SF 3098

2nd Engrossment - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am

  1.1                          A bill for an act
  1.2             relating to human services; modifying the Human 
  1.3             Services Licensing Act; amending fair hearing 
  1.4             requirements; clarifying a provision related to errors 
  1.5             when providing therapeutic conduct to a vulnerable 
  1.6             adult; making technical changes to continuing care 
  1.7             programs; repealing references to the continuing 
  1.8             education infectious disease requirement for licensed 
  1.9             acupuncturists; expanding the definition of project 
  1.10            construction costs and of eligible nursing home; 
  1.11            clarifying implementation deadlines for reimbursement 
  1.12            classifications; modifying medical assistance 
  1.13            provisions; providing for students placed for care and 
  1.14            treatment; modifying chemical dependency treatment 
  1.15            provisions; providing for certain deaf-blind services; 
  1.16            modifying commissioner's duties; establishing a 
  1.17            volunteer health care provider program; modifying 
  1.18            certain health licensing provisions; modifying rural 
  1.19            hospital grant provisions; providing for grants to the 
  1.20            ombudsman for corrections; modifying certain case 
  1.21            manager training requirements; modifying provisions 
  1.22            for interstate contracts for mental health services; 
  1.23            modifying plumbing licensure provisions; providing for 
  1.24            inspector certification; modifying the Minnesota 
  1.25            family investment program; modifying funding for the 
  1.26            health and human services worker program and the 
  1.27            pathways program; removing the cost of obtaining 
  1.28            health records when appealing denial to a disability 
  1.29            benefits program; requiring certain reports; 
  1.30            appropriating money; amending Minnesota Statutes 2000, 
  1.31            sections 144.335, subdivision 5; 147B.02, subdivision 
  1.32            9; 241.44, by adding a subdivision; 245.462, 
  1.33            subdivision 4; 245.4871, subdivision 4; 245.50, 
  1.34            subdivisions 1, 2, 5; 245A.02, by adding subdivisions; 
  1.35            245A.035, subdivision 3; 245A.04, by adding a 
  1.36            subdivision; 254B.09, subdivision 2; 256B.02, 
  1.37            subdivision 7; 256B.0625, by adding a subdivision; 
  1.38            256B.0915, subdivisions 4, 6, by adding a subdivision; 
  1.39            256B.32; 256B.431, subdivisions 14, 30; 256B.5012, 
  1.40            subdivision 2; 326.01, by adding a subdivision; 
  1.41            326.37, subdivision 1, by adding a subdivision; 
  1.42            326.40, subdivision 1; 626.557, subdivision 3a; 
  1.43            Minnesota Statutes 2001 Supplement, sections 125A.515; 
  1.44            144.122; 144.148, subdivision 2; 144A.071, subdivision 
  1.45            1a; 144A.36, subdivision 1; 245A.03, subdivision 2; 
  1.46            245A.04, subdivisions 3, 3a, 3b; 245A.07, subdivisions 
  2.1             2a, 3; 245A.144; 245A.16, subdivision 1; 256.01, 
  2.2             subdivision 2, as amended; 256.045, subdivisions 3b, 
  2.3             4; 256B.0625, subdivision 13, as amended; 256B.0627, 
  2.4             subdivision 10; 256B.0644; 256B.0911, subdivisions 4b, 
  2.5             4d; 256B.0913, subdivisions 4, 5, 8, 10, 12, 14; 
  2.6             256B.0915, subdivisions 3, 5; 256B.0924, subdivision 
  2.7             6; 256B.0951, subdivisions 7, 8; 256B.431, 
  2.8             subdivisions 2e, 33; 256B.437, subdivisions 3, 6; 
  2.9             256B.438, subdivision 1; 256B.69, subdivision 5b; 
  2.10            256B.75; 256B.76; 256J.425, subdivisions 3, 4, 5, 6, 
  2.11            by adding a subdivision; 326.38; 626.556, subdivision 
  2.12            10i; 626.557, subdivision 9d; proposing coding for new 
  2.13            law in Minnesota Statutes, chapters 214; 245A; 256B; 
  2.14            326; repealing Minnesota Statutes 2000, sections 
  2.15            147B.01, subdivisions 8, 15; 326.45; Minnesota 
  2.16            Statutes 2001 Supplement, section 256B.0621, 
  2.17            subdivision 1. 
  2.18  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  2.19                             ARTICLE 1
  2.20     CONTINUING CARE AND DEPARTMENT OF HUMAN SERVICES LICENSING
  2.21     Section 1.  Minnesota Statutes 2001 Supplement, section 
  2.22  125A.515, is amended to read: 
  2.23     125A.515 [PLACEMENT OF CHILDREN WITHOUT DISABILITIES 
  2.24  STUDENTS; APPROVAL OF EDUCATION PROGRAM.] 
  2.25     Subdivision 1.  [APPROVAL OF EDUCATION PROGRAMS.] The 
  2.26  commissioner shall approve education programs in care and 
  2.27  treatment facilities for placement of children without 
  2.28  disabilities and youth in care and treatment facilities 
  2.29  including detention centers, before being licensed by the 
  2.30  department of human services under Minnesota Rules, parts 
  2.31  9545.0905 to 9545.1125 and 9545.1400 to 9545.1480, or the 
  2.32  department of corrections under Minnesota Rules, chapters 2925, 
  2.33  2930, 2935, and 2950.  For the purposes of this section, care 
  2.34  and treatment facilities includes adult facilities that admit 
  2.35  children and provide an education program specifically designed 
  2.36  for children who are residents of the facility including 
  2.37  chemical dependency and other substance abuse programs, shelter 
  2.38  care facilities, hospitals, correctional facilities, mental 
  2.39  health programs, and detention facilities.  Education programs 
  2.40  in these facilities shall conform to state and federal education 
  2.41  laws including the Individuals with Disabilities Education Act 
  2.42  (IDEA). 
  2.43     Subd. 2.  [DEFINITION OF CARE AND TREATMENT 
  2.44  PLACEMENT.] Students placed in the following public or private 
  3.1   facilities are considered to be placed for care and treatment: 
  3.2      (1) group foster home, department of corrections; 
  3.3      (2) secure juvenile detention facilities, department of 
  3.4   corrections; 
  3.5      (3) juvenile residential facilities, department of 
  3.6   corrections; 
  3.7      (4) temporary holdover - eight day, department of 
  3.8   corrections; 
  3.9      (5) group homes, department of human services; 
  3.10     (6) residential academies, department of human services; 
  3.11     (7) transitional programs, department of human services; 
  3.12     (8) shelter care, department of human services and 
  3.13  department of corrections; 
  3.14     (9) shelter for homeless, department of human services; 
  3.15     (10) adult facilities that admit persons under the age of 
  3.16  22; and 
  3.17     (11) residential treatment program. 
  3.18     Subd. 3.  [RESPONSIBILITIES FOR PROVIDING EDUCATION.] (a) 
  3.19  The district in which the facility is located must provide 
  3.20  education services, including special education if eligible, to 
  3.21  all students placed in a facility for care and treatment. 
  3.22     (b) For education programs operated by the department of 
  3.23  corrections, the providing district shall be the department of 
  3.24  corrections.  For students remanded to the commissioner of 
  3.25  corrections, the providing and resident district shall be the 
  3.26  department of corrections.  
  3.27     (c) Placement for care and treatment does not automatically 
  3.28  make a student eligible for special education.  A student placed 
  3.29  in a care and treatment facility is eligible for special 
  3.30  education under state and federal law including the Individuals 
  3.31  with Disabilities Education Act under United States Code, title 
  3.32  20, chapter 33. 
  3.33     Subd. 4.  [EDUCATION SERVICES REQUIRED.] (a) Education 
  3.34  services must be provided to a student beginning within three 
  3.35  business days after the student enters the care and treatment 
  3.36  facility.  The first four days of the student's placement may be 
  4.1   used to screen the student for educational, social, and safety 
  4.2   issues. 
  4.3      (b) If the student does not meet the eligibility criteria 
  4.4   for special education, regular education services must be 
  4.5   provided in accordance with a personal education plan. 
  4.6      (c) A personal education plan shall include current 
  4.7   educational data, individual education goals, and an educational 
  4.8   transition plan for transition from the facility. 
  4.9      Subd. 5.  [EDUCATION PROGRAMS FOR STUDENTS PLACED IN 
  4.10  FACILITIES FOR CARE AND TREATMENT.] (a) When a student is placed 
  4.11  in a care and treatment facility that has an on-site education 
  4.12  program, the providing district must contact the resident 
  4.13  district within one business day to determine if a student has 
  4.14  been identified as having a disability, and to request at least 
  4.15  the student's transcript, and for students with disabilities, 
  4.16  the most recent individualized education plan (IEP) and 
  4.17  evaluation report, and to determine if the student has been 
  4.18  identified as a student with a disability.  The resident 
  4.19  district must send a facsimile copy to the providing district 
  4.20  within two business days of receiving the request. 
  4.21     (b) If a student placed for care and treatment has been 
  4.22  identified as having a disability and has an individual 
  4.23  education plan in the resident district: 
  4.24     (1) the providing agency must conduct an individualized 
  4.25  education plan meeting to reach an agreement about continuing or 
  4.26  modifying special education services in accordance with the 
  4.27  current individualized education plan goals and objectives and 
  4.28  to determine if additional evaluations are necessary; and 
  4.29     (2) at least the following people shall receive written 
  4.30  notice or documented phone call to be followed with written 
  4.31  notice to attend the individualized education plan meeting: 
  4.32     (i) the person or agency placing the student; 
  4.33     (ii) the resident district; 
  4.34     (iii) the appropriate teachers and related services staff 
  4.35  from the providing district; 
  4.36     (iv) appropriate staff from the care and treatment 
  5.1   facility; 
  5.2      (v) the parents or legal guardians of the student; and 
  5.3      (vi) when appropriate, the student. 
  5.4      (c) For a student who has not been identified as a student 
  5.5   with a disability: 
  5.6      (1) a screening must be conducted by the providing 
  5.7   districts as soon as possible to determine the student's 
  5.8   educational, social, emotional, and behavioral needs; and must 
  5.9   include a review of the student's educational records; and 
  5.10     (2) based on the documented results of the screening, a 
  5.11  decision shall be made about the need for prereferral 
  5.12  interventions, the need for an appropriate evaluation to 
  5.13  determine special education eligibility and whether an 
  5.14  evaluation can be completed before the student is transferred 
  5.15  out of the care and treatment facility.  When it is determined 
  5.16  the evaluation cannot be completed due to the anticipated length 
  5.17  of the student's placement, the student's need for an evaluation 
  5.18  shall be documented and communicated to the next providing 
  5.19  district and the resident district if different when the student 
  5.20  exits the care and treatment facility. 
  5.21     Subd. 6.  [EXIT REPORT SUMMARIZING EDUCATIONAL 
  5.22  PROGRESS.] If a student has been placed in a care and treatment 
  5.23  facility for 15 or more business days, the providing district 
  5.24  must prepare an exit report summarizing the regular education, 
  5.25  special education, evaluation, progress on education goals, and 
  5.26  service information and must send the report to the resident 
  5.27  district and the next providing district if different, the 
  5.28  parent or legal guardian, and any appropriate social service 
  5.29  agency.  For students with disabilities, this report must 
  5.30  include the student's IEP. 
  5.31     Subd. 7.  [MINIMUM EDUCATIONAL SERVICES REQUIRED.] At a 
  5.32  minimum, the providing district is responsible for: 
  5.33     (1) the education necessary, including summer school 
  5.34  services, for a student who is not performing at grade level as 
  5.35  indicated in the personal education plan or IEP; and 
  5.36     (2) a school day, of the same length as the school day of 
  6.1   the providing district, unless the unique needs of the student, 
  6.2   as documented through the IEP or personal education plan in 
  6.3   consultation with treatment providers, requires an alteration in 
  6.4   the length of the school day. 
  6.5      Subd. 8.  [PLACEMENT, SERVICES, AND DUE PROCESS.] When a 
  6.6   student's treatment and educational needs allow, education shall 
  6.7   be provided in a regular educational setting.  The determination 
  6.8   of the amount and site of integrated services must be a joint 
  6.9   decision between the student's parents or legal guardians and 
  6.10  the treatment and education staff.  When applicable, educational 
  6.11  placement decisions must be made by the IEP team of the 
  6.12  providing district.  Educational services shall be provided in 
  6.13  conformance with the least restrictive environment principle of 
  6.14  the Individuals with Disabilities Education Act.  The providing 
  6.15  district and care and treatment facility shall cooperatively 
  6.16  develop discipline and behavior management procedures to be used 
  6.17  in emergency situations that comply with the Minnesota Pupil 
  6.18  Fair Dismissal Act and other relevant state and federal laws and 
  6.19  regulations. 
  6.20     Subd. 9.  [REIMBURSEMENT FOR EDUCATION SERVICES.] (a) 
  6.21  Education services provided to students who have been placed for 
  6.22  care and treatment are reimbursable in accordance with special 
  6.23  education and general education statutes. 
  6.24     (b) Indirect or consultative services provided in 
  6.25  conjunction with regular education prereferral interventions and 
  6.26  assessment provided to regular education students suspected of 
  6.27  being disabled and who have demonstrated learning or behavioral 
  6.28  problems in a screening are reimbursable with special education 
  6.29  categorical aids. 
  6.30     (c) Regular education, including screening, provided to 
  6.31  students with or without disabilities is not reimbursable with 
  6.32  special education categorical aids. 
  6.33     Subd. 10.  [STUDENTS UNABLE TO ATTEND SCHOOL BUT NOT PLACED 
  6.34  IN CARE AND TREATMENT FACILITIES.] Students who are absent from, 
  6.35  or predicted to be absent from, school for 15 consecutive or 
  6.36  intermittent days, at home or in facilities not licensed by the 
  7.1   departments of corrections or human services are not students 
  7.2   placed for care and treatment.  These students include students 
  7.3   with and without disabilities who are home due to accident or 
  7.4   illness, in a hospital or other medical facility, or in a day 
  7.5   treatment center.  These students are entitled to education 
  7.6   services through their district of residence. 
  7.7      Sec. 2.  Minnesota Statutes 2000, section 144.335, 
  7.8   subdivision 5, is amended to read: 
  7.9      Subd. 5.  [COSTS.] (a) When a patient requests a copy of 
  7.10  the patient's record for purposes of reviewing current medical 
  7.11  care, the provider must not charge a fee.  
  7.12     (b) When a provider or its representative makes copies of 
  7.13  patient records upon a patient's request under this section, the 
  7.14  provider or its representative may charge the patient or the 
  7.15  patient's representative no more than 75 cents per page, plus 
  7.16  $10 for time spent retrieving and copying the records, unless 
  7.17  other law or a rule or contract provide for a lower maximum 
  7.18  charge.  This limitation does not apply to x-rays.  The provider 
  7.19  may charge a patient no more than the actual cost of reproducing 
  7.20  X-rays, plus no more than $10 for the time spent retrieving and 
  7.21  copying the x-rays. 
  7.22     (c) The respective maximum charges of 75 cents per page and 
  7.23  $10 for time provided in this subdivision are in effect for 
  7.24  calendar year 1992 and may be adjusted annually each calendar 
  7.25  year as provided in this subdivision.  The permissible maximum 
  7.26  charges shall change each year by an amount that reflects the 
  7.27  change, as compared to the previous year, in the consumer price 
  7.28  index for all urban consumers, Minneapolis-St. Paul (CPI-U), 
  7.29  published by the department of labor. 
  7.30     (d) A provider or its representative must not charge a fee 
  7.31  to provide copies of records requested by a patient or the 
  7.32  patient's authorized representative if the request for copies of 
  7.33  records is for purposes of appealing a denial of social security 
  7.34  disability income or social security disability benefits under 
  7.35  title II or title XVI of the Social Security Act. 
  7.36     Sec. 3.  Minnesota Statutes 2001 Supplement, section 
  8.1   144A.071, subdivision 1a, is amended to read: 
  8.2      Subd. 1a.  [DEFINITIONS.] For purposes of sections 144A.071 
  8.3   to 144A.073, the following terms have the meanings given them: 
  8.4      (a) "Attached fixtures" has the meaning given in Minnesota 
  8.5   Rules, part 9549.0020, subpart 6. 
  8.6      (b) "Buildings" has the meaning given in Minnesota Rules, 
  8.7   part 9549.0020, subpart 7. 
  8.8      (c) "Capital assets" has the meaning given in section 
  8.9   256B.421, subdivision 16. 
  8.10     (d) "Commenced construction" means that all of the 
  8.11  following conditions were met:  the final working drawings and 
  8.12  specifications were approved by the commissioner of health; the 
  8.13  construction contracts were let; a timely construction schedule 
  8.14  was developed, stipulating dates for beginning, achieving 
  8.15  various stages, and completing construction; and all zoning and 
  8.16  building permits were applied for. 
  8.17     (e) "Completion date" means the date on which a certificate 
  8.18  of occupancy is issued for a construction project, or if a 
  8.19  certificate of occupancy is not required, the date on which the 
  8.20  construction project is available for facility use. 
  8.21     (f) "Construction" means any erection, building, 
  8.22  alteration, reconstruction, modernization, or improvement 
  8.23  necessary to comply with the nursing home licensure rules. 
  8.24     (g) "Construction project" means: 
  8.25     (1) a capital asset addition to, or replacement of a 
  8.26  nursing home or certified boarding care home that results in new 
  8.27  space or the remodeling of or renovations to existing facility 
  8.28  space; 
  8.29     (2) the remodeling or renovation of existing facility space 
  8.30  the use of which is modified as a result of the project 
  8.31  described in clause (1).  This existing space and the project 
  8.32  described in clause (1) must be used for the functions as 
  8.33  designated on the construction plans on completion of the 
  8.34  project described in clause (1) for a period of not less than 24 
  8.35  months; or 
  8.36     (3) capital asset additions or replacements that are 
  9.1   completed within 12 months before or after the completion date 
  9.2   of the project described in clause (1). 
  9.3      (h) "New licensed" or "new certified beds" means: 
  9.4      (1) newly constructed beds in a facility or the 
  9.5   construction of a new facility that would increase the total 
  9.6   number of licensed nursing home beds or certified boarding care 
  9.7   or nursing home beds in the state; or 
  9.8      (2) newly licensed nursing home beds or newly certified 
  9.9   boarding care or nursing home beds that result from remodeling 
  9.10  of the facility that involves relocation of beds but does not 
  9.11  result in an increase in the total number of beds, except when 
  9.12  the project involves the upgrade of boarding care beds to 
  9.13  nursing home beds, as defined in section 144A.073, subdivision 
  9.14  1.  "Remodeling" includes any of the type of conversion, 
  9.15  renovation, replacement, or upgrading projects as defined in 
  9.16  section 144A.073, subdivision 1. 
  9.17     (i) "Project construction costs" means the cost of the 
  9.18  facility capital asset additions, replacements, renovations, or 
  9.19  remodeling projects, construction site preparation costs, and 
  9.20  related soft costs.  Project construction costs include the cost 
  9.21  of any remodeling or renovation of existing facility space which 
  9.22  is modified as a result of the construction project.  Project 
  9.23  construction costs also includes the cost of new technology 
  9.24  implemented as part of the construction project.  Project 
  9.25  construction costs also include the cost of new technology 
  9.26  implemented as part of the construction project and depreciable 
  9.27  equipment directly identified to the project.  Any new 
  9.28  technology and depreciable equipment included in the project 
  9.29  construction costs shall, at the written election of the 
  9.30  facility, be included in the facility's appraised value for 
  9.31  purposes of Minnesota Rules, part 9549.0020, subpart 5, and debt 
  9.32  incurred for its purchase shall be included as allowable debt 
  9.33  for purposes of Minnesota Rules, part 9549.0060, subpart 5, 
  9.34  items A and C.  Any new technology and depreciable equipment 
  9.35  included in the project construction costs that the facility 
  9.36  elects not to include in its appraised value and allowable debt 
 10.1   shall be treated as provided in section 256B.431, subdivision 
 10.2   17, paragraph (b).  Written election under this paragraph must 
 10.3   be included in the facility's request for the rate change 
 10.4   related to the project, and this election may not be changed. 
 10.5      (j) "Technology" means information systems or devices that 
 10.6   make documentation, charting, and staff time more efficient or 
 10.7   encourage and allow for care through alternative settings 
 10.8   including, but not limited to, touch screens, monitors, 
 10.9   hand-helds, swipe cards, motion detectors, pagers, telemedicine, 
 10.10  medication dispensers, and equipment to monitor vital signs and 
 10.11  self-injections, and to observe skin and other conditions. 
 10.12     Sec. 4.  Minnesota Statutes 2001 Supplement, section 
 10.13  144A.36, subdivision 1, is amended to read: 
 10.14     Subdivision 1.  [DEFINITIONS.] "Eligible nursing home" 
 10.15  means any nursing home licensed under sections 144A.01 to 
 10.16  144A.155 and or any boarding care facility, certified by the 
 10.17  appropriate authority under United States Code, title 42, 
 10.18  sections 1396-1396p, to participate as a vendor in the medical 
 10.19  assistance program established under chapter 256B. 
 10.20     Sec. 5.  Minnesota Statutes 2000, section 147B.02, 
 10.21  subdivision 9, is amended to read: 
 10.22     Subd. 9.  [RENEWAL.] (a) To renew a license an applicant 
 10.23  must: 
 10.24     (1) annually, or as determined by the board, complete a 
 10.25  renewal application on a form provided by the board; 
 10.26     (2) submit the renewal fee; 
 10.27     (3) provide evidence annually of one hour of continuing 
 10.28  education in the subject of infection control, including blood 
 10.29  borne pathogen diseases; 
 10.30     (4) provide documentation of current and active NCCAOM 
 10.31  certification; or 
 10.32     (5) (4) if licensed under subdivision 5 or 6, meet the same 
 10.33  NCCAOM professional development activity requirements as those 
 10.34  licensed under subdivision 7. 
 10.35     (b) An applicant shall submit any additional information 
 10.36  requested by the board to clarify information presented in the 
 11.1   renewal application.  The information must be submitted within 
 11.2   30 days after the board's request, or the renewal request is 
 11.3   nullified. 
 11.4      Sec. 6.  [214.40] [VOLUNTEER HEALTH CARE PROVIDER PROGRAM.] 
 11.5      Subdivision 1.  [DEFINITIONS.] (a) The definitions in this 
 11.6   subdivision apply to this section.  
 11.7      (b) "Administrative services unit" means the administrative 
 11.8   services unit for the health-related licensing boards. 
 11.9      (c) "Charitable organization" means a charitable 
 11.10  organization within the meaning of section 501(c)(3) of the 
 11.11  Internal Revenue Code that has as a purpose the sponsorship or 
 11.12  support of programs designed to improve the quality, awareness, 
 11.13  and availability of health care services and that serves as a 
 11.14  funding mechanism for providing those services.  
 11.15     (d) "Health care facility or organization" means a health 
 11.16  care facility licensed under this chapter or chapter 144A, or a 
 11.17  charitable organization, that meets the requirements of 
 11.18  subdivision 3.  
 11.19     (e) "Health care provider" means a physician licensed under 
 11.20  chapter 147, physician assistant registered and practicing under 
 11.21  chapter 147A, nurse licensed and registered to practice under 
 11.22  chapter 148, or dentist or dental hygienist licensed under 
 11.23  chapter 150A.  
 11.24     (f) "Health care services" means health prevention, health 
 11.25  monitoring, health education, diagnosis, or treatment other than 
 11.26  the administration of anesthesia, surgical procedures except for 
 11.27  minor surgical procedures and the administration of local 
 11.28  anesthesia for the stitching of wounds, and primary dental 
 11.29  services, including preventive, diagnostic, restorative, or 
 11.30  emergency treatment. 
 11.31     Subd. 2.  [ESTABLISHMENT.] The administrative services unit 
 11.32  shall establish a volunteer health care provider program to 
 11.33  facilitate the provision of health care services provided by 
 11.34  volunteer health care providers through eligible health care 
 11.35  facilities and organizations.  
 11.36     Subd. 3.  [PARTICIPATION OF HEALTH CARE FACILITIES.] To 
 12.1   participate in the program established in subdivision 2, a 
 12.2   health care facility or organization must register with the 
 12.3   administrative services unit on forms provided by the 
 12.4   administrative services unit and must meet the following 
 12.5   requirements: 
 12.6      (1) be licensed to the extent required by law or 
 12.7   regulation; 
 12.8      (2) provide evidence that the provision of health care 
 12.9   services to the uninsured and underinsured is the primary 
 12.10  purpose of the facility or organization; 
 12.11     (3) certify that it maintains adequate general liability 
 12.12  and professional liability insurance for program staff other 
 12.13  than the volunteer health care provider or is properly and 
 12.14  adequately self-insured; 
 12.15     (4) agree to cooperate with the state in defense of the 
 12.16  health care provider providing services through it and agree not 
 12.17  to charge the state for its expenses, costs, and efforts in the 
 12.18  defense of a claim or suit; 
 12.19     (5) agree that only the health care provider is afforded 
 12.20  protection under section 3.736, and the state assumes no 
 12.21  obligation to the facility or organization, its employees, 
 12.22  officers, or agents; 
 12.23     (6) agree to report annually to the administrative services 
 12.24  unit the number of volunteers, number of volunteer hours 
 12.25  provided, number of patients seen by volunteer providers, and 
 12.26  types of services provided; and 
 12.27     (7) agree to pay to the administrative services unit an 
 12.28  annual participation fee of $50.  All fees collected are 
 12.29  deposited into the state government special revenue fund and are 
 12.30  appropriated to the administrative services unit. 
 12.31     Subd. 4.  [HEALTH CARE PROVIDER REGISTRATION.] (a) To be 
 12.32  eligible for protection as an employee of the state for a claim 
 12.33  arising from the provision of unpaid health care services 
 12.34  through the program established in subdivision 2, a health care 
 12.35  provider must register with the administrative services unit.  
 12.36  Registration may be approved if the provider has submitted a 
 13.1   certified statement on forms provided by the administrative 
 13.2   services unit attesting that the health care provider agrees to: 
 13.3      (1) cooperate fully with the state in the defense of any 
 13.4   claim or suit relating to participation in the volunteer health 
 13.5   care provider program, including attending hearings, 
 13.6   depositions, and trials and assisting in securing and giving 
 13.7   evidence, responding to discovery, and obtaining the attendance 
 13.8   of witnesses; 
 13.9      (2) receive no direct monetary compensation of any kind for 
 13.10  services provided in the program; 
 13.11     (3) submit a sworn statement attesting that the license to 
 13.12  practice is free of restrictions.  The statement shall describe: 
 13.13     (i) any disciplinary action taken against the health care 
 13.14  provider by a professional licensing authority or health care 
 13.15  facility, including any voluntary surrender of license or other 
 13.16  agreement involving the health care provider's license to 
 13.17  practice or any restrictions on practice, suspension of 
 13.18  privileges, or other sanctions; and 
 13.19     (ii) any malpractice suits filed against the health care 
 13.20  provider and the outcome of any suits filed; 
 13.21     (4) submit any additional materials requested by the 
 13.22  commissioner; 
 13.23     (5) identify the eligible program through which the health 
 13.24  services will be provided and identify the health care 
 13.25  facilities at which the health services will be provided; and 
 13.26     (6) the provider has no professional liability insurance, 
 13.27  either personally or through another facility or employer, that 
 13.28  covers the provision of health care services by the provider at 
 13.29  the eligible health care facility or organization. 
 13.30     (b) Registration expires two years from the date the 
 13.31  registration was approved.  A health care provider may apply for 
 13.32  renewal by filing with the administrative services unit a 
 13.33  renewal application at least 60 days prior to the expiration of 
 13.34  the registration. 
 13.35     Subd. 5.  [REVOCATION OF ELIGIBILITY AND REGISTRATION.] The 
 13.36  administrative services unit may suspend, revoke, or condition 
 14.1   the eligibility of a health care provider for cause, including, 
 14.2   but not limited to:  the failure to comply with the agreement 
 14.3   with the commissioner; and the imposition of disciplinary action 
 14.4   by the licensing board that regulates the health care provider. 
 14.5      Subd. 6.  [BOARD NOTICE OF DISCIPLINARY ACTION.] The 
 14.6   applicable health-related licensing board shall immediately 
 14.7   notify the administrative services unit of the initiation of a 
 14.8   contested case against a registered health care provider or the 
 14.9   imposition of disciplinary action, including copies of any 
 14.10  contested case decision or settlement agreement with the health 
 14.11  care provider.  
 14.12     Subd. 7.  [HEALTH CARE PROVIDER; EMPLOYEE OF STATE.] A 
 14.13  health care provider who provides health care services under the 
 14.14  volunteer health care provider program under this section is an 
 14.15  employee of the state for purposes of section 3.736 while 
 14.16  providing those services, provided that:  
 14.17     (1) the provider registered with the administrative 
 14.18  services unit in accordance with subdivision 4; 
 14.19     (2) the health care services were provided through an 
 14.20  eligible health care facility or organization; 
 14.21     (3) the services were provided without compensation to the 
 14.22  provider; and 
 14.23     (4) the services were otherwise provided in compliance with 
 14.24  this section. 
 14.25     Sec. 7.  Minnesota Statutes 2000, section 245A.02, is 
 14.26  amended by adding a subdivision to read: 
 14.27     Subd. 2a.  [ADULT DAY CARE.] "Adult day care" means a 
 14.28  program operating less than 24 hours per day that provides 
 14.29  functionally impaired adults with an individualized and 
 14.30  coordinated set of services including health services, social 
 14.31  services, and nutritional services that are directed at 
 14.32  maintaining or improving the participants' capabilities for 
 14.33  self-care.  Adult day care does not include programs where 
 14.34  adults gather or congregate primarily for purposes of 
 14.35  socialization, education, supervision, caregiver respite, 
 14.36  religious expression, exercise, or nutritious meals. 
 15.1      Sec. 8.  Minnesota Statutes 2000, section 245A.02, is 
 15.2   amended by adding a subdivision to read: 
 15.3      Subd. 2b.  [ANNUAL OR ANNUALLY.] "Annual" or "annually" 
 15.4   means prior to or within the same month of the subsequent 
 15.5   calendar year. 
 15.6      Sec. 9.  Minnesota Statutes 2001 Supplement, section 
 15.7   245A.03, subdivision 2, is amended to read: 
 15.8      Subd. 2.  [EXCLUSION FROM LICENSURE.] (a) This chapter does 
 15.9   not apply to: 
 15.10     (1) residential or nonresidential programs that are 
 15.11  provided to a person by an individual who is related unless the 
 15.12  residential program is a child foster care placement made by a 
 15.13  local social services agency or a licensed child-placing agency, 
 15.14  except as provided in subdivision 2a; 
 15.15     (2) nonresidential programs that are provided by an 
 15.16  unrelated individual to persons from a single related family; 
 15.17     (3) residential or nonresidential programs that are 
 15.18  provided to adults who do not abuse chemicals or who do not have 
 15.19  a chemical dependency, a mental illness, mental retardation or a 
 15.20  related condition, a functional impairment, or a physical 
 15.21  handicap; 
 15.22     (4) sheltered workshops or work activity programs that are 
 15.23  certified by the commissioner of economic security; 
 15.24     (5) programs for children enrolled in kindergarten to the 
 15.25  12th grade and prekindergarten special education in a school as 
 15.26  defined in section 120A.22, subdivision 4, and programs serving 
 15.27  children in combined special education and regular 
 15.28  prekindergarten programs that are operated or assisted by the 
 15.29  commissioner of children, families, and learning; 
 15.30     (6) nonresidential programs primarily for children that 
 15.31  provide care or supervision, without charge for ten or fewer 
 15.32  days a year, and for periods of less than three hours a day 
 15.33  while the child's parent or legal guardian is in the same 
 15.34  building as the nonresidential program or present within another 
 15.35  building that is directly contiguous to the building in which 
 15.36  the nonresidential program is located; 
 16.1      (7) nursing homes or hospitals licensed by the commissioner 
 16.2   of health except as specified under section 245A.02; 
 16.3      (8) board and lodge facilities licensed by the commissioner 
 16.4   of health that provide services for five or more persons whose 
 16.5   primary diagnosis is mental illness who have refused an 
 16.6   appropriate residential program offered by a county agency.  
 16.7   This exclusion expires on July 1, 1990; 
 16.8      (9) homes providing programs for persons placed there by a 
 16.9   licensed agency for legal adoption, unless the adoption is not 
 16.10  completed within two years; 
 16.11     (10) programs licensed by the commissioner of corrections; 
 16.12     (11) recreation programs for children or adults that 
 16.13  operate for fewer than 40 calendar days in a calendar year or 
 16.14  programs operated by a park and recreation board of a city of 
 16.15  the first class whose primary purpose is to provide social and 
 16.16  recreational activities to school age children, provided the 
 16.17  program is approved by the park and recreation board; 
 16.18     (12) programs operated by a school as defined in section 
 16.19  120A.22, subdivision 4, whose primary purpose is to provide 
 16.20  child care to school-age children, provided the program is 
 16.21  approved by the district's school board; 
 16.22     (13) Head Start nonresidential programs which operate for 
 16.23  less than 31 days in each calendar year; 
 16.24     (14) noncertified boarding care homes unless they provide 
 16.25  services for five or more persons whose primary diagnosis is 
 16.26  mental illness or mental retardation; 
 16.27     (15) nonresidential programs for nonhandicapped children 
 16.28  provided for a cumulative total of less than 30 days in any 
 16.29  12-month period; 
 16.30     (16) residential programs for persons with mental illness, 
 16.31  that are located in hospitals, until the commissioner adopts 
 16.32  appropriate rules; 
 16.33     (17) the religious instruction of school-age children; 
 16.34  Sabbath or Sunday schools; or the congregate care of children by 
 16.35  a church, congregation, or religious society during the period 
 16.36  used by the church, congregation, or religious society for its 
 17.1   regular worship; 
 17.2      (18) camps licensed by the commissioner of health under 
 17.3   Minnesota Rules, chapter 4630; 
 17.4      (19) mental health outpatient services for adults with 
 17.5   mental illness or children with emotional disturbance; 
 17.6      (20) residential programs serving school-age children whose 
 17.7   sole purpose is cultural or educational exchange, until the 
 17.8   commissioner adopts appropriate rules; 
 17.9      (21) unrelated individuals who provide out-of-home respite 
 17.10  care services to persons with mental retardation or related 
 17.11  conditions from a single related family for no more than 90 days 
 17.12  in a 12-month period and the respite care services are for the 
 17.13  temporary relief of the person's family or legal representative; 
 17.14     (22) respite care services provided as a home and 
 17.15  community-based service to a person with mental retardation or a 
 17.16  related condition, in the person's primary residence; 
 17.17     (23) community support services programs as defined in 
 17.18  section 245.462, subdivision 6, and family community support 
 17.19  services as defined in section 245.4871, subdivision 17; 
 17.20     (24) the placement of a child by a birth parent or legal 
 17.21  guardian in a preadoptive home for purposes of adoption as 
 17.22  authorized by section 259.47; 
 17.23     (25) settings registered under chapter 144D which provide 
 17.24  home care services licensed by the commissioner of health to 
 17.25  fewer than seven adults; or 
 17.26     (26) consumer-directed community support service funded 
 17.27  under the Medicaid waiver for persons with mental retardation 
 17.28  and related conditions when the individual who provided the 
 17.29  service is:  
 17.30     (i) the same individual who is the direct payee of these 
 17.31  specific waiver funds or paid by a fiscal agent, fiscal 
 17.32  intermediary, or employer of record; and 
 17.33     (ii) not otherwise under the control of a residential or 
 17.34  nonresidential program that is required to be licensed under 
 17.35  this chapter when providing the service. 
 17.36     (b) For purposes of paragraph (a), clause (6), a building 
 18.1   is directly contiguous to a building in which a nonresidential 
 18.2   program is located if it shares a common wall with the building 
 18.3   in which the nonresidential program is located or is attached to 
 18.4   that building by skyway, tunnel, atrium, or common roof. 
 18.5      (c) Nothing in this chapter shall be construed to require 
 18.6   licensure for any services provided and funded according to an 
 18.7   approved federal waiver plan where licensure is specifically 
 18.8   identified as not being a condition for the services and funding.
 18.9      Sec. 10.  Minnesota Statutes 2000, section 245A.035, 
 18.10  subdivision 3, is amended to read: 
 18.11     Subd. 3.  [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an 
 18.12  emergency license may be issued, the following requirements must 
 18.13  be met: 
 18.14     (1) the county agency must conduct an initial inspection of 
 18.15  the premises where the foster care is to be provided to ensure 
 18.16  the health and safety of any child placed in the home.  The 
 18.17  county agency shall conduct the inspection using a form 
 18.18  developed by the commissioner; 
 18.19     (2) at the time of the inspection or placement, whichever 
 18.20  is earlier, the relative being considered for an emergency 
 18.21  license shall receive an application form for a child foster 
 18.22  care license; and 
 18.23     (3) whenever possible, prior to placing the child in the 
 18.24  relative's home, the relative being considered for an emergency 
 18.25  license shall provide the information required by section 
 18.26  245A.04, subdivision 3, paragraph (b); and 
 18.27     (4) if the county determines, prior to the issuance of an 
 18.28  emergency license, that the relative or family member may be 
 18.29  disqualified from obtaining a foster care license, and the 
 18.30  disqualification is one which the commissioner may not set 
 18.31  aside, as required by this chapter, an emergency license shall 
 18.32  not be issued. 
 18.33     Sec. 11.  Minnesota Statutes 2001 Supplement, section 
 18.34  245A.04, subdivision 3, is amended to read: 
 18.35     Subd. 3.  [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 
 18.36  (a) Individuals and organizations that are required in statute 
 19.1   to initiate background studies under this section shall comply 
 19.2   with the following requirements: 
 19.3      (1) Applicants for licensure, license holders, and other 
 19.4   entities as provided in this section must submit completed 
 19.5   background study forms to the commissioner before individuals 
 19.6   specified in paragraph (c), clauses (1) to (4), (6), and (7), 
 19.7   begin positions allowing direct contact in any licensed program. 
 19.8      (2) Applicants and license holders under the jurisdiction 
 19.9   of other state agencies who are required in other statutory 
 19.10  sections to initiate background studies under this section must 
 19.11  submit completed background study forms to the commissioner 
 19.12  prior to the background study subject beginning in a position 
 19.13  allowing direct contact in the licensed program, or where 
 19.14  applicable, prior to being employed. 
 19.15     (3) Organizations required to initiate background studies 
 19.16  under section 256B.0627 for individuals described in paragraph 
 19.17  (c), clause (5), must submit a completed background study form 
 19.18  to the commissioner before those individuals begin a position 
 19.19  allowing direct contact with persons served by the 
 19.20  organization.  The commissioner shall recover the cost of these 
 19.21  background studies through a fee of no more than $12 per study 
 19.22  charged to the organization responsible for submitting the 
 19.23  background study form.  The fees collected under this paragraph 
 19.24  are appropriated to the commissioner for the purpose of 
 19.25  conducting background studies.  
 19.26     Upon receipt of the background study forms from the 
 19.27  entities in clauses (1) to (3), the commissioner shall complete 
 19.28  the background study as specified under this section and provide 
 19.29  notices required in subdivision 3a.  Unless otherwise specified, 
 19.30  the subject of a background study may have direct contact with 
 19.31  persons served by a program after the background study form is 
 19.32  mailed or submitted to the commissioner pending notification of 
 19.33  the study results under subdivision 3a.  A county agency may 
 19.34  accept a background study completed by the commissioner under 
 19.35  this section in place of the background study required under 
 19.36  section 245A.16, subdivision 3, in programs with joint licensure 
 20.1   as home and community-based services and adult foster care for 
 20.2   people with developmental disabilities when the license holder 
 20.3   does not reside in the foster care residence and the subject of 
 20.4   the study has been continuously affiliated with the license 
 20.5   holder since the date of the commissioner's study. 
 20.6      (b) The definitions in this paragraph apply only to 
 20.7   subdivisions 3 to 3e. 
 20.8      (1) "Background study" means the review of records 
 20.9   conducted by the commissioner to determine whether a subject is 
 20.10  disqualified from direct contact with persons served by a 
 20.11  program, and where specifically provided in statutes, whether a 
 20.12  subject is disqualified from having access to persons served by 
 20.13  a program. 
 20.14     (2) "Continuous, direct supervision" means an individual is 
 20.15  within sight or hearing of the supervising person to the extent 
 20.16  that supervising person is capable at all times of intervening 
 20.17  to protect the health and safety of the persons served by the 
 20.18  program. 
 20.19     (3) "Contractor" means any person, regardless of employer, 
 20.20  who is providing program services for hire under the control of 
 20.21  the provider. 
 20.22     (4) "Direct contact" means providing face-to-face care, 
 20.23  training, supervision, counseling, consultation, or medication 
 20.24  assistance to persons served by the program. 
 20.25     (5) "Reasonable cause" means information or circumstances 
 20.26  exist which provide the commissioner with articulable suspicion 
 20.27  that further pertinent information may exist concerning a 
 20.28  subject.  The commissioner has reasonable cause when, but not 
 20.29  limited to, the commissioner has received a report from the 
 20.30  subject, the license holder, or a third party indicating that 
 20.31  the subject has a history that would disqualify the person or 
 20.32  that may pose a risk to the health or safety of persons 
 20.33  receiving services. 
 20.34     (6) "Subject of a background study" means an individual on 
 20.35  whom a background study is required or completed. 
 20.36     (c) The applicant, license holder, registrant under section 
 21.1   144A.71, subdivision 1, bureau of criminal apprehension, 
 21.2   commissioner of health, and county agencies, after written 
 21.3   notice to the individual who is the subject of the study, shall 
 21.4   help with the study by giving the commissioner criminal 
 21.5   conviction data and reports about the maltreatment of adults 
 21.6   substantiated under section 626.557 and the maltreatment of 
 21.7   minors in licensed programs substantiated under section 
 21.8   626.556.  If a background study is initiated by an applicant or 
 21.9   license holder and the applicant or license holder receives 
 21.10  information about the possible criminal or maltreatment history 
 21.11  of an individual who is the subject of the background study, the 
 21.12  applicant or license holder must immediately provide the 
 21.13  information to the commissioner.  The individuals to be studied 
 21.14  shall include: 
 21.15     (1) the applicant; 
 21.16     (2) persons age 13 and over living in the household where 
 21.17  the licensed program will be provided; 
 21.18     (3) current employees or contractors of the applicant who 
 21.19  will have direct contact with persons served by the facility, 
 21.20  agency, or program; 
 21.21     (4) volunteers or student volunteers who have direct 
 21.22  contact with persons served by the program to provide program 
 21.23  services, if the contact is not directly supervised by the 
 21.24  individuals under the continuous, direct supervision by an 
 21.25  individual listed in clause (1) or (3); 
 21.26     (5) any person required under section 256B.0627 to have a 
 21.27  background study completed under this section; 
 21.28     (6) persons ages 10 to 12 living in the household where the 
 21.29  licensed services will be provided when the commissioner has 
 21.30  reasonable cause; and 
 21.31     (7) persons who, without providing direct contact services 
 21.32  at a licensed program, may have unsupervised access to children 
 21.33  or vulnerable adults receiving services from the program 
 21.34  licensed to provide family child care for children, foster care 
 21.35  for children in the provider's own home, or foster care or day 
 21.36  care services for adults in the provider's own home when the 
 22.1   commissioner has reasonable cause. 
 22.2      (d) According to paragraph (c), clauses (2) and (6), the 
 22.3   commissioner shall review records from the juvenile courts.  For 
 22.4   persons under paragraph (c), clauses (1), (3), (4), (5), and 
 22.5   (7), who are ages 13 to 17, the commissioner shall review 
 22.6   records from the juvenile courts when the commissioner has 
 22.7   reasonable cause.  The juvenile courts shall help with the study 
 22.8   by giving the commissioner existing juvenile court records on 
 22.9   individuals described in paragraph (c), clauses (2), (6), and 
 22.10  (7), relating to delinquency proceedings held within either the 
 22.11  five years immediately preceding the background study or the 
 22.12  five years immediately preceding the individual's 18th birthday, 
 22.13  whichever time period is longer.  The commissioner shall destroy 
 22.14  juvenile records obtained pursuant to this subdivision when the 
 22.15  subject of the records reaches age 23. 
 22.16     (e) Beginning August 1, 2001, the commissioner shall 
 22.17  conduct all background studies required under this chapter and 
 22.18  initiated by supplemental nursing services agencies registered 
 22.19  under section 144A.71, subdivision 1.  Studies for the agencies 
 22.20  must be initiated annually by each agency.  The commissioner 
 22.21  shall conduct the background studies according to this chapter.  
 22.22  The commissioner shall recover the cost of the background 
 22.23  studies through a fee of no more than $8 per study, charged to 
 22.24  the supplemental nursing services agency.  The fees collected 
 22.25  under this paragraph are appropriated to the commissioner for 
 22.26  the purpose of conducting background studies. 
 22.27     (f) For purposes of this section, a finding that a 
 22.28  delinquency petition is proven in juvenile court shall be 
 22.29  considered a conviction in state district court. 
 22.30     (g) A study of an individual in paragraph (c), clauses (1) 
 22.31  to (7), shall be conducted at least upon application for initial 
 22.32  license for all license types or registration under section 
 22.33  144A.71, subdivision 1, and at reapplication for a license or 
 22.34  registration for family child care, child foster care, and adult 
 22.35  foster care.  The commissioner is not required to conduct a 
 22.36  study of an individual at the time of reapplication for a 
 23.1   license or if the individual has been continuously affiliated 
 23.2   with a foster care provider licensed by the commissioner of 
 23.3   human services and registered under chapter 144D, other than a 
 23.4   family day care or foster care license, if:  (i) a study of the 
 23.5   individual was conducted either at the time of initial licensure 
 23.6   or when the individual became affiliated with the license 
 23.7   holder; (ii) the individual has been continuously affiliated 
 23.8   with the license holder since the last study was conducted; and 
 23.9   (iii) the procedure described in paragraph (j) has been 
 23.10  implemented and was in effect continuously since the last study 
 23.11  was conducted.  For the purposes of this section, a physician 
 23.12  licensed under chapter 147 is considered to be continuously 
 23.13  affiliated upon the license holder's receipt from the 
 23.14  commissioner of health or human services of the physician's 
 23.15  background study results.  For individuals who are required to 
 23.16  have background studies under paragraph (c) and who have been 
 23.17  continuously affiliated with a foster care provider that is 
 23.18  licensed in more than one county, criminal conviction data may 
 23.19  be shared among those counties in which the foster care programs 
 23.20  are licensed.  A county agency's receipt of criminal conviction 
 23.21  data from another county agency shall meet the criminal data 
 23.22  background study requirements of this section. 
 23.23     (h) The commissioner may also conduct studies on 
 23.24  individuals specified in paragraph (c), clauses (3) and (4), 
 23.25  when the studies are initiated by: 
 23.26     (i) personnel pool agencies; 
 23.27     (ii) temporary personnel agencies; 
 23.28     (iii) educational programs that train persons by providing 
 23.29  direct contact services in licensed programs; and 
 23.30     (iv) professional services agencies that are not licensed 
 23.31  and which contract with licensed programs to provide direct 
 23.32  contact services or individuals who provide direct contact 
 23.33  services. 
 23.34     (i) Studies on individuals in paragraph (h), items (i) to 
 23.35  (iv), must be initiated annually by these agencies, programs, 
 23.36  and individuals.  Except as provided in paragraph (a), clause 
 24.1   (3), no applicant, license holder, or individual who is the 
 24.2   subject of the study shall pay any fees required to conduct the 
 24.3   study. 
 24.4      (1) At the option of the licensed facility, rather than 
 24.5   initiating another background study on an individual required to 
 24.6   be studied who has indicated to the licensed facility that a 
 24.7   background study by the commissioner was previously completed, 
 24.8   the facility may make a request to the commissioner for 
 24.9   documentation of the individual's background study status, 
 24.10  provided that: 
 24.11     (i) the facility makes this request using a form provided 
 24.12  by the commissioner; 
 24.13     (ii) in making the request the facility informs the 
 24.14  commissioner that either: 
 24.15     (A) the individual has been continuously affiliated with a 
 24.16  licensed facility since the individual's previous background 
 24.17  study was completed, or since October 1, 1995, whichever is 
 24.18  shorter; or 
 24.19     (B) the individual is affiliated only with a personnel pool 
 24.20  agency, a temporary personnel agency, an educational program 
 24.21  that trains persons by providing direct contact services in 
 24.22  licensed programs, or a professional services agency that is not 
 24.23  licensed and which contracts with licensed programs to provide 
 24.24  direct contact services or individuals who provide direct 
 24.25  contact services; and 
 24.26     (iii) the facility provides notices to the individual as 
 24.27  required in paragraphs (a) to (j), and that the facility is 
 24.28  requesting written notification of the individual's background 
 24.29  study status from the commissioner.  
 24.30     (2) The commissioner shall respond to each request under 
 24.31  paragraph (1) with a written or electronic notice to the 
 24.32  facility and the study subject.  If the commissioner determines 
 24.33  that a background study is necessary, the study shall be 
 24.34  completed without further request from a licensed agency or 
 24.35  notifications to the study subject.  
 24.36     (3) When a background study is being initiated by a 
 25.1   licensed facility or a foster care provider that is also 
 25.2   registered under chapter 144D, a study subject affiliated with 
 25.3   multiple licensed facilities may attach to the background study 
 25.4   form a cover letter indicating the additional facilities' names, 
 25.5   addresses, and background study identification numbers.  When 
 25.6   the commissioner receives such notices, each facility identified 
 25.7   by the background study subject shall be notified of the study 
 25.8   results.  The background study notice sent to the subsequent 
 25.9   agencies shall satisfy those facilities' responsibilities for 
 25.10  initiating a background study on that individual. 
 25.11     (j) If an individual who is affiliated with a program or 
 25.12  facility regulated by the department of human services or 
 25.13  department of health or who is affiliated with any type of home 
 25.14  care agency or provider of personal care assistance services, is 
 25.15  convicted of a crime constituting a disqualification under 
 25.16  subdivision 3d, the probation officer or corrections agent shall 
 25.17  notify the commissioner of the conviction.  For the purpose of 
 25.18  this paragraph, "conviction" has the meaning given it in section 
 25.19  609.02, subdivision 5.  The commissioner, in consultation with 
 25.20  the commissioner of corrections, shall develop forms and 
 25.21  information necessary to implement this paragraph and shall 
 25.22  provide the forms and information to the commissioner of 
 25.23  corrections for distribution to local probation officers and 
 25.24  corrections agents.  The commissioner shall inform individuals 
 25.25  subject to a background study that criminal convictions for 
 25.26  disqualifying crimes will be reported to the commissioner by the 
 25.27  corrections system.  A probation officer, corrections agent, or 
 25.28  corrections agency is not civilly or criminally liable for 
 25.29  disclosing or failing to disclose the information required by 
 25.30  this paragraph.  Upon receipt of disqualifying information, the 
 25.31  commissioner shall provide the notifications required in 
 25.32  subdivision 3a, as appropriate to agencies on record as having 
 25.33  initiated a background study or making a request for 
 25.34  documentation of the background study status of the individual.  
 25.35  This paragraph does not apply to family day care and child 
 25.36  foster care programs. 
 26.1      (k) The individual who is the subject of the study must 
 26.2   provide the applicant or license holder with sufficient 
 26.3   information to ensure an accurate study including the 
 26.4   individual's first, middle, and last name and all other names by 
 26.5   which the individual has been known; home address, city, county, 
 26.6   and state of residence for the past five years; zip code; sex; 
 26.7   date of birth; and driver's license number or state 
 26.8   identification number.  The applicant or license holder shall 
 26.9   provide this information about an individual in paragraph (c), 
 26.10  clauses (1) to (7), on forms prescribed by the commissioner.  By 
 26.11  January 1, 2000, for background studies conducted by the 
 26.12  department of human services, the commissioner shall implement a 
 26.13  system for the electronic transmission of:  (1) background study 
 26.14  information to the commissioner; and (2) background study 
 26.15  results to the license holder.  The commissioner may request 
 26.16  additional information of the individual, which shall be 
 26.17  optional for the individual to provide, such as the individual's 
 26.18  social security number or race. 
 26.19     (l) For programs directly licensed by the commissioner, a 
 26.20  study must include information related to names of substantiated 
 26.21  perpetrators of maltreatment of vulnerable adults that has been 
 26.22  received by the commissioner as required under section 626.557, 
 26.23  subdivision 9c, paragraph (i), and the commissioner's records 
 26.24  relating to the maltreatment of minors in licensed programs, 
 26.25  information from juvenile courts as required in paragraph (c) 
 26.26  for persons listed in paragraph (c), clauses (2), (6), and (7), 
 26.27  and information from the bureau of criminal apprehension.  For 
 26.28  child foster care, adult foster care, and family day care homes, 
 26.29  the study must include information from the county agency's 
 26.30  record of substantiated maltreatment of adults, and the 
 26.31  maltreatment of minors, information from juvenile courts as 
 26.32  required in paragraph (c) for persons listed in paragraph (c), 
 26.33  clauses (2), (6), and (7), and information from the bureau of 
 26.34  criminal apprehension.  The commissioner may also review arrest 
 26.35  and investigative information from the bureau of criminal 
 26.36  apprehension, the commissioner of health, a county attorney, 
 27.1   county sheriff, county agency, local chief of police, other 
 27.2   states, the courts, or the Federal Bureau of Investigation if 
 27.3   the commissioner has reasonable cause to believe the information 
 27.4   is pertinent to the disqualification of an individual listed in 
 27.5   paragraph (c), clauses (1) to (7).  The commissioner is not 
 27.6   required to conduct more than one review of a subject's records 
 27.7   from the Federal Bureau of Investigation if a review of the 
 27.8   subject's criminal history with the Federal Bureau of 
 27.9   Investigation has already been completed by the commissioner and 
 27.10  there has been no break in the subject's affiliation with the 
 27.11  license holder who initiated the background study. 
 27.12     (m) When the commissioner has reasonable cause to believe 
 27.13  that further pertinent information may exist on the subject, the 
 27.14  subject shall provide a set of classifiable fingerprints 
 27.15  obtained from an authorized law enforcement agency.  For 
 27.16  purposes of requiring fingerprints, the commissioner shall be 
 27.17  considered to have reasonable cause under, but not limited to, 
 27.18  the following circumstances: 
 27.19     (1) information from the bureau of criminal apprehension 
 27.20  indicates that the subject is a multistate offender; 
 27.21     (2) information from the bureau of criminal apprehension 
 27.22  indicates that multistate offender status is undetermined; or 
 27.23     (3) the commissioner has received a report from the subject 
 27.24  or a third party indicating that the subject has a criminal 
 27.25  history in a jurisdiction other than Minnesota. 
 27.26     (n) The failure or refusal of an applicant, license holder, 
 27.27  or registrant under section 144A.71, subdivision 1, to cooperate 
 27.28  with the commissioner is reasonable cause to disqualify a 
 27.29  subject, deny a license application or immediately suspend, 
 27.30  suspend, or revoke a license or registration.  Failure or 
 27.31  refusal of an individual to cooperate with the study is just 
 27.32  cause for denying or terminating employment of the individual if 
 27.33  the individual's failure or refusal to cooperate could cause the 
 27.34  applicant's application to be denied or the license holder's 
 27.35  license to be immediately suspended, suspended, or revoked. 
 27.36     (o) The commissioner shall not consider an application to 
 28.1   be complete until all of the information required to be provided 
 28.2   under this subdivision has been received.  
 28.3      (p) No person in paragraph (c), clauses (1) to (7), who is 
 28.4   disqualified as a result of this section may be retained by the 
 28.5   agency in a position involving direct contact with persons 
 28.6   served by the program or in a position allowing and no person in 
 28.7   paragraph (c), clauses (2), (6), and (7), or as provided 
 28.8   elsewhere in statute who is disqualified as a result of this 
 28.9   section may be allowed access to persons served by the 
 28.10  program as provided for in statutes, unless the commissioner has 
 28.11  provided written notice to the agency stating that: 
 28.12     (1) the individual may remain in direct contact during the 
 28.13  period in which the individual may request reconsideration as 
 28.14  provided in subdivision 3a, paragraph (b), clause (2) or (3); 
 28.15     (2) the individual's disqualification has been set aside 
 28.16  for that agency as provided in subdivision 3b, paragraph (b); or 
 28.17     (3) the license holder has been granted a variance for the 
 28.18  disqualified individual under subdivision 3e. 
 28.19     (q) Termination of affiliation with persons in paragraph 
 28.20  (c), clauses (1) to (7), made in good faith reliance on a notice 
 28.21  of disqualification provided by the commissioner shall not 
 28.22  subject the applicant or license holder to civil liability. 
 28.23     (r) The commissioner may establish records to fulfill the 
 28.24  requirements of this section. 
 28.25     (s) The commissioner may not disqualify an individual 
 28.26  subject to a study under this section because that person has, 
 28.27  or has had, a mental illness as defined in section 245.462, 
 28.28  subdivision 20. 
 28.29     (t) An individual subject to disqualification under this 
 28.30  subdivision has the applicable rights in subdivision 3a, 3b, or 
 28.31  3c. 
 28.32     (u) For the purposes of background studies completed by 
 28.33  tribal organizations performing licensing activities otherwise 
 28.34  required of the commissioner under this chapter, after obtaining 
 28.35  consent from the background study subject, tribal licensing 
 28.36  agencies shall have access to criminal history data in the same 
 29.1   manner as county licensing agencies and private licensing 
 29.2   agencies under this chapter. 
 29.3      Sec. 12.  Minnesota Statutes 2001 Supplement, section 
 29.4   245A.04, subdivision 3a, is amended to read: 
 29.5      Subd. 3a.  [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 
 29.6   STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) Within 15 
 29.7   working days, the commissioner shall notify the applicant, 
 29.8   license holder, or registrant under section 144A.71, subdivision 
 29.9   1, and the individual who is the subject of the study, in 
 29.10  writing or by electronic transmission, of the results of the 
 29.11  study or that more time is needed to complete the study.  When 
 29.12  the study is completed, a notice that the study was undertaken 
 29.13  and completed shall be maintained in the personnel files of the 
 29.14  program.  For studies on individuals pertaining to a license to 
 29.15  provide family day care or group family day care, foster care 
 29.16  for children in the provider's own home, or foster care or day 
 29.17  care services for adults in the provider's own home, the 
 29.18  commissioner is not required to provide a separate notice of the 
 29.19  background study results to the individual who is the subject of 
 29.20  the study unless the study results in a disqualification of the 
 29.21  individual. 
 29.22     The commissioner shall notify the individual studied if the 
 29.23  information in the study indicates the individual is 
 29.24  disqualified from direct contact with persons served by the 
 29.25  program.  The commissioner shall disclose the information 
 29.26  causing disqualification and instructions on how to request a 
 29.27  reconsideration of the disqualification to the individual 
 29.28  studied.  An applicant or license holder who is not the subject 
 29.29  of the study shall be informed that the commissioner has found 
 29.30  information that disqualifies the subject from direct contact 
 29.31  with persons served by the program.  However, only the 
 29.32  individual studied must be informed of the information contained 
 29.33  in the subject's background study unless the basis for the 
 29.34  disqualification is failure to cooperate, substantiated 
 29.35  maltreatment under section 626.556 or 626.557, the Data 
 29.36  Practices Act provides for release of the information, or the 
 30.1   individual studied authorizes the release of the information.  
 30.2   When a disqualification is based on the subject's failure to 
 30.3   cooperate with the background study or substantiated 
 30.4   maltreatment under section 626.556 or 626.557, the agency that 
 30.5   initiated the study shall be informed by the commissioner of the 
 30.6   reason for the disqualification. 
 30.7      (b) Except as provided in subdivision 3d, paragraph (b), if 
 30.8   the commissioner determines that the individual studied has a 
 30.9   disqualifying characteristic, the commissioner shall review the 
 30.10  information immediately available and make a determination as to 
 30.11  the subject's immediate risk of harm to persons served by the 
 30.12  program where the individual studied will have direct contact.  
 30.13  The commissioner shall consider all relevant information 
 30.14  available, including the following factors in determining the 
 30.15  immediate risk of harm:  the recency of the disqualifying 
 30.16  characteristic; the recency of discharge from probation for the 
 30.17  crimes; the number of disqualifying characteristics; the 
 30.18  intrusiveness or violence of the disqualifying characteristic; 
 30.19  the vulnerability of the victim involved in the disqualifying 
 30.20  characteristic; and the similarity of the victim to the persons 
 30.21  served by the program where the individual studied will have 
 30.22  direct contact.  The commissioner may determine that the 
 30.23  evaluation of the information immediately available gives the 
 30.24  commissioner reason to believe one of the following: 
 30.25     (1) The individual poses an imminent risk of harm to 
 30.26  persons served by the program where the individual studied will 
 30.27  have direct contact.  If the commissioner determines that an 
 30.28  individual studied poses an imminent risk of harm to persons 
 30.29  served by the program where the individual studied will have 
 30.30  direct contact, the individual and the license holder must be 
 30.31  sent a notice of disqualification.  The commissioner shall order 
 30.32  the license holder to immediately remove the individual studied 
 30.33  from direct contact.  The notice to the individual studied must 
 30.34  include an explanation of the basis of this determination. 
 30.35     (2) The individual poses a risk of harm requiring 
 30.36  continuous, direct supervision while providing direct contact 
 31.1   services during the period in which the subject may request a 
 31.2   reconsideration.  If the commissioner determines that an 
 31.3   individual studied poses a risk of harm that requires 
 31.4   continuous, direct supervision, the individual and the license 
 31.5   holder must be sent a notice of disqualification.  The 
 31.6   commissioner shall order the license holder to immediately 
 31.7   remove the individual studied from direct contact services or 
 31.8   assure that the individual studied is within sight or hearing 
 31.9   under the continuous, direct supervision of another staff person 
 31.10  when providing direct contact services during the period in 
 31.11  which the individual may request a reconsideration of the 
 31.12  disqualification.  If the individual studied does not submit a 
 31.13  timely request for reconsideration, or the individual submits a 
 31.14  timely request for reconsideration, but the disqualification is 
 31.15  not set aside for that license holder, the license holder will 
 31.16  be notified of the disqualification and ordered to immediately 
 31.17  remove the individual from any position allowing direct contact 
 31.18  with persons receiving services from the license holder. 
 31.19     (3) The individual does not pose an imminent risk of harm 
 31.20  or a risk of harm requiring continuous, direct supervision while 
 31.21  providing direct contact services during the period in which the 
 31.22  subject may request a reconsideration.  If the commissioner 
 31.23  determines that an individual studied does not pose a risk of 
 31.24  harm that requires continuous, direct supervision, only the 
 31.25  individual must be sent a notice of disqualification.  The 
 31.26  license holder must be sent a notice that more time is needed to 
 31.27  complete the individual's background study.  If the individual 
 31.28  studied submits a timely request for reconsideration, and if the 
 31.29  disqualification is set aside for that license holder, the 
 31.30  license holder will receive the same notification received by 
 31.31  license holders in cases where the individual studied has no 
 31.32  disqualifying characteristic.  If the individual studied does 
 31.33  not submit a timely request for reconsideration, or the 
 31.34  individual submits a timely request for reconsideration, but the 
 31.35  disqualification is not set aside for that license holder, the 
 31.36  license holder will be notified of the disqualification and 
 32.1   ordered to immediately remove the individual from any position 
 32.2   allowing direct contact with persons receiving services from the 
 32.3   license holder.  
 32.4      (c) County licensing agencies performing duties under this 
 32.5   subdivision may develop an alternative system for determining 
 32.6   the subject's immediate risk of harm to persons served by the 
 32.7   program, providing the notices under paragraph (b), and 
 32.8   documenting the action taken by the county licensing agency.  
 32.9   Each county licensing agency's implementation of the alternative 
 32.10  system is subject to approval by the commissioner.  
 32.11  Notwithstanding this alternative system, county licensing 
 32.12  agencies shall complete the requirements of paragraph (a). 
 32.13     Sec. 13.  Minnesota Statutes 2001 Supplement, section 
 32.14  245A.04, subdivision 3b, is amended to read: 
 32.15     Subd. 3b.  [RECONSIDERATION OF DISQUALIFICATION.] (a) The 
 32.16  individual who is the subject of the disqualification may 
 32.17  request a reconsideration of the disqualification.  
 32.18     The individual must submit the request for reconsideration 
 32.19  to the commissioner in writing.  A request for reconsideration 
 32.20  for an individual who has been sent a notice of disqualification 
 32.21  under subdivision 3a, paragraph (b), clause (1) or (2), must be 
 32.22  submitted within 30 calendar days of the disqualified 
 32.23  individual's receipt of the notice of disqualification.  Upon 
 32.24  showing that the information in clause (1) or (2) cannot be 
 32.25  obtained within 30 days, the disqualified individual may request 
 32.26  additional time, not to exceed 30 days, to obtain that 
 32.27  information.  A request for reconsideration for an individual 
 32.28  who has been sent a notice of disqualification under subdivision 
 32.29  3a, paragraph (b), clause (3), must be submitted within 15 
 32.30  calendar days of the disqualified individual's receipt of the 
 32.31  notice of disqualification.  An individual who was determined to 
 32.32  have maltreated a child under section 626.556 or a vulnerable 
 32.33  adult under section 626.557, and who was disqualified under this 
 32.34  section on the basis of serious or recurring maltreatment, may 
 32.35  request reconsideration of both the maltreatment and the 
 32.36  disqualification determinations.  The request for 
 33.1   reconsideration of the maltreatment determination and the 
 33.2   disqualification must be submitted within 30 calendar days of 
 33.3   the individual's receipt of the notice of disqualification.  
 33.4   Removal of a disqualified individual from direct contact shall 
 33.5   be ordered if the individual does not request reconsideration 
 33.6   within the prescribed time, and for an individual who submits a 
 33.7   timely request for reconsideration, if the disqualification is 
 33.8   not set aside.  The individual must present information showing 
 33.9   that: 
 33.10     (1) the information the commissioner relied upon in 
 33.11  determining that the underlying conduct giving rise to the 
 33.12  disqualification occurred, and for maltreatment, that the 
 33.13  maltreatment was serious or recurring, is incorrect or 
 33.14  inaccurate.  If the basis of a reconsideration request is that a 
 33.15  maltreatment determination or disposition under section 626.556 
 33.16  or 626.557 is incorrect, and the commissioner has issued a final 
 33.17  order in an appeal of that determination or disposition under 
 33.18  section 256.045 or 245A.08, subdivision 5, the commissioner's 
 33.19  order is conclusive on the issue of maltreatment.  If the 
 33.20  individual did not request reconsideration of the maltreatment 
 33.21  determination, the maltreatment determination is deemed 
 33.22  conclusive; or 
 33.23     (2) the subject of the study does not pose a risk of harm 
 33.24  to any person served by the applicant, license holder, or 
 33.25  registrant under section 144A.71, subdivision 1. 
 33.26     (b) The commissioner shall rescind the disqualification if 
 33.27  the commissioner finds that the information relied on to 
 33.28  disqualify the subject is incorrect.  The commissioner may set 
 33.29  aside the disqualification under this section if the 
 33.30  commissioner finds that the individual does not pose a risk of 
 33.31  harm to any person served by the applicant, license holder, or 
 33.32  registrant under section 144A.71, subdivision 1.  In determining 
 33.33  that an individual does not pose a risk of harm, the 
 33.34  commissioner shall consider the nature, severity, and 
 33.35  consequences of the event or events that lead to 
 33.36  disqualification, whether there is more than one disqualifying 
 34.1   event, the age and vulnerability of the victim at the time of 
 34.2   the event, the harm suffered by the victim, the similarity 
 34.3   between the victim and persons served by the program, the time 
 34.4   elapsed without a repeat of the same or similar event, 
 34.5   documentation of successful completion by the individual studied 
 34.6   of training or rehabilitation pertinent to the event, and any 
 34.7   other information relevant to reconsideration.  In reviewing a 
 34.8   disqualification under this section, the commissioner shall give 
 34.9   preeminent weight to the safety of each person to be served by 
 34.10  the license holder, applicant, or registrant under section 
 34.11  144A.71, subdivision 1, over the interests of the license 
 34.12  holder, applicant, or registrant under section 144A.71, 
 34.13  subdivision 1. 
 34.14     (c) Unless the information the commissioner relied on in 
 34.15  disqualifying an individual is incorrect, the commissioner may 
 34.16  not set aside the disqualification of an individual in 
 34.17  connection with a license to provide family day care for 
 34.18  children, foster care for children in the provider's own home, 
 34.19  or foster care or day care services for adults in the provider's 
 34.20  own home if: 
 34.21     (1) less than ten years have passed since the discharge of 
 34.22  the sentence imposed for the offense; and the individual has 
 34.23  been convicted of a violation of any offense listed in sections 
 34.24  609.20 (manslaughter in the first degree), 609.205 (manslaughter 
 34.25  in the second degree), criminal vehicular homicide under 609.21 
 34.26  (criminal vehicular homicide and injury), 609.215 (aiding 
 34.27  suicide or aiding attempted suicide), felony violations under 
 34.28  609.221 to 609.2231 (assault in the first, second, third, or 
 34.29  fourth degree), 609.713 (terroristic threats), 609.235 (use of 
 34.30  drugs to injure or to facilitate crime), 609.24 (simple 
 34.31  robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 
 34.32  609.255 (false imprisonment), 609.561 or 609.562 (arson in the 
 34.33  first or second degree), 609.71 (riot), burglary in the first or 
 34.34  second degree under 609.582 (burglary), 609.66 (dangerous 
 34.35  weapon), 609.665 (spring guns), 609.67 (machine guns and 
 34.36  short-barreled shotguns), 609.749 (harassment; stalking), 
 35.1   152.021 or 152.022 (controlled substance crime in the first or 
 35.2   second degree), 152.023, subdivision 1, clause (3) or (4), or 
 35.3   subdivision 2, clause (4) (controlled substance crime in the 
 35.4   third degree), 152.024, subdivision 1, clause (2), (3), or (4) 
 35.5   (controlled substance crime in the fourth degree), 609.224, 
 35.6   subdivision 2, paragraph (c) (fifth-degree assault by a 
 35.7   caregiver against a vulnerable adult), 609.228 (great bodily 
 35.8   harm caused by distribution of drugs), 609.23 (mistreatment of 
 35.9   persons confined), 609.231 (mistreatment of residents or 
 35.10  patients), 609.2325 (criminal abuse of a vulnerable adult), 
 35.11  609.233 (criminal neglect of a vulnerable adult), 609.2335 
 35.12  (financial exploitation of a vulnerable adult), 609.234 (failure 
 35.13  to report), 609.265 (abduction), 609.2664 to 609.2665 
 35.14  (manslaughter of an unborn child in the first or second degree), 
 35.15  609.267 to 609.2672 (assault of an unborn child in the first, 
 35.16  second, or third degree), 609.268 (injury or death of an unborn 
 35.17  child in the commission of a crime), 617.293 (disseminating or 
 35.18  displaying harmful material to minors), a felony level 
 35.19  conviction involving alcohol or drug use, a gross misdemeanor 
 35.20  offense under 609.324, subdivision 1 (other prohibited acts), a 
 35.21  gross misdemeanor offense under 609.378 (neglect or endangerment 
 35.22  of a child), a gross misdemeanor offense under 609.377 
 35.23  (malicious punishment of a child), 609.72, subdivision 3 
 35.24  (disorderly conduct against a vulnerable adult); or an attempt 
 35.25  or conspiracy to commit any of these offenses, as each of these 
 35.26  offenses is defined in Minnesota Statutes; or an offense in any 
 35.27  other state, the elements of which are substantially similar to 
 35.28  the elements of any of the foregoing offenses; 
 35.29     (2) regardless of how much time has passed since the 
 35.30  involuntary termination of parental rights under section 
 35.31  260C.301 or the discharge of the sentence imposed for the 
 35.32  offense, the individual was convicted of a violation of any 
 35.33  offense listed in sections 609.185 to 609.195 (murder in the 
 35.34  first, second, or third degree), 609.2661 to 609.2663 (murder of 
 35.35  an unborn child in the first, second, or third degree), a felony 
 35.36  offense under 609.377 (malicious punishment of a child), a 
 36.1   felony offense under 609.324, subdivision 1 (other prohibited 
 36.2   acts), a felony offense under 609.378 (neglect or endangerment 
 36.3   of a child), 609.322 (solicitation, inducement, and promotion of 
 36.4   prostitution), 609.342 to 609.345 (criminal sexual conduct in 
 36.5   the first, second, third, or fourth degree), 609.352 
 36.6   (solicitation of children to engage in sexual conduct), 617.246 
 36.7   (use of minors in a sexual performance), 617.247 (possession of 
 36.8   pictorial representations of a minor), 609.365 (incest), a 
 36.9   felony offense under sections 609.2242 and 609.2243 (domestic 
 36.10  assault), a felony offense of spousal abuse, a felony offense of 
 36.11  child abuse or neglect, a felony offense of a crime against 
 36.12  children, or an attempt or conspiracy to commit any of these 
 36.13  offenses as defined in Minnesota Statutes, or an offense in any 
 36.14  other state, the elements of which are substantially similar to 
 36.15  any of the foregoing offenses; 
 36.16     (3) within the seven years preceding the study, the 
 36.17  individual committed an act that constitutes maltreatment of a 
 36.18  child under section 626.556, subdivision 10e, and that resulted 
 36.19  in substantial bodily harm as defined in section 609.02, 
 36.20  subdivision 7a, or substantial mental or emotional harm as 
 36.21  supported by competent psychological or psychiatric evidence; or 
 36.22     (4) within the seven years preceding the study, the 
 36.23  individual was determined under section 626.557 to be the 
 36.24  perpetrator of a substantiated incident of maltreatment of a 
 36.25  vulnerable adult that resulted in substantial bodily harm as 
 36.26  defined in section 609.02, subdivision 7a, or substantial mental 
 36.27  or emotional harm as supported by competent psychological or 
 36.28  psychiatric evidence. 
 36.29     In the case of any ground for disqualification under 
 36.30  clauses (1) to (4), if the act was committed by an individual 
 36.31  other than the applicant, license holder, or registrant under 
 36.32  section 144A.71, subdivision 1, residing in the applicant's or 
 36.33  license holder's home, or the home of a registrant under section 
 36.34  144A.71, subdivision 1, the applicant, license holder, or 
 36.35  registrant under section 144A.71, subdivision 1, may seek 
 36.36  reconsideration when the individual who committed the act no 
 37.1   longer resides in the home.  
 37.2      The disqualification periods provided under clauses (1), 
 37.3   (3), and (4) are the minimum applicable disqualification 
 37.4   periods.  The commissioner may determine that an individual 
 37.5   should continue to be disqualified from licensure or 
 37.6   registration under section 144A.71, subdivision 1, because the 
 37.7   license holder, applicant, or registrant under section 144A.71, 
 37.8   subdivision 1, poses a risk of harm to a person served by that 
 37.9   individual after the minimum disqualification period has passed. 
 37.10     (d) The commissioner shall respond in writing or by 
 37.11  electronic transmission to all reconsideration requests for 
 37.12  which the basis for the request is that the information relied 
 37.13  upon by the commissioner to disqualify is incorrect or 
 37.14  inaccurate within 30 working days of receipt of a request and 
 37.15  all relevant information.  If the basis for the request is that 
 37.16  the individual does not pose a risk of harm, the commissioner 
 37.17  shall respond to the request within 15 working days after 
 37.18  receiving the request for reconsideration and all relevant 
 37.19  information.  If the request is based on both the correctness or 
 37.20  accuracy of the information relied on to disqualify the 
 37.21  individual and the risk of harm, the commissioner shall respond 
 37.22  to the request within 45 working days after receiving the 
 37.23  request for reconsideration and all relevant information.  If 
 37.24  the disqualification is set aside, the commissioner shall notify 
 37.25  the applicant or license holder in writing or by electronic 
 37.26  transmission of the decision. 
 37.27     (e) Except as provided in subdivision 3c, if a 
 37.28  disqualification for which reconsideration was requested is not 
 37.29  set aside or is not rescinded, an individual who was 
 37.30  disqualified on the basis of a preponderance of evidence that 
 37.31  the individual committed an act or acts that meet the definition 
 37.32  of any of the crimes lists listed in subdivision 3d, paragraph 
 37.33  (a), clauses (1) to (4); or for failure to make required reports 
 37.34  under section 626.556, subdivision 3, or 626.557, subdivision 3, 
 37.35  pursuant to subdivision 3d, paragraph (a), clause (4), may 
 37.36  request a fair hearing under section 256.045.  Except as 
 38.1   provided under subdivision 3c, the commissioner's final order 
 38.2   for an individual under this paragraph is conclusive on the 
 38.3   issue of maltreatment and disqualification, including for 
 38.4   purposes of subsequent studies conducted under subdivision 3, 
 38.5   and fair hearing is the only administrative appeal of the final 
 38.6   agency determination, specifically, including a challenge to the 
 38.7   accuracy and completeness of data under section 13.04.  
 38.8      (f) Except as provided under subdivision 3c, if an 
 38.9   individual was disqualified on the basis of a determination of 
 38.10  maltreatment under section 626.556 or 626.557, which was serious 
 38.11  or recurring, and the individual has requested reconsideration 
 38.12  of the maltreatment determination under section 626.556, 
 38.13  subdivision 10i, or 626.557, subdivision 9d, and also requested 
 38.14  reconsideration of the disqualification under this subdivision, 
 38.15  reconsideration of the maltreatment determination and 
 38.16  reconsideration of the disqualification shall be consolidated 
 38.17  into a single reconsideration.  For maltreatment and 
 38.18  disqualification determinations made by county agencies, the 
 38.19  consolidated reconsideration shall be conducted by the county 
 38.20  agency.  If the county agency has disqualified an individual on 
 38.21  multiple bases, one of which is a county maltreatment 
 38.22  determination for which the individual has a right to request 
 38.23  reconsideration, the county shall conduct the reconsideration of 
 38.24  all disqualifications.  Except as provided under subdivision 3c, 
 38.25  if an individual who was disqualified on the basis of serious or 
 38.26  recurring maltreatment requests a fair hearing on the 
 38.27  maltreatment determination under section 626.556, subdivision 
 38.28  10i, or 626.557, subdivision 9d, and requests a fair hearing on 
 38.29  the disqualification, which has not been set aside or rescinded 
 38.30  under this subdivision, the scope of the fair hearing under 
 38.31  section 256.045 shall include the maltreatment determination and 
 38.32  the disqualification.  Except as provided under subdivision 
 38.33  3c, the commissioner's final order for an individual under this 
 38.34  paragraph is conclusive on the issue of maltreatment and 
 38.35  disqualification, including for purposes of subsequent studies 
 38.36  conducted under subdivision 3, and a fair hearing is the only 
 39.1   administrative appeal of the final agency determination, 
 39.2   specifically, including a challenge to the accuracy and 
 39.3   completeness of data under section 13.04. 
 39.4      Sec. 14.  Minnesota Statutes 2000, section 245A.04, is 
 39.5   amended by adding a subdivision to read: 
 39.6      Subd. 3f.  [CONCLUSIVE DETERMINATIONS OR 
 39.7   DISPOSITIONS.] Unless otherwise specified in statute, the 
 39.8   following determinations or dispositions are deemed conclusive: 
 39.9      (1) a maltreatment determination or disposition under 
 39.10  section 626.556 or 626.557, if: 
 39.11     (i) the commissioner has issued a final order in an appeal 
 39.12  of that determination or disposition under section 256.045 or 
 39.13  245A.08, subdivision 5; 
 39.14     (ii) the individual did not request reconsideration on the 
 39.15  maltreatment determination or disposition under section 626.556 
 39.16  or 626.557; or 
 39.17     (iii) the individual did not request a hearing of the 
 39.18  maltreatment determination or disposition under section 256.045; 
 39.19  and 
 39.20     (2) a determination that the information relied upon to 
 39.21  disqualify an individual under subdivision 3d, was correct based 
 39.22  on serious or recurring maltreatment; or 
 39.23     (3) a preponderance of evidence shows that the individual 
 39.24  committed an act or acts that meet the definition of any of the 
 39.25  crimes listed in subdivision 3d, paragraph (a), clauses (1) to 
 39.26  (4); or the individual's failure to make required reports under 
 39.27  section 626.556, subdivision 3, or 626.557, subdivision 3, if: 
 39.28     (i) the commissioner has issued a final order in an appeal 
 39.29  of that determination under section 256.045 or 245A.08, 
 39.30  subdivision 5, or a court has issued a final decision; 
 39.31     (ii) the individual did not request reconsideration of the 
 39.32  disqualification under this subdivision; or 
 39.33     (iii) the individual did not request a hearing on the 
 39.34  disqualification under section 256.045. 
 39.35     Sec. 15.  Minnesota Statutes 2001 Supplement, section 
 39.36  245A.07, subdivision 2a, is amended to read: 
 40.1      Subd. 2a.  [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 
 40.2   Within five working days of receipt of the license holder's 
 40.3   timely appeal, the commissioner shall request assignment of an 
 40.4   administrative law judge.  The request must include a proposed 
 40.5   date, time, and place of a hearing.  A hearing must be conducted 
 40.6   by an administrative law judge within 30 calendar days of the 
 40.7   request for assignment, unless an extension is requested by 
 40.8   either party and granted by the administrative law judge for 
 40.9   good cause.  The commissioner shall issue a notice of hearing by 
 40.10  certified mail at least ten working days before the hearing.  
 40.11  The scope of the hearing shall be limited solely to the issue of 
 40.12  whether the temporary immediate suspension should remain in 
 40.13  effect pending the commissioner's final order under section 
 40.14  245A.08, regarding a licensing sanction issued under subdivision 
 40.15  3 following the immediate suspension.  The burden of proof in 
 40.16  expedited hearings under this subdivision shall be limited to 
 40.17  the commissioner's demonstration that reasonable cause exists to 
 40.18  believe that the license holder's actions or failure to comply 
 40.19  with applicable law or rule poses an imminent risk of harm to 
 40.20  the health, safety, or rights of persons served by the program.  
 40.21     (b) The administrative law judge shall issue findings of 
 40.22  fact, conclusions, and a recommendation within ten working days 
 40.23  from the date of hearing.  The commissioner's final order shall 
 40.24  be issued within ten working days from receipt of the 
 40.25  recommendation of the administrative law judge.  Within 90 
 40.26  calendar days after a final order affirming an immediate 
 40.27  suspension, the commissioner shall make a determination 
 40.28  regarding whether a final licensing sanction shall be issued 
 40.29  under subdivision 3.  The license holder shall continue to be 
 40.30  prohibited from operation of the program during this 90-day 
 40.31  period.  
 40.32     (c) When the final order under paragraph (b) affirms an 
 40.33  immediate suspension, and a final licensing sanction is issued 
 40.34  under subdivision 3, and the license holder appeals that 
 40.35  sanction, the license holder continues to be prohibited from 
 40.36  operation of the program pending a final commissioner's order 
 41.1   under section 245A.08, subdivision 5, regarding the final 
 41.2   licensing sanction. 
 41.3      Sec. 16.  Minnesota Statutes 2001 Supplement, section 
 41.4   245A.07, subdivision 3, is amended to read: 
 41.5      Subd. 3.  [LICENSE SUSPENSION, REVOCATION, OR FINE.] The 
 41.6   commissioner may suspend or revoke a license, or impose a fine 
 41.7   if a license holder fails to comply fully with applicable laws 
 41.8   or rules, or knowingly withholds relevant information from or 
 41.9   gives false or misleading information to the commissioner in 
 41.10  connection with an application for a license, in connection with 
 41.11  the background study status of an individual, or during an 
 41.12  investigation.  A license holder who has had a license 
 41.13  suspended, revoked, or has been ordered to pay a fine must be 
 41.14  given notice of the action by certified mail.  The notice must 
 41.15  be mailed to the address shown on the application or the last 
 41.16  known address of the license holder.  The notice must state the 
 41.17  reasons the license was suspended, revoked, or a fine was 
 41.18  ordered. 
 41.19     (a) If the license was suspended or revoked, the notice 
 41.20  must inform the license holder of the right to a contested case 
 41.21  hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 
 41.22  1400.8612 and successor rules.  The license holder may appeal an 
 41.23  order suspending or revoking a license.  The appeal of an order 
 41.24  suspending or revoking a license must be made in writing by 
 41.25  certified mail and must be received by the commissioner within 
 41.26  ten calendar days after the license holder receives notice that 
 41.27  the license has been suspended or revoked.  Except as provided 
 41.28  in subdivision 2a, paragraph (c), a timely appeal of an order 
 41.29  suspending or revoking a license shall stay the suspension or 
 41.30  revocation until the commissioner issues a final order.  
 41.31     (b)(1) If the license holder was ordered to pay a fine, the 
 41.32  notice must inform the license holder of the responsibility for 
 41.33  payment of fines and the right to a contested case hearing under 
 41.34  chapter 14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and 
 41.35  successor rules.  The appeal of an order to pay a fine must be 
 41.36  made in writing by certified mail and must be received by the 
 42.1   commissioner within ten calendar days after the license holder 
 42.2   receives notice that the fine has been ordered.  
 42.3      (2) The license holder shall pay the fines assessed on or 
 42.4   before the payment date specified.  If the license holder fails 
 42.5   to fully comply with the order, the commissioner may issue a 
 42.6   second fine or suspend the license until the license holder 
 42.7   complies.  If the license holder receives state funds, the 
 42.8   state, county, or municipal agencies or departments responsible 
 42.9   for administering the funds shall withhold payments and recover 
 42.10  any payments made while the license is suspended for failure to 
 42.11  pay a fine.  A timely appeal shall stay payment of the fine 
 42.12  until the commissioner issues a final order.  
 42.13     (3) A license holder shall promptly notify the commissioner 
 42.14  of human services, in writing, when a violation specified in the 
 42.15  order to forfeit a fine is corrected.  If upon reinspection the 
 42.16  commissioner determines that a violation has not been corrected 
 42.17  as indicated by the order to forfeit a fine, the commissioner 
 42.18  may issue a second fine.  The commissioner shall notify the 
 42.19  license holder by certified mail that a second fine has been 
 42.20  assessed.  The license holder may appeal the second fine as 
 42.21  provided under this subdivision. 
 42.22     (4) Fines shall be assessed as follows:  the license holder 
 42.23  shall forfeit $1,000 for each determination of maltreatment of a 
 42.24  child under section 626.556 or the maltreatment of a vulnerable 
 42.25  adult under section 626.557; the license holder shall forfeit 
 42.26  $200 for each occurrence of a violation of law or rule governing 
 42.27  matters of health, safety, or supervision, including but not 
 42.28  limited to the provision of adequate staff-to-child or adult 
 42.29  ratios, and failure to submit a background study; and the 
 42.30  license holder shall forfeit $100 for each occurrence of a 
 42.31  violation of law or rule other than those subject to a $1,000 or 
 42.32  $200 fine above.  For purposes of this section, "occurrence" 
 42.33  means each violation identified in the commissioner's fine order.
 42.34     (5) When a fine has been assessed, the license holder may 
 42.35  not avoid payment by closing, selling, or otherwise transferring 
 42.36  the licensed program to a third party.  In such an event, the 
 43.1   license holder will be personally liable for payment.  In the 
 43.2   case of a corporation, each controlling individual is personally 
 43.3   and jointly liable for payment.  
 43.4      Sec. 17.  [245A.085] [CONSOLIDATION OF HEARINGS; 
 43.5   RECONSIDERATION.] 
 43.6      Hearings authorized under this chapter and sections 
 43.7   256.045, 626.556, and 626.557, shall be consolidated if feasible 
 43.8   and in accordance with other applicable statutes and rules.  
 43.9   Reconsideration under sections 245A.04, subdivision 3c; 626.556, 
 43.10  subdivision 10i; and 626.557, subdivision 9d, shall also be 
 43.11  consolidated if feasible. 
 43.12     Sec. 18.  Minnesota Statutes 2001 Supplement, section 
 43.13  245A.144, is amended to read: 
 43.14     245A.144 [REDUCTION OF RISK OF SUDDEN INFANT DEATH SYNDROME 
 43.15  IN CHILD CARE PROGRAMS.] 
 43.16     License holders must ensure that before staff persons, 
 43.17  caregivers, and helpers assist in the care of infants, they 
 43.18  receive training on reducing the risk of sudden infant death 
 43.19  syndrome.  The training on reducing the risk of sudden infant 
 43.20  death syndrome may be provided as orientation training under 
 43.21  Minnesota Rules, part 9503.0035, subpart 1, as initial training 
 43.22  under Minnesota Rules, part 9502.0385, subpart 2, as in-service 
 43.23  training under Minnesota Rules, part 9503.0035, subpart 4, or as 
 43.24  ongoing training under Minnesota Rules, part 9502.0385, subpart 
 43.25  3.  Training required under this section must be at least one 
 43.26  hour in length and must be completed at least once every five 
 43.27  years.  At a minimum, the training must address the risk factors 
 43.28  related to sudden infant death syndrome, means of reducing the 
 43.29  risk of sudden infant death syndrome in child care, and license 
 43.30  holder communication with parents regarding reducing the risk of 
 43.31  sudden infant death syndrome.  Training for family and group 
 43.32  family child care providers must be approved by the county 
 43.33  licensing agency according to Minnesota Rules, part 9502.0385. 
 43.34     Sec. 19.  [245A.151] [FIRE INSPECTION.] 
 43.35     When licensure under this chapter requires an inspection by 
 43.36  a fire marshal in order to comply with the Minnesota Uniform 
 44.1   Fire Code under section 299F.011, a local fire code inspector 
 44.2   may conduct the inspection.  If a community does not have a 
 44.3   local fire code inspector, a local fire code inspector from 
 44.4   another community may conduct the inspection.  A local fire code 
 44.5   inspector may recover the cost of these inspections through a 
 44.6   fee of no more than $50 per inspection charged to the applicant 
 44.7   or license holder. 
 44.8      Sec. 20.  Minnesota Statutes 2001 Supplement, section 
 44.9   245A.16, subdivision 1, is amended to read: 
 44.10     Subdivision 1.  [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 
 44.11  County agencies and private agencies that have been designated 
 44.12  or licensed by the commissioner to perform licensing functions 
 44.13  and activities under section 245A.04, to recommend denial of 
 44.14  applicants under section 245A.05, to issue correction orders, to 
 44.15  issue variances, and recommend a conditional license under 
 44.16  section 245A.06, or to recommend suspending or revoking a 
 44.17  license or issuing a fine under section 245A.07, shall comply 
 44.18  with rules and directives of the commissioner governing those 
 44.19  functions and with this section.  The following variances are 
 44.20  excluded from the delegation of variance authority and may be 
 44.21  issued only by the commissioner: 
 44.22     (1) dual licensure of family child care and child foster 
 44.23  care, dual licensure of child and adult foster care, and adult 
 44.24  foster care and family child care; 
 44.25     (2) adult foster care maximum capacity; 
 44.26     (3) adult foster care minimum age requirement; 
 44.27     (4) child foster care maximum age requirement; 
 44.28     (5) variances regarding disqualified individuals except 
 44.29  that county agencies may issue variances under section 245A.04, 
 44.30  subdivision 3e, regarding disqualified individuals when the 
 44.31  county is responsible for conducting a consolidated 
 44.32  reconsideration according to section 245A.04, subdivision 3b, 
 44.33  paragraph (f), of a county maltreatment determination and a 
 44.34  disqualification based on serious or recurring maltreatment; and 
 44.35     (6) the required presence of a caregiver in the adult 
 44.36  foster care residence during normal sleeping hours. 
 45.1      (b) County agencies must report information about 
 45.2   disqualification reconsiderations under section 245A.04, 
 45.3   subdivision 3b, paragraph (f), and variances granted under 
 45.4   paragraph (a), clause (5), to the commissioner at least monthly 
 45.5   in a format prescribed by the commissioner. 
 45.6      (c) For family day care programs, the commissioner may 
 45.7   authorize licensing reviews every two years after a licensee has 
 45.8   had at least one annual review. 
 45.9      Sec. 21.  Minnesota Statutes 2000, section 254B.09, 
 45.10  subdivision 2, is amended to read: 
 45.11     Subd. 2.  [AMERICAN INDIAN AGREEMENTS.] The commissioner 
 45.12  may enter into agreements with federally recognized tribal units 
 45.13  to pay for chemical dependency treatment services provided under 
 45.14  Laws 1986, chapter 394, sections 8 to 20.  The agreements 
 45.15  must require clarify how the governing body of the tribal 
 45.16  unit to fulfill all county fulfill local agency responsibilities 
 45.17  regarding: 
 45.18     (1) selection of eligible vendors under section 254B.03, 
 45.19  subdivision 1; 
 45.20     (2) negotiation of agreements that establish vendor 
 45.21  services and rates for programs located on the tribal governing 
 45.22  body's reservation; 
 45.23     (3) the form and manner of invoicing,; and 
 45.24     (4) provide that only invoices for eligible vendors 
 45.25  according to section 254B.05 will be included in invoices sent 
 45.26  to the commissioner for payment, to the extent that money 
 45.27  allocated under subdivisions 3, 4, and 5 is used. 
 45.28     Sec. 22.  Minnesota Statutes 2001 Supplement, section 
 45.29  256.01, subdivision 2, as amended by Laws 2002, chapter 220, 
 45.30  article 15, section 4, is amended to read: 
 45.31     Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
 45.32  section 241.021, subdivision 2, the commissioner of human 
 45.33  services shall: 
 45.34     (1) Administer and supervise all forms of public assistance 
 45.35  provided for by state law and other welfare activities or 
 45.36  services as are vested in the commissioner.  Administration and 
 46.1   supervision of human services activities or services includes, 
 46.2   but is not limited to, assuring timely and accurate distribution 
 46.3   of benefits, completeness of service, and quality program 
 46.4   management.  In addition to administering and supervising human 
 46.5   services activities vested by law in the department, the 
 46.6   commissioner shall have the authority to: 
 46.7      (a) require county agency participation in training and 
 46.8   technical assistance programs to promote compliance with 
 46.9   statutes, rules, federal laws, regulations, and policies 
 46.10  governing human services; 
 46.11     (b) monitor, on an ongoing basis, the performance of county 
 46.12  agencies in the operation and administration of human services, 
 46.13  enforce compliance with statutes, rules, federal laws, 
 46.14  regulations, and policies governing welfare services and promote 
 46.15  excellence of administration and program operation; 
 46.16     (c) develop a quality control program or other monitoring 
 46.17  program to review county performance and accuracy of benefit 
 46.18  determinations; 
 46.19     (d) require county agencies to make an adjustment to the 
 46.20  public assistance benefits issued to any individual consistent 
 46.21  with federal law and regulation and state law and rule and to 
 46.22  issue or recover benefits as appropriate; 
 46.23     (e) delay or deny payment of all or part of the state and 
 46.24  federal share of benefits and administrative reimbursement 
 46.25  according to the procedures set forth in section 256.017; 
 46.26     (f) make contracts with and grants to public and private 
 46.27  agencies and organizations, both profit and nonprofit, and 
 46.28  individuals, using appropriated funds; and 
 46.29     (g) enter into contractual agreements with federally 
 46.30  recognized Indian tribes with a reservation in Minnesota to the 
 46.31  extent necessary for the tribe to operate a federally approved 
 46.32  family assistance program or any other program under the 
 46.33  supervision of the commissioner.  The commissioner shall consult 
 46.34  with the affected county or counties in the contractual 
 46.35  agreement negotiations, if the county or counties wish to be 
 46.36  included, in order to avoid the duplication of county and tribal 
 47.1   assistance program services.  The commissioner may establish 
 47.2   necessary accounts for the purposes of receiving and disbursing 
 47.3   funds as necessary for the operation of the programs. 
 47.4      (2) Inform county agencies, on a timely basis, of changes 
 47.5   in statute, rule, federal law, regulation, and policy necessary 
 47.6   to county agency administration of the programs. 
 47.7      (3) Administer and supervise all child welfare activities; 
 47.8   promote the enforcement of laws protecting handicapped, 
 47.9   dependent, neglected and delinquent children, and children born 
 47.10  to mothers who were not married to the children's fathers at the 
 47.11  times of the conception nor at the births of the children; 
 47.12  license and supervise child-caring and child-placing agencies 
 47.13  and institutions; supervise the care of children in boarding and 
 47.14  foster homes or in private institutions; and generally perform 
 47.15  all functions relating to the field of child welfare now vested 
 47.16  in the state board of control. 
 47.17     (4) Administer and supervise all noninstitutional service 
 47.18  to handicapped persons, including those who are visually 
 47.19  impaired, hearing impaired, or physically impaired or otherwise 
 47.20  handicapped.  The commissioner may provide and contract for the 
 47.21  care and treatment of qualified indigent children in facilities 
 47.22  other than those located and available at state hospitals when 
 47.23  it is not feasible to provide the service in state hospitals. 
 47.24     (5) Assist and actively cooperate with other departments, 
 47.25  agencies and institutions, local, state, and federal, by 
 47.26  performing services in conformity with the purposes of Laws 
 47.27  1939, chapter 431. 
 47.28     (6) Act as the agent of and cooperate with the federal 
 47.29  government in matters of mutual concern relative to and in 
 47.30  conformity with the provisions of Laws 1939, chapter 431, 
 47.31  including the administration of any federal funds granted to the 
 47.32  state to aid in the performance of any functions of the 
 47.33  commissioner as specified in Laws 1939, chapter 431, and 
 47.34  including the promulgation of rules making uniformly available 
 47.35  medical care benefits to all recipients of public assistance, at 
 47.36  such times as the federal government increases its participation 
 48.1   in assistance expenditures for medical care to recipients of 
 48.2   public assistance, the cost thereof to be borne in the same 
 48.3   proportion as are grants of aid to said recipients. 
 48.4      (7) Establish and maintain any administrative units 
 48.5   reasonably necessary for the performance of administrative 
 48.6   functions common to all divisions of the department. 
 48.7      (8) Act as designated guardian of both the estate and the 
 48.8   person of all the wards of the state of Minnesota, whether by 
 48.9   operation of law or by an order of court, without any further 
 48.10  act or proceeding whatever, except as to persons committed as 
 48.11  mentally retarded.  For children under the guardianship of the 
 48.12  commissioner whose interests would be best served by adoptive 
 48.13  placement, the commissioner may contract with a licensed 
 48.14  child-placing agency or a Minnesota tribal social services 
 48.15  agency to provide adoption services.  A contract with a licensed 
 48.16  child-placing agency must be designed to supplement existing 
 48.17  county efforts and may not replace existing county programs, 
 48.18  unless the replacement is agreed to by the county board and the 
 48.19  appropriate exclusive bargaining representative or the 
 48.20  commissioner has evidence that child placements of the county 
 48.21  continue to be substantially below that of other counties.  
 48.22  Funds encumbered and obligated under an agreement for a specific 
 48.23  child shall remain available until the terms of the agreement 
 48.24  are fulfilled or the agreement is terminated. 
 48.25     (9) Act as coordinating referral and informational center 
 48.26  on requests for service for newly arrived immigrants coming to 
 48.27  Minnesota. 
 48.28     (10) The specific enumeration of powers and duties as 
 48.29  hereinabove set forth shall in no way be construed to be a 
 48.30  limitation upon the general transfer of powers herein contained. 
 48.31     (11) Establish county, regional, or statewide schedules of 
 48.32  maximum fees and charges which may be paid by county agencies 
 48.33  for medical, dental, surgical, hospital, nursing and nursing 
 48.34  home care and medicine and medical supplies under all programs 
 48.35  of medical care provided by the state and for congregate living 
 48.36  care under the income maintenance programs. 
 49.1      (12) Have the authority to conduct and administer 
 49.2   experimental projects to test methods and procedures of 
 49.3   administering assistance and services to recipients or potential 
 49.4   recipients of public welfare.  To carry out such experimental 
 49.5   projects, it is further provided that the commissioner of human 
 49.6   services is authorized to waive the enforcement of existing 
 49.7   specific statutory program requirements, rules, and standards in 
 49.8   one or more counties.  The order establishing the waiver shall 
 49.9   provide alternative methods and procedures of administration, 
 49.10  shall not be in conflict with the basic purposes, coverage, or 
 49.11  benefits provided by law, and in no event shall the duration of 
 49.12  a project exceed four years.  It is further provided that no 
 49.13  order establishing an experimental project as authorized by the 
 49.14  provisions of this section shall become effective until the 
 49.15  following conditions have been met: 
 49.16     (a) The secretary of health and human services of the 
 49.17  United States has agreed, for the same project, to waive state 
 49.18  plan requirements relative to statewide uniformity. 
 49.19     (b) A comprehensive plan, including estimated project 
 49.20  costs, shall be approved by the legislative advisory commission 
 49.21  and filed with the commissioner of administration.  
 49.22     (13) According to federal requirements, establish 
 49.23  procedures to be followed by local welfare boards in creating 
 49.24  citizen advisory committees, including procedures for selection 
 49.25  of committee members. 
 49.26     (14) Allocate federal fiscal disallowances or sanctions 
 49.27  which are based on quality control error rates for the aid to 
 49.28  families with dependent children program formerly codified in 
 49.29  sections 256.72 to 256.87, medical assistance, or food stamp 
 49.30  program in the following manner:  
 49.31     (a) One-half of the total amount of the disallowance shall 
 49.32  be borne by the county boards responsible for administering the 
 49.33  programs.  For the medical assistance and the AFDC program 
 49.34  formerly codified in sections 256.72 to 256.87, disallowances 
 49.35  shall be shared by each county board in the same proportion as 
 49.36  that county's expenditures for the sanctioned program are to the 
 50.1   total of all counties' expenditures for the AFDC program 
 50.2   formerly codified in sections 256.72 to 256.87, and medical 
 50.3   assistance programs.  For the food stamp program, sanctions 
 50.4   shall be shared by each county board, with 50 percent of the 
 50.5   sanction being distributed to each county in the same proportion 
 50.6   as that county's administrative costs for food stamps are to the 
 50.7   total of all food stamp administrative costs for all counties, 
 50.8   and 50 percent of the sanctions being distributed to each county 
 50.9   in the same proportion as that county's value of food stamp 
 50.10  benefits issued are to the total of all benefits issued for all 
 50.11  counties.  Each county shall pay its share of the disallowance 
 50.12  to the state of Minnesota.  When a county fails to pay the 
 50.13  amount due hereunder, the commissioner may deduct the amount 
 50.14  from reimbursement otherwise due the county, or the attorney 
 50.15  general, upon the request of the commissioner, may institute 
 50.16  civil action to recover the amount due. 
 50.17     (b) Notwithstanding the provisions of paragraph (a), if the 
 50.18  disallowance results from knowing noncompliance by one or more 
 50.19  counties with a specific program instruction, and that knowing 
 50.20  noncompliance is a matter of official county board record, the 
 50.21  commissioner may require payment or recover from the county or 
 50.22  counties, in the manner prescribed in paragraph (a), an amount 
 50.23  equal to the portion of the total disallowance which resulted 
 50.24  from the noncompliance, and may distribute the balance of the 
 50.25  disallowance according to paragraph (a).  
 50.26     (15) Develop and implement special projects that maximize 
 50.27  reimbursements and result in the recovery of money to the 
 50.28  state.  For the purpose of recovering state money, the 
 50.29  commissioner may enter into contracts with third parties.  Any 
 50.30  recoveries that result from projects or contracts entered into 
 50.31  under this paragraph shall be deposited in the state treasury 
 50.32  and credited to a special account until the balance in the 
 50.33  account reaches $1,000,000.  When the balance in the account 
 50.34  exceeds $1,000,000, the excess shall be transferred and credited 
 50.35  to the general fund.  All money in the account is appropriated 
 50.36  to the commissioner for the purposes of this paragraph. 
 51.1      (16) Have the authority to make direct payments to 
 51.2   facilities providing shelter to women and their children 
 51.3   according to section 256D.05, subdivision 3.  Upon the written 
 51.4   request of a shelter facility that has been denied payments 
 51.5   under section 256D.05, subdivision 3, the commissioner shall 
 51.6   review all relevant evidence and make a determination within 30 
 51.7   days of the request for review regarding issuance of direct 
 51.8   payments to the shelter facility.  Failure to act within 30 days 
 51.9   shall be considered a determination not to issue direct payments.
 51.10     (17) Have the authority to establish and enforce the 
 51.11  following county reporting requirements:  
 51.12     (a) The commissioner shall establish fiscal and statistical 
 51.13  reporting requirements necessary to account for the expenditure 
 51.14  of funds allocated to counties for human services programs.  
 51.15  When establishing financial and statistical reporting 
 51.16  requirements, the commissioner shall evaluate all reports, in 
 51.17  consultation with the counties, to determine if the reports can 
 51.18  be simplified or the number of reports can be reduced. 
 51.19     (b) The county board shall submit monthly or quarterly 
 51.20  reports to the department as required by the commissioner.  
 51.21  Monthly reports are due no later than 15 working days after the 
 51.22  end of the month.  Quarterly reports are due no later than 30 
 51.23  calendar days after the end of the quarter, unless the 
 51.24  commissioner determines that the deadline must be shortened to 
 51.25  20 calendar days to avoid jeopardizing compliance with federal 
 51.26  deadlines or risking a loss of federal funding.  Only reports 
 51.27  that are complete, legible, and in the required format shall be 
 51.28  accepted by the commissioner.  
 51.29     (c) If the required reports are not received by the 
 51.30  deadlines established in clause (b), the commissioner may delay 
 51.31  payments and withhold funds from the county board until the next 
 51.32  reporting period.  When the report is needed to account for the 
 51.33  use of federal funds and the late report results in a reduction 
 51.34  in federal funding, the commissioner shall withhold from the 
 51.35  county boards with late reports an amount equal to the reduction 
 51.36  in federal funding until full federal funding is received.  
 52.1      (d) A county board that submits reports that are late, 
 52.2   illegible, incomplete, or not in the required format for two out 
 52.3   of three consecutive reporting periods is considered 
 52.4   noncompliant.  When a county board is found to be noncompliant, 
 52.5   the commissioner shall notify the county board of the reason the 
 52.6   county board is considered noncompliant and request that the 
 52.7   county board develop a corrective action plan stating how the 
 52.8   county board plans to correct the problem.  The corrective 
 52.9   action plan must be submitted to the commissioner within 45 days 
 52.10  after the date the county board received notice of noncompliance.
 52.11     (e) The final deadline for fiscal reports or amendments to 
 52.12  fiscal reports is one year after the date the report was 
 52.13  originally due.  If the commissioner does not receive a report 
 52.14  by the final deadline, the county board forfeits the funding 
 52.15  associated with the report for that reporting period and the 
 52.16  county board must repay any funds associated with the report 
 52.17  received for that reporting period. 
 52.18     (f) The commissioner may not delay payments, withhold 
 52.19  funds, or require repayment under paragraph (c) or (e) if the 
 52.20  county demonstrates that the commissioner failed to provide 
 52.21  appropriate forms, guidelines, and technical assistance to 
 52.22  enable the county to comply with the requirements.  If the 
 52.23  county board disagrees with an action taken by the commissioner 
 52.24  under paragraph (c) or (e), the county board may appeal the 
 52.25  action according to sections 14.57 to 14.69. 
 52.26     (g) Counties subject to withholding of funds under 
 52.27  paragraph (c) or forfeiture or repayment of funds under 
 52.28  paragraph (e) shall not reduce or withhold benefits or services 
 52.29  to clients to cover costs incurred due to actions taken by the 
 52.30  commissioner under paragraph (c) or (e). 
 52.31     (18) Allocate federal fiscal disallowances or sanctions for 
 52.32  audit exceptions when federal fiscal disallowances or sanctions 
 52.33  are based on a statewide random sample for the foster care 
 52.34  program under title IV-E of the Social Security Act, United 
 52.35  States Code, title 42, in direct proportion to each county's 
 52.36  title IV-E foster care maintenance claim for that period. 
 53.1      (19) Be responsible for ensuring the detection, prevention, 
 53.2   investigation, and resolution of fraudulent activities or 
 53.3   behavior by applicants, recipients, and other participants in 
 53.4   the human services programs administered by the department. 
 53.5      (20) Require county agencies to identify overpayments, 
 53.6   establish claims, and utilize all available and cost-beneficial 
 53.7   methodologies to collect and recover these overpayments in the 
 53.8   human services programs administered by the department. 
 53.9      (21) Have the authority to administer a drug rebate program 
 53.10  for drugs purchased pursuant to the prescription drug program 
 53.11  established under section 256.955 after the beneficiary's 
 53.12  satisfaction of any deductible established in the program.  The 
 53.13  commissioner shall require a rebate agreement from all 
 53.14  manufacturers of covered drugs as defined in section 256B.0625, 
 53.15  subdivision 13.  Rebate agreements for prescription drugs 
 53.16  delivered on or after July 1, 2002, must include rebates for 
 53.17  individuals covered under the prescription drug program who are 
 53.18  under 65 years of age.  For each drug, the amount of the rebate 
 53.19  shall be equal to the basic rebate as defined for purposes of 
 53.20  the federal rebate program in United States Code, title 42, 
 53.21  section 1396r-8(c)(1).  This basic rebate shall be applied to 
 53.22  single-source and multiple-source drugs.  The manufacturers must 
 53.23  provide full payment within 30 days of receipt of the state 
 53.24  invoice for the rebate within the terms and conditions used for 
 53.25  the federal rebate program established pursuant to section 1927 
 53.26  of title XIX of the Social Security Act.  The manufacturers must 
 53.27  provide the commissioner with any information necessary to 
 53.28  verify the rebate determined per drug.  The rebate program shall 
 53.29  utilize the terms and conditions used for the federal rebate 
 53.30  program established pursuant to section 1927 of title XIX of the 
 53.31  Social Security Act. 
 53.32     (22) Have the authority to administer the federal drug 
 53.33  rebate program for drugs purchased under the medical assistance 
 53.34  program as allowed by section 1927 of title XIX of the Social 
 53.35  Security Act and according to the terms and conditions of 
 53.36  section 1927.  Rebates shall be collected for all drugs that 
 54.1   have been dispensed or administered in an outpatient setting and 
 54.2   that are from manufacturers who have signed a rebate agreement 
 54.3   with the United States Department of Health and Human Services. 
 54.4      (23) Have the authority to administer a supplemental drug 
 54.5   rebate program for drugs purchased under the medical assistance 
 54.6   program and under the prescription drug program established in 
 54.7   section 256.955.  The commissioner may enter into supplemental 
 54.8   rebate contracts with pharmaceutical manufacturers and may 
 54.9   require prior authorization for drugs that are from 
 54.10  manufacturers that have not signed a supplemental rebate 
 54.11  contract.  Prior authorization of drugs shall be subject to the 
 54.12  provisions of section 256B.0625, subdivision 13, paragraph (b). 
 54.13     (24) Operate the department's communication systems account 
 54.14  established in Laws 1993, First Special Session chapter 1, 
 54.15  article 1, section 2, subdivision 2, to manage shared 
 54.16  communication costs necessary for the operation of the programs 
 54.17  the commissioner supervises.  A communications account may also 
 54.18  be established for each regional treatment center which operates 
 54.19  communications systems.  Each account must be used to manage 
 54.20  shared communication costs necessary for the operations of the 
 54.21  programs the commissioner supervises.  The commissioner may 
 54.22  distribute the costs of operating and maintaining communication 
 54.23  systems to participants in a manner that reflects actual usage. 
 54.24  Costs may include acquisition, licensing, insurance, 
 54.25  maintenance, repair, staff time and other costs as determined by 
 54.26  the commissioner.  Nonprofit organizations and state, county, 
 54.27  and local government agencies involved in the operation of 
 54.28  programs the commissioner supervises may participate in the use 
 54.29  of the department's communications technology and share in the 
 54.30  cost of operation.  The commissioner may accept on behalf of the 
 54.31  state any gift, bequest, devise or personal property of any 
 54.32  kind, or money tendered to the state for any lawful purpose 
 54.33  pertaining to the communication activities of the department.  
 54.34  Any money received for this purpose must be deposited in the 
 54.35  department's communication systems accounts.  Money collected by 
 54.36  the commissioner for the use of communication systems must be 
 55.1   deposited in the state communication systems account and is 
 55.2   appropriated to the commissioner for purposes of this section. 
 55.3      (25) Receive any federal matching money that is made 
 55.4   available through the medical assistance program for the 
 55.5   consumer satisfaction survey.  Any federal money received for 
 55.6   the survey is appropriated to the commissioner for this 
 55.7   purpose.  The commissioner may expend the federal money received 
 55.8   for the consumer satisfaction survey in either year of the 
 55.9   biennium. 
 55.10     (26) Incorporate cost reimbursement claims from First Call 
 55.11  Minnesota and Greater Twin Cities United Way into the federal 
 55.12  cost reimbursement claiming processes of the department 
 55.13  according to federal law, rule, and regulations.  Any 
 55.14  reimbursement received is appropriated to the commissioner and 
 55.15  shall be disbursed to First Call Minnesota and Greater Twin 
 55.16  Cities United Way according to normal department payment 
 55.17  schedules. 
 55.18     (27) Develop recommended standards for foster care homes 
 55.19  that address the components of specialized therapeutic services 
 55.20  to be provided by foster care homes with those services. 
 55.21     Sec. 23.  Minnesota Statutes 2001 Supplement, section 
 55.22  256.045, subdivision 3b, is amended to read: 
 55.23     Subd. 3b.  [STANDARD OF EVIDENCE FOR MALTREATMENT AND 
 55.24  DISQUALIFICATION HEARINGS.] (a) The state human services referee 
 55.25  shall determine that maltreatment has occurred if a 
 55.26  preponderance of evidence exists to support the final 
 55.27  disposition under sections 626.556 and 626.557.  For purposes of 
 55.28  hearings regarding disqualification, the state human services 
 55.29  referee shall affirm the proposed disqualification in an appeal 
 55.30  under subdivision 3, paragraph (a), clause (9), if a 
 55.31  preponderance of the evidence shows the individual has:  
 55.32     (1) committed maltreatment under section 626.556 or 
 55.33  626.557, which is serious or recurring; 
 55.34     (2) committed an act or acts meeting the definition of any 
 55.35  of the crimes listed in section 245A.04, subdivision 3d, 
 55.36  paragraph (a), clauses (1) to (4); or 
 56.1      (3) failed to make required reports under section 626.556 
 56.2   or 626.557, for incidents in which:  
 56.3      (i) the final disposition under section 626.556 or 626.557 
 56.4   was substantiated maltreatment; and 
 56.5      (ii) the maltreatment was recurring or serious; or 
 56.6   substantiated serious or recurring maltreatment of a minor under 
 56.7   section 626.556 or of a vulnerable adult under section 626.557 
 56.8   for which there is a preponderance of evidence that the 
 56.9   maltreatment occurred, and that the subject was responsible for 
 56.10  the maltreatment that was serious or recurring.  
 56.11     (b) If the disqualification is affirmed, the state human 
 56.12  services referee shall determine whether the individual poses a 
 56.13  risk of harm in accordance with the requirements of section 
 56.14  245A.04, subdivision 3b. 
 56.15     (c) The state human services referee shall recommend an 
 56.16  order to the commissioner of health, children, families, and 
 56.17  learning, or human services, as applicable, who shall issue a 
 56.18  final order.  The commissioner shall affirm, reverse, or modify 
 56.19  the final disposition.  Any order of the commissioner issued in 
 56.20  accordance with this subdivision is conclusive upon the parties 
 56.21  unless appeal is taken in the manner provided in subdivision 7.  
 56.22  Except as provided under section 245A.04, subdivisions 3b, 
 56.23  paragraphs (e) and (f), and 3c, In any licensing appeal under 
 56.24  chapter 245A and sections 144.50 to 144.58 and 144A.02 to 
 56.25  144A.46, the commissioner's determination as to maltreatment is 
 56.26  conclusive, as provided under section 245A.04, subdivision 3f. 
 56.27     Sec. 24.  Minnesota Statutes 2001 Supplement, section 
 56.28  256.045, subdivision 4, is amended to read: 
 56.29     Subd. 4.  [CONDUCT OF HEARINGS.] (a) All hearings held 
 56.30  pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 
 56.31  according to the provisions of the federal Social Security Act 
 56.32  and the regulations implemented in accordance with that act to 
 56.33  enable this state to qualify for federal grants-in-aid, and 
 56.34  according to the rules and written policies of the commissioner 
 56.35  of human services.  County agencies shall install equipment 
 56.36  necessary to conduct telephone hearings.  A state human services 
 57.1   referee may schedule a telephone conference hearing when the 
 57.2   distance or time required to travel to the county agency offices 
 57.3   will cause a delay in the issuance of an order, or to promote 
 57.4   efficiency, or at the mutual request of the parties.  Hearings 
 57.5   may be conducted by telephone conferences unless the applicant, 
 57.6   recipient, former recipient, person, or facility contesting 
 57.7   maltreatment objects.  The hearing shall not be held earlier 
 57.8   than five days after filing of the required notice with the 
 57.9   county or state agency.  The state human services referee shall 
 57.10  notify all interested persons of the time, date, and location of 
 57.11  the hearing at least five days before the date of the hearing.  
 57.12  Interested persons may be represented by legal counsel or other 
 57.13  representative of their choice, including a provider of therapy 
 57.14  services, at the hearing and may appear personally, testify and 
 57.15  offer evidence, and examine and cross-examine witnesses.  The 
 57.16  applicant, recipient, former recipient, person, or facility 
 57.17  contesting maltreatment shall have the opportunity to examine 
 57.18  the contents of the case file and all documents and records to 
 57.19  be used by the county or state agency at the hearing at a 
 57.20  reasonable time before the date of the hearing and during the 
 57.21  hearing.  In hearings under subdivision 3, paragraph (a), 
 57.22  clauses (4), (8), and (9), either party may subpoena the private 
 57.23  data relating to the investigation prepared by the agency under 
 57.24  section 626.556 or 626.557 that is not otherwise accessible 
 57.25  under section 13.04, provided the identity of the reporter may 
 57.26  not be disclosed. 
 57.27     (b) The private data obtained by subpoena in a hearing 
 57.28  under subdivision 3, paragraph (a), clause (4), (8), or (9), 
 57.29  must be subject to a protective order which prohibits its 
 57.30  disclosure for any other purpose outside the hearing provided 
 57.31  for in this section without prior order of the district court.  
 57.32  Disclosure without court order is punishable by a sentence of 
 57.33  not more than 90 days imprisonment or a fine of not more than 
 57.34  $700, or both.  These restrictions on the use of private data do 
 57.35  not prohibit access to the data under section 13.03, subdivision 
 57.36  6.  Except for appeals under subdivision 3, paragraph (a), 
 58.1   clauses (4), (5), (8), and (9), upon request, the county agency 
 58.2   shall provide reimbursement for transportation, child care, 
 58.3   photocopying, medical assessment, witness fee, and other 
 58.4   necessary and reasonable costs incurred by the applicant, 
 58.5   recipient, or former recipient in connection with the appeal.  
 58.6   All evidence, except that privileged by law, commonly accepted 
 58.7   by reasonable people in the conduct of their affairs as having 
 58.8   probative value with respect to the issues shall be submitted at 
 58.9   the hearing and such hearing shall not be "a contested case" 
 58.10  within the meaning of section 14.02, subdivision 3.  The agency 
 58.11  must present its evidence prior to or at the hearing, and may 
 58.12  not submit evidence after the hearing except by agreement of the 
 58.13  parties at the hearing, provided the petitioner has the 
 58.14  opportunity to respond. 
 58.15     (c) In hearings under subdivision 3, paragraph (a), clauses 
 58.16  (4), (8), and (9), involving determinations of maltreatment or 
 58.17  disqualification made by more than one county agency, by a 
 58.18  county agency and a state agency, or by more than one state 
 58.19  agency, the hearings may be consolidated into a single fair 
 58.20  hearing upon the consent of all parties and the state human 
 58.21  services referee. 
 58.22     Sec. 25.  Minnesota Statutes 2000, section 256B.02, 
 58.23  subdivision 7, is amended to read: 
 58.24     Subd. 7.  [VENDOR OF MEDICAL CARE.] (a) "Vendor of medical 
 58.25  care" means any person or persons furnishing, within the scope 
 58.26  of the vendor's respective license, any or all of the following 
 58.27  goods or services:  medical, surgical, hospital, optical, 
 58.28  visual, dental and nursing services; drugs and medical supplies; 
 58.29  appliances; laboratory, diagnostic, and therapeutic services; 
 58.30  nursing home and convalescent care; screening and health 
 58.31  assessment services provided by public health nurses as defined 
 58.32  in section 145A.02, subdivision 18; health care services 
 58.33  provided at the residence of the patient if the services are 
 58.34  performed by a public health nurse and the nurse indicates in a 
 58.35  statement submitted under oath that the services were actually 
 58.36  provided; and such other medical services or supplies provided 
 59.1   or prescribed by persons authorized by state law to give such 
 59.2   services and supplies.  The term includes, but is not limited 
 59.3   to, directors and officers of corporations or members of 
 59.4   partnerships who, either individually or jointly with another or 
 59.5   others, have the legal control, supervision, or responsibility 
 59.6   of submitting claims for reimbursement to the medical assistance 
 59.7   program.  The term only includes directors and officers of 
 59.8   corporations who personally receive a portion of the distributed 
 59.9   assets upon liquidation or dissolution, and their liability is 
 59.10  limited to the portion of the claim that bears the same 
 59.11  proportion to the total claim as their share of the distributed 
 59.12  assets bears to the total distributed assets.  
 59.13     (b) "Vendor of medical care" also includes any person who 
 59.14  is credentialed as a health professional under standards set by 
 59.15  the governing body of a federally recognized Indian tribe 
 59.16  authorized under an agreement with the federal government 
 59.17  according to United States Code, title 25, section 450f, to 
 59.18  provide health services to its members, and who through a tribal 
 59.19  facility provides covered services to American Indian people 
 59.20  within a contract health service delivery area of a Minnesota 
 59.21  reservation, as defined under Code of Federal Regulations, title 
 59.22  42, section 36.22. 
 59.23     (c) A federally recognized Indian tribe that intends to 
 59.24  implement standards for credentialing health professionals must 
 59.25  submit the standards to the commissioner of human services, 
 59.26  along with evidence of meeting, exceeding, or being exempt from 
 59.27  corresponding state standards.  The commissioner shall maintain 
 59.28  a copy of the standards and supporting evidence, and shall use 
 59.29  those standards to enroll tribal-approved health professionals 
 59.30  as medical assistance providers.  For purposes of this section, 
 59.31  "Indian" and "Indian tribe" mean persons or entities that meet 
 59.32  the definition in United States Code, title 25, section 450b. 
 59.33     Sec. 26.  Minnesota Statutes 2001 Supplement, section 
 59.34  256B.0625, subdivision 13, as amended by Laws 2002, chapter 220, 
 59.35  article 15, section 13, is amended to read: 
 59.36     Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs, 
 60.1   except for fertility drugs when specifically used to enhance 
 60.2   fertility, if prescribed by a licensed practitioner and 
 60.3   dispensed by a licensed pharmacist, by a physician enrolled in 
 60.4   the medical assistance program as a dispensing physician, or by 
 60.5   a physician or a nurse practitioner employed by or under 
 60.6   contract with a community health board as defined in section 
 60.7   145A.02, subdivision 5, for the purposes of communicable disease 
 60.8   control.  The commissioner, after receiving recommendations from 
 60.9   professional medical associations and professional pharmacist 
 60.10  associations, shall designate a formulary committee to advise 
 60.11  the commissioner on the names of drugs for which payment is 
 60.12  made, recommend a system for reimbursing providers on a set fee 
 60.13  or charge basis rather than the present system, and develop 
 60.14  methods encouraging use of generic drugs when they are less 
 60.15  expensive and equally effective as trademark drugs.  The 
 60.16  formulary committee shall consist of nine members, four of whom 
 60.17  shall be physicians who are not employed by the department of 
 60.18  human services, and a majority of whose practice is for persons 
 60.19  paying privately or through health insurance, three of whom 
 60.20  shall be pharmacists who are not employed by the department of 
 60.21  human services, and a majority of whose practice is for persons 
 60.22  paying privately or through health insurance, a consumer 
 60.23  representative, and a nursing home representative.  Committee 
 60.24  members shall serve three-year terms and shall serve without 
 60.25  compensation.  Members may be reappointed once.  
 60.26     (b) The commissioner shall establish a drug formulary.  Its 
 60.27  establishment and publication shall not be subject to the 
 60.28  requirements of the Administrative Procedure Act, but the 
 60.29  formulary committee shall review and comment on the formulary 
 60.30  contents.  
 60.31     The formulary shall not include:  
 60.32     (i) drugs or products for which there is no federal 
 60.33  funding; 
 60.34     (ii) over-the-counter drugs, except for antacids, 
 60.35  acetaminophen, family planning products, aspirin, insulin, 
 60.36  products for the treatment of lice, vitamins for adults with 
 61.1   documented vitamin deficiencies, vitamins for children under the 
 61.2   age of seven and pregnant or nursing women, and any other 
 61.3   over-the-counter drug identified by the commissioner, in 
 61.4   consultation with the drug formulary committee, as necessary, 
 61.5   appropriate, and cost-effective for the treatment of certain 
 61.6   specified chronic diseases, conditions or disorders, and this 
 61.7   determination shall not be subject to the requirements of 
 61.8   chapter 14; 
 61.9      (iii) anorectics, except that medically necessary 
 61.10  anorectics shall be covered for a recipient previously diagnosed 
 61.11  as having pickwickian syndrome and currently diagnosed as having 
 61.12  diabetes and being morbidly obese; 
 61.13     (iv) drugs for which medical value has not been 
 61.14  established; and 
 61.15     (v) drugs from manufacturers who have not signed a rebate 
 61.16  agreement with the Department of Health and Human Services 
 61.17  pursuant to section 1927 of title XIX of the Social Security Act.
 61.18     The commissioner shall publish conditions for prohibiting 
 61.19  payment for specific drugs after considering the formulary 
 61.20  committee's recommendations.  An honorarium of $100 per meeting 
 61.21  and reimbursement for mileage shall be paid to each committee 
 61.22  member in attendance.  
 61.23     (c) The basis for determining the amount of payment shall 
 61.24  be the lower of the actual acquisition costs of the drugs plus a 
 61.25  fixed dispensing fee; the maximum allowable cost set by the 
 61.26  federal government or by the commissioner plus the fixed 
 61.27  dispensing fee; or the usual and customary price charged to the 
 61.28  public.  The pharmacy dispensing fee shall be $3.65, except that 
 61.29  the dispensing fee for intravenous solutions which must be 
 61.30  compounded by the pharmacist shall be $8 per bag, $14 per bag 
 61.31  for cancer chemotherapy products, and $30 per bag for total 
 61.32  parenteral nutritional products dispensed in one liter 
 61.33  quantities, or $44 per bag for total parenteral nutritional 
 61.34  products dispensed in quantities greater than one liter.  Actual 
 61.35  acquisition cost includes quantity and other special discounts 
 61.36  except time and cash discounts.  The actual acquisition cost of 
 62.1   a drug shall be estimated by the commissioner, at average 
 62.2   wholesale price minus nine percent, except that where a drug has 
 62.3   had its wholesale price reduced as a result of the actions of 
 62.4   the National Association of Medicaid Fraud Control Units, the 
 62.5   estimated actual acquisition cost shall be the reduced average 
 62.6   wholesale price, without the nine percent deduction.  The 
 62.7   maximum allowable cost of a multisource drug may be set by the 
 62.8   commissioner and it shall be comparable to, but no higher than, 
 62.9   the maximum amount paid by other third-party payors in this 
 62.10  state who have maximum allowable cost programs.  The 
 62.11  commissioner shall set maximum allowable costs for multisource 
 62.12  drugs that are not on the federal upper limit list as described 
 62.13  in United States Code, title 42, chapter 7, section 1396r-8(e), 
 62.14  the Social Security Act, and Code of Federal Regulations, title 
 62.15  42, part 447, section 447.332.  Establishment of the amount of 
 62.16  payment for drugs shall not be subject to the requirements of 
 62.17  the Administrative Procedure Act.  An additional dispensing fee 
 62.18  of $.30 may be added to the dispensing fee paid to pharmacists 
 62.19  for legend drug prescriptions dispensed to residents of 
 62.20  long-term care facilities when a unit dose blister card system, 
 62.21  approved by the department, is used.  Under this type of 
 62.22  dispensing system, the pharmacist must dispense a 30-day supply 
 62.23  of drug.  The National Drug Code (NDC) from the drug container 
 62.24  used to fill the blister card must be identified on the claim to 
 62.25  the department.  The unit dose blister card containing the drug 
 62.26  must meet the packaging standards set forth in Minnesota Rules, 
 62.27  part 6800.2700, that govern the return of unused drugs to the 
 62.28  pharmacy for reuse.  The pharmacy provider will be required to 
 62.29  credit the department for the actual acquisition cost of all 
 62.30  unused drugs that are eligible for reuse.  Over-the-counter 
 62.31  medications must be dispensed in the manufacturer's unopened 
 62.32  package.  The commissioner may permit the drug clozapine to be 
 62.33  dispensed in a quantity that is less than a 30-day supply.  
 62.34  Whenever a generically equivalent product is available, payment 
 62.35  shall be on the basis of the actual acquisition cost of the 
 62.36  generic drug, unless the prescriber specifically indicates 
 63.1   "dispense as written - brand necessary" on the prescription as 
 63.2   required by section 151.21, subdivision 2. 
 63.3      (d) For purposes of this subdivision, "multisource drugs" 
 63.4   means covered outpatient drugs, excluding innovator multisource 
 63.5   drugs for which there are two or more drug products, which: 
 63.6      (1) are related as therapeutically equivalent under the 
 63.7   Food and Drug Administration's most recent publication of 
 63.8   "Approved Drug Products with Therapeutic Equivalence 
 63.9   Evaluations"; 
 63.10     (2) are pharmaceutically equivalent and bioequivalent as 
 63.11  determined by the Food and Drug Administration; and 
 63.12     (3) are sold or marketed in Minnesota. 
 63.13  "Innovator multisource drug" means a multisource drug that was 
 63.14  originally marketed under an original new drug application 
 63.15  approved by the Food and Drug Administration. 
 63.16     (e) The formulary committee shall review and recommend 
 63.17  drugs which require prior authorization.  The formulary 
 63.18  committee may recommend drugs for prior authorization directly 
 63.19  to the commissioner, as long as opportunity for public input is 
 63.20  provided.  Prior authorization may be requested by the 
 63.21  commissioner based on medical and clinical criteria and on cost 
 63.22  before certain drugs are eligible for payment.  Before a drug 
 63.23  may be considered for prior authorization at the request of the 
 63.24  commissioner: 
 63.25     (1) the drug formulary committee must develop criteria to 
 63.26  be used for identifying drugs; the development of these criteria 
 63.27  is not subject to the requirements of chapter 14, but the 
 63.28  formulary committee shall provide opportunity for public input 
 63.29  in developing criteria; 
 63.30     (2) the drug formulary committee must hold a public forum 
 63.31  and receive public comment for an additional 15 days; and 
 63.32     (3) the drug formulary committee must consider data from 
 63.33  the state Medicaid program if such data is available; and 
 63.34     (4) the commissioner must provide information to the 
 63.35  formulary committee on the impact that placing the drug on prior 
 63.36  authorization will have on the quality of patient care and on 
 64.1   program costs, and information regarding whether the drug is 
 64.2   subject to clinical abuse or misuse.  
 64.3      Prior authorization may be required by the commissioner 
 64.4   before certain formulary drugs are eligible for payment.  If 
 64.5   prior authorization of a drug is required by the commissioner, 
 64.6   the commissioner must provide a 30-day notice period before 
 64.7   implementing the prior authorization.  If a prior authorization 
 64.8   request is denied by the department, the recipient may appeal 
 64.9   the denial in accordance with section 256.045.  If an appeal is 
 64.10  filed, the drug must be provided without prior authorization 
 64.11  until a decision is made on the appeal.  
 64.12     (f) The basis for determining the amount of payment for 
 64.13  drugs administered in an outpatient setting shall be the lower 
 64.14  of the usual and customary cost submitted by the provider; the 
 64.15  average wholesale price minus five percent; or the maximum 
 64.16  allowable cost set by the federal government under United States 
 64.17  Code, title 42, chapter 7, section 1396r-8(e), and Code of 
 64.18  Federal Regulations, title 42, section 447.332, or by the 
 64.19  commissioner under paragraph (c). 
 64.20     Sec. 27.  Minnesota Statutes 2000, section 256B.0625, is 
 64.21  amended by adding a subdivision to read: 
 64.22     Subd. 44.  [TARGETED CASE MANAGEMENT SERVICES.] Medical 
 64.23  assistance covers case management services for vulnerable adults 
 64.24  and adults with developmental disabilities, in accordance with 
 64.25  section 256B.0924. 
 64.26     Sec. 28.  Minnesota Statutes 2001 Supplement, section 
 64.27  256B.0644, is amended to read: 
 64.28     256B.0644 [PARTICIPATION REQUIRED FOR REIMBURSEMENT UNDER 
 64.29  OTHER STATE HEALTH CARE PROGRAMS.] 
 64.30     A vendor of medical care, as defined in section 256B.02, 
 64.31  subdivision 7, and a health maintenance organization, as defined 
 64.32  in chapter 62D, must participate as a provider or contractor in 
 64.33  the medical assistance program, general assistance medical care 
 64.34  program, and MinnesotaCare as a condition of participating as a 
 64.35  provider in health insurance plans and programs or contractor 
 64.36  for state employees established under section 43A.18, the public 
 65.1   employees insurance program under section 43A.316, for health 
 65.2   insurance plans offered to local statutory or home rule charter 
 65.3   city, county, and school district employees, the workers' 
 65.4   compensation system under section 176.135, and insurance plans 
 65.5   provided through the Minnesota comprehensive health association 
 65.6   under sections 62E.01 to 62E.19.  The limitations on insurance 
 65.7   plans offered to local government employees shall not be 
 65.8   applicable in geographic areas where provider participation is 
 65.9   limited by managed care contracts with the department of human 
 65.10  services.  For providers other than health maintenance 
 65.11  organizations, participation in the medical assistance program 
 65.12  means that (1) the provider accepts new medical assistance, 
 65.13  general assistance medical care, and MinnesotaCare patients or 
 65.14  (2) for providers other than dental service providers, at least 
 65.15  20 percent of the provider's patients are covered by medical 
 65.16  assistance, general assistance medical care, and MinnesotaCare 
 65.17  as their primary source of coverage, or (3) for dental service 
 65.18  providers, at least ten percent of the provider's patients are 
 65.19  covered by medical assistance, general assistance medical care, 
 65.20  and MinnesotaCare as their primary source of coverage.  Patients 
 65.21  seen on a volunteer basis by the provider at a location other 
 65.22  than the provider's usual place of practice may be considered in 
 65.23  meeting this participation requirement.  The commissioner shall 
 65.24  establish participation requirements for health maintenance 
 65.25  organizations.  The commissioner shall provide lists of 
 65.26  participating medical assistance providers on a quarterly basis 
 65.27  to the commissioner of employee relations, the commissioner of 
 65.28  labor and industry, and the commissioner of commerce.  Each of 
 65.29  the commissioners shall develop and implement procedures to 
 65.30  exclude as participating providers in the program or programs 
 65.31  under their jurisdiction those providers who do not participate 
 65.32  in the medical assistance program.  The commissioner of employee 
 65.33  relations shall implement this section through contracts with 
 65.34  participating health and dental carriers. 
 65.35     Sec. 29.  Minnesota Statutes 2001 Supplement, section 
 65.36  256B.0913, subdivision 4, is amended to read: 
 66.1      Subd. 4.  [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 
 66.2   NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 
 66.3   under the alternative care program is available to persons who 
 66.4   meet the following criteria: 
 66.5      (1) the person has been determined by a community 
 66.6   assessment under section 256B.0911 to be a person who would 
 66.7   require the level of care provided in a nursing facility, but 
 66.8   for the provision of services under the alternative care 
 66.9   program; 
 66.10     (2) the person is age 65 or older; 
 66.11     (3) the person would be eligible for medical assistance 
 66.12  within 180 days of admission to a nursing facility; 
 66.13     (4) the person is not ineligible for the medical assistance 
 66.14  program due to an asset transfer penalty; 
 66.15     (5) the person needs services that are not funded through 
 66.16  other state or federal funding; and 
 66.17     (6) the monthly cost of the alternative care services 
 66.18  funded by the program for this person does not exceed 75 percent 
 66.19  of the statewide weighted average monthly nursing facility rate 
 66.20  of the case mix resident class to which the individual 
 66.21  alternative care client would be assigned under Minnesota Rules, 
 66.22  parts 9549.0050 to 9549.0059, less the recipient's maintenance 
 66.23  needs allowance as described in section 256B.0915, subdivision 
 66.24  1d, paragraph (a), until the first day of the state fiscal year 
 66.25  in which the resident assessment system, under section 256B.437, 
 66.26  for nursing home rate determination is implemented.  Effective 
 66.27  on the first day of the state fiscal year in which a resident 
 66.28  assessment system, under section 256B.437, for nursing home rate 
 66.29  determination is implemented and the first day of each 
 66.30  subsequent state fiscal year, the monthly cost of alternative 
 66.31  care services for this person shall not exceed the alternative 
 66.32  care monthly cap for the case mix resident class to which the 
 66.33  alternative care client would be assigned under Minnesota Rules, 
 66.34  parts 9549.0050 to 9549.0059, which was in effect on the last 
 66.35  day of the previous state fiscal year, and adjusted by the 
 66.36  greater of any legislatively adopted home and community-based 
 67.1   services cost-of-living percentage increase or any legislatively 
 67.2   adopted statewide percent rate increase for nursing facilities.  
 67.3   This monthly limit does not prohibit the alternative care client 
 67.4   from payment for additional services, but in no case may the 
 67.5   cost of additional services purchased under this section exceed 
 67.6   the difference between the client's monthly service limit 
 67.7   defined under section 256B.0915, subdivision 3, and the 
 67.8   alternative care program monthly service limit defined in this 
 67.9   paragraph.  If medical supplies and equipment or environmental 
 67.10  modifications are or will be purchased for an alternative care 
 67.11  services recipient, the costs may be prorated on a monthly basis 
 67.12  for up to 12 consecutive months beginning with the month of 
 67.13  purchase.  If the monthly cost of a recipient's other 
 67.14  alternative care services exceeds the monthly limit established 
 67.15  in this paragraph, the annual cost of the alternative care 
 67.16  services shall be determined.  In this event, the annual cost of 
 67.17  alternative care services shall not exceed 12 times the monthly 
 67.18  limit described in this paragraph. 
 67.19     (b) Alternative care funding under this subdivision is not 
 67.20  available for a person who is a medical assistance recipient or 
 67.21  who would be eligible for medical assistance without a spenddown 
 67.22  or waiver obligation.  A person whose initial application for 
 67.23  medical assistance is being processed may be served under the 
 67.24  alternative care program for a period up to 60 days.  If the 
 67.25  individual is found to be eligible for medical assistance, 
 67.26  medical assistance must be billed for services payable under the 
 67.27  federally approved elderly waiver plan and delivered from the 
 67.28  date the individual was found eligible for the federally 
 67.29  approved elderly waiver plan.  Notwithstanding this provision, 
 67.30  upon federal approval, alternative care funds may not be used to 
 67.31  pay for any service the cost of which is payable by medical 
 67.32  assistance or which is used by a recipient to meet a medical 
 67.33  assistance income spenddown or waiver obligation.  
 67.34     (c) Alternative care funding is not available for a person 
 67.35  who resides in a licensed nursing home, certified boarding care 
 67.36  home, hospital, or intermediate care facility, except for case 
 68.1   management services which are provided in support of the 
 68.2   discharge planning process to a nursing home resident or 
 68.3   certified boarding care home resident who is ineligible for case 
 68.4   management funded by medical assistance. 
 68.5      Sec. 30.  Minnesota Statutes 2001 Supplement, section 
 68.6   256B.0913, subdivision 5, is amended to read: 
 68.7      Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
 68.8   Alternative care funding may be used for payment of costs of: 
 68.9      (1) adult foster care; 
 68.10     (2) adult day care; 
 68.11     (3) home health aide; 
 68.12     (4) homemaker services; 
 68.13     (5) personal care; 
 68.14     (6) case management; 
 68.15     (7) respite care; 
 68.16     (8) assisted living; 
 68.17     (9) residential care services; 
 68.18     (10) care-related supplies and equipment; 
 68.19     (11) meals delivered to the home; 
 68.20     (12) transportation; 
 68.21     (13) skilled nursing services; 
 68.22     (14) chore services; 
 68.23     (15) companion services; 
 68.24     (16) nutrition services; 
 68.25     (17) training for direct informal caregivers; 
 68.26     (18) telemedicine telehome care devices to monitor 
 68.27  recipients in their own homes as an alternative to hospital 
 68.28  care, nursing home care, or home visits; 
 68.29     (19) other services which includes discretionary funds and 
 68.30  direct cash payments to clients, following approval by the 
 68.31  commissioner, subject to the provisions of paragraph (j).  Total 
 68.32  annual payments for "other services" for all clients within a 
 68.33  county may not exceed either ten percent of that county's annual 
 68.34  alternative care program base allocation or $5,000, whichever is 
 68.35  greater.  In no case shall this amount exceed the county's total 
 68.36  annual alternative care program base allocation; and 
 69.1      (20) environmental modifications. 
 69.2      (b) The county agency must ensure that the funds are not 
 69.3   used to supplant services available through other public 
 69.4   assistance or services programs. 
 69.5      (c) Unless specified in statute, the service services, 
 69.6   service definitions, and standards for alternative care services 
 69.7   shall be the same as the service services, service definitions, 
 69.8   and standards specified in the federally approved elderly waiver 
 69.9   plan.  Except for the county agencies' approval of direct cash 
 69.10  payments to clients as described in paragraph (j) or for a 
 69.11  provider of supplies and equipment when the monthly cost of the 
 69.12  supplies and equipment is less than $250, persons or agencies 
 69.13  must be employed by or under a contract with the county agency 
 69.14  or the public health nursing agency of the local board of health 
 69.15  in order to receive funding under the alternative care program.  
 69.16  Supplies and equipment may be purchased from a vendor not 
 69.17  certified to participate in the Medicaid program if the cost for 
 69.18  the item is less than that of a Medicaid vendor.  
 69.19     (d) The adult foster care rate shall be considered a 
 69.20  difficulty of care payment and shall not include room and 
 69.21  board.  The adult foster care rate shall be negotiated between 
 69.22  the county agency and the foster care provider.  The alternative 
 69.23  care payment for the foster care service in combination with the 
 69.24  payment for other alternative care services, including case 
 69.25  management, must not exceed the limit specified in subdivision 
 69.26  4, paragraph (a), clause (6). 
 69.27     (e) Personal care services must meet the service standards 
 69.28  defined in the federally approved elderly waiver plan, except 
 69.29  that a county agency may contract with a client's relative who 
 69.30  meets the relative hardship waiver requirement as defined in 
 69.31  section 256B.0627, subdivision 4, paragraph (b), clause (10), to 
 69.32  provide personal care services if the county agency ensures 
 69.33  supervision of this service by a registered nurse or mental 
 69.34  health practitioner qualified professional as defined in section 
 69.35  256B.0625, subdivision 19c.  
 69.36     (f) For purposes of this section, residential care services 
 70.1   are services which are provided to individuals living in 
 70.2   residential care homes.  Residential care homes are currently 
 70.3   licensed as board and lodging establishments and are registered 
 70.4   with the department of health as providing special services 
 70.5   under section 157.17 and are not subject to registration under 
 70.6   chapter 144D.  Residential care services are defined as 
 70.7   "supportive services" and "health-related services."  
 70.8   "Supportive services" means the provision of up to 24-hour 
 70.9   supervision and oversight.  Supportive services includes:  (1) 
 70.10  transportation, when provided by the residential care home only; 
 70.11  (2) socialization, when socialization is part of the plan of 
 70.12  care, has specific goals and outcomes established, and is not 
 70.13  diversional or recreational in nature; (3) assisting clients in 
 70.14  setting up meetings and appointments; (4) assisting clients in 
 70.15  setting up medical and social services; (5) providing assistance 
 70.16  with personal laundry, such as carrying the client's laundry to 
 70.17  the laundry room.  Assistance with personal laundry does not 
 70.18  include any laundry, such as bed linen, that is included in the 
 70.19  room and board rate.  "Health-related services" are limited to 
 70.20  minimal assistance with dressing, grooming, and bathing and 
 70.21  providing reminders to residents to take medications that are 
 70.22  self-administered or providing storage for medications, if 
 70.23  requested.  Individuals receiving residential care services 
 70.24  cannot receive homemaking services funded under this section.  
 70.25     (g) For the purposes of this section, "assisted living" 
 70.26  refers to supportive services provided by a single vendor to 
 70.27  clients who reside in the same apartment building of three or 
 70.28  more units which are not subject to registration under chapter 
 70.29  144D and are licensed by the department of health as a class A 
 70.30  home care provider or a class E home care provider.  Assisted 
 70.31  living services are defined as up to 24-hour supervision, and 
 70.32  oversight, supportive services as defined in clause (1), 
 70.33  individualized home care aide tasks as defined in clause (2), 
 70.34  and individualized home management tasks as defined in clause 
 70.35  (3) provided to residents of a residential center living in 
 70.36  their units or apartments with a full kitchen and bathroom.  A 
 71.1   full kitchen includes a stove, oven, refrigerator, food 
 71.2   preparation counter space, and a kitchen utensil storage 
 71.3   compartment.  Assisted living services must be provided by the 
 71.4   management of the residential center or by providers under 
 71.5   contract with the management or with the county. 
 71.6      (1) Supportive services include:  
 71.7      (i) socialization, when socialization is part of the plan 
 71.8   of care, has specific goals and outcomes established, and is not 
 71.9   diversional or recreational in nature; 
 71.10     (ii) assisting clients in setting up meetings and 
 71.11  appointments; and 
 71.12     (iii) providing transportation, when provided by the 
 71.13  residential center only.  
 71.14     (2) Home care aide tasks means:  
 71.15     (i) preparing modified diets, such as diabetic or low 
 71.16  sodium diets; 
 71.17     (ii) reminding residents to take regularly scheduled 
 71.18  medications or to perform exercises; 
 71.19     (iii) household chores in the presence of technically 
 71.20  sophisticated medical equipment or episodes of acute illness or 
 71.21  infectious disease; 
 71.22     (iv) household chores when the resident's care requires the 
 71.23  prevention of exposure to infectious disease or containment of 
 71.24  infectious disease; and 
 71.25     (v) assisting with dressing, oral hygiene, hair care, 
 71.26  grooming, and bathing, if the resident is ambulatory, and if the 
 71.27  resident has no serious acute illness or infectious disease.  
 71.28  Oral hygiene means care of teeth, gums, and oral prosthetic 
 71.29  devices.  
 71.30     (3) Home management tasks means:  
 71.31     (i) housekeeping; 
 71.32     (ii) laundry; 
 71.33     (iii) preparation of regular snacks and meals; and 
 71.34     (iv) shopping.  
 71.35     Individuals receiving assisted living services shall not 
 71.36  receive both assisted living services and homemaking services.  
 72.1   Individualized means services are chosen and designed 
 72.2   specifically for each resident's needs, rather than provided or 
 72.3   offered to all residents regardless of their illnesses, 
 72.4   disabilities, or physical conditions.  Assisted living services 
 72.5   as defined in this section shall not be authorized in boarding 
 72.6   and lodging establishments licensed according to sections 
 72.7   157.011 and 157.15 to 157.22. 
 72.8      (h) For establishments registered under chapter 144D, 
 72.9   assisted living services under this section means either the 
 72.10  services described in paragraph (g) and delivered by a class E 
 72.11  home care provider licensed by the department of health or the 
 72.12  services described under section 144A.4605 and delivered by an 
 72.13  assisted living home care provider or a class A home care 
 72.14  provider licensed by the commissioner of health. 
 72.15     (i) Payment for assisted living services and residential 
 72.16  care services shall be a monthly rate negotiated and authorized 
 72.17  by the county agency based on an individualized service plan for 
 72.18  each resident and may not cover direct rent or food costs.  
 72.19     (1) The individualized monthly negotiated payment for 
 72.20  assisted living services as described in paragraph (g) or (h), 
 72.21  and residential care services as described in paragraph (f), 
 72.22  shall not exceed the nonfederal share in effect on July 1 of the 
 72.23  state fiscal year for which the rate limit is being calculated 
 72.24  of the greater of either the statewide or any of the geographic 
 72.25  groups' weighted average monthly nursing facility payment rate 
 72.26  of the case mix resident class to which the alternative care 
 72.27  eligible client would be assigned under Minnesota Rules, parts 
 72.28  9549.0050 to 9549.0059, less the maintenance needs allowance as 
 72.29  described in section 256B.0915, subdivision 1d, paragraph (a), 
 72.30  until the first day of the state fiscal year in which a resident 
 72.31  assessment system, under section 256B.437, of nursing home rate 
 72.32  determination is implemented.  Effective on the first day of the 
 72.33  state fiscal year in which a resident assessment system, under 
 72.34  section 256B.437, of nursing home rate determination is 
 72.35  implemented and the first day of each subsequent state fiscal 
 72.36  year, the individualized monthly negotiated payment for the 
 73.1   services described in this clause shall not exceed the limit 
 73.2   described in this clause which was in effect on the last day of 
 73.3   the previous state fiscal year and which has been adjusted by 
 73.4   the greater of any legislatively adopted home and 
 73.5   community-based services cost-of-living percentage increase or 
 73.6   any legislatively adopted statewide percent rate increase for 
 73.7   nursing facilities. 
 73.8      (2) The individualized monthly negotiated payment for 
 73.9   assisted living services described under section 144A.4605 and 
 73.10  delivered by a provider licensed by the department of health as 
 73.11  a class A home care provider or an assisted living home care 
 73.12  provider and provided in a building that is registered as a 
 73.13  housing with services establishment under chapter 144D and that 
 73.14  provides 24-hour supervision in combination with the payment for 
 73.15  other alternative care services, including case management, must 
 73.16  not exceed the limit specified in subdivision 4, paragraph (a), 
 73.17  clause (6). 
 73.18     (j) A county agency may make payment from their alternative 
 73.19  care program allocation for "other services" which include use 
 73.20  of "discretionary funds" for services that are not otherwise 
 73.21  defined in this section and direct cash payments to the client 
 73.22  for the purpose of purchasing the services.  The following 
 73.23  provisions apply to payments under this paragraph: 
 73.24     (1) a cash payment to a client under this provision cannot 
 73.25  exceed 80 percent of the monthly payment limit for that client 
 73.26  as specified in subdivision 4, paragraph (a), clause (6); 
 73.27     (2) a county may not approve any cash payment for a client 
 73.28  who meets either of the following: 
 73.29     (i) has been assessed as having a dependency in 
 73.30  orientation, unless the client has an authorized 
 73.31  representative.  An "authorized representative" means an 
 73.32  individual who is at least 18 years of age and is designated by 
 73.33  the person or the person's legal representative to act on the 
 73.34  person's behalf.  This individual may be a family member, 
 73.35  guardian, representative payee, or other individual designated 
 73.36  by the person or the person's legal representative, if any, to 
 74.1   assist in purchasing and arranging for supports; or 
 74.2      (ii) is concurrently receiving adult foster care, 
 74.3   residential care, or assisted living services; 
 74.4      (3) cash payments to a person or a person's family will be 
 74.5   provided through a monthly payment and be in the form of cash, 
 74.6   voucher, or direct county payment to a vendor.  Fees or premiums 
 74.7   assessed to the person for eligibility for health and human 
 74.8   services are not reimbursable through this service option.  
 74.9   Services and goods purchased through cash payments must be 
 74.10  identified in the person's individualized care plan and must 
 74.11  meet all of the following criteria: 
 74.12     (i) they must be over and above the normal cost of caring 
 74.13  for the person if the person did not have functional 
 74.14  limitations; 
 74.15     (ii) they must be directly attributable to the person's 
 74.16  functional limitations; 
 74.17     (iii) they must have the potential to be effective at 
 74.18  meeting the goals of the program; 
 74.19     (iv) they must be consistent with the needs identified in 
 74.20  the individualized service plan.  The service plan shall specify 
 74.21  the needs of the person and family, the form and amount of 
 74.22  payment, the items and services to be reimbursed, and the 
 74.23  arrangements for management of the individual grant; and 
 74.24     (v) the person, the person's family, or the legal 
 74.25  representative shall be provided sufficient information to 
 74.26  ensure an informed choice of alternatives.  The local agency 
 74.27  shall document this information in the person's care plan, 
 74.28  including the type and level of expenditures to be reimbursed; 
 74.29     (4) the state of Minnesota, county, lead agency under 
 74.30  contract, or tribal government under contract to administer the 
 74.31  alternative care program shall not be liable for damages, 
 74.32  injuries, or liabilities sustained through the purchase of 
 74.33  direct supports or goods by the person, the person's family, or 
 74.34  the authorized representative with funds received through the 
 74.35  cash payments under this section.  Liabilities include, but are 
 74.36  not limited to, workers' compensation, the Federal Insurance 
 75.1   Contributions Act (FICA), or the Federal Unemployment Tax Act 
 75.2   (FUTA); 
 75.3      (5) persons receiving grants under this section shall have 
 75.4   the following responsibilities: 
 75.5      (i) spend the grant money in a manner consistent with their 
 75.6   individualized service plan with the local agency; 
 75.7      (ii) notify the local agency of any necessary changes in 
 75.8   the grant expenditures; 
 75.9      (iii) arrange and pay for supports; and 
 75.10     (iv) inform the local agency of areas where they have 
 75.11  experienced difficulty securing or maintaining supports; and 
 75.12     (6) the county shall report client outcomes, services, and 
 75.13  costs under this paragraph in a manner prescribed by the 
 75.14  commissioner. 
 75.15     (k) Upon implementation of direct cash payments to clients 
 75.16  under this section, any person determined eligible for the 
 75.17  alternative care program who chooses a cash payment approved by 
 75.18  the county agency shall receive the cash payment under this 
 75.19  section and not under section 256.476 unless the person was 
 75.20  receiving a consumer support grant under section 256.476 before 
 75.21  implementation of direct cash payments under this section. 
 75.22     Sec. 31.  Minnesota Statutes 2001 Supplement, section 
 75.23  256B.0913, subdivision 8, is amended to read: 
 75.24     Subd. 8.  [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 
 75.25  case manager shall implement the plan of care for each 
 75.26  alternative care client and ensure that a client's service needs 
 75.27  and eligibility are reassessed at least every 12 months.  The 
 75.28  plan shall include any services prescribed by the individual's 
 75.29  attending physician as necessary to allow the individual to 
 75.30  remain in a community setting.  In developing the individual's 
 75.31  care plan, the case manager should include the use of volunteers 
 75.32  from families and neighbors, religious organizations, social 
 75.33  clubs, and civic and service organizations to support the formal 
 75.34  home care services.  The county shall be held harmless for 
 75.35  damages or injuries sustained through the use of volunteers 
 75.36  under this subdivision including workers' compensation 
 76.1   liability.  The lead agency shall provide documentation in each 
 76.2   individual's plan of care and, if requested, to the commissioner 
 76.3   that the most cost-effective alternatives available have been 
 76.4   offered to the individual and that the individual was free to 
 76.5   choose among available qualified providers, both public and 
 76.6   private.  The case manager must give the individual a ten-day 
 76.7   written notice of any decrease in or denial, termination, or 
 76.8   reduction of alternative care services. 
 76.9      (b) If the county administering alternative care services 
 76.10  is different than the county of financial responsibility, the 
 76.11  care plan may be implemented without the approval of the county 
 76.12  of financial responsibility. 
 76.13     Sec. 32.  Minnesota Statutes 2001 Supplement, section 
 76.14  256B.0913, subdivision 10, is amended to read: 
 76.15     Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
 76.16  appropriation for fiscal years 1992 and beyond shall cover only 
 76.17  alternative care eligible clients.  Prior to By July 1 of each 
 76.18  year, the commissioner shall allocate to county agencies the 
 76.19  state funds available for alternative care for persons eligible 
 76.20  under subdivision 2. 
 76.21     (b) The adjusted base for each county is the county's 
 76.22  current fiscal year base allocation plus any targeted funds 
 76.23  approved during the current fiscal year.  Calculations for 
 76.24  paragraphs (c) and (d) are to be made as follows:  for each 
 76.25  county, the determination of alternative care program 
 76.26  expenditures shall be based on payments for services rendered 
 76.27  from April 1 through March 31 in the base year, to the extent 
 76.28  that claims have been submitted and paid by June 1 of that year. 
 76.29     (c) If the alternative care program expenditures as defined 
 76.30  in paragraph (b) are 95 percent or more of the county's adjusted 
 76.31  base allocation, the allocation for the next fiscal year is 100 
 76.32  percent of the adjusted base, plus inflation to the extent that 
 76.33  inflation is included in the state budget. 
 76.34     (d) If the alternative care program expenditures as defined 
 76.35  in paragraph (b) are less than 95 percent of the county's 
 76.36  adjusted base allocation, the allocation for the next fiscal 
 77.1   year is the adjusted base allocation less the amount of unspent 
 77.2   funds below the 95 percent level. 
 77.3      (e) If the annual legislative appropriation for the 
 77.4   alternative care program is inadequate to fund the combined 
 77.5   county allocations for a biennium, the commissioner shall 
 77.6   distribute to each county the entire annual appropriation as 
 77.7   that county's percentage of the computed base as calculated in 
 77.8   paragraphs (c) and (d). 
 77.9      Sec. 33.  Minnesota Statutes 2001 Supplement, section 
 77.10  256B.0913, subdivision 12, is amended to read: 
 77.11     Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
 77.12  all alternative care eligible clients to help pay for the cost 
 77.13  of participating in the program.  The amount of the premium for 
 77.14  the alternative care client shall be determined as follows: 
 77.15     (1) when the alternative care client's income less 
 77.16  recurring and predictable medical expenses is greater than the 
 77.17  recipient's maintenance needs allowance as defined in section 
 77.18  256B.0915, subdivision 1d, paragraph (a), but less than 150 
 77.19  percent of the federal poverty guideline effective on July 1 of 
 77.20  the state fiscal year in which the premium is being computed, 
 77.21  and total assets are less than $10,000, the fee is zero; 
 77.22     (2) when the alternative care client's income less 
 77.23  recurring and predictable medical expenses is greater than 150 
 77.24  percent of the federal poverty guideline effective on July 1 of 
 77.25  the state fiscal year in which the premium is being computed, 
 77.26  and total assets are less than $10,000, the fee is 25 percent of 
 77.27  the cost of alternative care services or the difference between 
 77.28  150 percent of the federal poverty guideline effective on July 1 
 77.29  of the state fiscal year in which the premium is being computed 
 77.30  and the client's income less recurring and predictable medical 
 77.31  expenses, whichever is less; and 
 77.32     (3) when the alternative care client's total assets are 
 77.33  greater than $10,000, the fee is 25 percent of the cost of 
 77.34  alternative care services.  
 77.35     For married persons, total assets are defined as the total 
 77.36  marital assets less the estimated community spouse asset 
 78.1   allowance, under section 256B.059, if applicable.  For married 
 78.2   persons, total income is defined as the client's income less the 
 78.3   monthly spousal allotment, under section 256B.058. 
 78.4      All alternative care services except case management shall 
 78.5   be included in the estimated costs for the purpose of 
 78.6   determining 25 percent of the costs. 
 78.7      The monthly premium shall be calculated based on the cost 
 78.8   of the first full month of alternative care services and shall 
 78.9   continue unaltered until the next reassessment is completed or 
 78.10  at the end of 12 months, whichever comes first.  Premiums are 
 78.11  due and payable each month alternative care services are 
 78.12  received unless the actual cost of the services is less than the 
 78.13  premium. 
 78.14     (b) The fee shall be waived by the commissioner when: 
 78.15     (1) a person who is residing in a nursing facility is 
 78.16  receiving case management only; 
 78.17     (2) a person is applying for medical assistance; 
 78.18     (3) a married couple is requesting an asset assessment 
 78.19  under the spousal impoverishment provisions; 
 78.20     (4) a person is found eligible for alternative care, but is 
 78.21  not yet receiving alternative care services; or 
 78.22     (5) a person's fee under paragraph (a) is less than $25. 
 78.23     (c) The county agency must record in the state's receivable 
 78.24  system the client's assessed premium amount or the reason the 
 78.25  premium has been waived.  The commissioner will bill and collect 
 78.26  the premium from the client.  Money collected must be deposited 
 78.27  in the general fund and is appropriated to the commissioner for 
 78.28  the alternative care program.  The client must supply the county 
 78.29  with the client's social security number at the time of 
 78.30  application.  The county shall supply the commissioner with the 
 78.31  client's social security number and other information the 
 78.32  commissioner requires to collect the premium from the client.  
 78.33  The commissioner shall collect unpaid premiums using the Revenue 
 78.34  Recapture Act in chapter 270A and other methods available to the 
 78.35  commissioner.  The commissioner may require counties to inform 
 78.36  clients of the collection procedures that may be used by the 
 79.1   state if a premium is not paid.  This paragraph does not apply 
 79.2   to alternative care pilot projects authorized in Laws 1993, 
 79.3   First Special Session chapter 1, article 5, section 133, if a 
 79.4   county operating under the pilot project reports the following 
 79.5   dollar amounts to the commissioner quarterly: 
 79.6      (1) total premiums billed to clients; 
 79.7      (2) total collections of premiums billed; and 
 79.8      (3) balance of premiums owed by clients. 
 79.9   If a county does not adhere to these reporting requirements, the 
 79.10  commissioner may terminate the billing, collecting, and 
 79.11  remitting portions of the pilot project and require the county 
 79.12  involved to operate under the procedures set forth in this 
 79.13  paragraph. 
 79.14     (d) The commissioner shall begin to adopt emergency or 
 79.15  permanent rules governing client premiums within 30 days after 
 79.16  July 1, 1991, including criteria for determining when services 
 79.17  to a client must be terminated due to failure to pay a premium.  
 79.18     Sec. 34.  Minnesota Statutes 2001 Supplement, section 
 79.19  256B.0913, subdivision 14, is amended to read: 
 79.20     Subd. 14.  [PROVIDER REQUIREMENTS, PAYMENT, AND RATE 
 79.21  ADJUSTMENTS.] (a) Unless otherwise specified in statute, 
 79.22  providers must be enrolled as Minnesota health care program 
 79.23  providers and abide by the requirements for provider 
 79.24  participation according to Minnesota Rules, part 9505.0195. 
 79.25     (b) Payment for provided alternative care services as 
 79.26  approved by the client's case manager shall be occur through the 
 79.27  invoice processing procedures of the department's Medicaid 
 79.28  Management Information System (MMIS).  To receive payment, the 
 79.29  county or vendor must submit invoices within 12 months following 
 79.30  the date of service.  The county agency and its vendors under 
 79.31  contract shall not be reimbursed for services which exceed the 
 79.32  county allocation. 
 79.33     (b) (c) The county shall negotiate individual rates with 
 79.34  vendors and may authorize service payment for actual costs up to 
 79.35  the county's current approved rate.  Notwithstanding any other 
 79.36  rule or statutory provision to the contrary, the commissioner 
 80.1   shall not be authorized to increase rates by an annual inflation 
 80.2   factor, unless so authorized by the legislature.  To improve 
 80.3   access to community services and eliminate payment disparities 
 80.4   between the alternative care program and the elderly waiver 
 80.5   program, the commissioner shall establish statewide maximum 
 80.6   service rate limits and eliminate county-specific service rate 
 80.7   limits. 
 80.8      (1) Effective July 1, 2001, for service rate limits, except 
 80.9   those in subdivision 5, paragraphs (d) and (i), the rate limit 
 80.10  for each service shall be the greater of the alternative care 
 80.11  statewide maximum rate or the elderly waiver statewide maximum 
 80.12  rate. 
 80.13     (2) Counties may negotiate individual service rates with 
 80.14  vendors for actual costs up to the statewide maximum service 
 80.15  rate limit. 
 80.16     Sec. 35.  Minnesota Statutes 2000, section 256B.0915, 
 80.17  subdivision 4, is amended to read: 
 80.18     Subd. 4.  [TERMINATION NOTICE.] The case manager must give 
 80.19  the individual a ten-day written notice of any decrease in 
 80.20  denial, reduction, or termination of waivered services. 
 80.21     Sec. 36.  Minnesota Statutes 2001 Supplement, section 
 80.22  256B.0915, subdivision 5, is amended to read: 
 80.23     Subd. 5.  [ASSESSMENTS AND REASSESSMENTS FOR WAIVER 
 80.24  CLIENTS.] Each client shall receive an initial assessment of 
 80.25  strengths, informal supports, and need for services in 
 80.26  accordance with section 256B.0911, subdivisions 3, 3a, and 3b.  
 80.27  A reassessment of a client served under the elderly waiver must 
 80.28  be conducted at least every 12 months and at other times when 
 80.29  the case manager determines that there has been significant 
 80.30  change in the client's functioning.  This may include instances 
 80.31  where the client is discharged from the hospital.  
 80.32     Sec. 37.  Minnesota Statutes 2000, section 256B.0915, 
 80.33  subdivision 6, is amended to read: 
 80.34     Subd. 6.  [IMPLEMENTATION OF CARE PLAN.] Each elderly 
 80.35  waiver client shall be provided a copy of a written care plan 
 80.36  that meets the requirements outlined in section 256B.0913, 
 81.1   subdivision 8.  If the county administering waivered services is 
 81.2   different than the county of financial responsibility, the care 
 81.3   plan may be implemented without the approval of the county of 
 81.4   financial responsibility. 
 81.5      Sec. 38.  Minnesota Statutes 2000, section 256B.0915, is 
 81.6   amended by adding a subdivision to read: 
 81.7      Subd. 8.  [SERVICES AND SUPPORTS.] (a) Services and 
 81.8   supports shall meet the requirements set out in United States 
 81.9   Code, title 42, section 1396n. 
 81.10     (b) Services and supports shall promote consumer choice and 
 81.11  be arranged and provided consistent with individualized, written 
 81.12  care plans. 
 81.13     (c) The state of Minnesota, county, or tribal government 
 81.14  under contract to administer the elderly waiver shall not be 
 81.15  liable for damages, injuries, or liabilities sustained through 
 81.16  the purchase of direct supports or goods by the person, the 
 81.17  person's family, or the authorized representatives with funds 
 81.18  received through consumer directed community support services 
 81.19  under the federally approved waiver plan.  Liabilities include, 
 81.20  but are not limited to, workers' compensation liability, the 
 81.21  Federal Insurance Contributions Act (FICA), or the Federal 
 81.22  Unemployment Tax Act (FUTA). 
 81.23     Sec. 39.  Minnesota Statutes 2000, section 256B.32, is 
 81.24  amended to read: 
 81.25     256B.32 [FACILITY FEE FOR OUTPATIENT HOSPITAL EMERGENCY 
 81.26  ROOM AND CLINIC VISITS.] 
 81.27     Subdivision 1.  [FACILITY FEE PAYMENT.] The commissioner 
 81.28  shall establish a facility fee payment mechanism that will pay a 
 81.29  facility fee to all enrolled outpatient hospitals for each 
 81.30  emergency room or outpatient clinic visit provided on or after 
 81.31  July 1, 1989.  This payment mechanism may not result in an 
 81.32  overall increase in outpatient payment rates.  This section does 
 81.33  not apply to federally mandated maximum payment limits, 
 81.34  department approved program packages, or services billed using a 
 81.35  nonoutpatient hospital provider number. 
 81.36     Subd. 2.  [PROSPECTIVE PAYMENT SYSTEM.] Effective for 
 82.1   services provided on or after July 1, 2003, rates that are based 
 82.2   on the Medicare outpatient prospective payment system shall be 
 82.3   replaced by a budget-neutral prospective payment system that is 
 82.4   derived using medical assistance data. 
 82.5      Sec. 40.  Minnesota Statutes 2001 Supplement, section 
 82.6   256B.431, subdivision 2e, is amended to read: 
 82.7      Subd. 2e.  [CONTRACTS FOR SERVICES FOR VENTILATOR-DEPENDENT 
 82.8   PERSONS.] The commissioner may contract negotiate with a nursing 
 82.9   facility eligible to receive medical assistance payments to 
 82.10  provide services to a ventilator-dependent person identified by 
 82.11  the commissioner according to criteria developed by the 
 82.12  commissioner, including:  
 82.13     (1) nursing facility care has been recommended for the 
 82.14  person by a preadmission screening team; 
 82.15     (2) the person has been hospitalized and no longer requires 
 82.16  inpatient acute care hospital services; and 
 82.17     (3) the commissioner has determined that necessary services 
 82.18  for the person cannot be provided under existing nursing 
 82.19  facility rates.  
 82.20     The commissioner may issue a request for proposals to 
 82.21  provide services to a ventilator-dependent person to nursing 
 82.22  facilities eligible to receive medical assistance payments and 
 82.23  shall select nursing facilities from among respondents according 
 82.24  to criteria developed by the commissioner, including:  
 82.25     (1) the cost-effectiveness and appropriateness of services; 
 82.26     (2) the nursing facility's compliance with federal and 
 82.27  state licensing and certification standards; and 
 82.28     (3) the proximity of the nursing facility to a 
 82.29  ventilator-dependent person identified by the commissioner who 
 82.30  requires nursing facility placement.  
 82.31     The commissioner may negotiate an adjustment to the 
 82.32  operating cost payment rate for a nursing facility selected by 
 82.33  the commissioner from among respondents to the request for 
 82.34  proposals with a resident who is ventilator-dependent, for that 
 82.35  resident.  The negotiated adjustment must reflect only the 
 82.36  actual additional cost of meeting the specialized care needs of 
 83.1   a ventilator-dependent person identified by the commissioner for 
 83.2   whom necessary services cannot be provided under existing 
 83.3   nursing facility rates and which are not otherwise covered under 
 83.4   Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to 
 83.5   9505.0475.  For persons who are initially admitted to a nursing 
 83.6   facility before July 1, 2001, and have their payment rate under 
 83.7   this subdivision negotiated after July 1, 2001, the negotiated 
 83.8   payment rate must not exceed 200 percent of the highest multiple 
 83.9   bedroom payment rate for the facility, as initially established 
 83.10  by the commissioner for the rate year for case mix 
 83.11  classification K; or, upon implementation of the RUGs-based case 
 83.12  mix system, 200 percent of the highest RUGs rate.  For persons 
 83.13  initially admitted to a nursing facility on or after July 1, 
 83.14  2001, the negotiated payment rate must not exceed 300 percent of 
 83.15  the facility's multiple bedroom payment rate for case mix 
 83.16  classification K; or, upon implementation of the RUGs-based case 
 83.17  mix system, 300 percent of the highest RUGs rate.  The 
 83.18  negotiated adjustment shall not affect the payment rate charged 
 83.19  to private paying residents under the provisions of section 
 83.20  256B.48, subdivision 1.  
 83.21     Sec. 41.  Minnesota Statutes 2000, section 256B.431, 
 83.22  subdivision 14, is amended to read: 
 83.23     Subd. 14.  [LIMITATIONS ON SALES OF NURSING FACILITIES.] 
 83.24  (a) For rate periods beginning on October 1, 1992, and for rate 
 83.25  years beginning after June 30, 1993, a nursing facility's 
 83.26  property-related payment rate as established under subdivision 
 83.27  13 shall be adjusted by either paragraph (b) or (c) for the sale 
 83.28  of the nursing facility, including sales occurring after June 
 83.29  30, 1992, as provided in this subdivision. 
 83.30     (b) If the nursing facility's property-related payment rate 
 83.31  under subdivision 13 prior to sale is greater than the nursing 
 83.32  facility's rental rate under Minnesota Rules, parts 9549.0010 to 
 83.33  9549.0080, and this section prior to sale, the nursing 
 83.34  facility's property-related payment rate after sale shall be the 
 83.35  greater of its property-related payment rate under subdivision 
 83.36  13 prior to sale or its rental rate under Minnesota Rules, parts 
 84.1   9549.0010 to 9549.0080, and this section calculated after sale. 
 84.2      (c) If the nursing facility's property-related payment rate 
 84.3   under subdivision 13 prior to sale is equal to or less than the 
 84.4   nursing facility's rental rate under Minnesota Rules, parts 
 84.5   9549.0010 to 9549.0080, and this section prior to sale, the 
 84.6   nursing facility's property-related payment rate after sale 
 84.7   shall be the nursing facility's property-related payment rate 
 84.8   under subdivision 13 plus the difference between its rental rate 
 84.9   calculated under Minnesota Rules, parts 9549.0010 to 9549.0080, 
 84.10  and this section prior to sale and its rental rate calculated 
 84.11  under Minnesota Rules, parts 9549.0010 to 9549.0080, and this 
 84.12  section calculated after sale. 
 84.13     (d) For purposes of this subdivision, "sale" means the 
 84.14  purchase of a nursing facility's capital assets with cash or 
 84.15  debt.  The term sale does not include a stock purchase of a 
 84.16  nursing facility or any of the following transactions:  
 84.17     (1) a sale and leaseback to the same licensee that does not 
 84.18  constitute a change in facility license; 
 84.19     (2) a transfer of an interest to a trust; 
 84.20     (3) gifts or other transfers for no consideration; 
 84.21     (4) a merger of two or more related organizations; 
 84.22     (5) a change in the legal form of doing business, other 
 84.23  than a publicly held organization that becomes privately held or 
 84.24  vice versa; 
 84.25     (6) the addition of a new partner, owner, or shareholder 
 84.26  who owns less than 20 percent of the nursing facility or the 
 84.27  issuance of stock; and 
 84.28     (7) a sale, merger, reorganization, or any other transfer 
 84.29  of interest between related organizations other than those 
 84.30  permitted in this section.  
 84.31     (e) For purposes of this subdivision, "sale" includes the 
 84.32  sale or transfer of a nursing facility to a close relative as 
 84.33  defined in Minnesota Rules, part 9549.0020, subpart 38, item C, 
 84.34  upon the death of an owner, due to serious illness or 
 84.35  disability, as defined under the Social Security Act, under 
 84.36  United States Code, title 42, section 423(d)(1)(A), or upon 
 85.1   retirement of an owner from the business of owning or operating 
 85.2   a nursing home at 62 years of age or older.  For sales to a 
 85.3   close relative allowed under this paragraph, otherwise 
 85.4   nonallowable debt resulting from seller financing of all or a 
 85.5   portion of the debt resulting from the sale shall be allowed and 
 85.6   shall not be subject to Minnesota Rules, part 9549.0060, subpart 
 85.7   5, item E, provided that in addition to existing requirements 
 85.8   for allowance of debt and interest, the debt is subject to 
 85.9   repayment through annual principal payments and the interest 
 85.10  rate on the related organization debt does not exceed three 
 85.11  percentage points above the posted yield for standard 
 85.12  conventional fixed rate mortgages of the Federal Home Loan 
 85.13  Mortgage Corporation for delivery in 60 days in effect on the 
 85.14  day of sale.  If at any time, the seller forgives the related 
 85.15  organization debt allowed under this paragraph for other than 
 85.16  equal amount of payment on that debt, then the buyer shall pay 
 85.17  to the state the total revenue received by the nursing facility 
 85.18  after the sale attributable to the amount of allowable debt 
 85.19  which has been forgiven.  Any assignment, sale, or transfer of 
 85.20  the debt instrument entered into by the close relatives, either 
 85.21  directly or indirectly, which grants to the close relative buyer 
 85.22  the right to receive all or a portion of the payments under the 
 85.23  debt instrument shall, effective on the date of the transfer, 
 85.24  result in the prospective reduction in the corresponding portion 
 85.25  of the allowable debt and interest expense.  Upon the death of 
 85.26  the close relative seller, any remaining balance of the close 
 85.27  relative debt must be refinanced and such refinancing shall be 
 85.28  subject to the provisions of Minnesota Rules, part 9549.0060, 
 85.29  subpart 7, item G.  This paragraph shall not apply to sales 
 85.30  occurring on or after June 30, 1997.  
 85.31     (f) For purposes of this subdivision, "effective date of 
 85.32  sale" means the later of either the date on which legal title to 
 85.33  the capital assets is transferred or the date on which closing 
 85.34  for the sale occurred.  
 85.35     (g) The effective day for the property-related payment rate 
 85.36  determined under this subdivision shall be the first day of the 
 86.1   month following the month in which the effective date of sale 
 86.2   occurs or October 1, 1992, whichever is later, provided that the 
 86.3   notice requirements under section 256B.47, subdivision 2, have 
 86.4   been met. 
 86.5      (h) Notwithstanding Minnesota Rules, part 9549.0060, 
 86.6   subparts 5, item A, subitems (3) and (4), and 7, items E and F, 
 86.7   the commissioner shall limit the total allowable debt and 
 86.8   related interest for sales occurring after June 30, 1992, to the 
 86.9   sum of clauses (1) to (3):  
 86.10     (1) the historical cost of capital assets, as of the 
 86.11  nursing facility's most recent previous effective date of sale 
 86.12  or, if there has been no previous sale, the nursing facility's 
 86.13  initial historical cost of constructing capital assets; 
 86.14     (2) the average annual capital asset additions after 
 86.15  deduction for capital asset deletions, not including 
 86.16  depreciations; and 
 86.17     (3) one-half of the allowed inflation on the nursing 
 86.18  facility's capital assets.  The commissioner shall compute the 
 86.19  allowed inflation as described in paragraph (h) (i). 
 86.20     (i) For purposes of computing the amount of allowed 
 86.21  inflation, the commissioner must apply the following principles: 
 86.22     (1) the lesser of the Consumer Price Index for all urban 
 86.23  consumers or the Dodge Construction Systems Costs for Nursing 
 86.24  Homes for any time periods during which both are available must 
 86.25  be used.  If the Dodge Construction Systems Costs for Nursing 
 86.26  Homes becomes unavailable, the commissioner shall substitute the 
 86.27  index in subdivision 3f, or such other index as the secretary of 
 86.28  the health care financing administration may designate; 
 86.29     (2) the amount of allowed inflation to be applied to the 
 86.30  capital assets in paragraph (g), clauses (1) and (2), must be 
 86.31  computed separately; 
 86.32     (3) the amount of allowed inflation must be determined on 
 86.33  an annual basis, prorated on a monthly basis for partial years 
 86.34  and if the initial month of use is not determinable for a 
 86.35  capital asset, then one-half of that calendar year shall be used 
 86.36  for purposes of prorating; 
 87.1      (4) the amount of allowed inflation to be applied to the 
 87.2   capital assets in paragraph (g), clauses (1) and (2), must not 
 87.3   exceed 300 percent of the total capital assets in any one of 
 87.4   those clauses; and 
 87.5      (5) the allowed inflation must be computed starting with 
 87.6   the month following the nursing facility's most recent previous 
 87.7   effective date of sale or, if there has been no previous sale, 
 87.8   the month following the date of the nursing facility's initial 
 87.9   occupancy, and ending with the month preceding the effective 
 87.10  date of sale. 
 87.11     (j) If the historical cost of a capital asset is not 
 87.12  readily available for the date of the nursing facility's most 
 87.13  recent previous sale or if there has been no previous sale for 
 87.14  the date of the nursing facility's initial occupancy, then the 
 87.15  commissioner shall limit the total allowable debt and related 
 87.16  interest after sale to the extent recognized by the Medicare 
 87.17  intermediary after the sale.  For a nursing facility that has no 
 87.18  historical capital asset cost data available and does not have 
 87.19  allowable debt and interest calculated by the Medicare 
 87.20  intermediary, the commissioner shall use the historical cost of 
 87.21  capital asset data from the point in time for which capital 
 87.22  asset data is recorded in the nursing facility's audited 
 87.23  financial statements. 
 87.24     (k) The limitations in this subdivision apply only to debt 
 87.25  resulting from a sale of a nursing facility occurring after June 
 87.26  30, 1992, including debt assumed by the purchaser of the nursing 
 87.27  facility. 
 87.28     Sec. 42.  Minnesota Statutes 2000, section 256B.431, 
 87.29  subdivision 30, is amended to read: 
 87.30     Subd. 30.  [BED LAYAWAY AND DELICENSURE.] (a) For rate 
 87.31  years beginning on or after July 1, 2000, a nursing facility 
 87.32  reimbursed under this section which has placed beds on layaway 
 87.33  shall, for purposes of application of the downsizing incentive 
 87.34  in subdivision 3a, paragraph (d) (c), and calculation of the 
 87.35  rental per diem, have those beds given the same effect as if the 
 87.36  beds had been delicensed so long as the beds remain on layaway.  
 88.1   At the time of a layaway, a facility may change its single bed 
 88.2   election for use in calculating capacity days under Minnesota 
 88.3   Rules, part 9549.0060, subpart 11.  The property payment rate 
 88.4   increase shall be effective the first day of the month following 
 88.5   the month in which the layaway of the beds becomes effective 
 88.6   under section 144A.071, subdivision 4b. 
 88.7      (b) For rate years beginning on or after July 1, 2000, 
 88.8   notwithstanding any provision to the contrary under section 
 88.9   256B.434, a nursing facility reimbursed under that section which 
 88.10  has placed beds on layaway shall, for so long as the beds remain 
 88.11  on layaway, be allowed to: 
 88.12     (1) aggregate the applicable investment per bed limits 
 88.13  based on the number of beds licensed immediately prior to 
 88.14  entering the alternative payment system; 
 88.15     (2) retain or change the facility's single bed election for 
 88.16  use in calculating capacity days under Minnesota Rules, part 
 88.17  9549.0060, subpart 11; and 
 88.18     (3) establish capacity days based on the number of beds 
 88.19  immediately prior to the layaway and the number of beds after 
 88.20  the layaway. 
 88.21  The commissioner shall increase the facility's property payment 
 88.22  rate by the incremental increase in the rental per diem 
 88.23  resulting from the recalculation of the facility's rental per 
 88.24  diem applying only the changes resulting from the layaway of 
 88.25  beds and clauses (1), (2), and (3).  If a facility reimbursed 
 88.26  under section 256B.434 completes a moratorium exception project 
 88.27  after its base year, the base year property rate shall be the 
 88.28  moratorium project property rate.  The base year rate shall be 
 88.29  inflated by the factors in section 256B.434, subdivision 4, 
 88.30  paragraph (c).  The property payment rate increase shall be 
 88.31  effective the first day of the month following the month in 
 88.32  which the layaway of the beds becomes effective. 
 88.33     (c) If a nursing facility removes a bed from layaway status 
 88.34  in accordance with section 144A.071, subdivision 4b, the 
 88.35  commissioner shall establish capacity days based on the number 
 88.36  of licensed and certified beds in the facility not on layaway 
 89.1   and shall reduce the nursing facility's property payment rate in 
 89.2   accordance with paragraph (b). 
 89.3      (d) For the rate years beginning on or after July 1, 2000, 
 89.4   notwithstanding any provision to the contrary under section 
 89.5   256B.434, a nursing facility reimbursed under that section, 
 89.6   which has delicensed beds after July 1, 2000, by giving notice 
 89.7   of the delicensure to the commissioner of health according to 
 89.8   the notice requirements in section 144A.071, subdivision 4b, 
 89.9   shall be allowed to: 
 89.10     (1) aggregate the applicable investment per bed limits 
 89.11  based on the number of beds licensed immediately prior to 
 89.12  entering the alternative payment system; 
 89.13     (2) retain or change the facility's single bed election for 
 89.14  use in calculating capacity days under Minnesota Rules, part 
 89.15  9549.0060, subpart 11; and 
 89.16     (3) establish capacity days based on the number of beds 
 89.17  immediately prior to the delicensure and the number of beds 
 89.18  after the delicensure. 
 89.19  The commissioner shall increase the facility's property payment 
 89.20  rate by the incremental increase in the rental per diem 
 89.21  resulting from the recalculation of the facility's rental per 
 89.22  diem applying only the changes resulting from the delicensure of 
 89.23  beds and clauses (1), (2), and (3).  If a facility reimbursed 
 89.24  under section 256B.434 completes a moratorium exception project 
 89.25  after its base year, the base year property rate shall be the 
 89.26  moratorium project property rate.  The base year rate shall be 
 89.27  inflated by the factors in section 256B.434, subdivision 4, 
 89.28  paragraph (c).  The property payment rate increase shall be 
 89.29  effective the first day of the month following the month in 
 89.30  which the delicensure of the beds becomes effective. 
 89.31     (e) For nursing facilities reimbursed under this section or 
 89.32  section 256B.434, any beds placed on layaway shall not be 
 89.33  included in calculating facility occupancy as it pertains to 
 89.34  leave days defined in Minnesota Rules, part 9505.0415. 
 89.35     (f) For nursing facilities reimbursed under this section or 
 89.36  section 256B.434, the rental rate calculated after placing beds 
 90.1   on layaway may not be less than the rental rate prior to placing 
 90.2   beds on layaway. 
 90.3      (g) A nursing facility receiving a rate adjustment as a 
 90.4   result of this section shall comply with section 256B.47, 
 90.5   subdivision 2. 
 90.6      (h) A facility that does not utilize the space made 
 90.7   available as a result of bed layaway or delicensure under this 
 90.8   subdivision to reduce the number of beds per room or provide 
 90.9   more common space for nursing facility uses or perform other 
 90.10  activities related to the operation of the nursing facility 
 90.11  shall have its property rate increase calculated under this 
 90.12  subdivision reduced by the ratio of the square footage made 
 90.13  available that is not used for these purposes to the total 
 90.14  square footage made available as a result of bed layaway or 
 90.15  delicensure. 
 90.16     Sec. 43.  Minnesota Statutes 2001 Supplement, section 
 90.17  256B.431, subdivision 33, is amended to read: 
 90.18     Subd. 33.  [STAGED REDUCTION IN RATE DISPARITIES.] (a) For 
 90.19  the rate years beginning July 1, 2001, and July 1, 2002, the 
 90.20  commissioner shall adjust the operating payment rates for 
 90.21  low-rate nursing facilities reimbursed under this section or 
 90.22  section 256B.434.  
 90.23     (b) For the rate year beginning July 1, 2001, for each case 
 90.24  mix level, if the amount computed under subdivision 32 31 is 
 90.25  less than the amount in clause (1), the commissioner shall make 
 90.26  available the lesser of the amount in clause (1) or an increase 
 90.27  of ten percent over the rate in effect on June 30, 2001, as an 
 90.28  adjustment to the operating payment rate.  For the rate year 
 90.29  beginning July 1, 2002, for each case mix level, if the amount 
 90.30  computed under subdivision 32 31 is less than the amount in 
 90.31  clause (2), the commissioner shall make available the lesser of 
 90.32  the amount in clause (2) or an increase of ten percent over the 
 90.33  rate in effect on June 30, 2002, as an adjustment to the 
 90.34  operating payment rate.  For purposes of this subdivision, 
 90.35  nursing facilities shall be considered to be metro if they are 
 90.36  located in Anoka, Carver, Dakota, Hennepin, Olmsted, Ramsey, 
 91.1   Scott, or Washington counties; or in the cities of Moorhead or 
 91.2   Breckenridge; or in St. Louis county, north of Toivola and south 
 91.3   of Cook; or in Itasca county, east of a north south line two 
 91.4   miles west of Grand Rapids:  
 91.5      (1) Operating Payment Rate Target Level for July 1, 2001: 
 91.6       Case Mix Classification        Metro       Nonmetro
 91.7                 A                    $ 76.00     $ 68.13
 91.8                 B                    $ 83.40     $ 74.46
 91.9                 C                    $ 91.67     $ 81.63
 91.10                D                    $ 99.51     $ 88.04
 91.11                E                    $107.46     $ 94.87
 91.12                F                    $107.96     $ 95.29
 91.13                G                    $114.67     $100.98
 91.14                H                    $126.99     $111.31
 91.15                I                    $131.42     $115.06
 91.16                J                    $138.34     $120.85
 91.17                K                    $152.26     $133.10
 91.18     (2) Operating Payment Rate Target Level for July 1, 2002: 
 91.19      Case Mix Classification        Metro       Nonmetro
 91.20                A                    $ 78.28     $ 70.51
 91.21                B                    $ 85.91     $ 77.16
 91.22                C                    $ 94.42     $ 84.62
 91.23                D                    $102.50     $ 91.42
 91.24                E                    $110.68     $ 98.40
 91.25                F                    $111.20     $ 98.84
 91.26                G                    $118.11     $104.77
 91.27                H                    $130.80     $115.64
 91.28                I                    $135.38     $119.50
 91.29                J                    $142.49     $125.38
 91.30                K                    $156.85     $137.77
 91.31     Sec. 44.  Minnesota Statutes 2001 Supplement, section 
 91.32  256B.437, subdivision 3, is amended to read: 
 91.33     Subd. 3.  [APPLICATIONS FOR PLANNED CLOSURE OF NURSING 
 91.34  FACILITIES.] (a) By August 15, 2001, the commissioner of human 
 91.35  services shall implement and announce a program for closure or 
 91.36  partial closure of nursing facilities.  Names and identifying 
 92.1   information provided in response to the announcement shall 
 92.2   remain private unless approved, according to the timelines 
 92.3   established in the plan.  The announcement must specify: 
 92.4      (1) the criteria in subdivision 4 that will be used by the 
 92.5   commissioner to approve or reject applications; 
 92.6      (2) a requirement for the submission of a letter of intent 
 92.7   before the submission of an application; 
 92.8      (3) the information that must accompany an application; and 
 92.9      (4) (3) that applications may combine planned closure rate 
 92.10  adjustments with moratorium exception funding, in which case a 
 92.11  single application may serve both purposes. 
 92.12  Between August 1, 2001, and June 30, 2003, the commissioner may 
 92.13  approve planned closures of up to 5,140 nursing facility beds, 
 92.14  less the number of licensed beds delicensed in facilities that 
 92.15  close during the same time period without approved closure plans 
 92.16  or that have notified the commissioner of health of their intent 
 92.17  to close without an approved closure plan. 
 92.18     (b) A facility or facilities reimbursed under section 
 92.19  256B.431 or 256B.434 with a closure plan approved by the 
 92.20  commissioner under subdivision 5 may assign a planned closure 
 92.21  rate adjustment to another facility or facilities that are not 
 92.22  closing or in the case of a partial closure, to the facility 
 92.23  undertaking the partial closure.  A facility may also elect to 
 92.24  have a planned closure rate adjustment shared equally by the 
 92.25  five nursing facilities with the lowest total operating payment 
 92.26  rates in the state development region designated under section 
 92.27  462.385, in which the facility that is closing is located.  The 
 92.28  planned closure rate adjustment must be calculated under 
 92.29  subdivision 6.  Facilities that close delicense beds without a 
 92.30  closure plan, or whose closure plan is not approved by the 
 92.31  commissioner, are not eligible to assign a planned closure rate 
 92.32  adjustment under subdivision 6., unless they are delicensing 
 92.33  five or fewer beds, or less than six percent of their total 
 92.34  licensed bed capacity, whichever is greater, are located in a 
 92.35  county in the top three quartiles of beds per 1,000 persons aged 
 92.36  65 or older, and have not delicensed beds in the prior three 
 93.1   months.  Facilities meeting these criteria are eligible to 
 93.2   assign the amount calculated under subdivision 6 to themselves.  
 93.3   If a facility is delicensing the greater of six or more beds, or 
 93.4   six percent or more of its total licensed bed capacity, and does 
 93.5   not have an approved closure plan or is not eligible for the 
 93.6   adjustment under subdivision 6, the commissioner shall calculate 
 93.7   the amount the facility would have been eligible to assign under 
 93.8   subdivision 6, and shall use this amount to provide equal rate 
 93.9   adjustments to the five nursing facilities with the lowest total 
 93.10  operating payment rates in the state development region 
 93.11  designated under section 462.385, in which the facility 
 93.12  that closed delicensed beds is located. 
 93.13     (c) To be considered for approval, an application must 
 93.14  include: 
 93.15     (1) a description of the proposed closure plan, which must 
 93.16  include identification of the facility or facilities to receive 
 93.17  a planned closure rate adjustment and the amount and timing of a 
 93.18  planned closure rate adjustment proposed for each facility; 
 93.19     (2) the proposed timetable for any proposed closure, 
 93.20  including the proposed dates for announcement to residents, 
 93.21  commencement of closure, and completion of closure; 
 93.22     (3) if available, the proposed relocation plan for current 
 93.23  residents of any facility designated for closure.  The proposed 
 93.24  If a relocation plan is not available, the application must 
 93.25  include a statement agreeing to develop a relocation plan must 
 93.26  be designed to comply with all applicable state and federal 
 93.27  statutes and regulations, including, but not limited to, section 
 93.28  144A.161; 
 93.29     (4) a description of the relationship between the nursing 
 93.30  facility that is proposed for closure and the nursing facility 
 93.31  or facilities proposed to receive the planned closure rate 
 93.32  adjustment.  If these facilities are not under common ownership, 
 93.33  copies of any contracts, purchase agreements, or other documents 
 93.34  establishing a relationship or proposed relationship must be 
 93.35  provided; 
 93.36     (5) documentation, in a format approved by the 
 94.1   commissioner, that all the nursing facilities receiving a 
 94.2   planned closure rate adjustment under the plan have accepted 
 94.3   joint and several liability for recovery of overpayments under 
 94.4   section 256B.0641, subdivision 2, for the facilities designated 
 94.5   for closure under the plan; and 
 94.6      (6) an explanation of how the application coordinates with 
 94.7   planning efforts under subdivision 2.  If the planning group 
 94.8   does not support a level of nursing facility closures that the 
 94.9   commissioner considers to be reasonable, the commissioner may 
 94.10  approve a planned closure proposal without its support. 
 94.11     (d) The application must address the criteria listed in 
 94.12  subdivision 4. 
 94.13     Sec. 45.  Minnesota Statutes 2001 Supplement, section 
 94.14  256B.438, subdivision 1, is amended to read: 
 94.15     Subdivision 1.  [SCOPE.] This section establishes the 
 94.16  method and criteria used to determine resident reimbursement 
 94.17  classifications based upon the assessments of residents of 
 94.18  nursing homes and boarding care homes whose payment rates are 
 94.19  established under section 256B.431, 256B.434, or 256B.435.  
 94.20  Resident reimbursement classifications shall be established 
 94.21  according to the 34 group, resource utilization groups, version 
 94.22  III or RUG-III model as described in section 144.0724.  
 94.23  Reimbursement classifications established under this section 
 94.24  shall be implemented after June 30, 2002, but no later than 
 94.25  January 1, 2003.  Reimbursement classifications established 
 94.26  under this section shall be implemented no earlier than six 
 94.27  weeks after the commissioner mails notices of payment rates to 
 94.28  the facilities. 
 94.29     Sec. 46.  Minnesota Statutes 2000, section 256B.5012, 
 94.30  subdivision 2, is amended to read: 
 94.31     Subd. 2.  [OPERATING PAYMENT RATE.] (a) The operating 
 94.32  payment rate equals the facility's total payment rate in effect 
 94.33  on September 30, 2000, minus the property rate.  The operating 
 94.34  payment rate includes the special operating rate and the 
 94.35  efficiency incentive in effect as of September 30, 2000.  Within 
 94.36  the limits of appropriations specifically for this purpose, the 
 95.1   operating payment shall be increased for each rate year by the 
 95.2   annual percentage change in the Employment Cost Index for 
 95.3   Private Industry Workers - Total Compensation, as forecasted by 
 95.4   the commissioner of finance's economic consultant, in the second 
 95.5   quarter of the calendar year preceding the start of each rate 
 95.6   year.  In the case of the initial rate year beginning October 1, 
 95.7   2000, and continuing through December 31, 2001, the percentage 
 95.8   change shall be based on the percentage change in the Employment 
 95.9   Cost Index for Private Industry Workers - Total Compensation for 
 95.10  the 15-month period beginning October 1, 2000, as forecast by 
 95.11  Data Resources, Inc., in the first quarter of 2000. 
 95.12     (b) Effective October 1, 2000, the operating payment rate 
 95.13  shall be adjusted to reflect an occupancy rate equal to 100 
 95.14  percent of the facility's capacity days as of September 30, 2000.
 95.15     (c) Effective July 1, 2001, the operating payment rate 
 95.16  shall be adjusted for the increases in the department of health 
 95.17  licensing fees that were adopted in Laws 2001, First Special 
 95.18  Session chapter 9, article 1, section 30. 
 95.19     Sec. 47.  Minnesota Statutes 2001 Supplement, section 
 95.20  256B.69, subdivision 5b, is amended to read: 
 95.21     Subd. 5b.  [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 
 95.22  prepaid medical assistance and general assistance medical care 
 95.23  program contract rates set by the commissioner under subdivision 
 95.24  5 and effective on or after January 1, 1998, capitation rates 
 95.25  for nonmetropolitan counties shall on a weighted average be no 
 95.26  less than 88 percent of the capitation rates for metropolitan 
 95.27  counties, excluding Hennepin county.  The commissioner shall 
 95.28  make a pro rata adjustment in capitation rates paid to counties 
 95.29  other than nonmetropolitan counties in order to make this 
 95.30  provision budget neutral.  The commissioner, in consultation 
 95.31  with a health care actuary, shall evaluate the regional rate 
 95.32  relationships based on actual health plan costs for Minnesota 
 95.33  health care programs.  The commissioner may establish, based on 
 95.34  the actuary's recommendation, new rate regions that recognize 
 95.35  metropolitan areas outside of the seven-county metropolitan area.
 95.36     (b) For prepaid medical assistance program contract rates 
 96.1   set by the commissioner under subdivision 5 and effective on or 
 96.2   after January 1, 2001, capitation rates for nonmetropolitan 
 96.3   counties shall, on a weighted average, be no less than 89 
 96.4   percent of the capitation rates for metropolitan counties, 
 96.5   excluding Hennepin county. 
 96.6      (c) This subdivision shall not affect the nongeographically 
 96.7   based risk adjusted rates established under section 62Q.03, 
 96.8   subdivision 5a. 
 96.9      Sec. 48.  Minnesota Statutes 2001 Supplement, section 
 96.10  256B.75, is amended to read: 
 96.11     256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 
 96.12     (a) For outpatient hospital facility fee payments for 
 96.13  services rendered on or after October 1, 1992, the commissioner 
 96.14  of human services shall pay the lower of (1) submitted charge, 
 96.15  or (2) 32 percent above the rate in effect on June 30, 1992, 
 96.16  except for those services for which there is a federal maximum 
 96.17  allowable payment.  Effective for services rendered on or after 
 96.18  January 1, 2000, payment rates for nonsurgical outpatient 
 96.19  hospital facility fees and emergency room facility fees shall be 
 96.20  increased by eight percent over the rates in effect on December 
 96.21  31, 1999, except for those services for which there is a federal 
 96.22  maximum allowable payment.  Services for which there is a 
 96.23  federal maximum allowable payment shall be paid at the lower of 
 96.24  (1) submitted charge, or (2) the federal maximum allowable 
 96.25  payment.  Total aggregate payment for outpatient hospital 
 96.26  facility fee services shall not exceed the Medicare upper 
 96.27  limit.  If it is determined that a provision of this section 
 96.28  conflicts with existing or future requirements of the United 
 96.29  States government with respect to federal financial 
 96.30  participation in medical assistance, the federal requirements 
 96.31  prevail.  The commissioner may, in the aggregate, prospectively 
 96.32  reduce payment rates to avoid reduced federal financial 
 96.33  participation resulting from rates that are in excess of the 
 96.34  Medicare upper limitations. 
 96.35     (b) Notwithstanding paragraph (a), payment for outpatient, 
 96.36  emergency, and ambulatory surgery hospital facility fee services 
 97.1   for critical access hospitals designated under section 144.1483, 
 97.2   clause (11), shall be paid on a cost-based payment system that 
 97.3   is based on the cost-finding methods and allowable costs of the 
 97.4   Medicare program. 
 97.5      (c) Effective for services provided on or after July 1, 
 97.6   2002 2003, rates that are based on the Medicare outpatient 
 97.7   prospective payment system shall be replaced by a budget neutral 
 97.8   prospective payment system that is derived using medical 
 97.9   assistance data.  The commissioner shall provide a proposal to 
 97.10  the 2002 legislature to define and implement this provision. 
 97.11     Sec. 49.  Minnesota Statutes 2001 Supplement, section 
 97.12  256B.76, is amended to read: 
 97.13     256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
 97.14     (a) Effective for services rendered on or after October 1, 
 97.15  1992, the commissioner shall make payments for physician 
 97.16  services as follows: 
 97.17     (1) payment for level one Health Care Finance 
 97.18  Administration's common procedural coding system (HCPCS) codes 
 97.19  titled "office and other outpatient services," "preventive 
 97.20  medicine new and established patient," "delivery, antepartum, 
 97.21  and postpartum care," "critical care," cesarean delivery and 
 97.22  pharmacologic management provided to psychiatric patients, and 
 97.23  HCPCS level three codes for enhanced services for prenatal high 
 97.24  risk, shall be paid at the lower of (i) submitted charges, or 
 97.25  (ii) 25 percent above the rate in effect on June 30, 1992.  If 
 97.26  the rate on any procedure code within these categories is 
 97.27  different than the rate that would have been paid under the 
 97.28  methodology in section 256B.74, subdivision 2, then the larger 
 97.29  rate shall be paid; 
 97.30     (2) payments for all other services shall be paid at the 
 97.31  lower of (i) submitted charges, or (ii) 15.4 percent above the 
 97.32  rate in effect on June 30, 1992; 
 97.33     (3) all physician rates shall be converted from the 50th 
 97.34  percentile of 1982 to the 50th percentile of 1989, less the 
 97.35  percent in aggregate necessary to equal the above increases 
 97.36  except that payment rates for home health agency services shall 
 98.1   be the rates in effect on September 30, 1992; 
 98.2      (4) effective for services rendered on or after January 1, 
 98.3   2000, payment rates for physician and professional services 
 98.4   shall be increased by three percent over the rates in effect on 
 98.5   December 31, 1999, except for home health agency and family 
 98.6   planning agency services; and 
 98.7      (5) the increases in clause (4) shall be implemented 
 98.8   January 1, 2000, for managed care. 
 98.9      (b) Effective for services rendered on or after October 1, 
 98.10  1992, the commissioner shall make payments for dental services 
 98.11  as follows: 
 98.12     (1) dental services shall be paid at the lower of (i) 
 98.13  submitted charges, or (ii) 25 percent above the rate in effect 
 98.14  on June 30, 1992; 
 98.15     (2) dental rates shall be converted from the 50th 
 98.16  percentile of 1982 to the 50th percentile of 1989, less the 
 98.17  percent in aggregate necessary to equal the above increases; 
 98.18     (3) effective for services rendered on or after January 1, 
 98.19  2000, payment rates for dental services shall be increased by 
 98.20  three percent over the rates in effect on December 31, 1999; 
 98.21     (4) the commissioner shall award grants to community 
 98.22  clinics or other nonprofit community organizations, political 
 98.23  subdivisions, professional associations, or other organizations 
 98.24  that demonstrate the ability to provide dental services 
 98.25  effectively to public program recipients.  Grants may be used to 
 98.26  fund the costs related to coordinating access for recipients, 
 98.27  developing and implementing patient care criteria, upgrading or 
 98.28  establishing new facilities, acquiring furnishings or equipment, 
 98.29  recruiting new providers, or other development costs that will 
 98.30  improve access to dental care in a region.  In awarding grants, 
 98.31  the commissioner shall give priority to applicants that plan to 
 98.32  serve areas of the state in which the number of dental providers 
 98.33  is not currently sufficient to meet the needs of recipients of 
 98.34  public programs or uninsured individuals.  The commissioner 
 98.35  shall consider the following in awarding the grants: 
 98.36     (i) potential to successfully increase access to an 
 99.1   underserved population; 
 99.2      (ii) the ability to raise matching funds; 
 99.3      (iii) the long-term viability of the project to improve 
 99.4   access beyond the period of initial funding; 
 99.5      (iv) the efficiency in the use of the funding; and 
 99.6      (v) the experience of the proposers in providing services 
 99.7   to the target population. 
 99.8      The commissioner shall monitor the grants and may terminate 
 99.9   a grant if the grantee does not increase dental access for 
 99.10  public program recipients.  The commissioner shall consider 
 99.11  grants for the following: 
 99.12     (i) implementation of new programs or continued expansion 
 99.13  of current access programs that have demonstrated success in 
 99.14  providing dental services in underserved areas; 
 99.15     (ii) a pilot program for utilizing hygienists outside of a 
 99.16  traditional dental office to provide dental hygiene services; 
 99.17  and 
 99.18     (iii) a program that organizes a network of volunteer 
 99.19  dentists, establishes a system to refer eligible individuals to 
 99.20  volunteer dentists, and through that network provides donated 
 99.21  dental care services to public program recipients or uninsured 
 99.22  individuals; 
 99.23     (5) beginning October 1, 1999, the payment for tooth 
 99.24  sealants and fluoride treatments shall be the lower of (i) 
 99.25  submitted charge, or (ii) 80 percent of median 1997 charges; 
 99.26     (6) the increases listed in clauses (3) and (5) shall be 
 99.27  implemented January 1, 2000, for managed care; and 
 99.28     (7) effective for services provided on or after January 1, 
 99.29  2002, payment for diagnostic examinations and dental x-rays 
 99.30  provided to children under age 21 shall be the lower of (i) the 
 99.31  submitted charge, or (ii) 85 percent of median 1999 charges.  
 99.32     (c) Effective for dental services rendered on or after 
 99.33  January 1, 2002, the commissioner may, within the limits of 
 99.34  available appropriation, increase reimbursements to dentists and 
 99.35  dental clinics deemed by the commissioner to be critical access 
 99.36  dental providers.  Reimbursement to a critical access dental 
100.1   provider may be increased by not more than 50 percent above the 
100.2   reimbursement rate that would otherwise be paid to the 
100.3   provider.  Payments to health plan companies shall be adjusted 
100.4   to reflect increased reimbursements to critical access dental 
100.5   providers as approved by the commissioner.  In determining which 
100.6   dentists and dental clinics shall be deemed critical access 
100.7   dental providers, the commissioner shall review: 
100.8      (1) the utilization rate in the service area in which the 
100.9   dentist or dental clinic operates for dental services to 
100.10  patients covered by medical assistance, general assistance 
100.11  medical care, or MinnesotaCare as their primary source of 
100.12  coverage; 
100.13     (2) the level of services provided by the dentist or dental 
100.14  clinic to patients covered by medical assistance, general 
100.15  assistance medical care, or MinnesotaCare as their primary 
100.16  source of coverage; and 
100.17     (3) whether the level of services provided by the dentist 
100.18  or dental clinic is critical to maintaining adequate levels of 
100.19  patient access within the service area. 
100.20  In the absence of a critical access dental provider in a service 
100.21  area, the commissioner may designate a dentist or dental clinic 
100.22  as a critical access dental provider if the dentist or dental 
100.23  clinic is willing to provide care to patients covered by medical 
100.24  assistance, general assistance medical care, or MinnesotaCare at 
100.25  a level which significantly increases access to dental care in 
100.26  the service area. 
100.27     (d) Effective July 1, 2001, the medical assistance rates 
100.28  for outpatient mental health services provided by an entity that 
100.29  operates: 
100.30     (1) a Medicare-certified comprehensive outpatient 
100.31  rehabilitation facility; and 
100.32     (2) a facility that was certified prior to January 1, 1993, 
100.33  with at least 33 percent of the clients receiving rehabilitation 
100.34  services in the most recent calendar year are medical assistance 
100.35  recipients, will be increased by 38 percent, when those services 
100.36  are provided within the comprehensive outpatient rehabilitation 
101.1   facility and provided to residents of nursing facilities owned 
101.2   by the entity. 
101.3      (e) An entity that operates both a Medicare certified 
101.4   comprehensive outpatient rehabilitation facility and a facility 
101.5   which was certified prior to January 1, 1993, that is licensed 
101.6   under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
101.7   whom at least 33 percent of the clients receiving rehabilitation 
101.8   services in the most recent calendar year are medical assistance 
101.9   recipients, shall be reimbursed by the commissioner for 
101.10  rehabilitation services at rates that are 38 percent greater 
101.11  than the maximum reimbursement rate allowed under paragraph (a), 
101.12  clause (2), when those services are (1) provided within the 
101.13  comprehensive outpatient rehabilitation facility and (2) 
101.14  provided to residents of nursing facilities owned by the entity. 
101.15     Sec. 50.  [256B.84] [AMERICAN INDIAN CONTRACTING 
101.16  PROVISIONS.] 
101.17     Notwithstanding other state laws or rules, Indian health 
101.18  services and agencies operated by Indian tribes are not required 
101.19  to have a county contract or county certification to enroll as 
101.20  providers of family community support services under section 
101.21  256B.0625, subdivision 35; therapeutic support of foster care 
101.22  under section 256B.0625, subdivision 36; adult rehabilitative 
101.23  mental health services under section 256B.0623; and adult mental 
101.24  health crisis response services under section 256B.0624.  In 
101.25  order to enroll as providers of these services, Indian health 
101.26  services and agencies operated by Indian tribes must meet the 
101.27  vendor of medical care requirements in section 256B.02, 
101.28  subdivision 7. 
101.29     Sec. 51.  Minnesota Statutes 2001 Supplement, section 
101.30  626.556, subdivision 10i, is amended to read: 
101.31     Subd. 10i.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
101.32  DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 
101.33  SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 
101.34  provided under paragraph (e), an individual or facility that the 
101.35  commissioner of human services, a local social service agency, 
101.36  or the commissioner of children, families, and learning 
102.1   determines has maltreated a child, an interested person acting 
102.2   on behalf of the child, regardless of the determination, who 
102.3   contests the investigating agency's final determination 
102.4   regarding maltreatment, may request the investigating agency to 
102.5   reconsider its final determination regarding maltreatment.  The 
102.6   request for reconsideration must be submitted in writing to the 
102.7   investigating agency within 15 calendar days after receipt of 
102.8   notice of the final determination regarding maltreatment or, if 
102.9   the request is made by an interested person who is not entitled 
102.10  to notice, within 15 days after receipt of the notice by the 
102.11  parent or guardian of the child.  Effective January 1, 2002, an 
102.12  individual who was determined to have maltreated a child under 
102.13  this section and who was disqualified on the basis of serious or 
102.14  recurring maltreatment under section 245A.04, subdivision 3d, 
102.15  may request reconsideration of the maltreatment determination 
102.16  and the disqualification.  The request for reconsideration of 
102.17  the maltreatment determination and the disqualification must be 
102.18  submitted within 30 calendar days of the individual's receipt of 
102.19  the notice of disqualification under section 245A.04, 
102.20  subdivision 3a. 
102.21     (b) Except as provided under paragraphs (e) and (f), if the 
102.22  investigating agency denies the request or fails to act upon the 
102.23  request within 15 calendar days after receiving the request for 
102.24  reconsideration, the person or facility entitled to a fair 
102.25  hearing under section 256.045 may submit to the commissioner of 
102.26  human services or the commissioner of children, families, and 
102.27  learning a written request for a hearing under that section.  
102.28  Section 256.045 also governs hearings requested to contest a 
102.29  final determination of the commissioner of children, families, 
102.30  and learning.  For reports involving maltreatment of a child in 
102.31  a facility, an interested person acting on behalf of the child 
102.32  may request a review by the child maltreatment review panel 
102.33  under section 256.022 if the investigating agency denies the 
102.34  request or fails to act upon the request or if the interested 
102.35  person contests a reconsidered determination.  The investigating 
102.36  agency shall notify persons who request reconsideration of their 
103.1   rights under this paragraph.  The request must be submitted in 
103.2   writing to the review panel and a copy sent to the investigating 
103.3   agency within 30 calendar days of receipt of notice of a denial 
103.4   of a request for reconsideration or of a reconsidered 
103.5   determination.  The request must specifically identify the 
103.6   aspects of the agency determination with which the person is 
103.7   dissatisfied. 
103.8      (c) If, as a result of a reconsideration or review, the 
103.9   investigating agency changes the final determination of 
103.10  maltreatment, that agency shall notify the parties specified in 
103.11  subdivisions 10b, 10d, and 10f. 
103.12     (d) Except as provided under paragraph (f), if an 
103.13  individual or facility contests the investigating agency's final 
103.14  determination regarding maltreatment by requesting a fair 
103.15  hearing under section 256.045, the commissioner of human 
103.16  services shall assure that the hearing is conducted and a 
103.17  decision is reached within 90 days of receipt of the request for 
103.18  a hearing.  The time for action on the decision may be extended 
103.19  for as many days as the hearing is postponed or the record is 
103.20  held open for the benefit of either party. 
103.21     (e) Effective January 1, 2002, if an individual was 
103.22  disqualified under section 245A.04, subdivision 3d, on the basis 
103.23  of a determination of maltreatment, which was serious or 
103.24  recurring, and the individual has requested reconsideration of 
103.25  the maltreatment determination under paragraph (a) and requested 
103.26  reconsideration of the disqualification under section 245A.04, 
103.27  subdivision 3b, reconsideration of the maltreatment 
103.28  determination and reconsideration of the disqualification shall 
103.29  be consolidated into a single reconsideration.  If 
103.30  reconsideration of the maltreatment determination is denied or 
103.31  if the disqualification is not set aside or rescinded under 
103.32  section 245A.04, subdivision 3b, the individual may request a 
103.33  fair hearing under section 256.045.  If an individual 
103.34  disqualified on the basis of a determination of maltreatment, 
103.35  which was serious or recurring requests a fair hearing under 
103.36  paragraph (b) on the maltreatment and the disqualification, the 
104.1   scope of the fair hearing shall include both the maltreatment 
104.2   determination and the disqualification. 
104.3      (f) Effective January 1, 2002, if a maltreatment 
104.4   determination or a disqualification based on serious or 
104.5   recurring maltreatment is the basis for a denial of a license 
104.6   under section 245A.05 or a licensing sanction under section 
104.7   245A.07, the license holder has the right to a contested case 
104.8   hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 
104.9   1400.8612 and successor rules.  As provided for under section 
104.10  245A.08, subdivision 2a, the scope of the contested case hearing 
104.11  shall include the maltreatment determination, disqualification, 
104.12  and licensing sanction or denial of a license.  In such cases, a 
104.13  fair hearing regarding the maltreatment determination shall not 
104.14  be conducted under paragraph (b).  If the disqualified subject 
104.15  is an individual other than the license holder and upon whom a 
104.16  background study must be conducted under section 245A.04, 
104.17  subdivision 3, the hearings of all parties may be consolidated 
104.18  into a single contested case hearing upon consent of all parties 
104.19  and the administrative law judge. 
104.20     (g) For purposes of this subdivision, "interested person 
104.21  acting on behalf of the child" means a parent or legal guardian; 
104.22  stepparent; grandparent; guardian ad litem; adult stepbrother, 
104.23  stepsister, or sibling; or adult aunt or uncle; unless the 
104.24  person has been determined to be the perpetrator of the 
104.25  maltreatment. 
104.26     Sec. 52.  Minnesota Statutes 2000, section 626.557, 
104.27  subdivision 3a, is amended to read: 
104.28     Subd. 3a.  [REPORT NOT REQUIRED.] The following events are 
104.29  not required to be reported under this section:  
104.30     (a) A circumstance where federal law specifically prohibits 
104.31  a person from disclosing patient identifying information in 
104.32  connection with a report of suspected maltreatment, unless the 
104.33  vulnerable adult, or the vulnerable adult's guardian, 
104.34  conservator, or legal representative, has consented to 
104.35  disclosure in a manner which conforms to federal requirements.  
104.36  Facilities whose patients or residents are covered by such a 
105.1   federal law shall seek consent to the disclosure of suspected 
105.2   maltreatment from each patient or resident, or a guardian, 
105.3   conservator, or legal representative, upon the patient's or 
105.4   resident's admission to the facility.  Persons who are 
105.5   prohibited by federal law from reporting an incident of 
105.6   suspected maltreatment shall immediately seek consent to make a 
105.7   report.  
105.8      (b) Verbal or physical aggression occurring between 
105.9   patients, residents, or clients of a facility, or self-abusive 
105.10  behavior by these persons does not constitute abuse unless the 
105.11  behavior causes serious harm.  The operator of the facility or a 
105.12  designee shall record incidents of aggression and self-abusive 
105.13  behavior to facilitate review by licensing agencies and county 
105.14  and local welfare agencies. 
105.15     (c) Accidents as defined in section 626.5572, subdivision 3.
105.16     (d) Events occurring in a facility that result from an 
105.17  individual's single mistake error in the provision of 
105.18  therapeutic conduct to a vulnerable adult, as defined provided 
105.19  in section 626.5572, subdivision 17, paragraph (c), clause (4). 
105.20     (e) Nothing in this section shall be construed to require a 
105.21  report of financial exploitation, as defined in section 
105.22  626.5572, subdivision 9, solely on the basis of the transfer of 
105.23  money or property by gift or as compensation for services 
105.24  rendered. 
105.25     Sec. 53.  Minnesota Statutes 2001 Supplement, section 
105.26  626.557, subdivision 9d, is amended to read: 
105.27     Subd. 9d.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
105.28  DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 
105.29  SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 
105.30  provided under paragraph (e), any individual or facility which a 
105.31  lead agency determines has maltreated a vulnerable adult, or the 
105.32  vulnerable adult or an interested person acting on behalf of the 
105.33  vulnerable adult, regardless of the lead agency's determination, 
105.34  who contests the lead agency's final disposition of an 
105.35  allegation of maltreatment, may request the lead agency to 
105.36  reconsider its final disposition.  The request for 
106.1   reconsideration must be submitted in writing to the lead agency 
106.2   within 15 calendar days after receipt of notice of final 
106.3   disposition or, if the request is made by an interested person 
106.4   who is not entitled to notice, within 15 days after receipt of 
106.5   the notice by the vulnerable adult or the vulnerable adult's 
106.6   legal guardian.  An individual who was determined to have 
106.7   maltreated a vulnerable adult under this section and who was 
106.8   disqualified on the basis of serious or recurring maltreatment 
106.9   under section 245A.04, subdivision 3d, may request 
106.10  reconsideration of the maltreatment determination and the 
106.11  disqualification.  The request for reconsideration of the 
106.12  maltreatment determination and the disqualification must be 
106.13  submitted within 30 calendar days of the individual's receipt of 
106.14  the notice of disqualification under section 245A.04, 
106.15  subdivision 3a. 
106.16     (b) Except as provided under paragraphs (e) and (f), if the 
106.17  lead agency denies the request or fails to act upon the request 
106.18  within 15 calendar days after receiving the request for 
106.19  reconsideration, the person or facility entitled to a fair 
106.20  hearing under section 256.045, may submit to the commissioner of 
106.21  human services a written request for a hearing under that 
106.22  statute.  The vulnerable adult, or an interested person acting 
106.23  on behalf of the vulnerable adult, may request a review by the 
106.24  vulnerable adult maltreatment review panel under section 256.021 
106.25  if the lead agency denies the request or fails to act upon the 
106.26  request, or if the vulnerable adult or interested person 
106.27  contests a reconsidered disposition.  The lead agency shall 
106.28  notify persons who request reconsideration of their rights under 
106.29  this paragraph.  The request must be submitted in writing to the 
106.30  review panel and a copy sent to the lead agency within 30 
106.31  calendar days of receipt of notice of a denial of a request for 
106.32  reconsideration or of a reconsidered disposition.  The request 
106.33  must specifically identify the aspects of the agency 
106.34  determination with which the person is dissatisfied.  
106.35     (c) If, as a result of a reconsideration or review, the 
106.36  lead agency changes the final disposition, it shall notify the 
107.1   parties specified in subdivision 9c, paragraph (d). 
107.2      (d) For purposes of this subdivision, "interested person 
107.3   acting on behalf of the vulnerable adult" means a person 
107.4   designated in writing by the vulnerable adult to act on behalf 
107.5   of the vulnerable adult, or a legal guardian or conservator or 
107.6   other legal representative, a proxy or health care agent 
107.7   appointed under chapter 145B or 145C, or an individual who is 
107.8   related to the vulnerable adult, as defined in section 245A.02, 
107.9   subdivision 13. 
107.10     (e) If an individual was disqualified under section 
107.11  245A.04, subdivision 3d, on the basis of a determination of 
107.12  maltreatment, which was serious or recurring, and the individual 
107.13  has requested reconsideration of the maltreatment determination 
107.14  under paragraph (a) and reconsideration of the disqualification 
107.15  under section 245A.04, subdivision 3b, reconsideration of the 
107.16  maltreatment determination and requested reconsideration of the 
107.17  disqualification shall be consolidated into a single 
107.18  reconsideration.  If reconsideration of the maltreatment 
107.19  determination is denied or if the disqualification is not set 
107.20  aside or rescinded under section 245A.04, subdivision 3b, the 
107.21  individual may request a fair hearing under section 256.045.  If 
107.22  an individual who was disqualified on the basis of serious or 
107.23  recurring maltreatment requests a fair hearing under paragraph 
107.24  (b) on the maltreatment and the disqualification, the scope of 
107.25  the fair hearing shall include both the maltreatment 
107.26  determination and the disqualification. 
107.27     (f) If a maltreatment determination or a disqualification 
107.28  based on serious or recurring maltreatment is the basis for a 
107.29  denial of a license under section 245A.05 or a licensing 
107.30  sanction under section 245A.07, the license holder has the right 
107.31  to a contested case hearing under chapter 14 and Minnesota 
107.32  Rules, parts 1400.8510 to 1400.8612 and successor rules.  As 
107.33  provided for under section 245A.08, the scope of the contested 
107.34  case hearing shall include the maltreatment determination, 
107.35  disqualification, and licensing sanction or denial of a 
107.36  license.  In such cases, a fair hearing shall not be conducted 
108.1   under paragraph (b).  If the disqualified subject is an 
108.2   individual other than the license holder and upon whom a 
108.3   background study must be conducted under section 245A.04, 
108.4   subdivision 3, the hearings of all parties may be consolidated 
108.5   into a single contested case hearing upon consent of all parties 
108.6   and the administrative law judge. 
108.7      (g) Until August 1, 2002, an individual or facility that 
108.8   was determined by the commissioner of human services or the 
108.9   commissioner of health to be responsible for neglect under 
108.10  section 626.5572, subdivision 17, after October 1, 1995, and 
108.11  before August 1, 2001, that believes that the finding of neglect 
108.12  does not meet an amended definition of neglect may request a 
108.13  reconsideration of the determination of neglect.  The 
108.14  commissioner of human services or the commissioner of health 
108.15  shall mail a notice to the last known address of individuals who 
108.16  are eligible to seek this reconsideration.  The request for 
108.17  reconsideration must state how the established findings no 
108.18  longer meet the elements of the definition of neglect.  The 
108.19  commissioner shall review the request for reconsideration and 
108.20  make a determination within 15 calendar days.  The 
108.21  commissioner's decision on this reconsideration is the final 
108.22  agency action. 
108.23     (1) For purposes of compliance with the data destruction 
108.24  schedule under subdivision 12b, paragraph (d), when a finding of 
108.25  substantiated maltreatment has been changed as a result of a 
108.26  reconsideration under this paragraph, the date of the original 
108.27  finding of a substantiated maltreatment must be used to 
108.28  calculate the destruction date. 
108.29     (2) For purposes of any background studies under section 
108.30  245A.04, when a determination of substantiated maltreatment has 
108.31  been changed as a result of a reconsideration under this 
108.32  paragraph, any prior disqualification of the individual under 
108.33  section 245A.04 that was based on this determination of 
108.34  maltreatment shall be rescinded, and for future background 
108.35  studies under section 245A.04 the commissioner must not use the 
108.36  previous determination of substantiated maltreatment as a basis 
109.1   for disqualification or as a basis for referring the 
109.2   individual's maltreatment history to a health-related licensing 
109.3   board under section 245A.04, subdivision 3d, paragraph (b). 
109.4      Sec. 54.  [PILOT PROGRAM FOR DEAF-BLIND SERVICES.] 
109.5      (a) The commissioners of human services; children, 
109.6   families, and learning; and state services for the blind shall 
109.7   meet with deaf-blind citizens, parents of deaf-blind children, 
109.8   and the Minnesota commission serving deaf and hard-of-hearing 
109.9   individuals to determine which agency can most efficiently and 
109.10  effectively develop and administer a pilot program for 
109.11  consumer-directed services to provide needed services to 
109.12  deaf-blind adults, children, and families. 
109.13     (b) The planning for this pilot program must proceed using 
109.14  current appropriations.  The agency that develops the pilot 
109.15  program described in paragraph (a) shall provide a report to the 
109.16  senate and house of representatives policy and fiscal committees 
109.17  having jurisdiction over human services issues by January 1, 
109.18  2003, that addresses future funding for the program.  The report 
109.19  shall include the program proposal, recommendations, and a 
109.20  fiscal note. 
109.21     Sec. 55.  [SERVICES FOR DEAF-BLIND PERSONS.] 
109.22     (a) Effective for fiscal years beginning on or after July 
109.23  1, 2003, the commissioner of human services shall combine the 
109.24  existing $1,000,000 biennial base level funding for deaf-blind 
109.25  services into a single grant program.  Within the limits of the 
109.26  appropriation for this purpose, each biennium at least $350,000 
109.27  shall be awarded for services to deaf-blind children and their 
109.28  families and at least $250,000 shall be awarded for services to 
109.29  deaf-blind adults. 
109.30     (b) The commissioner may make grants: 
109.31     (1) for services provided by organizations; and 
109.32     (2) to develop and administer consumer-directed services. 
109.33     (c) Any entity that is able to satisfy the grant criteria 
109.34  is eligible to receive a grant under paragraph (a). 
109.35     (d) Deaf-blind service providers are not required to, but 
109.36  may, provide intervenor services as part of the service package 
110.1   provided with grant funds under this section. 
110.2      Sec. 56.  [FEASIBILITY ASSESSMENT OF MEDICAL ASSISTANCE 
110.3   EXPANSION TO COVER DEAF-BLIND SERVICES.] 
110.4      (a) The commissioner of human services shall study and 
110.5   report to the legislature by January 15, 2003, with a 
110.6   feasibility assessment of the costs and policy implications, 
110.7   including the necessity of federal waivers, to expand benefits 
110.8   covered under medical assistance and under medical assistance 
110.9   waiver programs to include the following services for deaf-blind 
110.10  persons: 
110.11     (1) sign language interpreters; 
110.12     (2) intervenors; 
110.13     (3) support service persons; 
110.14     (4) orientation and mobility services; and 
110.15     (5) rehabilitation teaching services. 
110.16     (b) Notwithstanding Laws 2001, First Special Session 
110.17  chapter 9, article 17, section 10, subdivision 3, the 
110.18  commissioner may transfer $20,000 of deaf and hard-of-hearing 
110.19  grants to operations for purposes of paragraph (a).  The study 
110.20  and report under paragraph (a) is exempt from the consulting 
110.21  contract moratorium in Laws 2002, chapter 220, article 10, 
110.22  section 37. 
110.23     Sec. 57.  [PRIOR AUTHORIZATION REPORT.] 
110.24     The commissioner of human services shall review prior 
110.25  authorization of prescription drugs in the fee-for-service 
110.26  medical assistance program in terms of the cost effectiveness 
110.27  achieved through prior authorization on prescription drug costs 
110.28  and on other medical assistance costs and evaluate the effect 
110.29  that placing a drug on prior authorization has had on the 
110.30  quality of patient care.  The commissioner shall submit the 
110.31  results to the chairs and ranking minority members of the senate 
110.32  and house of representatives committees having jurisdiction over 
110.33  human services funding by January 15, 2004. 
110.34     Sec. 58.  [APPROPRIATION.] 
110.35     $50,000 is appropriated from the state government special 
110.36  revenue fund to the administrative services unit to pay for 
111.1   legal costs incurred by the attorney general in defending 
111.2   against any civil action brought against a health care provider 
111.3   relating to the provider's participation in the volunteer health 
111.4   care provider program under Minnesota Statutes, section 214.40.  
111.5   This appropriation is available until expended.  If any of this 
111.6   appropriation is expended for this purpose, the health licensing 
111.7   board with regulatory authority over the provider who was the 
111.8   subject of the claim or suit may adjust the fees the board is 
111.9   empowered to assess.  Any fee adjustment must be an amount 
111.10  sufficient to compensate the fund for the amount paid out.  The 
111.11  board of medical practice may compensate the fund for the amount 
111.12  paid out by using money provided for in the board's partner 
111.13  agency agreement with the attorney general.  The executive 
111.14  director of the health-related licensing board that administers 
111.15  the administrative services unit shall be considered the client 
111.16  for purposes of defending against any civil action brought 
111.17  against the provider relating to the provider's participation in 
111.18  the volunteer health care provider program under Minnesota 
111.19  Statutes, section 214.40.  No health-related licensing board 
111.20  shall be liable for payment of any awards or settlements 
111.21  resulting from any such civil actions. 
111.22     Sec. 59.  [REPEALER.] 
111.23     Minnesota Statutes 2000, section 147B.01, subdivisions 8 
111.24  and 15; and Minnesota Statutes 2001 Supplement, section 
111.25  256B.0621, subdivision 1, are repealed. 
111.26                             ARTICLE 2
111.27                   HUMAN SERVICES AND CORRECTIONS
111.28     Section 1.  Minnesota Statutes 2001 Supplement, section 
111.29  144.122, is amended to read: 
111.30     144.122 [LICENSE, PERMIT, AND SURVEY FEES.] 
111.31     (a) The state commissioner of health, by rule, may 
111.32  prescribe reasonable procedures and fees for filing with the 
111.33  commissioner as prescribed by statute and for the issuance of 
111.34  original and renewal permits, licenses, registrations, and 
111.35  certifications issued under authority of the commissioner.  The 
111.36  expiration dates of the various licenses, permits, 
112.1   registrations, and certifications as prescribed by the rules 
112.2   shall be plainly marked thereon.  Fees may include application 
112.3   and examination fees and a penalty fee for renewal applications 
112.4   submitted after the expiration date of the previously issued 
112.5   permit, license, registration, and certification.  The 
112.6   commissioner may also prescribe, by rule, reduced fees for 
112.7   permits, licenses, registrations, and certifications when the 
112.8   application therefor is submitted during the last three months 
112.9   of the permit, license, registration, or certification period.  
112.10  Fees proposed to be prescribed in the rules shall be first 
112.11  approved by the department of finance.  All fees proposed to be 
112.12  prescribed in rules shall be reasonable.  The fees shall be in 
112.13  an amount so that the total fees collected by the commissioner 
112.14  will, where practical, approximate the cost to the commissioner 
112.15  in administering the program.  All fees collected shall be 
112.16  deposited in the state treasury and credited to the state 
112.17  government special revenue fund unless otherwise specifically 
112.18  appropriated by law for specific purposes. 
112.19     (b) The commissioner shall adopt reasonable rules 
112.20  establishing criteria and procedures for refusal to grant or 
112.21  renew licenses and registrations, and for suspension and 
112.22  revocation of licenses and registrations. 
112.23     (c) The commissioner may refuse to grant or renew licenses 
112.24  and registrations, or suspend or revoke licenses and 
112.25  registrations, in accordance with the commissioner's criteria 
112.26  and procedures as adopted by rule. 
112.27     (d) The commissioner may charge a fee for voluntary 
112.28  certification of medical laboratories and environmental 
112.29  laboratories, and for environmental and medical laboratory 
112.30  services provided by the department, without complying with 
112.31  paragraph (a) or chapter 14.  Fees charged for environment and 
112.32  medical laboratory services provided by the department must be 
112.33  approximately equal to the costs of providing the services.  
112.34     (c) (e) The commissioner may develop a schedule of fees for 
112.35  diagnostic evaluations conducted at clinics held by the services 
112.36  for children with handicaps program.  All receipts generated by 
113.1   the program are annually appropriated to the commissioner for 
113.2   use in the maternal and child health program. 
113.3      (d) (f) The commissioner shall set license fees for 
113.4   hospitals and nursing homes that are not boarding care homes at 
113.5   the following levels: 
113.6   Joint Commission on Accreditation of Healthcare 
113.7   Organizations (JCAHO hospitals)  $7,055
113.8   Non-JCAHO hospitals              $4,680 plus $234 per bed
113.9   Nursing home                     $183 plus $91 per bed
113.10     The commissioner shall set license fees for outpatient 
113.11  surgical centers, boarding care homes, and supervised living 
113.12  facilities at the following levels: 
113.13  Outpatient surgical centers      $1,512
113.14  Boarding care homes              $183 plus $91 per bed
113.15  Supervised living facilities     $183 plus $91 per bed.
113.16     (e) (g) Unless prohibited by federal law, the commissioner 
113.17  of health shall charge applicants the following fees to cover 
113.18  the cost of any initial certification surveys required to 
113.19  determine a provider's eligibility to participate in the 
113.20  Medicare or Medicaid program: 
113.21  Prospective payment surveys for          $  900
113.22  hospitals
113.24  Swing bed surveys for nursing homes      $1,200
113.26  Psychiatric hospitals                    $1,400
113.28  Rural health facilities                  $1,100
113.30  Portable X-ray providers                 $  500
113.32  Home health agencies                     $1,800
113.34  Outpatient therapy agencies              $  800
113.36  End stage renal dialysis providers       $2,100
113.38  Independent therapists                   $  800
113.40  Comprehensive rehabilitation             $1,200
113.41  outpatient facilities
113.43  Hospice providers                        $1,700
113.45  Ambulatory surgical providers            $1,800
113.47  Hospitals                                $4,200
113.49  Other provider categories or             Actual surveyor costs:
113.50  additional resurveys required            average surveyor cost x
113.51  to complete initial certification        number of hours for the
114.1                                            survey process.
114.2      These fees shall be submitted at the time of the 
114.3   application for federal certification and shall not be 
114.4   refunded.  All fees collected after the date that the imposition 
114.5   of fees is not prohibited by federal law shall be deposited in 
114.6   the state treasury and credited to the state government special 
114.7   revenue fund. 
114.8      (h) The commissioner shall charge the following fees for 
114.9   examinations, registrations, licenses, plan reviews, and 
114.10  inspections: 
114.11  Plumbing examination                         $ 50
114.12  Water conditioning examination               $ 50
114.13  Plumbing bond registration fee               $ 40
114.14  Water conditioning bond registration fee     $ 40
114.15  Master plumber's license                     $120
114.16  Restricted plumbing contractor license       $ 90
114.17  Journeyman plumber's license                 $ 55
114.18  Apprentice registration                      $ 25
114.19  Water conditioning contractor license        $ 70
114.20  Water conditioning installer license         $ 35
114.21  Residential inspection fee (each visit)      $ 50
114.22  Public, commercial, and    Plan review fee   Inspection fee
114.23  industrial inspections
114.24     25 or fewer drainage
114.25     fixture units              $ 50              $  300
114.26     26 to 50 drainage
114.27     fixture units              $150              $  900
114.28     51 to 150 drainage
114.29     fixture units              $200              $1,200
114.30     151 to 249 drainage
114.31     fixture units              $250              $1,500
114.32     250 or more drainage
114.33     fixture units              $300              $1,800
114.34     Callback fee (each visit)                    $  100
114.35     Plumbing installations that require only fixture 
114.36  installation or replacement require a minimum of one 
114.37  inspection.  Residence remodeling involving plumbing 
114.38  installations requires a minimum of two inspections.  New 
114.39  residential plumbing installations require a minimum of three 
115.1   inspections.  For purposes of this paragraph, residences of more 
115.2   than four units are considered commercial.  
115.3      [EFFECTIVE DATE.] This section is effective July 1, 2003. 
115.4      Sec. 2.  Minnesota Statutes 2001 Supplement, section 
115.5   144.148, subdivision 2, is amended to read: 
115.6      Subd. 2.  [PROGRAM.] (a) The commissioner of health shall 
115.7   award rural hospital capital improvement grants to eligible 
115.8   rural hospitals.  Except as provided in paragraph (b), a grant 
115.9   shall not exceed $500,000 per hospital.  Prior to the receipt of 
115.10  any grant, the hospital must certify to the commissioner that at 
115.11  least one-quarter of the grant amount, which may include in-kind 
115.12  services, is available for the same purposes from nonstate 
115.13  resources.  Notwithstanding any law to the contrary, funds 
115.14  awarded to grantees in a grant agreement do not lapse until 
115.15  expended by the grantee.  
115.16     (b) A grant shall not exceed $1,500,000 per eligible rural 
115.17  hospital that also satisfies the following criteria: 
115.18     (1) is the only hospital in a county; 
115.19     (2) has 25 or fewer licensed hospital beds with a net 
115.20  hospital operating margin not greater than an average of two 
115.21  percent over the three fiscal years prior to application; 
115.22     (3) is located in a medically underserved community (MUC) 
115.23  or a health professional shortage area (HPSA); 
115.24     (4) is located near a migrant worker employment site and 
115.25  regularly treats significant numbers of migrant workers and 
115.26  their families; and 
115.27     (5) has not previously received a grant under this section 
115.28  prior to July 1, 1999. 
115.29     Sec. 3.  Minnesota Statutes 2000, section 241.44, is 
115.30  amended by adding a subdivision to read: 
115.31     Subd. 5.  [GRANTS.] The ombudsman may apply for and receive 
115.32  grants from public and private entities for purposes of carrying 
115.33  out the ombudsman's powers and duties under sections 241.41 to 
115.34  241.45.  
115.35     Sec. 4.  Minnesota Statutes 2000, section 245.462, 
115.36  subdivision 4, is amended to read: 
116.1      Subd. 4.  [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 
116.2   management service provider" means a case manager or case 
116.3   manager associate employed by the county or other entity 
116.4   authorized by the county board to provide case management 
116.5   services specified in section 245.4711.  
116.6      (b) A case manager must: 
116.7      (1) be skilled in the process of identifying and assessing 
116.8   a wide range of client needs; 
116.9      (2) be knowledgeable about local community resources and 
116.10  how to use those resources for the benefit of the client; 
116.11     (3) have a bachelor's degree in one of the behavioral 
116.12  sciences or related fields including, but not limited to, social 
116.13  work, psychology, or nursing from an accredited college or 
116.14  university or meet the requirements of paragraph (c); and 
116.15     (4) meet the supervision and continuing education 
116.16  requirements described in paragraphs (d), (e), and (f), as 
116.17  applicable.  
116.18     (c) Case managers without a bachelor's degree must meet one 
116.19  of the requirements in clauses (1) to (3):  
116.20     (1) have three or four years of experience as a case 
116.21  manager associate as defined in this section; 
116.22     (2) be a registered nurse without a bachelor's degree and 
116.23  have a combination of specialized training in psychiatry and 
116.24  work experience consisting of community interaction and 
116.25  involvement or community discharge planning in a mental health 
116.26  setting totaling three years; or 
116.27     (3) be a person who qualified as a case manager under the 
116.28  1998 department of human service waiver provision and meet the 
116.29  continuing education and mentoring requirements in this section. 
116.30     (d) A case manager with at least 2,000 hours of supervised 
116.31  experience in the delivery of services to adults with mental 
116.32  illness must receive regular ongoing supervision and clinical 
116.33  supervision totaling 38 hours per year of which at least one 
116.34  hour per month must be clinical supervision regarding individual 
116.35  service delivery with a case management supervisor.  The 
116.36  remaining 26 hours of supervision may be provided by a case 
117.1   manager with two years of experience.  Group supervision may not 
117.2   constitute more than one-half of the required supervision 
117.3   hours.  Clinical supervision must be documented in the client 
117.4   record. 
117.5      (e) A case manager without 2,000 hours of supervised 
117.6   experience in the delivery of services to adults with mental 
117.7   illness must: 
117.8      (1) receive clinical supervision regarding individual 
117.9   service delivery from a mental health professional at least one 
117.10  hour per week until the requirement of 2,000 hours of experience 
117.11  is met; and 
117.12     (2) complete 40 hours of training approved by the 
117.13  commissioner in case management skills and the characteristics 
117.14  and needs of adults with serious and persistent mental illness.  
117.15     (f) A case manager who is not licensed, registered, or 
117.16  certified by a health-related licensing board must receive 30 
117.17  hours of continuing education and training in mental illness and 
117.18  mental health services annually every two years. 
117.19     (g) A case manager associate (CMA) must: 
117.20     (1) work under the direction of a case manager or case 
117.21  management supervisor; 
117.22     (2) be at least 21 years of age; 
117.23     (3) have at least a high school diploma or its equivalent; 
117.24  and 
117.25     (4) meet one of the following criteria: 
117.26     (i) have an associate of arts degree in one of the 
117.27  behavioral sciences or human services; 
117.28     (ii) be a registered nurse without a bachelor's degree; 
117.29     (iii) within the previous ten years, have three years of 
117.30  life experience with serious and persistent mental illness as 
117.31  defined in section 245.462, subdivision 20; or as a child had 
117.32  severe emotional disturbance as defined in section 245.4871, 
117.33  subdivision 6; or have three years life experience as a primary 
117.34  caregiver to an adult with serious and persistent mental illness 
117.35  within the previous ten years; 
117.36     (iv) have 6,000 hours work experience as a nondegreed state 
118.1   hospital technician; or 
118.2      (v) be a mental health practitioner as defined in section 
118.3   245.462, subdivision 17, clause (2). 
118.4      Individuals meeting one of the criteria in items (i) to 
118.5   (iv), may qualify as a case manager after four years of 
118.6   supervised work experience as a case manager associate.  
118.7   Individuals meeting the criteria in item (v), may qualify as a 
118.8   case manager after three years of supervised experience as a 
118.9   case manager associate. 
118.10     (h) A case management associate must meet the following 
118.11  supervision, mentoring, and continuing education requirements:  
118.12     (1) have 40 hours of preservice training described under 
118.13  paragraph (e), clause (2); 
118.14     (2) receive at least 40 hours of continuing education in 
118.15  mental illness and mental health services annually; and 
118.16     (3) receive at least five hours of mentoring per week from 
118.17  a case management mentor.  
118.18  A "case management mentor" means a qualified, practicing case 
118.19  manager or case management supervisor who teaches or advises and 
118.20  provides intensive training and clinical supervision to one or 
118.21  more case manager associates.  Mentoring may occur while 
118.22  providing direct services to consumers in the office or in the 
118.23  field and may be provided to individuals or groups of case 
118.24  manager associates.  At least two mentoring hours per week must 
118.25  be individual and face-to-face. 
118.26     (i) A case management supervisor must meet the criteria for 
118.27  mental health professionals, as specified in section 245.462, 
118.28  subdivision 18. 
118.29     (j) An immigrant who does not have the qualifications 
118.30  specified in this subdivision may provide case management 
118.31  services to adult immigrants with serious and persistent mental 
118.32  illness who are members of the same ethnic group as the case 
118.33  manager if the person:  
118.34     (1) is currently enrolled in and is actively pursuing 
118.35  credits toward the completion of a bachelor's degree in one of 
118.36  the behavioral sciences or a related field including, but not 
119.1   limited to, social work, psychology, or nursing from an 
119.2   accredited college or university; 
119.3      (2) completes 40 hours of training as specified in this 
119.4   subdivision; and 
119.5      (3) receives clinical supervision at least once a week 
119.6   until the requirements of this subdivision are met. 
119.7      Sec. 5.  Minnesota Statutes 2000, section 245.4871, 
119.8   subdivision 4, is amended to read: 
119.9      Subd. 4.  [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 
119.10  management service provider" means a case manager or case 
119.11  manager associate employed by the county or other entity 
119.12  authorized by the county board to provide case management 
119.13  services specified in subdivision 3 for the child with severe 
119.14  emotional disturbance and the child's family.  
119.15     (b) A case manager must: 
119.16     (1) have experience and training in working with children; 
119.17     (2) have at least a bachelor's degree in one of the 
119.18  behavioral sciences or a related field including, but not 
119.19  limited to, social work, psychology, or nursing from an 
119.20  accredited college or university or meet the requirements of 
119.21  paragraph (d); 
119.22     (3) have experience and training in identifying and 
119.23  assessing a wide range of children's needs; 
119.24     (4) be knowledgeable about local community resources and 
119.25  how to use those resources for the benefit of children and their 
119.26  families; and 
119.27     (5) meet the supervision and continuing education 
119.28  requirements of paragraphs (e), (f), and (g), as applicable. 
119.29     (c) A case manager may be a member of any professional 
119.30  discipline that is part of the local system of care for children 
119.31  established by the county board. 
119.32     (d) A case manager without a bachelor's degree must meet 
119.33  one of the requirements in clauses (1) to (3):  
119.34     (1) have three or four years of experience as a case 
119.35  manager associate; 
119.36     (2) be a registered nurse without a bachelor's degree who 
120.1   has a combination of specialized training in psychiatry and work 
120.2   experience consisting of community interaction and involvement 
120.3   or community discharge planning in a mental health setting 
120.4   totaling three years; or 
120.5      (3) be a person who qualified as a case manager under the 
120.6   1998 department of human services waiver provision and meets the 
120.7   continuing education, supervision, and mentoring requirements in 
120.8   this section. 
120.9      (e) A case manager with at least 2,000 hours of supervised 
120.10  experience in the delivery of mental health services to children 
120.11  must receive regular ongoing supervision and clinical 
120.12  supervision totaling 38 hours per year, of which at least one 
120.13  hour per month must be clinical supervision regarding individual 
120.14  service delivery with a case management supervisor.  The other 
120.15  26 hours of supervision may be provided by a case manager with 
120.16  two years of experience.  Group supervision may not constitute 
120.17  more than one-half of the required supervision hours. 
120.18     (f) A case manager without 2,000 hours of supervised 
120.19  experience in the delivery of mental health services to children 
120.20  with emotional disturbance must: 
120.21     (1) begin 40 hours of training approved by the commissioner 
120.22  of human services in case management skills and in the 
120.23  characteristics and needs of children with severe emotional 
120.24  disturbance before beginning to provide case management 
120.25  services; and 
120.26     (2) receive clinical supervision regarding individual 
120.27  service delivery from a mental health professional at least one 
120.28  hour each week until the requirement of 2,000 hours of 
120.29  experience is met. 
120.30     (g) A case manager who is not licensed, registered, or 
120.31  certified by a health-related licensing board must receive 30 
120.32  hours of continuing education and training in severe emotional 
120.33  disturbance and mental health services annually every two years. 
120.34     (h) Clinical supervision must be documented in the child's 
120.35  record.  When the case manager is not a mental health 
120.36  professional, the county board must provide or contract for 
121.1   needed clinical supervision. 
121.2      (i) The county board must ensure that the case manager has 
121.3   the freedom to access and coordinate the services within the 
121.4   local system of care that are needed by the child. 
121.5      (j) A case manager associate (CMA) must: 
121.6      (1) work under the direction of a case manager or case 
121.7   management supervisor; 
121.8      (2) be at least 21 years of age; 
121.9      (3) have at least a high school diploma or its equivalent; 
121.10  and 
121.11     (4) meet one of the following criteria: 
121.12     (i) have an associate of arts degree in one of the 
121.13  behavioral sciences or human services; 
121.14     (ii) be a registered nurse without a bachelor's degree; 
121.15     (iii) have three years of life experience as a primary 
121.16  caregiver to a child with serious emotional disturbance as 
121.17  defined in section 245.4871, subdivision 6, within the previous 
121.18  ten years; 
121.19     (iv) have 6,000 hours work experience as a nondegreed state 
121.20  hospital technician; or 
121.21     (v) be a mental health practitioner as defined in 
121.22  subdivision 26, clause (2). 
121.23     Individuals meeting one of the criteria in items (i) to 
121.24  (iv) may qualify as a case manager after four years of 
121.25  supervised work experience as a case manager associate.  
121.26  Individuals meeting the criteria in item (v) may qualify as a 
121.27  case manager after three years of supervised experience as a 
121.28  case manager associate. 
121.29     (k) Case manager associates must meet the following 
121.30  supervision, mentoring, and continuing education requirements; 
121.31     (1) have 40 hours of preservice training described under 
121.32  paragraph (f), clause (1); 
121.33     (2) receive at least 40 hours of continuing education in 
121.34  severe emotional disturbance and mental health service annually; 
121.35  and 
121.36     (3) receive at least five hours of mentoring per week from 
122.1   a case management mentor.  A "case management mentor" means a 
122.2   qualified, practicing case manager or case management supervisor 
122.3   who teaches or advises and provides intensive training and 
122.4   clinical supervision to one or more case manager associates.  
122.5   Mentoring may occur while providing direct services to consumers 
122.6   in the office or in the field and may be provided to individuals 
122.7   or groups of case manager associates.  At least two mentoring 
122.8   hours per week must be individual and face-to-face. 
122.9      (l) A case management supervisor must meet the criteria for 
122.10  a mental health professional as specified in section 245.4871, 
122.11  subdivision 27. 
122.12     (m) An immigrant who does not have the qualifications 
122.13  specified in this subdivision may provide case management 
122.14  services to child immigrants with severe emotional disturbance 
122.15  of the same ethnic group as the immigrant if the person:  
122.16     (1) is currently enrolled in and is actively pursuing 
122.17  credits toward the completion of a bachelor's degree in one of 
122.18  the behavioral sciences or related fields at an accredited 
122.19  college or university; 
122.20     (2) completes 40 hours of training as specified in this 
122.21  subdivision; and 
122.22     (3) receives clinical supervision at least once a week 
122.23  until the requirements of obtaining a bachelor's degree and 
122.24  2,000 hours of supervised experience are met. 
122.25     Sec. 6.  Minnesota Statutes 2000, section 245.50, 
122.26  subdivision 1, is amended to read: 
122.27     Subdivision 1.  [DEFINITIONS.] For purposes of this 
122.28  section, the following terms have the meanings given them. 
122.29     (a) "Bordering state" means Iowa, North Dakota, South 
122.30  Dakota, or Wisconsin. 
122.31     (b) "Receiving agency or facility" means a public or 
122.32  private hospital, mental health center, or other person or 
122.33  organization authorized by a state to provide which provides 
122.34  mental health services under this section to individuals from a 
122.35  state other than the state in which the agency is located. 
122.36     (c) "Receiving state" means the state in which a receiving 
123.1   agency is located. 
123.2      (d) "Sending agency" means a state or county agency which 
123.3   sends an individual to a bordering state for treatment under 
123.4   this section. 
123.5      (e) "Sending state" means the state in which the sending 
123.6   agency is located. 
123.7      Sec. 7.  Minnesota Statutes 2000, section 245.50, 
123.8   subdivision 2, is amended to read: 
123.9      Subd. 2.  [PURPOSE AND AUTHORITY.] (a) The purpose of this 
123.10  section is to enable appropriate treatment to be provided to 
123.11  individuals, across state lines from the individual's state of 
123.12  residence, in qualified facilities that are closer to the homes 
123.13  of individuals than are facilities available in the individual's 
123.14  home state. 
123.15     (b) Unless prohibited by another law and subject to the 
123.16  exceptions listed in subdivision 3, a county board or the 
123.17  commissioner of human services may contract with an agency or 
123.18  facility in a bordering state for mental health services for 
123.19  residents of Minnesota, and a Minnesota mental health agency or 
123.20  facility may contract to provide services to residents of 
123.21  bordering states.  Except as provided in subdivision 5, a person 
123.22  who receives services in another state under this section is 
123.23  subject to the laws of the state in which services are 
123.24  provided.  A person who will receive services in another state 
123.25  under this section must be informed of the consequences of 
123.26  receiving services in another state, including the implications 
123.27  of the differences in state laws, to the extent the individual 
123.28  will be subject to the laws of the receiving state. 
123.29     Sec. 8.  Minnesota Statutes 2000, section 245.50, 
123.30  subdivision 5, is amended to read: 
123.31     Subd. 5.  [SPECIAL CONTRACTS; WISCONSIN BORDERING 
123.32  STATES.] The commissioner of the Minnesota department of human 
123.33  services must enter into negotiations with appropriate personnel 
123.34  at the Wisconsin department of health and social services and 
123.35  must develop an agreement that conforms to the requirements of 
123.36  subdivision 4, to enable the placement in Minnesota of patients 
124.1   who are on emergency holds or who have been involuntarily 
124.2   committed as mentally ill or chemically dependent in Wisconsin 
124.3   and to enable the temporary placement in Wisconsin of patients 
124.4   who are on emergency holds in Minnesota under section 253B.05, 
124.5   provided that the Minnesota courts retain jurisdiction over 
124.6   Minnesota patients, and the state of Wisconsin affords to 
124.7   Minnesota patients the rights under Minnesota law.  Persons 
124.8   committed by the Wisconsin courts and placed in Minnesota 
124.9   facilities shall continue to be in the legal custody of 
124.10  Wisconsin and Wisconsin's laws governing length of commitment, 
124.11  reexaminations, and extension of commitment shall continue to 
124.12  apply to these residents.  In all other respects, Wisconsin 
124.13  residents placed in Minnesota facilities are subject to 
124.14  Minnesota laws.  The agreement must specify that responsibility 
124.15  for payment for the cost of care of Wisconsin residents shall 
124.16  remain with the state of Wisconsin and the cost of care of 
124.17  Minnesota residents shall remain with the state of Minnesota.  
124.18  The commissioner shall be assisted by attorneys from the 
124.19  Minnesota attorney general's office in negotiating and 
124.20  finalizing this agreement.  The agreement shall be completed so 
124.21  as to permit placement of Wisconsin residents in Minnesota 
124.22  facilities and Minnesota residents in Wisconsin facilities 
124.23  beginning July 1, 1994. (a) An individual who is detained, 
124.24  committed, or placed on an involuntary basis under chapter 253B 
124.25  may be confined or treated in a bordering state pursuant to a 
124.26  contract under this section.  An individual who is detained, 
124.27  committed, or placed on an involuntary basis under the civil law 
124.28  of a bordering state may be confined or treated in Minnesota 
124.29  pursuant to a contract under this section.  A peace or health 
124.30  officer who is acting under the authority of the sending state 
124.31  may transport an individual to a receiving agency that provides 
124.32  services pursuant to a contract under this section, and may 
124.33  transport the individual back to the sending state under the 
124.34  laws of the sending state.  Court orders valid under the law of 
124.35  the sending state are granted recognition and reciprocity in the 
124.36  receiving state for individuals covered by a contract under this 
125.1   section to the extent that the court orders relate to 
125.2   confinement for treatment or care of mental illness.  Such 
125.3   treatment or care may address other conditions that may be 
125.4   co-occurring with the mental illness.  These court orders are 
125.5   not subject to legal challenge in the courts of the receiving 
125.6   state.  Individuals who are detained, committed, or placed under 
125.7   the law of a sending state and who are transferred to a 
125.8   receiving state under this section continue to be in the legal 
125.9   custody of the authority responsible for them under the law of 
125.10  the sending state.  Except in emergencies, those individuals may 
125.11  not be transferred, removed, or furloughed from a receiving 
125.12  agency without the specific approval of the authority 
125.13  responsible for them under the law of the sending state. 
125.14     (b) While in the receiving state pursuant to a contract 
125.15  under this section, an individual shall be subject to the 
125.16  sending state's laws and rules relating to length of 
125.17  confinement, reexaminations, and extensions of confinement.  No 
125.18  individual may be sent to another state pursuant to a contract 
125.19  under this section until the receiving state has enacted a law 
125.20  recognizing the validity and applicability of this section. 
125.21     (c) If an individual receiving services pursuant to a 
125.22  contract under this section leaves the receiving agency without 
125.23  permission and the individual is subject to involuntary 
125.24  confinement under the law of the sending state, the receiving 
125.25  agency shall use all reasonable means to return the individual 
125.26  to the receiving agency.  The receiving agency shall immediately 
125.27  report the absence to the sending agency.  The receiving state 
125.28  has the primary responsibility for, and the authority to direct, 
125.29  the return of these individuals within its borders and is liable 
125.30  for the cost of the action to the extent that it would be liable 
125.31  for costs of its own resident. 
125.32     (d) Responsibility for payment for the cost of care remains 
125.33  with the sending agency. 
125.34     (e) This subdivision also applies to county contracts under 
125.35  subdivision 2 which include emergency care and treatment 
125.36  provided to a county resident in a bordering state. 
126.1      Sec. 9.  Minnesota Statutes 2001 Supplement, section 
126.2   256B.0627, subdivision 10, is amended to read: 
126.3      Subd. 10.  [FISCAL INTERMEDIARY OPTION AVAILABLE FOR 
126.4   PERSONAL CARE ASSISTANT SERVICES.] (a) The commissioner may 
126.5   allow a recipient of personal care assistant services to use a 
126.6   fiscal intermediary to assist the recipient in paying and 
126.7   accounting for medically necessary covered personal care 
126.8   assistant services authorized in subdivision 4 and within the 
126.9   payment parameters of subdivision 5.  Unless otherwise provided 
126.10  in this subdivision, all other statutory and regulatory 
126.11  provisions relating to personal care assistant services apply to 
126.12  a recipient using the fiscal intermediary option. 
126.13     (b) The recipient or responsible party shall: 
126.14     (1) recruit, hire, and terminate a qualified professional, 
126.15  if a qualified professional is requested by the recipient or 
126.16  responsible party; 
126.17     (2) verify and document the credentials of the qualified 
126.18  professional, if a qualified professional is requested by the 
126.19  recipient or responsible party; 
126.20     (3) develop a service plan based on physician orders and 
126.21  public health nurse assessment with the assistance of a 
126.22  qualified professional, if a qualified professional is requested 
126.23  by the recipient or responsible party, that addresses the health 
126.24  and safety of the recipient; 
126.25     (4) recruit, hire, and terminate the personal care 
126.26  assistant; 
126.27     (5) orient and train the personal care assistant with 
126.28  assistance as needed from the qualified professional; 
126.29     (6) supervise and evaluate the personal care assistant with 
126.30  assistance as needed from the recipient's physician or the 
126.31  qualified professional; 
126.32     (7) monitor and verify in writing and report to the fiscal 
126.33  intermediary the number of hours worked by the personal care 
126.34  assistant and the qualified professional; and 
126.35     (8) enter into a written agreement, as specified in 
126.36  paragraph (f). 
127.1      (c) The duties of the fiscal intermediary shall be to: 
127.2      (1) bill the medical assistance program for personal care 
127.3   assistant and qualified professional services; 
127.4      (2) request and secure background checks on personal care 
127.5   assistants and qualified professionals according to section 
127.6   245A.04; 
127.7      (3) pay the personal care assistant and qualified 
127.8   professional based on actual hours of services provided; 
127.9      (4) withhold and pay all applicable federal and state 
127.10  taxes; 
127.11     (5) verify and keep records of hours worked by the personal 
127.12  care assistant and qualified professional; 
127.13     (6) make the arrangements and pay unemployment insurance, 
127.14  taxes, workers' compensation, liability insurance, and other 
127.15  benefits, if any; 
127.16     (7) enroll in the medical assistance program as a fiscal 
127.17  intermediary; and 
127.18     (8) enter into a written agreement as specified in 
127.19  paragraph (f) before services are provided. 
127.20     (d) The fiscal intermediary: 
127.21     (1) may not be related to the recipient, qualified 
127.22  professional, or the personal care assistant; 
127.23     (2) must ensure arm's length transactions with the 
127.24  recipient and personal care assistant; and 
127.25     (3) shall be considered a joint employer of the personal 
127.26  care assistant and qualified professional to the extent 
127.27  specified in this section. 
127.28     The fiscal intermediary or owners of the entity that 
127.29  provides fiscal intermediary services under this subdivision 
127.30  must pass a criminal background check as required in section 
127.31  256B.0627, subdivision 1, paragraph (e). 
127.32     (e) If the recipient or responsible party requests a 
127.33  qualified professional, the qualified professional providing 
127.34  assistance to the recipient shall meet the qualifications 
127.35  specified in section 256B.0625, subdivision 19c.  The qualified 
127.36  professional shall assist the recipient in developing and 
128.1   revising a plan to meet the recipient's needs, as assessed by 
128.2   the public health nurse.  In performing this function, the 
128.3   qualified professional must visit the recipient in the 
128.4   recipient's home at least once annually.  The qualified 
128.5   professional must report any suspected abuse, neglect, or 
128.6   financial exploitation of the recipient to the appropriate 
128.7   authorities.  
128.8      (f) The fiscal intermediary, recipient or responsible 
128.9   party, personal care assistant, and qualified professional shall 
128.10  enter into a written agreement before services are started.  The 
128.11  agreement shall include: 
128.12     (1) the duties of the recipient, qualified professional, 
128.13  personal care assistant, and fiscal agent based on paragraphs 
128.14  (a) to (e); 
128.15     (2) the salary and benefits for the personal care assistant 
128.16  and the qualified professional; 
128.17     (3) the administrative fee of the fiscal intermediary and 
128.18  services paid for with that fee, including background check 
128.19  fees; 
128.20     (4) procedures to respond to billing or payment complaints; 
128.21  and 
128.22     (5) procedures for hiring and terminating the personal care 
128.23  assistant and the qualified professional. 
128.24     (g) The rates paid for personal care assistant 
128.25  services, shared care services, qualified professional services, 
128.26  and fiscal intermediary services under this subdivision shall be 
128.27  the same rates paid for personal care assistant services and 
128.28  qualified professional services under subdivision 2 
128.29  respectively.  Except for the administrative fee of the fiscal 
128.30  intermediary specified in paragraph (f), the remainder of the 
128.31  rates paid to the fiscal intermediary must be used to pay for 
128.32  the salary and benefits for the personal care assistant or the 
128.33  qualified professional. 
128.34     (h) As part of the assessment defined in subdivision 1, the 
128.35  following conditions must be met to use or continue use of a 
128.36  fiscal intermediary: 
129.1      (1) the recipient must be able to direct the recipient's 
129.2   own care, or the responsible party for the recipient must be 
129.3   readily available to direct the care of the personal care 
129.4   assistant; 
129.5      (2) the recipient or responsible party must be 
129.6   knowledgeable of the health care needs of the recipient and be 
129.7   able to effectively communicate those needs; 
129.8      (3) a face-to-face assessment must be conducted by the 
129.9   local county public health nurse at least annually, or when 
129.10  there is a significant change in the recipient's condition or 
129.11  change in the need for personal care assistant services; 
129.12     (4) the recipient cannot select the shared services option 
129.13  recipients who choose to use the shared care option as specified 
129.14  in subdivision 8 must utilize the same fiscal intermediary; and 
129.15     (5) parties must be in compliance with the written 
129.16  agreement specified in paragraph (f). 
129.17     (i) The commissioner shall deny, revoke, or suspend the 
129.18  authorization to use the fiscal intermediary option if: 
129.19     (1) it has been determined by the qualified professional or 
129.20  local county public health nurse that the use of this option 
129.21  jeopardizes the recipient's health and safety; 
129.22     (2) the parties have failed to comply with the written 
129.23  agreement specified in paragraph (f); or 
129.24     (3) the use of the option has led to abusive or fraudulent 
129.25  billing for personal care assistant services.  
129.26     The recipient or responsible party may appeal the 
129.27  commissioner's action according to section 256.045.  The denial, 
129.28  revocation, or suspension to use the fiscal intermediary option 
129.29  shall not affect the recipient's authorized level of personal 
129.30  care assistant services as determined in subdivision 5. 
129.31     Sec. 10.  Minnesota Statutes 2001 Supplement, section 
129.32  256B.0911, subdivision 4b, is amended to read: 
129.33     Subd. 4b.  [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 
129.34  Exemptions from the federal screening requirements outlined in 
129.35  subdivision 4a, paragraphs (b) and (c), are limited to: 
129.36     (1) a person who, having entered an acute care facility 
130.1   from a certified nursing facility, is returning to a certified 
130.2   nursing facility; and 
130.3      (2) a person transferring from one certified nursing 
130.4   facility in Minnesota to another certified nursing facility in 
130.5   Minnesota; and 
130.6      (3) a person, 21 years of age or older, who satisfies the 
130.7   following criteria, as specified in the Code of Federal 
130.8   Regulations, title 42, section 483.106(b)(2): 
130.9      (i) the person is admitted to a nursing facility directly 
130.10  from a hospital after receiving acute inpatient care at the 
130.11  hospital; 
130.12     (ii) the person requires nursing facility services for the 
130.13  same condition for which care was provided in the hospital; and 
130.14     (iii) the attending physician has certified before the 
130.15  nursing facility admission that the person is likely to receive 
130.16  less than 30 days of nursing facility services. 
130.17     (b) Persons who are exempt from preadmission screening for 
130.18  purposes of level of care determination include: 
130.19     (1) persons described in paragraph (a); 
130.20     (2) an individual who has a contractual right to have 
130.21  nursing facility care paid for indefinitely by the veterans' 
130.22  administration; 
130.23     (3) an individual enrolled in a demonstration project under 
130.24  section 256B.69, subdivision 8, at the time of application to a 
130.25  nursing facility; 
130.26     (4) an individual currently being served under the 
130.27  alternative care program or under a home and community-based 
130.28  services waiver authorized under section 1915(c) of the federal 
130.29  Social Security Act; and 
130.30     (5) individuals admitted to a certified nursing facility 
130.31  for a short-term stay, which is expected to be 14 days or less 
130.32  in duration based upon a physician's certification, and who have 
130.33  been assessed and approved for nursing facility admission within 
130.34  the previous six months.  This exemption applies only if the 
130.35  consultation team member determines at the time of the initial 
130.36  assessment of the six-month period that it is appropriate to use 
131.1   the nursing facility for short-term stays and that there is an 
131.2   adequate plan of care for return to the home or community-based 
131.3   setting.  If a stay exceeds 14 days, the individual must be 
131.4   referred no later than the first county working day following 
131.5   the 14th resident day for a screening, which must be completed 
131.6   within five working days of the referral.  The payment 
131.7   limitations in subdivision 7 apply to an individual found at 
131.8   screening to not meet the level of care criteria for admission 
131.9   to a certified nursing facility. 
131.10     (c) Persons admitted to a Medicaid-certified nursing 
131.11  facility from the community on an emergency basis as described 
131.12  in paragraph (d) or from an acute care facility on a nonworking 
131.13  day must be screened the first working day after admission. 
131.14     (d) Emergency admission to a nursing facility prior to 
131.15  screening is permitted when all of the following conditions are 
131.16  met: 
131.17     (1) a person is admitted from the community to a certified 
131.18  nursing or certified boarding care facility during county 
131.19  nonworking hours; 
131.20     (2) a physician has determined that delaying admission 
131.21  until preadmission screening is completed would adversely affect 
131.22  the person's health and safety; 
131.23     (3) there is a recent precipitating event that precludes 
131.24  the client from living safely in the community, such as 
131.25  sustaining an injury, sudden onset of acute illness, or a 
131.26  caregiver's inability to continue to provide care; 
131.27     (4) the attending physician has authorized the emergency 
131.28  placement and has documented the reason that the emergency 
131.29  placement is recommended; and 
131.30     (5) the county is contacted on the first working day 
131.31  following the emergency admission. 
131.32  Transfer of a patient from an acute care hospital to a nursing 
131.33  facility is not considered an emergency except for a person who 
131.34  has received hospital services in the following situations: 
131.35  hospital admission for observation, care in an emergency room 
131.36  without hospital admission, or following hospital 24-hour bed 
132.1   care. 
132.2      (e) A nursing facility must provide a written notice to 
132.3   persons who satisfy the criteria in paragraph (a), clause (3), 
132.4   regarding the person's right to request and receive long-term 
132.5   care consultation services as defined in subdivision 1a.  The 
132.6   notice must be provided prior to the person's discharge from the 
132.7   facility and in a format specified by the commissioner. 
132.8      [EFFECTIVE DATE.] This section is effective the day 
132.9   following final enactment. 
132.10     Sec. 11.  Minnesota Statutes 2001 Supplement, section 
132.11  256B.0911, subdivision 4d, is amended to read: 
132.12     Subd. 4d.  [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 
132.13  YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 
132.14  ensure that individuals with disabilities or chronic illness are 
132.15  served in the most integrated setting appropriate to their needs 
132.16  and have the necessary information to make informed choices 
132.17  about home and community-based service options. 
132.18     (b) Individuals under 65 years of age who are admitted to a 
132.19  nursing facility from a hospital must be screened prior to 
132.20  admission as outlined in subdivisions 4a through 4c. 
132.21     (c) Individuals under 65 years of age who are admitted to 
132.22  nursing facilities with only a telephone screening must receive 
132.23  a face-to-face assessment from the long-term care consultation 
132.24  team member of the county in which the facility is located or 
132.25  from the recipient's county case manager within 20 working days 
132.26  of admission. 
132.27     (d) Individuals under 65 years of age who are admitted to a 
132.28  nursing facility without preadmission screening according to the 
132.29  exemption described in subdivision 4b, paragraph (a), clause 
132.30  (3), and who remain in the facility longer than 30 days must 
132.31  receive a face-to-face assessment within 40 days of admission. 
132.32     (d) (e) At the face-to-face assessment, the long-term care 
132.33  consultation team member or county case manager must perform the 
132.34  activities required under subdivision 3b. 
132.35     (e) (f) For individuals under 21 years of age, a screening 
132.36  interview which recommends nursing facility admission must be 
133.1   face-to-face and approved by the commissioner before the 
133.2   individual is admitted to the nursing facility. 
133.3      (f) (g) In the event that an individual under 65 years of 
133.4   age is admitted to a nursing facility on an emergency basis, the 
133.5   county must be notified of the admission on the next working 
133.6   day, and a face-to-face assessment as described in paragraph (c) 
133.7   must be conducted within 20 working days of admission. 
133.8      (g) (h) At the face-to-face assessment, the long-term care 
133.9   consultation team member or the case manager must present 
133.10  information about home and community-based options so the 
133.11  individual can make informed choices.  If the individual chooses 
133.12  home and community-based services, the long-term care 
133.13  consultation team member or case manager must complete a written 
133.14  relocation plan within 20 working days of the visit.  The plan 
133.15  shall describe the services needed to move out of the facility 
133.16  and a time line for the move which is designed to ensure a 
133.17  smooth transition to the individual's home and community. 
133.18     (h) (i) An individual under 65 years of age residing in a 
133.19  nursing facility shall receive a face-to-face assessment at 
133.20  least every 12 months to review the person's service choices and 
133.21  available alternatives unless the individual indicates, in 
133.22  writing, that annual visits are not desired.  In this case, the 
133.23  individual must receive a face-to-face assessment at least once 
133.24  every 36 months for the same purposes. 
133.25     (i) (j) Notwithstanding the provisions of subdivision 6, 
133.26  the commissioner may pay county agencies directly for 
133.27  face-to-face assessments for individuals under 65 years of age 
133.28  who are being considered for placement or residing in a nursing 
133.29  facility. 
133.30     [EFFECTIVE DATE.] This section is effective the day 
133.31  following final enactment. 
133.32     Sec. 12.  Minnesota Statutes 2001 Supplement, section 
133.33  256B.0913, subdivision 5, is amended to read: 
133.34     Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
133.35  Alternative care funding may be used for payment of costs of: 
133.36     (1) adult foster care; 
134.1      (2) adult day care; 
134.2      (3) home health aide; 
134.3      (4) homemaker services; 
134.4      (5) personal care; 
134.5      (6) case management; 
134.6      (7) respite care; 
134.7      (8) assisted living; 
134.8      (9) residential care services; 
134.9      (10) care-related supplies and equipment; 
134.10     (11) meals delivered to the home; 
134.11     (12) transportation; 
134.12     (13) skilled nursing; 
134.13     (14) chore services; 
134.14     (15) companion services; 
134.15     (16) nutrition services; 
134.16     (17) training for direct informal caregivers; 
134.17     (18) telemedicine devices to monitor recipients in their 
134.18  own homes as an alternative to hospital care, nursing home care, 
134.19  or home visits; 
134.20     (19) other services which includes discretionary funds and 
134.21  direct cash payments to clients, following approval by the 
134.22  commissioner, subject to the provisions of paragraph (j).  Total 
134.23  annual payments for "other services" for all clients within a 
134.24  county may not exceed either ten 25 percent of that county's 
134.25  annual alternative care program base allocation or $5,000, 
134.26  whichever is greater.  In no case shall this amount exceed the 
134.27  county's total annual alternative care program base allocation; 
134.28  and 
134.29     (20) environmental modifications. 
134.30     (b) The county agency must ensure that the funds are not 
134.31  used to supplant services available through other public 
134.32  assistance or services programs. 
134.33     (c) Unless specified in statute, the service definitions 
134.34  and standards for alternative care services shall be the same as 
134.35  the service definitions and standards specified in the federally 
134.36  approved elderly waiver plan.  Except for the county agencies' 
135.1   approval of direct cash payments to clients as described in 
135.2   paragraph (j) or for a provider of supplies and equipment when 
135.3   the monthly cost of the supplies and equipment is less than 
135.4   $250, persons or agencies must be employed by or under a 
135.5   contract with the county agency or the public health nursing 
135.6   agency of the local board of health in order to receive funding 
135.7   under the alternative care program.  Supplies and equipment may 
135.8   be purchased from a vendor not certified to participate in the 
135.9   Medicaid program if the cost for the item is less than that of a 
135.10  Medicaid vendor.  
135.11     (d) The adult foster care rate shall be considered a 
135.12  difficulty of care payment and shall not include room and 
135.13  board.  The adult foster care rate shall be negotiated between 
135.14  the county agency and the foster care provider.  The alternative 
135.15  care payment for the foster care service in combination with the 
135.16  payment for other alternative care services, including case 
135.17  management, must not exceed the limit specified in subdivision 
135.18  4, paragraph (a), clause (6). 
135.19     (e) Personal care services must meet the service standards 
135.20  defined in the federally approved elderly waiver plan, except 
135.21  that a county agency may contract with a client's relative who 
135.22  meets the relative hardship waiver requirement as defined in 
135.23  section 256B.0627, subdivision 4, paragraph (b), clause (10), to 
135.24  provide personal care services if the county agency ensures 
135.25  supervision of this service by a registered nurse or mental 
135.26  health practitioner.  
135.27     (f) For purposes of this section, residential care services 
135.28  are services which are provided to individuals living in 
135.29  residential care homes.  Residential care homes are currently 
135.30  licensed as board and lodging establishments and are registered 
135.31  with the department of health as providing special services 
135.32  under section 157.17 and are not subject to registration under 
135.33  chapter 144D.  Residential care services are defined as 
135.34  "supportive services" and "health-related services."  
135.35  "Supportive services" means the provision of up to 24-hour 
135.36  supervision and oversight.  Supportive services includes:  (1) 
136.1   transportation, when provided by the residential care home only; 
136.2   (2) socialization, when socialization is part of the plan of 
136.3   care, has specific goals and outcomes established, and is not 
136.4   diversional or recreational in nature; (3) assisting clients in 
136.5   setting up meetings and appointments; (4) assisting clients in 
136.6   setting up medical and social services; (5) providing assistance 
136.7   with personal laundry, such as carrying the client's laundry to 
136.8   the laundry room.  Assistance with personal laundry does not 
136.9   include any laundry, such as bed linen, that is included in the 
136.10  room and board rate.  "Health-related services" are limited to 
136.11  minimal assistance with dressing, grooming, and bathing and 
136.12  providing reminders to residents to take medications that are 
136.13  self-administered or providing storage for medications, if 
136.14  requested.  Individuals receiving residential care services 
136.15  cannot receive homemaking services funded under this section.  
136.16     (g) For the purposes of this section, "assisted living" 
136.17  refers to supportive services provided by a single vendor to 
136.18  clients who reside in the same apartment building of three or 
136.19  more units which are not subject to registration under chapter 
136.20  144D and are licensed by the department of health as a class A 
136.21  home care provider or a class E home care provider.  Assisted 
136.22  living services are defined as up to 24-hour supervision, and 
136.23  oversight, supportive services as defined in clause (1), 
136.24  individualized home care aide tasks as defined in clause (2), 
136.25  and individualized home management tasks as defined in clause 
136.26  (3) provided to residents of a residential center living in 
136.27  their units or apartments with a full kitchen and bathroom.  A 
136.28  full kitchen includes a stove, oven, refrigerator, food 
136.29  preparation counter space, and a kitchen utensil storage 
136.30  compartment.  Assisted living services must be provided by the 
136.31  management of the residential center or by providers under 
136.32  contract with the management or with the county. 
136.33     (1) Supportive services include:  
136.34     (i) socialization, when socialization is part of the plan 
136.35  of care, has specific goals and outcomes established, and is not 
136.36  diversional or recreational in nature; 
137.1      (ii) assisting clients in setting up meetings and 
137.2   appointments; and 
137.3      (iii) providing transportation, when provided by the 
137.4   residential center only.  
137.5      (2) Home care aide tasks means:  
137.6      (i) preparing modified diets, such as diabetic or low 
137.7   sodium diets; 
137.8      (ii) reminding residents to take regularly scheduled 
137.9   medications or to perform exercises; 
137.10     (iii) household chores in the presence of technically 
137.11  sophisticated medical equipment or episodes of acute illness or 
137.12  infectious disease; 
137.13     (iv) household chores when the resident's care requires the 
137.14  prevention of exposure to infectious disease or containment of 
137.15  infectious disease; and 
137.16     (v) assisting with dressing, oral hygiene, hair care, 
137.17  grooming, and bathing, if the resident is ambulatory, and if the 
137.18  resident has no serious acute illness or infectious disease.  
137.19  Oral hygiene means care of teeth, gums, and oral prosthetic 
137.20  devices.  
137.21     (3) Home management tasks means:  
137.22     (i) housekeeping; 
137.23     (ii) laundry; 
137.24     (iii) preparation of regular snacks and meals; and 
137.25     (iv) shopping.  
137.26     Individuals receiving assisted living services shall not 
137.27  receive both assisted living services and homemaking services.  
137.28  Individualized means services are chosen and designed 
137.29  specifically for each resident's needs, rather than provided or 
137.30  offered to all residents regardless of their illnesses, 
137.31  disabilities, or physical conditions.  Assisted living services 
137.32  as defined in this section shall not be authorized in boarding 
137.33  and lodging establishments licensed according to sections 
137.34  157.011 and 157.15 to 157.22. 
137.35     (h) For establishments registered under chapter 144D, 
137.36  assisted living services under this section means either the 
138.1   services described in paragraph (g) and delivered by a class E 
138.2   home care provider licensed by the department of health or the 
138.3   services described under section 144A.4605 and delivered by an 
138.4   assisted living home care provider or a class A home care 
138.5   provider licensed by the commissioner of health. 
138.6      (i) Payment for assisted living services and residential 
138.7   care services shall be a monthly rate negotiated and authorized 
138.8   by the county agency based on an individualized service plan for 
138.9   each resident and may not cover direct rent or food costs.  
138.10     (1) The individualized monthly negotiated payment for 
138.11  assisted living services as described in paragraph (g) or (h), 
138.12  and residential care services as described in paragraph (f), 
138.13  shall not exceed the nonfederal share in effect on July 1 of the 
138.14  state fiscal year for which the rate limit is being calculated 
138.15  of the greater of either the statewide or any of the geographic 
138.16  groups' weighted average monthly nursing facility payment rate 
138.17  of the case mix resident class to which the alternative care 
138.18  eligible client would be assigned under Minnesota Rules, parts 
138.19  9549.0050 to 9549.0059, less the maintenance needs allowance as 
138.20  described in section 256B.0915, subdivision 1d, paragraph (a), 
138.21  until the first day of the state fiscal year in which a resident 
138.22  assessment system, under section 256B.437, of nursing home rate 
138.23  determination is implemented.  Effective on the first day of the 
138.24  state fiscal year in which a resident assessment system, under 
138.25  section 256B.437, of nursing home rate determination is 
138.26  implemented and the first day of each subsequent state fiscal 
138.27  year, the individualized monthly negotiated payment for the 
138.28  services described in this clause shall not exceed the limit 
138.29  described in this clause which was in effect on the last day of 
138.30  the previous state fiscal year and which has been adjusted by 
138.31  the greater of any legislatively adopted home and 
138.32  community-based services cost-of-living percentage increase or 
138.33  any legislatively adopted statewide percent rate increase for 
138.34  nursing facilities. 
138.35     (2) The individualized monthly negotiated payment for 
138.36  assisted living services described under section 144A.4605 and 
139.1   delivered by a provider licensed by the department of health as 
139.2   a class A home care provider or an assisted living home care 
139.3   provider and provided in a building that is registered as a 
139.4   housing with services establishment under chapter 144D and that 
139.5   provides 24-hour supervision in combination with the payment for 
139.6   other alternative care services, including case management, must 
139.7   not exceed the limit specified in subdivision 4, paragraph (a), 
139.8   clause (6). 
139.9      (j) A county agency may make payment from their alternative 
139.10  care program allocation for "other services" which include use 
139.11  of "discretionary funds" for services that are not otherwise 
139.12  defined in this section and direct cash payments to the client 
139.13  for the purpose of purchasing the services.  The following 
139.14  provisions apply to payments under this paragraph: 
139.15     (1) a cash payment to a client under this provision cannot 
139.16  exceed 80 percent of the monthly payment limit for that client 
139.17  as specified in subdivision 4, paragraph (a), clause (6); 
139.18     (2) a county may not approve any cash payment for a client 
139.19  who meets either of the following: 
139.20     (i) has been assessed as having a dependency in 
139.21  orientation, unless the client has an authorized 
139.22  representative.  An "authorized representative" means an 
139.23  individual who is at least 18 years of age and is designated by 
139.24  the person or the person's legal representative to act on the 
139.25  person's behalf.  This individual may be a family member, 
139.26  guardian, representative payee, or other individual designated 
139.27  by the person or the person's legal representative, if any, to 
139.28  assist in purchasing and arranging for supports; or 
139.29     (ii) is concurrently receiving adult foster care, 
139.30  residential care, or assisted living services; 
139.31     (3) cash payments to a person or a person's family will be 
139.32  provided through a monthly payment and be in the form of cash, 
139.33  voucher, or direct county payment to a vendor.  Fees or premiums 
139.34  assessed to the person for eligibility for health and human 
139.35  services are not reimbursable through this service option.  
139.36  Services and goods purchased through cash payments must be 
140.1   identified in the person's individualized care plan and must 
140.2   meet all of the following criteria: 
140.3      (i) they must be over and above the normal cost of caring 
140.4   for the person if the person did not have functional 
140.5   limitations; 
140.6      (ii) they must be directly attributable to the person's 
140.7   functional limitations; 
140.8      (iii) they must have the potential to be effective at 
140.9   meeting the goals of the program; 
140.10     (iv) they must be consistent with the needs identified in 
140.11  the individualized service plan.  The service plan shall specify 
140.12  the needs of the person and family, the form and amount of 
140.13  payment, the items and services to be reimbursed, and the 
140.14  arrangements for management of the individual grant; and 
140.15     (v) the person, the person's family, or the legal 
140.16  representative shall be provided sufficient information to 
140.17  ensure an informed choice of alternatives.  The local agency 
140.18  shall document this information in the person's care plan, 
140.19  including the type and level of expenditures to be reimbursed; 
140.20     (4) the county, lead agency under contract, or tribal 
140.21  government under contract to administer the alternative care 
140.22  program shall not be liable for damages, injuries, or 
140.23  liabilities sustained through the purchase of direct supports or 
140.24  goods by the person, the person's family, or the authorized 
140.25  representative with funds received through the cash payments 
140.26  under this section.  Liabilities include, but are not limited 
140.27  to, workers' compensation, the Federal Insurance Contributions 
140.28  Act (FICA), or the Federal Unemployment Tax Act (FUTA); 
140.29     (5) persons receiving grants under this section shall have 
140.30  the following responsibilities: 
140.31     (i) spend the grant money in a manner consistent with their 
140.32  individualized service plan with the local agency; 
140.33     (ii) notify the local agency of any necessary changes in 
140.34  the grant expenditures; 
140.35     (iii) arrange and pay for supports; and 
140.36     (iv) inform the local agency of areas where they have 
141.1   experienced difficulty securing or maintaining supports; and 
141.2      (6) the county shall report client outcomes, services, and 
141.3   costs under this paragraph in a manner prescribed by the 
141.4   commissioner. 
141.5      (k) Upon implementation of direct cash payments to clients 
141.6   under this section, any person determined eligible for the 
141.7   alternative care program who chooses a cash payment approved by 
141.8   the county agency shall receive the cash payment under this 
141.9   section and not under section 256.476 unless the person was 
141.10  receiving a consumer support grant under section 256.476 before 
141.11  implementation of direct cash payments under this section. 
141.12     Sec. 13.  Minnesota Statutes 2001 Supplement, section 
141.13  256B.0915, subdivision 3, is amended to read: 
141.14     Subd. 3.  [LIMITS OF CASES, RATES, PAYMENTS, AND 
141.15  FORECASTING.] (a) The number of medical assistance waiver 
141.16  recipients that a county may serve must be allocated according 
141.17  to the number of medical assistance waiver cases open on July 1 
141.18  of each fiscal year.  Additional recipients may be served with 
141.19  the approval of the commissioner. 
141.20     (b) The monthly limit for the cost of waivered services to 
141.21  an individual elderly waiver client shall be the weighted 
141.22  average monthly nursing facility rate of the case mix resident 
141.23  class to which the elderly waiver client would be assigned under 
141.24  Minnesota Rules, parts 9549.0050 to 9549.0059, less the 
141.25  recipient's maintenance needs allowance as described in 
141.26  subdivision 1d, paragraph (a), until the first day of the state 
141.27  fiscal year in which the resident assessment system as described 
141.28  in section 256B.437 for nursing home rate determination is 
141.29  implemented.  Effective on the first day of the state fiscal 
141.30  year in which the resident assessment system as described in 
141.31  section 256B.437 for nursing home rate determination is 
141.32  implemented and the first day of each subsequent state fiscal 
141.33  year, the monthly limit for the cost of waivered services to an 
141.34  individual elderly waiver client shall be the rate of the case 
141.35  mix resident class to which the waiver client would be assigned 
141.36  under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect 
142.1   on the last day of the previous state fiscal year, adjusted by 
142.2   the greater of any legislatively adopted home and 
142.3   community-based services cost-of-living percentage increase or 
142.4   any legislatively adopted statewide percent rate increase for 
142.5   nursing facilities. 
142.6      (c) If extended medical supplies and equipment or 
142.7   environmental modifications are or will be purchased for an 
142.8   elderly waiver client, the costs may be prorated for up to 12 
142.9   consecutive months beginning with the month of purchase.  If the 
142.10  monthly cost of a recipient's waivered services exceeds the 
142.11  monthly limit established in paragraph (b), the annual cost of 
142.12  all waivered services shall be determined.  In this event, the 
142.13  annual cost of all waivered services shall not exceed 12 times 
142.14  the monthly limit of waivered services as described in paragraph 
142.15  (b).  
142.16     (d) For a person who is a nursing facility resident at the 
142.17  time of requesting a determination of eligibility for elderly 
142.18  waivered services, a monthly conversion limit for the cost of 
142.19  elderly waivered services may be requested.  The monthly 
142.20  conversion limit for the cost of elderly waiver services shall 
142.21  be the resident class assigned under Minnesota Rules, parts 
142.22  9549.0050 to 9549.0059, for that resident in the nursing 
142.23  facility where the resident currently resides until July 1 of 
142.24  the state fiscal year in which the resident assessment system as 
142.25  described in section 256B.437 for nursing home rate 
142.26  determination is implemented.  Effective on July 1 of the state 
142.27  fiscal year in which the resident assessment system as described 
142.28  in section 256B.437 for nursing home rate determination is 
142.29  implemented, the monthly conversion limit for the cost of 
142.30  elderly waiver services shall be the per diem nursing facility 
142.31  rate as determined by the resident assessment system as 
142.32  described in section 256B.437 for that resident in the nursing 
142.33  facility where the resident currently resides multiplied by 365 
142.34  and divided by 12, less the recipient's maintenance needs 
142.35  allowance as described in subdivision 1d.  The initially 
142.36  approved conversion rate may be adjusted by the greater of any 
143.1   subsequent legislatively adopted home and community-based 
143.2   services cost-of-living percentage increase or any subsequent 
143.3   legislatively adopted statewide percentage rate increase for 
143.4   nursing facilities.  The limit under this clause only applies to 
143.5   persons discharged from a nursing facility after a minimum 
143.6   30-day stay and found eligible for waivered services on or after 
143.7   July 1, 1997.  The following costs must be included in 
143.8   determining the total monthly costs for the waiver client: 
143.9      (1) cost of all waivered services, including extended 
143.10  medical supplies and equipment and environmental modifications; 
143.11  and 
143.12     (2) cost of skilled nursing, home health aide, and personal 
143.13  care services reimbursable by medical assistance.  
143.14     (e) Medical assistance funding for skilled nursing 
143.15  services, private duty nursing, home health aide, and personal 
143.16  care services for waiver recipients must be approved by the case 
143.17  manager and included in the individual care plan. 
143.18     (f) A county is not required to contract with a provider of 
143.19  supplies and equipment if the monthly cost of the supplies and 
143.20  equipment is less than $250.  
143.21     (g) The adult foster care rate shall be considered a 
143.22  difficulty of care payment and shall not include room and 
143.23  board.  The adult foster care service rate shall be negotiated 
143.24  between the county agency and the foster care provider.  The 
143.25  elderly waiver payment for the foster care service in 
143.26  combination with the payment for all other elderly waiver 
143.27  services, including case management, must not exceed the limit 
143.28  specified in paragraph (b). 
143.29     (h) Payment for assisted living service shall be a monthly 
143.30  rate negotiated and authorized by the county agency based on an 
143.31  individualized service plan for each resident and may not cover 
143.32  direct rent or food costs. 
143.33     (1) The individualized monthly negotiated payment for 
143.34  assisted living services as described in section 256B.0913, 
143.35  subdivision 5, paragraph (g) or (h), and residential care 
143.36  services as described in section 256B.0913, subdivision 5, 
144.1   paragraph (f), shall not exceed the nonfederal share, in effect 
144.2   on July 1 of the state fiscal year for which the rate limit is 
144.3   being calculated, of the greater of either the statewide or any 
144.4   of the geographic groups' weighted average monthly nursing 
144.5   facility rate of the case mix resident class to which the 
144.6   elderly waiver eligible client would be assigned under Minnesota 
144.7   Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 
144.8   allowance as described in subdivision 1d, paragraph (a), until 
144.9   the July 1 of the state fiscal year in which the resident 
144.10  assessment system as described in section 256B.437 for nursing 
144.11  home rate determination is implemented.  Effective on July 1 of 
144.12  the state fiscal year in which the resident assessment system as 
144.13  described in section 256B.437 for nursing home rate 
144.14  determination is implemented and July 1 of each subsequent state 
144.15  fiscal year, the individualized monthly negotiated payment for 
144.16  the services described in this clause shall not exceed the limit 
144.17  described in this clause which was in effect on June 30 of the 
144.18  previous state fiscal year and which has been adjusted by the 
144.19  greater of any legislatively adopted home and community-based 
144.20  services cost-of-living percentage increase or any legislatively 
144.21  adopted statewide percent rate increase for nursing facilities. 
144.22     (2) The individualized monthly negotiated payment for 
144.23  assisted living services described in section 144A.4605 and 
144.24  delivered by a provider licensed by the department of health as 
144.25  a class A home care provider or an assisted living home care 
144.26  provider and provided in a building that is registered as a 
144.27  housing with services establishment under chapter 144D and that 
144.28  provides 24-hour supervision in combination with the payment for 
144.29  other elderly waiver services, including case management, must 
144.30  not exceed the limit specified in paragraph (b). 
144.31     (i) The county shall negotiate individual service rates 
144.32  with vendors and may authorize payment for actual costs up to 
144.33  the county's current approved rate.  Persons or agencies must be 
144.34  employed by or under a contract with the county agency or the 
144.35  public health nursing agency of the local board of health in 
144.36  order to receive funding under the elderly waiver program, 
145.1   except as a provider of supplies and equipment when the monthly 
145.2   cost of the supplies and equipment is less than $250.  
145.3      (j) Reimbursement for the medical assistance recipients 
145.4   under the approved waiver shall be made from the medical 
145.5   assistance account through the invoice processing procedures of 
145.6   the department's Medicaid Management Information System (MMIS), 
145.7   only with the approval of the client's case manager.  The budget 
145.8   for the state share of the Medicaid expenditures shall be 
145.9   forecasted with the medical assistance budget, and shall be 
145.10  consistent with the approved waiver.  
145.11     (k) To improve access to community services and eliminate 
145.12  payment disparities between the alternative care program and the 
145.13  elderly waiver, the commissioner shall establish statewide 
145.14  maximum service rate limits and eliminate county-specific 
145.15  service rate limits. 
145.16     (1) Effective July 1, 2001, for service rate limits, except 
145.17  those described or defined in paragraphs (g) and (h), the rate 
145.18  limit for each service shall be the greater of the alternative 
145.19  care statewide maximum rate or the elderly waiver statewide 
145.20  maximum rate. 
145.21     (2) Counties may negotiate individual service rates with 
145.22  vendors for actual costs up to the statewide maximum service 
145.23  rate limit. 
145.24     (l) Beginning July 1, 1991, the state shall reimburse 
145.25  counties according to the payment schedule in section 256.025 
145.26  for the county share of costs incurred under this subdivision on 
145.27  or after January 1, 1991, for individuals who are receiving 
145.28  medical assistance. 
145.29     Sec. 14.  Minnesota Statutes 2001 Supplement, section 
145.30  256B.0924, subdivision 6, is amended to read: 
145.31     Subd. 6.  [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 
145.32  Medical assistance and MinnesotaCare payment for targeted case 
145.33  management shall be made on a monthly basis.  In order to 
145.34  receive payment for an eligible adult, the provider must 
145.35  document at least one contact per month and not more than two 
145.36  consecutive months without a face-to-face contact with the adult 
146.1   or the adult's legal representative, family, primary caregiver, 
146.2   or other relevant persons identified as necessary to the 
146.3   development or implementation of the goals of the personal 
146.4   service plan. 
146.5      (b) Payment for targeted case management provided by county 
146.6   staff under this subdivision shall be based on the monthly rate 
146.7   methodology under section 256B.094, subdivision 6, paragraph 
146.8   (b), calculated as one combined average rate together with adult 
146.9   mental health case management under section 256B.0625, 
146.10  subdivision 20, except for calendar year 2002.  In calendar year 
146.11  2002, the rate for case management under this section shall be 
146.12  the same as the rate for adult mental health case management in 
146.13  effect as of December 31, 2001.  Billing and payment must 
146.14  identify the recipient's primary population group to allow 
146.15  tracking of revenues. 
146.16     (c) Payment for targeted case management provided by 
146.17  county-contracted vendors shall be based on a monthly rate 
146.18  negotiated by the host county.  The negotiated rate must not 
146.19  exceed the rate charged by the vendor for the same service to 
146.20  other payers.  If the service is provided by a team of 
146.21  contracted vendors, the county may negotiate a team rate with a 
146.22  vendor who is a member of the team.  The team shall determine 
146.23  how to distribute the rate among its members.  No reimbursement 
146.24  received by contracted vendors shall be returned to the county, 
146.25  except to reimburse the county for advance funding provided by 
146.26  the county to the vendor. 
146.27     (d) If the service is provided by a team that includes 
146.28  contracted vendors and county staff, the costs for county staff 
146.29  participation on the team shall be included in the rate for 
146.30  county-provided services.  In this case, the contracted vendor 
146.31  and the county may each receive separate payment for services 
146.32  provided by each entity in the same month.  In order to prevent 
146.33  duplication of services, the county must document, in the 
146.34  recipient's file, the need for team targeted case management and 
146.35  a description of the different roles of the team members. 
146.36     (e) Notwithstanding section 256B.19, subdivision 1, the 
147.1   nonfederal share of costs for targeted case management shall be 
147.2   provided by the recipient's county of responsibility, as defined 
147.3   in sections 256G.01 to 256G.12, from sources other than federal 
147.4   funds or funds used to match other federal funds. 
147.5      (f) The commissioner may suspend, reduce, or terminate 
147.6   reimbursement to a provider that does not meet the reporting or 
147.7   other requirements of this section.  The county of 
147.8   responsibility, as defined in sections 256G.01 to 256G.12, is 
147.9   responsible for any federal disallowances.  The county may share 
147.10  this responsibility with its contracted vendors. 
147.11     (g) The commissioner shall set aside five percent of the 
147.12  federal funds received under this section for use in reimbursing 
147.13  the state for costs of developing and implementing this section. 
147.14     (h) Notwithstanding section 256.025, subdivision 2, 
147.15  payments to counties for targeted case management expenditures 
147.16  under this section shall only be made from federal earnings from 
147.17  services provided under this section.  Payments to contracted 
147.18  vendors shall include both the federal earnings and the county 
147.19  share. 
147.20     (i) Notwithstanding section 256B.041, county payments for 
147.21  the cost of case management services provided by county staff 
147.22  shall not be made to the state treasurer.  For the purposes of 
147.23  targeted case management services provided by county staff under 
147.24  this section, the centralized disbursement of payments to 
147.25  counties under section 256B.041 consists only of federal 
147.26  earnings from services provided under this section. 
147.27     (j) If the recipient is a resident of a nursing facility, 
147.28  intermediate care facility, or hospital, and the recipient's 
147.29  institutional care is paid by medical assistance, payment for 
147.30  targeted case management services under this subdivision is 
147.31  limited to the last 180 days of the recipient's residency in 
147.32  that facility and may not exceed more than six months in a 
147.33  calendar year. 
147.34     (k) Payment for targeted case management services under 
147.35  this subdivision shall not duplicate payments made under other 
147.36  program authorities for the same purpose. 
148.1      (l) Any growth in targeted case management services and 
148.2   cost increases under this section shall be the responsibility of 
148.3   the counties. 
148.4      Sec. 15.  Minnesota Statutes 2001 Supplement, section 
148.5   256B.0951, subdivision 7, is amended to read: 
148.6      Subd. 7.  [WAIVER OF RULES.] If a federal waiver is 
148.7   approved under subdivision 8, the commissioner of health may 
148.8   exempt residents of intermediate care facilities for persons 
148.9   with mental retardation (ICFs/MR) who participate in the 
148.10  three-year alternative quality assurance pilot project 
148.11  established in section 256B.095 from the requirements of 
148.12  Minnesota Rules, chapter 4665, upon approval by the federal 
148.13  government of a waiver of federal certification requirements for 
148.14  ICFs/MR.  
148.15     Sec. 16.  Minnesota Statutes 2001 Supplement, section 
148.16  256B.0951, subdivision 8, is amended to read: 
148.17     Subd. 8.  [FEDERAL WAIVER.] The commissioner of human 
148.18  services shall seek federal authority to waive provisions of 
148.19  intermediate care facilities for persons with mental retardation 
148.20  (ICFs/MR) regulations to enable the demonstration and evaluation 
148.21  of the alternative quality assurance system for ICFs/MR under 
148.22  the project.  The commissioner of human services shall apply for 
148.23  any necessary waivers as soon as practicable. a federal waiver 
148.24  to allow intermediate care facilities for persons with mental 
148.25  retardation (ICFs/MR) in region 10 of Minnesota to participate 
148.26  in the alternative licensing system.  If it is necessary for 
148.27  purposes of participation in this alternative licensing system 
148.28  for a facility to be decertified as an ICF/MR facility according 
148.29  to the terms of the federal waiver, when the facility seeks 
148.30  recertification under the provisions of ICF/MR regulations at 
148.31  the end of the demonstration project, it will not be considered 
148.32  a new ICF/MR as defined under section 252.291 provided the 
148.33  licensed capacity of the facility did not increase during its 
148.34  participation in the alternative licensing system.  The 
148.35  provisions of sections 252.82, 252.292, and 256B.5011 to 
148.36  256B.5015 will remain applicable for counties in region 10 of 
149.1   Minnesota and the ICFs/MR located within those counties 
149.2   notwithstanding a county's participation in the alternative 
149.3   licensing system. 
149.4      Sec. 17.  Minnesota Statutes 2001 Supplement, section 
149.5   256B.437, subdivision 6, is amended to read: 
149.6      Subd. 6.  [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 
149.7   commissioner of human services shall calculate the amount of the 
149.8   planned closure rate adjustment available under subdivision 3, 
149.9   paragraph (b), for up to 5,140 beds according to clauses (1) to 
149.10  (4): 
149.11     (1) the amount available is the net reduction of nursing 
149.12  facility beds multiplied by $2,080; 
149.13     (2) the total number of beds in the nursing facility or 
149.14  facilities receiving the planned closure rate adjustment must be 
149.15  identified; 
149.16     (3) capacity days are determined by multiplying the number 
149.17  determined under clause (2) by 365; and 
149.18     (4) the planned closure rate adjustment is the amount 
149.19  available in clause (1), divided by capacity days determined 
149.20  under clause (3). 
149.21     (b) A planned closure rate adjustment under this section is 
149.22  effective on the first day of the month following completion of 
149.23  closure of the facility designated for closure in the 
149.24  application and becomes part of the nursing facility's total 
149.25  operating payment rate. 
149.26     (c) Applicants may use the planned closure rate adjustment 
149.27  to allow for a property payment for a new nursing facility or an 
149.28  addition to an existing nursing facility or as an operating 
149.29  payment rate adjustment.  Applications approved under this 
149.30  subdivision are exempt from other requirements for moratorium 
149.31  exceptions under section 144A.073, subdivisions 2 and 3. 
149.32     (d) Upon the request of a closing facility, the 
149.33  commissioner must allow the facility a closure rate adjustment 
149.34  as provided under section 144A.161, subdivision 10. 
149.35     (e) A facility that has received a planned closure rate 
149.36  adjustment may reassign it to another facility that is under the 
150.1   same ownership at any time within three years of its effective 
150.2   date.  The amount of the adjustment shall be computed according 
150.3   to paragraph (a). 
150.4      (f) If the per bed dollar amount specified in paragraph 
150.5   (a), clause (1), is increased, the commissioner shall 
150.6   recalculate planned closure rate adjustments for facilities that 
150.7   delicense beds under this section on or after July 1, 2001, to 
150.8   reflect the increase in the per bed dollar amount.  The 
150.9   recalculated planned closure rate adjustment shall be effective 
150.10  from the date the per bed dollar amount is increased. 
150.11     Sec. 18.  Minnesota Statutes 2000, section 326.01, is 
150.12  amended by adding a subdivision to read: 
150.13     Subd. 9a.  [RESTRICTED PLUMBING CONTRACTOR.] A "restricted 
150.14  plumbing contractor" is any person skilled in the planning, 
150.15  superintending, and practical installation of plumbing who is 
150.16  otherwise lawfully qualified to contract for plumbing and 
150.17  installations and to conduct the business of plumbing, who is 
150.18  familiar with the laws and rules governing the business of 
150.19  plumbing, and who performs the plumbing trade in cities and 
150.20  towns with a population of fewer than 5,000 according to federal 
150.21  census. 
150.22     [EFFECTIVE DATE.] This section is effective July 1, 2003.  
150.23     Sec. 19.  Minnesota Statutes 2000, section 326.37, 
150.24  subdivision 1, is amended to read: 
150.25     Subdivision 1.  [RULES.] The state commissioner of 
150.26  health may shall, by rule, prescribe minimum uniform standards 
150.27  which shall be uniform, and which standards shall thereafter be 
150.28  effective for all new plumbing installations, including 
150.29  additions, extensions, alterations, and replacements connected 
150.30  with any water or sewage disposal system owned or operated by or 
150.31  for any municipality, institution, factory, office building, 
150.32  hotel, apartment building, or any other place of business 
150.33  regardless of location or the population of the city or town in 
150.34  which located.  Notwithstanding the provisions of Minnesota 
150.35  Rules, part 4715.3130, as they apply to review of plans and 
150.36  specifications, the commissioner may allow plumbing 
151.1   construction, alteration, or extension to proceed without 
151.2   approval of the plans or specifications by the commissioner. 
151.3      The commissioner shall administer the provisions of 
151.4   sections 326.37 to 326.45 326.451 and for such purposes may 
151.5   employ plumbing inspectors and other assistants. 
151.6      [EFFECTIVE DATE.] This section is effective July 1, 2003.  
151.7      Sec. 20.  Minnesota Statutes 2000, section 326.37, is 
151.8   amended by adding a subdivision to read: 
151.9      Subd. 1a.  [INSPECTION.] All new plumbing installations, 
151.10  including additions, extensions, alterations, and replacements, 
151.11  shall be inspected by the commissioner for compliance with 
151.12  accepted standards of construction for health, safety to life 
151.13  and property, and compliance with applicable codes.  The 
151.14  department of health shall have full implementation of its 
151.15  inspections plan in place and operational July 1, 2005.  This 
151.16  subdivision does not apply where a political subdivision 
151.17  requires, by ordinance, plumbing inspections similar to the 
151.18  requirements of this subdivision. 
151.19     [EFFECTIVE DATE.] This section is effective July 1, 2003.  
151.20     Sec. 21.  Minnesota Statutes 2001 Supplement, section 
151.21  326.38, is amended to read: 
151.22     326.38 [LOCAL REGULATIONS.] 
151.23     Any city having a system of waterworks or sewerage, or any 
151.24  town in which reside over 5,000 people exclusive of any 
151.25  statutory cities located therein, or the metropolitan airports 
151.26  commission, may, by ordinance, adopt local regulations providing 
151.27  for plumbing permits, bonds, approval of plans, and inspections 
151.28  of plumbing, which regulations are not in conflict with the 
151.29  plumbing standards on the same subject prescribed by the state 
151.30  commissioner of health.  No city or such town shall prohibit 
151.31  plumbers licensed by the state commissioner of health from 
151.32  engaging in or working at the business, except cities and 
151.33  statutory cities which, prior to April 21, 1933, by ordinance 
151.34  required the licensing of plumbers.  No city or such town shall 
151.35  require a license for persons performing building sewer or water 
151.36  service installation who have completed pipe laying training as 
152.1   prescribed by the state commissioner of health.  Any city by 
152.2   ordinance may prescribe regulations, reasonable standards, and 
152.3   inspections and grant permits to any person, firm, or 
152.4   corporation engaged in the business of installing water 
152.5   softeners, who is not licensed as a master plumber or journeyman 
152.6   plumber by the state commissioner of health, to connect water 
152.7   softening and water filtering equipment to private residence 
152.8   water distribution systems, where provision has been previously 
152.9   made therefor and openings left for that purpose or by use of 
152.10  cold water connections to a domestic water heater; where it is 
152.11  not necessary to rearrange, make any extension or alteration of, 
152.12  or addition to any pipe, fixture or plumbing connected with the 
152.13  water system except to connect the water softener, and provided 
152.14  the connections so made comply with minimum standards prescribed 
152.15  by the state commissioner of health. 
152.16     [EFFECTIVE DATE.] This section is effective July 1, 2003.  
152.17     Sec. 22.  Minnesota Statutes 2000, section 326.40, 
152.18  subdivision 1, is amended to read: 
152.19     Subdivision 1.  [PLUMBERS MUST BE LICENSED IN CERTAIN 
152.20  CITIES; MASTER AND JOURNEYMAN PLUMBERS MASTER, JOURNEYMAN, AND 
152.21  RESTRICTED PLUMBING CONTRACTORS; PLUMBING ON ONE'S OWN PREMISES; 
152.22  RULES FOR EXAMINATION.] In any city now or hereafter having 
152.23  5,000 or more population, according to the last federal census, 
152.24  and having a system of waterworks or sewerage, no person, firm, 
152.25  or corporation shall engage in or work at the business of a 
152.26  master plumber or journeyman plumber unless licensed to do so by 
152.27  the state commissioner of health.  No person, firm, or 
152.28  corporation shall engage in or work at the business of a master 
152.29  plumber, restricted plumbing contractor, or journeyman plumber 
152.30  unless licensed to do so by the state commissioner of health 
152.31  under sections 326.37 to 326.451.  A license is not required for:
152.32     (1) persons performing building sewer or water service 
152.33  installation who have completed pipe laying training as 
152.34  prescribed by the commissioner of health; or 
152.35     (2) persons selling an appliance plumbing installation 
152.36  service at point of sale if the installation work is performed 
153.1   by a plumber licensed under sections 326.37 to 326.451.  
153.2      A master plumber may also work as a journeyman plumber.  
153.3   Anyone not so licensed may do plumbing work which complies with 
153.4   the provisions of the minimum standard prescribed by the state 
153.5   commissioner of health on premises or that part of premises 
153.6   owned and actually occupied by the worker as a residence, unless 
153.7   otherwise forbidden to do so by a local ordinance. 
153.8      In any such city No person, firm, or corporation shall 
153.9   engage in the business of installing plumbing nor install 
153.10  plumbing in connection with the dealing in and selling of 
153.11  plumbing material and supplies unless at all times a licensed 
153.12  master plumber or restricted plumbing contractor, who shall be 
153.13  responsible for proper installation, is in charge of the 
153.14  plumbing work of the person, firm, or corporation. 
153.15     The department of health shall prescribe rules, not 
153.16  inconsistent herewith, for the examination and licensing of 
153.17  plumbers. 
153.18     [EFFECTIVE DATE.] This section is effective July 1, 2003.  
153.19     Sec. 23.  [326.402] [RESTRICTED PLUMBING CONTRACTOR 
153.20  LICENSE.] 
153.21     Subdivision 1.  [LICENSURE.] The commissioner shall grant a 
153.22  restricted plumbing contractor license to any person who applies 
153.23  to the commissioner and provides evidence of having at least two 
153.24  years of practical plumbing experience in the plumbing trade 
153.25  preceding application for licensure. 
153.26     Subd. 2.  [USE OF LICENSE.] A restricted plumbing 
153.27  contractor may engage in the plumbing trade only in cities and 
153.28  towns with a population of fewer than 5,000 according to federal 
153.29  census. 
153.30     Subd. 3.  [APPLICATION PERIOD.] Applications for restricted 
153.31  plumbing contractor licenses must be submitted to the 
153.32  commissioner prior to January 1, 2004. 
153.33     Subd. 4.  [USE PERIOD FOR RESTRICTED PLUMBING CONTRACTOR 
153.34  LICENSE.] A restricted plumbing contractor license does not 
153.35  expire and remains in effect for as long as that person engages 
153.36  in the plumbing trade. 
154.1      Subd. 5.  [PROHIBITION OF TRANSFERENCE.] A restricted 
154.2   plumbing contractor license must not be transferred or sold to 
154.3   any other person. 
154.4      Subd. 6.  [RESTRICTED PLUMBING CONTRACTOR LICENSE RENEWAL.] 
154.5   The commissioner shall adopt rules for renewal of the restricted 
154.6   plumbing contractor license. 
154.7      [EFFECTIVE DATE.] This section is effective July 1, 2003.  
154.8      Sec. 24.  [326.451] [INSPECTORS.] 
154.9      (a) The commissioner shall set all reasonable criteria and 
154.10  procedures by rule for inspector certification, certification 
154.11  period, examinations, examination fees, certification fees, and 
154.12  renewal of certifications. 
154.13     (b) The commissioner shall adopt reasonable rules 
154.14  establishing criteria and procedures for refusal to grant or 
154.15  renew inspector certifications, and for suspension and 
154.16  revocation of inspector certifications. 
154.17     (c) The commissioner shall refuse to renew or grant 
154.18  inspector certifications, or suspend or revoke inspector 
154.19  certifications, in accordance with the commissioner's criteria 
154.20  and procedures as adopted by rule.  
154.21     [EFFECTIVE DATE.] This section is effective July 1, 2003. 
154.22     Sec. 25.  [CASE MANAGEMENT STUDY.] 
154.23     The commissioner of human services, in consultation with 
154.24  consumers, providers, consumer advocates, and local social 
154.25  service agencies, shall study case management services for 
154.26  persons with disabilities.  The commissioner must report to the 
154.27  chairs and ranking minority members of the senate and the house 
154.28  of representatives committees having jurisdiction over human 
154.29  services issues by January 15, 2003, on strategies that: 
154.30     (1) streamline administration; 
154.31     (2) improve case management service availability across the 
154.32  state; 
154.33     (3) enhance consumer access to needed services and 
154.34  supports; 
154.35     (4) improve accountability and the use of performance 
154.36  measures; 
155.1      (5) provide for consumer choice of vendor; and 
155.2      (6) improve the financing of case management services. 
155.3      [EFFECTIVE DATE.] This section is effective the day 
155.4   following final enactment. 
155.5      Sec. 26.  [REVISOR INSTRUCTION.] 
155.6      The revisor of statutes shall change all references to 
155.7   section 326.45 to section 326.451 in Minnesota Statutes, 
155.8   sections 144.99, 326.44, 326.61, and 326.65. 
155.9      [EFFECTIVE DATE.] This section is effective July 1, 2003.  
155.10     Sec. 27.  [REPEALER.] 
155.11     Minnesota Statutes 2000, section 326.45, is repealed. 
155.12     [EFFECTIVE DATE.] This section is effective July 1, 2003. 
155.13                             ARTICLE 3 
155.14                                TANF
155.15     Section 1.  Minnesota Statutes 2001 Supplement, section 
155.16  256J.425, is amended by adding a subdivision to read: 
155.17     Subd. 1b.  [TEMPORARY EXTENSION.] (a) A temporary extension 
155.18  on assistance applies to participants who are: 
155.19     (i) not in sanction status in the 60th month of receiving 
155.20  assistance and are following the work search and other 
155.21  requirements in their plan; and 
155.22     (ii) have not obtained sufficient employment that results 
155.23  in a wage that is equal to or exceeds 120 percent of the federal 
155.24  poverty guidelines for a family of the same size. 
155.25     (b) All notices and information provided to participants 
155.26  under this chapter related to the 60-month time limit must 
155.27  include an explanation of the extension of the 60-month time 
155.28  limit under paragraph (a). 
155.29     (c) This subdivision expires on June 30, 2004. 
155.30     Sec. 2.  Minnesota Statutes 2001 Supplement, section 
155.31  256J.425, subdivision 3, is amended to read: 
155.32     Subd. 3.  [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 
155.33  subject to the time limit in section 256J.42, subdivision 1, in 
155.34  which any participant has received 60 counted months of 
155.35  assistance, is eligible to receive months of assistance under a 
155.36  hardship extension if the participant belongs to any of the 
156.1   following groups: 
156.2      (1) a person who is diagnosed by a licensed physician, 
156.3   psychological practitioner, or other qualified professional, as 
156.4   mentally retarded or mentally ill, and that condition prevents 
156.5   the person from obtaining or retaining unsubsidized employment; 
156.6      (2) a person who: 
156.7      (i) has been assessed by a vocational specialist or the 
156.8   county agency to be unemployable for purposes of this 
156.9   subdivision; or 
156.10     (ii) has an IQ below 80 who has been assessed by a 
156.11  vocational specialist or a county agency to be employable, but 
156.12  not at a level that makes the participant eligible for an 
156.13  extension under subdivision 4 or, in the case of a 
156.14  non-English-speaking person for whom it is not possible to 
156.15  provide a determination due to language barriers or absence of 
156.16  culturally appropriate assessment tools, is determined by a 
156.17  qualified professional to have an IQ below 80.  A person is 
156.18  considered employable if positions of employment in the local 
156.19  labor market exist, regardless of the current availability of 
156.20  openings for those positions, that the person is capable of 
156.21  performing; or 
156.22     (3) a person who is determined by the county agency to be 
156.23  learning disabled or, in the case of a non-English-speaking 
156.24  person for whom it is not possible to provide a medical 
156.25  diagnosis due to language barriers or absence of culturally 
156.26  appropriate assessment tools, is determined by a qualified 
156.27  professional to have a learning disability.  If a rehabilitation 
156.28  plan for the person is developed or approved by the county 
156.29  agency, the plan must be incorporated into the employment plan.  
156.30  However, a rehabilitation plan does not replace the requirement 
156.31  to develop and comply with an employment plan under section 
156.32  256J.52.  For purposes of this section, "learning disabled" 
156.33  means the applicant or recipient has a disorder in one or more 
156.34  of the psychological processes involved in perceiving, 
156.35  understanding, or using concepts through verbal language or 
156.36  nonverbal means.  The disability must severely limit the 
157.1   applicant or recipient in obtaining, performing, or maintaining 
157.2   suitable employment.  Learning disabled does not include 
157.3   learning problems that are primarily the result of visual, 
157.4   hearing, or motor handicaps; mental retardation; emotional 
157.5   disturbance; or due to environmental, cultural, or economic 
157.6   disadvantage.; or 
157.7      (4) a person who is a victim of family violence as defined 
157.8   in section 256J.49, subdivision 2, and who is participating in 
157.9   an alternative employment plan under section 256J.49, 
157.10  subdivision 1a.  
157.11     Sec. 3.  Minnesota Statutes 2001 Supplement, section 
157.12  256J.425, subdivision 4, is amended to read: 
157.13     Subd. 4.  [EMPLOYED PARTICIPANTS.] (a) An assistance unit 
157.14  subject to the time limit under section 256J.42, subdivision 1, 
157.15  in which any participant has received 60 months of assistance, 
157.16  is eligible to receive assistance under a hardship extension if 
157.17  the participant belongs to: 
157.18     (1) a one-parent assistance unit in which the participant 
157.19  is participating in work activities for at least 30 hours per 
157.20  week, of which an average of at least 25 hours per week every 
157.21  month are spent participating in employment; or 
157.22     (2) a two-parent assistance unit in which the participants 
157.23  are participating in work activities for at least 55 hours per 
157.24  week, of which an average of at least 45 hours per week every 
157.25  month are spent participating in employment.; or 
157.26     (3) an assistance unit in which a participant is 
157.27  participating in employment for fewer hours than those specified 
157.28  in clause (1), provided the participant submits verification 
157.29  from a health care provider, in a form acceptable to the 
157.30  commissioner, stating that the number of hours the participant 
157.31  may work is limited due to illness or disability, as long as the 
157.32  participant is participating in employment for at least the 
157.33  number of hours specified by the health care provider.  The 
157.34  participant must be following the treatment recommendations of 
157.35  the health care provider providing the verification.  The 
157.36  commissioner shall develop a form to be completed and signed by 
158.1   the health care provider, documenting the diagnosis and any 
158.2   additional information necessary to document the functional 
158.3   limitations of the participant that limit work hours.  If the 
158.4   participant is part of a two-parent assistance unit, the other 
158.5   parent must be treated as a one-parent assistance unit for 
158.6   purposes of meeting the work requirements under this subdivision.
158.7      For purposes of this section, employment means: 
158.8      (1) unsubsidized employment under section 256J.49, 
158.9   subdivision 13, clause (1); 
158.10     (2) subsidized employment under section 256J.49, 
158.11  subdivision 13, clause (2); 
158.12     (3) on-the-job training under section 256J.49, subdivision 
158.13  13, clause (4); 
158.14     (4) an apprenticeship under section 256J.49, subdivision 
158.15  13, clause (19); 
158.16     (5) supported work.  For purposes of this section, 
158.17  "supported work" means services supporting a participant on the 
158.18  job which include, but are not limited to, supervision, job 
158.19  coaching, and subsidized wages; 
158.20     (6) a combination of (1) to (5); or 
158.21     (7) child care under section 256J.49, subdivision 13, 
158.22  clause (25), if it is in combination with paid employment. 
158.23     (b) If a participant is complying with a child protection 
158.24  plan under chapter 260C, the number of hours required under the 
158.25  child protection plan count toward the number of hours required 
158.26  under this subdivision.  
158.27     (c) The county shall provide the opportunity for subsidized 
158.28  employment to participants needing that type of employment 
158.29  within available appropriations. 
158.30     (d) To be eligible for a hardship extension for employed 
158.31  participants under this subdivision, a participant in a 
158.32  one-parent assistance unit or both parents in a two-parent 
158.33  assistance unit must be in compliance for at least ten out of 
158.34  the 12 months immediately preceding the participant's 61st month 
158.35  on assistance.  If only one parent in a two-parent assistance 
158.36  unit fails to be in compliance ten out of the 12 months 
159.1   immediately preceding the participant's 61st month, the county 
159.2   shall give the assistance unit the option of disqualifying the 
159.3   noncompliant parent.  If the noncompliant participant is 
159.4   disqualified, the assistance unit must be treated as a 
159.5   one-parent assistance unit for the purposes of meeting the work 
159.6   requirements under this subdivision and the assistance unit's 
159.7   MFIP grant shall be calculated using the shared household 
159.8   standard under section 256J.08, subdivision 82a. 
159.9      (e) The employment plan developed under section 256J.52, 
159.10  subdivision 5, for participants under this subdivision must 
159.11  contain the number of hours specified in paragraph (a) related 
159.12  to employment and work activities.  The job counselor and the 
159.13  participant must sign the employment plan to indicate agreement 
159.14  between the job counselor and the participant on the contents of 
159.15  the plan. 
159.16     (f) Participants who fail to meet the requirements in 
159.17  paragraph (a), without good cause under section 256J.57, shall 
159.18  be sanctioned or permanently disqualified under subdivision 6.  
159.19  Good cause may only be granted for that portion of the month for 
159.20  which the good cause reason applies.  Participants must meet all 
159.21  remaining requirements in the approved employment plan or be 
159.22  subject to sanction or permanent disqualification.  
159.23     (g) If the noncompliance with an employment plan is due to 
159.24  the involuntary loss of employment, the participant is exempt 
159.25  from the hourly employment requirement under this subdivision 
159.26  for one month.  Participants must meet all remaining 
159.27  requirements in the approved employment plan or be subject to 
159.28  sanction or permanent disqualification.  This exemption is 
159.29  available to one-parent assistance units two times in a 12-month 
159.30  period, and two-parent assistance units, two times per parent in 
159.31  a 12-month period. 
159.32     (h) This subdivision expires on June 30, 2004. 
159.33     Sec. 4.  Minnesota Statutes 2001 Supplement, section 
159.34  256J.425, subdivision 5, is amended to read: 
159.35     Subd. 5.  [ACCRUAL OF CERTAIN EXEMPT MONTHS.] (a) A 
159.36  participant who received TANF assistance that counted towards 
160.1   the federal 60-month time limit while the participant was exempt 
160.2   under section 256J.56, paragraph (a), clause (7), from 
160.3   employment and training services requirements and who is no 
160.4   longer eligible for assistance under a hardship extension under 
160.5   subdivision 2, paragraph (a), clause (3), is eligible for 
160.6   assistance under a hardship extension for a period of time equal 
160.7   to the number of months that were counted toward the federal 
160.8   60-month time limit while the participant was exempt under 
160.9   section 256J.56, paragraph (a), clause (7), from the employment 
160.10  and training services requirements. 
160.11     (b) A participant who received TANF assistance that counted 
160.12  towards the federal 60-month time limit while the participant 
160.13  met the state time limit exemption criteria under section 
160.14  256J.42, subdivision 4 or 5, is eligible for assistance under a 
160.15  hardship extension for a period of time equal to the number of 
160.16  months that were counted toward the federal 60-month time limit 
160.17  while the participant met the state time limit exemption 
160.18  criteria under section 256J.42, subdivision 5. 
160.19     (c) A participant who received TANF assistance that counted 
160.20  towards the federal 60-month time limit while the participant 
160.21  was exempt under section 256J.56, paragraph (a), clause (3), 
160.22  from employment and training services requirements, who 
160.23  demonstrates at the time of the case review required under 
160.24  section 256J.42, subdivision 6, that the participant met the 
160.25  criteria for exemption from employment and training services 
160.26  requirements listed under section 256J.56, paragraph (a), clause 
160.27  (7), during one or more months the participant was exempt under 
160.28  section 256J.56, paragraph (a), clause (3), before or after July 
160.29  1, 2000, is eligible for assistance under a hardship extension 
160.30  for a period of time equal to the number of months that were 
160.31  counted toward the federal 60-month time limit during the time 
160.32  the participant met the criteria of section 256J.56, paragraph 
160.33  (a), clause (7).  At the time of the case review required under 
160.34  section 256J.42, subdivision 6, a county agency or job counselor 
160.35  must explain to the participant the basis for receiving a 
160.36  hardship extension based on the accrual of exempt months.  The 
161.1   participant must document the information necessary to enable 
161.2   the county agency or job counselor to determine whether the 
161.3   participant is eligible to receive a hardship extension based on 
161.4   the accrual of exempt months or authorize the county agency to 
161.5   verify the information. 
161.6      Sec. 5.  Minnesota Statutes 2001 Supplement, section 
161.7   256J.425, subdivision 6, is amended to read: 
161.8      Subd. 6.  [SANCTIONS FOR EXTENDED CASES.] (a) If one or 
161.9   both participants in an assistance unit receiving assistance 
161.10  under subdivision 1b, 3, or 4 are not in compliance with the 
161.11  employment and training service requirements in sections 256J.52 
161.12  to 256J.55, the sanctions under this subdivision apply.  For a 
161.13  first occurrence of noncompliance, an assistance unit must be 
161.14  sanctioned under section 256J.46, subdivision 1, paragraph (d), 
161.15  clause (1).  For a second or third occurrence of noncompliance, 
161.16  the assistance unit must be sanctioned under section 256J.46, 
161.17  subdivision 1, paragraph (d), clause (2).  For 
161.18     (b) Beginning July 1, 2004, and for fourth occurrences of 
161.19  noncompliance that occur on or after July 1, 2004, a fourth 
161.20  occurrence of noncompliance, results in the assistance unit is 
161.21  being disqualified from MFIP.  If a participant is determined to 
161.22  be out of compliance, the participant may claim a good cause 
161.23  exception under section 256J.57, however, the participant may 
161.24  not claim an exemption under section 256J.56.  
161.25     (b) (c) If both participants in a two-parent assistance 
161.26  unit are out of compliance at the same time, it is considered 
161.27  one occurrence of noncompliance. 
161.28     Sec. 6.  [HEALTH AND HUMAN SERVICES WORKER PROGRAM.] 
161.29     The unobliged balance for the health care and human 
161.30  services worker training and retention program under Minnesota 
161.31  Statutes, section 116L.10, as of January 1, 2002, is canceled. 
161.32     Notwithstanding Laws 2000, chapter 488, article 1, section 
161.33  16, paragraph (c), unexpended TANF funds appropriated for the 
161.34  health care and human services worker training and retention 
161.35  program cancel at the end of each biennium. 
161.36     Sec. 7.  [PATHWAYS PROGRAM.] 
162.1      Temporary assistance to needy families funding for the 
162.2   pathways program under Laws 1999, chapter 223, article 1, 
162.3   section 2, subdivision 2, and Laws 2000, chapter 488, article 1, 
162.4   section 16, subdivision (b), is eliminated as of July 1, 2002. 
162.5      Sec. 8.  [FISCAL 2003 TANF MAINTENANCE OF EFFORT.] 
162.6      The commissioner of human services must assure that the 
162.7   maintenance of effort amount used in the MFIP forecast of 
162.8   November 2002 and February 2003 is not less than $188,937,000 
162.9   with respect to fiscal year 2003.  
162.10     Sec. 9.  [APPROPRIATION.] 
162.11     (a) $6,095,000 is appropriated from the federal TANF fund 
162.12  to the commissioner of human services for the biennium ending 
162.13  June 30, 2003, for purposes of sections 1 to 4.  Of this 
162.14  appropriation, $2,137,000 is for child care costs associated 
162.15  with sections 1 to 4.  The commissioner of human services shall 
162.16  transfer 80 percent of the child care funds, or $1,710,000, to 
162.17  the federal child care and development fund block grant, and the 
162.18  remaining funds shall be transferred to the federal child care 
162.19  and development fund block grant based on a demonstrated need by 
162.20  the commissioner of children, families, and learning. 
162.21     (b) $1,450,000 is appropriated from the federal TANF fund 
162.22  to the commissioner of human services for fiscal year 2003 to 
162.23  increase the amount of funds available for reallocation under 
162.24  Minnesota Statutes, section 256J.76, subdivision 4.  If funds 
162.25  available for reallocation are insufficient to reimburse those 
162.26  counties that have eligible expenditures in excess of their 
162.27  allocations, the funds available for reallocation must be 
162.28  apportioned among those counties with excess expenditures in 
162.29  proportion to their share of the excess expenditures.  These 
162.30  funds must become part of the fiscal year 2004-2005 base.