1.1 A bill for an act
1.2 relating to human services; modifying provisions
1.3 relating to health department; health care; continuing
1.4 care and home care; consumer information and
1.5 assistance and community-based care; long-term care
1.6 reform and reimbursement; work force; regulation of
1.7 supplemental nursing services agencies; long-term
1.8 insurance; mental health and civil commitment;
1.9 assistance programs; licensing; adding an informed
1.10 consent provision for abortion procedures; creating a
1.11 child maltreatment review panel; requiring studies;
1.12 adding provisions relating to termination of parental
1.13 rights; appropriating money; amending Minnesota
1.14 Statutes 2000, sections 13.46, subdivision 4; 13.461,
1.15 subdivision 17; 13B.06, subdivision 4; 62A.48,
1.16 subdivision 4, by adding subdivisions; 62S.01, by
1.17 adding subdivisions; 62S.26; 103I.101, subdivision 6;
1.18 103I.112; 103I.208, subdivisions 1, 2; 103I.235,
1.19 subdivision 1; 103I.525, subdivisions 2, 6, 8, 9;
1.20 103I.531, subdivisions 2, 6, 8, 9; 103I.535,
1.21 subdivisions 2, 6, 8, 9; 103I.541, subdivisions 2b, 4,
1.22 5; 103I.545; 121A.15, subdivision 6; 135A.14, by
1.23 adding a subdivision; 144.057; 144.1202, subdivision
1.24 4; 144.122; 144.1222, by adding a subdivision;
1.25 144.1464; 144.148, subdivision 2; 144.226, subdivision
1.26 4; 144.551, subdivision 1; 144.98, subdivision 3;
1.27 144A.071, subdivisions 1, 1a, 2, 4a; 144A.073,
1.28 subdivisions 2, 4; 144A.44, subdivision 1; 144A.4605,
1.29 subdivision 4; 144A.62, subdivisions 1, 2, 3, 4;
1.30 144D.03, subdivision 2; 144D.04, subdivisions 2, 3;
1.31 144D.06; 145.881, subdivision 2; 145.882, subdivision
1.32 7, by adding a subdivision; 145.885, subdivision 2;
1.33 145.924; 145.925, subdivisions 1, 1a; 145A.15,
1.34 subdivision 1, by adding a subdivision; 145A.16,
1.35 subdivision 1, by adding a subdivision; 148.212;
1.36 148B.21, subdivision 6a; 148B.22, subdivision 3;
1.37 157.16, subdivision 3; 157.22; 214.104; 245.462,
1.38 subdivisions 8, 18, by adding a subdivision; 245.4871,
1.39 subdivisions 10, 27; 245.4876, subdivision 1, by
1.40 adding a subdivision; 245.4885, subdivision 1;
1.41 245.4886, subdivision 1; 245.99, subdivision 4;
1.42 245A.03, subdivision 2b; 245A.04, subdivisions 3, 3a,
1.43 3b, 3c, 3d; 245A.05; 245A.06; 245A.07; 245A.08;
1.44 245A.13, subdivisions 7, 8; 245A.14, by adding a
1.45 subdivision; 245A.16, subdivision 1; 245B.08,
1.46 subdivision 3; 246.57, by adding a subdivision;
2.1 252.275, subdivision 4b; 252A.02, subdivisions 12, 13,
2.2 by adding a subdivision; 252A.111, subdivision 6;
2.3 252A.16, subdivision 1; 252A.19, subdivision 2;
2.4 252A.20, subdivision 1; 254B.02, subdivision 3;
2.5 254B.03, subdivision 1; 254B.04, subdivision 1;
2.6 254B.09, by adding a subdivision; 256.01, subdivisions
2.7 2, 18, by adding a subdivision; 256.045, subdivisions
2.8 3, 3b, 4; 256.476, subdivisions 1, 2, 3, 4, 5, 8;
2.9 256.482, subdivision 8; 256.955, subdivision 2b;
2.10 256.9657, subdivision 2; 256.969, subdivisions 2b, 3a,
2.11 by adding a subdivision; 256.973, by adding a
2.12 subdivision; 256.975, by adding subdivisions; 256B.04,
2.13 by adding a subdivision; 256B.055, subdivision 3a;
2.14 256B.056, subdivisions 1a, 3, 4, 5; 256B.057,
2.15 subdivision 9, by adding a subdivision; 256B.0625,
2.16 subdivisions 3b, 7, 13, 13a, 17, 17a, 18a, 19a, 19c,
2.17 20, 30, 34, by adding subdivisions; 256B.0627,
2.18 subdivisions 1, 2, 4, 5, 7, 8, 10, 11, by adding
2.19 subdivisions; 256B.0635, subdivisions 1, 2; 256B.0911,
2.20 subdivisions 1, 3, 5, 6, 7, by adding subdivisions;
2.21 256B.0913, subdivisions 1, 2, 4, 5, 6, 7, 8, 9, 10,
2.22 11, 12, 13, 14; 256B.0915, subdivisions 1d, 3, 5;
2.23 256B.0916, subdivisions 1, 7, 9, by adding a
2.24 subdivision; 256B.0917, subdivision 7; 256B.092,
2.25 subdivisions 2a, 5; 256B.093, subdivision 3; 256B.095;
2.26 256B.0951, subdivisions 1, 3, 4, 5, 7, by adding
2.27 subdivisions; 256B.0952, subdivisions 1, 4; 256B.431,
2.28 subdivision 17, by adding subdivisions; 256B.434,
2.29 subdivision 4, by adding subdivisions; 256B.49, by
2.30 adding subdivisions; 256B.501, by adding a
2.31 subdivision; 256B.69, subdivisions 4, 5, 5b, 23, by
2.32 adding a subdivision; 256B.75; 256B.76; 256D.03,
2.33 subdivisions 3, 4; 256D.35, by adding subdivisions;
2.34 256D.44, subdivision 5; 256I.05, subdivision 1e;
2.35 256J.09, subdivisions 1, 2, 3, by adding subdivisions;
2.36 256J.15, by adding a subdivision; 256J.24, subdivision
2.37 10; 256J.26, subdivision 1; 256J.31, subdivisions 4,
2.38 12; 256J.32, subdivision 7a; 256J.42, by adding a
2.39 subdivision; 256J.45, subdivision 1; 256J.46,
2.40 subdivisions 1, 2a, by adding a subdivision; 256J.50,
2.41 subdivisions 1, 7; 256J.56; 256J.57, subdivision 2;
2.42 256J.62, subdivision 9; 256J.625, subdivisions 1, 2,
2.43 4; 256J.751; 256K.03, subdivision 1; 256K.07; 256K.25,
2.44 subdivisions 1, 3, 4, 5, 6; 256L.06, subdivision 3;
2.45 256L.12, subdivision 9, by adding a subdivision;
2.46 256L.16; 260C.301, by adding subdivisions; 260C.307,
2.47 subdivision 3; 260C.317, by adding a subdivision;
2.48 261.062; 268.0122, subdivision 2; 626.556,
2.49 subdivisions 3, 3c, 10, 10b, 10d, 10e, 10f, 10i, 11,
2.50 12, by adding subdivisions; 626.557, subdivisions 3,
2.51 9d; 626.5572, subdivision 17; 626.559, subdivision 2;
2.52 Laws 1995, chapter 178, article 2, section 36; Laws
2.53 1995, chapter 207, article 3, section 21, as amended;
2.54 Laws 1997, chapter 203, article 9, section 21, as
2.55 amended; Laws 1999, chapter 152, sections 1, 4; Laws
2.56 1999, chapter 245, article 3, section 45, as amended;
2.57 Laws 1999, chapter 245, article 4, section 110;
2.58 proposing coding for new law in Minnesota Statutes,
2.59 chapters 62S; 144; 144A; 145; 145A; 246; 256; 256B;
2.60 256I; 256J; 260; 299A; 325F; repealing Minnesota
2.61 Statutes 2000, sections 144.0721, subdivision 1;
2.62 144.148, subdivision 8; 145.882, subdivisions 3, 4;
2.63 145.9245; 145.927; 252A.111, subdivision 3; 256.476,
2.64 subdivision 7; 256B.037, subdivision 5; 256B.0635,
2.65 subdivision 3; 256B.0911, subdivisions 2, 2a, 4, 8, 9;
2.66 256B.0912; 256B.0913, subdivisions 3, 15a, 15b, 15c,
2.67 16; 256B.0915, subdivisions 3a, 3b, 3c; 256B.0951,
2.68 subdivision 6; 256B.434, subdivision 5; 256B.49,
2.69 subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10; 256E.06,
2.70 subdivision 2b; 256J.42, subdivision 4; 256J.44;
2.71 256J.46, subdivision 1a; Laws 1995, chapter 178,
3.1 article 2, section 48, subdivision 6; Minnesota Rules,
3.2 parts 9505.2390; 9505.2395; 9505.2396; 9505.2400;
3.3 9505.2405; 9505.2410; 9505.2413; 9505.2415; 9505.2420;
3.4 9505.2425; 9505.2426; 9505.2430; 9505.2435; 9505.2440;
3.5 9505.2445; 9505.2450; 9505.2455; 9505.2458; 9505.2460;
3.6 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480;
3.7 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496;
3.8 9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025;
3.9 9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085;
3.10 9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530;
3.11 9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560;
3.12 9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600;
3.13 9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626;
3.14 9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650;
3.15 9505.3660; 9505.3670.
3.16 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
3.17 ARTICLE 1
3.18 HEALTH DEPARTMENT
3.19 Section 1. Minnesota Statutes 2000, section 103I.101,
3.20 subdivision 6, is amended to read:
3.21 Subd. 6. [FEES FOR VARIANCES.] The commissioner shall
3.22 charge a nonrefundable application fee of $120 $150 to cover the
3.23 administrative cost of processing a request for a variance or
3.24 modification of rules adopted by the commissioner under this
3.25 chapter.
3.26 Sec. 2. Minnesota Statutes 2000, section 103I.112, is
3.27 amended to read:
3.28 103I.112 [FEE EXEMPTIONS FOR STATE AND LOCAL GOVERNMENT.]
3.29 (a) The commissioner of health may not charge fees required
3.30 under this chapter to a federal agency, state agency, or a local
3.31 unit of government or to a subcontractor performing work for the
3.32 state agency or local unit of government.
3.33 (b) "Local unit of government" means a statutory or home
3.34 rule charter city, town, county, or soil and water conservation
3.35 district, watershed district, an organization formed for the
3.36 joint exercise of powers under section 471.59, a board of health
3.37 or community health board, or other special purpose district or
3.38 authority with local jurisdiction in water and related land
3.39 resources management.
3.40 Sec. 3. Minnesota Statutes 2000, section 103I.208,
3.41 subdivision 1, is amended to read:
3.42 Subdivision 1. [WELL NOTIFICATION FEE.] The well
3.43 notification fee to be paid by a property owner is:
4.1 (1) for a new well, $120 $150, which includes the state
4.2 core function fee;
4.3 (2) for a well sealing, $20 $30 for each well, which
4.4 includes the state core function fee, except that for monitoring
4.5 wells constructed on a single property, having depths within a
4.6 25 foot range, and sealed within 48 hours of start of
4.7 construction, a single fee of $20 $30; and
4.8 (3) for construction of a dewatering well, $120 $150, which
4.9 includes the state core function fee, for each well except a
4.10 dewatering project comprising five or more wells shall be
4.11 assessed a single fee of $600 $750 for the wells recorded on the
4.12 notification.
4.13 Sec. 4. Minnesota Statutes 2000, section 103I.208,
4.14 subdivision 2, is amended to read:
4.15 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a
4.16 property owner is:
4.17 (1) for a well that is not in use under a maintenance
4.18 permit, $100 $125 annually;
4.19 (2) for construction of a monitoring well, $120 $150, which
4.20 includes the state core function fee;
4.21 (3) for a monitoring well that is unsealed under a
4.22 maintenance permit, $100 $125 annually;
4.23 (4) for monitoring wells used as a leak detection device at
4.24 a single motor fuel retail outlet, a single petroleum bulk
4.25 storage site excluding tank farms, or a single agricultural
4.26 chemical facility site, the construction permit fee
4.27 is $120 $150, which includes the state core function fee, per
4.28 site regardless of the number of wells constructed on the site,
4.29 and the annual fee for a maintenance permit for unsealed
4.30 monitoring wells is $100 $125 per site regardless of the number
4.31 of monitoring wells located on site;
4.32 (5) for a groundwater thermal exchange device, in addition
4.33 to the notification fee for wells, $120 $150, which includes the
4.34 state core function fee;
4.35 (6) for a vertical heat exchanger, $120 $150;
4.36 (7) for a dewatering well that is unsealed under a
5.1 maintenance permit, $100 $125 annually for each well, except a
5.2 dewatering project comprising more than five wells shall be
5.3 issued a single permit for $500 $625 annually for wells recorded
5.4 on the permit; and
5.5 (8) for excavating holes for the purpose of installing
5.6 elevator shafts, $120 $150 for each hole.
5.7 Sec. 5. Minnesota Statutes 2000, section 103I.235,
5.8 subdivision 1, is amended to read:
5.9 Subdivision 1. [DISCLOSURE OF WELLS TO BUYER.] (a) Before
5.10 signing an agreement to sell or transfer real property, the
5.11 seller must disclose in writing to the buyer information about
5.12 the status and location of all known wells on the property, by
5.13 delivering to the buyer either a statement by the seller that
5.14 the seller does not know of any wells on the property, or a
5.15 disclosure statement indicating the legal description and
5.16 county, and a map drawn from available information showing the
5.17 location of each well to the extent practicable. In the
5.18 disclosure statement, the seller must indicate, for each well,
5.19 whether the well is in use, not in use, or sealed.
5.20 (b) At the time of closing of the sale, the disclosure
5.21 statement information, name and mailing address of the buyer,
5.22 and the quartile, section, township, and range in which each
5.23 well is located must be provided on a well disclosure
5.24 certificate signed by the seller or a person authorized to act
5.25 on behalf of the seller.
5.26 (c) A well disclosure certificate need not be provided if
5.27 the seller does not know of any wells on the property and the
5.28 deed or other instrument of conveyance contains the statement:
5.29 "The Seller certifies that the Seller does not know of any wells
5.30 on the described real property."
5.31 (d) If a deed is given pursuant to a contract for deed, the
5.32 well disclosure certificate required by this subdivision shall
5.33 be signed by the buyer or a person authorized to act on behalf
5.34 of the buyer. If the buyer knows of no wells on the property, a
5.35 well disclosure certificate is not required if the following
5.36 statement appears on the deed followed by the signature of the
6.1 grantee or, if there is more than one grantee, the signature of
6.2 at least one of the grantees: "The Grantee certifies that the
6.3 Grantee does not know of any wells on the described real
6.4 property." The statement and signature of the grantee may be on
6.5 the front or back of the deed or on an attached sheet and an
6.6 acknowledgment of the statement by the grantee is not required
6.7 for the deed to be recordable.
6.8 (e) This subdivision does not apply to the sale, exchange,
6.9 or transfer of real property:
6.10 (1) that consists solely of a sale or transfer of severed
6.11 mineral interests; or
6.12 (2) that consists of an individual condominium unit as
6.13 described in chapters 515 and 515B.
6.14 (f) For an area owned in common under chapter 515 or 515B
6.15 the association or other responsible person must report to the
6.16 commissioner by July 1, 1992, the location and status of all
6.17 wells in the common area. The association or other responsible
6.18 person must notify the commissioner within 30 days of any change
6.19 in the reported status of wells.
6.20 (g) For real property sold by the state under section
6.21 92.67, the lessee at the time of the sale is responsible for
6.22 compliance with this subdivision.
6.23 (h) If the seller fails to provide a required well
6.24 disclosure certificate, the buyer, or a person authorized to act
6.25 on behalf of the buyer, may sign a well disclosure certificate
6.26 based on the information provided on the disclosure statement
6.27 required by this section or based on other available information.
6.28 (i) A county recorder or registrar of titles may not record
6.29 a deed or other instrument of conveyance dated after October 31,
6.30 1990, for which a certificate of value is required under section
6.31 272.115, or any deed or other instrument of conveyance dated
6.32 after October 31, 1990, from a governmental body exempt from the
6.33 payment of state deed tax, unless the deed or other instrument
6.34 of conveyance contains the statement made in accordance with
6.35 paragraph (c) or (d) or is accompanied by the well disclosure
6.36 certificate containing all the information required by paragraph
7.1 (b) or (d). The county recorder or registrar of titles must not
7.2 accept a certificate unless it contains all the required
7.3 information. The county recorder or registrar of titles shall
7.4 note on each deed or other instrument of conveyance accompanied
7.5 by a well disclosure certificate that the well disclosure
7.6 certificate was received. The notation must include the
7.7 statement "No wells on property" if the disclosure certificate
7.8 states there are no wells on the property. The well disclosure
7.9 certificate shall not be filed or recorded in the records
7.10 maintained by the county recorder or registrar of titles. After
7.11 noting "No wells on property" on the deed or other instrument of
7.12 conveyance, the county recorder or registrar of titles shall
7.13 destroy or return to the buyer the well disclosure certificate.
7.14 The county recorder or registrar of titles shall collect from
7.15 the buyer or the person seeking to record a deed or other
7.16 instrument of conveyance, a fee of $20 $30 for receipt of a
7.17 completed well disclosure certificate. By the tenth day of each
7.18 month, the county recorder or registrar of titles shall transmit
7.19 the well disclosure certificates to the commissioner of health.
7.20 By the tenth day after the end of each calendar quarter, the
7.21 county recorder or registrar of titles shall transmit to the
7.22 commissioner of health $17.50 $27.50 of the fee for each well
7.23 disclosure certificate received during the quarter. The
7.24 commissioner shall maintain the well disclosure certificate for
7.25 at least six years. The commissioner may store the certificate
7.26 as an electronic image. A copy of that image shall be as valid
7.27 as the original.
7.28 (j) No new well disclosure certificate is required under
7.29 this subdivision if the buyer or seller, or a person authorized
7.30 to act on behalf of the buyer or seller, certifies on the deed
7.31 or other instrument of conveyance that the status and number of
7.32 wells on the property have not changed since the last previously
7.33 filed well disclosure certificate. The following statement, if
7.34 followed by the signature of the person making the statement, is
7.35 sufficient to comply with the certification requirement of this
7.36 paragraph: "I am familiar with the property described in this
8.1 instrument and I certify that the status and number of wells on
8.2 the described real property have not changed since the last
8.3 previously filed well disclosure certificate." The
8.4 certification and signature may be on the front or back of the
8.5 deed or on an attached sheet and an acknowledgment of the
8.6 statement is not required for the deed or other instrument of
8.7 conveyance to be recordable.
8.8 (k) The commissioner in consultation with county recorders
8.9 shall prescribe the form for a well disclosure certificate and
8.10 provide well disclosure certificate forms to county recorders
8.11 and registrars of titles and other interested persons.
8.12 (l) Failure to comply with a requirement of this
8.13 subdivision does not impair:
8.14 (1) the validity of a deed or other instrument of
8.15 conveyance as between the parties to the deed or instrument or
8.16 as to any other person who otherwise would be bound by the deed
8.17 or instrument; or
8.18 (2) the record, as notice, of any deed or other instrument
8.19 of conveyance accepted for filing or recording contrary to the
8.20 provisions of this subdivision.
8.21 Sec. 6. Minnesota Statutes 2000, section 103I.525,
8.22 subdivision 2, is amended to read:
8.23 Subd. 2. [APPLICATION FEE.] The application fee for a well
8.24 contractor's license is $50 $75. The commissioner may not act
8.25 on an application until the application fee is paid.
8.26 Sec. 7. Minnesota Statutes 2000, section 103I.525,
8.27 subdivision 6, is amended to read:
8.28 Subd. 6. [LICENSE FEE.] The fee for a well contractor's
8.29 license is $250, except the fee for an individual well
8.30 contractor's license is $50 $75.
8.31 Sec. 8. Minnesota Statutes 2000, section 103I.525,
8.32 subdivision 8, is amended to read:
8.33 Subd. 8. [RENEWAL.] (a) A licensee must file an
8.34 application and a renewal application fee to renew the license
8.35 by the date stated in the license.
8.36 (b) The renewal application fee shall be set by the
9.1 commissioner under section 16A.1285 for a well contractor's
9.2 license is $250.
9.3 (c) The renewal application must include information that
9.4 the applicant has met continuing education requirements
9.5 established by the commissioner by rule.
9.6 (d) At the time of the renewal, the commissioner must have
9.7 on file all properly completed well reports, well sealing
9.8 reports, reports of excavations to construct elevator shafts,
9.9 well permits, and well notifications for work conducted by the
9.10 licensee since the last license renewal.
9.11 Sec. 9. Minnesota Statutes 2000, section 103I.525,
9.12 subdivision 9, is amended to read:
9.13 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails
9.14 to submit all information required for renewal in subdivision 8
9.15 or submits the application and information after the required
9.16 renewal date:
9.17 (1) the licensee must include an additional a late fee set
9.18 by the commissioner of $75; and
9.19 (2) the licensee may not conduct activities authorized by
9.20 the well contractor's license until the renewal application,
9.21 renewal application fee, late fee, and all other information
9.22 required in subdivision 8 are submitted.
9.23 Sec. 10. Minnesota Statutes 2000, section 103I.531,
9.24 subdivision 2, is amended to read:
9.25 Subd. 2. [APPLICATION FEE.] The application fee for a
9.26 limited well/boring contractor's license is $50 $75. The
9.27 commissioner may not act on an application until the application
9.28 fee is paid.
9.29 Sec. 11. Minnesota Statutes 2000, section 103I.531,
9.30 subdivision 6, is amended to read:
9.31 Subd. 6. [LICENSE FEE.] The fee for a limited well/boring
9.32 contractor's license is $50 $75.
9.33 Sec. 12. Minnesota Statutes 2000, section 103I.531,
9.34 subdivision 8, is amended to read:
9.35 Subd. 8. [RENEWAL.] (a) A person must file an application
9.36 and a renewal application fee to renew the limited well/boring
10.1 contractor's license by the date stated in the license.
10.2 (b) The renewal application fee shall be set by the
10.3 commissioner under section 16A.1285 for a limited well/boring
10.4 contractor's license is $75.
10.5 (c) The renewal application must include information that
10.6 the applicant has met continuing education requirements
10.7 established by the commissioner by rule.
10.8 (d) At the time of the renewal, the commissioner must have
10.9 on file all properly completed well sealing reports, well
10.10 permits, vertical heat exchanger permits, and well notifications
10.11 for work conducted by the licensee since the last license
10.12 renewal.
10.13 Sec. 13. Minnesota Statutes 2000, section 103I.531,
10.14 subdivision 9, is amended to read:
10.15 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails
10.16 to submit all information required for renewal in subdivision 8
10.17 or submits the application and information after the required
10.18 renewal date:
10.19 (1) the licensee must include an additional a late fee set
10.20 by the commissioner of $75; and
10.21 (2) the licensee may not conduct activities authorized by
10.22 the limited well/boring contractor's license until the renewal
10.23 application, renewal application fee, and late fee, and all
10.24 other information required in subdivision 8 are submitted.
10.25 Sec. 14. Minnesota Statutes 2000, section 103I.535,
10.26 subdivision 2, is amended to read:
10.27 Subd. 2. [APPLICATION FEE.] The application fee for an
10.28 elevator shaft contractor's license is $50 $75. The
10.29 commissioner may not act on an application until the application
10.30 fee is paid.
10.31 Sec. 15. Minnesota Statutes 2000, section 103I.535,
10.32 subdivision 6, is amended to read:
10.33 Subd. 6. [LICENSE FEE.] The fee for an elevator shaft
10.34 contractor's license is $50 $75.
10.35 Sec. 16. Minnesota Statutes 2000, section 103I.535,
10.36 subdivision 8, is amended to read:
11.1 Subd. 8. [RENEWAL.] (a) A person must file an application
11.2 and a renewal application fee to renew the license by the date
11.3 stated in the license.
11.4 (b) The renewal application fee shall be set by the
11.5 commissioner under section 16A.1285 for an elevator shaft
11.6 contractor's license is $75.
11.7 (c) The renewal application must include information that
11.8 the applicant has met continuing education requirements
11.9 established by the commissioner by rule.
11.10 (d) At the time of renewal, the commissioner must have on
11.11 file all reports and permits for elevator shaft work conducted
11.12 by the licensee since the last license renewal.
11.13 Sec. 17. Minnesota Statutes 2000, section 103I.535,
11.14 subdivision 9, is amended to read:
11.15 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails
11.16 to submit all information required for renewal in subdivision 8
11.17 or submits the application and information after the required
11.18 renewal date:
11.19 (1) the licensee must include an additional a late fee set
11.20 by the commissioner of $75; and
11.21 (2) the licensee may not conduct activities authorized by
11.22 the elevator shaft contractor's license until the renewal
11.23 application, renewal application fee, and late fee, and all
11.24 other information required in subdivision 8 are submitted.
11.25 Sec. 18. Minnesota Statutes 2000, section 103I.541,
11.26 subdivision 2b, is amended to read:
11.27 Subd. 2b. [APPLICATION FEE.] The application fee for a
11.28 monitoring well contractor registration is $50 $75. The
11.29 commissioner may not act on an application until the application
11.30 fee is paid.
11.31 Sec. 19. Minnesota Statutes 2000, section 103I.541,
11.32 subdivision 4, is amended to read:
11.33 Subd. 4. [RENEWAL.] (a) A person must file an application
11.34 and a renewal application fee to renew the registration by the
11.35 date stated in the registration.
11.36 (b) The renewal application fee shall be set by the
12.1 commissioner under section 16A.1285 for a monitoring well
12.2 contractor's registration is $75.
12.3 (c) The renewal application must include information that
12.4 the applicant has met continuing education requirements
12.5 established by the commissioner by rule.
12.6 (d) At the time of the renewal, the commissioner must have
12.7 on file all well reports, well sealing reports, well permits,
12.8 and notifications for work conducted by the registered person
12.9 since the last registration renewal.
12.10 Sec. 20. Minnesota Statutes 2000, section 103I.541,
12.11 subdivision 5, is amended to read:
12.12 Subd. 5. [INCOMPLETE OR LATE RENEWAL.] If a registered
12.13 person submits a renewal application after the required renewal
12.14 date:
12.15 (1) the registered person must include an additional a late
12.16 fee set by the commissioner of $75; and
12.17 (2) the registered person may not conduct activities
12.18 authorized by the monitoring well contractor's registration
12.19 until the renewal application, renewal application fee, late
12.20 fee, and all other information required in subdivision 4 are
12.21 submitted.
12.22 Sec. 21. Minnesota Statutes 2000, section 103I.545, is
12.23 amended to read:
12.24 103I.545 [REGISTRATION OF DRILLING MACHINES REQUIRED.]
12.25 Subdivision 1. [DRILLING MACHINE.] (a) A person may not
12.26 use a drilling machine such as a cable tool, rotary tool, hollow
12.27 rod tool, or auger for a drilling activity requiring a license
12.28 or registration under this chapter unless the drilling machine
12.29 is registered with the commissioner.
12.30 (b) A person must apply for the registration on forms
12.31 prescribed by the commissioner and submit a $50 $75 registration
12.32 fee.
12.33 (c) A registration is valid for one year.
12.34 Subd. 2. [PUMP HOIST.] (a) A person may not use a machine
12.35 such as a pump hoist for an activity requiring a license or
12.36 registration under this chapter to repair wells or borings, seal
13.1 wells or borings, or install pumps unless the machine is
13.2 registered with the commissioner.
13.3 (b) A person must apply for the registration on forms
13.4 prescribed by the commissioner and submit a $50 $75 registration
13.5 fee.
13.6 (c) A registration is valid for one year.
13.7 [EFFECTIVE DATE.] This section is effective July 1, 2002.
13.8 Sec. 22. Minnesota Statutes 2000, section 121A.15,
13.9 subdivision 6, is amended to read:
13.10 Subd. 6. [SUSPENSION OF IMMUNIZATION REQUIREMENT;
13.11 MODIFICATION TO SCHEDULE.] (a) The commissioner of health, on
13.12 finding that an immunization required pursuant to this section
13.13 is not necessary to protect the public's health, may suspend for
13.14 one year the requirement that children receive that immunization.
13.15 (b) During portions of the year in which the legislature is
13.16 not meeting in regular or special session, the commissioner of
13.17 health may modify the immunization requirements of this section.
13.18 A modification made under this paragraph must be part of the
13.19 current immunization recommendations of each of the following
13.20 organizations: the United States Public Health Service's
13.21 Advisory Committee on Immunization Practices, the American
13.22 Academy of Family Physicians, and the American Academy of
13.23 Pediatrics. The commissioner shall modify the immunization
13.24 requirements through rulemaking using the expedited process in
13.25 section 14.389. A rule adopted under this paragraph shall be in
13.26 effect until the adjournment of the next regular legislative
13.27 session held after the rule is adopted. The commissioner shall
13.28 report to the legislature on any rules adopted under this
13.29 paragraph during the previous calendar year. Such reports are
13.30 due by January 15 of the year following the calendar year in
13.31 which the rule is adopted, except that if a rule is adopted in
13.32 January, a report on that rule is due by February 15 of that
13.33 year.
13.34 Sec. 23. Minnesota Statutes 2000, section 135A.14, is
13.35 amended by adding a subdivision to read:
13.36 Subd. 7. [MODIFICATIONS TO SCHEDULE.] During portions of
14.1 the year in which the legislature is not meeting in regular or
14.2 special session, the commissioner of health may modify the
14.3 immunization requirements of this section. A modification made
14.4 under this subdivision must be part of the current immunization
14.5 recommendations of each of the following organizations: the
14.6 United States Public Health Service's Advisory Committee on
14.7 Immunization Practices, the American Academy of Family
14.8 Physicians, and the American Academy of Pediatrics. The
14.9 commissioner shall modify the immunization requirements through
14.10 rulemaking using the expedited process in section 14.389. A
14.11 rule adopted under this subdivision shall be in effect until the
14.12 adjournment of the next regular legislative session held after
14.13 the rule is adopted. The commissioner shall report to the
14.14 legislature on any rules adopted under this subdivision during
14.15 the previous calendar year. Such reports are due by January 15
14.16 of the year following the calendar year in which the rule is
14.17 adopted, except that if a rule is adopted in January, a report
14.18 on that rule is due by February 15 of that year.
14.19 Sec. 24. [144.0751] [HEALTH STANDARDS.]
14.20 When establishing or revising safe drinking water or air
14.21 quality standards, the commissioner shall take into account only
14.22 peer-reviewed, scientifically acceptable information which
14.23 includes a reasonable margin of safety in setting the standards
14.24 to adequately protect the health of infants, children, and
14.25 adults by taking into consideration each of the following
14.26 specific risks:
14.27 (1) reproductive development and function;
14.28 (2) respiratory function;
14.29 (3) immunologic suppression or hypersensitization;
14.30 (4) development of the brain and nervous system;
14.31 (5) endocrine (hormonal) function;
14.32 (6) cancer;
14.33 (7) general infant and child development; and
14.34 (8) any other important health outcomes identified by the
14.35 commissioner.
14.36 Sec. 25. Minnesota Statutes 2000, section 144.1202,
15.1 subdivision 4, is amended to read:
15.2 Subd. 4. [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An
15.3 agreement entered into before August 2, 2002 2003, must remain
15.4 in effect until terminated under the Atomic Energy Act of 1954,
15.5 United States Code, title 42, section 2021, paragraph (j). The
15.6 governor may not enter into an initial agreement with the
15.7 Nuclear Regulatory Commission after August 1, 2002 2003. If an
15.8 agreement is not entered into by August 1, 2002 2003, any rules
15.9 adopted under this section are repealed effective August 1, 2002
15.10 2003.
15.11 (b) An agreement authorized under subdivision 1 must be
15.12 approved by law before it may be implemented.
15.13 Sec. 26. [144.1205] [RADIOACTIVE MATERIAL; SOURCE AND
15.14 SPECIAL NUCLEAR MATERIAL; FEES; INSPECTION.]
15.15 Subdivision 1. [APPLICATION AND LICENSE RENEWAL FEE.] When
15.16 a license is required for radioactive material or source or
15.17 special nuclear material by a rule adopted under section
15.18 144.1202, subdivision 2, an application fee according to
15.19 subdivision 4 must be paid upon initial application for a
15.20 license. The licensee must renew the license 60 days before the
15.21 expiration date of the license by paying a license renewal fee
15.22 equal to the application fee under subdivision 4. The
15.23 expiration date of a license is the date set by the United
15.24 States Nuclear Regulatory Commission before transfer of the
15.25 licensing program under section 144.1202 and thereafter as
15.26 specified by rule of the commissioner of health.
15.27 Subd. 2. [ANNUAL FEE.] A licensee must pay an annual fee
15.28 at least 60 days before the anniversary date of the issuance of
15.29 the license. The annual fee is an amount equal to 80 percent of
15.30 the application fee under subdivision 4, rounded to the nearest
15.31 whole dollar.
15.32 Subd. 3. [FEE CATEGORIES; INCORPORATION OF FEDERAL
15.33 LICENSING CATEGORIES.] (a) Fee categories under this section are
15.34 equivalent to the licensing categories used by the United States
15.35 Nuclear Regulatory Commission under Code of Federal Regulations,
15.36 title 10, parts 30 to 36, 39, 40, 70, 71, and 150, except as
16.1 provided in paragraph (b).
16.2 (b) The category of "Academic, small" is the type of
16.3 license required for the use of radioactive materials in a
16.4 teaching institution. Radioactive materials are limited to ten
16.5 radionuclides not to exceed a total activity amount of one curie.
16.6 Subd. 4. [APPLICATION FEE.] A licensee must pay an
16.7 application fee as follows:
16.8 Radioactive material, Application U.S. Nuclear Regulatory
16.9 source and fee Commission licensing
16.10 special material category as reference
16.12 Type A broadscope $20,000 Medical institution type A
16.13 Type B broadscope $15,000 Research and development
16.14 type B
16.15 Type C broadscope $10,000 Academic type C
16.16 Medical use $4,000 Medical
16.17 Medical institution
16.18 Medical private practice
16.19 Mobile nuclear
16.20 medical laboratory $4,000 Mobile medical laboratory
16.21 Medical special use
16.22 sealed sources $6,000 Teletherapy
16.23 High dose rate remote
16.24 afterloaders
16.25 Stereotactic
16.26 radiosurgery devices
16.27 In vitro testing $2,300 In vitro testing
16.28 laboratories
16.29 Measuring gauge,
16.30 sealed sources $2,000 Fixed gauges
16.31 Portable gauges
16.32 Analytical instruments
16.33 Measuring systems - other
16.34 Gas chromatographs $1,200 Gas chromatographs
16.35 Manufacturing and
16.36 distribution $14,700 Manufacturing and
17.1 distribution - other
17.2 Distribution only $8,800 Distribution of
17.3 radioactive material
17.4 for commercial use only
17.5 Other services $1,500 Other services
17.6 Nuclear medicine
17.7 pharmacy $4,100 Nuclear pharmacy
17.8 Waste disposal $9,400 Waste disposal service
17.9 prepackage
17.10 Waste disposal service
17.11 processing/repackage
17.12 Waste storage only $7,000 To receive and store
17.13 radioactive material waste
17.14 Industrial
17.15 radiography $8,400 Industrial radiography
17.16 fixed location
17.17 Industrial radiography
17.18 portable/temporary sites
17.19 Irradiator -
17.20 self-shielded $4,100 Irradiators self-shielded
17.21 less than 10,000 curies
17.22 Irradiator -
17.23 less than 10,000 Ci $7,500 Irradiators less than
17.24 10,000 curies
17.25 Irradiator -
17.26 more than 10,000 Ci $11,500 Irradiators greater than
17.27 10,000 curies
17.28 Research and
17.29 development,
17.30 no distribution $4,100 Research and development
17.31 Radioactive material
17.32 possession only $1,000 By-product possession only
17.33 Source material $1,000 Source material shielding
17.34 Special nuclear
17.35 material, less than
17.36 200 grams $1,000 Special nuclear material
18.1 plutonium-neutron sources
18.2 less than 200 grams
18.3 Pacemaker
18.4 manufacturing $1,000 Pacemaker by-product
18.5 and/or special nuclear
18.6 material - medical
18.7 institution
18.8 General license
18.9 distribution $2,100 General license
18.10 distribution
18.11 General license
18.12 distribution, exempt $1,500 General license
18.13 distribution -
18.14 certain exempt items
18.15 Academic, small $1,000 Possession limit of ten
18.16 radionuclides, not to
18.17 exceed a total of one curie
18.18 of activity
18.19 Veterinary $2,000 Veterinary use
18.20 Well logging $5,000 Well logging
18.21 Subd. 5. [PENALTY FOR LATE PAYMENT.] An annual fee or a
18.22 license renewal fee submitted to the commissioner after the due
18.23 date specified by rule must be accompanied by an additional
18.24 amount equal to 25 percent of the fee due.
18.25 Subd. 6. [INSPECTIONS.] The commissioner of health shall
18.26 make periodic safety inspections of the radioactive material and
18.27 source and special nuclear material of a licensee. The
18.28 commissioner shall prescribe the frequency of safety inspections
18.29 by rule.
18.30 Subd. 7. [RECOVERY OF REINSPECTION COST.] If the
18.31 commissioner finds serious violations of public health standards
18.32 during an inspection under subdivision 6, the licensee must pay
18.33 all costs associated with subsequent reinspection of the
18.34 source. The costs shall be the actual costs incurred by the
18.35 commissioner and include, but are not limited to, labor,
18.36 transportation, per diem, materials, legal fees, testing, and
19.1 monitoring costs.
19.2 Subd. 8. [RECIPROCITY FEE.] A licensee submitting an
19.3 application for reciprocal recognition of a materials license
19.4 issued by another agreement state or the United States Nuclear
19.5 Regulatory Commission for a period of 180 days or less during a
19.6 calendar year must pay one-half of the application fee specified
19.7 under subdivision 4. For a period of 181 days or more, the
19.8 licensee must pay the entire application fee under subdivision 4.
19.9 Subd. 9. [FEES FOR LICENSE AMENDMENTS.] A licensee must
19.10 pay a fee to amend a license as follows:
19.11 (1) to amend a license requiring no license review
19.12 including, but not limited to, facility name change or removal
19.13 of a previously authorized user, no fee;
19.14 (2) to amend a license requiring review including, but not
19.15 limited to, addition of isotopes, procedure changes, new
19.16 authorized users, or a new radiation safety officer, $200; and
19.17 (3) to amend a license requiring review and a site visit
19.18 including, but not limited to, facility move or addition of
19.19 processes, $400.
19.20 [EFFECTIVE DATE.] This section is effective July 1, 2002.
19.21 Sec. 27. Minnesota Statutes 2000, section 144.122, is
19.22 amended to read:
19.23 144.122 [LICENSE, PERMIT, AND SURVEY FEES.]
19.24 (a) The state commissioner of health, by rule, may
19.25 prescribe reasonable procedures and fees for filing with the
19.26 commissioner as prescribed by statute and for the issuance of
19.27 original and renewal permits, licenses, registrations, and
19.28 certifications issued under authority of the commissioner. The
19.29 expiration dates of the various licenses, permits,
19.30 registrations, and certifications as prescribed by the rules
19.31 shall be plainly marked thereon. Fees may include application
19.32 and examination fees and a penalty fee for renewal applications
19.33 submitted after the expiration date of the previously issued
19.34 permit, license, registration, and certification. The
19.35 commissioner may also prescribe, by rule, reduced fees for
19.36 permits, licenses, registrations, and certifications when the
20.1 application therefor is submitted during the last three months
20.2 of the permit, license, registration, or certification period.
20.3 Fees proposed to be prescribed in the rules shall be first
20.4 approved by the department of finance. All fees proposed to be
20.5 prescribed in rules shall be reasonable. The fees shall be in
20.6 an amount so that the total fees collected by the commissioner
20.7 will, where practical, approximate the cost to the commissioner
20.8 in administering the program. All fees collected shall be
20.9 deposited in the state treasury and credited to the state
20.10 government special revenue fund unless otherwise specifically
20.11 appropriated by law for specific purposes.
20.12 (b) The commissioner may charge a fee for voluntary
20.13 certification of medical laboratories and environmental
20.14 laboratories, and for environmental and medical laboratory
20.15 services provided by the department, without complying with
20.16 paragraph (a) or chapter 14. Fees charged for environment and
20.17 medical laboratory services provided by the department must be
20.18 approximately equal to the costs of providing the services.
20.19 (c) The commissioner may develop a schedule of fees for
20.20 diagnostic evaluations conducted at clinics held by the services
20.21 for children with handicaps program. All receipts generated by
20.22 the program are annually appropriated to the commissioner for
20.23 use in the maternal and child health program.
20.24 (d) The commissioner, for fiscal years 1996 and beyond,
20.25 shall set license fees for hospitals and nursing homes that are
20.26 not boarding care homes at the following levels:
20.27 Joint Commission on Accreditation of Healthcare
20.28 Organizations (JCAHO hospitals) $1,017
20.29 $7,055
20.30 Non-JCAHO hospitals $762 plus $34 per bed
20.31 $4,680 plus $234 per bed
20.32 Nursing home $78 plus $19 per bed
20.33 $183 plus $91 per bed
20.34 For fiscal years 1996 and beyond, The commissioner shall
20.35 set license fees for outpatient surgical centers, boarding care
20.36 homes, and supervised living facilities at the following levels:
21.1 Outpatient surgical centers $517
21.2 $1,512
21.3 Boarding care homes $78 plus $19 per bed
21.4 $183 plus $91 per bed
21.5 Supervised living facilities $78 plus $19 per bed
21.6 $183 plus $91 per bed.
21.7 (e) Unless prohibited by federal law, the commissioner of
21.8 health shall charge applicants the following fees to cover the
21.9 cost of any initial certification surveys required to determine
21.10 a provider's eligibility to participate in the Medicare or
21.11 Medicaid program:
21.12 Prospective payment surveys for $ 900
21.13 hospitals
21.15 Swing bed surveys for nursing homes $1,200
21.17 Psychiatric hospitals $1,400
21.19 Rural health facilities $1,100
21.21 Portable X-ray providers $ 500
21.23 Home health agencies $1,800
21.25 Outpatient therapy agencies $ 800
21.27 End stage renal dialysis providers $2,100
21.29 Independent therapists $ 800
21.31 Comprehensive rehabilitation $1,200
21.32 outpatient facilities
21.34 Hospice providers $1,700
21.36 Ambulatory surgical providers $1,800
21.38 Hospitals $4,200
21.40 Other provider categories or Actual surveyor costs:
21.41 additional resurveys required average surveyor cost x
21.42 to complete initial certification number of hours for the
21.43 survey process.
21.44 These fees shall be submitted at the time of the
21.45 application for federal certification and shall not be
21.46 refunded. All fees collected after the date that the imposition
21.47 of fees is not prohibited by federal law shall be deposited in
21.48 the state treasury and credited to the state government special
21.49 revenue fund.
21.50 Sec. 28. Minnesota Statutes 2000, section 144.148,
21.51 subdivision 2, is amended to read:
22.1 Subd. 2. [PROGRAM.] (a) The commissioner of health shall
22.2 award rural hospital capital improvement grants to eligible
22.3 rural hospitals. Except as provided in paragraph (b), A grant
22.4 shall not exceed $300,000 per hospital. Prior to the receipt of
22.5 any grant, the hospital must certify to the commissioner that at
22.6 least one-quarter of the grant amount, which may include in-kind
22.7 services, is available for the same purposes from nonstate
22.8 resources.
22.9 (b) A grant shall not exceed $1,500,000 per eligible rural
22.10 hospital that also satisfies the following criteria:
22.11 (1) is the only hospital in a county;
22.12 (2) has 25 or fewer licensed hospital beds with a net
22.13 hospital operating margin not greater than an average of two
22.14 percent over the three fiscal years prior to application;
22.15 (3) is located in a medically underserved community (MUC)
22.16 or a health professional shortage area (HPSA);
22.17 (4) is located near a migrant worker employment site and
22.18 regularly treats significant numbers of migrant workers and
22.19 their families; and
22.20 (5) has not previously received a grant under this section
22.21 prior to July 1, 1999.
22.22 Sec. 29. Minnesota Statutes 2000, section 144.226,
22.23 subdivision 4, is amended to read:
22.24 Subd. 4. [VITAL RECORDS SURCHARGE.] In addition to any fee
22.25 prescribed under subdivision 1, there is a nonrefundable
22.26 surcharge of $3 $2 for each certified and noncertified birth or
22.27 death record, and for a certification that the record cannot be
22.28 found. The local or state registrar shall forward this amount
22.29 to the state treasurer to be deposited into the state government
22.30 special revenue fund. This surcharge shall not be charged under
22.31 those circumstances in which no fee for a birth or death record
22.32 is permitted under subdivision 1, paragraph (a). This surcharge
22.33 requirement expires June 30, 2002.
22.34 Sec. 30. Minnesota Statutes 2000, section 144.551,
22.35 subdivision 1, is amended to read:
22.36 Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.]
23.1 (a) The following construction or modification may not be
23.2 commenced:
23.3 (1) any erection, building, alteration, reconstruction,
23.4 modernization, improvement, extension, lease, or other
23.5 acquisition by or on behalf of a hospital that increases the bed
23.6 capacity of a hospital, relocates hospital beds from one
23.7 physical facility, complex, or site to another, or otherwise
23.8 results in an increase or redistribution of hospital beds within
23.9 the state; and
23.10 (2) the establishment of a new hospital.
23.11 (b) This section does not apply to:
23.12 (1) construction or relocation within a county by a
23.13 hospital, clinic, or other health care facility that is a
23.14 national referral center engaged in substantial programs of
23.15 patient care, medical research, and medical education meeting
23.16 state and national needs that receives more than 40 percent of
23.17 its patients from outside the state of Minnesota;
23.18 (2) a project for construction or modification for which a
23.19 health care facility held an approved certificate of need on May
23.20 1, 1984, regardless of the date of expiration of the
23.21 certificate;
23.22 (3) a project for which a certificate of need was denied
23.23 before July 1, 1990, if a timely appeal results in an order
23.24 reversing the denial;
23.25 (4) a project exempted from certificate of need
23.26 requirements by Laws 1981, chapter 200, section 2;
23.27 (5) a project involving consolidation of pediatric
23.28 specialty hospital services within the Minneapolis-St. Paul
23.29 metropolitan area that would not result in a net increase in the
23.30 number of pediatric specialty hospital beds among the hospitals
23.31 being consolidated;
23.32 (6) a project involving the temporary relocation of
23.33 pediatric-orthopedic hospital beds to an existing licensed
23.34 hospital that will allow for the reconstruction of a new
23.35 philanthropic, pediatric-orthopedic hospital on an existing site
23.36 and that will not result in a net increase in the number of
24.1 hospital beds. Upon completion of the reconstruction, the
24.2 licenses of both hospitals must be reinstated at the capacity
24.3 that existed on each site before the relocation;
24.4 (7) the relocation or redistribution of hospital beds
24.5 within a hospital building or identifiable complex of buildings
24.6 provided the relocation or redistribution does not result in:
24.7 (i) an increase in the overall bed capacity at that site; (ii)
24.8 relocation of hospital beds from one physical site or complex to
24.9 another; or (iii) redistribution of hospital beds within the
24.10 state or a region of the state;
24.11 (8) relocation or redistribution of hospital beds within a
24.12 hospital corporate system that involves the transfer of beds
24.13 from a closed facility site or complex to an existing site or
24.14 complex provided that: (i) no more than 50 percent of the
24.15 capacity of the closed facility is transferred; (ii) the
24.16 capacity of the site or complex to which the beds are
24.17 transferred does not increase by more than 50 percent; (iii) the
24.18 beds are not transferred outside of a federal health systems
24.19 agency boundary in place on July 1, 1983; and (iv) the
24.20 relocation or redistribution does not involve the construction
24.21 of a new hospital building;
24.22 (9) a construction project involving up to 35 new beds in a
24.23 psychiatric hospital in Rice county that primarily serves
24.24 adolescents and that receives more than 70 percent of its
24.25 patients from outside the state of Minnesota;
24.26 (10) a project to replace a hospital or hospitals with a
24.27 combined licensed capacity of 130 beds or less if: (i) the new
24.28 hospital site is located within five miles of the current site;
24.29 and (ii) the total licensed capacity of the replacement
24.30 hospital, either at the time of construction of the initial
24.31 building or as the result of future expansion, will not exceed
24.32 70 licensed hospital beds, or the combined licensed capacity of
24.33 the hospitals, whichever is less;
24.34 (11) the relocation of licensed hospital beds from an
24.35 existing state facility operated by the commissioner of human
24.36 services to a new or existing facility, building, or complex
25.1 operated by the commissioner of human services; from one
25.2 regional treatment center site to another; or from one building
25.3 or site to a new or existing building or site on the same
25.4 campus;
25.5 (12) the construction or relocation of hospital beds
25.6 operated by a hospital having a statutory obligation to provide
25.7 hospital and medical services for the indigent that does not
25.8 result in a net increase in the number of hospital beds; or
25.9 (13) a construction project involving the addition of up to
25.10 31 new beds in an existing nonfederal hospital in Beltrami
25.11 county; or
25.12 (14) a construction project involving the addition of up to
25.13 eight new beds in an existing nonfederal hospital in Otter Tail
25.14 county with 100 licensed acute care beds.
25.15 Sec. 31. [144.585] [HOSPITAL CHARITY CARE AID.]
25.16 Subdivision 1. [PURPOSE.] The purpose of charity care aid
25.17 is to help offset excess charity care burdens at Minnesota acute
25.18 care, short-term hospitals.
25.19 Subd. 2. [DEFINITIONS.] (a) For purposes of this section,
25.20 the terms in this subdivision have the meanings given to them.
25.21 (b) "Charity care" is the dollar amount of charity care
25.22 adjustments as determined under subdivision 3.
25.23 (c) "Cost-to-charge ratio" means a hospital's total
25.24 operating expenses over the sum of gross patient revenue and
25.25 other operating revenue, as reported to the commissioner of
25.26 health under rules adopted under sections 144.695 to 144.703.
25.27 The commissioner shall use the most recently available data to
25.28 calculate the cost-to-charge ratio.
25.29 Subd. 3. [CHARITY CARE REPORTING.] (a) For a hospital to
25.30 report amounts as charity care adjustments, the hospital:
25.31 (1) must generate and record a charge;
25.32 (2) have a policy on the provision of charity care and must
25.33 communicate the policy to the public;
25.34 (3) have made a reasonable effort to identify a third party
25.35 payer, encourage the patient to enroll in public programs, and
25.36 should, to the extent possible, aid the patient in the
26.1 enrollment process; and
26.2 (4) ensure that the patient meets the charity care criteria
26.3 of this subdivision, which must be consistent with statewide
26.4 income standards set out in paragraph (c).
26.5 (b) In determining whether to classify care as charity
26.6 care, the hospital must consider the following:
26.7 (1) charity care may include services which the provider is
26.8 obligated to render independently of the ability to collect;
26.9 (2) charity care may include care provided to low-income
26.10 patients who meet the charity care income standards under
26.11 paragraph (c) and have partial coverage, but are unable to pay
26.12 the remainder of their medical bills. This does not apply to
26.13 that portion of the bill which has been determined to be the
26.14 patient's responsibility after a partial charity care
26.15 classification;
26.16 (3) charity care may include care provided to low-income
26.17 patients who may qualify for a public health insurance program
26.18 and meet the statewide eligibility criteria for charity care,
26.19 but who do not complete the application process for public
26.20 insurance despite the facility's best efforts;
26.21 (4) charity care may include care to individuals whose
26.22 eligibility for charity care was determined through third party
26.23 services employed by the hospital for information gathering
26.24 purposes only;
26.25 (5) charity care may not include contractual allowances,
26.26 which is the difference between gross charges and payments
26.27 received under contractual arrangements with insurance companies
26.28 and payers;
26.29 (6) charity care may not include bad debt;
26.30 (7) charity care may not include what may be perceived as
26.31 underpayments for operating public programs;
26.32 (8) charity care may not include cases which are paid
26.33 through a charitable contribution through a third party or
26.34 facility-related foundation;
26.35 (9) charity care may not include unreimbursed costs of
26.36 basic or clinical research and of professional education and
27.1 training;
27.2 (10) charity care may not include professional courtesy
27.3 discounts;
27.4 (11) charity care may not include community service or
27.5 outreach activities; and
27.6 (12) charity care may not include services for patients
27.7 against whom collection actions where taken which result in a
27.8 credit report.
27.9 (c) The hospital must use the income standards in this
27.10 paragraph for determining charity care eligibility for reporting
27.11 purposes. The hospital does not need to make a patient asset
27.12 determination in order to apply charity care income standards.
27.13 (1) Care to a patient with a family income at or below 150
27.14 percent of the Federal Poverty Guideline (FPG) may be reported
27.15 as full charity care or free care.
27.16 (2) The hospital's share of discounted charges for care to
27.17 a patient with family income below 275 percent of the FPG
27.18 qualifies for classification as charity care. The following
27.19 sliding fee schedules apply:
27.20 income as charges paid corresponding
27.21 % of FPG by patient charity care
27.22 151-200% 20% 80%
27.23 201-225% 40% 60%
27.24 226-250% 60% 40%
27.25 251-275% 80% 20%
27.26 (3) Care to a patient is considered medical hardship when
27.27 qualified medical expenses, as defined for the purposes of
27.28 federal income tax deductibility, exceeds 30 percent of family
27.29 income. Qualified medical expenses may be counted as charity
27.30 care in the amount that exceeds 30 percent of family income.
27.31 This clause applies even if the patient's family income exceeds
27.32 the charity care income standards in clauses (1) and (2).
27.33 Subd. 4. [APPLICATION.] To be eligible for funds under
27.34 this section, hospitals must submit an application to the
27.35 commissioner of health by the deadline established by the
27.36 commissioner. Applications must meet the criteria as
28.1 established by the commissioner, but must contain:
28.2 (1) the dollar amount of charity care in the previous year,
28.3 as defined in subdivision 3, paragraphs (b) and (c);
28.4 (2) a list with the most common diagnoses for which charity
28.5 care is provided; and
28.6 (3) descriptive aggregate statistics of the characteristics
28.7 of patients who receive charity care.
28.8 Subd. 5. [ALLOCATION OF FUNDS.] A hospital's share of the
28.9 available charity care aid is equal to that hospital's share of
28.10 charity care relative to the total charity care provided by
28.11 applicants.
28.12 Sec. 32. Minnesota Statutes 2000, section 144.98,
28.13 subdivision 3, is amended to read:
28.14 Subd. 3. [FEES.] (a) An application for certification
28.15 under subdivision 1 must be accompanied by the biennial fee
28.16 specified in this subdivision. The fees are for:
28.17 (1) nonrefundable base certification fee, $500 $1,200; and
28.18 (2) test category certification fees:
28.19 Test Category Certification Fee
28.20 Clean water program bacteriology $200 $600
28.21 Safe drinking water program bacteriology $600
28.22 Clean water program inorganic chemistry,
28.23 fewer than four constituents $100 $600
28.24 Safe drinking water program inorganic chemistry,
28.25 four or more constituents $300 $600
28.26 Clean water program chemistry metals,
28.27 fewer than four constituents $200 $800
28.28 Safe drinking water program chemistry metals,
28.29 four or more constituents $500 $800
28.30 Resource conservation and recovery program
28.31 chemistry metals $800
28.32 Clean water program volatile organic compounds $600 $1,200
28.33 Safe drinking water program
28.34 volatile organic compounds $1,200
28.35 Resource conservation and recovery program
28.36 volatile organic compounds $1,200
29.1 Underground storage tank program
29.2 volatile organic compounds $1,200
29.3 Clean water program other organic compounds $600 $1,200
29.4 Safe drinking water program other organic compounds $1,200
29.5 Resource conservation and recovery program
29.6 other organic compounds $1,200
29.7 (b) The total biennial certification fee is the base fee
29.8 plus the applicable test category fees. The biennial
29.9 certification fee for a contract laboratory is 1.5 times the
29.10 total certification fee.
29.11 (c) Laboratories located outside of this state that require
29.12 an on-site survey will be assessed an additional $1,200 $2,500
29.13 fee.
29.14 (d) Fees must be set so that the total fees support the
29.15 laboratory certification program. Direct costs of the
29.16 certification service include program administration,
29.17 inspections, the agency's general support costs, and attorney
29.18 general costs attributable to the fee function.
29.19 (e) A change fee shall be assessed if a laboratory requests
29.20 additional analytes or methods at any time other than when
29.21 applying for or renewing its certification. The change fee is
29.22 equal to the test category certification fee for the analyte.
29.23 (f) A variance fee shall be assessed if a laboratory
29.24 requests and is granted a variance from a rule adopted under
29.25 this section. The variance fee is $500 per variance.
29.26 (g) Refunds or credits shall not be made for analytes or
29.27 methods requested but not approved.
29.28 (h) Certification of a laboratory shall not be awarded
29.29 until all fees are paid.
29.30 Sec. 33. Minnesota Statutes 2000, section 144A.44,
29.31 subdivision 1, is amended to read:
29.32 Subdivision 1. [STATEMENT OF RIGHTS.] A person who
29.33 receives home care services has these rights:
29.34 (1) the right to receive written information about rights
29.35 in advance of receiving care or during the initial evaluation
29.36 visit before the initiation of treatment, including what to do
30.1 if rights are violated;
30.2 (2) the right to receive care and services according to a
30.3 suitable and up-to-date plan, and subject to accepted medical or
30.4 nursing standards, to take an active part in creating and
30.5 changing the plan and evaluating care and services;
30.6 (3) the right to be told in advance of receiving care about
30.7 the services that will be provided, the disciplines that will
30.8 furnish care, the frequency of visits proposed to be furnished,
30.9 other choices that are available, and the consequences of these
30.10 choices including the consequences of refusing these services;
30.11 (4) the right to be told in advance of any change in the
30.12 plan of care and to take an active part in any change;
30.13 (5) the right to refuse services or treatment;
30.14 (6) the right to know, in advance, any limits to the
30.15 services available from a provider, and the provider's grounds
30.16 for a termination of services;
30.17 (7) the right to know in advance of receiving care whether
30.18 the services are covered by health insurance, medical
30.19 assistance, or other health programs, the charges for services
30.20 that will not be covered by Medicare, and the charges that the
30.21 individual may have to pay;
30.22 (8) the right to know what the charges are for services, no
30.23 matter who will be paying the bill;
30.24 (9) the right to know that there may be other services
30.25 available in the community, including other home care services
30.26 and providers, and to know where to go for information about
30.27 these services;
30.28 (10) the right to choose freely among available providers
30.29 and to change providers after services have begun, within the
30.30 limits of health insurance, medical assistance, or other health
30.31 programs;
30.32 (11) the right to have personal, financial, and medical
30.33 information kept private, and to be advised of the provider's
30.34 policies and procedures regarding disclosure of such
30.35 information;
30.36 (12) the right to be allowed access to records and written
31.1 information from records in accordance with section 144.335;
31.2 (13) the right to be served by people who are properly
31.3 trained and competent to perform their duties;
31.4 (14) the right to be treated with courtesy and respect, and
31.5 to have the patient's property treated with respect;
31.6 (15) the right to be free from physical and verbal abuse;
31.7 (16) the right to reasonable, advance notice of changes in
31.8 services or charges, including at least ten days' advance notice
31.9 of the termination of a service by a provider, except in cases
31.10 where:
31.11 (i) the recipient of services engages in conduct that
31.12 alters the conditions of employment as specified in the
31.13 employment contract between the home care provider and the
31.14 individual providing home care services, or creates an abusive
31.15 or unsafe work environment for the individual providing home
31.16 care services; or
31.17 (ii) an emergency for the informal caregiver or a
31.18 significant change in the recipient's condition has resulted in
31.19 service needs that exceed the current service provider agreement
31.20 and that cannot be safely met by the home care provider;
31.21 (17) the right to a coordinated transfer when there will be
31.22 a change in the provider of services;
31.23 (18) the right to voice grievances regarding treatment or
31.24 care that is, or fails to be, furnished, or regarding the lack
31.25 of courtesy or respect to the patient or the patient's property;
31.26 (19) the right to know how to contact an individual
31.27 associated with the provider who is responsible for handling
31.28 problems and to have the provider investigate and attempt to
31.29 resolve the grievance or complaint;
31.30 (20) the right to know the name and address of the state or
31.31 county agency to contact for additional information or
31.32 assistance; and
31.33 (21) the right to assert these rights personally, or have
31.34 them asserted by the patient's family or guardian when the
31.35 patient has been judged incompetent, without retaliation.
31.36 Sec. 34. Minnesota Statutes 2000, section 144A.4605,
32.1 subdivision 4, is amended to read:
32.2 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services
32.3 establishment registered under chapter 144D that is required to
32.4 obtain a home care license must obtain an assisted living home
32.5 care license according to this section or a class A or class E
32.6 license according to rule. A housing with services
32.7 establishment that obtains a class E license under this
32.8 subdivision remains subject to the payment limitations in
32.9 sections 256B.0913, subdivision 5, paragraph (h), and 256B.0915,
32.10 subdivision 3, paragraph (g).
32.11 (b) A board and lodging establishment registered for
32.12 special services as of December 31, 1996, and also registered as
32.13 a housing with services establishment under chapter 144D, must
32.14 deliver home care services according to sections 144A.43 to
32.15 144A.48, and may apply for a waiver from requirements under
32.16 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a
32.17 licensed agency under the standards of section 157.17. Such
32.18 waivers as may be granted by the department will expire upon
32.19 promulgation of home care rules implementing section 144A.4605.
32.20 (c) An adult foster care provider licensed by the
32.21 department of human services and registered under chapter 144D
32.22 may continue to provide health-related services under its foster
32.23 care license until the promulgation of home care rules
32.24 implementing this section.
32.25 (d) An assisted living home care provider licensed under
32.26 this section must comply with the disclosure provisions of
32.27 section 325F.691 to the extent they are applicable.
32.28 Sec. 35. Minnesota Statutes 2000, section 144D.03,
32.29 subdivision 2, is amended to read:
32.30 Subd. 2. [REGISTRATION INFORMATION.] The establishment
32.31 shall provide the following information to the commissioner in
32.32 order to be registered:
32.33 (1) the business name, street address, and mailing address
32.34 of the establishment;
32.35 (2) the name and mailing address of the owner or owners of
32.36 the establishment and, if the owner or owners are not natural
33.1 persons, identification of the type of business entity of the
33.2 owner or owners, and the names and addresses of the officers and
33.3 members of the governing body, or comparable persons for
33.4 partnerships, limited liability corporations, or other types of
33.5 business organizations of the owner or owners;
33.6 (3) the name and mailing address of the managing agent,
33.7 whether through management agreement or lease agreement, of the
33.8 establishment, if different from the owner or owners, and the
33.9 name of the on-site manager, if any;
33.10 (4) verification that the establishment has entered into an
33.11 elderly housing with services contract, as required in section
33.12 144D.04, with each resident or resident's representative;
33.13 (5) verification that the establishment is complying with
33.14 the requirements of section 325F.691, if applicable;
33.15 (5) (6) the name and address of at least one natural person
33.16 who shall be responsible for dealing with the commissioner on
33.17 all matters provided for in sections 144D.01 to 144D.06, and on
33.18 whom personal service of all notices and orders shall be made,
33.19 and who shall be authorized to accept service on behalf of the
33.20 owner or owners and the managing agent, if any; and
33.21 (6) (7) the signature of the authorized representative of
33.22 the owner or owners or, if the owner or owners are not natural
33.23 persons, signatures of at least two authorized representatives
33.24 of each owner, one of which shall be an officer of the owner.
33.25 Personal service on the person identified under clause (5)
33.26 (6) by the owner or owners in the registration shall be
33.27 considered service on the owner or owners, and it shall not be a
33.28 defense to any action that personal service was not made on each
33.29 individual or entity. The designation of one or more
33.30 individuals under this subdivision shall not affect the legal
33.31 responsibility of the owner or owners under sections 144D.01 to
33.32 144D.06.
33.33 Sec. 36. Minnesota Statutes 2000, section 144D.04,
33.34 subdivision 2, is amended to read:
33.35 Subd. 2. [CONTENTS OF CONTRACT.] An elderly housing with
33.36 services contract, which need not be entitled as such to comply
34.1 with this section, shall include at least the following elements
34.2 in itself or through supporting documents or attachments:
34.3 (1) name, street address, and mailing address of the
34.4 establishment;
34.5 (2) the name and mailing address of the owner or owners of
34.6 the establishment and, if the owner or owners is not a natural
34.7 person, identification of the type of business entity of the
34.8 owner or owners;
34.9 (3) the name and mailing address of the managing agent,
34.10 through management agreement or lease agreement, of the
34.11 establishment, if different from the owner or owners;
34.12 (4) the name and address of at least one natural person who
34.13 is authorized to accept service on behalf of the owner or owners
34.14 and managing agent;
34.15 (5) statement describing the registration and licensure
34.16 status of the establishment and any provider providing
34.17 health-related or supportive services under an arrangement with
34.18 the establishment;
34.19 (6) term of the contract;
34.20 (7) description of the services to be provided to the
34.21 resident in the base rate to be paid by resident;
34.22 (8) description of any additional services available for an
34.23 additional fee from the establishment directly or through
34.24 arrangements with the establishment;
34.25 (9) fee schedules outlining the cost of any additional
34.26 services;
34.27 (10) description of the process through which the contract
34.28 may be modified, amended, or terminated;
34.29 (11) description of the establishment's complaint
34.30 resolution process available to residents including the
34.31 toll-free complaint line for the office of ombudsman for older
34.32 Minnesotans;
34.33 (12) the resident's designated representative, if any;
34.34 (13) the establishment's referral procedures if the
34.35 contract is terminated;
34.36 (14) criteria used by the establishment to determine who
35.1 may continue to reside in the elderly housing with services
35.2 establishment;
35.3 (15) billing and payment procedures and requirements;
35.4 (16) statement regarding the ability of residents to
35.5 receive services from service providers with whom the
35.6 establishment does not have an arrangement; and
35.7 (17) statement regarding the availability of public funds
35.8 for payment for residence or services in the establishment.
35.9 Sec. 37. Minnesota Statutes 2000, section 144D.04,
35.10 subdivision 3, is amended to read:
35.11 Subd. 3. [CONTRACTS IN PERMANENT FILES.] Elderly housing
35.12 with services contracts and related documents executed by each
35.13 resident or resident's representative shall be maintained by the
35.14 establishment in files from the date of execution until three
35.15 years after the contract is terminated. The contracts and the
35.16 written disclosures required under section 325F.691, if
35.17 applicable, shall be made available for on-site inspection by
35.18 the commissioner upon request at any time.
35.19 Sec. 38. Minnesota Statutes 2000, section 144D.06, is
35.20 amended to read:
35.21 144D.06 [OTHER LAWS.]
35.22 A housing with services establishment shall obtain and
35.23 maintain all other licenses, permits, registrations, or other
35.24 governmental approvals required of it in addition to
35.25 registration under this chapter. A housing with services
35.26 establishment is subject to the provisions of section 325F.691
35.27 and chapter 504B.
35.28 Sec. 39. [145.4241] [DEFINITIONS.]
35.29 Subdivision 1. [APPLICABILITY.] As used in sections
35.30 145.4241 to 145.4246, the following terms have the meaning given
35.31 them.
35.32 Subd. 2. [ABORTION.] "Abortion" includes an act,
35.33 procedure, or use of any instrument, medicine, or drug which is
35.34 supplied or prescribed for or administered to a woman known to
35.35 be pregnant with the intention to terminate the pregnancy with
35.36 an intention other than to increase the probability of live
36.1 birth, to preserve the life or health of the child after live
36.2 birth, or to remove a dead fetus.
36.3 Subd. 3. [ATTEMPT TO PERFORM AN ABORTION.] "Attempt to
36.4 perform an abortion" means an act, or an omission of a
36.5 statutorily required act, that, under the circumstances as the
36.6 actor believes them to be, constitutes a substantial step in a
36.7 course of conduct planned to culminate in the performance of an
36.8 abortion in Minnesota in violation of sections 145.4241 to
36.9 145.4246.
36.10 Subd. 4. [MEDICAL EMERGENCY.] "Medical emergency" means
36.11 any condition that, on the basis of the physician's good faith
36.12 clinical judgment, complicates the medical condition of a
36.13 pregnant female to the extent that:
36.14 (1) an immediate abortion of her pregnancy is necessary to
36.15 avert her death; or
36.16 (2) a 24-hour delay in performing an abortion creates a
36.17 serious risk of substantial injury or impairment of a major
36.18 bodily function.
36.19 Subd. 5. [PHYSICIAN.] "Physician" means a person licensed
36.20 under chapter 147.
36.21 Subd. 6. [PROBABLE GESTATIONAL AGE OF THE FETUS.]
36.22 "Probable gestational age of the fetus" means what will, in the
36.23 judgment of the physician, with reasonable probability, be the
36.24 gestational age of the fetus at the time the abortion is planned
36.25 to be performed.
36.26 Sec. 40. [145.4242] [INFORMED CONSENT.]
36.27 (a) No abortion shall be performed in this state except
36.28 with the voluntary and informed consent of the female upon whom
36.29 the abortion is to be performed. Except in the case of a
36.30 medical emergency, consent to an abortion is voluntary and
36.31 informed only if the female is told the following, by telephone
36.32 or in person, by the physician who is to perform the abortion,
36.33 the referring physician, a registered nurse, or a licensed
36.34 practical nurse, at least 24 hours prior to the abortion:
36.35 (1) the particular medical risks associated with the
36.36 particular abortion procedure to be employed including, when
37.1 medically accurate, the risks of infection, hemorrhage, breast
37.2 cancer, danger to subsequent pregnancies, and infertility;
37.3 (2) the probable gestational age of the fetus at the time
37.4 the abortion is to be performed;
37.5 (3) the medical risks associated with carrying to term;
37.6 (4) that medical assistance benefits may be available for
37.7 prenatal care, childbirth, and neonatal care;
37.8 (5) that the father is liable to assist in the support of
37.9 her child except under certain circumstances, even in instances
37.10 when the father has offered to pay for the abortion;
37.11 (6) the availability of a toll-free number and Web site
37.12 that can provide information on support services during
37.13 pregnancy and while the child is dependent and offer
37.14 alternatives to abortion; and
37.15 (7) that she has the right to review the printed materials
37.16 described in section 145.4243, and the printed materials are
37.17 available on the state Web site.
37.18 (b) The physician or the physician's agent shall orally
37.19 inform the female that the materials have been provided by the
37.20 state of Minnesota and that they describe the unborn child and
37.21 list agencies that offer alternatives to abortion.
37.22 (c) The physician or the physician's agent shall orally
37.23 inform the female of the Web site address and toll-free number.
37.24 (d) If the female chooses to view the materials, they shall
37.25 either be given to her at least 24 hours before the abortion or
37.26 mailed to her at least 72 hours before the abortion by first
37.27 class mail, or at the woman's request, by certified mail,
37.28 restricted delivery to addressee, which means the postal
37.29 employee may only deliver the mail to the addressee. The
37.30 envelope used by the physician shall not identify the name of
37.31 the physician or the physician's clinic or business.
37.32 (e) If a physical examination, tests, or the availability
37.33 of other information to the physician subsequently indicates, in
37.34 the medical judgment of the physician, a revision of the
37.35 information previously supplied to the patient, that revised
37.36 information may be communicated to the patient at any time prior
38.1 to the performance of the abortion.
38.2 Sec. 41. [145.4243] [PRINTED INFORMATION.]
38.3 Subdivision 1. [MATERIALS.] (a) Within 90 days after the
38.4 effective date of sections 145.4241 to 145.4246, the department
38.5 of health shall cause to be published, in English and in each
38.6 language that is the primary language of two percent or more of
38.7 the state's population, the printed materials described in
38.8 paragraphs (b) and (c) in such a way as to ensure that the
38.9 information is easily comprehensible.
38.10 (b) The materials must be designed to inform the female of
38.11 the probable anatomical and physiological characteristics of the
38.12 fetus at two-week gestational increments from the time when a
38.13 female can be known to be pregnant to full term, including any
38.14 relevant information on the possibility of the fetus' survival
38.15 and pictures or drawings representing the development of the
38.16 fetus at two-week gestational increments, provided that any such
38.17 pictures or drawings must contain the dimensions of the fetus
38.18 and must be realistic and appropriate for the stage of pregnancy
38.19 depicted. The materials must be objective, nonjudgmental, and
38.20 designed to convey only accurate scientific information about
38.21 the fetus at the various gestational ages.
38.22 (c) The materials must contain objective information
38.23 describing the methods of abortion procedures commonly employed,
38.24 the medical risks commonly associated with each procedure, the
38.25 possible detrimental psychological effects of abortion, and the
38.26 medical risks commonly associated with carrying a child to term.
38.27 Subd. 2. [TYPEFACE; AVAILABILITY.] The materials referred
38.28 to in this section must be printed in a typeface large enough to
38.29 be clearly legible. The materials required under this section
38.30 must be available from the department of health upon request and
38.31 in appropriate number to any person, facility, or hospital at no
38.32 cost.
38.33 Sec. 42. [145.4244] [PROCEDURE IN CASE OF MEDICAL
38.34 EMERGENCY.]
38.35 When a medical emergency compels the performance of an
38.36 abortion, the physician shall inform the female, prior to the
39.1 abortion if possible, of the medical indications supporting the
39.2 physician's judgment that an abortion is necessary to avert her
39.3 death or that a 24-hour delay in conformance with section
39.4 145.4242 creates a serious risk of substantial injury or
39.5 impairment of a major bodily function.
39.6 Sec. 43. [145.4245] [TOLL-FREE TELEPHONE NUMBER AND WEB
39.7 SITE.]
39.8 Subdivision 1. [RIGHT TO KNOW.] All pregnant women have
39.9 the right to know information about resources available to
39.10 assist them and their families. The commissioner of health
39.11 shall establish and maintain a statewide toll-free telephone
39.12 number available seven days a week to provide information and
39.13 referrals to local community resources to assist women and
39.14 families through pregnancy and childbirth and while the child is
39.15 dependent.
39.16 Subd. 2. [INFORMATION.] The toll-free telephone number
39.17 must provide information regarding community resources on the
39.18 following topics:
39.19 (1) information regarding avoiding unplanned pregnancies;
39.20 (2) prenatal care, including the need for an initial risk
39.21 screening and assessment;
39.22 (3) adoption;
39.23 (4) health education, including the importance of good
39.24 nutrition during pregnancy and the risks associated with alcohol
39.25 and tobacco use during pregnancy;
39.26 (5) available social services, including medical assistance
39.27 benefits for prenatal care, childbirth, and neonatal care;
39.28 (6) legal assistance in obtaining child support; and
39.29 (7) community support services and other resources to
39.30 enhance family strengths and reduce the possibility of family
39.31 violence.
39.32 Subd. 3. [WEB SITE.] The commissioner shall design and
39.33 maintain a secure Web site to provide the information described
39.34 under subdivision 2 and section 145.4243 with a minimum
39.35 resolution of 72 PPI. The Web site shall provide the toll-free
39.36 information and referral telephone number described under
40.1 subdivision 2.
40.2 Sec. 44. [145.4246] [ENFORCEMENT PENALTIES.]
40.3 Subdivision 1. [STANDING.] A person with standing may
40.4 maintain an action against the performance or attempted
40.5 performance of abortions in violation of section 145.4242.
40.6 Those with standing are:
40.7 (1) a woman upon whom an abortion in violation of section
40.8 145.4242 has been performed or attempted to be performed; and
40.9 (2) the parent of an unemancipated minor upon whom an
40.10 abortion in violation of section 145.4242 has been, is about to
40.11 be, or was attempted to be performed; and
40.12 (3) attorney general of the state of Minnesota.
40.13 Subd. 2. [INJUNCTIONS.] Parties bringing actions against
40.14 the performance or attempted performance of abortions in
40.15 violation of section 145.4242 may seek temporary restraining
40.16 orders, preliminary injunctions, and injunctions related only to
40.17 the physician or facility where the violation occurred in
40.18 accordance with the Rules of Civil Procedure. Persons with
40.19 standing must bring any actions within six months of the date of
40.20 the performed or attempted performance of abortions in violation
40.21 of section 145.4242.
40.22 Subd. 3. [CONTEMPT.] Any person knowingly violating the
40.23 terms of an injunction against the performance or attempted
40.24 performance of abortions in violation of section 145.4242 is
40.25 subject to civil contempt, and shall be fined no more than
40.26 $1,000 for the first violation, no more than $5,000 for the
40.27 second violation, no more than $10,000 for the third violation,
40.28 and for each successive violation an amount sufficient to deter
40.29 future violations. The fine shall be the exclusive penalty for
40.30 a violation. Each performance or attempted performance of
40.31 abortion in violation of section 145.4242 is a separate
40.32 violation. No fine shall be assessed against the woman on whom
40.33 an abortion is performed or attempted.
40.34 Subd. 4. [REALLOCATION OF THE FINE.] Any fines collected
40.35 under this section must be sent to a special account at the
40.36 Minnesota department of health to be used for materials cited in
41.1 section 145.4243.
41.2 Sec. 45. [145.4247] [CUMULATIVE RIGHTS.]
41.3 The provisions of sections 145.4241 to 145.4246 are
41.4 cumulative with existing law regarding an individual's right to
41.5 consent to medical treatment and shall not impair any existing
41.6 right any patient may have under the common law or statutes of
41.7 this state.
41.8 Sec. 46. Minnesota Statutes 2000, section 145.881,
41.9 subdivision 2, is amended to read:
41.10 Subd. 2. [DUTIES.] The advisory task force shall meet on a
41.11 regular basis to perform the following duties:
41.12 (a) review and report on the health care needs of mothers
41.13 and children throughout the state of Minnesota;
41.14 (b) review and report on the type, frequency and impact of
41.15 maternal and child health care services provided to mothers and
41.16 children under existing maternal and child health care programs,
41.17 including programs administered by the commissioner of health;
41.18 (c) establish, review, and report to the commissioner a
41.19 list of program guidelines and criteria which the advisory task
41.20 force considers essential to providing an effective maternal and
41.21 child health care program to low income populations and high
41.22 risk persons and fulfilling the purposes defined in section
41.23 145.88;
41.24 (d) review staff recommendations of the department of
41.25 health regarding maternal and child health grant awards before
41.26 the awards are made;
41.27 (e) make recommendations to the commissioner for the use of
41.28 other federal and state funds available to meet maternal and
41.29 child health needs;
41.30 (f) make recommendations to the commissioner of health on
41.31 priorities for funding the following maternal and child health
41.32 services: (1) prenatal, delivery and postpartum care, (2)
41.33 comprehensive health care for children, especially from birth
41.34 through five years of age, (3) adolescent health services, (4)
41.35 family planning services, (5) preventive dental care, (6)
41.36 special services for chronically ill and handicapped children
42.1 and (7) any other services which promote the health of mothers
42.2 and children; and
42.3 (g) make recommendations to the commissioner of health on
42.4 the process to distribute, award and administer the maternal and
42.5 child health block grant funds; and
42.6 (h) review the measures that are used to define the
42.7 variables of the funding distribution formula in section
42.8 145.882, subdivision 4a, every two years and make
42.9 recommendations to the commissioner of health for changes based
42.10 upon principles established by the advisory task force for this
42.11 purpose.
42.12 Sec. 47. Minnesota Statutes 2000, section 145.882, is
42.13 amended by adding a subdivision to read:
42.14 Subd. 4a. [ALLOCATION TO COMMUNITY HEALTH BOARDS.] (a)
42.15 Federal maternal and child health block grant money remaining
42.16 after distributions made under subdivision 2 and money
42.17 appropriated for allocation to community health boards must be
42.18 allocated according to paragraphs (b) to (d) to community health
42.19 boards as defined in section 145A.02, subdivision 5.
42.20 (b) All community health boards must receive 95 percent of
42.21 the funding awarded to them for the 1998-1999 funding cycle. If
42.22 the amount of state and federal funding available is less than
42.23 95 percent of the amount awarded to community health boards for
42.24 the 1998-1999 funding cycle, the available funding must be
42.25 apportioned to reflect a proportional decrease for each
42.26 recipient.
42.27 (c) The federal and state funding remaining after
42.28 distributions made under paragraph (b) must be allocated to each
42.29 community health board based on the following three variables:
42.30 (1) 25 percent based on the maternal and child population
42.31 in the area served by the community health board;
42.32 (2) 50 percent based on the following factors, as
42.33 determined by averaging the data available for the three most
42.34 recent years:
42.35 (i) the proportion of infants in the area served by the
42.36 community health board whose weight at birth was less than 2,500
43.1 grams;
43.2 (ii) the proportion of mothers in the area served by the
43.3 community health board who received inadequate or no prenatal
43.4 care;
43.5 (iii) the proportion of births in the area served by the
43.6 community health board to women under age 19; and
43.7 (iv) the proportion of births in the area served by the
43.8 community health board to American Indian women and women of
43.9 color; and
43.10 (3) 25 percent based on the income of the maternal and
43.11 child population in the area served by the community health
43.12 board.
43.13 (d) Each variable must be expressed as a city or county
43.14 score consisting of the city or county frequency of each
43.15 variable in relation to the statewide frequency of the
43.16 variable. A total score for each city or county jurisdiction
43.17 must be computed by totaling the scores of the three variables.
43.18 Each community health board must be allocated an amount equal to
43.19 the total score obtained for the city, county, or counties in
43.20 its area multiplied by the amount of money available.
43.21 Sec. 48. Minnesota Statutes 2000, section 145.882,
43.22 subdivision 7, is amended to read:
43.23 Subd. 7. [USE OF BLOCK GRANT MONEY.] (a) Maternal and
43.24 child health block grant money allocated to a community health
43.25 board or community health services area under this section must
43.26 be used for qualified programs for high risk and low-income
43.27 individuals. Block grant money must be used for programs that:
43.28 (1) specifically address the highest risk populations,
43.29 particularly low-income and minority groups with a high rate of
43.30 infant mortality and children with low birth weight, by
43.31 providing services, including excluding prepregnancy family
43.32 planning services, calculated to produce measurable decreases in
43.33 infant mortality rates, instances of children with low birth
43.34 weight, and medical complications associated with pregnancy and
43.35 childbirth, including infant mortality, low birth rates, and
43.36 medical complications arising from chemical abuse by a mother
44.1 during pregnancy;
44.2 (2) specifically target pregnant women whose age, medical
44.3 condition, maternal history, or chemical abuse substantially
44.4 increases the likelihood of complications associated with
44.5 pregnancy and childbirth or the birth of a child with an
44.6 illness, disability, or special medical needs;
44.7 (3) specifically address the health needs of young children
44.8 who have or are likely to have a chronic disease or disability
44.9 or special medical needs, including physical, neurological,
44.10 emotional, and developmental problems that arise from chemical
44.11 abuse by a mother during pregnancy;
44.12 (4) provide family planning and preventive medical care,
44.13 excluding prepregnancy family planning services, for
44.14 specifically identified target populations, such as minority and
44.15 low-income teenagers, in a manner calculated to decrease the
44.16 occurrence of inappropriate pregnancy and minimize the risk of
44.17 complications associated with pregnancy and childbirth; or
44.18 (5) specifically address the frequency and severity of
44.19 childhood injuries and other child and adolescent health
44.20 problems in high-risk target populations by providing services,
44.21 excluding prepregnancy family planning services, calculated to
44.22 produce measurable decreases in mortality and
44.23 morbidity. However, money may be used for this purpose only if
44.24 the community health board's application includes program
44.25 components for the purposes in clauses (1) to (4) in the
44.26 proposed geographic service area and the total expenditure for
44.27 injury-related programs under this clause does not exceed ten
44.28 percent of the total allocation under subdivision 3.
44.29 (b) Maternal and child health block grant money may be used
44.30 for purposes other than the purposes listed in this subdivision
44.31 only under the following conditions:
44.32 (1) the community health board or community health services
44.33 area can demonstrate that existing programs fully address the
44.34 needs of the highest risk target populations described in this
44.35 subdivision; or
44.36 (2) the money is used to continue projects that received
45.1 funding before creation of the maternal and child health block
45.2 grant in 1981.
45.3 (c) Projects that received funding before creation of the
45.4 maternal and child health block grant in 1981, must be allocated
45.5 at least the amount of maternal and child health special project
45.6 grant funds received in 1989, unless (1) the local board of
45.7 health provides equivalent alternative funding for the project
45.8 from another source; or (2) the local board of health
45.9 demonstrates that the need for the specific services provided by
45.10 the project has significantly decreased as a result of changes
45.11 in the demographic characteristics of the population, or other
45.12 factors that have a major impact on the demand for services. If
45.13 the amount of federal funding to the state for the maternal and
45.14 child health block grant is decreased, these projects must
45.15 receive a proportional decrease as required in subdivision 1.
45.16 Increases in allocation amounts to local boards of health under
45.17 subdivision 4 may be used to increase funding levels for these
45.18 projects.
45.19 Sec. 49. Minnesota Statutes 2000, section 145.885,
45.20 subdivision 2, is amended to read:
45.21 Subd. 2. [ADDITIONAL REQUIREMENTS FOR COMMUNITY BOARDS OF
45.22 HEALTH.] Applications by community health boards as defined in
45.23 section 145A.02, subdivision 5, under section 145.882,
45.24 subdivision 3 4a, must also contain a summary of the process
45.25 used to develop the local program, including evidence that the
45.26 community health board notified local public and private
45.27 providers of the availability of funding through the community
45.28 health board for maternal and child health services; a list of
45.29 all public and private agency requests for grants submitted to
45.30 the community health board indicating which requests were
45.31 included in the grant application; and an explanation of how
45.32 priorities were established for selecting the requests to be
45.33 included in the grant application. The community health board
45.34 shall include, with the grant application, a written statement
45.35 of the criteria to be applied to public and private agency
45.36 requests for funding.
46.1 Sec. 50. Minnesota Statutes 2000, section 145.924, is
46.2 amended to read:
46.3 145.924 [AIDS PREVENTION GRANTS.]
46.4 Subdivision 1. [GRANT AWARDS.] (a) The commissioner may
46.5 award grants to boards of health as defined in section 145A.02,
46.6 subdivision 2, state agencies, state councils, or nonprofit
46.7 corporations to provide evaluation and counseling services to
46.8 populations at risk for acquiring human immunodeficiency virus
46.9 infection, including, but not limited to, minorities,
46.10 adolescents, intravenous drug users, and homosexual men.
46.11 (b) The commissioner may award grants to agencies
46.12 experienced in providing services to communities of color, for
46.13 the design of innovative outreach and education programs for
46.14 targeted groups within the community who may be at risk of
46.15 acquiring the human immunodeficiency virus infection, including
46.16 intravenous drug users and their partners, adolescents, gay and
46.17 bisexual individuals and women. Grants shall be awarded on a
46.18 request for proposal basis and shall include funds for
46.19 administrative costs. Priority for grants shall be given to
46.20 agencies or organizations that have experience in providing
46.21 service to the particular community which the grantee proposes
46.22 to serve; that have policymakers representative of the targeted
46.23 population; that have experience in dealing with issues relating
46.24 to HIV/AIDS; and that have the capacity to deal effectively with
46.25 persons of differing sexual orientations. For purposes of this
46.26 paragraph, the "communities of color" are: the American-Indian
46.27 community; the Hispanic community; the African-American
46.28 community; and the Asian-Pacific community.
46.29 (c) All state grants awarded under this section subdivision
46.30 for programs targeted to adolescents shall include the promotion
46.31 of abstinence from sexual activity and drug use.
46.32 Subd. 2. [OUTCOMES.] The commissioner, in consultation
46.33 with boards of health, agencies, councils, and nonprofit
46.34 organizations involved in human immunodeficiency virus infection
46.35 prevention efforts shall establish measurable outcomes to
46.36 determine the effectiveness of the grants provided under this
47.1 section in reducing the number of people who acquire human
47.2 immunodeficiency virus, the rates of infection, and average
47.3 numbers of sexual partners for populations served by grants
47.4 funded under this section.
47.5 Subd. 3. [EVALUATION.] (a) Using the outcomes established
47.6 according to subdivision 2, the commissioner shall conduct a
47.7 biennial evaluation of activities funded under this section.
47.8 The evaluation must include:
47.9 (1) the effect of these activities on the number of people
47.10 who acquire human immunodeficiency virus and the rates of
47.11 infection;
47.12 (2) the effect of these activities on average numbers of
47.13 sexual partners for populations served by grants funded under
47.14 this section; and
47.15 (3) a longitudinal tracking of outcomes for targeted
47.16 populations who are served under subdivision 1, paragraphs (a)
47.17 and (b).
47.18 (b) Grant recipients shall cooperate with the commissioner
47.19 in the evaluation and shall provide the commissioner with the
47.20 information needed to conduct the evaluation. Beginning January
47.21 15, 2003, the results of each evaluation must be submitted to
47.22 the chairs of the policy and finance committees in the house and
47.23 senate with jurisdiction over health and human services.
47.24 Sec. 51. Minnesota Statutes 2000, section 145.925,
47.25 subdivision 1, is amended to read:
47.26 Subdivision 1. [ELIGIBLE ORGANIZATIONS; PURPOSE.] The
47.27 commissioner of health may make special grants to cities,
47.28 counties, tribal governments, or groups of cities or, counties,
47.29 or nonprofit corporations or tribal governments to provide
47.30 prepregnancy family planning services. targeted to low-income
47.31 and minority populations. A city, county, tribal government, or
47.32 group of cities, counties, or tribal governments that receives a
47.33 grant is responsible for ensuring that the grant funds are used
47.34 for services targeted to low-income and minority populations,
47.35 and must establish a goal for reducing specific pregnancy rates
47.36 in the service area. In determining populations to serve and
48.1 services to provide, a city, county, tribal government, or group
48.2 of cities, counties, or tribal governments must consider the
48.3 spacing of pregnancies in low-income and minority populations in
48.4 the service area, teen birth rates in the service area, and the
48.5 needs of populations of color in the service area. A city,
48.6 county, tribal government, or group of cities, counties, or
48.7 tribal governments may contract for the provision of
48.8 prepregnancy family planning services using grant funds provided
48.9 under this section only if the contract is specifically
48.10 authorized by the governing body of the city, county, or tribal
48.11 government that is contracting for the services.
48.12 Any organization or an affiliate of an organization which
48.13 provides abortions, promotes abortions, or directly refers for
48.14 abortions, shall be ineligible to receive funds under this
48.15 subdivision.
48.16 Sec. 52. Minnesota Statutes 2000, section 145.925,
48.17 subdivision 1a, is amended to read:
48.18 Subd. 1a. [FAMILY PLANNING SERVICES; DEFINED.] "Family
48.19 planning services" means counseling by trained personnel
48.20 regarding family planning; distribution of information relating
48.21 to family planning, referral to licensed physicians or local
48.22 health agencies for consultation, examination, medical
48.23 treatment, genetic counseling, and prescriptions for the purpose
48.24 of family planning; and the distribution of family planning
48.25 products, such as charts, thermometers, drugs, medical
48.26 preparations, and contraceptive devices. Family planning
48.27 services do not include services that, directly or indirectly,
48.28 encourage, counsel, refer, or provide abortions or abortion
48.29 referrals. For purposes of sections 145A.01 to 145A.14, family
48.30 planning shall mean voluntary action by individuals to prevent
48.31 or aid conception but does not include the performance, or make
48.32 referrals for encouragement of voluntary termination of
48.33 pregnancy services that, directly or indirectly, encourage,
48.34 counsel, refer, or provide abortions or abortion referrals.
48.35 Sec. 53. [145.9257] [TEEN PREGNANCY PREVENTION.]
48.36 Subdivision 1. [GOAL.] It is the goal of the state to
49.1 reduce teen pregnancy rates by 24 percent by 2006. To do so,
49.2 the commissioner of health shall establish a grant program to
49.3 reduce the rates of unintended teen pregnancies in the state.
49.4 If this goal of reducing teen pregnancy rates by 24 percent is
49.5 not met by December 31, 2006, this section expires June 30,
49.6 2007. No funds awarded under this section may be used for
49.7 medical services or family planning services or for services
49.8 that, directly or indirectly, encourage, counsel, refer, or
49.9 provide abortions or abortion referrals.
49.10 Any organization or an affiliate of an organization which
49.11 provides abortions, promotes abortions, or directly refers for
49.12 abortions, shall be ineligible to receive funds under this
49.13 section.
49.14 Subd. 2. [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The
49.15 commissioner, in consultation with the commissioner of children,
49.16 families, and learning; the commissioner of human services; the
49.17 maternal and child health advisory task force under section
49.18 145.881; the Indian affairs council under section 3.922; the
49.19 council on affairs of Chicano/Latino people under section
49.20 3.9223; the council on Black Minnesotans under section 3.9225;
49.21 the council on Asian-Pacific Minnesotans under section 3.9226;
49.22 community health boards as defined in section 145A.02; tribal
49.23 governments; nonprofit community organizations; and others
49.24 interested in teen pregnancy prevention, shall develop and
49.25 implement a comprehensive, coordinated plan to reduce the number
49.26 of teen pregnancies.
49.27 Subd. 3. [MEASURABLE OUTCOMES.] The commissioner, in
49.28 consultation with the commissioners and community partners
49.29 listed in subdivision 2, shall establish measurable outcomes to
49.30 achieve the goal specified in subdivision 1 and to determine the
49.31 effectiveness of the grants provided under this section in
49.32 reducing teen pregnancies. The development of measurable
49.33 outcomes must be completed before any funds are distributed
49.34 under this section.
49.35 Subd. 4. [STATEWIDE ASSESSMENT.] The commissioner shall
49.36 use and enhance current statewide assessments of teen pregnancy
50.1 risk behaviors and attitudes among youth to establish a baseline
50.2 to measure the statewide effect of teen pregnancy prevention
50.3 activities. To the extent feasible, the commissioner shall
50.4 conduct the assessment so that the results may be compared to
50.5 national data.
50.6 Subd. 5. [PROCESS.] The commissioner, in consultation with
50.7 the commissioners and community partners listed in subdivision
50.8 2, shall develop the criteria and procedures used to allocate
50.9 grants under this section. In developing the criteria, the
50.10 commissioner shall establish an administrative cost limit for
50.11 grant recipients. At the time a grant is awarded, the
50.12 commissioner shall provide a grant recipient with information on
50.13 the outcomes established according to subdivision 3.
50.14 Subd. 6. [TEEN PREGNANCY PREVENTION DISPARITY GRANTS.] (a)
50.15 The commissioner shall award competitive grants to eligible
50.16 applicants for projects to reduce disparities in unintended teen
50.17 pregnancy rates for American Indians and populations of color,
50.18 as compared with unintended teen pregnancy rates for whites.
50.19 (b) No funds awarded under this subdivision may be used for
50.20 medical services or family planning services or for services
50.21 that, directly or indirectly, encourage, counsel, refer, or
50.22 provide abortions or abortion referrals.
50.23 Any organization or an affiliate of an organization which
50.24 provides abortions, promotes abortions, or directly refers for
50.25 abortions, shall be ineligible to receive funds under this
50.26 subdivision.
50.27 (c) Eligible applicants may include, but are not limited
50.28 to, nonprofit organizations, school districts, faith-based
50.29 organizations, community health boards, and tribal governments.
50.30 Applicants must submit proposals to the commissioner. A
50.31 proposal must specify the strategies to be implemented and must
50.32 take into account the need for a coordinated, statewide teen
50.33 pregnancy prevention effort. Strategies may include youth
50.34 development programs, after-school enrichment programs, youth
50.35 mentoring programs, academic support programs, and abstinence
50.36 until marriage education programs.
51.1 (d) The commissioner shall give priority to applicants who
51.2 demonstrate that their proposed project:
51.3 (1) emphasizes abstinence until marriage;
51.4 (2) is research-based or based on proven, effective
51.5 strategies;
51.6 (3) is designed to coordinate with related youth risk
51.7 behavior reduction activities;
51.8 (4) involves youth and parents in the project's development
51.9 and implementation;
51.10 (5) reflects racially and ethnically appropriate
51.11 approaches; and
51.12 (6) will be implemented through or with persons or
51.13 community-based organizations that reflect the race or ethnicity
51.14 of the population to be reached.
51.15 Subd. 7. [HIGH-RISK COMMUNITY TEEN PREGNANCY PREVENTION
51.16 GRANTS.] (a) The commissioner shall award grants to communities
51.17 that have significant risk factors for teen pregnancies, that
51.18 currently have in place youth development programs, and that are
51.19 interested in expanding existing efforts to prevent teen
51.20 pregnancies.
51.21 (b) No funds awarded under this subdivision may be used for
51.22 medical services or family planning services or for services
51.23 that, directly or indirectly, encourage, counsel, refer, or
51.24 provide abortions or abortion referrals.
51.25 Any organization or an affiliate of an organization which
51.26 provides abortions, promotes abortions, or directly refers for
51.27 abortions, shall be ineligible to receive funds under this
51.28 subdivision.
51.29 (c) To be eligible for a grant under this subdivision, an
51.30 applicant must be a tribal government or a community health
51.31 board as defined in section 145A.02. Applicants must submit
51.32 proposals to the commissioner. A proposal must specify the
51.33 strategies to be implemented. Strategies may include, but are
51.34 not limited to, youth development programs, youth mentoring
51.35 programs, academic support programs, and abstinence until
51.36 marriage education programs. Applicants must demonstrate that a
52.1 proposed project:
52.2 (1) emphasizes abstinence until marriage;
52.3 (2) is research-based or based on proven, effective
52.4 strategies;
52.5 (3) is designed to coordinate with related youth risk
52.6 behavior reduction activities;
52.7 (4) involves youth and parents in the project's development
52.8 and implementation;
52.9 (5) reflects racially and ethnically appropriate
52.10 approaches; and
52.11 (6) will be implemented through or with persons or
52.12 community-based organizations that reflect the race or ethnicity
52.13 of the population to be reached.
52.14 (d) Grants may be awarded to up to 15 community health
52.15 boards and three tribal governments based on areas having the
52.16 highest risk factors for teen pregnancies. The commissioner
52.17 shall award grants based on the following risk factors:
52.18 (1) the proportion of teens in the applicant's service area
52.19 who are sexually active;
52.20 (2) the proportion of births to teens in the applicant's
52.21 service area; and
52.22 (3) the proportion of births to teens who are American
52.23 Indian or of a population of color in the applicant's service
52.24 area.
52.25 Subd. 8. [ADOLESCENT PARENT GRANTS.] The commissioner
52.26 shall transfer funds to the commissioner of children, families,
52.27 and learning to increase the number of adolescent parent grants
52.28 currently provided by the commissioner of children, families,
52.29 and learning under section 124D.33.
52.30 Subd. 9. [COORDINATION.] The commissioner shall coordinate
52.31 the projects and initiatives funded under this section with
52.32 other efforts at the local, state, and national levels to avoid
52.33 duplication and promote complementary efforts.
52.34 Subd. 10. [EVALUATION.] Using the outcomes established
52.35 according to subdivision 3, the commissioner shall conduct a
52.36 biennial evaluation of the impact of each teen pregnancy
53.1 prevention initiative in this section. Grant recipients and the
53.2 commissioner of children, families, and learning shall cooperate
53.3 with the commissioner in the evaluation and shall provide the
53.4 commissioner with the information needed to conduct the
53.5 evaluation.
53.6 Subd. 11. [REPORT.] By January 15, 2002, and January 15 of
53.7 each even-numbered year thereafter, the commissioner shall
53.8 submit a report to the legislature on the projects funded under
53.9 this section and the results of the biennial evaluation.
53.10 Sec. 54. [145.9268] [COMMUNITY CLINIC GRANTS.]
53.11 Subdivision 1. [DEFINITION.] For purposes of this section,
53.12 "eligible community clinic" means:
53.13 (1) a clinic that provides services under conditions as
53.14 defined in Minnesota Rules, part 9505.0255 or 9505.0380, and
53.15 utilizes a sliding fee scale to determine eligibility for
53.16 charity care;
53.17 (2) an Indian tribal government or Indian health service
53.18 unit; or
53.19 (3) a consortium of clinics comprised of entities under
53.20 clause (1) or (2).
53.21 Subd. 2. [GRANTS AUTHORIZED.] The commissioner of health
53.22 shall award grants to eligible community clinics to improve the
53.23 ongoing viability of Minnesota's clinic-based safety net
53.24 providers. Grants shall be awarded to support the capacity of
53.25 eligible community clinics to serve low-income populations,
53.26 reduce current or future uncompensated care burdens, or provide
53.27 for improved care delivery infrastructure.
53.28 Subd. 3. [ALLOCATION OF GRANTS.] (a) To receive a grant
53.29 under this section, an eligible community clinic must submit an
53.30 application to the commissioner of health by the deadline
53.31 established by the commissioner. A grant may be awarded upon
53.32 the signing of a grant contract.
53.33 (b) An application must be on a form and contain
53.34 information as specified by the commissioner but at a minimum
53.35 must contain:
53.36 (1) a description of the project for which grant funds will
54.1 be used;
54.2 (2) a description of the problem the proposed project will
54.3 address; and
54.4 (3) a description of achievable objectives, a workplan, and
54.5 a timeline for project completion.
54.6 (c) The commissioner shall review each application to
54.7 determine whether the application is complete and whether the
54.8 applicant and the project are eligible for a grant. In
54.9 evaluating applications according to paragraph (e), the
54.10 commissioner shall establish criteria including, but not limited
54.11 to: the priority level of the project; the applicant's
54.12 thoroughness and clarity in describing the problem; a
54.13 description of the applicant's proposed project; the manner in
54.14 which the applicant will demonstrate the effectiveness of the
54.15 project; and evidence of efficiencies and effectiveness gained
54.16 through collaborative efforts. The commissioner may also take
54.17 into account other relevant factors, including, but not limited
54.18 to, the percentage for which uninsured patients represent the
54.19 applicant's patient base. During application review, the
54.20 commissioner may request additional information about a proposed
54.21 project, including information on project cost. Failure to
54.22 provide the information requested disqualifies an applicant.
54.23 (d) A grant awarded to an eligible community clinic may not
54.24 exceed $300,000 per eligible community clinic. For an applicant
54.25 applying as a consortium of clinics, a grant may not exceed
54.26 $300,000 per clinic included in the consortium. The
54.27 commissioner has discretion over the number of grants awarded.
54.28 (e) In determining which eligible community clinics will
54.29 receive grants under this section, the commissioner shall give
54.30 preference to those grant applications that show evidence of
54.31 collaboration with other eligible community clinics, hospitals,
54.32 health care providers, or community organizations. In addition,
54.33 the commissioner shall give priority, in declining order, to
54.34 grant applications for projects that:
54.35 (1) establish, update, or improve information, data
54.36 collection, or billing systems;
55.1 (2) procure, modernize, remodel, or replace equipment used
55.2 an the delivery of direct patient care at a clinic;
55.3 (3) provide improvements for care delivery, such as
55.4 increased translation and interpretation services;
55.5 (4) provide a direct offset to expenses incurred for
55.6 charity care services; or
55.7 (5) other projects determined by the commissioner to
55.8 improve the ability of applicants to provide care to the
55.9 vulnerable populations they serve.
55.10 Subd. 4. [EVALUATION.] The commissioner of health shall
55.11 evaluate the overall effectiveness of the grant program. The
55.12 commissioner shall collect progress reports to evaluate the
55.13 grant program from the eligible community clinics receiving
55.14 grants.
55.15 Sec. 55. [145.928] [ELIMINATING HEALTH DISPARITIES.]
55.16 Subdivision 1. [GOAL; ESTABLISHMENT.] It is the goal of
55.17 the state, by 2010, to decrease by 50 percent the disparities in
55.18 infant mortality rates and adult and child immunization rates
55.19 for American Indians and populations of color, as compared with
55.20 rates for whites. To do so and to achieve other measurable
55.21 outcomes, the commissioner of health shall establish a program
55.22 to close the gap in the health status of American Indians and
55.23 populations of color as compared with whites in the following
55.24 priority areas: infant mortality, breast and cervical cancer
55.25 screening, HIV/AIDS and sexually transmitted infections, adult
55.26 and child immunizations, cardiovascular disease, diabetes, and
55.27 accidental injuries and violence. If this goal of reducing
55.28 disparities in infant mortality rates and adult and child
55.29 immunization rates is not met by December 31, 2010, this section
55.30 expires June 30, 2011.
55.31 Subd. 2. [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The
55.32 commissioner, in partnership with culturally-based community
55.33 organizations; the Indian affairs council under section 3.922;
55.34 the council on affairs of Chicano/Latino people under section
55.35 3.9223; the council on Black Minnesotans under section 3.9225;
55.36 the council on Asian-Pacific Minnesotans under section 3.9226;
56.1 community health boards as defined in section 145A.02; and
56.2 tribal governments, shall develop and implement a comprehensive,
56.3 coordinated plan to reduce health disparities in the health
56.4 disparity priority areas identified in subdivision 1.
56.5 Subd. 3. [MEASURABLE OUTCOMES.] The commissioner, in
56.6 consultation with the community partners listed in subdivision
56.7 2, shall establish measurable outcomes to achieve the goal
56.8 specified in subdivision 1 and to determine the effectiveness of
56.9 the grants and other activities funded under this section in
56.10 reducing health disparities in the priority areas identified in
56.11 subdivision 1. The development of measurable outcomes must be
56.12 completed before any funds are distributed under this section.
56.13 Subd. 4. [STATEWIDE ASSESSMENT.] The commissioner shall
56.14 enhance current data tools to ensure a statewide assessment of
56.15 the risk behaviors associated with the health disparity priority
56.16 areas identified in subdivision 1. The statewide assessment
56.17 must be used to establish a baseline to measure the effect of
56.18 activities funded under this section. To the extent feasible,
56.19 the commissioner shall conduct the assessment so that the
56.20 results may be compared to national data.
56.21 Subd. 5. [TECHNICAL ASSISTANCE.] The commissioner shall
56.22 provide the necessary expertise to grant applicants to ensure
56.23 that submitted proposals are likely to be successful in reducing
56.24 the health disparities identified in subdivision 1. The
56.25 commissioner shall provide grant recipients with guidance and
56.26 training on best or most promising strategies to use to reduce
56.27 the health disparities identified in subdivision 1. The
56.28 commissioner shall also assist grant recipients in the
56.29 development of materials and procedures to evaluate local
56.30 community activities.
56.31 Subd. 6. [PROCESS.] (a) The commissioner, in consultation
56.32 with the community partners listed in subdivision 2, shall
56.33 develop the criteria and procedures used to allocate grants
56.34 under this section. In developing the criteria, the
56.35 commissioner shall establish an administrative cost limit for
56.36 grant recipients. At the time a grant is awarded, the
57.1 commissioner must provide a grant recipient with information on
57.2 the outcomes established according to subdivision 3.
57.3 (b) A grant recipient must coordinate its activities to
57.4 reduce health disparities with other entities receiving funds
57.5 under this section that are in the grant recipient's service
57.6 area.
57.7 Subd. 7. [COMMUNITY GRANT PROGRAM; IMMUNIZATION RATES AND
57.8 INFANT MORTALITY RATES.] (a) The commissioner shall award grants
57.9 to eligible applicants for local or regional projects and
57.10 initiatives directed at reducing health disparities in one or
57.11 both of the following priority areas:
57.12 (1) decreasing racial and ethnic disparities in infant
57.13 mortality rates; or
57.14 (2) increasing adult and child immunization rates in
57.15 nonwhite racial and ethnic populations.
57.16 (b) The commissioner may award up to 20 percent of the
57.17 funds available as planning grants. Planning grants must be
57.18 used to address such areas as community assessment, coordination
57.19 activities, and development of community supported strategies.
57.20 (c) Eligible applicants may include, but are not limited
57.21 to, faith-based organizations, social service organizations,
57.22 community nonprofit organizations, community health boards,
57.23 tribal governments, and community clinics. Applicants must
57.24 submit proposals to the commissioner. A proposal must specify
57.25 the strategies to be implemented to address one or both of the
57.26 priority areas listed in paragraph (a) and must be targeted to
57.27 achieve the outcomes established according to subdivision 3.
57.28 (d) The commissioner shall give priority to applicants who
57.29 demonstrate that their proposed project or initiative:
57.30 (1) is supported by the community the applicant will serve;
57.31 (2) is research-based or based on promising strategies;
57.32 (3) is designed to complement other related community
57.33 activities;
57.34 (4) utilizes strategies that positively impact both
57.35 priority areas;
57.36 (5) reflects racially and ethnically appropriate
58.1 approaches; and
58.2 (6) will be implemented through or with community-based
58.3 organizations that reflect the race or ethnicity of the
58.4 population to be reached.
58.5 Subd. 8. [COMMUNITY GRANT PROGRAM; OTHER HEALTH
58.6 DISPARITIES.] (a) The commissioner shall award grants to
58.7 eligible applicants for local or regional projects and
58.8 initiatives directed at reducing health disparities in one or
58.9 more of the following priority areas:
58.10 (1) decreasing racial and ethnic disparities in morbidity
58.11 and mortality rates from breast and cervical cancer;
58.12 (2) decreasing racial and ethnic disparities in morbidity
58.13 and mortality rates from HIV/AIDS and sexually transmitted
58.14 infections;
58.15 (3) decreasing racial and ethnic disparities in morbidity
58.16 and mortality rates from cardiovascular disease;
58.17 (4) decreasing racial and ethnic disparities in morbidity
58.18 and mortality rates from diabetes; or
58.19 (5) decreasing racial and ethnic disparities in morbidity
58.20 and mortality rates from accidental injuries or violence.
58.21 (b) The commissioner may award up to 20 percent of the
58.22 funds available as planning grants. Planning grants must be
58.23 used to address such areas as community assessment, determining
58.24 community priority areas, coordination activities, and
58.25 development of community supported strategies.
58.26 (c) Eligible applicants may include, but are not limited
58.27 to, faith-based organizations, social service organizations,
58.28 community nonprofit organizations, community health boards,
58.29 tribal governments, and community clinics. Applicants shall
58.30 submit proposals to the commissioner. A proposal must specify
58.31 the strategies to be implemented to address one or more of the
58.32 priority areas listed in paragraph (a) and must be targeted to
58.33 achieve the outcomes established according to subdivision 3.
58.34 (d) The commissioner shall give priority to applicants who
58.35 demonstrate that their proposed project or initiative:
58.36 (1) is supported by the community the applicant will serve;
59.1 (2) is research-based or based on promising strategies;
59.2 (3) is designed to complement other related community
59.3 activities;
59.4 (4) utilizes strategies that positively impact more than
59.5 one priority area;
59.6 (5) reflects racially and ethnically appropriate
59.7 approaches; and
59.8 (6) will be implemented through or with community-based
59.9 organizations that reflect the race or ethnicity of the
59.10 population to be reached.
59.11 Subd. 9. [REFUGEE AND IMMIGRANT HEALTH.] (a) The
59.12 commissioner shall distribute funds to community health boards
59.13 for health screening and follow-up services for tuberculosis for
59.14 refugees. Funds shall be distributed based on the following
59.15 formula:
59.16 (1) $1,500 per refugee with pulmonary tuberculosis in the
59.17 community health board's service area;
59.18 (2) $500 per refugee with extrapulmonary tuberculosis in
59.19 the community health board's service area;
59.20 (3) $500 per month of directly observed therapy provided by
59.21 the community health board for each uninsured refugee with
59.22 pulmonary or extrapulmonary tuberculosis; and
59.23 (4) $50 per refugee in the community health board's service
59.24 area.
59.25 (b) Payments must be made at the end of each state fiscal
59.26 year. The amount paid per tuberculosis case, per month of
59.27 directly observed therapy, and per refugee must be
59.28 proportionately increased or decreased to fit the actual amount
59.29 appropriated for that fiscal year.
59.30 Subd. 10. [COORDINATION.] The commissioner shall
59.31 coordinate the projects and initiatives funded under this
59.32 section with other efforts at the local, state, or national
59.33 level to avoid duplication and promote complementary efforts.
59.34 Subd. 11. [EVALUATION.] Using the outcomes established
59.35 according to subdivision 3, the commissioner shall conduct a
59.36 biennial evaluation of the community grant programs under
60.1 subdivisions 7 and 8. Grant recipients shall cooperate with the
60.2 commissioner in the evaluation and shall provide the
60.3 commissioner with the information needed to conduct the
60.4 evaluation.
60.5 Subd. 12. [REPORT.] By January 15, 2002, and January 15 of
60.6 each even-numbered year thereafter, the commissioner shall
60.7 submit a report to the legislature on the local community
60.8 projects and community health board activities funded under this
60.9 section. The report must include information on grant
60.10 recipients, activities conducted using grant funds, and
60.11 evaluation data and outcome measures if available.
60.12 Sec. 56. Minnesota Statutes 2000, section 145A.15,
60.13 subdivision 1, is amended to read:
60.14 Subdivision 1. [ESTABLISHMENT.] (a) The commissioner of
60.15 health shall expand the current grant program to fund additional
60.16 projects designed to prevent child abuse and neglect and reduce
60.17 juvenile delinquency by promoting positive parenting, resiliency
60.18 in children, and a healthy beginning for children by providing
60.19 early intervention services for families in need. Grant dollars
60.20 shall be available to train paraprofessionals to provide in-home
60.21 intervention services and to allow public health nurses to do
60.22 case management of services. The grant program shall provide
60.23 early intervention services for families in need and will
60.24 include:
60.25 (1) expansion of current public health nurse and family
60.26 aide home visiting programs and public health home visiting
60.27 projects which prevent child abuse and neglect, prevent juvenile
60.28 delinquency, and build resiliency in children;
60.29 (2) early intervention to promote a healthy and nurturing
60.30 beginning;
60.31 (3) distribution of educational and public information
60.32 programs and materials in hospital maternity divisions,
60.33 well-baby clinics, obstetrical clinics, and community clinics;
60.34 and
60.35 (4) training of home visitors in skills necessary for
60.36 comprehensive home visiting which promotes a healthy and
61.1 nurturing beginning for the child.
61.2 (b) No new grants shall be awarded under this section after
61.3 June 30, 2001. Grant contracts awarded and in effect under this
61.4 section as of July 1, 2001, shall continue until their
61.5 expiration date.
61.6 Sec. 57. Minnesota Statutes 2000, section 145A.15, is
61.7 amended by adding a subdivision to read:
61.8 Subd. 5. [EXPIRATION.] This section expires June 30, 2003.
61.9 Sec. 58. Minnesota Statutes 2000, section 145A.16,
61.10 subdivision 1, is amended to read:
61.11 Subdivision 1. [ESTABLISHMENT.] The commissioner shall
61.12 establish a grant program to fund universally offered home
61.13 visiting programs designed to serve all live births in
61.14 designated geographic areas. The commissioner shall designate
61.15 the geographic area to be served by each program. At least one
61.16 program must provide home visiting services to families within
61.17 the seven-county metropolitan area, and at least one program
61.18 must provide home visiting services to families outside the
61.19 metropolitan area. The purpose of the program is to strengthen
61.20 families and to promote positive parenting and healthy child
61.21 development. No new grants shall be awarded under this section
61.22 after June 30, 2001. Competitive grant contracts awarded and in
61.23 effect under this section as of July 1, 2001, shall expire
61.24 December 31, 2003.
61.25 Sec. 59. Minnesota Statutes 2000, section 145A.16, is
61.26 amended by adding a subdivision to read:
61.27 Subd. 10. [EXPIRATION.] This section expires December 31,
61.28 2003.
61.29 Sec. 60. [145A.17] [FAMILY HOME VISITING PROGRAMS.]
61.30 Subdivision 1. [ESTABLISHMENT; GOALS.] The commissioner
61.31 shall establish a program to fund family home visiting programs
61.32 designed to foster a healthy beginning for children in families
61.33 at or below 200 percent of the federal poverty guidelines,
61.34 prevent child abuse and neglect, reduce juvenile delinquency,
61.35 promote positive parenting and resiliency in children, and
61.36 promote family health and economic self-sufficiency. A program
62.1 funded under this section must serve families at or below 200
62.2 percent of the federal poverty guidelines, and other families
62.3 determined to be at risk for child abuse, neglect, or juvenile
62.4 delinquency. Programs must give priority for services to
62.5 families considered to be in need of services, including but not
62.6 limited to families with:
62.7 (1) adolescent parents;
62.8 (2) a history of alcohol or other drug abuse;
62.9 (3) a history of child abuse, domestic abuse, or other
62.10 types of violence;
62.11 (4) a history of domestic abuse, rape, or other forms of
62.12 victimization;
62.13 (5) reduced cognitive functioning;
62.14 (6) a lack of knowledge of child growth and development
62.15 stages;
62.16 (7) low resiliency to adversities and environmental
62.17 stresses; or
62.18 (8) insufficient financial resources to meet family needs.
62.19 Subd. 2. [ALLOCATION OF FUNDS.] The commissioner shall
62.20 distribute funds available under this section to community
62.21 health boards, as defined in section 145A.02, and to tribal
62.22 governments. Funds shall be distributed to community health
62.23 boards as follows: (1) each community health board shall
62.24 receive an allocation of $25,000 per year; and (2) remaining
62.25 funds available to community health boards shall be distributed
62.26 according to the formula in section 256J.625, subdivision 3.
62.27 The commissioner, in consultation with tribal governments, shall
62.28 establish a formula for distributing funds to tribal governments.
62.29 Subd. 3. [REQUIREMENTS FOR PROGRAMS; PROCESS.] (a) Before
62.30 a community health board or tribal government may receive an
62.31 allocation under subdivision 2, a community health board or
62.32 tribal government must submit a proposal to the commissioner
62.33 that includes identification, based on a community assessment,
62.34 of the populations at or below 200 percent of the federal
62.35 poverty guidelines that will be served and the other populations
62.36 that will be served. Each program that receives funds must:
63.1 (1) use either a broad community-based or selective
63.2 community-based strategy to provide preventive and early
63.3 intervention home visiting services;
63.4 (2) offer a home visit by a trained home visitor. If a
63.5 home visit is accepted, the first home visit must occur
63.6 prenatally or as soon after birth as possible and must include a
63.7 public health nursing assessment by a public health nurse;
63.8 (3) offer, at a minimum, information on infant care, child
63.9 growth and development, positive parenting, preventing diseases,
63.10 preventing exposure to environmental hazards, and support
63.11 services available in the community;
63.12 (4) provide information on and referrals to health care
63.13 services, if needed, including information on health care
63.14 coverage for which the child or family may be eligible; and
63.15 provide information on preventive services, developmental
63.16 assessments, and the availability of public assistance programs
63.17 as appropriate;
63.18 (5) recruit home visitors who will represent, to the extent
63.19 possible, the races, cultures, and languages spoken by families
63.20 that may be served;
63.21 (6) train and supervise home visitors in accordance with
63.22 the requirements established under subdivision 4;
63.23 (7) maximize resources and minimize duplication by
63.24 coordinating activities with local social and human services
63.25 organizations, education organizations, and other appropriate
63.26 governmental entities and community-based organizations and
63.27 agencies; and
63.28 (8) utilize appropriate racial and ethnic approaches to
63.29 providing home visiting services.
63.30 (b) Funds available under this section shall not be used
63.31 for medical services. The commissioner shall establish an
63.32 administrative cost limit for recipients of funds. The outcome
63.33 measures established under subdivision 6 must be specified to
63.34 recipients of funds at the time the funds are distributed.
63.35 (c) Data collected on individuals served by the home
63.36 visiting programs must remain confidential and must not be
64.1 disclosed by providers of home visiting services without a
64.2 specific informed written consent that identifies disclosures to
64.3 be made. Upon request, agencies providing home visiting
64.4 services must provide recipients with information on
64.5 disclosures, including the names of entities and individuals
64.6 receiving the information and the general purpose of the
64.7 disclosure. Prospective and current recipients of home visiting
64.8 services must be told and informed in writing that written
64.9 consent for disclosure of data is not required for access to
64.10 home visiting services.
64.11 Subd. 4. [TRAINING.] The commissioner shall establish
64.12 training requirements for home visitors and minimum requirements
64.13 for supervision by a public health nurse. The requirements for
64.14 nurses must be consistent with chapter 148. Training must
64.15 include child development, positive parenting techniques, and
64.16 diverse cultural practices in child rearing and family systems.
64.17 Subd. 5. [TECHNICAL ASSISTANCE.] The commissioner shall
64.18 provide administrative and technical assistance to each program,
64.19 including assistance in data collection and other activities
64.20 related to conducting short- and long-term evaluations of the
64.21 programs as required under subdivision 7. The commissioner may
64.22 request research and evaluation support from the University of
64.23 Minnesota.
64.24 Subd. 6. [OUTCOME MEASURES.] The commissioner shall
64.25 establish outcomes to determine the impact of family home
64.26 visiting programs funded under this section on the following
64.27 areas:
64.28 (1) appropriate utilization of preventive health care;
64.29 (2) rates of substantiated child abuse and neglect;
64.30 (3) rates of unintentional child injuries; and
64.31 (4) any additional qualitative goals and quantitative
64.32 measures established by the commissioner.
64.33 Subd. 7. [EVALUATION.] Using the qualitative goals and
64.34 quantitative outcome measures established under subdivisions 1
64.35 and 6, the commissioner shall conduct ongoing evaluations of the
64.36 programs funded under this section. Community health boards and
65.1 tribal governments shall cooperate with the commissioner in the
65.2 evaluations and shall provide the commissioner with the
65.3 information necessary to conduct the evaluations. As part of
65.4 the ongoing evaluations, the commissioner shall rate the impact
65.5 of the programs on the outcome measures listed in subdivision 6,
65.6 and shall periodically determine whether home visiting programs
65.7 are the best way to achieve the qualitative goals established in
65.8 subdivision 1 and by the commissioner. If the commissioner
65.9 determines that home visiting programs are not the best way to
65.10 achieve these goals, the commissioner shall provide the
65.11 legislature with alternative methods for achieving them.
65.12 Subd. 8. [REPORT.] By January 15, 2002, and January 15 of
65.13 each even-numbered year thereafter, the commissioner shall
65.14 submit a report to the legislature on the family home visiting
65.15 programs funded under this section and on the results of the
65.16 evaluations conducted under subdivision 7.
65.17 Subd. 9. [NO SUPPLANTING OF EXISTING FUNDS.] Funding
65.18 available under this section may be used only to supplement, not
65.19 to replace, nonstate funds being used for home visiting services
65.20 as of July 1, 2001.
65.21 Sec. 61. Minnesota Statutes 2000, section 157.16,
65.22 subdivision 3, is amended to read:
65.23 Subd. 3. [ESTABLISHMENT FEES; DEFINITIONS.] (a) The
65.24 following fees are required for food and beverage service
65.25 establishments, hotels, motels, lodging establishments, and
65.26 resorts licensed under this chapter. Food and beverage service
65.27 establishments must pay the highest applicable fee under
65.28 paragraph (e), clause (1), (2), (3), or (4), and establishments
65.29 serving alcohol must pay the highest applicable fee under
65.30 paragraph (e), clause (6) or (7). The license fee for new
65.31 operators previously licensed under this chapter for the same
65.32 calendar year is one-half of the appropriate annual license fee,
65.33 plus any penalty that may be required. The license fee for
65.34 operators opening on or after October 1 is one-half of the
65.35 appropriate annual license fee, plus any penalty that may be
65.36 required. The fees in paragraphs (b), (c), and (d) effective
66.1 until June 30, 2001, shall be phased up as specified in section
66.2 64 to the fee amounts effective beginning July 1, 2004.
66.3 Notwithstanding section 16A.1285, in fiscal years 2002, 2003,
66.4 and 2004, the commissioner shall regulate food and beverage
66.5 service establishments, hotels, motels, lodging establishments,
66.6 and resorts with the fees collected for that purpose.
66.7 (b) All food and beverage service establishments, except
66.8 special event food stands, and all hotels, motels, lodging
66.9 establishments, and resorts shall pay an annual base fee of $100
66.10 until June 30, 2001. Effective July 1, 2004, the annual base
66.11 fee shall be $145.
66.12 (c) A special event food stand shall pay a flat fee of $30
66.13 annually until June 30, 2001. Effective July 1, 2004, the
66.14 annual flat fee shall be $35. "Special event food stand" means
66.15 a fee category where food is prepared or served in conjunction
66.16 with celebrations, county fairs, or special events from a
66.17 special event food stand as defined in section 157.15.
66.18 (d) In addition to the base fee in paragraph (b), each food
66.19 and beverage service establishment, other than a special event
66.20 food stand, and each hotel, motel, lodging establishment, and
66.21 resort shall pay an additional annual fee for each fee category
66.22 as specified in this paragraph:
66.23 (1) Limited food menu selection, $30 until June 30, 2001.
66.24 Effective July 1, 2004, the annual fee shall be $40. "Limited
66.25 food menu selection" means a fee category that provides one or
66.26 more of the following:
66.27 (i) prepackaged food that receives heat treatment and is
66.28 served in the package;
66.29 (ii) frozen pizza that is heated and served;
66.30 (iii) a continental breakfast such as rolls, coffee, juice,
66.31 milk, and cold cereal;
66.32 (iv) soft drinks, coffee, or nonalcoholic beverages; or
66.33 (v) cleaning for eating, drinking, or cooking utensils,
66.34 when the only food served is prepared off site.
66.35 (2) Small establishment, including boarding establishments,
66.36 $55 until June 30, 2001. Effective July 1, 2004, the annual fee
67.1 shall be $75. "Small establishment" means a fee category that
67.2 has no salad bar and meets one or more of the following:
67.3 (i) possesses food service equipment that consists of no
67.4 more than a deep fat fryer, a grill, two hot holding containers,
67.5 and one or more microwave ovens;
67.6 (ii) serves dipped ice cream or soft serve frozen desserts;
67.7 (iii) serves breakfast in an owner-occupied bed and
67.8 breakfast establishment;
67.9 (iv) is a boarding establishment; or
67.10 (v) meets the equipment criteria in clause (3), item (i) or
67.11 (ii), and has a maximum patron seating capacity of not more than
67.12 50.
67.13 (3) Medium establishment, $150 until June 30, 2001.
67.14 Effective July 1, 2004, the annual fee shall be $210. "Medium
67.15 establishment" means a fee category that meets one or more of
67.16 the following:
67.17 (i) possesses food service equipment that includes a range,
67.18 oven, steam table, salad bar, or salad preparation area;
67.19 (ii) possesses food service equipment that includes more
67.20 than one deep fat fryer, one grill, or two hot holding
67.21 containers; or
67.22 (iii) is an establishment where food is prepared at one
67.23 location and served at one or more separate locations.
67.24 Establishments meeting criteria in clause (2), item (v),
67.25 are not included in this fee category.
67.26 (4) Large establishment, $250 until June 30, 2001.
67.27 Effective July 1, 2004, the annual fee shall be $350. "Large
67.28 establishment" means either:
67.29 (i) a fee category that (A) meets the criteria in clause
67.30 (3), items (i) or (ii), for a medium establishment, (B) seats
67.31 more than 175 people, and (C) offers the full menu selection an
67.32 average of five or more days a week during the weeks of
67.33 operation; or
67.34 (ii) a fee category that (A) meets the criteria in clause
67.35 (3), item (iii), for a medium establishment, and (B) prepares
67.36 and serves 500 or more meals per day.
68.1 (5) Other food and beverage service, including food carts,
68.2 mobile food units, seasonal temporary food stands, and seasonal
68.3 permanent food stands, $30 until June 30, 2001. Effective July
68.4 1, 2004, the annual fee shall be $40.
68.5 (6) Beer or wine table service, $30 until June 30, 2001.
68.6 Effective July 1, 2004, the annual fee shall be $40. "Beer or
68.7 wine table service" means a fee category where the only
68.8 alcoholic beverage service is beer or wine, served to customers
68.9 seated at tables.
68.10 (7) Alcoholic beverage service, other than beer or wine
68.11 table service, $75 until June 30, 2001. Effective July 1, 2004,
68.12 the annual fee shall be $105.
68.13 "Alcohol beverage service, other than beer or wine table
68.14 service" means a fee category where alcoholic mixed drinks are
68.15 served or where beer or wine are served from a bar.
68.16 (8) Until June 30, 2001, lodging per sleeping accommodation
68.17 unit, $4, including hotels, motels, lodging establishments, and
68.18 resorts, up to a maximum of $400. Effective July 1, 2004,
68.19 lodging per sleeping accommodation unit, $6, including hotels,
68.20 motels, lodging establishments, and resorts, up to a maximum of
68.21 $600. "Lodging per sleeping accommodation unit" means a fee
68.22 category including the number of guest rooms, cottages, or other
68.23 rental units of a hotel, motel, lodging establishment, or
68.24 resort; or the number of beds in a dormitory.
68.25 (9) First public swimming pool, $100 until June 30, 2001;
68.26 each additional public swimming pool, $50 until June 30, 2001.
68.27 Effective July 1, 2004, first public swimming pool, $140; each
68.28 additional public swimming pool, $80. "Public swimming pool"
68.29 means a fee category that has the meaning given in Minnesota
68.30 Rules, part 4717.0250, subpart 8.
68.31 (10) First spa, $50 until June 30, 2001; each additional
68.32 spa, $25 until June 30, 2001. Effective July 1, 2004, first
68.33 spa, $80; each additional spa, $40. "Spa pool" means a fee
68.34 category that has the meaning given in Minnesota Rules, part
68.35 4717.0250, subpart 9.
68.36 (11) Private sewer or water, $30 until June 30, 2001.
69.1 Effective July 1, 2004, private sewer or water, $40.
69.2 "Individual private water" means a fee category with a water
69.3 supply other than a community public water supply as defined in
69.4 Minnesota Rules, chapter 4720. "Individual private sewer" means
69.5 a fee category with an individual sewage treatment system which
69.6 uses subsurface treatment and disposal.
69.7 (e) A fee is not required for a food and beverage service
69.8 establishment operated by a school as defined in sections
69.9 120A.05, subdivisions 9, 11, 13, and 17 and 120A.22.
69.10 (f) A fee of $150 for review of the construction plans must
69.11 accompany the initial license application for food and beverage
69.12 service establishments, hotels, motels, lodging establishments,
69.13 or resorts.
69.14 (g) (f) When existing food and beverage service
69.15 establishments, hotels, motels, lodging establishments, or
69.16 resorts are extensively remodeled, a fee of $150 must be
69.17 submitted with the remodeling plans.
69.18 (h) (g) Seasonal temporary food stands and special event
69.19 food stands are not required to submit construction or
69.20 remodeling plans for review.
69.21 Sec. 62. Minnesota Statutes 2000, section 157.22, is
69.22 amended to read:
69.23 157.22 [EXEMPTIONS.]
69.24 This chapter shall not be construed to apply to:
69.25 (1) interstate carriers under the supervision of the United
69.26 States Department of Health and Human Services;
69.27 (2) any building constructed and primarily used for
69.28 religious worship;
69.29 (3) any building owned, operated, and used by a college or
69.30 university in accordance with health regulations promulgated by
69.31 the college or university under chapter 14;
69.32 (4) any person, firm, or corporation whose principal mode
69.33 of business is licensed under sections 28A.04 and 28A.05, is
69.34 exempt at that premises from licensure as a food or beverage
69.35 establishment; provided that the holding of any license pursuant
69.36 to sections 28A.04 and 28A.05 shall not exempt any person, firm,
70.1 or corporation from the applicable provisions of this chapter or
70.2 the rules of the state commissioner of health relating to food
70.3 and beverage service establishments;
70.4 (5) family day care homes and group family day care homes
70.5 governed by sections 245A.01 to 245A.16;
70.6 (6) nonprofit senior citizen centers for the sale of
70.7 home-baked goods; and
70.8 (7) food not prepared at an establishment and brought in by
70.9 individuals attending a potluck event for consumption at the
70.10 potluck event. An organization sponsoring a potluck event under
70.11 this clause may advertise the potluck event to the public
70.12 through any means. Individuals who are not members of an
70.13 organization sponsoring a potluck event under this clause may
70.14 attend the potluck event and consume the food at the event.
70.15 Licensed food establishments cannot be sponsors of potluck
70.16 events. Potluck event food shall not be brought into a licensed
70.17 food establishment kitchen; and
70.18 (8) a home school in which a child is provided instruction
70.19 at home.
70.20 Sec. 63. [325F.691] [DISCLOSURE OF SPECIAL CARE STATUS
70.21 REQUIRED.]
70.22 Subdivision 1. [PERSONS TO WHOM DISCLOSURE IS
70.23 REQUIRED.] Housing with services establishments, as defined in
70.24 sections 144D.01 to 144D.07, that secure, segregate, or provide
70.25 a special program or special unit for residents with a diagnosis
70.26 of probable Alzheimer's disease or a related disorder or that
70.27 advertise, market, or otherwise promote the establishment as
70.28 providing specialized care for Alzheimer's disease or a related
70.29 disorder are considered a "special care unit." All special care
70.30 units shall provide a written disclosure to the following:
70.31 (1) the commissioner of health, if requested;
70.32 (2) the office of ombudsman for older Minnesotans; and
70.33 (3) each person seeking placement within a residence, or
70.34 the person's authorized representative, before an agreement to
70.35 provide the care is entered into.
70.36 Subd. 2. [CONTENT.] Written disclosure shall include, but
71.1 is not limited to, the following:
71.2 (1) a statement of the overall philosophy and how it
71.3 reflects the special needs of residents with Alzheimer's disease
71.4 or other dementias;
71.5 (2) the criteria for determining who may reside in the
71.6 special care unit;
71.7 (3) the process used for assessment and establishment of
71.8 the service plan or agreement, including how the plan is
71.9 responsive to changes in the resident's condition;
71.10 (4) staffing credentials, job descriptions, and staff
71.11 duties and availability, including any training specific to
71.12 dementia;
71.13 (5) physical environment as well as design and security
71.14 features that specifically address the needs of residents with
71.15 Alzheimer's disease or other dementias;
71.16 (6) frequency and type of programs and activities for
71.17 residents of the special care unit;
71.18 (7) involvement of families in resident care and
71.19 availability of family support programs;
71.20 (8) fee schedules for additional services to the residents
71.21 of the special care unit; and
71.22 (9) a statement that residents will be given a written
71.23 notice 30 days prior to changes in the fee schedule.
71.24 Subd. 3. [DUTY TO UPDATE.] Substantial changes to
71.25 disclosures must be reported to the parties listed in
71.26 subdivision 1 at the time the change is made.
71.27 Subd. 4. [REMEDY.] The attorney general may seek the
71.28 remedies set forth in section 8.31 for repeated and intentional
71.29 violations of this section. However, no private right of action
71.30 may be maintained as provided under section 8.31, subdivision 3a.
71.31 Sec. 64. [ESTABLISHMENT FEES DURING TRANSITION PERIOD.]
71.32 For fiscal years 2002, 2003, and 2004, the following fees
71.33 shall apply to food and beverage service establishments, hotels,
71.34 motels, lodging establishments, and resorts for which fees are
71.35 established under Minnesota Statutes, section 157.16,
71.36 subdivision 3, paragraphs (b), (c), and (d):
72.1 Fiscal Year Fiscal Year Fiscal Year
72.2 Fee Category 2002 2003 2004
72.3 Annual base fee, all $111.25 $122.50 $133.75
72.4 food and beverage
72.5 service establishments
72.6 except special event
72.7 food stands and all
72.8 hotels, motels, lodging
72.9 establishments, and
72.10 resorts
72.11 Special event food $ 31.25 $ 32.50 $ 33.75
72.12 stand
72.13 Establishment with $ 32.50 $ 35.00 $ 37.50
72.14 limited food menu
72.15 selection
72.16 Small establishment $ 60.00 $ 65.00 $ 70.00
72.17 Medium establishment $165.00 $180.00 $195.00
72.18 Large establishment $275.00 $300.00 $325.00
72.19 Other food and $ 32.50 $ 35.00 $ 37.50
72.20 beverage service
72.21 Beer or wine table $ 32.50 $ 35.00 $ 37.50
72.22 service
72.23 Alcoholic beverage $ 82.50 $ 90.00 $ 97.50
72.24 service other than
72.25 beer or wine table
72.26 service
72.27 Lodging per sleeping $4.50 per $5.00 per $5.50 per
72.28 accommodation unit, unit, $450 unit, $500 unit, $550
72.29 up to a specified maximum maximum maximum
72.30 maximum
72.31 First public $110.00 $120.00 $130.00
72.32 swimming pool
72.33 Each additional $ 57.50 $ 65.00 $ 72.50
72.34 public swimming pool
72.35 First spa $ 57.50 $ 65.00 $ 72.50
72.36 Each additional spa $ 28.75 $ 32.50 $ 36.25
73.1 Private sewer or $ 32.50 $ 35.00 $ 37.50
73.2 water
73.3 Sec. 65. [RECOMMENDATIONS; INCENTIVES FOR MAGNET
73.4 HOSPITALS.]
73.5 The commissioner of health shall develop recommendations
73.6 for incentives that may be implemented to increase the number of
73.7 magnet hospitals in Minnesota. These recommendations must be
73.8 reported by December 1, 2001 to the chairs of the house and
73.9 senate committees with jurisdiction over health and human
73.10 services policy and finance issues.
73.11 Sec. 66. [STUDY; REIMBURSEMENT FOR CERTAIN ANTI-TOBACCO
73.12 USE EDUCATION ACTIVITIES.]
73.13 The commissioner of health, in consultation with persons
73.14 who have had laryngectomies to treat larynx cancer, who use
73.15 artificial larynxes for communication, and who engage in
73.16 anti-tobacco use education activities, shall study and develop
73.17 recommendations establishing a program to reimburse these
73.18 persons for mileage and other costs associated with traveling to
73.19 schools in the state to educate students about the health risks
73.20 of tobacco use. The recommendations must include proposals for
73.21 reimbursement levels, a funding source, expenses for which
73.22 persons may be reimbursed, and persons eligible for
73.23 reimbursement. The recommendations must be reported to the
73.24 chairs of the policy and finance committees in the House and
73.25 Senate with jurisdiction over health and human services issues
73.26 by January 15, 2002.
73.27 Sec. 67. [STUDY; EFFECTS OF NURSE STAFFING SHORTAGES.]
73.28 The commissioner of health, in consultation with consumers,
73.29 representatives of the Minnesota nurses association, and
73.30 representatives of the Minnesota hospital and healthcare
73.31 partnership, shall study and identify the effects of nurse
73.32 staffing shortages in health care facilities on patient care and
73.33 patient safety. The results of this study shall be reported by
73.34 December 1, 2001 to the chairs of the house and senate
73.35 committees with jurisdiction over health and human services
73.36 policy issues.
74.1 Sec. 68. [REPEALER.]
74.2 (a) Minnesota Statutes 2000, sections 145.882, subdivisions
74.3 3 and 4; and 145.927, are repealed.
74.4 (b) Minnesota Statutes 2000, section 144.148, subdivision
74.5 8, is repealed.
74.6 [EFFECTIVE DATE.] Paragraph (b) of this section is
74.7 effective the day following final enactment.
74.8 ARTICLE 2
74.9 HEALTH CARE
74.10 Section 1. Minnesota Statutes 2000, section 256.01,
74.11 subdivision 2, is amended to read:
74.12 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of
74.13 section 241.021, subdivision 2, the commissioner of human
74.14 services shall:
74.15 (1) Administer and supervise all forms of public assistance
74.16 provided for by state law and other welfare activities or
74.17 services as are vested in the commissioner. Administration and
74.18 supervision of human services activities or services includes,
74.19 but is not limited to, assuring timely and accurate distribution
74.20 of benefits, completeness of service, and quality program
74.21 management. In addition to administering and supervising human
74.22 services activities vested by law in the department, the
74.23 commissioner shall have the authority to:
74.24 (a) require county agency participation in training and
74.25 technical assistance programs to promote compliance with
74.26 statutes, rules, federal laws, regulations, and policies
74.27 governing human services;
74.28 (b) monitor, on an ongoing basis, the performance of county
74.29 agencies in the operation and administration of human services,
74.30 enforce compliance with statutes, rules, federal laws,
74.31 regulations, and policies governing welfare services and promote
74.32 excellence of administration and program operation;
74.33 (c) develop a quality control program or other monitoring
74.34 program to review county performance and accuracy of benefit
74.35 determinations;
74.36 (d) require county agencies to make an adjustment to the
75.1 public assistance benefits issued to any individual consistent
75.2 with federal law and regulation and state law and rule and to
75.3 issue or recover benefits as appropriate;
75.4 (e) delay or deny payment of all or part of the state and
75.5 federal share of benefits and administrative reimbursement
75.6 according to the procedures set forth in section 256.017;
75.7 (f) make contracts with and grants to public and private
75.8 agencies and organizations, both profit and nonprofit, and
75.9 individuals, using appropriated funds; and
75.10 (g) enter into contractual agreements with federally
75.11 recognized Indian tribes with a reservation in Minnesota to the
75.12 extent necessary for the tribe to operate a federally approved
75.13 family assistance program or any other program under the
75.14 supervision of the commissioner. The commissioner shall consult
75.15 with the affected county or counties in the contractual
75.16 agreement negotiations, if the county or counties wish to be
75.17 included, in order to avoid the duplication of county and tribal
75.18 assistance program services. The commissioner may establish
75.19 necessary accounts for the purposes of receiving and disbursing
75.20 funds as necessary for the operation of the programs.
75.21 (2) Inform county agencies, on a timely basis, of changes
75.22 in statute, rule, federal law, regulation, and policy necessary
75.23 to county agency administration of the programs.
75.24 (3) Administer and supervise all child welfare activities;
75.25 promote the enforcement of laws protecting handicapped,
75.26 dependent, neglected and delinquent children, and children born
75.27 to mothers who were not married to the children's fathers at the
75.28 times of the conception nor at the births of the children;
75.29 license and supervise child-caring and child-placing agencies
75.30 and institutions; supervise the care of children in boarding and
75.31 foster homes or in private institutions; and generally perform
75.32 all functions relating to the field of child welfare now vested
75.33 in the state board of control.
75.34 (4) Administer and supervise all noninstitutional service
75.35 to handicapped persons, including those who are visually
75.36 impaired, hearing impaired, or physically impaired or otherwise
76.1 handicapped. The commissioner may provide and contract for the
76.2 care and treatment of qualified indigent children in facilities
76.3 other than those located and available at state hospitals when
76.4 it is not feasible to provide the service in state hospitals.
76.5 (5) Assist and actively cooperate with other departments,
76.6 agencies and institutions, local, state, and federal, by
76.7 performing services in conformity with the purposes of Laws
76.8 1939, chapter 431.
76.9 (6) Act as the agent of and cooperate with the federal
76.10 government in matters of mutual concern relative to and in
76.11 conformity with the provisions of Laws 1939, chapter 431,
76.12 including the administration of any federal funds granted to the
76.13 state to aid in the performance of any functions of the
76.14 commissioner as specified in Laws 1939, chapter 431, and
76.15 including the promulgation of rules making uniformly available
76.16 medical care benefits to all recipients of public assistance, at
76.17 such times as the federal government increases its participation
76.18 in assistance expenditures for medical care to recipients of
76.19 public assistance, the cost thereof to be borne in the same
76.20 proportion as are grants of aid to said recipients.
76.21 (7) Establish and maintain any administrative units
76.22 reasonably necessary for the performance of administrative
76.23 functions common to all divisions of the department.
76.24 (8) Act as designated guardian of both the estate and the
76.25 person of all the wards of the state of Minnesota, whether by
76.26 operation of law or by an order of court, without any further
76.27 act or proceeding whatever, except as to persons committed as
76.28 mentally retarded. For children under the guardianship of the
76.29 commissioner whose interests would be best served by adoptive
76.30 placement, the commissioner may contract with a licensed
76.31 child-placing agency to provide adoption services. A contract
76.32 with a licensed child-placing agency must be designed to
76.33 supplement existing county efforts and may not replace existing
76.34 county programs, unless the replacement is agreed to by the
76.35 county board and the appropriate exclusive bargaining
76.36 representative or the commissioner has evidence that child
77.1 placements of the county continue to be substantially below that
77.2 of other counties. Funds encumbered and obligated under an
77.3 agreement for a specific child shall remain available until the
77.4 terms of the agreement are fulfilled or the agreement is
77.5 terminated.
77.6 (9) Act as coordinating referral and informational center
77.7 on requests for service for newly arrived immigrants coming to
77.8 Minnesota.
77.9 (10) The specific enumeration of powers and duties as
77.10 hereinabove set forth shall in no way be construed to be a
77.11 limitation upon the general transfer of powers herein contained.
77.12 (11) Establish county, regional, or statewide schedules of
77.13 maximum fees and charges which may be paid by county agencies
77.14 for medical, dental, surgical, hospital, nursing and nursing
77.15 home care and medicine and medical supplies under all programs
77.16 of medical care provided by the state and for congregate living
77.17 care under the income maintenance programs.
77.18 (12) Have the authority to conduct and administer
77.19 experimental projects to test methods and procedures of
77.20 administering assistance and services to recipients or potential
77.21 recipients of public welfare. To carry out such experimental
77.22 projects, it is further provided that the commissioner of human
77.23 services is authorized to waive the enforcement of existing
77.24 specific statutory program requirements, rules, and standards in
77.25 one or more counties. The order establishing the waiver shall
77.26 provide alternative methods and procedures of administration,
77.27 shall not be in conflict with the basic purposes, coverage, or
77.28 benefits provided by law, and in no event shall the duration of
77.29 a project exceed four years. It is further provided that no
77.30 order establishing an experimental project as authorized by the
77.31 provisions of this section shall become effective until the
77.32 following conditions have been met:
77.33 (a) The secretary of health and human services of the
77.34 United States has agreed, for the same project, to waive state
77.35 plan requirements relative to statewide uniformity.
77.36 (b) A comprehensive plan, including estimated project
78.1 costs, shall be approved by the legislative advisory commission
78.2 and filed with the commissioner of administration.
78.3 (13) According to federal requirements, establish
78.4 procedures to be followed by local welfare boards in creating
78.5 citizen advisory committees, including procedures for selection
78.6 of committee members.
78.7 (14) Allocate federal fiscal disallowances or sanctions
78.8 which are based on quality control error rates for the aid to
78.9 families with dependent children program formerly codified in
78.10 sections 256.72 to 256.87, medical assistance, or food stamp
78.11 program in the following manner:
78.12 (a) One-half of the total amount of the disallowance shall
78.13 be borne by the county boards responsible for administering the
78.14 programs. For the medical assistance and the AFDC program
78.15 formerly codified in sections 256.72 to 256.87, disallowances
78.16 shall be shared by each county board in the same proportion as
78.17 that county's expenditures for the sanctioned program are to the
78.18 total of all counties' expenditures for the AFDC program
78.19 formerly codified in sections 256.72 to 256.87, and medical
78.20 assistance programs. For the food stamp program, sanctions
78.21 shall be shared by each county board, with 50 percent of the
78.22 sanction being distributed to each county in the same proportion
78.23 as that county's administrative costs for food stamps are to the
78.24 total of all food stamp administrative costs for all counties,
78.25 and 50 percent of the sanctions being distributed to each county
78.26 in the same proportion as that county's value of food stamp
78.27 benefits issued are to the total of all benefits issued for all
78.28 counties. Each county shall pay its share of the disallowance
78.29 to the state of Minnesota. When a county fails to pay the
78.30 amount due hereunder, the commissioner may deduct the amount
78.31 from reimbursement otherwise due the county, or the attorney
78.32 general, upon the request of the commissioner, may institute
78.33 civil action to recover the amount due.
78.34 (b) Notwithstanding the provisions of paragraph (a), if the
78.35 disallowance results from knowing noncompliance by one or more
78.36 counties with a specific program instruction, and that knowing
79.1 noncompliance is a matter of official county board record, the
79.2 commissioner may require payment or recover from the county or
79.3 counties, in the manner prescribed in paragraph (a), an amount
79.4 equal to the portion of the total disallowance which resulted
79.5 from the noncompliance, and may distribute the balance of the
79.6 disallowance according to paragraph (a).
79.7 (15) Develop and implement special projects that maximize
79.8 reimbursements and result in the recovery of money to the
79.9 state. For the purpose of recovering state money, the
79.10 commissioner may enter into contracts with third parties. Any
79.11 recoveries that result from projects or contracts entered into
79.12 under this paragraph shall be deposited in the state treasury
79.13 and credited to a special account until the balance in the
79.14 account reaches $1,000,000. When the balance in the account
79.15 exceeds $1,000,000, the excess shall be transferred and credited
79.16 to the general fund. All money in the account is appropriated
79.17 to the commissioner for the purposes of this paragraph.
79.18 (16) Have the authority to make direct payments to
79.19 facilities providing shelter to women and their children
79.20 according to section 256D.05, subdivision 3. Upon the written
79.21 request of a shelter facility that has been denied payments
79.22 under section 256D.05, subdivision 3, the commissioner shall
79.23 review all relevant evidence and make a determination within 30
79.24 days of the request for review regarding issuance of direct
79.25 payments to the shelter facility. Failure to act within 30 days
79.26 shall be considered a determination not to issue direct payments.
79.27 (17) Have the authority to establish and enforce the
79.28 following county reporting requirements:
79.29 (a) The commissioner shall establish fiscal and statistical
79.30 reporting requirements necessary to account for the expenditure
79.31 of funds allocated to counties for human services programs.
79.32 When establishing financial and statistical reporting
79.33 requirements, the commissioner shall evaluate all reports, in
79.34 consultation with the counties, to determine if the reports can
79.35 be simplified or the number of reports can be reduced.
79.36 (b) The county board shall submit monthly or quarterly
80.1 reports to the department as required by the commissioner.
80.2 Monthly reports are due no later than 15 working days after the
80.3 end of the month. Quarterly reports are due no later than 30
80.4 calendar days after the end of the quarter, unless the
80.5 commissioner determines that the deadline must be shortened to
80.6 20 calendar days to avoid jeopardizing compliance with federal
80.7 deadlines or risking a loss of federal funding. Only reports
80.8 that are complete, legible, and in the required format shall be
80.9 accepted by the commissioner.
80.10 (c) If the required reports are not received by the
80.11 deadlines established in clause (b), the commissioner may delay
80.12 payments and withhold funds from the county board until the next
80.13 reporting period. When the report is needed to account for the
80.14 use of federal funds and the late report results in a reduction
80.15 in federal funding, the commissioner shall withhold from the
80.16 county boards with late reports an amount equal to the reduction
80.17 in federal funding until full federal funding is received.
80.18 (d) A county board that submits reports that are late,
80.19 illegible, incomplete, or not in the required format for two out
80.20 of three consecutive reporting periods is considered
80.21 noncompliant. When a county board is found to be noncompliant,
80.22 the commissioner shall notify the county board of the reason the
80.23 county board is considered noncompliant and request that the
80.24 county board develop a corrective action plan stating how the
80.25 county board plans to correct the problem. The corrective
80.26 action plan must be submitted to the commissioner within 45 days
80.27 after the date the county board received notice of noncompliance.
80.28 (e) The final deadline for fiscal reports or amendments to
80.29 fiscal reports is one year after the date the report was
80.30 originally due. If the commissioner does not receive a report
80.31 by the final deadline, the county board forfeits the funding
80.32 associated with the report for that reporting period and the
80.33 county board must repay any funds associated with the report
80.34 received for that reporting period.
80.35 (f) The commissioner may not delay payments, withhold
80.36 funds, or require repayment under paragraph (c) or (e) if the
81.1 county demonstrates that the commissioner failed to provide
81.2 appropriate forms, guidelines, and technical assistance to
81.3 enable the county to comply with the requirements. If the
81.4 county board disagrees with an action taken by the commissioner
81.5 under paragraph (c) or (e), the county board may appeal the
81.6 action according to sections 14.57 to 14.69.
81.7 (g) Counties subject to withholding of funds under
81.8 paragraph (c) or forfeiture or repayment of funds under
81.9 paragraph (e) shall not reduce or withhold benefits or services
81.10 to clients to cover costs incurred due to actions taken by the
81.11 commissioner under paragraph (c) or (e).
81.12 (18) Allocate federal fiscal disallowances or sanctions for
81.13 audit exceptions when federal fiscal disallowances or sanctions
81.14 are based on a statewide random sample for the foster care
81.15 program under title IV-E of the Social Security Act, United
81.16 States Code, title 42, in direct proportion to each county's
81.17 title IV-E foster care maintenance claim for that period.
81.18 (19) Be responsible for ensuring the detection, prevention,
81.19 investigation, and resolution of fraudulent activities or
81.20 behavior by applicants, recipients, and other participants in
81.21 the human services programs administered by the department.
81.22 (20) Require county agencies to identify overpayments,
81.23 establish claims, and utilize all available and cost-beneficial
81.24 methodologies to collect and recover these overpayments in the
81.25 human services programs administered by the department.
81.26 (21) Have the authority to administer a drug rebate program
81.27 for drugs purchased pursuant to the prescription drug program
81.28 established under section 256.955 after the beneficiary's
81.29 satisfaction of any deductible established in the program. The
81.30 commissioner shall require a rebate agreement from all
81.31 manufacturers of covered drugs as defined in section 256B.0625,
81.32 subdivision 13. Rebate agreements for prescription drugs
81.33 delivered on or after July 1, 2002, must include rebates for
81.34 individuals covered under the prescription drug program who are
81.35 under 65 years of age. For each drug, the amount of the rebate
81.36 shall be equal to the basic rebate as defined for purposes of
82.1 the federal rebate program in United States Code, title 42,
82.2 section 1396r-8(c)(1). This basic rebate shall be applied to
82.3 single-source and multiple-source drugs. The manufacturers must
82.4 provide full payment within 30 days of receipt of the state
82.5 invoice for the rebate within the terms and conditions used for
82.6 the federal rebate program established pursuant to section 1927
82.7 of title XIX of the Social Security Act. The manufacturers must
82.8 provide the commissioner with any information necessary to
82.9 verify the rebate determined per drug. The rebate program shall
82.10 utilize the terms and conditions used for the federal rebate
82.11 program established pursuant to section 1927 of title XIX of the
82.12 Social Security Act.
82.13 (22) Have the authority to administer the federal drug
82.14 rebate program for drugs purchased under the medical assistance
82.15 program as allowed by section 1927 of title XIX of the Social
82.16 Security Act and according to the terms and conditions of
82.17 section 1927. Rebates shall be collected for all drugs that
82.18 have been dispensed or administered in an outpatient setting and
82.19 that are from manufacturers who have signed a rebate agreement
82.20 with the United States Department of Health and Human Services.
82.21 (22) (23) Operate the department's communication systems
82.22 account established in Laws 1993, First Special Session chapter
82.23 1, article 1, section 2, subdivision 2, to manage shared
82.24 communication costs necessary for the operation of the programs
82.25 the commissioner supervises. A communications account may also
82.26 be established for each regional treatment center which operates
82.27 communications systems. Each account must be used to manage
82.28 shared communication costs necessary for the operations of the
82.29 programs the commissioner supervises. The commissioner may
82.30 distribute the costs of operating and maintaining communication
82.31 systems to participants in a manner that reflects actual usage.
82.32 Costs may include acquisition, licensing, insurance,
82.33 maintenance, repair, staff time and other costs as determined by
82.34 the commissioner. Nonprofit organizations and state, county,
82.35 and local government agencies involved in the operation of
82.36 programs the commissioner supervises may participate in the use
83.1 of the department's communications technology and share in the
83.2 cost of operation. The commissioner may accept on behalf of the
83.3 state any gift, bequest, devise or personal property of any
83.4 kind, or money tendered to the state for any lawful purpose
83.5 pertaining to the communication activities of the department.
83.6 Any money received for this purpose must be deposited in the
83.7 department's communication systems accounts. Money collected by
83.8 the commissioner for the use of communication systems must be
83.9 deposited in the state communication systems account and is
83.10 appropriated to the commissioner for purposes of this section.
83.11 (23) (24) Receive any federal matching money that is made
83.12 available through the medical assistance program for the
83.13 consumer satisfaction survey. Any federal money received for
83.14 the survey is appropriated to the commissioner for this
83.15 purpose. The commissioner may expend the federal money received
83.16 for the consumer satisfaction survey in either year of the
83.17 biennium.
83.18 (24) (25) Incorporate cost reimbursement claims from First
83.19 Call Minnesota into the federal cost reimbursement claiming
83.20 processes of the department according to federal law, rule, and
83.21 regulations. Any reimbursement received is appropriated to the
83.22 commissioner and shall be disbursed to First Call Minnesota
83.23 according to normal department payment schedules.
83.24 (25) (26) Develop recommended standards for foster care
83.25 homes that address the components of specialized therapeutic
83.26 services to be provided by foster care homes with those services.
83.27 Sec. 2. Minnesota Statutes 2000, section 256.955,
83.28 subdivision 2b, is amended to read:
83.29 Subd. 2b. [ELIGIBILITY.] Effective July 1, 2002, an
83.30 individual satisfying the following requirements and the
83.31 requirements described in subdivision 2, paragraph (d), is
83.32 eligible for the prescription drug program:
83.33 (1) is under 65 years of age; and
83.34 (2) is eligible as a qualified Medicare beneficiary
83.35 according to section 256B.057, subdivision 3 or 3a, or is
83.36 eligible under section 256B.057, subdivision 3 or 3a, and is
84.1 also eligible for medical assistance or general assistance
84.2 medical care with a spenddown as defined in section 256B.056,
84.3 subdivision 5.
84.4 Sec. 3. [256.956] [PURCHASING ALLIANCE STOP-LOSS FUND.]
84.5 Subdivision 1. [DEFINITIONS.] For purposes of this
84.6 section, the following definitions apply:
84.7 (a) "Commissioner" means the commissioner of human services.
84.8 (b) "Health plan" means a policy, contract, or certificate
84.9 issued by a health plan company to a qualifying purchasing
84.10 alliance. Any health plan issued to the members of a qualifying
84.11 purchasing alliance must meet the requirements of chapter 62L.
84.12 (c) "Health plan company" means:
84.13 (1) a health carrier as defined under section 62A.011,
84.14 subdivision 2;
84.15 (2) a community integrated service network operating under
84.16 chapter 62N; or
84.17 (3) an accountable provider network operating under chapter
84.18 62T.
84.19 (d) "Qualifying employer" means an employer who:
84.20 (1) is a member of a qualifying purchasing alliance;
84.21 (2) has at least one employee but no more than ten
84.22 employees or is a sole proprietor or farmer;
84.23 (3) did not offer employer-subsidized health care coverage
84.24 to its employees for at least 12 months prior to joining the
84.25 purchasing alliance; and
84.26 (4) is offering health coverage through the purchasing
84.27 alliance to all employees who work at least 20 hours per week
84.28 unless the employee is eligible for Medicare.
84.29 For purposes of this subdivision, "employer-subsidized health
84.30 coverage" means health coverage for which the employer pays at
84.31 least 50 percent of the cost of coverage for the employee.
84.32 (e) "Qualifying enrollee" means an employee of a qualifying
84.33 employer or the employee's dependent covered by a health plan.
84.34 (f) "Qualifying purchasing alliance" means a purchasing
84.35 alliance as defined in section 62T.01, subdivision 2, that:
84.36 (1) meets the requirements of chapter 62T;
85.1 (2) services a geographic area located in outstate
85.2 Minnesota, excluding the city of Duluth; and
85.3 (3) is organized and operating before May 1, 2001.
85.4 The criteria used by the qualifying purchasing alliance for
85.5 membership must be approved by the commissioner of health. A
85.6 qualifying purchasing alliance may begin enrolling qualifying
85.7 employers after July 1, 2001, with enrollment ending by December
85.8 31, 2003.
85.9 Subd. 2. [CREATION OF ACCOUNT.] A purchasing alliance
85.10 stop-loss fund account is established in the general fund. The
85.11 commissioner shall use the money to establish a stop-loss fund
85.12 from which a health plan company may receive reimbursement for
85.13 claims paid for qualifying enrollees. The account consists of
85.14 money appropriated by the legislature. Money from the account
85.15 must be used for the stop-loss fund.
85.16 Subd. 3. [REIMBURSEMENT.] (a) A health plan company may
85.17 receive reimbursement from the fund for 90 percent of the
85.18 portion of the claim that exceeds $30,000 but not of the portion
85.19 that exceeds $100,000 in a calendar year for a qualifying
85.20 enrollee.
85.21 (b) Claims shall be reported and funds shall be distributed
85.22 on a calendar-year basis. Claims shall be eligible for
85.23 reimbursement only for the calendar year in which the claims
85.24 were paid.
85.25 (c) Once claims paid on behalf of a qualifying enrollee
85.26 reach $100,000 in a given calendar year, no further claims may
85.27 be submitted for reimbursement on behalf of that enrollee in
85.28 that calendar year.
85.29 Subd. 4. [REQUEST PROCESS.] (a) Each health plan company
85.30 must submit a request for reimbursement from the fund on a form
85.31 prescribed by the commissioner. Requests for payment must be
85.32 submitted no later than April 1 following the end of the
85.33 calendar year for which the reimbursement request is being made,
85.34 beginning April 1, 2002.
85.35 (b) The commissioner may require a health plan company to
85.36 submit claims data as needed in connection with the
86.1 reimbursement request.
86.2 Subd. 5. [DISTRIBUTION.] (a) The commissioner shall
86.3 calculate the total claims reimbursement amount for all
86.4 qualifying health plan companies for the calendar year for which
86.5 claims are being reported and shall distribute the stop-loss
86.6 funds on an annual basis.
86.7 (b) In the event that the total amount requested for
86.8 reimbursement by the health plan companies for a calendar year
86.9 exceeds the funds available for distribution for claims paid by
86.10 all health plan companies during the same calendar year, the
86.11 commissioner shall provide for the pro rata distribution of the
86.12 available funds. Each health plan company shall be eligible to
86.13 receive only a proportionate amount of the available funds as
86.14 the health plan company's total eligible claims paid compares to
86.15 the total eligible claims paid by all health plan companies.
86.16 (c) In the event that funds available for distribution for
86.17 claims paid by all health plan companies during a calendar year
86.18 exceed the total amount requested for reimbursement by all
86.19 health plan companies during the same calendar year, any excess
86.20 funds shall be reallocated for distribution in the next calendar
86.21 year.
86.22 Subd. 6. [DATA.] Upon the request of the commissioner,
86.23 each health plan company shall furnish such data as the
86.24 commissioner deems necessary to administer the fund. The
86.25 commissioner may require that such data be submitted on a per
86.26 enrollee, aggregate, or categorical basis. Any data submitted
86.27 under this section shall be classified as private data or
86.28 nonpublic data as defined in section 13.02.
86.29 Subd. 7. [DELEGATION.] The commissioner may delegate any
86.30 or all of the commissioner's administrative duties to another
86.31 state agency or to a private contractor.
86.32 Subd. 8. [REPORT.] The commissioner of commerce, in
86.33 consultation with the office of rural health and the qualifying
86.34 purchasing alliances, shall evaluate the extent to which the
86.35 purchasing alliance stop-loss fund increases the availability of
86.36 employer-subsidized health care coverage for residents residing
87.1 in the geographic areas served by the qualifying purchasing
87.2 alliances. A preliminary report must be submitted to the
87.3 legislature by February 15, 2003, and a final report must be
87.4 submitted by February 15, 2004.
87.5 Subd. 9. [SUNSET.] This section shall expire January 1,
87.6 2005.
87.7 Sec. 4. [256.958] [RETIRED DENTIST PROGRAM.]
87.8 Subdivision 1. [PROGRAM.] The commissioner of human
87.9 services shall establish a program to reimburse a retired
87.10 dentist for the dentist's license fee and for the cost of
87.11 malpractice insurance in exchange for the dentist providing 100
87.12 hours of dental services on a volunteer basis within a 12-month
87.13 period at a community dental clinic or a dental training clinic
87.14 located at a Minnesota state college or university.
87.15 Subd. 2. [DOCUMENTATION.] Upon completion of the required
87.16 hours, the retired dentist shall submit to the commissioner the
87.17 following:
87.18 (1) documentation of service provided;
87.19 (2) the cost of malpractice insurance for the 12-month
87.20 period; and
87.21 (3) the cost of the license.
87.22 Subd. 3. [REIMBURSEMENT.] Upon receipt of the information
87.23 described in subdivision 2, the commissioner shall provide
87.24 reimbursement to the retired dentist for the cost of malpractice
87.25 insurance for the previous 12-month period and the cost of the
87.26 license.
87.27 Sec. 5. Minnesota Statutes 2000, section 256.9657,
87.28 subdivision 2, is amended to read:
87.29 Subd. 2. [HOSPITAL SURCHARGE.] (a) Effective October 1,
87.30 1992, each Minnesota hospital except facilities of the federal
87.31 Indian Health Service and regional treatment centers shall pay
87.32 to the medical assistance account a surcharge equal to 1.4
87.33 percent of net patient revenues excluding net Medicare revenues
87.34 reported by that provider to the health care cost information
87.35 system according to the schedule in subdivision 4.
87.36 (b) Effective July 1, 1994, the surcharge under paragraph
88.1 (a) is increased to 1.56 percent.
88.2 (c) Notwithstanding the Medicare cost finding and allowable
88.3 cost principles, the hospital surcharge is not an allowable cost
88.4 for purposes of rate setting under sections 256.9685 to 256.9695.
88.5 Sec. 6. Minnesota Statutes 2000, section 256.969,
88.6 subdivision 2b, is amended to read:
88.7 Subd. 2b. [OPERATING PAYMENT RATES.] In determining
88.8 operating payment rates for admissions occurring on or after the
88.9 rate year beginning January 1, 1991, and every two years after,
88.10 or more frequently as determined by the commissioner, the
88.11 commissioner shall obtain operating data from an updated base
88.12 year and, within the limits of available appropriations,
88.13 establish operating payment rates per admission for each
88.14 hospital based on the cost-finding methods and allowable costs
88.15 of the Medicare program in effect during the base year. Rates
88.16 under the general assistance medical care, medical assistance,
88.17 and MinnesotaCare programs shall not be rebased to more current
88.18 data on January 1, 1997. The base year operating payment rate
88.19 per admission is standardized by the case mix index and adjusted
88.20 by the hospital cost index, relative values, and
88.21 disproportionate population adjustment. The cost and charge
88.22 data used to establish operating rates shall only reflect
88.23 inpatient services covered by medical assistance and shall not
88.24 include property cost information and costs recognized in
88.25 outlier payments.
88.26 Sec. 7. Minnesota Statutes 2000, section 256.969, is
88.27 amended by adding a subdivision to read:
88.28 Subd. 26. [GREATER MINNESOTA PAYMENT ADJUSTMENT AFTER JUNE
88.29 30, 2001.] (a) For admissions occurring after June 30, 2001, the
88.30 commissioner shall pay all medical assistance inpatient
88.31 fee-for-service admissions for the diagnosis-related groups
88.32 specified in paragraph (b) at hospitals located outside of the
88.33 seven-county metropolitan area at the higher of:
88.34 (1) the hospital's current payment rate for the diagnostic
88.35 category to which the diagnosis-related group belongs, exclusive
88.36 of disproportionate population adjustments received under
89.1 subdivision 9 and hospital payment adjustments received under
89.2 subdivision 23; or
89.3 (2) the rate in clause (1) plus a proportion of the
89.4 difference between the current average payment rate for that
89.5 diagnostic category for hospitals located within the
89.6 seven-county metropolitan area, exclusive of disproportionate
89.7 population adjustments received under subdivision 9 and hospital
89.8 payment adjustments received under subdivision 23, and the
89.9 current rate in clause (1). This proportion shall be 12.5
89.10 percent for the fiscal year beginning July 1, 2001, and shall
89.11 increase by 12.5 percentage points for each of the next seven
89.12 fiscal years, such that the proportion is 100 percent for the
89.13 fiscal year beginning July 1, 2008.
89.14 (b) The reimbursement increases provided in paragraph (a)
89.15 apply to the following diagnosis-related groups as they fall
89.16 within the diagnostic categories:
89.17 (1) 370 C-section with complicating diagnosis;
89.18 (2) 371 C-section without complicating diagnosis;
89.19 (3) 372 vaginal delivery with complicating diagnosis;
89.20 (4) 373 vaginal delivery without complicating diagnosis;
89.21 (5) 386 extreme immaturity, weight greater than 1,500
89.22 grams;
89.23 (6) 388 full-term neonates with other problems;
89.24 (7) 390 prematurity without major problems;
89.25 (8) 391 normal newborn case;
89.26 (9) 385 neonate, died or transferred to another health care
89.27 facility;
89.28 (10) 425 acute adjustment reaction and psychosocial
89.29 dysfunctioning;
89.30 (11) 430 psychosis;
89.31 (12) 431 childhood mental disorders; and
89.32 (13) 164-167 appendectomy.
89.33 Sec. 8. Minnesota Statutes 2000, section 256B.04, is
89.34 amended by adding a subdivision to read:
89.35 Subd. 1b. [CONTRACT FOR SERVICES FOR AMERICAN INDIAN
89.36 CHILDREN.] Notwithstanding subdivision 1, the commissioner may
90.1 contract with federally recognized Indian tribes with a
90.2 reservation in Minnesota for the provision of early and periodic
90.3 screening, diagnosis, and treatment administrative services for
90.4 American Indian children, according to Code of Federal
90.5 Regulations, title 42, section 441, subpart B, and Minnesota
90.6 Rules, part 9505.1693 et seq., when the tribe chooses to provide
90.7 such services. For purposes of this subdivision, "American
90.8 Indian" has the meaning given to persons to whom services will
90.9 be provided for in Code of Federal Regulations, title 42,
90.10 section 36.12. Notwithstanding Minnesota Rules, part 9505.1748,
90.11 subpart 1, the commissioner, the local agency, and the tribe may
90.12 contract with any entity for the provision of early and periodic
90.13 screening, diagnosis, and treatment administrative services.
90.14 [EFFECTIVE DATE.] This section is effective the day
90.15 following final enactment.
90.16 Sec. 9. Minnesota Statutes 2000, section 256B.055,
90.17 subdivision 3a, is amended to read:
90.18 Subd. 3a. [MFIP-S FAMILIES; FAMILIES ELIGIBLE UNDER PRIOR
90.19 AFDC RULES.] (a) Beginning January 1, 1998, or on the date that
90.20 MFIP-S is implemented in counties, medical assistance may be
90.21 paid for a person receiving public assistance under the MFIP-S
90.22 program. Beginning July 1, 2002, medical assistance may be paid
90.23 for a person who would have been eligible, but for excess income
90.24 or assets, under the state's AFDC plan in effect as of July 16,
90.25 1996, with the base AFDC standard increased by three percent
90.26 effective July 1, 2000.
90.27 (b) Beginning January 1, 1998, July 1, 2002, medical
90.28 assistance may be paid for a person who would have been eligible
90.29 for public assistance under the income and resource assets
90.30 standards, or who would have been eligible but for excess income
90.31 or assets, under the state's AFDC plan in effect as of July 16,
90.32 1996, as required by the Personal Responsibility and Work
90.33 Opportunity Reconciliation Act of 1996 (PRWORA), Public Law
90.34 Number 104-193 with the base AFDC rate increased by three
90.35 percent effective July 1, 2000.
90.36 [EFFECTIVE DATE.] This section is effective July 1, 2002.
91.1 Sec. 10. Minnesota Statutes 2000, section 256B.056,
91.2 subdivision 1a, is amended to read:
91.3 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless
91.4 specifically required by state law or rule or federal law or
91.5 regulation, the methodologies used in counting income and assets
91.6 to determine eligibility for medical assistance for persons
91.7 whose eligibility category is based on blindness, disability, or
91.8 age of 65 or more years, the methodologies for the supplemental
91.9 security income program shall be used. Effective upon federal
91.10 approval, for children eligible under section 256B.055,
91.11 subdivision 12, or for home and community-based waiver services
91.12 whose eligibility for medical assistance is determined without
91.13 regard to parental income, child support payments, including any
91.14 payments made by an obligor in satisfaction of or in addition to
91.15 a temporary or permanent order for child support, social
91.16 security payments, and other benefits for basic needs are not
91.17 counted as income. For families and children, which includes
91.18 all other eligibility categories, the methodologies under the
91.19 state's AFDC plan in effect as of July 16, 1996, as required by
91.20 the Personal Responsibility and Work Opportunity Reconciliation
91.21 Act of 1996 (PRWORA), Public Law Number 104-193, shall be used.
91.22 Effective upon federal approval, in-kind contributions to, and
91.23 payments made on behalf of, a recipient, by an obligor, in
91.24 satisfaction of or in addition to a temporary or permanent order
91.25 for child support or maintenance, shall be considered income to
91.26 the recipient. For these purposes, a "methodology" does not
91.27 include an asset or income standard, or accounting method, or
91.28 method of determining effective dates.
91.29 Sec. 11. Minnesota Statutes 2000, section 256B.056,
91.30 subdivision 3, is amended to read:
91.31 Subd. 3. [ASSET LIMITATIONS.] To be eligible for medical
91.32 assistance, a person must not individually own more than $3,000
91.33 in assets, or if a member of a household with two family
91.34 members, husband and wife, or parent and child, the household
91.35 must not own more than $6,000 in assets, plus $200 for each
91.36 additional legal dependent. In addition to these maximum
92.1 amounts, an eligible individual or family may accrue interest on
92.2 these amounts, but they must be reduced to the maximum at the
92.3 time of an eligibility redetermination. The accumulation of the
92.4 clothing and personal needs allowance according to section
92.5 256B.35 must also be reduced to the maximum at the time of the
92.6 eligibility redetermination. The value of assets that are not
92.7 considered in determining eligibility for medical assistance is
92.8 the value of those assets excluded under the AFDC state plan as
92.9 of July 16, 1996, as required by the Personal Responsibility and
92.10 Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law
92.11 Number 104-193, for families and children, and the supplemental
92.12 security income program for aged, blind, and disabled persons,
92.13 with the following exceptions:
92.14 (a) Household goods and personal effects are not considered.
92.15 (b) Capital and operating assets of a trade or business
92.16 that the local agency determines are necessary to the person's
92.17 ability to earn an income are not considered.
92.18 (c) Motor vehicles are excluded to the same extent excluded
92.19 by the supplemental security income program.
92.20 (d) Assets designated as burial expenses are excluded to
92.21 the same extent excluded by the supplemental security income
92.22 program.
92.23 (e) Effective upon federal approval, for a person who no
92.24 longer qualifies as an employed person with a disability due to
92.25 loss of earnings, assets allowed while eligible for medical
92.26 assistance under section 256B.057, subdivision 9, are not
92.27 considered for 12 months, beginning with the first month of
92.28 ineligibility as an employed person with a disability, to the
92.29 extent that the person's total assets remain within the allowed
92.30 limits of section 256B.057, subdivision 9, paragraph (b).
92.31 Sec. 12. Minnesota Statutes 2000, section 256B.056,
92.32 subdivision 4, is amended to read:
92.33 Subd. 4. [INCOME.] (a) To be eligible for medical
92.34 assistance, a person eligible under section 256B.055,
92.35 subdivision subdivisions 7, 7a, and 12, not receiving
92.36 supplemental security income program payments, and may have
93.1 income up to the following specified percentages of the federal
93.2 poverty guidelines for the family size effective on April 1 of
93.3 each year:
93.4 (1) 80 percent, effective July 1, 2002;
93.5 (2) 90 percent, effective July 1, 2003;
93.6 (3) 100 percent, effective July 1, 2004.
93.7 Increases in benefits under title II of the Social Security Act
93.8 shall not be counted as income for purposes of this subdivision
93.9 until the first day of the second full month following
93.10 publication of the change in the federal poverty guidelines.
93.11 (b) To be eligible for medical assistance, families and
93.12 children may have an income up to 133-1/3 percent of the AFDC
93.13 income standard in effect under the July 16, 1996, AFDC state
93.14 plan. Effective July 1, 2000, the base AFDC standard in effect
93.15 on July 16, 1996, shall be increased by three percent. Effective
93.16 January 1, 2000, and each successive January, recipients of
93.17 supplemental security income may have an income up to the
93.18 supplemental security income standard in effect on that date.
93.19 (c) Effective July 1, 2002, to be eligible for medical
93.20 assistance, families and children may have an income up to 100
93.21 percent of the federal poverty guidelines for the family size
93.22 effective on April 1 of each year.
93.23 (d) In computing income to determine eligibility of persons
93.24 under paragraphs (a) to (c) who are not residents of long-term
93.25 care facilities, the commissioner shall disregard increases in
93.26 income as required by Public Law Numbers 94-566, section 503;
93.27 99-272; and 99-509. Veterans aid and attendance benefits and
93.28 Veterans Administration unusual medical expense payments are
93.29 considered income to the recipient.
93.30 Sec. 13. Minnesota Statutes 2000, section 256B.056,
93.31 subdivision 5, is amended to read:
93.32 Subd. 5. [EXCESS INCOME.] A person who has excess income
93.33 is eligible for medical assistance if the person has expenses
93.34 for medical care that are more than the amount of the person's
93.35 excess income, computed by deducting incurred medical expenses
93.36 from the excess income to reduce the excess to the income
94.1 standard specified in subdivision 4, except that if federal
94.2 authorization to use the standard in subdivision 4 is not
94.3 obtained, the medically needy standard for purposes of a
94.4 spenddown shall be 133 and 1/3 percent of the AFDC income
94.5 standard in effect under the July 16, 1996, AFDC state plan,
94.6 increased by three percent. The person shall elect to have the
94.7 medical expenses deducted at the beginning of a one-month budget
94.8 period or at the beginning of a six-month budget period. The
94.9 commissioner shall allow persons eligible for assistance on a
94.10 one-month spenddown basis under this subdivision to elect to pay
94.11 the monthly spenddown amount in advance of the month of
94.12 eligibility to the state agency in order to maintain eligibility
94.13 on a continuous basis. If the recipient does not pay the
94.14 spenddown amount on or before the 20th of the month, the
94.15 recipient is ineligible for this option for the following
94.16 month. The local agency shall code the Medicaid Management
94.17 Information System (MMIS) to indicate that the recipient has
94.18 elected this option. The state agency shall convey recipient
94.19 eligibility information relative to the collection of the
94.20 spenddown to providers through the Electronic Verification
94.21 System (EVS). A recipient electing advance payment must pay the
94.22 state agency the monthly spenddown amount on or before the 20th
94.23 of the month in order to be eligible for this option in the
94.24 following month.
94.25 Sec. 14. Minnesota Statutes 2000, section 256B.057,
94.26 subdivision 9, is amended to read:
94.27 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical
94.28 assistance may be paid for a person who is employed and who:
94.29 (1) meets the definition of disabled under the supplemental
94.30 security income program;
94.31 (2) is at least 16 but less than 65 years of age;
94.32 (3) meets the asset limits in paragraph (b); and
94.33 (4) pays a premium, if required, under paragraph (c).
94.34 Any spousal income or assets shall be disregarded for purposes
94.35 of eligibility and premium determinations.
94.36 (b) For purposes of determining eligibility under this
95.1 subdivision, a person's assets must not exceed $20,000,
95.2 excluding:
95.3 (1) all assets excluded under section 256B.056;
95.4 (2) retirement accounts, including individual accounts,
95.5 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and
95.6 (3) medical expense accounts set up through the person's
95.7 employer.
95.8 (c) A person whose earned and unearned income is equal to
95.9 or greater than 200 100 percent of federal poverty guidelines
95.10 for the applicable family size must pay a premium to be eligible
95.11 for medical assistance under this subdivision. The premium
95.12 shall be equal to ten percent of based on the person's gross
95.13 earned and unearned income above 200 percent of federal poverty
95.14 guidelines for and the applicable family size up to the cost of
95.15 coverage, using a sliding fee scale established by the
95.16 commissioner which begins at one percent of income at 100
95.17 percent of the federal poverty guidelines and gradually
95.18 increases to 7.5 percent of income for those with incomes at or
95.19 above 300 percent of the federal poverty guidelines.
95.20 (d) A person's eligibility and premium shall be determined
95.21 by the local county agency. Premiums must be paid to the
95.22 commissioner. All premiums are dedicated to the commissioner.
95.23 (e) Any required premium shall be determined at application
95.24 and redetermined annually at recertification or when a change in
95.25 income or family size occurs.
95.26 (f) Premium payment is due upon notification from the
95.27 commissioner of the premium amount required. Premiums may be
95.28 paid in installments at the discretion of the commissioner.
95.29 (g) Nonpayment of the premium shall result in denial or
95.30 termination of medical assistance unless the person demonstrates
95.31 good cause for nonpayment. Good cause exists if the
95.32 requirements specified in Minnesota Rules, part 9506.0040,
95.33 subpart 7, items B to D, are met. Nonpayment shall include
95.34 payment with a returned, refused, or dishonored instrument. The
95.35 commissioner may require a guaranteed form of payment as the
95.36 only means to replace a returned, refused, or dishonored
96.1 instrument.
96.2 [EFFECTIVE DATE.] This section is effective September 1,
96.3 2001.
96.4 Sec. 15. Minnesota Statutes 2000, section 256B.057, is
96.5 amended by adding a subdivision to read:
96.6 Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR
96.7 CERVICAL CANCER.] (a) Medical assistance may be paid for a
96.8 person who:
96.9 (1) has been screened for breast or cervical cancer by the
96.10 Minnesota breast and cervical cancer control program, and
96.11 program funds have been used to pay for the person's screening;
96.12 (2) according to the person's treating health professional,
96.13 needs treatment, including diagnostic services necessary to
96.14 determine the extent and proper course of treatment, for breast
96.15 or cervical cancer, including precancerous conditions and early
96.16 stage cancer;
96.17 (3) meets the income eligibility guidelines for the
96.18 Minnesota breast and cervical cancer control program;
96.19 (4) is under age 65;
96.20 (5) is not otherwise eligible for medical assistance under
96.21 United States Code, title 42, section 1396(a)(10)(A)(i); and
96.22 (6) is not otherwise covered under creditable coverage, as
96.23 defined under United States Code, title 42, section 300gg(c).
96.24 (b) Medical assistance provided for an eligible person
96.25 under this subdivision shall be limited to services provided
96.26 during the period that the person receives treatment for breast
96.27 or cervical cancer.
96.28 (c) A person meeting the criteria in paragraph (a) is
96.29 eligible for medical assistance without meeting the eligibility
96.30 criteria relating to income and assets in section 256B.056,
96.31 subdivisions 1a to 5b.
96.32 Sec. 16. Minnesota Statutes 2000, section 256B.0625,
96.33 subdivision 3b, is amended to read:
96.34 Subd. 3b. [TELEMEDICINE CONSULTATIONS.] (a) Medical
96.35 assistance covers telemedicine consultations. Telemedicine
96.36 consultations must be made via two-way, interactive video or
97.1 store-and-forward technology. Store-and-forward technology
97.2 includes telemedicine consultations that do not occur in real
97.3 time via synchronous transmissions, and that do not require a
97.4 face-to-face encounter with the patient for all or any part of
97.5 any such telemedicine consultation. The patient record must
97.6 include a written opinion from the consulting physician
97.7 providing the telemedicine consultation. A communication
97.8 between two physicians that consists solely of a telephone
97.9 conversation is not a telemedicine consultation. Coverage is
97.10 limited to three telemedicine consultations per recipient per
97.11 calendar week. Telemedicine consultations shall be paid at the
97.12 full allowable rate.
97.13 (b) This subdivision expires July 1, 2001.
97.14 Sec. 17. Minnesota Statutes 2000, section 256B.0625, is
97.15 amended by adding a subdivision to read:
97.16 Subd. 5a. [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY
97.17 SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.] (a)
97.18 [COVERAGE.] Medical assistance covers home-based intensive early
97.19 intervention behavior therapy for children with autism spectrum
97.20 disorders. Children with autism spectrum disorder, and their
97.21 custodial parents or foster parents, may access other covered
97.22 services to treat autism spectrum disorder, and are not required
97.23 to receive intensive early intervention behavior therapy
97.24 services under this subdivision. Intensive early intervention
97.25 behavior therapy does not include coverage for services to treat
97.26 developmental disorders of language, early onset psychosis,
97.27 Rett's disorder, selective mutism, social anxiety disorder,
97.28 stereotypic movement disorder, dementia, obsessive compulsive
97.29 disorder, schizoid personality disorder, avoidant personality
97.30 disorder, or reactive attachment disorder. If a child with
97.31 autism spectrum disorder is diagnosed to have one or more of
97.32 these conditions, intensive early intervention behavior therapy
97.33 includes coverage only for services necessary to treat the
97.34 autism spectrum disorder.
97.35 (b) [PURPOSE OF INTENSIVE EARLY INTERVENTION BEHAVIOR
97.36 THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to improve
98.1 the child's behavioral functioning, to prevent development of
98.2 challenging behaviors, to eliminate autistic behaviors, to
98.3 reduce the risk of out-of-home placement, and to establish
98.4 independent typical functioning in language and social
98.5 behavior. The procedures used to accomplish these goals are
98.6 based upon research in applied behavior analysis.
98.7 (c) [ELIGIBLE CHILDREN.] A child is eligible to initiate
98.8 IEIBTS if, the child meets the additional eligibility criteria
98.9 in paragraph (d) and in a diagnostic assessment by a mental
98.10 health professional who is not under the employ of the service
98.11 provider, the child:
98.12 (1) is found to have an autism spectrum disorder;
98.13 (2) has a current IQ of either untestable, or at least 30;
98.14 (3) if nonverbal, initiated behavior therapy by 42 months
98.15 of age;
98.16 (4) if verbal, initiated behavior therapy by 48 months of
98.17 age; or
98.18 (5) if having an IQ of at least 50, initiated behavior
98.19 therapy by 84 months of age.
98.20 To continue in IEIBTS, at least one of the child's custodial
98.21 parents or foster parents must participate in an average of at
98.22 least five hours of documented behavior therapy per week for six
98.23 months, and consistently implement behavior therapy
98.24 recommendations 24 hours a day. To continue after six-month
98.25 individualized treatment plan (ITP) reviews, the child must show
98.26 documented progress toward mastery of six-month benchmark
98.27 behavior objectives. The maximum number of months during which
98.28 services may be billed is 54. If significant progress towards
98.29 treatment goals has not been achieved after 24 months of
98.30 treatment, treatment must be discontinued.
98.31 (d) [ADDITIONAL ELIGIBILITY CRITERIA.] A child is eligible
98.32 to initiate IEIBTS if:
98.33 (1) in medical and diagnostic assessments by medical and
98.34 mental health professionals, it is determined that the child
98.35 does not have severe or profound mental retardation;
98.36 (2) an accurate assessment of the child's hearing has been
99.1 performed, including audiometry if the brain stem auditory
99.2 evokes response;
99.3 (3) a blood lead test has been performed prior to
99.4 initiation of treatment; and
99.5 (4) an EEG or neurologic evaluation is done, prior to
99.6 initiation of treatment, if the child has a history of staring
99.7 spells or developmental regression.
99.8 (e) [COVERED SERVICES.] The focus of IEIBTS must be to
99.9 treat the principal diagnostic features of the autism spectrum
99.10 disorder. All IEIBTS must be delivered by a team of
99.11 practitioners under the consistent supervision of a single
99.12 clinical supervisor. A mental health professional must develop
99.13 the ITP for IEIBTS. The ITP must include six-month benchmark
99.14 behavior objectives. All behavior therapy must be based upon
99.15 research in applied behavior analysis, with an emphasis upon
99.16 positive reinforcement of carefully task-analyzed skills for
99.17 optimum rates of progress. All behavior therapy must be
99.18 consistently applied and generalized throughout the 24-hour day
99.19 and seven-day week by all of the child's regular care
99.20 providers. When placing the child in school activities, a
99.21 majority of the peers must have no mental health diagnosis, and
99.22 the child must have sufficient social skills to succeed with 80
99.23 percent of the school activities. Reactive consequences, such
99.24 as redirection, correction, positive practice, or time-out, must
99.25 be used only when necessary to improve the child's success when
99.26 proactive procedures alone have not been effective. IEIBTS must
99.27 be delivered by a team of behavior therapy practitioners who are
99.28 employed under the direction of the same agency. The team may
99.29 deliver up to 200 billable hours per year of direct clinical
99.30 supervisor services, up to 750 billable hours per year of senior
99.31 behavior therapist services, and up to 1,800 billable hours per
99.32 year of direct behavior therapist services. A one-hour clinical
99.33 review meeting for the child, parents, and staff must be
99.34 scheduled 50 weeks a year, at which behavior therapy is reviewed
99.35 and planned. At least one-quarter of the annual clinical
99.36 supervisor billable hours shall consist of on-site clinical
100.1 meeting time. At least one-half of the annual senior behavior
100.2 therapist billable hours shall consist of direct services to the
100.3 child or parents. All of the behavioral therapist billable
100.4 hours shall consist of direct on-site services to the child or
100.5 parents. None of the senior behavior therapist billable hours
100.6 or behavior therapist billable hours shall consist of clinical
100.7 meeting time. If there is any regression of the autistic
100.8 spectrum disorder after 12 months of therapy, a neurologic
100.9 consultation must be performed.
100.10 (f) [PROVIDER QUALIFICATIONS.] The provider agency must be
100.11 capable of delivering consistent applied behavior analysis
100.12 (ABA)-based behavior therapy in the home. The site director of
100.13 the agency must be a mental health professional certified as a
100.14 behavior analyst by the Association for Behavior Analysis. Each
100.15 clinical supervisor must be certified as a behavior analyst by
100.16 the Association for Behavior Analysis.
100.17 (g) [SUPERVISION REQUIREMENTS.] (1) Each behavior therapist
100.18 practitioner must be continuously supervised while in the home
100.19 until the practitioner has mastered competencies for independent
100.20 practice. Each behavior therapist must have mastered three
100.21 credits of academic content and practice in an ABA sequence at
100.22 an accredited university. A college degree or minimum hours of
100.23 experience are not required. Each behavior therapist must
100.24 continue training through weekly direct observation by the
100.25 senior behavior therapist, through demonstrated performance in
100.26 clinical meetings with the clinical supervisor, and annual
100.27 training in ABA.
100.28 (2) Each senior behavior therapist practitioner must have
100.29 mastered the senior behavior therapy competencies, completed one
100.30 year of practice as a behavior therapist, and six months of
100.31 co-therapy training with another senior behavior therapist or
100.32 have an equivalent amount of experience in ABA. Each senior
100.33 behavior therapist must have mastered 12 credits of academic
100.34 content and practice in an ABA sequence at an accredited
100.35 university. Each senior behavior therapist must continue
100.36 training through demonstrated performance in clinical meetings
101.1 with the clinical supervisor, and annual training in ABA.
101.2 (3) Each clinical supervisor practitioner must have
101.3 mastered the clinical supervisor and family consultation
101.4 competencies, completed two years of practice as a senior
101.5 behavior therapist and one year of co-therapy training with
101.6 another clinical supervisor, or equivalent experience in ABA.
101.7 Each clinical supervisor must continue training through annual
101.8 training in ABA.
101.9 (h) [PLACE OF SERVICE.] IEIBTS are provided primarily in
101.10 the child's home and community. Services may be provided in the
101.11 child's natural school or preschool classroom, home of a
101.12 relative, natural recreational setting, or day care.
101.13 (i) [PRIOR AUTHORIZATION REQUIREMENTS.] Prior authorization
101.14 shall be required for services provided after 200 hours of
101.15 clinical supervisor, 750 hours of senior behavior therapist, or
101.16 1,800 hours of behavior therapist services per year.
101.17 (j) [PAYMENT RATES.] The following payment rates apply:
101.18 (1) for an IEIBTS clinical supervisor practitioner under
101.19 supervision of a mental health professional, the lower of the
101.20 submitted charge or $137 per hour unit;
101.21 (2) for an IEIBTS senior behavior therapist practitioner
101.22 under supervision of a mental health professional, the lower of
101.23 the submitted charge or $56 per hour unit; or
101.24 (3) for an IEIBTS behavior therapist practitioner under
101.25 supervision of a mental health professional, the lower of the
101.26 submitted charge or $19 per hour unit.
101.27 An IEIBTS practitioner may receive payment for travel time which
101.28 exceeds 50 minutes one-way. The maximum payment allowed will be
101.29 $0.51 per minute for up to a maximum of 300 hours per year.
101.30 For any week during which the above charges are made to
101.31 medical assistance, payments for the following services are
101.32 excluded: supervising mental health professional hours and
101.33 personal care attendant, home-based mental health,
101.34 family-community support, or mental health behavioral aide hours.
101.35 (k) [REPORT.] The commissioner shall collect evidence of
101.36 the effectiveness of intensive early intervention behavior
102.1 therapy services and present a report to the legislature by July
102.2 1, 2006.
102.3 [EFFECTIVE DATE.] This section is effective January 1, 2002.
102.4 Sec. 18. Minnesota Statutes 2000, section 256B.0625,
102.5 subdivision 13, is amended to read:
102.6 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs,
102.7 except for fertility drugs when specifically used to enhance
102.8 fertility, if prescribed by a licensed practitioner and
102.9 dispensed by a licensed pharmacist, by a physician enrolled in
102.10 the medical assistance program as a dispensing physician, or by
102.11 a physician or a nurse practitioner employed by or under
102.12 contract with a community health board as defined in section
102.13 145A.02, subdivision 5, for the purposes of communicable disease
102.14 control. The commissioner, after receiving recommendations from
102.15 professional medical associations and professional pharmacist
102.16 associations, shall designate a formulary committee to advise
102.17 the commissioner on the names of drugs for which payment is
102.18 made, recommend a system for reimbursing providers on a set fee
102.19 or charge basis rather than the present system, and develop
102.20 methods encouraging use of generic drugs when they are less
102.21 expensive and equally effective as trademark drugs. The
102.22 formulary committee shall consist of nine members, four of whom
102.23 shall be physicians who are not employed by the department of
102.24 human services, and a majority of whose practice is for persons
102.25 paying privately or through health insurance, three of whom
102.26 shall be pharmacists who are not employed by the department of
102.27 human services, and a majority of whose practice is for persons
102.28 paying privately or through health insurance, a consumer
102.29 representative, and a nursing home representative. Committee
102.30 members shall serve three-year terms and shall serve without
102.31 compensation. Members may be reappointed once.
102.32 (b) The commissioner shall establish a drug formulary. Its
102.33 establishment and publication shall not be subject to the
102.34 requirements of the Administrative Procedure Act, but the
102.35 formulary committee shall review and comment on the formulary
102.36 contents. The formulary committee shall review and recommend
103.1 drugs which require prior authorization. The formulary
103.2 committee may recommend drugs for prior authorization directly
103.3 to the commissioner, as long as opportunity for public input is
103.4 provided. Prior authorization may be requested by the
103.5 commissioner based on medical and clinical criteria before
103.6 certain drugs are eligible for payment. Before a drug may be
103.7 considered for prior authorization at the request of the
103.8 commissioner:
103.9 (1) the drug formulary committee must develop criteria to
103.10 be used for identifying drugs; the development of these criteria
103.11 is not subject to the requirements of chapter 14, but the
103.12 formulary committee shall provide opportunity for public input
103.13 in developing criteria;
103.14 (2) the drug formulary committee must hold a public forum
103.15 and receive public comment for an additional 15 days; and
103.16 (3) the commissioner must provide information to the
103.17 formulary committee on the impact that placing the drug on prior
103.18 authorization will have on the quality of patient care and
103.19 information regarding whether the drug is subject to clinical
103.20 abuse or misuse. Prior authorization may be required by the
103.21 commissioner before certain formulary drugs are eligible for
103.22 payment. The formulary shall not include:
103.23 (i) drugs or products for which there is no federal
103.24 funding;
103.25 (ii) over-the-counter drugs, except for antacids,
103.26 acetaminophen, family planning products, aspirin, insulin,
103.27 products for the treatment of lice, vitamins for adults with
103.28 documented vitamin deficiencies, vitamins for children under the
103.29 age of seven and pregnant or nursing women, and any other
103.30 over-the-counter drug identified by the commissioner, in
103.31 consultation with the drug formulary committee, as necessary,
103.32 appropriate, and cost-effective for the treatment of certain
103.33 specified chronic diseases, conditions or disorders, and this
103.34 determination shall not be subject to the requirements of
103.35 chapter 14;
103.36 (iii) anorectics, except that medically necessary
104.1 anorectics shall be covered for a recipient previously diagnosed
104.2 as having pickwickian syndrome and currently diagnosed as having
104.3 diabetes and being morbidly obese;
104.4 (iv) drugs for which medical value has not been
104.5 established; and
104.6 (v) drugs from manufacturers who have not signed a rebate
104.7 agreement with the Department of Health and Human Services
104.8 pursuant to section 1927 of title XIX of the Social Security Act.
104.9 The commissioner shall publish conditions for prohibiting
104.10 payment for specific drugs after considering the formulary
104.11 committee's recommendations. An honorarium of $100 per meeting
104.12 and reimbursement for mileage shall be paid to each committee
104.13 member in attendance.
104.14 (c) The basis for determining the amount of payment shall
104.15 be the lower of the actual acquisition costs of the drugs plus a
104.16 fixed dispensing fee; the maximum allowable cost set by the
104.17 federal government or by the commissioner plus the fixed
104.18 dispensing fee; or the usual and customary price charged to the
104.19 public. The pharmacy dispensing fee shall be $3.65, except that
104.20 the dispensing fee for intravenous solutions which must be
104.21 compounded by the pharmacist shall be $8 per bag, $14 per bag
104.22 for cancer chemotherapy products, and $30 per bag for total
104.23 parenteral nutritional products dispensed in one liter
104.24 quantities, or $44 per bag for total parenteral nutritional
104.25 products dispensed in quantities greater than one liter. Actual
104.26 acquisition cost includes quantity and other special discounts
104.27 except time and cash discounts. The actual acquisition cost of
104.28 a drug shall be estimated by the commissioner, at average
104.29 wholesale price minus nine percent, except that where a drug has
104.30 had its wholesale price reduced as a result of the actions of
104.31 the National Association of Medicaid Fraud Control Units, the
104.32 estimated actual acquisition cost shall be the reduced average
104.33 wholesale price, without the nine percent deduction. The
104.34 maximum allowable cost of a multisource drug may be set by the
104.35 commissioner and it shall be comparable to, but no higher than,
104.36 the maximum amount paid by other third-party payors in this
105.1 state who have maximum allowable cost programs. The
105.2 commissioner shall set maximum allowable costs for multisource
105.3 drugs that are not on the federal upper limit list as described
105.4 in United States Code, title 42, chapter 7, section 1396r-8(e),
105.5 the Social Security Act, and Code of Federal Regulations, title
105.6 42, part 447, section 447.332. Establishment of the amount of
105.7 payment for drugs shall not be subject to the requirements of
105.8 the Administrative Procedure Act. An additional dispensing fee
105.9 of $.30 may be added to the dispensing fee paid to pharmacists
105.10 for legend drug prescriptions dispensed to residents of
105.11 long-term care facilities when a unit dose blister card system,
105.12 approved by the department, is used. Under this type of
105.13 dispensing system, the pharmacist must dispense a 30-day supply
105.14 of drug. The National Drug Code (NDC) from the drug container
105.15 used to fill the blister card must be identified on the claim to
105.16 the department. The unit dose blister card containing the drug
105.17 must meet the packaging standards set forth in Minnesota Rules,
105.18 part 6800.2700, that govern the return of unused drugs to the
105.19 pharmacy for reuse. The pharmacy provider will be required to
105.20 credit the department for the actual acquisition cost of all
105.21 unused drugs that are eligible for reuse. Over-the-counter
105.22 medications must be dispensed in the manufacturer's unopened
105.23 package. The commissioner may permit the drug clozapine to be
105.24 dispensed in a quantity that is less than a 30-day supply.
105.25 Whenever a generically equivalent product is available, payment
105.26 shall be on the basis of the actual acquisition cost of the
105.27 generic drug, unless the prescriber specifically indicates
105.28 "dispense as written - brand necessary" on the prescription as
105.29 required by section 151.21, subdivision 2.
105.30 (d) For purposes of this subdivision, "multisource drugs"
105.31 means covered outpatient drugs, excluding innovator multisource
105.32 drugs for which there are two or more drug products, which:
105.33 (1) are related as therapeutically equivalent under the
105.34 Food and Drug Administration's most recent publication of
105.35 "Approved Drug Products with Therapeutic Equivalence
105.36 Evaluations";
106.1 (2) are pharmaceutically equivalent and bioequivalent as
106.2 determined by the Food and Drug Administration; and
106.3 (3) are sold or marketed in Minnesota.
106.4 "Innovator multisource drug" means a multisource drug that was
106.5 originally marketed under an original new drug application
106.6 approved by the Food and Drug Administration.
106.7 (e) The basis for determining the amount of payment for
106.8 drugs administered in an outpatient setting shall be the lower
106.9 of the usual and customary cost submitted by the provider; the
106.10 average wholesale price minus five percent; or the maximum
106.11 allowable cost set by the federal government under United States
106.12 Code, title 42, chapter 7, section 1396r-8(e) and Code of
106.13 Federal Regulations, title 42, section 447.332, or by the
106.14 commissioner under paragraph (c).
106.15 Sec. 19. Minnesota Statutes 2000, section 256B.0625,
106.16 subdivision 13a, is amended to read:
106.17 Subd. 13a. [DRUG UTILIZATION REVIEW BOARD.] A nine-member
106.18 drug utilization review board is established. The board is
106.19 comprised of at least three but no more than four licensed
106.20 physicians actively engaged in the practice of medicine in
106.21 Minnesota; at least three licensed pharmacists actively engaged
106.22 in the practice of pharmacy in Minnesota; and one consumer
106.23 representative; the remainder to be made up of health care
106.24 professionals who are licensed in their field and have
106.25 recognized knowledge in the clinically appropriate prescribing,
106.26 dispensing, and monitoring of covered outpatient drugs. The
106.27 board shall be staffed by an employee of the department who
106.28 shall serve as an ex officio nonvoting member of the board. The
106.29 members of the board shall be appointed by the commissioner and
106.30 shall serve three-year terms. The members shall be selected
106.31 from lists submitted by professional associations. The
106.32 commissioner shall appoint the initial members of the board for
106.33 terms expiring as follows: three members for terms expiring
106.34 June 30, 1996; three members for terms expiring June 30, 1997;
106.35 and three members for terms expiring June 30, 1998. Members may
106.36 be reappointed once. The board shall annually elect a chair
107.1 from among the members.
107.2 The commissioner shall, with the advice of the board:
107.3 (1) implement a medical assistance retrospective and
107.4 prospective drug utilization review program as required by
107.5 United States Code, title 42, section 1396r-8(g)(3);
107.6 (2) develop and implement the predetermined criteria and
107.7 practice parameters for appropriate prescribing to be used in
107.8 retrospective and prospective drug utilization review;
107.9 (3) develop, select, implement, and assess interventions
107.10 for physicians, pharmacists, and patients that are educational
107.11 and not punitive in nature;
107.12 (4) establish a grievance and appeals process for
107.13 physicians and pharmacists under this section;
107.14 (5) publish and disseminate educational information to
107.15 physicians and pharmacists regarding the board and the review
107.16 program;
107.17 (6) adopt and implement procedures designed to ensure the
107.18 confidentiality of any information collected, stored, retrieved,
107.19 assessed, or analyzed by the board, staff to the board, or
107.20 contractors to the review program that identifies individual
107.21 physicians, pharmacists, or recipients;
107.22 (7) establish and implement an ongoing process to (i)
107.23 receive public comment regarding drug utilization review
107.24 criteria and standards, and (ii) consider the comments along
107.25 with other scientific and clinical information in order to
107.26 revise criteria and standards on a timely basis; and
107.27 (8) adopt any rules necessary to carry out this section.
107.28 The board may establish advisory committees. The
107.29 commissioner may contract with appropriate organizations to
107.30 assist the board in carrying out the board's duties. The
107.31 commissioner may enter into contracts for services to develop
107.32 and implement a retrospective and prospective review program.
107.33 The board shall report to the commissioner annually on the
107.34 date the Drug Utilization Review Annual Report is due to the
107.35 Health Care Financing Administration. This report is to cover
107.36 the preceding federal fiscal year. The commissioner shall make
108.1 the report available to the public upon request. The report
108.2 must include information on the activities of the board and the
108.3 program; the effectiveness of implemented interventions;
108.4 administrative costs; and any fiscal impact resulting from the
108.5 program. An honorarium of $50 $100 per meeting and
108.6 reimbursement for mileage shall be paid to each board member in
108.7 attendance.
108.8 Sec. 20. Minnesota Statutes 2000, section 256B.0625,
108.9 subdivision 17, is amended to read:
108.10 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance
108.11 covers transportation costs incurred solely for obtaining
108.12 emergency medical care or transportation costs incurred by
108.13 nonambulatory persons in obtaining emergency or nonemergency
108.14 medical care when paid directly to an ambulance company, common
108.15 carrier, or other recognized providers of transportation
108.16 services. For the purpose of this subdivision, a person who is
108.17 incapable of transport by taxicab or bus shall be considered to
108.18 be nonambulatory.
108.19 (b) Medical assistance covers special transportation, as
108.20 defined in Minnesota Rules, part 9505.0315, subpart 1, item F,
108.21 if the provider receives and maintains a current physician's
108.22 order by the recipient's attending physician certifying that the
108.23 recipient has a physical or mental impairment that would
108.24 prohibit the recipient from safely accessing and using a bus,
108.25 taxi, other commercial transportation, or private automobile.
108.26 Special transportation includes driver-assisted service to
108.27 eligible individuals. Driver-assisted service includes
108.28 passenger pickup at and return to the individual's residence or
108.29 place of business, assistance with admittance of the individual
108.30 to the medical facility, and assistance in passenger securement
108.31 or in securing of wheelchairs or stretchers in the vehicle. The
108.32 commissioner shall establish maximum medical assistance
108.33 reimbursement rates for special transportation services for
108.34 persons who need a wheelchair lift accessible van or
108.35 stretcher-equipped vehicle and for those who do not need a
108.36 wheelchair lift accessible van or stretcher-equipped vehicle.
109.1 The average of these two rates per trip must not exceed $15 for
109.2 the base rate and $1.20 $1.50 per mile. Special transportation
109.3 provided to nonambulatory ambulatory persons who do not need a
109.4 wheelchair lift van or stretcher-equipped vehicle, may be
109.5 reimbursed at a lower rate than special transportation provided
109.6 to persons who need a wheelchair lift van or stretcher-equipped
109.7 vehicle.
109.8 Sec. 21. Minnesota Statutes 2000, section 256B.0625,
109.9 subdivision 17a, is amended to read:
109.10 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for
109.11 services rendered on or after July 1, 1999 2001, medical
109.12 assistance payments for ambulance services shall be increased by
109.13 five percent paid at the greater of: (1) the medical assistance
109.14 reimbursement rate in effect on June 30, 2000; or (2) the
109.15 current Medicare reimbursement rate for ambulance services.
109.16 Sec. 22. Minnesota Statutes 2000, section 256B.0625,
109.17 subdivision 18a, is amended to read:
109.18 Subd. 18a. [PAYMENT FOR MEALS AND LODGING ACCESS TO
109.19 MEDICAL SERVICES.] (a) Medical assistance reimbursement for
109.20 meals for persons traveling to receive medical care may not
109.21 exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner.
109.22 (b) Medical assistance reimbursement for lodging for
109.23 persons traveling to receive medical care may not exceed $50 per
109.24 day unless prior authorized by the local agency.
109.25 (c) Medical assistance direct mileage reimbursement to the
109.26 eligible person or the eligible person's driver may not exceed
109.27 20 cents per mile.
109.28 (d) Medical assistance covers oral language interpreter
109.29 services when provided by an enrolled health care provider
109.30 during the course of providing a direct, person-to-person
109.31 covered health care service to an enrolled recipient with
109.32 limited English proficiency.
109.33 Sec. 23. Minnesota Statutes 2000, section 256B.0625,
109.34 subdivision 30, is amended to read:
109.35 Subd. 30. [OTHER CLINIC SERVICES.] (a) Medical assistance
109.36 covers rural health clinic services, federally qualified health
110.1 center services, nonprofit community health clinic services,
110.2 public health clinic services, and the services of a clinic
110.3 meeting the criteria established in rule by the commissioner.
110.4 Rural health clinic services and federally qualified health
110.5 center services mean services defined in United States Code,
110.6 title 42, section 1396d(a)(2)(B) and (C). Payment for rural
110.7 health clinic and federally qualified health center services
110.8 shall be made according to applicable federal law and regulation.
110.9 (b) A federally qualified health center that is beginning
110.10 initial operation shall submit an estimate of budgeted costs and
110.11 visits for the initial reporting period in the form and detail
110.12 required by the commissioner. A federally qualified health
110.13 center that is already in operation shall submit an initial
110.14 report using actual costs and visits for the initial reporting
110.15 period. Within 90 days of the end of its reporting period, a
110.16 federally qualified health center shall submit, in the form and
110.17 detail required by the commissioner, a report of its operations,
110.18 including allowable costs actually incurred for the period and
110.19 the actual number of visits for services furnished during the
110.20 period, and other information required by the commissioner.
110.21 Federally qualified health centers that file Medicare cost
110.22 reports shall provide the commissioner with a copy of the most
110.23 recent Medicare cost report filed with the Medicare program
110.24 intermediary for the reporting year which support the costs
110.25 claimed on their cost report to the state.
110.26 (c) In order to continue cost-based payment under the
110.27 medical assistance program according to paragraphs (a) and (b),
110.28 a federally qualified health center or rural health clinic must
110.29 apply for designation as an essential community provider within
110.30 six months of final adoption of rules by the department of
110.31 health according to section 62Q.19, subdivision 7. For those
110.32 federally qualified health centers and rural health clinics that
110.33 have applied for essential community provider status within the
110.34 six-month time prescribed, medical assistance payments will
110.35 continue to be made according to paragraphs (a) and (b) for the
110.36 first three years after application. For federally qualified
111.1 health centers and rural health clinics that either do not apply
111.2 within the time specified above or who have had essential
111.3 community provider status for three years, medical assistance
111.4 payments for health services provided by these entities shall be
111.5 according to the same rates and conditions applicable to the
111.6 same service provided by health care providers that are not
111.7 federally qualified health centers or rural health clinics.
111.8 (d) Effective July 1, 1999, the provisions of paragraph (c)
111.9 requiring a federally qualified health center or a rural health
111.10 clinic to make application for an essential community provider
111.11 designation in order to have cost-based payments made according
111.12 to paragraphs (a) and (b) no longer apply.
111.13 (e) Effective January 1, 2000, payments made according to
111.14 paragraphs (a) and (b) shall be limited to the cost phase-out
111.15 schedule of the Balanced Budget Act of 1997.
111.16 (f) Effective January 1, 2001, each federally qualified
111.17 health center and rural health clinic may elect to be paid
111.18 either under the prospective payment system established in
111.19 United States Code, title 42, section 1396a, paragraph (a) or
111.20 under an alternative payment methodology consistent with the
111.21 requirements of United States Code, title 42, section 1392a,
111.22 paragraph (a) and approved by the health care financing
111.23 administration. The alternative payment methodology shall be
111.24 100 percent of cost as determined according to Medicare cost
111.25 principles.
111.26 Sec. 24. Minnesota Statutes 2000, section 256B.0625,
111.27 subdivision 34, is amended to read:
111.28 Subd. 34. [INDIAN HEALTH SERVICES FACILITIES.] Medical
111.29 assistance payments and MinnesotaCare payments to facilities of
111.30 the Indian health service and facilities operated by a tribe or
111.31 tribal organization under funding authorized by United States
111.32 Code, title 25, sections 450f to 450n, or title III of the
111.33 Indian Self-Determination and Education Assistance Act, Public
111.34 Law Number 93-638, for enrollees who are eligible for federal
111.35 financial participation, shall be at the option of the facility
111.36 in accordance with the rate published by the United States
112.1 Assistant Secretary for Health under the authority of United
112.2 States Code, title 42, sections 248(a) and 249(b). General
112.3 assistance medical care payments to facilities of the Indian
112.4 health services and facilities operated by a tribe or tribal
112.5 organization for the provision of outpatient medical care
112.6 services billed after June 30, 1990, must be in accordance with
112.7 the general assistance medical care rates paid for the same
112.8 services when provided in a facility other than a facility of
112.9 the Indian health service or a facility operated by a tribe or
112.10 tribal organization. MinnesotaCare payments for enrollees who
112.11 are not eligible for federal financial participation at
112.12 facilities of the Indian Health Service and facilities operated
112.13 by a tribe or tribal organization for the provision of
112.14 outpatient medical services must be in accordance with the
112.15 medical assistance rates paid for the same services when
112.16 provided in a facility other than a facility of the Indian
112.17 Health Service or a facility operated by a tribe or tribal
112.18 organization.
112.19 [EFFECTIVE DATE.] This section is effective the day
112.20 following final enactment.
112.21 Sec. 25. Minnesota Statutes 2000, section 256B.0635,
112.22 subdivision 1, is amended to read:
112.23 Subdivision 1. [INCREASED EMPLOYMENT.] Beginning January
112.24 1, 1998 (a) Until June 30, 2002, medical assistance may be paid
112.25 for persons who received MFIP-S or medical assistance for
112.26 families and children in at least three of six months preceding
112.27 the month in which the person became ineligible for MFIP-S or
112.28 medical assistance, if the ineligibility was due to an increase
112.29 in hours of employment or employment income or due to the loss
112.30 of an earned income disregard. In addition, to receive
112.31 continued assistance under this section, persons who received
112.32 medical assistance for families and children but did not receive
112.33 MFIP-S must have had income less than or equal to the assistance
112.34 standard for their family size under the state's AFDC plan in
112.35 effect as of July 16, 1996, as required by the Personal
112.36 Responsibility and Work Opportunity Reconciliation Act of 1996
113.1 (PRWORA), Public Law Number 104-193, increased by three percent
113.2 effective July 1, 2000, at the time medical assistance
113.3 eligibility began. A person who is eligible for extended
113.4 medical assistance is entitled to six months of assistance
113.5 without reapplication, unless the assistance unit ceases to
113.6 include a dependent child. For a person under 21 years of age,
113.7 medical assistance may not be discontinued within the six-month
113.8 period of extended eligibility until it has been determined that
113.9 the person is not otherwise eligible for medical assistance.
113.10 Medical assistance may be continued for an additional six months
113.11 if the person meets all requirements for the additional six
113.12 months, according to title XIX of the Social Security Act, as
113.13 amended by section 303 of the Family Support Act of 1988, Public
113.14 Law Number 100-485.
113.15 (b) Beginning July 1, 2002, medical assistance for families
113.16 and children may be paid for persons who were eligible under
113.17 section 256B.055, subdivision 3a, paragraph (b), in at least
113.18 three of six months preceding the month in which the person
113.19 became ineligible under that section if the ineligibility was
113.20 due to an increase in hours of employment or employment income
113.21 or due to the loss of an earned income disregard. A person who
113.22 is eligible for extended medical assistance is entitled to six
113.23 months of assistance without reapplication, unless the
113.24 assistance unit ceases to include a dependent child, except
113.25 medical assistance may not be discontinued for that dependent
113.26 child under 21 years of age within the six-month period of
113.27 extended eligibility until it has been determined that the
113.28 person is not otherwise eligible for medical assistance.
113.29 Medical assistance may be continued for an additional six months
113.30 if the person meets all requirements for the additional six
113.31 months, according to title XIX of the Social Security Act, as
113.32 amended by section 303 of the Family Support Act of 1988, Public
113.33 Law Number 100-485.
113.34 [EFFECTIVE DATE.] This section is effective July 1, 2001.
113.35 Sec. 26. Minnesota Statutes 2000, section 256B.0635,
113.36 subdivision 2, is amended to read:
114.1 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.] Beginning
114.2 January 1, 1998 (a) Until June 30, 2002, medical assistance may
114.3 be paid for persons who received MFIP-S or medical assistance
114.4 for families and children in at least three of the six months
114.5 preceding the month in which the person became ineligible for
114.6 MFIP-S or medical assistance, if the ineligibility was the
114.7 result of the collection of child or spousal support under part
114.8 D of title IV of the Social Security Act. In addition, to
114.9 receive continued assistance under this section, persons who
114.10 received medical assistance for families and children but did
114.11 not receive MFIP-S must have had income less than or equal to
114.12 the assistance standard for their family size under the state's
114.13 AFDC plan in effect as of July 16, 1996, as required by the
114.14 Personal Responsibility and Work Opportunity Reconciliation Act
114.15 of 1996 (PRWORA), Public Law Number 104-193 increased by three
114.16 percent effective July 1, 2000, at the time medical assistance
114.17 eligibility began. A person who is eligible for extended
114.18 medical assistance under this subdivision is entitled to four
114.19 months of assistance without reapplication, unless the
114.20 assistance unit ceases to include a dependent child. For a
114.21 person under 21 years of age, except medical assistance may not
114.22 be discontinued for that dependent child under 21 years of age
114.23 within the four-month period of extended eligibility until it
114.24 has been determined that the person is not otherwise eligible
114.25 for medical assistance.
114.26 (b) Beginning July 1, 2002, medical assistance for families
114.27 and children may be paid for persons who were eligible under
114.28 section 256B.055, subdivision 3a, paragraph (b), in at least
114.29 three of the six months preceding the month in which the person
114.30 became ineligible under that section if the ineligibility was
114.31 the result of the collection of child or spousal support under
114.32 part D of title IV of the Social Security Act. A person who is
114.33 eligible for extended medical assistance under this subdivision
114.34 is entitled to four months of assistance without reapplication,
114.35 unless the assistance unit ceases to include a dependent child,
114.36 except medical assistance may not be discontinued for that
115.1 dependent child under 21 years of age within the four-month
115.2 period of extended eligibility until it has been determined that
115.3 the person is not otherwise eligible for medical assistance.
115.4 [EFFECTIVE DATE.] This section is effective July 1, 2001.
115.5 Sec. 27. [256B.0637] [PRESUMPTIVE ELIGIBILITY FOR CERTAIN
115.6 PERSONS NEEDING TREATMENT FOR BREAST OR CERVICAL CANCER.]
115.7 Medical assistance is available during a presumptive
115.8 eligibility period for persons who meet the criteria in section
115.9 256B.057, subdivision 10. For purposes of this section, the
115.10 presumptive eligibility period begins on the date on which an
115.11 entity designated by the commissioner determines, based on
115.12 preliminary information, that the person meets the criteria in
115.13 section 256B.057, subdivision 10. The presumptive eligibility
115.14 period ends on the day on which a determination is made as to
115.15 the person's eligibility, except that if an application is not
115.16 submitted by the last day of the month following the month
115.17 during which the determination based on preliminary information
115.18 is made, the presumptive eligibility period ends on that last
115.19 day of the month.
115.20 Sec. 28. [256B.195] [HEALTH CARE SAFETY NET PRESERVATION.]
115.21 Subdivision 1. [INTERGOVERNMENTAL TRANSFERS AND RELATED
115.22 PAYMENTS.] (a) This section is contingent on federal approval of
115.23 the intergovernmental transfers and payments to safety net
115.24 hospitals authorized under this section.
115.25 (b) In addition to the percentage contribution paid by a
115.26 county under section 256B.19, subdivision 1, the governmental
115.27 units designated in this subdivision shall be responsible for an
115.28 additional portion of the nonfederal share of medical assistance
115.29 costs attributable to them. For purposes of this section,
115.30 "designated governmental unit" means Hennepin county, Ramsey
115.31 county, or the University of Minnesota. For purposes of this
115.32 section, "nonstate, government hospital" means Hennepin County
115.33 Medical Center, the successor or assignee to St. Paul-Ramsey
115.34 Medical Center as described in section 383A.91, or Fairview
115.35 University Medical Center.
115.36 (c) Effective July 1, 2001, the governmental units
116.1 designated in paragraph (a) shall in total transfer $2,833,333
116.2 on a monthly basis to the state Medicaid agency. The
116.3 commissioner shall allocate this assessment between the
116.4 governmental units based on the proportion of the Medicare upper
116.5 payment limit for each nonstate, government hospital located
116.6 within the governmental unit to the total Medicare upper payment
116.7 limit of all participating hospitals in paragraph (b).
116.8 (d) The commissioner shall distribute the proceeds of this
116.9 intergovernmental transfer, including the federal Medicaid
116.10 match, as follows:
116.11 (1) Proceeds may be no less than the amount of the
116.12 intergovernmental transfer in paragraph (c) multiplied by 1.75.
116.13 (2) The remaining proceeds provide funding for hospital
116.14 charity care aid under section 144.585. The commissioner of
116.15 human services shall work with the commissioner of health to
116.16 assure that hospital charity care aid payments are administered
116.17 in a manner that generates Medicaid matching funds.
116.18 (e) The successor or assignee to St. Paul-Ramsey Medical
116.19 Center shall transfer on a monthly basis to Ramsey county an
116.20 amount equal to the county assessment under paragraph (c).
116.21 Subd. 2. [DETERMINATION OF INTERGOVERNMENTAL TRANSFER
116.22 AMOUNTS.] Medicaid rate changes, including those required to
116.23 obtain federal financial participation under section 62J.692,
116.24 subdivision 8, enacted prior to the effective date of this
116.25 legislation, shall precede the determination of
116.26 intergovernmental transfer amounts determined in this section.
116.27 Participation in the intergovernmental transfer program shall
116.28 not result in the offset of any nonstate, government hospital's
116.29 receipt of Medicaid payment increases.
116.30 Subd. 3. [STATE PLAN AMENDMENTS.] The commissioner shall
116.31 amend the state Medicaid plan as necessary to implement this
116.32 section.
116.33 Subd. 4. [PROPORTIONATE ADJUSTMENTS.] (a) The commissioner
116.34 shall adjust the intergovernmental transfers under subdivision
116.35 1, paragraph (c), and the payments under subdivision 1,
116.36 paragraph (d), upon the approval of the designated governmental
117.1 unit named in subdivision 1, paragraph (b), based on the
117.2 commissioner's determination of Medicare upper payment limits,
117.3 hospital-specific federal limitations on disproportionate share
117.4 payments or to maximize additional federal reimbursements.
117.5 (b) In the event that: (i) federal approval is not
117.6 received for the total intergovernmental transfer amount
117.7 specified in subdivision 1, paragraph (d), or, (ii) federal
117.8 rules regarding the establishment of the 150 percent Medicare
117.9 upper payment limit, section 1102 of the Social Security Act,
117.10 United States Code, title 42, section 1302, enacted on March 13,
117.11 2001, are rescinded or, (iii) the federal 150 percent Medicare
117.12 upper payment limit is reduced to 100 percent, the amount of the
117.13 intergovernmental transfers and Medicaid payments to the
117.14 nonstate, government hospitals named in subdivision 1, paragraph
117.15 (b), shall be adjusted for each hospital based on the proportion
117.16 of each hospital's Medicaid inpatient hospital days to the total
117.17 Medicaid inpatient hospital days provided by all participating
117.18 hospitals.
117.19 [EFFECTIVE DATE.] This section is effective July 1, 2001.
117.20 Sec. 29. Minnesota Statutes 2000, section 256B.69,
117.21 subdivision 4, is amended to read:
117.22 Subd. 4. [LIMITATION OF CHOICE.] The commissioner shall
117.23 develop criteria to determine when limitation of choice may be
117.24 implemented in the experimental counties. The criteria shall
117.25 ensure that all eligible individuals in the county have
117.26 continuing access to the full range of medical assistance
117.27 services as specified in subdivision 6. The commissioner shall
117.28 exempt the following persons from participation in the project,
117.29 in addition to those who do not meet the criteria for limitation
117.30 of choice:
117.31 (1) persons eligible for medical assistance according to
117.32 section 256B.055, subdivision 1;
117.33 (2) persons eligible for medical assistance due to
117.34 blindness or disability as determined by the social security
117.35 administration or the state medical review team, unless:
117.36 (i) they are 65 years of age or older,; or
118.1 (ii) they reside in Itasca county or they reside in a
118.2 county in which the commissioner conducts a pilot project under
118.3 a waiver granted pursuant to section 1115 of the Social Security
118.4 Act;
118.5 (3) recipients who currently have private coverage through
118.6 a health maintenance organization;
118.7 (4) recipients who are eligible for medical assistance by
118.8 spending down excess income for medical expenses other than the
118.9 nursing facility per diem expense;
118.10 (5) recipients who receive benefits under the Refugee
118.11 Assistance Program, established under United States Code, title
118.12 8, section 1522(e);
118.13 (6) children who are both determined to be severely
118.14 emotionally disturbed and receiving case management services
118.15 according to section 256B.0625, subdivision 20; and
118.16 (7) adults who are both determined to be seriously and
118.17 persistently mentally ill and received case management services
118.18 according to section 256B.0625, subdivision 20; and
118.19 (8) persons eligible for medical assistance according to
118.20 section 256B.057, subdivision 10.
118.21 Children under age 21 who are in foster placement may enroll in
118.22 the project on an elective basis. Individuals excluded under
118.23 clauses (6) and (7) may choose to enroll on an elective basis.
118.24 The commissioner may allow persons with a one-month spenddown
118.25 who are otherwise eligible to enroll to voluntarily enroll or
118.26 remain enrolled, if they elect to prepay their monthly spenddown
118.27 to the state. Beginning on or after July 1, 1997, The
118.28 commissioner may require those individuals to enroll in the
118.29 prepaid medical assistance program who otherwise would have been
118.30 excluded under clauses (1) and, (3), and (8), and under
118.31 Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.
118.32 Before limitation of choice is implemented, eligible individuals
118.33 shall be notified and after notification, shall be allowed to
118.34 choose only among demonstration providers. The commissioner may
118.35 assign an individual with private coverage through a health
118.36 maintenance organization, to the same health maintenance
119.1 organization for medical assistance coverage, if the health
119.2 maintenance organization is under contract for medical
119.3 assistance in the individual's county of residence. After
119.4 initially choosing a provider, the recipient is allowed to
119.5 change that choice only at specified times as allowed by the
119.6 commissioner. If a demonstration provider ends participation in
119.7 the project for any reason, a recipient enrolled with that
119.8 provider must select a new provider but may change providers
119.9 without cause once more within the first 60 days after
119.10 enrollment with the second provider.
119.11 Sec. 30. Minnesota Statutes 2000, section 256B.69,
119.12 subdivision 5, is amended to read:
119.13 Subd. 5. [PROSPECTIVE PER CAPITA PAYMENT.] The
119.14 commissioner shall establish the method and amount of payments
119.15 for services. The commissioner shall annually contract with
119.16 demonstration providers to provide services consistent with
119.17 these established methods and amounts for payment. Payment
119.18 rates established by the commissioner must be within the limits
119.19 of available appropriations.
119.20 If allowed by the commissioner, a demonstration provider
119.21 may contract with an insurer, health care provider, nonprofit
119.22 health service plan corporation, or the commissioner, to provide
119.23 insurance or similar protection against the cost of care
119.24 provided by the demonstration provider or to provide coverage
119.25 against the risks incurred by demonstration providers under this
119.26 section. The recipients enrolled with a demonstration provider
119.27 are a permissible group under group insurance laws and chapter
119.28 62C, the Nonprofit Health Service Plan Corporations Act. Under
119.29 this type of contract, the insurer or corporation may make
119.30 benefit payments to a demonstration provider for services
119.31 rendered or to be rendered to a recipient. Any insurer or
119.32 nonprofit health service plan corporation licensed to do
119.33 business in this state is authorized to provide this insurance
119.34 or similar protection.
119.35 Payments to providers participating in the project are
119.36 exempt from the requirements of sections 256.966 and 256B.03,
120.1 subdivision 2. The commissioner shall complete development of
120.2 capitation rates for payments before delivery of services under
120.3 this section is begun. For payments made during calendar year
120.4 1990 and later years, the commissioner shall contract with an
120.5 independent actuary to establish prepayment rates.
120.6 By January 15, 1996, the commissioner shall report to the
120.7 legislature on the methodology used to allocate to participating
120.8 counties available administrative reimbursement for advocacy and
120.9 enrollment costs. The report shall reflect the commissioner's
120.10 judgment as to the adequacy of the funds made available and of
120.11 the methodology for equitable distribution of the funds. The
120.12 commissioner must involve participating counties in the
120.13 development of the report.
120.14 Sec. 31. Minnesota Statutes 2000, section 256B.69,
120.15 subdivision 5b, is amended to read:
120.16 Subd. 5b. [PROSPECTIVE REIMBURSEMENT RATES.] (a) For
120.17 prepaid medical assistance and general assistance medical care
120.18 program contract rates set by the commissioner under subdivision
120.19 5 and effective on or after January 1, 1998, capitation rates
120.20 for nonmetropolitan counties shall on a weighted average be no
120.21 less than 88 percent of the capitation rates for metropolitan
120.22 counties, excluding Hennepin county. The commissioner shall
120.23 make a pro rata adjustment in capitation rates paid to counties
120.24 other than nonmetropolitan counties in order to make this
120.25 provision budget neutral.
120.26 (b) For prepaid medical assistance program contract rates
120.27 set by the commissioner under subdivision 5 and effective on or
120.28 after January 1, 2001 2002, capitation rates for nonmetropolitan
120.29 counties shall, on a weighted average, be no less than 89 95
120.30 percent of the capitation rates for metropolitan counties,
120.31 excluding Hennepin county. The commissioner shall make a pro
120.32 rata adjustment in capitation rates paid to Hennepin county in
120.33 order to make the portion of the increase between 89 and 95
120.34 percent budget neutral.
120.35 (c) This subdivision shall not affect the nongeographically
120.36 based risk adjusted rates established under section 62Q.03,
121.1 subdivision 5a, paragraph (f).
121.2 (d) The commissioner shall require prepaid health plans to
121.3 use all revenue received from the increase in capitation rates
121.4 for nonmetropolitan counties from 89 to no less than 95 percent
121.5 of the capitation rate for metropolitan counties, excluding
121.6 Hennepin county, to increase reimbursement rates, effective
121.7 January 1, 2002, for providers under contract with the prepaid
121.8 health plan to serve enrollees from nonmetropolitan counties.
121.9 Sec. 32. Minnesota Statutes 2000, section 256B.69, is
121.10 amended by adding a subdivision to read:
121.11 Subd. 6c. [DENTAL SERVICES DEMONSTRATION PROJECT.] The
121.12 commissioner shall establish a dental services demonstration
121.13 project in Crow Wing, Todd, Morrison, Wadena, and Cass counties
121.14 for provision of dental services to medical assistance, general
121.15 assistance medical care, and MinnesotaCare recipients. The
121.16 commissioner may contract on a prospective per capita payment
121.17 basis for these dental services with an organization licensed
121.18 under chapter 62C, 62D, or 62N in accordance with section
121.19 256B.037 or may establish and administer a fee-for-service
121.20 system for the reimbursement of dental services.
121.21 [EFFECTIVE DATE.] This section is effective January 1, 2002.
121.22 Sec. 33. Minnesota Statutes 2000, section 256B.75, is
121.23 amended to read:
121.24 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.]
121.25 (a) For outpatient hospital facility fee payments for
121.26 services rendered on or after October 1, 1992, the commissioner
121.27 of human services shall pay the lower of (1) submitted charge,
121.28 or (2) 32 percent above the rate in effect on June 30, 1992,
121.29 except for those services for which there is a federal maximum
121.30 allowable payment. Effective for services rendered on or after
121.31 January 1, 2000, payment rates for nonsurgical outpatient
121.32 hospital facility fees and emergency room facility fees shall be
121.33 increased by eight percent over the rates in effect on December
121.34 31, 1999, except for those services for which there is a federal
121.35 maximum allowable payment. Services for which there is a
121.36 federal maximum allowable payment shall be paid at the lower of
122.1 (1) submitted charge, or (2) the federal maximum allowable
122.2 payment. Total aggregate payment for outpatient hospital
122.3 facility fee services shall not exceed the Medicare upper
122.4 limit. If it is determined that a provision of this section
122.5 conflicts with existing or future requirements of the United
122.6 States government with respect to federal financial
122.7 participation in medical assistance, the federal requirements
122.8 prevail. The commissioner may, in the aggregate, prospectively
122.9 reduce payment rates to avoid reduced federal financial
122.10 participation resulting from rates that are in excess of the
122.11 Medicare upper limitations.
122.12 (b) Notwithstanding paragraph (a), payment for outpatient,
122.13 emergency, and ambulatory surgery hospital facility fee services
122.14 for critical access hospitals designated under section 144.1483,
122.15 clause (11), shall be paid on a cost-based payment system that
122.16 is based on the cost-finding methods and allowable costs of the
122.17 Medicare program.
122.18 (c) Effective for services provided on or after July 1,
122.19 2002, rates that are based on the Medicare outpatient
122.20 prospective payment system shall be replaced by a budget neutral
122.21 prospective payment system that is derived using medical
122.22 assistance data. The department shall provide a proposal to the
122.23 2002 legislature to define and implement this provision.
122.24 Sec. 34. Minnesota Statutes 2000, section 256B.76, is
122.25 amended to read:
122.26 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.]
122.27 (a) Effective for services rendered on or after October 1,
122.28 1992, the commissioner shall make payments for physician
122.29 services as follows:
122.30 (1) payment for level one Health Care Finance
122.31 Administration's common procedural coding system (HCPCS) codes
122.32 titled "office and other outpatient services," "preventive
122.33 medicine new and established patient," "delivery, antepartum,
122.34 and postpartum care," "critical care," Caesarean cesarean
122.35 delivery and pharmacologic management provided to psychiatric
122.36 patients, and HCPCS level three codes for enhanced services for
123.1 prenatal high risk, shall be paid at the lower of (i) submitted
123.2 charges, or (ii) 25 percent above the rate in effect on June 30,
123.3 1992. If the rate on any procedure code within these categories
123.4 is different than the rate that would have been paid under the
123.5 methodology in section 256B.74, subdivision 2, then the larger
123.6 rate shall be paid;
123.7 (2) payments for all other services shall be paid at the
123.8 lower of (i) submitted charges, or (ii) 15.4 percent above the
123.9 rate in effect on June 30, 1992;
123.10 (3) all physician rates shall be converted from the 50th
123.11 percentile of 1982 to the 50th percentile of 1989, less the
123.12 percent in aggregate necessary to equal the above increases
123.13 except that payment rates for home health agency services shall
123.14 be the rates in effect on September 30, 1992;
123.15 (4) effective for services rendered on or after January 1,
123.16 2000, payment rates for physician and professional services
123.17 shall be increased by three percent over the rates in effect on
123.18 December 31, 1999, except for home health agency and family
123.19 planning agency services; and
123.20 (5) the increases in clause (4) shall be implemented
123.21 January 1, 2000, for managed care.
123.22 (b) Effective for services rendered on or after October 1,
123.23 1992, the commissioner shall make payments for dental services
123.24 as follows:
123.25 (1) dental services shall be paid at the lower of (i)
123.26 submitted charges, or (ii) 25 percent above the rate in effect
123.27 on June 30, 1992;
123.28 (2) dental rates shall be converted from the 50th
123.29 percentile of 1982 to the 50th percentile of 1989, less the
123.30 percent in aggregate necessary to equal the above increases;
123.31 (3) effective for services rendered on or after January 1,
123.32 2000, payment rates for dental services shall be increased by
123.33 three percent over the rates in effect on December 31, 1999;
123.34 (4) the commissioner shall award grants to community
123.35 clinics or other nonprofit community organizations, political
123.36 subdivisions, professional associations, or other organizations
124.1 that demonstrate the ability to provide dental services
124.2 effectively to public program recipients. Grants may be used to
124.3 fund the costs related to coordinating access for recipients,
124.4 developing and implementing patient care criteria, upgrading or
124.5 establishing new facilities, acquiring furnishings or equipment,
124.6 recruiting new providers, or other development costs that will
124.7 improve access to dental care in a region. In awarding grants,
124.8 the commissioner shall give priority to applicants that plan to
124.9 serve areas of the state in which the number of dental providers
124.10 is not currently sufficient to meet the needs of recipients of
124.11 public programs or uninsured individuals. The commissioner
124.12 shall consider the following in awarding the grants: (i)
124.13 potential to successfully increase access to an underserved
124.14 population; (ii) the ability to raise matching funds; (iii) the
124.15 long-term viability of the project to improve access beyond the
124.16 period of initial funding; (iv) the efficiency in the use of the
124.17 funding; and (v) the experience of the proposers in providing
124.18 services to the target population.
124.19 The commissioner shall monitor the grants and may terminate
124.20 a grant if the grantee does not increase dental access for
124.21 public program recipients. The commissioner shall consider
124.22 grants for the following:
124.23 (i) implementation of new programs or continued expansion
124.24 of current access programs that have demonstrated success in
124.25 providing dental services in underserved areas;
124.26 (ii) a pilot program for utilizing hygienists outside of a
124.27 traditional dental office to provide dental hygiene services;
124.28 and
124.29 (iii) a program that organizes a network of volunteer
124.30 dentists, establishes a system to refer eligible individuals to
124.31 volunteer dentists, and through that network provides donated
124.32 dental care services to public program recipients or uninsured
124.33 individuals.
124.34 (5) beginning October 1, 1999, the payment for tooth
124.35 sealants and fluoride treatments shall be the lower of (i)
124.36 submitted charge, or (ii) 80 percent of median 1997 charges; and
125.1 (6) the increases listed in clauses (3) and (5) shall be
125.2 implemented January 1, 2000, for managed care; and
125.3 (7) effective for services provided on or after October 1,
125.4 2001, payment for diagnostic examinations and dental x-rays
125.5 provided to children under age 21 shall be the lower of (i) the
125.6 submitted charge, or (ii) 85 percent of median 1999 charges.
125.7 (c) Effective for dental services rendered on or after July
125.8 1, 2001, the commissioner may increase reimbursements to
125.9 dentists and dental clinics deemed by the commissioner to be
125.10 critical access dental providers. Reimbursement to a critical
125.11 access dental provider may be increased by not more than 50
125.12 percent above the reimbursement rate that would otherwise be
125.13 paid to the provider. Payments to health plan companies shall
125.14 be adjusted to reflect increased reimbursements to critical
125.15 access dental providers as approved by the commissioner. In
125.16 determining which dentists and dental clinics shall be deemed
125.17 critical access dental providers, the commissioner shall review:
125.18 (1) the utilization rate in the service area in which the
125.19 dentist or dental clinic operates for dental services to
125.20 patients covered by medical assistance, general assistance
125.21 medical care, or MinnesotaCare as their primary source of
125.22 coverage;
125.23 (2) the level of services provided by the dentist or dental
125.24 clinic to patients covered by medical assistance, general
125.25 assistance medical care, or MinnesotaCare as their primary
125.26 source of coverage; and
125.27 (3) whether the level of services provided by the dentist
125.28 or dental clinic is critical to maintaining adequate levels of
125.29 patient access within the service area.
125.30 In the absence of a critical access dental provider in a service
125.31 area, the commissioner may designate a dentist or dental clinic
125.32 as a critical access dental provider if the dentist or dental
125.33 clinic is willing to provide care to patients covered by medical
125.34 assistance, general assistance medical care, or MinnesotaCare at
125.35 a level which significantly increases access to dental care in
125.36 the service area.
126.1 (d) An entity that operates both a Medicare certified
126.2 comprehensive outpatient rehabilitation facility and a facility
126.3 which was certified prior to January 1, 1993, that is licensed
126.4 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for
126.5 whom at least 33 percent of the clients receiving rehabilitation
126.6 services in the most recent calendar year are medical assistance
126.7 recipients, shall be reimbursed by the commissioner for
126.8 rehabilitation services at rates that are 38 percent greater
126.9 than the maximum reimbursement rate allowed under paragraph (a),
126.10 clause (2), when those services are (1) provided within the
126.11 comprehensive outpatient rehabilitation facility and (2)
126.12 provided to residents of nursing facilities owned by the entity.
126.13 [EFFECTIVE DATE.] This section is effective the day
126.14 following final enactment.
126.15 Sec. 35. [256B.78] [MEDICAL ASSISTANCE DEMONSTRATION
126.16 PROJECT FOR FAMILY PLANNING SERVICES.]
126.17 (a) The commissioner of human services shall establish a
126.18 medical assistance demonstration project to determine whether
126.19 improved access to coverage of prepregnancy family planning
126.20 services reduces medical assistance and MFIP costs.
126.21 (b) This section is effective upon federal approval of the
126.22 demonstration project.
126.23 Sec. 36. Minnesota Statutes 2000, section 256D.03,
126.24 subdivision 3, is amended to read:
126.25 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.]
126.26 (a) General assistance medical care may be paid for any person
126.27 who is not eligible for medical assistance under chapter 256B,
126.28 including eligibility for medical assistance based on a
126.29 spenddown of excess income according to section 256B.056,
126.30 subdivision 5, or MinnesotaCare as defined in paragraph (b),
126.31 except as provided in paragraph (c); and:
126.32 (1) who is receiving assistance under section 256D.05,
126.33 except for families with children who are eligible under
126.34 Minnesota family investment program-statewide (MFIP-S), who is
126.35 having a payment made on the person's behalf under sections
126.36 256I.01 to 256I.06, or who resides in group residential housing
127.1 as defined in chapter 256I and can meet a spenddown using the
127.2 cost of remedial services received through group residential
127.3 housing; or
127.4 (2)(i) who is a resident of Minnesota; and whose equity in
127.5 assets is not in excess of $1,000 per assistance unit. Exempt
127.6 assets, the reduction of excess assets, and the waiver of excess
127.7 assets must conform to the medical assistance program in chapter
127.8 256B, with the following exception: the maximum amount of
127.9 undistributed funds in a trust that could be distributed to or
127.10 on behalf of the beneficiary by the trustee, assuming the full
127.11 exercise of the trustee's discretion under the terms of the
127.12 trust, must be applied toward the asset maximum; and
127.13 (ii) who has countable income not in excess of the
127.14 assistance standards established in section 256B.056,
127.15 subdivision 4 that does not exceed 133 and 1/3 percent of the
127.16 AFDC income standard in effect under the July 16, 1996, AFDC
127.17 state plan, increased by three percent, or whose excess income
127.18 is spent down according to section 256B.056, subdivision 5,
127.19 using a six-month budget period. The method for calculating
127.20 earned income disregards and deductions for a person who resides
127.21 with a dependent child under age 21 shall follow section
127.22 256B.056, subdivision 1a. However, if a disregard of $30 and
127.23 one-third of the remainder has been applied to the wage earner's
127.24 income, the disregard shall not be applied again until the wage
127.25 earner's income has not been considered in an eligibility
127.26 determination for general assistance, general assistance medical
127.27 care, medical assistance, or MFIP-S for 12 consecutive months.
127.28 The earned income and work expense deductions for a person who
127.29 does not reside with a dependent child under age 21 shall be the
127.30 same as the method used to determine eligibility for a person
127.31 under section 256D.06, subdivision 1, except the disregard of
127.32 the first $50 of earned income is not allowed;
127.33 (3) who would be eligible for medical assistance except
127.34 that the person resides in a facility that is determined by the
127.35 commissioner or the federal Health Care Financing Administration
127.36 to be an institution for mental diseases; or
128.1 (4) who is ineligible for medical assistance under chapter
128.2 256B or general assistance medical care under any other
128.3 provision of this section, and is receiving care and
128.4 rehabilitation services from a nonprofit center established to
128.5 serve victims of torture. These individuals are eligible for
128.6 general assistance medical care only for the period during which
128.7 they are receiving services from the center. During this period
128.8 of eligibility, individuals eligible under this clause shall not
128.9 be required to participate in prepaid general assistance medical
128.10 care.
128.11 (b) Beginning January 1, 2000, applicants or recipients who
128.12 meet all eligibility requirements of MinnesotaCare as defined in
128.13 sections 256L.01 to 256L.16, and are:
128.14 (i) adults with dependent children under 21 whose gross
128.15 family income is equal to or less than 275 percent of the
128.16 federal poverty guidelines; or
128.17 (ii) adults without children with earned income and whose
128.18 family gross income is between 75 percent of the federal poverty
128.19 guidelines and the amount set by section 256L.04, subdivision 7,
128.20 shall be terminated from general assistance medical care upon
128.21 enrollment in MinnesotaCare.
128.22 (c) For services rendered on or after July 1, 1997,
128.23 eligibility is limited to one month prior to application if the
128.24 person is determined eligible in the prior month. A
128.25 redetermination of eligibility must occur every 12 months.
128.26 Beginning January 1, 2000, Minnesota health care program
128.27 applications completed by recipients and applicants who are
128.28 persons described in paragraph (b), may be returned to the
128.29 county agency to be forwarded to the department of human
128.30 services or sent directly to the department of human services
128.31 for enrollment in MinnesotaCare. If all other eligibility
128.32 requirements of this subdivision are met, eligibility for
128.33 general assistance medical care shall be available in any month
128.34 during which a MinnesotaCare eligibility determination and
128.35 enrollment are pending. Upon notification of eligibility for
128.36 MinnesotaCare, notice of termination for eligibility for general
129.1 assistance medical care shall be sent to an applicant or
129.2 recipient. If all other eligibility requirements of this
129.3 subdivision are met, eligibility for general assistance medical
129.4 care shall be available until enrollment in MinnesotaCare
129.5 subject to the provisions of paragraph (e).
129.6 (d) The date of an initial Minnesota health care program
129.7 application necessary to begin a determination of eligibility
129.8 shall be the date the applicant has provided a name, address,
129.9 and social security number, signed and dated, to the county
129.10 agency or the department of human services. If the applicant is
129.11 unable to provide an initial application when health care is
129.12 delivered due to a medical condition or disability, a health
129.13 care provider may act on the person's behalf to complete the
129.14 initial application. The applicant must complete the remainder
129.15 of the application and provide necessary verification before
129.16 eligibility can be determined. The county agency must assist
129.17 the applicant in obtaining verification if necessary. On the
129.18 basis of information provided on the completed application, an
129.19 applicant who meets the following criteria shall be determined
129.20 eligible beginning in the month of application:
129.21 (1) has gross income less than 90 percent of the applicable
129.22 income standard;
129.23 (2) has liquid assets that total within $300 of the asset
129.24 standard;
129.25 (3) does not reside in a long-term care facility; and
129.26 (4) meets all other eligibility requirements.
129.27 The applicant must provide all required verifications within 30
129.28 days' notice of the eligibility determination or eligibility
129.29 shall be terminated.
129.30 (e) County agencies are authorized to use all automated
129.31 databases containing information regarding recipients' or
129.32 applicants' income in order to determine eligibility for general
129.33 assistance medical care or MinnesotaCare. Such use shall be
129.34 considered sufficient in order to determine eligibility and
129.35 premium payments by the county agency.
129.36 (f) General assistance medical care is not available for a
130.1 person in a correctional facility unless the person is detained
130.2 by law for less than one year in a county correctional or
130.3 detention facility as a person accused or convicted of a crime,
130.4 or admitted as an inpatient to a hospital on a criminal hold
130.5 order, and the person is a recipient of general assistance
130.6 medical care at the time the person is detained by law or
130.7 admitted on a criminal hold order and as long as the person
130.8 continues to meet other eligibility requirements of this
130.9 subdivision.
130.10 (g) General assistance medical care is not available for
130.11 applicants or recipients who do not cooperate with the county
130.12 agency to meet the requirements of medical assistance. General
130.13 assistance medical care is limited to payment of emergency
130.14 services only for applicants or recipients as described in
130.15 paragraph (b), whose MinnesotaCare coverage is denied or
130.16 terminated for nonpayment of premiums as required by sections
130.17 256L.06 and 256L.07.
130.18 (h) In determining the amount of assets of an individual,
130.19 there shall be included any asset or interest in an asset,
130.20 including an asset excluded under paragraph (a), that was given
130.21 away, sold, or disposed of for less than fair market value
130.22 within the 60 months preceding application for general
130.23 assistance medical care or during the period of eligibility.
130.24 Any transfer described in this paragraph shall be presumed to
130.25 have been for the purpose of establishing eligibility for
130.26 general assistance medical care, unless the individual furnishes
130.27 convincing evidence to establish that the transaction was
130.28 exclusively for another purpose. For purposes of this
130.29 paragraph, the value of the asset or interest shall be the fair
130.30 market value at the time it was given away, sold, or disposed
130.31 of, less the amount of compensation received. For any
130.32 uncompensated transfer, the number of months of ineligibility,
130.33 including partial months, shall be calculated by dividing the
130.34 uncompensated transfer amount by the average monthly per person
130.35 payment made by the medical assistance program to skilled
130.36 nursing facilities for the previous calendar year. The
131.1 individual shall remain ineligible until this fixed period has
131.2 expired. The period of ineligibility may exceed 30 months, and
131.3 a reapplication for benefits after 30 months from the date of
131.4 the transfer shall not result in eligibility unless and until
131.5 the period of ineligibility has expired. The period of
131.6 ineligibility begins in the month the transfer was reported to
131.7 the county agency, or if the transfer was not reported, the
131.8 month in which the county agency discovered the transfer,
131.9 whichever comes first. For applicants, the period of
131.10 ineligibility begins on the date of the first approved
131.11 application.
131.12 (i) When determining eligibility for any state benefits
131.13 under this subdivision, the income and resources of all
131.14 noncitizens shall be deemed to include their sponsor's income
131.15 and resources as defined in the Personal Responsibility and Work
131.16 Opportunity Reconciliation Act of 1996, title IV, Public Law
131.17 Number 104-193, sections 421 and 422, and subsequently set out
131.18 in federal rules.
131.19 (j)(1) An undocumented noncitizen or a nonimmigrant is
131.20 ineligible for general assistance medical care other than
131.21 emergency services. For purposes of this subdivision, a
131.22 nonimmigrant is an individual in one or more of the classes
131.23 listed in United States Code, title 8, section 1101(a)(15), and
131.24 an undocumented noncitizen is an individual who resides in the
131.25 United States without the approval or acquiescence of the
131.26 Immigration and Naturalization Service.
131.27 (2) This paragraph does not apply to a child under age 18,
131.28 to a Cuban or Haitian entrant as defined in Public Law Number
131.29 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is
131.30 aged, blind, or disabled as defined in Code of Federal
131.31 Regulations, title 42, sections 435.520, 435.530, 435.531,
131.32 435.540, and 435.541, or effective October 1, 1998, to an
131.33 individual eligible for general assistance medical care under
131.34 paragraph (a), clause (4), who cooperates with the Immigration
131.35 and Naturalization Service to pursue any applicable immigration
131.36 status, including citizenship, that would qualify the individual
132.1 for medical assistance with federal financial participation.
132.2 (k) For purposes of paragraphs (g) and (j), "emergency
132.3 services" has the meaning given in Code of Federal Regulations,
132.4 title 42, section 440.255(b)(1), except that it also means
132.5 services rendered because of suspected or actual pesticide
132.6 poisoning.
132.7 (l) Notwithstanding any other provision of law, a
132.8 noncitizen who is ineligible for medical assistance due to the
132.9 deeming of a sponsor's income and resources, is ineligible for
132.10 general assistance medical care.
132.11 Sec. 37. Minnesota Statutes 2000, section 256D.03,
132.12 subdivision 4, is amended to read:
132.13 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a)
132.14 For a person who is eligible under subdivision 3, paragraph (a),
132.15 clause (3), general assistance medical care covers, except as
132.16 provided in paragraph (c):
132.17 (1) inpatient hospital services;
132.18 (2) outpatient hospital services;
132.19 (3) services provided by Medicare certified rehabilitation
132.20 agencies;
132.21 (4) prescription drugs and other products recommended
132.22 through the process established in section 256B.0625,
132.23 subdivision 13;
132.24 (5) equipment necessary to administer insulin and
132.25 diagnostic supplies and equipment for diabetics to monitor blood
132.26 sugar level;
132.27 (6) eyeglasses and eye examinations provided by a physician
132.28 or optometrist;
132.29 (7) hearing aids;
132.30 (8) prosthetic devices;
132.31 (9) laboratory and X-ray services;
132.32 (10) physician's services;
132.33 (11) medical transportation;
132.34 (12) chiropractic services as covered under the medical
132.35 assistance program;
132.36 (13) podiatric services;
133.1 (14) dental services;
133.2 (15) outpatient services provided by a mental health center
133.3 or clinic that is under contract with the county board and is
133.4 established under section 245.62;
133.5 (16) day treatment services for mental illness provided
133.6 under contract with the county board;
133.7 (17) prescribed medications for persons who have been
133.8 diagnosed as mentally ill as necessary to prevent more
133.9 restrictive institutionalization;
133.10 (18) psychological services, medical supplies and
133.11 equipment, and Medicare premiums, coinsurance and deductible
133.12 payments;
133.13 (19) medical equipment not specifically listed in this
133.14 paragraph when the use of the equipment will prevent the need
133.15 for costlier services that are reimbursable under this
133.16 subdivision;
133.17 (20) services performed by a certified pediatric nurse
133.18 practitioner, a certified family nurse practitioner, a certified
133.19 adult nurse practitioner, a certified obstetric/gynecological
133.20 nurse practitioner, a certified neonatal nurse practitioner, or
133.21 a certified geriatric nurse practitioner in independent
133.22 practice, if (1) the service is otherwise covered under this
133.23 chapter as a physician service, (2) the service provided on an
133.24 inpatient basis is not included as part of the cost for
133.25 inpatient services included in the operating payment rate, and
133.26 (3) the service is within the scope of practice of the nurse
133.27 practitioner's license as a registered nurse, as defined in
133.28 section 148.171;
133.29 (21) services of a certified public health nurse or a
133.30 registered nurse practicing in a public health nursing clinic
133.31 that is a department of, or that operates under the direct
133.32 authority of, a unit of government, if the service is within the
133.33 scope of practice of the public health nurse's license as a
133.34 registered nurse, as defined in section 148.171; and
133.35 (22) telemedicine consultations, to the extent they are
133.36 covered under section 256B.0625, subdivision 3b.
134.1 (b) Except as provided in paragraph (c), for a recipient
134.2 who is eligible under subdivision 3, paragraph (a), clause (1)
134.3 or (2), general assistance medical care covers the services
134.4 listed in paragraph (a) with the exception of special
134.5 transportation services.
134.6 (c) Gender reassignment surgery and related services are
134.7 not covered services under this subdivision unless the
134.8 individual began receiving gender reassignment services prior to
134.9 July 1, 1995.
134.10 (d) In order to contain costs, the commissioner of human
134.11 services shall select vendors of medical care who can provide
134.12 the most economical care consistent with high medical standards
134.13 and shall where possible contract with organizations on a
134.14 prepaid capitation basis to provide these services. The
134.15 commissioner shall consider proposals by counties and vendors
134.16 for prepaid health plans, competitive bidding programs, block
134.17 grants, or other vendor payment mechanisms designed to provide
134.18 services in an economical manner or to control utilization, with
134.19 safeguards to ensure that necessary services are provided.
134.20 Before implementing prepaid programs in counties with a county
134.21 operated or affiliated public teaching hospital or a hospital or
134.22 clinic operated by the University of Minnesota, the commissioner
134.23 shall consider the risks the prepaid program creates for the
134.24 hospital and allow the county or hospital the opportunity to
134.25 participate in the program in a manner that reflects the risk of
134.26 adverse selection and the nature of the patients served by the
134.27 hospital, provided the terms of participation in the program are
134.28 competitive with the terms of other participants considering the
134.29 nature of the population served. Payment for services provided
134.30 pursuant to this subdivision shall be as provided to medical
134.31 assistance vendors of these services under sections 256B.02,
134.32 subdivision 8, and 256B.0625. For payments made during fiscal
134.33 year 1990 and later years, the commissioner shall consult with
134.34 an independent actuary in establishing prepayment rates, but
134.35 shall retain final control over the rate methodology. Payment
134.36 rates established by the commissioner must be within the limits
135.1 of available appropriations. Notwithstanding the provisions of
135.2 subdivision 3, an individual who becomes ineligible for general
135.3 assistance medical care because of failure to submit income
135.4 reports or recertification forms in a timely manner, shall
135.5 remain enrolled in the prepaid health plan and shall remain
135.6 eligible for general assistance medical care coverage through
135.7 the last day of the month in which the enrollee became
135.8 ineligible for general assistance medical care.
135.9 (e) There shall be no copayment required of any recipient
135.10 of benefits for any services provided under this subdivision. A
135.11 hospital receiving a reduced payment as a result of this section
135.12 may apply the unpaid balance toward satisfaction of the
135.13 hospital's bad debts.
135.14 (f) Any county may, from its own resources, provide medical
135.15 payments for which state payments are not made.
135.16 (g) Chemical dependency services that are reimbursed under
135.17 chapter 254B must not be reimbursed under general assistance
135.18 medical care.
135.19 (h) The maximum payment for new vendors enrolled in the
135.20 general assistance medical care program after the base year
135.21 shall be determined from the average usual and customary charge
135.22 of the same vendor type enrolled in the base year.
135.23 (i) The conditions of payment for services under this
135.24 subdivision are the same as the conditions specified in rules
135.25 adopted under chapter 256B governing the medical assistance
135.26 program, unless otherwise provided by statute or rule.
135.27 Sec. 38. Minnesota Statutes 2000, section 256J.31,
135.28 subdivision 12, is amended to read:
135.29 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A
135.30 participant who is not in vendor payment status may discontinue
135.31 receipt of the cash assistance portion of the MFIP assistance
135.32 grant and retain eligibility for child care assistance under
135.33 section 119B.05 and for medical assistance under sections
135.34 256B.055, subdivision 3a, and 256B.0635. For the months a
135.35 participant chooses to discontinue the receipt of the cash
135.36 portion of the MFIP grant, the assistance unit accrues months of
136.1 eligibility to be applied toward eligibility for child care
136.2 under section 119B.05 and for medical assistance under sections
136.3 256B.055, subdivision 3a, and 256B.0635.
136.4 [EFFECTIVE DATE.] This section is effective July 1, 2002.
136.5 Sec. 39. Minnesota Statutes 2000, section 256K.03,
136.6 subdivision 1, is amended to read:
136.7 Subdivision 1. [NOTIFICATION OF PROGRAM.] Except for the
136.8 provisions in this section, the provisions for the MFIP
136.9 application process shall be followed. Within two days after
136.10 receipt of a completed combined application form, the county
136.11 agency must refer to the provider the applicant who meets the
136.12 conditions under section 256K.02, and notify the applicant in
136.13 writing of the program including the following provisions:
136.14 (1) notification that, as part of the application process,
136.15 applicants are required to attend orientation, to be followed
136.16 immediately by a job search;
136.17 (2) the program provider, the date, time, and location of
136.18 the scheduled program orientation;
136.19 (3) the procedures for qualifying for and receiving
136.20 benefits under the program;
136.21 (4) the immediate availability of supportive services,
136.22 including, but not limited to, child care, transportation,
136.23 medical assistance, and other work-related aid; and
136.24 (5) the rights, responsibilities, and obligations of
136.25 participants in the program, including, but not limited to, the
136.26 grounds for exemptions and deferrals, the consequences for
136.27 refusing or failing to participate fully, and the appeal process.
136.28 [EFFECTIVE DATE.] This section is effective July 1, 2002.
136.29 Sec. 40. Minnesota Statutes 2000, section 256K.07, is
136.30 amended to read:
136.31 256K.07 [ELIGIBILITY FOR FOOD STAMPS, MEDICAL ASSISTANCE,
136.32 AND CHILD CARE.]
136.33 The participant shall be treated as an MFIP recipient for
136.34 food stamps, medical assistance, and child care eligibility
136.35 purposes. The participant who leaves the program as a result of
136.36 increased earnings from employment shall be eligible for
137.1 transitional medical assistance and child care without regard to
137.2 MFIP receipt in three of the six months preceding ineligibility.
137.3 [EFFECTIVE DATE.] This section is effective July 1, 2002.
137.4 Sec. 41. Minnesota Statutes 2000, section 256L.06,
137.5 subdivision 3, is amended to read:
137.6 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a)
137.7 Premiums are dedicated to the commissioner for MinnesotaCare.
137.8 (b) The commissioner shall develop and implement procedures
137.9 to: (1) require enrollees to report changes in income; (2)
137.10 adjust sliding scale premium payments, based upon changes in
137.11 enrollee income; and (3) disenroll enrollees from MinnesotaCare
137.12 for failure to pay required premiums. Failure to pay includes
137.13 payment with a dishonored check, a returned automatic bank
137.14 withdrawal, or a refused credit card or debit card payment. The
137.15 commissioner may demand a guaranteed form of payment, including
137.16 a cashier's check or a money order, as the only means to replace
137.17 a dishonored, returned, or refused payment.
137.18 (c) Premiums are calculated on a calendar month basis and
137.19 may be paid on a monthly, quarterly, or annual basis, with the
137.20 first payment due upon notice from the commissioner of the
137.21 premium amount required. The commissioner shall inform
137.22 applicants and enrollees of these premium payment options.
137.23 Premium payment is required before enrollment is complete and to
137.24 maintain eligibility in MinnesotaCare.
137.25 (d) Nonpayment of the premium will result in disenrollment
137.26 from the plan within one calendar month after the due date
137.27 effective for the calendar month for which the premium was due.
137.28 Persons disenrolled for nonpayment or who voluntarily terminate
137.29 coverage from the program may not reenroll until four calendar
137.30 months have elapsed. Persons disenrolled for nonpayment who pay
137.31 all past due premiums as well as current premiums due, including
137.32 premiums due for the period of disenrollment, within 20 days of
137.33 disenrollment, shall be reenrolled retroactively to the first
137.34 day of disenrollment. Persons disenrolled for nonpayment or who
137.35 voluntarily terminate coverage from the program may not reenroll
137.36 for four calendar months unless the person demonstrates good
138.1 cause for nonpayment. Good cause does not exist if a person
138.2 chooses to pay other family expenses instead of the premium.
138.3 The commissioner shall define good cause in rule.
138.4 [EFFECTIVE DATE.] This section is effective July 1, 2002.
138.5 Sec. 42. Minnesota Statutes 2000, section 256L.12,
138.6 subdivision 9, is amended to read:
138.7 Subd. 9. [RATE SETTING.] Rates will be prospective, per
138.8 capita, where possible. The commissioner may allow health plans
138.9 to arrange for inpatient hospital services on a risk or nonrisk
138.10 basis. The commissioner shall consult with an independent
138.11 actuary to determine appropriate rates. Rates established by
138.12 the commissioner must be within the limits of available
138.13 appropriations.
138.14 Sec. 43. Minnesota Statutes 2000, section 256L.12, is
138.15 amended by adding a subdivision to read:
138.16 Subd. 11. [COVERAGE AT INDIAN HEALTH SERVICE
138.17 FACILITIES.] For American Indian enrollees of MinnesotaCare,
138.18 MinnesotaCare shall cover health care services provided at
138.19 Indian Health Service facilities and facilities operated by a
138.20 tribe or tribal organization under funding authorized by United
138.21 States Code, title 25, sections 450f to 450n, or title III of
138.22 the Indian Self-Determination and Education Act, Public Law
138.23 Number 93-638, if those services would otherwise be covered
138.24 under section 256L.03. Payments for services provided under
138.25 this subdivision shall be made on a fee-for-service basis, and
138.26 may, at the option of the tribe or organization, be made at the
138.27 rates authorized under sections 256.969, subdivision 16, and
138.28 256B.0625, subdivision 34, for those MinnesotaCare enrollees
138.29 eligible for coverage at medical assistance rates. For purposes
138.30 of this subdivision, "American Indian" has the meaning given to
138.31 persons to whom services will be provided for in the Code of
138.32 Federal Regulations, title 42, section 36.12.
138.33 Sec. 44. Minnesota Statutes 2000, section 256L.16, is
138.34 amended to read:
138.35 256L.16 [PAYMENT RATES; SERVICES FOR FAMILIES AND CHILDREN
138.36 UNDER THE MINNESOTACARE HEALTH CARE REFORM WAIVER.]
139.1 Section 256L.11, subdivision 2, shall not apply to services
139.2 provided to children families with children who are eligible to
139.3 receive expanded services according to section 256L.03,
139.4 subdivision 1a 256L.04, subdivision 1, paragraph (a).
139.5 Sec. 45. Laws 1995, chapter 178, article 2, section 36, is
139.6 amended to read:
139.7 Sec. 36. [EMPOWERMENT ZONES; ADMINISTRATIVE SIMPLIFICATION
139.8 OF WELFARE LAWS.]
139.9 (a) The commissioner of human services shall make
139.10 recommendations to effectuate the changes in federal laws and
139.11 regulations, state laws and rules, and the state plan to improve
139.12 the administrative efficiency of the aid to families with
139.13 dependent children, general assistance, work readiness, family
139.14 general assistance, medical assistance, general assistance
139.15 medical care, and food stamp programs. At a minimum, the
139.16 following administrative standards and procedures must be
139.17 changed.
139.18 The commissioner shall:
139.19 (1) require income or eligibility reviews no more
139.20 frequently than annually for cases in which income is normally
139.21 invariant, as in aid to families with dependent children cases
139.22 where the only source of household income is Supplemental Social
139.23 Security Income;
139.24 (2) permit households to report income annually when the
139.25 source of income is excluded, such as a minor's earnings;
139.26 (3) require income or eligibility reviews no more
139.27 frequently than annually for extended medical assistance cases;
139.28 (4) require income or eligibility reviews no more
139.29 frequently than annually for a medical assistance postpartum
139.30 client, where the client previously had eligibility under a
139.31 different basis prior to pregnancy or if other household members
139.32 have eligibility with the same income/basis that applies to the
139.33 client;
139.34 (5) (4) permit all income or eligibility reviews for foster
139.35 care medical assistance cases to use the short application form;
139.36 and
140.1 (6) (5) make dependent care expenses declaratory for
140.2 medical assistance; and
140.3 (7) permit households to only report gifts worth $100 or
140.4 more per month.
140.5 (b) The county's administrative savings resulting from
140.6 these changes may be allocated to fund any lawful purpose.
140.7 (c) The recommendations must be provided in a report to the
140.8 chairs of the appropriate legislative committees by August 1,
140.9 1995. The recommendations must include a list of the
140.10 administrative standards and procedures that require approval by
140.11 the federal government before implementation, and also which
140.12 administrative simplification standards and procedures may be
140.13 implemented by a county prior to receiving a federal waiver.
140.14 (d) The commissioner shall seek the necessary waivers from
140.15 the federal government as soon as possible to implement the
140.16 administrative simplification standards and procedures.
140.17 Sec. 46. Laws 1999, chapter 245, article 4, section 110,
140.18 is amended to read:
140.19 Sec. 110. [PROGRAMS FOR SENIOR CITIZENS.]
140.20 The commissioner of human services shall study the
140.21 eligibility criteria of and benefits provided to persons age 65
140.22 and over through the array of cash assistance and health care
140.23 programs administered by the department, and the extent to which
140.24 these programs can be combined, simplified, or coordinated to
140.25 reduce administrative costs and improve access. The
140.26 commissioner shall also study potential barriers to enrollment
140.27 for low-income seniors who would otherwise deplete resources
140.28 necessary to maintain independent community living. At a
140.29 minimum, the study must include an evaluation of asset
140.30 requirements and enrollment sites. The commissioner shall
140.31 report study findings and recommendations to the legislature by
140.32 June September 30, 2001.
140.33 Sec. 47. [NOTICE OF NEW PREMIUM SCHEDULE.]
140.34 The commissioner of human services shall provide medical
140.35 assistance enrollees subject to premiums as employed persons
140.36 with disabilities with prior notice of the new premium schedule
141.1 established under the section 13 amendment to section 256B.057,
141.2 subdivision 9, paragraph (c). This notice must be provided at
141.3 least two months before the month in which the first premium
141.4 payment under the new schedule is due.
141.5 Sec. 48. [MEDICATION THERAPY MANAGEMENT PILOT PROGRAM.]
141.6 Subdivision 1. [ESTABLISHMENT.] The commissioner of human
141.7 services, in consultation with the advisory committee
141.8 established under subdivision 2, shall implement, beginning July
141.9 1, 2001, a two-year medication therapy management pilot program
141.10 for medical assistance enrollees. Medication therapy management
141.11 must be provided by teams of physicians and pharmacists working
141.12 in collaborative practice, as defined in Minnesota Statutes,
141.13 section 151.01, subdivision 27, clause (5), to help patients use
141.14 medications safely and effectively. The commissioner may enroll
141.15 individual pharmacists who participate in the pilot program as
141.16 medical assistance providers and shall seek to ensure that
141.17 participating pharmacists represent all geographic regions of
141.18 the state.
141.19 Subd. 2. [ADVISORY COMMITTEE.] The commissioner shall
141.20 establish a ten-member medication therapy management advisory
141.21 committee, to advise the commissioner in the implementation and
141.22 administration of the program and the development of eligibility
141.23 criteria for enrollees and providers and requirements for
141.24 collaborative practice agreements. The committee shall be
141.25 comprised of: two licensed physicians; two licensed
141.26 pharmacists; two consumer representatives; three members with
141.27 expertise in the area of medication therapy management, who may
141.28 be licensed physicians or licensed pharmacists; and a
141.29 representative of the commissioner, who shall serve as an
141.30 ex-officio nonvoting member. In appointing members who are not
141.31 consumer representatives, the commissioner shall consider
141.32 recommendations of associations representing pharmacy and
141.33 medical practitioners. The committee is governed by section
141.34 15.059, except that committee members do not receive
141.35 compensation or reimbursement for expenses.
141.36 Subd. 3. [EVALUATION.] The commissioner shall evaluate the
142.1 cost-effectiveness of the pilot program and its effect on
142.2 patient outcomes and quality of care, and shall report to the
142.3 legislature by December 15, 2003. The commissioner may contract
142.4 with a vendor to conduct the evaluation.
142.5 Sec. 49. [REGULATORY SIMPLIFICATION FOR STATE HEALTH CARE
142.6 PROGRAM PROVIDERS.]
142.7 The commissioner of human services, in consultation with
142.8 providers participating in state health care programs, shall
142.9 identify nonfinancial barriers to increased provider enrollment
142.10 and provider retention in state health care programs, and shall
142.11 implement procedures to address these barriers. Areas to be
142.12 examined by the commissioner shall include, but are not limited
142.13 to, regulatory complexity and inconsistencies between state
142.14 health care programs, provider requirements, provision of
142.15 technical assistance to providers, responsiveness to provider
142.16 inquiries and complaints, claims processing turnaround times,
142.17 and policies for rejecting provider claims. The commissioner
142.18 shall report to the legislature by February 15, 2002, on any
142.19 changes to the administration of state health care programs that
142.20 will be implemented as a result of the study, and present
142.21 recommendations for any necessary changes in state law.
142.22 Sec. 50. [REPEALER.]
142.23 (a) Minnesota Statutes 2000, section 256B.037, subdivision
142.24 5, is repealed effective January 1, 2002.
142.25 (b) Minnesota Statutes 2000, section 256B.0635, subdivision
142.26 3, is repealed effective July 1, 2002.
142.27 ARTICLE 3
142.28 CONTINUING CARE AND HOME CARE
142.29 Section 1. Minnesota Statutes 2000, section 245A.13,
142.30 subdivision 7, is amended to read:
142.31 Subd. 7. [RATE RECOMMENDATION.] The commissioner of human
142.32 services may review rates of a residential program participating
142.33 in the medical assistance program which is in receivership and
142.34 that has needs or deficiencies documented by the department of
142.35 health or the department of human services. If the commissioner
142.36 of human services determines that a review of the rate
143.1 established under section 256B.501 sections 256B.5012 and
143.2 256B.5013 is needed, the commissioner shall:
143.3 (1) review the order or determination that cites the
143.4 deficiencies or needs; and
143.5 (2) determine the need for additional staff, additional
143.6 annual hours by type of employee, and additional consultants,
143.7 services, supplies, equipment, repairs, or capital assets
143.8 necessary to satisfy the needs or deficiencies.
143.9 Sec. 2. Minnesota Statutes 2000, section 245A.13,
143.10 subdivision 8, is amended to read:
143.11 Subd. 8. [ADJUSTMENT TO THE RATE.] Upon review of rates
143.12 under subdivision 7, the commissioner may adjust the residential
143.13 program's payment rate. The commissioner shall review the
143.14 circumstances, together with the residential program cost report
143.15 program's most recent income and expense report, to determine
143.16 whether or not the deficiencies or needs can be corrected or met
143.17 by reallocating residential program staff, costs, revenues,
143.18 or any other resources including any investments, efficiency
143.19 incentives, or allowances. If the commissioner determines that
143.20 any deficiency cannot be corrected or the need cannot be met
143.21 with the payment rate currently being paid, the commissioner
143.22 shall determine the payment rate adjustment by dividing the
143.23 additional annual costs established during the commissioner's
143.24 review by the residential program's actual resident days from
143.25 the most recent desk-audited cost income and expense report or
143.26 the estimated resident days in the projected receivership
143.27 period. The payment rate adjustment must meet the conditions in
143.28 Minnesota Rules, parts 9553.0010 to 9553.0080, and remains in
143.29 effect during the period of the receivership or until another
143.30 date set by the commissioner. Upon the subsequent sale,
143.31 closure, or transfer of the residential program, the
143.32 commissioner may recover amounts that were paid as payment rate
143.33 adjustments under this subdivision. This recovery shall be
143.34 determined through a review of actual costs and resident days in
143.35 the receivership period. The costs the commissioner finds to be
143.36 allowable shall be divided by the actual resident days for the
144.1 receivership period. This rate shall be compared to the rate
144.2 paid throughout the receivership period, with the difference,
144.3 multiplied by resident days, being the amount to be repaid to
144.4 the commissioner. Allowable costs shall be determined by the
144.5 commissioner as those ordinary, necessary, and related to
144.6 resident care by prudent and cost-conscious management. The
144.7 buyer or transferee shall repay this amount to the commissioner
144.8 within 60 days after the commissioner notifies the buyer or
144.9 transferee of the obligation to repay. This provision does not
144.10 limit the liability of the seller to the commissioner pursuant
144.11 to section 256B.0641.
144.12 Sec. 3. Minnesota Statutes 2000, section 252.275,
144.13 subdivision 4b, is amended to read:
144.14 Subd. 4b. [GUARANTEED FLOOR.] Each county with an original
144.15 allocation for the preceding year that is equal to or less than
144.16 the guaranteed floor minimum index shall have a guaranteed floor
144.17 equal to its original allocation for the preceding year. Each
144.18 county with an original allocation for the preceding year that
144.19 is greater than the guaranteed floor minimum index shall have a
144.20 guaranteed floor equal to the lesser of clause (1) or (2):
144.21 (1) the county's original allocation for the preceding
144.22 year; or
144.23 (2) 70 percent of the county's reported expenditures
144.24 eligible for reimbursement during the 12 months ending on June
144.25 30 of the preceding calendar year.
144.26 For calendar year 1993, the guaranteed floor minimum index
144.27 shall be $20,000. For each subsequent year, the index shall be
144.28 adjusted by the projected change in the average value in the
144.29 United States Department of Labor Bureau of Labor Statistics
144.30 consumer price index (all urban) for that year.
144.31 Notwithstanding this subdivision, no county shall be
144.32 allocated a guaranteed floor of less than $1,000.
144.33 When the amount of funds available for allocation is less
144.34 than the amount available in the previous year, each county's
144.35 previous year allocation shall be reduced in proportion to the
144.36 reduction in the statewide funding, to establish each county's
145.1 guaranteed floor.
145.2 Sec. 4. Minnesota Statutes 2000, section 254B.02,
145.3 subdivision 3, is amended to read:
145.4 Subd. 3. [RESERVE ACCOUNT.] The commissioner shall
145.5 allocate money from the reserve account to counties that, during
145.6 the current fiscal year, have met or exceeded the base level of
145.7 expenditures for eligible chemical dependency services from
145.8 local money. The commissioner shall establish the base level
145.9 for fiscal year 1988 as the amount of local money used for
145.10 eligible services in calendar year 1986. In later years, the
145.11 base level must be increased in the same proportion as state
145.12 appropriations to implement Laws 1986, chapter 394, sections 8
145.13 to 20, are increased. The base level must be decreased if the
145.14 fund balance from which allocations are made under section
145.15 254B.02, subdivision 1, is decreased in later years. The local
145.16 match rate for the reserve account is the same rate as applied
145.17 to the initial allocation. Reserve account payments must not be
145.18 included when calculating the county adjustments made according
145.19 to subdivision 2. For counties providing medical assistance or
145.20 general assistance medical care through managed care plans on
145.21 January 1, 1996, the base year is fiscal year 1995. For
145.22 counties beginning provision of managed care after January 1,
145.23 1996, the base year is the most recent fiscal year before
145.24 enrollment in managed care begins. For counties providing
145.25 managed care, the base level will be increased or decreased in
145.26 proportion to changes in the fund balance from which allocations
145.27 are made under subdivision 2, but will be additionally increased
145.28 or decreased in proportion to the change in county adjusted
145.29 population made in subdivision 1, paragraphs (b) and
145.30 (c). Effective July 1, 2001, funds deposited in the reserve
145.31 account in excess of those needed to meet obligations for
145.32 services provided during the biennium under this section and
145.33 sections 254B.06 and 254B.09 shall cancel to the general fund.
145.34 Sec. 5. Minnesota Statutes 2000, section 254B.03,
145.35 subdivision 1, is amended to read:
145.36 Subdivision 1. [LOCAL AGENCY DUTIES.] (a) Every local
146.1 agency shall provide chemical dependency services to persons
146.2 residing within its jurisdiction who meet criteria established
146.3 by the commissioner for placement in a chemical dependency
146.4 residential or nonresidential treatment service. Chemical
146.5 dependency money must be administered by the local agencies
146.6 according to law and rules adopted by the commissioner under
146.7 sections 14.001 to 14.69.
146.8 (b) In order to contain costs, the county board shall, with
146.9 the approval of the commissioner of human services, select
146.10 eligible vendors of chemical dependency services who can provide
146.11 economical and appropriate treatment. Unless the local agency
146.12 is a social services department directly administered by a
146.13 county or human services board, the local agency shall not be an
146.14 eligible vendor under section 254B.05. The commissioner may
146.15 approve proposals from county boards to provide services in an
146.16 economical manner or to control utilization, with safeguards to
146.17 ensure that necessary services are provided. If a county
146.18 implements a demonstration or experimental medical services
146.19 funding plan, the commissioner shall transfer the money as
146.20 appropriate. If a county selects a vendor located in another
146.21 state, the county shall ensure that the vendor is in compliance
146.22 with the rules governing licensure of programs located in the
146.23 state.
146.24 (c) The calendar year 1998 2002 rate for vendors may not
146.25 increase more than three two percent above the rate approved in
146.26 effect on January 1, 1997 2001. The calendar year 1999 2003
146.27 rate for vendors may not increase more than three two percent
146.28 above the rate in effect on January 1, 1998 2002. The calendar
146.29 years 2004 and 2005 rates may not exceed the rate in effect on
146.30 January 1, 2003.
146.31 (d) A culturally specific vendor that provides assessments
146.32 under a variance under Minnesota Rules, part 9530.6610, shall be
146.33 allowed to provide assessment services to persons not covered by
146.34 the variance.
146.35 Sec. 6. Minnesota Statutes 2000, section 254B.04,
146.36 subdivision 1, is amended to read:
147.1 Subdivision 1. [ELIGIBILITY.] (a) Persons eligible for
147.2 benefits under Code of Federal Regulations, title 25, part 20,
147.3 persons eligible for medical assistance benefits under sections
147.4 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6,
147.5 or who meet the income standards of section 256B.056,
147.6 subdivision 4, and persons eligible for general assistance
147.7 medical care under section 256D.03, subdivision 3, are entitled
147.8 to chemical dependency fund services. State money appropriated
147.9 for this paragraph must be placed in a separate account
147.10 established for this purpose.
147.11 Persons with dependent children who are determined to be in
147.12 need of chemical dependency treatment pursuant to an assessment
147.13 under section 626.556, subdivision 10, or a case plan under
147.14 section 260C.201, subdivision 6, or 260C.212, shall be assisted
147.15 by the local agency to access needed treatment services.
147.16 Treatment services must be appropriate for the individual or
147.17 family, which may include long-term care treatment or treatment
147.18 in a facility that allows the dependent children to stay in the
147.19 treatment facility. The county shall pay for out-of-home
147.20 placement costs, if applicable.
147.21 (b) A person not entitled to services under paragraph (a),
147.22 but with family income that is less than the 1997 federal
147.23 poverty guidelines equivalent of 60 percent of the state median
147.24 income for a family of like size and composition, shall be
147.25 eligible to receive chemical dependency fund services within the
147.26 limit of funds available after persons entitled to services
147.27 under paragraph (a) have been served appropriated for this group
147.28 for the fiscal year. If notified by the state agency of limited
147.29 funds, a county must give preferential treatment to persons with
147.30 dependent children who are in need of chemical dependency
147.31 treatment pursuant to an assessment under section 626.556,
147.32 subdivision 10, or a case plan under section 260C.201,
147.33 subdivision 6, or 260C.212. A county may spend money from its
147.34 own sources to serve persons under this paragraph. State money
147.35 appropriated for this paragraph must be placed in a separate
147.36 account established for this purpose.
148.1 (c) Persons whose income is between the 1997 federal
148.2 poverty guidelines equivalent of 60 percent and 115 percent of
148.3 the state median income shall be eligible for chemical
148.4 dependency services on a sliding fee basis, within the limit of
148.5 funds available, after persons entitled to services under
148.6 paragraph (a) and persons eligible for services under paragraph
148.7 (b) have been served appropriated for this group for the fiscal
148.8 year. Persons eligible under this paragraph must contribute to
148.9 the cost of services according to the sliding fee scale
148.10 established under subdivision 3. A county may spend money from
148.11 its own sources to provide services to persons under this
148.12 paragraph. State money appropriated for this paragraph must be
148.13 placed in a separate account established for this purpose.
148.14 Sec. 7. Minnesota Statutes 2000, section 254B.09, is
148.15 amended by adding a subdivision to read:
148.16 Subd. 8. [PAYMENTS TO IMPROVE SERVICES TO AMERICAN
148.17 INDIANS.] The commissioner may set rates for chemical dependency
148.18 services according to the American Indian Health Improvement
148.19 Act, Public Law Number 94-437, for eligible vendors. These
148.20 rates shall supersede rates set in county purchase of service
148.21 agreements when payments are made on behalf of clients eligible
148.22 according to Public Law Number 94-437.
148.23 Sec. 8. Minnesota Statutes 2000, section 256.01, is
148.24 amended by adding a subdivision to read:
148.25 Subd. 19. [GRANTS FOR CASE MANAGEMENT SERVICES TO PERSONS
148.26 WITH HIV OR AIDS.] The commissioner may award grants to eligible
148.27 vendors for the development, implementation, and evaluation of
148.28 case management services for individuals infected with the human
148.29 immunodeficiency virus. HIV/AIDs case management services will
148.30 be provided to increase access to cost effective health care
148.31 services, to reduce the risk of HIV transmission, to ensure that
148.32 basic client needs are met, and to increase client access to
148.33 needed community supports or services.
148.34 Sec. 9. Minnesota Statutes 2000, section 256.476,
148.35 subdivision 1, is amended to read:
148.36 Subdivision 1. [PURPOSE AND GOALS.] The commissioner of
149.1 human services shall establish a consumer support grant
149.2 program to assist for individuals with functional limitations
149.3 and their families in purchasing and securing supports which the
149.4 individuals need to live as independently and productively in
149.5 the community as possible who wish to purchase and secure their
149.6 own supports. The commissioner and local agencies shall jointly
149.7 develop an implementation plan which must include a way to
149.8 resolve the issues related to county liability. The program
149.9 shall:
149.10 (1) make support grants available to individuals or
149.11 families as an effective alternative to existing programs and
149.12 services, such as the developmental disability family support
149.13 program, the alternative care program, personal care attendant
149.14 services, home health aide services, and private duty nursing
149.15 facility services;
149.16 (2) provide consumers more control, flexibility, and
149.17 responsibility over the needed supports their services and
149.18 supports;
149.19 (3) promote local program management and decision making;
149.20 and
149.21 (4) encourage the use of informal and typical community
149.22 supports.
149.23 Sec. 10. Minnesota Statutes 2000, section 256.476,
149.24 subdivision 2, is amended to read:
149.25 Subd. 2. [DEFINITIONS.] For purposes of this section, the
149.26 following terms have the meanings given them:
149.27 (a) "County board" means the county board of commissioners
149.28 for the county of financial responsibility as defined in section
149.29 256G.02, subdivision 4, or its designated representative. When
149.30 a human services board has been established under sections
149.31 402.01 to 402.10, it shall be considered the county board for
149.32 the purposes of this section.
149.33 (b) "Family" means the person's birth parents, adoptive
149.34 parents or stepparents, siblings or stepsiblings, children or
149.35 stepchildren, grandparents, grandchildren, niece, nephew, aunt,
149.36 uncle, or spouse. For the purposes of this section, a family
150.1 member is at least 18 years of age.
150.2 (c) "Functional limitations" means the long-term inability
150.3 to perform an activity or task in one or more areas of major
150.4 life activity, including self-care, understanding and use of
150.5 language, learning, mobility, self-direction, and capacity for
150.6 independent living. For the purpose of this section, the
150.7 inability to perform an activity or task results from a mental,
150.8 emotional, psychological, sensory, or physical disability,
150.9 condition, or illness.
150.10 (d) "Informed choice" means a voluntary decision made by
150.11 the person or the person's legal representative, after becoming
150.12 familiarized with the alternatives to:
150.13 (1) select a preferred alternative from a number of
150.14 feasible alternatives;
150.15 (2) select an alternative which may be developed in the
150.16 future; and
150.17 (3) refuse any or all alternatives.
150.18 (e) "Local agency" means the local agency authorized by the
150.19 county board to carry out the provisions of this section.
150.20 (f) "Person" or "persons" means a person or persons meeting
150.21 the eligibility criteria in subdivision 3.
150.22 (g) "Authorized representative" means an individual
150.23 designated by the person or their legal representative to act on
150.24 their behalf. This individual may be a family member, guardian,
150.25 representative payee, or other individual designated by the
150.26 person or their legal representative, if any, to assist in
150.27 purchasing and arranging for supports. For the purposes of this
150.28 section, an authorized representative is at least 18 years of
150.29 age.
150.30 (h) "Screening" means the screening of a person's service
150.31 needs under sections 256B.0911 and 256B.092.
150.32 (i) "Supports" means services, care, aids, home
150.33 environmental modifications, or assistance purchased by the
150.34 person or the person's family. Examples of supports include
150.35 respite care, assistance with daily living, and adaptive aids
150.36 assistive technology. For the purpose of this section,
151.1 notwithstanding the provisions of section 144A.43, supports
151.2 purchased under the consumer support program are not considered
151.3 home care services.
151.4 (j) "Program of origination" means the program the
151.5 individual transferred from when approved for the consumer
151.6 support grant program.
151.7 Sec. 11. Minnesota Statutes 2000, section 256.476,
151.8 subdivision 3, is amended to read:
151.9 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person
151.10 is eligible to apply for a consumer support grant if the person
151.11 meets all of the following criteria:
151.12 (1) the person is eligible for and has been approved to
151.13 receive services under medical assistance as determined under
151.14 sections 256B.055 and 256B.056 or the person is eligible for and
151.15 has been approved to receive services under alternative care
151.16 services as determined under section 256B.0913 or the person has
151.17 been approved to receive a grant under the developmental
151.18 disability family support program under section 252.32;
151.19 (2) the person is able to direct and purchase the person's
151.20 own care and supports, or the person has a family member, legal
151.21 representative, or other authorized representative who can
151.22 purchase and arrange supports on the person's behalf;
151.23 (3) the person has functional limitations, requires ongoing
151.24 supports to live in the community, and is at risk of or would
151.25 continue institutionalization without such supports; and
151.26 (4) the person will live in a home. For the purpose of
151.27 this section, "home" means the person's own home or home of a
151.28 person's family member. These homes are natural home settings
151.29 and are not licensed by the department of health or human
151.30 services.
151.31 (b) Persons may not concurrently receive a consumer support
151.32 grant if they are:
151.33 (1) receiving home and community-based services under
151.34 United States Code, title 42, section 1396h(c); personal care
151.35 attendant and home health aide services under section 256B.0625;
151.36 a developmental disability family support grant; or alternative
152.1 care services under section 256B.0913; or
152.2 (2) residing in an institutional or congregate care setting.
152.3 (c) A person or person's family receiving a consumer
152.4 support grant shall not be charged a fee or premium by a local
152.5 agency for participating in the program.
152.6 (d) The commissioner may limit the participation of nursing
152.7 facility residents, residents of intermediate care facilities
152.8 for persons with mental retardation, and the recipients of
152.9 services from federal waiver programs in the consumer support
152.10 grant program if the participation of these individuals will
152.11 result in an increase in the cost to the state.
152.12 (e) The commissioner shall establish a budgeted
152.13 appropriation each fiscal year for the consumer support grant
152.14 program. The number of individuals participating in the program
152.15 will be adjusted so the total amount allocated to counties does
152.16 not exceed the amount of the budgeted appropriation. The
152.17 budgeted appropriation will be adjusted annually to accommodate
152.18 changes in demand for the consumer support grants.
152.19 Sec. 12. Minnesota Statutes 2000, section 256.476,
152.20 subdivision 4, is amended to read:
152.21 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A
152.22 county board may choose to participate in the consumer support
152.23 grant program. If a county board chooses to participate in the
152.24 program, the local agency shall establish written procedures and
152.25 criteria to determine the amount and use of support grants.
152.26 These procedures must include, at least, the availability of
152.27 respite care, assistance with daily living, and adaptive aids.
152.28 The local agency may establish monthly or annual maximum amounts
152.29 for grants and procedures where exceptional resources may be
152.30 required to meet the health and safety needs of the person on a
152.31 time-limited basis, however, the total amount awarded to each
152.32 individual may not exceed the limits established in subdivision
152.33 5, paragraph (f).
152.34 (b) Support grants to a person or a person's family will be
152.35 provided through a monthly subsidy payment and be in the form of
152.36 cash, voucher, or direct county payment to vendor. Support
153.1 grant amounts must be determined by the local agency. Each
153.2 service and item purchased with a support grant must meet all of
153.3 the following criteria:
153.4 (1) it must be over and above the normal cost of caring for
153.5 the person if the person did not have functional limitations;
153.6 (2) it must be directly attributable to the person's
153.7 functional limitations;
153.8 (3) it must enable the person or the person's family to
153.9 delay or prevent out-of-home placement of the person; and
153.10 (4) it must be consistent with the needs identified in the
153.11 service plan, when applicable.
153.12 (c) Items and services purchased with support grants must
153.13 be those for which there are no other public or private funds
153.14 available to the person or the person's family. Fees assessed
153.15 to the person or the person's family for health and human
153.16 services are not reimbursable through the grant.
153.17 (d) In approving or denying applications, the local agency
153.18 shall consider the following factors:
153.19 (1) the extent and areas of the person's functional
153.20 limitations;
153.21 (2) the degree of need in the home environment for
153.22 additional support; and
153.23 (3) the potential effectiveness of the grant to maintain
153.24 and support the person in the family environment or the person's
153.25 own home.
153.26 (e) At the time of application to the program or screening
153.27 for other services, the person or the person's family shall be
153.28 provided sufficient information to ensure an informed choice of
153.29 alternatives by the person, the person's legal representative,
153.30 if any, or the person's family. The application shall be made
153.31 to the local agency and shall specify the needs of the person
153.32 and family, the form and amount of grant requested, the items
153.33 and services to be reimbursed, and evidence of eligibility for
153.34 medical assistance or alternative care program.
153.35 (f) Upon approval of an application by the local agency and
153.36 agreement on a support plan for the person or person's family,
154.1 the local agency shall make grants to the person or the person's
154.2 family. The grant shall be in an amount for the direct costs of
154.3 the services or supports outlined in the service agreement.
154.4 (g) Reimbursable costs shall not include costs for
154.5 resources already available, such as special education classes,
154.6 day training and habilitation, case management, other services
154.7 to which the person is entitled, medical costs covered by
154.8 insurance or other health programs, or other resources usually
154.9 available at no cost to the person or the person's family.
154.10 (h) The state of Minnesota, the county boards participating
154.11 in the consumer support grant program, or the agencies acting on
154.12 behalf of the county boards in the implementation and
154.13 administration of the consumer support grant program shall not
154.14 be liable for damages, injuries, or liabilities sustained
154.15 through the purchase of support by the individual, the
154.16 individual's family, or the authorized representative under this
154.17 section with funds received through the consumer support grant
154.18 program. Liabilities include but are not limited to: workers'
154.19 compensation liability, the Federal Insurance Contributions Act
154.20 (FICA), or the Federal Unemployment Tax Act (FUTA). For
154.21 purposes of this section, participating county boards and
154.22 agencies acting on behalf of county boards are exempt from the
154.23 provisions of section 268.04.
154.24 Sec. 13. Minnesota Statutes 2000, section 256.476,
154.25 subdivision 5, is amended to read:
154.26 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a)
154.27 For the purpose of transferring persons to the consumer support
154.28 grant program from specific programs or services, such as the
154.29 developmental disability family support program and alternative
154.30 care program, personal care attendant assistant services, home
154.31 health aide services, or nursing facility private duty nursing
154.32 services, the amount of funds transferred by the commissioner
154.33 between the developmental disability family support program
154.34 account, the alternative care account, the medical assistance
154.35 account, or the consumer support grant account shall be based on
154.36 each county's participation in transferring persons to the
155.1 consumer support grant program from those programs and services.
155.2 (b) At the beginning of each fiscal year, county
155.3 allocations for consumer support grants shall be based on:
155.4 (1) the number of persons to whom the county board expects
155.5 to provide consumer supports grants;
155.6 (2) their eligibility for current program and services;
155.7 (3) the amount of nonfederal dollars expended on those
155.8 individuals for those programs and services or, in situations
155.9 where an individual is unable to obtain the support needed from
155.10 the program of origination due to the unavailability of service
155.11 providers at the time or the location where the supports are
155.12 needed, the allocation will be based on the county's best
155.13 estimate of the nonfederal dollars that would have been expended
155.14 if the services had been available; and
155.15 (4) projected dates when persons will start receiving
155.16 grants. County allocations shall be adjusted periodically by
155.17 the commissioner based on the actual transfer of persons or
155.18 service openings, and the nonfederal dollars associated with
155.19 those persons or service openings, to the consumer support grant
155.20 program.
155.21 (c) The amount of funds transferred by the commissioner
155.22 from the alternative care account and the medical assistance
155.23 account for an individual may be changed if it is determined by
155.24 the county or its agent that the individual's need for support
155.25 has changed.
155.26 (d) The authority to utilize funds transferred to the
155.27 consumer support grant account for the purposes of implementing
155.28 and administering the consumer support grant program will not be
155.29 limited or constrained by the spending authority provided to the
155.30 program of origination.
155.31 (e) The commissioner shall may use up to five percent of
155.32 each county's allocation, as adjusted, for payments to that
155.33 county for administrative expenses, to be paid as a
155.34 proportionate addition to reported direct service expenditures.
155.35 (f) Except as provided in this paragraph, the county
155.36 allocation for each individual or individual's family cannot
156.1 exceed 80 percent of the total nonfederal dollars expended on
156.2 the individual by the program of origination except for the
156.3 developmental disabilities family support grant program which
156.4 can be approved up to 100 percent of the nonfederal dollars and
156.5 in situations as described in paragraph (b), clause (3). In
156.6 situations where exceptional need exists or the individual's
156.7 need for support increases, up to 100 percent of the nonfederal
156.8 dollars expended by the consumer's program of origination may be
156.9 allocated to the county. Allocations that exceed 80 percent of
156.10 the nonfederal dollars expended on the individual by the program
156.11 of origination must be approved by the commissioner. The
156.12 remainder of the amount expended on the individual by the
156.13 program of origination will be used in the following
156.14 proportions: half will be made available to the consumer
156.15 support grant program and participating counties for consumer
156.16 training, resource development, and other costs, and half will
156.17 be returned to the state general fund.
156.18 (g) The commissioner may recover, suspend, or withhold
156.19 payments if the county board, local agency, or grantee does not
156.20 comply with the requirements of this section.
156.21 (h) Grant funds unexpended by consumers shall return to the
156.22 state once a year. The annual return of unexpended grant funds
156.23 shall occur in the quarter following the end of the state fiscal
156.24 year.
156.25 Sec. 14. Minnesota Statutes 2000, section 256.476,
156.26 subdivision 8, is amended to read:
156.27 Subd. 8. [COMMISSIONER RESPONSIBILITIES.] The commissioner
156.28 shall:
156.29 (1) transfer and allocate funds pursuant to this section;
156.30 (2) determine allocations based on projected and actual
156.31 local agency use;
156.32 (3) monitor and oversee overall program spending;
156.33 (4) evaluate the effectiveness of the program;
156.34 (5) provide training and technical assistance for local
156.35 agencies and consumers to help identify potential applicants to
156.36 the program; and
157.1 (6) develop guidelines for local agency program
157.2 administration and consumer information; and.
157.3 (7) apply for a federal waiver or take any other action
157.4 necessary to maximize federal funding for the program by
157.5 September 1, 1999.
157.6 Sec. 15. Minnesota Statutes 2000, section 256B.0625,
157.7 subdivision 7, is amended to read:
157.8 Subd. 7. [PRIVATE DUTY NURSING.] Medical assistance covers
157.9 private duty nursing services in a recipient's home. Recipients
157.10 who are authorized to receive private duty nursing services in
157.11 their home may use approved hours outside of the home during
157.12 hours when normal life activities take them outside of their
157.13 home and when, without the provision of private duty nursing,
157.14 their health and safety would be jeopardized. To use private
157.15 duty nursing services at school, the recipient or responsible
157.16 party must provide written authorization in the care plan
157.17 identifying the chosen provider and the daily amount of services
157.18 to be used at school. Medical assistance does not cover private
157.19 duty nursing services for residents of a hospital, nursing
157.20 facility, intermediate care facility, or a health care facility
157.21 licensed by the commissioner of health, except as authorized in
157.22 section 256B.64 for ventilator-dependent recipients in hospitals
157.23 or unless a resident who is otherwise eligible is on leave from
157.24 the facility and the facility either pays for the private duty
157.25 nursing services or forgoes the facility per diem for the leave
157.26 days that private duty nursing services are used. Total hours
157.27 of service and payment allowed for services outside the home
157.28 cannot exceed that which is otherwise allowed in an in-home
157.29 setting according to section 256B.0627. All private duty
157.30 nursing services must be provided according to the limits
157.31 established under section 256B.0627. Private duty nursing
157.32 services may not be reimbursed if the nurse is the spouse of the
157.33 recipient or the parent or foster care provider of a recipient
157.34 who is under age 18, or the recipient's legal guardian.
157.35 Sec. 16. Minnesota Statutes 2000, section 256B.0625,
157.36 subdivision 19a, is amended to read:
158.1 Subd. 19a. [PERSONAL CARE ASSISTANT SERVICES.] Medical
158.2 assistance covers personal care assistant services in a
158.3 recipient's home. To qualify for personal care assistant
158.4 services, recipients or responsible parties must be able to
158.5 identify the recipient's needs, direct and evaluate task
158.6 accomplishment, and provide for health and safety. Approved
158.7 hours may be used outside the home when normal life activities
158.8 take them outside the home and when, without the provision of
158.9 personal care, their health and safety would be jeopardized. To
158.10 use personal care assistant services at school, the recipient or
158.11 responsible party must provide written authorization in the care
158.12 plan identifying the chosen provider and the daily amount of
158.13 services to be used at school. Total hours for services,
158.14 whether actually performed inside or outside the recipient's
158.15 home, cannot exceed that which is otherwise allowed for personal
158.16 care assistant services in an in-home setting according to
158.17 section 256B.0627. Medical assistance does not cover personal
158.18 care assistant services for residents of a hospital, nursing
158.19 facility, intermediate care facility, health care facility
158.20 licensed by the commissioner of health, or unless a resident who
158.21 is otherwise eligible is on leave from the facility and the
158.22 facility either pays for the personal care assistant services or
158.23 forgoes the facility per diem for the leave days that personal
158.24 care assistant services are used. All personal care services
158.25 must be provided according to section 256B.0627. Personal
158.26 care assistant services may not be reimbursed if the personal
158.27 care assistant is the spouse or legal guardian of the recipient
158.28 or the parent of a recipient under age 18, or the responsible
158.29 party or the foster care provider of a recipient who cannot
158.30 direct the recipient's own care unless, in the case of a foster
158.31 care provider, a county or state case manager visits the
158.32 recipient as needed, but not less than every six months, to
158.33 monitor the health and safety of the recipient and to ensure the
158.34 goals of the care plan are met. Parents of adult recipients,
158.35 adult children of the recipient or adult siblings of the
158.36 recipient may be reimbursed for personal care assistant services
159.1 if they are not the recipient's legal guardian and, if they are
159.2 granted a waiver under section 256B.0627. Until July 1, 2001,
159.3 and Notwithstanding the provisions of section 256B.0627,
159.4 subdivision 4, paragraph (b), clause (4), the noncorporate legal
159.5 guardian or conservator of an adult, who is not the responsible
159.6 party and not the personal care provider organization, may be
159.7 granted a hardship waiver under section 256B.0627, to be
159.8 reimbursed to provide personal care assistant services to the
159.9 recipient, and shall not be considered to have a service
159.10 provider interest for purposes of participation on the screening
159.11 team under section 256B.092, subdivision 7.
159.12 Sec. 17. Minnesota Statutes 2000, section 256B.0625,
159.13 subdivision 19c, is amended to read:
159.14 Subd. 19c. [PERSONAL CARE.] Medical assistance covers
159.15 personal care assistant services provided by an individual who
159.16 is qualified to provide the services according to subdivision
159.17 19a and section 256B.0627, where the services are prescribed by
159.18 a physician in accordance with a plan of treatment and are
159.19 supervised by the recipient under the fiscal agent option
159.20 according to section 256B.0627, subdivision 10, or a qualified
159.21 professional. "Qualified professional" means a mental health
159.22 professional as defined in section 245.462, subdivision 18, or
159.23 245.4871, subdivision 27; or a registered nurse as defined in
159.24 sections 148.171 to 148.285. As part of the assessment, the
159.25 county public health nurse will consult with assist the
159.26 recipient or responsible party and to identify the most
159.27 appropriate person to provide supervision of the personal care
159.28 assistant. The qualified professional shall perform the duties
159.29 described in Minnesota Rules, part 9505.0335, subpart 4.
159.30 Sec. 18. Minnesota Statutes 2000, section 256B.0625,
159.31 subdivision 20, is amended to read:
159.32 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the
159.33 extent authorized by rule of the state agency, medical
159.34 assistance covers case management services to persons with
159.35 serious and persistent mental illness and children with severe
159.36 emotional disturbance. Services provided under this section
160.1 must meet the relevant standards in sections 245.461 to
160.2 245.4888, the Comprehensive Adult and Children's Mental Health
160.3 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and
160.4 9505.0322, excluding subpart 10.
160.5 (b) Entities meeting program standards set out in rules
160.6 governing family community support services as defined in
160.7 section 245.4871, subdivision 17, are eligible for medical
160.8 assistance reimbursement for case management services for
160.9 children with severe emotional disturbance when these services
160.10 meet the program standards in Minnesota Rules, parts 9520.0900
160.11 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
160.12 (c) Medical assistance and MinnesotaCare payment for mental
160.13 health case management shall be made on a monthly basis. In
160.14 order to receive payment for an eligible child, the provider
160.15 must document at least a face-to-face contact with the child,
160.16 the child's parents, or the child's legal representative. To
160.17 receive payment for an eligible adult, the provider must
160.18 document:
160.19 (1) at least a face-to-face contact with the adult or the
160.20 adult's legal representative; or
160.21 (2) at least a telephone contact with the adult or the
160.22 adult's legal representative and document a face-to-face contact
160.23 with the adult or the adult's legal representative within the
160.24 preceding two months.
160.25 (d) Payment for mental health case management provided by
160.26 county or state staff shall be based on the monthly rate
160.27 methodology under section 256B.094, subdivision 6, paragraph
160.28 (b), with separate rates calculated for child welfare and mental
160.29 health, and within mental health, separate rates for children
160.30 and adults.
160.31 (e) Payment for mental health case management provided by
160.32 county-contracted vendors shall be based on a monthly rate
160.33 negotiated by the host county. The negotiated rate must not
160.34 exceed the rate charged by the vendor for the same service to
160.35 other payers. If the service is provided by a team of
160.36 contracted vendors, the county may negotiate a team rate with a
161.1 vendor who is a member of the team. The team shall determine
161.2 how to distribute the rate among its members. No reimbursement
161.3 received by contracted vendors shall be returned to the county,
161.4 except to reimburse the county for advance funding provided by
161.5 the county to the vendor.
161.6 (f) If the service is provided by a team which includes
161.7 contracted vendors and county or state staff, the costs for
161.8 county or state staff participation in the team shall be
161.9 included in the rate for county-provided services. In this
161.10 case, the contracted vendor and the county may each receive
161.11 separate payment for services provided by each entity in the
161.12 same month. In order to prevent duplication of services, the
161.13 county must document, in the recipient's file, the need for team
161.14 case management and a description of the roles of the team
161.15 members.
161.16 (g) The commissioner shall calculate the nonfederal share
161.17 of actual medical assistance and general assistance medical care
161.18 payments for each county, based on the higher of calendar year
161.19 1995 or 1996, by service date, project that amount forward to
161.20 1999, and transfer one-half of the result from medical
161.21 assistance and general assistance medical care to each county's
161.22 mental health grants under sections 245.4886 and 256E.12 for
161.23 calendar year 1999. The annualized minimum amount added to each
161.24 county's mental health grant shall be $3,000 per year for
161.25 children and $5,000 per year for adults. The commissioner may
161.26 reduce the statewide growth factor in order to fund these
161.27 minimums. The annualized total amount transferred shall become
161.28 part of the base for future mental health grants for each county.
161.29 (h) Any net increase in revenue to the county as a result
161.30 of the change in this section must be used to provide expanded
161.31 mental health services as defined in sections 245.461 to
161.32 245.4888, the Comprehensive Adult and Children's Mental Health
161.33 Acts, excluding inpatient and residential treatment. For
161.34 adults, increased revenue may also be used for services and
161.35 consumer supports which are part of adult mental health projects
161.36 approved under Laws 1997, chapter 203, article 7, section 25.
162.1 For children, increased revenue may also be used for respite
162.2 care and nonresidential individualized rehabilitation services
162.3 as defined in section 245.492, subdivisions 17 and 23.
162.4 "Increased revenue" has the meaning given in Minnesota Rules,
162.5 part 9520.0903, subpart 3.
162.6 (i) Notwithstanding section 256B.19, subdivision 1, the
162.7 nonfederal share of costs for mental health case management
162.8 shall be provided by the recipient's county of responsibility,
162.9 as defined in sections 256G.01 to 256G.12, from sources other
162.10 than federal funds or funds used to match other federal funds.
162.11 (j) The commissioner may suspend, reduce, or terminate the
162.12 reimbursement to a provider that does not meet the reporting or
162.13 other requirements of this section. The county of
162.14 responsibility, as defined in sections 256G.01 to 256G.12, is
162.15 responsible for any federal disallowances. The county may share
162.16 this responsibility with its contracted vendors.
162.17 (k) The commissioner shall set aside a portion of the
162.18 federal funds earned under this section to repay the special
162.19 revenue maximization account under section 256.01, subdivision
162.20 2, clause (15). The repayment is limited to:
162.21 (1) the costs of developing and implementing this section;
162.22 and
162.23 (2) programming the information systems.
162.24 (l) Notwithstanding section 256.025, subdivision 2,
162.25 payments to counties for case management expenditures under this
162.26 section shall only be made from federal earnings from services
162.27 provided under this section. Payments to contracted vendors
162.28 shall include both the federal earnings and the county share.
162.29 (m) Notwithstanding section 256B.041, county payments for
162.30 the cost of mental health case management services provided by
162.31 county or state staff shall not be made to the state treasurer.
162.32 For the purposes of mental health case management services
162.33 provided by county or state staff under this section, the
162.34 centralized disbursement of payments to counties under section
162.35 256B.041 consists only of federal earnings from services
162.36 provided under this section.
163.1 (n) Case management services under this subdivision do not
163.2 include therapy, treatment, legal, or outreach services.
163.3 (o) If the recipient is a resident of a nursing facility,
163.4 intermediate care facility, or hospital, and the recipient's
163.5 institutional care is paid by medical assistance, payment for
163.6 case management services under this subdivision is limited to
163.7 the last 30 180 days of the recipient's residency in that
163.8 facility and may not exceed more than two six months in a
163.9 calendar year.
163.10 (p) Payment for case management services under this
163.11 subdivision shall not duplicate payments made under other
163.12 program authorities for the same purpose.
163.13 (q) By July 1, 2000, the commissioner shall evaluate the
163.14 effectiveness of the changes required by this section, including
163.15 changes in number of persons receiving mental health case
163.16 management, changes in hours of service per person, and changes
163.17 in caseload size.
163.18 (r) For each calendar year beginning with the calendar year
163.19 2001, the annualized amount of state funds for each county
163.20 determined under paragraph (g) shall be adjusted by the county's
163.21 percentage change in the average number of clients per month who
163.22 received case management under this section during the fiscal
163.23 year that ended six months prior to the calendar year in
163.24 question, in comparison to the prior fiscal year.
163.25 (s) For counties receiving the minimum allocation of $3,000
163.26 or $5,000 described in paragraph (g), the adjustment in
163.27 paragraph (r) shall be determined so that the county receives
163.28 the higher of the following amounts:
163.29 (1) a continuation of the minimum allocation in paragraph
163.30 (g); or
163.31 (2) an amount based on that county's average number of
163.32 clients per month who received case management under this
163.33 section during the fiscal year that ended six months prior to
163.34 the calendar year in question, in comparison to the prior fiscal
163.35 year, times the average statewide grant per person per month for
163.36 counties not receiving the minimum allocation.
164.1 (t) The adjustments in paragraphs (r) and (s) shall be
164.2 calculated separately for children and adults.
164.3 Sec. 19. Minnesota Statutes 2000, section 256B.0625, is
164.4 amended by adding a subdivision to read:
164.5 Subd. 43. [TARGETED CASE MANAGEMENT.] For purposes of
164.6 subdivisions 43a to 43h, the following terms have the meanings
164.7 given them:
164.8 (1) "Home care service recipients" means those individuals
164.9 receiving the following services under section 256B.0627:
164.10 skilled nursing visits, home health aide visits, private duty
164.11 nursing, personal care assistants, or therapies provided through
164.12 a home health agency.
164.13 (2) "Home care targeted case management" means the
164.14 provision of targeted case management services for the purpose
164.15 of assisting home care service recipients to gain access to
164.16 needed services and supports so that they may remain in the
164.17 community.
164.18 (3) "Institutions" means hospitals, consistent with Code of
164.19 Federal Regulations, title 42, section 440.10; regional
164.20 treatment center inpatient services, consistent with section
164.21 245.474; nursing facilities; and intermediate care facilities
164.22 for persons with mental retardation.
164.23 (4) "Relocation targeted case management" means the
164.24 provision of targeted case management services for the purpose
164.25 of assisting recipients to gain access to needed services and
164.26 supports if they choose to move from an institution to the
164.27 community. Relocation targeted case management may be provided
164.28 during the last 180 consecutive days of an eligible recipient's
164.29 institutional stay.
164.30 (5) "Targeted case management" means case management
164.31 services provided to help recipients gain access to needed
164.32 medical, social, educational, and other services and supports.
164.33 Sec. 20. Minnesota Statutes 2000, section 256B.0625, is
164.34 amended by adding a subdivision to read:
164.35 Subd. 43a. [ELIGIBILITY.] The following persons are
164.36 eligible for relocation targeted case management or home care
165.1 targeted case management:
165.2 (1) medical assistance eligible persons residing in
165.3 institutions who choose to move into the community are eligible
165.4 for relocation targeted case management services; and
165.5 (2) medical assistance eligible persons receiving home care
165.6 services, who are not eligible for any other medical assistance
165.7 reimbursable case management service, are eligible for home care
165.8 targeted case management services beginning January 1, 2003.
165.9 Sec. 21. Minnesota Statutes 2000, section 256B.0625, is
165.10 amended by adding a subdivision to read:
165.11 Subd. 43b. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER
165.12 QUALIFICATIONS.] The following qualifications and certification
165.13 standards must be met by providers of relocation targeted case
165.14 management:
165.15 (a) The commissioner must certify each provider of
165.16 relocation targeted case management before enrollment. The
165.17 certification process shall examine the provider's ability to
165.18 meet the requirements in this subdivision and other federal and
165.19 state requirements of this service. A certified relocation
165.20 targeted case management provider may subcontract with another
165.21 provider to deliver relocation targeted case management
165.22 services. Subcontracted providers must demonstrate the ability
165.23 to provide the services outlined in subdivision 43d.
165.24 (b) A relocation targeted case management provider is an
165.25 enrolled medical assistance provider who is determined by the
165.26 commissioner to have all of the following characteristics:
165.27 (1) the legal authority to provide public welfare under
165.28 sections 393.01, subdivision 7; and 393.07, or a federally
165.29 recognized Indian tribe;
165.30 (2) the demonstrated capacity and experience to provide the
165.31 components of case management to coordinate and link community
165.32 resources needed by the eligible population;
165.33 (3) the administrative capacity and experience to serve the
165.34 target population for whom it will provide services and ensure
165.35 quality of services under state and federal requirements;
165.36 (4) the legal authority to provide complete investigative
166.1 and protective services under section 626.556, subdivision 10,
166.2 and child welfare and foster care services under section 393.07,
166.3 subdivisions 1 and 2, or a federally recognized Indian tribe;
166.4 (5) a financial management system that provides accurate
166.5 documentation of services and costs under state and federal
166.6 requirements; and
166.7 (6) the capacity to document and maintain individual case
166.8 records under state and federal requirements.
166.9 A provider of targeted case management under subdivision 20 may
166.10 be deemed a certified provider of relocation targeted case
166.11 management.
166.12 Sec. 22. Minnesota Statutes 2000, section 256B.0625, is
166.13 amended by adding a subdivision to read:
166.14 Subd. 43c. [HOME CARE TARGETED CASE MANAGEMENT PROVIDER
166.15 QUALIFICATIONS.] The following qualifications and certification
166.16 standards must be met by providers of home care targeted case
166.17 management.
166.18 (a) The commissioner must certify each provider of home
166.19 care targeted case management before enrollment. The
166.20 certification process shall examine the provider's ability to
166.21 meet the requirements in this subdivision and other state and
166.22 federal requirements of this service.
166.23 (b) A home care targeted case management provider is an
166.24 enrolled medical assistance provider who has a minimum of a
166.25 bachelor's degree or a license in a health or human services
166.26 field, and is determined by the commissioner to have all of the
166.27 following characteristics:
166.28 (1) the demonstrated capacity and experience to provide the
166.29 components of case management to coordinate and link community
166.30 resources needed by the eligible population;
166.31 (2) the administrative capacity and experience to serve the
166.32 target population for whom it will provide services and ensure
166.33 quality of services under state and federal requirements;
166.34 (3) a financial management system that provides accurate
166.35 documentation of services and costs under state and federal
166.36 requirements;
167.1 (4) the capacity to document and maintain individual case
167.2 records under state and federal requirements; and
167.3 (5) the capacity to coordinate with county administrative
167.4 functions.
167.5 Sec. 23. Minnesota Statutes 2000, section 256B.0625, is
167.6 amended by adding a subdivision to read:
167.7 Subd. 43d. [ELIGIBLE SERVICES.] Services eligible for
167.8 medical assistance reimbursement as targeted case management
167.9 include:
167.10 (1) assessment of the recipient's need for targeted case
167.11 management services;
167.12 (2) development, completion, and regular review of a
167.13 written individual service plan, which is based upon the
167.14 assessment of the recipient's needs and choices, and which will
167.15 ensure access to medical, social, educational, and other related
167.16 services and supports;
167.17 (3) routine contact or communication with the recipient,
167.18 recipient's family, primary caregiver, legal representative,
167.19 substitute care provider, service providers, or other relevant
167.20 persons identified as necessary to the development or
167.21 implementation of the goals of the individual service plan;
167.22 (4) coordinating referrals for, and the provision of, case
167.23 management services for the recipient with appropriate service
167.24 providers, consistent with section 1902(a)(23) of the Social
167.25 Security Act;
167.26 (5) coordinating and monitoring the overall service
167.27 delivery to ensure quality of services, appropriateness, and
167.28 continued need;
167.29 (6) completing and maintaining necessary documentation that
167.30 supports and verifies the activities in this subdivision;
167.31 (7) traveling to conduct a visit with the recipient or
167.32 other relevant person necessary to develop or implement the
167.33 goals of the individual service plan; and
167.34 (8) coordinating with the institution discharge planner in
167.35 the 180-day period before the recipient's discharge.
167.36 Sec. 24. Minnesota Statutes 2000, section 256B.0625, is
168.1 amended by adding a subdivision to read:
168.2 Subd. 43e. [TIME LINES.] The following time lines must be
168.3 met for assigning a case manager:
168.4 (1) for relocation targeted case management, an eligible
168.5 recipient must be assigned a case manager who visits the person
168.6 within 20 working days of requesting a case manager from their
168.7 county of financial responsibility as determined under chapter
168.8 256G. If a county agency does not provide case management
168.9 services as required, the recipient may, after written notice to
168.10 the county agency, obtain targeted relocation case management
168.11 services from a home care targeted case management provider, as
168.12 defined in subdivision 43c; and
168.13 (2) for home care targeted case management, an eligible
168.14 recipient must be assigned a case manager within 20 working days
168.15 of requesting a case manager from a home care targeted case
168.16 management provider, as defined in subdivision 43c.
168.17 Sec. 25. Minnesota Statutes 2000, section 256B.0625, is
168.18 amended by adding a subdivision to read:
168.19 Subd. 43f. [EVALUATION.] The commissioner shall evaluate
168.20 the delivery of targeted case management, including, but not
168.21 limited to, access to case management services, consumer
168.22 satisfaction with case management services, and quality of case
168.23 management services.
168.24 Sec. 26. Minnesota Statutes 2000, section 256B.0625, is
168.25 amended by adding a subdivision to read:
168.26 Subd. 43g. [CONTACT DOCUMENTATION.] The case manager must
168.27 document each face-to-face and telephone contact with the
168.28 recipient and others involved in the recipient's individual
168.29 service plan.
168.30 Sec. 27. Minnesota Statutes 2000, section 256B.0625, is
168.31 amended by adding a subdivision to read:
168.32 Subd. 43h. [PAYMENT RATES.] The commissioner shall set
168.33 payment rates for targeted case management under this
168.34 subdivision. Case managers may bill according to the following
168.35 criteria:
168.36 (1) for relocation targeted case management, case managers
169.1 may bill for direct case management activities, including
169.2 face-to-face and telephone contacts, in the 180 days preceding
169.3 an eligible recipient's discharge from an institution;
169.4 (2) for home care targeted case management, case managers
169.5 may bill for direct case management activities, including
169.6 face-to-face and telephone contacts; and
169.7 (3) billings for targeted case management services under
169.8 this subdivision shall not duplicate payments made under other
169.9 program authorities for the same purpose.
169.10 Sec. 28. Minnesota Statutes 2000, section 256B.0627,
169.11 subdivision 1, is amended to read:
169.12 Subdivision 1. [DEFINITION.] (a) "Activities of daily
169.13 living" includes eating, toileting, grooming, dressing, bathing,
169.14 transferring, mobility, and positioning.
169.15 (b) "Assessment" means a review and evaluation of a
169.16 recipient's need for home care services conducted in person.
169.17 Assessments for private duty nursing shall be conducted by a
169.18 registered private duty nurse. Assessments for home health
169.19 agency services shall be conducted by a home health agency
169.20 nurse. Assessments for personal care assistant services shall
169.21 be conducted by the county public health nurse or a certified
169.22 public health nurse under contract with the county. A
169.23 face-to-face assessment must include: documentation of health
169.24 status, determination of need, evaluation of service
169.25 effectiveness, identification of appropriate services, service
169.26 plan development or modification, coordination of services,
169.27 referrals and follow-up to appropriate payers and community
169.28 resources, completion of required reports, recommendation of
169.29 service authorization, and consumer education. Once the need
169.30 for personal care assistant services is determined under this
169.31 section, the county public health nurse or certified public
169.32 health nurse under contract with the county is responsible for
169.33 communicating this recommendation to the commissioner and the
169.34 recipient. A face-to-face assessment for personal
169.35 care assistant services is conducted on those recipients who
169.36 have never had a county public health nurse assessment. A
170.1 face-to-face assessment must occur at least annually or when
170.2 there is a significant change in the recipient's condition or
170.3 when there is a change in the need for personal care assistant
170.4 services. A service update may substitute for the annual
170.5 face-to-face assessment when there is not a significant change
170.6 in recipient condition or a change in the need for personal care
170.7 assistant service. A service update or review for temporary
170.8 increase includes a review of initial baseline data, evaluation
170.9 of service effectiveness, redetermination of service need,
170.10 modification of service plan and appropriate referrals, update
170.11 of initial forms, obtaining service authorization, and on going
170.12 consumer education. Assessments for medical assistance home
170.13 care services for mental retardation or related conditions and
170.14 alternative care services for developmentally disabled home and
170.15 community-based waivered recipients may be conducted by the
170.16 county public health nurse to ensure coordination and avoid
170.17 duplication. Assessments must be completed on forms provided by
170.18 the commissioner within 30 days of a request for home care
170.19 services by a recipient or responsible party.
170.20 (b) (c) "Care plan" means a written description of personal
170.21 care assistant services developed by the qualified
170.22 professional or the recipient's physician with the recipient or
170.23 responsible party to be used by the personal care assistant with
170.24 a copy provided to the recipient or responsible party.
170.25 (d) "Complex and regular private duty nursing care" means,
170.26 effective July 1, 2001:
170.27 (1) complex care is private duty nursing provided to
170.28 recipients who are ventilator dependent or for whom a physician
170.29 has certified that were it not for private duty nursing the
170.30 recipient would meet the criteria for inpatient hospital
170.31 intensive care unit (ICU) level of care; and
170.32 (2) regular care is private duty nursing provided to all
170.33 other recipients.
170.34 (e) "Health-related functions" means functions that can be
170.35 delegated or assigned by a licensed health care professional
170.36 under state law to be performed by a personal care attendant.
171.1 (c) (f) "Home care services" means a health service,
171.2 determined by the commissioner as medically necessary, that is
171.3 ordered by a physician and documented in a service plan that is
171.4 reviewed by the physician at least once every 62 60 days for the
171.5 provision of home health services, or private duty nursing, or
171.6 at least once every 365 days for personal care. Home care
171.7 services are provided to the recipient at the recipient's
171.8 residence that is a place other than a hospital or long-term
171.9 care facility or as specified in section 256B.0625.
171.10 (g) "Instrumental activities of daily living" includes meal
171.11 planning and preparation, managing finances, shopping for food,
171.12 clothing, and other essential items, performing essential
171.13 household chores, communication by telephone and other media,
171.14 and getting around and participating in the community.
171.15 (d) (h) "Medically necessary" has the meaning given in
171.16 Minnesota Rules, parts 9505.0170 to 9505.0475.
171.17 (e) (i) "Personal care assistant" means a person who:
171.18 (1) is at least 18 years old, except for persons 16 to 18
171.19 years of age who participated in a related school-based job
171.20 training program or have completed a certified home health aide
171.21 competency evaluation;
171.22 (2) is able to effectively communicate with the recipient
171.23 and personal care provider organization;
171.24 (3) effective July 1, 1996, has completed one of the
171.25 training requirements as specified in Minnesota Rules, part
171.26 9505.0335, subpart 3, items A to D;
171.27 (4) has the ability to, and provides covered personal care
171.28 assistant services according to the recipient's care plan,
171.29 responds appropriately to recipient needs, and reports changes
171.30 in the recipient's condition to the supervising qualified
171.31 professional or physician;
171.32 (5) is not a consumer of personal care assistant services;
171.33 and
171.34 (6) is subject to criminal background checks and procedures
171.35 specified in section 245A.04.
171.36 (f) (j) "Personal care provider organization" means an
172.1 organization enrolled to provide personal care assistant
172.2 services under the medical assistance program that complies with
172.3 the following: (1) owners who have a five percent interest or
172.4 more, and managerial officials are subject to a background study
172.5 as provided in section 245A.04. This applies to currently
172.6 enrolled personal care provider organizations and those agencies
172.7 seeking enrollment as a personal care provider organization. An
172.8 organization will be barred from enrollment if an owner or
172.9 managerial official of the organization has been convicted of a
172.10 crime specified in section 245A.04, or a comparable crime in
172.11 another jurisdiction, unless the owner or managerial official
172.12 meets the reconsideration criteria specified in section 245A.04;
172.13 (2) the organization must maintain a surety bond and liability
172.14 insurance throughout the duration of enrollment and provides
172.15 proof thereof. The insurer must notify the department of human
172.16 services of the cancellation or lapse of policy; and (3) the
172.17 organization must maintain documentation of services as
172.18 specified in Minnesota Rules, part 9505.2175, subpart 7, as well
172.19 as evidence of compliance with personal care assistant training
172.20 requirements.
172.21 (g) (k) "Responsible party" means an individual residing
172.22 with a recipient of personal care assistant services who is
172.23 capable of providing the supportive care necessary to assist the
172.24 recipient to live in the community, is at least 18 years old,
172.25 and is not a personal care assistant. Responsible parties who
172.26 are parents of minors or guardians of minors or incapacitated
172.27 persons may delegate the responsibility to another adult during
172.28 a temporary absence of at least 24 hours but not more than six
172.29 months. The person delegated as a responsible party must be
172.30 able to meet the definition of responsible party, except that
172.31 the delegated responsible party is required to reside with the
172.32 recipient only while serving as the responsible party. Foster
172.33 care license holders may be designated the responsible party for
172.34 residents of the foster care home if case management is provided
172.35 as required in section 256B.0625, subdivision 19a. For persons
172.36 who, as of April 1, 1992, are sharing personal care assistant
173.1 services in order to obtain the availability of 24-hour
173.2 coverage, an employee of the personal care provider organization
173.3 may be designated as the responsible party if case management is
173.4 provided as required in section 256B.0625, subdivision 19a.
173.5 (h) (l) "Service plan" means a written description of the
173.6 services needed based on the assessment developed by the nurse
173.7 who conducts the assessment together with the recipient or
173.8 responsible party. The service plan shall include a description
173.9 of the covered home care services, frequency and duration of
173.10 services, and expected outcomes and goals. The recipient and
173.11 the provider chosen by the recipient or responsible party must
173.12 be given a copy of the completed service plan within 30 calendar
173.13 days of the request for home care services by the recipient or
173.14 responsible party.
173.15 (i) (m) "Skilled nurse visits" are provided in a
173.16 recipient's residence under a plan of care or service plan that
173.17 specifies a level of care which the nurse is qualified to
173.18 provide. These services are:
173.19 (1) nursing services according to the written plan of care
173.20 or service plan and accepted standards of medical and nursing
173.21 practice in accordance with chapter 148;
173.22 (2) services which due to the recipient's medical condition
173.23 may only be safely and effectively provided by a registered
173.24 nurse or a licensed practical nurse;
173.25 (3) assessments performed only by a registered nurse; and
173.26 (4) teaching and training the recipient, the recipient's
173.27 family, or other caregivers requiring the skills of a registered
173.28 nurse or licensed practical nurse.
173.29 (n) "Telehomecare" means the use of telecommunications
173.30 technology by a home health care professional to deliver home
173.31 health care services, within the professional's scope of
173.32 practice, to a patient located at a site other than the site
173.33 where the practitioner is located.
173.34 Sec. 29. Minnesota Statutes 2000, section 256B.0627,
173.35 subdivision 2, is amended to read:
173.36 Subd. 2. [SERVICES COVERED.] Home care services covered
174.1 under this section include:
174.2 (1) nursing services under section 256B.0625, subdivision
174.3 6a;
174.4 (2) private duty nursing services under section 256B.0625,
174.5 subdivision 7;
174.6 (3) home health aide services under section 256B.0625,
174.7 subdivision 6a;
174.8 (4) personal care assistant services under section
174.9 256B.0625, subdivision 19a;
174.10 (5) supervision of personal care assistant services
174.11 provided by a qualified professional under section 256B.0625,
174.12 subdivision 19a;
174.13 (6) consulting qualified professional of personal care
174.14 assistant services under the fiscal agent intermediary option as
174.15 specified in subdivision 10;
174.16 (7) face-to-face assessments by county public health nurses
174.17 for services under section 256B.0625, subdivision 19a; and
174.18 (8) service updates and review of temporary increases for
174.19 personal care assistant services by the county public health
174.20 nurse for services under section 256B.0625, subdivision 19a.
174.21 Sec. 30. Minnesota Statutes 2000, section 256B.0627,
174.22 subdivision 4, is amended to read:
174.23 Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The
174.24 personal care assistant services that are eligible for payment
174.25 are the following: services and supports furnished to an
174.26 individual, as needed, to assist in accomplishing activities of
174.27 daily living; instrumental activities of daily living;
174.28 health-related functions through hands-on assistance,
174.29 supervision, and cuing; and redirection and intervention for
174.30 behavior including observation and monitoring.
174.31 (b) Payment for services will be made within the limits
174.32 approved using the prior authorized process established in
174.33 subdivision 5.
174.34 (c) The amount and type of services authorized shall be
174.35 based on an assessment of the recipient's needs in these areas:
174.36 (1) bowel and bladder care;
175.1 (2) skin care to maintain the health of the skin;
175.2 (3) repetitive maintenance range of motion, muscle
175.3 strengthening exercises, and other tasks specific to maintaining
175.4 a recipient's optimal level of function;
175.5 (4) respiratory assistance;
175.6 (5) transfers and ambulation;
175.7 (6) bathing, grooming, and hairwashing necessary for
175.8 personal hygiene;
175.9 (7) turning and positioning;
175.10 (8) assistance with furnishing medication that is
175.11 self-administered;
175.12 (9) application and maintenance of prosthetics and
175.13 orthotics;
175.14 (10) cleaning medical equipment;
175.15 (11) dressing or undressing;
175.16 (12) assistance with eating and meal preparation and
175.17 necessary grocery shopping;
175.18 (13) accompanying a recipient to obtain medical diagnosis
175.19 or treatment;
175.20 (14) assisting, monitoring, or prompting the recipient to
175.21 complete the services in clauses (1) to (13);
175.22 (15) redirection, monitoring, and observation that are
175.23 medically necessary and an integral part of completing the
175.24 personal care assistant services described in clauses (1) to
175.25 (14);
175.26 (16) redirection and intervention for behavior, including
175.27 observation and monitoring;
175.28 (17) interventions for seizure disorders, including
175.29 monitoring and observation if the recipient has had a seizure
175.30 that requires intervention within the past three months;
175.31 (18) tracheostomy suctioning using a clean procedure if the
175.32 procedure is properly delegated by a registered nurse. Before
175.33 this procedure can be delegated to a personal care assistant, a
175.34 registered nurse must determine that the tracheostomy suctioning
175.35 can be accomplished utilizing a clean rather than a sterile
175.36 procedure and must ensure that the personal care assistant has
176.1 been taught the proper procedure; and
176.2 (19) incidental household services that are an integral
176.3 part of a personal care service described in clauses (1) to (18).
176.4 For purposes of this subdivision, monitoring and observation
176.5 means watching for outward visible signs that are likely to
176.6 occur and for which there is a covered personal care service or
176.7 an appropriate personal care intervention. For purposes of this
176.8 subdivision, a clean procedure refers to a procedure that
176.9 reduces the numbers of microorganisms or prevents or reduces the
176.10 transmission of microorganisms from one person or place to
176.11 another. A clean procedure may be used beginning 14 days after
176.12 insertion.
176.13 (b) (d) The personal care assistant services that are not
176.14 eligible for payment are the following:
176.15 (1) services not ordered by the physician;
176.16 (2) assessments by personal care assistant provider
176.17 organizations or by independently enrolled registered nurses;
176.18 (3) services that are not in the service plan;
176.19 (4) services provided by the recipient's spouse, legal
176.20 guardian for an adult or child recipient, or parent of a
176.21 recipient under age 18;
176.22 (5) services provided by a foster care provider of a
176.23 recipient who cannot direct the recipient's own care, unless
176.24 monitored by a county or state case manager under section
176.25 256B.0625, subdivision 19a;
176.26 (6) services provided by the residential or program license
176.27 holder in a residence for more than four persons;
176.28 (7) services that are the responsibility of a residential
176.29 or program license holder under the terms of a service agreement
176.30 and administrative rules;
176.31 (8) sterile procedures;
176.32 (9) injections of fluids into veins, muscles, or skin;
176.33 (10) services provided by parents of adult recipients,
176.34 adult children, or siblings of the recipient, unless these
176.35 relatives meet one of the following hardship criteria and the
176.36 commissioner waives this requirement:
177.1 (i) the relative resigns from a part-time or full-time job
177.2 to provide personal care for the recipient;
177.3 (ii) the relative goes from a full-time to a part-time job
177.4 with less compensation to provide personal care for the
177.5 recipient;
177.6 (iii) the relative takes a leave of absence without pay to
177.7 provide personal care for the recipient;
177.8 (iv) the relative incurs substantial expenses by providing
177.9 personal care for the recipient; or
177.10 (v) because of labor conditions, special language needs, or
177.11 intermittent hours of care needed, the relative is needed in
177.12 order to provide an adequate number of qualified personal care
177.13 assistants to meet the medical needs of the recipient;
177.14 (11) homemaker services that are not an integral part of a
177.15 personal care assistant services;
177.16 (12) home maintenance, or chore services;
177.17 (13) services not specified under paragraph (a); and
177.18 (14) services not authorized by the commissioner or the
177.19 commissioner's designee.
177.20 (e) The recipient or responsible party may choose to
177.21 supervise the personal care assistant or to have a qualified
177.22 professional, as defined in section 256B.0625, subdivision 19c,
177.23 provide the supervision. As required under section 256B.0625,
177.24 subdivision 19c, the county public health nurse, as a part of
177.25 the assessment, will assist the recipient or responsible party
177.26 to identify the most appropriate person to provide supervision
177.27 of the personal care assistant. Health-related delegated tasks
177.28 performed by the personal care assistant will be under the
177.29 supervision of a qualified professional or the direction of the
177.30 recipient's physician. If the recipient has a qualified
177.31 professional, Minnesota Rules, part 9505.0335, subpart 4,
177.32 applies.
177.33 Sec. 31. Minnesota Statutes 2000, section 256B.0627,
177.34 subdivision 5, is amended to read:
177.35 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance
177.36 payments for home care services shall be limited according to
178.1 this subdivision.
178.2 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A
178.3 recipient may receive the following home care services during a
178.4 calendar year:
178.5 (1) up to two face-to-face assessments to determine a
178.6 recipient's need for personal care assistant services;
178.7 (2) one service update done to determine a recipient's need
178.8 for personal care assistant services; and
178.9 (3) up to five nine skilled nurse visits.
178.10 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care
178.11 services above the limits in paragraph (a) must receive the
178.12 commissioner's prior authorization, except when:
178.13 (1) the home care services were required to treat an
178.14 emergency medical condition that if not immediately treated
178.15 could cause a recipient serious physical or mental disability,
178.16 continuation of severe pain, or death. The provider must
178.17 request retroactive authorization no later than five working
178.18 days after giving the initial service. The provider must be
178.19 able to substantiate the emergency by documentation such as
178.20 reports, notes, and admission or discharge histories;
178.21 (2) the home care services were provided on or after the
178.22 date on which the recipient's eligibility began, but before the
178.23 date on which the recipient was notified that the case was
178.24 opened. Authorization will be considered if the request is
178.25 submitted by the provider within 20 working days of the date the
178.26 recipient was notified that the case was opened;
178.27 (3) a third-party payor for home care services has denied
178.28 or adjusted a payment. Authorization requests must be submitted
178.29 by the provider within 20 working days of the notice of denial
178.30 or adjustment. A copy of the notice must be included with the
178.31 request;
178.32 (4) the commissioner has determined that a county or state
178.33 human services agency has made an error; or
178.34 (5) the professional nurse determines an immediate need for
178.35 up to 40 skilled nursing or home health aide visits per calendar
178.36 year and submits a request for authorization within 20 working
179.1 days of the initial service date, and medical assistance is
179.2 determined to be the appropriate payer.
179.3 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive
179.4 authorization will be evaluated according to the same criteria
179.5 applied to prior authorization requests.
179.6 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under
179.7 section 256B.0627, subdivision 1, paragraph (a), shall be
179.8 conducted initially, and at least annually thereafter, in person
179.9 with the recipient and result in a completed service plan using
179.10 forms specified by the commissioner. Within 30 days of
179.11 recipient or responsible party request for home care services,
179.12 the assessment, the service plan, and other information
179.13 necessary to determine medical necessity such as diagnostic or
179.14 testing information, social or medical histories, and hospital
179.15 or facility discharge summaries shall be submitted to the
179.16 commissioner. For personal care assistant services:
179.17 (1) The amount and type of service authorized based upon
179.18 the assessment and service plan will follow the recipient if the
179.19 recipient chooses to change providers.
179.20 (2) If the recipient's medical need changes, the
179.21 recipient's provider may assess the need for a change in service
179.22 authorization and request the change from the county public
179.23 health nurse. Within 30 days of the request, the public health
179.24 nurse will determine whether to request the change in services
179.25 based upon the provider assessment, or conduct a home visit to
179.26 assess the need and determine whether the change is appropriate.
179.27 (3) To continue to receive personal care assistant services
179.28 after the first year, the recipient or the responsible party, in
179.29 conjunction with the public health nurse, may complete a service
179.30 update on forms developed by the commissioner according to
179.31 criteria and procedures in subdivision 1.
179.32 (e) [PRIOR AUTHORIZATION.] The commissioner, or the
179.33 commissioner's designee, shall review the assessment, service
179.34 update, request for temporary services, service plan, and any
179.35 additional information that is submitted. The commissioner
179.36 shall, within 30 days after receiving a complete request,
180.1 assessment, and service plan, authorize home care services as
180.2 follows:
180.3 (1) [HOME HEALTH SERVICES.] All home health services
180.4 provided by a licensed nurse or a home health aide must be prior
180.5 authorized by the commissioner or the commissioner's designee.
180.6 Prior authorization must be based on medical necessity and
180.7 cost-effectiveness when compared with other care options. When
180.8 home health services are used in combination with personal care
180.9 and private duty nursing, the cost of all home care services
180.10 shall be considered for cost-effectiveness. The commissioner
180.11 shall limit nurse and home health aide visits to no more than
180.12 one visit each per day. The commissioner, or the commissioner's
180.13 designee, may authorize up to two skilled nurse visits per day.
180.14 (2) [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal
180.15 care assistant services and supervision by a qualified
180.16 professional, if requested by the recipient, must be prior
180.17 authorized by the commissioner or the commissioner's designee
180.18 except for the assessments established in paragraph (a). The
180.19 amount of personal care assistant services authorized must be
180.20 based on the recipient's home care rating. A child may not be
180.21 found to be dependent in an activity of daily living if because
180.22 of the child's age an adult would either perform the activity
180.23 for the child or assist the child with the activity and the
180.24 amount of assistance needed is similar to the assistance
180.25 appropriate for a typical child of the same age. Based on
180.26 medical necessity, the commissioner may authorize:
180.27 (A) up to two times the average number of direct care hours
180.28 provided in nursing facilities for the recipient's comparable
180.29 case mix level; or
180.30 (B) up to three times the average number of direct care
180.31 hours provided in nursing facilities for recipients who have
180.32 complex medical needs or are dependent in at least seven
180.33 activities of daily living and need physical assistance with
180.34 eating or have a neurological diagnosis; or
180.35 (C) up to 60 percent of the average reimbursement rate, as
180.36 of July 1, 1991, for care provided in a regional treatment
181.1 center for recipients who have Level I behavior, plus any
181.2 inflation adjustment as provided by the legislature for personal
181.3 care service; or
181.4 (D) up to the amount the commissioner would pay, as of July
181.5 1, 1991, plus any inflation adjustment provided for home care
181.6 services, for care provided in a regional treatment center for
181.7 recipients referred to the commissioner by a regional treatment
181.8 center preadmission evaluation team. For purposes of this
181.9 clause, home care services means all services provided in the
181.10 home or community that would be included in the payment to a
181.11 regional treatment center; or
181.12 (E) up to the amount medical assistance would reimburse for
181.13 facility care for recipients referred to the commissioner by a
181.14 preadmission screening team established under section 256B.0911
181.15 or 256B.092; and
181.16 (F) a reasonable amount of time for the provision of
181.17 supervision by a qualified professional of personal
181.18 care assistant services, if a qualified professional is
181.19 requested by the recipient or responsible party.
181.20 (ii) The number of direct care hours shall be determined
181.21 according to the annual cost report submitted to the department
181.22 by nursing facilities. The average number of direct care hours,
181.23 as established by May 1, 1992, shall be calculated and
181.24 incorporated into the home care limits on July 1, 1992. These
181.25 limits shall be calculated to the nearest quarter hour.
181.26 (iii) The home care rating shall be determined by the
181.27 commissioner or the commissioner's designee based on information
181.28 submitted to the commissioner by the county public health nurse
181.29 on forms specified by the commissioner. The home care rating
181.30 shall be a combination of current assessment tools developed
181.31 under sections 256B.0911 and 256B.501 with an addition for
181.32 seizure activity that will assess the frequency and severity of
181.33 seizure activity and with adjustments, additions, and
181.34 clarifications that are necessary to reflect the needs and
181.35 conditions of recipients who need home care including children
181.36 and adults under 65 years of age. The commissioner shall
182.1 establish these forms and protocols under this section and shall
182.2 use an advisory group, including representatives of recipients,
182.3 providers, and counties, for consultation in establishing and
182.4 revising the forms and protocols.
182.5 (iv) A recipient shall qualify as having complex medical
182.6 needs if the care required is difficult to perform and because
182.7 of recipient's medical condition requires more time than
182.8 community-based standards allow or requires more skill than
182.9 would ordinarily be required and the recipient needs or has one
182.10 or more of the following:
182.11 (A) daily tube feedings;
182.12 (B) daily parenteral therapy;
182.13 (C) wound or decubiti care;
182.14 (D) postural drainage, percussion, nebulizer treatments,
182.15 suctioning, tracheotomy care, oxygen, mechanical ventilation;
182.16 (E) catheterization;
182.17 (F) ostomy care;
182.18 (G) quadriplegia; or
182.19 (H) other comparable medical conditions or treatments the
182.20 commissioner determines would otherwise require institutional
182.21 care.
182.22 (v) A recipient shall qualify as having Level I behavior if
182.23 there is reasonable supporting evidence that the recipient
182.24 exhibits, or that without supervision, observation, or
182.25 redirection would exhibit, one or more of the following
182.26 behaviors that cause, or have the potential to cause:
182.27 (A) injury to the recipient's own body;
182.28 (B) physical injury to other people; or
182.29 (C) destruction of property.
182.30 (vi) Time authorized for personal care relating to Level I
182.31 behavior in subclause (v), items (A) to (C), shall be based on
182.32 the predictability, frequency, and amount of intervention
182.33 required.
182.34 (vii) A recipient shall qualify as having Level II behavior
182.35 if the recipient exhibits on a daily basis one or more of the
182.36 following behaviors that interfere with the completion of
183.1 personal care assistant services under subdivision 4, paragraph
183.2 (a):
183.3 (A) unusual or repetitive habits;
183.4 (B) withdrawn behavior; or
183.5 (C) offensive behavior.
183.6 (viii) A recipient with a home care rating of Level II
183.7 behavior in subclause (vii), items (A) to (C), shall be rated as
183.8 comparable to a recipient with complex medical needs under
183.9 subclause (iv). If a recipient has both complex medical needs
183.10 and Level II behavior, the home care rating shall be the next
183.11 complex category up to the maximum rating under subclause (i),
183.12 item (B).
183.13 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty
183.14 nursing services shall be prior authorized by the commissioner
183.15 or the commissioner's designee. Prior authorization for private
183.16 duty nursing services shall be based on medical necessity and
183.17 cost-effectiveness when compared with alternative care options.
183.18 The commissioner may authorize medically necessary private duty
183.19 nursing services in quarter-hour units when:
183.20 (i) the recipient requires more individual and continuous
183.21 care than can be provided during a nurse visit; or
183.22 (ii) the cares are outside of the scope of services that
183.23 can be provided by a home health aide or personal care assistant.
183.24 The commissioner may authorize:
183.25 (A) up to two times the average amount of direct care hours
183.26 provided in nursing facilities statewide for case mix
183.27 classification "K" as established by the annual cost report
183.28 submitted to the department by nursing facilities in May 1992;
183.29 (B) private duty nursing in combination with other home
183.30 care services up to the total cost allowed under clause (2);
183.31 (C) up to 16 hours per day if the recipient requires more
183.32 nursing than the maximum number of direct care hours as
183.33 established in item (A) and the recipient meets the hospital
183.34 admission criteria established under Minnesota Rules, parts
183.35 9505.0500 9505.0501 to 9505.0540.
183.36 The commissioner may authorize up to 16 hours per day of
184.1 medically necessary private duty nursing services or up to 24
184.2 hours per day of medically necessary private duty nursing
184.3 services until such time as the commissioner is able to make a
184.4 determination of eligibility for recipients who are
184.5 cooperatively applying for home care services under the
184.6 community alternative care program developed under section
184.7 256B.49, or until it is determined by the appropriate regulatory
184.8 agency that a health benefit plan is or is not required to pay
184.9 for appropriate medically necessary health care services.
184.10 Recipients or their representatives must cooperatively assist
184.11 the commissioner in obtaining this determination. Recipients
184.12 who are eligible for the community alternative care program may
184.13 not receive more hours of nursing under this section than would
184.14 otherwise be authorized under section 256B.49.
184.15 Beginning July 1, 2001, private duty nursing services shall
184.16 be authorized for complex and regular care according to
184.17 subdivision 1.
184.18 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is
184.19 ventilator-dependent, the monthly medical assistance
184.20 authorization for home care services shall not exceed what the
184.21 commissioner would pay for care at the highest cost hospital
184.22 designated as a long-term hospital under the Medicare program.
184.23 For purposes of this clause, home care services means all
184.24 services provided in the home that would be included in the
184.25 payment for care at the long-term hospital.
184.26 "Ventilator-dependent" means an individual who receives
184.27 mechanical ventilation for life support at least six hours per
184.28 day and is expected to be or has been dependent for at least 30
184.29 consecutive days.
184.30 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner
184.31 or the commissioner's designee shall determine the time period
184.32 for which a prior authorization shall be effective. If the
184.33 recipient continues to require home care services beyond the
184.34 duration of the prior authorization, the home care provider must
184.35 request a new prior authorization. Under no circumstances,
184.36 other than the exceptions in paragraph (b), shall a prior
185.1 authorization be valid prior to the date the commissioner
185.2 receives the request or for more than 12 months. A recipient
185.3 who appeals a reduction in previously authorized home care
185.4 services may continue previously authorized services, other than
185.5 temporary services under paragraph (h), pending an appeal under
185.6 section 256.045. The commissioner must provide a detailed
185.7 explanation of why the authorized services are reduced in amount
185.8 from those requested by the home care provider.
185.9 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or
185.10 the commissioner's designee shall determine the medical
185.11 necessity of home care services, the level of caregiver
185.12 according to subdivision 2, and the institutional comparison
185.13 according to this subdivision, the cost-effectiveness of
185.14 services, and the amount, scope, and duration of home care
185.15 services reimbursable by medical assistance, based on the
185.16 assessment, primary payer coverage determination information as
185.17 required, the service plan, the recipient's age, the cost of
185.18 services, the recipient's medical condition, and diagnosis or
185.19 disability. The commissioner may publish additional criteria
185.20 for determining medical necessity according to section 256B.04.
185.21 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.]
185.22 The agency nurse, the independently enrolled private duty nurse,
185.23 or county public health nurse may request a temporary
185.24 authorization for home care services by telephone. The
185.25 commissioner may approve a temporary level of home care services
185.26 based on the assessment, and service or care plan information,
185.27 and primary payer coverage determination information as required.
185.28 Authorization for a temporary level of home care services
185.29 including nurse supervision is limited to the time specified by
185.30 the commissioner, but shall not exceed 45 days, unless extended
185.31 because the county public health nurse has not completed the
185.32 required assessment and service plan, or the commissioner's
185.33 determination has not been made. The level of services
185.34 authorized under this provision shall have no bearing on a
185.35 future prior authorization.
185.36 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.]
186.1 Home care services provided in an adult or child foster care
186.2 setting must receive prior authorization by the department
186.3 according to the limits established in paragraph (a).
186.4 The commissioner may not authorize:
186.5 (1) home care services that are the responsibility of the
186.6 foster care provider under the terms of the foster care
186.7 placement agreement and administrative rules;
186.8 (2) personal care assistant services when the foster care
186.9 license holder is also the personal care provider or personal
186.10 care assistant unless the recipient can direct the recipient's
186.11 own care, or case management is provided as required in section
186.12 256B.0625, subdivision 19a;
186.13 (3) personal care assistant services when the responsible
186.14 party is an employee of, or under contract with, or has any
186.15 direct or indirect financial relationship with the personal care
186.16 provider or personal care assistant, unless case management is
186.17 provided as required in section 256B.0625, subdivision 19a; or
186.18 (4) personal care assistant and private duty nursing
186.19 services when the number of foster care residents is greater
186.20 than four unless the county responsible for the recipient's
186.21 foster placement made the placement prior to April 1, 1992,
186.22 requests that personal care assistant and private duty nursing
186.23 services be provided, and case management is provided as
186.24 required in section 256B.0625, subdivision 19a.
186.25 Sec. 32. Minnesota Statutes 2000, section 256B.0627,
186.26 subdivision 7, is amended to read:
186.27 Subd. 7. [NONCOVERED HOME CARE SERVICES.] The following
186.28 home care services are not eligible for payment under medical
186.29 assistance:
186.30 (1) skilled nurse visits for the sole purpose of
186.31 supervision of the home health aide;
186.32 (2) a skilled nursing visit:
186.33 (i) only for the purpose of monitoring medication
186.34 compliance with an established medication program for a
186.35 recipient; or
186.36 (ii) to administer or assist with medication
187.1 administration, including injections, prefilling syringes for
187.2 injections, or oral medication set-up of an adult recipient,
187.3 when as determined and documented by the registered nurse, the
187.4 need can be met by an available pharmacy or the recipient is
187.5 physically and mentally able to self-administer or prefill a
187.6 medication;
187.7 (3) home care services to a recipient who is eligible for
187.8 covered services including hospice, if elected by the recipient,
187.9 under the Medicare program or any other insurance held by the
187.10 recipient;
187.11 (4) services to other members of the recipient's household;
187.12 (5) a visit made by a skilled nurse solely to train other
187.13 home health agency workers;
187.14 (6) any home care service included in the daily rate of the
187.15 community-based residential facility where the recipient is
187.16 residing;
187.17 (7) nursing and rehabilitation therapy services that are
187.18 reasonably accessible to a recipient outside the recipient's
187.19 place of residence, excluding the assessment, counseling and
187.20 education, and personal assistant care;
187.21 (8) any home health agency service, excluding personal care
187.22 assistant services and private duty nursing services, which are
187.23 performed in a place other than the recipient's residence; and
187.24 (9) Medicare evaluation or administrative nursing visits on
187.25 dual-eligible recipients that do not qualify for Medicare visit
187.26 billing.
187.27 Sec. 33. Minnesota Statutes 2000, section 256B.0627,
187.28 subdivision 8, is amended to read:
187.29 Subd. 8. [SHARED PERSONAL CARE ASSISTANT SERVICES.] (a)
187.30 Medical assistance payments for shared personal care assistance
187.31 services shall be limited according to this subdivision.
187.32 (b) Recipients of personal care assistant services may
187.33 share staff and the commissioner shall provide a rate system for
187.34 shared personal care assistant services. For two persons
187.35 sharing services, the rate paid to a provider shall not exceed
187.36 1-1/2 times the rate paid for serving a single individual, and
188.1 for three persons sharing services, the rate paid to a provider
188.2 shall not exceed twice the rate paid for serving a single
188.3 individual. These rates apply only to situations in which all
188.4 recipients were present and received shared services on the date
188.5 for which the service is billed. No more than three persons may
188.6 receive shared services from a personal care assistant in a
188.7 single setting.
188.8 (c) Shared service is the provision of personal
188.9 care assistant services by a personal care assistant to two or
188.10 three recipients at the same time and in the same setting. For
188.11 the purposes of this subdivision, "setting" means:
188.12 (1) the home or foster care home of one of the individual
188.13 recipients; or
188.14 (2) a child care program in which all recipients served by
188.15 one personal care assistant are participating, which is licensed
188.16 under chapter 245A or operated by a local school district or
188.17 private school; or
188.18 (3) outside the home or foster care home of one of the
188.19 recipients when normal life activities take the recipients
188.20 outside the home.
188.21 The provisions of this subdivision do not apply when a
188.22 personal care assistant is caring for multiple recipients in
188.23 more than one setting.
188.24 (d) The recipient or the recipient's responsible party, in
188.25 conjunction with the county public health nurse, shall determine:
188.26 (1) whether shared personal care assistant services is an
188.27 appropriate option based on the individual needs and preferences
188.28 of the recipient; and
188.29 (2) the amount of shared services allocated as part of the
188.30 overall authorization of personal care assistant services.
188.31 The recipient or the responsible party, in conjunction with
188.32 the supervising qualified professional, if a qualified
188.33 professional is requested by any one of the recipients or
188.34 responsible parties, shall arrange the setting and grouping of
188.35 shared services based on the individual needs and preferences of
188.36 the recipients. Decisions on the selection of recipients to
189.1 share services must be based on the ages of the recipients,
189.2 compatibility, and coordination of their care needs.
189.3 (e) The following items must be considered by the recipient
189.4 or the responsible party and the supervising qualified
189.5 professional, if a qualified professional has been requested by
189.6 any one of the recipients or responsible parties, and documented
189.7 in the recipient's health service record:
189.8 (1) the additional qualifications needed by the personal
189.9 care assistant to provide care to several recipients in the same
189.10 setting;
189.11 (2) the additional training and supervision needed by the
189.12 personal care assistant to ensure that the needs of the
189.13 recipient are met appropriately and safely. The provider must
189.14 provide on-site supervision by a qualified professional within
189.15 the first 14 days of shared services, and monthly thereafter, if
189.16 supervision by a qualified provider has been requested by any
189.17 one of the recipients or responsible parties;
189.18 (3) the setting in which the shared services will be
189.19 provided;
189.20 (4) the ongoing monitoring and evaluation of the
189.21 effectiveness and appropriateness of the service and process
189.22 used to make changes in service or setting; and
189.23 (5) a contingency plan which accounts for absence of the
189.24 recipient in a shared services setting due to illness or other
189.25 circumstances and staffing contingencies.
189.26 (f) The provider must offer the recipient or the
189.27 responsible party the option of shared or one-on-one personal
189.28 care assistant services. The recipient or the responsible party
189.29 can withdraw from participating in a shared services arrangement
189.30 at any time.
189.31 (g) In addition to documentation requirements under
189.32 Minnesota Rules, part 9505.2175, a personal care provider must
189.33 meet documentation requirements for shared personal care
189.34 assistant services and must document the following in the health
189.35 service record for each individual recipient sharing services:
189.36 (1) permission by the recipient or the recipient's
190.1 responsible party, if any, for the maximum number of shared
190.2 services hours per week chosen by the recipient;
190.3 (2) permission by the recipient or the recipient's
190.4 responsible party, if any, for personal care assistant services
190.5 provided outside the recipient's residence;
190.6 (3) permission by the recipient or the recipient's
190.7 responsible party, if any, for others to receive shared services
190.8 in the recipient's residence;
190.9 (4) revocation by the recipient or the recipient's
190.10 responsible party, if any, of the shared service authorization,
190.11 or the shared service to be provided to others in the
190.12 recipient's residence, or the shared service to be provided
190.13 outside the recipient's residence;
190.14 (5) supervision of the shared personal care assistant
190.15 services by the qualified professional, if a qualified
190.16 professional is requested by one of the recipients or
190.17 responsible parties, including the date, time of day, number of
190.18 hours spent supervising the provision of shared services,
190.19 whether the supervision was face-to-face or another method of
190.20 supervision, changes in the recipient's condition, shared
190.21 services scheduling issues and recommendations;
190.22 (6) documentation by the qualified professional, if a
190.23 qualified professional is requested by one of the recipients or
190.24 responsible parties, of telephone calls or other discussions
190.25 with the personal care assistant regarding services being
190.26 provided to the recipient who has requested the supervision; and
190.27 (7) daily documentation of the shared services provided by
190.28 each identified personal care assistant including:
190.29 (i) the names of each recipient receiving shared services
190.30 together;
190.31 (ii) the setting for the shared services, including the
190.32 starting and ending times that the recipient received shared
190.33 services; and
190.34 (iii) notes by the personal care assistant regarding
190.35 changes in the recipient's condition, problems that may arise
190.36 from the sharing of services, scheduling issues, care issues,
191.1 and other notes as required by the qualified professional, if a
191.2 qualified professional is requested by one of the recipients or
191.3 responsible parties.
191.4 (h) Unless otherwise provided in this subdivision, all
191.5 other statutory and regulatory provisions relating to personal
191.6 care assistant services apply to shared services.
191.7 (i) In the event that supervision by a qualified
191.8 professional has been requested by one or more recipients, but
191.9 not by all of the recipients, the supervision duties of the
191.10 qualified professional shall be limited to only those recipients
191.11 who have requested the supervision.
191.12 Nothing in this subdivision shall be construed to reduce
191.13 the total number of hours authorized for an individual recipient.
191.14 Sec. 34. Minnesota Statutes 2000, section 256B.0627,
191.15 subdivision 10, is amended to read:
191.16 Subd. 10. [FISCAL AGENT INTERMEDIARY OPTION AVAILABLE FOR
191.17 PERSONAL CARE ASSISTANT SERVICES.] (a) "Fiscal agent option" is
191.18 an option that allows the recipient to:
191.19 (1) use a fiscal agent instead of a personal care provider
191.20 organization;
191.21 (2) supervise the personal care assistant; and
191.22 (3) use a consulting professional.
191.23 The commissioner may allow a recipient of personal care
191.24 assistant services to use a fiscal agent intermediary to assist
191.25 the recipient in paying and accounting for medically necessary
191.26 covered personal care assistant services authorized in
191.27 subdivision 4 and within the payment parameters of subdivision
191.28 5. Unless otherwise provided in this subdivision, all other
191.29 statutory and regulatory provisions relating to personal care
191.30 assistant services apply to a recipient using the fiscal agent
191.31 intermediary option.
191.32 (b) The recipient or responsible party shall:
191.33 (1) hire, and terminate the personal care assistant and
191.34 consulting professional, with the fiscal agent recruit, hire,
191.35 and terminate a qualified professional, if a qualified
191.36 professional is requested by the recipient or responsible party;
192.1 (2) recruit the personal care assistant and consulting
192.2 professional and orient and train the personal care assistant in
192.3 areas that do not require professional delegation as determined
192.4 by the county public health nurse verify and document the
192.5 credentials of the qualified professional, if a qualified
192.6 professional is requested by the recipient or responsible party;
192.7 (3) supervise and evaluate the personal care assistant in
192.8 areas that do not require professional delegation as determined
192.9 in the assessment;
192.10 (4) cooperate with a consulting develop a service plan
192.11 based on physician orders and public health nurse assessment
192.12 with the assistance of a qualified professional and implement
192.13 recommendations pertaining to the health and safety of the
192.14 recipient, if a qualified professional is requested by the
192.15 recipient or responsible party, that addresses the health and
192.16 safety of the recipient;
192.17 (5) hire a qualified professional to train and supervise
192.18 the performance of delegated tasks done by (4) recruit, hire,
192.19 and terminate the personal care assistant;
192.20 (6) monitor services and verify in writing the hours worked
192.21 by the personal care assistant and the consulting (5) orient and
192.22 train the personal care assistant with assistance as needed from
192.23 the qualified professional;
192.24 (7) develop and revise a care plan with assistance from a
192.25 consulting (6) supervise and evaluate the personal care
192.26 assistant with assistance as needed from the recipient's
192.27 physician or the qualified professional;
192.28 (8) verify and document the credentials of the consulting
192.29 (7) monitor and verify in writing and report to the fiscal
192.30 intermediary the number of hours worked by the personal care
192.31 assistant and the qualified professional; and
192.32 (9) (8) enter into a written agreement, as specified in
192.33 paragraph (f).
192.34 (c) The duties of the fiscal agent intermediary shall be to:
192.35 (1) bill the medical assistance program for personal care
192.36 assistant and consulting qualified professional services;
193.1 (2) request and secure background checks on personal care
193.2 assistants and consulting qualified professionals according to
193.3 section 245A.04;
193.4 (3) pay the personal care assistant and consulting
193.5 qualified professional based on actual hours of services
193.6 provided;
193.7 (4) withhold and pay all applicable federal and state
193.8 taxes;
193.9 (5) verify and document keep records of hours worked by the
193.10 personal care assistant and consulting qualified professional;
193.11 (6) make the arrangements and pay unemployment insurance,
193.12 taxes, workers' compensation, liability insurance, and other
193.13 benefits, if any;
193.14 (7) enroll in the medical assistance program as a fiscal
193.15 agent intermediary; and
193.16 (8) enter into a written agreement as specified in
193.17 paragraph (f) before services are provided.
193.18 (d) The fiscal agent intermediary:
193.19 (1) may not be related to the recipient, consulting
193.20 qualified professional, or the personal care assistant;
193.21 (2) must ensure arm's length transactions with the
193.22 recipient and personal care assistant; and
193.23 (3) shall be considered a joint employer of the personal
193.24 care assistant and consulting qualified professional to the
193.25 extent specified in this section.
193.26 The fiscal agent intermediary or owners of the entity that
193.27 provides fiscal agent intermediary services under this
193.28 subdivision must pass a criminal background check as required in
193.29 section 256B.0627, subdivision 1, paragraph (e).
193.30 (e) If the recipient or responsible party requests a
193.31 qualified professional, the consulting qualified professional
193.32 providing assistance to the recipient shall meet the
193.33 qualifications specified in section 256B.0625, subdivision 19c.
193.34 The consulting qualified professional shall assist the recipient
193.35 in developing and revising a plan to meet the
193.36 recipient's assessed needs, and supervise the performance of
194.1 delegated tasks, as determined by the public health nurse as
194.2 assessed by the public health nurse. In performing this
194.3 function, the consulting qualified professional must visit the
194.4 recipient in the recipient's home at least once annually.
194.5 The consulting qualified professional must report to the local
194.6 county public health nurse concerns relating to the health and
194.7 safety of the recipient, and any suspected abuse, neglect, or
194.8 financial exploitation of the recipient to the appropriate
194.9 authorities.
194.10 (f) The fiscal agent intermediary, recipient or responsible
194.11 party, personal care assistant, and consulting qualified
194.12 professional shall enter into a written agreement before
194.13 services are started. The agreement shall include:
194.14 (1) the duties of the recipient, qualified professional,
194.15 personal care assistant, and fiscal agent based on paragraphs
194.16 (a) to (e);
194.17 (2) the salary and benefits for the personal care assistant
194.18 and those providing professional consultation the qualified
194.19 professional;
194.20 (3) the administrative fee of the fiscal agent intermediary
194.21 and services paid for with that fee, including background check
194.22 fees;
194.23 (4) procedures to respond to billing or payment complaints;
194.24 and
194.25 (5) procedures for hiring and terminating the personal care
194.26 assistant and those providing professional consultation the
194.27 qualified professional.
194.28 (g) The rates paid for personal care assistant services,
194.29 qualified professional assistance services, and fiscal agency
194.30 intermediary services under this subdivision shall be the same
194.31 rates paid for personal care assistant services and qualified
194.32 professional services under subdivision 2 respectively. Except
194.33 for the administrative fee of the fiscal agent intermediary
194.34 specified in paragraph (f), the remainder of the rates paid to
194.35 the fiscal agent intermediary must be used to pay for the salary
194.36 and benefits for the personal care assistant or those providing
195.1 professional consultation the qualified professional.
195.2 (h) As part of the assessment defined in subdivision 1, the
195.3 following conditions must be met to use or continue use of a
195.4 fiscal agent intermediary:
195.5 (1) the recipient must be able to direct the recipient's
195.6 own care, or the responsible party for the recipient must be
195.7 readily available to direct the care of the personal care
195.8 assistant;
195.9 (2) the recipient or responsible party must be
195.10 knowledgeable of the health care needs of the recipient and be
195.11 able to effectively communicate those needs;
195.12 (3) a face-to-face assessment must be conducted by the
195.13 local county public health nurse at least annually, or when
195.14 there is a significant change in the recipient's condition or
195.15 change in the need for personal care assistant services. The
195.16 county public health nurse shall determine the services that
195.17 require professional delegation, if any, and the amount and
195.18 frequency of related supervision;
195.19 (4) the recipient cannot select the shared services option
195.20 as specified in subdivision 8; and
195.21 (5) parties must be in compliance with the written
195.22 agreement specified in paragraph (f).
195.23 (i) The commissioner shall deny, revoke, or suspend the
195.24 authorization to use the fiscal agent intermediary option if:
195.25 (1) it has been determined by the consulting qualified
195.26 professional or local county public health nurse that the use of
195.27 this option jeopardizes the recipient's health and safety;
195.28 (2) the parties have failed to comply with the written
195.29 agreement specified in paragraph (f); or
195.30 (3) the use of the option has led to abusive or fraudulent
195.31 billing for personal care assistant services.
195.32 The recipient or responsible party may appeal the
195.33 commissioner's action according to section 256.045. The denial,
195.34 revocation, or suspension to use the fiscal agent intermediary
195.35 option shall not affect the recipient's authorized level of
195.36 personal care assistant services as determined in subdivision 5.
196.1 Sec. 35. Minnesota Statutes 2000, section 256B.0627,
196.2 subdivision 11, is amended to read:
196.3 Subd. 11. [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a)
196.4 Medical assistance payments for shared private duty nursing
196.5 services by a private duty nurse shall be limited according to
196.6 this subdivision. For the purposes of this section, "private
196.7 duty nursing agency" means an agency licensed under chapter 144A
196.8 to provide private duty nursing services.
196.9 (b) Recipients of private duty nursing services may share
196.10 nursing staff and the commissioner shall provide a rate
196.11 methodology for shared private duty nursing. For two persons
196.12 sharing nursing care, the rate paid to a provider shall not
196.13 exceed 1.5 times the nonwaivered regular private duty nursing
196.14 rates paid for serving a single individual who is not ventilator
196.15 dependent, by a registered nurse or licensed practical nurse.
196.16 These rates apply only to situations in which both recipients
196.17 are present and receive shared private duty nursing care on the
196.18 date for which the service is billed. No more than two persons
196.19 may receive shared private duty nursing services from a private
196.20 duty nurse in a single setting.
196.21 (c) Shared private duty nursing care is the provision of
196.22 nursing services by a private duty nurse to two recipients at
196.23 the same time and in the same setting. For the purposes of this
196.24 subdivision, "setting" means:
196.25 (1) the home or foster care home of one of the individual
196.26 recipients; or
196.27 (2) a child care program licensed under chapter 245A or
196.28 operated by a local school district or private school; or
196.29 (3) an adult day care service licensed under chapter 245A;
196.30 or
196.31 (4) outside the home or foster care home of one of the
196.32 recipients when normal life activities take the recipients
196.33 outside the home.
196.34 This subdivision does not apply when a private duty nurse
196.35 is caring for multiple recipients in more than one setting.
196.36 (d) The recipient or the recipient's legal representative,
197.1 and the recipient's physician, in conjunction with the home
197.2 health care agency, shall determine:
197.3 (1) whether shared private duty nursing care is an
197.4 appropriate option based on the individual needs and preferences
197.5 of the recipient; and
197.6 (2) the amount of shared private duty nursing services
197.7 authorized as part of the overall authorization of nursing
197.8 services.
197.9 (e) The recipient or the recipient's legal representative,
197.10 in conjunction with the private duty nursing agency, shall
197.11 approve the setting, grouping, and arrangement of shared private
197.12 duty nursing care based on the individual needs and preferences
197.13 of the recipients. Decisions on the selection of recipients to
197.14 share services must be based on the ages of the recipients,
197.15 compatibility, and coordination of their care needs.
197.16 (f) The following items must be considered by the recipient
197.17 or the recipient's legal representative and the private duty
197.18 nursing agency, and documented in the recipient's health service
197.19 record:
197.20 (1) the additional training needed by the private duty
197.21 nurse to provide care to two recipients in the same setting and
197.22 to ensure that the needs of the recipients are met appropriately
197.23 and safely;
197.24 (2) the setting in which the shared private duty nursing
197.25 care will be provided;
197.26 (3) the ongoing monitoring and evaluation of the
197.27 effectiveness and appropriateness of the service and process
197.28 used to make changes in service or setting;
197.29 (4) a contingency plan which accounts for absence of the
197.30 recipient in a shared private duty nursing setting due to
197.31 illness or other circumstances;
197.32 (5) staffing backup contingencies in the event of employee
197.33 illness or absence; and
197.34 (6) arrangements for additional assistance to respond to
197.35 urgent or emergency care needs of the recipients.
197.36 (g) The provider must offer the recipient or responsible
198.1 party the option of shared or one-on-one private duty nursing
198.2 services. The recipient or responsible party can withdraw from
198.3 participating in a shared service arrangement at any time.
198.4 (h) The private duty nursing agency must document the
198.5 following in the health service record for each individual
198.6 recipient sharing private duty nursing care:
198.7 (1) permission by the recipient or the recipient's legal
198.8 representative for the maximum number of shared nursing care
198.9 hours per week chosen by the recipient;
198.10 (2) permission by the recipient or the recipient's legal
198.11 representative for shared private duty nursing services provided
198.12 outside the recipient's residence;
198.13 (3) permission by the recipient or the recipient's legal
198.14 representative for others to receive shared private duty nursing
198.15 services in the recipient's residence;
198.16 (4) revocation by the recipient or the recipient's legal
198.17 representative of the shared private duty nursing care
198.18 authorization, or the shared care to be provided to others in
198.19 the recipient's residence, or the shared private duty nursing
198.20 services to be provided outside the recipient's residence; and
198.21 (5) daily documentation of the shared private duty nursing
198.22 services provided by each identified private duty nurse,
198.23 including:
198.24 (i) the names of each recipient receiving shared private
198.25 duty nursing services together;
198.26 (ii) the setting for the shared services, including the
198.27 starting and ending times that the recipient received shared
198.28 private duty nursing care; and
198.29 (iii) notes by the private duty nurse regarding changes in
198.30 the recipient's condition, problems that may arise from the
198.31 sharing of private duty nursing services, and scheduling and
198.32 care issues.
198.33 (i) Unless otherwise provided in this subdivision, all
198.34 other statutory and regulatory provisions relating to private
198.35 duty nursing services apply to shared private duty nursing
198.36 services.
199.1 Nothing in this subdivision shall be construed to reduce
199.2 the total number of private duty nursing hours authorized for an
199.3 individual recipient under subdivision 5.
199.4 Sec. 36. Minnesota Statutes 2000, section 256B.0627, is
199.5 amended by adding a subdivision to read:
199.6 Subd. 13. [CONSUMER-DIRECTED HOME CARE DEMONSTRATION
199.7 PROJECT.] (a) Upon the receipt of federal waiver authority, the
199.8 commissioner shall implement a consumer-directed home care
199.9 demonstration project. The consumer-directed home care
199.10 demonstration project must demonstrate and evaluate the outcomes
199.11 of a consumer-directed service delivery alternative to improve
199.12 access, increase consumer control and accountability over
199.13 available resources, and enable the use of supports that are
199.14 more individualized and cost-effective for eligible medical
199.15 assistance recipients receiving certain medical assistance home
199.16 care services. The consumer-directed home care demonstration
199.17 project will be administered locally by county agencies, tribal
199.18 governments, or administrative entities under contract with the
199.19 state in regions where counties choose not to provide this
199.20 service.
199.21 (b) Grant awards for persons who have been receiving
199.22 medical assistance covered personal care, home health aide, or
199.23 private duty nursing services for a period of 12 consecutive
199.24 months or more prior to enrollment in the consumer-directed home
199.25 care demonstration project will be established on a case-by-case
199.26 basis using historical service expenditure data. An average
199.27 monthly expenditure for each continuing enrollee will be
199.28 calculated based on historical expenditures made on behalf of
199.29 the enrollee for personal care, home health aide, or private
199.30 duty nursing services during the 12 month period directly prior
199.31 to enrollment in the project. The grant award will equal 90
199.32 percent of the average monthly expenditure.
199.33 (c) Grant awards for project enrollees who have been
199.34 receiving medical assistance covered personal care, home health
199.35 aide, or private duty nursing services for a period of less than
199.36 12 consecutive months prior to project enrollment will be
200.1 calculated on a case-by-case basis using the service
200.2 authorization in place at the time of enrollment. The total
200.3 number of units of personal care, home health aide, or private
200.4 duty nursing services the enrollee has been authorized to
200.5 receive will be converted to the total cost of the authorized
200.6 services in a given month using the statewide average service
200.7 payment rates. To determine an estimated monthly expenditure,
200.8 the total authorized monthly personal care, home health aide or
200.9 private duty nursing service costs will be reduced by a
200.10 percentage rate equivalent to the difference between the
200.11 statewide average service authorization and the statewide
200.12 average utilization rate for each of the services by medical
200.13 assistance eligibles during the most recent fiscal year for
200.14 which 12 months of data is available. The grant award will
200.15 equal 90 percent of the estimated monthly expenditure.
200.16 (d) The state of Minnesota, county agencies, tribal
200.17 governments, or administrative entities under contract with the
200.18 state that participate in the implementation and administration
200.19 of the consumer-directed home care demonstration project, shall
200.20 not be liable for damages, injuries, or liabilities sustained
200.21 through the purchase of support by the individual, the
200.22 individual's family, or the authorized representative under this
200.23 section with funds received through the consumer-directed home
200.24 care demonstration project. Liabilities include but are not
200.25 limited to: workers' compensation liability, the Federal
200.26 Insurance Contributions Act (FICA), or the Federal Unemployment
200.27 Tax Act (FUTA).
200.28 Sec. 37. Minnesota Statutes 2000, section 256B.0627, is
200.29 amended by adding a subdivision to read:
200.30 Subd. 14. [TELEHOMECARE; SKILLED NURSE VISITS.] Medical
200.31 assistance covers skilled nurse visits according to section
200.32 256B.0625, subdivision 6a, provided via telehomecare, for
200.33 services which do not require hands-on care between the home
200.34 care nurse and recipient. The provision of telehomecare must be
200.35 made via live, two-way interactive audiovisual technology and
200.36 may be augmented by utilizing store-and-forward technologies.
201.1 Store-and-forward technology includes telehomecare services that
201.2 do not occur in real time via synchronous transmissions, and
201.3 that do not require a face-to-face encounter with the recipient
201.4 for all or any part of any such telehomecare visit.
201.5 Individually identifiable patient data obtained through
201.6 real-time or store-and-forward technology must be maintained in
201.7 a confidential manner. If the video is used for research,
201.8 training, or other purposes unrelated to the care of the
201.9 patient, the identity of the patient must be concealed. A
201.10 communication between the home care nurse and recipient that
201.11 consists solely of a telephone conversation, facsimile,
201.12 electronic mail, or a consultation between two health care
201.13 practitioners, is not to be considered a telehomecare visit.
201.14 Multiple daily skilled nurse visits provided via telehomecare
201.15 are allowed. Coverage of telehomecare is limited to two visits
201.16 per day. All skilled nurse visits provided via telehomecare
201.17 must be prior authorized by the commissioner or the
201.18 commissioner's designee and will be covered at the same
201.19 allowable rate as skilled nurse visits provided in-person.
201.20 Sec. 38. Minnesota Statutes 2000, section 256B.0627, is
201.21 amended by adding a subdivision to read:
201.22 Subd. 15. [THERAPIES THROUGH HOME HEALTH AGENCIES.] (a)
201.23 [PHYSICAL THERAPY.] Medical assistance covers physical therapy
201.24 and related services, including specialized maintenance
201.25 therapy. Services provided by a physical therapy assistant
201.26 shall be reimbursed at the same rate as services performed by a
201.27 physical therapist when the services of the physical therapy
201.28 assistant are provided under the direction of a physical
201.29 therapist who is on the premises. Services provided by a
201.30 physical therapy assistant that are provided under the direction
201.31 of a physical therapist who is not on the premises shall be
201.32 reimbursed at 65 percent of the physical therapist rate.
201.33 Direction of the physical therapy assistant must be provided by
201.34 the physical therapist as described in Minnesota Rules, part
201.35 9505.0390, subpart 1, item B. The physical therapist and
201.36 physical therapist assistant may not both bill for services
202.1 provided to a recipient on the same day.
202.2 (b) [OCCUPATIONAL THERAPY.] Medical assistance covers
202.3 occupational therapy and related services, including specialized
202.4 maintenance therapy. Services provided by an occupational
202.5 therapy assistant shall be reimbursed at the same rate as
202.6 services performed by an occupational therapist when the
202.7 services of the occupational therapy assistant are provided
202.8 under the direction of the occupational therapist who is on the
202.9 premises. Services provided by an occupational therapy
202.10 assistant under the direction of an occupational therapist who
202.11 is not on the premises shall be reimbursed at 65 percent of the
202.12 occupational therapist rate. Direction of the occupational
202.13 therapy assistant must be provided by the occupational therapist
202.14 as described in Minnesota Rules, part 9505.0390, subpart 1, item
202.15 B. The occupational therapist and occupational therapist
202.16 assistant may not both bill for services provided to a recipient
202.17 on the same day.
202.18 Sec. 39. Minnesota Statutes 2000, section 256B.0627, is
202.19 amended by adding a subdivision to read:
202.20 Subd. 16. [HARDSHIP CRITERIA; PRIVATE DUTY NURSING.] (a)
202.21 Payment is allowed for extraordinary services that require
202.22 specialized nursing skills and are provided by parents of minor
202.23 children, spouses, and legal guardians who are providing private
202.24 duty nursing care under the following conditions:
202.25 (1) the provision of these services is not legally required
202.26 of the parents, spouses, or legal guardians;
202.27 (2) the services are necessary to prevent hospitalization
202.28 of the recipient; and
202.29 (3) the recipient is eligible for state plan home care or a
202.30 home and community-based waiver and one of the following
202.31 hardship criteria are met:
202.32 (i) the parent, spouse, or legal guardian resigns from a
202.33 part-time or full-time job to provide nursing care for the
202.34 recipient; or
202.35 (ii) the parent, spouse, or legal guardian goes from a
202.36 full-time to a part-time job with less compensation to provide
203.1 nursing care for the recipient; or
203.2 (iii) the parent, spouse, or legal guardian takes a leave
203.3 of absence without pay to provide nursing care for the
203.4 recipient; or
203.5 (iv) because of labor conditions, special language needs,
203.6 or intermittent hours of care needed, the parent, spouse, or
203.7 legal guardian is needed in order to provide adequate private
203.8 duty nursing services to meet the medical needs of the recipient.
203.9 (b) Private duty nursing may be provided by a parent,
203.10 spouse, or legal guardian who is a nurse licensed in Minnesota.
203.11 Private duty nursing services provided by a parent, spouse, or
203.12 legal guardian cannot be used in lieu of nursing services
203.13 covered and available under liable third-party payers, including
203.14 Medicare. The private duty nursing provided by a parent,
203.15 spouse, or legal guardian must be included in the service plan.
203.16 Authorized skilled nursing services provided by the parent,
203.17 spouse, or legal guardian may not exceed 50 percent of the total
203.18 approved nursing hours, or eight hours per day, whichever is
203.19 less, up to a maximum of 40 hours per week. Nothing in this
203.20 subdivision precludes the parent's, spouse's, or legal
203.21 guardian's obligation of assuming the nonreimbursed family
203.22 responsibilities of emergency backup caregiver and primary
203.23 caregiver.
203.24 (c) A parent or a spouse may not be paid to provide private
203.25 duty nursing care if the parent or spouse fails to pass a
203.26 criminal background check according to section 245A.04, or if it
203.27 has been determined by the home health agency, the case manager,
203.28 or the physician that the private duty nursing care provided by
203.29 the parent, spouse, or legal guardian is unsafe.
203.30 Sec. 40. Minnesota Statutes 2000, section 256B.0627, is
203.31 amended by adding a subdivision to read:
203.32 Subd. 17. [QUALITY ASSURANCE PLAN FOR PERSONAL CARE
203.33 ASSISTANT SERVICES.] The commissioner shall establish a quality
203.34 assurance plan for personal care assistant services that
203.35 includes:
203.36 (1) performance-based provider agreements;
204.1 (2) meaningful consumer input, which may include consumer
204.2 surveys, that measure the extent to which participants receive
204.3 the services and supports described in the individual plan and
204.4 participant satisfaction with such services and supports;
204.5 (3) ongoing monitoring of the health and well-being of
204.6 consumers; and
204.7 (4) an ongoing public process for development,
204.8 implementation, and review of the quality assurance plan.
204.9 Sec. 41. Minnesota Statutes 2000, section 256B.0911, is
204.10 amended by adding a subdivision to read:
204.11 Subd. 4a. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65
204.12 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to
204.13 ensure that individuals with disabilities or chronic illness are
204.14 served in the most integrated setting appropriate to their needs
204.15 and have the necessary information to make informed choices
204.16 about home and community-based service options.
204.17 (b) Individuals under 65 years of age who are admitted to a
204.18 nursing facility from a hospital must be screened prior to
204.19 admission as outlined in subdivision 4.
204.20 (c) Individuals under 65 years of age who are admitted to
204.21 nursing facilities with only a telephone screening must receive
204.22 a face-to-face assessment from the long-term care consultation
204.23 team member of the county in which the facility is located or
204.24 from the recipient's county case manager within 20 working days
204.25 of admission.
204.26 (d) At the face-to-face assessment, the long-term care
204.27 consultation team member or county case manager must perform the
204.28 activities required under subdivision 3.
204.29 (e) For individuals under 21 years of age, the screening or
204.30 assessment which recommends nursing facility admission must be
204.31 approved by the commissioner before the individual is admitted
204.32 to the nursing facility.
204.33 (f) In the event that an individual under 65 years of age
204.34 is admitted to a nursing facility on an emergency basis, the
204.35 county must be notified of the admission on the next working
204.36 day, and a face-to-face assessment as described in paragraph (c)
205.1 must be conducted within 20 working days of admission.
205.2 (g) At the face-to-face assessment, the long-term care
205.3 consultation team member or the case manager must present
205.4 information about home and community-based options so the
205.5 individual can make informed choices. If the individual chooses
205.6 home and community-based services, the long-term care
205.7 consultation team member or case manager must complete a written
205.8 relocation plan within 20 working days of the visit. The plan
205.9 shall describe the services needed to move out of the facility
205.10 and a time line for the move which is designed to ensure a
205.11 smooth transition to the individual's home and community.
205.12 (h) An individual under 65 years of age residing in a
205.13 nursing facility shall receive a face-to-face assessment at
205.14 least every 12 months to review the person's service choices and
205.15 available alternatives unless the individual indicates, in
205.16 writing, that annual visits are not desired. In this case, the
205.17 individual must receive a face-to-face assessment at least once
205.18 every 36 months for the same purposes.
205.19 (i) Notwithstanding the provisions of subdivision 6, the
205.20 commissioner may pay county agencies directly for face-to-face
205.21 assessments for individuals who are eligible for medical
205.22 assistance, under 65 years of age, and being considered for
205.23 placement or residing in a nursing facility.
205.24 Sec. 42. Minnesota Statutes 2000, section 256B.0916,
205.25 subdivision 1, is amended to read:
205.26 Subdivision 1. [REDUCTION OF WAITING LIST.] (a) The
205.27 legislature recognizes that as of January 1, 1999, 3,300 persons
205.28 with mental retardation or related conditions have been screened
205.29 and determined eligible for the home and community-based waiver
205.30 services program for persons with mental retardation or related
205.31 conditions. Many wait for several years before receiving
205.32 service.
205.33 (b) The waiting list for this program shall be reduced or
205.34 eliminated by June 30, 2003. In order to reduce the number of
205.35 eligible persons waiting for identified services provided
205.36 through the home and community-based waiver for persons with
206.1 mental retardation or related conditions, during the period from
206.2 July 1, 1999, to June 30, 2003, funding shall be increased to
206.3 add 100 additional eligible persons each year beyond the
206.4 February 1999 medical assistance forecast.
206.5 (c) The commissioner shall allocate resources in such a
206.6 manner as to use all resources budgeted during a biennium for
206.7 the home and community-based waiver for persons with mental
206.8 retardation or related conditions according to the priorities
206.9 listed in subdivision 2, paragraph (b), and then to serve other
206.10 persons on the waiting list. Resources allocated for a fiscal
206.11 year to serve persons affected by public and private sector
206.12 ICF/MR closures, but not expected to be expended for that
206.13 purpose, must be reallocated within that fiscal year to serve
206.14 other persons on the waiting list, and the number of waiver
206.15 diversion slots shall be adjusted accordingly.
206.16 (d) For fiscal year 2001, at least one-half of the increase
206.17 in funding over the previous year provided in the February 1999
206.18 medical assistance forecast for the home and community-based
206.19 waiver for persons with mental retardation and related
206.20 conditions, including changes made by the 1999 legislature, must
206.21 be used to serve persons who are not affected by public and
206.22 private sector ICF/MR closures.
206.23 (e) The commissioner of finance shall not reduce the
206.24 expenditure forecast for a biennium for which appropriations
206.25 have been made, if at the time of the forecast there is a
206.26 waiting list for waiver services for persons with mental
206.27 retardation or related conditions who need services within the
206.28 next 30 months. Funds that would have resulted from a projected
206.29 reduction in expenditures must be used by the commissioner of
206.30 human services to serve persons with developmental disabilities
206.31 through the home and community-based waiver for persons with
206.32 mental retardation or related conditions.
206.33 Sec. 43. Minnesota Statutes 2000, section 256B.0916, is
206.34 amended by adding a subdivision to read:
206.35 Subd. 6a. [STATEWIDE AVAILABILITY OF CONSUMER-DIRECTED
206.36 COMMUNITY SUPPORT SERVICES.] (a) The commissioner shall submit
207.1 to the federal Health Care Financing Administration by August 1,
207.2 2001, an amendment to the home and community-based waiver for
207.3 persons with mental retardation or related conditions to make
207.4 consumer-directed community support services available in every
207.5 county of the state by January 1, 2002.
207.6 (b) If a county declines to meet the requirements for
207.7 provision of consumer-directed community supports, the
207.8 commissioner shall contract with another county, a group of
207.9 counties, or a private agency to plan for and administer
207.10 consumer-directed community supports in that county.
207.11 (c) The state of Minnesota, county agencies, tribal
207.12 governments, or administrative entities under contract to
207.13 participate in the implementation and administration of the home
207.14 and community-based waiver for persons with mental retardation
207.15 or a related condition, shall not be liable for damages,
207.16 injuries, or liabilities sustained through the purchase of
207.17 support by the individual, the individual's family, or the
207.18 authorized representative with funds received through the
207.19 consumer-directed community support service under this section.
207.20 Liabilities include but are not limited to: workers'
207.21 compensation liability, the Federal Insurance Contributions Act
207.22 (FICA), or the Federal Unemployment Tax Act (FUTA).
207.23 Sec. 44. Minnesota Statutes 2000, section 256B.0916,
207.24 subdivision 7, is amended to read:
207.25 Subd. 7. [ANNUAL REPORT BY COMMISSIONER.] Beginning
207.26 October 1, 1999, and each October 1 November 1, 2001, and each
207.27 November 1 thereafter, the commissioner shall issue an annual
207.28 report on county and state use of available resources for the
207.29 home and community-based waiver for persons with mental
207.30 retardation or related conditions. For each county or county
207.31 partnership, the report shall include:
207.32 (1) the amount of funds allocated but not used;
207.33 (2) the county specific allowed reserve amount approved and
207.34 used;
207.35 (3) the number, ages, and living situations of individuals
207.36 screened and waiting for services;
208.1 (4) the urgency of need for services to begin within one,
208.2 two, or more than two years for each individual;
208.3 (5) the services needed;
208.4 (6) the number of additional persons served by approval of
208.5 increased capacity within existing allocations;
208.6 (7) results of action by the commissioner to streamline
208.7 administrative requirements and improve county resource
208.8 management; and
208.9 (8) additional action that would decrease the number of
208.10 those eligible and waiting for waivered services.
208.11 The commissioner shall specify intended outcomes for the program
208.12 and the degree to which these specified outcomes are attained.
208.13 Sec. 45. Minnesota Statutes 2000, section 256B.0916,
208.14 subdivision 9, is amended to read:
208.15 Subd. 9. [LEGAL REPRESENTATIVE PARTICIPATION EXCEPTION.]
208.16 The commissioner, in cooperation with representatives of
208.17 counties, service providers, service recipients, family members,
208.18 legal representatives and advocates, shall develop criteria to
208.19 allow legal representatives to be reimbursed for providing
208.20 specific support services to meet the person's needs when a plan
208.21 which assures health and safety has been agreed upon and carried
208.22 out by the legal representative, the person, and the county.
208.23 Legal representatives providing support under consumer-directed
208.24 community support services pursuant to section 256B.092,
208.25 subdivision 4, the home and community-based waiver for persons
208.26 with mental retardation or related conditions or the consumer
208.27 support grant program pursuant to section 256B.092, subdivision
208.28 7 256.476, shall not be considered to have a direct or indirect
208.29 service provider interest under section 256B.092, subdivision 7,
208.30 if a health and safety plan which meets the criteria established
208.31 has been agreed upon and implemented. By October 1, 1999 August
208.32 1, 2001, the commissioner shall submit, for federal approval,
208.33 amendments to allow legal representatives to provide support and
208.34 receive reimbursement under the consumer-directed community
208.35 support services section of the home and community-based waiver
208.36 plan.
209.1 Sec. 46. Minnesota Statutes 2000, section 256B.092,
209.2 subdivision 2a, is amended to read:
209.3 Subd. 2a. [MEDICAL ASSISTANCE FOR CASE MANAGEMENT
209.4 ACTIVITIES UNDER THE STATE PLAN MEDICAID OPTION.] (a) Upon
209.5 receipt of federal approval, the commissioner shall make
209.6 payments to approved vendors counties, private individuals, and
209.7 agencies enrolled as providers of case management services
209.8 participating in the medical assistance program to reimburse
209.9 costs for providing case management service activities to
209.10 medical assistance eligible persons with mental retardation or a
209.11 related condition, in accordance with the state Medicaid plan,
209.12 the home and community-based waiver for persons with mental
209.13 retardation and related conditions plan, and federal
209.14 requirements and limitations.
209.15 (b) The commissioner shall ensure that each eligible person
209.16 is given a choice of county and private agency case management
209.17 service providers. Case management service providers are
209.18 prohibited from providing any other service to the person
209.19 receiving case management services.
209.20 Sec. 47. Minnesota Statutes 2000, section 256B.092,
209.21 subdivision 5, is amended to read:
209.22 Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall
209.23 apply for any federal waivers necessary to secure, to the extent
209.24 allowed by law, federal financial participation under United
209.25 States Code, title 42, sections 1396 et seq., as amended, for
209.26 the provision of services to persons who, in the absence of the
209.27 services, would need the level of care provided in a regional
209.28 treatment center or a community intermediate care facility for
209.29 persons with mental retardation or related conditions. The
209.30 commissioner may seek amendments to the waivers or apply for
209.31 additional waivers under United States Code, title 42, sections
209.32 1396 et seq., as amended, to contain costs. The commissioner
209.33 shall ensure that payment for the cost of providing home and
209.34 community-based alternative services under the federal waiver
209.35 plan shall not exceed the cost of intermediate care services
209.36 including day training and habilitation services that would have
210.1 been provided without the waivered services.
210.2 (b) The commissioner, in administering home and
210.3 community-based waivers for persons with mental retardation and
210.4 related conditions, shall ensure that day services for eligible
210.5 persons are not provided by the person's residential service
210.6 provider, unless the person or the person's legal representative
210.7 is offered a choice of providers and agrees in writing to
210.8 provision of day services by the residential service provider.
210.9 The individual service plan for individuals who choose to have
210.10 their residential service provider provide their day services
210.11 must describe how health, safety, and protection needs will be
210.12 met by frequent and regular contact with persons other than the
210.13 residential service provider.
210.14 Sec. 48. Minnesota Statutes 2000, section 256B.093,
210.15 subdivision 3, is amended to read:
210.16 Subd. 3. [TRAUMATIC BRAIN INJURY PROGRAM DUTIES.] The
210.17 department shall fund administrative case management under this
210.18 subdivision using medical assistance administrative funds. The
210.19 traumatic brain injury program duties include:
210.20 (1) recommending to the commissioner in consultation with
210.21 the medical review agent according to Minnesota Rules, parts
210.22 9505.0500 to 9505.0540, the approval or denial of medical
210.23 assistance funds to pay for out-of-state placements for
210.24 traumatic brain injury services and in-state traumatic brain
210.25 injury services provided by designated Medicare long-term care
210.26 hospitals;
210.27 (2) coordinating the traumatic brain injury home and
210.28 community-based waiver;
210.29 (3) approving traumatic brain injury waiver eligibility or
210.30 care plans or both;
210.31 (4) providing ongoing technical assistance and consultation
210.32 to county and facility case managers to facilitate care plan
210.33 development for appropriate, accessible, and cost-effective
210.34 medical assistance services;
210.35 (5) (4) providing technical assistance to promote statewide
210.36 development of appropriate, accessible, and cost-effective
211.1 medical assistance services and related policy;
211.2 (6) (5) providing training and outreach to facilitate
211.3 access to appropriate home and community-based services to
211.4 prevent institutionalization;
211.5 (7) (6) facilitating appropriate admissions, continued stay
211.6 review, discharges, and utilization review for neurobehavioral
211.7 hospitals and other specialized institutions;
211.8 (8) (7) providing technical assistance on the use of prior
211.9 authorization of home care services and coordination of these
211.10 services with other medical assistance services;
211.11 (9) (8) developing a system for identification of nursing
211.12 facility and hospital residents with traumatic brain injury to
211.13 assist in long-term planning for medical assistance services.
211.14 Factors will include, but are not limited to, number of
211.15 individuals served, length of stay, services received, and
211.16 barriers to community placement; and
211.17 (10) (9) providing information, referral, and case
211.18 consultation to access medical assistance services for
211.19 recipients without a county or facility case manager. Direct
211.20 access to this assistance may be limited due to the structure of
211.21 the program.
211.22 Sec. 49. Minnesota Statutes 2000, section 256B.095, is
211.23 amended to read:
211.24 256B.095 [THREE-YEAR QUALITY ASSURANCE PILOT PROJECT
211.25 ESTABLISHED.]
211.26 Effective July 1, 1998, an alternative quality assurance
211.27 licensing system pilot project for programs for persons with
211.28 developmental disabilities is established in Dodge, Fillmore,
211.29 Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele,
211.30 Wabasha, and Winona counties for the purpose of improving the
211.31 quality of services provided to persons with developmental
211.32 disabilities. A county, at its option, may choose to have all
211.33 programs for persons with developmental disabilities located
211.34 within the county licensed under chapter 245A using standards
211.35 determined under the alternative quality assurance licensing
211.36 system pilot project or may continue regulation of these
212.1 programs under the licensing system operated by the
212.2 commissioner. The pilot project expires on June 30, 2001 2005.
212.3 Sec. 50. Minnesota Statutes 2000, section 256B.0951,
212.4 subdivision 1, is amended to read:
212.5 Subdivision 1. [MEMBERSHIP.] The region 10 quality
212.6 assurance commission is established. The commission consists of
212.7 at least 14 but not more than 21 members as follows: at least
212.8 three but not more than five members representing advocacy
212.9 organizations; at least three but not more than five members
212.10 representing consumers, families, and their legal
212.11 representatives; at least three but not more than five members
212.12 representing service providers; at least three but not more than
212.13 five members representing counties; and the commissioner of
212.14 human services or the commissioner's designee. Initial
212.15 membership of the commission shall be recruited and approved by
212.16 the region 10 stakeholders group. Prior to approving the
212.17 commission's membership, the stakeholders group shall provide to
212.18 the commissioner a list of the membership in the stakeholders
212.19 group, as of February 1, 1997, a brief summary of meetings held
212.20 by the group since July 1, 1996, and copies of any materials
212.21 prepared by the group for public distribution. The first
212.22 commission shall establish membership guidelines for the
212.23 transition and recruitment of membership for the commission's
212.24 ongoing existence. Members of the commission who do not receive
212.25 a salary or wages from an employer for time spent on commission
212.26 duties may receive a per diem payment when performing commission
212.27 duties and functions. All members may be reimbursed for
212.28 expenses related to commission activities. Notwithstanding the
212.29 provisions of section 15.059, subdivision 5, the commission
212.30 expires on June 30, 2001 2005.
212.31 Sec. 51. Minnesota Statutes 2000, section 256B.0951,
212.32 subdivision 3, is amended to read:
212.33 Subd. 3. [COMMISSION DUTIES.] (a) By October 1, 1997, the
212.34 commission, in cooperation with the commissioners of human
212.35 services and health, shall do the following: (1) approve an
212.36 alternative quality assurance licensing system based on the
213.1 evaluation of outcomes; (2) approve measurable outcomes in the
213.2 areas of health and safety, consumer evaluation, education and
213.3 training, providers, and systems that shall be evaluated during
213.4 the alternative licensing process; and (3) establish variable
213.5 licensure periods not to exceed three years based on outcomes
213.6 achieved. For purposes of this subdivision, "outcome" means the
213.7 behavior, action, or status of a person that can be observed or
213.8 measured and can be reliably and validly determined.
213.9 (b) By January 15, 1998, the commission shall approve, in
213.10 cooperation with the commissioner of human services, a training
213.11 program for members of the quality assurance teams established
213.12 under section 256B.0952, subdivision 4.
213.13 (c) The commission and the commissioner shall establish an
213.14 ongoing review process for the alternative quality assurance
213.15 licensing system. The review shall take into account the
213.16 comprehensive nature of the alternative system, which is
213.17 designed to evaluate the broad spectrum of licensed and
213.18 unlicensed entities that provide services to clients, as
213.19 compared to the current licensing system.
213.20 (d) The commission shall contract with an independent
213.21 entity to conduct a financial review of the alternative quality
213.22 assurance pilot project. The review shall take into account the
213.23 comprehensive nature of the alternative system, which is
213.24 designed to evaluate the broad spectrum of licensed and
213.25 unlicensed entities that provide services to clients, as
213.26 compared to the current licensing system. The review shall
213.27 include an evaluation of possible budgetary savings within the
213.28 department of human services as a result of implementation of
213.29 the alternative quality assurance pilot project. If a federal
213.30 waiver is approved under subdivision 7, the financial review
213.31 shall also evaluate possible savings within the department of
213.32 health. This review must be completed by December 15, 2000.
213.33 (e) The commission shall submit a report to the legislature
213.34 by January 15, 2001, on the results of the review process for
213.35 the alternative quality assurance pilot project, a summary of
213.36 the results of the independent financial review, and a
214.1 recommendation on whether the pilot project should be extended
214.2 beyond June 30, 2001.
214.3 (f) The commissioner, in consultation with the commission,
214.4 shall examine the feasibility of expanding the project to other
214.5 populations or geographic areas and identify barriers to
214.6 expansion. The commissioner shall report findings and
214.7 recommendations to the legislature by December 15, 2004.
214.8 Sec. 52. Minnesota Statutes 2000, section 256B.0951,
214.9 subdivision 4, is amended to read:
214.10 Subd. 4. [COMMISSION'S AUTHORITY TO RECOMMEND VARIANCES OF
214.11 LICENSING STANDARDS.] The commission may recommend to the
214.12 commissioners of human services and health variances from the
214.13 standards governing licensure of programs for persons with
214.14 developmental disabilities in order to improve the quality of
214.15 services by implementing an alternative developmental
214.16 disabilities licensing system if the commission determines that
214.17 the alternative licensing system does not adversely affect the
214.18 health or safety of persons being served by the licensed program
214.19 nor compromise the qualifications of staff to provide services.
214.20 Sec. 53. Minnesota Statutes 2000, section 256B.0951,
214.21 subdivision 5, is amended to read:
214.22 Subd. 5. [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The
214.23 safety standards, rights, or procedural protections under
214.24 sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a,
214.25 3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2)
214.26 and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092,
214.27 subdivisions 1b, clause (7), and 10; 626.556; 626.557, and
214.28 procedures for the monitoring of psychotropic medications shall
214.29 not be varied under the alternative licensing system pilot
214.30 project. The commission may make recommendations to the
214.31 commissioners of human services and health or to the legislature
214.32 regarding alternatives to or modifications of the rules and
214.33 procedures referenced in this subdivision.
214.34 Sec. 54. Minnesota Statutes 2000, section 256B.0951,
214.35 subdivision 7, is amended to read:
214.36 Subd. 7. [WAIVER OF RULES.] The commissioner of health may
215.1 exempt residents of intermediate care facilities for persons
215.2 with mental retardation (ICFs/MR) who participate in the
215.3 three-year quality assurance pilot project established in
215.4 section 256B.095 from the requirements of Minnesota Rules,
215.5 chapter 4665, upon approval by the federal government of a
215.6 waiver of federal certification requirements for ICFs/MR. The
215.7 commissioners of health and human services shall apply for any
215.8 necessary waivers as soon as practicable and shall submit the
215.9 concept paper to the federal government by June 1, 1998.
215.10 Sec. 55. Minnesota Statutes 2000, section 256B.0951, is
215.11 amended by adding a subdivision to read:
215.12 Subd. 8. [FEDERAL WAIVER.] The commissioner of human
215.13 services shall seek federal authority to waive provisions of
215.14 intermediate care facilities for persons with mental retardation
215.15 (ICFs/MR) regulations to enable the demonstration and evaluation
215.16 of the alternative quality assurance system for ICFs/MR under
215.17 the project. The commissioner of human services shall apply for
215.18 any necessary waivers as soon as practicable.
215.19 Sec. 56. Minnesota Statutes 2000, section 256B.0951, is
215.20 amended by adding a subdivision to read:
215.21 Subd. 9. [EVALUATION.] The commission, in consultation
215.22 with the commissioner of human services, shall conduct an
215.23 evaluation of the alternative quality assurance system, and
215.24 present a report to the commissioner by June 30, 2004.
215.25 Sec. 57. Minnesota Statutes 2000, section 256B.0952,
215.26 subdivision 1, is amended to read:
215.27 Subdivision 1. [NOTIFICATION.] By January 15, 1998, each
215.28 affected county shall notify the commission and the
215.29 commissioners of human services and health as to whether it
215.30 chooses to implement on July 1, 1998, the alternative licensing
215.31 system for the pilot project. A county that does not implement
215.32 the alternative licensing system on July 1, 1998, may give
215.33 notice to the commission and the commissioners by January 15,
215.34 1999, or January 15, 2000, that it will implement the
215.35 alternative licensing system on the following July 1. A county
215.36 that implements the alternative licensing system commits to
216.1 participate until June 30, 2001. For each year of the project,
216.2 region 10 counties shall give notice to the commission and
216.3 commissioners of human services and health by March 15 of intent
216.4 to join the quality assurance alternative licensing system,
216.5 effective July 1 of that year. A county choosing to participate
216.6 in the alternative licensing system commits to participate until
216.7 June 30, 2005. Counties participating in the quality assurance
216.8 alternative licensing system as of January 1, 2001, shall notify
216.9 the commission and the commissioners of human services and
216.10 health by March 15, 2001, of intent to continue participation.
216.11 Counties that elect to continue participation must participate
216.12 in the alternative licensing system until June 30, 2005.
216.13 Sec. 58. Minnesota Statutes 2000, section 256B.0952,
216.14 subdivision 4, is amended to read:
216.15 Subd. 4. [APPOINTMENT OF QUALITY ASSURANCE MANAGER.] (a) A
216.16 county or group of counties that chooses to participate in the
216.17 alternative licensing system shall designate a quality assurance
216.18 manager and shall establish quality assurance teams in
216.19 accordance with subdivision 5. The manager shall recruit,
216.20 train, and assign duties to the quality assurance team members.
216.21 In assigning team members to conduct the quality assurance
216.22 process at a facility, program, or service, the manager shall
216.23 take into account the size of the service provider, the number
216.24 of services to be reviewed, the skills necessary for team
216.25 members to complete the process, and other relevant factors.
216.26 The manager shall ensure that no team member has a financial,
216.27 personal, or family relationship with the facility, program, or
216.28 service being reviewed or with any clients of the facility,
216.29 program, or service.
216.30 (b) Quality assurance teams shall report the findings of
216.31 their quality assurance reviews to the quality assurance manager.
216.32 The quality assurance manager shall provide the report from the
216.33 quality assurance team to the county and, upon request, to the
216.34 commissioners of human services and health, and shall provide a
216.35 summary of the report to the quality assurance review council.
216.36 Sec. 59. Minnesota Statutes 2000, section 256B.49, is
217.1 amended by adding a subdivision to read:
217.2 Subd. 11. [AUTHORITY.] (a) The commissioner is authorized
217.3 to apply for home and community-based service waivers, as
217.4 authorized under section 1915(c) of the Social Security Act to
217.5 serve persons under the age of 65 who are determined to require
217.6 the level of care provided in a nursing home and persons who
217.7 require the level of care provided in a hospital. The
217.8 commissioner shall apply for the home and community-based
217.9 waivers in order to: (i) promote the support of persons with
217.10 disabilities in the most integrated settings; (ii) expand the
217.11 availability of services for persons who are eligible for
217.12 medical assistance; (iii) promote cost-effective options to
217.13 institutional care; and (iv) obtain federal financial
217.14 participation.
217.15 (b) The provision of waivered services to medical
217.16 assistance recipients with disabilities shall comply with the
217.17 requirements outlined in the federally approved applications for
217.18 home and community-based services and subsequent amendments,
217.19 including provision of services according to a service plan
217.20 designed to meet the needs of the individual. For purposes of
217.21 this section, the approved home and community-based application
217.22 is considered the necessary federal requirement.
217.23 (c) The commissioner shall provide interested persons
217.24 serving on agency advisory committees and task forces, and
217.25 others upon request, with notice of, and an opportunity to
217.26 comment on, any changes or amendments to the federally approved
217.27 applications for home and community-based waivers, prior to
217.28 their submission to the federal health care financing
217.29 administration.
217.30 (d) The commissioner shall seek approval, as authorized
217.31 under section 1915(c) of the Social Security Act, to allow
217.32 medical assistance eligibility under this section for children
217.33 under age 21 without deeming of parental income or assets.
217.34 (e) The commissioner shall seek approval, as authorized
217.35 under section 1915(c) of the Social Act, to allow medical
217.36 assistance eligibility under this section for individuals under
218.1 age 65 without deeming the spouse's income or assets.
218.2 Sec. 60. Minnesota Statutes 2000, section 256B.49, is
218.3 amended by adding a subdivision to read:
218.4 Subd. 12. [INFORMED CHOICE.] Persons who are determined
218.5 likely to require the level of care provided in a nursing
218.6 facility or hospital shall be informed of the home and
218.7 community-based support alternatives to the provision of
218.8 inpatient hospital services or nursing facility services. Each
218.9 person must be given the choice of either institutional or home
218.10 and community-based services, using the provisions described in
218.11 section 256B.77, subdivision 2, paragraph (p).
218.12 Sec. 61. Minnesota Statutes 2000, section 256B.49, is
218.13 amended by adding a subdivision to read:
218.14 Subd. 13. [CASE MANAGEMENT.] (a) Each recipient of a home
218.15 and community-based waiver shall be provided case management
218.16 services by qualified vendors as described in the federally
218.17 approved waiver application. The case management service
218.18 activities provided will include:
218.19 (1) assessing the needs of the individual within 20 working
218.20 days of a recipient's request;
218.21 (2) developing the written individual service plan within
218.22 ten working days after the assessment is completed;
218.23 (3) informing the recipient or the recipient's legal
218.24 guardian or conservator of service options;
218.25 (4) assisting the recipient in the identification of
218.26 potential service providers;
218.27 (5) assisting the recipient to access services;
218.28 (6) coordinating, evaluating, and monitoring of the
218.29 services identified in the service plan;
218.30 (7) completing the annual reviews of the service plan; and
218.31 (8) informing the recipient or legal representative of the
218.32 right to have assessments completed and service plans developed
218.33 within specified time periods, and to appeal county action or
218.34 inaction under section 256.045, subdivision 3.
218.35 (b) The case manager may delegate certain aspects of the
218.36 case management service activities to another individual
219.1 provided there is oversight by the case manager. The case
219.2 manager may not delegate those aspects which require
219.3 professional judgment including assessments, reassessments, and
219.4 care plan development.
219.5 Sec. 62. Minnesota Statutes 2000, section 256B.49, is
219.6 amended by adding a subdivision to read:
219.7 Subd. 14. [ASSESSMENT AND REASSESSMENT.] (a) Assessments
219.8 of each recipient's strengths, informal support systems, and
219.9 need for services shall be completed within 20 working days of
219.10 the recipient's request. Reassessment of each recipient's
219.11 strengths, support systems, and need for services shall be
219.12 conducted at least every 12 months and at other times when there
219.13 has been a significant change in the recipient's functioning.
219.14 (b) Persons with mental retardation or a related condition
219.15 who apply for services under the nursing facility level waiver
219.16 programs shall be screened for the appropriate level of care
219.17 according to section 256B.092.
219.18 (c) Recipients who are found eligible for home and
219.19 community-based services under this section before their 65th
219.20 birthday may remain eligible for these services after their 65th
219.21 birthday if they continue to meet all other eligibility factors.
219.22 Sec. 63. Minnesota Statutes 2000, section 256B.49, is
219.23 amended by adding a subdivision to read:
219.24 Subd. 15. [INDIVIDUALIZED SERVICE PLAN.] Each recipient of
219.25 home and community-based waivered services shall be provided a
219.26 copy of the written service plan which:
219.27 (1) is developed and signed by the recipient within ten
219.28 working days of the completion of the assessment;
219.29 (2) meets the assessed needs of the recipient;
219.30 (3) reasonably ensures the health and safety of the
219.31 recipient;
219.32 (4) promotes independence;
219.33 (5) allows for services to be provided in the most
219.34 integrated settings; and
219.35 (6) provides for an informed choice, as defined in section
219.36 256B.77, subdivision 2, paragraph (p), of service and support
220.1 providers.
220.2 Sec. 64. Minnesota Statutes 2000, section 256B.49, is
220.3 amended by adding a subdivision to read:
220.4 Subd. 16. [SERVICES AND SUPPORTS.] (a) Services and
220.5 supports included in the home and community-based waivers for
220.6 persons with disabilities shall meet the requirements set out in
220.7 United States Code, title 42, section 1396n. The services and
220.8 supports, which are offered as alternatives to institutional
220.9 care, shall promote consumer choice, community inclusion,
220.10 self-sufficiency, and self-determination.
220.11 (b) Beginning January 1, 2003, the commissioner shall
220.12 simplify and improve access to home and community-based waivered
220.13 services, to the extent possible, through the establishment of a
220.14 common service menu that is available to eligible recipients
220.15 regardless of age, disability type, or waiver program.
220.16 (c) Consumer directed community support services shall be
220.17 offered as an option to all persons eligible for services under
220.18 subdivision 11, by January 1, 2002.
220.19 (d) Services and supports shall be arranged and provided
220.20 consistent with individualized written plans of care for
220.21 eligible waiver recipients.
220.22 (e) The state of Minnesota and county agencies that
220.23 administer home and community-based waivered services for
220.24 persons with disabilities, shall not be liable for damages,
220.25 injuries, or liabilities sustained through the purchase of
220.26 supports by the individual, the individual's family, or the
220.27 authorized representative with funds received through the
220.28 consumer-directed community support service under this section.
220.29 Liabilities include but are not limited to: workers'
220.30 compensation liability, the Federal Insurance Contributions Act
220.31 (FICA), or the Federal Unemployment Tax Act (FUTA).
220.32 Sec. 65. Minnesota Statutes 2000, section 256B.49, is
220.33 amended by adding a subdivision to read:
220.34 Subd. 17. [COST OF SERVICES AND SUPPORTS.] (a) The
220.35 commissioner shall ensure that the average per capita
220.36 expenditures estimated in any fiscal year for home and
221.1 community-based waiver recipients does not exceed the average
221.2 per capita expenditures that would have been made to provide
221.3 institutional services for recipients in the absence of the
221.4 waiver.
221.5 (b) The commissioner shall implement on January 1, 2002,
221.6 one or more aggregate, need-based methods for allocating to
221.7 local agencies the home and community-based waivered service
221.8 resources available to support recipients with disabilities in
221.9 need of the level of care provided in a nursing facility or a
221.10 hospital. The commissioner shall allocate resources to single
221.11 counties and county partnerships in a manner that reflects
221.12 consideration of:
221.13 (1) an incentive-based payment process for achieving
221.14 outcomes;
221.15 (2) the need for a state-level risk pool;
221.16 (3) the need for retention of management responsibility at
221.17 the state agency level; and
221.18 (4) a phase-in strategy as appropriate.
221.19 (c) Until the allocation methods described in paragraph (b)
221.20 are implemented, the annual allowable reimbursement level of
221.21 home and community-based waiver services shall be the greater of:
221.22 (1) the statewide average payment amount which the
221.23 recipient is assigned under the waiver reimbursement system in
221.24 place on June 30, 2001, modified by the percentage of any
221.25 provider rate increase appropriated for home and community-based
221.26 services; or
221.27 (2) an amount approved by the commissioner based on the
221.28 recipient's extraordinary needs that cannot be met within the
221.29 current allowable reimbursement level. The increased
221.30 reimbursement level must be necessary to allow the recipient to
221.31 be discharged from an institution or to prevent imminent
221.32 placement in an institution. The additional reimbursement may
221.33 be used to secure environmental modifications; assistive
221.34 technology and equipment; and increased costs for supervision,
221.35 training, and support services necessary to address the
221.36 recipient's extraordinary needs. The commissioner may approve
222.1 an increased reimbursement level for up to one year of the
222.2 recipient's relocation from an institution or up to six months
222.3 of a determination that a current waiver recipient is at
222.4 imminent risk of being placed in an institution.
222.5 (d) Beginning July 1, 2001, medically necessary private
222.6 duty nursing services will be authorized under this section as
222.7 complex and regular care according to section 256B.0627.
222.8 Sec. 66. Minnesota Statutes 2000, section 256B.49, is
222.9 amended by adding a subdivision to read:
222.10 Subd. 18. [PAYMENTS.] The commissioner shall reimburse
222.11 approved vendors from the medical assistance account for the
222.12 costs of providing home and community-based services to eligible
222.13 recipients using the invoice processing procedures of the
222.14 Medicaid management information system (MMIS). Recipients will
222.15 be screened and authorized for services according to the
222.16 federally approved waiver application and its subsequent
222.17 amendments.
222.18 Sec. 67. Minnesota Statutes 2000, section 256B.49, is
222.19 amended by adding a subdivision to read:
222.20 Subd. 19. [HEALTH AND WELFARE.] The commissioner of human
222.21 services shall take the necessary safeguards to protect the
222.22 health and welfare of individuals provided services under the
222.23 waiver.
222.24 Sec. 68. Minnesota Statutes 2000, section 256B.49, is
222.25 amended by adding a subdivision to read:
222.26 Subd. 20. [TRAUMATIC BRAIN INJURY AND RELATED CONDITIONS.]
222.27 The commissioner shall seek to amend the traumatic brain injury
222.28 waiver to include, as eligible persons, individuals with an
222.29 acquired or degenerative disease diagnosis where cognitive
222.30 impairment is present, such as multiple sclerosis.
222.31 Sec. 69. Minnesota Statutes 2000, section 256B.69,
222.32 subdivision 23, is amended to read:
222.33 Subd. 23. [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES;
222.34 ELDERLY AND DISABLED PERSONS.] (a) The commissioner may
222.35 implement demonstration projects to create alternative
222.36 integrated delivery systems for acute and long-term care
223.1 services to elderly persons and persons with disabilities as
223.2 defined in section 256B.77, subdivision 7a, that provide
223.3 increased coordination, improve access to quality services, and
223.4 mitigate future cost increases. The commissioner may seek
223.5 federal authority to combine Medicare and Medicaid capitation
223.6 payments for the purpose of such demonstrations. Medicare funds
223.7 and services shall be administered according to the terms and
223.8 conditions of the federal waiver and demonstration provisions.
223.9 For the purpose of administering medical assistance funds,
223.10 demonstrations under this subdivision are subject to
223.11 subdivisions 1 to 22. The provisions of Minnesota Rules, parts
223.12 9500.1450 to 9500.1464, apply to these demonstrations, with the
223.13 exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457,
223.14 subpart 1, items B and C, which do not apply to persons
223.15 enrolling in demonstrations under this section. An initial open
223.16 enrollment period may be provided. Persons who disenroll from
223.17 demonstrations under this subdivision remain subject to
223.18 Minnesota Rules, parts 9500.1450 to 9500.1464. When a person is
223.19 enrolled in a health plan under these demonstrations and the
223.20 health plan's participation is subsequently terminated for any
223.21 reason, the person shall be provided an opportunity to select a
223.22 new health plan and shall have the right to change health plans
223.23 within the first 60 days of enrollment in the second health
223.24 plan. Persons required to participate in health plans under
223.25 this section who fail to make a choice of health plan shall not
223.26 be randomly assigned to health plans under these demonstrations.
223.27 Notwithstanding section 256L.12, subdivision 5, and Minnesota
223.28 Rules, part 9505.5220, subpart 1, item A, if adopted, for the
223.29 purpose of demonstrations under this subdivision, the
223.30 commissioner may contract with managed care organizations,
223.31 including counties, to serve only elderly persons eligible for
223.32 medical assistance, elderly and disabled persons, or disabled
223.33 persons only. For persons with primary diagnoses of mental
223.34 retardation or a related condition, serious and persistent
223.35 mental illness, or serious emotional disturbance, the
223.36 commissioner must ensure that the county authority has approved
224.1 the demonstration and contracting design. Enrollment in these
224.2 projects for persons with disabilities shall be voluntary until
224.3 July 1, 2001. The commissioner shall not implement any
224.4 demonstration project under this subdivision for persons with
224.5 primary diagnoses of mental retardation or a related condition,
224.6 serious and persistent mental illness, or serious emotional
224.7 disturbance, without approval of the county board of the county
224.8 in which the demonstration is being implemented.
224.9 Before implementation of a demonstration project for
224.10 disabled persons, the commissioner must provide information to
224.11 appropriate committees of the house of representatives and
224.12 senate and must involve representatives of affected disability
224.13 groups in the design of the demonstration projects.
224.14 (b) A nursing facility reimbursed under the alternative
224.15 reimbursement methodology in section 256B.434 may, in
224.16 collaboration with a hospital, clinic, or other health care
224.17 entity provide services under paragraph (a). The commissioner
224.18 shall amend the state plan and seek any federal waivers
224.19 necessary to implement this paragraph.
224.20 Sec. 70. Minnesota Statutes 2000, section 256D.35, is
224.21 amended by adding a subdivision to read:
224.22 Subd. 11a. [INSTITUTION.] "Institution" means: a
224.23 hospital, consistent with Code of Federal Regulations, title 42,
224.24 section 440.10; regional treatment center inpatient services; a
224.25 nursing facility; and an intermediate care facility for persons
224.26 with mental retardation.
224.27 Sec. 71. Minnesota Statutes 2000, section 256D.35, is
224.28 amended by adding a subdivision to read:
224.29 Subd. 18a. [SHELTER COSTS.] "Shelter costs" means: rent,
224.30 manufactured home lot rentals; monthly principal, interest,
224.31 insurance premiums, and property taxes due for mortgages or
224.32 contract for deed costs; costs for utilities, including heating,
224.33 cooling, electricity, water, and sewerage; garbage collection
224.34 fees; and the basic service fee for one telephone.
224.35 Sec. 72. Minnesota Statutes 2000, section 256D.44,
224.36 subdivision 5, is amended to read:
225.1 Subd. 5. [SPECIAL NEEDS.] In addition to the state
225.2 standards of assistance established in subdivisions 1 to 4,
225.3 payments are allowed for the following special needs of
225.4 recipients of Minnesota supplemental aid who are not residents
225.5 of a nursing home, a regional treatment center, or a group
225.6 residential housing facility.
225.7 (a) The county agency shall pay a monthly allowance for
225.8 medically prescribed diets payable under the Minnesota family
225.9 investment program if the cost of those additional dietary needs
225.10 cannot be met through some other maintenance benefit.
225.11 (b) Payment for nonrecurring special needs must be allowed
225.12 for necessary home repairs or necessary repairs or replacement
225.13 of household furniture and appliances using the payment standard
225.14 of the AFDC program in effect on July 16, 1996, for these
225.15 expenses, as long as other funding sources are not available.
225.16 (c) A fee for guardian or conservator service is allowed at
225.17 a reasonable rate negotiated by the county or approved by the
225.18 court. This rate shall not exceed five percent of the
225.19 assistance unit's gross monthly income up to a maximum of $100
225.20 per month. If the guardian or conservator is a member of the
225.21 county agency staff, no fee is allowed.
225.22 (d) The county agency shall continue to pay a monthly
225.23 allowance of $68 for restaurant meals for a person who was
225.24 receiving a restaurant meal allowance on June 1, 1990, and who
225.25 eats two or more meals in a restaurant daily. The allowance
225.26 must continue until the person has not received Minnesota
225.27 supplemental aid for one full calendar month or until the
225.28 person's living arrangement changes and the person no longer
225.29 meets the criteria for the restaurant meal allowance, whichever
225.30 occurs first.
225.31 (e) A fee of ten percent of the recipient's gross income or
225.32 $25, whichever is less, is allowed for representative payee
225.33 services provided by an agency that meets the requirements under
225.34 SSI regulations to charge a fee for representative payee
225.35 services. This special need is available to all recipients of
225.36 Minnesota supplemental aid regardless of their living
226.1 arrangement.
226.2 (f) Notwithstanding the language in this subdivision, an
226.3 amount equal to the maximum allotment authorized by the federal
226.4 Food Stamp Program for a single individual which is in effect on
226.5 the first day of January of the previous year will be added to
226.6 the standards of assistance established in subdivisions 1 to 4
226.7 for individuals under the age of 65 who are relocating from an
226.8 institution and who are shelter needy. An eligible individual
226.9 who receives this benefit prior to age 65 may continue to
226.10 receive the benefit after the age of 65.
226.11 "Shelter needy" means that the assistance unit incurs
226.12 monthly shelter costs that exceed 40 percent of the assistance
226.13 unit's gross income before the application of this special needs
226.14 standard. "Gross income" for the purposes of this section is
226.15 the applicant's or recipient's income as defined in section
226.16 256D.35, subdivision 10, or the standard specified in
226.17 subdivision 3, whichever is greater. A recipient of a federal
226.18 or state housing subsidy, that limits shelter costs to a
226.19 percentage of gross income, shall not be considered shelter
226.20 needy for purposes of this paragraph.
226.21 Sec. 73. Minnesota Statutes 2000, section 256I.05,
226.22 subdivision 1e, is amended to read:
226.23 Subd. 1e. [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.]
226.24 Notwithstanding the provisions of subdivisions 1a and 1c,
226.25 beginning July 1, 1999 2001, a county agency shall negotiate a
226.26 supplementary rate in addition to the rate specified in
226.27 subdivision 1, equal to 25 125 percent of the amount specified
226.28 in subdivision 1a, including any legislatively authorized
226.29 inflationary adjustments, for a group residential housing
226.30 provider that:
226.31 (1) is located in Hennepin county and has had a group
226.32 residential housing contract with the county since June 1996;
226.33 (2) operates in three separate locations a 56-bed 71-bed
226.34 facility, a and two 40-bed facility, and a 30-bed facility
226.35 facilities; and
226.36 (3) serves a chemically dependent clientele, providing 24
227.1 hours per day supervision and limiting a resident's maximum
227.2 length of stay to 13 months out of a consecutive 24-month period.
227.3 Sec. 74. [256I.07] [RESPITE CARE PILOT PROJECT FOR FAMILY
227.4 ADULT FOSTER CARE PROVIDERS.]
227.5 Subdivision 1. [PROGRAM ESTABLISHED.] The state recognizes
227.6 the importance of developing and maintaining quality family
227.7 foster care resources. In order to accomplish that goal, the
227.8 commissioner shall establish a two-year respite care pilot
227.9 project for family adult foster care providers in three
227.10 counties. This pilot project is intended to provide support to
227.11 caregivers of adult foster care residents. The commissioner
227.12 shall establish a pilot project to accomplish the provisions in
227.13 subdivisions 2 to 4.
227.14 Subd. 2. [ELIGIBILITY.] A family adult foster care home
227.15 provider as defined under section 144D.01, subdivision 7, who
227.16 has been licensed for six months is eligible for 30 days of
227.17 respite care per calendar year. In cases of emergency, a county
227.18 social services agency may waive the six-month licensing
227.19 requirement. In order to be eligible to receive respite payment
227.20 from group residential housing and alternative care, a provider
227.21 must take time off away from their foster care residents.
227.22 Subd. 3. [PAYMENT STRUCTURE.] (a) The payment for respite
227.23 care for an adult foster care resident eligible for only group
227.24 residential housing shall be based on the current monthly group
227.25 residential housing base room and board rate and the current
227.26 maximum monthly group residential housing difficulty of care
227.27 rate.
227.28 (b) The payment for respite care for an adult foster care
227.29 resident eligible for alternative care funds shall be based on
227.30 the resident's alternative care foster care rate.
227.31 (c) The payment for respite care for an adult foster care
227.32 resident eligible for Medicaid home and community-based services
227.33 waiver funds shall be based on the group residential housing
227.34 base room and board rate.
227.35 (d) The total amount available to pay for respite care for
227.36 a family adult foster care provider shall be based on the number
228.1 of residents currently served in the foster care home and the
228.2 source of funding used to pay for each resident's foster care.
228.3 Respite care must be paid for on a per diem basis and for a full
228.4 day.
228.5 Subd. 4. [PRIVATE PAY RESIDENTS.] Payment for respite care
228.6 for private pay foster care residents must be arranged between
228.7 the provider and the resident or the resident's family.
228.8 Sec. 75. Laws 1999, chapter 152, section 1, is amended to
228.9 read:
228.10 Section 1. [TASK FORCE.]
228.11 A day training and habilitation task force is established.
228.12 Task force membership shall consist of representatives of the
228.13 commissioner of human services, counties, service consumers, and
228.14 vendors of day training and habilitation as defined in Minnesota
228.15 Statutes, section 252.41, subdivision 9, including at least one
228.16 representative from each association representing day training
228.17 and habilitation vendors. Appointments to the task force shall
228.18 be made by the commissioner of human services and technical
228.19 assistance shall be provided by the department of human services.
228.20 Sec. 76. Laws 1999, chapter 152, section 4, is amended to
228.21 read:
228.22 Sec. 4. [REPORT.]
228.23 The task force shall present a report recommending a new
228.24 payment rate structure to the legislature by January 15, 2000,
228.25 and shall make recommendations to the commissioner of human
228.26 services regarding the implementation of the pilot project for
228.27 the individualized payment rate structure, so the pilot project
228.28 can be implemented by July 1, 2002, as required in section 77.
228.29 The task force expires on March 15, 2000 December 30, 2003.
228.30 Sec. 77. [DAY TRAINING AND HABILITATION PAYMENT STRUCTURE
228.31 PILOT PROJECT.]
228.32 Subdivision 1. [INDIVIDUALIZED PAYMENT RATE
228.33 STRUCTURE.] Notwithstanding Minnesota Statutes, sections
228.34 252.451, subdivision 5; and 252.46; and Minnesota Rules, part
228.35 9525.1290, subpart 1, items A and B, the commissioner of human
228.36 services shall initiate a pilot project and phase-in for the
229.1 individualized payment rate structure described in this section
229.2 and section 78. The pilot project shall include actual
229.3 transfers of funds, not simulated transfers. The pilot project
229.4 may include all or some of the vendors in up to eight counties,
229.5 with no more than two counties from the seven-county
229.6 Minneapolis-St. Paul metropolitan area. Following initiation of
229.7 the pilot project, the commissioner shall phase in
229.8 implementation of the individualized payment rate structure to
229.9 the remaining counties and vendors according to the
229.10 implementation plan developed by the task force. The pilot and
229.11 phase-in shall not extend over more than 18 months and shall be
229.12 completed by December 31, 2003.
229.13 Subd. 2. [SUNSET.] The pilot project shall sunset upon
229.14 implementation of a new statewide rate structure according to
229.15 the implementation plan developed by the task force described in
229.16 subdivision 3, in its report to the legislature on December 1,
229.17 2001. The rates of vendors participating in the pilot project
229.18 must be modified to be consistent with the new statewide rate
229.19 structure, as implemented.
229.20 Subd. 3. [TASK FORCE RESPONSIBILITIES.] The day training
229.21 and habilitation task force established under Laws 1999, chapter
229.22 152, section 4, shall evaluate the pilot project authorized
229.23 under subdivision 1, and by December 1, 2001, shall report to
229.24 the legislature with an implementation plan, which shall address
229.25 how and when the pilot project individualized payment rate
229.26 structure will be implemented statewide, shall ensure that
229.27 vendors that wish to maintain their current per diem rate may do
229.28 so within the new payment system, and shall identify criteria
229.29 that would halt statewide implementation if vendors or clients
229.30 were adversely affected by the new payment rate structure, and
229.31 with recommendations for any amendments that should be made
229.32 before statewide implementation. These recommendations shall be
229.33 made in a report to the chairs of the house health and human
229.34 services policy and finance committees and the senate health and
229.35 family security committee and finance division.
229.36 Subd. 4. [RATE SETTING.] (a) The rate structure under this
230.1 section is intended to allow a county to authorize an individual
230.2 rate for each client in the vendor's program based on the needs
230.3 and expected outcomes of the individual client. Rates shall be
230.4 based on an authorized package of services for each individual
230.5 over a typical time frame. Rates may be established across
230.6 multiple sites run by a single vendor.
230.7 (b) With county concurrence, a vendor shall establish up to
230.8 four levels of service, A through D, based on the intensity of
230.9 services provided to an individual client of day training and
230.10 habilitation services. Service level A shall be the highest
230.11 intensity of services, marked primarily, but not exclusively, by
230.12 a one-to-one client-to-staff ratio. Service level D shall be
230.13 the lowest intensity of services. The county shall document the
230.14 vendor's description of the type and amount of services
230.15 associated with each service level.
230.16 (c) For each vendor, a county board shall establish a
230.17 dollar value for one hour of service at each of the service
230.18 levels defined in paragraph (b). In establishing these values
230.19 for existing vendors transitioning from the payment rate
230.20 structure under Minnesota Statutes, section 252.46, subdivision
230.21 1, the county board shall follow the formula and guidelines
230.22 developed by the day training and habilitation task force under
230.23 paragraph (e).
230.24 (d) A vendor may elect to maintain a single transportation
230.25 rate or may elect to establish up to five types of
230.26 transportation services: public transportation, public special
230.27 transportation, nonambulatory transportation, out-of-service
230.28 area transportation, and ambulatory transportation. For vendors
230.29 that elect to establish multiple transportation services, the
230.30 county board shall establish a dollar value for a round trip on
230.31 each type of transportation service offered through the vendor.
230.32 With vendor concurrence, the county may also establish a uniform
230.33 one-way trip value for some or all of the transportation service
230.34 types.
230.35 (e) The county board shall ensure that the vendor
230.36 translates the vendor's existing program and transportation
231.1 rates to the rates and values in the pilot project by using the
231.2 conversion calculations for services and transportation approved
231.3 by the day training and habilitation task force established
231.4 under Laws 1999, chapter 152, and included in the task force's
231.5 recommendations to the legislature. The conversion calculation
231.6 may be amended by the task force with the approval of the
231.7 commissioner and any amendments shall become effective upon
231.8 notification to the pilot project counties from the
231.9 commissioner. The calculation shall take the total
231.10 reimbursement dollars available to the vendor and divide by the
231.11 units of service expected at each service level and of each
231.12 transportation type. In determining the total reimbursement
231.13 dollars available to a vendor, the vendor shall multiply the
231.14 vendor's current per diem rate for both services and
231.15 transportation, including any new rate increases, by the
231.16 vendor's actual utilization for the year prior to implementation
231.17 of the pilot project. Vendors shall be allowed to allocate
231.18 available reimbursement dollars between service and
231.19 transportation before the vendor's service level and
231.20 transportation values are calculated. After translating its
231.21 existing service and transportation rates to the service level
231.22 and transportation values under the pilot, the vendor shall
231.23 project its expected reimbursement income using the expected
231.24 service and transportation packages for its existing clients,
231.25 based on current service authorizations. If the projected
231.26 reimbursement income is less than the vendor would have received
231.27 under the payment structure of Minnesota Statutes, section
231.28 252.46, the vendor and the county, with the approval of the
231.29 commissioner, shall adjust the vendor's service level and
231.30 transportation values to eliminate the shortfall. The
231.31 commissioner shall report all adjustments to the day training
231.32 and habilitation task force for consideration of possible
231.33 modifications to the pilot project individualized payment rate
231.34 structure.
231.35 Subd. 5. [INDIVIDUAL RATE AUTHORIZATION.] (a) As part of
231.36 its annual authorization of services for each client under
232.1 Minnesota Statutes, section 252.44, paragraph (a), clause (1),
232.2 and Minnesota Rules, part 9525.0016, subpart 12, the county
232.3 shall authorize and document a service package and a
232.4 transportation package as follows:
232.5 (1) the service package shall include the amount and type
232.6 of services at each applicable service level to be provided to
232.7 the client over a package period. An individual client may
232.8 receive services at multiple service levels over the course of
232.9 the package period. The service package rate shall be the sum
232.10 of the amount of services at each level over the package period,
232.11 multiplied by the dollar value for each service level;
232.12 (2) the transportation package shall include the amount and
232.13 type of transportation services to be provided to the client
232.14 over the package period. The transportation package rate shall
232.15 be the sum of the amount of transportation services, multiplied
232.16 by the dollar value associated with the type of transportation
232.17 service authorized for the client;
232.18 (3) the package period shall be established by the county,
232.19 and may be one week, two weeks, or one month; and
232.20 (4) the individual rate authorization may be reviewed and
232.21 modified by the county at any time and must be reviewed and
232.22 reauthorized by the county at least annually.
232.23 (b) For vendors with rates established under this section,
232.24 a service day under Minnesota Statutes, sections 245B.06 and
232.25 252.44, includes any day in which a client receives any
232.26 reimbursable service from a vendor or attends employment
232.27 arranged by the vendor.
232.28 Subd. 6. [BILLING FOR SERVICES.] The vendor shall bill
232.29 for, and shall be reimbursed for, the service package rate and
232.30 transportation package rate for the package period as authorized
232.31 by the county for each client in the vendor's program. The
232.32 length of the package period shall not affect the timing or
232.33 frequency of vendors' submissions of claims for payment under
232.34 the Medicaid Management Information System II (MMIS) or its
232.35 successors.
232.36 Subd. 7. [NOTIFICATION OF CHANGE IN CLIENT NEEDS.] The
233.1 vendor shall notify an individual client's case manager if the
233.2 vendor has knowledge of a material change in the client's needs
233.3 that may indicate a need for a change in service authorization.
233.4 Factors that would require such notice include, but are not
233.5 limited to, significant changes in medical status, residential
233.6 placement, attendance patterns, behavioral needs, or skill
233.7 functioning. The vendor shall notify the case manager as soon
233.8 as possible but no later than 30 calendar days after becoming
233.9 aware of the change in needs. The service authorization for the
233.10 client shall not change until the county authorizes a new
233.11 service and transportation package for the client in accordance
233.12 with the provisions in Minnesota Statutes, section 256B.092.
233.13 Sec. 78. [COUNTY BOARD RESPONSIBILITIES.]
233.14 For each vendor with rates established under section 77,
233.15 the county board shall document the vendor's description of the
233.16 type and amount of services associated with each service level,
233.17 the vendor's service level values, the vendor's transportation
233.18 values, and the package period that will be used to determine
233.19 the rate for each individual client. The county shall establish
233.20 a package period of one week, two weeks, or one month.
233.21 Sec. 79. [STUDY OF DAY TRAINING AND HABILITATION VENDOR
233.22 RATES.]
233.23 The commissioner shall identify the vendors with the lowest
233.24 rates or underfunded programs in the state and make
233.25 recommendations to reconcile the discrepancies prior to the
233.26 implementation of the individualized payment rate structure
233.27 described in sections 77 and 78.
233.28 Sec. 80. [FEDERAL APPROVAL.]
233.29 The commissioner shall seek any amendments to the state
233.30 Medicaid plan and any waivers necessary to permit implementation
233.31 of section 77 within the timelines specified.
233.32 Sec. 81. [SEMI-INDEPENDENT LIVING SERVICES (SILS) STUDY.]
233.33 The commissioner of human services, in consultation with
233.34 county representatives and other interested persons, shall
233.35 develop recommendations revising the funding methodology for
233.36 SILS as defined in Minnesota Statutes, section 252.275,
234.1 subdivisions 3, 4, 4b, and 4c, and report by January 15, 2002,
234.2 to the chair of the house of representatives health and human
234.3 services finance committee and the chairs of the senate health,
234.4 human services, and corrections budget division.
234.5 Sec. 82. [WAIVER REQUEST REGARDING SPOUSAL INCOME.]
234.6 By September 1, 2001, the commissioner of human services
234.7 shall seek federal approval to allow recipients of home and
234.8 community-based waivers authorized under Minnesota Statutes,
234.9 section 256B.49, to choose either a waiver of deeming of spousal
234.10 income or the spousal impoverishment protections authorized
234.11 under United States Code, title 42, section 1396r-5, with the
234.12 addition of the group residential housing rate set according to
234.13 Minnesota Statutes, section 256I.03, subdivision 5, to the
234.14 personal needs allowance authorized by Minnesota Statutes,
234.15 section 256B.0575.
234.16 Sec. 83. [PROGRAM OPTIONS FOR CERTAIN PERSONS WITH
234.17 DEVELOPMENTAL DISABILITIES.]
234.18 (a) The commissioner of human services shall ensure that
234.19 services continue to be available to persons with developmental
234.20 disabilities who were covered by social services supplemental
234.21 grants prior to July 1, 2001. Services shall be provided in
234.22 priority order as follows:
234.23 (1) to the extent possible, the commissioner shall
234.24 establish for these persons targeted slots under the home and
234.25 community-based waivered services program for persons with
234.26 mental retardation or related conditions;
234.27 (2) persons accommodated under clause (1) shall, if
234.28 eligible, receive room and board services through group
234.29 residential housing under Minnesota Statutes, chapter 256I; and
234.30 (3) any remaining persons shall continue to receive
234.31 services through community social services supplemental grants
234.32 to the affected counties.
234.33 (b) This section applies only to individuals receiving
234.34 services under social services supplemental grants as of June
234.35 30, 2001.
234.36 Sec. 84. [FEDERAL APPROVAL.]
235.1 The commissioner of human services, by September 1, 2001,
235.2 shall request any federal approval and plan amendments necessary
235.3 to implement the choice of case manager provision in section
235.4 256B.092, subdivision 2a, paragraph (b).
235.5 Sec. 85. [FEDERAL WAIVER REQUESTS.]
235.6 The commissioner of human services shall submit to the
235.7 federal Health Care Financing Administration by September 1,
235.8 2001, a request for a home and community-based services waiver
235.9 for day services, including: community inclusion, supported
235.10 employment, and day training and habilitation services defined
235.11 in Minnesota Statutes, section 252.41, subdivision 3, clause
235.12 (1), for persons eligible for the waiver under Minnesota
235.13 Statutes, section 256B.092.
235.14 Sec. 86. [REPEALER.]
235.15 (a) Minnesota Statutes 2000, sections 256B.0951,
235.16 subdivision 6; and 256E.06, subdivision 2b, are repealed.
235.17 (b) Minnesota Statutes 2000, sections 145.9245; 256.476,
235.18 subdivision 7; 256B.0912; 256B.0915, subdivisions 3a, 3b, and
235.19 3c; and 256B.49, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10,
235.20 are repealed.
235.21 (c) Laws 1995, chapter 178, article 2, section 48,
235.22 subdivision 6, is repealed.
235.23 (d) Minnesota Rules, parts 9505.2455; 9505.2458; 9505.2460;
235.24 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480;
235.25 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496;
235.26 9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025;
235.27 9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085;
235.28 9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530;
235.29 9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560;
235.30 9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600;
235.31 9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626;
235.32 9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650;
235.33 9505.3660; and 9505.3670, are repealed.
235.34 ARTICLE 4
235.35 CONSUMER INFORMATION AND ASSISTANCE
235.36 AND COMMUNITY-BASED CARE
236.1 Section 1. [144A.35] [EXPANSION OF BED DISTRIBUTION STUDY
236.2 AND CREATION OF CRITICAL ACCESS SITES.]
236.3 Subdivision 1. [OLDER ADULT SERVICES DISTRIBUTION
236.4 STUDY.] The commissioner of health, in coordination with the
236.5 commissioner of human services, shall monitor and analyze the
236.6 distribution of older adult services, including, but not limited
236.7 to, nursing home beds, senior housing, housing with services
236.8 units, and home and community-based services in the different
236.9 geographic areas of the state. The study shall include an
236.10 analysis of the impact of amendments to the nursing home
236.11 moratorium law which would allow for transfers of nursing home
236.12 beds within the state. The commissioner of health shall submit
236.13 to the legislature, beginning January 15, 2002, and each January
236.14 15 thereafter, an assessment of the distribution of long-term
236.15 health care services by geographic area, with particular
236.16 attention to service deficits or problems, the designation of
236.17 critical access service sites, and corrective action plans.
236.18 Subd. 2. [CRITICAL ACCESS SERVICE SITE.] "Critical access
236.19 service site" shall include nursing homes, senior housing,
236.20 housing with services, and home and community-based services
236.21 that are certified by the state as necessary providers of health
236.22 care services to a specific geographic area. For purposes of
236.23 this requirement, a "necessary provider of health care services"
236.24 is a provider that is:
236.25 (1) located more than 20 miles, defined as official mileage
236.26 as reported by the Minnesota department of transportation, from
236.27 the next nearest long-term health care provider;
236.28 (2) the sole long-term health care provider in the county;
236.29 or
236.30 (3) a long-term health care provider located in a medically
236.31 underserved area or health professional shortage area.
236.32 Subd. 3. [IDENTIFICATION OF CRITICAL ACCESS SERVICE
236.33 SITES.] Based on the results of the analysis completed in
236.34 subdivision 1, the commissioners of health and human services
236.35 shall identify and designate long-term health care providers as
236.36 critical access service sites.
237.1 Subd. 4. [CRITICAL ACCESS SERVICE SITES.] The commissioner
237.2 of health, in consultation with the commissioner of human
237.3 services, shall:
237.4 (1) develop and implement specific waivers to regulations
237.5 governing health care personnel scope of duties, physical plant
237.6 requirements, and location of community-based services, to
237.7 address critical access service site older adult service needs;
237.8 (2) identify payment barriers to the continued operation of
237.9 older adult services in critical access service sites, and
237.10 provide recommendations on changes to reimbursement rates to
237.11 facilitate the continued operation of these services.
237.12 Sec. 2. Minnesota Statutes 2000, section 256.973, is
237.13 amended by adding a subdivision to read:
237.14 Subd. 6. [GRANTS FOR HOME-SHARING PROGRAMS.] Grants
237.15 awarded for home-sharing programs under this section shall be
237.16 awarded through a request for proposals process every two years
237.17 according to criteria developed by the commissioner. In
237.18 awarding grants, the commissioner shall not give priority to an
237.19 applicant solely because the applicant has previously received a
237.20 grant under this section. Nothing under this subdivision shall
237.21 prohibit the commissioner from evaluating the performance of a
237.22 home-sharing program receiving a grant under this section and
237.23 allocating funds based on the evaluation.
237.24 Sec. 3. Minnesota Statutes 2000, section 256.975, is
237.25 amended by adding a subdivision to read:
237.26 Subd. 7. [CONSUMER INFORMATION AND ASSISTANCE; SENIOR
237.27 LINKAGE.] (a) The Minnesota board on aging shall operate a
237.28 statewide information and assistance service to aid older
237.29 Minnesotans and their families in making informed choices about
237.30 long-term care options and health care benefits. Language
237.31 services to persons with limited English language skills may be
237.32 made available. The service, known as Senior LinkAge Line, must
237.33 be available during business hours through a statewide toll-free
237.34 number and must also be available through the Internet.
237.35 (b) The service must assist older adults, caregivers, and
237.36 providers in accessing information about choices in long-term
238.1 care services that are purchased through private providers or
238.2 available through public options. The service must:
238.3 (1) develop a comprehensive database that includes detailed
238.4 listings in both consumer- and provider-oriented formats;
238.5 (2) make the database accessible on the Internet and
238.6 through other telecommunication and media-related tools;
238.7 (3) link callers to interactive long-term care screening
238.8 tools and make these tools available through the Internet by
238.9 integrating the tools with the database;
238.10 (4) develop community education materials with a focus on
238.11 planning for long-term care and evaluating independent living,
238.12 housing, and service options;
238.13 (5) conduct an outreach campaign to assist older adults and
238.14 their caregivers in finding information on the Internet and
238.15 through other means of communication;
238.16 (6) implement a messaging system for overflow callers and
238.17 respond to these callers by the next business day;
238.18 (7) link callers with county human services and other
238.19 providers to receive more in-depth assistance and consultation
238.20 related to long-term care options; and
238.21 (8) link callers with quality profiles for nursing
238.22 facilities and other providers developed by the commissioner of
238.23 health.
238.24 (c) The Minnesota board on aging shall conduct an
238.25 evaluation of the effectiveness of the statewide information and
238.26 assistance, and submit this evaluation to the legislature by
238.27 December 1, 2002. The evaluation must include an analysis of
238.28 funding adequacy, gaps in service delivery, continuity in
238.29 information between the service and identified linkages, and
238.30 potential use of private funding to enhance the service.
238.31 Sec. 4. [256.9754] [COMMUNITY SERVICES DEVELOPMENT GRANTS
238.32 PROGRAM.]
238.33 Subdivision 1. [DEFINITIONS.] For purposes of this
238.34 section, the following terms have the meanings given.
238.35 (a) "Community" means a town, township, city, or targeted
238.36 neighborhood within a city, or a consortium of towns, townships,
239.1 cities, or targeted neighborhoods within cities.
239.2 (b) "Older adult services" means any services available
239.3 under the elderly waiver program or alternative care grant
239.4 programs; nursing facility services; transportation services;
239.5 respite services; and other community-based services identified
239.6 as necessary either to maintain lifestyle choices for older
239.7 Minnesotans, or to promote independence.
239.8 (c) "Older adult" refers to individuals 65 years of age and
239.9 older.
239.10 Subd. 2. [CREATION.] The community services development
239.11 grants program is created under the administration of the
239.12 commissioner of human services.
239.13 Subd. 3. [PROVISION OF GRANTS.] The commissioner shall
239.14 make grants available to communities, providers of older adult
239.15 services identified in subdivision 1, or to a consortium of
239.16 providers of older adult services, to establish older adult
239.17 services. Grants may be provided for capital and other costs
239.18 including, but not limited to, start-up and training costs,
239.19 equipment, and supplies related to older adult services or other
239.20 residential or service alternatives to nursing facility care.
239.21 Grants may also be made to renovate current buildings, provide
239.22 transportation services, fund programs that would allow older
239.23 adults or disabled individuals to stay in their own homes by
239.24 sharing a home, fund programs that coordinate and manage formal
239.25 and informal services to older adults in their homes to enable
239.26 them to live as independently as possible in their own homes as
239.27 an alternative to nursing home care, or expand state-funded
239.28 programs in the area.
239.29 Subd. 4. [ELIGIBILITY.] Grants may be awarded only to
239.30 communities and providers or to a consortium of providers that
239.31 have a local match of 50 percent of the costs for the project in
239.32 the form of donations, local tax dollars, in-kind donations,
239.33 fundraising, or other local matches.
239.34 Subd. 5. [GRANT PREFERENCE.] The commissioner of human
239.35 services may award grants to the extent grant funds are
239.36 available and to the extent applications are approved by the
240.1 commissioner. Denial of approval of an application in one year
240.2 does not preclude submission of an application in a subsequent
240.3 year. The maximum grant amount is limited to $750,000.
240.4 Sec. 5. Minnesota Statutes 2000, section 256B.0911,
240.5 subdivision 1, is amended to read:
240.6 Subdivision 1. [PURPOSE AND GOAL.] (a) The purpose of the
240.7 preadmission screening program long-term care consultation
240.8 services is to assist persons with long-term or chronic care
240.9 needs in making long-term care decisions and selecting options
240.10 that meet their needs and reflect their preferences. The
240.11 availability of, and access to, information and other types of
240.12 assistance is also intended to prevent or delay certified
240.13 nursing facility placements by assessing applicants and
240.14 residents and offering cost-effective alternatives appropriate
240.15 for the person's needs and to provide transition assistance
240.16 after admission. Further, the goal of the program these
240.17 services is to contain costs associated with unnecessary
240.18 certified nursing facility admissions. The commissioners of
240.19 human services and health shall seek to maximize use of
240.20 available federal and state funds and establish the broadest
240.21 program possible within the funding available.
240.22 (b) These services must be coordinated with services
240.23 provided under sections 256.975, subdivision 7, and 256.9772,
240.24 and with services provided by other public and private agencies
240.25 in the community to offer a variety of cost-effective
240.26 alternatives to persons with disabilities and elderly persons.
240.27 The county agency providing long-term care consultation services
240.28 shall encourage the use of volunteers from families, religious
240.29 organizations, social clubs, and similar civic and service
240.30 organizations to provide community-based services.
240.31 Sec. 6. Minnesota Statutes 2000, section 256B.0911, is
240.32 amended by adding a subdivision to read:
240.33 Subd. 1a. [DEFINITIONS.] For purposes of this section, the
240.34 following definitions apply:
240.35 (a) "Long-term care consultation services" means:
240.36 (1) providing information and education to the general
241.1 public regarding availability of the services authorized under
241.2 this section;
241.3 (2) an intake process that provides access to the services
241.4 described in this section;
241.5 (3) assessment of the health, psychological, and social
241.6 needs of referred individuals;
241.7 (4) assistance in identifying services needed to maintain
241.8 an individual in the least restrictive environment;
241.9 (5) providing recommendations on cost-effective community
241.10 services that are available to the individual;
241.11 (6) development of an individual's community support plan;
241.12 (7) providing information regarding eligibility for
241.13 Minnesota health care programs;
241.14 (8) preadmission screening to determine the need for a
241.15 nursing facility level of care;
241.16 (9) preliminary determination of Minnesota health care
241.17 programs eligibility for individuals who need a nursing facility
241.18 level of care, with appropriate referrals for final
241.19 determination;
241.20 (10) providing recommendations for nursing facility
241.21 placement when there are no cost-effective community services
241.22 available; and
241.23 (11) assistance to transition people back to community
241.24 settings after facility admission.
241.25 (b) "Minnesota health care programs" means the medical
241.26 assistance program under chapter 256B, the alternative care
241.27 program under section 256B.0913, and the prescription drug
241.28 program under section 256.955.
241.29 Sec. 7. Minnesota Statutes 2000, section 256B.0911,
241.30 subdivision 3, is amended to read:
241.31 Subd. 3. [PERSONS RESPONSIBLE FOR CONDUCTING THE
241.32 PREADMISSION SCREENING LONG-TERM CARE CONSULTATION TEAM.] (a) A
241.33 local screening long-term care consultation team shall be
241.34 established by the county board of commissioners. Each local
241.35 screening consultation team shall consist of screeners who are a
241.36 at least one social worker and a at least one public health
242.1 nurse from their respective county agencies. The board may
242.2 designate public health or social services as the lead agency
242.3 for long-term care consultation services. If a county does not
242.4 have a public health nurse available, it may request approval
242.5 from the commissioner to assign a county registered nurse with
242.6 at least one year experience in home care to participate on the
242.7 team. The screening team members must confer regarding the most
242.8 appropriate care for each individual screened. Two or more
242.9 counties may collaborate to establish a joint local screening
242.10 consultation team or teams.
242.11 (b) In assessing a person's needs, screeners shall have a
242.12 physician available for consultation and shall consider the
242.13 assessment of the individual's attending physician, if any. The
242.14 individual's physician shall be included if the physician
242.15 chooses to participate. Other personnel may be included on the
242.16 team as deemed appropriate by the county agencies. The team is
242.17 responsible for providing long-term care consultation services
242.18 to all persons located in the county who request the services,
242.19 regardless of eligibility for Minnesota health care programs.
242.20 Sec. 8. Minnesota Statutes 2000, section 256B.0911, is
242.21 amended by adding a subdivision to read:
242.22 Subd. 3a. [ASSESSMENT AND SUPPORT PLANNING.] (a) Persons
242.23 requesting assessment, services planning, or other assistance
242.24 intended to support community-based living must be visited by a
242.25 long-term care consultation team within ten working days after
242.26 the date on which an assessment was requested or recommended.
242.27 Assessments must be conducted according to paragraphs (b) to (g).
242.28 (b) The county may utilize a team of either the social
242.29 worker or public health nurse, or both, to conduct the
242.30 assessment in a face-to-face interview. The consultation team
242.31 members must confer regarding the most appropriate care for each
242.32 individual screened or assessed.
242.33 (c) The long-term care consultation team must assess the
242.34 health and social needs of the person, using an assessment form
242.35 provided by the commissioner of human services.
242.36 (d) The team must conduct the assessment in a face-to-face
243.1 interview with the person being assessed and the person's legal
243.2 representative, if applicable.
243.3 (e) The team must provide the person, or the person's legal
243.4 representative, with written recommendations for facility- or
243.5 community-based services. The team must document that the most
243.6 cost-effective alternatives available were offered to the
243.7 individual. For purposes of this requirement, "cost-effective
243.8 alternatives" means community services and living arrangements
243.9 that cost the same as or less than nursing facility care.
243.10 (f) If the person chooses to use community-based services,
243.11 the team must provide the person or the person's legal
243.12 representative with a written community support plan, regardless
243.13 of whether the individual is eligible for Minnesota health care
243.14 programs. The person may request assistance in developing a
243.15 community support plan without participating in a complete
243.16 assessment.
243.17 (g) The team must give the person receiving assessment or
243.18 support planning, or the person's legal representative,
243.19 materials supplied by the commissioner of human services
243.20 containing the following information:
243.21 (1) the purpose of preadmission screening and assessment;
243.22 (2) information about Minnesota health care programs;
243.23 (3) the person's freedom to accept or reject the
243.24 recommendations of the team;
243.25 (4) the person's right to confidentiality under the
243.26 Minnesota Government Data Practices Act, chapter 13; and
243.27 (5) the person's right to appeal the decision regarding the
243.28 need for nursing facility level of care or the county's final
243.29 decisions regarding public programs eligibility according to
243.30 section 256.045, subdivision 3.
243.31 Sec. 9. Minnesota Statutes 2000, section 256B.0911, is
243.32 amended by adding a subdivision to read:
243.33 Subd. 3b. [TRANSITION ASSISTANCE.] (a) A long-term care
243.34 consultation team shall provide assistance to persons residing
243.35 in a nursing facility, hospital, regional treatment center, or
243.36 intermediate care facility for persons with mental retardation
244.1 who request or are referred for such assistance. Transition
244.2 assistance must include assessment, community support plan
244.3 development, referrals to Minnesota health care programs, and
244.4 referrals to programs that provide assistance with housing.
244.5 (b) The county shall develop transition processes with
244.6 institutional social workers and discharge planners to ensure
244.7 that:
244.8 (1) persons admitted to facilities receive information
244.9 about transition assistance that is available;
244.10 (2) the assessment is completed for persons within ten
244.11 working days of the date of request or recommendation for
244.12 assessment; and
244.13 (3) there is a plan for transition and follow-up for the
244.14 individual's return to the community. The plan must require
244.15 notification of other local agencies when a person who may
244.16 require assistance is screened by one county for admission to a
244.17 facility located in another county.
244.18 (c) If a person who is eligible for a Minnesota health care
244.19 program is admitted to a nursing facility, the nursing facility
244.20 must include a consultation team member or the case manager in
244.21 the discharge planning process.
244.22 Sec. 10. Minnesota Statutes 2000, section 256B.0911, is
244.23 amended by adding a subdivision to read:
244.24 Subd. 4a. [PREADMISSION SCREENING ACTIVITIES RELATED TO
244.25 NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid
244.26 certified nursing facilities, including certified boarding care
244.27 facilities, must be screened prior to admission regardless of
244.28 income, assets, or funding sources for nursing facility care,
244.29 except as described in subdivision 4b. The purpose of the
244.30 screening is to determine the need for nursing facility level of
244.31 care as described in paragraph (d) and to complete activities
244.32 required under federal law related to mental illness and mental
244.33 retardation as outlined in paragraph (b).
244.34 (b) A person who has a diagnosis or possible diagnosis of
244.35 mental illness, mental retardation, or a related condition must
244.36 receive a preadmission screening before admission regardless of
245.1 the exemptions outlined in subdivision 4b, paragraph (b), to
245.2 identify the need for further evaluation and specialized
245.3 services, unless the admission prior to screening is authorized
245.4 by the local mental health authority or the local developmental
245.5 disabilities case manager, or unless authorized by the county
245.6 agency according to Public Law Number 101-508.
245.7 The following criteria apply to the preadmission screening:
245.8 (1) the county must use forms and criteria developed by the
245.9 commissioner of human services to identify persons who require
245.10 referral for further evaluation and determination of the need
245.11 for specialized services; and
245.12 (2) the evaluation and determination of the need for
245.13 specialized services must be done by:
245.14 (i) a qualified independent mental health professional, for
245.15 persons with a primary or secondary diagnosis of a serious
245.16 mental illness; or
245.17 (ii) a qualified mental retardation professional, for
245.18 persons with a primary or secondary diagnosis of mental
245.19 retardation or related conditions. For purposes of this
245.20 requirement, a qualified mental retardation professional must
245.21 meet the standards for a qualified mental retardation
245.22 professional under Code of Federal Regulations, title 42,
245.23 section 483.430.
245.24 (c) The local county mental health authority or the state
245.25 mental retardation authority under Public Laws Numbers 100-203
245.26 and 101-508 may prohibit admission to a nursing facility if the
245.27 individual does not meet the nursing facility level of care
245.28 criteria or needs specialized services as defined in Public Laws
245.29 Numbers 100-203 and 101-508. For purposes of this section,
245.30 "specialized services" for a person with mental retardation or a
245.31 related condition means active treatment as that term is defined
245.32 under Code of Federal Regulations, title 42, section 483.440,
245.33 paragraph (a), clause (1).
245.34 (d) The determination of the need for nursing facility
245.35 level of care must be made according to criteria developed by
245.36 the commissioner of human services. In assessing a person's
246.1 needs, consultation team members shall have a physician
246.2 available for consultation and shall consider the assessment of
246.3 the individual's attending physician, if any. The individual's
246.4 physician must be included if the physician chooses to
246.5 participate. Other personnel may be included on the team as
246.6 deemed appropriate by the county.
246.7 Sec. 11. Minnesota Statutes 2000, section 256B.0911, is
246.8 amended by adding a subdivision to read:
246.9 Subd. 4b. [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a)
246.10 Exemptions from the federal screening requirements outlined in
246.11 subdivision 4a, paragraphs (b) and (c), are limited to:
246.12 (1) a person who, having entered an acute care facility
246.13 from a certified nursing facility, is returning to a certified
246.14 nursing facility; and
246.15 (2) a person transferring from one certified nursing
246.16 facility in Minnesota to another certified nursing facility in
246.17 Minnesota.
246.18 (b) Persons who are exempt from preadmission screening for
246.19 purposes of level of care determination include:
246.20 (1) persons described in paragraph (a);
246.21 (2) an individual who has a contractual right to have
246.22 nursing facility care paid for indefinitely by the veterans'
246.23 administration;
246.24 (3) an individual enrolled in a demonstration project under
246.25 section 256B.69, subdivision 8, at the time of application to a
246.26 nursing facility;
246.27 (4) an individual currently being served under the
246.28 alternative care program or under a home and community-based
246.29 services waiver authorized under section 1915(c) of the federal
246.30 Social Security Act; and
246.31 (5) individuals admitted to a certified nursing facility
246.32 for a short-term stay, which is expected to be 14 days or less
246.33 in duration based upon a physician's certification, and who have
246.34 been assessed and approved for nursing facility admission within
246.35 the previous six months. This exemption applies only if the
246.36 consultation team member determines at the time of the initial
247.1 assessment of the six-month period that it is appropriate to use
247.2 the nursing facility for short-term stays and that there is an
247.3 adequate plan of care for return to the home or community-based
247.4 setting. If a stay exceeds 14 days, the individual must be
247.5 referred no later than the first county working day following
247.6 the 14th resident day for a screening, which must be completed
247.7 within five working days of the referral. The payment
247.8 limitations in subdivision 7 apply to an individual found at
247.9 screening to not meet the level of care criteria for admission
247.10 to a certified nursing facility.
247.11 (c) Persons admitted to a Medicaid-certified nursing
247.12 facility from the community on an emergency basis as described
247.13 in paragraph (d) or from an acute care facility on a nonworking
247.14 day must be screened the first working day after admission.
247.15 (d) Emergency admission to a nursing facility prior to
247.16 screening is permitted when all of the following conditions are
247.17 met:
247.18 (1) a person is admitted from the community to a certified
247.19 nursing or certified boarding care facility during county
247.20 nonworking hours;
247.21 (2) a physician has determined that delaying admission
247.22 until preadmission screening is completed would adversely affect
247.23 the person's health and safety;
247.24 (3) there is a recent precipitating event that precludes
247.25 the client from living safely in the community, such as
247.26 sustaining an injury, sudden onset of acute illness, or a
247.27 caregiver's inability to continue to provide care;
247.28 (4) the attending physician has authorized the emergency
247.29 placement and has documented the reason that the emergency
247.30 placement is recommended; and
247.31 (5) the county is contacted on the first working day
247.32 following the emergency admission.
247.33 Transfer of a patient from an acute care hospital to a nursing
247.34 facility is not considered an emergency except for a person who
247.35 has received hospital services in the following situations:
247.36 hospital admission for observation, care in an emergency room
248.1 without hospital admission, or following hospital 24-hour bed
248.2 care.
248.3 Sec. 12. Minnesota Statutes 2000, section 256B.0911, is
248.4 amended by adding a subdivision to read:
248.5 Subd. 4c. [SCREENING REQUIREMENTS.] (a) A person may be
248.6 screened for nursing facility admission by telephone or in a
248.7 face-to-face screening interview. Consultation team members
248.8 shall identify each individual's needs using the following
248.9 categories:
248.10 (1) the person needs no face-to-face screening interview to
248.11 determine the need for nursing facility level of care based on
248.12 information obtained from other health care professionals;
248.13 (2) the person needs an immediate face-to-face screening
248.14 interview to determine the need for nursing facility level of
248.15 care and complete activities required under subdivision 4a; or
248.16 (3) the person may be exempt from screening requirements as
248.17 outlined in subdivision 4b, but will need transitional
248.18 assistance after admission or in-person follow-along after a
248.19 return home.
248.20 (b) Persons admitted on a nonemergency basis to a
248.21 Medicaid-certified nursing facility must be screened prior to
248.22 admission.
248.23 (c) The long-term care consultation team shall recommend a
248.24 case mix classification for persons admitted to a certified
248.25 nursing facility when sufficient information is received to make
248.26 that classification. The nursing facility is authorized to
248.27 conduct all case mix assessments for persons who have been
248.28 screened prior to admission for whom the county did not
248.29 recommend a case mix classification. The nursing facility is
248.30 authorized to conduct all case mix assessments for persons
248.31 admitted to the facility prior to a preadmission screening. The
248.32 county retains the responsibility of distributing appropriate
248.33 case mix forms to the nursing facility.
248.34 (d) The county screening or intake activity must include
248.35 processes to identify persons who may require transition
248.36 assistance as described in subdivision 3b.
249.1 Sec. 13. Minnesota Statutes 2000, section 256B.0911,
249.2 subdivision 5, is amended to read:
249.3 Subd. 5. [SIMPLIFICATION OF FORMS ADMINISTRATIVE
249.4 ACTIVITY.] The commissioner shall minimize the number of forms
249.5 required in the preadmission screening process provision of
249.6 long-term care consultation services and shall limit the
249.7 screening document to items necessary for care community support
249.8 plan approval, reimbursement, program planning, evaluation, and
249.9 policy development.
249.10 Sec. 14. Minnesota Statutes 2000, section 256B.0911,
249.11 subdivision 6, is amended to read:
249.12 Subd. 6. [PAYMENT FOR PREADMISSION SCREENING LONG-TERM
249.13 CARE CONSULTATION SERVICES.] (a) The total screening payment for
249.14 each county must be paid monthly by certified nursing facilities
249.15 in the county. The monthly amount to be paid by each nursing
249.16 facility for each fiscal year must be determined by dividing the
249.17 county's annual allocation for screenings long-term care
249.18 consultation services by 12 to determine the monthly payment and
249.19 allocating the monthly payment to each nursing facility based on
249.20 the number of licensed beds in the nursing facility. Payments
249.21 to counties in which there is no certified nursing facility must
249.22 be made by increasing the payment rate of the two facilities
249.23 located nearest to the county seat.
249.24 (b) The commissioner shall include the total annual payment
249.25 for screening determined under paragraph (a) for each nursing
249.26 facility according to section 256B.431, subdivision 2b,
249.27 paragraph (g), 256B.434, or 256B.435.
249.28 (c) Payments for screening activities long-term care
249.29 consultation services are available to the county or counties to
249.30 cover staff salaries and expenses to provide the screening
249.31 function services described in subdivision 1a. The lead agency
249.32 county shall employ, or contract with other agencies to employ,
249.33 within the limits of available funding, sufficient personnel
249.34 to conduct the preadmission screening activity provide long-term
249.35 care consultation services while meeting the state's long-term
249.36 care outcomes and objectives as defined in section 256B.0917,
250.1 subdivision 1. The local agency county shall be accountable for
250.2 meeting local objectives as approved by the commissioner in the
250.3 CSSA biennial plan.
250.4 (d) Notwithstanding section 256B.0641, overpayments
250.5 attributable to payment of the screening costs under the medical
250.6 assistance program may not be recovered from a facility.
250.7 (e) The commissioner of human services shall amend the
250.8 Minnesota medical assistance plan to include reimbursement for
250.9 the local screening consultation teams.
250.10 (f) The county may bill, as case management services,
250.11 assessments, support planning, and follow-along provided to
250.12 persons determined to be eligible for case management under
250.13 Minnesota health care programs. No individual or family member
250.14 shall be charged for an initial assessment or initial support
250.15 plan development provided under subdivision 3a or 3b.
250.16 Sec. 15. Minnesota Statutes 2000, section 256B.0911,
250.17 subdivision 7, is amended to read:
250.18 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.]
250.19 (a) Medical assistance reimbursement for nursing facilities
250.20 shall be authorized for a medical assistance recipient only if a
250.21 preadmission screening has been conducted prior to admission or
250.22 the local county agency has authorized an exemption. Medical
250.23 assistance reimbursement for nursing facilities shall not be
250.24 provided for any recipient who the local screener has determined
250.25 does not meet the level of care criteria for nursing facility
250.26 placement or, if indicated, has not had a level II PASARR OBRA
250.27 evaluation as required under the federal Omnibus Reconciliation
250.28 Act of 1987 completed unless an admission for a recipient with
250.29 mental illness is approved by the local mental health authority
250.30 or an admission for a recipient with mental retardation or
250.31 related condition is approved by the state mental retardation
250.32 authority.
250.33 (b) The nursing facility must not bill a person who is not
250.34 a medical assistance recipient for resident days that preceded
250.35 the date of completion of screening activities as required under
250.36 subdivisions 4a, 4b, and 4c. The nursing facility must include
251.1 unreimbursed resident days in the nursing facility resident day
251.2 totals reported to the commissioner.
251.3 (c) The commissioner shall make a request to the health
251.4 care financing administration for a waiver allowing screening
251.5 team approval of Medicaid payments for certified nursing
251.6 facility care. An individual has a choice and makes the final
251.7 decision between nursing facility placement and community
251.8 placement after the screening team's recommendation, except as
251.9 provided in paragraphs (b) and (c) subdivision 4a, paragraph (c).
251.10 (c) The local county mental health authority or the state
251.11 mental retardation authority under Public Law Numbers 100-203
251.12 and 101-508 may prohibit admission to a nursing facility, if the
251.13 individual does not meet the nursing facility level of care
251.14 criteria or needs specialized services as defined in Public Law
251.15 Numbers 100-203 and 101-508. For purposes of this section,
251.16 "specialized services" for a person with mental retardation or a
251.17 related condition means "active treatment" as that term is
251.18 defined in Code of Federal Regulations, title 42, section
251.19 483.440(a)(1).
251.20 (e) Appeals from the screening team's recommendation or the
251.21 county agency's final decision shall be made according to
251.22 section 256.045, subdivision 3.
251.23 Sec. 16. Minnesota Statutes 2000, section 256B.0913,
251.24 subdivision 1, is amended to read:
251.25 Subdivision 1. [PURPOSE AND GOALS.] The purpose of the
251.26 alternative care program is to provide funding for or access to
251.27 home and community-based services for frail elderly persons, in
251.28 order to limit nursing facility placements. The program is
251.29 designed to support frail elderly persons in their desire to
251.30 remain in the community as independently and as long as possible
251.31 and to support informal caregivers in their efforts to provide
251.32 care for frail elderly people. Further, the goals of the
251.33 program are:
251.34 (1) to contain medical assistance expenditures by providing
251.35 funding care in the community at a cost the same or less than
251.36 nursing facility costs; and
252.1 (2) to maintain the moratorium on new construction of
252.2 nursing home beds.
252.3 Sec. 17. Minnesota Statutes 2000, section 256B.0913,
252.4 subdivision 2, is amended to read:
252.5 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care
252.6 services are available to all frail older Minnesotans. This
252.7 includes:
252.8 (1) persons who are receiving medical assistance and served
252.9 under the medical assistance program or the Medicaid waiver
252.10 program;
252.11 (2) persons age 65 or older who are not eligible for
252.12 medical assistance without a spenddown or waiver obligation but
252.13 who would be eligible for medical assistance within 180 days of
252.14 admission to a nursing facility and served under subject to
252.15 subdivisions 4 to 13; and
252.16 (3) persons who are paying for their services out-of-pocket.
252.17 Sec. 18. Minnesota Statutes 2000, section 256B.0913,
252.18 subdivision 4, is amended to read:
252.19 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR
252.20 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services
252.21 under the alternative care program is available to persons who
252.22 meet the following criteria:
252.23 (1) the person has been screened by the county screening
252.24 team or, if previously screened and served under the alternative
252.25 care program, assessed by the local county social worker or
252.26 public health nurse determined by a community assessment under
252.27 section 256B.0911, to be a person who would require the level of
252.28 care provided in a nursing facility, but for the provision of
252.29 services under the alternative care program;
252.30 (2) the person is age 65 or older;
252.31 (3) the person would be financially eligible for medical
252.32 assistance within 180 days of admission to a nursing facility;
252.33 (4) the person meets the asset transfer requirements of is
252.34 not ineligible for the medical assistance program due to an
252.35 asset transfer penalty;
252.36 (5) the screening team would recommend nursing facility
253.1 admission or continued stay for the person if alternative care
253.2 services were not available;
253.3 (6) the person needs services that are not available at
253.4 that time in the county funded through other county, state, or
253.5 federal funding sources; and
253.6 (7) (6) the monthly cost of the alternative care services
253.7 funded by the program for this person does not exceed 75 percent
253.8 of the statewide average monthly medical assistance payment for
253.9 nursing facility care at the individual's case mix
253.10 classification weighted average monthly nursing facility rate of
253.11 the case mix resident class to which the individual alternative
253.12 care client would be assigned under Minnesota Rules, parts
253.13 9549.0050 to 9549.0059, less the recipient's maintenance needs
253.14 allowance as described in section 256B.0915, subdivision 1d,
253.15 paragraph (a), until the first day of the state fiscal year in
253.16 which the resident assessment system, under section 256B.437,
253.17 for nursing home rate determination is implemented. Effective
253.18 on the first day of the state fiscal year in which a resident
253.19 assessment system, under section 256B.437, for nursing home rate
253.20 determination is implemented and the first day of each
253.21 subsequent state fiscal year, the monthly cost of alternative
253.22 care services for this person shall not exceed the alternative
253.23 care monthly cap for the case mix resident class to which the
253.24 alternative care client would be assigned under Minnesota Rules,
253.25 parts 9549.0050 to 9549.0059, which was in effect on the last
253.26 day of the previous state fiscal year, and adjusted by the
253.27 greater of any legislatively adopted home and community-based
253.28 services cost-of-living percentage increase or any legislatively
253.29 adopted statewide percent rate increase for nursing facilities.
253.30 This monthly limit does not prohibit the alternative care client
253.31 from payment for additional services, but in no case may the
253.32 cost of additional services purchased under this section exceed
253.33 the difference between the client's monthly service limit
253.34 defined under section 256B.0915, subdivision 3, and the
253.35 alternative care program monthly service limit defined in this
253.36 paragraph. If medical supplies and equipment or adaptations
254.1 environmental modifications are or will be purchased for an
254.2 alternative care services recipient, the costs may be prorated
254.3 on a monthly basis throughout the year in which they are
254.4 purchased for up to 12 consecutive months beginning with the
254.5 month of purchase. If the monthly cost of a recipient's other
254.6 alternative care services exceeds the monthly limit established
254.7 in this paragraph, the annual cost of the alternative care
254.8 services shall be determined. In this event, the annual cost of
254.9 alternative care services shall not exceed 12 times the monthly
254.10 limit calculated described in this paragraph.
254.11 (b) Individuals who meet the criteria in paragraph (a) and
254.12 who have been approved for alternative care funding are called
254.13 180-day eligible clients.
254.14 (c) The statewide average payment for nursing facility care
254.15 is the statewide average monthly nursing facility rate in effect
254.16 on July 1 of the fiscal year in which the cost is incurred, less
254.17 the statewide average monthly income of nursing facility
254.18 residents who are age 65 or older and who are medical assistance
254.19 recipients in the month of March of the previous fiscal year.
254.20 This monthly limit does not prohibit the 180-day eligible client
254.21 from paying for additional services needed or desired.
254.22 (d) In determining the total costs of alternative care
254.23 services for one month, the costs of all services funded by the
254.24 alternative care program, including supplies and equipment, must
254.25 be included.
254.26 (e) Alternative care funding under this subdivision is not
254.27 available for a person who is a medical assistance recipient or
254.28 who would be eligible for medical assistance without a
254.29 spenddown, unless authorized by the commissioner or waiver
254.30 obligation. A person whose initial application for medical
254.31 assistance is being processed may be served under the
254.32 alternative care program for a period up to 60 days. If the
254.33 individual is found to be eligible for medical assistance, the
254.34 county must bill medical assistance must be billed for services
254.35 payable under the federally approved elderly waiver plan and
254.36 delivered from the date the individual was found eligible
255.1 for services reimbursable under the federally approved elderly
255.2 waiver program plan. Notwithstanding this provision, upon
255.3 federal approval, alternative care funds may not be used to pay
255.4 for any service the cost of which is payable by medical
255.5 assistance or which is used by a recipient to meet a medical
255.6 assistance income spenddown or waiver obligation.
255.7 (f) (c) Alternative care funding is not available for a
255.8 person who resides in a licensed nursing home or, certified
255.9 boarding care home, hospital, or intermediate care facility,
255.10 except for case management services which are being provided in
255.11 support of the discharge planning process to a nursing home
255.12 resident or certified boarding care home resident who is
255.13 ineligible for case management funded by medical assistance.
255.14 Sec. 19. Minnesota Statutes 2000, section 256B.0913,
255.15 subdivision 5, is amended to read:
255.16 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a)
255.17 Alternative care funding may be used for payment of costs of:
255.18 (1) adult foster care;
255.19 (2) adult day care;
255.20 (3) home health aide;
255.21 (4) homemaker services;
255.22 (5) personal care;
255.23 (6) case management;
255.24 (7) respite care;
255.25 (8) assisted living;
255.26 (9) residential care services;
255.27 (10) care-related supplies and equipment;
255.28 (11) meals delivered to the home;
255.29 (12) transportation;
255.30 (13) skilled nursing;
255.31 (14) chore services;
255.32 (15) companion services;
255.33 (16) nutrition services;
255.34 (17) training for direct informal caregivers;
255.35 (18) telemedicine devices to monitor recipients in their
255.36 own homes as an alternative to hospital care, nursing home care,
256.1 or home visits; and
256.2 (19) other services including which includes discretionary
256.3 funds and direct cash payments to clients, approved by the
256.4 county agency following approval by the commissioner, subject to
256.5 the provisions of paragraph (m) (j). Total annual payments for "
256.6 other services" for all clients within a county may not exceed
256.7 either ten percent of that county's annual alternative care
256.8 program base allocation or $5,000, whichever is greater. In no
256.9 case shall this amount exceed the county's total annual
256.10 alternative care program base allocation; and
256.11 (20) environmental modifications.
256.12 (b) The county agency must ensure that the funds are not
256.13 used only to supplement and not to supplant services available
256.14 through other public assistance or services programs.
256.15 (c) Unless specified in statute, the service definitions
256.16 and standards for alternative care services shall be the same as
256.17 the service definitions and standards defined specified in the
256.18 federally approved elderly waiver plan. Except for the county
256.19 agencies' approval of direct cash payments to clients as
256.20 described in paragraph (j) or for a provider of supplies and
256.21 equipment when the monthly cost of the supplies and equipment is
256.22 less than $250, persons or agencies must be employed by or under
256.23 a contract with the county agency or the public health nursing
256.24 agency of the local board of health in order to receive funding
256.25 under the alternative care program. Supplies and equipment may
256.26 be purchased from a non-Medicaid certified vendor if the cost
256.27 for the item is less than that of a Medicaid vendor.
256.28 (d) The adult foster care rate shall be considered a
256.29 difficulty of care payment and shall not include room and
256.30 board. The adult foster care daily rate shall be negotiated
256.31 between the county agency and the foster care provider. The
256.32 rate established under this section shall not exceed 75 percent
256.33 of the state average monthly nursing home payment for the case
256.34 mix classification to which the individual receiving foster care
256.35 is assigned, and it must allow for other alternative care
256.36 services to be authorized by the case manager. The alternative
257.1 care payment for the foster care service in combination with the
257.2 payment for other alternative care services, including case
257.3 management, must not exceed the limit specified in subdivision
257.4 4, paragraph (a), clause (6).
257.5 (e) Personal care services may be provided by a personal
257.6 care provider organization. must meet the service standards
257.7 defined in the federally approved elderly waiver plan, except
257.8 that a county agency may contract with a client's relative of
257.9 the client who meets the relative hardship waiver requirement as
257.10 defined in section 256B.0627, subdivision 4, paragraph (b),
257.11 clause (10), to provide personal care services, but must ensure
257.12 nursing if the county agency ensures supervision of this service
257.13 by a registered nurse or mental health practitioner. Covered
257.14 personal care services defined in section 256B.0627, subdivision
257.15 4, must meet applicable standards in Minnesota Rules, part
257.16 9505.0335.
257.17 (f) A county may use alternative care funds to purchase
257.18 medical supplies and equipment without prior approval from the
257.19 commissioner when: (1) there is no other funding source; (2)
257.20 the supplies and equipment are specified in the individual's
257.21 care plan as medically necessary to enable the individual to
257.22 remain in the community according to the criteria in Minnesota
257.23 Rules, part 9505.0210, item A; and (3) the supplies and
257.24 equipment represent an effective and appropriate use of
257.25 alternative care funds. A county may use alternative care funds
257.26 to purchase supplies and equipment from a non-Medicaid certified
257.27 vendor if the cost for the items is less than that of a Medicaid
257.28 vendor. A county is not required to contract with a provider of
257.29 supplies and equipment if the monthly cost of the supplies and
257.30 equipment is less than $250.
257.31 (g) For purposes of this section, residential care services
257.32 are services which are provided to individuals living in
257.33 residential care homes. Residential care homes are currently
257.34 licensed as board and lodging establishments and are registered
257.35 with the department of health as providing special
257.36 services under section 157.17 and are not subject to
258.1 registration under chapter 144D. Residential care services are
258.2 defined as "supportive services" and "health-related services."
258.3 "Supportive services" means the provision of up to 24-hour
258.4 supervision and oversight. Supportive services includes: (1)
258.5 transportation, when provided by the residential care center
258.6 home only; (2) socialization, when socialization is part of the
258.7 plan of care, has specific goals and outcomes established, and
258.8 is not diversional or recreational in nature; (3) assisting
258.9 clients in setting up meetings and appointments; (4) assisting
258.10 clients in setting up medical and social services; (5) providing
258.11 assistance with personal laundry, such as carrying the client's
258.12 laundry to the laundry room. Assistance with personal laundry
258.13 does not include any laundry, such as bed linen, that is
258.14 included in the room and board rate. "Health-related services"
258.15 are limited to minimal assistance with dressing, grooming, and
258.16 bathing and providing reminders to residents to take medications
258.17 that are self-administered or providing storage for medications,
258.18 if requested. Individuals receiving residential care services
258.19 cannot receive homemaking services funded under this section.
258.20 (h) (g) For the purposes of this section, "assisted living"
258.21 refers to supportive services provided by a single vendor to
258.22 clients who reside in the same apartment building of three or
258.23 more units which are not subject to registration under chapter
258.24 144D and are licensed by the department of health as a class A
258.25 home care provider or a class E home care provider. Assisted
258.26 living services are defined as up to 24-hour supervision, and
258.27 oversight, supportive services as defined in clause (1),
258.28 individualized home care aide tasks as defined in clause (2),
258.29 and individualized home management tasks as defined in clause
258.30 (3) provided to residents of a residential center living in
258.31 their units or apartments with a full kitchen and bathroom. A
258.32 full kitchen includes a stove, oven, refrigerator, food
258.33 preparation counter space, and a kitchen utensil storage
258.34 compartment. Assisted living services must be provided by the
258.35 management of the residential center or by providers under
258.36 contract with the management or with the county.
259.1 (1) Supportive services include:
259.2 (i) socialization, when socialization is part of the plan
259.3 of care, has specific goals and outcomes established, and is not
259.4 diversional or recreational in nature;
259.5 (ii) assisting clients in setting up meetings and
259.6 appointments; and
259.7 (iii) providing transportation, when provided by the
259.8 residential center only.
259.9 Individuals receiving assisted living services will not
259.10 receive both assisted living services and homemaking services.
259.11 Individualized means services are chosen and designed
259.12 specifically for each resident's needs, rather than provided or
259.13 offered to all residents regardless of their illnesses,
259.14 disabilities, or physical conditions.
259.15 (2) Home care aide tasks means:
259.16 (i) preparing modified diets, such as diabetic or low
259.17 sodium diets;
259.18 (ii) reminding residents to take regularly scheduled
259.19 medications or to perform exercises;
259.20 (iii) household chores in the presence of technically
259.21 sophisticated medical equipment or episodes of acute illness or
259.22 infectious disease;
259.23 (iv) household chores when the resident's care requires the
259.24 prevention of exposure to infectious disease or containment of
259.25 infectious disease; and
259.26 (v) assisting with dressing, oral hygiene, hair care,
259.27 grooming, and bathing, if the resident is ambulatory, and if the
259.28 resident has no serious acute illness or infectious disease.
259.29 Oral hygiene means care of teeth, gums, and oral prosthetic
259.30 devices.
259.31 (3) Home management tasks means:
259.32 (i) housekeeping;
259.33 (ii) laundry;
259.34 (iii) preparation of regular snacks and meals; and
259.35 (iv) shopping.
259.36 Individuals receiving assisted living services shall not
260.1 receive both assisted living services and homemaking services.
260.2 Individualized means services are chosen and designed
260.3 specifically for each resident's needs, rather than provided or
260.4 offered to all residents regardless of their illnesses,
260.5 disabilities, or physical conditions. Assisted living services
260.6 as defined in this section shall not be authorized in boarding
260.7 and lodging establishments licensed according to sections
260.8 157.011 and 157.15 to 157.22.
260.9 (i) (h) For establishments registered under chapter 144D,
260.10 assisted living services under this section means either the
260.11 services described and licensed in paragraph (g) and delivered
260.12 by a class E home care provider licensed by the department of
260.13 health or the services described under section 144A.4605 and
260.14 delivered by an assisted living home care provider or a class A
260.15 home care provider licensed by the commissioner of health.
260.16 (j) For the purposes of this section, reimbursement (i)
260.17 Payment for assisted living services and residential care
260.18 services shall be a monthly rate negotiated and authorized by
260.19 the county agency based on an individualized service plan for
260.20 each resident and may not cover direct rent or food costs. The
260.21 rate
260.22 (1) The individualized monthly negotiated payment for
260.23 assisted living services as described in paragraph (g) or (h),
260.24 and residential care services as described in paragraph (f),
260.25 shall not exceed the nonfederal share in effect on July 1 of the
260.26 state fiscal year for which the rate limit is being calculated
260.27 of the greater of either the statewide or any of the geographic
260.28 groups' weighted average monthly medical assistance nursing
260.29 facility payment rate of the case mix resident class to which
260.30 the 180-day alternative care eligible client would be assigned
260.31 under Minnesota Rules, parts 9549.0050 to 9549.0059, unless the
260.32 less the maintenance needs allowance as described in subdivision
260.33 1d, paragraph (a), until the first day of the state fiscal year
260.34 in which a resident assessment system, under section 256B.437,
260.35 of nursing home rate determination is implemented. Effective on
260.36 the first day of the state fiscal year in which a resident
261.1 assessment system, under section 256B.437, of nursing home rate
261.2 determination is implemented and the first day of each
261.3 subsequent state fiscal year, the individualized monthly
261.4 negotiated payment for the services described in this clause
261.5 shall not exceed the limit described in this clause which was in
261.6 effect on the last day of the previous state fiscal year and
261.7 which has been adjusted by the greater of any legislatively
261.8 adopted home and community-based services cost-of-living
261.9 percentage increase or any legislatively adopted statewide
261.10 percent rate increase for nursing facilities.
261.11 (2) The individualized monthly negotiated payment for
261.12 assisted living services are provided by a home care described
261.13 under section 144A.4605 and delivered by a provider licensed by
261.14 the department of health as a class A home care provider or an
261.15 assisted living home care provider and are provided in a
261.16 building that is registered as a housing with services
261.17 establishment under chapter 144D and that provides 24-hour
261.18 supervision in combination with the payment for other
261.19 alternative care services, including case management, must not
261.20 exceed the limit specified in subdivision 4, paragraph (a),
261.21 clause (6).
261.22 (k) For purposes of this section, companion services are
261.23 defined as nonmedical care, supervision and oversight, provided
261.24 to a functionally impaired adult. Companions may assist the
261.25 individual with such tasks as meal preparation, laundry and
261.26 shopping, but do not perform these activities as discrete
261.27 services. The provision of companion services does not entail
261.28 hands-on medical care. Providers may also perform light
261.29 housekeeping tasks which are incidental to the care and
261.30 supervision of the recipient. This service must be approved by
261.31 the case manager as part of the care plan. Companion services
261.32 must be provided by individuals or organizations who are under
261.33 contract with the local agency to provide the service. Any
261.34 person related to the waiver recipient by blood, marriage or
261.35 adoption cannot be reimbursed under this service. Persons
261.36 providing companion services will be monitored by the case
262.1 manager.
262.2 (l) For purposes of this section, training for direct
262.3 informal caregivers is defined as a classroom or home course of
262.4 instruction which may include: transfer and lifting skills,
262.5 nutrition, personal and physical cares, home safety in a home
262.6 environment, stress reduction and management, behavioral
262.7 management, long-term care decision making, care coordination
262.8 and family dynamics. The training is provided to an informal
262.9 unpaid caregiver of a 180-day eligible client which enables the
262.10 caregiver to deliver care in a home setting with high levels of
262.11 quality. The training must be approved by the case manager as
262.12 part of the individual care plan. Individuals, agencies, and
262.13 educational facilities which provide caregiver training and
262.14 education will be monitored by the case manager.
262.15 (m) (j) A county agency may make payment from their
262.16 alternative care program allocation for "other services"
262.17 provided to an alternative care program recipient if those
262.18 services prevent, shorten, or delay institutionalization. These
262.19 services may which include use of "discretionary funds" for
262.20 services that are not otherwise defined in this section and
262.21 direct cash payments to the recipient client for the purpose of
262.22 purchasing the recipient's services. The following provisions
262.23 apply to payments under this paragraph:
262.24 (1) a cash payment to a client under this provision cannot
262.25 exceed 80 percent of the monthly payment limit for that client
262.26 as specified in subdivision 4, paragraph (a), clause (7) (6);
262.27 (2) a county may not approve any cash payment for a client
262.28 who meets either of the following:
262.29 (i) has been assessed as having a dependency in
262.30 orientation, unless the client has an authorized
262.31 representative under section 256.476, subdivision 2, paragraph
262.32 (g), or for a client who. An "authorized representative" means
262.33 an individual who is at least 18 years of age and is designated
262.34 by the person or the person's legal representative to act on the
262.35 person's behalf. This individual may be a family member,
262.36 guardian, representative payee, or other individual designated
263.1 by the person or the person's legal representative, if any, to
263.2 assist in purchasing and arranging for supports; or
263.3 (ii) is concurrently receiving adult foster care,
263.4 residential care, or assisted living services;
263.5 (3) any service approved under this section must be a
263.6 service which meets the purpose and goals of the program as
263.7 listed in subdivision 1;
263.8 (4) cash payments must also meet the criteria of and are
263.9 governed by the procedures and liability protection established
263.10 in section 256.476, subdivision 4, paragraphs (b) through (h),
263.11 and recipients of cash grants must meet the requirements in
263.12 section 256.476, subdivision 10; and cash payments to a person
263.13 or a person's family will be provided through a monthly payment
263.14 and be in the form of cash, voucher, or direct county payment to
263.15 vendor. Fees or premiums assessed to the person for eligibility
263.16 for health and human services are not reimbursable through this
263.17 service option. Services and goods purchased through cash
263.18 payments must be identified in the person's individualized care
263.19 plan and must meet all of the following criteria:
263.20 (i) they must be over and above the normal cost of caring
263.21 for the person if the person did not have functional
263.22 limitations;
263.23 (ii) they must be directly attributable to the person's
263.24 functional limitations;
263.25 (iii) they must have the potential to be effective at
263.26 meeting the goals of the program;
263.27 (iv) they must be consistent with the needs identified in
263.28 the individualized service plan. The service plan shall specify
263.29 the needs of the person and family, the form and amount of
263.30 payment, the items and services to be reimbursed, and the
263.31 arrangements for management of the individual grant; and
263.32 (v) the person, the person's family, or the legal
263.33 representative shall be provided sufficient information to
263.34 ensure an informed choice of alternatives. The local agency
263.35 shall document this information in the person's care plan,
263.36 including the type and level of expenditures to be reimbursed;
264.1 (4) the county, lead agency under contract, or tribal
264.2 government under contract to administer the alternative care
264.3 program shall not be liable for damages, injuries, or
264.4 liabilities sustained through the purchase of direct supports or
264.5 goods by the person, the person's family, or the authorized
264.6 representative with funds received through the cash payments
264.7 under this section. Liabilities include, but are not limited
264.8 to, workers' compensation, the Federal Insurance Contributions
264.9 Act (FICA), or the Federal Unemployment Tax Act (FUTA);
264.10 (5) persons receiving grants under this section shall have
264.11 the following responsibilities:
264.12 (i) spend the grant money in a manner consistent with their
264.13 individualized service plan with the local agency;
264.14 (ii) notify the local agency of any necessary changes in
264.15 the grant-expenditures;
264.16 (iii) arrange and pay for supports; and
264.17 (iv) inform the local agency of areas where they have
264.18 experienced difficulty securing or maintaining supports; and
264.19 (5) (6) the county shall report client outcomes, services,
264.20 and costs under this paragraph in a manner prescribed by the
264.21 commissioner.
264.22 (k) Upon implementation of direct cash payments to clients
264.23 under this section, any person determined eligible for the
264.24 alternative care program who chooses a cash payment approved by
264.25 the county agency shall receive the cash payment under this
264.26 section and not under section 256.476 unless the person was
264.27 receiving a consumer support grant under section 256.476 before
264.28 implementation of direct cash payments under this section.
264.29 Sec. 20. Minnesota Statutes 2000, section 256B.0913,
264.30 subdivision 6, is amended to read:
264.31 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] The
264.32 alternative care program is administered by the county agency.
264.33 This agency is the lead agency responsible for the local
264.34 administration of the alternative care program as described in
264.35 this section. However, it may contract with the public health
264.36 nursing service to be the lead agency. The commissioner may
265.1 contract with federally recognized Indian tribes with a
265.2 reservation in Minnesota to serve as the lead agency responsible
265.3 for the local administration of the alternative care program as
265.4 described in the contract.
265.5 Sec. 21. Minnesota Statutes 2000, section 256B.0913,
265.6 subdivision 7, is amended to read:
265.7 Subd. 7. [CASE MANAGEMENT.] Providers of case management
265.8 services for persons receiving services funded by the
265.9 alternative care program must meet the qualification
265.10 requirements and standards specified in section 256B.0915,
265.11 subdivision 1b. The case manager must ensure the health and
265.12 safety of the individual client and not approve alternative care
265.13 funding for a client in any setting in which the case manager
265.14 cannot reasonably ensure the client's health and safety. The
265.15 case manager is responsible for the cost-effectiveness of the
265.16 alternative care individual care plan and must not approve any
265.17 care plan in which the cost of services funded by alternative
265.18 care and client contributions exceeds the limit specified in
265.19 section 256B.0915, subdivision 3, paragraph (b). The county may
265.20 allow a case manager employed by the county to delegate certain
265.21 aspects of the case management activity to another individual
265.22 employed by the county provided there is oversight of the
265.23 individual by the case manager. The case manager may not
265.24 delegate those aspects which require professional judgment
265.25 including assessments, reassessments, and care plan development.
265.26 Sec. 22. Minnesota Statutes 2000, section 256B.0913,
265.27 subdivision 8, is amended to read:
265.28 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The
265.29 case manager shall implement the plan of care for each 180-day
265.30 eligible alternative care client and ensure that a client's
265.31 service needs and eligibility are reassessed at least every 12
265.32 months. The plan shall include any services prescribed by the
265.33 individual's attending physician as necessary to allow the
265.34 individual to remain in a community setting. In developing the
265.35 individual's care plan, the case manager should include the use
265.36 of volunteers from families and neighbors, religious
266.1 organizations, social clubs, and civic and service organizations
266.2 to support the formal home care services. The county shall be
266.3 held harmless for damages or injuries sustained through the use
266.4 of volunteers under this subdivision including workers'
266.5 compensation liability. The lead agency shall provide
266.6 documentation to the commissioner verifying that the
266.7 individual's alternative care is not available at that time
266.8 through any other public assistance or service program. The
266.9 lead agency shall provide documentation in each individual's
266.10 plan of care and, if requested, to the commissioner that the
266.11 most cost-effective alternatives available have been offered to
266.12 the individual and that the individual was free to choose among
266.13 available qualified providers, both public and private. The
266.14 case manager must give the individual a ten-day written notice
266.15 of any decrease in or termination of alternative care services.
266.16 (b) If the county administering alternative care services
266.17 is different than the county of financial responsibility, the
266.18 care plan may be implemented without the approval of the county
266.19 of financial responsibility.
266.20 Sec. 23. Minnesota Statutes 2000, section 256B.0913,
266.21 subdivision 9, is amended to read:
266.22 Subd. 9. [CONTRACTING PROVISIONS FOR PROVIDERS.] The lead
266.23 agency shall document to the commissioner that the agency made
266.24 reasonable efforts to inform potential providers of the
266.25 anticipated need for services under the alternative care program
266.26 or waiver programs under sections 256B.0915 and 256B.49,
266.27 including a minimum of 14 days' written advance notice of the
266.28 opportunity to be selected as a service provider and an annual
266.29 public meeting with providers to explain and review the criteria
266.30 for selection. The lead agency shall also document to the
266.31 commissioner that the agency allowed potential providers an
266.32 opportunity to be selected to contract with the county agency.
266.33 Funds reimbursed to counties under this subdivision Alternative
266.34 care funds paid to service providers are subject to audit by the
266.35 commissioner for fiscal and utilization control.
266.36 The lead agency must select providers for contracts or
267.1 agreements using the following criteria and other criteria
267.2 established by the county:
267.3 (1) the need for the particular services offered by the
267.4 provider;
267.5 (2) the population to be served, including the number of
267.6 clients, the length of time services will be provided, and the
267.7 medical condition of clients;
267.8 (3) the geographic area to be served;
267.9 (4) quality assurance methods, including appropriate
267.10 licensure, certification, or standards, and supervision of
267.11 employees when needed;
267.12 (5) rates for each service and unit of service exclusive of
267.13 county administrative costs;
267.14 (6) evaluation of services previously delivered by the
267.15 provider; and
267.16 (7) contract or agreement conditions, including billing
267.17 requirements, cancellation, and indemnification.
267.18 The county must evaluate its own agency services under the
267.19 criteria established for other providers. The county shall
267.20 provide a written statement of the reasons for not selecting
267.21 providers.
267.22 Sec. 24. Minnesota Statutes 2000, section 256B.0913,
267.23 subdivision 10, is amended to read:
267.24 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care
267.25 appropriation for fiscal years 1992 and beyond shall cover
267.26 only 180-day alternative care eligible clients. Prior to July 1
267.27 of each year, the commissioner shall allocate to county agencies
267.28 the state funds available for alternative care for persons
267.29 eligible under subdivision 2.
267.30 (b) Prior to July 1 of each year, the commissioner shall
267.31 allocate to county agencies the state funds available for
267.32 alternative care for persons eligible under subdivision 2. The
267.33 allocation for fiscal year 1992 shall be calculated using a base
267.34 that is adjusted to exclude the medical assistance share of
267.35 alternative care expenditures. The adjusted base is calculated
267.36 by multiplying each county's allocation for fiscal year 1991 by
268.1 the percentage of county alternative care expenditures for
268.2 180-day eligible clients. The percentage is determined based on
268.3 expenditures for services rendered in fiscal year 1989 or
268.4 calendar year 1989, whichever is greater. The adjusted base for
268.5 each county is the county's current fiscal year base allocation
268.6 plus any targeted funds approved during the current fiscal
268.7 year. Calculations for paragraphs (c) and (d) are to be made as
268.8 follows: for each county, the determination of alternative care
268.9 program expenditures shall be based on payments for services
268.10 rendered from April 1 through March 31 in the base year, to the
268.11 extent that claims have been submitted and paid by June 1 of
268.12 that year.
268.13 (c) If the county alternative care program expenditures for
268.14 180-day eligible clients as defined in paragraph (b) are 95
268.15 percent or more of its the county's adjusted base allocation,
268.16 the allocation for the next fiscal year is 100 percent of the
268.17 adjusted base, plus inflation to the extent that inflation is
268.18 included in the state budget.
268.19 (d) If the county alternative care program expenditures for
268.20 180-day eligible clients as defined in paragraph (b) are less
268.21 than 95 percent of its the county's adjusted base allocation,
268.22 the allocation for the next fiscal year is the adjusted base
268.23 allocation less the amount of unspent funds below the 95 percent
268.24 level.
268.25 (e) For fiscal year 1992 only, a county may receive an
268.26 increased allocation if annualized service costs for the month
268.27 of May 1991 for 180-day eligible clients are greater than the
268.28 allocation otherwise determined. A county may apply for this
268.29 increase by reporting projected expenditures for May to the
268.30 commissioner by June 1, 1991. The amount of the allocation may
268.31 exceed the amount calculated in paragraph (b). The projected
268.32 expenditures for May must be based on actual 180-day eligible
268.33 client caseload and the individual cost of clients' care plans.
268.34 If a county does not report its expenditures for May, the amount
268.35 in paragraph (c) or (d) shall be used.
268.36 (f) Calculations for paragraphs (c) and (d) are to be made
269.1 as follows: for each county, the determination of expenditures
269.2 shall be based on payments for services rendered from April 1
269.3 through March 31 in the base year, to the extent that claims
269.4 have been submitted by June 1 of that year. Calculations for
269.5 paragraphs (c) and (d) must also include the funds transferred
269.6 to the consumer support grant program for clients who have
269.7 transferred to that program from April 1 through March 31 in the
269.8 base year.
269.9 (g) For the biennium ending June 30, 2001, the allocation
269.10 of state funds to county agencies shall be calculated as
269.11 described in paragraphs (c) and (d). If the annual legislative
269.12 appropriation for the alternative care program is inadequate to
269.13 fund the combined county allocations for fiscal year 2000 or
269.14 2001 a biennium, the commissioner shall distribute to each
269.15 county the entire annual appropriation as that county's
269.16 percentage of the computed base as calculated in paragraph
269.17 (f) paragraphs (c) and (d).
269.18 Sec. 25. Minnesota Statutes 2000, section 256B.0913,
269.19 subdivision 11, is amended to read:
269.20 Subd. 11. [TARGETED FUNDING.] (a) The purpose of targeted
269.21 funding is to make additional money available to counties with
269.22 the greatest need. Targeted funds are not intended to be
269.23 distributed equitably among all counties, but rather, allocated
269.24 to those with long-term care strategies that meet state goals.
269.25 (b) The funds available for targeted funding shall be the
269.26 total appropriation for each fiscal year minus county
269.27 allocations determined under subdivision 10 as adjusted for any
269.28 inflation increases provided in appropriations for the biennium.
269.29 (c) The commissioner shall allocate targeted funds to
269.30 counties that demonstrate to the satisfaction of the
269.31 commissioner that they have developed feasible plans to increase
269.32 alternative care spending. In making targeted funding
269.33 allocations, the commissioner shall use the following priorities:
269.34 (1) counties that received a lower allocation in fiscal
269.35 year 1991 than in fiscal year 1990. Counties remain in this
269.36 priority until they have been restored to their fiscal year 1990
270.1 level plus inflation;
270.2 (2) counties that sustain a base allocation reduction for
270.3 failure to spend 95 percent of the allocation if they
270.4 demonstrate that the base reduction should be restored;
270.5 (3) counties that propose projects to divert community
270.6 residents from nursing home placement or convert nursing home
270.7 residents to community living; and
270.8 (4) counties that can otherwise justify program growth by
270.9 demonstrating the existence of waiting lists, demographically
270.10 justified needs, or other unmet needs.
270.11 (d) Counties that would receive targeted funds according to
270.12 paragraph (c) must demonstrate to the commissioner's
270.13 satisfaction that the funds would be appropriately spent by
270.14 showing how the funds would be used to further the state's
270.15 alternative care goals as described in subdivision 1, and that
270.16 the county has the administrative and service delivery
270.17 capability to use them.
270.18 (e) The commissioner shall request applications by June 1
270.19 each year, for county agencies to apply for targeted funds by
270.20 November 1 of each year. The counties selected for targeted
270.21 funds shall be notified of the amount of their additional
270.22 funding by August 1 of each year. Targeted funds allocated to a
270.23 county agency in one year shall be treated as part of the
270.24 county's base allocation for that year in determining
270.25 allocations for subsequent years. No reallocations between
270.26 counties shall be made.
270.27 (f) The allocation for each year after fiscal year 1992
270.28 shall be determined using the previous fiscal year's allocation,
270.29 including any targeted funds, as the base and then applying the
270.30 criteria under subdivision 10, paragraphs (c), (d), and (f), to
270.31 the current year's expenditures.
270.32 Sec. 26. Minnesota Statutes 2000, section 256B.0913,
270.33 subdivision 12, is amended to read:
270.34 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for
270.35 all 180-day alternative care eligible clients to help pay for
270.36 the cost of participating in the program. The amount of the
271.1 premium for the alternative care client shall be determined as
271.2 follows:
271.3 (1) when the alternative care client's income less
271.4 recurring and predictable medical expenses is greater than the
271.5 medical assistance income standard recipient's maintenance needs
271.6 allowance as defined in section 256B.0915, subdivision 1d,
271.7 paragraph (a), but less than 150 percent of the federal poverty
271.8 guideline effective on July 1 of the state fiscal year in which
271.9 the premium is being computed, and total assets are less than
271.10 $10,000, the fee is zero;
271.11 (2) when the alternative care client's income less
271.12 recurring and predictable medical expenses is greater than 150
271.13 percent of the federal poverty guideline effective on July 1 of
271.14 the state fiscal year in which the premium is being computed,
271.15 and total assets are less than $10,000, the fee is 25 percent of
271.16 the cost of alternative care services or the difference between
271.17 150 percent of the federal poverty guideline effective on July 1
271.18 of the state fiscal year in which the premium is being computed
271.19 and the client's income less recurring and predictable medical
271.20 expenses, whichever is less; and
271.21 (3) when the alternative care client's total assets are
271.22 greater than $10,000, the fee is 25 percent of the cost of
271.23 alternative care services.
271.24 For married persons, total assets are defined as the total
271.25 marital assets less the estimated community spouse asset
271.26 allowance, under section 256B.059, if applicable. For married
271.27 persons, total income is defined as the client's income less the
271.28 monthly spousal allotment, under section 256B.058.
271.29 All alternative care services except case management shall
271.30 be included in the estimated costs for the purpose of
271.31 determining 25 percent of the costs.
271.32 The monthly premium shall be calculated based on the cost
271.33 of the first full month of alternative care services and shall
271.34 continue unaltered until the next reassessment is completed or
271.35 at the end of 12 months, whichever comes first. Premiums are
271.36 due and payable each month alternative care services are
272.1 received unless the actual cost of the services is less than the
272.2 premium.
272.3 (b) The fee shall be waived by the commissioner when:
272.4 (1) a person who is residing in a nursing facility is
272.5 receiving case management only;
272.6 (2) a person is applying for medical assistance;
272.7 (3) a married couple is requesting an asset assessment
272.8 under the spousal impoverishment provisions;
272.9 (4) a person is a medical assistance recipient, but has
272.10 been approved for alternative care-funded assisted living
272.11 services;
272.12 (5) a person is found eligible for alternative care, but is
272.13 not yet receiving alternative care services; or
272.14 (6) (5) a person's fee under paragraph (a) is less than $25.
272.15 (c) The county agency must record in the state's receivable
272.16 system the client's assessed premium amount or the reason the
272.17 premium has been waived. The commissioner will bill and collect
272.18 the premium from the client and forward the amounts collected to
272.19 the commissioner in the manner and at the times prescribed by
272.20 the commissioner. Money collected must be deposited in the
272.21 general fund and is appropriated to the commissioner for the
272.22 alternative care program. The client must supply the county
272.23 with the client's social security number at the time of
272.24 application. If a client fails or refuses to pay the premium
272.25 due, The county shall supply the commissioner with the client's
272.26 social security number and other information the commissioner
272.27 requires to collect the premium from the client. The
272.28 commissioner shall collect unpaid premiums using the Revenue
272.29 Recapture Act in chapter 270A and other methods available to the
272.30 commissioner. The commissioner may require counties to inform
272.31 clients of the collection procedures that may be used by the
272.32 state if a premium is not paid.
272.33 (d) The commissioner shall begin to adopt emergency or
272.34 permanent rules governing client premiums within 30 days after
272.35 July 1, 1991, including criteria for determining when services
272.36 to a client must be terminated due to failure to pay a premium.
273.1 Sec. 27. Minnesota Statutes 2000, section 256B.0913,
273.2 subdivision 13, is amended to read:
273.3 Subd. 13. [COUNTY BIENNIAL PLAN.] The county biennial plan
273.4 for the preadmission screening program long-term care
273.5 consultation under section 256B.0911, the alternative care
273.6 program under this section, and waivers for the elderly under
273.7 section 256B.0915, and waivers for the disabled under section
273.8 256B.49, shall be incorporated into the biennial Community
273.9 Social Services Act plan and shall meet the regulations and
273.10 timelines of that plan. This county biennial plan shall include:
273.11 (1) information on the administration of the preadmission
273.12 screening program;
273.13 (2) information on the administration of the home and
273.14 community-based services waivers for the elderly under section
273.15 256B.0915, and for the disabled under section 256B.49; and
273.16 (3) information on the administration of the alternative
273.17 care program.
273.18 Sec. 28. Minnesota Statutes 2000, section 256B.0913,
273.19 subdivision 14, is amended to read:
273.20 Subd. 14. [REIMBURSEMENT PAYMENT AND RATE ADJUSTMENTS.] (a)
273.21 Reimbursement Payment for expenditures for the provided
273.22 alternative care services as approved by the client's case
273.23 manager shall be through the invoice processing procedures of
273.24 the department's Medicaid Management Information System (MMIS).
273.25 To receive reimbursement payment, the county or vendor must
273.26 submit invoices within 12 months following the date of service.
273.27 The county agency and its vendors under contract shall not be
273.28 reimbursed for services which exceed the county allocation.
273.29 (b) If a county collects less than 50 percent of the client
273.30 premiums due under subdivision 12, the commissioner may withhold
273.31 up to three percent of the county's final alternative care
273.32 program allocation determined under subdivisions 10 and 11.
273.33 (c) The county shall negotiate individual rates with
273.34 vendors and may be reimbursed authorize service payment for
273.35 actual costs up to the greater of the county's current approved
273.36 rate or 60 percent of the maximum rate in fiscal year 1994 and
274.1 65 percent of the maximum rate in fiscal year 1995 for each
274.2 alternative care service. Notwithstanding any other rule or
274.3 statutory provision to the contrary, the commissioner shall not
274.4 be authorized to increase rates by an annual inflation factor,
274.5 unless so authorized by the legislature.
274.6 (d) (c) On July 1, 1993, the commissioner shall increase
274.7 the maximum rate for home delivered meals to $4.50 per meal. To
274.8 improve access to community services and eliminate payment
274.9 disparities between the alternative care program and the elderly
274.10 waiver program, the commissioner shall establish statewide
274.11 maximum service rate limits and eliminate county-specific
274.12 service rate limits.
274.13 (1) Effective July 1, 2001, for service rate limits, except
274.14 those in subdivision 5, paragraphs (d) and (j), the rate limit
274.15 for each service shall be the greater of the alternative care
274.16 statewide maximum rate or the elderly waiver statewide maximum
274.17 rate.
274.18 (2) Counties may negotiate individual service rates with
274.19 vendors for actual costs up to the statewide maximum service
274.20 rate limit.
274.21 Sec. 29. Minnesota Statutes 2000, section 256B.0915,
274.22 subdivision 1d, is amended to read:
274.23 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND
274.24 RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the
274.25 provisions of section 256B.056, the commissioner shall make the
274.26 following amendment to the medical assistance elderly waiver
274.27 program effective July 1, 1999, or upon federal approval,
274.28 whichever is later.
274.29 A recipient's maintenance needs will be an amount equal to
274.30 the Minnesota supplemental aid equivalent rate as defined in
274.31 section 256I.03, subdivision 5, plus the medical assistance
274.32 personal needs allowance as defined in section 256B.35,
274.33 subdivision 1, paragraph (a), when applying posteligibility
274.34 treatment of income rules to the gross income of elderly waiver
274.35 recipients, except for individuals whose income is in excess of
274.36 the special income standard according to Code of Federal
275.1 Regulations, title 42, section 435.236. Recipient maintenance
275.2 needs shall be adjusted under this provision each July 1.
275.3 (b) The commissioner of human services shall secure
275.4 approval of additional elderly waiver slots sufficient to serve
275.5 persons who will qualify under the revised income standard
275.6 described in paragraph (a) before implementing section
275.7 256B.0913, subdivision 16.
275.8 (c) In implementing this subdivision, the commissioner
275.9 shall consider allowing persons who would otherwise be eligible
275.10 for the alternative care program but would qualify for the
275.11 elderly waiver with a spenddown to remain on the alternative
275.12 care program.
275.13 Sec. 30. Minnesota Statutes 2000, section 256B.0915,
275.14 subdivision 3, is amended to read:
275.15 Subd. 3. [LIMITS OF CASES, RATES, REIMBURSEMENT PAYMENTS,
275.16 AND FORECASTING.] (a) The number of medical assistance waiver
275.17 recipients that a county may serve must be allocated according
275.18 to the number of medical assistance waiver cases open on July 1
275.19 of each fiscal year. Additional recipients may be served with
275.20 the approval of the commissioner.
275.21 (b) The monthly limit for the cost of waivered services to
275.22 an individual elderly waiver client shall be the statewide
275.23 average payment weighted average monthly nursing facility rate
275.24 of the case mix resident class to which the elderly waiver
275.25 client would be assigned under the medical assistance case mix
275.26 reimbursement system. Minnesota Rules, parts 9549.0050 to
275.27 9549.0059, less the recipient's maintenance needs allowance as
275.28 described in subdivision 1d, paragraph (a), until the first day
275.29 of the state fiscal year in which the resident assessment system
275.30 as described in section 256B.437 for nursing home rate
275.31 determination is implemented. Effective on the first day of the
275.32 state fiscal year in which the resident assessment system as
275.33 described in section 256B.437 for nursing home rate
275.34 determination is implemented and the first day of each
275.35 subsequent state fiscal year, the monthly limit for the cost of
275.36 waivered services to an individual elderly waiver client shall
276.1 be the rate of the case mix resident class to which the waiver
276.2 client would be assigned under Minnesota Rules, parts 9549.0050
276.3 to 9549.0059, in effect on the last day of the previous state
276.4 fiscal year, adjusted by the greater of any legislatively
276.5 adopted home and community-based services cost-of-living
276.6 percentage increase or any legislatively adopted statewide
276.7 percent rate increase for nursing facilities.
276.8 (c) If extended medical supplies and equipment or
276.9 adaptations environmental modifications are or will be purchased
276.10 for an elderly waiver services recipient client, the costs may
276.11 be prorated on a monthly basis throughout the year in which they
276.12 are purchased for up to 12 consecutive months beginning with the
276.13 month of purchase. If the monthly cost of a recipient's other
276.14 waivered services exceeds the monthly limit established in this
276.15 paragraph (b), the annual cost of the all waivered services
276.16 shall be determined. In this event, the annual cost of all
276.17 waivered services shall not exceed 12 times the monthly
276.18 limit calculated in this paragraph. The statewide average
276.19 payment rate is calculated by determining the statewide average
276.20 monthly nursing home rate, effective July 1 of the fiscal year
276.21 in which the cost is incurred, less the statewide average
276.22 monthly income of nursing home residents who are age 65 or
276.23 older, and who are medical assistance recipients in the month of
276.24 March of the previous state fiscal year. The annual cost
276.25 divided by 12 of elderly or disabled waivered services of
276.26 waivered services as described in paragraph (b).
276.27 (d) For a person who is a nursing facility resident at the
276.28 time of requesting a determination of eligibility for elderly or
276.29 disabled waivered services shall be the greater of the monthly
276.30 payment for: (i), a monthly conversion limit for the cost of
276.31 elderly waivered services may be requested. The monthly
276.32 conversion limit for the cost of elderly waiver services shall
276.33 be the resident class assigned under Minnesota Rules, parts
276.34 9549.0050 to 9549.0059, for that resident in the nursing
276.35 facility where the resident currently resides; or (ii) the
276.36 statewide average payment of the case mix resident class to
277.1 which the resident would be assigned under the medical
277.2 assistance case mix reimbursement system, provided that until
277.3 July 1 of the state fiscal year in which the resident assessment
277.4 system as described in section 256B.437 for nursing home rate
277.5 determination is implemented. Effective on July 1 of the state
277.6 fiscal year in which the resident assessment system as described
277.7 in section 256B.437 for nursing home rate determination is
277.8 implemented, the monthly conversion limit for the cost of
277.9 elderly waiver services shall be the per diem nursing facility
277.10 rate as determined by the resident assessment system as
277.11 described in section 256B.437 for that resident in the nursing
277.12 facility where the resident currently resides multiplied by 365
277.13 and divided by 12, less the recipient's maintenance needs
277.14 allowance as described in subdivision 1d. The limit under this
277.15 clause only applies to persons discharged from a nursing
277.16 facility after a minimum 30-day stay and found eligible for
277.17 waivered services on or after July 1, 1997. The following costs
277.18 must be included in determining the total monthly costs for the
277.19 waiver client:
277.20 (1) cost of all waivered services, including extended
277.21 medical supplies and equipment and environmental modifications;
277.22 and
277.23 (2) cost of skilled nursing, home health aide, and personal
277.24 care services reimbursable by medical assistance.
277.25 (c) (e) Medical assistance funding for skilled nursing
277.26 services, private duty nursing, home health aide, and personal
277.27 care services for waiver recipients must be approved by the case
277.28 manager and included in the individual care plan.
277.29 (d) For both the elderly waiver and the nursing facility
277.30 disabled waiver, a county may purchase extended supplies and
277.31 equipment without prior approval from the commissioner when
277.32 there is no other funding source and the supplies and equipment
277.33 are specified in the individual's care plan as medically
277.34 necessary to enable the individual to remain in the community
277.35 according to the criteria in Minnesota Rules, part 9505.0210,
277.36 items A and B. (f) A county is not required to contract with a
278.1 provider of supplies and equipment if the monthly cost of the
278.2 supplies and equipment is less than $250.
278.3 (e) (g) The adult foster care daily rate for the elderly
278.4 and disabled waivers shall be considered a difficulty of care
278.5 payment and shall not include room and board. The adult foster
278.6 care service rate shall be negotiated between the county agency
278.7 and the foster care provider. The rate established under this
278.8 section shall not exceed the state average monthly nursing home
278.9 payment for the case mix classification to which the individual
278.10 receiving foster care is assigned; the rate must allow for other
278.11 waiver and medical assistance home care services to be
278.12 authorized by the case manager. The elderly waiver payment for
278.13 the foster care service in combination with the payment for all
278.14 other elderly waiver services, including case management, must
278.15 not exceed the limit specified in paragraph (b).
278.16 (f) The assisted living and residential care service rates
278.17 for elderly and community alternatives for disabled individuals
278.18 (CADI) waivers shall be made to the vendor as a monthly rate
278.19 negotiated with the county agency based on an individualized
278.20 service plan for each resident. The rate shall not exceed the
278.21 nonfederal share of the greater of either the statewide or any
278.22 of the geographic groups' weighted average monthly medical
278.23 assistance nursing facility payment rate of the case mix
278.24 resident class to which the elderly or disabled client would be
278.25 assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,
278.26 unless the services are provided by a home care provider
278.27 licensed by the department of health and are provided in a
278.28 building that is registered as a housing with services
278.29 establishment under chapter 144D and that provides 24-hour
278.30 supervision. For alternative care assisted living projects
278.31 established under Laws 1988, chapter 689, article 2, section
278.32 256, monthly rates may not exceed 65 percent of the greater of
278.33 either the statewide or any of the geographic groups' weighted
278.34 average monthly medical assistance nursing facility payment rate
278.35 for the case mix resident class to which the elderly or disabled
278.36 client would be assigned under Minnesota Rules, parts 9549.0050
279.1 to 9549.0059. The rate may not cover direct rent or food costs.
279.2 (h) Payment for assisted living service shall be a monthly
279.3 rate negotiated and authorized by the county agency based on an
279.4 individualized service plan for each resident and may not cover
279.5 direct rent or food costs.
279.6 (1) The individualized monthly negotiated payment for
279.7 assisted living services as described in section 256B.0913,
279.8 subdivision 5, paragraph (g) or (h), and residential care
279.9 services as described in section 256B.0913, subdivision 5,
279.10 paragraph (f), shall not exceed the nonfederal share, in effect
279.11 on July 1 of the state fiscal year for which the rate limit is
279.12 being calculated, of the greater of either the statewide or any
279.13 of the geographic groups' weighted average monthly nursing
279.14 facility rate of the case mix resident class to which the
279.15 elderly waiver eligible client would be assigned under Minnesota
279.16 Rules, parts 9549.0050 to 9549.0059, less the maintenance needs
279.17 allowance as described in subdivision 1d, paragraph (a), until
279.18 the July 1 of the state fiscal year in which the resident
279.19 assessment system as described in section 256B.437 for nursing
279.20 home rate determination is implemented. Effective on July 1 of
279.21 the state fiscal year in which the resident assessment system as
279.22 described in section 256B.437 for nursing home rate
279.23 determination is implemented and July 1 of each subsequent state
279.24 fiscal year, the individualized monthly negotiated payment for
279.25 the services described in this clause shall not exceed the limit
279.26 described in this clause which was in effect on June 30 of the
279.27 previous state fiscal year and which has been adjusted by the
279.28 greater of any legislatively adopted home and community-based
279.29 services cost-of-living percentage increase or any legislatively
279.30 adopted statewide percent rate increase for nursing facilities.
279.31 (2) The individualized monthly negotiated payment for
279.32 assisted living services described in section 144A.4605 and
279.33 delivered by a provider licensed by the department of health as
279.34 a class A home care provider or an assisted living home care
279.35 provider and provided in a building that is registered as a
279.36 housing with services establishment under chapter 144D and that
280.1 provides 24-hour supervision in combination with the payment for
280.2 other elderly waiver services, including case management, must
280.3 not exceed the limit specified in paragraph (b).
280.4 (g) (i) The county shall negotiate individual service rates
280.5 with vendors and may be reimbursed authorize payment for actual
280.6 costs up to the greater of the county's current approved rate or
280.7 60 percent of the maximum rate in fiscal year 1994 and 65
280.8 percent of the maximum rate in fiscal year 1995 for each service
280.9 within each program. Persons or agencies must be employed by or
280.10 under a contract with the county agency or the public health
280.11 nursing agency of the local board of health in order to receive
280.12 funding under the elderly waiver program, except as a provider
280.13 of supplies and equipment when the monthly cost of the supplies
280.14 and equipment is less than $250.
280.15 (h) On July 1, 1993, the commissioner shall increase the
280.16 maximum rate for home-delivered meals to $4.50 per meal.
280.17 (i) (j) Reimbursement for the medical assistance recipients
280.18 under the approved waiver shall be made from the medical
280.19 assistance account through the invoice processing procedures of
280.20 the department's Medicaid Management Information System (MMIS),
280.21 only with the approval of the client's case manager. The budget
280.22 for the state share of the Medicaid expenditures shall be
280.23 forecasted with the medical assistance budget, and shall be
280.24 consistent with the approved waiver.
280.25 (k) To improve access to community services and eliminate
280.26 payment disparities between the alternative care program and the
280.27 elderly waiver, the commissioner shall establish statewide
280.28 maximum service rate limits and eliminate county-specific
280.29 service rate limits.
280.30 (1) Effective July 1, 2001, for service rate limits, except
280.31 those described or defined in paragraphs (g) and (h), the rate
280.32 limit for each service shall be the greater of the alternative
280.33 care statewide maximum rate or the elderly waiver statewide
280.34 maximum rate.
280.35 (2) Counties may negotiate individual service rates with
280.36 vendors for actual costs up to the statewide maximum service
281.1 rate limit.
281.2 (j) (l) Beginning July 1, 1991, the state shall reimburse
281.3 counties according to the payment schedule in section 256.025
281.4 for the county share of costs incurred under this subdivision on
281.5 or after January 1, 1991, for individuals who are receiving
281.6 medical assistance.
281.7 (k) For the community alternatives for disabled individuals
281.8 waiver, and nursing facility disabled waivers, county may use
281.9 waiver funds for the cost of minor adaptations to a client's
281.10 residence or vehicle without prior approval from the
281.11 commissioner if there is no other source of funding and the
281.12 adaptation:
281.13 (1) is necessary to avoid institutionalization;
281.14 (2) has no utility apart from the needs of the client; and
281.15 (3) meets the criteria in Minnesota Rules, part 9505.0210,
281.16 items A and B.
281.17 For purposes of this subdivision, "residence" means the client's
281.18 own home, the client's family residence, or a family foster
281.19 home. For purposes of this subdivision, "vehicle" means the
281.20 client's vehicle, the client's family vehicle, or the client's
281.21 family foster home vehicle.
281.22 (l) The commissioner shall establish a maximum rate unit
281.23 for baths provided by an adult day care provider that are not
281.24 included in the provider's contractual daily or hourly rate.
281.25 This maximum rate must equal the home health aide extended rate
281.26 and shall be paid for baths provided to clients served under the
281.27 elderly and disabled waivers.
281.28 Sec. 31. Minnesota Statutes 2000, section 256B.0915,
281.29 subdivision 5, is amended to read:
281.30 Subd. 5. [REASSESSMENTS FOR WAIVER CLIENTS.] A
281.31 reassessment of a client served under the elderly or disabled
281.32 waiver must be conducted at least every 12 months and at other
281.33 times when the case manager determines that there has been
281.34 significant change in the client's functioning. This may
281.35 include instances where the client is discharged from the
281.36 hospital.
282.1 Sec. 32. Minnesota Statutes 2000, section 256B.0917,
282.2 subdivision 7, is amended to read:
282.3 Subd. 7. [CONTRACT.] (a) The commissioner of human
282.4 services shall execute a contract with Living at Home/Block
282.5 Nurse Program, Inc. (LAH/BN, Inc.). The contract shall require
282.6 LAH/BN, Inc. to:
282.7 (1) develop criteria for and award grants to establish
282.8 community-based organizations that will implement
282.9 living-at-home/block nurse programs throughout the state;
282.10 (2) award grants to enable current living-at-home/block
282.11 nurse programs to continue to implement the combined
282.12 living-at-home/block nurse program model;
282.13 (3) serve as a state technical assistance center to assist
282.14 and coordinate the living-at-home/block nurse programs
282.15 established; and
282.16 (4) manage contracts with individual living-at-home/block
282.17 nurse programs.
282.18 (b) The contract shall be effective July 1, 1997, and
282.19 section 16B.17 shall not apply.
282.20 Sec. 33. [256B.0918] [DEVELOPMENT AND PURPOSE OF MEDICAL
282.21 ASSISTANCE PILOT PROJECT ON SENIOR SERVICES.]
282.22 Subdivision 1. [DEVELOPMENT AND PURPOSE.] The commissioner
282.23 of human services shall develop a medical assistance pilot
282.24 project on senior services to determine how converting the
282.25 delivery of housing, supportive services, and health care for
282.26 seniors into a flexible voucher program will impact public
282.27 expenditures for older adult service care and provide an
282.28 alternative way to purchase services based on consumer choice.
282.29 Subd. 2. [FEDERAL WAIVER AUTHORITY.] The commissioner
282.30 shall apply for any necessary federal waivers or approvals to
282.31 implement this pilot project. The commissioner shall submit the
282.32 waiver request no later than April 15, 2002.
282.33 Subd. 3. [REPORT.] The commissioner shall report to the
282.34 legislature by January 15, 2003, on approval of waivers
282.35 requested. Upon federal approval, the commissioner shall seek
282.36 legislative authorization to implement the pilot project. Once
283.1 the pilot project is implemented, participating communities and
283.2 the commissioner of human services shall collaborate to prepare
283.3 and issue an annual report each December 1 to the appropriate
283.4 committee chairs in the senate and house on: (1) the use of
283.5 state resources, including other funds leveraged for this
283.6 initiative; (2) the status of individuals being served in the
283.7 pilot project; and (3) the cost-effectiveness of the pilot
283.8 project. The commissioner shall provide data that may be needed
283.9 to evaluate the pilot project to communities that request the
283.10 data.
283.11 Subd. 4. [SUNSET.] This section sunsets June 30, 2008.
283.12 Sec. 34. [SERVICE ACCESS STUDY.]
283.13 By February 15, 2002, the commissioner of human services
283.14 shall submit to the legislature recommendations for creating
283.15 coordinated service access at the county agency level for both
283.16 publicly subsidized and nonsubsidized long-term care services
283.17 and housing options. The report must:
283.18 (1) include a plan to coordinate public funding streams to
283.19 allow low-income, privately paying consumers to purchase
283.20 services through a sliding fee scale; and
283.21 (2) evaluate the feasibility of statewide implementation,
283.22 based upon an evaluation of public cost, consumer preferences
283.23 and satisfaction, and other relevant factors.
283.24 Sec. 35. [RESPITE CARE.]
283.25 The Minnesota board on aging shall report to the
283.26 legislature by February 1, 2002, on the provision of in-home and
283.27 out-of-home respite care services on a sliding scale basis under
283.28 the federal Older Americans Act.
283.29 Sec. 36. [REPEALER.]
283.30 Minnesota Statutes 2000, sections 256B.0911, subdivisions
283.31 2, 2a, 4, 8, and 9; and 256B.0913, subdivisions 3, 15a, 15b,
283.32 15c, and 16; Minnesota Rules, parts 9505.2390; 9505.2395;
283.33 9505.2396; 9505.2400; 9505.2405; 9505.2410; 9505.2413;
283.34 9505.2415; 9505.2420; 9505.2425; 9505.2426; 9505.2430;
283.35 9505.2435; 9505.2440; 9505.2445; 9505.2450; 9505.2455;
283.36 9505.2458; 9505.2460; 9505.2465; 9505.2470; 9505.2473;
284.1 9505.2475; 9505.2480; 9505.2485; 9505.2486; 9505.2490;
284.2 9505.2495; 9505.2496; and 9505.2500, are repealed.
284.3 ARTICLE 5
284.4 LONG-TERM CARE REFORM AND REIMBURSEMENT
284.5 Section 1. [144.0724] [RESIDENT REIMBURSEMENT
284.6 CLASSIFICATION.]
284.7 Subdivision 1. [RESIDENT REIMBURSEMENT
284.8 CLASSIFICATIONS.] The commissioner of health shall establish
284.9 resident reimbursement classifications based upon the
284.10 assessments of residents of nursing homes and boarding care
284.11 homes conducted under this section and according to section
284.12 256B.437. The reimbursement classifications established under
284.13 this section shall be implemented after June 30, 2002, but no
284.14 later than January 1, 2003.
284.15 Subd. 2. [DEFINITIONS.] For purposes of this section, the
284.16 following terms have the meanings given.
284.17 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference
284.18 date" means the last day of the minimum data set observation
284.19 period. The date sets the designated endpoint of the common
284.20 observation period, and all minimum data set items refer back in
284.21 time from that point.
284.22 (b) [CASE MIX INDEX.] "Case mix index" means the weighting
284.23 factors assigned to the RUG-III classifications.
284.24 (c) [INDEX MAXIMIZATION.] "Index maximization" means
284.25 classifying a resident who could be assigned to more than one
284.26 category, to the category with the highest case mix index.
284.27 (d) [MINIMUM DATA SET.] "Minimum data set" means the
284.28 assessment instrument specified by the Health Care Financing
284.29 Administration and designated by the Minnesota department of
284.30 health.
284.31 (e) [REPRESENTATIVE.] "Representative" means a person who
284.32 is the resident's guardian or conservator, the person authorized
284.33 to pay the nursing home expenses of the resident, a
284.34 representative of the nursing home ombudsman's office whose
284.35 assistance has been requested, or any other individual
284.36 designated by the resident.
285.1 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource
285.2 utilization groups" or "RUG" means the system for grouping a
285.3 nursing facility's residents according to their clinical and
285.4 functional status identified in data supplied by the facility's
285.5 minimum data set.
285.6 Subd. 3. [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] (a)
285.7 Resident reimbursement classifications shall be based on the
285.8 minimum data set, version 2.0 assessment instrument, or its
285.9 successor version mandated by the Health Care Financing
285.10 Administration that nursing facilities are required to complete
285.11 for all residents. The commissioner of health shall establish
285.12 resident classes according to the 34 group, resource utilization
285.13 groups, version III or RUG-III model. Resident classes must be
285.14 established based on the individual items on the minimum data
285.15 set and must be completed according to the facility manual for
285.16 case mix classification issued by the Minnesota department of
285.17 health. The facility manual for case mix classification shall
285.18 be drafted by the Minnesota department of health and presented
285.19 to the chairs of health and human services legislative
285.20 committees by December 31, 2001.
285.21 (b) Each resident must be classified based on the
285.22 information from the minimum data set according to general
285.23 domains in clauses (1) to (7):
285.24 (1) extensive services where a resident requires
285.25 intravenous feeding or medications, suctioning, tracheostomy
285.26 care, or is on a ventilator or respirator;
285.27 (2) rehabilitation where a resident requires physical,
285.28 occupational, or speech therapy;
285.29 (3) special care where a resident has cerebral palsy;
285.30 quadriplegia; multiple sclerosis; pressure ulcers; fever with
285.31 vomiting, weight loss, or dehydration; tube feeding and aphasia;
285.32 or is receiving radiation therapy;
285.33 (4) clinically complex status where a resident has burns,
285.34 coma, septicemia, pneumonia, internal bleeding, chemotherapy,
285.35 wounds, kidney failure, urinary tract infections, oxygen, or
285.36 transfusions;
286.1 (5) impaired cognition where a resident has poor cognitive
286.2 performance;
286.3 (6) behavior problems where a resident exhibits wandering,
286.4 has hallucinations, or is physically or verbally abusive toward
286.5 others, unless the resident's other condition would place the
286.6 resident in other categories; and
286.7 (7) reduced physical functioning where a resident has no
286.8 special clinical conditions.
286.9 (c) The commissioner of health shall establish resident
286.10 classification according to a 34 group model based on the
286.11 information on the minimum data set and within the general
286.12 domains listed in paragraph (b), clauses (1) to (7). Detailed
286.13 descriptions of each resource utilization group shall be defined
286.14 in the facility manual for case mix classification issued by the
286.15 Minnesota department of health. The 34 groups are described as
286.16 follows:
286.17 (1) SE3: requires four or five extensive services;
286.18 (2) SE2: requires two or three extensive services;
286.19 (3) SE1: requires one extensive service;
286.20 (4) RAD: requires rehabilitation services and is dependent
286.21 in activity of daily living (ADL) at a count of 17 or 18;
286.22 (5) RAC: requires rehabilitation services and ADL count is
286.23 14 to 16;
286.24 (6) RAB: requires rehabilitation services and ADL count is
286.25 ten to 13;
286.26 (7) RAA: requires rehabilitation services and ADL count is
286.27 four to nine;
286.28 (8) SSC: requires special care and ADL count is 17 or 18;
286.29 (9) SSB: requires special care and ADL count is 15 or 16;
286.30 (10) SSA: requires special care and ADL count is seven to
286.31 14;
286.32 (11) CC2: clinically complex with depression and ADL count
286.33 is 17 or 18;
286.34 (12) CC1: clinically complex with no depression and ADL
286.35 count is 17 or 18;
286.36 (13) CB2: clinically complex with depression and ADL count
287.1 is 12 to 16;
287.2 (14) CB1: clinically complex with no depression and ADL
287.3 count is 12 to 16;
287.4 (15) CA2: clinically complex with depression and ADL count
287.5 is four to 11;
287.6 (16) CA1: clinically complex with no depression and ADL
287.7 count is four to 11;
287.8 (17) IB2: impaired cognition with nursing rehabilitation
287.9 and ADL count is six to ten;
287.10 (18) IB1: impaired cognition with no nursing
287.11 rehabilitation and ADL count is six to ten;
287.12 (19) IA2: impaired cognition with nursing rehabilitation
287.13 and ADL count is four or five;
287.14 (20) IA1: impaired cognition with no nursing
287.15 rehabilitation and ADL count is four or five;
287.16 (21) BB2: behavior problems with nursing rehabilitation
287.17 and ADL count is six to ten;
287.18 (22) BB1: behavior problems with no nursing rehabilitation
287.19 and ADL count is six to ten;
287.20 (23) BA2: behavior problems with nursing rehabilitation
287.21 and ADL count is four to five;
287.22 (24) BA1: behavior problems with no nursing rehabilitation
287.23 and ADL count is four to five;
287.24 (25) PE2: reduced physical functioning with nursing
287.25 rehabilitation and ADL count is 16 to 18;
287.26 (26) PE1: reduced physical functioning with no nursing
287.27 rehabilitation and ADL count is 16 to 18;
287.28 (27) PD2: reduced physical functioning with nursing
287.29 rehabilitation and ADL count is 11 to 15;
287.30 (28) PD1: reduced physical functioning with no nursing
287.31 rehabilitation and ADL count is 11 to 15;
287.32 (29) PC2: reduced physical functioning with nursing
287.33 rehabilitation and ADL count is nine or ten;
287.34 (30) PC1: reduced physical functioning with no nursing
287.35 rehabilitation and ADL count is nine or ten;
287.36 (31) PB2: reduced physical functioning with nursing
288.1 rehabilitation and ADL count is six to eight;
288.2 (32) PB1: reduced physical functioning with no nursing
288.3 rehabilitation and ADL count is six to eight;
288.4 (33) PA2: reduced physical functioning with nursing
288.5 rehabilitation and ADL count is four or five; and
288.6 (34) PA1: reduced physical functioning with no nursing
288.7 rehabilitation and ADL count is four or five.
288.8 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) A facility
288.9 must conduct and electronically submit to the commissioner of
288.10 health case mix assessments that conform with the assessment
288.11 schedule defined by the Code of Federal Regulations, title 42,
288.12 section 483.20, and published by the United States Department of
288.13 Health and Human Services, Health Care Financing Administration,
288.14 in the Long Term Care Assessment Instrument User's Manual,
288.15 version 2.0, October 1995, and subsequent clarifications made in
288.16 the Long-Term Care Assessment Instrument Questions and Answers,
288.17 version 2.0, August 1996. The commissioner of health may
288.18 substitute successor manuals or question and answer documents
288.19 published by the United States Department of Health and Human
288.20 Services, Health Care Financing Administration, to replace or
288.21 supplement the current version of the manual or document.
288.22 (b) The assessments used to determine a case mix
288.23 classification for reimbursement include the following:
288.24 (1) a new admission assessment must be completed by day 14
288.25 following admission;
288.26 (2) an annual assessment must be completed within 366 days
288.27 of the last comprehensive assessment;
288.28 (3) a significant change assessment must be completed
288.29 within 14 days of the identification of a significant change;
288.30 and
288.31 (4) the second quarterly assessment following either a new
288.32 admission assessment, an annual assessment, or a significant
288.33 change assessment. Each quarterly assessment must be completed
288.34 within 92 days of the previous assessment.
288.35 Subd. 5. [SHORT STAYS.] (a) A facility must submit to the
288.36 commissioner of health an initial admission assessment for all
289.1 residents who stay in the facility less than 14 days.
289.2 (b) Notwithstanding the admission assessment requirements
289.3 of paragraph (a), a facility may elect to accept a default rate
289.4 with a case mix index of 1.0 for all facility residents who stay
289.5 less than 14 days in lieu of submitting an initial assessment.
289.6 Facilities may make this election to be effective on the day of
289.7 implementation of the revised case mix system.
289.8 (c) After implementation of the revised case mix system,
289.9 nursing facilities must elect one of the options described in
289.10 paragraphs (a) and (b) on the annual report to the commissioner
289.11 of human services filed for each report year ending September
289.12 30. The election shall be effective on the following July 1.
289.13 (d) For residents who are admitted or readmitted and leave
289.14 the facility on a frequent basis and for whom readmission is
289.15 expected, the resident may be discharged on an extended leave
289.16 status. This status does not require reassessment each time the
289.17 resident returns to the facility unless a significant change in
289.18 the resident's status has occurred since the last assessment.
289.19 The case mix classification for these residents is determined by
289.20 the facility election made in paragraphs (a) and (b).
289.21 Subd. 6. [PENALTIES FOR LATE OR NONSUBMISSION.] A facility
289.22 that fails to complete or submit an assessment for a RUG-III
289.23 classification within seven days of the time requirements in
289.24 subdivisions 4 and 5 is subject to a reduced rate for that
289.25 resident. The reduced rate shall be the lowest rate for that
289.26 facility. The reduced rate is effective on the day of admission
289.27 for new admission assessments or on the day that the assessment
289.28 was due for all other assessments and continues in effect until
289.29 the first day of the month following the date of submission of
289.30 the resident's assessment.
289.31 Subd. 7. [NOTICE OF RESIDENT REIMBURSEMENT
289.32 CLASSIFICATION.] (a) A facility must elect between the options
289.33 in clauses (1) and (2) to provide notice to a resident of the
289.34 resident's case mix classification.
289.35 (1) The commissioner of health shall provide to a nursing
289.36 facility a notice for each resident of the reimbursement
290.1 classification established under subdivision 1. The notice must
290.2 inform the resident of the classification that was assigned, the
290.3 opportunity to review the documentation supporting the
290.4 classification, the opportunity to obtain clarification from the
290.5 commissioner, and the opportunity to request a reconsideration
290.6 of the classification. The commissioner must send notice of
290.7 resident classification by first class mail. A nursing facility
290.8 is responsible for the distribution of the notice to each
290.9 resident, to the person responsible for the payment of the
290.10 resident's nursing home expenses, or to another person
290.11 designated by the resident. This notice must be distributed
290.12 within three working days after the facility's receipt of the
290.13 notice from the commissioner of health.
290.14 (2) A facility may choose to provide a classification
290.15 notice, as prescribed by the commissioner of health, to a
290.16 resident upon receipt of the confirmation of the case mix
290.17 classification calculated by a facility or a corrected case mix
290.18 classification as indicated on the final validation report from
290.19 the commissioner. A nursing facility is responsible for the
290.20 distribution of the notice to each resident, to the person
290.21 responsible for the payment of the resident's nursing home
290.22 expenses, or to another person designated by the resident. This
290.23 notice must be distributed within three working days after the
290.24 facility's receipt of the validation report from the
290.25 commissioner. If a facility elects this option, the
290.26 commissioner of health shall provide the facility with a list of
290.27 residents and their case mix classifications as determined by
290.28 the commissioner. A nursing facility may make this election to
290.29 be effective on the day of implementation of the revised case
290.30 mix system.
290.31 (3) After implementation of the revised case mix system, a
290.32 nursing facility shall elect a notice of resident reimbursement
290.33 classification procedure as described in clause (1) or (2) on
290.34 the annual report to the commissioner of human services filed
290.35 for each report year ending September 30. The election will be
290.36 effective the following July 1.
291.1 (b) If a facility submits a correction to an assessment
291.2 conducted under subdivision 3 that results in a change in case
291.3 mix classification, the facility shall give written notice to
291.4 the resident or the resident's representative about the item
291.5 that was corrected and the reason for the correction. The
291.6 notice of corrected assessment may be provided at the same time
291.7 that the resident or resident's representative is provided the
291.8 resident's corrected notice of classification.
291.9 Subd. 8. [REQUEST FOR RECONSIDERATION OF RESIDENT
291.10 CLASSIFICATIONS.] (a) The resident, or resident's
291.11 representative, or the nursing facility or boarding care home
291.12 may request that the commissioner of health reconsider the
291.13 assigned reimbursement classification. The request for
291.14 reconsideration must be submitted in writing to the commissioner
291.15 within 30 days of the day the resident or the resident's
291.16 representative receives the resident classification notice. The
291.17 request for reconsideration must include the name of the
291.18 resident, the name and address of the facility in which the
291.19 resident resides, the reasons for the reconsideration, the
291.20 requested classification changes, and documentation supporting
291.21 the requested classification. The documentation accompanying
291.22 the reconsideration request is limited to documentation which
291.23 establishes that the needs of the resident at the time of the
291.24 assessment justify a classification which is different than the
291.25 classification established by the commissioner of health.
291.26 (b) Upon request, the nursing facility must give the
291.27 resident or the resident's representative a copy of the
291.28 assessment form and the other documentation that was given to
291.29 the commissioner of health to support the assessment findings.
291.30 The nursing facility shall also provide access to and a copy of
291.31 other information from the resident's record that has been
291.32 requested by or on behalf of the resident to support a
291.33 resident's reconsideration request. A copy of any requested
291.34 material must be provided within three working days of receipt
291.35 of a written request for the information. If a facility fails
291.36 to provide the material within this time, it is subject to the
292.1 issuance of a correction order and penalty assessment under
292.2 sections 144.653 and 144A.10. Notwithstanding those sections,
292.3 any correction order issued under this subdivision must require
292.4 that the nursing facility immediately comply with the request
292.5 for information and that as of the date of the issuance of the
292.6 correction order, the facility shall forfeit to the state a $100
292.7 fine for the first day of noncompliance, and an increase in the
292.8 $100 fine by $50 increments for each day the noncompliance
292.9 continues.
292.10 (c) In addition to the information required under
292.11 paragraphs (a) and (b), a reconsideration request from a nursing
292.12 facility must contain the following information: (i) the date
292.13 the reimbursement classification notices were received by the
292.14 facility; (ii) the date the classification notices were
292.15 distributed to the resident or the resident's representative;
292.16 and (iii) a copy of a notice sent to the resident or to the
292.17 resident's representative. This notice must inform the resident
292.18 or the resident's representative that a reconsideration of the
292.19 resident's classification is being requested, the reason for the
292.20 request, that the resident's rate will change if the request is
292.21 approved by the commissioner, the extent of the change, that
292.22 copies of the facility's request and supporting documentation
292.23 are available for review, and that the resident also has the
292.24 right to request a reconsideration. If the facility fails to
292.25 provide the required information with the reconsideration
292.26 request, the request must be denied, and the facility may not
292.27 make further reconsideration requests on that specific
292.28 reimbursement classification.
292.29 (d) Reconsideration by the commissioner must be made by
292.30 individuals not involved in reviewing the assessment, audit, or
292.31 reconsideration that established the disputed classification.
292.32 The reconsideration must be based upon the initial assessment
292.33 and upon the information provided to the commissioner under
292.34 paragraphs (a) and (b). If necessary for evaluating the
292.35 reconsideration request, the commissioner may conduct on-site
292.36 reviews. Within 15 working days of receiving the request for
293.1 reconsideration, the commissioner shall affirm or modify the
293.2 original resident classification. The original classification
293.3 must be modified if the commissioner determines that the
293.4 assessment resulting in the classification did not accurately
293.5 reflect the needs or assessment characteristics of the resident
293.6 at the time of the assessment. The resident and the nursing
293.7 facility or boarding care home shall be notified within five
293.8 working days after the decision is made. A decision by the
293.9 commissioner under this subdivision is the final administrative
293.10 decision of the agency for the party requesting reconsideration.
293.11 (e) The resident classification established by the
293.12 commissioner shall be the classification that applies to the
293.13 resident while the request for reconsideration is pending.
293.14 (f) The commissioner may request additional documentation
293.15 regarding a reconsideration necessary to make an accurate
293.16 reconsideration determination.
293.17 Subd. 9. [AUDIT AUTHORITY.] (a) The commissioner shall
293.18 audit the accuracy of resident assessments performed under
293.19 section 256B.437 through desk audits, on-site review of
293.20 residents and their records, and interviews with staff and
293.21 families. The commissioner shall reclassify a resident if the
293.22 commissioner determines that the resident was incorrectly
293.23 classified.
293.24 (b) The commissioner is authorized to conduct on-site
293.25 audits on an unannounced basis.
293.26 (c) A facility must grant the commissioner access to
293.27 examine the medical records relating to the resident assessments
293.28 selected for audit under this subdivision. The commissioner may
293.29 also observe and speak to facility staff and residents.
293.30 (d) The commissioner shall consider documentation under the
293.31 time frames for coding items on the minimum data set as set out
293.32 in the Resident Assessment Instrument Manual published by the
293.33 Health Care Financing Administration.
293.34 (e) The commissioner shall develop an audit selection
293.35 procedure that includes the following factors:
293.36 (1) The commissioner may target facilities that demonstrate
294.1 an atypical pattern of scoring minimum data set items,
294.2 nonsubmission of assessments, late submission of assessments, or
294.3 a previous history of audit changes of greater than 35 percent.
294.4 The commissioner shall select at least 20 percent of the most
294.5 current assessments submitted to the state for audit. Audits of
294.6 assessments selected in the targeted facilities must focus on
294.7 the factors leading to the audit. If the number of targeted
294.8 assessments selected does not meet the threshold of 20 percent
294.9 of the facility residents, then a stratified sample of the
294.10 remainder of assessments shall be drawn to meet the quota. If
294.11 the total change exceeds 35 percent, the commissioner may
294.12 conduct an expanded audit up to 100 percent of the remaining
294.13 current assessments.
294.14 (2) Facilities that are not a part of the targeted group
294.15 shall be placed in a general pool from which facilities will be
294.16 selected on a random basis for audit. Every facility shall be
294.17 audited annually. If a facility has two successive audits in
294.18 which the percentage of change is five percent or less and the
294.19 facility has not been the subject of a targeted audit in the
294.20 past 36 months, the facility may be audited biannually. A
294.21 stratified sample of 15 percent of the most current assessments
294.22 shall be selected for audit. If more than 20 percent of the
294.23 RUGS-III classifications after the audit are changed, the audit
294.24 shall be expanded to a second 15 percent sample. If the total
294.25 change between the first and second samples exceed 35 percent,
294.26 the commissioner may expand the audit to all of the remaining
294.27 assessments.
294.28 (3) If a facility qualifies for an expanded audit, the
294.29 commissioner may audit the facility again within six months. If
294.30 a facility has two expanded audits within a 24-month period,
294.31 that facility will be audited at least every six months for the
294.32 next 18 months.
294.33 (4) The commissioner may conduct special audits if the
294.34 commissioner determines that circumstances exist that could
294.35 alter or affect the validity of case mix classifications of
294.36 residents. These circumstances include, but are not limited to,
295.1 the following:
295.2 (i) frequent changes in the administration or management of
295.3 the facility;
295.4 (ii) an unusually high percentage of residents in a
295.5 specific case mix classification;
295.6 (iii) a high frequency in the number of reconsideration
295.7 requests received from a facility;
295.8 (iv) frequent adjustments of case mix classifications as
295.9 the result of reconsiderations or audits;
295.10 (v) a criminal indictment alleging provider fraud; or
295.11 (vi) other similar factors that relate to a facility's
295.12 ability to conduct accurate assessments.
295.13 (f) Within 15 working days of completing the audit process,
295.14 the commissioner shall mail the written results of the audit to
295.15 the facility, along with a written notice for each resident
295.16 affected to be forwarded by the facility. The notice must
295.17 contain the resident's classification and a statement informing
295.18 the resident, the resident's authorized representative, and the
295.19 facility of their right to review the commissioner's documents
295.20 supporting the classification and to request a reconsideration
295.21 of the classification. This notice must also include the
295.22 address and telephone number of the area nursing home ombudsman.
295.23 Subd. 10. [TRANSITION.] After implementation of this
295.24 section, reconsiderations requested for classifications made
295.25 under section 144.0722, subdivision 1, shall be determined under
295.26 section 144.0722, subdivision 3.
295.27 Sec. 2. Minnesota Statutes 2000, section 144A.071,
295.28 subdivision 1, is amended to read:
295.29 Subdivision 1. [FINDINGS.] The legislature declares that a
295.30 moratorium on the licensure and medical assistance certification
295.31 of new nursing home beds and construction projects that
295.32 exceed $750,000 $1,000,000 is necessary to control nursing home
295.33 expenditure growth and enable the state to meet the needs of its
295.34 elderly by providing high quality services in the most
295.35 appropriate manner along a continuum of care.
295.36 Sec. 3. Minnesota Statutes 2000, section 144A.071,
296.1 subdivision 1a, is amended to read:
296.2 Subd. 1a. [DEFINITIONS.] For purposes of sections 144A.071
296.3 to 144A.073, the following terms have the meanings given them:
296.4 (a) "attached fixtures" has the meaning given in Minnesota
296.5 Rules, part 9549.0020, subpart 6.
296.6 (b) "buildings" has the meaning given in Minnesota Rules,
296.7 part 9549.0020, subpart 7.
296.8 (c) "capital assets" has the meaning given in section
296.9 256B.421, subdivision 16.
296.10 (d) "commenced construction" means that all of the
296.11 following conditions were met: the final working drawings and
296.12 specifications were approved by the commissioner of health; the
296.13 construction contracts were let; a timely construction schedule
296.14 was developed, stipulating dates for beginning, achieving
296.15 various stages, and completing construction; and all zoning and
296.16 building permits were applied for.
296.17 (e) "completion date" means the date on which a certificate
296.18 of occupancy is issued for a construction project, or if a
296.19 certificate of occupancy is not required, the date on which the
296.20 construction project is available for facility use.
296.21 (f) "construction" means any erection, building,
296.22 alteration, reconstruction, modernization, or improvement
296.23 necessary to comply with the nursing home licensure rules.
296.24 (g) "construction project" means:
296.25 (1) a capital asset addition to, or replacement of a
296.26 nursing home or certified boarding care home that results in new
296.27 space or the remodeling of or renovations to existing facility
296.28 space;
296.29 (2) the remodeling or renovation of existing facility space
296.30 the use of which is modified as a result of the project
296.31 described in clause (1). This existing space and the project
296.32 described in clause (1) must be used for the functions as
296.33 designated on the construction plans on completion of the
296.34 project described in clause (1) for a period of not less than 24
296.35 months; or
296.36 (3) capital asset additions or replacements that are
297.1 completed within 12 months before or after the completion date
297.2 of the project described in clause (1).
297.3 (h) "new licensed" or "new certified beds" means:
297.4 (1) newly constructed beds in a facility or the
297.5 construction of a new facility that would increase the total
297.6 number of licensed nursing home beds or certified boarding care
297.7 or nursing home beds in the state; or
297.8 (2) newly licensed nursing home beds or newly certified
297.9 boarding care or nursing home beds that result from remodeling
297.10 of the facility that involves relocation of beds but does not
297.11 result in an increase in the total number of beds, except when
297.12 the project involves the upgrade of boarding care beds to
297.13 nursing home beds, as defined in section 144A.073, subdivision
297.14 1. "Remodeling" includes any of the type of conversion,
297.15 renovation, replacement, or upgrading projects as defined in
297.16 section 144A.073, subdivision 1.
297.17 (i) "project construction costs" means the cost of the
297.18 facility capital asset additions, replacements, renovations, or
297.19 remodeling projects, construction site preparation costs, and
297.20 related soft costs. Project construction costs also include the
297.21 cost of any remodeling or renovation of existing facility space
297.22 which is modified as a result of the construction
297.23 project. Project construction costs also includes the cost of
297.24 new technology implemented as part of the construction project.
297.25 (j) "technology" means information systems or devices that
297.26 make documentation, charting, and staff time more efficient or
297.27 encourage and allow for care through alternative settings
297.28 including, but not limited to, touch screens, monitors,
297.29 hand-helds, swipe cards, motion detectors, pagers, telemedicine,
297.30 medication dispensers, and equipment to monitor vital signs and
297.31 self-injections, and to observe skin and other conditions.
297.32 Sec. 4. Minnesota Statutes 2000, section 144A.071,
297.33 subdivision 2, is amended to read:
297.34 Subd. 2. [MORATORIUM.] The commissioner of health, in
297.35 coordination with the commissioner of human services, shall deny
297.36 each request for new licensed or certified nursing home or
298.1 certified boarding care beds except as provided in subdivision 3
298.2 or 4a, or section 144A.073. "Certified bed" means a nursing
298.3 home bed or a boarding care bed certified by the commissioner of
298.4 health for the purposes of the medical assistance program, under
298.5 United States Code, title 42, sections 1396 et seq.
298.6 The commissioner of human services, in coordination with
298.7 the commissioner of health, shall deny any request to issue a
298.8 license under section 252.28 and chapter 245A to a nursing home
298.9 or boarding care home, if that license would result in an
298.10 increase in the medical assistance reimbursement amount.
298.11 In addition, the commissioner of health must not approve
298.12 any construction project whose cost exceeds $750,000 $1,000,000
298.13 unless:
298.14 (a) any construction costs exceeding $750,000 $1,000,000
298.15 are not added to the facility's appraised value and are not
298.16 included in the facility's payment rate for reimbursement under
298.17 the medical assistance program; or
298.18 (b) the project:
298.19 (1) has been approved through the process described in
298.20 section 144A.073;
298.21 (2) meets an exception in subdivision 3 or 4a;
298.22 (3) is necessary to correct violations of state or federal
298.23 law issued by the commissioner of health;
298.24 (4) is necessary to repair or replace a portion of the
298.25 facility that was damaged by fire, lightning, groundshifts, or
298.26 other such hazards, including environmental hazards, provided
298.27 that the provisions of subdivision 4a, clause (a), are met;
298.28 (5) as of May 1, 1992, the facility has submitted to the
298.29 commissioner of health written documentation evidencing that the
298.30 facility meets the "commenced construction" definition as
298.31 specified in subdivision 1a, clause (d), or that substantial
298.32 steps have been taken prior to April 1, 1992, relating to the
298.33 construction project. "Substantial steps" require that the
298.34 facility has made arrangements with outside parties relating to
298.35 the construction project and include the hiring of an architect
298.36 or construction firm, submission of preliminary plans to the
299.1 department of health or documentation from a financial
299.2 institution that financing arrangements for the construction
299.3 project have been made; or
299.4 (6) is being proposed by a licensed nursing facility that
299.5 is not certified to participate in the medical assistance
299.6 program and will not result in new licensed or certified beds.
299.7 Prior to the final plan approval of any construction
299.8 project, the commissioner of health shall be provided with an
299.9 itemized cost estimate for the project construction costs. If a
299.10 construction project is anticipated to be completed in phases,
299.11 the total estimated cost of all phases of the project shall be
299.12 submitted to the commissioner and shall be considered as one
299.13 construction project. Once the construction project is
299.14 completed and prior to the final clearance by the commissioner,
299.15 the total project construction costs for the construction
299.16 project shall be submitted to the commissioner. If the final
299.17 project construction cost exceeds the dollar threshold in this
299.18 subdivision, the commissioner of human services shall not
299.19 recognize any of the project construction costs or the related
299.20 financing costs in excess of this threshold in establishing the
299.21 facility's property-related payment rate.
299.22 The dollar thresholds for construction projects are as
299.23 follows: for construction projects other than those authorized
299.24 in clauses (1) to (6), the dollar threshold
299.25 is $750,000 $1,000,000. For projects authorized after July 1,
299.26 1993, under clause (1), the dollar threshold is the cost
299.27 estimate submitted with a proposal for an exception under
299.28 section 144A.073, plus inflation as calculated according to
299.29 section 256B.431, subdivision 3f, paragraph (a). For projects
299.30 authorized under clauses (2) to (4), the dollar threshold is the
299.31 itemized estimate project construction costs submitted to the
299.32 commissioner of health at the time of final plan approval, plus
299.33 inflation as calculated according to section 256B.431,
299.34 subdivision 3f, paragraph (a).
299.35 The commissioner of health shall adopt rules to implement
299.36 this section or to amend the emergency rules for granting
300.1 exceptions to the moratorium on nursing homes under section
300.2 144A.073.
300.3 Sec. 5. Minnesota Statutes 2000, section 144A.071,
300.4 subdivision 4a, is amended to read:
300.5 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the
300.6 best interest of the state to ensure that nursing homes and
300.7 boarding care homes continue to meet the physical plant
300.8 licensing and certification requirements by permitting certain
300.9 construction projects. Facilities should be maintained in
300.10 condition to satisfy the physical and emotional needs of
300.11 residents while allowing the state to maintain control over
300.12 nursing home expenditure growth.
300.13 The commissioner of health in coordination with the
300.14 commissioner of human services, may approve the renovation,
300.15 replacement, upgrading, or relocation of a nursing home or
300.16 boarding care home, under the following conditions:
300.17 (a) to license or certify beds in a new facility
300.18 constructed to replace a facility or to make repairs in an
300.19 existing facility that was destroyed or damaged after June 30,
300.20 1987, by fire, lightning, or other hazard provided:
300.21 (i) destruction was not caused by the intentional act of or
300.22 at the direction of a controlling person of the facility;
300.23 (ii) at the time the facility was destroyed or damaged the
300.24 controlling persons of the facility maintained insurance
300.25 coverage for the type of hazard that occurred in an amount that
300.26 a reasonable person would conclude was adequate;
300.27 (iii) the net proceeds from an insurance settlement for the
300.28 damages caused by the hazard are applied to the cost of the new
300.29 facility or repairs;
300.30 (iv) the new facility is constructed on the same site as
300.31 the destroyed facility or on another site subject to the
300.32 restrictions in section 144A.073, subdivision 5;
300.33 (v) the number of licensed and certified beds in the new
300.34 facility does not exceed the number of licensed and certified
300.35 beds in the destroyed facility; and
300.36 (vi) the commissioner determines that the replacement beds
301.1 are needed to prevent an inadequate supply of beds.
301.2 Project construction costs incurred for repairs authorized under
301.3 this clause shall not be considered in the dollar threshold
301.4 amount defined in subdivision 2;
301.5 (b) to license or certify beds that are moved from one
301.6 location to another within a nursing home facility, provided the
301.7 total costs of remodeling performed in conjunction with the
301.8 relocation of beds does not exceed $750,000 $1,000,000;
301.9 (c) to license or certify beds in a project recommended for
301.10 approval under section 144A.073;
301.11 (d) to license or certify beds that are moved from an
301.12 existing state nursing home to a different state facility,
301.13 provided there is no net increase in the number of state nursing
301.14 home beds;
301.15 (e) to certify and license as nursing home beds boarding
301.16 care beds in a certified boarding care facility if the beds meet
301.17 the standards for nursing home licensure, or in a facility that
301.18 was granted an exception to the moratorium under section
301.19 144A.073, and if the cost of any remodeling of the facility does
301.20 not exceed $750,000 $1,000,000. If boarding care beds are
301.21 licensed as nursing home beds, the number of boarding care beds
301.22 in the facility must not increase beyond the number remaining at
301.23 the time of the upgrade in licensure. The provisions contained
301.24 in section 144A.073 regarding the upgrading of the facilities do
301.25 not apply to facilities that satisfy these requirements;
301.26 (f) to license and certify up to 40 beds transferred from
301.27 an existing facility owned and operated by the Amherst H. Wilder
301.28 Foundation in the city of St. Paul to a new unit at the same
301.29 location as the existing facility that will serve persons with
301.30 Alzheimer's disease and other related disorders. The transfer
301.31 of beds may occur gradually or in stages, provided the total
301.32 number of beds transferred does not exceed 40. At the time of
301.33 licensure and certification of a bed or beds in the new unit,
301.34 the commissioner of health shall delicense and decertify the
301.35 same number of beds in the existing facility. As a condition of
301.36 receiving a license or certification under this clause, the
302.1 facility must make a written commitment to the commissioner of
302.2 human services that it will not seek to receive an increase in
302.3 its property-related payment rate as a result of the transfers
302.4 allowed under this paragraph;
302.5 (g) to license and certify nursing home beds to replace
302.6 currently licensed and certified boarding care beds which may be
302.7 located either in a remodeled or renovated boarding care or
302.8 nursing home facility or in a remodeled, renovated, newly
302.9 constructed, or replacement nursing home facility within the
302.10 identifiable complex of health care facilities in which the
302.11 currently licensed boarding care beds are presently located,
302.12 provided that the number of boarding care beds in the facility
302.13 or complex are decreased by the number to be licensed as nursing
302.14 home beds and further provided that, if the total costs of new
302.15 construction, replacement, remodeling, or renovation exceed ten
302.16 percent of the appraised value of the facility or $200,000,
302.17 whichever is less, the facility makes a written commitment to
302.18 the commissioner of human services that it will not seek to
302.19 receive an increase in its property-related payment rate by
302.20 reason of the new construction, replacement, remodeling, or
302.21 renovation. The provisions contained in section 144A.073
302.22 regarding the upgrading of facilities do not apply to facilities
302.23 that satisfy these requirements;
302.24 (h) to license as a nursing home and certify as a nursing
302.25 facility a facility that is licensed as a boarding care facility
302.26 but not certified under the medical assistance program, but only
302.27 if the commissioner of human services certifies to the
302.28 commissioner of health that licensing the facility as a nursing
302.29 home and certifying the facility as a nursing facility will
302.30 result in a net annual savings to the state general fund of
302.31 $200,000 or more;
302.32 (i) to certify, after September 30, 1992, and prior to July
302.33 1, 1993, existing nursing home beds in a facility that was
302.34 licensed and in operation prior to January 1, 1992;
302.35 (j) to license and certify new nursing home beds to replace
302.36 beds in a facility acquired by the Minneapolis community
303.1 development agency as part of redevelopment activities in a city
303.2 of the first class, provided the new facility is located within
303.3 three miles of the site of the old facility. Operating and
303.4 property costs for the new facility must be determined and
303.5 allowed under section 256B.431 or 256B.434;
303.6 (k) to license and certify up to 20 new nursing home beds
303.7 in a community-operated hospital and attached convalescent and
303.8 nursing care facility with 40 beds on April 21, 1991, that
303.9 suspended operation of the hospital in April 1986. The
303.10 commissioner of human services shall provide the facility with
303.11 the same per diem property-related payment rate for each
303.12 additional licensed and certified bed as it will receive for its
303.13 existing 40 beds;
303.14 (l) to license or certify beds in renovation, replacement,
303.15 or upgrading projects as defined in section 144A.073,
303.16 subdivision 1, so long as the cumulative total costs of the
303.17 facility's remodeling projects do not
303.18 exceed $750,000 $1,000,000;
303.19 (m) to license and certify beds that are moved from one
303.20 location to another for the purposes of converting up to five
303.21 four-bed wards to single or double occupancy rooms in a nursing
303.22 home that, as of January 1, 1993, was county-owned and had a
303.23 licensed capacity of 115 beds;
303.24 (n) to allow a facility that on April 16, 1993, was a
303.25 106-bed licensed and certified nursing facility located in
303.26 Minneapolis to layaway all of its licensed and certified nursing
303.27 home beds. These beds may be relicensed and recertified in a
303.28 newly-constructed teaching nursing home facility affiliated with
303.29 a teaching hospital upon approval by the legislature. The
303.30 proposal must be developed in consultation with the interagency
303.31 committee on long-term care planning. The beds on layaway
303.32 status shall have the same status as voluntarily delicensed and
303.33 decertified beds, except that beds on layaway status remain
303.34 subject to the surcharge in section 256.9657. This layaway
303.35 provision expires July 1, 1998;
303.36 (o) to allow a project which will be completed in
304.1 conjunction with an approved moratorium exception project for a
304.2 nursing home in southern Cass county and which is directly
304.3 related to that portion of the facility that must be repaired,
304.4 renovated, or replaced, to correct an emergency plumbing problem
304.5 for which a state correction order has been issued and which
304.6 must be corrected by August 31, 1993;
304.7 (p) to allow a facility that on April 16, 1993, was a
304.8 368-bed licensed and certified nursing facility located in
304.9 Minneapolis to layaway, upon 30 days prior written notice to the
304.10 commissioner, up to 30 of the facility's licensed and certified
304.11 beds by converting three-bed wards to single or double
304.12 occupancy. Beds on layaway status shall have the same status as
304.13 voluntarily delicensed and decertified beds except that beds on
304.14 layaway status remain subject to the surcharge in section
304.15 256.9657, remain subject to the license application and renewal
304.16 fees under section 144A.07 and shall be subject to a $100 per
304.17 bed reactivation fee. In addition, at any time within three
304.18 years of the effective date of the layaway, the beds on layaway
304.19 status may be:
304.20 (1) relicensed and recertified upon relocation and
304.21 reactivation of some or all of the beds to an existing licensed
304.22 and certified facility or facilities located in Pine River,
304.23 Brainerd, or International Falls; provided that the total
304.24 project construction costs related to the relocation of beds
304.25 from layaway status for any facility receiving relocated beds
304.26 may not exceed the dollar threshold provided in subdivision 2
304.27 unless the construction project has been approved through the
304.28 moratorium exception process under section 144A.073;
304.29 (2) relicensed and recertified, upon reactivation of some
304.30 or all of the beds within the facility which placed the beds in
304.31 layaway status, if the commissioner has determined a need for
304.32 the reactivation of the beds on layaway status.
304.33 The property-related payment rate of a facility placing
304.34 beds on layaway status must be adjusted by the incremental
304.35 change in its rental per diem after recalculating the rental per
304.36 diem as provided in section 256B.431, subdivision 3a, paragraph
305.1 (c). The property-related payment rate for a facility
305.2 relicensing and recertifying beds from layaway status must be
305.3 adjusted by the incremental change in its rental per diem after
305.4 recalculating its rental per diem using the number of beds after
305.5 the relicensing to establish the facility's capacity day
305.6 divisor, which shall be effective the first day of the month
305.7 following the month in which the relicensing and recertification
305.8 became effective. Any beds remaining on layaway status more
305.9 than three years after the date the layaway status became
305.10 effective must be removed from layaway status and immediately
305.11 delicensed and decertified;
305.12 (q) to license and certify beds in a renovation and
305.13 remodeling project to convert 12 four-bed wards into 24 two-bed
305.14 rooms, expand space, and add improvements in a nursing home
305.15 that, as of January 1, 1994, met the following conditions: the
305.16 nursing home was located in Ramsey county; had a licensed
305.17 capacity of 154 beds; and had been ranked among the top 15
305.18 applicants by the 1993 moratorium exceptions advisory review
305.19 panel. The total project construction cost estimate for this
305.20 project must not exceed the cost estimate submitted in
305.21 connection with the 1993 moratorium exception process;
305.22 (r) to license and certify up to 117 beds that are
305.23 relocated from a licensed and certified 138-bed nursing facility
305.24 located in St. Paul to a hospital with 130 licensed hospital
305.25 beds located in South St. Paul, provided that the nursing
305.26 facility and hospital are owned by the same or a related
305.27 organization and that prior to the date the relocation is
305.28 completed the hospital ceases operation of its inpatient
305.29 hospital services at that hospital. After relocation, the
305.30 nursing facility's status under section 256B.431, subdivision
305.31 2j, shall be the same as it was prior to relocation. The
305.32 nursing facility's property-related payment rate resulting from
305.33 the project authorized in this paragraph shall become effective
305.34 no earlier than April 1, 1996. For purposes of calculating the
305.35 incremental change in the facility's rental per diem resulting
305.36 from this project, the allowable appraised value of the nursing
306.1 facility portion of the existing health care facility physical
306.2 plant prior to the renovation and relocation may not exceed
306.3 $2,490,000;
306.4 (s) to license and certify two beds in a facility to
306.5 replace beds that were voluntarily delicensed and decertified on
306.6 June 28, 1991;
306.7 (t) to allow 16 licensed and certified beds located on July
306.8 1, 1994, in a 142-bed nursing home and 21-bed boarding care home
306.9 facility in Minneapolis, notwithstanding the licensure and
306.10 certification after July 1, 1995, of the Minneapolis facility as
306.11 a 147-bed nursing home facility after completion of a
306.12 construction project approved in 1993 under section 144A.073, to
306.13 be laid away upon 30 days' prior written notice to the
306.14 commissioner. Beds on layaway status shall have the same status
306.15 as voluntarily delicensed or decertified beds except that they
306.16 shall remain subject to the surcharge in section 256.9657. The
306.17 16 beds on layaway status may be relicensed as nursing home beds
306.18 and recertified at any time within five years of the effective
306.19 date of the layaway upon relocation of some or all of the beds
306.20 to a licensed and certified facility located in Watertown,
306.21 provided that the total project construction costs related to
306.22 the relocation of beds from layaway status for the Watertown
306.23 facility may not exceed the dollar threshold provided in
306.24 subdivision 2 unless the construction project has been approved
306.25 through the moratorium exception process under section 144A.073.
306.26 The property-related payment rate of the facility placing
306.27 beds on layaway status must be adjusted by the incremental
306.28 change in its rental per diem after recalculating the rental per
306.29 diem as provided in section 256B.431, subdivision 3a, paragraph
306.30 (c). The property-related payment rate for the facility
306.31 relicensing and recertifying beds from layaway status must be
306.32 adjusted by the incremental change in its rental per diem after
306.33 recalculating its rental per diem using the number of beds after
306.34 the relicensing to establish the facility's capacity day
306.35 divisor, which shall be effective the first day of the month
306.36 following the month in which the relicensing and recertification
307.1 became effective. Any beds remaining on layaway status more
307.2 than five years after the date the layaway status became
307.3 effective must be removed from layaway status and immediately
307.4 delicensed and decertified;
307.5 (u) to license and certify beds that are moved within an
307.6 existing area of a facility or to a newly constructed addition
307.7 which is built for the purpose of eliminating three- and
307.8 four-bed rooms and adding space for dining, lounge areas,
307.9 bathing rooms, and ancillary service areas in a nursing home
307.10 that, as of January 1, 1995, was located in Fridley and had a
307.11 licensed capacity of 129 beds;
307.12 (v) to relocate 36 beds in Crow Wing county and four beds
307.13 from Hennepin county to a 160-bed facility in Crow Wing county,
307.14 provided all the affected beds are under common ownership;
307.15 (w) to license and certify a total replacement project of
307.16 up to 49 beds located in Norman county that are relocated from a
307.17 nursing home destroyed by flood and whose residents were
307.18 relocated to other nursing homes. The operating cost payment
307.19 rates for the new nursing facility shall be determined based on
307.20 the interim and settle-up payment provisions of Minnesota Rules,
307.21 part 9549.0057, and the reimbursement provisions of section
307.22 256B.431, except that subdivision 26, paragraphs (a) and (b),
307.23 shall not apply until the second rate year after the settle-up
307.24 cost report is filed. Property-related reimbursement rates
307.25 shall be determined under section 256B.431, taking into account
307.26 any federal or state flood-related loans or grants provided to
307.27 the facility;
307.28 (x) to license and certify a total replacement project of
307.29 up to 129 beds located in Polk county that are relocated from a
307.30 nursing home destroyed by flood and whose residents were
307.31 relocated to other nursing homes. The operating cost payment
307.32 rates for the new nursing facility shall be determined based on
307.33 the interim and settle-up payment provisions of Minnesota Rules,
307.34 part 9549.0057, and the reimbursement provisions of section
307.35 256B.431, except that subdivision 26, paragraphs (a) and (b),
307.36 shall not apply until the second rate year after the settle-up
308.1 cost report is filed. Property-related reimbursement rates
308.2 shall be determined under section 256B.431, taking into account
308.3 any federal or state flood-related loans or grants provided to
308.4 the facility;
308.5 (y) to license and certify beds in a renovation and
308.6 remodeling project to convert 13 three-bed wards into 13 two-bed
308.7 rooms and 13 single-bed rooms, expand space, and add
308.8 improvements in a nursing home that, as of January 1, 1994, met
308.9 the following conditions: the nursing home was located in
308.10 Ramsey county, was not owned by a hospital corporation, had a
308.11 licensed capacity of 64 beds, and had been ranked among the top
308.12 15 applicants by the 1993 moratorium exceptions advisory review
308.13 panel. The total project construction cost estimate for this
308.14 project must not exceed the cost estimate submitted in
308.15 connection with the 1993 moratorium exception process;
308.16 (z) to license and certify up to 150 nursing home beds to
308.17 replace an existing 285 bed nursing facility located in St.
308.18 Paul. The replacement project shall include both the renovation
308.19 of existing buildings and the construction of new facilities at
308.20 the existing site. The reduction in the licensed capacity of
308.21 the existing facility shall occur during the construction
308.22 project as beds are taken out of service due to the construction
308.23 process. Prior to the start of the construction process, the
308.24 facility shall provide written information to the commissioner
308.25 of health describing the process for bed reduction, plans for
308.26 the relocation of residents, and the estimated construction
308.27 schedule. The relocation of residents shall be in accordance
308.28 with the provisions of law and rule;
308.29 (aa) to allow the commissioner of human services to license
308.30 an additional 36 beds to provide residential services for the
308.31 physically handicapped under Minnesota Rules, parts 9570.2000 to
308.32 9570.3400, in a 198-bed nursing home located in Red Wing,
308.33 provided that the total number of licensed and certified beds at
308.34 the facility does not increase;
308.35 (bb) to license and certify a new facility in St. Louis
308.36 county with 44 beds constructed to replace an existing facility
309.1 in St. Louis county with 31 beds, which has resident rooms on
309.2 two separate floors and an antiquated elevator that creates
309.3 safety concerns for residents and prevents nonambulatory
309.4 residents from residing on the second floor. The project shall
309.5 include the elimination of three- and four-bed rooms;
309.6 (cc) to license and certify four beds in a 16-bed certified
309.7 boarding care home in Minneapolis to replace beds that were
309.8 voluntarily delicensed and decertified on or before March 31,
309.9 1992. The licensure and certification is conditional upon the
309.10 facility periodically assessing and adjusting its resident mix
309.11 and other factors which may contribute to a potential
309.12 institution for mental disease declaration. The commissioner of
309.13 human services shall retain the authority to audit the facility
309.14 at any time and shall require the facility to comply with any
309.15 requirements necessary to prevent an institution for mental
309.16 disease declaration, including delicensure and decertification
309.17 of beds, if necessary; or
309.18 (dd) to license and certify 72 beds in an existing facility
309.19 in Mille Lacs county with 80 beds as part of a renovation
309.20 project. The renovation must include construction of an
309.21 addition to accommodate ten residents with beginning and
309.22 midstage dementia in a self-contained living unit; creation of
309.23 three resident households where dining, activities, and support
309.24 spaces are located near resident living quarters; designation of
309.25 four beds for rehabilitation in a self-contained area;
309.26 designation of 30 private rooms; and other improvements.;
309.27 (ee) to license and certify beds in a facility that has
309.28 undergone replacement or remodeling as part of a planned closure
309.29 under section 256B.437;
309.30 (ff) to license and certify a total replacement project of
309.31 up to 124 beds located in Wilkin county that are in need of
309.32 relocation from a nursing home substantially destroyed by
309.33 flood. The operating cost payment rates for the new nursing
309.34 facility shall be determined based on the interim and settle-up
309.35 payment provisions of Minnesota Rules, part 9549.0057, and the
309.36 reimbursement provisions of section 256B.431, except that
310.1 section 256B.431, subdivision 26, paragraphs (a) and (b), shall
310.2 not apply until the second rate year after the settle-up cost
310.3 report is filed. Property-related reimbursement rates shall be
310.4 determined under section 256B.431, taking into account any
310.5 federal or state flood-related loans or grants provided to the
310.6 facility;
310.7 (gg) to allow the commissioner of human services to license
310.8 an additional nine beds to provide residential services for the
310.9 physically handicapped under Minnesota Rules, parts 9570.2000 to
310.10 9570.3400, in a 215-bed nursing home located in Duluth, provided
310.11 that the total number of licensed and certified beds at the
310.12 facility does not increase;
310.13 (hh) to license and certify up to 120 new nursing facility
310.14 beds to replace beds in a facility in Anoka county, which was
310.15 licensed for 98 beds as of July 1, 2000, provided the new
310.16 facility is located within four miles of the existing facility
310.17 and is in Anoka county. Operating and property rates shall be
310.18 determined and allowed under section 256B.431 and Minnesota
310.19 Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or
310.20 256B.435. The provisions of section 256B.431, subdivision 26,
310.21 paragraphs (a) and (b), do not apply until the second rate year
310.22 following settle-up; or
310.23 (ii) to transfer up to 98 beds of a 129-licensed bed
310.24 facility located in Anoka county that, as of March 25, 2001, is
310.25 in the active process of closing, to a 122-licensed bed
310.26 nonprofit nursing facility located in the city of Columbia
310.27 Heights or its affiliate. The transfer is effective when the
310.28 receiving facility notifies the commissioner in writing of the
310.29 number of beds accepted. The commissioner shall place all
310.30 transferred beds on layaway status held in the name of the
310.31 receiving facility. The layaway adjustment provisions of
310.32 section 256B.431, subdivision 30, do not apply to this layaway.
310.33 The receiving facility may only remove the beds from layaway for
310.34 recertification and relicensure at the receiving facility's
310.35 current site, or at a newly constructed facility located in
310.36 Anoka county. The receiving facility must receive statutory
311.1 authorization before removing these beds from layaway.
311.2 Sec. 6. Minnesota Statutes 2000, section 144A.073,
311.3 subdivision 2, is amended to read:
311.4 Subd. 2. [REQUEST FOR PROPOSALS.] At the authorization by
311.5 the legislature of additional medical assistance expenditures
311.6 for exceptions to the moratorium on nursing homes, the
311.7 interagency committee shall publish in the State Register a
311.8 request for proposals for nursing home projects to be licensed
311.9 or certified under section 144A.071, subdivision 4a, clause
311.10 (c). The public notice of this funding and the request for
311.11 proposals must specify how the approval criteria will be
311.12 prioritized by the advisory review panel, the interagency
311.13 long-term care planning committee, and the commissioner. The
311.14 notice must describe the information that must accompany a
311.15 request and state that proposals must be submitted to the
311.16 interagency committee within 90 days of the date of
311.17 publication. The notice must include the amount of the
311.18 legislative appropriation available for the additional costs to
311.19 the medical assistance program of projects approved under this
311.20 section. If no money is appropriated for a year, the
311.21 interagency committee shall publish a notice to that effect, and
311.22 no proposals shall be requested. If money is appropriated, the
311.23 interagency committee shall initiate the application and review
311.24 process described in this section at least twice each biennium
311.25 and up to four times each biennium, according to dates
311.26 established by rule. Authorized funds shall be allocated
311.27 proportionally to the number of processes. Funds not encumbered
311.28 by an earlier process within a biennium shall carry forward to
311.29 subsequent iterations of the process. Authorization for
311.30 expenditures does not carry forward into the following
311.31 biennium. To be considered for approval, a proposal must
311.32 include the following information:
311.33 (1) whether the request is for renovation, replacement,
311.34 upgrading, conversion, or relocation;
311.35 (2) a description of the problem the project is designed to
311.36 address;
312.1 (3) a description of the proposed project;
312.2 (4) an analysis of projected costs of the nursing facility
312.3 proposal, which are not required to exceed the cost threshold
312.4 referred to in section 144A.071, subdivision 1, to be considered
312.5 under this section, including initial construction and
312.6 remodeling costs; site preparation costs; technology costs;
312.7 financing costs, including the current estimated long-term
312.8 financing costs of the proposal, which consists of estimates of
312.9 the amount and sources of money, reserves if required under the
312.10 proposed funding mechanism, annual payments schedule, interest
312.11 rates, length of term, closing costs and fees, insurance costs,
312.12 and any completed marketing study or underwriting review; and
312.13 estimated operating costs during the first two years after
312.14 completion of the project;
312.15 (5) for proposals involving replacement of all or part of a
312.16 facility, the proposed location of the replacement facility and
312.17 an estimate of the cost of addressing the problem through
312.18 renovation;
312.19 (6) for proposals involving renovation, an estimate of the
312.20 cost of addressing the problem through replacement;
312.21 (7) the proposed timetable for commencing construction and
312.22 completing the project;
312.23 (8) a statement of any licensure or certification issues,
312.24 such as certification survey deficiencies;
312.25 (9) the proposed relocation plan for current residents if
312.26 beds are to be closed so that the department of human services
312.27 can estimate the total costs of a proposal; and
312.28 (10) other information required by permanent rule of the
312.29 commissioner of health in accordance with subdivisions 4 and 8.
312.30 Sec. 7. Minnesota Statutes 2000, section 144A.073,
312.31 subdivision 4, is amended to read:
312.32 Subd. 4. [CRITERIA FOR REVIEW.] The following criteria
312.33 shall be used in a consistent manner to compare, evaluate, and
312.34 rank all proposals submitted. Except for the criteria specified
312.35 in clause (3), the application of criteria listed under this
312.36 subdivision shall not reflect any distinction based on the
313.1 geographic location of the proposed project:
313.2 (1) the extent to which the proposal furthers state
313.3 long-term care goals, including the goals stated in section
313.4 144A.31, and including the goal of enhancing the availability
313.5 and use of alternative care services and the goal of reducing
313.6 the number of long-term care resident rooms with more than two
313.7 beds;
313.8 (2) the proposal's long-term effects on state costs
313.9 including the cost estimate of the project according to section
313.10 144A.071, subdivision 5a;
313.11 (3) the extent to which the proposal promotes equitable
313.12 access to long-term care services in nursing homes through
313.13 redistribution of the nursing home bed supply, as measured by
313.14 the number of beds relative to the population 85 or older,
313.15 projected to the year 2000 by the state demographer, and
313.16 according to items (i) to (iv):
313.17 (i) reduce beds in counties where the supply is high,
313.18 relative to the statewide mean, and increase beds in counties
313.19 where the supply is low, relative to the statewide mean;
313.20 (ii) adjust the bed supply so as to create the greatest
313.21 benefits in improving the distribution of beds;
313.22 (iii) adjust the existing bed supply in counties so that
313.23 the bed supply in a county moves toward the statewide mean; and
313.24 (iv) adjust the existing bed supply so that the
313.25 distribution of beds as projected for the year 2020 would be
313.26 consistent with projected need, based on the methodology
313.27 outlined in the interagency long-term care committee's 1993
313.28 nursing home bed distribution study;
313.29 (4) the extent to which the project improves conditions
313.30 that affect the health or safety of residents, such as narrow
313.31 corridors, narrow door frames, unenclosed fire exits, and wood
313.32 frame construction, and similar provisions contained in fire and
313.33 life safety codes and licensure and certification rules;
313.34 (5) the extent to which the project improves conditions
313.35 that affect the comfort or quality of life of residents in a
313.36 facility or the ability of the facility to provide efficient
314.1 care, such as a relatively high number of residents in a room;
314.2 inadequate lighting or ventilation; poor access to bathing or
314.3 toilet facilities; a lack of available ancillary space for
314.4 dining rooms, day rooms, or rooms used for other activities;
314.5 problems relating to heating, cooling, or energy efficiency;
314.6 inefficient location of nursing stations; narrow corridors; or
314.7 other provisions contained in the licensure and certification
314.8 rules;
314.9 (6) the extent to which the applicant demonstrates the
314.10 delivery of quality care, as defined in state and federal
314.11 statutes and rules, to residents as evidenced by the two most
314.12 recent state agency certification surveys and the applicants'
314.13 response to those surveys;
314.14 (7) the extent to which the project removes the need for
314.15 waivers or variances previously granted by either the licensing
314.16 agency, certifying agency, fire marshal, or local government
314.17 entity; and
314.18 (8) the extent to which the project increases the number of
314.19 private or single bed rooms; and
314.20 (9) other factors that may be developed in permanent rule
314.21 by the commissioner of health that evaluate and assess how the
314.22 proposed project will further promote or protect the health,
314.23 safety, comfort, treatment, or well-being of the facility's
314.24 residents.
314.25 Sec. 8. [144A.185] [DEFINITIONS.]
314.26 Subdivision 1. [APPLICABILITY.] For purposes of sections
314.27 144A.185 to 144A.1887, the terms defined in this section have
314.28 the meanings given them.
314.29 Subd. 2. [CLOSURE.] "Closure" means the cessation of
314.30 operations of a nursing home and the delicensure or
314.31 decertification of all beds within the facility.
314.32 Subd. 3. [CURTAILMENT, REDUCTION, OR CHANGE IN
314.33 OPERATIONS.] "Curtailment, reduction, or change in operations"
314.34 means any change in operations or services that would result in
314.35 or encourage the relocation of residents.
314.36 Subd. 4. [FACILITY.] "Facility" means a licensed nursing
315.1 home or a certified boarding care home licensed according to
315.2 sections 144.50 to 144.56.
315.3 Subd. 5. [LICENSEE.] "Licensee" means the owner of the
315.4 facility or the owner's designee or the commissioner of health
315.5 for a facility in receivership.
315.6 Subd. 6. [LOCAL AGENCY.] "Local agency" means a county or
315.7 a multicounty social service agency authorized under section
315.8 393.01 as the agency responsible for providing social services
315.9 for the county in which the facility is located.
315.10 Subd. 7. [PLAN.] "Plan" means a process developed under
315.11 section 144A.186 for the closure or curtailment, reduction, or
315.12 change in operations of a facility and for the subsequent
315.13 relocation of residents.
315.14 Subd. 8. [RELOCATION.] "Relocation" means the discharge of
315.15 a resident and movement of the resident to another facility or
315.16 living arrangement as a result of a closure or curtailment,
315.17 reduction, or change in operations of a facility.
315.18 Sec. 9. [144A.1855] [INITIAL NOTICE.]
315.19 Subdivision 1. [NOTIFICATION; PARTIES.] A licensee shall
315.20 notify the following parties in writing when there is an intent
315.21 to close or curtail, reduce, or change operations which would
315.22 result in or encourage the relocation of residents:
315.23 (1) the commissioner of health;
315.24 (2) the commissioner of human services;
315.25 (3) the local agency;
315.26 (4) the office of the ombudsman for older Minnesotans; and
315.27 (5) the office of the ombudsman for mental health and
315.28 mental retardation.
315.29 Subd. 2. [NOTICE REQUIREMENTS.] The written notice shall
315.30 include the names, telephone numbers, fax numbers, and e-mail
315.31 addresses of the persons in the facility who are responsible for
315.32 coordinating the facility's efforts in the planning process and
315.33 the number of residents potentially affected by the closure or
315.34 curtailment, reduction, or change in operations.
315.35 Sec. 10. [144A.186] [PLANNING PROCESS.]
315.36 Subdivision 1. [LOCAL AGENCY REQUIREMENTS.] (a) A local
316.1 agency, within five working days of receiving an initial notice
316.2 from a licensee according to section 144A.1855, shall provide
316.3 all parties identified in section 144A.1855, subdivision 1, with
316.4 the names, telephone numbers, fax numbers, and e-mail addresses
316.5 of those persons who are responsible for coordinating local
316.6 agency efforts in the planning process.
316.7 (b) Within ten working days of receipt of the notice under
316.8 paragraph (a), the local agency and licensee shall meet to
316.9 develop the relocation plan under subdivision 2. The local
316.10 agency shall inform the departments of health and human
316.11 services, the office of the ombudsman for older Minnesotans, and
316.12 the office of the ombudsman for mental health and mental
316.13 retardation of the date, time, and location of the meeting so
316.14 that their representatives may attend. The relocation plan must
316.15 be completed within 45 days, but may be completed earlier
316.16 according to a schedule agreed to by all parties.
316.17 Subd. 2. [RELOCATION PLAN.] (a) The plan shall:
316.18 (1) identify the expected date of closure or curtailment,
316.19 reduction, or change in operations;
316.20 (2) outline the process for public notification of the
316.21 closure or curtailment, reduction, or change in operations;
316.22 (3) outline the process to ensure 60-day advance written
316.23 notice to residents, family members, and designated
316.24 representatives of residents;
316.25 (4) present an aggregate description of the resident
316.26 population remaining to be relocated and the population's needs;
316.27 (5) outline the individual resident assessment process to
316.28 be used;
316.29 (6) identify an inventory of available relocation options,
316.30 including home and community-based services;
316.31 (7) identify a timeline for submission of the list required
316.32 under section 144A.1865, subdivision 3; and
316.33 (8) identify a schedule for each element of the plan.
316.34 (b) All parties to the plan shall refrain from any public
316.35 notification of the intent to close or curtail, reduce, or
316.36 change operations until a relocation plan has been established.
317.1 Sec. 11. [144A.1865] [REQUIREMENTS OF LICENSEE.]
317.2 Subdivision 1. [RELOCATION.] The licensee shall provide
317.3 for the safe, orderly, and appropriate relocation of residents.
317.4 The licensee and facility staff shall cooperate with
317.5 representatives from the local agency, the departments of health
317.6 and human services, the office of the ombudsman for older
317.7 Minnesotans, and the office of the ombudsman for mental health
317.8 and mental retardation in planning for and implementing the
317.9 relocation of residents.
317.10 Subd. 2. [INTERDISCIPLINARY TEAM.] The licensee shall
317.11 establish an interdisciplinary team responsible for coordinating
317.12 and implementing the plan under section 144A.186, subdivision
317.13 2. The interdisciplinary team shall include representatives
317.14 from the local agency, the office of the ombudsman for older
317.15 Minnesotans, facility staff who provide direct care services to
317.16 the residents, and the facility administration.
317.17 Subd. 3. [RESIDENT LISTS.] The licensee shall provide a
317.18 list to the local agency that includes the following information
317.19 on each resident to be relocated:
317.20 (1) name;
317.21 (2) date of birth;
317.22 (3) social security number;
317.23 (4) medical assistance ID number;
317.24 (5) all diagnoses; and
317.25 (6) name of and contact information for the resident's
317.26 family or other designated representative.
317.27 Subd. 4. [CONSULTATION WITH LOCAL AGENCY.] The licensee
317.28 shall consult with the local agency on the availability and
317.29 development of resources and in the resident relocation process.
317.30 [EFFECTIVE DATE.] This section is effective the day
317.31 following final enactment.
317.32 Sec. 12. [144A.187] [RESIDENT AND PHYSICIAN NOTICE.]
317.33 Subdivision 1. [RESIDENT NOTICE REQUIRED.] (a) At least 60
317.34 days before the proposed date of closure or curtailment,
317.35 reduction, or change in operations as agreed to in the plan
317.36 under section 144A.186, the licensee shall send a written notice
318.1 of closure or curtailment, reduction, or change in operations to
318.2 each resident being relocated, the resident's family member or
318.3 designated representative, and the resident's attending
318.4 physician.
318.5 (b) The notice must include:
318.6 (1) the date of the proposed closure or curtailment,
318.7 reduction, or change in operations;
318.8 (2) the name, address, telephone number, fax number, and
318.9 e-mail address of the individuals in the facility responsible
318.10 for providing assistance and information;
318.11 (3) a notice of upcoming meetings for residents, families
318.12 and designated representatives, and resident and family councils
318.13 to discuss the relocation of residents;
318.14 (4) the name, address, and telephone number of the local
318.15 agency contact person;
318.16 (5) the name, address, and telephone number of the office
318.17 of the ombudsman for older Minnesotans and the office of the
318.18 ombudsman for mental health and mental retardation; and
318.19 (6) a notice of resident rights during discharge and
318.20 relocation.
318.21 (c) The notice to residents must comply with all applicable
318.22 state and federal requirements for notice of transfer or
318.23 discharge of nursing home residents.
318.24 Subd. 2. [MEDICAL INFORMATION REQUEST.] The licensee shall
318.25 request the attending physician to furnish the licensee with, or
318.26 arrange for the release of, any medical information needed to
318.27 update a resident's medical records and to prepare transfer
318.28 forms and discharge summaries.
318.29 Sec. 13. [144A.1875] [RELOCATION OF RESIDENTS.]
318.30 Subdivision 1. [PREPARATION; PLACEMENT INFORMATION.] A
318.31 licensee shall provide sufficient preparation to residents to
318.32 ensure safe, orderly, and appropriate discharge and relocation.
318.33 The facility is responsible for assisting residents in finding
318.34 placement within the resident's desired geographic location
318.35 using the Senior LinkAge database of the department of human
318.36 services. By January 1, 2002, Senior LinkAge line shall make
319.1 available via a Web site the name, address, and telephone and
319.2 fax numbers of each facility with available beds, the
319.3 certification level of the available beds, the types of services
319.4 available, and the number of beds that are available as updated
319.5 daily by the licensee. The Web site shall include the
319.6 information required by section 256.975, subdivision 7,
319.7 paragraph (b), clause (1), and home and community-based services
319.8 and other options for individuals with special needs. The
319.9 licensee must provide residents, their families or designated
319.10 representatives, the office of the ombudsman for older
319.11 Minnesotans, the office of the ombudsman for mental health and
319.12 mental retardation, and the local agency with the toll-free
319.13 number and Web site address for the Senior LinkAge line.
319.14 Subd. 2. [RESIDENT AND FAMILY MEETINGS.] After preparing
319.15 the plan according to section 144A.186, the licensee shall
319.16 conduct meetings with residents, families and designated
319.17 representatives, and resident and family councils to notify them
319.18 of the process for resident relocation. Representatives from
319.19 the local agency, the office of the ombudsman for older
319.20 Minnesotans, the office of the ombudsman for mental health and
319.21 mental retardation, the departments of health and human services
319.22 shall receive advance notice of these meetings.
319.23 Subd. 3. [PERSONAL PROPERTY.] (a) The licensee shall
319.24 update the inventory of residents' personal possessions and
319.25 provide a copy of the final inventory to each resident and the
319.26 resident's family or designated representative prior to the
319.27 relocation of the resident. The licensee is responsible for the
319.28 timely transfer of a resident's possessions for all relocations
319.29 within the state and within a 50-mile radius of the facility for
319.30 relocations outside the state.
319.31 (b) The licensee shall complete a final accounting of
319.32 personal funds held in trust by the licensee and provide a copy
319.33 of the accounting to each resident and the resident's family or
319.34 designated representative. The licensee is responsible for the
319.35 timely transfer of all personal funds held in trust by the
319.36 licensee.
320.1 Subd. 4. [SITE VISITS.] The licensee is responsible for
320.2 assisting residents desiring to make site visits to facilities
320.3 or other placements to which the resident may be relocated,
320.4 unless it is medically inadvisable, as documented by the
320.5 attending physician in the resident's care record. The licensee
320.6 shall provide, or make arrangements for, transportation for site
320.7 visits to facilities or other placements within a 50-mile radius.
320.8 Subd. 5. [FINAL NOTICE OF RELOCATION.] (a) Before
320.9 relocating a resident, the licensee shall provide a final
320.10 written notice to the resident, the resident's family or
320.11 designated representative, and the resident's attending
320.12 physician.
320.13 (b) The final written notice shall:
320.14 (1) be provided seven days before the relocation of a
320.15 resident, unless the resident agrees to waive the resident's
320.16 right to advance notice; and
320.17 (2) identify the date of the anticipated relocation and the
320.18 location to which the resident is being relocated.
320.19 Subd. 6. [ADMINISTRATIVE DUTIES.] (a) All administrative
320.20 duties of the licensee under subdivisions 1, 2, 4, and 5 must be
320.21 completed before relocation of a resident.
320.22 (b) The licensee is responsible for providing the receiving
320.23 facility or other health, housing, or care entity with a
320.24 complete and accurate resident record, including information on
320.25 family members, designated representatives, guardians, social
320.26 service caseworkers, and other contact information. The record
320.27 must also include all information necessary to provide
320.28 appropriate medical care and social services, including, but not
320.29 limited to, information on preadmission screening, Level I and
320.30 Level II screening, minimum data set and all other assessments,
320.31 resident diagnosis, behavior, and medication.
320.32 (c) For residents with special care needs, the licensee
320.33 shall consult with the receiving facility or other placement
320.34 entity and provide staff training or other preparation as needed
320.35 to assist in providing for the special needs.
320.36 (d) The licensee shall assist residents with the transfer
321.1 or reconnection of telephone service. The licensee shall bear
321.2 all costs associated with reestablishing telephone service.
321.3 Subd. 7. [TRANSPORTATION; CONTINUITY OF CARE.] The
321.4 licensee shall make arrangements or provide for the
321.5 transportation of residents to the new facility or placement
321.6 within the state or within a 50-mile radius for relocations
321.7 outside the state. The licensee shall provide a staff person to
321.8 accompany the resident during transportation, upon request of
321.9 the resident, the resident's family, or designated
321.10 representative. The discharge and relocation of residents must
321.11 comply with all applicable state and federal requirements and
321.12 must be conducted in a safe, orderly, and appropriate manner.
321.13 The licensee must ensure that there is no disruption in
321.14 providing meals, medications, or treatments of a resident during
321.15 the relocation process.
321.16 Sec. 14. [144A.1885] [RELOCATION REPORTS.]
321.17 (a) Beginning the week following development of the initial
321.18 relocation plan under section 144A.186, the licensee shall
321.19 submit weekly status reports to the commissioners of health and
321.20 human services, or their designees, and to the local agency.
321.21 (b) The first status report must identify the relocation
321.22 plan developed under section 144A.186, the interdisciplinary
321.23 team members, and the number of residents to be relocated.
321.24 (c) Subsequent status reports must note any modifications
321.25 to the relocation plan, any change of interdisciplinary team
321.26 members or number of residents relocated, the placement
321.27 destination to which residents have been relocated, and the
321.28 number of residents remaining to be relocated. Subsequent
321.29 status reports must also identify issues or problems encountered
321.30 during the relocation process and the resolution of these issues.
321.31 Sec. 15. [144A.1886] [REQUIREMENTS OF LOCAL AGENCY.]
321.32 Subdivision 1. [MEETING; REPRESENTATION.] (a) The local
321.33 agency with the licensee shall convene a meeting to develop a
321.34 plan according to section 144A.186, subdivision 1, paragraph (b).
321.35 (b) The local agency shall designate a representative to
321.36 the interdisciplinary team established by the licensee
322.1 responsible for coordinating the relocation efforts.
322.2 Subd. 2. [RESOURCE.] (a) The local agency shall serve as a
322.3 resource in the relocation process.
322.4 (b) Concurrent with the notice sent to residents from the
322.5 licensee according to section 144A.187, subdivision 1, the local
322.6 agency shall provide written notice to residents, family
322.7 members, and designated representatives describing:
322.8 (1) the local agency's role in the relocation process and
322.9 in the follow-up to relocation;
322.10 (2) a local agency contact name, address, and telephone
322.11 number; and
322.12 (3) the name, address, and telephone number of the office
322.13 of the ombudsman for older Minnesotans and the office of the
322.14 ombudsman for mental health and mental retardation.
322.15 (c) The local agency is responsible for the safe and
322.16 orderly relocation of residents in cases where an emergent need
322.17 arises or when the licensee has abrogated the licensee's
322.18 responsibilities under the relocation plan.
322.19 Subd. 3. [COORDINATION; OVERSIGHT.] (a) The local agency
322.20 shall meet with appropriate facility staff to coordinate any
322.21 assistance. Coordination shall include participating in group
322.22 meetings with residents, family members, and designated
322.23 representatives to explain the transfer or relocation process.
322.24 (b) The local agency shall monitor compliance with all
322.25 components of the relocation plan. When the licensee is not in
322.26 compliance, the local agency shall notify the commissioners of
322.27 health and human services.
322.28 (c) Except as requested by the resident, family member, or
322.29 designated representative and within the parameters of the
322.30 Vulnerable Adults Act, the local agency may halt a relocation
322.31 that it deems inappropriate or dangerous to the health or safety
322.32 of a resident.
322.33 Subd. 4. [FOLLOW-UP REVIEW.] (a) A member of the local
322.34 agency staff shall visit residents relocated within 100 miles of
322.35 the county within 30 days after a relocation. Local agency
322.36 staff shall interview the resident and family member or
323.1 designated representative or shall observe the resident on-site,
323.2 or both, and review and discuss pertinent medical or social
323.3 records with appropriate facility staff to assess the adjustment
323.4 of the resident to the new placement, recommend services or
323.5 methods to meet any special needs of the resident, and identify
323.6 residents at risk.
323.7 (b) The local agency may conduct subsequent follow-up
323.8 visits in cases where the adjustment of the resident to the new
323.9 placement is in question.
323.10 (c) Within 60 days of the completion of the follow-up
323.11 visits, the local agency shall submit a written summary of the
323.12 follow-up work to the commissioners of health and human
323.13 services, in a manner approved by the commissioners.
323.14 (d) The local agency shall submit a report of any issues
323.15 that may require further review or monitoring to the
323.16 commissioner of health.
323.17 Sec. 16. [144A.1887] [FUNDING.]
323.18 (a) Within 60 days of a nursing home ceasing operations,
323.19 the commissioner of human services shall reimburse nursing homes
323.20 that are reimbursed under sections 256B.431, 256B.434, and
323.21 256B.435 for operating costs incurred by the nursing home during
323.22 the closure process. The amount to be reimbursed to the nursing
323.23 home shall be determined by applying paragraphs (b) to (f).
323.24 (b) The facility shall provide the commissioner of human
323.25 services with the nursing home's operating costs for the time
323.26 period of 30 days prior to the notice specified under section
323.27 144A.16, to 30 days after the nursing home's closure.
323.28 (c) The nursing home shall provide the commissioner of
323.29 human services with the number of medical assistance, Medicare,
323.30 private pay, and other resident days for the period referenced
323.31 in paragraph (b) by the 11 case mix categories.
323.32 (d) The commissioner of human services shall calculate a
323.33 nursing home closure rate by dividing the facility operating
323.34 costs in paragraph (b) by the total resident days in paragraph
323.35 (c).
323.36 (e) The total closure costs attributable to medical
324.1 assistance shall be determined by multiplying the nursing home
324.2 closure rate in paragraph (d) by the medical assistance days
324.3 provided by the nursing facility in paragraph (c).
324.4 (f) The amount to be reimbursed to the nursing home is
324.5 equal to the total closure costs in paragraph (e) minus the sum
324.6 of the nursing facility's 11 operating rates times their
324.7 respective number of medical assistance days by case mix as
324.8 referenced in paragraph (c).
324.9 Sec. 17. [144A.36] [TRANSITION PLANNING GRANTS.]
324.10 Subdivision 1. [DEFINITIONS.] "Eligible nursing home"
324.11 means any nursing home licensed under sections 144A.01 to
324.12 144A.16 and certified by the appropriate authority under United
324.13 States Code, title 42, sections 1396-1396p, to participate as a
324.14 vendor in the medical assistance program established under
324.15 chapter 256B.
324.16 Subd. 2. [GRANTS AUTHORIZED.] (a) The commissioner shall
324.17 establish a program of transition planning grants to assist
324.18 eligible nursing homes in implementing the provisions in
324.19 paragraphs (b) and (c).
324.20 (b) Transition planning grants may be used by nursing homes
324.21 to develop strategic plans which identify the appropriate
324.22 institutional and noninstitutional settings necessary to meet
324.23 the older adult service needs of the community.
324.24 (c) At a minimum, a strategic plan must consist of:
324.25 (1) a needs assessment to determine what older adult
324.26 services are needed and desired by the community;
324.27 (2) an assessment of the appropriate settings in which to
324.28 provide needed older adult services;
324.29 (3) an assessment identifying currently available services
324.30 and their settings in the community; and
324.31 (4) a transition plan to achieve the needed outcome
324.32 identified by the assessment.
324.33 Subd. 3. [ALLOCATION OF GRANTS.] (a) Eligible nursing
324.34 homes must apply to the commissioner no later than September 1
324.35 of each fiscal year for grants awarded in that fiscal year. A
324.36 grant shall be awarded upon signing of a grant contract.
325.1 (b) The commissioner must make a final decision on the
325.2 funding of each application within 60 days of the deadline for
325.3 receiving applications.
325.4 Subd. 4. [EVALUATION.] The commissioner shall evaluate the
325.5 overall effectiveness of the grant program. The commissioner
325.6 may collect, from the nursing homes receiving grants, the
325.7 information necessary to evaluate the grant program.
325.8 Information related to the financial condition of individual
325.9 nursing homes shall be classified as nonpublic data.
325.10 Sec. 18. [144A.37] [ALTERNATIVE NURSING HOME SURVEY
325.11 PROCESS.]
325.12 Subdivision 1. [ALTERNATIVE NURSING HOME SURVEY
325.13 SCHEDULES.] (a) The commissioner of health shall implement
325.14 alternative procedures for the nursing home survey process as
325.15 authorized under this section.
325.16 (b) These alternative survey process procedures seek to:
325.17 (1) use department resources more effectively and efficiently to
325.18 target problem areas; (2) use other existing or new mechanisms
325.19 to provide objective assessments of quality and to measure
325.20 quality improvement; (3) provide for frequent collaborative
325.21 interaction of facility staff and surveyors rather than a
325.22 punitive approach; and (4) reward a nursing home that has
325.23 performed very well by extending intervals between full surveys.
325.24 (c) The commissioner shall pursue changes in federal law
325.25 necessary to accomplish this process and shall apply for any
325.26 necessary federal waivers or approval. If a federal waiver is
325.27 approved, the commissioner shall promptly submit, to the house
325.28 and senate committees with jurisdiction over health and human
325.29 services policy and finance, fiscal estimates for implementing
325.30 the alternative survey process waiver. The commissioner shall
325.31 also pursue any necessary federal law changes during the 107th
325.32 Congress.
325.33 (d) The alternative nursing home survey schedule and
325.34 related educational activities shall not be implemented until
325.35 funding is appropriated by the legislature.
325.36 Subd. 2. [SURVEY INTERVALS.] The commissioner of health
326.1 must extend the time period between standard surveys up to 30
326.2 months based on the criteria established in subdivision 4. In
326.3 using the alternative survey schedule, the requirement for the
326.4 statewide average to not exceed 12 months does not apply.
326.5 Subd. 3. [COMPLIANCE HISTORY.] The commissioner shall
326.6 develop a process for identifying the survey cycles for skilled
326.7 nursing facilities based upon the compliance history of the
326.8 facility. This process can use a range of months for survey
326.9 intervals. At a minimum, the process must be based on
326.10 information from the last two survey cycles and shall take into
326.11 consideration any deficiencies issued as the result of a survey
326.12 or a complaint investigation during the interval. A skilled
326.13 nursing facility with a finding of substandard quality of care
326.14 or a finding of immediate jeopardy is not entitled to a survey
326.15 interval greater than 12 months. The commissioner shall alter
326.16 the survey cycle for a specific skilled nursing facility based
326.17 on findings identified through the completion of a survey, a
326.18 monitoring visit, or a complaint investigation. The
326.19 commissioner must also take into consideration information other
326.20 than the facility's compliance history.
326.21 Subd. 4. [CRITERIA FOR SURVEY INTERVAL
326.22 CLASSIFICATION.] (a) The commissioner shall provide public
326.23 notice of the classification process and shall identify the
326.24 selected survey cycles for each skilled nursing facility. The
326.25 classification system must be based on an analysis of the
326.26 findings made during the past two standard survey intervals, but
326.27 it only takes one survey or complaint finding to modify the
326.28 interval.
326.29 (b) The commissioner shall also take into consideration
326.30 information obtained from residents and family members in each
326.31 skilled nursing facility and from other sources such as
326.32 employees and ombudsmen in determining the appropriate survey
326.33 intervals for facilities.
326.34 Subd. 5. [REQUIRED MONITORING.] (a) The commissioner shall
326.35 conduct at least one monitoring visit on an annual basis for
326.36 every skilled nursing facility which has been selected for a
327.1 survey cycle greater than 12 months. The commissioner shall
327.2 develop protocols for the monitoring visits which shall be less
327.3 extensive than the requirements for a standard survey. The
327.4 commissioner shall use the criteria in paragraph (b) to
327.5 determine whether additional monitoring visits to a facility
327.6 will be required.
327.7 (b) The criteria shall include, but not be limited to, the
327.8 following:
327.9 (1) changes in ownership, administration of the facility,
327.10 or direction of the facility's nursing service;
327.11 (2) changes in the facility's quality indicators which
327.12 might evidence a decline in the facility's quality of care;
327.13 (3) reductions in staffing or an increase in the
327.14 utilization of temporary nursing personnel; and
327.15 (4) complaint information or other information that
327.16 identifies potential concerns for the quality of the care and
327.17 services provided in the skilled nursing facility.
327.18 Subd. 6. [SURVEY REQUIREMENTS FOR FACILITIES NOT APPROVED
327.19 FOR EXTENDED SURVEY INTERVALS.] The commissioner shall establish
327.20 a process for surveying and monitoring of facilities which
327.21 require a survey interval of less than 15 months. This
327.22 information shall identify the steps that the commissioner must
327.23 take to monitor the facility in addition to the standard survey.
327.24 Subd. 7. [IMPACT ON SURVEY AGENCY'S BUDGET.] The
327.25 implementation of an alternative survey process for the state
327.26 must not result in any reduction of funding that would have been
327.27 provided to the state survey agency for survey and enforcement
327.28 activity based upon the completion of full standard surveys for
327.29 each skilled nursing facility in the state.
327.30 Subd. 8. [EDUCATIONAL ACTIVITIES.] The commissioner shall
327.31 expand the state survey agency's ability to conduct training and
327.32 educational efforts for skilled nursing facilities, residents
327.33 and family members, residents and family councils, long-term
327.34 care ombudsman programs, and the general public.
327.35 Subd. 9. [EVALUATION.] The commissioner shall develop a
327.36 process for the evaluation of the effectiveness of an
328.1 alternative survey process conducted under this section.
328.2 [EFFECTIVE DATE.] This section is effective the day
328.3 following final enactment.
328.4 Sec. 19. [144A.38] [INNOVATIONS IN QUALITY DEMONSTRATION
328.5 GRANTS.]
328.6 Subdivision 1. [PROGRAM ESTABLISHED.] The commissioner of
328.7 health and the commissioner of human services shall establish a
328.8 long-term care grant program that demonstrates best practices
328.9 and innovation for long-term care service delivery and housing.
328.10 The grants must fund demonstrations that create new means and
328.11 models for serving the elderly or demonstrate creativity in
328.12 service provision through the scope of their program or service.
328.13 Subd. 2. [ELIGIBILITY.] Grants may only be made to those
328.14 who provide direct service or housing to the elderly within the
328.15 state. Grants may only be made for projects that show
328.16 innovations and measurable improvement in resident care, quality
328.17 of life, use of technology, or customer satisfaction.
328.18 Subd. 3. [AWARDING OF GRANTS.] (a) Applications for grants
328.19 must be made to the commissioners on forms prescribed by the
328.20 commissioners.
328.21 (b) The commissioners shall review applications and award
328.22 grants based on the following criteria:
328.23 (1) improvement in direct care to residents;
328.24 (2) increase in efficiency through the use of technology;
328.25 (3) increase in quality of care through the use of
328.26 technology;
328.27 (4) increase in the access and delivery of service;
328.28 (5) enhancement of nursing staff training;
328.29 (6) the effectiveness of the project as a demonstration;
328.30 and
328.31 (7) the immediate transferability of the project to scale.
328.32 (c) In reviewing applications and awarding grants, the
328.33 commissioners shall consult with long-term care providers,
328.34 consumers of long-term care, long-term care researchers, and
328.35 staff of other state agencies.
328.36 (d) Grants for eligible projects may not exceed $100,000.
329.1 Sec. 20. [144A.39] [LONG-TERM CARE QUALITY PROFILES.]
329.2 Subdivision l. [DEVELOPMENT AND IMPLEMENTATION OF QUALITY
329.3 PROFILES.] (a) The commissioner of health and the commissioner
329.4 of human services shall develop and implement a quality profile
329.5 system for nursing facilities and, beginning not later than July
329.6 1, 2003, other providers of long-term care services, except when
329.7 the quality profile system would duplicate requirements under
329.8 sections 256B.5011 and 256B.5013. The system must be developed
329.9 and implemented to the extent possible without the collection of
329.10 new data. To the extent possible, the system must incorporate
329.11 or be coordinated with information on quality maintained by area
329.12 agencies on aging, long-term care trade associations, and other
329.13 entities. The system must be designed to provide information on
329.14 quality:
329.15 (1) to consumers and their families to facilitate informed
329.16 choices of service providers;
329.17 (2) to providers to enable them to measure the results of
329.18 their quality improvement efforts and compare quality
329.19 achievements with other service providers; and
329.20 (3) to public and private purchasers of long-term care
329.21 services to enable them to purchase high-quality care.
329.22 (b) The system must be developed in consultation with the
329.23 long-term care task force, area agencies on aging, and
329.24 representatives of consumers, providers, and labor unions.
329.25 Within the limits of available appropriations, the commissioners
329.26 may employ consultants to assist with this project.
329.27 Subd. 2. [QUALITY MEASUREMENT TOOLS.] The commissioners
329.28 shall identify and apply existing quality measurement tools to:
329.29 (1) emphasize quality of care and its relationship to
329.30 quality of life; and
329.31 (2) address the needs of various users of long-term care
329.32 services, including, but not limited to, short-stay residents,
329.33 persons with behavioral problems, persons with dementia, and
329.34 persons who are members of minority groups.
329.35 The tools must be identified and applied, to the extent
329.36 possible, without requiring providers to supply information
330.1 beyond current state and federal requirements.
330.2 Subd. 3. [CONSUMER SURVEYS.] Following identification of
330.3 the quality measurement tool, the commissioners shall conduct
330.4 surveys of long-term care service consumers to develop quality
330.5 profiles of providers. To the extent possible, surveys must be
330.6 conducted face-to-face by state employees or contractors. At
330.7 the discretion of the commissioners, surveys may be conducted by
330.8 telephone or by provider staff. Surveys must be conducted
330.9 periodically to update quality profiles of individual service
330.10 providers.
330.11 Subd. 4. [DISSEMINATION OF QUALITY PROFILES.] By July 1,
330.12 2002, the commissioners shall implement a system to disseminate
330.13 the quality profiles developed from consumer surveys using the
330.14 quality measurement tool. Profiles must be disseminated to the
330.15 Senior LinkAge line and to consumers, providers, and purchasers
330.16 of long-term care services through all feasible printed and
330.17 electronic outlets. The commissioners shall conduct a public
330.18 awareness campaign to inform potential users regarding profile
330.19 contents and potential uses.
330.20 Sec. 21. Minnesota Statutes 2000, section 256B.431,
330.21 subdivision 17, is amended to read:
330.22 Subd. 17. [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.]
330.23 (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3,
330.24 for rate periods beginning on October 1, 1992, and for rate
330.25 years beginning after June 30, 1993, a nursing facility that (1)
330.26 has completed a construction project approved under section
330.27 144A.071, subdivision 4a, clause (m); (2) has completed a
330.28 construction project approved under section 144A.071,
330.29 subdivision 4a, and effective after June 30, 1995; or (3) has
330.30 completed a renovation, replacement, or upgrading project
330.31 approved under the moratorium exception process in section
330.32 144A.073 shall be reimbursed for costs directly identified to
330.33 that project as provided in subdivision 16 and this subdivision.
330.34 (b) Notwithstanding Minnesota Rules, part 9549.0060,
330.35 subparts 5, item A, subitems (1) and (3), and 7, item D,
330.36 allowable interest expense on debt shall include:
331.1 (1) interest expense on debt related to the cost of
331.2 purchasing or replacing depreciable equipment, excluding
331.3 vehicles, not to exceed six percent of the total historical cost
331.4 of the project; and
331.5 (2) interest expense on debt related to financing or
331.6 refinancing costs, including costs related to points, loan
331.7 origination fees, financing charges, legal fees, and title
331.8 searches; and issuance costs including bond discounts, bond
331.9 counsel, underwriter's counsel, corporate counsel, printing, and
331.10 financial forecasts. Allowable debt related to items in this
331.11 clause shall not exceed seven percent of the total historical
331.12 cost of the project. To the extent these costs are financed,
331.13 the straight-line amortization of the costs in this clause is
331.14 not an allowable cost; and
331.15 (3) interest on debt incurred for the establishment of a
331.16 debt reserve fund, net of the interest earned on the debt
331.17 reserve fund.
331.18 (c) Debt incurred for costs under paragraph (b) is not
331.19 subject to Minnesota Rules, part 9549.0060, subpart 5, item A,
331.20 subitem (5) or (6).
331.21 (d) The incremental increase in a nursing facility's rental
331.22 rate, determined under Minnesota Rules, parts 9549.0010 to
331.23 9549.0080, and this section, resulting from the acquisition of
331.24 allowable capital assets, and allowable debt and interest
331.25 expense under this subdivision shall be added to its
331.26 property-related payment rate and shall be effective on the
331.27 first day of the month following the month in which the
331.28 moratorium project was completed.
331.29 (e) Notwithstanding subdivision 3f, paragraph (a), for rate
331.30 periods beginning on October 1, 1992, and for rate years
331.31 beginning after June 30, 1993, the replacement-costs-new per bed
331.32 limit to be used in Minnesota Rules, part 9549.0060, subpart 4,
331.33 item B, for a nursing facility that has completed a renovation,
331.34 replacement, or upgrading project that has been approved under
331.35 the moratorium exception process in section 144A.073, or that
331.36 has completed an addition to or replacement of buildings,
332.1 attached fixtures, or land improvements for which the total
332.2 historical cost exceeds the lesser of $150,000 or ten percent of
332.3 the most recent appraised value, must be $47,500 per licensed
332.4 bed in multiple-bed rooms and $71,250 per licensed bed in a
332.5 single-bed room. These amounts must be adjusted annually as
332.6 specified in subdivision 3f, paragraph (a), beginning January 1,
332.7 1993.
332.8 (f) For purposes of this paragraph, a total replacement
332.9 means the complete replacement of the nursing facility's
332.10 physical plant through the construction of a new physical plant,
332.11 the transfer of the nursing facility's license from one physical
332.12 plant location to another, or a new building addition to
332.13 relocate beds from three- and four-bed wards. For total
332.14 replacement projects completed on or after July 1, 1992, the
332.15 commissioner shall compute the incremental change in the nursing
332.16 facility's rental per diem, for rate years beginning on or after
332.17 July 1, 1995, by replacing its appraised value, including the
332.18 historical capital asset costs, and the capital debt and
332.19 interest costs with the new nursing facility's allowable capital
332.20 asset costs and the related allowable capital debt and interest
332.21 costs. If the new nursing facility has decreased its licensed
332.22 capacity, the aggregate investment per bed limit in subdivision
332.23 3a, paragraph (c), shall apply. If the new nursing facility has
332.24 retained a portion of the original physical plant for nursing
332.25 facility usage, then a portion of the appraised value prior to
332.26 the replacement must be retained and included in the calculation
332.27 of the incremental change in the nursing facility's rental per
332.28 diem. For purposes of this part, the original nursing facility
332.29 means the nursing facility prior to the total replacement
332.30 project. The portion of the appraised value to be retained
332.31 shall be calculated according to clauses (1) to (3):
332.32 (1) The numerator of the allocation ratio shall be the
332.33 square footage of the area in the original physical plant which
332.34 is being retained for nursing facility usage.
332.35 (2) The denominator of the allocation ratio shall be the
332.36 total square footage of the original nursing facility physical
333.1 plant.
333.2 (3) Each component of the nursing facility's allowable
333.3 appraised value prior to the total replacement project shall be
333.4 multiplied by the allocation ratio developed by dividing clause
333.5 (1) by clause (2).
333.6 In the case of either type of total replacement as
333.7 authorized under section 144A.071 or 144A.073, the provisions of
333.8 this subdivision shall also apply. For purposes of the
333.9 moratorium exception authorized under section 144A.071,
333.10 subdivision 4a, paragraph (s), if the total replacement involves
333.11 the renovation and use of an existing health care facility
333.12 physical plant, the new allowable capital asset costs and
333.13 related debt and interest costs shall include first the
333.14 allowable capital asset costs and related debt and interest
333.15 costs of the renovation, to which shall be added the allowable
333.16 capital asset costs of the existing physical plant prior to the
333.17 renovation, and if reported by the facility, the related
333.18 allowable capital debt and interest costs.
333.19 (g) Notwithstanding Minnesota Rules, part 9549.0060,
333.20 subpart 11, item C, subitem (2), for a total replacement, as
333.21 defined in paragraph (f), authorized under section 144A.071 or
333.22 144A.073 after July 1, 1999, or any building project that is a
333.23 relocation, renovation, upgrading, or conversion authorized
333.24 under section 144A.073, completed on or after July 1, 2001, the
333.25 replacement-costs-new per bed limit shall be $74,280 per
333.26 licensed bed in multiple-bed rooms, $92,850 per licensed bed in
333.27 semiprivate rooms with a fixed partition separating the resident
333.28 beds, and $111,420 per licensed bed in single rooms. Minnesota
333.29 Rules, part 9549.0060, subpart 11, item C, subitem (2), does not
333.30 apply. These amounts must be adjusted annually as specified in
333.31 subdivision 3f, paragraph (a), beginning January 1, 2000.
333.32 (h) For a total replacement, as defined in paragraph (f),
333.33 authorized under section 144A.073 for a 96-bed nursing home in
333.34 Carlton county, the replacement-costs-new per bed limit shall be
333.35 $74,280 per licensed bed in multiple-bed rooms, $92,850 per
333.36 licensed bed in semiprivate rooms with a fixed partition
334.1 separating the resident's beds, and $111,420 per licensed bed in
334.2 a single room. Minnesota Rules, part 9549.0060, subpart 11,
334.3 item C, subitem (2), does not apply. The resulting maximum
334.4 allowable replacement-costs-new multiplied by 1.25 shall
334.5 constitute the project's dollar threshold for purposes of
334.6 application of the limit set forth in section 144A.071,
334.7 subdivision 2. The commissioner of health may waive the
334.8 requirements of section 144A.073, subdivision 3b, paragraph (b),
334.9 clause (2), on the condition that the other requirements of that
334.10 paragraph are met.
334.11 (i) For a renovation authorized under section 144A.073 for
334.12 a 65-bed nursing home in St. Louis county, the incremental
334.13 increase in rental rate for purposes of paragraph (d) shall be
334.14 $8.16, and the total replacement cost, allowable appraised
334.15 value, allowable debt, and allowable interest shall be increased
334.16 according to the incremental increase.
334.17 (j) For a total replacement, as defined in paragraph (f),
334.18 authorized under section 144A.073 involving a new building
334.19 addition that relocates beds from three-bed wards for an 80-bed
334.20 nursing home in Redwood county, the replacement-costs-new per
334.21 bed limit shall be $74,280 per licensed bed for multiple-bed
334.22 rooms; $92,850 per licensed bed for semiprivate rooms with a
334.23 fixed partition separating the beds; and $111,420 per licensed
334.24 bed for single rooms. These amounts shall be adjusted annually,
334.25 beginning January 1, 2001. Minnesota Rules, part 9549.0060,
334.26 subpart 11, item C, subitem (2), does not apply. The resulting
334.27 maximum allowable replacement-costs-new multiplied by 1.25 shall
334.28 constitute the project's dollar threshold for purposes of
334.29 application of the limit set forth in section 144A.071,
334.30 subdivision 2. The commissioner of health may waive the
334.31 requirements of section 144A.073, subdivision 3b, paragraph (b),
334.32 clause (2), on the condition that the other requirements of that
334.33 paragraph are met.
334.34 Sec. 22. Minnesota Statutes 2000, section 256B.431, is
334.35 amended by adding a subdivision to read:
334.36 Subd. 31. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate
335.1 years beginning on or after July 1, 2001, the total payment rate
335.2 for a facility reimbursed under this section, section 256B.434,
335.3 or any other section for the first 90 days after admission shall
335.4 be:
335.5 (1) for the first 30 paid days, the rate shall be 120
335.6 percent of the facility's medical assistance rate for each case
335.7 mix class; and
335.8 (2) for the next 60 days after the first 30 paid days, the
335.9 rate shall be 110 percent of the facility's medical assistance
335.10 rate for each case mix class.
335.11 (b) Beginning with the 91st paid day after admission, the
335.12 payment rate shall be the rate otherwise determined under this
335.13 section, section 256B.434, or any other section.
335.14 (c) This subdivision applies to admissions occurring on or
335.15 after July 1, 2001.
335.16 Sec. 23. Minnesota Statutes 2000, section 256B.431, is
335.17 amended by adding a subdivision to read:
335.18 Subd. 32. [NURSING FACILITY RATE INCREASES BEGINNING JULY
335.19 1, 2001, AND JULY 1, 2002.] For the rate years beginning July 1,
335.20 2001, and July 1, 2002, the commissioner shall provide to each
335.21 nursing facility reimbursed under this section or section
335.22 256B.434 an adjustment equal to 3.0 percent of the total
335.23 operating payment rate. The operating payment rates in effect
335.24 on June 30, 2001, and June 30, 2002, respectively, shall include
335.25 the adjustment in subdivision 2i, paragraph (c).
335.26 Sec. 24. Minnesota Statutes 2000, section 256B.431, is
335.27 amended by adding a subdivision to read:
335.28 Subd. 33. [ADDITIONAL INCREASES FOR LOW RATE METROPOLITAN
335.29 AREA FACILITIES.] After the calculation of the increase for the
335.30 rate year beginning July 1, 2001, in subdivision 32, the
335.31 commissioner must provide for special increases to facilities
335.32 determined to be the lowest rate facilities in state development
335.33 region 11, as defined in section 462.385. Within this region,
335.34 the commissioner shall identify the median nursing facility rate
335.35 by case mix category for all nursing facilities under section
335.36 256B.431 or 256B.434. Nursing home rates that are below the
336.1 median for case mix class A must be adjusted to the set of case
336.2 mix rates for the facility at the median for case mix class A.
336.3 Sec. 25. Minnesota Statutes 2000, section 256B.431, is
336.4 amended by adding a subdivision to read:
336.5 Subd. 34. [RATE FLOOR FOR FACILITIES LOCATED OUTSIDE THE
336.6 METROPOLITAN AREA.] (a) For the rate year beginning July 1,
336.7 2001, the commissioner shall adjust operating costs per diem for
336.8 nursing facilities located outside of state development region
336.9 11, as defined in section 462.385, reimbursed under this section
336.10 and sections 256B.434 and 256B.435, as provided in this
336.11 subdivision.
336.12 (b) For each nursing facility, the commissioner shall
336.13 compare the operating costs per diem listed in this paragraph to
336.14 the operating costs per diem the facility would otherwise
336.15 receive for the July 1, 2001, rate year after provision of any
336.16 other rate increases required by this chapter.
336.17 Case mix classification Operating costs per diem
336.18 A $ 67.02
336.19 B $ 73.00
336.20 C $ 79.77
336.21 D $ 85.94
336.22 E $ 92.32
336.23 F $ 92.72
336.24 G $ 98.13
336.25 H $108.40
336.26 I $112.03
336.27 J $117.67
336.28 K $129.55
336.29 (c) If a facility's total reimbursement for operating
336.30 costs, using the case mix classification operating costs per
336.31 diem listed in paragraph (b), is greater than the total
336.32 reimbursement for operating costs the facility would otherwise
336.33 receive, the commissioner shall calculate operating costs per
336.34 diem for that facility for the rate year beginning July 1, 2001,
336.35 using the case mix classification operating costs per diem
336.36 listed in paragraph (b).
337.1 (d) If a facility's total reimbursement for operating
337.2 costs, using the case mix classification costs per diem listed
337.3 in paragraph (b), is less than the total reimbursement for
337.4 operating costs the facility would otherwise receive, the
337.5 commissioner shall reimburse that facility for the rate year
337.6 beginning July 1, 2001, as provided in this section, section
337.7 256B.434, or 256B.435, whichever is applicable, and shall not
337.8 calculate operating costs per diem for that facility using the
337.9 case mix classification operating costs per diem listed in
337.10 paragraph (b).
337.11 Sec. 26. Minnesota Statutes 2000, section 256B.431, is
337.12 amended by adding a subdivision to read:
337.13 Subd. 35. [EXCLUSION OF RAW FOOD COST ADJUSTMENT.] For
337.14 rate years beginning on or after July 1, 2001, in calculating a
337.15 nursing facility's operating cost per diem for the purposes of
337.16 constructing an array, determining a median, or otherwise
337.17 performing a statistical measure of nursing facility payment
337.18 rates to be used to determine future rate increases under this
337.19 section, section 256B.434, or any other section, the
337.20 commissioner shall exclude adjustments for raw food costs under
337.21 subdivision 2b, paragraph (h), that are related to providing
337.22 special diets based on religious beliefs.
337.23 Sec. 27. Minnesota Statutes 2000, section 256B.434,
337.24 subdivision 4, is amended to read:
337.25 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For
337.26 nursing facilities which have their payment rates determined
337.27 under this section rather than section 256B.431, the
337.28 commissioner shall establish a rate under this subdivision. The
337.29 nursing facility must enter into a written contract with the
337.30 commissioner.
337.31 (b) A nursing facility's case mix payment rate for the
337.32 first rate year of a facility's contract under this section is
337.33 the payment rate the facility would have received under section
337.34 256B.431.
337.35 (c) A nursing facility's case mix payment rates for the
337.36 second and subsequent years of a facility's contract under this
338.1 section are the previous rate year's contract payment rates plus
338.2 an inflation adjustment and, for facilities reimbursed under
338.3 this section or section 256B.431, an adjustment to include the
338.4 cost of any increase in health department licensing fees for the
338.5 facility taking effect on or after July 1, 2001. The index for
338.6 the inflation adjustment must be based on the change in the
338.7 Consumer Price Index-All Items (United States City average)
338.8 (CPI-U) forecasted by Data Resources, Inc., as forecasted in the
338.9 fourth quarter of the calendar year preceding the rate year.
338.10 The inflation adjustment must be based on the 12-month period
338.11 from the midpoint of the previous rate year to the midpoint of
338.12 the rate year for which the rate is being determined. For the
338.13 rate years beginning on July 1, 1999, and July 1, 2000, July 1,
338.14 2001, and July 1, 2002, this paragraph shall apply only to the
338.15 property-related payment rate, except that adjustments to
338.16 include the cost of any increase in health department licensing
338.17 fees taking effect on or after July 1, 2001, shall be provided.
338.18 In determining the amount of the property-related payment rate
338.19 adjustment under this paragraph, the commissioner shall
338.20 determine the proportion of the facility's rates that are
338.21 property-related based on the facility's most recent cost report.
338.22 (d) The commissioner shall develop additional
338.23 incentive-based payments of up to five percent above the
338.24 standard contract rate for achieving outcomes specified in each
338.25 contract. The specified facility-specific outcomes must be
338.26 measurable and approved by the commissioner. The commissioner
338.27 may establish, for each contract, various levels of achievement
338.28 within an outcome. After the outcomes have been specified the
338.29 commissioner shall assign various levels of payment associated
338.30 with achieving the outcome. Any incentive-based payment cancels
338.31 if there is a termination of the contract. In establishing the
338.32 specified outcomes and related criteria the commissioner shall
338.33 consider the following state policy objectives:
338.34 (1) improved cost effectiveness and quality of life as
338.35 measured by improved clinical outcomes;
338.36 (2) successful diversion or discharge to community
339.1 alternatives;
339.2 (3) decreased acute care costs;
339.3 (4) improved consumer satisfaction;
339.4 (5) the achievement of quality; or
339.5 (6) any additional outcomes proposed by a nursing facility
339.6 that the commissioner finds desirable.
339.7 Sec. 28. Minnesota Statutes 2000, section 256B.434, is
339.8 amended by adding a subdivision to read:
339.9 Subd. 4c. [FACILITY RATE INCREASES EFFECTIVE JANUARY 1,
339.10 2002.] For the rate period beginning January 1, 2002, and for
339.11 the rate year beginning July 1, 2002, a nursing facility in
339.12 Morrison county licensed for 83 beds shall receive an increase
339.13 of $2.54 in each case mix payment rate to offset property tax
339.14 payments due as a result of the facility's conversion from
339.15 nonprofit to for-profit status. The increases under this
339.16 subdivision shall be added following the determination under
339.17 this chapter of the payment rate for the rate year beginning
339.18 July 1, 2001, and shall be included in the facility's total
339.19 payment rates for the purposes of determining future rates under
339.20 this section or any other section.
339.21 Sec. 29. Minnesota Statutes 2000, section 256B.434, is
339.22 amended by adding a subdivision to read:
339.23 Subd. 4d. [FACILITY RATE INCREASES EFFECTIVE JULY 1,
339.24 2001.] For the rate year beginning July 1, 2001, a nursing
339.25 facility in Hennepin county licensed for 302 beds shall receive
339.26 an increase of 29 cents in each case mix payment rate to correct
339.27 an error in the cost-reporting system that occurred prior to the
339.28 date that the facility entered the alternative payment
339.29 demonstration project. The increases under this subdivision
339.30 shall be added following the determination under this chapter of
339.31 the payment rate for the rate year beginning July 1, 2001, and
339.32 shall be included in the facility's total payment rates for the
339.33 purposes of determining future rates under this section or any
339.34 other section.
339.35 Sec. 30. Minnesota Statutes 2000, section 256B.434, is
339.36 amended by adding a subdivision to read:
340.1 Subd. 4e. [RATE INCREASE EFFECTIVE JULY 1, 2001.] A
340.2 nursing facility in Anoka county licensed for 98 beds as of July
340.3 1, 2000, shall receive an increase of $10 in each case mix rate
340.4 for the rate year beginning July 1, 2001. The increases under
340.5 this subdivision shall be added following the determination
340.6 under this chapter of the payment rate for the rate year
340.7 beginning July 1, 2001, and shall be included in the facility's
340.8 total payment rate for purposes of determining future rates
340.9 under this section or any other section through June 30, 2004.
340.10 Sec. 31. [256B.437] [IMPLEMENTATION OF A CASE MIX SYSTEM
340.11 FOR NURSING FACILITIES BASED ON THE MINIMUM DATA SET.]
340.12 Subdivision 1. [SCOPE.] This section establishes the
340.13 method and criteria used to determine resident reimbursement
340.14 classifications based upon the assessments of residents of
340.15 nursing homes and boarding care homes whose payment rates are
340.16 established under section 256B.431, 256B.434, or 256B.435.
340.17 Resident reimbursement classifications shall be established
340.18 according to the 34 group, resource utilization groups, version
340.19 III or RUG-III model as described in section 144.0724.
340.20 Reimbursement classifications established under this section
340.21 shall be implemented after June 30, 2002, but no later than
340.22 January 1, 2003.
340.23 Subd. 2. [DEFINITIONS.] For purposes of this section, the
340.24 following terms have the meanings given.
340.25 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference
340.26 date" has the meaning given in section 144.0724, subdivision 2,
340.27 paragraph (a).
340.28 (b) [CASE MIX INDEX.] "Case mix index" has the meaning
340.29 given in section 144.0724, subdivision 2, paragraph (b).
340.30 (c) [INDEX MAXIMIZATION.] "Index maximization" has the
340.31 meaning given in section 144.0724, subdivision 2, paragraph (c).
340.32 (d) [MINIMUM DATA SET.] "Minimum data set" has the meaning
340.33 given in section 144.0724, subdivision 2, paragraph (d).
340.34 (e) [REPRESENTATIVE.] "Representative" has the meaning
340.35 given in section 144.0724, subdivision 2, paragraph (e).
340.36 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource
341.1 utilization groups" or "RUG" has the meaning given in section
341.2 144.0724, subdivision 2, paragraph (f).
341.3 Subd. 3. [CASE MIX INDICES.] (a) The commissioner of human
341.4 services shall assign a case mix index to each resident class
341.5 based on the Health Care Financing Administration's staff time
341.6 measurement study and adjusted for Minnesota-specific wage
341.7 indices. The case mix indices assigned to each resident class
341.8 shall be published in the Minnesota State Register at least 120
341.9 days prior to the implementation of the 34 group, RUG-III
341.10 resident classification system.
341.11 (b) An index maximization approach shall be used to
341.12 classify residents.
341.13 (c) After implementation of the revised case mix system,
341.14 the commissioner of human services may annually rebase case mix
341.15 indices and base rates using more current data on average wage
341.16 rates and staff time measurement studies. This rebasing shall
341.17 be calculated under subdivision 7, paragraph (b). The
341.18 commissioner shall publish in the Minnesota State Register
341.19 adjusted case mix indices at least 45 days prior to the
341.20 effective date of the adjusted case mix indices.
341.21 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) Nursing
341.22 facilities shall conduct and submit case mix assessments
341.23 according to the schedule established by the commissioner of
341.24 health under section 144.0724, subdivisions 4 and 5.
341.25 (b) The resident reimbursement classifications established
341.26 under section 144.0724, subdivision 3, shall be effective the
341.27 day of admission for new admission assessments. The effective
341.28 date for significant change assessments shall be the assessment
341.29 reference date. The effective date for annual and second
341.30 quarterly assessments shall be the first day of the month
341.31 following assessment reference date.
341.32 Subd. 5. [NOTICE OF RESIDENT REIMBURSEMENT
341.33 CLASSIFICATION.] Nursing facilities shall provide notice to a
341.34 resident of the resident's case mix classification according to
341.35 procedures established by the commissioner of health under
341.36 section 144.0724, subdivision 7.
342.1 Subd. 6. [RECONSIDERATION OF RESIDENT CLASSIFICATION.] Any
342.2 request for reconsideration of a resident classification must be
342.3 made under section 144.0724, subdivision 8.
342.4 Subd. 7. [RATE DETERMINATION UPON TRANSITION TO RUG-III
342.5 PAYMENT RATES.] (a) The commissioner of human services shall
342.6 determine payment rates at the time of transition to the RUG
342.7 based payment model in a facility-specific, budget-neutral
342.8 manner. The case mix indices as defined in subdivision 3 shall
342.9 be used to allocate the case mix adjusted component of total
342.10 payment across all case mix groups. To transition from the
342.11 current calculation methodology to the RUG based methodology,
342.12 the commissioner of health shall report to the commissioner of
342.13 human services the resident days classified according to the
342.14 categories defined in subdivision 3 for the 12-month reporting
342.15 period ending September 30, 2001, for each nursing facility.
342.16 The commissioner of human services shall use this data to
342.17 compute the standardized days for the reporting period under the
342.18 RUG system.
342.19 (b) The commissioner of human services shall determine the
342.20 case mix adjusted component of the rate as follows:
342.21 (1) determine the case mix portion of the 11 case mix rates
342.22 in effect on June 30, 2002, or the 34 case mix rates in effect
342.23 on or after June 30, 2003;
342.24 (2) multiply each amount in clause (1) by the number of
342.25 resident days assigned to each group for the reporting period
342.26 ending September 30, 2001, or the most recent year for which
342.27 data is available;
342.28 (3) compute the sum of the amounts in clause (2);
342.29 (4) determine the total RUG standardized days for the
342.30 reporting period ending September 30, 2001, or the most recent
342.31 year for which data is available using new indices calculated
342.32 under subdivision 3, paragraph (c);
342.33 (5) divide the amount in clause (3) by the amount in clause
342.34 (4) which shall be the average case mix adjusted component of
342.35 the rate under the RUG method; and
342.36 (6) multiply this average rate by the case mix weight in
343.1 subdivision 3 for each RUG group.
343.2 (c) The noncase mix component will be allocated to each RUG
343.3 group as a constant amount to determine the transition payment
343.4 rate. Any other rate adjustments that are effective on or after
343.5 July 1, 2002, shall be applied to the transition rates
343.6 determined under this section.
343.7 Sec. 32. [256B.4371] [NURSING FACILITY VOLUNTARY CLOSURES
343.8 AND PLANNING AND DEVELOPMENT OF COMMUNITY-BASED ALTERNATIVES.]
343.9 Subdivision 1. [DEFINITIONS.] (a) The definitions in this
343.10 subdivision apply to subdivisions 2 to 9.
343.11 (b) "Closure" means the cessation of operations of a
343.12 nursing facility and delicensure and decertification of all beds
343.13 within the facility.
343.14 (c) "Commencement of closure" means the date on which
343.15 residents and designated representatives are notified of a
343.16 planned closure according to sections 144A.185 to 144A.1887 as
343.17 part of an approved closure plan.
343.18 (d) "Completion of closure" means the date on which the
343.19 final resident of the nursing facility or nursing facilities
343.20 designated for closure in an approved closure plan is discharged
343.21 from the facility or facilities.
343.22 (e) "Closure plan" means a plan to close a nursing facility
343.23 and reallocate the resulting savings to provide planned closure
343.24 rate adjustments at other facilities.
343.25 (f) "Partial closure" means the delicensure and
343.26 decertification of a portion of the beds within the facility.
343.27 (g) "Planned closure rate adjustment" means an increase in
343.28 a nursing facility's operating rates resulting from a partial
343.29 planned closure of a facility or a planned closure of another
343.30 facility.
343.31 Subd. 2. [PLANNING AND DEVELOPMENT OF COMMUNITY BASED
343.32 SERVICES.] (a) The commissioner of human services shall
343.33 establish a process to adjust the capacity and distribution of
343.34 long-term care services to equalize the supply and demand for
343.35 different types of services. This process must include
343.36 community planning, expansion or establishment of needed
344.1 services, and analysis of voluntary nursing facility closures.
344.2 (b) The purpose of this process is to support the planning
344.3 and development of community-based services. This process must
344.4 support early intervention, advocacy, and consumer protection
344.5 while providing resources and incentives for expanded county
344.6 planning and for nursing facilities to transition to meet
344.7 community needs.
344.8 (c) The process shall support and facilitate expansion of
344.9 community-based services under the county-administered
344.10 alternative care program under section 256B.0913 and waivers for
344.11 elderly under section 256B.0915, including the development of
344.12 supportive services such as housing and transportation. The
344.13 process shall utilize community assessments and planning
344.14 developed for the community health services plan and plan update
344.15 and for the community social services act plan.
344.16 (d) The addendum to the biennial plan shall be submitted
344.17 annually, beginning in 2001, and shall include recommendations
344.18 for development of community-based services. Both planning and
344.19 implementation shall be implemented within the amount of funding
344.20 made available to the county board for these purposes.
344.21 (e) The commissioner of health and the commissioner of
344.22 human services, as appropriate, shall provide available data
344.23 necessary for the county, including but not limited to data on
344.24 nursing facility bed distribution, housing with services
344.25 options, the closure of nursing facilities that occur outside of
344.26 the planned closure process, and approval of planned closures in
344.27 the county and contiguous counties.
344.28 (f) The plan, within the funding allocated, shall:
344.29 (1) identify the need for services based on demographic
344.30 data, service availability, caseload information, and provider
344.31 information;
344.32 (2) involve providers, consumers, cities, townships,
344.33 businesses, and area agencies on aging in the planning process;
344.34 (3) address the availability of alternative care and
344.35 elderly waiver services for eligible recipients;
344.36 (4) address the development of other supportive services,
345.1 such as transit, housing, and workforce and economic
345.2 development; and
345.3 (5) estimate the cost and timelines for development.
345.4 (g) The biennial plan addendum shall be coordinated with
345.5 the county mental health plan for inclusion in the community
345.6 health services plan and included as an addendum to the
345.7 community social services plan.
345.8 (h) The county board having financial responsibility for
345.9 persons present in another county shall cooperate with that
345.10 county for planning and development of services.
345.11 (i) The county board shall cooperate in planning and
345.12 development of community based services with other counties, as
345.13 necessary, and coordinate planning for long-term care services
345.14 that involve more than one county, within the funding allocated
345.15 for these purposes.
345.16 (j) The commissioners of health and human services, in
345.17 cooperation with county boards, shall report to the legislature
345.18 by February 1 of each year, beginning February 1, 2002,
345.19 regarding the development of community based services,
345.20 transition or closure of nursing facilities, and consumer
345.21 outcomes achieved, as documented by each county and reported to
345.22 the commissioner by December 31 of each year.
345.23 (k) The process established by the commissioner of human
345.24 services shall ensure:
345.25 (1) that counties consider multicounty service areas in
345.26 developing services that may impact delivery efficiencies; and
345.27 (2) review and comment by the area agencies on aging,
345.28 regional development commissions, where they exist, and other
345.29 planning agencies of the biennial plan addendum.
345.30 Subd. 3. [REQUEST FOR APPLICATIONS FOR PLANNED CLOSURE OF
345.31 NURSING FACILITIES.] (a) By July 15, 2001, the commissioner of
345.32 human services shall implement and announce a program for
345.33 closure or partial closure of nursing facilities. Names and
345.34 identifying information provided in response to the announcement
345.35 shall remain private unless approved, according to the timelines
345.36 established in the plan. The announcement must specify:
346.1 (1) the criteria that will be used by the interagency
346.2 long-term care planning committee established under section
346.3 144A.31 and the commissioner to approve or reject applications;
346.4 (2) a requirement for the submission of a letter of intent
346.5 before the submission of an application;
346.6 (3) the information that must accompany an application;
346.7 (4) a schedule for letters of intent, applications, and
346.8 consideration of applications for a minimum of four review
346.9 processes to be conducted before June 30, 2003; and
346.10 (5) that applications may combine planned closure rate
346.11 adjustments with moratorium exception funding, in which case a
346.12 single application may serve both purposes.
346.13 Between October 1, 2001, and June 30, 2003, the commissioner
346.14 shall approve planned closures of at least 5,140 nursing
346.15 facility beds, with no more than 2,070 approved for closure
346.16 prior to July 1, 2002, less the number of licensed beds in
346.17 facilities that close during the same time period without
346.18 approved closure plans or have notified the commissioner of
346.19 health of their intent to close without an approved closure plan.
346.20 (b) A facility or facilities reimbursed under section
346.21 256B.431, 256B.434, or 256B.435 with a closure plan approved by
346.22 the commissioner under subdivision 6 may assign a planned
346.23 closure rate adjustment to another facility that is not closing
346.24 or facilities that are not closing, or in the case of a partial
346.25 closure, to the facility undertaking the partial closure. A
346.26 facility may also elect to have a planned closure rate
346.27 adjustment shared equally by the five nursing facilities with
346.28 the lowest total operating payment rates in the state
346.29 development region, designated under section 462.385, in which
346.30 the facility receiving the planned closure rate adjustment is
346.31 located. The planned closure rate adjustment must be calculated
346.32 under subdivision 7. A planned closure rate adjustment under
346.33 this section is effective on the first day of the month
346.34 following completion of closure of all facilities designated for
346.35 closure in the application and becomes part of the nursing
346.36 facility's total operating payment rate.
347.1 Applicants may use the planned closure rate adjustment to
347.2 allow for a property payment for a new nursing facility or an
347.3 addition to an existing nursing facility. Applications approved
347.4 under this paragraph are exempt from other requirements for
347.5 moratorium exceptions under section 144A.073, subdivisions 2 and
347.6 3.
347.7 Facilities without a closure plan, or whose closure plan is
347.8 not approved by the commissioner, are not eligible for a planned
347.9 closure rate adjustment under subdivision 7. However, the
347.10 commissioner shall calculate the amount the facility would have
347.11 received under subdivision 7 and shall use this amount to
347.12 provide equal rate adjustments to the five nursing facilities
347.13 with the lowest total operating payment rates in the state
347.14 development region, designated under section 462.385, in which
347.15 the facility is located.
347.16 (c) To be considered for approval, an application must
347.17 include:
347.18 (1) a description of the proposed closure plan, which must
347.19 include identification of the facility or facilities to receive
347.20 a planned closure rate adjustment and the amount and timing of a
347.21 planned closure rate adjustment proposed for each facility;
347.22 (2) the proposed timetable for any proposed closure,
347.23 including the proposed dates for announcement to residents,
347.24 commencement of closure, and completion of closure;
347.25 (3) the proposed relocation plan for current residents of
347.26 any facility designated for closure. The proposed relocation
347.27 plan must be designed to comply with all applicable state and
347.28 federal statutes and regulations, including, but not limited to,
347.29 section 144A.16 and Minnesota Rules, parts 4655.6810 to
347.30 4655.6830, 4658.1600 to 4658.1690, and 9546.0010 to 9546.0060;
347.31 (4) a description of the relationship between the nursing
347.32 facility that is proposed for closure and the nursing facility
347.33 or facilities proposed to receive the planned closure rate
347.34 adjustment. If these facilities are not under common ownership,
347.35 copies of any contracts, purchase agreements, or other documents
347.36 establishing a relationship or proposed relationship must be
348.1 provided;
348.2 (5) documentation, in a format approved by the
348.3 commissioner, that all the nursing facilities receiving a
348.4 planned closure rate adjustment under the plan have accepted
348.5 joint and several liability for recovery of overpayments under
348.6 section 256B.0641, subdivision 2, for the facilities designated
348.7 for closure under the plan; and
348.8 (6) an explanation of how the application coordinates with
348.9 planning efforts under subdivision 2.
348.10 (d) The application must address the criteria listed in
348.11 subdivision 4.
348.12 Subd. 4. [CRITERIA FOR REVIEW OF APPLICATION.] In
348.13 reviewing and approving closure proposals, the commissioner
348.14 shall consider, but not be limited to, the following criteria:
348.15 (1) improved quality of care and quality of life for
348.16 consumers;
348.17 (2) closure of a nursing facility that has a poor physical
348.18 plant;
348.19 (3) the existence of excess nursing facility beds, measured
348.20 in terms of beds per thousand persons aged 85 or older. The
348.21 excess must be measured in reference to:
348.22 (i) the county in which the facility is located;
348.23 (ii) the county and all contiguous counties;
348.24 (iii) the region in which the facility is located; or
348.25 (iv) the facility's service area.
348.26 The facility shall indicate in its proposal the area it believes
348.27 is appropriate for this measurement. A facility in a county
348.28 that is in the lowest quartile of counties with reference to
348.29 beds per thousand persons aged 85 or older is not in an area of
348.30 excess capacity;
348.31 (4) low-occupancy rates, provided that the unoccupied beds
348.32 are not the result of a personnel shortage. In analyzing
348.33 occupancy rates, the commissioner shall examine waiting lists in
348.34 the applicant facility and at facilities in the surrounding
348.35 area, as determined under clause (3);
348.36 (5) evidence of a community planning process to determine
349.1 what services are needed and ensure that needed services are
349.2 established;
349.3 (6) innovative use of reinvestment funds;
349.4 (7) innovative use planned for the closed facility's
349.5 physical plant;
349.6 (8) evidence that the proposal serves the interests of the
349.7 state; and
349.8 (9) evidence of other factors that affect the viability of
349.9 the facility, including excessive nursing pool costs.
349.10 Subd. 5. [REVIEW AND APPROVAL OF PROPOSALS.] (a) The
349.11 interagency long-term care planning committee may recommend that
349.12 the commissioner of human services grant approval, within the
349.13 limits established in subdivision 3, paragraph (a), to
349.14 applications that satisfy the requirements of this section. The
349.15 interagency committee may appoint an advisory review panel
349.16 composed of representatives of counties, SAIL projects,
349.17 consumers, and providers to review proposals and provide
349.18 comments and recommendations to the committee. The
349.19 commissioners of human services and health shall provide staff
349.20 and technical assistance to the committee for the review and
349.21 analysis of proposals. The commissioners of human services and
349.22 health shall jointly approve or disapprove an application within
349.23 30 days after receiving the committee's recommendations.
349.24 (b) Approval of a planned closure expires 18 months after
349.25 approval by the commissioner of human services, unless
349.26 commencement of closure has begun.
349.27 (c) The commissioner of human services may change any
349.28 provision of the application to which all parties agree.
349.29 Subd. 6. [PLANNED CLOSURE RATE ADJUSTMENT.] The
349.30 commissioner of human services shall calculate the amount of the
349.31 planned closure rate adjustment available under subdivision 3,
349.32 paragraph (b), according to clauses (1) to (4):
349.33 (1) the amount available is the net reduction of nursing
349.34 facility beds multiplied by $2,080;
349.35 (2) the total number of beds in the nursing facility
349.36 receiving the planned closure rate adjustment must be
350.1 identified;
350.2 (3) capacity days are determined by multiplying the number
350.3 determined under clause (2) by 365; and
350.4 (4) the planned closure rate adjustment is the amount
350.5 available in clause (1), divided by capacity days determined
350.6 under clause (3).
350.7 Subd. 7. [OTHER RATE ADJUSTMENTS.] Facilities receiving
350.8 planned closure rate adjustments remain eligible for any
350.9 applicable rate adjustments provided under section 256B.431,
350.10 256B.434, or any other section.
350.11 Subd. 8. [COUNTY COSTS.] The commissioner of human
350.12 services shall allocate up to $500 per nursing facility bed that
350.13 is closing, within the limits of the appropriation specified for
350.14 this purpose, to be used for relocation costs incurred by
350.15 counties for planned closures under this section or resident
350.16 relocation under sections 144A.185 to 144A.1887. To be eligible
350.17 for this allocation, a county in which a nursing facility closes
350.18 must provide to the commissioner a detailed statement in a form
350.19 provided by the commissioner of additional costs, not to exceed
350.20 $500 per bed closed, that are directly incurred related to the
350.21 county's required role in the relocation process.
350.22 Sec. 33. Minnesota Statutes 2000, section 256B.501, is
350.23 amended by adding a subdivision to read:
350.24 Subd. 14. [ICF/MR RATE INCREASES BEGINNING JULY 1, 2001,
350.25 AND JULY 1, 2002.] (a) For the rate periods beginning July 1,
350.26 2001, and July 1, 2002, the commissioner shall make available to
350.27 each facility reimbursed under this section, section 256B.5011,
350.28 and Laws 1993, First Special Session chapter 1, article 4,
350.29 section 11, an adjustment to the total operating payment rate of
350.30 3.0 percent.
350.31 (b) For each facility, the commissioner shall determine the
350.32 payment rate adjustment using the percentage specified in
350.33 paragraph (a) multiplied by the total operating payment rate in
350.34 effect on the last day of the prior rate year, and dividing the
350.35 resulting amount by the facility's actual resident days. The
350.36 total operating payment rate shall include the adjustment
351.1 provided in subdivision 12.
351.2 (c) Any facility whose payment rates are governed by
351.3 closure agreements, receivership agreements, or Minnesota Rules,
351.4 part 9553.0075, is not eligible for an adjustment otherwise
351.5 granted under this subdivision.
351.6 Sec. 34. Minnesota Statutes 2000, section 256B.76, is
351.7 amended to read:
351.8 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.]
351.9 (a) Effective for services rendered on or after October 1,
351.10 1992, the commissioner shall make payments for physician
351.11 services as follows:
351.12 (1) payment for level one Health Care Finance
351.13 Administration's common procedural coding system (HCPCS) codes
351.14 titled "office and other outpatient services," "preventive
351.15 medicine new and established patient," "delivery, antepartum,
351.16 and postpartum care," "critical care," Caesarean cesarean
351.17 delivery and pharmacologic management provided to psychiatric
351.18 patients, and HCPCS level three codes for enhanced services for
351.19 prenatal high risk, shall be paid at the lower of (i) submitted
351.20 charges, or (ii) 25 percent above the rate in effect on June 30,
351.21 1992. If the rate on any procedure code within these categories
351.22 is different than the rate that would have been paid under the
351.23 methodology in section 256B.74, subdivision 2, then the larger
351.24 rate shall be paid;
351.25 (2) payments for all other services shall be paid at the
351.26 lower of (i) submitted charges, or (ii) 15.4 percent above the
351.27 rate in effect on June 30, 1992;
351.28 (3) all physician rates shall be converted from the 50th
351.29 percentile of 1982 to the 50th percentile of 1989, less the
351.30 percent in aggregate necessary to equal the above increases
351.31 except that payment rates for home health agency services shall
351.32 be the rates in effect on September 30, 1992;
351.33 (4) effective for services rendered on or after January 1,
351.34 2000, payment rates for physician and professional services
351.35 shall be increased by three percent over the rates in effect on
351.36 December 31, 1999, except for home health agency and family
352.1 planning agency services; and
352.2 (5) the increases in clause (4) shall be implemented
352.3 January 1, 2000, for managed care.
352.4 (b) Effective for services rendered on or after October 1,
352.5 1992, the commissioner shall make payments for dental services
352.6 as follows:
352.7 (1) dental services shall be paid at the lower of (i)
352.8 submitted charges, or (ii) 25 percent above the rate in effect
352.9 on June 30, 1992;
352.10 (2) dental rates shall be converted from the 50th
352.11 percentile of 1982 to the 50th percentile of 1989, less the
352.12 percent in aggregate necessary to equal the above increases;
352.13 (3) effective for services rendered on or after January 1,
352.14 2000, payment rates for dental services shall be increased by
352.15 three percent over the rates in effect on December 31, 1999;
352.16 (4) the commissioner shall award grants to community
352.17 clinics or other nonprofit community organizations, political
352.18 subdivisions, professional associations, or other organizations
352.19 that demonstrate the ability to provide dental services
352.20 effectively to public program recipients. Grants may be used to
352.21 fund the costs related to coordinating access for recipients,
352.22 developing and implementing patient care criteria, upgrading or
352.23 establishing new facilities, acquiring furnishings or equipment,
352.24 recruiting new providers, or other development costs that will
352.25 improve access to dental care in a region. In awarding grants,
352.26 the commissioner shall give priority to applicants that plan to
352.27 serve areas of the state in which the number of dental providers
352.28 is not currently sufficient to meet the needs of recipients of
352.29 public programs or uninsured individuals. The commissioner
352.30 shall consider the following in awarding the grants: (i)
352.31 potential to successfully increase access to an underserved
352.32 population; (ii) the ability to raise matching funds; (iii) the
352.33 long-term viability of the project to improve access beyond the
352.34 period of initial funding; (iv) the efficiency in the use of the
352.35 funding; and (v) the experience of the proposers in providing
352.36 services to the target population.
353.1 The commissioner shall monitor the grants and may terminate
353.2 a grant if the grantee does not increase dental access for
353.3 public program recipients. The commissioner shall consider
353.4 grants for the following:
353.5 (i) implementation of new programs or continued expansion
353.6 of current access programs that have demonstrated success in
353.7 providing dental services in underserved areas;
353.8 (ii) a pilot program for utilizing hygienists outside of a
353.9 traditional dental office to provide dental hygiene services;
353.10 and
353.11 (iii) a program that organizes a network of volunteer
353.12 dentists, establishes a system to refer eligible individuals to
353.13 volunteer dentists, and through that network provides donated
353.14 dental care services to public program recipients or uninsured
353.15 individuals.
353.16 (5) beginning October 1, 1999, the payment for tooth
353.17 sealants and fluoride treatments shall be the lower of (i)
353.18 submitted charge, or (ii) 80 percent of median 1997 charges; and
353.19 (6) the increases listed in clauses (3) and (5) shall be
353.20 implemented January 1, 2000, for managed care.
353.21 (c) An entity that operates both a Medicare certified
353.22 comprehensive outpatient rehabilitation facility and a facility
353.23 which was certified prior to January 1, 1993, that is licensed
353.24 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for
353.25 whom at least 33 percent of the clients receiving rehabilitation
353.26 services and mental health services in the most recent calendar
353.27 year are medical assistance recipients, shall be reimbursed by
353.28 the commissioner for rehabilitation services and mental health
353.29 services at rates that are 38 percent greater than the maximum
353.30 reimbursement rate allowed under paragraph (a), clause (2), when
353.31 those services are (1) provided within the comprehensive
353.32 outpatient rehabilitation facility and (2) provided to residents
353.33 of nursing facilities owned by the entity.
353.34 Sec. 35. Laws 1995, chapter 207, article 3, section 21, as
353.35 amended by Laws 1999, chapter 245, article 3, section 43, is
353.36 amended to read:
354.1 Sec. 21. [FACILITY CERTIFICATION.]
354.2 (a) Notwithstanding Minnesota Statutes, section 252.291,
354.3 subdivisions 1 and 2, the commissioner of health shall inspect
354.4 to certify a large community-based facility currently licensed
354.5 under Minnesota Rules, parts 9525.0215 to 9525.0355, for more
354.6 than 16 beds and located in Northfield. The facility may be
354.7 certified for up to 44 beds. The commissioner of health must
354.8 inspect to certify the facility as soon as possible after the
354.9 effective date of this section. The commissioner of human
354.10 services shall work with the facility and affected counties to
354.11 relocate any current residents of the facility who do not meet
354.12 the admission criteria for an ICF/MR. Until January 1, 1999, in
354.13 order to fund the ICF/MR services and relocations of current
354.14 residents authorized, the commissioner of human services may
354.15 transfer on a quarterly basis to the medical assistance account
354.16 from each affected county's community social service allocation,
354.17 an amount equal to the state share of medical assistance
354.18 reimbursement for the residential and day habilitation services
354.19 funded by medical assistance and provided to clients for whom
354.20 the county is financially responsible.
354.21 (b) After January 1, 1999, the commissioner of human
354.22 services shall fund the services under the state medical
354.23 assistance program and may transfer on a quarterly basis to the
354.24 medical assistance account from each affected county's community
354.25 social service allocation, an amount equal to one-half of the
354.26 state share of medical assistance reimbursement for the
354.27 residential and day habilitation services funded by medical
354.28 assistance and provided to clients for whom the county is
354.29 financially responsible.
354.30 (c) Effective July 1, 2001, the commissioner of human
354.31 services shall fund the entire state share of medical assistance
354.32 reimbursement for the residential and day habilitation services
354.33 funded by medical assistance and provided to clients for whom
354.34 counties are financially responsible from the medical assistance
354.35 account, and shall not make any transfer from the community
354.36 social service allocations of affected counties.
355.1 (d) For nonresidents of Minnesota seeking admission to the
355.2 facility, Rice county shall be notified in order to assure that
355.3 appropriate funding is guaranteed from their state or country of
355.4 residence.
355.5 Sec. 36. Laws 1999, chapter 245, article 3, section 45, as
355.6 amended by Laws 2000, chapter 312, section 3, is amended to read:
355.7 Sec. 45. [STATE LICENSURE CONFLICTS WITH FEDERAL
355.8 REGULATIONS.]
355.9 (a) Notwithstanding the provisions of Minnesota Rules, part
355.10 4658.0520, an incontinent resident must be checked according to
355.11 a specific time interval written in the resident's care plan.
355.12 The resident's attending physician must authorize in writing any
355.13 interval longer than two hours unless the resident, if
355.14 competent, or a family member or legally appointed conservator,
355.15 guardian, or health care agent of a resident who is not
355.16 competent, agrees in writing to waive physician involvement in
355.17 determining this interval.
355.18 (b) This section expires July 1, 2001 2003.
355.19 Sec. 37. [DEVELOPMENT OF NEW NURSING FACILITY
355.20 REIMBURSEMENT SYSTEM.]
355.21 (a) The commissioner of human services shall develop and
355.22 report to the legislature by January 15, 2003, a system to
355.23 replace the current nursing facility reimbursement system
355.24 established under Minnesota Statutes, sections 256B.431,
355.25 256B.434, and 256B.435.
355.26 (b) The system must be developed in consultation with the
355.27 long-term care task force and with representatives of consumers,
355.28 providers, and labor unions. Within the limits of available
355.29 appropriations, the commissioner may employ consultants to
355.30 assist with this project.
355.31 (c) The new reimbursement system must:
355.32 (1) provide incentives to enhance quality of life and
355.33 quality of care;
355.34 (2) recognize cost differences in the care of different
355.35 types of populations, including subacute care and dementia care;
355.36 (3) establish rates that are sufficient without being
356.1 excessive;
356.2 (4) be affordable for the state and for private-pay
356.3 residents;
356.4 (5) be sensitive to changing conditions in the long-term
356.5 care environment;
356.6 (6) avoid creating access problems related to insufficient
356.7 funding;
356.8 (7) allow providers maximum flexibility in their business
356.9 operations;
356.10 (8) recognize the need for capital investment to improve
356.11 physical plants; and
356.12 (9) provide incentives for the development and use of
356.13 private rooms.
356.14 (d) Notwithstanding Minnesota Statutes, section 256B.435,
356.15 the commissioner must not implement a performance-based
356.16 contracting system for nursing facilities prior to July 1, 2003.
356.17 The commissioner shall continue to reimburse nursing facilities
356.18 under Minnesota Statutes, section 256B.431 or 256B.434, until
356.19 otherwise directed by law.
356.20 (e) The commissioner of human services, in consultation
356.21 with the commissioner of health, shall conduct or contract for a
356.22 time study to determine staff time being spent on various case
356.23 mix categories; recommend adjustments to the case mix weights
356.24 based on the time study data; and determine whether current
356.25 staffing standards are adequate for providing quality care based
356.26 on professional best practice and consumer experience. If the
356.27 commissioner determines the current standards are inadequate,
356.28 the commissioner shall determine an appropriate staffing
356.29 standard for the various case mix categories and the financial
356.30 implications of phasing into this standard over the next four
356.31 years.
356.32 Sec. 38. [REPORT ON STANDARDS FOR SUBACUTE CARE FACILITY
356.33 LICENSURE.]
356.34 By January 15, 2003, the commissioner of health shall
356.35 submit a report to the legislature on implementation of a
356.36 licensure program for subacute care. This report must include:
357.1 (1) definitions of subacute care and applicability of the
357.2 proposed licensure program to various types of licensed
357.3 facilities;
357.4 (2) an analysis of whether specific standards for subacute
357.5 levels of care need to be developed and the potential for
357.6 increased costs for existing providers of subacute care;
357.7 (3) recommendations on the applicability of the nursing
357.8 home moratorium law to the licensure of subacute care facilities
357.9 or programs;
357.10 (4) identification of federal regulations guiding the
357.11 provision of subacute care and whether further state standards
357.12 are needed; and
357.13 (5) identification of current and potential reimbursement
357.14 for subacute care under Medicare, Medicaid, or managed care
357.15 programs.
357.16 Sec. 39. [REGULATORY FLEXIBILITY.]
357.17 (a) By July 1, 2001, the commissioners of health and human
357.18 services shall:
357.19 (1) develop a summary of federal nursing facility and
357.20 community long-term care regulations that hamper state
357.21 flexibility and place burdens on the goal of achieving
357.22 high-quality care and optimum outcomes for consumers of
357.23 services; and
357.24 (2) share this summary with the legislature, other states,
357.25 national groups that advocate for state interests with Congress,
357.26 and the Minnesota congressional delegation.
357.27 (b) The commissioners shall conduct ongoing follow-up with
357.28 the entities to which this summary is provided and with the
357.29 health care financing administration to achieve maximum
357.30 regulatory flexibility, including the possibility of pilot
357.31 projects to demonstrate regulatory flexibility on less than a
357.32 statewide basis.
357.33 Sec. 40. [REPORT.]
357.34 By January 15, 2003, the commissioner of health and the
357.35 commissioner of human services shall report to the senate health
357.36 and family security committee and the house health and human
358.1 services policy committee on the number of closures that have
358.2 taken place under Minnesota Statutes, section 256B.437, and any
358.3 other nursing facility closures that may have taken place,
358.4 alternatives to nursing facility care that have been developed,
358.5 any problems with access to long-term care services that have
358.6 resulted, and any recommendations for continuation of the
358.7 regional long-term care planning process and the closure process
358.8 after June 30, 2003.
358.9 Sec. 41. [NURSING ASSISTANT; HOME HEALTH AIDE CURRICULUM.]
358.10 By January 1, 2003, the commissioner of health, in
358.11 consultation with long-term care consumers, advocates, unions,
358.12 and trade associations, shall present to the chairs of the
358.13 legislative committees dealing with health care policy
358.14 recommendations for updating the nursing assistant and home
358.15 health aide curriculum (1998 edition) to help students learn
358.16 front-line survival skills that support job motivation and
358.17 satisfaction. These skills include, but are not limited to,
358.18 working with challenging behaviors, communication skills, stress
358.19 management including the impact of personal life stress in the
358.20 work setting, building relationships with families, cultural
358.21 competencies, and working with death and dying.
358.22 Sec. 42. [EVALUATION OF REPORTING REQUIREMENTS.]
358.23 The commissioners of human services and health, in
358.24 consultation with interested parties, shall evaluate long-term
358.25 care provider reporting requirements, balancing the need for
358.26 public accountability with the need to reduce unnecessary
358.27 paperwork, and shall eliminate unnecessary reporting
358.28 requirements, seeking any necessary changes in federal and state
358.29 law. The commissioners shall present a progress report by
358.30 February 1, 2002, to the chairs of the house and senate
358.31 committees with jurisdiction over health and human services
358.32 policy and finance.
358.33 Sec. 43. [NURSING FACILITY MULTIPLE SCLEROSIS PILOT
358.34 PROJECT.]
358.35 (a) For the period from July 1, 2001, to June 30, 2003, the
358.36 commissioner of human services shall establish and implement a
359.1 pilot project to contract with nursing facilities eligible to
359.2 receive medical assistance payments that, at the time of
359.3 enrollment in the pilot project, serve ten or more persons with
359.4 a diagnosis of multiple sclerosis. The commissioner shall
359.5 negotiate a payment rate with eligible facilities to provide
359.6 services to persons with multiple sclerosis that must not exceed
359.7 150 percent of the person's case mix classification payment rate
359.8 for that facility. The commissioner may contract with up to six
359.9 nursing facilities.
359.10 (b) Facilities may enroll in the pilot project between July
359.11 1, 2001, and December 31, 2001.
359.12 (c) The commissioner shall evaluate the additional payments
359.13 made under the pilot project to determine if the adjustment
359.14 enables participating facilities to adequately meet the needs
359.15 for individual care and specialized programming, including
359.16 programs to meet psychosocial, physiological, and case
359.17 management needs, without incurring financial losses. The
359.18 commissioner of human services, in consultation with the
359.19 commissioner of health, shall report to the legislature by
359.20 January 15, 2003, on the results of the project and with a
359.21 recommendation on whether the project should be made permanent.
359.22 (d) The negotiated adjustment shall not affect the payment
359.23 rate charged to private paying residents under the provisions of
359.24 Minnesota Statutes, section 256B.48, subdivision 1.
359.25 Sec. 44. [MINIMUM STAFFING STANDARDS REPORT.]
359.26 By January 15, 2002, the commissioner of health and the
359.27 commissioner of human services shall report to the legislature
359.28 on whether they should translate the minimum nurse staffing
359.29 requirement in Minnesota Statutes, section 144A.04, subdivision
359.30 7, paragraph (a), upon the transition to the RUG-III
359.31 classification system, or whether they should establish
359.32 different time-based standards, and how to accomplish either.
359.33 Sec. 45. [REPEALER.]
359.34 Minnesota Statutes 2000, sections 144.0721, subdivision 1,
359.35 and 256B.434, subdivision 5, are repealed.
359.36 ARTICLE 6
360.1 WORK FORCE
360.2 Section 1. Minnesota Statutes 2000, section 144.1464, is
360.3 amended to read:
360.4 144.1464 [SUMMER HEALTH CARE INTERNS.]
360.5 Subdivision 1. [SUMMER INTERNSHIPS.] The commissioner of
360.6 health, through a contract with a nonprofit organization as
360.7 required by subdivision 4, shall award grants to hospitals and,
360.8 clinics, nursing facilities, and home care providers to
360.9 establish a secondary and post-secondary summer health care
360.10 intern program. The purpose of the program is to expose
360.11 interested secondary and post-secondary pupils to various
360.12 careers within the health care profession.
360.13 Subd. 2. [CRITERIA.] (a) The commissioner, through the
360.14 organization under contract, shall award grants to
360.15 hospitals and, clinics, nursing facilities, and home care
360.16 providers that agree to:
360.17 (1) provide secondary and post-secondary summer health care
360.18 interns with formal exposure to the health care profession;
360.19 (2) provide an orientation for the secondary and
360.20 post-secondary summer health care interns;
360.21 (3) pay one-half the costs of employing the secondary and
360.22 post-secondary summer health care intern, based on an overall
360.23 hourly wage that is at least the minimum wage but does not
360.24 exceed $6 an hour;
360.25 (4) interview and hire secondary and post-secondary pupils
360.26 for a minimum of six weeks and a maximum of 12 weeks; and
360.27 (5) employ at least one secondary student for each
360.28 post-secondary student employed, to the extent that there are
360.29 sufficient qualifying secondary student applicants.
360.30 (b) In order to be eligible to be hired as a secondary
360.31 summer health intern by a hospital or, clinic, nursing facility,
360.32 or home care provider, a pupil must:
360.33 (1) intend to complete high school graduation requirements
360.34 and be between the junior and senior year of high school; and
360.35 (2) be from a school district in proximity to the facility;
360.36 and
361.1 (3) provide the facility with a letter of recommendation
361.2 from a health occupations or science educator.
361.3 (c) In order to be eligible to be hired as a post-secondary
361.4 summer health care intern by a hospital or clinic, a pupil must:
361.5 (1) intend to complete a health care training program or a
361.6 two-year or four-year degree program and be planning on
361.7 enrolling in or be enrolled in that training program or degree
361.8 program; and
361.9 (2) be enrolled in a Minnesota educational institution or
361.10 be a resident of the state of Minnesota; priority must be given
361.11 to applicants from a school district or an educational
361.12 institution in proximity to the facility; and
361.13 (3) provide the facility with a letter of recommendation
361.14 from a health occupations or science educator.
361.15 (d) Hospitals and, clinics, nursing facilities, and home
361.16 care providers awarded grants may employ pupils as secondary and
361.17 post-secondary summer health care interns beginning on or after
361.18 June 15, 1993, if they agree to pay the intern, during the
361.19 period before disbursement of state grant money, with money
361.20 designated as the facility's 50 percent contribution towards
361.21 internship costs.
361.22 Subd. 3. [GRANTS.] The commissioner, through the
361.23 organization under contract, shall award separate grants to
361.24 hospitals and, clinics, nursing facilities, and home care
361.25 providers meeting the requirements of subdivision 2. The grants
361.26 must be used to pay one-half of the costs of employing secondary
361.27 and post-secondary pupils in a hospital or, clinic, nursing
361.28 facility, or home care setting during the course of the
361.29 program. No more than 50 percent of the participants may be
361.30 post-secondary students, unless the program does not receive
361.31 enough qualified secondary applicants per fiscal year. No more
361.32 than five pupils may be selected from any secondary or
361.33 post-secondary institution to participate in the program and no
361.34 more than one-half of the number of pupils selected may be from
361.35 the seven-county metropolitan area.
361.36 Subd. 4. [CONTRACT.] The commissioner shall contract with
362.1 a statewide, nonprofit organization representing facilities at
362.2 which secondary and post-secondary summer health care interns
362.3 will serve, to administer the grant program established by this
362.4 section. Grant funds that are not used in one fiscal year may
362.5 be carried over to the next fiscal year. The organization
362.6 awarded the grant shall provide the commissioner with any
362.7 information needed by the commissioner to evaluate the program,
362.8 in the form and at the times specified by the commissioner.
362.9 Sec. 2. [144.1499] [PROMOTION OF HEALTH CARE AND LONG-TERM
362.10 CARE CAREERS.]
362.11 The commissioner of health, in consultation with an
362.12 organization representing health care employers, long-term care
362.13 employers, and educational institutions, may make grants to
362.14 qualifying consortia as defined in section 116L.11, subdivision
362.15 4, for intergenerational programs to encourage middle and high
362.16 school students to work and volunteer in health care and
362.17 long-term care settings. To qualify for a grant under this
362.18 section, a consortium shall:
362.19 (1) develop a health and long-term care careers curriculum
362.20 that provides career exploration and training in national skill
362.21 standards for health care and long-term care and that is
362.22 consistent with Minnesota graduation standards and other related
362.23 requirements;
362.24 (2) offer programs for high school students that provide
362.25 training in health and long-term care careers with credits that
362.26 articulate into post-secondary programs; and
362.27 (3) provide technical support to the participating health
362.28 care and long-term care employer to enable the use of the
362.29 employer's facilities and programs for K-12 health and long-term
362.30 care careers education.
362.31 Sec. 3. Minnesota Statutes 2000, section 144A.62,
362.32 subdivision 1, is amended to read:
362.33 Subdivision 1. [ASSISTANCE WITH EATING AND DRINKING.] (a)
362.34 Upon federal approval, a nursing home may employ resident
362.35 attendants to assist with the activities authorized under
362.36 subdivision 2. The resident attendant will not shall be counted
363.1 in the minimum staffing requirements under section 144A.04,
363.2 subdivision 7.
363.3 (b) The commissioner shall submit by May July 15, 2000
363.4 2001, a new request for a federal waiver necessary to implement
363.5 this section.
363.6 Sec. 4. Minnesota Statutes 2000, section 144A.62,
363.7 subdivision 2, is amended to read:
363.8 Subd. 2. [DEFINITION.] (a) "Resident attendant" means an
363.9 individual who assists residents in a nursing home with the one
363.10 or more of the following activities of eating and drinking:
363.11 (1) eating and drinking; and
363.12 (2) transporting.
363.13 (b) A resident attendant does not include an individual who:
363.14 (1) is a licensed health professional or a registered
363.15 dietitian;
363.16 (2) volunteers without monetary compensation; or
363.17 (3) is a registered nursing assistant.
363.18 Sec. 5. Minnesota Statutes 2000, section 144A.62,
363.19 subdivision 3, is amended to read:
363.20 Subd. 3. [REQUIREMENTS.] (a) A nursing home may not use on
363.21 a full-time or other paid basis any individual as a resident
363.22 attendant in the nursing home unless the individual:
363.23 (1) has completed a training and competency evaluation
363.24 program encompassing the tasks activities in subdivision 2 that
363.25 the individual provides;
363.26 (2) is competent to provide feeding and hydration services
363.27 those activities; and
363.28 (3) is under the supervision of the director of nursing.
363.29 (b) A nursing home may not use a current employee as a
363.30 resident attendant unless the employee satisfies the
363.31 requirements of paragraph (a) and volunteers to be used in that
363.32 capacity.
363.33 Sec. 6. Minnesota Statutes 2000, section 144A.62,
363.34 subdivision 4, is amended to read:
363.35 Subd. 4. [EVALUATION.] The training and competency
363.36 evaluation program may be facility based. It must include, at a
364.1 minimum, the training and competency standards for eating and
364.2 drinking assistance the specific activities the attendant will
364.3 be conducting contained in the nursing assistant training
364.4 curriculum.
364.5 Sec. 7. Minnesota Statutes 2000, section 148.212, is
364.6 amended to read:
364.7 148.212 [TEMPORARY PERMIT.]
364.8 Upon receipt of the applicable licensure or reregistration
364.9 fee and permit fee, and in accordance with rules of the board,
364.10 the board may issue a nonrenewable temporary permit to practice
364.11 professional or practical nursing to an applicant for licensure
364.12 or reregistration who is not the subject of a pending
364.13 investigation or disciplinary action, nor disqualified for any
364.14 other reason, under the following circumstances:
364.15 (a) The applicant for licensure by examination under
364.16 section 148.211, subdivision 1, has graduated from an approved
364.17 nursing program within the 60 days preceding board receipt of an
364.18 affidavit of graduation or transcript and has been authorized by
364.19 the board to write the licensure examination for the first time
364.20 in the United States. The permit holder must practice
364.21 professional or practical nursing under the direct supervision
364.22 of a registered nurse. The permit is valid from the date of
364.23 issue until the date the board takes action on the application
364.24 or for 60 days whichever occurs first.
364.25 (b) The applicant for licensure by endorsement under
364.26 section 148.211, subdivision 2, is currently licensed to
364.27 practice professional or practical nursing in another state,
364.28 territory, or Canadian province. The permit is valid from
364.29 submission of a proper request until the date of board action on
364.30 the application.
364.31 (c) The applicant for licensure by endorsement under
364.32 section 148.211, subdivision 2, or for reregistration under
364.33 section 148.231, subdivision 5, is currently registered in a
364.34 formal, structured refresher course or its equivalent for nurses
364.35 that includes clinical practice.
364.36 (d) The applicant for licensure by examination under
365.1 section 148.211, subdivision 1, as a registered nurse has been
365.2 issued a commission on graduates of foreign nurse schools
365.3 certificate, has completed all requirements for licensure except
365.4 the licensing examination, and has been authorized by the board
365.5 to write the licensure examination for the first time in the
365.6 United States. The permit holder must practice professional
365.7 nursing under the direct supervision of a registered nurse. The
365.8 permit is valid from the date of issue until the date the board
365.9 takes action on the application or for 60 days, whichever occurs
365.10 first.
365.11 ARTICLE 7
365.12 REGULATION OF SUPPLEMENTAL
365.13 NURSING SERVICES AGENCIES
365.14 Section 1. [144A.70] [REGISTRATION OF SUPPLEMENTAL NURSING
365.15 SERVICES AGENCIES; DEFINITIONS.]
365.16 Subdivision 1. [SCOPE.] As used in sections 144A.70 to
365.17 144A.74, the terms defined in this section have the meanings
365.18 given them.
365.19 Subd. 2. [COMMISSIONER.] "Commissioner" means the
365.20 commissioner of health.
365.21 Subd. 3. [CONTROLLING PERSON.] "Controlling person" means
365.22 a business entity, officer, program administrator, or director
365.23 whose responsibilities include the direction of the management
365.24 or policies of a supplemental nursing services agency.
365.25 Controlling person also means an individual who, directly or
365.26 indirectly, beneficially owns an interest in a corporation,
365.27 partnership, or other business association that is a controlling
365.28 person.
365.29 Subd. 4. [HEALTH CARE FACILITY.] "Health care facility"
365.30 means a hospital, boarding care home, or outpatient surgical
365.31 center licensed under sections 144.50 to 144.58, a nursing home
365.32 or home care agency licensed under this chapter, a residential
365.33 care home, or a board and lodging establishment that is
365.34 registered to provide supportive or health supervision services
365.35 under section 157.17.
365.36 Subd. 5. [PERSON.] "Person" includes an individual, firm,
366.1 corporation, partnership, or association.
366.2 Subd. 6. [SUPPLEMENTAL NURSING SERVICES
366.3 AGENCY.] "Supplemental nursing services agency" means a person,
366.4 firm, corporation, partnership, or association engaged for hire
366.5 in the business of providing or procuring temporary employment
366.6 in health care facilities for nurses, nursing assistants, nurse
366.7 aides, and orderlies. Supplemental nursing services agency does
366.8 not include an individual who only engages in providing the
366.9 individual's services on a temporary basis to health care
366.10 facilities. Supplemental nursing services agency also does not
366.11 include any nursing services agency that is limited to providing
366.12 temporary nursing personnel solely to one or more health care
366.13 facilities owned or operated by the same person, firm,
366.14 corporation, or partnership.
366.15 Sec. 2. [144A.71] [SUPPLEMENTAL NURSING SERVICES AGENCY
366.16 REGISTRATION.]
366.17 Subdivision 1. [DUTY TO REGISTER.] A person who operates a
366.18 supplemental nursing services agency shall register the agency
366.19 with the commissioner. Each separate location of the business
366.20 of a supplemental nursing services agency shall register the
366.21 agency with the commissioner. Each separate location of the
366.22 business of a supplemental nursing services agency shall have a
366.23 separate registration.
366.24 Subd. 2. [APPLICATION INFORMATION AND FEE.] The
366.25 commissioner shall establish forms and procedures for processing
366.26 each supplemental nursing services agency registration
366.27 application. An application for a supplemental nursing services
366.28 agency registration must include at least the following:
366.29 (1) the names and addresses of the owner or owners of the
366.30 supplemental nursing services agency;
366.31 (2) if the owner is a corporation, copies of its articles
366.32 of incorporation and current bylaws, together with the names and
366.33 addresses of its officers and directors;
366.34 (3) any other relevant information that the commissioner
366.35 determines is necessary to properly evaluate an application for
366.36 registration; and
367.1 (4) the annual registration fee for a supplemental nursing
367.2 services agency, which is $891.
367.3 Subd. 3. [REGISTRATION NOT TRANSFERABLE.] A registration
367.4 issued by the commissioner according to this section is
367.5 effective for a period of one year from the date of its issuance
367.6 unless the registration is revoked or suspended under section
367.7 144A.72, subdivision 2, or unless the supplemental nursing
367.8 services agency is sold or ownership or management is
367.9 transferred. When a supplemental nursing services agency is
367.10 sold or ownership or management is transferred, the registration
367.11 of the agency must be voided and the new owner or operator may
367.12 apply for a new registration.
367.13 Sec. 3. [144A.72] [REGISTRATION REQUIREMENTS.]
367.14 The commissioner shall require that, as a condition of
367.15 registration:
367.16 (1) the supplemental nursing services agency shall document
367.17 that each temporary employee provided to health care facilities
367.18 currently meets the minimum licensing, training, and continuing
367.19 education standards for the position in which the employee will
367.20 be working;
367.21 (2) the supplemental nursing services agency shall comply
367.22 with all pertinent requirements relating to the health and other
367.23 qualifications of personnel employed in health care facilities;
367.24 (3) the supplemental nursing services agency must not
367.25 restrict in any manner the employment opportunities of its
367.26 employees;
367.27 (4) the supplemental nursing services agency, when
367.28 supplying temporary employees to a health care facility, and
367.29 when requested by the facility to do so, shall agree that at
367.30 least 30 percent of the total personnel hours supplied are
367.31 during night, holiday, or weekend shifts;
367.32 (5) the supplemental nursing services agency shall carry
367.33 medical malpractice insurance to insure against the loss,
367.34 damage, or expense incident to a claim arising out of the death
367.35 or injury of any person as the result of negligence or
367.36 malpractice in the provision of health care services by the
368.1 supplemental nursing services agency or by any employee of the
368.2 agency; and
368.3 (6) the supplemental nursing services agency must not, in
368.4 any contract with any employee or health care facility, require
368.5 the payment of liquidated damages, employment fees, or other
368.6 compensation should the employee be hired as a permanent
368.7 employee of a health care facility.
368.8 Sec. 4. [144A.73] [COMPLAINT SYSTEM.]
368.9 The commissioner shall establish a system for reporting
368.10 complaints against a supplemental nursing services agency or its
368.11 employees. Complaints may be made by any member of the public.
368.12 Written complaints must be forwarded to the employer of each
368.13 person against whom a complaint is made. The employer shall
368.14 promptly report to the commissioner any corrective action taken.
368.15 Sec. 5. [144A.74] [MAXIMUM CHARGES.]
368.16 A supplemental nursing services agency must not bill or
368.17 receive payments from a nursing home licensed under this chapter
368.18 at a rate higher than 150 percent of the weighted average wage
368.19 rate for the applicable employee classification for the
368.20 geographic group to which the nursing home is assigned under
368.21 chapter 256B. The weighted average wage rates must be
368.22 determined by the commissioner of human services and reported to
368.23 the commissioner of health on an annual basis. Facilities shall
368.24 provide information necessary to determine weighted average wage
368.25 rates to the commissioner of human services in a format
368.26 requested by the commissioner. The maximum rate must include
368.27 all charges for administrative fees, contract fees, or other
368.28 special charges in addition to the hourly rates for the
368.29 temporary nursing pool personnel supplied to a nursing home.
368.30 Sec. 6. Minnesota Statutes 2000, section 245A.04,
368.31 subdivision 3, is amended to read:
368.32 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.]
368.33 (a) Before the commissioner issues a license, the commissioner
368.34 shall conduct a study of the individuals specified in paragraph
368.35 (c) (d), clauses (1) to (5), according to rules of the
368.36 commissioner.
369.1 Beginning January 1, 1997, the commissioner shall also
369.2 conduct a study of employees providing direct contact services
369.3 for nonlicensed personal care provider organizations described
369.4 in paragraph (c) (d), clause (5).
369.5 The commissioner shall recover the cost of these background
369.6 studies through a fee of no more than $12 per study charged to
369.7 the personal care provider organization. The fees collected
369.8 under this paragraph are appropriated to the commissioner for
369.9 the purpose of conducting background studies.
369.10 Beginning August 1, 1997, the commissioner shall conduct
369.11 all background studies required under this chapter for adult
369.12 foster care providers who are licensed by the commissioner of
369.13 human services and registered under chapter 144D. The
369.14 commissioner shall conduct these background studies in
369.15 accordance with this chapter. The commissioner shall initiate a
369.16 pilot project to conduct up to 5,000 background studies under
369.17 this chapter in programs with joint licensure as home and
369.18 community-based services and adult foster care for people with
369.19 developmental disabilities when the license holder does not
369.20 reside in the foster care residence.
369.21 (b) Beginning July 1, 1998, the commissioner shall conduct
369.22 a background study on individuals specified in
369.23 paragraph (c) (d), clauses (1) to (5), who perform direct
369.24 contact services in a nursing home or a home care agency
369.25 licensed under chapter 144A or a boarding care home licensed
369.26 under sections 144.50 to 144.58, when the subject of the study
369.27 resides outside Minnesota; the study must be at least as
369.28 comprehensive as that of a Minnesota resident and include a
369.29 search of information from the criminal justice data
369.30 communications network in the state where the subject of the
369.31 study resides.
369.32 (c) Beginning August 1, 2001, the commissioner shall
369.33 conduct all background studies required under this chapter and
369.34 initiated by supplemental nursing services agencies registered
369.35 under chapter 144A. Studies for the agencies must be initiated
369.36 annually by each agency. The commissioner shall conduct the
370.1 background studies according to this chapter. The commissioner
370.2 shall recover the cost of the background studies through a fee
370.3 of no more than $8 per study, charged to the supplemental
370.4 nursing services agency. The fees collected under this
370.5 paragraph are appropriated to the commissioner for the purpose
370.6 of conducting background studies.
370.7 (d) The applicant, license holder, the registrant, bureau
370.8 of criminal apprehension, the commissioner of health, and county
370.9 agencies, after written notice to the individual who is the
370.10 subject of the study, shall help with the study by giving the
370.11 commissioner criminal conviction data and reports about the
370.12 maltreatment of adults substantiated under section 626.557 and
370.13 the maltreatment of minors in licensed programs substantiated
370.14 under section 626.556. The individuals to be studied shall
370.15 include:
370.16 (1) the applicant;
370.17 (2) persons over the age of 13 living in the household
370.18 where the licensed program will be provided;
370.19 (3) current employees or contractors of the applicant who
370.20 will have direct contact with persons served by the facility,
370.21 agency, or program;
370.22 (4) volunteers or student volunteers who have direct
370.23 contact with persons served by the program to provide program
370.24 services, if the contact is not directly supervised by the
370.25 individuals listed in clause (1) or (3); and
370.26 (5) any person who, as an individual or as a member of an
370.27 organization, exclusively offers, provides, or arranges for
370.28 personal care assistant services under the medical assistance
370.29 program as authorized under sections 256B.04, subdivision 16,
370.30 and 256B.0625, subdivision 19a.
370.31 The juvenile courts shall also help with the study by
370.32 giving the commissioner existing juvenile court records on
370.33 individuals described in clause (2) relating to delinquency
370.34 proceedings held within either the five years immediately
370.35 preceding the application or the five years immediately
370.36 preceding the individual's 18th birthday, whichever time period
371.1 is longer. The commissioner shall destroy juvenile records
371.2 obtained pursuant to this subdivision when the subject of the
371.3 records reaches age 23.
371.4 For purposes of this section and Minnesota Rules, part
371.5 9543.3070, a finding that a delinquency petition is proven in
371.6 juvenile court shall be considered a conviction in state
371.7 district court.
371.8 For purposes of this subdivision, "direct contact" means
371.9 providing face-to-face care, training, supervision, counseling,
371.10 consultation, or medication assistance to persons served by a
371.11 program. For purposes of this subdivision, "directly supervised"
371.12 means an individual listed in clause (1), (3), or (5) is within
371.13 sight or hearing of a volunteer to the extent that the
371.14 individual listed in clause (1), (3), or (5) is capable at all
371.15 times of intervening to protect the health and safety of the
371.16 persons served by the program who have direct contact with the
371.17 volunteer.
371.18 A study of an individual in clauses (1) to (5) shall be
371.19 conducted at least upon application for initial license or
371.20 registration and reapplication for a license or registration.
371.21 The commissioner is not required to conduct a study of an
371.22 individual at the time of reapplication for a license or if the
371.23 individual has been continuously affiliated with a foster care
371.24 provider licensed by the commissioner of human services and
371.25 registered under chapter 144D, other than a family day care or
371.26 foster care license, if: (i) a study of the individual was
371.27 conducted either at the time of initial licensure or when the
371.28 individual became affiliated with the license holder; (ii) the
371.29 individual has been continuously affiliated with the license
371.30 holder since the last study was conducted; and (iii) the
371.31 procedure described in paragraph (d) (e) has been implemented
371.32 and was in effect continuously since the last study was
371.33 conducted. For the purposes of this section, a physician
371.34 licensed under chapter 147 is considered to be continuously
371.35 affiliated upon the license holder's receipt from the
371.36 commissioner of health or human services of the physician's
372.1 background study results. For individuals who are required to
372.2 have background studies under clauses (1) to (5) and who have
372.3 been continuously affiliated with a foster care provider that is
372.4 licensed in more than one county, criminal conviction data may
372.5 be shared among those counties in which the foster care programs
372.6 are licensed. A county agency's receipt of criminal conviction
372.7 data from another county agency shall meet the criminal data
372.8 background study requirements of this section.
372.9 The commissioner may also conduct studies on individuals
372.10 specified in clauses (3) and (4) when the studies are initiated
372.11 by:
372.12 (i) personnel pool agencies;
372.13 (ii) temporary personnel agencies;
372.14 (iii) educational programs that train persons by providing
372.15 direct contact services in licensed programs; and
372.16 (iv) professional services agencies that are not licensed
372.17 and which contract with licensed programs to provide direct
372.18 contact services or individuals who provide direct contact
372.19 services.
372.20 Studies on individuals in items (i) to (iv) must be
372.21 initiated annually by these agencies, programs, and
372.22 individuals. Except for personal care provider
372.23 organizations and supplemental nursing services agencies, no
372.24 applicant, license holder, or individual who is the subject of
372.25 the study shall pay any fees required to conduct the study.
372.26 (1) At the option of the licensed facility, rather than
372.27 initiating another background study on an individual required to
372.28 be studied who has indicated to the licensed facility that a
372.29 background study by the commissioner was previously completed,
372.30 the facility may make a request to the commissioner for
372.31 documentation of the individual's background study status,
372.32 provided that:
372.33 (i) the facility makes this request using a form provided
372.34 by the commissioner;
372.35 (ii) in making the request the facility informs the
372.36 commissioner that either:
373.1 (A) the individual has been continuously affiliated with a
373.2 licensed facility since the individual's previous background
373.3 study was completed, or since October 1, 1995, whichever is
373.4 shorter; or
373.5 (B) the individual is affiliated only with a personnel pool
373.6 agency, a temporary personnel agency, an educational program
373.7 that trains persons by providing direct contact services in
373.8 licensed programs, or a professional services agency that is not
373.9 licensed and which contracts with licensed programs to provide
373.10 direct contact services or individuals who provide direct
373.11 contact services; and
373.12 (iii) the facility provides notices to the individual as
373.13 required in paragraphs (a) to (d) (e), and that the facility is
373.14 requesting written notification of the individual's background
373.15 study status from the commissioner.
373.16 (2) The commissioner shall respond to each request under
373.17 paragraph (1) with a written or electronic notice to the
373.18 facility and the study subject. If the commissioner determines
373.19 that a background study is necessary, the study shall be
373.20 completed without further request from a licensed agency or
373.21 notifications to the study subject.
373.22 (3) When a background study is being initiated by a
373.23 licensed facility or a foster care provider that is also
373.24 registered under chapter 144D, a study subject affiliated with
373.25 multiple licensed facilities may attach to the background study
373.26 form a cover letter indicating the additional facilities' names,
373.27 addresses, and background study identification numbers. When
373.28 the commissioner receives such notices, each facility identified
373.29 by the background study subject shall be notified of the study
373.30 results. The background study notice sent to the subsequent
373.31 agencies shall satisfy those facilities' responsibilities for
373.32 initiating a background study on that individual.
373.33 (d) (e) If an individual who is affiliated with a program
373.34 or facility regulated by the department of human services or
373.35 department of health or who is affiliated with a nonlicensed
373.36 personal care provider organization, is convicted of a crime
374.1 constituting a disqualification under subdivision 3d, the
374.2 probation officer or corrections agent shall notify the
374.3 commissioner of the conviction. The commissioner, in
374.4 consultation with the commissioner of corrections, shall develop
374.5 forms and information necessary to implement this paragraph and
374.6 shall provide the forms and information to the commissioner of
374.7 corrections for distribution to local probation officers and
374.8 corrections agents. The commissioner shall inform individuals
374.9 subject to a background study that criminal convictions for
374.10 disqualifying crimes will be reported to the commissioner by the
374.11 corrections system. A probation officer, corrections agent, or
374.12 corrections agency is not civilly or criminally liable for
374.13 disclosing or failing to disclose the information required by
374.14 this paragraph. Upon receipt of disqualifying information, the
374.15 commissioner shall provide the notifications required in
374.16 subdivision 3a, as appropriate to agencies on record as having
374.17 initiated a background study or making a request for
374.18 documentation of the background study status of the individual.
374.19 This paragraph does not apply to family day care and child
374.20 foster care programs.
374.21 (e) (f) The individual who is the subject of the study must
374.22 provide the applicant or license holder with sufficient
374.23 information to ensure an accurate study including the
374.24 individual's first, middle, and last name; home address, city,
374.25 county, and state of residence for the past five years; zip
374.26 code; sex; date of birth; and driver's license number. The
374.27 applicant or license holder shall provide this information about
374.28 an individual in paragraph (c) (d), clauses (1) to (5), on forms
374.29 prescribed by the commissioner. By January 1, 2000, for
374.30 background studies conducted by the department of human
374.31 services, the commissioner shall implement a system for the
374.32 electronic transmission of: (1) background study information to
374.33 the commissioner; and (2) background study results to the
374.34 license holder. The commissioner may request additional
374.35 information of the individual, which shall be optional for the
374.36 individual to provide, such as the individual's social security
375.1 number or race.
375.2 (f) (g) Except for child foster care, adult foster care,
375.3 and family day care homes, a study must include information
375.4 related to names of substantiated perpetrators of maltreatment
375.5 of vulnerable adults that has been received by the commissioner
375.6 as required under section 626.557, subdivision 9c, paragraph
375.7 (i), and the commissioner's records relating to the maltreatment
375.8 of minors in licensed programs, information from juvenile courts
375.9 as required in paragraph (c) (d) for persons listed in paragraph
375.10 (c) (d), clause (2), and information from the bureau of criminal
375.11 apprehension. For child foster care, adult foster care, and
375.12 family day care homes, the study must include information from
375.13 the county agency's record of substantiated maltreatment of
375.14 adults, and the maltreatment of minors, information from
375.15 juvenile courts as required in paragraph (c) (d) for persons
375.16 listed in paragraph (c) (d), clause (2), and information from
375.17 the bureau of criminal apprehension. The commissioner may also
375.18 review arrest and investigative information from the bureau of
375.19 criminal apprehension, the commissioner of health, a county
375.20 attorney, county sheriff, county agency, local chief of police,
375.21 other states, the courts, or the Federal Bureau of Investigation
375.22 if the commissioner has reasonable cause to believe the
375.23 information is pertinent to the disqualification of an
375.24 individual listed in paragraph (c) (d), clauses (1) to (5). The
375.25 commissioner is not required to conduct more than one review of
375.26 a subject's records from the Federal Bureau of Investigation if
375.27 a review of the subject's criminal history with the Federal
375.28 Bureau of Investigation has already been completed by the
375.29 commissioner and there has been no break in the subject's
375.30 affiliation with the license holder who initiated the background
375.31 studies.
375.32 When the commissioner has reasonable cause to believe that
375.33 further pertinent information may exist on the subject, the
375.34 subject shall provide a set of classifiable fingerprints
375.35 obtained from an authorized law enforcement agency. For
375.36 purposes of requiring fingerprints, the commissioner shall be
376.1 considered to have reasonable cause under, but not limited to,
376.2 the following circumstances:
376.3 (1) information from the bureau of criminal apprehension
376.4 indicates that the subject is a multistate offender;
376.5 (2) information from the bureau of criminal apprehension
376.6 indicates that multistate offender status is undetermined; or
376.7 (3) the commissioner has received a report from the subject
376.8 or a third party indicating that the subject has a criminal
376.9 history in a jurisdiction other than Minnesota.
376.10 (g) (h) An applicant's or, license holder's, or
376.11 registrant's failure or refusal to cooperate with the
376.12 commissioner is reasonable cause to disqualify a subject, deny a
376.13 license application or immediately suspend, suspend, or revoke a
376.14 license or registration. Failure or refusal of an individual to
376.15 cooperate with the study is just cause for denying or
376.16 terminating employment of the individual if the individual's
376.17 failure or refusal to cooperate could cause the applicant's
376.18 application to be denied or the license holder's license to be
376.19 immediately suspended, suspended, or revoked.
376.20 (h) (i) The commissioner shall not consider an application
376.21 to be complete until all of the information required to be
376.22 provided under this subdivision has been received.
376.23 (i) (j) No person in paragraph (c) (d), clause (1), (2),
376.24 (3), (4), or (5), who is disqualified as a result of this
376.25 section may be retained by the agency in a position involving
376.26 direct contact with persons served by the program.
376.27 (j) (k) Termination of persons in paragraph (c) (d), clause
376.28 (1), (2), (3), (4), or (5), made in good faith reliance on a
376.29 notice of disqualification provided by the commissioner shall
376.30 not subject the applicant or license holder to civil liability.
376.31 (k) (l) The commissioner may establish records to fulfill
376.32 the requirements of this section.
376.33 (l) (m) The commissioner may not disqualify an individual
376.34 subject to a study under this section because that person has,
376.35 or has had, a mental illness as defined in section 245.462,
376.36 subdivision 20.
377.1 (m) (n) An individual subject to disqualification under
377.2 this subdivision has the applicable rights in subdivision 3a,
377.3 3b, or 3c.
377.4 (n) (o) For the purposes of background studies completed by
377.5 tribal organizations performing licensing activities otherwise
377.6 required of the commissioner under this chapter, after obtaining
377.7 consent from the background study subject, tribal licensing
377.8 agencies shall have access to criminal history data in the same
377.9 manner as county licensing agencies and private licensing
377.10 agencies under this chapter.
377.11 Sec. 7. [REPORT ON SUPPLEMENTAL NURSING SERVICES AGENCY
377.12 USE.]
377.13 Beginning July 1, 2001, through June 30, 2003, the
377.14 commissioner of human services shall require nursing facilities
377.15 and other providers of long-term care services to report
377.16 semiannually on the use of supplemental nursing services, in the
377.17 form and manner specified by the commissioner. The information
377.18 reported must include, but is not limited to:
377.19 (1) number of hours worked by supplemental nursing services
377.20 personnel, by job classification, for each month;
377.21 (2) payments to supplemental nursing services agencies, on
377.22 a per hour worked basis, by job classification, for each month;
377.23 and
377.24 (3) percentage of total monthly work hours provided by
377.25 supplemental nursing services agency personnel, by job
377.26 classification, for each shift and for weekdays and weekends.
377.27 ARTICLE 8
377.28 LONG-TERM CARE INSURANCE
377.29 Section 1. Minnesota Statutes 2000, section 62A.48,
377.30 subdivision 4, is amended to read:
377.31 Subd. 4. [LOSS RATIO.] The anticipated loss ratio for
377.32 long-term care policies must not be less than 65 percent for
377.33 policies issued on a group basis or 60 percent for policies
377.34 issued on an individual or mass-market basis. This subdivision
377.35 does not apply to policies issued on or after January 1, 2002,
377.36 that comply with sections 62S.021 and 62S.081.
378.1 [EFFECTIVE DATE.] This section is effective the day
378.2 following final enactment.
378.3 Sec. 2. Minnesota Statutes 2000, section 62A.48, is
378.4 amended by adding a subdivision to read:
378.5 Subd. 10. [REGULATION OF PREMIUMS AND PREMIUM
378.6 INCREASES.] Policies issued under sections 62A.46 to 62A.56 on
378.7 or after January 1, 2002, must comply with sections 62S.021,
378.8 62S.081, 62S.265, and 62S.266 to the same extent as policies
378.9 issued under chapter 62S.
378.10 [EFFECTIVE DATE.] This section is effective the day
378.11 following final enactment.
378.12 Sec. 3. Minnesota Statutes 2000, section 62A.48, is
378.13 amended by adding a subdivision to read:
378.14 Subd. 11. [NONFORFEITURE BENEFITS.] Policies issued under
378.15 sections 62A.46 to 62A.56 on or after January 1, 2002, must
378.16 comply with section 62S.02, subdivision 2, to the same extent as
378.17 policies issued under chapter 62S.
378.18 [EFFECTIVE DATE.] This section is effective the day
378.19 following final enactment.
378.20 Sec. 4. Minnesota Statutes 2000, section 62S.01, is
378.21 amended by adding a subdivision to read:
378.22 Subd. 13a. [EXCEPTIONAL INCREASE.] (a) "Exceptional
378.23 increase" means only those premium rate increases filed by an
378.24 insurer as exceptional for which the commissioner determines
378.25 that the need for the premium rate increase is justified due to
378.26 changes in laws or rules applicable to long-term care coverage
378.27 in this state, or due to increased and unexpected utilization
378.28 that affects the majority of insurers of similar products.
378.29 (b) Except as provided in section 62S.265, exceptional
378.30 increases are subject to the same requirements as other premium
378.31 rate schedule increases. The commissioner may request a review
378.32 by an independent actuary or a professional actuarial body of
378.33 the basis for a request that an increase be considered an
378.34 exceptional increase. The commissioner, in determining that the
378.35 necessary basis for an exceptional increase exists, shall also
378.36 determine any potential offsets to higher claims costs.
379.1 [EFFECTIVE DATE.] This section is effective the day
379.2 following final enactment.
379.3 Sec. 5. Minnesota Statutes 2000, section 62S.01, is
379.4 amended by adding a subdivision to read:
379.5 Subd. 17a. [INCIDENTAL.] "Incidental," as used in section
379.6 62S.265, subdivision 10, means that the value of the long-term
379.7 care benefits provided is less than ten percent of the total
379.8 value of the benefits provided over the life of the policy.
379.9 These values must be measured as of the date of issue.
379.10 [EFFECTIVE DATE.] This section is effective the day
379.11 following final enactment.
379.12 Sec. 6. Minnesota Statutes 2000, section 62S.01, is
379.13 amended by adding a subdivision to read:
379.14 Subd. 23a. [QUALIFIED ACTUARY.] "Qualified actuary" means
379.15 a member in good standing of the American Academy of Actuaries.
379.16 [EFFECTIVE DATE.] This section is effective the day
379.17 following final enactment.
379.18 Sec. 7. Minnesota Statutes 2000, section 62S.01, is
379.19 amended by adding a subdivision to read:
379.20 Subd. 25a. [SIMILAR POLICY FORMS.] "Similar policy forms"
379.21 means all of the long-term care insurance policies and
379.22 certificates issued by an insurer in the same long-term care
379.23 benefit classification as the policy form being considered.
379.24 Certificates of groups that meet the definition in section
379.25 62S.01, subdivision 15, clause (1), are not considered similar
379.26 to certificates or policies otherwise issued as long-term care
379.27 insurance, but are similar to other comparable certificates with
379.28 the same long-term care benefit classifications. For purposes
379.29 of determining similar policy forms, long-term care benefit
379.30 classifications are defined as follows: institutional long-term
379.31 care benefits only, noninstitutional long-term care benefits
379.32 only, or comprehensive long-term care benefits.
379.33 [EFFECTIVE DATE.] This section is effective the day
379.34 following final enactment.
379.35 Sec. 8. [62S.021] [LONG-TERM CARE INSURANCE; INITIAL
379.36 FILING.]
380.1 Subdivision 1. [APPLICABILITY.] This section applies to
380.2 any long-term care policy issued in this state on or after
380.3 January 1, 2002, under this chapter or sections 62A.46 to 62A.56.
380.4 Subd. 2. [REQUIRED SUBMISSION TO COMMISSIONER.] An insurer
380.5 shall provide the following information to the commissioner 30
380.6 days prior to making a long-term care insurance form available
380.7 for sale:
380.8 (1) a copy of the disclosure documents required in section
380.9 62S.081; and
380.10 (2) an actuarial certification consisting of at least the
380.11 following:
380.12 (i) a statement that the initial premium rate schedule is
380.13 sufficient to cover anticipated costs under moderately adverse
380.14 experience and that the premium rate schedule is reasonably
380.15 expected to be sustainable over the life of the form with no
380.16 future premium increases anticipated;
380.17 (ii) a statement that the policy design and coverage
380.18 provided have been reviewed and taken into consideration;
380.19 (iii) a statement that the underwriting and claims
380.20 adjudication processes have been reviewed and taken into
380.21 consideration; and
380.22 (iv) a complete description of the basis for contract
380.23 reserves that are anticipated to be held under the form, to
380.24 include:
380.25 (A) sufficient detail or sample calculations provided so as
380.26 to have a complete depiction of the reserve amounts to be held;
380.27 (B) a statement that the assumptions used for reserves
380.28 contain reasonable margins for adverse experience;
380.29 (C) a statement that the net valuation premium for renewal
380.30 years does not increase, except for attained-age rating where
380.31 permitted;
380.32 (D) a statement that the difference between the gross
380.33 premium and the net valuation premium for renewal years is
380.34 sufficient to cover expected renewal expenses, or if such a
380.35 statement cannot be made, a complete description of the
380.36 situations in which this does not occur. An aggregate
381.1 distribution of anticipated issues may be used as long as the
381.2 underlying gross premiums maintain a reasonably consistent
381.3 relationship. If the gross premiums for certain age groups
381.4 appear to be inconsistent with this requirement, the
381.5 commissioner may request a demonstration under item (i) based on
381.6 a standard age distribution; and
381.7 (E) either a statement that the premium rate schedule is
381.8 not less than the premium rate schedule for existing similar
381.9 policy forms also available from the insurer except for
381.10 reasonable differences attributable to benefits, or a comparison
381.11 of the premium schedules for similar policy forms that are
381.12 currently available from the insurer with an explanation of the
381.13 differences.
381.14 Subd. 3. [ACTUARIAL DEMONSTRATION.] The commissioner may
381.15 request an actuarial demonstration that benefits are reasonable
381.16 in relation to premiums. The actuarial demonstration must
381.17 include either premium and claim experience on similar policy
381.18 forms, adjusted for any premium or benefit differences, relevant
381.19 and credible data from other studies, or both. If the
381.20 commissioner asks for additional information under this
381.21 subdivision, the 30-day time limit in subdivision 2 does not
381.22 include the time during which the insurer is preparing the
381.23 requested information.
381.24 [EFFECTIVE DATE.] This section is effective the day
381.25 following final enactment.
381.26 Sec. 9. [62S.081] [REQUIRED DISCLOSURE OF RATING PRACTICES
381.27 TO CONSUMERS.]
381.28 Subdivision 1. [APPLICATION.] This section applies as
381.29 follows:
381.30 (a) Except as provided in paragraph (b), this section
381.31 applies to any long-term care policy or certificate issued in
381.32 this state on or after January 1, 2002.
381.33 (b) For certificates issued on or after the effective date
381.34 of this section under a policy of group long-term care insurance
381.35 as defined in section 62S.01, subdivision 15, that was in force
381.36 on the effective date of this section, this section applies on
382.1 the policy anniversary following June 30, 2002.
382.2 Subd. 2. [REQUIRED DISCLOSURES.] Other than policies for
382.3 which no applicable premium rate or rate schedule increases can
382.4 be made, insurers shall provide all of the information listed in
382.5 this subdivision to the applicant at the time of application or
382.6 enrollment, unless the method of application does not allow for
382.7 delivery at that time; in this case, an insurer shall provide
382.8 all of the information listed in this subdivision to the
382.9 applicant no later than at the time of delivery of the policy or
382.10 certificate:
382.11 (1) a statement that the policy may be subject to rate
382.12 increases in the future;
382.13 (2) an explanation of potential future premium rate
382.14 revisions and the policyholder's or certificate holder's option
382.15 in the event of a premium rate revision;
382.16 (3) the premium rate or rate schedules applicable to the
382.17 applicant that will be in effect until a request is made for an
382.18 increase;
382.19 (4) a general explanation of applying premium rate or rate
382.20 schedule adjustments that must include:
382.21 (i) a description of when premium rate or rate schedule
382.22 adjustments will be effective, for example the next anniversary
382.23 date or the next billing date; and
382.24 (ii) the right to a revised premium rate or rate schedule
382.25 as provided in clause (3) if the premium rate or rate schedule
382.26 is changed; and
382.27 (5)(i) information regarding each premium rate increase on
382.28 this policy form or similar policy forms over the past ten years
382.29 for this state or any other state that, at a minimum, identifies:
382.30 (A) the policy forms for which premium rates have been
382.31 increased;
382.32 (B) the calendar years when the form was available for
382.33 purchase; and
382.34 (C) the amount or percent of each increase. The percentage
382.35 may be expressed as a percentage of the premium rate prior to
382.36 the increase and may also be expressed as minimum and maximum
383.1 percentages if the rate increase is variable by rating
383.2 characteristics;
383.3 (ii) the insurer may, in a fair manner, provide additional
383.4 explanatory information related to the rate increases;
383.5 (iii) an insurer has the right to exclude from the
383.6 disclosure premium rate increases that apply only to blocks of
383.7 business acquired from other nonaffiliated insurers or the
383.8 long-term care policies acquired from other nonaffiliated
383.9 insurers when those increases occurred prior to the acquisition;
383.10 (iv) if an acquiring insurer files for a rate increase on a
383.11 long-term care policy form acquired from nonaffiliated insurers
383.12 or a block of policy forms acquired from nonaffiliated insurers
383.13 on or before the later of the effective date of this section, or
383.14 the end of a 24-month period following the acquisition of the
383.15 block of policies, the acquiring insurer may exclude that rate
383.16 increase from the disclosure. However, the nonaffiliated
383.17 selling company must include the disclosure of that rate
383.18 increase according to item (i); and
383.19 (v) if the acquiring insurer in item (iv) files for a
383.20 subsequent rate increase, even within the 24-month period, on
383.21 the same policy form acquired from nonaffiliated insurers or
383.22 block of policy forms acquired from nonaffiliated insurers
383.23 referenced in item (iv), the acquiring insurer shall make all
383.24 disclosures required by this subdivision, including disclosure
383.25 of the earlier rate increase referenced in item (iv).
383.26 Subd. 3. [ACKNOWLEDGMENT.] An applicant shall sign an
383.27 acknowledgment at the time of application, unless the method of
383.28 application does not allow for signature at that time, that the
383.29 insurer made the disclosure required under subdivision 2. If,
383.30 due to the method of application, the applicant cannot sign an
383.31 acknowledgment at the time of application, the applicant shall
383.32 sign no later than at the time of delivery of the policy or
383.33 certificate.
383.34 Subd. 4. [FORMS.] An insurer shall use the forms in
383.35 Appendices B and F of the Long-term Care Insurance Model
383.36 Regulation adopted by the National Association of Insurance
384.1 Commissioners to comply with the requirements of subdivisions 1
384.2 and 2.
384.3 Subd. 5. [NOTICE OF INCREASE.] An insurer shall provide
384.4 notice of an upcoming premium rate schedule increase, after the
384.5 increase has been approved by the commissioner, to all
384.6 policyholders or certificate holders, if applicable, at least 45
384.7 days prior to the implementation of the premium rate schedule
384.8 increase by the insurer. The notice must include the
384.9 information required by subdivision 2 when the rate increase is
384.10 implemented.
384.11 [EFFECTIVE DATE.] This section is effective the day
384.12 following final enactment.
384.13 Sec. 10. Minnesota Statutes 2000, section 62S.26, is
384.14 amended to read:
384.15 62S.26 [LOSS RATIO.]
384.16 (a) The minimum loss ratio must be at least 60 percent,
384.17 calculated in a manner which provides for adequate reserving of
384.18 the long-term care insurance risk. In evaluating the expected
384.19 loss ratio, the commissioner shall give consideration to all
384.20 relevant factors, including:
384.21 (1) statistical credibility of incurred claims experience
384.22 and earned premiums;
384.23 (2) the period for which rates are computed to provide
384.24 coverage;
384.25 (3) experienced and projected trends;
384.26 (4) concentration of experience within early policy
384.27 duration;
384.28 (5) expected claim fluctuation;
384.29 (6) experience refunds, adjustments, or dividends;
384.30 (7) renewability features;
384.31 (8) all appropriate expense factors;
384.32 (9) interest;
384.33 (10) experimental nature of the coverage;
384.34 (11) policy reserves;
384.35 (12) mix of business by risk classification; and
384.36 (13) product features such as long elimination periods,
385.1 high deductibles, and high maximum limits.
385.2 (b) This section does not apply to policies or certificates
385.3 that are subject to sections 62S.021, 62S.081, and 62S.265, and
385.4 that comply with those sections.
385.5 [EFFECTIVE DATE.] This section is effective the day
385.6 following final enactment.
385.7 Sec. 11. [62S.265] [PREMIUM RATE SCHEDULE INCREASES.]
385.8 Subdivision 1. [APPLICABILITY.] (a) Except as provided in
385.9 paragraph (b), this section applies to any long-term care policy
385.10 or certificate issued in this state on or after January 1, 2002,
385.11 under this chapter or sections 62A.46 to 62A.56.
385.12 (b) For certificates issued on or after the effective date
385.13 of this section under a group long-term care insurance policy as
385.14 defined in section 62S.01, subdivision 15, issued under this
385.15 chapter, that was in force on the effective date of this
385.16 section, this section applies on the policy anniversary
385.17 following June 30, 2002.
385.18 Subd. 2. [NOTICE.] An insurer shall file a requested
385.19 premium rate schedule increase, including an exceptional
385.20 increase, to the commissioner for prior approval at least 60
385.21 days prior to the notice to the policyholders and shall include:
385.22 (1) all information required by section 62S.081;
385.23 (2) certification by a qualified actuary that:
385.24 (i) if the requested premium rate schedule increase is
385.25 implemented and the underlying assumptions, which reflect
385.26 moderately adverse conditions, are realized, no further premium
385.27 rate schedule increases are anticipated; and
385.28 (ii) the premium rate filing complies with this section;
385.29 (3) an actuarial memorandum justifying the rate schedule
385.30 change request that includes:
385.31 (i) lifetime projections of earned premiums and incurred
385.32 claims based on the filed premium rate schedule increase and the
385.33 method and assumptions used in determining the projected values,
385.34 including reflection of any assumptions that deviate from those
385.35 used for pricing other forms currently available for sale;
385.36 (A) annual values for the five years preceding and the
386.1 three years following the valuation date must be provided
386.2 separately;
386.3 (B) the projections must include the development of the
386.4 lifetime loss ratio, unless the rate increase is an exceptional
386.5 increase;
386.6 (C) the projections must demonstrate compliance with
386.7 subdivision 3; and
386.8 (D) for exceptional increases, the projected experience
386.9 must be limited to the increases in claims expenses attributable
386.10 to the approved reasons for the exceptional increase and, if the
386.11 commissioner determines that offsets to higher claim costs may
386.12 exist, the insurer shall use appropriate net projected
386.13 experience;
386.14 (ii) disclosure of how reserves have been incorporated in
386.15 this rate increase whenever the rate increase will trigger
386.16 contingent benefit upon lapse;
386.17 (iii) disclosure of the analysis performed to determine why
386.18 a rate adjustment is necessary, which pricing assumptions were
386.19 not realized and why, and what other actions taken by the
386.20 company have been relied upon by the actuary;
386.21 (iv) a statement that policy design, underwriting, and
386.22 claims adjudication practices have been taken into
386.23 consideration; and
386.24 (v) if it is necessary to maintain consistent premium rates
386.25 for new certificates and certificates receiving a rate increase,
386.26 the insurer shall file composite rates reflecting projections of
386.27 new certificates;
386.28 (4) a statement that renewal premium rate schedules are not
386.29 greater than new business premium rate schedules except for
386.30 differences attributable to benefits, unless sufficient
386.31 justification is provided to the commissioner; and
386.32 (5) sufficient information for review and approval of the
386.33 premium rate schedule increase by the commissioner.
386.34 Subd. 3. [REQUIREMENTS PERTAINING TO RATE INCREASES.] All
386.35 premium rate schedule increases must be determined according to
386.36 the following requirements:
387.1 (1) exceptional increases must provide that 70 percent of
387.2 the present value of projected additional premiums from the
387.3 exceptional increase will be returned to policyholders in
387.4 benefits;
387.5 (2) premium rate schedule increases must be calculated so
387.6 that the sum of the accumulated value of incurred claims,
387.7 without the inclusion of active life reserves, and the present
387.8 value of future projected incurred claims, without the inclusion
387.9 of active life reserves, will not be less than the sum of the
387.10 following:
387.11 (i) the accumulated value of the initial earned premium
387.12 times 58 percent;
387.13 (ii) 85 percent of the accumulated value of prior premium
387.14 rate schedule increases on an earned basis;
387.15 (iii) the present value of future projected initial earned
387.16 premiums times 58 percent; and
387.17 (iv) 85 percent of the present value of future projected
387.18 premiums not in item (iii) on an earned basis;
387.19 (3) if a policy form has both exceptional and other
387.20 increases, the values in clause (2), items (ii) and (iv), must
387.21 also include 70 percent for exceptional rate increase amounts;
387.22 and
387.23 (4) all present and accumulated values used to determine
387.24 rate increases must use the maximum valuation interest rate for
387.25 contract reserves permitted for valuation of whole life
387.26 insurance policies issued in this state on the same date. The
387.27 actuary shall disclose as part of the actuarial memorandum the
387.28 use of any appropriate averages.
387.29 Subd. 4. [PROJECTIONS.] For each rate increase that is
387.30 implemented, the insurer shall file for approval by the
387.31 commissioner updated projections, as described in subdivision 2,
387.32 clause (3), item (i), annually for the next three years and
387.33 include a comparison of actual results to projected values. The
387.34 commissioner may extend the period to greater than three years
387.35 if actual results are not consistent with projected values from
387.36 prior projections. For group insurance policies that meet the
388.1 conditions in subdivision 11, the projections required by this
388.2 subdivision must be provided to the policyholder in lieu of
388.3 filing with the commissioner.
388.4 Subd. 5. [LIFETIME PROJECTIONS.] If any premium rate in
388.5 the revised premium rate schedule is greater than 200 percent of
388.6 the comparable rate in the initial premium schedule, lifetime
388.7 projections, as described in subdivision 2, clause (3), item
388.8 (i), must be filed for approval by the commissioner every five
388.9 years following the end of the required period in subdivision
388.10 4. For group insurance policies that meet the conditions in
388.11 subdivision 11, the projections required by this subdivision
388.12 must be provided to the policyholder in lieu of filing with the
388.13 commissioner.
388.14 Subd. 6. [EFFECT OF ACTUAL EXPERIENCE.] (a) If the
388.15 commissioner has determined that the actual experience following
388.16 a rate increase does not adequately match the projected
388.17 experience and that the current projections under moderately
388.18 adverse conditions demonstrate that incurred claims will not
388.19 exceed proportions of premiums specified in subdivision 3, the
388.20 commissioner may require the insurer to implement any of the
388.21 following:
388.22 (1) premium rate schedule adjustments; or
388.23 (2) other measures to reduce the difference between the
388.24 projected and actual experience.
388.25 (b) In determining whether the actual experience adequately
388.26 matches the projected experience, consideration must be given to
388.27 subdivision 2, clause (3), item (v), if applicable.
388.28 Subd. 7. [CONTINGENT BENEFIT UPON LAPSE.] If the majority
388.29 of the policies or certificates to which the increase is
388.30 applicable are eligible for the contingent benefit upon lapse,
388.31 the insurer shall file:
388.32 (1) a plan, subject to commissioner approval, for improved
388.33 administration or claims processing designed to eliminate the
388.34 potential for further deterioration of the policy form requiring
388.35 further premium rate schedule increases, or both, or a
388.36 demonstration that appropriate administration and claims
389.1 processing have been implemented or are in effect; otherwise,
389.2 the commissioner may impose the condition in subdivision 8,
389.3 paragraph (b); and
389.4 (2) the original anticipated lifetime loss ratio, and the
389.5 premium rate schedule increase that would have been calculated
389.6 according to subdivision 3 had the greater of the original
389.7 anticipated lifetime loss ratio or 58 percent been used in the
389.8 calculations described in subdivision 3, clause (2), items (i)
389.9 and (iii).
389.10 Subd. 8. [PROJECTED LAPSE RATES.] (a) For a rate increase
389.11 filing that meets the following criteria, the commissioner shall
389.12 review, for all policies included in the filing, the projected
389.13 lapse rates and past lapse rates during the 12 months following
389.14 each increase to determine if significant adverse lapsation has
389.15 occurred or is anticipated:
389.16 (1) the rate increase is not the first rate increase
389.17 requested for the specific policy form or forms;
389.18 (2) the rate increase is not an exceptional increase; and
389.19 (3) the majority of the policies or certificates to which
389.20 the increase is applicable are eligible for the contingent
389.21 benefit upon lapse.
389.22 (b) If significant adverse lapsation has occurred, is
389.23 anticipated in the filing, or is evidenced in the actual results
389.24 as presented in the updated projections provided by the insurer
389.25 following the requested rate increase, the commissioner may
389.26 determine that a rate spiral exists. Following the
389.27 determination that a rate spiral exists, the commissioner may
389.28 require the insurer to offer, without underwriting, to all
389.29 in-force insureds subject to the rate increase, the option to
389.30 replace existing coverage with one or more reasonably comparable
389.31 products being offered by the insurer or its affiliates. The
389.32 offer must:
389.33 (1) be subject to the approval of the commissioner;
389.34 (2) be based upon actuarially sound principles, but not be
389.35 based upon attained age; and
389.36 (3) provide that maximum benefits under any new policy
390.1 accepted by an insured will be reduced by comparable benefits
390.2 already paid under the existing policy.
390.3 (c) The insurer shall maintain the experience of all the
390.4 replacement insureds separate from the experience of insureds
390.5 originally issued the policy forms. In the event of a request
390.6 for a rate increase on the policy form, the rate increase must
390.7 be limited to the lesser of the maximum rate increase determined
390.8 based on the combined experience and the maximum rate increase
390.9 determined based only upon the experience of the insureds
390.10 originally issued the form plus ten percent.
390.11 Subd. 9. [PERSISTENT PRACTICE OF INADEQUATE INITIAL
390.12 RATES.] If the commissioner determines that the insurer has
390.13 exhibited a persistent practice of filing inadequate initial
390.14 premium rates for long-term care insurance, the commissioner
390.15 may, in addition to the provisions of subdivision 8, take either
390.16 of the following actions:
390.17 (1) prohibit the insurer from filing and marketing
390.18 comparable coverage for a period of up to five years; or
390.19 (2) prohibit the insurer from offering all other similar
390.20 coverages and limit the insurer's marketing of new applications
390.21 for the products that are subject to recent premium rate
390.22 schedule increases.
390.23 Subd. 10. [INCIDENTAL LONG-TERM CARE
390.24 BENEFITS.] Subdivisions 1 to 9 do not apply to policies for
390.25 which the long-term care benefits provided by the policy are
390.26 incidental, as defined in section 62S.01, subdivision 17a, if
390.27 the policy complies with all of the following provisions:
390.28 (1) the interest credited internally to determine cash
390.29 value accumulations, including long-term care, if any, are
390.30 guaranteed not to be less than the minimum guaranteed interest
390.31 rate for cash value accumulations without long-term care set
390.32 forth in the policy;
390.33 (2) the portion of the policy that provides insurance
390.34 benefits other than long-term care coverage meets the
390.35 nonforfeiture requirements as applicable in any of the following:
390.36 (i) for life insurance, section 61A.25;
391.1 (ii) for individual deferred annuities, section 61A.245;
391.2 and
391.3 (iii) for variable annuities, section 61A.21;
391.4 (3) the policy meets the disclosure requirements of
391.5 sections 62S.10 and 62S.11 if the policy is governed by chapter
391.6 62S and of section 62A.50 if the policy is governed by sections
391.7 62A.46 to 62A.56;
391.8 (4) the portion of the policy that provides insurance
391.9 benefits other than long-term care coverage meets the
391.10 requirements as applicable in the following:
391.11 (i) policy illustrations to the extent required by state
391.12 law applicable to life insurance;
391.13 (ii) disclosure requirements in state law applicable to
391.14 annuities; and
391.15 (iii) disclosure requirements applicable to variable
391.16 annuities; and
391.17 (5) an actuarial memorandum is filed with the commissioner
391.18 that includes:
391.19 (i) a description of the basis on which the long-term care
391.20 rates were determined;
391.21 (ii) a description of the basis for the reserves;
391.22 (iii) a summary of the type of policy, benefits,
391.23 renewability, general marketing method, and limits on ages of
391.24 issuance;
391.25 (iv) a description and a table of each actuarial assumption
391.26 used. For expenses, an insurer must include percent of premium
391.27 dollars per policy and dollars per unit of benefits, if any;
391.28 (v) a description and a table of the anticipated policy
391.29 reserves and additional reserves to be held in each future year
391.30 for active lives;
391.31 (vi) the estimated average annual premium per policy and
391.32 the average issue age;
391.33 (vii) a statement as to whether underwriting is performed
391.34 at the time of application. The statement must indicate whether
391.35 underwriting is used and, if used, the statement must include a
391.36 description of the type or types of underwriting used, such as
392.1 medical underwriting or functional assessment underwriting.
392.2 Concerning a group policy, the statement must indicate whether
392.3 the enrollee or any dependent will be underwritten and when
392.4 underwriting occurs; and
392.5 (viii) a description of the effect of the long-term care
392.6 policy provision on the required premiums, nonforfeiture values,
392.7 and reserves on the underlying insurance policy, both for active
392.8 lives and those in long-term care claim status.
392.9 Subd. 11. [LARGE GROUP POLICIES.] Subdivisions 6 and 9 do
392.10 not apply to group long-term care insurance policies as defined
392.11 in section 62S.01, subdivision 15, where:
392.12 (1) the policies insure 250 or more persons, and the
392.13 policyholder has 5,000 or more eligible employees of a single
392.14 employer; or
392.15 (2) the policyholder, and not the certificate holders, pays
392.16 a material portion of the premium, which is not less than 20
392.17 percent of the total premium for the group in the calendar year
392.18 prior to the year in which a rate increase is filed.
392.19 [EFFECTIVE DATE.] This section is effective the day
392.20 following final enactment.
392.21 Sec. 12. [62S.266] [NONFORFEITURE BENEFIT REQUIREMENT.]
392.22 Subdivision 1. [APPLICABILITY.] This section does not
392.23 apply to life insurance policies or riders containing
392.24 accelerated long-term care benefits.
392.25 Subd. 2. [REQUIREMENT.] An insurer must offer each
392.26 prospective policyholder a nonforfeiture benefit in compliance
392.27 with the following requirements:
392.28 (1) a policy or certificate offered with nonforfeiture
392.29 benefits must have coverage elements, eligibility, benefit
392.30 triggers, and benefit length that are the same as coverage to be
392.31 issued without nonforfeiture benefits. The nonforfeiture
392.32 benefit included in the offer must be the benefit described in
392.33 subdivision 5; and
392.34 (2) the offer must be in writing if the nonforfeiture
392.35 benefit is not otherwise described in the outline of coverage or
392.36 other materials given to the prospective policyholder.
393.1 Subd. 3. [EFFECT OF REJECTION OF OFFER.] If the offer
393.2 required to be made under subdivision 2 is rejected, the insurer
393.3 shall provide the contingent benefit upon lapse described in
393.4 this section.
393.5 Subd. 4. [CONTINGENT BENEFIT UPON LAPSE.] (a) After
393.6 rejection of the offer required under subdivision 2, for
393.7 individual and group policies without nonforfeiture benefits
393.8 issued after the effective date of this section, the insurer
393.9 shall provide a contingent benefit upon lapse.
393.10 (b) If a group policyholder elects to make the
393.11 nonforfeiture benefit an option to the certificate holder, a
393.12 certificate shall provide either the nonforfeiture benefit or
393.13 the contingent benefit upon lapse.
393.14 (c) The contingent benefit on lapse must be triggered every
393.15 time an insurer increases the premium rates to a level which
393.16 results in a cumulative increase of the annual premium equal to
393.17 or exceeding the percentage of the insured's initial annual
393.18 premium based on the insured's issue age provided in this
393.19 paragraph, and the policy or certificate lapses within 120 days
393.20 of the due date of the premium increase. Unless otherwise
393.21 required, policyholders shall be notified at least 30 days prior
393.22 to the due date of the premium reflecting the rate increase.
393.23 Triggers for a Substantial Premium Increase
393.24 Percent Increase
393.25 Issue Age Over Initial Premium
393.26 29 and Under 200
393.27 30-34 190
393.28 35-39 170
393.29 40-44 150
393.30 45-49 130
393.31 50-54 110
393.32 55-59 90
393.33 60 70
393.34 61 66
393.35 62 62
393.36 63 58
394.1 64 54
394.2 65 50
394.3 66 48
394.4 67 46
394.5 68 44
394.6 69 42
394.7 70 40
394.8 71 38
394.9 72 36
394.10 73 34
394.11 74 32
394.12 75 30
394.13 76 28
394.14 77 26
394.15 78 24
394.16 79 22
394.17 80 20
394.18 81 19
394.19 82 18
394.20 83 17
394.21 84 16
394.22 85 15
394.23 86 14
394.24 87 13
394.25 88 12
394.26 89 11
394.27 90 and over 10
394.28 (d) On or before the effective date of a substantial
394.29 premium increase as defined in paragraph (c), the insurer shall:
394.30 (1) offer to reduce policy benefits provided by the current
394.31 coverage without the requirement of additional underwriting so
394.32 that required premium payments are not increased;
394.33 (2) offer to convert the coverage to a paid-up status with
394.34 a shortened benefit period according to the terms of subdivision
394.35 5. This option may be elected at any time during the 120-day
394.36 period referenced in paragraph (c); and
395.1 (3) notify the policyholder or certificate holder that a
395.2 default or lapse at any time during the 120-day period
395.3 referenced in paragraph (c) is deemed to be the election of the
395.4 offer to convert in clause (2).
395.5 Subd. 5. [NONFORFEITURE BENEFITS; REQUIREMENTS.] (a)
395.6 Benefits continued as nonforfeiture benefits, including
395.7 contingent benefits upon lapse, must be as described in this
395.8 subdivision.
395.9 (b) For purposes of this subdivision, "attained age rating"
395.10 is defined as a schedule of premiums starting from the issue
395.11 date which increases with age at least one percent per year
395.12 prior to age 50, and at least three percent per year beyond age
395.13 50.
395.14 (c) For purposes of this subdivision, the nonforfeiture
395.15 benefit must be of a shortened benefit period providing paid-up,
395.16 long-term care insurance coverage after lapse. The same
395.17 benefits, amounts, and frequency in effect at the time of lapse,
395.18 but not increased thereafter, will be payable for a qualifying
395.19 claim, but the lifetime maximum dollars or days of benefits must
395.20 be determined as specified in paragraph (d).
395.21 (d) The standard nonforfeiture credit is equal to 100
395.22 percent of the sum of all premiums paid, including the premiums
395.23 paid prior to any changes in benefits. The insurer may offer
395.24 additional shortened benefit period options, so long as the
395.25 benefits for each duration equal or exceed the standard
395.26 nonforfeiture credit for that duration. However, the minimum
395.27 nonforfeiture credit must not be less than 30 times the daily
395.28 nursing home benefit at the time of lapse. In either event, the
395.29 calculation of the nonforfeiture credit is subject to the
395.30 limitation of this subdivision.
395.31 (e) The nonforfeiture benefit must begin not later than the
395.32 end of the third year following the policy or certificate issue
395.33 date. The contingent benefit upon lapse must be effective
395.34 during the first three years as well as thereafter.
395.35 (f) Notwithstanding paragraph (e), for a policy or
395.36 certificate with attained age rating, the nonforfeiture benefit
396.1 must begin on the earlier of:
396.2 (1) the end of the tenth year following the policy or
396.3 certificate issue date; or
396.4 (2) the end of the second year following the date the
396.5 policy or certificate is no longer subject to attained age
396.6 rating.
396.7 (g) Nonforfeiture credits may be used for all care and
396.8 services qualifying for benefits under the terms of the policy
396.9 or certificate, up to the limits specified in the policy or
396.10 certificate.
396.11 Subd. 6. [BENEFIT LIMIT.] All benefits paid by the insurer
396.12 while the policy or certificate is in premium-paying status and
396.13 in the paid-up status will not exceed the maximum benefits which
396.14 would be payable if the policy or certificate had remained in
396.15 premium-paying status.
396.16 Subd. 7. [MINIMUM BENEFITS; INDIVIDUAL AND GROUP
396.17 POLICIES.] There must be no difference in the minimum
396.18 nonforfeiture benefits as required under this section for group
396.19 and individual policies.
396.20 Subd. 8. [APPLICATION; EFFECTIVE DATES.] This section
396.21 becomes effective January 1, 2002, and applies as follows:
396.22 (a) Except as provided in paragraph (b), this section
396.23 applies to any long-term care policy issued in this state on or
396.24 after the effective date of this section.
396.25 (b) For certificates issued on or after the effective date
396.26 of this section, under a group long-term care insurance policy
396.27 that was in force on the effective date of this section, the
396.28 provisions of this section do not apply.
396.29 Subd. 9. [EFFECT ON LOSS RATIO.] Premiums charged for a
396.30 policy or certificate containing nonforfeiture benefits or a
396.31 contingent benefit on lapse are subject to the loss ratio
396.32 requirements of section 62A.48, subdivision 4, or 62S.26,
396.33 treating the policy as a whole, except for policies or
396.34 certificates that are subject to sections 62S.021, 62S.081, and
396.35 62S.265 and that comply with those sections.
396.36 Subd. 10. [PURCHASED BLOCKS OF BUSINESS.] To determine
397.1 whether contingent nonforfeiture upon lapse provisions are
397.2 triggered under subdivision 4, paragraph (c), a replacing
397.3 insurer that purchased or otherwise assumed a block or blocks of
397.4 long-term care insurance policies from another insurer shall
397.5 calculate the percentage increase based on the initial annual
397.6 premium paid by the insured when the policy was first purchased
397.7 from the original insurer.
397.8 Subd. 11. [LEVEL PREMIUM CONTRACTS.] A nonforfeiture
397.9 benefit for qualified long-term care insurance contracts that
397.10 are level premium contracts must be offered that meets the
397.11 following requirements:
397.12 (1) the nonforfeiture provision must be appropriately
397.13 captioned;
397.14 (2) the nonforfeiture provision must provide a benefit
397.15 available in the event of a default in the payment of any
397.16 premiums and must state that the amount of the benefit may be
397.17 adjusted subsequent to being initially granted only as necessary
397.18 to reflect changes in claims, persistency, and interest as
397.19 reflected in changes in rates for premium paying contracts
397.20 approved by the commissioner for the same contract form; and
397.21 (3) the nonforfeiture provision must provide at least one
397.22 of the following:
397.23 (i) reduced paid-up insurance;
397.24 (ii) extended term insurance;
397.25 (iii) shortened benefit period; or
397.26 (iv) other similar offerings approved by the commissioner.
397.27 [EFFECTIVE DATE.] This section is effective the day
397.28 following final enactment.
397.29 Sec. 13. Minnesota Statutes 2000, section 256.975, is
397.30 amended by adding a subdivision to read:
397.31 Subd. 8. [PROMOTION OF LONG-TERM CARE INSURANCE.] The
397.32 Minnesota board on aging, either directly or through contract,
397.33 shall promote the provision of employer-sponsored, long-term
397.34 care insurance. The board shall encourage private and public
397.35 sector employers to make long-term care insurance available to
397.36 employees, provide interested employers with information on the
398.1 long-term care insurance product offered to state employees, and
398.2 provide technical assistance to employers in designing long-term
398.3 care insurance products and contacting companies offering
398.4 long-term care insurance products.
398.5 Sec. 14. [256B.0571] [LONG-TERM CARE PARTNERSHIP.]
398.6 Subdivision 1. [DEFINITIONS.] For purposes of this
398.7 section, the following terms have the meanings given them.
398.8 (a) "Home care service" means care described in section
398.9 144A.43.
398.10 (b) "Long-term care insurance" means a policy described in
398.11 section 62S.01.
398.12 (c) "Medical assistance" means the program of medical
398.13 assistance established under section 256B.01.
398.14 (d) "Nursing home" means nursing home as described in
398.15 section 144A.01.
398.16 (e) "Partnership policy" means a long-term care insurance
398.17 policy that meets the requirements under chapter 62S.
398.18 (f) "Partnership program" means the Minnesota partnership
398.19 for long-term care program established under this section.
398.20 Subd. 2. [PARTNERSHIP PROGRAM.] (a) Subject to federal
398.21 waiver approval, the commissioner of human services, along with
398.22 the commissioner of commerce, shall establish the Minnesota
398.23 partnership for long-term care program to provide for the
398.24 financing of long-term care through a combination of private
398.25 insurance and medical assistance.
398.26 (b) An individual who meets the requirements in paragraph
398.27 (c) is eligible to participate in the partnership program.
398.28 (c) The individual must:
398.29 (1) be a Minnesota resident;
398.30 (2) purchase a partnership policy that is delivered, issued
398.31 for delivery, or renewed on or after the effective date of this
398.32 section, and maintains the partnership policy in effect
398.33 throughout the period of participation in the partnership
398.34 program; and
398.35 (3) exhaust the minimum benefits under the partnership
398.36 policy as described in this section. Benefits received under a
399.1 long-term care insurance policy before the effective date of
399.2 this section do not count toward the exhaustion of benefits
399.3 required in this subdivision.
399.4 Subd. 3. [MEDICAL ASSISTANCE ELIGIBILITY.] (a) Upon
399.5 application of an individual who meets the requirements
399.6 described in subdivision 2, the commissioner of human services
399.7 shall determine the individual's eligibility for medical
399.8 assistance according to paragraphs (b) and (c).
399.9 (b) After disregarding financial assets exempted under
399.10 medical assistance eligibility requirements, the department
399.11 shall disregard an additional amount of financial assets equal
399.12 to the dollar amount of coverage under the partnership policy.
399.13 (c) The department shall consider the individual's income
399.14 according to medical assistance eligibility requirements.
399.15 Subd. 4. [FEDERAL APPROVAL.] (a) The commissioner of human
399.16 services shall seek appropriate amendments to the medical
399.17 assistance state plan and shall apply for any necessary waiver
399.18 of medical assistance requirements by the federal Health Care
399.19 Financing Administration to implement the partnership program.
399.20 The state shall not implement the partnership program unless the
399.21 provisions in paragraphs (b) and (c) apply.
399.22 (b) The commissioner shall seek any necessary federal
399.23 waiver of medical assistance requirements.
399.24 (c) Individuals who receive medical assistance under this
399.25 section are exempt from estate recovery requirements under
399.26 section 1917, title XIX of the federal Social Security Act,
399.27 United States Code, title 42, section 1396p.
399.28 Subd. 5. [APPROVED POLICIES.] (a) A partnership policy
399.29 must meet all of the requirements in paragraphs (b) to (h).
399.30 (b) Minimum coverage shall be for a period of not less than
399.31 three years and for a dollar amount equal to 36 months of
399.32 nursing home care at the minimum daily benefit rate determined
399.33 and adjusted under paragraph (c). The policy shall provide for
399.34 home health care benefits to be substituted for nursing home
399.35 care benefits on the basis of two home health care days for one
399.36 nursing home care day.
400.1 (c) Minimum daily benefits shall be $130 for nursing home
400.2 care or $65 for home care. These minimum daily benefit amounts
400.3 shall be adjusted by the department on October 1 of each year,
400.4 based on the health care index used under medical assistance for
400.5 nursing home rate setting. Adjusted minimum daily benefit
400.6 amounts shall be rounded to the nearest whole dollar.
400.7 (d) The insured shall be entitled to designate a third
400.8 party to receive notice if the policy is about to lapse for
400.9 nonpayment of premium, and an additional 30-day grace period for
400.10 payment of premium shall be granted following notification to
400.11 that person.
400.12 (e) The policy must cover all of the following services:
400.13 (1) nursing home stay;
400.14 (2) home care service;
400.15 (3) care management; and
400.16 (4) up to 14 days of nursing care in a hospital while the
400.17 individual is waiting for long-term care placement.
400.18 (f) Payment for service under paragraph (e), clause (4),
400.19 must not exceed the daily benefit amount for nursing home care.
400.20 (g) A partnership policy must offer both options in
400.21 paragraph (h) for an adjusted premium.
400.22 (h) The options are:
400.23 (1) an elimination period of not more than 100 days; and
400.24 (2) nonforfeiture benefits for applicants between the ages
400.25 of 18 and 75.
400.26 ARTICLE 9
400.27 MENTAL HEALTH AND CIVIL COMMITMENT
400.28 Section 1. [145.56] [SUICIDE PREVENTION.]
400.29 Subdivision 1. [PUBLIC HEALTH GOAL; SUICIDE PREVENTION
400.30 PLAN.] The commissioner of health shall make suicide prevention
400.31 an important public health goal of the state and shall conduct
400.32 suicide prevention activities to accomplish that goal using an
400.33 evidence-based, public health approach focused on prevention.
400.34 The commissioner shall refine, coordinate, and implement the
400.35 state's suicide prevention plan, in collaboration with assigned
400.36 staff from the department of human services; the department of
401.1 public safety; the department of children, families, and
401.2 learning; and appropriate agencies, organizations, and
401.3 institutions in the community.
401.4 Subd. 2. [COMMUNITY-BASED PROGRAMS.] (a) The commissioner
401.5 shall establish a grant program consistent with the policy goals
401.6 of this section to fund:
401.7 (1) community-based programs to provide education,
401.8 outreach, and advocacy services to populations who may be at
401.9 risk for suicide;
401.10 (2) community-based programs that educate natural community
401.11 helpers and gatekeepers, such as family members, spiritual
401.12 leaders, coaches, and business owners, employers, and coworkers,
401.13 on how to prevent suicide by encouraging help-seeking behaviors;
401.14 and
401.15 (3) community-based programs to provide evidence-based
401.16 suicide prevention and intervention education to school staff,
401.17 parents, and students in kindergarten through grade 12.
401.18 (b) Education to populations at risk for suicide and to
401.19 community helpers and gatekeepers must include information on
401.20 the symptoms of depression and other psychiatric illnesses, the
401.21 warning signs of suicide, skills for preventing suicides, and
401.22 making or seeking effective referrals to intervention and
401.23 community resources.
401.24 Subd. 3. [WORKPLACE AND PROFESSIONAL EDUCATION.] (a) The
401.25 commissioner shall promote the use of employee assistance and
401.26 workplace programs to support employees with depression and
401.27 other psychiatric illnesses and substance abuse disorders, and
401.28 refer them to services. In promoting these programs, the
401.29 commissioner shall collaborate with employer and professional
401.30 associations, unions, and safety councils.
401.31 (b) The commissioner shall provide training and technical
401.32 assistance to local public health and other community-based
401.33 professionals to provide for integrated implementation of best
401.34 practices for preventing suicides.
401.35 Subd. 4. [COLLECTING AND REPORTING SUICIDE DATA.] The
401.36 commissioner shall coordinate with federal, regional, local, and
402.1 other state agencies to collect, analyze, and annually issue a
402.2 public report on Minnesota-specific data on suicide and suicidal
402.3 behaviors.
402.4 Subd. 5. [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The
402.5 commissioner shall conduct periodic evaluations of the impact of
402.6 and outcomes from implementation of the state's suicide
402.7 prevention plan and each of the activities specified in this
402.8 section. By July 1, 2002, and July 1 of each even-numbered year
402.9 thereafter, the commissioner shall report the results of these
402.10 evaluations to the chairs of the policy and finance committees
402.11 in the house and senate with jurisdiction over health and human
402.12 services issues.
402.13 Sec. 2. Minnesota Statutes 2000, section 245.462,
402.14 subdivision 8, is amended to read:
402.15 Subd. 8. [DAY TREATMENT SERVICES.] "Day treatment," "day
402.16 treatment services," or "day treatment program" means a
402.17 structured program of treatment and care provided to an adult in
402.18 or by: (1) a hospital accredited by the joint commission on
402.19 accreditation of health organizations and licensed under
402.20 sections 144.50 to 144.55; (2) a community mental health center
402.21 under section 245.62; or (3) an entity that is under contract
402.22 with the county board to operate a program that meets the
402.23 requirements of section 245.4712, subdivision 2, and Minnesota
402.24 Rules, parts 9505.0170 to 9505.0475. Day treatment consists of
402.25 group psychotherapy and other intensive therapeutic services
402.26 that are provided at least one day a week by a multidisciplinary
402.27 staff under the clinical supervision of a mental health
402.28 professional. Day treatment may include education and
402.29 consultation provided to families and other individuals as part
402.30 of the treatment process. The services are aimed at stabilizing
402.31 the adult's mental health status, providing mental health
402.32 services, and developing and improving the adult's independent
402.33 living and socialization skills. The goal of day treatment is
402.34 to reduce or relieve mental illness and to enable the adult to
402.35 live in the community. Day treatment services are not a part of
402.36 inpatient or residential treatment services. Day treatment
403.1 services are distinguished from day care by their structured
403.2 therapeutic program of psychotherapy services. The commissioner
403.3 may limit medical assistance reimbursement for day treatment to
403.4 15 hours per week per person instead of the three hours per day
403.5 per person specified in Minnesota Rules, part 9505.0323, subpart
403.6 15.
403.7 Sec. 3. Minnesota Statutes 2000, section 245.462,
403.8 subdivision 18, is amended to read:
403.9 Subd. 18. [MENTAL HEALTH PROFESSIONAL.] "Mental health
403.10 professional" means a person providing clinical services in the
403.11 treatment of mental illness who is qualified in at least one of
403.12 the following ways:
403.13 (1) in psychiatric nursing: a registered nurse who is
403.14 licensed under sections 148.171 to 148.285, and who is certified
403.15 as a clinical specialist in adult psychiatric and mental health
403.16 nursing by a national nurse certification organization or who
403.17 has a master's degree in nursing or one of the behavioral
403.18 sciences or related fields from an accredited college or
403.19 university or its equivalent, with at least 4,000 hours of
403.20 post-master's supervised experience in the delivery of clinical
403.21 services in the treatment of mental illness;
403.22 (2) in clinical social work: a person licensed as an
403.23 independent clinical social worker under section 148B.21,
403.24 subdivision 6, or a person with a master's degree in social work
403.25 from an accredited college or university, with at least 4,000
403.26 hours of post-master's supervised experience in the delivery of
403.27 clinical services in the treatment of mental illness;
403.28 (3) in psychology: a psychologist an individual licensed
403.29 by the board of psychology under sections 148.88 to 148.98 who
403.30 has stated to the board of psychology competencies in the
403.31 diagnosis and treatment of mental illness;
403.32 (4) in psychiatry: a physician licensed under chapter 147
403.33 and certified by the American board of psychiatry and neurology
403.34 or eligible for board certification in psychiatry;
403.35 (5) in marriage and family therapy: the mental health
403.36 professional must be a marriage and family therapist licensed
404.1 under sections 148B.29 to 148B.39 with at least two years of
404.2 post-master's supervised experience in the delivery of clinical
404.3 services in the treatment of mental illness; or
404.4 (6) in allied fields: a person with a master's degree from
404.5 an accredited college or university in one of the behavioral
404.6 sciences or related fields, with at least 4,000 hours of
404.7 post-master's supervised experience in the delivery of clinical
404.8 services in the treatment of mental illness.
404.9 Sec. 4. Minnesota Statutes 2000, section 245.462, is
404.10 amended by adding a subdivision to read:
404.11 Subd. 25a. [SIGNIFICANT IMPAIRMENT IN FUNCTIONING.]
404.12 "Significant impairment in functioning" means a condition,
404.13 including significant suicidal ideation or thoughts of harming
404.14 self or others, which harmfully affects, recurrently or
404.15 consistently, a person's activities of daily living in
404.16 employment, housing, family, and social relationships, or
404.17 education.
404.18 Sec. 5. Minnesota Statutes 2000, section 245.4871,
404.19 subdivision 10, is amended to read:
404.20 Subd. 10. [DAY TREATMENT SERVICES.] "Day treatment," "day
404.21 treatment services," or "day treatment program" means a
404.22 structured program of treatment and care provided to a child in:
404.23 (1) an outpatient hospital accredited by the joint
404.24 commission on accreditation of health organizations and licensed
404.25 under sections 144.50 to 144.55;
404.26 (2) a community mental health center under section 245.62;
404.27 (3) an entity that is under contract with the county board
404.28 to operate a program that meets the requirements of section
404.29 245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to
404.30 9505.0475; or
404.31 (4) an entity that operates a program that meets the
404.32 requirements of section 245.4884, subdivision 2, and Minnesota
404.33 Rules, parts 9505.0170 to 9505.0475, that is under contract with
404.34 an entity that is under contract with a county board.
404.35 Day treatment consists of group psychotherapy and other
404.36 intensive therapeutic services that are provided for a minimum
405.1 three-hour time block by a multidisciplinary staff under the
405.2 clinical supervision of a mental health professional. Day
405.3 treatment may include education and consultation provided to
405.4 families and other individuals as an extension of the treatment
405.5 process. The services are aimed at stabilizing the child's
405.6 mental health status, and developing and improving the child's
405.7 daily independent living and socialization skills. Day
405.8 treatment services are distinguished from day care by their
405.9 structured therapeutic program of psychotherapy services. Day
405.10 treatment services are not a part of inpatient hospital or
405.11 residential treatment services. Day treatment services for a
405.12 child are an integrated set of education, therapy, and family
405.13 interventions.
405.14 A day treatment service must be available to a child at
405.15 least five days a week throughout the year and must be
405.16 coordinated with, integrated with, or part of an education
405.17 program offered by the child's school.
405.18 Sec. 6. Minnesota Statutes 2000, section 245.4871,
405.19 subdivision 27, is amended to read:
405.20 Subd. 27. [MENTAL HEALTH PROFESSIONAL.] "Mental health
405.21 professional" means a person providing clinical services in the
405.22 diagnosis and treatment of children's emotional disorders. A
405.23 mental health professional must have training and experience in
405.24 working with children consistent with the age group to which the
405.25 mental health professional is assigned. A mental health
405.26 professional must be qualified in at least one of the following
405.27 ways:
405.28 (1) in psychiatric nursing, the mental health professional
405.29 must be a registered nurse who is licensed under sections
405.30 148.171 to 148.285 and who is certified as a clinical specialist
405.31 in child and adolescent psychiatric or mental health nursing by
405.32 a national nurse certification organization or who has a
405.33 master's degree in nursing or one of the behavioral sciences or
405.34 related fields from an accredited college or university or its
405.35 equivalent, with at least 4,000 hours of post-master's
405.36 supervised experience in the delivery of clinical services in
406.1 the treatment of mental illness;
406.2 (2) in clinical social work, the mental health professional
406.3 must be a person licensed as an independent clinical social
406.4 worker under section 148B.21, subdivision 6, or a person with a
406.5 master's degree in social work from an accredited college or
406.6 university, with at least 4,000 hours of post-master's
406.7 supervised experience in the delivery of clinical services in
406.8 the treatment of mental disorders;
406.9 (3) in psychology, the mental health professional must be a
406.10 psychologist an individual licensed by the board of psychology
406.11 under sections 148.88 to 148.98 who has stated to the board of
406.12 psychology competencies in the diagnosis and treatment of mental
406.13 disorders;
406.14 (4) in psychiatry, the mental health professional must be a
406.15 physician licensed under chapter 147 and certified by the
406.16 American board of psychiatry and neurology or eligible for board
406.17 certification in psychiatry;
406.18 (5) in marriage and family therapy, the mental health
406.19 professional must be a marriage and family therapist licensed
406.20 under sections 148B.29 to 148B.39 with at least two years of
406.21 post-master's supervised experience in the delivery of clinical
406.22 services in the treatment of mental disorders or emotional
406.23 disturbances; or
406.24 (6) in allied fields, the mental health professional must
406.25 be a person with a master's degree from an accredited college or
406.26 university in one of the behavioral sciences or related fields,
406.27 with at least 4,000 hours of post-master's supervised experience
406.28 in the delivery of clinical services in the treatment of
406.29 emotional disturbances.
406.30 Sec. 7. Minnesota Statutes 2000, section 245.4876,
406.31 subdivision 1, is amended to read:
406.32 Subdivision 1. [CRITERIA.] Children's mental health
406.33 services required by sections 245.487 to 245.4888 must be:
406.34 (1) based, when feasible, on research findings;
406.35 (2) based on individual clinical, cultural, and ethnic
406.36 needs, and other special needs of the children being served;
407.1 (3) delivered in a manner that improves family functioning
407.2 when clinically appropriate;
407.3 (4) provided in the most appropriate, least restrictive
407.4 setting that meets the requirements in subdivision 1a, and that
407.5 is available to the county board to meet the child's treatment
407.6 needs;
407.7 (5) accessible to all age groups of children;
407.8 (6) appropriate to the developmental age of the child being
407.9 served;
407.10 (7) delivered in a manner that provides accountability to
407.11 the child for the quality of service delivered and continuity of
407.12 services to the child during the years the child needs services
407.13 from the local system of care;
407.14 (8) provided by qualified individuals as required in
407.15 sections 245.487 to 245.4888;
407.16 (9) coordinated with children's mental health services
407.17 offered by other providers;
407.18 (10) provided under conditions that protect the rights and
407.19 dignity of the individuals being served; and
407.20 (11) provided in a manner and setting most likely to
407.21 facilitate progress toward treatment goals.
407.22 Sec. 8. Minnesota Statutes 2000, section 245.4876, is
407.23 amended by adding a subdivision to read:
407.24 Subd. 1a. [APPROPRIATE SETTING TO RECEIVE SERVICES.] A
407.25 child must be provided with mental health services in the least
407.26 restrictive setting that is appropriate to the needs and current
407.27 condition of the individual child. For a child to receive
407.28 mental health services in a residential treatment or acute care
407.29 hospital inpatient setting, the family may not be required to
407.30 demonstrate that services were first provided in a less
407.31 restrictive setting and that the child failed to make progress
407.32 toward or meet treatment goals in the less restrictive setting.
407.33 Sec. 9. Minnesota Statutes 2000, section 245.4885,
407.34 subdivision 1, is amended to read:
407.35 Subdivision 1. [SCREENING REQUIRED.] The county board
407.36 shall, prior to admission, except in the case of emergency
408.1 admission, screen all children referred for treatment of severe
408.2 emotional disturbance to a residential treatment facility or
408.3 informally admitted to a regional treatment center if public
408.4 funds are used to pay for the services. The county board shall
408.5 also screen all children admitted to an acute care hospital for
408.6 treatment of severe emotional disturbance if public funds other
408.7 than reimbursement under chapters 256B and 256D are used to pay
408.8 for the services. If a child is admitted to a residential
408.9 treatment facility or acute care hospital for emergency
408.10 treatment or held for emergency care by a regional treatment
408.11 center under section 253B.05, subdivision 1, screening must
408.12 occur within three working days of admission. Screening shall
408.13 determine whether the proposed treatment:
408.14 (1) is necessary;
408.15 (2) is appropriate to the child's individual treatment
408.16 needs;
408.17 (3) cannot be effectively provided in the child's home; and
408.18 (4) provides a length of stay as short as possible
408.19 consistent with the individual child's need.
408.20 When a screening is conducted, the county board may not
408.21 determine that referral or admission to a residential treatment
408.22 facility or acute care hospital is not appropriate solely
408.23 because services were not first provided to the child in a less
408.24 restrictive setting and the child failed to make progress toward
408.25 or meet treatment goals in the less restrictive setting.
408.26 Screening shall include both a diagnostic assessment and a
408.27 functional assessment which evaluates family, school, and
408.28 community living situations. If a diagnostic assessment or
408.29 functional assessment has been completed by a mental health
408.30 professional within 180 days, a new diagnostic or functional
408.31 assessment need not be completed unless in the opinion of the
408.32 current treating mental health professional the child's mental
408.33 health status has changed markedly since the assessment was
408.34 completed. The child's parent shall be notified if an
408.35 assessment will not be completed and of the reasons. A copy of
408.36 the notice shall be placed in the child's file. Recommendations
409.1 developed as part of the screening process shall include
409.2 specific community services needed by the child and, if
409.3 appropriate, the child's family, and shall indicate whether or
409.4 not these services are available and accessible to the child and
409.5 family.
409.6 During the screening process, the child, child's family, or
409.7 child's legal representative, as appropriate, must be informed
409.8 of the child's eligibility for case management services and
409.9 family community support services and that an individual family
409.10 community support plan is being developed by the case manager,
409.11 if assigned.
409.12 Screening shall be in compliance with section 256F.07 or
409.13 260C.212, whichever applies. Wherever possible, the parent
409.14 shall be consulted in the screening process, unless clinically
409.15 inappropriate.
409.16 The screening process, and placement decision, and
409.17 recommendations for mental health services must be documented in
409.18 the child's record.
409.19 An alternate review process may be approved by the
409.20 commissioner if the county board demonstrates that an alternate
409.21 review process has been established by the county board and the
409.22 times of review, persons responsible for the review, and review
409.23 criteria are comparable to the standards in clauses (1) to (4).
409.24 Sec. 10. Minnesota Statutes 2000, section 245.4886,
409.25 subdivision 1, is amended to read:
409.26 Subdivision 1. [STATEWIDE PROGRAM; ESTABLISHMENT.] The
409.27 commissioner shall establish a statewide program to assist
409.28 counties in providing services to children with severe emotional
409.29 disturbance as defined in section 245.4871, subdivision 15, and
409.30 their families; and to young adults meeting the criteria for
409.31 transition services in section 245.4875, subdivision 8, and
409.32 their families. Services must be designed to help each child to
409.33 function and remain with the child's family in the community.
409.34 Transition services to eligible young adults must be designed to
409.35 foster independent living in the community. The commissioner
409.36 shall make grants to counties to establish, operate, or contract
410.1 with private providers to provide the following services in the
410.2 following order of priority when these cannot be reimbursed
410.3 under section 256B.0625:
410.4 (1) family community support services including crisis
410.5 placement and crisis respite care as specified in section
410.6 245.4871, subdivision 17;
410.7 (2) case management services as specified in section
410.8 245.4871, subdivision 3;
410.9 (3) day treatment services as specified in section
410.10 245.4871, subdivision 10;
410.11 (4) professional home-based family treatment as specified
410.12 in section 245.4871, subdivision 31; and
410.13 (5) therapeutic support of foster care as specified in
410.14 section 245.4871, subdivision 34.
410.15 Funding appropriated beginning July 1, 1991, must be used
410.16 by county boards to provide family community support services
410.17 and case management services. Additional services shall be
410.18 provided in the order of priority as identified in this
410.19 subdivision.
410.20 Sec. 11. Minnesota Statutes 2000, section 245.99,
410.21 subdivision 4, is amended to read:
410.22 Subd. 4. [ADMINISTRATION OF CRISIS HOUSING ASSISTANCE.]
410.23 The commissioner may contract with organizations or government
410.24 units experienced in housing assistance to operate the program
410.25 under this section. This program is not an entitlement. The
410.26 commissioner may take any of the following steps whenever the
410.27 commissioner projects that funds will be inadequate to meet
410.28 demand in a given fiscal year:
410.29 (1) transfer funds from mental health grants in the same
410.30 appropriation; and
410.31 (2) impose statewide restrictions as to the type and amount
410.32 of assistance available to each recipient under this program
410.33 including reducing the income eligibility level, limiting
410.34 reimbursement to a percentage of each recipient's costs,
410.35 limiting housing assistance to 60 days per recipient, or closing
410.36 the program for the remainder of the fiscal year.
411.1 Sec. 12. Minnesota Statutes 2000, section 256.969,
411.2 subdivision 3a, is amended to read:
411.3 Subd. 3a. [PAYMENTS.] Acute care hospital billings under
411.4 the medical assistance program must not be submitted until the
411.5 recipient is discharged. However, the commissioner shall
411.6 establish monthly interim payments for inpatient hospitals that
411.7 have individual patient lengths of stay over 30 days regardless
411.8 of diagnostic category. Except as provided in section 256.9693,
411.9 medical assistance reimbursement for treatment of mental illness
411.10 shall be reimbursed based on diagnostic classifications. The
411.11 commissioner may selectively contract with hospitals for
411.12 services within the diagnostic categories relating to mental
411.13 illness and chemical dependency under competitive bidding when
411.14 reasonable geographic access by recipients can be assured. No
411.15 physician shall be denied the privilege of treating a recipient
411.16 required to use a hospital under contract with the commissioner,
411.17 as long as the physician meets credentialing standards of the
411.18 individual hospital. Individual hospital payments established
411.19 under this section and sections 256.9685, 256.9686, and
411.20 256.9695, in addition to third party and recipient liability,
411.21 for discharges occurring during the rate year shall not exceed,
411.22 in aggregate, the charges for the medical assistance covered
411.23 inpatient services paid for the same period of time to the
411.24 hospital. This payment limitation shall be calculated
411.25 separately for medical assistance and general assistance medical
411.26 care services. The limitation on general assistance medical
411.27 care shall be effective for admissions occurring on or after
411.28 July 1, 1991. Services that have rates established under
411.29 subdivision 11 or 12, must be limited separately from other
411.30 services. After consulting with the affected hospitals, the
411.31 commissioner may consider related hospitals one entity and may
411.32 merge the payment rates while maintaining separate provider
411.33 numbers. The operating and property base rates per admission or
411.34 per day shall be derived from the best Medicare and claims data
411.35 available when rates are established. The commissioner shall
411.36 determine the best Medicare and claims data, taking into
412.1 consideration variables of recency of the data, audit
412.2 disposition, settlement status, and the ability to set rates in
412.3 a timely manner. The commissioner shall notify hospitals of
412.4 payment rates by December 1 of the year preceding the rate
412.5 year. The rate setting data must reflect the admissions data
412.6 used to establish relative values. Base year changes from 1981
412.7 to the base year established for the rate year beginning January
412.8 1, 1991, and for subsequent rate years, shall not be limited to
412.9 the limits ending June 30, 1987, on the maximum rate of increase
412.10 under subdivision 1. The commissioner may adjust base year
412.11 cost, relative value, and case mix index data to exclude the
412.12 costs of services that have been discontinued by the October 1
412.13 of the year preceding the rate year or that are paid separately
412.14 from inpatient services. Inpatient stays that encompass
412.15 portions of two or more rate years shall have payments
412.16 established based on payment rates in effect at the time of
412.17 admission unless the date of admission preceded the rate year in
412.18 effect by six months or more. In this case, operating payment
412.19 rates for services rendered during the rate year in effect and
412.20 established based on the date of admission shall be adjusted to
412.21 the rate year in effect by the hospital cost index.
412.22 [EFFECTIVE DATE.] This section is effective July 1, 2002.
412.23 Sec. 13. [256.9693] [CONTINUING CARE PROGRAM FOR PERSONS
412.24 WITH MENTAL ILLNESS.]
412.25 The commissioner shall establish a continuing care benefit
412.26 program for persons with mental illness, in which persons with
412.27 mental illness may obtain acute care hospital inpatient
412.28 treatment for mental illness for up to 45 days beyond that
412.29 allowed by section 256.969. Persons with mental illness who are
412.30 eligible for medical assistance may obtain inpatient treatment
412.31 under this program in hospital beds for which the commissioner
412.32 contracts under this section. The commissioner may selectively
412.33 contract with hospitals to provide this benefit through
412.34 competitive bidding when reasonable geographic access by
412.35 recipients can be assured. Payments under this section shall
412.36 not affect payments under section 256.969. The commissioner may
413.1 contract externally with a utilization review organization to
413.2 authorize persons with mental illness to access the continuing
413.3 care benefit program. The commissioner, as part of the
413.4 contracts with hospitals, shall establish admission criteria to
413.5 allow persons with mental illness to access the continuing care
413.6 benefit program. If a court orders acute care hospital
413.7 inpatient treatment for mental illness for a person, the person
413.8 may obtain the treatment under the continuing care benefit
413.9 program. The commissioner shall not require, as part of the
413.10 admission criteria, any commitment or petition under chapter
413.11 253B as a condition of accessing the program. This benefit is
413.12 not available for people who are also eligible for Medicare and
413.13 who have not exhausted their annual or lifetime inpatient
413.14 psychiatric benefit under Medicare. If a recipient is enrolled
413.15 in a prepaid plan, this program is included in the plan's
413.16 coverage.
413.17 [EFFECTIVE DATE.] This section is effective July 1, 2002.
413.18 Sec. 14. [256B.0623] [ADULT REHABILITATIVE MENTAL HEALTH
413.19 SERVICES.]
413.20 Subdivision 1. [SCOPE.] Medical assistance covers adult
413.21 rehabilitative mental health services as defined in subdivision
413.22 2, subject to federal approval, if provided to recipients as
413.23 defined in subdivision 3 and provided by a qualified provider
413.24 entity meeting the standards in this section and by a qualified
413.25 individual provider working within the provider's scope of
413.26 practice and identified in the recipient's individual treatment
413.27 plan as defined in section 245.462, subdivision 14, and if
413.28 determined to be medically necessary according to section 62Q.53.
413.29 Subd. 2. [DEFINITIONS.] For purposes of this section, the
413.30 following terms have the meanings given them.
413.31 (a) "Adult rehabilitative mental health services" means
413.32 mental health services which are rehabilitative and enable the
413.33 recipient to develop and enhance psychiatric stability, social
413.34 competencies, personal and emotional adjustment, and independent
413.35 living and community skills, when these abilities are impaired
413.36 by the symptoms of mental illness. Adult rehabilitative mental
414.1 health services are also appropriate when provided to enable a
414.2 recipient to retain stability and functioning, if the recipient
414.3 would be at risk of significant functional decompensation or
414.4 more restrictive service settings without these services.
414.5 (1) Adult rehabilitative mental health services instruct,
414.6 assist, and support the recipient in areas such as:
414.7 interpersonal communication skills, community resource
414.8 utilization and integration skills, crisis assistance, relapse
414.9 prevention skills, health care directives, budgeting and
414.10 shopping skills, healthy lifestyle skills and practices, cooking
414.11 and nutrition skills, transportation skills, medication
414.12 education and monitoring, mental illness symptom management
414.13 skills, household management skills, employment-related skills,
414.14 and transition to community living services.
414.15 (2) These services shall be provided to the recipient on a
414.16 one-to-one basis in the recipient's home or another community
414.17 setting or in groups.
414.18 (b) "Medication education services" means services provided
414.19 individually or in groups which focus on educating the recipient
414.20 about mental illness and symptoms; the role and effects of
414.21 medications in treating symptoms of mental illness; and the side
414.22 effects of medications. Medication education is coordinated
414.23 with medication management services, and does not duplicate it.
414.24 Medication education services are provided by physicians,
414.25 pharmacists, or registered nurses.
414.26 (c) "Transition to community living services" means
414.27 services which maintain continuity of contact between the
414.28 rehabilitation services provider and the recipient and which
414.29 facilitate discharge from a hospital, residential treatment
414.30 program under Minnesota Rules, chapter 9505, board and lodging
414.31 facility, or nursing home. Transition to community living
414.32 services are not intended to provide other areas of adult
414.33 rehabilitative mental health services.
414.34 Subd. 3. [ELIGIBILITY.] An eligible recipient is an
414.35 individual who:
414.36 (1) is age 18 or older;
415.1 (2) is diagnosed with a medical condition, such as mental
415.2 illness or traumatic brain injury, for which adult
415.3 rehabilitative mental health services are needed;
415.4 (3) has substantial disability and functional impairment in
415.5 three or more of the areas listed in section 245.462,
415.6 subdivision 11a, so that self-sufficiency is markedly reduced;
415.7 and
415.8 (4) has had a recent diagnostic assessment by a qualified
415.9 professional that documents adult rehabilitative mental health
415.10 services are medically necessary to address identified
415.11 disability and functional impairments and individual recipient
415.12 goals.
415.13 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) The provider
415.14 entity must be:
415.15 (1) a county operated entity certified by the state; or
415.16 (2) a noncounty entity certified by the entity's host
415.17 county.
415.18 (b) The certification process is a determination as to
415.19 whether the entity meets the standards in this subdivision. The
415.20 certification must specify which adult rehabilitative mental
415.21 health services the entity is qualified to provide.
415.22 (c) If an entity seeks to provide services outside its host
415.23 county, it must obtain additional certification from each county
415.24 in which it will provide services. The additional certification
415.25 must be based on the adequacy of the entity's knowledge of that
415.26 county's local health and human service system, and the ability
415.27 of the entity to coordinate its services with the other services
415.28 available in that county.
415.29 (d) Recertification must occur at least every two years.
415.30 (e) The commissioner may intervene at any time and
415.31 decertify providers with cause. The decertification is subject
415.32 to appeal to the state. A county board may recommend that the
415.33 state decertify a provider for cause.
415.34 (f) The adult rehabilitative mental health services
415.35 provider entity must meet the following standards:
415.36 (1) have capacity to recruit, hire, manage, and train
416.1 mental health professionals, mental health practitioners, and
416.2 mental health rehabilitation workers;
416.3 (2) have adequate administrative ability to ensure
416.4 availability of services;
416.5 (3) ensure adequate preservice and inservice training for
416.6 staff;
416.7 (4) ensure that mental health professionals, mental health
416.8 practitioners, and mental health rehabilitation workers are
416.9 skilled in the delivery of the specific adult rehabilitative
416.10 mental health services provided to the individual eligible
416.11 recipient;
416.12 (5) ensure that staff is capable of implementing culturally
416.13 specific services that are culturally competent and appropriate
416.14 as determined by the recipient's culture, beliefs, values, and
416.15 language as identified in the individual treatment plan;
416.16 (6) ensure enough flexibility in service delivery to
416.17 respond to the changing and intermittent care needs of a
416.18 recipient as identified by the recipient and the individual
416.19 treatment plan;
416.20 (7) ensure that the mental health professional or mental
416.21 health practitioner, who is under the clinical supervision of a
416.22 mental health professional, involved in a recipient's services
416.23 participates in the development of the individual treatment
416.24 plan;
416.25 (8) assist the recipient in arranging needed crisis
416.26 assessment, intervention, and stabilization services;
416.27 (9) ensure that services are coordinated with other
416.28 recipient mental health services providers and the county mental
416.29 health authority and the federally recognized American Indian
416.30 authority and necessary others after obtaining the consent of
416.31 the recipient. Services must also be coordinated with the
416.32 recipient's case manager or care coordinator, if the recipient
416.33 is receiving case management or care coordination services;
416.34 (10) develop and maintain recipient files, individual
416.35 treatment plans, and contact charting;
416.36 (11) develop and maintain staff training and personnel
417.1 files;
417.2 (12) submit information as required by the state;
417.3 (13) establish and maintain a quality assurance plan to
417.4 evaluate the outcome of services provided;
417.5 (14) keep all necessary records required by law;
417.6 (15) deliver services as required by section 245.461;
417.7 (16) comply with all applicable laws;
417.8 (17) be an enrolled Medicaid provider;
417.9 (18) maintain a quality assurance plan to determine
417.10 specific service outcomes and the recipient's satisfaction with
417.11 services; and
417.12 (19) develop and maintain written policies and procedures
417.13 regarding service provision and administration of the provider
417.14 entity.
417.15 (g) The commissioner shall develop statewide procedures for
417.16 provider certification, including timelines for counties to
417.17 certify qualified providers.
417.18 Subd. 5. [QUALIFICATIONS OF PROVIDER STAFF.] Adult
417.19 rehabilitative mental health services must be provided by
417.20 qualified individual provider staff of a certified provider
417.21 entity. Individual provider staff must be qualified under one
417.22 of the following criteria:
417.23 (1) a mental health professional as defined in section
417.24 245.462, subdivision 18, clauses (1) to (5);
417.25 (2) a mental health practitioner as defined in section
417.26 245.462, subdivision 17. The mental health practitioner must
417.27 work under the clinical supervision of a mental health
417.28 professional; or
417.29 (3) a mental health rehabilitation worker. A mental health
417.30 rehabilitation worker means a staff person working under the
417.31 direction of a mental health practitioner or mental health
417.32 professional, and under the clinical supervision of a mental
417.33 health professional in the implementation of rehabilitative
417.34 mental health services as identified in the recipient's
417.35 individual treatment plan; and who:
417.36 (i) is at least 21 years of age;
418.1 (ii) has a high school diploma or equivalent;
418.2 (iii) has successfully completed 30 hours of training
418.3 during the past two years in all of the following areas:
418.4 recipient rights, recipient-centered individual treatment
418.5 planning, behavioral terminology, mental illness, co-occurring
418.6 mental illness and substance abuse, psychotropic medications and
418.7 side effects, functional assessment, local community resources,
418.8 adult vulnerability, recipient confidentiality; and
418.9 (iv) meets the qualifications in (A) or (B):
418.10 (A) has an associate of arts degree in one of the
418.11 behavioral sciences or human services, or is a registered nurse
418.12 without a bachelor's degree, or who within the previous ten
418.13 years has:
418.14 (1) three years of personal life experience with serious
418.15 and persistent mental illness;
418.16 (2) three years of life experience as a primary caregiver
418.17 to an adult with a serious mental illness or traumatic brain
418.18 injury; or
418.19 (3) 4,000 hours of supervised paid work experience in the
418.20 delivery of mental health services to adults with a serious
418.21 mental illness or traumatic brain injury; or
418.22 (B)(1) be fluent in the non-English language or competent
418.23 in the culture of the ethnic group to which at least 50 percent
418.24 of the mental health rehabilitation worker's clients belong;
418.25 (2) receives during the first 2,000 hours of work, monthly
418.26 documented individual clinical supervision by a mental health
418.27 professional;
418.28 (3) has 18 hours of documented field supervision by a
418.29 mental health professional or practitioner during the first 160
418.30 hours of contact work with recipients, and at least six hours of
418.31 field supervision quarterly during the following year;
418.32 (4) has review and cosignature of charting of recipient
418.33 contacts during field supervision by a mental health
418.34 professional or practitioner; and
418.35 (5) has 40 hours of additional continuing education on
418.36 mental health topics during the first year of employment.
419.1 Subd. 6. [REQUIRED TRAINING AND SUPERVISION.] (a) Mental
419.2 health rehabilitation workers must receive ongoing continuing
419.3 education training of at least 30 hours every two years in areas
419.4 of mental illness and mental health services and other areas
419.5 specific to the population being served. Mental health
419.6 rehabilitation workers must also be subject to the ongoing
419.7 direction and clinical supervision standards in paragraphs (c)
419.8 and (d).
419.9 (b) Mental health practitioners must receive ongoing
419.10 continuing education training as required by their professional
419.11 license; or if the practitioner is not licensed, the
419.12 practitioner must receive ongoing continuing education training
419.13 of at least 30 hours every two years in areas of mental illness
419.14 and mental health services. Mental health practitioners must
419.15 meet the ongoing clinical supervision standards in paragraph (c).
419.16 (c) A mental health professional providing clinical
419.17 supervision of staff delivering adult rehabilitative mental
419.18 health services must provide the following guidance:
419.19 (1) review the information in the recipient's file;
419.20 (2) review and approve initial and updates of individual
419.21 treatment plans;
419.22 (3) meet with mental health rehabilitation workers and
419.23 practitioners, individually or in small groups, at least monthly
419.24 to discuss treatment topics of interest to the workers and
419.25 practitioners;
419.26 (4) meet with mental health rehabilitation workers and
419.27 practitioners, individually or in small groups, at least monthly
419.28 to discuss treatment plans of recipients, and approve by
419.29 signature and document in the recipient's file any resulting
419.30 plan updates;
419.31 (5) meet at least twice a month with the directing mental
419.32 health practitioner, if there is one, to review needs of the
419.33 adult rehabilitative mental health services program, review
419.34 staff on-site observations and evaluate mental health
419.35 rehabilitation workers, plan staff training, review program
419.36 evaluation and development, and consult with the directing
420.1 practitioner;
420.2 (6) be available for urgent consultation as the individual
420.3 recipient needs or the situation necessitates; and
420.4 (7) provide clinical supervision by full- or part-time
420.5 mental health professionals employed by or under contract with
420.6 the provider entity.
420.7 (d) An adult rehabilitative mental health services provider
420.8 entity must have a treatment director who is a mental health
420.9 practitioner or mental health professional. The treatment
420.10 director must ensure the following:
420.11 (1) while delivering direct services to recipients, a newly
420.12 hired mental health rehabilitation worker must be directly
420.13 observed delivering services to recipients by the mental health
420.14 practitioner or mental health professional for at least six
420.15 hours per 40 hours worked during the first 160 hours that the
420.16 mental health rehabilitation worker works;
420.17 (2) the mental health rehabilitation worker must receive
420.18 ongoing on-site direct service observation by a mental health
420.19 professional or mental health practitioner for at least six
420.20 hours for every six months of employment;
420.21 (3) progress notes are reviewed from on-site service
420.22 observation prepared by the mental health rehabilitation worker
420.23 and mental health practitioner for accuracy and consistency with
420.24 actual recipient contact and the individual treatment plan and
420.25 goals;
420.26 (4) immediate availability by phone or in person for
420.27 consultation by a mental health professional or a mental health
420.28 practitioner to the mental health rehabilitation services worker
420.29 during service provision;
420.30 (5) oversee the identification of changes in individual
420.31 recipient treatment strategies, revise the plan and communicate
420.32 treatment instructions and methodologies as appropriate to
420.33 ensure that treatment is implemented correctly;
420.34 (6) model service practices which: respect the recipient,
420.35 include the recipient in planning and implementation of the
420.36 individual treatment plan, recognize the recipient's strengths,
421.1 collaborate and coordinate with other involved parties and
421.2 providers;
421.3 (7) ensure that mental health practitioners and mental
421.4 health rehabilitation workers are able to effectively
421.5 communicate with the recipients, significant others, and
421.6 providers; and
421.7 (8) oversee the record of the results of on-site
421.8 observation and charting evaluation and corrective actions taken
421.9 to modify the work of the mental health practitioners and mental
421.10 health rehabilitation workers.
421.11 (e) A mental health practitioner who is providing treatment
421.12 direction for a provider entity must receive supervision at
421.13 least monthly from a mental health professional to:
421.14 (1) identify and plan for general needs of the recipient
421.15 population served;
421.16 (2) identify and plan to address provider entity program
421.17 needs and effectiveness;
421.18 (3) identify and plan provider entity staff training and
421.19 personnel needs and issues; and
421.20 (4) plan, implement, and evaluate provider entity quality
421.21 improvement programs.
421.22 Subd. 7. [PERSONNEL FILE.] The adult rehabilitative mental
421.23 health services provider entity must maintain a personnel file
421.24 on each staff. Each file must contain:
421.25 (1) an annual performance review;
421.26 (2) a summary of on-site service observations and charting
421.27 review;
421.28 (3) a criminal background check of all direct service
421.29 staff;
421.30 (4) evidence of academic degree and qualifications;
421.31 (5) a copy of professional license;
421.32 (6) any job performance recognition and disciplinary
421.33 actions;
421.34 (7) any individual staff written input into own personnel
421.35 file;
421.36 (8) all clinical supervision provided; and
422.1 (9) documentation of compliance with continuing education
422.2 requirements.
422.3 Subd. 8. [DIAGNOSTIC ASSESSMENT.] Providers of adult
422.4 rehabilitative mental health services must complete a diagnostic
422.5 assessment as defined in section 245.462, subdivision 9, within
422.6 five days after the recipient's second visit or within 30 days
422.7 after intake, whichever occurs first. In cases where a
422.8 diagnostic assessment is available that reflects the recipient's
422.9 current status, and has been completed within 180 days preceding
422.10 admission, an update must be completed. An update shall include
422.11 a written summary by a mental health professional of the
422.12 recipient's current mental health status and service needs. If
422.13 the recipient's mental health status has changed significantly
422.14 since the adult's most recent diagnostic assessment, a new
422.15 diagnostic assessment is required.
422.16 Subd. 9. [FUNCTIONAL ASSESSMENT.] Providers of adult
422.17 rehabilitative mental health services must complete a written
422.18 functional assessment as defined in section 245.462, subdivision
422.19 11a, for each recipient. The functional assessment must be
422.20 completed within 30 days of intake, and reviewed and updated at
422.21 least every six months after it is developed, unless there is a
422.22 significant change in the functioning of the recipient. If
422.23 there is a significant change in functioning, the assessment
422.24 must be updated. A single functional assessment can meet case
422.25 management and adult rehabilitative mental health services
422.26 requirements, if agreed to by the recipient. Unless the
422.27 recipient refuses, the recipient must have significant
422.28 participation in the development of the functional assessment.
422.29 Subd. 10. [INDIVIDUAL TREATMENT PLAN.] All providers of
422.30 adult rehabilitative mental health services must develop and
422.31 implement an individual treatment plan for each recipient. The
422.32 provisions in clauses (1) and (2) apply:
422.33 (1) Individual treatment plan means a plan of intervention,
422.34 treatment, and services for an individual recipient written by a
422.35 mental health professional or by a mental health practitioner
422.36 under the clinical supervision of a mental health professional.
423.1 The individual treatment plan must be based on diagnostic and
423.2 functional assessments. To the extent possible, the development
423.3 and implementation of a treatment plan must be a collaborative
423.4 process involving the recipient, and with the permission of the
423.5 recipient, the recipient's family and others in the recipient's
423.6 support system. Providers of adult rehabilitative mental health
423.7 services must develop the individual treatment plan within 30
423.8 calendar days of intake. The treatment plan must be updated at
423.9 least every six months thereafter, or more often when there is
423.10 significant change in the recipient's situation or functioning,
423.11 or in services or service methods to be used, or at the request
423.12 of the recipient or the recipient's legal guardian.
423.13 (2) The individual treatment plan must include:
423.14 (i) a list of problems identified in the assessment;
423.15 (ii) the recipient's strengths and resources;
423.16 (iii) concrete, measurable goals to be achieved, including
423.17 time frames for achievement;
423.18 (iv) specific objectives directed toward the achievement of
423.19 each one of the goals;
423.20 (v) documentation of participants in the treatment planning.
423.21 The recipient, if possible, must be a participant. The
423.22 recipient or the recipient's legal guardian must sign the
423.23 treatment plan, or documentation must be provided why this was
423.24 not possible. A copy of the plan must be given to the recipient
423.25 or legal guardian. Referral to formal services must be
423.26 arranged, including specific providers where applicable;
423.27 (vi) cultural considerations, resources, and needs of the
423.28 recipient must be included;
423.29 (vii) planned frequency and type of services must be
423.30 initiated; and
423.31 (viii) clear progress notes on outcome of goals.
423.32 (3) The individual community support plan defined in
423.33 section 245.462, subdivision 12, may serve as the individual
423.34 treatment plan if there is involvement of a mental health case
423.35 manager, and with the approval of the recipient. The individual
423.36 community support plan must include the criteria in clause (2).
424.1 Subd. 11. [RECIPIENT FILE.] Providers of adult
424.2 rehabilitative mental health services must maintain a file for
424.3 each recipient that contains the following information:
424.4 (1) diagnostic assessment or verification of its location,
424.5 that is current and that was reviewed by a mental health
424.6 professional who is employed by or under contract with the
424.7 provider entity;
424.8 (2) functional assessments;
424.9 (3) individual treatment plans signed by the recipient and
424.10 the mental health professional, or if the recipient refused to
424.11 sign the plan, the date and reason stated by the recipient as to
424.12 why the recipient would not sign the plan;
424.13 (4) recipient history;
424.14 (5) signed release forms;
424.15 (6) recipient health information and current medications;
424.16 (7) emergency contacts for the recipient;
424.17 (8) case records which document the date of service, the
424.18 place of service delivery, signature of the person providing the
424.19 service, nature, extent and units of service, and place of
424.20 service delivery;
424.21 (9) contacts, direct or by telephone, with recipient's
424.22 family or others, other providers, or other resources for
424.23 service coordination;
424.24 (10) summary of recipient case reviews by staff; and
424.25 (11) written information by the recipient that the
424.26 recipient requests be included in the file.
424.27 Subd. 12. [ADDITIONAL REQUIREMENTS.] (a) Providers of
424.28 adult rehabilitative mental health services must comply with the
424.29 requirements relating to referrals for case management in
424.30 section 245.467, subdivision 4.
424.31 (b) Adult rehabilitative mental health services are
424.32 provided for most recipients in the recipient's home and
424.33 community. Services may also be provided at the home of a
424.34 relative or significant other, job site, psychosocial clubhouse,
424.35 drop-in center, social setting, classroom, or other places in
424.36 the community. Except for "transition to community services,"
425.1 the place of service does not include a regional treatment
425.2 center, nursing home, residential treatment facility licensed
425.3 under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36),
425.4 or an acute care hospital.
425.5 (c) Adult rehabilitative mental health services may be
425.6 provided in group settings if appropriate to each participating
425.7 recipient's needs and treatment plan. A group is defined as two
425.8 to ten clients, at least one of whom is a recipient, who is
425.9 concurrently receiving a service which is identified in this
425.10 section. The service and group must be specified in the
425.11 recipient's treatment plan. No more than two qualified staff
425.12 may bill Medicaid for services provided to the same group of
425.13 recipients. If two adult rehabilitative mental health workers
425.14 bill for recipients in the same group session, they must each
425.15 bill for different recipients.
425.16 Subd. 13. [EXCLUDED SERVICES.] The following services are
425.17 excluded from reimbursement as adult rehabilitative mental
425.18 health services:
425.19 (1) recipient transportation services;
425.20 (2) a service provided and billed by a provider who is not
425.21 enrolled to provide adult rehabilitative mental health service;
425.22 (3) adult rehabilitative mental health services performed
425.23 by volunteers;
425.24 (4) provider performance of household tasks, chores, or
425.25 related activities, such as laundering clothes, moving the
425.26 recipient's household, housekeeping, and grocery shopping for
425.27 the recipient;
425.28 (5) direct billing of time spent "on call" when not
425.29 delivering services to recipients;
425.30 (6) activities which are primarily social or recreational
425.31 in nature, rather than rehabilitative, for the individual
425.32 recipient, as determined by the individual's needs and treatment
425.33 plan;
425.34 (7) job-specific skills services, such as on-the-job
425.35 training;
425.36 (8) provider service time included in case management
426.1 reimbursement;
426.2 (9) outreach services to potential recipients;
426.3 (10) a mental health service that is not medically
426.4 necessary; and
426.5 (11) any services provided by a hospital, board and
426.6 lodging, or residential facility to an individual who is a
426.7 patient in or resident of that facility.
426.8 Subd. 14. [BILLING WHEN SERVICES ARE PROVIDED BY QUALIFIED
426.9 STATE STAFF.] When rehabilitative services are provided by
426.10 qualified state staff who are assigned to pilot projects under
426.11 section 245.4661, the county or other local entity to which the
426.12 qualified state staff are assigned may consider these staff part
426.13 of the local provider entity for which certification is sought
426.14 under this section, and may bill the medical assistance program
426.15 for qualifying services provided by the qualified state staff.
426.16 Notwithstanding section 256.025, subdivision 2, payments for
426.17 services provided by state staff who are assigned to adult
426.18 mental health initiatives shall only be made from federal funds.
426.19 Sec. 15. [256B.0624] [ADULT MENTAL HEALTH CRISIS RESPONSE
426.20 SERVICES.]
426.21 Subdivision 1. [SCOPE.] Medical assistance covers adult
426.22 mental health crisis response services as defined in subdivision
426.23 2, paragraphs (c) to (e), subject to federal approval, if
426.24 provided to a recipient as defined in subdivision 3 and provided
426.25 by a qualified provider entity as defined in this section and by
426.26 a qualified individual provider working within the provider's
426.27 scope of practice and as defined in this subdivision and
426.28 identified in the recipient's individual crisis treatment plan
426.29 as defined in subdivision 10 and if determined to be medically
426.30 necessary.
426.31 Subd. 2. [DEFINITIONS.] For purposes of this section, the
426.32 following terms have the meanings given them.
426.33 (a) "Mental health crisis" is an adult behavioral,
426.34 emotional, or psychiatric situation which, but for the provision
426.35 of crisis response services, would likely result in
426.36 significantly reduced levels of functioning in primary
427.1 activities of daily living, or in an emergency situation, or in
427.2 the placement of the recipient in a more restrictive setting,
427.3 including, but not limited to, inpatient hospitalization.
427.4 (b) "Mental health emergency" is an adult behavioral,
427.5 emotional, or psychiatric situation which causes an immediate
427.6 need for mental health services and is consistent with section
427.7 62Q.55.
427.8 A mental health crisis or emergency is determined for
427.9 medical assistance service reimbursement by a physician, a
427.10 mental health professional, or crisis mental health practitioner
427.11 with input from the recipient whenever possible.
427.12 (c) "Mental health crisis assessment" means an immediate
427.13 face-to-face assessment by a physician, a mental health
427.14 professional, or mental health practitioner under the clinical
427.15 supervision of a mental health professional, following a
427.16 screening that suggests that the adult may be experiencing a
427.17 mental health crisis or mental health emergency situation.
427.18 (d) "Mental health mobile crisis intervention services"
427.19 means face-to-face, short-term intensive mental health services
427.20 initiated during a mental health crisis or mental health
427.21 emergency to help the recipient cope with immediate stressors,
427.22 identify and utilize available resources and strengths, and
427.23 begin to return to the recipient's baseline level of functioning.
427.24 (1) This service is provided on-site by a mobile crisis
427.25 intervention team outside of an inpatient hospital setting.
427.26 Mental health mobile crisis intervention services must be
427.27 available 24 hours a day, seven days a week.
427.28 (2) The initial screening must consider other available
427.29 services to determine which service intervention would best
427.30 address the recipient's needs and circumstances.
427.31 (3) The mobile crisis intervention team must be available
427.32 to meet promptly face-to-face with a person in mental health
427.33 crisis or emergency in a community setting.
427.34 (4) The intervention must consist of a mental health crisis
427.35 assessment and a crisis treatment plan.
427.36 (5) The treatment plan must include recommendations for any
428.1 needed crisis stabilization services for the recipient.
428.2 (e) "Mental health crisis stabilization services" means
428.3 individualized mental health services provided to a recipient
428.4 following crisis intervention services which are designed to
428.5 restore the recipient to the recipient's prior functional
428.6 level. Mental health crisis stabilization services may be
428.7 provided in the recipient's home, the home of a family member or
428.8 friend of the recipient, another community setting, or a
428.9 short-term supervised, licensed residential program. Mental
428.10 health crisis stabilization does not include partial
428.11 hospitalization or day treatment.
428.12 Subd. 3. [ELIGIBILITY.] An eligible recipient is an
428.13 individual who:
428.14 (1) is age 18 or older;
428.15 (2) is screened as possibly experiencing a mental health
428.16 crisis or emergency where a mental health crisis assessment is
428.17 needed; and
428.18 (3) is assessed as experiencing a mental health crisis or
428.19 emergency, and mental health crisis intervention or crisis
428.20 intervention and stabilization services are determined to be
428.21 medically necessary.
428.22 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A provider
428.23 entity is an entity that meets the standards listed in paragraph
428.24 (b) and:
428.25 (1) is a county board operated entity; or
428.26 (2) is a provider entity that is under contract with the
428.27 county board in the county where the potential crisis or
428.28 emergency is occurring. To provide services under this section,
428.29 the provider entity must directly provide the services; or if
428.30 services are subcontracted, the provider entity must maintain
428.31 responsibility for services and billing.
428.32 (b) The adult mental health crisis response services
428.33 provider entity must meet the following standards:
428.34 (1) has the capacity to recruit, hire, and manage and train
428.35 mental health professionals, practitioners, and rehabilitation
428.36 workers;
429.1 (2) has adequate administrative ability to ensure
429.2 availability of services;
429.3 (3) is able to ensure adequate preservice and in-service
429.4 training;
429.5 (4) is able to ensure that staff providing these services
429.6 are skilled in the delivery of mental health crisis response
429.7 services to recipients;
429.8 (5) is able to ensure that staff are capable of
429.9 implementing culturally specific treatment identified in the
429.10 individual treatment plan that is meaningful and appropriate as
429.11 determined by the recipient's culture, beliefs, values, and
429.12 language;
429.13 (6) is able to ensure enough flexibility to respond to the
429.14 changing intervention and care needs of a recipient as
429.15 identified by the recipient during the service partnership
429.16 between the recipient and providers;
429.17 (7) is able to ensure that mental health professionals and
429.18 mental health practitioners have the communication tools and
429.19 procedures to communicate and consult promptly about crisis
429.20 assessment and interventions as services occur;
429.21 (8) is able to coordinate these services with county
429.22 emergency services and mental health crisis services;
429.23 (9) is able to ensure that mental health crisis assessment
429.24 and mobile crisis intervention services are available 24 hours a
429.25 day, seven days a week;
429.26 (10) is able to ensure that services are coordinated with
429.27 other mental health service providers, county mental health
429.28 authorities, or federally recognized American Indian authorities
429.29 and others as necessary, with the consent of the adult.
429.30 Services must also be coordinated with the recipient's case
429.31 manager if the adult is receiving case management services;
429.32 (11) is able to ensure that crisis intervention services
429.33 are provided in a manner consistent with sections 245.461 to
429.34 245.486;
429.35 (12) is able to submit information as required by the
429.36 state;
430.1 (13) maintains staff training and personnel files;
430.2 (14) is able to establish and maintain a quality assurance
430.3 and evaluation plan to evaluate the outcomes of services and
430.4 recipient satisfaction;
430.5 (15) is able to keep records as required by applicable
430.6 laws;
430.7 (16) is able to comply with all applicable laws and
430.8 statutes;
430.9 (17) is an enrolled medical assistance provider; and
430.10 (18) develops and maintains written policies and procedures
430.11 regarding service provision and administration of the provider
430.12 entity including safety of staff and recipients in high risk
430.13 situations.
430.14 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF
430.15 QUALIFICATIONS.] For provision of adult mental health mobile
430.16 crisis intervention services, a mobile crisis intervention team
430.17 is comprised of at least two mental health professionals as
430.18 defined in section 245.462, subdivision 18, clauses (1) to (5),
430.19 or a combination of at least one mental health professional and
430.20 one mental health practitioner as defined in section 245.462,
430.21 subdivision 17, with the required mental health crisis training
430.22 and under the clinical supervision of a mental health
430.23 professional on the team. The team must have at least two
430.24 people with at least one member providing on-site crisis
430.25 intervention services when needed. Team members must be
430.26 experienced in mental health assessment, crisis intervention
430.27 techniques, and clinical decision-making under emergency
430.28 conditions and have knowledge of local services and resources.
430.29 The team must recommend and coordinate the team's services with
430.30 appropriate local resources such as the county social services
430.31 agency, mental health services, and local law enforcement when
430.32 necessary.
430.33 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE
430.34 INTERVENTION TREATMENT PLANNING.] (a) Prior to initiating mobile
430.35 crisis intervention services, a screening of the potential
430.36 crisis situation must be conducted. The screening may use the
431.1 resources of crisis assistance and emergency services as defined
431.2 in sections 245.462, subdivision 6, and 245.469, subdivisions 1
431.3 and 2. The screening must gather information, determine whether
431.4 a crisis situation exists, identify parties involved, and
431.5 determine an appropriate response.
431.6 (b) If a crisis exists, a crisis assessment must be
431.7 completed. A crisis assessment evaluates any immediate needs
431.8 for which emergency services are needed and, as time permits,
431.9 the recipient's current life situation, sources of stress,
431.10 mental health problems and symptoms, strengths, cultural
431.11 considerations, support network, vulnerabilities, and current
431.12 functioning.
431.13 (c) If the crisis assessment determines mobile crisis
431.14 intervention services are needed, the intervention services must
431.15 be provided promptly. As opportunity presents during the
431.16 intervention, at least two members of the mobile crisis
431.17 intervention team must confer directly or by telephone about the
431.18 assessment, treatment plan, and actions taken and needed. At
431.19 least one of the team members must be on-site providing crisis
431.20 intervention services. If providing on-site crisis intervention
431.21 services, a mental health practitioner must seek clinical
431.22 supervision as required in subdivision 8.
431.23 (d) The mobile crisis intervention team must develop an
431.24 initial, brief crisis treatment plan as soon as appropriate but
431.25 no later than 24 hours after the initial face-to-face
431.26 intervention. The plan must address the needs and problems
431.27 noted in the crisis assessment and include measurable short-term
431.28 goals, cultural considerations, and frequency and type of
431.29 services to be provided to achieve the goals and reduce or
431.30 eliminate the crisis. The treatment plan must be updated as
431.31 needed to reflect current goals and services.
431.32 (e) The team must document which short-term goals have been
431.33 met, and when no further crisis intervention services are
431.34 required.
431.35 (f) If the recipient's crisis is stabilized, but the
431.36 recipient needs a referral to other services, the team must
432.1 provide referrals to these services. If the recipient has a
432.2 case manager, planning for other services must be coordinated
432.3 with the case manager.
432.4 Subd. 7. [CRISIS STABILIZATION SERVICES.] (a) Crisis
432.5 stabilization services must be provided by qualified staff of a
432.6 crisis stabilization services provider entity and must meet the
432.7 following standards:
432.8 (1) a crisis stabilization treatment plan must be developed
432.9 which meets the criteria in subdivision 11;
432.10 (2) staff must be qualified as defined in subdivision 8;
432.11 and
432.12 (3) services must be delivered according to the treatment
432.13 plan and include face-to-face contact with the recipient by
432.14 qualified staff for further assessment, help with referrals,
432.15 updating of the crisis stabilization treatment plan, supportive
432.16 counseling, skills training, and collaboration with other
432.17 service providers in the community.
432.18 (b) If crisis stabilization services are provided in a
432.19 supervised, licensed residential setting, the recipient must be
432.20 contacted face-to-face daily by a qualified mental health
432.21 practitioner or mental health professional. The program must
432.22 have 24-hour-a-day residential staffing which may include staff
432.23 who do not meet the qualifications in subdivision 8. The
432.24 residential staff must have 24-hour-a-day immediate direct or
432.25 telephone access to a qualified mental health professional or
432.26 practitioner.
432.27 (c) If crisis stabilization services are provided in a
432.28 supervised, licensed residential setting that serves no more
432.29 than four adult residents, and no more than two are recipients
432.30 of crisis stabilization services, the residential staff must
432.31 include, for at least eight hours per day, at least one
432.32 individual who meets the qualifications in subdivision 8.
432.33 (d) If crisis stabilization services are provided in a
432.34 supervised, licensed residential setting that serves more than
432.35 four adult residents, and one or more are recipients of crisis
432.36 stabilization services, the residential staff must include, for
433.1 24 hours a day, at least one individual who meets the
433.2 qualifications in subdivision 8. During the first 48 hours that
433.3 a recipient is in the residential program, the residential
433.4 program must have at least two staff working 24 hours a day.
433.5 Staffing levels may be adjusted thereafter according to the
433.6 needs of the recipient as specified in the crisis stabilization
433.7 treatment plan.
433.8 Subd. 8. [ADULT CRISIS STABILIZATION STAFF
433.9 QUALIFICATIONS.] (a) Adult mental health crisis stabilization
433.10 services must be provided by qualified individual staff of a
433.11 qualified provider entity. Individual provider staff must have
433.12 the following qualifications:
433.13 (1) be a mental health professional as defined in section
433.14 245.462, subdivision 18, clauses (1) to (5);
433.15 (2) be a mental health practitioner as defined in section
433.16 245.462, subdivision 17. The mental health practitioner must
433.17 work under the clinical supervision of a mental health
433.18 professional; or
433.19 (3) be a mental health rehabilitation worker who meets the
433.20 criteria in section 256B.0623, subdivision 5, clause (3); works
433.21 under the direction of a mental health practitioner as defined
433.22 in section 245.462, subdivision 17, or under direction of a
433.23 mental health professional; and works under the clinical
433.24 supervision of a mental health professional.
433.25 (b) Mental health practitioners and mental health
433.26 rehabilitation workers must have completed at least 30 hours of
433.27 training in crisis intervention and stabilization during the
433.28 past two years.
433.29 Subd. 9. [SUPERVISION.] Mental health practitioners may
433.30 provide crisis assessment and mobile crisis intervention
433.31 services if the following clinical supervision requirements are
433.32 met:
433.33 (1) the mental health provider entity must accept full
433.34 responsibility for the services provided;
433.35 (2) the mental health professional of the provider entity,
433.36 who is an employee or under contract with the provider entity,
434.1 must be available by phone or in person for clinical
434.2 supervision;
434.3 (3) the mental health professional is consulted, in person
434.4 or by phone, during the first three hours when a mental health
434.5 practitioner provides on-site service;
434.6 (4) the mental health professional must:
434.7 (i) review and approve of the tentative crisis assessment
434.8 and crisis treatment plan;
434.9 (ii) document the consultation; and
434.10 (iii) sign the crisis assessment and treatment plan within
434.11 the next business day;
434.12 (5) if the mobile crisis intervention services continue
434.13 into a second calendar day, a mental health professional must
434.14 contact the recipient face-to-face on the second day to provide
434.15 services and update the crisis treatment plan; and
434.16 (6) the on-site observation must be documented in the
434.17 recipient's record and signed by the mental health professional.
434.18 Subd. 10. [RECIPIENT FILE.] Providers of mobile crisis
434.19 intervention or crisis stabilization services must maintain a
434.20 file for each recipient containing the following information:
434.21 (1) individual crisis treatment plans signed by the
434.22 recipient, mental health professional, and mental health
434.23 practitioner who developed the crisis treatment plan, or if the
434.24 recipient refused to sign the plan, the date and reason stated
434.25 by the recipient as to why the recipient would not sign the
434.26 plan;
434.27 (2) signed release forms;
434.28 (3) recipient health information and current medications;
434.29 (4) emergency contacts for the recipient;
434.30 (5) case records which document the date of service, place
434.31 of service delivery, signature of the person providing the
434.32 service, and the nature, extent, and units of service. Direct
434.33 or telephone contact with the recipient's family or others
434.34 should be documented;
434.35 (6) required clinical supervision by mental health
434.36 professionals;
435.1 (7) summary of the recipient's case reviews by staff; and
435.2 (8) any written information by the recipient that the
435.3 recipient wants in the file.
435.4 Documentation in the file must comply with all requirements of
435.5 the commissioner.
435.6 Subd. 11. [TREATMENT PLAN.] The individual crisis
435.7 stabilization treatment plan must include, at a minimum:
435.8 (1) a list of problems identified in the assessment;
435.9 (2) a list of the recipient's strengths and resources;
435.10 (3) concrete, measurable short-term goals and tasks to be
435.11 achieved, including time frames for achievement;
435.12 (4) specific objectives directed toward the achievement of
435.13 each one of the goals;
435.14 (5) documentation of the participants involved in the
435.15 service planning. The recipient, if possible, must be a
435.16 participant. The recipient or the recipient's legal guardian
435.17 must sign the service plan or documentation must be provided why
435.18 this was not possible. A copy of the plan must be given to the
435.19 recipient and the recipient's legal guardian. The plan should
435.20 include services arranged, including specific providers where
435.21 applicable;
435.22 (6) planned frequency and type of services initiated;
435.23 (7) a crisis response action plan if a crisis should occur;
435.24 (8) clear progress notes on outcome of goals;
435.25 (9) a written plan must be completed within 24 hours of
435.26 beginning services with the recipient; and
435.27 (10) a treatment plan must be developed by a mental health
435.28 professional or mental health practitioner under the clinical
435.29 supervision of a mental health professional. The mental health
435.30 professional must approve and sign all treatment plans.
435.31 Subd. 12. [EXCLUDED SERVICES.] The following services are
435.32 excluded from reimbursement under this section:
435.33 (1) room and board services;
435.34 (2) services delivered to a recipient while admitted to an
435.35 inpatient hospital;
435.36 (3) recipient transportation costs may be covered under
436.1 other medical assistance provisions, but transportation services
436.2 are not an adult mental health crisis response service;
436.3 (4) services provided and billed by a provider who is not
436.4 enrolled under medical assistance to provide adult mental health
436.5 crisis response services;
436.6 (5) services performed by volunteers;
436.7 (6) direct billing of time spent "on call" when not
436.8 delivering services to a recipient;
436.9 (7) provider service time included in case management
436.10 reimbursement. When a provider is eligible to provide more than
436.11 one type of medical assistance service, the recipient must have
436.12 a choice of provider for each service, unless otherwise provided
436.13 for by law;
436.14 (8) outreach services to potential recipients; and
436.15 (9) a mental health service that is not medically necessary.
436.16 Sec. 16. Minnesota Statutes 2000, section 256B.0625,
436.17 subdivision 20, is amended to read:
436.18 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the
436.19 extent authorized by rule of the state agency, medical
436.20 assistance covers case management services to persons with
436.21 serious and persistent mental illness and children with severe
436.22 emotional disturbance. Services provided under this section
436.23 must meet the relevant standards in sections 245.461 to
436.24 245.4888, the Comprehensive Adult and Children's Mental Health
436.25 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and
436.26 9505.0322, excluding subpart 10.
436.27 (b) Entities meeting program standards set out in rules
436.28 governing family community support services as defined in
436.29 section 245.4871, subdivision 17, are eligible for medical
436.30 assistance reimbursement for case management services for
436.31 children with severe emotional disturbance when these services
436.32 meet the program standards in Minnesota Rules, parts 9520.0900
436.33 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
436.34 (c) Medical assistance and MinnesotaCare payment for mental
436.35 health case management shall be made on a monthly basis. In
436.36 order to receive payment for an eligible child, the provider
437.1 must document at least a face-to-face contact with the child,
437.2 the child's parents, or the child's legal representative. To
437.3 receive payment for an eligible adult, the provider must
437.4 document:
437.5 (1) at least a face-to-face contact with the adult or the
437.6 adult's legal representative; or
437.7 (2) at least a telephone contact with the adult or the
437.8 adult's legal representative and document a face-to-face contact
437.9 with the adult or the adult's legal representative within the
437.10 preceding two months.
437.11 (d) Payment for mental health case management provided by
437.12 county or state staff shall be based on the monthly rate
437.13 methodology under section 256B.094, subdivision 6, paragraph
437.14 (b), with separate rates calculated for child welfare and mental
437.15 health, and within mental health, separate rates for children
437.16 and adults.
437.17 (e) Payment for mental health case management provided by
437.18 Indian health services or by agencies operated by Indian tribes
437.19 may be made according to this section or other relevant
437.20 federally approved rate setting methodology.
437.21 (f) Payment for mental health case management provided by
437.22 county-contracted vendors who contract with a county or Indian
437.23 tribe shall be based on a monthly rate negotiated by the host
437.24 county or tribe. The negotiated rate must not exceed the rate
437.25 charged by the vendor for the same service to other payers. If
437.26 the service is provided by a team of contracted vendors, the
437.27 county or tribe may negotiate a team rate with a vendor who is a
437.28 member of the team. The team shall determine how to distribute
437.29 the rate among its members. No reimbursement received by
437.30 contracted vendors shall be returned to the county or tribe,
437.31 except to reimburse the county or tribe for advance funding
437.32 provided by the county or tribe to the vendor.
437.33 (f) (g) If the service is provided by a team which includes
437.34 contracted vendors, tribal staff, and county or state staff, the
437.35 costs for county or state staff participation in the team shall
437.36 be included in the rate for county-provided services. In this
438.1 case, the contracted vendor, the tribal agency, and the county
438.2 may each receive separate payment for services provided by each
438.3 entity in the same month. In order to prevent duplication of
438.4 services, the county each entity must document, in the
438.5 recipient's file, the need for team case management and a
438.6 description of the roles of the team members.
438.7 (g) (h) The commissioner shall calculate the nonfederal
438.8 share of actual medical assistance and general assistance
438.9 medical care payments for each county, based on the higher of
438.10 calendar year 1995 or 1996, by service date, project that amount
438.11 forward to 1999, and transfer one-half of the result from
438.12 medical assistance and general assistance medical care to each
438.13 county's mental health grants under sections 245.4886 and
438.14 256E.12 for calendar year 1999. The annualized minimum amount
438.15 added to each county's mental health grant shall be $3,000 per
438.16 year for children and $5,000 per year for adults. The
438.17 commissioner may reduce the statewide growth factor in order to
438.18 fund these minimums. The annualized total amount transferred
438.19 shall become part of the base for future mental health grants
438.20 for each county.
438.21 (h) (i) Any net increase in revenue to the county or tribe
438.22 as a result of the change in this section must be used to
438.23 provide expanded mental health services as defined in sections
438.24 245.461 to 245.4888, the Comprehensive Adult and Children's
438.25 Mental Health Acts, excluding inpatient and residential
438.26 treatment. For adults, increased revenue may also be used for
438.27 services and consumer supports which are part of adult mental
438.28 health projects approved under Laws 1997, chapter 203, article
438.29 7, section 25. For children, increased revenue may also be used
438.30 for respite care and nonresidential individualized
438.31 rehabilitation services as defined in section 245.492,
438.32 subdivisions 17 and 23. "Increased revenue" has the meaning
438.33 given in Minnesota Rules, part 9520.0903, subpart 3.
438.34 (i) (j) Notwithstanding section 256B.19, subdivision 1, the
438.35 nonfederal share of costs for mental health case management
438.36 shall be provided by the recipient's county of responsibility,
439.1 as defined in sections 256G.01 to 256G.12, from sources other
439.2 than federal funds or funds used to match other federal
439.3 funds. If the service is provided by a tribal agency, the
439.4 nonfederal share, if any, shall be provided by the recipient's
439.5 tribe.
439.6 (j) (k) The commissioner may suspend, reduce, or terminate
439.7 the reimbursement to a provider that does not meet the reporting
439.8 or other requirements of this section. The county of
439.9 responsibility, as defined in sections 256G.01 to 256G.12, or,
439.10 if applicable, the tribal agency, is responsible for any federal
439.11 disallowances. The county or tribe may share this
439.12 responsibility with its contracted vendors.
439.13 (k) (l) The commissioner shall set aside a portion of the
439.14 federal funds earned under this section to repay the special
439.15 revenue maximization account under section 256.01, subdivision
439.16 2, clause (15). The repayment is limited to:
439.17 (1) the costs of developing and implementing this section;
439.18 and
439.19 (2) programming the information systems.
439.20 (l) (m) Notwithstanding section 256.025, subdivision 2,
439.21 payments to counties and tribal agencies for case management
439.22 expenditures under this section shall only be made from federal
439.23 earnings from services provided under this section. Payments to
439.24 contracted county-contracted vendors shall include both the
439.25 federal earnings and the county share.
439.26 (m) (n) Notwithstanding section 256B.041, county payments
439.27 for the cost of mental health case management services provided
439.28 by county or state staff shall not be made to the state
439.29 treasurer. For the purposes of mental health case management
439.30 services provided by county or state staff under this section,
439.31 the centralized disbursement of payments to counties under
439.32 section 256B.041 consists only of federal earnings from services
439.33 provided under this section.
439.34 (n) (o) Case management services under this subdivision do
439.35 not include therapy, treatment, legal, or outreach services.
439.36 (o) (p) If the recipient is a resident of a nursing
440.1 facility, intermediate care facility, or hospital, and the
440.2 recipient's institutional care is paid by medical assistance,
440.3 payment for case management services under this subdivision is
440.4 limited to the last 30 days of the recipient's residency in that
440.5 facility and may not exceed more than two months in a calendar
440.6 year.
440.7 (p) (q) Payment for case management services under this
440.8 subdivision shall not duplicate payments made under other
440.9 program authorities for the same purpose.
440.10 (q) (r) By July 1, 2000, the commissioner shall evaluate
440.11 the effectiveness of the changes required by this section,
440.12 including changes in number of persons receiving mental health
440.13 case management, changes in hours of service per person, and
440.14 changes in caseload size.
440.15 (r) (s) For each calendar year beginning with the calendar
440.16 year 2001, the annualized amount of state funds for each county
440.17 determined under paragraph (g) (h) shall be adjusted by the
440.18 county's percentage change in the average number of clients per
440.19 month who received case management under this section during the
440.20 fiscal year that ended six months prior to the calendar year in
440.21 question, in comparison to the prior fiscal year.
440.22 (s) (t) For counties receiving the minimum allocation of
440.23 $3,000 or $5,000 described in paragraph (g) (h), the adjustment
440.24 in paragraph (r) (s) shall be determined so that the county
440.25 receives the higher of the following amounts:
440.26 (1) a continuation of the minimum allocation in paragraph
440.27 (g) (h); or
440.28 (2) an amount based on that county's average number of
440.29 clients per month who received case management under this
440.30 section during the fiscal year that ended six months prior to
440.31 the calendar year in question, in comparison to the prior fiscal
440.32 year, times the average statewide grant per person per month for
440.33 counties not receiving the minimum allocation.
440.34 (t) (u) The adjustments in paragraphs (r) and (s) and (t)
440.35 shall be calculated separately for children and adults.
440.36 Sec. 17. Minnesota Statutes 2000, section 256B.0625, is
441.1 amended by adding a subdivision to read:
441.2 Subd. 43. [APPEAL PROCESS.] If a county contract or
441.3 certification is required to enroll as an authorized provider of
441.4 mental health services under medical assistance, and if a county
441.5 refuses to grant the necessary contract or certification, the
441.6 provider may appeal the county decision to the commissioner. A
441.7 recipient may initiate an appeal on behalf of a provider who has
441.8 been denied certification. The commissioner shall determine
441.9 whether the provider meets applicable standards under state laws
441.10 and rules based on an independent review of the facts, including
441.11 comments from the county review. If the commissioner finds that
441.12 the provider meets the applicable standards, the commissioner
441.13 shall enroll the provider as an authorized provider. The
441.14 commissioner shall develop procedures for providers and
441.15 recipients to appeal a county decision to refuse to enroll a
441.16 provider. After the commissioner makes a decision regarding an
441.17 appeal, the county, provider, or recipient may request that the
441.18 commissioner reconsider the commissioner's initial decision. The
441.19 commissioner's reconsideration decision is final and not subject
441.20 to further appeal.
441.21 Sec. 18. Minnesota Statutes 2000, section 256B.0625, is
441.22 amended by adding a subdivision to read:
441.23 Subd. 44. [MENTAL HEALTH PROVIDER TRAVEL TIME.] Medical
441.24 assistance covers provider travel time if a recipient's
441.25 individual treatment plan requires the provision of mental
441.26 health services outside of the provider's normal place of
441.27 business. This does not include any travel time which is
441.28 included in other billable services, and is only covered when
441.29 the mental health service being provided to a recipient is
441.30 covered under medical assistance.
441.31 Sec. 19. [256B.761] [REIMBURSEMENT FOR MENTAL HEALTH
441.32 SERVICES.]
441.33 Payment for medication management provided to psychiatric
441.34 patients, outpatient mental health services, day treatment
441.35 services, home-based mental health services, and family
441.36 community support services shall be paid at:
442.1 (1) for services rendered on or after July 1, 2001, and
442.2 before July 1, 2002, the lower of (i) submitted charges, or (ii)
442.3 the 73rd percentile of the 50th percentile of 1999 charges; and
442.4 (2) for services rendered on or after July 1, 2002, the
442.5 lower of (i) submitted charges, or (ii) the 75th percentile of
442.6 the 50th percentile of 1999 charges.
442.7 Sec. 20. [299A.76] [SUICIDE STATISTICS.]
442.8 (a) The commissioner of public safety shall not:
442.9 (1) include any statistics on committing suicide or
442.10 attempting suicide in any compilation of crime statistics
442.11 published by the commissioner; or
442.12 (2) label as a crime statistic, any data on committing
442.13 suicide or attempting suicide.
442.14 (b) This section does not apply to the crimes of aiding
442.15 suicide under section 609.215, subdivision 1, or aiding
442.16 attempted suicide under section 609.215, subdivision 2, or to
442.17 statistics directly related to the commission of a crime.
442.18 Sec. 21. [NOTICE REGARDING ESTABLISHMENT OF CONTINUING
442.19 CARE BENEFIT PROGRAM.]
442.20 When the continuing care benefit program for persons with
442.21 mental illness under Minnesota Statutes, section 256.9693 is
442.22 established, the commissioner of human services shall notify
442.23 counties, health plan companies with prepaid medical assistance
442.24 contracts, health care providers, and enrollees of the benefit
442.25 program through bulletins, workshops, and other meetings.
442.26 [EFFECTIVE DATE.] This section is effective July 1, 2002.
442.27 Sec. 22. [STUDY; LENGTH OF STAY FOR MEDICARE-ELIGIBLE
442.28 PERSONS.]
442.29 The commissioner of human services shall study and make
442.30 recommendations on how Medicare-eligible persons with mental
442.31 illness may obtain acute care hospital inpatient treatment for
442.32 mental illness for a length of stay beyond that allowed by the
442.33 diagnostic classifications for mental illness according to
442.34 Minnesota Statutes, section 256.969, subdivision 3a. The study
442.35 and recommendations shall be reported to the legislature by
442.36 January 15, 2002.
443.1 Sec. 23. [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT
443.2 RESIDENTIAL SERVICES GRANTS.]
443.3 The commissioner of human services shall review funding
443.4 methods for adult residential services grants under Minnesota
443.5 Rules, parts 9535.2000 to 9535.3000, and shall develop a payment
443.6 system that takes into account client difficulty of care as
443.7 manifested by client physical, mental, or behavioral
443.8 conditions. The payment system must provide reimbursement for
443.9 education, consultation, and support services provided to
443.10 families and other individuals as an extension of the treatment
443.11 process. The commissioner shall present recommendations and
443.12 draft legislation for an adult residential services payment
443.13 system to the legislature by January 15, 2002. The
443.14 recommendations must address whether additional funding for
443.15 adult residential services grants is necessary for the provision
443.16 of high quality services under a payment reimbursement system.
443.17 ARTICLE 10
443.18 ASSISTANCE PROGRAMS
443.19 Section 1. Minnesota Statutes 2000, section 256.01,
443.20 subdivision 18, is amended to read:
443.21 Subd. 18. [IMMIGRATION STATUS VERIFICATIONS.] (a)
443.22 Notwithstanding any waiver of this requirement by the secretary
443.23 of the United States Department of Health and Human Services,
443.24 effective July 1, 2001, the commissioner shall utilize the
443.25 Systematic Alien Verification for Entitlements (SAVE) program to
443.26 conduct immigration status verifications:
443.27 (1) as required under United States Code, title 8, section
443.28 1642;
443.29 (2) for all applicants for food assistance benefits,
443.30 whether under the federal food stamp program, the MFIP or work
443.31 first program, or the Minnesota food assistance program;
443.32 (3) for all applicants for general assistance medical care,
443.33 except assistance for an emergency medical condition, for
443.34 immunization with respect to an immunizable disease, or for
443.35 testing and treatment of symptoms of a communicable disease; and
443.36 (4) for all applicants for general assistance, Minnesota
444.1 supplemental aid, MinnesotaCare, or group residential housing,
444.2 when the benefits provided by these programs would fall under
444.3 the definition of "federal public benefit" under United States
444.4 Code, title 8, section 1642, if federal funds were used to pay
444.5 for all or part of the benefits.
444.6 The commissioner shall report to the Immigration and
444.7 Naturalization Service all undocumented persons who have been
444.8 identified through application verification procedures or by the
444.9 self-admission of an applicant for assistance. Reports made
444.10 under this subdivision must comply with the requirements of
444.11 section 411A of the Social Security Act, as amended, and United
444.12 States Code, title 8, section 1644.
444.13 (b) The commissioner shall comply with the reporting
444.14 requirements under United States Code, title 42, section 611a,
444.15 and any federal regulation or guidance adopted under that law.
444.16 Sec. 2. [256J.021] [SEPARATE STATE PROGRAM FOR USE OF
444.17 STATE MONEY.]
444.18 Beginning October 1, 2001, and each year thereafter, the
444.19 commissioner of human services must treat financial assistance
444.20 expenditures made to or on behalf of any minor child under
444.21 section 256J.02, subdivision 2, clause (1), who is a resident of
444.22 this state under section 256J.12, and who is part of a
444.23 two-parent eligible household as expenditures under a separately
444.24 funded state program and report those expenditures to the
444.25 federal Department of Health and Human Services as separate
444.26 state program expenditures under Code of Federal Regulations,
444.27 title 45, section 263.5.
444.28 Sec. 3. Minnesota Statutes 2000, section 256J.09,
444.29 subdivision 1, is amended to read:
444.30 Subdivision 1. [WHERE TO APPLY.] To apply for assistance a
444.31 person must apply for assistance at submit a signed application
444.32 to the county agency in the county where that person lives.
444.33 Sec. 4. Minnesota Statutes 2000, section 256J.09,
444.34 subdivision 2, is amended to read:
444.35 Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE
444.36 INFORMATION.] When a person inquires about assistance, a county
445.1 agency must inform a person who inquires about assistance about:
445.2 (1) explain the eligibility requirements for assistance of,
445.3 and how to apply for, diversionary assistance, including
445.4 diversionary assistance and as provided in section 256J.47;
445.5 emergency assistance. as provided in section 256J.48; MFIP as
445.6 provided in section 256J.10; or any other assistance for which
445.7 the person may be eligible; and
445.8 A county agency must (2) offer the person brochures
445.9 developed or approved by the commissioner that describe how to
445.10 apply for assistance.
445.11 Sec. 5. Minnesota Statutes 2000, section 256J.09,
445.12 subdivision 3, is amended to read:
445.13 Subd. 3. [SUBMITTING THE APPLICATION FORM.] (a) A county
445.14 agency must offer, in person or by mail, the application forms
445.15 prescribed by the commissioner as soon as a person makes a
445.16 written or oral inquiry. At that time, the county agency must:
445.17 (1) inform the person that assistance begins with the date
445.18 the signed application is received by the county agency or the
445.19 date all eligibility criteria are met, whichever is later. The
445.20 county agency must;
445.21 (2) inform the applicant person that any delay in
445.22 submitting the application will reduce the amount of assistance
445.23 paid for the month of application. A county agency must;
445.24 (3) inform a person that the person may submit the
445.25 application before an interview appointment. To apply for
445.26 assistance, a person must submit a signed application to the
445.27 county agency.;
445.28 (4) explain the information that will be verified during
445.29 the application process by the county agency as provided in
445.30 section 256J.32;
445.31 (5) inform a person about the county agency's average
445.32 application processing time and explain how the application will
445.33 be processed under subdivision 5;
445.34 (6) explain how to contact the county agency if a person's
445.35 application information changes and how to withdraw the
445.36 application;
446.1 (7) inform a person that the next step in the application
446.2 process is an interview and what a person must do if the
446.3 application is approved including, but not limited to, attending
446.4 orientation under section 256J.45 and complying with employment
446.5 and training services requirements in sections 256J.52 to
446.6 256J.55;
446.7 (8) explain the child care and transportation services that
446.8 are available under paragraph (c) to enable caregivers to attend
446.9 the interview, screening, and orientation; and
446.10 (9) identify any language barriers and arrange for
446.11 translation assistance during appointments, including, but not
446.12 limited to, screening under subdivision 3a, orientation under
446.13 section 256J.45, and the initial assessment under section
446.14 256J.52.
446.15 (b) Upon receipt of a signed application, the county agency
446.16 must stamp the date of receipt on the face of the application.
446.17 The county agency must process the application within the time
446.18 period required under subdivision 5. An applicant may withdraw
446.19 the application at any time by giving written or oral notice to
446.20 the county agency. The county agency must issue a written
446.21 notice confirming the withdrawal. The notice must inform the
446.22 applicant of the county agency's understanding that the
446.23 applicant has withdrawn the application and no longer wants to
446.24 pursue it. When, within ten days of the date of the agency's
446.25 notice, an applicant informs a county agency, in writing, that
446.26 the applicant does not wish to withdraw the application, the
446.27 county agency must reinstate the application and finish
446.28 processing the application.
446.29 (c) Upon a participant's request, the county agency must
446.30 arrange for transportation and child care or reimburse the
446.31 participant for transportation and child care expenses necessary
446.32 to enable participants to attend the screening under subdivision
446.33 3a and orientation under section 256J.45.
446.34 Sec. 6. Minnesota Statutes 2000, section 256J.09, is
446.35 amended by adding a subdivision to read:
446.36 Subd. 3a. [SCREENING.] The county agency, or at county
447.1 option, the county's employment and training service provider as
447.2 defined in section 256J.49, must screen each applicant to
447.3 determine immediate needs and to determine if the applicant may
447.4 be eligible for:
447.5 (1) another program that is not partially funded through
447.6 the federal temporary assistance to needy families block grant
447.7 under Title I of Public Law Number 104-193, including the
447.8 expedited issuance of food stamps under section 256J.28,
447.9 subdivision 1. If the applicant may be eligible for another
447.10 program, a county caseworker must provide the appropriate
447.11 referral to the program;
447.12 (2) the diversionary assistance program under section
447.13 256J.47; or
447.14 (3) the emergency assistance program under section 256J.48.
447.15 Sec. 7. Minnesota Statutes 2000, section 256J.09, is
447.16 amended by adding a subdivision to read:
447.17 Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.]
447.18 If the applicant is not diverted from applying for MFIP, and if
447.19 the applicant meets the MFIP eligibility requirements, then a
447.20 county agency must:
447.21 (1) identify an applicant who is under the age of 20 and
447.22 explain to the applicant the assessment procedures and
447.23 employment plan requirements for minor parents under section
447.24 256J.54;
447.25 (2) explain to the applicant the eligibility criteria for
447.26 an exemption under the family violence provisions in section
447.27 256J.52, subdivision 6, and explain what an applicant should do
447.28 to develop an alternative employment plan;
447.29 (3) determine if an applicant qualifies for an exemption
447.30 under section 256J.56 from employment and training services
447.31 requirements, explain how a person should report to the county
447.32 agency any status changes, and explain that an applicant who is
447.33 exempt may volunteer to participate in employment and training
447.34 services;
447.35 (4) for applicants who are not exempt from the requirement
447.36 to attend orientation, arrange for an orientation under section
448.1 256J.45 and an initial assessment under section 256J.52;
448.2 (5) inform an applicant who is not exempt from the
448.3 requirement to attend orientation that failure to attend the
448.4 orientation is considered an occurrence of noncompliance with
448.5 program requirements and will result in an imposition of a
448.6 sanction under section 256J.46; and
448.7 (6) explain how to contact the county agency if an
448.8 applicant has questions about compliance with program
448.9 requirements.
448.10 Sec. 8. Minnesota Statutes 2000, section 256J.15, is
448.11 amended by adding a subdivision to read:
448.12 Subd. 3. [ELIGIBILITY AFTER DISQUALIFICATION DUE TO
448.13 NONCOMPLIANCE.] (a) An applicant who is a member of an
448.14 assistance unit that was disqualified from receiving MFIP under
448.15 section 256J.46, subdivision 1, paragraph (d), clause (3), and
448.16 who applies for MFIP assistance within six months of the date of
448.17 the disqualification is considered to be a new applicant for
448.18 purposes of the property limitations under section 256J.20 and,
448.19 at county option, the payment of assistance provisions under
448.20 section 256J.24, subdivision 8. The county agency must also use
448.21 the initial income test under section 256J.21, subdivision 3, in
448.22 determining the applicant's eligibility for assistance.
448.23 (b) Notwithstanding section 256J.24, subdivisions 5 to 7
448.24 and 9, for an applicant who is eligible for MFIP under this
448.25 subdivision, the residual amount of the grant, after making any
448.26 applicable vendor payments for shelter and utility costs, if
448.27 any, must be reduced by ten percent of the applicable MFIP
448.28 standard of need for an assistance unit of the same size for
448.29 each of the first six months on MFIP before the residual amount
448.30 of the grant is paid to the assistance unit.
448.31 (c) A participant who is disqualified from MFIP a second or
448.32 subsequent time and who is eligible for MFIP under this
448.33 subdivision is considered to have a third occurrence of
448.34 noncompliance and must be sanctioned under section 256J.46,
448.35 subdivision 1, paragraph (d), clause (2), for the first six
448.36 months on MFIP under this subdivision.
449.1 Sec. 9. Minnesota Statutes 2000, section 256J.24,
449.2 subdivision 10, is amended to read:
449.3 Subd. 10. [MFIP EXIT LEVEL.] (a) In state fiscal years
449.4 2000 and 2001, The commissioner shall adjust the MFIP earned
449.5 income disregard to ensure that most participants do not lose
449.6 eligibility for MFIP until their income reaches at least 120
449.7 percent of the federal poverty guidelines in effect in October
449.8 of each fiscal year. The adjustment to the disregard shall be
449.9 based on a household size of three, and the resulting earned
449.10 income disregard percentage must be applied to all household
449.11 sizes. The adjustment under this subdivision must be
449.12 implemented at the same time as the October food stamp
449.13 cost-of-living adjustment is reflected in the food portion of
449.14 MFIP transitional standard as required under subdivision 5a.
449.15 (b) In state fiscal year 2002 and thereafter, the earned
449.16 income disregard percentage must be the same as the percentage
449.17 implemented in October 2000.
449.18 Sec. 10. Minnesota Statutes 2000, section 256J.26,
449.19 subdivision 1, is amended to read:
449.20 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a)
449.21 Applicants or participants who have been convicted of a drug
449.22 offense committed after July 1, 1997, may, if otherwise
449.23 eligible, receive MFIP benefits subject to the following
449.24 conditions:
449.25 (1) Benefits for the entire assistance unit must be paid in
449.26 vendor form for shelter and utilities during any time the
449.27 applicant is part of the assistance unit.
449.28 (2) The convicted applicant or participant shall be subject
449.29 to random drug testing as a condition of continued eligibility
449.30 and following any positive test for an illegal controlled
449.31 substance is subject to the following sanctions:
449.32 (i) for failing a drug test the first time, the
449.33 participant's grant shall be reduced by ten percent of the MFIP
449.34 standard of need, prior to making vendor payments for shelter
449.35 and utility costs; or
449.36 (ii) for failing a drug test two or more times, the
450.1 residual amount of the participant's grant after making vendor
450.2 payments for shelter and utility costs, if any, must be reduced
450.3 by an amount equal to 30 percent of the MFIP standard of
450.4 need for an assistance unit of the same size. When a sanction
450.5 under this subdivision is in effect, the job counselor must
450.6 attempt to meet with the person face-to-face. During the
450.7 face-to-face meeting, the job counselor must explain the
450.8 consequences of a subsequent drug test failure and inform the
450.9 participant of the right to appeal the sanction under section
450.10 256J.40. If a face-to-face meeting is not possible, the county
450.11 agency must send the participant a notice of adverse action as
450.12 provided in section 256J.31, subdivisions 4 and 5, and must
450.13 include the information required in the face-to-face meeting; or
450.14 (ii) for failing a drug test two times, the participant is
450.15 permanently disqualified from receiving MFIP assistance, both
450.16 the cash and food portions. The assistance unit's MFIP grant
450.17 must be reduced by the amount which would have otherwise been
450.18 made available to the disqualified participant.
450.19 Disqualification under this item does not make a participant
450.20 ineligible for food stamps. Before a disqualification under
450.21 this provision is imposed, the job counselor must attempt to
450.22 meet with the participant face-to-face. During the face-to-face
450.23 meeting, the job counselor must identify other resources that
450.24 may be available to the participant to meet the needs of the
450.25 family and inform the participant of the right to appeal the
450.26 disqualification under section 256J.40. If a face-to-face
450.27 meeting is not possible, the county agency must send the
450.28 participant a notice of adverse action as provided in section
450.29 256J.31, subdivisions 4 and 5, and must include the information
450.30 required in the face-to-face meeting.
450.31 (3) A participant who fails an initial a drug test the
450.32 first time and is under a sanction due to other MFIP program
450.33 requirements is considered to have more than one occurrence of
450.34 noncompliance and is subject to the applicable level of sanction
450.35 in clause (2)(ii) as specified under section 256J.46,
450.36 subdivision 1, paragraph (d).
451.1 (b) Applicants requesting only food stamps or participants
451.2 receiving only food stamps, who have been convicted of a drug
451.3 offense that occurred after July 1, 1997, may, if otherwise
451.4 eligible, receive food stamps if the convicted applicant or
451.5 participant is subject to random drug testing as a condition of
451.6 continued eligibility. Following a positive test for an illegal
451.7 controlled substance, the applicant is subject to the following
451.8 sanctions:
451.9 (1) for failing a drug test the first time, food stamps
451.10 shall be reduced by ten percent of the applicable food stamp
451.11 allotment; and
451.12 (2) for failing a drug test two or more times, food stamps
451.13 shall be reduced by an amount equal to 30 percent of the
451.14 applicable food stamp allotment. When a sanction under this
451.15 clause is in effect, a job counselor must attempt to meet with
451.16 the person face-to-face. During the face-to-face meeting, a job
451.17 counselor must explain the consequences of a subsequent drug
451.18 test failure and inform the participant of the right to appeal
451.19 the sanction under section 256J.40. If a face-to-face meeting
451.20 is not possible, a county agency must send the participant a
451.21 notice of adverse action as provided in section 256J.31,
451.22 subdivisions 4 and 5, and must include the information required
451.23 in the face-to-face meeting; and
451.24 (2) for failing a drug test two times, the participant is
451.25 permanently disqualified from receiving food stamps. Before a
451.26 disqualification under this provision is imposed, a job
451.27 counselor must attempt to meet with the participant
451.28 face-to-face. During the face-to-face meeting, the job
451.29 counselor must identify other resources that may be available to
451.30 the participant to meet the needs of the family and inform the
451.31 participant of the right to appeal the disqualification under
451.32 section 256J.40. If a face-to-face meeting is not possible, a
451.33 county agency must send the participant a notice of adverse
451.34 action as provided in section 256J.31, subdivisions 4 and 5, and
451.35 must include the information required in the face-to-face
451.36 meeting.
452.1 (c) For the purposes of this subdivision, "drug offense"
452.2 means an offense that occurred after July 1, 1997, of sections
452.3 152.021 to 152.025, 152.0261, or 152.096. Drug offense also
452.4 means a conviction in another jurisdiction of the possession,
452.5 use, or distribution of a controlled substance, or conspiracy to
452.6 commit any of these offenses, if the offense occurred after July
452.7 1, 1997, and the conviction is a felony offense in that
452.8 jurisdiction, or in the case of New Jersey, a high misdemeanor.
452.9 Sec. 11. Minnesota Statutes 2000, section 256J.31,
452.10 subdivision 4, is amended to read:
452.11 Subd. 4. [PARTICIPANT'S RIGHT TO NOTICE.] A county agency
452.12 must give a participant written notice of all adverse actions
452.13 affecting the participant including payment reductions,
452.14 suspensions, terminations, and use of protective, vendor, or
452.15 two-party payments. The notice of adverse action must be on a
452.16 form prescribed or approved by the commissioner, must be
452.17 understandable at a seventh grade reading level, and must be
452.18 mailed to the last known mailing address provided by the
452.19 participant. A notice written in English must include the
452.20 department of human services language block and must be sent to
452.21 every applicable participant. The county agency must state on
452.22 the notice of adverse action the action it intends to take, the
452.23 reasons for the action, the participant's right to appeal the
452.24 action, the conditions under which assistance can be continued
452.25 pending an appeal decision, and the related consequences of the
452.26 action.
452.27 Sec. 12. Minnesota Statutes 2000, section 256J.32,
452.28 subdivision 7a, is amended to read:
452.29 Subd. 7a. [REQUIREMENT TO REPORT TO IMMIGRATION AND
452.30 NATURALIZATION SERVICES.] Notwithstanding subdivision 7,
452.31 effective July 1, 2001, the commissioner shall report to the
452.32 Immigration and Naturalization Services all undocumented persons
452.33 who have been identified through application verification
452.34 procedures or by the self-admission of an applicant for
452.35 assistance. Reports made under this subdivision must comply
452.36 with the requirements of section 411A of the Social Security
453.1 Act, as amended, and United States Code, title 8, section 1644.
453.2 The commissioner shall comply with the reporting requirements
453.3 under United States Code, title 42, section 611a, and any
453.4 federal regulation or guidance adopted under that law.
453.5 Sec. 13. Minnesota Statutes 2000, section 256J.42, is
453.6 amended by adding a subdivision to read:
453.7 Subd. 6. [CASE REVIEW.] (a) Within 180 days before the end
453.8 of the participant's 60th month on MFIP, the county agency or
453.9 job counselor must review the participant's case to determine if
453.10 the employment plan is still appropriate, or if the participant
453.11 is exempt under section 256J.56 from the employment and training
453.12 services component, and attempt to meet with the participant
453.13 face-to-face.
453.14 (b) During the face-to-face meeting, a county agency or the
453.15 job counselor must:
453.16 (1) inform the participant how many months of counted
453.17 assistance the participant has accrued and when the participant
453.18 is expected to reach the 60th month;
453.19 (2) explain the hardship extension criteria under section
453.20 256J.425 and what the participant should do if the participant
453.21 thinks a hardship extension applies;
453.22 (3) identify other resources that may be available to the
453.23 participant to meet the needs of the family; and
453.24 (4) inform the participant of the right to appeal the case
453.25 closure under section 256J.40.
453.26 (c) If a face-to-face meeting is not possible, the county
453.27 agency must send the participant a notice of adverse action as
453.28 provided in section 256J.31, subdivisions 4 and 5.
453.29 (d) Before a participant's case is closed under this
453.30 section, the county must ensure that:
453.31 (1) the case has been reviewed by the job counselor's
453.32 supervisor or the review team designated in the county's
453.33 approved local service unit plan to determine if the criteria
453.34 for a hardship extension, if requested, were applied
453.35 appropriately; and
453.36 (2) the county agency or the job counselor attempted to
454.1 meet with the participant face-to-face.
454.2 Sec. 14. [256J.425] [HARDSHIP EXTENSIONS.]
454.3 Subdivision 1. [ELIGIBILITY.] An assistance unit subject
454.4 to the time limit under section 256J.42, subdivision 1, in which
454.5 any participant has received 60 counted months of assistance is
454.6 not eligible to receive months of assistance beyond the first 60
454.7 months under a hardship extension, if the participant is not in
454.8 compliance. If there is more than one participant in the
454.9 household, each participant must be in compliance to be eligible
454.10 for a hardship extension. For purposes of determining
454.11 eligibility for a hardship extension, a participant is in
454.12 compliance in any month that the participant has not been
454.13 sanctioned under section 256J.46, subdivision 1, or under
454.14 256J.26, subdivision 1.
454.15 Subd. 2. [ILL OR INCAPACITATED PARTICIPANTS; DEPENDENT
454.16 HOUSEHOLD MEMBER.] (a) An assistance unit subject to the time
454.17 limit in section 256J.42, subdivision 1, in which any
454.18 participant has received 60 counted months of assistance, is
454.19 eligible to receive months of assistance under a hardship
454.20 extension if the participant belongs to any of the following
454.21 groups:
454.22 (1) participants who are suffering from a professionally
454.23 certified illness, injury, or incapacity which is expected to
454.24 continue for more than 30 days and which prevents the person
454.25 from obtaining or retaining employment and who are following the
454.26 treatment recommendations of the health care provider certifying
454.27 the illness, injury, or incapacity;
454.28 (2) participants whose presence in the home is required
454.29 because of the professionally certified illness or incapacity of
454.30 another member in the assistance unit, a relative in the
454.31 household, or a foster child in the household and the illness or
454.32 incapacity is expected to continue for more than 30 days; or
454.33 (3) caregivers with a child or an adult in the household
454.34 who meets the disability or medical criteria for home care
454.35 services under section 256B.0627, subdivision 1, paragraph (c),
454.36 or a home and community-based waiver services program under
455.1 chapter 256B, or meets the criteria for severe emotional
455.2 disturbance under section 245.4871, subdivision 6, or for
455.3 serious and persistent mental illness under section 245.462,
455.4 subdivision 20, paragraph (c). Caregivers in this category are
455.5 presumed to be prevented from obtaining or retaining employment.
455.6 (b) An assistance unit receiving assistance under a
455.7 hardship extension under this subdivision may continue to
455.8 receive assistance under MFIP as long as the participant meets
455.9 the criteria in paragraph (a), clause (1), (2), or (3). A
455.10 county agency or job counselor must, on a quarterly basis,
455.11 review the case file of an assistance unit receiving assistance
455.12 under this subdivision to determine if the participant still
455.13 meets the criteria in paragraph (a), clause (1), (2), or (3).
455.14 Subd. 3. [CERTAIN HARD-TO-EMPLOY PARTICIPANTS.] (a) An
455.15 assistance unit subject to the time limit in section 256J.42,
455.16 subdivision 1, in which any participant has received 60 counted
455.17 months of assistance, is eligible to receive months of
455.18 assistance under a hardship extension if the participant belongs
455.19 to any of the following groups:
455.20 (1) a person who is diagnosed by a licensed physician,
455.21 psychological practitioner, or other qualified professional, as
455.22 mentally retarded or mentally ill, and that condition prevents
455.23 the person from obtaining or retaining employment;
455.24 (2) a person who has been assessed by a vocational
455.25 specialist, job counselor, or the county agency to be
455.26 unemployable for purposes of this subdivision; a person is
455.27 considered employable if positions of employment in the local
455.28 labor market exist, regardless of the current availability of
455.29 openings for those positions, that the person is capable of
455.30 performing. The person's eligibility under this category must
455.31 be reassessed at least annually; or
455.32 (3) a person who is determined by the county agency,
455.33 according to Minnesota Rules, part 9500.1251, subpart 2, item I,
455.34 to be learning disabled, provided that if a rehabilitation plan
455.35 for the person is developed or approved by the county agency,
455.36 the person is following the plan. A rehabilitation plan does
456.1 not replace the requirement to develop and comply with an
456.2 employment plan under section 256J.52.
456.3 (b) An assistance unit receiving assistance under a
456.4 hardship extension under this subdivision may continue to
456.5 receive assistance under MFIP as long as the participant meets
456.6 the criteria in paragraph (a), clause (1), (2), or (3), and all
456.7 participants in the assistance unit remain in compliance with,
456.8 or are exempt from, the employment and training services
456.9 requirements in sections 256J.52 to 256J.55.
456.10 Subd. 4. [VICTIMS OF FAMILY VIOLENCE.] A participant who
456.11 received TANF assistance that counted towards the federal
456.12 60-month time limit while the participant complied with a safety
456.13 plan or, after October 1, 2001, an alternative employment plan
456.14 under the MFIP employment and training component is eligible for
456.15 assistance under a hardship extension for a period of time equal
456.16 to the number of months that were counted toward the federal
456.17 60-month time limit while the participant complied with a safety
456.18 plan or, after October 1, 2001, an alternative employment plan
456.19 under the MFIP employment and training component.
456.20 Subd. 5. [ACCRUAL OF CERTAIN EXEMPT MONTHS.] (a) A
456.21 participant who received TANF assistance that counted towards
456.22 the federal 60-month time limit while the participant was or
456.23 would have been exempt under section 256J.56, paragraph (a),
456.24 clause (7), from employment and training services requirements
456.25 and who is no longer eligible for assistance under a hardship
456.26 extension under subdivision 2, paragraph (a), clause (3), is
456.27 eligible for assistance under a hardship extension for a period
456.28 of time equal to the number of months that were counted toward
456.29 the federal 60-month time limit while the participant was or
456.30 would have been exempt under section 256J.56, paragraph (a),
456.31 clause (7), from the employment and training services
456.32 requirements.
456.33 (b) A participant who received TANF assistance that counted
456.34 towards the federal 60-month time limit while the participant
456.35 met the state time limit exemption criteria under section
456.36 256J.42, subdivision 5, is eligible for assistance under a
457.1 hardship extension for a period of time equal to the number of
457.2 months that were counted toward the federal 60-month time limit
457.3 while the participant met the state time limit exemption
457.4 criteria under section 256J.42, subdivision 5.
457.5 Sec. 15. Minnesota Statutes 2000, section 256J.45,
457.6 subdivision 1, is amended to read:
457.7 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A
457.8 county agency must provide a face-to-face orientation to each
457.9 MFIP caregiver who is not exempt under section 256J.56,
457.10 paragraph (a), clause (6) or (8), with a face-to-face
457.11 orientation unless the caregiver is:
457.12 (1) a single parent, or one parent in a two-parent family,
457.13 employed at least 35 hours per week; or
457.14 (2) a second parent in a two-parent family who is employed
457.15 for 20 or more hours per week provided the first parent is
457.16 employed at least 35 hours per week.
457.17 The county agency must inform caregivers who are not exempt
457.18 under section 256J.56, paragraph (a), clause (6) or (8), clause
457.19 (1) or (2) that failure to attend the orientation is considered
457.20 an occurrence of noncompliance with program requirements, and
457.21 will result in the imposition of a sanction under section
457.22 256J.46. If the client complies with the orientation
457.23 requirement prior to the first day of the month in which the
457.24 grant reduction is proposed to occur, the orientation sanction
457.25 shall be lifted.
457.26 Sec. 16. Minnesota Statutes 2000, section 256J.46,
457.27 subdivision 1, is amended to read:
457.28 Subdivision 1. [SANCTIONS FOR PARTICIPANTS NOT COMPLYING
457.29 WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without
457.30 good cause to comply with the requirements of this chapter, and
457.31 who is not subject to a sanction under subdivision 2, shall be
457.32 subject to a sanction as provided in this subdivision. Prior to
457.33 the imposition of a sanction, a county agency shall provide a
457.34 notice of intent to sanction under section 256J.57, subdivision
457.35 2, and, when applicable, a notice of adverse action as provided
457.36 in section 256J.31.
458.1 (b) A participant who fails to comply with an alternative
458.2 employment plan must have the plan reviewed by a person trained
458.3 in domestic violence and a job counselor to determine if
458.4 components of the alternative employment plan are still
458.5 appropriate. If the activities are no longer appropriate, the
458.6 plan must be revised with a person trained in domestic violence
458.7 and approved by a job counselor. A participant who fails to
458.8 comply with a plan that is determined not to need revision will
458.9 lose their exemption and be required to comply with regular
458.10 employment services activities.
458.11 (c) A sanction under this subdivision becomes effective the
458.12 month following the month in which a required notice is given.
458.13 A sanction must not be imposed when a participant comes into
458.14 compliance with the requirements for orientation under section
458.15 256J.45 or third-party liability for medical services under
458.16 section 256J.30, subdivision 10, prior to the effective date of
458.17 the sanction. A sanction must not be imposed when a participant
458.18 comes into compliance with the requirements for employment and
458.19 training services under sections 256J.49 to 256J.72 256J.55 ten
458.20 days prior to the effective date of the sanction. For purposes
458.21 of this subdivision, each month that a participant fails to
458.22 comply with a requirement of this chapter shall be considered a
458.23 separate occurrence of noncompliance. A participant who has had
458.24 one or more sanctions imposed must remain in compliance with the
458.25 provisions of this chapter for six months in order for a
458.26 subsequent occurrence of noncompliance to be considered a first
458.27 occurrence.
458.28 (b) (d) Sanctions for noncompliance shall be imposed as
458.29 follows:
458.30 (1) For the first occurrence of noncompliance by a
458.31 participant in a single-parent household or by one participant
458.32 in a two-parent household an assistance unit, the assistance
458.33 unit's grant shall be reduced by ten percent of the MFIP
458.34 standard of need for an assistance unit of the same size with
458.35 the residual grant paid to the participant. The reduction in
458.36 the grant amount must be in effect for a minimum of one month
459.1 and shall be removed in the month following the month that the
459.2 participant returns to compliance.
459.3 (2) For a second or subsequent and third occurrence of
459.4 noncompliance by a participant in an assistance unit, or
459.5 when both each of the participants in a two-parent household are
459.6 out of compliance assistance unit have a first occurrence of
459.7 noncompliance at the same time, the assistance unit's shelter
459.8 costs shall be vendor paid up to the amount of the cash portion
459.9 of the MFIP grant for which the participant's assistance unit is
459.10 eligible. At county option, the assistance unit's utilities may
459.11 also be vendor paid up to the amount of the cash portion of the
459.12 MFIP grant remaining after vendor payment of the assistance
459.13 unit's shelter costs. The residual amount of the grant after
459.14 vendor payment, if any, must be reduced by an amount equal to 30
459.15 percent of the MFIP standard of need for an assistance unit of
459.16 the same size before the residual grant is paid to the
459.17 assistance unit. The reduction in the grant amount must be in
459.18 effect for a minimum of one month and shall be removed in the
459.19 month following the month that a the participant in a one-parent
459.20 household assistance unit returns to compliance. In a
459.21 two-parent household assistance unit, the grant reduction must
459.22 be in effect for a minimum of one month and shall be removed in
459.23 the month following the month both participants return to
459.24 compliance. The vendor payment of shelter costs and, if
459.25 applicable, utilities shall be removed six months after the
459.26 month in which the participant or participants return to
459.27 compliance. If an assistance unit is sanctioned under this
459.28 clause, the participant's case file must be reviewed as required
459.29 under paragraph (e).
459.30 (3) For a fourth occurrence of noncompliance, the
459.31 assistance unit is disqualified from receiving MFIP assistance,
459.32 both the cash and food portions. This disqualification must be
459.33 in effect for a minimum of one full month. Disqualification
459.34 under this clause does not make a participant ineligible for
459.35 food stamps. Before an assistance unit is disqualified under
459.36 this clause, the county must ensure that:
460.1 (i) the case has been reviewed by the job counselor's
460.2 supervisor or the review team designated in the county's
460.3 approved local service unit plan to determine if the review
460.4 required under paragraph (e) has occurred; and
460.5 (ii) the job counselor attempted to meet with the
460.6 participant face-to-face.
460.7 (c) No later than during the second month that (e) When a
460.8 sanction under paragraph (b) (d), clause (2), is in effect due
460.9 to noncompliance with employment services, the participant's
460.10 case file must be reviewed to determine if, the county agency or
460.11 job counselor must review the participant's case to determine if
460.12 the employment plan is still appropriate and attempt to meet
460.13 with the participant face-to-face. If a face-to-face meeting is
460.14 not possible, the county agency must send the participant a
460.15 notice of adverse action as provided in section 256J.31,
460.16 subdivisions 4 and 5.
460.17 (1) During the face-to-face meeting, the job counselor must:
460.18 (i) determine whether the continued noncompliance can be
460.19 explained and mitigated by providing a needed preemployment
460.20 activity, as defined in section 256J.49, subdivision 13, clause
460.21 (16), or services under a local intervention grant for
460.22 self-sufficiency under section 256J.625;
460.23 (ii) determine whether the participant qualifies for a good
460.24 cause exception under section 256J.57; or
460.25 (iii) determine whether the participant qualifies for an
460.26 exemption under section 256J.56;
460.27 (iv) determine whether the participant qualifies for an
460.28 exemption for victims of family violence under section 256J.52,
460.29 subdivision 6;
460.30 (v) inform the participant of the participant's sanction
460.31 status and explain the consequences of continuing noncompliance;
460.32 (vi) identify other resources that may be available to the
460.33 participant to meet the needs of the family if the participant
460.34 is sanctioned and disqualified from MFIP under paragraph (d),
460.35 clause (3); and
460.36 (vii) inform the participant of the right to appeal under
461.1 section 256J.40.
461.2 (2) If the lack of an identified activity can explain the
461.3 noncompliance, the county must work with the participant to
461.4 provide the identified activity, and the county must restore the
461.5 participant's grant amount to the full amount for which the
461.6 assistance unit is eligible. The grant must be restored
461.7 retroactively to the first day of the month in which the
461.8 participant was found to lack preemployment activities or to
461.9 qualify for an exemption or under section 256J.56, a good cause
461.10 exception under section 256J.57, or an exemption for victims of
461.11 family violence under section 256J.52, subdivision 6.
461.12 (3) If the participant is found to qualify for a good cause
461.13 exception or an exemption, the county must restore the
461.14 participant's grant to the full amount for which the assistance
461.15 unit is eligible.
461.16 [EFFECTIVE DATE.] The family violence provisions in
461.17 paragraph (e) are effective October 1, 2001, if the alternative
461.18 employment plan and family violence provisions in section
461.19 256J.52, subdivision 6, are enacted during the 2001 session.
461.20 Sec. 17. Minnesota Statutes 2000, section 256J.46,
461.21 subdivision 2a, is amended to read:
461.22 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the
461.23 provisions of subdivisions 1 and 2, for a participant subject to
461.24 a sanction for refusal to comply with child support requirements
461.25 under subdivision 2 and subject to a concurrent sanction for
461.26 refusal to cooperate with other program requirements under
461.27 subdivision 1, sanctions shall be imposed in the manner
461.28 prescribed in this subdivision.
461.29 A participant who has had one or more sanctions imposed
461.30 under this subdivision must remain in compliance with the
461.31 provisions of this chapter for six months in order for a
461.32 subsequent occurrence of noncompliance to be considered a first
461.33 occurrence. Any vendor payment of shelter costs or utilities
461.34 under this subdivision must remain in effect for six months
461.35 after the month in which the participant is no longer subject to
461.36 sanction under subdivision 1.
462.1 (b) If the participant was subject to sanction for:
462.2 (i) noncompliance under subdivision 1 before being subject
462.3 to sanction for noncooperation under subdivision 2; or
462.4 (ii) noncooperation under subdivision 2 before being
462.5 subject to sanction for noncompliance under subdivision 1; under
462.6 subdivision 1 or 2 before being subject to sanction under the
462.7 other of those subdivisions, the participant shall be sanctioned
462.8 as provided in subdivision 1, paragraph (b) (d), clause
462.9 clauses (2) and (3), and the requirement that the county conduct
462.10 a review as specified in subdivision 1, paragraph (c) (e),
462.11 remains in effect.
462.12 (c) A participant who first becomes subject to sanction
462.13 under both subdivisions 1 and 2 in the same month is subject to
462.14 sanction as follows:
462.15 (i) in the first month of noncompliance and noncooperation,
462.16 the participant's grant must be reduced by 25 percent of the
462.17 applicable MFIP standard of need, with any residual amount paid
462.18 to the participant;
462.19 (ii) in the second and subsequent months of noncompliance
462.20 and noncooperation, the participant shall be sanctioned as
462.21 provided in subdivision 1, paragraph (b) (d), clause clauses (2)
462.22 and (3).
462.23 The requirement that the county conduct a review as
462.24 specified in subdivision 1, paragraph (c) (e), remains in effect.
462.25 (d) A participant remains subject to sanction under
462.26 subdivision 2 if the participant:
462.27 (i) returns to compliance and is no longer subject to
462.28 sanction under subdivision 1; or
462.29 (ii) has the sanction under subdivision 1,
462.30 paragraph (b) (d), removed upon completion of the review under
462.31 subdivision 1, paragraph (c) (e).
462.32 A participant remains subject to sanction under subdivision
462.33 1, paragraph (b) (d), if the participant cooperates and is no
462.34 longer subject to sanction under subdivision 2.
462.35 Sec. 18. Minnesota Statutes 2000, section 256J.46, is
462.36 amended by adding a subdivision to read:
463.1 Subd. 3. [SANCTION STATUS AFTER DISQUALIFICATION.] An
463.2 applicant who is a member of an assistance unit that was
463.3 disqualified from receiving MFIP under subdivision 1, paragraph
463.4 (d), clause (3), who applies for MFIP assistance within six
463.5 months of the date of the disqualification, and who is
463.6 determined to be eligible for MFIP assistance, is considered to
463.7 have a first occurrence of noncompliance. An applicant who is a
463.8 member of an assistance unit that was disqualified from MFIP
463.9 under subdivision 1, paragraph (d), clause (3), a second or
463.10 subsequent time, who applies for assistance within six months of
463.11 the date of disqualification, and who is determined to be
463.12 eligible for MFIP assistance, is considered to have a third
463.13 occurrence of noncompliance. The applicant must remain in
463.14 compliance with the provisions of this chapter for six months in
463.15 order for a subsequent occurrence of noncompliance to be
463.16 considered a first occurrence.
463.17 Sec. 19. Minnesota Statutes 2000, section 256J.50,
463.18 subdivision 1, is amended to read:
463.19 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT
463.20 OF MFIP.] (a) By January 1, 1998, each county must develop and
463.21 implement an employment and training services component of MFIP
463.22 which is designed to put participants on the most direct path to
463.23 unsubsidized employment. Participation in these services is
463.24 mandatory for all MFIP caregivers, unless the caregiver is
463.25 exempt under section 256J.56.
463.26 (b) A county must provide employment and training services
463.27 under sections 256J.515 to 256J.74 within 30 days after the
463.28 caregiver's participation becomes mandatory under subdivision
463.29 5 or within 30 days of receipt of a request for services from a
463.30 caregiver who under section 256J.42 is no longer eligible to
463.31 receive MFIP but whose income is below 120 percent of the
463.32 federal poverty guidelines for a family of the same size. The
463.33 request must be made within 12 months of the date the
463.34 caregivers' MFIP case was closed.
463.35 Sec. 20. Minnesota Statutes 2000, section 256J.50,
463.36 subdivision 7, is amended to read:
464.1 Subd. 7. [LOCAL SERVICE UNIT PLAN.] (a) Each local or
464.2 county service unit shall prepare and submit a plan as specified
464.3 in section 268.88.
464.4 (b) The plan must include a description of how projects
464.5 funded under the local intervention grants for self-sufficiency
464.6 in section 256J.625, subdivisions 2 and 3, operate in the local
464.7 service unit, including:
464.8 (1) the target populations of hard-to-employ participants
464.9 and, working participants in need of job retention and wage
464.10 advancement services, and caregivers who, within the last 12
464.11 months, have been determined under section 256J.42 to no longer
464.12 be eligible to receive MFIP and whose income is below 120
464.13 percent of the federal poverty guidelines for a family of the
464.14 same size, with a description of how individual participant
464.15 needs will be met;
464.16 (2) services that will be provided which may include paid
464.17 work experience, enhanced mental health services, outreach to
464.18 sanctioned families and to caregivers who, within the last 12
464.19 months, have been determined under section 256J.42 to no longer
464.20 be eligible to receive MFIP but whose income is below 120
464.21 percent of the federal poverty guidelines for a family of the
464.22 same size, child care for social services, child care transition
464.23 year set-aside, homeless and housing advocacy, and
464.24 transportation;
464.25 (3) projected expenditures by activity;
464.26 (4) anticipated program outcomes including the anticipated
464.27 impact the intervention efforts will have on performance
464.28 measures under section 256J.751 and on reducing the number of
464.29 MFIP participants expected to reach their 60-month time limit;
464.30 and
464.31 (5) a description of services that are provided or will be
464.32 provided to MFIP participants affected by chemical dependency,
464.33 mental health issues, learning disabilities, or family violence.
464.34 Each plan must demonstrate how the county or tribe is
464.35 working within its organization and with other organizations in
464.36 the community to serve hard-to-employ populations, including how
465.1 organizations in the community were engaged in planning for use
465.2 of these funds, services other entities will provide under the
465.3 plan, and whether multicounty or regional strategies are being
465.4 implemented as part of this plan.
465.5 (c) Activities and expenditures in the plan must enhance or
465.6 supplement MFIP activities without supplanting existing
465.7 activities and expenditures. However, this paragraph does not
465.8 require a county to maintain either:
465.9 (1) its current provision of child care assistance to MFIP
465.10 families through the expenditure of county resources under
465.11 chapter 256E for social services child care assistance if funds
465.12 are appropriated by another law for an MFIP social services
465.13 child care pool;
465.14 (2) its current provision of transition-year child care
465.15 assistance through the expenditure of county resources if funds
465.16 are appropriated by another law for this purpose; or
465.17 (3) its current provision of intensive ESL programs through
465.18 the expenditure of county resources if funds are appropriated by
465.19 another law for intensive ESL grants.
465.20 (d) The plan required under this subdivision must be
465.21 approved before the local or county service unit is eligible to
465.22 receive funds under section 256J.625, subdivisions 2 and 3.
465.23 Sec. 21. Minnesota Statutes 2000, section 256J.56, is
465.24 amended to read:
465.25 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT;
465.26 EXEMPTIONS.]
465.27 (a) An MFIP caregiver participant is exempt from the
465.28 requirements of sections 256J.52 to 256J.55 if the caregiver
465.29 participant belongs to any of the following groups:
465.30 (1) individuals participants who are age 60 or older;
465.31 (2) individuals participants who are suffering from a
465.32 professionally certified permanent or temporary illness, injury,
465.33 or incapacity which is expected to continue for more than 30
465.34 days and which prevents the person from obtaining or retaining
465.35 employment. Persons in this category with a temporary illness,
465.36 injury, or incapacity must be reevaluated at least quarterly;
466.1 (3) caregivers participants whose presence in the home is
466.2 required because of the professionally certified illness or
466.3 incapacity of another member in the assistance unit, a relative
466.4 in the household, or a foster child in the household and the
466.5 illness or incapacity is expected to continue for more than 30
466.6 days;
466.7 (4) women who are pregnant, if the pregnancy has resulted
466.8 in a professionally certified incapacity that prevents the woman
466.9 from obtaining or retaining employment;
466.10 (5) caregivers of a child under the age of one year who
466.11 personally provide full-time care for the child. This exemption
466.12 may be used for only 12 months in a lifetime. In two-parent
466.13 households, only one parent or other relative may qualify for
466.14 this exemption;
466.15 (6) individuals who are single parents, or one parent in a
466.16 two-parent family, employed at least 35 hours per week;
466.17 (7) individuals (6) participants experiencing a personal or
466.18 family crisis that makes them incapable of participating in the
466.19 program, as determined by the county agency. If the participant
466.20 does not agree with the county agency's determination, the
466.21 participant may seek professional certification, as defined in
466.22 section 256J.08, that the participant is incapable of
466.23 participating in the program.
466.24 Persons in this exemption category must be reevaluated
466.25 every 60 days; or
466.26 (8) second parents in two-parent families employed for 20
466.27 or more hours per week, provided the first parent is employed at
466.28 least 35 hours per week; or
466.29 (9) (7) caregivers with a child or an adult in the
466.30 household who meets the disability or medical criteria for home
466.31 care services under section 256B.0627, subdivision 1, paragraph
466.32 (c), or a home and community-based waiver services program under
466.33 chapter 256B, or meets the criteria for severe emotional
466.34 disturbance under section 245.4871, subdivision 6, or for
466.35 serious and persistent mental illness under section 245.462,
466.36 subdivision 20, paragraph (c). Caregivers in this exemption
467.1 category are presumed to be prevented from obtaining or
467.2 retaining employment.
467.3 A caregiver who is exempt under clause (5) must enroll in
467.4 and attend an early childhood and family education class, a
467.5 parenting class, or some similar activity, if available, during
467.6 the period of time the caregiver is exempt under this section.
467.7 Notwithstanding section 256J.46, failure to attend the required
467.8 activity shall not result in the imposition of a sanction.
467.9 (b) The county agency must provide employment and training
467.10 services to MFIP caregivers participants who are exempt under
467.11 this section, but who volunteer to participate. Exempt
467.12 volunteers may request approval for any work activity under
467.13 section 256J.49, subdivision 13. The hourly participation
467.14 requirements for nonexempt caregivers participants under section
467.15 256J.50, subdivision 5, do not apply to exempt caregivers
467.16 participants who volunteer to participate.
467.17 Sec. 22. Minnesota Statutes 2000, section 256J.57,
467.18 subdivision 2, is amended to read:
467.19 Subd. 2. [NOTICE OF INTENT TO SANCTION.] (a) When a
467.20 participant fails without good cause to comply with the
467.21 requirements of sections 256J.52 to 256J.55, the job counselor
467.22 or the county agency must provide a notice of intent to sanction
467.23 to the participant specifying the program requirements that were
467.24 not complied with, informing the participant that the county
467.25 agency will impose the sanctions specified in section 256J.46,
467.26 and informing the participant of the opportunity to request a
467.27 conciliation conference as specified in paragraph (b). The
467.28 notice must also state that the participant's continuing
467.29 noncompliance with the specified requirements will result in
467.30 additional sanctions under section 256J.46, without the need for
467.31 additional notices or conciliation conferences under this
467.32 subdivision. The notice, written in English, must include the
467.33 department of human services language block, and must be sent to
467.34 every applicable participant. If the participant does not
467.35 request a conciliation conference within ten calendar days of
467.36 the mailing of the notice of intent to sanction, the job
468.1 counselor must notify the county agency that the assistance
468.2 payment should be reduced. The county must then send a notice
468.3 of adverse action to the participant informing the participant
468.4 of the sanction that will be imposed, the reasons for the
468.5 sanction, the effective date of the sanction, and the
468.6 participant's right to have a fair hearing under section 256J.40.
468.7 (b) The participant may request a conciliation conference
468.8 by sending a written request, by making a telephone request, or
468.9 by making an in-person request. The request must be received
468.10 within ten calendar days of the date the county agency mailed
468.11 the ten-day notice of intent to sanction. If a timely request
468.12 for a conciliation is received, the county agency's service
468.13 provider must conduct the conference within five days of the
468.14 request. The job counselor's supervisor, or a designee of the
468.15 supervisor, must review the outcome of the conciliation
468.16 conference. If the conciliation conference resolves the
468.17 noncompliance, the job counselor must promptly inform the county
468.18 agency and request withdrawal of the sanction notice.
468.19 (c) Upon receiving a sanction notice, the participant may
468.20 request a fair hearing under section 256J.40, without exercising
468.21 the option of a conciliation conference. In such cases, the
468.22 county agency shall not require the participant to engage in a
468.23 conciliation conference prior to the fair hearing.
468.24 (d) If the participant requests a fair hearing or a
468.25 conciliation conference, sanctions will not be imposed until
468.26 there is a determination of noncompliance. Sanctions must be
468.27 imposed as provided in section 256J.46.
468.28 Sec. 23. Minnesota Statutes 2000, section 256J.62,
468.29 subdivision 9, is amended to read:
468.30 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] At the
468.31 request of the caregiver participant, the county may continue to
468.32 provide case management, counseling, or other support services
468.33 to a participant following the participant's achievement of:
468.34 (a) who has achieved the employment goal,; or
468.35 (b) who under section 256J.42 is no longer eligible to
468.36 receive MFIP.
469.1 These services may be provided for up to 12 months
469.2 following termination of the participant's eligibility for MFIP.
469.3 A county may expend funds for a specific employment and
469.4 training service for the duration of that service to a
469.5 participant if the funds are obligated or expended prior to the
469.6 participant losing MFIP eligibility.
469.7 Sec. 24. Minnesota Statutes 2000, section 256J.625,
469.8 subdivision 1, is amended to read:
469.9 Subdivision 1. [ESTABLISHMENT; GUARANTEED MINIMUM
469.10 ALLOCATION.] (a) The commissioner shall make grants under this
469.11 subdivision to assist county and tribal TANF programs to more
469.12 effectively serve hard-to-employ MFIP participants and
469.13 participants who, within the last 12 months, have been
469.14 determined under section 256J.42 to no longer be eligible to
469.15 receive MFIP but whose income is below 120 percent of the
469.16 federal poverty guidelines for a family of the same size. Funds
469.17 appropriated for local intervention grants for self-sufficiency
469.18 must be allocated first in amounts equal to the guaranteed
469.19 minimum in paragraph (b), and second according to the provisions
469.20 of subdivision 2. Any remaining funds must be allocated
469.21 according to the formula in subdivision 3. Counties or tribes
469.22 must have an approved local service unit plan under section
469.23 256J.50, subdivision 7, paragraph (b), in order to receive and
469.24 expend funds under subdivisions 2 and 3.
469.25 (b) Each county or tribal program shall receive a
469.26 guaranteed minimum annual allocation of $25,000.
469.27 Sec. 25. Minnesota Statutes 2000, section 256J.625,
469.28 subdivision 2, is amended to read:
469.29 Subd. 2. [SET-ASIDE FUNDS.] (a) Of the funds appropriated
469.30 for grants under this section, after the allocation in
469.31 subdivision 1, paragraph (b), is made, 20 percent of the
469.32 remaining funds each year shall be retained by the commissioner
469.33 and awarded to counties or tribes whose approved plans
469.34 demonstrate additional need based on their identification of
469.35 hard-to-employ families and, working participants in need of job
469.36 retention and wage advancement services, and participants who
470.1 within the last 12 months, have been determined under section
470.2 256J.42 to no longer be eligible to receive MFIP but whose
470.3 income is below 120 percent of the federal poverty guidelines
470.4 for a family of same size, strong anticipated outcomes for
470.5 families and an effective plan for monitoring performance, or,
470.6 use of a multicounty, multi-entity or regional approach to serve
470.7 hard-to-employ families and, working participants in need of job
470.8 retention and wage advancement services, and participants who,
470.9 within the last 12 months, have been determined under section
470.10 256J.42 to no longer be eligible to receive MFIP but whose
470.11 income is below 120 percent of the federal poverty guidelines
470.12 for a family of the same size, who are identified as a target
470.13 population to be served in the plan submitted under section
470.14 256J.50, subdivision 7, paragraph (b). In distributing funds
470.15 under this paragraph, the commissioner must achieve a geographic
470.16 balance. The commissioner may award funds under this paragraph
470.17 to other public, private, or nonprofit entities to deliver
470.18 services in a county or region where the entity or entities
470.19 submit a plan that demonstrates a strong capability to fulfill
470.20 the terms of the plan and where the plan shows an innovative or
470.21 multi-entity approach.
470.22 (b) For fiscal year 2001 only, of the funds available under
470.23 this subdivision the commissioner must allocate funding in the
470.24 amounts specified in article 1, section 2, subdivision 7, for an
470.25 intensive intervention transitional employment training project
470.26 and for nontraditional career assistance and training programs.
470.27 These allocations must occur before any set-aside funds are
470.28 allocated under paragraph (a).
470.29 Sec. 26. Minnesota Statutes 2000, section 256J.625,
470.30 subdivision 4, is amended to read:
470.31 Subd. 4. [USE OF FUNDS.] (a) A county or tribal program
470.32 may use funds allocated under this subdivision to provide
470.33 services to MFIP participants who are hard-to-employ and their
470.34 families. Services provided must be intended to reduce the
470.35 number of MFIP participants who are expected to reach the
470.36 60-month time limit under section 256J.42. Counties, tribes,
471.1 and other entities receiving funds under subdivision 2 or 3 must
471.2 submit semiannual progress reports to the commissioner which
471.3 detail program outcomes.
471.4 (b) Funds allocated under this section may not be used to
471.5 provide benefits that are defined as "assistance" in Code of
471.6 Federal Regulations, title 45, section 260.31, to an assistance
471.7 unit that is only receiving the food portion of MFIP benefits or
471.8 under section 256J.42 is no longer eligible to receive MFIP.
471.9 (c) A county may use funds allocated under this section for
471.10 that part of the match for federal access to jobs transportation
471.11 funds that is TANF-eligible. A county may also use funds
471.12 allocated under this section to enhance transportation choices
471.13 for eligible recipients up to 150 percent of the federal poverty
471.14 guidelines.
471.15 Sec. 27. Minnesota Statutes 2000, section 256J.751, is
471.16 amended to read:
471.17 256J.751 [COUNTY PERFORMANCE MANAGEMENT.]
471.18 (a) Subdivision 1. [QUARTERLY COUNTY CASELOAD REPORT.] The
471.19 commissioner shall report quarterly to all counties each county
471.20 on the county's performance on the following measures:
471.21 (1) percent of MFIP caseload working in paid employment;
471.22 (2) percent number of MFIP caseload cases receiving only
471.23 the food portion of assistance;
471.24 (2) number of child-only cases;
471.25 (3) number of minor caregivers;
471.26 (4) number of cases that are exempt from the 60-month time
471.27 limit by the exemption category under section 256J.42;
471.28 (5) number of participants who are exempt from employment
471.29 and training services requirements by the exemption category
471.30 under section 256J.56;
471.31 (6) number of assistance units receiving assistance under a
471.32 hardship extension under section 256J.425;
471.33 (7) number of participants and number of months spent in
471.34 each level of sanction under section 256J.46, subdivision 1;
471.35 (3) (8) number of MFIP cases that have left assistance;
471.36 (4) (9) federal participation requirements as specified in
472.1 title 1 of Public Law Number 104-193; and
472.2 (5) (10) median placement wage rate.; and
472.3 (b) (11) of each county's total MFIP caseload less the
472.4 number of cases in clauses (1) to (6):
472.5 (i) number of one-parent cases;
472.6 (ii) number of two-parent cases;
472.7 (iii) percent of one-parent cases that are working more
472.8 than 20 hours per week;
472.9 (iv) percent of two-parent cases that are working more than
472.10 20 hours per week; and
472.11 (v) percent of cases that have received more than 36 months
472.12 of assistance.
472.13 Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner
472.14 shall report quarterly to all counties on each county's
472.15 performance on the following measures:
472.16 (1) percent of MFIP caseload working in paid employment;
472.17 (2) percent of MFIP caseload receiving only the food
472.18 portion of assistance;
472.19 (3) number of MFIP cases that have left assistance;
472.20 (4) federal participation requirements as specified in
472.21 Title 1 of Public Law Number 104-193;
472.22 (5) median placement wage rate; and
472.23 (6) caseload by months of TANF assistance.
472.24 Subd. 3. [ANNUAL REPORT.] The commissioner must report to
472.25 all counties and to the legislature on each county's annual
472.26 performance on the measures required under subdivision 1 by
472.27 racial and ethnic group and, to the extent consistent with state
472.28 and federal law, must include each county's performance on:
472.29 (1) the number of out-of-wedlock births and births to teen
472.30 mothers; and
472.31 (2) number of cases by racial and ethnic group.
472.32 The report must be completed by January 1, 2002, and
472.33 January 1 of each year thereafter and must comply with sections
472.34 3.195 and 3.197.
472.35 Subd. 4. [DEVELOPMENT OF PERFORMANCE MEASURES.] By January
472.36 1, 2002, the commissioner shall, in consultation with counties,
473.1 develop measures for county performance in addition to those in
473.2 paragraph (a) subdivision 1 and 2. In developing these
473.3 measures, the commissioner must consider:
473.4 (1) a measure for MFIP cases that leave assistance due to
473.5 employment;
473.6 (2) job retention after participants leave MFIP; and
473.7 (3) participant's earnings at a follow-up point after the
473.8 participant has left MFIP; and
473.9 (4) the appropriateness of services provided to minority
473.10 groups.
473.11 (c) Subd. 5. [FAILURE TO MEET FEDERAL PERFORMANCE
473.12 STANDARDS.] (a) If sanctions occur for failure to meet the
473.13 performance standards specified in title 1 of Public Law Number
473.14 104-193 of the Personal Responsibility and Work Opportunity Act
473.15 of 1996, the state shall pay 88 percent of the sanction. The
473.16 remaining 12 percent of the sanction will be paid by the
473.17 counties. The county portion of the sanction will be
473.18 distributed across all counties in proportion to each county's
473.19 percentage of the MFIP average monthly caseload during the
473.20 period for which the sanction was applied.
473.21 (d) (b) If a county fails to meet the performance standards
473.22 specified in title 1 of Public Law Number 104-193 of the
473.23 Personal Responsibility and Work Opportunity Act of 1996 for any
473.24 year, the commissioner shall work with counties to organize a
473.25 joint state-county technical assistance team to work with the
473.26 county. The commissioner shall coordinate any technical
473.27 assistance with other departments and agencies including the
473.28 departments of economic security and children, families, and
473.29 learning as necessary to achieve the purpose of this paragraph.
473.30 Sec. 28. Minnesota Statutes 2000, section 256K.25,
473.31 subdivision 1, is amended to read:
473.32 Subdivision 1. [ESTABLISHMENT AND PURPOSE.] (a) The
473.33 commissioner shall establish a supportive housing and managed
473.34 care pilot project in two counties, one within the seven-county
473.35 metropolitan area and one outside of that area, to determine
473.36 whether the integrated delivery of employment services,
474.1 supportive services, housing, and health care into a single,
474.2 flexible program will:
474.3 (1) reduce public expenditures on homeless families with
474.4 minor children, homeless noncustodial parents, and other
474.5 homeless individuals;
474.6 (2) increase the employment rates of these persons; and
474.7 (3) provide a new alternative to providing services to this
474.8 hard-to-serve population.
474.9 (b) The commissioner shall create a program for counties
474.10 for the purpose of providing integrated intensive and
474.11 individualized case management services, employment services,
474.12 health care services, rent subsidies or other short- or
474.13 medium-term housing assistance, and other supportive services to
474.14 eligible families and individuals. Minimum project and
474.15 application requirements shall be developed by the commissioner
474.16 in cooperation with counties and their nonprofit partners with
474.17 the goal to provide the maximum flexibility in program design.
474.18 (c) Services available under this project must be
474.19 coordinated with available health care services for an eligible
474.20 project participant.
474.21 Sec. 29. Minnesota Statutes 2000, section 256K.25,
474.22 subdivision 3, is amended to read:
474.23 Subd. 3. [COUNTY ELIGIBILITY.] (a) A county may request
474.24 funding under this pilot project if the county:
474.25 (1) agrees to develop, in cooperation with nonprofit
474.26 partners, a supportive housing and managed care pilot project
474.27 that integrates the delivery of employment services, supportive
474.28 services, housing and health care for eligible families and
474.29 individuals, or agrees to contract with an existing integrated
474.30 program;
474.31 (2) for eligible participants who are also MFIP recipients,
474.32 agrees to develop, in cooperation with nonprofit partners,
474.33 procedures to ensure that the services provided under the pilot
474.34 project are closely coordinated with the services provided under
474.35 MFIP; and
474.36 (3) develops a method for evaluating the quality of the
475.1 integrated services provided and the amount of any resulting
475.2 cost savings to the county and state.; and
475.3 (4) addresses in the pilot design the prevalence in the
475.4 homeless population served those individuals with mental
475.5 illness, a history of substance abuse, or HIV.
475.6 (b) Preference may be given to counties that cooperate with
475.7 other counties participating in the pilot project for purposes
475.8 of evaluation and counties that provide additional funding.
475.9 Sec. 30. Minnesota Statutes 2000, section 256K.25,
475.10 subdivision 4, is amended to read:
475.11 Subd. 4. [PARTICIPANT ELIGIBILITY.] (a) In order to be
475.12 eligible meet initial eligibility criteria for the pilot
475.13 project, the county must determine that a participant is
475.14 homeless or is at risk of homelessness; has a mental illness, a
475.15 history of substance abuse, or HIV; and is a family that meets
475.16 the criteria in paragraph (b) or is an individual who meets the
475.17 criteria in paragraph (c).
475.18 (b) An eligible family must include a minor child or a
475.19 pregnant woman, and:
475.20 (1) be receiving or be eligible for MFIP assistance under
475.21 chapter 256J; or
475.22 (2) include an adult caregiver who is employed or is
475.23 receiving employment and training services, and have household
475.24 income below the MFIP exit level in section 256J.24, subdivision
475.25 10.
475.26 (c) An eligible individual must:
475.27 (1) meet the eligibility requirements of the group
475.28 residential housing program under section 256I.04, subdivision
475.29 1; or
475.30 (2) be a noncustodial parent who is employed or is
475.31 receiving employment and training services, and have household
475.32 income below the MFIP exit level in section 256J.24, subdivision
475.33 10.
475.34 (d) Counties participating in the pilot project may develop
475.35 and initiate disenrollment criteria, subject to approval by the
475.36 commissioner of human services.
476.1 Sec. 31. Minnesota Statutes 2000, section 256K.25,
476.2 subdivision 5, is amended to read:
476.3 Subd. 5. [FUNDING.] A county may request funding from the
476.4 commissioner for a specified number of TANF-eligible project
476.5 participants. The commissioner shall review the request for
476.6 compliance with subdivisions 1 to 4 and may approve or
476.7 disapprove the request. If other funds are available, the
476.8 commissioner may allocate funding for project participants who
476.9 meet the eligibility requirements of subdivision 4, paragraph
476.10 (c). The commissioner may also redirect funds to the pilot
476.11 project.
476.12 Sec. 32. Minnesota Statutes 2000, section 256K.25,
476.13 subdivision 6, is amended to read:
476.14 Subd. 6. [REPORT.] Participating counties and the
476.15 commissioner shall collaborate to prepare and issue an annual
476.16 report, beginning December 1, 2001, to the chairs of the
476.17 appropriate legislative committees on the pilot project's use of
476.18 public resources, including other funds leveraged for this
476.19 initiative, and an assessment of the feasibility of financing
476.20 the pilot through other health and human services programs, the
476.21 employment and housing status of the families and individuals
476.22 served in the project, and the cost-effectiveness of the
476.23 project. The annual report must also evaluate the pilot project
476.24 with respect to the following project goals: that participants
476.25 will lead more productive, healthier, more stable and better
476.26 quality lives; that the teams created under the project to
476.27 deliver services for each project participant will be
476.28 accountable for ensuring that services are more appropriate,
476.29 cost-effective and well-coordinated; and that the system-wide
476.30 costs of serving this population, and the inappropriate use of
476.31 emergency, crisis-oriented or institutional services, will be
476.32 materially reduced. The commissioner shall provide data that
476.33 may be needed to evaluate the project to participating counties
476.34 that request the data.
476.35 Sec. 33. Minnesota Statutes 2000, section 261.062, is
476.36 amended to read:
477.1 261.062 [TAX FOR SUPPORT OF POOR.]
477.2 The county board shall may levy a tax annually sufficient
477.3 to defray the estimated expenses of supporting and relieving the
477.4 poor therein during the succeeding year, and to make up any
477.5 deficiency in the fund raised for that purpose during the
477.6 preceding year.
477.7 Sec. 34. Minnesota Statutes 2000, section 268.0122,
477.8 subdivision 2, is amended to read:
477.9 Subd. 2. [SPECIFIC POWERS.] The commissioner of economic
477.10 security shall:
477.11 (1) administer and supervise all forms of unemployment
477.12 benefits provided for under federal and state laws that are
477.13 vested in the commissioner, including make investigations and
477.14 audits, secure and transmit information, and make available
477.15 services and facilities as the commissioner considers necessary
477.16 or appropriate to facilitate the administration of any other
477.17 states, or the federal Economic Security Law, and accept and use
477.18 information, services, and facilities made available by other
477.19 states or the federal government;
477.20 (2) administer and supervise all employment and training
477.21 services assigned to the department under federal or state law;
477.22 (3) review and comment on local service unit plans and
477.23 community investment program plans and approve or disapprove the
477.24 plans;
477.25 (4) establish and maintain administrative units necessary
477.26 to perform administrative functions common to all divisions of
477.27 the department;
477.28 (5) supervise the county boards of commissioners, local
477.29 service units, and any other units of government designated in
477.30 federal or state law as responsible for employment and training
477.31 programs;
477.32 (6) establish administrative standards and payment
477.33 conditions for providers of employment and training services;
477.34 (7) act as the agent of, and cooperate with, the federal
477.35 government in matters of mutual concern, including the
477.36 administration of any federal funds granted to the state to aid
478.1 in the performance of functions of the commissioner;
478.2 (8) obtain reports from local service units and service
478.3 providers for the purpose of evaluating the performance of
478.4 employment and training services; and
478.5 (9) review and comment on plans for Indian tribe employment
478.6 and training services and approve or disapprove the plans; and
478.7 (10) require all general employment and training programs
478.8 that receive state funds to make available information about
478.9 opportunities for women in nontraditional careers in the trades
478.10 and technical occupations.
478.11 Sec. 35. Laws 1997, chapter 203, article 9, section 21, as
478.12 amended by Laws 1998, chapter 407, article 6, section 111, and
478.13 Laws 2000, chapter 488, article 10, section 28, is amended to
478.14 read:
478.15 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.]
478.16 (a) Effective on the date specified, the following persons
478.17 will be ineligible for general assistance and general assistance
478.18 medical care under Minnesota Statutes, chapter 256D, group
478.19 residential housing under Minnesota Statutes, chapter 256I, and
478.20 MFIP assistance under Minnesota Statutes, chapter 256J, funded
478.21 with state money:
478.22 (1) Beginning July 1, 2002, persons who are terminated from
478.23 or denied Supplemental Security Income due to the 1996 changes
478.24 in the federal law making persons whose alcohol or drug
478.25 addiction is a material factor contributing to the person's
478.26 disability ineligible for Supplemental Security Income, and are
478.27 eligible for general assistance under Minnesota Statutes,
478.28 section 256D.05, subdivision 1, paragraph (a), clause (15),
478.29 general assistance medical care under Minnesota Statutes,
478.30 chapter 256D, or group residential housing under Minnesota
478.31 Statutes, chapter 256I;
478.32 (2) Beginning July 1, 2002, legal noncitizens who are
478.33 ineligible for Supplemental Security Income due to the 1996
478.34 changes in federal law making certain noncitizens ineligible for
478.35 these programs due to their noncitizen status; and
478.36 (3) Beginning July 1, 2001 2002, legal noncitizens who are
479.1 eligible for MFIP assistance, either the cash assistance portion
479.2 or the food assistance portion, funded entirely with state money.
479.3 (b) State money that remains unspent due to changes in
479.4 federal law enacted after May 12, 1997, that reduce state
479.5 spending for legal noncitizens or for persons whose alcohol or
479.6 drug addiction is a material factor contributing to the person's
479.7 disability, or enacted after February 1, 1998, that reduce state
479.8 spending for food benefits for legal noncitizens shall not
479.9 cancel and shall be deposited in the TANF reserve account.
479.10 Sec. 36. [REPORT ON ASSESSMENT OF COUNTY PERFORMANCE.]
479.11 By January 15, 2003, the commissioner, in consultation with
479.12 counties, must report to the chairs of the house and senate
479.13 committees having jurisdiction over human services, on a
479.14 proposal for assessing county performance using a methodology
479.15 that controls for demographic, economic, and other variables
479.16 that may impact county achievement of MFIP performance
479.17 outcomes. The proposal must recommend how state and federal
479.18 funds may be allocated to counties to encourage and reward high
479.19 performance.
479.20 Sec. 37. [REPEALER.]
479.21 Minnesota Statutes 2000, sections 256J.42, subdivision 4;
479.22 256J.44; and 256J.46, subdivision 1a, are repealed.
479.23 ARTICLE 11
479.24 DHS LICENSING
479.25 Section 1. Minnesota Statutes 2000, section 13.46,
479.26 subdivision 4, is amended to read:
479.27 Subd. 4. [LICENSING DATA.] (a) As used in this subdivision:
479.28 (1) "licensing data" means all data collected, maintained,
479.29 used, or disseminated by the welfare system pertaining to
479.30 persons licensed or registered or who apply for licensure or
479.31 registration or who formerly were licensed or registered under
479.32 the authority of the commissioner of human services;
479.33 (2) "client" means a person who is receiving services from
479.34 a licensee or from an applicant for licensure; and
479.35 (3) "personal and personal financial data" means social
479.36 security numbers, identity of and letters of reference,
480.1 insurance information, reports from the bureau of criminal
480.2 apprehension, health examination reports, and social/home
480.3 studies.
480.4 (b)(1) Except as provided in paragraph (c), the following
480.5 data on current and former licensees are public: name, address,
480.6 telephone number of licensees, licensed capacity, type of client
480.7 preferred, variances granted, type of dwelling, name and
480.8 relationship of other family members, previous license history,
480.9 class of license, and the existence and status of complaints.
480.10 When disciplinary action has been taken against a licensee or
480.11 the complaint is resolved, the following data are public: the
480.12 substance of the complaint, the findings of the investigation of
480.13 the complaint, the record of informal resolution of a licensing
480.14 violation, orders of hearing, findings of fact, conclusions of
480.15 law, and specifications of the final disciplinary action
480.16 contained in the record of disciplinary action.
480.17 (2) The following data on persons subject to
480.18 disqualification under section 245A.04 in connection with a
480.19 license to provide family day care for children, child care
480.20 center services, foster care for children in the provider's
480.21 home, or foster care or day care services for adults in the
480.22 provider's home, are public: the nature of any disqualification
480.23 set aside under section 245A.04, subdivision 3b, and the reasons
480.24 for setting aside the disqualification; and the reasons for
480.25 granting any variance under section 245A.04, subdivision 9.
480.26 (3) When maltreatment is substantiated under section
480.27 626.556 or 626.557 and the victim and the substantiated
480.28 perpetrator are affiliated with a program licensed under chapter
480.29 245A, the commissioner of human services, local social services
480.30 agency, or county welfare agency may inform the license holder
480.31 where the maltreatment occurred of the identity of the
480.32 substantiated perpetrator and the victim.
480.33 (c) The following are private data on individuals under
480.34 section 13.02, subdivision 12, or nonpublic data under section
480.35 13.02, subdivision 9: personal and personal financial data on
480.36 family day care program and family foster care program
481.1 applicants and licensees and their family members who provide
481.2 services under the license.
481.3 (d) The following are private data on individuals: the
481.4 identity of persons who have made reports concerning licensees
481.5 or applicants that appear in inactive investigative data, and
481.6 the records of clients or employees of the licensee or applicant
481.7 for licensure whose records are received by the licensing agency
481.8 for purposes of review or in anticipation of a contested
481.9 matter. The names of reporters under sections 626.556 and
481.10 626.557 may be disclosed only as provided in section 626.556,
481.11 subdivision 11, or 626.557, subdivision 12b.
481.12 (e) Data classified as private, confidential, nonpublic, or
481.13 protected nonpublic under this subdivision become public data if
481.14 submitted to a court or administrative law judge as part of a
481.15 disciplinary proceeding in which there is a public hearing
481.16 concerning the disciplinary action.
481.17 (f) Data generated in the course of licensing
481.18 investigations that relate to an alleged violation of law are
481.19 investigative data under subdivision 3.
481.20 (g) Data that are not public data collected, maintained,
481.21 used, or disseminated under this subdivision that relate to or
481.22 are derived from a report as defined in section 626.556,
481.23 subdivision 2, are subject to the destruction provisions of
481.24 section 626.556, subdivision 11.
481.25 (h) Upon request, not public data collected, maintained,
481.26 used, or disseminated under this subdivision that relate to or
481.27 are derived from a report of substantiated maltreatment as
481.28 defined in section 626.556 or 626.557 may be exchanged with the
481.29 department of health for purposes of completing background
481.30 studies pursuant to section 144.057.
481.31 (i) Data on individuals collected according to licensing
481.32 activities under chapter 245A, and data on individuals collected
481.33 by the commissioner of human services according to maltreatment
481.34 investigations under sections 626.556 and 626.557, may be shared
481.35 with the department of human rights, the department of health,
481.36 the department of corrections, the ombudsman for mental health
482.1 and retardation, and the individual's professional regulatory
482.2 board when there is reason to believe that laws or standards
482.3 under the jurisdiction of those agencies may have been violated.
482.4 (j) In addition to the notice of determinations required
482.5 under section 626.556, subdivision 10f, if the commissioner or
482.6 the local social services agency has determined that an
482.7 individual is a substantiated perpetrator of maltreatment of a
482.8 child based on sexual abuse, as defined in section 626.556,
482.9 subdivision 2, and the commissioner or local social services
482.10 agency knows that the individual is a person responsible for a
482.11 child's care in another facility, the commissioner or local
482.12 social services agency shall notify the head of that facility of
482.13 this determination. The notification must include an
482.14 explanation of the individual's available appeal rights and the
482.15 status of any appeal. If a notice is given under this
482.16 paragraph, the government entity making the notification shall
482.17 provide a copy of the notice to the individual who is the
482.18 subject of the notice.
482.19 [EFFECTIVE DATE.] This section is effective July 1, 2001.
482.20 Sec. 2. Minnesota Statutes 2000, section 13.461,
482.21 subdivision 17, is amended to read:
482.22 Subd. 17. [VULNERABLE ADULT MALTREATMENT REVIEW PANEL
482.23 PANELS.] Data of the vulnerable adult maltreatment review
482.24 panel or the child maltreatment review panel are classified
482.25 under section 256.021 or section 256.022.
482.26 [EFFECTIVE DATE.] This section is effective July 1, 2001.
482.27 Sec. 3. Minnesota Statutes 2000, section 144.057, is
482.28 amended to read:
482.29 144.057 [BACKGROUND STUDIES ON LICENSEES AND SUPPLEMENTAL
482.30 NURSING SERVICES AGENCY PERSONNEL.]
482.31 Subdivision 1. [BACKGROUND STUDIES REQUIRED.] The
482.32 commissioner of health shall contract with the commissioner of
482.33 human services to conduct background studies of:
482.34 (1) individuals providing services which have direct
482.35 contact, as defined under section 245A.04, subdivision 3, with
482.36 patients and residents in hospitals, boarding care homes,
483.1 outpatient surgical centers licensed under sections 144.50 to
483.2 144.58; nursing homes and home care agencies licensed under
483.3 chapter 144A; residential care homes licensed under chapter
483.4 144B, and board and lodging establishments that are registered
483.5 to provide supportive or health supervision services under
483.6 section 157.17; and
483.7 (2) beginning July 1, 1999, all other employees in nursing
483.8 homes licensed under chapter 144A, and boarding care homes
483.9 licensed under sections 144.50 to 144.58. A disqualification of
483.10 an individual in this section shall disqualify the individual
483.11 from positions allowing direct contact or access to patients or
483.12 residents receiving services;
483.13 (3) individuals employed by a supplemental nursing services
483.14 agency, as defined under section 144A.70, who are providing
483.15 services in health care facilities; and
483.16 (4) controlling persons of a supplemental nursing services
483.17 agency, as defined under section 144A.70.
483.18 If a facility or program is licensed by the department of
483.19 human services and subject to the background study provisions of
483.20 chapter 245A and is also licensed by the department of health,
483.21 the department of human services is solely responsible for the
483.22 background studies of individuals in the jointly licensed
483.23 programs.
483.24 Subd. 2. [RESPONSIBILITIES OF DEPARTMENT OF HUMAN
483.25 SERVICES.] The department of human services shall conduct the
483.26 background studies required by subdivision 1 in compliance with
483.27 the provisions of chapter 245A and Minnesota Rules, parts
483.28 9543.3000 to 9543.3090. For the purpose of this section, the
483.29 term "residential program" shall include all facilities
483.30 described in subdivision 1. The department of human services
483.31 shall provide necessary forms and instructions, shall conduct
483.32 the necessary background studies of individuals, and shall
483.33 provide notification of the results of the studies to the
483.34 facilities, supplemental nursing services agencies, individuals,
483.35 and the commissioner of health. Individuals shall be
483.36 disqualified under the provisions of chapter 245A and Minnesota
484.1 Rules, parts 9543.3000 to 9543.3090. If an individual is
484.2 disqualified, the department of human services shall notify the
484.3 facility, the supplemental nursing services agency, and the
484.4 individual and shall inform the individual of the right to
484.5 request a reconsideration of the disqualification by submitting
484.6 the request to the department of health.
484.7 Subd. 3. [RECONSIDERATIONS.] The commissioner of health
484.8 shall review and decide reconsideration requests, including the
484.9 granting of variances, in accordance with the procedures and
484.10 criteria contained in chapter 245A and Minnesota Rules, parts
484.11 9543.3000 to 9543.3090. The commissioner's decision shall be
484.12 provided to the individual and to the department of human
484.13 services. The commissioner's decision to grant or deny a
484.14 reconsideration of disqualification is the final administrative
484.15 agency action, except for the provisions under section 245A.04,
484.16 subdivisions 3b, paragraphs (e) and (f); and 3c, paragraph (a).
484.17 [EFFECTIVE DATE.] This subdivision is effective January 1,
484.18 2002.
484.19 Subd. 4. [RESPONSIBILITIES OF FACILITIES AND AGENCIES.]
484.20 Facilities and agencies described in subdivision 1 shall be
484.21 responsible for cooperating with the departments in implementing
484.22 the provisions of this section. The responsibilities imposed on
484.23 applicants and licensees under chapter 245A and Minnesota Rules,
484.24 parts 9543.3000 to 9543.3090, shall apply to these
484.25 facilities and supplemental nursing services agencies. The
484.26 provision of section 245A.04, subdivision 3, paragraph (e),
484.27 shall apply to applicants, licensees, registrants, or an
484.28 individual's refusal to cooperate with the completion of the
484.29 background studies. Supplemental nursing services agencies
484.30 subject to the registration requirements in section 144A.71 must
484.31 maintain records verifying compliance with the background study
484.32 requirements under this section.
484.33 Sec. 4. Minnesota Statutes 2000, section 214.104, is
484.34 amended to read:
484.35 214.104 [HEALTH-RELATED LICENSING BOARDS; DETERMINATIONS
484.36 REGARDING DISQUALIFICATIONS FOR MALTREATMENT.]
485.1 (a) A health-related licensing board shall make
485.2 determinations as to whether licensees regulated persons who are
485.3 under the board's jurisdiction should be disqualified under
485.4 section 245A.04, subdivision 3d, from positions allowing direct
485.5 contact with persons receiving services the subject of
485.6 disciplinary or corrective action because of substantiated
485.7 maltreatment under section 626.556 or 626.557. A determination
485.8 under this section may be done as part of an investigation under
485.9 section 214.103. The board shall make a determination within 90
485.10 days of upon receipt, and after the review, of an investigation
485.11 memorandum or other notice of substantiated maltreatment under
485.12 section 626.556 or 626.557, or of a notice from the commissioner
485.13 of human services that a background study of a licensee
485.14 regulated person shows substantiated maltreatment. The board
485.15 shall also make a determination under this section upon
485.16 consideration of the licensure of an individual who was subject
485.17 to disqualification before licensure because of substantiated
485.18 maltreatment.
485.19 (b) In making a determination under this section, the board
485.20 shall consider the nature and extent of any injury or harm
485.21 resulting from the conduct that would constitute grounds for
485.22 disqualification, the seriousness of the misconduct, the extent
485.23 that disqualification is necessary to protect persons receiving
485.24 services or the public, and other factors specified in section
485.25 245A.04, subdivision 3b, paragraph (b).
485.26 (c) The board shall determine the duration and extent of
485.27 the disqualification or may establish conditions under which the
485.28 licensee may hold a position allowing direct contact with
485.29 persons receiving services or in a licensed facility.
485.30 (b) Upon completion of its review of a report of
485.31 substantiated maltreatment, the board shall notify the
485.32 commissioner of human services and the lead agency that
485.33 conducted an investigation under section 626.556 or 626.557, as
485.34 applicable, of its determination. The board shall notify the
485.35 commissioner of human services if, following a review of the
485.36 report of substantiated maltreatment, the board determines that
486.1 it does not have jurisdiction in the matter and the commissioner
486.2 shall make the appropriate disqualification decision regarding
486.3 the regulated person as otherwise provided in chapter 245A. The
486.4 board shall also notify the commissioner of health or the
486.5 commissioner of human services immediately upon receipt of
486.6 knowledge of a facility or program allowing a regulated person
486.7 to provide direct contact services at the facility or program
486.8 while not complying with requirements placed on the regulated
486.9 person.
486.10 (c) In addition to any other remedy provided by law, the
486.11 board may, through its designated board member, temporarily
486.12 suspend the license of a licensee; deny a credential to an
486.13 applicant; or require the regulated person to be continuously
486.14 supervised, if the board finds there is probable cause to
486.15 believe the regulated person referred to the board according to
486.16 paragraph (a) poses an immediate risk of harm to vulnerable
486.17 persons. The board shall consider all relevant information
486.18 available, which may include but is not limited to:
486.19 (1) the extent the action is needed to protect persons
486.20 receiving services or the public;
486.21 (2) the recency of the maltreatment;
486.22 (3) the number of incidents of maltreatment;
486.23 (4) the intrusiveness or violence of the maltreatment; and
486.24 (5) the vulnerability of the victim of maltreatment.
486.25 The action shall take effect upon written notice to the
486.26 regulated person, served by certified mail, specifying the
486.27 statute violated. The board shall notify the commissioner of
486.28 health or the commissioner of human services of the suspension
486.29 or denial of a credential. The action shall remain in effect
486.30 until the board issues a temporary stay or a final order in the
486.31 matter after a hearing or upon agreement between the board and
486.32 the regulated person. At the time the board issues the notice,
486.33 the regulated person shall inform the board of all settings in
486.34 which the regulated person is employed or practices and the
486.35 board shall inform all known employment and practice settings of
486.36 the board action and schedule a disciplinary hearing to be held
487.1 under chapter 14. The board shall provide the regulated person
487.2 with at least 30 days' notice of the hearing, unless the parties
487.3 agree to a hearing date that provides less than 30 days notice,
487.4 and shall schedule the hearing to begin no later than 90 days
487.5 after issuance of the notice of hearing.
487.6 [EFFECTIVE DATE.] This section is effective July 1, 2001.
487.7 Sec. 5. Minnesota Statutes 2000, section 245A.03,
487.8 subdivision 2b, is amended to read:
487.9 Subd. 2b. [EXCEPTION.] The provision in subdivision 2,
487.10 clause (2), does not apply to:
487.11 (1) a child care provider who as an applicant for licensure
487.12 or as a license holder has received a license denial under
487.13 section 245A.05, a fine conditional license under section
487.14 245A.06, or a sanction under section 245A.07 from the
487.15 commissioner that has not been reversed on appeal; or
487.16 (2) a child care provider, or a child care provider who has
487.17 a household member who, as a result of a licensing process, has
487.18 a disqualification under this chapter that has not been set
487.19 aside by the commissioner.
487.20 [EFFECTIVE DATE.] This section is effective January 1, 2002.
487.21 Sec. 6. Minnesota Statutes 2000, section 245A.04,
487.22 subdivision 3a, is amended to read:
487.23 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF
487.24 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The
487.25 commissioner shall notify the applicant or, license holder, or
487.26 registrant and the individual who is the subject of the study,
487.27 in writing or by electronic transmission, of the results of the
487.28 study. When the study is completed, a notice that the study was
487.29 undertaken and completed shall be maintained in the personnel
487.30 files of the program. For studies on individuals pertaining to
487.31 a license to provide family day care or group family day care,
487.32 foster care for children in the provider's own home, or foster
487.33 care or day care services for adults in the provider's own home,
487.34 the commissioner is not required to provide a separate notice of
487.35 the background study results to the individual who is the
487.36 subject of the study unless the study results in a
488.1 disqualification of the individual.
488.2 The commissioner shall notify the individual studied if the
488.3 information in the study indicates the individual is
488.4 disqualified from direct contact with persons served by the
488.5 program. The commissioner shall disclose the information
488.6 causing disqualification and instructions on how to request a
488.7 reconsideration of the disqualification to the individual
488.8 studied. An applicant or license holder who is not the subject
488.9 of the study shall be informed that the commissioner has found
488.10 information that disqualifies the subject from direct contact
488.11 with persons served by the program. However, only the
488.12 individual studied must be informed of the information contained
488.13 in the subject's background study unless the only basis for the
488.14 disqualification is failure to cooperate, substantiated
488.15 maltreatment under section 626.556 or 626.557, the Data
488.16 Practices Act provides for release of the information, or the
488.17 individual studied authorizes the release of the
488.18 information. When a disqualification is based on the subject's
488.19 failure to cooperate with the background study or substantiated
488.20 maltreatment under section 626.556 or 626.557, the agency that
488.21 initiated the study shall be informed by the commissioner of the
488.22 reason for the disqualification.
488.23 (b) Except as provided in subdivision 3d, paragraph (b), if
488.24 the commissioner determines that the individual studied has a
488.25 disqualifying characteristic, the commissioner shall review the
488.26 information immediately available and make a determination as to
488.27 the subject's immediate risk of harm to persons served by the
488.28 program where the individual studied will have direct contact.
488.29 The commissioner shall consider all relevant information
488.30 available, including the following factors in determining the
488.31 immediate risk of harm: the recency of the disqualifying
488.32 characteristic; the recency of discharge from probation for the
488.33 crimes; the number of disqualifying characteristics; the
488.34 intrusiveness or violence of the disqualifying characteristic;
488.35 the vulnerability of the victim involved in the disqualifying
488.36 characteristic; and the similarity of the victim to the persons
489.1 served by the program where the individual studied will have
489.2 direct contact. The commissioner may determine that the
489.3 evaluation of the information immediately available gives the
489.4 commissioner reason to believe one of the following:
489.5 (1) The individual poses an imminent risk of harm to
489.6 persons served by the program where the individual studied will
489.7 have direct contact. If the commissioner determines that an
489.8 individual studied poses an imminent risk of harm to persons
489.9 served by the program where the individual studied will have
489.10 direct contact, the individual and the license holder must be
489.11 sent a notice of disqualification. The commissioner shall order
489.12 the license holder to immediately remove the individual studied
489.13 from direct contact. The notice to the individual studied must
489.14 include an explanation of the basis of this determination.
489.15 (2) The individual poses a risk of harm requiring
489.16 continuous supervision while providing direct contact services
489.17 during the period in which the subject may request a
489.18 reconsideration. If the commissioner determines that an
489.19 individual studied poses a risk of harm that requires continuous
489.20 supervision, the individual and the license holder must be sent
489.21 a notice of disqualification. The commissioner shall order the
489.22 license holder to immediately remove the individual studied from
489.23 direct contact services or assure that the individual studied is
489.24 within sight or hearing of another staff person when providing
489.25 direct contact services during the period in which the
489.26 individual may request a reconsideration of the
489.27 disqualification. If the individual studied does not submit a
489.28 timely request for reconsideration, or the individual submits a
489.29 timely request for reconsideration, but the disqualification is
489.30 not set aside for that license holder, the license holder will
489.31 be notified of the disqualification and ordered to immediately
489.32 remove the individual from any position allowing direct contact
489.33 with persons receiving services from the license holder.
489.34 (3) The individual does not pose an imminent risk of harm
489.35 or a risk of harm requiring continuous supervision while
489.36 providing direct contact services during the period in which the
490.1 subject may request a reconsideration. If the commissioner
490.2 determines that an individual studied does not pose a risk of
490.3 harm that requires continuous supervision, only the individual
490.4 must be sent a notice of disqualification. The license holder
490.5 must be sent a notice that more time is needed to complete the
490.6 individual's background study. If the individual studied
490.7 submits a timely request for reconsideration, and if the
490.8 disqualification is set aside for that license holder, the
490.9 license holder will receive the same notification received by
490.10 license holders in cases where the individual studied has no
490.11 disqualifying characteristic. If the individual studied does
490.12 not submit a timely request for reconsideration, or the
490.13 individual submits a timely request for reconsideration, but the
490.14 disqualification is not set aside for that license holder, the
490.15 license holder will be notified of the disqualification and
490.16 ordered to immediately remove the individual from any position
490.17 allowing direct contact with persons receiving services from the
490.18 license holder.
490.19 (c) County licensing agencies performing duties under this
490.20 subdivision may develop an alternative system for determining
490.21 the subject's immediate risk of harm to persons served by the
490.22 program, providing the notices under paragraph (b), and
490.23 documenting the action taken by the county licensing agency.
490.24 Each county licensing agency's implementation of the alternative
490.25 system is subject to approval by the commissioner.
490.26 Notwithstanding this alternative system, county licensing
490.27 agencies shall complete the requirements of paragraph (a).
490.28 [EFFECTIVE DATE.] This section is effective July 1, 2001.
490.29 Sec. 7. Minnesota Statutes 2000, section 245A.04,
490.30 subdivision 3b, is amended to read:
490.31 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The
490.32 individual who is the subject of the disqualification may
490.33 request a reconsideration of the disqualification.
490.34 The individual must submit the request for reconsideration
490.35 to the commissioner in writing. A request for reconsideration
490.36 for an individual who has been sent a notice of disqualification
491.1 under subdivision 3a, paragraph (b), clause (1) or (2), must be
491.2 submitted within 30 calendar days of the disqualified
491.3 individual's receipt of the notice of disqualification. A
491.4 request for reconsideration for an individual who has been sent
491.5 a notice of disqualification under subdivision 3a, paragraph
491.6 (b), clause (3), must be submitted within 15 calendar days of
491.7 the disqualified individual's receipt of the notice of
491.8 disqualification. An individual who was determined to have
491.9 maltreated a child under section 626.556 or a vulnerable adult
491.10 under section 626.557, and who was disqualified under this
491.11 section on the basis of serious or recurring maltreatment, may
491.12 request reconsideration of both the maltreatment and the
491.13 disqualification determinations. The request for
491.14 reconsideration of the maltreatment determination and the
491.15 disqualification must be submitted within 30 calendar days of
491.16 the individual's receipt of the notice of disqualification.
491.17 Removal of a disqualified individual from direct contact shall
491.18 be ordered if the individual does not request reconsideration
491.19 within the prescribed time, and for an individual who submits a
491.20 timely request for reconsideration, if the disqualification is
491.21 not set aside. The individual must present information showing
491.22 that:
491.23 (1) the information the commissioner relied upon is
491.24 incorrect or inaccurate. If the basis of a reconsideration
491.25 request is that a maltreatment determination or disposition
491.26 under section 626.556 or 626.557 is incorrect, and the
491.27 commissioner has issued a final order in an appeal of that
491.28 determination or disposition under section 256.045 or 245A.08,
491.29 subdivision 5, the commissioner's order is conclusive on the
491.30 issue of maltreatment. If the individual did not request
491.31 reconsideration of the maltreatment determination, the
491.32 maltreatment determination is deemed conclusive; or
491.33 (2) the subject of the study does not pose a risk of harm
491.34 to any person served by the applicant or, license holder, or
491.35 registrant.
491.36 (b) The commissioner shall rescind the disqualification if
492.1 the commissioner finds that the information relied on to
492.2 disqualify the subject is incorrect. The commissioner may set
492.3 aside the disqualification under this section if the
492.4 commissioner finds that the information the commissioner relied
492.5 upon is incorrect or the individual does not pose a risk of harm
492.6 to any person served by the applicant or, license holder, or
492.7 registrant. In determining that an individual does not pose a
492.8 risk of harm, the commissioner shall consider the consequences
492.9 of the event or events that lead to disqualification, whether
492.10 there is more than one disqualifying event, the vulnerability of
492.11 the victim at the time of the event, the time elapsed without a
492.12 repeat of the same or similar event, documentation of successful
492.13 completion by the individual studied of training or
492.14 rehabilitation pertinent to the event, and any other information
492.15 relevant to reconsideration. In reviewing a disqualification
492.16 under this section, the commissioner shall give preeminent
492.17 weight to the safety of each person to be served by the license
492.18 holder or, applicant, or registrant over the interests of the
492.19 license holder or, applicant, or registrant.
492.20 (c) Unless the information the commissioner relied on in
492.21 disqualifying an individual is incorrect, the commissioner may
492.22 not set aside the disqualification of an individual in
492.23 connection with a license to provide family day care for
492.24 children, foster care for children in the provider's own home,
492.25 or foster care or day care services for adults in the provider's
492.26 own home if:
492.27 (1) less than ten years have passed since the discharge of
492.28 the sentence imposed for the offense; and the individual has
492.29 been convicted of a violation of any offense listed in sections
492.30 609.20 (manslaughter in the first degree), 609.205 (manslaughter
492.31 in the second degree), criminal vehicular homicide under 609.21
492.32 (criminal vehicular homicide and injury), 609.215 (aiding
492.33 suicide or aiding attempted suicide), felony violations under
492.34 609.221 to 609.2231 (assault in the first, second, third, or
492.35 fourth degree), 609.713 (terroristic threats), 609.235 (use of
492.36 drugs to injure or to facilitate crime), 609.24 (simple
493.1 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping),
493.2 609.255 (false imprisonment), 609.561 or 609.562 (arson in the
493.3 first or second degree), 609.71 (riot), burglary in the first or
493.4 second degree under 609.582 (burglary), 609.66 (dangerous
493.5 weapon), 609.665 (spring guns), 609.67 (machine guns and
493.6 short-barreled shotguns), 609.749 (harassment; stalking),
493.7 152.021 or 152.022 (controlled substance crime in the first or
493.8 second degree), 152.023, subdivision 1, clause (3) or (4), or
493.9 subdivision 2, clause (4) (controlled substance crime in the
493.10 third degree), 152.024, subdivision 1, clause (2), (3), or (4)
493.11 (controlled substance crime in the fourth degree), 609.224,
493.12 subdivision 2, paragraph (c) (fifth-degree assault by a
493.13 caregiver against a vulnerable adult), 609.228 (great bodily
493.14 harm caused by distribution of drugs), 609.23 (mistreatment of
493.15 persons confined), 609.231 (mistreatment of residents or
493.16 patients), 609.2325 (criminal abuse of a vulnerable adult),
493.17 609.233 (criminal neglect of a vulnerable adult), 609.2335
493.18 (financial exploitation of a vulnerable adult), 609.234 (failure
493.19 to report), 609.265 (abduction), 609.2664 to 609.2665
493.20 (manslaughter of an unborn child in the first or second degree),
493.21 609.267 to 609.2672 (assault of an unborn child in the first,
493.22 second, or third degree), 609.268 (injury or death of an unborn
493.23 child in the commission of a crime), 617.293 (disseminating or
493.24 displaying harmful material to minors), a gross misdemeanor
493.25 offense under 609.324, subdivision 1 (other prohibited acts), a
493.26 gross misdemeanor offense under 609.378 (neglect or endangerment
493.27 of a child), a gross misdemeanor offense under 609.377
493.28 (malicious punishment of a child), 609.72, subdivision 3
493.29 (disorderly conduct against a vulnerable adult); or an attempt
493.30 or conspiracy to commit any of these offenses, as each of these
493.31 offenses is defined in Minnesota Statutes; or an offense in any
493.32 other state, the elements of which are substantially similar to
493.33 the elements of any of the foregoing offenses;
493.34 (2) regardless of how much time has passed since the
493.35 discharge of the sentence imposed for the offense, the
493.36 individual was convicted of a violation of any offense listed in
494.1 sections 609.185 to 609.195 (murder in the first, second, or
494.2 third degree), 609.2661 to 609.2663 (murder of an unborn child
494.3 in the first, second, or third degree), a felony offense under
494.4 609.377 (malicious punishment of a child), a felony offense
494.5 under 609.324, subdivision 1 (other prohibited acts), a felony
494.6 offense under 609.378 (neglect or endangerment of a child),
494.7 609.322 (solicitation, inducement, and promotion of
494.8 prostitution), 609.342 to 609.345 (criminal sexual conduct in
494.9 the first, second, third, or fourth degree), 609.352
494.10 (solicitation of children to engage in sexual conduct), 617.246
494.11 (use of minors in a sexual performance), 617.247 (possession of
494.12 pictorial representations of a minor), 609.365 (incest), a
494.13 felony offense under sections 609.2242 and 609.2243 (domestic
494.14 assault), a felony offense of spousal abuse, a felony offense of
494.15 child abuse or neglect, a felony offense of a crime against
494.16 children, or an attempt or conspiracy to commit any of these
494.17 offenses as defined in Minnesota Statutes, or an offense in any
494.18 other state, the elements of which are substantially similar to
494.19 any of the foregoing offenses;
494.20 (3) within the seven years preceding the study, the
494.21 individual committed an act that constitutes maltreatment of a
494.22 child under section 626.556, subdivision 10e, and that resulted
494.23 in substantial bodily harm as defined in section 609.02,
494.24 subdivision 7a, or substantial mental or emotional harm as
494.25 supported by competent psychological or psychiatric evidence; or
494.26 (4) within the seven years preceding the study, the
494.27 individual was determined under section 626.557 to be the
494.28 perpetrator of a substantiated incident of maltreatment of a
494.29 vulnerable adult that resulted in substantial bodily harm as
494.30 defined in section 609.02, subdivision 7a, or substantial mental
494.31 or emotional harm as supported by competent psychological or
494.32 psychiatric evidence.
494.33 In the case of any ground for disqualification under
494.34 clauses (1) to (4), if the act was committed by an individual
494.35 other than the applicant or, license holder, or registrant
494.36 residing in the applicant's or, license holder's, or
495.1 registrant's home, the applicant or, license holder, or
495.2 registrant may seek reconsideration when the individual who
495.3 committed the act no longer resides in the home.
495.4 The disqualification periods provided under clauses (1),
495.5 (3), and (4) are the minimum applicable disqualification
495.6 periods. The commissioner may determine that an individual
495.7 should continue to be disqualified from licensure or
495.8 registration because the license holder or, applicant, or
495.9 registrant poses a risk of harm to a person served by that
495.10 individual after the minimum disqualification period has passed.
495.11 (d) The commissioner shall respond in writing or by
495.12 electronic transmission to all reconsideration requests for
495.13 which the basis for the request is that the information relied
495.14 upon by the commissioner to disqualify is incorrect or
495.15 inaccurate within 30 working days of receipt of a request and
495.16 all relevant information. If the basis for the request is that
495.17 the individual does not pose a risk of harm, the commissioner
495.18 shall respond to the request within 15 working days after
495.19 receiving the request for reconsideration and all relevant
495.20 information. If the request is based on both the correctness or
495.21 accuracy of the information relied on to disqualify the
495.22 individual and the risk of harm, the commissioner shall respond
495.23 to the request within 45 working days after receiving the
495.24 request for reconsideration and all relevant information. If
495.25 the disqualification is set aside, the commissioner shall notify
495.26 the applicant or license holder in writing or by electronic
495.27 transmission of the decision.
495.28 (e) Except as provided in subdivision 3c, the
495.29 commissioner's decision to disqualify an individual, including
495.30 the decision to grant or deny a rescission or set aside a
495.31 disqualification under this section, is the final administrative
495.32 agency action and shall not be subject to further review in a
495.33 contested case under chapter 14 involving a negative licensing
495.34 appeal taken in response to the disqualification or involving an
495.35 accuracy and completeness appeal under section 13.04. if a
495.36 disqualification is not set aside or is not rescinded, an
496.1 individual who was disqualified on the basis of a preponderance
496.2 of evidence that the individual committed an act or acts that
496.3 meet the definition of any of the crimes lists in subdivision
496.4 3d, paragraph (a), clauses (1) to (4); or for failure to make
496.5 required reports under section 626.556, subdivision 3, or
496.6 626.557, subdivision 3, pursuant to subdivision 3d, paragraph
496.7 (a), clause (4), may request a fair hearing under section
496.8 256.045. Except as provided under subdivision 3c, the
496.9 commissioner's final order for an individual under this
496.10 paragraph is conclusive on the issue of disqualification,
496.11 including for purposes of subsequent studies conducted under
496.12 section 245A.04, subdivision 3, and is the only administrative
496.13 appeal of the final agency determination, specifically,
496.14 including a challenge to the accuracy and completeness of data
496.15 under section 13.04.
496.16 (f) Except as provided under subdivision 3c, if an
496.17 individual was disqualified on the basis of a determination of
496.18 maltreatment under section 626.556 or 626.557, which was serious
496.19 or recurring, and the individual has requested reconsideration
496.20 of the maltreatment determination under section 626.556,
496.21 subdivision 10i, or 626.557, subdivision 9d, and also requested
496.22 reconsideration of the disqualification under this subdivision,
496.23 reconsideration of the maltreatment determination and
496.24 reconsideration of the disqualification shall be consolidated
496.25 into a single reconsideration. For maltreatment and
496.26 disqualification determinations made by county agencies, the
496.27 consolidated reconsideration shall be conducted by the county
496.28 agency. Except as provided under subdivision 3c, if an
496.29 individual who was disqualified on the basis of serious or
496.30 recurring maltreatment requests a fair hearing on the
496.31 maltreatment determination under section 626.556, subdivision
496.32 10i, or 626.557, subdivision 9d, the scope of the fair hearing
496.33 under section 256.045 shall include the maltreatment
496.34 determination and the disqualification. Except as provided
496.35 under subdivision 3c, the commissioner's final order for an
496.36 individual under this paragraph is conclusive on the issue of
497.1 maltreatment and disqualification, including for purposes of
497.2 subsequent studies conducted under subdivision 3, and is the
497.3 only administrative appeal of the final agency determination,
497.4 specifically, including a challenge to the accuracy and
497.5 completeness of data under section 13.04.
497.6 [EFFECTIVE DATE.] This section is effective January 1, 2002.
497.7 Sec. 8. Minnesota Statutes 2000, section 245A.04,
497.8 subdivision 3c, is amended to read:
497.9 Subd. 3c. [CONTESTED CASE.] (a) Notwithstanding
497.10 subdivision 3b, paragraphs (e) and (f), if a disqualification is
497.11 not set aside, a person who is an employee of an employer, as
497.12 defined in section 179A.03, subdivision 15, may request a
497.13 contested case hearing under chapter 14. If the
497.14 disqualification which was not set aside or was not rescinded
497.15 was based on a maltreatment determination, the scope of the
497.16 contested case hearing shall include the maltreatment
497.17 determination and the disqualification. In such cases, a fair
497.18 hearing shall not be conducted under section 256.045. Rules
497.19 adopted under this chapter may not preclude an employee in a
497.20 contested case hearing for disqualification from submitting
497.21 evidence concerning information gathered under subdivision 3,
497.22 paragraph (e).
497.23 (b) If a disqualification for which reconsideration was
497.24 requested and which was not set aside or was not rescinded under
497.25 subdivision 3b is the basis for a denial of a license under
497.26 section 245A.05 or a licensing sanction under section 245A.07,
497.27 the license holder has the right to a contested case hearing
497.28 under chapter 14 and Minnesota Rules, parts 1400.8510 to
497.29 1400.8612 and successor rules. The appeal must be submitted in
497.30 accordance with section 245A.05 or 245A.07, subdivision 3. As
497.31 provided for under section 245A.08, subdivision 2a, the scope of
497.32 the consolidated contested case hearing shall include the
497.33 disqualification and the licensing sanction or denial of a
497.34 license. If the disqualification was based on a determination
497.35 of substantiated serious or recurring maltreatment under section
497.36 626.556 or 626.557, the appeal must be submitted in accordance
498.1 with sections 245A.07, subdivision 3, and 626.556, subdivision
498.2 10i, or 626.557, subdivision 9d. As provided for under section
498.3 245A.08, subdivision 2a, the scope of the contested case hearing
498.4 shall include the maltreatment determination, the
498.5 disqualification, and the licensing sanction or denial of a
498.6 license. In such cases, a fair hearing shall not be conducted
498.7 under section 256.045.
498.8 (c) If a maltreatment determination or disqualification,
498.9 which was not set aside or was not rescinded under subdivision
498.10 3b, is the basis for a denial of a license under section 245A.05
498.11 or a licensing sanction under section 245A.07, and the
498.12 disqualified subject is an individual other than the license
498.13 holder and upon whom a background study must be conducted under
498.14 subdivision 3, the hearing of all parties may be consolidated
498.15 into a single contested case hearing upon consent of all parties
498.16 and the administrative law judge.
498.17 (d) The commissioner's final order under section 245A.08,
498.18 subdivision 5, is conclusive on the issue of maltreatment and
498.19 disqualification, including for purposes of subsequent
498.20 background studies. The contested case hearing under this
498.21 subdivision is the only administrative appeal of the final
498.22 agency determination, specifically, including a challenge to the
498.23 accuracy and completeness of data under section 13.04.
498.24 [EFFECTIVE DATE.] This section is effective January 1, 2002.
498.25 Sec. 9. Minnesota Statutes 2000, section 245A.04,
498.26 subdivision 3d, is amended to read:
498.27 Subd. 3d. [DISQUALIFICATION.] (a) Except as provided in
498.28 paragraph (b), when a background study completed under
498.29 subdivision 3 shows any of the following: a conviction of one
498.30 or more crimes listed in clauses (1) to (4); the individual has
498.31 admitted to or a preponderance of the evidence indicates the
498.32 individual has committed an act or acts that meet the definition
498.33 of any of the crimes listed in clauses (1) to (4); or an
498.34 investigation results in an administrative determination listed
498.35 under clause (4), the individual shall be disqualified from any
498.36 position allowing direct contact with persons receiving services
499.1 from the license holder, registrant and for individuals studied
499.2 under section 245A.04, subdivision 3, paragraph (c), clauses
499.3 (2), (6), and (7), in H.F. 1381, if enacted, the individual
499.4 shall also be disqualified from access to persons receiving
499.5 services from the license holder:
499.6 (1) regardless of how much time has passed since the
499.7 discharge of the sentence imposed for the offense, and unless
499.8 otherwise specified, regardless of the level of the conviction,
499.9 the individual was convicted of any of the following offenses:
499.10 sections 609.185 (murder in the first degree); 609.19 (murder in
499.11 the second degree); 609.195 (murder in the third degree);
499.12 609.2661 (murder of an unborn child in the first degree);
499.13 609.2662 (murder of an unborn child in the second degree);
499.14 609.2663 (murder of an unborn child in the third degree);
499.15 609.322 (solicitation, inducement, and promotion of
499.16 prostitution); 609.342 (criminal sexual conduct in the first
499.17 degree); 609.343 (criminal sexual conduct in the second degree);
499.18 609.344 (criminal sexual conduct in the third degree); 609.345
499.19 (criminal sexual conduct in the fourth degree); 609.352
499.20 (solicitation of children to engage in sexual conduct); 609.365
499.21 (incest); felony offense under 609.377 (malicious punishment of
499.22 a child); a felony offense under 609.378 (neglect or
499.23 endangerment of a child); a felony offense under 609.324,
499.24 subdivision 1 (other prohibited acts); 617.246 (use of minors in
499.25 sexual performance prohibited); 617.247 (possession of pictorial
499.26 representations of minors); a felony offense under sections
499.27 609.2242 and 609.2243 (domestic assault), a felony offense of
499.28 spousal abuse, a felony offense of child abuse or neglect, a
499.29 felony offense of a crime against children; or attempt or
499.30 conspiracy to commit any of these offenses as defined in
499.31 Minnesota Statutes, or an offense in any other state or country,
499.32 where the elements are substantially similar to any of the
499.33 offenses listed in this clause;
499.34 (2) if less than 15 years have passed since the discharge
499.35 of the sentence imposed for the offense; and the individual has
499.36 received a felony conviction for a violation of any of these
500.1 offenses: sections 609.20 (manslaughter in the first degree);
500.2 609.205 (manslaughter in the second degree); 609.21 (criminal
500.3 vehicular homicide and injury); 609.215 (suicide); 609.221 to
500.4 609.2231 (assault in the first, second, third, or fourth
500.5 degree); repeat offenses under 609.224 (assault in the fifth
500.6 degree); repeat offenses under 609.3451 (criminal sexual conduct
500.7 in the fifth degree); 609.713 (terroristic threats); 609.235
500.8 (use of drugs to injure or facilitate crime); 609.24 (simple
500.9 robbery); 609.245 (aggravated robbery); 609.25 (kidnapping);
500.10 609.255 (false imprisonment); 609.561 (arson in the first
500.11 degree); 609.562 (arson in the second degree); 609.563 (arson in
500.12 the third degree); repeat offenses under 617.23 (indecent
500.13 exposure; penalties); repeat offenses under 617.241 (obscene
500.14 materials and performances; distribution and exhibition
500.15 prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons);
500.16 609.67 (machine guns and short-barreled shotguns); 609.749
500.17 (harassment; stalking; penalties); 609.228 (great bodily harm
500.18 caused by distribution of drugs); 609.2325 (criminal abuse of a
500.19 vulnerable adult); 609.2664 (manslaughter of an unborn child in
500.20 the first degree); 609.2665 (manslaughter of an unborn child in
500.21 the second degree); 609.267 (assault of an unborn child in the
500.22 first degree); 609.2671 (assault of an unborn child in the
500.23 second degree); 609.268 (injury or death of an unborn child in
500.24 the commission of a crime); 609.52 (theft); 609.2335 (financial
500.25 exploitation of a vulnerable adult); 609.521 (possession of
500.26 shoplifting gear); 609.582 (burglary); 609.625 (aggravated
500.27 forgery); 609.63 (forgery); 609.631 (check forgery; offering a
500.28 forged check); 609.635 (obtaining signature by false pretense);
500.29 609.27 (coercion); 609.275 (attempt to coerce); 609.687
500.30 (adulteration); 260C.301 (grounds for termination of parental
500.31 rights); and chapter 152 (drugs; controlled substance). An
500.32 attempt or conspiracy to commit any of these offenses, as each
500.33 of these offenses is defined in Minnesota Statutes; or an
500.34 offense in any other state or country, the elements of which are
500.35 substantially similar to the elements of the offenses in this
500.36 clause. If the individual studied is convicted of one of the
501.1 felonies listed in this clause, but the sentence is a gross
501.2 misdemeanor or misdemeanor disposition, the lookback period for
501.3 the conviction is the period applicable to the disposition, that
501.4 is the period for gross misdemeanors or misdemeanors;
501.5 (3) if less than ten years have passed since the discharge
501.6 of the sentence imposed for the offense; and the individual has
501.7 received a gross misdemeanor conviction for a violation of any
501.8 of the following offenses: sections 609.224 (assault in the
501.9 fifth degree); 609.2242 and 609.2243 (domestic assault);
501.10 violation of an order for protection under 518B.01, subdivision
501.11 14; 609.3451 (criminal sexual conduct in the fifth degree);
501.12 repeat offenses under 609.746 (interference with privacy);
501.13 repeat offenses under 617.23 (indecent exposure); 617.241
501.14 (obscene materials and performances); 617.243 (indecent
501.15 literature, distribution); 617.293 (harmful materials;
501.16 dissemination and display to minors prohibited); 609.71 (riot);
501.17 609.66 (dangerous weapons); 609.749 (harassment; stalking;
501.18 penalties); 609.224, subdivision 2, paragraph (c) (assault in
501.19 the fifth degree by a caregiver against a vulnerable adult);
501.20 609.23 (mistreatment of persons confined); 609.231 (mistreatment
501.21 of residents or patients); 609.2325 (criminal abuse of a
501.22 vulnerable adult); 609.233 (criminal neglect of a vulnerable
501.23 adult); 609.2335 (financial exploitation of a vulnerable adult);
501.24 609.234 (failure to report maltreatment of a vulnerable adult);
501.25 609.72, subdivision 3 (disorderly conduct against a vulnerable
501.26 adult); 609.265 (abduction); 609.378 (neglect or endangerment of
501.27 a child); 609.377 (malicious punishment of a child); 609.324,
501.28 subdivision 1a (other prohibited acts; minor engaged in
501.29 prostitution); 609.33 (disorderly house); 609.52 (theft);
501.30 609.582 (burglary); 609.631 (check forgery; offering a forged
501.31 check); 609.275 (attempt to coerce); or an attempt or conspiracy
501.32 to commit any of these offenses, as each of these offenses is
501.33 defined in Minnesota Statutes; or an offense in any other state
501.34 or country, the elements of which are substantially similar to
501.35 the elements of any of the offenses listed in this clause. If
501.36 the defendant is convicted of one of the gross misdemeanors
502.1 listed in this clause, but the sentence is a misdemeanor
502.2 disposition, the lookback period for the conviction is the
502.3 period applicable to misdemeanors; or
502.4 (4) if less than seven years have passed since the
502.5 discharge of the sentence imposed for the offense; and the
502.6 individual has received a misdemeanor conviction for a violation
502.7 of any of the following offenses: sections 609.224 (assault in
502.8 the fifth degree); 609.2242 (domestic assault); violation of an
502.9 order for protection under 518B.01 (Domestic Abuse Act);
502.10 violation of an order for protection under 609.3232 (protective
502.11 order authorized; procedures; penalties); 609.746 (interference
502.12 with privacy); 609.79 (obscene or harassing phone calls);
502.13 609.795 (letter, telegram, or package; opening; harassment);
502.14 617.23 (indecent exposure; penalties); 609.2672 (assault of an
502.15 unborn child in the third degree); 617.293 (harmful materials;
502.16 dissemination and display to minors prohibited); 609.66
502.17 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial
502.18 exploitation of a vulnerable adult); 609.234 (failure to report
502.19 maltreatment of a vulnerable adult); 609.52 (theft); 609.27
502.20 (coercion); or an attempt or conspiracy to commit any of these
502.21 offenses, as each of these offenses is defined in Minnesota
502.22 Statutes; or an offense in any other state or country, the
502.23 elements of which are substantially similar to the elements of
502.24 any of the offenses listed in this clause; failure to make
502.25 required reports under section 626.556, subdivision 3, or
502.26 626.557, subdivision 3, for incidents in which: (i) the final
502.27 disposition under section 626.556 or 626.557 was substantiated
502.28 maltreatment, and (ii) the maltreatment was recurring or
502.29 serious; or substantiated serious or recurring maltreatment of a
502.30 minor under section 626.556 or of a vulnerable adult under
502.31 section 626.557 for which there is a preponderance of evidence
502.32 that the maltreatment occurred, and that the subject was
502.33 responsible for the maltreatment.
502.34 For the purposes of this section, "serious maltreatment"
502.35 means sexual abuse; maltreatment resulting in death; or
502.36 maltreatment resulting in serious injury which reasonably
503.1 requires the care of a physician whether or not the care of a
503.2 physician was sought; or abuse resulting in serious injury. For
503.3 purposes of this section, "abuse resulting in serious injury"
503.4 means: bruises, bites, skin laceration or tissue damage;
503.5 fractures; dislocations; evidence of internal injuries; head
503.6 injuries with loss of consciousness; extensive second-degree or
503.7 third-degree burns and other burns for which complications are
503.8 present; extensive second-degree or third-degree frostbite, and
503.9 others for which complications are present; irreversible
503.10 mobility or avulsion of teeth; injuries to the eyeball;
503.11 ingestion of foreign substances and objects that are harmful;
503.12 near drowning; and heat exhaustion or sunstroke. For purposes
503.13 of this section, "care of a physician" is treatment received or
503.14 ordered by a physician, but does not include diagnostic testing,
503.15 assessment, or observation. For the purposes of this section,
503.16 "recurring maltreatment" means more than one incident of
503.17 maltreatment for which there is a preponderance of evidence that
503.18 the maltreatment occurred, and that the subject was responsible
503.19 for the maltreatment. For purposes of this section, "access"
503.20 means physical access to an individual receiving services or the
503.21 individual's personal property without continuous, direct
503.22 supervision as defined in section 245A.04, subdivision 3.
503.23 (b) If Except for background studies related to child
503.24 foster care, adult foster care, or family child care licensure,
503.25 when the subject of a background study is licensed regulated by
503.26 a health-related licensing board as defined in chapter 214, and
503.27 the regulated person has been determined to have been
503.28 responsible for substantiated maltreatment under section 626.556
503.29 or 626.557, instead of the commissioner making a decision
503.30 regarding disqualification, the board shall make the a
503.31 determination regarding a disqualification under this
503.32 subdivision based on a finding of substantiated maltreatment
503.33 under section 626.556 or 626.557. The commissioner shall notify
503.34 the health-related licensing board if a background study shows
503.35 that a licensee would be disqualified because of substantiated
503.36 maltreatment and the board shall make a determination under
504.1 section 214.104. whether to impose disciplinary or corrective
504.2 action under chapter 214.
504.3 (1) The commissioner shall notify the health-related
504.4 licensing board:
504.5 (i) upon completion of a background study that produces a
504.6 record showing that the individual was determined to have been
504.7 responsible for substantiated maltreatment;
504.8 (ii) upon the commissioner's completion of an investigation
504.9 that determined the individual was responsible for substantiated
504.10 maltreatment; or
504.11 (iii) upon receipt from another agency of a finding of
504.12 substantiated maltreatment for which the individual was
504.13 responsible.
504.14 (2) The commissioner's notice shall indicate whether the
504.15 individual would have been disqualified by the commissioner for
504.16 the substantiated maltreatment if the individual were not
504.17 regulated by the board. The commissioner shall concurrently
504.18 send a copy of this notice to the individual.
504.19 (3) Notwithstanding the exclusion from this subdivision for
504.20 individuals who provide child foster care, adult foster care, or
504.21 family child care, when the commissioner or a local agency has
504.22 reason to believe that the direct contact services provided by
504.23 the individual may fall within the jurisdiction of a
504.24 health-related licensing board, a referral shall be made to the
504.25 board as provided in this section.
504.26 (4) If, upon review of the information provided by the
504.27 commissioner, a health-related licensing board informs the
504.28 commissioner that the board does not have jurisdiction to take
504.29 disciplinary or corrective action, the commissioner shall make
504.30 the appropriate disqualification decision regarding the
504.31 individual as otherwise provided in this chapter.
504.32 (5) The commissioner has the authority to monitor the
504.33 facility's compliance with any requirements that the
504.34 health-related licensing board places on regulated persons
504.35 practicing in a facility either during the period pending a
504.36 final decision on a disciplinary or corrective action or as a
505.1 result of a disciplinary or corrective action. The commissioner
505.2 has the authority to order the immediate removal of a regulated
505.3 person from direct contact or access when a board issues an
505.4 order of temporary suspension based on a determination that the
505.5 regulated person poses an immediate risk of harm to persons
505.6 receiving services in a licensed facility.
505.7 (6) A facility that allows a regulated person to provide
505.8 direct contact services while not complying with the
505.9 requirements imposed by the health-related licensing board is
505.10 subject to action by the commissioner as specified under
505.11 sections 245A.06 and 245A.07.
505.12 (7) The commissioner shall notify a health-related
505.13 licensing board immediately upon receipt of knowledge of
505.14 noncompliance with requirements placed on a facility or upon a
505.15 person regulated by the board.
505.16 [EFFECTIVE DATE.] This section is effective July 1, 2001.
505.17 Sec. 10. Minnesota Statutes 2000, section 245A.05, is
505.18 amended to read:
505.19 245A.05 [DENIAL OF APPLICATION.]
505.20 The commissioner may deny a license if an applicant fails
505.21 to comply with applicable laws or rules, or knowingly withholds
505.22 relevant information from or gives false or misleading
505.23 information to the commissioner in connection with an
505.24 application for a license or during an investigation. An
505.25 applicant whose application has been denied by the commissioner
505.26 must be given notice of the denial. Notice must be given by
505.27 certified mail. The notice must state the reasons the
505.28 application was denied and must inform the applicant of the
505.29 right to a contested case hearing under chapter 14 and Minnesota
505.30 Rules, parts 1400.8510 to 1400.8612 and successor rules. The
505.31 applicant may appeal the denial by notifying the commissioner in
505.32 writing by certified mail within 20 calendar days after
505.33 receiving notice that the application was denied. Section
505.34 245A.08 applies to hearings held to appeal the commissioner's
505.35 denial of an application.
505.36 [EFFECTIVE DATE.] This section is effective January 1, 2002.
506.1 Sec. 11. Minnesota Statutes 2000, section 245A.06, is
506.2 amended to read:
506.3 245A.06 [CORRECTION ORDER AND FINES CONDITIONAL LICENSE.]
506.4 Subdivision 1. [CONTENTS OF CORRECTION ORDERS OR FINES AND
506.5 CONDITIONAL LICENSES.] (a) If the commissioner finds that the
506.6 applicant or license holder has failed to comply with an
506.7 applicable law or rule and this failure does not imminently
506.8 endanger the health, safety, or rights of the persons served by
506.9 the program, the commissioner may issue a correction order and
506.10 an order of conditional license to or impose a fine on the
506.11 applicant or license holder. When issuing a conditional
506.12 license, the commissioner shall consider the nature, chronicity,
506.13 or severity of the violation of law or rule and the effect of
506.14 the violation on the health, safety, or rights of persons served
506.15 by the program. The correction order or fine conditional
506.16 license must state:
506.17 (1) the conditions that constitute a violation of the law
506.18 or rule;
506.19 (2) the specific law or rule violated;
506.20 (3) the time allowed to correct each violation; and
506.21 (4) if a fine is imposed, the amount of the fine license is
506.22 made conditional, the length and terms of the conditional
506.23 license.
506.24 (b) Nothing in this section prohibits the commissioner from
506.25 proposing a sanction as specified in section 245A.07, prior to
506.26 issuing a correction order or fine conditional license.
506.27 Subd. 2. [RECONSIDERATION OF CORRECTION ORDERS.] If the
506.28 applicant or license holder believes that the contents of the
506.29 commissioner's correction order are in error, the applicant or
506.30 license holder may ask the department of human services to
506.31 reconsider the parts of the correction order that are alleged to
506.32 be in error. The request for reconsideration must be in writing
506.33 and received by the commissioner within 20 calendar days after
506.34 receipt of the correction order by the applicant or license
506.35 holder, and:
506.36 (1) specify the parts of the correction order that are
507.1 alleged to be in error;
507.2 (2) explain why they are in error; and
507.3 (3) include documentation to support the allegation of
507.4 error.
507.5 A request for reconsideration does not stay any provisions
507.6 or requirements of the correction order. The commissioner's
507.7 disposition of a request for reconsideration is final and not
507.8 subject to appeal under chapter 14.
507.9 Subd. 3. [FAILURE TO COMPLY.] If the commissioner finds
507.10 that the applicant or license holder has not corrected the
507.11 violations specified in the correction order or conditional
507.12 license, the commissioner may impose a fine and order other
507.13 licensing sanctions pursuant to section 245A.07. If a fine was
507.14 imposed and the violation was not corrected, the commissioner
507.15 may impose an additional fine. This section does not prohibit
507.16 the commissioner from seeking a court order, denying an
507.17 application, or suspending, revoking, or making conditional the
507.18 license in addition to imposing a fine.
507.19 Subd. 4. [NOTICE OF FINE CONDITIONAL LICENSE;
507.20 RECONSIDERATION OF FINE CONDITIONAL LICENSE.] A license holder
507.21 who is ordered to pay a fine If a license is made conditional,
507.22 the license holder must be notified of the order by certified
507.23 mail. The notice must be mailed to the address shown on the
507.24 application or the last known address of the license holder.
507.25 The notice must state the reasons the fine conditional license
507.26 was ordered and must inform the license holder of the
507.27 responsibility for payment of fines in subdivision 7 and the
507.28 right to request reconsideration of the fine conditional license
507.29 by the commissioner. The license holder may request
507.30 reconsideration of the order to forfeit a fine of conditional
507.31 license by notifying the commissioner by certified mail within
507.32 20 calendar days after receiving the order. The request must be
507.33 in writing and must be received by the commissioner within ten
507.34 calendar days after the license holder received the order. The
507.35 license holder may submit with the request for reconsideration
507.36 written argument or evidence in support of the request for
508.1 reconsideration. A timely request for reconsideration shall
508.2 stay forfeiture of the fine imposition of the terms of the
508.3 conditional license until the commissioner issues a decision on
508.4 the request for reconsideration. The request for
508.5 reconsideration must be in writing and:
508.6 (1) specify the parts of the violation that are alleged to
508.7 be in error;
508.8 (2) explain why they are in error;
508.9 (3) include documentation to support the allegation of
508.10 error; and
508.11 (4) any other information relevant to the fine or the
508.12 amount of the fine.
508.13 The commissioner's disposition of a request for
508.14 reconsideration is final and not subject to appeal under chapter
508.15 14.
508.16 Subd. 5. [FORFEITURE OF FINES.] The license holder shall
508.17 pay the fines assessed on or before the payment date specified
508.18 in the commissioner's order. If the license holder fails to
508.19 fully comply with the order, the commissioner shall issue a
508.20 second fine or suspend the license until the license holder
508.21 complies. If the license holder receives state funds, the
508.22 state, county, or municipal agencies or departments responsible
508.23 for administering the funds shall withhold payments and recover
508.24 any payments made while the license is suspended for failure to
508.25 pay a fine.
508.26 Subd. 5a. [ACCRUAL OF FINES.] A license holder shall
508.27 promptly notify the commissioner of human services, in writing,
508.28 when a violation specified in an order to forfeit is corrected.
508.29 If upon reinspection the commissioner determines that a
508.30 violation has not been corrected as indicated by the order to
508.31 forfeit, the commissioner may issue a second fine. The
508.32 commissioner shall notify the license holder by certified mail
508.33 that a second fine has been assessed. The license holder may
508.34 request reconsideration of the second fine under the provisions
508.35 of subdivision 4.
508.36 Subd. 6. [AMOUNT OF FINES.] Fines shall be assessed as
509.1 follows:
509.2 (1) the license holder shall forfeit $1,000 for each
509.3 occurrence of violation of law or rule prohibiting the
509.4 maltreatment of children or the maltreatment of vulnerable
509.5 adults, including but not limited to corporal punishment,
509.6 illegal or unauthorized use of physical, mechanical, or chemical
509.7 restraints, and illegal or unauthorized use of aversive or
509.8 deprivation procedures;
509.9 (2) the license holder shall forfeit $200 for each
509.10 occurrence of a violation of law or rule governing matters of
509.11 health, safety, or supervision, including but not limited to the
509.12 provision of adequate staff to child or adult ratios; and
509.13 (3) the license holder shall forfeit $100 for each
509.14 occurrence of a violation of law or rule other than those
509.15 included in clauses (1) and (2).
509.16 For the purposes of this section, "occurrence" means each
509.17 violation identified in the commissioner's forfeiture order.
509.18 Subd. 7. [RESPONSIBILITY FOR PAYMENT OF FINES.] When a
509.19 fine has been assessed, the license holder may not avoid payment
509.20 by closing, selling, or otherwise transferring the licensed
509.21 program to a third party. In such an event, the license holder
509.22 will be personally liable for payment. In the case of a
509.23 corporation, each controlling individual is personally and
509.24 jointly liable for payment.
509.25 Fines for child care centers must be assessed according to
509.26 this section.
509.27 [EFFECTIVE DATE.] This section is effective January 1, 2002.
509.28 Sec. 12. Minnesota Statutes 2000, section 245A.07, is
509.29 amended to read:
509.30 245A.07 [SANCTIONS.]
509.31 Subdivision 1. [SANCTIONS AVAILABLE.] In addition to
509.32 ordering forfeiture of fines making a license conditional under
509.33 section 245A.06, the commissioner may propose to suspend, or
509.34 revoke, or make conditional the license, impose a fine, or
509.35 secure an injunction against the continuing operation of the
509.36 program of a license holder who does not comply with applicable
510.1 law or rule. When applying sanctions authorized under this
510.2 section, the commissioner shall consider the nature, chronicity,
510.3 or severity of the violation of law or rule and the effect of
510.4 the violation on the health, safety, or rights of persons served
510.5 by the program.
510.6 Subd. 2. [IMMEDIATE SUSPENSION IN CASES OF IMMINENT DANGER
510.7 TO HEALTH, SAFETY, OR RIGHTS TEMPORARY IMMEDIATE SUSPENSION.] (a)
510.8 If the license holder's actions or failure to comply with
510.9 applicable law or rule has placed poses an imminent risk of harm
510.10 to the health, safety, or rights of persons served by the
510.11 program in imminent danger, the commissioner shall act
510.12 immediately to temporarily suspend the license. No state funds
510.13 shall be made available or be expended by any agency or
510.14 department of state, county, or municipal government for use by
510.15 a license holder regulated under this chapter while a license is
510.16 under immediate suspension. A notice stating the reasons for
510.17 the immediate suspension and informing the license holder of the
510.18 right to a contested case an expedited hearing under chapter
510.19 14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and
510.20 successor rules, must be delivered by personal service to the
510.21 address shown on the application or the last known address of
510.22 the license holder. The license holder may appeal an order
510.23 immediately suspending a license. The appeal of an order
510.24 immediately suspending a license must be made in writing by
510.25 certified mail and must be received by the commissioner within
510.26 five calendar days after the license holder receives notice that
510.27 the license has been immediately suspended. A license holder
510.28 and any controlling individual shall discontinue operation of
510.29 the program upon receipt of the commissioner's order to
510.30 immediately suspend the license.
510.31 (b) The commissioner is liable to the license holder for
510.32 actual damages for days of lost service in an amount not more
510.33 than $50,000 when:
510.34 (1) the commissioner immediately suspends a license under
510.35 paragraph (a); and
510.36 (2) the administrative law judge recommends, after a review
511.1 of the facts in an expedited hearing under chapter 14 and
511.2 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor
511.3 rules, that reasonable cause did not exist at the time the
511.4 commissioner issued the immediate suspension.
511.5 (c) If the commissioner immediately suspends a license
511.6 under paragraph (a) and the administrative law judge recommends
511.7 that reasonable cause exists for the immediate suspension, the
511.8 commissioner is not liable to the license holder.
511.9 Subd. 2a. [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a)
511.10 Within five working days of receipt of the license holder's
511.11 timely appeal, the commissioner shall request assignment of an
511.12 administrative law judge. The request must include a proposed
511.13 date, time, and place of a hearing. A hearing must be conducted
511.14 by an administrative law judge within 30 calendar days of the
511.15 request for assignment, unless an extension is requested by
511.16 either party and granted by the administrative law judge for
511.17 good cause. The commissioner shall issue a notice of hearing by
511.18 certified mail at least ten working days before the hearing.
511.19 The scope of the hearing shall be limited solely to the issue of
511.20 whether the temporary immediate suspension should remain in
511.21 effect pending the commissioner's final order under section
511.22 245A.08, regarding a licensing sanction issued under subdivision
511.23 3 following the immediate suspension. The burden of proof in
511.24 expedited hearings under this subdivision shall be limited to
511.25 the commissioner's demonstration that reasonable cause exists to
511.26 believe that the license holder's actions or failure to comply
511.27 with applicable law or rule poses an imminent risk of harm to
511.28 the health, safety, or rights of persons served by the program.
511.29 (b) The administrative law judge shall issue findings of
511.30 fact, conclusions, and a recommendation within ten working days
511.31 from the date of hearing. The commissioner's final order shall
511.32 be issued within ten working days from receipt of the
511.33 recommendation of the administrative law judge. Within 90
511.34 calendar days after a final order affirming an immediate
511.35 suspension, the commissioner shall make a determination
511.36 regarding whether a final licensing sanction shall be issued
512.1 under subdivision 3. The license holder shall continue to be
512.2 prohibited from operation of the program during this 90-day
512.3 period.
512.4 Subd. 3. [LICENSE SUSPENSION, REVOCATION, DENIAL OR
512.5 CONDITIONAL LICENSE FINE.] The commissioner may suspend, or
512.6 revoke, make conditional, or deny a license, or impose a fine if
512.7 an applicant or a license holder fails to comply fully with
512.8 applicable laws or rules, or knowingly withholds relevant
512.9 information from or gives false or misleading information to the
512.10 commissioner in connection with an application for a license or
512.11 during an investigation. A license holder who has had a license
512.12 suspended, revoked, or made conditional has been ordered to pay
512.13 a fine must be given notice of the action by certified mail.
512.14 The notice must be mailed to the address shown on the
512.15 application or the last known address of the license holder.
512.16 The notice must state the reasons the license was suspended,
512.17 revoked, or made conditional a fine was ordered.
512.18 (a) If the license was suspended or revoked, the notice
512.19 must inform the license holder of the right to a contested case
512.20 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to
512.21 1400.8612 and successor rules. The license holder may appeal an
512.22 order suspending or revoking a license. The appeal of an order
512.23 suspending or revoking a license must be made in writing by
512.24 certified mail and must be received by the commissioner within
512.25 ten calendar days after the license holder receives notice that
512.26 the license has been suspended or revoked.
512.27 (b) If the license was made conditional, the notice must
512.28 inform the license holder of the right to request a
512.29 reconsideration by the commissioner. The request for
512.30 reconsideration must be made in writing by certified mail and
512.31 must be received by the commissioner within ten calendar days
512.32 after the license holder receives notice that the license has
512.33 been made conditional. The license holder may submit with the
512.34 request for reconsideration written argument or evidence in
512.35 support of the request for reconsideration. The commissioner's
512.36 disposition of a request for reconsideration is final and is not
513.1 subject to appeal under chapter 14. (1) If the license holder
513.2 was ordered to pay a fine, the notice must inform the license
513.3 holder of the responsibility for payment of fines and the right
513.4 to a contested case hearing under chapter 14 and Minnesota
513.5 Rules, parts 1400.8510 to 1400.8612 and successor rules. The
513.6 appeal of an order to pay a fine must be made in writing by
513.7 certified mail and must be received by the commissioner within
513.8 ten calendar days after the license holder receives notice that
513.9 the fine has been ordered.
513.10 (2) The license holder shall pay the fines assessed on or
513.11 before the payment date specified. If the license holder fails
513.12 to fully comply with the order, the commissioner may issue a
513.13 second fine or suspend the license until the license holder
513.14 complies. If the license holder receives state funds, the
513.15 state, county, or municipal agencies or departments responsible
513.16 for administering the funds shall withhold payments and recover
513.17 any payments made while the license is suspended for failure to
513.18 pay a fine. A timely appeal shall stay payment of the fine
513.19 until the commissioner issues a final order.
513.20 (3) A license holder shall promptly notify the commissioner
513.21 of human services, in writing, when a violation specified in the
513.22 order to forfeit a fine is corrected. If upon reinspection the
513.23 commissioner determines that a violation has not been corrected
513.24 as indicated by the order to forfeit a fine, the commissioner
513.25 may issue a second fine. The commissioner shall notify the
513.26 license holder by certified mail that a second fine has been
513.27 assessed. The license holder may appeal the second fine as
513.28 provided under this subdivision.
513.29 (4) Fines shall be assessed as follows: the license holder
513.30 shall forfeit $1,000 for each determination of maltreatment of a
513.31 child under section 626.556 or the maltreatment of a vulnerable
513.32 adult under section 626.557; the license holder shall forfeit
513.33 $200 for each occurrence of a violation of law or rule governing
513.34 matters of health, safety, or supervision, including but not
513.35 limited to the provision of adequate staff to child or adult
513.36 ratios, and failure to submit a background study; and the
514.1 license holder shall forfeit $100 for each occurrence of a
514.2 violation of law or rule other than those subject to a $1,000 or
514.3 $200 fine above. For purposes of this section, "occurrence"
514.4 means each violation identified in the commissioner's fine order.
514.5 (5) When a fine has been assessed, the license holder may
514.6 not avoid payment by closing, selling, or otherwise transferring
514.7 the licensed program to a third party. In such an event, the
514.8 license holder will be personally liable for payment. In the
514.9 case of a corporation, each controlling individual is personally
514.10 and jointly liable for payment.
514.11 Subd. 4. [ADOPTION AGENCY VIOLATIONS.] If a license holder
514.12 licensed to place children for adoption fails to provide
514.13 services as described in the disclosure form required by section
514.14 259.37, subdivision 2, the sanctions under this section may be
514.15 imposed.
514.16 [EFFECTIVE DATE.] This section is effective January 1, 2002.
514.17 Sec. 13. Minnesota Statutes 2000, section 245A.08, is
514.18 amended to read:
514.19 245A.08 [HEARINGS.]
514.20 Subdivision 1. [RECEIPT OF APPEAL; CONDUCT OF HEARING.]
514.21 Upon receiving a timely appeal or petition pursuant to
514.22 section 245A.04, subdivision 3c, 245A.05, or 245A.07,
514.23 subdivision 3, the commissioner shall issue a notice of and
514.24 order for hearing to the appellant under chapter 14 and
514.25 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor
514.26 rules.
514.27 Subd. 2. [CONDUCT OF HEARINGS.] At any hearing provided
514.28 for by section 245A.04, subdivision 3c, 245A.05, or 245A.07,
514.29 subdivision 3, the appellant may be represented by counsel and
514.30 has the right to call, examine, and cross-examine witnesses.
514.31 The administrative law judge may require the presence of
514.32 witnesses and evidence by subpoena on behalf of any party.
514.33 Subd. 2a. [CONSOLIDATED CONTESTED CASE HEARINGS FOR
514.34 SANCTIONS BASED ON MALTREATMENT DETERMINATIONS AND
514.35 DISQUALIFICATIONS.] (a) When a denial of a license under section
514.36 245A.05 or a licensing sanction under section 245A.07,
515.1 subdivision 3, is based on a disqualification for which
515.2 reconsideration was requested and which was not set aside or was
515.3 not rescinded under section 245A.04, subdivision 3b, the scope
515.4 of the contested case hearing shall include the disqualification
515.5 and the licensing sanction or denial of a license. When the
515.6 licensing sanction or denial of a license is based on a
515.7 determination of maltreatment under section 626.556 or 626.557,
515.8 or a disqualification for serious or recurring maltreatment
515.9 which was not set aside or was not rescinded, the scope of the
515.10 contested case hearing shall include the maltreatment
515.11 determination, disqualification, and the licensing sanction or
515.12 denial of a license. In such cases, a fair hearing under
515.13 section 256.045 shall not be conducted as provided for in
515.14 sections 626.556, subdivision 10i, and 626.557, subdivision 9d.
515.15 (b) In consolidated contested case hearings regarding
515.16 sanctions issued in family child care, child foster care, and
515.17 adult foster care, the county attorney shall defend the
515.18 commissioner's orders in accordance with section 245A.16,
515.19 subdivision 4.
515.20 (c) The commissioner's final order under subdivision 5 is
515.21 the final agency action on the issue of maltreatment and
515.22 disqualification, including for purposes of subsequent
515.23 background studies under section 245A.04, subdivision 3, and is
515.24 the only administrative appeal of the final agency
515.25 determination, specifically, including a challenge to the
515.26 accuracy and completeness of data under section 13.04.
515.27 (d) When consolidated hearings under this subdivision
515.28 involve a licensing sanction based on a previous maltreatment
515.29 determination for which the commissioner has issued a final
515.30 order in an appeal of that determination under section 256.045,
515.31 or the individual failed to exercise the right to appeal the
515.32 previous maltreatment determination under section 626.556,
515.33 subdivision 10i, or 626.557, subdivision 9d, the commissioner's
515.34 order is conclusive on the issue of maltreatment. In such
515.35 cases, the scope of the administrative law judge's review shall
515.36 be limited to the disqualification and the licensing sanction or
516.1 denial of a license. In the case of a denial of a license or a
516.2 licensing sanction issued to a facility based on a maltreatment
516.3 determination regarding an individual who is not the license
516.4 holder or a household member, the scope of the administrative
516.5 law judge's review includes the maltreatment determination.
516.6 (e) If a maltreatment determination or disqualification,
516.7 which was not set aside or was not rescinded under section
516.8 245A.04, subdivision 3b, is the basis for a denial of a license
516.9 under section 245A.05 or a licensing sanction under section
516.10 245A.07, and the disqualified subject is an individual other
516.11 than the license holder and upon whom a background study must be
516.12 conducted under section 245A.04, subdivision 3, the hearings of
516.13 all parties may be consolidated into a single contested case
516.14 hearing upon consent of all parties and the administrative law
516.15 judge.
516.16 Subd. 3. [BURDEN OF PROOF.] (a) At a hearing regarding
516.17 suspension, immediate suspension, or revocation of a license for
516.18 family day care or foster care a licensing sanction under
516.19 section 245A.07, including consolidated hearings under
516.20 subdivision 2a, the commissioner may demonstrate reasonable
516.21 cause for action taken by submitting statements, reports, or
516.22 affidavits to substantiate the allegations that the license
516.23 holder failed to comply fully with applicable law or rule. If
516.24 the commissioner demonstrates that reasonable cause existed, the
516.25 burden of proof in hearings involving suspension, immediate
516.26 suspension, or revocation of a family day care or foster care
516.27 license shifts to the license holder to demonstrate by a
516.28 preponderance of the evidence that the license holder was in
516.29 full compliance with those laws or rules that the commissioner
516.30 alleges the license holder violated, at the time that the
516.31 commissioner alleges the violations of law or rules occurred.
516.32 (b) At a hearing on denial of an application, the applicant
516.33 bears the burden of proof to demonstrate by a preponderance of
516.34 the evidence that the appellant has complied fully with sections
516.35 245A.01 to 245A.15 this chapter and other applicable law or rule
516.36 and that the application should be approved and a license
517.1 granted.
517.2 (c) At all other hearings under this section, the
517.3 commissioner bears the burden of proof to demonstrate, by a
517.4 preponderance of the evidence, that the violations of law or
517.5 rule alleged by the commissioner occurred.
517.6 Subd. 4. [RECOMMENDATION OF ADMINISTRATIVE LAW JUDGE.] The
517.7 administrative law judge shall recommend whether or not the
517.8 commissioner's order should be affirmed. The recommendations
517.9 must be consistent with this chapter and the rules of the
517.10 commissioner. The recommendations must be in writing and
517.11 accompanied by findings of fact and conclusions and must be
517.12 mailed to the parties by certified mail to their last known
517.13 addresses as shown on the license or application.
517.14 Subd. 5. [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After
517.15 considering the findings of fact, conclusions, and
517.16 recommendations of the administrative law judge, the
517.17 commissioner shall issue a final order. The commissioner shall
517.18 consider, but shall not be bound by, the recommendations of the
517.19 administrative law judge. The appellant must be notified of the
517.20 commissioner's final order as required by chapter 14 and
517.21 Minnesota Rules, parts 1400.8510 to 1400.8612 and successor
517.22 rules. The notice must also contain information about the
517.23 appellant's rights under chapter 14 and Minnesota Rules, parts
517.24 1400.8510 to 1400.8612 and successor rules. The institution of
517.25 proceedings for judicial review of the commissioner's final
517.26 order shall not stay the enforcement of the final order except
517.27 as provided in section 14.65. A license holder and each
517.28 controlling individual of a license holder whose license has
517.29 been revoked because of noncompliance with applicable law or
517.30 rule must not be granted a license for five years following the
517.31 revocation. An applicant whose application was denied must not
517.32 be granted a license for two years following a denial, unless
517.33 the applicant's subsequent application contains new information
517.34 which constitutes a substantial change in the conditions that
517.35 caused the previous denial.
517.36 [EFFECTIVE DATE.] This section is effective January 1, 2002.
518.1 Sec. 14. Minnesota Statutes 2000, section 245A.16,
518.2 subdivision 1, is amended to read:
518.3 Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a)
518.4 County agencies and private agencies that have been designated
518.5 or licensed by the commissioner to perform licensing functions
518.6 and activities under section 245A.04, to recommend denial of
518.7 applicants under section 245A.05, to issue correction orders, to
518.8 issue variances, and recommend fines a conditional license under
518.9 section 245A.06, or to recommend suspending, or revoking, and
518.10 making licenses probationary a license or issuing a fine under
518.11 section 245A.07, shall comply with rules and directives of the
518.12 commissioner governing those functions and with this section.
518.13 (b) For family day care programs, the commissioner may
518.14 authorize licensing reviews every two years after a licensee has
518.15 had at least one annual review.
518.16 [EFFECTIVE DATE.] This section is effective January 1, 2002.
518.17 Sec. 15. Minnesota Statutes 2000, section 245B.08,
518.18 subdivision 3, is amended to read:
518.19 Subd. 3. [SANCTIONS AVAILABLE.] Nothing in this
518.20 subdivision shall be construed to limit the commissioner's
518.21 authority to suspend, or revoke a license, or make conditional
518.22 issue a fine at any time a license under section 245A.07; make
518.23 correction orders and require fines make a license conditional
518.24 for failure to comply with applicable laws or rules under
518.25 section 245A.06; or deny an application for license under
518.26 section 245A.05.
518.27 [EFFECTIVE DATE.] This section is effective January 1, 2002.
518.28 Sec. 16. [256.022] [CHILD MALTREATMENT REVIEW PANEL.]
518.29 Subdivision 1. [CREATION.] The commissioner of human
518.30 services shall establish a review panel for purposes of
518.31 reviewing investigating agency determinations regarding
518.32 maltreatment of a child in a facility in response to requests
518.33 received under section 626.556, subdivision 10i, paragraph (b).
518.34 The review panel consists of the commissioners of health; human
518.35 services; children, families, and learning; and corrections; the
518.36 ombudsman for crime victims; and the ombudsman for mental health
519.1 and mental retardation; or their designees.
519.2 Subd. 2. [REVIEW PROCEDURE.] (a) The panel shall hold
519.3 quarterly meetings for purposes of conducting reviews under this
519.4 section. If an interested person acting on behalf of a child
519.5 requests a review under this section, the panel shall review the
519.6 request at its next quarterly meeting. If the next quarterly
519.7 meeting is within ten days of the panel's receipt of the request
519.8 for review, the review may be delayed until the next subsequent
519.9 meeting. The panel shall review the request and the final
519.10 determination regarding maltreatment made by the investigating
519.11 agency and may review any other data on the investigation
519.12 maintained by the agency that are pertinent and necessary to its
519.13 review of the determination. If more than one person requests a
519.14 review under this section with respect to the same
519.15 determination, the review panel shall combine the requests into
519.16 one review. Upon receipt of a request for a review, the panel
519.17 shall notify the alleged perpetrator of maltreatment that a
519.18 review has been requested and provide an approximate timeline
519.19 for conducting the review.
519.20 (b) Within 30 days of the review under this section, the
519.21 panel shall notify the investigating agency and the interested
519.22 person who requested the review as to whether the panel agrees
519.23 with the determination or whether the investigating agency must
519.24 reconsider the determination. If the panel determines that the
519.25 agency must reconsider the determination, the panel must make
519.26 specific investigative recommendations to the agency. Within 30
519.27 days the investigating agency shall conduct a review and report
519.28 back to the panel with its reconsidered determination and the
519.29 specific rationale for its determination.
519.30 Subd. 3. [REPORT.] By January 15 of each year, the panel
519.31 shall submit a report to the committees of the legislature with
519.32 jurisdiction over section 626.556 regarding the number of
519.33 requests for review it receives under this section, the number
519.34 of cases where the panel requires the investigating agency to
519.35 reconsider its final determination, the number of cases where
519.36 the final determination is changed, and any recommendations to
520.1 improve the review or investigative process.
520.2 Subd. 4. [DATA.] Data of the review panel created as part
520.3 of a review under this section are private data on individuals
520.4 as defined in section 13.02.
520.5 [EFFECTIVE DATE.] This section is effective July 1, 2001.
520.6 Sec. 17. Minnesota Statutes 2000, section 256.045,
520.7 subdivision 3, is amended to read:
520.8 Subd. 3. [STATE AGENCY HEARINGS.] (a) State agency
520.9 hearings are available for the following: (1) any person
520.10 applying for, receiving or having received public assistance,
520.11 medical care, or a program of social services granted by the
520.12 state agency or a county agency or the federal Food Stamp Act
520.13 whose application for assistance is denied, not acted upon with
520.14 reasonable promptness, or whose assistance is suspended,
520.15 reduced, terminated, or claimed to have been incorrectly paid;
520.16 (2) any patient or relative aggrieved by an order of the
520.17 commissioner under section 252.27; (3) a party aggrieved by a
520.18 ruling of a prepaid health plan; (4) except as provided under
520.19 chapter 245A, any individual or facility determined by a lead
520.20 agency to have maltreated a vulnerable adult under section
520.21 626.557 after they have exercised their right to administrative
520.22 reconsideration under section 626.557; (5) any person whose
520.23 claim for foster care payment according to a placement of the
520.24 child resulting from a child protection assessment under section
520.25 626.556 is denied or not acted upon with reasonable promptness,
520.26 regardless of funding source; (6) any person to whom a right of
520.27 appeal according to this section is given by other provision of
520.28 law; (7) an applicant aggrieved by an adverse decision to an
520.29 application for a hardship waiver under section
520.30 256B.15; or (8) except as provided under chapter 245A, an
520.31 individual or facility determined to have maltreated a minor
520.32 under section 626.556, after the individual or facility has
520.33 exercised the right to administrative reconsideration under
520.34 section 626.556; or (9) except as provided under chapter 245A,
520.35 an individual disqualified under section 245A.04, subdivision
520.36 3d, on the basis of serious or recurring maltreatment; a
521.1 preponderance of the evidence that the individual has committed
521.2 an act or acts that meet the definition of any of the crimes
521.3 listed in section 245A.04, subdivision 3d, paragraph (a),
521.4 clauses (1) to (4); or for failing to make reports required
521.5 under section 626.556, subdivision 3, or 626.557, subdivision
521.6 3. Hearings regarding a maltreatment determination under clause
521.7 (4) or (8) and a disqualification under this clause in which the
521.8 basis for a disqualification is serious or recurring
521.9 maltreatment, which has not been set aside or rescinded under
521.10 section 245A.04, subdivision 3b, shall be consolidated into a
521.11 single fair hearing. In such cases, the scope of review by the
521.12 human services referee shall include both the maltreatment
521.13 determination and the disqualification. The failure to exercise
521.14 the right to an administrative reconsideration shall not be a
521.15 bar to a hearing under this section if federal law provides an
521.16 individual the right to a hearing to dispute a finding of
521.17 maltreatment. Individuals and organizations specified in this
521.18 section may contest the specified action, decision, or final
521.19 disposition before the state agency by submitting a written
521.20 request for a hearing to the state agency within 30 days after
521.21 receiving written notice of the action, decision, or final
521.22 disposition, or within 90 days of such written notice if the
521.23 applicant, recipient, patient, or relative shows good cause why
521.24 the request was not submitted within the 30-day time limit.
521.25 The hearing for an individual or facility under clause
521.26 (4) or, (8), or (9) is the only administrative appeal to the
521.27 final agency determination specifically, including a challenge
521.28 to the accuracy and completeness of data under section 13.04.
521.29 Hearings requested under clause (4) apply only to incidents of
521.30 maltreatment that occur on or after October 1, 1995. Hearings
521.31 requested by nursing assistants in nursing homes alleged to have
521.32 maltreated a resident prior to October 1, 1995, shall be held as
521.33 a contested case proceeding under the provisions of chapter 14.
521.34 Hearings requested under clause (8) apply only to incidents of
521.35 maltreatment that occur on or after July 1, 1997. A hearing for
521.36 an individual or facility under clause (8) is only available
522.1 when there is no juvenile court or adult criminal action
522.2 pending. If such action is filed in either court while an
522.3 administrative review is pending, the administrative review must
522.4 be suspended until the judicial actions are completed. If the
522.5 juvenile court action or criminal charge is dismissed or the
522.6 criminal action overturned, the matter may be considered in an
522.7 administrative hearing.
522.8 For purposes of this section, bargaining unit grievance
522.9 procedures are not an administrative appeal.
522.10 The scope of hearings involving claims to foster care
522.11 payments under clause (5) shall be limited to the issue of
522.12 whether the county is legally responsible for a child's
522.13 placement under court order or voluntary placement agreement
522.14 and, if so, the correct amount of foster care payment to be made
522.15 on the child's behalf and shall not include review of the
522.16 propriety of the county's child protection determination or
522.17 child placement decision.
522.18 (b) A vendor of medical care as defined in section 256B.02,
522.19 subdivision 7, or a vendor under contract with a county agency
522.20 to provide social services under section 256E.08, subdivision 4,
522.21 is not a party and may not request a hearing under this section,
522.22 except if assisting a recipient as provided in subdivision 4.
522.23 (c) An applicant or recipient is not entitled to receive
522.24 social services beyond the services included in the amended
522.25 community social services plan developed under section 256E.081,
522.26 subdivision 3, if the county agency has met the requirements in
522.27 section 256E.081.
522.28 (d) The commissioner may summarily affirm the county or
522.29 state agency's proposed action without a hearing when the sole
522.30 issue is an automatic change due to a change in state or federal
522.31 law.
522.32 [EFFECTIVE DATE.] This section is effective January 1, 2002.
522.33 Sec. 18. Minnesota Statutes 2000, section 256.045,
522.34 subdivision 3b, is amended to read:
522.35 Subd. 3b. [STANDARD OF EVIDENCE FOR MALTREATMENT AND
522.36 DISQUALIFICATION HEARINGS.] The state human services referee
523.1 shall determine that maltreatment has occurred if a
523.2 preponderance of evidence exists to support the final
523.3 disposition under sections 626.556 and 626.557. For purposes of
523.4 hearings regarding disqualification, the state human services
523.5 referee shall affirm the proposed disqualification in an appeal
523.6 under subdivision 3, paragraph (a), clause (9), if a
523.7 preponderance of the evidence shows the individual has:
523.8 (1) committed maltreatment under section 626.556 or
523.9 626.557, which is serious or recurring;
523.10 (2) committed an act or acts meeting the definition of any
523.11 of the crimes listed in section 245A.04, subdivision 3d,
523.12 paragraph (a), clauses (1) to (4); or
523.13 (3) failed to make required reports under section 626.556
523.14 or 626.557 for incidents in which:
523.15 (i) the final disposition under section 626.556 or 626.557
523.16 was substantiated maltreatment; and
523.17 (ii) the maltreatment was recurring or serious; or
523.18 substantiated serious or recurring maltreatment of a minor under
523.19 section 626.556 or of a vulnerable adult under section 626.557
523.20 for which there is a preponderance of evidence that the
523.21 maltreatment occurred, and that the subject was responsible for
523.22 the maltreatment. If the disqualification is affirmed, the
523.23 state human services referee shall determine whether the
523.24 individual poses a risk of harm in accordance with the
523.25 requirements of section 245A.04, subdivision 3b.
523.26 The state human services referee shall recommend an order
523.27 to the commissioner of health or human services, as applicable,
523.28 who shall issue a final order. The commissioner shall affirm,
523.29 reverse, or modify the final disposition. Any order of the
523.30 commissioner issued in accordance with this subdivision is
523.31 conclusive upon the parties unless appeal is taken in the manner
523.32 provided in subdivision 7. Except as provided under section
523.33 245A.04, subdivisions 3b, paragraphs (e) and (f); and 3c, in any
523.34 licensing appeal under chapter 245A and sections 144.50 to
523.35 144.58 and 144A.02 to 144A.46, the commissioner's determination
523.36 as to maltreatment is conclusive.
524.1 [EFFECTIVE DATE.] This section is effective January 1, 2002.
524.2 Sec. 19. Minnesota Statutes 2000, section 256.045,
524.3 subdivision 4, is amended to read:
524.4 Subd. 4. [CONDUCT OF HEARINGS.] (a) All hearings held
524.5 pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted
524.6 according to the provisions of the federal Social Security Act
524.7 and the regulations implemented in accordance with that act to
524.8 enable this state to qualify for federal grants-in-aid, and
524.9 according to the rules and written policies of the commissioner
524.10 of human services. County agencies shall install equipment
524.11 necessary to conduct telephone hearings. A state human services
524.12 referee may schedule a telephone conference hearing when the
524.13 distance or time required to travel to the county agency offices
524.14 will cause a delay in the issuance of an order, or to promote
524.15 efficiency, or at the mutual request of the parties. Hearings
524.16 may be conducted by telephone conferences unless the applicant,
524.17 recipient, former recipient, person, or facility contesting
524.18 maltreatment objects. The hearing shall not be held earlier
524.19 than five days after filing of the required notice with the
524.20 county or state agency. The state human services referee shall
524.21 notify all interested persons of the time, date, and location of
524.22 the hearing at least five days before the date of the hearing.
524.23 Interested persons may be represented by legal counsel or other
524.24 representative of their choice, including a provider of therapy
524.25 services, at the hearing and may appear personally, testify and
524.26 offer evidence, and examine and cross-examine witnesses. The
524.27 applicant, recipient, former recipient, person, or facility
524.28 contesting maltreatment shall have the opportunity to examine
524.29 the contents of the case file and all documents and records to
524.30 be used by the county or state agency at the hearing at a
524.31 reasonable time before the date of the hearing and during the
524.32 hearing. In hearings under subdivision 3, paragraph (a),
524.33 clauses (4) and, (8), and (9), either party may subpoena the
524.34 private data relating to the investigation prepared by the
524.35 agency under section 626.556 or 626.557 that is not otherwise
524.36 accessible under section 13.04, provided the identity of the
525.1 reporter may not be disclosed.
525.2 (b) The private data obtained by subpoena in a hearing
525.3 under subdivision 3, paragraph (a), clause (4) or, (8), or (9),
525.4 must be subject to a protective order which prohibits its
525.5 disclosure for any other purpose outside the hearing provided
525.6 for in this section without prior order of the district court.
525.7 Disclosure without court order is punishable by a sentence of
525.8 not more than 90 days imprisonment or a fine of not more than
525.9 $700, or both. These restrictions on the use of private data do
525.10 not prohibit access to the data under section 13.03, subdivision
525.11 6. Except for appeals under subdivision 3, paragraph (a),
525.12 clauses (4), (5), and (8), and (9), upon request, the county
525.13 agency shall provide reimbursement for transportation, child
525.14 care, photocopying, medical assessment, witness fee, and other
525.15 necessary and reasonable costs incurred by the applicant,
525.16 recipient, or former recipient in connection with the appeal.
525.17 All evidence, except that privileged by law, commonly accepted
525.18 by reasonable people in the conduct of their affairs as having
525.19 probative value with respect to the issues shall be submitted at
525.20 the hearing and such hearing shall not be "a contested case"
525.21 within the meaning of section 14.02, subdivision 3. The agency
525.22 must present its evidence prior to or at the hearing, and may
525.23 not submit evidence after the hearing except by agreement of the
525.24 parties at the hearing, provided the petitioner has the
525.25 opportunity to respond.
525.26 [EFFECTIVE DATE.] This section is effective January 1, 2002.
525.27 Sec. 20. Minnesota Statutes 2000, section 626.556, is
525.28 amended by adding a subdivision to read:
525.29 Subd. 2a. [DEFINITION; THREATENED INJURY.] As used in this
525.30 section, "threatened injury," as defined in subdivision 2,
525.31 paragraph (l) includes, but is not limited to, exposing a child
525.32 to a person responsible for the child's care, as defined in
525.33 paragraph (b), clause (1), who has:
525.34 (1) subjected a child to, or failed to protect a child
525.35 from, an overt act or condition that constitutes egregious harm,
525.36 as defined in section 260C.007, subdivision 26, or a similar law
526.1 of another jurisdiction;
526.2 (2) been found to be palpably unfit under section 260C.301,
526.3 paragraph (b), clause (4), or a similar law of another
526.4 jurisdiction;
526.5 (3) committed an act that has resulted in an involuntary
526.6 termination of parental rights under section 260C.301, or a
526.7 similar law of another jurisdiction; or
526.8 (4) committed an act that has resulted in the involuntary
526.9 transfer of permanent legal and physical custody of a child to a
526.10 relative under section 260C.201, subdivision 11, paragraph (e),
526.11 clause (1), or a similar law of another jurisdiction.
526.12 Sec. 21. Minnesota Statutes 2000, section 626.556,
526.13 subdivision 3, is amended to read:
526.14 Subd. 3. [PERSONS MANDATED TO REPORT.] (a) A person who
526.15 knows or has reason to believe a child is being neglected or
526.16 physically or sexually abused, as defined in subdivision 2, or
526.17 has been neglected or physically or sexually abused within the
526.18 preceding three years, shall immediately report the information
526.19 to the local welfare agency, agency responsible for assessing or
526.20 investigating the report, police department, or the county
526.21 sheriff if the person is:
526.22 (1) a professional or professional's delegate who is
526.23 engaged in the practice of the healing arts, social services,
526.24 hospital administration, psychological or psychiatric treatment,
526.25 child care, education, or law enforcement; or
526.26 (2) employed as a member of the clergy and received the
526.27 information while engaged in ministerial duties, provided that a
526.28 member of the clergy is not required by this subdivision to
526.29 report information that is otherwise privileged under section
526.30 595.02, subdivision 1, paragraph (c).
526.31 The police department or the county sheriff, upon receiving
526.32 a report, shall immediately notify the local welfare agency or
526.33 agency responsible for assessing or investigating the report,
526.34 orally and in writing. The local welfare agency, or agency
526.35 responsible for assessing or investigating the report, upon
526.36 receiving a report, shall immediately notify the local police
527.1 department or the county sheriff orally and in writing. The
527.2 county sheriff and the head of every local welfare agency,
527.3 agency responsible for assessing or investigating reports, and
527.4 police department shall each designate a person within their
527.5 agency, department, or office who is responsible for ensuring
527.6 that the notification duties of this paragraph and paragraph (b)
527.7 are carried out. Nothing in this subdivision shall be construed
527.8 to require more than one report from any institution, facility,
527.9 school, or agency.
527.10 (b) Any person may voluntarily report to the local welfare
527.11 agency, agency responsible for assessing or investigating the
527.12 report, police department, or the county sheriff if the person
527.13 knows, has reason to believe, or suspects a child is being or
527.14 has been neglected or subjected to physical or sexual abuse.
527.15 The police department or the county sheriff, upon receiving a
527.16 report, shall immediately notify the local welfare agency or
527.17 agency responsible for assessing or investigating the report,
527.18 orally and in writing. The local welfare agency or agency
527.19 responsible for assessing or investigating the report, upon
527.20 receiving a report, shall immediately notify the local police
527.21 department or the county sheriff orally and in writing.
527.22 (c) A person mandated to report physical or sexual child
527.23 abuse or neglect occurring within a licensed facility shall
527.24 report the information to the agency specified under
527.25 subdivisions 3b and 3c as responsible for licensing
527.26 the assessing or investigating a facility licensed under
527.27 sections 144.50 to 144.58; a facility licensed under section
527.28 241.021; 245A.01 to 245A.16; or 245B, or a facility licensed
527.29 under chapter 245A; a school as defined in sections section
527.30 120A.05, subdivisions 9, 11, and 13; and, or section 124D.10; or
527.31 a nonlicensed personal care provider organization as defined
527.32 in sections section 256B.04, subdivision 16; and, or section
527.33 256B.0625, subdivision 19. A health or corrections An agency
527.34 receiving a report may request the local welfare agency to
527.35 provide assistance pursuant to subdivisions 10, 10a, and 10b.
527.36 (d) Any person mandated to report shall receive a summary
528.1 of the disposition of any report made by that reporter,
528.2 including whether the case has been opened for child protection
528.3 or other services, or if a referral has been made to a community
528.4 organization, unless release would be detrimental to the best
528.5 interests of the child. Any person who is not mandated to
528.6 report shall, upon request to the local welfare agency, receive
528.7 a concise summary of the disposition of any report made by that
528.8 reporter, unless release would be detrimental to the best
528.9 interests of the child.
528.10 (e) For purposes of this subdivision, "immediately" means
528.11 as soon as possible but in no event longer than 24 hours.
528.12 [EFFECTIVE DATE.] This section is effective July 1, 2001.
528.13 Sec. 22. Minnesota Statutes 2000, section 626.556,
528.14 subdivision 3c, is amended to read:
528.15 Subd. 3c. [AGENCY RESPONSIBLE FOR ASSESSING OR
528.16 INVESTIGATING REPORTS OF MALTREATMENT.] The following agencies
528.17 are the administrative agencies responsible for assessing or
528.18 investigating reports of alleged child maltreatment in
528.19 facilities made under this section:
528.20 (1) the county local welfare agency is the agency
528.21 responsible for assessing or investigating allegations of
528.22 maltreatment in child foster care, family child care, and
528.23 legally unlicensed child care and;
528.24 (2) the department of human services is the agency
528.25 responsible for assessing or investigating allegations of
528.26 maltreatment in juvenile correctional facilities licensed under
528.27 section 241.021 located in the local welfare agency's county;
528.28 (2) (3) the department of human services is the agency
528.29 responsible for assessing or investigating allegations of
528.30 maltreatment in facilities licensed under chapters 245A and
528.31 245B, except for child foster care and family child care; and
528.32 (3) (4) the department of health is the agency responsible
528.33 for assessing or investigating allegations of child maltreatment
528.34 in facilities licensed under sections 144.50 to 144.58, and in
528.35 unlicensed home health care.
528.36 [EFFECTIVE DATE.] This section is effective July 1, 2001.
529.1 Sec. 23. Minnesota Statutes, section 626.556, is amended
529.2 by adding a subdivision to read:
529.3 Subd. 3d. [COMMISSIONER OF HEALTH;
529.4 DUTIES.] Notwithstanding the designation of certain data as
529.5 confidential under section 144.225, subdivision 2 or private
529.6 under section 144.225, subdivision 2a, the commissioner shall
529.7 give the commissioner of human services access to birth record
529.8 data and data contained in recognitions of parentage prepared
529.9 according to section 257.75 necessary to enable the commissioner
529.10 of human services to identify a child who is subject to
529.11 threatened injury, as defined in subdivision 2, paragraph (l),
529.12 by a person responsible for the child's care, as defined in
529.13 subdivision 2, paragraph (b), clause (1). The commissioner
529.14 shall be given access to all data included on official birth
529.15 certificates.
529.16 Sec. 24. Minnesota Statutes 2000, section 626.556,
529.17 subdivision 10, is amended to read:
529.18 Subd. 10. [DUTIES OF LOCAL WELFARE AGENCY AND LOCAL LAW
529.19 ENFORCEMENT AGENCY UPON RECEIPT OF A REPORT.] (a) If the report
529.20 alleges neglect, physical abuse, or sexual abuse by a parent,
529.21 guardian, or individual functioning within the family unit as a
529.22 person responsible for the child's care, the local welfare
529.23 agency shall immediately conduct an assessment including
529.24 gathering information on the existence of substance abuse and
529.25 offer protective social services for purposes of preventing
529.26 further abuses, safeguarding and enhancing the welfare of the
529.27 abused or neglected minor, and preserving family life whenever
529.28 possible. If the report alleges a violation of a criminal
529.29 statute involving sexual abuse, physical abuse, or neglect or
529.30 endangerment, under section 609.378, the local law enforcement
529.31 agency and local welfare agency shall coordinate the planning
529.32 and execution of their respective investigation and assessment
529.33 efforts to avoid a duplication of fact-finding efforts and
529.34 multiple interviews. Each agency shall prepare a separate
529.35 report of the results of its investigation. In cases of alleged
529.36 child maltreatment resulting in death, the local agency may rely
530.1 on the fact-finding efforts of a law enforcement investigation
530.2 to make a determination of whether or not maltreatment
530.3 occurred. When necessary the local welfare agency shall seek
530.4 authority to remove the child from the custody of a parent,
530.5 guardian, or adult with whom the child is living. In performing
530.6 any of these duties, the local welfare agency shall maintain
530.7 appropriate records.
530.8 If the assessment indicates there is a potential for abuse
530.9 of alcohol or other drugs by the parent, guardian, or person
530.10 responsible for the child's care, the local welfare agency shall
530.11 conduct a chemical use assessment pursuant to Minnesota Rules,
530.12 part 9530.6615. The local welfare agency shall report the
530.13 determination of the chemical use assessment, and the
530.14 recommendations and referrals for alcohol and other drug
530.15 treatment services to the state authority on alcohol and drug
530.16 abuse.
530.17 (b) When a local agency receives a report or otherwise has
530.18 information indicating that a child who is a client, as defined
530.19 in section 245.91, has been the subject of physical abuse,
530.20 sexual abuse, or neglect at an agency, facility, or program as
530.21 defined in section 245.91, it shall, in addition to its other
530.22 duties under this section, immediately inform the ombudsman
530.23 established under sections 245.91 to 245.97.
530.24 (c) Authority of the local welfare agency responsible for
530.25 assessing the child abuse or neglect report and of the local law
530.26 enforcement agency for investigating the alleged abuse or
530.27 neglect includes, but is not limited to, authority to interview,
530.28 without parental consent, the alleged victim and any other
530.29 minors who currently reside with or who have resided with the
530.30 alleged offender. The interview may take place at school or at
530.31 any facility or other place where the alleged victim or other
530.32 minors might be found or the child may be transported to, and
530.33 the interview conducted at, a place appropriate for the
530.34 interview of a child designated by the local welfare agency or
530.35 law enforcement agency. The interview may take place outside
530.36 the presence of the alleged offender or parent, legal custodian,
531.1 guardian, or school official. Except as provided in this
531.2 paragraph, the parent, legal custodian, or guardian shall be
531.3 notified by the responsible local welfare or law enforcement
531.4 agency no later than the conclusion of the investigation or
531.5 assessment that this interview has occurred. Notwithstanding
531.6 rule 49.02 of the Minnesota rules of procedure for juvenile
531.7 courts, the juvenile court may, after hearing on an ex parte
531.8 motion by the local welfare agency, order that, where reasonable
531.9 cause exists, the agency withhold notification of this interview
531.10 from the parent, legal custodian, or guardian. If the interview
531.11 took place or is to take place on school property, the order
531.12 shall specify that school officials may not disclose to the
531.13 parent, legal custodian, or guardian the contents of the
531.14 notification of intent to interview the child on school
531.15 property, as provided under this paragraph, and any other
531.16 related information regarding the interview that may be a part
531.17 of the child's school record. A copy of the order shall be sent
531.18 by the local welfare or law enforcement agency to the
531.19 appropriate school official.
531.20 (d) When the local welfare or local law enforcement agency
531.21 determines that an interview should take place on school
531.22 property, written notification of intent to interview the child
531.23 on school property must be received by school officials prior to
531.24 the interview. The notification shall include the name of the
531.25 child to be interviewed, the purpose of the interview, and a
531.26 reference to the statutory authority to conduct an interview on
531.27 school property. For interviews conducted by the local welfare
531.28 agency, the notification shall be signed by the chair of the
531.29 local social services agency or the chair's designee. The
531.30 notification shall be private data on individuals subject to the
531.31 provisions of this paragraph. School officials may not disclose
531.32 to the parent, legal custodian, or guardian the contents of the
531.33 notification or any other related information regarding the
531.34 interview until notified in writing by the local welfare or law
531.35 enforcement agency that the investigation or assessment has been
531.36 concluded. Until that time, the local welfare or law
532.1 enforcement agency shall be solely responsible for any
532.2 disclosures regarding the nature of the assessment or
532.3 investigation.
532.4 Except where the alleged offender is believed to be a
532.5 school official or employee, the time and place, and manner of
532.6 the interview on school premises shall be within the discretion
532.7 of school officials, but the local welfare or law enforcement
532.8 agency shall have the exclusive authority to determine who may
532.9 attend the interview. The conditions as to time, place, and
532.10 manner of the interview set by the school officials shall be
532.11 reasonable and the interview shall be conducted not more than 24
532.12 hours after the receipt of the notification unless another time
532.13 is considered necessary by agreement between the school
532.14 officials and the local welfare or law enforcement agency.
532.15 Where the school fails to comply with the provisions of this
532.16 paragraph, the juvenile court may order the school to comply.
532.17 Every effort must be made to reduce the disruption of the
532.18 educational program of the child, other students, or school
532.19 staff when an interview is conducted on school premises.
532.20 (e) Where the alleged offender or a person responsible for
532.21 the care of the alleged victim or other minor prevents access to
532.22 the victim or other minor by the local welfare agency, the
532.23 juvenile court may order the parents, legal custodian, or
532.24 guardian to produce the alleged victim or other minor for
532.25 questioning by the local welfare agency or the local law
532.26 enforcement agency outside the presence of the alleged offender
532.27 or any person responsible for the child's care at reasonable
532.28 places and times as specified by court order.
532.29 (f) Before making an order under paragraph (e), the court
532.30 shall issue an order to show cause, either upon its own motion
532.31 or upon a verified petition, specifying the basis for the
532.32 requested interviews and fixing the time and place of the
532.33 hearing. The order to show cause shall be served personally and
532.34 shall be heard in the same manner as provided in other cases in
532.35 the juvenile court. The court shall consider the need for
532.36 appointment of a guardian ad litem to protect the best interests
533.1 of the child. If appointed, the guardian ad litem shall be
533.2 present at the hearing on the order to show cause.
533.3 (g) The commissioner, the ombudsman for mental health and
533.4 mental retardation, the local welfare agencies responsible for
533.5 investigating reports, and the local law enforcement agencies
533.6 have the right to enter facilities as defined in subdivision 2
533.7 and to inspect and copy the facility's records, including
533.8 medical records, as part of the investigation. Notwithstanding
533.9 the provisions of chapter 13, they also have the right to inform
533.10 the facility under investigation that they are conducting an
533.11 investigation, to disclose to the facility the names of the
533.12 individuals under investigation for abusing or neglecting a
533.13 child, and to provide the facility with a copy of the report and
533.14 the investigative findings.
533.15 (h) The local welfare agency shall collect available and
533.16 relevant information to ascertain whether maltreatment occurred
533.17 and whether protective services are needed. Information
533.18 collected includes, when relevant, information with regard to
533.19 the person reporting the alleged maltreatment, including the
533.20 nature of the reporter's relationship to the child and to the
533.21 alleged offender, and the basis of the reporter's knowledge for
533.22 the report; the child allegedly being maltreated; the alleged
533.23 offender; the child's caretaker; and other collateral sources
533.24 having relevant information related to the alleged
533.25 maltreatment. The local welfare agency may make a determination
533.26 of no maltreatment early in an assessment, and close the case
533.27 and retain immunity, if the collected information shows no basis
533.28 for a full assessment or investigation.
533.29 Information relevant to the assessment or investigation
533.30 must be asked for, and may include:
533.31 (1) the child's sex and age, prior reports of maltreatment,
533.32 information relating to developmental functioning, credibility
533.33 of the child's statement, and whether the information provided
533.34 under this clause is consistent with other information collected
533.35 during the course of the assessment or investigation;
533.36 (2) the alleged offender's age, a record check for prior
534.1 reports of maltreatment, and criminal charges and convictions.
534.2 The local welfare agency must provide the alleged offender with
534.3 an opportunity to make a statement. The alleged offender may
534.4 submit supporting documentation relevant to the assessment or
534.5 investigation;
534.6 (3) collateral source information regarding the alleged
534.7 maltreatment and care of the child. Collateral information
534.8 includes, when relevant: (i) a medical examination of the
534.9 child; (ii) prior medical records relating to the alleged
534.10 maltreatment or the care of the child maintained by any
534.11 facility, clinic, or health care professional and an interview
534.12 with the treating professionals; and (iii) interviews with the
534.13 child's caretakers, including the child's parent, guardian,
534.14 foster parent, child care provider, teachers, counselors, family
534.15 members, relatives, and other persons who may have knowledge
534.16 regarding the alleged maltreatment and the care of the child;
534.17 and
534.18 (4) information on the existence of domestic abuse and
534.19 violence in the home of the child, and substance abuse.
534.20 Nothing in this paragraph precludes the local welfare
534.21 agency from collecting other relevant information necessary to
534.22 conduct the assessment or investigation. Notwithstanding
534.23 section 13.384 or 144.335, the local welfare agency has access
534.24 to medical data and records for purposes of clause (3).
534.25 Notwithstanding the data's classification in the possession of
534.26 any other agency, data acquired by the local welfare agency
534.27 during the course of the assessment or investigation are private
534.28 data on individuals and must be maintained in accordance with
534.29 subdivision 11.
534.30 (i) In the initial stages of an assessment or
534.31 investigation, the local welfare agency shall conduct a
534.32 face-to-face observation of the child reported to be maltreated
534.33 and a face-to-face interview of the alleged offender. The
534.34 interview with the alleged offender may be postponed if it would
534.35 jeopardize an active law enforcement investigation.
534.36 (j) The local welfare agency shall use a question and
535.1 answer interviewing format with questioning as nondirective as
535.2 possible to elicit spontaneous responses. The following
535.3 interviewing methods and procedures must be used whenever
535.4 possible when collecting information:
535.5 (1) audio recordings of all interviews with witnesses and
535.6 collateral sources; and
535.7 (2) in cases of alleged sexual abuse, audio-video
535.8 recordings of each interview with the alleged victim and child
535.9 witnesses.
535.10 [EFFECTIVE DATE.] This section is effective July 1, 2001.
535.11 Sec. 25. Minnesota Statutes 2000, section 626.556,
535.12 subdivision 10b, is amended to read:
535.13 Subd. 10b. [DUTIES OF COMMISSIONER; NEGLECT OR ABUSE IN
535.14 FACILITY.] (a) This section applies to the commissioners of
535.15 human services, health, and children, families, and learning.
535.16 The commissioner of the agency responsible for assessing or
535.17 investigating the report shall immediately investigate if the
535.18 report alleges that:
535.19 (1) a child who is in the care of a facility as defined in
535.20 subdivision 2 is neglected, physically abused, or sexually
535.21 abused, or is the victim of maltreatment in a facility by an
535.22 individual in that facility, or has been so neglected or abused,
535.23 or been the victim of maltreatment in a facility by an
535.24 individual in that facility within the three years preceding the
535.25 report; or
535.26 (2) a child was neglected, physically abused, or sexually
535.27 abused, or is the victim of maltreatment in a facility by an
535.28 individual in a facility defined in subdivision 2, while in the
535.29 care of that facility within the three years preceding the
535.30 report.
535.31 The commissioner of the agency responsible for assessing or
535.32 investigating the report shall arrange for the transmittal to
535.33 the commissioner of reports received by local agencies and may
535.34 delegate to a local welfare agency the duty to investigate
535.35 reports. In conducting an investigation under this section, the
535.36 commissioner has the powers and duties specified for local
536.1 welfare agencies under this section. The commissioner of the
536.2 agency responsible for assessing or investigating the report or
536.3 local welfare agency may interview any children who are or have
536.4 been in the care of a facility under investigation and their
536.5 parents, guardians, or legal custodians.
536.6 (b) Prior to any interview, the commissioner of the agency
536.7 responsible for assessing or investigating the report or local
536.8 welfare agency shall notify the parent, guardian, or legal
536.9 custodian of a child who will be interviewed in the manner
536.10 provided for in subdivision 10d, paragraph (a). If reasonable
536.11 efforts to reach the parent, guardian, or legal custodian of a
536.12 child in an out-of-home placement have failed, the child may be
536.13 interviewed if there is reason to believe the interview is
536.14 necessary to protect the child or other children in the
536.15 facility. The commissioner of the agency responsible for
536.16 assessing or investigating the report or local agency must
536.17 provide the information required in this subdivision to the
536.18 parent, guardian, or legal custodian of a child interviewed
536.19 without parental notification as soon as possible after the
536.20 interview. When the investigation is completed, any parent,
536.21 guardian, or legal custodian notified under this subdivision
536.22 shall receive the written memorandum provided for in subdivision
536.23 10d, paragraph (c).
536.24 (c) In conducting investigations under this subdivision the
536.25 commissioner or local welfare agency responsible for assessing
536.26 or investigating the report shall obtain be given access to
536.27 information consistent with subdivision 10, paragraphs (g), (h),
536.28 (i), and (j), and shall be granted the same access to the
536.29 facility as the facility's licensing agency under the
536.30 corresponding facility licensing statute. A facility that
536.31 denies the investigating agency access to this information shall
536.32 be subject to a negative licensing action by the appropriate
536.33 licensing agency. When the agency responsible for assessing or
536.34 investigating a report under this section and the licensing
536.35 agency for the facility involved are not the same agency, the
536.36 investigating agency and the licensing agency may share not
537.1 public data as necessary to complete the investigation or to
537.2 determine appropriate licensing action.
537.3 (d) Except for foster care and family child care, the
537.4 commissioner has the primary responsibility for the
537.5 investigations and notifications required under subdivisions 10d
537.6 and 10f for reports that allege maltreatment related to the care
537.7 provided by or in facilities licensed by the commissioner. The
537.8 commissioner may request assistance from the local social
537.9 services agency.
537.10 [EFFECTIVE DATE.] This section is effective July 1, 2001.
537.11 Sec. 26. Minnesota Statutes 2000, section 626.556,
537.12 subdivision 10d, is amended to read:
537.13 Subd. 10d. [NOTIFICATION OF NEGLECT OR ABUSE IN FACILITY.]
537.14 (a) When a report is received that alleges neglect, physical
537.15 abuse, or sexual abuse, or maltreatment of a child while in the
537.16 care of a licensed or unlicensed day care facility, residential
537.17 facility, agency, hospital, sanitarium, or other facility or
537.18 institution required to be licensed according to sections 144.50
537.19 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B, or a
537.20 school as defined in sections 120A.05, subdivisions 9, 11, and
537.21 13; and 124D.10; or a nonlicensed personal care provider
537.22 organization as defined in section 256B.04, subdivision 16, and
537.23 256B.0625, subdivision 19a, the commissioner of the agency
537.24 responsible for assessing or investigating the report or local
537.25 welfare agency investigating the report shall provide the
537.26 following information to the parent, guardian, or legal
537.27 custodian of a child alleged to have been neglected, physically
537.28 abused, or sexually abused, or the victim of maltreatment of a
537.29 child in the facility: the name of the facility; the fact that
537.30 a report alleging neglect, physical abuse, or sexual abuse, or
537.31 maltreatment of a child in the facility has been received; the
537.32 nature of the alleged neglect, physical abuse, or sexual abuse,
537.33 or maltreatment of a child in the facility; that the agency is
537.34 conducting an investigation; any protective or corrective
537.35 measures being taken pending the outcome of the investigation;
537.36 and that a written memorandum will be provided when the
538.1 investigation is completed.
538.2 (b) The commissioner of the agency responsible for
538.3 assessing or investigating the report or local welfare agency
538.4 may also provide the information in paragraph (a) to the parent,
538.5 guardian, or legal custodian of any other child in the facility
538.6 if the investigative agency knows or has reason to believe the
538.7 alleged neglect, physical abuse, or sexual abuse, or
538.8 maltreatment of a child in the facility has occurred. In
538.9 determining whether to exercise this authority, the commissioner
538.10 of the agency responsible for assessing or investigating the
538.11 report or local welfare agency shall consider the seriousness of
538.12 the alleged neglect, physical abuse, or sexual abuse, or
538.13 maltreatment of a child in the facility; the number of children
538.14 allegedly neglected, physically abused, or sexually abused, or
538.15 victims of maltreatment of a child in the facility; the number
538.16 of alleged perpetrators; and the length of the investigation.
538.17 The facility shall be notified whenever this discretion is
538.18 exercised.
538.19 (c) When the commissioner of the agency responsible for
538.20 assessing or investigating the report or local welfare agency
538.21 has completed its investigation, every parent, guardian, or
538.22 legal custodian notified of the investigation by the
538.23 commissioner or local welfare agency shall be provided with the
538.24 following information in a written memorandum: the name of the
538.25 facility investigated; the nature of the alleged neglect,
538.26 physical abuse, or sexual abuse, or maltreatment of a child in
538.27 the facility; the investigator's name; a summary of the
538.28 investigation findings; a statement whether maltreatment was
538.29 found; and the protective or corrective measures that are being
538.30 or will be taken. The memorandum shall be written in a manner
538.31 that protects the identity of the reporter and the child and
538.32 shall not contain the name, or to the extent possible, reveal
538.33 the identity of the alleged perpetrator or of those interviewed
538.34 during the investigation. If maltreatment is determined to
538.35 exist, the commissioner or local welfare agency shall also
538.36 provide the written memorandum to the parent, guardian, or legal
539.1 custodian of each child in the facility if maltreatment is
539.2 determined to exist who had contact with the individual
539.3 responsible for the maltreatment. When the facility is the
539.4 responsible party for maltreatment, the commissioner or local
539.5 welfare agency shall also provide the written memorandum to the
539.6 parent, guardian, or legal custodian of each child who received
539.7 services in the population of the facility where the
539.8 maltreatment occurred. This notification must be provided to
539.9 the parent, guardian, or legal custodian of each child receiving
539.10 services from the time the maltreatment occurred until either
539.11 the individual responsible for maltreatment is no longer in
539.12 contact with a child or children in the facility or the
539.13 conclusion of the investigation.
539.14 [EFFECTIVE DATE.] This section is effective July 1, 2001.
539.15 Sec. 27. Minnesota Statutes 2000, section 626.556,
539.16 subdivision 10e, is amended to read:
539.17 Subd. 10e. [DETERMINATIONS.] Upon the conclusion of every
539.18 assessment or investigation it conducts, the local welfare
539.19 agency shall make two determinations: first, whether
539.20 maltreatment has occurred; and second, whether child protective
539.21 services are needed. When maltreatment is determined in an
539.22 investigation involving a facility, the investigating agency
539.23 shall also determine whether the facility or individual was
539.24 responsible for the maltreatment using the mitigating factors in
539.25 paragraph (d). Determinations under this subdivision must be
539.26 made based on a preponderance of the evidence.
539.27 (a) For the purposes of this subdivision, "maltreatment"
539.28 means any of the following acts or omissions committed by a
539.29 person responsible for the child's care:
539.30 (1) physical abuse as defined in subdivision 2, paragraph
539.31 (d);
539.32 (2) neglect as defined in subdivision 2, paragraph (c);
539.33 (3) sexual abuse as defined in subdivision 2, paragraph
539.34 (a); or
539.35 (4) mental injury as defined in subdivision 2, paragraph
539.36 (k); or
540.1 (5) maltreatment of a child in a facility as defined in
540.2 subdivision 2, paragraph (f).
540.3 (b) For the purposes of this subdivision, a determination
540.4 that child protective services are needed means that the local
540.5 welfare agency has documented conditions during the assessment
540.6 or investigation sufficient to cause a child protection worker,
540.7 as defined in section 626.559, subdivision 1, to conclude that a
540.8 child is at significant risk of maltreatment if protective
540.9 intervention is not provided and that the individuals
540.10 responsible for the child's care have not taken or are not
540.11 likely to take actions to protect the child from maltreatment or
540.12 risk of maltreatment.
540.13 (c) This subdivision does not mean that maltreatment has
540.14 occurred solely because the child's parent, guardian, or other
540.15 person responsible for the child's care in good faith selects
540.16 and depends upon spiritual means or prayer for treatment or care
540.17 of disease or remedial care of the child, in lieu of medical
540.18 care. However, if lack of medical care may result in serious
540.19 danger to the child's health, the local welfare agency may
540.20 ensure that necessary medical services are provided to the child.
540.21 (d) When determining whether the facility or individual is
540.22 the responsible party for determined maltreatment in a facility,
540.23 the investigating agency shall consider at least the following
540.24 mitigating factors:
540.25 (1) whether the actions of the facility or the individual
540.26 caregivers were according to, and followed the terms of, an
540.27 erroneous physician order, prescription, individual care plan,
540.28 or directive; however, this is not a mitigating factor when the
540.29 facility or caregiver was responsible for the issuance of the
540.30 erroneous order, prescription, individual care plan, or
540.31 directive or knew or should have known of the errors and took no
540.32 reasonable measures to correct the defect before administering
540.33 care;
540.34 (2) comparative responsibility between the facility, other
540.35 caregivers, and requirements placed upon an employee, including
540.36 the facility's compliance with related regulatory standards and
541.1 the adequacy of facility policies and procedures, facility
541.2 training, an individual's participation in the training, the
541.3 caregiver's supervision, and facility staffing levels and the
541.4 scope of the individual employee's authority and discretion; and
541.5 (3) whether the facility or individual followed
541.6 professional standards in exercising professional judgment.
541.7 Individual counties may implement more detailed definitions
541.8 or criteria that indicate which allegations to investigate, as
541.9 long as a county's policies are consistent with the definitions
541.10 in the statutes and rules and are approved by the county board.
541.11 Each local welfare agency shall periodically inform mandated
541.12 reporters under subdivision 3 who work in the county of the
541.13 definitions of maltreatment in the statutes and rules and any
541.14 additional definitions or criteria that have been approved by
541.15 the county board.
541.16 [EFFECTIVE DATE.] This section is effective July 1, 2001.
541.17 Sec. 28. Minnesota Statutes 2000, section 626.556,
541.18 subdivision 10f, is amended to read:
541.19 Subd. 10f. [NOTICE OF DETERMINATIONS.] Within ten working
541.20 days of the conclusion of an assessment, the local welfare
541.21 agency or agency responsible for assessing or investigating the
541.22 report shall notify the parent or guardian of the child, the
541.23 person determined to be maltreating the child, and if
541.24 applicable, the director of the facility, of the determination
541.25 and a summary of the specific reasons for the determination.
541.26 The notice must also include a certification that the
541.27 information collection procedures under subdivision 10,
541.28 paragraphs (h), (i), and (j), were followed and a notice of the
541.29 right of a data subject to obtain access to other private data
541.30 on the subject collected, created, or maintained under this
541.31 section. In addition, the notice shall include the length of
541.32 time that the records will be kept under subdivision 11c. The
541.33 investigating agency shall notify the parent or guardian of the
541.34 child who is the subject of the report, and any person or
541.35 facility determined to have maltreated a child, of their
541.36 appeal or review rights under this section or section 256.022.
542.1 [EFFECTIVE DATE.] This section is effective July 1, 2001.
542.2 Sec. 29. Minnesota Statutes 2000, section 626.556,
542.3 subdivision 10i, is amended to read:
542.4 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL
542.5 DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON
542.6 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as
542.7 provided under paragraph (e), an individual or facility that the
542.8 commissioner or a local social service agency determines has
542.9 maltreated a child, or the child's designee an interested person
542.10 acting on behalf of the child, regardless of the determination,
542.11 who contests the investigating agency's final determination
542.12 regarding maltreatment, may request the investigating agency to
542.13 reconsider its final determination regarding maltreatment. The
542.14 request for reconsideration must be submitted in writing to the
542.15 investigating agency within 15 calendar days after receipt of
542.16 notice of the final determination regarding maltreatment or, if
542.17 the request is made by an interested person who is not entitled
542.18 to notice, within 15 days after receipt of the notice by the
542.19 parent or guardian of the child. Effective January 1, 2002, an
542.20 individual who was determined to have maltreated a child under
542.21 this section and who was disqualified on the basis of serious or
542.22 recurring maltreatment under section 245A.04, subdivision 3d,
542.23 may request reconsideration of the maltreatment determination
542.24 and the disqualification. The request for reconsideration of
542.25 the maltreatment determination and the disqualification must be
542.26 submitted within 30 calendar days of the individual's receipt of
542.27 the notice of disqualification under section 245A.04,
542.28 subdivision 3a.
542.29 (b) Except as provided under paragraphs (e) and (f), if the
542.30 investigating agency denies the request or fails to act upon the
542.31 request within 15 calendar days after receiving the request for
542.32 reconsideration, the person or facility entitled to a fair
542.33 hearing under section 256.045 may submit to the commissioner of
542.34 human services a written request for a hearing under that
542.35 section. For reports involving maltreatment of a child in a
542.36 facility, an interested person acting on behalf of the child may
543.1 request a review by the child maltreatment review panel under
543.2 section 256.022 if the investigating agency denies the request
543.3 or fails to act upon the request or if the interested person
543.4 contests a reconsidered determination. The investigating agency
543.5 shall notify persons who request reconsideration of their rights
543.6 under this paragraph. The request must be submitted in writing
543.7 to the review panel and a copy sent to the investigating agency
543.8 within 30 calendar days of receipt of notice of a denial of a
543.9 request for reconsideration or of a reconsidered determination.
543.10 The request must specifically identify the aspects of the agency
543.11 determination with which the person is dissatisfied.
543.12 (c) If, as a result of the a reconsideration or review, the
543.13 investigating agency changes the final determination of
543.14 maltreatment, that agency shall notify the parties specified in
543.15 subdivisions 10b, 10d, and 10f.
543.16 (d) Except as provided under paragraph (f), if an
543.17 individual or facility contests the investigating agency's final
543.18 determination regarding maltreatment by requesting a fair
543.19 hearing under section 256.045, the commissioner of human
543.20 services shall assure that the hearing is conducted and a
543.21 decision is reached within 90 days of receipt of the request for
543.22 a hearing. The time for action on the decision may be extended
543.23 for as many days as the hearing is postponed or the record is
543.24 held open for the benefit of either party.
543.25 (e) Effective January 1, 2002, if an individual was
543.26 disqualified under section 245A.04, subdivision 3d, on the basis
543.27 of a determination of maltreatment, which was serious or
543.28 recurring, and the individual has requested reconsideration of
543.29 the maltreatment determination under paragraph (a) and requested
543.30 reconsideration of the disqualification under section 245A.04,
543.31 subdivision 3b, reconsideration of the maltreatment
543.32 determination and reconsideration of the disqualification shall
543.33 be consolidated into a single reconsideration. If an individual
543.34 disqualified on the basis of a determination of maltreatment,
543.35 which was serious or recurring requests a fair hearing under
543.36 paragraph (b), the scope of the fair hearing shall include the
544.1 maltreatment determination and the disqualification.
544.2 (f) Effective January 1, 2002, if a maltreatment
544.3 determination or a disqualification based on serious or
544.4 recurring maltreatment is the basis for a denial of a license
544.5 under section 245A.05 or a licensing sanction under section
544.6 245A.07, the license holder has the right to a contested case
544.7 hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to
544.8 1400.8612 and successor rules. As provided for under section
544.9 245A.08, subdivision 2a, the scope of the contested case hearing
544.10 shall include the maltreatment determination, disqualification,
544.11 and licensing sanction or denial of a license. In such cases, a
544.12 fair hearing regarding the maltreatment determination shall not
544.13 be conducted under paragraph (b). If the disqualified subject
544.14 is an individual other than the license holder and upon whom a
544.15 background study must be conducted under section 245A.04,
544.16 subdivision 3, the hearings of all parties may be consolidated
544.17 into a single contested case hearing upon consent of all parties
544.18 and the administrative law judge.
544.19 (g) For purposes of this subdivision, "interested person
544.20 acting on behalf of the child" means a parent or legal guardian;
544.21 stepparent; grandparent; guardian ad litem; adult stepbrother,
544.22 stepsister, or sibling; or adult aunt or uncle; unless the
544.23 person has been determined to be the perpetrator of the
544.24 maltreatment.
544.25 Sec. 30. Minnesota Statutes 2000, section 626.556,
544.26 subdivision 11, is amended to read:
544.27 Subd. 11. [RECORDS.] (a) Except as provided in paragraph
544.28 (b) or (c) and subdivisions 10b, 10d, 10g, and 11b, all records
544.29 concerning individuals maintained by a local welfare agency or
544.30 agency responsible for assessing or investigating the report
544.31 under this section, including any written reports filed under
544.32 subdivision 7, shall be private data on individuals, except
544.33 insofar as copies of reports are required by subdivision 7 to be
544.34 sent to the local police department or the county sheriff.
544.35 Reports maintained by any police department or the county
544.36 sheriff shall be private data on individuals except the reports
545.1 shall be made available to the investigating, petitioning, or
545.2 prosecuting authority, including county medical examiners or
545.3 county coroners. Section 13.82, subdivisions 7, 5a, and 5b,
545.4 apply to law enforcement data other than the reports. The local
545.5 social services agency or agency responsible for assessing or
545.6 investigating the report shall make available to the
545.7 investigating, petitioning, or prosecuting authority, including
545.8 county medical examiners or county coroners or their
545.9 professional delegates, any records which contain information
545.10 relating to a specific incident of neglect or abuse which is
545.11 under investigation, petition, or prosecution and information
545.12 relating to any prior incidents of neglect or abuse involving
545.13 any of the same persons. The records shall be collected and
545.14 maintained in accordance with the provisions of chapter 13. In
545.15 conducting investigations and assessments pursuant to this
545.16 section, the notice required by section 13.04, subdivision 2,
545.17 need not be provided to a minor under the age of ten who is the
545.18 alleged victim of abuse or neglect. An individual subject of a
545.19 record shall have access to the record in accordance with those
545.20 sections, except that the name of the reporter shall be
545.21 confidential while the report is under assessment or
545.22 investigation except as otherwise permitted by this
545.23 subdivision. Any person conducting an investigation or
545.24 assessment under this section who intentionally discloses the
545.25 identity of a reporter prior to the completion of the
545.26 investigation or assessment is guilty of a misdemeanor. After
545.27 the assessment or investigation is completed, the name of the
545.28 reporter shall be confidential. The subject of the report may
545.29 compel disclosure of the name of the reporter only with the
545.30 consent of the reporter or upon a written finding by the court
545.31 that the report was false and that there is evidence that the
545.32 report was made in bad faith. This subdivision does not alter
545.33 disclosure responsibilities or obligations under the rules of
545.34 criminal procedure.
545.35 (b) Upon request of the legislative auditor, data on
545.36 individuals maintained under this section must be released to
546.1 the legislative auditor in order for the auditor to fulfill the
546.2 auditor's duties under section 3.971. The auditor shall
546.3 maintain the data in accordance with chapter 13.
546.4 (c) The investigating agency shall exchange not public data
546.5 with the child maltreatment review panel under section 256.022
546.6 if the data are pertinent and necessary for a review requested
546.7 under section 256.022. Upon completion of the review, the not
546.8 public data received by the review panel must be returned to the
546.9 investigating agency.
546.10 [EFFECTIVE DATE.] This section is effective July 1, 2001.
546.11 Sec. 31. Minnesota Statutes 2000, section 626.556,
546.12 subdivision 12, is amended to read:
546.13 Subd. 12. [DUTIES OF FACILITY OPERATORS.] Any operator,
546.14 employee, or volunteer worker at any facility who intentionally
546.15 neglects, physically abuses, or sexually abuses any child in the
546.16 care of that facility may be charged with a violation of section
546.17 609.255, 609.377, or 609.378. Any operator of a facility who
546.18 knowingly permits conditions to exist which result in neglect,
546.19 physical abuse, or sexual abuse, or maltreatment of a child in a
546.20 facility while in the care of that facility may be charged with
546.21 a violation of section 609.378. The facility operator shall
546.22 inform all mandated reporters employed by or otherwise
546.23 associated with the facility of the duties required of mandated
546.24 reporters and shall inform all mandatory reporters of the
546.25 prohibition against retaliation for reports made in good faith
546.26 under this section.
546.27 [EFFECTIVE DATE.] This section is effective July 1, 2001.
546.28 Sec. 32. Minnesota Statutes 2000, section 626.557,
546.29 subdivision 3, is amended to read:
546.30 Subd. 3. [TIMING OF REPORT.] (a) A mandated reporter who
546.31 has reason to believe that a vulnerable adult is being or has
546.32 been maltreated, or who has knowledge that a vulnerable adult
546.33 has sustained a physical injury which is not reasonably
546.34 explained shall immediately report the information to the common
546.35 entry point. If an individual is a vulnerable adult solely
546.36 because the individual is admitted to a facility, a mandated
547.1 reporter is not required to report suspected maltreatment of the
547.2 individual that occurred prior to admission, unless:
547.3 (1) the individual was admitted to the facility from
547.4 another facility and the reporter has reason to believe the
547.5 vulnerable adult was maltreated in the previous facility; or
547.6 (2) the reporter knows or has reason to believe that the
547.7 individual is a vulnerable adult as defined in section 626.5572,
547.8 subdivision 21, clause (4).
547.9 (b) A person not required to report under the provisions of
547.10 this section may voluntarily report as described above.
547.11 (c) Nothing in this section requires a report of known or
547.12 suspected maltreatment, if the reporter knows or has reason to
547.13 know that a report has been made to the common entry point.
547.14 (d) Nothing in this section shall preclude a reporter from
547.15 also reporting to a law enforcement agency.
547.16 (e) A mandated reporter who knows or has reason to believe
547.17 that an error under section 626.5572, subdivision 17, paragraph
547.18 (c), clause (5), occurred must make a report under this
547.19 subdivision. If the reporter or a facility, at any time
547.20 believes that an investigation by a lead agency will determine
547.21 or should determine that the reported error was not neglect
547.22 according to the criteria under section 626.5572, subdivision
547.23 17, paragraph (c), clause (5), the reporter or facility may
547.24 provide to the common entry point or directly to the lead agency
547.25 information explaining how the event meets the criteria under
547.26 section 626.5572, subdivision 17, paragraph (c), clause (5).
547.27 The lead agency shall consider this information when making an
547.28 initial disposition of the report under subdivision 9c.
547.29 [EFFECTIVE DATE.] This section is effective August 1, 2001.
547.30 Sec. 33. Minnesota Statutes 2000, section 626.557,
547.31 subdivision 9d, is amended to read:
547.32 Subd. 9d. [ADMINISTRATIVE RECONSIDERATION OF FINAL
547.33 DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON
547.34 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as
547.35 provided under paragraph (e), any individual or facility which a
547.36 lead agency determines has maltreated a vulnerable adult, or the
548.1 vulnerable adult or an interested person acting on behalf of the
548.2 vulnerable adult, regardless of the lead agency's determination,
548.3 who contests the lead agency's final disposition of an
548.4 allegation of maltreatment, may request the lead agency to
548.5 reconsider its final disposition. The request for
548.6 reconsideration must be submitted in writing to the lead agency
548.7 within 15 calendar days after receipt of notice of final
548.8 disposition or, if the request is made by an interested person
548.9 who is not entitled to notice, within 15 days after receipt of
548.10 the notice by the vulnerable adult or the vulnerable adult's
548.11 legal guardian. An individual who was determined to have
548.12 maltreated a vulnerable adult under this section and who was
548.13 disqualified on the basis of serious or recurring maltreatment
548.14 under section 245A.04, subdivision 3d, may request
548.15 reconsideration of the maltreatment determination and the
548.16 disqualification. The request for reconsideration of the
548.17 maltreatment determination and the disqualification must be
548.18 submitted within 30 calendar days of the individual's receipt of
548.19 the notice of disqualification under section 245A.04,
548.20 subdivision 3a.
548.21 (b) Except as provided under paragraphs (e) and (f), if the
548.22 lead agency denies the request or fails to act upon the request
548.23 within 15 calendar days after receiving the request for
548.24 reconsideration, the person or facility entitled to a fair
548.25 hearing under section 256.045, may submit to the commissioner of
548.26 human services a written request for a hearing under that
548.27 statute. The vulnerable adult, or an interested person acting
548.28 on behalf of the vulnerable adult, may request a review by the
548.29 vulnerable adult maltreatment review panel under section 256.021
548.30 if the lead agency denies the request or fails to act upon the
548.31 request, or if the vulnerable adult or interested person
548.32 contests a reconsidered disposition. The lead agency shall
548.33 notify persons who request reconsideration of their rights under
548.34 this paragraph. The request must be submitted in writing to the
548.35 review panel and a copy sent to the lead agency within 30
548.36 calendar days of receipt of notice of a denial of a request for
549.1 reconsideration or of a reconsidered disposition. The request
549.2 must specifically identify the aspects of the agency
549.3 determination with which the person is dissatisfied.
549.4 (c) If, as a result of a reconsideration or review, the
549.5 lead agency changes the final disposition, it shall notify the
549.6 parties specified in subdivision 9c, paragraph (d).
549.7 (d) For purposes of this subdivision, "interested person
549.8 acting on behalf of the vulnerable adult" means a person
549.9 designated in writing by the vulnerable adult to act on behalf
549.10 of the vulnerable adult, or a legal guardian or conservator or
549.11 other legal representative, a proxy or health care agent
549.12 appointed under chapter 145B or 145C, or an individual who is
549.13 related to the vulnerable adult, as defined in section 245A.02,
549.14 subdivision 13.
549.15 (e) If an individual was disqualified under section
549.16 245A.04, subdivision 3d, on the basis of a determination of
549.17 maltreatment, which was serious or recurring, and the individual
549.18 has requested reconsideration of the maltreatment determination
549.19 under paragraph (a) and reconsideration of the disqualification
549.20 under section 245A.04, subdivision 3b, reconsideration of the
549.21 maltreatment determination and requested reconsideration of the
549.22 disqualification shall be consolidated into a single
549.23 reconsideration. If an individual who was disqualified on the
549.24 basis of serious or recurring maltreatment requests a fair
549.25 hearing under paragraph (b), the scope of the fair hearing shall
549.26 include the maltreatment determination and the disqualification.
549.27 (f) If a maltreatment determination or a disqualification
549.28 based on serious or recurring maltreatment is the basis for a
549.29 denial of a license under section 245A.05 or a licensing
549.30 sanction under section 245A.07, the license holder has the right
549.31 to a contested case hearing under chapter 14 and Minnesota
549.32 Rules, parts 1400.8510 to 1400.8612 and successor rules. As
549.33 provided for under section 245A.08, the scope of the contested
549.34 case hearing shall include the maltreatment determination,
549.35 disqualification, and licensing sanction or denial of a
549.36 license. In such cases, a fair hearing shall not be conducted
550.1 under paragraph (b). If the disqualified subject is an
550.2 individual other than the license holder and upon whom a
550.3 background study must be conducted under section 245A.04,
550.4 subdivision 3, the hearings of all parties may be consolidated
550.5 into a single contested case hearing upon consent of all parties
550.6 and the administrative law judge.
550.7 (g) Until August 1, 2002, an individual or facility that
550.8 was determined by the commissioner of human services or the
550.9 commissioner of health to be responsible for neglect under
550.10 section 626.5572, subdivision 17, after October 1, 1995, and
550.11 before August 1, 2001, that believes that the finding of neglect
550.12 does not meet an amended definition of neglect may request a
550.13 reconsideration of the determination of neglect. The
550.14 commissioner of human services or the commissioner of health
550.15 shall mail a notice to the last known address of individuals who
550.16 are eligible to seek this reconsideration. The request for
550.17 reconsideration must state how the established findings no
550.18 longer meet the elements of the definition of neglect. The
550.19 commissioner shall review the request for reconsideration and
550.20 make a determination within 15 calendar days. The
550.21 commissioner's decision on this reconsideration is the final
550.22 agency action.
550.23 (1) For purposes of compliance with the data destruction
550.24 schedule under subdivision 12b, paragraph (d), when a finding of
550.25 substantiated maltreatment has been changed as a result of a
550.26 reconsideration under this paragraph, the date of the original
550.27 finding of a substantiated maltreatment must be used to
550.28 calculate the destruction date.
550.29 (2) For purposes of any background studies under section
550.30 245A.04, when a determination of substantiated maltreatment has
550.31 been changed as a result of a reconsideration under this
550.32 paragraph, any prior disqualification of the individual under
550.33 section 245A.04 that was based on this determination of
550.34 maltreatment shall be rescinded, and for future background
550.35 studies under section 245A.04 the commissioner must not use the
550.36 previous determination of substantiated maltreatment as a basis
551.1 for disqualification or as a basis for referring the
551.2 individual's maltreatment history to a health-related licensing
551.3 board under section 245A.04, subdivision 3d, paragraph (b).
551.4 [EFFECTIVE DATE.] Paragraph (g) of this section is
551.5 effective the day following final enactment. Paragraphs (a),
551.6 (b), (e), and (f) are effective January 1, 2002.
551.7 Sec. 34. Minnesota Statutes 2000, section 626.5572,
551.8 subdivision 17, is amended to read:
551.9 Subd. 17. [NEGLECT.] "Neglect" means:
551.10 (a) The failure or omission by a caregiver to supply a
551.11 vulnerable adult with care or services, including but not
551.12 limited to, food, clothing, shelter, health care, or supervision
551.13 which is:
551.14 (1) reasonable and necessary to obtain or maintain the
551.15 vulnerable adult's physical or mental health or safety,
551.16 considering the physical and mental capacity or dysfunction of
551.17 the vulnerable adult; and
551.18 (2) which is not the result of an accident or therapeutic
551.19 conduct.
551.20 (b) The absence or likelihood of absence of care or
551.21 services, including but not limited to, food, clothing, shelter,
551.22 health care, or supervision necessary to maintain the physical
551.23 and mental health of the vulnerable adult which a reasonable
551.24 person would deem essential to obtain or maintain the vulnerable
551.25 adult's health, safety, or comfort considering the physical or
551.26 mental capacity or dysfunction of the vulnerable adult.
551.27 (c) For purposes of this section, a vulnerable adult is not
551.28 neglected for the sole reason that:
551.29 (1) the vulnerable adult or a person with authority to make
551.30 health care decisions for the vulnerable adult under sections
551.31 144.651, 144A.44, chapter 145B, 145C, or 252A, or section
551.32 253B.03, or 525.539 to 525.6199, refuses consent or withdraws
551.33 consent, consistent with that authority and within the boundary
551.34 of reasonable medical practice, to any therapeutic conduct,
551.35 including any care, service, or procedure to diagnose, maintain,
551.36 or treat the physical or mental condition of the vulnerable
552.1 adult, or, where permitted under law, to provide nutrition and
552.2 hydration parenterally or through intubation; this paragraph
552.3 does not enlarge or diminish rights otherwise held under law by:
552.4 (i) a vulnerable adult or a person acting on behalf of a
552.5 vulnerable adult, including an involved family member, to
552.6 consent to or refuse consent for therapeutic conduct; or
552.7 (ii) a caregiver to offer or provide or refuse to offer or
552.8 provide therapeutic conduct; or
552.9 (2) the vulnerable adult, a person with authority to make
552.10 health care decisions for the vulnerable adult, or a caregiver
552.11 in good faith selects and depends upon spiritual means or prayer
552.12 for treatment or care of disease or remedial care of the
552.13 vulnerable adult in lieu of medical care, provided that this is
552.14 consistent with the prior practice or belief of the vulnerable
552.15 adult or with the expressed intentions of the vulnerable adult;
552.16 (3) the vulnerable adult, who is not impaired in judgment
552.17 or capacity by mental or emotional dysfunction or undue
552.18 influence, engages in sexual contact with:
552.19 (i) a person including a facility staff person when a
552.20 consensual sexual personal relationship existed prior to the
552.21 caregiving relationship; or
552.22 (ii) a personal care attendant, regardless of whether the
552.23 consensual sexual personal relationship existed prior to the
552.24 caregiving relationship; or
552.25 (4) an individual makes an error in the provision of
552.26 therapeutic conduct to a vulnerable adult which: (i) does not
552.27 result in injury or harm which reasonably requires medical or
552.28 mental health care; or, if it reasonably requires care,
552.29 (5) an individual makes an error in the provision of
552.30 therapeutic conduct to a vulnerable adult that results in injury
552.31 or harm which reasonably requires the care of a physician; and:
552.32 (i) the necessary care is sought and provided in a timely
552.33 fashion as dictated by the condition of the vulnerable adult;
552.34 and (ii) the injury or harm that required care does not result
552.35 in substantial acute, or chronic injury or illness, or permanent
552.36 disability above and beyond the vulnerable adult's preexisting
553.1 condition;
553.2 (ii) is (iii) the error is not part of a pattern of errors
553.3 by the individual;
553.4 (iv) if in a facility, the error is immediately reported as
553.5 required under section 626.557, and recorded internally by the
553.6 employee or person providing services in the facility in order
553.7 to evaluate and identify corrective action;
553.8 (v) if in a facility, the facility identifies and takes
553.9 corrective action and implements measures designed to reduce the
553.10 risk of further occurrence of this error and similar errors; and
553.11 (iii) is (vi) if in a facility, the actions required under
553.12 items (iv) and (v) are sufficiently documented for review and
553.13 evaluation by the facility and any applicable licensing,
553.14 certification, and ombudsman agency; and.
553.15 (iv) is not part of a pattern of errors by the individual.
553.16 (d) Nothing in this definition requires a caregiver, if
553.17 regulated, to provide services in excess of those required by
553.18 the caregiver's license, certification, registration, or other
553.19 regulation.
553.20 (e) If the findings of an investigation by a lead agency
553.21 result in a determination of substantiated maltreatment for the
553.22 sole reason that the actions required of a facility under
553.23 paragraph (c), clause (5), item (iv), (v), or (vi), were not
553.24 taken, then the facility is subject to a correction order. This
553.25 must not alter the lead agency's determination of mitigating
553.26 factors under section 626.557, subdivision 9c, paragraph (c).
553.27 [EFFECTIVE DATE.] This section is effective the day
553.28 following final enactment.
553.29 Sec. 35. Minnesota Statutes 2000, section 626.559,
553.30 subdivision 2, is amended to read:
553.31 Subd. 2. [JOINT TRAINING.] The commissioners of human
553.32 services and public safety shall cooperate in the development of
553.33 a joint program for training child abuse services professionals
553.34 in the appropriate techniques for child abuse assessment and
553.35 investigation. The program shall include but need not be
553.36 limited to the following areas:
554.1 (1) the public policy goals of the state as set forth in
554.2 section 260C.001 and the role of the assessment or investigation
554.3 in meeting these goals;
554.4 (2) the special duties of child protection workers and law
554.5 enforcement officers under section 626.556;
554.6 (3) the appropriate methods for directing and managing
554.7 affiliated professionals who may be utilized in providing
554.8 protective services and strengthening family ties;
554.9 (4) the appropriate methods for interviewing alleged
554.10 victims of child abuse and other minors in the course of
554.11 performing an assessment or an investigation;
554.12 (5) the dynamics of child abuse and neglect within family
554.13 systems and the appropriate methods for interviewing parents in
554.14 the course of the assessment or investigation, including
554.15 training in recognizing cases in which one of the parents is a
554.16 victim of domestic abuse and in need of special legal or medical
554.17 services;
554.18 (6) the legal, evidentiary considerations that may be
554.19 relevant to the conduct of an assessment or an investigation;
554.20 (7) the circumstances under which it is appropriate to
554.21 remove the alleged abuser or the alleged victim from the home;
554.22 (8) the protective social services that are available to
554.23 protect alleged victims from further abuse, to prevent child
554.24 abuse and domestic abuse, and to preserve the family unit, and
554.25 training in the preparation of case plans to coordinate services
554.26 for the alleged child abuse victim with services for any parents
554.27 who are victims of domestic abuse; and
554.28 (9) the methods by which child protection workers and law
554.29 enforcement workers cooperate in conducting assessments and
554.30 investigations in order to avoid duplication of efforts; and
554.31 (10) appropriate methods for interviewing alleged victims
554.32 of child abuse and conducting investigations in cases where the
554.33 alleged victim is developmentally, physically, or mentally
554.34 disabled.
554.35 [EFFECTIVE DATE.] This section is effective July 1, 2001.
554.36 Sec. 36. [FEDERAL LAW CHANGE REQUEST OR WAIVER.]
555.1 The commissioner of health or human services, whichever is
555.2 appropriate, shall pursue changes to federal law necessary to
555.3 allow greater discretion on disciplinary activities of
555.4 unlicensed health care workers and apply for necessary federal
555.5 waivers or approval that would allow for a set-aside process
555.6 related to disqualifications for nurse aides in nursing homes by
555.7 July 1, 2002.
555.8 [EFFECTIVE DATE.] This section is effective July 1, 2001.
555.9 Sec. 37. [WAIVER FROM FEDERAL RULES AND REGULATIONS.]
555.10 By January 2002, the commissioner of health shall work with
555.11 providers to examine federal rules and regulations prohibiting
555.12 neglect, abuse, and financial exploitation of residents in
555.13 licensed nursing facilities and shall apply for federal waivers
555.14 to:
555.15 (1) allow the use of Minnesota Statutes, section 626.5572,
555.16 to control the identification and prevention of maltreatment of
555.17 residents in licensed nursing facilities, rather than the
555.18 definitions under federal rules and regulations; and
555.19 (2) allow the use of Minnesota Statutes, sections 214.104,
555.20 245A.04, and 626.557 to control the disqualification or
555.21 discipline of any persons providing services to residents in
555.22 licensed nursing facilities, rather than the nurse aide registry
555.23 or other exclusionary provisions of federal rules and
555.24 regulations.
555.25 [EFFECTIVE DATE.] This section is effective July 1, 2001.
555.26 ARTICLE 12
555.27 MISCELLANEOUS
555.28 Section 1. Minnesota Statutes 2000, section 144.1222, is
555.29 amended by adding a subdivision to read:
555.30 Subd. 2a. [POOLS AT FAMILY DAY CARE OR GROUP FAMILY DAY
555.31 CARE HOMES.] Notwithstanding Minnesota Rules, part 4717.0250,
555.32 subpart 8, a pool that is located at a family day care or group
555.33 family day care home licensed under Minnesota Rules, chapter
555.34 9502, shall not be considered a public pool, and is exempt from
555.35 the requirements for public pools in Minnesota Rules, parts
555.36 4717.0150 to 4717.3975. If the provider chooses to allow
556.1 children cared for at the family day care or group family day
556.2 care home to use the pool located at the home, the provider must
556.3 satisfy the requirements in section 245A.14, subdivision 10.
556.4 Sec. 2. Minnesota Statutes 2000, section 148B.21,
556.5 subdivision 6a, is amended to read:
556.6 Subd. 6a. [BACKGROUND CHECKS.] The board shall request a
556.7 criminal history background check from the superintendent of the
556.8 bureau of criminal apprehension on all applicants for initial
556.9 licensure. An application for a license under this section must
556.10 be accompanied by an executed criminal history consent form and
556.11 the fee for conducting the criminal history background
556.12 check. The board shall deposit all fees paid by applicants for
556.13 criminal history background checks under this subdivision into
556.14 the miscellaneous special revenue fund and shall reimburse the
556.15 bureau of criminal apprehension for the cost of the background
556.16 checks upon their completion.
556.17 Sec. 3. Minnesota Statutes 2000, section 148B.22,
556.18 subdivision 3, is amended to read:
556.19 Subd. 3. [BACKGROUND CHECKS.] The board shall request a
556.20 criminal history background check from the superintendent of the
556.21 bureau of criminal apprehension on all licensees under its
556.22 jurisdiction who did not complete a criminal history background
556.23 check as part of an application for initial licensure. This
556.24 background check is a one-time requirement. An application for
556.25 a license under this section must be accompanied by an executed
556.26 criminal history consent form and the fee for conducting the
556.27 criminal history background check. The board shall deposit all
556.28 fees paid by licensees for criminal history background checks
556.29 under this subdivision into the miscellaneous special revenue
556.30 fund and shall reimburse the bureau of criminal apprehension for
556.31 the cost of the background checks upon their completion.
556.32 Sec. 4. Minnesota Statutes 2000, section 245A.14, is
556.33 amended by adding a subdivision to read:
556.34 Subd. 10. [SWIMMING POOLS; FAMILY DAY CARE AND GROUP
556.35 FAMILY DAY CARE PROVIDERS.] (a) This subdivision governs pools
556.36 located at family day care or group family day care homes
557.1 licensed under Minnesota Rules, chapter 9502. This subdivision
557.2 does not apply to portable wading pools or whirlpools located at
557.3 family day care or group family day care homes licensed under
557.4 Minnesota Rules, chapter 9502. For a provider to be eligible to
557.5 allow a child cared for at the family day care or group family
557.6 day care home to use the pool located at the home, the provider
557.7 must not have had a licensing sanction under section 245A.07 or
557.8 a correction order or fine under section 245A.06 relating to the
557.9 supervision or health and safety of children substantiated by
557.10 the county agency during the prior 24 months, and must satisfy
557.11 the following requirements:
557.12 (1) obtain written consent from a child's parent or legal
557.13 guardian allowing the child to use the pool, and renew the
557.14 parent's or legal guardian's written consent at least annually.
557.15 The written consent must include a statement that the parent or
557.16 legal guardian has received and read materials provided by the
557.17 department of health to the department of human services for
557.18 distribution to all family day care or group family day care
557.19 homes related to the risk of disease transmission as well as
557.20 other health risks associated with swimming pools. The written
557.21 consent must also include a statement that the department of
557.22 health and county agency will not monitor or inspect the
557.23 provider's swimming pool to ensure compliance with the
557.24 requirements in this subdivision;
557.25 (2) enter into a written contract with a child's parent or
557.26 legal guardian, and renew the written contract annually. The
557.27 terms of the written contract must specify that the provider
557.28 agrees to perform all of the requirements in this subdivision;
557.29 (3) attend and successfully complete a pool operator
557.30 training course once every five years. Acceptable training
557.31 courses are:
557.32 (i) the National Swimming Pool Foundation Certified Pool
557.33 Operator course;
557.34 (ii) the National Spa and Pool Institute Tech I and Tech II
557.35 courses (both required); or
557.36 (iii) the National Recreation and Park Association Aquatic
558.1 Facility Operator course;
558.2 (4) require a caregiver trained in first aid and adult and
558.3 child cardiopulmonary resuscitation to supervise and be present
558.4 at the pool with any children in the pool;
558.5 (5) toilet all potty-trained children before they enter the
558.6 pool;
558.7 (6) require all children who are not potty-trained to wear
558.8 swim diapers while in the pool;
558.9 (7) if fecal material enters the pool water, add three
558.10 times the normal shock treatment to the pool water to raise the
558.11 chlorine level to at least 20 parts per million, and close the
558.12 pool to swimming for the 24 hours following the entrance of
558.13 fecal material into the water or until the water pH and
558.14 disinfectant concentration levels have returned to the standards
558.15 specified in clause (9), whichever is later;
558.16 (8) prevent any child from entering the pool who has an
558.17 open wound or any child who has or is suspected of having a
558.18 communicable disease;
558.19 (9) maintain the pool water at a pH of not less than 7.2
558.20 and not more than 8.0, maintain the disinfectant concentration
558.21 between two and five parts per million for chlorine or between
558.22 2.3 and 4.5 parts per million for bromine, and maintain a daily
558.23 record of the pool's operation with pH and disinfectant
558.24 concentration readings on days when children cared for at the
558.25 family day care or group family day care home are present;
558.26 (10) have a disinfectant feeder or feeders;
558.27 (11) have a recirculation system that will clarify and
558.28 disinfect the pool volume of water in ten hours or less;
558.29 (12) maintain the pool's water clarity so that an object on
558.30 the pool floor at the pool's deepest point is easily visible;
558.31 (13) have two or more suction lines in the pool;
558.32 (14) have in place and enforce written safety rules and
558.33 pool policies;
558.34 (15) prohibit diving;
558.35 (16) prohibit pushing or rough play in the pool area;
558.36 (17) have in place at all times a safety rope that divides
559.1 the shallow and deep portions of the pool;
559.2 (18) satisfy any existing local ordinances regarding pool
559.3 installation, decks, and fencing;
559.4 (19) maintain a water temperature of not more than 104
559.5 degrees Fahrenheit and not less than 70 degrees Fahrenheit; and
559.6 (20) for lifesaving equipment, have a United States Coast
559.7 Guard-approved life ring attached to a rope, an exit ladder, and
559.8 a shepherd's hook available at all times to the caregiver
559.9 supervising the pool.
559.10 (b) A violation of this subdivision is grounds for a
559.11 sanction under section 245A.07, or a correction order or fine
559.12 under section 245A.06. If a provider under this subdivision
559.13 receives a licensing sanction or a correction order or fine
559.14 relating to the supervision or health and safety of children,
559.15 the provider is prohibited from allowing a child cared for at
559.16 the family day care or group family day care home to continue to
559.17 use the pool located at the home.
559.18 Sec. 5. Minnesota Statutes 2000, section 246.57, is
559.19 amended by adding a subdivision to read:
559.20 Subd. 7. [SHARED SERVICES ACCOUNT.] Notwithstanding
559.21 subdivision 1, beginning July 1, 2001, $6,000,000 each biennium
559.22 is transferred from the shared services account into which
559.23 receipts for shared services under subdivision 1 are deposited
559.24 to the general fund. This subdivision expires June 30, 2005.
559.25 Sec. 6. Minnesota Statutes 2000, section 252A.02, is
559.26 amended by adding a subdivision to read:
559.27 Subd. 3a. [GUARDIANSHIP SERVICE PROVIDERS.] "Guardianship
559.28 service providers" are individuals or agencies that meet the
559.29 ethical conduct and best practice standards of the National
559.30 Guardianship Association, meet the criminal background check
559.31 requirements of section 245A.04, and do not provide any other
559.32 services to the individuals for whom guardianship services are
559.33 provided.
559.34 Sec. 7. Minnesota Statutes 2000, section 252A.02,
559.35 subdivision 12, is amended to read:
559.36 Subd. 12. [COMPREHENSIVE EVALUATION.] "Comprehensive
560.1 evaluation" shall consist of:
560.2 (1) a medical report on the health status and physical
560.3 condition of the proposed ward, prepared under the direction of
560.4 a licensed physician;
560.5 (2) a report on the proposed ward's intellectual capacity
560.6 and functional abilities, specifying the tests and other data
560.7 used in reaching its conclusions, prepared by a psychologist who
560.8 is qualified in the diagnosis of mental retardation; and
560.9 (3) a report from the case manager that includes:
560.10 (i) the most current assessment of individual service needs
560.11 as described in rules of the commissioner;
560.12 (ii) the most current individual service plan as described
560.13 in rules of the commissioner under section 256B.092, subdivision
560.14 1b; and
560.15 (iii) a description of contacts with and responses of near
560.16 relatives of the proposed ward notifying them that a nomination
560.17 for public guardianship has been made and advising them that
560.18 they may seek private guardianship.
560.19 Each report shall contain recommendations as to the amount
560.20 of assistance and supervision required by the proposed ward to
560.21 function as independently as possible in society. To be
560.22 considered part of the comprehensive evaluation, reports must be
560.23 completed no more than one year before filing the petition under
560.24 section 252A.05.
560.25 Sec. 8. Minnesota Statutes 2000, section 252A.02,
560.26 subdivision 13, is amended to read:
560.27 Subd. 13. [CASE MANAGER.] "Case manager" means the person
560.28 designated by the county board under rules of the commissioner
560.29 to provide case management services under section 256B.092.
560.30 Sec. 9. Minnesota Statutes 2000, section 252A.111,
560.31 subdivision 6, is amended to read:
560.32 Subd. 6. [SPECIAL DUTIES.] In exercising powers and duties
560.33 under this chapter, the commissioner shall:
560.34 (1) maintain close contact with the ward, visiting at least
560.35 twice a year;
560.36 (2) prohibit filming a ward in any way that would reveal
561.1 the identity of the ward unless the commissioner determines the
561.2 filming to be in the best interests of the ward. The
561.3 commissioner may give written consent for filming of the ward
561.4 after permitting and encouraging input by the nearest relative
561.5 protect and exercise the legal rights of the ward;
561.6 (3) take actions and make decisions on behalf of the ward
561.7 that encourage and allow the maximum level of independent
561.8 functioning in a manner least restrictive of the ward's personal
561.9 freedom consistent with the need for supervision and protection;
561.10 and
561.11 (4) permit and encourage maximum self-reliance on the part
561.12 of the ward and permit and encourage input by the nearest
561.13 relative of the ward in planning and decision making on behalf
561.14 of the ward.
561.15 Sec. 10. Minnesota Statutes 2000, section 252A.16,
561.16 subdivision 1, is amended to read:
561.17 Subdivision 1. [REVIEW REQUIRED.] The commissioner
561.18 shall provide require an annual review of the physical, mental,
561.19 and social adjustment and progress of every ward and
561.20 conservatee. A copy of this review shall be kept on file at the
561.21 department of human services and may be inspected by the ward or
561.22 conservatee, the ward's or conservatee's parents, spouse, or
561.23 relatives and other persons who receive the permission of the
561.24 commissioner. The review shall contain information required
561.25 under rules of the commissioner Minnesota Rules, part 9525.3065,
561.26 subpart 1.
561.27 Sec. 11. Minnesota Statutes 2000, section 252A.19,
561.28 subdivision 2, is amended to read:
561.29 Subd. 2. [PETITION.] The commissioner, ward, or any
561.30 interested person may petition the appointing court or the court
561.31 to which venue has been transferred for an order to remove the
561.32 guardianship or to limit or expand the powers of the
561.33 conservatorship or to appoint a guardian or conservator under
561.34 sections 525.539 to 525.705 or to restore the ward or
561.35 conservatee to full legal capacity or to review de novo any
561.36 decision made by the public guardian or public conservator for
562.1 or on behalf of a ward or conservatee or for any other order as
562.2 the court may deem just and equitable. Section 525.61,
562.3 subdivision 3, does not apply to a petition to remove a public
562.4 guardian.
562.5 Sec. 12. Minnesota Statutes 2000, section 252A.20,
562.6 subdivision 1, is amended to read:
562.7 Subdivision 1. [WITNESS AND ATTORNEY FEES.] In each
562.8 proceeding under sections 252A.01 to 252A.21, the court shall
562.9 allow and order paid to each witness subpoenaed the fees and
562.10 mileage prescribed by law; to each physician, psychologist, or
562.11 social worker who assists in the preparation of the
562.12 comprehensive evaluation and who is not in the employ of the
562.13 local agency, or the state department of human services, or area
562.14 mental health-mental retardation board, a reasonable sum for
562.15 services and for travel; and to the ward's counsel, when
562.16 appointed by the court, a reasonable sum for travel and for each
562.17 day or portion of a day actually employed in court or actually
562.18 consumed in preparing for the hearing. Upon order the county
562.19 auditor shall issue a warrant on the county treasurer for
562.20 payment of the amount allowed.
562.21 Sec. 13. Minnesota Statutes 2000, section 256.482,
562.22 subdivision 8, is amended to read:
562.23 Subd. 8. [SUNSET.] Notwithstanding section 15.059,
562.24 subdivision 5, the council on disability shall not sunset until
562.25 June 30, 2001 2005.
562.26 Sec. 14. [260.0121] [PRIOR INVOLUNTARY TERMINATION OF
562.27 PARENTAL RIGHTS.]
562.28 In addition to the circumstances listed in section 260.012,
562.29 paragraph (a), clause (1) under which reasonable efforts for
562.30 rehabilitation and reunification are not required, reasonable
562.31 efforts for rehabilitation and reunification are also not
562.32 required upon a determination by the court that a termination of
562.33 parental rights petition has been filed stating a prima facie
562.34 case that the parent's custodial rights to another child have
562.35 been involuntarily transferred to a relative under section
562.36 260C.201, subdivision 11, paragraph (e), clause (1), or a
563.1 similar law of another jurisdiction.
563.2 Sec. 15. Minnesota Statutes 2000, section 260C.307,
563.3 subdivision 3, is amended to read:
563.4 Subd. 3. [NOTICE.] The court shall have notice of the
563.5 time, place, and purpose of the hearing served on the parents,
563.6 as defined in sections 257.51 to 257.74 or 259.49, subdivision
563.7 1, clause (2), and upon the child's grandparent if the child has
563.8 lived with the grandparent within the two years immediately
563.9 preceding the filing of the petition. Notice must be served in
563.10 the manner provided in sections 260C.151 and 260C.152, except
563.11 that personal service shall be made at least ten days before the
563.12 day of the hearing. Published notice shall be made for three
563.13 weeks, the last publication to be at least ten days before the
563.14 day of the hearing; and notice sent by certified mail shall be
563.15 mailed at least 20 days before the day of the hearing. A parent
563.16 who consents to the termination of parental rights under the
563.17 provisions of section 260C.301, subdivision 2, clause (a), may
563.18 waive in writing the notice required by this subdivision;
563.19 however, if the parent is a minor or incompetent the waiver
563.20 shall be effective only if the parent's guardian ad litem
563.21 concurs in writing.
563.22 Sec. 16. Minnesota Statutes 2000, section 260C.301, is
563.23 amended by adding a subdivision to read:
563.24 Subd. 3a. ADDITIONAL GROUND FOR REQUIRED TERMINATION OF
563.25 PARENTAL RIGHTS.] In addition to the grounds listed in
563.26 subdivision 3, paragraph (a), the county attorney shall file a
563.27 termination of parental rights petition within 30 days of the
563.28 responsible social services agency determining that the parent
563.29 has lost parental rights to another child through an order
563.30 involuntarily terminating the parent's rights, or another child
563.31 of the parent is the subject of an order transferring permanent
563.32 legal and physical custody of the child to a relative under
563.33 section 260C.201, subdivision 11, paragraph (e), clause (1), or
563.34 a similar law of another jurisdiction.
563.35 Sec. 17. Minnesota Statutes 2000, section 260C.301, is
563.36 amended by adding a subdivision to read:
564.1 Subd. 1a. [ADDITIONAL FACTOR UPON WHICH PARENTAL RIGHTS
564.2 MAY BE TERMINATED.] In addition to the presumptions upon which
564.3 parental rights may be terminated that are listed in subdivision
564.4 1, paragraph (b), clause (4), it is presumed that a parent is
564.5 palpably unfit to be a party to the parent and child
564.6 relationship upon a showing that the parent's custodial rights
564.7 to another child have been involuntarily transferred to a
564.8 relative under section 260C.201, subdivision 11, paragraph (e),
564.9 clause (1), or a similar law of another jurisdiction.
564.10 Sec. 18. Minnesota Statutes 2000, section 260C.317, is
564.11 amended by adding a subdivision to read:
564.12 Subd. 5. [GRANDPARENT VISITATION.] In all proceedings for
564.13 termination of parental rights, after notification of a
564.14 grandparent under section 260C.307, subdivision 3, or at any
564.15 time after completion of the proceeding and continuing during
564.16 the minority of the child, a grandparent may seek an order of
564.17 the court granting visitation rights to the grandparent under
564.18 section 257.022, subdivision 2.
564.19 [EFFECTIVE DATE.] This section applies to proceedings
564.20 commenced or completed before the effective date of this section.
564.21 Sec. 19. [PUBLIC GUARDIANSHIP ALTERNATIVES.]
564.22 The commissioner of human services shall provide county
564.23 agencies with funds up to the amount appropriated for public
564.24 guardianship alternatives based on proposals by the counties to
564.25 establish private alternatives.
564.26 Sec. 20. [AUTOMATIC DEFIBRILLATOR STUDY.]
564.27 The emergency medical services regulatory board, in
564.28 consultation with the department of public safety, shall study
564.29 and report to the legislature by December 15, 2002, regarding
564.30 the availability of automatic defibrillators outside the
564.31 seven-county metropolitan area. The report shall include
564.32 recommendations to make these devices accessible within a
564.33 reasonable distance throughout the nonmetropolitan area,
564.34 including recommendations for funding their acquisition and
564.35 distribution.
564.36 Sec. 21. [AH-GWAH-CHING CENTER.]
565.1 The commissioner of human services and the Cass county
565.2 board of commissioners, in consultation with the commissioner of
565.3 administration, shall evaluate the feasibility of allowing Cass
565.4 county to buy or lease unused portions of Ah-Gwah-Ching center.
565.5 The commissioner shall present the results of this evaluation
565.6 and recommendations to the chairs of the house and senate
565.7 committees with jurisdiction over health and human services
565.8 policy and finance.
565.9 Sec. 22. [STUDY OF OUTCOMES FOR CHILDREN IN THE CHILD
565.10 PROTECTION SYSTEM.]
565.11 (a) The commissioner of human services, in consultation
565.12 with local social services agencies, councils of color,
565.13 representatives of communities of color, and other interested
565.14 parties, shall study why African American children in Minnesota
565.15 are disproportionately represented in out-of-home placements.
565.16 The commissioner also shall study each stage of the proceedings
565.17 concerning children in need of protection or services, including
565.18 the point at which children enter the child welfare system, each
565.19 decision-making point in the child welfare system, and the
565.20 outcomes for children in the child welfare system, to determine
565.21 why outcomes for children differ by race. The commissioner
565.22 shall use child welfare performance and outcome indicators and
565.23 data and other available data as part of this study. The
565.24 commissioner also shall study and determine if there are
565.25 decision-making points in the child welfare system that lead to
565.26 different outcomes for children and how those decision-making
565.27 points affect outcomes for children. The commissioner shall
565.28 report and make legislative recommendations on the following:
565.29 (1) amending the child welfare statutes to reduce any
565.30 identified disparities in the child welfare system relating to
565.31 outcomes for children of color, as compared to white children;
565.32 (2) reducing any identified bias in the child welfare
565.33 system;
565.34 (3) reducing the number and duration of out-of-home
565.35 placements for African American children; and
565.36 (4) improving the long-term outcomes for African American
566.1 children in out-of-home placements.
566.2 (b) The commissioner of human services shall submit the
566.3 report and recommended legislation to the chairs and ranking
566.4 minority members of the committees in the house of
566.5 representatives and senate with jurisdiction over child
566.6 protection and out-of-home placement issues by January 15, 2002.
566.7 Sec. 23. [BOARD OF NURSING FEES.]
566.8 Fee modifications proposed by the governor for the board of
566.9 nursing in the 2002-2003 health and human services biennial
566.10 budget document are approved.
566.11 Sec. 24. [BOARD OF MARRIAGE AND FAMILY THERAPY FEES.]
566.12 Fee increases and new fees proposed by the governor for the
566.13 board of marriage and family therapy in the 2002-2003 health and
566.14 human services biennial budget document are approved.
566.15 Sec. 25. [REPEALER.]
566.16 Minnesota Statutes 2000, section 252A.111, subdivision 3,
566.17 is repealed.
566.18 ARTICLE 13
566.19 APPROPRIATIONS
566.20 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.]
566.21 The sums shown in the columns marked "APPROPRIATIONS" are
566.22 appropriated from the general fund, or any other named fund, to
566.23 the agencies and for the purposes specified in the following
566.24 sections of this article, to be available for the fiscal years
566.25 indicated for each purpose. The figures "2002" and "2003" where
566.26 used in this article, mean that the appropriation or
566.27 appropriations listed under them are available for the fiscal
566.28 year ending June 30, 2002, or June 30, 2003, respectively.
566.29 Where a dollar amount appears in parentheses, it means a
566.30 reduction of an appropriation.
566.31 SUMMARY BY FUND
566.32 APPROPRIATIONS BIENNIAL
566.33 2002 2003 TOTAL
566.34 General $3,083,463,000 $3,390,947,000 $6,474,410,000
566.35 State Government
566.36 Special Revenue 35,451,000 37,127,000 72,578,000
566.37 Health Care
567.1 Access 214,712,000 269,923,000 484,635,000
567.2 Federal TANF 318,103,000 277,420,000 595,523,000
567.3 Lottery Cash Flow 1,300,000 1,300,000 2,600,000
567.4 TOTAL $3,653,029,000 $3,976,717,000 $7,629,746,000
567.5 APPROPRIATIONS
567.6 Available for the Year
567.7 Ending June 30
567.8 2002 2003
567.9 Sec. 2. COMMISSIONER OF
567.10 HUMAN SERVICES
567.11 Subdivision 1. Total
567.12 Appropriation $3,475,621,000 $3,799,990,000
567.13 Summary by Fund
567.14 General 2,962,827,000 3,272,668,000
567.15 State Government
567.16 Special Revenue 507,000 507,000
567.17 Health Care
567.18 Access 207,884,000 263,095,000
567.19 Federal TANF 303,103,000 262,420,000
567.20 Lottery Cash Flow 1,300,000 1,300,000
567.21 [APPROPRIATION FOR COURT-ORDERED MENTAL
567.22 HEALTH TREATMENT.] Of the general fund
567.23 appropriation, $2,289,000 in fiscal
567.24 year 2002 and $2,289,000 in fiscal year
567.25 2003 are for the cost of implementing
567.26 H.F. 560, if enacted. This
567.27 appropriation is available only if H.F.
567.28 560 is enacted.
567.29 [APPROPRIATIONS FOR CIVIL COMMITMENT.]
567.30 (a) Of the general fund appropriation,
567.31 $3,386,000 in fiscal year 2003 is for
567.32 the cost of implementing H.F. 281, if
567.33 enacted. This appropriation is
567.34 available only if H.F. 281 is enacted.
567.35 (b) Of the general fund appropriation,
567.36 $155,000 in fiscal year 2003 is
567.37 appropriated to the commissioner to be
567.38 transferred to the Minnesota supreme
567.39 court for costs associated with
567.40 petitions filed for judicial
567.41 commitment. This appropriation is
567.42 available only if H.F. 281 is enacted.
567.43 [APPROPRIATIONS FOR CHILD SUPPORT.] (1)
567.44 Of the general fund appropriation,
567.45 $32,000 in fiscal year 2002 and $32,000
567.46 in fiscal year 2003 are for the cost of
567.47 implementing H.F. 1807, if enacted.
567.48 This appropriation is available only if
567.49 H.F. 1807 is enacted.
567.50 (2) Of the general fund appropriation,
567.51 $435,000 in fiscal year 2002 is for the
567.52 cost of implementing H.F. 1446, if
567.53 enacted. This appropriation is
567.54 available only if H.F. 1446 is enacted.
568.1 [APPROPRIATION FOR PATIENT
568.2 PROTECTIONS.] (a) Of the general fund
568.3 appropriation, $248,000 in fiscal year
568.4 2002 and $591,000 in fiscal year 2003
568.5 are for the cost of implementing the
568.6 patient protection provisions in H.F.
568.7 560, if enacted. This appropriation is
568.8 available only if H.F. 560 is enacted.
568.9 (b) Of the health care access fund
568.10 appropriation, $106,000 in fiscal year
568.11 2002 and $255,000 in fiscal year 2003
568.12 are for the cost of implementing H.F.
568.13 560, if enacted. This appropriation is
568.14 available only if H.F. 560 is enacted.
568.15 [RECEIPTS FOR SYSTEMS PROJECTS.]
568.16 Appropriations and federal receipts for
568.17 information system projects for MAXIS,
568.18 PRISM, MMIS, and SSIS must be deposited
568.19 in the state system account authorized
568.20 in Minnesota Statutes, section
568.21 256.014. Money appropriated for
568.22 computer projects approved by the
568.23 Minnesota office of technology, funded
568.24 by the legislature, and approved by the
568.25 commissioner of finance may be
568.26 transferred from one project to another
568.27 and from development to operations as
568.28 the commissioner of human services
568.29 considers necessary. Any unexpended
568.30 balance in the appropriation for these
568.31 projects does not cancel but is
568.32 available for ongoing development and
568.33 operations.
568.34 [GIFTS.] Notwithstanding Minnesota
568.35 Statutes, chapter 7, the commissioner
568.36 may accept on behalf of the state
568.37 additional funding from sources other
568.38 than state funds for the purpose of
568.39 financing the cost of assistance
568.40 program grants or nongrant
568.41 administration. All additional funding
568.42 is appropriated to the commissioner for
568.43 use as designated by the grantor of
568.44 funding.
568.45 [SYSTEMS CONTINUITY.] In the event of
568.46 disruption of technical systems or
568.47 computer operations, the commissioner
568.48 may use available grant appropriations
568.49 to ensure continuity of payments for
568.50 maintaining the health, safety, and
568.51 well-being of clients served by
568.52 programs administered by the department
568.53 of human services. Grant funds must be
568.54 used in a manner consistent with the
568.55 original intent of the appropriation.
568.56 [SPECIAL REVENUE FUND INFORMATION.] On
568.57 December 1, 2001, and December 1, 2002,
568.58 the commissioner shall provide the
568.59 chairs of the house health and human
568.60 services finance committee and the
568.61 senate health, human services, and
568.62 corrections budget division with
568.63 detailed fund balance information for
568.64 each special revenue fund account.
568.65 [FEDERAL ADMINISTRATIVE REIMBURSEMENT.]
569.1 Federal administrative reimbursement
569.2 resulting from MinnesotaCare outreach
569.3 grants and the Minnesota senior health
569.4 options project are appropriated to the
569.5 commissioner for these activities. Any
569.6 balance from this appropriation
569.7 remaining at the end of the biennium
569.8 shall be transferred to the general
569.9 fund.
569.10 [NONFEDERAL SHARE TRANSFERS.] The
569.11 nonfederal share of activities for
569.12 which federal administrative
569.13 reimbursement is appropriated to the
569.14 commissioner may be transferred to the
569.15 special revenue fund. Any balance from
569.16 this appropriation remaining at the end
569.17 of the biennium shall be transferred to
569.18 the general fund.
569.19 [MAJOR SYSTEMS TRANSFER.] (1)
569.20 $21,550,000 of funds available in the
569.21 state systems account authorized in
569.22 Minnesota Statutes, section 256.014, is
569.23 transferred to the general fund for the
569.24 biennium ending June 30, 2003.
569.25 (2) $2,450,000 of funds available in
569.26 the state systems account authorized in
569.27 Minnesota Statutes, section 256.014, is
569.28 transferred to the general fund for the
569.29 biennium ending June 30, 2005.
569.30 Notwithstanding section 13 of this
569.31 article, this rider does not expire on
569.32 June 30, 2003.
569.33 [TANF FUNDS APPROPRIATED TO OTHER
569.34 ENTITIES.] Any expenditures from the
569.35 TANF block grant shall be expended in
569.36 accordance with the requirements and
569.37 limitations of part A of title IV of
569.38 the Social Security Act, as amended,
569.39 and any other applicable federal
569.40 requirement or limitation. Prior to
569.41 any expenditure of these funds, the
569.42 commissioner shall assure that funds
569.43 are expended in compliance with the
569.44 requirements and limitations of federal
569.45 law and that any reporting requirements
569.46 of federal law are met. It shall be
569.47 the responsibility of any entity to
569.48 which these funds are appropriated to
569.49 implement a memorandum of understanding
569.50 with the commissioner that provides the
569.51 necessary assurance of compliance prior
569.52 to any expenditure of funds. The
569.53 commissioner shall receipt TANF funds
569.54 appropriated to other state agencies
569.55 and coordinate all related interagency
569.56 accounting transactions necessary to
569.57 implement these appropriations.
569.58 Unexpended TANF funds appropriated to
569.59 any state, local, or nonprofit entity
569.60 cancel at the end of the state fiscal
569.61 year unless appropriating language
569.62 permits otherwise.
569.63 [TANF FUNDS TRANSFERRED TO OTHER
569.64 FEDERAL GRANTS.] The commissioner must
569.65 authorize transfers from TANF to other
569.66 federal block grants so that funds are
570.1 available to meet the annual
570.2 expenditure needs as appropriated.
570.3 Transfers may be authorized prior to
570.4 the expenditure year with the agreement
570.5 of the receiving entity. Transferred
570.6 funds must be expended in the year for
570.7 which the funds were appropriated
570.8 unless appropriation language permits
570.9 otherwise. In accelerating transfer
570.10 authorizations, the commissioner must
570.11 aim to preserve the future potential
570.12 transfer capacity from TANF to other
570.13 block grants.
570.14 [TANF MAINTENANCE OF EFFORT.] (a) In
570.15 order to meet the basic maintenance of
570.16 effort (MOE) requirements of the TANF
570.17 block grant specified under Code of
570.18 Federal Regulations, title 45, section
570.19 263.1, the commissioner may only report
570.20 nonfederal money expended for allowable
570.21 activities listed in the following
570.22 clauses as TANF MOE expenditures:
570.23 (1) MFIP cash and food assistance
570.24 benefits under Minnesota Statutes,
570.25 chapter 256J;
570.26 (2) the child care assistance programs
570.27 under Minnesota Statutes, sections
570.28 119B.03 and 119B.05, and county child
570.29 care administrative costs under
570.30 Minnesota Statutes, section 119B.15;
570.31 (3) state and county MFIP
570.32 administrative costs under Minnesota
570.33 Statutes, chapters 256J and 256K;
570.34 (4) state, county, and tribal MFIP
570.35 employment services under Minnesota
570.36 Statutes, chapters 256J and 256K; and
570.37 (5) expenditures made on behalf of
570.38 noncitizen MFIP recipients who qualify
570.39 for the medical assistance without
570.40 federal financial participation program
570.41 under Minnesota Statutes, section
570.42 256B.06, subdivision 4, paragraphs (d),
570.43 (e), and (j).
570.44 (b) The commissioner shall ensure that
570.45 sufficient qualified nonfederal
570.46 expenditures are made each year to meet
570.47 the state's TANF MOE requirements. For
570.48 the activities listed in paragraph (a),
570.49 clauses (2) to (5), the commissioner
570.50 may only report expenditures that are
570.51 excluded from the definition of
570.52 assistance under Code of Federal
570.53 Regulations, title 45, section 260.31.
570.54 (c) If nonfederal expenditures for the
570.55 programs and purposes listed in
570.56 paragraph (a) are insufficient to meet
570.57 the state's TANF MOE requirements, the
570.58 commissioner shall recommend additional
570.59 allowable sources of nonfederal
570.60 expenditures to the legislature, if the
570.61 legislature is or will be in session to
570.62 take action to specify additional
570.63 sources of nonfederal expenditures for
571.1 TANF MOE before a federal penalty is
571.2 imposed. The commissioner shall
571.3 otherwise provide notice to the
571.4 legislative commission on planning and
571.5 fiscal policy under paragraph (e).
571.6 (d) If the commissioner uses authority
571.7 granted under Laws 1999, chapter 245,
571.8 article 1, section 10, or similar
571.9 authority granted by a subsequent
571.10 legislature, to meet the state's TANF
571.11 MOE requirements in a reporting period,
571.12 the commissioner shall inform the
571.13 chairs of the appropriate legislative
571.14 committees about all transfers made
571.15 under that authority for this purpose.
571.16 (e) If the commissioner determines that
571.17 nonfederal expenditures under paragraph
571.18 (a) are insufficient to meet TANF MOE
571.19 expenditure requirements, and if the
571.20 legislature is not or will not be in
571.21 session to take timely action to avoid
571.22 a federal penalty, the commissioner may
571.23 report nonfederal expenditures from
571.24 other allowable sources as TANF MOE
571.25 expenditures after the requirements of
571.26 this paragraph are met. The
571.27 commissioner may report nonfederal
571.28 expenditures in addition to those
571.29 specified under paragraph (a) as
571.30 nonfederal TANF MOE expenditures, but
571.31 only ten days after the commissioner of
571.32 finance has first submitted the
571.33 commissioner's recommendations for
571.34 additional allowable sources of
571.35 nonfederal TANF MOE expenditures to the
571.36 members of the legislative commission
571.37 on planning and fiscal policy for their
571.38 review.
571.39 (f) The commissioner of finance shall
571.40 not incorporate any changes in federal
571.41 TANF expenditures or nonfederal
571.42 expenditures for TANF MOE that may
571.43 result from reporting additional
571.44 allowable sources of nonfederal TANF
571.45 MOE expenditures under the interim
571.46 procedures in paragraph (e) into the
571.47 February or November forecasts required
571.48 under Minnesota Statutes, section
571.49 16A.103, unless the commissioner of
571.50 finance has approved the additional
571.51 sources of expenditures under paragraph
571.52 (e).
571.53 (g) The provisions of Minnesota
571.54 Statutes, section 256.011, subdivision
571.55 3, which require that federal grants or
571.56 aids secured or obtained under that
571.57 subdivision be used to reduce any
571.58 direct appropriations provided by law,
571.59 do not apply if the grants or aids are
571.60 federal TANF funds.
571.61 (h) Notwithstanding section 14 of this
571.62 article, paragraphs (a) to (h) expire
571.63 June 30, 2005.
571.64 Subd. 2. Agency Management
572.1 General 34,546,000 33,003,000
572.2 State Government
572.3 Special Revenue 392,000 392,000
572.4 Health Care
572.5 Access 3,591,000 3,602,000
572.6 Federal TANF 546,000 454,000
572.7 The amounts that may be spent from the
572.8 appropriation for each purpose are as
572.9 follows:
572.10 (a) Financial Operations
572.11 General 6,708,000 6,708,000
572.12 Health Care
572.13 Access 803,000 803,000
572.14 Federal TANF 546,000 454,000
572.15 (b) Legal and Regulation Operations
572.16 General 8,728,000 8,337,000
572.17 State Government
572.18 Special Revenue 392,000 392,000
572.19 Health Care
572.20 Access 233,000 244,000
572.21 [CORE LICENSING ACTIVITIES.] Of the
572.22 general fund appropriation, $1,138,000
572.23 in fiscal year 2002 and $923,000 in
572.24 fiscal year 2003 is to support 14 new
572.25 licensor positions. Of this amount,
572.26 $72,000 in fiscal year 2002 and
572.27 $107,000 in fiscal year 2003 is to
572.28 cover maintenance and operational costs
572.29 for a new computer system, which will
572.30 provide public access to licensing
572.31 information. In order to receive
572.32 continued appropriations for these
572.33 purposes, by January 1, 2003, the
572.34 commissioner shall:
572.35 (1) reduce the average length of time
572.36 to complete investigations of licensing
572.37 complaints within 75 days;
572.38 (2) complete all licensing reviews
572.39 within the one-year and two-year
572.40 intervals set forth in statutes; and
572.41 (3) complete negative licensing action
572.42 decisions within 45 days of county
572.43 recommendations.
572.44 [EXPEDITED MALTREATMENT
572.45 INVESTIGATIONS.] Of the general fund
572.46 appropriation, $359,000 in fiscal year
572.47 2002 and $277,000 in fiscal year 2003
572.48 are for one senior investigator
572.49 position, three investigator positions,
572.50 and one-half of a clerical position to
572.51 achieve the goals for expedited
572.52 maltreatment investigations. In order
572.53 to receive continued appropriations for
572.54 this purpose, by January 1, 2003, the
573.1 commissioner shall reduce the average
573.2 length of time to complete maltreatment
573.3 investigations to 60 days.
573.4 [PUBLIC GUARDIANSHIP INCENTIVES.] Of
573.5 the general fund appropriation,
573.6 $250,000 in fiscal year 2002 and
573.7 $250,000 in fiscal year 2003 is to be
573.8 used for the purposes of providing
573.9 fiscal incentives to encourage counties
573.10 to establish private alternatives.
573.11 [CHILD MALTREATMENT REVIEW PANEL.] Of
573.12 the general fund appropriation, $46,000
573.13 in fiscal year 2002 and $32,000 in
573.14 fiscal year 2003 is to establish a
573.15 review panel for purposes of reviewing
573.16 investigating agency determinations
573.17 regarding maltreatment of a child in a
573.18 facility in response to requests
573.19 received under Minnesota Statutes,
573.20 section 626.556, subdivision 10i,
573.21 paragraph (b).
573.22 (c) Management Operations
573.23 General 19,110,000 17,958,000
573.24 Health Care
573.25 Access 2,555,000 2,555,000
573.26 Subd. 3. Administrative Reimbursement/
573.27 Pass Through
573.28 Federal TANF 60,565 51,992
573.29 Subd. 4. Children's Services Grants
573.30 General 59,320,000 59,833,000
573.31 Federal TANF 6,290,000 6,290,000
573.32 [ADOPTION ASSISTANCE INCENTIVE GRANTS.]
573.33 Federal funds available during fiscal
573.34 year 2002 and fiscal year 2003, for
573.35 adoption incentive grants are
573.36 appropriated to the commissioner for
573.37 these purposes.
573.38 [TANF TRANSFER TO SOCIAL SERVICES.]
573.39 $4,650,000 is appropriated to the
573.40 commissioner in fiscal year 2002 and in
573.41 fiscal year 2003 for purposes of
573.42 increasing services for families with
573.43 children whose incomes are at or below
573.44 200 percent of the federal poverty
573.45 guidelines. The commissioner shall
573.46 authorize a sufficient transfer of
573.47 funds from the state's federal TANF
573.48 block grant to the state's federal
573.49 social services block grant to meet
573.50 this appropriation.
573.51 [SOCIAL SERVICES BLOCK GRANT FUNDS FOR
573.52 CONCURRENT PERMANENCY PLANNING.]
573.53 Notwithstanding Minnesota Statutes,
573.54 section 256E.07, $4,650,000 in fiscal
573.55 year 2002 and $4,650,000 in fiscal year
573.56 2003 in social services block grant
573.57 funds allocated to the commissioner
573.58 under title XX of the Social Security
574.1 Act are available for distribution to
574.2 counties under the formula in Minnesota
574.3 Statutes, section 260C.213, for the
574.4 purposes of concurrent permanency
574.5 planning.
574.6 Subd. 5. Children's Services Management
574.7 General 4,880,000 4,252,000
574.8 Subd. 6. Basic Health Care Grants
574.9 Summary by Fund
574.10 General 1,114,020,000 1,317,641,000
574.11 Health Care
574.12 Access 189,392,000 244,592,000
574.13 The amounts that may be spent from this
574.14 appropriation for each purpose are as
574.15 follows:
574.16 (a) MinnesotaCare Grants
574.17 Health Care
574.18 Access 188,642,000 243,842,000
574.19 [MINNESOTACARE FEDERAL RECEIPTS.]
574.20 Receipts received as a result of
574.21 federal participation pertaining to
574.22 administrative costs of the Minnesota
574.23 health care reform waiver shall be
574.24 deposited as nondedicated revenue in
574.25 the health care access fund. Receipts
574.26 received as a result of federal
574.27 participation pertaining to grants
574.28 shall be deposited in the federal fund
574.29 and shall offset health care access
574.30 funds for payments to providers.
574.31 [MINNESOTACARE FUNDING.] The
574.32 commissioner may expend money
574.33 appropriated from the health care
574.34 access fund for MinnesotaCare in either
574.35 fiscal year of the biennium.
574.36 (b) MA Basic Health Care Grants -
574.37 Families and Children
574.38 General 433,298,000 517,563,000
574.39 (c) MA Basic Health Care Grants -
574.40 Elderly and Disabled
574.41 General 511,946,000 604,451,000
574.42 [MEDICALLY NEEDY STANDARD AND FEDERAL
574.43 AUTHORIZATION.] If federal
574.44 authorization to use the medical
574.45 assistance income standard in Minnesota
574.46 Statutes, section 256B.056, subdivision
574.47 4, as the medically needy standard is
574.48 not obtained, the commissioner shall
574.49 use all resulting savings to provide
574.50 services under the home and
574.51 community-based waiver for persons with
574.52 mental retardation and related
574.53 conditions.
574.54 (d) General Assistance Medical Care
575.1 General 155,744,000 176,748,000
575.2 (e) Health Care Grants - Other Assistance
575.3 General 13,032,000 18,879,000
575.4 Health Care
575.5 Access 750,000 750,000
575.6 [PURCHASING ALLIANCE STOP-LOSS
575.7 FUNDING.] Of the general fund
575.8 appropriation, $150,000 in fiscal year
575.9 2002 and $500,000 in fiscal year 2003
575.10 are appropriated to the commissioner
575.11 for the cost of establishing the
575.12 Purchasing Alliance Stop-loss fund
575.13 under Minnesota Statutes, section
575.14 256.956.
575.15 Subd. 7. Basic Health Care Management
575.16 General 20,730,000 20,715,000
575.17 Health Care
575.18 Access 13,583,000 13,583,000
575.19 The amounts that may be spent from this
575.20 appropriation for each purpose are as
575.21 follows:
575.22 (a) Health Care Policy Administration
575.23 General 2,822,000 2,862,000
575.24 Health Care
575.25 Access 562,000 562,000
575.26 (b) Health Care Operations
575.27 General 17,908,000 17,853,000
575.28 Health Care
575.29 Access 13,021,000 13,021,000
575.30 [PREPAID MEDICAL PROGRAMS.] The
575.31 nonfederal share of the prepaid medical
575.32 assistance program fund, which has been
575.33 appropriated to fund county managed
575.34 care advocacy and enrollment operating
575.35 costs, shall be disbursed as grants
575.36 using either a reimbursement or block
575.37 grant mechanism.
575.38 Subd. 8. State-Operated Services
575.39 General 205,868,000 199,287,000
575.40 The amounts that may be spent from this
575.41 appropriation for each purpose are as
575.42 follows:
575.43 [MITIGATION RELATED TO STATE-OPERATED
575.44 SERVICES RESTRUCTURING.] Money
575.45 appropriated to finance mitigation
575.46 expenses related to restructuring
575.47 state-operated services programs and
575.48 administrative services may be
575.49 transferred between fiscal years within
575.50 the biennium.
575.51 [STATE-OPERATED SERVICES CHEMICAL
576.1 DEPENDENCY PROGRAMS.] When the
576.2 operations of the state-operated
576.3 services chemical dependency fund
576.4 created in Minnesota Statutes, section
576.5 246.18, subdivision 2, are impeded by
576.6 projected cash deficiencies resulting
576.7 from delays in the receipt of grants,
576.8 dedicated income, or other similar
576.9 receivables, and when the deficiencies
576.10 would be corrected within the budget
576.11 period involved, the commissioner of
576.12 finance may transfer general fund cash
576.13 reserves into this account as necessary
576.14 to meet cash demands. The cash flow
576.15 transfers must be returned to the
576.16 general fund in the fiscal year that
576.17 the transfer was made. Any interest
576.18 earned on general fund cash flow
576.19 transfers accrues to the general fund
576.20 and not the state-operated services
576.21 chemical dependency fund.
576.22 [STATE-OPERATED SERVICES
576.23 RESTRUCTURING.] For purposes of
576.24 restructuring state-operated services,
576.25 any state-operated services employee
576.26 whose position is to be eliminated
576.27 shall be afforded the options provided
576.28 in applicable collective bargaining
576.29 agreements. All salary and mitigation
576.30 allocations from fiscal year 2002 shall
576.31 be carried forward into fiscal year
576.32 2003. Provided there is no conflict
576.33 with any collective bargaining
576.34 agreement, any state-operated services
576.35 position reduction must only be
576.36 accomplished through mitigation,
576.37 attrition, transfer, and other measures
576.38 as provided in state or applicable
576.39 collective bargaining agreements and in
576.40 Minnesota Statutes, section 252.50,
576.41 subdivision 11, and not through layoff.
576.42 [REPAIRS AND BETTERMENTS.] The
576.43 commissioner may transfer unencumbered
576.44 appropriation balances between fiscal
576.45 years within the biennium for the state
576.46 residential facilities repairs and
576.47 betterments account and special
576.48 equipment.
576.49 Subd. 9. Continuing Care Grants
576.50 General 1,370,056,000 1,486,468,000
576.51 Lottery Cash Flow 1,158,000 1,158,000
576.52 The amounts that may be spent from this
576.53 appropriation for each purpose are as
576.54 follows:
576.55 (a) Community Social Services
576.56 Block Grants
576.57 48,718,000 49,695,000
576.58 [CSSA TRADITIONAL APPROPRIATION.]
576.59 Notwithstanding Minnesota Statutes,
576.60 section 256E.06, subdivisions 1 and 2,
576.61 the appropriations available under that
576.62 section in fiscal years 2002 and 2003
577.1 must be distributed to each county
577.2 proportionately to the aid received by
577.3 the county in calendar year 2000.
577.4 (b) Aging Adult Service Grants
577.5 13,500,000 13,732,000
577.6 [COUNTY PLANNING AND SERVICE
577.7 DEVELOPMENT.] Of this appropriation,
577.8 $1,200,000 in fiscal year 2002 and
577.9 $1,600,000 in fiscal year 2003 are for
577.10 distribution to county boards for
577.11 planning and development of community
577.12 services for the elderly as required
577.13 under Minnesota Statutes, section
577.14 256B.437, subdivision 2. For Phase I
577.15 funding to develop the initial biennial
577.16 plan addendum, the commissioner shall
577.17 distribute a minimum of $10,000 to each
577.18 county on July 1, 2001. In a county
577.19 with more than 10,000 persons over 65
577.20 years, the funding allocation shall be
577.21 $15,000; with more than 30,000 persons
577.22 over 65 years - $20,000; with more than
577.23 50,000 persons over 65 years - $25,000;
577.24 and with more than 100,000 persons over
577.25 65 years - $30,000. Upon submission of
577.26 the completed biennial plan addendum,
577.27 the commissioner shall distribute Phase
577.28 II funding to each county for
577.29 development of community-based services
577.30 no later than January 1, 2002. For
577.31 counties with less than 4,500 persons
577.32 under 65 years, the Phase II allocation
577.33 shall be $10,000. For counties with
577.34 more than 4,500 persons over 65 years,
577.35 the Phase II allocation shall be $2.23
577.36 per person over 65 years. Any
577.37 remaining funds shall be available as
577.38 targeted funds distributed to counties
577.39 with designated critical access sites.
577.40 Phase I funding may be carried over by
577.41 the county into 2002 and 2003 for the
577.42 development of services.
577.43 [GRANTS FOR SENIOR NUTRITION.] Of the
577.44 general fund appropriation, $40,881 in
577.45 fiscal year 2002 is appropriated to the
577.46 commissioner for senior nutrition
577.47 programs under Minnesota Statutes,
577.48 section 256.9752 and shall be
577.49 distributed as follows:
577.50 (1) $12,023 is for development region
577.51 6E;
577.52 (2) $18,692 is for development region
577.53 6W; and
577.54 (3) $10,166 is for development region 8.
577.55 [MINNESOTA SENIOR SERVICE CORPS.] Of
577.56 the general fund appropriation,
577.57 $3,200,000 for fiscal year 2002 and
577.58 fiscal year 2003 is for the following
577.59 purposes:
577.60 (a) $1,000,000 each year in fiscal year
577.61 2002 and fiscal year 2003 is for the
577.62 volunteer programs for retired senior
578.1 citizens under Minnesota Statutes,
578.2 section 256.9753, to expand the seniors
578.3 in schools initiative, provide travel
578.4 reimbursement to volunteers, and to
578.5 continue community outreach and the
578.6 expansion of the program.
578.7 (b) $200,000 each year in fiscal year
578.8 2002 and fiscal year 2003 is for the
578.9 foster grandparents program under
578.10 Minnesota Statutes, section 256.976, to
578.11 assist with necessary extensive
578.12 training expenses and travel
578.13 reimbursement for volunteers.
578.14 (c) $400,000 each year in fiscal year
578.15 2002 and fiscal year 2003 is for the
578.16 senior companion program under
578.17 Minnesota Statutes, section 256.977, to
578.18 expand the program, assist with travel
578.19 reimbursement for volunteers, and
578.20 continue the experience corps for
578.21 independent living.
578.22 (c) Deaf and Hard-of-Hearing
578.23 Services Grants
578.24 1,923,000 1,825,000
578.25 [SERVICES TO DEAF PERSONS WITH MENTAL
578.26 ILLNESS.] Of this appropriation,
578.27 $100,000 in fiscal year 2002 and
578.28 $100,000 in fiscal year 2003 is for a
578.29 grant to a nonprofit agency that
578.30 currently serves deaf and
578.31 hard-of-hearing adults with mental
578.32 illness through residential programs
578.33 and supportive housing outreach
578.34 activities. The grant must be used to
578.35 continue and maintain community support
578.36 services for deaf and hard-of-hearing
578.37 adults with mental illness who use or
578.38 wish to use sign language as their
578.39 primary means of communication.
578.40 (d) Mental Health Grants
578.41 General 50,014,000 51,525,000
578.42 Lottery Cash Flow 1,158,000 1,158,000
578.43 (e) Community Support Grants
578.44 12,698,000 12,920,000
578.45 (f) Medical Assistance Long-Term
578.46 Care Waivers and Home Care
578.47 452,689,000 533,489,000
578.48 [PROVIDER RATE INCREASES.] (1) The
578.49 commissioner shall increase
578.50 reimbursement rates by 3.0 percent the
578.51 first year of the biennium and by 3.0
578.52 percent the second year for the
578.53 providers listed in paragraph (2). The
578.54 increases shall be effective for
578.55 services rendered on or after July 1 of
578.56 each year.
578.57 (2) The rate increases described in
579.1 this section shall be provided to home
579.2 and community-based waivered services
579.3 for persons with mental retardation or
579.4 related conditions under Minnesota
579.5 Statutes, section 256B.501; home and
579.6 community-based waivered services for
579.7 the elderly under Minnesota Statutes,
579.8 section 256B.0915; waivered services
579.9 under community alternatives for
579.10 disabled individuals under Minnesota
579.11 Statutes, section 256B.49; community
579.12 alternative care waivered services
579.13 under Minnesota Statutes, section
579.14 256B.49; traumatic brain injury
579.15 waivered services under Minnesota
579.16 Statutes, section 256B.49; nursing
579.17 services and home health services under
579.18 Minnesota Statutes, section 256B.0625,
579.19 subdivision 6a; personal care services
579.20 and nursing supervision of personal
579.21 care services under Minnesota Statutes,
579.22 section 256B.0625, subdivision 19a;
579.23 private-duty nursing services under
579.24 Minnesota Statutes, section 256B.0625,
579.25 subdivision 7; day training and
579.26 habilitation services for adults with
579.27 mental retardation or related
579.28 conditions under Minnesota Statutes,
579.29 sections 252.40 to 252.46; alternative
579.30 care services under Minnesota Statutes,
579.31 section 256B.0913; adult residential
579.32 program grants under Minnesota Rules,
579.33 parts 9535.2000 to 9535.3000; adult and
579.34 family community support grants under
579.35 Minnesota Rules, parts 9535.1700 to
579.36 9535.1760; semi-independent living
579.37 services under Minnesota Statutes,
579.38 section 252.275, including SILS funding
579.39 under county social services grants
579.40 formerly funded under Minnesota
579.41 Statutes, chapter 256I; community
579.42 support services for deaf and
579.43 hard-of-hearing adults with mental
579.44 illness who use or wish to use sign
579.45 language as their primary means of
579.46 communication; and living skills
579.47 training programs for persons with
579.48 intractable epilepsy who need
579.49 assistance in the transition to
579.50 independent living; and group
579.51 residential housing supplementary
579.52 service rate under Minnesota Statutes,
579.53 section 256I.05, subdivision 1a.
579.54 (g) Medical Assistance Long-Term
579.55 Care Facilities
579.56 590,638,000 599,866,000
579.57 [MORATORIUM EXCEPTIONS.] During each
579.58 year of the biennium beginning July 1,
579.59 2001, the commissioner of health may
579.60 approve moratorium exception projects
579.61 under Minnesota Statutes, section
579.62 144A.073, for which the full annualized
579.63 state share of medical assistance costs
579.64 does not exceed $2,000,000.
579.65 [NURSING FACILITY OPERATED BY THE RED
579.66 LAKE BAND OF CHIPPEWA INDIANS.] (1) The
579.67 medical assistance payment rates for
580.1 the 47-bed nursing facility operated by
580.2 the Red Lake Band of Chippewa Indians
580.3 must be calculated according to
580.4 allowable reimbursement costs under the
580.5 medical assistance program, as
580.6 specified in Minnesota Statutes,
580.7 section 246.50, and are subject to the
580.8 facility-specific Medicare upper limits.
580.9 (2) In addition, the commissioner shall
580.10 make available rate adjustments for the
580.11 biennium beginning July 1, 2001, on the
580.12 same basis as the adjustments provided
580.13 to nursing facilities under Minnesota
580.14 Statutes, section 256B.431. The
580.15 commissioner must use the facility's
580.16 final 2000 and 2001 Medicare cost
580.17 reports to calculate the adjustments.
580.18 This rate increase shall become part of
580.19 the facility's base rate for future
580.20 rate years.
580.21 [ICF/MR DISALLOWANCES.] Of this
580.22 appropriation, $65,000 in each fiscal
580.23 year is to reimburse a four-bed ICF/MR
580.24 in Ramsey county for disallowance
580.25 resulting from field audit findings.
580.26 The commissioner shall exempt these
580.27 facilities from the provisions of
580.28 Minnesota Statutes, section 256B.501,
580.29 subdivision 5b, paragraph (d), clause
580.30 (6), for the rate years beginning
580.31 October 1, 1996, and October 1, 1997.
580.32 [COMMUNITY SERVICES DEVELOPMENT GRANTS
580.33 PROGRAM.] Of this appropriation,
580.34 $18,000,000 for the biennium ending
580.35 June 30, 2003, is to the commissioner
580.36 for grants under Minnesota Statutes,
580.37 section 256.9754. Unexpended
580.38 appropriations in fiscal year 2002 do
580.39 not cancel but are available to the
580.40 commissioner for these purposes in
580.41 fiscal year 2003. This is a one-time
580.42 appropriation and shall not become part
580.43 of the base-level funding for the
580.44 2004-2005 biennium.
580.45 [LONG-TERM CARE CONSULTATION SERVICES.]
580.46 Long-term care consultation services
580.47 payments to all counties shall continue
580.48 at the payment amount in effect for
580.49 preadmission screening in fiscal year
580.50 2001.
580.51 (h) Alternative Care Grants
580.52 General 75,764,000 89,646,000
580.53 [ALTERNATIVE CARE TRANSFER.] Any money
580.54 allocated to the alternative care
580.55 program that is not spent for the
580.56 purposes indicated does not cancel but
580.57 shall be transferred to the medical
580.58 assistance account.
580.59 [ALTERNATIVE CARE APPROPRIATION.] The
580.60 commissioner may expend the money
580.61 appropriated for the alternative care
580.62 program for that purpose in either year
580.63 of the biennium.
581.1 (i) Group Residential Housing
581.2 General 78,712,000 86,807,000
581.3 (j) Chemical Dependency
581.4 Entitlement Grants
581.5 General 39,459,000 41,045,000
581.6 (k) Chemical Dependency
581.7 Nonentitlement Grants
581.8 General 5,941,000 5,918,000
581.9 [CONSOLIDATED CHEMICAL DEPENDENCY
581.10 TREATMENT FUND ONE-TIME TRANSFER.]
581.11 $9,367,000 of funds available in the
581.12 consolidated chemical dependency
581.13 treatment fund general reserve account
581.14 is transferred in fiscal year 2002 to
581.15 the general fund.
581.16 Subd. 10. Continuing Care Management
581.17 General 24,546,000 23,928,000
581.18 State Government
581.19 Special Revenue 115,000 115,000
581.20 Lottery Cash Flow 142,000 142,000
581.21 [COUNTY INVOLVEMENT COSTS.] Of this
581.22 appropriation, up to $481,000 in fiscal
581.23 year 2002 and up to $642,000 in fiscal
581.24 year 2003 are for the commissioner to
581.25 allocate to counties for resident
581.26 relocation costs resulting from planned
581.27 closures under Minnesota Statutes,
581.28 section 256B.437, and resident
581.29 relocations under Minnesota Statutes,
581.30 section 144A.161. Unexpended funds for
581.31 fiscal year 2002 do not cancel but are
581.32 available to the commissioner for this
581.33 purpose in fiscal year 2003.
581.34 [REGION 10 QUALITY ASSURANCE
581.35 COMMISSION.] (1) Of the appropriation
581.36 from the general fund for the biennium
581.37 ending June 30, 2003, $548,000 is to
581.38 the commissioner of human services to
581.39 be allocated to the region 10 quality
581.40 assurance commission for operating
581.41 costs of the alternative quality
581.42 assurance licensing project and for
581.43 grants to counties participating in
581.44 that project.
581.45 (2) $50,000 is appropriated from the
581.46 general fund to the commissioner of
581.47 human services for the biennium ending
581.48 June 30, 2003, for the region 10
581.49 quality assurance commission to conduct
581.50 the evaluation required under Minnesota
581.51 Statutes, section 256B.0951,
581.52 subdivision 9.
581.53 (3) $150,000 is appropriated from the
581.54 general fund to the commissioner of
581.55 human services for the biennium ending
581.56 June 30, 2003, for the commissioner to
581.57 conduct the project evaluation required
582.1 for the federal 1115 waiver of ICF/MR
582.2 regulations.
582.3 Subd. 11. Economic Support Grants
582.4 General 91,086,000 90,136,000
582.5 Federal TANF 233,209,000 202,741,000
582.6 The amounts that may be spent from this
582.7 appropriation for each purpose are as
582.8 follows:
582.9 (a) Assistance to Families Grants
582.10 General 25,237,000 21,821,000
582.11 Federal TANF 164,745,000 133,553,000
582.12 (b) Work Grants
582.13 General 9,844,000 9,844,000
582.14 Federal TANF 67,203,000 66,403,000
582.15 [NONTRADITIONAL CAREER ASSISTANCE.] Of
582.16 the federal TANF appropriation,
582.17 $500,000 for fiscal year 2002 and
582.18 $500,000 for fiscal year 2003 is for
582.19 grants for nontraditional career
582.20 assistance training programs under
582.21 Minnesota Statutes, section 256K.30.
582.22 This is a one-time appropriation and
582.23 shall not be added to the base-level
582.24 funding in the 2004-2005 biennium.
582.25 [SUPPORTIVE HOUSING AND MANAGED CARE
582.26 PILOT PROJECT.] Of the general fund
582.27 appropriation, $2,000,000 in fiscal
582.28 year 2002 and $5,000,000 in fiscal year
582.29 2003 is for the supportive housing and
582.30 managed care pilot project under
582.31 Minnesota Statutes, section 256K.25.
582.32 This appropriation may be transferred
582.33 between fiscal years within the
582.34 biennium.
582.35 [INTENSIVE INTERVENTION TRANSITIONAL
582.36 EMPLOYMENT TRAINING PROJECT.] Of the
582.37 federal TANF appropriation, $800,000
582.38 for the biennium ending June 30, 2003,
582.39 is for the Southeast Asian
582.40 collaborative in Hennepin county for an
582.41 intensive intervention transitional
582.42 employment training project, which
582.43 serves TANF-eligible recipients, and
582.44 which moves refugee and immigrant
582.45 welfare recipients into unsubsidized
582.46 employment leading to
582.47 self-sufficiency. The commissioner
582.48 must select one of the five partners in
582.49 the collaborative as the fiscal agent
582.50 for the project. The primary effort of
582.51 the project must be on intensive
582.52 employment skills training, including
582.53 workplace English and overcoming
582.54 cultural barriers, and on specialized
582.55 training in fields of work which
582.56 involve a credit-based curriculum. For
582.57 recipients without a high school
582.58 diploma or a GED, extra effort shall be
583.1 made to help the recipient meet the
583.2 "ability to benefit test" so the
583.3 recipient can receive financial aid for
583.4 further training. During the
583.5 specialized training, efforts should be
583.6 made to involve the recipients with an
583.7 internship program and retention
583.8 specialist. A minor amount of the
583.9 grant may be used for other efforts to
583.10 make the recipient families more
583.11 self-sufficient as provided within TANF
583.12 rules. This is a one-time
583.13 appropriation and shall not be added to
583.14 the base-level funding for the
583.15 2004-2005 biennium.
583.16 [LOCAL INTERVENTION GRANTS FOR
583.17 SELF-SUFFICIENCY CARRYFORWARD.]
583.18 Unexpended funds appropriated for local
583.19 intervention grants under Minnesota
583.20 Statutes, section 256J.625, for fiscal
583.21 year 2002 do not cancel but are
583.22 available to the commissioner for these
583.23 purposes in fiscal year 2003.
583.24 [WELFARE-TO-WORK GRANTS.] Of the
583.25 federal TANF appropriation, $5,000,000
583.26 each year in fiscal year 2002 and
583.27 fiscal year 2003 is for welfare-to-work
583.28 programs administered by the
583.29 commissioner of economic security that
583.30 have utilized all of the federal
583.31 welfare-to-work funding received. The
583.32 commissioner of economic security shall
583.33 establish guidelines for distributing
583.34 the funds to local workforce service
583.35 areas based on current expenditures and
583.36 documented need and, by January 15,
583.37 2003, shall report to the chairs of the
583.38 house health and human services finance
583.39 committee and the senate health, human
583.40 services and corrections budget
583.41 division on the use of state and
583.42 federal funds appropriated for
583.43 welfare-to-work programs and the
583.44 effectiveness of such programs.
583.45 (c) Economic Support Grants -
583.46 Other Assistance
583.47 General 4,682,000 6,931,000
583.48 Federal TANF 1,001,000 2,525,000
583.49 [TANF TRANSFER TO CHILD CARE AND
583.50 DEVELOPMENT BLOCK GRANT.] $1,526,000
583.51 for fiscal year 2003 is appropriated to
583.52 the commissioner of children, families,
583.53 and learning for the purposes of
583.54 Minnesota Statutes, section 119B.05.
583.55 The commissioner of human services
583.56 shall authorize a sufficient transfer
583.57 of funds from the state's federal TANF
583.58 block grant to the state's child care
583.59 and development fund block grant to
583.60 meet this appropriation.
583.61 [WORKING FAMILY TAX CREDITS.] (1) On a
583.62 regular basis, the commissioner of
583.63 revenue, with the assistance of the
583.64 commissioner of human services, shall
584.1 calculate the value of the refundable
584.2 portion of the Minnesota working family
584.3 credits provided under Minnesota
584.4 Statutes, section 290.0671, that
584.5 qualifies for federal reimbursement
584.6 from the temporary assistance for needy
584.7 families block grant. The commissioner
584.8 of revenue shall provide the
584.9 commissioner of human services with
584.10 such expenditure records and
584.11 information as are necessary to support
584.12 draws of federal funds.
584.13 (2) Federal TANF funds, as specified in
584.14 this paragraph, are appropriated to the
584.15 commissioner of human services based on
584.16 calculations under paragraph (a) of
584.17 working family tax credit expenditures
584.18 that qualify for reimbursement from the
584.19 TANF block grant for income tax refunds
584.20 payable in federal fiscal years
584.21 beginning October 1, 2001. The draws
584.22 of federal TANF funds shall be made on
584.23 a regular basis based on calculations
584.24 of credit expenditures by the
584.25 commissioner of revenue. Up to the
584.26 following amounts of federal TANF draws
584.27 are appropriated to the commissioner of
584.28 human services to deposit in the
584.29 general fund: in fiscal year 2002,
584.30 $25,000,000; and in fiscal year 2003,
584.31 $16,000,000.
584.32 (d) Child Support Enforcement
584.33 General 4,239,000 4,239,000
584.34 Federal TANF 260,000 260,000
584.35 [CHILD SUPPORT PAYMENT CENTER.]
584.36 Payments to the commissioner from other
584.37 governmental units, private
584.38 enterprises, and individuals for
584.39 services performed by the child support
584.40 payment center must be deposited in the
584.41 state systems account authorized under
584.42 Minnesota Statutes, section 256.014.
584.43 These payments are appropriated to the
584.44 commissioner for the operation of the
584.45 child support payment center or system,
584.46 according to Minnesota Statutes,
584.47 section 256.014.
584.48 (e) General Assistance
584.49 General 17,156,000 15,700,000
584.50 [GENERAL ASSISTANCE STANDARD.] The
584.51 commissioner shall set the monthly
584.52 standard of assistance for general
584.53 assistance units consisting of an adult
584.54 recipient who is childless and
584.55 unmarried or living apart from his or
584.56 her parents or a legal guardian at
584.57 $203. The commissioner may reduce this
584.58 amount in accordance with Laws 1997,
584.59 chapter 85, article 3, section 54.
584.60 (f) Minnesota Supplemental Aid
584.61 General 29,678,000 31,351,000
585.1 (g) Refugee Services
585.2 General 250,000 250,000
585.3 Subd. 12. Economic Support
585.4 Management
585.5 General 37,775,000 37,405,000
585.6 Health Care
585.7 Access 1,318,000 1,318,000
585.8 Federal TANF 2,493,000 943,000
585.9 The amounts that may be spent from this
585.10 appropriation for each purpose are as
585.11 follows:
585.12 (a) Economic Support Policy
585.13 Administration
585.14 General 6,528,000 6,191,000
585.15 Federal TANF 2,493,000 943,000
585.16 [FOOD STAMP ADMINISTRATIVE
585.17 REIMBURSEMENT.] The commissioner shall
585.18 reduce quarterly food stamp
585.19 administrative reimbursement to
585.20 counties in fiscal years 2002 and 2003
585.21 by the amount that the United States
585.22 Department of Health and Human Services
585.23 determines to be the county random
585.24 moment study share of the food stamp
585.25 adjustment under Public Law Number
585.26 105-185. The reductions shall be
585.27 allocated to each county in proportion
585.28 to each county's contribution, if any,
585.29 to the amount of the adjustment. Any
585.30 adjustment to medical assistance
585.31 administrative reimbursement that is
585.32 based on the United States Department
585.33 of Health and Human Services'
585.34 determinations under Public Law Number
585.35 105-185 shall be distributed to
585.36 counties in the same manner.
585.37 [EMPLOYMENT SERVICES TRACKING SYSTEM.]
585.38 Of the federal TANF appropriation,
585.39 $1,750,000 in fiscal year 2002 and
585.40 $200,000 in fiscal year 2003 are for
585.41 development of an employment tracking
585.42 system in collaboration with the
585.43 department of economic security.
585.44 Unexpended funds in fiscal year 2002 do
585.45 not cancel but are available to the
585.46 commissioner for these purposes in
585.47 fiscal year 2003. This is a one-time
585.48 appropriation and shall not be added to
585.49 the base-level funding for the
585.50 2004-2005 biennium.
585.51 (b) Economic Support Operations
585.52 General 31,247,000 31,214,000
585.53 Health Care
585.54 Access 1,318,000 1,318,000
585.55 Federal TANF ...,-0-,... ...,-0-,...
586.1 [SPENDING AUTHORITY FOR FOOD STAMP
586.2 ENHANCED FUNDING.] In the event that
586.3 Minnesota qualifies for United States
586.4 Department of Agriculture Food and
586.5 Nutrition Services Food Stamp Program
586.6 enhanced funding beginning in federal
586.7 fiscal year 1998, the money is
586.8 appropriated to the commissioner for
586.9 the purposes of the program. The
586.10 commissioner shall retain 25 percent of
586.11 the enhanced funding for the Minnesota
586.12 food assistance program, with the
586.13 remaining 75 percent divided among the
586.14 counties according to a formula that
586.15 takes into account each county's impact
586.16 on the statewide food stamp error rate.
586.17 [FINANCIAL INSTITUTION DATA MATCH AND
586.18 PAYMENT OF FEES.] The commissioner is
586.19 authorized to allocate up to $310,000
586.20 each year in fiscal year 2002 and
586.21 fiscal year 2003 from the PRISM special
586.22 revenue account to make payments to
586.23 financial institutions in exchange for
586.24 performing data matches between account
586.25 information held by financial
586.26 institutions and the public authority's
586.27 database of child support obligors as
586.28 authorized by Minnesota Statutes,
586.29 section 13B.06, subdivision 7.
586.30 Sec. 3. COMMISSIONER OF HEALTH
586.31 Subdivision 1. Total
586.32 Appropriation 130,391,000 130,516,000
586.33 Summary by Fund
586.34 General 84,419,000 82,960,000
586.35 State Government
586.36 Special Revenue 24,144,000 25,728,000
586.37 Health Care
586.38 Access 6,828,000 6,828,000
586.39 Federal TANF 15,000,000 15,000,000
586.40 Subd. 2. Family and
586.41 Community Health 64,335,000 64,647,000
586.42 Summary by Fund
586.43 General 44,743,000 44,056,000
586.44 State Government
586.45 Special Revenue 936,000 1,935,000
586.46 Health Care
586.47 Access 3,656,000 3,656,000
586.48 Federal TANF 15,000,000 15,000,000
586.49 [ELIMINATING HEALTH DISPARITIES.] Of
586.50 the general fund appropriation,
586.51 $6,000,000 each year is for reducing
586.52 health disparities. Of the amounts
586.53 available:
586.54 (1) $1,500,000 each year is for
586.55 competitive grants under Minnesota
587.1 Statutes, section 145.928, subdivision
587.2 7, to eligible applicants to reduce
587.3 health disparities in infant mortality
587.4 rates and adult and child immunization
587.5 rates.
587.6 (2) $2,000,000 each year is for
587.7 competitive grants under Minnesota
587.8 Statutes, section 145.928, subdivision
587.9 8, to eligible applicants to reduce
587.10 health disparities in breast and
587.11 cervical cancer screening rates,
587.12 HIV/AIDS and sexually transmitted
587.13 infection rates, cardiovascular disease
587.14 rates, diabetes rates, and rates of
587.15 accidental injuries and violence.
587.16 (3) $500,000 each year is for grants
587.17 under Minnesota Statutes, section
587.18 145.928, subdivision 9, to community
587.19 health boards as defined in Minnesota
587.20 Statutes, section 145A.02, to improve
587.21 access to health screening and
587.22 follow-up services for refugee
587.23 populations.
587.24 (4) $2,000,000 each year is for grants
587.25 to community health boards as defined
587.26 in Minnesota Statutes, section 145A.02,
587.27 according to the formula in Minnesota
587.28 Statutes, section 145.882, subdivision
587.29 4a, to provide services targeted at
587.30 reducing maternal and child health
587.31 disparities.
587.32 [TEEN PREGNANCY PREVENTION.]
587.33 $10,000,000 from the TANF fund for the
587.34 2002-2003 biennium is appropriated to
587.35 the commissioner of health for a teen
587.36 pregnancy prevention program. Of the
587.37 amounts available:
587.38 (1) $1,750,000 in fiscal year 2002 and
587.39 $2,500,000 in fiscal year 2003 are for
587.40 teen pregnancy prevention disparity
587.41 grants under Minnesota Statutes,
587.42 section 145.9257, subdivision 6.
587.43 (2) $1,500,000 in fiscal year 2002 and
587.44 $1,500,000 in fiscal year 2003 are for
587.45 high-risk community teen pregnancy
587.46 prevention grants under Minnesota
587.47 Statutes, section 145.9257, subdivision
587.48 7.
587.49 (3) $1,000,000 in fiscal year 2002 and
587.50 $1,000,000 in fiscal year 2003 are for
587.51 transfer to the commissioner of
587.52 children, families, and learning to
587.53 increase the number of adolescent
587.54 parenting grants.
587.55 (4) $750,000 in fiscal year 2002 is for
587.56 one-time grants to public school
587.57 districts to implement an abstinence
587.58 until marriage curriculum and to train
587.59 staff to implement the curriculum. The
587.60 curriculum shall educate adolescents
587.61 that abstinence from sexual activity
587.62 outside of marriage is the expected
587.63 standard and that sexual activity
588.1 outside the context of marriage is
588.2 likely to have harmful emotional,
588.3 physical, and social effects; and shall
588.4 provide an explanation of the value of
588.5 the institution of marriage and a
588.6 discussion of the historical purpose
588.7 and significance of marriage. The
588.8 commissioner of health, in consultation
588.9 with the commissioner of children,
588.10 families, and learning, shall make
588.11 school districts aware of the
588.12 availability of funds for this
588.13 purpose. This appropriation shall not
588.14 become part of the base-level funding
588.15 for this activity.
588.16 [POISON INFORMATION SYSTEM.] Of the
588.17 general fund appropriation, $1,360,000
588.18 each fiscal year is for poison control
588.19 system grants under Minnesota Statutes,
588.20 section 145.93. This is a one-time
588.21 appropriation that shall not become
588.22 part of base-level funding in 2004-2005.
588.23 [SUICIDE PREVENTION.] Of the general
588.24 fund appropriation, $1,100,000 each
588.25 fiscal year is for suicide prevention
588.26 activities under Minnesota Statutes,
588.27 section 145.56. Of the amounts
588.28 available:
588.29 (1) $275,000 each fiscal year is for
588.30 refining, coordinating, and
588.31 implementing the suicide prevention
588.32 plan according to Minnesota Statutes,
588.33 section 145.56, subdivisions 1, 3, 4,
588.34 and 5.
588.35 (2) $825,000 each fiscal year is to
588.36 fund community-based programs under
588.37 Minnesota Statutes, section 145.56,
588.38 subdivision 2.
588.39 [TANF HOME VISITING PROGRAM.] Of the
588.40 federal TANF appropriation, $10,000,000
588.41 in fiscal year 2002 and $10,000,000 in
588.42 fiscal year 2003 are for family home
588.43 visiting programs under Minnesota
588.44 Statutes, section 145A.17. These
588.45 amounts include $7,000,000 in fiscal
588.46 year 2002 and $7,000,000 in fiscal year
588.47 2003 of appropriations to the
588.48 commissioner of human services for
588.49 transfer to the commissioner of health
588.50 authorized in Laws 2000, chapter 488,
588.51 article 13, section 15, subdivision 6,
588.52 clause (3), as amended by Laws 2000,
588.53 chapter 499, sections 22 and 39.
588.54 [TANF HOME VISITING CARRYFORWARD.] Any
588.55 unexpended balance of the TANF funds
588.56 appropriated for family home visiting
588.57 in the first year of the biennium does
588.58 not cancel but is available for the
588.59 second year.
588.60 [TEEN PREGNANCY PREVENTION
588.61 CARRYFORWARD.] Any unexpended balance
588.62 of the TANF funds appropriated for teen
588.63 pregnancy prevention in the first
588.64 fiscal year of the biennium does not
589.1 cancel but is available for the second
589.2 year.
589.3 [WIC TRANSFERS.] The general fund
589.4 appropriation for the women, infants,
589.5 and children (WIC) food supplement
589.6 program is available for either year of
589.7 the biennium. Transfers of these funds
589.8 between fiscal years must be either to
589.9 maximize federal funds or to minimize
589.10 fluctuations in the number of program
589.11 participants.
589.12 [MINNESOTA CHILDREN WITH SPECIAL HEALTH
589.13 NEEDS CARRYFORWARD.] General fund
589.14 appropriations for treatment services
589.15 in the services for Minnesota children
589.16 with special health needs program are
589.17 available for either year of the
589.18 biennium.
589.19 [ONE-TIME REDUCTION FOR FAMILY PLANNING
589.20 SPECIAL PROJECT GRANTS.] For fiscal
589.21 year 2003, base-level funding for the
589.22 Family Planning Special Project Grants
589.23 under Minnesota Statutes, section
589.24 145.925, shall be reduced by $690,000.
589.25 Subd. 3. Access and Quality
589.26 Improvement 31,284,000 30,268,000
589.27 Summary by Fund
589.28 General 21,160,000 20,194,000
589.29 State Government
589.30 Special Revenue 6,952,000 6,902,000
589.31 Health Care
589.32 Access 3,172,000 3,172,000
589.33 [HEALTH CARE SAFETY NET.] (1) Of the
589.34 general fund appropriation, $5,000,000
589.35 each year is for a grant program to aid
589.36 safety net community clinics.
589.37 (2) $5,000,000 each year is for a grant
589.38 program to provide rural hospital
589.39 capital improvement grants described in
589.40 Minnesota Statutes, section 144.148.
589.41 [LICENSE FEES.] Notwithstanding the
589.42 provisions of Minnesota Statutes,
589.43 sections 144.122, 144.53, and 144A.07,
589.44 a health care facility licensed under
589.45 the provisions of Minnesota Statutes,
589.46 chapter 144 or 144A, may submit the
589.47 required fee for licensure renewal in
589.48 quarterly installments. Any health
589.49 care facility requesting to pay the
589.50 renewal fees in quarterly payments
589.51 shall make the request at the time of
589.52 license renewal. Facilities licensed
589.53 under the provisions of Minnesota
589.54 Statutes, chapter 144, shall submit
589.55 quarterly payments by January 1, April
589.56 1, July 1, and October 1 of each year.
589.57 Nursing homes licensed under Minnesota
589.58 Statutes, chapter 144A, shall submit
589.59 the first quarterly payment with the
589.60 application for renewal, and the
590.1 remaining payments shall be submitted
590.2 at three-month intervals from the
590.3 license expiration date. The
590.4 commissioner of health can require full
590.5 payment of any outstanding balance if a
590.6 quarterly payment is late. Full
590.7 payment of the annual renewal fee will
590.8 be required in the event that the
590.9 facility is sold or ceases operation
590.10 during the licensure year. Failure to
590.11 pay the licensure fee is grounds for
590.12 the nonrenewal of the license.
590.13 Subd. 4. Health Protection 29,808,000 30,639,000
590.14 Summary by Fund
590.15 General 13,699,000 13,895,000
590.16 State Government
590.17 Special Revenue 16,109,000 16,744,000
590.18 [EMERGING HEALTH THREATS.] (a) Of the
590.19 general fund appropriation, $2,200,000
590.20 in the first year and $2,400,000 in the
590.21 second year are to increase the state
590.22 capacity to identify and respond to
590.23 emerging health threats.
590.24 (b) Of these amounts, $1,900,000 in the
590.25 first year and $2,100,000 in the second
590.26 year are to expand state laboratory
590.27 capacity to identify infectious disease
590.28 organisms, evaluate environmental
590.29 contaminants, develop new analytical
590.30 techniques, provide emergency response,
590.31 and support local government by
590.32 training health care system workers to
590.33 deal with biological and chemical
590.34 health threats.
590.35 (c) $300,000 each year is to train,
590.36 consult, and otherwise assist local
590.37 officials responding to clandestine
590.38 drug laboratories and minimizing health
590.39 risks to responders and the public.
590.40 Subd. 5. Management and
590.41 Support Services 4,964,000 4,962,000
590.42 Summary by Fund
590.43 General 4,817,000 4,815,000
590.44 State Government
590.45 Special Revenue 147,000 147,000
590.46 Sec. 4. VETERANS NURSING
590.47 HOMES BOARD 30,943,000 30,019,000
590.48 [VETERANS HOME RATE INCREASE.] Of the
590.49 general fund appropriation, $607,000 in
590.50 fiscal year 2002 and $1,235,000 in
590.51 fiscal year 2003 is for a base
590.52 adjustment for salary and benefits for
590.53 employees of the veterans nursing homes
590.54 board.
590.55 [VETERANS HOMES SPECIAL REVENUE
590.56 ACCOUNT.] The general fund
590.57 appropriations made to the board may be
591.1 transferred to a veterans homes special
591.2 revenue account in the special revenue
591.3 fund in the same manner as other
591.4 receipts are deposited according to
591.5 Minnesota Statutes, section 198.34, and
591.6 are appropriated to the board for the
591.7 operation of board facilities and
591.8 programs.
591.9 [SETTING COST OF CARE.] The cost of
591.10 care for the domiciliary residents at
591.11 the Minneapolis veterans home for
591.12 fiscal year 2002 and fiscal year 2003
591.13 shall be calculated based on 100
591.14 percent occupancy at each facility.
591.15 [DEFICIENCY FUNDING.] Of the general
591.16 fund appropriation in fiscal year 2002,
591.17 $2,000,000 is available with the
591.18 approval of the commissioner of
591.19 finance. Approval of the commissioner
591.20 of finance is contingent upon review of
591.21 the board's submittal of a report
591.22 outlining the following:
591.23 (1) a long-term revenue outlook for the
591.24 homes;
591.25 (2) a review and recommendation of
591.26 alternative funding sources for the
591.27 homes' operations; and
591.28 (3) administrative and service options
591.29 to bring cost growth in line with
591.30 revenues.
591.31 Sec. 5. HEALTH-RELATED BOARDS
591.32 Subdivision 1. Total
591.33 Appropriation 10,800,000 10,892,000
591.34 [STATE GOVERNMENT SPECIAL REVENUE
591.35 FUND.] The appropriations in this
591.36 section are from the state government
591.37 special revenue fund.
591.38 [NO SPENDING IN EXCESS OF REVENUES.]
591.39 The commissioner of finance shall not
591.40 permit the allotment, encumbrance, or
591.41 expenditure of money appropriated in
591.42 this section in excess of the
591.43 anticipated biennial revenues or
591.44 accumulated surplus revenues from fees
591.45 collected by the boards. Neither this
591.46 provision nor Minnesota Statutes,
591.47 section 214.06, applies to transfers
591.48 from the general contingent account.
591.49 Subd. 2. Board of Chiropractic
591.50 Examiners 361,000 361,000
591.51 Subd. 3. Board of Dentistry 806,000 806,000
591.52 Subd. 4. Board of Dietetic
591.53 and Nutrition Practice 95,000 95,000
591.54 Subd. 5. Board of Marriage and
591.55 Family Therapy 111,000 111,000
591.56 Subd. 6. Board of Medical
591.57 Practice 3,270,000 3,270,000
592.1 Subd. 7. Board of Nursing 2,704,000 2,772,000
592.2 [HEALTH PROFESSIONAL SERVICES
592.3 ACTIVITY.] Of these appropriations,
592.4 $534,000 in fiscal year 2002 and
592.5 $566,000 in fiscal year 2003 are for
592.6 the Health Professional Services
592.7 Activity.
592.8 Subd. 8. Board of Nursing
592.9 Home Administrators 194,000 186,000
592.10 Subd. 9. Board of Optometry 90,000 90,000
592.11 Subd. 10. Board of Pharmacy 1,301,000 1,316,000
592.12 [ADMINISTRATIVE SERVICES UNIT.] Of this
592.13 appropriation, $433,000 the first year
592.14 and $441,000 the second year are for
592.15 the health boards administrative
592.16 services unit. The administrative
592.17 services unit may receive and expend
592.18 reimbursements for services performed
592.19 for other agencies.
592.20 Subd. 11. Board of Physical Therapy 185,000 185,000
592.21 Subd. 12. Board of Podiatry 52,000 42,000
592.22 Subd. 13. Board of Psychology 653,000 647,000
592.23 Subd. 14. Board of Social Work 825,000 832,000
592.24 Subd. 15. Board of Veterinary
592.25 Medicine 153,000 179,000
592.26 Sec. 6. EMERGENCY MEDICAL
592.27 SERVICES BOARD 3,033,000 3,037,000
592.28 Summary by Fund
592.29 General 3,033,000 3,037,000
592.30 [COMPREHENSIVE ADVANCED LIFE SUPPORT
592.31 (CALS).] $500,000 in fiscal year 2002
592.32 and $500,000 in fiscal year 2003 are
592.33 for the comprehensive advanced life
592.34 support educational program under
592.35 Minnesota Statutes, section 144E.37.
592.36 Sec. 7. COUNCIL ON DISABILITY 692,000 714,000
592.37 Sec. 8. OMBUDSMAN FOR MENTAL
592.38 HEALTH AND MENTAL RETARDATION 1,378,000 1,378,000
592.39 Sec. 9. OMBUDSMAN
592.40 FOR FAMILIES 171,000 171,000
592.41 Sec. 10. TRANSFERS
592.42 Subdivision 1. Grants
592.43 The commissioner of human services,
592.44 with the approval of the commissioner
592.45 of finance, and after notification of
592.46 the chair of the senate health and
592.47 family security budget division and the
592.48 chair of the house health and human
592.49 services finance committee, may
592.50 transfer unencumbered appropriation
593.1 balances for the biennium ending June
593.2 30, 2003, within fiscal years among the
593.3 MFIP, general assistance, general
593.4 assistance medical care, medical
593.5 assistance, Minnesota supplemental aid,
593.6 and group residential housing programs,
593.7 and the entitlement portion of the
593.8 chemical dependency consolidated
593.9 treatment fund, and between fiscal
593.10 years of the biennium.
593.11 Subd. 2. Administration
593.12 Positions, salary money, and nonsalary
593.13 administrative money may be transferred
593.14 within the departments of human
593.15 services and health and within the
593.16 programs operated by the veterans
593.17 nursing homes board as the
593.18 commissioners and the board consider
593.19 necessary, with the advance approval of
593.20 the commissioner of finance. The
593.21 commissioner or the board shall inform
593.22 the chairs of the house health and
593.23 human services finance committee and
593.24 the senate health and family security
593.25 budget division quarterly about
593.26 transfers made under this provision.
593.27 Sec. 11. INDIRECT COSTS NOT TO
593.28 FUND PROGRAMS.
593.29 The commissioners of health and of
593.30 human services shall not use indirect
593.31 cost allocations to pay for the
593.32 operational costs of any program for
593.33 which they are responsible.
593.34 Sec. 12. CARRYOVER LIMITATION
593.35 None of the appropriations in this
593.36 article which are allowed to be carried
593.37 forward from fiscal year 2002 to fiscal
593.38 year 2003 shall become part of the base
593.39 level funding for the 2004-2005
593.40 biennial budget, unless specifically
593.41 directed by the legislature.
593.42 Sec. 13. SUNSET OF UNCODIFIED LANGUAGE
593.43 All uncodified language contained in
593.44 this article expires on June 30, 2003,
593.45 unless a different expiration date is
593.46 explicit.
593.47 Sec. 14. FINANCIAL ADJUSTMENTS AND DIRECT CARE
593.48 STAFF OR SERVICES
593.49 The commissioners of health and of
593.50 human services, in making agency
593.51 financial adjustments related to
593.52 funding levels for salary supplements
593.53 and rent increases, shall not layoff
593.54 employees providing direct health care
593.55 or mental health services to patients,
593.56 or reduce the level of funding for the
593.57 provision of direct health care and
593.58 mental health services.
593.59 Sec. 15. Minnesota Statutes 2000, section 13B.06,
594.1 subdivision 4, is amended to read:
594.2 Subd. 4. [METHOD TO PROVIDE DATA.] To comply with the
594.3 requirements of this section, a financial institution may either:
594.4 (1) provide to the public authority a list containing only
594.5 the names and other necessary personal identifying information
594.6 of all account holders for the public authority to compare
594.7 against its list of child support obligors for the purpose of
594.8 identifying which obligors maintain an account at the financial
594.9 institution; the names of the obligors who maintain an account
594.10 at the institution shall then be transmitted to the financial
594.11 institution which shall provide the public authority with
594.12 account information on those obligors; or
594.13 (2) must obtain a list of child support obligors from the
594.14 public authority and compare that data to the data maintained at
594.15 the financial institution to identify which of the identified
594.16 obligors maintains an account at the financial institution.
594.17 A financial institution shall elect either method in
594.18 writing upon written request of the public authority, and the
594.19 election remains in effect unless the public authority agrees in
594.20 writing to a change.
594.21 The commissioner shall keep track of the number of
594.22 financial institutions that elect to report under clauses (1)
594.23 and (2) respectively and shall report this information to the
594.24 legislature by December 1, 1999.
594.25 Sec. 16. [246.141] [PROJECT LABOR.]
594.26 Wages for project labor may be paid by the commissioner out
594.27 of repairs and betterments money if the individual is to be
594.28 engaged in a construction project or a repair project of
594.29 short-term and nonrecurring nature. Compensation for project
594.30 labor shall be based on the prevailing wage rates, as defined in
594.31 section 177.42, subdivision 6. Project laborers are excluded
594.32 from the provisions of sections 43A.22 to 43A.30, and shall not
594.33 be eligible for state-paid insurance and benefits.
594.34 Sec. 17. [EXCHANGE OF RECORDS BETWEEN DEPARTMENT OF HEALTH
594.35 AND DEPARTMENT OF HUMAN SERVICES.]
594.36 The commissioners of health and human services shall
595.1 exchange birth record data and data contained in recognitions of
595.2 parentage for the purpose of identifying a child who is subject
595.3 to threatened injury by a person responsible for a child's care
595.4 to the extent possible using existing resources and information
595.5 systems.