as introduced - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to the organization and operation of state 1.3 government; providing for programs relating to human 1.4 services, health, and corrections; appropriating money 1.5 and reducing earlier appropriations with certain 1.6 conditions; amending Minnesota Statutes 2000, sections 1.7 169A.73, subdivision 3; 246.54; 251.013, subdivision 1.8 1; 252.282, subdivisions 1, 3, 4, 5; 254A.17, 1.9 subdivision 1; 256B.059, subdivisions 1, 3, 5; 1.10 256B.0595, subdivision 4; 256B.0916, subdivision 5; 1.11 256B.19, subdivision 1; 256B.32; 256B.5013, 1.12 subdivisions 2, 4, 5, 6; 256B.69, subdivision 5a, by 1.13 adding subdivisions; 256D.051, subdivisions 1, 6c; 1.14 256J.02, subdivisions 2, 3, by adding a subdivision; 1.15 256L.03, subdivision 1; 256L.07, subdivisions 1, 3; 1.16 256L.12, subdivision 9; 256L.15, subdivision 3; 1.17 257.81; Minnesota Statutes 2001 Supplement, sections 1.18 62J.692, subdivision 7; 144.1464, subdivisions 1, 2, 1.19 3; 242.192; 256.01, subdivision 2; 256.955, 1.20 subdivision 2a; 256.969, subdivision 3a; 256B.056, 1.21 subdivision 3; 256B.057, subdivision 9; 256B.0595, 1.22 subdivisions 1, 2; 256B.0625, subdivision 13; 1.23 256B.431, subdivision 33; 256B.437, subdivision 2; 1.24 256B.439, subdivisions 1, 4; 256B.5013, subdivision 1; 1.25 256B.69, subdivisions 4, 5b, 5c; 256B.75; 256I.05, 1.26 subdivisions 1d, 1e; 256J.52, subdivision 2; 256J.53, 1.27 subdivision 1; 256L.15, subdivision 1; Laws 1999, 1.28 chapter 152, section 2; Laws 1999, chapter 152, 1.29 section 4, as amended; Laws 2001, First Special 1.30 Session chapter 9, article 5, section 35; Laws 2001, 1.31 First Special Session chapter 9, article 13, section 1.32 25; repealing Minnesota Statutes 2000, sections 1.33 144.6905; 145.475; 145.9266, subdivisions 2, 5, 6, 7; 1.34 254A.17, subdivision 2; 256.973; 256.9731, 1.35 subdivisions 1, 3, 4, 5, 6, 7, 8, 9, 10; 256B.0916, 1.36 subdivisions 1, 6; 256E.06, subdivision 2b; 256K.01, 1.37 subdivisions 1, 2, 3, 4, 5, 6, 7; 256K.015; 256K.02; 1.38 256K.03, subdivisions 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 1.39 12; 256K.04; 256K.05; 256K.06; 256K.08; 256K.09; 1.40 626.562; Minnesota Statutes 2001 Supplement, sections 1.41 256.955, subdivision 2b; 256B.057, subdivision 10; 1.42 256B.0625, subdivision 5a; 256B.0637; 256I.05, 1.43 subdivision 1f; 256I.07; 256K.03, subdivision 1; 1.44 256K.07; 256L.03, subdivision 5a; Laws 2001, First 1.45 Special Session chapter 9, article 13, sections 22; 1.46 25, subdivisions 1, 2, 4, 5, 6, 7; 26; 27; 28. 2.1 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 2.2 ARTICLE 1 2.3 APPROPRIATIONS 2.4 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 2.5 The dollar amounts shown in the columns marked 2.6 "APPROPRIATIONS" are added to or, if shown in parentheses, are 2.7 subtracted from the appropriations in Laws 2001, First Special 2.8 Session chapter 9, or other law, and are appropriated from the 2.9 general fund, or any other fund named, to the agencies and for 2.10 the purposes specified in this article, to be available for the 2.11 fiscal years indicated for each purpose. The figures "2002" and 2.12 "2003" used in this article mean that the appropriation or 2.13 appropriations listed under them are available for the fiscal 2.14 year ending June 30, 2002, or June 30, 2003, respectively. 2.15 APPROPRIATIONS 2.16 Available for the Year 2.17 Ending June 30 2.18 2002 2003 2.19 Sec. 2. COMMISSIONER OF 2.20 HUMAN SERVICES 2.21 Subdivision 1. Total 2.22 Appropriation $ 21,507,000 $ (44,523,000) 2.23 Summary by Fund 2.24 General 10,676,000 (48,459,000) 2.25 Health Care 2.26 Access 13,081,000 (143,000) 2.27 Federal TANF (2,250,000) 4,079,000 2.28 Subd. 2. Agency Management 2.29 General -0- (8,401,000) 2.30 The amounts that may be spent from the 2.31 appropriation for each purpose are as 2.32 follows: 2.33 Management Operations 2.34 General -0- (8,401,000) 2.35 Subd. 3. Administrative 2.36 Reimbursement/Passthrough 2.37 Federal TANF (2,250,000) 1,250,000 2.38 [TANF TRANSFER TO SOCIAL SERVICES.] 2.39 $3,000,000 is appropriated to the 2.40 commissioner in fiscal year 2003 for 2.41 purposes of increasing services for 2.42 families with children whose incomes 2.43 are at or below 200 percent of the 3.1 federal poverty guidelines. The 3.2 commissioner shall authorize a 3.3 sufficient transfer of funds from the 3.4 state's federal TANF block grant to the 3.5 state's federal social services block 3.6 grant to meet this appropriation. This 3.7 is a onetime appropriation. 3.8 Subd. 4. Children's Services 3.9 Grants 3.10 General -0- (3,255,000) 3.11 Subd. 5. Basic Health Care 3.12 Grants 3.13 General 11,992,000 (8,661,000) 3.14 Health Care 3.15 Access 13,081,000 (143,000) 3.16 The amounts that may be spent from this 3.17 appropriation for each purpose are as 3.18 follows: 3.19 (a) MinnesotaCare Grants 3.20 Health Care 3.21 Access 13,881,000 (143,000) 3.22 (b) MA Basic Health Care 3.23 Grants - Families and Children 3.24 General (17,319,000) (22,473,000) 3.25 [TRANSFER.] Of the general fund 3.26 appropriations to the University of 3.27 Minnesota in the higher education 3.28 omnibus appropriation bill, $8,000,000 3.29 in fiscal year 2003 and in each fiscal 3.30 year thereafter is to be transferred to 3.31 the department of human services for 3.32 the following purposes: (1) $4,000,000 3.33 is for the capitation payments under 3.34 Minnesota Statutes, section 256B.69. 3.35 (2) $4,000,000 is to be deposited in 3.36 the general fund. These transfers 3.37 shall not be made until the federal 3.38 government approves the medical 3.39 education payments authorized in 3.40 Minnesota Statutes, section 62J.692, 3.41 subdivision 7, paragraph (c). 3.42 Notwithstanding the provisions of 3.43 section 6, this provision shall not 3.44 expire. 3.45 (c) MA Basic Health Care 3.46 Grants - Elderly and Disabled 3.47 General 3,062,000 (23,200,000) 3.48 (d) General Assistance 3.49 Medical Care Grants 3.50 General 26,249,000 39,391,000 3.51 (e) Health Care Grants - 3.52 Other Assistance 3.53 General -0- (2,882,000) 4.1 Health Care 4.2 Access (800,000) -0- 4.3 [DENTAL ACCESS GRANTS REPEAL.] The 4.4 dental access grant from Laws 2001, 4.5 First Special Session chapter 9, 4.6 article 17, section 2, subdivision 6, 4.7 is repealed. 4.8 [PRESCRIPTION DRUG PROGRAM FUNDING.] 4.9 (1) The commissioner may expend money 4.10 appropriated for the prescription drug 4.11 program in either fiscal year of the 4.12 2002-2003 biennium. (2) The 4.13 commissioner shall administer the 4.14 prescription drug program pursuant to 4.15 Minnesota Statutes, section 256.955, 4.16 subdivision 9, so that the costs total 4.17 not more than funds appropriated plus 4.18 the drug rebate proceeds. 4.19 Subd. 6. Basic Health Care 4.20 Management 4.21 General -0- (1,090,000) 4.22 The amounts that may be spent from this 4.23 appropriation for each purpose are as 4.24 follows: 4.25 (a) Health Care Policy 4.26 Administration 4.27 General -0- 375,000 4.28 (b) Health Care 4.29 Operations 4.30 General -0- (1,465,000) 4.31 Subd. 7. State-Operated 4.32 Services 4.33 General -0- (9,050,000) 4.34 Subd. 8. Continuing Care 4.35 Grants 4.36 General (17,947,000) (36,377,000) 4.37 The amounts that may be spent from this 4.38 appropriation for each purpose are as 4.39 follows: 4.40 (a) Community Social 4.41 Services Grants 4.42 General -0- (598,000) 4.43 [TRANSFERS TO TITLE XX FOR CSSA.] The 4.44 base-level funding for the 2004-2005 4.45 biennium for the community social 4.46 services aids includes $9,500,000 in 4.47 fiscal year 2004 and $9,500,000 in 4.48 fiscal year 2005 in funding that is 4.49 transferred from the state's federal 4.50 TANF block grant to the state's federal 4.51 Title XX block grant. Notwithstanding 4.52 the provisions of Minnesota Statutes, 4.53 section 256E.07, the commissioner shall 4.54 allocate the portion of the state's 5.1 community social services aids funding 5.2 that is comprised of these transferred 5.3 funds proportionate to the amount a 5.4 county received in calendar year 2000 5.5 community social services aids under 5.6 Minnesota Statutes, section 256E.06. 5.7 The commissioner shall ensure that 5.8 money allocated under this provision is 5.9 used in accordance with the 5.10 requirements of United States Code, 5.11 title 42, section 604(d)(3)(B). 5.12 Section 6, sunset of the uncodified 5.13 language, does not apply to this 5.14 provision. 5.15 (b) Aging Adult Service 5.16 Grants 5.17 General (163,000) (2,512,000) 5.18 [HOME SHARING GRANT REPEAL.] The home 5.19 sharing grant from Laws 2001, First 5.20 Special Session chapter 9, article 17, 5.21 section 2, subdivision 9, is repealed. 5.22 [PLANNING AND SERVICE DEVELOPMENT.] The 5.23 planning and service development grant 5.24 from Laws 2001, First Special Session 5.25 chapter 9, article 17, section 2, 5.26 subdivision 9, is eliminated for fiscal 5.27 year 2003. Base funding for the 5.28 2004-2005 biennium shall be $550,000 5.29 each year. Notwithstanding Laws 2001, 5.30 First Special Session chapter 9, 5.31 article 17, section 2, subdivision 9, 5.32 beginning in fiscal year 2004, the 5.33 commissioner shall annually distribute 5.34 $5,000 to each county. Counties with 5.35 more than 10,000 persons over age 65 5.36 shall receive a distribution of an 5.37 additional 25 cents for each person 5.38 over age 65. The amount distributed to 5.39 each area agency on aging shall be 5.40 $2,500. 5.41 (c) Deaf and Hard-of-Hearing 5.42 Services Grants 5.43 General -0- (89,000) 5.44 [SERVICES TO DEAF PERSONS WITH MENTAL 5.45 ILLNESS.] (1) Of this reduction, $3,000 5.46 is to the grant for a nonprofit agency 5.47 that currently serves deaf and 5.48 hard-of-hearing adults with mental 5.49 illness through residential programs 5.50 and supportive housing outreach 5.51 activities. 5.52 (2) Notwithstanding Laws 2001, First 5.53 Special Session chapter 9, article 17, 5.54 section 2, subdivision 9, the 5.55 base-level funding for the 2004-2005 5.56 biennium shall be zero. 5.57 (d) Mental Health 5.58 Grants 5.59 General -0- (2,576,000) 5.60 (e) Community Support 6.1 Grants 6.2 General -0- (614,000) 6.3 [REGION 10 QUALITY ASSURANCE 6.4 COMMISSION.] The appropriation in Laws 6.5 2001, First Special Session chapter 9, 6.6 article 17, section 2, subdivision 9, 6.7 to the commissioner of human services 6.8 for allocation to the region 10 quality 6.9 assurance commission from the general 6.10 fund for the biennium ending June 30, 6.11 2003, is reduced by $15,000. 6.12 (f) Medical Assistance 6.13 Long-Term Care Waivers and 6.14 Home Care Grants 6.15 General 18,471,000 12,833,000 6.16 (g) Medical Assistance 6.17 Long-Term Care Facilities 6.18 Grants 6.19 General (35,634,000) (39,280,000) 6.20 [MORATORIUM EXCEPTIONS.] During each 6.21 year of the biennium beginning July 1, 6.22 2001, the full annualized costs for the 6.23 state share of medical assistance that 6.24 the commissioner of health may approve 6.25 for moratorium exception projects under 6.26 Minnesota Statutes, section 144A.073, 6.27 is reduced by $500,000. 6.28 (h) Group Residential 6.29 Housing Grants 6.30 General (621,000) (776,000) 6.31 (i) Chemical Dependency 6.32 Entitlement Grants 6.33 General -0- (84,000) 6.34 (j) Chemical Dependency 6.35 Nonentitlement Grants 6.36 General -0- (2,681) 6.37 [CONSOLIDATED CHEMICAL DEPENDENCY 6.38 TREATMENT FUND TIER II FUNDING.] For 6.39 the fiscal year beginning July 1, 2002, 6.40 the state appropriation for chemical 6.41 dependency treatment to persons 6.42 eligible for services under Minnesota 6.43 Statutes, section 254B.04, subdivision 6.44 1, paragraph (b), is eliminated. 6.45 $15,159,000 of funds available in the 6.46 consolidated chemical dependency 6.47 treatment fund reserve general reserve 6.48 account is transferred in fiscal year 6.49 2003 to the general fund. 6.50 Subd. 9. Continuing Care 6.51 Management 6.52 General (1,295,000) (205,000) 6.53 [DAY TRAINING TASK FORCE.] The general 6.54 fund appropriation in fiscal year 2003 7.1 in Laws 2001, First Special Session 7.2 chapter 9, article 17, section 2, 7.3 subdivision 10, for the day training 7.4 and habilitation restructuring task 7.5 force is eliminated. 7.6 Subd. 10. Economic 7.7 Support Grants 7.8 General 17,926,000 18,580,000 7.9 Federal TANF -0- 2,829,000 7.10 The amounts that may be spent from the 7.11 appropriation for each purpose are as 7.12 follows: 7.13 (a) Assistance to Families 7.14 Grants 7.15 General 16,988,000 17,675,000 7.16 Federal TANF -0- 9,993,000 7.17 (b) Work Grants 7.18 General -0- (1,620,000) 7.19 Federal TANF -0- (6,395,000) 7.20 [LOCAL INTERVENTION GRANTS FOR 7.21 SELF-SUFFICIENCY CARRYFORWARD WITH 7.22 LIMITATION.] Unexpended funds in an 7.23 amount up to $1,010,000 appropriated in 7.24 Laws 2001, First Special Session 7.25 chapter 9, article 17, section 2, 7.26 subdivision 11, for local intervention 7.27 grants under Minnesota Statutes, 7.28 section 256J.625, for fiscal year 2002 7.29 do not cancel but are available to the 7.30 commissioner for these purposes in 7.31 fiscal year 2003. 7.32 [SUPPORTED WORK.] Of this reduction in 7.33 fiscal year 2003, $135,000 is to the 7.34 appropriation in Laws 2001, First 7.35 Special Session chapter 9, article 17, 7.36 section 2, subdivision 11, for the 7.37 grant to counties and tribes for 7.38 supported work under Minnesota 7.39 Statutes, section 256J.425. Unexpended 7.40 funds in an amount up to $135,000 7.41 appropriated in fiscal year 2002 in 7.42 Laws 2001, First Special Session 7.43 chapter 9, article 17, section 2, 7.44 subdivision 11, for supported work do 7.45 not cancel but are available to the 7.46 commissioner for this purpose in 2003. 7.47 Base-level funding for supportive work 7.48 shall be $3,500,000 for fiscal year 7.49 2004. 7.50 [WELFARE-TO-WORK-GRANTS.] The fiscal 7.51 year 2003 appropriation of 7.52 welfare-to-work grants administered by 7.53 the commissioner of economic security 7.54 in Laws 2001, First Special Session 7.55 chapter 9, article 17, section 2, 7.56 subdivision 11, is eliminated. 7.57 (c) Economic Support 8.1 Grants - Other Assistance 8.2 General (1,000,000) (100,000) 8.3 Federal TANF -0- (509,000) 8.4 [TANF TRANSFER TO CHILD CARE AND 8.5 DEVELOPMENT BLOCK GRANT.] For fiscal 8.6 year 2003, the reduction is to the 8.7 federal TANF appropriation in Laws 8.8 2001, First Special Session chapter 9, 8.9 article 17, section 2, subdivision 11, 8.10 to the commissioner of children, 8.11 families, and learning for the purposes 8.12 of Minnesota Statutes, section 119B.05. 8.13 (d) Child Support 8.14 Enforcement Grants 8.15 General -0- (209,000) 8.16 Federal TANF -0- (260,000) 8.17 (e) General Assistance 8.18 Grants 8.19 General 3,300,000 4,288,000 8.20 (f) Minnesota Supplemental 8.21 Aid Grants 8.22 General (1,362,000) (1,441,000) 8.23 (g) Refugee Services 8.24 Grants 8.25 General -0- (13,000) 8.26 Sec. 3. COMMISSIONER OF HEALTH 8.27 Subdivision 1. Total Appropriation 8.28 Reductions (13,568,000) (9,518,000) 8.29 SUMMARY BY FUND 8.30 2002 2003 8.31 General (7,568,000) (7,018,000) 8.32 Federal TANF (6,000,000) (2,500,000) 8.33 Subd. 2. Family and Community 8.34 Health (7,997,000) (4,047,000) 8.35 Summary by Fund 8.36 General (1,997,000) (1,547,000) 8.37 Federal TANF (6,000,000) (2,500,000) 8.38 [ONETIME GRANT REDUCTIONS.] $200,000 of 8.39 the appropriation reduction the first 8.40 year is from competitive grants to 8.41 reduce health disparities in infant 8.42 mortality rates and adult and child 8.43 immunization rates authorized in Laws 8.44 2001, First Special Session chapter 9, 8.45 article 17, section 3, subdivision 2. 8.46 $300,000 of the appropriation reduction 8.47 the first year is from competitive 9.1 grants to reduce health disparities in 9.2 breast and cervical cancer screening 9.3 rates, HIV/AIDS and sexually 9.4 transmitted infection rates, 9.5 cardiovascular disease rates, diabetes 9.6 rates, and rates of accidental injuries 9.7 and violence authorized in Laws 2001, 9.8 First Special Session chapter 9, 9.9 article 17, section 3, subdivision 2. 9.10 $150,000 of the appropriation reduction 9.11 the first year is from community-based 9.12 programs for suicide prevention 9.13 authorized in Laws 2001, First Special 9.14 Session chapter 9, article 17, section 9.15 3, subdivision 2. 9.16 [BASE REDUCTIONS.] The commissioner of 9.17 finance shall further reduce base level 9.18 funding for family and community health 9.19 by $140,000 in fiscal year 2004 and 9.20 $280,000 in fiscal year 2005. 9.21 [TRANSFERS.] Notwithstanding Minnesota 9.22 Statutes, section 144.395, subdivision 9.23 2, paragraph (a), $6,000,000 of the 9.24 funds appropriated in fiscal years 2003 9.25 and 2004 under Minnesota Statutes, 9.26 section 144.395, subdivision 2, 9.27 paragraph (c), clause (1), shall be 9.28 transferred to the general fund. This 9.29 transfer shall occur for two fiscal 9.30 years only and is contingent upon 9.31 passage, on or before March 1, 2002, of 9.32 a 29-cent increase in the rate of tax 9.33 on cigarette and tobacco products 9.34 authorized in Minnesota Statutes, 9.35 section 297F.05. 9.36 Subd. 3. Access and Quality 9.37 Improvement (4,970,000) (4,970,000) 9.38 [HEALTH STATUS IMPROVEMENT GRANTS.] Of 9.39 this reduction, $120,000 each year is 9.40 from money for grants appropriated 9.41 under Laws 2001, First Special Session 9.42 chapter 9, article 17, section 3, 9.43 subdivision 2. 9.44 Subd. 4. Health Protection (351,000) (251,000) 9.45 [FOOD SAFETY.] Of this reduction, 9.46 $200,000 in fiscal year 2002 is from 9.47 money appropriated under Laws 2001, 9.48 First Special Session chapter 9, 9.49 article 17, section 3, subdivision 4, 9.50 for a community health education and 9.51 promotion program on food safety. 9.52 Subd. 5. Management and Support 9.53 Services (250,000) (250,000) 9.54 Sec. 4. VETERANS NURSING HOMES 9.55 BOARD -0- 1,400,000 9.56 This appropriation is for the operation 9.57 of existing licensed bed capacity at 9.58 the veterans nursing homes. 9.59 Sec. 5. HEALTH-RELATED BOARDS 10.1 Subdivision 1. Total 10.2 Appropriation 75,000 -0- 10.3 The appropriations in this section are 10.4 from the state government special 10.5 revenue fund. 10.6 [NO SPENDING IN EXCESS OF REVENUES.] 10.7 The commissioner of finance shall not 10.8 permit the allotment, encumbrance, or 10.9 expenditure of money appropriated in 10.10 this section in excess of the 10.11 anticipated biennial revenues or 10.12 accumulated surplus revenues from fees 10.13 collected by the boards. Neither this 10.14 provision nor Minnesota Statutes, 10.15 section 214.06, applies to transfers 10.16 from the general contingent account. 10.17 Subd. 2. Board of Chiropractic 10.18 Examiners 75,000 -0- 10.19 [LEGAL COSTS.] Of this appropriation, 10.20 $75,000 for the fiscal year beginning 10.21 July 1, 2001, is to the board to pay 10.22 for extraordinary legal costs. This is 10.23 a onetime appropriation and shall not 10.24 become part of base-level funding for 10.25 the 2004-2005 biennium. 10.26 Sec. 6. [SUNSET OF UNCODIFIED LANGUAGE.] 10.27 All uncodified language contained in this article expires 10.28 on June 30, 2003, unless a different expiration date is explicit. 10.29 Sec. 7. [EFFECTIVE DATE.] 10.30 The appropriations and reductions for fiscal year 2002 in 10.31 this article are effective the day following final enactment. 10.32 ARTICLE 2 10.33 CONTINUING CARE 10.34 Section 1. Minnesota Statutes 2000, section 252.282, 10.35 subdivision 1, is amended to read: 10.36 Subdivision 1. [HOST COUNTY RESPONSIBILITY.] (a) For 10.37 purposes of this section, "local system needs planning" means 10.38 the determination of need for ICF/MR services by program type, 10.39 location, demographics, and size of licensed services for 10.40 persons with developmental disabilities or related conditions. 10.41 (b) This section does not apply to semi-independent living 10.42 services and residential-based habilitation services funded as 10.43 home and community-based services. 10.44 (c) In collaboration with the commissioner and ICF/MR 10.45 providers, counties shall complete a local system needs planning 10.46 process for each ICF/MR facility. Counties shall evaluate the 11.1 preferences and needs of persons with developmental disabilities 11.2 to determine resource demands through a systematic assessment 11.3 and planning process by May 15, 2000, and by July 1 every two 11.4 years thereafter beginning in 2001. 11.5 (d) A local system needs planning process shall be 11.6 undertaken more frequently when the needs or preferences of 11.7 consumers change significantly to require reformation of the 11.8 resources available to persons with developmental disabilities. 11.9 (e) A local system needs plan shall be amended anytime 11.10 recommendations for modifications to existing ICF/MR services 11.11 are made to the host county, including recommendations for: 11.12 (1) closure; 11.13 (2) relocation of services; 11.14 (3) downsizing; or 11.15 (4)rate adjustments exceeding 90 days duration to address11.16access; or11.17(5)modification of existing services for which a change in 11.18 the framework of service delivery is advocated. 11.19 Sec. 2. Minnesota Statutes 2000, section 252.282, 11.20 subdivision 3, is amended to read: 11.21 Subd. 3. [RECOMMENDATIONS.] (a) Upon completion of the 11.22 local system needs planning assessment, the host county shall 11.23 make recommendations by May 15, 2000, and by July 1 every two 11.24 years thereafter beginning in 2001. If no change is 11.25 recommended, a copy of the assessment along with corresponding 11.26 documentation shall be provided to the commissioner by July 1 11.27 prior to the contract year. 11.28 (b) Except as provided in section 252.292, subdivision 4, 11.29 recommendations regarding closures, relocations, or downsizings 11.30 that include a rate increaseand recommendations regarding rate11.31adjustments exceeding 90 daysshall be submitted to the 11.32 statewide advisory committee for reviewand determination, along 11.33 with the assessment, plan, and correspondingbudget11.34 documentation that supports the payment rate adjustment request. 11.35 (c) Recommendations for closures, relocations, and 11.36 downsizings that do not include a rate increase and for 12.1 modification of existing services for which a change in the 12.2 framework of service delivery is necessary shall be provided to 12.3 the commissioner by July 1 prior to the contract year or at 12.4 least 90 days prior to the anticipated change, along with the 12.5 assessment and corresponding documentation. 12.6 Sec. 3. Minnesota Statutes 2000, section 252.282, 12.7 subdivision 4, is amended to read: 12.8 Subd. 4. [STATEWIDE ADVISORY COMMITTEE.] (a) The 12.9 commissioner shall appoint a five-member statewide advisory 12.10 committee. The advisory committee shall include representatives 12.11 of providers and counties and the commissioner or the 12.12 commissioner's designee. 12.13 (b) The criteria for ranking proposals, already developed 12.14 in 1997 by a task force authorized by the legislature, shall be 12.15 adopted and incorporated into the decision-making process. 12.16 Specific guidelines, including: 12.17 (1) time frame for submission of requests; 12.18 (2) the funds appropriated by the legislature for the 12.19 purposes outlined in section 256B.5013, subdivisions 2 to 4; and 12.20 (3) state policy directions for the provision of services 12.21 to persons with developmental disabilities, shall be established 12.22 and announced through the State Register, and all requests shall 12.23 be considered in comparison to each other and the ranking 12.24 criteria. The advisory committee shall review and recommend 12.25 requestsforto the commissioner for approval of facility rate 12.26 adjustments to address closures,downsizing, relocation, or12.27access needs within the county and shall forward recommendations12.28and documentation to the commissionerdownsizings, or 12.29 relocations. The committee shall ensure that: 12.30 (1) applications are in compliance with applicable state 12.31 and federal law and with the state plan;and12.32 (2) cost projections for the proposed service are within 12.33fiscal limitationsthe fundings limits established by the 12.34 legislative appropriation; and 12.35 (3) their recommendations are submitted to the commissioner. 12.36(c) The advisory committee shall review proposals and13.1submit recommendations to the commissioner within 60 days13.2following the published deadline for submission under13.3subdivision 5.13.4 Sec. 4. Minnesota Statutes 2000, section 252.282, 13.5 subdivision 5, is amended to read: 13.6 Subd. 5. [RESPONSIBILITIES OF COMMISSIONER.] (a) In 13.7 collaboration with counties, providers, and the statewide 13.8 advisory committee, the commissioner shall ensure that services 13.9 recognize the preferences and needs of persons with 13.10 developmental disabilities and related conditions through a 13.11 recurring systemic review and assessment of ICF/MR facilities 13.12 within the state. 13.13 (b) The commissioner shall publish a notice in the State 13.14 Registertwice each calendar yearno less than biannually to 13.15 announce the opportunity for counties or providers to submit 13.16 requests for payment rate adjustments associated with plans for 13.17 downsizing, relocation, and closure of ICF/MR facilities. 13.18 (c) The commissioner shall designate funding parameters to 13.19 counties and to the statewide advisory committee for the overall 13.20 implementation of system needs within the fiscal resources 13.21 allocated by the legislature. 13.22 (d) The commissioner shall contract with ICF/MR providers. 13.23 The initial contracts shall cover the period from October 1, 13.24 2000, to December 31, 2001. Subsequent contracts shall be for 13.25 two-year periods beginning January 1, 2002. 13.26 Sec. 5. Minnesota Statutes 2000, section 256B.0916, 13.27 subdivision 5, is amended to read: 13.28 Subd. 5. [ALLOCATION OF NEW DIVERSIONS AND PRIORITIES FOR 13.29 REASSIGNMENT OF RESOURCESAND APPROVAL OF INCREASED CAPACITYFOR 13.30 THE HOME AND COMMUNITY-BASED WAIVER FOR PERSONS WITH MENTAL 13.31 RETARDATION OR RELATED CONDITIONS.]In order to maximize the13.32number of persons served with waiver funds,The commissioner 13.33 shall monitor county utilization of allocated resources and, as 13.34 appropriate, reassign resources not utilizedand approve13.35increased capacity within available county allocations. 13.36 (a) Effective July 1, 2002, the commissioner shall 14.1 authorize the spending of new diversion resources beginning 14.2 January 1 of each year. 14.3 (b) Effective July 1, 2002, the commissioner shall manage 14.4 the reassignment of waiver resources that occur from persons who 14.5 have left the waiver in a manner that results in the cost 14.6 reduction equivalent to delaying the reuse of those waiver 14.7 resources by 180 days. 14.8 (c) Priority consideration for reassignment of resources 14.9and approval of increased capacityshall be given tocounties14.10with sufficient capacity andcounties that form partnerships. 14.11 In addition to the priorities listed in Minnesota Rules, part 14.12 9525.1880, the commissioner shall also give priority 14.13 consideration to persons whose living situations are unstable 14.14 due to the age or incapacity of the primary caregiver and to 14.15 children to avoid out-of-home placement. 14.16 Sec. 6. Minnesota Statutes 2000, section 256B.19, 14.17 subdivision 1, is amended to read: 14.18 Subdivision 1. [DIVISION OF COST.] The state and county 14.19 share of medical assistance costs not paid by federal funds 14.20 shall be as follows: 14.21 (1) ninety percent state funds and ten percent county 14.22 funds, unless otherwise provided below; 14.23 (2) beginning January 1, 1992, 50 percent state funds and 14.24 50 percent county funds for the cost of placement of severely 14.25 emotionally disturbed children in regional treatment centers; 14.26 and 14.27 (3) beginning January 1, 2003, 80 percent state funds and 14.28 20 percent county funds for the costs of nursing facility 14.29 placements of persons with disabilities under the age of 65 that 14.30 have exceeded 90 days. 14.31 For counties that participate in a Medicaid demonstration 14.32 project under sections 256B.69 and 256B.71, the division of the 14.33 nonfederal share of medical assistance expenses for payments 14.34 made to prepaid health plans or for payments made to health 14.35 maintenance organizations in the form of prepaid capitation 14.36 payments, this division of medical assistance expenses shall be 15.1 95 percent by the state and five percent by the county of 15.2 financial responsibility. 15.3 In counties where prepaid health plans are under contract 15.4 to the commissioner to provide services to medical assistance 15.5 recipients, the cost of court ordered treatment ordered without 15.6 consulting the prepaid health plan that does not include 15.7 diagnostic evaluation, recommendation, and referral for 15.8 treatment by the prepaid health plan is the responsibility of 15.9 the county of financial responsibility. 15.10 Sec. 7. Minnesota Statutes 2001 Supplement, section 15.11 256B.5013, subdivision 1, is amended to read: 15.12 Subdivision 1. [VARIABLE RATE ADJUSTMENTS.] For rate years 15.13 beginning on or after October 1, 2000, when there is a 15.14 documented increase in theresourceneeds of a current ICF/MR 15.15 recipientor recipients, or a person is admitted to a facility15.16who requires additional resources, the county of financial 15.17 responsibility may recommendapproval ofa variable rate to 15.18 enable the facility to meet the individual's increased needs. 15.19 Variable rate adjustments made under this subdivision replace 15.20 payments for persons with special needs under section 256B.501, 15.21 subdivision 8, and payments for persons with special needs for 15.22 crisis intervention services under section 256B.501, subdivision 15.23 8a.Resource needs directly attributable to an individual that15.24may be considered under the variable rate adjustment include15.25increased direct staff hours, other specialized services, and15.26equipment. The guidelines in paragraphs (a) to (d) apply for15.27the payment rate adjustments under this section.Facilities 15.28 with a base rate above the 50th percentile of the statewide 15.29 average reimbursement rate for Class A facility or Class B 15.30 facility, whichever matches the facility licensure, are not 15.31 eligible for a variable rate adjustment. Variable rate 15.32 adjustments may not exceed a 12-month period, except when 15.33 approved for purposes established in subdivision 1, paragraph 15.34 (a), clause (1). Variable rate adjustments approved solely on 15.35 the basis of changes on a developmental disabilities screening 15.36 document will end June 30, 2002. 16.1 (a)All persons must be screened according to section16.2256B.092, subdivisions 7 and 8, prior to implementation of the16.3new payment system, and annually thereafter, and when a variable16.4rate is being requested due to changes in the needs of the16.5recipient. Screening data shall be used to monitor changes as16.6follows:16.7(1) the functional ability of a recipient to care for and16.8maintain the recipient's own basic needs;16.9(2) the intensity of any aggressive or destructive16.10behavior; and16.11(3) any history of obstructive behavior in combination with16.12a diagnosis of psychosis or neurosis.16.13(b)A variable rate may be recommended by the county of 16.14 financial responsibility for increasedserviceneedssuch asin 16.15 the following situations: 16.16 (1) a need for resources due toa change in resident day16.17program participation because the residentan individual's full 16.18 or partial retirement from participation in a day training and 16.19 habilitation service when the individual: (i) has reached the 16.20 age of 65 or has a change in health condition that makes it 16.21 difficult for the person to participate in day training and 16.22 habilitation services over an extended period of time because it 16.23 is medically contraindicated; and (ii) has expressed a desire 16.24 for change through the mental retardation and related conditions 16.25 screening process under section 256B.092;and16.26 (2) a need for additional resources for intensive 16.27 short-term programming which is necessary prior toa recipient's16.28 an individual's discharge to a less restrictive, more integrated 16.29 setting.; 16.30Recommendations for a variable rate shall be used to link16.31resource needs to funding. The variable rate must be applied to16.32expenses related to increased direct staff hours, other16.33specialized services, and equipment.16.34(c) A recipient must be screened by the county of financial16.35responsibility using the developmental disabilities screening16.36document completed immediately prior to approval of a variable17.1rate by the county. A comparison of the updated screening and17.2the previous screening must demonstrate an increase in resource17.3needs.17.4(d) Rate adjustments projected to exceed the authorized17.5funding level associated with the person's profile must be17.6submitted to the commissioner.17.7 (3) a demonstrated medical need that significantly impacts 17.8 the type or amount of services needed by the individual; or 17.9 (4) a demonstrated behavioral need that significantly 17.10 impacts the type or amount of services needed by the individual. 17.11(e)(b) The county of financial responsibility must 17.12indicatejustify the purpose, the projected length of timethat, 17.13 and the additional fundingmay beneeded for the facility to 17.14 meet the needs of the individual.The need to continue an17.15individual variable rate must be reviewed at the end of the17.16anticipated duration of need but at least annually through the17.17completion of the developmental disabilities screening document.17.18 (c) The facility shall provide a quarterly report to the 17.19 county case manager on the use of the variable rate funds and 17.20 the status of the individual on whose behalf the funds were 17.21 approved. The county case manager will forward the facility's 17.22 report with a recommendation to the commissioner to approve or 17.23 disapprove a continuation of the variable rate. 17.24 (d) Funds made available through the variable rate process 17.25 that are not used by the facility to meet the needs of the 17.26 individual for whom they were approved shall be returned to the 17.27 state. 17.28 Sec. 8. Minnesota Statutes 2000, section 256B.5013, 17.29 subdivision 2, is amended to read: 17.30 Subd. 2. [OTHER PAYMENT RATE ADJUSTMENTS.] Facility total 17.31 payment rates may be adjusted by the commissioner following the 17.32 recommendation of both the host county,with authorization from17.33aand the statewide advisory committee, if, through the local 17.34 system needs planning process, it is determined that a need 17.35 exists to amend the package of purchased services with a 17.36 resulting increase or decrease in costs. Except as provided in 18.1 section 252.292, subdivision 4, if a provider demonstrates that 18.2 the loss of revenues caused by the downsizing or closure of a 18.3 facility cannot be absorbed by the facility based on current 18.4 operations, the host county or the provider may submit a request 18.5 to the statewide advisory committee for a facility base rate 18.6 adjustment. Funds for this purpose are limited to those made 18.7 available through a legislative appropriation and published in 18.8 the State Register notice required by section 252.282, 18.9 subdivision 5. 18.10 Sec. 9. Minnesota Statutes 2000, section 256B.5013, 18.11 subdivision 4, is amended to read: 18.12 Subd. 4. [TEMPORARY RATE ADJUSTMENTS TO ADDRESS OCCUPANCY 18.13 AND ACCESS.]If a facility is operating at less than 100 percent18.14occupancy on September 30, 2000, or if a recipient is discharged18.15from a facility,Beginning July 1, 2002, the commissioner shall 18.16 adjust the total payment rate for up to9075 days for the 18.17 remaining recipients for facilities in which the monthly 18.18 occupancy rate of licensed beds is 75 percent or greater. This 18.19 mechanism shall not be used to pay for hospital or therapeutic 18.20 leave days beyond the maximums allowed.Facility payment18.21adjustments exceeding 90 days to address a demonstrated need for18.22access must be submitted to the statewide advisory committee18.23with a local system needs assessment, plan, and budget for18.24review and recommendation.18.25 Sec. 10. Minnesota Statutes 2000, section 256B.5013, 18.26 subdivision 5, is amended to read: 18.27 Subd. 5. [REQUIRED OCCUPANCY DATA; PAYMENT ADJUSTMENTS.] 18.28 Facilities shall maintainand submitmonthly occupancy bed use 18.29 datain the form of resident days and variable rate18.30information. When a variable rate is reported by a facility,18.31monthly bed use data shall be used to track the amount and time18.32span of the rate adjustment. The total payments made to a18.33facility may be adjusted based on concurrent changes in the18.34needs of recipients that are covered by a variable rate18.35adjustment. Any adjustment for multiple resident changes shall18.36not result in a decrease to the facility base rateby client and 19.1 report this data monthly in a format determined by the 19.2 commissioner. 19.3 Sec. 11. Minnesota Statutes 2000, section 256B.5013, 19.4 subdivision 6, is amended to read: 19.5 Subd. 6. [COMMISSIONER REVIEWCOMMISSIONER'S 19.6 RESPONSIBILITIES.]During the initial contracting period,The 19.7 commissioner shallreview the process of variable rate19.8adjustments to determine if the variable rate process is being19.9effectively implemented and whether the variable rate process19.10minimizes unnecessary detailed recordkeeping and meets recipient19.11needs.: 19.12 (1) make a determination to approve, deny, or modify a 19.13 request for a variable rate adjustment within 30 days of the 19.14 receipt of the completed application; 19.15 (2) notify the ICF/MR facility and county case manager of 19.16 the duration and conditions of variable rate adjustment 19.17 approvals; 19.18 (3) modify MMIS II service agreements to reimburse ICF/MR 19.19 facilities for approved variable rates; 19.20 (4) provide notification of legislatively appropriated 19.21 funding for facility closures, downsizings, and relocations; 19.22 (5) assess the fiscal impacts of the proposals for 19.23 closures, downsizings, and relocations forwarded for 19.24 consideration through the state advisory committee; and 19.25 (6) review the payment rate process on a biannual basis and 19.26 make recommendations to the legislature for necessary 19.27 adjustments to the review and approval process. 19.28 Sec. 12. Laws 1999, chapter 152, section 2, is amended to 19.29 read: 19.30 Sec. 2. [PAYMENT STRUCTURE.] 19.31 The task force shall develop a new payment rate structure 19.32 for day training and habilitation services that reflects 19.33 individual consumer needs and demands for services. The payment 19.34 structure shall be based on individual need, flexibility, and 19.35 simplicity in administration and a reflection of costs. An 19.36 equitable distribution of funds based on need shall be 20.1 ensured with no additional cost to the state. 20.2 Sec. 13. Laws 1999, chapter 152, section 4, as amended by 20.3 Laws 2001, First Special Session chapter 9, article 13, section 20.4 18, is amended to read: 20.5 Sec. 4. [REPORT.] 20.6 The task force shall present a report recommendinga newan 20.7 individual payment rate structure to the legislature byJanuary20.815, 2000, and shall makeJuly 31, 2002, with recommendationsto20.9the commissioner of human services regardingon the 20.10 implementation ofthe pilot project for theindividualized 20.11 payment rate structure, so the pilot project can be implemented20.12as required in section 25that results in no additional costs to 20.13 the state. The task force expires onDecemberJune 30,200320.14 2002. 20.15 Sec. 14. Laws 2001, First Special Session chapter 9, 20.16 article 13, section 25, is amended to read: 20.17 Sec. 25. [DAY TRAINING AND HABILITATION INDIVIDUALIZED 20.18 PAYMENT RATE STRUCTUREPILOT PROJECTREPORT.] 20.19 Subdivision 1. [INDIVIDUALIZED PAYMENT RATE STRUCTURE.] 20.20 Notwithstanding Minnesota Statutes, sections 252.451, 20.21 subdivision 5; and 252.46; and Minnesota Rules, part 9525.1290, 20.22 subpart 1, items A and B, the commissioner of human services 20.23 shall initiate a pilot project and phase-in for the 20.24 individualized payment rate structure described in this section 20.25 and section 26. The pilot project shall include actual 20.26 transfers of funds, not simulated transfers. The pilot project 20.27 may include all or some of the vendors in up to eight counties, 20.28 with no more than two counties from the seven-county 20.29 Minneapolis-St. Paul metropolitan area. Following initiation of 20.30 the pilot project, the commissioner shall phase in 20.31 implementation of the individualized payment rate structure to 20.32 the remaining counties and vendors according to the 20.33 implementation plan developed by the task force. The pilot and 20.34 phase-in shall not extend over more than 18 months. 20.35 Subd. 2. [SUNSET.] The pilot project shall sunset upon 20.36 implementation of a new statewide rate structure according to 21.1 the implementation plan developed by the task force described in 21.2 subdivision 3, in its report to the legislature. The rates of 21.3 vendors participating in the pilot project must be modified to 21.4 be consistent with the new statewide rate structure, as 21.5 implemented. 21.6 Subd. 3. [TASK FORCE RESPONSIBILITIES.] The day training 21.7 and habilitation task force established under Laws 1999, chapter 21.8 152, section 4, shall evaluate thepilot project authorized21.9under subdivision 1feasibility of a conversion to an individual 21.10 rate structure, and shall submit a report to the legislature 21.11with an implementation plan, which shall address how and when21.12the pilot project individualized payment rate structure will be21.13implemented statewide, shall ensure that vendors that wish to21.14maintain their current per diem rate may do so within the new21.15payment system, and shall identify criteria that would halt21.16statewide implementation if vendors or clients were adversely21.17affected by the new payment rate structure, and with21.18recommendations for any amendments that should be made before21.19statewide implementation. These recommendations shall be made 21.20 in a report to the chairs of the house health and human services 21.21 policy and finance committees and the senate health and family 21.22 security committee and finance division by July 1, 2002. 21.23 Subd. 4. [RATE SETTING.] (a) The rate structure under this 21.24 section is intended to allow a county to authorize an individual 21.25 rate for each client in the vendor's program based on the needs 21.26 and expected outcomes of the individual client. Rates shall be 21.27 based on an authorized package of services for each individual 21.28 over a typical time frame. Rates may be established across 21.29 multiple sites run by a single vendor. 21.30 (b) With county concurrence, a vendor shall establish up to 21.31 four levels of service, A through D, based on the intensity of 21.32 services provided to an individual client of day training and 21.33 habilitation services. Service level A shall be the highest 21.34 intensity of services, marked primarily, but not exclusively, by 21.35 a one-to-one client-to-staff ratio. Service level D shall be 21.36 the lowest intensity of services. The county shall document the 22.1 vendor's description of the type and amount of services 22.2 associated with each service level. 22.3 (c) For each vendor, a county board shall establish a 22.4 dollar value for one hour of service at each of the service 22.5 levels defined in paragraph (b). In establishing these values 22.6 for existing vendors transitioning from the payment rate 22.7 structure under Minnesota Statutes, section 252.46, subdivision 22.8 1, the county board shall follow the formula and guidelines 22.9 developed by the day training and habilitation task force under 22.10 paragraph (e). 22.11 (d) A vendor may elect to maintain a single transportation 22.12 rate or may elect to establish up to five types of 22.13 transportation services: public transportation, public special 22.14 transportation, nonambulatory transportation, out-of-service 22.15 area transportation, and ambulatory transportation. For vendors 22.16 that elect to establish multiple transportation services, the 22.17 county board shall establish a dollar value for a round trip on 22.18 each type of transportation service offered through the vendor. 22.19 With vendor concurrence, the county may also establish a uniform 22.20 one-way trip value for some or all of the transportation service 22.21 types. 22.22 (e) The county board shall ensure that the vendor 22.23 translates the vendor's existing program and transportation 22.24 rates to the rates and values in the pilot project by using the 22.25 conversion calculations for services and transportation approved 22.26 by the day training and habilitation task force established 22.27 under Laws 1999, chapter 152, and included in the task force's 22.28 recommendations to the legislature. The conversion calculation 22.29 may be amended by the task force with the approval of the 22.30 commissioner and any amendments shall become effective upon 22.31 notification to the pilot project counties from the 22.32 commissioner. The calculation shall take the total 22.33 reimbursement dollars available to the vendor and divide by the 22.34 units of service expected at each service level and of each 22.35 transportation type. In determining the total reimbursement 22.36 dollars available to a vendor, the vendor shall multiply the 23.1 vendor's current per diem rate for both services and 23.2 transportation, including any new rate increases, by the 23.3 vendor's actual utilization for the year prior to implementation 23.4 of the pilot project. Vendors shall be allowed to allocate 23.5 available reimbursement dollars between service and 23.6 transportation before the vendor's service level and 23.7 transportation values are calculated. After translating its 23.8 existing service and transportation rates to the service level 23.9 and transportation values under the pilot, the vendor shall 23.10 project its expected reimbursement income using the expected 23.11 service and transportation packages for its existing clients, 23.12 based on current service authorizations. If the projected 23.13 reimbursement income is less than the vendor would have received 23.14 under the payment structure of Minnesota Statutes, section 23.15 252.46, the vendor and the county, with the approval of the 23.16 commissioner, shall adjust the vendor's service level and 23.17 transportation values to eliminate the shortfall. The 23.18 commissioner shall report all adjustments to the day training 23.19 and habilitation task force for consideration of possible 23.20 modifications to the pilot project individualized payment rate 23.21 structure. 23.22 Subd. 5. [INDIVIDUAL RATE AUTHORIZATION.] (a) As part of 23.23 its annual authorization of services for each client under 23.24 Minnesota Statutes, section 252.44, paragraph (a), clause (1), 23.25 and Minnesota Rules, part 9525.0016, subpart 12, the county 23.26 shall authorize and document a service package and a 23.27 transportation package as follows: 23.28 (1) the service package shall include the amount and type 23.29 of services at each applicable service level to be provided to 23.30 the client over a package period. An individual client may 23.31 receive services at multiple service levels over the course of 23.32 the package period. The service package rate shall be the sum 23.33 of the amount of services at each level over the package period, 23.34 multiplied by the dollar value for each service level; 23.35 (2) the transportation package shall include the amount and 23.36 type of transportation services to be provided to the client 24.1 over the package period. The transportation package rate shall 24.2 be the sum of the amount of transportation services, multiplied 24.3 by the dollar value associated with the type of transportation 24.4 service authorized for the client; 24.5 (3) the package period shall be established by the county, 24.6 and may be one week, two weeks, or one month; and 24.7 (4) the individual rate authorization may be reviewed and 24.8 modified by the county at any time and must be reviewed and 24.9 reauthorized by the county at least annually. 24.10 (b) For vendors with rates established under this section, 24.11 a service day under Minnesota Statutes, sections 245B.06 and 24.12 252.44, includes any day in which a client receives any 24.13 reimbursable service from a vendor or attends employment 24.14 arranged by the vendor. 24.15 Subd. 6. [BILLING FOR SERVICES.] The vendor shall bill 24.16 for, and shall be reimbursed for, the service package rate and 24.17 transportation package rate for the package period as authorized 24.18 by the county for each client in the vendor's program. The 24.19 length of the package period shall not affect the timing or 24.20 frequency of vendors' submissions of claims for payment under 24.21 the Medicaid Management Information System II (MMIS) or its 24.22 successors. 24.23 Subd. 7. [NOTIFICATION OF CHANGE IN CLIENT NEEDS.] The 24.24 vendor shall notify an individual client's case manager if the 24.25 vendor has knowledge of a material change in the client's needs 24.26 that may indicate a need for a change in service authorization. 24.27 Factors that would require such notice include, but are not 24.28 limited to, significant changes in medical status, residential 24.29 placement, attendance patterns, behavioral needs, or skill 24.30 functioning. The vendor shall notify the case manager as soon 24.31 as possible but no later than 30 calendar days after becoming 24.32 aware of the change in needs. The service authorization for the 24.33 client shall not change until the county authorizes a new 24.34 service and transportation package for the client in accordance 24.35 with the provisions in Minnesota Statutes, section 256B.092. 24.36 ARTICLE 3 25.1 HEALTH CARE 25.2 Section 1. Minnesota Statutes 2001 Supplement, section 25.3 62J.692, subdivision 7, is amended to read: 25.4 Subd. 7. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 25.5 SERVICES.] (a) The amount transferred according to section 25.6 256B.69, subdivision 5c, paragraph (a), clause (1), shall be 25.7 distributed by the commissioner to clinical medical education 25.8 programs that meet the qualifications of subdivision 3 based on 25.9 a distribution formula that reflects a summation of two factors: 25.10 (1) an education factor, which is determined by the total 25.11 number of eligible trainee FTEs and the total statewide average 25.12 costs per trainee, by type of trainee, in each clinical medical 25.13 education program; and 25.14 (2) a public program volume factor, which is determined by 25.15 the total volume of public program revenue received by each 25.16 training site as a percentage of all public program revenue 25.17 received by all training sites in the fund pool created under 25.18 this subdivision. 25.19 In this formula, the education factor shall be weighted at 25.20 50 percent and the public program volume factor shall be 25.21 weighted at 50 percent. 25.22 Public program revenue for the distribution formula shall 25.23 include revenue from medical assistance, prepaid medical 25.24 assistance, general assistance medical care, and prepaid general 25.25 assistance medical care. Training sites that receive no public 25.26 program revenue shall be ineligible for funds available under 25.27 this paragraph. 25.28 (b) Fifty percent of the amount transferred according to 25.29 section 256B.69, subdivision 5c, paragraph (a), clause (2), 25.30 shall be distributed by the commissioner to the University of 25.31 Minnesota board of regents for the purposes described in 25.32 sections 137.38 to 137.40. Of the remaining amount transferred 25.33 according to section 256B.69, subdivision 5c, paragraph (a), 25.34 clause (2), 24 percent of the amount shall be distributed by the 25.35 commissioner to the Hennepin County Medical Center for clinical 25.36 medical education. The remaining 26 percent of the amount 26.1 transferred shall be distributed by the commissioner in 26.2 accordance with subdivision 7a. If the federal approval is not 26.3 obtained for the matching funds under section 256B.69, 26.4 subdivision 5c, paragraph (a), clause (2), 100 percent of the 26.5 amount transferred under this paragraph shall be distributed by 26.6 the commissioner to the University of Minnesota board of regents 26.7 for the purposes described in sections 137.38 to 137.40. 26.8 (c) The amount transferred according to section 256B.69, 26.9 subdivision 5c, paragraph (a), clause (3), shall be distributed 26.10 by the commissioner to the University of Minnesota board of 26.11 regents for the purposes of clinical graduate medical education 26.12 by June 30 of each fiscal year. 26.13 Sec. 2. Minnesota Statutes 2001 Supplement, section 26.14 256.01, subdivision 2, is amended to read: 26.15 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 26.16 section 241.021, subdivision 2, the commissioner of human 26.17 services shall: 26.18 (1) Administer and supervise all forms of public assistance 26.19 provided for by state law and other welfare activities or 26.20 services as are vested in the commissioner. Administration and 26.21 supervision of human services activities or services includes, 26.22 but is not limited to, assuring timely and accurate distribution 26.23 of benefits, completeness of service, and quality program 26.24 management. In addition to administering and supervising human 26.25 services activities vested by law in the department, the 26.26 commissioner shall have the authority to: 26.27 (a) require county agency participation in training and 26.28 technical assistance programs to promote compliance with 26.29 statutes, rules, federal laws, regulations, and policies 26.30 governing human services; 26.31 (b) monitor, on an ongoing basis, the performance of county 26.32 agencies in the operation and administration of human services, 26.33 enforce compliance with statutes, rules, federal laws, 26.34 regulations, and policies governing welfare services and promote 26.35 excellence of administration and program operation; 26.36 (c) develop a quality control program or other monitoring 27.1 program to review county performance and accuracy of benefit 27.2 determinations; 27.3 (d) require county agencies to make an adjustment to the 27.4 public assistance benefits issued to any individual consistent 27.5 with federal law and regulation and state law and rule and to 27.6 issue or recover benefits as appropriate; 27.7 (e) delay or deny payment of all or part of the state and 27.8 federal share of benefits and administrative reimbursement 27.9 according to the procedures set forth in section 256.017; 27.10 (f) make contracts with and grants to public and private 27.11 agencies and organizations, both profit and nonprofit, and 27.12 individuals, using appropriated funds; and 27.13 (g) enter into contractual agreements with federally 27.14 recognized Indian tribes with a reservation in Minnesota to the 27.15 extent necessary for the tribe to operate a federally approved 27.16 family assistance program or any other program under the 27.17 supervision of the commissioner. The commissioner shall consult 27.18 with the affected county or counties in the contractual 27.19 agreement negotiations, if the county or counties wish to be 27.20 included, in order to avoid the duplication of county and tribal 27.21 assistance program services. The commissioner may establish 27.22 necessary accounts for the purposes of receiving and disbursing 27.23 funds as necessary for the operation of the programs. 27.24 (2) Inform county agencies, on a timely basis, of changes 27.25 in statute, rule, federal law, regulation, and policy necessary 27.26 to county agency administration of the programs. 27.27 (3) Administer and supervise all child welfare activities; 27.28 promote the enforcement of laws protecting handicapped, 27.29 dependent, neglected and delinquent children, and children born 27.30 to mothers who were not married to the children's fathers at the 27.31 times of the conception nor at the births of the children; 27.32 license and supervise child-caring and child-placing agencies 27.33 and institutions; supervise the care of children in boarding and 27.34 foster homes or in private institutions; and generally perform 27.35 all functions relating to the field of child welfare now vested 27.36 in the state board of control. 28.1 (4) Administer and supervise all noninstitutional service 28.2 to handicapped persons, including those who are visually 28.3 impaired, hearing impaired, or physically impaired or otherwise 28.4 handicapped. The commissioner may provide and contract for the 28.5 care and treatment of qualified indigent children in facilities 28.6 other than those located and available at state hospitals when 28.7 it is not feasible to provide the service in state hospitals. 28.8 (5) Assist and actively cooperate with other departments, 28.9 agencies and institutions, local, state, and federal, by 28.10 performing services in conformity with the purposes of Laws 28.11 1939, chapter 431. 28.12 (6) Act as the agent of and cooperate with the federal 28.13 government in matters of mutual concern relative to and in 28.14 conformity with the provisions of Laws 1939, chapter 431, 28.15 including the administration of any federal funds granted to the 28.16 state to aid in the performance of any functions of the 28.17 commissioner as specified in Laws 1939, chapter 431, and 28.18 including the promulgation of rules making uniformly available 28.19 medical care benefits to all recipients of public assistance, at 28.20 such times as the federal government increases its participation 28.21 in assistance expenditures for medical care to recipients of 28.22 public assistance, the cost thereof to be borne in the same 28.23 proportion as are grants of aid to said recipients. 28.24 (7) Establish and maintain any administrative units 28.25 reasonably necessary for the performance of administrative 28.26 functions common to all divisions of the department. 28.27 (8) Act as designated guardian of both the estate and the 28.28 person of all the wards of the state of Minnesota, whether by 28.29 operation of law or by an order of court, without any further 28.30 act or proceeding whatever, except as to persons committed as 28.31 mentally retarded. For children under the guardianship of the 28.32 commissioner whose interests would be best served by adoptive 28.33 placement, the commissioner may contract with a licensed 28.34 child-placing agency or a Minnesota tribal social services 28.35 agency to provide adoption services. A contract with a licensed 28.36 child-placing agency must be designed to supplement existing 29.1 county efforts and may not replace existing county programs, 29.2 unless the replacement is agreed to by the county board and the 29.3 appropriate exclusive bargaining representative or the 29.4 commissioner has evidence that child placements of the county 29.5 continue to be substantially below that of other counties. 29.6 Funds encumbered and obligated under an agreement for a specific 29.7 child shall remain available until the terms of the agreement 29.8 are fulfilled or the agreement is terminated. 29.9 (9) Act as coordinating referral and informational center 29.10 on requests for service for newly arrived immigrants coming to 29.11 Minnesota. 29.12 (10) The specific enumeration of powers and duties as 29.13 hereinabove set forth shall in no way be construed to be a 29.14 limitation upon the general transfer of powers herein contained. 29.15 (11) Establish county, regional, or statewide schedules of 29.16 maximum fees and charges which may be paid by county agencies 29.17 for medical, dental, surgical, hospital, nursing and nursing 29.18 home care and medicine and medical supplies under all programs 29.19 of medical care provided by the state and for congregate living 29.20 care under the income maintenance programs. 29.21 (12) Have the authority to conduct and administer 29.22 experimental projects to test methods and procedures of 29.23 administering assistance and services to recipients or potential 29.24 recipients of public welfare. To carry out such experimental 29.25 projects, it is further provided that the commissioner of human 29.26 services is authorized to waive the enforcement of existing 29.27 specific statutory program requirements, rules, and standards in 29.28 one or more counties. The order establishing the waiver shall 29.29 provide alternative methods and procedures of administration, 29.30 shall not be in conflict with the basic purposes, coverage, or 29.31 benefits provided by law, and in no event shall the duration of 29.32 a project exceed four years. It is further provided that no 29.33 order establishing an experimental project as authorized by the 29.34 provisions of this section shall become effective until the 29.35 following conditions have been met: 29.36 (a) The secretary of health and human services of the 30.1 United States has agreed, for the same project, to waive state 30.2 plan requirements relative to statewide uniformity. 30.3 (b) A comprehensive plan, including estimated project 30.4 costs, shall be approved by the legislative advisory commission 30.5 and filed with the commissioner of administration. 30.6 (13) According to federal requirements, establish 30.7 procedures to be followed by local welfare boards in creating 30.8 citizen advisory committees, including procedures for selection 30.9 of committee members. 30.10 (14) Allocate federal fiscal disallowances or sanctions 30.11 which are based on quality control error rates for the aid to 30.12 families with dependent children program formerly codified in 30.13 sections 256.72 to 256.87, medical assistance, or food stamp 30.14 program in the following manner: 30.15 (a) One-half of the total amount of the disallowance shall 30.16 be borne by the county boards responsible for administering the 30.17 programs. For the medical assistance and the AFDC program 30.18 formerly codified in sections 256.72 to 256.87, disallowances 30.19 shall be shared by each county board in the same proportion as 30.20 that county's expenditures for the sanctioned program are to the 30.21 total of all counties' expenditures for the AFDC program 30.22 formerly codified in sections 256.72 to 256.87, and medical 30.23 assistance programs. For the food stamp program, sanctions 30.24 shall be shared by each county board, with 50 percent of the 30.25 sanction being distributed to each county in the same proportion 30.26 as that county's administrative costs for food stamps are to the 30.27 total of all food stamp administrative costs for all counties, 30.28 and 50 percent of the sanctions being distributed to each county 30.29 in the same proportion as that county's value of food stamp 30.30 benefits issued are to the total of all benefits issued for all 30.31 counties. Each county shall pay its share of the disallowance 30.32 to the state of Minnesota. When a county fails to pay the 30.33 amount due hereunder, the commissioner may deduct the amount 30.34 from reimbursement otherwise due the county, or the attorney 30.35 general, upon the request of the commissioner, may institute 30.36 civil action to recover the amount due. 31.1 (b) Notwithstanding the provisions of paragraph (a), if the 31.2 disallowance results from knowing noncompliance by one or more 31.3 counties with a specific program instruction, and that knowing 31.4 noncompliance is a matter of official county board record, the 31.5 commissioner may require payment or recover from the county or 31.6 counties, in the manner prescribed in paragraph (a), an amount 31.7 equal to the portion of the total disallowance which resulted 31.8 from the noncompliance, and may distribute the balance of the 31.9 disallowance according to paragraph (a). 31.10 (15) Develop and implement special projects that maximize 31.11 reimbursements and result in the recovery of money to the 31.12 state. For the purpose of recovering state money, the 31.13 commissioner may enter into contracts with third parties. Any 31.14 recoveries that result from projects or contracts entered into 31.15 under this paragraph shall be deposited in the state treasury 31.16 and credited to a special account until the balance in the 31.17 account reaches $1,000,000. When the balance in the account 31.18 exceeds $1,000,000, the excess shall be transferred and credited 31.19 to the general fund. All money in the account is appropriated 31.20 to the commissioner for the purposes of this paragraph. 31.21 (16) Have the authority to make direct payments to 31.22 facilities providing shelter to women and their children 31.23 according to section 256D.05, subdivision 3. Upon the written 31.24 request of a shelter facility that has been denied payments 31.25 under section 256D.05, subdivision 3, the commissioner shall 31.26 review all relevant evidence and make a determination within 30 31.27 days of the request for review regarding issuance of direct 31.28 payments to the shelter facility. Failure to act within 30 days 31.29 shall be considered a determination not to issue direct payments. 31.30 (17) Have the authority to establish and enforce the 31.31 following county reporting requirements: 31.32 (a) The commissioner shall establish fiscal and statistical 31.33 reporting requirements necessary to account for the expenditure 31.34 of funds allocated to counties for human services programs. 31.35 When establishing financial and statistical reporting 31.36 requirements, the commissioner shall evaluate all reports, in 32.1 consultation with the counties, to determine if the reports can 32.2 be simplified or the number of reports can be reduced. 32.3 (b) The county board shall submit monthly or quarterly 32.4 reports to the department as required by the commissioner. 32.5 Monthly reports are due no later than 15 working days after the 32.6 end of the month. Quarterly reports are due no later than 30 32.7 calendar days after the end of the quarter, unless the 32.8 commissioner determines that the deadline must be shortened to 32.9 20 calendar days to avoid jeopardizing compliance with federal 32.10 deadlines or risking a loss of federal funding. Only reports 32.11 that are complete, legible, and in the required format shall be 32.12 accepted by the commissioner. 32.13 (c) If the required reports are not received by the 32.14 deadlines established in clause (b), the commissioner may delay 32.15 payments and withhold funds from the county board until the next 32.16 reporting period. When the report is needed to account for the 32.17 use of federal funds and the late report results in a reduction 32.18 in federal funding, the commissioner shall withhold from the 32.19 county boards with late reports an amount equal to the reduction 32.20 in federal funding until full federal funding is received. 32.21 (d) A county board that submits reports that are late, 32.22 illegible, incomplete, or not in the required format for two out 32.23 of three consecutive reporting periods is considered 32.24 noncompliant. When a county board is found to be noncompliant, 32.25 the commissioner shall notify the county board of the reason the 32.26 county board is considered noncompliant and request that the 32.27 county board develop a corrective action plan stating how the 32.28 county board plans to correct the problem. The corrective 32.29 action plan must be submitted to the commissioner within 45 days 32.30 after the date the county board received notice of noncompliance. 32.31 (e) The final deadline for fiscal reports or amendments to 32.32 fiscal reports is one year after the date the report was 32.33 originally due. If the commissioner does not receive a report 32.34 by the final deadline, the county board forfeits the funding 32.35 associated with the report for that reporting period and the 32.36 county board must repay any funds associated with the report 33.1 received for that reporting period. 33.2 (f) The commissioner may not delay payments, withhold 33.3 funds, or require repayment under paragraph (c) or (e) if the 33.4 county demonstrates that the commissioner failed to provide 33.5 appropriate forms, guidelines, and technical assistance to 33.6 enable the county to comply with the requirements. If the 33.7 county board disagrees with an action taken by the commissioner 33.8 under paragraph (c) or (e), the county board may appeal the 33.9 action according to sections 14.57 to 14.69. 33.10 (g) Counties subject to withholding of funds under 33.11 paragraph (c) or forfeiture or repayment of funds under 33.12 paragraph (e) shall not reduce or withhold benefits or services 33.13 to clients to cover costs incurred due to actions taken by the 33.14 commissioner under paragraph (c) or (e). 33.15 (18) Allocate federal fiscal disallowances or sanctions for 33.16 audit exceptions when federal fiscal disallowances or sanctions 33.17 are based on a statewide random sample for the foster care 33.18 program under title IV-E of the Social Security Act, United 33.19 States Code, title 42, in direct proportion to each county's 33.20 title IV-E foster care maintenance claim for that period. 33.21 (19) Be responsible for ensuring the detection, prevention, 33.22 investigation, and resolution of fraudulent activities or 33.23 behavior by applicants, recipients, and other participants in 33.24 the human services programs administered by the department. 33.25 (20) Require county agencies to identify overpayments, 33.26 establish claims, and utilize all available and cost-beneficial 33.27 methodologies to collect and recover these overpayments in the 33.28 human services programs administered by the department. 33.29 (21) Have the authority to administer a drug rebate program 33.30 for drugs purchased pursuant to the prescription drug program 33.31 established under section 256.955 after the beneficiary's 33.32 satisfaction of any deductible established in the program. The 33.33 commissioner shall require a rebate agreement from all 33.34 manufacturers of covered drugs as defined in section 256B.0625, 33.35 subdivision 13. Rebate agreements for prescription drugs 33.36 delivered on or after July 1, 2002, must include rebates for 34.1 individuals covered under the prescription drug program who are 34.2 under 65 years of age. For each drug, the amount of the rebate 34.3 shall be equal to the basic rebate as defined for purposes of 34.4 the federal rebate program in United States Code, title 42, 34.5 section 1396r-8(c)(1). This basic rebate shall be applied to 34.6 single-source and multiple-source drugs. The manufacturers must 34.7 provide full payment within 30 days of receipt of the state 34.8 invoice for the rebate within the terms and conditions used for 34.9 the federal rebate program established pursuant to section 1927 34.10 of title XIX of the Social Security Act. The manufacturers must 34.11 provide the commissioner with any information necessary to 34.12 verify the rebate determined per drug. The rebate program shall 34.13 utilize the terms and conditions used for the federal rebate 34.14 program established pursuant to section 1927 of title XIX of the 34.15 Social Security Act. 34.16 (22) Have the authority to administer the federal drug 34.17 rebate program for drugs purchased under the medical assistance 34.18 program as allowed by section 1927 of title XIX of the Social 34.19 Security Act and according to the terms and conditions of 34.20 section 1927. Rebates shall be collected for all drugs that 34.21 have been dispensed or administered in an outpatient setting and 34.22 that are from manufacturers who have signed a rebate agreement 34.23 with the United States Department of Health and Human Services. 34.24 (23) Have the authority to administer a supplemental drug 34.25 rebate program for drugs purchased under the medical assistance 34.26 program and under the prescription drug program established in 34.27 section 256.955. The commissioner may enter into supplemental 34.28 rebate contracts with pharmaceutical manufacturers and may 34.29 require prior authorization for drugs that are from 34.30 manufacturers that have not signed a supplemental rebate 34.31 contract. Prior authorization of drugs shall be subject to the 34.32 provisions of section 256B.0625, subdivision 13, paragraph (b). 34.33 (24) Operate the department's communication systems account 34.34 established in Laws 1993, First Special Session chapter 1, 34.35 article 1, section 2, subdivision 2, to manage shared 34.36 communication costs necessary for the operation of the programs 35.1 the commissioner supervises. A communications account may also 35.2 be established for each regional treatment center which operates 35.3 communications systems. Each account must be used to manage 35.4 shared communication costs necessary for the operations of the 35.5 programs the commissioner supervises. The commissioner may 35.6 distribute the costs of operating and maintaining communication 35.7 systems to participants in a manner that reflects actual usage. 35.8 Costs may include acquisition, licensing, insurance, 35.9 maintenance, repair, staff time and other costs as determined by 35.10 the commissioner. Nonprofit organizations and state, county, 35.11 and local government agencies involved in the operation of 35.12 programs the commissioner supervises may participate in the use 35.13 of the department's communications technology and share in the 35.14 cost of operation. The commissioner may accept on behalf of the 35.15 state any gift, bequest, devise or personal property of any 35.16 kind, or money tendered to the state for any lawful purpose 35.17 pertaining to the communication activities of the department. 35.18 Any money received for this purpose must be deposited in the 35.19 department's communication systems accounts. Money collected by 35.20 the commissioner for the use of communication systems must be 35.21 deposited in the state communication systems account and is 35.22 appropriated to the commissioner for purposes of this section. 35.23(24)(25) Receive any federal matching money that is made 35.24 available through the medical assistance program for the 35.25 consumer satisfaction survey. Any federal money received for 35.26 the survey is appropriated to the commissioner for this 35.27 purpose. The commissioner may expend the federal money received 35.28 for the consumer satisfaction survey in either year of the 35.29 biennium. 35.30(25)(26) Incorporate cost reimbursement claims from First 35.31 Call Minnesota and Greater Twin Cities United Way into the 35.32 federal cost reimbursement claiming processes of the department 35.33 according to federal law, rule, and regulations. Any 35.34 reimbursement received is appropriated to the commissioner and 35.35 shall be disbursed to First Call Minnesota and Greater Twin 35.36 Cities United Way according to normal department payment 36.1 schedules. 36.2(26)(27) Develop recommended standards for foster care 36.3 homes that address the components of specialized therapeutic 36.4 services to be provided by foster care homes with those services. 36.5 Sec. 3. Minnesota Statutes 2001 Supplement, section 36.6 256.955, subdivision 2a, is amended to read: 36.7 Subd. 2a. [ELIGIBILITY.] An individual satisfying the 36.8 following requirements and the requirements described in 36.9 subdivision 2, paragraph (d), is eligible for the prescription 36.10 drug program: 36.11 (1) is at least 65 years of age or older; and 36.12 (2) is eligible as a qualified Medicare beneficiary 36.13 according to section 256B.057, subdivision 3,or 3a,or 3b,36.14clause (1),or is eligible under section 256B.057, subdivision 36.15 3,or 3a,or 3b, clause (1),and is also eligible for medical 36.16 assistance or general assistance medical care with a spenddown 36.17 as defined in section 256B.056, subdivision 5. 36.18 [EFFECTIVE DATE.] This section is effective July 1, 2002. 36.19 Sec. 4. Minnesota Statutes 2001 Supplement, section 36.20 256.969, subdivision 3a, is amended to read: 36.21 Subd. 3a. [PAYMENTS.] (a) Acute care hospital billings 36.22 under the medical assistance program must not be submitted until 36.23 the recipient is discharged. However, the commissioner shall 36.24 establish monthly interim payments for inpatient hospitals that 36.25 have individual patient lengths of stay over 30 days regardless 36.26 of diagnostic category. Except as provided in section 256.9693, 36.27 medical assistance reimbursement for treatment of mental illness 36.28 shall be reimbursed based on diagnostic classifications. 36.29 Individual hospital payments established under this section and 36.30 sections 256.9685, 256.9686, and 256.9695, in addition to third 36.31 party and recipient liability, for discharges occurring during 36.32 the rate year shall not exceed, in aggregate, the charges for 36.33 the medical assistance covered inpatient services paid for the 36.34 same period of time to the hospital. This payment limitation 36.35 shall be calculated separately for medical assistance and 36.36 general assistance medical care services. The limitation on 37.1 general assistance medical care shall be effective for 37.2 admissions occurring on or after July 1, 1991. Services that 37.3 have rates established under subdivision 11 or 12, must be 37.4 limited separately from other services. After consulting with 37.5 the affected hospitals, the commissioner may consider related 37.6 hospitals one entity and may merge the payment rates while 37.7 maintaining separate provider numbers. The operating and 37.8 property base rates per admission or per day shall be derived 37.9 from the best Medicare and claims data available when rates are 37.10 established. The commissioner shall determine the best Medicare 37.11 and claims data, taking into consideration variables of recency 37.12 of the data, audit disposition, settlement status, and the 37.13 ability to set rates in a timely manner. The commissioner shall 37.14 notify hospitals of payment rates by December 1 of the year 37.15 preceding the rate year. The rate setting data must reflect the 37.16 admissions data used to establish relative values. Base year 37.17 changes from 1981 to the base year established for the rate year 37.18 beginning January 1, 1991, and for subsequent rate years, shall 37.19 not be limited to the limits ending June 30, 1987, on the 37.20 maximum rate of increase under subdivision 1. The commissioner 37.21 may adjust base year cost, relative value, and case mix index 37.22 data to exclude the costs of services that have been 37.23 discontinued by the October 1 of the year preceding the rate 37.24 year or that are paid separately from inpatient services. 37.25 Inpatient stays that encompass portions of two or more rate 37.26 years shall have payments established based on payment rates in 37.27 effect at the time of admission unless the date of admission 37.28 preceded the rate year in effect by six months or more. In this 37.29 case, operating payment rates for services rendered during the 37.30 rate year in effect and established based on the date of 37.31 admission shall be adjusted to the rate year in effect by the 37.32 hospital cost index. 37.33 (b) For fee-for-service admissions occurring on or after 37.34 July 1, 2002, the total payment, before third party liability 37.35 and spenddown, made to hospitals for inpatient services is 37.36 reduced by one percent from the current statutory rates. 38.1 Sec. 5. Minnesota Statutes 2001 Supplement, section 38.2 256B.056, subdivision 3, is amended to read: 38.3 Subd. 3. [ASSET LIMITATIONS FOR ELDERLY AND DISABLED 38.4 INDIVIDUALS.] To be eligible for medical assistance, a person 38.5 must not individually own more than $3,000 in assets, or if a 38.6 member of a household with two family members, husband and wife, 38.7 or parent and child, the household must not own more than $6,000 38.8 in assets, plus $200 for each additional legal dependent. In 38.9 addition to these maximum amounts, an eligible individual or 38.10 family may accrue interest on these amounts, but they must be 38.11 reduced to the maximum at the time of an eligibility 38.12 redetermination. The accumulation of the clothing and personal 38.13 needs allowance according to section 256B.35 must also be 38.14 reduced to the maximum at the time of the eligibility 38.15 redetermination. The value of assets that are not considered in 38.16 determining eligibility for medical assistance is the value of 38.17 those assets excluded under the supplemental security income 38.18 program for aged, blind, and disabled persons, with the 38.19 following exceptions: 38.20 (a) Household goods and personal effects are not considered. 38.21 (b) Capital and operating assets of a trade or business 38.22 that the local agency determines are necessary to the person's 38.23 ability to earn an income are not considered. 38.24 (c) Motor vehicles are excluded to the same extent excluded 38.25 by the supplemental security income program. 38.26 (d) Assets designated as burial expenses are excluded to 38.27 the same extent excluded by the supplemental security income 38.28 program. Burial expenses funded by annuity contracts or life 38.29 insurance policies must designate the individual's estate as 38.30 contingent beneficiary to the extent proceeds are not used for 38.31 payment of selected burial expenses. 38.32 (e) Effective upon federal approval, for a person who no 38.33 longer qualifies as an employed person with a disability due to 38.34 loss of earnings, assets allowed while eligible for medical 38.35 assistance under section 256B.057, subdivision 9, are not 38.36 considered for 12 months, beginning with the first month of 39.1 ineligibility as an employed person with a disability, to the 39.2 extent that the person's total assets remain within the allowed 39.3 limits of section 256B.057, subdivision 9, paragraph (b). 39.4 Sec. 6. Minnesota Statutes 2001 Supplement, section 39.5 256B.057, subdivision 9, is amended to read: 39.6 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 39.7 assistance may be paid for a person who is employed and who: 39.8 (1) meets the definition of disabled under the supplemental 39.9 security income program; 39.10 (2) is at least 16 but less than 65 years of age; 39.11 (3) meets the asset limits in paragraph (b); and 39.12 (4) pays a premium, if required, under paragraph (c). 39.13 The person must verify earnings from employment by documenting 39.14 that social security and Medicare taxes are withheld, and, if 39.15 applicable, state and federal income taxes are also withheld. 39.16 If the person is self-employed, the person must document payment 39.17 of self-employment tax and, if applicable, state and federal 39.18 income taxes. 39.19 Any spousal income or assets shall be disregarded for purposes 39.20 of eligibility and premium determinations. 39.21 After the month of enrollment, a person enrolled in medical 39.22 assistance under this subdivision who is temporarily unable to 39.23 work and without receipt of earned income due to a medical 39.24 condition, as verified by a physician, may retain eligibility 39.25 for up to four calendar months. 39.26 (b) For purposes of determining eligibility under this 39.27 subdivision, a person's assets must not exceed $20,000, 39.28 excluding: 39.29 (1) all assets excluded under section 256B.056; 39.30 (2) retirement accounts, including individual accounts, 39.31 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 39.32 (3) medical expense accounts set up through the person's 39.33 employer. 39.34 (c) A person whose earned and unearned income is equal to 39.35 or greater than 100 percent of federal poverty guidelines for 39.36 the applicable family size must pay a premium to be eligible for 40.1 medical assistance under this subdivision. The premium shall be 40.2 based on the person's gross earned and unearned income and the 40.3 applicable family size using a sliding fee scale established by 40.4 the commissioner, which begins at one percent of income at 100 40.5 percent of the federal poverty guidelines and increases to 7.5 40.6 percent of income for those with incomes at or above 300 percent 40.7 of the federal poverty guidelines. Annual adjustments in the 40.8 premium schedule based upon changes in the federal poverty 40.9 guidelines shall be effective for premiums due in July of each 40.10 year. 40.11 (d) A person's eligibility and premium shall be determined 40.12 by the local county agency. Premiums must be paid to the 40.13 commissioner. All premiums are dedicated to the commissioner. 40.14 (e) Any required premium shall be determined at application 40.15 and redetermined annually at recertification or when a change in 40.16 income or family size occurs. 40.17 (f) Premium payment is due upon notification from the 40.18 commissioner of the premium amount required. Premiums may be 40.19 paid in installments at the discretion of the commissioner. 40.20 (g) Nonpayment of the premium shall result in denial or 40.21 termination of medical assistance unless the person demonstrates 40.22 good cause for nonpayment. Good cause exists if the 40.23 requirements specified in Minnesota Rules, part 9506.0040, 40.24 subpart 7, items B to D, are met. Nonpayment shall include 40.25 payment with a returned, refused, or dishonored instrument. The 40.26 commissioner may require a guaranteed form of payment as the 40.27 only means to replace a returned, refused, or dishonored 40.28 instrument. 40.29 Sec. 7. Minnesota Statutes 2000, section 256B.059, 40.30 subdivision 1, is amended to read: 40.31 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 40.32 section and section 256B.0595, the terms defined in this 40.33 subdivision have the meanings given them. 40.34 (b) "Community spouse" means the spouse of an 40.35 institutionalized spouse. 40.36 (c) "Spousal share" means one-half of the total value of 41.1 all assets, to the extent that either the institutionalized 41.2 spouse or the community spouse had an ownership interest at the 41.3 time of institutionalization. 41.4 (d) "Assets otherwise available to the community spouse" 41.5 means assets individually or jointly owned by the community 41.6 spouse, other than assets excluded by subdivision 5, paragraph 41.7 (c). 41.8 (e) "Community spouse asset allowance" is the value of 41.9 assets that can be transferred under subdivision 3. 41.10 (f) "Institutionalized spouse" means a person who is: 41.11 (1) in a hospital, nursing facility, or intermediate care 41.12 facility for persons with mental retardation, or receiving home 41.13 and community-based services under section 256B.0915 or 256B.49, 41.14 and is expected to remain in the facility or institution or 41.15 receive the home and community-based services for at least 30 41.16 consecutive days; and 41.17 (2) married to a person who is not in a hospital, nursing 41.18 facility, or intermediate care facility for persons with mental 41.19 retardation, and is not receiving home and community-based 41.20 services under section 256B.0915 or 256B.49. 41.21 (g) "For the sole benefit of" means no other individual or 41.22 entity can benefit in any way from the assets or income at the 41.23 time of a transfer or at any time in the future. 41.24 Sec. 8. Minnesota Statutes 2000, section 256B.059, 41.25 subdivision 3, is amended to read: 41.26 Subd. 3. [COMMUNITY SPOUSE ASSET ALLOWANCE.] An 41.27 institutionalized spouse may transfer assets to the community 41.28 spousesolelyfor the sole benefit of the community spouse. 41.29 Except for increased amounts allowable under subdivision 4, the 41.30 maximum amount of assets allowed to be transferred is the amount 41.31 which, when added to the assets otherwise available to the 41.32 community spouse, is as follows: 41.33 (1) prior to July 1, 1994, the greater of: 41.34 (i) $14,148; 41.35 (ii) the lesser of the spousal share or $70,740; or 41.36 (iii) the amount required by court order to be paid to the 42.1 community spouse; and 42.2 (2) for persons whose date of initial determination of 42.3 eligibility for medical assistance following their first 42.4 continuous period of institutionalization occurs on or after 42.5 July 1, 1994, the greater of: 42.6 (i) $20,000; 42.7 (ii) the lesser of the spousal share or $70,740; or 42.8 (iii) the amount required by court order to be paid to the 42.9 community spouse. 42.10 If the assets available to the community spouse are already 42.11 at the limit permissible under this section, or the higher limit 42.12 attributable to increases under subdivision 4, no assets may be 42.13 transferred from the institutionalized spouse to the community 42.14 spouse. The transfer must be made as soon as practicable after 42.15 the date the institutionalized spouse is determined eligible for 42.16 medical assistance, or within the amount of time needed for any 42.17 court order required for the transfer. On January 1, 1994, and 42.18 every January 1 thereafter, the limits in this subdivision shall 42.19 be adjusted by the same percentage change in the consumer price 42.20 index for all urban consumers (all items; United States city 42.21 average) between the two previous Septembers. These adjustments 42.22 shall also be applied to the limits in subdivision 5. 42.23 Sec. 9. Minnesota Statutes 2000, section 256B.059, 42.24 subdivision 5, is amended to read: 42.25 Subd. 5. [ASSET AVAILABILITY.] (a) At the time of initial 42.26 determination of eligibility for medical assistance benefits 42.27 following the first continuous period of institutionalization on 42.28 or after October 1, 1989, assets considered available to the 42.29 institutionalized spouse shall be the total value of all assets 42.30 in which either spouse has an ownership interest, reduced by the 42.31 following amount for the community spouse: 42.32 (1) prior to July 1, 1994, the greater of: 42.33 (i) $14,148; 42.34 (ii) the lesser of the spousal share or $70,740; or 42.35 (iii) the amount required by court order to be paid to the 42.36 community spouse; 43.1 (2) for persons whose date of initial determination of 43.2 eligibility for medical assistance following their first 43.3 continuous period of institutionalization occurs on or after 43.4 July 1, 1994, the greater of: 43.5 (i) $20,000; 43.6 (ii) the lesser of the spousal share or $70,740; or 43.7 (iii) the amount required by court order to be paid to the 43.8 community spouse. 43.9 The value of assets transferred for the sole benefit of the 43.10 community spouse under section 256B.0595, subdivision 4, in 43.11 combination with other assets available to the community spouse 43.12 under this section, cannot exceed the limit for the community 43.13 spouse asset allowance determined under subdivision 3 or 4. 43.14 Assets that exceed this allowance shall be considered available 43.15 to the institutionalized spouse whether or not converted to 43.16 income. If the community spouse asset allowance has been 43.17 increased under subdivision 4, then the assets considered 43.18 available to the institutionalized spouse under this subdivision 43.19 shall be further reduced by the value of additional amounts 43.20 allowed under subdivision 4. 43.21 (b) An institutionalized spouse may be found eligible for 43.22 medical assistance even though assets in excess of the allowable 43.23 amount are found to be available under paragraph (a) if the 43.24 assets are owned jointly or individually by the community 43.25 spouse, and the institutionalized spouse cannot use those assets 43.26 to pay for the cost of care without the consent of the community 43.27 spouse, and if: (i) the institutionalized spouse assigns to the 43.28 commissioner the right to support from the community spouse 43.29 under section 256B.14, subdivision 3; (ii) the institutionalized 43.30 spouse lacks the ability to execute an assignment due to a 43.31 physical or mental impairment; or (iii) the denial of 43.32 eligibility would cause an imminent threat to the 43.33 institutionalized spouse's health and well-being. 43.34 (c) After the month in which the institutionalized spouse 43.35 is determined eligible for medical assistance, during the 43.36 continuous period of institutionalization, no assets of the 44.1 community spouse are considered available to the 44.2 institutionalized spouse, unless the institutionalized spouse 44.3 has been found eligible under paragraph (b). 44.4 (d) Assets determined to be available to the 44.5 institutionalized spouse under this section must be used for the 44.6 health care or personal needs of the institutionalized spouse. 44.7 (e) For purposes of this section, assets do not include 44.8 assets excluded under the supplemental security income program. 44.9 [EFFECTIVE DATE.] This section is effective July 1, 2002. 44.10 Sec. 10. Minnesota Statutes 2001 Supplement, section 44.11 256B.0595, subdivision 1, is amended to read: 44.12 Subdivision 1. [PROHIBITED TRANSFERS.] (a) For transfers 44.13 of assets made on or before August 10, 1993, if a person or the 44.14 person's spouse has given away, sold, or disposed of, for less 44.15 than fair market value, any asset or interest therein, except 44.16 assets other than the homestead that are excluded under the 44.17 supplemental security program, within 30 months before or any 44.18 time after the date of institutionalization if the person has 44.19 been determined eligible for medical assistance, or within 30 44.20 months before or any time after the date of the first approved 44.21 application for medical assistance if the person has not yet 44.22 been determined eligible for medical assistance, the person is 44.23 ineligible for long-term care services for the period of time 44.24 determined under subdivision 2. 44.25 (b) Effective for transfers made after August 10, 1993, a 44.26 person, a person's spouse, or any person, court, or 44.27 administrative body with legal authority to act in place of, on 44.28 behalf of, at the direction of, or upon the request of the 44.29 person or person's spouse, may not give away, sell, or dispose 44.30 of, for less than fair market value, any asset or interest 44.31 therein, except assets other than the homestead that are 44.32 excluded under the supplemental security income program, for the 44.33 purpose of establishing or maintaining medical assistance 44.34 eligibility. For purposes of determining eligibility for 44.35 long-term care services, any transfer of such assets within 36 44.36 months before or any time after an institutionalized person 45.1 applies for medical assistance, or 36 months before or any time 45.2 after a medical assistance recipient becomes institutionalized, 45.3 for less than fair market value may be considered. Any such 45.4 transfer is presumed to have been made for the purpose of 45.5 establishing or maintaining medical assistance eligibility and 45.6 the person is ineligible for long-term care services for the 45.7 period of time determined under subdivision 2, unless the person 45.8 furnishes convincing evidence to establish that the transaction 45.9 was exclusively for another purpose, or unless the transfer is 45.10 permitted under subdivision 3 or 4. Notwithstanding the 45.11 provisions of this paragraph, in the case of payments from a 45.12 trust or portions of a trust that are considered transfers of 45.13 assets under federal law, any transfers made within 60 months 45.14 before or any time after an institutionalized person applies for 45.15 medical assistance and within 60 months before or any time after 45.16 a medical assistance recipient becomes institutionalized, may be 45.17 considered. 45.18 (c) This section applies to transfers, for less than fair 45.19 market value, of income or assets, including assets that are 45.20 considered income in the month received, such as inheritances, 45.21 court settlements, and retroactive benefit payments or income to 45.22 which the person or the person's spouse is entitled but does not 45.23 receive due to action by the person, the person's spouse, or any 45.24 person, court, or administrative body with legal authority to 45.25 act in place of, on behalf of, at the direction of, or upon the 45.26 request of the person or the person's spouse. 45.27 (d) This section applies to payments for care or personal 45.28 services provided by a relative, unless the compensation was 45.29 stipulated in a notarized, written agreement which was in 45.30 existence when the service was performed, the care or services 45.31 directly benefited the person, and the payments made represented 45.32 reasonable compensation for the care or services provided. A 45.33 notarized written agreement is not required if payment for the 45.34 services was made within 60 days after the service was provided. 45.35 (e) This section applies to the portion of any asset or 45.36 interest that a person, a person's spouse, or any person, court, 46.1 or administrative body with legal authority to act in place of, 46.2 on behalf of, at the direction of, or upon the request of the 46.3 person or the person's spouse, transfers to any annuity that 46.4 exceeds the value of the benefit likely to be returned to the 46.5 person or spouse while alive, based on estimated life expectancy 46.6 using the life expectancy tables employed by the supplemental 46.7 security income program to determine the value of an agreement 46.8 for services for life. The commissioner may adopt rules 46.9 reducing life expectancies based on the need for long-term 46.10 care. This section applies to an annuity described in this 46.11 paragraph purchased on or after March 1, 2002, that: 46.12 (1) is not purchased from an insurance company or financial 46.13 institution that is subject to licensing or regulation by the 46.14 Minnesota department of commerce or a similar regulatory agency 46.15 of another state; 46.16 (2) does not pay out principal and interest in equal 46.17 monthly installments; or 46.18 (3) does not begin payment at the earliest possible date 46.19 after annuitization. 46.20 (f) For purposes of this section, long-term care services 46.21 include services in a nursing facility, services that are 46.22 eligible for payment according to section 256B.0625, subdivision 46.23 2, because they are provided in a swing bed, intermediate care 46.24 facility for persons with mental retardation, and home and 46.25 community-based services provided pursuant to sections 46.26 256B.0915, 256B.092, and 256B.49. For purposes of this 46.27 subdivision and subdivisions 2, 3, and 4, "institutionalized 46.28 person" includes a person who is an inpatient in a nursing 46.29 facility or in a swing bed, or intermediate care facility for 46.30 persons with mental retardation or who is receiving home and 46.31 community-based services under sections 256B.0915, 256B.092, and 46.32 256B.49. 46.33 Sec. 11. Minnesota Statutes 2001 Supplement, section 46.34 256B.0595, subdivision 2, is amended to read: 46.35 Subd. 2. [PERIOD OF INELIGIBILITY.] (a) For any 46.36 uncompensated transfer occurring on or before August 10, 1993, 47.1 the number of months of ineligibility for long-term care 47.2 services shall be the lesser of 30 months, or the uncompensated 47.3 transfer amount divided by the average medical assistance rate 47.4 for nursing facility services in the state in effect on the date 47.5 of application. The amount used to calculate the average 47.6 medical assistance payment rate shall be adjusted each July 1 to 47.7 reflect payment rates for the previous calendar year. The 47.8 period of ineligibility begins with the month in which the 47.9 assets were transferred. If the transfer was not reported to 47.10 the local agency at the time of application, and the applicant 47.11 received long-term care services during what would have been the 47.12 period of ineligibility if the transfer had been reported, a 47.13 cause of action exists against the transferee for the cost of 47.14 long-term care services provided during the period of 47.15 ineligibility, or for the uncompensated amount of the transfer, 47.16 whichever is less. The action may be brought by the state or 47.17 the local agency responsible for providing medical assistance 47.18 under chapter 256G. The uncompensated transfer amount is the 47.19 fair market value of the asset at the time it was given away, 47.20 sold, or disposed of, less the amount of compensation received. 47.21 (b) For uncompensated transfers made after August 10, 1993, 47.22 the number of months of ineligibility for long-term care 47.23 services shall be the total uncompensated value of the resources 47.24 transferred divided by the average medical assistance rate for 47.25 nursing facility services in the state in effect on the date of 47.26 application. The amount used to calculate the average medical 47.27 assistance payment rate shall be adjusted each July 1 to reflect 47.28 payment rates for the previous calendar year. The period of 47.29 ineligibility begins with the month in which the assets were 47.30 transferred except that if one or more uncompensated transfers 47.31 are made during a period of ineligibility, the total assets 47.32 transferred during the ineligibility period shall be combined 47.33 and a penalty period calculated to begin in the month the first 47.34 uncompensated transfer was made. If the transfer was not 47.35 reported to the local agency at the time of application, and the 47.36 applicant received medical assistance services during what would 48.1 have been the period of ineligibility if the transfer had been 48.2 reported, a cause of action exists against the transferee for 48.3 the cost of medical assistance services provided during the 48.4 period of ineligibility, or for the uncompensated amount of the 48.5 transfer, whichever is less. The action may be brought by the 48.6 state or the local agency responsible for providing medical 48.7 assistance under chapter 256G. The uncompensated transfer 48.8 amount is the fair market value of the asset at the time it was 48.9 given away, sold, or disposed of, less the amount of 48.10 compensation received. Effective for transfers made on or after 48.11 March 1, 1996, involving persons who apply for medical 48.12 assistance on or after April 13, 1996, no cause of action exists 48.13 for a transfer unless: 48.14 (1) the transferee knew or should have known that the 48.15 transfer was being made by a person who was a resident of a 48.16 long-term care facility or was receiving that level of care in 48.17 the community at the time of the transfer; 48.18 (2) the transferee knew or should have known that the 48.19 transfer was being made to assist the person to qualify for or 48.20 retain medical assistance eligibility; or 48.21 (3) the transferee actively solicited the transfer with 48.22 intent to assist the person to qualify for or retain eligibility 48.23 for medical assistance. 48.24 (c) If a calculation of a penalty period results in a 48.25 partial month, payments for long-term care services shall be 48.26 reduced in an amount equal to the fraction, except that in 48.27 calculating the value of uncompensated transfers, if the total 48.28 value of all uncompensated transfers made in a month not 48.29 included in an existing penalty period does not 48.30 exceed$500$200, then such transfers shall be disregarded for 48.31 each month prior to the month of application for or during 48.32 receipt of medical assistance. 48.33 Sec. 12. Minnesota Statutes 2000, section 256B.0595, 48.34 subdivision 4, is amended to read: 48.35 Subd. 4. [OTHER EXCEPTIONS TO TRANSFER PROHIBITION.] An 48.36 institutionalized person who has made, or whose spouse has made 49.1 a transfer prohibited by subdivision 1, is not ineligible for 49.2 long-term care services if one of the following conditions 49.3 applies: 49.4 (1) the assets were transferred to the individual's spouse 49.5 or to another for the sole benefit of the spouse; or 49.6 (2) the institutionalized spouse, prior to being 49.7 institutionalized, transferred assets to a spouse, provided that 49.8 the spouse to whom the assets were transferred does not then 49.9 transfer those assets to another person for less than fair 49.10 market value. (At the time when one spouse is 49.11 institutionalized, assets must be allocated between the spouses 49.12 as provided under section 256B.059); or 49.13 (3) the assets were transferred to the individual's child 49.14 who is blind or permanently and totally disabled as determined 49.15 in the supplemental security income program; or 49.16 (4) a satisfactory showing is made that the individual 49.17 intended to dispose of the assets either at fair market value or 49.18 for other valuable consideration; or 49.19 (5) the local agency determines that denial of eligibility 49.20 for long-term care services would work an undue hardship and 49.21 grants a waiver of a penalty resulting from a transfer for less 49.22 than fair market value based on an imminent threat to the 49.23 individual's health and well-being. Whenever an applicant or 49.24 recipient is denied eligibility because of a transfer for less 49.25 than fair market value, the local agency shall notify the 49.26 applicant or recipient that the applicant or recipient may 49.27 request a waiver of the penalty if the denial of eligibility 49.28 will cause undue hardship. In evaluating a waiver, the local 49.29 agency shall take into account whether the individual was the 49.30 victim of financial exploitation, whether the individual has 49.31 made reasonable efforts to recover the transferred property or 49.32 resource, and other factors relevant to a determination of 49.33 hardship. If the local agency does not approve a hardship 49.34 waiver, the local agency shall issue a written notice to the 49.35 individual stating the reasons for the denial and the process 49.36 for appealing the local agency's decision. When a waiver is 50.1 granted, a cause of action exists against the person to whom the 50.2 assets were transferred for that portion of long-term care 50.3 services granted within: 50.4 (i) 30 months of a transfer made on or before August 10, 50.5 1993; 50.6 (ii) 60 months of a transfer if the assets were transferred 50.7 after August 30, 1993, to a trust or portion of a trust that is 50.8 considered a transfer of assets under federal law; or 50.9 (iii) 36 months of a transfer if transferred in any other 50.10 manner after August 10, 1993, 50.11 or the amount of the uncompensated transfer, whichever is less, 50.12 together with the costs incurred due to the action. The action 50.13 shall be brought by the state unless the state delegates this 50.14 responsibility to the local agency responsible for providing 50.15 medical assistance under this chapter; or 50.16 (6) for transfers occurring after August 10, 1993, the 50.17 assets were transferred by the person or person's spouse: (i) 50.18 into a trust establishedsolelyfor the sole benefit of a son or 50.19 daughter of any age who is blind or disabled as defined by the 50.20 Supplemental Security Income program; or (ii) into a trust 50.21 establishedsolelyfor the sole benefit of an individual who is 50.22 under 65 years of age who is disabled as defined by the 50.23 Supplemental Security Income program. 50.24 "For the sole benefit of" has the meaning found in section 50.25 256B.059, subdivision 1. 50.26 [EFFECTIVE DATE.] This section is effective July 1, 2002. 50.27 Sec. 13. Minnesota Statutes 2001 Supplement, section 50.28 256B.0625, subdivision 13, is amended to read: 50.29 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 50.30 except for fertility drugs when specifically used to enhance 50.31 fertility, if prescribed by a licensed practitioner and 50.32 dispensed by a licensed pharmacist, by a physician enrolled in 50.33 the medical assistance program as a dispensing physician, or by 50.34 a physician or a nurse practitioner employed by or under 50.35 contract with a community health board as defined in section 50.36 145A.02, subdivision 5, for the purposes of communicable disease 51.1 control. The commissioner, after receiving recommendations from 51.2 professional medical associations and professional pharmacist 51.3 associations, shall designate a formulary committee to advise 51.4 the commissioner on the names of drugs for which payment is 51.5 made, recommend a system for reimbursing providers on a set fee 51.6 or charge basis rather than the present system, and develop 51.7 methods encouraging use of generic drugs when they are less 51.8 expensive and equally effective as trademark drugs. The 51.9 formulary committee shall consist of nine members, four of whom 51.10 shall be physicians who are not employed by the department of 51.11 human services, and a majority of whose practice is for persons 51.12 paying privately or through health insurance, three of whom 51.13 shall be pharmacists who are not employed by the department of 51.14 human services, and a majority of whose practice is for persons 51.15 paying privately or through health insurance, a consumer 51.16 representative, and a nursing home representative. Committee 51.17 members shall serve three-year terms and shall serve without 51.18 compensation. Members may be reappointed once. 51.19 (b) The commissioner shall establish a drug formulary. Its 51.20 establishment and publication shall not be subject to the 51.21 requirements of the Administrative Procedure Act, but the 51.22 formulary committee shall review and comment on the formulary 51.23 contents.The formulary committee shall review and recommend51.24drugs which require prior authorization. The formulary51.25committee may recommend drugs for prior authorization directly51.26to the commissioner, as long as opportunity for public input is51.27provided. Prior authorization may be requested by the51.28commissioner based on medical and clinical criteria before51.29certain drugs are eligible for payment. Before a drug may be51.30considered for prior authorization at the request of the51.31commissioner:51.32(1) the drug formulary committee must develop criteria to51.33be used for identifying drugs; the development of these criteria51.34is not subject to the requirements of chapter 14, but the51.35formulary committee shall provide opportunity for public input51.36in developing criteria;52.1(2) the drug formulary committee must hold a public forum52.2and receive public comment for an additional 15 days; and52.3(3) the commissioner must provide information to the52.4formulary committee on the impact that placing the drug on prior52.5authorization will have on the quality of patient care and52.6information regarding whether the drug is subject to clinical52.7abuse or misuse. Prior authorization may be required by the52.8commissioner before certain formulary drugs are eligible for52.9payment.The formulary shall not include: 52.10 (i) drugs or products for which there is no federal 52.11 funding; 52.12 (ii) over-the-counter drugs, except for antacids, 52.13 acetaminophen, family planning products, aspirin, insulin, 52.14 products for the treatment of lice, vitamins for adults with 52.15 documented vitamin deficiencies, vitamins for children under the 52.16 age of seven and pregnant or nursing women, and any other 52.17 over-the-counter drug identified by the commissioner, in 52.18 consultation with the drug formulary committee, as necessary, 52.19 appropriate, and cost-effective for the treatment of certain 52.20 specified chronic diseases, conditions or disorders, and this 52.21 determination shall not be subject to the requirements of 52.22 chapter 14; 52.23 (iii) anorectics, except that medically necessary 52.24 anorectics shall be covered for a recipient previously diagnosed 52.25 as having pickwickian syndrome and currently diagnosed as having 52.26 diabetes and being morbidly obese; 52.27 (iv) drugs for which medical value has not been 52.28 established; and 52.29 (v) drugs from manufacturers who have not signed a rebate 52.30 agreement with the Department of Health and Human Services 52.31 pursuant to section 1927 of title XIX of the Social Security Act. 52.32 The commissioner shall publish conditions for prohibiting 52.33 payment for specific drugs after considering the formulary 52.34 committee's recommendations. An honorarium of $100 per meeting 52.35 and reimbursement for mileage shall be paid to each committee 52.36 member in attendance. 53.1 (c) The basis for determining the amount of payment shall 53.2 be the lower of the actual acquisition costs of the drugs plus a 53.3 fixed dispensing fee; the maximum allowable cost set by the 53.4 federal government or by the commissioner plus the fixed 53.5 dispensing fee; or the usual and customary price charged to the 53.6 public. The pharmacy dispensing fee shall be$3.65$4.15, 53.7 except that the dispensing fee for intravenous solutions which 53.8 must be compounded by the pharmacist shall be $8 per bag, $14 53.9 per bag for cancer chemotherapy products, and $30 per bag for 53.10 total parenteral nutritional products dispensed in one liter 53.11 quantities, or $44 per bag for total parenteral nutritional 53.12 products dispensed in quantities greater than one liter. Actual 53.13 acquisition cost includes quantity and other special discounts 53.14 except time and cash discounts. The actual acquisition cost of 53.15 a drug shall be estimated by the commissioner, at average 53.16 wholesale price minusnine14 percent, except that where a drug 53.17 has had its wholesale price reduced as a result of the actions 53.18 of the National Association of Medicaid Fraud Control Units, the 53.19 estimated actual acquisition cost shall be the reduced average 53.20 wholesale price, without thenine14 percent deduction. The 53.21 maximum allowable cost of a multisource drug may be set by the 53.22 commissioner and it shall be comparable to, but no higher than, 53.23 the maximum amount paid by other third-party payors in this 53.24 state who have maximum allowable cost programs.The53.25commissioner shall set maximum allowable costs for multisource53.26drugs that are not on the federal upper limit list as described53.27in United States Code, title 42, chapter 7, section 1396r-8(e),53.28the Social Security Act, and Code of Federal Regulations, title53.2942, part 447, section 447.332. Establishment of the amount of53.30payment for drugs shall not be subject to the requirements of53.31the Administrative Procedure Act.An additional dispensing fee 53.32 of $.30 may be added to the dispensing fee paid to pharmacists 53.33 for legend drug prescriptions dispensed to residents of 53.34 long-term care facilities when a unit dose blister card system, 53.35 approved by the department, is used. Under this type of 53.36 dispensing system, the pharmacist must dispense a 30-day supply 54.1 of drug. The National Drug Code (NDC) from the drug container 54.2 used to fill the blister card must be identified on the claim to 54.3 the department. The unit dose blister card containing the drug 54.4 must meet the packaging standards set forth in Minnesota Rules, 54.5 part 6800.2700, that govern the return of unused drugs to the 54.6 pharmacy for reuse. The pharmacy provider will be required to 54.7 credit the department for the actual acquisition cost of all 54.8 unused drugs that are eligible for reuse. Over-the-counter 54.9 medications must be dispensed in the manufacturer's unopened 54.10 package. The commissioner may permit the drug clozapine to be 54.11 dispensed in a quantity that is less than a 30-day supply. 54.12 Whenever a generically equivalent product is available, payment 54.13 shall be on the basis of the actual acquisition cost of the 54.14 generic drug, unless the prescriber specifically indicates 54.15 "dispense as written - brand necessary" on the prescription as 54.16 required by section 151.21, subdivision 2. 54.17 (d)For purposes of this subdivision, "multisource drugs"54.18means covered outpatient drugs, excluding innovator multisource54.19drugs for which there are two or more drug products, which:54.20(1) are related as therapeutically equivalent under the54.21Food and Drug Administration's most recent publication of54.22"Approved Drug Products with Therapeutic Equivalence54.23Evaluations";54.24(2) are pharmaceutically equivalent and bioequivalent as54.25determined by the Food and Drug Administration; and54.26(3) are sold or marketed in Minnesota.54.27"Innovator multisource drug" means a multisource drug that was54.28originally marketed under an original new drug application54.29approved by the Food and Drug Administration.The formulary 54.30 committee shall review and recommend drugs which require prior 54.31 authorization. The formulary committee may recommend drugs for 54.32 prior authorization directly to the commissioner, as long as 54.33 opportunity for public input is provided. Prior authorization 54.34 may be requested by the commissioner based on medical and 54.35 clinical criteria and on cost before certain drugs are eligible 54.36 for payment. Before a drug may be considered for prior 55.1 authorization at the request of the commissioner: 55.2 (1) the drug formulary committee must develop criteria to 55.3 be used for identifying drugs; the development of these criteria 55.4 is not subject to the requirements of chapter 14, but the 55.5 formulary committee shall provide opportunity for public input 55.6 in developing criteria; 55.7 (2) the drug formulary committee must hold a public forum 55.8 and receive public comment for an additional 15 days; and 55.9 (3) the commissioner must provide information to the 55.10 formulary committee on the impact that placing the drug on prior 55.11 authorization will have on the quality of patient care and on 55.12 program costs, and information regarding whether the drug is 55.13 subject to clinical abuse or misuse. Prior authorization may be 55.14 required by the commissioner before certain formulary drugs are 55.15 eligible for payment. 55.16 (e) The basis for determining the amount of payment for 55.17 drugs administered in an outpatient setting shall be the lower 55.18 of the usual and customary cost submitted by the provider; the 55.19 average wholesale price minus five percent; or the maximum 55.20 allowable cost set by the federal government under United States 55.21 Code, title 42, chapter 7, section 1396r-8(e), and Code of 55.22 Federal Regulations, title 42, section 447.332, or by the 55.23 commissioner under paragraph (c). 55.24 Sec. 14. Minnesota Statutes 2000, section 256B.32, is 55.25 amended to read: 55.26 256B.32 [FACILITY FEE FOR OUTPATIENT HOSPITAL EMERGENCY 55.27 ROOM AND CLINIC VISITS.] 55.28 (a) The commissioner shall establish a facility fee payment 55.29 mechanism that will pay a facility fee to all enrolled 55.30 outpatient hospitals for each emergency room or outpatient 55.31 clinic visit provided on or after July 1, 1989. This payment 55.32 mechanism may not result in an overall increase in outpatient 55.33 payment rates. This section does not apply to federally 55.34 mandated maximum payment limits, department approved program 55.35 packages, or services billed using a nonoutpatient hospital 55.36 provider number. 56.1 (b) For fee-for-service services provided on or after July 56.2 1, 2002, the total payment, before third party liability and 56.3 spenddown, made to hospitals for outpatient hospital facility 56.4 services is reduced by one percent from the current statutory 56.5 rates. 56.6 Sec. 15. Minnesota Statutes 2001 Supplement, section 56.7 256B.69, subdivision 4, is amended to read: 56.8 Subd. 4. [LIMITATION OF CHOICE.] (a) The commissioner 56.9 shall develop criteria to determine when limitation of choice 56.10 may be implemented in the experimental counties. The criteria 56.11 shall ensure that all eligible individuals in the county have 56.12 continuing access to the full range of medical assistance 56.13 services as specified in subdivision 6. 56.14 (b) The commissioner shall exempt the following persons 56.15 from participation in the project, in addition to those who do 56.16 not meet the criteria for limitation of choice: 56.17 (1) persons eligible for medical assistance according to 56.18 section 256B.055, subdivision 1; 56.19 (2) persons eligible for medical assistance due to 56.20 blindness or disability as determined by the social security 56.21 administration or the state medical review team, unless: 56.22 (i) they are 65 years of age or older; or 56.23 (ii) they reside in Itasca county or they reside in a 56.24 county in which the commissioner conducts a pilot project under 56.25 a waiver granted pursuant to section 1115 of the Social Security 56.26 Act; 56.27 (3) recipients who currently have private coverage through 56.28 a health maintenance organization; 56.29 (4) recipients who are eligible for medical assistance by 56.30 spending down excess income for medical expenses other than the 56.31 nursing facility per diem expense; 56.32 (5) recipients who receive benefits under the Refugee 56.33 Assistance Program, established under United States Code, title 56.34 8, section 1522(e); 56.35 (6) children who are both determined to be severely 56.36 emotionally disturbed and receiving case management services 57.1 according to section 256B.0625, subdivision 20; and 57.2 (7) adults who are both determined to be seriously and 57.3 persistently mentally ill and received case management services 57.4 according to section 256B.0625, subdivision 20; and57.5(8) persons eligible for medical assistance according to57.6section 256B.057, subdivision 10. 57.7 Children under age 21 who are in foster placement may enroll in 57.8 the project on an elective basis. Individuals excluded under 57.9 clauses (6) and (7) may choose to enroll on an elective basis. 57.10 (c) The commissioner may allow persons with a one-month 57.11 spenddown who are otherwise eligible to enroll to voluntarily 57.12 enroll or remain enrolled, if they elect to prepay their monthly 57.13 spenddown to the state. 57.14 (d) The commissioner may require those individuals to 57.15 enroll in the prepaid medical assistance program who otherwise 57.16 would have been excluded under paragraph (b), clauses 57.17 (1),and (3),and (8),and under Minnesota Rules, part 57.18 9500.1452, subpart 2, items H, K, and L. 57.19 (e) Before limitation of choice is implemented, eligible 57.20 individuals shall be notified and after notification, shall be 57.21 allowed to choose only among demonstration providers. The 57.22 commissioner may assign an individual with private coverage 57.23 through a health maintenance organization, to the same health 57.24 maintenance organization for medical assistance coverage, if the 57.25 health maintenance organization is under contract for medical 57.26 assistance in the individual's county of residence. After 57.27 initially choosing a provider, the recipient is allowed to 57.28 change that choice only at specified times as allowed by the 57.29 commissioner. If a demonstration provider ends participation in 57.30 the project for any reason, a recipient enrolled with that 57.31 provider must select a new provider but may change providers 57.32 without cause once more within the first 60 days after 57.33 enrollment with the second provider. 57.34 Sec. 16. Minnesota Statutes 2000, section 256B.69, 57.35 subdivision 5a, is amended to read: 57.36 Subd. 5a. [MANAGED CARE CONTRACTS.] (a) Managed care 58.1 contracts under this section and sections 256L.12 and 256D.03, 58.2 shall be entered into or renewed on a calendar year basis 58.3 beginning January 1, 1996. Managed care contracts which were in 58.4 effect on June 30, 1995, and set to renew on July 1, 1995, shall 58.5 be renewed for the period July 1, 1995 through December 31, 1995 58.6 at the same terms that were in effect on June 30, 1995. 58.7 (b) A prepaid health plan providing covered health services 58.8 for eligible persons pursuant to chapters 256B, 256D, and 256L, 58.9 is responsible for complying with the terms of its contract with 58.10 the commissioner. Requirements applicable to managed care 58.11 programs under chapters 256B, 256D, and 256L, established after 58.12 the effective date of a contract with the commissioner take 58.13 effect when the contract is next issued or renewed. 58.14 (c) Effective for services rendered on or after January 1, 58.15 2003, the commissioner shall withhold five percent of managed 58.16 care plan payments under this section for the prepaid medical 58.17 assistance and general assistance medical care programs pending 58.18 completion of performance targets. The withheld funds will be 58.19 returned no sooner than July of the following year if 58.20 performance targets in the contract are achieved. The 58.21 commissioner may exclude special demonstration projects under 58.22 subdivision 23. 58.23 Sec. 17. Minnesota Statutes 2001 Supplement, section 58.24 256B.69, subdivision 5b, is amended to read: 58.25 Subd. 5b. [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 58.26 prepaid medical assistance and general assistance medical care 58.27 program contract rates set by the commissioner under subdivision 58.28 5 and effective on or after January 1,19982003, capitation 58.29 rates for nonmetropolitan counties shall on a weighted average 58.30 be no less than8887 percent of the capitation rates for 58.31 metropolitan counties, excluding Hennepin county. The 58.32 commissioner shall make a pro rata adjustment in capitation 58.33 rates paid to counties other than nonmetropolitan counties in 58.34 order to make this provision budget neutral. 58.35 (b)For prepaid medical assistance program contract rates58.36set by the commissioner under subdivision 5 and effective on or59.1after January 1, 2001, capitation rates for nonmetropolitan59.2counties shall, on a weighted average, be no less than 8959.3percent of the capitation rates for metropolitan counties,59.4excluding Hennepin county.59.5(c)This subdivision shall not affect the nongeographically 59.6 based risk adjusted rates established under section 62Q.03, 59.7 subdivision 5a. 59.8 Sec. 18. Minnesota Statutes 2001 Supplement, section 59.9 256B.69, subdivision 5c, is amended to read: 59.10 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) The 59.11 commissioner of human services shall transfer each year to the 59.12 medical education and research fund established under section 59.13 62J.692, the following: 59.14 (1) an amount equal to the reduction in the prepaid medical 59.15 assistance and prepaid general assistance medical care payments 59.16 as specified in this clause. Until January 1, 2002, the county 59.17 medical assistance and general assistance medical care 59.18 capitation base rate prior to plan specific adjustments and 59.19 after the regional rate adjustments under section 256B.69, 59.20 subdivision 5b, is reduced 6.3 percent for Hennepin county, two 59.21 percent for the remaining metropolitan counties, and no 59.22 reduction for nonmetropolitan Minnesota counties; and after 59.23 January 1, 2002, the county medical assistance and general 59.24 assistance medical care capitation base rate prior to plan 59.25 specific adjustments is reduced 6.3 percent for Hennepin county, 59.26 two percent for the remaining metropolitan counties, and 1.6 59.27 percent for nonmetropolitan Minnesota counties. Nursing 59.28 facility and elderly waiver payments and demonstration project 59.29 payments operating under subdivision 23 are excluded from this 59.30 reduction. The amount calculated under this clause shall not be 59.31 adjusted for periods already paid due to subsequent changes to 59.32 the capitation payments;and59.33 (2) beginning July 1, 2001, $2,537,000 from the capitation 59.34 rates paid under this section plus any federal matching funds on 59.35 this amount; and 59.36 (3) beginning July 1, 2002, an additional $8,000,000 from 60.1 the capitation rates paid under this section. 60.2 (b) This subdivision shall be effective upon approval of a 60.3 federal waiver which allows federal financial participation in 60.4 the medical education and research fund. 60.5 Sec. 19. Minnesota Statutes 2000, section 256B.69, is 60.6 amended by adding a subdivision to read: 60.7 Subd. 5f. [CAPITATION RATES.] Beginning July 1, 2002, the 60.8 capitation rates paid under this section are increased by 60.9 $8,000,000 per year. 60.10 Sec. 20. Minnesota Statutes 2000, section 256B.69, is 60.11 amended by adding a subdivision to read: 60.12 Subd. 5g. [PAYMENT FOR COVERED SERVICES.] For services 60.13 rendered on or after January 1, 2003, the total payment made to 60.14 managed care plans for covered services is reduced by one 60.15 percent from their current statutory rates. This provision 60.16 excludes payments for nursing home services, home and 60.17 community-based waivers, and payments to demonstration projects 60.18 for people with disabilities. 60.19 Sec. 21. Minnesota Statutes 2001 Supplement, section 60.20 256B.75, is amended to read: 60.21 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 60.22 (a) For outpatient hospital facility fee payments for 60.23 services rendered on or after October 1, 1992, the commissioner 60.24 of human services shall pay the lower of (1) submitted charge, 60.25 or (2) 32 percent above the rate in effect on June 30, 1992, 60.26 except for those services for which there is a federal maximum 60.27 allowable payment. Effective for services rendered on or after 60.28 January 1, 2000, payment rates for nonsurgical outpatient 60.29 hospital facility fees and emergency room facility fees shall be 60.30 increased by eight percent over the rates in effect on December 60.31 31, 1999, except for those services for which there is a federal 60.32 maximum allowable payment. Services for which there is a 60.33 federal maximum allowable payment shall be paid at the lower of 60.34 (1) submitted charge, or (2) the federal maximum allowable 60.35 payment. Total aggregate payment for outpatient hospital 60.36 facility fee services shall not exceed the Medicare upper 61.1 limit. If it is determined that a provision of this section 61.2 conflicts with existing or future requirements of the United 61.3 States government with respect to federal financial 61.4 participation in medical assistance, the federal requirements 61.5 prevail. The commissioner may, in the aggregate, prospectively 61.6 reduce payment rates to avoid reduced federal financial 61.7 participation resulting from rates that are in excess of the 61.8 Medicare upper limitations. 61.9 (b) Notwithstanding paragraph (a), payment for outpatient, 61.10 emergency, and ambulatory surgery hospital facility fee services 61.11 for critical access hospitals designated under section 144.1483, 61.12 clause (11), shall be paid on a cost-based payment system that 61.13 is based on the cost-finding methods and allowable costs of the 61.14 Medicare program. 61.15 (c) Effective for services provided on or after July 1, 61.1620022003, rates that are based on the Medicare outpatient 61.17 prospective payment system shall be replaced by a budget neutral 61.18 prospective payment system that is derived using medical 61.19 assistance data. The commissioner shall provide a proposal to 61.20 the20022003 legislature to define and implement this provision. 61.21 (d) For fee-for-service services provided on or after July 61.22 1, 2002, the total payment, before third party liability and 61.23 spenddown, made to hospitals for outpatient hospital facility 61.24 services is reduced by one percent from the current statutory 61.25 rate. 61.26 Sec. 22. Minnesota Statutes 2000, section 256L.03, 61.27 subdivision 1, is amended to read: 61.28 Subdivision 1. [COVERED HEALTH SERVICES.] "Covered health 61.29 services" means the health services reimbursed under chapter 61.30 256B, with the exception of inpatient hospital services, special 61.31 education services, private duty nursing services,adult dental61.32care services other than preventive services,orthodontic 61.33 services, nonemergency medical transportation services, personal 61.34 care assistant and case management services, nursing home or 61.35 intermediate care facilities services, inpatient mental health 61.36 services, and chemical dependency services.Effective July 1,62.11998, adult dental care for nonpreventive services with the62.2exception of orthodontic services is available to persons who62.3qualify under section 256L.04, subdivisions 1 to 7, with family62.4gross income equal to or less than 175 percent of the federal62.5poverty guidelines.Dental care services are limited to 62.6 preventive services for adults who qualify under section 62.7 256L.04, subdivision 1, with family gross income greater than 62.8 175 percent of the federal poverty guidelines and equal to or 62.9 less than 275 percent of the federal poverty guidelines. Dental 62.10 care services are not covered health services for adults who 62.11 qualify under section 256L.04, subdivision 1, with family gross 62.12 income greater than 275 percent of the federal poverty 62.13 guidelines or who qualify under section 256L.04, subdivision 7. 62.14 Outpatient mental health services covered under the 62.15 MinnesotaCare program are limited to diagnostic assessments, 62.16 psychological testing, explanation of findings, medication 62.17 management by a physician, day treatment, partial 62.18 hospitalization, and individual, family, and group psychotherapy. 62.19 No public funds shall be used for coverage of abortion 62.20 under MinnesotaCare except where the life of the female would be 62.21 endangered or substantial and irreversible impairment of a major 62.22 bodily function would result if the fetus were carried to term; 62.23 or where the pregnancy is the result of rape or incest. 62.24 Covered health services shall be expanded as provided in 62.25 this section. 62.26 [EFFECTIVE DATE.] This section is effective January 1, 2003. 62.27 Sec. 23. Minnesota Statutes 2000, section 256L.07, 62.28 subdivision 1, is amended to read: 62.29 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 62.30 enrolled in the original children's health plan as of September 62.31 30, 1992, children who enrolled in the MinnesotaCare program 62.32 after September 30, 1992, pursuant to Laws 1992, chapter 549, 62.33 article 4, section 17, and children who have family gross 62.34 incomes that are equal to or less than150175 percent of the 62.35 federal poverty guidelines are eligible without meeting the 62.36 requirements of subdivision 2, as long as they maintain 63.1 continuous coverage in the MinnesotaCare program or medical 63.2 assistance. Children who apply for MinnesotaCare on or after 63.3 the implementation date of the employer-subsidized health 63.4 coverage program as described in Laws 1998, chapter 407, article 63.5 5, section 45, who have family gross incomes that are equal to 63.6 or less than150175 percent of the federal poverty guidelines, 63.7 must meet the requirements of subdivision 2 to be eligible for 63.8 MinnesotaCare. 63.9 (b) Families enrolled in MinnesotaCare under section 63.10 256L.04, subdivision 1, whose income increases above 275 percent 63.11 of the federal poverty guidelines, are no longer eligible for 63.12 the program and shall be disenrolled by the commissioner. 63.13 Individuals enrolled in MinnesotaCare under section 256L.04, 63.14 subdivision 7, whose income increases above 175 percent of the 63.15 federal poverty guidelines are no longer eligible for the 63.16 program and shall be disenrolled by the commissioner. For 63.17 persons disenrolled under this subdivision, MinnesotaCare 63.18 coverage terminates the last day of the calendar month following 63.19 the month in which the commissioner determines that the income 63.20 of a family or individual exceeds program income limits. 63.21 (c) Notwithstanding paragraph (b), individuals and families 63.22 may remain enrolled in MinnesotaCare if ten percent of their 63.23 annual income is less than the annual premium for a policy with 63.24 a $500 deductible available through the Minnesota comprehensive 63.25 health association. Individuals and families who are no longer 63.26 eligible for MinnesotaCare under this subdivision shall be given 63.27 an 18-month notice period from the date that ineligibility is 63.28 determined before disenrollment. 63.29 [EFFECTIVE DATE.] This section is effective July 1, 2003. 63.30 Sec. 24. Minnesota Statutes 2000, section 256L.07, 63.31 subdivision 3, is amended to read: 63.32 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 63.33 individuals enrolled in the MinnesotaCare program must have no 63.34 health coverage while enrolled or for at least four months prior 63.35 to application and renewal. Children enrolled in the original 63.36 children's health plan and children in families with income 64.1 equal to or less than150175 percent of the federal poverty 64.2 guidelines, who have other health insurance, are eligible if the 64.3 coverage: 64.4 (1) lacks two or more of the following: 64.5 (i) basic hospital insurance; 64.6 (ii) medical-surgical insurance; 64.7 (iii) prescription drug coverage; 64.8 (iv) dental coverage; or 64.9 (v) vision coverage; 64.10 (2) requires a deductible of $100 or more per person per 64.11 year; or 64.12 (3) lacks coverage because the child has exceeded the 64.13 maximum coverage for a particular diagnosis or the policy 64.14 excludes a particular diagnosis. 64.15 The commissioner may change this eligibility criterion for 64.16 sliding scale premiums in order to remain within the limits of 64.17 available appropriations. The requirement of no health coverage 64.18 does not apply to newborns. 64.19 (b) Medical assistance, general assistance medical care, 64.20 and civilian health and medical program of the uniformed 64.21 service, CHAMPUS, are not considered insurance or health 64.22 coverage for purposes of the four-month requirement described in 64.23 this subdivision. 64.24 (c) For purposes of this subdivision, Medicare Part A or B 64.25 coverage under title XVIII of the Social Security Act, United 64.26 States Code, title 42, sections 1395c to 1395w-4, is considered 64.27 health coverage. An applicant or enrollee may not refuse 64.28 Medicare coverage to establish eligibility for MinnesotaCare. 64.29 (d) Applicants who were recipients of medical assistance or 64.30 general assistance medical care within one month of application 64.31 must meet the provisions of this subdivision and subdivision 2. 64.32 [EFFECTIVE DATE.] This section is effective July 1, 2003. 64.33 Sec. 25. Minnesota Statutes 2000, section 256L.12, 64.34 subdivision 9, is amended to read: 64.35 Subd. 9. [RATE SETTING.] (a) Rates will be prospective, 64.36 per capita, where possible. The commissioner may allow health 65.1 plans to arrange for inpatient hospital services on a risk or 65.2 nonrisk basis. The commissioner shall consult with an 65.3 independent actuary to determine appropriate rates. 65.4 (b) For services rendered on or after January 1, 2003, the 65.5 commissioner shall withhold five percent of managed care plan 65.6 payments under this section pending completion of performance 65.7 targets. The withheld funds will be returned no sooner than 65.8 July of the following year if performance targets in the 65.9 contract are achieved. 65.10 (c) For services rendered on or after January 1, 2003, the 65.11 total payment made to managed care plans for covered services is 65.12 reduced by one percent from their current statutory rates. 65.13 Sec. 26. Minnesota Statutes 2001 Supplement, section 65.14 256L.15, subdivision 1, is amended to read: 65.15 Subdivision 1. [PREMIUM DETERMINATION.] (a) Families with 65.16 children and individuals shall pay a premium determined 65.17 according to a sliding fee based on a percentage of the family's 65.18 gross family income. 65.19 (b) Pregnant women and children under age two are exempt 65.20 from the provisions of section 256L.06, subdivision 3, paragraph 65.21 (b), clause (3), requiring disenrollment for failure to pay 65.22 premiums. For pregnant women, this exemption continues until 65.23 the first day of the month following the 60th day postpartum. 65.24 Women who remain enrolled during pregnancy or the postpartum 65.25 period, despite nonpayment of premiums, shall be disenrolled on 65.26 the first of the month following the 60th day postpartum for the 65.27 penalty period that otherwise applies under section 256L.06, 65.28 unless they begin paying premiums. 65.29(c) Effective July 1, 2002, through June 30, 2006, at their65.30option, children with gross family income at or below 21765.31percent of the federal poverty guidelines who are eligible for65.32MinnesotaCare in the first month following termination from65.33medical assistance shall not pay a premium for 12 months.65.34 [EFFECTIVE DATE.] This section is effective July 1, 2002. 65.35 Sec. 27. Minnesota Statutes 2000, section 256L.15, 65.36 subdivision 3, is amended to read: 66.1 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 66.2 of $48 is required for all children in families with income at 66.3 or less than150175 percent of federal poverty guidelines. 66.4 [EFFECTIVE DATE.] This section is effective July 1, 2003. 66.5 ARTICLE 4 66.6 MISCELLANEOUS 66.7 Section 1. Minnesota Statutes 2000, section 246.54, is 66.8 amended to read: 66.9 246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 66.10 Except for chemical dependency services provided under 66.11 sections 254B.01 to 254B.09, the client's county shall pay to 66.12 the state of Minnesota a portion of the cost of care provided in 66.13 a regional treatment center to a client legally settled in that 66.14 county. Effective January 1, 2003, a county's payment shall be 66.15 made from the county's own sources of revenue and payments shall 66.16 be paid as follows: payments to the state from the county shall 66.17 equalten20 percent of the cost of care, as determined by the 66.18 commissioner, for each day, or the portion thereof, that the 66.19 client spends at a regional treatment center. If payments 66.20 received by the state under sections 246.50 to 246.53 exceed9066.21 80 percent of the cost of care, the county shall be responsible 66.22 for paying the state only the remaining amount. The county 66.23 shall not be entitled to reimbursement from the client, the 66.24 client's estate, or from the client's relatives, except as 66.25 provided in section 246.53. No such payments shall be made for 66.26 any client who was last committed prior to July 1, 1947. 66.27 Sec. 2. Minnesota Statutes 2000, section 251.013, 66.28 subdivision 1, is amended to read: 66.29 Subdivision 1. [INTENT.] It is the intent of the 66.30 legislature that the commissioner of human services consolidate 66.31 the nursing home services from the Ah-Gwah-Ching facility to the 66.32 Brainerd regional human services center effective July 1, 2002. 66.33 The Ah-Gwah-Chingcenterprogram shall continue operationin66.34Walker, Minnesota,as a provider of nursing care to geriatric 66.35 and other residents whose aggressive or difficult to manage 66.36 behavioral needs cannot be met in their home community. 67.1 Sec. 3. Minnesota Statutes 2000, section 254A.17, 67.2 subdivision 1, is amended to read: 67.3 Subdivision 1. [MATERNAL AND CHILD SERVICE PROGRAMS.] (a) 67.4 The commissioner shall fund maternal and child health and social 67.5 service programs designed to improve the health and functioning 67.6 of children born to mothers using alcohol and controlled 67.7 substances. Comprehensive programs shall include immediate and 67.8 ongoing intervention, treatment, and coordination of medical, 67.9 educational, and social services through a child's preschool 67.10 years. Programs shall also include research and evaluation to 67.11 identify methods most effective in improving outcomes among this 67.12 high-risk population. The commissioner shall ensure that the 67.13 programs are available on a statewide basis to the extent 67.14 possiblewithwithin limits of available funds. 67.15 (b) The commissioner of human services shall develop models 67.16 for the treatment of children ages 6 to 12 who are in need of 67.17 chemical dependency treatment. The commissioner shall fund at 67.18 least two pilot projects with qualified providers to provide 67.19 nonresidential treatment for children in this age group. Model 67.20 programs must include a component to monitor and evaluate 67.21 treatment outcomes. 67.22 Sec. 4. Minnesota Statutes 2001 Supplement, section 67.23 256B.431, subdivision 33, is amended to read: 67.24 Subd. 33. [STAGED REDUCTION IN RATE DISPARITIES.] (a) For 67.25 the rateyearsyear beginning July 1, 2001,and July 1, 2002,67.26 the commissioner shall adjust the operating payment rates for 67.27 low-rate nursing facilities reimbursed under this section or 67.28 section 256B.434. 67.29 (b) For the rate year beginning July 1, 2001, for each case 67.30 mix level, if the amount computed under subdivision3231 is 67.31 less than the amount inclause (1)the table in this paragraph, 67.32 the commissioner shall make available the lesser of the amount 67.33 inclause (1)the table in this paragraph or an increase of ten 67.34 percent over the rate in effect on June 30, 2001, as an 67.35 adjustment to the operating payment rate.For the rate year67.36beginning July 1, 2002, for each case mix level, if the amount68.1computed under subdivision 32 is less than the amount in clause68.2(2), the commissioner shall make available the lesser of the68.3amount in clause (2) or an increase of ten percent over the rate68.4in effect on June 30, 2002, as an adjustment to the operating68.5payment rate.For purposes of this subdivision, nursing 68.6 facilities shall be considered to be metro if they are located 68.7 in Anoka, Carver, Dakota, Hennepin, Olmsted, Ramsey, Scott, or 68.8 Washington counties; or in the cities of Moorhead or 68.9 Breckenridge; or in St. Louis county, north of Toivola and south 68.10 of Cook; or in Itasca county, east of a north south line two 68.11 miles west of Grand Rapids: 68.12(1)Operating Payment Rate Target Level for July 1, 2001: 68.13 Case Mix Classification Metro Nonmetro 68.14 A $ 76.00 $ 68.13 68.15 B $ 83.40 $ 74.46 68.16 C $ 91.67 $ 81.63 68.17 D $ 99.51 $ 88.04 68.18 E $107.46 $ 94.87 68.19 F $107.96 $ 95.29 68.20 G $114.67 $100.98 68.21 H $126.99 $111.31 68.22 I $131.42 $115.06 68.23 J $138.34 $120.85 68.24 K $152.26 $133.10 68.25(2) Operating Payment Rate Target Level for July 1, 2002:68.26Case Mix ClassificationMetroNonmetro68.27A$78.28$70.5168.28B$85.91$77.1668.29C$94.42$84.6268.30D$102.50$91.4268.31E$110.68$98.4068.32F$111.20$98.8468.33G$118.11$104.7768.34H$130.80$115.6468.35I$135.38$119.5068.36J$142.49$125.3869.1K$156.85$137.7769.2 Sec. 5. Minnesota Statutes 2001 Supplement, section 69.3 256B.437, subdivision 2, is amended to read: 69.4 Subd. 2. [PLANNING AND DEVELOPMENT OF COMMUNITY-BASED 69.5 SERVICES.] (a) The commissioner of human services shall 69.6 establish a process to adjust the capacity and distribution of 69.7 long-term care services to equalize the supply and demand for 69.8 different types of services. This process must include 69.9 community planning, expansion or establishment of needed 69.10 services, and analysis of voluntary nursing facility closures. 69.11 (b) The purpose of this process is to support the planning 69.12 and development of community-based services. This process must 69.13 support early intervention, advocacy, and consumer protection 69.14 while providing resources and incentives for expanded county 69.15 planning and for nursing facilities to transition to meet 69.16 community needs. 69.17 (c) The process shall support and facilitate expansion of 69.18 community-based services under the county-administered 69.19 alternative care program under section 256B.0913 and waivers for 69.20 elderly under section 256B.0915, including, but not limited to, 69.21 the development of supportive services such as housing and 69.22 transportation. The process shall utilize community assessments 69.23 and planning developed for the community health services plan 69.24 and plan update and for the community social services act plan, 69.25 and other relevant information. 69.26 (d) The commissioners of health and human services, as 69.27 appropriate, shall provide, by July 15, 2001, available data 69.28 necessary for the county, including, but not limited to, data on 69.29 nursing facility bed distribution, housing with services 69.30 options, the closure of nursing facilities that occur outside of 69.31 the planned closure process, and approval of planned closures in 69.32 the county and contiguous counties. 69.33 (e) Each county shall submit to the commissioner of human 69.34 services, by October 15, 2001, a gaps analysis that identifies 69.35 local service needs, pending development of services, and any 69.36 other issues that would contribute to or impede further 70.1 development of community-based services. The gaps analysis must 70.2 also be sent to the local area agency on aging and, if 70.3 applicable, local SAIL projects, for review and comment. The 70.4 review and comment must assess needs across county boundaries. 70.5 The area agencies on aging and SAIL projects must provide the 70.6 commissioner and the counties with their review and analyses by 70.7 November 15, 2001. 70.8 (f) The addendum to the biennial plan shall be submitted 70.9annuallybiennially, beginning December 31, 2001, andeach70.10December 31every other year thereafter in accordance with the 70.11 Community Social Services Act plan timeline, and shall include 70.12 recommendations for development of community-based 70.13 services. Area agencies on aging and SAIL projects must provide 70.14 the commissioner and the counties with their review and analyses 70.15 within 60 days following the Community Social Services Act plan 70.16 submission date. Both planning and implementation shall be 70.17 implemented within the amount of funding made available to the 70.18 county board for these purposes. 70.19 (g) The plan, within the funding allocated, shall: 70.20 (1) include the gaps analysis required by paragraph (e); 70.21 (2) involve providers, consumers, cities, townships, 70.22 businesses, and area agencies on aging in the planning process; 70.23 (3) address the availability of alternative care and 70.24 elderly waiver services for eligible recipients; 70.25 (4) address the development of other supportive services, 70.26 such as transit, housing, and workforce and economic 70.27 development; and 70.28 (5) estimate the cost and timelines for development. 70.29 (h) The biennial plan addendum shall be coordinated with 70.30 the county mental health plan for inclusion in the community 70.31 health services plan and included as an addendum to the 70.32 community social services plan. 70.33 (i) The county board having financial responsibility for 70.34 persons present in another county shall cooperate with that 70.35 county for planning and development of services. 70.36 (j) The county board shall cooperate in planning and 71.1 development of community-based services with other counties, as 71.2 necessary, and coordinate planning for long-term care services 71.3 that involve more than one county, within the funding allocated 71.4 for these purposes. 71.5 (k) The commissioners of health and human services, in 71.6 cooperation with county boards, shall report biennially to the 71.7 legislatureby February 1 of each year, beginning February 1, 71.8 2002, regarding the development of community-based services, 71.9 transition or closure of nursing facilities, and specific gaps 71.10 in services in identified geographic areas that may require 71.11 additional resources or flexibility, as documented by the 71.12 process in this subdivisionand reported to the commissioners by71.13December 31 of each year. 71.14 Sec. 6. Minnesota Statutes 2001 Supplement, section 71.15 256B.439, subdivision 1, is amended to read: 71.16 Subdivision 1. [DEVELOPMENT AND IMPLEMENTATION OF QUALITY 71.17 PROFILES.] (a) The commissioner of human services, in 71.18 cooperation with the commissioner of health, shall develop and 71.19 implement a quality profile system for nursing facilities and, 71.20 beginning not later than July 1,20032004, other providers of 71.21 long-term care services, except when the quality profile system 71.22 would duplicate requirements under section 256B.5011, 256B.5012, 71.23 or 256B.5013. The system must be developed and implemented to 71.24 the extent possible without the collection of significant 71.25 amounts of new data. To the extent possible, the system must 71.26 incorporate or be coordinated with information on quality 71.27 maintained by area agencies on aging, long-term care trade 71.28 associations, and other entities. The system must be designed 71.29 to provide information on quality to: 71.30 (1) consumers and their families to facilitate informed 71.31 choices of service providers; 71.32 (2) providers to enable them to measure the results of 71.33 their quality improvement efforts and compare quality 71.34 achievements with other service providers; and 71.35 (3) public and private purchasers of long-term care 71.36 services to enable them to purchase high-quality care. 72.1 (b) The system must be developed in consultation with the 72.2 long-term care task force, area agencies on aging, and 72.3 representatives of consumers, providers, and labor unions. 72.4 Within the limits of available appropriations, the commissioners 72.5 may employ consultants to assist with this project. 72.6 Sec. 7. Minnesota Statutes 2001 Supplement, section 72.7 256B.439, subdivision 4, is amended to read: 72.8 Subd. 4. [DISSEMINATION OF QUALITY PROFILES.] By July 72.9 1,20022003, the commissioners shall implement a system to 72.10 disseminate the quality profiles developed from consumer surveys 72.11 using the quality measurement tool. Profiles may be 72.12 disseminated to the Senior LinkAge line and to consumers, 72.13 providers, and purchasers of long-term care services through all 72.14 feasible printed and electronic outlets. The commissioners may 72.15 conduct a public awareness campaign to inform potential users 72.16 regarding profile contents and potential uses. 72.17 Sec. 8. Minnesota Statutes 2000, section 256D.051, 72.18 subdivision 1, is amended to read: 72.19 Subdivision 1. [FOOD STAMP EMPLOYMENT AND TRAINING 72.20 PROGRAM.] The commissioner shall implement a food stamp 72.21 employment and training program in order to meet the food stamp 72.22 employment and training participation requirements of the United 72.23 States Department of Agriculture. The commissioner shall 72.24 determine, based on the resources available, whether the program 72.25 shall be operated statewide or only in selected counties. 72.26 Unless exempt under subdivision 3a, each adult recipient in the 72.27 unit must participate in the food stamp employment and training 72.28 program each month that the person is eligible for food stamps. 72.29 The person's participation in food stamp employment and training 72.30 services must begin no later than the first day of the calendar 72.31 month following the determination of eligibility for food 72.32 stamps. With the county agency's consent, and to the extent of 72.33 available resources, the person may voluntarily continue to 72.34 participate in food stamp employment and training services for 72.35 up to three additional consecutive months immediately following 72.36 termination of food stamp benefits in order to complete the 73.1 provisions of the person's employability development plan. 73.2 Sec. 9. Minnesota Statutes 2000, section 256D.051, 73.3 subdivision 6c, is amended to read: 73.4 Subd. 6c. [PROGRAM FUNDING.] Within the limits of 73.5 available resources, the commissioner shall reimburse the actual 73.6 costs of county agencies and their employment and training 73.7 service providers for the provision of food stamp employment and 73.8 training services, including participant support services, 73.9 direct program services, and program administrative activities. 73.10The cost of services for each county's food stamp employment and73.11training program shall not exceed an average of $400 per73.12participant.No more than 15 percent of program funds may be 73.13 used for administrative activities. The county agency may 73.14 expend county funds in excess of the limits of this subdivision 73.15 without state reimbursement. 73.16 Program funds shall be allocated based on the county's 73.17 average number of food stamp cases as compared to thestatewide73.18 total number of such cases in counties where food stamp 73.19 employment and training services are provided. The average 73.20 number of cases shall be based on counts of cases as of March 73.21 31, June 30, September 30, and December 31 of the previous 73.22 calendar year. The commissioner may reallocate unexpended money 73.23 appropriated under this section to those county agencies that 73.24 demonstrate a need for additional funds. 73.25 Sec. 10. Minnesota Statutes 2001 Supplement, section 73.26 256I.05, subdivision 1d, is amended to read: 73.27 Subd. 1d. [SUPPLEMENTARY SERVICE RATES FOR CERTAIN 73.28 FACILITIES SERVING PERSONS WITH MENTAL ILLNESS OR CHEMICAL 73.29 DEPENDENCY.] Notwithstanding the provisions of subdivisions 1a 73.30 and 1c, a county agency may negotiate a supplementary service 73.31 rate in addition to the board and lodging rate for facilities 73.32 licensed and registered by the Minnesota department of health 73.33 under section 157.17 prior to December 31, 1996, if the facility 73.34 meets the following criteria: 73.35 (1) at least 75 percent of the residents have a primary 73.36 diagnosis of mental illness, chemical dependency, or both, and 74.1 have related special needs; 74.2 (2) the facility provides 24-hour, on-site, year-round 74.3 supportive services by qualified staff capable of intervention 74.4 in a crisis of persons with late-state inebriety or mental 74.5 illness who are vulnerable to abuse or neglect; 74.6 (3) the services at the facility include, but are not 74.7 limited to: 74.8 (i) secure central storage of medication; 74.9 (ii) reminders and monitoring of medication for 74.10 self-administration; 74.11 (iii) support for developing an individual medical and 74.12 social service plan, updating the plan, and monitoring 74.13 compliance with the plan; and 74.14 (iv) assistance with setting up meetings, appointments, and 74.15 transportation to access medical, chemical health, and mental 74.16 health service providers; 74.17 (4) each resident has a documented need for at least one of 74.18 the services provided; 74.19 (5) each resident has been offered an opportunity to apply 74.20 for admission to a licensed residential treatment program for 74.21 mental illness, chemical dependency, or both, have refused that 74.22 offer, and the offer and their refusal has been documented to 74.23 writing; and 74.24 (6) the residents are not eligible for home and 74.25 community-based services waivers because of their unique need 74.26 for community support. 74.27Until June 30, 2002, the supplementary service rate of74.28qualifying facilities under this subdivision may be increased by74.29up to 15 percent of the supplementary service rate in effect on74.30January 1, 2001, for the facility. Qualifying facilities with74.31no supplementary service rate may negotiate a supplementary74.32service rate not to exceed $300 per month.The total 74.33 supplementary service rate must not exceed $575 per month, plus 74.34 any legislatively authorized cost of living adjustments. 74.35 Sec. 11. Minnesota Statutes 2001 Supplement, section 74.36 256I.05, subdivision 1e, is amended to read: 75.1 Subd. 1e. [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.] 75.2 Notwithstanding the provisions of subdivisions 1a and 1c, 75.3 beginning July 1,20012002, a county agency shall negotiate a 75.4 supplementary rate in addition to the rate specified in 75.5 subdivision 1, equal to4625 percent of the amount specified in 75.6 subdivision 1a, including any legislatively authorized75.7inflationary adjustments,for a group residential housing 75.8 provider that: 75.9 (1) is located in Hennepin county and has had a group 75.10 residential housing contract with the county since June 1996; 75.11 (2) operates in three separate locations a 71-bed facility, 75.12 and two 40-bed facilities; and 75.13 (3) serves a chemically dependent clientele, providing 24 75.14 hours per day supervision and limiting a resident's maximum 75.15 length of stay to 13 months out of a consecutive 24-month period. 75.16 Sec. 12. Minnesota Statutes 2000, section 256J.02, 75.17 subdivision 2, is amended to read: 75.18 Subd. 2. [USE OF MONEY.] State money appropriated for 75.19 purposes of this section and TANF block grant money must be used 75.20 for: 75.21 (1) financial assistance to or on behalf of any minor child 75.22 who is a resident of this state under section 256J.12; 75.23 (2) employment and training services under this chapter or 75.24 chapter 256K; 75.25 (3) emergency financial assistance and services under 75.26 section 256J.48; 75.27 (4) diversionary assistance under section 256J.47; 75.28 (5) the health care and human services training and 75.29 retention program under chapter 116L, for costs associated with 75.30 families with children with incomes below 200 percent of the 75.31 federal poverty guidelines; 75.32 (6) the pathways program under section 116L.04, subdivision 75.33 1a; 75.34 (7) welfare-to-work extended employment services for MFIP 75.35 participants with severe impairment to employment as defined in 75.36 section 268A.15, subdivision 1a; 76.1 (8) the family homeless prevention and assistance program 76.2 under section 462A.204; 76.3 (9) the rent assistance for family stabilization 76.4 demonstration project under section 462A.205; 76.5 (10) welfare to work transportation authorized under Public 76.6 Law Number 105-178; 76.7 (11) reimbursements for the federal share of child support 76.8 collections passed through to the custodial parent; 76.9 (12) reimbursements for the working family credit under 76.10 section 290.0671; 76.11 (13) intensive ESL grants under Laws 2000, chapter 489, 76.12 article 1; 76.13 (14) transitional housing programs under section 119A.43; 76.14 (15) emergency services under Laws 1997, chapter 162, 76.15 article 3; 76.16 (16) home visiting programs under section 145A.16; 76.17 (17) MN ENABL program under section 145.9255; 76.18 (18) local public health promotion program under section 76.19 144.396; 76.20 (19) eliminating health disparities program under section 76.21 145.928; 76.22 (20) displaced homemaker program under section 268.96; 76.23 (21) welfare to work grants under Laws 2001, First Special 76.24 Session chapter 9, article 17; 76.25 (22) opportunities industrialization centers and Lifetrack 76.26 resources projects under Laws 2001, First Special Session 76.27 chapter 4, article 1; 76.28 (23) job gap pilot projects under Laws 2001, First Special 76.29 Session chapter 4, article 2; 76.30 (24) programs and pilot projects under chapter 256K; and 76.31(16)(25) program administration under this chapter. 76.32 Sec. 13. Minnesota Statutes 2000, section 256J.02, 76.33 subdivision 3, is amended to read: 76.34 Subd. 3. [CARRY FORWARD OF FEDERAL MONEY.] Temporary 76.35 assistance for needy families block grant money must be 76.36 appropriated for the purposes in this sectionand is available77.1until expended. 77.2 Sec. 14. Minnesota Statutes 2000, section 256J.02, is 77.3 amended by adding a subdivision to read: 77.4 Subd. 6. [ADMINISTRATIVE REIMBURSEMENT.] Unspent TANF 77.5 funds appropriated to the programs listed in subdivision 2 may 77.6 be used to match state expenditures for MAXIS program 77.7 administration to the extent that TANF funds appropriated to 77.8 MAXIS are insufficient to maintain a 50 percent share of 77.9 TANF-eligible expenditures. 77.10 Sec. 15. Minnesota Statutes 2001 Supplement, section 77.11 256J.52, subdivision 2, is amended to read: 77.12 Subd. 2. [INITIAL ASSESSMENT.] (a) The job counselor must, 77.13 with the cooperation of the participant, assess the 77.14 participant's ability to obtain and retain employment. This 77.15 initial assessment must include a review of the participant's 77.16 education level, prior employment or work experience, 77.17 transferable work skills, and existing job markets. 77.18 (b) In assessing the participant, the job counselor must 77.19 determine if the participant needs refresher courses for 77.20 professional certification or licensure, in which case, the job 77.21 search plan under subdivision 3 must include the courses 77.22 necessary to obtain the certification or licensure, in addition 77.23 to other work activities, provided the combination of the 77.24 courses and other work activities are at least for 40 hours per 77.25 week. 77.26 (c) If a participant can demonstrate to the satisfaction of 77.27 the county agency that lack of proficiency in English is a 77.28 barrier to obtaining suitable employment, the job counselor must 77.29 include participation in an intensive English as a second 77.30 language program if available or otherwise a regular English as 77.31 a second language program in the individual's employment plan 77.32 under subdivision 5. Lack of proficiency in English is not 77.33 necessarily a barrier to employment. 77.34 (d) The job counselor may approve an education or training 77.35 plan, and postpone the job search requirement, if the 77.36 participant has a proposal for an education program which: 78.1 (1) can be completed within2412 months; and 78.2 (2) meets the criteria of section 256J.53, subdivisions 1, 78.3 2, 3, and 5. 78.4 (e) A participant who, at the time of the initial 78.5 assessment, presents a plan that includes farming as a 78.6 self-employed work activity must have an employment plan 78.7 developed under subdivision 5 that includes the farming as an 78.8 approved work activity. 78.9 Sec. 16. Minnesota Statutes 2001 Supplement, section 78.10 256J.53, subdivision 1, is amended to read: 78.11 Subdivision 1. [LENGTH OF PROGRAM.] In order for a 78.12 post-secondary education or training program to be approved work 78.13 activity as defined in section 256J.49, subdivision 13, clause 78.14 (18), it must be a program lasting2412 months or less, and the 78.15 participant must meet the requirements of subdivisions 2 and 3. 78.16 A program lasting up to 24 months may be approved on an 78.17 exception basis if the conditions specified in subdivisions 2 to 78.18 4 are met. A participant may not be approved for more than a 78.19 total of 24 months of post-secondary education or training. 78.20 Participants who have an approved education plan in place as of 78.21 July 1, 2002, that allows 24 months of post-secondary education 78.22 or training shall be allowed to complete that plan provided that 78.23 the conditions specified in subdivisions 2 and 3 continue to be 78.24 met. 78.25 Sec. 17. Minnesota Statutes 2000, section 257.81, is 78.26 amended to read: 78.27 257.81 [TRAINING FOR INTERVIEWERS OF MALTREATED CHILDREN; 78.28 COMMISSIONER OF HUMAN SERVICES DUTIES.] 78.29 Within the limits of available funds, the commissioner of 78.30 human services shall develop training programs designed to 78.31 provide specialized interviewer training to persons who 78.32 interview allegedly maltreated children. The training must 78.33 include information on interviewing adolescents and address the 78.34 best methods of so doing. All training shall be presented 78.35 within a child development model framework and include 78.36 information on working with children of color and children with 79.1 special needs. To accomplish this objective, the commissioner 79.2 shall: 79.3 (1) establish criteria for adequately trained interviewers; 79.4 (2) determine the number of trained interviewers and 79.5 evaluate the extent of the need for interviewer training; 79.6 (3) offer forums and tuition to county professionals for 79.7 specialized interviewer training where the need exists; and 79.8 (4) encourage counties to assess local needs and assist 79.9 counties in making interviewer training available to meet those 79.10 needs. 79.11 Sec. 18. Laws 2001, First Special Session chapter 9, 79.12 article 5, section 35, is amended to read: 79.13 Sec. 35. [DEVELOPMENT OF NEW NURSING FACILITY 79.14 REIMBURSEMENT SYSTEM.] 79.15 (a) The commissioner of human services shall develop and 79.16 report to the legislature by January 15,20032004, a system to 79.17 replace the current nursing facility reimbursement system 79.18 established under Minnesota Statutes, sections 256B.431, 79.19 256B.434, and 256B.435. 79.20 (b) The system must be developed in consultation with the 79.21 long-term care task force and with representatives of consumers, 79.22 providers, and labor unions. Within the limits of available 79.23 appropriations, the commissioner may employ consultants to 79.24 assist with this project. 79.25 (c) The new reimbursement system must: 79.26 (1) provide incentives to enhance quality of life and 79.27 quality of care; 79.28 (2) recognize cost differences in the care of different 79.29 types of populations, including subacute care and dementia care; 79.30 (3) establish rates that are sufficient without being 79.31 excessive; 79.32 (4) be affordable for the state and for private-pay 79.33 residents; 79.34 (5) be sensitive to changing conditions in the long-term 79.35 care environment; 79.36 (6) avoid creating access problems related to insufficient 80.1 funding; 80.2 (7) allow providers maximum flexibility in their business 80.3 operations; 80.4 (8) recognize the need for capital investment to improve 80.5 physical plants; and 80.6 (9) provide incentives for the development and use of 80.7 private rooms. 80.8 (d) Notwithstanding Minnesota Statutes, section 256B.435, 80.9 the commissioner must not implement a performance-based 80.10 contracting system for nursing facilities prior to July 1,200380.11 2004. The commissioner shall continue to reimburse nursing 80.12 facilities under Minnesota Statutes, section 256B.431 or 80.13 256B.434, until otherwise directed by law. 80.14 (e) The commissioner of human services, in consultation 80.15 with the commissioner of health, shall conduct or contract for a 80.16 time study to determine staff time being spent on various case 80.17 mix categories; recommend adjustments to the case mix weights 80.18 based on the time study data; and determine whether current 80.19 staffing standards are adequate for providing quality care based 80.20 on professional best practice and consumer experience. If the 80.21 commissioner determines the current standards are inadequate, 80.22 the commissioner shall determine an appropriate staffing 80.23 standard for the various case mix categories and the financial 80.24 implications of phasing into this standard over the next four 80.25 years. 80.26 Sec. 19. [REPEALER.] 80.27 (a) Minnesota Statutes 2000, sections 254A.17, subdivision 80.28 2; 256B.0916, subdivisions 1 and 6; 256E.06, subdivision 2b; 80.29 256K.01, subdivisions 1, 2, 3, 4, 5, 6, and 7; 256K.015; 80.30 256K.02; 256K.03, subdivisions 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 80.31 and 12; 256K.04; 256K.05; 256K.06; 256K.08; 256K.09; 626.562; 80.32 and Minnesota Statutes 2001 Supplement, sections 256B.0625, 80.33 subdivision 5a; 256K.03, subdivision 1; and 256K.07, are 80.34 repealed. 80.35 (b) Minnesota Statutes 2000, sections 256.973; 256.9731, 80.36 subdivisions 1, 3, 4, 5, 6, 7, 8, 9, and 10; and Minnesota 81.1 Statutes 2001 Supplement, sections 256I.05, subdivision 1f; and 81.2 256I.07, are repealed June 30, 2002. 81.3 (c) Minnesota Statutes 2001 Supplement, sections 256.955, 81.4 subdivision 2b; 256B.057, subdivision 10; 256B.0637; and 81.5 256L.03, subdivision 5a, are repealed July 1, 2002. 81.6 (d) Laws 2001, First Special Session chapter 9, article 13, 81.7 section 22, is repealed. 81.8 (e) Laws 2001, First Special Session chapter 9, article 13, 81.9 section 25, subdivisions 1, 2, 4, 5, 6, and 7, are repealed. 81.10 (f) Laws 2001, First Special Session chapter 9, article 13, 81.11 sections 26, 27, and 28, are repealed. 81.12 ARTICLE 5 81.13 HEALTH DEPARTMENT 81.14 Section 1. Minnesota Statutes 2001 Supplement, section 81.15 144.1464, subdivision 1, is amended to read: 81.16 Subdivision 1. [SUMMER INTERNSHIPS.] The commissioner of 81.17 health, through a contract with a nonprofit organization as 81.18 required by subdivision 4, shall award grants to hospitals,and 81.19 clinics, nursing facilities, and home care providersto 81.20 establish a secondary and post-secondary summer health care 81.21 intern program. The purpose of the program is to expose 81.22 interested secondary and post-secondary pupils to various 81.23 careers within the health care profession. 81.24 Sec. 2. Minnesota Statutes 2001 Supplement, section 81.25 144.1464, subdivision 2, is amended to read: 81.26 Subd. 2. [CRITERIA.] (a) The commissioner, through the 81.27 organization under contract, shall award grants to 81.28 hospitals,and clinics, nursing facilities, and home care81.29providersthat agree to: 81.30 (1) provide secondary and post-secondary summer health care 81.31 interns with formal exposure to the health care profession; 81.32 (2) provide an orientation for the secondary and 81.33 post-secondary summer health care interns; 81.34 (3) pay one-half the costs of employing the secondary and 81.35 post-secondary summer health care intern; 81.36 (4) interview and hire secondary and post-secondary pupils 82.1 for a minimum of six weeks and a maximum of 12 weeks; and 82.2 (5) employ at least one secondary student for each 82.3 post-secondary student employed, to the extent that there are 82.4 sufficient qualifying secondary student applicants. 82.5 (b) In order to be eligible to be hired as a secondary 82.6 summer health intern by a hospital,or clinic, nursing facility,82.7or home care provider, a pupil must: 82.8 (1) intend to complete high school graduation requirements 82.9 and be between the junior and senior year of high school; and 82.10 (2) be from a school district in proximity to the facility. 82.11 (c) In order to be eligible to be hired as a post-secondary 82.12 summer health care intern by a hospital or clinic, a pupil must: 82.13 (1) intend to complete a health care training program or a 82.14 two-year or four-year degree program and be planning on 82.15 enrolling in or be enrolled in that training program or degree 82.16 program; and 82.17 (2) be enrolled in a Minnesota educational institution or 82.18 be a resident of the state of Minnesota; priority must be given 82.19 to applicants from a school district or an educational 82.20 institution in proximity to the facility. 82.21 (d) Hospitals,and clinics, nursing facilities, and home82.22care providersawarded grants may employ pupils as secondary and 82.23 post-secondary summer health care interns beginning on or after 82.24 June 15, 1993, if they agree to pay the intern, during the 82.25 period before disbursement of state grant money, with money 82.26 designated as the facility's 50 percent contribution towards 82.27 internship costs. 82.28 Sec. 3. Minnesota Statutes 2001 Supplement, section 82.29 144.1464, subdivision 3, is amended to read: 82.30 Subd. 3. [GRANTS.] The commissioner, through the 82.31 organization under contract, shall award separate grants to 82.32 hospitals,and clinics, nursing facilities, and home care82.33providersmeeting the requirements of subdivision 2. The grants 82.34 must be used to pay one-half of the costs of employing secondary 82.35 and post-secondary pupils in a hospital, clinic, nursing 82.36 facility, or home care setting during the course of the 83.1 program. No more than 50 percent of the participants may be 83.2 post-secondary students, unless the program does not receive 83.3 enough qualified secondary applicants per fiscal year. No more 83.4 than five pupils may be selected from any secondary or 83.5 post-secondary institution to participate in the program and no 83.6 more than one-half of the number of pupils selected may be from 83.7 the seven-county metropolitan area. 83.8 Sec. 4. [REPEALER.] 83.9 Minnesota Statutes 2000, sections 144.6905; 145.475; and 83.10 145.9266, subdivisions 2, 5, 6, and 7, are repealed. 83.11 ARTICLE 6 83.12 CORRECTIONS 83.13 Section 1. [CORRECTIONS APPROPRIATIONS/REDUCTIONS.] 83.14 The dollar amounts in the columns under "APPROPRIATIONS" 83.15 are added to or, if shown in parentheses, are subtracted from 83.16 the appropriations in Laws 2001, First Special Session chapter 83.17 9, or other law to the specified agencies. The appropriations 83.18 are from the general fund or other named fund and are available 83.19 for the fiscal years indicated for each purpose. The figure 83.20 "2002" or "2003" means that the addition to or subtraction from 83.21 the appropriations listed under the figure are for the fiscal 83.22 year ending June 30, 2002, or June 30, 2003, respectively. 83.23 SUMMARY BY FUND 83.24 2002 2003 83.25 General Fund Expenditures (5,165,000) (12,561,000) 83.26 General Fund Revenues 35,000 (3,826,000) 83.27 APPROPRIATIONS 83.28 2002 2003 83.29 Sec. 2. BOARD OF PUBLIC 83.30 DEFENSE -0- (2,735,000) 83.31 Sec. 3. CORRECTIONS 83.32 Subdivision 1. Total 83.33 Appropriation Changes (5,165,000) (9,826,000) 83.34 Subd. 2. Adult Institutions (5,200,000) -0- 83.35 Subd. 3. Juvenile Services -0- (115,000) 83.36 Subd. 4. Community Services 35,000 (9,411,000) 83.37 [JUVENILE RESIDENTIAL TREATMENT 83.38 GRANTS.] $5,000,000 the second year is 84.1 to reduce juvenile residential 84.2 treatment grants. $765,000 the second 84.3 year is to eliminate funding for the 84.4 remote alcohol monitoring (REAM) 84.5 program. $322,000 the second year is 84.6 to eliminate pretrial bail evaluation 84.7 reimbursement. $1,998,000 the second 84.8 year is to eliminate extended juvenile 84.9 jurisdiction reimbursement. $200,000 84.10 the second year is to eliminate the 84.11 community re-entry program. $800,000 84.12 the second year is to reduce the 84.13 Community Corrections Act subsidy 84.14 funding. $80,000 the second year is to 84.15 reduce county probation officer 84.16 reimbursement. $320,000 the second 84.17 year is to reduce probation and 84.18 supervised release services provided by 84.19 the department. 84.20 [PROBATION SERVICES.] $35,000 the first 84.21 year and $74,000 the second year are 84.22 for an increase to probation services 84.23 provided to Clearwater county. It is 84.24 anticipated that the county will 84.25 reimburse the state for these costs and 84.26 that these proceeds will be deposited 84.27 in the general fund. 84.28 Subd. 5. Management Services -0- (300,000) 84.29 Sec. 4. Minnesota Statutes 2000, section 169A.73, 84.30 subdivision 3, is amended to read: 84.31 Subd. 3. [COST OF PROGRAM.] Offenders who are ordered to 84.32 participate in the program shall also be ordered to pay the per 84.33 diem cost of the monitoring unless the offender is indigent.The84.34commissioner of corrections shall reimburse the judicial84.35districts in a manner proportional to their use of remote84.36electronic alcohol monitoring for any costs the districts incur84.37in participating in the program.84.38 Sec. 5. Minnesota Statutes 2001 Supplement, section 84.39 242.192, is amended to read: 84.40 242.192 [CHARGES TO COUNTIES.] 84.41(a) Until June 30, 2002,The commissioner shall charge 84.42 counties or other appropriate jurisdictions 65 percent of the 84.43 per diem cost of confinement, excluding educational costs and 84.44 nonbillable service, of juveniles at the Minnesota correctional 84.45 facility-Red Wing and of juvenile females committed to the 84.46 commissioner of corrections. This charge applies to juveniles 84.47 committed to the commissioner of corrections and juveniles 84.48 admitted to the Minnesota correctional facility-Red Wing under 85.1 established admissions criteria. This charge applies to both 85.2 counties that participate in the Community Corrections Act and 85.3 those that do not. The commissioner shall determine the per 85.4 diem cost of confinement based on projected population, pricing 85.5 incentives, market conditions, and the requirement that expense 85.6 and revenue balance out over a period of two years. All money 85.7 received under this section must be deposited in the state 85.8 treasury and credited to the general fund. 85.9(b) Until June 30, 2002, the department of corrections85.10shall be responsible for 35 percent of the per diem cost of85.11confinement described in this section.