basis that the same or
similar services are covered under this subdivision.

(e) The commissioner shall develop and implement package rates, bundled rates, or
per diem rates for special education services under which separately covered services are
grouped together and billed as a unit in order to reduce administrative complexity.

(f) The commissioner shall develop a cost-based payment structure for payment
of these services.new text begin The commissioner shall reimburse claims submitted based on an
interim rate, and shall settle at a final rate once the department has determined it. The
commissioner shall notify the school district of the final rate. The school district has 60
days to appeal the final rate. To appeal the final rate, the school district shall file a written
appeal request to the commissioner within 60 days of the date the final rate determination
was mailed. The appeal request shall specify (1) the disputed items and (2) the name and
address of the person to contact regarding the appeal.
new text end

(g) Effective July 1, 2000, medical assistance services provided under an individual
education plan or an individual family service plan by local school districts shall not count
against medical assistance authorization thresholds for that child.

(h) Nursing services as defined in section 148.171, subdivision 15, and provided
as an individual education plan health-related service, are eligible for medical assistance
payment if they are otherwise a covered service under the medical assistance program.
Medical assistance covers the administration of prescription medications by a licensed
nurse who is employed by or under contract with a school district when the administration
of medications is identified in the child's individualized education plan. The simple
administration of medications alone is not covered under medical assistance when
administered by a provider other than a school district or when it is not identified in the
child's individualized education plan.

Sec. 26.

Minnesota Statutes 2008, section 256B.15, subdivision 1a, is amended to read:


Subd. 1a.

Estates subject to claims.

new text begin(a) new text endIf a person receives any medical assistance
hereunder, on the person's death, if single, or on the death of the survivor of a married
couple, either or both of whom received medical assistance, or as otherwise provided
for in this section, the total amount paid for medical assistance rendered for the person
and spouse shall be filed as a claim against the estate of the person or the estate of the
surviving spouse in the court having jurisdiction to probate the estate or to issue a decree
of descent according to sections 525.31 to 525.313.

new text begin (b) For the purposes of this section, the person's estate must consist of:
new text end

new text begin (1) the person's probate estate;
new text end

new text begin (2) all of the person's interests or proceeds of those interests in real property the
person owned as a life tenant or as a joint tenant with a right of survivorship at the time of
the person's death;
new text end

new text begin (3) all of the person's interests or proceeds of those interests in securities the person
owned in beneficiary form as provided under sections 524.6-301 to 524.6-311 at the time
of the person's death, to the extent the interests or proceeds of those interests become part
of the probate estate under section 524.6-307;
new text end

new text begin (4) all of the person's interests in joint accounts, multiple-party accounts, and
pay-on-death accounts, brokerage accounts, investment accounts, or the proceeds of
those accounts, as provided under sections 524.6-201 to 524.6-214 at the time of the
person's death to the extent the interests become part of the probate estate under section
524.6-207; and
new text end

new text begin (5) assets conveyed to a survivor, heir, or assign of the person through survivorship,
living trust, or other arrangements.
new text end

new text begin (c) For the purpose of this section and recovery in a surviving spouse's estate for
medical assistance paid for a predeceased spouse, the estate must consist of all of the legal
title and interests the deceased individual's predeceased spouse had in jointly owned or
marital property at the time of the spouse's death, as defined in subdivision 2b, and the
proceeds of those interests, that passed to the deceased individual or another individual, a
survivor, an heir, or an assign of the predeceased spouse through a joint tenancy, tenancy
in common, survivorship, life estate, living trust, or other arrangement. A deceased
recipient who, at death, owned the property jointly with the surviving spouse shall have
an interest in the entire property.
new text end

new text begin (d) For the purpose of recovery in a single person's estate or the estate of a survivor
of a married couple, "other arrangement" includes any other means by which title to all or
any part of the jointly owned or marital property or interest passed from the predeceased
spouse to another including, but not limited to, transfers between spouses which are
permitted, prohibited, or penalized for purposes of medical assistance.
new text end

new text begin (e) new text endA claim shall be filed if medical assistance was rendered for either or both
persons under one of the following circumstances:

deleted text begin (a)deleted text endnew text begin (1)new text end the person was over 55 years of age, and received services under this chapter;

deleted text begin (b)deleted text endnew text begin (2)new text end the person resided in a medical institution for six months or longer, received
services under this chapter, and, at the time of institutionalization or application for
medical assistance, whichever is later, the person could not have reasonably been expected
to be discharged and returned home, as certified in writing by the person's treating
physician. For purposes of this section only, a "medical institution" means a skilled
nursing facility, intermediate care facility, intermediate care facility for persons with
developmental disabilities, nursing facility, or inpatient hospital; or

deleted text begin (c)deleted text endnew text begin (3)new text end the person received general assistance medical care services under chapter
256D.

new text begin (f) new text endThe claim shall be considered an expense of the last illness of the decedent for the
purpose of section 524.3-805.new text begin Notwithstanding any law or rule to the contrary, a state or
county agency with a claim under this section must be a creditor under section 524.6-307.
new text end
Any statute of limitations that purports to limit any county agency or the state agency,
or both, to recover for medical assistance granted hereunder shall not apply to any claim
made hereunder for reimbursement for any medical assistance granted hereunder. Notice
of the claim shall be given to all heirs and devisees of the decedent whose identity can be
ascertained with reasonable diligence. The notice must include procedures and instructions
for making an application for a hardship waiver under subdivision 5; time frames for
submitting an application and determination; and information regarding appeal rights and
procedures. Counties are entitled to one-half of the nonfederal share of medical assistance
collections from estates that are directly attributable to county effort. Counties are entitled
to ten percent of the collections for alternative care directly attributable to county effort.

Sec. 27.

Minnesota Statutes 2008, section 256B.15, subdivision 1h, is amended to read:


Subd. 1h.

Estates of specific persons receiving medical assistance.

(a) For
purposes of this section, paragraphs (b) to deleted text begin(k)deleted text endnew text begin (j)new text end apply if a person received medical
assistance for which a claim may be filed under this section and died single, or the
surviving spouse of the couple and was not survived by any of the persons described
in subdivisions 3 and 4.

deleted text begin (b) For purposes of this section, the person's estate consists of: (1) the person's
probate estate; (2) all of the person's interests or proceeds of those interests in real property
the person owned as a life tenant or as a joint tenant with a right of survivorship at the
time of the person's death; (3) all of the person's interests or proceeds of those interests in
securities the person owned in beneficiary form as provided under sections 524.6-301 to
524.6-311 at the time of the person's death, to the extent they become part of the probate
estate under section 524.6-307; (4) all of the person's interests in joint accounts, multiple
party accounts, and pay on death accounts, or the proceeds of those accounts, as provided
under sections 524.6-201 to 524.6-214 at the time of the person's death to the extent
they become part of the probate estate under section 524.6-207; and (5) the person's
legal title or interest at the time of the person's death in real property transferred under
a transfer on death deed under section 507.071, or in the proceeds from the subsequent
sale of the person's interest in the real property. Notwithstanding any law or rule to the
contrary, a state or county agency with a claim under this section shall be a creditor under
section 524.6-307.
deleted text end

deleted text begin (c)deleted text endnew text begin (b)new text end Notwithstanding any law or rule to the contrary, the person's life estate or joint
tenancy interest in real property not subject to a medical assistance lien under sections
514.980 to 514.985 on the date of the person's death shall not end upon the person's death
and shall continue as provided in this subdivision. The life estate in the person's estate
shall be that portion of the interest in the real property subject to the life estate that is equal
to the life estate percentage factor for the life estate as listed in the Life Estate Mortality
Table of the health care program's manual for a person who was the age of the medical
assistance recipient on the date of the person's death. The joint tenancy interest in real
property in the estate shall be equal to the fractional interest the person would have owned
in the jointly held interest in the property had they and the other owners held title to the
property as tenants in common on the date the person died.

deleted text begin (d)deleted text endnew text begin (c)new text end The court upon its own motion, or upon motion by the personal representative
or any interested party, may enter an order directing the remaindermen or surviving joint
tenants and their spouses, if any, to sign all documents, take all actions, and otherwise
fully cooperate with the personal representative and the court to liquidate the decedent's
life estate or joint tenancy interests in the estate and deliver the cash or the proceeds of
those interests to the personal representative and provide for any legal and equitable
sanctions as the court deems appropriate to enforce and carry out the order, including an
award of reasonable attorney fees.

deleted text begin (e)deleted text endnew text begin (d)new text end The personal representative may make, execute, and deliver any conveyances
or other documents necessary to convey the decedent's life estate or joint tenancy interest
in the estate that are necessary to liquidate and reduce to cash the decedent's interest or
for any other purposes.

deleted text begin (f)deleted text endnew text begin (e)new text end Subject to administration, all costs, including reasonable attorney fees,
directly and immediately related to liquidating the decedent's life estate or joint tenancy
interest in the decedent's estate, shall be paid from the gross proceeds of the liquidation
allocable to the decedent's interest and the net proceeds shall be turned over to the personal
representative and applied to payment of the claim presented under this section.

deleted text begin (g)deleted text endnew text begin (f)new text end The personal representative shall bring a motion in the district court in which
the estate is being probated to compel the remaindermen or surviving joint tenants to
account for and deliver to the personal representative all or any part of the proceeds of any
sale, mortgage, transfer, conveyance, or any disposition of real property allocable to the
decedent's life estate or joint tenancy interest in the decedent's estate, and do everything
necessary to liquidate and reduce to cash the decedent's interest and turn the proceeds of
the sale or other disposition over to the personal representative. The court may grant any
legal or equitable relief including, but not limited to, ordering a partition of real estate
under chapter 558 necessary to make the value of the decedent's life estate or joint tenancy
interest available to the estate for payment of a claim under this section.

deleted text begin (h)deleted text endnew text begin (g)new text end Subject to administration, the personal representative shall use all of the cash
or proceeds of interests to pay an allowable claim under this section. The remaindermen
or surviving joint tenants and their spouses, if any, may enter into a written agreement
with the personal representative or the claimant to settle and satisfy obligations imposed at
any time before or after a claim is filed.

deleted text begin (i)deleted text endnew text begin (h)new text end The personal representative may, at their discretion, provide any or all of the
other owners, remaindermen, or surviving joint tenants with an affidavit terminating the
decedent's estate's interest in real property the decedent owned as a life tenant or as a joint
tenant with others, if the personal representative determines in good faith that neither the
decedent nor any of the decedent's predeceased spouses received any medical assistance
for which a claim could be filed under this section, or if the personal representative has
filed an affidavit with the court that the estate has other assets sufficient to pay a claim, as
presented, or if there is a written agreement under paragraph deleted text begin(h)deleted text endnew text begin (g)new text end, or if the claim, as
allowed, has been paid in full or to the full extent of the assets the estate has available
to pay it. The affidavit may be recorded in the office of the county recorder or filed in
the Office of the Registrar of Titles for the county in which the real property is located.
Except as provided in section 514.981, subdivision 6, when recorded or filed, the affidavit
shall terminate the decedent's interest in real estate the decedent owned as a life tenant or a
joint tenant with others. The affidavit shall:

(1) be signed by the personal representative;

(2) identify the decedent and the interest being terminated;

(3) give recording information sufficient to identify the instrument that created the
interest in real property being terminated;

(4) legally describe the affected real property;

(5) state that the personal representative has determined that neither the decedent
nor any of the decedent's predeceased spouses received any medical assistance for which
a claim could be filed under this section;

(6) state that the decedent's estate has other assets sufficient to pay the claim, as
presented, or that there is a written agreement between the personal representative and
the claimant and the other owners or remaindermen or other joint tenants to satisfy the
obligations imposed under this subdivision; and

(7) state that the affidavit is being given to terminate the estate's interest under this
subdivision, and any other contents as may be appropriate.

The recorder or registrar of titles shall accept the affidavit for recording or filing. The
affidavit shall be effective as provided in this section and shall constitute notice even if it
does not include recording information sufficient to identify the instrument creating the
interest it terminates. The affidavit shall be conclusive evidence of the stated facts.

deleted text begin (j)deleted text endnew text begin (i)new text end The holder of a lien arising under subdivision 1c shall release the lien at
the holder's expense against an interest terminated under paragraph deleted text begin(h)deleted text endnew text begin (g)new text end to the extent
of the termination.

deleted text begin (k)deleted text endnew text begin (j)new text end If a lien arising under subdivision 1c is not released under paragraph deleted text begin(j)deleted text endnew text begin (i)new text end,
prior to closing the estate, the personal representative shall deed the interest subject to the
lien to the remaindermen or surviving joint tenants as their interests may appear. Upon
recording or filing, the deed shall work a merger of the recipient's life estate or joint
tenancy interest, subject to the lien, into the remainder interest or interest the decedent and
others owned jointly. The lien shall attach to and run with the property to the extent of
the decedent's interest at the time of the decedent's death.

Sec. 28.

Minnesota Statutes 2008, section 256B.15, subdivision 2, is amended to read:


Subd. 2.

Limitations on claims.

The claim shall include only the total amount
of medical assistance rendered after age 55 or during a period of institutionalization
described in subdivision 1a, deleted text beginclause (b)deleted text endnew text begin paragraph (e)new text end, and the total amount of general
assistance medical care rendered, and shall not include interest. Claims that have been
allowed but not paid shall bear interest according to section 524.3-806, paragraph (d). A
claim against the estate of a surviving spouse who did not receive medical assistance, for
medical assistance rendered for the predeceased spouse,new text begin shall be payable from the full
value of all of the predeceased spouse's assets and interests which are part of the surviving
spouse's estate under subdivisions 1a and 2b. Recovery of medical assistance expenses in
the nonrecipient surviving spouse's estate
new text end is limited to the value of the assets of the estate
that were marital property or jointly owned property at any time during the marriage.new text begin The
claim is not payable from the value of assets or proceeds of assets in the estate attributable
to a predeceased spouse whom the individual married after the death of the predeceased
recipient spouse for whom the claim is filed or from assets and the proceeds of assets in the
estate which the nonrecipient decedent spouse acquired with assets which were not marital
property or jointly owned property after the death of the predeceased recipient spouse.
new text end
Claims for alternative care shall be net of all premiums paid under section 256B.0913,
subdivision 12
, on or after July 1, 2003, and shall be limited to services provided on or
after July 1, 2003. new text beginClaims against marital property shall be limited to claims against
recipients who died on or after July 1, 2009.
new text end

Sec. 29.

Minnesota Statutes 2008, section 256B.15, is amended by adding a
subdivision to read:


new text begin Subd. 2b. new text end

new text begin Controlling provisions. new text end

new text begin (a) For purposes of this subdivision and
subdivisions 1a and 2, paragraphs (b) to (d) apply.
new text end

new text begin (b) At the time of death of a recipient spouse and solely for purpose of recovery of
medical assistance benefits received, a predeceased recipient spouse shall have a legal
title or interest in the undivided whole of all of the property which the recipient and the
recipient's surviving spouse owned jointly or which was marital property at any time
during their marriage regardless of the form of ownership and regardless of whether
it was owned or titled in the names of one or both the recipient and the recipient's
spouse. Title and interest in the property of a predeceased recipient spouse shall not end
or extinguish upon the person's death and shall continue for the purpose of allowing
recovery of medical assistance in the estate of the surviving spouse. Upon the death of
the predeceased recipient spouse, title and interest in the predeceased spouse's property
shall vest in the surviving spouse by operation of law and without the necessity for any
probate or decree of descent proceedings and shall continue to exist after the death of the
predeceased spouse and the surviving spouse to permit recovery of medical assistance.
The recipient spouse and the surviving spouse of a deceased recipient spouse shall not
encumber, disclaim, transfer, alienate, hypothecate, or otherwise divest themselves of
these interests before or upon death.
new text end

new text begin (c) For purposes of this section, "marital property" includes any and all real or
personal property of any kind or interests in such property the predeceased recipient
spouse and their spouse, or either of them, owned at the time of their marriage to each
other or acquired during their marriage regardless of whether it was owned or titled in
the names of one or both of them. If either or both spouses of a married couple received
medical assistance, all property owned during the marriage or which either or both spouses
acquired during their marriage shall be presumed to be marital property for purposes of
recovering medical assistance unless there is clear and convincing evidence to the contrary.
new text end

new text begin (d) The agency responsible for the claim for medical assistance for a recipient spouse
may, at its discretion, release specific real and personal property from the provisions of
this section. The release shall extinguish the interest created under paragraph (b) in the
land it describes upon filing or recording. The release need not be attested, certified, or
acknowledged as a condition of filing or recording and shall be filed or recorded in the
office of the county recorder or registrar of titles, as appropriate, in the county where the
real property is located. The party to whom the release is given shall be responsible for
paying all fees and costs necessary to record and file the release. If the property described
in the release is registered property, the registrar of titles shall accept it for recording and
shall record it on the certificate of title for each parcel of property described in the release.
If the property described in the release is abstract property, the recorder shall accept it
for filing and file it in the county's grantor-grantee indexes and any tract index the county
maintains for each parcel of property described in the release.
new text end

Sec. 30.

Minnesota Statutes 2008, section 256B.15, is amended by adding a
subdivision to read:


new text begin Subd. 9. new text end

new text begin Commissioner's intervention. new text end

new text begin The commissioner shall be permitted to
intervene as a party in any proceeding involving recovery of medical assistance upon
filing a notice of intervention and serving such notice on the other parties.
new text end

Sec. 31.

Minnesota Statutes 2008, section 256B.199, is amended to read:


256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.

(a) Effective July 1, 2007, the commissioner shall apply for federal matching funds
for the expenditures in paragraphs (b) and (c).new text begin The funds in paragraphs (b) and (c) are
appropriated to the commissioner to offset medical assistance expenditures.
new text end

(b) The commissioner shall apply for federal matching funds for certified public
expenditures as follows:

(1) Hennepin Countydeleted text begin,deleted text end new text beginand new text endHennepin County Medical Centerdeleted text begin, Ramsey County,
Regions Hospital, the University of Minnesota, and Fairview-University Medical Center
deleted text end
shall report quarterly to the commissioner beginning June 1, 2007, payments made during
the second previous quarter that may qualify for reimbursement under federal law;

(2) based on these reports, the commissioner shall apply for federal matching
fundsdeleted text begin. These funds are appropriated to the commissioner for the payments under section
256.969, subdivision 27
deleted text end; and

(3) by May 1 of each year, beginning May 1, 2007, the commissioner shall inform
the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share
hospital payment money expected to be available in the current federal fiscal year.

(c) The commissioner shall apply for federal matching funds for general assistance
medical care expenditures as follows:

(1) for hospital services occurring on or after July 1, 2007, general assistance medical
care expenditures for fee-for-service inpatient and outpatient hospital payments made by
the department shall be used to apply for federal matching funds, except as limited below:

(i) only those general assistance medical care expenditures made to an individual
hospital that would not cause the hospital to exceed its individual hospital limits under
section 1923 of the Social Security Act may be considered; and

(ii) general assistance medical care expenditures may be considered only to the extent
of Minnesota's aggregate allotment under section 1923 of the Social Security Act; and

(2) all hospitals must provide any necessary expenditure, cost, and revenue
information required by the commissioner as necessary for purposes of obtaining federal
Medicaid matching funds for general assistance medical care expenditures.

Sec. 32.

Minnesota Statutes 2008, section 256B.69, subdivision 5a, is amended to read:


Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section
and sections 256L.12 and 256D.03, shall be entered into or renewed on a calendar year
basis beginning January 1, 1996. Managed care contracts which were in effect on June
30, 1995, and set to renew on July 1, 1995, shall be renewed for the period July 1, 1995
through December 31, 1995 at the same terms that were in effect on June 30, 1995. The
commissioner may issue separate contracts with requirements specific to services to
medical assistance recipients age 65 and older.

(b) A prepaid health plan providing covered health services for eligible persons
pursuant to chapters 256B, 256D, and 256L, is responsible for complying with the terms
of its contract with the commissioner. Requirements applicable to managed care programs
under chapters 256B, 256D, and 256L, established after the effective date of a contract
with the commissioner take effect when the contract is next issued or renewed.

(c) Effective for services rendered on or after January 1, 2003, the commissioner
shall withhold five percent of managed care plan payments under this section for the
prepaid medical assistance and general assistance medical care programs pending
completion of performance targets. Each performance target must be quantifiable,
objective, measurable, and reasonably attainable, except in the case of a performance
target based on a federal or state law or rule. Criteria for assessment of each performance
target must be outlined in writing prior to the contract effective date. The managed
care plan must demonstrate, to the commissioner's satisfaction, that the data submitted
regarding attainment of the performance target is accurate. The commissioner shall
periodically change the administrative measures used as performance targets in order
to improve plan performance across a broader range of administrative services. The
performance targets must include measurement of plan efforts to contain spending
on health care services and administrative activities. The commissioner may adopt
plan-specific performance targets that take into account factors affecting only one plan,
including characteristics of the plan's enrollee population. The withheld funds must be
returned no sooner than July of the following year if performance targets in the contract
are achieved. The commissioner may exclude special demonstration projects under
subdivision 23. A managed care plan or a county-based purchasing plan under section
256B.692 may include as admitted assets under section 62D.044 any amount withheld
under this paragraph that is reasonably expected to be returned.

(d)(1) Effective for services rendered on or after January 1, 2009, the commissioner
shall withhold three percent of managed care plan payments under this section for the
prepaid medical assistance and general assistance medical care programs. The withheld
funds must be returned no sooner than July 1 and no later than July 31 of the following
year. deleted text beginThe commissioner may exclude special demonstration projects under subdivision 23.
deleted text end

(2) A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under
this paragraph. The return of the withhold under this paragraph is not subject to the
requirements of paragraph (c).

Sec. 33.

Minnesota Statutes 2008, section 256B.69, subdivision 5c, is amended to read:


Subd. 5c.

Medical education and research fund.

(a) Except as provided in
paragraph (c), the commissioner of human services shall transfer each year to the medical
education and research fund established under section 62J.692, the following:

(1) an amount equal to the reduction in the prepaid medical assistance and prepaid
general assistance medical care payments as specified in this clause. Until January 1,
2002, the county medical assistance and general assistance medical care capitation base
rate prior to plan specific adjustments and after the regional rate adjustments under section
256B.69, subdivision 5b, is reduced 6.3 percent for Hennepin County, two percent for
the remaining metropolitan counties, and no reduction for nonmetropolitan Minnesota
counties; and after January 1, 2002, the county medical assistance and general assistance
medical care capitation base rate prior to plan specific adjustments is reduced 6.3 percent
for Hennepin County, two percent for the remaining metropolitan counties, and 1.6 percent
for nonmetropolitan Minnesota counties. Nursing facility and elderly waiver payments
and demonstration project payments operating under subdivision 23 are excluded from
this reduction. The amount calculated under this clause shall not be adjusted for periods
already paid due to subsequent changes to the capitation payments;

(2) beginning July 1, 2003, deleted text begin$2,157,000deleted text endnew text begin $4,314,000new text end from the capitation rates paid
under this section deleted text beginplus any federal matching funds on this amountdeleted text end;

(3) beginning July 1, 2002, an additional $12,700,000 from the capitation rates
paid under this section; and

(4) beginning July 1, 2003, an additional $4,700,000 from the capitation rates paid
under this section.

(b) This subdivision shall be effective upon approval of a federal waiver which
allows federal financial participation in the medical education and research fund.new text begin Effective
July 1, 2009, and thereafter, the transfers required by paragraph (a), clauses (1) to (4),
must not exceed the total amount transferred for fiscal year 2009. Any excess must first
reduce the amounts otherwise required to be transferred under paragraph (a), clauses (2) to
(4), and then proportionally reduce the transfers under paragraph (a), clause (1).
new text end

(c) Effective July 1, 2003, the amount reduced from the prepaid general assistance
medical care payments under paragraph (a), clause (1), shall be transferred to the general
fund.

new text begin (d) Beginning July 1, 2010, of the amounts in paragraph (a), the commissioner shall
transfer $21,714,000 each fiscal year to the medical education and research fund. The
balance of the transfers under paragraph (a) must be transferred to the medical education
and research fund no earlier than July 1 of the following fiscal year.
new text end

Sec. 34.

Minnesota Statutes 2008, section 256B.69, subdivision 5f, is amended to read:


Subd. 5f.

Capitation rates.

new text begin(a) new text endBeginning July 1, 2002, the capitation rates paid
under this section are increased by $12,700,000 per year. Beginning July 1, 2003, the
capitation rates paid under this section are increased by $4,700,000 per year.

new text begin (b) Beginning July 1, 2009, the capitation rates paid under this section are increased
each year by the lesser of $21,714,000 or an amount equal to the difference between the
estimated value of the reductions described in subdivision 5c, paragraph (a), clause (1),
and the amount of the limit described in subdivision 5c, paragraph (b).
new text end

Sec. 35.

new text begin [256B.695] PAYMENT FOR BASIC CARE SERVICES.
new text end

new text begin Effective service date July 1, 2009, total payments for basic care services,
except prescription drugs, medical supplies, prosthetics, lab, radiology, and medical
transportation, shall be reduced by 3.0 percent, prior to third-party liability and spenddown
calculation. Payments made to managed care plans shall be reduced for services provided
on or after January 1, 2010, to reflect this reduction.
new text end

Sec. 36.

Minnesota Statutes 2008, section 256D.03, subdivision 3, is amended to read:


Subd. 3.

General assistance medical care; eligibility.

(a) General assistance
medical care may be paid for any person who is not eligible for medical assistance
under chapter 256B, including eligibility for medical assistance based on a spenddown
of excess income according to section 256B.056, subdivision 5, deleted text beginor MinnesotaCare as
defined in paragraph (b), except as provided in paragraph (c),
deleted text end andnew text begin who satisfies one of the
requirements in clause (1) or clauses (2) and (3)
new text end:

(1) deleted text beginwho isdeleted text end new text beginthe person must be new text endreceiving assistance under section 256D.05, except
for families with children who are eligible under Minnesota family investment program
(MFIP), or who is having a payment made on the person's behalf under sections 256I.01
to 256I.06; deleted text beginordeleted text end

(2) deleted text beginwho isdeleted text end new text beginthe person must be new text enda resident of Minnesotadeleted text begin; anddeleted text endnew text begin:new text end

(i) who has gross countable income not in excess of 75 percent of the federal poverty
guidelines for the family size, using a six-month budget period and whose equity in assets
is not in excess of $1,000 per assistance unit. General assistance medical care is not
available for applicants or enrollees who are otherwise eligible for medical assistance but
fail to verify their assets. Enrollees who become eligible for medical assistance shall be
terminated and transferred to medical assistance. Exempt assets, the reduction of excess
assets, and the waiver of excess assets must conform to the medical assistance program in
section 256B.056, subdivisions 3 and 3d, with the following exception: the maximum
amount of undistributed funds in a trust that could be distributed to or on behalf of the
beneficiary by the trustee, assuming the full exercise of the trustee's discretion under the
terms of the trust, must be applied toward the asset maximum; new text beginor
new text end

(ii) who has gross countable income above 75 percent of the federal poverty
guidelines but not in excess of 175 percent of the federal poverty guidelines for the family
size, using a six-month budget period, whose equity in assets is not in excess of the limits
in section 256B.056, subdivision 3c, and who applies during an inpatient hospitalizationnew text begin
that occurs on or before January 1, 2010
new text end; or

deleted text begin (iii) the commissioner shall adjust the income standards under this section each July
1 by the annual update of the federal poverty guidelines following publication by the
United States Department of Health and Human Services.
deleted text end

deleted text begin (b) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may not be paid for applicants or recipients who are adults
with dependent children under 21 whose gross family income is equal to or less than 275
percent of the federal poverty guidelines who are not described in paragraph (e).
deleted text end

deleted text begin (c) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may be paid for applicants and recipients who meet all
eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
beginning the date of application. Immediately following approval of general assistance
medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
subdivision 7
, with covered services as provided in section 256L.03 for the rest of the
six-month general assistance medical care eligibility period, until their six-month renewal.
deleted text end

deleted text begin (d) To be eligible for general assistance medical care following enrollment in
MinnesotaCare as required by paragraph (c), an individual must complete a new
application.
deleted text end

deleted text begin (e) Applicants and recipients eligible under paragraph (a), clause (1), are exempt
from the MinnesotaCare enrollment requirements in this subdivision if they:
deleted text end

deleted text begin (1) have applied for and are awaiting a determination of blindness or disability by
the state medical review team or a determination of eligibility for Supplemental Security
Income or Social Security Disability Insurance by the Social Security Administration;
deleted text end

deleted text begin (2) fail to meet the requirements of section 256L.09, subdivision 2;
deleted text end

deleted text begin (3) are homeless as defined by United States Code, title 42, section 11301, et seq.;
deleted text end

deleted text begin (4) are classified as end-stage renal disease beneficiaries in the Medicare program;
deleted text end

deleted text begin (5) are enrolled in private health care coverage as defined in section 256B.02,
subdivision 9;
deleted text end

deleted text begin (6) are eligible under paragraph (j);
deleted text end

deleted text begin (7) receive treatment funded pursuant to section 254B.02; or
deleted text end

deleted text begin (8) reside in the Minnesota sex offender program defined in chapter 246B.
deleted text end

new text begin (3) the person must meet at least one of the following criteria:
new text end

new text begin (i) the person has applied for and is awaiting a determination of blindness
or disability by the state medical review team or a determination of eligibility for
Supplemental Security Income or Social Security Disability Insurance by the Social
Security Administration;
new text end

new text begin (ii) the person is homeless as defined by United States Code, title 42, section 11301,
et seq.;
new text end

new text begin (iii) the person is classified as an end-stage renal disease beneficiary in the Medicare
program;
new text end

new text begin (iv) the person is enrolled in private health care coverage as defined in section
256B.02, subdivision 9;
new text end

new text begin (v) the person is:
new text end

new text begin (A) detained by law for less than one year in a county correctional or detention
facility as a person accused or convicted of a crime, or admitted as an inpatient to a
hospital on a criminal hold order;
new text end

new text begin (B) is a recipient of general assistance medical care at the time the person is detained
by law or admitted on a criminal hold order; and
new text end

new text begin (C) continues to meet other eligibility requirements of this subdivision;
new text end

new text begin (vi) the person receives treatment funded under section 254B.02; or
new text end

new text begin (vii) the person resides in the Minnesota sex offender program defined in chapter
246B.
new text end

deleted text begin (f)deleted text end new text begin(b) new text endFor applications received on or after October 1, 2003, eligibility may begin no
earlier than the date of application. For individuals eligible under paragraph (a), clause
(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization deleted text beginbut
may reapply if there is a subsequent period of inpatient hospitalization
deleted text endnew text begin that occurs on or
before January 1, 2010
new text end.

deleted text begin (g) Beginning September 1, 2006, Minnesota health care program applications and
renewals completed by recipients and applicants who are persons described in paragraph
(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility
by the county agency. If all other eligibility requirements of this subdivision are met,
eligibility for general assistance medical care shall be available in any month during which
MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare,
notice of termination for eligibility for general assistance medical care shall be sent to
an applicant or recipient. If all other eligibility requirements of this subdivision are
met, eligibility for general assistance medical care shall be available until enrollment in
MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).
deleted text end

deleted text begin (h)deleted text end new text begin(c) new text endThe date of an initial Minnesota health care program application necessary to
begin a determination of eligibility shall be the date the applicant has provided a name,
address, and Social Security number, signed and dated, to the county agency or the
Department of Human Services. If the applicant is unable to provide a name, address,
Social Security number, and signature when health care is delivered due to a medical
condition or disability, a health care provider may act on an applicant's behalf to establish
the date of an initial Minnesota health care program application by providing the county
agency or Department of Human Services with provider identification and a temporary
unique identifier for the applicant. The applicant must complete the remainder of the
application and provide necessary verification before eligibility can be determined. The
county agency must assist the applicant in obtaining verification if necessary.

deleted text begin (i)deleted text end new text begin(d) new text endCounty agencies are authorized to use all automated databases containing
information regarding recipients' or applicants' income in order to determine eligibility for
general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
in order to determine eligibility and premium payments by the county agency.

deleted text begin (j) General assistance medical care is not available for a person in a correctional
facility unless the person is detained by law for less than one year in a county correctional
or detention facility as a person accused or convicted of a crime, or admitted as an
inpatient to a hospital on a criminal hold order, and the person is a recipient of general
assistance medical care at the time the person is detained by law or admitted on a criminal
hold order and as long as the person continues to meet other eligibility requirements
of this subdivision.
deleted text end

deleted text begin (k)deleted text end new text begin(e) new text endGeneral assistance medical care is not available for applicants or recipients
who do not cooperate with the county agency to meet the requirements of medical
assistance.

deleted text begin (l)deleted text end new text begin(f) new text endIn determining the amount of assets of an individual eligible under paragraph
(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
an asset excluded under paragraph (a), that was given away, sold, or disposed of for
less than fair market value within the 60 months preceding application for general
assistance medical care or during the period of eligibility. Any transfer described in this
paragraph shall be presumed to have been for the purpose of establishing eligibility for
general assistance medical care, unless the individual furnishes convincing evidence to
establish that the transaction was exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair market value at the time it
was given away, sold, or disposed of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility, including partial months,
shall be calculated by dividing the uncompensated transfer amount by the average monthly
per person payment made by the medical assistance program to skilled nursing facilities
for the previous calendar year. The individual shall remain ineligible until this fixed period
has expired. The period of ineligibility may exceed 30 months, and a reapplication for
benefits after 30 months from the date of the transfer shall not result in eligibility unless
and until the period of ineligibility has expired. The period of ineligibility begins in the
month the transfer was reported to the county agency, or if the transfer was not reported,
the month in which the county agency discovered the transfer, whichever comes first. For
applicants, the period of ineligibility begins on the date of the first approved application.

deleted text begin (m)deleted text end new text begin(g) new text endWhen determining eligibility for any state benefits under this subdivision,
the income and resources of all noncitizens shall be deemed to include their sponsor's
income and resources as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
subsequently set out in federal rules.

deleted text begin (n)deleted text end new text begin(h) new text endUndocumented noncitizens and nonimmigrants are ineligible for general
assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and
an undocumented noncitizen is an individual who resides in the United States without the
approval or acquiescence of the United States Citizenship and Immigration Services.

deleted text begin (o)deleted text end new text begin(i) new text endNotwithstanding any other provision of law, a noncitizen who is ineligible for
medical assistance due to the deeming of a sponsor's income and resources, is ineligible
for general assistance medical care.

deleted text begin (p)deleted text end new text begin(j) new text endEffective July 1, 2003, general assistance medical care emergency services
end.

new text begin (k) The commissioner shall adjust the income standards under this section each July
1 by the annual update of the federal poverty guidelines following publication by the
United States Department of Health and Human Services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2010.
new text end

Sec. 37.

Minnesota Statutes 2008, section 256D.03, subdivision 4, is amended to read:


Subd. 4.

General assistance medical care; services.

(a)(i) For a person who is
eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
care covers, except as provided in paragraph (c):

(1) inpatient hospital services;

(2) outpatient hospital services;

(3) services provided by Medicare certified rehabilitation agencies;

(4) prescription drugs and other products recommended through the process
established in section 256B.0625, subdivision 13;

(5) equipment necessary to administer insulin and diagnostic supplies and equipment
for diabetics to monitor blood sugar level;

(6) eyeglasses and eye examinations provided by a physician or optometrist;

(7) hearing aids;

(8) prosthetic devices;

(9) laboratory and X-ray services;

(10) physician's services;

(11) medical transportation except special transportation;

(12) chiropractic services as covered under the medical assistance program;

(13) podiatric services;

(14) dental services as covered under the medical assistance program;

(15) mental health services covered under chapter 256B;

(16) prescribed medications for persons who have been diagnosed as mentally ill as
necessary to prevent more restrictive institutionalization;

(17) medical supplies and equipment, and Medicare premiums, coinsurance and
deductible payments;

(18) medical equipment not specifically listed in this paragraph when the use of
the equipment will prevent the need for costlier services that are reimbursable under
this subdivision;

(19) services performed by a certified pediatric nurse practitioner, a certified family
nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
practitioner in independent practice, if (1) the service is otherwise covered under this
chapter as a physician service, (2) the service provided on an inpatient basis is not included
as part of the cost for inpatient services included in the operating payment rate, and (3) the
service is within the scope of practice of the nurse practitioner's license as a registered
nurse, as defined in section 148.171;

(20) services of a certified public health nurse or a registered nurse practicing in
a public health nursing clinic that is a department of, or that operates under the direct
authority of, a unit of government, if the service is within the scope of practice of the
public health nurse's license as a registered nurse, as defined in section 148.171;

(21) telemedicine consultations, to the extent they are covered under section
256B.0625, subdivision 3b;

(22) care coordination and patient education services provided by a community
health worker according to section 256B.0625, subdivision 49; and

(23) regardless of the number of employees that an enrolled health care provider
may have, sign language interpreter services when provided by an enrolled health care
provider during the course of providing a direct, person-to-person covered health care
service to an enrolled recipient who has a hearing loss and uses interpreting services.

(ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
to inpatient hospital services, including physician services provided during the inpatient
hospital stay. A $1,000 deductible is required for each inpatient hospitalization.

(b) Effective August 1, 2005, sex reassignment surgery is not covered under this
subdivision.

(c) In order to contain costs, the commissioner of human services shall select
vendors of medical care who can provide the most economical care consistent with high
medical standards and shall where possible contract with organizations on a prepaid
capitation basis to provide these services. The commissioner shall consider proposals by
counties and vendors for prepaid health plans, competitive bidding programs, block grants,
or other vendor payment mechanisms designed to provide services in an economical
manner or to control utilization, with safeguards to ensure that necessary services are
provided. Before implementing prepaid programs in counties with a county operated or
affiliated public teaching hospital or a hospital or clinic operated by the University of
Minnesota, the commissioner shall consider the risks the prepaid program creates for the
hospital and allow the county or hospital the opportunity to participate in the program in a
manner that reflects the risk of adverse selection and the nature of the patients served by
the hospital, provided the terms of participation in the program are competitive with the
terms of other participants considering the nature of the population served. Payment for
services provided pursuant to this subdivision shall be as provided to medical assistance
vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
payments made during fiscal year 1990 and later years, the commissioner shall consult
with an independent actuary in establishing prepayment rates, but shall retain final control
over the rate methodology.

(d) Effective January 1, 2008, drug coverage under general assistance medical
care is limited to prescription drugs that:

(i) are covered under the medical assistance program as described in section
256B.0625, subdivisions 13 and 13d; and

(ii) are provided by manufacturers that have fully executed general assistance
medical care rebate agreements with the commissioner and comply with the agreements.
Prescription drug coverage under general assistance medical care must conform to
coverage under the medical assistance program according to section 256B.0625,
subdivisions 13 to 13g.

(e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
co-payments for services provided on or after October 1, 2003, and before January 1, 2009:

(1) $25 for eyeglasses;

(2) $25 for nonemergency visits to a hospital-based emergency room;

(3) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $12 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness; and

(4) 50 percent coinsurance on restorative dental services.

(f) Recipients eligible under subdivision 3, paragraph (a), shall include the following
co-payments for services provided on or after January 1, 2009:

(1) $25 for nonemergency visits to a hospital-based emergency room; and

(2) $3 per brand-name drug prescription and $1 per generic drug prescription,
subject to a $7 per month maximum for prescription drug co-payments. No co-payments
shall apply to antipsychotic drugs when used for the treatment of mental illness.

(g) MS 2007 Supp [Expired]

(h) Effective January 1, 2009, co-payments shall be limited to one per day per
provider for nonemergency visits to a hospital-based emergency room. Recipients of
general assistance medical care are responsible for all co-payments in this subdivision.
The general assistance medical care reimbursement to the provider shall be reduced by the
amount of the co-payment, except that reimbursement for prescription drugs shall not be
reduced once a recipient has reached the $7 per month maximum for prescription drug
co-payments. The provider collects the co-payment from the recipient. Providers may not
deny services to recipients who are unable to pay the co-payment.

(i) General assistance medical care reimbursement to fee-for-service providers
and payments to managed care plans shall not be increased as a result of the removal of
the co-payments effective January 1, 2009.

(j) Any county may, from its own resources, provide medical payments for which
state payments are not made.

(k) Chemical dependency services that are reimbursed under chapter 254B must not
be reimbursed under general assistance medical care.

(l) The maximum payment for new vendors enrolled in the general assistance
medical care program after the base year shall be determined from the average usual and
customary charge of the same vendor type enrolled in the base year.

(m) The conditions of payment for services under this subdivision are the same
as the conditions specified in rules adopted under chapter 256B governing the medical
assistance program, unless otherwise provided by statute or rule.

(n) Inpatient and outpatient payments shall be reduced by five percent, effective July
1, 2003. This reduction is in addition to the five percent reduction effective July 1, 2003,
and incorporated by reference in paragraph (l).

(o) Payments for all other health services except inpatient, outpatient, and pharmacy
services shall be reduced by five percent, effective July 1, 2003.

(p) Payments to managed care plans shall be reduced by five percent for services
provided on or after October 1, 2003.

(q) A hospital receiving a reduced payment as a result of this section may apply the
unpaid balance toward satisfaction of the hospital's bad debts.

(r) Fee-for-service payments for nonpreventive visits shall be reduced by $3 for
services provided on or after January 1, 2006. For purposes of this subdivision, a visit
means an episode of service which is required because of a recipient's symptoms,
diagnosis, or established illness, and which is delivered in an ambulatory setting by
a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
audiologist, optician, or optometrist.

(s) Payments to managed care plans shall not be increased as a result of the removal
of the $3 nonpreventive visit co-payment effective January 1, 2006.

(t) Payments for mental health services added as covered benefits after December
31, 2007, are not subject to the reductions in paragraphs (l), (n), (o), and (p).

new text begin (u) In addition to the reductions in paragraphs (k) and (l), effective service date
July 1, 2009, total payments for basic care services, except prescription drugs, medical
supplies, prosthetics, lab, radiology, and medical transportation, shall be reduced by 3.0
percent, prior to third-party liability and spenddown calculation. Payments made to
managed care plans shall be reduced for services provided on or after January 1, 2010,
to reflect this reduction.
new text end

Sec. 38.

Minnesota Statutes 2008, section 256L.01, subdivision 1a, is amended to read:


Subd. 1a.

Child.

new text begin(a) new text end"Child" means an individual under 21 years of age, including
the unborn child of a pregnant woman, an emancipated minor, and an emancipated minor's
spouse.new text begin This paragraph expires July 1, 2010, or upon federal approval, whichever is later.
new text end

new text begin (b) Effective July 1, 2010, or upon federal approval, whichever is later, "child"
means an individual under 21 years of age, an emancipated minor, and an emancipated
minor's spouse.
new text end

Sec. 39.

Minnesota Statutes 2008, section 256L.01, subdivision 3a, is amended to read:


Subd. 3a.

Family with children.

(a) "Family with children" means:

(1) parents and their children residing in the same household; or

(2) grandparents, foster parents, relative caretakers as defined in the medical
assistance program, or legal guardians; and their wards who are children residing in the
same household.

(b) The term includes children who are temporarily absent from the household in
settings such as schools, camps, or parenting time with noncustodial parents.

new text begin (c) This subdivision expires July 1, 2010, or upon federal approval, whichever is
later.
new text end

Sec. 40.

Minnesota Statutes 2008, section 256L.01, is amended by adding a subdivision
to read:


new text begin Subd. 3b. new text end

new text begin Family premium. new text end

new text begin Effective July 1, 2011, or upon federal approval,
whichever is later, "family premium" means the premium determined according to section
256L.15, subdivision 2a or 2b, based on gross individual or gross family income.
new text end

Sec. 41.

Minnesota Statutes 2008, section 256L.01, subdivision 4, is amended to read:


Subd. 4.

Gross individual or gross family income.

(a) "Gross individual or gross
family income" for nonfarm self-employed means income calculated for the 12-month
period of eligibility using the net profit or loss reported on the applicant's federal income
tax form for the previous year and using the medical assistance families with children
methodology for determining allowable and nonallowable self-employment expenses
and countable income.new text begin This subdivision expires July 1, 2011, or upon federal approval,
whichever is later.
new text end

(b) "Gross individual or gross family income" for farm self-employed means income
calculated for the 12-month period of eligibility using as the baseline the adjusted gross
income reported on the applicant's federal income tax form for the previous year.new text begin This
subdivision expires July 1, 2011, or upon federal approval, whichever is later.
new text end

(c) "Gross individual or gross family income" means the total income for all family
members, calculated for the 12-month period of eligibility.new text begin This subdivision expires July
1, 2011, or upon federal approval, whichever is later.
new text end

new text begin (d) Beginning July 1, 2011, or upon federal approval, whichever is later, "gross
individual or gross family income" means the total income for all family members,
calculated for the six-month period of eligibility, for purposes of determining the premium
under section 256L.15.
new text end

Sec. 42.

Minnesota Statutes 2008, section 256L.01, subdivision 5, is amended to read:


Subd. 5.

Income.

(a) "Income" has the meaning given for earned and unearned
income for families and children in the medical assistance program, according to the state's
aid to families with dependent children plan in effect as of July 16, 1996. The definition
does not include medical assistance income methodologies and deeming requirements.
The earned income of full-time and part-time students under age 19 is not counted as
income. Public assistance payments and supplemental security income are not excluded
income.new text begin This paragraph expires July 1, 2011, or upon federal approval, whichever is later.
new text end

new text begin (b) Effective July 1, 2011, or upon federal approval, whichever is later, "income" has
the meaning given for earned and unearned income for families and children in the medical
assistance program, according to the methodologies for families with children in section
256B.056, subdivision 1a. The deductions in section 256B.056, subdivision 1c, paragraph
(a), clause (3), must apply to the income calculated to determine eligibility for children
age two through 18. The deductions in section 256B.056, subdivision 1c, paragraph (b),
must apply to the income calculated to determine eligibility for children ages 19 and 20.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end For purposes of this subdivision, and unless otherwise specified in this
section, the commissioner shall use reasonable methods to calculate gross earned and
unearned income including, but not limited to, projecting income based on income
received within the past 30 days, the last 90 days, or the last 12 months.

Sec. 43.

Minnesota Statutes 2008, section 256L.02, subdivision 1, is amended to read:


Subdivision 1.

Purpose.

new text begin(a) new text endThe MinnesotaCare program is established to promote
access to appropriate health care services to deleted text beginassuredeleted text endnew text begin ensurenew text end healthy children and adults.new text begin
This paragraph expires July 1, 2010, or upon federal approval, whichever is later.
new text end

new text begin (b) Effective July 1, 2010, or upon federal approval, whichever is later, the purpose
of the MinnesotaCare program is to promote access to appropriate health care services to
ensure healthy children.
new text end

Sec. 44.

Minnesota Statutes 2008, section 256L.02, subdivision 3, is amended to read:


Subd. 3.

Financial management.

(a) The commissioner shall manage spending for
the MinnesotaCare program in a manner that maintains a minimum reserve. As part of
each state revenue and expenditure forecast, the commissioner must make an assessment
of the expected expenditures for the covered services for the remainder of the current
biennium and for the following biennium. The estimated expenditure, including the
reserve, shall be compared to an estimate of the revenues that will be available in the health
care access fund. Based on this comparison, and after consulting with the chairs of the
house of representatives Ways and Means Committee and the senate Finance Committee,
and the Legislative Commission on Health Care Access, the commissioner shall, as
necessary, make the adjustments specified in paragraph (b) to ensure that expenditures
remain within the limits of available revenues for the remainder of the current biennium
and for the following biennium. The commissioner shall not hire additional staff using
appropriations from the health care access fund until the commissioner of finance makes
a determination that the adjustments implemented under paragraph (b) are sufficient to
allow MinnesotaCare expenditures to remain within the limits of available revenues for
the remainder of the current biennium and for the following biennium.

(b) The adjustments the commissioner shall use must be implemented in this order:
first, deleted text beginstop enrollment of single adults and households without children; second, upon 45
days' notice, stop coverage of single adults and households without children already
enrolled in the MinnesotaCare program; third,
deleted text end upon 90 days' notice, decrease the premium
subsidy amounts by ten percent for families with gross annual income above 200 percent
of the federal poverty guidelines; deleted text beginfourthdeleted text endnew text begin secondnew text end, upon 90 days' notice, decrease the
premium subsidy amounts by ten percent for families with gross annual income at or
below 200 percent; and deleted text beginfifthdeleted text endnew text begin thirdnew text end, require applicants to be uninsured for at least six months
prior to eligibility in the MinnesotaCare program. If these measures are insufficient to
limit the expenditures to the estimated amount of revenue, the commissioner shall further
limit enrollment or decrease premium subsidies.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2010.
new text end

Sec. 45.

Minnesota Statutes 2008, section 256L.03, subdivision 1, is amended to read:


Subdivision 1.

Covered health services.

"Covered health services" means the
health services reimbursed under chapter 256B, with the exception of inpatient hospital
services, special education services, private duty nursing servicesdeleted text begin, adult dental care
services other than services covered under section 256B.0625, subdivision 9, orthodontic
services
deleted text end, nonemergency medical transportation services, personal care assistant and case
management services, nursing home or intermediate care facilities services, inpatient
mental health services, and chemical dependency services.

No public funds shall be used for coverage of abortion under MinnesotaCare
except where the life of the female would be endangered or substantial and irreversible
impairment of a major bodily function would result if the fetus were carried to term; or
where the pregnancy is the result of rape or incest.

Covered health services shall be expanded as provided in this section.

Sec. 46.

Minnesota Statutes 2008, section 256L.03, subdivision 1a, is amended to read:


Subd. 1a.

Pregnant women and children; MinnesotaCare health care reform
waiver.

new text begin(a) new text endBeginning January 1, 1999, children and pregnant women are eligible for
coverage of all services that are eligible for reimbursement under the medical assistance
program according to chapter 256B, except that abortion services under MinnesotaCare
shall be limited as provided under subdivision 1. Pregnant women and children are
exempt from the provisions of subdivision 5, regarding co-payments. Pregnant women
and children who are lawfully residing in the United States but who are not "qualified
noncitizens" under title IV of the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, Public Law 104-193, Statutes at Large, volume 110, page
2105, are eligible for coverage of all services provided under the medical assistance
program according to chapter 256B.new text begin This paragraph expires July 1, 2010, or upon federal
approval, whichever is later.
new text end

new text begin (b) Beginning July 1, 2010, or upon federal approval, whichever is later, children
are eligible for coverage of all services that are eligible for reimbursement under the
medical assistance program under chapter 256B, except that abortion services under
MinnesotaCare shall be limited as provided under subdivision 1. Children who are
lawfully residing in the United States but who are not "qualified noncitizens" under title IV
of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Public
Law 104-193, Statutes at Large, volume 110, page 2105, are eligible for coverage of all
services provided under the medical assistance program according to chapter 256B.
new text end

Sec. 47.

Minnesota Statutes 2008, section 256L.03, subdivision 1b, is amended to read:


Subd. 1b.

Pregnant women; eligibility for full medical assistance services.

A pregnant woman enrolled in MinnesotaCare is eligible for coverage of all services
provided under the medical assistance program according to chapter 256B retroactive
to the date of conception. Co-payments totaling $30 or more, paid after the date of
conception, shall be refunded.new text begin This subdivision expires July 1, 2010, or upon federal
approval, whichever is later.
new text end

Sec. 48.

Minnesota Statutes 2008, section 256L.03, subdivision 3, is amended to read:


Subd. 3.

Inpatient hospital services.

(a) Covered health services shall include
inpatient hospital services, including inpatient hospital mental health services and inpatient
hospital and residential chemical dependency treatment, subject to those limitations
necessary to coordinate the provision of these services with eligibility under the medical
assistance spenddown. The inpatient hospital benefit for adult enrollees who qualify under
section 256L.04, subdivision 7, or who qualify under section 256L.04, subdivisions 1 and
2
, with family gross income that exceeds 200 percent of the federal poverty guidelines or
215 percent of the federal poverty guidelines on or after July 1, 2009, and who are not
pregnant, is subject to an annual limit of $10,000.new text begin This paragraph expires July 1, 2010, or
upon federal approval, whichever is later.
new text end

new text begin (b) Effective July 1, 2010, or upon federal approval, whichever is later, covered
health services shall include inpatient hospital services, including inpatient hospital mental
health services and inpatient hospital and residential chemical dependency treatment,
subject to those limitations necessary to coordinate the provision of these services with
eligibility under the medical assistance spend down.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end Admissions for inpatient hospital services paid for under section 256L.11,
subdivision 3
, must be certified as medically necessary in accordance with Minnesota
Rules, parts 9505.0500 to 9505.0540, except as provided in clauses (1) and (2):

(1) all admissions must be certified, except those authorized under rules established
under section 254A.03, subdivision 3, or approved under Medicare; and

(2) payment under section 256L.11, subdivision 3, shall be reduced by five percent
for admissions for which certification is requested more than 30 days after the day of
admission. The hospital may not seek payment from the enrollee for the amount of the
payment reduction under this clause.

Sec. 49.

Minnesota Statutes 2008, section 256L.03, subdivision 5, is amended to read:


Subd. 5.

Co-payments and coinsurance.

(a) Except as provided in paragraphs (b)
and (c), the MinnesotaCare benefit plan shall include the following co-payments and
coinsurance requirements for all enrollees:

(1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
$3,000 per family;

(2) $3 per prescription for adult enrollees;

(3) $25 for eyeglasses for adult enrollees;

(4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
episode of service which is required because of a recipient's symptoms, diagnosis, or
established illness, and which is delivered in an ambulatory setting by a physician or
physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
audiologist, optician, or optometrist; and

(5) $6 for nonemergency visits to a hospital-based emergency room.

(b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
children under the age of 21.

(c) Paragraph (a) does not apply to pregnant women and children under the age of 21.

(d) Paragraph (a), clause (4), does not apply to mental health services.

(e) Adult enrollees with family gross income that exceeds 200 percent of the federal
poverty guidelines or 215 percent of the federal poverty guidelines on or after July 1, 2009,
and who are not pregnant shall be financially responsible for the coinsurance amount, if
applicable, and amounts which exceed the $10,000 inpatient hospital benefit limit.

(f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
or changes from one prepaid health plan to another during a calendar year, any charges
submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
expenses incurred by the enrollee for inpatient services, that were submitted or incurred
prior to enrollment, or prior to the change in health plans, shall be disregarded.

new text begin (g) This subdivision expires July 1, 2010, or upon federal approval, whichever is
later.
new text end

Sec. 50.

Minnesota Statutes 2008, section 256L.04, subdivision 1, is amended to read:


Subdivision 1.

Families with children.

(a)new text begin(1)new text end Families with children with family
income equal to or less than 275 percent of the federal poverty guidelines for the
applicable family size shall be eligible for MinnesotaCare according to this section. All
other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
to enrollment under section 256L.07, shall apply unless otherwise specified. new text beginThis clause
expires upon implementation of clause (2).
new text end

new text begin (2) Effective July 1, 2010, or upon federal approval, whichever is later, children with
family income equal to or less than 275 percent of the federal poverty guidelines for the
applicable family size shall be eligible for MinnesotaCare according to this section.
new text end

(b)new text begin(1)new text end Parents who enroll in the MinnesotaCare program must also enroll their
children, if the children are eligible. Children may be enrolled separately without
enrollment by parents. However, if one parent in the household enrolls, both parents must
enroll, unless other insurance is available. If one child from a family is enrolled, all
children must be enrolled, unless other insurance is available. If one spouse in a household
enrolls, the other spouse in the household must also enroll, unless other insurance is
available. Families cannot choose to enroll only certain uninsured members.new text begin This clause
expires upon implementation of clause (2).
new text end

new text begin (2) Effective July 1, 2010, or upon federal approval, whichever is later, if one child
from a family is enrolled, all children must be enrolled, unless other insurance in available.
Families cannot choose to enroll only certain uninsured children.
new text end

(c) Beginning October 1, 2003, the dependent sibling definition no longer applies
to the MinnesotaCare program. These persons are no longer counted in the parental
household and may apply as a separate household.

(d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents are
not eligible for MinnesotaCare if their gross income exceeds $57,500.new text begin This paragraph
expires July 1, 2010, or upon federal approval, whichever is later.
new text end

(e) Children formerly enrolled in medical assistance and automatically deemed
eligible for MinnesotaCare according to section 256B.057, subdivision 2c, are exempt
from the requirements of this section until renewal.new text begin This paragraph expires July 1, 2009,
or upon federal approval, whichever is later.
new text end

new text begin (f) Effective July 1, 2011, or upon federal approval, whichever is later, children ages
two through 18 whose countable income is above 150 percent of the federal poverty
guidelines but not in excess of 275 percent of the federal poverty guidelines shall be
eligible for MinnesotaCare according to this section.
new text end

new text begin (g) Effective July 1, 2011, or upon federal approval, whichever is later, children ages
19 and 20 whose countable income is above 100 percent of the federal poverty guidelines
but not in excess of 275 percent of the federal poverty guidelines shall be eligible for
MinnesotaCare according to this section.
new text end

Sec. 51.

Minnesota Statutes 2008, section 256L.04, subdivision 1a, is amended to read:


Subd. 1a.

Social Security number required.

(a) Individuals and families applying
for MinnesotaCare coverage must provide a Social Security number.

(b) The commissioner shall not deny eligibility to an otherwise eligible applicant
who has applied for a Social Security number and is awaiting issuance of that Social
Security number.

(c) Newborns enrolled under section 256L.05, subdivision 3, are exempt from the
requirements of this subdivision.new text begin This paragraph expires July 1, 2011, or upon federal
approval, whichever is later.
new text end

(d) Individuals who refuse to provide a Social Security number because of
well-established religious objections are exempt from the requirements of this subdivision.
The term "well-established religious objections" has the meaning given in Code of Federal
Regulations, title 42, section 435.910.

Sec. 52.

Minnesota Statutes 2008, section 256L.04, subdivision 2, is amended to read:


Subd. 2.

Third-party liability, paternity, and other medical support.

(a) To be
eligible for MinnesotaCare, individuals and families must cooperate with the state agency
to identify potentially liable third-party payers and assist the state in obtaining third-party
payments. "Cooperation" includes, but is not limited to, complying with the notice
requirements in section 256B.056, subdivision 9, identifying any third party who may be
liable for care and services provided under MinnesotaCare to the enrollee, providing
relevant information to assist the state in pursuing a potentially liable third party, and
completing forms necessary to recover third-party payments.new text begin This paragraph expires July
1, 2010, or upon federal approval, whichever is later.
new text end

new text begin (b) Beginning July 1, 2010, or upon federal approval, whichever is later, to be
eligible for MinnesotaCare, children and parents, guardians, and relative caretakers of
enrolled children must cooperate with the state agency to identify potentially liable
third-party payers and assist the state in obtaining third-party payments. "Cooperation"
includes, but is not limited to, complying with the notice requirements in section
256B.056, subdivision 9, identifying any third party who may be liable for care and
services provided under MinnesotaCare to the enrollee, providing relevant information to
assist the state in pursuing a potentially liable third party, and completing forms necessary
to recover third-party payments.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end A parent, guardian, relative caretaker, or child enrolled in the MinnesotaCare
program must cooperate with the Department of Human Services and the local agency in
establishing the paternity of an enrolled child and in obtaining medical care support and
payments for the child and any other person for whom the person can legally assign rights,
in accordance with applicable laws and rules governing the medical assistance program. A
child shall not be ineligible for or disenrolled from the MinnesotaCare program solely
because the child's parent, relative caretaker, or guardian fails to cooperate in establishing
paternity or obtaining medical support.new text begin This paragraph expires July 1, 2010, or upon
federal approval, whichever is later.
new text end

new text begin (d) Beginning July 1, 2010, or upon federal approval, whichever is later, a parent,
guardian, or relative caretaker of a child enrolled in the MinnesotaCare program must
cooperate with the Department of Human Services and the local agency in establishing the
paternity of an enrolled child and in obtaining medical care support and payments for the
child and any other person for whom the person can legally assign rights, according to
applicable laws and rules governing the medical assistance program. A child shall not be
ineligible for or disenrolled from the MinnesotaCare program based solely on the child's
parent, relative caretaker, or guardian failure to cooperate in establishing paternity or
obtaining medical support.
new text end

Sec. 53.

Minnesota Statutes 2008, section 256L.04, subdivision 8, is amended to read:


Subd. 8.

Applicants potentially eligible for medical assistance.

(a) Individuals
who receive supplemental security income or retirement, survivors, or disability benefits
due to a disability, or other disability-based pension, who qualify under subdivision 7, but
who are potentially eligible for medical assistance without a spenddown shall be allowed
to enroll in MinnesotaCare for a period of 60 days, so long as the applicant meets all other
conditions of eligibility. The commissioner shall identify and refer the applications of
such individuals to their county social service agency. The county and the commissioner
shall cooperate to ensure that the individuals obtain medical assistance coverage for any
months for which they are eligible.new text begin This paragraph expires January 1, 2010.
new text end

(b) The enrollee must cooperate with the county social service agency in determining
medical assistance eligibility within the 60-day enrollment period. Enrollees who do not
cooperate with medical assistance within the 60-day enrollment period shall be disenrolled
from the plan within one calendar month. Persons disenrolled for nonapplication for
medical assistance may not reenroll until they have obtained a medical assistance
eligibility determination. Persons disenrolled for noncooperation with medical assistance
may not reenroll until they have cooperated with the county agency and have obtained a
medical assistance eligibility determination.new text begin This paragraph expires January 1, 2010.
new text end

(c) Beginning January 1, 2000, counties that choose to become MinnesotaCare
enrollment sites shall consider MinnesotaCare applications to also be applications for
medical assistance. Applicants who are potentially eligible for medical assistance, except
for those described in paragraph (a), may choose to enroll in either MinnesotaCare or
medical assistance.new text begin This paragraph expires July 1, 2011, or upon federal approval,
whichever is later.
new text end

new text begin (d) Beginning July 1, 2011, or upon federal approval, whichever is later, children
who become ineligible due to a decrease in income must be redetermined for medical
assistance.
new text end

deleted text begin (d)deleted text endnew text begin (e)new text end The commissioner shall redetermine provider payments made under
MinnesotaCare to the appropriate medical assistance payments for those enrollees who
subsequently become eligible for medical assistance.

Sec. 54.

Minnesota Statutes 2008, section 256L.04, subdivision 10, is amended to read:


Subd. 10.

Citizenship requirements.

new text begin(a) new text endEligibility for MinnesotaCare is limited
to citizens or nationals of the United States, qualified noncitizens, and other persons
residing lawfully in the United States as described in section 256B.06, subdivision 4,
paragraphs (a) to (e) and (j). Undocumented noncitizens and nonimmigrants are ineligible
for MinnesotaCare. For purposes of this subdivision, a nonimmigrant is an individual in
one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and
an undocumented noncitizen is an individual who resides in the United States without
the approval or acquiescence of the United States Citizenship and Immigration Services.
Families with children who are citizens or nationals of the United States must cooperate in
obtaining satisfactory documentary evidence of citizenship or nationality according to
the requirements of the federal Deficit Reduction Act of 2005, Public Law 109-171.new text begin This
paragraph expires July 1, 2010, or upon federal approval, whichever is later.
new text end

new text begin (b) Beginning July 1, 2010, or upon federal approval, whichever is later, eligibility
for MinnesotaCare is limited to citizens or nationals of the United States, qualified
noncitizens, and other persons residing lawfully in the United States as described in
section 256B.06, subdivision 4, paragraphs (a) to (e) and (j). Undocumented noncitizens
and nonimmigrants are ineligible for MinnesotaCare. For purposes of this subdivision,
a nonimmigrant is an individual in one or more of the classes listed in United States
Code, title 8, section 1101(a)(15), and an undocumented noncitizen is an individual
who resides in the United States without the approval or acquiescence of the United
States Citizenship and Immigration Services. Children who are citizens or nationals
of the United States must cooperate in obtaining satisfactory documentary evidence of
citizenship or nationality according to the requirements of the federal Deficit Reduction
Act of 2005, Public Law 109-171.
new text end

Sec. 55.

Minnesota Statutes 2008, section 256L.04, subdivision 13, is amended to read:


Subd. 13.

Families with relative caretakers, foster parents, or legal guardians.

new text begin (a) new text endBeginning January 1, 1999, in families that include a relative caretaker as defined in the
medical assistance program, foster parent, or legal guardian, the relative caretaker, foster
parent, or legal guardian may apply as a family or may apply separately for the children. If
the caretaker applies separately for the children, only the children's income is counted and
the provisions of subdivision 1, paragraph (b), do not apply. If the relative caretaker, foster
parent, or legal guardian applies with the children, their income is included in the gross
family income for determining eligibility and premium amount.new text begin This paragraph expires
July 1, 2010, or upon federal approval, whichever is later.
new text end

new text begin (b) Beginning July 1, 2010, or upon federal approval, whichever is later, if a relative
caretaker, foster parent, or legal guardian applies for the children in the household, only
the children's income is counted for purposes of eligibility under this chapter.
new text end

Sec. 56.

Minnesota Statutes 2008, section 256L.05, subdivision 3, is amended to read:


Subd. 3.

Effective date of coverage.

(a) new text beginBeginning July 1, 2005, the effective
date of coverage is the first day of the month following the month in which eligibility is
approved and the first premium payment has been received. This paragraph expires upon
implementation of paragraph (d).
new text end

new text begin (b) As provided in section 256B.057, coverage for newborns is automatic from the
date of birth and must be coordinated with other health coverage. This paragraph expires
upon implementation of paragraph (d).
new text end

new text begin (c) The effective date of coverage for eligible newly adoptive children added to a
family receiving covered health services is the date of entry into the family. The effective
date of coverage for other new recipients added to the family receiving covered health
services is the first day of the month following the month in which eligibility is approved
or at renewal, whichever the family receiving covered health services prefers. All
eligibility criteria must be met by the family at the time the new family member is added.
The income of the new family member is included with the family's gross income and the
adjusted premium begins in the month the new family member is added. This paragraph
expires upon implementation of paragraph (d).
new text end

new text begin (d) Effective July 1, 2009, new text endthe effective date of coverage is the first day of the month
following the month in which eligibility is approved and the first premium payment has
been received. As provided in section 256B.057, coverage for newborns is automatic from
the date of birth and must be coordinated with other health coverage. The effective date
of coverage for eligible newly adoptive children added to a family receiving covered
health services is the month of placement. The effective date of coverage for other new
members added to the family is the first day of the month following the month in which
the change is reported. All eligibility criteria must be met by the family at the time the
new family member is added. The income of the new family member is included with
the family's gross income and the adjusted premium begins in the month the new family
member is added.

deleted text begin (b)deleted text endnew text begin (e)new text end The initial premium must be received by the last working day of the month
for coverage to begin the first day of the following month.

deleted text begin (c)deleted text endnew text begin (f)new text end Benefits are not available until the day following discharge if an enrollee is
hospitalized on the first day of coverage.

deleted text begin (d)deleted text endnew text begin (g)new text end Notwithstanding any other law to the contrary, benefits under sections
256L.01 to 256L.18 are secondary to a plan of insurance or benefit program under which
an eligible person may have coverage and the commissioner shall use cost avoidance
techniques to ensure coordination of any other health coverage for eligible persons. The
commissioner shall identify eligible persons who may have coverage or benefits under
other plans of insurance or who become eligible for medical assistance.

deleted text begin (e)deleted text endnew text begin (h)new text endnew text begin Effective September 1, 2006,new text end the effective date of coverage for single adults
and households with no children formerly enrolled in general assistance medical care
and enrolled in MinnesotaCare according to section 256D.03, subdivision 3, is the first
day of the month following the last day of general assistance medical care coverage.new text begin
This paragraph expires January 1, 2010.
new text end

Sec. 57.

Minnesota Statutes 2008, section 256L.05, subdivision 3a, is amended to read:


Subd. 3a.

Renewal of eligibility.

(a)new text begin(1)new text end Beginning July 1, 2007, an enrollee's
eligibility must be renewed every 12 months. The 12-month period begins in the month
after the month the application is approved.new text begin This clause expires upon implementation
of clause (2).
new text end

new text begin (2) Effective July 1, 2011, or upon federal approval, whichever is later, an enrollee's
eligibility must be renewed every six months. The six-month period begins in the month
after the month the application is approved.
new text end

(b) Each new period of eligibility must take into account any changes in
circumstances that impact eligibility and premium amount. An enrollee must provide all
the information needed to redetermine eligibility by the first day of the month that ends
the eligibility period.

new text begin (c) new text endIf there is no change in circumstances, the enrollee may renew eligibility at
designated locations that include community clinics and health care providers' offices. The
designated sites shall forward the renewal forms to the commissioner. The commissioner
may establish criteria and timelines for sites to forward applications to the commissioner
or county agencies.

new text begin (d)new text end The premium for the new period of eligibility must be received as provided in
section 256L.06 in order for eligibility to continue.

deleted text begin (c)deleted text endnew text begin (e) Effective September 1, 2006,new text end for single adults and households with
no children formerly enrolled in general assistance medical care and enrolled in
MinnesotaCare according to section 256D.03, subdivision 3, the first period of eligibility
begins the month the enrollee submitted the application or renewal for general assistance
medical care.new text begin This paragraph expires January 1, 2010.
new text end

deleted text begin (d)deleted text endnew text begin (f)new text end An enrollee who fails to submit renewal forms and related documentation
necessary for verification of continued eligibility in a timely manner shall remain eligible
for one additional month beyond the end of the current eligibility period before being
disenrolled. The enrollee remains responsible for MinnesotaCare premiums for the
additional month.new text begin This paragraph expires July 1, 2009.
new text end

Sec. 58.

Minnesota Statutes 2008, section 256L.05, subdivision 3b, is amended to read:


Subd. 3b.

Reapplication.

new text begin(a) new text endBeginning January 1, 1999, families and individuals
must reapply after a lapse in coverage of one calendar month or more and must meet
all eligibility criteria.new text begin This paragraph expires July 1, 2010, or upon federal approval,
whichever is later.
new text end

new text begin (b) Beginning July 1, 2010, or upon federal approval, whichever is later, children
must reapply after a lapse in coverage of one calendar month or more and must meet all
eligibility criteria.
new text end

Sec. 59.

Minnesota Statutes 2008, section 256L.05, subdivision 3c, is amended to read:


Subd. 3c.

Retroactive coverage.

new text begin(a) new text endNotwithstanding subdivision 3, the effective
date of coverage shall be the first day of the month following termination from medical
assistance or general assistance medical care for families and individuals who are eligible
for MinnesotaCare and who submitted a written request for retroactive MinnesotaCare
coverage with a completed application within 30 days of the mailing of notification of
termination from medical assistance or general assistance medical care. The applicant
must provide all required verifications within 30 days of the written request for
verification. For retroactive coverage, premiums must be paid in full for any retroactive
month, current month, and next month within 30 days of the premium billing.new text begin This
paragraph expires July 1, 2010, or upon federal approval, whichever is later.
new text end

new text begin (b) Beginning July 1, 2010, or upon federal approval, whichever is later,
notwithstanding subdivision 3, the effective date of coverage shall be the first day of
the month following termination from medical assistance for children who are eligible
for MinnesotaCare and who submitted a written request for retroactive MinnesotaCare
coverage with a completed application within 30 days of the mailing of notification of
termination from medical assistance. The applicant must provide all required verifications
within 30 days of the written request for verification. For retroactive coverage, premiums
must be paid in full for any retroactive month, current month, and next month within
30 days of the premium billing.
new text end

Sec. 60.

Minnesota Statutes 2008, section 256L.05, subdivision 5, is amended to read:


Subd. 5.

Availability of private insurance.

new text begin(a) new text endThe commissioner, in consultation
with the commissioners of health and commerce, shall provide information regarding the
availability of private health insurance coverage and the possibility of disenrollment
under section 256L.07, subdivision 1, paragraphs (b) and (c), to all: (1) families enrolled
in the MinnesotaCare program whose gross family income is equal to or more than 225
percent of the federal poverty guidelines; and (2) single adults and households without
children enrolled in the MinnesotaCare program whose gross family income is equal
to or more than 165 percent of the federal poverty guidelines. This information must
be provided upon initial enrollment and annually thereafter. The commissioner shall
also include information regarding the availability of private health insurance coverage
in the notice of ineligibility provided to persons subject to disenrollment under section
256L.07, subdivision 1, paragraphs (b) and (c). new text beginThis paragraph expires July 1, 2010, or
upon federal approval, whichever is later.
new text end

new text begin (b) Effective July 1, 2010, or upon federal approval, whichever is later, the
commissioner, in consultation with the commissioners of health and commerce, shall
provide information regarding the availability of private health insurance coverage and the
possibility of disenrollment under section 256L.07, subdivision 1, to all children enrolled
in the MinnesotaCare program whose income is equal to or more than 225 percent of the
federal poverty guidelines. This information must be provided upon initial enrollment
and annually thereafter. The commissioner shall also include information regarding the
availability of private health insurance coverage in the notice of ineligibility provided to
persons subject to disenrollment under section 256L.07, subdivision 1.
new text end

Sec. 61.

Minnesota Statutes 2008, section 256L.06, subdivision 3, is amended to read:


Subd. 3.

Commissioner's duties and payment.

(a) Premiums are dedicated to the
commissioner for MinnesotaCare.

(b) The commissioner shall develop and implement procedures to: (1) require
enrollees to report changes in income; (2)new text begin(i)new text end adjust sliding scale premium payments, based
upon both increases and decreases in enrollee income, at the time the change in income is
reported;new text begin or (ii) beginning July 1, 2011, or upon federal approval, whichever is later, adjust
sliding scale premium payments based upon both increases and decreases in gross family
income, at the time the change in income is reported;
new text end and (3) disenroll enrollees from
MinnesotaCare for failure to pay required premiums. Failure to pay includes payment
with a dishonored check, a returned automatic bank withdrawal, or a refused credit card
or debit card payment. The commissioner may demand a guaranteed form of payment,
including a cashier's check or a money order, as the only means to replace a dishonored,
returned, or refused payment.

(c) Premiums are calculated on a calendar month basis and may be paid on a
monthly, quarterly, or semiannual basis, with the first payment due upon notice from the
commissioner of the premium amount required. The commissioner shall inform applicants
and enrollees of these premium payment options. Premium payment is required before
enrollment is complete and to maintain eligibility in MinnesotaCare. Premium payments
received before noon are credited the same day. Premium payments received after noon
are credited on the next working day.

(d)new text begin(1) Effective upon federal approval,new text end nonpayment of the premium will result in
disenrollment from the plan effective the first day of the calendar month following the
calendar month for which the premium was due. Persons disenrolled for nonpayment
or who voluntarily terminate coverage from the program may not reenroll until four
calendar months have elapsed. The commissioner shall waive premiums for coverage
provided under this paragraph to persons disenrolled for nonpayment who reapply under
section 256L.05, subdivision 3b. Persons disenrolled for nonpayment or who voluntarily
terminate coverage from the program may not reenroll for four calendar months unless the
person demonstrates good cause for nonpayment. Good cause does not exist if a person
chooses to pay other family expenses instead of the premium. The commissioner shall
define good cause in rule.new text begin This paragraph expires July 1, 2009.
new text end

new text begin (2) Effective July 1, 2009, nonpayment of the premium will result in disenrollment
from the plan effective for the calendar month for which the premium was due. Persons
disenrolled for nonpayment or who voluntarily terminate coverage from the program may
not reenroll until four calendar months have elapsed. Persons disenrolled for nonpayment
who pay all past due premiums as well as current premiums due, including premiums
due for the period of disenrollment, within 20 days of disenrollment, shall be reenrolled
retroactively to the first day of disenrollment. Persons disenrolled for nonpayment or
who voluntarily terminate coverage from the program may not reenroll for four calendar
months unless the person demonstrates good cause for nonpayment. Good cause does
not exist if a person chooses to pay other family expenses instead of the premium. The
commissioner shall define good cause in rule.
new text end

Sec. 62.

Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision
to read:


new text begin Subd. 1a. new text end

new text begin General requirements. new text end

new text begin (a) Children enrolled in the original children's
health plan as of September 30, 1992; children who enrolled in the MinnesotaCare
program after September 30, 1992, under Laws 1992, chapter 549, article 4, section 17;
and children who have family gross incomes that are equal to or less than 150 percent of
the federal poverty guidelines are eligible without meeting the requirements of subdivision
2 and the four-month requirement in subdivision 3, as long as they maintain continuous
coverage in the MinnesotaCare program or medical assistance. Children who apply for
MinnesotaCare on or after the implementation date of the employer-subsidized health
coverage program described in Laws 1998, chapter 407, article 5, section 45, who have
family gross incomes that are equal to or less than 150 percent of the federal poverty
guidelines, must meet the requirements of subdivision 2 to be eligible for MinnesotaCare.
new text end

new text begin (b) Families enrolled in MinnesotaCare under section 256L.04, subdivision 1, whose
income increases above 275 percent of the federal poverty guidelines, are no longer
eligible for the program and shall be disenrolled by the commissioner. For persons
disenrolled under this subdivision, MinnesotaCare coverage terminates the last day of
the calendar month following the month in which the commissioner determines that the
income of a family or individual exceeds program income limits.
new text end

new text begin (c) Notwithstanding paragraph (b), children may remain enrolled in MinnesotaCare
if ten percent of their annual family income is less than the annual premium for a
policy with a $500 deductible available through the Minnesota Comprehensive Health
Association. Children who are no longer eligible for MinnesotaCare under this paragraph
shall be given a 12-month notice period from the date that ineligibility is determined before
disenrollment. The premium for children remaining eligible under this paragraph shall be
the maximum premium determined under section 256L.15, subdivision 2a, paragraph (b).
new text end

new text begin (d) Notwithstanding paragraphs (b) and (c), parents are not eligible for
MinnesotaCare if gross household income exceeds $50,000.
new text end

new text begin (e) This subdivision is effective August 1, 2005, and expires July 1, 2011, or upon
federal approval, whichever is later.
new text end

Sec. 63.

Minnesota Statutes 2008, section 256L.07, is amended by adding a subdivision
to read:


new text begin Subd. 1b. new text end

new text begin General requirements; contingent on federal approval. new text end

new text begin (a)
Effective July 1, 2011, or upon federal approval, whichever is later, children enrolled in
MinnesotaCare under section 256L.04, subdivision 1, whose income increases above
275 percent of the federal poverty guidelines, are no longer eligible for the program and
shall be disenrolled by the commissioner. For persons disenrolled under this subdivision,
MinnesotaCare coverage terminates the last day of the calendar month following the
month in which the commissioner determines that the income of a family or individual
exceeds program income limits.
new text end

new text begin (b) Beginning January 1, 2008, individuals enrolled in MinnesotaCare under section
256L.04, subdivision 7, whose income increases above 200 percent of the federal poverty
guidelines or 250 percent of the federal poverty guidelines on or after July 1, 2009, are
no longer eligible for the program and shall be disenrolled by the commissioner. This
paragraph expires January 1, 2010.
new text end

new text begin (c) Notwithstanding paragraphs (a) and (b), and subdivision 1a, paragraph (a),
children may remain enrolled in MinnesotaCare if ten percent of their gross individual
or gross family income as defined in section 256L.01, subdivision 4, is less than the
annual premium for a policy with a $500 deductible available through the Minnesota
Comprehensive Health Association. Beginning July 1, 2011, or upon federal approval,
whichever is later, children may remain enrolled in MinnesotaCare if ten percent of their
income as defined in section 256L.01, subdivision 5, is less than the annual premium for a
policy with a $500 deductible available through the Minnesota Comprehensive Health
Association. Children who are no longer eligible for MinnesotaCare under this paragraph
shall be given a 12-month notice period from the date that ineligibility is determined before
disenrollment. The premium for children remaining eligible under this paragraph shall be
the maximum premium determined under section 256L.15, subdivision 2b, paragraph (b).
new text end

new text begin (d) Notwithstanding paragraphs (a) and (b), and subdivision 1a, paragraph (a),
parents are not eligible for MinnesotaCare if gross household income exceeds $57,500 for
the 12-month period of eligibility. This paragraph expires July 1, 2010, or upon federal
approval, whichever is later.
new text end

Sec. 64.

Minnesota Statutes 2008, section 256L.07, subdivision 2, is amended to read:


Subd. 2.

Must not have access to employer-subsidized coverage.

(a) To be
eligible, a family or individual must not have access to subsidized health coverage through
an employer and must not have had access to employer-subsidized coverage through
a current employer for 18 months prior to application or reapplication. A family or
individual whose employer-subsidized coverage is lost due to an employer terminating
health care coverage as an employee benefit during the previous 18 months is not eligible.new text begin
This paragraph expires July 1, 2010, or upon federal approval, whichever is later.
new text end

new text begin (b) Beginning July 1, 2010, or upon federal approval, whichever is later, to be
eligible for MinnesotaCare, a child must not have access to subsidized health coverage
through an employer and must not have had access to employer-subsidized coverage
through a current employer for 18 months prior to application or reapplication. A child
whose employer-subsidized coverage is lost due to an employer terminating health care
coverage as an employee benefit during the previous 18 months is not eligible. This
subdivision does not apply to a child who was enrolled in MinnesotaCare within six
months or less of reapplication and who no longer has employer-subsidized coverage due
to the employer terminating health care coverage as an employee benefit.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end This subdivision does not apply to a family or individual who was enrolled
in MinnesotaCare within six months or less of reapplication and who no longer has
employer-subsidized coverage due to the employer terminating health care coverage as
an employee benefit.new text begin This paragraph expires July 1, 2010, or upon federal approval,
whichever is later.
new text end

deleted text begin (c)deleted text endnew text begin (d)new text end For purposes of this requirement, subsidized health coverage means health
coverage for which the employer pays at least 50 percent of the cost of coverage for
the employee or dependent, or a higher percentage as specified by the commissioner.
Children are eligible for employer-subsidized coverage through either parent, including
the noncustodial parent. The commissioner must treat employer contributions to Internal
Revenue Code Section 125 plans and any other employer benefits intended to pay
health care costs as qualified employer subsidies toward the cost of health coverage for
employees for purposes of this subdivision.

Sec. 65.

Minnesota Statutes 2008, section 256L.07, subdivision 3, is amended to read:


Subd. 3.

Other health coverage.

(a) Families and individuals enrolled in the
MinnesotaCare program must have no health coverage while enrolled or for at least four
months prior to application and renewal. Children enrolled in the original children's health
plan and children in families with income equal to or less than 150 percent of the federal
poverty guidelines, who have other health insurance, are eligible if the coverage:

(1) lacks two or more of the following:

(i) basic hospital insurance;

(ii) medical-surgical insurance;

(iii) prescription drug coverage;

(iv) dental coverage; or

(v) vision coverage;

(2) requires a deductible of $100 or more per person per year; or

(3) lacks coverage because the child has exceeded the maximum coverage for a
particular diagnosis or the policy excludes a particular diagnosis.

The commissioner may change this eligibility criterion for sliding scale premiums
in order to remain within the limits of available appropriations. The requirement of no
health coverage does not apply to newborns.new text begin This paragraph expires July 1, 2011, or
upon federal approval, whichever is later.
new text end

new text begin (b) Effective July 1, 2011, or upon federal approval, whichever is later, children
enrolled in the MinnesotaCare program must have no health coverage while enrolled or
for at least four months prior to application and renewal.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end Medical assistance, general assistance medical care, and the Civilian Health
and Medical Program of the Uniformed Service, CHAMPUS, or other coverage provided
under United States Code, title 10, subtitle A, part II, chapter 55, are not considered
insurance or health coverage for purposes of the four-month requirement described in this
subdivision.new text begin This paragraph expires July 1, 2011, or upon federal approval, whichever is
later.
new text end

new text begin (d) Beginning July 1, 2011, or upon federal approval, whichever is later, medical
assistance and the Civilian Health and Medical Program of the Uniformed Service,
CHAMPUS, or other coverage provided under United States Code, title 10, subtitle A,
part II, chapter 55, are not considered insurance or health coverage for purposes of the
four-month requirement described in this subdivision.
new text end

deleted text begin (c)deleted text endnew text begin (e)new text end For purposes of this subdivision, an applicant or enrollee who is entitled to
Medicare Part A or enrolled in Medicare Part B coverage under title XVIII of the Social
Security Act, United States Code, title 42, sections 1395c to 1395w-152, is considered to
have health coverage. An applicant or enrollee who is entitled to premium-free Medicare
Part A may not refuse to apply for or enroll in Medicare coverage to establish eligibility
for MinnesotaCare.

deleted text begin (d)deleted text endnew text begin (f)new text end Applicants who were recipients of medical assistance or general assistance
medical care within one month of application must meet the provisions of this subdivision
and subdivision 2.new text begin This paragraph expires July 1, 2011, or upon federal approval,
whichever is later.
new text end

new text begin (g) Beginning July 1, 2011, or upon federal approval, whichever is later, applicants
who were recipients of medical assistance within one month of application must meet the
provisions of this subdivision and subdivision 2.
new text end

deleted text begin (e)deleted text endnew text begin (h)new text end Cost-effective health insurance that was paid for by medical assistance is
not considered health coverage for purposes of the four-month requirement under this
section, except if the insurance continued after medical assistance no longer considered it
cost-effective or after medical assistance closed.

Sec. 66.

Minnesota Statutes 2008, section 256L.07, subdivision 5, is amended to read:


Subd. 5.

Voluntary disenrollment for members of military.

new text begin(a) new text endNotwithstanding
section 256L.05, subdivision 3b, MinnesotaCare enrollees who are members of the
military and their families, who choose to voluntarily disenroll from the program when
one or more family members are called to active duty, may reenroll during or following
that member's tour of active duty. Those individuals and families shall be considered
to have good cause for voluntary termination under section 256L.06, subdivision 3,
paragraph (d). Income and asset increases reported at the time of reenrollment shall be
disregarded. All provisions of sections 256L.01 to 256L.18 shall apply to individuals and
families enrolled under this subdivision upon 12-month renewal.new text begin This paragraph expires
July 1, 2010, or upon federal approval, whichever is later.
new text end

new text begin (b) Beginning July 1, 2010, or upon federal approval, whichever is later,
notwithstanding section 256L.05, subdivision 3b, MinnesotaCare enrollees who are
members of the military under age 21 and children whose parents are military members
may choose to voluntarily disenroll from the program when one or more family members
are called to active duty, and may reenroll during or following that member's tour of active
duty. Those children shall be considered to have good cause for voluntary termination
under section 256L.06, subdivision 3, paragraph (d). Income and asset increases reported
at the time of reenrollment shall be disregarded. All provisions of sections 256L.01 to
256L.18 shall apply to children enrolled under this subdivision upon renewal.
new text end

Sec. 67.

Minnesota Statutes 2008, section 256L.07, subdivision 7, is amended to read:


Subd. 7.

Exception for certain children.

new text begin(a) new text endChildren formerly enrolled in medical
assistance and automatically deemed eligible for MinnesotaCare according to section
256B.057, subdivision 2c, are exempt from the requirements of this section until renewal.

new text begin (b) This subdivision expires July 1, 2009.
new text end

Sec. 68.

Minnesota Statutes 2008, section 256L.09, subdivision 2, is amended to read:


Subd. 2.

Residency requirement.

(a) To be eligible for health coverage under
the MinnesotaCare program, adults without children must be permanent residents of
Minnesota.new text begin This paragraph expires January 1, 2010.
new text end

(b) To be eligible for health coverage under the MinnesotaCare program, pregnant
women, families, and children must meet the residency requirements as provided by Code
of Federal Regulations, title 42, section 435.403, except that the provisions of section
256B.056, subdivision 1, shall apply upon receipt of federal approval. new text beginThis paragraph
expires July 1, 2010, or upon federal approval, whichever is later.
new text end

new text begin (c) Effective July 1, 2010, or upon federal approval, whichever is later, to be eligible
for health coverage under the MinnesotaCare program, children must meet the residency
requirements as provided by Code of Federal Regulations, title 42, section 435.403.
new text end

Sec. 69.

Minnesota Statutes 2008, section 256L.11, subdivision 1, is amended to read:


Subdivision 1.

Medical assistance rate to be used.

new text begin(a) new text endPayment to providers under
sections 256L.01 to 256L.11 shall be at the same rates and conditions established for
medical assistance, except as provided in subdivisions 2 to 6.

new text begin (b) Effective service date July 1, 2009, total payments for basic care services,
except prescription drugs, medical supplies, prosthetics, lab, radiology, and medical
transportation, shall be reduced by 3.0 percent, prior to third-party liability and spenddown
calculation. Payments made to managed care plans shall be reduced for services provided
on or after January 1, 2010, to reflect this reduction.
new text end

Sec. 70.

Minnesota Statutes 2008, section 256L.11, subdivision 2a, is amended to read:


Subd. 2a.

Payment rates; services for families and children under the
MinnesotaCare health care reform waiver.

new text begin(a) new text endSubdivision 2 shall not apply to services
provided to families with children who are eligible according to section 256L.04,
subdivision 1
, paragraph (a).new text begin This paragraph expires July 1, 2010, or upon federal
approval, whichever is later.
new text end

new text begin (b) Beginning July 1, 2010, or upon federal approval, whichever is later, subdivision
2 must not apply to services provided to children who are eligible according to section
256L.04, subdivision 1, paragraph (a).
new text end

Sec. 71.

Minnesota Statutes 2008, section 256L.11, subdivision 6, is amended to read:


Subd. 6.

Enrollees 18 or older.

Payment by the MinnesotaCare program for
inpatient hospital services provided to MinnesotaCare enrollees deleted text begineligible under section
256L.04, subdivision 7, or
deleted text end who qualify under section 256L.04, subdivisions 1 and 2,
with family gross income that exceeds 175 percent of the federal poverty guidelines
and who are not pregnant, who are 18 years old or older on the date of admission to the
inpatient hospital must be in accordance with paragraphs (a) and (b). Payment for adults
who are not pregnant and are eligible under section 256L.04, subdivisions 1 and 2, and
whose incomes are equal to or less than 175 percent of the federal poverty guidelines,
shall be as provided for under paragraph (c).

(a) If the medical assistance rate minus any co-payment required under section
256L.03, subdivision 4, is less than or equal to the amount remaining in the enrollee's
benefit limit under section 256L.03, subdivision 3, payment must be the medical
assistance rate minus any co-payment required under section 256L.03, subdivision 4. The
hospital must not seek payment from the enrollee in addition to the co-payment. The
MinnesotaCare payment plus the co-payment must be treated as payment in full.

(b) If the medical assistance rate minus any co-payment required under section
256L.03, subdivision 4, is greater than the amount remaining in the enrollee's benefit limit
under section 256L.03, subdivision 3, payment must be the lesser of:

(1) the amount remaining in the enrollee's benefit limit; or

(2) charges submitted for the inpatient hospital services less any co-payment
established under section 256L.03, subdivision 4.

The hospital may seek payment from the enrollee for the amount by which usual and
customary charges exceed the payment under this paragraph. If payment is reduced under
section 256L.03, subdivision 3, paragraph (b), the hospital may not seek payment from the
enrollee for the amount of the reduction.

(c) For admissions occurring during the period of July 1, 1997, through June 30,
1998, for adults who are not pregnant and are eligible under section 256L.04, subdivisions
1 and 2
, and whose incomes are equal to or less than 175 percent of the federal poverty
guidelines, the commissioner shall pay hospitals directly, up to the medical assistance
payment rate, for inpatient hospital benefits in excess of the $10,000 annual inpatient
benefit limit.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2010.
new text end

Sec. 72.

Minnesota Statutes 2008, section 256L.12, subdivision 6, is amended to read:


Subd. 6.

Co-payments and benefit limits.

new text begin(a) new text endEnrollees are responsible for all
co-payments in sections 256L.03, subdivision 5, and 256L.035, and shall pay co-payments
to the managed care plan or to its participating providers. The enrollee is also responsible
for payment of inpatient hospital charges which exceed the MinnesotaCare benefit limit.

new text begin (b) This subdivision expires July 1, 2010, or upon federal approval, whichever is
later.
new text end

Sec. 73.

Minnesota Statutes 2008, section 256L.12, subdivision 9, is amended to read:


Subd. 9.

Rate setting; performance withholds.

(a) Rates will be prospective,
per capita, where possible. The commissioner may allow health plans to arrange for
inpatient hospital services on a risk or nonrisk basis. The commissioner shall consult with
an independent actuary to determine appropriate rates.

(b) For services rendered on or after January 1, 2003, to December 31, 2003, the
commissioner shall withhold .5 percent of managed care plan payments under this section
pending completion of performance targets. The withheld funds must be returned no
sooner than July 1 and no later than July 31 of the following year if performance targets
in the contract are achieved. A managed care plan may include as admitted assets under
section 62D.044 any amount withheld under this paragraph that is reasonably expected
to be returned.

(c) For services rendered on or after January 1, 2004, the commissioner shall
withhold five percent of managed care plan payments under this section pending
completion of performance targets. Each performance target must be quantifiable,
objective, measurable, and reasonably attainable, except in the case of a performance target
based on a federal or state law or rule. Criteria for assessment of each performance target
must be outlined in writing prior to the contract effective date. The managed care plan
must demonstrate, to the commissioner's satisfaction, that the data submitted regarding
attainment of the performance target is accurate. The commissioner shall periodically
change the administrative measures used as performance targets in order to improve plan
performance across a broader range of administrative services. The performance targets
must include measurement of plan efforts to contain spending on health care services and
administrative activities. The commissioner may adopt plan-specific performance targets
that take into account factors affecting only one plan, such as characteristics of the plan's
enrollee population. The withheld funds must be returned no sooner than July 1 and no
later than July 31 of the following calendar year if performance targets in the contract are
achieved. A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under this
paragraph that is reasonably expected to be returned.

new text begin (d) For services rendered on or after January 1, 2010, the commissioner shall
withhold an additional three percent of managed care plan payments under this section.
The withheld funds must be returned no sooner than July 1 and no later than July 31
of the following calendar year.
new text end

new text begin (e) A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under
this paragraph. The return of the withhold under this paragraph is not subject to the
requirements of paragraph (b) or (c).
new text end

Sec. 74.

Minnesota Statutes 2008, section 256L.15, subdivision 1, is amended to read:


Subdivision 1.

Premium determination.

(a) Families with children and individuals
shall pay a premium determined according to subdivision deleted text begin2deleted text endnew text begin 2anew text end.new text begin This paragraph expires
July 1, 2010, or upon federal approval, whichever is later.
new text end

new text begin (b) Beginning July 1, 2010, or upon federal approval, whichever is later, children
shall pay a premium determined according to subdivision 2b.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end Pregnant women and children under age two are exempt from the provisions
of section 256L.06, subdivision 3, paragraph (b), clause (3), requiring disenrollment
for failure to pay premiums. For pregnant women, this exemption continues until the
first day of the month following the 60th day postpartum. Women who remain enrolled
during pregnancy or the postpartum period, despite nonpayment of premiums, shall be
disenrolled on the first of the month following the 60th day postpartum for the penalty
period that otherwise applies under section 256L.06, unless they begin paying premiums.
new text begin This paragraph expires July 1, 2011, or upon federal approval, whichever is later.
new text end

deleted text begin (c)deleted text endnew text begin (d) Effective upon federal approval,new text end members of the military and their families
who meet the eligibility criteria for MinnesotaCare upon eligibility approval made within
24 months following the end of the member's tour of active duty shall have their premiums
paid by the commissioner. The effective date of coverage for an individual or family
who meets the criteria of this paragraph shall be the first day of the month following the
month in which eligibility is approved. This exemption applies for 12 months. This
paragraph expires June 30, 2010.

Sec. 75.

Minnesota Statutes 2008, section 256L.15, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Sliding fee scale to determine percentage of gross individual or family
income.
new text end

new text begin (a) Effective August 1, 2005, the commissioner shall establish a sliding fee
scale to determine the percentage of gross individual or family income that households at
different income levels must pay to obtain coverage through the MinnesotaCare program.
The sliding fee scale must be based on the enrollee's gross individual or family income.
The sliding fee scale must contain separate tables based on enrollment of one, two, or
three or more persons. The sliding fee scale begins with a premium of 1.5 percent of gross
individual or family income for individuals or families with incomes below the limits for
the medical assistance program for families and children in effect on January 1, 1999,
and proceeds through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4,
and 8.8 percent. These percentages are matched to evenly spaced income steps ranging
from the medical assistance income limit for families and children in effect on January
1, 1999, to 275 percent of the federal poverty guidelines for the applicable family size,
up to a family size of five. The sliding fee scale for a family of five must be used for
families of more than five. Effective October 1, 2003, the commissioner shall increase
each percentage by 0.5 percentage points for enrollees with income greater than 100
percent but not exceeding 200 percent of the federal poverty guidelines and shall increase
each percentage by 1.0 percentage points for families and children with incomes greater
than 200 percent of the federal poverty guidelines. The sliding fee scale and percentages
are not subject to the provisions of chapter 14. If a family or individual reports increased
income after enrollment, premiums shall not be adjusted until eligibility renewal.
new text end

new text begin (b) Effective August 1, 2005, children in families whose gross income is above 275
percent of the federal poverty guidelines shall pay the maximum premium. The maximum
premium is defined as a base charge for one, two, or three or more enrollees so that if all
MinnesotaCare cases paid the maximum premium, the total revenue would equal the
total cost of MinnesotaCare medical coverage and administration. In this calculation,
administrative costs shall be assumed to equal ten percent of the total. The costs of
medical coverage for children under age two and pregnant women and the enrollees in
these groups shall be excluded from the total. The maximum premium for two enrollees
shall be twice the maximum premium for one, and the maximum premium for three or
more enrollees shall be three times the maximum premium for one.
new text end

new text begin (c) This subdivision expires July 1, 2010, or upon federal approval, whichever is
later.
new text end

Sec. 76.

Minnesota Statutes 2008, section 256L.15, is amended by adding a subdivision
to read:


new text begin Subd. 2b. new text end

new text begin Sliding fee scale to determine monthly gross income. new text end

new text begin (a) Effective July
1, 2010, or upon federal approval, whichever is later, the commissioner shall establish
a sliding fee scale to determine the percentage of monthly gross individual or family
income that households at different income levels must pay to obtain coverage through the
MinnesotaCare program. The sliding fee scale must be based on the enrollee's monthly
gross individual or family income. The sliding fee scale must contain separate tables
based on enrollment of one, two, or three or more persons. The sliding fee scale begins
with a premium of 1.5 percent of monthly gross family income for children with family
incomes below the limits for the medical assistance program for families and children in
effect on January 1, 1999, and proceeds through the following evenly spaced steps: 1.8,
2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent. These percentages are matched to evenly
spaced income steps ranging from the medical assistance income limit for families and
children in effect on January 1, 1999, to 275 percent of the federal poverty guidelines for
the applicable family size, up to a family size of five. The sliding fee scale for children in
a family of five must be used for children in families of more than five. Effective July
1, 2009, the commissioner shall increase each percentage by 0.5 percentage points for
enrollees with income greater than 100 percent but not exceeding 200 percent of the
federal poverty guidelines and shall increase each percentage by 1.0 percentage points
for families and children with incomes greater than 200 percent of the federal poverty
guidelines. The sliding fee scale and percentages are not subject to the provisions of
chapter 14. If a child or individual reports increased income after enrollment, premiums
shall be adjusted at the time the change in income is reported.
new text end

new text begin (b) Effective July 1, 2010, or upon federal approval, whichever is later, children in
families whose gross income is above 275 percent of the federal poverty guidelines shall
pay the maximum premium. The maximum premium is defined as a base charge for one,
two, or three or more enrollees so that if all MinnesotaCare cases paid the maximum
premium, the total revenue would equal the total cost of MinnesotaCare medical coverage
and administration. In this calculation, administrative costs shall be assumed to equal
ten percent of the total. The maximum premium for two enrollees shall be twice the
maximum premium for one, and the maximum premium for three or more enrollees shall
be three times the maximum premium for one.
new text end

Sec. 77.

Minnesota Statutes 2008, section 256L.15, is amended by adding a subdivision
to read:


new text begin Subd. 3a. new text end

new text begin Exceptions to sliding scale. new text end

new text begin Effective July 1, 2011, or upon federal
approval, whichever is later, children ages 19 and 20 enrolled under section 256L.04,
subdivision 1, paragraph (a), in families with income at or below 150 percent of the
federal poverty guidelines pay a monthly premium of $4.
new text end

Sec. 78.

Minnesota Statutes 2008, section 256L.17, is amended by adding a subdivision
to read:


new text begin Subd. 8. new text end

new text begin Expiration. new text end

new text begin This section expires July 1, 2010, or upon federal approval,
whichever is later.
new text end

Sec. 79.

Minnesota Statutes 2008, section 501B.89, is amended by adding a
subdivision to read:


new text begin Subd. 4. new text end

new text begin Annual filing requirement for supplemental needs trusts. new text end

new text begin (a) A trustee
of a trust under subdivision 3 and United States Code, title 42, section 1396p(d)(4)(A) or
(C), shall submit to the commissioner of human services, at the time of a beneficiary's
request for medical assistance, the following information about the trust:
new text end

new text begin (1) a copy of the trust instrument; and
new text end

new text begin (2) an inventory of the beneficiary's trust account assets and the value of those assets.
new text end

new text begin (b) A trustee of a trust under subdivision 3 and United States Code, title 42, section
1396p(d)(4)(A) or (C), shall submit an accounting of the beneficiary's trust account to the
commissioner of human services at least annually until the trust, or the beneficiary's
interest in the trust, terminates. Accountings are due on the anniversary of the execution
date of the trust unless another annual date is established by the terms of the trust. The
accounting must include the following information for the accounting period:
new text end

new text begin (1) an inventory of trust assets and the value of those assets at the beginning of the
accounting period;
new text end

new text begin (2) additions to the trust during the accounting period and the source of those
additions;
new text end

new text begin (3) itemized distributions from the trust during the accounting period, including the
purpose of the distributions and to whom the distributions were made;
new text end

new text begin (4) an inventory of trust assets and the value of those assets at the end of the
accounting period; and
new text end

new text begin (5) changes to the trust instrument during the accounting period.
new text end

new text begin (c) For the purpose of paragraph (b), an accounting period is 12 months unless an
accounting period of a different length is permitted by the commissioner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for applications for medical
assistance and renewals of medical assistance submitted on or after July 1, 2009.
new text end

Sec. 80.

Minnesota Statutes 2008, section 519.05, is amended to read:


519.05 LIABILITY OF HUSBAND AND WIFE.

(a) A spouse is not liable to a creditor for any debts of the other spouse. Where
husband and wife are living together, they shall be jointly and severally liable for
necessary medical services that have been furnished to either spouse,new text begin including any claims
arising under section 246.53, 256B.15, 256D.16, or 261.04,
new text end and necessary household
articles and supplies furnished to and used by the family. Notwithstanding this paragraph,
in a proceeding under chapter 518 the court may apportion such debt between the spouses.

(b) Either spouse may close a credit card account or other unsecured consumer line
of credit on which both spouses are contractually liable, by giving written notice to the
creditor.

Sec. 81.

Laws 2005, First Special Session chapter 4, article 8, section 66, the effective
date, is amended to read:


EFFECTIVE DATE.

deleted text beginParagraph (a) is effective August 1, 2007, or upon
HealthMatch implementation, whichever is later, and
deleted text end Paragraph (e) is effective September
1, 2006.

Sec. 82.

Laws 2008, chapter 358, article 3, section 8, the effective date, is amended to
read:


EFFECTIVE DATE.

This section is effective January 1, 2009deleted text begin, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained
deleted text end.

Sec. 83. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2008, sections 256.962, subdivisions 1, 2, 5, and 7; 256B.76,
subdivision 4; 256L.07, subdivision 1; 256L.09, subdivision 2; 256L.11, subdivision 7;
and 256L.15, subdivisions 2 and 3,
new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2008, sections 256B.057, subdivision 2c; and 256L.07,
subdivision 7,
new text end new text begin are repealed effective July 1, 2009, or upon federal approval, whichever is
later. The commissioner of human services shall notify the revisor when federal approval
is obtained.
new text end

new text begin (c) new text end new text begin Minnesota Statutes 2008, section 256.969, subdivisions 26 and 27, new text end new text begin are repealed
effective July 1, 2009.
new text end

new text begin (d) new text end new text begin Minnesota Statutes 2008, sections 256L.04, subdivisions 7 and 9; 256L.05,
subdivision 1b; 256L.07, subdivision 6; 256L.09, subdivisions 4, 5, and 6; and 256L.15,
subdivision 4,
new text end new text begin are repealed effective January 1, 2010.
new text end

new text begin (e) new text end new text begin Laws 2005, chapter 10, article 1, sections 56; and 57; Laws 2005, First Special
Session chapter 4, article 8, sections 67; 69; 74; and 75; Laws 2007, chapter 147, article 5,
sections 28; and 33; and Laws 2008, chapter 358, article 3, sections 10; 11; and 14,
new text end new text begin are
repealed.
new text end

new text begin (f) new text end new text begin Laws 2005, First Special Session chapter 4, article 8, section 61, the effective
date; Laws 2007, chapter 147, article 13, section 2, the effective date; Laws 2007, chapter
147, article 5, section 32, the effective date; and Laws 2008, chapter 358, article 3,
sections 8, the effective date; and 9, the effective date,
new text end new text begin are repealed.
new text end

ARTICLE 10

STATE-OPERATED SERVICES COST OF CARE

Section 1.

Minnesota Statutes 2008, section 246.50, subdivision 5, is amended to read:


Subd. 5.

Cost of care.

"Cost of care" means the commissioner's charge for services
provided to any person admitted to a state facility.

For purposes of this subdivision, "charge for services" means the deleted text begincost of services,
treatment, maintenance, bonds issued for capital improvements, depreciation of buildings
and equipment, and indirect costs related to the operation of state facilities. The
commissioner may determine the charge for services on an anticipated average per diem
basis as an all inclusive charge per facility, per disability group, or per treatment program.
The commissioner may determine a charge per service, using a method that includes direct
and indirect costs.
deleted text endnew text begin usual and customary fee charged for services provided to clients. The
usual and customary fee shall be established in a manner required to appropriately bill
services to all payers and shall include the costs related to the operations of any program
offered by the state.
new text end

Sec. 2.

Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision
to read:


new text begin Subd. 10. new text end

new text begin State-operated community-based program. new text end

new text begin "State-operated
community-based program" means any program operated in the community including
community behavioral health hospitals, crisis centers, residential facilities, outpatient
services, and other community-based services developed and operated by the state and
under the commissioner's control.
new text end

Sec. 3.

Minnesota Statutes 2008, section 246.50, is amended by adding a subdivision
to read:


new text begin Subd. 11. new text end

new text begin Health plan company. new text end

new text begin "Health plan company" has the meaning given it
in section 62Q.01, subdivision 4, and also includes a demonstration provider as defined in
section 256B.69, subdivision 2, paragraph (b), a county or group of counties participating
in county-based purchasing according to section 256B.692, and a children's mental health
collaborative under contract to provide medical assistance for individuals enrolled in
the prepaid medical assistance and MinnesotaCare programs under sections 245.493 to
245.495.
new text end

Sec. 4.

Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision
to read:


new text begin Subd. 1a. new text end

new text begin Clients in state-operated community-based programs; determination.
new text end

new text begin For clients admitted to a state-operated community-based program, the commissioner shall
make an investigation to determine the available health plan coverage for services being
provided. If the health plan coverage requires a co-pay or deductible, or if there is no
available health plan coverage, the commission shall make an investigation as necessary
to determine, and as circumstances require redetermine, what part of the noncovered
cost of care, if any, the client is able to pay. If the client is unable to pay the uncovered
cost of care, the commissioner shall make a determination as to the ability of the client's
relatives to pay. The client and relatives shall provide the commissioner documents and
proof necessary to determine their ability to pay. Failure to provide the commissioner with
sufficient information to determine ability to pay may make the client or relatives liable
for the full cost of care until the time when sufficient information is provided. If it is
determined that the responsible party does not have the ability to pay, the commissioner
shall waive payment of the portion that exceeds ability to pay under the determination.
new text end

Sec. 5.

Minnesota Statutes 2008, section 246.51, is amended by adding a subdivision
to read:


new text begin Subd. 1b. new text end

new text begin Clients served by regional treatment centers or nursing homes;
determination.
new text end

new text begin For clients served in regional treatment centers or nursing homes operated
by state-operated services, the commissioner shall make investigation as necessary to
determine, and as circumstances require redetermine, what part of the cost of care, if any,
the client is able to pay. If the client is unable to pay the full cost of care, the commissioner
shall determine whether the client's relatives have the ability to pay. The client and
relatives shall provide the commissioner documents and proof necessary to determine their
ability to pay. Failure to provide the commissioner with sufficient information to determine
ability to pay may make the client or relatives liable for the full cost of care until the time
when sufficient information is provided. No parent shall be liable for the cost of care given
a client at a regional treatment center after the client has reached the age of 18 years.
new text end

Sec. 6.

Minnesota Statutes 2008, section 246.511, is amended to read:


246.511 RELATIVE RESPONSIBILITY.

Except for chemical dependency services paid for with funds provided under chapter
254B, a client's relatives shall not, pursuant to the commissioner's authority under section
246.51, be ordered to pay more than deleted text beginten percent of the cost ofdeleted text end new text beginthe following: (1) for
services provided in a community-based service, the noncovered cost of care as determined
under the ability to pay determination; and (2) for services provided at a regional treatment
center operated by state-operated services, 20 percent of the cost of
new text endcare, unless they
reside outside the state. Parents of children in state facilities shall have their responsibility
to pay determined according to section 252.27, subdivision 2, or in rules adopted under
chapter 254B if the cost of care is paid under chapter 254B. The commissioner may
accept voluntary payments in excess of deleted text begintendeleted text endnew text begin 20new text end percent. The commissioner may require
full payment of the full per capita cost of care in state facilities for clients whose parent,
parents, spouse, guardian, or conservator do not reside in Minnesota.

Sec. 7.

Minnesota Statutes 2008, section 246.52, is amended to read:


246.52 PAYMENT FOR CARE; ORDER; ACTION.

The commissioner shall issue an order to the client or the guardian of the estate, if
there be one, and relatives determined able to pay requiring them to pay deleted text beginmonthlydeleted text end to the
state of Minnesota the amounts so determined the total of which shall not exceed the full
cost of care. Such order shall specifically state the commissioner's determination and shall
be conclusive unless appealed from as herein provided. When a client or relative fails to
pay the amount due hereunder the attorney general, upon request of the commissioner,
may institute, or direct the appropriate county attorney to institute, civil action to recover
such amount.

Sec. 8.

Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision
to read:


new text begin Subd. 1a. new text end

new text begin Client. new text end

new text begin "Client" means a person who is admitted to the Minnesota sex
offender program or subject to a court hold order under section 253B.185 for the purpose
of assessment, diagnosis, care, treatment, supervision, or other services provided by the
Minnesota sex offender program.
new text end

Sec. 9.

Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision
to read:


new text begin Subd. 1b. new text end

new text begin Client's county. new text end

new text begin "Client's county" means the county of the client's
legal settlement for poor relief purposes at the time of commitment. If the client has no
legal settlement for poor relief in this state, it means the county of commitment, except
that when a client with no legal settlement for poor relief is committed while serving a
sentence at a penal institution, it means the county from which the client was sentenced.
new text end

Sec. 10.

Minnesota Statutes 2008, section 246B.01, is amended by adding a
subdivision to read:


new text begin Subd. 2a. new text end

new text begin Cost of care. new text end

new text begin "Cost of care" means the commissioner's charge for housing
and treatment services provided to any person admitted to the Minnesota sex offender
program.
new text end

new text begin For purposes of this subdivision, "charge for housing and treatment services" means
the cost of services, treatment, maintenance, bonds issued for capital improvements,
depreciation of buildings and equipment, and indirect costs related to the operation of
state facilities. The commissioner may determine the charge for services on an anticipated
average per diem basis as an all-inclusive charge per facility.
new text end

Sec. 11.

Minnesota Statutes 2008, section 246B.01, is amended by adding a subdivision
to read:


new text begin Subd. 2b. new text end

new text begin Local social services agency. new text end

new text begin "Local social services agency" means the
local social services agency of the client's county as defined in subdivision 1b and of the
county of commitment, and any other local social services agency possessing information
regarding, or requested by the commissioner to investigate, the financial circumstances
of a client.
new text end

Sec. 12.

new text begin [246B.07] PAYMENT FOR CARE AND TREATMENT:
DETERMINATION.
new text end

new text begin Subdivision 1. new text end

new text begin Procedures. new text end

new text begin The commissioner shall make investigation as
necessary to determine, and as circumstances require redetermine, what part of the cost of
care, if any, the client is able to pay. The client shall provide the commissioner documents
and proof necessary to determine the ability to pay. Failure to provide the commissioner
with sufficient information to determine ability to pay may make the client liable for the
full cost of care until the time when sufficient information is provided.
new text end

new text begin Subd. 2. new text end

new text begin Rules. new text end

new text begin The commissioner shall adopt, pursuant to the Administrative
Procedure Act, rules establishing uniform standards for determination of client liability
for care provided by the Minnesota sex offender program. These rules shall have the
force and effect of law.
new text end

new text begin Subd. 3. new text end

new text begin Applicability. new text end

new text begin The commissioner may recover, under sections 246B.07 to
246B.10, the cost of any care provided by the Minnesota sex offender program.
new text end

Sec. 13.

new text begin [246B.08] PAYMENT FOR CARE; ORDER; ACTION.
new text end

new text begin The commissioner shall issue an order to the client or the guardian of the estate, if
there is one, requiring them to pay to the state the amounts so determined, the total of which
shall not exceed the full cost of care. The order shall specifically state the commissioner's
determination and must be conclusive, unless appealed. When a client fails to pay the
amount due, the attorney general, upon request of the commissioner, may institute, or
direct the appropriate county attorney to institute, civil action to recover the amount.
new text end

Sec. 14.

new text begin [246B.09] CLAIM AGAINST ESTATE OF DECEASED CLIENT.
new text end

new text begin Subdivision 1. new text end

new text begin Client's estate. new text end

new text begin Upon the death of a client, or a former client, the
total cost of care given the client, less the amount actually paid toward the cost of care by
the client, shall be filed by the commissioner as a claim against the estate of the client
with the court having jurisdiction to probate the estate and all proceeds collected by the
state in the case shall be divided between the state and county in proportion to the cost
of care each has borne.
new text end

new text begin Subd. 2. new text end

new text begin Preferred status. new text end

new text begin An estate claim in subdivision 1 shall be considered an
expense of the last illness for purposes of section 524.3-805.
new text end

new text begin If the commissioner of human services determines that the property or estate of a
client is not more than needed to care for and maintain the spouse and minor or dependent
children of a deceased client, the commissioner has the power to compromise the claim of
the state in a manner deemed just and proper.
new text end

new text begin Subd. 3. new text end

new text begin Exception from statute of limitations. new text end

new text begin Any statute of limitations that
limits the commissioner in recovering the cost of care obligation incurred by a client or
former client must not apply to any claim against an estate made under this section to
recover cost of care.
new text end

Sec. 15.

new text begin [246B.10] LIABILITY OF COUNTY; REIMBURSEMENT.
new text end

new text begin The client's county shall pay to the state a portion of the cost of care provided in
the Minnesota sex offender program to a client legally settled in that county. A county's
payment shall be made from the county's own sources of revenue and payments shall
equal ten percent of the cost of care, as determined by the commissioner, for each day or
portion of a day, that the client spends at the facility. If payments received by the state
under sections 246.50 to 246.53 exceed 90 percent of the cost of care, the county shall
be responsible for paying the state only the remaining amount. The county shall not be
entitled to reimbursement from the client, the client's estate, or from the client's relatives,
except as provided in section 246B.07.
new text end

Sec. 16. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2008, sections 246.51, subdivision 1; and 246.53, subdivision
3,
new text end new text begin are repealed.
new text end

ARTICLE 11

DEPARTMENT OF HEALTH

Section 1.

Minnesota Statutes 2008, section 103I.208, subdivision 2, is amended to
read:


Subd. 2.

Permit fee.

The permit fee to be paid by a property owner is:

(1) for a water supply well that is not in use under a maintenance permit, $175
annually;

(2) for construction of a monitoring well, $215, which includes the state core
function fee;

(3) for a monitoring well that is unsealed under a maintenance permit, $175 annually;

(4) new text beginfor a monitoring well owned by a federal agency, state agency, or local unit of
government that is unsealed under a maintenance permit, $50 annually. "Local unit of
government" means a statutory or home rule charter city, town, county, or soil and water
conservation district, watershed district, and organization formed for the joint exercise
of powers under section 471.59, a board of health or community health board, or other
special purpose district or authority with local jurisdiction in water and related land
resources management;
new text end

new text begin (5) new text endfor monitoring wells used as a leak detection device at a single motor fuel retail
outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural
chemical facility site, the construction permit fee is $215, which includes the state core
function fee, per site regardless of the number of wells constructed on the site, and
the annual fee for a maintenance permit for unsealed monitoring wells is $175 per site
regardless of the number of monitoring wells located on site;

deleted text begin (5)deleted text endnew text begin (6)new text end for a groundwater thermal exchange device, in addition to the notification fee
for water supply wells, $215, which includes the state core function fee;

deleted text begin (6)deleted text endnew text begin (7)new text end for a vertical heat exchangernew text begin with less than ten tons of heating/cooling
capacity
new text end, $215;

new text begin (8) for a vertical heat exchanger with ten to 50 tons of heating/cooling capacity, $425;
new text end

new text begin (9) for a vertical heat exchanger with greater than 50 tons of heating/cooling
capacity, $650;
new text end

deleted text begin (7)deleted text endnew text begin (10)new text end for a dewatering well that is unsealed under a maintenance permit, $175
annually for each dewatering well, except a dewatering project comprising more than five
dewatering wells shall be issued a single permit for $875 annually for dewatering wells
recorded on the permit; and

deleted text begin (8)deleted text endnew text begin (11)new text end for an elevator boring, $215 for each boring.

Sec. 2.

Minnesota Statutes 2008, section 144.121, subdivision 1a, is amended to read:


Subd. 1a.

Fees for ionizing radiation-producing equipment.

new text begin(a) new text endA facility with
ionizing radiation-producing equipment must pay an annual initial or annual renewal
registration fee consisting of a base facility fee of deleted text begin$66deleted text endnew text begin $100new text end and an additional fee for
each radiation source, as follows:

(1)
medical or veterinary equipment
$
deleted text begin 53 deleted text end new text begin 100
new text end
(2)
dental x-ray equipment
$
deleted text begin 33 deleted text end new text begin 40
new text end
deleted text begin (3)
deleted text end
deleted text begin accelerator
deleted text end
deleted text begin $
deleted text end
deleted text begin 66
deleted text end
deleted text begin (4)
deleted text end
deleted text begin radiation therapy equipment
deleted text end
deleted text begin $
deleted text end
deleted text begin 66
deleted text end
deleted text begin (5) deleted text end new text begin (3)
new text end
x-ray equipment not used on
humans or animals
$
deleted text begin 53 deleted text end new text begin 100
new text end
deleted text begin (6) deleted text end new text begin (4)
new text end
devices with sources of ionizing
radiation not used on humans or
animals
$
deleted text begin 53 deleted text end new text begin 100
new text end

new text begin (b) A facility with radiation therapy and accelerator equipment must pay an annual
registration fee of $500. A facility with an industrial accelerator must pay an annual
registration fee of $150.
new text end

new text begin (c) Electron microscopy equipment is exempt from the registration fee requirements
of this section.
new text end

Sec. 3.

Minnesota Statutes 2008, section 144.121, subdivision 1b, is amended to read:


Subd. 1b.

Penalty fee for late registration.

Applications for initial or renewal
registrations submitted to the commissioner after the time specified by the commissioner
shall be accompanied by deleted text begina penalty fee of $20deleted text endnew text begin an amount equal to 25 percent of the fee
due
new text end in addition to the fees prescribed in subdivision 1a.

Sec. 4.

Minnesota Statutes 2008, section 144.122, is amended to read:


144.122 LICENSE, PERMIT, AND SURVEY FEES.

(a) The state commissioner of health, by rule, may prescribe procedures and fees
for filing with the commissioner as prescribed by statute and for the issuance of original
and renewal permits, licenses, registrations, and certifications issued under authority of
the commissioner. The expiration dates of the various licenses, permits, registrations,
and certifications as prescribed by the rules shall be plainly marked thereon. Fees may
include application and examination fees and a penalty fee for renewal applications
submitted after the expiration date of the previously issued permit, license, registration,
and certification. The commissioner may also prescribe, by rule, reduced fees for permits,
licenses, registrations, and certifications when the application therefor is submitted
during the last three months of the permit, license, registration, or certification period.
Fees proposed to be prescribed in the rules shall be first approved by the Department of
Finance. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
in an amount so that the total fees collected by the commissioner will, where practical,
approximate the cost to the commissioner in administering the program. All fees collected
shall be deposited in the state treasury and credited to the state government special revenue
fund unless otherwise specifically appropriated by law for specific purposes.

(b) The commissioner may charge a fee for voluntary certification of medical
laboratories and environmental laboratories, and for environmental and medical laboratory
services provided by the department, without complying with paragraph (a) or chapter 14.
Fees charged for environment and medical laboratory services provided by the department
must be approximately equal to the costs of providing the services.

(c) The commissioner may develop a schedule of fees for diagnostic evaluations
conducted at clinics held by the services for children with disabilities program. All
receipts generated by the program are annually appropriated to the commissioner for use
in the maternal and child health program.

(d) The commissioner shall set license fees for hospitals and nursing homes that are
not boarding care homes at the following levels:

Joint Commission on Accreditation of
Healthcare Organizations (JCAHO) and
American Osteopathic Association (AOA)
hospitals
deleted text begin$7,555deleted text endnew text begin$7,655new text end plus deleted text begin$13deleted text endnew text begin$16new text end per bed
Non-JCAHO and non-AOA hospitals
deleted text begin $5,180deleted text endnew text begin$5,280new text end plus deleted text begin$247deleted text endnew text begin$250new text end per bed
Nursing home
$183 plus $91 per bed

The commissioner shall set license fees for outpatient surgical centers, boarding care
homes, and supervised living facilities at the following levels:

Outpatient surgical centers
deleted text begin $3,349 deleted text end new text begin $3,712
new text end
Boarding care homes
$183 plus $91 per bed
Supervised living facilities
$183 plus $91 per bed.

(e) Unless prohibited by federal law, the commissioner of health shall charge
applicants the following fees to cover the cost of any initial certification surveys required
to determine a provider's eligibility to participate in the Medicare or Medicaid program:

Prospective payment surveys for hospitals
$
900
Swing bed surveys for nursing homes
$
1,200
Psychiatric hospitals
$
1,400
Rural health facilities
$
1,100
Portable x-ray providers
$
500
Home health agencies
$
1,800
Outpatient therapy agencies
$
800
End stage renal dialysis providers
$
2,100
Independent therapists
$
800
Comprehensive rehabilitation outpatient facilities
$
1,200
Hospice providers
$
1,700
Ambulatory surgical providers
$
1,800
Hospitals
$
4,200
Other provider categories or additional
resurveys required to complete initial
certification
Actual surveyor costs: average
surveyor cost x number of hours
for the survey process.

These fees shall be submitted at the time of the application for federal certification
and shall not be refunded. All fees collected after the date that the imposition of fees is not
prohibited by federal law shall be deposited in the state treasury and credited to the state
government special revenue fund.

Sec. 5.

Minnesota Statutes 2008, section 144.1222, subdivision 1a, is amended to read:


Subd. 1a.

Fees.

All plans and specifications for public pool and spa construction,
installation, or alteration or requests for a variance that are submitted to the commissioner
according to Minnesota Rules, part 4717.3975, shall be accompanied by the appropriate
fees. All public pool construction plans submitted for review after January 1, 2009,
must be certified by a professional engineer registered in the state of Minnesota. If the
commissioner determines, upon review of the plans, that inadequate fees were paid, the
necessary additional fees shall be paid before plan approval. For purposes of determining
fees, a project is defined as a proposal to construct or install a public pool, spa, special
purpose pool, or wading pool and all associated water treatment equipment and drains,
gutters, decks, water recreation features, spray pads, and those design and safety features
that are within five feet of any pool or spa. The commissioner shall charge the following
fees for plan review and inspection of public pools and spas and for requests for variance
from the public pool and spa rules:

(1) each pool, deleted text begin$800deleted text endnew text begin $1,500new text end;

(2) each spa pool, deleted text begin$500deleted text endnew text begin $800new text end;

(3) each slide, deleted text begin$400deleted text endnew text begin $600new text end;

(4) projects valued at $250,000 or more, the greater of the sum of the fees in clauses
(1), (2), and (3) or 0.5 percent of the documented estimated project cost to a maximum
fee of deleted text begin$10,000deleted text endnew text begin $15,000new text end;

(5) alterations to an existing pool without changing the size or configuration of
the pool, deleted text begin$400deleted text endnew text begin $600new text end;

(6) removal or replacement of pool disinfection equipment only, deleted text begin$75deleted text endnew text begin $100new text end; and

(7) request for variance from the public pool and spa rules, $500.

Sec. 6.

Minnesota Statutes 2008, section 144.226, subdivision 4, is amended to read:


Subd. 4.

Vital records surcharge.

(a) In addition to any fee prescribed under
subdivision 1, there is a nonrefundable surcharge of $2 for each certified and noncertified
birth, stillbirth, or death record, and for a certification that the record cannot be found.
The local or state registrar shall forward this amount to the commissioner of finance to
be deposited into the state government special revenue fund. This surcharge shall not be
charged under those circumstances in which no fee for a birth, stillbirth, or death record is
permitted under subdivision 1, paragraph (a).

(b) Effective August 1, 2005, deleted text beginto June 30, 2009,deleted text end the surcharge in paragraph (a) deleted text beginshall
be
deleted text endnew text begin isnew text end $4.

Sec. 7.

Minnesota Statutes 2008, section 144.72, subdivision 1, is amended to read:


Subdivision 1.

deleted text beginPermitsdeleted text endnew text begin License requirednew text end.

The state commissioner of health is
authorized to issue deleted text beginpermits for the operation of youth camps which are required to obtain
the permits
deleted text endnew text begin a license according to chapter 157new text end.

Sec. 8.

Minnesota Statutes 2008, section 144.72, subdivision 3, is amended to read:


Subd. 3.

Issuance of deleted text beginpermitsdeleted text endnew text begin licensenew text end.

If the commissioner should determine from
the application that the health and safety of the persons using the camp will be properly
safeguarded, the commissioner may, prior to actual inspection of the camp, issue the
deleted text begin permitdeleted text endnew text begin licensenew text end in writing. deleted text beginNo fee shall be charged for the permit.deleted text end The deleted text beginpermitdeleted text endnew text begin licensenew text end shall
be posted in a conspicuous place on the premises occupied by the camp.

Sec. 9.

Minnesota Statutes 2008, section 144.9501, is amended by adding a subdivision
to read:


new text begin Subd. 8a. new text end

new text begin Disclosure pamphlet. new text end

new text begin "Disclosure pamphlet" means the EPA pamphlet
titled "Renovate Right: Important Lead Hazard Information for Families, Child Care
Providers and Schools" developed under section 406(a) of the Toxic Substance Control
Act.
new text end

Sec. 10.

Minnesota Statutes 2008, section 144.9501, subdivision 22b, is amended to
read:


Subd. 22b.

Lead sampling technician.

"Lead sampling technician" means an
individual who performs clearance inspections for deleted text beginnonabatement or nonorder lead hazard
reduction
deleted text endnew text begin renovationnew text end sitesdeleted text begin,deleted text endnew text begin andnew text end lead dust sampling deleted text beginin other settings, or visual assessment
for deteriorated paint
deleted text endnew text begin for nonabatement sitesnew text end, and who is registered with the commissioner
under section 144.9505.

Sec. 11.

Minnesota Statutes 2008, section 144.9501, subdivision 26a, is amended to
read:


Subd. 26a.

Regulated lead work.

(a) "Regulated lead work" means:

(1) abatement;

(2) interim controls;

(3) a clearance inspection;

(4) a lead hazard screen;

(5) a lead inspection;

(6) a lead risk assessment;

(7) lead project designer services;

(8) lead sampling technician services; deleted text beginor
deleted text end

(9) swab team servicesdeleted text begin.deleted text endnew text begin;
new text end

new text begin (10) renovation activities; or
new text end

new text begin (11) activities performed to comply with lead orders issued by a board of health.
new text end

(b) Regulated lead work does not includenew text begin abatement, interim controls, swab team
services, or renovation activities that disturb painted surfaces that total no more than
new text end:

deleted text begin (1) activities such as remodeling, renovation, installation, rehabilitation, or
landscaping activities, the primary intent of which is to remodel, repair, or restore a
structure or dwelling, rather than to permanently eliminate lead hazards, even though these
activities may incidentally result in a reduction in lead hazards; or
deleted text end

deleted text begin (2) interim control activities that are not performed as a result of a lead order and
that do not disturb painted surfaces that total more than:
deleted text end

deleted text begin (i)deleted text endnew text begin (1)new text end 20 square feet (two square meters) on exterior surfaces;new text begin or
new text end

deleted text begin (ii)deleted text endnew text begin (2)new text end deleted text begintwodeleted text endnew text begin sixnew text end square feet (deleted text begin0.2deleted text endnew text begin 0.6new text end square meters) in an interior roomdeleted text begin; ordeleted text endnew text begin.
new text end

deleted text begin (iii) ten percent of the total surface area on an interior or exterior type of component
with a small surface area.
deleted text end

Sec. 12.

Minnesota Statutes 2008, section 144.9501, is amended by adding a
subdivision to read:


new text begin Subd. 26b. new text end

new text begin Renovation. new text end

new text begin "Renovation" means the modification of any affected
property that results in the disturbance of painted surfaces, unless that activity is performed
as an abatement. A renovation performed for the purpose of converting a building or part
of a building into an affected property is a renovation under this subdivision.
new text end

Sec. 13.

Minnesota Statutes 2008, section 144.9505, subdivision 1g, is amended to
read:


Subd. 1g.

Certified lead firm.

deleted text beginA person within the state intending to directly
perform or cause to be performed through subcontracting or similar delegation any
regulated lead work shall first obtain certification from the commissioner
deleted text endnew text begin A person who
employs individuals to perform regulated lead work outside of the person's property must
obtain certification as a lead firm
new text end. The certificate must be in writing, contain an expiration
date, be signed by the commissioner, and give the name and address of the person to
whom it is issued. The certification fee is $100, is nonrefundable, and must be submitted
with each application. The certificate or a copy of the certificate must be readily available
at the worksite for review by the contracting entity, the commissioner, and other public
health officials charged with the health, safety, and welfare of the state's citizens.

Sec. 14.

Minnesota Statutes 2008, section 144.9505, subdivision 4, is amended to read:


Subd. 4.

Notice of regulated lead work.

(a) At least five working days before
starting work at each regulated lead worksite, the person performing the regulated lead
work shall give written notice to the commissioner and the appropriate board of health.

(b) This provision does not apply to lead hazard screen, lead inspection, lead risk
assessment, lead sampling technician,new text begin renovation,new text end or lead project design activities.

Sec. 15.

Minnesota Statutes 2008, section 144.9508, subdivision 2, is amended to read:


Subd. 2.

Regulated lead work standards and methods.

(a) The commissioner
shall adopt rules establishing regulated lead work standards and methods in accordance
with the provisions of this section, for lead in paint, dust, drinking water, and soil in
a manner that protects public health and the environment for all residences, including
residences also used for a commercial purpose, child care facilities, playgrounds, and
schools.

(b) In the rules required by this section, the commissioner shall require lead hazard
reduction of intact paint only if the commissioner finds that the intact paint is on a
chewable or lead-dust producing surface that is a known source of actual lead exposure to
a specific individual. The commissioner shall prohibit methods that disperse lead dust into
the air that could accumulate to a level that would exceed the lead dust standard specified
under this section. The commissioner shall work cooperatively with the commissioner
of administration to determine which lead hazard reduction methods adopted under this
section may be used for lead-safe practices including prohibited practices, preparation,
disposal, and cleanup. The commissioner shall work cooperatively with the commissioner
of the Pollution Control Agency to develop disposal procedures. In adopting rules under
this section, the commissioner shall require the best available technology for regulated
lead work methods, paint stabilization, and repainting.

(c) The commissioner of health shall adopt regulated lead work standards and
methods for lead in bare soil in a manner to protect public health and the environment.
The commissioner shall adopt a maximum standard of 100 parts of lead per million in
bare soil. The commissioner shall set a soil replacement standard not to exceed 25 parts
of lead per million. Soil lead hazard reduction methods shall focus on erosion control
and covering of bare soil.

(d) The commissioner shall adopt regulated lead work standards and methods for
lead in dust in a manner to protect the public health and environment. Dust standards
shall use a weight of lead per area measure and include dust on the floor, on the window
sills, and on window wells. Lead hazard reduction methods for dust shall focus on dust
removal and other practices which minimize the formation of lead dust from paint, soil, or
other sources.

(e) The commissioner shall adopt lead hazard reduction standards and methods for
lead in drinking water both at the tap and public water supply system or private well
in a manner to protect the public health and the environment. The commissioner may
adopt the rules for controlling lead in drinking water as contained in Code of Federal
Regulations, title 40, part 141. Drinking water lead hazard reduction methods may include
an educational approach of minimizing lead exposure from lead in drinking water.

(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that
removal of exterior lead-based coatings from residences and steel structures by abrasive
blasting methods is conducted in a manner that protects health and the environment.

(g) All regulated lead work standards shall provide reasonable margins of safety that
are consistent with more than a summary review of scientific evidence and an emphasis on
overprotection rather than underprotection when the scientific evidence is ambiguous.

(h) No unit of local government shall have an ordinance or regulation governing
regulated lead work standards or methods for lead in paint, dust, drinking water, or soil
that require a different regulated lead work standard or method than the standards or
methods established under this section.

(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit
of local government of an innovative lead hazard reduction method which is consistent
in approach with methods established under this section.

(j) The commissioner shall adopt rules for issuing lead orders required under section
144.9504, rules for notification of abatement or interim control activities requirements,
and other rules necessary to implement sections 144.9501 to 144.9512.

new text begin (k) The commissioners shall adopt rules consistent with section 402(c)(3) of the
Toxic Substances Control Act to ensure that renovation is a pre-1978 affected property
where a child or pregnant female resides is conducted in a manner that protects health
and the environment.
new text end

new text begin (l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b) of
the Toxic Substances Control Act.
new text end

Sec. 16.

Minnesota Statutes 2008, section 144.9508, subdivision 3, is amended to read:


Subd. 3.

Licensure and certification.

The commissioner shall adopt rules to
license lead supervisors, lead workers, lead project designers, lead inspectors, deleted text beginanddeleted text end lead
risk assessorsnew text begin, and lead sampling techniciansnew text end. The commissioner shall also adopt rules
requiring certification of firms that perform regulated lead work deleted text beginand rules requiring
registration of lead sampling technicians
deleted text end. The commissioner shall require periodic renewal
of licensesdeleted text begin,deleted text endnew text begin andnew text end certificatesdeleted text begin, and registrationsdeleted text end and shall establish the renewal periods.

Sec. 17.

Minnesota Statutes 2008, section 144.9508, subdivision 4, is amended to read:


Subd. 4.

Lead training course.

The commissioner shall establish by rule
requirements for training course providers and the renewal period for each lead-related
training course required for certification or licensure. The commissioner shall establish
criteria in rules for the content and presentation of training courses intended to qualify
trainees for licensure under subdivision 3. The commissioner shall establish criteria
in rules for the content and presentation of training courses for lead deleted text begininterim control
workers
deleted text endnew text begin renovation and lead sampling techniciansnew text end. Training course permit fees shall be
nonrefundable and must be submitted with each application in the amount of $500 for an
initial training course, $250 for renewal of a permit for an initial training course, $250 for
a refresher training course, and $125 for renewal of a permit of a refresher training course.

Sec. 18.

Minnesota Statutes 2008, section 144.97, subdivision 2, is amended to read:


Subd. 2.

deleted text beginCertificationdeleted text endnew text begin Accreditationnew text end.

deleted text begin"Certification" means written
acknowledgment of a laboratory's demonstrated capability to perform tests for a specific
purpose
deleted text endnew text begin "Accreditation" means written acknowledgment that a laboratory has the
policies, procedures, equipment, and practices to produce reliable data in the analysis of
environmental samples
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 19.

Minnesota Statutes 2008, section 144.97, subdivision 4, is amended to read:


Subd. 4.

deleted text beginContractdeleted text end new text beginCommercial new text endlaboratory.

"deleted text beginContractdeleted text endnew text begin Commercialnew text end laboratory"
means a laboratory that performs tests on samples on a contract or fee-for-service basis.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 20.

Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision
to read:


new text begin Subd. 5a. new text end

new text begin Field of testing. new text end

new text begin "Field of testing" means the combination of analyte,
method, matrix, and test category for which a laboratory may hold accreditation.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 21.

Minnesota Statutes 2008, section 144.97, subdivision 6, is amended to read:


Subd. 6.

Laboratory.

"Laboratory" means the state, a person, corporation, or other
entity, including governmental, that examines, analyzes, or tests samplesnew text begin in a specified
physical location
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 22.

Minnesota Statutes 2008, section 144.97, is amended by adding a subdivision
to read:


new text begin Subd. 8. new text end

new text begin Test category. new text end

new text begin "Test category" means the combination of program and
category as provided by section 144.98, subdivisions 3, paragraph (b), clauses (1) to (10),
and 3a, paragraph (a), clauses (1) to (5).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 23.

Minnesota Statutes 2008, section 144.98, subdivision 1, is amended to read:


Subdivision 1.

Authorization.

The commissioner of health deleted text beginmay certifydeleted text endnew text begin shall
accredit environmental
new text end laboratories deleted text beginthat test environmental samplesdeleted text endnew text begin according to national
standards developed using a consensus process as established by Circular A-119,
published by the United States Office of Management and Budget
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 24.

Minnesota Statutes 2008, section 144.98, subdivision 2, is amended to read:


Subd. 2.

Rulesnew text begin and standardsnew text end.

The commissioner may adopt rules to deleted text beginimplement
this section, including:
deleted text endnew text begin carry out the commissioner's responsibilities under the national
standards specified in subdivisions 1 and 2a.
new text end

deleted text begin (1) procedures, requirements, and fee adjustments for laboratory certification,
including provisional status and recertification;
deleted text end

deleted text begin (2) standards and fees for certificate approval, suspension, and revocation;
deleted text end

deleted text begin (3) standards for environmental samples;
deleted text end

deleted text begin (4) analysis methods that assure reliable test results;
deleted text end

deleted text begin (5) laboratory quality assurance, including internal quality control, proficiency
testing, and personnel training; and
deleted text end

deleted text begin (6) criteria for recognition of certification programs of other states and the federal
government.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 25.

Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Standards. new text end

new text begin The commissioner shall accredit laboratories according to
the most current environmental laboratory accreditation standards under subdivision 1
and as accepted by the accreditation bodies recognized by the National Environmental
Laboratory Accreditation Program, NELAP, of the NELAC Institute.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 26.

Minnesota Statutes 2008, section 144.98, subdivision 3, is amended to read:


Subd. 3.

new text beginAnnual new text endfees.

(a) An application for deleted text begincertificationdeleted text endnew text begin accreditationnew text end under
subdivision deleted text begin1deleted text endnew text begin 6new text end must be accompanied by the deleted text beginbiennial feedeleted text endnew text begin annual feesnew text end specified in this
subdivision. The deleted text beginfees are fordeleted text endnew text begin annual fees includenew text end:

(1) base deleted text begincertificationdeleted text endnew text begin accreditationnew text end fee, deleted text begin$1,600deleted text endnew text begin $1,500new text end;

(2) sample preparation techniques deleted text beginfeesdeleted text endnew text begin feenew text end, deleted text begin$100deleted text endnew text begin $200new text end per technique; deleted text beginand
deleted text end

(3)new text begin an administrative fee for laboratories located outside this state, $3,750; and
new text end

new text begin (4)new text end test category deleted text begincertificationdeleted text end feesdeleted text begin:deleted text endnew text begin.
new text end

deleted text begin Test Category
deleted text end
deleted text begin Certification
Fee
deleted text end
deleted text begin Clean water program bacteriology
deleted text end
deleted text begin $800
deleted text end
deleted text begin Safe drinking water program bacteriology
deleted text end
deleted text begin $800
deleted text end
deleted text begin Clean water program inorganic chemistry
deleted text end
deleted text begin $800
deleted text end
deleted text begin Safe drinking water program inorganic chemistry
deleted text end
deleted text begin $800
deleted text end
deleted text begin Clean water program chemistry metals
deleted text end
deleted text begin $1,200
deleted text end
deleted text begin Safe drinking water program chemistry metals
deleted text end
deleted text begin $1,200
deleted text end
deleted text begin Resource conservation and recovery program chemistry metals
deleted text end
deleted text begin $1,200
deleted text end
deleted text begin Clean water program volatile organic compounds
deleted text end
deleted text begin $1,500
deleted text end
deleted text begin Safe drinking water program volatile organic compounds
deleted text end
deleted text begin $1,500
deleted text end
deleted text begin Resource conservation and recovery program volatile organic compounds
deleted text end
deleted text begin $1,500
deleted text end
deleted text begin Underground storage tank program volatile organic compounds
deleted text end
deleted text begin $1,500
deleted text end
deleted text begin Clean water program other organic compounds
deleted text end
deleted text begin $1,500
deleted text end
deleted text begin Safe drinking water program other organic compounds
deleted text end
deleted text begin $1,500
deleted text end
deleted text begin Resource conservation and recovery program other organic compounds
deleted text end
deleted text begin $1,500
deleted text end
deleted text begin Clean water program radiochemistry
deleted text end
deleted text begin $2,500
deleted text end
deleted text begin Safe drinking water program radiochemistry
deleted text end
deleted text begin $2,500
deleted text end
deleted text begin Resource conservation and recovery program agricultural contaminants
deleted text end
deleted text begin $2,500
deleted text end
deleted text begin Resource conservation and recovery program emerging contaminants
deleted text end
deleted text begin $2,500
deleted text end

(b) deleted text beginLaboratories located outside of this state that require an on-site inspection shall be
assessed an additional $3,750 fee.
deleted text endnew text begin For the programs in subdivision 3a, the commissioner
may accredit laboratories for fields of testing under the categories listed in clauses (1) to
(10) upon completion of the application requirements provided by subdivision 6 and
receipt of the fees for each category under each program that accreditation is requested.
The categories offered and related fees include:
new text end

new text begin (1) microbiology, $450;
new text end

new text begin (2) inorganics, $450;
new text end

new text begin (3) metals, $1,000;
new text end

new text begin (4) volatile organics, $1,300;
new text end

new text begin (5) other organics, $1,300;
new text end

new text begin (6) radiochemistry, $1,500;
new text end

new text begin (7) emerging contaminants, $1,500;
new text end

new text begin (8) agricultural contaminants, $1,250;
new text end

new text begin (9) toxicity (bioassay), $1,000; and
new text end

new text begin (10) physical characterization, $250.
new text end

(c) The total deleted text beginbiennial certificationdeleted text endnew text begin annualnew text end fee includes the base fee, the sample
preparation techniques fees, the test category feesnew text begin per programnew text end, and, when applicable, deleted text beginthe
on-site inspection fee
deleted text endnew text begin an administrative fee for out-of-state laboratoriesnew text end.

deleted text begin (d) Fees must be set so that the total fees support the laboratory certification program.
Direct costs of the certification service include program administration, inspections, the
agency's general support costs, and attorney general costs attributable to the fee function.
deleted text end

deleted text begin (e) A change fee shall be assessed if a laboratory requests additional analytes
or methods at any time other than when applying for or renewing its certification. The
change fee is equal to the test category certification fee for the analyte.
deleted text end

deleted text begin (f) A variance fee shall be assessed if a laboratory requests and is granted a variance
from a rule adopted under this section. The variance fee is $500 per variance.
deleted text end

deleted text begin (g) Refunds or credits shall not be made for analytes or methods requested but
not approved.
deleted text end

deleted text begin (h) Certification of a laboratory shall not be awarded until all fees are paid.
deleted text end

Sec. 27.

Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
to read:


new text begin Subd. 3a. new text end

new text begin Available programs, categories, and analytes. new text end

new text begin (a) The commissioner
shall accredit laboratories that test samples under the following programs:
new text end

new text begin (1) the clean water program, such as compliance monitoring under the federal Clean
Water Act, and ambient monitoring of surface and ground water, or analysis of biological
tissue;
new text end

new text begin (2) the safe drinking water program, including compliance monitoring under the
federal Safe Drinking Water Act, and the state requirements for monitoring private wells;
new text end

new text begin (3) the resource conservation and recovery program, including federal and state
requirements for monitoring solid and hazardous wastes, biological tissue, leachates, and
ground water monitoring wells not intended as drinking water sources;
new text end

new text begin (4) the underground storage tank program; and
new text end

new text begin (5) the clean air program, including air and emissions testing under the federal Clean
Air Act, and state and federal requirements for vapor intrusion monitoring.
new text end

new text begin (b) The commissioner shall maintain and publish a list of analytes available for
accreditation. The list must be reviewed at least once every six months and the changes
published in the State Register and posted on the program's Web site. The commissioner
shall publish the notification of changes and review comments on the changes no less than
30 days from the date the list is published.
new text end

Sec. 28.

Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
to read:


new text begin Subd. 3b. new text end

new text begin Additional fees. new text end

new text begin (a) Laboratories located outside of this state that require
an on-site assessment more frequent than once every two years must pay an additional
assessed fee of $3,000 per assessment for each additional on-site assessment conducted.
The laboratory must pay the fee within 15 business days of receiving the commissioner's
notification that an on-site assessment is required. The commissioner may conduct
additional on-site assessments to determine a laboratory's continued compliance with
the standards provided in subdivision 2a.
new text end

new text begin (b) A late fee of $200 shall be added to the annual fee for accredited laboratories
submitting renewal applications to the commissioner after November 1.
new text end

new text begin (c) A change fee shall be assessed if a laboratory requests additional fields of testing
at any time other than when initially applying for or renewing its accreditation. A change
fee does not apply for applications to add fields of testing for new analytes in response
to the published notice under subdivision 3a, paragraph (b), if the laboratory holds valid
accreditation for the changed test category and applies for additional analytes within the
same test category. The change fee is equal to the applicable test category fee for the
field of testing requested. An application that requests accreditation of multiple fields of
testing within a test category requires a single payment of the applicable test category fee
per application submitted.
new text end

new text begin (d) A variance fee shall be assessed if a laboratory requests a variance from a
standard provided in subdivision 2a. The variance fee is $500 per variance.
new text end

new text begin (e) The commissioner shall assess a fee for changes to laboratory information
regarding ownership, name, address, or personnel. Laboratories must submit changes
through the application process under subdivision 6. The information update fee is $250
per application.
new text end

new text begin (f) Fees must be set so that the total fees support the laboratory accreditation
program. Direct costs of the accreditation service include program administration,
assessments, the agency's general support costs, and attorney general costs attributable
to the fee function.
new text end

Sec. 29.

Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
to read:


new text begin Subd. 3c. new text end

new text begin Refunds and nonpayment. new text end

new text begin Refunds or credits shall not be made for
applications received but not approved. Accreditation of a laboratory shall not be awarded
until all fees are paid.
new text end

Sec. 30.

Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
to read:


new text begin Subd. 6. new text end

new text begin Application. new text end

new text begin (a) Laboratories seeking accreditation must apply on a form
provided by the commissioner, include the laboratory's procedures and quality manual,
and pay the applicable fees.
new text end

new text begin (b) Laboratories may be fixed-base or mobile. The commissioner shall accredit
mobile laboratories individually and require a vehicle identification number, license
plate number, or other uniquely identifying information in addition to the application
requirements of paragraph (a).
new text end

new text begin (c) Laboratories maintained on separate properties, even though operated under the
same management or ownership, must apply separately. Laboratories with more than one
building on the same or adjoining properties do not need to submit a separate application.
new text end

new text begin (d) The commissioner may accredit laboratories located out-of-state. Accreditation
for out-of-state laboratories may be obtained directly from the commissioner following
the requirements in paragraph (a), or out-of-state laboratories may be accredited through
a reciprocal agreement if the laboratory:
new text end

new text begin (1) is accredited by a NELAP-recognized accreditation body for those fields of
testing in which the laboratory requests accreditation from the commissioner;
new text end

new text begin (2) submits an application and documentation according to this subdivision; and
new text end

new text begin (3) submits a current copy of the laboratory's unexpired accreditation from a
NELAP-recognized accreditation body showing the fields of accreditation for which the
laboratory is currently accredited.
new text end

new text begin (e) Under the conflict of interest determinations provided in section 43A.38,
subdivision 6, clause (a), the commissioner shall not accredit governmental laboratories
operated by agencies of the executive branch of the state. If accreditation is required,
laboratories operated by agencies of the executive branch of the state must apply for
accreditation through any other NELAP-recognized accreditation body.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 31.

Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
to read:


new text begin Subd. 6a. new text end

new text begin Implementation and effective date. new text end

new text begin All laboratories must comply with
standards under this section by July 1, 2009. Fees under subdivisions 3 and 3b apply to
applications received and accreditations issued after June 30, 2009. Accreditations issued
on or after June 30, 2009, shall expire upon their current expiration date.
new text end

Sec. 32.

Minnesota Statutes 2008, section 144.98, is amended by adding a subdivision
to read:


new text begin Subd. 7. new text end

new text begin Initial accreditation and annual accreditation renewal. new text end

new text begin (a) The
commissioner shall issue or renew accreditation after receipt of the completed application
and documentation required in this section, provided the laboratory maintains compliance
with the standards specified in subdivision 2a, and attests to the compliance on the
application form.
new text end

new text begin (b) The commissioner shall prorate the fees in subdivision 3 for laboratories
applying for accreditation after December 31. The fees are prorated on a quarterly basis
beginning with the quarter in which the commissioner receives the completed application
from the laboratory.
new text end

new text begin (c) Applications for renewal of accreditation must be received by November 1 and
no earlier than October 1 of each year. The commissioner shall send annual renewal
notices to laboratories 90 days before expiration. Failure to receive a renewal notice does
not exempt laboratories from meeting the annual November 1 renewal date.
new text end

new text begin (d) The commissioner shall issue all accreditations for the calendar year for which
the application is made, and the accreditation shall expire on December 31 of that year.
new text end

new text begin (e) The accreditation of any laboratory that fails to submit a renewal application
and fees to the commissioner expires automatically on December 31 without notice or
further proceeding. Any person who operates a laboratory as accredited after expiration of
accreditation or without having submitted an application and paid the fees is in violation
of the provisions of this section and is subject to enforcement action under sections
144.989 to 144.993, the Health Enforcement Consolidation Act. A laboratory with expired
accreditation may reapply under subdivision 6.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 33.

Minnesota Statutes 2008, section 144.99, subdivision 1, is amended to read:


Subdivision 1.

Remedies available.

The provisions of chapters 103I and 157 and
sections 115.71 to 115.77; 144.12, subdivision 1, paragraphs (1), (2), (5), (6), (10), (12),
(13), (14), and (15)
; 144.1201 to 144.1204; 144.121; 144.1222; 144.35; 144.381 to
144.385; 144.411 to 144.417; 144.495; 144.71 to 144.74; 144.9501 to 144.9512; 144.992;
new text begin 144.97 to 144.98; new text end326.70 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all
rules, orders, stipulation agreements, settlements, compliance agreements, licenses,
registrations, certificates, and permits adopted or issued by the department or under any
other law now in force or later enacted for the preservation of public health may, in
addition to provisions in other statutes, be enforced under this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2009.
new text end

Sec. 34.

Minnesota Statutes 2008, section 148.6445, is amended by adding a
subdivision to read:


new text begin Subd. 2a. new text end

new text begin Duplicate license fee. new text end

new text begin The fee for a duplicate license is $25.
new text end

Sec. 35.

Minnesota Statutes 2008, section 153A.17, is amended to read:


153A.17 EXPENSES; FEES.

The expenses for administering the certification requirements including the
complaint handling system for hearing aid dispensers in sections 153A.14 and 153A.15
and the Consumer Information Center under section 153A.18 must be paid from initial
application and examination fees, renewal fees, penalties, and fines. All fees are
nonrefundable. Thenew text begin initial and annual renewalnew text end certificate application fee is deleted text begin$350deleted text endnew text begin $700new text end,
the examination fee is deleted text begin$250deleted text endnew text begin $500new text end for the written portion and deleted text begin$250deleted text endnew text begin $500new text end for the practical
portion each time one or the other is takendeleted text begin, anddeleted text endnew text begin. For persons meeting the requirements of
section 148.515, subdivision 2, the fee for the practical portion of the hearing instrument
dispensing examination is $250 each time it is taken.
new text end The trainee application fee is
$200.new text begin Effective July 1, 2009, a surcharge of $550 shall be paid at the time of certification
application or renewal until June 30, 2011, to recover the commissioner's accumulated
direct expenditures for administering the requirements of this chapter.
new text end The penalty fee for
late submission of a renewal application is $200. The fee for verification of certification
to other jurisdictions or entities is $25. All fees, penalties, and fines received must be
deposited in the state government special revenue fund. The commissioner may prorate
the certification fee for new applicants based on the number of quarters remaining in
the annual certification period.

Sec. 36.

Minnesota Statutes 2008, section 157.15, is amended by adding a subdivision
to read:


new text begin Subd. 20. new text end

new text begin Youth camp. new text end

new text begin "Youth camp" has the meaning given in section 144.71,
subdivision 2.
new text end

Sec. 37.

Minnesota Statutes 2008, section 157.16, is amended to read:


157.16 LICENSES REQUIRED; FEES.

Subdivision 1.

License required annually.

A license is required annually for every
person, firm, or corporation engaged in the business of conducting a food and beverage
service establishment,new text begin youth camp,new text end hotel, motel, lodging establishment, public pool, or
resort. Any person wishing to operate a place of business licensed in this section shall
first make application, pay the required fee specified in this section, and receive approval
for operation, including plan review approval. deleted text beginSeasonal and temporary food stands anddeleted text end
Special event food stands are not required to submit plans. Nonprofit organizations
operating a special event food stand with multiple locations at an annual one-day event
shall be issued only one license. Application shall be made on forms provided by the
commissioner and shall require the applicant to state the full name and address of the
owner of the building, structure, or enclosure, the lessee and manager of the food and
beverage service establishment, hotel, motel, lodging establishment, public pool, or resort;
the name under which the business is to be conducted; and any other information as may
be required by the commissioner to complete the application for license.

Subd. 2.

License renewal.

Initial and renewal licenses for all food and beverage
service establishments,new text begin youth camps,new text end hotels, motels, lodging establishments, public pools,
and resorts shall be issued deleted text beginfor the calendar year for which application is made and shall
expire on December 31 of such year
deleted text endnew text begin on an annual basisnew text end. Any person who operates a place
of business after the expiration date of a license or without having submitted an application
and paid the fee shall be deemed to have violated the provisions of this chapter and shall
be subject to enforcement action, as provided in the Health Enforcement Consolidation
Act, sections 144.989 to 144.993. In addition, a penalty of deleted text begin$50deleted text endnew text begin $60new text end shall be added to the
total of the license fee for any food and beverage service establishment operating without
a license as a mobile food unit, a seasonal temporary or seasonal permanent food stand, or
a special event food stand, and a penalty of deleted text begin$100deleted text endnew text begin $120new text end shall be added to the total of the
license fee for all restaurants, food carts, hotels, motels, lodging establishments,new text begin youth
camps,
new text end public pools, and resorts operating without a license for a period of up to 30 days.
A late fee of deleted text begin$300deleted text endnew text begin $360new text end shall be added to the license fee for establishments operating more
than 30 days without a license.

Subd. 2a.

Food manager certification.

An applicant for certification or certification
renewal as a food manager must submit to the commissioner a deleted text begin$28deleted text endnew text begin $35new text end nonrefundable
certification fee payable to the Department of Health.new text begin The commissioner shall issue a
duplicate certificate to replace a lost, destroyed, or mutilated certificate if the applicant
submits a completed application on a form provided by the commissioner for a duplicate
certificate and pays $20 to the department for the cost of duplication.
new text end

Subd. 3.

Establishment fees; definitions.

(a) The following fees are required
for food and beverage service establishments,new text begin youth camps,new text end hotels, motels, lodging
establishments, public pools, and resorts licensed under this chapter. Food and beverage
service establishments must pay the highest applicable fee under paragraph (d), clause
(1), (2), (3), or (4), and establishments serving alcohol must pay the highest applicable
fee under paragraph (d), clause (6) or (7). The license fee for new operators previously
licensed under this chapter for the same calendar year is one-half of the appropriate annual
license fee, plus any penalty that may be required. The license fee for operators opening
on or after October 1 is one-half of the appropriate annual license fee, plus any penalty
that may be required.

(b) All food and beverage service establishments, except special event food stands,
and all hotels, motels, lodging establishments, public pools, and resorts shall pay an
annual base fee of $150.

(c) A special event food stand shall pay a flat fee of deleted text begin$40deleted text endnew text begin $50new text end annually. "Special event
food stand" means a fee category where food is prepared or served in conjunction with
celebrations, county fairs, or special events from a special event food stand as defined
in section 157.15.

(d) In addition to the base fee in paragraph (b), each food and beverage service
establishment, other than a special event food stand, and each hotel, motel, lodging
establishment, public pool, and resort shall pay an additional annual fee for each fee
category, additional food service, or required additional inspection specified in this
paragraph:

(1) Limited food menu selection, deleted text begin$50deleted text endnew text begin $60new text end. "Limited food menu selection" means a
fee category that provides one or more of the following:

(i) prepackaged food that receives heat treatment and is served in the package;

(ii) frozen pizza that is heated and served;

(iii) a continental breakfast such as rolls, coffee, juice, milk, and cold cereal;

(iv) soft drinks, coffee, or nonalcoholic beverages; or

(v) cleaning for eating, drinking, or cooking utensils, when the only food served
is prepared off site.

(2) Small establishment, including boarding establishments, deleted text begin$100deleted text endnew text begin $120new text end. "Small
establishment" means a fee category that has no salad bar and meets one or more of
the following:

(i) possesses food service equipment that consists of no more than a deep fat fryer, a
grill, two hot holding containers, and one or more microwave ovens;

(ii) serves dipped ice cream or soft serve frozen desserts;

(iii) serves breakfast in an owner-occupied bed and breakfast establishment;

(iv) is a boarding establishment; or

(v) meets the equipment criteria in clause (3), item (i) or (ii), and has a maximum
patron seating capacity of not more than 50.

(3) Medium establishment, deleted text begin$260deleted text endnew text begin $310new text end. "Medium establishment" means a fee
category that meets one or more of the following:

(i) possesses food service equipment that includes a range, oven, steam table, salad
bar, or salad preparation area;

(ii) possesses food service equipment that includes more than one deep fat fryer,
one grill, or two hot holding containers; or

(iii) is an establishment where food is prepared at one location and served at one or
more separate locations.

Establishments meeting criteria in clause (2), item (v), are not included in this fee
category.

(4) Large establishment, deleted text begin$460deleted text endnew text begin $540new text end. "Large establishment" means either:

(i) a fee category that (A) meets the criteria in clause (3), items (i) or (ii), for a
medium establishment, (B) seats more than 175 people, and (C) offers the full menu
selection an average of five or more days a week during the weeks of operation; or

(ii) a fee category that (A) meets the criteria in clause (3), item (iii), for a medium
establishment, and (B) prepares and serves 500 or more meals per day.

(5) Other food and beverage service, including food carts, mobile food units,
seasonal temporary food stands, and seasonal permanent food stands, deleted text begin$50deleted text endnew text begin $60new text end.

(6) Beer or wine table service, deleted text begin$50deleted text endnew text begin $60new text end. "Beer or wine table service" means a fee
category where the only alcoholic beverage service is beer or wine, served to customers
seated at tables.

(7) Alcoholic beverage service, other than beer or wine table service, deleted text begin$135deleted text endnew text begin $165new text end.

"Alcohol beverage service, other than beer or wine table service" means a fee
category where alcoholic mixed drinks are served or where beer or wine are served from
a bar.

(8) Lodging per sleeping accommodation unit, deleted text begin$8deleted text endnew text begin $10new text end, including hotels, motels,
lodging establishments, and resorts, up to a maximum of deleted text begin$800deleted text endnew text begin $1,000new text end. "Lodging per
sleeping accommodation unit" means a fee category including the number of guest rooms,
cottages, or other rental units of a hotel, motel, lodging establishment, or resort; or the
number of beds in a dormitory.

(9) First public pool, deleted text begin$180deleted text endnew text begin $325new text end; each additional public pool, deleted text begin$100deleted text endnew text begin $175new text end. "Public
pool" means a fee category that has the meaning given in section 144.1222, subdivision 4.

(10) First spa, deleted text begin$110deleted text endnew text begin $175new text end; each additional spa, deleted text begin$50deleted text endnew text begin $100new text end. "Spa pool" means a fee
category that has the meaning given in Minnesota Rules, part 4717.0250, subpart 9.

(11) Private sewer or water, deleted text begin$50deleted text endnew text begin $60new text end. "Individual private water" means a fee
category with a water supply other than a community public water supply as defined in
Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an
individual sewage treatment system which uses subsurface treatment and disposal.

(12) Additional food service, deleted text begin$130deleted text endnew text begin $150new text end. "Additional food service" means a location
at a food service establishment, other than the primary food preparation and service area,
used to prepare or serve food to the public.

(13) Additional inspection fee, deleted text begin$300deleted text endnew text begin $360new text end. "Additional inspection fee" means a
fee to conduct the second inspection each year for elementary and secondary education
facility school lunch programs when required by the Richard B. Russell National School
Lunch Act.

(e) A fee deleted text beginof $350deleted text end for review of deleted text beginthedeleted text end construction plans must accompany the initial
license application for restaurants, hotels, motels, lodging establishments, deleted text beginordeleted text end resorts deleted text beginwith
five or more sleeping units.
deleted text endnew text begin, seasonal food stands, and mobile food units. The fee for
this construction plan review is as follows:
new text end

new text begin Service Area
new text end
new text begin Type
new text end
new text begin Fee
new text end
new text begin Food
new text end
new text begin limited food menu
new text end
new text begin $275
new text end
new text begin small establishment
new text end
new text begin $400
new text end
new text begin medium establishment
new text end
new text begin $450
new text end
new text begin large food establishment
new text end
new text begin $500
new text end
new text begin additional food service
new text end
new text begin $150
new text end
new text begin Transient food service
new text end
new text begin food cart
new text end
new text begin $250
new text end
new text begin seasonal permanent food stand
new text end
new text begin $250
new text end
new text begin seasonal temporary food stand
new text end
new text begin $250
new text end
new text begin mobile food unit
new text end
new text begin $350
new text end
new text begin Alcohol
new text end
new text begin beer or wine table service
new text end
new text begin $150
new text end
new text begin alcohol service from bar
new text end
new text begin $250
new text end
new text begin Lodging
new text end
new text begin < 25 rooms
new text end
new text begin $375
new text end
new text begin ≥ 25 to < 100 rooms
new text end
new text begin $400
new text end
new text begin ≥ 100 rooms
new text end
new text begin $500
new text end
new text begin < five cabins
new text end
new text begin $350
new text end
new text begin ≥ five to < ten cabins
new text end
new text begin $400
new text end
new text begin ≥ ten cabins
new text end
new text begin $450
new text end

(f) When existing food and beverage service establishments, hotels, motels, lodging
establishments, deleted text beginordeleted text end resortsnew text begin, seasonal food stands, and mobile food unitsnew text end are extensively
remodeled, a fee deleted text beginof $250deleted text end must be submitted with the remodeling plans. deleted text beginA fee of $250
must be submitted for new construction or remodeling for a restaurant with a limited food
menu selection, a seasonal permanent food stand, a mobile food unit, or a food cart, or for
a hotel, motel, resort, or lodging establishment addition of less than five sleeping units.
deleted text endnew text begin
The fee for this construction plan review is as follows:
new text end

new text begin Service Area
new text end
new text begin Type
new text end
new text begin Fee
new text end
new text begin Food
new text end
new text begin limited food menu
new text end
new text begin $250
new text end
new text begin small establishment
new text end
new text begin $300
new text end
new text begin medium establishment
new text end
new text begin $350
new text end
new text begin large food establishment
new text end
new text begin $400
new text end
new text begin additional food service
new text end
new text begin $150
new text end
new text begin Transient food service
new text end
new text begin food cart
new text end
new text begin $250
new text end
new text begin seasonal permanent food stand
new text end
new text begin $250
new text end
new text begin seasonal temporary food stand
new text end
new text begin $250
new text end
new text begin mobile food unit
new text end
new text begin $250
new text end
new text begin Alcohol
new text end
new text begin beer or wine table service
new text end
new text begin $150
new text end
new text begin alcohol service from bar
new text end
new text begin $250
new text end
new text begin Lodging
new text end
new text begin < 25 rooms
new text end
new text begin $250
new text end
new text begin ≥ 25 to < 100 rooms
new text end
new text begin $300
new text end
new text begin ≥ 100 rooms
new text end
new text begin $450
new text end
new text begin < five cabins
new text end
new text begin $250
new text end
new text begin ≥ five to < ten cabins
new text end
new text begin $350
new text end
new text begin ≥ ten cabins
new text end
new text begin $400
new text end

(g) deleted text beginSeasonal temporary food stands anddeleted text end Special event food stands are not required to
submit construction or remodeling plans for review.

new text begin (h) Youth camp fee, $500.
new text end

Subd. 3a.

Statewide hospitality fee.

Every person, firm, or corporation that
operates a licensed boarding establishment, food and beverage service establishment,
seasonal temporary or permanent food stand, special event food stand, mobile food unit,
food cart, resort, hotel, motel, or lodging establishment in Minnesota must submit to the
commissioner a $35 annual statewide hospitality fee for each licensed activity. The fee
for establishments licensed by the Department of Health is required at the same time the
licensure fee is due. For establishments licensed by local governments, the fee is due by
July 1 of each year.

Subd. 4.

Posting requirements.

Every food and beverage service establishment,new text begin
youth camp,
new text end hotel, motel, lodging establishment, public pool, or resort must have the
license posted in a conspicuous place at the establishment.new text begin Mobile food units, food carts,
and seasonal temporary food stands shall be issued decals with the initial license and each
calendar year with license renewals. The current license year decal must be placed on the
unit or stand in a location determined by the commissioner. Decals are not transferable.
new text end

Sec. 38.

Minnesota Statutes 2008, section 157.22, is amended to read:


157.22 EXEMPTIONS.

This chapter deleted text beginshall not be construed todeleted text endnew text begin does notnew text end apply to:

(1) interstate carriers under the supervision of the United States Department of
Health and Human Services;

(2) any building constructed and primarily used for religious worship;

(3) any building owned, operated, and used by a college or university in accordance
with health regulations promulgated by the college or university under chapter 14;

(4) any person, firm, or corporation whose principal mode of business is licensed
under sections 28A.04 and 28A.05, is exempt at that premises from licensure as a food
or beverage establishment; provided that the holding of any license pursuant to sections
28A.04 and 28A.05 shall not exempt any person, firm, or corporation from the applicable
provisions of this chapter or the rules of the state commissioner of health relating to
food and beverage service establishments;

(5) family day care homes and group family day care homes governed by sections
245A.01 to 245A.16;

(6) nonprofit senior citizen centers for the sale of home-baked goods;

(7) fraternal or patriotic organizations that are tax exempt under section 501(c)(3),
501(c)(4), 501(c)(6), 501(c)(7), 501(c)(10), or 501(c)(19) of the Internal Revenue Code of
1986, or organizations related to or affiliated with such fraternal or patriotic organizations.
Such organizations may organize events at which home-prepared food is donated by
organization members for sale at the events, provided:

(i) the event is not a circus, carnival, or fair;

(ii) the organization controls the admission of persons to the event, the event agenda,
or both; and

(iii) the organization's licensed kitchen is not used in any manner for the event;

(8) food not prepared at an establishment and brought in by individuals attending a
potluck event for consumption at the potluck event. An organization sponsoring a potluck
event under this clause may advertise the potluck event to the public through any means.
Individuals who are not members of an organization sponsoring a potluck event under this
clause may attend the potluck event and consume the food at the event. Licensed food
establishments other than schools cannot be sponsors of potluck events. A school may
sponsor and hold potluck events in areas of the school other than the school's kitchen,
provided that the school's kitchen is not used in any manner for the potluck event. For
purposes of this clause, "school" means a public school as defined in section 120A.05,
subdivisions 9, 11, 13, and 17
, or a nonpublic school, church, or religious organization
at which a child is provided with instruction in compliance with sections 120A.22 and
120A.24. Potluck event food shall not be brought into a licensed food establishment
kitchen; deleted text beginanddeleted text end

(9) a home school in which a child is provided instruction at homedeleted text begin.deleted text endnew text begin; and
new text end

new text begin (10) concession stands operated in conjunction with school-sponsored events on
school property are exempt from the 21-day restriction.
new text end

Sec. 39.

Minnesota Statutes 2008, section 327.14, is amended by adding a subdivision
to read:


new text begin Subd. 9. new text end

new text begin Special event recreational camping area. new text end

new text begin "Special event recreational
camping area" means a recreational camping area which operates no more than two times
annually and for no more than 14 consecutive days.
new text end

Sec. 40.

Minnesota Statutes 2008, section 327.15, is amended to read:


327.15 LICENSE REQUIRED; RENEWAL; deleted text beginPLANS FOR EXPANSIONdeleted text endnew text begin new text endnew text beginFEESnew text end.

new text begin Subdivision 1. new text end

new text begin License required; plan review. new text end

No person, firm or corporation shall
establish, maintain, conduct or operate a manufactured home park or recreational camping
area within this state without first obtaining deleted text beginadeleted text endnew text begin an annualnew text end license therefor from the state
Department of Health.new text begin Any person wishing to obtain a license shall first make application,
pay the required fee specified in this section, and receive approval for operation, including
plan review approval. Application shall be made on forms provided by the commissioner
and shall require the applicant to state the full name and address of the owner of the
manufactured home park or recreational camping area, the name under which the business
is to be conducted, and any other information as may be required by the commissioner
to complete the application for license.
new text end Any person, firm, or corporation desiring to
operate either a manufactured home park or a recreational camping area on the same site
in connection with the other, need only obtain one license. deleted text beginA license shall expire and be
renewed as prescribed by the commissioner pursuant to section 144.122.
deleted text end The license shall
state the number of manufactured home sites and recreational camping sites allowed
according to state commissioner of health approval. deleted text beginNo renewal license shall be issued if
the number of sites specified in the application exceeds those of the original application
deleted text endnew text begin
The number of licensed sites shall not be increased
new text end unless the plans for expansion deleted text beginor
the construction for expansion
deleted text end arenew text begin submitted and the expansionnew text end first approved by the
Department of Health. deleted text beginAny manufactured home park or recreational camping area located
in more than one municipality shall be dealt with as two separate manufactured home
parks or camping areas.
deleted text end The license shall be conspicuously displayed in the office of the
manufactured home park or camping area. The license is not transferable as tonew text begin person
or
new text end place.

new text begin Subd. 2. new text end

new text begin License renewal. new text end

new text begin Initial and renewal licenses for all manufactured home
parks and recreational camping areas shall be issued annually and shall have an expiration
date included on the license. Any person who operates a manufactured home park or
recreational camping area after the expiration date of a license or without having submitted
an application and paid the fee shall be deemed to have violated the provisions of this
chapter and shall be subject to enforcement action, as provided in the Health Enforcement
Consolidation Act, sections 144.989 to 144.993. In addition, a penalty of $120 shall
be added to the total of the license fee for any manufactured home park or recreational
camping area operating without a license for a period of up to 30 days. A late fee of $360
shall be added to the license fee for any manufactured home park or recreational camping
area operating more than 30 days without a license.
new text end

new text begin Subd. 3. new text end

new text begin Fees, manufactured home parks and recreational camping areas. new text end

new text begin (a)
The following fees are required for manufactured home parks and recreational camping
areas licensed under this chapter. Recreational camping areas and manufactured home
parks must pay the highest applicable fee under paragraph (c). The license fee for new
operators of a manufactured home park or recreational camping area previously licensed
under this chapter for the same calendar year is one-half of the appropriate annual license
fee, plus any penalty that may be required. The license fee for operators opening on
or after October 1 is one-half of the appropriate annual license fee, plus any penalty
that may be required.
new text end

new text begin (b) All manufactured home parks and recreational camping areas, except special
event recreational camping areas, shall pay an annual base fee of $150 plus $4 for each
licensed site, except that any operator of a manufactured home park or recreational
camping area who is licensed under section 157.16 for the same location shall not be
required to pay the base fee.
new text end

new text begin (c) In addition to the fee in paragraph (b), each manufactured home park or
recreational camping area shall pay an additional annual fee for each fee category
specified in this paragraph:
new text end

new text begin (1) Manufactured home parks and recreational camping areas with public swimming
pools and spas shall pay the appropriate fees specified in section 157.16.
new text end

new text begin (2) Individual private sewer or water, $60. "Individual private water" means a fee
category with a water supply other than a community public water supply as defined in
Minnesota Rules, chapter 4720. "Individual private sewer" means a fee category with an
individual sewage treatment system which uses subsurface treatment and disposal.
new text end

new text begin (d) The following fees must accompany a plan review application for initial
construction of a manufactured home park or recreational camping area:
new text end

new text begin (1) for initial construction of less than 25 sites, $375;
new text end

new text begin (2) for initial construction of 25 to less than 100 sites, $400; and
new text end

new text begin (3) for initial construction of 100 or more sites, $500.
new text end

new text begin (e) The following fees must accompany a plan review application when an existing
manufactured home park or recreational camping area is expanded:
new text end

new text begin (1) for expansion of less than 25 sites, $250;
new text end

new text begin (2) for expansion of 25 and less than 100 sites, $300; and
new text end

new text begin (3) for expansion of 100 or more sites, $450.
new text end

new text begin Subd. 4. new text end

new text begin Fees, special event recreational camping areas. new text end

new text begin (a) The following fees
are required for special event recreational camping areas licensed under this chapter.
new text end

new text begin (b) All special event recreational camping areas shall pay an annual fee of $150 plus
$1 for each licensed site.
new text end

new text begin (c) A special event recreational camping area shall pay a late fee of $360 for failing
to obtain a license prior to operating.
new text end

new text begin (d) The following fees must accompany a plan review application for initial
construction of a special event recreational camping area:
new text end

new text begin (1) for initial construction of less than 25 special event recreational camping sites,
$375;
new text end

new text begin (2) for initial construction of 25 to less than 100 sites, $400; and
new text end

new text begin (3) for initial construction of 100 or more sites, $500.
new text end

new text begin (e) The following fees must accompany a plan review application for expansion of a
special event recreational camping area:
new text end

new text begin (1) for expansion of less than 25 sites, $250;
new text end

new text begin (2) for expansion of 25 and less than 100 sites, $300; and
new text end

new text begin (3) for expansion of 100 or more sites, $450.
new text end

Sec. 41.

Minnesota Statutes 2008, section 327.16, is amended to read:


327.16 deleted text beginLICENSEdeleted text endnew text begin PLAN REVIEWnew text end APPLICATION.

Subdivision 1.

Made to state Department of Health.

The new text beginplan review new text endapplication
for deleted text beginlicense to operate and maintaindeleted text end a manufactured home park or recreational camping
area shall be made to the state Department of Health, at such office and in such manner
as may be prescribed by that department.

Subd. 2.

Contents.

The deleted text beginapplicant for a primary license or annual license shall make
application in writing
deleted text endnew text begin plan review application shall be madenew text end upon a form provided by the
state Department of Health setting forth:

(1) The full name and address of the applicant or applicants, or names and addresses
of the partners if the applicant is a partnership, or the names and addresses of the officers
if the applicant is a corporation.

(2) A legal description of the site, lot, field, or tract of land upon which the applicant
proposes to operate and maintain a manufactured home park or recreational camping area.

(3) The proposed and existing facilities on and about the site, lot, field, or tract of
land for the proposed construction or alteration and maintaining of a sanitary community
building for toilets, urinals, sinks, wash basins, slop-sinks, showers, drains, laundry
facilities, source of water supply, sewage, garbage and waste disposal; except that no
toilet facilities shall be required in any manufactured home park which permits only
manufactured homes equipped with toilet facilities discharging to water carried sewage
disposal systems; and method of fire and storm protection.

(4) The proposed method of lighting the structures and site, lot, field, or tract of land
upon which the manufactured home park or recreational camping area is to be located.

(5) The calendar months of the year which the applicant will operate the
manufactured home park or recreational camping area.

(6) Plans and drawings for new construction or alteration, including buildings, wells,
plumbing and sewage disposal systems.

Subd. 3.

deleted text beginFees;deleted text end Approval.

The application for deleted text beginthe primary licensedeleted text endnew text begin plan reviewnew text end shall
be submitted with all plans and specifications enumerated in subdivision 2, deleted text beginand payment
of a fee in an amount prescribed by the state commissioner of health pursuant to section
144.122
deleted text end and shall be accompanied by an approved zoning permit from the municipality or
county wherein the park is to be located, or a statement from the municipality or county
that it does not require an approved zoning permit. deleted text beginThe fee for the annual license shall be
in an amount prescribed by the state commissioner of health pursuant to section 144.122.
All license fees paid to the commissioner of health shall be turned over to the state
treasury.
deleted text end The fee submitted for the deleted text beginprimary licensedeleted text endnew text begin plan reviewnew text end shall be retained by the
state even though the proposed project is not approved and a license is denied.

When construction has been completed in accordance with approved plans and
specifications the state commissioner of health shall promptly cause the manufactured
home park or recreational camping area and appurtenances thereto to be inspected. When
the inspection and report has been made and the state commissioner of health finds that
all requirements of sections 327.10, 327.11, 327.14 to 327.28, and such conditions of
health and safety as the state commissioner of health may require, have been met by
the applicant, the state commissioner of health shall forthwith issue the deleted text beginprimarydeleted text end license
in the name of the state.

Subd. 4.

deleted text beginSanitary facilitiesdeleted text endnew text begin Compliance with current state lawnew text end.

deleted text begin During the
pendency of the application for such primary license any change in the sanitary or safety
facilities of the intended manufactured home park or recreational camping area shall be
immediately reported in writing to the state Department of Health through the office
through which the application was made. If no objection is made by the state Department
of Health to such change in such sanitary or safety facilities within 60 days of the date
such change is reported, it shall be deemed to have the approval of the state Department of
Health.
deleted text end new text begin Any manufactured home park or recreational camping area must be constructed
and operated according to all applicable state electrical, fire, plumbing, and building codes.
new text end

Subd. 5.

Permit.

When the plans and specifications have been approved, the state
Department of Health shall issue an approval report permitting the applicant to construct
or make alterations upon a manufactured home park or recreational camping area and the
appurtenances thereto according to the plans and specifications presented.

Such approval does not relieve the applicant from securing building permits in
municipalities that require permits or from complying with any other municipal ordinance
or ordinances, applicable thereto, not in conflict with this statute.

Subd. 6.

Denial of construction.

If the application to construct or make alterations
upon a manufactured home park or recreational camping area and the appurtenances
thereto or a deleted text beginprimarydeleted text end license to operate and maintain the same is denied by the state
commissioner of health, the commissioner shall so state in writing giving the reason
or reasons for denying the application. If the objections can be corrected the applicant
may amend the application and resubmit it for approval, and if denied the applicant may
appeal from the decision of the state commissioner of health as provided in section
144.99, subdivision 10.

Sec. 42.

Minnesota Statutes 2008, section 327.20, subdivision 1, is amended to read:


Subdivision 1.

Rules.

No domestic animals or house pets of occupants of
manufactured home parks or recreational camping areas shall be allowed to run at large,
or commit any nuisances within the limits of a manufactured home park or recreational
camping area. Each manufactured home park or recreational camping area licensed under
the provisions of sections 327.10, 327.11,new text begin andnew text end 327.14 to 327.28 shall, among other things,
provide for the followingdeleted text begin, in the manner hereinafter specifieddeleted text end:

(1) A responsible attendant or caretaker shall be in charge of every manufactured
home park or recreational camping area at all times, who shall maintain the park or
area, and its facilities and equipment in a clean, orderly and sanitary condition. In any
manufactured home park containing more than 50 lots, the attendant, caretaker, or other
responsible park employee, shall be readily available at all times in case of emergency.

(2) All manufactured home parks shall be well drained and be located so that the
drainage of the park area will not endanger any water supply. No wastewater from
manufactured homes or recreational camping vehicles shall be deposited on the surface of
the ground. All sewage and other water carried wastes shall be discharged into a municipal
sewage system whenever available. When a municipal sewage system is not available, a
sewage disposal system acceptable to the state commissioner of health shall be provided.

(3) No manufactured home shall be located closer than three feet to the side lot lines
of a manufactured home park, if the abutting property is improved property, or closer than
ten feet to a public street or alley. Each individual site shall abut or face on a driveway
or clear unoccupied space of not less than 16 feet in width, which space shall have
unobstructed access to a public highway or alley. There shall be an open space of at least
ten feet between the sides of adjacent manufactured homes including their attachments
and at least three feet between manufactured homes when parked end to end. The space
between manufactured homes may be used for the parking of motor vehicles and other
property, if the vehicle or other property is parked at least ten feet from the nearest
adjacent manufactured home position. The requirements of this paragraph shall not apply
to recreational camping areas and variances may be granted by the state commissioner
of health in manufactured home parks when the variance is applied for in writing and in
the opinion of the commissioner the variance will not endanger the health, safety, and
welfare of manufactured home park occupants.

(4) An adequate supply of water of safe, sanitary quality shall be furnished at each
manufactured home park or recreational camping area. The source of the water supply
shall first be approved by the state Department of Health.

(5) All plumbing shall be installed in accordance with the rules of the state
commissioner of labor and industry and the provisions of the Minnesota Plumbing Code.

(6) In the case of a manufactured home park with less than ten manufactured homes,
a plan for the sheltering or the safe evacuation to a safe place of shelter of the residents of
the park in times of severe weather conditions, such as tornadoes, high winds, and floods.
The shelter or evacuation plan shall be developed with the assistance and approval of
the municipality where the park is located and shall be posted at conspicuous locations
throughout the park. The park owner shall provide each resident with a copy of the
approved shelter or evacuation plan, as provided by section 327C.01, subdivision 1c.
Nothing in this paragraph requires the Department of Health to review or approve any
shelter or evacuation plan developed by a park. Failure of a municipality to approve a plan
submitted by a park shall not be grounds for action against the park by the Department of
Health if the park has made a good faith effort to develop the plan and obtain municipal
approval.

(7) A manufactured home park with ten or more manufactured homes, licensed prior
to March 1, 1988, shall provide a safe place of shelter for park residents or a plan for the
evacuation of park residents to a safe place of shelter within a reasonable distance of the
park for use by park residents in times of severe weather, including tornadoes and high
winds. The shelter or evacuation plan must be approved by the municipality by March 1,
1989. The municipality may require the park owner to construct a shelter if it determines
that a safe place of shelter is not available within a reasonable distance from the park. A
copy of the municipal approval and the plan shall be submitted by the park owner to the
Department of Health. The park owner shall provide each resident with a copy of the
approved shelter or evacuation plan, as provided by section 327C.01, subdivision 1c.

(8) A manufactured home park with ten or more manufactured homes, receiving
deleted text begin a primarydeleted text endnew text begin an initialnew text end license after March 1, 1988, must provide the type of shelter required
by section 327.205, except that for manufactured home parks established as temporary,
emergency housing in a disaster area declared by the President of the United States or
the governor, an approved evacuation plan may be provided in lieu of a shelter for a
period not exceeding 18 months.

(9) For the purposes of this subdivision, "park owner" and "resident" have the
deleted text begin meaningdeleted text endnew text begin meaningsnew text end given them in section 327C.01.

Sec. 43.

Minnesota Statutes 2008, section 327.20, is amended by adding a subdivision
to read:


new text begin Subd. 4. new text end

new text begin Special event recreational camping areas. new text end

new text begin Each special event camping
area licensed under sections 327.10, 327.11, and 327.14 to 327.28 is subject to this section.
new text end

new text begin (1) Recreational camping vehicles and tents, including attachments, must be
separated from each other and other structures by at least seven feet.
new text end

new text begin (2) A minimum area of 300 square feet per site must be provided and the total
number of sites must not exceed one site for every 300 square feet of usable land area.
new text end

new text begin (3) Each site must abut or face a driveway or clear unoccupied space of at least 16
feet in width, which space must have unobstructed access to a public roadway.
new text end

new text begin (4) If no approved on-site water supply system is available, hauled water may be
used, provided that persons using hauled water comply with Minnesota Rules, parts
4720.4000 to 4720.4600.
new text end

new text begin (5) Nonburied sewer lines may be permitted provided they are of approved materials,
watertight, and properly maintained.
new text end

new text begin (6) If a sanitary dumping station is not provided on-site, arrangements must be
made with a licensed sewage pumper to service recreational camping vehicle holding
tanks as needed.
new text end

new text begin (7) Toilet facilities must be provided consisting of toilets connected to an approved
sewage disposal system, portable toilets, or approved, properly constructed privies.
new text end

new text begin (8) Toilets must be provided in the ratio of one toilet for each sex for each 150 sites.
new text end

new text begin (9) Toilets must be not more than 400 feet from any site.
new text end

new text begin (10) If a central building or buildings are provided with running water, then toilets
and hand-washing lavatories must be provided in the building or buildings that meet the
requirements of this subdivision.
new text end

new text begin (11) Showers, if provided, must be provided in the ratio of one shower for each sex
for each 250 sites. Showerheads must be provided, where running water is available, for
each camping event exceeding two nights.
new text end

new text begin (12) Central toilet and shower buildings, if provided, must be constructed with
adequate heating, ventilation, and lighting, and floors of impervious material sloped
to drain. Walls must be of a washable material. Permanent facilities must meet the
requirements of the Americans with Disabilities Act.
new text end

new text begin (13) An adequate number of durable, covered, watertight containers must be
provided for all garbage and refuse. Garbage and refuse must be collected as often as
necessary to prevent nuisance conditions.
new text end

new text begin (14) Campgrounds must be located in areas free of poison ivy or other noxious
weeds considered detrimental to health. Sites must not be located in areas of tall grass or
weeds and sites must be adequately drained.
new text end

new text begin (15) Campsites for recreational vehicles may not be located on inclines of greater
than eight percent grade or one inch drop per lineal foot.
new text end

new text begin (16) A responsible attendant or caretaker must be available on-site at all times during
the operation of any special event recreational camping area that has 50 or more sites.
new text end

Sec. 44. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2008, sections 62U.08; 103I.112; 144.9501, subdivision 17b;
and 327.14, subdivisions 5 and 6,
new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Rules, part 4626.2015, subpart 9, new text end new text begin is repealed.
new text end

ARTICLE 12

TECHNICAL

Section 1.

Minnesota Statutes 2008, section 125A.744, subdivision 3, is amended to
read:


Subd. 3.

Implementation.

Consistent with section 256B.0625, subdivision 26,
school districts may enroll as medical assistance providers or subcontractors and bill
the Department of Human Services under the medical assistance fee for service claims
processing system for special education services which are covered services under chapter
256B, which are provided in the school setting for a medical assistance recipient, and for
whom the district has secured informed consent consistent with section 13.05, subdivision
4
, paragraph (d), and section 256B.77, subdivision 2, paragraph (p), to bill for each type
of covered service. School districts shall be reimbursed by the commissioner of human
services for the federal share of individual education plan health-related services that
qualify for reimbursement by medical assistance, minus up to five percent retained by the
commissioner of human services for administrative costs, not to exceed $350,000 per
fiscal year. The commissioner may withhold up to five percent of each payment to a
school district. Following the end of each fiscal year, the commissioner shall settle up with
each school district in order to ensure that collections from each district for departmental
administrative costs are made on a pro rata basis according to federal earnings for these
services in each district. A school district is not eligible to enroll as a home care provider
or a personal care provider organization for purposes of billing home care services under
sections 256B.0651 deleted text beginand 256B.0653deleted text end to 256B.0656 new text beginand 256B.0659 new text enduntil the commissioner
of human services issues a bulletin instructing county public health nurses on how to
assess for the needs of eligible recipients during school hours. To use private duty nursing
services or personal care services at school, the recipient or responsible party must provide
written authorization in the care plan identifying the chosen provider and the daily amount
of services to be used at school.

Sec. 2.

Minnesota Statutes 2008, section 144A.46, subdivision 1, is amended to read:


Subdivision 1.

License required.

(a) A home care provider may not operate in the
state without a current license issued by the commissioner of health. A home care provider
may hold a separate license for each class of home care licensure.

(b) Within ten days after receiving an application for a license, the commissioner
shall acknowledge receipt of the application in writing. The acknowledgment must
indicate whether the application appears to be complete or whether additional information
is required before the application will be considered complete. Within 90 days after
receiving a complete application, the commissioner shall either grant or deny the license.
If an applicant is not granted or denied a license within 90 days after submitting a
complete application, the license must be deemed granted. An applicant whose license has
been deemed granted must provide written notice to the commissioner before providing a
home care service.

(c) Each application for a home care provider license, or for a renewal of a license,
shall be accompanied by a fee to be set by the commissioner under section 144.122.

(d) The commissioner of health, in consultation with the commissioner of human
services, shall provide recommendations to the legislature by February 15, 2009, for
provider standards for personal care assistant services as described in section deleted text begin256B.0655deleted text endnew text begin
256B.0659
new text end.

Sec. 3.

Minnesota Statutes 2008, section 176.011, subdivision 9, is amended to read:


Subd. 9.

Employee.

"Employee" means any person who performs services for
another for hire including the following:

(1) an alien;

(2) a minor;

(3) a sheriff, deputy sheriff, police officer, firefighter, county highway engineer, and
peace officer while engaged in the enforcement of peace or in the pursuit or capture of a
person charged with or suspected of crime;

(4) a person requested or commanded to aid an officer in arresting or retaking a
person who has escaped from lawful custody, or in executing legal process, in which
cases, for purposes of calculating compensation under this chapter, the daily wage of the
person shall be the prevailing wage for similar services performed by paid employees;

(5) a county assessor;

(6) an elected or appointed official of the state, or of a county, city, town, school
district, or governmental subdivision in the state. An officer of a political subdivision
elected or appointed for a regular term of office, or to complete the unexpired portion of a
regular term, shall be included only after the governing body of the political subdivision
has adopted an ordinance or resolution to that effect;

(7) an executive officer of a corporation, except those executive officers excluded
by section 176.041;

(8) a voluntary uncompensated worker, other than an inmate, rendering services in
state institutions under the commissioners of human services and corrections similar to
those of officers and employees of the institutions, and whose services have been accepted
or contracted for by the commissioner of human services or corrections as authorized by
law. In the event of injury or death of the worker, the daily wage of the worker, for the
purpose of calculating compensation under this chapter, shall be the usual wage paid at
the time of the injury or death for similar services in institutions where the services are
performed by paid employees;

(9) a voluntary uncompensated worker engaged in emergency management as
defined in section 12.03, subdivision 4, who is:

(i) registered with the state or any political subdivision of it, according to the
procedures set forth in the state or political subdivision emergency operations plan; and

(ii) acting under the direction and control of, and within the scope of duties approved
by, the state or political subdivision.

The daily wage of the worker, for the purpose of calculating compensation under this
chapter, shall be the usual wage paid at the time of the injury or death for similar services
performed by paid employees;

(10) a voluntary uncompensated worker participating in a program established by a
local social services agency. For purposes of this clause, "local social services agency"
means any agency established under section 393.01. In the event of injury or death of the
worker, the wage of the worker, for the purpose of calculating compensation under this
chapter, shall be the usual wage paid in the county at the time of the injury or death for
similar services performed by paid employees working a normal day and week;

(11) a voluntary uncompensated worker accepted by the commissioner of natural
resources who is rendering services as a volunteer pursuant to section 84.089. The daily
wage of the worker for the purpose of calculating compensation under this chapter, shall
be the usual wage paid at the time of injury or death for similar services performed by
paid employees;

(12) a voluntary uncompensated worker in the building and construction industry
who renders services for joint labor-management nonprofit community service projects.
The daily wage of the worker for the purpose of calculating compensation under this
chapter shall be the usual wage paid at the time of injury or death for similar services
performed by paid employees;

(13) a member of the military forces, as defined in section 190.05, while in state
active service, as defined in section 190.05, subdivision 5a. The daily wage of the member
for the purpose of calculating compensation under this chapter shall be based on the
member's usual earnings in civil life. If there is no evidence of previous occupation or
earning, the trier of fact shall consider the member's earnings as a member of the military
forces;

(14) a voluntary uncompensated worker, accepted by the director of the Minnesota
Historical Society, rendering services as a volunteer, pursuant to chapter 138. The daily
wage of the worker, for the purposes of calculating compensation under this chapter,
shall be the usual wage paid at the time of injury or death for similar services performed
by paid employees;

(15) a voluntary uncompensated worker, other than a student, who renders services
at the Minnesota State Academy for the Deaf or the Minnesota State Academy for the
Blind, and whose services have been accepted or contracted for by the commissioner of
education, as authorized by law. In the event of injury or death of the worker, the daily
wage of the worker, for the purpose of calculating compensation under this chapter, shall
be the usual wage paid at the time of the injury or death for similar services performed in
institutions by paid employees;

(16) a voluntary uncompensated worker, other than a resident of the veterans home,
who renders services at a Minnesota veterans home, and whose services have been
accepted or contracted for by the commissioner of veterans affairs, as authorized by law.
In the event of injury or death of the worker, the daily wage of the worker, for the purpose
of calculating compensation under this chapter, shall be the usual wage paid at the time of
the injury or death for similar services performed in institutions by paid employees;

(17) a worker performing services under section deleted text begin256B.0655deleted text end new text begin256B.0659 new text endfor a
recipient in the home of the recipient or in the community under section 256B.0625,
subdivision 19a
, who is paid from government funds through a fiscal intermediary under
section deleted text begin256B.0655, subdivision 7deleted text endnew text begin 256B.0659, subdivision 33new text end. For purposes of maintaining
workers' compensation insurance, the employer of the worker is as designated in law
by the commissioner of the Department of Human Services, notwithstanding any other
law to the contrary;

(18) students enrolled in and regularly attending the Medical School of the
University of Minnesota in the graduate school program or the postgraduate program. The
students shall not be considered employees for any other purpose. In the event of the
student's injury or death, the weekly wage of the student for the purpose of calculating
compensation under this chapter, shall be the annualized educational stipend awarded to
the student, divided by 52 weeks. The institution in which the student is enrolled shall
be considered the "employer" for the limited purpose of determining responsibility for
paying benefits under this chapter;

(19) a faculty member of the University of Minnesota employed for an academic
year is also an employee for the period between that academic year and the succeeding
academic year if:

(a) the member has a contract or reasonable assurance of a contract from the
University of Minnesota for the succeeding academic year; and

(b) the personal injury for which compensation is sought arises out of and in the
course of activities related to the faculty member's employment by the University of
Minnesota;

(20) a worker who performs volunteer ambulance driver or attendant services is an
employee of the political subdivision, nonprofit hospital, nonprofit corporation, or other
entity for which the worker performs the services. The daily wage of the worker for the
purpose of calculating compensation under this chapter shall be the usual wage paid at the
time of injury or death for similar services performed by paid employees;

(21) a voluntary uncompensated worker, accepted by the commissioner of
administration, rendering services as a volunteer at the Department of Administration. In
the event of injury or death of the worker, the daily wage of the worker, for the purpose of
calculating compensation under this chapter, shall be the usual wage paid at the time of the
injury or death for similar services performed in institutions by paid employees;

(22) a voluntary uncompensated worker rendering service directly to the Pollution
Control Agency. The daily wage of the worker for the purpose of calculating compensation
payable under this chapter is the usual going wage paid at the time of injury or death for
similar services if the services are performed by paid employees;

(23) a voluntary uncompensated worker while volunteering services as a first
responder or as a member of a law enforcement assistance organization while acting
under the supervision and authority of a political subdivision. The daily wage of the
worker for the purpose of calculating compensation payable under this chapter is the
usual going wage paid at the time of injury or death for similar services if the services
are performed by paid employees;

(24) a voluntary uncompensated member of the civil air patrol rendering service on
the request and under the authority of the state or any of its political subdivisions. The
daily wage of the member for the purposes of calculating compensation payable under this
chapter is the usual going wage paid at the time of injury or death for similar services if
the services are performed by paid employees; and

(25) a Minnesota Responds Medical Reserve Corps volunteer, as provided in
sections 145A.04 and 145A.06, responding at the request of or engaged in training
conducted by the commissioner of health. The daily wage of the volunteer for the purposes
of calculating compensation payable under this chapter is established in section 145A.06.
A person who qualifies under this clause and who may also qualify under another clause
of this subdivision shall receive benefits in accordance with this clause.

If it is difficult to determine the daily wage as provided in this subdivision, the trier
of fact may determine the wage upon which the compensation is payable.

Sec. 4.

Minnesota Statutes 2008, section 245C.03, subdivision 2, is amended to read:


Subd. 2.

Personal care provider organizations.

The commissioner shall conduct
background studies on any individual required under sections 256B.0651 deleted text beginand 256B.0653deleted text end
to 256B.0656 new text beginand 256B.0659 new text endto have a background study completed under this chapter.

Sec. 5.

Minnesota Statutes 2008, section 245C.04, subdivision 3, is amended to read:


Subd. 3.

Personal care provider organizations.

(a) The commissioner shall
conduct a background study of an individual required to be studied under section 245C.03,
subdivision 2
, at least upon application for initial enrollment under sections 256B.0651
deleted text begin and 256B.0653deleted text end to 256B.0656new text begin and 256B.0659new text end.

(b) Organizations required to initiate background studies under sections 256B.0651
deleted text begin and 256B.0653deleted text end to 256B.0656 new text beginand 256B.0659 new text endfor individuals described in section 245C.03,
subdivision 2
, must submit a completed background study form to the commissioner
before those individuals begin a position allowing direct contact with persons served
by the organization.

Sec. 6.

Minnesota Statutes 2008, section 245C.10, subdivision 3, is amended to read:


Subd. 3.

Personal care provider organizations.

The commissioner shall recover
the cost of background studies initiated by a personal care provider organization under
sections 256B.0651 deleted text beginand 256B.0653deleted text end to 256B.0656 new text beginand 256B.0659 new text endthrough a fee of no
more than $20 per study charged to the organization responsible for submitting the
background study form. The fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.

Sec. 7.

Minnesota Statutes 2008, section 256B.04, subdivision 16, is amended to read:


Subd. 16.

Personal care services.

(a) Notwithstanding any contrary language in
this paragraph, the commissioner of human services and the commissioner of health shall
jointly promulgate rules to be applied to the licensure of personal care services provided
under the medical assistance program. The rules shall consider standards for personal care
services that are based on the World Institute on Disability's recommendations regarding
personal care services. These rules shall at a minimum consider the standards and
requirements adopted by the commissioner of health under section 144A.45, which the
commissioner of human services determines are applicable to the provision of personal
care services, in addition to other standards or modifications which the commissioner of
human services determines are appropriate.

The commissioner of human services shall establish an advisory group including
personal care consumers and providers to provide advice regarding which standards or
modifications should be adopted. The advisory group membership must include not less
than 15 members, of which at least 60 percent must be consumers of personal care services
and representatives of recipients with various disabilities and diagnoses and ages. At least
51 percent of the members of the advisory group must be recipients of personal care.

The commissioner of human services may contract with the commissioner of health
to enforce the jointly promulgated licensure rules for personal care service providers.

Prior to final promulgation of the joint rule the commissioner of human services
shall report preliminary findings along with any comments of the advisory group and a
plan for monitoring and enforcement by the Department of Health to the legislature by
February 15, 1992.

Limits on the extent of personal care services that may be provided to an individual
must be based on the cost-effectiveness of the services in relation to the costs of inpatient
hospital care, nursing home care, and other available types of care. The rules must
provide, at a minimum:

(1) that agencies be selected to contract with or employ and train staff to provide and
supervise the provision of personal care services;

(2) that agencies employ or contract with a qualified applicant that a qualified
recipient proposes to the agency as the recipient's choice of assistant;

(3) that agencies bill the medical assistance program for a personal care service
by a personal care assistant and supervision by a qualified professional supervising the
personal care assistant unless the recipient selects the fiscal agent option under section
deleted text begin 256B.0655, subdivision 7deleted text endnew text begin 256B.0659, subdivision 33new text end;

(4) that agencies establish a grievance mechanism; and

(5) that agencies have a quality assurance program.

(b) The commissioner may waive the requirement for the provision of personal care
services through an agency in a particular county, when there are less than two agencies
providing services in that county and shall waive the requirement for personal care
assistants required to join an agency for the first time during 1993 when personal care
services are provided under a relative hardship waiver under Minnesota Statutes 1992,
section 256B.0627, subdivision 4, paragraph (b), clause (7), and at least two agencies
providing personal care services have refused to employ or contract with the independent
personal care assistant.

Sec. 8.

Minnesota Statutes 2008, section 256B.055, subdivision 12, is amended to read:


Subd. 12.

Disabled children.

(a) A person is eligible for medical assistance if the
person is under age 19 and qualifies as a disabled individual under United States Code,
title 42, section 1382c(a), and would be eligible for medical assistance under the state
plan if residing in a medical institution, and the child requires a level of care provided in
a hospital, nursing facility, or intermediate care facility for persons with developmental
disabilities, for whom home care is appropriate, provided that the cost to medical
assistance under this section is not more than the amount that medical assistance would pay
for if the child resides in an institution. After the child is determined to be eligible under
this section, the commissioner shall review the child's disability under United States Code,
title 42, section 1382c(a) and level of care defined under this section no more often than
annually and may elect, based on the recommendation of health care professionals under
contract with the state medical review team, to extend the review of disability and level of
care up to a maximum of four years. The commissioner's decision on the frequency of
continuing review of disability and level of care is not subject to administrative appeal
under section 256.045. The county agency shall send a notice of disability review to the
enrollee six months prior to the date the recertification of disability is due. Nothing in this
subdivision shall be construed as affecting other redeterminations of medical assistance
eligibility under this chapter and annual cost-effective reviews under this section.

(b) For purposes of this subdivision, "hospital" means an institution as defined
in section 144.696, subdivision 3, 144.55, subdivision 3, or Minnesota Rules, part
4640.3600, and licensed pursuant to sections 144.50 to 144.58. For purposes of this
subdivision, a child requires a level of care provided in a hospital if the child is determined
by the commissioner to need an extensive array of health services, including mental health
services, for an undetermined period of time, whose health condition requires frequent
monitoring and treatment by a health care professional or by a person supervised by a
health care professional, who would reside in a hospital or require frequent hospitalization
if these services were not provided, and the daily care needs are more complex than
a nursing facility level of care.

A child with serious emotional disturbance requires a level of care provided in a
hospital if the commissioner determines that the individual requires 24-hour supervision
because the person exhibits recurrent or frequent suicidal or homicidal ideation or
behavior, recurrent or frequent psychosomatic disorders or somatopsychic disorders that
may become life threatening, recurrent or frequent severe socially unacceptable behavior
associated with psychiatric disorder, ongoing and chronic psychosis or severe, ongoing
and chronic developmental problems requiring continuous skilled observation, or severe
disabling symptoms for which office-centered outpatient treatment is not adequate, and
which overall severely impact the individual's ability to function.

(c) For purposes of this subdivision, "nursing facility" means a facility which
provides nursing care as defined in section 144A.01, subdivision 5, licensed pursuant to
sections 144A.02 to 144A.10, which is appropriate if a person is in active restorative
treatment; is in need of special treatments provided or supervised by a licensed nurse; or
has unpredictable episodes of active disease processes requiring immediate judgment
by a licensed nurse. For purposes of this subdivision, a child requires the level of care
provided in a nursing facility if the child is determined by the commissioner to meet
the requirements of the preadmission screening assessment document under section
256B.0911 and the home care independent rating document under section deleted text begin256B.0655,
subdivision 4
, clause (3)
deleted text endnew text begin 256B.0659new text end, adjusted to address age-appropriate standards for
children age 18 and under, pursuant to section deleted text begin256B.0655, subdivision 3deleted text endnew text begin 256B.0659new text end.

(d) For purposes of this subdivision, "intermediate care facility for persons with
developmental disabilities" or "ICF/MR" means a program licensed to provide services to
persons with developmental disabilities under section 252.28, and chapter 245A, and a
physical plant licensed as a supervised living facility under chapter 144, which together
are certified by the Minnesota Department of Health as meeting the standards in Code of
Federal Regulations, title 42, part 483, for an intermediate care facility which provides
services for persons with developmental disabilities who require 24-hour supervision
and active treatment for medical, behavioral, or habilitation needs. For purposes of this
subdivision, a child requires a level of care provided in an ICF/MR if the commissioner
finds that the child has a developmental disability in accordance with section 256B.092,
is in need of a 24-hour plan of care and active treatment similar to persons with
developmental disabilities, and there is a reasonable indication that the child will need
ICF/MR services.

(e) For purposes of this subdivision, a person requires the level of care provided
in a nursing facility if the person requires 24-hour monitoring or supervision and a plan
of mental health treatment because of specific symptoms or functional impairments
associated with a serious mental illness or disorder diagnosis, which meet severity criteria
for mental health established by the commissioner and published in March 1997 as
the Minnesota Mental Health Level of Care for Children and Adolescents with Severe
Emotional Disorders.

(f) The determination of the level of care needed by the child shall be made by
the commissioner based on information supplied to the commissioner by the parent or
guardian, the child's physician or physicians, and other professionals as requested by the
commissioner. The commissioner shall establish a screening team to conduct the level of
care determinations according to this subdivision.

(g) If a child meets the conditions in paragraph (b), (c), (d), or (e), the commissioner
must assess the case to determine whether:

(1) the child qualifies as a disabled individual under United States Code, title 42,
section 1382c(a), and would be eligible for medical assistance if residing in a medical
institution; and

(2) the cost of medical assistance services for the child, if eligible under this
subdivision, would not be more than the cost to medical assistance if the child resides in a
medical institution to be determined as follows:

(i) for a child who requires a level of care provided in an ICF/MR, the cost of
care for the child in an institution shall be determined using the average payment rate
established for the regional treatment centers that are certified as ICF's/MR;

(ii) for a child who requires a level of care provided in an inpatient hospital setting
according to paragraph (b), cost-effectiveness shall be determined according to Minnesota
Rules, part 9505.3520, items F and G; and

(iii) for a child who requires a level of care provided in a nursing facility according
to paragraph (c) or (e), cost-effectiveness shall be determined according to Minnesota
Rules, part 9505.3040, except that the nursing facility average rate shall be adjusted to
reflect rates which would be paid for children under age 16. The commissioner may
authorize an amount up to the amount medical assistance would pay for a child referred to
the commissioner by the preadmission screening team under section 256B.0911.

(h) Children eligible for medical assistance services under section 256B.055,
subdivision 12
, as of June 30, 1995, must be screened according to the criteria in this
subdivision prior to January 1, 1996. Children found to be ineligible may not be removed
from the program until January 1, 1996.

Sec. 9.

Minnesota Statutes 2008, section 256B.0621, subdivision 2, is amended to read:


Subd. 2.

Targeted case management; definitions.

For purposes of subdivisions 3
to 10, the following terms have the meanings given them:

(1) "home care service recipients" means those individuals receiving the following
services under sections 256B.0651 to 256B.0656new text begin and 256B.0659new text end: skilled nursing visits,
home health aide visits, private duty nursing, personal care assistants, or therapies
provided through a home health agency;

(2) "home care targeted case management" means the provision of targeted case
management services for the purpose of assisting home care service recipients to gain
access to needed services and supports so that they may remain in the community;

(3) "institutions" means hospitals, consistent with Code of Federal Regulations, title
42, section 440.10; regional treatment center inpatient services, consistent with section
245.474; nursing facilities; and intermediate care facilities for persons with developmental
disabilities;

(4) "relocation targeted case management" includes the provision of both county
targeted case management and public or private vendor service coordination services
for the purpose of assisting recipients to gain access to needed services and supports if
they choose to move from an institution to the community. Relocation targeted case
management may be provided during the lesser of:

(i) the last 180 consecutive days of an eligible recipient's institutional stay; or

(ii) the limits and conditions which apply to federal Medicaid funding for this
service; and

(5) "targeted case management" means case management services provided to help
recipients gain access to needed medical, social, educational, and other services and
supports.

Sec. 10.

Minnesota Statutes 2008, section 256B.0625, subdivision 19a, is amended to
read:


Subd. 19a.

Personal care assistant services.

Medical assistance covers personal
care assistant services in a recipient's home. To qualify for personal care assistant services,
recipients or responsible parties must be able to identify the recipient's needs, direct and
evaluate task accomplishment, and provide for health and safety. Approved hours may be
used outside the home when normal life activities take them outside the home. To use
personal care assistant services at school, the recipient or responsible party must provide
written authorization in the care plan identifying the chosen provider and the daily amount
of services to be used at school. Total hours for services, whether actually performed
inside or outside the recipient's home, cannot exceed that which is otherwise allowed for
personal care assistant services in an in-home setting according to sections 256B.0651 deleted text beginand
256B.0653
deleted text end to 256B.0656new text begin and 256B.0659new text end. Medical assistance does not cover personal care
assistant services for residents of a hospital, nursing facility, intermediate care facility,
health care facility licensed by the commissioner of health, or unless a resident who is
otherwise eligible is on leave from the facility and the facility either pays for the personal
care assistant services or forgoes the facility per diem for the leave days that personal care
assistant services are used. All personal care assistant services must be provided according
to sections 256B.0651 deleted text beginand 256B.0653deleted text end to 256B.0656new text begin and 256B.0659new text end. Personal care
assistant services may not be reimbursed if the personal care assistant is the spouse or legal
guardian of the recipient or the parent of a recipient under age 18, or the responsible party
or the foster care provider of a recipient who cannot direct the recipient's own care unless,
in the case of a foster care provider, a county or state case manager visits the recipient as
needed, but not less than every six months, to monitor the health and safety of the recipient
and to ensure the goals of the care plan are met. Parents of adult recipients, adult children
of the recipient or adult siblings of the recipient may be reimbursed for personal care
assistant services, if they are granted a waiver under sections 256B.0651 deleted text beginand 256B.0653deleted text end
to 256B.0656new text begin and 256B.0659new text end. Notwithstanding the provisions of section deleted text begin256B.0655,
subdivision 2
, paragraph (b), clause (4)
deleted text endnew text begin 256B.0659new text end, the noncorporate legal guardian or
conservator of an adult, who is not the responsible party and not the personal care provider
organization, may be granted a hardship waiver under sections 256B.0651 deleted text beginand 256B.0653deleted text end
to 256B.0656new text begin and 256B.0659new text end, to be reimbursed to provide personal care assistant services
to the recipient, and shall not be considered to have a service provider interest for purposes
of participation on the screening team under section 256B.092, subdivision 7.

Sec. 11.

Minnesota Statutes 2008, section 256B.0651, subdivision 13, is amended to
read:


Subd. 13.

Recovery of excessive payments.

The commissioner shall seek
monetary recovery from providers of payments made for services which exceed the
limits established in this section and sections deleted text begin256B.0653deleted text end new text begin256B.0652 new text endto 256B.0656new text begin and
256B.0659
new text end. This subdivision does not apply to services provided to a recipient at the
previously authorized level pending an appeal under section 256.045, subdivision 10.

Sec. 12.

Minnesota Statutes 2008, section 256B.0652, subdivision 3, is amended to
read:


Subd. 3.

Assessment and prior authorization process.

Effective January 1, 1996,
for purposes of providing informed choice, coordinating of local planning decisions, and
streamlining administrative requirements, the assessment and prior authorization process
for persons receiving both home care and home and community-based waivered services
for persons with developmental disabilities shall meet the requirements of sections
256B.0651 deleted text beginand 256B.0653deleted text end to 256B.0656 new text beginand 256B.0659 new text endwith the following exceptions:

(a) Upon request for home care services and subsequent assessment by the public
health nurse under sections 256B.0651 deleted text beginand 256B.0653deleted text end to 256B.0656new text begin and 256B.0659new text end,
the public health nurse shall participate in the screening process, as appropriate, and,
if home care services are determined to be necessary, participate in the development
of a service plan coordinating the need for home care and home and community-based
waivered services with the assigned county case manager, the recipient of services, and
the recipient's legal representative, if any.

(b) The public health nurse shall give prior authorization for home care services
to the extent that home care services are:

(1) medically necessary;

(2) chosen by the recipient and their legal representative, if any, from the array of
home care and home and community-based waivered services available;

(3) coordinated with other services to be received by the recipient as described
in the service plan; and

(4) provided within the county's reimbursement limits for home care and home and
community-based waivered services for persons with developmental disabilities.

(c) If the public health agency is or may be the provider of home care services to the
recipient, the public health agency shall provide the commissioner of human services with
a written plan that specifies how the assessment and prior authorization process will be
held separate and distinct from the provision of services.

Sec. 13.

Minnesota Statutes 2008, section 256B.0657, subdivision 2, is amended to
read:


Subd. 2.

Eligibility.

(a) The self-directed supports option is available to a person
who:

(1) is a recipient of medical assistance as determined under sections 256B.055,
256B.056, and 256B.057, subdivision 9;

(2) is eligible for personal care assistant services under section deleted text begin256B.0655deleted text endnew text begin
256B.0659
new text end;

(3) lives in the person's own apartment or home, which is not owned, operated, or
controlled by a provider of services not related by blood or marriage;

(4) has the ability to hire, fire, supervise, establish staff compensation for, and
manage the individuals providing services, and to choose and obtain items, related
services, and supports as described in the participant's plan. If the recipient is not able to
carry out these functions but has a legal guardian or parent to carry them out, the guardian
or parent may fulfill these functions on behalf of the recipient; and

(5) has not been excluded or disenrolled by the commissioner.

(b) The commissioner may disenroll or exclude recipients, including guardians and
parents, under the following circumstances:

(1) recipients who have been restricted by the Primary Care Utilization Review
Committee may be excluded for a specified time period;

(2) recipients who exit the self-directed supports option during the recipient's
service plan year shall not access the self-directed supports option for the remainder of
that service plan year; and

(3) when the department determines that the recipient cannot manage recipient
responsibilities under the program.

Sec. 14.

Minnesota Statutes 2008, section 256B.0657, subdivision 6, is amended to
read:


Subd. 6.

Services covered.

(a) Services covered under the self-directed supports
option include:

(1) personal care assistant services under section deleted text begin256B.0655deleted text endnew text begin 256B.0659new text end; and

(2) items, related services, and supports, including assistive technology, that increase
independence or substitute for human assistance to the extent expenditures would
otherwise be used for human assistance.

(b) Items, supports, and related services purchased under this option shall not be
considered home care services for the purposes of section 144A.43.

Sec. 15.

Minnesota Statutes 2008, section 256B.0657, subdivision 8, is amended to
read:


Subd. 8.

Self-directed budget requirements.

The budget for the provision of the
self-directed service option shall be equal to the greater of either:

(1) the annual amount of personal care assistant services under section deleted text begin256B.0655deleted text end
new text begin 256B.0659 new text endthat the recipient has used in the most recent 12-month period; or

(2) the amount determined using the consumer support grant methodology under
section 256.476, subdivision 11, except that the budget amount shall include the federal
and nonfederal share of the average service costs.

Sec. 16.

Minnesota Statutes 2008, section 256B.49, subdivision 17, is amended to read:


Subd. 17.

Cost of services and supports.

(a) The commissioner shall ensure
that the average per capita expenditures estimated in any fiscal year for home and
community-based waiver recipients does not exceed the average per capita expenditures
that would have been made to provide institutional services for recipients in the absence
of the waiver.

(b) The commissioner shall implement on January 1, 2002, one or more aggregate,
need-based methods for allocating to local agencies the home and community-based
waivered service resources available to support recipients with disabilities in need of
the level of care provided in a nursing facility or a hospital. The commissioner shall
allocate resources to single counties and county partnerships in a manner that reflects
consideration of:

(1) an incentive-based payment process for achieving outcomes;

(2) the need for a state-level risk pool;

(3) the need for retention of management responsibility at the state agency level; and

(4) a phase-in strategy as appropriate.

(c) Until the allocation methods described in paragraph (b) are implemented, the
annual allowable reimbursement level of home and community-based waiver services
shall be the greater of:

(1) the statewide average payment amount which the recipient is assigned under the
waiver reimbursement system in place on June 30, 2001, modified by the percentage of
any provider rate increase appropriated for home and community-based services; or

(2) an amount approved by the commissioner based on the recipient's extraordinary
needs that cannot be met within the current allowable reimbursement level. The
increased reimbursement level must be necessary to allow the recipient to be discharged
from an institution or to prevent imminent placement in an institution. The additional
reimbursement may be used to secure environmental modifications; assistive technology
and equipment; and increased costs for supervision, training, and support services
necessary to address the recipient's extraordinary needs. The commissioner may approve
an increased reimbursement level for up to one year of the recipient's relocation from an
institution or up to six months of a determination that a current waiver recipient is at
imminent risk of being placed in an institution.

(d) Beginning July 1, 2001, medically necessary private duty nursing services
will be authorized under this section as complex and regular care according to sections
256B.0651 deleted text beginand 256B.0653deleted text end to 256B.0656new text begin and 256B.0659new text end. The rate established by the
commissioner for registered nurse or licensed practical nurse services under any home and
community-based waiver as of January 1, 2001, shall not be reduced.

Sec. 17.

Minnesota Statutes 2008, section 256B.501, subdivision 4a, is amended to
read:


Subd. 4a.

Inclusion of home care costs in waiver rates.

The commissioner
shall adjust the limits of the established average daily reimbursement rates for waivered
services to include the cost of home care services that may be provided to waivered
services recipients. This adjustment must be used to maintain or increase services and
shall not be used by county agencies for inflation increases for waivered services vendors.
Home care services referenced in this section are those listed in section 256B.0651,
subdivision 2
. The average daily reimbursement rates established in accordance with
the provisions of this subdivision apply only to the combined average, daily costs of
waivered and home care services and do not change home care limitations under sections
256B.0651 deleted text beginand 256B.0653deleted text end to 256B.0656new text begin and 256B.0659new text end. Waivered services recipients
receiving home care as of June 30, 1992, shall not have the amount of their services
reduced as a result of this section.

Sec. 18.

Minnesota Statutes 2008, section 256G.02, subdivision 6, is amended to read:


Subd. 6.

Excluded time.

"Excluded time" means:

(a) any period an applicant spends in a hospital, sanitarium, nursing home, shelter
other than an emergency shelter, halfway house, foster home, semi-independent living
domicile or services program, residential facility offering care, board and lodging facility
or other institution for the hospitalization or care of human beings, as defined in section
144.50, 144A.01, or 245A.02, subdivision 14; maternity home, battered women's shelter,
or correctional facility; or any facility based on an emergency hold under sections
253B.05, subdivisions 1 and 2, and 253B.07, subdivision 6;

(b) any period an applicant spends on a placement basis in a training and habilitation
program, including a rehabilitation facility or work or employment program as defined
in section 268A.01; or receiving personal care assistant services pursuant to section
deleted text begin 256B.0655, subdivision 2deleted text endnew text begin 256B.0659new text end; semi-independent living services provided under
section 252.275, and Minnesota Rules, parts 9525.0500 to 9525.0660; day training and
habilitation programs and assisted living services; and

(c) any placement for a person with an indeterminate commitment, including
independent living.

Sec. 19.

Minnesota Statutes 2008, section 256I.05, subdivision 1a, is amended to read:


Subd. 1a.

Supplementary service rates.

(a) Subject to the provisions of section
256I.04, subdivision 3, the county agency may negotiate a payment not to exceed $426.37
for other services necessary to provide room and board provided by the group residence
if the residence is licensed by or registered by the Department of Health, or licensed by
the Department of Human Services to provide services in addition to room and board,
and if the provider of services is not also concurrently receiving funding for services for
a recipient under a home and community-based waiver under title XIX of the Social
Security Act; or funding from the medical assistance program under section deleted text begin256B.0655,
subdivision 2
deleted text endnew text begin 256B.0659new text end, for personal care services for residents in the setting; or residing
in a setting which receives funding under Minnesota Rules, parts 9535.2000 to 9535.3000.
If funding is available for other necessary services through a home and community-based
waiver, or personal care services under section deleted text begin256B.0655, subdivision 2deleted text endnew text begin 256B.0659new text end,
then the GRH rate is limited to the rate set in subdivision 1. Unless otherwise provided
in law, in no case may the supplementary service rate exceed $426.37. The registration
and licensure requirement does not apply to establishments which are exempt from state
licensure because they are located on Indian reservations and for which the tribe has
prescribed health and safety requirements. Service payments under this section may be
prohibited under rules to prevent the supplanting of federal funds with state funds. The
commissioner shall pursue the feasibility of obtaining the approval of the Secretary of
Health and Human Services to provide home and community-based waiver services under
title XIX of the Social Security Act for residents who are not eligible for an existing home
and community-based waiver due to a primary diagnosis of mental illness or chemical
dependency and shall apply for a waiver if it is determined to be cost-effective.

(b) The commissioner is authorized to make cost-neutral transfers from the GRH
fund for beds under this section to other funding programs administered by the department
after consultation with the county or counties in which the affected beds are located.
The commissioner may also make cost-neutral transfers from the GRH fund to county
human service agencies for beds permanently removed from the GRH census under a plan
submitted by the county agency and approved by the commissioner. The commissioner
shall report the amount of any transfers under this provision annually to the legislature.

(c) The provisions of paragraph (b) do not apply to a facility that has its
reimbursement rate established under section 256B.431, subdivision 4, paragraph (c).

Sec. 20.

Minnesota Statutes 2008, section 256J.45, subdivision 3, is amended to read:


Subd. 3.

Good cause exemptions for not attending orientation.

(a) The county
agency shall not impose the sanction under section 256J.46 if it determines that the
participant has good cause for failing to attend orientation. Good cause exists when:

(1) appropriate child care is not available;

(2) the participant is ill or injured;

(3) a family member is ill and needs care by the participant that prevents the
participant from attending orientation. For a caregiver with a child or adult in the
household who meets the disability or medical criteria for home care services under
section deleted text begin256B.0655, subdivision 1cdeleted text endnew text begin 256B.0659new text end, or a home and community-based waiver
services program under chapter 256B, or meets the criteria for severe emotional
disturbance under section 245.4871, subdivision 6, or for serious and persistent mental
illness under section 245.462, subdivision 20, paragraph (c), good cause also exists when
an interruption in the provision of those services occurs which prevents the participant
from attending orientation;

(4) the caregiver is unable to secure necessary transportation;

(5) the caregiver is in an emergency situation that prevents orientation attendance;

(6) the orientation conflicts with the caregiver's work, training, or school schedule; or

(7) the caregiver documents other verifiable impediments to orientation attendance
beyond the caregiver's control.

(b) Counties must work with clients to provide child care and transportation
necessary to ensure a caregiver has every opportunity to attend orientation.

Sec. 21.

Minnesota Statutes 2008, section 604A.33, subdivision 1, is amended to read:


Subdivision 1.

Application.

This section applies to residential treatment programs
for children or group homes for children licensed under chapter 245A, residential
services and programs for juveniles licensed under section 241.021, providers licensed
pursuant to sections 144A.01 to 144A.33 or sections 144A.43 to 144A.47, personal care
provider organizations under section deleted text begin256B.0655, subdivision 1gdeleted text endnew text begin 256B.0659new text end, providers
of day training and habilitation services under sections 252.40 to 252.46, board and
lodging facilities licensed under chapter 157, intermediate care facilities for persons with
developmental disabilities, and other facilities licensed to provide residential services to
persons with developmental disabilities.

Sec. 22.

Minnesota Statutes 2008, section 609.232, subdivision 11, is amended to read:


Subd. 11.

Vulnerable adult.

"Vulnerable adult" means any person 18 years of
age or older who:

(1) is a resident inpatient of a facility;

(2) receives services at or from a facility required to be licensed to serve adults
under sections 245A.01 to 245A.15, except that a person receiving outpatient services for
treatment of chemical dependency or mental illness, or one who is committed as a sexual
psychopathic personality or as a sexually dangerous person under chapter 253B, is not
considered a vulnerable adult unless the person meets the requirements of clause (4);

(3) receives services from a home care provider required to be licensed under section
144A.46; or from a person or organization that exclusively offers, provides, or arranges
for personal care assistant services under the medical assistance program as authorized
under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651deleted text begin, and
256B.0653
deleted text end to 256B.0656new text begin and 256B.0659new text end; or

(4) regardless of residence or whether any type of service is received, possesses a
physical or mental infirmity or other physical, mental, or emotional dysfunction:

(i) that impairs the individual's ability to provide adequately for the individual's
own care without assistance, including the provision of food, shelter, clothing, health
care, or supervision; and

(ii) because of the dysfunction or infirmity and the need for assistance, the individual
has an impaired ability to protect the individual from maltreatment.

Sec. 23.

Minnesota Statutes 2008, section 626.5572, subdivision 6, is amended to read:


Subd. 6.

Facility.

(a) "Facility" means a hospital or other entity required to be
licensed under sections 144.50 to 144.58; a nursing home required to be licensed to
serve adults under section 144A.02; a residential or nonresidential facility required to
be licensed to serve adults under sections 245A.01 to 245A.16; a home care provider
licensed or required to be licensed under section 144A.46; a hospice provider licensed
under sections 144A.75 to 144A.755; or a person or organization that exclusively offers,
provides, or arranges for personal care assistant services under the medical assistance
program as authorized under sections 256B.04, subdivision 16, 256B.0625, subdivision
19a
, 256B.0651deleted text begin, and 256B.0653deleted text end to 256B.0656new text begin, and 256B.0659new text end.

(b) For home care providers and personal care attendants, the term "facility" refers
to the provider or person or organization that exclusively offers, provides, or arranges for
personal care services, and does not refer to the client's home or other location at which
services are rendered.

Sec. 24.

Minnesota Statutes 2008, section 626.5572, subdivision 21, is amended to
read:


Subd. 21.

Vulnerable adult.

"Vulnerable adult" means any person 18 years of
age or older who:

(1) is a resident or inpatient of a facility;

(2) receives services at or from a facility required to be licensed to serve adults
under sections 245A.01 to 245A.15, except that a person receiving outpatient services for
treatment of chemical dependency or mental illness, or one who is served in the Minnesota
sex offender program on a court-hold order for commitment, or is committed as a sexual
psychopathic personality or as a sexually dangerous person under chapter 253B, is not
considered a vulnerable adult unless the person meets the requirements of clause (4);

(3) receives services from a home care provider required to be licensed under section
144A.46; or from a person or organization that exclusively offers, provides, or arranges
for personal care assistant services under the medical assistance program as authorized
under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, 256B.0651, deleted text beginanddeleted text end
256B.0653 to 256B.0656new text begin, and 256B.0659new text end; or

(4) regardless of residence or whether any type of service is received, possesses a
physical or mental infirmity or other physical, mental, or emotional dysfunction:

(i) that impairs the individual's ability to provide adequately for the individual's
own care without assistance, including the provision of food, shelter, clothing, health
care, or supervision; and

(ii) because of the dysfunction or infirmity and the need for assistance, the individual
has an impaired ability to protect the individual from maltreatment.

ARTICLE 13

CHEMICAL AND MENTAL HEALTH

Section 1.

Minnesota Statutes 2008, section 245.4885, subdivision 1, is amended to
read:


Subdivision 1.

Admission criteria.

deleted text beginThe county board shall,deleted text endnew text begin (a)new text end Prior to admission,
except in the case of emergency admission, deleted text begindetermine the needed level of care fordeleted text end all
children referred for treatment of severe emotional disturbance in a treatment foster care
setting, residential treatment facility, or informally admitted to a regional treatment centernew text begin
shall undergo an assessment to determine the appropriate level of care
new text end if public funds are
used to pay for the services. deleted text beginThe county board shall also determine the needed level of
care for all children admitted to an acute care hospital for treatment of severe emotional
disturbance if public funds other than reimbursement under chapters 256B and 256D
are used to pay for the services.
deleted text end

new text begin (b) The county board shall determine the appropriate level of care when
county-controlled funds are used to pay for the services. When the child is enrolled in
a prepaid health program under section 256B.69, the enrolled child's contracted health
plan must determine the appropriate level of care. When the child is an Indian tribal
member seeking placement through the tribe in a tribally operated or contracted facility,
the tribe must determine the appropriate level of care. When more than one entity bears
responsibility for coverage, the entities shall coordinate level of care determination
activities to the extent possible.
new text end

new text begin (c)new text end The level of care determination shall determine whether the proposed treatment:

(1) is necessary;

(2) is appropriate to the child's individual treatment needs;

(3) cannot be effectively provided in the child's home; and

(4) provides a length of stay as short as possible consistent with the individual
child's need.

new text begin (d) new text endWhen a level of care determination is conducted, the deleted text begincounty boarddeleted text endnew text begin responsible
entity
new text end may not determine that referral or admission to a treatment foster care settingdeleted text begin,deleted text endnew text begin ornew text end
residential treatment facilitydeleted text begin, or acute care hospitaldeleted text end is not appropriate solely because
services were not first provided to the child in a less restrictive setting and the child failed
to make progress toward or meet treatment goals in the less restrictive setting. The level
of care determination must be based on a diagnostic assessment that includes a functional
assessment which evaluates family, school, and community living situations; and an
assessment of the child's need for care out of the home using a validated tool which
assesses a child's functional status and assigns an appropriate level of care. The validated
tool must be approved by the commissioner of human services. If a diagnostic assessment
including a functional assessment has been completed by a mental health professional
within the past 180 days, a new diagnostic assessment need not be completed unless in the
opinion of the current treating mental health professional the child's mental health status
has changed markedly since the assessment was completed. The child's parent shall be
notified if an assessment will not be completed and of the reasons. A copy of the notice
shall be placed in the child's file. Recommendations developed as part of the level of care
determination process shall include specific community services needed by the child and,
if appropriate, the child's family, and shall indicate whether or not these services are
available and accessible to the child and family.

During the level of care determination process, the child, child's family, or child's
legal representative, as appropriate, must be informed of the child's eligibility for case
management services and family community support services and that an individual
family community support plan is being developed by the case manager, if assigned.

The level of care determination shall comply with section 260C.212. deleted text beginWherever
possible,
deleted text end The parent shall be consulted in the process, unless clinically deleted text begininappropriatedeleted text endnew text begin
detrimental to the child
new text end.

The level of care determination, and placement decision, and recommendations for
mental health services must be documented in the child's record.

deleted text begin An alternate review process may be approved by the commissioner if the county
board demonstrates that an alternate review process has been established by the county
board and the times of review, persons responsible for the review, and review criteria are
comparable to the standards in clauses (1) to (4).
deleted text end

Sec. 2.

Minnesota Statutes 2008, section 254A.02, is amended by adding a subdivision
to read:


new text begin Subd. 8a. new text end

new text begin Placing authority. new text end

new text begin "Placing authority" means a county, prepaid health
plan, or tribal governing board governed by Minnesota Rules, parts 9530.6600 to
9530.6655.
new text end

Sec. 3.

new text begin [254A.081] GRANTS FOR DETOXIFICATION SERVICES.
new text end

new text begin (a) Effective January 1, 2011, funds appropriated for alcohol and drug abuse services
from the children's and community services act grants under section 256M.40 must be
allocated to counties for detoxification services as defined in section 254A.08.
new text end

new text begin (b) Funds must be allocated in proportion to the percent of state population at or
below 100 percent of the federal poverty guideline residing in each county.
new text end

new text begin (c) Upon receipt of county expenditure reports for January to June of each year, the
commissioner shall pay each county based on the county's actual expenditures to date plus
projected expenditures for the remainder of the calendar year up to the total amount of
the allocation.
new text end

new text begin (d) By January 31, 2012, and each year thereafter, counties shall report actual
expenditures for detoxification services for the prior year. The commissioner shall
reallocate unexpended funds to counties that expended more than their allocation, based
on the percent of state population at or below 100 percent of the federal poverty guideline
residing in each eligible county.
new text end

Sec. 4.

Minnesota Statutes 2008, section 254A.16, is amended by adding a subdivision
to read:


new text begin Subd. 6. new text end

new text begin Monitoring. new text end

new text begin The commissioner shall gather and placing authorities shall
provide information to measure compliance with Minnesota Rules, parts 9530.6600 to
9530.6655. The commissioner shall specify the format for data collection to facilitate
tracking, aggregating, and using the information.
new text end

Sec. 5.

Minnesota Statutes 2008, section 254B.03, subdivision 3, is amended to read:


Subd. 3.

Local agencies to pay state for county share.

Local agencies shall pay
the state for the county share of the services authorized by the local agencynew text begin, except when
the payment is made according to section 254B.09, subdivision 8
new text end.

Sec. 6.

new text begin [254B.11] MAXIMUM RATES.
new text end

new text begin The commissioner shall publish maximum rates for vendors of the consolidated
chemical dependency treatment fund by July 1 of each year for implementation the
following January 1. Rates for calendar year 2010 must not exceed 185 percent of the
average rate on January 1, 2009, for each group of vendors with similar attributes. Unless
a new rate methodology is developed under section 254B.12, rates for services provided on
and after July 1, 2011, must not exceed 160 percent of the average rate on January 1, 2009,
for each group of vendors with similar attributes. Payment for services provided by Indian
Health Services or by agencies operated by Indian tribes for medical assistance-eligible
individuals must be governed by the applicable federal rate methodology.
new text end

Sec. 7.

new text begin [254B.12] RATE METHODOLOGY.
new text end

new text begin (a) The commissioner shall, with broad-based stakeholder input, develop a
recommendation and present a report to the 2011 legislature, including proposed
legislation for a new rate methodology for the consolidated chemical dependency
treatment fund. The new methodology must replace county-negotiated rates with a
uniform statewide methodology that must include:
new text end

new text begin (1) a graduated reimbursement scale based on the patients' level of acuity and
complexity; and
new text end

new text begin (2) beginning July 1, 2011, retroactive quality incentive payments up to four percent
of each provider's prior-year approved chemical dependency fund claims.
new text end

new text begin (b) The quality incentive payments under paragraph (a), clause (2), must be based on
each provider's performance in the prior year relating to certain program criteria, based on
best practices in addiction treatment. The quality incentive criteria under paragraph (a),
clause (2), may include program completion rates, national outcome measures, program
innovations, lack of licensing violations, and other measures to be determined by the
commissioner.
new text end

Sec. 8.

Minnesota Statutes 2008, section 256B.0625, subdivision 41, is amended to
read:


Subd. 41.

Residential services for children with severe emotional disturbance.

Medical assistance covers rehabilitative services in accordance with section 256B.0945
that are provided by a deleted text begincounty through adeleted text end residential facilitynew text begin under contract with a county or
Indian tribe
new text end, for children who have been diagnosed with severe emotional disturbance and
have been determined to require the level of care provided in a residential facility.

Sec. 9.

Minnesota Statutes 2008, section 256B.0625, subdivision 47, is amended to
read:


Subd. 47.

Treatment foster care services.

Effective July 1, deleted text begin2007deleted text endnew text begin 2011new text end, and subject
to federal approval, medical assistance covers treatment foster care services according to
section 256B.0946.

Sec. 10.

Minnesota Statutes 2008, section 256B.0944, is amended by adding a
subdivision to read:


new text begin Subd. 4a. new text end

new text begin Alternative provider standards. new text end

new text begin If a provider entity demonstrates that,
due to geographic or other barriers, it is not feasible to provide mobile crisis intervention
services 24 hours a day, seven days a week, according to the standards in subdivision 4,
paragraph (b), clause (1), the commissioner may approve a crisis response provider based
on an alternative plan proposed by a provider entity. The alternative plan must:
new text end

new text begin (1) result in increased access and a reduction in disparities in the availability of
crisis services; and
new text end

new text begin (2) provide mobile services outside of the usual nine-to-five office hours and on
weekends and holidays.
new text end

Sec. 11.

Minnesota Statutes 2008, section 256B.0945, subdivision 4, is amended to
read:


Subd. 4.

Payment rates.

(a) Notwithstanding sections 256B.19 and 256B.041,
payments to counties for residential services provided by a residential facility shall only
be made of federal earnings for services provided under this section, and the nonfederal
share of costs for services provided under this section shall be paid by the county from
sources other than federal funds or funds used to match other federal funds. Payment to
counties for services provided according to this section shall be a proportion of the per
day contract rate that relates to rehabilitative mental health services and shall not include
payment for costs or services that are billed to the IV-E program as room and board.

deleted text begin (b) Per diem rates paid to providers under this section by prepaid plans shall be the
proportion of the per-day contract rate that relates to rehabilitative mental health services
and shall not include payment for group foster care costs or services that are billed to the
county of financial responsibility.
deleted text end

deleted text begin (c)deleted text endnew text begin (b)new text end The commissioner shall set aside a portion not to exceed five percent of the
federal funds earned for county expenditures under this section to cover the state costs of
administering this section. Any unexpended funds from the set-aside shall be distributed
to the counties in proportion to their earnings under this section.

new text begin (c) The payment rate negotiated and paid to a provider by prepaid health plans
under section 256B.69 for services under this section must be supplemented by the
commissioner from state appropriations to cover the nontreatment costs at a rate equal to
the portion of the county negotiated per diem attributable to nontreatment service costs for
that provider as determined by the commissioner of human services.
new text end

new text begin (d) Payment for mental health rehabilitative services provided under this section by
or under contract with an Indian tribe or tribal organization or by agencies operated by or
under contract with an Indian tribe or tribal organization may be made according to section
256B.0625, subdivision 34, or other relevant federally approved rate setting methodology.
new text end

Sec. 12.

Minnesota Statutes 2008, section 256B.0947, subdivision 1, is amended to
read:


Subdivision 1.

Scope.

deleted text beginSubject to federal approvaldeleted text endnew text begin Effective May 1, 2010new text end, medical
assistance covers medically necessary, intensive nonresidential rehabilitative mental
health services as defined in subdivision 2, for recipients as defined in subdivision 3, when
the services are provided by an entity meeting the standards in this section.

Sec. 13.

Minnesota Statutes 2008, section 256B.761, is amended to read:


256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.

(a) Effective for services rendered on or after July 1, 2001, payment for medication
management provided to psychiatric patients, outpatient mental health services, day
treatment services, home-based mental health services, and family community support
services shall be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the
50th percentile of 1999 charges.

(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
services provided by an entity that operates: (1) a Medicare-certified comprehensive
outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1,
1993, with at least 33 percent of the clients receiving rehabilitation services in the most
recent calendar year who are medical assistance recipients, will be increased by 38 percent,
when those services are provided within the comprehensive outpatient rehabilitation
facility and provided to residents of nursing facilities owned by the entity.

new text begin (c) Effective January 1, 2010, the rate for partial hospitalization for children is
increased to equal the rate for partial hospitalization for adults.
new text end

Sec. 14. new text beginMENTAL HEALTH PORTION OF CHILDREN'S AND COMMUNITY
SERVICES ACT GRANTS.
new text end

new text begin The commissioner of human services shall consult with stakeholders to develop a
recommendation to the 2010 legislative session regarding administration of the mental
health services portion of those funds to be allocated to mental health starting January 1,
2011, from the children's and community services act grants under Minnesota Statutes,
section 256M.40. The recommendation must include:
new text end

new text begin (1) an effective and efficient process to administer these funds together with other
mental health services funding;
new text end

new text begin (2) identification of the priorities and services to be funded;
new text end

new text begin (3) a reporting and monitoring methodology that is efficient and ensures
accountability; and
new text end

new text begin (4) a funding allocation method.
new text end

ARTICLE 14

HEALTH-RELATED FEES

Section 1.

Minnesota Statutes 2008, section 148.108, is amended to read:


148.108 FEES.

Subdivision 1.

Fees.

In addition to the fees established in Minnesota Rules, chapter
2500, new text beginand according to sections 148.05, 148.06, 148.07, and 148.10, subdivisions 2 and 3,
new text endthe board is authorized to charge the fees in this section.

Subd. 2.

deleted text beginAnnual renewal of inactive acupuncture registrationdeleted text endnew text begin License and
registration fees
new text end.

deleted text begin The annual renewal of an inactive acupuncture registration fee is $25. deleted text end new text begin
License and registration fees are as follows:
new text end

new text begin (1) for a license application fee, $300;
new text end

new text begin (2) for a license active renewal fee, $220;
new text end

new text begin (3) for a license inactive renewal fee, $165;
new text end

new text begin (4) for an acupuncture initial registration fee, $125;
new text end

new text begin (5) for an acupuncture active registration renewal fee, $75;
new text end

new text begin (6) for an acupuncture registration reinstatement fee, $50;
new text end

new text begin (7) for an acupuncture inactive registration renewal fee, $25;
new text end

new text begin (8) for an animal chiropractic registration fee, $125;
new text end

new text begin (9) for an animal chiropractic active registration renewal fee, $75; and
new text end

new text begin (10) for an animal chiropractic inactive registration renewal fee, $25.
new text end

deleted text begin Subd. 3. deleted text end

deleted text begin Acupuncture reinstatement. deleted text end

deleted text begin The acupuncture reinstatement fee is $50.
deleted text end

Sec. 2.

Minnesota Statutes 2008, section 148D.180, subdivision 1, is amended to read:


Subdivision 1.

Application fees.

Application fees for licensure are as follows:

(1) for a licensed social worker, $45;

(2) for a licensed graduate social worker, $45;

(3) for a licensed independent social worker, deleted text begin$90deleted text endnew text begin $45new text end;

(4) for a licensed independent clinical social worker, deleted text begin$90deleted text endnew text begin $45new text end;

(5) for a temporary license, $50; and

(6) for a licensure by endorsement, deleted text begin$150deleted text endnew text begin $85new text end.

The fee for criminal background checks is the fee charged by the Bureau of Criminal
Apprehension. The criminal background check fee must be included with the application
fee as required pursuant to section 148D.055.

Sec. 3.

Minnesota Statutes 2008, section 148D.180, subdivision 2, is amended to read:


Subd. 2.

License fees.

License fees are as follows:

(1) for a licensed social worker, deleted text begin$115.20deleted text endnew text begin $81new text end;

(2) for a licensed graduate social worker, deleted text begin$201.60deleted text endnew text begin $144new text end;

(3) for a licensed independent social worker, deleted text begin$302.40deleted text endnew text begin $216new text end;

(4) for a licensed independent clinical social worker, deleted text begin$331.20deleted text endnew text begin $238.50new text end;

(5) for an emeritus license, $43.20; and

(6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.

If the licensee's initial license term is less or more than 24 months, the required
license fees must be prorated proportionately.

Sec. 4.

Minnesota Statutes 2008, section 148D.180, subdivision 3, is amended to read:


Subd. 3.

Renewal fees.

Renewal fees for licensure are as follows:

(1) for a licensed social worker, deleted text begin$115.20deleted text endnew text begin $81new text end;

(2) for a licensed graduate social worker, deleted text begin$201.60deleted text endnew text begin $144new text end;

(3) for a licensed independent social worker, deleted text begin$302.40deleted text endnew text begin $216new text end; and

(4) for a licensed independent clinical social worker, deleted text begin$331.20deleted text endnew text begin $238.50new text end.

Sec. 5.

Minnesota Statutes 2008, section 148D.180, subdivision 5, is amended to read:


Subd. 5.

Late fees.

Late fees are as follows:

(1) renewal late fee, deleted text beginone-halfdeleted text endnew text begin one-fourthnew text end of the renewal fee specified in subdivision
3; and

(2) supervision plan late fee, $40.

Sec. 6.

Minnesota Statutes 2008, section 148E.180, subdivision 1, is amended to read:


Subdivision 1.

Application fees.

Application fees for licensure are as follows:

(1) for a licensed social worker, $45;

(2) for a licensed graduate social worker, $45;

(3) for a licensed independent social worker, deleted text begin$90deleted text endnew text begin $45new text end;

(4) for a licensed independent clinical social worker, deleted text begin$90deleted text endnew text begin $45new text end;

(5) for a temporary license, $50; and

(6) for a licensure by endorsement, deleted text begin$150deleted text endnew text begin $85new text end.

The fee for criminal background checks is the fee charged by the Bureau of Criminal
Apprehension. The criminal background check fee must be included with the application
fee as required according to section 148E.055.

Sec. 7.

Minnesota Statutes 2008, section 148E.180, subdivision 2, is amended to read:


Subd. 2.

License fees.

License fees are as follows:

(1) for a licensed social worker, deleted text begin$115.20deleted text endnew text begin $81new text end;

(2) for a licensed graduate social worker, deleted text begin$201.60deleted text endnew text begin $144new text end;

(3) for a licensed independent social worker, deleted text begin$302.40deleted text endnew text begin $216new text end;

(4) for a licensed independent clinical social worker, deleted text begin$331.20deleted text endnew text begin $238.50new text end;

(5) for an emeritus license, $43.20; and

(6) for a temporary leave fee, the same as the renewal fee specified in subdivision 3.

If the licensee's initial license term is less or more than 24 months, the required
license fees must be prorated proportionately.

Sec. 8.

Minnesota Statutes 2008, section 148E.180, subdivision 3, is amended to read:


Subd. 3.

Renewal fees.

Renewal fees for licensure are as follows:

(1) for a licensed social worker, deleted text begin$115.20deleted text endnew text begin $81new text end;

(2) for a licensed graduate social worker, deleted text begin$201.60deleted text endnew text begin $144new text end;

(3) for a licensed independent social worker, deleted text begin$302.40deleted text endnew text begin $216new text end; and

(4) for a licensed independent clinical social worker, deleted text begin$331.20deleted text endnew text begin $238.50new text end.

Sec. 9.

Minnesota Statutes 2008, section 148E.180, subdivision 5, is amended to read:


Subd. 5.

Late fees.

Late fees are as follows:

(1) renewal late fee, deleted text beginone-halfdeleted text endnew text begin one-fourthnew text end of the renewal fee specified in subdivision
3; and

(2) supervision plan late fee, $40.

Sec. 10.

new text begin [156.011] LICENSE, APPLICATION, AND EXAMINATION FEES.
new text end

new text begin Subdivision 1. new text end

new text begin Application fee. new text end

new text begin A person applying for a license to practice
veterinary medicine in Minnesota or applying for a permit to take the national veterinary
medical examination must pay a $60 nonrefundable application fee to the board. Persons
submitting concurrent applications for licensure and a national examination permit shall
pay only one application fee.
new text end

new text begin Subd. 2. new text end

new text begin Examination fees. new text end

new text begin (a) An applicant for veterinary licensure in Minnesota
must successfully pass the Minnesota Veterinary Jurisprudence Examination. The fee for
this examination is $60, payable to the board.
new text end

new text begin (b) An applicant participating in the national veterinary licensing examination must
complete a separate application for the national examination and submit the application
to the board for approval. Payment for the national examination must be made by the
applicant to the national board examination committee.
new text end

Sec. 11.

new text begin [156.012] INITIAL AND RENEWAL FEE.
new text end

new text begin Subdivision 1. new text end

new text begin Required for licensure. new text end

new text begin A person now licensed to practice
veterinary medicine in this state, or who becomes licensed by the Board of Veterinary
Medicine to engage in the practice, shall pay an initial fee or a biennial license renewal
fee if the person wishes to practice veterinary medicine in the coming two-year period
or remain licensed as a veterinarian. A licensure period begins on March 1 and expires
the last day of February two years later. A licensee with an even-numbered license shall
renew by March 1 of even-numbered years and a licensee with an odd-numbered license
shall renew by March 1 of odd-numbered years.
new text end

new text begin Subd. 2. new text end

new text begin Amount. new text end

new text begin The initial licensure fee and the biennial renewal fee is $280
and must be paid to the executive director of the board. By January 1 of the first year
for which the biennial renewal fee is due, the board shall issue a renewal application to
a current licensee to the last address maintained in the board file. Failure to receive this
notice does not relieve the licensee of the obligation to pay renewal fees so that they are
received by the board on or before the renewal date of March 1.
new text end

new text begin Initial licenses issued after the start of the licensure renewal period are valid only
until the end of the period.
new text end

new text begin Subd. 3. new text end

new text begin Date due. new text end

new text begin A licensee must apply for a renewal license on or before March
1 of the first year of the biennial license renewal period. A renewal license is valid
from March 1 through the last day of February of the last year of the two-year license
renewal period. An application postmarked no later than the last day of February must be
considered to have been received on March 1.
new text end

new text begin Subd. 4. new text end

new text begin Late renewal penalty. new text end

new text begin An applicant for renewal must pay a late renewal
penalty of $140 in addition to the renewal fee if the application for renewal is received
after March 1 of the licensure renewal period. A renewed license issued after March 1 of
the licensure renewal period is valid only to the end of the period regardless of when the
renewal fee is received.
new text end

new text begin Subd. 5. new text end

new text begin Reinstatement fee. new text end

new text begin An applicant for license renewal whose license
has previously been suspended by official board action for nonrenewal must pay a
reinstatement fee of $60 in addition to the $280 renewal fee and the $140 late renewal
penalty.
new text end

new text begin Subd. 6. new text end

new text begin Penalty for failure to pay. new text end

new text begin Within 30 days after the renewal date, a
licensee who has not renewed the license must be notified by letter sent to the last known
address of the licensee in the file of the board that the renewal is overdue and that failure
to pay the current fee and current late fee within 60 days after the renewal date will result
in suspension of the license. A second notice must be sent by registered or certified mail at
least seven days before a board meeting occurring 60 days or more after the renewal date
to a licensee who has not paid the renewal fee and late fee.
new text end

new text begin Subd. 7. new text end

new text begin Suspension. new text end

new text begin The board, by means of a roll call vote, shall suspend the
license of a licensee whose license renewal is at least 60 days overdue and to whom
notification has been sent as provided in subpart 5. Failure of a licensee to receive
notification is not grounds for later challenge by the licensee of the suspension. The
former licensee must be notified by registered or certified letter within seven days of the
board action. The suspended status placed on a license may be removed only on payment
of renewal fees and late penalty fees for each licensure period or part of a period that the
license was not renewed. A licensee who fails to renew a license for five years or more
must meet the criteria of section 156.071, for relicensure.
new text end

new text begin Subd. 8. new text end

new text begin Inactive license. new text end

new text begin (a) A person holding a current active license to practice
veterinary medicine in Minnesota may, at the time of the person's next biennial license
renewal date, renew the license as an inactive license at one-half the renewal fee of an
active license. The license may be continued in an inactive status by renewal on a biennial
basis at one-half the regular license fee.
new text end

new text begin (b) A person holding an inactive license is not permitted to practice veterinary
medicine in Minnesota and remains under the disciplinary authority of the board.
new text end

new text begin (c) A person may convert a current inactive license to an active license upon
application to and approval by the board. The application must include:
new text end

new text begin (1) documentation of licensure in good standing and of having met continuing
education requirements of current state of practice, or documentation of having met
Minnesota continuing education requirements retroactive to the date of licensure
inactivation;
new text end

new text begin (2) certification by the applicant that the applicant is not currently under disciplinary
orders or investigation for acts that could result in disciplinary action in any other
jurisdiction; and
new text end

new text begin (3) payment of a fee equal to the full difference between an inactive and active
license if converting during the first year of the biennial license cycle or payment of a fee
equal to one-half the difference between an inactive and an active license if converting
during the second year of the license cycle.
new text end

new text begin (d) Deadline for renewal of an inactive license is March 1 of the first year of the
biennial license renewal period. A late renewal penalty of one-half the inactive renewal
fee must be paid if renewal is received after March 1.
new text end

Sec. 12.

Minnesota Statutes 2008, section 156.015, is amended to read:


156.015 new text beginMISCELLANEOUS new text endFEES.

Subdivision 1.

Verification of licensure.

The board may charge a fee of $25 per
license verification to a licensee for verification of licensure status provided to other
veterinary licensing boards.

Subd. 2.

Continuing education review.

The board may charge a fee of $50 per
submission to a sponsor for review and approval of individual continuing education
seminars, courses, wet labs, and lectures. This fee does not apply to continuing education
sponsors that already meet the criteria for preapproval under Minnesota Rules, part
9100.1000, subpart 3, item A.

new text begin Subd. 3. new text end

new text begin Temporary license fee. new text end

new text begin A person meeting the requirements for issuance
of a temporary permit to practice veterinary medicine under section 156.073, pending
examination, who desires a temporary permit shall pay a fee of $60 to the board.
new text end

new text begin Subd. 4. new text end

new text begin Duplicate license. new text end

new text begin A person requesting issuance of a duplicate or
replacement license shall pay a fee of $15 to the board.
new text end

new text begin Subd. 5. new text end

new text begin Mailing examination and reference materials. new text end

new text begin An applicant who resides
outside the Twin Cities metropolitan area may request to take the Minnesota Veterinary
Jurisprudence Examination by mail. The fee for mailing the examination and reference
materials is $15.
new text end

Sec. 13. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Rules, parts 9100.0400, subparts 1 and 3; 9100.0500; and 9100.0600, new text end new text begin
are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2008, section 148D.180, subdivision 8, new text end new text begin is repealed.
new text end

ARTICLE 15

CORRECTIONAL STATE EMPLOYEES RETIREMENT PLAN - I

Section 1.

Minnesota Statutes 2008, section 352.90, is amended to read:


352.90 POLICY.

It is the policy of the legislature to provide special retirement benefits for and special
contributions by certain correctional employees who may be required to retire at an early
age because they lose the mental or physical capacity required to maintain the safety,
security, discipline, and custody of inmates at state correctional facilities deleted text beginordeleted text endnew text begin,new text end of patients at
the Minnesota Security Hospital, new text beginor new text endof patients in the Minnesota sex offender programdeleted text begin, or
of patients in the Minnesota extended treatment options program
deleted text end.

Sec. 2.

Minnesota Statutes 2008, section 352.91, subdivision 1, is amended to read:


Subdivision 1.

Qualifying jobs.

"Covered correctional service" means service
performed by a state employee, as defined in section 352.01, new text beginwho is new text endemployed at a state
correctional facility, the Minnesota Security Hospital, or the Minnesota sex offender
program as:

(1) a corrections officer 1;

(2) a corrections officer 2;

(3) a corrections officer 3;

deleted text begin (4) a corrections officer supervisor;
deleted text end

deleted text begin (5)deleted text endnew text begin (4)new text end a corrections lieutenant;

deleted text begin (6)deleted text endnew text begin (5)new text end a corrections captain;

deleted text begin (7)deleted text endnew text begin (6)new text end a security counselor;

deleted text begin (8)deleted text endnew text begin (7)new text end a security counselor lead; deleted text beginor
deleted text end

deleted text begin (9)deleted text endnew text begin (8)new text end a corrections canine officerdeleted text begin.deleted text endnew text begin;
new text end

new text begin (9) group supervisor; or
new text end

new text begin (10) group supervisor assistant.
new text end

Sec. 3.

Minnesota Statutes 2008, section 352.91, subdivision 3h, is amended to read:


Subd. 3h.

Employment occupation name changes.

(a) If the occupational title of a
state employee covered by the Minnesota correctional employees retirement plan changes
from the applicable title listed in subdivision 1, deleted text begin2, 2a, 3c, 3d, 3e, 3f, or 3g,deleted text end qualification for
coverage by the correctional state employees retirement plan continues until the July 1
next following the title change if the commissioner of finance certifies to the executive
director of the Minnesota State Retirement System and to the executive director of the
Legislative Commission on Pensions and Retirement that the duties, requirements, and
responsibilities of the new occupational title are substantially identical to the duties,
requirements, and responsibilities of the prior occupational title.

(b) If the commissioner of finance does not certify a new occupational title under
paragraph (a), eligibility for future correctional state employees retirement coverage
terminates as of the start of the first payroll period next following the effective date of the
occupational title change.

(c) For consideration by the Legislative Commission on Pensions and Retirement
during the legislative session next following an occupational title change involving a state
employee in covered correctional service, the commissioner of finance shall submit the
applicable draft proposed legislation reflecting the occupational title change covered
by this section.

Sec. 4. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2008, section 352.91, subdivisions 2, 2a, 3c, 3d, 3e, 3f, 3g, 3i,
4a, 4b, and 5,
new text end new text begin are repealed.
new text end

Sec. 5. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 1 to 4 are effective July 1, 2009.
new text end

ARTICLE 16

CORRECTIONAL STATE EMPLOYEES RETIREMENT PLAN - II

Section 1.

Minnesota Statutes 2008, section 352.72, subdivision 1, is amended to read:


Subdivision 1.

Entitlement to annuity.

(a) new text beginExcept as provided in paragraph (b), new text endany
person who has been an employee covered by a retirement system listed in paragraph deleted text begin(b)deleted text end
new text begin (c) new text endis entitled when qualified to an annuity from each fund if total allowable service in all
funds or in any two of these funds totals three or more years.

(b) new text beginIf the combination of retirement plans includes the correctional state employees
retirement plan of the Minnesota State Retirement System, no retirement annuity is
payable from the correctional state employees retirement plan unless the person has credit
for at least ten years of covered correctional service under section 352.91, although any
covered correctional service may be used to establish eligibility for an annuity from
another retirement plan and a service credit transfer under section 352.93, subdivision
4a, may be elected.
new text end

new text begin (c) new text endThis section applies to the Minnesota State Retirement System, the Public
Employees Retirement Association including the Public Employees Retirement
Association police and fire fund, the Teachers Retirement Association, the State Patrol
Retirement Association, or any other public employee retirement system in the state with
a similar provision, except as noted in paragraph deleted text begin(c)deleted text endnew text begin (d)new text end.

deleted text begin (c)deleted text end new text begin(d) new text endThis section does not apply to deleted text beginotherdeleted text end funds providing benefits for police
officers or firefightersnew text begin under chapter 423A, 423B, or 424Anew text end.

deleted text begin (d)deleted text end new text begin(e) new text endNo portion of the allowable service upon which the retirement annuity from
one fund is based shall be again used in the computation for benefits from another fund.
No refund may have been taken from any one of these funds since service entitling the
employee to coverage under the system or the employee's membership in any of the
associations last terminated. The annuity from each fund must be determined by the
appropriate provisions of the law except that the requirement that a person must have at
least three years allowable service in the respective system or association does not apply
for the purposes of this section if the combined service in two or more of these funds
equals three or more years.

Sec. 2.

Minnesota Statutes 2008, section 352.93, subdivision 1, is amended to read:


Subdivision 1.

Basis of annuity; when to apply.

After separation from state
service, an employee covered under section 352.91 who has reached age 55 years and
has credit for at least deleted text beginthreedeleted text end new text beginten new text endyears of covered correctional service deleted text beginor a combination
of covered correctional service and general employees state retirement plan service
deleted text end is
entitled upon application to a retirement annuity under this section, based only on covered
correctional employees' service. Application may be made no earlier than 60 days before
the date the employee is eligible to retire by reason of both age and service requirements.

Sec. 3.

Minnesota Statutes 2008, section 352.93, subdivision 2a, is amended to read:


Subd. 2a.

Early retirement.

Any covered correctional employee who becomes at
least 50 years old and who has at least deleted text beginthreedeleted text end new text beginten new text endyears of deleted text beginallowabledeleted text end new text begincovered correctional
new text endservice is entitled upon application to a reduced retirement annuity equal to the annuity
calculated under subdivision 2, reduced by two-tenths of one percent for each month that
the correctional employee is under age 55 at the time of retirement.

Sec. 4.

Minnesota Statutes 2008, section 352.93, subdivision 4, is amended to read:


Subd. 4.

Employee with regular and correctional service.

A former employee
who has both regular and correctional service shall, if new text beginthe employee has at least ten years
of covered correctional service and is otherwise
new text endqualified, receive an annuity based on
both periods of service under applicable sections of law but no period of service shall be
used more than once in calculating the annuity.

Sec. 5.

Minnesota Statutes 2008, section 352.93, is amended by adding a subdivision
to read:


new text begin Subd. 4a. new text end

new text begin Service credit transfer and partial refund in certain instances. new text end

new text begin An
employee covered under section 352.91 who has reached the age of 55 years and who has
credit for less than ten years of covered correctional service may, upon written application,
have that covered correctional service credited as allowable service credit in the general
state employees retirement plan and used to calculate a retirement annuity under sections
352.115 and 352.116, and receive, 30 days following retirement, a refund of that portion
of employee contributions during covered correctional service under section 352.92,
subdivision 1, that exceeds the employee contributions required under the general state
employees retirement plan under section 352.04, subdivision 2, for the same period, plus
annual compound interest on the partial refund amount from the date of each contribution
until the date of refund payment at the rate of six percent.
new text end

Sec. 6.

Minnesota Statutes 2008, section 356.30, subdivision 1, is amended to read:


Subdivision 1.

Eligibility; computation of annuity.

(a) Notwithstanding any
provisions of the laws governing the retirement plans enumerated in subdivision 3, a
person who has met the qualifications of paragraph (b) may elect to receive a retirement
annuity from each enumerated retirement plannew text begin, other than the correctional state employees
retirement plan of the Minnesota State Retirement System,
new text end in which the person has at least
one-half year of allowable service, based on the allowable service in each plan, subject to
the provisions of paragraph (c).

(b) A person may receive, upon retirement, a retirement annuity from each
enumerated retirement plannew text begin, other than the correctional state employees retirement plan of
the Minnesota State Retirement System,
new text end in which the person has at least one-half year of
allowable service, and augmentation of a deferred annuity calculated at the appropriate
rate under the laws governing each public pension plan or fund named in subdivision 3,
based on the date of the person's initial entry into public employment from the date the
person terminated all public service if:

(1) the person has allowable service totaling an amount that allows the person to
receive an annuity in any two or more of the enumerated plans; and

(2) the person has not begun to receive an annuity from any enumerated plan or the
person has made application for benefits from each applicable plan and the effective
dates of the retirement annuity with each plan under which the person chooses to receive
an annuity are within a one-year period.

(c) The retirement annuity from each plan must be based upon the allowable service,
accrual rates, and average salary in the applicable plan except as further specified or
modified in the following clauses:

(1) the laws governing annuities must be the law in effect on the date of termination
from the last period of public service under a covered retirement plan with which the
person earned a minimum of one-half year of allowable service credit during that
employment;

(2) the "average salary" on which the annuity from each covered plan in which
the employee has credit in a formula plan must be based on the employee's highest five
successive years of covered salary during the entire service in covered plans;

(3) the accrual rates to be used by each plan must be those percentages prescribed by
each plan's formula as continued for the respective years of allowable service from one
plan to the next, recognizing all previous allowable service with the other covered plans;

(4) the allowable service in all the plans must be combined in determining eligibility
for and the application of each plan's provisions in respect to reduction in the annuity
amount for retirement prior to normal retirement age; deleted text beginanddeleted text end

(5) the annuity amount payable for any allowable service under a nonformula plan
of a covered plan must not be affected, but such service and covered salary must be used
in the above calculationdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (6) for a person who was a member of the correctional state employees retirement
plan, the person must have at least ten years of covered correctional service under section
352.91 in order to receive a retirement annuity from that plan, but may apply for a service
credit transfer and partial refund under section 352.93, subdivision 4a.
new text end

(d) This section does not apply to any person whose final termination from the last
public service under a covered plan was before May 1, 1975.

(e) For the purpose of computing annuities under this section, the accrual rates
used by any covered plan, except the public employees police and fire plan, the judges
retirement fund, and the State Patrol retirement plan, must not exceed the percent specified
in section 356.315, subdivision 4, per year of service for any year of service or fraction
thereof. The formula percentage used by the judges retirement fund must not exceed the
percentage rate specified in section 356.315, subdivision 8, per year of service for any
year of service or fraction thereof. The accrual rate used by the public employees police
and fire plan and the State Patrol retirement plan must not exceed the percentage rate
specified in section 356.315, subdivision 6, per year of service for any year of service or
fraction thereof. The accrual rate or rates used by the legislators retirement plan must not
exceed 2.5 percent, but this limit does not apply to the adjustment provided under section
3A.02, subdivision 1, paragraph (c).

(f) Any period of time for which a person has credit in more than one of the covered
plans must be used only once for the purpose of determining total allowable service.

(g) If the period of duplicated service credit is more than one-half year, or the person
has credit for more than one-half year, with each of the plans, each plan must apply its
formula to a prorated service credit for the period of duplicated service based on a fraction
of the salary on which deductions were paid to that fund for the period divided by the total
salary on which deductions were paid to all plans for the period.

(h) If the period of duplicated service credit is less than one-half year, or when
added to other service credit with that plan is less than one-half year, the service credit
must be ignored and a refund of contributions made to the person in accord with that
plan's refund provisions.

Sec. 7. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 1 to 6 are effective July 1, 2009.
new text end

ARTICLE 17

HEALTH AND HUMAN SERVICES APPROPRIATIONS

Section 1. new text begin SUMMARY OF APPROPRIATIONS.
new text end

new text begin The amounts shown in this section summarize direct appropriations by fund made
in this article.
new text end

new text begin 2010
new text end
new text begin 2011
new text end
new text begin Total
new text end
new text begin General
new text end
new text begin $
new text end
new text begin 5,311,561,000
new text end
new text begin $
new text end
new text begin 5,544,392,000
new text end
new text begin $
new text end
new text begin 10,855,953,000
new text end
new text begin State Government Special
Revenue
new text end
new text begin 60,719,000
new text end
new text begin 60,532,000
new text end
new text begin 121,251,000
new text end
new text begin Health Care Access
new text end
new text begin 372,976,000
new text end
new text begin 118,764,000
new text end
new text begin 491,740,000
new text end
new text begin Federal TANF
new text end
new text begin 281,030,000
new text end
new text begin 274,912,000
new text end
new text begin 555,942,000
new text end
new text begin Lottery Prize
new text end
new text begin 1,665,000
new text end
new text begin 1,665,000
new text end
new text begin 3,330,000
new text end
new text begin Clean Water
new text end
new text begin 1,250,000
new text end
new text begin 2,500,000
new text end
new text begin 3,750,000
new text end
new text begin Total
new text end
new text begin $
new text end
new text begin 6,029,201,000
new text end
new text begin $
new text end
new text begin 6,002,765,000
new text end
new text begin $
new text end
new text begin 12,031,966,000
new text end

Sec. 2. new text beginHEALTH AND HUMAN SERVICES APPROPRIATION.
new text end

new text begin The sums shown in the columns marked "Appropriations" are appropriated to the
agencies and for the purposes specified in this article. The appropriations are from the
general fund, or another named fund, and are available for the fiscal years indicated
for each purpose. The figures "2010" and "2011" used in this article mean that the
appropriations listed under them are available for the fiscal year ending June 30, 2010, or
June 30, 2011, respectively. "The first year" is fiscal year 2010. "The second year" is fiscal
year 2011. "The biennium" is fiscal years 2010 and 2011. Appropriations for the fiscal
year ending June 30, 2009, are effective the day following final enactment.
new text end

new text begin APPROPRIATIONS
new text end
new text begin Available for the Year
new text end
new text begin Ending June 30
new text end
new text begin 2010
new text end
new text begin 2011
new text end

Sec. 3. new text beginHUMAN SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin 5,861,298,000
new text end
new text begin $
new text end
new text begin 5,840,623,000
new text end
new text begin Appropriations by Fund
new text end
new text begin 2010
new text end
new text begin 2011
new text end
new text begin General
new text end
new text begin 5,237,520,000
new text end
new text begin 5,475,544,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 565,000
new text end
new text begin 565,000
new text end
new text begin Health Care Access
new text end
new text begin 352,251,000
new text end
new text begin 99,670,000
new text end
new text begin Federal TANF
new text end
new text begin 269,297,000
new text end
new text begin 263,179,000
new text end
new text begin Lottery Prize
new text end
new text begin 1,665,000
new text end
new text begin 1,665,000
new text end

new text begin new text begin Receipts for Systems Projects.new text end
Appropriations and federal receipts for
information systems projects for MAXIS,
PRISM, MMIS, and SSIS must be deposited
in the state system account authorized in
Minnesota Statutes, section 256.014. Money
appropriated for computer projects approved
by the Minnesota Office of Enterprise
Technology, funded by the legislature, and
approved by the commissioner of finance,
may be transferred from one project to
another and from development to operations
as the commissioner of human services
considers necessary. Any unexpended
balance in the appropriation for these
projects does not cancel but is available for
ongoing development and operations.
new text end

new text begin Nonfederal Share Transfers. new text end new text begin The
nonfederal share of activities for which
federal administrative reimbursement is
appropriated to the commissioner may be
transferred to the special revenue fund.
new text end

new text begin TANF Maintenance of Effort.
new text end

new text begin (a) In order to meet the basic maintenance
of effort (MOE) requirements of the TANF
block grant specified under Code of Federal
Regulations, title 45, section 263.1, the
commissioner may only report nonfederal
money expended for allowable activities
listed in the following clauses as TANF/MOE
expenditures:
new text end

new text begin (1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 256J;
new text end

new text begin (2) the child care assistance programs
under Minnesota Statutes, sections 119B.03
and 119B.05, and county child care
administrative costs under Minnesota
Statutes, section 119B.15;
new text end

new text begin (3) state and county MFIP administrative
costs under Minnesota Statutes, chapters
256J and 256K;
new text end

new text begin (4) state, county, and tribal MFIP
employment services under Minnesota
Statutes, chapters 256J and 256K;
new text end

new text begin (5) expenditures made on behalf of
noncitizen MFIP recipients who qualify
for the medical assistance without federal
financial participation program under
Minnesota Statutes, section 256B.06,
subdivision 4, paragraphs (d), (e), and (j);
and
new text end

new text begin (6) qualifying working family credit
expenditures under Minnesota Statutes,
section 290.0671.
new text end

new text begin (b) The commissioner shall ensure that
sufficient qualified nonfederal expenditures
are made each year to meet the state's
TANF/MOE requirements. For the activities
listed in paragraph (a), clauses (2) to
(6), the commissioner may only report
expenditures that are excluded from the
definition of assistance under Code of
Federal Regulations, title 45, section 260.31.
new text end

new text begin (c) For fiscal years beginning with state
fiscal year 2003, the commissioner shall
ensure that the maintenance of effort used
by the commissioner of finance for the
February and November forecasts required
under Minnesota Statutes, section 16A.103,
contains expenditures under paragraph (a),
clause (1), equal to at least 16 percent of
the total required under Code of Federal
Regulations, title 45, section 263.1.
new text end

new text begin (d) For the federal fiscal year beginning
October 1, 2007, the commissioner may not
claim an amount of TANF/MOE in excess of
the 75 percent standard in Code of Federal
Regulations, title 45, section 263.1(a)(2),
except:
new text end

new text begin (1) to the extent necessary to meet the 80
percent standard under Code of Federal
Regulations, title 45, section 263.1(a)(1),
if it is determined by the commissioner
that the state will not meet the TANF work
participation target rate for the current year;
new text end

new text begin (2) to provide any additional amounts
under Code of Federal Regulations, title 45,
section 264.5, that relate to replacement of
TANF funds due to the operation of TANF
penalties; and
new text end

new text begin (3) to provide any additional amounts that
may contribute to avoiding or reducing
TANF work participation penalties through
the operation of the excess MOE provisions
of Code of Federal Regulations, title 45,
section 261.43(a)(2).
new text end

new text begin For the purposes of clauses (1) to (3),
the commissioner may supplement the
MOE claim with working family credit
expenditures to the extent such expenditures
or other qualified expenditures are otherwise
available after considering the expenditures
allowed in this section.
new text end

new text begin (e) Minnesota Statutes, section 256.011,
subdivision 3, which requires that federal
grants or aids secured or obtained under that
subdivision be used to reduce any direct
appropriations provided by law, do not apply
if the grants or aids are federal TANF funds.
new text end

new text begin (f) Notwithstanding any contrary provision
in this article, this provision expires June 30,
2013.
new text end

new text begin new text begin Working Family Credit Expenditures as
TANF/MOE.
new text end
The commissioner may claim
as TANF/MOE up to $6,707,000 per year for
fiscal year 2010 through fiscal year 2011.
new text end

new text begin new text begin Working Family Credit Expenditures
to be Claimed for TANF/MOE.
new text end
The
commissioner may count the following
amounts of working family credit expenditure
as TANF/MOE:
new text end

new text begin (1) fiscal year 2010, $42,079,000;
new text end

new text begin (2) fiscal year 2011, $61,494,000;
new text end

new text begin (3) fiscal year 2012, $44,236,000; and
new text end

new text begin (4) fiscal year 2013, $46,952,000.
new text end

new text begin Notwithstanding any contrary provision in
this article, this rider expires June 30, 2013.
new text end

new text begin new text begin TANF Transfer to Federal Child Care
and Development Fund.
new text end
The following
TANF fund amounts are appropriated to the
commissioner for the purposes of MFIP and
transition year child care under Minnesota
Statutes, section 119B.05:
new text end

new text begin (1) fiscal year 2010, $9,415,000;
new text end

new text begin (2) fiscal year 2011, $24,568,000;
new text end

new text begin (3) fiscal year 2012, $26,866,000; and
new text end

new text begin (4) fiscal year 2013, $29,664,000.
new text end

new text begin The commissioner shall authorize the
transfer of sufficient TANF funds to the
federal child care and development fund to
meet this appropriation and shall ensure that
all transferred funds are expended according
to federal child care and development fund
regulations.
new text end

new text begin new text begin Child Care and Development Fund
Unexpended Balance.
new text end
(a) The commissioner
shall determine the unexpended balance of
the federal Child Care and Development
Fund (CCDF) for the basic sliding fee child
care program by February 28, 2009. The
balance must first be used to fund programs
described in paragraph (b) and the remainder
must be available for the basic sliding fee
child care under Minnesota Statutes, section
119B.03.
new text end

new text begin (b) Notwithstanding Minnesota Statutes,
section 119B.03, subdivision 5b, and
Minnesota Rules, part 3400.0060, subpart
4, the commissioner shall expend up to
$763,000 in fiscal year 2010 and up to
$760,000 in fiscal year 2011 to continue the
school readiness service agreements pilot
under Minnesota Statutes, section 119B.231.
The commissioner shall expend up to
$990,000 in fiscal year 2011 to support the
Parent Aware pilot. The commissioner shall
ensure that all child care and development
funds are expended according to the
federal Child Care and Development Fund
regulations.
new text end

new text begin new text begin Food Stamps Employment and Training.new text end
Notwithstanding Minnesota Statutes, sections
256J.626 and 256D.051, subdivisions 1a, 6b,
and 6c, federal food stamps employment and
training funds received as reimbursement of
MFIP consolidated fund grant expenditures
and child care assistance program
expenditures for two-parent families must be
deposited in the general fund. The amount of
funds must be limited to $3,400,000 in fiscal
year 2010 and $4,400,000 in fiscal years
2011 through 2013, contingent on approval
by the federal Food and Nutrition Service.
Consistent with the receipt of these federal
funds, the commissioner may adjust the
level of working family credit expenditures
claimed as TANF maintenance of effort.
Notwithstanding any contrary provision in
this article, this rider expires June 30, 2013.
new text end

new text begin Subd. 2. new text end

new text begin Agency Management
new text end

new text begin The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end

new text begin (a) Financial Operations
new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 3,380,000
new text end
new text begin 3,908,000
new text end
new text begin Health Care Access
new text end
new text begin 1,241,000
new text end
new text begin 1,016,000
new text end
new text begin Federal TANF
new text end
new text begin 122,000
new text end
new text begin 122,000
new text end
new text begin (b) Legal and Regulatory Operations
new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 13,690,000
new text end
new text begin 13,470,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 440,000
new text end
new text begin 440,000
new text end
new text begin Health Care Access
new text end
new text begin 943,000
new text end
new text begin 943,000
new text end
new text begin Federal TANF
new text end
new text begin 100,000
new text end
new text begin 100,000
new text end

new text begin new text begin Base Adjustment.new text end The general fund base
is decreased $4,550,000 in fiscal year 2012
and $4,550,000 in fiscal year 2013. The state
government special revenue fund base is
increased $4,500,000 in fiscal year 2012 and
$4,500,000 in fiscal year 2013.
new text end

new text begin (c) Management Operations
new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 4,715,000
new text end
new text begin 4,715,000
new text end
new text begin Health Care Access
new text end
new text begin 242,000
new text end
new text begin 242,000
new text end
new text begin (d) Information Technology Operations
new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 28,077,000
new text end
new text begin 28,077,000
new text end
new text begin Health Care Access
new text end
new text begin 4,856,000
new text end
new text begin 4,868,000
new text end

new text begin Subd. 3. new text end

new text begin Revenue and Pass-Through Revenue
Expenditures
new text end

new text begin 75,161,000
new text end
new text begin 91,656,000
new text end

new text begin This appropriation is from the federal TANF
fund.
new text end

new text begin Subd. 4. new text end

new text begin Children and Economic Assistance
Grants
new text end

new text begin The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end

new text begin (a) MFIP/DWP Grants
new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 67,984,000
new text end
new text begin 75,077,000
new text end
new text begin Federal TANF
new text end
new text begin 82,257,000
new text end
new text begin 71,494,000
new text end
new text begin (b) Support Services Grants
new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 8,715,000
new text end
new text begin 8,715,000
new text end
new text begin Federal TANF
new text end
new text begin 110,961,000
new text end
new text begin 99,111,000
new text end

new text begin new text begin MFIP Consolidated Fund.new text end The MFIP
consolidated fund TANF appropriation is
reduced by $2,750,000 in fiscal year 2010
and $5,500,000 in fiscal year 2011.
new text end

new text begin (c) MFIP Child Care Assistance Grants
new text end
new text begin 52,219,000
new text end
new text begin 37,204,000
new text end
new text begin (d) Basic Sliding Fee Child Care Assistance
Grants
new text end
new text begin 42,855,000
new text end
new text begin 42,330,000
new text end

new text begin Base Adjustment. new text end new text begin The general fund base is
increased by $5,000 in fiscal year 2012 and
$7,000 in fiscal year 2013.
new text end

new text begin (e) Child Care Development Grants
new text end
new text begin 1,389,000
new text end
new text begin 1,340,000
new text end

new text begin new text begin Child Care Program Integrity Funds for
State Fraud Program.
new text end
Child care program
integrity grants are reduced to $49,000 in
fiscal year 2010 and $0 in fiscal year 2011
for the purpose of funding state assumption
of the county fraud prevention investigation
function.
new text end

new text begin (f) Child Support Enforcement Grants
new text end
new text begin 3,705,000
new text end
new text begin 3,705,000
new text end
new text begin (g) Children's Services Grants
new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 50,590,000
new text end
new text begin 54,879,000
new text end
new text begin Federal TANF
new text end
new text begin 200,000
new text end
new text begin 200,000
new text end

new text begin Base Adjustment. new text end new text begin The general fund base is
increased by $4,625,000 in fiscal year 2012
and $7,192,000 in fiscal year 2013.
new text end

new text begin Privatized Adoption Grants. new text end new text begin Federal
reimbursement for privatized adoption grant
and foster care recruitment grant expenditures
is appropriated to the commissioner for
adoption grants and foster care and adoption
administrative purposes.
new text end

new text begin Adoption Assistance Incentive Grants. new text end new text begin
Federal funds available during fiscal year
2010 and fiscal year 2011 for the adoption
incentive grants are appropriated to the
commissioner for these purposes.
new text end

new text begin Adoption Assistance, Relative Custody
Assistance, and Northstar Care for
Children.
new text end
new text begin The commissioner may transfer
unencumbered appropriation balances
for adoption assistance, relative custody
assistance, and Northstar care for children
between fiscal years and between programs.
new text end

new text begin (h) Children and Community Services Grants
new text end
new text begin 67,604,000
new text end
new text begin 67,463,000
new text end

new text begin new text begin Targeted Case Management Temporary
Funding Adjustment.
new text end
The commissioner
shall recover from each county and tribe
receiving a targeted case management
temporary funding payment in fiscal year
2008 an amount equal to that payment. The
commissioner shall recover one-half of the
funds by February 1, 2010, and the remainder
by February 1, 2011. At the commissioner's
discretion and at the request of a county
or tribe, the commissioner may revise
the payment schedule, but full payment
must not be delayed beyond May 1, 2011.
The commissioner may use the recovery
procedure under Minnesota Statutes, section
256.017, to recover the funds. Recovered
funds must be deposited into the general
fund.
new text end

new text begin new text begin CCSA Distribution.new text end Beginning July 1, 2011,
the general fund base must be distributed
among program categories according to the
following percentages: Children's Services,
56.5 percent; Mental Health and Chemical
Dependency 28.0 percent; and Adult and
Disability 15.5 percent. The commissioner
shall transfer funds from this appropriation
to implement this distribution.
new text end

new text begin new text begin Children and Communities Services Act
Distribution of County Social Services
Block Grant (SSBG) Funds.
new text end
Beginning
January 1, 2011, the federal SSBG funds
available for grants for the calendar year will
be distributed among programs according
to the following percentages: children's
services, 51.8 percent; mental health and
chemical dependency, 28.9 percent; and
adult and disability, 19.3 percent. Funds
transferred from the TANF block grant
to SSBG shall be considered part of the
distribution to the children's services
program.
new text end

new text begin (i) General Assistance Grants
new text end
new text begin 49,301,000
new text end
new text begin 49,723,000
new text end

new text begin General Assistance Standard. new text end new text begin The
commissioner shall set the monthly standard
of assistance for general assistance units
consisting of an adult recipient who is
childless and unmarried or living apart
from parents or a legal guardian at $203.
The commissioner may reduce this amount
according to Laws 1997, chapter 85, article
3, section 54.
new text end

new text begin Combining Emergency Assistance for
MSA and GA.
new text end
new text begin The amount appropriated
for emergency general assistance funds is
limited to no more than $8,989,812 in fiscal
year 2010 and $8,989,812 in fiscal year 2011.
Funds to counties must be allocated by the
commissioner using the allocation method
specified in Minnesota Statutes, section
256D.06.
new text end

new text begin (j) Minnesota Supplemental Aid Grants
new text end
new text begin 31,774,000
new text end
new text begin 32,757,000
new text end
new text begin (k) Group Residential Housing Grants
new text end
new text begin 105,229,000
new text end
new text begin 107,268,000
new text end
new text begin (l) Children's Mental Health Grants
new text end
new text begin 16,885,000
new text end
new text begin 16,882,000
new text end

new text begin new text begin Funding Usage.new text end Up to 75 percent of a fiscal
year's appropriation for children's mental
health grants may be used to fund allocations
in that portion of the fiscal year ending
December 31.
new text end

new text begin (m) Other Children and Economic Assistance
Grants
new text end
new text begin 14,818,000
new text end
new text begin 13,865,000
new text end

new text begin new text begin Fraud Prevention Grants for State Fraud
Program.
new text end
Fraud prevention investigation
grants are reduced to $463,000 in fiscal
year 2010 and $0 in fiscal year 2011 for
the purposes of funding state assumption of
the county fraud prevention investigation
function.
new text end

new text begin Subd. 5. new text end

new text begin Children and Economic Assistance
Management
new text end

new text begin The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end

new text begin (a) Children and Economic Assistance
Administration
new text end
new text begin new text end new text begin new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 11,950,000
new text end
new text begin 12,844,000
new text end
new text begin Federal TANF
new text end
new text begin 496,000
new text end
new text begin 496,000
new text end
new text begin (b) Children and Economic Assistance
Operations
new text end
new text begin new text end new text begin new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 34,263,000
new text end
new text begin 33,423,000
new text end
new text begin Health Care Access
new text end
new text begin 361,000
new text end
new text begin 361,000
new text end

new text begin new text begin State Assumption of County Fraud
Prevention Program.
new text end
Of the amounts
appropriated, $1,682,000 in fiscal year
2010 and $2,536,000 in fiscal year 2011 is
available to fund state assumption of county
fraud prevention programs.
new text end

new text begin Financial Institution Data Match and
Payment of Fees.
new text end
new text begin The commissioner is
authorized to allocate up to $310,000 each
year in fiscal years 2010 and 2011 from the
PRISM special revenue account to make
payments to financial institutions in exchange
for performing data matches between account
information held by financial institutions
and the public authority's database of child
support obligors as authorized by Minnesota
Statutes, section 13B.06, subdivision 7.
new text end

new text begin Subd. 6. new text end

new text begin Basic Health Care Grants
new text end

new text begin The amounts that may be spent from this
appropriation for each purpose are as follows:
new text end

new text begin (a) MinnesotaCare Grants
new text end
new text begin 320,717,000
new text end
new text begin 69,978,000
new text end

new text begin This appropriation is from the health care
access fund.
new text end

new text begin (b) MA Basic Health Care Grants - Families
and Children
new text end
new text begin 979,255,000
new text end
new text begin 1,027,604,000
new text end

new text begin new text begin Medical Education Research Costs
(MERC).
new text end
(1) Of these funds, the
commissioner of human services shall
transfer $38,000,000 in fiscal year 2010 to
the medical education research fund. These
funds must restore the fiscal year 2009
unallotment of the transfers under Minnesota
Statutes, section 256B.69, subdivision 5c,
paragraph (a), for the July 1, 2008, through
June 30, 2009, period.
new text end

new text begin (2) In fiscal year 2010, the commissioner
of human services shall reduce the amount
transferred to the medical education
research fund under Minnesota Statutes,
section 256B.69, subdivision 5c, paragraph
(a), for the July 1, 2009, through June
30, 2010, period by $28,000,000. The
commissioner shall first reduce the transfers
under Minnesota Statutes, section 256B.69,
subdivision 5c, paragraph (a), clauses (2), (3),
and (4), and second, proportionally reduce
the transfers under Minnesota Statutes,
section 256B.69, subdivision 5c, paragraph
(a), clause (1), to meet the $28,000,000
reduction.
new text end

new text begin (c) MA Basic Health Care Grants - Elderly and
Disabled
new text end
new text begin 1,156,525,000
new text end
new text begin 1,251,736,000
new text end

new text begin new text begin Minnesota Disability Health Options.new text end
The monthly enrollment of home and
community-based services recipients,
including personal care assistance and
private duty nurse recipients, in the
Minnesota disability health options program
shall not exceed 1,043 in calendar year 2009,
1,201 in calendar year 2010, and 1,402 in
calendar year 2011.
new text end

new text begin new text begin Hospital Fee-for-Service Payment Delay.new text end
Payments from the Medicaid Management
Information System that would otherwise
have been made for inpatient hospital
services for Minnesota health care program
enrollees must be delayed as follows: (1)
for fiscal year 2010, the payments for the
month of June must be included in the
first payments in fiscal year 2011; and (2)
for fiscal year 2011, the payments in the
month of June must be included in the first
payment of fiscal year 2012. The provisions
of Minnesota Statutes, section 16A.124, do
not apply to these delayed payments.
new text end

new text begin new text begin Nonhospital Fee-for-Service Payment
Delay.
new text end
Payments from the Medicaid
Management Information System that would
otherwise have been made for nonhospital
acute care services for Minnesota health
care program enrollees must be delayed
as follows: (1) the last payment for fiscal
year 2010 must be included in the first
payment for fiscal year 2011; and (2) the
last payment for fiscal year 2011 must be
included in the first payment for fiscal year
2012. This payment delay must not include
nursing facilities, intermediate care facilities
for developmental disabilities, home and
community-based services, prepaid health
plans, personal care provider organizations,
and home health agencies. The provisions of
Minnesota Statutes, section 16A.124, do not
apply to these delayed payments.
new text end

new text begin (d) General Assistance Medical Care Grants
new text end
new text begin 333,074,000
new text end
new text begin 362,264,000
new text end
new text begin (e) Other Health Care Grants
new text end
new text begin new text end new text begin new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 205,000
new text end
new text begin 205,000
new text end
new text begin Health Care Access
new text end
new text begin 900,000
new text end
new text begin 150,000
new text end

new text begin Subd. 7. new text end

new text begin Health Care Management
new text end

new text begin The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end

new text begin (a) Health Care Administration
new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 5,274,000
new text end
new text begin 5,235,000
new text end
new text begin Health Care Access
new text end
new text begin 789,000
new text end
new text begin 746,000
new text end

new text begin new text begin Base Adjustment.new text end The health care access
fund base is increased by $183,000 in fiscal
year 2012.
new text end

new text begin (b) Health Care Operations
new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 19,685,000
new text end
new text begin 18,830,000
new text end
new text begin Health Care Access
new text end
new text begin 21,452,000
new text end
new text begin 20,616,000
new text end

new text begin new text begin Base Adjustment.new text end The health care access
fund base is decreased by $667,000 in fiscal
year 2012 and $1,170,000 in fiscal year
2013. The general fund base is decreased by
$278,000 in fiscal year 2012 and $278,000 in
fiscal year 2013.
new text end

new text begin Subd. 8. new text end

new text begin Continuing Care Grants
new text end

new text begin The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end

new text begin (a) Aging and Adult Services Grants
new text end
new text begin 14,532,000
new text end
new text begin 19,703,000
new text end

new text begin Base Adjustment. new text end new text begin The general fund base is
increased by $1,181,000 in fiscal year 2012
and $2,093,000 in fiscal year 2013.
new text end

new text begin Information and Assistance
Reimbursement.
new text end
new text begin Federal administrative
reimbursement obtained from information
and assistance services provided by the
Senior LinkAge or Disability Linkage lines
to people who are identified as eligible for
medical assistance shall be appropriated to
the commissioner for this activity.
new text end

new text begin Community Service Development Grant
Reduction.
new text end new text begin Funding for community service
development grants must be reduced by
$240,000 per year for fiscal years 2010 and
2011. This reduction shall not adjust the base
appropriation.
new text end

new text begin (b) Alternative Care Grants
new text end
new text begin 50,507,000
new text end
new text begin 45,269,000
new text end

new text begin Base Adjustment. new text end new text begin The general fund base is
decreased by $681,000 in fiscal year 2012
and $1,078,000 in fiscal year 2013.
new text end

new text begin Alternative Care Transfer. new text end new text begin Any money
allocated to the alternative care program that
is not spent for the purposes indicated does
not cancel but must be transferred to the
medical assistance account.
new text end

new text begin (c) Medical Assistance Grants; Long-Term
Care Facilities.
new text end
new text begin 475,969,000
new text end
new text begin 476,918,000
new text end
new text begin (d) Medical Assistance Long-Term Care
Waivers and Home Care Grants
new text end
new text begin 1,100,137,000
new text end
new text begin 1,155,618,000
new text end

new text begin new text begin Manage Growth in TBI and CADI
Waivers.
new text end
During the fiscal years beginning
on July 1, 2009, and July 1, 2010, the
commissioner shall allocate money for home
and community-based waiver programs
under Minnesota Statutes, section 256B.49,
to ensure a reduction in state spending that is
equivalent to limiting the caseload growth of
the TBI waiver to 12.5 allocations per month
each year of the biennium and the CADI
waiver to 95 allocations per month each year
of the biennium. Limits do not apply: (1)
when there is an approved plan for nursing
facility bed closures for individuals under
age 65 who require relocation due to the
bed closure; (2) to fiscal year 2009 waiver
allocations delayed due to unallotment; or (3)
to transfers authorized by the commissioner
from the personal care assistance program
of individuals having a home care rating
of "CS," "MT," or "HL." Priorities for the
allocation of funds must be for individuals
anticipated to be discharged from institutional
settings or who are at imminent risk of a
placement in an institutional setting.
new text end

new text begin new text begin Manage Growth in DD Waiver.new text end The
commissioner shall manage the growth in
the DD waiver by limiting the allocations
included in the February 2009 forecast to 15
additional diversion allocations each month
for the calendar years that begin on January
1, 2010, and January 1, 2011. Additional
allocations must be made available for
transfers authorized by the commissioner
from the personal care program of individuals
having a home care rating of "CS," "MT,"
or "HL."
new text end

new text begin new text begin Adjustment to Lead Agency Waiver
allocations.
new text end
Prior to the availability of the
alternative license defined in Minnesota
Statutes, section 245A.11, subdivision 8,
the commissioner shall reduce lead agency
waiver allocations for the purposes of
implementing a moratorium on corporate
foster care.
new text end

new text begin (e) Mental Health Grants
new text end
new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 76,989,000
new text end
new text begin 78,456,000
new text end
new text begin Health Care Access
new text end
new text begin 750,000
new text end
new text begin 750,000
new text end
new text begin Lottery Prize
new text end
new text begin 1,508,000
new text end
new text begin 1,508,000
new text end

new text begin new text begin Funding Usage.new text end Up to 75 percent of a fiscal
year's appropriation for children's mental
health grants may be used to fund allocations
in that portion of the fiscal year ending
December 31.
new text end

new text begin (f) Deaf and Hard-of-Hearing Grants
new text end
new text begin 1,924,000
new text end
new text begin 1,909,000
new text end
new text begin (g) Chemical Dependency Entitlement Grants
new text end
new text begin 112,316,000
new text end
new text begin 121,295,000
new text end

new text begin Payments for Substance Abuse Treatment.
For services provided in fiscal years 2010
and 2011, county-negotiated rates and
provider claims to the consolidated chemical
dependency fund must not exceed rates
charged for services in excess of those
in effect on January 1, 2009. If statutes
authorize a cost-of-living adjustment
during fiscal years 2010 and 2011, then
notwithstanding any law to the contrary,
fiscal years 2010 and 2011 rates must
not exceed those in effect on January 2,
2009, plus any authorized cost-of-living
adjustments.
new text end

new text begin (h) Chemical Dependency Nonentitlement
Grants
new text end
new text begin 1,383,000
new text end
new text begin 1,036,000
new text end
new text begin (i) Other Continuing Care Grants
new text end
new text begin 18,168,000
new text end
new text begin 12,300,000
new text end

new text begin Base Adjustment. new text end new text begin The general fund base is
decreased $1,142,000 in fiscal year 2012 and
$2,146,000 in fiscal year 2013.
new text end

new text begin new text begin Technology Grants.new text end $650,000 in fiscal
year 2010 and $1,000,000 in fiscal year
2011 are for technology grants, case
consultation, evaluation, and consumer
information grants related to developing and
supporting alternatives to shift-staff foster
care residential service models.
new text end

new text begin Subd. 9. new text end

new text begin Continuing Care Management
new text end new text begin new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 25,036,000
new text end
new text begin 25,079,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 125,000
new text end
new text begin 125,000
new text end
new text begin Lottery Prize
new text end
new text begin 157,000
new text end
new text begin 157,000
new text end

new text begin The general fund base is decreased
$2,900,000 in fiscal year 2012 and
$2,900,000 in fiscal year 2013.
new text end

new text begin Subd. 10. new text end

new text begin State-Operated Services
new text end

new text begin 257,399,000
new text end
new text begin 264,442,000
new text end

new text begin The amounts that may be spent from the
appropriation for each purpose are as follows:
new text end

new text begin Transfer Authority Related to
State-Operated Services.
new text end
new text begin Money
appropriated to finance state-operated
services may be transferred between the
fiscal years of the biennium with the approval
of the commissioner of finance.
new text end

new text begin new text begin County Past Due Receivables.new text end The
commissioner is authorized to withhold
county federal administrative reimbursement
when the county of financial responsibility
for cost-of-care payments due the state
under Minnesota Statutes, section 246.54
or 253B.045, is 90 days past due. The
commissioner shall deposit the withheld
federal administrative earnings for the county
into the general fund to settle the claims with
the county of financial responsibility. The
process for withholding funds is governed by
Minnesota Statutes, section 256.017.
new text end

new text begin (a) Adult Mental Health Services
new text end
new text begin 110,216,000
new text end
new text begin 114,953,000
new text end

new text begin new text begin Appropriation Limitation.new text end No part of
the appropriation in this article to the
commissioner for mental health treatment
services provided by state-operated services
shall be used for the Minnesota sex offender
program.
new text end

new text begin Community Behavioral Health Hospitals. new text end new text begin
Under Minnesota Statutes, section 246.51,
subdivision 1, a determination order for the
clients served in a community behavioral
health hospital operated by the commissioner
of human services is only required when
a client's third-party coverage has been
exhausted.
new text end

new text begin (b) Minnesota Security
Hospital and METO
Services
new text end
new text begin 82,918,000
new text end
new text begin 82,652,000
new text end

new text begin Minnesota Security Hospital. new text end new text begin For the
purposes of enhancing the safety of
the public, improving supervision, and
enhancing community-based mental health
treatment, state-operated services may
establish additional community capacity
for providing treatment and supervision
of clients who have been ordered into a
less restrictive alternative of care from the
state-operated services transitional services
program consistent with Minnesota Statutes,
section 246.014.
new text end

new text begin (c) Minnesota Sex Offender Services
new text end
new text begin 64,265,000
new text end
new text begin 66,837,000
new text end

Sec. 4. new text beginCOMMISSIONER OF HEALTH
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin 147,432,000
new text end
new text begin $
new text end
new text begin 141,858,000
new text end
new text begin Appropriations by Fund
new text end
new text begin 2010
new text end
new text begin 2011
new text end
new text begin General
new text end
new text begin 68,309,000
new text end
new text begin 63,116,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 45,415,000
new text end
new text begin 45,415,000
new text end
new text begin Health Care Access
new text end
new text begin 20,725,000
new text end
new text begin 19,094,000
new text end
new text begin Federal TANF
new text end
new text begin 11,733,000
new text end
new text begin 11,733,000
new text end
new text begin Clean Water
new text end
new text begin 1,250,000
new text end
new text begin 2,500,000
new text end

new text begin Subd. 2. new text end

new text begin Community and Family Health
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 43,430,000
new text end
new text begin 38,237,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 1,033,000
new text end
new text begin 1,033,000
new text end
new text begin Health Care Access
new text end
new text begin 7,642,000
new text end
new text begin 7,719,000
new text end
new text begin Federal TANF
new text end
new text begin 11,733,000
new text end
new text begin 11,733,000
new text end

new text begin Funding Usage. new text end new text begin Up to 75 percent of the
fiscal year 2012 appropriation for local public
health grants may be used to fund calendar
year 2011 allocations for this program. The
general fund reduction of $5,193,000 in
fiscal year 2011 for local public health grants
is onetime and the base funding for local
public health grants for fiscal year 2012 is
increased by $5,193,000.
new text end

new text begin Statewide Health Improvement Programs. new text end new text begin
Of the health care access fund appropriation,
$6,000,000 per fiscal year is for the statewide
health improvement program. Up to ten
percent of the funding may be used for
administrative purposes. Base funding for
this program expires June 30, 2013.
new text end

new text begin TANF Appropriations. new text end new text begin (1) $1,156,000 of
the TANF funds are appropriated each year to
the commissioner for family planning grants
under Minnesota Statutes, section 145.925.
new text end

new text begin (2) $3,579,000 of the TANF funds are
appropriated each year to the commissioner
for home visiting and nutritional services
listed under Minnesota Statutes, section
145.882, subdivision 7, clauses (6) and (7).
Funds must be distributed to community
health boards according to Minnesota
Statutes, section 145A.131, subdivision 1.
new text end

new text begin (3) $2,000,000 of the TANF funds are
appropriated each year to the commissioner
for decreasing racial and ethnic disparities
in infant mortality rates under Minnesota
Statutes, section 145.928, subdivision 7.
new text end

new text begin (4) $4,998,000 of the TANF funds are
appropriated each year to the commissioner
for the family home visiting grant program
according to Minnesota Statutes, section
145A.17. $4,000,000 of the funding must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1. $998,000 of
the funding must be distributed to tribal
governments based on Minnesota Statutes,
section 145A.14, subdivision 2a. The
commissioner may use five percent of
the funds appropriated each fiscal year to
conduct the ongoing evaluations required
under Minnesota Statutes, section 145A.17,
subdivision 7, and may use ten percent of
the funds appropriated each fiscal year to
provide training and technical assistance as
required under Minnesota Statutes, section
145A.17, subdivisions 4 and 5.
new text end

new text begin TANF Carryforward. new text end new text begin Any unexpended
balance of the TANF appropriation in the
first year of the biennium does not cancel but
is available for the second year.
new text end

new text begin Subd. 3. new text end

new text begin Policy Quality and Compliance
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 7,593,000
new text end
new text begin 7,593,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 14,173,000
new text end
new text begin 14,173,000
new text end
new text begin Health Care Access
new text end
new text begin 13,083,000
new text end
new text begin 11,375,000
new text end

new text begin MERC Federal Compliance. new text end new text begin
Notwithstanding Laws 2008, chapter
363, article 18, section 4, subdivision 3, the
base level funding for the commissioner to
distribute to the Mayo Clinic for transitional
funding while federal compliance changes
are made to the medical education and
research cost funding distribution formula
shall be $0 for fiscal years 2010 and 2011.
new text end

new text begin Value-Based Insurance Designs. new text end new text begin The
commissioner of health, in consultation
with the commissioner of human services,
commerce, and Minnesota management
and budget, shall study and report to the
legislature on value-based insurance designs
that vary enrollee cost-sharing based on
clinical or cost-effectiveness of services.
In performing this study, the commissioner
shall consult with and seek input from
health plans, health care providers, and
employers. The commissioner shall report to
the legislature by January 15, 2010.
new text end

new text begin Base Adjustment. new text end new text begin The general fund base
is $8,593,000 for each of fiscal years 2012
and 2013. The health care access fund
base is $10,775,000 in fiscal year 2012 and
$7,641,000 in fiscal year 2013.
new text end

new text begin Subd. 4. new text end

new text begin Health Protection
new text end

new text begin Appropriations by Fund
new text end
new text begin General
new text end
new text begin 9,930,000
new text end
new text begin 9,930,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 30,209,000
new text end
new text begin 30,209,000
new text end
new text begin Clean Water
new text end
new text begin 1,250,000
new text end
new text begin 2,500,000
new text end

new text begin Clean Water Act Funding. new text end new text begin Of the
appropriations from the clean water fund,
$805,000 in fiscal year 2010 and $1,610,000
in fiscal year 2012 are for protection of
drinking water sources and $445,000 in fiscal
year 2010 and $890,000 in fiscal year 2011
are for addressing public health concerns
related to contaminants found in Minnesota
drinking water for which no health-based
drinking water standard exists.
new text end

new text begin Subd. 5. new text end

new text begin Administrative Support Services
new text end

new text begin 7,356,000
new text end
new text begin 7,356,000
new text end

Sec. 5. new text beginHEALTH RELATED BOARDS
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin 14,035,000
new text end
new text begin $
new text end
new text begin 13,848,000
new text end

new text begin This appropriation is from the state
government special revenue fund.
new text end

new text begin The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end

new text begin Subd. 2. new text end

new text begin Board of Chiropractic Examiners
new text end

new text begin 447,000
new text end
new text begin 447,000
new text end

new text begin Subd. 3. new text end

new text begin Board of Dentistry
new text end

new text begin 1,009,000
new text end
new text begin 1,009,000
new text end

new text begin Subd. 4. new text end

new text begin Board of Dietetic and Nutrition
Practice
new text end

new text begin 105,000
new text end
new text begin 105,000
new text end

new text begin Subd. 5. new text end

new text begin Board of Marriage and Family
Therapy
new text end

new text begin 137,000
new text end
new text begin 137,000
new text end

new text begin Subd. 6. new text end

new text begin Board of Medical Practice
new text end

new text begin 3,682,000
new text end
new text begin 3,682,000
new text end

new text begin Subd. 7. new text end

new text begin Board of Nursing
new text end

new text begin 3,287,000
new text end
new text begin 3,289,000
new text end

new text begin Subd. 8. new text end

new text begin Board of Nursing Home
Administrators
new text end

new text begin 1,212,000
new text end
new text begin 1,023,000
new text end

new text begin new text begin Administrative Services Unit - Operating
Costs.
new text end
Of this appropriation, $524,000
in fiscal year 2010 and $526,000 in
fiscal year 2011 are for operating costs
of the administrative services unit. The
administrative services unit may receive
and expend reimbursements for services
performed by other agencies.
new text end

new text begin new text begin Administrative Services Unit - Retirement
Costs.
new text end
Of this appropriation in fiscal year
2010, $201,000 is for onetime retirement
costs in the health-related boards. This
funding may be transferred to the health
boards incurring those costs for their
payment. These funds are available either
year of the biennium.
new text end

new text begin new text begin Administrative Services Unit - Volunteer
Health Care Provider Program.
new text end
Of this
appropriation, $79,000 in fiscal year 2010
and $89,000 in fiscal year 2011 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
new text end

new text begin new text begin Administrative Services Unit - Contested
Cases and Other Legal Proceedings.
new text end
Of
this appropriation, $200,000 in fiscal year
2010 and $200,000 in fiscal year 2011
are for costs of contested case hearings
and other unanticipated costs of legal
proceedings involving health-related
boards funded under this section. Upon
certification of a health-related board to the
administrative services unit that the costs
will be incurred and that there is insufficient
money available to pay for the costs out of
money currently available to that board, the
administrative services unit is authorized
to transfer money from this appropriation
to the board for payment of those costs
with the approval of the commissioner of
finance. This appropriation does not cancel.
Any unencumbered and unspent balances
remain available for these expenditures in
subsequent fiscal years.
new text end

new text begin Subd. 9. new text end

new text begin Board of Optometry
new text end

new text begin 101,000
new text end
new text begin 101,000
new text end

new text begin Subd. 10. new text end

new text begin Board of Pharmacy
new text end

new text begin 1,388,000
new text end
new text begin 1,388,000
new text end

new text begin Subd. 11. new text end

new text begin Board of Physical Therapy
new text end

new text begin 295,000
new text end
new text begin 295,000
new text end

new text begin Subd. 12. new text end

new text begin Board of Podiatry
new text end

new text begin 56,000
new text end
new text begin 56,000
new text end

new text begin Subd. 13. new text end

new text begin Board of Psychology
new text end

new text begin 806,000
new text end
new text begin 806,000
new text end

new text begin Subd. 14. new text end

new text begin Board of Social Work
new text end

new text begin 921,000
new text end
new text begin 921,000
new text end

new text begin Subd. 15. new text end

new text begin Board of Veterinary Medicine
new text end

new text begin 195,000
new text end
new text begin 195,000
new text end

new text begin Subd. 16. new text end

new text begin Board of Behavioral Health and
Therapy
new text end

new text begin 394,000
new text end
new text begin 394,000
new text end

Sec. 6. new text beginEMERGENCY MEDICAL SERVICES
BOARD
new text end

new text begin $
new text end
new text begin 3,992,000
new text end
new text begin $
new text end
new text begin 3,992,000
new text end
new text begin Appropriations by Fund
new text end
new text begin 2010
new text end
new text begin 2011
new text end
new text begin General
new text end
new text begin 3,288,000
new text end
new text begin 3,288,000
new text end
new text begin State Government
Special Revenue
new text end
new text begin 704,000
new text end
new text begin 704,000
new text end

new text begin new text begin Longevity Award and Incentive Program.new text end
Of the general fund appropriation, $700,000
in fiscal year 2010 and $700,000 in fiscal
year 2011 are to the board for the ambulance
service personnel longevity award and
incentive program, under Minnesota Statutes,
section 144E.40.
new text end

new text begin new text begin Health Professional Services Program.new text end
$704,000 in fiscal year 2010 and $704,000 in
fiscal year 2011 from the state government
special revenue fund are for the health
professional services program.
new text end

Sec. 7. new text beginCOUNCIL ON DISABILITY
new text end

new text begin $
new text end
new text begin 524,000
new text end
new text begin $
new text end
new text begin 524,000
new text end

Sec. 8. new text beginOMBUDSMAN FOR MENTAL
HEALTH AND DEVELOPMENTAL
DISABILITIES
new text end

new text begin $
new text end
new text begin 1,655,000
new text end
new text begin $
new text end
new text begin 1,655,000
new text end

Sec. 9. new text beginOMBUDSPERSON FOR FAMILIES
new text end

new text begin $
new text end
new text begin 265,000
new text end
new text begin $
new text end
new text begin 265,000
new text end

Sec. 10.

Minnesota Statutes 2008, section 16A.725, subdivision 3, is amended to read:


Subd. 3.

Fund reimbursements.

deleted text begin(a)deleted text end Each fiscal year, the commissioner of finance
shall deleted text beginfirstdeleted text end transfer from the health impact fund to the general fund an amount sufficient
to offset the general fund cost of the certified expenditures under subdivision 2 or the
balance of the fund, whichever is less.

deleted text begin (b) If any balance remains in the health impact fund after the transfer in paragraph
(a), the commissioner of finance shall transfer to the health care access fund the amount
sufficient to offset the health care access fund cost of the certified expenditures in
subdivision 2, or the balance of the fund, whichever is less.
deleted text end

Sec. 11.

Minnesota Statutes 2008, section 144.1501, subdivision 2, is amended to read:


Subd. 2.

Creation of account.

(a) A health professional education loan forgiveness
program account is establishednew text begin in the general fundnew text end. The commissioner of health shall use
money from the account to establish a loan forgiveness program:

(1) for medical residents agreeing to practice in designated rural areas or underserved
urban communities or specializing in the area of pediatric psychiatry;

(2) for midlevel practitioners agreeing to practice in designated rural areas or to
teach at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary
program at the undergraduate level or the equivalent at the graduate level;

(3) for nurses who agree to practice in a Minnesota nursing home or intermediate
care facility for persons with developmental disability or to teach at least 12 credit hours,
or 720 hours per year in the nursing field in a postsecondary program at the undergraduate
level or the equivalent at the graduate level;

(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
hours per year in their designated field in a postsecondary program at the undergraduate
level or the equivalent at the graduate level. The commissioner, in consultation with
the Healthcare Education-Industry Partnership, shall determine the health care fields
where the need is the greatest, including, but not limited to, respiratory therapy, clinical
laboratory technology, radiologic technology, and surgical technology;

(5) for pharmacists who agree to practice in designated rural areas; and

(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
encounters to state public program enrollees or patients receiving sliding fee schedule
discounts through a formal sliding fee schedule meeting the standards established by
the United States Department of Health and Human Services under Code of Federal
Regulations, title 42, section 51, chapter 303.

(b) Appropriations made to the account do not cancel and are available until
expended, except that at the end of each biennium, any remaining balance in the account
that is not committed by contract and not needed to fulfill existing commitments shall
cancel to the new text begingeneral new text endfund.

Sec. 12.

Minnesota Statutes 2008, section 144.1501, subdivision 5, is amended to read:


Subd. 5.

Penalty for nonfulfillment.

If a participant does not fulfill the required
minimum commitment of service according to subdivision 3, the commissioner of health
shall collect from the participant the total amount paid to the participant under the loan
forgiveness program plus interest at a rate established according to section 270C.40. The
commissioner shall deposit the money collected in the deleted text beginhealth care accessdeleted text end new text begingeneral new text endfund
to be credited to the health professional education loan forgiveness program account
established in subdivision 2. The commissioner shall allow waivers of all or part of the
money owed the commissioner as a result of a nonfulfillment penalty if emergency
circumstances prevented fulfillment of the minimum service commitment.

Sec. 13.

Minnesota Statutes 2008, section 145.986, subdivision 5, is amended to read:


Subd. 5.

Report.

The commissioner shall submit a biennial report to the legislature
on the statewide health improvement program funded under this section. These reports
must include information on grant recipients, activities that were conducted using grant
funds, evaluation data, and outcome measures, if available. In addition, the commissioner
shall provide recommendations on future areas of focus for health improvement. These
reports are due by January 15 of every other year, beginning in 2010. In the report due
on January 15, 2010, the commissioner shall include recommendations on a sustainable
funding source for the statewide health improvement program deleted text beginother than the health care
access fund
deleted text end.

Sec. 14.

new text begin [256.0191] RECEIPTS FOR SYSTEMS PROJECTS.
new text end

new text begin Appropriations and federal receipts for information systems projects for MAXIS,
PRISM, MMIS, and SSIS must be deposited in the state system account authorized
in section 256.014. Money appropriated for computer projects approved by the
Minnesota Office of Enterprise Technology, funded by the legislature, and approved by
the commissioner of finance, may be transferred from one project to another and from
development to operations as the commissioner of human services considers necessary.
Any unexpended balance in the appropriation for these projects does not cancel but is
available for ongoing development and operations.
new text end

Sec. 15.

Minnesota Statutes 2008, section 295.58, is amended to read:


295.58 DEPOSIT OF REVENUES AND PAYMENT OF REFUNDS.

The commissioner shall deposit all revenues, including penalties and interest,
derived from the taxes imposed by sections 295.50 to 295.57 and from the insurance
premiums tax imposed by section 297I.05, subdivision 5, on health maintenance
organizations, community integrated service networks, and nonprofit health service plan
corporations in the deleted text beginhealth care accessdeleted text end new text begingeneral new text endfund. There is annually appropriated from
the deleted text beginhealth care accessdeleted text end new text begingeneral new text endfund to the commissioner of revenue the amount necessary
to make refunds under this chapter.

Sec. 16.

Minnesota Statutes 2008, section 297I.05, subdivision 5, is amended to read:


Subd. 5.

Health maintenance organizations, nonprofit health service plan
corporations, and community integrated service networks.

(a) A tax is imposed on
health maintenance organizations, community integrated service networks, and nonprofit
health care service plan corporations. The rate of tax is equal to one percent of gross
premiums less return premiums on all direct business received by the organization,
network, or corporation or its agents in Minnesota, in cash or otherwise, in the calendar
year.

(b) The commissioner shall deposit all revenues, including penalties and interest,
collected under this chapter from health maintenance organizations, community integrated
service networks, and nonprofit health service plan corporations in the deleted text beginhealth care accessdeleted text end
new text begin general new text endfund. Refunds of overpayments of tax imposed by this subdivision must be paid
from the deleted text beginhealth care accessdeleted text end new text begingeneral new text endfund. There is annually appropriated from the deleted text beginhealth
care access
deleted text end new text begingeneral new text endfund to the commissioner the amount necessary to make any refunds
of the tax imposed under this subdivision.

Sec. 17.

Laws 2003, First Special Session chapter 14, article 13C, section 2, subdivision
1, as amended by Laws 2004, chapter 272, article 2, section 2, is amended to read:


Subdivision 1.

Total Appropriation

$
3,848,049,000
$
4,135,780,000
Summary by Fund
General
3,301,811,000
3,561,055,000
State Government
534,000
534,000
Special Revenue
Health Care Access
273,723,000
302,272,000
Federal TANF
270,425,000
270,363,000
Lottery Cash Flow
1,556,000
1,556,000

FEDERAL CONTINGENCY
APPROPRIATION.
(a) Federal Medicaid
funds made available under title IV of
the federal Jobs and Growth Tax Relief
Reconciliation Act of 2003 are appropriated
to the commissioner of human services
for use in the state's medical assistance
and MinnesotaCare programs. The
commissioners of human services and
finance shall report to the legislative advisory
committee on the additional federal Medicaid
matching funds that will be available to the
state.

(b) Because of the availability of these funds,
the following policies shall become effective:

(1) medical assistance and MinnesotaCare
eligibility and local financial participation
changes provided for in this act may be
implemented prior to September 2, 2003, or
may be delayed as necessary to maximize
the use of federal funds received under
title IV of the Jobs and Growth Tax Relief
Reconciliation Act of 2003;

(2) the aggregate cap on the services
identified in Minnesota Statutes, section
256L.035, paragraph (a), clause (3), shall
be increased from $2,000 to $5,000. This
increase shall expire at the end of fiscal year
2007. Funds may be transferred from the
general fund to the health care access fund as
necessary to implement this provision; and

(3) the following payment shifts shall not be
implemented:

(i) MFIP payment shift found in subdivision
11;

(ii) the county payment shift found in
subdivision 1; and

(iii) the delay in medical assistance
and general assistance medical care
fee-for-service payments found in
subdivision 6.

(c) Notwithstanding section 14, paragraphs
(a) and (b) shall expire June 30, 2007.

RECEIPTS FOR SYSTEMS PROJECTS.
Appropriations and federal receipts for
information system projects for MAXIS,
PRISM, MMIS, and SSIS must be deposited
in the state system account authorized in
Minnesota Statutes, section 256.014. Money
appropriated for computer projects approved
by the Minnesota office of technology,
funded by the legislature, and approved
by the commissioner of finance may be
transferred from one project to another
and from development to operations as the
commissioner of human services considers
necessary. Any unexpended balance in
the appropriation for these projects does
not cancel but is available for ongoing
development and operations.

GIFTS. Notwithstanding Minnesota
Statutes, chapter 7, the commissioner may
accept on behalf of the state additional
funding from sources other than state funds
for the purpose of financing the cost of
assistance program grants or nongrant
administration. All additional funding is
appropriated to the commissioner for use as
designated by the grantor of funding.

SYSTEMS CONTINUITY. In the event of
disruption of technical systems or computer
operations, the commissioner may use
available grant appropriations to ensure
continuity of payments for maintaining the
health, safety, and well-being of clients
served by programs administered by the
department of human services. Grant funds
must be used in a manner consistent with the
original intent of the appropriation.

NONFEDERAL SHARE TRANSFERS.
The nonfederal share of activities for which
federal administrative reimbursement is
appropriated to the commissioner may be
transferred to the special revenue fund.

TANF FUNDS APPROPRIATED TO
OTHER ENTITIES.
Any expenditures
from the TANF block grant shall be expended
in accordance with the requirements and
limitations of part A of title IV of the
Social Security Act, as amended, and any
other applicable federal requirement or
limitation. Prior to any expenditure of these
funds, the commissioner shall assure that
funds are expended in compliance with the
requirements and limitations of federal law
and that any reporting requirements of federal
law are met. It shall be the responsibility
of any entity to which these funds are
appropriated to implement a memorandum
of understanding with the commissioner
that provides the necessary assurance of
compliance prior to any expenditure of funds.
The commissioner shall receipt TANF funds
appropriated to other state agencies and
coordinate all related interagency accounting
transactions necessary to implement these
appropriations. Unexpended TANF funds
appropriated to any state, local, or nonprofit
entity cancel at the end of the state fiscal
year unless appropriating language permits
otherwise.

TANF FUNDS TRANSFERRED TO
OTHER FEDERAL GRANTS.
The
commissioner must authorize transfers
from TANF to other federal block grants so
that funds are available to meet the annual
expenditure needs as appropriated. Transfers
may be authorized prior to the expenditure
year with the agreement of the receiving
entity. Transferred funds must be expended
in the year for which the funds were
appropriated unless appropriation language
permits otherwise. In accelerating transfer
authorizations, the commissioner must aim to
preserve the future potential transfer capacity
from TANF to other block grants.

TANF MAINTENANCE OF EFFORT.
(a) In order to meet the basic maintenance
of effort (MOE) requirements of the TANF
block grant specified under Code of Federal
Regulations, title 45, section 263.1, the
commissioner may only report nonfederal
money expended for allowable activities
listed in the following clauses as TANF/MOE
expenditures:

(1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 256J;

(2) the child care assistance programs
under Minnesota Statutes, sections 119B.03
and 119B.05, and county child care
administrative costs under Minnesota
Statutes, section 119B.15;

(3) state and county MFIP administrative
costs under Minnesota Statutes, chapters
256J and 256K;

(4) state, county, and tribal MFIP
employment services under Minnesota
Statutes, chapters 256J and 256K;

(5) expenditures made on behalf of
noncitizen MFIP recipients who qualify
for the medical assistance without federal
financial participation program under
Minnesota Statutes, section 256B.06,
subdivision 4
, paragraphs (d), (e), and (j);
and

(6) qualifying working family credit
expenditures under Minnesota Statutes,
section 290.0671.

(b) The commissioner shall ensure that
sufficient qualified nonfederal expenditures
are made each year to meet the state's
TANF/MOE requirements. For the activities
listed in paragraph (a), clauses (2) to
(6), the commissioner may only report
expenditures that are excluded from the
definition of assistance under Code of
Federal Regulations, title 45, section 260.31.

(c) By August 31 of each year, the
commissioner shall make a preliminary
calculation to determine the likelihood
that the state will meet its annual federal
work participation requirement under Code
of Federal Regulations, title 45, sections
261.21 and 261.23, after adjustment for any
caseload reduction credit under Code of
Federal Regulations, title 45, section 261.41.
If the commissioner determines that the
state will meet its federal work participation
rate for the federal fiscal year ending that
September, the commissioner may reduce the
expenditure under paragraph (a), clause (1),
to the extent allowed under Code of Federal
Regulations, title 45, section 263.1(a)(2).

(d) For fiscal years beginning with state
fiscal year 2003, the commissioner shall
assure that the maintenance of effort used
by the commissioner of finance for the
February and November forecasts required
under Minnesota Statutes, section 16A.103,
contains expenditures under paragraph (a),
clause (1), equal to at least 25 percent of
the total required under Code of Federal
Regulations, title 45, section 263.1.

(e) If nonfederal expenditures for the
programs and purposes listed in paragraph
(a) are insufficient to meet the state's
TANF/MOE requirements, the commissioner
shall recommend additional allowable
sources of nonfederal expenditures to the
legislature, if the legislature is or will be in
session to take action to specify additional
sources of nonfederal expenditures for
TANF/MOE before a federal penalty is
imposed. The commissioner shall otherwise
provide notice to the legislative commission
on planning and fiscal policy under paragraph
(g).

(f) If the commissioner uses authority
granted under section 11, or similar authority
granted by a subsequent legislature, to
meet the state's TANF/MOE requirement
in a reporting period, the commissioner
shall inform the chairs of the appropriate
legislative committees about all transfers
made under that authority for this purpose.

(g) If the commissioner determines that
nonfederal expenditures under paragraph
(a) are insufficient to meet TANF/MOE
expenditure requirements, and if the
legislature is not or will not be in
session to take timely action to avoid a
federal penalty, the commissioner may
report nonfederal expenditures from
other allowable sources as TANF/MOE
expenditures after the requirements of this
paragraph are met. The commissioner
may report nonfederal expenditures
in addition to those specified under
paragraph (a) as nonfederal TANF/MOE
expenditures, but only ten days after the
commissioner of finance has first submitted
the commissioner's recommendations for
additional allowable sources of nonfederal
TANF/MOE expenditures to the members of
the legislative commission on planning and
fiscal policy for their review.

(h) The commissioner of finance shall not
incorporate any changes in federal TANF
expenditures or nonfederal expenditures for
TANF/MOE that may result from reporting
additional allowable sources of nonfederal
TANF/MOE expenditures under the interim
procedures in paragraph (g) into the February
or November forecasts required under
Minnesota Statutes, section 16A.103, unless
the commissioner of finance has approved
the additional sources of expenditures under
paragraph (g).

(i) Minnesota Statutes, section 256.011,
subdivision 3
, which requires that federal
grants or aids secured or obtained under that
subdivision be used to reduce any direct
appropriations provided by law, do not apply
if the grants or aids are federal TANF funds.

(j) Notwithstanding section 14, paragraph
(a), clauses (1) to (6), and paragraphs (b) to
(j) expire June 30, 2007.

WORKING FAMILY CREDIT
EXPENDITURES AS TANF MOE.

The commissioner may claim as TANF
maintenance of effort up to the following
amounts of working family credit
expenditures for the following fiscal years:

(1) fiscal year 2004, $7,013,000;

(2) fiscal year 2005, $25,133,000;

(3) fiscal year 2006, $6,942,000; and

(4) fiscal year 2007, $6,707,000.

FISCAL YEAR 2003 APPROPRIATIONS
CARRYFORWARD.
Effective the day
following final enactment, notwithstanding
Minnesota Statutes, section 16A.28, or any
other law to the contrary, state agencies and
constitutional offices may carry forward
unexpended and unencumbered nongrant
operating balances from fiscal year 2003
general fund appropriations into fiscal year
2004 to offset general budget reductions.

TRANSFER OF GRANT BALANCES.
Effective the day following final enactment,
the commissioner of human services,
with the approval of the commissioner of
finance and after notification of the chair
of the senate health, human services and
corrections budget division and the chair
of the house of representatives health
and human services finance committee,
may transfer unencumbered appropriation
balances for the biennium ending June 30,
2003, in fiscal year 2003 among the MFIP,
MFIP child care assistance under Minnesota
Statutes, section 119B.05, general assistance,
general assistance medical care, medical
assistance, Minnesota supplemental aid,
and group residential housing programs,
and the entitlement portion of the chemical
dependency consolidated treatment fund, and
between fiscal years of the biennium.

TANF APPROPRIATION
CANCELLATION.
Notwithstanding
the provisions of Laws 2000, chapter 488,
article 1, section 16, any prior appropriations
of TANF funds to the department of trade and
economic development or to the job skills
partnership board or any transfers of TANF
funds from another agency to the department
of trade and economic development or to the
job skills partnership board are not available
until expended, and if unobligated as of June
30, 2003, these appropriations or transfers
shall cancel to the TANF fund.

SHIFT COUNTY PAYMENT. The
commissioner shall make up to 100 percent
of the calendar year 2005 payments to
counties for developmental disabilities
semi-independent living services grants,
developmental disabilities family support
grants, and adult mental health grants from
fiscal year 2006 appropriations. This is a
onetime payment shift. Calendar year 2006
and future payments for these grants are not
affected by this shift. This provision expires
June 30, 2006.

CAPITATION RATE INCREASE. Of
the health care access fund appropriations
to the University of Minnesota in the
higher education omnibus appropriation
bill, deleted text begin$2,157,000 in fiscal year 2004 and
$2,157,000 in fiscal year 2005 are to be used
to increase the capitation payments under
deleted text endnew text begin
for fiscal years beginning on July 1, 2003,
and thereafter, $2,157,000 each year must be
transferred to the commissioner for purposes
of
new text end Minnesota Statutes, section 256B.69.
Notwithstanding the provisions of section
14, this provision shall not expire.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from July 1, 2003.
new text end

Sec. 18. new text beginTRANSFERS.
new text end

new text begin Subdivision 1. new text end

new text begin Grants. new text end

new text begin The commissioner of human services, with the approval
of the commissioner of finance, and after notification of the chairs of the relevant senate
budget division and house of representatives finance division committee, may transfer
unencumbered appropriation balances for the biennium ending June 30, 2011, within
fiscal years among the MFIP, general assistance, general assistance medical care, medical
assistance, MinnesotaCare, MFIP child care assistance under Minnesota Statutes, section
119B.05, Minnesota supplemental aid, and group residential housing programs, and the
entitlement portion of the chemical dependency consolidated treatment fund, and between
fiscal years of the biennium.
new text end

new text begin Subd. 2. new text end

new text begin Administration. new text end

new text begin Positions, salary money, and nonsalary administrative
money may be transferred within the Departments of Human Services and Health as the
commissioners consider necessary, with the advance approval of the commissioner of
finance. The commissioner shall inform the chairs of the relevant house and senate health
committees quarterly about transfers made under this provision.
new text end

Sec. 19. new text begin2007 AND 2008 APPROPRIATION AMENDMENTS.
new text end

new text begin (a) The base for the integrated service projects authorized under Laws 2007, chapter
147, article 19, section 3, subdivision 4, paragraph (b), as amended by Laws 2008, chapter
363, article 18, section 7, paragraph (b), is $1,250,000 in fiscal year 2010 and $0 in fiscal
year 2011. This paragraph is effective retroactively from July 1, 2008.
new text end

new text begin (b) Notwithstanding Laws 2007, chapter 147, article 19, section 3, subdivision 4,
paragraph (g), as amended by Laws 2008, chapter 363, article 18, section 7, the TANF
fund base for the Children's Mental Health Pilots is $0 in fiscal year 2011. This paragraph
is effective retroactively from July 1, 2008.
new text end

new text begin (c) Notwithstanding Laws 2007, chapter 147, article 19, section 3, subdivision
4, paragraph (g), as amended by Laws 2008, chapter 363, article 18, section 7, the
appropriations for grants for programs serving young parents do not become part of the
agency's base. This paragraph is effective retroactively from July 1, 2008.
new text end

new text begin (d) Notwithstanding Laws 2007, chapter 147, article 19, section 3, subdivision
4, paragraph (k), as amended by Laws 2008, chapter 363, article 18, section 7, the
appropriation for People Incorporated does not become part of the agency's base. This
paragraph is effective retroactively from July 1, 2008.
new text end

new text begin (e) The appropriation for patient incentive programs under Laws 2007, chapter 147,
article 19, section 3, subdivision 6, paragraph (e), is canceled. This paragraph is effective
retroactively from July 1, 2007.
new text end

new text begin (f) The onetime general fund base reduction for Child Care Development Grants
under Laws 2008, chapter 363, article 18, section 3, subdivision 4, paragraph (d), is
increased by $4,000. This paragraph is effective retroactively from July 1, 2008.
new text end

new text begin (g) The base for Children Services Grants under Laws 2008, chapter 363, article 18,
section 3, subdivision 4, paragraph (e), is decreased $1,000 in each year of the fiscal year
2010 and 2011 biennium. This paragraph is effective retroactively from July 1, 2008.
new text end

new text begin (h) Notwithstanding Laws 2008, chapter 363, article 18, section 3, subdivision 4, the
general fund base adjustment for Children and Community Services Grants under Laws
2008, chapter 363, article 18, section 3, subdivision 4, paragraph (f), is increased by
$98,000 each year of fiscal years 2010 and 2011. This paragraph is effective retroactively
from July 1, 2008.
new text end

new text begin (i) The base for Other Continuing Care Grants under Laws 2008, chapter 363, article
18, section 3, subdivision 6, paragraph (h), is decreased by $10,000 in fiscal year 2010.
This paragraph is effective retroactively from July 1, 2008.
new text end

new text begin (j) The appropriation for the Community-Based Health Care Demonstration Project
under Minnesota Statutes, section 62Q.80, subdivision 1a, authorized under Laws 2007,
chapter 147, article 19, section 3, subdivision 6, paragraph (e), is canceled. This paragraph
is effective retroactively from July 1, 2007.
new text end

new text begin (k) The appropriation for Section 125 Employer Incentives in Laws 2008, chapter
358, article 5, section 4, subdivision 3, is reduced by $800,000. This paragraph is effective
retroactively from July 1, 2008.
new text end

Sec. 20. new text beginHEALTH CARE ACCESS FUND RESOURCES AND
APPROPRIATIONS.
new text end

new text begin Effective July 1, 2009, all health care access fund resources and agency
appropriations become general fund resources and agency appropriations.
new text end

Sec. 21. new text beginINDIRECT COSTS NOT TO FUND PROGRAMS.
new text end

new text begin The commissioners of health and human services shall not use indirect cost
allocations to pay for the operational costs of any program for which they are responsible.
new text end

Sec. 22. new text beginEXPIRATION OF UNCODIFIED LANGUAGE.
new text end

new text begin All uncodified language contained in this article expires on June 30, 2011, unless a
different expiration date is explicit.
new text end

Sec. 23. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2008, section 16A.724, new text end new text begin is repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2008, section 62U.10, subdivision 4, new text end new text begin is repealed.
new text end

new text begin (c) new text end new text begin Minnesota Statutes 2008, section 256L.02, subdivision 3, new text end new text begin is repealed.
new text end

new text begin (d) new text end new text begin Minnesota Statutes 2008, section 295.581, new text end new text begin is repealed.
new text end

Sec. 24. new text beginEFFECTIVE DATE.
new text end

new text begin The provisions in this article are effective July 1, 2009, unless a different effective
date is specified.
new text end