HF 3435

2nd Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to human services; making technical changes; amending health care
and miscellaneous provisions; amending Minnesota Statutes 2006, sections
254A.035, subdivision 2; 254A.04; 256.046; 256B.093, subdivision 1; 256L.07,
subdivision 5; Minnesota Statutes 2007 Supplement, sections 256.01, subdivision
2b; 256.476, subdivisions 4, 5; 256B.057, subdivision 2c; 256B.06, subdivision
4; 256B.0655, subdivision 12; 256D.03, subdivision 3; 256L.15, subdivision 2;
repealing Minnesota Statutes 2006, section 256B.039.

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

ARTICLE 1

HEALTH CARE AND CONTINUING CARE

Section 1.

Minnesota Statutes 2007 Supplement, section 256.01, subdivision 2b,
is amended to read:

Subd. 2b.

Performance payments.

(a) The commissioner shall develop and
implement a pay-for-performance system to provide performance payments to eligible
medical groups and clinics that demonstrate optimum care in serving individuals
with chronic diseases who are enrolled in health care programs administered by the
commissioner under chapters 256B, 256D, and 256L. The commissioner may receive any
federal matching money that is made available through the medical assistance program
for managed care oversight contracted through vendors, including consumer surveys,
studies, and external quality reviews as required by the federal Balanced Budget Act of
1997, Code of Federal Regulations, title 42, part 438-managed care, subpart E-external
quality review. Any federal money received for managed care oversight is appropriated
to the commissioner for this purpose. The commissioner may expend the federal money
received in either year of the biennium.

(b) Effective July 1, deleted text begin 2009 deleted text end new text begin 2008 new text end , or upon federal approval, whichever is later, the
commissioner shall develop and implement a patient incentive health program to provide
incentives and rewards to patients who are enrolled in health care programs administered
by the commissioner under chapters 256B, 256D, and 256L, and who have agreed to and
have met personal health goals established with the patients' primary care providers to
manage a chronic disease or condition, including but not limited to diabetes, high blood
pressure, and coronary artery disease.

Sec. 2.

Minnesota Statutes 2006, section 256.046, is amended to read:

256.046 ADMINISTRATIVE FRAUD DISQUALIFICATION HEARINGS.

Subdivision 1.

Hearing authority.

A local agency must initiate an administrative
fraud disqualification hearing for individuals, including child care providers caring for
children receiving child care assistance, accused of wrongfully obtaining assistance or
intentional program violations, in lieu of a criminal action when it has not been pursued, in
the aid to families with dependent children program formerly codified in sections 256.72
to 256.87, MFIP, the diversionary work program, child care assistance programs, general
assistance, family general assistance program formerly codified in section 256D.05,
subdivision 1, clause (15), Minnesota supplemental aid, food stamp programs, general
assistance medical care, MinnesotaCare for adults without children, and upon federal
approval, all categories of medical assistance and remaining categories of MinnesotaCare
except for children through age 18. The Department of Human Services, in lieu of a local
agency, may initiate an administrative fraud disqualification hearing when the state agency
is directly responsible for administration new text begin or investigation new text end of the deleted text begin health care deleted text end program for
which benefits were wrongfully obtained. The hearing is subject to the requirements of
section 256.045 and the requirements in Code of Federal Regulations, title 7, section
273.16 deleted text begin , for the food stamp program and title 45, section 235.112, as of September 30, 1995,
for the cash grant, medical care programs, and child care assistance under chapter 119B deleted text end .

Subd. 2.

Combined hearing.

The referee may combine a fair hearing and
administrative fraud disqualification hearing into a single hearing if the factual issues
arise out of the same, or related, circumstances and the individual receives prior notice
that the hearings will be combined. If the administrative fraud disqualification hearing
and fair hearing are combined, the time frames for administrative fraud disqualification
hearings specified in Code of Federal Regulations, title 7, section 273.16 deleted text begin , and title 45,
section 235.112, as of September 30, 1995, apply deleted text end . If the individual accused of wrongfully
obtaining assistance is charged under section 256.98 for the same act or acts which are
the subject of the hearing, the individual may request that the hearing be delayed until
the criminal charge is decided by the court or withdrawn.

Sec. 3.

Minnesota Statutes 2007 Supplement, section 256.476, subdivision 4, is
amended to read:

Subd. 4.

Support grants; criteria and limitations.

(a) A county board may
choose to participate in the consumer support grant program. If a county has not chosen
to participate by July 1, 2002, the commissioner shall contract with another county or
other entity to provide access to residents of the nonparticipating county who choose
the consumer support grant option. The commissioner shall notify the county board
in a county that has declined to participate of the commissioner's intent to enter into
a contract with another county or other entity at least 30 days in advance of entering
into the contract. The local agency shall establish written procedures and criteria to
determine the amount and use of support grants. These procedures must include, at least,
the availability of respite care, assistance with daily living, and adaptive aids. The local
agency may establish monthly or annual maximum amounts for grants and procedures
where exceptional resources may be required to meet the health and safety needs of the
person on a time-limited basis, however, the total amount awarded to each individual may
not exceed the limits established in subdivision 11.

(b) Support grants to a person, a person's legal representative, or other authorized
representative will be provided through a monthly subsidy payment and be in the form
of cash, voucher, or direct county payment to vendor. Support grant amounts must be
determined by the local agency. Each service and item purchased with a support grant
must meet all of the following criteria:

(1) it must be over and above the normal cost of caring for the person if the person
did not have functional limitations;

(2) it must be directly attributable to the person's functional limitations;

(3) it must enable the person, a person's legal representative, or other authorized
representative to delay or prevent out-of-home placement of the person; and

(4) it must be consistent with the needs identified in the service agreement, when
applicable.

(c) Items and services purchased with support grants must be those for which there
are no other public or private funds available to the person, a person's legal representative,
or other authorized representative. Fees assessed to the person or the person's family for
health and human services are not reimbursable through the grant.

(d) In approving or denying applications, the local agency shall consider the
following factors:

(1) the extent and areas of the person's functional limitations;

(2) the degree of need in the home environment for additional support; and

(3) the potential effectiveness of the grant to maintain and support the person in the
family environment or the person's own home.

(e) At the time of application to the program or screening for other services, the
person, a person's legal representative, or other authorized representative shall be provided
sufficient information to ensure an informed choice of alternatives by the person, the
person's legal representative, or other authorized representative, if any. The application
shall be made to the local agency and shall specify the needs of the person deleted text begin and family deleted text end new text begin or
the person's legal representative or other authorized representative new text end , the form and amount
of grant requested, the items and services to be reimbursed, and evidence of eligibility for
medical assistance.

(f) Upon approval of an application by the local agency and agreement on a
support plan for the person or new text begin the new text end person's deleted text begin family deleted text end new text begin legal representative or other authorized
representative new text end , the local agency shall make grants to the person or the person's deleted text begin family deleted text end new text begin legal
representative or other authorized representative new text end . The grant shall be in an amount for the
direct costs of the services or supports outlined in the service agreement.

(g) Reimbursable costs shall not include costs for resources already available,
such as special education classes, day training and habilitation, case management, other
services to which the person is entitled, medical costs covered by insurance or other health
programs, or other resources usually available at no cost to the person or the person's
deleted text begin family deleted text end new text begin legal representative or other authorized representative new text end .

(h) The state of Minnesota, the county boards participating in the consumer
support grant program, or the agencies acting on behalf of the county boards in the
implementation and administration of the consumer support grant program shall not be
liable for damages, injuries, or liabilities sustained through the purchase of support by
the individual, the individual's family, or the authorized representative under this section
with funds received through the consumer support grant program. Liabilities include but
are not limited to: workers' compensation liability, the Federal Insurance Contributions
Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section,
participating county boards and agencies acting on behalf of county boards are exempt
from the provisions of section 268.04.

Sec. 4.

Minnesota Statutes 2007 Supplement, section 256.476, subdivision 5, is
amended to read:

Subd. 5.

Reimbursement, allocations, and reporting.

(a) For the purpose of
transferring persons to the consumer support grant program from the family support
program and personal care assistant services, home health aide services, or private duty
nursing services, the amount of funds transferred by the commissioner between the
family support program account, the medical assistance account, or the consumer support
grant account shall be based on each county's participation in transferring persons to the
consumer support grant program from those programs and services.

(b) At the beginning of each fiscal year, county allocations for consumer support
grants shall be based on:

(1) the number of persons to whom the county board expects to provide consumer
supports grants;

(2) their eligibility for current program and services;

(3) the amount of nonfederal dollars allowed under subdivision 11; and

(4) projected dates when persons will start receiving grants. County allocations shall
be adjusted periodically by the commissioner based on the actual transfer of persons or
service openings, and the nonfederal dollars associated with those persons or service
openings, to the consumer support grant program.

(c) The amount of funds transferred by the commissioner from the medical
assistance account for an individual may be changed if it is determined by the county or its
agent that the individual's need for support has changed.

(d) The authority to utilize funds transferred to the consumer support grant account
for the purposes of implementing and administering the consumer support grant program
will not be limited or constrained by the spending authority provided to the program
of origination.

(e) The commissioner may use up to five percent of each county's allocation, as
adjusted, for payments for administrative expenses, to be paid as a proportionate addition
to reported direct service expenditures.

(f) The county allocation for each deleted text begin individual deleted text end new text begin person new text end or deleted text begin individual's family deleted text end new text begin the
person's legal representative or other authorized representative new text end cannot exceed the amount
allowed under subdivision 11.

(g) The commissioner may recover, suspend, or withhold payments if the county
board, local agency, or grantee does not comply with the requirements of this section.

(h) Grant funds unexpended by consumers shall return to the state once a year. The
annual return of unexpended grant funds shall occur in the quarter following the end of
the state fiscal year.

Sec. 5.

Minnesota Statutes 2007 Supplement, section 256B.057, subdivision 2c,
is amended to read:

Subd. 2c.

Extended coverage for children.

A child receiving medical assistance
under subdivision 2, who becomes ineligible due to excess income, is eligible for two
additional months of medical assistance. Eligibility under this section is effective
following any coverage available under section deleted text begin 256B.0625 deleted text end new text begin 256B.0635 new text end .

A child eligible for extended coverage under this section is deemed automatically
eligible for MinnesotaCare until renewal. MinnesotaCare coverage begins in accordance
with section 256L.05, subdivision 3.

Sec. 6.

Minnesota Statutes 2007 Supplement, section 256B.06, subdivision 4, is
amended to read:

Subd. 4.

Citizenship requirements.

(a) Eligibility for medical assistance is limited
to citizens of the United States, qualified noncitizens as defined in this subdivision, and
other persons residing lawfully in the United States. Citizens or nationals of the United
States must cooperate in obtaining satisfactory documentary evidence of citizenship or
nationality according to the requirements of the federal Deficit Reduction Act of 2005,
Public Law 109-171.

(b) "Qualified noncitizen" means a person who meets one of the following
immigration criteria:

(1) admitted for lawful permanent residence according to United States Code, title 8;

(2) admitted to the United States as a refugee according to United States Code,
title 8, section 1157;

(3) granted asylum according to United States Code, title 8, section 1158;

(4) granted withholding of deportation according to United States Code, title 8,
section 1253(h);

(5) paroled for a period of at least one year according to United States Code, title 8,
section 1182(d)(5);

(6) granted conditional entrant status according to United States Code, title 8,
section 1153(a)(7);

(7) determined to be a battered noncitizen by the United States Attorney General
according to the Illegal Immigration Reform and Immigrant Responsibility Act of 1996,
title V of the Omnibus Consolidated Appropriations Bill, Public Law 104-200;

(8) is a child of a noncitizen determined to be a battered noncitizen by the United
States Attorney General according to the Illegal Immigration Reform and Immigrant
Responsibility Act of 1996, title V, of the Omnibus Consolidated Appropriations Bill,
Public Law 104-200; or

(9) determined to be a Cuban or Haitian entrant as defined in section 501(e) of Public
Law 96-422, the Refugee Education Assistance Act of 1980.

(c) All qualified noncitizens who were residing in the United States before August
22, 1996, who otherwise meet the eligibility requirements of this chapter, are eligible for
medical assistance with federal financial participation.

(d) All qualified noncitizens who entered the United States on or after August 22,
1996, and who otherwise meet the eligibility requirements of this chapter, are eligible for
medical assistance with federal financial participation through November 30, 1996.

Beginning December 1, 1996, qualified noncitizens who entered the United States
on or after August 22, 1996, and who otherwise meet the eligibility requirements of this
chapter are eligible for medical assistance with federal participation for five years if they
meet one of the following criteria:

(i) refugees admitted to the United States according to United States Code, title 8,
section 1157;

(ii) persons granted asylum according to United States Code, title 8, section 1158;

(iii) persons granted withholding of deportation according to United States Code,
title 8, section 1253(h);

(iv) veterans of the United States armed forces with an honorable discharge for
a reason other than noncitizen status, their spouses and unmarried minor dependent
children; or

(v) persons on active duty in the United States armed forces, other than for training,
their spouses and unmarried minor dependent children.

Beginning December 1, 1996, qualified noncitizens who do not meet one of the
criteria in items (i) to (v) are eligible for medical assistance without federal financial
participation as described in paragraph (j).

(e) Noncitizens who are not qualified noncitizens as defined in paragraph (b),
who are lawfully deleted text begin residing deleted text end new text begin present new text end in the United States new text begin , as defined in Code of Federal
Regulations, title 8, section 103.12, new text end and who otherwise meet the eligibility requirements of
this chapter, are eligible for medical assistance under clauses (1) to (3). These individuals
must cooperate with the United States Citizenship and Immigration Services to pursue any
applicable immigration status, including citizenship, that would qualify them for medical
assistance with federal financial participation.

(1) Persons who were medical assistance recipients on August 22, 1996, are eligible
for medical assistance with federal financial participation through December 31, 1996.

(2) Beginning January 1, 1997, persons described in clause (1) are eligible for
medical assistance without federal financial participation as described in paragraph (j).

(3) Beginning December 1, 1996, persons residing in the United States prior to
August 22, 1996, who were not receiving medical assistance and persons who arrived on
or after August 22, 1996, are eligible for medical assistance without federal financial
participation as described in paragraph (j).

(f) Nonimmigrants who otherwise meet the eligibility requirements of this chapter
are eligible for the benefits as provided in paragraphs (g) to (i). For purposes of this
subdivision, a "nonimmigrant" is a person in one of the classes listed in United States
Code, title 8, section 1101(a)(15).

(g) Payment shall also be made for care and services that are furnished to noncitizens,
regardless of immigration status, who otherwise meet the eligibility requirements of
this chapter, if such care and services are necessary for the treatment of an emergency
medical condition, except for organ transplants and related care and services and routine
prenatal care.

(h) For purposes of this subdivision, the term "emergency medical condition" means
a medical condition that meets the requirements of United States Code, title 42, section
1396b(v).

(i) Pregnant noncitizens who are undocumented, nonimmigrants, or eligible for
medical assistance as described in paragraph (j), and who are not covered by a group
health plan or health insurance coverage according to Code of Federal Regulations, title
42, section 457.310, and who otherwise meet the eligibility requirements of this chapter,
are eligible for medical assistance through the period of pregnancy, including labor and
delivery, to the extent federal funds are available under title XXI of the Social Security
Act, and the state children's health insurance program, followed by 60 days postpartum
without federal financial participation.

(j) Qualified noncitizens as described in paragraph (d), and all other noncitizens
lawfully residing in the United States as described in paragraph (e), who are ineligible
for medical assistance with federal financial participation and who otherwise meet the
eligibility requirements of chapter 256B and of this paragraph, are eligible for medical
assistance without federal financial participation. Qualified noncitizens as described
in paragraph (d) are only eligible for medical assistance without federal financial
participation for five years from their date of entry into the United States.

(k) Beginning October 1, 2003, persons who are receiving care and rehabilitation
services from a nonprofit center established to serve victims of torture and are otherwise
ineligible for medical assistance under this chapter are eligible for medical assistance
without federal financial participation. These individuals are eligible only for the period
during which they are receiving services from the center. Individuals eligible under this
paragraph shall not be required to participate in prepaid medical assistance.

Sec. 7.

Minnesota Statutes 2007 Supplement, section 256B.0655, subdivision 12,
is amended to read:

Subd. 12.

Personal care provider; employment prohibition.

A personal care
provider shall not employ a person to provide personal care service for a qualified
recipient if the person:

(1) refuses to provide full disclosure of criminal history records as specified in
deleted text begin subdivision 1g, clause (1) deleted text end new text begin Minnesota Rules, part 9505.0335, subpart 12 new text end ;

(2) has been convicted of a crime that directly relates to the occupation of providing
personal care services to a qualified recipient;

(3) has jeopardized the health or welfare of a vulnerable adult through physical
abuse, sexual abuse, or neglect as defined in section 626.557; or

(4) is misusing or is dependent on mood-altering chemicals, including alcohol, to
the extent that the personal care provider knows or has reason to believe that the use of
chemicals has a negative effect on the person's ability to provide personal care services
or the use of chemicals is apparent during the hours the person is providing personal
care services.

Sec. 8.

Minnesota Statutes 2006, section 256B.093, subdivision 1, is amended to read:

Subdivision 1.

State traumatic brain injury program.

The commissioner of
human services shall:

(1) maintain a statewide traumatic brain injury program;

(2) supervise and coordinate services and policies for persons with traumatic brain
injuries;

(3) contract with qualified agencies or employ staff to provide statewide
administrative case management and consultation;

(4) maintain an advisory committee to provide recommendations in reports to the
commissioner regarding program and service needs of persons with traumatic brain
injuries;

(5) investigate the need for the development of rules or statutes for the traumatic
brain injury home and community-based services waiver;

(6) investigate present and potential models of service coordination which can be
delivered at the local level; and

(7) the advisory committee required by clause (4) must consist of no fewer than ten
members and no more than 30 members. The commissioner shall appoint all advisory
committee members to one- or two-year terms and appoint one member as chair.
Notwithstanding section 15.059, subdivision 5, the advisory committee does not terminate
until June 30, deleted text begin 2008 deleted text end new text begin 2012 new text end .

Sec. 9.

Minnesota Statutes 2007 Supplement, section 256D.03, subdivision 3, is
amended to read:

Subd. 3.

General assistance medical care; eligibility.

(a) General assistance
medical care may be paid for any person who is not eligible for medical assistance under
chapter 256B, including eligibility for medical assistance based on a spenddown of excess
income according to section 256B.056, subdivision 5, or MinnesotaCare as defined in
paragraph (b), except as provided in paragraph (c), and:

(1) who is receiving assistance under section 256D.05, except for families with
children who are eligible under Minnesota family investment program (MFIP), or who is
having a payment made on the person's behalf under sections 256I.01 to 256I.06; or

(2) who is a resident of Minnesota; and

(i) who has gross countable income not in excess of 75 percent of the federal poverty
guidelines for the family size, using a six-month budget period and whose equity in assets
is not in excess of $1,000 per assistance unit. General assistance medical care is not
available for applicants or enrollees who are otherwise eligible for medical assistance but
fail to verify their assets. Enrollees who become eligible for medical assistance shall be
terminated and transferred to medical assistance. Exempt assets, the reduction of excess
assets, and the waiver of excess assets must conform to the medical assistance program in
section 256B.056, deleted text begin subdivision deleted text end new text begin subdivisions new text end 3 new text begin and 3d new text end , with the following exception: the
maximum amount of undistributed funds in a trust that could be distributed to or on behalf
of the beneficiary by the trustee, assuming the full exercise of the trustee's discretion under
the terms of the trust, must be applied toward the asset maximum;

(ii) who has gross countable income above 75 percent of the federal poverty
guidelines but not in excess of 175 percent of the federal poverty guidelines for the
family size, using a six-month budget period, whose equity in assets is not in excess
of the limits in section 256B.056, subdivision 3c, and who applies during an inpatient
hospitalization; or

(iii) the commissioner shall adjust the income standards under this section each July
1 by the annual update of the federal poverty guidelines following publication by the
United States Department of Health and Human Services.

(b) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may not be paid for applicants or recipients who are adults
with dependent children under 21 whose gross family income is equal to or less than 275
percent of the federal poverty guidelines who are not described in paragraph (e).

(c) Effective for applications and renewals processed on or after September 1, 2006,
general assistance medical care may be paid for applicants and recipients who meet all
eligibility requirements of paragraph (a), clause (2), item (i), for a temporary period
beginning the date of application. Immediately following approval of general assistance
medical care, enrollees shall be enrolled in MinnesotaCare under section 256L.04,
subdivision 7, with covered services as provided in section 256L.03 for the rest of the
six-month general assistance medical care eligibility period, until their six-month renewal.

(d) To be eligible for general assistance medical care following enrollment in
MinnesotaCare as required by paragraph (c), an individual must complete a new
application.

(e) Applicants and recipients eligible under paragraph (a), clause (1); who have
applied for and are awaiting a determination of blindness or disability by the state medical
review team or a determination of eligibility for Supplemental Security Income or Social
Security Disability Insurance by the Social Security Administration; who fail to meet the
requirements of section 256L.09, subdivision 2; who are homeless as defined by United
States Code, title 42, section 11301, et seq.; who are classified as end-stage renal disease
beneficiaries in the Medicare program; who are enrolled in private health care coverage as
defined in section 256B.02, subdivision 9; who are eligible under paragraph (j); or who
receive treatment funded pursuant to section 254B.02 are exempt from the MinnesotaCare
enrollment requirements of this subdivision.

(f) For applications received on or after October 1, 2003, eligibility may begin no
earlier than the date of application. For individuals eligible under paragraph (a), clause
(2), item (i), a redetermination of eligibility must occur every 12 months. Individuals are
eligible under paragraph (a), clause (2), item (ii), only during inpatient hospitalization but
may reapply if there is a subsequent period of inpatient hospitalization.

(g) Beginning September 1, 2006, Minnesota health care program applications and
renewals completed by recipients and applicants who are persons described in paragraph
(c) and submitted to the county agency shall be determined for MinnesotaCare eligibility
by the county agency. If all other eligibility requirements of this subdivision are met,
eligibility for general assistance medical care shall be available in any month during which
MinnesotaCare enrollment is pending. Upon notification of eligibility for MinnesotaCare,
notice of termination for eligibility for general assistance medical care shall be sent to
an applicant or recipient. If all other eligibility requirements of this subdivision are
met, eligibility for general assistance medical care shall be available until enrollment in
MinnesotaCare subject to the provisions of paragraphs (c), (e), and (f).

(h) The date of an initial Minnesota health care program application necessary to
begin a determination of eligibility shall be the date the applicant has provided a name,
address, and Social Security number, signed and dated, to the county agency or the
Department of Human Services. If the applicant is unable to provide a name, address,
Social Security number, and signature when health care is delivered due to a medical
condition or disability, a health care provider may act on an applicant's behalf to establish
the date of an initial Minnesota health care program application by providing the county
agency or Department of Human Services with provider identification and a temporary
unique identifier for the applicant. The applicant must complete the remainder of the
application and provide necessary verification before eligibility can be determined. The
county agency must assist the applicant in obtaining verification if necessary.

(i) County agencies are authorized to use all automated databases containing
information regarding recipients' or applicants' income in order to determine eligibility for
general assistance medical care or MinnesotaCare. Such use shall be considered sufficient
in order to determine eligibility and premium payments by the county agency.

(j) General assistance medical care is not available for a person in a correctional
facility unless the person is detained by law for less than one year in a county correctional
or detention facility as a person accused or convicted of a crime, or admitted as an
inpatient to a hospital on a criminal hold order, and the person is a recipient of general
assistance medical care at the time the person is detained by law or admitted on a criminal
hold order and as long as the person continues to meet other eligibility requirements
of this subdivision.

(k) General assistance medical care is not available for applicants or recipients who
do not cooperate with the county agency to meet the requirements of medical assistance.

(l) In determining the amount of assets of an individual eligible under paragraph
(a), clause (2), item (i), there shall be included any asset or interest in an asset, including
an asset excluded under paragraph (a), that was given away, sold, or disposed of for
less than fair market value within the 60 months preceding application for general
assistance medical care or during the period of eligibility. Any transfer described in this
paragraph shall be presumed to have been for the purpose of establishing eligibility for
general assistance medical care, unless the individual furnishes convincing evidence to
establish that the transaction was exclusively for another purpose. For purposes of this
paragraph, the value of the asset or interest shall be the fair market value at the time it
was given away, sold, or disposed of, less the amount of compensation received. For any
uncompensated transfer, the number of months of ineligibility, including partial months,
shall be calculated by dividing the uncompensated transfer amount by the average monthly
per person payment made by the medical assistance program to skilled nursing facilities
for the previous calendar year. The individual shall remain ineligible until this fixed period
has expired. The period of ineligibility may exceed 30 months, and a reapplication for
benefits after 30 months from the date of the transfer shall not result in eligibility unless
and until the period of ineligibility has expired. The period of ineligibility begins in the
month the transfer was reported to the county agency, or if the transfer was not reported,
the month in which the county agency discovered the transfer, whichever comes first. For
applicants, the period of ineligibility begins on the date of the first approved application.

(m) When determining eligibility for any state benefits under this subdivision,
the income and resources of all noncitizens shall be deemed to include their sponsor's
income and resources as defined in the Personal Responsibility and Work Opportunity
Reconciliation Act of 1996, title IV, Public Law 104-193, sections 421 and 422, and
subsequently set out in federal rules.

(n) Undocumented noncitizens and nonimmigrants are ineligible for general
assistance medical care. For purposes of this subdivision, a nonimmigrant is an individual
in one or more of the classes listed in United States Code, title 8, section 1101(a)(15), and
an undocumented noncitizen is an individual who resides in the United States without the
approval or acquiescence of the United States Citizenship and Immigration Services.

(o) Notwithstanding any other provision of law, a noncitizen who is ineligible for
medical assistance due to the deeming of a sponsor's income and resources, is ineligible
for general assistance medical care.

(p) Effective July 1, 2003, general assistance medical care emergency services end.

Sec. 10.

Minnesota Statutes 2006, section 256L.07, subdivision 5, is amended to read:

Subd. 5.

Voluntary disenrollment for members of military.

Notwithstanding
section 256L.05, subdivision 3b, MinnesotaCare enrollees who are members of the
military and their families, who choose to voluntarily disenroll from the program when
one or more family members are called to active duty, may reenroll during or following
that member's tour of active duty. Those individuals and families shall be considered
to have good cause for voluntary termination under section 256L.06, subdivision 3,
paragraph (d). Income and asset increases reported at the time of reenrollment shall be
disregarded. All provisions of sections 256L.01 to 256L.18 shall apply to individuals and
families enrolled under this subdivision upon deleted text begin six-month deleted text end new text begin 12-month new text end renewal.

Sec. 11.

Minnesota Statutes 2007 Supplement, section 256L.15, subdivision 2, is
amended to read:

Subd. 2.

Sliding fee scale; monthly gross individual or family income.

(a) The
commissioner shall establish a sliding fee scale to determine the percentage of monthly
gross individual or family income that households at different income levels must pay
to obtain coverage through the MinnesotaCare program. The sliding fee scale must be
based on the enrollee's monthly gross individual or family income. The sliding fee scale
must contain separate tables based on enrollment of one, two, or three or more persons.
The sliding fee scale begins with a premium of 1.5 percent of monthly gross individual or
family income for individuals or families with incomes below the limits for the medical
assistance program for families and children in effect on January 1, 1999, and proceeds
through the following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent.
These percentages are matched to evenly spaced income steps ranging from the medical
assistance income limit for families and children in effect on January 1, 1999, to 275
percent of the federal poverty guidelines for the applicable family size, up to a family size
of five. The sliding fee scale for a family of five must be used for families of more than
five. The sliding fee scale and percentages are not subject to the provisions of chapter
14. If a family or individual reports increased income after enrollment, premiums shall
be adjusted at the time the change in income is reported.

(b) deleted text begin Families deleted text end new text begin Children new text end whose gross income is above 275 percent of the federal
poverty guidelines shall pay the maximum premium. The maximum premium is defined
as a base charge for one, two, or three or more enrollees so that if all MinnesotaCare
cases paid the maximum premium, the total revenue would equal the total cost of
MinnesotaCare medical coverage and administration. In this calculation, administrative
costs shall be assumed to equal ten percent of the total. The costs of medical coverage
for pregnant women and children under age two and the enrollees in these groups shall
be excluded from the total. The maximum premium for two enrollees shall be twice the
maximum premium for one, and the maximum premium for three or more enrollees shall
be three times the maximum premium for one.

ARTICLE 2

MISCELLANEOUS

Section 1.

Minnesota Statutes 2006, section 254A.035, subdivision 2, is amended to
read:

Subd. 2.

Membership terms, compensation, removal and expiration.

The
membership of this council shall be composed of 17 persons who are American Indians
and who are appointed by the commissioner. The commissioner shall appoint one
representative from each of the following groups: Red Lake Band of Chippewa Indians;
Fond du Lac Band, Minnesota Chippewa Tribe; Grand Portage Band, Minnesota
Chippewa Tribe; Leech Lake Band, Minnesota Chippewa Tribe; Mille Lacs Band,
Minnesota Chippewa Tribe; Bois Forte Band, Minnesota Chippewa Tribe; White Earth
Band, Minnesota Chippewa Tribe; Lower Sioux Indian Reservation; Prairie Island Sioux
Indian Reservation; Shakopee Mdewakanton Sioux Indian Reservation; Upper Sioux
Indian Reservation; International Falls Northern Range; Duluth Urban Indian Community;
and two representatives from the Minneapolis Urban Indian Community and two from the
St. Paul Urban Indian Community. The terms, compensation, and removal of American
Indian Advisory Council members shall be as provided in section 15.059. The council
expires June 30, deleted text begin 2008 deleted text end new text begin 2012 new text end .

Sec. 2.

Minnesota Statutes 2006, section 254A.04, is amended to read:

254A.04 CITIZENS ADVISORY COUNCIL.

There is hereby created an Alcohol and Other Drug Abuse Advisory Council to
advise the Department of Human Services concerning the problems of alcohol and
other drug dependency and abuse, composed of ten members. Five members shall be
individuals whose interests or training are in the field of alcohol dependency and abuse;
and five members whose interests or training are in the field of dependency and abuse of
drugs other than alcohol. The terms, compensation and removal of members shall be as
provided in section 15.059. The council expires June 30, deleted text begin 2008 deleted text end new text begin 2012 new text end . The commissioner
of human services shall appoint members whose terms end in even-numbered years. The
commissioner of health shall appoint members whose terms end in odd-numbered years.

Sec. 3. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2006, section 256B.039, new text end new text begin is repealed.
new text end