1st Engrossment - 83rd Legislature, 2003 1st Special Session (2003 - 2003) Posted on 12/15/2009 12:00am
Engrossments | ||
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Introduction | Posted on 05/20/2003 | |
1st Engrossment | Posted on 05/29/2003 |
1.1 A bill for an act 1.2 relating to state government; making changes to public 1.3 assistance programs, long-term care, continuing care 1.4 for persons with disabilities, children's services, 1.5 occupational licenses, human services licensing, 1.6 county initiatives, local public health grants, child 1.7 care provisions, child support provisions, and health 1.8 care; establishing the Community Services Act; 1.9 establishing alternative care liens; modifying 1.10 petroleum product specifications; conveying land in 1.11 Cass county; making forecast adjustments; 1.12 appropriating money; amending Minnesota Statutes 2002, 1.13 sections 13.69, subdivision 1; 41A.09, subdivision 2a; 1.14 61A.072, subdivision 6; 62A.31, subdivisions 1f, 1u, 1.15 by adding a subdivision; 62A.315; 62A.316; 62A.48, by 1.16 adding a subdivision; 62A.49, by adding a subdivision; 1.17 62A.65, subdivision 7; 62D.095, subdivision 2, by 1.18 adding a subdivision; 62E.06, subdivision 1; 62J.17, 1.19 subdivision 2; 62J.23, by adding a subdivision; 1.20 62J.52, subdivisions 1, 2; 62J.692, subdivisions 3, 4, 1.21 5, 7, 8; 62J.694, by adding a subdivision; 62L.05, 1.22 subdivision 4; 62Q.19, subdivisions 1, 2; 62S.22, 1.23 subdivision 1; 69.021, subdivision 11; 119B.011, 1.24 subdivisions 5, 6, 15, 19, 20, 21, by adding a 1.25 subdivision; 119B.02, subdivision 1; 119B.03, 1.26 subdivisions 4, 9; 119B.05, subdivision 1; 119B.08, 1.27 subdivision 3; 119B.09, subdivisions 1, 2, 7, by 1.28 adding subdivisions; 119B.11, subdivision 2a; 119B.12, 1.29 subdivision 2; 119B.13, subdivisions 1, 6, by adding a 1.30 subdivision; 119B.16, subdivision 2, by adding 1.31 subdivisions; 119B.19, subdivision 7; 119B.21, 1.32 subdivision 11; 119B.23, subdivision 3; 124D.23, 1.33 subdivision 1; 144.1222, by adding a subdivision; 1.34 144.125; 144.128; 144.1481, subdivision 1; 144.1483; 1.35 144.1488, subdivision 4; 144.1491, subdivision 1; 1.36 144.1502, subdivision 4; 144.396, subdivisions 1, 5, 1.37 7, 10, 11, 12; 144.414, subdivision 3; 144.551, 1.38 subdivision 1; 144A.04, subdivision 3, by adding a 1.39 subdivision; 144A.071, subdivision 4c, as added; 1.40 144A.10, by adding a subdivision; 144A.4605, 1.41 subdivision 4; 144E.11, subdivision 6; 144E.50, 1.42 subdivision 5; 145.88; 145.881, subdivisions 1, 2; 1.43 145.882, subdivisions 1, 2, 3, 7, by adding a 1.44 subdivision; 145.883, subdivisions 1, 9; 145A.02, 1.45 subdivisions 5, 6, 7; 145A.06, subdivision 1; 145A.09, 1.46 subdivisions 2, 4, 7; 145A.10, subdivisions 2, 10, by 2.1 adding a subdivision; 145A.11, subdivisions 2, 4; 2.2 145A.12, subdivisions 1, 2, by adding a subdivision; 2.3 145A.13, by adding a subdivision; 145A.14, subdivision 2.4 2, by adding a subdivision; 147A.08; 148.5194, 2.5 subdivisions 1, 2, 3, by adding a subdivision; 2.6 148.6445, subdivision 7; 148C.01, subdivisions 2, 12, 2.7 by adding subdivisions; 148C.03, subdivision 1; 2.8 148C.0351, subdivision 1, by adding a subdivision; 2.9 148C.04; 148C.05, subdivision 1, by adding 2.10 subdivisions; 148C.07; 148C.10, subdivisions 1, 2; 2.11 148C.11; 153A.17; 171.06, subdivision 3; 171.07, by 2.12 adding a subdivision; 174.30, subdivision 1; 239.761, 2.13 subdivisions 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13; 2.14 239.792; 245.0312; 245.4874; 245.493, subdivision 1a; 2.15 245A.035, subdivision 3; 245A.04, subdivisions 3, 3b, 2.16 3d; 245A.09, subdivision 7; 245A.10; 245A.11, 2.17 subdivisions 2a, 2b, by adding a subdivision; 245B.03, 2.18 subdivision 2, by adding a subdivision; 245B.04, 2.19 subdivision 2; 245B.06, subdivisions 2, 5, 8; 245B.07, 2.20 subdivisions 6, 9, 11; 245B.08, subdivision 1; 2.21 246.014; 246.015, subdivision 3; 246.018, subdivisions 2.22 2, 3, 4; 246.13; 246.15; 246.16; 246.54; 246.57, 2.23 subdivisions 1, 4, 6; 246.71, subdivisions 4, 5; 2.24 246B.02; 246B.03; 246B.04; 252.025, subdivision 7; 2.25 252.06; 252.27, subdivision 2a; 252.32, subdivisions 2.26 1, 1a, 3, 3c; 252.41, subdivision 3; 252.46, 2.27 subdivision 1; 253.015, subdivision 1; 253.017; 2.28 253.20; 253.26; 253B.02, subdivision 18a; 253B.04, 2.29 subdivision 1; 253B.05, subdivision 3; 253B.09, 2.30 subdivision 1; 256.01, subdivision 2; 256.012; 2.31 256.046, subdivision 1; 256.0471, subdivision 1; 2.32 256.476, subdivisions 1, 3, 4, 5, 11; 256.482, 2.33 subdivision 8; 256.955, subdivisions 2a, 3, by adding 2.34 a subdivision; 256.9657, subdivisions 1, 4, by adding 2.35 a subdivision; 256.969, subdivisions 2b, 3a, by adding 2.36 a subdivision; 256.975, by adding a subdivision; 2.37 256.98, subdivisions 3, 4, 8; 256.984, subdivision 1; 2.38 256B.055, by adding a subdivision; 256B.056, 2.39 subdivisions 1a, 1c, 3c, 6; 256B.057, subdivisions 1, 2.40 2, 3b, 9, 10; 256B.0595, subdivisions 1, 2, by adding 2.41 subdivisions; 256B.06, subdivision 4; 256B.061; 2.42 256B.0621, subdivisions 4, 7; 256B.0623, subdivisions 2.43 2, 4, 5, 6, 8; 256B.0625, subdivisions 5a, 9, 13, 17, 2.44 19c, 23, by adding subdivisions; 256B.0627, 2.45 subdivisions 1, 4, 9; 256B.0635, subdivisions 1, 2; 2.46 256B.064, subdivision 2; 256B.0911, subdivision 4d; 2.47 256B.0913, subdivisions 2, 4, 5, 6, 7, 8, 10, 12; 2.48 256B.0915, subdivision 3, by adding a subdivision; 2.49 256B.092, subdivisions 1a, 5, by adding a subdivision; 2.50 256B.0945, subdivisions 2, 4; 256B.095; 256B.0951, 2.51 subdivisions 1, 2, 3, 5, 7, 9; 256B.0952, subdivision 2.52 1; 256B.0953, subdivision 2; 256B.0955; 256B.15, 2.53 subdivisions 1, 1a, 2, 3, 4, by adding subdivisions; 2.54 256B.19, subdivision 1; 256B.195, subdivisions 3, 5; 2.55 256B.32, subdivision 1; 256B.431, subdivisions 2r, 32, 2.56 36, by adding subdivisions; 256B.434, subdivisions 4, 2.57 10; 256B.47, subdivision 2; 256B.49, subdivision 15; 2.58 256B.501, subdivision 1, by adding a subdivision; 2.59 256B.5012, by adding a subdivision; 256B.5013, by 2.60 adding a subdivision; 256B.5015; 256B.69, subdivisions 2.61 2, 4, 5, 5a, 5c, 6a, 6b, 8, by adding subdivisions; 2.62 256B.75; 256B.76; 256B.761; 256B.82; 256D.03, 2.63 subdivisions 3, 3a, 4; 256D.06, subdivision 2; 2.64 256D.44, subdivision 5; 256D.46, subdivisions 1, 3; 2.65 256D.48, subdivision 1; 256G.05, subdivision 2; 2.66 256I.02; 256I.04, subdivision 3; 256I.05, subdivisions 2.67 1, 1a, 7c; 256J.01, subdivision 5; 256J.02, 2.68 subdivision 2; 256J.021; 256J.08, subdivisions 35, 65, 2.69 82, 85, by adding subdivisions; 256J.09, subdivisions 2.70 2, 3, 3a, 3b, 8, 10; 256J.14; 256J.20, subdivision 3; 2.71 256J.21, subdivisions 1, 2; 256J.24, subdivisions 3, 3.1 5, 6, 7, 10; 256J.30, subdivision 9; 256J.32, 3.2 subdivisions 2, 4, 5a, by adding a subdivision; 3.3 256J.37, subdivision 9, by adding subdivisions; 3.4 256J.38, subdivisions 3, 4; 256J.40; 256J.42, 3.5 subdivisions 4, 5, 6; 256J.425, subdivisions 1, 1a, 2, 3.6 3, 4, 6, 7; 256J.45, subdivision 2; 256J.46, 3.7 subdivisions 1, 2, 2a; 256J.49, subdivisions 4, 5, 9, 3.8 13, by adding subdivisions; 256J.50, subdivisions 1, 3.9 9, 10; 256J.51, subdivisions 1, 2, 3, 4; 256J.53, 3.10 subdivisions 1, 2, 5; 256J.54, subdivisions 1, 2, 3, 3.11 5; 256J.55, subdivisions 1, 2; 256J.56; 256J.57; 3.12 256J.62, subdivision 9; 256J.645, subdivision 3; 3.13 256J.66, subdivision 2; 256J.69, subdivision 2; 3.14 256J.75, subdivision 3; 256J.751, subdivisions 1, 2, 3.15 5; 256L.03, subdivision 1; 256L.04, subdivisions 1, 3.16 10; 256L.05, subdivisions 3a, 4; 256L.06, subdivision 3.17 3; 256L.07, subdivisions 1, 3; 256L.12, subdivisions 3.18 6, 9, by adding a subdivision; 256L.15, subdivisions 3.19 1, 2, 3; 256L.17, subdivision 2; 257.05; 257.0769; 3.20 259.21, subdivision 6; 259.67, subdivisions 4, 7; 3.21 260B.157, subdivision 1; 260B.176, subdivision 2; 3.22 260B.178, subdivision 1; 260B.193, subdivision 2; 3.23 260B.235, subdivision 6; 260C.141, subdivision 2; 3.24 261.063; 295.53, subdivision 1; 295.55, subdivision 2; 3.25 296A.01, subdivisions 2, 7, 8, 14, 19, 20, 22, 23, 24, 3.26 25, 26, 28, by adding a subdivision; 297I.15, 3.27 subdivisions 1, 4; 326.42; 393.07, subdivisions 1, 5, 3.28 10; 471.59, subdivision 1; 514.981, subdivision 6; 3.29 518.167, subdivision 1; 518.551, subdivisions 7, 12, 3.30 13; 518.6111, subdivisions 2, 3, 4, 16; 524.3-805; 3.31 626.559, subdivision 5; 641.15, subdivision 2; Laws 3.32 1997, chapter 203, article 9, section 21, as amended; 3.33 Laws 1997, chapter 245, article 2, section 11; 2003 3.34 S.F. No. 1019, sections 2, 3, 7, if enacted; proposing 3.35 coding for new law in Minnesota Statutes, chapters 3.36 62J; 62Q; 62S; 97A; 119B; 144; 144A; 145; 145A; 148C; 3.37 245; 246; 256; 256B; 256I; 256J; 256L; 514; proposing 3.38 coding for new law as Minnesota Statutes, chapter 3.39 256M; repealing Minnesota Statutes 2002, sections 3.40 62J.15; 62J.152; 62J.451; 62J.452; 62J.66; 62J.68; 3.41 119B.061; 119B.13, subdivision 2; 144.126; 144.1484; 3.42 144.1494; 144.1495; 144.1496; 144.1497; 144.401; 3.43 144A.071, subdivision 5; 144A.35; 144A.36; 144A.38; 3.44 145.882, subdivisions 4, 5, 6, 8; 145.883, 3.45 subdivisions 4, 7; 145.884; 145.885; 145.886; 145.888; 3.46 145.889; 145.890; 145A.02, subdivisions 9, 10, 11, 12, 3.47 13, 14; 145A.09, subdivision 6; 145A.10, subdivisions 3.48 5, 6, 8; 145A.11, subdivision 3; 145A.12, subdivisions 3.49 3, 4, 5; 145A.14, subdivisions 3, 4; 145A.17, 3.50 subdivision 2; 148.5194, subdivision 3a; 148.6445, 3.51 subdivision 9; 148C.0351, subdivision 2; 148C.05, 3.52 subdivisions 2, 3, 4; 148C.06; 148C.10, subdivision 3.53 1a; 245.478; 245.4886; 245.4888; 245.496; 246.017, 3.54 subdivision 2; 246.022; 246.06; 246.07; 246.08; 3.55 246.11; 246.19; 246.42; 252.025, subdivisions 1, 2, 4, 3.56 5, 6; 252.032; 252.10; 252.32, subdivision 2; 253.015, 3.57 subdivisions 2, 3; 253.10; 253.19; 253.201; 253.202; 3.58 253.25; 253.27; 254A.17; 256.05; 256.06; 256.08; 3.59 256.09; 256.10; 256.955, subdivision 8; 256.973; 3.60 256.9772; 256B.055, subdivision 10a; 256B.057, 3.61 subdivision 1b; 256B.0625, subdivisions 35, 36; 3.62 256B.0945, subdivision 10; 256B.437, subdivision 2; 3.63 256B.5013, subdivision 4; 256E.01; 256E.02; 256E.03; 3.64 256E.04; 256E.05; 256E.06; 256E.07; 256E.08; 256E.081; 3.65 256E.09; 256E.10; 256E.11; 256E.115; 256E.13; 256E.14; 3.66 256E.15; 256F.01; 256F.02; 256F.03; 256F.04; 256F.05; 3.67 256F.06; 256F.07; 256F.08; 256F.11; 256F.12; 256F.14; 3.68 256J.02, subdivision 3; 256J.08, subdivisions 28, 70; 3.69 256J.24, subdivision 8; 256J.30, subdivision 10; 3.70 256J.462; 256J.47; 256J.48; 256J.49, subdivisions 1a, 3.71 2, 6, 7; 256J.50, subdivisions 2, 3, 3a, 5, 7; 4.1 256J.52; 256J.55, subdivision 5; 256J.62, subdivisions 4.2 1, 2a, 4, 6, 7, 8; 256J.625; 256J.655; 256J.74, 4.3 subdivision 3; 256J.751, subdivisions 3, 4; 256J.76; 4.4 256K.30; 257.075; 257.81; 260.152; 268A.08; 626.562; 4.5 Laws 1998, chapter 407, article 4, section 63; Laws 4.6 2000, chapter 488, article 10, section 29; Laws 2000, 4.7 chapter 489, article 1, section 36; Laws 2001, First 4.8 Special Session chapter 3, article 1, section 16; Laws 4.9 2001, First Special Session chapter 9, article 13, 4.10 section 24; Laws 2002, chapter 374, article 9, section 4.11 8; Laws 2003, chapter 55, sections 1, 4; Minnesota 4.12 Rules, parts 4705.0100; 4705.0200; 4705.0300; 4.13 4705.0400; 4705.0500; 4705.0600; 4705.0700; 4705.0800; 4.14 4705.0900; 4705.1000; 4705.1100; 4705.1200; 4705.1300; 4.15 4705.1400; 4705.1500; 4705.1600; 4736.0010; 4736.0020; 4.16 4736.0030; 4736.0040; 4736.0050; 4736.0060; 4736.0070; 4.17 4736.0080; 4736.0090; 4736.0120; 4736.0130; 4747.0030, 4.18 subparts 25, 28, 30; 4747.0040, subpart 3, item A; 4.19 4747.0060, subpart 1, items A, B, D; 4747.0070, 4.20 subparts 4, 5; 4747.0080; 4747.0090; 4747.0100; 4.21 4747.0300; 4747.0400, subparts 2, 3; 4747.0500; 4.22 4747.0600; 4747.1000; 4747.1100, subpart 3; 4747.1600; 4.23 4763.0100; 4763.0110; 4763.0125; 4763.0135; 4763.0140; 4.24 4763.0150; 4763.0160; 4763.0170; 4763.0180; 4763.0190; 4.25 4763.0205; 4763.0215; 4763.0220; 4763.0230; 4763.0240; 4.26 4763.0250; 4763.0260; 4763.0270; 4763.0285; 4763.0295; 4.27 4763.0300; 9505.0324; 9505.0326; 9505.0327; 9505.3045; 4.28 9505.3050; 9505.3055; 9505.3060; 9505.3068; 9505.3070; 4.29 9505.3075; 9505.3080; 9505.3090; 9505.3095; 9505.3100; 4.30 9505.3105; 9505.3107; 9505.3110; 9505.3115; 9505.3120; 4.31 9505.3125; 9505.3130; 9505.3138; 9505.3139; 9505.3140; 4.32 9505.3680; 9505.3690; 9505.3700; 9545.2000; 9545.2010; 4.33 9545.2020; 9545.2030; 9545.2040; 9550.0010; 9550.0020; 4.34 9550.0030; 9550.0040; 9550.0050; 9550.0060; 9550.0070; 4.35 9550.0080; 9550.0090; 9550.0091; 9550.0092; 9550.0093. 4.36 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 4.37 ARTICLE 1 4.38 WELFARE REFORM 4.39 Section 1. Minnesota Statutes 2002, section 119B.03, 4.40 subdivision 4, is amended to read: 4.41 Subd. 4. [FUNDING PRIORITY.] (a) First priority for child 4.42 care assistance under the basic sliding fee program must be 4.43 given to eligible non-MFIP families who do not have a high 4.44 school or general equivalency diploma or who need remedial and 4.45 basic skill courses in order to pursue employment or to pursue 4.46 education leading to employment and who need child care 4.47 assistance to participate in the education program. Within this 4.48 priority, the following subpriorities must be used: 4.49 (1) child care needs of minor parents; 4.50 (2) child care needs of parents under 21 years of age; and 4.51 (3) child care needs of other parents within the priority 4.52 group described in this paragraph. 4.53 (b) Second priority must be given to parents who have 5.1 completed their MFIP or work first transition year, or parents 5.2 who are no longer receiving or eligible for diversionary work 5.3 program supports. 5.4 (c) Third priority must be given to families who are 5.5 eligible for portable basic sliding fee assistance through the 5.6 portability pool under subdivision 9. 5.7 Sec. 2. Minnesota Statutes 2002, section 256.984, 5.8 subdivision 1, is amended to read: 5.9 Subdivision 1. [DECLARATION.] Every application for public 5.10 assistance under this chapterand/oror chapters 256B, 256D, 5.11256K, MFIP program256J, and food stamps or food support under 5.12 chapter 393 shall be in writing or reduced to writing as 5.13 prescribed by the state agency and shall contain the following 5.14 declaration which shall be signed by the applicant: 5.15 "I declare under the penalties of perjury that this 5.16 application has been examined by me and to the best of my 5.17 knowledge is a true and correct statement of every material 5.18 point. I understand that a person convicted of perjury may 5.19 be sentenced to imprisonment of not more than five years or 5.20 to payment of a fine of not more than $10,000, or both." 5.21 Sec. 3. Minnesota Statutes 2002, section 256D.06, 5.22 subdivision 2, is amended to read: 5.23 Subd. 2. [EMERGENCY NEED.] Notwithstanding the provisions 5.24 of subdivision 1, a grant of emergency general assistance shall, 5.25 to the extent funds are available, be made to an eligible single 5.26 adult, married couple, or family for an emergency need, as 5.27 defined in rules promulgated by the commissioner, where the 5.28 recipient requests temporary assistance not exceeding 30 days if 5.29 an emergency situation appears to exist and(a) until March 31,5.301998, the individual is ineligible for the program of emergency5.31assistance under aid to families with dependent children and is5.32not a recipient of aid to families with dependent children at5.33the time of application; or (b)the individual or family is(i)5.34 ineligible for MFIP or DWP or is not a participant of MFIP; and5.35(ii) is ineligible for emergency assistance under section5.36256J.48or DWP. If an applicant or recipient relates facts to 6.1 the county agency which may be sufficient to constitute an 6.2 emergency situation, the county agency shall, to the extent 6.3 funds are available, advise the person of the procedure for 6.4 applying for assistance according to this subdivision. An 6.5 emergency general assistance grant is available to a recipient 6.6 not more than once in any 12-month period. Funding for an 6.7 emergency general assistance program is limited to the 6.8 appropriation. Each fiscal year, the commissioner shall 6.9 allocate to counties the money appropriated for emergency 6.10 general assistance grants based on each county agency's average 6.11 share of state's emergency general expenditures for the 6.12 immediate past three fiscal years as determined by the 6.13 commissioner, and may reallocate any unspent amounts to other 6.14 counties. Any emergency general assistance expenditures by a 6.15 county above the amount of the commissioner's allocation to the 6.16 county must be made from county funds. 6.17 Sec. 4. Minnesota Statutes 2002, section 256D.44, 6.18 subdivision 5, is amended to read: 6.19 Subd. 5. [SPECIAL NEEDS.] In addition to the state 6.20 standards of assistance established in subdivisions 1 to 4, 6.21 payments are allowed for the following special needs of 6.22 recipients of Minnesota supplemental aid who are not residents 6.23 of a nursing home, a regional treatment center, or a group 6.24 residential housing facility. 6.25 (a) The county agency shall pay a monthly allowance for 6.26 medically prescribed dietspayable under the Minnesota family6.27investment programif the cost of those additional dietary needs 6.28 cannot be met through some other maintenance benefit. The need 6.29 for special diets or dietary items must be prescribed by a 6.30 licensed physician. Costs for special diets shall be determined 6.31 as percentages of the allotment for a one-person household under 6.32 the thrifty food plan as defined by the United States Department 6.33 of Agriculture. The types of diets and the percentages of the 6.34 thrifty food plan that are covered are as follows: 6.35 (1) high protein diet, at least 80 grams daily, 25 percent 6.36 of thrifty food plan; 7.1 (2) controlled protein diet, 40 to 60 grams and requires 7.2 special products, 100 percent of thrifty food plan; 7.3 (3) controlled protein diet, less than 40 grams and 7.4 requires special products, 125 percent of thrifty food plan; 7.5 (4) low cholesterol diet, 25 percent of thrifty food plan; 7.6 (5) high residue diet, 20 percent of thrifty food plan; 7.7 (6) pregnancy and lactation diet, 35 percent of thrifty 7.8 food plan; 7.9 (7) gluten-free diet, 25 percent of thrifty food plan; 7.10 (8) lactose-free diet, 25 percent of thrifty food plan; 7.11 (9) antidumping diet, 15 percent of thrifty food plan; 7.12 (10) hypoglycemic diet, 15 percent of thrifty food plan; or 7.13 (11) ketogenic diet, 25 percent of thrifty food plan. 7.14 (b) Payment for nonrecurring special needs must be allowed 7.15 for necessary home repairs or necessary repairs or replacement 7.16 of household furniture and appliances using the payment standard 7.17 of the AFDC program in effect on July 16, 1996, for these 7.18 expenses, as long as other funding sources are not available. 7.19 (c) A fee for guardian or conservator service is allowed at 7.20 a reasonable rate negotiated by the county or approved by the 7.21 court. This rate shall not exceed five percent of the 7.22 assistance unit's gross monthly income up to a maximum of $100 7.23 per month. If the guardian or conservator is a member of the 7.24 county agency staff, no fee is allowed. 7.25 (d) The county agency shall continue to pay a monthly 7.26 allowance of $68 for restaurant meals for a person who was 7.27 receiving a restaurant meal allowance on June 1, 1990, and who 7.28 eats two or more meals in a restaurant daily. The allowance 7.29 must continue until the person has not received Minnesota 7.30 supplemental aid for one full calendar month or until the 7.31 person's living arrangement changes and the person no longer 7.32 meets the criteria for the restaurant meal allowance, whichever 7.33 occurs first. 7.34 (e) A fee of ten percent of the recipient's gross income or 7.35 $25, whichever is less, is allowed for representative payee 7.36 services provided by an agency that meets the requirements under 8.1 SSI regulations to charge a fee for representative payee 8.2 services. This special need is available to all recipients of 8.3 Minnesota supplemental aid regardless of their living 8.4 arrangement. 8.5 (f) Notwithstanding the language in this subdivision, an 8.6 amount equal to the maximum allotment authorized by the federal 8.7 Food Stamp Program for a single individual which is in effect on 8.8 the first day of January of the previous year will be added to 8.9 the standards of assistance established in subdivisions 1 to 4 8.10 for individuals under the age of 65 who are relocating from an 8.11 institution and who are shelter needy. An eligible individual 8.12 who receives this benefit prior to age 65 may continue to 8.13 receive the benefit after the age of 65. 8.14 "Shelter needy" means that the assistance unit incurs 8.15 monthly shelter costs that exceed 40 percent of the assistance 8.16 unit's gross income before the application of this special needs 8.17 standard. "Gross income" for the purposes of this section is 8.18 the applicant's or recipient's income as defined in section 8.19 256D.35, subdivision 10, or the standard specified in 8.20 subdivision 3, whichever is greater. A recipient of a federal 8.21 or state housing subsidy, that limits shelter costs to a 8.22 percentage of gross income, shall not be considered shelter 8.23 needy for purposes of this paragraph. 8.24 Sec. 5. Minnesota Statutes 2002, section 256D.46, 8.25 subdivision 1, is amended to read: 8.26 Subdivision 1. [ELIGIBILITY.] A county agency must grant 8.27 emergency Minnesota supplemental aidmust be granted, to the 8.28 extent funds are available, if the recipient is without adequate 8.29 resources to resolve an emergency that, if unresolved, will 8.30 threaten the health or safety of the recipient. For the 8.31 purposes of this section, the term "recipient" includes persons 8.32 for whom a group residential housing benefit is being paid under 8.33 sections 256I.01 to 256I.06. 8.34 Sec. 6. Minnesota Statutes 2002, section 256D.46, 8.35 subdivision 3, is amended to read: 8.36 Subd. 3. [PAYMENT AMOUNT.] The amount of assistance 9.1 granted under emergency Minnesota supplemental aid is limited to 9.2 the amount necessary to resolve the emergency. An emergency 9.3 Minnesota supplemental aid grant is available to a recipient no 9.4 more than once in any 12-month period. Funding for emergency 9.5 Minnesota supplemental aid is limited to the appropriation. 9.6 Each fiscal year, the commissioner shall allocate to counties 9.7 the money appropriated for emergency Minnesota supplemental aid 9.8 grants based on each county agency's average share of state's 9.9 emergency Minnesota supplemental aid expenditures for the 9.10 immediate past three fiscal years as determined by the 9.11 commissioner, and may reallocate any unspent amounts to other 9.12 counties. Any emergency Minnesota supplemental aid expenditures 9.13 by a county above the amount of the commissioner's allocation to 9.14 the county must be made from county funds. 9.15 Sec. 7. Minnesota Statutes 2002, section 256D.48, 9.16 subdivision 1, is amended to read: 9.17 Subdivision 1. [NEED FOR PROTECTIVE PAYEE.] The county 9.18 agency shall determine whether a recipient needs a protective 9.19 payee when a physical or mental condition renders the recipient 9.20 unable to manage funds and when payments to the recipient would 9.21 be contrary to the recipient's welfare. Protective payments 9.22 must be issued when there is evidence of: (1) repeated 9.23 inability to plan the use of income to meet necessary 9.24 expenditures; (2) repeated observation that the recipient is not 9.25 properly fed or clothed; (3) repeated failure to meet 9.26 obligations for rent, utilities, food, and other essentials; (4) 9.27 evictions or a repeated incurrence of debts; or (5) lost or 9.28 stolen checks; or (6) use of emergency Minnesota supplemental9.29aid more than twice in a calendar year. The determination of 9.30 representative payment by the Social Security Administration for 9.31 the recipient is sufficient reason for protective payment of 9.32 Minnesota supplemental aid payments. 9.33 Sec. 8. Minnesota Statutes 2002, section 256J.01, 9.34 subdivision 5, is amended to read: 9.35 Subd. 5. [COMPLIANCE SYSTEM.] The commissioner shall 9.36 administer a compliance system for the state's temporary 10.1 assistance for needy families (TANF) program, the food stamp 10.2 program,emergency assistance,general assistance, medical 10.3 assistance, general assistance medical care, emergency general 10.4 assistance, Minnesota supplemental aid, preadmission screening, 10.5 child support program, and alternative care grants under the 10.6 powers and authorities named in section 256.01, subdivision 2. 10.7 The purpose of the compliance system is to permit the 10.8 commissioner to supervise the administration of public 10.9 assistance programs and to enforce timely and accurate 10.10 distribution of benefits, completeness of service and efficient 10.11 and effective program management and operations, to increase 10.12 uniformity and consistency in the administration and delivery of 10.13 public assistance programs throughout the state, and to reduce 10.14 the possibility of sanction and fiscal disallowances for 10.15 noncompliance with federal regulations and state statutes. 10.16 Sec. 9. Minnesota Statutes 2002, section 256J.02, 10.17 subdivision 2, is amended to read: 10.18 Subd. 2. [USE OF MONEY.] State money appropriated for 10.19 purposes of this section and TANF block grant money must be used 10.20 for: 10.21 (1) financial assistance to or on behalf of any minor child 10.22 who is a resident of this state under section 256J.12; 10.23 (2)employment and training services under this chapter or10.24chapter 256K;10.25(3) emergency financial assistance and services under10.26section 256J.48;10.27(4) diversionary assistance under section 256J.47;10.28(5)the health care and human services training and 10.29 retention program under chapter 116L, for costs associated with 10.30 families with children with incomes below 200 percent of the 10.31 federal poverty guidelines; 10.32(6)(3) the pathways program under section 116L.04, 10.33 subdivision 1a; 10.34(7) welfare-to-work extended employment services for MFIP10.35participants with severe impairment to employment as defined in10.36section 268A.15, subdivision 1a;11.1(8) the family homeless prevention and assistance program11.2under section 462A.204;11.3(9) the rent assistance for family stabilization11.4demonstration project under section 462A.205;11.5(10)(4) welfare to work transportation authorized under 11.6 Public LawNumber105-178; 11.7(11)(5) reimbursements for the federal share of child 11.8 support collections passed through to the custodial parent; 11.9(12)(6) reimbursements for the working family credit under 11.10 section 290.0671; 11.11(13) intensive ESL grants under Laws 2000, chapter 489,11.12article 1;11.13(14) transitional housing programs under section 119A.43;11.14(15) programs and pilot projects under chapter 256K; and11.15(16)(7) program administration under this chapter; 11.16 (8) the diversionary work program under section 256J.95; 11.17 (9) the MFIP consolidated fund under section 256J.626; and 11.18 (10) the Minnesota department of health consolidated fund 11.19 under Laws 2001, First Special Session chapter 9, article 17, 11.20 section 3, subdivision 2. 11.21 Sec. 10. Minnesota Statutes 2002, section 256J.021, is 11.22 amended to read: 11.23 256J.021 [SEPARATE STATE PROGRAM FOR USE OF STATE MONEY.] 11.24 Beginning October 1, 2001, and each year thereafter, the 11.25 commissioner of human services must treatfinancial assistance11.26 MFIP expenditures made to or on behalf of any minor child under 11.27 section 256J.02, subdivision 2, clause (1), who is a resident of 11.28 this state under section 256J.12, and who is part of a 11.29 two-parent eligible household as expenditures under a separately 11.30 funded state program and report those expenditures to the 11.31 federal Department of Health and Human Services as separate 11.32 state program expenditures under Code of Federal Regulations, 11.33 title 45, section 263.5. 11.34 Sec. 11. Minnesota Statutes 2002, section 256J.08, is 11.35 amended by adding a subdivision to read: 11.36 Subd. 11a. [CHILD ONLY CASE.] "Child only case" means a 12.1 case that would be part of the child only TANF program under 12.2 section 256J.88. 12.3 Sec. 12. Minnesota Statutes 2002, section 256J.08, is 12.4 amended by adding a subdivision to read: 12.5 Subd. 24b. [DIVERSIONARY WORK PROGRAM OR DWP.] 12.6 "Diversionary work program" or "DWP" has the meaning given in 12.7 section 256J.95. 12.8 Sec. 13. Minnesota Statutes 2002, section 256J.08, is 12.9 amended by adding a subdivision to read: 12.10 Subd. 28b. [EMPLOYABLE.] "Employable" means a person is 12.11 capable of performing existing positions in the local labor 12.12 market, regardless of the current availability of openings for 12.13 those positions. 12.14 Sec. 14. Minnesota Statutes 2002, section 256J.08, is 12.15 amended by adding a subdivision to read: 12.16 Subd. 34a. [FAMILY VIOLENCE.] (a) "Family violence" means 12.17 the following, if committed against a family or household member 12.18 by a family or household member: 12.19 (1) physical harm, bodily injury, or assault; 12.20 (2) the infliction of fear of imminent physical harm, 12.21 bodily injury, or assault; or 12.22 (3) terroristic threats, within the meaning of section 12.23 609.713, subdivision 1; criminal sexual conduct, within the 12.24 meaning of section 609.342, 609.343, 609.344, 609.345, or 12.25 609.3451; or interference with an emergency call within the 12.26 meaning of section 609.78, subdivision 2. 12.27 (b) For the purposes of family violence, "family or 12.28 household member" means: 12.29 (1) spouses and former spouses; 12.30 (2) parents and children; 12.31 (3) persons related by blood; 12.32 (4) persons who are residing together or who have resided 12.33 together in the past; 12.34 (5) persons who have a child in common regardless of 12.35 whether they have been married or have lived together at any 12.36 time; 13.1 (6) a man and woman if the woman is pregnant and the man is 13.2 alleged to be the father, regardless of whether they have been 13.3 married or have lived together at anytime; and 13.4 (7) persons involved in a current or past significant 13.5 romantic or sexual relationship. 13.6 Sec. 15. Minnesota Statutes, section 256J.08, is amended 13.7 by adding a subdivision to read: 13.8 Subd. 34b. [FAMILY VIOLENCE WAIVER.] "Family violence 13.9 waiver" means a waiver of the 60-month time limit for victims of 13.10 family violence who meet the criteria in section 256J.545 and 13.11 are complying with an employment plan in section 256J.521, 13.12 subdivision 3. 13.13 Sec. 16. Minnesota Statutes 2002, section 256J.08, 13.14 subdivision 35, is amended to read: 13.15 Subd. 35. [FAMILY WAGE LEVEL.] "Family wage level" means 13.16 110 percent of the transitional standard as specified in section 13.17 256J.24, subdivision 7. 13.18 Sec. 17. Minnesota Statutes 2002, section 256J.08, is 13.19 amended by adding a subdivision to read: 13.20 Subd. 51b. [LEARNING DISABLED.] "Learning disabled," for 13.21 purposes of an extension to the 60-month time limit under 13.22 section 256J.425, subdivision 3, clause (3), means the person 13.23 has a disorder in one or more of the psychological processes 13.24 involved in perceiving, understanding, or using concepts through 13.25 verbal language or nonverbal means. Learning disabled does not 13.26 include learning problems that are primarily the result of 13.27 visual, hearing, or motor handicaps, mental retardation, 13.28 emotional disturbance, or due to environmental, cultural, or 13.29 economic disadvantage. 13.30 Sec. 18. Minnesota Statutes 2002, section 256J.08, 13.31 subdivision 65, is amended to read: 13.32 Subd. 65. [PARTICIPANT.] "Participant" means a person who 13.33 is currently receiving cash assistance or the food portion 13.34 available through MFIPas funded by TANF and the food stamp13.35program. A person who fails to withdraw or access 13.36 electronically any portion of the person's cash and food 14.1 assistance payment by the end of the payment month, who makes a 14.2 written request for closure before the first of a payment month 14.3 and repays cash and food assistance electronically issued for 14.4 that payment month within that payment month, or who returns any 14.5 uncashed assistance check and food coupons and withdraws from 14.6 the program is not a participant. A person who withdraws a cash 14.7 or food assistance payment by electronic transfer or receives 14.8 and cashes an MFIP assistance check or food coupons and is 14.9 subsequently determined to be ineligible for assistance for that 14.10 period of time is a participant, regardless whether that 14.11 assistance is repaid. The term "participant" includes the 14.12 caregiver relative and the minor child whose needs are included 14.13 in the assistance payment. A person in an assistance unit who 14.14 does not receive a cash and food assistance payment because the 14.15personcase has been suspended from MFIP is a participant. A 14.16 person who receives cash payments under the diversionary work 14.17 program under section 256J.95 is a participant. 14.18 Sec. 19. Minnesota Statutes 2002, section 256J.08, is 14.19 amended by adding a subdivision to read: 14.20 Subd. 65a. [PARTICIPATION REQUIREMENTS OF 14.21 TANF.] "Participation requirements of TANF" means activities and 14.22 hourly requirements allowed under title IV-A of the federal 14.23 Social Security Act. 14.24 Sec. 20. Minnesota Statutes 2002, section 256J.08, is 14.25 amended by adding a subdivision to read: 14.26 Subd. 73a. [QUALIFIED PROFESSIONAL.] (a) For physical 14.27 illness, injury, or incapacity, a "qualified professional" means 14.28 a licensed physician, a physician's assistant, a nurse 14.29 practitioner, or a licensed chiropractor. 14.30 (b) For mental retardation and intelligence testing, a 14.31 "qualified professional" means an individual qualified by 14.32 training and experience to administer the tests necessary to 14.33 make determinations, such as tests of intellectual functioning, 14.34 assessments of adaptive behavior, adaptive skills, and 14.35 developmental functioning. These professionals include licensed 14.36 psychologists, certified school psychologists, or certified 15.1 psychometrists working under the supervision of a licensed 15.2 psychologist. 15.3 (c) For learning disabilities, a "qualified professional" 15.4 means a licensed psychologist or school psychologist with 15.5 experience determining learning disabilities. 15.6 (d) For mental health, a "qualified professional" means a 15.7 licensed physician or a qualified mental health professional. A 15.8 "qualified mental health professional" means: 15.9 (1) for children, in psychiatric nursing, a registered 15.10 nurse who is licensed under sections 148.171 to 148.285, and who 15.11 is certified as a clinical specialist in child and adolescent 15.12 psychiatric or mental health nursing by a national nurse 15.13 certification organization or who has a master's degree in 15.14 nursing or one of the behavioral sciences or related fields from 15.15 an accredited college or university or its equivalent, with at 15.16 least 4,000 hours of post-master's supervised experience in the 15.17 delivery of clinical services in the treatment of mental 15.18 illness; 15.19 (2) for adults, in psychiatric nursing, a registered nurse 15.20 who is licensed under sections 148.171 to 148.285, and who is 15.21 certified as a clinical specialist in adult psychiatric and 15.22 mental health nursing by a national nurse certification 15.23 organization or who has a master's degree in nursing or one of 15.24 the behavioral sciences or related fields from an accredited 15.25 college or university or its equivalent, with at least 4,000 15.26 hours of post-master's supervised experience in the delivery of 15.27 clinical services in the treatment of mental illness; 15.28 (3) in clinical social work, a person licensed as an 15.29 independent clinical social worker under section 148B.21, 15.30 subdivision 6, or a person with a master's degree in social work 15.31 from an accredited college or university, with at least 4,000 15.32 hours of post-master's supervised experience in the delivery of 15.33 clinical services in the treatment of mental illness; 15.34 (4) in psychology, an individual licensed by the board of 15.35 psychology under sections 148.88 to 148.98, who has stated to 15.36 the board of psychology competencies in the diagnosis and 16.1 treatment of mental illness; 16.2 (5) in psychiatry, a physician licensed under chapter 147 16.3 and certified by the American Board of Psychiatry and Neurology 16.4 or eligible for board certification in psychiatry; and 16.5 (6) in marriage and family therapy, the mental health 16.6 professional must be a marriage and family therapist licensed 16.7 under sections 148B.29 to 148B.39, with at least two years of 16.8 post-master's supervised experience in the delivery of clinical 16.9 services in the treatment of mental illness. 16.10 Sec. 21. Minnesota Statutes 2002, section 256J.08, 16.11 subdivision 82, is amended to read: 16.12 Subd. 82. [SANCTION.] "Sanction" means the reduction of a 16.13 family's assistance payment by a specified percentage of the 16.14 MFIP standard of need because: a nonexempt participant fails to 16.15 comply with the requirements of sections256J.52256J.515 to 16.16256J.55256J.57; a parental caregiver fails without good cause 16.17 to cooperate with the child support enforcement requirements; or 16.18 a participant fails to comply withthe insurance, tort16.19liability, orother requirements of this chapter. 16.20 Sec. 22. Minnesota Statutes 2002, section 256J.08, is 16.21 amended by adding a subdivision to read: 16.22 Subd. 84a. [SSI RECIPIENT.] "SSI recipient" means a person 16.23 who receives at least $1 in SSI benefits, or who is not 16.24 receiving an SSI benefit due to recoupment or a one month 16.25 suspension by the Social Security Administration due to excess 16.26 income. 16.27 Sec. 23. Minnesota Statutes 2002, section 256J.08, 16.28 subdivision 85, is amended to read: 16.29 Subd. 85. [TRANSITIONAL STANDARD.] "Transitional standard" 16.30 means the basic standard for a familywith no other income or a16.31nonworking familywithout earned income and is a combination of 16.32 the cashassistance needsportion and foodassistance needs for16.33a family of that sizeportion as specified in section 256J.24, 16.34 subdivision 5. 16.35 Sec. 24. Minnesota Statutes 2002, section 256J.08, is 16.36 amended by adding a subdivision to read: 17.1 Subd. 90. [SEVERE FORMS OF TRAFFICKING IN 17.2 PERSONS.] "Severe forms of trafficking in persons" means: (1) 17.3 sex trafficking in which a commercial sex act is induced by 17.4 force, fraud, or coercion, or in which the person induced to 17.5 perform the act has not attained 18 years of age; or (2) the 17.6 recruitment, harboring, transportation, provision, or obtaining 17.7 of a person for labor or services through the use of force, 17.8 fraud, or coercion for the purposes of subjection to involuntary 17.9 servitude, peonage, debt bondage, or slavery. 17.10 Sec. 25. Minnesota Statutes 2002, section 256J.09, 17.11 subdivision 2, is amended to read: 17.12 Subd. 2. [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 17.13 INFORMATION.] When a person inquires about assistance, a county 17.14 agency must: 17.15 (1) explain the eligibility requirements of, and how to 17.16 apply for, diversionary assistance as provided in section17.17256J.47; emergency assistance as provided in section 256J.48;17.18MFIP as provided in section 256J.10; oranyotherassistance for 17.19 which the person may be eligible; and 17.20 (2) offer the person brochures developed or approved by the 17.21 commissioner that describe how to apply for assistance. 17.22 Sec. 26. Minnesota Statutes 2002, section 256J.09, 17.23 subdivision 3, is amended to read: 17.24 Subd. 3. [SUBMITTING THE APPLICATION FORM.] (a) A county 17.25 agency must offer, in person or by mail, the application forms 17.26 prescribed by the commissioner as soon as a person makes a 17.27 written or oral inquiry. At that time, the county agency must: 17.28 (1) inform the person that assistance begins with the date 17.29 the signed application is received by the county agency or the 17.30 date all eligibility criteria are met, whichever is later; 17.31 (2) inform the person that any delay in submitting the 17.32 application will reduce the amount of assistance paid for the 17.33 month of application; 17.34 (3) inform a person that the person may submit the 17.35 application before an interview; 17.36 (4) explain the information that will be verified during 18.1 the application process by the county agency as provided in 18.2 section 256J.32; 18.3 (5) inform a person about the county agency's average 18.4 application processing time and explain how the application will 18.5 be processed under subdivision 5; 18.6 (6) explain how to contact the county agency if a person's 18.7 application information changes and how to withdraw the 18.8 application; 18.9 (7) inform a person that the next step in the application 18.10 process is an interview and what a person must do if the 18.11 application is approved including, but not limited to, attending 18.12 orientation under section 256J.45 and complying with employment 18.13 and training services requirements in sections256J.52256J.515 18.14 to256J.55256J.57; 18.15 (8) explain the child care and transportation services that 18.16 are available under paragraph (c) to enable caregivers to attend 18.17 the interview, screening, and orientation; and 18.18 (9) identify any language barriers and arrange for 18.19 translation assistance during appointments, including, but not 18.20 limited to, screening under subdivision 3a, orientation under 18.21 section 256J.45, andthe initialassessment under section 18.22256J.52256J.521. 18.23 (b) Upon receipt of a signed application, the county agency 18.24 must stamp the date of receipt on the face of the application. 18.25 The county agency must process the application within the time 18.26 period required under subdivision 5. An applicant may withdraw 18.27 the application at any time by giving written or oral notice to 18.28 the county agency. The county agency must issue a written 18.29 notice confirming the withdrawal. The notice must inform the 18.30 applicant of the county agency's understanding that the 18.31 applicant has withdrawn the application and no longer wants to 18.32 pursue it. When, within ten days of the date of the agency's 18.33 notice, an applicant informs a county agency, in writing, that 18.34 the applicant does not wish to withdraw the application, the 18.35 county agency must reinstate the application and finish 18.36 processing the application. 19.1 (c) Upon a participant's request, the county agency must 19.2 arrange for transportation and child care or reimburse the 19.3 participant for transportation and child care expenses necessary 19.4 to enable participants to attend the screening under subdivision 19.5 3a and orientation under section 256J.45. 19.6 Sec. 27. Minnesota Statutes 2002, section 256J.09, 19.7 subdivision 3a, is amended to read: 19.8 Subd. 3a. [SCREENING.] The county agency, or at county 19.9 option, the county's employment and training service provider as 19.10 defined in section 256J.49, must screen each applicant to 19.11 determine immediate needs and to determine if the applicant may 19.12 be eligible for:19.13(1)another program that is not partially funded through 19.14 the federal temporary assistance to needy families block grant 19.15 under Title I of Public LawNumber104-193, including the 19.16 expedited issuance of food stamps under section 256J.28, 19.17 subdivision 1.If the applicant may be eligible for another19.18program, a county caseworker must provide the appropriate19.19referral to the program;19.20(2) the diversionary assistance program under section19.21256J.47; or19.22(3) the emergency assistance program under section19.23256J.48.If the applicant appears eligible for another program, 19.24 including any program funded by the MFIP consolidated fund, the 19.25 county must make a referral to the appropriate program. 19.26 Sec. 28. Minnesota Statutes 2002, section 256J.09, 19.27 subdivision 3b, is amended to read: 19.28 Subd. 3b. [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 19.29 If the applicant is not diverted from applying for MFIP, and if 19.30 the applicant meets the MFIP eligibility requirements, then a 19.31 county agency must: 19.32 (1) identify an applicant who is under the age of 19.33 20 without a high school diploma or its equivalent and explain 19.34 to the applicant the assessment procedures and employment plan 19.35 requirementsfor minor parentsunder section 256J.54; 19.36 (2) explain to the applicant the eligibility criteria in 20.1 section 256J.545 foran exemption underthe family violence 20.2provisions in section 256J.52, subdivision 6waiver, andexplain20.3 what an applicant should do to develop analternativeemployment 20.4 plan; 20.5 (3) determine if an applicant qualifies for an exemption 20.6 under section 256J.56 from employment and training services 20.7 requirements, explain how a person should report to the county 20.8 agency any status changes, and explain that an applicant who is 20.9 exempt may volunteer to participate in employment and training 20.10 services; 20.11 (4) for applicants who are not exempt from the requirement 20.12 to attend orientation, arrange for an orientation under section 20.13 256J.45 and aninitialassessment under section256J.5220.14 256J.521; 20.15 (5) inform an applicant who is not exempt from the 20.16 requirement to attend orientation that failure to attend the 20.17 orientation is considered an occurrence of noncompliance with 20.18 program requirements and will result in an imposition of a 20.19 sanction under section 256J.46; and 20.20 (6) explain how to contact the county agency if an 20.21 applicant has questions about compliance with program 20.22 requirements. 20.23 Sec. 29. Minnesota Statutes 2002, section 256J.09, 20.24 subdivision 8, is amended to read: 20.25 Subd. 8. [ADDITIONAL APPLICATIONS.] Until a county agency 20.26 issues notice of approval or denial, additional applications 20.27 submitted by an applicant are void. However, an application for 20.28 monthly assistance or other benefits funded under section 20.29 256J.626 and an application foremergency assistance or20.30 emergency general assistance may exist concurrently. More than 20.31 one application for monthly assistance, emergency assistance,or 20.32 emergency general assistance may exist concurrently when the 20.33 county agency decisions on one or more earlier applications have 20.34 been appealed to the commissioner, and the applicant asserts 20.35 that a change in circumstances has occurred that would allow 20.36 eligibility. A county agency must require additional 21.1 application forms or supplemental forms as prescribed by the 21.2 commissioner when a payee's name changes, or when a caregiver 21.3 requests the addition of another person to the assistance unit. 21.4 Sec. 30. Minnesota Statutes 2002, section 256J.09, 21.5 subdivision 10, is amended to read: 21.6 Subd. 10. [APPLICANTS WHO DO NOT MEET ELIGIBILITY 21.7 REQUIREMENTS FOR MFIP OR THE DIVERSIONARY WORK PROGRAM.] When an 21.8 applicant is not eligible for MFIP or the diversionary work 21.9 program under section 256J.95 because the applicant does not 21.10 meet eligibility requirements, the county agency must determine 21.11 whether the applicant is eligible for food stamps, medical21.12assistance, diversionary assistance, or has a need for emergency21.13assistance when the applicant meets the eligibility requirements21.14for those programsor health care programs. The county must 21.15 also inform applicants about resources available through the 21.16 county or other agencies to meet short-term emergency needs. 21.17 Sec. 31. Minnesota Statutes 2002, section 256J.14, is 21.18 amended to read: 21.19 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 21.20 (a) The definitions in this paragraph only apply to this 21.21 subdivision. 21.22 (1) "Household of a parent, legal guardian, or other adult 21.23 relative" means the place of residence of: 21.24 (i) a natural or adoptive parent; 21.25 (ii) a legal guardian according to appointment or 21.26 acceptance under section 260C.325, 525.615, or 525.6165, and 21.27 related laws; 21.28 (iii) a caregiver as defined in section 256J.08, 21.29 subdivision 11; or 21.30 (iv) an appropriate adult relative designated by a county 21.31 agency. 21.32 (2) "Adult-supervised supportive living arrangement" means 21.33 a private family setting which assumes responsibility for the 21.34 care and control of the minor parent and minor child, or other 21.35 living arrangement, not including a public institution, licensed 21.36 by the commissioner of human services which ensures that the 22.1 minor parent receives adult supervision and supportive services, 22.2 such as counseling, guidance, independent living skills 22.3 training, or supervision. 22.4 (b) A minor parent and the minor child who is in the care 22.5 of the minor parent must reside in the household of a parent, 22.6 legal guardian, other adult relative, or in an adult-supervised 22.7 supportive living arrangement in order to receive MFIP unless: 22.8 (1) the minor parent has no living parent, other adult 22.9 relative, or legal guardian whose whereabouts is known; 22.10 (2) no living parent, other adult relative, or legal 22.11 guardian of the minor parent allows the minor parent to live in 22.12 the parent's, other adult relative's, or legal guardian's home; 22.13 (3) the minor parent lived apart from the minor parent's 22.14 own parent or legal guardian for a period of at least one year 22.15 before either the birth of the minor child or the minor parent's 22.16 application for MFIP; 22.17 (4) the physical or emotional health or safety of the minor 22.18 parent or minor child would be jeopardized if the minor parent 22.19 and the minor child resided in the same residence with the minor 22.20 parent's parent, other adult relative, or legal guardian; or 22.21 (5) an adult supervised supportive living arrangement is 22.22 not available for the minor parent and child in the county in 22.23 which the minor parent and child currently reside. If an adult 22.24 supervised supportive living arrangement becomes available 22.25 within the county, the minor parent and child must reside in 22.26 that arrangement. 22.27 (c) The county agency shall inform minor applicants both 22.28 orally and in writing about the eligibility requirements, their 22.29 rights and obligations under the MFIP program, and any other 22.30 applicable orientation information. The county must advise the 22.31 minor of the possible exemptions under section 256J.54, 22.32 subdivision 5, and specifically ask whether one or more of these 22.33 exemptions is applicable. If the minor alleges one or more of 22.34 these exemptions, then the county must assist the minor in 22.35 obtaining the necessary verifications to determine whether or 22.36 not these exemptions apply. 23.1 (d) If the county worker has reason to suspect that the 23.2 physical or emotional health or safety of the minor parent or 23.3 minor child would be jeopardized if they resided with the minor 23.4 parent's parent, other adult relative, or legal guardian, then 23.5 the county worker must make a referral to child protective 23.6 services to determine if paragraph (b), clause (4), applies. A 23.7 new determination by the county worker is not necessary if one 23.8 has been made within the last six months, unless there has been 23.9 a significant change in circumstances which justifies a new 23.10 referral and determination. 23.11 (e) If a minor parent is not living with a parent, legal 23.12 guardian, or other adult relative due to paragraph (b), clause 23.13 (1), (2), or (4), the minor parent must reside, when possible, 23.14 in a living arrangement that meets the standards of paragraph 23.15 (a), clause (2). 23.16 (f) Regardless of living arrangement, MFIP must be paid, 23.17 when possible, in the form of a protective payment on behalf of 23.18 the minor parent and minor child according to section 256J.39, 23.19 subdivisions 2 to 4. 23.20 Sec. 32. Minnesota Statutes 2002, section 256J.20, 23.21 subdivision 3, is amended to read: 23.22 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 23.23 MFIP, the equity value of all nonexcluded real and personal 23.24 property of the assistance unit must not exceed $2,000 for 23.25 applicants and $5,000 for ongoing participants. The value of 23.26 assets in clauses (1) to (19) must be excluded when determining 23.27 the equity value of real and personal property: 23.28 (1) a licensed vehicle up to a loan value of less than or 23.29 equal to $7,500. The county agency shall apply any excess loan 23.30 value as if it were equity value to the asset limit described in 23.31 this section. If the assistance unit owns more than one 23.32 licensed vehicle, the county agency shall determine the vehicle 23.33 with the highest loan value and count only the loan value over 23.34 $7,500, excluding: (i) the value of one vehicle per physically 23.35 disabled person when the vehicle is needed to transport the 23.36 disabled unit member; this exclusion does not apply to mentally 24.1 disabled people; (ii) the value of special equipment for a 24.2 handicapped member of the assistance unit; and (iii) any vehicle 24.3 used for long-distance travel, other than daily commuting, for 24.4 the employment of a unit member. 24.5 The county agency shall count the loan value of all other 24.6 vehicles and apply this amount as if it were equity value to the 24.7 asset limit described in this section. To establish the loan 24.8 value of vehicles, a county agency must use the N.A.D.A. 24.9 Official Used Car Guide, Midwest Edition, for newer model cars. 24.10 When a vehicle is not listed in the guidebook, or when the 24.11 applicant or participant disputes the loan value listed in the 24.12 guidebook as unreasonable given the condition of the particular 24.13 vehicle, the county agency may require the applicant or 24.14 participant document the loan value by securing a written 24.15 statement from a motor vehicle dealer licensed under section 24.16 168.27, stating the amount that the dealer would pay to purchase 24.17 the vehicle. The county agency shall reimburse the applicant or 24.18 participant for the cost of a written statement that documents a 24.19 lower loan value; 24.20 (2) the value of life insurance policies for members of the 24.21 assistance unit; 24.22 (3) one burial plot per member of an assistance unit; 24.23 (4) the value of personal property needed to produce earned 24.24 income, including tools, implements, farm animals, inventory, 24.25 business loans, business checking and savings accounts used at 24.26 least annually and used exclusively for the operation of a 24.27 self-employment business, and any motor vehicles if at least 50 24.28 percent of the vehicle's use is to produce income and if the 24.29 vehicles are essential for the self-employment business; 24.30 (5) the value of personal property not otherwise specified 24.31 which is commonly used by household members in day-to-day living 24.32 such as clothing, necessary household furniture, equipment, and 24.33 other basic maintenance items essential for daily living; 24.34 (6) the value of real and personal property owned by a 24.35 recipient of Supplemental Security Income or Minnesota 24.36 supplemental aid; 25.1 (7) the value of corrective payments, but only for the 25.2 month in which the payment is received and for the following 25.3 month; 25.4 (8) a mobile home or other vehicle used by an applicant or 25.5 participant as the applicant's or participant's home; 25.6 (9) money in a separate escrow account that is needed to 25.7 pay real estate taxes or insurance and that is used for this 25.8 purpose; 25.9 (10) money held in escrow to cover employee FICA, employee 25.10 tax withholding, sales tax withholding, employee worker 25.11 compensation, business insurance, property rental, property 25.12 taxes, and other costs that are paid at least annually, but less 25.13 often than monthly; 25.14 (11) monthly assistance, emergency assistance, and25.15diversionarypayments for the current month'sneedsor 25.16 short-term emergency needs under section 256J.626, subdivision 25.17 2; 25.18 (12) the value of school loans, grants, or scholarships for 25.19 the period they are intended to cover; 25.20 (13) payments listed in section 256J.21, subdivision 2, 25.21 clause (9), which are held in escrow for a period not to exceed 25.22 three months to replace or repair personal or real property; 25.23 (14) income received in a budget month through the end of 25.24 the payment month; 25.25 (15) savings from earned income of a minor child or a minor 25.26 parent that are set aside in a separate account designated 25.27 specifically for future education or employment costs; 25.28 (16) the federal earned income credit, Minnesota working 25.29 family credit, state and federal income tax refunds, state 25.30 homeowners and renters credits under chapter 290A, property tax 25.31 rebates and other federal or state tax rebates in the month 25.32 received and the following month; 25.33 (17) payments excluded under federal law as long as those 25.34 payments are held in a separate account from any nonexcluded 25.35 funds; 25.36 (18) the assets of children ineligible to receive MFIP 26.1 benefits because foster care or adoption assistance payments are 26.2 made on their behalf; and 26.3 (19) the assets of persons whose income is excluded under 26.4 section 256J.21, subdivision 2, clause (43). 26.5 Sec. 33. Minnesota Statutes 2002, section 256J.21, 26.6 subdivision 1, is amended to read: 26.7 Subdivision 1. [INCOME INCLUSIONS.] To determine MFIP 26.8 eligibility, the county agency must evaluate income received by 26.9 members of an assistance unit, or by other persons whose income 26.10 is considered available to the assistance unit, and only count 26.11 income that is available to the member of the assistance unit. 26.12 Income is available if the individual has legal access to the 26.13 income. All payments, unless specifically excluded in 26.14 subdivision 2, must be counted as income. The county agency 26.15 shall verify the income of all MFIP recipients and applicants. 26.16 Sec. 34. Minnesota Statutes 2002, section 256J.21, 26.17 subdivision 2, is amended to read: 26.18 Subd. 2. [INCOME EXCLUSIONS.] The following must be 26.19 excluded in determining a family's available income: 26.20 (1) payments for basic care, difficulty of care, and 26.21 clothing allowances received for providing family foster care to 26.22 children or adults under Minnesota Rules, parts 9545.0010 to 26.23 9545.0260 and 9555.5050 to 9555.6265, and payments received and 26.24 used for care and maintenance of a third-party beneficiary who 26.25 is not a household member; 26.26 (2) reimbursements for employment training received through 26.27 theJob Training PartnershipWorkforce Investment Act 1998, 26.28 United States Code, title2920, chapter1973,sections 150126.29to 1792bsection 9201; 26.30 (3) reimbursement for out-of-pocket expenses incurred while 26.31 performing volunteer services, jury duty, employment, or 26.32 informal carpooling arrangements directly related to employment; 26.33 (4) all educational assistance, except the county agency 26.34 must count graduate student teaching assistantships, 26.35 fellowships, and other similar paid work as earned income and, 26.36 after allowing deductions for any unmet and necessary 27.1 educational expenses, shall count scholarships or grants awarded 27.2 to graduate students that do not require teaching or research as 27.3 unearned income; 27.4 (5) loans, regardless of purpose, from public or private 27.5 lending institutions, governmental lending institutions, or 27.6 governmental agencies; 27.7 (6) loans from private individuals, regardless of purpose, 27.8 provided an applicant or participant documents that the lender 27.9 expects repayment; 27.10 (7)(i) state income tax refunds; and 27.11 (ii) federal income tax refunds; 27.12 (8)(i) federal earned income credits; 27.13 (ii) Minnesota working family credits; 27.14 (iii) state homeowners and renters credits under chapter 27.15 290A; and 27.16 (iv) federal or state tax rebates; 27.17 (9) funds received for reimbursement, replacement, or 27.18 rebate of personal or real property when these payments are made 27.19 by public agencies, awarded by a court, solicited through public 27.20 appeal, or made as a grant by a federal agency, state or local 27.21 government, or disaster assistance organizations, subsequent to 27.22 a presidential declaration of disaster; 27.23 (10) the portion of an insurance settlement that is used to 27.24 pay medical, funeral, and burial expenses, or to repair or 27.25 replace insured property; 27.26 (11) reimbursements for medical expenses that cannot be 27.27 paid by medical assistance; 27.28 (12) payments by a vocational rehabilitation program 27.29 administered by the state under chapter 268A, except those 27.30 payments that are for current living expenses; 27.31 (13) in-kind income, including any payments directly made 27.32 by a third party to a provider of goods and services; 27.33 (14) assistance payments to correct underpayments, but only 27.34 for the month in which the payment is received; 27.35 (15)emergency assistancepayments for short-term emergency 27.36 needs under section 256J.626, subdivision 2; 28.1 (16) funeral and cemetery payments as provided by section 28.2 256.935; 28.3 (17) nonrecurring cash gifts of $30 or less, not exceeding 28.4 $30 per participant in a calendar month; 28.5 (18) any form of energy assistance payment made through 28.6 Public LawNumber97-35, Low-Income Home Energy Assistance Act 28.7 of 1981, payments made directly to energy providers by other 28.8 public and private agencies, and any form of credit or rebate 28.9 payment issued by energy providers; 28.10 (19) Supplemental Security Income (SSI), including 28.11 retroactive SSI payments and other income of an SSI recipient, 28.12 except as described in section 256J.37, subdivision 3b; 28.13 (20) Minnesota supplemental aid, including retroactive 28.14 payments; 28.15 (21) proceeds from the sale of real or personal property; 28.16 (22) adoption assistance payments under section 259.67; 28.17 (23) state-funded family subsidy program payments made 28.18 under section 252.32 to help families care for children with 28.19 mental retardation or related conditions, consumer support grant 28.20 funds under section 256.476, and resources and services for a 28.21 disabled household member under one of the home and 28.22 community-based waiver services programs under chapter 256B; 28.23 (24) interest payments and dividends from property that is 28.24 not excluded from and that does not exceed the asset limit; 28.25 (25) rent rebates; 28.26 (26) income earned by a minor caregiver, minor child 28.27 through age 6, or a minor child who is at least a half-time 28.28 student in an approved elementary or secondary education 28.29 program; 28.30 (27) income earned by a caregiver under age 20 who is at 28.31 least a half-time student in an approved elementary or secondary 28.32 education program; 28.33 (28) MFIP child care payments under section 119B.05; 28.34 (29) all other payments made through MFIP to support a 28.35 caregiver's pursuit of greaterself-supporteconomic stability; 28.36 (30) income a participant receives related to shared living 29.1 expenses; 29.2 (31) reverse mortgages; 29.3 (32) benefits provided by the Child Nutrition Act of 1966, 29.4 United States Code, title 42, chapter 13A, sections 1771 to 29.5 1790; 29.6 (33) benefits provided by the women, infants, and children 29.7 (WIC) nutrition program, United States Code, title 42, chapter 29.8 13A, section 1786; 29.9 (34) benefits from the National School Lunch Act, United 29.10 States Code, title 42, chapter 13, sections 1751 to 1769e; 29.11 (35) relocation assistance for displaced persons under the 29.12 Uniform Relocation Assistance and Real Property Acquisition 29.13 Policies Act of 1970, United States Code, title 42, chapter 61, 29.14 subchapter II, section 4636, or the National Housing Act, United 29.15 States Code, title 12, chapter 13, sections 1701 to 1750jj; 29.16 (36) benefits from the Trade Act of 1974, United States 29.17 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 29.18 (37) war reparations payments to Japanese Americans and 29.19 Aleuts under United States Code, title 50, sections 1989 to 29.20 1989d; 29.21 (38) payments to veterans or their dependents as a result 29.22 of legal settlements regarding Agent Orange or other chemical 29.23 exposure under Public LawNumber101-239, section 10405, 29.24 paragraph (a)(2)(E); 29.25 (39) income that is otherwise specifically excluded from 29.26 MFIP consideration in federal law, state law, or federal 29.27 regulation; 29.28 (40) security and utility deposit refunds; 29.29 (41) American Indian tribal land settlements excluded under 29.30 PublicLaw NumbersLaws 98-123, 98-124, and 99-377 to the 29.31 Mississippi Band Chippewa Indians of White Earth, Leech Lake, 29.32 and Mille Lacs reservations and payments to members of the White 29.33 Earth Band, under United States Code, title 25, chapter 9, 29.34 section 331, and chapter 16, section 1407; 29.35 (42) all income of the minor parent's parents and 29.36 stepparents when determining the grant for the minor parent in 30.1 households that include a minor parent living with parents or 30.2 stepparents on MFIP with other children; 30.3 (43) income of the minor parent's parents and stepparents 30.4 equal to 200 percent of the federal poverty guideline for a 30.5 family size not including the minor parent and the minor 30.6 parent's child in households that include a minor parent living 30.7 with parents or stepparents not on MFIP when determining the 30.8 grant for the minor parent. The remainder of income is deemed 30.9 as specified in section 256J.37, subdivision 1b; 30.10 (44) payments made to children eligible for relative 30.11 custody assistance under section 257.85; 30.12 (45) vendor payments for goods and services made on behalf 30.13 of a client unless the client has the option of receiving the 30.14 payment in cash; and 30.15 (46) the principal portion of a contract for deed payment. 30.16 Sec. 35. Minnesota Statutes 2002, section 256J.24, 30.17 subdivision 3, is amended to read: 30.18 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 30.19 ASSISTANCE UNIT.] (a) The following individuals who are part of 30.20 the assistance unit determined under subdivision 2 are 30.21 ineligible to receive MFIP: 30.22 (1) individualsreceivingwho are recipients of 30.23 Supplemental Security Income or Minnesota supplemental aid; 30.24 (2) individuals disqualified from the food stamp program or 30.25 MFIP, until the disqualification ends; 30.26 (3) children on whose behalf federal, state or local foster 30.27 care payments are made, except as provided in sections 256J.13, 30.28 subdivision 2, and 256J.74, subdivision 2; and 30.29 (4) children receiving ongoing monthly adoption assistance 30.30 payments under section 259.67. 30.31 (b) The exclusion of a person under this subdivision does 30.32 not alter the mandatory assistance unit composition. 30.33 Sec. 36. Minnesota Statutes 2002, section 256J.24, 30.34 subdivision 5, is amended to read: 30.35 Subd. 5. [MFIP TRANSITIONAL STANDARD.] Thefollowing table30.36represents theMFIP transitional standardtable when all members31.1ofis based on the number of persons in the assistance unitare31.2 eligible for both food and cash assistance unless the 31.3 restrictions in subdivision 6 on the birth of a child apply. 31.4 The following table represents the transitional standards 31.5 effective October 1, 2002. 31.6 Number of Transitional Cash Food 31.7 Eligible People Standard Portion Portion 31.8 1$351$370: $250 $120 31.9 2$609$658: $437 $221 31.10 3$763$844: $532 $312 31.11 4$903$998: $621 $377 31.12 5$1,025$1,135: $697 $438 31.13 6$1,165$1,296: $773 $523 31.14 7$1,273$1,414: $850 $564 31.15 8$1,403$1,558: $916 $642 31.16 9$1,530$1,700: $980 $720 31.17 10$1,653$1,836: $1,035 $801 31.18 over 10 add$121$136: $53 $83 31.19 per additional member. 31.20 The commissioner shall annually publish in the State 31.21 Register the transitional standard for an assistance unit sizes 31.22 1 to 10 including a breakdown of the cash and food portions. 31.23 Sec. 37. Minnesota Statutes 2002, section 256J.24, 31.24 subdivision 6, is amended to read: 31.25 Subd. 6. [APPLICATION OF ASSISTANCE STANDARDSFAMILY CAP.] 31.26The standards apply to the number of eligible persons in the31.27assistance unit.(a) MFIP assistance units shall not receive an 31.28 increase in the cash portion of the transitional standard as a 31.29 result of the birth of a child, unless one of the conditions 31.30 under paragraph (b) is met. The child shall be considered a 31.31 member of the assistance unit according to subdivisions 1 to 3, 31.32 but shall be excluded in determining family size for purposes of 31.33 determining the amount of the cash portion of the transitional 31.34 standard under subdivision 5. The child shall be included in 31.35 determining family size for purposes of determining the food 31.36 portion of the transitional standard. The transitional standard 32.1 under this subdivision shall be the total of the cash and food 32.2 portions as specified in this paragraph. The family wage level 32.3 under this subdivision shall be based on the family size used to 32.4 determine the food portion of the transitional standard. 32.5 (b) A child shall be included in determining family size 32.6 for purposes of determining the amount of the cash portion of 32.7 the MFIP transitional standard when at least one of the 32.8 following conditions is met: 32.9 (1) for families receiving MFIP assistance on July 1, 2003, 32.10 the child is born to the adult parent before May 1, 2004; 32.11 (2) for families who apply for the diversionary work 32.12 program under section 256J.95 or MFIP assistance on or after 32.13 July 1, 2003, the child is born to the adult parent within ten 32.14 months of the date the family is eligible for assistance; 32.15 (3) the child was conceived as a result of a sexual assault 32.16 or incest, provided that the incident has been reported to a law 32.17 enforcement agency; 32.18 (4) the child's mother is a minor caregiver as defined in 32.19 section 256J.08, subdivision 59, and the child, or multiple 32.20 children, are the mother's first birth; or 32.21 (5) any child previously excluded in determining family 32.22 size under paragraph (a) shall be included if the adult parent 32.23 or parents have not received benefits from the diversionary work 32.24 program under section 256J.95 or MFIP assistance in the previous 32.25 ten months. An adult parent or parents who reapply and have 32.26 received benefits from the diversionary work program or MFIP 32.27 assistance in the past ten months shall be under the ten-month 32.28 grace period of their previous application under clause (2). 32.29 (c) Income and resources of a child excluded under this 32.30 subdivision, except child support received or distributed on 32.31 behalf of this child, must be considered using the same policies 32.32 as for other children when determining the grant amount of the 32.33 assistance unit. 32.34 (d) The caregiver must assign support and cooperate with 32.35 the child support enforcement agency to establish paternity and 32.36 collect child support on behalf of the excluded child. Failure 33.1 to cooperate results in the sanction specified in section 33.2 256J.46, subdivisions 2 and 2a. Current support paid on behalf 33.3 of the excluded child shall be distributed according to section 33.4 256.741, subdivision 15. 33.5 (e) County agencies must inform applicants of the 33.6 provisions under this subdivision at the time of each 33.7 application and at recertification. 33.8 (f) Children excluded under this provision shall be deemed 33.9 MFIP recipients for purposes of child care under chapter 119B. 33.10 Sec. 38. Minnesota Statutes 2002, section 256J.24, 33.11 subdivision 7, is amended to read: 33.12 Subd. 7. [FAMILY WAGE LEVELSTANDARD.] The family wage 33.13 levelstandardis 110 percent of the transitional standard under 33.14 subdivision 5 or 6, when applicable, and is the standard used 33.15 when there is earned income in the assistance unit. As 33.16 specified in section 256J.21, earned income is subtracted from 33.17 the family wage level to determine the amount of the assistance 33.18 payment.Not includingThefamily wage level standard,33.19 assistancepaymentspayment may not exceed theMFIP standard of33.20needtransitional standard under subdivision 5 or 6, or the 33.21 shared household standard under subdivision 9, whichever is 33.22 applicable, for the assistance unit. 33.23 Sec. 39. Minnesota Statutes 2002, section 256J.24, 33.24 subdivision 10, is amended to read: 33.25 Subd. 10. [MFIP EXIT LEVEL.] The commissioner shall adjust 33.26 the MFIP earned income disregard to ensure that most 33.27 participants do not lose eligibility for MFIP until their income 33.28 reaches at least120115 percent of the federal poverty 33.29 guidelines in effect in October of each fiscal year. The 33.30 adjustment to the disregard shall be based on a household size 33.31 of three, and the resulting earned income disregard percentage 33.32 must be applied to all household sizes. The adjustment under 33.33 this subdivision must be implemented at the same time as the 33.34 October food stamp cost-of-living adjustment is reflected in the 33.35 food portion of MFIP transitional standard as required under 33.36 subdivision 5a. 34.1 Sec. 40. Minnesota Statutes 2002, section 256J.30, 34.2 subdivision 9, is amended to read: 34.3 Subd. 9. [CHANGES THAT MUST BE REPORTED.] A caregiver must 34.4 report the changes or anticipated changes specified in clauses 34.5 (1) to(17)(16) within ten days of the date they occur, at the 34.6 time of the periodic recertification of eligibility under 34.7 section 256J.32, subdivision 6, or within eight calendar days of 34.8 a reporting period as in subdivision 5 or 6, whichever occurs 34.9 first. A caregiver must report other changes at the time of the 34.10 periodic recertification of eligibility under section 256J.32, 34.11 subdivision 6, or at the end of a reporting period under 34.12 subdivision 5 or 6, as applicable. A caregiver must make these 34.13 reports in writing to the county agency. When a county agency 34.14 could have reduced or terminated assistance for one or more 34.15 payment months if a delay in reporting a change specified under 34.16 clauses (1) to(16)(15) had not occurred, the county agency 34.17 must determine whether a timely notice under section 256J.31, 34.18 subdivision 4, could have been issued on the day that the change 34.19 occurred. When a timely notice could have been issued, each 34.20 month's overpayment subsequent to that notice must be considered 34.21 a client error overpayment under section 256J.38. Calculation 34.22 of overpayments for late reporting under clause(17)(16) is 34.23 specified in section 256J.09, subdivision 9. Changes in 34.24 circumstances which must be reported within ten days must also 34.25 be reported on the MFIP household report form for the reporting 34.26 period in which those changes occurred. Within ten days, a 34.27 caregiver must report: 34.28 (1) a change in initial employment; 34.29 (2) a change in initial receipt of unearned income; 34.30 (3) a recurring change in unearned income; 34.31 (4) a nonrecurring change of unearned income that exceeds 34.32 $30; 34.33 (5) the receipt of a lump sum; 34.34 (6) an increase in assets that may cause the assistance 34.35 unit to exceed asset limits; 34.36 (7) a change in the physical or mental status of an 35.1 incapacitated member of the assistance unit if the physical or 35.2 mental status is the basis of exemption from an MFIP employment 35.3 services program under section 256J.56, or as the basis for 35.4 reducing the hourly participation requirements under section 35.5 256J.55, subdivision 1, or the type of activities included in an 35.6 employment plan under section 256J.521, subdivision 2; 35.7 (8) a change in employment status; 35.8 (9) information affecting an exception under section 35.9 256J.24, subdivision 9; 35.10 (10)a change in health insurance coverage;35.11(11)the marriage or divorce of an assistance unit member; 35.12(12)(11) the death of a parent, minor child, or 35.13 financially responsible person; 35.14(13)(12) a change in address or living quarters of the 35.15 assistance unit; 35.16(14)(13) the sale, purchase, or other transfer of 35.17 property; 35.18(15)(14) a change in school attendance of acustodial35.19parentcaregiver under age 20 or an employed child; 35.20(16)(15) filing a lawsuit, a workers' compensation claim, 35.21 or a monetary claim against a third party; and 35.22(17)(16) a change in household composition, including 35.23 births, returns to and departures from the home of assistance 35.24 unit members and financially responsible persons, or a change in 35.25 the custody of a minor child. 35.26 Sec. 41. Minnesota Statutes 2002, section 256J.32, 35.27 subdivision 2, is amended to read: 35.28 Subd. 2. [DOCUMENTATION.] The applicant or participant 35.29 must document the information required under subdivisions 4 to 6 35.30 or authorize the county agency to verify the information. The 35.31 applicant or participant has the burden of providing documentary 35.32 evidence to verify eligibility. The county agency shall assist 35.33 the applicant or participant in obtaining required documents 35.34 when the applicant or participant is unable to do so.When an35.35applicant or participant and the county agency are unable to35.36obtain documents needed to verify information, the county agency36.1may accept an affidavit from an applicant or participant as36.2sufficient documentation.The county agency may accept an 36.3 affidavit only for factors specified under subdivision 8. 36.4 Sec. 42. Minnesota Statutes 2002, section 256J.32, 36.5 subdivision 4, is amended to read: 36.6 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 36.7 verify the following at application: 36.8 (1) identity of adults; 36.9 (2) presence of the minor child in the home, if 36.10 questionable; 36.11 (3) relationship of a minor child to caregivers in the 36.12 assistance unit; 36.13 (4) age, if necessary to determine MFIP eligibility; 36.14 (5) immigration status; 36.15 (6) social security number according to the requirements of 36.16 section 256J.30, subdivision 12; 36.17 (7) income; 36.18 (8) self-employment expenses used as a deduction; 36.19 (9) source and purpose of deposits and withdrawals from 36.20 business accounts; 36.21 (10) spousal support and child support payments made to 36.22 persons outside the household; 36.23 (11) real property; 36.24 (12) vehicles; 36.25 (13) checking and savings accounts; 36.26 (14) savings certificates, savings bonds, stocks, and 36.27 individual retirement accounts; 36.28 (15) pregnancy, if related to eligibility; 36.29 (16) inconsistent information, if related to eligibility; 36.30 (17)medical insurance;36.31(18)burial accounts; 36.32(19)(18) school attendance, if related to eligibility; 36.33(20)(19) residence; 36.34(21)(20) a claim of family violence if used as a basisfor36.35ato qualify for the family violence waiverfrom the 60-month36.36time limit in section 256J.42 and regular employment and37.1training services requirements in section 256J.56; 37.2(22)(21) disability if used as the basis for an exemption 37.3 from employment and training services requirements under section 37.4 256J.56 or as the basis for reducing the hourly participation 37.5 requirements under section 256J.55, subdivision 1, or the type 37.6 of activity included in an employment plan under section 37.7 256J.521, subdivision 2; and 37.8(23)(22) information needed to establish an exception 37.9 under section 256J.24, subdivision 9. 37.10 Sec. 43. Minnesota Statutes 2002, section 256J.32, 37.11 subdivision 5a, is amended to read: 37.12 Subd. 5a. [INCONSISTENT INFORMATION.] When the county 37.13 agency verifies inconsistent information under subdivision 4, 37.14 clause (16), or 6, clause(4)(5), the reason for verifying the 37.15 information must be documented in the financial case record. 37.16 Sec. 44. Minnesota Statutes 2002, section 256J.32, is 37.17 amended by adding a subdivision to read: 37.18 Subd. 8. [AFFIDAVIT.] The county agency may accept an 37.19 affidavit from the applicant or recipient as sufficient 37.20 documentation at the time of application or recertification only 37.21 for the following factors: 37.22 (1) a claim of family violence if used as a basis to 37.23 qualify for the family violence waiver; 37.24 (2) information needed to establish an exception under 37.25 section 256J.24, subdivision 9; 37.26 (3) relationship of a minor child to caregivers in the 37.27 assistance unit; and 37.28 (4) citizenship status from a noncitizen who reports to be, 37.29 or is identified as, a victim of severe forms of trafficking in 37.30 persons, if the noncitizen reports that the noncitizen's 37.31 immigration documents are being held by an individual or group 37.32 of individuals against the noncitizen's will. The noncitizen 37.33 must follow up with the Office of Refugee Resettlement (ORR) to 37.34 pursue certification. If verification that certification is 37.35 being pursued is not received within 30 days, the MFIP case must 37.36 be closed and the agency shall pursue overpayments. The ORR 38.1 documents certifying the noncitizen's status as a victim of 38.2 severe forms of trafficking in persons, or the reason for the 38.3 delay in processing, must be received within 90 days, or the 38.4 MFIP case must be closed and the agency shall pursue 38.5 overpayments. 38.6 Sec. 45. Minnesota Statutes 2002, section 256J.37, is 38.7 amended by adding a subdivision to read: 38.8 Subd. 3a. [RENTAL SUBSIDIES; UNEARNED INCOME.] (a) 38.9 Effective July 1, 2003, the county agency shall count $50 of the 38.10 value of public and assisted rental subsidies provided through 38.11 the Department of Housing and Urban Development (HUD) as 38.12 unearned income to the cash portion of the MFIP grant. The full 38.13 amount of the subsidy must be counted as unearned income when 38.14 the subsidy is less than $50. The income from this subsidy 38.15 shall be budgeted according to section 256J.34. 38.16 (b) The provisions of this subdivision shall not apply to 38.17 an MFIP assistance unit which includes a participant who is: 38.18 (1) age 60 or older; 38.19 (2) a caregiver who is suffering from an illness, injury, 38.20 or incapacity that has been certified by a qualified 38.21 professional when the illness, injury, or incapacity is expected 38.22 to continue for more than 30 days and prevents the person from 38.23 obtaining or retaining employment; or 38.24 (3) a caregiver whose presence in the home is required due 38.25 to the illness or incapacity of another member in the assistance 38.26 unit, a relative in the household, or a foster child in the 38.27 household when the illness or incapacity and the need for the 38.28 participant's presence in the home has been certified by a 38.29 qualified professional and is expected to continue for more than 38.30 30 days. 38.31 (c) The provisions of this subdivision shall not apply to 38.32 an MFIP assistance unit where the parental caregiver is an SSI 38.33 recipient. 38.34 (d) Prior to implementing this provision, the commissioner 38.35 must identify the MFIP participants subject to this provision 38.36 and provide written notice to these participants at least 30 39.1 days before the first grant reduction. The notice must inform 39.2 the participant of the basis for the potential grant reduction, 39.3 the exceptions to the provision, if any, and inform the 39.4 participant of the steps necessary to claim an exception. A 39.5 person who is found not to meet one of the exceptions to the 39.6 provision must be notified and informed of the right to a fair 39.7 hearing under section 256J.40. The notice must also inform the 39.8 participant that the participant may be eligible for a rent 39.9 reduction resulting from a reduction in the MFIP grant, and 39.10 encourage the participant to contact the local housing authority. 39.11 Sec. 46. Minnesota Statutes 2002, section 256J.37, is 39.12 amended by adding a subdivision to read: 39.13 Subd. 3b. [TREATMENT OF SUPPLEMENTAL SECURITY 39.14 INCOME.] Effective July 1, 2003, the county shall reduce the 39.15 cash portion of the MFIP grant by $125 per SSI recipient who 39.16 resides in the household, and who would otherwise be included in 39.17 the MFIP assistance unit under section 256J.24, subdivision 2, 39.18 but is excluded solely due to the SSI recipient status under 39.19 section 256J.24, subdivision 3, paragraph (a), clause (1). If 39.20 the SSI recipient receives less than $125 of SSI, only the 39.21 amount received shall be used in calculating the MFIP cash 39.22 assistance payment. This provision does not apply to relative 39.23 caregivers who could elect to be included in the MFIP assistance 39.24 unit under section 256J.24, subdivision 4, unless the 39.25 caregiver's children or stepchildren are included in the MFIP 39.26 assistance unit. 39.27 Sec. 47. Minnesota Statutes 2002, section 256J.37, 39.28 subdivision 9, is amended to read: 39.29 Subd. 9. [UNEARNED INCOME.](a)The county agency must 39.30 apply unearned income to the MFIP standard of need. When 39.31 determining the amount of unearned income, the county agency 39.32 must deduct the costs necessary to secure payments of unearned 39.33 income. These costs include legal fees, medical fees, and 39.34 mandatory deductions such as federal and state income taxes. 39.35(b) Effective July 1, 2003, the county agency shall count39.36$100 of the value of public and assisted rental subsidies40.1provided through the Department of Housing and Urban Development40.2(HUD) as unearned income. The full amount of the subsidy must40.3be counted as unearned income when the subsidy is less than $100.40.4(c) The provisions of paragraph (b) shall not apply to MFIP40.5participants who are exempt from the employment and training40.6services component because they are:40.7(i) individuals who are age 60 or older;40.8(ii) individuals who are suffering from a professionally40.9certified permanent or temporary illness, injury, or incapacity40.10which is expected to continue for more than 30 days and which40.11prevents the person from obtaining or retaining employment; or40.12(iii) caregivers whose presence in the home is required40.13because of the professionally certified illness or incapacity of40.14another member in the assistance unit, a relative in the40.15household, or a foster child in the household.40.16(d) The provisions of paragraph (b) shall not apply to an40.17MFIP assistance unit where the parental caregiver receives40.18supplemental security income.40.19 Sec. 48. Minnesota Statutes 2002, section 256J.38, 40.20 subdivision 3, is amended to read: 40.21 Subd. 3. [RECOVERING OVERPAYMENTSFROM FORMER40.22PARTICIPANTS.] A county agency must initiate efforts to recover 40.23 overpayments paid to a former participant or caregiver.Adults40.24 Caregivers, both parental and nonparental, and minor caregivers 40.25 of an assistance unit at the time an overpayment occurs, whether 40.26 receiving assistance or not, are jointly and individually liable 40.27 for repayment of the overpayment. The county agency must 40.28 request repayment from the former participants and caregivers. 40.29 When an agreement for repayment is not completed within six 40.30 months of the date of discovery or when there is a default on an 40.31 agreement for repayment after six months, the county agency must 40.32 initiate recovery consistent with chapter 270A, or section 40.33 541.05. When a person has been convicted of fraud under section 40.34 256.98, recovery must be sought regardless of the amount of 40.35 overpayment. When an overpayment is less than $35, and is not 40.36 the result of a fraud conviction under section 256.98, the 41.1 county agency must not seek recovery under this subdivision. 41.2 The county agency must retain information about all overpayments 41.3 regardless of the amount. When an adult, adult caregiver, or 41.4 minor caregiver reapplies for assistance, the overpayment must 41.5 be recouped under subdivision 4. 41.6 Sec. 49. Minnesota Statutes 2002, section 256J.38, 41.7 subdivision 4, is amended to read: 41.8 Subd. 4. [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 41.9 participant may voluntarily repay, in part or in full, an 41.10 overpayment even if assistance is reduced under this 41.11 subdivision, until the total amount of the overpayment is 41.12 repaid. When an overpayment occurs due to fraud, the county 41.13 agency must recover from the overpaid assistance unit, including 41.14 child only cases, ten percent of the applicable standard or the 41.15 amount of the monthly assistance payment, whichever is less. 41.16 When a nonfraud overpayment occurs, the county agency must 41.17 recover from the overpaid assistance unit, including child only 41.18 cases, three percent of the MFIP standard of need or the amount 41.19 of the monthly assistance payment, whichever is less. 41.20 Sec. 50. Minnesota Statutes 2002, section 256J.40, is 41.21 amended to read: 41.22 256J.40 [FAIR HEARINGS.] 41.23 Caregivers receiving a notice of intent to sanction or a 41.24 notice of adverse action that includes a sanction, reduction in 41.25 benefits, suspension of benefits, denial of benefits, or 41.26 termination of benefits may request a fair hearing. A request 41.27 for a fair hearing must be submitted in writing to the county 41.28 agency or to the commissioner and must be mailed within 30 days 41.29 after a participant or former participant receives written 41.30 notice of the agency's action or within 90 days when a 41.31 participant or former participant shows good cause for not 41.32 submitting the request within 30 days. A former participant who 41.33 receives a notice of adverse action due to an overpayment may 41.34 appeal the adverse action according to the requirements in this 41.35 section. Issues that may be appealed are: 41.36 (1) the amount of the assistance payment; 42.1 (2) a suspension, reduction, denial, or termination of 42.2 assistance; 42.3 (3) the basis for an overpayment, the calculated amount of 42.4 an overpayment, and the level of recoupment; 42.5 (4) the eligibility for an assistance payment; and 42.6 (5) the use of protective or vendor payments under section 42.7 256J.39, subdivision 2, clauses (1) to (3). 42.8 Except for benefits issued under section 256J.95, a county 42.9 agency must not reduce, suspend, or terminate payment when an 42.10 aggrieved participant requests a fair hearing prior to the 42.11 effective date of the adverse action or within ten days of the 42.12 mailing of the notice of adverse action, whichever is later, 42.13 unless the participant requests in writing not to receive 42.14 continued assistance pending a hearing decision. An appeal 42.15 request cannot extend benefits for the diversionary work program 42.16 under section 256J.95 beyond the four-month time limit. 42.17 Assistance issued pending a fair hearing is subject to recovery 42.18 under section 256J.38 when as a result of the fair hearing 42.19 decision the participant is determined ineligible for assistance 42.20 or the amount of the assistance received. A county agency may 42.21 increase or reduce an assistance payment while an appeal is 42.22 pending when the circumstances of the participant change and are 42.23 not related to the issue on appeal. The commissioner's order is 42.24 binding on a county agency. No additional notice is required to 42.25 enforce the commissioner's order. 42.26 A county agency shall reimburse appellants for reasonable 42.27 and necessary expenses of attendance at the hearing, such as 42.28 child care and transportation costs and for the transportation 42.29 expenses of the appellant's witnesses and representatives to and 42.30 from the hearing. Reasonable and necessary expenses do not 42.31 include legal fees. Fair hearings must be conducted at a 42.32 reasonable time and date by an impartial referee employed by the 42.33 department. The hearing may be conducted by telephone or at a 42.34 site that is readily accessible to persons with disabilities. 42.35 The appellant may introduce new or additional evidence 42.36 relevant to the issues on appeal. Recommendations of the 43.1 appeals referee and decisions of the commissioner must be based 43.2 on evidence in the hearing record and are not limited to a 43.3 review of the county agency action. 43.4 Sec. 51. Minnesota Statutes 2002, section 256J.42, 43.5 subdivision 4, is amended to read: 43.6 Subd. 4. [VICTIMS OF FAMILY VIOLENCE.] Any cash assistance 43.7 received by an assistance unit in a month when a caregiver 43.8 complied with a safety plan, an alternative employment plan, or 43.9 an employment planor after October 1, 2001, complied or is43.10complying with an alternative employment planunder section 43.11256J.49256J.521, subdivision1a3, does not count toward the 43.12 60-month limitation on assistance. 43.13 Sec. 52. Minnesota Statutes 2002, section 256J.42, 43.14 subdivision 5, is amended to read: 43.15 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 43.16 assistance received by an assistance unit does not count toward 43.17 the 60-month limit on assistance during a month in which the 43.18 caregiver isin the category inage 60 or older, including 43.19 months during which the caregiver was exempt under section 43.20 256J.56, paragraph (a), clause (1). 43.21 (b) From July 1, 1997, until the date MFIP is operative in 43.22 the caregiver's county of financial responsibility, any cash 43.23 assistance received by a caregiver who is complying with 43.24 Minnesota Statutes 1996, section 256.73, subdivision 5a, and 43.25 Minnesota Statutes 1998, section 256.736, if applicable, does 43.26 not count toward the 60-month limit on assistance. Thereafter, 43.27 any cash assistance received by a minor caregiver who is 43.28 complying with the requirements of sections 256J.14 and 256J.54, 43.29 if applicable, does not count towards the 60-month limit on 43.30 assistance. 43.31 (c) Any diversionary assistance or emergency assistance 43.32 received prior to July 1, 2003, does not count toward the 43.33 60-month limit. 43.34 (d) Any cash assistance received by an 18- or 19-year-old 43.35 caregiver who is complying withthe requirements ofan 43.36 employment plan that includes an education option under section 44.1 256J.54 does not count toward the 60-month limit. 44.2 (e) Payments provided to meet short-term emergency needs 44.3 under section 256J.626 and diversionary work program benefits 44.4 provided under section 256J.95 do not count toward the 60-month 44.5 time limit. 44.6 Sec. 53. Minnesota Statutes 2002, section 256J.42, 44.7 subdivision 6, is amended to read: 44.8 Subd. 6. [CASE REVIEW.] (a) Within 180 days, but not less 44.9 than 60 days, before the end of the participant's 60th month on 44.10 assistance, the county agency or job counselor must review the 44.11 participant's case to determine if the employment plan is still 44.12 appropriate or if the participant is exempt under section 44.13 256J.56 from the employment and training services component, and 44.14 attempt to meet with the participant face-to-face. 44.15 (b) During the face-to-face meeting, a county agency or the 44.16 job counselor must: 44.17 (1) inform the participant how many months of counted 44.18 assistance the participant has accrued and when the participant 44.19 is expected to reach the 60th month; 44.20 (2) explain the hardship extension criteria under section 44.21 256J.425 and what the participant should do if the participant 44.22 thinks a hardship extension applies; 44.23 (3) identify other resources that may be available to the 44.24 participant to meet the needs of the family; and 44.25 (4) inform the participant of the right to appeal the case 44.26 closure under section 256J.40. 44.27 (c) If a face-to-face meeting is not possible, the county 44.28 agency must send the participant a notice of adverse action as 44.29 provided in section 256J.31, subdivisions 4 and 5. 44.30 (d) Before a participant's case is closed under this 44.31 section, the county must ensure that: 44.32 (1) the case has been reviewed by the job counselor's 44.33 supervisor or the review team designatedinby thecounty's44.34approved local service unit plancounty to determine if the 44.35 criteria for a hardship extension, if requested, were applied 44.36 appropriately; and 45.1 (2) the county agency or the job counselor attempted to 45.2 meet with the participant face-to-face. 45.3 Sec. 54. Minnesota Statutes 2002, section 256J.425, 45.4 subdivision 1, is amended to read: 45.5 Subdivision 1. [ELIGIBILITY.] (a) To be eligible for a 45.6 hardship extension, a participant in an assistance unit subject 45.7 to the time limit under section 256J.42, subdivision 1,in which45.8any participant has received 60 counted months of assistance,45.9 must be in compliance in the participant's 60th counted month 45.10the participant is applying for the extension. For purposes of 45.11 determining eligibility for a hardship extension, a participant 45.12 is in compliance in any month that the participant has not been 45.13 sanctioned. 45.14 (b) If one participant in a two-parent assistance unit is 45.15 determined to be ineligible for a hardship extension, the county 45.16 shall give the assistance unit the option of disqualifying the 45.17 ineligible participant from MFIP. In that case, the assistance 45.18 unit shall be treated as a one-parent assistance unit and the 45.19 assistance unit's MFIP grant shall be calculated using the 45.20 shared household standard under section 256J.08, subdivision 82a. 45.21 Sec. 55. Minnesota Statutes 2002, section 256J.425, 45.22 subdivision 1a, is amended to read: 45.23 Subd. 1a. [REVIEW.] If a county grants a hardship 45.24 extension under this section, a county agency shall review the 45.25 case every six or 12 months, whichever is appropriate based on 45.26 the participant's circumstances and the extension 45.27 category. More frequent reviews shall be required if 45.28 eligibility for an extension is based on a condition that is 45.29 subject to change in less than six months. 45.30 Sec. 56. Minnesota Statutes 2002, section 256J.425, 45.31 subdivision 2, is amended to read: 45.32 Subd. 2. [ILL OR INCAPACITATED.] (a) An assistance unit 45.33 subject to the time limit in section 256J.42, subdivision 1,in45.34which any participant has received 60 counted months of45.35assistance,is eligible to receive months of assistance under a 45.36 hardship extension if the participant who reached the time limit 46.1 belongs to any of the following groups: 46.2 (1) participants who are suffering froma professionally46.3certifiedan illness, injury, or incapacity which has been 46.4 certified by a qualified professional when the illness, injury, 46.5 or incapacity is expected to continue for more than 30 days 46.6 andwhichprevents the person from obtaining or retaining 46.7 employmentand who are following. These participants must 46.8 follow the treatment recommendations of thehealth care provider46.9 qualified professional certifying the illness, injury, or 46.10 incapacity; 46.11 (2) participants whose presence in the home is required as 46.12 a caregiver because ofa professionally certifiedthe illness, 46.13 injury, or incapacity of another member in the assistance unit, 46.14 a relative in the household, or a foster child in the 46.15 householdandwhen the illness or incapacity and the need for a 46.16 person to provide assistance in the home has been certified by a 46.17 qualified professional and is expected to continue for more than 46.18 30 days; or 46.19 (3) caregivers with a child or an adult in the household 46.20 who meets the disability or medical criteria for home care 46.21 services under section 256B.0627, subdivision 1, paragraph 46.22(c)(f), or a home and community-based waiver services program 46.23 under chapter 256B, or meets the criteria for severe emotional 46.24 disturbance under section 245.4871, subdivision 6, or for 46.25 serious and persistent mental illness under section 245.462, 46.26 subdivision 20, paragraph (c). Caregivers in this category are 46.27 presumed to be prevented from obtaining or retaining employment. 46.28 (b) An assistance unit receiving assistance under a 46.29 hardship extension under this subdivision may continue to 46.30 receive assistance as long as the participant meets the criteria 46.31 in paragraph (a), clause (1), (2), or (3). 46.32 Sec. 57. Minnesota Statutes 2002, section 256J.425, 46.33 subdivision 3, is amended to read: 46.34 Subd. 3. [HARD-TO-EMPLOY PARTICIPANTS.] An assistance unit 46.35 subject to the time limit in section 256J.42, subdivision 1,in46.36which any participant has received 60 counted months of47.1assistance,is eligible to receive months of assistance under a 47.2 hardship extension if the participant who reached the time limit 47.3 belongs to any of the following groups: 47.4 (1) a person who is diagnosed by a licensed physician, 47.5 psychological practitioner, or other qualified professional, as 47.6 mentally retarded or mentally ill, and that condition prevents 47.7 the person from obtaining or retaining unsubsidized employment; 47.8 (2) a person who: 47.9 (i) has been assessed by a vocational specialist or the 47.10 county agency to be unemployable for purposes of this 47.11 subdivision; or 47.12 (ii) has an IQ below 80 who has been assessed by a 47.13 vocational specialist or a county agency to be employable, but 47.14 not at a level that makes the participant eligible for an 47.15 extension under subdivision 4or,. The determination of IQ 47.16 level must be made by a qualified professional. In the case of 47.17 a non-English-speaking personfor whom it is not possible to47.18provide a determination due to language barriers or absence of47.19culturally appropriate assessment tools, is determined by a47.20qualified professional to have an IQ below 80. A person is47.21considered employable if positions of employment in the local47.22labor market exist, regardless of the current availability of47.23openings for those positions, that the person is capable of47.24performing: (A) the determination must be made by a qualified 47.25 professional with experience conducting culturally appropriate 47.26 assessments, whenever possible; (B) the county may accept 47.27 reports that identify an IQ range as opposed to a specific 47.28 score; (C) these reports must include a statement of confidence 47.29 in the results; 47.30 (3) a person who is determined bythe county agencya 47.31 qualified professional to be learning disabledor, and the 47.32 disability severely limits the person's ability to obtain, 47.33 perform, or maintain suitable employment. For purposes of the 47.34 initial approval of a learning disability extension, the 47.35 determination must have been made or confirmed within the 47.36 previous 12 months. In the case of a non-English-speaking 48.1 personfor whom it is not possible to provide a medical48.2diagnosis due to language barriers or absence of culturally48.3appropriate assessment tools, is determined by a qualified48.4professional to have a learning disability. If a rehabilitation48.5plan for the person is developed or approved by the county48.6agency, the plan must be incorporated into the employment plan.48.7However, a rehabilitation plan does not replace the requirement48.8to develop and comply with an employment plan under section48.9256J.52. For purposes of this section, "learning disabled"48.10means the applicant or recipient has a disorder in one or more48.11of the psychological processes involved in perceiving,48.12understanding, or using concepts through verbal language or48.13nonverbal means. The disability must severely limit the48.14applicant or recipient in obtaining, performing, or maintaining48.15suitable employment. Learning disabled does not include48.16learning problems that are primarily the result of visual,48.17hearing, or motor handicaps; mental retardation; emotional48.18disturbance; or due to environmental, cultural, or economic48.19disadvantage: (i) the determination must be made by a qualified 48.20 professional with experience conducting culturally appropriate 48.21 assessments, whenever possible; and (ii) these reports must 48.22 include a statement of confidence in the results. If a 48.23 rehabilitation plan for a participant extended as learning 48.24 disabled is developed or approved by the county agency, the plan 48.25 must be incorporated into the employment plan. However, a 48.26 rehabilitation plan does not replace the requirement to develop 48.27 and comply with an employment plan under section 256J.521; or 48.28 (4) a person whois a victim ofhas been granted a family 48.29 violenceas defined in section 256J.49, subdivision 2waiver, 48.30 and who isparticipating incomplying with analternative48.31 employment plan under section256J.49256J.521, subdivision1a48.32 3. 48.33 Sec. 58. Minnesota Statutes 2002, section 256J.425, 48.34 subdivision 4, is amended to read: 48.35 Subd. 4. [EMPLOYED PARTICIPANTS.] (a) An assistance unit 48.36 subject to the time limit under section 256J.42, subdivision 1, 49.1in which any participant has received 60 months of assistance,49.2 is eligible to receive assistance under a hardship extension if 49.3 the participant who reached the time limit belongs to: 49.4 (1) a one-parent assistance unit in which the participant 49.5 is participating in work activities for at least 30 hours per 49.6 week, of which an average of at least 25 hours per week every 49.7 month are spent participating in employment; 49.8 (2) a two-parent assistance unit in which the participants 49.9 are participating in work activities for at least 55 hours per 49.10 week, of which an average of at least 45 hours per week every 49.11 month are spent participating in employment; or 49.12 (3) an assistance unit in which a participant is 49.13 participating in employment for fewer hours than those specified 49.14 in clause (1), and the participant submits verification from a 49.15health care providerqualified professional, in a form 49.16 acceptable to the commissioner, stating that the number of hours 49.17 the participant may work is limited due to illness or 49.18 disability, as long as the participant is participating in 49.19 employment for at least the number of hours specified by 49.20 thehealth care providerqualified professional. The 49.21 participant must be following the treatment recommendations of 49.22 thehealth care providerqualified professional providing the 49.23 verification. The commissioner shall develop a form to be 49.24 completed and signed by thehealth care providerqualified 49.25 professional, documenting the diagnosis and any additional 49.26 information necessary to document the functional limitations of 49.27 the participant that limit work hours. If the participant is 49.28 part of a two-parent assistance unit, the other parent must be 49.29 treated as a one-parent assistance unit for purposes of meeting 49.30 the work requirements under this subdivision. 49.31 (b) For purposes of this section, employment means: 49.32 (1) unsubsidized employment under section 256J.49, 49.33 subdivision 13, clause (1); 49.34 (2) subsidized employment under section 256J.49, 49.35 subdivision 13, clause (2); 49.36 (3) on-the-job training under section 256J.49, subdivision 50.1 13, clause(4)(2); 50.2 (4) an apprenticeship under section 256J.49, subdivision 50.3 13, clause(19)(1); 50.4 (5) supported work. For purposes of this section,50.5"supported work" means services supporting a participant on the50.6job which include, but are not limited to, supervision, job50.7coaching, and subsidized wagesunder section 256J.49, 50.8 subdivision 13, clause (2); 50.9 (6) a combination of clauses (1) to (5); or 50.10 (7) child care under section 256J.49, subdivision 13, 50.11 clause(25)(7), if it is in combination with paid employment. 50.12 (c) If a participant is complying with a child protection 50.13 plan under chapter 260C, the number of hours required under the 50.14 child protection plan count toward the number of hours required 50.15 under this subdivision. 50.16 (d) The county shall provide the opportunity for subsidized 50.17 employment to participants needing that type of employment 50.18 within available appropriations. 50.19 (e) To be eligible for a hardship extension for employed 50.20 participants under this subdivision, a participantin a50.21one-parent assistance unit or both parents in a two-parent50.22assistance unitmust be in compliance for at least ten out of 50.23 the 12 months immediately preceding the participant's 61st month 50.24 on assistance.If only one parent in a two-parent assistance50.25unit fails to be in compliance ten out of the 12 months50.26immediately preceding the participant's 61st month, the county50.27shall give the assistance unit the option of disqualifying the50.28noncompliant parent. If the noncompliant participant is50.29disqualified, the assistance unit must be treated as a50.30one-parent assistance unit for the purposes of meeting the work50.31requirements under this subdivision and the assistance unit's50.32MFIP grant shall be calculated using the shared household50.33standard under section 256J.08, subdivision 82a.50.34 (f) The employment plan developed under section256J.5250.35 256J.521, subdivision52, for participants under this 50.36 subdivision must contain the number of hours specified in 51.1 paragraph (a) related to employment and work activities. The 51.2 job counselor and the participant must sign the employment plan 51.3 to indicate agreement between the job counselor and the 51.4 participant on the contents of the plan. 51.5 (g) Participants who fail to meet the requirements in 51.6 paragraph (a), without good cause under section 256J.57, shall 51.7 be sanctioned or permanently disqualified under subdivision 6. 51.8 Good cause may only be granted for that portion of the month for 51.9 which the good cause reason applies. Participants must meet all 51.10 remaining requirements in the approved employment plan or be 51.11 subject to sanction or permanent disqualification. 51.12 (h) If the noncompliance with an employment plan is due to 51.13 the involuntary loss of employment, the participant is exempt 51.14 from the hourly employment requirement under this subdivision 51.15 for one month. Participants must meet all remaining 51.16 requirements in the approved employment plan or be subject to 51.17 sanction or permanent disqualification. This exemption is 51.18 available toone-parent assistance unitsa participant two times 51.19 in a 12-month period, and two-parent assistance units, two times51.20per parent in a 12-month period. 51.21(i) This subdivision expires on June 30, 2004.51.22 Sec. 59. Minnesota Statutes 2002, section 256J.425, 51.23 subdivision 6, is amended to read: 51.24 Subd. 6. [SANCTIONS FOR EXTENDED CASES.] (a) If one or 51.25 both participants in an assistance unit receiving assistance 51.26 under subdivision 3 or 4 are not in compliance with the 51.27 employment and training service requirements in sections256J.5251.28 256J.521 to256J.55256J.57, the sanctions under this 51.29 subdivision apply. For a first occurrence of noncompliance, an 51.30 assistance unit must be sanctioned under section 256J.46, 51.31 subdivision 1, paragraph(d)(c), clause (1). For a second or 51.32 third occurrence of noncompliance, the assistance unit must be 51.33 sanctioned under section 256J.46, subdivision 1, 51.34 paragraph(d)(c), clause (2). For a fourth occurrence of 51.35 noncompliance, the assistance unit is disqualified from MFIP. 51.36 If a participant is determined to be out of compliance, the 52.1 participant may claim a good cause exception under section 52.2 256J.57, however, the participant may not claim an exemption 52.3 under section 256J.56. 52.4 (b) If both participants in a two-parent assistance unit 52.5 are out of compliance at the same time, it is considered one 52.6 occurrence of noncompliance. 52.7 Sec. 60. Minnesota Statutes 2002, section 256J.425, 52.8 subdivision 7, is amended to read: 52.9 Subd. 7. [STATUS OF DISQUALIFIED PARTICIPANTS.] (a) An 52.10 assistance unit that is disqualified under subdivision 6, 52.11 paragraph (a), may be approved for MFIP if the participant 52.12 complies with MFIP program requirements and demonstrates 52.13 compliance for up to one month. No assistance shall be paid 52.14 during this period. 52.15 (b) An assistance unit that is disqualified under 52.16 subdivision 6, paragraph (a), and that reapplies under paragraph 52.17 (a) is subject to sanction under section 256J.46, subdivision 1, 52.18 paragraph(d)(c), clause (1), for a first occurrence of 52.19 noncompliance. A subsequent occurrence of noncompliance results 52.20 in a permanent disqualification. 52.21 (c) If one participant in a two-parent assistance unit 52.22 receiving assistance under a hardship extension under 52.23 subdivision 3 or 4 is determined to be out of compliance with 52.24 the employment and training services requirements under sections 52.25256J.52256J.521 to256J.55256J.57, the county shall give the 52.26 assistance unit the option of disqualifying the noncompliant 52.27 participant from MFIP. In that case, the assistance unit shall 52.28 be treated as a one-parent assistance unit for the purposes of 52.29 meeting the work requirements under subdivision 4 and the 52.30 assistance unit's MFIP grant shall be calculated using the 52.31 shared household standard under section 256J.08, subdivision 52.32 82a. An applicant who is disqualified from receiving assistance 52.33 under this paragraph may reapply under paragraph (a). If a 52.34 participant is disqualified from MFIP under this subdivision a 52.35 second time, the participant is permanently disqualified from 52.36 MFIP. 53.1 (d) Prior to a disqualification under this subdivision, a 53.2 county agency must review the participant's case to determine if 53.3 the employment plan is still appropriate and attempt to meet 53.4 with the participant face-to-face. If a face-to-face meeting is 53.5 not conducted, the county agency must send the participant a 53.6 notice of adverse action as provided in section 256J.31. During 53.7 the face-to-face meeting, the county agency must: 53.8 (1) determine whether the continued noncompliance can be 53.9 explained and mitigated by providing a needed preemployment 53.10 activity, as defined in section 256J.49, subdivision 13, clause 53.11(16), or services under a local intervention grant for53.12self-sufficiency under section 256J.625(9); 53.13 (2) determine whether the participant qualifies for a good 53.14 cause exception under section 256J.57; 53.15 (3) inform the participant of the family violence waiver 53.16 criteria and make appropriate referrals if the waiver is 53.17 requested; 53.18 (4) inform the participant of the participant's sanction 53.19 status and explain the consequences of continuing noncompliance; 53.20(4)(5) identify other resources that may be available to 53.21 the participant to meet the needs of the family; and 53.22(5)(6) inform the participant of the right to appeal under 53.23 section 256J.40. 53.24 Sec. 61. Minnesota Statutes 2002, section 256J.45, 53.25 subdivision 2, is amended to read: 53.26 Subd. 2. [GENERAL INFORMATION.] The MFIP orientation must 53.27 consist of a presentation that informs caregivers of: 53.28 (1) the necessity to obtain immediate employment; 53.29 (2) the work incentives under MFIP, including the 53.30 availability of the federal earned income tax credit and the 53.31 Minnesota working family tax credit; 53.32 (3) the requirement to comply with the employment plan and 53.33 other requirements of the employment and training services 53.34 component of MFIP, including a description of the range of work 53.35 and training activities that are allowable under MFIP to meet 53.36 the individual needs of participants; 54.1 (4) the consequences for failing to comply with the 54.2 employment plan and other program requirements, and that the 54.3 county agency may not impose a sanction when failure to comply 54.4 is due to the unavailability of child care or other 54.5 circumstances where the participant has good cause under 54.6 subdivision 3; 54.7 (5) the rights, responsibilities, and obligations of 54.8 participants; 54.9 (6) the types and locations of child care services 54.10 available through the county agency; 54.11 (7) the availability and the benefits of the early 54.12 childhood health and developmental screening under sections 54.13 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 54.14 (8) the caregiver's eligibility for transition year child 54.15 care assistance under section 119B.05; 54.16 (9)the caregiver's eligibility for extended medical54.17assistance when the caregiver loses eligibility for MFIP due to54.18increased earnings or increased child or spousal supportthe 54.19 availability of all health care programs, including transitional 54.20 medical assistance; 54.21 (10) the caregiver's option to choose an employment and 54.22 training provider and information about each provider, including 54.23 but not limited to, services offered, program components, job 54.24 placement rates, job placement wages, and job retention rates; 54.25 (11) the caregiver's option to request approval of an 54.26 education and training plan according to section256J.5254.27 256J.53; 54.28 (12) the work study programs available under the higher 54.29 education system; and 54.30 (13)effective October 1, 2001,information about the 54.31 60-month time limitexemption and waivers of regular employment54.32and training requirements for family violence victimsexemptions 54.33 under the family violence waiver and referral information about 54.34 shelters and programs for victims of family violence. 54.35 Sec. 62. Minnesota Statutes 2002, section 256J.46, 54.36 subdivision 1, is amended to read: 55.1 Subdivision 1. [PARTICIPANTS NOT COMPLYING WITH PROGRAM 55.2 REQUIREMENTS.] (a) A participant who fails without good 55.3 cause under section 256J.57 to comply with the requirements of 55.4 this chapter, and who is not subject to a sanction under 55.5 subdivision 2, shall be subject to a sanction as provided in 55.6 this subdivision. Prior to the imposition of a sanction, a 55.7 county agency shall provide a notice of intent to sanction under 55.8 section 256J.57, subdivision 2, and, when applicable, a notice 55.9 of adverse action as provided in section 256J.31. 55.10 (b)A participant who fails to comply with an alternative55.11employment plan must have the plan reviewed by a person trained55.12in domestic violence and a job counselor or the county agency to55.13determine if components of the alternative employment plan are55.14still appropriate. If the activities are no longer appropriate,55.15the plan must be revised with a person trained in domestic55.16violence and approved by a job counselor or the county agency.55.17A participant who fails to comply with a plan that is determined55.18not to need revision will lose their exemption and be required55.19to comply with regular employment services activities.55.20(c)A sanction under this subdivision becomes effective the 55.21 month following the month in which a required notice is given. 55.22 A sanction must not be imposed when a participant comes into 55.23 compliance with the requirements for orientation under section 55.24 256J.45or third-party liability for medical services under55.25section 256J.30, subdivision 10,prior to the effective date of 55.26 the sanction. A sanction must not be imposed when a participant 55.27 comes into compliance with the requirements for employment and 55.28 training services under sections256J.49256J.515 to 55.29256J.55256J.57 ten days prior to the effective date of the 55.30 sanction. For purposes of this subdivision, each month that a 55.31 participant fails to comply with a requirement of this chapter 55.32 shall be considered a separate occurrence of noncompliance.A55.33participant who has had one or more sanctions imposed must55.34remain in compliance with the provisions of this chapter for six55.35months in order for a subsequent occurrence of noncompliance to55.36be considered a first occurrence.If both participants in a 56.1 two-parent assistance unit are out of compliance at the same 56.2 time, it is considered one occurrence of noncompliance. 56.3(d)(c) Sanctions for noncompliance shall be imposed as 56.4 follows: 56.5 (1) For the first occurrence of noncompliance by a 56.6 participant in an assistance unit, the assistance unit's grant 56.7 shall be reduced by ten percent of the MFIP standard of need for 56.8 an assistance unit of the same size with the residual grant paid 56.9 to the participant. The reduction in the grant amount must be 56.10 in effect for a minimum of one month and shall be removed in the 56.11 month following the month that the participant returns to 56.12 compliance. 56.13 (2) For a secondor subsequent, third, fourth, fifth, or 56.14 sixth occurrence of noncompliance by a participant in an 56.15 assistance unit,or when each of the participants in a56.16two-parent assistance unit have a first occurrence of56.17noncompliance at the same time,the assistance unit's shelter 56.18 costs shall be vendor paid up to the amount of the cash portion 56.19 of the MFIP grant for which the assistance unit is eligible. At 56.20 county option, the assistance unit's utilities may also be 56.21 vendor paid up to the amount of the cash portion of the MFIP 56.22 grant remaining after vendor payment of the assistance unit's 56.23 shelter costs. The residual amount of the grant after vendor 56.24 payment, if any, must be reduced by an amount equal to 30 56.25 percent of the MFIP standard of need for an assistance unit of 56.26 the same size before the residual grant is paid to the 56.27 assistance unit. The reduction in the grant amount must be in 56.28 effect for a minimum of one month and shall be removed in the 56.29 month following the month that the participant in a one-parent 56.30 assistance unit returns to compliance. In a two-parent 56.31 assistance unit, the grant reduction must be in effect for a 56.32 minimum of one month and shall be removed in the month following 56.33 the month both participants return to compliance. The vendor 56.34 payment of shelter costs and, if applicable, utilities shall be 56.35 removed six months after the month in which the participant or 56.36 participants return to compliance. If an assistance unit is 57.1 sanctioned under this clause, the participant's case file must 57.2 be reviewedas required under paragraph (e)to determine if the 57.3 employment plan is still appropriate. 57.4(e) When a sanction under paragraph (d), clause (2), is in57.5effect(d) For a seventh occurrence of noncompliance by a 57.6 participant in an assistance unit, or when the participants in a 57.7 two-parent assistance unit have a total of seven occurrences of 57.8 noncompliance, the county agency shall close the MFIP assistance 57.9 unit's financial assistance case, both the cash and food 57.10 portions. The case must remain closed for a minimum of one full 57.11 month. Closure under this paragraph does not make a participant 57.12 automatically ineligible for food support, if otherwise eligible. 57.13 Before the case is closed, the county agency must review the 57.14 participant's case to determine if the employment plan is still 57.15 appropriate and attempt to meet with the participant 57.16 face-to-face. The participant may bring an advocate to the 57.17 face-to-face meeting. If a face-to-face meeting is not 57.18 conducted, the county agency must send the participant a written 57.19 notice that includes the information required under clause (1). 57.20 (1) During the face-to-face meeting, the county agency must: 57.21 (i) determine whether the continued noncompliance can be 57.22 explained and mitigated by providing a needed preemployment 57.23 activity, as defined in section 256J.49, subdivision 13, clause 57.24(16), or services under a local intervention grant for57.25self-sufficiency under section 256J.625(9); 57.26 (ii) determine whether the participant qualifies for a good 57.27 cause exception under section 256J.57, or if the sanction is for 57.28 noncooperation with child support requirements, determine if the 57.29 participant qualifies for a good cause exemption under section 57.30 256.741, subdivision 10; 57.31 (iii) determine whether the participant qualifies for an 57.32 exemption under section 256J.56 or the work activities in the 57.33 employment plan are appropriate based on the criteria in section 57.34 256J.521, subdivision 2 or 3; 57.35 (iv)determine whether the participant qualifies for an57.36exemption from regular employment services requirements for58.1victims of family violence under section 256J.52, subdivision58.26determine whether the participant qualifies for the family 58.3 violence waiver; 58.4 (v) inform the participant of the participant's sanction 58.5 status and explain the consequences of continuing noncompliance; 58.6 (vi) identify other resources that may be available to the 58.7 participant to meet the needs of the family; and 58.8 (vii) inform the participant of the right to appeal under 58.9 section 256J.40. 58.10 (2) If the lack of an identified activity or service can 58.11 explain the noncompliance, the county must work with the 58.12 participant to provide the identified activity, and the county58.13must restore the participant's grant amount to the full amount58.14for which the assistance unit is eligible. The grant must be58.15restored retroactively to the first day of the month in which58.16the participant was found to lack preemployment activities or to58.17qualify for an exemption under section 256J.56, a good cause58.18exception under section 256J.57, or an exemption for victims of58.19family violence under section 256J.52, subdivision 6. 58.20 (3)If the participant is found to qualify for a good cause58.21exception or an exemption, the county must restore the58.22participant's grant to the full amount for which the assistance58.23unit is eligible.The grant must be restored to the full amount 58.24 for which the assistance unit is eligible retroactively to the 58.25 first day of the month in which the participant was found to 58.26 lack preemployment activities or to qualify for an exemption 58.27 under section 256J.56, a family violence waiver, or for a good 58.28 cause exemption under section 256.741, subdivision 10, or 58.29 256J.57. 58.30 (e) For the purpose of applying sanctions under this 58.31 section, only occurrences of noncompliance that occur after the 58.32 effective date of this section shall be considered. If the 58.33 participant is in 30 percent sanction in the month this section 58.34 takes effect, that month counts as the first occurrence for 58.35 purposes of applying the sanctions under this section, but the 58.36 sanction shall remain at 30 percent for that month. 59.1 (f) An assistance unit whose case is closed under paragraph 59.2 (d) or (g), or under an approved county option sanction plan 59.3 under section 256J.462 in effect June 30, 2003, or a county 59.4 pilot project under Laws 2000, chapter 488, article 10, section 59.5 29, in effect June 30, 2003, may reapply for MFIP and shall be 59.6 eligible if the participant complies with MFIP program 59.7 requirements and demonstrates compliance for up to one month. 59.8 No assistance shall be paid during this period. 59.9 (g) An assistance unit whose case has been closed for 59.10 noncompliance, that reapplies under paragraph (f) is subject to 59.11 sanction under paragraph (c), clause (2), for a first occurrence 59.12 of noncompliance. Any subsequent occurrence of noncompliance 59.13 shall result in case closure under paragraph (d). 59.14 Sec. 63. Minnesota Statutes 2002, section 256J.46, 59.15 subdivision 2, is amended to read: 59.16 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 59.17 REQUIREMENTS.] The grant of an MFIP caregiver who refuses to 59.18 cooperate, as determined by the child support enforcement 59.19 agency, with support requirements under section 256.741, shall 59.20 be subject to sanction as specified in this subdivision and 59.21 subdivision 1. For a first occurrence of noncooperation, the 59.22 assistance unit's grant must be reduced by2530 percent of the 59.23 applicable MFIP standard of need. Subsequent occurrences of 59.24 noncooperation shall be subject to sanction under subdivision 1, 59.25 paragraphs (c), clause (2), and (d). The residual amount of the 59.26 grant, if any, must be paid to the caregiver. A sanction under 59.27 this subdivision becomes effective the first month following the 59.28 month in which a required notice is given. A sanction must not 59.29 be imposed when a caregiver comes into compliance with the 59.30 requirements under section 256.741 prior to the effective date 59.31 of the sanction. The sanction shall be removed in the month 59.32 following the month that the caregiver cooperates with the 59.33 support requirements. Each month that an MFIP caregiver fails 59.34 to comply with the requirements of section 256.741 must be 59.35 considered a separate occurrence of noncompliance for the 59.36 purpose of applying sanctions under subdivision 1, paragraphs 60.1 (c), clause (2), and (d).An MFIP caregiver who has had one or60.2more sanctions imposed must remain in compliance with the60.3requirements of section 256.741 for six months in order for a60.4subsequent sanction to be considered a first occurrence.60.5 Sec. 64. Minnesota Statutes 2002, section 256J.46, 60.6 subdivision 2a, is amended to read: 60.7 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 60.8 provisions of subdivisions 1 and 2, for a participant subject to 60.9 a sanction for refusal to comply with child support requirements 60.10 under subdivision 2 and subject to a concurrent sanction for 60.11 refusal to cooperate with other program requirements under 60.12 subdivision 1, sanctions shall be imposed in the manner 60.13 prescribed in this subdivision. 60.14A participant who has had one or more sanctions imposed60.15under this subdivision must remain in compliance with the60.16provisions of this chapter for six months in order for a60.17subsequent occurrence of noncompliance to be considered a first60.18occurrence.Any vendor payment of shelter costs or utilities 60.19 under this subdivision must remain in effect for six months 60.20 after the month in which the participant is no longer subject to 60.21 sanction under subdivision 1. 60.22 (b) If the participant was subject to sanction for: 60.23 (i) noncompliance under subdivision 1 before being subject 60.24 to sanction for noncooperation under subdivision 2; or 60.25 (ii) noncooperation under subdivision 2 before being 60.26 subject to sanction for noncompliance under subdivision 1, the 60.27 participant is considered to have a second occurrence of 60.28 noncompliance and shall be sanctioned as provided in subdivision 60.29 1, paragraph(d)(c), clause (2). Each subsequent occurrence of 60.30 noncompliance shall be considered one additional occurrence and 60.31 shall be subject to the applicable level of sanction under 60.32 subdivision 1, paragraph (d), or section 256J.462. The 60.33 requirement that the county conduct a review as specified in 60.34 subdivision 1, paragraph(e)(d), remains in effect. 60.35 (c) A participant who first becomes subject to sanction 60.36 under both subdivisions 1 and 2 in the same month is subject to 61.1 sanction as follows: 61.2 (i) in the first month of noncompliance and noncooperation, 61.3 the participant's grant must be reduced by2530 percent of the 61.4 applicable MFIP standard of need, with any residual amount paid 61.5 to the participant; 61.6 (ii) in the second and subsequent months of noncompliance 61.7 and noncooperation, the participant shall be subject to the 61.8 applicable level of sanction under subdivision 1, paragraph (d),61.9or section 256J.462. 61.10 The requirement that the county conduct a review as 61.11 specified in subdivision 1, paragraph(e)(d), remains in effect. 61.12 (d) A participant remains subject to sanction under 61.13 subdivision 2 if the participant: 61.14 (i) returns to compliance and is no longer subject to 61.15 sanctionunder subdivision 1 or section 256J.462for 61.16 noncompliance with section 256J.45 or sections 256J.515 to 61.17 256J.57; or 61.18 (ii) has the sanctionunder subdivision 1, paragraph (d),61.19or section 256J.462for noncompliance with section 256J.45 or 61.20 sections 256J.515 to 256J.57 removed upon completion of the 61.21 review under subdivision 1, paragraph (e). 61.22 A participant remains subject to the applicable level of 61.23 sanction under subdivision 1, paragraph (d), or section 256J.46261.24 if the participant cooperates and is no longer subject to 61.25 sanction under subdivision 2. 61.26 Sec. 65. Minnesota Statutes 2002, section 256J.49, 61.27 subdivision 4, is amended to read: 61.28 Subd. 4. [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 61.29 "Employment and training service provider" means: 61.30 (1) a public, private, or nonprofit employment and training 61.31 agency certified by the commissioner of economic security under 61.32 sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 61.33 is approved under section 256J.51 and is included in the county 61.34planservice agreement submitted under section256J.50256J.626, 61.35 subdivision74; 61.36 (2) a public, private, or nonprofit agency that is not 62.1 certified by the commissioner under clause (1), but with which a 62.2 county has contracted to provide employment and training 62.3 services and which is included in the county'splanservice 62.4 agreement submitted under section256J.50256J.626, 62.5 subdivision74; or 62.6 (3) a county agency, if the county has opted to provide 62.7 employment and training services and the county has indicated 62.8 that fact in theplanservice agreement submitted under section 62.9256J.50256J.626, subdivision74. 62.10 Notwithstanding section 268.871, an employment and training 62.11 services provider meeting this definition may deliver employment 62.12 and training services under this chapter. 62.13 Sec. 66. Minnesota Statutes 2002, section 256J.49, 62.14 subdivision 5, is amended to read: 62.15 Subd. 5. [EMPLOYMENT PLAN.] "Employment plan" means a plan 62.16 developed by the job counselor and the participant which 62.17 identifies the participant's most direct path to unsubsidized 62.18 employment, lists the specific steps that the caregiver will 62.19 take on that path, and includes a timetable for the completion 62.20 of each step. The plan should also identify any subsequent 62.21 steps that support long-term economic stability. For 62.22 participants who request and qualify for a family violence 62.23 waiver, an employment plan must be developed by the job 62.24 counselor and the participant, and in consultation with a person 62.25 trained in domestic violence and follow the employment plan 62.26 provisions in section 256J.521, subdivision 3. 62.27 Sec. 67. Minnesota Statutes 2002, section 256J.49, is 62.28 amended by adding a subdivision to read: 62.29 Subd. 6a. [FUNCTIONAL WORK LITERACY.] "Functional work 62.30 literacy" means an intensive English as a second language 62.31 program that is work focused and offers at least 20 hours of 62.32 class time per week. 62.33 Sec. 68. Minnesota Statutes 2002, section 256J.49, 62.34 subdivision 9, is amended to read: 62.35 Subd. 9. [PARTICIPANT.] "Participant" means a recipient of 62.36 MFIP assistance who participates or is required to participate 63.1 in employment and training services under sections 256J.515 to 63.2 256J.57 and 256J.95. 63.3 Sec. 69. Minnesota Statutes 2002, section 256J.49, is 63.4 amended by adding a subdivision to read: 63.5 Subd. 12a. [SUPPORTED WORK.] "Supported work" means a 63.6 subsidized or unsubsidized work experience placement with a 63.7 public or private sector employer, which may include services 63.8 such as individualized supervision and job coaching to support 63.9 the participant on the job. 63.10 Sec. 70. Minnesota Statutes 2002, section 256J.49, 63.11 subdivision 13, is amended to read: 63.12 Subd. 13. [WORK ACTIVITY.] "Work activity" means any 63.13 activity in a participant's approved employment plan thatis63.14tied to the participant'sleads to employmentgoal. For 63.15 purposes of the MFIP program,any activity that is included in a63.16participant's approved employment plan meetsthis includes 63.17 activities that meet the definition of work activityas counted63.18 under thefederalparticipationstandardsrequirements of TANF. 63.19 Work activity includes, but is not limited to: 63.20 (1) unsubsidized employment, including work study and paid 63.21 apprenticeships or internships; 63.22 (2) subsidized private sector or public sector employment, 63.23 including grant diversion as specified in section 256J.69, 63.24 on-the-job training as specified in section 256J.66, the 63.25 self-employment investment demonstration program (SEID) as 63.26 specified in section 256J.65, paid work experience, and 63.27 supported work when a wage subsidy is provided; 63.28 (3) unpaid work experience, includingCWEPcommunity 63.29 service, volunteer work, the community work experience program 63.30 as specified in section 256J.67, unpaid apprenticeships or 63.31 internships, andincluding work associated with the refurbishing63.32of publicly assisted housing if sufficient private sector63.33employment is not availablesupported work when a wage subsidy 63.34 is not provided; 63.35 (4)on-the-job training as specified in section 256J.66job 63.36 search including job readiness assistance, job clubs, job 64.1 placement, job-related counseling, and job retention services; 64.2(5) job search, either supervised or unsupervised;64.3(6) job readiness assistance;64.4(7) job clubs, including job search workshops;64.5(8) job placement;64.6(9) job development;64.7(10) job-related counseling;64.8(11) job coaching;64.9(12) job retention services;64.10(13) job-specific training or education;64.11(14) job skills training directly related to employment;64.12(15) the self-employment investment demonstration (SEID),64.13as specified in section 256J.65;64.14(16) preemployment activities, based on availability and64.15resources, such as volunteer work, literacy programs and related64.16activities, citizenship classes, English as a second language64.17(ESL) classes as limited by the provisions of section 256J.52,64.18subdivisions 3, paragraph (d), and 5, paragraph (c), or64.19participation in dislocated worker services, chemical dependency64.20treatment, mental health services, peer group networks,64.21displaced homemaker programs, strength-based resiliency64.22training, parenting education, or other programs designed to64.23help families reach their employment goals and enhance their64.24ability to care for their children;64.25(17) community service programs;64.26(18) vocational educational training or educational64.27programs that can reasonably be expected to lead to employment,64.28as limited by the provisions of section 256J.53;64.29(19) apprenticeships;64.30(20) satisfactory attendance in general educational64.31development diploma classes or an adult diploma program;64.32(21) satisfactory attendance at secondary school, if the64.33participant has not received a high school diploma;64.34(22) adult basic education classes;64.35(23) internships;64.36(24) bilingual employment and training services;65.1(25) providing child care services to a participant who is65.2working in a community service program; and65.3(26) activities included in an alternative employment plan65.4that is developed under section 256J.52, subdivision 6.65.5 (5) job readiness education, including English as a second 65.6 language (ESL) or functional work literacy classes as limited by 65.7 the provisions of section 256J.531, subdivision 2, general 65.8 educational development (GED) course work, high school 65.9 completion, and adult basic education as limited by the 65.10 provisions of section 256J.531, subdivision 1; 65.11 (6) job skills training directly related to employment, 65.12 including education and training that can reasonably be expected 65.13 to lead to employment, as limited by the provisions of section 65.14 256J.53; 65.15 (7) providing child care services to a participant who is 65.16 working in a community service program; 65.17 (8) activities included in the employment plan that is 65.18 developed under section 256J.521, subdivision 3; and 65.19 (9) preemployment activities including chemical and mental 65.20 health assessments, treatment, and services; learning 65.21 disabilities services; child protective services; family 65.22 stabilization services; or other programs designed to enhance 65.23 employability. 65.24 Sec. 71. Minnesota Statutes 2002, section 256J.50, 65.25 subdivision 1, is amended to read: 65.26 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT 65.27 OF MFIP.] (a)By January 1, 1998,Each county must develop and 65.28implementprovide an employment and training services component 65.29of MFIPwhich is designed to put participants on the most direct 65.30 path to unsubsidized employment. Participation in these 65.31 services is mandatory for all MFIP caregivers, unless the 65.32 caregiver is exempt under section 256J.56. 65.33 (b) A county must provide employment and training services 65.34 under sections 256J.515 to 256J.74 within 30 days after 65.35 thecaregiver's participation becomes mandatory under65.36subdivision 5 or within 30 days of receipt of a request for66.1services from a caregiver who under section 256J.42 is no longer66.2eligible to receive MFIP but whose income is below 120 percent66.3of the federal poverty guidelines for a family of the same66.4size. The request must be made within 12 months of the date the66.5caregivers' MFIP case was closedcaregiver is determined 66.6 eligible for MFIP, or within ten days when the caregiver 66.7 participated in the diversionary work program under section 66.8 256J.95 within the past 12 months. 66.9 Sec. 72. Minnesota Statutes 2002, section 256J.50, 66.10 subdivision 9, is amended to read: 66.11 Subd. 9. [EXCEPTION; FINANCIAL HARDSHIP.] Notwithstanding 66.12 subdivision 8, a county that explains in theplanservice 66.13 agreement required under section 256J.626, subdivision74, that 66.14 the provision of alternative employment and training service 66.15 providers would result in financial hardship for the county is 66.16 not required to make available more than one employment and 66.17 training provider. 66.18 Sec. 73. Minnesota Statutes 2002, section 256J.50, 66.19 subdivision 10, is amended to read: 66.20 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OF FAMILY 66.21 VIOLENCE.] (a) County agencies and their contractors must 66.22 provide universal notification to all applicants and recipients 66.23 of MFIP that: 66.24 (1) referrals to counseling and supportive services are 66.25 available for victims of family violence; 66.26 (2) nonpermanent resident battered individuals married to 66.27 United States citizens or permanent residents may be eligible to 66.28 petition for permanent residency under the federal Violence 66.29 Against Women Act, and that referrals to appropriate legal 66.30 services are available; 66.31 (3) victims of family violence are exempt from the 60-month 66.32 limit on assistancewhile the individual isif they are 66.33 complying with anapproved safety plan or, after October 1,66.342001, an alternativeemployment plan, as defined inunder 66.35 section256J.49256J.521, subdivision1a3; and 66.36 (4) victims of family violence may choose to have regular 67.1 work requirements waived while the individual is complying with 67.2 analternativeemployment planas defined inunder section 67.3256J.49256J.521, subdivision1a3. 67.4 (b) If analternativeemployment plan under section 67.5 256J.521, subdivision 3, is denied, the county or a job 67.6 counselor must provide reasons why the plan is not approved and 67.7 document how the denial of the plan does not interfere with the 67.8 safety of the participant or children. 67.9 Notification must be in writing and orally at the time of 67.10 application and recertification, when the individual is referred 67.11 to the title IV-D child support agency, and at the beginning of 67.12 any job training or work placement assistance program. 67.13 Sec. 74. Minnesota Statutes 2002, section 256J.51, 67.14 subdivision 1, is amended to read: 67.15 Subdivision 1. [PROVIDER APPLICATION.] An employment and 67.16 training service provider that is not included in a county's 67.17planservice agreement under section256J.50256J.626, 67.18 subdivision74, because the county has demonstrated financial 67.19 hardship under section 256J.50, subdivision 9of that section, 67.20 may appeal its exclusion to the commissioner of economic 67.21 security under this section. 67.22 Sec. 75. Minnesota Statutes 2002, section 256J.51, 67.23 subdivision 2, is amended to read: 67.24 Subd. 2. [APPEAL; ALTERNATE APPROVAL.] (a) An employment 67.25 and training service provider that is not included by a county 67.26 agency in theplanservice agreement under section 67.27256J.50256J.626, subdivision74, and that meets the criteria 67.28 in paragraph (b), may appeal its exclusion to the commissioner 67.29 of economic security, and may request alternative approval by 67.30 the commissioner of economic security to provide services in the 67.31 county. 67.32 (b) An employment and training services provider that is 67.33 requesting alternative approval must demonstrate to the 67.34 commissioner that the provider meets the standards specified in 67.35 section 268.871, subdivision 1, paragraph (b), except that the 67.36 provider's past experience may be in services and programs 68.1 similar to those specified in section 268.871, subdivision 1, 68.2 paragraph (b). 68.3 Sec. 76. Minnesota Statutes 2002, section 256J.51, 68.4 subdivision 3, is amended to read: 68.5 Subd. 3. [COMMISSIONER'S REVIEW.] (a) The commissioner 68.6 must act on a request for alternative approval under this 68.7 section within 30 days of the receipt of the request. If after 68.8 reviewing the provider's request, and the county'splanservice 68.9 agreement submitted under section256J.50256J.626, 68.10 subdivision74, the commissioner determines that the provider 68.11 meets the criteria under subdivision 2, paragraph (b), and that 68.12 approval of the provider would not cause financial hardship to 68.13 the county, the county must submit a revisedplanservice 68.14 agreement under subdivision 4 that includes the approved 68.15 provider. 68.16 (b) If the commissioner determines that the approval of the 68.17 provider would cause financial hardship to the county, the 68.18 commissioner must notify the provider and the county of this 68.19 determination. The alternate approval process under this 68.20 section shall be closed to other requests for alternate approval 68.21 to provide employment and training services in the county for up 68.22 to 12 months from the date that the commissioner makes a 68.23 determination under this paragraph. 68.24 Sec. 77. Minnesota Statutes 2002, section 256J.51, 68.25 subdivision 4, is amended to read: 68.26 Subd. 4. [REVISEDPLANSERVICE AGREEMENT REQUIRED.] The 68.27 commissioner of economic security must notify the county agency 68.28 when the commissioner grants an alternative approval to an 68.29 employment and training service provider under subdivision 2. 68.30 Upon receipt of the notice, the county agency must submit a 68.31 revisedplanservice agreement under section256J.50256J.626, 68.32 subdivision74, that includes the approved provider. The 68.33 county has 90 days from the receipt of the commissioner's notice 68.34 to submit the revisedplanservice agreement. 68.35 Sec. 78. [256J.521] [ASSESSMENT; EMPLOYMENT PLANS.] 68.36 Subdivision 1. [ASSESSMENTS.] (a) For purposes of MFIP 69.1 employment services, assessment is a continuing process of 69.2 gathering information related to employability for the purpose 69.3 of identifying both participant's strengths and strategies for 69.4 coping with issues that interfere with employment. The job 69.5 counselor must use information from the assessment process to 69.6 develop and update the employment plan under subdivision 2. 69.7 (b) The scope of assessment must cover at least the 69.8 following areas: 69.9 (1) basic information about the participant's ability to 69.10 obtain and retain employment, including: a review of the 69.11 participant's education level; interests, skills, and abilities; 69.12 prior employment or work experience; transferable work skills; 69.13 child care and transportation needs; 69.14 (2) identification of personal and family circumstances 69.15 that impact the participant's ability to obtain and retain 69.16 employment, including: any special needs of the children, the 69.17 level of English proficiency, family violence issues, and any 69.18 involvement with social services or the legal system; 69.19 (3) the results of a mental and chemical health screening 69.20 tool designed by the commissioner and results of the brief 69.21 screening tool for special learning needs. Screening tools for 69.22 mental and chemical health and special learning needs must be 69.23 approved by the commissioner and may only be administered by job 69.24 counselors or county staff trained in using such screening 69.25 tools. The commissioner shall work with county agencies to 69.26 develop protocols for referrals and follow-up actions after 69.27 screens are administered to participants, including guidance on 69.28 how employment plans may be modified based upon outcomes of 69.29 certain screens. Participants must be told of the purpose of 69.30 the screens and how the information will be used to assist the 69.31 participant in identifying and overcoming barriers to 69.32 employment. Screening for mental and chemical health and 69.33 special learning needs must be completed by participants who are 69.34 unable to find suitable employment after six weeks of job search 69.35 under subdivision 2, paragraph (b), and participants who are 69.36 determined to have barriers to employment under subdivision 2, 70.1 paragraph (d). Failure to complete the screens will result in 70.2 sanction under section 256J.46; and 70.3 (4) a comprehensive review of participation and progress 70.4 for participants who have received MFIP assistance and have not 70.5 worked in unsubsidized employment during the past 12 months. 70.6 The purpose of the review is to determine the need for 70.7 additional services and supports, including placement in 70.8 subsidized employment or unpaid work experience under section 70.9 256J.49, subdivision 13. 70.10 (c) Information gathered during a caregiver's participation 70.11 in the diversionary work program under section 256J.95 must be 70.12 incorporated into the assessment process. 70.13 (d) The job counselor may require the participant to 70.14 complete a professional chemical use assessment to be performed 70.15 according to the rules adopted under section 254A.03, 70.16 subdivision 3, including provisions in the administrative rules 70.17 which recognize the cultural background of the participant, or a 70.18 professional psychological assessment as a component of the 70.19 assessment process, when the job counselor has a reasonable 70.20 belief, based on objective evidence, that a participant's 70.21 ability to obtain and retain suitable employment is impaired by 70.22 a medical condition. The job counselor may assist the 70.23 participant with arranging services, including child care 70.24 assistance and transportation, necessary to meet needs 70.25 identified by the assessment. Data gathered as part of a 70.26 professional assessment must be classified and disclosed 70.27 according to the provisions in section 13.46. 70.28 Subd. 2. [EMPLOYMENT PLAN; CONTENTS.] (a) Based on the 70.29 assessment under subdivision 1, the job counselor and the 70.30 participant must develop an employment plan that includes 70.31 participation in activities and hours that meet the requirements 70.32 of section 256J.55, subdivision 1. The purpose of the 70.33 employment plan is to identify for each participant the most 70.34 direct path to unsubsidized employment and any subsequent steps 70.35 that support long-term economic stability. The employment plan 70.36 should be developed using the highest level of activity 71.1 appropriate for the participant. Activities must be chosen from 71.2 clauses (1) to (6), which are listed in order of preference. 71.3 The employment plan must also list the specific steps the 71.4 participant will take to obtain employment, including steps 71.5 necessary for the participant to progress from one level of 71.6 activity to another, and a timetable for completion of each 71.7 step. Levels of activity include: 71.8 (1) unsubsidized employment; 71.9 (2) job search; 71.10 (3) subsidized employment or unpaid work experience; 71.11 (4) unsubsidized employment and job readiness education or 71.12 job skills training; 71.13 (5) unsubsidized employment or unpaid work experience, and 71.14 activities related to a family violence waiver or preemployment 71.15 needs; and 71.16 (6) activities related to a family violence waiver or 71.17 preemployment needs. 71.18 (b) Participants who are determined to possess sufficient 71.19 skills such that the participant is likely to succeed in 71.20 obtaining unsubsidized employment must job search at least 30 71.21 hours per week for up to six weeks, and accept any offer of 71.22 suitable employment. The remaining hours necessary to meet the 71.23 requirements of section 256J.55, subdivision 1, may be met 71.24 through participation in other work activities under section 71.25 256J.49, subdivision 13. The participant's employment plan must 71.26 specify, at a minimum: (1) whether the job search is supervised 71.27 or unsupervised; (2) support services that will be provided; and 71.28 (3) how frequently the participant must report to the job 71.29 counselor. Participants who are unable to find suitable 71.30 employment after six weeks must meet with the job counselor to 71.31 determine whether other activities in paragraph (a) should be 71.32 incorporated into the employment plan. Job search activities 71.33 which are continued after six weeks must be structured and 71.34 supervised. 71.35 (c) Beginning July 1, 2004, activities and hourly 71.36 requirements in the employment plan may be adjusted as necessary 72.1 to accommodate the personal and family circumstances of 72.2 participants identified under section 256J.561, subdivision 2, 72.3 paragraph (d). Participants who no longer meet the provisions 72.4 of section 256J.561, subdivision 2, paragraph (d), must meet 72.5 with the job counselor within ten days of the determination to 72.6 revise the employment plan. 72.7 (d) Participants who are determined to have barriers to 72.8 obtaining or retaining employment that will not be overcome 72.9 during six weeks of job search under paragraph (b) must work 72.10 with the job counselor to develop an employment plan that 72.11 addresses those barriers by incorporating appropriate activities 72.12 from paragraph (a), clauses (1) to (6). The employment plan 72.13 must include enough hours to meet the participation requirements 72.14 in section 256J.55, subdivision 1, unless a compelling reason to 72.15 require fewer hours is noted in the participant's file. 72.16 (e) The job counselor and the participant must sign the 72.17 employment plan to indicate agreement on the contents. Failure 72.18 to develop or comply with activities in the plan, or voluntarily 72.19 quitting suitable employment without good cause, will result in 72.20 the imposition of a sanction under section 256J.46. 72.21 (f) Employment plans must be reviewed at least every three 72.22 months to determine whether activities and hourly requirements 72.23 should be revised. 72.24 Subd. 3. [EMPLOYMENT PLAN; FAMILY VIOLENCE WAIVER.] (a) A 72.25 participant who requests and qualifies for a family violence 72.26 waiver shall develop or revise the employment plan as specified 72.27 in this subdivision with a job counselor or county, and a person 72.28 trained in domestic violence. The revised or new employment 72.29 plan must be approved by the county or the job counselor. The 72.30 plan may address safety, legal, or emotional issues, and other 72.31 demands on the family as a result of the family violence. 72.32 Information in section 256J.515, clauses (1) to (8), must be 72.33 included as part of the development of the plan. 72.34 (b) The primary goal of an employment plan developed under 72.35 this subdivision is to ensure the safety of the caregiver and 72.36 children. To the extent it is consistent with ensuring safety, 73.1 the plan shall also include activities that are designed to lead 73.2 to economic stability. An activity is inconsistent with 73.3 ensuring safety if, in the opinion of a person trained in 73.4 domestic violence, the activity would endanger the safety of the 73.5 participant or children. A plan under this subdivision may not 73.6 automatically include a provision that requires a participant to 73.7 obtain an order for protection or to attend counseling. 73.8 (c) If at any time there is a disagreement over whether the 73.9 activities in the plan are appropriate or the participant is not 73.10 complying with activities in the plan under this subdivision, 73.11 the participant must receive the assistance of a person trained 73.12 in domestic violence to help resolve the disagreement or 73.13 noncompliance with the county or job counselor. If the person 73.14 trained in domestic violence recommends that the activities are 73.15 still appropriate, the county or a job counselor must approve 73.16 the activities in the plan or provide written reasons why 73.17 activities in the plan are not approved and document how denial 73.18 of the activities do not endanger the safety of the participant 73.19 or children. 73.20 Subd. 4. [SELF-EMPLOYMENT.] (a) Self-employment activities 73.21 may be included in an employment plan contingent on the 73.22 development of a business plan which establishes a timetable and 73.23 earning goals that will result in the participant exiting MFIP 73.24 assistance. Business plans must be developed with assistance 73.25 from an individual or organization with expertise in small 73.26 business as approved by the job counselor. 73.27 (b) Participants with an approved plan that includes 73.28 self-employment must meet the participation requirements in 73.29 section 256J.55, subdivision 1. Only hours where the 73.30 participant earns at least minimum wage shall be counted toward 73.31 the requirement. Additional activities and hours necessary to 73.32 meet the participation requirements in section 256J.55, 73.33 subdivision 1, must be included in the employment plan. 73.34 (c) Employment plans which include self-employment 73.35 activities must be reviewed every three months. Participants 73.36 who fail, without good cause, to make satisfactory progress as 74.1 established in the business plan must revise the employment plan 74.2 to replace the self-employment with other approved work 74.3 activities. 74.4 (d) The requirements of this subdivision may be waived for 74.5 participants who are enrolled in the self-employment investment 74.6 demonstration program (SEID) under section 256J.65, and who make 74.7 satisfactory progress as determined by the job counselor and the 74.8 SEID provider. 74.9 Subd. 5. [TRANSITION FROM THE DIVERSIONARY WORK 74.10 PROGRAM.] Participants who become eligible for MFIP assistance 74.11 after completing the diversionary work program under section 74.12 256J.95 must comply with all requirements of subdivisions 1 and 74.13 2. Participants who become eligible for MFIP assistance after 74.14 being determined unable to benefit from the diversionary work 74.15 program must comply with the requirements of subdivisions 1 and 74.16 2, with the exception of subdivision 2, paragraph (b). 74.17 Subd. 6. [LOSS OF EMPLOYMENT.] Participants who are laid 74.18 off, quit with good cause, or are terminated from employment 74.19 through no fault of their own must meet with the job counselor 74.20 within ten working days to ascertain the reason for the job loss 74.21 and to revise the employment plan as necessary to address the 74.22 problem. 74.23 Sec. 79. Minnesota Statutes 2002, section 256J.53, 74.24 subdivision 1, is amended to read: 74.25 Subdivision 1. [LENGTH OF PROGRAM.] In order for a 74.26 post-secondary education or training program to be an approved 74.27 work activity as defined in section 256J.49, subdivision 13, 74.28 clause(18)(6), it must be a program lasting 24 months or less, 74.29 and the participant must meet the requirements of subdivisions 2 74.30and, 3, and 5. 74.31 Sec. 80. Minnesota Statutes 2002, section 256J.53, 74.32 subdivision 2, is amended to read: 74.33 Subd. 2. [DOCUMENTATION SUPPORTING PROGRAMAPPROVAL OF 74.34 POSTSECONDARY EDUCATION OR TRAINING.] (a) In order for a 74.35 post-secondary education or training program to be an approved 74.36 activity ina participant'san employment plan, the participant 75.1or the employment and training service providermustprovide75.2documentation that:be working in unsubsidized employment at 75.3 least 20 hours per week. 75.4 (b) Participants seeking approval of a postsecondary 75.5 education or training plan must provide documentation that: 75.6 (1) theparticipant'semploymentplan identifies specific75.7goals thatgoal can only be met with the additional education or 75.8 training; 75.9 (2) there are suitable employment opportunities that 75.10 require the specific education or training in the area in which 75.11 the participant resides or is willing to reside; 75.12 (3) the education or training will result in significantly 75.13 higher wages for the participant than the participant could earn 75.14 without the education or training; 75.15 (4) the participant can meet the requirements for admission 75.16 into the program; and 75.17 (5) there is a reasonable expectation that the participant 75.18 will complete the training program based on such factors as the 75.19 participant's MFIP assessment, previous education, training, and 75.20 work history; current motivation; and changes in previous 75.21 circumstances. 75.22 (c) The hourly unsubsidized employment requirement may be 75.23 reduced for intensive education or training programs lasting 12 75.24 weeks or less when full-time attendance is required. 75.25 (d) Participants with an approved employment plan in place 75.26 on July 1, 2003, which includes more than 12 months of 75.27 postsecondary education or training shall be allowed to complete 75.28 that plan provided that hourly requirements in section 256J.55, 75.29 subdivision 1, and conditions specified in paragraph (b), and 75.30 subdivisions 3 and 5 are met. 75.31 Sec. 81. Minnesota Statutes 2002, section 256J.53, 75.32 subdivision 5, is amended to read: 75.33 Subd. 5. [JOB SEARCH AFTER COMPLETION OF WORK ACTIVITY75.34 REQUIREMENTS AFTER POSTSECONDARY EDUCATION OR TRAINING.]If a75.35participant's employment plan includes a post-secondary75.36educational or training program, the plan must include an76.1anticipated completion date for those activities. At the time76.2the education or training is completed, the participant must76.3participate in job search. If, after three months of job76.4search, the participant does not find a job that is consistent76.5with the participant's employment goal, the participant must76.6accept any offer of suitable employment.Upon completion of an 76.7 approved education or training program, a participant who does 76.8 not meet the participation requirements in section 256J.55, 76.9 subdivision 1, through unsubsidized employment must participate 76.10 in job search. If, after six weeks of job search, the 76.11 participant does not find a full-time job consistent with the 76.12 employment goal, the participant must accept any offer of 76.13 full-time suitable employment, or meet with the job counselor to 76.14 revise the employment plan to include additional work activities 76.15 necessary to meet hourly requirements. 76.16 Sec. 82. [256J.531] [BASIC EDUCATION; ENGLISH AS A SECOND 76.17 LANGUAGE.] 76.18 Subdivision 1. [APPROVAL OF ADULT BASIC EDUCATION.] With 76.19 the exception of classes related to obtaining a general 76.20 educational development credential (GED), a participant must 76.21 have reading or mathematics proficiency below a ninth grade 76.22 level in order for adult basic education classes to be an 76.23 approved work activity. The employment plan must also specify 76.24 that the participant fulfill no more than one-half of the 76.25 participation requirements in section 256J.55, subdivision 1, 76.26 through attending adult basic education or general educational 76.27 development classes. 76.28 Subd. 2. [APPROVAL OF ENGLISH AS A SECOND LANGUAGE.] In 76.29 order for English as a second language (ESL) classes to be an 76.30 approved work activity in an employment plan, a participant must 76.31 be below a spoken language proficiency level of SPL6 or its 76.32 equivalent, as measured by a nationally recognized test. In 76.33 approving ESL as a work activity, the job counselor must give 76.34 preference to enrollment in a functional work literacy program, 76.35 if one is available, over a regular ESL program. A participant 76.36 may not be approved for more than a combined total of 24 months 77.1 of ESL classes while participating in the diversionary work 77.2 program and the employment and training services component of 77.3 MFIP. The employment plan must also specify that the 77.4 participant fulfill no more than one-half of the participation 77.5 requirements in section 256J.55, subdivision 1, through 77.6 attending ESL classes. For participants enrolled in functional 77.7 work literacy classes, no more than two-thirds of the 77.8 participation requirements in section 256J.55, subdivision 1, 77.9 may be met through attending functional work literacy classes. 77.10 Sec. 83. Minnesota Statutes 2002, section 256J.54, 77.11 subdivision 1, is amended to read: 77.12 Subdivision 1. [ASSESSMENT OF EDUCATIONAL PROGRESS AND 77.13 NEEDS.] (a) The county agency must document the educational 77.14 level of each MFIP caregiver who is under the age of 20 and 77.15 determine if the caregiver has obtained a high school diploma or 77.16 its equivalent. If the caregiver has not obtained a high school 77.17 diploma or its equivalent,and is not exempt from the77.18requirement to attend school under subdivision 5,the county 77.19 agency must complete an individual assessment for the 77.20 caregiver unless the caregiver is exempt from the requirement to 77.21 attend school under subdivision 5 or has chosen to have an 77.22 employment plan under section 256J.521, subdivision 2, as 77.23 allowed in paragraph (b). The assessment must be performed as 77.24 soon as possible but within 30 days of determining MFIP 77.25 eligibility for the caregiver. The assessment must provide an 77.26 initial examination of the caregiver's educational progress and 77.27 needs, literacy level, child care and supportive service needs, 77.28 family circumstances, skills, and work experience. In the case 77.29 of a caregiver under the age of 18, the assessment must also 77.30 consider the results of either the caregiver's or the 77.31 caregiver's minor child's child and teen checkup under Minnesota 77.32 Rules, parts 9505.0275 and 9505.1693 to 9505.1748, if available, 77.33 and the effect of a child's development and educational needs on 77.34 the caregiver's ability to participate in the program. The 77.35 county agency must advise the caregiver that the caregiver's 77.36 first goal must be to complete an appropriateeducational78.1 education option if one is identified for the caregiver through 78.2 the assessment and, in consultation with educational agencies, 78.3 must review the various school completion options with the 78.4 caregiver and assist in selecting the most appropriate option. 78.5 (b) The county agency must give a caregiver, who is age 18 78.6 or 19 and has not obtained a high school diploma or its 78.7 equivalent, the option to choose an employment plan with an 78.8 education option under subdivision 3 or an employment plan under 78.9 section 256J.521, subdivision 2. 78.10 Sec. 84. Minnesota Statutes 2002, section 256J.54, 78.11 subdivision 2, is amended to read: 78.12 Subd. 2. [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 78.13 PLAN.] For caregivers who are under age 18 without a high school 78.14 diploma or its equivalent, the assessment under subdivision 1 78.15 and the employment plan under subdivision 3 must be completed by 78.16 the social services agency under section 257.33. For caregivers 78.17 who are age 18 or 19 without a high school diploma or its 78.18 equivalent who choose to have an employment plan with an 78.19 education option under subdivision 3, the assessment under 78.20 subdivision 1 and the employment plan under subdivision 3 must 78.21 be completed by the job counselor or, at county option, by the 78.22 social services agency under section 257.33. Upon reaching age 78.23 18 or 19 a caregiver who received social services under section 78.24 257.33 and is without a high school diploma or its equivalent 78.25 has the option to choose whether to continue receiving services 78.26 under the caregiver's plan from the social services agency or to 78.27 utilize an MFIP employment and training service provider. The 78.28 social services agency or the job counselor shall consult with 78.29 representatives of educational agencies that are required to 78.30 assist in developing educational plans under section 124D.331. 78.31 Sec. 85. Minnesota Statutes 2002, section 256J.54, 78.32 subdivision 3, is amended to read: 78.33 Subd. 3. [EDUCATIONALEDUCATION OPTION DEVELOPED.] If the 78.34 job counselor or county social services agency identifies an 78.35 appropriateeducationaleducation option for a minor caregiver 78.36under the age of 20without a high school diploma or its 79.1 equivalent, or a caregiver age 18 or 19 without a high school 79.2 diploma or its equivalent who chooses an employment plan with an 79.3 education option, the job counselor or agency must develop an 79.4 employment plan which reflects the identified option. The plan 79.5 must specify that participation in an educational activity is 79.6 required, what school or educational program is most 79.7 appropriate, the services that will be provided, the activities 79.8 the caregiver will take part in, including child care and 79.9 supportive services, the consequences to the caregiver for 79.10 failing to participate or comply with the specified 79.11 requirements, and the right to appeal any adverse action. The 79.12 employment plan must, to the extent possible, reflect the 79.13 preferences of the caregiver. 79.14 Sec. 86. Minnesota Statutes 2002, section 256J.54, 79.15 subdivision 5, is amended to read: 79.16 Subd. 5. [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 79.17 the provisions of section 256J.56, minor parents, or 18- or 79.18 19-year-old parents without a high school diploma or its 79.19 equivalent who chooses an employment plan with an education 79.20 option must attend school unless: 79.21 (1) transportation services needed to enable the caregiver 79.22 to attend school are not available; 79.23 (2) appropriate child care services needed to enable the 79.24 caregiver to attend school are not available; 79.25 (3) the caregiver is ill or incapacitated seriously enough 79.26 to prevent attendance at school; or 79.27 (4) the caregiver is needed in the home because of the 79.28 illness or incapacity of another member of the household. This 79.29 includes a caregiver of a child who is younger than six weeks of 79.30 age. 79.31 (b) The caregiver must be enrolled in a secondary school 79.32 and meeting the school's attendance requirements. The county, 79.33 social service agency, or job counselor must verify at least 79.34 once per quarter that the caregiver is meeting the school's 79.35 attendance requirements. An enrolled caregiver is considered to 79.36 be meeting the attendance requirements when the school is not in 80.1 regular session, including during holiday and summer breaks. 80.2 Sec. 87. [256J.545] [FAMILY VIOLENCE WAIVER CRITERIA.] 80.3 (a) In order to qualify for a family violence waiver, an 80.4 individual must provide documentation of past or current family 80.5 violence which may prevent the individual from participating in 80.6 certain employment activities. A claim of family violence must 80.7 be documented by the applicant or participant providing a sworn 80.8 statement which is supported by collateral documentation. 80.9 (b) Collateral documentation may consist of: 80.10 (1) police, government agency, or court records; 80.11 (2) a statement from a battered women's shelter staff with 80.12 knowledge of the circumstances or credible evidence that 80.13 supports the sworn statement; 80.14 (3) a statement from a sexual assault or domestic violence 80.15 advocate with knowledge of the circumstances or credible 80.16 evidence that supports the sworn statement; 80.17 (4) a statement from professionals from whom the applicant 80.18 or recipient has sought assistance for the abuse; or 80.19 (5) a sworn statement from any other individual with 80.20 knowledge of circumstances or credible evidence that supports 80.21 the sworn statement. 80.22 Sec. 88. Minnesota Statutes 2002, section 256J.55, 80.23 subdivision 1, is amended to read: 80.24 Subdivision 1. [COMPLIANCE WITH JOB SEARCH OR EMPLOYMENT80.25PLAN; SUITABLE EMPLOYMENTPARTICIPATION REQUIREMENTS.](a) Each80.26MFIP participant must comply with the terms of the participant's80.27job search support plan or employment plan. When the80.28participant has completed the steps listed in the employment80.29plan, the participant must comply with section 256J.53,80.30subdivision 5, if applicable, and then the participant must not80.31refuse any offer of suitable employment. The participant may80.32choose to accept an offer of suitable employment before the80.33participant has completed the steps of the employment plan.80.34(b) For a participant under the age of 20 who is without a80.35high school diploma or general educational development diploma,80.36the requirement to comply with the terms of the employment plan81.1means the participant must meet the requirements of section81.2256J.54.81.3(c) Failure to develop or comply with a job search support81.4plan or an employment plan, or quitting suitable employment81.5without good cause, shall result in the imposition of a sanction81.6as specified in sections 256J.46 and 256J.57.81.7 (a) All caregivers must participate in employment services 81.8 under sections 256J.515 to 256J.57 concurrent with receipt of 81.9 MFIP assistance. 81.10 (b) Until July 1, 2004, participants who meet the 81.11 requirements of section 256J.56 are exempt from participation 81.12 requirements. 81.13 (c) Participants under paragraph (a) must develop and 81.14 comply with an employment plan under section 256J.521, or 81.15 section 256J.54 in the case of a participant under the age of 20 81.16 who has not obtained a high school diploma or its equivalent. 81.17 (d) With the exception of participants under the age of 20 81.18 who must meet the education requirements of section 256J.54, all 81.19 participants must meet the hourly participation requirements of 81.20 TANF or the hourly requirements listed in clauses (1) to (3), 81.21 whichever is higher. 81.22 (1) In single-parent families with no children under six 81.23 years of age, the job counselor and the caregiver must develop 81.24 an employment plan that includes 30 to 35 hours per week of work 81.25 activities. 81.26 (2) In single-parent families with a child under six years 81.27 of age, the job counselor and the caregiver must develop an 81.28 employment plan that includes 20 to 35 hours per week of work 81.29 activities. 81.30 (3) In two-parent families, the job counselor and the 81.31 caregivers must develop employment plans which result in a 81.32 combined total of at least 55 hours per week of work activities. 81.33 (e) Failure to participate in employment services, 81.34 including the requirement to develop and comply with an 81.35 employment plan, including hourly requirements, without good 81.36 cause under section 256J.57, shall result in the imposition of a 82.1 sanction under section 256J.46. 82.2 Sec. 89. Minnesota Statutes 2002, section 256J.55, 82.3 subdivision 2, is amended to read: 82.4 Subd. 2. [DUTY TO REPORT.] The participant must inform the 82.5 job counselor withinthreeten working days regarding any 82.6 changes related to the participant's employment status. 82.7 Sec. 90. Minnesota Statutes 2002, section 256J.56, is 82.8 amended to read: 82.9 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 82.10 EXEMPTIONS.] 82.11 (a) An MFIP participant is exempt from the requirements of 82.12 sections256J.52256J.515 to256J.55256J.57 if the participant 82.13 belongs to any of the following groups: 82.14 (1) participants who are age 60 or older; 82.15 (2) participants who are suffering from aprofessionally82.16certifiedpermanent or temporary illness, injury, or incapacity 82.17 which has been certified by a qualified professional when the 82.18 illness, injury, or incapacity is expected to continue for more 82.19 than 30 days andwhichprevents the person from obtaining or 82.20 retaining employment. Persons in this category with a temporary 82.21 illness, injury, or incapacity must be reevaluated at least 82.22 quarterly; 82.23 (3) participants whose presence in the home is required as 82.24 a caregiver because ofa professionally certifiedthe illness, 82.25 injury, or incapacity of another member in the assistance unit, 82.26 a relative in the household, or a foster child in the 82.27 householdandwhen the illness or incapacity and the need for a 82.28 person to provide assistance in the home has been certified by a 82.29 qualified professional and is expected to continue for more than 82.30 30 days; 82.31 (4) women who are pregnant, if the pregnancy has resulted 82.32 ina professionally certifiedan incapacity that prevents the 82.33 woman from obtaining or retaining employment, and the incapacity 82.34 has been certified by a qualified professional; 82.35 (5) caregivers of a child under the age of one year who 82.36 personally provide full-time care for the child. This exemption 83.1 may be used for only 12 months in a lifetime. In two-parent 83.2 households, only one parent or other relative may qualify for 83.3 this exemption; 83.4 (6) participants experiencing a personal or family crisis 83.5 that makes them incapable of participating in the program, as 83.6 determined by the county agency. If the participant does not 83.7 agree with the county agency's determination, the participant 83.8 may seekprofessionalcertification from a qualified 83.9 professional, as defined in section 256J.08, that the 83.10 participant is incapable of participating in the program. 83.11 Persons in this exemption category must be reevaluated 83.12 every 60 days. A personal or family crisis related to family 83.13 violence, as determined by the county or a job counselor with 83.14 the assistance of a person trained in domestic violence, should 83.15 not result in an exemption, but should be addressed through the 83.16 development or revision of analternativeemployment plan under 83.17 section256J.52256J.521, subdivision63; or 83.18 (7) caregivers with a child or an adult in the household 83.19 who meets the disability or medical criteria for home care 83.20 services under section 256B.0627, subdivision 1, 83.21 paragraph(c)(f), or a home and community-based waiver services 83.22 program under chapter 256B, or meets the criteria for severe 83.23 emotional disturbance under section 245.4871, subdivision 6, or 83.24 for serious and persistent mental illness under section 245.462, 83.25 subdivision 20, paragraph (c). Caregivers in this exemption 83.26 category are presumed to be prevented from obtaining or 83.27 retaining employment. 83.28 A caregiver who is exempt under clause (5) must enroll in 83.29 and attend an early childhood and family education class, a 83.30 parenting class, or some similar activity, if available, during 83.31 the period of time the caregiver is exempt under this section. 83.32 Notwithstanding section 256J.46, failure to attend the required 83.33 activity shall not result in the imposition of a sanction. 83.34 (b) The county agency must provide employment and training 83.35 services to MFIP participants who are exempt under this section, 83.36 but who volunteer to participate. Exempt volunteers may request 84.1 approval for any work activity under section 256J.49, 84.2 subdivision 13. The hourly participation requirements for 84.3 nonexempt participants under section256J.50256J.55, 84.4 subdivision51, do not apply to exempt participants who 84.5 volunteer to participate. 84.6 (c) This section expires on June 30, 2004. 84.7 Sec. 91. [256J.561] [UNIVERSAL PARTICIPATION REQUIRED.] 84.8 Subdivision 1. [IMPLEMENTATION OF UNIVERSAL PARTICIPATION 84.9 REQUIREMENTS.] (a) All caregivers whose applications were 84.10 received July 1, 2004, or after, are immediately subject to the 84.11 requirements in subdivision 2. 84.12 (b) For all MFIP participants who were exempt from 84.13 participating in employment services under section 256J.56 as of 84.14 June 30, 2004, between July 1, 2004, and June 30, 2005, the 84.15 county, as part of the participant's recertification under 84.16 section 256J.32, subdivision 6, shall determine whether a new 84.17 employment plan is required to meet the requirements in 84.18 subdivision 2. Counties shall notify each participant who is in 84.19 need of an employment plan that the participant must meet with a 84.20 job counselor within ten days to develop an employment plan. 84.21 Until a participant's employment plan is developed, the 84.22 participant shall be considered in compliance with the 84.23 participation requirements in this section if the participant 84.24 continues to meet the criteria for an exemption under section 84.25 256J.56 as in effect on June 30, 2004, and is cooperating in the 84.26 development of the new plan. 84.27 Subd. 2. [PARTICIPATION REQUIREMENTS.] (a) All MFIP 84.28 caregivers, except caregivers who meet the criteria in 84.29 subdivision 3, must participate in employment services. Except 84.30 as specified in paragraphs (b) to (d), the employment plan must 84.31 meet the requirements of section 256J.521, subdivision 2, 84.32 contain allowable work activities, as defined in section 84.33 256J.49, subdivision 13, and, include at a minimum, the number 84.34 of participation hours required under section 256J.55, 84.35 subdivision 1. 84.36 (b) Minor caregivers and caregivers who are less than age 85.1 20 who have not completed high school or obtained a GED are 85.2 required to comply with section 256J.54. 85.3 (c) A participant who has a family violence waiver shall 85.4 develop and comply with an employment plan under section 85.5 256J.521, subdivision 3. 85.6 (d) As specified in section 256J.521, subdivision 2, 85.7 paragraph (c), a participant who meets any one of the following 85.8 criteria may work with the job counselor to develop an 85.9 employment plan that contains less than the number of 85.10 participation hours under section 256J.55, subdivision 1. 85.11 Employment plans for participants covered under this paragraph 85.12 must be tailored to recognize the special circumstances of 85.13 caregivers and families including limitations due to illness or 85.14 disability and caregiving needs: 85.15 (1) a participant who is age 60 or older; 85.16 (2) a participant who has been diagnosed by a qualified 85.17 professional as suffering from an illness or incapacity that is 85.18 expected to last for 30 days or more, including a pregnant 85.19 participant who is determined to be unable to obtain or retain 85.20 employment due to the pregnancy; or 85.21 (3) a participant who is determined by a qualified 85.22 professional as being needed in the home to care for an ill or 85.23 incapacitated family member, including caregivers with a child 85.24 or an adult in the household who meets the disability or medical 85.25 criteria for home care services under section 256B.0627, 85.26 subdivision 1, paragraph (f), or a home and community-based 85.27 waiver services program under chapter 256B, or meets the 85.28 criteria for severe emotional disturbance under section 85.29 245.4871, subdivision 6, or for serious and persistent mental 85.30 illness under section 245.462, subdivision 20, paragraph (c). 85.31 (e) For participants covered under paragraphs (c) and (d), 85.32 the county shall review the participant's employment services 85.33 status every three months to determine whether conditions have 85.34 changed. When it is determined that the participant's status is 85.35 no longer covered under paragraph (c) or (d), the county shall 85.36 notify the participant that a new or revised employment plan is 86.1 needed. The participant and job counselor shall meet within ten 86.2 days of the determination to revise the employment plan. 86.3 Subd. 3. [CHILD UNDER 12 WEEKS OF AGE.] (a) A participant 86.4 who has a natural born child who is less than 12 weeks of age 86.5 who meets the criteria in clauses (1) and (2) is not required to 86.6 participate in employment services until the child reaches 12 86.7 weeks of age. To be eligible for this provision, the following 86.8 conditions must be met: 86.9 (1) the child must have been born within ten months of the 86.10 caregiver's application for the diversionary work program or 86.11 MFIP; and 86.12 (2) the assistance unit must not have already used this 86.13 provision or the previously allowed child under age one 86.14 exemption. However, an assistance unit that has an approved 86.15 child under age one exemption at the time this provision becomes 86.16 effective may continue to use that exemption until the child 86.17 reaches one year of age. 86.18 (b) The provision in paragraph (a) ends the first full 86.19 month after the child reaches 12 weeks of age. This provision 86.20 is available only once in a caregiver's lifetime. In a 86.21 two-parent household, only one parent shall be allowed to use 86.22 this provision. The participant and job counselor must meet 86.23 within ten days after the child reaches 12 weeks of age to 86.24 revise the participant's employment plan. 86.25 [EFFECTIVE DATE.] This section is effective July 1, 2004. 86.26 Sec. 92. Minnesota Statutes 2002, section 256J.57, is 86.27 amended to read: 86.28 256J.57 [GOOD CAUSE; FAILURE TO COMPLY; NOTICE; 86.29 CONCILIATION CONFERENCE.] 86.30 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 86.31 county agency shall not impose the sanction under section 86.32 256J.46 if it determines that the participant has good cause for 86.33 failing to comply with the requirements of sections256J.5286.34 256J.515 to256J.55256J.57. Good cause exists when: 86.35 (1) appropriate child care is not available; 86.36 (2) the job does not meet the definition of suitable 87.1 employment; 87.2 (3) the participant is ill or injured; 87.3 (4) a member of the assistance unit, a relative in the 87.4 household, or a foster child in the household is ill and needs 87.5 care by the participant that prevents the participant from 87.6 complying with thejob search support plan oremployment plan; 87.7 (5) the parental caregiver is unable to secure necessary 87.8 transportation; 87.9 (6) the parental caregiver is in an emergency situation 87.10 that prevents compliance with thejob search support plan or87.11 employment plan; 87.12 (7) the schedule of compliance with thejob search support87.13plan oremployment plan conflicts with judicial proceedings; 87.14 (8) a mandatory MFIP meeting is scheduled during a time 87.15 that conflicts with a judicial proceeding or a meeting related 87.16 to a juvenile court matter, or a participant's work schedule; 87.17 (9) the parental caregiver is already participating in 87.18 acceptable work activities; 87.19 (10) the employment plan requires an educational program 87.20 for a caregiver under age 20, but the educational program is not 87.21 available; 87.22 (11) activities identified in thejob search support plan87.23oremployment plan are not available; 87.24 (12) the parental caregiver is willing to accept suitable 87.25 employment, but suitable employment is not available; or 87.26 (13) the parental caregiver documents other verifiable 87.27 impediments to compliance with thejob search support plan or87.28 employment plan beyond the parental caregiver's control. 87.29 The job counselor shall work with the participant to 87.30 reschedule mandatory meetings for individuals who fall under 87.31 clauses (1), (3), (4), (5), (6), (7), and (8). 87.32 Subd. 2. [NOTICE OF INTENT TO SANCTION.] (a) When a 87.33 participant fails without good cause to comply with the 87.34 requirements of sections256J.52256J.515 to256J.55256J.57, 87.35 the job counselor or the county agency must provide a notice of 87.36 intent to sanction to the participant specifying the program 88.1 requirements that were not complied with, informing the 88.2 participant that the county agency will impose the sanctions 88.3 specified in section 256J.46, and informing the participant of 88.4 the opportunity to request a conciliation conference as 88.5 specified in paragraph (b). The notice must also state that the 88.6 participant's continuing noncompliance with the specified 88.7 requirements will result in additional sanctions under section 88.8 256J.46, without the need for additional notices or conciliation 88.9 conferences under this subdivision. The notice, written in 88.10 English, must include the department of human services language 88.11 block, and must be sent to every applicable participant. If the 88.12 participant does not request a conciliation conference within 88.13 ten calendar days of the mailing of the notice of intent to 88.14 sanction, the job counselor must notify the county agency that 88.15 the assistance payment should be reduced. The county must then 88.16 send a notice of adverse action to the participant informing the 88.17 participant of the sanction that will be imposed, the reasons 88.18 for the sanction, the effective date of the sanction, and the 88.19 participant's right to have a fair hearing under section 256J.40. 88.20 (b) The participant may request a conciliation conference 88.21 by sending a written request, by making a telephone request, or 88.22 by making an in-person request. The request must be received 88.23 within ten calendar days of the date the county agency mailed 88.24 the ten-day notice of intent to sanction. If a timely request 88.25 for a conciliation is received, the county agency's service 88.26 provider must conduct the conference within five days of the 88.27 request. The job counselor's supervisor, or a designee of the 88.28 supervisor, must review the outcome of the conciliation 88.29 conference. If the conciliation conference resolves the 88.30 noncompliance, the job counselor must promptly inform the county 88.31 agency and request withdrawal of the sanction notice. 88.32 (c) Upon receiving a sanction notice, the participant may 88.33 request a fair hearing under section 256J.40, without exercising 88.34 the option of a conciliation conference. In such cases, the 88.35 county agency shall not require the participant to engage in a 88.36 conciliation conference prior to the fair hearing. 89.1 (d) If the participant requests a fair hearing or a 89.2 conciliation conference, sanctions will not be imposed until 89.3 there is a determination of noncompliance. Sanctions must be 89.4 imposed as provided in section 256J.46. 89.5 Sec. 93. Minnesota Statutes 2002, section 256J.62, 89.6 subdivision 9, is amended to read: 89.7 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] Only if 89.8 services were approved as part of an employment plan prior to 89.9 June 30, 2003, at the request of the participant, the county may 89.10 continue to provide case management, counseling, or other 89.11 support services to a participant: 89.12(a)(1) who has achieved the employment goal; or 89.13(b)(2) who under section 256J.42 is no longer eligible to 89.14 receive MFIP but whose income is below 115 percent of the 89.15 federal poverty guidelines for a family of the same size. 89.16 These services may be provided for up to 12 months 89.17 following termination of the participant's eligibility for MFIP. 89.18 Sec. 94. [256J.626] [MFIP CONSOLIDATED FUND.] 89.19 Subdivision 1. [CONSOLIDATED FUND.] The consolidated fund 89.20 is established to support counties and tribes in meeting their 89.21 duties under this chapter. Counties and tribes must use funds 89.22 from the consolidated fund to develop programs and services that 89.23 are designed to improve participant outcomes as measured in 89.24 section 256J.751, subdivision 2. Counties may use the funds for 89.25 any allowable expenditures under subdivision 2. Tribes may use 89.26 the funds for any allowable expenditures under subdivision 2, 89.27 except those in clauses (1) and (6). 89.28 Subd. 2. [ALLOWABLE EXPENDITURES.] (a) The commissioner 89.29 must restrict expenditures under the consolidated fund to 89.30 benefits and services allowed under title IV-A of the federal 89.31 Social Security Act. Allowable expenditures under the 89.32 consolidated fund may include, but are not limited to: 89.33 (1) short-term, nonrecurring shelter and utility needs that 89.34 are excluded from the definition of assistance under Code of 89.35 Federal Regulations, title 45, section 260.31, for families who 89.36 meet the residency requirement in section 256J.12, subdivisions 90.1 1 and 1a. Payments under this subdivision are not considered 90.2 TANF cash assistance and are not counted towards the 60-month 90.3 time limit; 90.4 (2) transportation needed to obtain or retain employment or 90.5 to participate in other approved work activities; 90.6 (3) direct and administrative costs of staff to deliver 90.7 employment services for MFIP or the diversionary work program, 90.8 to administer financial assistance, and to provide specialized 90.9 services intended to assist hard-to-employ participants to 90.10 transition to work; 90.11 (4) costs of education and training including functional 90.12 work literacy and English as a second language; 90.13 (5) cost of work supports including tools, clothing, boots, 90.14 and other work-related expenses; 90.15 (6) county administrative expenses as defined in Code of 90.16 Federal Regulations, title 45, section 260(b); 90.17 (7) services to parenting and pregnant teens; 90.18 (8) supported work; 90.19 (9) wage subsidies; 90.20 (10) child care needed for MFIP or diversionary work 90.21 program participants to participate in social services; 90.22 (11) child care to ensure that families leaving MFIP or 90.23 diversionary work program will continue to receive child care 90.24 assistance from the time the family no longer qualifies for 90.25 transition year child care until an opening occurs under the 90.26 basic sliding fee child care program; and 90.27 (12) services to help noncustodial parents who live in 90.28 Minnesota and have minor children receiving MFIP or DWP 90.29 assistance, but do not live in the same household as the child, 90.30 obtain or retain employment. 90.31 (b) Administrative costs that are not matched with county 90.32 funds as provided in subdivision 8 may not exceed 7.5 percent of 90.33 a county's or 15 percent of a tribe's reimbursement under this 90.34 section. The commissioner shall define administrative costs for 90.35 purposes of this subdivision. 90.36 Subd. 3. [ELIGIBILITY FOR SERVICES.] Families with a minor 91.1 child, a pregnant woman, or a noncustodial parent of a minor 91.2 child receiving assistance, with incomes below 200 percent of 91.3 the federal poverty guideline for a family of the applicable 91.4 size, are eligible for services funded under the consolidated 91.5 fund. Counties and tribes must give priority to families 91.6 currently receiving MFIP or diversionary work program, and 91.7 families at risk of receiving MFIP or diversionary work program. 91.8 Subd. 4. [COUNTY AND TRIBAL BIENNIAL SERVICE 91.9 AGREEMENTS.] (a) Effective January 1, 2004, and each two-year 91.10 period thereafter, each county and tribe must have in place an 91.11 approved biennial service agreement related to the services and 91.12 programs in this chapter. In counties with a city of the first 91.13 class with a population over 300,000, the county must consider a 91.14 service agreement that includes a jointly developed plan for the 91.15 delivery of employment services with the city. Counties may 91.16 collaborate to develop multicounty, multitribal, or regional 91.17 service agreements. 91.18 (b) The service agreements will be completed in a form 91.19 prescribed by the commissioner. The agreement must include: 91.20 (1) a statement of the needs of the service population and 91.21 strengths and resources in the community; 91.22 (2) numerical goals for participant outcomes measures to be 91.23 accomplished during the biennial period. The commissioner may 91.24 identify outcomes from section 256J.751, subdivision 2, as core 91.25 outcomes for all counties and tribes; 91.26 (3) strategies the county or tribe will pursue to achieve 91.27 the outcome targets. Strategies must include specification of 91.28 how funds under this section will be used and may include 91.29 community partnerships that will be established or strengthened; 91.30 and 91.31 (4) other items prescribed by the commissioner in 91.32 consultation with counties and tribes. 91.33 (c) The commissioner shall provide each county and tribe 91.34 with information needed to complete an agreement, including: 91.35 (1) information on MFIP cases in the county or tribe; (2) 91.36 comparisons with the rest of the state; (3) baseline performance 92.1 on outcome measures; and (4) promising program practices. 92.2 (d) The service agreement must be submitted to the 92.3 commissioner by October 15, 2003, and October 15 of each second 92.4 year thereafter. The county or tribe must allow a period of not 92.5 less than 30 days prior to the submission of the agreement to 92.6 solicit comments from the public on the contents of the 92.7 agreement. 92.8 (e) The commissioner must, within 60 days of receiving each 92.9 county or tribal service agreement, inform the county or tribe 92.10 if the service agreement is approved. If the service agreement 92.11 is not approved, the commissioner must inform the county or 92.12 tribe of any revisions needed prior to approval. 92.13 (f) The service agreement in this subdivision supersedes 92.14 the plan requirements of section 268.88. 92.15 Subd. 5. [INNOVATION PROJECTS.] Beginning January 1, 2005, 92.16 no more than $3,000,000 of the funds annually appropriated to 92.17 the commissioner for use in the consolidated fund shall be 92.18 available to the commissioner for projects testing innovative 92.19 approaches to improving outcomes for MFIP participants, and 92.20 persons at risk of receiving MFIP as detailed in subdivision 3. 92.21 Projects shall be targeted to geographic areas with poor 92.22 outcomes as specified in section 256J.751, subdivision 5, or to 92.23 subgroups within the MFIP case load who are experiencing poor 92.24 outcomes. 92.25 Subd. 6. [BASE ALLOCATION TO COUNTIES AND TRIBES.] (a) For 92.26 purposes of this section, the following terms have the meanings 92.27 given them: 92.28 (1) "2002 historic spending base" means the commissioner's 92.29 determination of the sum of the reimbursement related to fiscal 92.30 year 2002 of county or tribal agency expenditures for the base 92.31 programs listed in clause (4), items (i) through (iv), and 92.32 earnings related to calendar year 2002 in the base program 92.33 listed in clause (4), item (v), and the amount of spending in 92.34 fiscal year 2002 in the base program listed in clause (4), item 92.35 (vi), issued to or on behalf of persons residing in the county 92.36 or tribal service delivery area. 93.1 (2) "Initial allocation" means the amount potentially 93.2 available to each county or tribe based on the formula in 93.3 paragraphs (b) through (d). 93.4 (3) "Final allocation" means the amount available to each 93.5 county or tribe based on the formula in paragraphs (b) through 93.6 (d), after adjustment by subdivision 7. 93.7 (4) "Base programs" means the: 93.8 (i) MFIP employment and training services under section 93.9 256J.62, subdivision 1, in effect June 30, 2002; 93.10 (ii) bilingual employment and training services to refugees 93.11 under section 256J.62, subdivision 6, in effect June 30, 2002; 93.12 (iii) work literacy language programs under section 93.13 256J.62, subdivision 7, in effect June 30, 2002; 93.14 (iv) supported work program authorized in Laws 2001, First 93.15 Special Session chapter 9, article 17, section 2, in effect June 93.16 30, 2002; 93.17 (v) administrative aid program under section 256J.76 in 93.18 effect December 31, 2002; and 93.19 (vi) emergency assistance program under section 256J.48 in 93.20 effect June 30, 2002. 93.21 (b)(1) Beginning July 1, 2003, the commissioner shall 93.22 determine the initial allocation of funds available under this 93.23 section according to clause (2). 93.24 (2) All of the funds available for the period beginning 93.25 July 1, 2003, and ending December 31, 2004, shall be allocated 93.26 to each county or tribe in proportion to the county's or tribe's 93.27 share of the statewide 2002 historic spending base. 93.28 (c) For calendar year 2005, the commissioner shall 93.29 determine the initial allocation of funds to be made available 93.30 under this section in proportion to the county or tribe's 93.31 initial allocation for the period of July 1, 2003 to December 93.32 31, 2004. 93.33 (d) The formula under this subdivision sunsets December 31, 93.34 2005. 93.35 (e) Before November 30, 2003, a county or tribe may ask for 93.36 a review of the commissioner's determination of the historic 94.1 base spending when the county or tribe believes the 2002 94.2 information was inaccurate or incomplete. By January 1, 2004, 94.3 the commissioner must adjust that county's or tribe's base when 94.4 the commissioner has determined that inaccurate or incomplete 94.5 information was used to develop that base. The commissioner 94.6 shall adjust each county's or tribe's initial allocation under 94.7 paragraph (c) and final allocation under subdivision 7 to 94.8 reflect the base change. 94.9 (f) Effective January 1, 2005, counties and tribes will 94.10 have their final allocations adjusted based on the performance 94.11 provisions of subdivision 7. 94.12 Subd. 7. [PERFORMANCE BASE FUNDS.] (a) Each county and 94.13 tribe will be allocated 95 percent of their initial calendar 94.14 year 2005 allocation. Counties and tribes will be allocated 94.15 additional funds based on performance as follows: 94.16 (1) a county or tribe that achieves a 50 percent rate or 94.17 higher on the MFIP participation rate under section 256J.751, 94.18 subdivision 2, clause (8), as averaged across the four quarterly 94.19 measurements for the most recent year for which the measurements 94.20 are available, will receive an additional allocation equal to 94.21 2.5 percent of its initial allocation; and 94.22 (2) a county or tribe that performs above the top of its 94.23 range of expected performance on the three-year self-support 94.24 index under section 256J.751, subdivision 2, clause (7), in both 94.25 measurements in the preceding year will receive an additional 94.26 allocation equal to five percent of its initial allocation; or 94.27 (3) a county or tribe that performs within its range of 94.28 expected performance on the three-year self-support index under 94.29 section 256J.751, subdivision 2, clause (7), in both 94.30 measurements in the preceding year, or above the top of its 94.31 range of expected performance in one measurement and within its 94.32 expected range of performance in the other measurement, will 94.33 receive an additional allocation equal to 2.5 percent of its 94.34 initial allocation. 94.35 (b) Funds remaining unallocated after the performance-based 94.36 allocations in paragraph (a) are available to the commissioner 95.1 for innovation projects under subdivision 5. 95.2 (c)(1) If available funds are insufficient to meet county 95.3 and tribal allocations under paragraph (a), the commissioner may 95.4 make available for allocation funds that are unobligated and 95.5 available from the innovation projects through the end of the 95.6 current biennium. 95.7 (2) If after the application of clause (1) funds remain 95.8 insufficient to meet county and tribal allocations under 95.9 paragraph (a), the commissioner must proportionally reduce the 95.10 allocation of each county and tribe with respect to their 95.11 maximum allocation available under paragraph (a). 95.12 Subd. 8. [REPORTING REQUIREMENT AND REIMBURSEMENT.] (a) 95.13 The commissioner shall specify requirements for reporting 95.14 according to section 256.01, subdivision 2, clause (17). Each 95.15 county or tribe shall be reimbursed for eligible expenditures up 95.16 to the limit of its allocation and subject to availability of 95.17 funds. 95.18 (b) Reimbursements for county administrative-related 95.19 expenditures determined through the income maintenance random 95.20 moment time study shall be reimbursed at a rate of 50 percent of 95.21 eligible expenditures. 95.22 (c) The commissioner of human services shall review county 95.23 and tribal agency expenditures of the MFIP consolidated fund as 95.24 appropriate and may reallocate unencumbered or unexpended money 95.25 appropriated under this section to those county and tribal 95.26 agencies that can demonstrate a need for additional money. 95.27 Subd. 9. [REPORT.] The commissioner shall, in consultation 95.28 with counties and tribes: 95.29 (1) determine how performance-based allocations under 95.30 subdivision 7, paragraph (a), clauses (2) and (3), will be 95.31 allocated to groupings of counties and tribes when groupings are 95.32 used to measure expected performance ranges for the self-support 95.33 index under section 256J.751, subdivision 2, clause (7); and 95.34 (2) determine how performance-based allocations under 95.35 subdivision 7, paragraph (a), clauses (2) and (3), will be 95.36 allocated to tribes. 96.1 The commissioner shall report to the legislature on the formulas 96.2 developed in clauses (1) and (2) by January 1, 2004. 96.3 Sec. 95. Minnesota Statutes 2002, section 256J.645, 96.4 subdivision 3, is amended to read: 96.5 Subd. 3. [FUNDING.] If the commissioner and an Indian 96.6 tribe are parties to an agreement under this subdivision, the 96.7 agreement shall annually provide to the Indian tribe the funding 96.8 allocated in section256J.62, subdivisions 1 and 2a256J.626. 96.9 Sec. 96. Minnesota Statutes 2002, section 256J.66, 96.10 subdivision 2, is amended to read: 96.11 Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies 96.12 shall limit the length of training based on the complexity of 96.13 the job and the caregiver's previous experience and training. 96.14 Placement in an on-the-job training position with an employer is 96.15 for the purpose of training and employment with the same 96.16 employer who has agreed to retain the person upon satisfactory 96.17 completion of training. 96.18 (b) Placement of any participant in an on-the-job training 96.19 position must be compatible with the participant's assessment 96.20 and employment plan under section256J.52256J.521. 96.21 Sec. 97. Minnesota Statutes 2002, section 256J.69, 96.22 subdivision 2, is amended to read: 96.23 Subd. 2. [TRAINING AND PLACEMENT.] (a) County agencies 96.24 shall limit the length of training to nine months. Placement in 96.25 a grant diversion training position with an employer is for the 96.26 purpose of training and employment with the same employer who 96.27 has agreed to retain the person upon satisfactory completion of 96.28 training. 96.29 (b) Placement of any participant in a grant diversion 96.30 subsidized training position must be compatible with the 96.31 assessment and employment plan or employability development plan 96.32 established for the recipient under section256J.52 or 256K.03,96.33subdivision 8256J.521. 96.34 Sec. 98. Minnesota Statutes 2002, section 256J.75, 96.35 subdivision 3, is amended to read: 96.36 Subd. 3. [RESPONSIBILITY FOR INCORRECT ASSISTANCE 97.1 PAYMENTS.] A county of residence, when different from the county 97.2 of financial responsibility, will be charged by the commissioner 97.3 for the value of incorrect assistance paymentsand medical97.4assistancepaid to or on behalf of a person who was not eligible 97.5 to receive that amount. Incorrect payments include payments to 97.6 an ineligible person or family resulting from decisions, 97.7 failures to act, miscalculations, or overdue recertification. 97.8 However, financial responsibility does not accrue for a county 97.9 when the recertification is overdue at the time the referral is 97.10 received by the county of residence or when the county of 97.11 financial responsibility does not act on the recommendation of 97.12 the county of residence.When federal or state law requires97.13that medical assistance continue after assistance ends, this97.14subdivision also governs financial responsibility for the97.15extended medical assistance.97.16 Sec. 99. Minnesota Statutes 2002, section 256J.751, 97.17 subdivision 1, is amended to read: 97.18 Subdivision 1. [QUARTERLYMONTHLY COUNTY CASELOAD REPORT.] 97.19 The commissioner shall reportquarterlymonthly to each county 97.20onthecounty's performance on the following measuresfollowing 97.21 caseload information: 97.22(1) number of cases receiving only the food portion of97.23assistance;97.24(2) number of child-only cases;97.25(3) number of minor caregivers;97.26(4) number of cases that are exempt from the 60-month time97.27limit by the exemption category under section 256J.42;97.28(5) number of participants who are exempt from employment97.29and training services requirements by the exemption category97.30under section 256J.56;97.31(6) number of assistance units receiving assistance under a97.32hardship extension under section 256J.425;97.33(7) number of participants and number of months spent in97.34each level of sanction under section 256J.46, subdivision 1;97.35(8) number of MFIP cases that have left assistance;97.36(9) federal participation requirements as specified in98.1title 1 of Public Law Number 104-193;98.2(10) median placement wage rate; and98.3(11) of each county's total MFIP caseload less the number98.4of cases in clauses (1) to (6):98.5(i) number of one-parent cases;98.6(ii) number of two-parent cases;98.7(iii) percent of one-parent cases that are working more98.8than 20 hours per week;98.9(iv) percent of two-parent cases that are working more than98.1020 hours per week; and98.11(v) percent of cases that have received more than 36 months98.12of assistance.98.13 (1) total number of cases receiving MFIP, and subtotals of 98.14 cases with one eligible parent, two eligible parents, and an 98.15 eligible caregiver who is not a parent; 98.16 (2) total number of child only assistance cases; 98.17 (3) total number of eligible adults and children receiving 98.18 an MFIP grant, and subtotals for cases with one eligible parent, 98.19 two eligible parents, an eligible caregiver who is not a parent, 98.20 and child only cases; 98.21 (4) number of cases with an exemption from the 60-month 98.22 time limit based on a family violence waiver; 98.23 (5) number of MFIP cases with work hours, and subtotals for 98.24 cases with one eligible parent, two eligible parents, and an 98.25 eligible caregiver who is not a parent; 98.26 (6) number of employed MFIP cases, and subtotals for cases 98.27 with one eligible parent, two eligible parents, and an eligible 98.28 caregiver who is not a parent; 98.29 (7) average monthly gross earnings, and averages for 98.30 subgroups of cases with one eligible parent, two eligible 98.31 parents, and an eligible caregiver who is not a parent; 98.32 (8) number of employed cases receiving only the food 98.33 portion of assistance; 98.34 (9) number of parents or caregivers exempt from work 98.35 activity requirements, with subtotals for each exemption type; 98.36 and 99.1 (10) number of cases with a sanction, with subtotals by 99.2 level of sanction for cases with one eligible parent, two 99.3 eligible parents, and an eligible caregiver who is not a parent. 99.4 Sec. 100. Minnesota Statutes 2002, section 256J.751, 99.5 subdivision 2, is amended to read: 99.6 Subd. 2. [QUARTERLY COMPARISON REPORT.] The commissioner 99.7 shall report quarterly to all counties on each county's 99.8 performance on the following measures: 99.9 (1) percent of MFIP caseload working in paid employment; 99.10 (2) percent of MFIP caseload receiving only the food 99.11 portion of assistance; 99.12 (3) number of MFIP cases that have left assistance; 99.13 (4) federal participation requirements as specified in 99.14 Title 1 of Public LawNumber104-193; 99.15 (5) median placement wage rate;and99.16 (6) caseload by months of TANF assistance; 99.17 (7) percent of MFIP cases off cash assistance or working 30 99.18 or more hours per week at one-year, two-year, and three-year 99.19 follow-up points from a base line quarter. This measure is 99.20 called the self-support index. Twice annually, the commissioner 99.21 shall report an expected range of performance for each county, 99.22 county grouping, and tribe on the self-support index. The 99.23 expected range shall be derived by a statistical methodology 99.24 developed by the commissioner in consultation with the counties 99.25 and tribes. The statistical methodology shall control 99.26 differences across counties in economic conditions and 99.27 demographics of the MFIP case load; and 99.28 (8) the MFIP work participation rate, defined as the 99.29 participation requirements specified in title 1 of Public Law 99.30 104-193 applied to all MFIP cases except child only cases and 99.31 cases exempt under section 256J.56. 99.32 Sec. 101. Minnesota Statutes 2002, section 256J.751, 99.33 subdivision 5, is amended to read: 99.34 Subd. 5. [FAILURE TO MEET FEDERAL PERFORMANCE STANDARDS.] 99.35 (a) If sanctions occur for failure to meet the performance 99.36 standards specified in title 1 of Public LawNumber104-193 of 100.1 the Personal Responsibility and Work Opportunity Act of 1996, 100.2 the state shall pay 88 percent of the sanction. The remaining 100.3 12 percent of the sanction will be paid by the counties. The 100.4 county portion of the sanction will be distributed across all 100.5 counties in proportion to each county's percentage of the MFIP 100.6 average monthly caseload during the period for which the 100.7 sanction was applied. 100.8 (b) If a county fails to meet the performance standards 100.9 specified in title 1 of Public LawNumber104-193 of the 100.10 Personal Responsibility and Work Opportunity Act of 1996 for any 100.11 year, the commissioner shall work with counties to organize a 100.12 joint state-county technical assistance team to work with the 100.13 county. The commissioner shall coordinate any technical 100.14 assistance with other departments and agencies including the 100.15 departments of economic security and children, families, and 100.16 learning as necessary to achieve the purpose of this paragraph. 100.17 (c) For state performance measures, a low-performing county 100.18 is one that: 100.19 (1) performs below the bottom of their expected range for 100.20 the measure in subdivision 2, clause (7), in both measurements 100.21 during the year; or 100.22 (2) performs below 40 percent for the measure in 100.23 subdivision 2, clause (8), as averaged across the four quarterly 100.24 measurements for the year, or the ten counties with the lowest 100.25 rates if more than ten are below 40 percent. 100.26 (d) Low-performing counties under paragraph (c) must engage 100.27 in corrective action planning as defined by the commissioner. 100.28 The commissioner may coordinate technical assistance as 100.29 specified in paragraph (b) for low-performing counties under 100.30 paragraph (c). 100.31 Sec. 102. [256J.95] [DIVERSIONARY WORK PROGRAM.] 100.32 Subdivision 1. [ESTABLISHING A DIVERSIONARY WORK PROGRAM 100.33 (DWP).] (a) The Personal Responsibility and Work Opportunity 100.34 Reconciliation Act of 1996, Public Law 104-193, establishes 100.35 block grants to states for temporary assistance for needy 100.36 families (TANF). TANF provisions allow states to use TANF 101.1 dollars for nonrecurrent, short-term diversionary benefits. The 101.2 diversionary work program established on July 1, 2003, is 101.3 Minnesota's TANF program to provide short-term diversionary 101.4 benefits to eligible recipients of the diversionary work program. 101.5 (b) The goal of the diversionary work program is to provide 101.6 short-term, necessary services and supports to families which 101.7 will lead to unsubsidized employment, increase economic 101.8 stability, and reduce the risk of those families needing longer 101.9 term assistance, under the Minnesota family investment program 101.10 (MFIP). 101.11 (c) When a family unit meets the eligibility criteria in 101.12 this section, the family must receive a diversionary work 101.13 program grant and is not eligible for MFIP. 101.14 (d) A family unit is eligible for the diversionary work 101.15 program for a maximum of four months only once in a 12-month 101.16 period. The 12-month period begins at the date of application 101.17 or the date eligibility is met, whichever is later. During the 101.18 four-month period, family maintenance needs as defined in 101.19 subdivision 2, shall be vendor paid, up to the cash portion of 101.20 the MFIP standard of need for the same size household. To the 101.21 extent there is a balance available between the amount paid for 101.22 family maintenance needs and the cash portion of the 101.23 transitional standard, a personal needs allowance of up to $70 101.24 per DWP recipient in the family unit shall be issued. The 101.25 personal needs allowance payment plus the family maintenance 101.26 needs shall not exceed the cash portion of the MFIP standard of 101.27 need. Counties may provide supportive and other allowable 101.28 services funded by the MFIP consolidated fund under section 101.29 256J.626 to eligible participants during the four-month 101.30 diversionary period. 101.31 Subd. 2. [DEFINITIONS.] The terms used in this section 101.32 have the following meanings. 101.33 (a) "Diversionary Work Program (DWP)" means the program 101.34 established under this section. 101.35 (b) "Employment plan" means a plan developed by the job 101.36 counselor and the participant which identifies the participant's 102.1 most direct path to unsubsidized employment, lists the specific 102.2 steps that the caregiver will take on that path, and includes a 102.3 timetable for the completion of each step. For participants who 102.4 request and qualify for a family violence waiver in section 102.5 256J.521, subdivision 3, an employment plan must be developed by 102.6 the job counselor, the participant and a person trained in 102.7 domestic violence and follow the employment plan provisions in 102.8 section 256J.521, subdivision 3. Employment plans under this 102.9 section shall be written for a period of time not to exceed four 102.10 months. 102.11 (c) "Employment services" means programs, activities, and 102.12 services in this section that are designed to assist 102.13 participants in obtaining and retaining employment. 102.14 (d) "Family maintenance needs" means current housing costs 102.15 including rent, manufactured home lot rental costs, or monthly 102.16 principal, interest, insurance premiums, and property taxes due 102.17 for mortgages or contracts for deed, association fees required 102.18 for homeownership, utility costs for current month expenses of 102.19 gas and electric, garbage, water and sewer, and a flat rate of 102.20 $35 for telephone services. 102.21 (e) "Family unit" means a group of people applying for or 102.22 receiving DWP benefits together. For the purposes of 102.23 determining eligibility for this program, the unit includes the 102.24 relationships in section 256J.24, subdivisions 2 and 4. 102.25 (f) "Minnesota family investment program (MFIP)" means the 102.26 assistance program as defined in section 256J.08, subdivision 57. 102.27 (g) "Personal needs allowance" means an allowance of up to 102.28 $70 per month per DWP unit member to pay for expenses such as 102.29 household products and personal products. 102.30 (h) "Work activities" means allowable work activities as 102.31 defined in section 256J.49, subdivision 13. 102.32 Subd. 3. [ELIGIBILITY FOR DIVERSIONARY WORK PROGRAM.] (a) 102.33 Except for the categories of family units listed below, all 102.34 family units who apply for cash benefits and who meet MFIP 102.35 eligibility as required in sections 256J.11 to 256J.15 are 102.36 eligible and must participate in the diversionary work program. 103.1 Family units that are not eligible for the diversionary work 103.2 program include: 103.3 (1) child only cases; 103.4 (2) a single-parent family unit that includes a child under 103.5 12 weeks of age. A parent is eligible for this exception once 103.6 in a parent's lifetime and is not eligible if the parent has 103.7 already used the previously allowed child under age one 103.8 exemption from MFIP employment services; 103.9 (3) a minor parent without a high school diploma or its 103.10 equivalent; 103.11 (4) a caregiver 18 or 19 years of age without a high school 103.12 diploma or its equivalent who chooses to have an employment plan 103.13 with an education option; 103.14 (5) a caregiver age 60 or over; 103.15 (6) family units with a parent who received DWP benefits 103.16 within a 12-month period as defined in subdivision 1, paragraph 103.17 (d); and 103.18 (7) family units with a parent who received MFIP within the 103.19 past 12 months. 103.20 (b) A two-parent family must participate in DWP unless both 103.21 parents meet the criteria for an exception under paragraph (a), 103.22 clauses (1) through (5), or the family unit includes a parent 103.23 who meets the criteria in paragraph (a), clause (6) or (7). 103.24 Subd. 4. [COOPERATION WITH PROGRAM REQUIREMENTS.] (a) To 103.25 be eligible for DWP, an applicant must comply with the 103.26 requirements of paragraphs (b) to (d). 103.27 (b) Applicants and participants must cooperate with the 103.28 requirements of the child support enforcement program, but will 103.29 not be charged a fee under section 518.551, subdivision 7. 103.30 (c) The applicant must provide each member of the family 103.31 unit's social security number to the county agency. This 103.32 requirement is satisfied when each member of the family unit 103.33 cooperates with the procedures for verification of numbers, 103.34 issuance of duplicate cards, and issuance of new numbers which 103.35 have been established jointly between the Social Security 103.36 Administration and the commissioner. 104.1 (d) Before DWP benefits can be issued to a family unit, the 104.2 caregiver must, in conjunction with a job counselor, develop and 104.3 sign an employment plan. In two-parent family units, both 104.4 parents must develop and sign employment plans before benefits 104.5 can be issued. Food support and health care benefits are not 104.6 contingent on the requirement for a signed employment plan. 104.7 Subd. 5. [SUBMITTING APPLICATION FORM.] The eligibility 104.8 date for the diversionary work program begins with the date the 104.9 signed combined application form (CAF) is received by the county 104.10 agency or the date diversionary work program eligibility 104.11 criteria are met, whichever is later. The county agency must 104.12 inform the applicant that any delay in submitting the 104.13 application will reduce the benefits paid for the month of 104.14 application. The county agency must inform a person that an 104.15 application may be submitted before the person has an interview 104.16 appointment. Upon receipt of a signed application, the county 104.17 agency must stamp the date of receipt on the face of the 104.18 application. The applicant may withdraw the application at any 104.19 time prior to approval by giving written or oral notice to the 104.20 county agency. The county agency must follow the notice 104.21 requirements in section 256J.09, subdivision 3, when issuing a 104.22 notice confirming the withdrawal. 104.23 Subd. 6. [INITIAL SCREENING OF APPLICATIONS.] Upon receipt 104.24 of the application, the county agency must determine if the 104.25 applicant may be eligible for other benefits as required in 104.26 sections 256J.09, subdivision 3a, and 256J.28, subdivisions 1 104.27 and 5. The county must also follow the provisions in section 104.28 256J.09, subdivision 3b, clause (2). 104.29 Subd. 7. [PROGRAM AND PROCESSING STANDARDS.] (a) The 104.30 interview to determine financial eligibility for the 104.31 diversionary work program must be conducted within five working 104.32 days of the receipt of the cash application form. During the 104.33 intake interview the financial worker must discuss: 104.34 (1) the goals, requirements, and services of the 104.35 diversionary work program; 104.36 (2) the availability of child care assistance. If child 105.1 care is needed, the worker must obtain a completed application 105.2 for child care from the applicant before the interview is 105.3 terminated. The same day the application for child care is 105.4 received, the application must be forwarded to the appropriate 105.5 child care worker. For purposes of eligibility for child care 105.6 assistance under chapter 119B, DWP participants shall be 105.7 eligible for the same benefits as MFIP recipients; and 105.8 (3) if the applicant has not requested food support and 105.9 health care assistance on the application, the county agency 105.10 shall, during the interview process, talk with the applicant 105.11 about the availability of these benefits. 105.12 (b) The county shall follow section 256J.74, subdivision 2, 105.13 paragraph (b), clauses (1) and (2), when an applicant or a 105.14 recipient of DWP has a person who is a member of more than one 105.15 assistance unit in a given payment month. 105.16 (c) If within 30 days the county agency cannot determine 105.17 eligibility for the diversionary work program, the county must 105.18 deny the application and inform the applicant of the decision 105.19 according to the notice provisions in section 256J.31. A family 105.20 unit is eligible for a fair hearing under section 256J.40. 105.21 Subd. 8. [VERIFICATION REQUIREMENTS.] (a) A county agency 105.22 must only require verification of information necessary to 105.23 determine DWP eligibility and the amount of the payment. The 105.24 applicant or participant must document the information required 105.25 or authorize the county agency to verify the information. The 105.26 applicant or participant has the burden of providing documentary 105.27 evidence to verify eligibility. The county agency shall assist 105.28 the applicant or participant in obtaining required documents 105.29 when the applicant or participant is unable to do so. 105.30 (b) A county agency must not request information about an 105.31 applicant or participant that is not a matter of public record 105.32 from a source other than county agencies, the department of 105.33 human services, or the United States Department of Health and 105.34 Human Services without the person's prior written consent. An 105.35 applicant's signature on an application form constitutes consent 105.36 for contact with the sources specified on the application. A 106.1 county agency may use a single consent form to contact a group 106.2 of similar sources, but the sources to be contacted must be 106.3 identified by the county agency prior to requesting an 106.4 applicant's consent. 106.5 (c) Factors to be verified shall follow section 256J.32, 106.6 subdivision 4. Except for personal needs, family maintenance 106.7 needs must be verified before the expense can be allowed in the 106.8 calculation of the DWP grant. 106.9 Subd. 9. [PROPERTY AND INCOME LIMITATIONS.] The asset 106.10 limits and exclusions in section 256J.20, apply to applicants 106.11 and recipients of DWP. All payments, unless excluded in section 106.12 256J.21, must be counted as income to determine eligibility for 106.13 the diversionary work program. The county shall treat income as 106.14 outlined in section 256J.37, except for subdivision 3a. The 106.15 initial income test and the disregards in section 256J.21, 106.16 subdivision 3, shall be followed for determining eligibility for 106.17 the diversionary work program. 106.18 Subd. 10. [DIVERSIONARY WORK PROGRAM GRANT.] (a) The 106.19 amount of cash benefits that a family unit is eligible for under 106.20 the diversionary work program is based on the number of persons 106.21 in the family unit, the family maintenance needs, personal needs 106.22 allowance, and countable income. The county agency shall 106.23 evaluate the income of the family unit that is requesting 106.24 payments under the diversionary work program. Countable income 106.25 means gross earned and unearned income not excluded or 106.26 disregarded under MFIP. The same disregards for earned income 106.27 that are allowed under MFIP are allowed for the diversionary 106.28 work program. 106.29 (b) The DWP grant is based on the family maintenance needs 106.30 for which the DWP family unit is responsible plus a personal 106.31 needs allowance. Housing and utilities, except for telephone 106.32 service, shall be vendor paid. Unless otherwise stated in this 106.33 section, actual housing and utility expenses shall be used when 106.34 determining the amount of the DWP grant. 106.35 (c) The maximum monthly benefit amount available under the 106.36 diversionary work program is the difference between the family 107.1 unit's needs under paragraph (b) and the family unit's countable 107.2 income not to exceed the cash portion of the MFIP standard of 107.3 need as defined in section 256J.08, subdivision 55a, for the 107.4 family unit's size. 107.5 (d) Once the county has determined a grant amount, the DWP 107.6 grant amount will not be decreased if the determination is based 107.7 on the best information available at the time of approval and 107.8 shall not be decreased because of any additional income to the 107.9 family unit. The grant must be increased if a participant later 107.10 verifies an increase in family maintenance needs or family unit 107.11 size. The minimum cash benefit amount, if income and asset 107.12 tests are met, is $10. Benefits of $10 shall not be vendor paid. 107.13 (e) When all criteria are met, including the development of 107.14 an employment plan as described in subdivision 14 and 107.15 eligibility exists for the month of application, the amount of 107.16 benefits for the diversionary work program retroactive to the 107.17 date of application is as specified in section 256J.35, 107.18 paragraph (a). 107.19 (f) Any month during the four-month DWP period that a 107.20 person receives a DWP benefit directly or through a vendor 107.21 payment made on the person's behalf, that person is ineligible 107.22 for MFIP or any other TANF cash assistance program except for 107.23 benefits defined in section 256J.626, subdivision 2, clause (1). 107.24 If during the four-month period a family unit that receives 107.25 DWP benefits moves to a county that has not established a 107.26 diversionary work program, the family unit may be eligible for 107.27 MFIP the month following the last month of the issuance of the 107.28 DWP benefit. 107.29 Subd. 11. [UNIVERSAL PARTICIPATION REQUIRED.] (a) All DWP 107.30 caregivers, except caregivers who meet the criteria in paragraph 107.31 (d), are required to participate in DWP employment services. 107.32 Except as specified in paragraphs (b) and (c), employment plans 107.33 under DWP must, at a minimum, meet the requirements in section 107.34 256J.55, subdivision 1. 107.35 (b) A caregiver who is a member of a two-parent family that 107.36 is required to participate in DWP who would otherwise be 108.1 ineligible for DWP under subdivision 3 may be allowed to develop 108.2 an employment plan under section 256J.521, subdivision 2, 108.3 paragraph (c), that may contain alternate activities and reduced 108.4 hours. 108.5 (c) A participant who has a family violence waiver shall be 108.6 allowed to develop an employment plan under section 256J.521, 108.7 subdivision 3. 108.8 (d) One parent in a two-parent family unit that has a 108.9 natural born child under 12 weeks of age is not required to have 108.10 an employment plan until the child reaches 12 weeks of age 108.11 unless the family unit has already used the exclusion under 108.12 section 256J.561, subdivision 2, or the previously allowed child 108.13 under age one exemption under section 256J.56, paragraph (a), 108.14 clause (5). 108.15 (e) The provision in paragraph (d) ends the first full 108.16 month after the child reaches 12 weeks of age. This provision 108.17 is allowable only once in a caregiver's lifetime. In a 108.18 two-parent household, only one parent shall be allowed to use 108.19 this category. 108.20 (f) The participant and job counselor must meet within ten 108.21 working days after the child reaches 12 weeks of age to revise 108.22 the participant's employment plan. The employment plan for a 108.23 family unit that has a child under 12 weeks of age that has 108.24 already used the exclusion in section 256J.561 or the previously 108.25 allowed child under age one exemption under section 256J.56, 108.26 paragraph (a), clause (5), must be tailored to recognize the 108.27 caregiving needs of the parent. 108.28 Subd. 12. [CONVERSION OR REFERRAL TO MFIP.] (a) If at any 108.29 time during the DWP application process or during the four-month 108.30 DWP eligibility period, it is determined that a participant is 108.31 unlikely to benefit from the diversionary work program, the 108.32 county shall convert or refer the participant to MFIP as 108.33 specified in paragraph (d). Participants who are determined to 108.34 be unlikely to benefit from the diversionary work program must 108.35 develop and sign an employment plan. Participants who meet any 108.36 one of the criteria in paragraph (b) shall be considered to be 109.1 unlikely to benefit from DWP, provided the necessary 109.2 documentation is available to support the determination. 109.3 (b) A participant who: 109.4 (1) has been determined by a qualified professional as 109.5 being unable to obtain or retain employment due to an illness, 109.6 injury, or incapacity that is expected to last at least 60 days; 109.7 (2) is required in the home as a caregiver because of the 109.8 illness, injury, or incapacity, of a family member, or a 109.9 relative in the household, or a foster child, and the illness, 109.10 injury, or incapacity and the need for a person to provide 109.11 assistance in the home has been certified by a qualified 109.12 professional and is expected to continue more than 60 days; 109.13 (3) is determined by a qualified professional as being 109.14 needed in the home to care for a child meeting the special 109.15 medical criteria in section 256J.425, subdivision 2, clause (3); 109.16 (4) is pregnant and is determined by a qualified 109.17 professional as being unable to obtain or retain employment due 109.18 to the pregnancy; or 109.19 (5) has applied for SSI or RSDI. 109.20 (c) In a two-parent family unit, both parents must be 109.21 determined to be unlikely to benefit from the diversionary work 109.22 program before the family unit can be converted or referred to 109.23 MFIP. 109.24 (d) A participant who is determined to be unlikely to 109.25 benefit from the diversionary work program shall be converted to 109.26 MFIP and, if the determination was made within 30 days of the 109.27 initial application for benefits, no additional application form 109.28 is required. A participant who is determined to be unlikely to 109.29 benefit from the diversionary work program shall be referred to 109.30 MFIP and, if the determination is made more than 30 days after 109.31 the initial application, the participant must submit a program 109.32 change request form. The county agency shall process the 109.33 program change request form by the first of the following month 109.34 to ensure that no gap in benefits is due to delayed action by 109.35 the county agency. In processing the program change request 109.36 form, the county must follow section 256J.32, subdivision 1, 110.1 except that the county agency shall not require additional 110.2 verification of the information in the case file from the DWP 110.3 application unless the information in the case file is 110.4 inaccurate, questionable, or no longer current. 110.5 (e) The county shall not request a combined application 110.6 form for a participant who has exhausted the four months of the 110.7 diversionary work program, has continued need for cash and food 110.8 assistance, and has completed, signed, and submitted a program 110.9 change request form within 30 days of the fourth month of the 110.10 diversionary work program. The county must process the program 110.11 change request according to section 256J.32, subdivision 1, 110.12 except that the county agency shall not require additional 110.13 verification of information in the case file unless the 110.14 information is inaccurate, questionable, or no longer current. 110.15 When a participant does not request MFIP within 30 days of the 110.16 diversionary work program benefits being exhausted, a new 110.17 combined application form must be completed for any subsequent 110.18 request for MFIP. 110.19 Subd. 13. [IMMEDIATE REFERRAL TO EMPLOYMENT SERVICES.] 110.20 Within one working day of determination that the applicant is 110.21 eligible for the diversionary work program, but before benefits 110.22 are issued to or on behalf of the family unit, the county shall 110.23 refer all caregivers to employment services. The referral to 110.24 the DWP employment services must be in writing and must contain 110.25 the following information: 110.26 (1) notification that, as part of the application process, 110.27 applicants are required to develop an employment plan or the DWP 110.28 application will be denied; 110.29 (2) the employment services provider name and phone number; 110.30 (3) the date, time, and location of the scheduled 110.31 employment services interview; 110.32 (4) the immediate availability of supportive services, 110.33 including, but not limited to, child care, transportation, and 110.34 other work-related aid; and 110.35 (5) the rights, responsibilities, and obligations of 110.36 participants in the program, including, but not limited to, the 111.1 grounds for good cause, the consequences of refusing or failing 111.2 to participate fully with program requirements, and the appeal 111.3 process. 111.4 Subd. 14. [EMPLOYMENT PLAN; DWP BENEFITS.] As soon as 111.5 possible, but no later than ten working days of being notified 111.6 that a participant is financially eligible for the diversionary 111.7 work program, the employment services provider shall provide the 111.8 participant with an opportunity to meet to develop an initial 111.9 employment plan. Once the initial employment plan has been 111.10 developed and signed by the participant and the job counselor, 111.11 the employment services provider shall notify the county within 111.12 one working day that the employment plan has been signed. The 111.13 county shall issue DWP benefits within one working day after 111.14 receiving notice that the employment plan has been signed. 111.15 Subd. 15. [LIMITATIONS ON CERTAIN WORK ACTIVITIES.] (a) 111.16 Except as specified in paragraphs (b) to (d), employment 111.17 activities listed in section 256J.49, subdivision 13, are 111.18 allowable under the diversionary work program. 111.19 (b) Work activities under section 256J.49, subdivision 13, 111.20 clause (5), shall be allowable only when in combination with 111.21 approved work activities under section 256J.49, subdivision 13, 111.22 clauses (1) to (4), and shall be limited to no more than 111.23 one-half of the hours required in the employment plan. 111.24 (c) In order for an English as a second language (ESL) 111.25 class to be an approved work activity, a participant must: 111.26 (1) be below a spoken language proficiency level of SPL6 or 111.27 its equivalent, as measured by a nationally recognized test; and 111.28 (2) not have been enrolled in ESL for more than 24 months 111.29 while previously participating in MFIP or DWP. A participant 111.30 who has been enrolled in ESL for 20 or more months may be 111.31 approved for ESL until the participant has received 24 total 111.32 months. 111.33 (d) Work activities under section 256J.49, subdivision 13, 111.34 clause (6), shall be allowable only when the training or 111.35 education program will be completed within the four-month DWP 111.36 period. Training or education programs that will not be 112.1 completed within the four-month DWP period shall not be approved. 112.2 Subd. 16. [FAILURE TO COMPLY WITH REQUIREMENTS.] A family 112.3 unit that includes a participant who fails to comply with DWP 112.4 employment service or child support enforcement requirements, 112.5 without good cause as defined in sections 256.741 and 256J.57, 112.6 shall be disqualified from the diversionary work program. The 112.7 county shall provide written notice as specified in section 112.8 256J.31 to the participant prior to disqualifying the family 112.9 unit due to noncompliance with employment service or child 112.10 support. The disqualification does not apply to food support or 112.11 health care benefits. 112.12 Subd. 17. [GOOD CAUSE FOR NOT COMPLYING WITH 112.13 REQUIREMENTS.] A participant who fails to comply with the 112.14 requirements of the diversionary work program may claim good 112.15 cause for reasons listed in sections 256.741 and 256J.57, 112.16 subdivision 1, clauses (1) to (13). The county shall not impose 112.17 a disqualification if good cause exists. 112.18 Subd. 18. [REINSTATEMENT FOLLOWING DISQUALIFICATION.] A 112.19 participant who has been disqualified from the diversionary work 112.20 program due to noncompliance with employment services may regain 112.21 eligibility for the diversionary work program by complying with 112.22 program requirements. A participant who has been disqualified 112.23 from the diversionary work program due to noncooperation with 112.24 child support enforcement requirements may regain eligibility by 112.25 complying with child support requirements under section 112.26 256.741. Once a participant has been reinstated, the county 112.27 shall issue prorated benefits for the remaining portion of the 112.28 month. A family unit that has been disqualified from the 112.29 diversionary work program due to noncompliance shall not be 112.30 eligible for MFIP or any other TANF cash program during the 112.31 period of time the participant remains noncompliant. In a 112.32 two-parent family, both parents must be in compliance before the 112.33 family unit can regain eligibility for benefits. 112.34 Subd. 19. [RECOVERY OF OVERPAYMENTS.] When an overpayment 112.35 or an ATM error is determined, the overpayment shall be recouped 112.36 or recovered as specified in section 256J.38. 113.1 Subd. 20. [IMPLEMENTATION OF DWP.] Counties may establish 113.2 a diversionary work program according to this section any time 113.3 on or after July 1, 2003. Prior to establishing a diversionary 113.4 work program, the county must notify the commissioner. All 113.5 counties must implement the provisions of this section no later 113.6 than July 1, 2004. 113.7 Sec. 103. Minnesota Statutes 2002, section 261.063, is 113.8 amended to read: 113.9 261.063 [TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; 113.10 PENALTY.] 113.11 (a) The board of county commissioners of each county shall 113.12 annually levy taxes and fix a rate sufficient to produce the 113.13 full amount required for poor relief, general assistance, 113.14 Minnesota family investment program, diversionary work program, 113.15 county share of county and state supplemental aid to 113.16 supplemental security income applicants or recipients, and any 113.17 other social security measures wherein there is now or may 113.18 hereafter be county participation, sufficient to produce the 113.19 full amount necessary for each such item, including 113.20 administrative expenses, for the ensuing year, within the time 113.21 fixed by law in addition to all other tax levies and tax rates, 113.22 however fixed or determined, and any commissioner who shall fail 113.23 to comply herewith shall be guilty of a gross misdemeanor and 113.24 shall be immediately removed from office by the governor. For 113.25 the purposes of this paragraph, "poor relief" means county 113.26 services provided under sections 261.035, 261.04,and 261.21 to 113.27 261.231. 113.28 (b) Nothing within the provisions of this section shall be 113.29 construed as requiring a county agency to provide income support 113.30 or cash assistance to needy persons when they are no longer 113.31 eligible for assistance under general assistance,the Minnesota113.32family investment programchapter 256J, or Minnesota 113.33 supplemental aid. 113.34 Sec. 104. Minnesota Statutes 2002, section 393.07, 113.35 subdivision 10, is amended to read: 113.36 Subd. 10. [FEDERAL FOOD STAMP PROGRAM AND THE MATERNAL AND 114.1 CHILD NUTRITION ACT.] (a) The local social services agency shall 114.2 establish and administer the food stamp or support program 114.3 according to rules of the commissioner of human services, the 114.4 supervision of the commissioner as specified in section 256.01, 114.5 and all federal laws and regulations. The commissioner of human 114.6 services shall monitor food stamp or support program delivery on 114.7 an ongoing basis to ensure that each county complies with 114.8 federal laws and regulations. Program requirements to be 114.9 monitored include, but are not limited to, number of 114.10 applications, number of approvals, number of cases pending, 114.11 length of time required to process each application and deliver 114.12 benefits, number of applicants eligible for expedited issuance, 114.13 length of time required to process and deliver expedited 114.14 issuance, number of terminations and reasons for terminations, 114.15 client profiles by age, household composition and income level 114.16 and sources, and the use of phone certification and home 114.17 visits. The commissioner shall determine the county-by-county 114.18 and statewide participation rate. 114.19 (b) On July 1 of each year, the commissioner of human 114.20 services shall determine a statewide and county-by-county food 114.21 stamp program participation rate. The commissioner may 114.22 designate a different agency to administer the food stamp 114.23 program in a county if the agency administering the program 114.24 fails to increase the food stamp program participation rate 114.25 among families or eligible individuals, or comply with all 114.26 federal laws and regulations governing the food stamp program. 114.27 The commissioner shall review agency performance annually to 114.28 determine compliance with this paragraph. 114.29 (c) A person who commits any of the following acts has 114.30 violated section 256.98 or 609.821, or both, and is subject to 114.31 both the criminal and civil penalties provided under those 114.32 sections: 114.33 (1) obtains or attempts to obtain, or aids or abets any 114.34 person to obtain by means of a willful statement or 114.35 misrepresentation, or intentional concealment of a material 114.36 fact, food stamps or vouchers issued according to sections 115.1 145.891 to 145.897 to which the person is not entitled or in an 115.2 amount greater than that to which that person is entitled or 115.3 which specify nutritional supplements to which that person is 115.4 not entitled; or 115.5 (2) presents or causes to be presented, coupons or vouchers 115.6 issued according to sections 145.891 to 145.897 for payment or 115.7 redemption knowing them to have been received, transferred or 115.8 used in a manner contrary to existing state or federal law; or 115.9 (3) willfully uses, possesses, or transfers food stamp 115.10 coupons, authorization to purchase cards or vouchers issued 115.11 according to sections 145.891 to 145.897 in any manner contrary 115.12 to existing state or federal law, rules, or regulations; or 115.13 (4) buys or sells food stamp coupons, authorization to 115.14 purchase cards, other assistance transaction devices, vouchers 115.15 issued according to sections 145.891 to 145.897, or any food 115.16 obtained through the redemption of vouchers issued according to 115.17 sections 145.891 to 145.897 for cash or consideration other than 115.18 eligible food. 115.19 (d) A peace officer or welfare fraud investigator may 115.20 confiscate food stamps, authorization to purchase cards, or 115.21 other assistance transaction devices found in the possession of 115.22 any person who is neither a recipient of the food stamp program 115.23 nor otherwise authorized to possess and use such materials. 115.24 Confiscated property shall be disposed of as the commissioner 115.25 may direct and consistent with state and federal food stamp 115.26 law. The confiscated property must be retained for a period of 115.27 not less than 30 days to allow any affected person to appeal the 115.28 confiscation under section 256.045. 115.29 (e) Food stamp overpayment claims which are due in whole or 115.30 in part to client error shall be established by the county 115.31 agency for a period of six years from the date of any resultant 115.32 overpayment. 115.33 (f) With regard to the federal tax revenue offset program 115.34 only, recovery incentives authorized by the federal food and 115.35 consumer service shall be retained at the rate of 50 percent by 115.36 the state agency and 50 percent by the certifying county agency. 116.1 (g) A peace officer, welfare fraud investigator, federal 116.2 law enforcement official, or the commissioner of health may 116.3 confiscate vouchers found in the possession of any person who is 116.4 neither issued vouchers under sections 145.891 to 145.897, nor 116.5 otherwise authorized to possess and use such vouchers. 116.6 Confiscated property shall be disposed of as the commissioner of 116.7 health may direct and consistent with state and federal law. 116.8 The confiscated property must be retained for a period of not 116.9 less than 30 days. 116.10 (h) The commissioner of human services may seek a waiver 116.11 from the United States Department of Agriculture to allow the 116.12 state to specify foods that may and may not be purchased in 116.13 Minnesota with benefits funded by the federal Food Stamp 116.14 Program. The commissioner shall consult with the members of the 116.15 house of representatives and senate policy committees having 116.16 jurisdiction over food support issues in developing the waiver. 116.17 The commissioner, in consultation with the commissioners of 116.18 health and education, shall develop a broad public health policy 116.19 related to improved nutrition and health status. The 116.20 commissioner must seek legislative approval prior to 116.21 implementing the waiver. 116.22 Sec. 105. Laws 1997, chapter 203, article 9, section 21, 116.23 as amended by Laws 1998, chapter 407, article 6, section 111, 116.24 Laws 2000, chapter 488, article 10, section 28, and Laws 2001, 116.25 First Special Session chapter 9, article 10, section 62, is 116.26 amended to read: 116.27 Sec. 21. [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 116.28(a) Effective on the date specified, the following116.29personsBeginning July 1, 2007, legal noncitizens ineligible for 116.30 federally funded cash or food benefits due to 1996 changes in 116.31 federal law and subsequent relevant enactments, who are eligible 116.32 for state-funded MFIP cash or food assistance, will be 116.33 ineligible forgeneral assistance and general assistance medical116.34care under Minnesota Statutes, chapter 256D, group residential116.35housing under Minnesota Statutes, chapter 256I, andstate-funded 116.36 MFIPassistanceunder Minnesota Statutes, chapter 256J, funded117.1with state money:. 117.2(1) Beginning July 1, 2002, persons who are terminated from117.3or denied Supplemental Security Income due to the 1996 changes117.4in the federal law making persons whose alcohol or drug117.5addiction is a material factor contributing to the person's117.6disability ineligible for Supplemental Security Income, and are117.7eligible for general assistance under Minnesota Statutes,117.8section 256D.05, subdivision 1, paragraph (a), clause (15),117.9general assistance medical care under Minnesota Statutes,117.10chapter 256D, or group residential housing under Minnesota117.11Statutes, chapter 256I; and117.12(2) Beginning July 1, 2002, legal noncitizens who are117.13ineligible for Supplemental Security Income due to the 1996117.14changes in federal law making certain noncitizens ineligible for117.15these programs due to their noncitizen status; and117.16(3) beginning July 1, 2003, legal noncitizens who are117.17eligible for MFIP assistance, either the cash assistance portion117.18or the food assistance portion, funded entirely with state money.117.19(b) State money that remains unspent due to changes in117.20federal law enacted after May 12, 1997, that reduce state117.21spending for legal noncitizens or for persons whose alcohol or117.22drug addiction is a material factor contributing to the person's117.23disability, or enacted after February 1, 1998, that reduce state117.24spending for food benefits for legal noncitizens shall not117.25cancel and shall be deposited in the TANF reserve account.117.26 Sec. 106. [REVISOR'S INSTRUCTION.] 117.27 (a) In the next publication of Minnesota Statutes, the 117.28 revisor of statutes shall codify section 108 of this act. 117.29 (b) Wherever "food stamp" or "food stamps" appears in 117.30 Minnesota Statutes and Rules, the revisor of statutes shall 117.31 insert "food support" or "or food support" except for instances 117.32 where federal code or federal law is referenced. 117.33 (c) For sections in Minnesota Statutes and Minnesota Rules 117.34 affected by the repealed sections in this article, the revisor 117.35 shall delete internal cross-references where appropriate and 117.36 make changes necessary to correct the punctuation, grammar, or 118.1 structure of the remaining text and preserve its meaning. 118.2 Sec. 107. [REPEALER.] 118.3 (a) Minnesota Statutes 2002, sections 256J.02, subdivision 118.4 3; 256J.08, subdivisions 28 and 70; 256J.24, subdivision 8; 118.5 256J.30, subdivision 10; 256J.462; 256J.47; 256J.48; 256J.49, 118.6 subdivisions 1a, 2, 6, and 7; 256J.50, subdivisions 2, 3, 3a, 5, 118.7 and 7; 256J.52; 256J.55, subdivision 5; 256J.62, subdivisions 1, 118.8 2a, 4, 6, 7, and 8; 256J.625; 256J.655; 256J.74, subdivision 3; 118.9 256J.751, subdivisions 3 and 4; 256J.76; and 256K.30, are 118.10 repealed. 118.11 (b) Laws 2000, chapter 488, article 10, section 29, is 118.12 repealed. 118.13 ARTICLE 2 118.14 LONG-TERM CARE 118.15 Section 1. Minnesota Statutes 2002, section 61A.072, 118.16 subdivision 6, is amended to read: 118.17 Subd. 6. [ACCELERATED BENEFITS.] (a) "Accelerated 118.18 benefits" covered under this section are benefits payable under 118.19 the life insurance contract: 118.20 (1) to a policyholder or certificate holder, during the 118.21 lifetime of the insured,in anticipation of deathupon the 118.22 occurrence of a specified life-threatening or catastrophic 118.23 condition as defined by the policy or rider; 118.24 (2) that reduce the death benefit otherwise payable under 118.25 the life insurance contract; and 118.26 (3) that are payable upon the occurrence of a single 118.27 qualifying event that results in the payment of a benefit amount 118.28 fixed at the time of acceleration. 118.29 (b) "Qualifying event" means one or more of the following: 118.30 (1) a medical condition that would result in a drastically 118.31 limited life span as specified in the contract; 118.32 (2) a medical condition that has required or requires 118.33 extraordinary medical intervention, such as, but not limited to, 118.34 major organ transplant or continuous artificial life support 118.35 without which the insured would die;or118.36 (3) a condition that requires continuous confinement in an 119.1 eligible institution as defined in the contract if the insured 119.2 is expected to remain there for the rest of the insured's life; 119.3 (4) a long-term care illness or physical condition that 119.4 results in cognitive impairment or the inability to perform the 119.5 activities of daily life or the substantial and material duties 119.6 of any occupation; or 119.7 (5) other qualifying events that the commissioner approves 119.8 for a particular filing. 119.9 [EFFECTIVE DATE.] This section is effective the day 119.10 following final enactment and applies to policies issued on or 119.11 after that date. 119.12 Sec. 2. Minnesota Statutes 2002, section 62A.315, is 119.13 amended to read: 119.14 62A.315 [EXTENDED BASIC MEDICARE SUPPLEMENT PLAN; 119.15 COVERAGE.] 119.16 The extended basic Medicare supplement plan must have a 119.17 level of coverage so that it will be certified as a qualified 119.18 plan pursuant to section 62E.07, and will provide: 119.19 (1) coverage for all of the Medicare part A inpatient 119.20 hospital deductible and coinsurance amounts, and 100 percent of 119.21 all Medicare part A eligible expenses for hospitalization not 119.22 covered by Medicare; 119.23 (2) coverage for the daily copayment amount of Medicare 119.24 part A eligible expenses for the calendar year incurred for 119.25 skilled nursing facility care; 119.26 (3) coverage for the copayment amount of Medicare eligible 119.27 expenses under Medicare part B regardless of hospital 119.28 confinement, and the Medicare part B deductible amount; 119.29 (4) 80 percent of the usual and customary hospital and 119.30 medical expenses and supplies described in section 62E.06, 119.31 subdivision 1, not to exceed any charge limitation established 119.32 by the Medicare program or state law, the usual and customary 119.33 hospital and medical expenses and supplies, described in section 119.34 62E.06, subdivision 1, while in a foreign country, and 119.35 prescription drug expenses, not covered by Medicare; 119.36 (5) coverage for the reasonable cost of the first three 120.1 pints of blood, or equivalent quantities of packed red blood 120.2 cells as defined under federal regulations under Medicare parts 120.3 A and B, unless replaced in accordance with federal regulations; 120.4 (6) 100 percent of the cost of immunizations and routine 120.5 screening procedures for cancer, including mammograms and pap 120.6 smears; 120.7 (7) preventive medical care benefit: coverage for the 120.8 following preventive health services: 120.9 (i) an annual clinical preventive medical history and 120.10 physical examination that may include tests and services from 120.11 clause (ii) and patient education to address preventive health 120.12 care measures; 120.13 (ii) any one or a combination of the following preventive 120.14 screening tests or preventive services, the frequency of which 120.15 is considered medically appropriate: 120.16 (A) fecal occult blood test and/or digital rectal 120.17 examination; 120.18 (B) dipstick urinalysis for hematuria, bacteriuria, and 120.19 proteinuria; 120.20 (C) pure tone (air only) hearing screening test 120.21 administered or ordered by a physician; 120.22 (D) serum cholesterol screening every five years; 120.23 (E) thyroid function test; 120.24 (F) diabetes screening; 120.25 (iii) any other tests or preventive measures determined 120.26 appropriate by the attending physician. 120.27 Reimbursement shall be for the actual charges up to 100 120.28 percent of the Medicare-approved amount for each service as if 120.29 Medicare were to cover the service as identified in American 120.30 Medical Association current procedural terminology (AMA CPT) 120.31 codes to a maximum of $120 annually under this benefit. This 120.32 benefit shall not include payment for any procedure covered by 120.33 Medicare; 120.34 (8) at-home recovery benefit: coverage for services to 120.35 provide short-term at-home assistance with activities of daily 120.36 living for those recovering from an illness, injury, or surgery: 121.1 (i) for purposes of this benefit, the following definitions 121.2 shall apply: 121.3 (A) "activities of daily living" include, but are not 121.4 limited to, bathing, dressing, personal hygiene, transferring, 121.5 eating, ambulating, assistance with drugs that are normally 121.6 self-administered, and changing bandages or other dressings; 121.7 (B) "care provider" means a duly qualified or licensed home 121.8 health aide/homemaker, personal care aide, or nurse provided 121.9 through a licensed home health care agency or referred by a 121.10 licensed referral agency or licensed nurses registry; 121.11 (C) "home" means a place used by the insured as a place of 121.12 residence, provided that the place would qualify as a residence 121.13 for home health care services covered by Medicare. A hospital 121.14 or skilled nursing facility shall not be considered the 121.15 insured's place of residence; 121.16 (D) "at-home recovery visit" means the period of a visit 121.17 required to provide at-home recovery care, without limit on the 121.18 duration of the visit, except each consecutive four hours in a 121.19 24-hour period of services provided by a care provider is one 121.20 visit; 121.21 (ii) coverage requirements and limitations: 121.22 (A) at-home recovery services provided must be primarily 121.23 services that assist in activities of daily living; 121.24 (B) the insured's attending physician must certify that the 121.25 specific type and frequency of at-home recovery services are 121.26 necessary because of a condition for which a home care plan of 121.27 treatment was approved by Medicare; 121.28 (C) coverage is limited to: 121.29 (I) no more than the number and type of at-home recovery 121.30 visits certified as medically necessary by the insured's 121.31 attending physician. The total number of at-home recovery 121.32 visits shall not exceed the number of Medicare-approved home 121.33 health care visits under a Medicare-approved home care plan of 121.34 treatment; 121.35 (II) the actual charges for each visit up to a maximum 121.36 reimbursement of$40$100 per visit; 122.1 (III)$1,600$4,000 per calendar year; 122.2 (IV) seven visits in any one week; 122.3 (V) care furnished on a visiting basis in the insured's 122.4 home; 122.5 (VI) services provided by a care provider as defined in 122.6 this section; 122.7 (VII) at-home recovery visits while the insured is covered 122.8 under the policy or certificate and not otherwise excluded; 122.9 (VIII) at-home recovery visits received during the period 122.10 the insured is receiving Medicare-approved home care services or 122.11 no more than eight weeks after the service date of the last 122.12 Medicare-approved home health care visit; 122.13 (iii) coverage is excluded for: 122.14 (A) home care visits paid for by Medicare or other 122.15 government programs; and 122.16 (B) care provided byfamily members,unpaid volunteers,or 122.17 providers who are not care providers. 122.18 [EFFECTIVE DATE.] This section is effective January 1, 122.19 2004, and applies to policies issued on or after that date. 122.20 Sec. 3. Minnesota Statutes 2002, section 62A.48, is 122.21 amended by adding a subdivision to read: 122.22 Subd. 12. [REGULATORY FLEXIBILITY.] The commissioner may 122.23 upon written request issue an order to modify or suspend a 122.24 specific provision or provisions of sections 62A.46 to 62A.56 122.25 with respect to a specific long-term care insurance policy or 122.26 certificate upon a written finding that: 122.27 (1) the modification or suspension is in the best interest 122.28 of the insureds; 122.29 (2) the purpose to be achieved could not be effectively or 122.30 efficiently achieved without the modifications or suspension; 122.31 and 122.32 (3)(i) the modification or suspension is necessary to the 122.33 development of an innovative and reasonable approach for 122.34 insuring long-term care; 122.35 (ii) the policy or certificate is to be issued to residents 122.36 of a life care or continuing care retirement community or some 123.1 other residential community for the elderly and the modification 123.2 or suspension is reasonably related to the special needs or 123.3 nature of such a community; or 123.4 (iii) the modification or suspension is necessary to permit 123.5 long-term care insurance to be sold as part of, or in 123.6 conjunction with, another insurance product. 123.7 [EFFECTIVE DATE.] This section is effective January 1, 123.8 2004, and applies to policies issued on or after that date. 123.9 Sec. 4. Minnesota Statutes 2002, section 62A.49, is 123.10 amended by adding a subdivision to read: 123.11 Subd. 3. [PROHIBITED LIMITATIONS.] A long-term care 123.12 insurance policy or certificate shall not, if it provides 123.13 benefits for home health care or community care services, limit 123.14 or exclude benefits by: 123.15 (1) requiring that the insured would need care in a skilled 123.16 nursing facility if home health care services were not provided; 123.17 (2) requiring that the insured first or simultaneously 123.18 receive nursing or therapeutic services in a home, community, or 123.19 institutional setting before home health care services are 123.20 covered; 123.21 (3) limiting eligible services to services provided by a 123.22 registered nurse or licensed practical nurse; 123.23 (4) requiring that a nurse or therapist provide services 123.24 covered by the policy that can be provided by a home health aide 123.25 or other licensed or certified home care worker acting within 123.26 the scope of licensure or certification; 123.27 (5) excluding coverage for personal care services provided 123.28 by a home health aide; 123.29 (6) requiring that the provision of home health care 123.30 services be at a level of certification or licensure greater 123.31 than that required by the eligible service; 123.32 (7) requiring that the insured have an acute condition 123.33 before home health care services are covered; 123.34 (8) limiting benefits to services provided by 123.35 Medicare-certified agencies or providers; 123.36 (9) excluding coverage for adult day care services; or 124.1 (10) excluding coverage based upon location or type of 124.2 residence in which the home health care services would be 124.3 provided. 124.4 [EFFECTIVE DATE.] This section is effective January 1, 124.5 2004, and applies to policies issued on or after that date. 124.6 Sec. 5. Minnesota Statutes 2002, section 62S.22, 124.7 subdivision 1, is amended to read: 124.8 Subdivision 1. [PROHIBITED LIMITATIONS.] A long-term care 124.9 insurance policy or certificate shall not, if it provides 124.10 benefits for home health care or community care services, limit 124.11 or exclude benefits by: 124.12 (1) requiring that the insured would need care in a skilled 124.13 nursing facility if home health care services were not provided; 124.14 (2) requiring that the insured first or simultaneously 124.15 receive nursing or therapeutic services in a home, community, or 124.16 institutional setting before home health care services are 124.17 covered; 124.18 (3) limiting eligible services to services provided by a 124.19 registered nurse or licensed practical nurse; 124.20 (4) requiring that a nurse or therapist provide services 124.21 covered by the policy that can be provided by a home health aide 124.22 or other licensed or certified home care worker acting within 124.23 the scope of licensure or certification; 124.24 (5) excluding coverage for personal care services provided 124.25 by a home health aide; 124.26 (6) requiring that the provision of home health care 124.27 services be at a level of certification or licensure greater 124.28 than that required by the eligible service; 124.29 (7) requiring that the insured have an acute condition 124.30 before home health care services are covered; 124.31 (8) limiting benefits to services provided by 124.32 Medicare-certified agencies or providers;or124.33 (9) excluding coverage for adult day care services; or 124.34 (10) excluding coverage based upon location or type of 124.35 residence in which the home health care services would be 124.36 provided. 125.1 [EFFECTIVE DATE.] This section is effective January 1, 125.2 2004, and applies to policies issued on or after that date. 125.3 Sec. 6. [62S.34] [REGULATORY FLEXIBILITY.] 125.4 The commissioner may upon written request issue an order to 125.5 modify or suspend a specific provision or provisions of this 125.6 chapter with respect to a specific long-term care insurance 125.7 policy or certificate upon a written finding that: 125.8 (1) the modification or suspension is in the best interest 125.9 of the insureds; 125.10 (2) the purpose to be achieved could not be effectively or 125.11 efficiently achieved without the modifications or suspension; 125.12 and 125.13 (3)(i) the modification or suspension is necessary to the 125.14 development of an innovative and reasonable approach for 125.15 insuring long-term care; 125.16 (ii) the policy or certificate is to be issued to residents 125.17 of a life care or continuing care retirement community or some 125.18 other residential community for the elderly and the modification 125.19 or suspension is reasonably related to the special needs or 125.20 nature of such a community; or 125.21 (iii) the modification or suspension is necessary to permit 125.22 long-term care insurance to be sold as part of, or in 125.23 conjunction with, another insurance product. 125.24 [EFFECTIVE DATE.] This section is effective January 1, 125.25 2004, and applies to policies issued on or after that date. 125.26 Sec. 7. Minnesota Statutes 2002, section 144A.04, 125.27 subdivision 3, is amended to read: 125.28 Subd. 3. [STANDARDS.] (a) The facility must meet the 125.29 minimum health, sanitation, safety and comfort standards 125.30 prescribed by the rules of the commissioner of health with 125.31 respect to the construction, equipment, maintenance and 125.32 operation of a nursing home. The commissioner of health may 125.33 temporarily waive compliance with one or more of the standards 125.34 if the commissioner determines that: 125.35(a)(1) temporary noncompliance with the standard will not 125.36 create an imminent risk of harm to a nursing home resident; and 126.1(b)(2) a controlling person on behalf of all other 126.2 controlling persons: 126.3(1)(i) has entered into a contract to obtain the materials 126.4 or labor necessary to meet the standard set by the commissioner 126.5 of health, but the supplier or other contractor has failed to 126.6 perform the terms of the contract and the inability of the 126.7 nursing home to meet the standard is due solely to that failure; 126.8 or 126.9(2)(ii) is otherwise making a diligent good faith effort 126.10 to meet the standard. 126.11 The commissioner shall make available to other nursing 126.12 homes information on facility-specific waivers related to 126.13 technology or physical plant that are granted. The commissioner 126.14 shall, upon the request of a facility, extend a waiver granted 126.15 to a specific facility related to technology or physical plant 126.16 to the facility making the request, if the commissioner 126.17 determines that the facility also satisfies clauses (1) and (2) 126.18 and any other terms and conditions of the waiver. 126.19 The commissioner of health shall allow, by rule, a nursing 126.20 home to provide fewer hours of nursing care to intermediate care 126.21 residents of a nursing home than required by the present rules 126.22 of the commissioner if the commissioner determines that the 126.23 needs of the residents of the home will be adequately met by a 126.24 lesser amount of nursing care. 126.25 (b) A facility is not required to seek a waiver for room 126.26 furniture or equipment under paragraph (a) when responding to 126.27 resident-specific requests, if the facility has discussed health 126.28 and safety concerns with the resident and the resident request 126.29 and discussion of health and safety concerns are documented in 126.30 the resident's patient record. 126.31 [EFFECTIVE DATE.] This section is effective the day 126.32 following final enactment. 126.33 Sec. 8. Minnesota Statutes 2002, section 144A.04, is 126.34 amended by adding a subdivision to read: 126.35 Subd. 11. [INCONTINENT RESIDENTS.] Notwithstanding 126.36 Minnesota Rules, part 4658.0520, an incontinent resident must be 127.1 checked according to a specific time interval written in the 127.2 resident's care plan. The resident's attending physician must 127.3 authorize in writing any interval longer than two hours unless 127.4 the resident, if competent, or a family member or legally 127.5 appointed conservator, guardian, or health care agent of a 127.6 resident who is not competent, agrees in writing to waive 127.7 physician involvement in determining this interval, and this 127.8 waiver is documented in the resident's care plan. 127.9 [EFFECTIVE DATE.] This section is effective July 1, 2003. 127.10 Sec. 9. Minnesota Statutes 2002, section 144A.071, 127.11 subdivision 4c, as added by Laws 2003, chapter 16, section 1, is 127.12 amended to read: 127.13 Subd. 4c. [EXCEPTIONS FOR REPLACEMENT BEDS AFTER JUNE 30, 127.14 2003.] (a) The commissioner of health, in coordination with the 127.15 commissioner of human services, may approve the renovation, 127.16 replacement, upgrading, or relocation of a nursing home or 127.17 boarding care home, under the following conditions: 127.18 (1) to license and certify an 80-bed city-owned facility in 127.19 Nicollet county to be constructed on the site of a new 127.20 city-owned hospital to replace an existing 85-bed facility 127.21 attached to a hospital that is also being replaced. The 127.22 threshold allowed for this project under section 144A.073 shall 127.23 be the maximum amount available to pay the additional medical 127.24 assistance costs of the new facility; and 127.25 (2) to license and certify 29 beds to be added to an 127.26 existing 69-bed facility in St. Louis county, provided that the 127.27 29 beds must be transferred from active or layaway status at an 127.28 existing facility in St. Louis county that had 235 beds on April 127.29 1, 2003. 127.30 The licensed capacity at the 235-bed facility must be reduced to 127.31 206 beds, but the payment rate at that facility shall not be 127.32 adjusted as a result of this transfer. The operating payment 127.33 rate of the facility adding beds after completion of this 127.34 project shall be the same as it was on the day prior to the day 127.35 the beds are licensed and certified. This project shall not 127.36 proceed unless it is approved and financed under the provisions 128.1 of section 144A.073. 128.2 (b) Projects approved under this subdivision shall be 128.3 treated in a manner equivalent to projects approved under 128.4 subdivision 4a. 128.5 Sec. 10. Minnesota Statutes 2002, section 144A.10, is 128.6 amended by adding a subdivision to read: 128.7 Subd. 16. [INDEPENDENT INFORMAL DISPUTE RESOLUTION.] (a) 128.8 Notwithstanding subdivision 15, a facility certified under the 128.9 federal Medicare or Medicaid programs may request from the 128.10 commissioner, in writing, an independent informal dispute 128.11 resolution process regarding any deficiency citation issued to 128.12 the facility. The facility must specify in its written request 128.13 each deficiency citation that it disputes. The commissioner 128.14 shall provide a hearing under sections 14.57 to 14.62. Upon the 128.15 written request of the facility, the parties must submit the 128.16 issues raised to arbitration by an administrative law judge. 128.17 (b) Upon receipt of a written request for an arbitration 128.18 proceeding, the commissioner shall file with the office of 128.19 administrative hearings a request for the appointment of an 128.20 arbitrator and simultaneously serve the facility with notice of 128.21 the request. The arbitrator for the dispute shall be an 128.22 administrative law judge appointed by the office of 128.23 administrative hearings. The disclosure provisions of section 128.24 572.10 and the notice provisions of section 572.12 apply. The 128.25 facility and the commissioner have the right to be represented 128.26 by an attorney. 128.27 (c) The commissioner and the facility may present written 128.28 evidence, depositions, and oral statements and arguments at the 128.29 arbitration proceeding. Oral statements and arguments may be 128.30 made by telephone. 128.31 (d) Within ten working days of the close of the arbitration 128.32 proceeding, the administrative law judge shall issue findings 128.33 regarding each of the deficiencies in dispute. The findings 128.34 shall be one or more of the following: 128.35 (1) Supported in full. The citation is supported in full, 128.36 with no deletion of findings and no change in the scope or 129.1 severity assigned to the deficiency citation. 129.2 (2) Supported in substance. The citation is supported, but 129.3 one or more findings are deleted without any change in the scope 129.4 or severity assigned to the deficiency. 129.5 (3) Deficient practice cited under wrong requirement of 129.6 participation. The citation is amended by moving it to the 129.7 correct requirement of participation. 129.8 (4) Scope not supported. The citation is amended through a 129.9 change in the scope assigned to the citation. 129.10 (5) Severity not supported. The citation is amended 129.11 through a change in the severity assigned to the citation. 129.12 (6) No deficient practice. The citation is deleted because 129.13 the findings did not support the citation or the negative 129.14 resident outcome was unavoidable. The findings of the 129.15 arbitrator are not binding on the commissioner. 129.16 (e) The commissioner shall reimburse the office of 129.17 administrative hearings for the costs incurred by that office 129.18 for the arbitration proceeding. The facility shall reimburse 129.19 the commissioner for the proportion of the costs that represent 129.20 the sum of deficiency citations supported in full under 129.21 paragraph (d), clause (1), or in substance under paragraph (d), 129.22 clause (2), divided by the total number of deficiencies 129.23 disputed. A deficiency citation for which the administrative 129.24 law judge's sole finding is that the deficient practice was 129.25 cited under the wrong requirements of participation shall not be 129.26 counted in the numerator or denominator in the calculation of 129.27 the proportion of costs. 129.28 [EFFECTIVE DATE.] This section is effective July 1, 2003. 129.29 Sec. 11. [144A.351] [BALANCING LONG-TERM CARE: REPORT 129.30 REQUIRED.] 129.31 The commissioners of health and human services, with the 129.32 cooperation of counties and regional entities, shall prepare a 129.33 report to the legislature by January 15, 2004, and biennially 129.34 thereafter, regarding the status of the full range of long-term 129.35 care services for the elderly in Minnesota. The report shall 129.36 address: 130.1 (1) demographics and need for long-term care in Minnesota; 130.2 (2) summary of county and regional reports on long-term 130.3 care gaps, surpluses, imbalances, and corrective action plans; 130.4 (3) status of long-term care services by county and region 130.5 including: 130.6 (i) changes in availability of the range of long-term care 130.7 services and housing options; 130.8 (ii) access problems regarding long-term care; and 130.9 (iii) comparative measures of long-term care availability 130.10 and progress over time; and 130.11 (4) recommendations regarding goals for the future of 130.12 long-term care services, policy changes, and resource needs. 130.13 Sec. 12. Minnesota Statutes 2002, section 144A.4605, 130.14 subdivision 4, is amended to read: 130.15 Subd. 4. [LICENSE REQUIRED.] (a) A housing with services 130.16 establishment registered under chapter 144D that is required to 130.17 obtain a home care license must obtain an assisted living home 130.18 care license according to this section or a class A or class E 130.19 license according to rule. A housing with services 130.20 establishment that obtains a class E license under this 130.21 subdivision remains subject to the payment limitations in 130.22 sections 256B.0913, subdivision55f, paragraph(h)(b), and 130.23 256B.0915, subdivision3, paragraph (g)3d. 130.24 (b) A board and lodging establishment registered for 130.25 special services as of December 31, 1996, and also registered as 130.26 a housing with services establishment under chapter 144D, must 130.27 deliver home care services according to sections 144A.43 to 130.28 144A.47, and may apply for a waiver from requirements under 130.29 Minnesota Rules, parts 4668.0002 to 4668.0240, to operate a 130.30 licensed agency under the standards of section 157.17. Such 130.31 waivers as may be granted by the department will expire upon 130.32 promulgation of home care rules implementing section 144A.4605. 130.33 (c) An adult foster care provider licensed by the 130.34 department of human services and registered under chapter 144D 130.35 may continue to provide health-related services under its foster 130.36 care license until the promulgation of home care rules 131.1 implementing this section. 131.2 (d) An assisted living home care provider licensed under 131.3 this section must comply with the disclosure provisions of 131.4 section 325F.72 to the extent they are applicable. 131.5 Sec. 13. Minnesota Statutes 2002, section 256.9657, 131.6 subdivision 1, is amended to read: 131.7 Subdivision 1. [NURSING HOME LICENSE SURCHARGE.] (a) 131.8 Effective July 1, 1993, each non-state-operated nursing home 131.9 licensed under chapter 144A shall pay to the commissioner an 131.10 annual surcharge according to the schedule in subdivision 4. 131.11 The surcharge shall be calculated as $620 per licensed bed. If 131.12 the number of licensed beds is reduced, the surcharge shall be 131.13 based on the number of remaining licensed beds the second month 131.14 following the receipt of timely notice by the commissioner of 131.15 human services that beds have been delicensed. The nursing home 131.16 must notify the commissioner of health in writing when beds are 131.17 delicensed. The commissioner of health must notify the 131.18 commissioner of human services within ten working days after 131.19 receiving written notification. If the notification is received 131.20 by the commissioner of human services by the 15th of the month, 131.21 the invoice for the second following month must be reduced to 131.22 recognize the delicensing of beds. Beds on layaway status 131.23 continue to be subject to the surcharge. The commissioner of 131.24 human services must acknowledge a medical care surcharge appeal 131.25 within 30 days of receipt of the written appeal from the 131.26 provider. 131.27 (b) Effective July 1, 1994, the surcharge in paragraph (a) 131.28 shall be increased to $625. 131.29 (c) Effective August 15, 2002, the surcharge under 131.30 paragraph (b) shall be increased to $990. 131.31 (d) Effective July 15, 2003, the surcharge under paragraph 131.32 (c) shall be increased to $2,815. 131.33 (e) The commissioner may reduce, and may subsequently 131.34 restore, the surcharge under paragraph (d) based on the 131.35 commissioner's determination of a permissible surcharge. 131.36 (f) Between April 1, 2002, and August 15,20032004, a 132.1 facility governed by this subdivision may elect to assume full 132.2 participation in the medical assistance program by agreeing to 132.3 comply with all of the requirements of the medical assistance 132.4 program, including the rate equalization law in section 256B.48, 132.5 subdivision 1, paragraph (a), and all other requirements 132.6 established in law or rule, and to begin intake of new medical 132.7 assistance recipients. Rates will be determined under Minnesota 132.8 Rules, parts 9549.0010 to 9549.0080. Notwithstanding section 132.9 256B.431, subdivision 27, paragraph (i), rate calculations will 132.10 be subject to limits as prescribed in rule and law. Other than 132.11 the adjustments in sections 256B.431, subdivisions 30 and 32; 132.12 256B.437, subdivision 3, paragraph (b), Minnesota Rules, part 132.13 9549.0057, and any other applicable legislation enacted prior to 132.14 the finalization of rates, facilities assuming full 132.15 participation in medical assistance under this paragraph are not 132.16 eligible for any rate adjustments until the July 1 following 132.17 their settle-up period. 132.18 [EFFECTIVE DATE.] This section is effective June 30, 2003. 132.19 Sec. 14. Minnesota Statutes 2002, section 256.9657, is 132.20 amended by adding a subdivision to read: 132.21 Subd. 3a. [ICF/MR LICENSE SURCHARGE.] Effective July 1, 132.22 2003, each nonstate-operated facility as defined under section 132.23 256B.501, subdivision 1, shall pay to the commissioner an annual 132.24 surcharge according to the schedule in subdivision 4, paragraph 132.25 (d). The annual surcharge shall be $1,040 per licensed bed. If 132.26 the number of licensed beds is reduced, the surcharge shall be 132.27 based on the number of remaining licensed beds the second month 132.28 following the receipt of timely notice by the commissioner of 132.29 human services that beds have been delicensed. The facility 132.30 must notify the commissioner of health in writing when beds are 132.31 delicensed. The commissioner of health must notify the 132.32 commissioner of human services within ten working days after 132.33 receiving written notification. If the notification is received 132.34 by the commissioner of human services by the 15th of the month, 132.35 the invoice for the second following month must be reduced to 132.36 recognize the delicensing of beds. The commissioner may reduce, 133.1 and may subsequently restore, the surcharge under this 133.2 subdivision based on the commissioner's determination of a 133.3 permissible surcharge. 133.4 [EFFECTIVE DATE.] This section is effective the day 133.5 following final enactment. 133.6 Sec. 15. Minnesota Statutes 2002, section 256.9657, 133.7 subdivision 4, is amended to read: 133.8 Subd. 4. [PAYMENTS INTO THE ACCOUNT.] (a) Payments to the 133.9 commissioner under subdivisions 1 to 3 must be paid in monthly 133.10 installments due on the 15th of the month beginning October 15, 133.11 1992. The monthly payment must be equal to the annual surcharge 133.12 divided by 12. Payments to the commissioner under subdivisions 133.13 2 and 3 for fiscal year 1993 must be based on calendar year 1990 133.14 revenues. Effective July 1 of each year, beginning in 1993, 133.15 payments under subdivisions 2 and 3 must be based on revenues 133.16 earned in the second previous calendar year. 133.17 (b) Effective October 1, 1995, and each October 1 133.18 thereafter, the payments in subdivisions 2 and 3 must be based 133.19 on revenues earned in the previous calendar year. 133.20 (c) If the commissioner of health does not provide by 133.21 August 15 of any year data needed to update the base year for 133.22 the hospital and health maintenance organization surcharges, the 133.23 commissioner of human services may estimate base year revenue 133.24 and use that estimate for the purposes of this section until 133.25 actual data is provided by the commissioner of health. 133.26 (d) Payments to the commissioner under subdivision 3a must 133.27 be paid in monthly installments due on the 15th of the month 133.28 beginning July 15, 2003. The monthly payment must be equal to 133.29 the annual surcharge divided by 12. 133.30 [EFFECTIVE DATE.] This section is effective the day 133.31 following final enactment. 133.32 Sec. 16. Minnesota Statutes 2002, section 256B.056, 133.33 subdivision 6, is amended to read: 133.34 Subd. 6. [ASSIGNMENT OF BENEFITS.] To be eligible for 133.35 medical assistance a person must have applied or must agree to 133.36 apply all proceeds received or receivable by the person or the 134.1 person'sspouselegal representative from any thirdpersonparty 134.2 liable for the costs of medical carefor the person, the spouse,134.3and children.The state agency shall require from any applicant134.4or recipient of medical assistance the assignment of any rights134.5to medical support and third party payments.By accepting or 134.6 receiving assistance, the person is deemed to have assigned the 134.7 person's rights to medical support and third party payments as 134.8 required by Title 19 of the Social Security Act. Persons must 134.9 cooperate with the state in establishing paternity and obtaining 134.10 third party payments. Bysigning an application foraccepting 134.11 medical assistance, a person assigns to the department of human 134.12 services all rights the person may have to medical support or 134.13 payments for medical expenses from any other person or entity on 134.14 their own or their dependent's behalf and agrees to cooperate 134.15 with the state in establishing paternity and obtaining third 134.16 party payments. Any rights or amounts so assigned shall be 134.17 applied against the cost of medical care paid for under this 134.18 chapter. Any assignment takes effect upon the determination 134.19 that the applicant is eligible for medical assistance and up to 134.20 three months prior to the date of application if the applicant 134.21 is determined eligible for and receives medical assistance 134.22 benefits. The application must contain a statement explaining 134.23 this assignment.Any assignment shall not be effective as to134.24benefits paid or provided under automobile accident coverage and134.25private health care coverage prior to notification of the134.26assignment by the person or organization providing the134.27benefits.For the purposes of this section, "the department of 134.28 human services or the state" includes prepaid health plans under 134.29 contract with the commissioner according to sections 256B.031, 134.30 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 134.31 children's mental health collaboratives under section 245.493; 134.32 demonstration projects for persons with disabilities under 134.33 section 256B.77; nursing facilities under the alternative 134.34 payment demonstration project under section 256B.434; and the 134.35 county-based purchasing entities under section 256B.692. 134.36 Sec. 17. Minnesota Statutes 2002, section 256B.064, 135.1 subdivision 2, is amended to read: 135.2 Subd. 2. [IMPOSITION OF MONETARY RECOVERY AND SANCTIONS.] 135.3 (a) The commissioner shall determine any monetary amounts to be 135.4 recovered and sanctions to be imposed upon a vendor of medical 135.5 care under this section. Except as provided in 135.6paragraphparagraphs (b) and (d), neither a monetary recovery 135.7 nor a sanction will be imposed by the commissioner without prior 135.8 notice and an opportunity for a hearing, according to chapter 135.9 14, on the commissioner's proposed action, provided that the 135.10 commissioner may suspend or reduce payment to a vendor of 135.11 medical care, except a nursing home or convalescent care 135.12 facility, after notice and prior to the hearing if in the 135.13 commissioner's opinion that action is necessary to protect the 135.14 public welfare and the interests of the program. 135.15 (b) Except for a nursing home or convalescent care 135.16 facility, the commissioner may withhold or reduce payments to a 135.17 vendor of medical care without providing advance notice of such 135.18 withholding or reduction if either of the following occurs: 135.19 (1) the vendor is convicted of a crime involving the 135.20 conduct described in subdivision 1a; or 135.21 (2) the commissioner receives reliable evidence of fraud or 135.22 willful misrepresentation by the vendor. 135.23 (c) The commissioner must send notice of the withholding or 135.24 reduction of payments under paragraph (b) within five days of 135.25 taking such action. The notice must: 135.26 (1) state that payments are being withheld according to 135.27 paragraph (b); 135.28 (2) except in the case of a conviction for conduct 135.29 described in subdivision 1a, state that the withholding is for a 135.30 temporary period and cite the circumstances under which 135.31 withholding will be terminated; 135.32 (3) identify the types of claims to which the withholding 135.33 applies; and 135.34 (4) inform the vendor of the right to submit written 135.35 evidence for consideration by the commissioner. 135.36 The withholding or reduction of payments will not continue 136.1 after the commissioner determines there is insufficient evidence 136.2 of fraud or willful misrepresentation by the vendor, or after 136.3 legal proceedings relating to the alleged fraud or willful 136.4 misrepresentation are completed, unless the commissioner has 136.5 sent notice of intention to impose monetary recovery or 136.6 sanctions under paragraph (a). 136.7 (d) The commissioner may suspend or terminate a vendor's 136.8 participation in the program without providing advance notice 136.9 and an opportunity for a hearing when the suspension or 136.10 termination is required because of the vendor's exclusion from 136.11 participation in Medicare. Within five days of taking such 136.12 action, the commissioner must send notice of the suspension or 136.13 termination. The notice must: 136.14 (1) state that suspension or termination is the result of 136.15 the vendor's exclusion from Medicare; 136.16 (2) identify the effective date of the suspension or 136.17 termination; 136.18 (3) inform the vendor of the need to be reinstated to 136.19 Medicare before reapplying for participation in the program; and 136.20 (4) inform the vendor of the right to submit written 136.21 evidence for consideration by the commissioner. 136.22 (e) Upon receipt of a notice under paragraph (a) that a 136.23 monetary recovery or sanction is to be imposed, a vendor may 136.24 request a contested case, as defined in section 14.02, 136.25 subdivision 3, by filing with the commissioner a written request 136.26 of appeal. The appeal request must be received by the 136.27 commissioner no later than 30 days after the date the 136.28 notification of monetary recovery or sanction was mailed to the 136.29 vendor. The appeal request must specify: 136.30 (1) each disputed item, the reason for the dispute, and an 136.31 estimate of the dollar amount involved for each disputed item; 136.32 (2) the computation that the vendor believes is correct; 136.33 (3) the authority in statute or rule upon which the vendor 136.34 relies for each disputed item; 136.35 (4) the name and address of the person or entity with whom 136.36 contacts may be made regarding the appeal; and 137.1 (5) other information required by the commissioner. 137.2 Sec. 18. Minnesota Statutes 2002, section 256B.0913, 137.3 subdivision 2, is amended to read: 137.4 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 137.5 services are available to Minnesotans age 65 or olderwho are137.6not eligible for medical assistance without a spenddown or137.7waiver obligation butwho would be eligible for medical 137.8 assistance within 180 days of admission to a nursing facility 137.9 and subject to subdivisions 4 to 13. 137.10 Sec. 19. Minnesota Statutes 2002, section 256B.0913, 137.11 subdivision 4, is amended to read: 137.12 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 137.13 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 137.14 under the alternative care program is available to persons who 137.15 meet the following criteria: 137.16 (1) the person has been determined by a community 137.17 assessment under section 256B.0911 to be a person who would 137.18 require the level of care provided in a nursing facility, but 137.19 for the provision of services under the alternative care 137.20 program; 137.21 (2) the person is age 65 or older; 137.22 (3) the person would be eligible for medical assistance 137.23 within 180 days of admission to a nursing facility; 137.24 (4) the person is not ineligible for the medical assistance 137.25 program due to an asset transfer penalty; 137.26 (5) the person needs services that are not funded through 137.27 other state or federal funding;and137.28 (6) the monthly cost of the alternative care services 137.29 funded by the program for this person does not exceed 75 percent 137.30 of thestatewide weighted average monthly nursing facility rate137.31of the case mix resident class to which the individual137.32alternative care client would be assigned under Minnesota Rules,137.33parts 9549.0050 to 9549.0059, less the recipient's maintenance137.34needs allowance as described in section 256B.0915, subdivision137.351d, paragraph (a), until the first day of the state fiscal year137.36in which the resident assessment system, under section 256B.437,138.1for nursing home rate determination is implemented. Effective138.2on the first day of the state fiscal year in which a resident138.3assessment system, under section 256B.437, for nursing home rate138.4determination is implemented and the first day of each138.5subsequent state fiscal year, the monthly cost of alternative138.6care services for this person shall not exceed the alternative138.7care monthly cap for the case mix resident class to which the138.8alternative care client would be assigned under Minnesota Rules,138.9parts 9549.0050 to 9549.0059, which was in effect on the last138.10day of the previous state fiscal year, and adjusted by the138.11greater of any legislatively adopted home and community-based138.12services cost-of-living percentage increase or any legislatively138.13adopted statewide percent rate increase for nursing138.14facilitiesmonthly limit described under section 256B.0915, 138.15 subdivision 3a. This monthly limit does not prohibit the 138.16 alternative care client from payment for additional services, 138.17 but in no case may the cost of additional services purchased 138.18 under this section exceed the difference between the client's 138.19 monthly service limit defined under section 256B.0915, 138.20 subdivision 3, and the alternative care program monthly service 138.21 limit defined in this paragraph. If medical supplies and 138.22 equipment or environmental modifications are or will be 138.23 purchased for an alternative care services recipient, the costs 138.24 may be prorated on a monthly basis for up to 12 consecutive 138.25 months beginning with the month of purchase. If the monthly 138.26 cost of a recipient's other alternative care services exceeds 138.27 the monthly limit established in this paragraph, the annual cost 138.28 of the alternative care services shall be determined. In this 138.29 event, the annual cost of alternative care services shall not 138.30 exceed 12 times the monthly limit described in this paragraph.; 138.31 and 138.32 (7) the person is making timely payments of the assessed 138.33 monthly fee. 138.34 A person is ineligible if payment of the fee is over 60 days 138.35 past due, unless the person agrees to: 138.36 (i) the appointment of a representative payee; 139.1 (ii) automatic payment from a financial account; 139.2 (iii) the establishment of greater family involvement in 139.3 the financial management of payments; or 139.4 (iv) another method acceptable to the county to ensure 139.5 prompt fee payments. 139.6 The county shall extend the client's eligibility as 139.7 necessary while making arrangements to facilitate payment of 139.8 past-due amounts and future premium payments. Following 139.9 disenrollment due to nonpayment of a monthly fee, eligibility 139.10 shall not be reinstated for a period of 30 days. 139.11 (b) Alternative care funding under this subdivision is not 139.12 available for a person who is a medical assistance recipient or 139.13 who would be eligible for medical assistance without a spenddown 139.14 or waiver obligation. A person whose initial application for 139.15 medical assistance and the elderly waiver program is being 139.16 processed may be served under the alternative care program for a 139.17 period up to 60 days. If the individual is found to be eligible 139.18 for medical assistance, medical assistance must be billed for 139.19 services payable under the federally approved elderly waiver 139.20 plan and delivered from the date the individual was found 139.21 eligible for the federally approved elderly waiver plan. 139.22 Notwithstanding this provision,upon federal approval,139.23 alternative care funds may not be used to pay for any service 139.24 the cost of which: (i) is payable by medical assistanceor139.25which; (ii) is used by a recipient to meet amedical assistance139.26income spenddown orwaiver obligation; or (iii) is used to pay a 139.27 medical assistance income spenddown for a person who is eligible 139.28 to participate in the federally approved elderly waiver program 139.29 under the special income standard provision. 139.30 (c) Alternative care funding is not available for a person 139.31 who resides in a licensed nursing home, certified boarding care 139.32 home, hospital, or intermediate care facility, except for case 139.33 management services which are provided in support of the 139.34 discharge planning processtofor a nursing home resident or 139.35 certified boarding care home resident to assist with a 139.36 relocation process to a community-based setting. 140.1 (d) Alternative care funding is not available for a person 140.2 whose income is greater than the maintenance needs allowance 140.3 under section 256B.0915, subdivision 1d, but equal to or less 140.4 than 120 percent of the federal poverty guideline effective July 140.5 1, in the year for which alternative care eligibility is 140.6 determined, who would be eligible for the elderly waiver with a 140.7 waiver obligation. 140.8 Sec. 20. Minnesota Statutes 2002, section 256B.0913, 140.9 subdivision 5, is amended to read: 140.10 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.](a)140.11 Alternative care funding may be used for payment of costs of: 140.12 (1) adult foster care; 140.13 (2) adult day care; 140.14 (3) home health aide; 140.15 (4) homemaker services; 140.16 (5) personal care; 140.17 (6) case management; 140.18 (7) respite care; 140.19 (8) assisted living; 140.20 (9) residential care services; 140.21 (10) care-related supplies and equipment; 140.22 (11) meals delivered to the home; 140.23 (12) transportation; 140.24 (13) nursing services; 140.25 (14) chore services; 140.26 (15) companion services; 140.27 (16) nutrition services; 140.28 (17) training for direct informal caregivers; 140.29 (18) telehome caredevicestomonitor recipientsprovide 140.30 services in their own homesas an alternative to hospital care,140.31nursing home care, or homein conjunction with in-home visits; 140.32 (19)other services which includesdiscretionaryfunds and140.33direct cash payments to clients,services, for which counties 140.34 may make payment from their alternative care program allocation 140.35 or services not otherwise defined in this section or section 140.36 256B.0625, following approval by the commissioner, subject to141.1the provisions of paragraph (j). Total annual payments for141.2"other services" for all clients within a county may not exceed141.325 percent of that county's annual alternative care program base141.4allocation;and141.5 (20) environmental modifications.; and 141.6 (21) direct cash payments for which counties may make 141.7 payment from their alternative care program allocation to 141.8 clients for the purpose of purchasing services, following 141.9 approval by the commissioner, and subject to the provisions of 141.10 subdivision 5h, until approval and implementation of 141.11 consumer-directed services through the federally approved 141.12 elderly waiver plan. Upon implementation, consumer-directed 141.13 services under the alternative care program are available 141.14 statewide and limited to the average monthly expenditures 141.15 representative of all alternative care program participants for 141.16 the same case mix resident class assigned in the most recent 141.17 fiscal year for which complete expenditure data is available. 141.18 Total annual payments for discretionary services and direct 141.19 cash payments, until the federally approved consumer-directed 141.20 service option is implemented statewide, for all clients within 141.21 a county may not exceed 25 percent of that county's annual 141.22 alternative care program base allocation. Thereafter, 141.23 discretionary services are limited to 25 percent of the county's 141.24 annual alternative care program base allocation. 141.25 Subd. 5a. [SERVICES; SERVICE DEFINITIONS; SERVICE 141.26 STANDARDS.] (a) Unless specified in statute, the services, 141.27 service definitions, and standards for alternative care services 141.28 shall be the same as the services, service definitions, and 141.29 standards specified in the federally approved elderly waiver 141.30 plan, except for transitional support services. 141.31 (b) The county agency must ensure that the funds are not 141.32 used to supplant services available through other public 141.33 assistance or services programs. 141.34(c) Unless specified in statute, the services, service141.35definitions, and standards for alternative care services shall141.36be the same as the services, service definitions, and standards142.1specified in the federally approved elderly waiver plan. Except142.2for the county agencies' approval of direct cash payments to142.3clients as described in paragraph (j) orFor a provider of 142.4 supplies and equipment when the monthly cost of the supplies and 142.5 equipment is less than $250, persons or agencies must be 142.6 employed by or under a contract with the county agency or the 142.7 public health nursing agency of the local board of health in 142.8 order to receive funding under the alternative care program. 142.9 Supplies and equipment may be purchased from a vendor not 142.10 certified to participate in the Medicaid program if the cost for 142.11 the item is less than that of a Medicaid vendor. 142.12 (c) Personal care services must meet the service standards 142.13 defined in the federally approved elderly waiver plan, except 142.14 that a county agency may contract with a client's relative who 142.15 meets the relative hardship waiver requirements or a relative 142.16 who meets the criteria and is also the responsible party under 142.17 an individual service plan that ensures the client's health and 142.18 safety and supervision of the personal care services by a 142.19 qualified professional as defined in section 256B.0625, 142.20 subdivision 19c. Relative hardship is established by the county 142.21 when the client's care causes a relative caregiver to do any of 142.22 the following: resign from a paying job, reduce work hours 142.23 resulting in lost wages, obtain a leave of absence resulting in 142.24 lost wages, incur substantial client-related expenses, provide 142.25 services to address authorized, unstaffed direct care time, or 142.26 meet special needs of the client unmet in the formal service 142.27 plan. 142.28(d)Subd. 5b. [ADULT FOSTER CARE RATE.] The adult foster 142.29 care rate shall be considered a difficulty of care payment and 142.30 shall not include room and board. The adult foster care rate 142.31 shall be negotiated between the county agency and the foster 142.32 care provider. The alternative care payment for the foster care 142.33 service in combination with the payment for other alternative 142.34 care services, including case management, must not exceed the 142.35 limit specified in subdivision 4, paragraph (a), clause (6). 142.36(e) Personal care services must meet the service standards143.1defined in the federally approved elderly waiver plan, except143.2that a county agency may contract with a client's relative who143.3meets the relative hardship waiver requirement as defined in143.4section 256B.0627, subdivision 4, paragraph (b), clause (10), to143.5provide personal care services if the county agency ensures143.6supervision of this service by a qualified professional as143.7defined in section 256B.0625, subdivision 19c.143.8(f)Subd. 5c. [RESIDENTIAL CARE SERVICES; SUPPORTIVE 143.9 SERVICES; HEALTH-RELATED SERVICES.] For purposes of this 143.10 section, residential care services are services which are 143.11 provided to individuals living in residential care homes. 143.12 Residential care homes are currently licensed as board and 143.13 lodging establishments under section 157.16, and are registered 143.14 with the department of health as providing special services 143.15 under section 157.17and are not subject to registrationexcept 143.16 settings that are currently registered under chapter 144D. 143.17 Residential care services are defined as "supportive services" 143.18 and "health-related services." "Supportive services" meansthe143.19provision of up to 24-hour supervision and oversight.143.20Supportive services includes: (1) transportation, when provided143.21by the residential care home only; (2) socialization, when143.22socialization is part of the plan of care, has specific goals143.23and outcomes established, and is not diversional or recreational143.24in nature; (3) assisting clients in setting up meetings and143.25appointments; (4) assisting clients in setting up medical and143.26social services; (5) providing assistance with personal laundry,143.27such as carrying the client's laundry to the laundry room.143.28Assistance with personal laundry does not include any laundry,143.29such as bed linen, that is included in the room and board rate143.30 services as defined in section 157.17, subdivision 1, paragraph 143.31 (a). "Health-related services"are limited to minimal143.32assistance with dressing, grooming, and bathing and providing143.33reminders to residents to take medications that are143.34self-administered or providing storage for medications, if143.35requestedmeans services covered in section 157.17, subdivision 143.36 1, paragraph (b). Individuals receiving residential care 144.1 services cannot receive homemaking services funded under this 144.2 section. 144.3(g)Subd. 5d. [ASSISTED LIVING SERVICES.] For the purposes 144.4 of this section, "assisted living" refers to supportive services 144.5 provided by a single vendor to clients who reside in the same 144.6 apartment building of three or more units which are not subject 144.7 to registration under chapter 144D and are licensed by the 144.8 department of health as a class A home care provider or a class 144.9 E home care provider. Assisted living services are defined as 144.10 up to 24-hour supervision,andoversight, and supportive 144.11 services as defined inclause (1)section 157.17, subdivision 1, 144.12 paragraph (a), individualized home care aide tasks as defined in 144.13clause (2)Minnesota Rules, part 4668.0110, and individualized 144.14 home management tasks as defined inclause (3)Minnesota Rules, 144.15 part 4668.0120 provided to residents of a residential center 144.16 living in their units or apartments with a full kitchen and 144.17 bathroom. A full kitchen includes a stove, oven, refrigerator, 144.18 food preparation counter space, and a kitchen utensil storage 144.19 compartment. Assisted living services must be provided by the 144.20 management of the residential center or by providers under 144.21 contract with the management or with the county. 144.22(1) Supportive services include:144.23(i) socialization, when socialization is part of the plan144.24of care, has specific goals and outcomes established, and is not144.25diversional or recreational in nature;144.26(ii) assisting clients in setting up meetings and144.27appointments; and144.28(iii) providing transportation, when provided by the144.29residential center only.144.30(2) Home care aide tasks means:144.31(i) preparing modified diets, such as diabetic or low144.32sodium diets;144.33(ii) reminding residents to take regularly scheduled144.34medications or to perform exercises;144.35(iii) household chores in the presence of technically144.36sophisticated medical equipment or episodes of acute illness or145.1infectious disease;145.2(iv) household chores when the resident's care requires the145.3prevention of exposure to infectious disease or containment of145.4infectious disease; and145.5(v) assisting with dressing, oral hygiene, hair care,145.6grooming, and bathing, if the resident is ambulatory, and if the145.7resident has no serious acute illness or infectious disease.145.8Oral hygiene means care of teeth, gums, and oral prosthetic145.9devices.145.10(3) Home management tasks means:145.11(i) housekeeping;145.12(ii) laundry;145.13(iii) preparation of regular snacks and meals; and145.14(iv) shopping.145.15 Subd. 5e. [FURTHER ASSISTED LIVING REQUIREMENTS.] (a) 145.16 Individuals receiving assisted living services shall not receive 145.17 both assisted living services and homemaking services. 145.18 Individualized means services are chosen and designed 145.19 specifically for each resident's needs, rather than provided or 145.20 offered to all residents regardless of their illnesses, 145.21 disabilities, or physical conditions. Assisted living services 145.22 as defined in this section shall not be authorized in boarding 145.23 and lodging establishments licensed according to sections 145.24 157.011 and 157.15 to 157.22. 145.25(h)(b) For establishments registered under chapter 144D, 145.26 assisted living services under this section means either the 145.27 services described inparagraph (g)subdivision 5d and delivered 145.28 by a class E home care provider licensed by the department of 145.29 health or the services described under section 144A.4605 and 145.30 delivered by an assisted living home care provider or a class A 145.31 home care provider licensed by the commissioner of health. 145.32(i)Subd. 5f. [PAYMENT RATES FOR ASSISTED LIVING SERVICES 145.33 AND RESIDENTIAL CARE.] (a) Payment for assisted living services 145.34 and residential care services shall be a monthly rate negotiated 145.35 and authorized by the county agency based on an individualized 145.36 service plan for each resident and may not cover direct rent or 146.1 food costs. 146.2(1)(b) The individualized monthly negotiated payment for 146.3 assisted living services as described inparagraph146.4(g)subdivision 5d or(h)5e, paragraph (b), and residential 146.5 care services as described inparagraph (f)subdivision 5c, 146.6 shall not exceed the nonfederal share in effect on July 1 of the 146.7 state fiscal year for which the rate limit is being calculated 146.8 of the greater of either the statewide or any of the geographic 146.9groups' weighted average monthly nursing facility payment rate146.10of the case mix resident class to which the alternative care146.11eligible client would be assigned under Minnesota Rules, parts146.129549.0050 to 9549.0059, less the maintenance needs allowance as146.13described in section 256B.0915, subdivision 1d, paragraph (a),146.14until the first day of the state fiscal year in which a resident146.15assessment system, under section 256B.437, of nursing home rate146.16determination is implemented. Effective on the first day of the146.17state fiscal year in which a resident assessment system, under146.18section 256B.437, of nursing home rate determination is146.19implemented and the first day of each subsequent state fiscal146.20year, the individualized monthly negotiated payment for the146.21services described in this clause shall not exceed the limit146.22described in this clause which was in effect on the last day of146.23the previous state fiscal year and which has been adjusted by146.24the greater of any legislatively adopted home and146.25community-based services cost-of-living percentage increase or146.26any legislatively adopted statewide percent rate increase for146.27nursing facilitiesgroups according to subdivision 4, paragraph 146.28 (a), clause (6). 146.29(2)(c) The individualized monthly negotiated payment for 146.30 assisted living services described under section 144A.4605 and 146.31 delivered by a provider licensed by the department of health as 146.32 a class A home care provider or an assisted living home care 146.33 provider and provided in a building that is registered as a 146.34 housing with services establishment under chapter 144D and that 146.35 provides 24-hour supervision in combination with the payment for 146.36 other alternative care services, including case management, must 147.1 not exceed the limit specified in subdivision 4, paragraph (a), 147.2 clause (6). 147.3(j)Subd. 5g. [PROVISIONS GOVERNING DIRECT CASH PAYMENTS.] 147.4 A county agency may make payment from their alternative care 147.5 program allocation for"other services" which include use of147.6"discretionary funds" for services that are not otherwise147.7defined in this section anddirect cash payments to the client 147.8 for the purpose of purchasing the services. The following 147.9 provisions apply to payments under thisparagraphsubdivision: 147.10 (1) a cash payment to a client under this provision cannot 147.11 exceed the monthly payment limit for that client as specified in 147.12 subdivision 4, paragraph (a), clause (6); and 147.13 (2) a county may not approve any cash payment for a client 147.14 who meets either of the following: 147.15 (i) has been assessed as having a dependency in 147.16 orientation, unless the client has an authorized 147.17 representative. An "authorized representative" means an 147.18 individual who is at least 18 years of age and is designated by 147.19 the person or the person's legal representative to act on the 147.20 person's behalf. This individual may be a family member, 147.21 guardian, representative payee, or other individual designated 147.22 by the person or the person's legal representative, if any, to 147.23 assist in purchasing and arranging for supports; or 147.24 (ii) is concurrently receiving adult foster care, 147.25 residential care, or assisted living services;. 147.26(3)Subd. 5h. [CASH PAYMENTS TO PERSONS.] (a) Cash 147.27 payments to a person or a person's family will be provided 147.28 through a monthly payment and be in the form of cash, voucher, 147.29 or direct county payment to a vendor. Fees or premiums assessed 147.30 to the person for eligibility for health and human services are 147.31 not reimbursable through this service option. Services and 147.32 goods purchased through cash payments must be identified in the 147.33 person's individualized care plan and must meet all of the 147.34 following criteria: 147.35(i)(1) they must be over and above the normal cost of 147.36 caring for the person if the person did not have functional 148.1 limitations; 148.2(ii)(2) they must be directly attributable to the person's 148.3 functional limitations; 148.4(iii)(3) they must have the potential to be effective at 148.5 meeting the goals of the program; and 148.6(iv)(4) they must be consistent with the needs identified 148.7 in the individualized service plan. The service plan shall 148.8 specify the needs of the person and family, the form and amount 148.9 of payment, the items and services to be reimbursed, and the 148.10 arrangements for management of the individual grant; and. 148.11(v)(b) The person, the person's family, or the legal 148.12 representative shall be provided sufficient information to 148.13 ensure an informed choice of alternatives. The local agency 148.14 shall document this information in the person's care plan, 148.15 including the type and level of expenditures to be reimbursed;. 148.16 (c) Persons receiving grants under this section shall have 148.17 the following responsibilities: 148.18 (1) spend the grant money in a manner consistent with their 148.19 individualized service plan with the local agency; 148.20 (2) notify the local agency of any necessary changes in the 148.21 grant expenditures; 148.22 (3) arrange and pay for supports; and 148.23 (4) inform the local agency of areas where they have 148.24 experienced difficulty securing or maintaining supports. 148.25 (d) The county shall report client outcomes, services, and 148.26 costs under this paragraph in a manner prescribed by the 148.27 commissioner. 148.28(4)Subd. 5i. [IMMUNITY.] The state of Minnesota, county, 148.29 lead agency under contract, or tribal government under contract 148.30 to administer the alternative care program shall not be liable 148.31 for damages, injuries, or liabilities sustained through the 148.32 purchase of direct supports or goods by the person, the person's 148.33 family, or the authorized representative with funds received 148.34 through the cash payments under this section. Liabilities 148.35 include, but are not limited to, workers' compensation, the 148.36 Federal Insurance Contributions Act (FICA), or the Federal 149.1 Unemployment Tax Act (FUTA);. 149.2(5) persons receiving grants under this section shall have149.3the following responsibilities:149.4(i) spend the grant money in a manner consistent with their149.5individualized service plan with the local agency;149.6(ii) notify the local agency of any necessary changes in149.7the grant expenditures;149.8(iii) arrange and pay for supports; and149.9(iv) inform the local agency of areas where they have149.10experienced difficulty securing or maintaining supports; and149.11(6) the county shall report client outcomes, services, and149.12costs under this paragraph in a manner prescribed by the149.13commissioner.149.14 Sec. 21. Minnesota Statutes 2002, section 256B.0913, 149.15 subdivision 6, is amended to read: 149.16 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] (a) 149.17 The alternative care program is administered by the county 149.18 agency. This agency is the lead agency responsible for the 149.19 local administration of the alternative care program as 149.20 described in this section. However, it may contract with the 149.21 public health nursing service to be the lead agency. The 149.22 commissioner may contract with federally recognized Indian 149.23 tribes with a reservation in Minnesota to serve as the lead 149.24 agency responsible for the local administration of the 149.25 alternative care program as described in the contract. 149.26 (b) Alternative care pilot projects operate according to 149.27 this section and the provisions of Laws 1993, First Special 149.28 Session chapter 1, article 5, section 133, under agreement with 149.29 the commissioner. Each pilot project agreement period shall 149.30 begin no later than the first payment cycle of the state fiscal 149.31 year and continue through the last payment cycle of the state 149.32 fiscal year. 149.33 [EFFECTIVE DATE.] This section is effective July 1, 2004. 149.34 Sec. 22. Minnesota Statutes 2002, section 256B.0913, 149.35 subdivision 7, is amended to read: 149.36 Subd. 7. [CASE MANAGEMENT.]Providers of case management150.1services for persons receiving services funded by the150.2alternative care program must meet the qualification150.3requirements and standards specified in section 256B.0915,150.4subdivision 1b.The case manager must not approve alternative 150.5 care funding for a client in any setting in which the case 150.6 manager cannot reasonably ensure the client's health and 150.7 safety. The case manager is responsible for the 150.8 cost-effectiveness of the alternative care individual care plan 150.9 and must not approve any care plan in which the cost of services 150.10 funded by alternative care and client contributions exceeds the 150.11 limit specified in section 256B.0915, subdivision 3, paragraph 150.12 (b).The county may allow a case manager employed by the county150.13to delegate certain aspects of the case management activity to150.14another individual employed by the county provided there is150.15oversight of the individual by the case manager. The case150.16manager may not delegate those aspects which require150.17professional judgment including assessments, reassessments, and150.18care plan development.150.19 Sec. 23. Minnesota Statutes 2002, section 256B.0913, 150.20 subdivision 8, is amended to read: 150.21 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 150.22 case manager shall implement the plan of care for each 150.23 alternative care client and ensure that a client's service needs 150.24 and eligibility are reassessed at least every 12 months. The 150.25 plan shall include any services prescribed by the individual's 150.26 attending physician as necessary to allow the individual to 150.27 remain in a community setting. In developing the individual's 150.28 care plan, the case manager should include the use of volunteers 150.29 from families and neighbors, religious organizations, social 150.30 clubs, and civic and service organizations to support the formal 150.31 home care services. The county shall be held harmless for 150.32 damages or injuries sustained through the use of volunteers 150.33 under this subdivision including workers' compensation 150.34 liability. The lead agency shall provide documentation in each 150.35 individual's plan of care and, if requested, to the commissioner 150.36 that the most cost-effective alternatives available have been 151.1 offered to the individual and that the individual was free to 151.2 choose among available qualified providers, both public and 151.3 private, including qualified case management or service 151.4 coordination providers other than those employed by the lead 151.5 agency when the lead agency maintains responsibility for prior 151.6 authorizing services in accordance with statutory and 151.7 administrative requirements. The case manager must give the 151.8 individual a ten-day written notice of any denial, termination, 151.9 or reduction of alternative care services. 151.10 (b) If the county administering alternative care services 151.11 is different than the county of financial responsibility, the 151.12 care plan may be implemented without the approval of the county 151.13 of financial responsibility. 151.14 [EFFECTIVE DATE.] This section is effective July 1, 2005. 151.15 Sec. 24. Minnesota Statutes 2002, section 256B.0913, 151.16 subdivision 10, is amended to read: 151.17 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 151.18 appropriation for fiscal years 1992 and beyond shall cover only 151.19 alternative care eligible clients. By July 1 of each year, the 151.20 commissioner shall allocate to county agencies the state funds 151.21 available for alternative care for persons eligible under 151.22 subdivision 2. 151.23 (b) The adjusted base for each county is the county's 151.24 current fiscal year base allocation plus any targeted funds 151.25 approved during the current fiscal year. Calculations for 151.26 paragraphs (c) and (d) are to be made as follows: for each 151.27 county, the determination of alternative care program 151.28 expenditures shall be based on payments for services rendered 151.29 from April 1 through March 31 in the base year, to the extent 151.30 that claims have been submitted and paid by June 1 of that year. 151.31 (c) If the alternative care program expenditures as defined 151.32 in paragraph (b) are 95 percent or more of the county's adjusted 151.33 base allocation, the allocation for the next fiscal year is 100 151.34 percent of the adjusted base, plus inflation to the extent that 151.35 inflation is included in the state budget. 151.36 (d) If the alternative care program expenditures as defined 152.1 in paragraph (b) are less than 95 percent of the county's 152.2 adjusted base allocation, the allocation for the next fiscal 152.3 year is the adjusted base allocation less the amount of unspent 152.4 funds below the 95 percent level. 152.5 (e) If the annual legislative appropriation for the 152.6 alternative care program is inadequate to fund the combined 152.7 county allocations for a biennium, the commissioner shall 152.8 distribute to each county the entire annual appropriation as 152.9 that county's percentage of the computed base as calculated in 152.10 paragraphs (c) and (d). 152.11 (f) On agreement between the commissioner and the lead 152.12 agency, the commissioner may have discretion to reallocate 152.13 alternative care base allocations distributed to lead agencies 152.14 in which the base amount exceeds program expenditures. 152.15 Sec. 25. Minnesota Statutes 2002, section 256B.0913, 152.16 subdivision 12, is amended to read: 152.17 Subd. 12. [CLIENTPREMIUMSFEES.] (a) Apremiumfee is 152.18 required for all alternative care eligible clients to help pay 152.19 for the cost of participating in the program. The amount of the 152.20premiumfee for the alternative care client shall be determined 152.21 as follows: 152.22 (1) when the alternative care client's income less 152.23 recurring and predictable medical expenses isgreater than the152.24recipient's maintenance needs allowance as defined in section152.25256B.0915, subdivision 1d, paragraph (a), butless than150100 152.26 percent of the federal poverty guideline effective on July 1 of 152.27 the state fiscal year in which thepremiumfee is being 152.28 computed, and total assets are less than $10,000, the fee is 152.29 zero; 152.30 (2) when the alternative care client's income less 152.31 recurring and predictable medical expenses is equal to or 152.32 greater than 100 percent but less than 150 percent of the 152.33 federal poverty guideline effective on July 1 of the state 152.34 fiscal year in which thepremiumfee is being computed, and 152.35 total assets are less than $10,000, the fee is25five percent 152.36 of the cost of alternative care servicesor the difference153.1between 150 percent of the federal poverty guideline effective153.2on July 1 of the state fiscal year in which the premium is being153.3computed and the client's income less recurring and predictable153.4medical expenses, whichever is less;and153.5 (3) when the alternative care client'stotal assets are153.6greaterincome less recurring and predictable medical expenses 153.7 is equal to or greater than 150 percent but less than 200 153.8 percent of the federal poverty guidelines effective on July 1 of 153.9 the state fiscal year in which the fee is being computed and 153.10 assets are less than $10,000, the fee is2515 percent of the 153.11 cost of alternative care services; 153.12 (4) when the alternative care client's income less 153.13 recurring and predictable medical expenses is equal to or 153.14 greater than 200 percent of the federal poverty guidelines 153.15 effective on July 1 of the state fiscal year in which the fee is 153.16 being computed and assets are less than $10,000, the fee is 30 153.17 percent of the cost of alternative care services; and 153.18 (5) when the alternative care client's assets are equal to 153.19 or greater than $10,000, the fee is 30 percent of the cost of 153.20 alternative care services. 153.21 For married persons, total assets are defined as the total 153.22 marital assets less the estimated community spouse asset 153.23 allowance, under section 256B.059, if applicable. For married 153.24 persons, total income is defined as the client's income less the 153.25 monthly spousal allotment, under section 256B.058. 153.26 All alternative care servicesexcept case managementshall 153.27 be included in the estimated costs for the purpose of 153.28 determining25 percent ofthecostsfee. 153.29PremiumsFees are due and payable each month alternative 153.30 care services are received unless the actual cost of the 153.31 services is less than thepremiumfee, in which case the fee is 153.32 the lesser amount. 153.33 (b) The fee shall be waived by the commissioner when: 153.34 (1) a person who is residing in a nursing facility is 153.35 receiving case management only; 153.36 (2)a person is applying for medical assistance;154.1(3)a married couple is requesting an asset assessment 154.2 under the spousal impoverishment provisions; 154.3(4)(3) a person is found eligible for alternative care, 154.4 but is not yet receiving alternative care services; or 154.5(5) a person's fee under paragraph (a) is less than $25154.6 (4) a person has chosen to participate in a 154.7 consumer-directed service plan for which the cost is no greater 154.8 than the total cost of the person's alternative care service 154.9 plan less the monthly fee amount that would otherwise be 154.10 assessed. 154.11 (c) The county agency must record in the state's receivable 154.12 system the client's assessedpremiumfee amount or the reason 154.13 thepremiumfee has been waived. The commissioner will bill and 154.14 collect thepremiumfee from the client. Money collected must 154.15 be deposited in the general fund and is appropriated to the 154.16 commissioner for the alternative care program. The client must 154.17 supply the county with the client's social security number at 154.18 the time of application. The county shall supply the 154.19 commissioner with the client's social security number and other 154.20 information the commissioner requires to collect thepremiumfee 154.21 from the client. The commissioner shall collect unpaidpremiums154.22 fees using the Revenue Recapture Act in chapter 270A and other 154.23 methods available to the commissioner. The commissioner may 154.24 require counties to inform clients of the collection procedures 154.25 that may be used by the state if apremiumfee is not paid. 154.26 This paragraph does not apply to alternative care pilot projects 154.27 authorized in Laws 1993, First Special Session chapter 1, 154.28 article 5, section 133, if a county operating under the pilot 154.29 project reports the following dollar amounts to the commissioner 154.30 quarterly: 154.31 (1) totalpremiumsfees billed to clients; 154.32 (2) total collections ofpremiumsfees billed; and 154.33 (3) balance ofpremiumsfees owed by clients. 154.34 If a county does not adhere to these reporting requirements, the 154.35 commissioner may terminate the billing, collecting, and 154.36 remitting portions of the pilot project and require the county 155.1 involved to operate under the procedures set forth in this 155.2 paragraph. 155.3 Sec. 26. Minnesota Statutes 2002, section 256B.0915, 155.4 subdivision 3, is amended to read: 155.5 Subd. 3. [LIMITS OF CASES, RATES, PAYMENTS, AND155.6FORECASTING.](a)The number of medical assistance waiver 155.7 recipients that a county may serve must be allocated according 155.8 to the number of medical assistance waiver cases open on July 1 155.9 of each fiscal year. Additional recipients may be served with 155.10 the approval of the commissioner. 155.11(b)Subd. 3a. [ELDERLY WAIVER COST LIMITS.] (a) The 155.12 monthly limit for the cost of waivered services to an individual 155.13 elderly waiver client shall be the weighted average monthly 155.14 nursing facility rate of the case mix resident class to which 155.15 the elderly waiver client would be assigned under Minnesota 155.16 Rules, parts 9549.0050 to 9549.0059, less the recipient's 155.17 maintenance needs allowance as described in subdivision 1d, 155.18 paragraph (a), until the first day of the state fiscal year in 155.19 which the resident assessment system as described in section 155.20 256B.437 for nursing home rate determination is implemented. 155.21 Effective on the first day of the state fiscal year in which the 155.22 resident assessment system as described in section 256B.437 for 155.23 nursing home rate determination is implemented and the first day 155.24 of each subsequent state fiscal year, the monthly limit for the 155.25 cost of waivered services to an individual elderly waiver client 155.26 shall be the rate of the case mix resident class to which the 155.27 waiver client would be assigned under Minnesota Rules, parts 155.28 9549.0050 to 9549.0059, in effect on the last day of the 155.29 previous state fiscal year, adjusted by the greater of any 155.30 legislatively adopted home and community-based services 155.31 cost-of-living percentage increase or any legislatively adopted 155.32 statewide percent rate increase for nursing facilities. 155.33(c)(b) If extended medical supplies and equipment or 155.34 environmental modifications are or will be purchased for an 155.35 elderly waiver client, the costs may be prorated for up to 12 155.36 consecutive months beginning with the month of purchase. If the 156.1 monthly cost of a recipient's waivered services exceeds the 156.2 monthly limit established in paragraph(b)(a), the annual cost 156.3 of all waivered services shall be determined. In this event, 156.4 the annual cost of all waivered services shall not exceed 12 156.5 times the monthly limit of waivered services as described in 156.6 paragraph(b)(a). 156.7(d)Subd. 3b. [COST LIMITS FOR ELDERLY WAIVER APPLICANTS 156.8 WHO RESIDE IN A NURSING FACILITY.] (a) For a person who is a 156.9 nursing facility resident at the time of requesting a 156.10 determination of eligibility for elderly waivered services, a 156.11 monthly conversion limit for the cost of elderly waivered 156.12 services may be requested. The monthly conversion limit for the 156.13 cost of elderly waiver services shall be the resident class 156.14 assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 156.15 for that resident in the nursing facility where the resident 156.16 currently resides until July 1 of the state fiscal year in which 156.17 the resident assessment system as described in section 256B.437 156.18 for nursing home rate determination is implemented. Effective 156.19 on July 1 of the state fiscal year in which the resident 156.20 assessment system as described in section 256B.437 for nursing 156.21 home rate determination is implemented, the monthly conversion 156.22 limit for the cost of elderly waiver services shall be the per 156.23 diem nursing facility rate as determined by the resident 156.24 assessment system as described in section 256B.437 for that 156.25 resident in the nursing facility where the resident currently 156.26 resides multiplied by 365 and divided by 12, less the 156.27 recipient's maintenance needs allowance as described in 156.28 subdivision 1d. The initially approved conversion rate may be 156.29 adjusted by the greater of any subsequent legislatively adopted 156.30 home and community-based services cost-of-living percentage 156.31 increase or any subsequent legislatively adopted statewide 156.32 percentage rate increase for nursing facilities. The limit 156.33 under thisclausesubdivision only applies to persons discharged 156.34 from a nursing facility after a minimum 30-day stay and found 156.35 eligible for waivered services on or after July 1, 1997. 156.36 (b) The following costs must be included in determining the 157.1 total monthly costs for the waiver client: 157.2 (1) cost of all waivered services, including extended 157.3 medical supplies and equipment and environmental modifications; 157.4 and 157.5 (2) cost of skilled nursing, home health aide, and personal 157.6 care services reimbursable by medical assistance. 157.7(e)Subd. 3c. [SERVICE APPROVAL AND CONTRACTING 157.8 PROVISIONS.] (a) Medical assistance funding for skilled nursing 157.9 services, private duty nursing, home health aide, and personal 157.10 care services for waiver recipients must be approved by the case 157.11 manager and included in the individual care plan. 157.12(f)(b) A county is not required to contract with a 157.13 provider of supplies and equipment if the monthly cost of the 157.14 supplies and equipment is less than $250. 157.15(g)Subd. 3d. [ADULT FOSTER CARE RATE.] The adult foster 157.16 care rate shall be considered a difficulty of care payment and 157.17 shall not include room and board. The adult foster care service 157.18 rate shall be negotiated between the county agency and the 157.19 foster care provider. The elderly waiver payment for the foster 157.20 care service in combination with the payment for all other 157.21 elderly waiver services, including case management, must not 157.22 exceed the limit specified in subdivision 3a, paragraph(b)(a). 157.23(h)Subd. 3e. [ASSISTED LIVING SERVICE RATE.] (a) Payment 157.24 for assisted living service shall be a monthly rate negotiated 157.25 and authorized by the county agency based on an individualized 157.26 service plan for each resident and may not cover direct rent or 157.27 food costs. 157.28(1)(b) The individualized monthly negotiated payment for 157.29 assisted living services as described in section 256B.0913, 157.30subdivision 5, paragraph (g) or (h)subdivisions 5d to 5f, and 157.31 residential care services as described in section 256B.0913, 157.32 subdivision5, paragraph (f)5c, shall not exceed the nonfederal 157.33 share, in effect on July 1 of the state fiscal year for which 157.34 the rate limit is being calculated, of the greater of either the 157.35 statewide or any of the geographic groups' weighted average 157.36 monthly nursing facility rate of the case mix resident class to 158.1 which the elderly waiver eligible client would be assigned under 158.2 Minnesota Rules, parts 9549.0050 to 9549.0059, less the 158.3 maintenance needs allowance as described in subdivision 1d, 158.4 paragraph (a), until the July 1 of the state fiscal year in 158.5 which the resident assessment system as described in section 158.6 256B.437 for nursing home rate determination is implemented. 158.7 Effective on July 1 of the state fiscal year in which the 158.8 resident assessment system as described in section 256B.437 for 158.9 nursing home rate determination is implemented and July 1 of 158.10 each subsequent state fiscal year, the individualized monthly 158.11 negotiated payment for the services described in this clause 158.12 shall not exceed the limit described in this clause which was in 158.13 effect on June 30 of the previous state fiscal year and which 158.14 has been adjusted by the greater of any legislatively adopted 158.15 home and community-based services cost-of-living percentage 158.16 increase or any legislatively adopted statewide percent rate 158.17 increase for nursing facilities. 158.18(2)(c) The individualized monthly negotiated payment for 158.19 assisted living services described in section 144A.4605 and 158.20 delivered by a provider licensed by the department of health as 158.21 a class A home care provider or an assisted living home care 158.22 provider and provided in a building that is registered as a 158.23 housing with services establishment under chapter 144D and that 158.24 provides 24-hour supervision in combination with the payment for 158.25 other elderly waiver services, including case management, must 158.26 not exceed the limit specified inparagraph (b)subdivision 3a. 158.27(i)Subd. 3f. [INDIVIDUAL SERVICE RATES; EXPENDITURE 158.28 FORECASTS.] (a) The county shall negotiate individual service 158.29 rates with vendors and may authorize payment for actual costs up 158.30 to the county's current approved rate. Persons or agencies must 158.31 be employed by or under a contract with the county agency or the 158.32 public health nursing agency of the local board of health in 158.33 order to receive funding under the elderly waiver program, 158.34 except as a provider of supplies and equipment when the monthly 158.35 cost of the supplies and equipment is less than $250. 158.36(j)(b) Reimbursement for the medical assistance recipients 159.1 under the approved waiver shall be made from the medical 159.2 assistance account through the invoice processing procedures of 159.3 the department's Medicaid Management Information System (MMIS), 159.4 only with the approval of the client's case manager. The budget 159.5 for the state share of the Medicaid expenditures shall be 159.6 forecasted with the medical assistance budget, and shall be 159.7 consistent with the approved waiver. 159.8(k)Subd. 3g. [SERVICE RATE LIMITS; STATE ASSUMPTION OF 159.9 COSTS.] (a) To improve access to community services and 159.10 eliminate payment disparities between the alternative care 159.11 program and the elderly waiver, the commissioner shall establish 159.12 statewide maximum service rate limits and eliminate 159.13 county-specific service rate limits. 159.14(1)(b) Effective July 1, 2001, for service rate limits, 159.15 except those described or defined inparagraphs (g) and159.16(h)subdivisions 3d and 3e, the rate limit for each service 159.17 shall be the greater of the alternative care statewide maximum 159.18 rate or the elderly waiver statewide maximum rate. 159.19(2)(c) Counties may negotiate individual service rates 159.20 with vendors for actual costs up to the statewide maximum 159.21 service rate limit. 159.22 Sec. 27. Minnesota Statutes 2002, section 256B.15, 159.23 subdivision 1, is amended to read: 159.24 Subdivision 1. [DEFINITION.] For purposes of this section, 159.25 "medical assistance" includes the medical assistance program 159.26 under this chapter and the general assistance medical care 159.27 program under chapter 256D, but does not include the alternative159.28care program for nonmedical assistance recipients under section159.29256B.0913, subdivision 4and alternative care for nonmedical 159.30 assistance recipients under section 256B.0913. 159.31 [EFFECTIVE DATE.] This section is effective July 1, 2003, 159.32 for decedents dying on or after that date. 159.33 Sec. 28. Minnesota Statutes 2002, section 256B.15, 159.34 subdivision 1a, is amended to read: 159.35 Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person 159.36 receives any medical assistance hereunder, on the person's 160.1 death, if single, or on the death of the survivor of a married 160.2 couple, either or both of whom received medical assistance, or 160.3 as otherwise provided for in this section, the total amount paid 160.4 for medical assistance rendered for the person and spouse shall 160.5 be filed as a claim against the estate of the person or the 160.6 estate of the surviving spouse in the court having jurisdiction 160.7 to probate the estate or to issue a decree of descent according 160.8 to sections 525.31 to 525.313. 160.9 A claim shall be filed if medical assistance was rendered 160.10 for either or both persons under one of the following 160.11 circumstances: 160.12 (a) the person was over 55 years of age, and received 160.13 services under this chapter, excluding alternative care; 160.14 (b) the person resided in a medical institution for six 160.15 months or longer, received services under this chapterexcluding160.16alternative care, and, at the time of institutionalization or 160.17 application for medical assistance, whichever is later, the 160.18 person could not have reasonably been expected to be discharged 160.19 and returned home, as certified in writing by the person's 160.20 treating physician. For purposes of this section only, a 160.21 "medical institution" means a skilled nursing facility, 160.22 intermediate care facility, intermediate care facility for 160.23 persons with mental retardation, nursing facility, or inpatient 160.24 hospital; or 160.25 (c) the person received general assistance medical care 160.26 services under chapter 256D. 160.27 The claim shall be considered an expense of the last 160.28 illness of the decedent for the purpose of section 524.3-805. 160.29 Any statute of limitations that purports to limit any county 160.30 agency or the state agency, or both, to recover for medical 160.31 assistance granted hereunder shall not apply to any claim made 160.32 hereunder for reimbursement for any medical assistance granted 160.33 hereunder. Notice of the claim shall be given to all heirs and 160.34 devisees of the decedent whose identity can be ascertained with 160.35 reasonable diligence. The notice must include procedures and 160.36 instructions for making an application for a hardship waiver 161.1 under subdivision 5; time frames for submitting an application 161.2 and determination; and information regarding appeal rights and 161.3 procedures. Counties are entitled to one-half of the nonfederal 161.4 share of medical assistance collections from estates that are 161.5 directly attributable to county effort. Counties are entitled 161.6 to ten percent of the collections for alternative care directly 161.7 attributable to county effort. 161.8 [EFFECTIVE DATE.] The amendments in this section relating 161.9 to the alternative care program are effective July 1, 2003, and 161.10 apply to the estates of decedents who die on or after that 161.11 date. The remaining amendments in this section are effective 161.12 August 1, 2003, and apply to the estates of decedents who die on 161.13 and after that date. 161.14 Sec. 29. Minnesota Statutes 2002, section 256B.15, 161.15 subdivision 2, is amended to read: 161.16 Subd. 2. [LIMITATIONS ON CLAIMS.] The claim shall include 161.17 only the total amount of medical assistance rendered after age 161.18 55 or during a period of institutionalization described in 161.19 subdivision 1a, clause (b), and the total amount of general 161.20 assistance medical care rendered, and shall not include 161.21 interest. Claims that have been allowed but not paid shall bear 161.22 interest according to section 524.3-806, paragraph (d). A claim 161.23 against the estate of a surviving spouse who did not receive 161.24 medical assistance, for medical assistance rendered for the 161.25 predeceased spouse, is limited to the value of the assets of the 161.26 estate that were marital property or jointly owned property at 161.27 any time during the marriage. Claims for alternative care shall 161.28 be net of all premiums paid under section 256B.0913, subdivision 161.29 12, on or after July 1, 2003, and shall be limited to services 161.30 provided on or after July 1, 2003. 161.31 [EFFECTIVE DATE.] This section is effective July 1, 2003, 161.32 for decedents dying on or after that date. 161.33 Sec. 30. Minnesota Statutes 2002, section 256B.431, 161.34 subdivision 2r, is amended to read: 161.35 Subd. 2r. [PAYMENT RESTRICTIONS ON LEAVE DAYS.] Effective 161.36 July 1, 1993, the commissioner shall limit payment for leave 162.1 days in a nursing facility to 79 percent of that nursing 162.2 facility's total payment rate for the involved resident. For 162.3 services rendered on or after July 1, 2003, for facilities 162.4 reimbursed under this section or section 256B.434, the 162.5 commissioner shall limit payment for leave days in a nursing 162.6 facility to 60 percent of that nursing facility's total payment 162.7 rate for the involved resident. 162.8 Sec. 31. Minnesota Statutes 2002, section 256B.431, is 162.9 amended by adding a subdivision to read: 162.10 Subd. 2t. [PAYMENT LIMITATION.] For services rendered on 162.11 or after July 1, 2003, for facilities reimbursed under this 162.12 section or section 256B.434, the Medicaid program shall only pay 162.13 a co-payment during a Medicare-covered skilled nursing facility 162.14 stay if the Medicare rate less the resident's co-payment 162.15 responsibility is less than the Medicaid RUG-III case-mix 162.16 payment rate. The amount that shall be paid by the Medicaid 162.17 program is equal to the amount by which the Medicaid RUG-III 162.18 case-mix payment rate exceeds the Medicare rate less the 162.19 co-payment responsibility. Health plans paying for nursing home 162.20 services under section 256B.69, subdivision 6a, may limit 162.21 payments as allowed under this subdivision. 162.22 Sec. 32. Minnesota Statutes 2002, section 256B.431, 162.23 subdivision 32, is amended to read: 162.24 Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 162.25 years beginning on or after July 1, 2001, the total payment rate 162.26 for a facility reimbursed under this section, section 256B.434, 162.27 or any other section for the first 90 paid days after admission 162.28 shall be: 162.29 (1) for the first 30 paid days, the rate shall be 120 162.30 percent of the facility's medical assistance rate for each case 162.31 mix class;and162.32 (2) for the next 60 paid days after the first 30 paid days, 162.33 the rate shall be 110 percent of the facility's medical 162.34 assistance rate for each case mix class.; 162.35(b)(3) beginning with the 91st paid day after admission, 162.36 the payment rate shall be the rate otherwise determined under 163.1 this section, section 256B.434, or any other section.; and 163.2(c)(4) payments under thissubdivision appliesparagraph 163.3 apply to admissions occurring on or after July 1, 2001, and 163.4 before July 1, 2003, and to resident days occurring before July 163.5 30, 2003. 163.6 (b) For rate years beginning on or after July 1, 2003, the 163.7 total payment rate for a facility reimbursed under this section, 163.8 section 256B.434, or any other section shall be: 163.9 (1) for the first 30 calendar days after admission, the 163.10 rate shall be 120 percent of the facility's medical assistance 163.11 rate for each RUG class; 163.12 (2) beginning with the 31st calendar day after admission, 163.13 the payment rate shall be the rate otherwise determined under 163.14 this section, section 256B.434, or any other section; and 163.15 (3) payments under this paragraph apply to admissions 163.16 occurring on or after July 1, 2003. 163.17 (c) Effective January 1, 2004, the enhanced rates under 163.18 this subdivision shall not be allowed if a resident has resided 163.19 during the previous 30 calendar days in: 163.20 (1) the same nursing facility; 163.21 (2) a nursing facility owned or operated by a related 163.22 party; or 163.23 (3) a nursing facility or part of a facility that closed. 163.24 Sec. 33. Minnesota Statutes 2002, section 256B.431, 163.25 subdivision 36, is amended to read: 163.26 Subd. 36. [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN 163.27 ENGLISH AS A SECOND LANGUAGE.] (a) For the period between July 163.28 1, 2001, and June 30, 2003, the commissioner shall provide to 163.29 each nursing facility reimbursed under this section, section 163.30 256B.434, or any other section, a scholarship per diem of 25 163.31 cents to the total operating payment rate to be used: 163.32 (1) for employee scholarships that satisfy the following 163.33 requirements: 163.34 (i) scholarships are available to all employees who work an 163.35 average of at least 20 hours per week at the facility except the 163.36 administrator, department supervisors, and registered nurses; 164.1 and 164.2 (ii) the course of study is expected to lead to career 164.3 advancement with the facility or in long-term care, including 164.4 medical care interpreter services and social work; and 164.5 (2) to provide job-related training in English as a second 164.6 language. 164.7 (b) A facility receiving a rate adjustment under this 164.8 subdivision may submit to the commissioner on a schedule 164.9 determined by the commissioner and on a form supplied by the 164.10 commissioner a calculation of the scholarship per diem, 164.11 including: the amount received from this rate adjustment; the 164.12 amount used for training in English as a second language; the 164.13 number of persons receiving the training; the name of the person 164.14 or entity providing the training; and for each scholarship 164.15 recipient, the name of the recipient, the amount awarded, the 164.16 educational institution attended, the nature of the educational 164.17 program, the program completion date, and a determination of the 164.18 per diem amount of these costs based on actual resident days. 164.19 (c) On July 1, 2003, the commissioner shall remove the 25 164.20 cent scholarship per diem from the total operating payment rate 164.21 of each facility. 164.22 (d) For rate years beginning after June 30, 2003, the 164.23 commissioner shall provide to each facility the scholarship per 164.24 diem determined in paragraph (b). In calculating the per diem 164.25 under paragraph (b), the commissioner shall allow only costs 164.26 related to tuition and direct educational expenses. 164.27 Sec. 34. Minnesota Statutes 2002, section 256B.431, is 164.28 amended by adding a subdivision to read: 164.29 Subd. 38. [NURSING HOME RATE INCREASES EFFECTIVE IN FISCAL 164.30 YEAR 2003.] Effective June 1, 2003, the commissioner shall 164.31 provide to each nursing home reimbursed under this section or 164.32 section 256B.434, an increase in each case mix payment rate 164.33 equal to the increase in the per-bed surcharge paid under 164.34 section 256.9657, subdivision 1, paragraph (d), divided by 365 164.35 and further divided by .90. The increase shall not be subject 164.36 to any annual percentage increase. The 30-day advance notice 165.1 requirement in section 256B.47, subdivision 2, shall not apply 165.2 to rate increases resulting from this section. The commissioner 165.3 shall not adjust the rate increase under this subdivision unless 165.4 the adjustment is greater than 1.5 percent of the monthly 165.5 surcharge payment amount under section 256.9657, subdivision 4. 165.6 [EFFECTIVE DATE.] This section is effective May 31, 2003. 165.7 Sec. 35. Minnesota Statutes 2002, section 256B.431, is 165.8 amended by adding a subdivision to read: 165.9 Subd. 39. [FACILITY RATES BEGINNING ON OR AFTER JULY 1, 165.10 2003.] For rate years beginning on or after July 1, 2003, 165.11 nursing facilities reimbursed under this section shall have 165.12 their July 1 operating payment rate be equal to their operating 165.13 payment rate in effect on the prior June 30th. 165.14 Sec. 36. Minnesota Statutes 2002, section 256B.434, 165.15 subdivision 4, is amended to read: 165.16 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 165.17 nursing facilities which have their payment rates determined 165.18 under this section rather than section 256B.431, the 165.19 commissioner shall establish a rate under this subdivision. The 165.20 nursing facility must enter into a written contract with the 165.21 commissioner. 165.22 (b) A nursing facility's case mix payment rate for the 165.23 first rate year of a facility's contract under this section is 165.24 the payment rate the facility would have received under section 165.25 256B.431. 165.26 (c) A nursing facility's case mix payment rates for the 165.27 second and subsequent years of a facility's contract under this 165.28 section are the previous rate year's contract payment rates plus 165.29 an inflation adjustment and, for facilities reimbursed under 165.30 this section or section 256B.431, an adjustment to include the 165.31 cost of any increase in health department licensing fees for the 165.32 facility taking effect on or after July 1, 2001. The index for 165.33 the inflation adjustment must be based on the change in the 165.34 Consumer Price Index-All Items (United States City average) 165.35 (CPI-U) forecasted byData Resources, Inc.the commissioner of 165.36 finance's national economic consultant, as forecasted in the 166.1 fourth quarter of the calendar year preceding the rate year. 166.2 The inflation adjustment must be based on the 12-month period 166.3 from the midpoint of the previous rate year to the midpoint of 166.4 the rate year for which the rate is being determined. For the 166.5 rate years beginning on July 1, 1999, July 1, 2000, July 1, 166.6 2001,andJuly 1, 2002, July 1, 2003, and July 1, 2004, this 166.7 paragraph shall apply only to the property-related payment rate, 166.8 except that adjustments to include the cost of any increase in 166.9 health department licensing fees taking effect on or after July 166.10 1, 2001, shall be provided. In determining the amount of the 166.11 property-related payment rate adjustment under this paragraph, 166.12 the commissioner shall determine the proportion of the 166.13 facility's rates that are property-related based on the 166.14 facility's most recent cost report. 166.15 (d) The commissioner shall develop additional 166.16 incentive-based payments of up to five percent above the 166.17 standard contract rate for achieving outcomes specified in each 166.18 contract. The specified facility-specific outcomes must be 166.19 measurable and approved by the commissioner. The commissioner 166.20 may establish, for each contract, various levels of achievement 166.21 within an outcome. After the outcomes have been specified the 166.22 commissioner shall assign various levels of payment associated 166.23 with achieving the outcome. Any incentive-based payment cancels 166.24 if there is a termination of the contract. In establishing the 166.25 specified outcomes and related criteria the commissioner shall 166.26 consider the following state policy objectives: 166.27 (1) improved cost effectiveness and quality of life as 166.28 measured by improved clinical outcomes; 166.29 (2) successful diversion or discharge to community 166.30 alternatives; 166.31 (3) decreased acute care costs; 166.32 (4) improved consumer satisfaction; 166.33 (5) the achievement of quality; or 166.34 (6) any additional outcomes proposed by a nursing facility 166.35 that the commissioner finds desirable. 166.36 Sec. 37. Minnesota Statutes 2002, section 256B.434, 167.1 subdivision 10, is amended to read: 167.2 Subd. 10. [EXEMPTIONS.] (a) To the extent permitted by 167.3 federal law, (1) a facility that has entered into a contract 167.4 under this section is not required to file a cost report, as 167.5 defined in Minnesota Rules, part 9549.0020, subpart 13, for any 167.6 year after the base year that is the basis for the calculation 167.7 of the contract payment rate for the first rate year of the 167.8 alternative payment demonstration project contract; and (2) a 167.9 facility under contract is not subject to audits of historical 167.10 costs or revenues, or paybacks or retroactive adjustments based 167.11 on these costs or revenues, except audits, paybacks, or 167.12 adjustments relating to the cost report that is the basis for 167.13 calculation of the first rate year under the contract. 167.14 (b) A facility that is under contract with the commissioner 167.15 under this section is not subject to the moratorium on licensure 167.16 or certification of new nursing home beds in section 144A.071, 167.17 unless the project results in a net increase in bed capacity or 167.18 involves relocation of beds from one site to another. Contract 167.19 payment rates must not be adjusted to reflect any additional 167.20 costs that a nursing facility incurs as a result of a 167.21 construction project undertaken under this paragraph. In 167.22 addition, as a condition of entering into a contract under this 167.23 section, a nursing facility must agree that any future medical 167.24 assistance payments for nursing facility services will not 167.25 reflect any additional costs attributable to the sale of a 167.26 nursing facility under this section and to construction 167.27 undertaken under this paragraph that otherwise would not be 167.28 authorized under the moratorium in section 144A.073. Nothing in 167.29 this section prevents a nursing facility participating in the 167.30 alternative payment demonstration project under this section 167.31 from seeking approval of an exception to the moratorium through 167.32 the process established in section 144A.073, and if approved the 167.33 facility's rates shall be adjusted to reflect the cost of the 167.34 project. Nothing in this section prevents a nursing facility 167.35 participating in the alternative payment demonstration project 167.36 from seeking legislative approval of an exception to the 168.1 moratorium under section 144A.071, and, if enacted, the 168.2 facility's rates shall be adjusted to reflect the cost of the 168.3 project. 168.4 (c) Notwithstanding section 256B.48, subdivision 6, 168.5 paragraphs (c), (d), and (e), and pursuant to any terms and 168.6 conditions contained in the facility's contract, a nursing 168.7 facility that is under contract with the commissioner under this 168.8 section is in compliance with section 256B.48, subdivision 6, 168.9 paragraph (b), if the facility is Medicare certified. 168.10 (d) Notwithstanding paragraph (a), if by April 1, 1996, the 168.11 health care financing administration has not approved a required 168.12 waiver, or the Centers for Medicare and Medicaid Services 168.13 otherwise requires cost reports to be filed prior to the 168.14 waiver's approval, the commissioner shall require a cost report 168.15 for the rate year. 168.16 (e) A facility that is under contract with the commissioner 168.17 under this section shall be allowed to change therapy 168.18 arrangements from an unrelated vendor to a related vendor during 168.19 the term of the contract. The commissioner may develop 168.20 reasonable requirements designed to prevent an increase in 168.21 therapy utilization for residents enrolled in the medical 168.22 assistance program. 168.23 (f) Nursing facilities participating in the alternative 168.24 payment system demonstration project must either participate in 168.25 the alternative payment system quality improvement program 168.26 established by the commissioner or submit information on their 168.27 own quality improvement process to the commissioner for 168.28 approval. Nursing facilities that have had their own quality 168.29 improvement process approved by the commissioner must report 168.30 results for at least one key area of quality improvement 168.31 annually to the commissioner. 168.32 [EFFECTIVE DATE.] This section is effective the day 168.33 following final enactment. 168.34 Sec. 38. Minnesota Statutes 2002, section 256B.5012, is 168.35 amended by adding a subdivision to read: 168.36 Subd. 5. [RATE INCREASE EFFECTIVE JUNE 1, 2003.] For rate 169.1 periods beginning on or after June 1, 2003, the commissioner 169.2 shall increase the total operating payment rate for each 169.3 facility reimbursed under this section by $3 per day. The 169.4 increase shall not be subject to any annual percentage increase. 169.5 [EFFECTIVE DATE.] This section is effective the day 169.6 following final enactment. 169.7 Sec. 39. Minnesota Statutes 2002, section 256B.76, is 169.8 amended to read: 169.9 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 169.10 (a) Effective for services rendered on or after October 1, 169.11 1992, the commissioner shall make payments for physician 169.12 services as follows: 169.13 (1) payment for level one Centers for Medicare and Medicaid 169.14 Services' common procedural coding system codes titled "office 169.15 and other outpatient services," "preventive medicine new and 169.16 established patient," "delivery, antepartum, and postpartum 169.17 care," "critical care," cesarean delivery and pharmacologic 169.18 management provided to psychiatric patients, and level three 169.19 codes for enhanced services for prenatal high risk, shall be 169.20 paid at the lower of (i) submitted charges, or (ii) 25 percent 169.21 above the rate in effect on June 30, 1992. If the rate on any 169.22 procedure code within these categories is different than the 169.23 rate that would have been paid under the methodology in section 169.24 256B.74, subdivision 2, then the larger rate shall be paid; 169.25 (2) payments for all other services shall be paid at the 169.26 lower of (i) submitted charges, or (ii) 15.4 percent above the 169.27 rate in effect on June 30, 1992; 169.28 (3) all physician rates shall be converted from the 50th 169.29 percentile of 1982 to the 50th percentile of 1989, less the 169.30 percent in aggregate necessary to equal the above increases 169.31 except that payment rates for home health agency services shall 169.32 be the rates in effect on September 30, 1992; 169.33 (4) effective for services rendered on or after January 1, 169.34 2000, payment rates for physician and professional services 169.35 shall be increased by three percent over the rates in effect on 169.36 December 31, 1999, except for home health agency and family 170.1 planning agency services; and 170.2 (5) the increases in clause (4) shall be implemented 170.3 January 1, 2000, for managed care. 170.4 (b) Effective for services rendered on or after October 1, 170.5 1992, the commissioner shall make payments for dental services 170.6 as follows: 170.7 (1) dental services shall be paid at the lower of (i) 170.8 submitted charges, or (ii) 25 percent above the rate in effect 170.9 on June 30, 1992; 170.10 (2) dental rates shall be converted from the 50th 170.11 percentile of 1982 to the 50th percentile of 1989, less the 170.12 percent in aggregate necessary to equal the above increases; 170.13 (3) effective for services rendered on or after January 1, 170.14 2000, payment rates for dental services shall be increased by 170.15 three percent over the rates in effect on December 31, 1999; 170.16 (4) the commissioner shall award grants to community 170.17 clinics or other nonprofit community organizations, political 170.18 subdivisions, professional associations, or other organizations 170.19 that demonstrate the ability to provide dental services 170.20 effectively to public program recipients. Grants may be used to 170.21 fund the costs related to coordinating access for recipients, 170.22 developing and implementing patient care criteria, upgrading or 170.23 establishing new facilities, acquiring furnishings or equipment, 170.24 recruiting new providers, or other development costs that will 170.25 improve access to dental care in a region. In awarding grants, 170.26 the commissioner shall give priority to applicants that plan to 170.27 serve areas of the state in which the number of dental providers 170.28 is not currently sufficient to meet the needs of recipients of 170.29 public programs or uninsured individuals. The commissioner 170.30 shall consider the following in awarding the grants: 170.31 (i) potential to successfully increase access to an 170.32 underserved population; 170.33 (ii) the ability to raise matching funds; 170.34 (iii) the long-term viability of the project to improve 170.35 access beyond the period of initial funding; 170.36 (iv) the efficiency in the use of the funding; and 171.1 (v) the experience of the proposers in providing services 171.2 to the target population. 171.3 The commissioner shall monitor the grants and may terminate 171.4 a grant if the grantee does not increase dental access for 171.5 public program recipients. The commissioner shall consider 171.6 grants for the following: 171.7 (i) implementation of new programs or continued expansion 171.8 of current access programs that have demonstrated success in 171.9 providing dental services in underserved areas; 171.10 (ii) a pilot program for utilizing hygienists outside of a 171.11 traditional dental office to provide dental hygiene services; 171.12 and 171.13 (iii) a program that organizes a network of volunteer 171.14 dentists, establishes a system to refer eligible individuals to 171.15 volunteer dentists, and through that network provides donated 171.16 dental care services to public program recipients or uninsured 171.17 individuals; 171.18 (5) beginning October 1, 1999, the payment for tooth 171.19 sealants and fluoride treatments shall be the lower of (i) 171.20 submitted charge, or (ii) 80 percent of median 1997 charges; 171.21 (6) the increases listed in clauses (3) and (5) shall be 171.22 implemented January 1, 2000, for managed care; and 171.23 (7) effective for services provided on or after January 1, 171.24 2002, payment for diagnostic examinations and dental x-rays 171.25 provided to children under age 21 shall be the lower of (i) the 171.26 submitted charge, or (ii) 85 percent of median 1999 charges. 171.27 (c) Effective for dental services rendered on or after 171.28 January 1, 2002, the commissioner may, within the limits of 171.29 available appropriation, increase reimbursements to dentists and 171.30 dental clinics deemed by the commissioner to be critical access 171.31 dental providers. Reimbursement to a critical access dental 171.32 provider may be increased by not more than 50 percent above the 171.33 reimbursement rate that would otherwise be paid to the 171.34 provider. Payments to health plan companies shall be adjusted 171.35 to reflect increased reimbursements to critical access dental 171.36 providers as approved by the commissioner. In determining which 172.1 dentists and dental clinics shall be deemed critical access 172.2 dental providers, the commissioner shall review: 172.3 (1) the utilization rate in the service area in which the 172.4 dentist or dental clinic operates for dental services to 172.5 patients covered by medical assistance, general assistance 172.6 medical care, or MinnesotaCare as their primary source of 172.7 coverage; 172.8 (2) the level of services provided by the dentist or dental 172.9 clinic to patients covered by medical assistance, general 172.10 assistance medical care, or MinnesotaCare as their primary 172.11 source of coverage; and 172.12 (3) whether the level of services provided by the dentist 172.13 or dental clinic is critical to maintaining adequate levels of 172.14 patient access within the service area. 172.15 In the absence of a critical access dental provider in a service 172.16 area, the commissioner may designate a dentist or dental clinic 172.17 as a critical access dental provider if the dentist or dental 172.18 clinic is willing to provide care to patients covered by medical 172.19 assistance, general assistance medical care, or MinnesotaCare at 172.20 a level which significantly increases access to dental care in 172.21 the service area. 172.22 (d)Effective July 1, 2001, the medical assistance rates172.23for outpatient mental health services provided by an entity that172.24operates:172.25(1) a Medicare-certified comprehensive outpatient172.26rehabilitation facility; and172.27(2) a facility that was certified prior to January 1, 1993,172.28with at least 33 percent of the clients receiving rehabilitation172.29services in the most recent calendar year who are medical172.30assistance recipients, will be increased by 38 percent, when172.31those services are provided within the comprehensive outpatient172.32rehabilitation facility and provided to residents of nursing172.33facilities owned by the entity.172.34(e)An entity that operates both a Medicare certified 172.35 comprehensive outpatient rehabilitation facility and a facility 172.36 which was certified prior to January 1, 1993, that is licensed 173.1 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 173.2 whom at least 33 percent of the clients receiving rehabilitation 173.3 services in the most recent calendar year are medical assistance 173.4 recipients, shall be reimbursed by the commissioner for 173.5 rehabilitation services at rates that are 38 percent greater 173.6 than the maximum reimbursement rate allowed under paragraph (a), 173.7 clause (2), when those services are (1) provided within the 173.8 comprehensive outpatient rehabilitation facility and (2) 173.9 provided to residents of nursing facilities owned by the entity. 173.10 Sec. 40. Minnesota Statutes 2002, section 256B.761, is 173.11 amended to read: 173.12 256B.761 [REIMBURSEMENT FOR MENTAL HEALTH SERVICES.] 173.13 (a) Effective for services rendered on or after July 1, 173.14 2001, payment for medication management provided to psychiatric 173.15 patients, outpatient mental health services, day treatment 173.16 services, home-based mental health services, and family 173.17 community support services shall be paid at the lower of (1) 173.18 submitted charges, or (2) 75.6 percent of the 50th percentile of 173.19 1999 charges. 173.20 (b) Effective July 1, 2001, the medical assistance rates 173.21 for outpatient mental health services provided by an entity that 173.22 operates: (1) a Medicare-certified comprehensive outpatient 173.23 rehabilitation facility; and (2) a facility that was certified 173.24 prior to January 1, 1993, with at least 33 percent of the 173.25 clients receiving rehabilitation services in the most recent 173.26 calendar year who are medical assistance recipients, will be 173.27 increased by 38 percent, when those services are provided within 173.28 the comprehensive outpatient rehabilitation facility and 173.29 provided to residents of nursing facilities owned by the entity. 173.30 Sec. 41. Minnesota Statutes 2002, section 256D.03, 173.31 subdivision 3a, is amended to read: 173.32 Subd. 3a. [CLAIMS; ASSIGNMENT OF BENEFITS.] Claims must be 173.33 filed pursuant to section 256D.16. General assistance medical 173.34 care applicants and recipients must apply or agree to apply 173.35 third party health and accident benefits to the costs of medical 173.36 care. They must cooperate with the state in establishing 174.1 paternity and obtaining third party payments. Bysigning an174.2application foraccepting general assistance, a person assigns 174.3 to the department of human services all rights to medical 174.4 support or payments for medical expenses from another person or 174.5 entity on their own or their dependent's behalf and agrees to 174.6 cooperate with the state in establishing paternity and obtaining 174.7 third party payments. The application shall contain a statement 174.8 explaining the assignment. Any rights or amounts assigned shall 174.9 be applied against the cost of medical care paid for under this 174.10 chapter. An assignment is effective on the date general 174.11 assistance medical care eligibility takes effect.The174.12assignment shall not affect benefits paid or provided under174.13automobile accident coverage and private health care coverage174.14until the person or organization providing the benefits has174.15received notice of the assignment.174.16 Sec. 42. Minnesota Statutes 2002, section 256I.02, is 174.17 amended to read: 174.18 256I.02 [PURPOSE.] 174.19 The Group Residential Housing Act establishes a 174.20 comprehensive system of rates and payments for persons who 174.21 reside ina group residencethe community and who meet the 174.22 eligibility criteria under section 256I.04, subdivision 1. 174.23 Sec. 43. Minnesota Statutes 2002, section 256I.04, 174.24 subdivision 3, is amended to read: 174.25 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 174.26 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 174.27 into agreements for new group residential housing beds with 174.28 total rates in excess of the MSA equivalent rate except: (1) 174.29for group residential housing establishments meeting the174.30requirements of subdivision 2a, clause (2) with department174.31approval; (2)for group residential housing establishments 174.32 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 174.33 provided the facility is needed to meet the census reduction 174.34 targets for persons with mental retardation or related 174.35 conditions at regional treatment centers;(3)(2) to ensure 174.36 compliance with the federal Omnibus Budget Reconciliation Act 175.1 alternative disposition plan requirements for inappropriately 175.2 placed persons with mental retardation or related conditions or 175.3 mental illness;(4)(3) up to 80 beds in a single, specialized 175.4 facility located in Hennepin county that will provide housing 175.5 for chronic inebriates who are repetitive users of 175.6 detoxification centers and are refused placement in emergency 175.7 shelters because of their state of intoxication, and planning 175.8 for the specialized facility must have been initiated before 175.9 July 1, 1991, in anticipation of receiving a grant from the 175.10 housing finance agency under section 462A.05, subdivision 20a, 175.11 paragraph (b);(5)(4) notwithstanding the provisions of 175.12 subdivision 2a, for up to 190 supportive housing units in Anoka, 175.13 Dakota, Hennepin, or Ramsey county for homeless adults with a 175.14 mental illness, a history of substance abuse, or human 175.15 immunodeficiency virus or acquired immunodeficiency syndrome. 175.16 For purposes of this section, "homeless adult" means a person 175.17 who is living on the street or in a shelter or discharged from a 175.18 regional treatment center, community hospital, or residential 175.19 treatment program and has no appropriate housing available and 175.20 lacks the resources and support necessary to access appropriate 175.21 housing. At least 70 percent of the supportive housing units 175.22 must serve homeless adults with mental illness, substance abuse 175.23 problems, or human immunodeficiency virus or acquired 175.24 immunodeficiency syndrome who are about to be or, within the 175.25 previous six months, has been discharged from a regional 175.26 treatment center, or a state-contracted psychiatric bed in a 175.27 community hospital, or a residential mental health or chemical 175.28 dependency treatment program. If a person meets the 175.29 requirements of subdivision 1, paragraph (a), and receives a 175.30 federal or state housing subsidy, the group residential housing 175.31 rate for that person is limited to the supplementary rate under 175.32 section 256I.05, subdivision 1a, and is determined by 175.33 subtracting the amount of the person's countable income that 175.34 exceeds the MSA equivalent rate from the group residential 175.35 housing supplementary rate. A resident in a demonstration 175.36 project site who no longer participates in the demonstration 176.1 program shall retain eligibility for a group residential housing 176.2 payment in an amount determined under section 256I.06, 176.3 subdivision 8, using the MSA equivalent rate. Service funding 176.4 under section 256I.05, subdivision 1a, will end June 30, 1997, 176.5 if federal matching funds are available and the services can be 176.6 provided through a managed care entity. If federal matching 176.7 funds are not available, then service funding will continue 176.8 under section 256I.05, subdivision 1a; or (6) for group 176.9 residential housing beds in settings meeting the requirements of 176.10 subdivision 2a, clauses (1) and (3), which are used exclusively 176.11 for recipients receiving home and community-based waiver 176.12 services under sections 256B.0915, 256B.092, subdivision 5, 176.13 256B.093, and 256B.49, and who resided in a nursing facility for 176.14 the six months immediately prior to the month of entry into the 176.15 group residential housing setting. The group residential 176.16 housing rate for these beds must be set so that the monthly 176.17 group residential housing payment for an individual occupying 176.18 the bed when combined with the nonfederal share of services 176.19 delivered under the waiver for that person does not exceed the 176.20 nonfederal share of the monthly medical assistance payment made 176.21 for the person to the nursing facility in which the person 176.22 resided prior to entry into the group residential housing 176.23 establishment. The rate may not exceed the MSA equivalent rate 176.24 plus $426.37 for any case. 176.25 (b) A county agency may enter into a group residential 176.26 housing agreement for beds with rates in excess of the MSA 176.27 equivalent rate in addition to those currently covered under a 176.28 group residential housing agreement if the additional beds are 176.29 only a replacement of beds with rates in excess of the MSA 176.30 equivalent rate which have been made available due to closure of 176.31 a setting, a change of licensure or certification which removes 176.32 the beds from group residential housing payment, or as a result 176.33 of the downsizing of a group residential housing setting. The 176.34 transfer of available beds from one county to another can only 176.35 occur by the agreement of both counties. 176.36 Sec. 44. Minnesota Statutes 2002, section 256I.05, 177.1 subdivision 1, is amended to read: 177.2 Subdivision 1. [MAXIMUM RATES.](a)Monthly room and board 177.3 rates negotiated by a county agency for a recipient living in 177.4 group residential housing must not exceed the MSA equivalent 177.5 rate specified under section 256I.03, subdivision 5,.with the177.6exception that a county agency may negotiate a supplementary177.7room and board rate that exceeds the MSA equivalent rate for177.8recipients of waiver services under title XIX of the Social177.9Security Act. This exception is subject to the following177.10conditions:177.11(1) the setting is licensed by the commissioner of human177.12services under Minnesota Rules, parts 9555.5050 to 9555.6265;177.13(2) the setting is not the primary residence of the license177.14holder and in which the license holder is not the primary177.15caregiver; and177.16(3) the average supplementary room and board rate in a177.17county for a calendar year may not exceed the average177.18supplementary room and board rate for that county in effect on177.19January 1, 2000. For calendar years beginning on or after177.20January 1, 2002, within the limits of appropriations177.21specifically for this purpose, the commissioner shall increase177.22each county's supplemental room and board rate average on an177.23annual basis by a factor consisting of the percentage change in177.24the Consumer Price Index-All items, United States city average177.25(CPI-U) for that calendar year compared to the preceding177.26calendar year as forecasted by Data Resources, Inc., in the177.27third quarter of the preceding calendar year. If a county has177.28not negotiated supplementary room and board rates for any177.29facilities located in the county as of January 1, 2000, or has177.30an average supplemental room and board rate under $100 per177.31person as of January 1, 2000, it may submit a supplementary room177.32and board rate request with budget information for a facility to177.33the commissioner for approval.177.34The county agency may at any time negotiate a higher or lower177.35room and board rate than the average supplementary room and177.36board rate.178.1(b) Notwithstanding paragraph (a), clause (3), county178.2agencies may negotiate a supplementary room and board rate that178.3exceeds the MSA equivalent rate by up to $426.37 for up to five178.4facilities, serving not more than 20 individuals in total, that178.5were established to replace an intermediate care facility for178.6persons with mental retardation and related conditions located178.7in the city of Roseau that became uninhabitable due to flood178.8damage in June 2002.178.9 [EFFECTIVE DATE.] This section is effective July 1, 2004, 178.10 or upon receipt of federal approval of waiver amendment, 178.11 whichever is later. 178.12 Sec. 45. Minnesota Statutes 2002, section 256I.05, 178.13 subdivision 1a, is amended to read: 178.14 Subd. 1a. [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 178.15 the provisions of section 256I.04, subdivision 3,in addition to178.16the room and board rate specified in subdivision 1,the county 178.17 agency may negotiate a payment not to exceed $426.37 for other 178.18 services necessary to provide room and board provided by the 178.19 group residence if the residence is licensed by or registered by 178.20 the department of health, or licensed by the department of human 178.21 services to provide services in addition to room and board, and 178.22 if the provider of services is not also concurrently receiving 178.23 funding for services for a recipient under a home and 178.24 community-based waiver under title XIX of the Social Security 178.25 Act; or funding from the medical assistance program under 178.26 section 256B.0627, subdivision 4, for personal care services for 178.27 residents in the setting; or residing in a setting which 178.28 receives funding under Minnesota Rules, parts 9535.2000 to 178.29 9535.3000. If funding is available for other necessary services 178.30 through a home and community-based waiver, or personal care 178.31 services under section 256B.0627, subdivision 4, then the GRH 178.32 rate is limited to the rate set in subdivision 1. Unless 178.33 otherwise provided in law, in no case may the supplementary 178.34 service rateplus the supplementary room and board rateexceed 178.35 $426.37. The registration and licensure requirement does not 178.36 apply to establishments which are exempt from state licensure 179.1 because they are located on Indian reservations and for which 179.2 the tribe has prescribed health and safety requirements. 179.3 Service payments under this section may be prohibited under 179.4 rules to prevent the supplanting of federal funds with state 179.5 funds. The commissioner shall pursue the feasibility of 179.6 obtaining the approval of the Secretary of Health and Human 179.7 Services to provide home and community-based waiver services 179.8 under title XIX of the Social Security Act for residents who are 179.9 not eligible for an existing home and community-based waiver due 179.10 to a primary diagnosis of mental illness or chemical dependency 179.11 and shall apply for a waiver if it is determined to be 179.12 cost-effective. 179.13 (b) The commissioner is authorized to make cost-neutral 179.14 transfers from the GRH fund for beds under this section to other 179.15 funding programs administered by the department after 179.16 consultation with the county or counties in which the affected 179.17 beds are located. The commissioner may also make cost-neutral 179.18 transfers from the GRH fund to county human service agencies for 179.19 beds permanently removed from the GRH census under a plan 179.20 submitted by the county agency and approved by the 179.21 commissioner. The commissioner shall report the amount of any 179.22 transfers under this provision annually to the legislature. 179.23 (c) The provisions of paragraph (b) do not apply to a 179.24 facility that has its reimbursement rate established under 179.25 section 256B.431, subdivision 4, paragraph (c). 179.26 Sec. 46. Minnesota Statutes 2002, section 256I.05, 179.27 subdivision 7c, is amended to read: 179.28 Subd. 7c. [DEMONSTRATION PROJECT.] The commissioner is 179.29 authorized to pursue a demonstration project under federal food 179.30 stamp regulation for the purpose of gaining federal 179.31 reimbursement of food and nutritional costs currently paid by 179.32 the state group residential housing program. The commissioner 179.33 shall seek approval no later than January 1, 2004. Any 179.34 reimbursement received is nondedicated revenue to the general 179.35 fund. 179.36 Sec. 47. [514.991] [ALTERNATIVE CARE LIENS; DEFINITIONS.] 180.1 Subdivision 1. [APPLICABILITY.] The definitions in this 180.2 section apply to sections 514.991 to 514.995. 180.3 Subd. 2. [ALTERNATIVE CARE AGENCY, AGENCY, OR 180.4 DEPARTMENT.] "Alternative care agency," "agency," or "department" 180.5 means the department of human services when it pays for or 180.6 provides alternative care benefits for a nonmedical assistance 180.7 recipient directly or through a county social services agency 180.8 under chapter 256B according to section 256B.0913. 180.9 Subd. 3. [ALTERNATIVE CARE BENEFIT OR 180.10 BENEFITS.] "Alternative care benefit" or "benefits" means a 180.11 benefit provided to a nonmedical assistance recipient under 180.12 chapter 256B according to section 256B.0913. 180.13 Subd. 4. [ALTERNATIVE CARE RECIPIENT OR 180.14 RECIPIENT.] "Alternative care recipient" or "recipient" means a 180.15 person who receives alternative care grant benefits. 180.16 Subd. 5. [ALTERNATIVE CARE LIEN OR LIEN.] "Alternative 180.17 care lien" or "lien" means a lien filed under sections 514.992 180.18 to 514.995. 180.19 [EFFECTIVE DATE.] This section is effective July 1, 2003, 180.20 for services for persons first enrolling in the alternative care 180.21 program on or after that date and on the first day of the first 180.22 eligibility renewal period for persons enrolled in the 180.23 alternative care program prior to July 1, 2003. 180.24 Sec. 48. [514.992] [ALTERNATIVE CARE LIEN.] 180.25 Subdivision 1. [PROPERTY SUBJECT TO LIEN; LIEN AMOUNT.] (a) 180.26 Subject to sections 514.991 to 514.995, payments made by an 180.27 alternative care agency to provide benefits to a recipient or to 180.28 the recipient's spouse who owns property in this state 180.29 constitute a lien in favor of the agency on all real property 180.30 the recipient owns at and after the time the benefits are first 180.31 paid. 180.32 (b) The amount of the lien is limited to benefits paid for 180.33 services provided to recipients over 55 years of age and 180.34 provided on and after July 1, 2003. 180.35 Subd. 2. [ATTACHMENT.] (a) A lien attaches to and becomes 180.36 enforceable against specific real property as of the date when 181.1 all of the following conditions are met: 181.2 (1) the agency has paid benefits for a recipient; 181.3 (2) the recipient has been given notice and an opportunity 181.4 for a hearing under paragraph (b); 181.5 (3) the lien has been filed as provided for in section 181.6 514.993 or memorialized on the certificate of title for the 181.7 property it describes; and 181.8 (4) all restrictions against enforcement have ceased to 181.9 apply. 181.10 (b) An agency may not file a lien until it has sent the 181.11 recipient, their authorized representative, or their legal 181.12 representative written notice of its lien rights by certified 181.13 mail, return receipt requested, or registered mail and there has 181.14 been an opportunity for a hearing under section 256.045. No 181.15 person other than the recipient shall have a right to a hearing 181.16 under section 256.045 prior to the time the lien is filed. The 181.17 hearing shall be limited to whether the agency has met all of 181.18 the prerequisites for filing the lien and whether any of the 181.19 exceptions in this section apply. 181.20 (c) An agency may not file a lien against the recipient's 181.21 homestead when any of the following exceptions apply: 181.22 (1) while the recipient's spouse is also physically present 181.23 and lawfully and continuously residing in the homestead; 181.24 (2) a child of the recipient who is under age 21 or who is 181.25 blind or totally and permanently disabled according to 181.26 supplemental security income criteria is also physically present 181.27 on the property and lawfully and continuously residing on the 181.28 property from and after the date the recipient first receives 181.29 benefits; 181.30 (3) a child of the recipient who has also lawfully and 181.31 continuously resided on the property for a period beginning at 181.32 least two years before the first day of the month in which the 181.33 recipient began receiving alternative care, and who provided 181.34 uncompensated care to the recipient which enabled the recipient 181.35 to live without alternative care services for the two-year 181.36 period; 182.1 (4) a sibling of the recipient who has an ownership 182.2 interest in the property of record in the office of the county 182.3 recorder or registrar of titles for the county in which the real 182.4 property is located and who has also continuously occupied the 182.5 homestead for a period of at least one year immediately prior to 182.6 the first day of the first month in which the recipient received 182.7 benefits and continuously since that date. 182.8 (d) A lien only applies to the real property it describes. 182.9 Subd. 3. [CONTINUATION OF LIEN.] A lien remains effective 182.10 from the time it is filed until it is paid, satisfied, 182.11 discharged, or becomes unenforceable under sections 514.991 to 182.12 514.995. 182.13 Subd. 4. [PRIORITY OF LIEN.] (a) A lien which attaches to 182.14 the real property it describes is subject to the rights of 182.15 anyone else whose interest in the real property is perfected of 182.16 record before the lien has been recorded or filed under section 182.17 514.993, including: 182.18 (1) an owner, other than the recipient or the recipient's 182.19 spouse; 182.20 (2) a good faith purchaser for value without notice of the 182.21 lien; 182.22 (3) a holder of a mortgage or security interest; or 182.23 (4) a judgment lien creditor whose judgment lien has 182.24 attached to the recipient's interest in the real property. 182.25 (b) The rights of the other person have the same 182.26 protections against an alternative care lien as are afforded 182.27 against a judgment lien that arises out of an unsecured 182.28 obligation and arises as of the time of the filing of an 182.29 alternative care grant lien under section 514.993. The lien 182.30 shall be inferior to a lien for property taxes and special 182.31 assessments and shall be superior to all other matters first 182.32 appearing of record after the time and date the lien is filed or 182.33 recorded. 182.34 Subd. 5. [SETTLEMENT, SUBORDINATION, AND RELEASE.] (a) An 182.35 agency may, with absolute discretion, settle or subordinate the 182.36 lien to any other lien or encumbrance of record upon the terms 183.1 and conditions it deems appropriate. 183.2 (b) The agency filing the lien shall release and discharge 183.3 the lien: 183.4 (1) if it has been paid, discharged, or satisfied; 183.5 (2) if it has received reimbursement for the amounts 183.6 secured by the lien, has entered into a binding and legally 183.7 enforceable agreement under which it is reimbursed for the 183.8 amount of the lien, or receives other collateral sufficient to 183.9 secure payment of the lien; 183.10 (3) against some, but not all, of the property it describes 183.11 upon the terms, conditions, and circumstances the agency deems 183.12 appropriate; 183.13 (4) to the extent it cannot be lawfully enforced against 183.14 the property it describes because of an error, omission, or 183.15 other material defect in the legal description contained in the 183.16 lien or a necessary prerequisite to enforcement of the lien; and 183.17 (5) if, in its discretion, it determines the filing or 183.18 enforcement of the lien is contrary to the public interest. 183.19 (c) The agency executing the lien shall execute and file 183.20 the release as provided for in section 514.993, subdivision 2. 183.21 Subd. 6. [LENGTH OF LIEN.] (a) A lien shall be a lien on 183.22 the real property it describes for a period of ten years from 183.23 the date it attaches according to subdivision 2, paragraph (a), 183.24 except as otherwise provided for in sections 514.992 to 183.25 514.995. The agency filing the lien may renew the lien for one 183.26 additional ten-year period from the date it would otherwise 183.27 expire by recording or filing a certificate of renewal before 183.28 the lien expires. The certificate of renewal shall be recorded 183.29 or filed in the office of the county recorder or registrar of 183.30 titles for the county in which the lien is recorded or filed. 183.31 The certificate must refer to the recording or filing data for 183.32 the lien it renews. The certificate need not be attested, 183.33 certified, or acknowledged as a condition for recording or 183.34 filing. The recorder or registrar of titles shall record, file, 183.35 index, and return the certificate of renewal in the same manner 183.36 provided for liens in section 514.993, subdivision 2. 184.1 (b) An alternative care lien is not enforceable against the 184.2 real property of an estate to the extent there is a 184.3 determination by a court of competent jurisdiction, or by an 184.4 officer of the court designated for that purpose, that there are 184.5 insufficient assets in the estate to satisfy the lien in whole 184.6 or in part because of the homestead exemption under section 184.7 256B.15, subdivision 4, the rights of a surviving spouse or a 184.8 minor child under section 524.2-403, paragraphs (a) and (b), or 184.9 claims with a priority under section 524.3-805, paragraph (a), 184.10 clauses (1) to (4). For purposes of this section, the rights of 184.11 the decedent's adult children to exempt property under section 184.12 524.2-403, paragraph (b), shall not be considered costs of 184.13 administration under section 524.3-805, paragraph (a), clause 184.14 (1). 184.15 [EFFECTIVE DATE.] This section is effective July 1, 2003, 184.16 for services for persons first enrolling in the alternative care 184.17 program on or after that date and on the first day of the first 184.18 eligibility renewal period for persons enrolled in the 184.19 alternative care program prior to July 1, 2003. 184.20 Sec. 49. [514.993] [LIEN; CONTENTS AND FILING.] 184.21 Subdivision 1. [CONTENTS.] A lien shall be dated and must 184.22 contain: 184.23 (1) the recipient's full name, last known address, and 184.24 social security number; 184.25 (2) a statement that benefits have been paid to or for the 184.26 recipient's benefit; 184.27 (3) a statement that all of the recipient's interests in 184.28 the real property described in the lien may be subject to or 184.29 affected by the agency's right to reimbursement for benefits; 184.30 (4) a legal description of the real property subject to the 184.31 lien and whether it is registered or abstract property; and 184.32 (5) such other contents, if any, as the agency deems 184.33 appropriate. 184.34 Subd. 2. [FILING.] Any lien, release, or other document 184.35 required or permitted to be filed under sections 514.991 to 184.36 514.995 must be recorded or filed in the office of the county 185.1 recorder or registrar of titles, as appropriate, in the county 185.2 where the real property is located. Notwithstanding section 185.3 386.77, the agency shall pay the applicable filing fee for any 185.4 documents filed under sections 514.991 to 514.995. An 185.5 attestation, certification, or acknowledgment is not required as 185.6 a condition of filing. If the property described in the lien is 185.7 registered property, the registrar of titles shall record it on 185.8 the certificate of title for each parcel of property described 185.9 in the lien. If the property described in the lien is abstract 185.10 property, the recorder shall file the lien in the county's 185.11 grantor-grantee indexes and any tract indexes the county 185.12 maintains for each parcel of property described in the lien. 185.13 The recorder or registrar shall return the recorded or filed 185.14 lien to the agency at no cost. If the agency provides a 185.15 duplicate copy of the lien, the recorder or registrar of titles 185.16 shall show the recording or filing data on the copy and return 185.17 it to the agency at no cost. The agency is responsible for 185.18 filing any lien, release, or other documents under sections 185.19 514.991 to 514.995. 185.20 [EFFECTIVE DATE.] This section is effective July 1, 2003, 185.21 for services for persons first enrolling in the alternative care 185.22 program on or after that date and on the first day of the first 185.23 eligibility renewal period for persons enrolled in the 185.24 alternative care program prior to July 1, 2003. 185.25 Sec. 50. [514.994] [ENFORCEMENT; OTHER REMEDIES.] 185.26 Subdivision 1. [FORECLOSURE OR ENFORCEMENT OF LIEN.] The 185.27 agency may enforce or foreclose a lien filed under sections 185.28 514.991 to 514.995 in the manner provided for by law for 185.29 enforcement of judgment liens against real estate or by a 185.30 foreclosure by action under chapter 581. The lien shall remain 185.31 enforceable as provided for in sections 514.991 to 514.995 185.32 notwithstanding any laws limiting the enforceability of 185.33 judgments. 185.34 Subd. 2. [HOMESTEAD EXEMPTION.] The lien may not be 185.35 enforced against the homestead property of the recipient or the 185.36 spouse while they physically occupy it as their lawful residence. 186.1 Subd. 3. [AGENCY CLAIM OR REMEDY.] Sections 514.992 to 186.2 514.995 do not limit the agency's right to file a claim against 186.3 the recipient's estate or the estate of the recipient's spouse, 186.4 do not limit any other claims for reimbursement the agency may 186.5 have, and do not limit the availability of any other remedy to 186.6 the agency. 186.7 [EFFECTIVE DATE.] This section is effective July 1, 2003, 186.8 for services for persons first enrolling in the alternative care 186.9 program on or after that date and on the first day of the first 186.10 eligibility renewal period for persons enrolled in the 186.11 alternative care program prior to July 1, 2003. 186.12 Sec. 51. [514.995] [AMOUNTS RECEIVED TO SATISFY LIEN.] 186.13 Amounts the agency receives to satisfy the lien must be 186.14 deposited in the state treasury and credited to the fund from 186.15 which the benefits were paid. 186.16 [EFFECTIVE DATE.] This section is effective July 1, 2003, 186.17 for services for persons first enrolling in the alternative care 186.18 program on or after that date and on the first day of the first 186.19 eligibility renewal period for persons enrolled in the 186.20 alternative care program prior to July 1, 2003. 186.21 Sec. 52. Minnesota Statutes 2002, section 524.3-805, is 186.22 amended to read: 186.23 524.3-805 [CLASSIFICATION OF CLAIMS.] 186.24 (a) If the applicable assets of the estate are insufficient 186.25 to pay all claims in full, the personal representative shall 186.26 make payment in the following order: 186.27 (1) costs and expenses of administration; 186.28 (2) reasonable funeral expenses; 186.29 (3) debts and taxes with preference under federal law; 186.30 (4) reasonable and necessary medical, hospital, or nursing 186.31 home expenses of the last illness of the decedent, including 186.32 compensation of persons attending the decedent, a claim filed 186.33 under section 256B.15 for recovery of expenditures for 186.34 alternative care for nonmedical assistance recipients under 186.35 section 256B.0913, and including a claim filed pursuant to 186.36 section 256B.15; 187.1 (5) reasonable and necessary medical, hospital, and nursing 187.2 home expenses for the care of the decedent during the year 187.3 immediately preceding death; 187.4 (6) debts with preference under other laws of this state, 187.5 and state taxes; 187.6 (7) all other claims. 187.7 (b) No preference shall be given in the payment of any 187.8 claim over any other claim of the same class, and a claim due 187.9 and payable shall not be entitled to a preference over claims 187.10 not due, except that if claims for expenses of the last illness 187.11 involve only claims filed under section 256B.15 for recovery of 187.12 expenditures for alternative care for nonmedical assistance 187.13 recipients under section 256B.0913, section 246.53 for costs of 187.14 state hospital care and claims filed under section 256B.15, 187.15 claims filed to recover expenditures for alternative care for 187.16 nonmedical assistance recipients under section 256B.0913 shall 187.17 have preference over claims filed under both sections 246.53 and 187.18 other claims filed under section 256B.15, and claims filed under 187.19 section 246.53 have preference over claims filed under section 187.20 256B.15 for recovery of amounts other than those for 187.21 expenditures for alternative care for nonmedical assistance 187.22 recipients under section 256B.0913. 187.23 [EFFECTIVE DATE.] This section is effective July 1, 2003, 187.24 for decedents dying on or after that date. 187.25 Sec. 53. [IMPOSITION OF FEDERAL CERTIFICATION REMEDIES.] 187.26 The commissioner of health shall seek changes in the 187.27 federal policy that mandates the imposition of federal sanctions 187.28 without providing an opportunity for a nursing facility to 187.29 correct deficiencies, solely as the result of previous 187.30 deficiencies issued to the nursing facility. 187.31 [EFFECTIVE DATE.] This section is effective July 1, 2003. 187.32 Sec. 54. [REPORT ON LONG-TERM CARE.] 187.33 The report on long-term care services required under 187.34 Minnesota Statutes, section 144A.351, that is presented to the 187.35 legislature by January 15, 2004, must also address the 187.36 feasibility of offering government or private sector loans or 188.1 lines of credit to individuals age 65 and over, for the purchase 188.2 of long-term care services. 188.3 Sec. 55. [REPORTS; POTENTIAL SAVINGS TO STATE FROM CERTAIN 188.4 LONG-TERM CARE INSURANCE PURCHASE INCENTIVES.] 188.5 The commissioner of human services shall report to the 188.6 legislature by January 15, 2005, on long-term care financing 188.7 reform. The report must include a new mix of public and private 188.8 approaches to the financing of long-term care. The report shall 188.9 examine strategies and financing options that will increase the 188.10 availability and use of nongovernment resources to pay for 188.11 long-term care, including new ways of using limited government 188.12 funds for long-term care. The report shall examine the 188.13 feasibility of: 188.14 (1) initiating a long-term care insurance partnership 188.15 program, similar to those adopted in other states, under which 188.16 the state would encourage the purchase of private long-term care 188.17 insurance by permitting the insured to retain assets in excess 188.18 of those otherwise permitted for medical assistance eligibility, 188.19 if the insured later exhausts the private long-term care 188.20 insurance benefits. The report must include the feasibility of 188.21 obtaining any necessary federal waiver; 188.22 (2) using state medical assistance funds to subsidize the 188.23 purchase of private long-term care insurance by individuals who 188.24 would be unlikely to purchase it without a subsidy, in order to 188.25 generate long-term medical assistance savings; and 188.26 (3) adding a nursing facility benefit to Medicare-related 188.27 coverage, as defined in Minnesota Statutes, section 62Q.01, 188.28 subdivision 6. The report must quantify the costs or savings 188.29 resulting from adding a nursing facility benefit. 188.30 The report must comply with Minnesota Statutes, sections 188.31 3.195 and 3.197. 188.32 [EFFECTIVE DATE.] This section is effective July 1, 2003. 188.33 Sec. 56. [REVISOR'S INSTRUCTION.] 188.34 For sections in Minnesota Statutes and Minnesota Rules 188.35 affected by the repealed sections in this article, the revisor 188.36 shall delete internal cross-references where appropriate and 189.1 make changes necessary to correct the punctuation, grammar, or 189.2 structure of the remaining text and preserve its meaning. 189.3 Sec. 57. [REPEALER.] 189.4 (a) Minnesota Statutes 2002, sections 256.973; 256.9772; 189.5 and 256B.437, subdivision 2, are repealed effective July 1, 2003. 189.6 (b) Minnesota Statutes 2002, sections 62J.66; 62J.68; 189.7 144A.071, subdivision 5; and 144A.35, are repealed. 189.8 (c) Laws 1998, chapter 407, article 4, section 63, is 189.9 repealed. 189.10 (d) Minnesota Rules, parts 9505.3045; 9505.3050; 9505.3055; 189.11 9505.3060; 9505.3068; 9505.3070; 9505.3075; 9505.3080; 189.12 9505.3090; 9505.3095; 9505.3100; 9505.3105; 9505.3107; 189.13 9505.3110; 9505.3115; 9505.3120; 9505.3125; 9505.3130; 189.14 9505.3138; 9505.3139; 9505.3140; 9505.3680; 9505.3690; and 189.15 9505.3700, are repealed effective July 1, 2003. 189.16 (e) Laws 2003, chapter 55, sections 1 and 4, are repealed 189.17 effective the day following final enactment. 189.18 ARTICLE 3 189.19 CONTINUING CARE FOR PERSONS WITH DISABILITIES 189.20 Section 1. Minnesota Statutes 2002, section 174.30, 189.21 subdivision 1, is amended to read: 189.22 Subdivision 1. [APPLICABILITY.] (a) The operating 189.23 standards for special transportation service adopted under this 189.24 section do not apply to special transportation provided by: 189.25 (1) a common carrier operating on fixed routes and 189.26 schedules; 189.27 (2) a volunteer driver using a private automobile; 189.28 (3) a school bus as defined in section 169.01, subdivision 189.29 6; or 189.30 (4) an emergency ambulance regulated under chapter 144. 189.31 (b) The operating standards adopted under this section only 189.32 apply to providers of special transportation service who receive 189.33 grants or other financial assistance from either the state or 189.34 the federal government, or both, to provide or assist in 189.35 providing that service; except that the operating standards 189.36 adopted under this section do not apply to any nursing home 190.1 licensed under section 144A.02, to any board and care facility 190.2 licensed under section 144.50, or to any day training and 190.3 habilitation services, day care, or group home facility licensed 190.4 under sections 245A.01 to 245A.19 unless the facility or program 190.5 provides transportation to nonresidents on a regular basis and 190.6 the facility receives reimbursement, other than per diem 190.7 payments, for that service under rules promulgated by the 190.8 commissioner of human services. 190.9 (c) Notwithstanding paragraph (b), the operating standards 190.10 adopted under this section do not apply to any vendor of 190.11 services licensed under chapter 245B that provides 190.12 transportation services to consumers or residents of other 190.13 vendors licensed under chapter 245B and transports 15 or fewer 190.14 persons, including consumers or residents and the driver. 190.15 Sec. 2. Minnesota Statutes 2002, section 245B.06, 190.16 subdivision 8, is amended to read: 190.17 Subd. 8. [LEAVING THE RESIDENCE.]As specified in each190.18consumer's individual service plan,Each consumer requiring a 190.19 24-hour plan of caremust leave the residence to participate in190.20regular education, employment, or community activitiesshall 190.21 receive services during the day outside the residence unless 190.22 otherwise specified in the individual's service plan. License 190.23 holders, providing services to consumers living in a licensed 190.24 site, shall ensure that they are prepared to care for consumers 190.25 whenever they are at the residence during the day because of 190.26 illness, work schedules, or other reasons. 190.27 Sec. 3. Minnesota Statutes 2002, section 245B.07, 190.28 subdivision 11, is amended to read: 190.29 Subd. 11. [TRAVEL TIME TO AND FROM A DAY TRAINING AND 190.30 HABILITATION SITE.] Except in unusual circumstances, the license 190.31 holder must not transport a consumer receiving services for 190.32 longer thanone hour90 minutes per one-way trip. Nothing in 190.33 this subdivision relieves the provider of the obligation to 190.34 provide the number of program hours as identified in the 190.35 individualized service plan. 190.36 Sec. 4. Minnesota Statutes 2002, section 246.54, is 191.1 amended to read: 191.2 246.54 [LIABILITY OF COUNTY; REIMBURSEMENT.] 191.3 Subdivision 1. [COUNTY PORTION FOR COST OF CARE.] Except 191.4 for chemical dependency services provided under sections 254B.01 191.5 to 254B.09, the client's county shall pay to the state of 191.6 Minnesota a portion of the cost of care provided in a regional 191.7 treatment center or a state nursing facility to a client legally 191.8 settled in that county. A county's payment shall be made from 191.9 the county's own sources of revenue and payments shall be paid 191.10 as follows: payments to the state from the county shall 191.11 equalten20 percent of the cost of care, as determined by the 191.12 commissioner, for each day, or the portion thereof, that the 191.13 client spends at a regional treatment center or a state nursing 191.14 facility. If payments received by the state under sections 191.15 246.50 to 246.53 exceed9080 percent of the cost of care, the 191.16 county shall be responsible for paying the state only the 191.17 remaining amount. The county shall not be entitled to 191.18 reimbursement from the client, the client's estate, or from the 191.19 client's relatives, except as provided in section 246.53. No 191.20 such payments shall be made for any client who was last 191.21 committed prior to July 1, 1947. 191.22 Subd. 2. [EXCEPTIONS.] Subdivision 1 does not apply to 191.23 services provided at the Minnesota security hospital, the 191.24 Minnesota sex offender program, or the Minnesota extended 191.25 treatment options program. For services at these facilities, a 191.26 county's payment shall be made from the county's own sources of 191.27 revenue and payments shall be paid as follows: payments to the 191.28 state from the county shall equal ten percent of the cost of 191.29 care, as determined by the commissioner, for each day, or the 191.30 portion thereof, that the client spends at the facility. If 191.31 payments received by the state under sections 246.50 to 246.53 191.32 exceed 90 percent of the cost of care, the county shall be 191.33 responsible for paying the state only the remaining amount. The 191.34 county shall not be entitled to reimbursement from the client, 191.35 the client's estate, or from the client's relatives, except as 191.36 provided in section 246.53. 192.1 [EFFECTIVE DATE.] This section is effective July 1, 2004. 192.2 Sec. 5. Minnesota Statutes 2002, section 252.32, 192.3 subdivision 1, is amended to read: 192.4 Subdivision 1. [PROGRAM ESTABLISHED.] In accordance with 192.5 state policy established in section 256F.01 that all children 192.6 are entitled to live in families that offer safe, nurturing, 192.7 permanent relationships, and that public services be directed 192.8 toward preventing the unnecessary separation of children from 192.9 their families, and because many families who have children with 192.10mental retardation or related conditionsdisabilities have 192.11 special needs and expenses that other families do not have, the 192.12 commissioner of human services shall establish a program to 192.13 assist families who havedependentsdependent children with 192.14mental retardation or related conditionsdisabilities living in 192.15 their home. The program shall make support grants available to 192.16 the families. 192.17 Sec. 6. Minnesota Statutes 2002, section 252.32, 192.18 subdivision 1a, is amended to read: 192.19 Subd. 1a. [SUPPORT GRANTS.] (a) Provision of support 192.20 grants must be limited to families who require support and whose 192.21 dependents are under the age of22 and who have mental192.22retardation or who have a related condition21 and who have been 192.23determined by a screening team establishedcertified disabled 192.24 under section256B.092 to be at risk of192.25institutionalization256B.055, subdivision 12, paragraphs (a), 192.26 (b), (c), (d), and (e). Families who are receiving home and 192.27 community-based waivered services for persons with mental 192.28 retardation or related conditions are not eligible for support 192.29 grants. 192.30Families receiving grants who will be receiving home and192.31community-based waiver services for persons with mental192.32retardation or a related condition for their family member192.33within the grant year, and who have ongoing payments for192.34environmental or vehicle modifications which have been approved192.35by the county as a grant expense and would have qualified for192.36payment under this waiver may receive a onetime grant payment193.1from the commissioner to reduce or eliminate the principal of193.2the remaining debt for the modifications, not to exceed the193.3maximum amount allowable for the remaining years of eligibility193.4for a family support grant. The commissioner is authorized to193.5use up to $20,000 annually from the grant appropriation for this193.6purpose. Any amount unexpended at the end of the grant year193.7shall be allocated by the commissioner in accordance with193.8subdivision 3a, paragraph (b), clause (2).Families whose 193.9 annual adjusted gross income is $60,000 or more are not eligible 193.10 for support grants except in cases where extreme hardship is 193.11 demonstrated. Beginning in state fiscal year 1994, the 193.12 commissioner shall adjust the income ceiling annually to reflect 193.13 the projected change in the average value in the United States 193.14 Department of Labor Bureau of Labor Statistics consumer price 193.15 index (all urban) for that year. 193.16 (b) Support grants may be made available as monthly subsidy 193.17 grants and lump sum grants. 193.18 (c) Support grants may be issued in the form of cash, 193.19 voucher, and direct county payment to a vendor. 193.20 (d) Applications for the support grant shall be made by the 193.21 legal guardian to the county social service agency. The 193.22 application shall specify the needs of the families, the form of 193.23 the grant requested by the families, andthatthefamilies have193.24agreed to use the support grant foritems and serviceswithin193.25the designated reimbursable expense categories and193.26recommendations of the countyto be reimbursed. 193.27(e) Families who were receiving subsidies on the date of193.28implementation of the $60,000 income limit in paragraph (a)193.29continue to be eligible for a family support grant until193.30December 31, 1991, if all other eligibility criteria are met.193.31After December 31, 1991, these families are eligible for a grant193.32in the amount of one-half the grant they would otherwise193.33receive, for as long as they remain eligible under other193.34eligibility criteria.193.35 Sec. 7. Minnesota Statutes 2002, section 252.32, 193.36 subdivision 3, is amended to read: 194.1 Subd. 3. [AMOUNT OF SUPPORT GRANT; USE.] Support grant 194.2 amounts shall be determined by the county social service 194.3 agency.Each serviceServices anditemitems purchased with a 194.4 support grant must: 194.5 (1) be over and above the normal costs of caring for the 194.6 dependent if the dependent did not have a disability; 194.7 (2) be directly attributable to the dependent's disabling 194.8 condition; and 194.9 (3) enable the family to delay or prevent the out-of-home 194.10 placement of the dependent. 194.11 The design and delivery of services and items purchased 194.12 under this section must suit the dependent's chronological age 194.13 and be provided in the least restrictive environment possible, 194.14 consistent with the needs identified in the individual service 194.15 plan. 194.16 Items and services purchased with support grants must be 194.17 those for which there are no other public or private funds 194.18 available to the family. Fees assessed to parents for health or 194.19 human services that are funded by federal, state, or county 194.20 dollars are not reimbursable through this program. 194.21 In approving or denying applications, the county shall 194.22 consider the following factors: 194.23 (1) the extent and areas of the functional limitations of 194.24 the disabled child; 194.25 (2) the degree of need in the home environment for 194.26 additional support; and 194.27 (3) the potential effectiveness of the grant to maintain 194.28 and support the person in the family environment. 194.29 The maximum monthly grant amount shall be $250 per eligible 194.30 dependent, or $3,000 per eligible dependent per state fiscal 194.31 year, within the limits of available funds. The county social 194.32 service agency may consider the dependent's supplemental 194.33 security income in determining the amount of the support grant. 194.34The county social service agency may exceed $3,000 per state194.35fiscal year per eligible dependent for emergency circumstances194.36in cases where exceptional resources of the family are required195.1to meet the health, welfare-safety needs of the child.195.2County social service agencies shall continue to provide195.3funds to families receiving state grants on June 30, 1997, if195.4eligibility criteria continue to be met.Any adjustments to 195.5 their monthly grant amount must be based on the needs of the 195.6 family and funding availability. 195.7 Sec. 8. Minnesota Statutes 2002, section 252.32, 195.8 subdivision 3c, is amended to read: 195.9 Subd. 3c. [COUNTY BOARD RESPONSIBILITIES.] County boards 195.10 receiving funds under this section shall: 195.11 (1)determine the needs of families for services in195.12accordance with section 256B.092 or 256E.08 and any rules195.13adopted under those sections;submit a plan to the department 195.14 for the management of the family support grant program. The 195.15 plan must include the projected number of families the county 195.16 will serve and policies and procedures for: 195.17 (i) identifying potential families for the program; 195.18 (ii) grant distribution; 195.19 (iii) waiting list procedures; and 195.20 (iv) prioritization of families to receive grants; 195.21 (2) determine the eligibility of all persons proposed for 195.22 program participation; 195.23 (3) approve a plan for items and services to be reimbursed 195.24 and inform families of the county's approval decision; 195.25 (4) issue support grants directly to, or on behalf of, 195.26 eligible families; 195.27 (5) inform recipients of their right to appeal under 195.28 subdivision 3e; 195.29 (6) submit quarterly financial reports under subdivision 3b 195.30 and indicateon the screening documentsthe annual grant level 195.31 for each family, the families denied grants, and the families 195.32 eligible but waiting for funding; and 195.33 (7) coordinate services with other programs offered by the 195.34 county. 195.35 Sec. 9. Minnesota Statutes 2002, section 252.41, 195.36 subdivision 3, is amended to read: 196.1 Subd. 3. [DAY TRAINING AND HABILITATION SERVICES FOR 196.2 ADULTS WITH MENTAL RETARDATION, RELATED CONDITIONS.] "Day 196.3 training and habilitation services for adults with mental 196.4 retardation and related conditions" means services that: 196.5 (1) include supervision, training, assistance, and 196.6 supported employment, work-related activities, or other 196.7 community-integrated activities designed and implemented in 196.8 accordance with the individual service and individual 196.9 habilitation plans required under Minnesota Rules, parts 196.10 9525.0015 to 9525.0165, to help an adult reach and maintain the 196.11 highest possible level of independence, productivity, and 196.12 integration into the community; and 196.13 (2) are provided under contract with the county where the 196.14 services are delivered by a vendor licensed under sections 196.15 245A.01 to 245A.16 and 252.28, subdivision 2, to provide day 196.16 training and habilitation services; and196.17(3) are regularly provided to one or more adults with196.18mental retardation or related conditions in a place other than196.19the adult's own home or residence unless medically196.20contraindicated. 196.21 Day training and habilitation services reimbursable under 196.22 this section do not include special education and related 196.23 services as defined in the Education of the Handicapped Act, 196.24 United States Code, title 20, chapter 33, section 1401, clauses 196.25 (6) and (17), or vocational services funded under section 110 of 196.26 the Rehabilitation Act of 1973, United States Code, title 29, 196.27 section 720, as amended. 196.28 Sec. 10. Minnesota Statutes 2002, section 252.46, 196.29 subdivision 1, is amended to read: 196.30 Subdivision 1. [RATES.] (a) Payment rates to vendors, 196.31 except regional centers, for county-funded day training and 196.32 habilitation services and transportation provided to persons 196.33 receiving day training and habilitation services established by 196.34 a county board are governed by subdivisions 2 to 19. The 196.35 commissioner shall approve the following three payment rates for 196.36 services provided by a vendor: 197.1 (1) a full-day service rate for persons who receive at 197.2 least six service hours a day, including the time it takes to 197.3 transport the person to and from the service site; 197.4 (2) a partial-day service rate that must not exceed 75 197.5 percent of the full-day service rate for persons who receive 197.6 less than a full day of service; and 197.7 (3) a transportation rate for providing, or arranging and 197.8 paying for, transportation of a person to and from the person's 197.9 residence to the service site. 197.10(b) The commissioner may also approve an hourly job-coach,197.11follow-along rate for services provided by one employee at or en197.12route to or from community locations to supervise, support, and197.13assist one person receiving the vendor's services to learn197.14job-related skills necessary to obtain or retain employment when197.15and where no other persons receiving services are present and197.16when all the following criteria are met:197.17(1) the vendor requests and the county recommends the197.18optional rate;197.19(2) the service is prior authorized by the county on the197.20Medicaid Management Information System for no more than 414197.21hours in a 12-month period and the daily per person charge to197.22medical assistance does not exceed the vendor's approved full197.23day plus transportation rates;197.24(3) separate full day, partial day, and transportation197.25rates are not billed for the same person on the same day;197.26(4) the approved hourly rate does not exceed the sum of the197.27vendor's current average hourly direct service wage, including197.28fringe benefits and taxes, plus a component equal to the197.29vendor's average hourly nondirect service wage expenses; and197.30(5) the actual revenue received for provision of hourly197.31job-coach, follow-along services is subtracted from the vendor's197.32total expenses for the same time period and those adjusted197.33expenses are used for determining recommended full day and197.34transportation payment rates under subdivision 5 in accordance197.35with the limitations in subdivision 3.197.36 (b) Notwithstanding any law or rule to the contrary, the 198.1 commissioner may authorize county participation in a voluntary 198.2 individualized payment rate structure for day training and 198.3 habilitation services to allow a county the flexibility to 198.4 change, after consulting with providers, from a site-based 198.5 payment rate structure to an individual payment rate structure 198.6 for the providers of day training and habilitation services in 198.7 the county. The commissioner shall seek input from providers 198.8 and consumers in establishing procedures for determining the 198.9 structure of voluntary individualized payment rates to ensure 198.10 that there is no additional cost to the state or counties and 198.11 that the rate structure is cost-neutral to providers of day 198.12 training and habilitation services, on July 1, 2004, or on day 198.13 one of the individual rate structure, whichever is later. 198.14 (c) Medical assistance rates for home and community-based 198.15 service provided under section 256B.501, subdivision 4, by 198.16 licensed vendors of day training and habilitation services must 198.17 not be greater than the rates for the same services established 198.18 by counties under sections 252.40 to 252.46. For very dependent 198.19 persons with special needs the commissioner may approve an 198.20 exception to the approved payment rate under section 256B.501, 198.21 subdivision 4 or 8. 198.22 Sec. 11. Minnesota Statutes 2002, section 256.476, 198.23 subdivision 1, is amended to read: 198.24 Subdivision 1. [PURPOSE AND GOALS.] The commissioner of 198.25 human services shall establish a consumer support grant program 198.26 for individuals with functional limitations and their families 198.27 who wish to purchase and secure their own supports. The 198.28 commissioner and local agencies shall jointly develop an 198.29 implementation plan which must include a way to resolve the 198.30 issues related to county liability. The program shall: 198.31 (1) make support grantsor exception grants described in198.32subdivision 11available to individuals or families as an 198.33 effective alternative toexisting programs and services, such as198.34 the developmental disability family support program, personal 198.35 care attendant services, home health aide services, and private 198.36 duty nursing services; 199.1 (2) provide consumers more control, flexibility, and 199.2 responsibility over their services and supports; 199.3 (3) promote local program management and decision making; 199.4 and 199.5 (4) encourage the use of informal and typical community 199.6 supports. 199.7 [EFFECTIVE DATE.] This section is effective January 1, 2004. 199.8 Sec. 12. Minnesota Statutes 2002, section 256.476, 199.9 subdivision 3, is amended to read: 199.10 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 199.11 is eligible to apply for a consumer support grant if the person 199.12 meets all of the following criteria: 199.13 (1) the person is eligible for and has been approved to 199.14 receive services under medical assistance as determined under 199.15 sections 256B.055 and 256B.056 or the person has been approved 199.16 to receive a grant under the developmental disability family 199.17 support program under section 252.32; 199.18 (2) the person is able to direct and purchase the person's 199.19 own care and supports, or the person has a family member, legal 199.20 representative, or other authorized representative who can 199.21 purchase and arrange supports on the person's behalf; 199.22 (3) the person has functional limitations, requires ongoing 199.23 supports to live in the community, and is at risk of or would 199.24 continue institutionalization without such supports; and 199.25 (4) the person will live in a home. For the purpose of 199.26 this section, "home" means the person's own home or home of a 199.27 person's family member. These homes are natural home settings 199.28 and are not licensed by the department of health or human 199.29 services. 199.30 (b) Persons may not concurrently receive a consumer support 199.31 grant if they are: 199.32 (1) receivinghome and community-based services under199.33United States Code, title 42, section 1396h(c);personal care 199.34 attendant and home health aide services, or private duty nursing 199.35 under section 256B.0625; a developmental disability family 199.36 support grant; or alternative care services under section 200.1 256B.0913; or 200.2 (2) residing in an institutional or congregate care setting. 200.3 (c) A person or person's family receiving a consumer 200.4 support grant shall not be charged a fee or premium by a local 200.5 agency for participating in the program. 200.6 (d)The commissioner may limit the participation of200.7recipients of services from federal waiver programs in the200.8consumer support grant program if the participation of these200.9individuals will result in an increase in the cost to the200.10state.Individuals receiving home and community-based waivers 200.11 under United States Code, title 42, section 1396h(c), are not 200.12 eligible for the consumer support grant, except for individuals 200.13 receiving consumer support grants before July 1, 2003, as long 200.14 as other eligibility criteria are met. 200.15 (e) The commissioner shall establish a budgeted 200.16 appropriation each fiscal year for the consumer support grant 200.17 program. The number of individuals participating in the program 200.18 will be adjusted so the total amount allocated to counties does 200.19 not exceed the amount of the budgeted appropriation. The 200.20 budgeted appropriation will be adjusted annually to accommodate 200.21 changes in demand for the consumer support grants. 200.22 Sec. 13. Minnesota Statutes 2002, section 256.476, 200.23 subdivision 4, is amended to read: 200.24 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 200.25 county board may choose to participate in the consumer support 200.26 grant program. If a county has not chosen to participate by 200.27 July 1, 2002, the commissioner shall contract with another 200.28 county or other entity to provide access to residents of the 200.29 nonparticipating county who choose the consumer support grant 200.30 option. The commissioner shall notify the county board in a 200.31 county that has declined to participate of the commissioner's 200.32 intent to enter into a contract with another county or other 200.33 entity at least 30 days in advance of entering into the 200.34 contract. The local agency shall establish written procedures 200.35 and criteria to determine the amount and use of support grants. 200.36 These procedures must include, at least, the availability of 201.1 respite care, assistance with daily living, and adaptive aids. 201.2 The local agency may establish monthly or annual maximum amounts 201.3 for grants and procedures where exceptional resources may be 201.4 required to meet the health and safety needs of the person on a 201.5 time-limited basis, however, the total amount awarded to each 201.6 individual may not exceed the limits established in subdivision 201.7 11. 201.8 (b) Support grants to a person or a person's family will be 201.9 provided through a monthly subsidy payment and be in the form of 201.10 cash, voucher, or direct county payment to vendor. Support 201.11 grant amounts must be determined by the local agency. Each 201.12 service and item purchased with a support grant must meet all of 201.13 the following criteria: 201.14 (1) it must be over and above the normal cost of caring for 201.15 the person if the person did not have functional limitations; 201.16 (2) it must be directly attributable to the person's 201.17 functional limitations; 201.18 (3) it must enable the person or the person's family to 201.19 delay or prevent out-of-home placement of the person; and 201.20 (4) it must be consistent with the needs identified in the 201.21 serviceplanagreement, when applicable. 201.22 (c) Items and services purchased with support grants must 201.23 be those for which there are no other public or private funds 201.24 available to the person or the person's family. Fees assessed 201.25 to the person or the person's family for health and human 201.26 services are not reimbursable through the grant. 201.27 (d) In approving or denying applications, the local agency 201.28 shall consider the following factors: 201.29 (1) the extent and areas of the person's functional 201.30 limitations; 201.31 (2) the degree of need in the home environment for 201.32 additional support; and 201.33 (3) the potential effectiveness of the grant to maintain 201.34 and support the person in the family environment or the person's 201.35 own home. 201.36 (e) At the time of application to the program or screening 202.1 for other services, the person or the person's family shall be 202.2 provided sufficient information to ensure an informed choice of 202.3 alternatives by the person, the person's legal representative, 202.4 if any, or the person's family. The application shall be made 202.5 to the local agency and shall specify the needs of the person 202.6 and family, the form and amount of grant requested, the items 202.7 and services to be reimbursed, and evidence of eligibility for 202.8 medical assistance. 202.9 (f) Upon approval of an application by the local agency and 202.10 agreement on a support plan for the person or person's family, 202.11 the local agency shall make grants to the person or the person's 202.12 family. The grant shall be in an amount for the direct costs of 202.13 the services or supports outlined in the service agreement. 202.14 (g) Reimbursable costs shall not include costs for 202.15 resources already available, such as special education classes, 202.16 day training and habilitation, case management, other services 202.17 to which the person is entitled, medical costs covered by 202.18 insurance or other health programs, or other resources usually 202.19 available at no cost to the person or the person's family. 202.20 (h) The state of Minnesota, the county boards participating 202.21 in the consumer support grant program, or the agencies acting on 202.22 behalf of the county boards in the implementation and 202.23 administration of the consumer support grant program shall not 202.24 be liable for damages, injuries, or liabilities sustained 202.25 through the purchase of support by the individual, the 202.26 individual's family, or the authorized representative under this 202.27 section with funds received through the consumer support grant 202.28 program. Liabilities include but are not limited to: workers' 202.29 compensation liability, the Federal Insurance Contributions Act 202.30 (FICA), or the Federal Unemployment Tax Act (FUTA). For 202.31 purposes of this section, participating county boards and 202.32 agencies acting on behalf of county boards are exempt from the 202.33 provisions of section 268.04. 202.34 Sec. 14. Minnesota Statutes 2002, section 256.476, 202.35 subdivision 5, is amended to read: 202.36 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 203.1 For the purpose of transferring persons to the consumer support 203.2 grant program fromspecific programs or services, such asthe 203.3 developmental disability family support program and personal 203.4 care assistant services, home health aide services, or private 203.5 duty nursing services, the amount of funds transferred by the 203.6 commissioner between the developmental disability family support 203.7 program account, the medical assistance account, or the consumer 203.8 support grant account shall be based on each county's 203.9 participation in transferring persons to the consumer support 203.10 grant program from those programs and services. 203.11 (b) At the beginning of each fiscal year, county 203.12 allocations for consumer support grants shall be based on: 203.13 (1) the number of persons to whom the county board expects 203.14 to provide consumer supports grants; 203.15 (2) their eligibility for current program and services; 203.16 (3) the amount of nonfederal dollars allowed under 203.17 subdivision 11; and 203.18 (4) projected dates when persons will start receiving 203.19 grants. County allocations shall be adjusted periodically by 203.20 the commissioner based on the actual transfer of persons or 203.21 service openings, and the nonfederal dollars associated with 203.22 those persons or service openings, to the consumer support grant 203.23 program. 203.24 (c) The amount of funds transferred by the commissioner 203.25 from the medical assistance account for an individual may be 203.26 changed if it is determined by the county or its agent that the 203.27 individual's need for support has changed. 203.28 (d) The authority to utilize funds transferred to the 203.29 consumer support grant account for the purposes of implementing 203.30 and administering the consumer support grant program will not be 203.31 limited or constrained by the spending authority provided to the 203.32 program of origination. 203.33 (e) The commissioner may use up to five percent of each 203.34 county's allocation, as adjusted, for payments for 203.35 administrative expenses, to be paid as a proportionate addition 203.36 to reported direct service expenditures. 204.1 (f) The county allocation for each individual or 204.2 individual's family cannot exceed the amount allowed under 204.3 subdivision 11. 204.4 (g) The commissioner may recover, suspend, or withhold 204.5 payments if the county board, local agency, or grantee does not 204.6 comply with the requirements of this section. 204.7 (h) Grant funds unexpended by consumers shall return to the 204.8 state once a year. The annual return of unexpended grant funds 204.9 shall occur in the quarter following the end of the state fiscal 204.10 year. 204.11 Sec. 15. Minnesota Statutes 2002, section 256.476, 204.12 subdivision 11, is amended to read: 204.13 Subd. 11. [CONSUMER SUPPORT GRANT PROGRAM AFTER JULY 1, 204.14 2001.] (a) Effective July 1, 2001, the commissioner shall 204.15 allocate consumer support grant resources to serve additional 204.16 individuals based on a review of Medicaid authorization and 204.17 payment information of persons eligible for a consumer support 204.18 grant from the most recent fiscal year. The commissioner shall 204.19 use the following methodology to calculate maximum allowable 204.20 monthly consumer support grant levels: 204.21 (1) For individuals whose program of origination is medical 204.22 assistance home care under section 256B.0627, the maximum 204.23 allowable monthly grant levels are calculated by: 204.24 (i) determining the nonfederal share of the average service 204.25 authorization for each home care rating; 204.26 (ii) calculating the overall ratio of actual payments to 204.27 service authorizations by program; 204.28 (iii) applying the overall ratio to the average service 204.29 authorization level of each home care rating; 204.30 (iv) adjusting the result for any authorized rate increases 204.31 provided by the legislature; and 204.32 (v) adjusting the result for the average monthly 204.33 utilization per recipient; and. 204.34 (2)for persons with programs of origination other than the204.35program described in clause (1), the maximum grant level for an204.36individual shall not exceed the total of the nonfederal dollars205.1expended on the individual by the program of originationThe 205.2 commissioner may review and evaluate the methodology to reflect 205.3 changes in the home care programs overall ratio of actual 205.4 payments to service authorizations. 205.5 (b) Effective January 1, 2004, persons previously receiving 205.6consumer supportexception grantsprior to July 1, 2001, may205.7continue to receive the grant amount established prior to July205.81, 2001will have their grants calculated using the methodology 205.9 in paragraph (a), clause (1). If a person currently receiving 205.10 an exception grant wishes to have their home care rating 205.11 reevaluated, they may request an assessment as defined in 205.12 section 256B.0627, subdivision 1, paragraph (b). 205.13(c) The commissioner may provide up to 200 exception205.14grants, including grants in use under paragraph (b). Eligible205.15persons shall be provided an exception grant in priority order205.16based upon the date of the commissioner's receipt of the county205.17request. The maximum allowable grant level for an exception205.18grant shall be based upon the nonfederal share of the average205.19service authorization from the most recent fiscal year for each205.20home care rating category. The amount of each exception grant205.21shall be based upon the commissioner's determination of the205.22nonfederal dollars that would have been expended if services had205.23been available for an individual who is unable to obtain the205.24support needed from the program of origination due to the205.25unavailability of qualified service providers at the time or the205.26location where the supports are needed.205.27 Sec. 16. Minnesota Statutes 2002, section 256.482, 205.28 subdivision 8, is amended to read: 205.29 Subd. 8. [SUNSET.] Notwithstanding section 15.059, 205.30 subdivision 5, the council on disability shall not sunset until 205.31 June 30,20032007. 205.32 [EFFECTIVE DATE.] This section is effective May 30, 2003. 205.33 Sec. 17. Minnesota Statutes 2002, section 256B.0621, 205.34 subdivision 4, is amended to read: 205.35 Subd. 4. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 205.36 QUALIFICATIONS.]The following qualifications and certification206.1standards must be met by providers of relocation targeted case206.2management:206.3(a) The commissioner must certify each provider of206.4relocation targeted case management before enrollment. The206.5certification process shall examine the provider's ability to206.6meet the requirements in this subdivision and other federal and206.7state requirements of this service. A certified relocation206.8targeted case management provider may subcontract with another206.9provider to deliver relocation targeted case management206.10services. Subcontracted providers must demonstrate the ability206.11to provide the services outlined in subdivision 6.206.12(b)(a) A relocation targeted case management provider is 206.13 an enrolled medical assistance provider who is determined by the 206.14 commissioner to have all of the following characteristics: 206.15 (1) the legal authority to provide public welfare under 206.16 sections 393.01, subdivision 7; and 393.07; or a federally 206.17 recognized Indian tribe; 206.18 (2) the demonstrated capacity and experience to provide the 206.19 components of case management to coordinate and link community 206.20 resources needed by the eligible population; 206.21 (3) the administrative capacity and experience to serve the 206.22 target population for whom it will provide services and ensure 206.23 quality of services under state and federal requirements; 206.24 (4) the legal authority to provide complete investigative 206.25 and protective services under section 626.556, subdivision 10; 206.26 and child welfare and foster care services under section 393.07, 206.27 subdivisions 1 and 2; or a federally recognized Indian tribe; 206.28 (5) a financial management system that provides accurate 206.29 documentation of services and costs under state and federal 206.30 requirements; and 206.31 (6) the capacity to document and maintain individual case 206.32 records under state and federal requirements. 206.33 (b) A provider of targeted case management under section 206.34 256B.0625, subdivision 20, may be deemed a certified provider of 206.35 relocation targeted case management. 206.36 (c) A relocation targeted case management provider may 207.1 subcontract with another provider to deliver relocation targeted 207.2 case management services. Subcontracted providers must 207.3 demonstrate the ability to provide the services outlined in 207.4 subdivision 6, and have a procedure in place that notifies the 207.5 recipient and the recipient's legal representative of any 207.6 conflict of interest if the contracted targeted case management 207.7 provider also provides, or will provide, the recipient's 207.8 services and supports. Contracted providers must provide 207.9 information on all conflicts of interest and obtain the 207.10 recipient's informed consent or provide the recipient with 207.11 alternatives. 207.12 Sec. 18. Minnesota Statutes 2002, section 256B.0621, 207.13 subdivision 7, is amended to read: 207.14 Subd. 7. [TIME LINES.] The following time lines must be 207.15 met for assigning a case manager: 207.16(1)(a) For relocation targeted case management, an 207.17 eligible recipient must be assigned a case manager who visits 207.18 the person within 20 working days of requesting a case manager 207.19 from their county of financial responsibility as determined 207.20 under chapter 256G. 207.21 (1) If a county agency, its contractor, or federally 207.22 recognized tribe does not provide case management services as 207.23 required, the recipient may, after written notice to the county207.24agency,obtain targeted relocation case management services from 207.25a home care targeted case management provider, as defined in207.26subdivision 5; andan alternative provider of targeted case 207.27 management services enrolled by the commissioner. 207.28 (2) The commissioner may waive the provider requirements in 207.29 subdivision 4, paragraph (a), clauses (1) and (4), to ensure 207.30 recipient access to the assistance necessary to move from an 207.31 institution to the community. The recipient or the recipient's 207.32 legal guardian shall provide written notice to the county or 207.33 tribe of the decision to obtain services from an alternative 207.34 provider. 207.35 (3) Providers of relocation targeted case management 207.36 enrolled under this subdivision shall: 208.1 (i) meet the provider requirements under subdivision 4 that 208.2 are not waived by the commissioner; 208.3 (ii) be qualified to provide the services specified in 208.4 subdivision 6; 208.5 (iii) coordinate efforts with local social service agencies 208.6 and tribes; and 208.7 (iv) comply with the conflict of interest provisions 208.8 established under subdivision 4, paragraph (c). 208.9 (4) Local social service agencies and federally recognized 208.10 tribes shall cooperate with providers certified by the 208.11 commissioner under this subdivision to facilitate the 208.12 recipient's successful relocation from an institution to the 208.13 community. 208.14 (b) For home care targeted case management, an eligible 208.15 recipient must be assigned a case manager within 20 working days 208.16 of requesting a case manager from a home care targeted case 208.17 management provider, as defined in subdivision 5. 208.18 [EFFECTIVE DATE.] This section is effective the day 208.19 following final enactment. 208.20 Sec. 19. [256B.0622] [INTENSIVE REHABILITATIVE MENTAL 208.21 HEALTH SERVICES.] 208.22 Subdivision 1. [SCOPE.] Subject to federal approval, 208.23 medical assistance covers medically necessary, intensive 208.24 nonresidential and residential rehabilitative mental health 208.25 services as defined in subdivision 2, for recipients as defined 208.26 in subdivision 3, when the services are provided by an entity 208.27 meeting the standards in this section. 208.28 Subd. 2. [DEFINITIONS.] For purposes of this section, the 208.29 following terms have the meanings given them. 208.30 (a) "Intensive nonresidential rehabilitative mental health 208.31 services" means adult rehabilitative mental health services as 208.32 defined in section 256B.0623, subdivision 2, paragraph (a), 208.33 except that these services are provided by a multidisciplinary 208.34 staff using a total team approach consistent with assertive 208.35 community treatment, the Fairweather Lodge treatment model, and 208.36 other evidence-based practices, and directed to recipients with 209.1 a serious mental illness who require intensive services. 209.2 (b) "Intensive residential rehabilitative mental health 209.3 services" means short-term, time-limited services provided in a 209.4 residential setting to recipients who are in need of more 209.5 restrictive settings and are at risk of significant functional 209.6 deterioration if they do not receive these services. Services 209.7 are designed to develop and enhance psychiatric stability, 209.8 personal and emotional adjustment, self-sufficiency, and skills 209.9 to live in a more independent setting. Services must be 209.10 directed toward a targeted discharge date with specified client 209.11 outcomes and must be consistent with evidence-based practices. 209.12 (c) "Evidence-based practices" are nationally recognized 209.13 mental health services that are proven by substantial research 209.14 to be effective in helping individuals with serious mental 209.15 illness obtain specific treatment goals. 209.16 (d) "Overnight staff" means a member of the intensive 209.17 residential rehabilitative mental health treatment team who is 209.18 responsible during hours when recipients are typically asleep. 209.19 (e) "Treatment team" means all staff who provide services 209.20 under this section to recipients. At a minimum, this includes 209.21 the clinical supervisor, mental health professionals, mental 209.22 health practitioners, and mental health rehabilitation workers. 209.23 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 209.24 individual who: 209.25 (1) is age 18 or older; 209.26 (2) is eligible for medical assistance; 209.27 (3) is diagnosed with a mental illness; 209.28 (4) because of a mental illness, has substantial disability 209.29 and functional impairment in three or more of the areas listed 209.30 in section 245.462, subdivision 11a, so that self-sufficiency is 209.31 markedly reduced; 209.32 (5) has one or more of the following: a history of two or 209.33 more inpatient hospitalizations in the past year, significant 209.34 independent living instability, homelessness, or very frequent 209.35 use of mental health and related services yielding poor 209.36 outcomes; and 210.1 (6) in the written opinion of a licensed mental health 210.2 professional, has the need for mental health services that 210.3 cannot be met with other available community-based services, or 210.4 is likely to experience a mental health crisis or require a more 210.5 restrictive setting if intensive rehabilitative mental health 210.6 services are not provided. 210.7 Subd. 4. [PROVIDER CERTIFICATION AND CONTRACT 210.8 REQUIREMENTS.] (a) The intensive nonresidential rehabilitative 210.9 mental health services provider must: 210.10 (1) have a contract with the host county to provide 210.11 intensive adult rehabilitative mental health services; and 210.12 (2) be certified by the commissioner as being in compliance 210.13 with this section and section 256B.0623. 210.14 (b) The intensive residential rehabilitative mental health 210.15 services provider must: 210.16 (1) be licensed under Minnesota Rules, parts 9520.0500 to 210.17 9520.0670; 210.18 (2) not exceed 16 beds per site; 210.19 (3) comply with the additional standards in this section; 210.20 and 210.21 (4) have a contract with the host county to provide these 210.22 services. 210.23 (c) The commissioner shall develop procedures for counties 210.24 and providers to submit contracts and other documentation as 210.25 needed to allow the commissioner to determine whether the 210.26 standards in this section are met. 210.27 Subd. 5. [STANDARDS APPLICABLE TO BOTH NONRESIDENTIAL AND 210.28 RESIDENTIAL PROVIDERS.] (a) Services must be provided by 210.29 qualified staff as defined in section 256B.0623, subdivision 5, 210.30 who are trained and supervised according to section 256B.0623, 210.31 subdivision 6, except that mental health rehabilitation workers 210.32 acting as overnight staff are not required to comply with 210.33 section 256B.0623, subdivision 5, clause (3)(iv). 210.34 (b) The clinical supervisor must be an active member of the 210.35 treatment team. The treatment team must meet with the clinical 210.36 supervisor at least weekly to discuss recipients' progress and 211.1 make rapid adjustments to meet recipients' needs. The team 211.2 meeting shall include recipient-specific case reviews and 211.3 general treatment discussions among team members. 211.4 Recipient-specific case reviews and planning must be documented 211.5 in the individual recipient's treatment record. 211.6 (c) Treatment staff must have prompt access in person or by 211.7 telephone to a mental health practitioner or mental health 211.8 professional. The provider must have the capacity to promptly 211.9 and appropriately respond to emergent needs and make any 211.10 necessary staffing adjustments to assure the health and safety 211.11 of recipients. 211.12 (d) The initial functional assessment must be completed 211.13 within ten days of intake and updated at least every three 211.14 months or prior to discharge from the service, whichever comes 211.15 first. 211.16 (e) The initial individual treatment plan must be completed 211.17 within ten days of intake and reviewed and updated at least 211.18 monthly with the recipient. 211.19 Subd. 6. [ADDITIONAL STANDARDS APPLICABLE ONLY TO 211.20 INTENSIVE RESIDENTIAL REHABILITATIVE MENTAL HEALTH 211.21 SERVICES.] (a) The provider of intensive residential services 211.22 must have sufficient staff to provide 24 hour per day coverage 211.23 to deliver the rehabilitative services described in the 211.24 treatment plan and to safely supervise and direct the activities 211.25 of recipients given the recipient's level of behavioral and 211.26 psychiatric stability, cultural needs, and vulnerability. The 211.27 provider must have the capacity within the facility to provide 211.28 integrated services for chemical dependency, illness management 211.29 services, and family education when appropriate. 211.30 (b) At a minimum: 211.31 (1) staff must be available and provide direction and 211.32 supervision whenever recipients are present in the facility; 211.33 (2) staff must remain awake during all work hours; 211.34 (3) there must be a staffing ratio of at least one to nine 211.35 recipients for each day and evening shift. If more than nine 211.36 recipients are present at the residential site, there must be a 212.1 minimum of two staff during day and evening shifts, one of whom 212.2 must be a mental health practitioner or mental health 212.3 professional; 212.4 (4) if services are provided to recipients who need the 212.5 services of a medical professional, the provider shall assure 212.6 that these services are provided either by the provider's own 212.7 medical staff or through referral to a medical professional; and 212.8 (5) the provider must assure the timely availability of a 212.9 licensed registered nurse, either directly employed or under 212.10 contract, who is responsible for ensuring the effectiveness and 212.11 safety of medication administration in the facility and 212.12 assessing patients for medication side effects and drug 212.13 interactions. 212.14 Subd. 7. [ADDITIONAL STANDARDS FOR NONRESIDENTIAL 212.15 SERVICES.] The standards in this subdivision apply to intensive 212.16 nonresidential rehabilitative mental health services. 212.17 (1) The treatment team must use team treatment, not an 212.18 individual treatment model. 212.19 (2) The clinical supervisor must function as a practicing 212.20 clinician at least on a part-time basis. 212.21 (3) The staffing ratio must not exceed ten recipients to 212.22 one full-time equivalent treatment team position. 212.23 (4) Services must be available at times that meet client 212.24 needs. 212.25 (5) The treatment team must actively and assertively engage 212.26 and reach out to the recipient's family members and significant 212.27 others, after obtaining the recipient's permission. 212.28 (6) The treatment team must establish ongoing communication 212.29 and collaboration between the team, family, and significant 212.30 others and educate the family and significant others about 212.31 mental illness, symptom management, and the family's role in 212.32 treatment. 212.33 (7) The treatment team must provide interventions to 212.34 promote positive interpersonal relationships. 212.35 Subd. 8. [MEDICAL ASSISTANCE PAYMENT FOR INTENSIVE 212.36 REHABILITATIVE MENTAL HEALTH SERVICES.] (a) Payment for 213.1 residential and nonresidential services in this section shall be 213.2 based on one daily rate per provider inclusive of the following 213.3 services received by an eligible recipient in a given calendar 213.4 day: all rehabilitative services under this section and crisis 213.5 stabilization services under section 256B.0624. 213.6 (b) Except as indicated in paragraph (c), payment will not 213.7 be made to more than one entity for each recipient for services 213.8 provided under this section on a given day. If services under 213.9 this section are provided by a team that includes staff from 213.10 more than one entity, the team must determine how to distribute 213.11 the payment among the members. 213.12 (c) The host county shall recommend to the commissioner one 213.13 rate for each entity that will bill medical assistance for 213.14 residential services under this section and two rates for each 213.15 nonresidential provider. The first nonresidential rate is for 213.16 recipients who are not receiving residential services. The 213.17 second nonresidential rate is for recipients who are temporarily 213.18 receiving residential services and need continued contact with 213.19 the nonresidential team to assure timely discharge from 213.20 residential services. In developing these rates, the host 213.21 county shall consider and document: 213.22 (1) the cost for similar services in the local trade area; 213.23 (2) actual costs incurred by entities providing the 213.24 services; 213.25 (3) the intensity and frequency of services to be provided 213.26 to each recipient; 213.27 (4) the degree to which recipients will receive services 213.28 other than services under this section; 213.29 (5) the costs of other services, such as case management, 213.30 that will be separately reimbursed; and 213.31 (6) input from the local planning process authorized by the 213.32 adult mental health initiative under section 245.4661, regarding 213.33 recipients' service needs. 213.34 (d) The rate for intensive rehabilitative mental health 213.35 services must exclude room and board, as defined in section 213.36 256I.03, subdivision 6, and services not covered under this 214.1 section, such as case management, partial hospitalization, home 214.2 care, and inpatient services. Physician services that are not 214.3 separately billed may be included in the rate to the extent that 214.4 a psychiatrist is a member of the treatment team. The county's 214.5 recommendation shall specify the period for which the rate will 214.6 be applicable, not to exceed two years. 214.7 (e) When services under this section are provided by an 214.8 assertive community team, case management functions must be an 214.9 integral part of the team. The county must allocate costs which 214.10 are reimbursable under this section versus costs which are 214.11 reimbursable through case management or other reimbursement, so 214.12 that payment is not duplicated. 214.13 (f) The rate for a provider must not exceed the rate 214.14 charged by that provider for the same service to other payors. 214.15 (g) The commissioner shall approve or reject the county's 214.16 rate recommendation, based on the commissioner's own analysis of 214.17 the criteria in paragraph (c). 214.18 Subd. 9. [PROVIDER ENROLLMENT; RATE SETTING FOR 214.19 COUNTY-OPERATED ENTITIES.] Counties that employ their own staff 214.20 to provide services under this section shall apply directly to 214.21 the commissioner for enrollment and rate setting. In this case, 214.22 a county contract is not required and the commissioner shall 214.23 perform the program review and rate setting duties which would 214.24 otherwise be required of counties under this section. 214.25 Subd. 10. [PROVIDER ENROLLMENT; RATE SETTING FOR 214.26 SPECIALIZED PROGRAM.] A provider proposing to serve a 214.27 subpopulation of eligible recipients may bypass the county 214.28 approval procedures in this section and receive approval for 214.29 provider enrollment and rate setting directly from the 214.30 commissioner under the following circumstances: 214.31 (1) the provider demonstrates that the subpopulation to be 214.32 served requires a specialized program which is not available 214.33 from county-approved entities; and 214.34 (2) the subpopulation to be served is of such a low 214.35 incidence that it is not feasible to develop a program serving a 214.36 single county or regional group of counties. 215.1 For providers meeting the criteria in clauses (1) and (2), 215.2 the commissioner shall perform the program review and rate 215.3 setting duties which would otherwise be required of counties 215.4 under this section. 215.5 Sec. 20. Minnesota Statutes 2002, section 256B.0623, 215.6 subdivision 2, is amended to read: 215.7 Subd. 2. [DEFINITIONS.] For purposes of this section, the 215.8 following terms have the meanings given them. 215.9 (a) "Adult rehabilitative mental health services" means 215.10 mental health services which are rehabilitative and enable the 215.11 recipient to develop and enhance psychiatric stability, social 215.12 competencies, personal and emotional adjustment, and independent 215.13 living and community skills, when these abilities are impaired 215.14 by the symptoms of mental illness. Adult rehabilitative mental 215.15 health services are also appropriate when provided to enable a 215.16 recipient to retain stability and functioning, if the recipient 215.17 would be at risk of significant functional decompensation or 215.18 more restrictive service settings without these services. 215.19 (1) Adult rehabilitative mental health services instruct, 215.20 assist, and support the recipient in areas such as: 215.21 interpersonal communication skills, community resource 215.22 utilization and integration skills, crisis assistance, relapse 215.23 prevention skills, health care directives, budgeting and 215.24 shopping skills, healthy lifestyle skills and practices, cooking 215.25 and nutrition skills, transportation skills, medication 215.26 education and monitoring, mental illness symptom management 215.27 skills, household management skills, employment-related skills, 215.28 and transition to community living services. 215.29 (2) These services shall be provided to the recipient on a 215.30 one-to-one basis in the recipient's home or another community 215.31 setting or in groups. 215.32 (b) "Medication education services" means services provided 215.33 individually or in groups which focus on educating the recipient 215.34 about mental illness and symptoms; the role and effects of 215.35 medications in treating symptoms of mental illness; and the side 215.36 effects of medications. Medication education is coordinated 216.1 with medication management services and does not duplicate it. 216.2 Medication education services are provided by physicians, 216.3 pharmacists, physician's assistants, or registered nurses. 216.4 (c) "Transition to community living services" means 216.5 services which maintain continuity of contact between the 216.6 rehabilitation services provider and the recipient and which 216.7 facilitate discharge from a hospital, residential treatment 216.8 program under Minnesota Rules, chapter 9505, board and lodging 216.9 facility, or nursing home. Transition to community living 216.10 services are not intended to provide other areas of adult 216.11 rehabilitative mental health services. 216.12 Sec. 21. Minnesota Statutes 2002, section 256B.0623, 216.13 subdivision 4, is amended to read: 216.14 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) The provider 216.15 entity must be:216.16(1) a county operated entity certified by the state; or216.17(2) a noncounty entity certified by the entity's host216.18countycertified by the state following the certification 216.19 process and procedures developed by the commissioner. 216.20 (b) The certification process is a determination as to 216.21 whether the entity meets the standards in this subdivision. The 216.22 certification must specify which adult rehabilitative mental 216.23 health services the entity is qualified to provide. 216.24 (c)If an entity seeks to provide services outside its host216.25county, itA noncounty provider entity must obtain additional 216.26 certification from each county in which it will provide 216.27 services. The additional certification must be based on the 216.28 adequacy of the entity's knowledge of that county's local health 216.29 and human service system, and the ability of the entity to 216.30 coordinate its services with the other services available in 216.31 that county. A county-operated entity must obtain this 216.32 additional certification from any other county in which it will 216.33 provide services. 216.34 (d) Recertification must occur at least everytwothree 216.35 years. 216.36 (e) The commissioner may intervene at any time and 217.1 decertify providers with cause. The decertification is subject 217.2 to appeal to the state. A county board may recommend that the 217.3 state decertify a provider for cause. 217.4 (f) The adult rehabilitative mental health services 217.5 provider entity must meet the following standards: 217.6 (1) have capacity to recruit, hire, manage, and train 217.7 mental health professionals, mental health practitioners, and 217.8 mental health rehabilitation workers; 217.9 (2) have adequate administrative ability to ensure 217.10 availability of services; 217.11 (3) ensure adequate preservice and inservice and ongoing 217.12 training for staff; 217.13 (4) ensure that mental health professionals, mental health 217.14 practitioners, and mental health rehabilitation workers are 217.15 skilled in the delivery of the specific adult rehabilitative 217.16 mental health services provided to the individual eligible 217.17 recipient; 217.18 (5) ensure that staff is capable of implementing culturally 217.19 specific services that are culturally competent and appropriate 217.20 as determined by the recipient's culture, beliefs, values, and 217.21 language as identified in the individual treatment plan; 217.22 (6) ensure enough flexibility in service delivery to 217.23 respond to the changing and intermittent care needs of a 217.24 recipient as identified by the recipient and the individual 217.25 treatment plan; 217.26 (7) ensure that the mental health professional or mental 217.27 health practitioner, who is under the clinical supervision of a 217.28 mental health professional, involved in a recipient's services 217.29 participates in the development of the individual treatment 217.30 plan; 217.31 (8) assist the recipient in arranging needed crisis 217.32 assessment, intervention, and stabilization services; 217.33 (9) ensure that services are coordinated with other 217.34 recipient mental health services providers and the county mental 217.35 health authority and the federally recognized American Indian 217.36 authority and necessary others after obtaining the consent of 218.1 the recipient. Services must also be coordinated with the 218.2 recipient's case manager or care coordinator if the recipient is 218.3 receiving case management or care coordination services; 218.4 (10) develop and maintain recipient files, individual 218.5 treatment plans, and contact charting; 218.6 (11) develop and maintain staff training and personnel 218.7 files; 218.8 (12) submit information as required by the state; 218.9 (13) establish and maintain a quality assurance plan to 218.10 evaluate the outcome of services provided; 218.11 (14) keep all necessary records required by law; 218.12 (15) deliver services as required by section 245.461; 218.13 (16) comply with all applicable laws; 218.14 (17) be an enrolled Medicaid provider; 218.15 (18) maintain a quality assurance plan to determine 218.16 specific service outcomes and the recipient's satisfaction with 218.17 services; and 218.18 (19) develop and maintain written policies and procedures 218.19 regarding service provision and administration of the provider 218.20 entity. 218.21(g) The commissioner shall develop statewide procedures for218.22provider certification, including timelines for counties to218.23certify qualified providers.218.24 Sec. 22. Minnesota Statutes 2002, section 256B.0623, 218.25 subdivision 5, is amended to read: 218.26 Subd. 5. [QUALIFICATIONS OF PROVIDER STAFF.] Adult 218.27 rehabilitative mental health services must be provided by 218.28 qualified individual provider staff of a certified provider 218.29 entity. Individual provider staff must be qualified under one 218.30 of the following criteria: 218.31 (1) a mental health professional as defined in section 218.32 245.462, subdivision 18, clauses (1) to (5). If the recipient 218.33 has a current diagnostic assessment by a licensed mental health 218.34 professional as defined in section 245.462, subdivision 18, 218.35 clauses (1) to (5), recommending receipt of adult mental health 218.36 rehabilitative services, the definition of mental health 219.1 professional for purposes of this section includes a person who 219.2 is qualified under section 245.462, subdivision 18, clause (6), 219.3 and who holds a current and valid national certification as a 219.4 certified rehabilitation counselor or certified psychosocial 219.5 rehabilitation practitioner; 219.6 (2) a mental health practitioner as defined in section 219.7 245.462, subdivision 17. The mental health practitioner must 219.8 work under the clinical supervision of a mental health 219.9 professional; or 219.10 (3) a mental health rehabilitation worker. A mental health 219.11 rehabilitation worker means a staff person working under the 219.12 direction of a mental health practitioner or mental health 219.13 professional and under the clinical supervision of a mental 219.14 health professional in the implementation of rehabilitative 219.15 mental health services as identified in the recipient's 219.16 individual treatment plan who: 219.17 (i) is at least 21 years of age; 219.18 (ii) has a high school diploma or equivalent; 219.19 (iii) has successfully completed 30 hours of training 219.20 during the past two years in all of the following areas: 219.21 recipient rights, recipient-centered individual treatment 219.22 planning, behavioral terminology, mental illness, co-occurring 219.23 mental illness and substance abuse, psychotropic medications and 219.24 side effects, functional assessment, local community resources, 219.25 adult vulnerability, recipient confidentiality; and 219.26 (iv) meets the qualifications in subitem (A) or (B): 219.27 (A) has an associate of arts degree in one of the 219.28 behavioral sciences or human services, or is a registered nurse 219.29 without a bachelor's degree, or who within the previous ten 219.30 years has: 219.31 (1) three years of personal life experience with serious 219.32 and persistent mental illness; 219.33 (2) three years of life experience as a primary caregiver 219.34 to an adult with a serious mental illness or traumatic brain 219.35 injury; or 219.36 (3) 4,000 hours of supervised paid work experience in the 220.1 delivery of mental health services to adults with a serious 220.2 mental illness or traumatic brain injury; or 220.3 (B)(1) is fluent in the non-English language or competent 220.4 in the culture of the ethnic group to which at least5020 220.5 percent of the mental health rehabilitation worker's clients 220.6 belong; 220.7 (2) receives during the first 2,000 hours of work, monthly 220.8 documented individual clinical supervision by a mental health 220.9 professional; 220.10 (3) has 18 hours of documented field supervision by a 220.11 mental health professional or practitioner during the first 160 220.12 hours of contact work with recipients, and at least six hours of 220.13 field supervision quarterly during the following year; 220.14 (4) has review and cosignature of charting of recipient 220.15 contacts during field supervision by a mental health 220.16 professional or practitioner; and 220.17 (5) has 40 hours of additional continuing education on 220.18 mental health topics during the first year of employment. 220.19 Sec. 23. Minnesota Statutes 2002, section 256B.0623, 220.20 subdivision 6, is amended to read: 220.21 Subd. 6. [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 220.22 health rehabilitation workers must receive ongoing continuing 220.23 education training of at least 30 hours every two years in areas 220.24 of mental illness and mental health services and other areas 220.25 specific to the population being served. Mental health 220.26 rehabilitation workers must also be subject to the ongoing 220.27 direction and clinical supervision standards in paragraphs (c) 220.28 and (d). 220.29 (b) Mental health practitioners must receive ongoing 220.30 continuing education training as required by their professional 220.31 license; or if the practitioner is not licensed, the 220.32 practitioner must receive ongoing continuing education training 220.33 of at least 30 hours every two years in areas of mental illness 220.34 and mental health services. Mental health practitioners must 220.35 meet the ongoing clinical supervision standards in paragraph (c). 220.36 (c) Clinical supervision may be provided by a full- or 221.1 part-time qualified professional employed by or under contract 221.2 with the provider entity. Clinical supervision may be provided 221.3 by interactive videoconferencing according to procedures 221.4 developed by the commissioner. A mental health professional 221.5 providing clinical supervision of staff delivering adult 221.6 rehabilitative mental health services must provide the following 221.7 guidance: 221.8 (1) review the information in the recipient's file; 221.9 (2) review and approve initial and updates of individual 221.10 treatment plans; 221.11 (3) meet with mental health rehabilitation workers and 221.12 practitioners, individually or in small groups, at least monthly 221.13 to discuss treatment topics of interest to the workers and 221.14 practitioners; 221.15 (4) meet with mental health rehabilitation workers and 221.16 practitioners, individually or in small groups, at least monthly 221.17 to discuss treatment plans of recipients, and approve by 221.18 signature and document in the recipient's file any resulting 221.19 plan updates; 221.20 (5) meet at leasttwice a monthmonthly with the directing 221.21 mental health practitioner, if there is one, to review needs of 221.22 the adult rehabilitative mental health services program, review 221.23 staff on-site observations and evaluate mental health 221.24 rehabilitation workers, plan staff training, review program 221.25 evaluation and development, and consult with the directing 221.26 practitioner; and 221.27 (6) be available for urgent consultation as the individual 221.28 recipient needs or the situation necessitates; and221.29(7) provide clinical supervision by full- or part-time221.30mental health professionals employed by or under contract with221.31the provider entity. 221.32 (d) An adult rehabilitative mental health services provider 221.33 entity must have a treatment director who is a mental health 221.34 practitioner or mental health professional. The treatment 221.35 director must ensure the following: 221.36 (1) while delivering direct services to recipients, a newly 222.1 hired mental health rehabilitation worker must be directly 222.2 observed delivering services to recipients bythea mental 222.3 health practitioner or mental health professional for at least 222.4 six hours per 40 hours worked during the first 160 hours that 222.5 the mental health rehabilitation worker works; 222.6 (2) the mental health rehabilitation worker must receive 222.7 ongoing on-site direct service observation by a mental health 222.8 professional or mental health practitioner for at least six 222.9 hours for every six months of employment; 222.10 (3) progress notes are reviewed from on-site service 222.11 observation prepared by the mental health rehabilitation worker 222.12 and mental health practitioner for accuracy and consistency with 222.13 actual recipient contact and the individual treatment plan and 222.14 goals; 222.15 (4) immediate availability by phone or in person for 222.16 consultation by a mental health professional or a mental health 222.17 practitioner to the mental health rehabilitation services worker 222.18 during service provision; 222.19 (5) oversee the identification of changes in individual 222.20 recipient treatment strategies, revise the plan, and communicate 222.21 treatment instructions and methodologies as appropriate to 222.22 ensure that treatment is implemented correctly; 222.23 (6) model service practices which: respect the recipient, 222.24 include the recipient in planning and implementation of the 222.25 individual treatment plan, recognize the recipient's strengths, 222.26 collaborate and coordinate with other involved parties and 222.27 providers; 222.28 (7) ensure that mental health practitioners and mental 222.29 health rehabilitation workers are able to effectively 222.30 communicate with the recipients, significant others, and 222.31 providers; and 222.32 (8) oversee the record of the results of on-site 222.33 observation and charting evaluation and corrective actions taken 222.34 to modify the work of the mental health practitioners and mental 222.35 health rehabilitation workers. 222.36 (e) A mental health practitioner who is providing treatment 223.1 direction for a provider entity must receive supervision at 223.2 least monthly from a mental health professional to: 223.3 (1) identify and plan for general needs of the recipient 223.4 population served; 223.5 (2) identify and plan to address provider entity program 223.6 needs and effectiveness; 223.7 (3) identify and plan provider entity staff training and 223.8 personnel needs and issues; and 223.9 (4) plan, implement, and evaluate provider entity quality 223.10 improvement programs. 223.11 Sec. 24. Minnesota Statutes 2002, section 256B.0623, 223.12 subdivision 8, is amended to read: 223.13 Subd. 8. [DIAGNOSTIC ASSESSMENT.] Providers of adult 223.14 rehabilitative mental health services must complete a diagnostic 223.15 assessment as defined in section 245.462, subdivision 9, within 223.16 five days after the recipient's second visit or within 30 days 223.17 after intake, whichever occurs first. In cases where a 223.18 diagnostic assessment is available that reflects the recipient's 223.19 current status, and has been completed within 180 days preceding 223.20 admission, an update must be completed. An update shall include 223.21 a written summary by a mental health professional of the 223.22 recipient's current mental health status and service needs. If 223.23 the recipient's mental health status has changed significantly 223.24 since the adult's most recent diagnostic assessment, a new 223.25 diagnostic assessment is required. For initial implementation 223.26 of adult rehabilitative mental health services, until June 30, 223.27 2005, a diagnostic assessment that reflects the recipient's 223.28 current status and has been completed within the past three 223.29 years preceding admission is acceptable. 223.30 Sec. 25. Minnesota Statutes 2002, section 256B.0625, 223.31 subdivision 19c, is amended to read: 223.32 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 223.33 personal care assistant services provided by an individual who 223.34 is qualified to provide the services according to subdivision 223.35 19a and section 256B.0627, where the services are prescribed by 223.36 a physician in accordance with a plan of treatment and are 224.1 supervised by the recipient or a qualified professional. 224.2 "Qualified professional" means a mental health professional as 224.3 defined in section 245.462, subdivision 18, or 245.4871, 224.4 subdivision 27; or a registered nurse as defined in sections 224.5 148.171 to 148.285, or a licensed social worker as defined in 224.6 section 148B.21. As part of the assessment, the county public 224.7 health nurse will assist the recipient or responsible party to 224.8 identify the most appropriate person to provide supervision of 224.9 the personal care assistant. The qualified professional shall 224.10 perform the duties described in Minnesota Rules, part 9505.0335, 224.11 subpart 4. 224.12 Sec. 26. Minnesota Statutes 2002, section 256B.0627, 224.13 subdivision 1, is amended to read: 224.14 Subdivision 1. [DEFINITION.] (a) "Activities of daily 224.15 living" includes eating, toileting, grooming, dressing, bathing, 224.16 transferring, mobility, and positioning. 224.17 (b) "Assessment" means a review and evaluation of a 224.18 recipient's need for home care services conducted in person. 224.19 Assessments for private duty nursing shall be conducted by a 224.20 registered private duty nurse. Assessments for home health 224.21 agency services shall be conducted by a home health agency 224.22 nurse. Assessments for personal care assistant services shall 224.23 be conducted by the county public health nurse or a certified 224.24 public health nurse under contract with the county. A 224.25 face-to-face assessment must include: documentation of health 224.26 status, determination of need, evaluation of service 224.27 effectiveness, identification of appropriate services, service 224.28 plan development or modification, coordination of services, 224.29 referrals and follow-up to appropriate payers and community 224.30 resources, completion of required reports, recommendation of 224.31 service authorization, and consumer education. Once the need 224.32 for personal care assistant services is determined under this 224.33 section, the county public health nurse or certified public 224.34 health nurse under contract with the county is responsible for 224.35 communicating this recommendation to the commissioner and the 224.36 recipient. A face-to-face assessment for personal care 225.1 assistant services is conducted on those recipients who have 225.2 never had a county public health nurse assessment. A 225.3 face-to-face assessment must occur at least annually or when 225.4 there is a significant change in the recipient's condition or 225.5 when there is a change in the need for personal care assistant 225.6 services. A service update may substitute for the annual 225.7 face-to-face assessment when there is not a significant change 225.8 in recipient condition or a change in the need for personal care 225.9 assistant service. A service update or review for temporary 225.10 increase includes a review of initial baseline data, evaluation 225.11 of service effectiveness, redetermination of service need, 225.12 modification of service plan and appropriate referrals, update 225.13 of initial forms, obtaining service authorization, and on going 225.14 consumer education. Assessments for medical assistance home 225.15 care services for mental retardation or related conditions and 225.16 alternative care services for developmentally disabled home and 225.17 community-based waivered recipients may be conducted by the 225.18 county public health nurse to ensure coordination and avoid 225.19 duplication. Assessments must be completed on forms provided by 225.20 the commissioner within 30 days of a request for home care 225.21 services by a recipient or responsible party. 225.22 (c) "Care plan" means a written description of personal 225.23 care assistant services developed by the qualified professional 225.24 or the recipient's physician with the recipient or responsible 225.25 party to be used by the personal care assistant with a copy 225.26 provided to the recipient or responsible party. 225.27 (d) "Complex and regular private duty nursing care" means: 225.28 (1) complex care is private duty nursing provided to 225.29 recipients who are ventilator dependent or for whom a physician 225.30 has certified that were it not for private duty nursing the 225.31 recipient would meet the criteria for inpatient hospital 225.32 intensive care unit (ICU) level of care; and 225.33 (2) regular care is private duty nursing provided to all 225.34 other recipients. 225.35 (e) "Health-related functions" means functions that can be 225.36 delegated or assigned by a licensed health care professional 226.1 under state law to be performed by a personal care attendant. 226.2 (f) "Home care services" means a health service, determined 226.3 by the commissioner as medically necessary, that is ordered by a 226.4 physician and documented in a service plan that is reviewed by 226.5 the physician at least once every 60 days for the provision of 226.6 home health services, or private duty nursing, or at least once 226.7 every 365 days for personal care. Home care services are 226.8 provided to the recipient at the recipient's residence that is a 226.9 place other than a hospital or long-term care facility or as 226.10 specified in section 256B.0625. 226.11 (g) "Instrumental activities of daily living" includes meal 226.12 planning and preparation, managing finances, shopping for food, 226.13 clothing, and other essential items, performing essential 226.14 household chores, communication by telephone and other media, 226.15 and getting around and participating in the community. 226.16 (h) "Medically necessary" has the meaning given in 226.17 Minnesota Rules, parts 9505.0170 to 9505.0475. 226.18 (i) "Personal care assistant" means a person who: 226.19 (1) is at least 18 years old, except for persons 16 to 18 226.20 years of age who participated in a related school-based job 226.21 training program or have completed a certified home health aide 226.22 competency evaluation; 226.23 (2) is able to effectively communicate with the recipient 226.24 and personal care provider organization; 226.25 (3) effective July 1, 1996, has completed one of the 226.26 training requirements as specified in Minnesota Rules, part 226.27 9505.0335, subpart 3, items A to D; 226.28 (4) has the ability to, and provides covered personal care 226.29 assistant services according to the recipient's care plan, 226.30 responds appropriately to recipient needs, and reports changes 226.31 in the recipient's condition to the supervising qualified 226.32 professional or physician; 226.33 (5) is not a consumer of personal care assistant services; 226.34 and 226.35 (6) is subject to criminal background checks and procedures 226.36 specified in section 245A.04. 227.1 (j) "Personal care provider organization" means an 227.2 organization enrolled to provide personal care assistant 227.3 services under the medical assistance program that complies with 227.4 the following: (1) owners who have a five percent interest or 227.5 more, and managerial officials are subject to a background study 227.6 as provided in section 245A.04. This applies to currently 227.7 enrolled personal care provider organizations and those agencies 227.8 seeking enrollment as a personal care provider organization. An 227.9 organization will be barred from enrollment if an owner or 227.10 managerial official of the organization has been convicted of a 227.11 crime specified in section 245A.04, or a comparable crime in 227.12 another jurisdiction, unless the owner or managerial official 227.13 meets the reconsideration criteria specified in section 245A.04; 227.14 (2) the organization must maintain a surety bond and liability 227.15 insurance throughout the duration of enrollment and provides 227.16 proof thereof. The insurer must notify the department of human 227.17 services of the cancellation or lapse of policy; and (3) the 227.18 organization must maintain documentation of services as 227.19 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 227.20 as evidence of compliance with personal care assistant training 227.21 requirements. 227.22 (k) "Responsible party" means an individualresiding with a227.23recipient of personal care assistant serviceswho is capable of 227.24 providing thesupportive caresupport necessary to assist the 227.25 recipient to live in the community, is at least 18 years 227.26 old, actively participates in planning and directing of personal 227.27 care assistant services, and is notathe personal care 227.28 assistant. The responsible party must be accessible to the 227.29 recipient and the personal care assistant when personal care 227.30 services are being provided and monitor the services at least 227.31 weekly according to the plan of care. The responsible party 227.32 must be identified at the time of assessment and listed on the 227.33 recipient's service agreement and care plan. Responsible 227.34 partieswho are parents of minors or guardians of minors or227.35incapacitated personsmay delegate the responsibility to another 227.36 adultduring a temporary absence of at least 24 hours but not228.1more than six months. The person delegated as a responsible228.2party must be able to meet the definition of responsible party,228.3except that the delegated responsible party is required to228.4reside with the recipient only while serving as the responsible228.5partywho is not the personal care assistant. The responsible 228.6 party must assure that the delegate performs the functions of 228.7 the responsible party, is identified at the time of the 228.8 assessment, and is listed on the service agreement and the care 228.9 plan. Foster care license holders may be designated the 228.10 responsible party for residents of the foster care home if case 228.11 management is provided as required in section 256B.0625, 228.12 subdivision 19a. For persons who, as of April 1, 1992, are 228.13 sharing personal care assistant services in order to obtain the 228.14 availability of 24-hour coverage, an employee of the personal 228.15 care provider organization may be designated as the responsible 228.16 party if case management is provided as required in section 228.17 256B.0625, subdivision 19a. 228.18 (l) "Service plan" means a written description of the 228.19 services needed based on the assessment developed by the nurse 228.20 who conducts the assessment together with the recipient or 228.21 responsible party. The service plan shall include a description 228.22 of the covered home care services, frequency and duration of 228.23 services, and expected outcomes and goals. The recipient and 228.24 the provider chosen by the recipient or responsible party must 228.25 be given a copy of the completed service plan within 30 calendar 228.26 days of the request for home care services by the recipient or 228.27 responsible party. 228.28 (m) "Skilled nurse visits" are provided in a recipient's 228.29 residence under a plan of care or service plan that specifies a 228.30 level of care which the nurse is qualified to provide. These 228.31 services are: 228.32 (1) nursing services according to the written plan of care 228.33 or service plan and accepted standards of medical and nursing 228.34 practice in accordance with chapter 148; 228.35 (2) services which due to the recipient's medical condition 228.36 may only be safely and effectively provided by a registered 229.1 nurse or a licensed practical nurse; 229.2 (3) assessments performed only by a registered nurse; and 229.3 (4) teaching and training the recipient, the recipient's 229.4 family, or other caregivers requiring the skills of a registered 229.5 nurse or licensed practical nurse. 229.6 (n) "Telehomecare" means the use of telecommunications 229.7 technology by a home health care professional to deliver home 229.8 health care services, within the professional's scope of 229.9 practice, to a patient located at a site other than the site 229.10 where the practitioner is located. 229.11 Sec. 27. Minnesota Statutes 2002, section 256B.0627, 229.12 subdivision 4, is amended to read: 229.13 Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The 229.14 personal care assistant services that are eligible for payment 229.15 are services and supports furnished to an individual, as needed, 229.16 to assist in accomplishing activities of daily living; 229.17 instrumental activities of daily living; health-related 229.18 functions through hands-on assistance, supervision, and cuing; 229.19 and redirection and intervention for behavior including 229.20 observation and monitoring. 229.21 (b) Payment for services will be made within the limits 229.22 approved using the prior authorized process established in 229.23 subdivision 5. 229.24 (c) The amount and type of services authorized shall be 229.25 based on an assessment of the recipient's needs in these areas: 229.26 (1) bowel and bladder care; 229.27 (2) skin care to maintain the health of the skin; 229.28 (3) repetitive maintenance range of motion, muscle 229.29 strengthening exercises, and other tasks specific to maintaining 229.30 a recipient's optimal level of function; 229.31 (4) respiratory assistance; 229.32 (5) transfers and ambulation; 229.33 (6) bathing, grooming, and hairwashing necessary for 229.34 personal hygiene; 229.35 (7) turning and positioning; 229.36 (8) assistance with furnishing medication that is 230.1 self-administered; 230.2 (9) application and maintenance of prosthetics and 230.3 orthotics; 230.4 (10) cleaning medical equipment; 230.5 (11) dressing or undressing; 230.6 (12) assistance with eating and meal preparation and 230.7 necessary grocery shopping; 230.8 (13) accompanying a recipient to obtain medical diagnosis 230.9 or treatment; 230.10 (14) assisting, monitoring, or prompting the recipient to 230.11 complete the services in clauses (1) to (13); 230.12 (15) redirection, monitoring, and observation that are 230.13 medically necessary and an integral part of completing the 230.14 personal care assistant services described in clauses (1) to 230.15 (14); 230.16 (16) redirection and intervention for behavior, including 230.17 observation and monitoring; 230.18 (17) interventions for seizure disorders, including 230.19 monitoring and observation if the recipient has had a seizure 230.20 that requires intervention within the past three months; 230.21 (18) tracheostomy suctioning using a clean procedure if the 230.22 procedure is properly delegated by a registered nurse. Before 230.23 this procedure can be delegated to a personal care assistant, a 230.24 registered nurse must determine that the tracheostomy suctioning 230.25 can be accomplished utilizing a clean rather than a sterile 230.26 procedure and must ensure that the personal care assistant has 230.27 been taught the proper procedure; and 230.28 (19) incidental household services that are an integral 230.29 part of a personal care service described in clauses (1) to (18). 230.30 For purposes of this subdivision, monitoring and observation 230.31 means watching for outward visible signs that are likely to 230.32 occur and for which there is a covered personal care service or 230.33 an appropriate personal care intervention. For purposes of this 230.34 subdivision, a clean procedure refers to a procedure that 230.35 reduces the numbers of microorganisms or prevents or reduces the 230.36 transmission of microorganisms from one person or place to 231.1 another. A clean procedure may be used beginning 14 days after 231.2 insertion. 231.3 (d) The personal care assistant services that are not 231.4 eligible for payment are the following: 231.5 (1) services not ordered by the physician; 231.6 (2) assessments by personal care assistant provider 231.7 organizations or by independently enrolled registered nurses; 231.8 (3) services that are not in the service plan; 231.9 (4) services provided by the recipient's spouse, legal 231.10 guardian for an adult or child recipient, or parent of a 231.11 recipient under age 18; 231.12 (5) services provided by a foster care provider of a 231.13 recipient who cannot direct the recipient's own care, unless 231.14 monitored by a county or state case manager under section 231.15 256B.0625, subdivision 19a; 231.16 (6) services provided by the residential or program license 231.17 holder in a residence for more than four persons; 231.18 (7) services that are the responsibility of a residential 231.19 or program license holder under the terms of a service agreement 231.20 and administrative rules; 231.21 (8) sterile procedures; 231.22 (9) injections of fluids into veins, muscles, or skin; 231.23 (10)services provided by parents of adult recipients,231.24adult children, or siblings of the recipient, unless these231.25relatives meet one of the following hardship criteria and the231.26commissioner waives this requirement:231.27(i) the relative resigns from a part-time or full-time job231.28to provide personal care for the recipient;231.29(ii) the relative goes from a full-time to a part-time job231.30with less compensation to provide personal care for the231.31recipient;231.32(iii) the relative takes a leave of absence without pay to231.33provide personal care for the recipient;231.34(iv) the relative incurs substantial expenses by providing231.35personal care for the recipient; or231.36(v) because of labor conditions, special language needs, or232.1intermittent hours of care needed, the relative is needed in232.2order to provide an adequate number of qualified personal care232.3assistants to meet the medical needs of the recipient;232.4(11)homemaker services that are not an integral part of a 232.5 personal care assistant services; 232.6(12)(11) home maintenance, or chore services; 232.7(13)(12) services not specified under paragraph (a); and 232.8(14)(13) services not authorized by the commissioner or 232.9 the commissioner's designee. 232.10 (e) The recipient or responsible party may choose to 232.11 supervise the personal care assistant or to have a qualified 232.12 professional, as defined in section 256B.0625, subdivision 19c, 232.13 provide the supervision. As required under section 256B.0625, 232.14 subdivision 19c, the county public health nurse, as a part of 232.15 the assessment, will assist the recipient or responsible party 232.16 to identify the most appropriate person to provide supervision 232.17 of the personal care assistant. Health-related delegated tasks 232.18 performed by the personal care assistant will be under the 232.19 supervision of a qualified professional or the direction of the 232.20 recipient's physician. If the recipient has a qualified 232.21 professional, Minnesota Rules, part 9505.0335, subpart 4, 232.22 applies. 232.23 Sec. 28. Minnesota Statutes 2002, section 256B.0627, 232.24 subdivision 9, is amended to read: 232.25 Subd. 9. [FLEXIBLE USE OF PERSONAL CARE ASSISTANT HOURS.] 232.26 (a)The commissioner may allow for the flexible use of personal232.27care assistant hours."Flexible use" means the scheduled use of 232.28 authorized hours of personal care assistant services, which vary 232.29 within the length of the service authorization in order to more 232.30 effectively meet the needs and schedule of the recipient. 232.31 Recipients may use their approved hours flexibly within the 232.32 service authorization period for medically necessary covered 232.33 services specified in the assessment required in subdivision 1. 232.34 The flexible use of authorized hours does not increase the total 232.35 amount of authorized hours available to a recipient as 232.36 determined under subdivision 5. The commissioner shall not 233.1 authorize additional personal care assistant services to 233.2 supplement a service authorization that is exhausted before the 233.3 end date under a flexible service use plan, unless the county 233.4 public health nurse determines a change in condition and a need 233.5 for increased services is established. 233.6 (b)The recipient or responsible party, together with the233.7county public health nurse, shall determine whether flexible use233.8is an appropriate option based on the needs and preferences of233.9the recipient or responsible party, and, if appropriate, must233.10ensure that the allocation of hours covers the ongoing needs of233.11the recipient over the entire service authorization period. As233.12part of the assessment and service planning process, the233.13recipient or responsible party must work with the county public233.14health nurse to develop a written month-to-month plan of the233.15projected use of personal care assistant services that is part233.16of the service plan and ensures that the:233.17(1) health and safety needs of the recipient will be met;233.18(2) total annual authorization will not exceed before the233.19end date; and233.20(3) how actual use of hours will be monitored.233.21(c) If the actual use of personal care assistant service233.22varies significantly from the use projected in the plan, the233.23written plan must be promptly updated by the recipient or233.24responsible party and the county public health nurse.233.25(d)The recipient or responsible party, together with the 233.26 provider, must work to monitor and document the use of 233.27 authorized hours and ensure that a recipient is able to manage 233.28 services effectively throughout the authorized period.The233.29provider must ensure that the month-to-month plan is233.30incorporated into the care plan.Upon request of the recipient 233.31 or responsible party, the provider must furnish regular updates 233.32 to the recipient or responsible party on the amount of personal 233.33 care assistant services used. 233.34(e) The recipient or responsible party may revoke the233.35authorization for flexible use of hours by notifying the233.36provider and county public health nurse in writing.234.1(f) If the requirements in paragraphs (a) to (e) have not234.2substantially been met, the commissioner shall deny, revoke, or234.3suspend the authorization to use authorized hours flexibly. The234.4recipient or responsible party may appeal the commissioner's234.5action according to section 256.045. The denial, revocation, or234.6suspension to use the flexible hours option shall not affect the234.7recipient's authorized level of personal care assistant services234.8as determined under subdivision 5.234.9 Sec. 29. Minnesota Statutes 2002, section 256B.0911, 234.10 subdivision 4d, is amended to read: 234.11 Subd. 4d. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 234.12 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 234.13 ensure that individuals with disabilities or chronic illness are 234.14 served in the most integrated setting appropriate to their needs 234.15 and have the necessary information to make informed choices 234.16 about home and community-based service options. 234.17 (b) Individuals under 65 years of age who are admitted to a 234.18 nursing facility from a hospital must be screened prior to 234.19 admission as outlined in subdivisions 4a through 4c. 234.20 (c) Individuals under 65 years of age who are admitted to 234.21 nursing facilities with only a telephone screening must receive 234.22 a face-to-face assessment from the long-term care consultation 234.23 team member of the county in which the facility is located or 234.24 from the recipient's county case manager within20 working40 234.25 calendar days of admission. 234.26 (d) Individuals under 65 years of age who are admitted to a 234.27 nursing facility without preadmission screening according to the 234.28 exemption described in subdivision 4b, paragraph (a), clause 234.29 (3), and who remain in the facility longer than 30 days must 234.30 receive a face-to-face assessment within 40 days of admission. 234.31 (e) At the face-to-face assessment, the long-term care 234.32 consultation team member or county case manager must perform the 234.33 activities required under subdivision 3b. 234.34 (f) For individuals under 21 years of age, a screening 234.35 interview which recommends nursing facility admission must be 234.36 face-to-face and approved by the commissioner before the 235.1 individual is admitted to the nursing facility. 235.2 (g) In the event that an individual under 65 years of age 235.3 is admitted to a nursing facility on an emergency basis, the 235.4 county must be notified of the admission on the next working 235.5 day, and a face-to-face assessment as described in paragraph (c) 235.6 must be conducted within20 working days40 calendar days of 235.7 admission. 235.8 (h) At the face-to-face assessment, the long-term care 235.9 consultation team member or the case manager must present 235.10 information about home and community-based options so the 235.11 individual can make informed choices. If the individual chooses 235.12 home and community-based services, the long-term care 235.13 consultation team member or case manager must complete a written 235.14 relocation plan within 20 working days of the visit. The plan 235.15 shall describe the services needed to move out of the facility 235.16 and a time line for the move which is designed to ensure a 235.17 smooth transition to the individual's home and community. 235.18 (i) An individual under 65 years of age residing in a 235.19 nursing facility shall receive a face-to-face assessment at 235.20 least every 12 months to review the person's service choices and 235.21 available alternatives unless the individual indicates, in 235.22 writing, that annual visits are not desired. In this case, the 235.23 individual must receive a face-to-face assessment at least once 235.24 every 36 months for the same purposes. 235.25 (j) Notwithstanding the provisions of subdivision 6, the 235.26 commissioner may pay county agencies directly for face-to-face 235.27 assessments for individuals under 65 years of age who are being 235.28 considered for placement or residing in a nursing facility. 235.29 Sec. 30. Minnesota Statutes 2002, section 256B.0915, is 235.30 amended by adding a subdivision to read: 235.31 Subd. 9. [TRIBAL MANAGEMENT OF ELDERLY WAIVER.] 235.32 Notwithstanding contrary provisions of this section, or those in 235.33 other state laws or rules, the commissioner and White Earth 235.34 reservation may develop a model for tribal management of the 235.35 elderly waiver program and implement this model through a 235.36 contract between the state and White Earth reservation. The 236.1 model shall include the provision of tribal waiver case 236.2 management, assessment for personal care assistance, and 236.3 administrative requirements otherwise carried out by counties 236.4 but shall not include tribal financial eligibility determination 236.5 for medical assistance. 236.6 Sec. 31. Minnesota Statutes 2002, section 256B.092, 236.7 subdivision 1a, is amended to read: 236.8 Subd. 1a. [CASE MANAGEMENT ADMINISTRATION AND SERVICES.] 236.9 (a) The administrative functions of case management provided to 236.10 or arranged for a person include: 236.11 (1)intakereview of eligibility for services; 236.12 (2)diagnosisscreening; 236.13 (3)screeningintake; 236.14 (4)service authorizationdiagnosis; 236.15 (5)review of eligibility for servicesthe review and 236.16 authorization of services based upon an individualized service 236.17 plan; and 236.18 (6) responding to requests for conciliation conferences and 236.19 appeals according to section 256.045 made by the person, the 236.20 person's legal guardian or conservator, or the parent if the 236.21 person is a minor. 236.22 (b) Case management service activities provided to or 236.23 arranged for a person include: 236.24 (1) development of the individual service plan;236.25 (2) informing the individual or the individual's legal 236.26 guardian or conservator, or parent if the person is a minor, of 236.27 service options; 236.28 (3) consulting with relevant medical experts or service 236.29 providers; 236.30(3)(4) assisting the person in the identification of 236.31 potential providers; 236.32(4)(5) assisting the person to access services; 236.33(5)(6) coordination of services, if coordination is not 236.34 provided by another service provider; 236.35(6)(7) evaluation and monitoring of the services 236.36 identified in the plan; and 237.1(7)(8) annual reviews of service plans and services 237.2 provided. 237.3 (c) Case management administration and service activities 237.4 that are provided to the person with mental retardation or a 237.5 related condition shall be provided directly by county agencies 237.6 or under contract. 237.7 (d) Case managers are responsible for the administrative 237.8 duties and service provisions listed in paragraphs (a) and (b). 237.9 Case managers shall collaborate with consumers, families, legal 237.10 representatives, and relevant medical experts and service 237.11 providers in the development and annual review of the 237.12 individualized service and habilitation plans. 237.13 (e) The department of human services shall offer ongoing 237.14 education in case management to case managers. Case managers 237.15 shall receive no less than ten hours of case management 237.16 education and disability-related training each year. 237.17 Sec. 32. Minnesota Statutes 2002, section 256B.092, 237.18 subdivision 5, is amended to read: 237.19 Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall 237.20 apply for any federal waivers necessary to secure, to the extent 237.21 allowed by law, federal financial participation under United 237.22 States Code, title 42, sections 1396 et seq., as amended, for 237.23 the provision of services to persons who, in the absence of the 237.24 services, would need the level of care provided in a regional 237.25 treatment center or a community intermediate care facility for 237.26 persons with mental retardation or related conditions. The 237.27 commissioner may seek amendments to the waivers or apply for 237.28 additional waivers under United States Code, title 42, sections 237.29 1396 et seq., as amended, to contain costs. The commissioner 237.30 shall ensure that payment for the cost of providing home and 237.31 community-based alternative services under the federal waiver 237.32 plan shall not exceed the cost of intermediate care services 237.33 including day training and habilitation services that would have 237.34 been provided without the waivered services. 237.35 (b) The commissioner, in administering home and 237.36 community-based waivers for persons with mental retardation and 238.1 related conditions, shall ensure that day services for eligible 238.2 persons are not provided by the person's residential service 238.3 provider, unless the person or the person's legal representative 238.4 is offered a choice of providers and agrees in writing to 238.5 provision of day services by the residential service provider. 238.6 The individual service plan for individuals who choose to have 238.7 their residential service provider provide their day services 238.8 must describe how health, safety,andprotection, and 238.9 habilitation needs will be metby, including how frequent and 238.10 regular contact with persons other than the residential service 238.11 provider will occur. The individualized service plan must 238.12 address the provision of services during the day outside the 238.13 residence on weekdays. 238.14 (c) When a county is evaluating denials, reductions, or 238.15 terminations of home and community-based services under section 238.16 256B.0916 for an individual, the case manager shall offer to 238.17 meet with the individual or the individual's guardian in order 238.18 to discuss the prioritization of service needs within the 238.19 individualized service plan. The reduction in the authorized 238.20 services for an individual due to changes in funding for 238.21 waivered services may not exceed the amount needed to ensure 238.22 medically necessary services to meet the individual's health, 238.23 safety, and welfare. 238.24 Sec. 33. Minnesota Statutes 2002, section 256B.095, is 238.25 amended to read: 238.26 256B.095 [QUALITY ASSURANCEPROJECTSYSTEM ESTABLISHED.] 238.27 (a) Effective July 1, 1998,an alternativea quality 238.28 assurancelicensingsystemprojectfor persons with 238.29 developmental disabilities, which includes an alternative 238.30 quality assurance licensing system for programsfor persons with238.31developmental disabilities, is established in Dodge, Fillmore, 238.32 Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 238.33 Wabasha, and Winona counties for the purpose of improving the 238.34 quality of services provided to persons with developmental 238.35 disabilities. A county, at its option, may choose to have all 238.36 programs for persons with developmental disabilities located 239.1 within the county licensed under chapter 245A using standards 239.2 determined under the alternative quality assurance licensing 239.3 systemprojector may continue regulation of these programs 239.4 under the licensing system operated by the commissioner. The 239.5 project expires on June 30,20052007. 239.6 (b) Effective July 1, 2003, a county not listed in 239.7 paragraph (a) may apply to participate in the quality assurance 239.8 system established under paragraph (a). The commission 239.9 established under section 256B.0951 may, at its option, allow 239.10 additional counties to participate in the system. 239.11 (c) Effective July 1, 2003, any county or group of counties 239.12 not listed in paragraph (a) may establish a quality assurance 239.13 system under this section. A new system established under this 239.14 section shall have the same rights and duties as the system 239.15 established under paragraph (a). A new system shall be governed 239.16 by a commission under section 256B.0951. The commissioner shall 239.17 appoint the initial commission members based on recommendations 239.18 from advocates, families, service providers, and counties in the 239.19 geographic area included in the new system. Counties that 239.20 choose to participate in a new system shall have the duties 239.21 assigned under section 256B.0952. The new system shall 239.22 establish a quality assurance process under section 256B.0953. 239.23 The provisions of section 256B.0954 shall apply to a new system 239.24 established under this paragraph. The commissioner shall 239.25 delegate authority to a new system established under this 239.26 paragraph according to section 256B.0955. 239.27 [EFFECTIVE DATE.] This section is effective July 1, 2003. 239.28 Sec. 34. Minnesota Statutes 2002, section 256B.0951, 239.29 subdivision 1, is amended to read: 239.30 Subdivision 1. [MEMBERSHIP.] Theregion 10quality 239.31 assurance commission is established. The commission consists of 239.32 at least 14 but not more than 21 members as follows: at least 239.33 three but not more than five members representing advocacy 239.34 organizations; at least three but not more than five members 239.35 representing consumers, families, and their legal 239.36 representatives; at least three but not more than five members 240.1 representing service providers; at least three but not more than 240.2 five members representing counties; and the commissioner of 240.3 human services or the commissioner's designee.Initial240.4membership of the commission shall be recruited and approved by240.5the region 10 stakeholders group. Prior to approving the240.6commission's membership, the stakeholders group shall provide to240.7the commissioner a list of the membership in the stakeholders240.8group, as of February 1, 1997, a brief summary of meetings held240.9by the group since July 1, 1996, and copies of any materials240.10prepared by the group for public distribution.The first 240.11 commission shall establish membership guidelines for the 240.12 transition and recruitment of membership for the commission's 240.13 ongoing existence. Members of the commission who do not receive 240.14 a salary or wages from an employer for time spent on commission 240.15 duties may receive a per diem payment when performing commission 240.16 duties and functions. All members may be reimbursed for 240.17 expenses related to commission activities. Notwithstanding the 240.18 provisions of section 15.059, subdivision 5, the commission 240.19 expires on June 30,20052007. 240.20 [EFFECTIVE DATE.] This section is effective July 1, 2003. 240.21 Sec. 35. Minnesota Statutes 2002, section 256B.0951, 240.22 subdivision 2, is amended to read: 240.23 Subd. 2. [AUTHORITY TO HIRE STAFF; CHARGE FEES; PROVIDE 240.24 TECHNICAL ASSISTANCE.] (a) The commission may hire staff to 240.25 perform the duties assigned in this section. 240.26 (b) The commission may charge fees for its services. 240.27 (c) The commission may provide technical assistance to 240.28 other counties, families, providers, and advocates interested in 240.29 participating in a quality assurance system under section 240.30 256B.095, paragraph (b) or (c). 240.31 [EFFECTIVE DATE.] This section is effective July 1, 2003. 240.32 Sec. 36. Minnesota Statutes 2002, section 256B.0951, 240.33 subdivision 3, is amended to read: 240.34 Subd. 3. [COMMISSION DUTIES.] (a) By October 1, 1997, the 240.35 commission, in cooperation with the commissioners of human 240.36 services and health, shall do the following: (1) approve an 241.1 alternative quality assurance licensing system based on the 241.2 evaluation of outcomes; (2) approve measurable outcomes in the 241.3 areas of health and safety, consumer evaluation, education and 241.4 training, providers, and systems that shall be evaluated during 241.5 the alternative licensing process; and (3) establish variable 241.6 licensure periods not to exceed three years based on outcomes 241.7 achieved. For purposes of this subdivision, "outcome" means the 241.8 behavior, action, or status of a person that can be observed or 241.9 measured and can be reliably and validly determined. 241.10 (b) By January 15, 1998, the commission shall approve, in 241.11 cooperation with the commissioner of human services, a training 241.12 program for members of the quality assurance teams established 241.13 under section 256B.0952, subdivision 4. 241.14 (c) The commission and the commissioner shall establish an 241.15 ongoing review process for the alternative quality assurance 241.16 licensing system. The review shall take into account the 241.17 comprehensive nature of the alternative system, which is 241.18 designed to evaluate the broad spectrum of licensed and 241.19 unlicensed entities that provide services to clients, as241.20compared to the current licensing system. 241.21 (d)The commission shall contract with an independent241.22entity to conduct a financial review of the alternative quality241.23assurance project. The review shall take into account the241.24comprehensive nature of the alternative system, which is241.25designed to evaluate the broad spectrum of licensed and241.26unlicensed entities that provide services to clients, as241.27compared to the current licensing system. The review shall241.28include an evaluation of possible budgetary savings within the241.29department of human services as a result of implementation of241.30the alternative quality assurance project. If a federal waiver241.31is approved under subdivision 7, the financial review shall also241.32evaluate possible savings within the department of health. This241.33review must be completed by December 15, 2000.241.34(e) The commission shall submit a report to the legislature241.35by January 15, 2001, on the results of the review process for241.36the alternative quality assurance project, a summary of the242.1results of the independent financial review, and a242.2recommendation on whether the project should be extended beyond242.3June 30, 2001.242.4(f)Thecommissionercommission, in consultation with 242.5 thecommissioncommissioner, shallexamine the feasibility of242.6expandingwork cooperatively with other populations to expand 242.7 theprojectsystem tootherthose populationsor geographic242.8areasand identify barriers to expansion. The commissioner 242.9 shall report findings and recommendations to the legislature by 242.10 December 15, 2004. 242.11 [EFFECTIVE DATE.] This section is effective July 1, 2003. 242.12 Sec. 37. Minnesota Statutes 2002, section 256B.0951, 242.13 subdivision 5, is amended to read: 242.14 Subd. 5. [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 242.15 safety standards, rights, or procedural protections under 242.16 sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 242.17 3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 242.18 and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 242.19 subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 242.20 procedures for the monitoring of psychotropic medications shall 242.21 not be varied under the alternativelicensingquality assurance 242.22 licensing systemproject. The commission may make 242.23 recommendations to the commissioners of human services and 242.24 health or to the legislature regarding alternatives to or 242.25 modifications of the rules and procedures referenced in this 242.26 subdivision. 242.27 [EFFECTIVE DATE.] This section is effective July 1, 2003. 242.28 Sec. 38. Minnesota Statutes 2002, section 256B.0951, 242.29 subdivision 7, is amended to read: 242.30 Subd. 7. [WAIVER OF RULES.] If a federal waiver is 242.31 approved under subdivision 8, the commissioner of health may 242.32 exempt residents of intermediate care facilities for persons 242.33 with mental retardation (ICFs/MR) who participate in the 242.34 alternative quality assuranceprojectsystem established in 242.35 section 256B.095 from the requirements of Minnesota Rules, 242.36 chapter 4665. 243.1 [EFFECTIVE DATE.] This section is effective July 1, 2003. 243.2 Sec. 39. Minnesota Statutes 2002, section 256B.0951, 243.3 subdivision 9, is amended to read: 243.4 Subd. 9. [EVALUATION.] The commission, in consultation 243.5 with the commissioner of human services, shall conduct an 243.6 evaluation of thealternativequality assurance system, and 243.7 present a report to the commissioner by June 30, 2004. 243.8 [EFFECTIVE DATE.] This section is effective July 1, 2003. 243.9 Sec. 40. Minnesota Statutes 2002, section 256B.0952, 243.10 subdivision 1, is amended to read: 243.11 Subdivision 1. [NOTIFICATION.]For each year of the243.12project, region 10Counties shall give notice to the commission 243.13 and commissioners of human services and healthby March 15of 243.14 intent to join thequality assurancealternative quality 243.15 assurance licensing system, effective July 1 of that year. A 243.16 county choosing to participate in the alternative quality 243.17 assurance licensing system commits to participateuntil June 30,243.182005. Counties participating in the quality assurance243.19alternative licensing system as of January 1, 2001, shall notify243.20the commission and the commissioners of human services and243.21health by March 15, 2001, of intent to continue participation.243.22Counties that elect to continue participation must participate243.23in the alternative licensing system until June 30, 2005for 243.24 three years. 243.25 [EFFECTIVE DATE.] This section is effective July 1, 2003. 243.26 Sec. 41. Minnesota Statutes 2002, section 256B.0953, 243.27 subdivision 2, is amended to read: 243.28 Subd. 2. [LICENSURE PERIODS.] (a) In order to be licensed 243.29 under the alternative quality assuranceprocesslicensing 243.30 system, a facility, program, or service must satisfy the health 243.31 and safety outcomes approved for thepilot projectalternative 243.32 quality assurance licensing system. 243.33 (b) Licensure shall be approved for periods of one to three 243.34 years for a facility, program, or service that satisfies the 243.35 requirements of paragraph (a) and achieves the outcome 243.36 measurements in the categories of consumer evaluation, education 244.1 and training, providers, and systems. 244.2 [EFFECTIVE DATE.] This section is effective July 1, 2003. 244.3 Sec. 42. Minnesota Statutes 2002, section 256B.0955, is 244.4 amended to read: 244.5 256B.0955 [DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.] 244.6 (a) Effective July 1, 1998, the commissioner of human 244.7 services shall delegate authority to perform licensing functions 244.8 and activities, in accordance with section 245A.16, to counties 244.9 participating in the alternative quality assurance licensing 244.10 system. The commissioner shall not license or reimburse a 244.11 facility, program, or service for persons with developmental 244.12 disabilities in a county that participates in the 244.13 alternative quality assurance licensing system if the 244.14 commissioner has received from the appropriate county 244.15 notification that the facility, program, or service has been 244.16 reviewed by a quality assurance team and has failed to qualify 244.17 for licensure. 244.18 (b) The commissioner may conduct random licensing 244.19 inspections based on outcomes adopted under section 256B.0951 at 244.20 facilities, programs, and services governed by the alternative 244.21 quality assurance licensing system. The role of such random 244.22 inspections shall be to verify that the alternative quality 244.23 assurance licensing system protects the safety and well-being of 244.24 consumers and maintains the availability of high-quality 244.25 services for persons with developmental disabilities. 244.26(c) The commissioner shall provide technical assistance and244.27support or training to the alternative licensing system pilot244.28project.244.29 [EFFECTIVE DATE.] This section is effective July 1, 2003. 244.30 Sec. 43. Minnesota Statutes 2002, section 256B.19, 244.31 subdivision 1, is amended to read: 244.32 Subdivision 1. [DIVISION OF COST.] The state and county 244.33 share of medical assistance costs not paid by federal funds 244.34 shall be as follows: 244.35 (1) beginning January 1, 1992, 50 percent state funds and 244.36 50 percent county funds for the cost of placement of severely 245.1 emotionally disturbed children in regional treatment centers; 245.2and245.3 (2) beginning January 1, 2003, 80 percent state funds and 245.4 20 percent county funds for the costs of nursing facility 245.5 placements of persons with disabilities under the age of 65 that 245.6 have exceeded 90 days. This clause shall be subject to chapter 245.7 256G and shall not apply to placements in facilities not 245.8 certified to participate in medical assistance.; 245.9 (3) beginning July 1, 2004, 80 percent state funds and 20 245.10 percent county funds for the costs of placements that have 245.11 exceeded 90 days in intermediate care facilities for persons 245.12 with mental retardation or a related condition that have seven 245.13 or more beds. This provision includes pass-through payments 245.14 made under section 256B.5015; and 245.15 (4) beginning July 1, 2004, when state funds are used to 245.16 pay for a nursing facility placement due to the facility's 245.17 status as an institution for mental diseases (IMD), the county 245.18 shall pay 20 percent of the nonfederal share of costs that have 245.19 exceeded 90 days. This clause is subject to chapter 256G. 245.20 For counties that participate in a Medicaid demonstration 245.21 project under sections 256B.69 and 256B.71, the division of the 245.22 nonfederal share of medical assistance expenses for payments 245.23 made to prepaid health plans or for payments made to health 245.24 maintenance organizations in the form of prepaid capitation 245.25 payments, this division of medical assistance expenses shall be 245.26 95 percent by the state and five percent by the county of 245.27 financial responsibility. 245.28 In counties where prepaid health plans are under contract 245.29 to the commissioner to provide services to medical assistance 245.30 recipients, the cost of court ordered treatment ordered without 245.31 consulting the prepaid health plan that does not include 245.32 diagnostic evaluation, recommendation, and referral for 245.33 treatment by the prepaid health plan is the responsibility of 245.34 the county of financial responsibility. 245.35 Sec. 44. Minnesota Statutes 2002, section 256B.47, 245.36 subdivision 2, is amended to read: 246.1 Subd. 2. [NOTICE TO RESIDENTS.] (a) No increase in nursing 246.2 facility rates for private paying residents shall be effective 246.3 unless the nursing facility notifies the resident or person 246.4 responsible for payment of the increase in writing 30 days 246.5 before the increase takes effect. 246.6 A nursing facility may adjust its rates without giving the 246.7 notice required by this subdivision when the purpose of the rate 246.8 adjustment is to reflect anecessarychange in thelevel of care246.9provided to acase-mix classification of the resident. If the 246.10 state fails to set rates as required by section 246.11 256B.431, subdivision 1, the time required for giving notice is 246.12 decreased by the number of days by which the state was late in 246.13 setting the rates. 246.14 (b) If the state does not set rates by the date required in 246.15 section 256B.431, subdivision 1, nursing facilities shall meet 246.16 the requirement for advance notice by informing the resident or 246.17 person responsible for payments, on or before the effective date 246.18 of the increase, that a rate increase will be effective on that 246.19 date. If the exact amount has not yet been determined, the 246.20 nursing facility may raise the rates by the amount anticipated 246.21 to be allowed. Any amounts collected from private pay residents 246.22 in excess of the allowable rate must be repaid to private pay 246.23 residents with interest at the rate used by the commissioner of 246.24 revenue for the late payment of taxes and in effect on the date 246.25 the rate increase is effective. 246.26 Sec. 45. Minnesota Statutes 2002, section 256B.47, 246.27 subdivision 2, is amended to read: 246.28 Subd. 2. [NOTICE TO RESIDENTS.] (a) No increase in nursing 246.29 facility rates for private paying residents shall be effective 246.30 unless the nursing facility notifies the resident or person 246.31 responsible for payment of the increase in writing 30 days 246.32 before the increase takes effect. 246.33 A nursing facility may adjust its rates without giving the 246.34 notice required by this subdivision when the purpose of the rate 246.35 adjustment is to reflect anecessarychange in thelevel of care246.36provided to acase-mix classification of the resident. If the 247.1 state fails to set rates as required by section 247.2 256B.431, subdivision 1, the time required for giving notice is 247.3 decreased by the number of days by which the state was late in 247.4 setting the rates. 247.5 (b) If the state does not set rates by the date required in 247.6 section 256B.431, subdivision 1, nursing facilities shall meet 247.7 the requirement for advance notice by informing the resident or 247.8 person responsible for payments, on or before the effective date 247.9 of the increase, that a rate increase will be effective on that 247.10 date. If the exact amount has not yet been determined, the 247.11 nursing facility may raise the rates by the amount anticipated 247.12 to be allowed. Any amounts collected from private pay residents 247.13 in excess of the allowable rate must be repaid to private pay 247.14 residents with interest at the rate used by the commissioner of 247.15 revenue for the late payment of taxes and in effect on the date 247.16 the rate increase is effective. 247.17 Sec. 46. Minnesota Statutes 2002, section 256B.49, 247.18 subdivision 15, is amended to read: 247.19 Subd. 15. [INDIVIDUALIZED SERVICE PLAN.] (a) Each 247.20 recipient of home and community-based waivered services shall be 247.21 provided a copy of the written service plan which: 247.22 (1) is developed and signed by the recipient within ten 247.23 working days of the completion of the assessment; 247.24 (2) meets the assessed needs of the recipient; 247.25 (3) reasonably ensures the health and safety of the 247.26 recipient; 247.27 (4) promotes independence; 247.28 (5) allows for services to be provided in the most 247.29 integrated settings; and 247.30 (6) provides for an informed choice, as defined in section 247.31 256B.77, subdivision 2, paragraph (p), of service and support 247.32 providers. 247.33 (b) When a county is evaluating denials, reductions, or 247.34 terminations of home and community-based services under section 247.35 256B.49 for an individual, the case manager shall offer to meet 247.36 with the individual or the individual's guardian in order to 248.1 discuss the prioritization of service needs within the 248.2 individualized service plan. The reduction in the authorized 248.3 services for an individual due to changes in funding for 248.4 waivered services may not exceed the amount needed to ensure 248.5 medically necessary services to meet the individual's health, 248.6 safety, and welfare. 248.7 Sec. 47. Minnesota Statutes 2002, section 256B.501, 248.8 subdivision 1, is amended to read: 248.9 Subdivision 1. [DEFINITIONS.] For the purposes of this 248.10 section, the following terms have the meaning given them. 248.11 (a) "Commissioner" means the commissioner of human services. 248.12 (b) "Facility" means a facility licensed as a mental 248.13 retardation residential facility under section 252.28, licensed 248.14 as a supervised living facility under chapter 144, and certified 248.15 as an intermediate care facility for persons with mental 248.16 retardation or related conditions. The term does not include a 248.17 state regional treatment center. 248.18 (c) "Habilitation services" means health and social 248.19 services directed toward increasing and maintaining the 248.20 physical, intellectual, emotional, and social functioning of 248.21 persons with mental retardation or related conditions. 248.22 Habilitation services include therapeutic activities, 248.23 assistance, training, supervision, and monitoring in the areas 248.24 of self-care, sensory and motor development, interpersonal 248.25 skills, communication, socialization, reduction or elimination 248.26 of maladaptive behavior, community living and mobility, health 248.27 care, leisure and recreation, money management, and household 248.28 chores. 248.29 (d) "Services during the day" means services or supports 248.30 provided to a person that enables the person to be fully 248.31 integrated into the community. Services during the day must 248.32 include habilitation services, and may include a variety of 248.33 supports to enable the person to exercise choices for community 248.34 integration and inclusion activities. Services during the day 248.35 may include, but are not limited to: supported work, support 248.36 during community activities, community volunteer opportunities, 249.1 adult day care, recreational activities, and other 249.2 individualized integrated supports. 249.3 (e) "Waivered service" means home or community-based 249.4 service authorized under United States Code, title 42, section 249.5 1396n(c), as amended through December 31, 1987, and defined in 249.6 the Minnesota state plan for the provision of medical assistance 249.7 services. Waivered services include, at a minimum, case 249.8 management, family training and support, developmental training 249.9 homes, supervised living arrangements, semi-independent living 249.10 services, respite care, and training and habilitation services. 249.11 Sec. 48. Minnesota Statutes 2002, section 256B.501, is 249.12 amended by adding a subdivision to read: 249.13 Subd. 3m. [SERVICES DURING THE DAY.] When establishing a 249.14 rate for services during the day, the commissioner shall ensure 249.15 that these services comply with active treatment requirements 249.16 for persons residing in an ICF/MR as defined under federal 249.17 regulations and shall ensure that services during the day for 249.18 eligible persons are not provided by the person's residential 249.19 service provider, unless the person or the person's legal 249.20 representative is offered a choice of providers and agrees in 249.21 writing to provision of services during the day by the 249.22 residential service provider, consistent with the individual 249.23 service plan. The individual service plan for individuals who 249.24 choose to have their residential service provider provide their 249.25 services during the day must describe how health, safety, 249.26 protection, and habilitation needs will be met, including how 249.27 frequent and regular contact with persons other than the 249.28 residential service provider will occur. The individualized 249.29 service plan must address the provision of services during the 249.30 day outside the residence. 249.31 Sec. 49. Minnesota Statutes 2002, section 256B.5013, is 249.32 amended by adding a subdivision to read: 249.33 Subd. 7. [RATE ADJUSTMENTS FOR SHORT-TERM ADMISSIONS FOR 249.34 CRISIS OR SPECIALIZED MEDICAL CARE.] Beginning July 1, 2003, the 249.35 commissioner may designate up to 25 beds in ICF/MR facilities 249.36 statewide for short-term admissions due to crisis care needs or 250.1 care for medically fragile individuals. The commissioner shall 250.2 adjust the monthly facility rate to provide payment for 250.3 vacancies in designated short-term beds by an amount equal to 250.4 the rate for each recipient residing in a designated bed for up 250.5 to 15 days per bed per month. The commissioner may designate 250.6 short-term beds in ICF/MR facilities based on the short-term 250.7 care needs of a region or county as provided in section 252.28. 250.8 Nothing in this section shall be construed as limiting payments 250.9 for short-term admissions of eligible recipients to an ICF/MR 250.10 that is not designated for short-term admissions for crisis or 250.11 specialized medical care under this subdivision and does not 250.12 receive a temporary rate adjustment. 250.13 Sec. 50. Minnesota Statutes 2002, section 256B.5015, is 250.14 amended to read: 250.15 256B.5015 [PASS-THROUGH OFTRAINING AND HABILITATIONOTHER 250.16 SERVICES COSTS.] 250.17 Subdivision 1. [DAY TRAINING AND HABILITATION SERVICES.] 250.18 Day training and habilitation services costs shall be paid as a 250.19 pass-through payment at the lowest rate paid for the comparable 250.20 services at that site under sections 252.40 to 252.46. The 250.21 pass-through payments for training and habilitation services 250.22 shall be paid separately by the commissioner and shall not be 250.23 included in the computation of the ICF/MR facility total payment 250.24 rate. 250.25 Subd. 2. [SERVICES DURING THE DAY.] Services during the 250.26 day, as defined in section 256B.501, but excluding day training 250.27 and habilitation services, shall be paid as a pass-through 250.28 payment no later than January 1, 2004. The commissioner shall 250.29 establish rates for these services, other than day training and 250.30 habilitation services, at levels that do not exceed 75 percent 250.31 of a recipient's day training and habilitation service costs 250.32 prior to the service change. 250.33 When establishing a rate for these services, the 250.34 commissioner shall also consider an individual recipient's needs 250.35 as identified in the individualized service plan and the 250.36 person's need for active treatment as defined under federal 251.1 regulations. The pass-through payments for services during the 251.2 day shall be paid separately by the commissioner and shall not 251.3 be included in the computation of the ICF/MR facility total 251.4 payment rate. 251.5 Sec. 51. Minnesota Statutes 2002, section 256B.82, is 251.6 amended to read: 251.7 256B.82 [PREPAID PLANS AND MENTAL HEALTH REHABILITATIVE 251.8 SERVICES.] 251.9 Medical assistance and MinnesotaCare prepaid health plans 251.10 may include coverage for adult mental health rehabilitative 251.11 services under section 256B.0623, intensive rehabilitative 251.12 services under section 256B.0622, and adult mental health crisis 251.13 response services under section 256B.0624, beginning January 1, 251.1420042005. 251.15 By January 15,20032004, the commissioner shall report to 251.16 the legislature how these services should be included in prepaid 251.17 plans. The commissioner shall consult with mental health 251.18 advocates, health plans, and counties in developing this 251.19 report. The report recommendations must include a plan to 251.20 ensure coordination of these services between health plans and 251.21 counties, assure recipient access to essential community 251.22 providers, and monitor the health plans' delivery of services 251.23 through utilization review and quality standards. 251.24 Sec. 52. [256I.08] [COUNTY SHARE FOR CERTAIN NURSING 251.25 FACILITY STAYS.] 251.26 Beginning July 1, 2004, if group residential housing is 251.27 used to pay for a nursing facility placement due to the 251.28 facility's status as an Institution for Mental Diseases, the 251.29 county is liable for 20 percent of the nonfederal share of costs 251.30 for persons under the age of 65 that have exceeded 90 days. 251.31 Sec. 53. [CASE MANAGEMENT ACCESS FOR PERSONS SEEKING 251.32 COMMUNITY-BASED SERVICES.] 251.33 When a person requests services authorized under Minnesota 251.34 Statutes, section 256B.0621, 256B.092, or 256B.49, subdivision 251.35 13, the county must determine whether the person qualifies, 251.36 begin the screening process, begin individualized service plan 252.1 development, and provide mandated case management services or 252.2 relocation service coordination to those eligible within a 252.3 reasonable time. If a county is unable to provide case 252.4 management services within the required time period under 252.5 Minnesota Statutes, sections 256B.0621, subdivision 7; 256B.49, 252.6 subdivision 13; and Minnesota Rules, parts 9525.0004 to 252.7 9525.0036, the county shall contract for case management 252.8 services to meet the obligation. 252.9 Sec. 54. [CASE MANAGEMENT SERVICES REDESIGN.] 252.10 The commissioner shall report to the legislature on the 252.11 redesign of case management services. In preparing the report, 252.12 the commissioner shall consult with representatives for 252.13 consumers, consumer advocates, counties, and service providers. 252.14 The report shall include draft legislation for case management 252.15 changes that will (1) streamline administration, (2) improve 252.16 consumer access to case management services, (3) address the use 252.17 of a comprehensive universal assessment protocol for persons 252.18 seeking community supports, (4) establish case management 252.19 performance measures, (5) provide for consumer choice of the 252.20 case management service vendor, and (6) provide a method of 252.21 payment for case management services that is cost-effective and 252.22 best supports the draft legislation in clauses (1) to (5). The 252.23 proposed legislation shall be provided to the legislative 252.24 committees with jurisdiction over health and human services 252.25 issues by January 15, 2005. 252.26 Sec. 55. [VACANCY LISTINGS.] 252.27 The commissioner of human services shall work with 252.28 interested stakeholders on how provider and industry specific 252.29 Web sites can provide useful information to consumers on bed 252.30 vacancies for group residential housing providers and 252.31 intermediate care facilities for persons with mental retardation 252.32 and related conditions. Providers and industry trade 252.33 organizations are responsible for all costs related to 252.34 maintaining Web sites listing bed vacancies. 252.35 Sec. 56. [HOMELESS SERVICES; STATE CONTRACTS.] 252.36 The commissioner of human services may contract directly 253.1 with nonprofit organizations providing homeless services in two 253.2 or more counties. 253.3 Sec. 57. [GOVERNOR'S COUNCIL ON DEVELOPMENTAL DISABILITY, 253.4 OMBUDSMAN FOR MENTAL HEALTH AND MENTAL RETARDATION, AND COUNCIL 253.5 ON DISABILITIES.] 253.6 The governor's council on developmental disability under 253.7 Minnesota Statutes, section 16B.053, the ombudsman for mental 253.8 health and mental retardation under Minnesota Statutes, section 253.9 245.92, the centers for independent living, and the council on 253.10 disability under Minnesota Statutes, section 256.482, must study 253.11 the feasibility of reducing costs and increasing effectiveness 253.12 through (1) space coordination, (2) shared use of technology, 253.13 (3) coordination of resource priorities, and (4) consolidation 253.14 and make recommendations to the house and senate committees with 253.15 jurisdiction over these entities by January 15, 2004. 253.16 Sec. 58. [LICENSING CHANGE.] 253.17 Notwithstanding Minnesota Statutes, sections 245A.11 and 253.18 252.291, the commissioner of human services shall allow an 253.19 existing intermediate care facility for persons with mental 253.20 retardation or related conditions located in Goodhue county 253.21 serving 39 children to be converted to four separately licensed 253.22 or certified cottages serving up to six children each. 253.23 Sec. 59. [REVISOR'S INSTRUCTION.] 253.24 For sections in Minnesota Statutes and Minnesota Rules 253.25 affected by the repealed sections in this article, the revisor 253.26 shall delete internal cross-references where appropriate and 253.27 make changes necessary to correct the punctuation, grammar, or 253.28 structure of the remaining text and preserve its meaning. 253.29 Sec. 60. [REPEALER.] 253.30 (a) Minnesota Statutes 2002, sections 252.32, subdivision 253.31 2; and 256B.5013, subdivision 4, are repealed July 1, 2003. 253.32 (b) Laws 2001, First Special Session chapter 9, article 13, 253.33 section 24, is repealed July 1, 2003. 253.34 ARTICLE 4 253.35 CHILDREN'S SERVICES 253.36 Section 1. Minnesota Statutes 2002, section 124D.23, 254.1 subdivision 1, is amended to read: 254.2 Subdivision 1. [ESTABLISHMENT.] (a) In order to qualify as 254.3 a family services collaborative, a minimum of one school 254.4 district, one county, one public health entity, one community 254.5 action agency as defined in section 119A.375, and one Head Start 254.6 grantee if the community action agency is not the designated 254.7 federal grantee for the Head Start program must agree in writing 254.8 to provide coordinated family services and commit resources to 254.9 an integrated fund. Collaboratives are expected to have broad 254.10 community representation, which may include other local 254.11 providers, including additional school districts, counties, and 254.12 public health entities, other municipalities, public libraries, 254.13 existing culturally specific community organizations, tribal 254.14 entities, local health organizations, private and nonprofit 254.15 service providers, child care providers, local foundations, 254.16 community-based service groups, businesses, local transit 254.17 authorities or other transportation providers, community action 254.18 agencies under section 119A.375, senior citizen volunteer 254.19 organizations, parent organizations, parents, and sectarian 254.20 organizations that provide nonsectarian services. 254.21 (b) Members of the governing bodies of political 254.22 subdivisions involved in the establishment of a family services 254.23 collaborative shall select representatives of the 254.24 nongovernmental entities listed in paragraph (a) to serve on the 254.25 governing board of a collaborative. The governing body members 254.26 of the political subdivisions shall select one or more 254.27 representatives of the nongovernmental entities within the 254.28 family service collaborative. 254.29 (c) Two or more family services collaboratives or 254.30 children's mental health collaboratives may consolidate 254.31 decision-making, pool resources, and collectively act on behalf 254.32 of the individual collaboratives, based on a written agreement 254.33 among the participating collaboratives. 254.34 Sec. 2. Minnesota Statutes 2002, section 245.4874, is 254.35 amended to read: 254.36 245.4874 [DUTIES OF COUNTY BOARD.] 255.1 The county board in each county shall use its share of 255.2 mental health and Community Social Services Act funds allocated 255.3 by the commissioner according to a biennial children's mental 255.4 health component of the community social services plan required 255.5 under section 245.4888, and approved by the commissioner. The 255.6 county board must: 255.7 (1) develop a system of affordable and locally available 255.8 children's mental health services according to sections 245.487 255.9 to 245.4888; 255.10 (2) establish a mechanism providing for interagency 255.11 coordination as specified in section 245.4875, subdivision 6; 255.12 (3) develop a biennial children's mental health component 255.13 of the community social services plan required under section 255.14 256E.09 which considers the assessment of unmet needs in the 255.15 county as reported by the local children's mental health 255.16 advisory council under section 245.4875, subdivision 5, 255.17 paragraph (b), clause (3). The county shall provide, upon 255.18 request of the local children's mental health advisory council, 255.19 readily available data to assist in the determination of unmet 255.20 needs; 255.21 (4) assure that parents and providers in the county receive 255.22 information about how to gain access to services provided 255.23 according to sections 245.487 to 245.4888; 255.24 (5) coordinate the delivery of children's mental health 255.25 services with services provided by social services, education, 255.26 corrections, health, and vocational agencies to improve the 255.27 availability of mental health services to children and the 255.28 cost-effectiveness of their delivery; 255.29 (6) assure that mental health services delivered according 255.30 to sections 245.487 to 245.4888 are delivered expeditiously and 255.31 are appropriate to the child's diagnostic assessment and 255.32 individual treatment plan; 255.33 (7) provide the community with information about predictors 255.34 and symptoms of emotional disturbances and how to access 255.35 children's mental health services according to sections 245.4877 255.36 and 245.4878; 256.1 (8) provide for case management services to each child with 256.2 severe emotional disturbance according to sections 245.486; 256.3 245.4871, subdivisions 3 and 4; and 245.4881, subdivisions 1, 3, 256.4 and 5; 256.5 (9) provide for screening of each child under section 256.6 245.4885 upon admission to a residential treatment facility, 256.7 acute care hospital inpatient treatment, or informal admission 256.8 to a regional treatment center; 256.9 (10) prudently administer grants and purchase-of-service 256.10 contracts that the county board determines are necessary to 256.11 fulfill its responsibilities under sections 245.487 to 245.4888; 256.12 (11) assure that mental health professionals, mental health 256.13 practitioners, and case managers employed by or under contract 256.14 to the county to provide mental health services are qualified 256.15 under section 245.4871; 256.16 (12) assure that children's mental health services are 256.17 coordinated with adult mental health services specified in 256.18 sections 245.461 to 245.486 so that a continuum of mental health 256.19 services is available to serve persons with mental illness, 256.20 regardless of the person's age;and256.21 (13) assure that culturally informed mental health 256.22 consultants are used as necessary to assist the county board in 256.23 assessing and providing appropriate treatment for children of 256.24 cultural or racial minority heritage; and 256.25 (14) arrange for or provide a children's mental health 256.26 screening to a child receiving child protective services or a 256.27 child in out-of-home placement, a child for whom parental rights 256.28 have been terminated, a child found to be delinquent, and a 256.29 child found to have committed a juvenile petty offense for the 256.30 third or subsequent time, unless a screening has been performed 256.31 within the previous 180 days, or the child is currently under 256.32 the care of a mental health professional. The court or county 256.33 agency must notify a parent or guardian whose parental rights 256.34 have not been terminated of the potential mental health 256.35 screening and the option to prevent the screening by notifying 256.36 the court or county agency in writing. The screening shall be 257.1 conducted with a screening instrument approved by the 257.2 commissioner of human services according to criteria that are 257.3 updated and issued annually to ensure that approved screening 257.4 instruments are valid and useful for child welfare and juvenile 257.5 justice populations, and shall be conducted by a mental health 257.6 practitioner as defined in section 245.4871, subdivision 26, or 257.7 a probation officer or local social services agency staff person 257.8 who is trained in the use of the screening instrument. Training 257.9 in the use of the instrument shall include training in the 257.10 administration of the instrument, the interpretation of its 257.11 validity given the child's current circumstances, the state and 257.12 federal data practices laws and confidentiality standards, the 257.13 parental consent requirement, and providing respect for families 257.14 and cultural values. If the screen indicates a need for 257.15 assessment, the child's family, or if the family lacks mental 257.16 health insurance, the local social services agency, in 257.17 consultation with the child's family, shall have conducted a 257.18 diagnostic assessment, including a functional assessment, as 257.19 defined in section 245.4871. The administration of the 257.20 screening shall safeguard the privacy of children receiving the 257.21 screening and their families and shall comply with the Minnesota 257.22 Government Data Practices Act, chapter 13, and the federal 257.23 Health Insurance Portability and Accountability Act of 1996, 257.24 Public Law 104-191. Screening results shall be considered 257.25 private data and the commissioner shall not collect individual 257.26 screening results. 257.27 [EFFECTIVE DATE.] This section is effective July 1, 2004. 257.28 Sec. 3. Minnesota Statutes 2002, section 245.493, 257.29 subdivision 1a, is amended to read: 257.30 Subd. 1a. [DUTIES OF CERTAIN COORDINATING BODIES.] (a) By 257.31 mutual agreement of the collaborative and a coordinating body 257.32 listed in this subdivision, a children's mental health 257.33 collaborative or a collaborative established by the merger of a 257.34 children's mental health collaborative and a family services 257.35 collaborative under section 124D.23, may assume the duties of a 257.36 community transition interagency committee established under 258.1 section 125A.22; an interagency early intervention committee 258.2 established under section 125A.30; a local advisory council 258.3 established under section 245.4875, subdivision 5; or a local 258.4 coordinating council established under section 245.4875, 258.5 subdivision 6. 258.6 (b) Two or more family services collaboratives or 258.7 children's mental health collaboratives may consolidate 258.8 decision-making, pool resources, and collectively act on behalf 258.9 of the individual collaboratives, based on a written agreement 258.10 among the participating collaboratives. 258.11 Sec. 4. Minnesota Statutes 2002, section 256B.0625, 258.12 subdivision 23, is amended to read: 258.13 Subd. 23. [DAY TREATMENT SERVICES.] Medical assistance 258.14 covers day treatment services as specified in sections 245.462, 258.15 subdivision 8, and 245.4871, subdivision 10, that are provided 258.16 under contract with the county board. Notwithstanding Minnesota 258.17 Rules, part 9505.0323, subpart 15, the commissioner may set 258.18 authorization thresholds for day treatment for adults according 258.19 to section 256B.0625, subdivision 25. Effective July 1, 2004, 258.20 medical assistance covers day treatment services for children as 258.21 specified under section 256B.0943. 258.22 Sec. 5. Minnesota Statutes 2002, section 256B.0625, is 258.23 amended by adding a subdivision to read: 258.24 Subd. 35a. [CHILDREN'S MENTAL HEALTH CRISIS RESPONSE 258.25 SERVICES.] Medical assistance covers children's mental health 258.26 crisis response services according to section 256B.0944. 258.27 [EFFECTIVE DATE.] This section is effective July 1, 2004. 258.28 Sec. 6. Minnesota Statutes 2002, section 256B.0625, is 258.29 amended by adding a subdivision to read: 258.30 Subd. 35b. [CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.] 258.31 Medical assistance covers children's therapeutic services and 258.32 supports according to section 256B.0943. 258.33 [EFFECTIVE DATE.] This section is effective July 1, 2004. 258.34 Sec. 7. Minnesota Statutes 2002, section 256B.0625, is 258.35 amended by adding a subdivision to read: 258.36 Subd. 45. [SUBACUTE PSYCHIATRIC CARE FOR PERSONS UNDER 21 259.1 YEARS OF AGE.] Medical assistance covers subacute psychiatric 259.2 care for person under 21 years of age when: 259.3 (1) the services meet the requirements of Code of Federal 259.4 Regulations, title 42, section 440.160; 259.5 (2) the facility is accredited as a psychiatric treatment 259.6 facility by the joint commission on accreditation of healthcare 259.7 organizations, the commission on accreditation of rehabilitation 259.8 facilities, or the council on accreditation; and 259.9 (3) the facility is licensed by the commissioner of health 259.10 under section 144.50. 259.11 [EFFECTIVE DATE.] This section is effective July 1, 2003. 259.12 Sec. 8. [256B.0943] [CHILDREN'S THERAPEUTIC SERVICES AND 259.13 SUPPORTS.] 259.14 Subdivision 1. [DEFINITIONS.] For purposes of this 259.15 section, the following terms have the meanings given them. 259.16 (a) "Children's therapeutic services and supports" means 259.17 the flexible package of mental health services for children who 259.18 require varying therapeutic and rehabilitative levels of 259.19 intervention. The services are time-limited interventions that 259.20 are delivered using various treatment modalities and 259.21 combinations of services designed to reach treatment outcomes 259.22 identified in the individual treatment plan. 259.23 (b) "Clinical supervision" means the overall responsibility 259.24 of the mental health professional for the control and direction 259.25 of individualized treatment planning, service delivery, and 259.26 treatment review for each client. A mental health professional 259.27 who is an enrolled Minnesota health care program provider 259.28 accepts full professional responsibility for a supervisee's 259.29 actions and decisions, instructs the supervisee in the 259.30 supervisee's work, and oversees or directs the supervisee's work. 259.31 (c) "County board" means the county board of commissioners 259.32 or board established under sections 402.01 to 402.10 or 471.59. 259.33 (d) "Crisis assistance" has the meaning given in section 259.34 245.4871, subdivision 9a. 259.35 (e) "Culturally competent provider" means a provider who 259.36 understands and can utilize to a client's benefit the client's 260.1 culture when providing services to the client. A provider may 260.2 be culturally competent because the provider is of the same 260.3 cultural or ethnic group as the client or the provider has 260.4 developed the knowledge and skills through training and 260.5 experience to provide services to culturally diverse clients. 260.6 (f) "Day treatment program" for children means a site-based 260.7 structured program consisting of group psychotherapy for more 260.8 than three individuals and other intensive therapeutic services 260.9 provided by a multidisciplinary team, under the clinical 260.10 supervision of a mental health professional. 260.11 (g) "Diagnostic assessment" has the meaning given in 260.12 section 245.4871, subdivision 11. 260.13 (h) "Direct service time" means the time that a mental 260.14 health professional, mental health practitioner, or mental 260.15 health behavioral aide spends face-to-face with a client and the 260.16 client's family. Direct service time includes time in which the 260.17 provider obtains a client's history or provides service 260.18 components of children's therapeutic services and supports. 260.19 Direct service time does not include time doing work before and 260.20 after providing direct services, including scheduling, 260.21 maintaining clinical records, consulting with others about the 260.22 client's mental health status, preparing reports, receiving 260.23 clinical supervision directly related to the client's 260.24 psychotherapy session, and revising the client's individual 260.25 treatment plan. 260.26 (i) "Direction of mental health behavioral aide" means the 260.27 activities of a mental health professional or mental health 260.28 practitioner in guiding the mental health behavioral aide in 260.29 providing services to a client. The direction of a mental 260.30 health behavioral aide must be based on the client's 260.31 individualized treatment plan and meet the requirements in 260.32 subdivision 6, paragraph (b), clause (5). 260.33 (j) "Emotional disturbance" has the meaning given in 260.34 section 245.4871, subdivision 15. For persons at least age 18 260.35 but under age 21, mental illness has the meaning given in 260.36 section 245.462, subdivision 20, paragraph (a). 261.1 (k) "Individual behavioral plan" means a plan of 261.2 intervention, treatment, and services for a child written by a 261.3 mental health professional or mental health practitioner, under 261.4 the clinical supervision of a mental health professional, to 261.5 guide the work of the mental health behavioral aide. 261.6 (l) "Individual treatment plan" has the meaning given in 261.7 section 245.4871, subdivision 21. 261.8 (m) "Mental health professional" means an individual as 261.9 defined in section 245.4871, subdivision 27, clauses (1) to (5), 261.10 or tribal vendor as defined in section 256B.02, subdivision 7, 261.11 paragraph (b). 261.12 (n) "Preschool program" means a day program licensed under 261.13 Minnesota Rules, parts 9503.0005 to 9503.0175, and enrolled as a 261.14 children's therapeutic services and supports provider to provide 261.15 a structured treatment program to a child who is at least 33 261.16 months old but who has not yet attended the first day of 261.17 kindergarten. 261.18 (o) "Skills training" means individual, family, or group 261.19 training designed to improve the basic functioning of the child 261.20 with emotional disturbance and the child's family in the 261.21 activities of daily living and community living, and to improve 261.22 the social functioning of the child and the child's family in 261.23 areas important to the child's maintaining or reestablishing 261.24 residency in the community. Individual, family, and group 261.25 skills training must: 261.26 (1) consist of activities designed to promote skill 261.27 development of the child and the child's family in the use of 261.28 age-appropriate daily living skills, interpersonal and family 261.29 relationships, and leisure and recreational services; 261.30 (2) consist of activities that will assist the family's 261.31 understanding of normal child development and to use parenting 261.32 skills that will help the child with emotional disturbance 261.33 achieve the goals outlined in the child's individual treatment 261.34 plan; and 261.35 (3) promote family preservation and unification, promote 261.36 the family's integration with the community, and reduce the use 262.1 of unnecessary out-of-home placement or institutionalization of 262.2 children with emotional disturbance. 262.3 Subd. 2. [COVERED SERVICE COMPONENTS OF CHILDREN'S 262.4 THERAPEUTIC SERVICES AND SUPPORTS.] (a) Subject to federal 262.5 approval, medical assistance covers medically necessary 262.6 children's therapeutic services and supports as defined in this 262.7 section that an eligible provider entity under subdivisions 4 262.8 and 5 provides to a client eligible under subdivision 3. 262.9 (b) The service components of children's therapeutic 262.10 services and supports are: 262.11 (1) individual, family, and group psychotherapy; 262.12 (2) individual, family, or group skills training provided 262.13 by a mental health professional or mental health practitioner; 262.14 (3) crisis assistance; 262.15 (4) mental health behavioral aide services; and 262.16 (5) direction of a mental health behavioral aide. 262.17 (c) Service components may be combined to constitute 262.18 therapeutic programs, including day treatment programs and 262.19 preschool programs. Although day treatment and preschool 262.20 programs have specific client and provider eligibility 262.21 requirements, medical assistance only pays for the service 262.22 components listed in paragraph (b). 262.23 Subd. 3. [DETERMINATION OF CLIENT ELIGIBILITY.] A client's 262.24 eligibility to receive children's therapeutic services and 262.25 supports under this section shall be determined based on a 262.26 diagnostic assessment by a mental health professional that is 262.27 performed within 180 days of the initial start of service. The 262.28 diagnostic assessment must: 262.29 (1) include current diagnoses on all five axes of the 262.30 client's current mental health status; 262.31 (2) determine whether a child under age 18 has a diagnosis 262.32 of emotional disturbance or, if the person is between the ages 262.33 of 18 and 21, whether the person has a mental illness; 262.34 (3) document children's therapeutic services and supports 262.35 as medically necessary to address an identified disability, 262.36 functional impairment, and the individual client's needs and 263.1 goals; 263.2 (4) be used in the development of the individualized 263.3 treatment plan; and 263.4 (5) be completed annually until age 18. For individuals 263.5 between age 18 and 21, unless a client's mental health condition 263.6 has changed markedly since the client's most recent diagnostic 263.7 assessment, annual updating is necessary. For the purpose of 263.8 this section, "updating" means a written summary, including 263.9 current diagnoses on all five axes, by a mental health 263.10 professional of the client's current mental health status and 263.11 service needs. 263.12 Subd. 4. [PROVIDER ENTITY CERTIFICATION.] (a) Effective 263.13 July 1, 2003, the commissioner shall establish an initial 263.14 provider entity application and certification process and 263.15 recertification process to determine whether a provider entity 263.16 has an administrative and clinical infrastructure that meets the 263.17 requirements in subdivisions 5 and 6. The commissioner shall 263.18 recertify a provider entity at least every three years. The 263.19 commissioner shall establish a process for decertification of a 263.20 provider entity that no longer meets the requirements in this 263.21 section. The county, tribe, and the commissioner shall be 263.22 mutually responsible and accountable for the county's, tribe's, 263.23 and state's part of the certification, recertification, and 263.24 decertification processes. 263.25 (b) For purposes of this section, a provider entity must be: 263.26 (1) an Indian health services facility or a facility owned 263.27 and operated by a tribe or tribal organization operating as a 263.28 638 facility under Public Law 93-368 certified by the state; 263.29 (2) a county-operated entity certified by the state; or 263.30 (3) a noncounty entity recommended for certification by the 263.31 provider's host county and certified by the state. 263.32 Subd. 5. [PROVIDER ENTITY ADMINISTRATIVE INFRASTRUCTURE 263.33 REQUIREMENTS.] (a) To be an eligible provider entity under this 263.34 section, a provider entity must have an administrative 263.35 infrastructure that establishes authority and accountability for 263.36 decision making and oversight of functions, including finance, 264.1 personnel, system management, clinical practice, and performance 264.2 measurement. The provider must have written policies and 264.3 procedures that it reviews and updates every three years and 264.4 distributes to staff initially and upon each subsequent update. 264.5 (b) The administrative infrastructure written policies and 264.6 procedures must include: 264.7 (1) personnel procedures, including a process for: (i) 264.8 recruiting, hiring, training, and retention of culturally and 264.9 linguistically competent providers; (ii) conducting a criminal 264.10 background check on all direct service providers and volunteers; 264.11 (iii) investigating, reporting, and acting on violations of 264.12 ethical conduct standards; (iv) investigating, reporting, and 264.13 acting on violations of data privacy policies that are compliant 264.14 with federal and state laws; (v) utilizing volunteers, including 264.15 screening applicants, training and supervising volunteers, and 264.16 providing liability coverage for volunteers; and (vi) 264.17 documenting that a mental health professional, mental health 264.18 practitioner, or mental health behavioral aide meets the 264.19 applicable provider qualification criteria, training criteria 264.20 under subdivision 8, and clinical supervision or direction of a 264.21 mental health behavioral aide requirements under subdivision 6; 264.22 (2) fiscal procedures, including internal fiscal control 264.23 practices and a process for collecting revenue that is compliant 264.24 with federal and state laws; 264.25 (3) if a client is receiving services from a case manager 264.26 or other provider entity, a service coordination process that 264.27 ensures services are provided in the most appropriate manner to 264.28 achieve maximum benefit to the client. The provider entity must 264.29 ensure coordination and nonduplication of services consistent 264.30 with county board coordination procedures established under 264.31 section 245.4881, subdivision 5; 264.32 (4) a performance measurement system, including monitoring 264.33 to determine cultural appropriateness of services identified in 264.34 the individual treatment plan, as determined by the client's 264.35 culture, beliefs, values, and language, and family-driven 264.36 services; and 265.1 (5) a process to establish and maintain individual client 265.2 records. The client's records must include: (i) the client's 265.3 personal information; (ii) forms applicable to data privacy; 265.4 (iii) the client's diagnostic assessment, updates, tests, 265.5 individual treatment plan, and individual behavior plan, if 265.6 necessary; (iv) documentation of service delivery as specified 265.7 under subdivision 6; (v) telephone contacts; (vi) discharge 265.8 plan; and (vii) if applicable, insurance information. 265.9 Subd. 6. [PROVIDER ENTITY CLINICAL INFRASTRUCTURE 265.10 REQUIREMENTS.] (a) To be an eligible provider entity under this 265.11 section, a provider entity must have a clinical infrastructure 265.12 that utilizes diagnostic assessment, an individualized treatment 265.13 plan, service delivery, and individual treatment plan review 265.14 that are culturally competent, child-centered, and family-driven 265.15 to achieve maximum benefit for the client. The provider entity 265.16 must review and update the clinical policies and procedures 265.17 every three years and must distribute the policies and 265.18 procedures to staff initially and upon each subsequent update. 265.19 (b) The clinical infrastructure written policies and 265.20 procedures must include policies and procedures for: 265.21 (1) providing or obtaining a client's diagnostic assessment 265.22 that identifies acute and chronic clinical disorders, 265.23 co-occurring medical conditions, sources of psychological and 265.24 environmental problems, and a functional assessment. The 265.25 functional assessment must clearly summarize the client's 265.26 individual strengths and needs; 265.27 (2) developing an individual treatment plan that is: (i) 265.28 based on the information in the client's diagnostic assessment; 265.29 (ii) developed no later than the end of the first psychotherapy 265.30 session after the completion of the client's diagnostic 265.31 assessment by the mental health professional who provides the 265.32 client's psychotherapy; (iii) developed through a 265.33 child-centered, family-driven planning process that identifies 265.34 service needs and individualized, planned, and culturally 265.35 appropriate interventions that contain specific treatment goals 265.36 and objectives for the client and the client's family or foster 266.1 family; (iv) reviewed at least once every 90 days and revised, 266.2 if necessary; and (v) signed by the client or, if appropriate, 266.3 by the client's parent or other person authorized by statute to 266.4 consent to mental health services for the client; 266.5 (3) developing an individual behavior plan that documents 266.6 services to be provided by the mental health behavioral aide. 266.7 The individual behavior plan must include: (i) detailed 266.8 instructions on the service to be provided; (ii) time allocated 266.9 to each service; (iii) methods of documenting the child's 266.10 behavior; (iv) methods of monitoring the child's progress in 266.11 reaching objectives; and (v) goals to increase or decrease 266.12 targeted behavior as identified in the individual treatment 266.13 plan; 266.14 (4) clinical supervision of the mental health practitioner 266.15 and mental health behavioral aide. A mental health professional 266.16 must document the clinical supervision the professional provides 266.17 by cosigning individual treatment plans and making entries in 266.18 the client's record on supervisory activities. Clinical 266.19 supervision does not include the authority to make or terminate 266.20 court-ordered placements of the child. A clinical supervisor 266.21 must be available for urgent consultation as required by the 266.22 individual client's needs or the situation. Clinical 266.23 supervision may occur individually or in a small group to 266.24 discuss treatment and review progress toward goals. The focus 266.25 of clinical supervision must be the client's treatment needs and 266.26 progress and the mental health practitioner's or behavioral 266.27 aide's ability to provide services; 266.28 (5) providing direction to a mental health behavioral 266.29 aide. For entities that employ mental health behavioral aides, 266.30 the clinical supervisor must be employed by the provider entity 266.31 to ensure necessary and appropriate oversight for the client's 266.32 treatment and continuity of care. The mental health 266.33 professional or mental health practitioner giving direction must 266.34 begin with the goals on the individualized treatment plan, and 266.35 instruct the mental health behavioral aide on how to construct 266.36 therapeutic activities and interventions that will lead to goal 267.1 attainment. The professional or practitioner giving direction 267.2 must also instruct the mental health behavioral aide about the 267.3 client's diagnosis, functional status, and other characteristics 267.4 that are likely to affect service delivery. Direction must also 267.5 include determining that the mental health behavioral aide has 267.6 the skills to interact with the client and the client's family 267.7 in ways that convey personal and cultural respect and that the 267.8 aide actively solicits information relevant to treatment from 267.9 the family. The aide must be able to clearly explain the 267.10 activities the aide is doing with the client and the activities' 267.11 relationship to treatment goals. Direction is more didactic 267.12 than is supervision and requires the professional or 267.13 practitioner providing it to continuously evaluate the mental 267.14 health behavioral aide's ability to carry out the activities of 267.15 the individualized treatment plan and the individualized 267.16 behavior plan. When providing direction, the professional or 267.17 practitioner must: (i) review progress notes prepared by the 267.18 mental health behavioral aide for accuracy and consistency with 267.19 diagnostic assessment, treatment plan, and behavior goals and 267.20 the professional or practitioner must approve and sign the 267.21 progress notes; (ii) identify changes in treatment strategies, 267.22 revise the individual behavior plan, and communicate treatment 267.23 instructions and methodologies as appropriate to ensure that 267.24 treatment is implemented correctly; (iii) demonstrate 267.25 family-friendly behaviors that support healthy collaboration 267.26 among the child, the child's family, and providers as treatment 267.27 is planned and implemented; (iv) ensure that the mental health 267.28 behavioral aide is able to effectively communicate with the 267.29 child, the child's family, and the provider; and (v) record the 267.30 results of any evaluation and corrective actions taken to modify 267.31 the work of the mental health behavioral aide; 267.32 (6) providing service delivery that implements the 267.33 individual treatment plan and meets the requirements under 267.34 subdivision 9; and 267.35 (7) individual treatment plan review. The review must 267.36 determine the extent to which the services have met the goals 268.1 and objectives in the previous treatment plan. The review must 268.2 assess the client's progress and ensure that services and 268.3 treatment goals continue to be necessary and appropriate to the 268.4 client and the client's family or foster family. Revision of 268.5 the individual treatment plan does not require a new diagnostic 268.6 assessment unless the client's mental health status has changed 268.7 markedly. The updated treatment plan must be signed by the 268.8 client, if appropriate, and by the client's parent or other 268.9 person authorized by statute to give consent to the mental 268.10 health services for the child. 268.11 Subd. 7. [QUALIFICATIONS OF INDIVIDUAL AND TEAM 268.12 PROVIDERS.] (a) An individual or team provider working within 268.13 the scope of the provider's practice or qualifications may 268.14 provide service components of children's therapeutic services 268.15 and supports that are identified as medically necessary in a 268.16 client's individual treatment plan. 268.17 (b) An individual provider and multidisciplinary team 268.18 include: 268.19 (1) a mental health professional as defined in subdivision 268.20 1, paragraph (m); 268.21 (2) a mental health practitioner as defined in section 268.22 245.4871, subdivision 26. The mental health practitioner must 268.23 work under the clinical supervision of a mental health 268.24 professional; 268.25 (3) a mental health behavioral aide working under the 268.26 direction of a mental health professional to implement the 268.27 rehabilitative mental health services identified in the client's 268.28 individual treatment plan. A level I mental health behavioral 268.29 aide must: (i) be at least 18 years old; (ii) have a high 268.30 school diploma or general equivalency diploma (GED) or two years 268.31 of experience as a primary caregiver to a child with severe 268.32 emotional disturbance within the previous ten years; and (iii) 268.33 meet preservices and continuing education requirements under 268.34 subdivision 8. A level II mental health behavioral aide must: 268.35 (i) be at least 18 years old; (ii) have an associate or 268.36 bachelor's degree or 4,000 hours of experience in delivering 269.1 clinical services in the treatment of mental illness concerning 269.2 children or adolescents; and (iii) meet preservice and 269.3 continuing education requirements in subdivision 8; 269.4 (4) a preschool program multidisciplinary team that 269.5 includes at least one mental health professional and one or more 269.6 of the following individuals under the clinical supervision of a 269.7 mental health professional: (i) a mental health practitioner; 269.8 or (ii) a program person, including a teacher, assistant 269.9 teacher, or aide, who meets the qualifications and training 269.10 standards of a level I mental health behavioral aide; or 269.11 (5) a day treatment multidisciplinary team that includes at 269.12 least one mental health professional and one mental health 269.13 practitioner. 269.14 Subd. 8. [REQUIRED PRESERVICE AND CONTINUING 269.15 EDUCATION.] (a) A provider entity shall establish a plan to 269.16 provide preservice and continuing education for staff. The plan 269.17 must clearly describe the type of training necessary to maintain 269.18 current skills and obtain new skills, and that relates to the 269.19 provider entity's goals and objectives for services offered. 269.20 (b) A provider that employs a mental health behavioral aide 269.21 under this section must require the mental health behavioral 269.22 aide to complete 30 hours of preservice training. The 269.23 preservice training must include topics specified in Minnesota 269.24 Rules, part 9535.4068, subparts 1 and 2, and parent team 269.25 training. The preservice training must include 15 hours of 269.26 in-person training of a mental health behavioral aide in mental 269.27 health services delivery and eight hours of parent team 269.28 training. Components of parent team training include: 269.29 (1) partnering with parents; 269.30 (2) fundamentals of family support; 269.31 (3) fundamentals of policy and decision making; 269.32 (4) defining equal partnership; 269.33 (5) complexities of the parent and service provider 269.34 partnership in multiple service delivery systems due to system 269.35 strengths and weaknesses; 269.36 (6) sibling impacts; 270.1 (7) support networks; and 270.2 (8) community resources. 270.3 (c) A provider entity that employs a mental health 270.4 practitioner and a mental health behavioral aide to provide 270.5 children's therapeutic services and supports under this section 270.6 must require the mental health practitioner and mental health 270.7 behavioral aide to complete 20 hours of continuing education 270.8 every two calendar years. The continuing education must be 270.9 related to serving the needs of a child with emotional 270.10 disturbance in the child's home environment and the child's 270.11 family. The topics covered in orientation and training must 270.12 conform to Minnesota Rules, part 9535.4068. 270.13 (d) The provider entity must document the mental health 270.14 practitioner's or mental health behavioral aide's annual 270.15 completion of the required continuing education. The 270.16 documentation must include the date, subject, and number of 270.17 hours of the continuing education, and attendance records, as 270.18 verified by the staff member's signature, job title, and the 270.19 instructor's name. The provider entity must keep documentation 270.20 for each employee, including records of attendance at 270.21 professional workshops and conferences, at a central location 270.22 and in the employee's personnel file. 270.23 Subd. 9. [SERVICE DELIVERY CRITERIA.] (a) In delivering 270.24 services under this section, a certified provider entity must 270.25 ensure that: 270.26 (1) each individual provider's caseload size permits the 270.27 provider to deliver services to both clients with severe, 270.28 complex needs and clients with less intensive needs. The 270.29 provider's caseload size should reasonably enable the provider 270.30 to play an active role in service planning, monitoring, and 270.31 delivering services to meet the client's and client's family's 270.32 needs, as specified in each client's individual treatment plan; 270.33 (2) site-based programs, including day treatment and 270.34 preschool programs, provide staffing and facilities to ensure 270.35 the client's health, safety, and protection of rights, and that 270.36 the programs are able to implement each client's individual 271.1 treatment plan; 271.2 (3) a day treatment program is provided to a group of 271.3 clients by a multidisciplinary staff under the clinical 271.4 supervision of a mental health professional. The day treatment 271.5 program must be provided in and by: (i) an outpatient hospital 271.6 accredited by the joint commission on accreditation of health 271.7 organizations and licensed under sections 144.50 to 144.55; (ii) 271.8 a community mental health center under section 245.62; and (iii) 271.9 an entity that is under contract with the county board to 271.10 operate a program that meets the requirements of sections 271.11 245.4712, subdivision 2, and 245.4884, subdivision 2, and 271.12 Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment 271.13 program must stabilize the client's mental health status while 271.14 developing and improving the client's independent living and 271.15 socialization skills. The goal of the day treatment program 271.16 must be to reduce or relieve the effects of mental illness and 271.17 provide training to enable the client to live in the community. 271.18 The program must be available at least one day a week for a 271.19 minimum three-hour time block. The three-hour time block must 271.20 include at least one hour, but no more than two hours, of 271.21 individual or group psychotherapy. The remainder of the 271.22 three-hour time block may include recreation therapy, 271.23 socialization therapy, or independent living skills therapy, but 271.24 only if the therapies are included in the client's individual 271.25 treatment plan. Day treatment programs are not part of 271.26 inpatient or residential treatment services; and 271.27 (4) a preschool program is a structured treatment program 271.28 offered to a child who is at least 33 months old, but who has 271.29 not yet reached the first day of kindergarten, by a preschool 271.30 multidisciplinary team in a day program licensed under Minnesota 271.31 Rules, parts 9503.0005 to 9503.0175. The program must be 271.32 available at least one day a week for a minimum two-hour time 271.33 block. The structured treatment program may include individual 271.34 or group psychotherapy and recreation therapy, socialization 271.35 therapy, or independent living skills therapy, if included in 271.36 the client's individual treatment plan. 272.1 (b) A provider entity must delivery the service components 272.2 of children's therapeutic services and supports in compliance 272.3 with the following requirements: 272.4 (1) individual, family, and group psychotherapy must be 272.5 delivered as specified in Minnesota Rules, parts 9505.0523; 272.6 (2) individual, family, or group skills training must be 272.7 provided by a mental health professional or a mental health 272.8 practitioner who has a consulting relationship with a mental 272.9 health professional who accepts full professional responsibility 272.10 for the training; 272.11 (3) crisis assistance must be an intense, time-limited, and 272.12 designed to resolve or stabilize crisis through arrangements for 272.13 direct intervention and support services to the child and the 272.14 child's family. Crisis assistance must utilize resources 272.15 designed to address abrupt or substantial changes in the 272.16 functioning of the child or the child's family as evidenced by a 272.17 sudden change in behavior with negative consequences for well 272.18 being, a loss of usual coping mechanisms, or the presentation of 272.19 danger to self or others; 272.20 (4) medically necessary services that are provided by a 272.21 mental health behavioral aide must be designed to improve the 272.22 functioning of the child and support the family in activities of 272.23 daily and community living. A mental health behavioral aide 272.24 must document the delivery of services in written progress 272.25 notes. The mental health behavioral aide must implement goals 272.26 in the treatment plan for the child's emotional disturbance that 272.27 allow the child to acquire developmentally and therapeutically 272.28 appropriate daily living skills, social skills, and leisure and 272.29 recreational skills through targeted activities. These 272.30 activities may include: 272.31 (i) assisting a child as needed with skills development in 272.32 dressing, eating, and toileting; 272.33 (ii) assisting, monitoring, and guiding the child to 272.34 complete tasks, including facilitating the child's participation 272.35 in medical appointments; 272.36 (iii) observing the child and intervening to redirect the 273.1 child's inappropriate behavior; 273.2 (iv) assisting the child in using age-appropriate 273.3 self-management skills as related to the child's emotional 273.4 disorder or mental illness, including problem solving, decision 273.5 making, communication, conflict resolution, anger management, 273.6 social skills, and recreational skills; 273.7 (v) implementing deescalation techniques as recommended by 273.8 the mental health professional; 273.9 (vi) implementing any other mental health service that the 273.10 mental health professional has approved as being within the 273.11 scope of the behavioral aide's duties; or 273.12 (vii) assisting the parents to develop and use parenting 273.13 skills that help the child achieve the goals outlined in the 273.14 child's individual treatment plan or individual behavioral 273.15 plan. Parenting skills must be directed exclusively to the 273.16 child's treatment; and 273.17 (5) direction of a mental health behavioral aide must 273.18 include the following: 273.19 (i) a total of one hour of on-site observation by a mental 273.20 health professional during the first 12 hours of service 273.21 provided to a child; 273.22 (ii) ongoing on-site observation by a mental health 273.23 professional or mental health practitioner for at least a total 273.24 of one hour during every 40 hours of service provided to a 273.25 child; and 273.26 (iii) immediate accessibility of the mental health 273.27 professional or mental health practitioner to the mental health 273.28 behavioral aide during service provision. 273.29 Subd. 10. [SERVICE AUTHORIZATION.] The commissioner shall 273.30 publish in the State Register a list of health services that 273.31 require prior authorization, as well as the criteria and 273.32 standards used to select health services on the list. The list 273.33 and the criteria and standards used to formulate the list are 273.34 not subject to the requirements of sections 14.001 to 14.69. 273.35 The commissioner's decision on whether prior authorization is 273.36 required for a health service is not subject to administrative 274.1 appeal. 274.2 Subd. 11. [DOCUMENTATION AND BILLING.] (a) A provider 274.3 entity must document the services it provides under this 274.4 section. The provider entity must ensure that the entity's 274.5 documentation standards meet the requirements of federal and 274.6 state laws. Services billed under this section that are not 274.7 documented according to this subdivision shall be subject to 274.8 monetary recovery by the commissioner. 274.9 (b) An individual mental health provider must promptly 274.10 document the following in a client's record after providing 274.11 services to the client: 274.12 (1) each occurrence of the client's mental health service, 274.13 including the date, type, length, and scope of the service; 274.14 (2) the name of the person who gave the service; 274.15 (3) contact made with other persons interested in the 274.16 client, including representatives of the courts, corrections 274.17 systems, or schools. The provider must document the name and 274.18 date of each contact; 274.19 (4) any contact made with the client's other mental health 274.20 providers, case manager, family members, primary caregiver, 274.21 legal representative, or the reason the provider did not contact 274.22 the client's family members, primary caregiver, or legal 274.23 representative, if applicable; and 274.24 (5) required clinical supervision, as appropriate. 274.25 Subd. 12. [EXCLUDED SERVICES.] The following services are 274.26 not eligible for medical assistance payment as children's 274.27 therapeutic services and supports: 274.28 (1) service components of children's therapeutic services 274.29 and supports simultaneously provided by more than one provider 274.30 entity unless prior authorization is obtained; 274.31 (2) children's therapeutic services and supports provided 274.32 in violation of medical assistance policy in Minnesota Rules, 274.33 part 9505.0220; 274.34 (3) mental health behavioral aide services provided by a 274.35 personal care assistant who is not qualified as a mental health 274.36 behavioral aide and employed by a certified children's 275.1 therapeutic services and supports provider entity; 275.2 (4) services that are the responsibility of a residential 275.3 or program license holder, including foster care providers under 275.4 the terms of a service agreement or administrative rules 275.5 governing licensure; 275.6 (5) up to 15 hours of children's therapeutic services and 275.7 supports provided within a six-month period to a child with 275.8 severe emotional disturbance who is residing in a hospital, a 275.9 group home as defined in Minnesota Rules, part 9560.0520, 275.10 subpart 4, a residential treatment facility licensed under 275.11 Minnesota Rules, parts 9545.0900 to 9545.1090, a regional 275.12 treatment center, or other institutional group setting or who is 275.13 participating in a program of partial hospitalization are 275.14 eligible for medical assistance payment if part of the discharge 275.15 plan; and 275.16 (6) adjunctive activities that may be offered by a provider 275.17 entity but are not otherwise covered by medical assistance, 275.18 including: 275.19 (i) a service that is primarily recreation oriented or that 275.20 is provided in a setting that is not medically supervised. This 275.21 includes sports activities, exercise groups, activities such as 275.22 craft hours, leisure time, social hours, meal or snack time, 275.23 trips to community activities, and tours; 275.24 (ii) a social or educational service that does not have or 275.25 cannot reasonably be expected to have a therapeutic outcome 275.26 related to the client's emotional disturbance; 275.27 (iii) consultation with other providers or service agency 275.28 staff about the care or progress of a client; 275.29 (iv) prevention or education programs provided to the 275.30 community; and 275.31 (v) treatment for clients with primary diagnoses of alcohol 275.32 or other drug abuse. 275.33 [EFFECTIVE DATE.] Unless otherwise specified, this section 275.34 is effective July 1, 2004. 275.35 Sec. 9. [256B.0944] [COVERED SERVICES; CHILDREN'S MENTAL 275.36 HEALTH CRISIS RESPONSE SERVICES.] 276.1 Subdivision 1. [DEFINITIONS.] For purposes of this 276.2 section, the following terms have the meanings given them. 276.3 (a) "Mental health crisis" means a child's behavioral, 276.4 emotional, or psychiatric situation that, but for the provision 276.5 of crisis response services to the child, would likely result in 276.6 significantly reduced levels of functioning in primary 276.7 activities of daily living, an emergency situation, or the 276.8 child's placement in a more restrictive setting, including, but 276.9 not limited to, inpatient hospitalization. 276.10 (b) "Mental health emergency" means a child's behavioral, 276.11 emotional, or psychiatric situation that causes an immediate 276.12 need for mental health services and is consistent with section 276.13 62Q.55. A physician, mental health professional, or crisis 276.14 mental health practitioner determines a mental health crisis or 276.15 emergency for medical assistance reimbursement with input from 276.16 the client and the client's family, if possible. 276.17 (c) "Mental health crisis assessment" means an immediate 276.18 face-to-face assessment by a physician, mental health 276.19 professional, or mental health practitioner under the clinical 276.20 supervision of a mental health professional, following a 276.21 screening that suggests the child may be experiencing a mental 276.22 health crisis or mental health emergency situation. 276.23 (d) "Mental health mobile crisis intervention services" 276.24 means face-to-face, short-term intensive mental health services 276.25 initiated during a mental health crisis or mental health 276.26 emergency. Mental health mobile crisis services must help the 276.27 recipient cope with immediate stressors, identify and utilize 276.28 available resources and strengths, and begin to return to the 276.29 recipient's baseline level of functioning. Mental health mobile 276.30 services must be provided on-site by a mobile crisis 276.31 intervention team outside of an emergency room, urgent care, or 276.32 an inpatient hospital setting. 276.33 (e) "Mental health crisis stabilization services" means 276.34 individualized mental health services provided to a recipient 276.35 following crisis intervention services that are designed to 276.36 restore the recipient to the recipient's prior functional 277.1 level. The individual treatment plan recommending mental health 277.2 crisis stabilization must be completed by the intervention team 277.3 or by staff after an inpatient or urgent care visit. Mental 277.4 health crisis stabilization services may be provided in the 277.5 recipient's home, the home of a family member or friend of the 277.6 recipient, schools, another community setting, or a short-term 277.7 supervised, licensed residential program if the service is not 277.8 included in the facility's cost pool or per diem. Mental health 277.9 crisis stabilization is not reimbursable when provided as part 277.10 of a partial hospitalization or day treatment program. 277.11 Subd. 2. [MEDICAL ASSISTANCE COVERAGE.] Medical assistance 277.12 covers medically necessary children's mental health crisis 277.13 response services, subject to federal approval, if provided to 277.14 an eligible recipient under subdivision 3, by a qualified 277.15 provider entity under subdivision 4 or a qualified individual 277.16 provider working within the provider's scope of practice, and 277.17 identified in the recipient's individual crisis treatment plan 277.18 under subdivision 8. 277.19 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 277.20 individual who: 277.21 (1) is eligible for medical assistance; 277.22 (2) is under age 18 or between the ages of 18 and 21; 277.23 (3) is screened as possibly experiencing a mental health 277.24 crisis or mental health emergency where a mental health crisis 277.25 assessment is needed; 277.26 (4) is assessed as experiencing a mental health crisis or 277.27 mental health emergency, and mental health mobile crisis 277.28 intervention or mental health crisis stabilization services are 277.29 determined to be medically necessary; and 277.30 (5) meets the criteria for emotional disturbance or mental 277.31 illness. 277.32 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A crisis 277.33 intervention and crisis stabilization provider entity must meet 277.34 the administrative and clinical standards specified in section 277.35 256B.0943, subdivisions 5 and 6, meet the standards listed in 277.36 paragraph (b), and be: 278.1 (1) an Indian health service facility or facility owned and 278.2 operated by a tribe or a tribal organization operating under 278.3 Public Law 93-638 as a 638 facility; 278.4 (2) a county board-operated entity; or 278.5 (3) a provider entity that is under contract with the 278.6 county board in the county where the potential crisis or 278.7 emergency is occurring. 278.8 (b) The children's mental health crisis response services 278.9 provider entity must: 278.10 (1) ensure that mental health crisis assessment and mobile 278.11 crisis intervention services are available 24 hours a day, seven 278.12 days a week; 278.13 (2) directly provide the services or, if services are 278.14 subcontracted, the provider entity must maintain clinical 278.15 responsibility for services and billing; 278.16 (3) ensure that crisis intervention services are provided 278.17 in a manner consistent with sections 245.487 to 245.4888; and 278.18 (4) develop and maintain written policies and procedures 278.19 regarding service provision that include safety of staff and 278.20 recipients in high-risk situations. 278.21 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF 278.22 QUALIFICATIONS.] (a) To provide children's mental health mobile 278.23 crisis intervention services, a mobile crisis intervention team 278.24 must include: 278.25 (1) at least two mental health professionals as defined in 278.26 section 256B.0943, subdivision 1, paragraph (m); or 278.27 (2) a combination of at least one mental health 278.28 professional and one mental health practitioner as defined in 278.29 section 245.4871, subdivision 26, with the required mental 278.30 health crisis training and under the clinical supervision of a 278.31 mental health professional on the team. 278.32 (b) The team must have at least two people with at least 278.33 one member providing on-site crisis intervention services when 278.34 needed. Team members must be experienced in mental health 278.35 assessment, crisis intervention techniques, and clinical 278.36 decision making under emergency conditions and have knowledge of 279.1 local services and resources. The team must recommend and 279.2 coordinate the team's services with appropriate local resources, 279.3 including as the county social services agency, mental health 279.4 service providers, and local law enforcement, if necessary. 279.5 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 279.6 INTERVENTION TREATMENT PLANNING.] (a) Before initiating mobile 279.7 crisis intervention services, a screening of the potential 279.8 crisis situation must be conducted. The screening may use the 279.9 resources of crisis assistance and emergency services as defined 279.10 in sections 245.4871, subdivision 14, and 245.4879, subdivisions 279.11 1 and 2. The screening must gather information, determine 279.12 whether a crisis situation exists, identify the parties 279.13 involved, and determine an appropriate response. 279.14 (b) If a crisis exists, a crisis assessment must be 279.15 completed. A crisis assessment must evaluate any immediate 279.16 needs for which emergency services are needed and, as time 279.17 permits, the recipient's current life situation, sources of 279.18 stress, mental health problems and symptoms, strengths, cultural 279.19 considerations, support network, vulnerabilities, and current 279.20 functioning. 279.21 (c) If the crisis assessment determines mobile crisis 279.22 intervention services are needed, the intervention services must 279.23 be provided promptly. As the opportunity presents itself during 279.24 the intervention, at least two members of the mobile crisis 279.25 intervention team must confer directly or by telephone about the 279.26 assessment, treatment plan, and actions taken and needed. At 279.27 least one of the team members must be on site providing crisis 279.28 intervention services. If providing on-site crisis intervention 279.29 services, a mental health practitioner must seek clinical 279.30 supervision as required under subdivision 9. 279.31 (d) The mobile crisis intervention team must develop an 279.32 initial, brief crisis treatment plan as soon as appropriate but 279.33 no later than 24 hours after the initial face-to-face 279.34 intervention. The plan must address the needs and problems 279.35 noted in the crisis assessment and include measurable short-term 279.36 goals, cultural considerations, and frequency and type of 280.1 services to be provided to achieve the goals and reduce or 280.2 eliminate the crisis. The crisis treatment plan must be updated 280.3 as needed to reflect current goals and services. The team must 280.4 involve the client and the client's family in developing and 280.5 implementing the plan. 280.6 (e) The team must document in progress notes which 280.7 short-term goals have been met and when no further crisis 280.8 intervention services are required. 280.9 (f) If the client's crisis is stabilized, but the client 280.10 needs a referral for mental health crisis stabilization services 280.11 or to other services, the team must provide a referral to these 280.12 services. If the recipient has a case manager, planning for 280.13 other services must be coordinated with the case manager. 280.14 Subd. 7. [CRISIS STABILIZATION SERVICES.] (a) Crisis 280.15 stabilization services must be provided by a mental health 280.16 professional or a mental health practitioner who works under the 280.17 clinical supervision of a mental health professional and for a 280.18 crisis stabilization services provider entity, and must meet the 280.19 following standards: 280.20 (1) a crisis stabilization treatment plan must be developed 280.21 which meets the criteria in subdivision 8; 280.22 (2) services must be delivered according to the treatment 280.23 plan and include face-to-face contact with the recipient by 280.24 qualified staff for further assessment, help with referrals, 280.25 updating the crisis stabilization treatment plan, supportive 280.26 counseling, skills training, and collaboration with other 280.27 service providers in the community; and 280.28 (3) mental health practitioners must have completed at 280.29 least 30 hours of training in crisis intervention and 280.30 stabilization during the past two years. 280.31 Subd. 8. [TREATMENT PLAN.] (a) The individual crisis 280.32 stabilization treatment plan must include, at a minimum: 280.33 (1) a list of problems identified in the assessment; 280.34 (2) a list of the recipient's strengths and resources; 280.35 (3) concrete, measurable short-term goals and tasks to be 280.36 achieved, including time frames for achievement of the goals; 281.1 (4) specific objectives directed toward the achievement of 281.2 each goal; 281.3 (5) documentation of the participants involved in the 281.4 service planning; 281.5 (6) planned frequency and type of services initiated; 281.6 (7) a crisis response action plan if a crisis should occur; 281.7 and 281.8 (8) clear progress notes on the outcome of goals. 281.9 (b) The client, if clinically appropriate, must be a 281.10 participant in the development of the crisis stabilization 281.11 treatment plan. The client or the client's legal guardian must 281.12 sign the service plan or documentation must be provided why this 281.13 was not possible. A copy of the plan must be given to the 281.14 client and the client's legal guardian. The plan should include 281.15 services arranged, including specific providers where applicable. 281.16 (c) A treatment plan must be developed by a mental health 281.17 professional or mental health practitioner under the clinical 281.18 supervision of a mental health professional. A written plan 281.19 must be completed within 24 hours of beginning services with the 281.20 client. 281.21 Subd. 9. [SUPERVISION.] (a) A mental health practitioner 281.22 may provide crisis assessment and mobile crisis intervention 281.23 services if the following clinical supervision requirements are 281.24 met: 281.25 (1) the mental health provider entity must accept full 281.26 responsibility for the services provided; 281.27 (2) the mental health professional of the provider entity, 281.28 who is an employee or under contract with the provider entity, 281.29 must be immediately available by telephone or in person for 281.30 clinical supervision; 281.31 (3) the mental health professional is consulted, in person 281.32 or by telephone, during the first three hours when a mental 281.33 health practitioner provides on-site service; and 281.34 (4) the mental health professional must review and approve 281.35 the tentative crisis assessment and crisis treatment plan, 281.36 document the consultation, and sign the crisis assessment and 282.1 treatment plan within the next business day. 282.2 (b) If the mobile crisis intervention services continue 282.3 into a second calendar day, a mental health professional must 282.4 contact the client face-to-face on the second day to provide 282.5 services and update the crisis treatment plan. The on-site 282.6 observation must be documented in the client's record and signed 282.7 by the mental health professional. 282.8 Subd. 10. [CLIENT RECORD.] The provider must maintain a 282.9 file for each client that complies with the requirements under 282.10 section 256B.0943, subdivision 11, and contains the following 282.11 information: 282.12 (1) individual crisis treatment plans signed by the 282.13 recipient, mental health professional, and mental health 282.14 practitioner who developed the crisis treatment plan, or if the 282.15 recipient refused to sign the plan, the date and reason stated 282.16 by the recipient for not signing the plan; 282.17 (2) signed release of information forms; 282.18 (3) recipient health information and current medications; 282.19 (4) emergency contacts for the recipient; 282.20 (5) case records that document the date of service, place 282.21 of service delivery, signature of the person providing the 282.22 service, and the nature, extent, and units of service. Direct 282.23 or telephone contact with the recipient's family or others 282.24 should be documented; 282.25 (6) required clinical supervision by mental health 282.26 professionals; 282.27 (7) summary of the recipient's case reviews by staff; and 282.28 (8) any written information by the recipient that the 282.29 recipient wants in the file. 282.30 Subd. 11. [EXCLUDED SERVICES.] The following services are 282.31 excluded from reimbursement under this section: 282.32 (1) room and board services; 282.33 (2) services delivered to a recipient while admitted to an 282.34 inpatient hospital; 282.35 (3) transportation services under children's mental health 282.36 crisis response service; 283.1 (4) services provided and billed by a provider who is not 283.2 enrolled under medical assistance to provide children's mental 283.3 health crisis response services; 283.4 (5) crisis response services provided by a residential 283.5 treatment center to clients in their facility; 283.6 (6) services performed by volunteers; 283.7 (7) direct billing of time spent "on call" when not 283.8 delivering services to a recipient; 283.9 (8) provider service time included in case management 283.10 reimbursement; 283.11 (9) outreach services to potential recipients; and 283.12 (10) a mental health service that is not medically 283.13 necessary. 283.14 [EFFECTIVE DATE.] This section is effective July 1, 2004. 283.15 Sec. 10. Minnesota Statutes 2002, section 256B.0945, 283.16 subdivision 2, is amended to read: 283.17 Subd. 2. [COVERED SERVICES.] All services must be included 283.18 in a child's individualized treatment or multiagency plan of 283.19 care as defined in chapter 245. 283.20(a) For facilities that are institutions for mental283.21diseases according to statute and regulation or are not283.22institutions for mental diseases but are approved by the283.23commissioner to provide services under this paragraph, medical283.24assistance covers the full contract rate, including room and283.25board if the services meet the requirements of Code of Federal283.26Regulations, title 42, section 440.160.283.27(b)For facilities that are not institutions for mental 283.28 diseases according to federal statute and regulationand are not283.29providing services under paragraph (a), medical assistance 283.30 covers mental health related services that are required to be 283.31 provided by a residential facility under section 245.4882 and 283.32 administrative rules promulgated thereunder, except for room and 283.33 board. 283.34 Sec. 11. Minnesota Statutes 2002, section 256B.0945, 283.35 subdivision 4, is amended to read: 283.36 Subd. 4. [PAYMENT RATES.] (a) Notwithstanding sections 284.1 256B.19 and 256B.041, payments to counties for residential 284.2 services provided by a residential facility shall only be made 284.3 of federal earnings for services provided under this section, 284.4 and the nonfederal share of costs for services provided under 284.5 this section shall be paid by the county from sources other than 284.6 federal funds or funds used to match other federal funds. 284.7Payment to counties for services provided according to284.8subdivision 2, paragraph (a), shall be the federal share of the284.9contract rate.Payment to counties for services provided 284.10 according tosubdivision 2, paragraph (b),this section shall be 284.11 a proportion of the per day contract rate that relates to 284.12 rehabilitative mental health services and shall not include 284.13 payment for costs or services that are billed to the IV-E 284.14 program as room and board. 284.15 (b) The commissioner shall set aside a portion not to 284.16 exceed five percent of the federal funds earned under this 284.17 section to cover the state costs of administering this section. 284.18 Any unexpended funds from the set-aside shall be distributed to 284.19 the counties in proportion to their earnings under this section. 284.20 Sec. 12. Minnesota Statutes 2002, section 257.05, is 284.21 amended to read: 284.22 257.05 [IMPORTATION.] 284.23 Subdivision 1. [NOTIFICATION AND DUTIES OF COMMISSIONER.] 284.24 No person, except as provided bysubdivisionsubdivisions 2 and 284.25 3, shall bring or send into the state any child for the purpose 284.26 of placing the child out or procuring the child's adoption 284.27 without first obtaining the consent of the commissioner of human 284.28 services, and such person shall conform to all rules of the 284.29 commissioner of human services and laws of the state of 284.30 Minnesota relating to protection of children in foster care. 284.31 Before any child shall be brought or sent into the state for the 284.32 purpose of being placed in foster care, the person bringing or 284.33 sending the child into the state shall first notify the 284.34 commissioner of human services of the person's intention, and 284.35 shall obtain from the commissioner of human services a 284.36 certificate stating that the home in which the child is to be 285.1 placed is, in the opinion of the commissioner of human services, 285.2 a suitable adoptive home for the child if legal adoption is 285.3 contemplated or that the home meets the commissioner's 285.4 requirements for licensing of foster homes if legal adoption is 285.5 not contemplated. The commissioner is responsible for 285.6 protecting the child's interests so long as the child remains 285.7 within the state and until the child reaches the age of 18 or is 285.8 legally adopted. Notice to the commissioner shall state the 285.9 name, age, and personal description of the child, and the name 285.10 and address of the person with whom the child is to be placed, 285.11 and such other information about the child and the foster home 285.12 as may be required by the commissioner. 285.13 Subd. 2. [EXEMPT RELATIVES.] A parent, stepparent, 285.14 grandparent, brother, sister and aunt or uncle in the first 285.15 degree of the minor child who bring a child into the state for 285.16 placement within their own home shall be exempt from the 285.17 provisions of subdivision 1. This relationship may be by blood 285.18 or marriage. 285.19 Subd. 3. [INTERNATIONAL ADOPTIONS.] Subject to state and 285.20 federal laws and rules, adoption agencies licensed under chapter 285.21 245A and Minnesota Rules, parts 9545.0755 to 9545.0845, and 285.22 county social services agencies are authorized to certify that 285.23 the prospective adoptive home of a child brought into the state 285.24 from another country for the purpose of adoption is a suitable 285.25 home, or that the home meets the commissioner's requirements for 285.26 licensing of foster homes if legal adoption is not contemplated. 285.27 Sec. 13. Minnesota Statutes 2002, section 259.67, 285.28 subdivision 4, is amended to read: 285.29 Subd. 4. [ELIGIBILITY CONDITIONS.] (a) The placing agency 285.30 shall use the AFDC requirements as specified in federal law as 285.31 of July 16, 1996, when determining the child's eligibility for 285.32 adoption assistance under title IV-E of the Social Security 285.33 Act. If the child does not qualify, the placing agency shall 285.34 certify a child as eligible for state funded adoption assistance 285.35 only if the following criteria are met: 285.36 (1) Due to the child's characteristics or circumstances it 286.1 would be difficult to provide the child an adoptive home without 286.2 adoption assistance. 286.3 (2)(i) A placement agency has made reasonable efforts to 286.4 place the child for adoption without adoption assistance, but 286.5 has been unsuccessful; or 286.6 (ii) the child's licensed foster parents desire to adopt 286.7 the child and it is determined by the placing agency that the 286.8 adoption is in the best interest of the child. 286.9 (3) The child has been a ward of the commissioneror, a 286.10 Minnesota-licensed child-placing agency, or a tribal social 286.11 service agency of Minnesota recognized by the Secretary of the 286.12 Interior. 286.13 (b) For purposes of this subdivision, the characteristics 286.14 or circumstances that may be considered in determining whether a 286.15 child is a child with special needs under United States Code, 286.16 title 42, chapter 7, subchapter IV, part E, or meets the 286.17 requirements of paragraph (a), clause (1), are the following: 286.18 (1) The child is a member of a sibling group to be placed 286.19 as one unit in which at least one sibling is older than 15 286.20 months of age or is described in clause (2) or (3). 286.21 (2) The child has documented physical, mental, emotional, 286.22 or behavioral disabilities. 286.23 (3) The child has a high risk of developing physical, 286.24 mental, emotional, or behavioral disabilities. 286.25 (4) The child is adopted according to tribal law without a 286.26 termination of parental rights or relinquishment, provided that 286.27 the tribe has documented the valid reason why the child cannot 286.28 or should not be returned to the home of the child's parent. 286.29 (c) When a child's eligibility for adoption assistance is 286.30 based upon the high risk of developing physical, mental, 286.31 emotional, or behavioral disabilities, payments shall not be 286.32 made under the adoption assistance agreement unless and until 286.33 the potential disability manifests itself as documented by an 286.34 appropriate health care professional. 286.35 Sec. 14. Minnesota Statutes 2002, section 260B.157, 286.36 subdivision 1, is amended to read: 287.1 Subdivision 1. [INVESTIGATION.] Upon request of the court 287.2 the local social services agency or probation officer shall 287.3 investigate the personal and family history and environment of 287.4 any minor coming within the jurisdiction of the court under 287.5 section 260B.101 and shall report its findings to the court. 287.6 The court may order any minor coming within its jurisdiction to 287.7 be examined by a duly qualified physician, psychiatrist, or 287.8 psychologist appointed by the court. 287.9 The court shall have a chemical use assessment conducted 287.10 when a child is (1) found to be delinquent for violating a 287.11 provision of chapter 152, or for committing a felony-level 287.12 violation of a provision of chapter 609 if the probation officer 287.13 determines that alcohol or drug use was a contributing factor in 287.14 the commission of the offense, or (2) alleged to be delinquent 287.15 for violating a provision of chapter 152, if the child is being 287.16 held in custody under a detention order. The assessor's 287.17 qualifications and the assessment criteria shall comply with 287.18 Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under 287.19 chapter 254B are to be used to pay for the recommended 287.20 treatment, the assessment and placement must comply with all 287.21 provisions of Minnesota Rules, parts 9530.6600 to 9530.6655 and 287.22 9530.7000 to 9530.7030. The commissioner of human services 287.23 shall reimburse the court for the cost of the chemical use 287.24 assessment, up to a maximum of $100. 287.25 The court shall have a children's mental health screening 287.26 conducted when a child is found to be delinquent. The screening 287.27 shall be conducted with a screening instrument approved by the 287.28 commissioner of human services and shall be conducted by a 287.29 mental health practitioner as defined in section 245.4871, 287.30 subdivision 26, or a probation officer who is trained in the use 287.31 of the screening instrument. If the screening indicates a need 287.32 for assessment, the local social services agency, in 287.33 consultation with the child's family, shall have a diagnostic 287.34 assessment conducted, including a functional assessment, as 287.35 defined in section 245.4871. 287.36 With the consent of the commissioner of corrections and 288.1 agreement of the county to pay the costs thereof, the court may, 288.2 by order, place a minor coming within its jurisdiction in an 288.3 institution maintained by the commissioner for the detention, 288.4 diagnosis, custody and treatment of persons adjudicated to be 288.5 delinquent, in order that the condition of the minor be given 288.6 due consideration in the disposition of the case. Any funds 288.7 received under the provisions of this subdivision shall not 288.8 cancel until the end of the fiscal year immediately following 288.9 the fiscal year in which the funds were received. The funds are 288.10 available for use by the commissioner of corrections during that 288.11 period and are hereby appropriated annually to the commissioner 288.12 of corrections as reimbursement of the costs of providing these 288.13 services to the juvenile courts. 288.14 [EFFECTIVE DATE.] This section is effective July 1, 2004. 288.15 Sec. 15. Minnesota Statutes 2002, section 260B.176, 288.16 subdivision 2, is amended to read: 288.17 Subd. 2. [REASONS FOR DETENTION.] (a) If the child is not 288.18 released as provided in subdivision 1, the person taking the 288.19 child into custody shall notify the court as soon as possible of 288.20 the detention of the child and the reasons for detention. 288.21 (b) No child may be detained in a juvenile secure detention 288.22 facility or shelter care facility longer than 36 hours, 288.23 excluding Saturdays, Sundays, and holidays, after being taken 288.24 into custody for a delinquent act as defined in section 288.25 260B.007, subdivision 6, unless a petition has been filed and 288.26 the judge or referee determines pursuant to section 260B.178 288.27 that the child shall remain in detention. 288.28 (c) No child may be detained in an adult jail or municipal 288.29 lockup longer than 24 hours, excluding Saturdays, Sundays, and 288.30 holidays, or longer than six hours in an adult jail or municipal 288.31 lockup in a standard metropolitan statistical area, after being 288.32 taken into custody for a delinquent act as defined in section 288.33 260B.007, subdivision 6, unless: 288.34 (1) a petition has been filed under section 260B.141; and 288.35 (2) a judge or referee has determined under section 288.36 260B.178 that the child shall remain in detention. 289.1 After August 1, 1991, no child described in this paragraph 289.2 may be detained in an adult jail or municipal lockup longer than 289.3 24 hours, excluding Saturdays, Sundays, and holidays, or longer 289.4 than six hours in an adult jail or municipal lockup in a 289.5 standard metropolitan statistical area, unless the requirements 289.6 of this paragraph have been met and, in addition, a motion to 289.7 refer the child for adult prosecution has been made under 289.8 section 260B.125. Notwithstanding this paragraph, continued 289.9 detention of a child in an adult detention facility outside of a 289.10 standard metropolitan statistical area county is permissible if: 289.11 (i) the facility in which the child is detained is located 289.12 where conditions of distance to be traveled or other ground 289.13 transportation do not allow for court appearances within 24 289.14 hours. A delay not to exceed 48 hours may be made under this 289.15 clause; or 289.16 (ii) the facility is located where conditions of safety 289.17 exist. Time for an appearance may be delayed until 24 hours 289.18 after the time that conditions allow for reasonably safe 289.19 travel. "Conditions of safety" include adverse life-threatening 289.20 weather conditions that do not allow for reasonably safe travel. 289.21 The continued detention of a child under clause (i) or (ii) 289.22 must be reported to the commissioner of corrections. 289.23 (d) If a child described in paragraph (c) is to be detained 289.24 in a jail beyond 24 hours, excluding Saturdays, Sundays, and 289.25 holidays, the judge or referee, in accordance with rules and 289.26 procedures established by the commissioner of corrections, shall 289.27 notify the commissioner of the place of the detention and the 289.28 reasons therefor. The commissioner shall thereupon assist the 289.29 court in the relocation of the child in an appropriate juvenile 289.30 secure detention facility or approved jail within the county or 289.31 elsewhere in the state, or in determining suitable 289.32 alternatives. The commissioner shall direct that a child 289.33 detained in a jail be detained after eight days from and 289.34 including the date of the original detention order in an 289.35 approved juvenile secure detention facility with the approval of 289.36 the administrative authority of the facility. If the court 290.1 refers the matter to the prosecuting authority pursuant to 290.2 section 260B.125, notice to the commissioner shall not be 290.3 required. 290.4 (e) When a child is detained for an alleged delinquent act 290.5 in a state licensed juvenile facility or program, or when a 290.6 child is detained in an adult jail or municipal lockup as 290.7 provided in paragraph (c), the supervisor of the facility shall, 290.8 if the child's parent or legal guardian consents, have a 290.9 children's mental health screening conducted with a screening 290.10 instrument approved by the commissioner of human services, 290.11 unless a screening has been performed within the previous 180 290.12 days or the child is currently under the care of a mental health 290.13 professional. The screening shall be conducted by a mental 290.14 health practitioner as defined in section 245.4871, subdivision 290.15 26, or a probation officer who is trained in the use of the 290.16 screening instrument. The screening shall be conducted after 290.17 the initial detention hearing has been held and the court has 290.18 ordered the child continued in detention. The results of the 290.19 screening may only be presented to the court at the 290.20 dispositional phase of the court proceedings on the matter 290.21 unless the parent or legal guardian consents to presentation at 290.22 a different time. If the screening indicates a need for 290.23 assessment, the local social services agency or probation 290.24 officer, with the approval of the child's parent or legal 290.25 guardian, shall have a diagnostic assessment conducted, 290.26 including a functional assessment, as defined in section 290.27 245.4871. 290.28 [EFFECTIVE DATE.] This section is effective July 1, 2004. 290.29 Sec. 16. Minnesota Statutes 2002, section 260B.178, 290.30 subdivision 1, is amended to read: 290.31 Subdivision 1. [HEARING AND RELEASE REQUIREMENTS.] (a) The 290.32 court shall hold a detention hearing: 290.33 (1) within 36 hours of the time the child was taken into 290.34 custody, excluding Saturdays, Sundays, and holidays, if the 290.35 child is being held at a juvenile secure detention facility or 290.36 shelter care facility; or 291.1 (2) within 24 hours of the time the child was taken into 291.2 custody, excluding Saturdays, Sundays, and holidays, if the 291.3 child is being held at an adult jail or municipal lockup. 291.4 (b) Unless there is reason to believe that the child would 291.5 endanger self or others, not return for a court hearing, run 291.6 away from the child's parent, guardian, or custodian or 291.7 otherwise not remain in the care or control of the person to 291.8 whose lawful custody the child is released, or that the child's 291.9 health or welfare would be immediately endangered, the child 291.10 shall be released to the custody of a parent, guardian, 291.11 custodian, or other suitable person, subject to reasonable 291.12 conditions of release including, but not limited to, a 291.13 requirement that the child undergo a chemical use assessment as 291.14 provided in section 260B.157, subdivision 1, and a children's 291.15 mental health screening as provided in section 260B.176, 291.16 subdivision 2, paragraph (e). In determining whether the 291.17 child's health or welfare would be immediately endangered, the 291.18 court shall consider whether the child would reside with a 291.19 perpetrator of domestic child abuse. 291.20 [EFFECTIVE DATE.] This section is effective July 1, 2004. 291.21 Sec. 17. Minnesota Statutes 2002, section 260B.193, 291.22 subdivision 2, is amended to read: 291.23 Subd. 2. [CONSIDERATION OF REPORTS.] Before making a 291.24 disposition in a case, or appointing a guardian for a child, the 291.25 court may consider any report or recommendation made by the 291.26 local social services agency, probation officer, licensed 291.27 child-placing agency, foster parent, guardian ad litem, tribal 291.28 representative, or other authorized advocate for the child or 291.29 child's family, a school district concerning the effect on 291.30 student transportation of placing a child in a school district 291.31 in which the child is not a resident, or any other information 291.32 deemed material by the court. In addition, the court may 291.33 consider the results of the children's mental health screening 291.34 provided in section 260B.157, subdivision 1. 291.35 [EFFECTIVE DATE.] This section is effective July 1, 2004. 291.36 Sec. 18. Minnesota Statutes 2002, section 260B.235, 292.1 subdivision 6, is amended to read: 292.2 Subd. 6. [ALTERNATIVE DISPOSITION.] In addition to 292.3 dispositional alternatives authorized by subdivision34, in the 292.4 case of a third or subsequent finding by the court pursuant to 292.5 an admission in court or after trial that a child has committed 292.6 a juvenile alcohol or controlled substance offense, the juvenile 292.7 court shall order a chemical dependency evaluation of the child 292.8 and if warranted by the evaluation, the court may order 292.9 participation by the child in an inpatient or outpatient 292.10 chemical dependency treatment program, or any other treatment 292.11 deemed appropriate by the court. In the case of a third or 292.12 subsequent finding that a child has committed any juvenile petty 292.13 offense, the court shall order a children's mental health 292.14 screening be conducted as provided in section 260B.157, 292.15 subdivision 1, and if indicated by the screening, to undergo a 292.16 diagnostic assessment, including a functional assessment, as 292.17 defined in section 245.4871. 292.18 [EFFECTIVE DATE.] This section is effective July 1, 2004. 292.19 Sec. 19. Minnesota Statutes 2002, section 260C.141, 292.20 subdivision 2, is amended to read: 292.21 Subd. 2. [REVIEW OF FOSTER CARE STATUS.] The social 292.22 services agency responsible for the placement of a child in a 292.23 residential facility, as defined in section 260C.212, 292.24 subdivision 1, pursuant to a voluntary release by the child's 292.25 parent or parents must proceed in juvenile court to review the 292.26 foster care status of the child in the manner provided in this 292.27 section. 292.28 (a) Except for a child in placement due solely to the 292.29 child's developmental disability or emotional disturbance, when 292.30 a child continues in voluntary placement according to section 292.31 260C.212, subdivision 8, a petition shall be filed alleging the 292.32 child to be in need of protection or services or seeking 292.33 termination of parental rights or other permanent placement of 292.34 the child away from the parent within 90 days of the date of the 292.35 voluntary placement agreement. The petition shall state the 292.36 reasons why the child is in placement, the progress on the 293.1 out-of-home placement plan required under section 260C.212, 293.2 subdivision 1, and the statutory basis for the petition under 293.3 section 260C.007, subdivision 6, 260C.201, subdivision 11, or 293.4 260C.301. 293.5 (1) In the case of a petition alleging the child to be in 293.6 need of protection or services filed under this paragraph, if 293.7 all parties agree and the court finds it is in the best 293.8 interests of the child, the court may find the petition states a 293.9 prima facie case that: 293.10 (i) the child's needs are being met; 293.11 (ii) the placement of the child in foster care is in the 293.12 best interests of the child; 293.13 (iii) reasonable efforts to reunify the child and the 293.14 parent or guardian are being made; and 293.15 (iv) the child will be returned home in the next three 293.16 months. 293.17 (2) If the court makes findings under paragraph (1), the 293.18 court shall approve the voluntary arrangement and continue the 293.19 matter for up to three more months to ensure the child returns 293.20 to the parents' home. The responsible social services agency 293.21 shall: 293.22 (i) report to the court when the child returns home and the 293.23 progress made by the parent on the out-of-home placement plan 293.24 required under section 260C.212, in which case the court shall 293.25 dismiss jurisdiction; 293.26 (ii) report to the court that the child has not returned 293.27 home, in which case the matter shall be returned to the court 293.28 for further proceedings under section 260C.163; or 293.29 (iii) if any party does not agree to continue the matter 293.30 under paragraph (1) and this paragraph, the matter shall proceed 293.31 under section 260C.163. 293.32 (b) In the case of a child in voluntary placement due 293.33 solely to the child's developmental disability or emotional 293.34 disturbance according to section 260C.212, subdivision 9, the 293.35 following procedures apply: 293.36 (1) [REPORT TO COURT.] (i) Unless the county attorney 294.1 determines that a petition under subdivision 1 is appropriate, 294.2 without filing a petition, a written report shall be forwarded 294.3 to the court within 165 days of the date of the voluntary 294.4 placement agreement. The written report shall contain necessary 294.5 identifying information for the court to proceed, a copy of the 294.6 out-of-home placement plan required under section 260C.212, 294.7 subdivision 1, a written summary of the proceedings of any 294.8 administrative review required under section 260C.212, 294.9 subdivision 7, and any other information the responsible social 294.10 services agency, parent or guardian, the child or the foster 294.11 parent or other residential facility wants the court to consider. 294.12 (ii) The responsible social services agency, where 294.13 appropriate, must advise the child, parent or guardian, the 294.14 foster parent, or representative of the residential facility of 294.15 the requirements of this section and of their right to submit 294.16 information to the court. If the child, parent or guardian, 294.17 foster parent, or representative of the residential facility 294.18 wants to send information to the court, the responsible social 294.19 services agency shall advise those persons of the reporting date 294.20 and the identifying information necessary for the court 294.21 administrator to accept the information and submit it to a judge 294.22 with the agency's report. The responsible social services 294.23 agency must also notify those persons that they have the right 294.24 to be heard in person by the court and how to exercise that 294.25 right. The responsible social services agency must also provide 294.26 notice that an in-court hearing will not be held unless 294.27 requested by a parent or guardian, foster parent, or the child. 294.28 (iii) After receiving the required report, the court has 294.29 jurisdiction to make the following determinations and must do so 294.30 within ten days of receiving the forwarded report: (A) whether 294.31 or not the placement of the child is in the child's best 294.32 interests; and (B) whether the parent and agency are 294.33 appropriately planning for the child. Unless requested by a 294.34 parent or guardian, foster parent, or child, no in-court hearing 294.35 need be held in order for the court to make findings and issue 294.36 an order under this paragraph. 295.1 (iv) If the court finds the placement is in the child's 295.2 best interests and that the agency and parent are appropriately 295.3 planning for the child, the court shall issue an order 295.4 containing explicit, individualized findings to support its 295.5 determination. The court shall send a copy of the order to the 295.6 county attorney, the responsible social services agency, the 295.7 parent or guardian, the child, and the foster parents. The 295.8 court shall also send the parent or guardian, the child, and the 295.9 foster parent notice of the required review under clause (2). 295.10 (v) If the court finds continuing the placement not to be 295.11 in the child's best interests or that the agency or the parent 295.12 or guardian is not appropriately planning for the child, the 295.13 court shall notify the county attorney, the responsible social 295.14 services agency, the parent or guardian, the foster parent, the 295.15 child, and the county attorney of the court's determinations and 295.16 the basis for the court's determinations. 295.17 (2) [PERMANENCY REVIEW BY PETITION.] If a child with a 295.18 developmental disability or an emotional disturbance continues 295.19 in out-of-home placement for 13 months from the date of a 295.20 voluntary placement, a petition alleging the child to be in need 295.21 of protection or services, for termination of parental rights, 295.22 or for permanent placement of the child away from the parent 295.23 under section 260C.201 shall be filed. The court shall conduct 295.24 a permanency hearing on the petition no later than 14 months 295.25 after the date of the voluntary placement. At the permanency 295.26 hearing, the court shall determine the need for an order 295.27 permanently placing the child away from the parent or determine 295.28 whether there are compelling reasons that continued voluntary 295.29 placement is in the child's best interests. A petition alleging 295.30 the child to be in need of protection or services shall state 295.31 the date of the voluntary placement agreement, the nature of the 295.32 child's developmental disability or emotional disturbance, the 295.33 plan for the ongoing care of the child, the parents' 295.34 participation in the plan, the responsible social services 295.35 agency's efforts to finalize a plan for the permanent placement 295.36 of the child, and the statutory basis for the petition. 296.1 (i) If a petition alleging the child to be in need of 296.2 protection or services is filed under this paragraph, the court 296.3 may find, based on the contents of the sworn petition, and the 296.4 agreement of all parties, including the child, where 296.5 appropriate, that there are compelling reasons that the 296.6 voluntary arrangement is in the best interests of the child and 296.7 that the responsible social services agency has made reasonable 296.8 efforts to finalize a plan for the permanent placement of the 296.9 child, approve the continued voluntary placement, and continue 296.10 the matter under the court's jurisdiction for the purpose of 296.11 reviewing the child's placement as a continued voluntary 296.12 arrangement every 12 months as long as the child continues in 296.13 out-of-home placement. The matter must be returned to the court 296.14 for further review every 12 months as long as the child remains 296.15 in placement. The court shall give notice to the parent or 296.16 guardian of the continued review requirements under this 296.17 section. Nothing in this paragraph shall be construed to mean 296.18 the court must order permanent placement for the child under 296.19 section 260C.201, subdivision 11, as long as the court finds 296.20 compelling reasons at the first review required under this 296.21 section. 296.22 (ii) If a petition for termination of parental rights, for 296.23 transfer of permanent legal and physical custody to a relative, 296.24 for long-term foster care, or for foster care for a specified 296.25 period of time is filed, the court must proceed under section 296.26 260C.201, subdivision 11. 296.27 (3) If any party, including the child, disagrees with the 296.28 voluntary arrangement, the court shall proceed under section 296.29 260C.163. 296.30 Sec. 20. Minnesota Statutes 2002, section 626.559, 296.31 subdivision 5, is amended to read: 296.32 Subd. 5. [REVENUE.] The commissioner of human services 296.33 shall add the following funds to the funds appropriated under 296.34 section 626.5591, subdivision 2, to develop and support training: 296.35 (a) The commissioner of human services shall submit claims 296.36 for federal reimbursement earned through the activities and 297.1 services supported through department of human services child 297.2 protection or child welfare training funds. Federal revenue 297.3 earned must be used to improve and expand training services by 297.4 the department. The department expenditures eligible for 297.5 federal reimbursement under this section must not be made from 297.6 federal funds or funds used to match other federal funds. 297.7 (b) Each year, the commissioner of human services shall 297.8 withhold from funds distributed to each county under Minnesota 297.9 Rules, parts 9550.0300 to 9550.0370, an amount equivalent to 1.5 297.10 percent of each county's annual title XX allocation under 297.11 section256E.07256M.50. The commissioner must use these funds 297.12 to ensure decentralization of training. 297.13 (c) The federal revenue under this subdivision is available 297.14 for these purposes until the funds are expended. 297.15 Sec. 21. [MEDICAL ASSISTANCE FOR MENTAL HEALTH SERVICES 297.16 PROVIDED IN OUT-OF-HOME PLACEMENT SETTINGS.] 297.17 The commissioner of human services shall develop a plan in 297.18 conjunction with the commissioner of corrections and 297.19 representatives from counties, provider groups, and other 297.20 stakeholders, to secure medical assistance funding for mental 297.21 health-related services provided in out-of-home placement 297.22 settings, including treatment foster care, group homes, and 297.23 residential programs licensed under Minnesota Statutes, chapters 297.24 241 and 245A. The plan must include proposed legislation, 297.25 fiscal implications, and other pertinent information. 297.26 Treatment foster care services must be provided by a child 297.27 placing agency licensed under Minnesota Rules, parts 9543.0010 297.28 to 9543.0150 or 9545.0755 to 9545.0845. 297.29 The commissioner shall report to the legislature by January 297.30 15, 2004. 297.31 Sec. 22. [TRANSITION TO CHILDREN'S THERAPEUTIC SERVICES 297.32 AND SUPPORTS.] 297.33 Beginning July 1, 2003, the commissioner shall use the 297.34 provider certification process under Minnesota Statutes, section 297.35 256B.0943, instead of the provider certification process 297.36 required in Minnesota Rules, parts 9505.0324; 9505.0326; and 298.1 9505.0327. 298.2 Sec. 23. [REVISOR'S INSTRUCTION.] 298.3 For sections in Minnesota Statutes and Minnesota Rules 298.4 affected by the repealed sections in this article, the revisor 298.5 shall delete internal cross-references where appropriate and 298.6 make changes necessary to correct the punctuation, grammar, or 298.7 structure of the remaining text and preserve its meaning. 298.8 Sec. 24. [REPEALER.] 298.9 (a) Minnesota Statutes 2002, sections 256B.0945, 298.10 subdivision 10, is repealed. 298.11 (b) Minnesota Statutes 2002, section 256B.0625, 298.12 subdivisions 35 and 36, are repealed effective July 1, 2004. 298.13 (c) Minnesota Rules, parts 9505.0324; 9505.0326; and 298.14 9505.0327, are repealed effective July 1, 2004. 298.15 ARTICLE 5 298.16 OCCUPATIONAL LICENSES 298.17 Section 1. Minnesota Statutes 2002, section 148C.01, is 298.18 amended by adding a subdivision to read: 298.19 Subd. 1a. [ACCREDITING ASSOCIATION.] "Accrediting 298.20 association" means an organization recognized by the 298.21 commissioner that evaluates schools and education programs of 298.22 alcohol and drug counseling or is listed in Nationally 298.23 Recognized Accrediting Agencies and Associations, Criteria and 298.24 Procedures for Listing by the U.S. Secretary of Education and 298.25 Current List (1996), which is incorporated by reference. 298.26 Sec. 2. Minnesota Statutes 2002, section 148C.01, 298.27 subdivision 2, is amended to read: 298.28 Subd. 2. [ALCOHOL AND DRUG COUNSELOR.] "Alcohol and drug 298.29 counselor" or "counselor" means a person who: 298.30 (1) uses, as a representation to the public, any title, 298.31 initials, or description of services incorporating the words 298.32 "alcohol and drug counselor"; 298.33 (2) offers to render professional alcohol and drug 298.34 counseling services relative to the abuse of or the dependency 298.35 on alcohol or other drugs to the general public or groups, 298.36 organizations, corporations, institutions, or government 299.1 agencies for compensation, implying that the person is licensed 299.2 and trained, experienced or expert in alcohol and drug 299.3 counseling; 299.4 (3) holds a valid license issued undersections 148C.01 to299.5148C.11this chapter to engage in the practice of alcohol and 299.6 drug counseling; or 299.7 (4) is an applicant for an alcohol and drug counseling 299.8 license. 299.9 Sec. 3. Minnesota Statutes 2002, section 148C.01, is 299.10 amended by adding a subdivision to read: 299.11 Subd. 2a. [ALCOHOL AND DRUG COUNSELOR ACADEMIC COURSE 299.12 WORK.] "Alcohol and drug counselor academic course work" means 299.13 classroom education, which is directly related to alcohol and 299.14 drug counseling and meets the requirements of section 148C.04, 299.15 subdivision 5a, and is taken through an accredited school or 299.16 educational program. 299.17 Sec. 4. Minnesota Statutes 2002, section 148C.01, is 299.18 amended by adding a subdivision to read: 299.19 Subd. 2b. [ALCOHOL AND DRUG COUNSELOR CONTINUING EDUCATION 299.20 ACTIVITY.] "Alcohol and drug counselor continuing education 299.21 activity" means clock hours that meet the requirements of 299.22 section 148C.075 and Minnesota Rules, part 4747.1100, and are 299.23 obtained by a licensee at educational programs of annual 299.24 conferences, lectures, panel discussions, workshops, seminars, 299.25 symposiums, employer-sponsored inservices, or courses taken 299.26 through accredited schools or education programs, including home 299.27 study courses. A home study course need not be provided by an 299.28 accredited school or education program to meet continuing 299.29 education requirements. 299.30 Sec. 5. Minnesota Statutes 2002, section 148C.01, is 299.31 amended by adding a subdivision to read: 299.32 Subd. 2c. [ALCOHOL AND DRUG COUNSELOR 299.33 TECHNICIAN.] "Alcohol and drug counselor technician" means a 299.34 person not licensed as an alcohol and drug counselor who is 299.35 performing acts authorized under section 148C.045. 299.36 Sec. 6. Minnesota Statutes 2002, section 148C.01, is 300.1 amended by adding a subdivision to read: 300.2 Subd. 2d. [ALCOHOL AND DRUG COUNSELOR TRAINING.] "Alcohol 300.3 and drug counselor training" means clock hours obtained by an 300.4 applicant at educational programs of annual conferences, 300.5 lectures, panel discussions, workshops, seminars, symposiums, 300.6 employer-sponsored inservices, or courses taken through 300.7 accredited schools or education programs, including home study 300.8 courses. Clock hours obtained from accredited schools or 300.9 education programs must be measured under Minnesota Rules, part 300.10 4747.1100, subpart 5. 300.11 Sec. 7. Minnesota Statutes 2002, section 148C.01, is 300.12 amended by adding a subdivision to read: 300.13 Subd. 2f. [CLOCK HOUR.] "Clock hour" means an 300.14 instructional session of 50 consecutive minutes, excluding 300.15 coffee breaks, registration, meals without a speaker, and social 300.16 activities. 300.17 Sec. 8. Minnesota Statutes 2002, section 148C.01, is 300.18 amended by adding a subdivision to read: 300.19 Subd. 2g. [CREDENTIAL.] "Credential" means a license, 300.20 permit, certification, registration, or other evidence of 300.21 qualification or authorization to engage in the practice of an 300.22 occupation. 300.23 Sec. 9. Minnesota Statutes 2002, section 148C.01, is 300.24 amended by adding a subdivision to read: 300.25 Subd. 4a. [LICENSEE.] "Licensee" means a person who holds 300.26 a valid license under this chapter. 300.27 Sec. 10. Minnesota Statutes 2002, section 148C.01, is 300.28 amended by adding a subdivision to read: 300.29 Subd. 11a. [STUDENT.] "Student" means a person enrolled in 300.30 an alcohol and drug counselor education program at an accredited 300.31 school or educational program and earning a minimum of nine 300.32 semester credits per calendar year towards completion of an 300.33 associate's, bachelor's, master's, or doctorate degree 300.34 requirements that include an additional 18 semester credits or 300.35 270 clock hours of alcohol and drug counseling specific course 300.36 work and 440 clock hours of practicum. 301.1 Sec. 11. Minnesota Statutes 2002, section 148C.01, 301.2 subdivision 12, is amended to read: 301.3 Subd. 12. [SUPERVISED ALCOHOL AND DRUGCOUNSELING301.4EXPERIENCECOUNSELOR.]Except during the transition period,301.5 "Supervised alcohol and drugcounseling experiencecounselor" 301.6 meanspractical experience gained bya student,volunteer, or301.7 either before, during, or after the student completes a program 301.8 from an accredited school or educational program of alcohol and 301.9 drug counseling, an intern,andor a person issued a temporary 301.10 permit under section 148C.04, subdivision 4, and who is 301.11 supervised by a person either licensed under this chapter or 301.12 exempt under its provisions; either before, during, or after the301.13student completes a program from an accredited school or301.14educational program of alcohol and drug counseling. 301.15 Sec. 12. Minnesota Statutes 2002, section 148C.01, is 301.16 amended by adding a subdivision to read: 301.17 Subd. 12a. [SUPERVISOR.] "Supervisor" means a licensed 301.18 alcohol and drug counselor licensed under this chapter or other 301.19 licensed professional practicing alcohol and drug counseling 301.20 under section 148C.11 who monitors activities of and accepts 301.21 legal liability for the person practicing under supervision. A 301.22 supervisor shall supervise no more than three trainees 301.23 practicing under section 148C.04, subdivision 6. 301.24 Sec. 13. Minnesota Statutes 2002, section 148C.03, 301.25 subdivision 1, is amended to read: 301.26 Subdivision 1. [GENERAL.] The commissioner shall, after 301.27 consultation with the advisory council or a committee 301.28 established by rule: 301.29 (a) adopt and enforce rules for licensure of alcohol and 301.30 drug counselors, including establishing standards and methods of 301.31 determining whether applicants and licensees are qualified under 301.32 section 148C.04. The rules must provide for examinations and 301.33 establish standards for the regulation of professional conduct. 301.34 The rules must be designed to protect the public; 301.35 (b) develop and, at least twice a year, administer an 301.36 examination to assess applicants' knowledge and skills. The 302.1 commissioner may contract for the administration of an 302.2 examination with an entity designated by the commissioner. The 302.3 examinations must be psychometrically valid and reliable; must 302.4 be written and oral, with the oral examination based on a 302.5 written case presentation; must minimize cultural bias; and must 302.6 be balanced in various theories relative to the practice of 302.7 alcohol and drug counseling; 302.8 (c) issue licenses to individuals qualified under sections 302.9 148C.01 to 148C.11; 302.10 (d) issue copies of the rules for licensure to all 302.11 applicants; 302.12 (e) adopt rules to establish and implement procedures, 302.13 including a standard disciplinary process and rules of 302.14 professional conduct; 302.15 (f) carry out disciplinary actions against licensees; 302.16 (g) establish, with the advice and recommendations of the 302.17 advisory council, written internal operating procedures for 302.18 receiving and investigating complaints and for taking 302.19 disciplinary actions as appropriate; 302.20 (h) educate the public about the existence and content of 302.21 the rules for alcohol and drug counselor licensing to enable 302.22 consumers to file complaints against licensees who may have 302.23 violated the rules; 302.24 (i) evaluate the rules in order to refine and improve the 302.25 methods used to enforce the commissioner's standards; and 302.26 (j)set,collect, and adjustlicense fees for alcohol and 302.27 drug counselorsso that the total fees collected will as closely302.28as possible equal anticipated expenditures during the biennium,302.29as provided in section 16A.1285; fees for initial and renewal302.30application and examinations; late fees for counselors who302.31submit license renewal applications after the renewal deadline;302.32and a surcharge fee. The surcharge fee must include an amount302.33necessary to recover, over a five-year period, the302.34commissioner's direct expenditures for the adoption of the rules302.35providing for the licensure of alcohol and drug counselors. All302.36fees received shall be deposited in the state treasury and303.1credited to the special revenue fund. 303.2 Sec. 14. Minnesota Statutes 2002, section 148C.0351, 303.3 subdivision 1, is amended to read: 303.4 Subdivision 1. [APPLICATION FORMS.] Unless exempted under 303.5 section 148C.11, a person who practices alcohol and drug 303.6 counseling in Minnesota must: 303.7 (1) apply to the commissioner for a license to practice 303.8 alcohol and drug counseling on forms provided by the 303.9 commissioner; 303.10 (2) include with the application a statement that the 303.11 statements in the application are true and correct to the best 303.12 of the applicant's knowledge and belief; 303.13 (3) include with the application a nonrefundable 303.14 application fee specifiedby the commissionerin section 303.15 148C.12; 303.16 (4) include with the application information describing the 303.17 applicant's experience, including the number of years and months 303.18 the applicant has practiced alcohol and drug counseling as 303.19 defined in section 148C.01; 303.20 (5) include with the application the applicant's business 303.21 address and telephone number, or home address and telephone 303.22 number if the applicant conducts business out of the home, and 303.23 if applicable, the name of the applicant's supervisor, manager, 303.24 and employer; 303.25 (6) include with the application a written and signed 303.26 authorization for the commissioner to make inquiries to 303.27 appropriate state regulatory agencies and private credentialing 303.28 organizations in this or any other state where the applicant has 303.29 practiced alcohol and drug counseling; and 303.30 (7) complete the application in sufficient detail for the 303.31 commissioner to determine whether the applicant meets the 303.32 requirements for filing. The commissioner may ask the applicant 303.33 to provide additional information necessary to clarify 303.34 incomplete or ambiguous information submitted in the application. 303.35 Sec. 15. Minnesota Statutes 2002, section 148C.0351, is 303.36 amended by adding a subdivision to read: 304.1 Subd. 4. [INITIAL LICENSE; TERM.] (a) An initial license 304.2 is effective on the date the commissioner indicates on the 304.3 license certificate, with the license number, sent to the 304.4 applicant upon approval of the application. 304.5 (b) An initial license is valid for a period beginning with 304.6 the effective date in paragraph (a) and ending on the date 304.7 specified by the commissioner on the license certificate placing 304.8 the applicant in an existing two-year renewal cycle, as 304.9 established under section 148C.05, subdivision 1. 304.10 Sec. 16. [148C.0355] [COMMISSIONER ACTION ON APPLICATIONS 304.11 FOR LICENSURE.] 304.12 The commissioner shall act on each application for 304.13 licensure within 90 days from the date the completed application 304.14 and all required information is received by the commissioner. 304.15 The commissioner shall determine if the applicant meets the 304.16 requirements for licensure and whether there are grounds for 304.17 denial of licensure under this chapter. If the commissioner 304.18 denies an application on grounds other than the applicant's 304.19 failure of an examination, the commissioner shall: 304.20 (1) notify the applicant, in writing, of the denial and the 304.21 reason for the denial and provide the applicant 30 days from the 304.22 date of the letter informing the applicant of the denial in 304.23 which the applicant may provide additional information to 304.24 address the reasons for the denial. If the applicant does not 304.25 respond in writing to the commissioner within the 30-day period, 304.26 the denial is final. If the commissioner receives additional 304.27 information, the commissioner shall review it and make a final 304.28 determination thereafter; 304.29 (2) notify the applicant that an application submitted 304.30 following denial is a new application and must be accompanied by 304.31 the appropriate fee as specified in section 148C.12; and 304.32 (3) notify the applicant of the right to request a hearing 304.33 under chapter 14. 304.34 Sec. 17. Minnesota Statutes 2002, section 148C.04, is 304.35 amended to read: 304.36 148C.04 [REQUIREMENTS FOR LICENSURE.] 305.1 Subdivision 1. [GENERAL REQUIREMENTS.] The commissioner 305.2 shall issue licenses to the individuals qualified undersections305.3148C.01 to 148C.11this chapter to practice alcohol and drug 305.4 counseling. 305.5 Subd. 2. [FEE.] Each applicant shall pay a nonrefundable 305.6 feeset by the commissioner pursuant to section 148C.03as 305.7 specified in section 148C.12. Fees paid to the commissioner 305.8 shall be deposited in the special revenue fund. 305.9 Subd. 3. [LICENSINGREQUIREMENTS FORTHE FIRST FIVE305.10YEARSLICENSURE BEFORE JULY 1, 2008.]For five years after the305.11effective date of the rules authorized in section 148C.03,305.12theAn applicant, unless qualified under section 148C.06 during305.13the 25-month period authorized therein, under section 148C.07,305.14or under subdivision 4,for a license must furnish evidence 305.15 satisfactory to the commissioner that the applicant has met all 305.16 the requirements in clauses (1) to (3). The applicant must have: 305.17 (1) received an associate degree, or an equivalent number 305.18 of credit hours, and a certificate in alcohol and drug 305.19 counseling, including 18 semester credits or 270 clock hours of 305.20alcohol and drug counseling classroom educationacademic course 305.21 work in accordance with subdivision 5a, paragraph (a), from an 305.22 accredited school or educational program and 880 clock hours of 305.23 supervised alcohol and drug counseling practicum; 305.24 (2) completed a written case presentation and 305.25 satisfactorily passed an oral examination established by the 305.26 commissioner that demonstrates competence in the core functions; 305.27 and 305.28 (3) satisfactorily passed a written examination as 305.29 established by the commissioner. 305.30 Subd. 4. [LICENSINGREQUIREMENTSAFTER FIVE YEARSFOR 305.31 LICENSURE AFTER JULY 1, 2008.]Beginning five years after the305.32effective date of the rules authorized in section 148C.03,305.33subdivision 1 ,An applicant forlicensurea license must submit 305.34 evidence to the commissioner that the applicant has met one of 305.35 the following requirements: 305.36 (1) the applicant must have: 306.1 (i) received a bachelor's degree from an accredited school 306.2 or educational program, including48018 semester credits or 270 306.3 clock hours ofalcohol and drug counseling educationacademic 306.4 course work in accordance with subdivision 5a, paragraph (a), 306.5 from an accredited school or educational program and 880 clock 306.6 hours of supervised alcohol and drug counseling practicum; 306.7 (ii) completed a written case presentation and 306.8 satisfactorily passed an oral examination established by the 306.9 commissioner that demonstrates competence in the core functions; 306.10 and 306.11 (iii) satisfactorily passed a written examination as 306.12 established by the commissioner; or 306.13 (2) the applicant must meet the requirements of section 306.14 148C.07. 306.15 Subd. 5a. [ACADEMIC COURSE WORK.] (a) Minimum academic 306.16 course work requirements for licensure as referred to under 306.17 subdivision 3, clause (1), and subdivision 4, clause (1), item 306.18 (i), must be in the following areas: 306.19 (1) overview of alcohol and drug counseling focusing on the 306.20 transdisciplinary foundations of alcohol and drug counseling and 306.21 providing an understanding of theories of chemical dependency, 306.22 the continuum of care, and the process of change; 306.23 (2) pharmacology of substance abuse disorders and the 306.24 dynamics of addiction; 306.25 (3) screening, intake, assessment, and treatment planning; 306.26 (4) counseling theory and practice, crisis intervention, 306.27 orientation, and client education; 306.28 (5) case management, consultation, referral, treatment 306.29 planning, reporting, record keeping, and professional and 306.30 ethical responsibilities; and 306.31 (6) multicultural aspects of chemical dependency to include 306.32 awareness of learning outcomes described in Minnesota Rules, 306.33 part 4747.1100, subpart 2, and the ability to know when 306.34 consultation is needed. 306.35 (b) Advanced academic course work includes, at a minimum, 306.36 the course work required in paragraph (a) and additional course 307.1 work in the following areas: 307.2 (1) advanced study in the areas listed in paragraph (a); 307.3 (2) chemical dependency and the family; 307.4 (3) treating substance abuse disorders in culturally 307.5 diverse and identified populations; 307.6 (4) dual diagnoses/co-occurring disorders with substance 307.7 abuse disorders; and 307.8 (5) ethics and chemical dependency. 307.9 Subd. 6. [TEMPORARYPRACTICEPERMIT REQUIREMENTS.] (a)A307.10person may temporarilyThe commissioner shall issue a temporary 307.11 permit to practice alcohol and drug counseling prior to being 307.12 licensed under this chapter if the person: 307.13 (1) either: 307.14 (i)meets the associate degree education and practicum307.15requirements of subdivision 3, clause (1);307.16(ii) meets the bachelor's degree education and practicum307.17requirements of subdivision 4, clause (1), item (i); or307.18(iii)submits verification of a current and unrestricted 307.19 credential for the practice of alcohol and drug counseling from 307.20 a national certification body or a certification or licensing 307.21 body from another state, United States territory, or federally 307.22 recognized tribal authority; 307.23 (ii) submits verification of the completion of at least 64 307.24 semester credits, including 270 clock hours or 18 semester 307.25 credits of formal classroom education in alcohol and drug 307.26 counseling and at least 880 clock hours of alcohol and drug 307.27 counseling practicum from an accredited school or educational 307.28 program; or 307.29 (iii) meets the requirements of section 148C.11, 307.30 subdivision 6, clauses (1), (2), and (5); 307.31 (2)requestsapplies, in writing,temporary practice status307.32with the commissioneron an application formaccording to307.33section 148C.0351provided by the commissioner, which includes 307.34 the nonrefundablelicensetemporary permit fee as specified in 307.35 section 148C.12 and an affirmation by the person's supervisor, 307.36 as defined in paragraph(b)(c), clause (1),andwhich is signed 308.1 and dated by the person and the person's supervisor; and 308.2 (3) has not been disqualified to practice temporarily on 308.3 the basis of a background investigation under section 148C.09, 308.4 subdivision 1a; and. 308.5(4) has been notified(b) The commissioner must notify the 308.6 person in writing within 90 days from the date the completed 308.7 application and all required information is received by the 308.8 commissionerthatwhether the person is qualified to practice 308.9 under this subdivision. 308.10(b)(c) A person practicing under this subdivision: 308.11 (1) may practiceonly in a program licensed by the308.12department of human services andunder tribal jurisdiction or 308.13 under the direct, on-sitesupervision of a person who is 308.14 licensed under this chapterand employed in that licensed308.15program; 308.16 (2) is subject to the rules of professional conduct set by 308.17 rule; and 308.18 (3) is not subject to the continuing education requirements 308.19 of section148C.05148C.075. 308.20(c)(d) A person practicing under this subdivisionmay not308.21 must usewith the public anythe title or description stating or 308.22 implying that the person islicensed to engagea trainee engaged 308.23 in the practice of alcohol and drug counseling. 308.24(d)(e)The temporary status ofA personapplying for308.25temporary practicepracticing under this subdivisionexpires on308.26the date the commissioner grants or denies licensingmust 308.27 annually submit a renewal application on forms provided by the 308.28 commissioner with the renewal fee required in section 148C.12, 308.29 subdivision 3, and the commissioner may renew the temporary 308.30 permit if the trainee meets the requirements of this 308.31 subdivision. A trainee may renew a practice permit no more than 308.32 five times. 308.33(e)(f) A temporary permit expires if not renewed, upon a 308.34 change of employment of the trainee or upon a change in 308.35 supervision, or upon the granting or denial by the commissioner 308.36 of a license. 309.1 Subd. 7. [EFFECT AND SUSPENSION OF TEMPORARYPRACTICE309.2 PERMIT.] Approval of a person's application for 309.3 temporarypracticepermit creates no rights to or expectation of 309.4 approval from the commissioner for licensure as an alcohol and 309.5 drug counselor. The commissioner may suspend or restrict a 309.6 person's temporarypracticepermit status according to section 309.7 148C.09. 309.8 [EFFECTIVE DATE.] Subdivisions 1, 2, 3, 4, and 5a are 309.9 effective January 28, 2003. Subdivision 6 is effective July 1, 309.10 2003. 309.11 Sec. 18. [148C.045] [ALCOHOL AND DRUG COUNSELOR 309.12 TECHNICIAN.] 309.13 An alcohol and drug counselor technician may perform the 309.14 services described in section 148C.01, subdivision 9, paragraphs 309.15 (1), (2), and (3), while under the direct supervision of a 309.16 licensed alcohol and drug counselor. 309.17 Sec. 19. Minnesota Statutes 2002, section 148C.05, 309.18 subdivision 1, is amended to read: 309.19 Subdivision 1. [BIENNIAL RENEWALREQUIREMENTS.]To renew a309.20license, an applicant must:309.21(1) complete a renewal application every two years on a309.22form provided by the commissioner and submit the biennial309.23renewal fee by the deadline; and309.24(2) submit additional information if requested by the309.25commissioner to clarify information presented in the renewal309.26application. This information must be submitted within 30 days309.27of the commissioner's request.A license must be renewed every 309.28 two years. 309.29 Sec. 20. Minnesota Statutes 2002, section 148C.05, is 309.30 amended by adding a subdivision to read: 309.31 Subd. 1a. [RENEWAL REQUIREMENTS.] To renew a license, an 309.32 applicant must submit to the commissioner: 309.33 (1) a completed and signed application for license renewal, 309.34 including a signed consent authorizing the commissioner to 309.35 obtain information about the applicant from third parties, 309.36 including, but not limited to, employers, former employers, and 310.1 law enforcement agencies; 310.2 (2) the renewal fee required under section 148C.12; and 310.3 (3) additional information as requested by the commissioner 310.4 to clarify information presented in the renewal application. 310.5 The licensee must submit information within 30 days of the date 310.6 of the commissioner's request. 310.7 Sec. 21. Minnesota Statutes 2002, section 148C.05, is 310.8 amended by adding a subdivision to read: 310.9 Subd. 5. [LICENSE RENEWAL NOTICE.] At least 60 calendar 310.10 days before the renewal deadline date in subdivision 6, the 310.11 commissioner shall mail a renewal notice to the licensee's last 310.12 known address on file with the commissioner. The notice must 310.13 include an application for license renewal, the renewal 310.14 deadline, and notice of fees required for renewal. The 310.15 licensee's failure to receive notice does not relieve the 310.16 licensee of the obligation to meet the renewal deadline and 310.17 other requirements for license renewal. 310.18 Sec. 22. Minnesota Statutes 2002, section 148C.05, is 310.19 amended by adding a subdivision to read: 310.20 Subd. 6. [RENEWAL DEADLINE AND LAPSE OF LICENSURE.] (a) 310.21 Licensees must comply with paragraphs (b) to (d). 310.22 (b) Each license certificate must state an expiration 310.23 date. An application for license renewal must be received by 310.24 the commissioner or postmarked at least 30 calendar days before 310.25 the expiration date. If the postmark is illegible, the 310.26 application must be considered timely if received at least 21 310.27 calendar days before the expiration date. 310.28 (c) An application for license renewal not received within 310.29 the time required under paragraph (b) must be accompanied by a 310.30 late fee in addition to the renewal fee required in section 310.31 148C.12. 310.32 (d) A licensee's license lapses if the licensee fails to 310.33 submit to the commissioner a license renewal application by the 310.34 licensure expiration date. A licensee shall not engage in the 310.35 practice of alcohol and drug counseling while the license is 310.36 lapsed. A licensee whose license has lapsed may renew the 311.1 license by complying with section 148C.055. 311.2 Sec. 23. [148C.055] [INACTIVE OR LAPSED LICENSE.] 311.3 Subdivision 1. [INACTIVE LICENSE STATUS.] Unless a 311.4 complaint is pending against the licensee, a licensee whose 311.5 license is in good standing may request, in writing, that the 311.6 license be placed on the inactive list. If a complaint is 311.7 pending against a licensee, a license may not be placed on the 311.8 inactive list until action relating to the complaint is 311.9 concluded. The commissioner must receive the request for 311.10 inactive status before expiration of the license. A request for 311.11 inactive status received after the license expiration date must 311.12 be denied. A licensee may renew a license that is inactive 311.13 under this subdivision by meeting the renewal requirements of 311.14 subdivision 2, except that payment of a late renewal fee is not 311.15 required. A licensee must not practice alcohol and drug 311.16 counseling while the license is inactive. 311.17 Subd. 2. [RENEWAL OF INACTIVE LICENSE.] A licensee whose 311.18 license is inactive shall renew the inactive status by the 311.19 inactive status expiration date determined by the commissioner 311.20 or the license will lapse. An application for renewal of 311.21 inactive status must include evidence satisfactory to the 311.22 commissioner that the licensee has completed 40 clock hours of 311.23 continuing professional education required in section 148C.075, 311.24 and be received by the commissioner at least 30 calendar days 311.25 before the expiration date. If the postmark is illegible, the 311.26 application must be considered timely if received at least 21 311.27 calendar days before the expiration date. Late renewal of 311.28 inactive status must be accompanied by a late fee as required in 311.29 section 148C.12. 311.30 Subd. 3. [RENEWAL OF LAPSED LICENSE.] An individual whose 311.31 license has lapsed for less than two years may renew the license 311.32 by submitting: 311.33 (1) a completed and signed license renewal application; 311.34 (2) the inactive license renewal fee or the renewal fee and 311.35 the late fee as required under section 148C.12; and 311.36 (3) proof of having met the continuing education 312.1 requirements in section 148C.075 since the individual's initial 312.2 licensure or last license renewal. The license issued is then 312.3 effective for the remainder of the next two-year license cycle. 312.4 Subd. 4. [LICENSE RENEWAL FOR TWO YEARS OR MORE AFTER 312.5 LICENSE EXPIRATION DATE.] An individual who submitted a license 312.6 renewal two years or more after the license expiration date must 312.7 submit the following: 312.8 (1) a completed and signed application for licensure, as 312.9 required by section 148C.0351; 312.10 (2) the initial license fee as required in section 148C.12; 312.11 and 312.12 (3) verified documentation of having achieved a passing 312.13 score within the past year on an examination required by the 312.14 commissioner. 312.15 Sec. 24. Minnesota Statutes 2002, section 148C.07, is 312.16 amended to read: 312.17 148C.07 [RECIPROCITY.] 312.18The commissioner shall issue an appropriate license to(a) 312.19 An individual who holds a current license orother credential to312.20engage in alcohol and drug counselingnational certification as 312.21 an alcohol and drug counselor from another jurisdictionif the312.22commissioner finds that the requirements for that credential are312.23substantially similar to the requirements in sections 148C.01 to312.24148C.11must file with the commissioner a completed application 312.25 for licensure by reciprocity containing the information required 312.26 under this section. 312.27 (b) The applicant must request the credentialing authority 312.28 of the jurisdiction in which the credential is held to send 312.29 directly to the commissioner a statement that the credential is 312.30 current and in good standing, the applicant's qualifications 312.31 that entitled the applicant to the credential, and a copy of the 312.32 jurisdiction's credentialing laws and rules that were in effect 312.33 at the time the applicant obtained the credential. 312.34 (c) The commissioner shall issue a license if the 312.35 commissioner finds that the requirements, which the applicant 312.36 had to meet to obtain the credential from the other jurisdiction 313.1 were substantially similar to the current requirements for 313.2 licensure in this chapter, and the applicant is not otherwise 313.3 disqualified under section 148C.09. 313.4 Sec. 25. [148C.075] [CONTINUING EDUCATION REQUIREMENTS.] 313.5 Subdivision 1. [GENERAL REQUIREMENTS.] The commissioner 313.6 shall establish a two-year continuing education reporting 313.7 schedule requiring licensees to report completion of the 313.8 requirements of this section. Licensees must document 313.9 completion of a minimum of 40 clock hours of continuing 313.10 education activities each reporting period. A licensee may be 313.11 given credit only for activities that directly relate to the 313.12 practice of alcohol and drug counseling, the core functions, or 313.13 the rules of professional conduct in Minnesota Rules, part 313.14 4747.1400. The continuing education reporting form must require 313.15 reporting of the following information: 313.16 (1) the continuing education activity title; 313.17 (2) a brief description of the continuing education 313.18 activity; 313.19 (3) the sponsor, presenter, or author; 313.20 (4) the location and attendance dates; 313.21 (5) the number of clock hours; and 313.22 (6) a statement that the information is true and correct to 313.23 the best knowledge of the licensee. 313.24 Only continuing education obtained during the previous 313.25 two-year reporting period may be considered at the time of 313.26 reporting. Clock hours must be earned and reported in 313.27 increments of one-half clock hour with a minimum of one clock 313.28 hour for each continuing education activity. 313.29 Subd. 2. [CONTINUING EDUCATION REQUIREMENTS FOR LICENSEE'S 313.30 FIRST FOUR YEARS.] A licensee must, as part of meeting the clock 313.31 hour requirement of this section, obtain and document 18 hours 313.32 of cultural diversity training within the first four years after 313.33 the licensee's initial license effective date according to the 313.34 commissioner's reporting schedule. 313.35 Subd. 3. [CONTINUING EDUCATION REQUIREMENTS AFTER 313.36 LICENSEE'S INITIAL FOUR YEARS.] Beginning four years following a 314.1 licensee's initial license effective date and according to the 314.2 board's reporting schedule, a licensee must document completion 314.3 of a minimum of six clock hours each reporting period of 314.4 cultural diversity training. Licensees must also document 314.5 completion of six clock hours in courses directly related to the 314.6 rules of professional conduct in Minnesota Rules, part 4747.1400. 314.7 Subd. 4. [STANDARDS FOR APPROVAL.] In order to obtain 314.8 clock hour credit for a continuing education activity, the 314.9 activity must: 314.10 (1) constitute an organized program of learning; 314.11 (2) reasonably be expected to advance the knowledge and 314.12 skills of the alcohol and drug counselor; 314.13 (3) pertain to subjects that directly relate to the 314.14 practice of alcohol and drug counseling and the core functions 314.15 of an alcohol and drug counselor, or the rules of professional 314.16 conduct in Minnesota Rules, part 4747.1400; 314.17 (4) be conducted by individuals who have education, 314.18 training, and experience and are knowledgeable about the subject 314.19 matter; and 314.20 (5) be presented by a sponsor who has a system to verify 314.21 participation and maintains attendance records for three years, 314.22 unless the sponsor provides dated evidence to each participant 314.23 with the number of clock hours awarded. 314.24 Sec. 26. Minnesota Statutes 2002, section 148C.10, 314.25 subdivision 1, is amended to read: 314.26 Subdivision 1. [PRACTICE.]After the commissioner adopts314.27rules,Noindividualperson, other than those individuals 314.28 exempted under section 148C.11, or 148C.045, shall engage in 314.29 alcohol and drug counselingpractice unless that individual314.30holds a valid licensewithout first being licensed under this 314.31 chapter as an alcohol and drug counselor. For purposes of this 314.32 chapter, an individual engages in the practice of alcohol and 314.33 drug counseling if the individual performs or offers to perform 314.34 alcohol and drug counseling services as defined in section 314.35 148C.01, subdivision 10, or if the individual is held out as 314.36 able to perform those services. 315.1 Sec. 27. Minnesota Statutes 2002, section 148C.10, 315.2 subdivision 2, is amended to read: 315.3 Subd. 2. [USE OF TITLES.]After the commissioner adopts315.4rules,Noindividualperson shall present themselves or any 315.5 other individual to the public by any title incorporating the 315.6 words "licensed alcohol and drug counselor" or otherwise hold 315.7 themselves out to the public by any title or description stating 315.8 or implying that they are licensed or otherwise qualified to 315.9 practice alcohol and drug counseling unless that individual 315.10 holds a valid license.City, county, and state agency alcohol315.11and drug counselors who are not licensed under sections 148C.01315.12to 148C.11 may use the title "city agency alcohol and drug315.13counselor," "county agency alcohol and drug counselor," or315.14"state agency alcohol and drug counselor." Hospital alcohol and315.15drug counselors who are not licensed under sections 148C.01 to315.16148C.11 may use the title "hospital alcohol and drug counselor"315.17while acting within the scope of their employmentPersons issued 315.18 a temporary permit must use titles consistent with section 315.19 148C.04, subdivision 6, paragraph (c). 315.20 Sec. 28. Minnesota Statutes 2002, section 148C.11, is 315.21 amended to read: 315.22 148C.11 [EXCEPTIONS TO LICENSE REQUIREMENT.] 315.23 Subdivision 1. [OTHER PROFESSIONALS.] (a) Nothing in 315.24sections 148C.01 to 148C.10 shall preventthis chapter prevents 315.25 members of other professions or occupations from performing 315.26 functions for which they are qualified or licensed. This 315.27 exception includes, but is not limited to, licensed physicians, 315.28 registered nurses, licensed practical nurses, licensed 315.29 psychological practitioners, members of the clergy, American 315.30 Indian medicine men and women, licensed attorneys, probation 315.31 officers, licensed marriage and family therapists, licensed 315.32 social workers, licensed professional counselors, licensed 315.33 school counselors, and registered occupational therapists or 315.34 occupational therapy assistants. 315.35 (b) Nothing in this chapter prohibits technicians and 315.36 resident managers in programs licensed by the department of 316.1 human services from discharging their duties as provided in 316.2 Minnesota Rules, chapter 9530. 316.3 (c) Any person who is exempt under this section but who 316.4 elects to obtain a license under this chapter is subject to this 316.5 chapter to the same extent as other licensees. 316.6 (d) These persons must not, however, use a title 316.7 incorporating the words "alcohol and drug counselor" or 316.8 "licensed alcohol and drug counselor" or otherwise hold 316.9 themselves out to the public by any title or description stating 316.10 or implying that they are engaged in the practice of alcohol and 316.11 drug counseling, or that they are licensed to engage in the 316.12 practice of alcohol and drug counseling. Persons engaged in the 316.13 practice of alcohol and drug counseling are not exempt from the 316.14 commissioner's jurisdiction solely by the use of one of the 316.15 above titles. 316.16 Subd. 2. [STUDENTS.] Nothing in sections 148C.01 to 316.17 148C.10 shall prevent students enrolled in an accredited school 316.18 of alcohol and drug counseling from engaging in the practice of 316.19 alcohol and drug counseling while under qualified supervision in 316.20 an accredited school of alcohol and drug counseling. 316.21 Subd. 3. [FEDERALLY RECOGNIZED TRIBES; ETHNIC MINORITIES.] 316.22 (a) Alcohol and drug counselorslicensed to practicepracticing 316.23 alcohol and drug counseling according to standards established 316.24 by federally recognized tribes, while practicing under tribal 316.25 jurisdiction, are exempt from the requirements of this chapter. 316.26 In practicing alcohol and drug counseling under tribal 316.27 jurisdiction, individualslicensedpracticing under that 316.28 authority shall be afforded the same rights, responsibilities, 316.29 and recognition as persons licensed pursuant to this chapter. 316.30 (b) The commissioner shall develop special licensing 316.31 criteria for issuance of a license to alcohol and drug 316.32 counselors who: (1) practice alcohol and drug counseling with a 316.33 member of an ethnic minority population or with a person with a 316.34 disability as defined by rule; or (2) are employed by agencies 316.35 whose primary agency service focus addresses ethnic minority 316.36 populations or persons with a disability as defined by rule. 317.1 These licensing criteria may differ from the licensing 317.2criteriarequirements specified in section 148C.04. To develop, 317.3 implement, and evaluate the effect of these criteria, the 317.4 commissioner shall establish a committee comprised of, but not 317.5 limited to, representatives from the Minnesota commission 317.6 serving deaf and hard-of-hearing people, the council on affairs 317.7 of Chicano/Latino people, the council on Asian-Pacific 317.8 Minnesotans, the council on Black Minnesotans, the council on 317.9 disability, and the Indian affairs council. The committee does 317.10 not expire. 317.11 (c) The commissioner shall issue a license to an applicant 317.12 who (1) is an alcohol and drug counselor who is exempt under 317.13 paragraph (a) from the requirements of this chapter; (2) has at 317.14 least 2,000 hours of alcohol and drug counselor experience as 317.15 defined by the core functions; and (3) meets the licensing 317.16 requirements that are in effect on the date of application under 317.17 section 148C.04, subdivision 3 or 4, except the written case 317.18 presentation and oral examination component under section 317.19 148C.04, subdivision 3, clause (2), or 4, clause (1), item 317.20 (ii). When applying for a license under this paragraph, an 317.21 applicant must follow the procedures for admission to licensure 317.22 specified under section 148C.0351. A person who receives a 317.23 license under this paragraph must complete the written case 317.24 presentation and satisfactorily pass the oral examination 317.25 component under section 148C.04, subdivision 3, clause (2), or 317.26 4, clause (1), item (ii), at the earliest available opportunity 317.27 after the commissioner begins administering oral examinations. 317.28 The commissioner may suspend or restrict a person's license 317.29 according to section 148C.09 if the person fails to complete the 317.30 written case presentation and satisfactorily pass the oral 317.31 examination. This paragraph expires July 1, 2004. 317.32 Subd. 4. [HOSPITAL ALCOHOL AND DRUG COUNSELORS.]The317.33licensing of hospital alcohol and drug counselors shall be317.34voluntary, while the counselor is employed by the hospital.317.35 Effective January 1, 2006, hospitals employing alcohol and drug 317.36 counselors shallnotbe required to employ licensed alcohol and 318.1 drug counselors, nor shall they require their alcohol and drug318.2counselors to be licensed, however, nothing in this chapter will318.3prohibit hospitals from requiring their counselors to be318.4eligible for licensure. An alcohol or drug counselor employed 318.5 by a hospital must be licensed as an alcohol and drug counselor 318.6 in accordance with this chapter. 318.7 Subd. 5. [CITY, COUNTY, AND STATE AGENCY ALCOHOL AND DRUG 318.8 COUNSELORS.]The licensing of city, county, and state agency318.9alcohol and drug counselors shall be voluntary, while the318.10counselor is employed by the city, county, or state agency.318.11 Effective January 1, 2006, city, county, and state agencies 318.12 employing alcohol and drug counselors shallnotbe required to 318.13 employ licensed alcohol and drug counselors, nor shall they318.14require their drug and alcohol counselors to be licensed. An 318.15 alcohol and drug counselor employed by a city, county, or state 318.16 agency must be licensed as an alcohol and drug counselor in 318.17 accordance with this chapter. 318.18 Subd. 6. [TRANSITION PERIOD FOR HOSPITAL AND CITY, COUNTY, 318.19 AND STATE AGENCY ALCOHOL AND DRUG COUNSELORS.] For the period 318.20 between July 1, 2003, and January 1, 2006, the commissioner 318.21 shall grant a license to an individual who is employed as an 318.22 alcohol and drug counselor at a Minnesota hospital or a city, 318.23 county, or state agency in Minnesota if the individual: 318.24 (1) was employed as an alcohol and drug counselor at a 318.25 hospital or a city, county, or state agency before August 1, 318.26 2002; 318.27 (2) has 8,000 hours of alcohol and drug counselor work 318.28 experience; 318.29 (3) has completed a written case presentation and 318.30 satisfactorily passed an oral examination established by the 318.31 commissioner; 318.32 (4) has satisfactorily passed a written examination as 318.33 established by the commissioner; and 318.34 (5) meets the requirements in section 148C.0351. 318.35 Sec. 29. [148C.12] [FEES.] 318.36 Subdivision 1. [APPLICATION FEE.] The application fee is 319.1 $295. 319.2 Subd. 2. [BIENNIAL RENEWAL FEE.] The license renewal fee 319.3 is $295. If the commissioner changes the renewal schedule and 319.4 the expiration date is less than two years, the fee must be 319.5 prorated. 319.6 Subd. 3. [TEMPORARY PERMIT FEE.] The initial fee for 319.7 applicants under section 148C.04, subdivision 6, paragraph (a), 319.8 is $100. The fee for annual renewal of a temporary permit is 319.9 $100. 319.10 Subd. 4. [EXAMINATION FEE.] The examination fee for the 319.11 written examination is $95 and for the oral examination is $200. 319.12 Subd. 5. [INACTIVE RENEWAL FEE.] The inactive renewal fee 319.13 is $150. 319.14 Subd. 6. [LATE FEE.] The late fee is 25 percent of the 319.15 biennial renewal fee, the inactive renewal fee, or the annual 319.16 fee for renewal of temporary practice status. 319.17 Subd. 7. [FEE TO RENEW AFTER EXPIRATION OF LICENSE.] The 319.18 fee for renewal of a license that has expired for less than two 319.19 years is the total of the biennial renewal fee, the late fee, 319.20 and a fee of $100 for review and approval of the continuing 319.21 education report. 319.22 Subd. 8. [FEE FOR LICENSE VERIFICATIONS.] The fee for 319.23 license verification to institutions and other jurisdictions is 319.24 $25. 319.25 Subd. 9. [SURCHARGE FEE.] Notwithstanding section 319.26 16A.1285, subdivision 2, a surcharge of $99 shall be paid at the 319.27 time of initial application for or renewal of an alcohol and 319.28 drug counselor license until June 30, 2013. 319.29 Subd. 10. [NONREFUNDABLE FEES.] All fees are nonrefundable. 319.30 Sec. 30. [REPEALER.] 319.31 (a) Minnesota Statutes 2002, sections 148C.0351, 319.32 subdivision 2; 148C.05, subdivisions 2, 3, and 4; 148C.06; and 319.33 148C.10, subdivision 1a, are repealed. 319.34 (b) Minnesota Rules, parts 4747.0030, subparts 25, 28, and 319.35 30; 4747.0040, subpart 3, item A; 4747.0060, subpart 1, items A, 319.36 B, and D; 4747.0070, subparts 4 and 5; 4747.0080; 4747.0090; 320.1 4747.0100; 4747.0300; 4747.0400, subparts 2 and 3; 4747.0500; 320.2 4747.0600; 4747.1000; 4747.1100, subpart 3; and 4747.1600, are 320.3 repealed. 320.4 ARTICLE 6 320.5 HUMAN SERVICES LICENSING, COUNTY INITIATIVES, 320.6 AND MISCELLANEOUS 320.7 Section 1. Minnesota Statutes 2002, section 69.021, 320.8 subdivision 11, is amended to read: 320.9 Subd. 11. [EXCESS POLICE STATE-AID HOLDING ACCOUNT.] (a) 320.10 The excess police state-aid holding account is established in 320.11 the general fund. The excess police state-aid holding account 320.12 must be administered by the commissioner. 320.13 (b) Excess police state aid determined according to 320.14 subdivision 10, must be deposited in the excess police state-aid 320.15 holding account. 320.16 (c) From the balance in the excess police state-aid holding 320.17 account,$1,000,000$900,000 is appropriated to and must be 320.18 transferred annually to the ambulance service personnel 320.19 longevity award and incentive suspense account established by 320.20 section 144E.42, subdivision 2. 320.21 (d) If a police officer stress reduction program is created 320.22 by law and money is appropriated for that program, an amount 320.23 equal to that appropriation must be transferred from the balance 320.24 in the excess police state-aid holding account. 320.25 (e) On October 1, 1997, and annually on each subsequent 320.26 October 1, one-half of the balance of the excess police 320.27 state-aid holding account remaining after the deductions under 320.28 paragraphs (c) and (d) is appropriated for additional 320.29 amortization aid under section 423A.02, subdivision 1b. 320.30 (f) Annually, the remaining balance in the excess police 320.31 state-aid holding account, after the deductions under paragraphs 320.32 (c), (d), and (e), cancels to the general fund. 320.33 Sec. 2. Minnesota Statutes 2002, section 245.0312, is 320.34 amended to read: 320.35 245.0312 [DESIGNATING SPECIAL UNITS AND REGIONAL CENTERS.] 320.36 Notwithstanding any provision of law to the contrary, 321.1 during the biennium, the commissioner of human services, upon 321.2 the approval of the governor after consulting with the 321.3 legislative advisory commission, may designate portions of 321.4hospitals for the mentally illstate-operated services 321.5 facilities under the commissioner's control as special care 321.6 unitsfor mentally retarded or inebriate persons, or as nursing321.7homes for persons over the age of 65, and may designate portions321.8of the hospitals designated in Minnesota Statutes 1969, section321.9252.025, subdivision 1, as special care units for mentally ill321.10or inebriate persons, and may plan to develop all hospitals for321.11mentally ill, mentally retarded, or inebriate persons under the321.12commissioner's control as multipurpose regional centers for321.13programs related to all of the said problems. 321.14If approved by the governor, the commissioner may rename321.15the state hospital as a state regional center and appoint the321.16hospital administrator as administrator of the center, in321.17accordance with section 246.0251.321.18The directors of the separate program units of regional321.19centers shall be responsible directly to the commissioner at the321.20discretion of the commissioner.321.21 Sec. 3. [245.945] [REIMBURSEMENT TO OMBUDSMAN FOR MENTAL 321.22 HEALTH AND MENTAL RETARDATION.] 321.23 The commissioner shall obtain federal financial 321.24 participation for eligible activity by the ombudsman for mental 321.25 health and mental retardation. The ombudsman shall maintain and 321.26 transmit to the department of human services documentation that 321.27 is necessary in order to obtain federal funds. 321.28 Sec. 4. Minnesota Statutes 2002, section 245A.035, 321.29 subdivision 3, is amended to read: 321.30 Subd. 3. [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an 321.31 emergency license may be issued, the following requirements must 321.32 be met: 321.33 (1) the county agency must conduct an initial inspection of 321.34 the premises where the foster care is to be provided to ensure 321.35 the health and safety of any child placed in the home. The 321.36 county agency shall conduct the inspection using a form 322.1 developed by the commissioner; 322.2 (2) at the time of the inspection or placement, whichever 322.3 is earlier, the relative being considered for an emergency 322.4 license shall receive an application form for a child foster 322.5 care license; 322.6 (3) whenever possible, prior to placing the child in the 322.7 relative's home, the relative being considered for an emergency 322.8 license shall provide the information required by section 322.9 245A.04, subdivision 3, paragraph(b)(k); and 322.10 (4) if the county determines, prior to the issuance of an 322.11 emergency license, that anyone requiring a background study may 322.12 be disqualified under section 245A.04, and the disqualification 322.13 is one which the commissioner cannot set aside, an emergency 322.14 license shall not be issued. 322.15 [EFFECTIVE DATE.] This section is effective the day 322.16 following final enactment. 322.17 Sec. 5. Minnesota Statutes 2002, section 245A.04, 322.18 subdivision 3, is amended to read: 322.19 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 322.20 (a) Individuals and organizations that are required in statute 322.21 to initiate background studies under this section shall comply 322.22 with the following requirements: 322.23 (1) Applicants for licensure, license holders, and other 322.24 entities as provided in this section must submit completed 322.25 background study forms to the commissioner before individuals 322.26 specified in paragraph (c), clauses (1) to (4), (6), and (7), 322.27 begin positions allowing direct contact in any licensed program. 322.28 (2) Applicants and license holders under the jurisdiction 322.29 of other state agencies who are required in other statutory 322.30 sections to initiate background studies under this section must 322.31 submit completed background study forms to the commissioner 322.32 prior to the background study subject beginning in a position 322.33 allowing direct contact in the licensed program, or where 322.34 applicable, prior to being employed. 322.35 (3) Organizations required to initiate background studies 322.36 under section 256B.0627 for individuals described in paragraph 323.1 (c), clause (5), must submit a completed background study form 323.2 to the commissioner before those individuals begin a position 323.3 allowing direct contact with persons served by the 323.4 organization. The commissioner shall recover the cost of these 323.5 background studies through a fee of no more than $12 per study 323.6 charged to the organization responsible for submitting the 323.7 background study form. The fees collected under this paragraph 323.8 are appropriated to the commissioner for the purpose of 323.9 conducting background studies. 323.10 Upon receipt of the background study forms from the 323.11 entities in clauses (1) to (3), the commissioner shall complete 323.12 the background study as specified under this section and provide 323.13 notices required in subdivision 3a. Unless otherwise specified, 323.14 the subject of a background study may have direct contact with 323.15 persons served by a program after the background study form is 323.16 mailed or submitted to the commissioner pending notification of 323.17 the study results under subdivision 3a. A county agency may 323.18 accept a background study completed by the commissioner under 323.19 this section in place of the background study required under 323.20 section 245A.16, subdivision 3, in programs with joint licensure 323.21 as home and community-based services and adult foster care for 323.22 people with developmental disabilities when the license holder 323.23 does not reside in the foster care residence and the subject of 323.24 the study has been continuously affiliated with the license 323.25 holder since the date of the commissioner's study. 323.26 (b) The definitions in this paragraph apply only to 323.27 subdivisions 3 to 3e. 323.28 (1) "Background study" means the review of records 323.29 conducted by the commissioner to determine whether a subject is 323.30 disqualified from direct contact with persons served by a 323.31 program, and where specifically provided in statutes, whether a 323.32 subject is disqualified from having access to persons served by 323.33 a program. 323.34 (2) "Continuous, direct supervision" means an individual is 323.35 within sight or hearing of the supervising person to the extent 323.36 that supervising person is capable at all times of intervening 324.1 to protect the health and safety of the persons served by the 324.2 program. 324.3 (3) "Contractor" means any person, regardless of employer, 324.4 who is providing program services for hire under the control of 324.5 the provider. 324.6 (4) "Direct contact" means providing face-to-face care, 324.7 training, supervision, counseling, consultation, or medication 324.8 assistance to persons served by the program. 324.9 (5) "Reasonable cause" means information or circumstances 324.10 exist which provide the commissioner with articulable suspicion 324.11 that further pertinent information may exist concerning a 324.12 subject. The commissioner has reasonable cause when, but not 324.13 limited to, the commissioner has received a report from the 324.14 subject, the license holder, or a third party indicating that 324.15 the subject has a history that would disqualify the person or 324.16 that may pose a risk to the health or safety of persons 324.17 receiving services. 324.18 (6) "Subject of a background study" means an individual on 324.19 whom a background study is required or completed. 324.20 (c) The applicant, license holder, registrant under section 324.21 144A.71, subdivision 1, bureau of criminal apprehension, 324.22 commissioner of health, and county agencies, after written 324.23 notice to the individual who is the subject of the study, shall 324.24 help with the study by giving the commissioner criminal 324.25 conviction data and reports about the maltreatment of adults 324.26 substantiated under section 626.557 and the maltreatment of 324.27 minors in licensed programs substantiated under section 324.28 626.556. If a background study is initiated by an applicant or 324.29 license holder and the applicant or license holder receives 324.30 information about the possible criminal or maltreatment history 324.31 of an individual who is the subject of the background study, the 324.32 applicant or license holder must immediately provide the 324.33 information to the commissioner. The individuals to be studied 324.34 shall include: 324.35 (1) the applicant; 324.36 (2) persons age 13 and over living in the household where 325.1 the licensed program will be provided; 325.2 (3) current employees or contractors of the applicant who 325.3 will have direct contact with persons served by the facility, 325.4 agency, or program; 325.5 (4) volunteers or student volunteers who have direct 325.6 contact with persons served by the program to provide program 325.7 services, if the contact is not under the continuous, direct 325.8 supervision by an individual listed in clause (1) or (3); 325.9 (5) any person required under section 256B.0627 to have a 325.10 background study completed under this section; 325.11 (6) persons ages 10 to 12 living in the household where the 325.12 licensed services will be provided when the commissioner has 325.13 reasonable cause; and 325.14 (7) persons who, without providing direct contact services 325.15 at a licensed program, may have unsupervised access to children 325.16 or vulnerable adults receiving services from the program 325.17 licensed to provide family child care for children, foster care 325.18 for children in the provider's own home, or foster care or day 325.19 care services for adults in the provider's own home when the 325.20 commissioner has reasonable cause. 325.21 (d) According to paragraph (c), clauses (2) and (6), the 325.22 commissioner shall review records from the juvenile courts. For 325.23 persons under paragraph (c), clauses (1), (3), (4), (5), and 325.24 (7), who are ages 13 to 17, the commissioner shall review 325.25 records from the juvenile courts when the commissioner has 325.26 reasonable cause. The juvenile courts shall help with the study 325.27 by giving the commissioner existing juvenile court records on 325.28 individuals described in paragraph (c), clauses (2), (6), and 325.29 (7), relating to delinquency proceedings held within either the 325.30 five years immediately preceding the background study or the 325.31 five years immediately preceding the individual's 18th birthday, 325.32 whichever time period is longer. The commissioner shall destroy 325.33 juvenile records obtained pursuant to this subdivision when the 325.34 subject of the records reaches age 23. 325.35 (e) Beginning August 1, 2001, the commissioner shall 325.36 conduct all background studies required under this chapter and 326.1 initiated by supplemental nursing services agencies registered 326.2 under section 144A.71, subdivision 1. Studies for the agencies 326.3 must be initiated annually by each agency. The commissioner 326.4 shall conduct the background studies according to this chapter. 326.5 The commissioner shall recover the cost of the background 326.6 studies through a fee of no more than $8 per study, charged to 326.7 the supplemental nursing services agency. The fees collected 326.8 under this paragraph are appropriated to the commissioner for 326.9 the purpose of conducting background studies. 326.10 (f) For purposes of this section, a finding that a 326.11 delinquency petition is proven in juvenile court shall be 326.12 considered a conviction in state district court. 326.13 (g) A study of an individual in paragraph (c), clauses (1) 326.14 to (7), shall be conducted at least upon application for initial 326.15 license for all license types or registration under section 326.16 144A.71, subdivision 1, and at reapplication for a license for 326.17 family child care, child foster care, and adult foster care. 326.18 The commissioner is not required to conduct a study of an 326.19 individual at the time of reapplication for a license or if the 326.20 individual has been continuously affiliated with a foster care 326.21 provider licensed by the commissioner of human services and 326.22 registered under chapter 144D, other than a family day care or 326.23 foster care license, if: (i) a study of the individual was 326.24 conducted either at the time of initial licensure or when the 326.25 individual became affiliated with the license holder; (ii) the 326.26 individual has been continuously affiliated with the license 326.27 holder since the last study was conducted; and (iii) the 326.28 procedure described in paragraph (j) has been implemented and 326.29 was in effect continuously since the last study was conducted. 326.30 For the purposes of this section, a physician licensed under 326.31 chapter 147 is considered to be continuously affiliated upon the 326.32 license holder's receipt from the commissioner of health or 326.33 human services of the physician's background study results. For 326.34 individuals who are required to have background studies under 326.35 paragraph (c) and who have been continuously affiliated with a 326.36 foster care provider that is licensed in more than one county, 327.1 criminal conviction data may be shared among those counties in 327.2 which the foster care programs are licensed. A county agency's 327.3 receipt of criminal conviction data from another county agency 327.4 shall meet the criminal data background study requirements of 327.5 this section. 327.6 (h) The commissioner may also conduct studies on 327.7 individuals specified in paragraph (c), clauses (3) and (4), 327.8 when the studies are initiated by: 327.9 (i) personnel pool agencies; 327.10 (ii) temporary personnel agencies; 327.11 (iii) educational programs that train persons by providing 327.12 direct contact services in licensed programs; and 327.13 (iv) professional services agencies that are not licensed 327.14 and which contract with licensed programs to provide direct 327.15 contact services or individuals who provide direct contact 327.16 services. 327.17 (i) Studies on individuals in paragraph (h), items (i) to 327.18 (iv), must be initiated annually by these agencies, programs, 327.19 and individuals. Except as provided in paragraph (a), clause 327.20 (3), no applicant, license holder, or individual who is the 327.21 subject of the study shall pay any fees required to conduct the 327.22 study. 327.23 (1) At the option of the licensed facility, rather than 327.24 initiating another background study on an individual required to 327.25 be studied who has indicated to the licensed facility that a 327.26 background study by the commissioner was previously completed, 327.27 the facility may make a request to the commissioner for 327.28 documentation of the individual's background study status, 327.29 provided that: 327.30 (i) the facility makes this request using a form provided 327.31 by the commissioner; 327.32 (ii) in making the request the facility informs the 327.33 commissioner that either: 327.34 (A) the individual has been continuously affiliated with a 327.35 licensed facility since the individual's previous background 327.36 study was completed, or since October 1, 1995, whichever is 328.1 shorter; or 328.2 (B) the individual is affiliated only with a personnel pool 328.3 agency, a temporary personnel agency, an educational program 328.4 that trains persons by providing direct contact services in 328.5 licensed programs, or a professional services agency that is not 328.6 licensed and which contracts with licensed programs to provide 328.7 direct contact services or individuals who provide direct 328.8 contact services; and 328.9 (iii) the facility provides notices to the individual as 328.10 required in paragraphs (a) to (j), and that the facility is 328.11 requesting written notification of the individual's background 328.12 study status from the commissioner. 328.13 (2) The commissioner shall respond to each request under 328.14 paragraph (1) with a written or electronic notice to the 328.15 facility and the study subject. If the commissioner determines 328.16 that a background study is necessary, the study shall be 328.17 completed without further request from a licensed agency or 328.18 notifications to the study subject. 328.19 (3) When a background study is being initiated by a 328.20 licensed facility or a foster care provider that is also 328.21 registered under chapter 144D, a study subject affiliated with 328.22 multiple licensed facilities may attach to the background study 328.23 form a cover letter indicating the additional facilities' names, 328.24 addresses, and background study identification numbers. When 328.25 the commissioner receives such notices, each facility identified 328.26 by the background study subject shall be notified of the study 328.27 results. The background study notice sent to the subsequent 328.28 agencies shall satisfy those facilities' responsibilities for 328.29 initiating a background study on that individual. 328.30 (j) If an individual who is affiliated with a program or 328.31 facility regulated by the department of human services or 328.32 department of health, a facility serving children or youth 328.33 licensed by the department of corrections, orwho is affiliated328.34 with any type of home care agency or provider of personal care 328.35 assistance services, is convicted of a crime constituting a 328.36 disqualification under subdivision 3d, the probation officer or 329.1 corrections agent shall notify the commissioner of the 329.2 conviction. For the purpose of this paragraph, "conviction" has 329.3 the meaning given it in section 609.02, subdivision 5. The 329.4 commissioner, in consultation with the commissioner of 329.5 corrections, shall develop forms and information necessary to 329.6 implement this paragraph and shall provide the forms and 329.7 information to the commissioner of corrections for distribution 329.8 to local probation officers and corrections agents. The 329.9 commissioner shall inform individuals subject to a background 329.10 study that criminal convictions for disqualifying crimes will be 329.11 reported to the commissioner by the corrections system. A 329.12 probation officer, corrections agent, or corrections agency is 329.13 not civilly or criminally liable for disclosing or failing to 329.14 disclose the information required by this paragraph. Upon 329.15 receipt of disqualifying information, the commissioner shall 329.16 provide the notifications required in subdivision 3a, as 329.17 appropriate to agencies on record as having initiated a 329.18 background study or making a request for documentation of the 329.19 background study status of the individual. This paragraph does 329.20 not apply to family day care and child foster care programs. 329.21 (k) The individual who is the subject of the study must 329.22 provide the applicant or license holder with sufficient 329.23 information to ensure an accurate study including the 329.24 individual's first, middle, and last name and all other names by 329.25 which the individual has been known; home address, city, county, 329.26 and state of residence for the past five years; zip code; sex; 329.27 date of birth; and driver's license number or state 329.28 identification number. The applicant or license holder shall 329.29 provide this information about an individual in paragraph (c), 329.30 clauses (1) to (7), on forms prescribed by the commissioner. By 329.31 January 1, 2000, for background studies conducted by the 329.32 department of human services, the commissioner shall implement a 329.33 system for the electronic transmission of: (1) background study 329.34 information to the commissioner; and (2) background study 329.35 results to the license holder. The commissioner may request 329.36 additional information of the individual, which shall be 330.1 optional for the individual to provide, such as the individual's 330.2 social security number or race. 330.3 (l) For programs directly licensed by the commissioner, a 330.4 study must include information related to names of substantiated 330.5 perpetrators of maltreatment of vulnerable adults that has been 330.6 received by the commissioner as required under section 626.557, 330.7 subdivision 9c, paragraph (i), and the commissioner's records 330.8 relating to the maltreatment of minors in licensed programs, 330.9 information from juvenile courts as required in paragraph (c) 330.10 for persons listed in paragraph (c), clauses (2), (6), and (7), 330.11 and information from the bureau of criminal apprehension. For 330.12 child foster care, adult foster care, and family day care homes, 330.13 the study must include information from the county agency's 330.14 record of substantiated maltreatment of adults, and the 330.15 maltreatment of minors, information from juvenile courts as 330.16 required in paragraph (c) for persons listed in paragraph (c), 330.17 clauses (2), (6), and (7), and information from the bureau of 330.18 criminal apprehension. For any background study completed under 330.19 this section, the commissioner may also review arrest and 330.20 investigative information from the bureau of criminal 330.21 apprehension, the commissioner of health, a county attorney, 330.22 county sheriff, county agency, local chief of police, other 330.23 states, the courts, or the Federal Bureau of Investigation if 330.24 the commissioner has reasonable cause to believe the information 330.25 is pertinent to the disqualification of an individual listed in 330.26 paragraph (c), clauses (1) to (7). The commissioner is not 330.27 required to conduct more than one review of a subject's records 330.28 from the Federal Bureau of Investigation if a review of the 330.29 subject's criminal history with the Federal Bureau of 330.30 Investigation has already been completed by the commissioner and 330.31 there has been no break in the subject's affiliation with the 330.32 license holder who initiated the background study. 330.33 (m) For any background study completed under this section, 330.34 when the commissioner has reasonable cause to believe that 330.35 further pertinent information may exist on the subject, the 330.36 subject shall provide a set of classifiable fingerprints 331.1 obtained from an authorized law enforcement agency. For 331.2 purposes of requiring fingerprints, the commissioner shall be 331.3 considered to have reasonable cause under, but not limited to, 331.4 the following circumstances: 331.5 (1) information from the bureau of criminal apprehension 331.6 indicates that the subject is a multistate offender; 331.7 (2) information from the bureau of criminal apprehension 331.8 indicates that multistate offender status is undetermined; or 331.9 (3) the commissioner has received a report from the subject 331.10 or a third party indicating that the subject has a criminal 331.11 history in a jurisdiction other than Minnesota. 331.12 (n) The failure or refusal of an applicant, license holder, 331.13 or registrant under section 144A.71, subdivision 1, to cooperate 331.14 with the commissioner is reasonable cause to disqualify a 331.15 subject, deny a license application or immediately suspend, 331.16 suspend, or revoke a license or registration. Failure or 331.17 refusal of an individual to cooperate with the study is just 331.18 cause for denying or terminating employment of the individual if 331.19 the individual's failure or refusal to cooperate could cause the 331.20 applicant's application to be denied or the license holder's 331.21 license to be immediately suspended, suspended, or revoked. 331.22 (o) The commissioner shall not consider an application to 331.23 be complete until all of the information required to be provided 331.24 under this subdivision has been received. 331.25 (p) No person in paragraph (c), clauses (1) to (7), who is 331.26 disqualified as a result of this section may be retained by the 331.27 agency in a position involving direct contact with persons 331.28 served by the program and no person in paragraph (c), clauses 331.29 (2), (6), and (7), or as provided elsewhere in statute who is 331.30 disqualified as a result of this section may be allowed access 331.31 to persons served by the program, unless the commissioner has 331.32 provided written notice to the agency stating that: 331.33 (1) the individual may remain in direct contact during the 331.34 period in which the individual may request reconsideration as 331.35 provided in subdivision 3a, paragraph (b), clause (2) or (3); 331.36 (2) the individual's disqualification has been set aside 332.1 for that agency as provided in subdivision 3b, paragraph (b); or 332.2 (3) the license holder has been granted a variance for the 332.3 disqualified individual under subdivision 3e. 332.4 (q) Termination of affiliation with persons in paragraph 332.5 (c), clauses (1) to (7), made in good faith reliance on a notice 332.6 of disqualification provided by the commissioner shall not 332.7 subject the applicant or license holder to civil liability. 332.8 (r) The commissioner may establish records to fulfill the 332.9 requirements of this section. 332.10 (s) The commissioner may not disqualify an individual 332.11 subject to a study under this section because that person has, 332.12 or has had, a mental illness as defined in section 245.462, 332.13 subdivision 20. 332.14 (t) An individual subject to disqualification under this 332.15 subdivision has the applicable rights in subdivision 3a, 3b, or 332.16 3c. 332.17 (u) For the purposes of background studies completed by 332.18 tribal organizations performing licensing activities otherwise 332.19 required of the commissioner under this chapter, after obtaining 332.20 consent from the background study subject, tribal licensing 332.21 agencies shall have access to criminal history data in the same 332.22 manner as county licensing agencies and private licensing 332.23 agencies under this chapter. 332.24 (v) County agencies shall have access to the criminal 332.25 history data in the same manner as county licensing agencies 332.26 under this chapter for purposes of background studies completed 332.27 by county agencies on legal nonlicensed child care providers to 332.28 determine eligibility for child care funds under chapter 119B. 332.29 [EFFECTIVE DATE.] This section is effective the day 332.30 following final enactment. 332.31 Sec. 6. Minnesota Statutes 2002, section 245A.04, 332.32 subdivision 3b, is amended to read: 332.33 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 332.34 individual who is the subject of the disqualification may 332.35 request a reconsideration of the disqualification. 332.36 The individual must submit the request for reconsideration 333.1 to the commissioner in writing. A request for reconsideration 333.2 for an individual who has been sent a notice of disqualification 333.3 under subdivision 3a, paragraph (b), clause (1) or (2), must be 333.4 submitted within 30 calendar days of the disqualified 333.5 individual's receipt of the notice of disqualification. Upon 333.6 showing that the information in clause (1) or (2) cannot be 333.7 obtained within 30 days, the disqualified individual may request 333.8 additional time, not to exceed 30 days, to obtain that 333.9 information. A request for reconsideration for an individual 333.10 who has been sent a notice of disqualification under subdivision 333.11 3a, paragraph (b), clause (3), must be submitted within 15 333.12 calendar days of the disqualified individual's receipt of the 333.13 notice of disqualification. An individual who was determined to 333.14 have maltreated a child under section 626.556 or a vulnerable 333.15 adult under section 626.557, and who was disqualified under this 333.16 section on the basis of serious or recurring maltreatment, may 333.17 request reconsideration of both the maltreatment and the 333.18 disqualification determinations. The request for 333.19 reconsideration of the maltreatment determination and the 333.20 disqualification must be submitted within 30 calendar days of 333.21 the individual's receipt of the notice of disqualification. 333.22 Removal of a disqualified individual from direct contact shall 333.23 be ordered if the individual does not request reconsideration 333.24 within the prescribed time, and for an individual who submits a 333.25 timely request for reconsideration, if the disqualification is 333.26 not set aside. The individual must present information showing 333.27 that: 333.28 (1) the information the commissioner relied upon in 333.29 determining that the underlying conduct giving rise to the 333.30 disqualification occurred, and for maltreatment, that the 333.31 maltreatment was serious or recurring, is incorrect; or 333.32 (2) the subject of the study does not pose a risk of harm 333.33 to any person served by the applicant, license holder, or 333.34 registrant under section 144A.71, subdivision 1. 333.35 (b) The commissioner shall rescind the disqualification if 333.36 the commissioner finds that the information relied on to 334.1 disqualify the subject is incorrect. The commissioner may set 334.2 aside the disqualification under this section if the 334.3 commissioner finds that the individual does not pose a risk of 334.4 harm to any person served by the applicant, license holder, or 334.5 registrant under section 144A.71, subdivision 1. In determining 334.6 that an individual does not pose a risk of harm, the 334.7 commissioner shall consider the nature, severity, and 334.8 consequences of the event or events that lead to 334.9 disqualification, whether there is more than one disqualifying 334.10 event, the age and vulnerability of the victim at the time of 334.11 the event, the harm suffered by the victim, the similarity 334.12 between the victim and persons served by the program, the time 334.13 elapsed without a repeat of the same or similar event, 334.14 documentation of successful completion by the individual studied 334.15 of training or rehabilitation pertinent to the event, and any 334.16 other information relevant to reconsideration. In reviewing a 334.17 disqualification under this section, the commissioner shall give 334.18 preeminent weight to the safety of each person to be served by 334.19 the license holder, applicant, or registrant under section 334.20 144A.71, subdivision 1, over the interests of the license 334.21 holder, applicant, or registrant under section 144A.71, 334.22 subdivision 1. If the commissioner sets aside a 334.23 disqualification under this section, the disqualified individual 334.24 remains disqualified, but may hold a license and have direct 334.25 contact with or access to persons receiving services. The 334.26 commissioner's set aside of a disqualification is limited solely 334.27 to the licensed program, applicant, or agency specified in the 334.28 set aside notice, unless otherwise specified in the notice. The 334.29 commissioner may rescind a previous set aside of a 334.30 disqualification under this section based on new information 334.31 that indicates the individual may pose a risk of harm to persons 334.32 served by the applicant, license holder, or registrant. If the 334.33 commissioner rescinds a set aside of a disqualification under 334.34 this paragraph, the appeal rights under paragraphs (a) and (e) 334.35 shall apply. 334.36 (c) Unless the information the commissioner relied on in 335.1 disqualifying an individual is incorrect, the commissioner may 335.2 not set aside the disqualification of an individual in 335.3 connection with a license to provide family day care for 335.4 children, foster care for children in the provider's own home, 335.5 or foster care or day care services for adults in the provider's 335.6 own home if: 335.7 (1) less than ten years have passed since the discharge of 335.8 the sentence imposed for the offense; and the individual has 335.9 been convicted of a violation of any offense listed in sections 335.10 609.165 (felon ineligible to possess firearm), criminal 335.11 vehicular homicide under 609.21 (criminal vehicular homicide and 335.12 injury), 609.215 (aiding suicide or aiding attempted suicide), 335.13 felony violations under 609.223 or 609.2231 (assault in the 335.14 third or fourth degree), 609.713 (terroristic threats), 609.235 335.15 (use of drugs to injure or to facilitate crime), 609.24 (simple 335.16 robbery), 609.255 (false imprisonment), 609.562 (arson in the 335.17 second degree), 609.71 (riot), 609.498, subdivision 1 or1a1b 335.18 (aggravated first degree or first degree tampering with a 335.19 witness), burglary in the first or second degree under 609.582 335.20 (burglary), 609.66 (dangerous weapon), 609.665 (spring guns), 335.21 609.67 (machine guns and short-barreled shotguns), 609.749, 335.22 subdivision 2 (gross misdemeanor harassment; stalking), 152.021 335.23 or 152.022 (controlled substance crime in the first or second 335.24 degree), 152.023, subdivision 1, clause (3) or (4), or 335.25 subdivision 2, clause (4) (controlled substance crime in the 335.26 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 335.27 (controlled substance crime in the fourth degree), 609.224, 335.28 subdivision 2, paragraph (c) (fifth-degree assault by a 335.29 caregiver against a vulnerable adult), 609.23 (mistreatment of 335.30 persons confined), 609.231 (mistreatment of residents or 335.31 patients), 609.2325 (criminal abuse of a vulnerable adult), 335.32 609.233 (criminal neglect of a vulnerable adult), 609.2335 335.33 (financial exploitation of a vulnerable adult), 609.234 (failure 335.34 to report), 609.265 (abduction), 609.2664 to 609.2665 335.35 (manslaughter of an unborn child in the first or second degree), 335.36 609.267 to 609.2672 (assault of an unborn child in the first, 336.1 second, or third degree), 609.268 (injury or death of an unborn 336.2 child in the commission of a crime), 617.293 (disseminating or 336.3 displaying harmful material to minors), a felony level 336.4 conviction involving alcohol or drug use, a gross misdemeanor 336.5 offense under 609.324, subdivision 1 (other prohibited acts), a 336.6 gross misdemeanor offense under 609.378 (neglect or endangerment 336.7 of a child), a gross misdemeanor offense under 609.377 336.8 (malicious punishment of a child), 609.72, subdivision 3 336.9 (disorderly conduct against a vulnerable adult); or an attempt 336.10 or conspiracy to commit any of these offenses, as each of these 336.11 offenses is defined in Minnesota Statutes; or an offense in any 336.12 other state, the elements of which are substantially similar to 336.13 the elements of any of the foregoing offenses; 336.14 (2) regardless of how much time has passed since the 336.15 involuntary termination of parental rights under section 336.16 260C.301 or the discharge of the sentence imposed for the 336.17 offense, the individual was convicted of a violation of any 336.18 offense listed in sections 609.185 to 609.195 (murder in the 336.19 first, second, or third degree), 609.20 (manslaughter in the 336.20 first degree), 609.205 (manslaughter in the second degree), 336.21 609.245 (aggravated robbery), 609.25 (kidnapping), 609.561 336.22 (arson in the first degree), 609.749, subdivision 3, 4, or 5 336.23 (felony-level harassment; stalking), 609.228 (great bodily harm 336.24 caused by distribution of drugs), 609.221 or 609.222 (assault in 336.25 the first or second degree), 609.66, subdivision 1e (drive-by 336.26 shooting), 609.855, subdivision 5 (shooting in or at a public 336.27 transit vehicle or facility), 609.2661 to 609.2663 (murder of an 336.28 unborn child in the first, second, or third degree), a felony 336.29 offense under 609.377 (malicious punishment of a child), a 336.30 felony offense under 609.324, subdivision 1 (other prohibited 336.31 acts), a felony offense under 609.378 (neglect or endangerment 336.32 of a child), 609.322 (solicitation, inducement, and promotion of 336.33 prostitution), 609.342 to 609.345 (criminal sexual conduct in 336.34 the first, second, third, or fourth degree), 609.352 336.35 (solicitation of children to engage in sexual conduct), 617.246 336.36 (use of minors in a sexual performance), 617.247 (possession of 337.1 pictorial representations of a minor), 609.365 (incest), a 337.2 felony offense under sections 609.2242 and 609.2243 (domestic 337.3 assault), a felony offense of spousal abuse, a felony offense of 337.4 child abuse or neglect, a felony offense of a crime against 337.5 children, or an attempt or conspiracy to commit any of these 337.6 offenses as defined in Minnesota Statutes, or an offense in any 337.7 other state, the elements of which are substantially similar to 337.8 any of the foregoing offenses; 337.9 (3) within the seven years preceding the study, the 337.10 individual committed an act that constitutes maltreatment of a 337.11 child under section 626.556, subdivision 10e, and that resulted 337.12 in substantial bodily harm as defined in section 609.02, 337.13 subdivision 7a, or substantial mental or emotional harm as 337.14 supported by competent psychological or psychiatric evidence; or 337.15 (4) within the seven years preceding the study, the 337.16 individual was determined under section 626.557 to be the 337.17 perpetrator of a substantiated incident of maltreatment of a 337.18 vulnerable adult that resulted in substantial bodily harm as 337.19 defined in section 609.02, subdivision 7a, or substantial mental 337.20 or emotional harm as supported by competent psychological or 337.21 psychiatric evidence. 337.22 In the case of any ground for disqualification under 337.23 clauses (1) to (4), if the act was committed by an individual 337.24 other than the applicant, license holder, or registrant under 337.25 section 144A.71, subdivision 1, residing in the applicant's or 337.26 license holder's home, or the home of a registrant under section 337.27 144A.71, subdivision 1, the applicant, license holder, or 337.28 registrant under section 144A.71, subdivision 1, may seek 337.29 reconsideration when the individual who committed the act no 337.30 longer resides in the home. 337.31 The disqualification periods provided under clauses (1), 337.32 (3), and (4) are the minimum applicable disqualification 337.33 periods. The commissioner may determine that an individual 337.34 should continue to be disqualified from licensure or 337.35 registration under section 144A.71, subdivision 1, because the 337.36 license holder, applicant, or registrant under section 144A.71, 338.1 subdivision 1, poses a risk of harm to a person served by that 338.2 individual after the minimum disqualification period has passed. 338.3 (d) The commissioner shall respond in writing or by 338.4 electronic transmission to all reconsideration requests for 338.5 which the basis for the request is that the information relied 338.6 upon by the commissioner to disqualify is incorrect or 338.7 inaccurate within 30 working days of receipt of a request and 338.8 all relevant information. If the basis for the request is that 338.9 the individual does not pose a risk of harm, the commissioner 338.10 shall respond to the request within 15 working days after 338.11 receiving the request for reconsideration and all relevant 338.12 information. If the request is based on both the correctness or 338.13 accuracy of the information relied on to disqualify the 338.14 individual and the risk of harm, the commissioner shall respond 338.15 to the request within 45 working days after receiving the 338.16 request for reconsideration and all relevant information. If 338.17 the disqualification is set aside, the commissioner shall notify 338.18 the applicant or license holder in writing or by electronic 338.19 transmission of the decision. 338.20 (e) Except as provided in subdivision 3c, if a 338.21 disqualification for which reconsideration was requested is not 338.22 set aside or is not rescinded, an individual who was 338.23 disqualified on the basis of a preponderance of evidence that 338.24 the individual committed an act or acts that meet the definition 338.25 of any of the crimes listed in subdivision 3d, paragraph (a), 338.26 clauses (1) to (4); for a determination under section 626.556 or 338.27 626.557 of substantiated maltreatment that was serious or 338.28 recurring under subdivision 3d, paragraph (a), clause (4); or 338.29 for failure to make required reports under section 626.556, 338.30 subdivision 3, or 626.557, subdivision 3, pursuant to 338.31 subdivision 3d, paragraph (a), clause (4), may request a fair 338.32 hearing under section 256.045. Except as provided under 338.33 subdivision 3c, the fair hearing is the only administrative 338.34 appeal of the final agency determination for purposes of appeal 338.35 by the disqualified individual, specifically, including a 338.36 challenge to the accuracy and completeness of data under section 339.1 13.04. If the individual was disqualified based on a conviction 339.2 or admission to any crimes listed in subdivision 3d, paragraph 339.3 (a), clauses (1) to (4), the reconsideration decision under this 339.4 subdivision is the final agency determination for purposes of 339.5 appeal by the disqualified individual and is not subject to a 339.6 hearing under section 256.045. 339.7 (f) Except as provided under subdivision 3c, if an 339.8 individual was disqualified on the basis of a determination of 339.9 maltreatment under section 626.556 or 626.557, which was serious 339.10 or recurring, and the individual has requested reconsideration 339.11 of the maltreatment determination under section 626.556, 339.12 subdivision 10i, or 626.557, subdivision 9d, and also requested 339.13 reconsideration of the disqualification under this subdivision, 339.14 reconsideration of the maltreatment determination and 339.15 reconsideration of the disqualification shall be consolidated 339.16 into a single reconsideration. For maltreatment and 339.17 disqualification determinations made by county agencies, the 339.18 consolidated reconsideration shall be conducted by the county 339.19 agency. If the county agency has disqualified an individual on 339.20 multiple bases, one of which is a county maltreatment 339.21 determination for which the individual has a right to request 339.22 reconsideration, the county shall conduct the reconsideration of 339.23 all disqualifications. Except as provided under subdivision 3c, 339.24 if an individual who was disqualified on the basis of serious or 339.25 recurring maltreatment requests a fair hearing on the 339.26 maltreatment determination under section 626.556, subdivision 339.27 10i, or 626.557, subdivision 9d, and requests a fair hearing on 339.28 the disqualification, which has not been set aside or rescinded 339.29 under this subdivision, the scope of the fair hearing under 339.30 section 256.045 shall include the maltreatment determination and 339.31 the disqualification. Except as provided under subdivision 3c, 339.32 a fair hearing is the only administrative appeal of the final 339.33 agency determination, specifically, including a challenge to the 339.34 accuracy and completeness of data under section 13.04. 339.35 (g) In the notice from the commissioner that a 339.36 disqualification has been set aside, the license holder must be 340.1 informed that information about the nature of the 340.2 disqualification and which factors under paragraph (b) were the 340.3 bases of the decision to set aside the disqualification is 340.4 available to the license holder upon request without consent of 340.5 the background study subject. With the written consent of a 340.6 background study subject, the commissioner may release to the 340.7 license holder copies of all information related to the 340.8 background study subject's disqualification and the 340.9 commissioner's decision to set aside the disqualification as 340.10 specified in the written consent. 340.11 [EFFECTIVE DATE.] This section is effective the day 340.12 following final enactment. 340.13 Sec. 7. Minnesota Statutes 2002, section 245A.04, 340.14 subdivision 3d, is amended to read: 340.15 Subd. 3d. [DISQUALIFICATION.] (a) Upon receipt of 340.16 information showing, or when a background study completed under 340.17 subdivision 3 shows any of the following: a conviction of one 340.18 or more crimes listed in clauses (1) to (4); the individual has 340.19 admitted to or a preponderance of the evidence indicates the 340.20 individual has committed an act or acts that meet the definition 340.21 of any of the crimes listed in clauses (1) to (4); or an 340.22 investigation results in an administrative determination listed 340.23 under clause (4), the individual shall be disqualified from any 340.24 position allowing direct contact with persons receiving services 340.25 from the license holder, entity identified in subdivision 3, 340.26 paragraph (a), or registrant under section 144A.71, subdivision 340.27 1, and for individuals studied under section 245A.04, 340.28 subdivision 3, paragraph (c), clauses (2), (6), and (7), the 340.29 individual shall also be disqualified from access to a person 340.30 receiving services from the license holder: 340.31 (1) regardless of how much time has passed since the 340.32 involuntary termination of parental rights under section 340.33 260C.301 or the discharge of the sentence imposed for the 340.34 offense, and unless otherwise specified, regardless of the level 340.35 of the conviction, the individual was convicted of any of the 340.36 following offenses: sections 609.185 (murder in the first 341.1 degree); 609.19 (murder in the second degree); 609.195 (murder 341.2 in the third degree); 609.2661 (murder of an unborn child in the 341.3 first degree); 609.2662 (murder of an unborn child in the second 341.4 degree); 609.2663 (murder of an unborn child in the third 341.5 degree); 609.20 (manslaughter in the first degree); 609.205 341.6 (manslaughter in the second degree); 609.221 or 609.222 (assault 341.7 in the first or second degree); 609.228 (great bodily harm 341.8 caused by distribution of drugs); 609.245 (aggravated robbery); 341.9 609.25 (kidnapping); 609.561 (arson in the first degree); 341.10 609.749, subdivision 3, 4, or 5 (felony-level harassment; 341.11 stalking); 609.66, subdivision 1e (drive-by shooting); 609.855, 341.12 subdivision 5 (shooting at or in a public transit vehicle or 341.13 facility); 609.322 (solicitation, inducement, and promotion of 341.14 prostitution); 609.342 (criminal sexual conduct in the first 341.15 degree); 609.343 (criminal sexual conduct in the second degree); 341.16 609.344 (criminal sexual conduct in the third degree); 609.345 341.17 (criminal sexual conduct in the fourth degree); 609.352 341.18 (solicitation of children to engage in sexual conduct); 609.365 341.19 (incest); felony offense under 609.377 (malicious punishment of 341.20 a child); a felony offense under 609.378 (neglect or 341.21 endangerment of a child); a felony offense under 609.324, 341.22 subdivision 1 (other prohibited acts); 617.246 (use of minors in 341.23 sexual performance prohibited); 617.247 (possession of pictorial 341.24 representations of minors); a felony offense under sections 341.25 609.2242 and 609.2243 (domestic assault), a felony offense of 341.26 spousal abuse, a felony offense of child abuse or neglect, a 341.27 felony offense of a crime against children; or attempt or 341.28 conspiracy to commit any of these offenses as defined in 341.29 Minnesota Statutes, or an offense in any other state or country, 341.30 where the elements are substantially similar to any of the 341.31 offenses listed in this clause; 341.32 (2) if less than 15 years have passed since the discharge 341.33 of the sentence imposed for the offense; and the individual has 341.34 received a felony conviction for a violation of any of these 341.35 offenses: sections 609.21 (criminal vehicular homicide and 341.36 injury); 609.165 (felon ineligible to possess firearm); 609.215 342.1 (suicide); 609.223 or 609.2231 (assault in the third or fourth 342.2 degree); repeat offenses under 609.224 (assault in the fifth 342.3 degree); repeat offenses under 609.3451 (criminal sexual conduct 342.4 in the fifth degree); 609.498, subdivision 1 or1a342.5 1b (aggravated first degree or first degree tampering with a 342.6 witness); 609.713 (terroristic threats); 609.235 (use of drugs 342.7 to injure or facilitate crime); 609.24 (simple robbery); 609.255 342.8 (false imprisonment); 609.562 (arson in the second degree); 342.9 609.563 (arson in the third degree); repeat offenses under 342.10 617.23 (indecent exposure; penalties); repeat offenses under 342.11 617.241 (obscene materials and performances; distribution and 342.12 exhibition prohibited; penalty); 609.71 (riot); 609.66 342.13 (dangerous weapons); 609.67 (machine guns and short-barreled 342.14 shotguns); 609.2325 (criminal abuse of a vulnerable adult); 342.15 609.2664 (manslaughter of an unborn child in the first degree); 342.16 609.2665 (manslaughter of an unborn child in the second degree); 342.17 609.267 (assault of an unborn child in the first degree); 342.18 609.2671 (assault of an unborn child in the second degree); 342.19 609.268 (injury or death of an unborn child in the commission of 342.20 a crime); 609.52 (theft); 609.2335 (financial exploitation of a 342.21 vulnerable adult); 609.521 (possession of shoplifting gear); 342.22 609.582 (burglary); 609.625 (aggravated forgery); 609.63 342.23 (forgery); 609.631 (check forgery; offering a forged check); 342.24 609.635 (obtaining signature by false pretense); 609.27 342.25 (coercion); 609.275 (attempt to coerce); 609.687 (adulteration); 342.26 260C.301 (grounds for termination of parental rights); chapter 342.27 152 (drugs; controlled substance); and a felony level conviction 342.28 involving alcohol or drug use. An attempt or conspiracy to 342.29 commit any of these offenses, as each of these offenses is 342.30 defined in Minnesota Statutes; or an offense in any other state 342.31 or country, the elements of which are substantially similar to 342.32 the elements of the offenses in this clause. If the individual 342.33 studied is convicted of one of the felonies listed in this 342.34 clause, but the sentence is a gross misdemeanor or misdemeanor 342.35 disposition, the lookback period for the conviction is the 342.36 period applicable to the disposition, that is the period for 343.1 gross misdemeanors or misdemeanors; 343.2 (3) if less than ten years have passed since the discharge 343.3 of the sentence imposed for the offense; and the individual has 343.4 received a gross misdemeanor conviction for a violation of any 343.5 of the following offenses: sections 609.224 (assault in the 343.6 fifth degree); 609.2242 and 609.2243 (domestic assault); 343.7 violation of an order for protection under 518B.01, subdivision 343.8 14; 609.3451 (criminal sexual conduct in the fifth degree); 343.9 repeat offenses under 609.746 (interference with privacy); 343.10 repeat offenses under 617.23 (indecent exposure); 617.241 343.11 (obscene materials and performances); 617.243 (indecent 343.12 literature, distribution); 617.293 (harmful materials; 343.13 dissemination and display to minors prohibited); 609.71 (riot); 343.14 609.66 (dangerous weapons); 609.749, subdivision 2 (harassment; 343.15 stalking); 609.224, subdivision 2, paragraph (c) (assault in the 343.16 fifth degree by a caregiver against a vulnerable adult); 609.23 343.17 (mistreatment of persons confined); 609.231 (mistreatment of 343.18 residents or patients); 609.2325 (criminal abuse of a vulnerable 343.19 adult); 609.233 (criminal neglect of a vulnerable adult); 343.20 609.2335 (financial exploitation of a vulnerable adult); 609.234 343.21 (failure to report maltreatment of a vulnerable adult); 609.72, 343.22 subdivision 3 (disorderly conduct against a vulnerable adult); 343.23 609.265 (abduction); 609.378 (neglect or endangerment of a 343.24 child); 609.377 (malicious punishment of a child); 609.324, 343.25 subdivision 1a (other prohibited acts; minor engaged in 343.26 prostitution); 609.33 (disorderly house); 609.52 (theft); 343.27 609.582 (burglary); 609.631 (check forgery; offering a forged 343.28 check); 609.275 (attempt to coerce); or an attempt or conspiracy 343.29 to commit any of these offenses, as each of these offenses is 343.30 defined in Minnesota Statutes; or an offense in any other state 343.31 or country, the elements of which are substantially similar to 343.32 the elements of any of the offenses listed in this clause. If 343.33 the defendant is convicted of one of the gross misdemeanors 343.34 listed in this clause, but the sentence is a misdemeanor 343.35 disposition, the lookback period for the conviction is the 343.36 period applicable to misdemeanors; or 344.1 (4) if less than seven years have passed since the 344.2 discharge of the sentence imposed for the offense; and the 344.3 individual has received a misdemeanor conviction for a violation 344.4 of any of the following offenses: sections 609.224 (assault in 344.5 the fifth degree); 609.2242 (domestic assault); violation of an 344.6 order for protection under 518B.01 (Domestic Abuse Act); 344.7 violation of an order for protection under 609.3232 (protective 344.8 order authorized; procedures; penalties); 609.746 (interference 344.9 with privacy); 609.79 (obscene or harassing phone calls); 344.10 609.795 (letter, telegram, or package; opening; harassment); 344.11 617.23 (indecent exposure; penalties); 609.2672 (assault of an 344.12 unborn child in the third degree); 617.293 (harmful materials; 344.13 dissemination and display to minors prohibited); 609.66 344.14 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 344.15 exploitation of a vulnerable adult); 609.234 (failure to report 344.16 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 344.17 (coercion); or an attempt or conspiracy to commit any of these 344.18 offenses, as each of these offenses is defined in Minnesota 344.19 Statutes; or an offense in any other state or country, the 344.20 elements of which are substantially similar to the elements of 344.21 any of the offenses listed in this clause; a determination or 344.22 disposition of failure to make required reports under section 344.23 626.556, subdivision 3, or 626.557, subdivision 3, for incidents 344.24 in which: (i) the final disposition under section 626.556 or 344.25 626.557 was substantiated maltreatment, and (ii) the 344.26 maltreatment was recurring or serious; or a determination or 344.27 disposition of substantiated serious or recurring maltreatment 344.28 of a minor under section 626.556 or of a vulnerable adult under 344.29 section 626.557 for which there is a preponderance of evidence 344.30 that the maltreatment occurred, and that the subject was 344.31 responsible for the maltreatment. 344.32 For the purposes of this section, "serious maltreatment" 344.33 means sexual abuse; maltreatment resulting in death; or 344.34 maltreatment resulting in serious injury which reasonably 344.35 requires the care of a physician whether or not the care of a 344.36 physician was sought; or abuse resulting in serious injury. For 345.1 purposes of this section, "abuse resulting in serious injury" 345.2 means: bruises, bites, skin laceration or tissue damage; 345.3 fractures; dislocations; evidence of internal injuries; head 345.4 injuries with loss of consciousness; extensive second-degree or 345.5 third-degree burns and other burns for which complications are 345.6 present; extensive second-degree or third-degree frostbite, and 345.7 others for which complications are present; irreversible 345.8 mobility or avulsion of teeth; injuries to the eyeball; 345.9 ingestion of foreign substances and objects that are harmful; 345.10 near drowning; and heat exhaustion or sunstroke. For purposes 345.11 of this section, "care of a physician" is treatment received or 345.12 ordered by a physician, but does not include diagnostic testing, 345.13 assessment, or observation. For the purposes of this section, 345.14 "recurring maltreatment" means more than one incident of 345.15 maltreatment for which there is a preponderance of evidence that 345.16 the maltreatment occurred, and that the subject was responsible 345.17 for the maltreatment. For purposes of this section, "access" 345.18 means physical access to an individual receiving services or the 345.19 individual's personal property without continuous, direct 345.20 supervision as defined in section 245A.04, subdivision 3. 345.21 (b) Except for background studies related to child foster 345.22 care, adult foster care, or family child care licensure, when 345.23 the subject of a background study is regulated by a 345.24 health-related licensing board as defined in chapter 214, and 345.25 the regulated person has been determined to have been 345.26 responsible for substantiated maltreatment under section 626.556 345.27 or 626.557, instead of the commissioner making a decision 345.28 regarding disqualification, the board shall make a determination 345.29 whether to impose disciplinary or corrective action under 345.30 chapter 214. 345.31 (1) The commissioner shall notify the health-related 345.32 licensing board: 345.33 (i) upon completion of a background study that produces a 345.34 record showing that the individual was determined to have been 345.35 responsible for substantiated maltreatment; 345.36 (ii) upon the commissioner's completion of an investigation 346.1 that determined the individual was responsible for substantiated 346.2 maltreatment; or 346.3 (iii) upon receipt from another agency of a finding of 346.4 substantiated maltreatment for which the individual was 346.5 responsible. 346.6 (2) The commissioner's notice shall indicate whether the 346.7 individual would have been disqualified by the commissioner for 346.8 the substantiated maltreatment if the individual were not 346.9 regulated by the board. The commissioner shall concurrently 346.10 send this notice to the individual. 346.11 (3) Notwithstanding the exclusion from this subdivision for 346.12 individuals who provide child foster care, adult foster care, or 346.13 family child care, when the commissioner or a local agency has 346.14 reason to believe that the direct contact services provided by 346.15 the individual may fall within the jurisdiction of a 346.16 health-related licensing board, a referral shall be made to the 346.17 board as provided in this section. 346.18 (4) If, upon review of the information provided by the 346.19 commissioner, a health-related licensing board informs the 346.20 commissioner that the board does not have jurisdiction to take 346.21 disciplinary or corrective action, the commissioner shall make 346.22 the appropriate disqualification decision regarding the 346.23 individual as otherwise provided in this chapter. 346.24 (5) The commissioner has the authority to monitor the 346.25 facility's compliance with any requirements that the 346.26 health-related licensing board places on regulated persons 346.27 practicing in a facility either during the period pending a 346.28 final decision on a disciplinary or corrective action or as a 346.29 result of a disciplinary or corrective action. The commissioner 346.30 has the authority to order the immediate removal of a regulated 346.31 person from direct contact or access when a board issues an 346.32 order of temporary suspension based on a determination that the 346.33 regulated person poses an immediate risk of harm to persons 346.34 receiving services in a licensed facility. 346.35 (6) A facility that allows a regulated person to provide 346.36 direct contact services while not complying with the 347.1 requirements imposed by the health-related licensing board is 347.2 subject to action by the commissioner as specified under 347.3 sections 245A.06 and 245A.07. 347.4 (7) The commissioner shall notify a health-related 347.5 licensing board immediately upon receipt of knowledge of 347.6 noncompliance with requirements placed on a facility or upon a 347.7 person regulated by the board. 347.8 [EFFECTIVE DATE.] This section is effective the day 347.9 following final enactment. 347.10 Sec. 8. Minnesota Statutes 2002, section 245A.09, 347.11 subdivision 7, is amended to read: 347.12 Subd. 7. [REGULATORY METHODS.] (a) Where appropriate and 347.13 feasible the commissioner shall identify and implement 347.14 alternative methods of regulation and enforcement to the extent 347.15 authorized in this subdivision. These methods shall include: 347.16 (1) expansion of the types and categories of licenses that 347.17 may be granted; 347.18 (2) when the standards of another state or federal 347.19 governmental agency or an independent accreditation body have 347.20 been shown topredict compliance with the rulesrequire the same 347.21 standards, methods, or alternative methods to achieve 347.22 substantially the same intended outcomes as the licensing 347.23 standards, the commissioner shall consider compliance with the 347.24 governmental or accreditation standards to be equivalent to 347.25 partial compliance with theruleslicensing standards; and 347.26 (3) use of an abbreviated inspection that employs key 347.27 standards that have been shown to predict full compliance with 347.28 the rules. 347.29 (b) If the commissioner accepts accreditation as 347.30 documentation of compliance with a licensing standard under 347.31 paragraph (a), the commissioner shall continue to investigate 347.32 complaints related to noncompliance with all licensing standards. 347.33 The commissioner may take a licensing action for noncompliance 347.34 under this chapter and shall recognize all existing appeal 347.35 rights regarding any licensing actions taken under this chapter. 347.36 (c) The commissioner shall work with the commissioners of 348.1 health, public safety, administration, and children, families, 348.2 and learning in consolidating duplicative licensing and 348.3 certification rules and standards if the commissioner determines 348.4 that consolidation is administratively feasible, would 348.5 significantly reduce the cost of licensing, and would not reduce 348.6 the protection given to persons receiving services in licensed 348.7 programs. Where administratively feasible and appropriate, the 348.8 commissioner shall work with the commissioners of health, public 348.9 safety, administration, and children, families, and learning in 348.10 conducting joint agency inspections of programs. 348.11(c)(d) The commissioner shall work with the commissioners 348.12 of health, public safety, administration, and children, 348.13 families, and learning in establishing a single point of 348.14 application for applicants who are required to obtain concurrent 348.15 licensure from more than one of the commissioners listed in this 348.16 clause. 348.17(d)(e) Unless otherwise specified in statute, the 348.18 commissioner mayspecify in rule periods of licensure up to two348.19yearsconduct routine inspections biennially. 348.20 Sec. 9. Minnesota Statutes 2002, section 245A.10, is 348.21 amended to read: 348.22 245A.10 [FEES.] 348.23 Subdivision 1. [APPLICATION OR LICENSE FEE REQUIRED, 348.24 PROGRAMS EXEMPT FROM FEE.] (a) Unless exempt under paragraph 348.25 (b), the commissioner shall charge a fee for evaluation of 348.26 applications and inspection of programs, other than family day348.27care and foster care,which are licensed under this chapter. 348.28The commissioner may charge a fee for the licensing of school348.29age child care programs, in an amount sufficient to cover the348.30cost to the state agency of processing the license.348.31 (b) Except as provided under subdivision 2, no application 348.32 or license fee shall be charged for child foster care, adult 348.33 foster care, family and group family child care or 348.34 state-operated programs, unless the state-operated program is an 348.35 intermediate care facility for persons with mental retardation 348.36 or related conditions (ICF/MR). 349.1 Subd. 2. [COUNTY FEES FOR BACKGROUND STUDIES AND LICENSING 349.2 INSPECTIONS IN FAMILY AND GROUP FAMILY CHILD CARE.] (a) For 349.3 purposes of family and group family child care licensing under 349.4 this chapter, a county agency may charge a fee to an applicant 349.5 or license holder to recover the actual cost of background 349.6 studies, but in any case not to exceed $100 annually. A county 349.7 agency may also charge a fee to an applicant or license holder 349.8 to recover the actual cost of licensing inspections, but in any 349.9 case not to exceed $150 annually. 349.10 (b) A county agency may charge a fee to a legal nonlicensed 349.11 child care provider or applicant for authorization to recover 349.12 the actual cost of background studies completed under section 349.13 119B.125, but in any case not to exceed $100 annually. 349.14 (c) Counties may elect to reduce or waive the fees in 349.15 paragraph (a) or (b): 349.16 (1) in cases of financial hardship; 349.17 (2) if the county has a shortage of providers in the 349.18 county's area; 349.19 (3) for new providers; or 349.20 (4) for providers who have attained at least 16 hours of 349.21 training before seeking initial licensure. 349.22 (d) Counties may allow providers to pay the applicant fees 349.23 in paragraph (a) or (b) on an installment basis for up to one 349.24 year. If the provider is receiving child care assistance 349.25 payments from the state, the provider may have the fees under 349.26 paragraph (a) or (b) deducted from the child care assistance 349.27 payments for up to one year and the state shall reimburse the 349.28 county for the county fees collected in this manner. 349.29 Subd. 3. [APPLICATION FEE FOR INITIAL LICENSE OR 349.30 CERTIFICATION.] (a) For fees required under subdivision 1, an 349.31 applicant for an initial license or certification issued by the 349.32 commissioner shall submit a $500 application fee with each new 349.33 application required under this subdivision. The application 349.34 fee shall not be prorated, is nonrefundable, and is in lieu of 349.35 the annual license or certification fee that expires on December 349.36 31. The commissioner shall not process an application until the 350.1 application fee is paid. 350.2 (b) Except as provided in clauses (1) to (3), an applicant 350.3 shall apply for a license to provide services at a specific 350.4 location. 350.5 (1) For a license to provide waivered services to persons 350.6 with developmental disabilities or related conditions, an 350.7 applicant shall submit an application for each county in which 350.8 the waivered services will be provided. 350.9 (2) For a license to provide semi-independent living 350.10 services to persons with developmental disabilities or related 350.11 conditions, an applicant shall submit a single application to 350.12 provide services statewide. 350.13 (3) For a license to provide independent living assistance 350.14 for youth under section 245A.22, an applicant shall submit a 350.15 single application to provide services statewide. 350.16 Subd. 4. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 350.17 WITH LICENSED CAPACITY.] (a) Child care centers and programs 350.18 with a licensed capacity shall pay an annual nonrefundable 350.19 license or certification fee based on the following schedule: 350.20 Licensed Capacity Child Care Other 350.21 Center Program 350.22 License Fee License Fee 350.23 1 to 24 persons $300 $400 350.24 25 to 49 persons $450 $600 350.25 50 to 74 persons $600 $800 350.26 75 to 99 persons $750 $1,000 350.27 100 to 124 persons $900 $1,200 350.28 125 to 149 persons $1,200 $1,400 350.29 150 to 174 persons $1,400 $1,600 350.30 175 to 199 persons $1,600 $1,800 350.31 200 to 224 persons $1,800 $2,000 350.32 225 or more persons $2,000 $2,500 350.33 (b) A day training and habilitation program serving persons 350.34 with developmental disabilities or related conditions shall be 350.35 assessed a license fee based on the schedule in paragraph (a) 350.36 unless the license holder serves more than 50 percent of the 351.1 same persons at two or more locations in the community. When a 351.2 day training and habilitation program serves more than 50 351.3 percent of the same persons in two or more locations in a 351.4 community, the day training and habilitation program shall pay a 351.5 license fee based on the licensed capacity of the largest 351.6 facility and the other facility or facilities shall be charged a 351.7 license fee based on a licensed capacity of a residential 351.8 program serving one to 24 persons. 351.9 Subd. 5. [ANNUAL LICENSE OR CERTIFICATION FEE FOR PROGRAMS 351.10 WITHOUT A LICENSED CAPACITY.] (a) Except as provided in 351.11 paragraph (b), a program without a stated licensed capacity 351.12 shall pay a license or certification fee of $400. 351.13 (b) A mental health center or mental health clinic 351.14 requesting certification for purposes of insurance and 351.15 subscriber contract reimbursement under Minnesota Rules, parts 351.16 9520.0750 to 9520.0870 shall pay a certification fee of $1,000 351.17 per year. If the mental health center or mental health clinic 351.18 provides services at a primary location with satellite 351.19 facilities, the satellite facilities shall be certified with the 351.20 primary location without an additional charge. 351.21 Subd. 6. [LICENSE NOT ISSUED UNTIL LICENSE OR 351.22 CERTIFICATION FEE IS PAID.] The commissioner shall not issue a 351.23 license or certification until the license or certification fee 351.24 is paid. The commissioner shall send a bill for the license or 351.25 certification fee to the billing address identified by the 351.26 license holder. If the license holder does not submit the 351.27 license or certification fee payment by the due date, the 351.28 commissioner shall send the license holder a past due notice. 351.29 If the license holder fails to pay the license or certification 351.30 fee by the due date on the past due notice, the commissioner 351.31 shall send a final notice to the license holder informing the 351.32 license holder that the program license will expire on December 351.33 31 unless the license fee is paid before December 31. If a 351.34 license expires, the program is no longer licensed and, unless 351.35 exempt from licensure under section 245A.03, subdivision 2, must 351.36 not operate after the expiration date. After a license expires, 352.1 if the former license holder wishes to provide licensed 352.2 services, the former license holder must submit a new license 352.3 application and application fee under subdivision 3. 352.4 Sec. 10. Minnesota Statutes 2002, section 245A.11, 352.5 subdivision 2a, is amended to read: 352.6 Subd. 2a. [ADULT FOSTER CARE LICENSE CAPACITY.] (a) An 352.7 adult foster care license holder may have a maximum license 352.8 capacity of five if all persons in care are age 55 or over and 352.9 do not have a serious and persistent mental illness or a 352.10 developmental disability. 352.11 (b) The commissioner may grant variances to paragraph (a) 352.12 to allow a foster care provider with a licensed capacity of five 352.13 persons to admit an individual under the age of 55 if the 352.14 variance complies with section 245A.04, subdivision 9, and 352.15 approval of the variance is recommended by the county in which 352.16 the licensed foster care provider is located. 352.17 (c) The commissioner may grant variances to paragraph (a) 352.18 to allow the use of a fifth bed for emergency crisis services 352.19 for a person with serious and persistent mental illness or a 352.20 developmental disability, regardless of age, if the variance 352.21 complies with section 245A.04, subdivision 9, and approval of 352.22 the variance is recommended by the county in which the licensed 352.23 foster care provider is located. 352.24 (d) Notwithstanding paragraph (a), the commissioner may 352.25 issue an adult foster care license with a capacity of five 352.26 adults when the capacity is recommended by the county licensing 352.27 agency of the county in which the facility is located and if the 352.28 recommendation verifies that: 352.29 (1) the facility meets the physical environment 352.30 requirements in the adult foster care licensing rule; 352.31 (2) the five-bed living arrangement is specified for each 352.32 resident in the resident's: 352.33 (i) individualized plan of care; 352.34 (ii) individual service plan under section 256B.092, 352.35 subdivision 1b, if required; or 352.36 (iii) individual resident placement agreement under 353.1 Minnesota Rules, part 9555.5105, subpart 19, if required; 353.2 (3) the license holder obtains written and signed informed 353.3 consent from each resident or resident's legal representative 353.4 documenting the resident's informed choice to living in the home 353.5 and that the resident's refusal to consent would not have 353.6 resulted in service termination; and 353.7 (4) the facility was licensed for adult foster care before 353.8 March 1, 2003. 353.9 (e) The commissioner shall not issue a new adult foster 353.10 care license under paragraph (d) after June 30, 2005. The 353.11 commissioner shall allow a facility with an adult foster care 353.12 license issued under paragraph (d) before June 30, 2005, to 353.13 continue with a capacity of five or six adults if the license 353.14 holder continues to comply with the requirements in paragraph 353.15 (d). 353.16 Sec. 11. Minnesota Statutes 2002, section 245A.11, 353.17 subdivision 2b, is amended to read: 353.18 Subd. 2b. [ADULT FOSTER CARE; FAMILY ADULT DAY CARE.] An 353.19 adult foster care license holder licensed under the conditions 353.20 in subdivision 2a may also provide family adult day care for 353.21 adults age 55 or over if no persons in the adult foster or adult 353.22 family day care program have a serious and persistent mental 353.23 illness or a developmental disability. The maximum combined 353.24 capacity for adult foster care and family adult day care is five 353.25 adults, except that the commissioner may grant a variance for a 353.26 family adult day care provider to admit up to seven individuals 353.27 for day care services and one individual for respite care 353.28 services, if all of the following requirements are met: (1) the 353.29 variance complies with section 245A.04, subdivision 9; (2) a 353.30 second caregiver is present whenever six or more clients are 353.31 being served; and (3) the variance is recommended by the county 353.32 social service agency in the county where the provider is 353.33 located. A separate license is not required to provide family 353.34 adult day care under this subdivision. Adult foster care homes 353.35 providing services to five adults under this section shall not 353.36 be subject to licensure by the commissioner of health under the 354.1 provisions of chapter 144, 144A, 157, or any other law requiring 354.2 facility licensure by the commissioner of health. 354.3 Sec. 12. Minnesota Statutes 2002, section 245A.11, is 354.4 amended by adding a subdivision to read: 354.5 Subd. 7. [ADULT FOSTER CARE; VARIANCE FOR ALTERNATE 354.6 OVERNIGHT SUPERVISION.] (a) The commissioner may grant a 354.7 variance under section 245A.04, subdivision 9, to rule parts 354.8 requiring a caregiver to be present in an adult foster care home 354.9 during normal sleeping hours to allow for alternative methods of 354.10 overnight supervision. The commissioner may grant the variance 354.11 if the local county licensing agency recommends the variance and 354.12 the county recommendation includes documentation verifying that: 354.13 (1) the county has approved the license holder's plan for 354.14 alternative methods of providing overnight supervision and 354.15 determined the plan protects the residents' health, safety, and 354.16 rights; 354.17 (2) the license holder has obtained written and signed 354.18 informed consent from each resident or each resident's legal 354.19 representative documenting the resident's or legal 354.20 representative's agreement with the alternative method of 354.21 overnight supervision; and 354.22 (3) the alternative method of providing overnight 354.23 supervision is specified for each resident in the resident's: 354.24 (i) individualized plan of care; (ii) individual service plan 354.25 under section 256B.092, subdivision 1b, if required; or (iii) 354.26 individual resident placement agreement under Minnesota Rules, 354.27 part 9555.5105, subpart 19, if required. 354.28 (b) To be eligible for a variance under paragraph (a), the 354.29 adult foster care license holder must not have had a licensing 354.30 action under section 245A.06 or 245A.07 during the prior 24 354.31 months based on failure to provide adequate supervision, health 354.32 care services, or resident safety in the adult foster care home. 354.33 Sec. 13. Minnesota Statutes 2002, section 245B.03, 354.34 subdivision 2, is amended to read: 354.35 Subd. 2. [RELATIONSHIP TO OTHER STANDARDS GOVERNING 354.36 SERVICES FOR PERSONS WITH MENTAL RETARDATION OR RELATED 355.1 CONDITIONS.] (a) ICFs/MR are exempt from: 355.2 (1) section 245B.04; 355.3 (2) section 245B.06, subdivisions 4 and 6; and 355.4 (3) section 245B.07, subdivisions 4, paragraphs (b) and 355.5 (c); 7; and 8, paragraphs (1), clause (iv), and (2). 355.6 (b) License holders also licensed under chapter 144 as a 355.7 supervised living facility are exempt from section 245B.04. 355.8 (c) Residential service sites controlled by license holders 355.9 licensed under chapter 245B for home and community-based 355.10 waivered services for four or fewer adults are exempt from 355.11 compliance with Minnesota Rules, parts 9543.0040, subpart 2, 355.12 item C; 9555.5505; 9555.5515, items B and G; 9555.5605; 355.13 9555.5705; 9555.6125, subparts 3, item C, subitem (2), and 4 to 355.14 6; 9555.6185; 9555.6225, subpart 8; 9555.6245; 9555.6255; and 355.15 9555.6265; and as provided under section 245B.06, subdivision 2, 355.16 the license holder is exempt from the program abuse prevention 355.17 plans and individual abuse prevention plans otherwise required 355.18 under sections 245A.65, subdivision 2, and 626.557, subdivision 355.19 14. The commissioner may approve alternative methods of 355.20 providing overnight supervision using the process and criteria 355.21 for granting a variance in section 245A.04, subdivision 9. This 355.22 chapter does not apply to foster care homes that do not provide 355.23 residential habilitation services funded under the home and 355.24 community-based waiver programs defined in section 256B.092. 355.25 (d) Residential service sites controlled by license holders 355.26 licensed under this chapter for home and community-based 355.27 waivered services for four or fewer children are exempt from 355.28 compliance with Minnesota Rules, parts 9545.0130; 9545.0140; 355.29 9545.0150; 9545.0170; 9545.0220, subparts 1, items C, F, and I, 355.30 and 3; and 9545.0230. 355.31 (e) The commissioner may exempt license holders from 355.32 applicable standards of this chapter when the license holder 355.33 meets the standards under section 245A.09, subdivision 7. 355.34 License holders that are accredited by an independent 355.35 accreditation body shall continue to be licensed under this 355.36 chapter. 356.1(e)(f) License holders governed by sections 245B.02 to 356.2 245B.07 must also meet the licensure requirements in chapter 356.3 245A. 356.4(f)(g) Nothing in this chapter prohibits license holders 356.5 from concurrently serving consumers with and without mental 356.6 retardation or related conditions provided this chapter's 356.7 standards are met as well as other relevant standards. 356.8(g)(h) The documentation that sections 245B.02 to 245B.07 356.9 require of the license holder meets the individual program plan 356.10 required in section 256B.092 or successor provisions. 356.11 Sec. 14. Minnesota Statutes 2002, section 245B.03, is 356.12 amended by adding a subdivision to read: 356.13 Subd. 3. [CONTINUITY OF CARE.] (a) When a consumer changes 356.14 service to the same type of service provided under a different 356.15 license held by the same license holder and the policies and 356.16 procedures under section 245B.07, subdivision 8, are 356.17 substantially similar, the license holder is exempt from the 356.18 requirements in sections 245B.06, subdivisions 2, paragraphs (e) 356.19 and (f), and 4; and 245B.07, subdivision 9, clause (2). 356.20 (b) When a direct service staff person begins providing 356.21 direct service under one or more licenses other than the license 356.22 for which the staff person initially received the staff 356.23 orientation requirements under section 245B.07, subdivision 5, 356.24 the license holder is exempt from all staff orientation 356.25 requirements under section 245B.07, subdivision 5, except that: 356.26 (1) if the service provision location changes, the staff 356.27 person must receive orientation regarding any policies or 356.28 procedures under section 245B.07, subdivision 8, that are 356.29 specific to the service provision location; and 356.30 (2) if the staff person provides direct service to one or 356.31 more consumers for whom the staff person has not previously 356.32 provided direct service, the staff person must review each 356.33 consumer's: (i) service plans and risk management plan in 356.34 accordance with section 245B.07, subdivision 5, paragraph (b), 356.35 clause (1); and (ii) medication administration in accordance 356.36 with section 245B.07, subdivision 5, paragraph (b), clause (6). 357.1 Sec. 15. Minnesota Statutes 2002, section 245B.04, 357.2 subdivision 2, is amended to read: 357.3 Subd. 2. [SERVICE-RELATED RIGHTS.] A consumer's 357.4 service-related rights include the right to: 357.5 (1) refuse or terminate services and be informed of the 357.6 consequences of refusing or terminating services; 357.7 (2) know, in advance, limits to the services available from 357.8 the license holder; 357.9 (3) know conditions and terms governing the provision of 357.10 services, including those related to initiation and termination; 357.11 (4) know what the charges are for services, regardless of 357.12 who will be paying for the services, and be notified upon 357.13 request of changes in those charges; 357.14 (5) know, in advance, whether services are covered by 357.15 insurance, government funding, or other sources, and be told of 357.16 any charges the consumer or other private party may have to pay; 357.17 and 357.18 (6) receive licensed services from individuals who are 357.19 competent and trained, who have professional certification or 357.20 licensure, as required, and who meet additional qualifications 357.21 identified in the individual service plan. 357.22 Sec. 16. Minnesota Statutes 2002, section 245B.06, 357.23 subdivision 2, is amended to read: 357.24 Subd. 2. [RISK MANAGEMENT PLAN.] (a) The license holder 357.25 must developand, document in writing, and implement a risk 357.26 management plan thatincorporates the individual abuse357.27prevention plan as required in section 245A.65meets the 357.28 requirements of this subdivision. License holders licensed 357.29 under this chapter are exempt from sections 245A.65, subdivision 357.30 2, and 626.557, subdivision 14, if the requirements of this 357.31 subdivision are met. 357.32 (b) The risk management plan must identify areas in which 357.33 the consumer is vulnerable, based on an assessment, at a 357.34 minimum, of the following areas: 357.35 (1) an adult consumer's susceptibility to physical, 357.36 emotional, and sexual abuse as defined in section 626.5572, 358.1 subdivision 2, and financial exploitation as defined in section 358.2 626.5572, subdivision 9; a minor consumer's susceptibility to 358.3 sexual and physical abuse as defined in section 626.556, 358.4 subdivision 2; and a consumer's susceptibility to self-abuse, 358.5 regardless of age; 358.6 (2) the consumer's health needs, considering the consumer's 358.7 physical disabilities; allergies; sensory impairments; seizures; 358.8 diet; need for medications; and ability to obtain medical 358.9 treatment; 358.10 (3) the consumer's safety needs, considering the consumer's 358.11 ability to take reasonable safety precautions; community 358.12 survival skills; water survival skills; ability to seek 358.13 assistance or provide medical care; and access to toxic 358.14 substances or dangerous items; 358.15 (4) environmental issues, considering the program's 358.16 location in a particular neighborhood or community; the type of 358.17 grounds and terrain surrounding the building; and the consumer's 358.18 ability to respond to weather-related conditions, open locked 358.19 doors, and remain alone in any environment; and 358.20 (5) the consumer's behavior, including behaviors that may 358.21 increase the likelihood of physical aggression between consumers 358.22 or sexual activity between consumers involving force or 358.23 coercion, as defined under section 245B.02, subdivision 10, 358.24 clauses (6) and (7). 358.25 (c) When assessing a consumer's vulnerability, the license 358.26 holder must consider only the consumer's skills and abilities, 358.27 independent of staffing patterns, supervision plans, the 358.28 environment, or other situational elements. 358.29 (d) License holders jointly providing services to a 358.30 consumer shall coordinate and use the resulting assessment of 358.31 risk areas for the development ofthiseach license holder's 358.32 risk management or the shared risk management plan.Upon358.33initiation of services, the license holder will have in place an358.34initial risk management plan that identifies areas in which the358.35consumer is vulnerable, including health, safety, and358.36environmental issues and the supports the provider will have in359.1place to protect the consumer and to minimize these risks. The359.2plan must be changed based on the needs of the individual359.3consumer and reviewed at least annually.The license holder's 359.4 plan must include the specific actions a staff person will take 359.5 to protect the consumer and minimize risks for the identified 359.6 vulnerability areas. The specific actions must include the 359.7 proactive measures being taken, training being provided, or a 359.8 detailed description of actions a staff person will take when 359.9 intervention is needed. 359.10 (e) Prior to or upon initiating services, a license holder 359.11 must develop an initial risk management plan that is, at a 359.12 minimum, verbally approved by the consumer or consumer's legal 359.13 representative and case manager. The license holder must 359.14 document the date the license holder receives the consumer's or 359.15 consumer's legal representative's and case manager's verbal 359.16 approval of the initial plan. 359.17 (f) As part of the meeting held within 45 days of 359.18 initiating service, as required under section 245B.06, 359.19 subdivision 4, the license holder must review the initial risk 359.20 management plan for accuracy and revise the plan if necessary. 359.21 The license holder must give the consumer or consumer's legal 359.22 representative and case manager an opportunity to participate in 359.23 this plan review. If the license holder revises the plan, or if 359.24 the consumer or consumer's legal representative and case manager 359.25 have not previously signed and dated the plan, the license 359.26 holder must obtain dated signatures to document the plan's 359.27 approval. 359.28 (g) After plan approval, the license holder must review the 359.29 plan at least annually and update the plan based on the 359.30 individual consumer's needs and changes to the environment. The 359.31 license holder must give the consumer or consumer's legal 359.32 representative and case manager an opportunity to participate in 359.33 the ongoing plan development. The license holder shall obtain 359.34 dated signatures from the consumer or consumer's legal 359.35 representative and case manager to document completion of the 359.36 annual review and approval of plan changes. 360.1 Sec. 17. Minnesota Statutes 2002, section 245B.06, 360.2 subdivision 5, is amended to read: 360.3 Subd. 5. [PROGRESS REVIEWS.] The license holder must 360.4 participate in progress review meetings following stated time 360.5 lines established in the consumer's individual service plan or 360.6 as requested in writing by the consumer, the consumer's legal 360.7 representative, or the case manager, at a minimum of once a 360.8 year. The license holder must summarize the progress toward 360.9 achieving the desired outcomes and make recommendations in a 360.10 written report sent to the consumer or the consumer's legal 360.11 representative and case manager prior to the review meeting. 360.12For consumers under public guardianship, the license holder is360.13required to provide quarterly written progress review reports to360.14the consumer, designated family member, and case manager.360.15 Sec. 18. Minnesota Statutes 2002, section 245B.07, 360.16 subdivision 6, is amended to read: 360.17 Subd. 6. [STAFF TRAINING.] (a)TheA license holder 360.18 providing semi-independent living services shall ensure that 360.19 direct service staff annually complete hours of training equal 360.20 totwoone percent of the number of hours the staff person 360.21 workedor one percent for license holders providing360.22semi-independent living services. All other license holders 360.23 shall ensure that direct service staff annually complete hours 360.24 of training as follows: 360.25 (1) if the direct services staff have been employed for one 360.26 to 24 months and: 360.27 (i) the average number of work hours scheduled per week is 360.28 30 to 40 hours, the staff must annually complete 40 training 360.29 hours; 360.30 (ii) the average number of work hours scheduled per week is 360.31 20 to 29 hours, the staff must annually complete 30 training 360.32 hours; and 360.33 (iii) the average number of work hours scheduled per week 360.34 is one to 19 hours, the staff must annually complete 20 training 360.35 hours; or 360.36 (2) if the direct services staff have been employed for 361.1 more than 24 months and: 361.2 (i) the average number of work hours scheduled per week is 361.3 30 to 40 hours, the staff must annually complete 20 training 361.4 hours; 361.5 (ii) the average number of work hours scheduled per week is 361.6 20 to 29 hours, the staff must annually complete 15 training 361.7 hours; and 361.8 (iii) the average number of work hours scheduled per week 361.9 is one to 19 hours, the staff must annually complete 12 training 361.10 hours. 361.11 If direct service staff has received training from a 361.12 license holder licensed under a program rule identified in this 361.13 chapter or completed course work regarding disability-related 361.14 issues from a post-secondary educational institute, that 361.15 training may also count toward training requirements for other 361.16 services and for other license holders. 361.17 (b) The license holder must document the training completed 361.18 by each employee. 361.19 (c) Training shall address staff competencies necessary to 361.20 address the consumer needs as identified in the consumer's 361.21 individual service plan and ensure consumer health, safety, and 361.22 protection of rights. Training may also include other areas 361.23 identified by the license holder. 361.24 (d) For consumers requiring a 24-hour plan of care, the 361.25 license holder shall provide training in cardiopulmonary 361.26 resuscitation, from a qualified source determined by the 361.27 commissioner, if the consumer's health needs as determined by 361.28 the consumer's physician indicate trained staff would be 361.29 necessary to the consumer. 361.30 Sec. 19. Minnesota Statutes 2002, section 245B.07, 361.31 subdivision 9, is amended to read: 361.32 Subd. 9. [AVAILABILITY OF CURRENT WRITTEN POLICIES AND 361.33 PROCEDURES.] The license holder shall: 361.34 (1) review and update, as needed, the written policies and 361.35 procedures in this chapterand inform all consumers or the361.36consumer's legal representatives, case managers, and employees362.1of the revised policies and procedures when they affect the362.2service provision; 362.3 (2) inform consumers or the consumer's legal 362.4 representatives of the written policies and procedures in this 362.5 chapter upon service initiation. Copies must be available to 362.6 consumers or the consumer's legal representatives, case 362.7 managers, the county where services are located, and the 362.8 commissioner upon request;and362.9 (3) provide all consumers or the consumers' legal 362.10 representatives and case managers a copy and explanation of 362.11 revisions to policies and procedures that affect consumers' 362.12 service-related or protection-related rights under section 362.13 245B.04. Unless there is reasonable cause, the license holder 362.14 must provide this notice at least 30 days before implementing 362.15 the revised policy and procedure. The license holder must 362.16 document the reason for not providing the notice at least 30 362.17 days before implementing the revisions; 362.18 (4) annually notify all consumers or the consumers' legal 362.19 representatives and case managers of any revised policies and 362.20 procedures under this chapter, other than those in clause (3). 362.21 Upon request, the license holder must provide the consumer or 362.22 consumer's legal representative and case manager copies of the 362.23 revised policies and procedures; 362.24 (5) before implementing revisions to policies and 362.25 procedures under this chapter, inform all employees of the 362.26 revised policies and procedures; and 362.27 (6) document and maintain relevant information related to 362.28 the policies and procedures in this chapter. 362.29 Sec. 20. Minnesota Statutes 2002, section 245B.08, 362.30 subdivision 1, is amended to read: 362.31 Subdivision 1. [ALTERNATIVE METHODS OF DETERMINING 362.32 COMPLIANCE.] (a) In addition to methods specified in chapter 362.33 245A, the commissioner may use alternative methods and new 362.34 regulatory strategies to determine compliance with this 362.35 section. The commissioner may use sampling techniques to ensure 362.36 compliance with this section. Notwithstanding section 245A.09, 363.1 subdivision 7, paragraph(d)(e), the commissioner may also 363.2 extend periods of licensure, not to exceed five years, for 363.3 license holders who have demonstrated substantial and consistent 363.4 compliance with sections 245B.02 to 245B.07 and have 363.5 consistently maintained the health and safety of consumers and 363.6 have demonstrated by alternative methods in paragraph (b) that 363.7 they meet or exceed the requirements of this section. For 363.8 purposes of this section, "substantial and consistent 363.9 compliance" means that during the current licensing period: 363.10 (1) the license holder's license has not been made 363.11 conditional, suspended, or revoked; 363.12 (2) there have been no substantiated allegations of 363.13 maltreatment against the license holder; 363.14 (3) there have been no program deficiencies that have been 363.15 identified that would jeopardize the health or safety of 363.16 consumers being served; and 363.17 (4) the license holder is in substantial compliance with 363.18 the other requirements of chapter 245A and other applicable laws 363.19 and rules. 363.20 (b) To determine the length of a license, the commissioner 363.21 shall consider: 363.22 (1) information from affected consumers, and the license 363.23 holder's responsiveness to consumers' concerns and 363.24 recommendations; 363.25 (2) self assessments and peer reviews of the standards of 363.26 this section, corrective actions taken by the license holder, 363.27 and sharing the results of the inspections with consumers, the 363.28 consumers' families, and others, as requested; 363.29 (3) length of accreditation by an independent accreditation 363.30 body, if applicable; 363.31 (4) information from the county where the license holder is 363.32 located; and 363.33 (5) information from the license holder demonstrating 363.34 performance that meets or exceeds the minimum standards of this 363.35 chapter. 363.36 (c) The commissioner may reduce the length of the license 364.1 if the license holder fails to meet the criteria in paragraph 364.2 (a) and the conditions specified in paragraph (b). 364.3 Sec. 21. Minnesota Statutes 2002, section 246.014, is 364.4 amended to read: 364.5 246.014 [SERVICES.] 364.6 The measure of services established and prescribed by 364.7 section 246.012, are: 364.8 (a) The commissioner of human services shall develop and 364.9 maintain state-operated services in a manner consistent with 364.10 sections 245.461, 245.487, and 253.28, and chapters 252A, 254A, 364.11 and 254B. State-operated services shall be provided in 364.12 coordination with counties and other vendors. State-operated 364.13 services shall include regional treatment centers, specialized 364.14 inpatient or outpatient treatment programs, enterprise services, 364.15 community-based services and programs, community preparation 364.16 services, consultative services, and other services consistent 364.17 with the mission of the department of human services. These 364.18 services shall include crisis beds, waivered homes, intermediate 364.19 care facilities, and day training and habilitation facilities. 364.20 The administrative structure of state-operated services must be 364.21 statewide in character. The state-operated services staff may 364.22 deliver services at any location throughout the state. 364.23 (b) The commissioner of human services shall create and 364.24 maintain forensic services programs. Forensic services shall be 364.25 provided in coordination with counties and other vendors. 364.26 Forensic services shall include specialized inpatient programs 364.27 at secure treatment facilities as defined in section 253B.02, 364.28 subdivision 18a, consultative services, aftercare services, 364.29 community-based services and programs, transition services, or 364.30 other services consistent with the mission of the department of 364.31 human services. 364.32 (c) Community preparation services as identified in 364.33 paragraphs (a) and (b) are defined as specialized inpatient or 364.34 outpatient services or programs operated outside of a secure 364.35 environment but are administered by a secured treatment facility. 364.36 (d) The commissioner of human services may establish 365.1 policies and procedures which govern the operation of the 365.2 services and programs under the direct administrative authority 365.3 of the commissioner. 365.4(1) There shall be served in state hospitals a single365.5standard of food for patients and employees alike, which is365.6nutritious and palatable together with special diets as365.7prescribed by the medical staff thereof. There shall be a chief365.8dietitian in the department of human services and at least one365.9dietitian at each state hospital. There shall be adequate staff365.10and equipment for processing, preparation, distribution and365.11serving of food.365.12(2) There shall be a staff of persons, professional and365.13lay, sufficient in number, trained in the diagnosis, care and365.14treatment of persons with mental illness, physical illness, and365.15including religious and spiritual counsel through qualified365.16chaplains (who shall be in the unclassified service) adequate to365.17take advantage of and put into practice modern methods of365.18psychiatry, medicine and related field. 365.19(3) There shall be a staff and facilities to provide365.20occupational and recreational therapy, entertainment and other365.21creative activities as are consistent with modern methods of365.22treatment and well being.365.23(4) There shall be in each state hospital for the care and365.24treatment of persons with mental illness facilities for the365.25segregation and treatment of patients and residents who have365.26communicable disease.365.27(5) The commissioner of human services shall provide modern365.28and adequate psychiatric social case work service.365.29(6) The commissioner of human services shall make every365.30effort to improve the accommodations for patients and residents365.31so that the same shall be comfortable and attractive with365.32adequate furnishings, clothing, and supplies.365.33(7) The commissioner of human services shall establish365.34training programs for the training of personnel and may require365.35the participation of personnel in such programs. Within the365.36limits of the appropriations available the commissioner may366.1establish professional training programs in the forms of366.2educational stipends for positions for which there is a scarcity366.3of applicants.366.4(8) The standards herein established shall be adapted and366.5applied to the diagnosis, care and treatment of persons with366.6chemical dependency or mental retardation who come within those366.7terms as defined in the laws relating to the hospitalization and366.8commitment of such persons, and of persons who have sexual366.9psychopathic personalities or are sexually dangerous persons as366.10defined in chapter 253B.366.11(9) The commissioner of human services shall establish a366.12program of detection, diagnosis and treatment of persons with366.13mental illness and persons described in clause (8), and within366.14the limits of appropriations may establish clinics and staff the366.15same with persons specially trained in psychiatry and related366.16fields.366.17(10) The commissioner of employee relations may reclassify366.18employees of the state hospitals from time to time, and assign366.19classifications to such salary brackets as will adequately366.20compensate personnel and reasonably assure a continuity of366.21adequate staff.366.22(11) In addition to the chaplaincy services, provided in366.23clause (2), the commissioner of human services shall open said366.24state hospitals to members of the clergy and other spiritual366.25leaders to the end that religious and spiritual counsel and366.26services are made available to the patients and residents366.27therein, and shall cooperate with all members of the clergy and366.28other spiritual leaders in making said patients and residents366.29available for religious and spiritual counsel, and shall provide366.30such members of the clergy and other spiritual leaders with366.31meals and accommodations.366.32(12) Within the limits of the appropriations therefor, the366.33commissioner of human services shall establish and provide366.34facilities and equipment for research and study in the field of366.35modern hospital management, the causes of mental and related366.36illness and the treatment, diagnosis and care of persons with367.1mental illness and funds provided therefor may be used to make367.2available services, abilities and advice of leaders in these and367.3related fields, and may provide them with meals and367.4accommodations and compensate them for traveling expenses and367.5services.367.6 Sec. 22. Minnesota Statutes 2002, section 246.015, 367.7 subdivision 3, is amended to read: 367.8 Subd. 3.Within the limits of the appropriations367.9available,The commissioner of human services may authorize 367.10 state-operated services to provide consultative services for 367.11 courts,andstate welfare agencies, and supervise the placement 367.12 and aftercare of patients, on a fee-for-service basis as defined 367.13 in section 246.50, provisionally or otherwise discharged from 367.14 astate hospital or institution,state-operated services 367.15 facility. State-operated services may also promote and conduct 367.16 programs of educationfor the people of the staterelating to 367.17the problem ofmental healthand mental hygiene. The 367.18 commissioner shall administer, expend, and distribute federal 367.19 funds which may be made available to the state and other funds 367.20other than thosenot appropriated by the legislature, which may 367.21 be made available to the state for mental healthand mental367.22hygienepurposes. 367.23 Sec. 23. Minnesota Statutes 2002, section 246.018, 367.24 subdivision 2, is amended to read: 367.25 Subd. 2. [MEDICAL DIRECTOR.] The commissioner of human 367.26 services shall appointa medical director, and unless otherwise 367.27 established by law, set the salary of a licensed physician to 367.28 serve as medical director to assist in establishing and 367.29 maintaining the medical policies of the department of human 367.30 services. The commissioner may place the medical director's 367.31 position in the unclassified service if the position meets the 367.32 criteria of section 43A.08, subdivision 1a. The medical 367.33 director must be a psychiatrist certified by the board of 367.34 psychiatry. 367.35 Sec. 24. Minnesota Statutes 2002, section 246.018, 367.36 subdivision 3, is amended to read: 368.1 Subd. 3. [DUTIES.] The medical director shall: 368.2 (1) oversee the clinical provision of inpatient mental 368.3 health services provided in the state's regional treatment 368.4 centers; 368.5 (2) recruit and retain psychiatrists to serve on the state 368.6 medical staff established in subdivision 4; 368.7 (3) consult with the commissioner of human services,the368.8assistant commissioner of mental health,community mental health 368.9 center directors, and theregional treatment center governing368.10bodiesstate-operated services governing body to develop 368.11 standards for treatment and care of patients inregional368.12treatment centers and outpatientstate-operated service 368.13 programs; 368.14 (4) develop and oversee a continuing education program for 368.15 members of theregional treatment centermedical staff; and 368.16 (5)consult with the commissioner on the appointment of the368.17chief executive officers for regional treatment centers; and368.18(6)participate and cooperate in the development and 368.19 maintenance of a quality assurance program forregional368.20treatment centersstate-operated services that assures that 368.21 residents receive quality inpatient care and continuous quality 368.22 care once they are discharged or transferred to an outpatient 368.23 setting. 368.24 Sec. 25. Minnesota Statutes 2002, section 246.018, 368.25 subdivision 4, is amended to read: 368.26 Subd. 4. [REGIONAL TREATMENT CENTERSTATE-OPERATED 368.27 SERVICES MEDICAL STAFF.] (a) Thecommissioner of human services368.28 medical director shall establish aregional treatment center368.29 state-operated service medical staff which shall be under the 368.30 clinical direction of the office of medical director. 368.31 (b) The medical director, in conjunction with theregional368.32treatment centermedical staff, shall: 368.33 (1) establish standards and define qualifications for 368.34 physicians who care for residents inregional treatment368.35centersstate-operated services; 368.36 (2) monitor the performance of physicians who care for 369.1 residents inregional treatment centersstate-operated services; 369.2 and 369.3 (3) recommend to the commissioner changes in procedures for 369.4 operatingregional treatment centersstate-operated service 369.5 facilities that are needed to improve the provision of medical 369.6 care in those facilities. 369.7 Sec. 26. Minnesota Statutes 2002, section 246.13, is 369.8 amended to read: 369.9 246.13 [RECORD OF PATIENTS AND RESIDENTS; DEPARTMENT OF369.10HUMANIN STATE-OPERATED SERVICES.] 369.11 The commissioner of human services' office shall have, 369.12 accessible only by consent of the commissioner or on the order 369.13 of a judge or court of record, a record showing the residence, 369.14 sex, age, nativity, occupation, civil condition, and date of 369.15 entrance or commitment of every person, in thestate hospitals369.16 state-operated services facilities as defined under section 369.17 246.014 under exclusive control of the commissioner,; the date 369.18 of discharge and whether such discharge was final,; the 369.19 condition ofsuchthe person when the person left thestate369.20hospital,state-operated services facility; and the date and 369.21 cause of all deaths. The record shall state every transfer from 369.22 onestate hospitalstate-operated services facility to another, 369.23 naming each state-operated services facility. This information 369.24 shall be furnished to the commissioner of human services by each 369.25 publicand privateagency, along withsuchother obtainable 369.26 facts as the commissioner mayfrom time to timerequire.The369.27chief executive officer of each such state hospital, within ten369.28days after the commitment or entrance thereto of a patient or369.29resident, shall cause a true copy of an entrance record to be369.30forwarded to the commissioner of human services.When a patient 369.31 or residentleaves,in a state-operated services facility is 369.32 dischargedor, transferred, or diesin any state hospital, 369.33 thechief executive officer, or other person in chargehead of 369.34 the state-operated services facility or designee shall inform 369.35 the commissioner of human services of these events within ten 369.36 daysthereafteron forms furnished by the commissioner. 370.1The commissioner of human services may authorize the chief370.2executive officer of any state hospital for persons with mental370.3illness or mental retardation, to release to public or private370.4medical personnel, hospitals, clinics, local social services370.5agencies or other specifically designated interested persons or370.6agencies any information regarding any patient or resident370.7thereat, if, in the opinion of the commissioner, it will be for370.8the benefit of the patient or resident.370.9 Sec. 27. Minnesota Statutes 2002, section 246.15, is 370.10 amended to read: 370.11 246.15 [MONEY OFINMATES OF PUBLIC WELFARE INSTITUTIONS370.12 PATIENTS OR RESIDENTS.] 370.13 Subdivision 1. [RECORD KEEPING OF MONEY.] Thechief370.14executive officer of each institutionhead of the state-operated 370.15 services facility or designee under the jurisdiction of the 370.16 commissioner of human servicesshallmay have the care and 370.17 custody of all money belonging toinmates thereofpatients or 370.18 residents which may come into thechief executive officer'shead 370.19 of the state-operated services facility or designee's hands,. 370.20 The head of the state-operated services facility or designee 370.21 shall keep accurate accountsthereofof the money, and pay them 370.22 out under rules prescribed by law or by the commissioner of 370.23 human services, taking vouchersthereforfor the money. 370.24 Allsuchmoney received by any officer or employee shall be paid 370.25 to thechief executive officer forthwithhead of the 370.26 state-operated services facility or designee immediately. Every 370.27such executive officerhead of the state-operated services 370.28 facility or designee, at the close of each month, oroftener370.29 earlier if required by the commissioner, shall forward to the 370.30 commissioner a statement of the amount of all moneysoreceived 370.31 and the names of theinmatespatients or residents from whom 370.32 received, accompanied by a check for the amount, payable to the 370.33 state treasurer. On receipt ofsuchthe statement, the 370.34 commissioner shall transmit thesamestatement along with a 370.35 check to the commissioner of finance, together with such check, 370.36 who shall deliver thesamestatement and check to the state 371.1 treasurer. Upon the payment ofsuchthe check, the amount shall 371.2 be credited to a fund to be known as "InmatesClient Fund," for 371.3 the institution from which thesamecheck was received. All 371.4suchfunds shall be paid out by the state treasurer upon 371.5 vouchers duly approved by the commissioner of human servicesas371.6in other cases. The commissioner may permit a contingent fund 371.7 to remain in the hands of theexecutive officerhead of the 371.8 state-operated services facility or designee ofany suchthe 371.9 institution from which necessaryexpenditureexpenditures may 371.10from time to timebe made. 371.11 Subd. 2. [CORRECTIONAL INMATES FUND.] Any money in the 371.12 inmates fund provided for in this section, belonging to inmates 371.13 of state institutions under the jurisdiction of the commissioner 371.14 of corrections shallforthwithbe immediately transferred by the 371.15 commissioner of human services to the correctionalinmates371.16 inmates' fund created by section 241.08. 371.17 Sec. 28. Minnesota Statutes 2002, section 246.16, is 371.18 amended to read: 371.19 246.16 [UNCLAIMED MONEY OR PERSONAL PROPERTY OF 371.20INMATESPATIENTS OR RESIDENTS.] 371.21 Subdivision 1. [UNCLAIMED MONEY.] Whentheremoney has 371.22heretoforeaccumulatedor shall hereafter accumulatein the 371.23 hands of thesuperintendent of any state institutionhead of the 371.24 state-operated services facility or designee under the 371.25 jurisdiction of the commissioner of human services money 371.26 belonging toinmatespatients or residents ofsuchthe 371.27 institution who have diedthereinthere, or 371.28 disappearedtherefromfrom there, and for whichmoneythere is 371.29 no claimant or person entitledtheretoto the money known to the 371.30superintendent, suchhead of the state-operated services 371.31 facility or designee the money may, at the discretion ofsuch371.32superintendentthe head of the state-operated services facility 371.33 or designee,tobe expended under the direction of the 371.34superintendenthead of the state-operated services facility or 371.35 designee for theamusement, entertainment, and generalbenefit 371.36 of theinmatespatients or residents ofsuchthe institution. 372.1 No money shall besoused until itshall havehas remained 372.2 unclaimed for at least five years. If, at any time after the 372.3 expiration of the five years, the legal heirs of theinmate372.4shallpatients or residents appear and make proper proof ofsuch372.5 heirship, they shall be entitled to receive from the state 372.6treasurer suchthe sum of moneyas shall have beenexpended by 372.7 thesuperintendenthead of the state-operated services facility 372.8 or designee belonging to theinmatepatient or resident. 372.9 Subd. 2. [UNCLAIMED PERSONAL PROPERTY.] When any 372.10inmatepatient or resident of astate institutionstate-operated 372.11 services facility under the jurisdiction of the commissioner of 372.12 human serviceshas died or disappeared therefrom, or hereafter372.13shall die or disappear therefromdies or disappears from the 372.14 state-operated services facility, leaving personal property 372.15 exclusive of money in the custody of thesuperintendent thereof372.16personal property, exclusive of money, whichhead of the 372.17 state-operated services facility or designee and the property 372.18 remains unclaimed for a period of two years,and there iswith 372.19 no person entitledtheretoto the property known to the 372.20superintendenthead of the state-operated services or designee, 372.21 thesuperintendent or an agenthead of the state-operated 372.22 services facility or designee may sellsuchthe property at 372.23 public auction. Notice ofsuchthe sale shall be published for 372.24 two consecutive weeks in a legal newspaper in the countywherein372.25 where theinstitutionstate-operated services facility is 372.26 located and shall state the time and place ofsuchthe sale. 372.27 The proceeds of the sale, after deduction of the costs of 372.28 publication and auction, may be expended, at the discretion of 372.29 thesuperintendenthead of the state-operated services facility 372.30 or designee, for theentertainment andbenefit of theinmates372.31 patients or residents ofsuch institutionthe state-operated 372.32 services facility. Anyinmatepatient or resident, or heir or 372.33 representative of theinmatepatient or resident, may file with, 372.34 and make proof of ownership to, thesuperintendenthead of the 372.35 state-operated services facility or designee of theinstitution372.36 state-operated services facility disposing ofsuchthe personal 373.1 property within four years aftersuchthe sale, and, uponproof373.2 satisfactory proof tosuch superintendentthe head of the 373.3 state-operated services or designee, shall certify for payment 373.4 to the state treasurer the amount received by the sale ofsuch373.5 the property. No suit shall be brought for damages consequent 373.6 to the disposal of personal property or use of money in 373.7 accordance with this section against the state or any official, 373.8 employee, or agent thereof. 373.9 Sec. 29. Minnesota Statutes 2002, section 246.57, 373.10 subdivision 1, is amended to read: 373.11 Subdivision 1. [AUTHORIZED.] The commissioner of human 373.12 services may authorize anystatestate-operated services 373.13facility operated under the authority of the commissionerto 373.14 enter into agreement with other governmental entities and both 373.15 nonprofit and for-profit organizations for participation in 373.16 shared service agreements that would be of mutual benefit to the 373.17 state, other governmental entities and organizations involved, 373.18 and the public.Notwithstanding section 16C.05, subdivision 2,373.19the commissioner of human services may delegate the execution of373.20shared services contracts to the chief executive officers of the373.21regional centers or state operated nursing homes. No additional373.22employees shall be added to the legislatively approved373.23complement for any regional center or state nursing home as a373.24result of entering into any shared service agreement. However,373.25 Positions funded by a shared service agreementmay beare 373.26 authorizedby the commissioner of financefor the duration of 373.27 the shared service agreement. The charges for the services 373.28 shall be on an actual cost basis. All receipts for shared 373.29 services may be retained by theregional treatment center or373.30 state-operatednursing homeservice that provided the services,373.31in addition to other funding the regional treatment center or373.32state-operated nursing home receives. 373.33 Sec. 30. Minnesota Statutes 2002, section 246.57, 373.34 subdivision 4, is amended to read: 373.35 Subd. 4. [SHARED STAFF OR SERVICES.] The commissioner of 373.36 human services may authorize aregional treatment center374.1 state-operated services to provide staff or services to Camp 374.2 Confidence in return for services to, or use of the camp's 374.3 facilities by, residents of thetreatment centerfacility who 374.4 have mental retardation or a related condition. 374.5 Sec. 31. Minnesota Statutes 2002, section 246.57, 374.6 subdivision 6, is amended to read: 374.7 Subd. 6. [DENTAL SERVICES.] The commissioner of human 374.8 services shall authorize anyregional treatment center or374.9 state-operatednursing homeservices facility under the 374.10 commissioner's authority to provide dental services to disabled 374.11 persons who are eligible for medical assistance and are not 374.12 residing at the regional treatment center or state-operated 374.13 nursing home, provided that the reimbursement received for these 374.14 services is sufficient to cover actual costs. To provide these 374.15 services, regional treatment centers and state-operated nursing 374.16 homes may participate under contract with health networks in 374.17 their service area.Notwithstanding section 16C.05, subdivision374.182, the commissioner of human services may delegate the execution374.19of these dental services contracts to the chief executive374.20officers of the regional centers or state-operated nursing374.21homes.All receipts for these dental services shall be retained 374.22 by the regional treatment center or state-operated nursing home 374.23 that provides the services and shall be in addition to other 374.24 funding the regional treatment center or state-operated nursing 374.25 home receives. 374.26 Sec. 32. Minnesota Statutes 2002, section 246.71, 374.27 subdivision 4, is amended to read: 374.28 Subd. 4. [EMPLOYEE OF A SECURE TREATMENT FACILITY OR 374.29 EMPLOYEE.] "Employee of a secure treatment facility" or 374.30 "employee" means an employee of the Minnesota security hospital 374.31 or a secure treatment facility operated by the Minnesotasexual374.32psychopathic personality treatment centersex offender program. 374.33 Sec. 33. Minnesota Statutes 2002, section 246.71, 374.34 subdivision 5, is amended to read: 374.35 Subd. 5. [SECURE TREATMENT FACILITY.] "Secure treatment 374.36 facility" means the Minnesota security hospitalor the Minnesota375.1sexual psychopathic personality treatment centerand the 375.2 Minnesota sex offender program facility in Moose Lake and any 375.3 portion of the Minnesota sex offender program operated by the 375.4 Minnesota sex offender program at the Minnesota security 375.5 hospital. 375.6 Sec. 34. Minnesota Statutes 2002, section 246B.02, is 375.7 amended to read: 375.8 246B.02 [ESTABLISHMENT OF MINNESOTASEXUAL PSYCHOPATHIC375.9PERSONALITY TREATMENT CENTERSEX OFFENDER PROGRAM.] 375.10 The commissioner of human services shall establish and 375.11 maintain a secure facility located in Moose Lake. The facility 375.12shall be known asshall be operated by the MinnesotaSexual375.13Psychopathic Personality Treatment Centersex offender program. 375.14 Thefacilityprogram shall provide care and treatment in secure 375.15 treatment facilities to100persons committed by the courts as 375.16 sexual psychopathic personalities or sexually dangerous persons, 375.17 or persons admitted there with the consent of the commissioner 375.18 of human services. 375.19 Sec. 35. Minnesota Statutes 2002, section 246B.03, is 375.20 amended to read: 375.21 246B.03 [LICENSURE.] 375.22 The commissioner of human services shall apply to the 375.23 commissioner of health to license the secure treatment 375.24 facilities operated by the MinnesotaSexual Psychopathic375.25Personality Treatment Centersex offender program asa375.26 supervised livingfacilityfacilities with applicable program 375.27 licensing standards. 375.28 Sec. 36. Minnesota Statutes 2002, section 246B.04, is 375.29 amended to read: 375.30 246B.04 [RULES; EVALUATION.] 375.31 The commissioner of human services shall adopt rules to 375.32 govern the operation, maintenance, and licensure ofthesecure 375.33 treatment facilities operated by the Minnesota sex offender 375.34 programestablished at the Minnesota Sexual Psychopathic375.35Personality Treatment Center,or at any other facility operated 375.36 by the commissioner, for persons committed as a sexual 376.1 psychopathic personality or sexually dangerous person. The 376.2 commissioner shall establish an evaluation process to measure 376.3 outcomes and behavioral changes as a result of treatment 376.4 compared with incarceration without treatment, to determine the 376.5 value, if any, of treatment in protecting the public. 376.6 Sec. 37. Minnesota Statutes 2002, section 252.025, 376.7 subdivision 7, is amended to read: 376.8 Subd. 7. [MINNESOTA EXTENDED TREATMENT OPTIONS.] The 376.9 commissioner shall develop by July 1, 1997, the Minnesota 376.10 extended treatment options to serve Minnesotans who have mental 376.11 retardation and exhibit severe behaviors which present a risk to 376.12 public safety. This program must provide specialized 376.13 residential serviceson the Cambridge campusin Cambridge and an 376.14 array of community support services statewide. 376.15 Sec. 38. Minnesota Statutes 2002, section 252.06, is 376.16 amended to read: 376.17 252.06 [SHERIFF TO TRANSPORT PERSONSWITH MENTAL376.18RETARDATION.] 376.19 It shall be the duty of the sheriff of any county, upon the 376.20 request of the commissioner of human services, to take charge of 376.21and, transport, and deliver any personwith mental retardation376.22 who has been committed by the district court of any county to 376.23 the care and custody of the commissioner of human services 376.24 tosuch state hospitala state-operated services facility as may 376.25 be designated by the commissioner of human servicesand there376.26deliver such person to the chief executive officer of the state376.27hospital. 376.28 Sec. 39. Minnesota Statutes 2002, section 252.27, 376.29 subdivision 2a, is amended to read: 376.30 Subd. 2a. [CONTRIBUTION AMOUNT.] (a) The natural or 376.31 adoptive parents of a minor child, including a child determined 376.32 eligible for medical assistance without consideration of 376.33 parental income, must contribute monthly to the cost of 376.34 services, unless the child is married or has been married, 376.35 parental rights have been terminated, or the child's adoption is 376.36 subsidized according to section 259.67 or through title IV-E of 377.1 the Social Security Act. 377.2 (b) For households with adjusted gross income equal to or 377.3 greater than 100 percent of federal poverty guidelines, the 377.4 parental contribution shall bethe greater of a minimum monthly377.5fee of $25 for households with adjusted gross income of $30,000377.6and over, or an amount to becomputed by applying the following 377.7 schedule of rates to the adjusted gross income of the natural or 377.8 adoptive parentsthat exceeds 150 percent of the federal poverty377.9guidelines for the applicable household size, the following377.10schedule of rates: 377.11 (1)on the amount of adjusted gross income over 150 percent377.12of poverty, but not over $50,000, ten percentif the adjusted 377.13 gross income is equal to or greater than 100 percent of federal 377.14 poverty guidelines and less than 175 percent of federal poverty 377.15 guidelines, the parental contribution is $4 per month; 377.16 (2)onif theamount ofadjusted gross incomeover 150377.17percent of poverty and over $50,000 but not over $60,000, 12377.18percentis equal to or greater than 175 percent of federal 377.19 poverty guidelines and less than or equal to 375 percent of 377.20 federal poverty guidelines, the parental contribution shall be 377.21 determined using a sliding fee scale established by the 377.22 commissioner of human services which begins at one percent of 377.23 adjusted gross income at 175 percent of federal poverty 377.24 guidelines and increases to 7.5 percent of adjusted gross income 377.25 for those with adjusted gross income up to 375 percent of 377.26 federal poverty guidelines; 377.27 (3)onif theamount ofadjusted gross incomeover 150is 377.28 greater than 375 percent of federal poverty, and over $60,000377.29but not over $75,000, 14 percentguidelines and less than 675 377.30 percent of federal poverty guidelines, the parental contribution 377.31 shall be 7.5 percent of adjusted gross income;and377.32 (4)on allif the adjusted gross incomeamounts over 150is 377.33 equal to or greater than 675 percent of federal poverty, and377.34over $75,000, 15 percentguidelines and less than 975 percent of 377.35 federal poverty guidelines, the parental contribution shall be 377.36 ten percent of adjusted gross income; and 378.1 (5) if the adjusted gross income is equal to or greater 378.2 than 975 percent of federal poverty guidelines, the parental 378.3 contribution shall be 12.5 percent of adjusted gross income. 378.4 If the child lives with the parent, theparental378.5contributionannual adjusted gross income is reduced by$200,378.6except that the parent must pay the minimum monthly $25 fee378.7under this paragraph$2,400 prior to calculating the parental 378.8 contribution. If the child resides in an institution specified 378.9 in section 256B.35, the parent is responsible for the personal 378.10 needs allowance specified under that section in addition to the 378.11 parental contribution determined under this section. The 378.12 parental contribution is reduced by any amount required to be 378.13 paid directly to the child pursuant to a court order, but only 378.14 if actually paid. 378.15 (c) The household size to be used in determining the amount 378.16 of contribution under paragraph (b) includes natural and 378.17 adoptive parents and their dependents under age 21, including 378.18 the child receiving services. Adjustments in the contribution 378.19 amount due to annual changes in the federal poverty guidelines 378.20 shall be implemented on the first day of July following 378.21 publication of the changes. 378.22 (d) For purposes of paragraph (b), "income" means the 378.23 adjusted gross income of the natural or adoptive parents 378.24 determined according to the previous year's federal tax form. 378.25 (e) The contribution shall be explained in writing to the 378.26 parents at the time eligibility for services is being 378.27 determined. The contribution shall be made on a monthly basis 378.28 effective with the first month in which the child receives 378.29 services. Annually upon redetermination or at termination of 378.30 eligibility, if the contribution exceeded the cost of services 378.31 provided, the local agency or the state shall reimburse that 378.32 excess amount to the parents, either by direct reimbursement if 378.33 the parent is no longer required to pay a contribution, or by a 378.34 reduction in or waiver of parental fees until the excess amount 378.35 is exhausted. 378.36 (f) The monthly contribution amount must be reviewed at 379.1 least every 12 months; when there is a change in household size; 379.2 and when there is a loss of or gain in income from one month to 379.3 another in excess of ten percent. The local agency shall mail a 379.4 written notice 30 days in advance of the effective date of a 379.5 change in the contribution amount. A decrease in the 379.6 contribution amount is effective in the month that the parent 379.7 verifies a reduction in income or change in household size. 379.8 (g) Parents of a minor child who do not live with each 379.9 other shall each pay the contribution required under paragraph 379.10 (a), except that a. An amount equal to the annual court-ordered 379.11 child support payment actually paid on behalf of the child 379.12 receiving services shall be deducted from thecontribution379.13 adjusted gross income of the parent making the payment prior to 379.14 calculating the parental contribution under paragraph (b). 379.15 (h) The contribution under paragraph (b) shall be increased 379.16 by an additional five percent if the local agency determines 379.17 that insurance coverage is available but not obtained for the 379.18 child. For purposes of this section, "available" means the 379.19 insurance is a benefit of employment for a family member at an 379.20 annual cost of no more than five percent of the family's annual 379.21 income. For purposes of this section, "insurance" means health 379.22 and accident insurance coverage, enrollment in a nonprofit 379.23 health service plan, health maintenance organization, 379.24 self-insured plan, or preferred provider organization. 379.25 Parents who have more than one child receiving services 379.26 shall not be required to pay more than the amount for the child 379.27 with the highest expenditures. There shall be no resource 379.28 contribution from the parents. The parent shall not be required 379.29 to pay a contribution in excess of the cost of the services 379.30 provided to the child, not counting payments made to school 379.31 districts for education-related services. Notice of an increase 379.32 in fee payment must be given at least 30 days before the 379.33 increased fee is due. 379.34 (i) The contribution under paragraph (b) shall be reduced 379.35 by $300 per fiscal year if, in the 12 months prior to July 1: 379.36 (1) the parent applied for insurance for the child; 380.1 (2) the insurer denied insurance; 380.2 (3) the parents submitted a complaint or appeal, in writing 380.3 to the insurer, submitted a complaint or appeal, in writing, to 380.4 the commissioner of health or the commissioner of commerce, or 380.5 litigated the complaint or appeal; and 380.6 (4) as a result of the dispute, the insurer reversed its 380.7 decision and granted insurance. 380.8 For purposes of this section, "insurance" has the meaning 380.9 given in paragraph (h). 380.10 A parent who has requested a reduction in the contribution 380.11 amount under this paragraph shall submit proof in the form and 380.12 manner prescribed by the commissioner or county agency, 380.13 including, but not limited to, the insurer's denial of 380.14 insurance, the written letter or complaint of the parents, court 380.15 documents, and the written response of the insurer approving 380.16 insurance. The determinations of the commissioner or county 380.17 agency under this paragraph are not rules subject to chapter 14. 380.18 [EFFECTIVE DATE.] This section is effective July 1, 2003. 380.19 Sec. 40. Minnesota Statutes 2002, section 253.015, 380.20 subdivision 1, is amended to read: 380.21 Subdivision 1. [STATE HOSPITALSSTATE-OPERATED SERVICES 380.22 FOR PERSONS WITH MENTAL ILLNESS.] Thestate hospitals380.23 state-operated services facilities located at Anoka, Brainerd, 380.24 Fergus Falls, St. Peter, and Willmar, and Moose Lake until June380.2530, 1995,shall constitute thestate hospitalsstate-operated 380.26 services facilities for persons with mental illness, and shall 380.27 be maintained under the general management of the commissioner 380.28 of human services. The commissioner of human services shall 380.29 determine to whatstate hospitalstate-operated services 380.30 facility persons with mental illness shall be committed from 380.31 each county and notify the judge exercising probate jurisdiction 380.32 thereof, and of changes made from time to time.The chief380.33executive officer of each hospital for persons with mental380.34illness shall be known as the chief executive officer.380.35 Sec. 41. Minnesota Statutes 2002, section 253.017, is 380.36 amended to read: 381.1 253.017 [TREATMENT PROVIDED BYREGIONAL TREATMENT CENTERS381.2 STATE-OPERATED SERVICES.] 381.3 Subdivision 1. [ACTIVE PSYCHIATRIC TREATMENT.] The 381.4regional treatment centersstate-operated services shall provide 381.5 active psychiatric treatment according to contemporary 381.6 professional standards. Treatment must be designed to: 381.7 (1) stabilize the individual and the symptoms that required 381.8 hospital admission; 381.9 (2) restore individual functioning to a level permitting 381.10 return to the community; 381.11 (3) strengthen family and community support; and 381.12 (4) facilitate discharge, after care, and follow-up as 381.13 patients return to the community. 381.14 Subd. 2. [NEED FOR SERVICES.] The commissioner shall 381.15 determine the need for the psychiatric services provided by the 381.16 department based upon individual needs assessments of persons in 381.17 theregional treatment centersstate-operated services as 381.18 required by section 245.474, subdivision 2, and an evaluation 381.19 of: (1)regional treatment centerstate-operated service 381.20 programs, (2) programs needed in the region for persons who 381.21 require hospitalization, and (3) available epidemiologic data. 381.22 Throughout its planning and implementation, the assessment 381.23 process must be discussed with the state advisory council on 381.24 mental health in accordance with its duties under section 381.25 245.697. Continuing assessment of this information must be 381.26 considered in planning for and implementing changes in 381.27 state-operated programs and facilities for persons with mental 381.28 illness.By January 31, 1990, the commissioner shall submit a381.29proposal for renovation or new construction of the facilities at381.30Anoka, Brainerd, Moose Lake, and Fergus Falls.Expansion may be 381.31 considered only after a thorough analysis of need and in 381.32 conjunction with a comprehensive mental health plan. 381.33 Subd. 3. [DISSEMINATION OF ADMISSION AND STAY CRITERIA.] 381.34 The commissioner shall periodically disseminate criteria for 381.35 admission and continued stay in aregional treatment center and381.36security hospitalstate-operated services facility. The 382.1 commissioner shall disseminate the criteria to the courts of the 382.2 state and counties. 382.3 Sec. 42. Minnesota Statutes 2002, section 253.20, is 382.4 amended to read: 382.5 253.20 [MINNESOTA SECURITY HOSPITAL.] 382.6 The commissioner of human servicesis hereby authorized and382.7directed toshall erect, equip, and maintain inconnection with382.8a state hospital atSt. Peter a suitable building to be known as 382.9 the Minnesota Security Hospital, for the purpose ofholding in382.10custody and caring for such persons with mental illness or382.11mental retardation asproviding a secure treatment facility as 382.12 defined in section 253B.02, subdivision 18a, for persons who may 382.13 be committedtheretothere by courtsof criminal jurisdiction, 382.14 or otherwise, or transferredtheretothere by the commissioner 382.15 of human services, and forsuchpersonsas may be declared382.16insanewho are found to be mentally ill while confined in any 382.17penal institutioncorrectional facility, or who may be found to 382.18 be mentally ill and dangerous, and the commissioner shall 382.19 supervise and manage the same as in the case of other state 382.20 hospitals. 382.21 Sec. 43. Minnesota Statutes 2002, section 253.26, is 382.22 amended to read: 382.23 253.26 [TRANSFERS OF PATIENTS OR RESIDENTS.] 382.24When any person of the state hospital for patients with382.25mental illness or residents with mental retardation is found by382.26the commissioner of human services to have homicidal tendencies382.27or to be under sentence or indictment or information the person382.28may be transferred by the commissioner to the Minnesota Security382.29Hospital for safekeeping and treatmentThe commissioner of human 382.30 services may transfer a committed patient to the Minnesota 382.31 Security Hospital following a determination that the patient's 382.32 behavior presents a danger to others and treatment in a secure 382.33 treatment facility is necessary. The commissioner shall 382.34 establish a written policy creating the transfer criteria. 382.35 Sec. 44. Minnesota Statutes 2002, section 253B.02, 382.36 subdivision 18a, is amended to read: 383.1 Subd. 18a. [SECURE TREATMENT FACILITY.] "Secure treatment 383.2 facility" means the Minnesota security hospitalor the Minnesota383.3sexual psychopathic personality treatment centerand the 383.4 Minnesota sex offender program facility in Moose Lake and any 383.5 portion of the Minnesota sex offender program operated by the 383.6 Minnesota sex offender program at the Minnesota security 383.7 hospital, but does not include services or programs administered 383.8 by the secure treatment facility outside a secure environment. 383.9 Sec. 45. Minnesota Statutes 2002, section 253B.04, 383.10 subdivision 1, is amended to read: 383.11 Subdivision 1. [VOLUNTARY ADMISSION AND TREATMENT.] (a) 383.12 Voluntary admission is preferred over involuntary commitment and 383.13 treatment. Any person 16 years of age or older may request to 383.14 be admitted to a treatment facility as a voluntary patient for 383.15 observation, evaluation, diagnosis, care and treatment without 383.16 making formal written application. Any person under the age of 383.17 16 years may be admitted as a patient with the consent of a 383.18 parent or legal guardian if it is determined by independent 383.19 examination that there is reasonable evidence that (1) the 383.20 proposed patient has a mental illness, or is mentally retarded 383.21 or chemically dependent; and (2) the proposed patient is 383.22 suitable for treatment. The head of the treatment facility 383.23 shall not arbitrarily refuse any person seeking admission as a 383.24 voluntary patient. In making decisions regarding admissions, 383.25 the facility shall use clinical admission criteria consistent 383.26 with the current applicable inpatient admission standards 383.27 established by the American Psychiatric Association or the 383.28 American Academy of Child and Adolescent Psychiatry. These 383.29 criteria must be no more restrictive than, and must be 383.30 consistent with, the requirements of section 62Q.53. The 383.31 facility may not refuse to admit a person voluntarily solely 383.32 because the person does not meet the criteria for involuntary 383.33 holds under section 253B.05 or the definition of mental illness 383.34 under section 253B.02, subdivision 13. 383.35 (b) In addition to the consent provisions of paragraph (a), 383.36 a person who is 16 or 17 years of age who refuses to consent 384.1 personally to admission may be admitted as a patient for mental 384.2 illness or chemical dependency treatment with the consent of a 384.3 parent or legal guardian if it is determined by an independent 384.4 examination that there is reasonable evidence that the proposed 384.5 patient is chemically dependent or has a mental illness and is 384.6 suitable for treatment. The person conducting the examination 384.7 shall notify the proposed patient and the parent or legal 384.8 guardian of this determination. 384.9 (c) A person who is voluntarily participating in treatment 384.10 for a mental illness is not subject to civil commitment under 384.11 this chapter if the person: 384.12 (1) has given informed consent or, if lacking capacity, is 384.13 a person for whom legally valid substitute consent has been 384.14 given; and 384.15 (2) is participating in a medically appropriate course of 384.16 treatment, including clinically appropriate and lawful use of 384.17 neuroleptic medication and electroconvulsive therapy. The 384.18 limitation on commitment in this paragraph does not apply if, 384.19 based on clinical assessment, the court finds that it is 384.20 unlikely that the person will remain in and cooperate with a 384.21 medically appropriate course of treatment absent commitment and 384.22 the standards for commitment are otherwise met. This paragraph 384.23 does not apply to a person for whom commitment proceedings are 384.24 initiated pursuant to rule 20.01 or 20.02 of the Rules of 384.25 Criminal Procedure, or a person found by the court to meet the 384.26 requirements under section 253B.02, subdivision 17. 384.27 Legally valid substitute consent may be provided by a proxy 384.28 under a health care directive, a guardian or conservator with 384.29 authority to consent to mental health treatment, or consent to 384.30 admission under subdivision 1a or 1b. 384.31 Sec. 46. Minnesota Statutes 2002, section 253B.05, 384.32 subdivision 3, is amended to read: 384.33 Subd. 3. [DURATION OF HOLD.] (a) Any person held pursuant 384.34 to this section may be held up to 72 hours, exclusive of 384.35 Saturdays, Sundays, and legal holidays after admission. If a 384.36 petition for the commitment of the person is filed in the 385.1 district court in the county of the person's residence or of the 385.2 county in which the treatment facility is located, the court may 385.3 issue a judicial hold order pursuant to section 253B.07, 385.4 subdivision 2b. 385.5 (b) During the 72-hour hold period, a court may not release 385.6 a person held under this section unless the court has received a 385.7 written petition for release and held a summary hearing 385.8 regarding the release. The petition must include the name of 385.9 the person being held, the basis for and location of the hold, 385.10 and a statement as to why the hold is improper. The petition 385.11 also must include copies of any written documentation under 385.12 subdivision 1 or 2 in support of the hold, unless the person 385.13 holding the petitioner refuses to supply the documentation. The 385.14 hearing must be held as soon as practicable and may be conducted 385.15 by means of a telephone conference call or similar method by 385.16 which the participants are able to simultaneously hear each 385.17 other. If the court decides to release the person, the court 385.18 shall direct the release and shall issue written findings 385.19 supporting the decision. The release may not be delayed pending 385.20 the written order. Before deciding to release the person, the 385.21 court shall make every reasonable effort to provide notice of 385.22 the proposed release to: 385.23 (1) any specific individuals identified in a statement 385.24 under subdivision 1 or 2 or individuals identified in the record 385.25 who might be endangered if the person was not held; 385.26 (2) the examiner whose written statement was a basis for a 385.27 hold under subdivision 1; and 385.28 (3) the peace or health officer who applied for a hold 385.29 under subdivision 2. 385.30 (c) If a person is intoxicated in public and held under 385.31 this section for detoxification, a treatment facility may 385.32 release the person without providing notice under paragraph (d) 385.33 as soon as the treatment facility determines the person is no 385.34 longer a danger to themselves or others. Notice must be 385.35 provided to the peace officer or health officer who transported 385.36 the person, or the appropriate law enforcement agency, if the 386.1 officer or agency requests notification. 386.2(c)(d) If a treatment facility releases a person during 386.3 the 72-hour hold period, the head of the treatment facility 386.4 shall immediately notify the agency which employs the peace or 386.5 health officer who transported the person to the treatment 386.6 facility under this section. 386.7 (e) A person held under a 72-hour emergency hold must be 386.8 released by the facility within 72 hours unless a court order to 386.9 hold the person is obtained. A consecutive emergency hold order 386.10 under this section may not be issued. 386.11 Sec. 47. Minnesota Statutes 2002, section 253B.09, 386.12 subdivision 1, is amended to read: 386.13 Subdivision 1. [STANDARD OF PROOF.] (a) If the court finds 386.14 by clear and convincing evidence that the proposed patient is a 386.15 person who is mentally ill, mentally retarded, or chemically 386.16 dependent and after careful consideration of reasonable 386.17 alternative dispositions, including but not limited to, 386.18 dismissal of petition, voluntary outpatient care, voluntary 386.19 admission to a treatment facility, appointment of a guardian or 386.20 conservator, or release before commitment as provided for in 386.21 subdivision 4, it finds that there is no suitable alternative to 386.22 judicial commitment, the court shall commit the patient to the 386.23 least restrictive treatment program or alternative programs 386.24 which can meet the patient's treatment needs consistent with 386.25 section 253B.03, subdivision 7. 386.26 (b) In deciding on the least restrictive program, the court 386.27 shall consider a range of treatment alternatives including, but 386.28 not limited to, community-based nonresidential treatment, 386.29 community residential treatment, partial hospitalization, acute 386.30 care hospital, and regional treatment center services. The 386.31 court shall also consider the proposed patient's treatment 386.32 preferences and willingness to participate voluntarily in the 386.33 treatment ordered. The court may not commit a patient to a 386.34 facility or program that is not capable of meeting the patient's 386.35 needs. 386.36 (c) If the commitment as mentally ill, chemically 387.1 dependent, or mentally retarded is to a service facility 387.2 provided by the commissioner of human services, the court shall 387.3 order the commitment to the commissioner. The commissioner 387.4 shall designate the placement of the person to the court. 387.5 (d) If the court finds a proposed patient to be a person 387.6 who is mentally ill under section 253B.02, subdivision 13, 387.7 paragraph (a), clause (2) or (4), the court shall commit to a 387.8 community-based program that meets the proposed patient's 387.9 needs. For purposes of this paragraph, a community-based 387.10 program may include inpatient mental health services at a 387.11 community hospital. 387.12 Sec. 48. Minnesota Statutes 2002, section 256.012, is 387.13 amended to read: 387.14 256.012 [MINNESOTA MERIT SYSTEM.] 387.15 Subdivision 1. [MINNESOTA MERIT SYSTEM.] The commissioner 387.16 of human services shall promulgate by rule personnel standards 387.17 on a merit basis in accordance with federal standards for a 387.18 merit system of personnel administration for all employees of 387.19 county boards engaged in the administration of community social 387.20 services or income maintenance programs, all employees of human 387.21 services boards that have adopted the rules of the Minnesota 387.22 merit system, and all employees of local social services 387.23 agencies. 387.24 Excluded from the rules are employees of institutions and 387.25 hospitals under the jurisdiction of the aforementioned boards 387.26 and agencies; employees of county personnel systems otherwise 387.27 provided for by law that meet federal merit system requirements; 387.28 duly appointed or elected members of the aforementioned boards 387.29 and agencies; and the director of community social services and 387.30 employees in positions that, upon the request of the appointing 387.31 authority, the commissioner chooses to exempt, provided the 387.32 exemption accords with the federal standards for a merit system 387.33 of personnel administration. 387.34 Subd. 2. [PAYMENT FOR SERVICES PROVIDED.] (a) The cost of 387.35 merit system operations shall be paid by counties and other 387.36 entities that utilize merit system services. Total costs shall 388.1 be determined by the commissioner annually and must be set at a 388.2 level that neither significantly overrecovers nor underrecovers 388.3 the costs of providing the service. The costs of merit system 388.4 services shall be prorated among participating counties in 388.5 accordance with an agreement between the commissioner and these 388.6 counties. Participating counties will be billed quarterly in 388.7 advance and shall pay their share of the costs upon receipt of 388.8 the billing. 388.9 (b) This subdivision does not apply to counties with 388.10 personnel systems otherwise provided by law that meet federal 388.11 merit system requirements. A county that applies to withdraw 388.12 from the merit system must notify the commissioner of the 388.13 county's intent to develop its own personnel system. This 388.14 notice must be provided in writing by December 31 of the year 388.15 preceding the year of final participation in the merit system. 388.16 The county may withdraw after the commissioner has certified 388.17 that its personnel system meets federal merit system 388.18 requirements. 388.19 (c) A county merit system operations account is established 388.20 in the special revenue fund. Payments received by the 388.21 commissioner for merit system costs must be deposited in the 388.22 merit system operations account and must be used for the purpose 388.23 of providing the services and administering the merit system. 388.24 (d) County payment of merit system costs is effective July 388.25 1, 2003, however payment for the period from July 1, 2003 388.26 through December 31, 2003, shall be made no later than January 388.27 31, 2004. 388.28 Subd. 3. [PARTICIPATING COUNTY CONSULTATION.] The 388.29 commissioner shall ensure that participating counties are 388.30 consulted regularly and offered the opportunity to provide input 388.31 on the management of the merit system to ensure effective use of 388.32 resources and to monitor system performance. 388.33 Sec. 49. [256.0451] [HEARING PROCEDURES.] 388.34 Subdivision 1. [SCOPE.] The requirements in this section 388.35 apply to all fair hearings and appeals under section 256.045, 388.36 subdivision 3, paragraph (a), clauses (1), (2), (3), (5), (6), 389.1 and (7). Except as provided in subdivisions 3 and 19, the 389.2 requirements under this section apply to fair hearings and 389.3 appeals under section 256.045, subdivision 3, paragraph (a), 389.4 clauses (4), (8), and (9). 389.5 The term "person" is used in this section to mean an 389.6 individual who, on behalf of themselves or their household, is 389.7 appealing or disputing or challenging an action, a decision, or 389.8 a failure to act, by an agency in the human services system. 389.9 When a person involved in a proceeding under this section is 389.10 represented by an attorney or by an authorized representative, 389.11 the term "person" also refers to the person's attorney or 389.12 authorized representative. Any notice sent to the person 389.13 involved in the hearing must also be sent to the person's 389.14 attorney or authorized representative. 389.15 The term "agency" includes the county human services 389.16 agency, the state human services agency, and, where applicable, 389.17 any entity involved under a contract, subcontract, grant, or 389.18 subgrant with the state agency or with a county agency, that 389.19 provides or operates programs or services in which appeals are 389.20 governed by section 256.045. 389.21 Subd. 2. [ACCESS TO FILES.] A person involved in a fair 389.22 hearing appeal has the right of access to the person's complete 389.23 case files and to examine all private welfare data on the person 389.24 which has been generated, collected, stored, or disseminated by 389.25 the agency. A person involved in a fair hearing appeal has the 389.26 right to a free copy of all documents in the case file involved 389.27 in a fair hearing appeal. "Case file" means the information, 389.28 documents, and data, in whatever form, which have been 389.29 generated, collected, stored, or disseminated by the agency in 389.30 connection with the person and the program or service involved. 389.31 Subd. 3. [AGENCY APPEAL SUMMARY.] (a) Except in fair 389.32 hearings and appeals under section 256.045, subdivision 3, 389.33 paragraph (a), clauses (4), (8), and (9), the agency involved in 389.34 an appeal must prepare a state agency appeal summary for each 389.35 fair hearing appeal. The state agency appeal summary shall be 389.36 mailed or otherwise delivered to the person who is involved in 390.1 the appeal at least three working days before the date of the 390.2 hearing. The state agency appeal summary must also be mailed or 390.3 otherwise delivered to the department's appeals office at least 390.4 three working days before the date of the fair hearing appeal. 390.5 (b) In addition, the appeals referee shall confirm that the 390.6 state agency appeal summary is mailed or otherwise delivered to 390.7 the person involved in the appeal as required under paragraph 390.8 (a). The person involved in the fair hearing should be 390.9 provided, through the state agency appeal summary or other 390.10 reasonable methods, appropriate information about the procedures 390.11 for the fair hearing and an adequate opportunity to prepare. 390.12 These requirements apply equally to the state agency or an 390.13 entity under contract when involved in the appeal. 390.14 (c) The contents of the state agency appeal summary must be 390.15 adequate to inform the person involved in the appeal of the 390.16 evidence on which the agency relies and the legal basis for the 390.17 agency's action or determination. 390.18 Subd. 4. [ENFORCING ACCESS TO FILES.] A person involved in 390.19 a fair hearing appeal may enforce the right of access to data 390.20 and copies of the case file by making a request to the appeals 390.21 referee. The appeals referee will make an appropriate order 390.22 enforcing the person's rights under the Minnesota Government 390.23 Data Practices Act, including but not limited to, ordering 390.24 access to files, data, and documents; continuing a hearing to 390.25 allow adequate time for access to data; or prohibiting use by 390.26 the agency of files, data, or documents which have been 390.27 generated, collected, stored, or disseminated without compliance 390.28 with the Minnesota Government Data Practices Act and which have 390.29 not been provided to the person involved in the appeal. 390.30 Subd. 5. [PREHEARING CONFERENCES.] (a) The appeals referee 390.31 prior to a fair hearing appeal may hold a prehearing conference 390.32 to further the interests of justice or efficiency and must 390.33 include the person involved in the appeal. A person involved in 390.34 a fair hearing appeal or the agency may request a prehearing 390.35 conference. The prehearing conference may be conducted by 390.36 telephone, in person, or in writing. The prehearing conference 391.1 may address the following: 391.2 (1) disputes regarding access to files, evidence, 391.3 subpoenas, or testimony; 391.4 (2) the time required for the hearing or any need for 391.5 expedited procedures or decision; 391.6 (3) identification or clarification of legal or other 391.7 issues that may arise at the hearing; 391.8 (4) identification of and possible agreement to factual 391.9 issues; and 391.10 (5) scheduling and any other matter which will aid in the 391.11 proper and fair functioning of the hearing. 391.12 (b) The appeals referee shall make a record or otherwise 391.13 contemporaneously summarize the prehearing conference in 391.14 writing, which shall be sent to both the person involved in the 391.15 hearing, the person's attorney or authorized representative, and 391.16 the agency. 391.17 Subd. 6. [APPEAL REQUEST FOR EMERGENCY ASSISTANCE OR 391.18 URGENT MATTER.] (a) When an appeal involves an application for 391.19 emergency assistance, the agency involved shall mail or 391.20 otherwise deliver the state agency appeal summary to the 391.21 department's appeals office within two working days of receiving 391.22 the request for an appeal. A person may also request that a 391.23 fair hearing be held on an emergency basis when the issue 391.24 requires an immediate resolution. The appeals referee shall 391.25 schedule the fair hearing on the earliest available date 391.26 according to the urgency of the issue involved. Issuance of the 391.27 recommended decision after an emergency hearing shall be 391.28 expedited. 391.29 (b) The commissioner shall issue a written decision within 391.30 five working days of receiving the recommended decision, shall 391.31 immediately inform the parties of the outcome by telephone, and 391.32 shall mail the decision no later than two working days following 391.33 the date of the decision. 391.34 Subd. 7. [CONTINUANCE, RESCHEDULING, OR ADJOURNING A 391.35 HEARING.] (a) A person involved in a fair hearing, or the 391.36 agency, may request a continuance, a rescheduling, or an 392.1 adjournment of a hearing for a reasonable period of time. The 392.2 grounds for granting a request for a continuance, a 392.3 rescheduling, or adjournment of a hearing include, but are not 392.4 limited to, the following: 392.5 (1) to reasonably accommodate the appearance of a witness; 392.6 (2) to ensure that the person has adequate opportunity for 392.7 preparation and for presentation of evidence and argument; 392.8 (3) to ensure that the person or the agency has adequate 392.9 opportunity to review, evaluate, and respond to new evidence, or 392.10 where appropriate, to require that the person or agency review, 392.11 evaluate, and respond to new evidence; 392.12 (4) to permit the person involved and the agency to 392.13 negotiate toward resolution of some or all of the issues where 392.14 both agree that additional time is needed; 392.15 (5) to permit the agency to reconsider a previous action or 392.16 determination; 392.17 (6) to permit or to require the performance of actions not 392.18 previously taken; and 392.19 (7) to provide additional time or to permit or require 392.20 additional activity by the person or agency as the interests of 392.21 fairness may require. 392.22 (b) Requests for continuances or for rescheduling may be 392.23 made orally or in writing. The person or agency requesting the 392.24 continuance or rescheduling must first make reasonable efforts 392.25 to contact the other participants in the hearing or their 392.26 representatives, and seek to obtain an agreement on the 392.27 request. Requests for continuance or rescheduling should be 392.28 made no later than three working days before the scheduled date 392.29 of the hearing, unless there is a good cause as specified in 392.30 subdivision 13. Granting a continuance or rescheduling may be 392.31 conditioned upon a waiver by the requester of applicable time 392.32 limits, but should not cause unreasonable delay. 392.33 Subd. 8. [SUBPOENAS.] A person involved in a fair hearing 392.34 or the agency may request a subpoena for a witness, for 392.35 evidence, or for both. A reasonable number of subpoenas shall 392.36 be issued to require the attendance and the testimony of 393.1 witnesses, and the production of evidence relating to any issue 393.2 of fact in the appeal hearing. The request for a subpoena must 393.3 show a need for the subpoena and the general relevance to the 393.4 issues involved. The subpoena shall be issued in the name of 393.5 the department and shall be served and enforced as provided in 393.6 section 357.22 and the Minnesota Rules of Civil Procedure. 393.7 An individual or entity served with a subpoena may petition 393.8 the appeals referee in writing to vacate or modify a subpoena. 393.9 The appeals referee shall resolve such a petition in a 393.10 prehearing conference involving all parties and shall make a 393.11 written decision. A subpoena may be vacated or modified if the 393.12 appeals referee determines that the testimony or evidence sought 393.13 does not relate with reasonable directness to the issues of the 393.14 fair hearing appeal; that the subpoena is unreasonable, over 393.15 broad, or oppressive; that the evidence sought is repetitious or 393.16 cumulative; or that the subpoena has not been served reasonably 393.17 in advance of the time when the appeal hearing will be held. 393.18 Subd. 9. [NO EX PARTE CONTACT.] The appeals referee shall 393.19 not have ex parte contact on substantive issues with the agency 393.20 or with any person or witness in a fair hearing appeal. No 393.21 employee of the department or agency shall review, interfere 393.22 with, change, or attempt to influence the recommended decision 393.23 of the appeals referee in any fair hearing appeal, except 393.24 through the procedure allowed in subdivision 18. The 393.25 limitations in this subdivision do not affect the commissioner's 393.26 authority to review or reconsider decisions or make final 393.27 decisions. 393.28 Subd. 10. [TELEPHONE OR FACE-TO-FACE HEARING.] A fair 393.29 hearing appeal may be conducted by telephone, by other 393.30 electronic media, or by an in-person, face-to-face hearing. At 393.31 the request of the person involved in a fair hearing appeal or 393.32 their representative, a face-to-face hearing shall be conducted 393.33 with all participants personally present before the appeals 393.34 referee. 393.35 Subd. 11. [HEARING FACILITIES AND EQUIPMENT.] The appeals 393.36 referee shall conduct the hearing in the county where the person 394.1 involved resides, unless an alternate location is mutually 394.2 agreed upon before the hearing, or unless the person has agreed 394.3 to a hearing by telephone. Hearings under section 256.045, 394.4 subdivision 3, paragraph (a), clauses (4), (8), and (9), must be 394.5 conducted in the county where the determination was made, unless 394.6 an alternate location is mutually agreed upon before the 394.7 hearing. The hearing room shall be of sufficient size and 394.8 layout to adequately accommodate both the number of individuals 394.9 participating in the hearing and any identified special needs of 394.10 any individual participating in the hearing. The appeals 394.11 referee shall ensure that all communication and recording 394.12 equipment that is necessary to conduct the hearing and to create 394.13 an adequate record is present and functioning properly. If any 394.14 necessary communication or recording equipment fails or ceases 394.15 to operate effectively, the appeals referee shall take any steps 394.16 necessary, including stopping or adjourning the hearing, until 394.17 the necessary equipment is present and functioning properly. 394.18 All reasonable efforts shall be undertaken to prevent and avoid 394.19 any delay in the hearing process caused by defective 394.20 communication or recording equipment. 394.21 Subd. 12. [INTERPRETER AND TRANSLATION SERVICES.] The 394.22 appeals referee has a duty to inquire and to determine whether 394.23 any participant in the hearing needs the services of an 394.24 interpreter or translator in order to participate in or to 394.25 understand the hearing process. Necessary interpreter or 394.26 translation services must be provided at no charge to the person 394.27 involved in the hearing. If it appears that interpreter or 394.28 translation services are needed but are not available for the 394.29 scheduled hearing, the appeals referee shall continue or 394.30 postpone the hearing until appropriate services can be provided. 394.31 Subd. 13. [FAILURE TO APPEAR; GOOD CAUSE.] If a person 394.32 involved in a fair hearing appeal fails to appear at the 394.33 hearing, the appeals referee may dismiss the appeal. The person 394.34 may reopen the appeal if within ten working days the person 394.35 submits information to the appeals referee to show good cause 394.36 for not appearing. Good cause can be shown when there is: 395.1 (1) a death or serious illness in the person's family; 395.2 (2) a personal injury or illness which reasonably prevents 395.3 the person from attending the hearing; 395.4 (3) an emergency, crisis, or unforeseen event which 395.5 reasonably prevents the person from attending the hearing; 395.6 (4) an obligation or responsibility of the person which a 395.7 reasonable person, in the conduct of one's affairs, could 395.8 reasonably determine takes precedence over attending the 395.9 hearing; 395.10 (5) lack of or failure to receive timely notice of the 395.11 hearing in the preferred language of the person involved in the 395.12 hearing; and 395.13 (6) excusable neglect, excusable inadvertence, excusable 395.14 mistake, or other good cause as determined by the appeals 395.15 referee. 395.16 Subd. 14. [COMMENCEMENT OF HEARING.] The appeals referee 395.17 shall begin each hearing by describing the process to be 395.18 followed in the hearing, including the swearing-in of witnesses, 395.19 how testimony and evidence are presented, the order of examining 395.20 and cross-examining witnesses, and the opportunity for an 395.21 opening statement and a closing statement. The appeals referee 395.22 shall identify for the participants the issues to be addressed 395.23 at the hearing and shall explain to the participants the burden 395.24 of proof which applies to the person involved and the agency. 395.25 The appeals referee shall confirm, prior to proceeding with the 395.26 hearing, that the state agency appeal summary, if required under 395.27 subdivision 3, has been properly completed and provided to the 395.28 person involved in the hearing, and that the person has been 395.29 provided documents and an opportunity to review the case file, 395.30 as provided in this section. 395.31 Subd. 15. [CONDUCT OF THE HEARING.] The appeals referee 395.32 shall act in a fair and impartial manner at all times. At the 395.33 beginning of the hearing the agency must designate one person as 395.34 their representative who shall be responsible for presenting the 395.35 agency's evidence and questioning any witnesses. The appeals 395.36 referee shall make sure that the person and the agency are 396.1 provided sufficient time to present testimony and evidence, to 396.2 confront and cross-examine all adverse witnesses, and to make 396.3 any relevant statement at the hearing. The appeals referee 396.4 shall make reasonable efforts to explain the hearing process to 396.5 persons who are not represented, and shall ensure that the 396.6 hearing is conducted fairly and efficiently. Upon the 396.7 reasonable request of the person or the agency involved, the 396.8 appeals referee may direct witnesses to remain outside the 396.9 hearing room, except during their individual testimony. The 396.10 appeals referee shall not terminate the hearing before affording 396.11 the person and the agency a complete opportunity to submit all 396.12 admissible evidence, and reasonable opportunity for oral or 396.13 written statement. When a hearing extends beyond the time which 396.14 was anticipated, the hearing shall be rescheduled or continued 396.15 from day-to-day until completion. Hearings that have been 396.16 continued shall be timely scheduled to minimize delay in the 396.17 disposition of the appeal. 396.18 Subd. 16. [SCOPE OF ISSUES ADDRESSED AT THE HEARING.] The 396.19 hearing shall address the correctness and legality of the 396.20 agency's action and shall not be limited simply to a review of 396.21 the propriety of the agency's action. The person involved may 396.22 raise and present evidence on all legal claims or defenses 396.23 arising under state or federal law as a basis for appealing or 396.24 disputing an agency action, but not constitutional claims beyond 396.25 the jurisdiction of the fair hearing. The appeals referee may 396.26 take official notice of adjudicative facts. 396.27 Subd. 17. [BURDEN OF PERSUASION.] The burden of persuasion 396.28 is governed by specific state or federal law and regulations 396.29 that apply to the subject of the hearing. If there is no 396.30 specific law, then the participant in the hearing who asserts 396.31 the truth of a claim is under the burden to persuade the appeals 396.32 referee that the claim is true. 396.33 Subd. 18. [INVITING COMMENT BY DEPARTMENT.] The appeals 396.34 referee or the commissioner may determine that a written comment 396.35 by the department about the policy implications of a specific 396.36 legal issue could help resolve a pending appeal. Such a written 397.1 policy comment from the department shall be obtained only by a 397.2 written request that is also sent to the person involved and to 397.3 the agency or its representative. When such a written comment 397.4 is received, both the person involved in the hearing and the 397.5 agency shall have adequate opportunity to review, evaluate, and 397.6 respond to the written comment, including submission of 397.7 additional testimony or evidence, and cross-examination 397.8 concerning the written comment. 397.9 Subd. 19. [DEVELOPING THE RECORD.] The appeals referee 397.10 shall accept all evidence, except evidence privileged by law, 397.11 that is commonly accepted by reasonable people in the conduct of 397.12 their affairs as having probative value on the issues to be 397.13 addressed at the hearing. Except in fair hearings and appeals 397.14 under section 256.045, subdivision 3, paragraph (a), clauses 397.15 (4), (8), and (9), in cases involving medical issues such as a 397.16 diagnosis, a physician's report, or a review team's decision, 397.17 the appeals referee shall consider whether it is necessary to 397.18 have a medical assessment other than that of the individual 397.19 making the original decision. When necessary, the appeals 397.20 referee shall require an additional assessment be obtained at 397.21 agency expense and made part of the hearing record. The appeals 397.22 referee shall ensure for all cases that the record is 397.23 sufficiently complete to make a fair and accurate decision. 397.24 Subd. 20. [UNREPRESENTED PERSONS.] In cases involving 397.25 unrepresented persons, the appeals referee shall take 397.26 appropriate steps to identify and develop in the hearing 397.27 relevant facts necessary for making an informed and fair 397.28 decision. These steps may include, but are not limited to, 397.29 asking questions of witnesses, and referring the person to a 397.30 legal services office. An unrepresented person shall be 397.31 provided an adequate opportunity to respond to testimony or 397.32 other evidence presented by the agency at the hearing. The 397.33 appeals referee shall ensure that an unrepresented person has a 397.34 full and reasonable opportunity at the hearing to establish a 397.35 record for appeal. 397.36 Subd. 21. [CLOSING OF THE RECORD.] The agency must present 398.1 its evidence prior to or at the hearing. The agency shall not 398.2 be permitted to submit evidence after the hearing except by 398.3 agreement at the hearing between the person involved, the 398.4 agency, and the appeals referee. If evidence is submitted after 398.5 the hearing, based on such an agreement, the person involved and 398.6 the agency must be allowed sufficient opportunity to respond to 398.7 the evidence. When necessary, the record shall remain open to 398.8 permit a person to submit additional evidence on the issues 398.9 presented at the hearing. 398.10 Subd. 22. [DECISIONS.] A timely, written decision must be 398.11 issued in every appeal. Each decision must contain a clear 398.12 ruling on the issues presented in the appeal hearing, and should 398.13 contain a ruling only on questions directly presented by the 398.14 appeal and the arguments raised in the appeal. 398.15 (a) [TIMELINESS.] A written decision must be issued within 398.16 90 days of the date the person involved requested the appeal 398.17 unless a shorter time is required by law. An additional 30 days 398.18 is provided in those cases where the commissioner refuses to 398.19 accept the recommended decision. 398.20 (b) [CONTENTS OF HEARING DECISION.] The decision must 398.21 contain both findings of fact and conclusions of law, clearly 398.22 separated and identified. The findings of fact must be based on 398.23 the entire record. Each finding of fact made by the appeals 398.24 referee shall be supported by a preponderance of the evidence 398.25 unless a different standard is required under the regulations of 398.26 a particular program. The "preponderance of the evidence" 398.27 means, in light of the record as a whole, the evidence leads the 398.28 appeals referee to believe that the finding of fact is more 398.29 likely to be true than not true. The legal claims or arguments 398.30 of a participant do not constitute either a finding of fact or a 398.31 conclusion of law, except to the extent the appeals referee 398.32 adopts an argument as a finding of fact or conclusion of law. 398.33 The decision shall contain at least the following: 398.34 (1) a listing of the date and place of the hearing and the 398.35 participants at the hearing; 398.36 (2) a clear and precise statement of the issues, including 399.1 the dispute under consideration and the specific points which 399.2 must be resolved in order to decide the case; 399.3 (3) a listing of the material, including exhibits, records, 399.4 reports, placed into evidence at the hearing, and upon which the 399.5 hearing decision is based; 399.6 (4) the findings of fact based upon the entire hearing 399.7 record. The findings of fact must be adequate to inform the 399.8 participants and any interested person in the public of the 399.9 basis of the decision. If the evidence is in conflict on an 399.10 issue which must be resolved, the findings of fact must state 399.11 the reasoning used in resolving the conflict; 399.12 (5) conclusions of law that address the legal authority for 399.13 the hearing and the ruling, and which give appropriate attention 399.14 to the claims of the participants to the hearing; 399.15 (6) a clear and precise statement of the decision made 399.16 resolving the dispute under consideration in the hearing; and 399.17 (7) written notice of the right to appeal to district court 399.18 or to request reconsideration, and of the actions required and 399.19 the time limits for taking appropriate action to appeal to 399.20 district court or to request a reconsideration. 399.21 (c) [NO INDEPENDENT INVESTIGATION.] The appeals referee 399.22 shall not independently investigate facts or otherwise rely on 399.23 information not presented at the hearing. The appeals referee 399.24 may not contact other agency personnel, except as provided in 399.25 subdivision 18. The appeals referee's recommended decision must 399.26 be based exclusively on the testimony and evidence presented at 399.27 the hearing, and legal arguments presented, and the appeals 399.28 referee's research and knowledge of the law. 399.29 (d) [RECOMMENDED DECISION.] The commissioner will review 399.30 the recommended decision and accept or refuse to accept the 399.31 decision according to section 256.045, subdivision 5. 399.32 Subd. 23. [REFUSAL TO ACCEPT RECOMMENDED ORDERS.] (a) If 399.33 the commissioner refuses to accept the recommended order from 399.34 the appeals referee, the person involved, the person's attorney 399.35 or authorized representative, and the agency shall be sent a 399.36 copy of the recommended order, a detailed explanation of the 400.1 basis for refusing to accept the recommended order, and the 400.2 proposed modified order. 400.3 (b) The person involved and the agency shall have at least 400.4 ten business days to respond to the proposed modification of the 400.5 recommended order. The person involved and the agency may 400.6 submit a legal argument concerning the proposed modification, 400.7 and may propose to submit additional evidence that relates to 400.8 the proposed modified order. 400.9 Subd. 24. [RECONSIDERATION.] Reconsideration may be 400.10 requested within 30 days of the date of the commissioner's final 400.11 order. If reconsideration is requested, the other participants 400.12 in the appeal shall be informed of the request. The person 400.13 seeking reconsideration has the burden to demonstrate why the 400.14 matter should be reconsidered. The request for reconsideration 400.15 may include legal argument and may include proposed additional 400.16 evidence supporting the request. The other participants shall 400.17 be sent a copy of all material submitted in support of the 400.18 request for reconsideration and must be given ten days to 400.19 respond. 400.20 (a) [FINDINGS OF FACT.] When the requesting party raises a 400.21 question as to the appropriateness of the findings of fact, the 400.22 commissioner shall review the entire record. 400.23 (b) [CONCLUSIONS OF LAW.] When the requesting party 400.24 questions the appropriateness of a conclusion of law, the 400.25 commissioner shall consider the recommended decision, the 400.26 decision under reconsideration, and the material submitted in 400.27 connection with the reconsideration. The commissioner shall 400.28 review the remaining record as necessary to issue a reconsidered 400.29 decision. 400.30 (c) [WRITTEN DECISION.] The commissioner shall issue a 400.31 written decision on reconsideration in a timely fashion. The 400.32 decision must clearly inform the parties that this constitutes 400.33 the final administrative decision, advise the participants of 400.34 the right to seek judicial review, and the deadline for doing so. 400.35 Subd. 25. [ACCESS TO APPEAL DECISIONS.] Appeal decisions 400.36 must be maintained in a manner so that the public has ready 401.1 access to previous decisions on particular topics, subject to 401.2 appropriate procedures for safeguarding names, personal 401.3 identifying information, and other private data on the 401.4 individual persons involved in the appeal. 401.5 Sec. 50. Minnesota Statutes 2002, section 256B.092, 401.6 subdivision 5, is amended to read: 401.7 Subd. 5. [FEDERAL WAIVERS.] (a) The commissioner shall 401.8 apply for any federal waivers necessary to secure, to the extent 401.9 allowed by law, federal financial participation under United 401.10 States Code, title 42, sections 1396 et seq., as amended, for 401.11 the provision of services to persons who, in the absence of the 401.12 services, would need the level of care provided in a regional 401.13 treatment center or a community intermediate care facility for 401.14 persons with mental retardation or related conditions. The 401.15 commissioner may seek amendments to the waivers or apply for 401.16 additional waivers under United States Code, title 42, sections 401.17 1396 et seq., as amended, to contain costs. The commissioner 401.18 shall ensure that payment for the cost of providing home and 401.19 community-based alternative services under the federal waiver 401.20 plan shall not exceed the cost of intermediate care services 401.21 including day training and habilitation services that would have 401.22 been provided without the waivered services. 401.23 The commissioner shall seek an amendment to the 1915c home 401.24 and community-based waiver to allow properly licensed adult 401.25 foster care homes to provide residential services to up to five 401.26 individuals with mental retardation or a related condition. If 401.27 the amendment to the waiver is approved, adult foster care 401.28 providers that can accommodate five individuals shall increase 401.29 their capacity to five beds, provided the providers continue to 401.30 meet all applicable licensing requirements. 401.31 (b) The commissioner, in administering home and 401.32 community-based waivers for persons with mental retardation and 401.33 related conditions, shall ensure that day services for eligible 401.34 persons are not provided by the person's residential service 401.35 provider, unless the person or the person's legal representative 401.36 is offered a choice of providers and agrees in writing to 402.1 provision of day services by the residential service provider. 402.2 The individual service plan for individuals who choose to have 402.3 their residential service provider provide their day services 402.4 must describe how health, safety, and protection needs will be 402.5 met by frequent and regular contact with persons other than the 402.6 residential service provider. 402.7 Sec. 51. Minnesota Statutes 2002, section 256B.092, is 402.8 amended by adding a subdivision to read: 402.9 Subd. 5a. [INCREASING ADULT FOSTER CARE CAPACITY TO SERVE 402.10 FIVE PERSONS.] (a) When an adult foster care provider increases 402.11 the capacity of an existing home licensed to serve four persons 402.12 to serve a fifth person under this section, the county agency 402.13 shall reduce the contracted per diem cost for room and board and 402.14 the mental retardation or a related condition waiver services of 402.15 the existing foster care home by an average of 14 percent for 402.16 all individuals living in that home. A county agency may 402.17 average the required per diem rate reductions across several 402.18 adult foster care homes that expand capacity under this section, 402.19 to achieve the necessary overall per diem reduction. 402.20 (b) Following the contract changes in paragraph (a), the 402.21 commissioner shall adjust: 402.22 (1) individual county allocations for mental retardation or 402.23 a related condition waivered services by the amount of savings 402.24 that results from the changes made for mental retardation or a 402.25 related condition waiver recipients for whom the county is 402.26 financially responsible; and 402.27 (2) group residential housing rate payments to the adult 402.28 foster home by the amount of savings that results from the 402.29 changes made. 402.30 (c) Effective July 1, 2003, when a new five-person adult 402.31 foster care home is licensed under this section, county agencies 402.32 shall not establish group residential housing room and board 402.33 rates and mental retardation or a related condition waiver 402.34 service rates for the new home that exceed 86 percent of the 402.35 average per diem room and board and mental retardation or a 402.36 related condition waiver services costs of four-person homes 403.1 serving persons with comparable needs and in the same geographic 403.2 area. A county agency developing more than one new five-person 403.3 adult foster care home may average the required per diem rates 403.4 across the homes to achieve the necessary overall per diem 403.5 reductions. 403.6 (d) The commissioner shall reduce the individual county 403.7 allocations for mental retardation or a related condition 403.8 waivered services by the savings resulting from the per diem 403.9 limits on adult foster care recipients for whom the county is 403.10 financially responsible, and shall limit the group residential 403.11 housing rate for a new five-person adult foster care home. 403.12 Sec. 52. Minnesota Statutes 2002, section 257.0769, is 403.13 amended to read: 403.14 257.0769 [FUNDING FOR THE OMBUDSPERSON PROGRAM.] 403.15 Subdivision 1. [APPROPRIATIONS.] (a) Money is appropriated 403.16 from the special fund authorized by section 256.01, subdivision 403.17 2, clause (15), to the Indian affairs council for the purposes 403.18 of sections 257.0755 to 257.0768. 403.19 (b) Money is appropriated from the special fund authorized 403.20 by section 256.01, subdivision 2, clause (15), to the council on 403.21 affairs of Chicano/Latino people for the purposes of sections 403.22 257.0755 to 257.0768. 403.23 (c) Money is appropriated from the special fund authorized 403.24 by section 256.01, subdivision 2, clause (15), to the Council of 403.25 Black Minnesotans for the purposes of sections 257.0755 to 403.26 257.0768. 403.27 (d) Money is appropriated from the special fund authorized 403.28 by section 256.01, subdivision 2, clause (15), to the Council on 403.29 Asian-Pacific Minnesotans for the purposes of sections 257.0755 403.30 to 257.0768. 403.31 Subd. 2. [TITLE IV-E REIMBURSEMENT.] The commissioner 403.32 shall obtain federal title IV-E financial participation for 403.33 eligible activity by the ombudsperson for families under section 403.34 257.0755. The ombudsperson for families shall maintain and 403.35 transmit to the department of human services documentation that 403.36 is necessary in order to obtain federal funds. 404.1 Sec. 53. Minnesota Statutes 2002, section 259.21, 404.2 subdivision 6, is amended to read: 404.3 Subd. 6. [AGENCY.] "Agency" means an organization or 404.4 department of government designated or authorized by law to 404.5 place children for adoption or any person, group of persons, 404.6 organization, association or society licensed or certified by 404.7 the commissioner of human services to place children for 404.8 adoption, including a Minnesota federally recognized tribe. 404.9 Sec. 54. Minnesota Statutes 2002, section 259.67, 404.10 subdivision 7, is amended to read: 404.11 Subd. 7. [REIMBURSEMENT OF COSTS.] (a) Subject to rules of 404.12 the commissioner, and the provisions of this subdivision a 404.13 child-placing agency licensed in Minnesota or any other state, 404.14 or local or tribal social services agency shall receive a 404.15 reimbursement from the commissioner equal to 100 percent of the 404.16 reasonable and appropriate cost of providing adoption services 404.17 for a child certified as eligible for adoption assistance under 404.18 subdivision 4. Such assistance may include adoptive family 404.19 recruitment, counseling, and special training when needed. A 404.20 child-placing agency licensed in Minnesota or any other state 404.21 shall receive reimbursement for adoption services it purchases 404.22 for or directly provides to an eligible child. A local or 404.23 tribal social services agency shall receive such reimbursement 404.24 only for adoption services it purchases for an eligible child. 404.25 (b) A child-placing agency licensed in Minnesota or any 404.26 other state or local or tribal social services agency seeking 404.27 reimbursement under this subdivision shall enter into a 404.28 reimbursement agreement with the commissioner before providing 404.29 adoption services for which reimbursement is sought. No 404.30 reimbursement under this subdivision shall be made to an agency 404.31 for services provided prior to entering a reimbursement 404.32 agreement. Separate reimbursement agreements shall be made for 404.33 each child and separate records shall be kept on each child for 404.34 whom a reimbursement agreement is made. Funds encumbered and 404.35 obligated under such an agreement for the child remain available 404.36 until the terms of the agreement are fulfilled or the agreement 405.1 is terminated. 405.2 (c) When a local or tribal social services agency uses a 405.3 purchase of service agreement to provide services reimbursable 405.4 under a reimbursement agreement, the commissioner may make 405.5 reimbursement payments directly to the agency providing the 405.6 service if direct reimbursement is specified by the purchase of 405.7 service agreement, and if the request for reimbursement is 405.8 submitted by the local or tribal social services agency along 405.9 with a verification that the service was provided. 405.10 Sec. 55. Minnesota Statutes 2002, section 393.07, 405.11 subdivision 1, is amended to read: 405.12 Subdivision 1. [PUBLIC CHILD WELFARE PROGRAM.] (a) To 405.13 assist in carrying out the child protection, delinquency 405.14 prevention and family assistance responsibilities of the state, 405.15 the local social services agency shall administer a program of 405.16 social services and financial assistance to be known as the 405.17 public child welfare program. The public child welfare program 405.18 shall be supervised by the commissioner of human services and 405.19 administered by the local social services agency in accordance 405.20 with law and with rules of the commissioner. 405.21 (b) The purpose of the public child welfare program is to 405.22 assure protection for and financial assistance to children who 405.23 are confronted with social, physical, or emotional problems 405.24 requiring protection and assistance. These problems include, 405.25 but are not limited to the following: 405.26 (1) mental, emotional, or physical handicap; 405.27 (2) birth of a child to a mother who was not married to the 405.28 child's father when the child was conceived nor when the child 405.29 was born, including but not limited to costs of prenatal care, 405.30 confinement and other care necessary for the protection of a 405.31 child born to a mother who was not married to the child's father 405.32 at the time of the child's conception nor at the birth; 405.33 (3) dependency, neglect; 405.34 (4) delinquency; 405.35 (5) abuse or rejection of a child by its parents; 405.36 (6) absence of a parent or guardian able and willing to 406.1 provide needed care and supervision; 406.2 (7) need of parents for assistance with child rearing 406.3 problems, or in placing the child in foster care. 406.4 (c) A local social services agency shall make the services 406.5 of its public child welfare program available as required by 406.6 law, by the commissioner, or by the courts and shall cooperate 406.7 with other agencies, public or private, dealing with the 406.8 problems of children and their parents as provided in this 406.9 subdivision. 406.10The public child welfare program shall be available in406.11divorce cases for investigations of children and home conditions406.12and for supervision of children when directed by the court406.13hearing the divorce.406.14 (d) A local social services agency may rent, lease, or 406.15 purchase property, or in any other way approved by the 406.16 commissioner, contract with individuals or agencies to provide 406.17 needed facilities for foster care of children. It may purchase 406.18 services or child care from duly authorized individuals, 406.19 agencies or institutions when in its judgment the needs of a 406.20 child or the child's family can best be met in this way. 406.21 Sec. 56. Minnesota Statutes 2002, section 393.07, 406.22 subdivision 5, is amended to read: 406.23 Subd. 5. [COMPLIANCE WITH FEDERAL SOCIAL SECURITY ACT; 406.24 MERIT SYSTEM.] The commissioner of human services shall have 406.25 authority to require such methods of administration as are 406.26 necessary for compliance with requirements of the federal Social 406.27 Security Act, as amended, and for the proper and efficient 406.28 operation of all welfare programs. This authority to require 406.29 methods of administration includes methods relating to the 406.30 establishment and maintenance of personnel standards on a merit 406.31 basis as concerns all employees of local social services 406.32 agencies except those employed in an institution, sanitarium, or 406.33 hospital. The commissioner of human services shall exercise no 406.34 authority with respect to the selection, tenure of office, and 406.35 compensation of any individual employed in accordance with such 406.36 methods. The adoption of methods relating to the establishment 407.1 and maintenance of personnel standards on a merit basis of all 407.2 such employees of the local social services agencies and the 407.3 examination thereof, and the administration thereof shall be 407.4 directed and controlled exclusively by the commissioner of human 407.5 services. 407.6 Notwithstanding the provisions of any other law to the 407.7 contrary, every employee of every local social services agency 407.8 who occupies a position which requires as prerequisite to 407.9 eligibility therefor graduation from an accredited four year 407.10 college or a certificate of registration as a registered nurse 407.11 under section 148.231, must be employed in such position under 407.12 the merit system established under authority of this 407.13 subdivision. Every such employee now employed by a local social 407.14 services agency and who is not under said merit system is 407.15 transferred, as of January 1, 1962, to a position of comparable 407.16 classification in the merit system with the same status therein 407.17 as the employee had in the county of employment prior thereto 407.18 and every such employee shall be subject to and have the benefit 407.19 of the merit system, including seniority within the local social 407.20 services agency, as though the employee had served thereunder 407.21 from the date of entry into the service of the local social 407.22 services agency. 407.23By March 1, 1996, the commissioner of human services shall407.24report to the chair of the senate health care and family407.25services finance division and the chair of the house health and407.26human services finance division on options for the delivery of407.27merit-based employment services by entities other than the407.28department of human services in order to reduce the407.29administrative costs to the state while maintaining compliance407.30with applicable federal regulations.407.31 Sec. 57. Minnesota Statutes 2002, section 518.167, 407.32 subdivision 1, is amended to read: 407.33 Subdivision 1. [COURT ORDER.] In contested custody 407.34 proceedings, and in other custody proceedings if a parent or the 407.35 child's custodian requests, the court may order an investigation 407.36 and report concerning custodial arrangements for the child. If 408.1 the county elects to conduct an investigation, the county may 408.2 charge a fee. The investigation and report may be made by the 408.3 county welfare agency or department of court services. 408.4 Sec. 58. Minnesota Statutes 2002, section 518.551, 408.5 subdivision 7, is amended to read: 408.6 Subd. 7. [SERVICE FEEFEES AND COST RECOVERY FEES FOR IV-D 408.7 SERVICES.]When the public agency responsible for child support408.8enforcement provides child support collection services either to408.9a public assistance recipient or to a party who does not receive408.10public assistance, the public agency may upon written notice to408.11the obligor charge a monthly collection fee equivalent to the408.12full monthly cost to the county of providing collection408.13services, in addition to the amount of the child support which408.14was ordered by the court. The fee shall be deposited in the408.15county general fund. The service fee assessed is limited to ten408.16percent of the monthly court ordered child support and shall not408.17be assessed to obligors who are current in payment of the408.18monthly court ordered child support.(a) When a recipient of 408.19 IV-D services is no longer receiving assistance under the 408.20 state's title IV-A, IV-E foster care, medical assistance, or 408.21 MinnesotaCare programs, the public authority responsible for 408.22 child support enforcement must notify the recipient, within five 408.23 working days of the notification of ineligibility, that IV-D 408.24 services will be continued unless the public authority is 408.25 notified to the contrary by the recipient. The notice must 408.26 include the implications of continuing to receive IV-D services, 408.27 including the available services and fees, cost recovery fees, 408.28 and distribution policies relating to fees. 408.29 (b) An application fee of $25 shall be paid by the person 408.30 who applies for child support and maintenance collection 408.31 services, except persons who are receiving public assistance as 408.32 defined in section 256.741 and, if enacted, the diversionary 408.33 work program under section 256J.95, persons who transfer from 408.34 public assistance to nonpublic assistance status, and minor 408.35 parents and parents enrolled in a public secondary school, area 408.36 learning center, or alternative learning program approved by the 409.1 commissioner of children, families, and learning. 409.2 (c) When the public authority provides full IV-D services 409.3 to an obligee who has applied for those services, upon written 409.4 notice to the obligee, the public authority must charge a cost 409.5 recovery fee of one percent of the amount collected. This fee 409.6 must be deducted from the amount of the child support and 409.7 maintenance collected and not assigned under section 256.741, 409.8 before disbursement to the obligee. This fee does not apply to 409.9 an obligee who: 409.10 (1) is currently receiving assistance under the state's 409.11 title IV-A, IV-E foster care, medical assistance, or 409.12 MinnesotaCare programs; or 409.13 (2) has received assistance under the state's title IV-A or 409.14 IV-E foster care programs, until the person has not received 409.15 this assistance for 24 consecutive months. 409.16 (d) When the public authority provides full IV-D services 409.17 to an obligor who has applied for such services, upon written 409.18 notice to the obligor, the public authority must charge a cost 409.19 recovery fee of one percent of the monthly court ordered child 409.20 support and maintenance obligation. The fee may be collected 409.21 through income withholding, as well as by any other enforcement 409.22 remedy available to the public authority responsible for child 409.23 support enforcement. 409.24 (e) Fees assessed by state and federal tax agencies for 409.25 collection of overdue support owed to or on behalf of a person 409.26 not receiving public assistance must be imposed on the person 409.27 for whom these services are provided. The public authority upon 409.28 written notice to the obligee shall assess a fee of $25 to the 409.29 person not receiving public assistance for each successful 409.30 federal tax interception. The fee must be withheld prior to the 409.31 release of the funds received from each interception and 409.32 deposited in the general fund. 409.33 (f) Cost recovery fees collected under paragraphs (c) and 409.34 (d) shall be considered child support program income according 409.35 to Code of Federal Regulations, title 45, section 304.50, and 409.36 shall be deposited in the cost recovery fee account established 410.1 under paragraph (h). The commissioner of human services must 410.2 elect to recover costs based on either actual or standardized 410.3 costs. 410.4However,(g) The limitations of this subdivision on the 410.5 assessment of fees shall not apply to the extent inconsistent 410.6 with the requirements of federal law for receiving funds for the 410.7 programs under Title IV-A and Title IV-D of the Social Security 410.8 Act, United States Code, title 42, sections 601 to 613 and 410.9 United States Code, title 42, sections 651 to 662. 410.10 (h) The commissioner of human services is authorized to 410.11 establish a special revenue fund account to receive child 410.12 support cost recovery fees. A portion of the nonfederal share 410.13 of these fees may be retained for expenditures necessary to 410.14 administer the fee, and must be transferred to the child support 410.15 system special revenue account. The remaining nonfederal share 410.16 of the cost recovery fee must be retained by the commissioner 410.17 and dedicated to the child support general fund county 410.18 performance based grant account authorized under sections 410.19 256.979 and 256.9791. 410.20 [EFFECTIVE DATE.] This section is effective July 1, 2004, 410.21 except paragraph (d) is effective July 1, 2005. 410.22 Sec. 59. Minnesota Statutes 2002, section 518.6111, 410.23 subdivision 2, is amended to read: 410.24 Subd. 2. [APPLICATION.] This section applies to all 410.25 support orders issued by a court or an administrative tribunal 410.26 and orders for or notices of withholding issued by the public 410.27 authorityaccording to section 518.5513, subdivision 5,410.28paragraph (a), clause (5). 410.29 [EFFECTIVE DATE.] This section is effective July 1, 2004. 410.30 Sec. 60. Minnesota Statutes 2002, section 518.6111, 410.31 subdivision 3, is amended to read: 410.32 Subd. 3. [ORDER.] Every support order must address income 410.33 withholding. Whenever a support order is initially entered or 410.34 modified, the full amount of the support order must be 410.35withheldsubject to income withholding from the income of the 410.36 obligor. If the obligee or obligor applies for either full IV-D 411.1 services or for income withholding only services from the public 411.2 authority responsible for child support enforcement, the full 411.3 amount of the support order must be withheld from the income of 411.4 the obligor and forwarded to the public authority. Every order 411.5 for support or maintenance shall provide for a conspicuous 411.6 notice of the provisions of this section that complies with 411.7 section 518.68, subdivision 2. An order without this notice 411.8 remains subject to this section. This section applies 411.9 regardless of the source of income of the person obligated to 411.10 pay the support or maintenance. 411.11 A payor of funds shall implement income withholding 411.12 according to this section upon receipt of an order for or notice 411.13 of withholding. The notice of withholding shall be on a form 411.14 provided by the commissioner of human services. 411.15 [EFFECTIVE DATE.] This section is effective July 1, 2004. 411.16 Sec. 61. Minnesota Statutes 2002, section 518.6111, 411.17 subdivision 4, is amended to read: 411.18 Subd. 4. [COLLECTION SERVICES.] (a) The commissioner of 411.19 human services shall prepare and make available to the courts a 411.20 notice of services that explains child support and maintenance 411.21 collection services available through the public authority, 411.22 including income withholding, and the fees for such services. 411.23 Upon receiving a petition for dissolution of marriage or legal 411.24 separation, the court administrator shall promptly send the 411.25 notice of services to the petitioner and respondent at the 411.26 addresses stated in the petition. 411.27 (b) Either the obligee or obligor may at any time apply to 411.28 the public authority for either full IV-D services or for income 411.29 withholding only services. 411.30Upon receipt of a support order requiring income411.31withholding, a petitioner or respondent, who is not a recipient411.32of public assistance and does not receive child support services411.33from the public authority, shall apply to the public authority411.34for either full child support collection services or for income411.35withholding only services.411.36 (c) For those persons applying for income withholding only 412.1 services, a monthly service fee of $15 must be charged to the 412.2 obligor. This fee is in addition to the amount of the support 412.3 order and shall be withheld through income withholding. The 412.4 public authority shall explain the service options in this 412.5 section to the affected parties and encourage the application 412.6 for full child support collection services. 412.7 (d) If the obligee is not a current recipient of public 412.8 assistance as defined in section 256.741, the person who applied 412.9 for services may at any time choose to terminate either full 412.10 IV-D services or income withholding only services regardless of 412.11 whether income withholding is currently in place. The obligee 412.12 or obligor may reapply for either full IV-D services or income 412.13 withholding only services at any time. Unless the applicant is 412.14 a recipient of public assistance as defined in section 256.741, 412.15 a $25 application fee shall be charged at the time of each 412.16 application. 412.17 (e) When a person terminates IV-D services, if an arrearage 412.18 for public assistance as defined in section 256.741 exists, the 412.19 public authority may continue income withholding, as well as use 412.20 any other enforcement remedy for the collection of child 412.21 support, until all public assistance arrears are paid in full. 412.22 Income withholding shall be in an amount equal to 20 percent of 412.23 the support order in effect at the time the services terminated. 412.24 [EFFECTIVE DATE.] This section is effective July 1, 2004. 412.25 Sec. 62. Minnesota Statutes 2002, section 518.6111, 412.26 subdivision 16, is amended to read: 412.27 Subd. 16. [WAIVER.] (a) If the public authority is 412.28 providing child support and maintenance enforcement services and 412.29 child support or maintenance is not assigned under section 412.30 256.741, the court may waive the requirements of this section if 412.31the court finds there is no arrearage in child support and412.32maintenance as of the date of the hearing and: 412.33 (1) one party demonstrates and the courtfindsdetermines 412.34 there is good cause to waive the requirements of this section or 412.35 to terminate an order for or notice of income withholding 412.36 previously entered under this section. The court must make 413.1 written findings to include the reasons income withholding would 413.2 not be in the best interests of the child. In cases involving a 413.3 modification of support, the court must also make a finding that 413.4 support payments have been timely made; or 413.5 (2)all parties reach anthe obligee and obligor sign a 413.6 written agreementand the agreementproviding for an alternative 413.7 payment arrangement which isapprovedreviewed and entered in 413.8 the record by the courtafter a finding that the agreement is413.9likely to result in regular and timely payments. The court's413.10findings waiving the requirements of this paragraph shall413.11include a written explanation of the reasons why income413.12withholding would not be in the best interests of the child. 413.13In addition to the other requirements in this subdivision,413.14if the case involves a modification of support, the court shall413.15make a finding that support has been timely made.413.16 (b) If the public authority is not providing child support 413.17 and maintenance enforcement services and child support or 413.18 maintenance is not assigned under section 256.741, the court may 413.19 waive the requirements of this section if the parties sign a 413.20 written agreement. 413.21 (c) If the court waives income withholding, the obligee or 413.22 obligor may at any time request income withholding under 413.23 subdivision 7. 413.24 [EFFECTIVE DATE.] This section is effective July 1, 2004. 413.25 Sec. 63. [STATE-OPERATED SERVICES STUDY.] 413.26 The commissioner of human services shall study the services 413.27 provided to persons with developmental disabilities who have 413.28 complex care needs. The commissioner shall analyze: 413.29 (1) the needs of the target population; 413.30 (2) the methods of providing services to the target 413.31 population; 413.32 (3) the costs and cost-effectiveness of providing services 413.33 to the target population; 413.34 (4) factors that encourage and inhibit vendors, including 413.35 state-operated community services (SOCS), to provide services to 413.36 the target population; 414.1 (5) alternative populations that could be served by 414.2 state-operated residential facilities; and 414.3 (6) the population served by Minnesota extended treatment 414.4 options and the cost-effectiveness of these services. 414.5 The commissioner shall report on the results of the study 414.6 under this section to the chairs of the house and senate 414.7 committees with jurisdiction over state-operated services by 414.8 January 15, 2004. 414.9 Sec. 64. [STATE-OPERATED SERVICES REFINANCING STRATEGY.] 414.10 Subdivision 1. [REDESIGN OF MENTAL HEALTH SAFETY NET.] (a) 414.11 Pursuant to Minnesota Statutes, sections 246.0135, 251.011, and 414.12 251.013, the commissioner of human services must seek specific 414.13 legislative authorization to close any regional treatment center 414.14 or state-operated nursing home or any program at a regional 414.15 treatment center or state-operated nursing home. 414.16 (b) In developing and seeking legislative authorization for 414.17 any proposals to restructure state-operated services under this 414.18 subdivision, the commissioner must consider: 414.19 (1) the needs and preferences of the individuals served by 414.20 affected state-operated services programs and their families; 414.21 (2) the location of necessary support services, as 414.22 identified in the service or treatment plans of individuals 414.23 served by affected state-operated services programs; 414.24 (3) the appropriate grouping of individuals served by a 414.25 community-based state-operated services program; 414.26 (4) the availability of qualified staff to provide services 414.27 in community-based state-operated services programs; 414.28 (5) the need for state-operated services programs in 414.29 certain geographical regions in the state; and 414.30 (6) whether commuting distance to the program for staff and 414.31 families is reasonable. 414.32 (c) The commissioner's proposals to close a regional 414.33 treatment center, state-operated nursing home or program 414.34 operated by a regional treatment center or state-operated 414.35 nursing home under this subdivision must not result in a net 414.36 reduction in the total number of services in any catchment area 415.1 in the state and must ensure that any new community-based 415.2 programs are located in areas that are convenient to the 415.3 individuals receiving services and their families. 415.4 (d) Legislative authorization as required by Minnesota 415.5 Statutes, sections 246.0135, 251.011, and 251.013, shall mean 415.6 language specifically authorizing the commissioner's proposals, 415.7 the authorization to transfer land on which a regional treatment 415.8 center is located to a nonstate entity, or the authorization to 415.9 demolish buildings in which programs are or were housed. 415.10 Subd. 2. [REDEVELOPMENT PLAN.] (a) In closing any regional 415.11 treatment center or state-operated nursing home, the 415.12 commissioner shall develop or aid in the development of a 415.13 comprehensive redevelopment plan for any facilities or land 415.14 vacated as a result of the proposal in consultation with the 415.15 local governmental entity in the jurisdiction in which the 415.16 facility is located. If a local government entity cannot be 415.17 secured for facility redevelopment, then the commissioner shall 415.18 develop the plan in collaboration with affected communities. 415.19 The plan must include specific information on the redevelopment 415.20 of the affected facilities or land, specific information about 415.21 the implementation schedule for the plan, proposed legislation, 415.22 and letters of commitment regarding the reuse and redevelopment 415.23 of the facilities or land vacated as a result of the proposal. 415.24 (b) The commissioner shall not implement a redevelopment 415.25 plan under this subdivision until a local governmental entity in 415.26 which any regional treatment center is located that is affected 415.27 by the commissioner's redevelopment plan approves the plan. 415.28 Subd. 3. [STAFFING.] When closing or restructuring a 415.29 regional treatment center or state-operated nursing home or a 415.30 program at a regional treatment center or state-operated nursing 415.31 home, the commissioner shall comply with the provisions of the 415.32 applicable collective bargaining agreements or future negotiated 415.33 agreements, and the agreement authorized under Minnesota 415.34 Statutes, section 252.50, subdivision 11. 415.35 Subd. 4. [STATE-OPERATED SERVICES COSTS.] (a) Programs 415.36 that remain at a regional treatment center campus during and 416.1 after the restructuring of state-operated services shall not be 416.2 assessed any disproportional increase in fees, charges, or other 416.3 costs associated with operating and maintaining the campus. 416.4 Increased costs associated with inflation are permissible. 416.5 (b) There shall be no increase in the county share of the 416.6 cost of care provided in state-operated services without 416.7 legislative authority. 416.8 Subd. 5. [REQUEST FOR FEDERAL WAIVER.] By January 1, 2004, 416.9 the commissioner of human services shall apply to the federal 416.10 government for a waiver from Medicaid requirements to permit 416.11 medical assistance coverage for: 416.12 (1) mental health treatment services provided by an 416.13 existing program located at a regional treatment center with a 416.14 capacity of more than 15 beds; and 416.15 (2) mental health treatment services provided by a new 416.16 program at a facility with a capacity of more than 15 beds. 416.17 Sec. 65. [FEDERAL GRANTS TO MAINTAIN INDEPENDENCE AND 416.18 EMPLOYMENT.] 416.19 (a) The commissioner of human services shall seek federal 416.20 funding to participate in grant activities authorized under 416.21 Public Law 106-170, the Ticket to Work and Work Incentives 416.22 Improvement Act of 1999. The purpose of the federal grant funds 416.23 are to establish: 416.24 (1) a demonstration project to improve the availability of 416.25 health care services and benefits to workers with potentially 416.26 severe physical or mental impairments that are likely to lead to 416.27 disability without access to Medicaid services; and 416.28 (2) a comprehensive initiative to remove employment 416.29 barriers that includes linkages with non-Medicaid programs, 416.30 including those administered by the Social Security 416.31 Administration and the Department of Labor. 416.32 (b) The state's proposal for a demonstration project in 416.33 paragraph (a), clause (1), shall focus on assisting workers with: 416.34 (1) a serious mental illness as defined by the federal 416.35 Center for Mental Health Services; 416.36 (2) concurrent mental health and chemical dependency 417.1 conditions; and 417.2 (3) young adults up to the age of 24 who have a physical or 417.3 mental impairment that is severe and will potentially lead to a 417.4 determination of disability by the Social Security 417.5 Administration or state medical review team. 417.6 (c) The commissioner is authorized to take the actions 417.7 necessary to design and implement the demonstration project in 417.8 paragraph (a), clause (1), that include: 417.9 (1) establishing work-related requirements for 417.10 participation in the demonstration project; 417.11 (2) working with stakeholders to establish methods that 417.12 identify the population that will be served in the demonstration 417.13 project; 417.14 (3) seeking funding for activities to design, implement, 417.15 and evaluate the demonstration project; 417.16 (4) taking necessary administrative actions to implement 417.17 the demonstration project by July 1, 2004, or within 180 days of 417.18 receiving formal notice from the Centers for Medicare and 417.19 Medicaid Services that a grant has been awarded; 417.20 (5) establishing limits on income and resources; 417.21 (6) establishing a method to coordinate health care 417.22 benefits and payments with other coverage that is available to 417.23 the participants; 417.24 (7) establishing premiums based on guidelines that are 417.25 consistent with those found in Minnesota Statutes, section 417.26 256B.057, subdivision 9, for employed persons with disabilities; 417.27 (8) notifying local agencies of potentially eligible 417.28 individuals in accordance with Minnesota Statutes, section 417.29 256B.19, subdivision 2c; and 417.30 (9) limiting the caseload of qualifying individuals 417.31 participating in the demonstration project. 417.32 (d) The state's proposal for the comprehensive employment 417.33 initiative in paragraph (a), clause (2), shall focus on: 417.34 (1) infrastructure development that creates incentives for 417.35 greater work effort and participation by people with 417.36 disabilities or workers with severe physical or mental 418.1 impairments; 418.2 (2) consumer access to information and benefit assistance 418.3 that enables the person to maximize employment and career 418.4 advancement potential; 418.5 (3) improved consumer access to essential assistance and 418.6 support; 418.7 (4) enhanced linkages between state and federal agencies to 418.8 decrease the barriers to employment experienced by persons with 418.9 disabilities or workers with severe physical or mental 418.10 impairments; and 418.11 (5) research efforts to provide useful information to guide 418.12 future policy development on both the state and federal levels. 418.13 (e) Funds awarded by the federal government for the 418.14 purposes of this section are appropriated to the commissioner of 418.15 human services. 418.16 (f) The commissioner shall report to the chairs of the 418.17 senate and house of representatives finance divisions having 418.18 jurisdiction over health care issues on the federal approval of 418.19 the waiver under this section and the projected savings in the 418.20 November and February forecasts. 418.21 The commissioner must consider using the savings to 418.22 increase GAMC hospital rates to the July 1, 2003, levels as a 418.23 supplemental budget proposal in the 2004 legislative session. 418.24 Sec. 66. [CONVEYANCE OF SURPLUS STATE LAND; CASS COUNTY.] 418.25 (a) Notwithstanding Minnesota Statutes, chapter 94, or 418.26 other law, administrative rule, or commissioner's order to the 418.27 contrary, the commissioner of administration may convey to Cass 418.28 county or a regional jail authority for no consideration all the 418.29 buildings and land that are described in paragraph (c), except 418.30 the land described in paragraph (d). 418.31 (b) The conveyance shall be in a form approved by the 418.32 attorney general and subject to Minnesota Statutes, section 418.33 16A.695. The commissioner of administration shall have a 418.34 registered land surveyor prepare a legal description of the 418.35 property to be conveyed. The attorney general may make 418.36 necessary changes in the legal description to correct errors and 419.1 ensure accuracy. 419.2 (c) The land and buildings of the Ah-Gwah-Ching property 419.3 that may be conveyed to Cass county or a regional jail authority 419.4 are located in that part of the South Half, Section 35, Township 419.5 142 North, Range 31 West and that part of Government Lot 6, 419.6 Section 2, Township 141 North, Range 31 West, in Cass county, 419.7 depicted on the certificate of survey prepared by Landecker and 419.8 Associates, Inc. dated April 25, 2002. The land described in 419.9 paragraph (d) is excepted from the conveyance. 419.10 (d) That portion of the Ah-Gwah-Ching property to be 419.11 excepted from the conveyance to Cass county or a regional jail 419.12 authority is the land located between the shoreline and the top 419.13 of the bluff line and is approximately described as follows: 419.14 (1) all that part of the Southeast Quarter of Southwest 419.15 Quarter, Section 35, Township 142 North, Range 31 West, lying 419.16 southeasterly of a line that lies 450 feet southeasterly of and 419.17 parallel with Minnesota Highway No. 290; 419.18 (2) Government Lot 4, Section 35, Township 142 North, Range 419.19 31 West; 419.20 (3) that part of Government Lot 3, Section 35, Township 142 419.21 North, Range 31 West, lying southerly of Minnesota Highway No. 419.22 290 and westerly of Minnesota Highway No. 371; and 419.23 (4) that part of Government Lot 6, Section 2, Township 141 419.24 North, Range 31 West, lying southeasterly of the 1,410 foot 419.25 contour. 419.26 The commissioner of administration shall determine the exact 419.27 legal description upon further site analysis and the preparation 419.28 of the surveyor's legal description described in paragraph (b). 419.29 (e) Notwithstanding anything herein to the contrary, a 419.30 conveyance under this section to Cass county or a regional jail 419.31 authority may include a conveyance by a bill of sale of the 419.32 water treatment facilities located within the land described in 419.33 paragraph (d) and a nonexclusive appurtenant easement for such 419.34 facilities over the land upon which such facilities are located, 419.35 including ingress and egress as determined by the commissioner. 419.36 The easement shall be in a form approved by the attorney general. 420.1 (f) At the option of the state, Cass county or the regional 420.2 jail authority must, for a period of at least two years, allow 420.3 the state to lease the space necessary to operate its programs 420.4 for the cost of utilities for the leased space. During the term 420.5 of the lease, the state shall be responsible for any and all 420.6 maintenance and repairs the state determines are necessary for 420.7 its use of the leased space. 420.8 Sec. 67. [REVISOR'S INSTRUCTION.] 420.9 For sections in Minnesota Statutes and Minnesota Rules 420.10 affected by the repealed sections in this article, the revisor 420.11 shall delete internal cross-references where appropriate and 420.12 make changes necessary to correct the punctuation, grammar, or 420.13 structure of the remaining text and preserve its meaning. 420.14 Sec. 68. [REPEALER.] 420.15 (a) Minnesota Statutes 2002, sections 246.017, subdivision 420.16 2; 246.022; 246.06; 246.07; 246.08; 246.11; 246.19; 246.42; 420.17 252.025, subdivisions 1, 2, 4, 5, and 6; 252.032; 252.10; 420.18 253.015, subdivisions 2 and 3; 253.10; 253.19; 253.201; 253.202; 420.19 253.25; 253.27; 256.05; 256.06; 256.08; 256.09; 256.10; and 420.20 268A.08, are repealed. 420.21 (b) Minnesota Rules, parts 9545.2000; 9545.2010; 9545.2020; 420.22 9545.2030; and 9545.2040, are repealed. 420.23 ARTICLE 7 420.24 HEALTH MISCELLANEOUS 420.25 Section 1. Minnesota Statutes 2002, section 41A.09, 420.26 subdivision 2a, is amended to read: 420.27 Subd. 2a. [DEFINITIONS.] For the purposes of this section, 420.28 the terms defined in this subdivision have the meanings given 420.29 them. 420.30 (a) "Ethanol" means fermentation ethyl alcohol derived from 420.31 agricultural products, including potatoes, cereal, grains, 420.32 cheese whey, and sugar beets; forest products; or other 420.33 renewable resources, including residue and waste generated from 420.34 the production, processing, and marketing of agricultural 420.35 products, forest products, and other renewable resources, that: 420.36 (1) meets all of the specifications in ASTM specificationD421.14806-88D4806-01; and 421.2 (2) is denatured as specified in Code of Federal 421.3 Regulations, title 27, parts 20 and 21. 421.4 (b) "Wet alcohol" means agriculturally derived fermentation 421.5 ethyl alcohol having a purity of at least 50 percent but less 421.6 than 99 percent. 421.7 (c) "Anhydrous alcohol" means fermentation ethyl alcohol 421.8 derived from agricultural products as described in paragraph 421.9 (a), but that does not meet ASTM specifications or is not 421.10 denatured and is shipped in bond for further processing. 421.11 (d) "Ethanol plant" means a plant at which ethanol, 421.12 anhydrous alcohol, or wet alcohol is produced. 421.13 Sec. 2. Minnesota Statutes 2002, section 62A.31, 421.14 subdivision 1f, is amended to read: 421.15 Subd. 1f. [SUSPENSION BASED ON ENTITLEMENT TO MEDICAL 421.16 ASSISTANCE.] (a) The policy or certificate must provide that 421.17 benefits and premiums under the policy or certificate shall be 421.18 suspended for any period that may be provided by federal 421.19 regulation at the request of the policyholder or certificate 421.20 holder for the period, not to exceed 24 months, in which the 421.21 policyholder or certificate holder has applied for and is 421.22 determined to be entitled to medical assistance under title XIX 421.23 of the Social Security Act, but only if the policyholder or 421.24 certificate holder notifies the issuer of the policy or 421.25 certificate within 90 days after the date the individual becomes 421.26 entitled to this assistance. 421.27 (b) If suspension occurs and if the policyholder or 421.28 certificate holder loses entitlement to this medical assistance, 421.29 the policy or certificate shall be automatically reinstated, 421.30 effective as of the date of termination of this entitlement, if 421.31 the policyholder or certificate holder provides notice of loss 421.32 of the entitlement within 90 days after the date of the loss and 421.33 pays the premium attributable to the period, effective as of the 421.34 date of termination of entitlement. 421.35 (c) The policy must provide that upon reinstatement (1) 421.36 there is no additional waiting period with respect to treatment 422.1 of preexisting conditions, (2) coverage is provided which is 422.2 substantially equivalent to coverage in effect before the date 422.3 of the suspension, and (3) premiums are classified on terms that 422.4 are at least as favorable to the policyholder or certificate 422.5 holder as the premium classification terms that would have 422.6 applied to the policyholder or certificate holder had coverage 422.7 not been suspended. 422.8 Sec. 3. Minnesota Statutes 2002, section 62A.31, 422.9 subdivision 1u, is amended to read: 422.10 Subd. 1u. [GUARANTEED ISSUE FOR ELIGIBLE PERSONS.] (a)(1) 422.11 Eligible persons are those individuals described in paragraph 422.12 (b) whoapply to enroll under the Medicare supplement policy not422.13later than 63 days after the date of the termination of422.14enrollment described in paragraph (b),seek to enroll under the 422.15 policy during the period specified in paragraph (c), and who 422.16 submit evidence of the date of termination or disenrollment with 422.17 the application for a Medicare supplement policy. 422.18 (2) With respect to eligible persons, an issuer shall not: 422.19 deny or condition the issuance or effectiveness of a Medicare 422.20 supplement policy described in paragraph (c) that is offered and 422.21 is available for issuance to new enrollees by the issuer; 422.22 discriminate in the pricing of such a Medicare supplement policy 422.23 because of health status, claims experience, receipt of health 422.24 care, medical condition, or age; or impose an exclusion of 422.25 benefits based upon a preexisting condition under such a 422.26 Medicare supplement policy. 422.27 (b) An eligible person is an individual described in any of 422.28 the following: 422.29 (1) the individual is enrolled under an employee welfare 422.30 benefit plan that provides health benefits that supplement the 422.31 benefits under Medicare; and the plan terminates, or the plan 422.32 ceases to provide all such supplemental health benefits to the 422.33 individual; 422.34 (2) the individual is enrolled with a Medicare+Choice 422.35 organization under a Medicare+Choice plan under Medicare part C, 422.36 and any of the following circumstances apply, or the individual 423.1 is 65 years of age or older and is enrolled with a Program of 423.2 All-Inclusive Care for the Elderly (PACE) provider under section 423.3 1894 of the federal Social Security Act, and there are 423.4 circumstances similar to those described in this clause that 423.5 would permit discontinuance of the individual's enrollment with 423.6 the provider if the individual were enrolled in a 423.7 Medicare+Choice plan: 423.8 (i) the organization's or plan's certification under 423.9 Medicare part C has been terminated or the organization has 423.10 terminated or otherwise discontinued providing the plan in the 423.11 area in which the individual resides; 423.12 (ii) the individual is no longer eligible to elect the plan 423.13 because of a change in the individual's place of residence or 423.14 other change in circumstances specified by the secretary, but 423.15 not including termination of the individual's enrollment on the 423.16 basis described in section 1851(g)(3)(B) of the federal Social 423.17 Security Act, United States Code, title 42, section 423.18 1395w-21(g)(3)(b) (where the individual has not paid premiums on 423.19 a timely basis or has engaged in disruptive behavior as 423.20 specified in standards under section 1856 of the federal Social 423.21 Security Act, United States Code, title 42, section 1395w-26), 423.22 or the plan is terminated for all individuals within a residence 423.23 area; 423.24 (iii) the individual demonstrates, in accordance with 423.25 guidelines established by the Secretary, that: 423.26 (A) the organization offering the plan substantially 423.27 violated a material provision of the organization's contract in 423.28 relation to the individual, including the failure to provide an 423.29 enrollee on a timely basis medically necessary care for which 423.30 benefits are available under the plan or the failure to provide 423.31 such covered care in accordance with applicable quality 423.32 standards; or 423.33 (B) the organization, or agent or other entity acting on 423.34 the organization's behalf, materially misrepresented the plan's 423.35 provisions in marketing the plan to the individual; or 423.36 (iv) the individual meets such other exceptional conditions 424.1 as the secretary may provide; 424.2 (3)(i) the individual is enrolled with: 424.3 (A) an eligible organization under a contract under section 424.4 1876 of the federal Social Security Act, United States Code, 424.5 title 42, section 1395mm (Medicarerisk orcost); 424.6 (B) a similar organization operating under demonstration 424.7 project authority, effective for periods before April 1, 1999; 424.8 (C) an organization under an agreement under section 424.9 1833(a)(1)(A) of the federal Social Security Act, United States 424.10 Code, title 42, section 1395l(a)(1)(A) (health care prepayment 424.11 plan); or 424.12 (D) an organization under a Medicare Select policy under 424.13 section 62A.318 or the similar law of another state; and 424.14 (ii) the enrollment ceases under the same circumstances 424.15 that would permit discontinuance of an individual's election of 424.16 coverage under clause (2); 424.17 (4) the individual is enrolled under a Medicare supplement 424.18 policy, and the enrollment ceases because: 424.19 (i)(A) of the insolvency of the issuer or bankruptcy of the 424.20 nonissuer organization; or 424.21 (B) of other involuntary termination of coverage or 424.22 enrollment under the policy; 424.23 (ii) the issuer of the policy substantially violated a 424.24 material provision of the policy; or 424.25 (iii) the issuer, or an agent or other entity acting on the 424.26 issuer's behalf, materially misrepresented the policy's 424.27 provisions in marketing the policy to the individual; 424.28 (5)(i) the individual was enrolled under a Medicare 424.29 supplement policy and terminates that enrollment and 424.30 subsequently enrolls, for the first time, with any 424.31 Medicare+Choice organization under a Medicare+Choice plan under 424.32 Medicare part C; any eligible organization under a contract 424.33 under section 1876 of the federal Social Security Act, United 424.34 States Code, title 42, section 1395mm (Medicarerisk orcost); 424.35 any similar organization operating under demonstration project 424.36 authority;an organization under an agreement under section425.11833(a)(1)(A) of the federal Social Security Act, United States425.2Code, title 42, section 1395l(a)(1)(A) (health care prepayment425.3plan);any PACE provider under section 1894 of the federal 425.4 Social Security Act, or a Medicare Select policy under section 425.5 62A.318 or the similar law of another state; and 425.6 (ii) the subsequent enrollment underparagraph (a)item (i) 425.7 is terminated by the enrollee during any period within the first 425.8 12 months ofsuchthe subsequent enrollment during which the 425.9 enrollee is permitted to terminate the subsequent enrollment 425.10 under section 1851(e) of the federal Social Security Act; or 425.11 (6) the individual, upon first enrolling for benefits under 425.12 Medicare part B, enrolls in a Medicare+Choice plan under 425.13 Medicare part C, or with a PACE provider under section 1894 of 425.14 the federal Social Security Act, and disenrolls from the plan by 425.15 not later than 12 months after the effective date of enrollment. 425.16 (c)(1) In the case of an individual described in paragraph 425.17 (b), clause (1), the guaranteed issue period begins on the date 425.18 the individual receives a notice of termination or cessation of 425.19 all supplemental health benefits or, if a notice is not 425.20 received, notice that a claim has been denied because of a 425.21 termination or cessation, and ends 63 days after the date of the 425.22 applicable notice. 425.23 (2) In the case of an individual described in paragraph 425.24 (b), clause (2), (3), (5), or (6), whose enrollment is 425.25 terminated involuntarily, the guaranteed issue period begins on 425.26 the date that the individual receives a notice of termination 425.27 and ends 63 days after the date the applicable coverage is 425.28 terminated. 425.29 (3) In the case of an individual described in paragraph 425.30 (b), clause (4), item (i), the guaranteed issue period begins on 425.31 the earlier of: (i) the date that the individual receives a 425.32 notice of termination, a notice of the issuer's bankruptcy or 425.33 insolvency, or other such similar notice if any; and (ii) the 425.34 date that the applicable coverage is terminated, and ends on the 425.35 date that is 63 days after the date the coverage is terminated. 425.36 (4) In the case of an individual described in paragraph 426.1 (b), clause (2), (4), (5), or (6), who disenrolls voluntarily, 426.2 the guaranteed issue period begins on the date that is 60 days 426.3 before the effective date of the disenrollment and ends on the 426.4 date that is 63 days after the effective date. 426.5 (5) In the case of an individual described in paragraph (b) 426.6 but not described in this paragraph, the guaranteed issue period 426.7 begins on the effective date of disenrollment and ends on the 426.8 date that is 63 days after the effective date. 426.9 (d)(1) In the case of an individual described in paragraph 426.10 (b), clause (5), or deemed to be so described, pursuant to this 426.11 paragraph, whose enrollment with an organization or provider 426.12 described in paragraph (b), clause (5), item (i), is 426.13 involuntarily terminated within the first 12 months of 426.14 enrollment, and who, without an intervening enrollment, enrolls 426.15 with another such organization or provider, the subsequent 426.16 enrollment is deemed to be an initial enrollment described in 426.17 paragraph (b), clause (5). 426.18 (2) In the case of an individual described in paragraph 426.19 (b), clause (6), or deemed to be so described, pursuant to this 426.20 paragraph, whose enrollment with a plan or in a program 426.21 described in paragraph (b), clause (6), is involuntarily 426.22 terminated within the first 12 months of enrollment, and who, 426.23 without an intervening enrollment, enrolls in another such plan 426.24 or program, the subsequent enrollment is deemed to be an initial 426.25 enrollment described in paragraph (b), clause (6). 426.26 (3) For purposes of paragraph (b), clauses (5) and (6), no 426.27 enrollment of an individual with an organization or provider 426.28 described in paragraph (b), clause (5), item (i), or with a plan 426.29 or in a program described in paragraph (b), clause (6), may be 426.30 deemed to be an initial enrollment under this paragraph after 426.31 the two-year period beginning on the date on which the 426.32 individual first enrolled with the organization, provider, plan, 426.33 or program. 426.34 (e) The Medicare supplement policy to which eligible 426.35 persons are entitled under: 426.36 (1) paragraph (b), clauses (1) to (4), is any Medicare 427.1 supplement policy that has a benefit package consisting of the 427.2 basic Medicare supplement plan described in section 62A.316, 427.3 paragraph (a), plus any combination of the three optional riders 427.4 described in section 62A.316, paragraph (b), clauses (1) to (3), 427.5 offered by any issuer; 427.6 (2) paragraph (b), clause (5), is the same Medicare 427.7 supplement policy in which the individual was most recently 427.8 previously enrolled, if available from the same issuer, or, if 427.9 not so available, any policy described in clause (1) offered by 427.10 any issuer; 427.11 (3) paragraph (b), clause (6), shall include any Medicare 427.12 supplement policy offered by any issuer. 427.13(d)(f)(1) At the time of an event described in paragraph 427.14 (b), because of which an individual loses coverage or benefits 427.15 due to the termination of a contract or agreement, policy, or 427.16 plan, the organization that terminates the contract or 427.17 agreement, the issuer terminating the policy, or the 427.18 administrator of the plan being terminated, respectively, shall 427.19 notify the individual of the individual's rights under this 427.20 subdivision, and of the obligations of issuers of Medicare 427.21 supplement policies under paragraph (a). The notice must be 427.22 communicated contemporaneously with the notification of 427.23 termination. 427.24 (2) At the time of an event described in paragraph (b), 427.25 because of which an individual ceases enrollment under a 427.26 contract or agreement, policy, or plan, the organization that 427.27 offers the contract or agreement, regardless of the basis for 427.28 the cessation of enrollment, the issuer offering the policy, or 427.29 the administrator of the plan, respectively, shall notify the 427.30 individual of the individual's rights under this subdivision, 427.31 and of the obligations of issuers of Medicare supplement 427.32 policies under paragraph (a). The notice must be communicated 427.33 within ten working days of the issuer receiving notification of 427.34 disenrollment. 427.35(e)(g) Reference in this subdivision to a situation in 427.36 which, or to a basis upon which, an individual's coverage has 428.1 been terminated does not provide authority under the laws of 428.2 this state for the termination in that situation or upon that 428.3 basis. 428.4(f)(h) An individual's rights under this subdivision are 428.5 in addition to, and do not modify or limit, the individual's 428.6 rights under subdivision 1h. 428.7 Sec. 4. Minnesota Statutes 2002, section 62A.31, is 428.8 amended by adding a subdivision to read: 428.9 Subd. 7. [MEDICARE PRESCRIPTION DRUG BENEFIT.] If Congress 428.10 enacts legislation creating a prescription drug benefit in the 428.11 Medicare program, nothing in this section or any other section 428.12 shall prohibit an issuer of a Medicare supplement policy from 428.13 offering this prescription drug benefit consistent with the 428.14 applicable federal law or regulations. If an issuer offers the 428.15 federal benefit, such an offer shall be deemed to meet the 428.16 issuer's mandatory offer obligations under this section and may, 428.17 at the discretion of the issuer, constitute replacement coverage 428.18 as defined in subdivision 1i for any existing policy containing 428.19 a prescription drug benefit. 428.20 Sec. 5. Minnesota Statutes 2002, section 62A.315, is 428.21 amended to read: 428.22 62A.315 [EXTENDED BASIC MEDICARE SUPPLEMENT PLAN; 428.23 COVERAGE.] 428.24 The extended basic Medicare supplement plan must have a 428.25 level of coverage so that it will be certified as a qualified 428.26 plan pursuant to section 62E.07, and will provide: 428.27 (1) coverage for all of the Medicare part A inpatient 428.28 hospital deductible and coinsurance amounts, and 100 percent of 428.29 all Medicare part A eligible expenses for hospitalization not 428.30 covered by Medicare; 428.31 (2) coverage for the daily copayment amount of Medicare 428.32 part A eligible expenses for the calendar year incurred for 428.33 skilled nursing facility care; 428.34 (3) coverage for thecopaymentcoinsurance amount or in the 428.35 case of hospital outpatient department services paid under a 428.36 prospective payment system, the co-payment amount, of Medicare 429.1 eligible expenses under Medicare part B regardless of hospital 429.2 confinement, and the Medicare part B deductible amount; 429.3 (4) 80 percent of the usual and customary hospital and 429.4 medical expenses and supplies described in section 62E.06, 429.5 subdivision 1, not to exceed any charge limitation established 429.6 by the Medicare program or state law, the usual and customary 429.7 hospital and medical expenses and supplies, described in section 429.8 62E.06, subdivision 1, while in a foreign country, and 429.9 prescription drug expenses, not covered by Medicare; 429.10 (5) coverage for the reasonable cost of the first three 429.11 pints of blood, or equivalent quantities of packed red blood 429.12 cells as defined under federal regulations under Medicare parts 429.13 A and B, unless replaced in accordance with federal regulations; 429.14 (6) 100 percent of the cost of immunizations and routine 429.15 screening procedures for cancer, including mammograms and pap 429.16 smears; 429.17 (7) preventive medical care benefit: coverage for the 429.18 following preventive health services: 429.19 (i) an annual clinical preventive medical history and 429.20 physical examination that may include tests and services from 429.21 clause (ii) and patient education to address preventive health 429.22 care measures; 429.23 (ii) any one or a combination of the following preventive 429.24 screening tests or preventive services, the frequency of which 429.25 is considered medically appropriate: 429.26 (A) fecal occult blood test and/or digital rectal 429.27 examination; 429.28 (B) dipstick urinalysis for hematuria, bacteriuria, and 429.29 proteinuria; 429.30 (C) pure tone (air only) hearing screening test 429.31 administered or ordered by a physician; 429.32 (D) serum cholesterol screening every five years; 429.33 (E) thyroid function test; 429.34 (F) diabetes screening; 429.35 (iii) any other tests or preventive measures determined 429.36 appropriate by the attending physician. 430.1 Reimbursement shall be for the actual charges up to 100 430.2 percent of the Medicare-approved amount for each service as if 430.3 Medicare were to cover the service as identified in American 430.4 Medical Association current procedural terminology (AMA CPT) 430.5 codes to a maximum of $120 annually under this benefit. This 430.6 benefit shall not include payment for any procedure covered by 430.7 Medicare; 430.8 (8) at-home recovery benefit: coverage for services to 430.9 provide short-term at-home assistance with activities of daily 430.10 living for those recovering from an illness, injury, or surgery: 430.11 (i) for purposes of this benefit, the following definitions 430.12 shall apply: 430.13 (A) "activities of daily living" include, but are not 430.14 limited to, bathing, dressing, personal hygiene, transferring, 430.15 eating, ambulating, assistance with drugs that are normally 430.16 self-administered, and changing bandages or other dressings; 430.17 (B) "care provider" means a duly qualified or licensed home 430.18 health aide/homemaker, personal care aide, or nurse provided 430.19 through a licensed home health care agency or referred by a 430.20 licensed referral agency or licensed nurses registry; 430.21 (C) "home" means a place used by the insured as a place of 430.22 residence, provided that the place would qualify as a residence 430.23 for home health care services covered by Medicare. A hospital 430.24 or skilled nursing facility shall not be considered the 430.25 insured's place of residence; 430.26 (D) "at-home recovery visit" means the period of a visit 430.27 required to provide at-home recovery care, without limit on the 430.28 duration of the visit, except each consecutive four hours in a 430.29 24-hour period of services provided by a care provider is one 430.30 visit; 430.31 (ii) coverage requirements and limitations: 430.32 (A) at-home recovery services provided must be primarily 430.33 services that assist in activities of daily living; 430.34 (B) the insured's attending physician must certify that the 430.35 specific type and frequency of at-home recovery services are 430.36 necessary because of a condition for which a home care plan of 431.1 treatment was approved by Medicare; 431.2 (C) coverage is limited to: 431.3 (I) no more than the number and type of at-home recovery 431.4 visits certified as medically necessary by the insured's 431.5 attending physician. The total number of at-home recovery 431.6 visits shall not exceed the number of Medicare-approved home 431.7 health care visits under a Medicare-approved home care plan of 431.8 treatment; 431.9 (II) the actual charges for each visit up to a maximum 431.10 reimbursement of $40 per visit; 431.11 (III) $1,600 per calendar year; 431.12 (IV) seven visits in any one week; 431.13 (V) care furnished on a visiting basis in the insured's 431.14 home; 431.15 (VI) services provided by a care provider as defined in 431.16 this section; 431.17 (VII) at-home recovery visits while the insured is covered 431.18 under the policy or certificate and not otherwise excluded; 431.19 (VIII) at-home recovery visits received during the period 431.20 the insured is receiving Medicare-approved home care services or 431.21 no more than eight weeks after the service date of the last 431.22 Medicare-approved home health care visit; 431.23 (iii) coverage is excluded for: 431.24 (A) home care visits paid for by Medicare or other 431.25 government programs; and 431.26 (B) care provided by family members, unpaid volunteers, or 431.27 providers who are not care providers. 431.28 Sec. 6. Minnesota Statutes 2002, section 62A.316, is 431.29 amended to read: 431.30 62A.316 [BASIC MEDICARE SUPPLEMENT PLAN; COVERAGE.] 431.31 (a) The basic Medicare supplement plan must have a level of 431.32 coverage that will provide: 431.33 (1) coverage for all of the Medicare part A inpatient 431.34 hospital coinsurance amounts, and 100 percent of all Medicare 431.35 part A eligible expenses for hospitalization not covered by 431.36 Medicare, after satisfying the Medicare part A deductible; 432.1 (2) coverage for the daily copayment amount of Medicare 432.2 part A eligible expenses for the calendar year incurred for 432.3 skilled nursing facility care; 432.4 (3) coverage for thecopaymentcoinsurance amount, or in 432.5 the case of outpatient department services paid under a 432.6 prospective payment system, the co-payment amount, of Medicare 432.7 eligible expenses under Medicare part B regardless of hospital 432.8 confinement, subject to the Medicare part B deductible amount; 432.9 (4) 80 percent of the hospital and medical expenses and 432.10 supplies incurred during travel outside the United States as a 432.11 result of a medical emergency; 432.12 (5) coverage for the reasonable cost of the first three 432.13 pints of blood, or equivalent quantities of packed red blood 432.14 cells as defined under federal regulations under Medicare parts 432.15 A and B, unless replaced in accordance with federal regulations; 432.16 (6) 100 percent of the cost of immunizations and routine 432.17 screening procedures for cancer screening including mammograms 432.18 and pap smears; and 432.19 (7) 80 percent of coverage for all physician prescribed 432.20 medically appropriate and necessary equipment and supplies used 432.21 in the management and treatment of diabetes. Coverage must 432.22 include persons with gestational, type I, or type II diabetes. 432.23 (b) Only the following optional benefit riders may be added 432.24 to this plan: 432.25 (1) coverage for all of the Medicare part A inpatient 432.26 hospital deductible amount; 432.27 (2) a minimum of 80 percent of eligible medical expenses 432.28 and supplies not covered by Medicare part B, not to exceed any 432.29 charge limitation established by the Medicare program or state 432.30 law; 432.31 (3) coverage for all of the Medicare part B annual 432.32 deductible; 432.33 (4) coverage for at least 50 percent, or the equivalent of 432.34 50 percent, of usual and customary prescription drug expenses; 432.35 (5) coverage for the following preventive health services: 432.36 (i) an annual clinical preventive medical history and 433.1 physical examination that may include tests and services from 433.2 clause (ii) and patient education to address preventive health 433.3 care measures; 433.4 (ii) any one or a combination of the following preventive 433.5 screening tests or preventive services, the frequency of which 433.6 is considered medically appropriate: 433.7 (A) fecal occult blood test and/or digital rectal 433.8 examination; 433.9 (B) dipstick urinalysis for hematuria, bacteriuria, and 433.10 proteinuria; 433.11 (C) pure tone (air only) hearing screening test, 433.12 administered or ordered by a physician; 433.13 (D) serum cholesterol screening every five years; 433.14 (E) thyroid function test; 433.15 (F) diabetes screening; 433.16 (iii) any other tests or preventive measures determined 433.17 appropriate by the attending physician. 433.18 Reimbursement shall be for the actual charges up to 100 433.19 percent of the Medicare-approved amount for each service, as if 433.20 Medicare were to cover the service as identified in American 433.21 Medical Association current procedural terminology (AMA CPT) 433.22 codes, to a maximum of $120 annually under this benefit. This 433.23 benefit shall not include payment for a procedure covered by 433.24 Medicare; 433.25 (6) coverage for services to provide short-term at-home 433.26 assistance with activities of daily living for those recovering 433.27 from an illness, injury, or surgery: 433.28 (i) For purposes of this benefit, the following definitions 433.29 apply: 433.30 (A) "activities of daily living" include, but are not 433.31 limited to, bathing, dressing, personal hygiene, transferring, 433.32 eating, ambulating, assistance with drugs that are normally 433.33 self-administered, and changing bandages or other dressings; 433.34 (B) "care provider" means a duly qualified or licensed home 433.35 health aide/homemaker, personal care aid, or nurse provided 433.36 through a licensed home health care agency or referred by a 434.1 licensed referral agency or licensed nurses registry; 434.2 (C) "home" means a place used by the insured as a place of 434.3 residence, provided that the place would qualify as a residence 434.4 for home health care services covered by Medicare. A hospital 434.5 or skilled nursing facility shall not be considered the 434.6 insured's place of residence; 434.7 (D) "at-home recovery visit" means the period of a visit 434.8 required to provide at-home recovery care, without limit on the 434.9 duration of the visit, except each consecutive four hours in a 434.10 24-hour period of services provided by a care provider is one 434.11 visit; 434.12 (ii) Coverage requirements and limitations: 434.13 (A) at-home recovery services provided must be primarily 434.14 services that assist in activities of daily living; 434.15 (B) the insured's attending physician must certify that the 434.16 specific type and frequency of at-home recovery services are 434.17 necessary because of a condition for which a home care plan of 434.18 treatment was approved by Medicare; 434.19 (C) coverage is limited to: 434.20 (I) no more than the number and type of at-home recovery 434.21 visits certified as necessary by the insured's attending 434.22 physician. The total number of at-home recovery visits shall 434.23 not exceed the number of Medicare-approved home care visits 434.24 under a Medicare-approved home care plan of treatment; 434.25 (II) the actual charges for each visit up to a maximum 434.26 reimbursement of $40 per visit; 434.27 (III) $1,600 per calendar year; 434.28 (IV) seven visits in any one week; 434.29 (V) care furnished on a visiting basis in the insured's 434.30 home; 434.31 (VI) services provided by a care provider as defined in 434.32 this section; 434.33 (VII) at-home recovery visits while the insured is covered 434.34 under the policy or certificate and not otherwise excluded; 434.35 (VIII) at-home recovery visits received during the period 434.36 the insured is receiving Medicare-approved home care services or 435.1 no more than eight weeks after the service date of the last 435.2 Medicare-approved home health care visit; 435.3 (iii) Coverage is excluded for: 435.4 (A) home care visits paid for by Medicare or other 435.5 government programs; and 435.6 (B) care provided by family members, unpaid volunteers, or 435.7 providers who are not care providers; 435.8 (7) coverage for at least 50 percent, or the equivalent of 435.9 50 percent, of usual and customary prescription drug expenses to 435.10 a maximum of $1,200 paid by the issuer annually under this 435.11 benefit. An issuer of Medicare supplement insurance policies 435.12 that elects to offer this benefit rider shall also make 435.13 available coverage that contains the rider specified in clause 435.14 (4). 435.15 Sec. 7. Minnesota Statutes 2002, section 62A.65, 435.16 subdivision 7, is amended to read: 435.17 Subd. 7. [SHORT-TERM COVERAGE.] (a) For purposes of this 435.18 section, "short-term coverage" means an individual health plan 435.19 that: 435.20 (1) is issued to provide coverage for a period of 185 days 435.21 or less, except that the health plan may permit coverage to 435.22 continue until the end of a period of hospitalization for a 435.23 condition for which the covered person was hospitalized on the 435.24 day that coverage would otherwise have ended; 435.25 (2) is nonrenewable, provided that the health carrier may 435.26 provide coverage for one or more subsequent periods that satisfy 435.27 clause (1), if the total of the periods of coverage do not 435.28 exceed a total of185365 days out of any365-day555-day 435.29 period, plus any additional days covered as a result of 435.30 hospitalization on the day that a period of coverage would 435.31 otherwise have ended; 435.32 (3) does not cover any preexisting conditions, including 435.33 ones that originated during a previous identical policy or 435.34 contract with the same health carrier where coverage was 435.35 continuous between the previous and the current policy or 435.36 contract; and 436.1 (4) is available with an immediate effective date without 436.2 underwriting upon receipt of a completed application indicating 436.3 eligibility under the health carrier's eligibility requirements, 436.4 provided that coverage that includes optional benefits may be 436.5 offered on a basis that does not meet this requirement. 436.6 (b) Short-term coverage is not subject to subdivisions 2 436.7 and 5. Short-term coverage may exclude as a preexisting 436.8 condition any injury, illness, or condition for which the 436.9 covered person had medical treatment, symptoms, or any 436.10 manifestations before the effective date of the coverage, but 436.11 dependent children born or placed for adoption during the policy 436.12 period must not be subject to this provision. 436.13 (c) Notwithstanding subdivision 3, and section 62A.021, a 436.14 health carrier may combine short-term coverage with its most 436.15 commonly sold individual qualified plan, as defined in section 436.16 62E.02, other than short-term coverage, for purposes of 436.17 complying with the loss ratio requirement. 436.18 (d) The185365 day coverage limitation provided in 436.19 paragraph (a) applies to the total number of days of short-term 436.20 coverage that covers a person, regardless of the number of 436.21 policies, contracts, or health carriers that provide the 436.22 coverage. A written application for short-term coverage must 436.23 ask the applicant whether the applicant has been covered by 436.24 short-term coverage by any health carrier within the365555 436.25 days immediately preceding the effective date of the coverage 436.26 being applied for. Short-term coverage issued in violation of 436.27 the185-day365-day limitation is valid until the end of its 436.28 term and does not lose its status as short-term coverage, in 436.29 spite of the violation. A health carrier that knowingly issues 436.30 short-term coverage in violation of the185-day365-day 436.31 limitation is subject to the administrative penalties otherwise 436.32 available to the commissioner of commerce or the commissioner of 436.33 health, as appropriate. 436.34 (e) Time spent under short-term coverage counts as time 436.35 spent under a preexisting condition limitation for purposes of 436.36 group or individual health plans, other than short-term 437.1 coverage, subsequently issued to that person, or to cover that 437.2 person, by any health carrier, if the person maintains 437.3 continuous coverage as defined in section 62L.02. Short-term 437.4 coverage is a health plan and is qualifying coverage as defined 437.5 in section 62L.02. Notwithstanding any other law to the 437.6 contrary, a health carrier is not required under any 437.7 circumstances to provide a person covered by short-term coverage 437.8 the right to obtain coverage on a guaranteed issue basis under 437.9 another health plan offered by the health carrier, as a result 437.10 of the person's enrollment in short-term coverage. 437.11 [EFFECTIVE DATE.] This section is effective the day 437.12 following final enactment and applies to policies issued on or 437.13 after that date. 437.14 Sec. 8. Minnesota Statutes 2002, section 62D.095, 437.15 subdivision 2, is amended to read: 437.16 Subd. 2. [CO-PAYMENTS.] (a) A health maintenance contract 437.17 may impose a co-payment as authorized under Minnesota Rules, 437.18 part 4685.0801, or under this section. 437.19 (b) A health maintenance organization may impose a flat fee 437.20 co-payment on outpatient office visits not to exceed 40 percent 437.21 of the median provider's charges for similar services or goods 437.22 received by the enrollees as calculated under Minnesota Rules, 437.23 part 4685.0801. A health maintenance organization may impose a 437.24 flat fee co-payment on outpatient prescription drugs not to 437.25 exceed 50 percent of the median provider's charges for similar 437.26 services or goods received by the enrollees as calculated under 437.27 Minnesota Rules, part 4685.0801. 437.28 (c) If a health maintenance contract is permitted to impose 437.29 a co-payment for preexisting health status under sections 62D.01 437.30 to 62D.30, these provisions may vary with respect to length of 437.31 enrollment in the health plan. 437.32 Sec. 9. Minnesota Statutes 2002, section 62D.095, is 437.33 amended by adding a subdivision to read: 437.34 Subd. 6. [PUBLIC PROGRAMS.] This section does not apply to 437.35 the prepaid medical assistance program, the MinnesotaCare 437.36 program, the prepaid general assistance program, the federal 438.1 Medicare program, or the health plans provided through any of 438.2 those programs. 438.3 Sec. 10. Minnesota Statutes 2002, section 62E.06, 438.4 subdivision 1, is amended to read: 438.5 Subdivision 1. [NUMBER THREE PLAN.] A plan of health 438.6 coverage shall be certified as a number three qualified plan if 438.7 it otherwise meets the requirements established by chapters 62A, 438.8 62C, and 62Q, and the other laws of this state, whether or not 438.9 the policy is issued in Minnesota, and meets or exceeds the 438.10 following minimum standards: 438.11 (a) The minimum benefits for a covered individual shall, 438.12 subject to the other provisions of this subdivision, be equal to 438.13 at least 80 percent of the cost of covered services in excess of 438.14 an annual deductible which does not exceed $150 per person. The 438.15 coverage shall include a limitation of $3,000 per person on 438.16 total annual out-of-pocket expenses for services covered under 438.17 this subdivision. The coverage shall be subject to a maximum 438.18 lifetime benefit of not less than $1,000,000. 438.19 The $3,000 limitation on total annual out-of-pocket 438.20 expenses and the $1,000,000 maximum lifetime benefit shall not 438.21 be subject to change or substitution by use of an actuarially 438.22 equivalent benefit. 438.23 (b) Covered expenses shall be the usual and customary 438.24 charges for the following services and articles when prescribed 438.25 by a physician: 438.26 (1) hospital services; 438.27 (2) professional services for the diagnosis or treatment of 438.28 injuries, illnesses, or conditions, other than dental, which are 438.29 rendered by a physician or at the physician's direction; 438.30 (3) drugs requiring a physician's prescription; 438.31 (4) services of a nursing home for not more than 120 days 438.32 in a year if the services would qualify as reimbursable services 438.33 under Medicare; 438.34 (5) services of a home health agency if the services would 438.35 qualify as reimbursable services under Medicare; 438.36 (6) use of radium or other radioactive materials; 439.1 (7) oxygen; 439.2 (8) anesthetics; 439.3 (9) prostheses other than dental but including scalp hair 439.4 prostheses worn for hair loss suffered as a result of alopecia 439.5 areata; 439.6 (10) rental or purchase, as appropriate, of durable medical 439.7 equipment other than eyeglasses and hearing aids, unless 439.8 coverage is required under section 62Q.675; 439.9 (11) diagnostic x-rays and laboratory tests; 439.10 (12) oral surgery for partially or completely unerupted 439.11 impacted teeth, a tooth root without the extraction of the 439.12 entire tooth, or the gums and tissues of the mouth when not 439.13 performed in connection with the extraction or repair of teeth; 439.14 (13) services of a physical therapist; 439.15 (14) transportation provided by licensed ambulance service 439.16 to the nearest facility qualified to treat the condition; or a 439.17 reasonable mileage rate for transportation to a kidney dialysis 439.18 center for treatment; and 439.19 (15) services of an occupational therapist. 439.20 (c) Covered expenses for the services and articles 439.21 specified in this subdivision do not include the following: 439.22 (1) any charge for care for injury or disease either (i) 439.23 arising out of an injury in the course of employment and subject 439.24 to a workers' compensation or similar law, (ii) for which 439.25 benefits are payable without regard to fault under coverage 439.26 statutorily required to be contained in any motor vehicle, or 439.27 other liability insurance policy or equivalent self-insurance, 439.28 or (iii) for which benefits are payable under another policy of 439.29 accident and health insurance, Medicare, or any other 439.30 governmental program except as otherwise provided by section 439.31 62A.04, subdivision 3, clause (4); 439.32 (2) any charge for treatment for cosmetic purposes other 439.33 than for reconstructive surgery when such service is incidental 439.34 to or follows surgery resulting from injury, sickness, or other 439.35 diseases of the involved part or when such service is performed 439.36 on a covered dependent child because of congenital disease or 440.1 anomaly which has resulted in a functional defect as determined 440.2 by the attending physician; 440.3 (3) care which is primarily for custodial or domiciliary 440.4 purposes which would not qualify as eligible services under 440.5 Medicare; 440.6 (4) any charge for confinement in a private room to the 440.7 extent it is in excess of the institution's charge for its most 440.8 common semiprivate room, unless a private room is prescribed as 440.9 medically necessary by a physician, provided, however, that if 440.10 the institution does not have semiprivate rooms, its most common 440.11 semiprivate room charge shall be considered to be 90 percent of 440.12 its lowest private room charge; 440.13 (5) that part of any charge for services or articles 440.14 rendered or prescribed by a physician, dentist, or other health 440.15 care personnel which exceeds the prevailing charge in the 440.16 locality where the service is provided; and 440.17 (6) any charge for services or articles the provision of 440.18 which is not within the scope of authorized practice of the 440.19 institution or individual rendering the services or articles. 440.20 (d) The minimum benefits for a qualified plan shall 440.21 include, in addition to those benefits specified in clauses (a) 440.22 and (e), benefits for well baby care, effective July 1, 1980, 440.23 subject to applicable deductibles, coinsurance provisions, and 440.24 maximum lifetime benefit limitations. 440.25 (e) Effective July 1, 1979, the minimum benefits of a 440.26 qualified plan shall include, in addition to those benefits 440.27 specified in clause (a), a second opinion from a physician on 440.28 all surgical procedures expected to cost a total of $500 or more 440.29 in physician, laboratory, and hospital fees, provided that the 440.30 coverage need not include the repetition of any diagnostic tests. 440.31 (f) Effective August 1, 1985, the minimum benefits of a 440.32 qualified plan must include, in addition to the benefits 440.33 specified in clauses (a), (d), and (e), coverage for special 440.34 dietary treatment for phenylketonuria when recommended by a 440.35 physician. 440.36 (g) Outpatient mental health coverage is subject to section 441.1 62A.152, subdivision 2. 441.2 [EFFECTIVE DATE.] This section is effective August 1, 2003, 441.3 and applies to policies, contracts, and certificates issued or 441.4 renewed on or after that date. 441.5 Sec. 11. Minnesota Statutes 2002, section 62J.17, 441.6 subdivision 2, is amended to read: 441.7 Subd. 2. [DEFINITIONS.] For purposes of this section, the 441.8 terms defined in this subdivision have the meanings given. 441.9 (a) "Access" means the financial, temporal, and geographic 441.10 availability of health care to individuals who need it. 441.11 (b) "Capital expenditure" means an expenditure which, under 441.12 generally accepted accounting principles, is not properly 441.13 chargeable as an expense of operation and maintenance. 441.14 (c) "Cost" means the amount paid by consumers or third 441.15 party payers for health care services or products. 441.16 (d) "Date of the major spending commitment" means the date 441.17 the provider formally obligated itself to the major spending 441.18 commitment. The obligation may be incurred by entering into a 441.19 contract, making a down payment, issuing bonds or entering a 441.20 loan agreement to provide financing for the major spending 441.21 commitment, or taking some other formal, tangible action 441.22 evidencing the provider's intention to make the major spending 441.23 commitment. 441.24 (e) "Health care service" means: 441.25 (1) a service or item that would be covered by the medical 441.26 assistance program under chapter 256B if provided in accordance 441.27 with medical assistance requirements to an eligible medical 441.28 assistance recipient; and 441.29 (2) a service or item that would be covered by medical 441.30 assistance except that it is characterized as experimental, 441.31 cosmetic, or voluntary. 441.32 "Health care service" does not include retail, 441.33 over-the-counter sales of nonprescription drugs and other retail 441.34 sales of health-related products that are not generally paid for 441.35 by medical assistance and other third-party coverage. 441.36 (f) "Major spending commitment" means an expenditure in 442.1 excess of$500,000$1,000,000 for: 442.2 (1) acquisition of a unit of medical equipment; 442.3 (2) a capital expenditure for a single project for the 442.4 purposes of providing health care services, other than for the 442.5 acquisition of medical equipment; 442.6 (3) offering a new specialized service not offered before; 442.7 (4) planning for an activity that would qualify as a major 442.8 spending commitment under this paragraph; or 442.9 (5) a project involving a combination of two or more of the 442.10 activities in clauses (1) to (4). 442.11 The cost of acquisition of medical equipment, and the 442.12 amount of a capital expenditure, is the total cost to the 442.13 provider regardless of whether the cost is distributed over time 442.14 through a lease arrangement or other financing or payment 442.15 mechanism. 442.16 (g) "Medical equipment" means fixed and movable equipment 442.17 that is used by a provider in the provision of a health care 442.18 service. "Medical equipment" includes, but is not limited to, 442.19 the following: 442.20 (1) an extracorporeal shock wave lithotripter; 442.21 (2) a computerized axial tomography (CAT) scanner; 442.22 (3) a magnetic resonance imaging (MRI) unit; 442.23 (4) a positron emission tomography (PET) scanner; and 442.24 (5) emergency and nonemergency medical transportation 442.25 equipment and vehicles. 442.26 (h) "New specialized service" means a specialized health 442.27 care procedure or treatment regimen offered by a provider that 442.28 was not previously offered by the provider, including, but not 442.29 limited to: 442.30 (1) cardiac catheterization services involving high-risk 442.31 patients as defined in the Guidelines for Coronary Angiography 442.32 established by the American Heart Association and the American 442.33 College of Cardiology; 442.34 (2) heart, heart-lung, liver, kidney, bowel, or pancreas 442.35 transplantation service, or any other service for 442.36 transplantation of any other organ; 443.1 (3) megavoltage radiation therapy; 443.2 (4) open heart surgery; 443.3 (5) neonatal intensive care services; and 443.4 (6) any new medical technology for which premarket approval 443.5 has been granted by the United States Food and Drug 443.6 Administration, excluding implantable and wearable devices. 443.7 Sec. 12. Minnesota Statutes 2002, section 62J.23, is 443.8 amended by adding a subdivision to read: 443.9 Subd. 5. [AUDITS OF EXEMPT PROVIDERS.] The commissioner 443.10 may audit the referral patterns of providers that qualify for 443.11 exceptions under the federal Stark Law, United States Code, 443.12 title 42, section 1395nn. The commissioner has access to 443.13 provider records according to section 144.99, subdivision 2. 443.14 The commissioner shall report to the legislature any audit 443.15 results that reveal a pattern of referrals by a provider for the 443.16 furnishing of health services to an entity with which the 443.17 provider has a direct or indirect financial relationship. 443.18 Sec. 13. [62J.26] [EVALUATION OF PROPOSED HEALTH COVERAGE 443.19 MANDATES.] 443.20 Subdivision 1. [DEFINITIONS.] For purposes of this 443.21 section, the following terms have the meanings given unless the 443.22 context otherwise requires: 443.23 (1) "commissioner" means the commissioner of commerce; 443.24 (2) "health plan" means a health plan as defined in section 443.25 62A.011, subdivision 3, but includes coverage listed in clauses 443.26 (7) and (10) of that definition; 443.27 (3) "mandated health benefit proposal" means a proposal 443.28 that would statutorily require a health plan to do the following: 443.29 (i) provide coverage or increase the amount of coverage for 443.30 the treatment of a particular disease, condition, or other 443.31 health care need; 443.32 (ii) provide coverage or increase the amount of coverage of 443.33 a particular type of health care treatment or service or of 443.34 equipment, supplies, or drugs used in connection with a health 443.35 care treatment or service; or 443.36 (iii) provide coverage for care delivered by a specific 444.1 type of provider. 444.2 "Mandated health benefit proposal" does not include health 444.3 benefit proposals amending the scope of practice of a licensed 444.4 health care professional. 444.5 Subd. 2. [EVALUATION PROCESS AND CONTENT.] (a) The 444.6 commissioner, in consultation with the commissioners of health 444.7 and employee relations, must evaluate mandated health benefit 444.8 proposals as provided under subdivision 3. 444.9 (b) The purpose of the evaluation is to provide the 444.10 legislature with a complete and timely analysis of all 444.11 ramifications of any mandated health benefit proposal. The 444.12 evaluation must include, in addition to other relevant 444.13 information, the following: 444.14 (1) scientific and medical information on the proposed 444.15 health benefit, on the potential for harm or benefit to the 444.16 patient, and on the comparative benefit or harm from alternative 444.17 forms of treatment; 444.18 (2) public health, economic, and fiscal impacts of the 444.19 proposed mandate on persons receiving health services in 444.20 Minnesota, on the relative cost-effectiveness of the benefit, 444.21 and on the health care system in general; 444.22 (3) the extent to which the service is generally utilized 444.23 by a significant portion of the population; 444.24 (4) the extent to which insurance coverage for the proposed 444.25 mandated benefit is already generally available; 444.26 (5) the extent to which the mandated coverage will increase 444.27 or decrease the cost of the service; and 444.28 (6) the commissioner may consider actuarial analysis done 444.29 by health insurers in determining the cost of the proposed 444.30 mandated benefit. 444.31 (c) The commissioner must summarize the nature and quality 444.32 of available information on these issues, and, if possible, must 444.33 provide preliminary information to the public. The commissioner 444.34 may conduct research on these issues or may determine that 444.35 existing research is sufficient to meet the informational needs 444.36 of the legislature. The commissioner may seek the assistance 445.1 and advice of researchers, community leaders, or other persons 445.2 or organizations with relevant expertise. 445.3 Subd. 3. [REQUESTS FOR EVALUATION.] (a) Whenever a 445.4 legislative measure containing a mandated health benefit 445.5 proposal is introduced as a bill or offered as an amendment to a 445.6 bill, or is likely to be introduced as a bill or offered as an 445.7 amendment, a chair of any standing legislative committee that 445.8 has jurisdiction over the subject matter of the proposal may 445.9 request that the commissioner complete an evaluation of the 445.10 proposal under this section, to inform any committee of floor 445.11 action by either house of the legislature. 445.12 (b) The commissioner must conduct an evaluation described 445.13 in subdivision 2 of each mandated health benefit proposal for 445.14 which an evaluation is requested under paragraph (a), unless the 445.15 commissioner determines under paragraph (c) or subdivision 4 445.16 that priorities and resources do not permit its evaluation. 445.17 (c) If requests for evaluation of multiple proposals are 445.18 received, the commissioner must consult with the chairs of the 445.19 standing legislative committees having jurisdiction over the 445.20 subject matter of the mandated health benefit proposals to 445.21 prioritize the requests and establish a reporting date for each 445.22 proposal to be evaluated. The commissioner is not required to 445.23 direct an unreasonable quantity of the commissioner's resources 445.24 to these evaluations. 445.25 Subd. 4. [SOURCES OF FUNDING.] (a) The commissioner need 445.26 not use any funds for purposes of this section other than as 445.27 provided in this subdivision or as specified in an appropriation. 445.28 (b) The commissioner may seek and accept funding from 445.29 sources other than the state to pay for evaluations under this 445.30 section to supplement or replace state appropriations. Any 445.31 money received under this paragraph must be deposited in the 445.32 state treasury, credited to a separate account for this purpose 445.33 in the special revenue fund, and is appropriated to the 445.34 commissioner for purposes of this section. 445.35 (c) If a request for an evaluation under this section has 445.36 been made, the commissioner may use for purposes of the 446.1 evaluation: 446.2 (1) any funds appropriated to the commissioner specifically 446.3 for purposes of this section; or 446.4 (2) funds available under paragraph (b), if use of the 446.5 funds for evaluation of that mandated health benefit proposal is 446.6 consistent with any restrictions imposed by the source of the 446.7 funds. 446.8 (d) The commissioner must ensure that the source of the 446.9 funding has no influence on the process or outcome of the 446.10 evaluation. 446.11 Subd. 5. [REPORT TO LEGISLATURE.] The commissioner must 446.12 submit a written report on the evaluation to the legislature no 446.13 later than 180 days after the request. The report must be 446.14 submitted in compliance with sections 3.195 and 3.197. 446.15 [EFFECTIVE DATE.] This section is effective January 1, 2004. 446.16 Sec. 14. Minnesota Statutes 2002, section 62J.52, 446.17 subdivision 1, is amended to read: 446.18 Subdivision 1. [UNIFORM BILLING FORM HCFA 1450.] (a) On 446.19 and after January 1, 1996, all institutional inpatient hospital 446.20 services, ancillary services, institutionally owned or operated 446.21 outpatient services rendered by providers in Minnesota, and 446.22 institutional or noninstitutional home health services that are 446.23 not being billed using an equivalent electronic billing format, 446.24 must be billed using the uniform billing form HCFA 1450, except 446.25 as provided in subdivision 5. 446.26 (b) The instructions and definitions for the use of the 446.27 uniform billing form HCFA 1450 shall be in accordance with the 446.28 uniform billing form manual specified by the commissioner. In 446.29 promulgating these instructions, the commissioner may utilize 446.30 the manual developed by the National Uniform Billing Committee, 446.31 as adopted and finalized by the Minnesota uniform billing 446.32 committee. 446.33 (c) Services to be billed using the uniform billing form 446.34 HCFA 1450 include: institutional inpatient hospital services 446.35 and distinct units in the hospital such as psychiatric unit 446.36 services, physical therapy unit services, swing bed (SNF) 447.1 services, inpatient state psychiatric hospital services, 447.2 inpatient skilled nursing facility services, home health 447.3 services (Medicare part A), and hospice services; ancillary 447.4 services, where benefits are exhausted or patient has no 447.5 Medicare part A, from hospitals, state psychiatric hospitals, 447.6 skilled nursing facilities, and home health (Medicare part B); 447.7 institutional owned or operated outpatient services such as 447.8 waivered services, hospital outpatient services, including 447.9 ambulatory surgical center services, hospital referred 447.10 laboratory services, hospital-based ambulance services, and 447.11 other hospital outpatient services, skilled nursing facilities, 447.12 home health,including infusion therapy,freestanding renal 447.13 dialysis centers, comprehensive outpatient rehabilitation 447.14 facilities (CORF), outpatient rehabilitation facilities (ORF), 447.15 rural health clinics, and community mental health centers; home 447.16 health services such as home health intravenous therapy 447.17 providers, waivered services, personal care attendants, and 447.18 hospice; and any other health care provider certified by the 447.19 Medicare program to use this form. 447.20 (d) On and after January 1, 1996, a mother and newborn 447.21 child must be billed separately, and must not be combined on one 447.22 claim form. 447.23 Sec. 15. Minnesota Statutes 2002, section 62J.52, 447.24 subdivision 2, is amended to read: 447.25 Subd. 2. [UNIFORM BILLING FORM HCFA 1500.] (a) On and 447.26 after January 1, 1996, all noninstitutional health care services 447.27 rendered by providers in Minnesota except dental or pharmacy 447.28 providers, that are not currently being billed using an 447.29 equivalent electronic billing format, must be billed using the 447.30 health insurance claim form HCFA 1500, except as provided in 447.31 subdivision 5. 447.32 (b) The instructions and definitions for the use of the 447.33 uniform billing form HCFA 1500 shall be in accordance with the 447.34 manual developed by the administrative uniformity committee 447.35 entitled standards for the use of the HCFA 1500 form, dated 447.36 February 1994, as further defined by the commissioner. 448.1 (c) Services to be billed using the uniform billing form 448.2 HCFA 1500 include physician services and supplies, durable 448.3 medical equipment, noninstitutional ambulance services, 448.4 independent ancillary services including occupational therapy, 448.5 physical therapy, speech therapy and audiology, home infusion 448.6 therapy, podiatry services, optometry services, mental health 448.7 licensed professional services, substance abuse licensed 448.8 professional services, nursing practitioner professional 448.9 services, certified registered nurse anesthetists, 448.10 chiropractors, physician assistants, laboratories, medical 448.11 suppliers, and other health care providers such as day activity 448.12 centers and freestanding ambulatory surgical centers. 448.13 Sec. 16. Minnesota Statutes 2002, section 62J.692, 448.14 subdivision 3, is amended to read: 448.15 Subd. 3. [APPLICATION PROCESS.] (a) A clinical medical 448.16 education program conducted in Minnesota by a teaching 448.17 institution to train physicians, doctor of pharmacy 448.18 practitioners, dentists, chiropractors, or physician assistants 448.19 is eligible for funds under subdivision 4 if the program: 448.20 (1) is funded, in part, by patient care revenues; 448.21 (2) occurs in patient care settings that face increased 448.22 financial pressure as a result of competition with nonteaching 448.23 patient care entities; and 448.24 (3) emphasizes primary care or specialties that are in 448.25 undersupply in Minnesota. 448.26 (b) A clinical medical education program for advanced 448.27 practice nursing is eligible for funds under subdivision 4 if 448.28 the program meets the eligibility requirements in paragraph (a), 448.29 clauses (1) to (3), and is sponsored by the University of 448.30 Minnesota Academic Health Center, the Mayo Foundation, or 448.31 institutions that are part of the Minnesota state colleges and 448.32 universities system or members of the Minnesota private college 448.33 council. 448.34 (c) Applications must be submitted to the commissioner by a 448.35 sponsoring institution on behalf of an eligible clinical medical 448.36 education program and must be received by October 31 of each 449.1 year for distribution in the following year. An application for 449.2 funds must contain the following information: 449.3 (1) the official name and address of the sponsoring 449.4 institution and the official name and site address of the 449.5 clinical medical education programs on whose behalf the 449.6 sponsoring institution is applying; 449.7 (2) the name, title, and business address of those persons 449.8 responsible for administering the funds; 449.9 (3) for each clinical medical education program for which 449.10 funds are being sought; the type and specialty orientation of 449.11 trainees in the program; the name, site address, and medical 449.12 assistance provider number of each training site used in the 449.13 program; the total number of trainees at each training site; and 449.14 the total number of eligible trainee FTEs at each site. Only 449.15 those training sites that host 0.5 FTE or more eligible trainees 449.16 for a program may be included in the program's application; and 449.17 (4) other supporting information the commissioner deems 449.18 necessary to determine program eligibility based on the criteria 449.19 inparagraphparagraphs (a) and (b) and to ensure the equitable 449.20 distribution of funds. 449.21(c)(d) An application must include the information 449.22 specified in clauses (1) to (3) for each clinical medical 449.23 education program on an annual basis for three consecutive 449.24 years. After that time, an application must include the 449.25 information specified in clauses (1) to (3) in the first year of 449.26 each biennium: 449.27 (1) audited clinical training costs per trainee for each 449.28 clinical medical education program when available or estimates 449.29 of clinical training costs based on audited financial data; 449.30 (2) a description of current sources of funding for 449.31 clinical medical education costs, including a description and 449.32 dollar amount of all state and federal financial support, 449.33 including Medicare direct and indirect payments; and 449.34 (3) other revenue received for the purposes of clinical 449.35 training. 449.36(d)(e) An applicant that does not provide information 450.1 requested by the commissioner shall not be eligible for funds 450.2 for the current funding cycle. 450.3 Sec. 17. Minnesota Statutes 2002, section 62J.692, 450.4 subdivision 4, is amended to read: 450.5 Subd. 4. [DISTRIBUTION OF FUNDS.] (a) The commissioner 450.6 shall annually distribute 90 percent of available medical 450.7 education funds to all qualifying applicants based onthe450.8following criteriaa distribution formula that reflects a 450.9 summation of two factors: 450.10 (1)total medical education funds available for450.11distribution;an education factor, which is determined by the 450.12 total number of eligible trainee FTEs and the total statewide 450.13 average costs per trainee, by type of trainee, in each clinical 450.14 medical education program; and 450.15 (2)total number of eligible trainee FTEs in each clinical450.16medical education program; and450.17(3) the statewide average cost per trainee as determined by450.18the application information provided in the first year of the450.19biennium, by type of trainee, in each clinical medical education450.20program.a public program volume factor, which is determined by 450.21 the total volume of public program revenue received by each 450.22 training site as a percentage of all public program revenue 450.23 received by all training sites in the fund pool. 450.24 In this formula, the education factor is weighted at 67 450.25 percent and the public program volume factor is weighted at 33 450.26 percent. 450.27 Public program revenue for the distribution formula 450.28 includes revenue from medical assistance, prepaid medical 450.29 assistance, general assistance medical care, and prepaid general 450.30 assistance medical care. Training sites that receive no public 450.31 program revenue are ineligible for funds available under this 450.32 paragraph. Total statewide average costs per trainee for 450.33 medical residents is based on audited clinical training costs 450.34 per trainee in primary care clinical medical education programs 450.35 for medical residents. Total statewide average costs per 450.36 trainee for dental residents is based on audited clinical 451.1 training costs per trainee in clinical medical education 451.2 programs for dental students. Total statewide average costs per 451.3 trainee for pharmacy residents is based on audited clinical 451.4 training costs per trainee in clinical medical education 451.5 programs for pharmacy students. 451.6 (b) The commissioner shall annually distribute ten percent 451.7 of total available medical education funds to all qualifying 451.8 applicants based on the percentage received by each applicant 451.9 under paragraph (a). These funds are to be used to offset 451.10 clinical education costs at eligible clinical training sites 451.11 based on criteria developed by the clinical medical education 451.12 program. Applicants may choose to distribute funds allocated 451.13 under this paragraph based on the distribution formula described 451.14 in paragraph (a). Applicants may also choose to distribute 451.15 funds to clinical training sites with a valid Minnesota medical 451.16 assistance identification number that host fewer than 0.5 451.17 eligible trainee FTE's for a clinical medical education program. 451.18 (c) Funds distributed shall not be used to displace current 451.19 funding appropriations from federal or state sources. 451.20(c)(d) Funds shall be distributed to the sponsoring 451.21 institutions indicating the amount to be distributed to each of 451.22 the sponsor's clinical medical education programs based on the 451.23 criteria in this subdivision and in accordance with the 451.24 commissioner's approval letter. Each clinical medical education 451.25 program must distribute funds allocated under paragraph (a) to 451.26 the training sites as specified in the commissioner's approval 451.27 letter. Sponsoring institutions, which are accredited through 451.28 an organization recognized by the department of education or the 451.29 Centers for Medicare and Medicaid Services, may contract 451.30 directly with training sites to provide clinical training. To 451.31 ensure the quality of clinical training, those accredited 451.32 sponsoring institutions must: 451.33 (1) develop contracts specifying the terms, expectations, 451.34 and outcomes of the clinical training conducted at sites; and 451.35 (2) take necessary action if the contract requirements are 451.36 not met. Action may include the withholding of payments under 452.1 this section or the removal of students from the site. 452.2(d)(e) Any funds not distributed in accordance with the 452.3 commissioner's approval letter must be returned to the medical 452.4 education and research fund within 30 days of receiving notice 452.5 from the commissioner. The commissioner shall distribute 452.6 returned funds to the appropriate training sites in accordance 452.7 with the commissioner's approval letter. 452.8(e) The commissioner shall distribute by June 30 of each452.9year an amount equal to the funds transferred under section452.1062J.694, subdivision 2a, paragraph (b), plus five percent452.11interest to the University of Minnesota board of regents for the452.12costs of the academic health center as specified under section452.1362J.694, subdivision 2a, paragraph (a).452.14 Sec. 18. Minnesota Statutes 2002, section 62J.692, 452.15 subdivision 5, is amended to read: 452.16 Subd. 5. [REPORT.] (a) Sponsoring institutions receiving 452.17 funds under this section must sign and submit a medical 452.18 education grant verification report (GVR) to verify that the 452.19 correct grant amount was forwarded to each eligible training 452.20 site. If the sponsoring institution fails to submit the GVR by 452.21 the stated deadline, or to request and meet the deadline for an 452.22 extension, the sponsoring institution is required to return the 452.23 full amount of funds received to the commissioner within 30 days 452.24 of receiving notice from the commissioner. The commissioner 452.25 shall distribute returned funds to the appropriate training 452.26 sites in accordance with the commissioner's approval letter. 452.27 (b) The reports must provide verification of the 452.28 distribution of the funds and must include: 452.29 (1) the total number of eligible trainee FTEs in each 452.30 clinical medical education program; 452.31 (2) the name of each funded program and, for each program, 452.32 the dollar amount distributed to each training site; 452.33 (3) documentation of any discrepancies between the initial 452.34 grant distribution notice included in the commissioner's 452.35 approval letter and the actual distribution; 452.36 (4) a statement by the sponsoring institution describing 453.1 the distribution of funds allocated under subdivision 4, 453.2 paragraph (b), including information on which clinical training 453.3 sites received funding and the rationale used for determining 453.4 funding priorities; 453.5 (5) a statement by the sponsoring institution stating that 453.6 the completed grant verification report is valid and accurate; 453.7 and 453.8(5)(6) other information the commissioner, with advice 453.9 from the advisory committee, deems appropriate to evaluate the 453.10 effectiveness of the use of funds for medical education. 453.11 (c) By February 15 of each year, the commissioner, with 453.12 advice from the advisory committee, shall provide an annual 453.13 summary report to the legislature on the implementation of this 453.14 section. 453.15 Sec. 19. Minnesota Statutes 2002, section 62J.692, 453.16 subdivision 7, is amended to read: 453.17 Subd. 7. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 453.18 SERVICES.] (a) The amount transferred according to section 453.19 256B.69, subdivision 5c, paragraph (a), clause (1), shall be 453.20 distributed by the commissioner annually to clinical medical 453.21 education programs that meet the qualifications of subdivision 3 453.22 based ona distribution formula that reflects a summation of two453.23factors:the formula in subdivision 4, paragraph (a). 453.24(1) an education factor, which is determined by the total453.25number of eligible trainee FTEs and the total statewide average453.26costs per trainee, by type of trainee, in each clinical medical453.27education program; and453.28(2) a public program volume factor, which is determined by453.29the total volume of public program revenue received by each453.30training site as a percentage of all public program revenue453.31received by all training sites in the fund pool created under453.32this subdivision.453.33In this formula, the education factor shall be weighted at453.3450 percent and the public program volume factor shall be453.35weighted at 50 percent.453.36Public program revenue for the distribution formula shall454.1include revenue from medical assistance, prepaid medical454.2assistance, general assistance medical care, and prepaid general454.3assistance medical care. Training sites that receive no public454.4program revenue shall be ineligible for funds available under454.5this paragraph.454.6 (b) Fifty percent of the amount transferred according to 454.7 section 256B.69, subdivision 5c, paragraph (a), clause (2), 454.8 shall be distributed by the commissioner to the University of 454.9 Minnesota board of regents for the purposes described in 454.10 sections 137.38 to 137.40. Of the remaining amount transferred 454.11 according to section 256B.69, subdivision 5c, paragraph (a), 454.12 clause (2), 24 percent of the amount shall be distributed by the 454.13 commissioner to the Hennepin County Medical Center for clinical 454.14 medical education. The remaining 26 percent of the amount 454.15 transferred shall be distributed by the commissioner in 454.16 accordance with subdivision 7a. If the federal approval is not 454.17 obtained for the matching funds under section 256B.69, 454.18 subdivision 5c, paragraph (a), clause (2), 100 percent of the 454.19 amount transferred under this paragraph shall be distributed by 454.20 the commissioner to the University of Minnesota board of regents 454.21 for the purposes described in sections 137.38 to 137.40. 454.22 (c) The amount transferred according to section 256B.69, 454.23 subdivision 5c, paragraph (a), clause (3), shall be distributed 454.24 by the commissioner upon receipt to the University of Minnesota 454.25 board of regents for the purposes of clinical graduate medical 454.26 education. 454.27 Sec. 20. Minnesota Statutes 2002, section 62J.694, is 454.28 amended by adding a subdivision to read: 454.29 Subd. 5. [EFFECTIVE DATE.] This section is only in effect 454.30 if there are funds available in the medical education endowment 454.31 fund. 454.32 Sec. 21. Minnesota Statutes 2002, section 62L.05, 454.33 subdivision 4, is amended to read: 454.34 Subd. 4. [BENEFITS.] The medical services and supplies 454.35 listed in this subdivision are the benefits that must be covered 454.36 by the small employer plans described in subdivisions 2 and 3. 455.1 Benefits under this subdivision may be provided through the 455.2 managed care procedures practiced by health carriers: 455.3 (1) inpatient and outpatient hospital services, excluding 455.4 services provided for the diagnosis, care, or treatment of 455.5 chemical dependency or a mental illness or condition, other than 455.6 those conditions specified in clauses (10), (11), and (12). The 455.7 health care services required to be covered under this clause 455.8 must also be covered if rendered in a nonhospital environment, 455.9 on the same basis as coverage provided for those same treatments 455.10 or services if rendered in a hospital, provided, however, that 455.11 this sentence must not be interpreted as expanding the types or 455.12 extent of services covered; 455.13 (2) physician, chiropractor, and nurse practitioner 455.14 services for the diagnosis or treatment of illnesses, injuries, 455.15 or conditions; 455.16 (3) diagnostic x-rays and laboratory tests; 455.17 (4) ground transportation provided by a licensed ambulance 455.18 service to the nearest facility qualified to treat the 455.19 condition, or as otherwise required by the health carrier; 455.20 (5) services of a home health agency if the services 455.21 qualify as reimbursable services under Medicare; 455.22 (6) services of a private duty registered nurse if 455.23 medically necessary, as determined by the health carrier; 455.24 (7) the rental or purchase, as appropriate, of durable 455.25 medical equipment, other than eyeglasses and hearing aids, 455.26 unless coverage is required under section 62Q.675; 455.27 (8) child health supervision services up to age 18, as 455.28 defined in section 62A.047; 455.29 (9) maternity and prenatal care services, as defined in 455.30 sections 62A.041 and 62A.047; 455.31 (10) inpatient hospital and outpatient services for the 455.32 diagnosis and treatment of certain mental illnesses or 455.33 conditions, as defined by the International Classification of 455.34 Diseases-Clinical Modification (ICD-9-CM), seventh edition 455.35 (1990) and as classified as ICD-9 codes 295 to 299; 455.36 (11) ten hours per year of outpatient mental health 456.1 diagnosis or treatment for illnesses or conditions not described 456.2 in clause (10); 456.3 (12) 60 hours per year of outpatient treatment of chemical 456.4 dependency; and 456.5 (13) 50 percent of eligible charges for prescription drugs, 456.6 up to a separate annual maximum out-of-pocket expense of $1,000 456.7 per individual for prescription drugs, and 100 percent of 456.8 eligible charges thereafter. 456.9 [EFFECTIVE DATE.] This section is effective August 1, 2003, 456.10 and applies to policies, contracts, and certificates issued or 456.11 renewed on or after that date. 456.12 Sec. 22. Minnesota Statutes 2002, section 62Q.19, 456.13 subdivision 1, is amended to read: 456.14 Subdivision 1. [DESIGNATION.] (a) The commissioner shall 456.15 designate essential community providers. The criteria for 456.16 essential community provider designation shall be the following: 456.17 (1) a demonstrated ability to integrate applicable 456.18 supportive and stabilizing services with medical care for 456.19 uninsured persons and high-risk and special needs populations, 456.20 underserved, and other special needs populations; and 456.21 (2) a commitment to serve low-income and underserved 456.22 populations by meeting the following requirements: 456.23 (i) has nonprofit status in accordance with chapter 317A; 456.24 (ii) has tax exempt status in accordance with the Internal 456.25 Revenue Service Code, section 501(c)(3); 456.26 (iii) charges for services on a sliding fee schedule based 456.27 on current poverty income guidelines; and 456.28 (iv) does not restrict access or services because of a 456.29 client's financial limitation; 456.30 (3) status as a local government unit as defined in section 456.31 62D.02, subdivision 11, a hospital district created or 456.32 reorganized under sections 447.31 to 447.37, an Indian tribal 456.33 government, an Indian health service unit, or a community health 456.34 board as defined in chapter 145A; 456.35 (4) a former state hospital that specializes in the 456.36 treatment of cerebral palsy, spina bifida, epilepsy, closed head 457.1 injuries, specialized orthopedic problems, and other disabling 457.2 conditions; or 457.3 (5)a rural hospital that has qualified fora sole 457.4 community hospitalfinancial assistance grant in the past three457.5years under section 144.1484, subdivision 1. For these rural 457.6 hospitals, the essential community provider designation applies 457.7 to all health services provided, including both inpatient and 457.8 outpatient services. For purposes of this section, "sole 457.9 community hospital" means a rural hospital that: 457.10 (i) is eligible to be classified as a sole community 457.11 hospital according to Code of Federal Regulations, title 42, 457.12 section 412.92, or is located in a community with a population 457.13 of less than 5,000 and located more than 25 miles from a like 457.14 hospital currently providing acute short-term services; 457.15 (ii) has experienced net operating income losses in two of 457.16 the previous three most recent consecutive hospital fiscal years 457.17 for which audited financial information is available; and 457.18 (iii) consists of 40 or fewer licensed beds. 457.19 (b) Prior to designation, the commissioner shall publish 457.20 the names of all applicants in the State Register. The public 457.21 shall have 30 days from the date of publication to submit 457.22 written comments to the commissioner on the application. No 457.23 designation shall be made by the commissioner until the 30-day 457.24 period has expired. 457.25 (c) The commissioner may designate an eligible provider as 457.26 an essential community provider for all the services offered by 457.27 that provider or for specific services designated by the 457.28 commissioner. 457.29 (d) For the purpose of this subdivision, supportive and 457.30 stabilizing services include at a minimum, transportation, child 457.31 care, cultural, and linguistic services where appropriate. 457.32 Sec. 23. Minnesota Statutes 2002, section 62Q.19, 457.33 subdivision 2, is amended to read: 457.34 Subd. 2. [APPLICATION.] (a) Any provider may apply to the 457.35 commissioner for designation as an essential community provider 457.36 by submitting an application form developed by the 458.1 commissioner. Except as provided inparagraph458.2 paragraphs (d) and (e), applications must be accepted within two 458.3 years after the effective date of the rules adopted by the 458.4 commissioner to implement this section. 458.5 (b) Each application submitted must be accompanied by an 458.6 application fee in an amount determined by the commissioner. 458.7 The fee shall be no more than what is needed to cover the 458.8 administrative costs of processing the application. 458.9 (c) The name, address, contact person, and the date by 458.10 which the commissioner's decision is expected to be made shall 458.11 be classified as public data under section 13.41. All other 458.12 information contained in the application form shall be 458.13 classified as private data under section 13.41 until the 458.14 application has been approved, approved as modified, or denied 458.15 by the commissioner. Once the decision has been made, all 458.16 information shall be classified as public data unless the 458.17 applicant designates and the commissioner determines that the 458.18 information contains trade secret information. 458.19 (d) The commissioner shall accept an application for 458.20 designation as an essential community provider until June 30, 458.21 2001, from: 458.22 (1) one applicant that is a nonprofit community health care 458.23 facility, certified as a medical assistance provider effective 458.24 April 1, 1998, that provides culturally competent health care to 458.25 an underserved Southeast Asian immigrant and refugee population 458.26 residing in the immediate neighborhood of the facility; 458.27 (2) one applicant that is a nonprofit home health care 458.28 provider, certified as a Medicare and a medical assistance 458.29 provider that provides culturally competent home health care 458.30 services to a low-income culturally diverse population; 458.31 (3) up to five applicants that are nonprofit community 458.32 mental health centers certified as medical assistance providers 458.33 that provide mental health services to children with serious 458.34 emotional disturbance and their families or to adults with 458.35 serious and persistent mental illness; and 458.36 (4) one applicant that is a nonprofit provider certified as 459.1 a medical assistance provider that provides mental health, child 459.2 development, and family services to children with physical and 459.3 mental health disorders and their families. 459.4 (e) The commissioner shall accept an application for 459.5 designation as an essential community provider until June 30, 459.6 2003, from one applicant that is a nonprofit community clinic 459.7 located in Hennepin county that provides health care to an 459.8 underserved American Indian population and that is collaborating 459.9 with other neighboring organizations on a community diabetes 459.10 project and an immunization project. 459.11 [EFFECTIVE DATE.] This section is effective the day 459.12 following final enactment. 459.13 Sec. 24. [62Q.675] [HEARING AIDS; PERSONS 18 OR YOUNGER.] 459.14 A health plan must cover hearing aids for individuals 18 459.15 years of age or younger for hearing loss due to functional 459.16 congenital malformation of the ears that is not correctable by 459.17 other covered procedures. Coverage required under this section 459.18 is limited to one hearing aid in each ear every three years. No 459.19 special deductible, coinsurance, co-payment, or other limitation 459.20 on the coverage under this section that is not generally 459.21 applicable to other coverages under the plan may be imposed. 459.22 [EFFECTIVE DATE.] This section is effective August 1, 2003, 459.23 and applies to policies, contracts, and certificates issued or 459.24 renewed on or after that date. 459.25 Sec. 25. Minnesota Statutes 2002, section 144.1222, is 459.26 amended by adding a subdivision to read: 459.27 Subd. 1a. [FEES.] All plans and specifications for public 459.28 swimming pool and spa construction, installation, or alteration 459.29 or requests for a variance that are submitted to the 459.30 commissioner according to Minnesota Rules, part 4717.3975, shall 459.31 be accompanied by the appropriate fees. If the commissioner 459.32 determines, upon review of the plans, that inadequate fees were 459.33 paid, the necessary additional fees shall be paid before plan 459.34 approval. For purposes of determining fees, a project is 459.35 defined as a proposal to construct or install a public pool, 459.36 spa, special purpose pool, or wading pool and all associated 460.1 water treatment equipment and drains, gutters, decks, water 460.2 recreation features, spray pads, and those design and safety 460.3 features that are within five feet of any pool or spa. The 460.4 commissioner shall charge the following fees for plan review and 460.5 inspection of public pools and spas and for requests for 460.6 variance from the public pool and spa rules: 460.7 (1) each spa pool, $500; 460.8 (2) projects valued at $250,000 or less, a minimum of $800 460.9 per pool plus: 460.10 (i) for each slide, an additional $400; and 460.11 (ii) for each spa pool, an additional $500; 460.12 (3) projects valued at $250,000 or more, 0.5 percent of 460.13 documented estimated project cost to a maximum fee of $10,000; 460.14 (4) alterations to an existing pool without changing the 460.15 size or configuration of the pool, $400; 460.16 (5) removal or replacement of pool disinfection equipment 460.17 only, $75; and 460.18 (6) request for variance from the public pool and spa 460.19 rules, $500. 460.20 Sec. 26. Minnesota Statutes 2002, section 144.125, is 460.21 amended to read: 460.22 144.125 [TESTS OF INFANTS FORINBORN METABOLIC ERRORS460.23 HERITABLE AND CONGENITAL DISORDERS.] 460.24 Subdivision 1. [DUTY TO PERFORM TESTING.] It is the duty 460.25 of (1) the administrative officer or other person in charge of 460.26 each institution caring for infants 28 days or less of age, (2) 460.27 the person required in pursuance of the provisions of section 460.28 144.215, to register the birth of a child, or (3) the nurse 460.29 midwife or midwife in attendance at the birth, to arrange to 460.30 have administered to every infant or child in its care tests for 460.31inborn errors of metabolism in accordance withheritable and 460.32 congenital disorders according to subdivision 2 and rules 460.33 prescribed by the state commissioner of health.In determining460.34which tests must be administered, the commissioner shall take460.35into consideration the adequacy of laboratory methods to detect460.36the inborn metabolic error, the ability to treat or prevent461.1medical conditions caused by the inborn metabolic error, and the461.2severity of the medical conditions caused by the inborn461.3metabolic error.Testing and the recording and reporting of 461.4 test results shall be performed at the times and in the manner 461.5 prescribed by the commissioner of health. The commissioner 461.6 shall charge laboratory service fees so that the total of fees 461.7 collected will approximate the costs of conducting the tests and 461.8 implementing and maintaining a system to follow-up infants with 461.9inborn metabolic errorsheritable or congenital disorders. The 461.10 laboratory service fee is $61 per specimen. Costs associated 461.11 with capital expenditures and the development of new procedures 461.12 may be prorated over a three-year period when calculating the 461.13 amount of the fees. 461.14 Subd. 2. [DETERMINATION OF TESTS TO BE ADMINISTERED.] The 461.15 commissioner shall periodically revise the list of tests to be 461.16 administered for determining the presence of a heritable or 461.17 congenital disorder. Revisions to the list shall reflect 461.18 advances in medical science, new and improved testing methods, 461.19 or other factors that will improve the public health. In 461.20 determining whether a test must be administered, the 461.21 commissioner shall take into consideration the adequacy of 461.22 laboratory methods to detect the heritable or congenital 461.23 disorder, the ability to treat or prevent medical conditions 461.24 caused by the heritable or congenital disorder, and the severity 461.25 of the medical conditions caused by the heritable or congenital 461.26 disorder. The list of tests to be performed may be revised if 461.27 the changes are recommended by the advisory committee 461.28 established under section 144.1255, approved by the 461.29 commissioner, and published in the State Register. The revision 461.30 is exempt from the rulemaking requirements in chapter 14 and 461.31 sections 14.385 and 14.386 do not apply. 461.32 Subd. 3. [OBJECTION OF PARENTS TO TEST.] Persons with a 461.33 duty to perform testing under subdivision 1 shall advise parents 461.34 of infants (1) that the blood or tissue samples used to perform 461.35 testing thereunder as well as the results of such testing may be 461.36 retained by the department of health, (2) the benefit of 462.1 retaining the blood or tissue sample, and (3) that the following 462.2 options are available to them with respect to the testing: 462.3 (i) to decline to have the tests, or 462.4 (ii) to elect to have the tests but to require that all 462.5 blood samples and records of test results be destroyed within 24 462.6 months of the testing. If the parents of an infant object in 462.7 writing to testing for heritable and congenital disorders or 462.8 elect to require that blood samples and test results be 462.9 destroyed, the objection or election shall be recorded on a form 462.10 that is signed by a parent or legal guardian and made part of 462.11 the infant's medical record. A written objection exempts an 462.12 infant from the requirements of this section and section 144.128. 462.13 Sec. 27. [144.1255] [ADVISORY COMMITTEE ON HERITABLE AND 462.14 CONGENITAL DISORDERS.] 462.15 Subdivision 1. [CREATION AND MEMBERSHIP.] (a) By July 1, 462.16 2003, the commissioner of health shall appoint an advisory 462.17 committee to provide advice and recommendations to the 462.18 commissioner concerning tests and treatments for heritable and 462.19 congenital disorders found in newborn children. Membership of 462.20 the committee shall include, but not be limited to, at least one 462.21 member from each of the following representative groups: 462.22 (1) parents and other consumers; 462.23 (2) primary care providers; 462.24 (3) clinicians and researchers specializing in newborn 462.25 diseases and disorders; 462.26 (4) genetic counselors; 462.27 (5) birth hospital representatives; 462.28 (6) newborn screening laboratory professionals; 462.29 (7) nutritionists; and 462.30 (8) other experts as needed representing related fields 462.31 such as emerging technologies and health insurance. 462.32 (b) The terms and removal of members are governed by 462.33 section 15.059. Members shall not receive per diems but shall 462.34 be compensated for expenses. Notwithstanding section 15.059, 462.35 subdivision 5, the advisory committee does not expire. 462.36 Subd. 2. [FUNCTION AND OBJECTIVES.] The committee's 463.1 activities include, but are not limited to: 463.2 (1) collection of information on the efficacy and 463.3 reliability of various tests for heritable and congenital 463.4 disorders; 463.5 (2) collection of information on the availability and 463.6 efficacy of treatments for heritable and congenital disorders; 463.7 (3) collection of information on the severity of medical 463.8 conditions caused by heritable and congenital disorders; 463.9 (4) discussion and assessment of the benefits of performing 463.10 tests for heritable or congenital disorders as compared to the 463.11 costs, treatment limitations, or other potential disadvantages 463.12 of requiring the tests; 463.13 (5) discussion and assessment of ethical considerations 463.14 surrounding the testing, treatment, and handling of data and 463.15 specimens generated by the testing requirements of sections 463.16 144.125 to 144.128; and 463.17 (6) providing advice and recommendations to the 463.18 commissioner concerning tests and treatments for heritable and 463.19 congenital disorders found in newborn children. 463.20 [EFFECTIVE DATE.] This section is effective the day 463.21 following final enactment. 463.22 Sec. 28. Minnesota Statutes 2002, section 144.128, is 463.23 amended to read: 463.24 144.128 [TREATMENT FOR POSITIVE DIAGNOSIS, REGISTRY OF463.25CASESCOMMISSIONER'S DUTIES.] 463.26 The commissioner shall: 463.27 (1) notify the physicians of newborns tested of the results 463.28 of the tests performed; 463.29(1)(2) makearrangementsreferrals for the necessary 463.30 treatment of diagnosed cases ofhemoglobinopathy,463.31phenylketonuria, and other inborn errors of metabolismheritable 463.32 or congenital disorders when treatment is indicatedand the463.33family is uninsured and, because of a lack of available income,463.34is unable to pay the cost of the treatment; 463.35(2)(3) maintain a registry of the cases of 463.36hemoglobinopathy, phenylketonuria, and other inborn errors of464.1metabolismheritable and congenital disorders detected by the 464.2 screening program for the purpose of follow-up services; and 464.3(3)(4) adopt rules to carry outsection 144.126 and this464.4sectionsections 144.125 to 144.128. 464.5 Sec. 29. Minnesota Statutes 2002, section 144.1481, 464.6 subdivision 1, is amended to read: 464.7 Subdivision 1. [ESTABLISHMENT; MEMBERSHIP.] The 464.8 commissioner of health shall establish a 15-member rural health 464.9 advisory committee. The committee shall consist of the 464.10 following members, all of whom must reside outside the 464.11 seven-county metropolitan area, as defined in section 473.121, 464.12 subdivision 2: 464.13 (1) two members from the house of representatives of the 464.14 state of Minnesota, one from the majority party and one from the 464.15 minority party; 464.16 (2) two members from the senate of the state of Minnesota, 464.17 one from the majority party and one from the minority party; 464.18 (3) a volunteer member of an ambulance service based 464.19 outside the seven-county metropolitan area; 464.20 (4) a representative of a hospital located outside the 464.21 seven-county metropolitan area; 464.22 (5) a representative of a nursing home located outside the 464.23 seven-county metropolitan area; 464.24 (6) a medical doctor or doctor of osteopathy licensed under 464.25 chapter 147; 464.26 (7) a midlevel practitioner; 464.27 (8) a registered nurse or licensed practical nurse; 464.28 (9) a licensed health care professional from an occupation 464.29 not otherwise represented on the committee; 464.30 (10) a representative of an institution of higher education 464.31 located outside the seven-county metropolitan area that provides 464.32 training for rural health care providers; and 464.33 (11) three consumers, at least one of whom must be an 464.34 advocate for persons who are mentally ill or developmentally 464.35 disabled. 464.36 The commissioner will make recommendations for committee 465.1 membership. Committee members will be appointed by the 465.2 governor. In making appointments, the governor shall ensure 465.3 that appointments provide geographic balance among those areas 465.4 of the state outside the seven-county metropolitan area. The 465.5 chair of the committee shall be elected by the members. The 465.6 advisory committee is governed by section 15.059, except that 465.7 the members do not receive per diem 465.8 compensation. Notwithstanding section 15.059, the advisory 465.9 committee does not expire. 465.10 Sec. 30. Minnesota Statutes 2002, section 144.1483, is 465.11 amended to read: 465.12 144.1483 [RURAL HEALTH INITIATIVES.] 465.13 The commissioner of health, through the office of rural 465.14 health, and consulting as necessary with the commissioner of 465.15 human services, the commissioner of commerce, the higher 465.16 education services office, and other state agencies, shall: 465.17 (1) develop a detailed plan regarding the feasibility of 465.18 coordinating rural health care services by organizing individual 465.19 medical providers and smaller hospitals and clinics into 465.20 referral networks with larger rural hospitals and clinics that 465.21 provide a broader array of services; 465.22 (2) develop and implement a program to assist rural 465.23 communities in establishing community health centers, as 465.24 required by section 144.1486; 465.25 (3)administer the program of financial assistance465.26established under section 144.1484 for rural hospitals in465.27isolated areas of the state that are in danger of closing465.28without financial assistance, and that have exhausted local465.29sources of support;465.30(4)develop recommendations regarding health education and 465.31 training programs in rural areas, including but not limited to a 465.32 physician assistants' training program, continuing education 465.33 programs for rural health care providers, and rural outreach 465.34 programs for nurse practitioners within existing training 465.35 programs; 465.36(5)(4) develop a statewide, coordinated recruitment 466.1 strategy for health care personnel and maintain a database on 466.2 health care personnel as required under section 144.1485; 466.3(6)(5) develop and administer technical assistance 466.4 programs to assist rural communities in: (i) planning and 466.5 coordinating the delivery of local health care services; and 466.6 (ii) hiring physicians, nurse practitioners, public health 466.7 nurses, physician assistants, and other health personnel; 466.8(7)(6) study and recommend changes in the regulation of 466.9 health care personnel, such as nurse practitioners and physician 466.10 assistants, related to scope of practice, the amount of on-site 466.11 physician supervision, and dispensing of medication, to address 466.12 rural health personnel shortages; 466.13(8)(7) support efforts to ensure continued funding for 466.14 medical and nursing education programs that will increase the 466.15 number of health professionals serving in rural areas; 466.16(9)(8) support efforts to secure higher reimbursement for 466.17 rural health care providers from the Medicare and medical 466.18 assistance programs; 466.19(10)(9) coordinate the development of a statewide plan for 466.20 emergency medical services, in cooperation with the emergency 466.21 medical services advisory council; 466.22(11)(10) establish a Medicare rural hospital flexibility 466.23 program pursuant to section 1820 of the federal Social Security 466.24 Act, United States Code, title 42, section 1395i-4, by 466.25 developing a state rural health plan and designating, consistent 466.26 with the rural health plan, rural nonprofit or public hospitals 466.27 in the state as critical access hospitals. Critical access 466.28 hospitals shall include facilities that are certified by the 466.29 state as necessary providers of health care services to 466.30 residents in the area. Necessary providers of health care 466.31 services are designated as critical access hospitals on the 466.32 basis of being more than 20 miles, defined as official mileage 466.33 as reported by the Minnesota department of transportation, from 466.34 the next nearest hospital, being the sole hospital in the 466.35 county, being a hospital located in a county with a designated 466.36 medically underserved area or health professional shortage area, 467.1 or being a hospital located in a county contiguous to a county 467.2 with a medically underserved area or health professional 467.3 shortage area. A critical access hospital located in a county 467.4 with a designated medically underserved area or a health 467.5 professional shortage area or in a county contiguous to a county 467.6 with a medically underserved area or health professional 467.7 shortage area shall continue to be recognized as a critical 467.8 access hospital in the event the medically underserved area or 467.9 health professional shortage area designation is subsequently 467.10 withdrawn; and 467.11(12)(11) carry out other activities necessary to address 467.12 rural health problems. 467.13 Sec. 31. Minnesota Statutes 2002, section 144.1488, 467.14 subdivision 4, is amended to read: 467.15 Subd. 4. [ELIGIBLE HEALTH PROFESSIONALS.] (a) To be 467.16 eligible to apply to the commissioner for the loan repayment 467.17 program, health professionals must be citizens or nationals of 467.18 the United States, must not have any unserved obligations for 467.19 service to a federal, state, or local government, or other 467.20 entity, must have a current and unrestricted Minnesota license 467.21 to practice, and must be ready to begin full-time clinical 467.22 practice upon signing a contract for obligated service. 467.23 (b) Eligible providers are those specified by the federal 467.24 Bureau ofPrimary Health CareHealth Professions in the policy 467.25 information notice for the state's current federal grant 467.26 application. A health professional selected for participation 467.27 is not eligible for loan repayment until the health professional 467.28 has an employment agreement or contract with an eligible loan 467.29 repayment site and has signed a contract for obligated service 467.30 with the commissioner. 467.31 Sec. 32. Minnesota Statutes 2002, section 144.1491, 467.32 subdivision 1, is amended to read: 467.33 Subdivision 1. [PENALTIES FOR BREACH OF CONTRACT.] A 467.34 program participant who fails to completetwothe required years 467.35 of obligated service shall repay the amount paid, as well as a 467.36 financial penaltybased upon the length of the service468.1obligation not fulfilled. If the participant has served at468.2least one year, the financial penalty is the number of unserved468.3months multiplied by $1,000. If the participant has served less468.4than one year, the financial penalty is the total number of468.5obligated months multiplied by $1,000specified by the federal 468.6 Bureau of Health Professions in the policy information notice 468.7 for the state's current federal grant application. The 468.8 commissioner shall report to the appropriate health-related 468.9 licensing board a participant who fails to complete the service 468.10 obligation and fails to repay the amount paid or fails to pay 468.11 any financial penalty owed under this subdivision. 468.12 Sec. 33. [144.1501] [HEALTH PROFESSIONAL EDUCATION LOAN 468.13 FORGIVENESS PROGRAM.] 468.14 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 468.15 section, the following definitions apply. 468.16 (b) "Designated rural area" means: 468.17 (1) an area in Minnesota outside the counties of Anoka, 468.18 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 468.19 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 468.20 and St. Cloud; or 468.21 (2) a municipal corporation, as defined under section 468.22 471.634, that is physically located, in whole or in part, in an 468.23 area defined as a designated rural area under clause (1). 468.24 (c) "Emergency circumstances" means those conditions that 468.25 make it impossible for the participant to fulfill the service 468.26 commitment, including death, total and permanent disability, or 468.27 temporary disability lasting more than two years. 468.28 (d) "Medical resident" means an individual participating in 468.29 a medical residency in family practice, internal medicine, 468.30 obstetrics and gynecology, pediatrics, or psychiatry. 468.31 (e) "Midlevel practitioner" means a nurse practitioner, 468.32 nurse-midwife, nurse anesthetist, advanced clinical nurse 468.33 specialist, or physician assistant. 468.34 (f) "Nurse" means an individual who has completed training 468.35 and received all licensing or certification necessary to perform 468.36 duties as a licensed practical nurse or registered nurse. 469.1 (g) "Nurse-midwife" means a registered nurse who has 469.2 graduated from a program of study designed to prepare registered 469.3 nurses for advanced practice as nurse-midwives. 469.4 (h) "Nurse practitioner" means a registered nurse who has 469.5 graduated from a program of study designed to prepare registered 469.6 nurses for advanced practice as nurse practitioners. 469.7 (i) "Physician" means an individual who is licensed to 469.8 practice medicine in the areas of family practice, internal 469.9 medicine, obstetrics and gynecology, pediatrics, or psychiatry. 469.10 (j) "Physician assistant" means a person registered under 469.11 chapter 147A. 469.12 (k) "Qualified educational loan" means a government, 469.13 commercial, or foundation loan for actual costs paid for 469.14 tuition, reasonable education expenses, and reasonable living 469.15 expenses related to the graduate or undergraduate education of a 469.16 health care professional. 469.17 (l) "Underserved urban community" means a Minnesota urban 469.18 area or population included in the list of designated primary 469.19 medical care health professional shortage areas (HPSAs), 469.20 medically underserved areas (MUAs), or medically underserved 469.21 populations (MUPs) maintained and updated by the United States 469.22 Department of Health and Human Services. 469.23 Subd. 2. [CREATION OF ACCOUNT.] A health professional 469.24 education loan forgiveness program account is established. The 469.25 commissioner of health shall use money from the account to 469.26 establish a loan forgiveness program for medical residents 469.27 agreeing to practice in designated rural areas or underserved 469.28 urban communities, for midlevel practitioners agreeing to 469.29 practice in designated rural areas, and for nurses who agree to 469.30 practice in a Minnesota nursing home or intermediate care 469.31 facility for persons with mental retardation or related 469.32 conditions. Appropriations made to the account do not cancel 469.33 and are available until expended, except that at the end of each 469.34 biennium, any remaining balance in the account that is not 469.35 committed by contract and not needed to fulfill existing 469.36 commitments shall cancel to the fund. 470.1 Subd. 3. [ELIGIBILITY.] (a) To be eligible to participate 470.2 in the loan forgiveness program, an individual must: 470.3 (1) be a medical resident or be enrolled in a midlevel 470.4 practitioner, registered nurse, or a licensed practical nurse 470.5 training program; and 470.6 (2) submit an application to the commissioner of health. 470.7 (b) An applicant selected to participate must sign a 470.8 contract to agree to serve a minimum three-year full-time 470.9 service obligation according to subdivision 2, which shall begin 470.10 no later than March 31 following completion of required training. 470.11 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 470.12 may select applicants each year for participation in the loan 470.13 forgiveness program, within the limits of available funding. 470.14 The commissioner shall distribute available funds for loan 470.15 forgiveness proportionally among the eligible professions 470.16 according to the vacancy rate for each profession in the 470.17 required geographic area or facility type specified in 470.18 subdivision 2. The commissioner shall allocate funds for 470.19 physician loan forgiveness so that 75 percent of the funds 470.20 available are used for rural physician loan forgiveness and 25 470.21 percent of the funds available are used for underserved urban 470.22 communities loan forgiveness. If the commissioner does not 470.23 receive enough qualified applicants each year to use the entire 470.24 allocation of funds for urban underserved communities, the 470.25 remaining funds may be allocated for rural physician loan 470.26 forgiveness. Applicants are responsible for securing their own 470.27 qualified educational loans. The commissioner shall select 470.28 participants based on their suitability for practice serving the 470.29 required geographic area or facility type specified in 470.30 subdivision 2, as indicated by experience or training. The 470.31 commissioner shall give preference to applicants closest to 470.32 completing their training. For each year that a participant 470.33 meets the service obligation required under subdivision 3, up to 470.34 a maximum of four years, the commissioner shall make annual 470.35 disbursements directly to the participant equivalent to 15 470.36 percent of the average educational debt for indebted graduates 471.1 in their profession in the year closest to the applicant's 471.2 selection for which information is available, not to exceed the 471.3 balance of the participant's qualifying educational loans. 471.4 Before receiving loan repayment disbursements and as requested, 471.5 the participant must complete and return to the commissioner an 471.6 affidavit of practice form provided by the commissioner 471.7 verifying that the participant is practicing as required under 471.8 subdivisions 2 and 3. The participant must provide the 471.9 commissioner with verification that the full amount of loan 471.10 repayment disbursement received by the participant has been 471.11 applied toward the designated loans. After each disbursement, 471.12 verification must be received by the commissioner and approved 471.13 before the next loan repayment disbursement is made. 471.14 Participants who move their practice remain eligible for loan 471.15 repayment as long as they practice as required under subdivision 471.16 2. 471.17 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 471.18 does not fulfill the required minimum commitment of service 471.19 according to subdivision 3, the commissioner of health shall 471.20 collect from the participant the total amount paid to the 471.21 participant under the loan forgiveness program plus interest at 471.22 a rate established according to section 270.75. The 471.23 commissioner shall deposit the money collected in the health 471.24 care access fund to be credited to the health professional 471.25 education loan forgiveness program account established in 471.26 subdivision 2. The commissioner shall allow waivers of all or 471.27 part of the money owed the commissioner as a result of a 471.28 nonfulfillment penalty if emergency circumstances prevented 471.29 fulfillment of the minimum service commitment. 471.30 Subd. 6. [RULES.] The commissioner may adopt rules to 471.31 implement this section. 471.32 Sec. 34. Minnesota Statutes 2002, section 144.1502, 471.33 subdivision 4, is amended to read: 471.34 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 471.35 may acceptup to 14applicantspereach year for participation 471.36 in the loan forgiveness program, within the limits of available 472.1 funding. Applicants are responsible for securing their own 472.2 loans. The commissioner shall select participants based on 472.3 their suitability for practice serving public program patients, 472.4 as indicated by experience or training. The commissioner shall 472.5 give preference to applicants who have attended a Minnesota 472.6 dentistry educational institution and to applicants closest to 472.7 completing their training. For each year that a participant 472.8 meets the service obligation required under subdivision 3, up to 472.9 a maximum of four years, the commissioner shall make annual 472.10 disbursements directly to the participant equivalent to$10,000472.11per year of service, not to exceed $40,00015 percent of the 472.12 average educational debt for indebted dental school graduates in 472.13 the year closest to the applicant's selection for which 472.14 information is available or the balance of the qualifying 472.15 educational loans, whichever is less. Before receiving loan 472.16 repayment disbursements and as requested, the participant must 472.17 complete and return to the commissioner an affidavit of practice 472.18 form provided by the commissioner verifying that the participant 472.19 is practicing as required under subdivision 3. The participant 472.20 must provide the commissioner with verification that the full 472.21 amount of loan repayment disbursement received by the 472.22 participant has been applied toward the designated loans. After 472.23 each disbursement, verification must be received by the 472.24 commissioner and approved before the next loan repayment 472.25 disbursement is made. Participants who move their practice 472.26 remain eligible for loan repayment as long as they practice as 472.27 required under subdivision 3. 472.28 Sec. 35. Minnesota Statutes 2002, section 144.396, 472.29 subdivision 1, is amended to read: 472.30 Subdivision 1. [PURPOSE.] The legislature finds that it is 472.31 important to reduce the prevalence of tobacco use among the 472.32 youth of this state. It is a goal of the state to reduce 472.33 tobacco use among youth by3025 percent by the year 2005, and 472.34 to promote statewide and local tobacco use prevention activities 472.35 to achieve this goal. 472.36 Sec. 36. Minnesota Statutes 2002, section 144.396, 473.1 subdivision 5, is amended to read: 473.2 Subd. 5. [STATEWIDE TOBACCO PREVENTION GRANTS.] (a) To the 473.3 extent funds are appropriated for the purposes of this 473.4 subdivision, the commissioner of health shall award competitive 473.5 grants to eligible applicants for projects and initiatives 473.6 directed at the prevention of tobacco use. The project areas 473.7 for grants include: 473.8 (1) statewide public education and information campaigns 473.9 which include implementation at the local level; and 473.10 (2) coordinated special projects, including training and 473.11 technical assistance, a resource clearinghouse, and contracts 473.12 with ethnic and minority communities. 473.13 (b) Eligible applicants may include, but are not limited 473.14 to, nonprofit organizations, colleges and universities, 473.15 professional health associations, community health boards, and 473.16 other health care organizations. Applicants must submit 473.17 proposals to the commissioner. The proposals must specify the 473.18 strategies to be implemented to target tobacco use among youth, 473.19 and must take into account the need for a coordinated statewide 473.20 tobacco prevention effort. 473.21 (c) The commissioner must give priority to applicants who 473.22 demonstrate that the proposed project: 473.23 (1) is research based or based on proven effective 473.24 strategies; 473.25 (2) is designed to coordinate with other activities and 473.26 education messages related to other health initiatives; 473.27 (3) utilizes and enhances existing prevention activities 473.28 and resources; or 473.29 (4) involves innovative approaches preventing tobacco use 473.30 among youth. 473.31 Sec. 37. Minnesota Statutes 2002, section 144.396, 473.32 subdivision 7, is amended to read: 473.33 Subd. 7. [LOCAL PUBLIC HEALTH PROMOTION AND PROTECTION.] 473.34 The commissioner shall distributethefundsavailable under473.35section 144.395, subdivision 2, paragraph (c), clause473.36(3)appropriated for the purpose of local health promotion and 474.1 protection activities to community health boardsfor local474.2health promotion and protection activitiesfor local health 474.3 initiatives other than tobacco prevention aimed at high risk 474.4 health behaviors among youth. The commissioner shall distribute 474.5 these funds to the community health boards based on demographics 474.6 and other need-based factors relating to health. 474.7 Sec. 38. Minnesota Statutes 2002, section 144.396, 474.8 subdivision 10, is amended to read: 474.9 Subd. 10. [REPORT.] The commissioner of health shall 474.10 submitan annuala biennial report to the chairs and members of 474.11 the house health and human services finance committee and the 474.12 senate health and family security budget division on the 474.13 statewide and local projects and community health board 474.14 prevention activities funded under this section. These reports 474.15 must include information on grant recipients, activities that 474.16 were conducted using grant funds, and evaluation data and 474.17 outcome measures, if available. These reports are due by 474.18 January 15 ofeach yearthe odd-numbered years, beginning in 474.19 2001. 474.20 Sec. 39. Minnesota Statutes 2002, section 144.396, 474.21 subdivision 11, is amended to read: 474.22 Subd. 11. [AUDITS.] The legislative auditorshallmay 474.23 audit tobacco use prevention and local public healthendowment474.24fundexpenditures to ensure that the money is spent for tobacco 474.25 use prevention measures and public health initiatives. 474.26 Sec. 40. Minnesota Statutes 2002, section 144.396, 474.27 subdivision 12, is amended to read: 474.28 Subd. 12. [ENDOWMENT FUNDFUNDS NOT TO SUPPLANT EXISTING 474.29 FUNDING.]Appropriations from the tobacco use prevention and474.30local public health endowment fundFunds appropriated to the 474.31 statewide tobacco prevention grants, local tobacco prevention 474.32 grants, or the local public health promotion and prevention must 474.33 not be used as a substitute for traditional sources of funding 474.34 tobacco use prevention activities or public health initiatives. 474.35 Any local unit of government receiving money under this section 474.36 must ensure that existing local financial efforts remain in 475.1 place. 475.2 Sec. 41. Minnesota Statutes 2002, section 144.414, 475.3 subdivision 3, is amended to read: 475.4 Subd. 3. [HEALTH CARE FACILITIES AND CLINICS.] (a) Smoking 475.5 is prohibited in any area of a hospital, health care clinic, 475.6 doctor's office, or other health care-related facility, other 475.7 than a nursing home, boarding care facility, or licensed 475.8 residential facility, except as allowed in this subdivision. 475.9 (b)Smoking by patients in a chemical dependency treatment475.10program or mental health program may be allowed in a separated475.11well-ventilated area pursuant to a policy established by the475.12administrator of the program that identifies circumstances in475.13which prohibiting smoking would interfere with the treatment of475.14persons recovering from chemical dependency or mental illness.475.15(c)Smoking by participants in peer reviewed scientific 475.16 studies related to the health effects of smoking may be allowed 475.17 in a separated room ventilated at a rate of 60 cubic feet per 475.18 minute per person pursuant to a policy that is approved by the 475.19 commissioner and is established by the administrator of the 475.20 program to minimize exposure of nonsmokers to smoke. 475.21 [EFFECTIVE DATE.] This section is effective January 1, 2004. 475.22 Sec. 42. [144.5509] [RADIATION THERAPY FACILITY 475.23 CONSTRUCTION.] 475.24 (a) A radiation therapy facility may be constructed only by 475.25 an entity owned, operated, or controlled by a hospital licensed 475.26 according to sections 144.50 to 144.56 either alone or in 475.27 cooperation with another entity. 475.28 (b) This section expires August 1, 2008. 475.29 [EFFECTIVE DATE.] This section is effective the day 475.30 following final enactment and applies to construction commenced 475.31 on or after that date. 475.32 Sec. 43. Minnesota Statutes 2002, section 144.551, 475.33 subdivision 1, is amended to read: 475.34 Subdivision 1. [RESTRICTED CONSTRUCTION OR MODIFICATION.] 475.35 (a) The following construction or modification may not be 475.36 commenced: 476.1 (1) any erection, building, alteration, reconstruction, 476.2 modernization, improvement, extension, lease, or other 476.3 acquisition by or on behalf of a hospital that increases the bed 476.4 capacity of a hospital, relocates hospital beds from one 476.5 physical facility, complex, or site to another, or otherwise 476.6 results in an increase or redistribution of hospital beds within 476.7 the state; and 476.8 (2) the establishment of a new hospital. 476.9 (b) This section does not apply to: 476.10 (1) construction or relocation within a county by a 476.11 hospital, clinic, or other health care facility that is a 476.12 national referral center engaged in substantial programs of 476.13 patient care, medical research, and medical education meeting 476.14 state and national needs that receives more than 40 percent of 476.15 its patients from outside the state of Minnesota; 476.16 (2) a project for construction or modification for which a 476.17 health care facility held an approved certificate of need on May 476.18 1, 1984, regardless of the date of expiration of the 476.19 certificate; 476.20 (3) a project for which a certificate of need was denied 476.21 before July 1, 1990, if a timely appeal results in an order 476.22 reversing the denial; 476.23 (4) a project exempted from certificate of need 476.24 requirements by Laws 1981, chapter 200, section 2; 476.25 (5) a project involving consolidation of pediatric 476.26 specialty hospital services within the Minneapolis-St. Paul 476.27 metropolitan area that would not result in a net increase in the 476.28 number of pediatric specialty hospital beds among the hospitals 476.29 being consolidated; 476.30 (6) a project involving the temporary relocation of 476.31 pediatric-orthopedic hospital beds to an existing licensed 476.32 hospital that will allow for the reconstruction of a new 476.33 philanthropic, pediatric-orthopedic hospital on an existing site 476.34 and that will not result in a net increase in the number of 476.35 hospital beds. Upon completion of the reconstruction, the 476.36 licenses of both hospitals must be reinstated at the capacity 477.1 that existed on each site before the relocation; 477.2 (7) the relocation or redistribution of hospital beds 477.3 within a hospital building or identifiable complex of buildings 477.4 provided the relocation or redistribution does not result in: 477.5 (i) an increase in the overall bed capacity at that site; (ii) 477.6 relocation of hospital beds from one physical site or complex to 477.7 another; or (iii) redistribution of hospital beds within the 477.8 state or a region of the state; 477.9 (8) relocation or redistribution of hospital beds within a 477.10 hospital corporate system that involves the transfer of beds 477.11 from a closed facility site or complex to an existing site or 477.12 complex provided that: (i) no more than 50 percent of the 477.13 capacity of the closed facility is transferred; (ii) the 477.14 capacity of the site or complex to which the beds are 477.15 transferred does not increase by more than 50 percent; (iii) the 477.16 beds are not transferred outside of a federal health systems 477.17 agency boundary in place on July 1, 1983; and (iv) the 477.18 relocation or redistribution does not involve the construction 477.19 of a new hospital building; 477.20 (9) a construction project involving up to 35 new beds in a 477.21 psychiatric hospital in Rice county that primarily serves 477.22 adolescents and that receives more than 70 percent of its 477.23 patients from outside the state of Minnesota; 477.24 (10) a project to replace a hospital or hospitals with a 477.25 combined licensed capacity of 130 beds or less if: (i) the new 477.26 hospital site is located within five miles of the current site; 477.27 and (ii) the total licensed capacity of the replacement 477.28 hospital, either at the time of construction of the initial 477.29 building or as the result of future expansion, will not exceed 477.30 70 licensed hospital beds, or the combined licensed capacity of 477.31 the hospitals, whichever is less; 477.32 (11) the relocation of licensed hospital beds from an 477.33 existing state facility operated by the commissioner of human 477.34 services to a new or existing facility, building, or complex 477.35 operated by the commissioner of human services; from one 477.36 regional treatment center site to another; or from one building 478.1 or site to a new or existing building or site on the same 478.2 campus; 478.3 (12) the construction or relocation of hospital beds 478.4 operated by a hospital having a statutory obligation to provide 478.5 hospital and medical services for the indigent that does not 478.6 result in a net increase in the number of hospital beds; 478.7 (13) a construction project involving the addition of up to 478.8 31 new beds in an existing nonfederal hospital in Beltrami 478.9 county;or478.10 (14) a construction project involving the addition of up to 478.11 eight new beds in an existing nonfederal hospital in Otter Tail 478.12 county with 100 licensed acute care beds; 478.13 (15) a construction project involving the addition of 20 478.14 new hospital beds used for rehabilitation services in an 478.15 existing hospital in Carver county serving the southwest 478.16 suburban metropolitan area. Beds constructed under this clause 478.17 shall not be eligible for reimbursement under medical 478.18 assistance, general assistance medical care, or MinnesotaCare; 478.19 or 478.20 (16) a project for the construction or relocation of up to 478.21 20 hospital beds for the operation of up to two psychiatric 478.22 facilities or units for children provided that the operation of 478.23 the facilities or units have received the approval of the 478.24 commissioner of human services. 478.25 Sec. 44. Minnesota Statutes 2002, section 144E.50, 478.26 subdivision 5, is amended to read: 478.27 Subd. 5. [DISTRIBUTION.] Money from the fund shall be 478.28 distributed according to this subdivision.Ninety-three and478.29one-thirdNinety-five percent of the fund shall be distributed 478.30 annually on a contract for services basis with each of the eight 478.31 regional emergency medical services systems designated by the 478.32 board. The systems shall be governed by a body consisting of 478.33 appointed representatives from each of the counties in that 478.34 region and shall also include representatives from emergency 478.35 medical services organizations. The board shall contract with a 478.36 regional entity only if the contract proposal satisfactorily 479.1 addresses proposed emergency medical services activities in the 479.2 following areas: personnel training, transportation 479.3 coordination, public safety agency cooperation, communications 479.4 systems maintenance and development, public involvement, health 479.5 care facilities involvement, and system management. If each of 479.6 the regional emergency medical services systems submits a 479.7 satisfactory contract proposal, then this part of the fund shall 479.8 be distributed evenly among the regions. If one or more of the 479.9 regions does not contract for the full amount of its even share 479.10 or if its proposal is unsatisfactory, then the board may 479.11 reallocate the unused funds to the remaining regions on a pro 479.12 rata basis.Six and two-thirdsFive percent of the fund shall 479.13 be used by the board to support regionwide reporting systems and 479.14 to provide other regional administration and technical 479.15 assistance. 479.16 Sec. 45. Minnesota Statutes 2002, section 145.881, 479.17 subdivision 1, is amended to read: 479.18 Subdivision 1. [COMPOSITION OF TASK FORCE.] The 479.19 commissioner shall establish and appoint a maternal and child 479.20 health advisory task force consisting of 15 members who will 479.21 provide equal representation from: 479.22 (1) professionals with expertise in maternal and child 479.23 health services; 479.24 (2) representatives of community health boards as defined 479.25 in section 145A.02, subdivision 5; and 479.26 (3) consumer representatives interested in the health of 479.27 mothers and children. 479.28 No members shall be employees of the state department of 479.29 health. Section 15.059 governs the maternal and child health 479.30 advisory task force. Notwithstanding section 15.059, the 479.31 maternal and child health advisory task force expires June 30, 479.32 2007. 479.33 Sec. 46. Minnesota Statutes 2002, section 145A.10, 479.34 subdivision 10, is amended to read: 479.35 Subd. 10. [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A 479.36 state community health advisory committee is established to 480.1 advise, consult with, and make recommendations to the 480.2 commissioner on the development, maintenance, funding, and 480.3 evaluation of community health services. Each community health 480.4 board may appoint a member to serve on the committee. The 480.5 committee must meet at least quarterly, and special meetings may 480.6 be called by the committee chair or a majority of the members. 480.7 Members or their alternates may receive a per diem and must be 480.8 reimbursed for travel and other necessary expenses while engaged 480.9 in their official duties. Notwithstanding section 15.059, the 480.10 state community health advisory committee does not expire. 480.11 (b) The city councils or county boards that have 480.12 established or are members of a community health board must 480.13 appoint a community health advisory committee to advise, consult 480.14 with, and make recommendations to the community health board on 480.15 matters relating to the development, maintenance, funding, and 480.16 evaluation of community health services. The committee must 480.17 consist of at least five members and must be generally 480.18 representative of the population and health care providers of 480.19 the community health service area. The committee must meet at 480.20 least three times a year and at the call of the chair or a 480.21 majority of the members. Members may receive a per diem and 480.22 reimbursement for travel and other necessary expenses while 480.23 engaged in their official duties. 480.24 (c) State and local advisory committees must adopt bylaws 480.25 or operating procedures that specify the length of terms of 480.26 membership, procedures for assuring that no more than half of 480.27 these terms expire during the same year, and other matters 480.28 relating to the conduct of committee business. Bylaws or 480.29 operating procedures may allow one alternate to be appointed for 480.30 each member of a state or local advisory committee. Alternates 480.31 may be given full or partial powers and duties of members. 480.32 Sec. 47. Minnesota Statutes 2002, section 147A.08, is 480.33 amended to read: 480.34 147A.08 [EXEMPTIONS.] 480.35 (a) This chapter does not apply to, control, prevent, or 480.36 restrict the practice, service, or activities of persons listed 481.1 in section 147.09, clauses (1) to (6) and (8) to (13), persons 481.2 regulated under section 214.01, subdivision 2, or persons 481.3 defined in section144.1495144.1501, subdivision 1, 481.4 paragraphs(a) to (d)(e), (g), and (h). 481.5 (b) Nothing in this chapter shall be construed to require 481.6 registration of: 481.7 (1) a physician assistant student enrolled in a physician 481.8 assistant or surgeon assistant educational program accredited by 481.9 the Committee on Allied Health Education and Accreditation or by 481.10 its successor agency approved by the board; 481.11 (2) a physician assistant employed in the service of the 481.12 federal government while performing duties incident to that 481.13 employment; or 481.14 (3) technicians, other assistants, or employees of 481.15 physicians who perform delegated tasks in the office of a 481.16 physician but who do not identify themselves as a physician 481.17 assistant. 481.18 Sec. 48. Minnesota Statutes 2002, section 148.5194, 481.19 subdivision 1, is amended to read: 481.20 Subdivision 1. [FEE PRORATION.] The commissioner shall 481.21 prorate the registration fee for clinical fellowship, temporary, 481.22 and first time registrants according to the number of months 481.23 that have elapsed between the date registration is issued and 481.24 the date registration expires or must be renewed under section 481.25 148.5191, subdivision 4. 481.26 Sec. 49. Minnesota Statutes 2002, section 148.5194, 481.27 subdivision 2, is amended to read: 481.28 Subd. 2. [BIENNIAL REGISTRATION FEE.] The fee for initial 481.29 registration and biennial registration, clinical fellowship 481.30 registration, temporary registration, or renewal is $200. 481.31 Sec. 50. Minnesota Statutes 2002, section 148.5194, 481.32 subdivision 3, is amended to read: 481.33 Subd. 3. [BIENNIAL REGISTRATION FEE FOR DUAL 481.34 REGISTRATION.] The fee for initial registration and biennial 481.35 registration, clinical fellowship registration, temporary 481.36 registration, or renewal is $200. 482.1 Sec. 51. Minnesota Statutes 2002, section 148.5194, is 482.2 amended by adding a subdivision to read: 482.3 Subd. 6. [VERIFICATION OF CREDENTIAL.] The fee for written 482.4 verification of credentialed status is $25. 482.5 Sec. 52. Minnesota Statutes 2002, section 148.6445, 482.6 subdivision 7, is amended to read: 482.7 Subd. 7. [CERTIFICATIONVERIFICATION TO OTHER STATES.] The 482.8 fee forcertificationverification of licensure to other states 482.9 is $25. 482.10 Sec. 53. [148C.12] [FEES.] 482.11 Subdivision 1. [APPLICATION FEE.] The application fee is 482.12 $295. 482.13 Subd. 2. [BIENNIAL RENEWAL FEE.] The license renewal fee 482.14 is $295. If the commissioner changes the renewal schedule and 482.15 the expiration date is less than two years, the fee must be 482.16 prorated. 482.17 Subd. 3. [TEMPORARY PERMIT FEE.] The initial fee for 482.18 applicants under section 148C.04, subdivision 6, paragraph (a), 482.19 is $100. The fee for annual renewal of a temporary permit is 482.20 $100. 482.21 Subd. 4. [EXAMINATION FEE.] The examination fee for the 482.22 written examination is $95 and for the oral examination is $200. 482.23 Subd. 5. [INACTIVE RENEWAL FEE.] The inactive renewal fee 482.24 is $150. 482.25 Subd. 6. [LATE FEE.] The late fee is 25 percent of the 482.26 biennial renewal fee, the inactive renewal fee, or the annual 482.27 fee for renewal of temporary practice status. 482.28 Subd. 7. [FEE TO RENEW AFTER EXPIRATION OF LICENSE.] The 482.29 fee for renewal of a license that has expired for less than two 482.30 years is the total of the biennial renewal fee, the late fee, 482.31 and a fee of $100 for review and approval of the continuing 482.32 education report. 482.33 Subd. 8. [FEE FOR LICENSE VERIFICATIONS.] The fee for 482.34 license verification to institutions and other jurisdictions is 482.35 $25. 482.36 Subd. 9. [SURCHARGE FEE.] Notwithstanding section 483.1 16A.1285, subdivision 2, a surcharge of $99 shall be paid at the 483.2 time of initial application for or renewal of an alcohol and 483.3 drug counselor license until June 30, 2013. 483.4 Subd. 10. [NONREFUNDABLE FEES.] All fees are nonrefundable. 483.5 Sec. 54. Minnesota Statutes 2002, section 153A.17, is 483.6 amended to read: 483.7 153A.17 [EXPENSES; FEES.] 483.8 The expenses for administering the certification 483.9 requirements including the complaint handling system for hearing 483.10 aid dispensers in sections 153A.14 and 153A.15 and the consumer 483.11 information center under section 153A.18 must be paid from 483.12 initial application and examination fees, renewal fees, 483.13 penalties, and fines. All fees are nonrefundable. The 483.14 certificate application fee is$165 for audiologists registered483.15under section 148.511 and $490 for all others$350, the 483.16 examination fee is$200$250 for the written portion and 483.17$200$250 for the practical portion each time one or the other 483.18 is taken, and the trainee application fee 483.19 is$100$200.Notwithstanding the policy set forth in section483.2016A.1285, subdivision 2, a surcharge of $165 for audiologists483.21registered under section 148.511 and $330 for all others shall483.22be paid at the time of application or renewal until June 30,483.232003, to recover the commissioner's accumulated direct483.24expenditures for administering the requirements of this483.25chapter.The penalty fee for late submission of a renewal 483.26 application is $200. The fee for verification of certification 483.27 to other jurisdictions or entities is $25. All fees, penalties, 483.28 and fines received must be deposited in the state government 483.29 special revenue fund. The commissioner may prorate the 483.30 certification fee for new applicants based on the number of 483.31 quarters remaining in the annual certification period. 483.32 Sec. 55. Minnesota Statutes 2002, section 239.761, 483.33 subdivision 3, is amended to read: 483.34 Subd. 3. [GASOLINE.] (a) Gasoline that is not blended with 483.35 ethanol must not be contaminated with water or other impurities 483.36 and must comply with ASTM specificationD 4814-96D4814-01. 484.1 Gasoline that is not blended with ethanol must also comply with 484.2 the volatility requirements in Code of Federal Regulations, 484.3 title 40, part 80. 484.4 (b) After gasoline is sold, transferred, or otherwise 484.5 removed from a refinery or terminal, a person responsible for 484.6 the product: 484.7 (1) may blend the gasoline with agriculturally derived 484.8 ethanol as provided in subdivision 4; 484.9 (2) shall not blend the gasoline with any oxygenate other 484.10 than denatured, agriculturally derived ethanol; 484.11 (3) shall not blend the gasoline with other petroleum 484.12 products that are not gasoline or denatured, agriculturally 484.13 derived ethanol; 484.14 (4) shall not blend the gasoline with products commonly and 484.15 commercially known as casinghead gasoline, absorption gasoline, 484.16 condensation gasoline, drip gasoline, or natural gasoline; and 484.17 (5) may blend the gasoline with a detergent additive, an 484.18 antiknock additive, or an additive designed to replace 484.19 tetra-ethyl lead, that is registered by the EPA. 484.20 Sec. 56. Minnesota Statutes 2002, section 239.761, 484.21 subdivision 4, is amended to read: 484.22 Subd. 4. [GASOLINE BLENDED WITH ETHANOL.] (a) Gasoline may 484.23 be blended with up to ten percent, by volume, agriculturally 484.24 derived, denatured ethanol that complies with the requirements 484.25 of subdivision 5. 484.26 (b) A gasoline-ethanol blend must: 484.27 (1) comply with the volatility requirements in Code of 484.28 Federal Regulations, title 40, part 80; 484.29 (2) comply with ASTM specificationD 4814-96D4814-01, or 484.30 the gasoline base stock from which a gasoline-ethanol blend was 484.31 produced must comply with ASTM specificationD 4814-96D4814-01; 484.32 and 484.33 (3) not be blended with casinghead gasoline, absorption 484.34 gasoline, condensation gasoline, drip gasoline, or natural 484.35 gasoline after the gasoline-ethanol blend has been sold, 484.36 transferred, or otherwise removed from a refinery or terminal. 485.1 Sec. 57. Minnesota Statutes 2002, section 239.761, 485.2 subdivision 5, is amended to read: 485.3 Subd. 5. [DENATURED ETHANOL.] Denatured ethanol that is to 485.4 be blended with gasoline must be agriculturally derived and must 485.5 comply with ASTM specificationD 4806-95bD4806-01. This 485.6 includes the requirement that ethanol may be denatured only as 485.7 specified in Code of Federal Regulations, title 27, parts 20 and 485.8 21. 485.9 Sec. 58. Minnesota Statutes 2002, section 239.761, 485.10 subdivision 6, is amended to read: 485.11 Subd. 6. [GASOLINE BLENDED WITH NONETHANOL OXYGENATE.] (a) 485.12 A person responsible for the product shall comply with the 485.13 following requirements: 485.14 (1) after July 1, 2000, gasoline containing in excess of 485.15 one-third of one percent, in total, ofthenonethanol oxygenates 485.16 listed in paragraph (b)maymust not be sold or offered for sale 485.17 at any time in this state; and 485.18 (2) after July 1, 2005, gasoline containing any of the 485.19 nonethanol oxygenates listed in paragraph (b)maymust not be 485.20 sold or offered for sale in this state. 485.21 (b) The oxygenates prohibited under paragraph (a) are: 485.22 (1) methyl tertiary butyl ether, as defined in section 485.23 296A.01, subdivision 34; 485.24 (2) ethyl tertiary butyl ether, as defined in section 485.25 296A.01, subdivision 18; or 485.26 (3) tertiary amyl methyl ether. 485.27 (c) Gasoline that is blended withana nonethanol oxygenate 485.28, other than denatured ethanol,must comply with ASTM 485.29 specificationD 4814-96D4814-01. Nonethanol oxygenates, other485.30than denatured ethanol,must not be blended into gasoline after 485.31 the gasoline has been sold, transferred, or otherwise removed 485.32 from a refinery or terminal. 485.33 Sec. 59. Minnesota Statutes 2002, section 239.761, 485.34 subdivision 7, is amended to read: 485.35 Subd. 7. [HEATING FUEL OIL.] Heating fuel oil must comply 485.36 with ASTM specificationD 396-96D396-01. 486.1 Sec. 60. Minnesota Statutes 2002, section 239.761, 486.2 subdivision 8, is amended to read: 486.3 Subd. 8. [DIESEL FUEL OIL.] Diesel fuel oil must comply 486.4 with ASTM specificationD 975-96aD975-01a. 486.5 Sec. 61. Minnesota Statutes 2002, section 239.761, 486.6 subdivision 9, is amended to read: 486.7 Subd. 9. [KEROSENE.] Kerosene must comply with ASTM 486.8 specificationD 3699-96aD3699-01. 486.9 Sec. 62. Minnesota Statutes 2002, section 239.761, 486.10 subdivision 10, is amended to read: 486.11 Subd. 10. [AVIATION GASOLINE.] Aviation gasoline must 486.12 comply with ASTM specificationD 910-96D910-00. 486.13 Sec. 63. Minnesota Statutes 2002, section 239.761, 486.14 subdivision 11, is amended to read: 486.15 Subd. 11. [AVIATION TURBINE FUEL, JET FUEL.] Aviation 486.16 turbine fuel and jet fuel must comply with ASTM specificationD486.171655-96cD1655-01. 486.18 Sec. 64. Minnesota Statutes 2002, section 239.761, 486.19 subdivision 12, is amended to read: 486.20 Subd. 12. [GAS TURBINE FUEL OIL.] Fuel oil for use in 486.21 nonaviation gas turbine engines must comply with ASTM 486.22 specificationD 2880-96aD2880-00. 486.23 Sec. 65. Minnesota Statutes 2002, section 239.761, 486.24 subdivision 13, is amended to read: 486.25 Subd. 13. [E85.] A blend of ethanol and gasoline, 486.26 containing at least 60 percent ethanol and not more than 85 486.27 percent ethanol, produced for use as a motor fuel in alternative 486.28 fuel vehicles as defined in section 296A.01, subdivision 5, must 486.29 comply with ASTM specificationD 5798-96D5798-99. 486.30 Sec. 66. Minnesota Statutes 2002, section 239.792, is 486.31 amended to read: 486.32 239.792 [GASOLINE OCTANE.] 486.33 Subdivision 1. [DISCLOSURE.] A manufacturer, hauler, 486.34 blender, agent, jobber, consignment agent, importer, or 486.35 distributor who sells, delivers, or distributes gasoline or 486.36 gasoline-oxygenate blends, shall provide, at the time of 487.1 delivery, a bill of lading or shipping manifest to the person 487.2 who receives the gasoline. The bill or manifest must state the 487.3 minimum octane of the gasoline delivered. The stated octane 487.4 number must be the average of the "motor method" octane number 487.5 and the "research method" octane number as determined by the 487.6 test methods in ASTM specificationD 4814-96D4814-01, or by a 487.7 test method adopted by department rule. 487.8 Subd. 2. [DISPENSER LABELING.] A person responsible for 487.9 the product shall clearly, conspicuously, and permanently label 487.10 each gasoline dispenser that is used to sell gasoline or 487.11 gasoline-oxygenate blends at retail or to dispense gasoline or 487.12 gasoline-oxygenate blends into the fuel supply tanks of motor 487.13 vehicles, with the minimum octane of the gasoline dispensed. 487.14 The label must meet the following requirements: 487.15 (a) The octane number displayed on the label must represent 487.16 the average of the "motor method" octane number and the 487.17 "research method" octane number as determined by the test 487.18 methods in ASTM specificationD 4814-96D4814-01, or by a test 487.19 method adopted by department rule. 487.20 (b) The label must be at least 2-1/2 inches high and three 487.21 inches wide, with a yellow background, black border, and black 487.22 figures and letters. 487.23 (c) The number representing the octane of the gasoline must 487.24 be at least one inch high. 487.25 (d) The label must include the words "minimum octane" and 487.26 the term "(R+M)/2" or "(RON+MON)/2." 487.27 Sec. 67. [246.0141] [TOBACCO USE PROHIBITED.] 487.28 No patient, staff, guest, or visitor on the grounds or in a 487.29 state regional treatment center, the Minnesota security 487.30 hospital, the Minnesota sex offender program, or the Minnesota 487.31 extended treatment options program may possess or use tobacco or 487.32 a tobacco related device. For the purposes of this section, 487.33 "tobacco" and "tobacco related device" have the meanings given 487.34 in section 609.685, subdivision 1. This section does not 487.35 prohibit the possession or use of tobacco or a tobacco related 487.36 device by an adult as part of a traditional Indian spiritual or 488.1 cultural ceremony. For purposes of this section, an Indian is a 488.2 person who is a member of an Indian tribe as defined in section 488.3 260.755, subdivision 12. 488.4 [EFFECTIVE DATE.] This section is effective January 1, 2004. 488.5 Sec. 68. Minnesota Statutes 2002, section 295.55, 488.6 subdivision 2, is amended to read: 488.7 Subd. 2. [ESTIMATED TAX; HOSPITALS; SURGICAL CENTERS.] (a) 488.8 Each hospital or surgical center must make estimated payments of 488.9 the taxes for the calendar year in monthly installments to the 488.10 commissioner within 15 days after the end of the month. 488.11 (b) Estimated tax payments are not required of hospitals or 488.12 surgical centers if: (1) the tax for the current calendar year 488.13 is less than $500; or (2) the tax for the previous calendar year 488.14 is less than $500, if the taxpayer had a tax liability and was 488.15 doing business the entire year; or (3) if a hospital has been488.16allowed a grant under section 144.1484, subdivision 2, for the488.17year. 488.18 (c) Underpayment of estimated installments bear interest at 488.19 the rate specified in section 270.75, from the due date of the 488.20 payment until paid or until the due date of the annual return 488.21 whichever comes first. An underpayment of an estimated 488.22 installment is the difference between the amount paid and the 488.23 lesser of (1) 90 percent of one-twelfth of the tax for the 488.24 calendar year or (2) one-twelfth of the total tax for the 488.25 previous calendar year if the taxpayer had a tax liability and 488.26 was doing business the entire year. 488.27 Sec. 69. Minnesota Statutes 2002, section 296A.01, 488.28 subdivision 2, is amended to read: 488.29 Subd. 2. [AGRICULTURAL ALCOHOL GASOLINE.] "Agricultural 488.30 alcohol gasoline" means a gasoline-ethanol blend of up to ten 488.31 percent agriculturally derived fermentation ethanol derived from 488.32 agricultural products, such as potatoes, cereal, grains, cheese 488.33 whey, sugar beets, forest products, or other renewable 488.34 resources, that: 488.35 (1) meets the specifications in ASTM specificationD488.364806-95bD4806-01; and 489.1 (2) is denatured as specified in Code of Federal 489.2 Regulations, title 27, parts 20 and 21. 489.3 Sec. 70. Minnesota Statutes 2002, section 296A.01, 489.4 subdivision 7, is amended to read: 489.5 Subd. 7. [AVIATION GASOLINE.] "Aviation gasoline" means 489.6 any gasoline that is capable of use for the purpose of producing 489.7 or generating power for propelling internal combustion engine 489.8 aircraft, that meets the specifications in ASTM specificationD489.9910-96D910-00, and that either: 489.10 (1) is invoiced and billed by a producer, manufacturer, 489.11 refiner, or blender to a distributor or dealer, by a distributor 489.12 to a dealer or consumer, or by a dealer to consumer, as 489.13 "aviation gasoline"; or 489.14 (2) whether or not invoiced and billed as provided in 489.15 clause (1), is received, sold, stored, or withdrawn from storage 489.16 by any person, to be used for the purpose of producing or 489.17 generating power for propelling internal combustion engine 489.18 aircraft. 489.19 Sec. 71. Minnesota Statutes 2002, section 296A.01, 489.20 subdivision 8, is amended to read: 489.21 Subd. 8. [AVIATION TURBINE FUEL AND JET FUEL.] "Aviation 489.22 turbine fuel" and "jet fuel" mean blends of hydrocarbons derived 489.23 from crude petroleum, natural gasoline, and synthetic 489.24 hydrocarbons, intended for use in aviation turbine engines, and 489.25 that meet the specifications in ASTM specificationD489.261655-96cD1655-01. 489.27 Sec. 72. Minnesota Statutes 2002, section 296A.01, 489.28 subdivision 14, is amended to read: 489.29 Subd. 14. [DIESEL FUEL OIL.] "Diesel fuel oil" means a 489.30 petroleum distillate or blend of petroleum distillate and 489.31 residual fuels, intended for use as a motor fuel in internal 489.32 combustion diesel engines, that meets the specifications in ASTM 489.33 specificationD 975-96aD975-01A. Diesel fuel includes number 1 489.34 and number 2 fuel oils. K-1 kerosene is not diesel fuel unless 489.35 it is blended with diesel fuel for use in motor vehicles. 489.36 Sec. 73. Minnesota Statutes 2002, section 296A.01, 490.1 subdivision 19, is amended to read: 490.2 Subd. 19. [E85.] "E85" means a petroleum product that is a 490.3 blend of agriculturally derived denatured ethanol and gasoline 490.4 or natural gasoline that typically contains 85 percent ethanol 490.5 by volume, but at a minimum must contain 60 percent ethanol by 490.6 volume. For the purposes of this chapter, the energy content of 490.7 E85 will be considered to be 82,000 BTUs per gallon. E85 490.8 produced for use as a motor fuel in alternative fuel vehicles as 490.9 defined in subdivision 5 must comply with ASTM specificationD490.105798-96D5798-99. 490.11 Sec. 74. Minnesota Statutes 2002, section 296A.01, 490.12 subdivision 20, is amended to read: 490.13 Subd. 20. [ETHANOL, DENATURED.] "Ethanol, denatured" means 490.14 ethanol that is to be blended with gasoline, has been 490.15 agriculturally derived, and complies with ASTM specificationD490.164806-95bD4806-01. This includes the requirement that ethanol 490.17 may be denatured only as specified in Code of Federal 490.18 Regulations, title 27, parts 20 and 21. 490.19 Sec. 75. Minnesota Statutes 2002, section 296A.01, 490.20 subdivision 22, is amended to read: 490.21 Subd. 22. [GAS TURBINE FUEL OIL.] "Gas turbine fuel oil" 490.22 means fuel that contains mixtures of hydrocarbon oils free of 490.23 inorganic acid and excessive amounts of solid or fibrous foreign 490.24 matter, intended for use in nonaviation gas turbine engines, and 490.25 that meets the specifications in ASTM specificationD 2880-96a490.26 D2880-00. 490.27 Sec. 76. Minnesota Statutes 2002, section 296A.01, 490.28 subdivision 23, is amended to read: 490.29 Subd. 23. [GASOLINE.] (a) "Gasoline" means: 490.30 (1) all products commonly or commercially known or sold as 490.31 gasoline regardless of their classification or uses, except 490.32 casinghead gasoline, absorption gasoline, condensation gasoline, 490.33 drip gasoline, or natural gasoline that under the requirements 490.34 of section 239.761, subdivision 3, must not be blended with 490.35 gasoline that has been sold, transferred, or otherwise removed 490.36 from a refinery or terminal; and 491.1 (2) any liquid prepared, advertised, offered for sale or 491.2 sold for use as, or commonly and commercially used as, a fuel in 491.3 spark-ignition, internal combustion engines, and that when 491.4 tested by the weights and measures division meets the 491.5 specifications in ASTM specificationD 4814-96D4814-01. 491.6 (b) Gasoline that is not blended with ethanol must not be 491.7 contaminated with water or other impurities and must comply with 491.8 both ASTM specificationD 4814-96D4814-01 and the volatility 491.9 requirements in Code of Federal Regulations, title 40, part 80. 491.10 (c) After gasoline is sold, transferred, or otherwise 491.11 removed from a refinery or terminal, a person responsible for 491.12 the product: 491.13 (1) may blend the gasoline with agriculturally derived 491.14 ethanol, as provided in subdivision 24; 491.15 (2) must not blend the gasoline with any oxygenate other 491.16 than denatured, agriculturally derived ethanol; 491.17 (3) must not blend the gasoline with other petroleum 491.18 products that are not gasoline or denatured, agriculturally 491.19 derived ethanol; 491.20 (4) must not blend the gasoline with products commonly and 491.21 commercially known as casinghead gasoline, absorption gasoline, 491.22 condensation gasoline, drip gasoline, or natural gasoline; and 491.23 (5) may blend the gasoline with a detergent additive, an 491.24 antiknock additive, or an additive designed to replace 491.25 tetra-ethyl lead, that is registered by the EPA. 491.26 Sec. 77. Minnesota Statutes 2002, section 296A.01, 491.27 subdivision 24, is amended to read: 491.28 Subd. 24. [GASOLINE BLENDED WITH NONETHANOL OXYGENATE.] 491.29 "Gasoline blended with nonethanol oxygenate" means gasoline 491.30 blended with ETBE, MTBE, or other alcohol or ether, except 491.31 denatured ethanol, that is approved as an oxygenate by the EPA, 491.32 and that complies with ASTM specificationD 4814-96D4814-01. 491.33 Oxygenates, other than denatured ethanol, must not be blended 491.34 into gasoline after the gasoline has been sold, transferred, or 491.35 otherwise removed from a refinery or terminal. 491.36 Sec. 78. Minnesota Statutes 2002, section 296A.01, 492.1 subdivision 25, is amended to read: 492.2 Subd. 25. [GASOLINE BLENDED WITH ETHANOL.] "Gasoline 492.3 blended with ethanol" means gasoline blended with up to ten 492.4 percent, by volume, agriculturally derived, denatured ethanol. 492.5 The blend must comply with the volatility requirements in Code 492.6 of Federal Regulations, title 40, part 80. The blend must also 492.7 comply with ASTM specificationD 4814-96D4814-01, or the 492.8 gasoline base stock from which a gasoline-ethanol blend was 492.9 produced must comply with ASTM specificationD 4814-96D4814-01; 492.10 and the gasoline-ethanol blend must not be blended with 492.11 casinghead gasoline, absorption gasoline, condensation gasoline, 492.12 drip gasoline, or natural gasoline after the gasoline-ethanol 492.13 blend has been sold, transferred, or otherwise removed from a 492.14 refinery or terminal. The blend need not comply with ASTM 492.15 specificationD 4814-96D4814-01 if it is subjected to a 492.16 standard distillation test. For a distillation test, a 492.17 gasoline-ethanol blend is not required to comply with the 492.18 temperature specification at the 50 percent liquid recovery 492.19 point, if the gasoline from which the gasoline-ethanol blend was 492.20 produced complies with all of the distillation specifications. 492.21 Sec. 79. Minnesota Statutes 2002, section 296A.01, 492.22 subdivision 26, is amended to read: 492.23 Subd. 26. [HEATING FUEL OIL.] "Heating fuel oil" means a 492.24 petroleum distillate, blend of petroleum distillates and 492.25 residuals, or petroleum residual heating fuel that meets the 492.26 specifications in ASTM specificationD 396-96D396-01. 492.27 Sec. 80. Minnesota Statutes 2002, section 296A.01, 492.28 subdivision 28, is amended to read: 492.29 Subd. 28. [KEROSENE.] "Kerosene" means a refined petroleum 492.30 distillate consisting of a homogeneous mixture of hydrocarbons 492.31 essentially free of water, inorganic acidic and basic compounds, 492.32 and excessive amounts of particulate contaminants and that meets 492.33 the specifications in ASTM specificationD 3699-96aD3699-01. 492.34 Sec. 81. Minnesota Statutes 2002, section 296A.01, is 492.35 amended by adding a subdivision to read: 492.36 Subd. 38a. [NONETHANOL OXYGENATE.] "Nonethanol oxygenate" 493.1 means ETBE or MTBE, as defined in this section, or other alcohol 493.2 or ether, except denatured ethanol, that is approved as an 493.3 oxygenate by the EPA. 493.4 Sec. 82. Minnesota Statutes 2002, section 326.42, is 493.5 amended to read: 493.6 326.42 [APPLICATIONS, FEES.] 493.7 Subdivision 1. [APPLICATION.] Applications for plumber's 493.8 license shall be made to the state commissioner of health, with 493.9 fee. Unless the applicant is entitled to a renewal, the 493.10 applicant shall be licensed by the state commissioner of health 493.11 only after passing a satisfactory examination by the examiners 493.12 showing fitness. Examination fees for both journeyman and 493.13 master plumbers shall be in an amount prescribed by the state 493.14 commissioner of health pursuant to section 144.122. Upon being 493.15 notified that of having successfully passed the examination for 493.16 original license the applicant shall submit an application, with 493.17 the license fee herein provided. License fees shall be in an 493.18 amount prescribed by the state commissioner of health pursuant 493.19 to section 144.122. Licenses shall expire and be renewed as 493.20 prescribed by the commissioner pursuant to section 144.122. 493.21 Subd. 2. [FEES.] Plumbing system plans and specifications 493.22 that are submitted to the commissioner for review shall be 493.23 accompanied by the appropriate plan examination fees. If the 493.24 commissioner determines, upon review of the plans, that 493.25 inadequate fees were paid, the necessary additional fees shall 493.26 be paid prior to plan approval. The commissioner shall charge 493.27 the following fees for plan reviews and audits of plumbing 493.28 installations for public, commercial, and industrial buildings: 493.29 (1) systems with both water distribution and drain, waste, 493.30 and vent systems and having: 493.31 (i) 25 or fewer drainage fixture units, $150; 493.32 (ii) 26 to 50 drainage fixture units, $250; 493.33 (iii) 51 to 150 drainage fixture units, $350; 493.34 (iv) 151 to 249 drainage fixture units, $500; 493.35 (v) 250 or more drainage fixture units, $3 per drainage 493.36 fixture unit to a maximum of $4,000; and 494.1 (vi) interceptors, separators, or catch basins, $70 per 494.2 interceptor, separator, or catch basin; 494.3 (2) building sewer service only, $150; 494.4 (3) building water service only, $150; 494.5 (4) building water distribution system only, no drainage 494.6 system, $5 per supply fixture unit or $150, whichever is 494.7 greater; 494.8 (5) storm drainage system, a minimum fee of $150 or: 494.9 (i) $50 per drain opening, up to a maximum of $500; and 494.10 (ii) $70 per interceptor, separator, or catch basin; 494.11 (6) manufactured home park or campground, 1 to 25 sites, 494.12 $300; 494.13 (7) manufactured home park or campground, 26 to 50 sites, 494.14 $350; 494.15 (8) manufactured home park or campground, 51 to 125 sites, 494.16 $400; 494.17 (9) manufactured home park or campground, more than 125 494.18 sites, $500; 494.19 (10) accelerated review, double the regular fee, one-half 494.20 to be refunded if no response from the commissioner within 15 494.21 business days; and 494.22 (11) revision to previously reviewed or incomplete plans: 494.23 (i) review of plans for which commissioner has issued two 494.24 or more requests for additional information, per review, $100 or 494.25 ten percent of the original fee, whichever is greater; 494.26 (ii) proposer-requested revision with no increase in 494.27 project scope, $50 or ten percent of original fee, whichever is 494.28 greater; and 494.29 (iii) proposer-requested revision with an increase in 494.30 project scope, $50 plus the difference between the original 494.31 project fee and the revised project fee. 494.32 Sec. 83. Minnesota Statutes 2002, section 471.59, 494.33 subdivision 1, is amended to read: 494.34 Subdivision 1. [AGREEMENT.] Two or more governmental 494.35 units, by agreement entered into through action of their 494.36 governing bodies, may jointly or cooperatively exercise any 495.1 power common to the contracting parties or any similar powers, 495.2 including those which are the same except for the territorial 495.3 limits within which they may be exercised. The agreement may 495.4 provide for the exercise of such powers by one or more of the 495.5 participating governmental units on behalf of the other 495.6 participating units. The term "governmental unit" as used in 495.7 this section includes every city, county, town, school district, 495.8 other political subdivision of this or another state, another 495.9 state, the University of Minnesota, nonprofit hospitals licensed 495.10 under sections 144.50 to 144.56, and any agency of the state of 495.11 Minnesota or the United States, and includes any instrumentality 495.12 of a governmental unit. For the purpose of this section, an 495.13 instrumentality of a governmental unit means an instrumentality 495.14 having independent policy making and appropriating authority. 495.15 Sec. 84. 2003 S.F. No. 1019, section 2, if enacted, is 495.16 amended to read: 495.17 Sec. 2. [144.7063] [DEFINITIONS.] 495.18 Subdivision 1. [SCOPE.] Unless the context clearly 495.19 indicates otherwise, for the purposes of sections 144.706 to 495.20 144.7069, the terms defined in this section have the meanings 495.21 given them. 495.22 Subd. 2. [COMMISSIONER.] "Commissioner" means the 495.23 commissioner of health. 495.24 Subd. 3. [FACILITY.] "Facility" means a hospital licensed 495.25 under sections 144.50 to 144.58. 495.26 Subd. 4. [SERIOUS DISABILITY.] "Serious disability" means 495.27 (1) a physical or mental impairment that substantially limits 495.28 one or more of the major life activities of an individual,495.29(2)or a loss of bodily function, if the impairment or loss 495.30 lasts more than seven days or is still present at the time of 495.31 discharge from an inpatient health care facility, or(3)(2) 495.32 loss of a body part. 495.33 Subd. 5. [SURGERY.] "Surgery" means the treatment of 495.34 disease, injury, or deformity by manual or operative methods. 495.35 Surgery includes endoscopies and other invasive procedures. 495.36 Sec. 85. 2003 S.F. No. 1019, section 3, if enacted, is 496.1 amended to read: 496.2 Sec. 3. [144.7065] [FACILITY REQUIREMENTS TO REPORT, 496.3 ANALYZE, AND CORRECT.] 496.4 Subdivision 1. [REPORTS OF ADVERSE HEALTH CARE EVENTS 496.5 REQUIRED.] Each facility shall report to the commissioner the 496.6 occurrence of any of the adverse health care events described in 496.7 subdivisions 2 to 7 as soon as is reasonably and practically 496.8 possible, but no later than 15 working days after discovery of 496.9 the event. The report shall be filed in a format specified by 496.10 the commissioner and shall identify the facility but shall not 496.11 include any identifying information for any of the health care 496.12 professionals, facility employees, or patients involved. The 496.13 commissioner may consult with experts and organizations familiar 496.14 with patient safety when developing the format for reporting and 496.15 in further defining events in order to be consistent with 496.16 industry standards. 496.17 Subd. 2. [SURGICAL EVENTS.] Events reportable under this 496.18 subdivision are: 496.19 (1) surgery performed on a wrong body part that is not 496.20 consistent with the documented informed consent for that 496.21 patient. Reportable events under this clause do not include 496.22 situations requiring prompt action that occur in the course of 496.23 surgery or situations whose urgency precludes obtaining informed 496.24 consent; 496.25 (2) surgery performed on the wrong patient; 496.26 (3) the wrong surgical procedure performed on a patient 496.27 that is not consistent with the documented informed consent for 496.28 that patient. Reportable events under this clause do not 496.29 include situations requiring prompt action that occur in the 496.30 course of surgery or situations whose urgency precludes 496.31 obtaining informed consent; 496.32 (4) retention of a foreign object in a patient after 496.33 surgery or other procedure, excluding objects intentionally 496.34 implanted as part of a planned intervention and objects present 496.35 prior to surgery that are intentionally retained; and 496.36 (5) death during or immediately after surgery of a normal, 497.1 healthy patient who has no organic, physiologic, biochemical, or 497.2 psychiatric disturbance and for whom the pathologic processes 497.3 for which the operation is to be performed are localized and do 497.4 not entail a systemic disturbance. 497.5 Subd. 3. [PRODUCT OR DEVICE EVENTS.] Events reportable 497.6 under this subdivision are: 497.7 (1) patient death or serious disability associated with the 497.8 use of contaminated drugs, devices, or biologics provided by the 497.9 facility when the contamination is the result of generally 497.10 detectable contaminants in drugs, devices, or biologics 497.11 regardless of the source of the contamination or the product; 497.12 (2) patient death or serious disability associated with the 497.13 use or function of a device in patient care in which the device 497.14 is used or functions other than as intended. "Device" includes, 497.15 but is not limited to, catheters, drains, and other specialized 497.16 tubes, infusion pumps, and ventilators; and 497.17 (3) patient death or serious disability associated with 497.18 intravascular air embolism that occurs while being cared for in 497.19 a facility, excluding deaths associated with neurosurgical 497.20 procedures known to present a high risk of intravascular air 497.21 embolism. 497.22 Subd. 4. [PATIENT PROTECTION EVENTS.] Events reportable 497.23 under this subdivision are: 497.24 (1) an infant discharged to the wrong person; 497.25 (2) patient death or serious disability associated with 497.26 patient disappearance for more than four hours, excluding events 497.27 involving adults who have decision-making capacity; and 497.28 (3) patient suicide or attempted suicide resulting in 497.29 serious disability while being cared for in a facility due to 497.30 patient actions after admission to the facility, excluding 497.31 deaths resulting from self-inflicted injuries that were the 497.32 reason for admission to the facility. 497.33 Subd. 5. [CARE MANAGEMENT EVENTS.] Events reportable under 497.34 this subdivision are: 497.35 (1) patient death or serious disability associated with a 497.36 medication error, including, but not limited to, errors 498.1 involving the wrong drug, the wrong dose, the wrong patient, the 498.2 wrong time, the wrong rate, the wrong preparation, or the wrong 498.3 route of administration, excluding reasonable differences in 498.4 clinical judgment on drug selection and dose; 498.5 (2) patient death or serious disability associated with a 498.6 hemolytic reaction due to the administration of ABO-incompatible 498.7 blood or blood products; 498.8 (3) maternal death or serious disability associated with 498.9 labor or delivery in a low-risk pregnancy while being cared for 498.10 in a facility, including events that occur within 42 days 498.11 postdelivery and excluding deaths from pulmonary or amniotic 498.12 fluid embolism, acute fatty liver of pregnancy, or 498.13 cardiomyopathy; 498.14 (4) patient death or serious disability directly related to 498.15 hypoglycemia, the onset of which occurs while the patient is 498.16 being cared for in a facility; 498.17 (5) death or serious disability, including kernicterus, 498.18 associated with failure to identify and treat hyperbilirubinemia 498.19 in neonates during the first 28 days of life. 498.20 "Hyperbilirubinemia" means bilirubin levels greater than 30 498.21 milligrams per deciliter; 498.22 (6) stage 3 or 4 ulcers acquired after admission to a 498.23 facility, excluding progression from stage 2 to stage 3 if stage 498.24 2 was recognized upon admission; and 498.25 (7) patient death or serious disability due to spinal 498.26 manipulative therapy. 498.27 Subd. 6. [ENVIRONMENTAL EVENTS.] Events reportable under 498.28 this subdivision are: 498.29 (1) patient death or serious disability associated with an 498.30 electric shock while being cared for in a facility, excluding 498.31 events involving planned treatments such as electric 498.32 countershock; 498.33 (2) any incident in which a line designated for oxygen or 498.34 other gas to be delivered to a patient contains the wrong gas or 498.35 is contaminated by toxic substances; 498.36 (3) patient death or serious disability associated with a 499.1 burn incurred from any source while being cared for in a 499.2 facility; 499.3 (4) patient death associated with a fall while being cared 499.4 for in a facility; and 499.5 (5) patient death or serious disability associated with the 499.6 use or lack of restraints or bedrails while being cared for in a 499.7 facility. 499.8 Subd. 7. [CRIMINAL EVENTS.] Events reportable under this 499.9 subdivision are: 499.10 (1) any instance of care ordered by or provided by someone 499.11 impersonating a physician, nurse, pharmacist, or other licensed 499.12 health care provider; 499.13 (2) abduction of a patient of any age; 499.14 (3) sexual assault on a patient within or on the grounds of 499.15 a facility; and 499.16 (4) death or significant injury of a patient or staff 499.17 member resulting from a physical assault that occurs within or 499.18 on the grounds of a facility. 499.19 Subd. 8. [ROOT CAUSE ANALYSIS; CORRECTIVE ACTION PLAN.] 499.20 Following the occurrence of an adverse health care event, the 499.21 facility must conduct a root cause analysis of the event. 499.22 Following the analysis, the facility must: (1) implement a 499.23 corrective action plan to implement the findings of the analysis 499.24 or (2) report to the commissioner any reasons for not taking 499.25 corrective action. If the root cause analysis and the 499.26 implementation of a corrective action plan are complete at the 499.27 time an event must be reported, the findings of the analysis and 499.28 the corrective action plan must be included in the report of the 499.29 event. The findings of the root cause analysis and a copy of 499.30 the corrective action plan must otherwise be filed with the 499.31 commissioner within 60 days of the event. 499.32 Subd. 9. [ELECTRONIC REPORTING.] The commissioner must 499.33 design the reporting system so that a facility may file by 499.34 electronic means the reports required under this section. The 499.35 commissioner shall encourage a facility to use the electronic 499.36 filing option when that option is feasible for the facility. 500.1 Subd. 10. [RELATION TO OTHER LAW.] (a) Adverse health 500.2 events described in subdivisions 2 to 6 do not constitute 500.3 "maltreatment" or "a physical injury that is not reasonably 500.4 explained" under section 626.557 and are excluded from the 500.5 reporting requirements of section 626.557, provided the facility 500.6 makes a determination within 24 hours of the discovery of the 500.7 event that this section is applicable and the facility files the 500.8 reports required under this section in a timely fashion. 500.9 (b) A facility that has determined that an event described 500.10 in subdivisions 2 to 6 has occurred must inform persons who are 500.11 mandated reporters under section 626.5572, subdivision 16, of 500.12 that determination. A mandated reporter otherwise required to 500.13 report under section 626.557, subdivision 3, paragraph (e), is 500.14 relieved of the duty to report an event that the facility 500.15 determines under paragraph (a) to be reportable under 500.16 subdivisions 2 to 6. 500.17 (c) The protections and immunities applicable to voluntary 500.18 reports under section 626.557 are not affected by this section. 500.19 (d) Notwithstanding section 626.557, a lead agency under 500.20 section 626.5572, subdivision 13, is not required to conduct an 500.21 investigation of an event described in subdivisions 2 to 6. 500.22 Sec. 86. 2003 S.F. No. 1019, section 7, if enacted, is 500.23 amended to read: 500.24 Sec. 7. [ADVERSE HEALTH CARE EVENTS REPORTING SYSTEM 500.25 TRANSITION PERIOD.] 500.26 (a) Effective July 1, 2003, limited implementation of the 500.27 Adverse Health Care Events Reporting Act shall begin, provided 500.28 the commissioner of health has secured sufficient nonstate funds 500.29 for this purpose. During this period, the commissioner must: 500.30 (1) solicit additional nonstate funds to support full 500.31 implementation of the system; 500.32 (2) work with organizations and experts familiar with 500.33 patient safety to review reporting categories in Minnesota 500.34 Statutes, section 144.7065, make necessary clarifications, and 500.35 develop educational materials; and 500.36 (3) monitor activities of the National Quality Forum and 501.1 other patient safety organizations, other states, and the 501.2 federal government in the area of patient safety. 501.3 (b) Effective July 1, 2003, facilities defined in Minnesota 501.4 Statutes, section 144.7063, subdivision 3, shall report any 501.5 adverse health care events, as defined in Minnesota Statutes, 501.6 section 144.7065, to the incident reporting system maintained by 501.7 the Minnesota Hospital Association. The association shall 501.8 provide a summary report to the commissioner that identifies the 501.9 types of events by category. The association shall consult with 501.10 the commissioner regarding the data to be reported to the 501.11 commissioner, storage of data received by the association but 501.12 not reported to the commissioner, and eventual retrieval by the 501.13 commissioner of stored data. 501.14 (c) The commissioner shall report to the legislature by 501.15 January 15 of 2004 and 2005, with a list of the number of 501.16 reported events by type and recommendations, if any, for 501.17 reporting system modifications, including additional categories 501.18 of events that should be reported. 501.19 (d) From July 1, 2003, until full implementation of the 501.20 reporting system, the commissioner of health shall not make a 501.21 final disposition as defined in Minnesota Statutes, section 501.22 626.5572, subdivision 8, for investigations conducted in 501.23 licensed hospitals under the provisions of Minnesota Statutes, 501.24 section 626.557. The commissioner's findings in these cases 501.25 shall identify noncompliance with federal certification or state 501.26 licensure rules or laws. 501.27 (e) Effective July 1, 2004, the reporting system shall be 501.28 fully implemented, provided (1) the commissioner has secured 501.29 sufficient funds from nonstate sources to operate the system 501.30 during fiscal year 2005, and (2) the commissioner has notified 501.31 facilities by April 1, 2004, of their duty to report. 501.32(f) Effective July 1, 2005, the reporting system shall be501.33operated with state appropriations.501.34 Sec. 87. [AUTHORITY TO COLLECT CERTAIN FEES SUSPENDED.] 501.35 (a) The commissioner's authority to collect the certificate 501.36 application fee from hearing instrument dispensers under 502.1 Minnesota Statutes, section 153A.17, is suspended for certified 502.2 hearing instrument dispensers renewing certification in fiscal 502.3 year 2004. 502.4 (b) The commissioner's authority to collect the license 502.5 renewal fee from occupational therapy practitioners under 502.6 Minnesota Statutes, section 148.6445, subdivision 2, is 502.7 suspended for fiscal years 2004 and 2005. 502.8 Sec. 88. [REVISOR'S INSTRUCTION.] 502.9 (a) The revisor of statutes shall delete the reference to 502.10 "144.1495" in Minnesota Statutes, section 62Q.145, and insert 502.11 "144.1501." 502.12 (b) For sections in Minnesota Statutes and Minnesota Rules 502.13 affected by the repealed sections in this article, the revisor 502.14 shall delete internal cross-references where appropriate and 502.15 make changes necessary to correct the punctuation, grammar, or 502.16 structure of the remaining text and preserve its meaning. 502.17 Sec. 89. [REPEALER.] 502.18 (a) Minnesota Statutes 2002, sections 62J.15; 62J.152; 502.19 62J.451; 62J.452; 144.126; 144.1484; 144.1494; 144.1495; 502.20 144.1496; 144.1497; 144A.36; 144A.38; 148.5194, subdivision 3a; 502.21 and 148.6445, subdivision 9, are repealed. 502.22 (b) Minnesota Rules, parts 4763.0100; 4763.0110; 4763.0125; 502.23 4763.0135; 4763.0140; 4763.0150; 4763.0160; 4763.0170; 502.24 4763.0180; 4763.0190; 4763.0205; 4763.0215; 4763.0220; 502.25 4763.0230; 4763.0240; 4763.0250; 4763.0260; 4763.0270; 502.26 4763.0285; 4763.0295; and 4763.0300, are repealed. 502.27 ARTICLE 8 502.28 LOCAL PUBLIC HEALTH GRANTS 502.29 Section 1. Minnesota Statutes 2002, section 144E.11, 502.30 subdivision 6, is amended to read: 502.31 Subd. 6. [REVIEW CRITERIA.] When reviewing an application 502.32 for licensure, the board and administrative law judge shall 502.33 consider the following factors: 502.34 (1)the relationship of the proposed service or expansion502.35in primary service area to the current community health plan as502.36approved by the commissioner of health under section 145A.12,503.1subdivision 4;503.2(2)the recommendations or comments of the governing bodies 503.3 of the counties, municipalities, community health boards as 503.4 defined under section 145A.09, subdivision 2, and regional 503.5 emergency medical services system designated under section 503.6 144E.50 in which the service would be provided; 503.7(3)(2) the deleterious effects on the public health from 503.8 duplication, if any, of ambulance services that would result 503.9 from granting the license; 503.10(4)(3) the estimated effect of the proposed service or 503.11 expansion in primary service area on the public health; and 503.12(5)(4) whether any benefit accruing to the public health 503.13 would outweigh the costs associated with the proposed service or 503.14 expansion in primary service area. The administrative law judge 503.15 shall recommend that the board either grant or deny a license or 503.16 recommend that a modified license be granted. The reasons for 503.17 the recommendation shall be set forth in detail. The 503.18 administrative law judge shall make the recommendations and 503.19 reasons available to any individual requesting them. 503.20 Sec. 2. Minnesota Statutes 2002, section 145.88, is 503.21 amended to read: 503.22 145.88 [PURPOSE.] 503.23The legislature finds that it is in the public interest to503.24assure:503.25(a) statewide planning and coordination of maternal and503.26child health services through the acquisition and analysis of503.27population-based health data, provision of technical support and503.28training, and coordination of the various public and private503.29maternal and child health efforts; and503.30(b) support for targeted maternal and child health services503.31in communities with significant populations of high risk, low503.32income families through a grants process.503.33 Federal money received by the Minnesota department of 503.34 health, pursuant to United States Code, title 42, sections 701 503.35 to 709, shall be expended to: 503.36 (1) assure access to quality maternal and child health 504.1 services for mothers and children, especially those of low 504.2 income and with limited availability to health services and 504.3 those children at risk of physical, neurological, emotional, and 504.4 developmental problems arising from chemical abuse by a mother 504.5 during pregnancy; 504.6 (2) reduce infant mortality and the incidence of 504.7 preventable diseases and handicapping conditions among children; 504.8 (3) reduce the need for inpatient and long-term care 504.9 services and to otherwise promote the health of mothers and 504.10 children, especially by providing preventive and primary care 504.11 services for low-income mothers and children and prenatal, 504.12 delivery and postpartum care for low-income mothers; 504.13 (4) provide rehabilitative services for blind and disabled 504.14 children under age 16 receiving benefits under title XVI of the 504.15 Social Security Act; and 504.16 (5) provide and locate medical, surgical, corrective and 504.17 other service for children who are crippled or who are suffering 504.18 from conditions that lead to crippling. 504.19 Sec. 3. Minnesota Statutes 2002, section 145.881, 504.20 subdivision 2, is amended to read: 504.21 Subd. 2. [DUTIES.] The advisory task force shall meet on a 504.22 regular basis to perform the following duties: 504.23 (a) review and report on the health care needs of mothers 504.24 and children throughout the state of Minnesota; 504.25 (b) review and report on the type, frequency and impact of 504.26 maternal and child health care services provided to mothers and 504.27 children under existing maternal and child health care programs, 504.28 including programs administered by the commissioner of health; 504.29 (c) establish, review, and report to the commissioner a 504.30 list of program guidelines and criteria which the advisory task 504.31 force considers essential to providing an effective maternal and 504.32 child health care program to low income populations and high 504.33 risk persons and fulfilling the purposes defined in section 504.34 145.88; 504.35 (d)review staff recommendations of the department of504.36health regarding maternal and child health grant awards before505.1the awards are made;505.2(e)make recommendations to the commissioner for the use of 505.3 other federal and state funds available to meet maternal and 505.4 child health needs; 505.5(f)(e) make recommendations to the commissioner of health 505.6 on priorities for funding the following maternal and child 505.7 health services: (1) prenatal, delivery and postpartum care, (2) 505.8 comprehensive health care for children, especially from birth 505.9 through five years of age, (3) adolescent health services, (4) 505.10 family planning services, (5) preventive dental care, (6) 505.11 special services for chronically ill and handicapped children 505.12 and (7) any other services which promote the health of mothers 505.13 and children; and 505.14(g) make recommendations to the commissioner of health on505.15the process to distribute, award and administer the maternal and505.16child health block grant funds; and505.17(h) review the measures that are used to define the505.18variables of the funding distribution formula in section505.19145.882, subdivision 4, every two years and make recommendations505.20to the commissioner of health for changes based upon principles505.21established by the advisory task force for this purpose.505.22 (f) establish, in consultation with the commissioner and 505.23 the state community health advisory committee established under 505.24 section 145A.10, subdivision 10, paragraph (a), statewide 505.25 outcomes that will improve the health status of mothers and 505.26 children as required in section 145A.12, subdivision 7. 505.27 Sec. 4. Minnesota Statutes 2002, section 145.882, 505.28 subdivision 1, is amended to read: 505.29 Subdivision 1. [FUNDINGLEVELS AND ADVISORY TASK FORCE505.30REVIEW.] Any decrease in the amount of federal funding to the 505.31 state for the maternal and child health block grant must be 505.32 apportioned to reflect a proportional decrease for each 505.33 recipient. Any increase in the amount of federal funding to the 505.34 state must be distributed under subdivisions 2,and 3, and 4. 505.35The advisory task force shall review and recommend the505.36proportion of maternal and child health block grant funds to be506.1expended for indirect costs, direct services and special506.2projects.506.3 Sec. 5. Minnesota Statutes 2002, section 145.882, 506.4 subdivision 2, is amended to read: 506.5 Subd. 2. [ALLOCATION TO THE COMMISSIONER OF HEALTH.] 506.6 Beginning January 1, 1986, up to one-third of the total maternal 506.7 and child health block grant money may be retained by the 506.8 commissioner of healthfor administrative and technical506.9assistance services, projects of regional or statewide506.10significance, direct services to children with handicaps, and506.11other activities of the commissioner.to: 506.12 (1) meet federal maternal and child block grant 506.13 requirements of a statewide needs assessment every five years 506.14 and prepare the annual federal block grant application and 506.15 report; 506.16 (2) collect and disseminate statewide data on the health 506.17 status of mothers and children within one year of the end of the 506.18 year; 506.19 (3) provide technical assistance to community health boards 506.20 in meeting statewide outcomes under section 145A.12, subdivision 506.21 7; 506.22 (4) evaluate the impact of maternal and child health 506.23 activities on the health status of mothers and children; 506.24 (5) provide services to children under age 16 receiving 506.25 benefits under title XVI of the Social Security Act; and 506.26 (6) perform other maternal and child health activities 506.27 listed in section 145.88 and as deemed necessary by the 506.28 commissioner. 506.29 Sec. 6. Minnesota Statutes 2002, section 145.882, 506.30 subdivision 3, is amended to read: 506.31 Subd. 3. [ALLOCATION TO COMMUNITY HEALTHSERVICES506.32AREASBOARDS.] (a) The maternal and child health block grant 506.33 money remaining after distributions made under subdivision 2 506.34 must be allocated according to the formula insubdivision 4 to506.35community health services areassection 145A.131, subdivision 2, 506.36 for distributionbyto community health boards.as defined in507.1section 145A.02, subdivision 5, to qualified programs that507.2provide essential services within the community health services507.3area as long as:507.4(1) the Minneapolis community health service area is507.5allocated at least $1,626,215 per year;507.6(2) the St. Paul community health service area is allocated507.7at least $822,931 per year; and507.8(3) all other community health service areas are allocated507.9at least $30,000 per county per year or their 1988-1989 funding507.10cycle award, whichever is less.507.11 (b)Notwithstanding paragraph (a), if the total amount of507.12maternal and child health block grant funding decreases, the507.13decrease must be apportioned to reflect a proportional decrease507.14for each recipient, including recipients who would otherwise507.15receive a guaranteed minimum allocation under paragraph (a).A 507.16 community health board that receives funding under this section 507.17 shall provide at least a 50 percent match for funds received 507.18 under United States Code, title 42, sections 701 to 709. 507.19 Eligible funds must be used to meet match requirements. 507.20 Eligible funds include funds from local property taxes, 507.21 reimbursements from third parties, fees, other funds, donations, 507.22 nonfederal grants, or state funds received under the local 507.23 public health grant defined in section 145A.131, that are used 507.24 for maternal and child health activities as described in section 507.25 145.882, subdivision 7. 507.26 Sec. 7. Minnesota Statutes 2002, section 145.882, is 507.27 amended by adding a subdivision to read: 507.28 Subd. 5a. [NONPARTICIPATING COMMUNITY HEALTH BOARDS.] If a 507.29 community health board decides not to participate in maternal 507.30 and child health block grant activities under subdivision 3 or 507.31 the commissioner determines under section 145A.131, subdivision 507.32 7, not to fund the community health board, the commissioner is 507.33 responsible for directing maternal and child health block grant 507.34 activities in that community health board's geographic area. 507.35 The commissioner may elect to directly provide public health 507.36 activities to meet the statewide outcomes or to contract with 508.1 other governmental units or nonprofit organizations. 508.2 Sec. 8. Minnesota Statutes 2002, section 145.882, 508.3 subdivision 7, is amended to read: 508.4 Subd. 7. [USE OF BLOCK GRANT MONEY.](a)Maternal and 508.5 child health block grant money allocated to a community health 508.6 boardor community health services areaunder this section must 508.7 be used for qualified programs for high risk and low-income 508.8 individuals. Block grant money must be used for programs that: 508.9 (1) specifically address the highest risk populations, 508.10 particularly low-income and minority groups with a high rate of 508.11 infant mortality and children with low birth weight, by 508.12 providing services, including prepregnancy family planning 508.13 services, calculated to produce measurable decreases in infant 508.14 mortality rates, instances of children with low birth weight, 508.15 and medical complications associated with pregnancy and 508.16 childbirth, including infant mortality, low birth rates, and 508.17 medical complications arising from chemical abuse by a mother 508.18 during pregnancy; 508.19 (2) specifically target pregnant women whose age, medical 508.20 condition, maternal history, or chemical abuse substantially 508.21 increases the likelihood of complications associated with 508.22 pregnancy and childbirth or the birth of a child with an 508.23 illness, disability, or special medical needs; 508.24 (3) specifically address the health needs of young children 508.25 who have or are likely to have a chronic disease or disability 508.26 or special medical needs, including physical, neurological, 508.27 emotional, and developmental problems that arise from chemical 508.28 abuse by a mother during pregnancy; 508.29 (4) provide family planning and preventive medical care for 508.30 specifically identified target populations, such as minority and 508.31 low-income teenagers, in a manner calculated to decrease the 508.32 occurrence of inappropriate pregnancy and minimize the risk of 508.33 complications associated with pregnancy and childbirth;or508.34 (5) specifically address the frequency and severity of 508.35 childhood and adolescent health issues, including injuries in 508.36 high risk target populations by providing services calculated to 509.1 produce measurable decreases in mortality and morbidity.; 509.2However, money may be used for this purpose only if the509.3community health board's application includes program components509.4for the purposes in clauses (1) to (4) in the proposed509.5geographic service area and the total expenditure for509.6injury-related programs under this clause does not exceed ten509.7percent of the total allocation under subdivision 3.509.8(b) Maternal and child health block grant money may be used509.9for purposes other than the purposes listed in this subdivision509.10only under the following conditions:509.11(1) the community health board or community health services509.12area can demonstrate that existing programs fully address the509.13needs of the highest risk target populations described in this509.14subdivision; or509.15(2) the money is used to continue projects that received509.16funding before creation of the maternal and child health block509.17grant in 1981.509.18(c) Projects that received funding before creation of the509.19maternal and child health block grant in 1981, must be allocated509.20at least the amount of maternal and child health special project509.21grant funds received in 1989, unless (1) the local board of509.22health provides equivalent alternative funding for the project509.23from another source; or (2) the local board of health509.24demonstrates that the need for the specific services provided by509.25the project has significantly decreased as a result of changes509.26in the demographic characteristics of the population, or other509.27factors that have a major impact on the demand for services. If509.28the amount of federal funding to the state for the maternal and509.29child health block grant is decreased, these projects must509.30receive a proportional decrease as required in subdivision 1.509.31Increases in allocation amounts to local boards of health under509.32subdivision 4 may be used to increase funding levels for these509.33projects.509.34 (6) specifically address preventing child abuse and 509.35 neglect, reducing juvenile delinquency, promoting positive 509.36 parenting and resiliency in children, and promoting family 510.1 health and economic sufficiency through public health nurse home 510.2 visits under section 145A.17; or 510.3 (7) specifically address nutritional issues of women, 510.4 infants, and young children through WIC clinic services. 510.5 Sec. 9. [145.8821] [ACCOUNTABILITY.] 510.6 (a) Coordinating with the statewide outcomes established 510.7 under section 145A.12, subdivision 7, and with accountability 510.8 measures outlined in section 145A.131, subdivision 7, each 510.9 community health board that receives money under section 510.10 145.882, subdivision 3, shall select by February 1, 2005, and 510.11 every five years thereafter, up to two statewide maternal and 510.12 child health outcomes. 510.13 (b) For the period January 1, 2004, to December 31, 2005, 510.14 each community health board must work toward the Healthy People 510.15 2010 goal to reduce the state's percentage of low birth weight 510.16 infants. 510.17 (c) The commissioner shall monitor and evaluate whether 510.18 each community health board has made sufficient progress toward 510.19 the selected outcomes established in paragraph (b) and under 510.20 section 145A.12, subdivision 7. 510.21 (d) Community health boards shall provide the commissioner 510.22 with annual information necessary to evaluate progress toward 510.23 selected statewide outcomes and to meet federal reporting 510.24 requirements. 510.25 Sec. 10. Minnesota Statutes 2002, section 145.883, 510.26 subdivision 1, is amended to read: 510.27 Subdivision 1. [SCOPE.] For purposes of sections 145.881 510.28 to145.888145.883, the terms defined in this section shall have 510.29 the meanings given them. 510.30 Sec. 11. Minnesota Statutes 2002, section 145.883, 510.31 subdivision 9, is amended to read: 510.32 Subd. 9. [COMMUNITY HEALTHSERVICES AREABOARD.] 510.33 "Community healthservices areaboard" meansa city, county, or510.34multicounty area that is organized as a community health board510.35under section 145A.09 and for which a state subsidy is received510.36under sections 145A.09 to 145A.13a board of health established, 511.1 operating, and eligible for a local public health grant under 511.2 sections 145A.09 to 145A.131. 511.3 Sec. 12. Minnesota Statutes 2002, section 145A.02, 511.4 subdivision 5, is amended to read: 511.5 Subd. 5. [COMMUNITY HEALTH BOARD.] "Community health 511.6 board" means a board of health established, operating, and 511.7 eligible for asubsidylocal public health grant under sections 511.8 145A.09 to145A.13145A.131. 511.9 Sec. 13. Minnesota Statutes 2002, section 145A.02, 511.10 subdivision 6, is amended to read: 511.11 Subd. 6. [COMMUNITY HEALTH SERVICES.] "Community health 511.12 services" means activities designed to protect and promote the 511.13 health of the general population within a community health 511.14 service area by emphasizing the prevention of disease, injury, 511.15 disability, and preventable death through the promotion of 511.16 effective coordination and use of community resources, and by 511.17 extending health services into the community.Program511.18categories of community health services include disease511.19prevention and control, emergency medical care, environmental511.20health, family health, health promotion, and home health care.511.21 Sec. 14. Minnesota Statutes 2002, section 145A.02, 511.22 subdivision 7, is amended to read: 511.23 Subd. 7. [COMMUNITY HEALTH SERVICE AREA.] "Community 511.24 health service area" means a city, county, or multicounty area 511.25 that is organized as a community health board under section 511.26 145A.09 and for which asubsidylocal public health grant is 511.27 received under sections 145A.09 to145A.13145A.131. 511.28 Sec. 15. Minnesota Statutes 2002, section 145A.06, 511.29 subdivision 1, is amended to read: 511.30 Subdivision 1. [GENERALLY.] In addition to other powers 511.31 and duties provided by law, the commissioner has the powers 511.32 listed in subdivisions 2 to45. 511.33 Sec. 16. Minnesota Statutes 2002, section 145A.09, 511.34 subdivision 2, is amended to read: 511.35 Subd. 2. [COMMUNITY HEALTH BOARD; ELIGIBILITY.] A board of 511.36 health that meets the requirements of sections 145A.09 512.1 to145A.13145A.131 is a community health board and is eligible 512.2 for acommunity health subsidylocal public health grant under 512.3 section145A.13145A.131. 512.4 Sec. 17. Minnesota Statutes 2002, section 145A.09, 512.5 subdivision 4, is amended to read: 512.6 Subd. 4. [CITIES.] A city that received a subsidy under 512.7 section 145A.13 and that meets the requirements of sections 512.8 145A.09 to145A.13145A.131 is eligible for acommunity health512.9subsidylocal public health grant under section 512.10145A.13145A.131. 512.11 Sec. 18. Minnesota Statutes 2002, section 145A.09, 512.12 subdivision 7, is amended to read: 512.13 Subd. 7. [WITHDRAWAL.] (a) A county or city that has 512.14 established or joined a community health board may withdraw from 512.15 thesubsidylocal public health grant program authorized by 512.16 sections 145A.09 to145A.13145A.131 by resolution of its 512.17 governing body in accordance with section 145A.03, subdivision 512.18 3, and this subdivision. 512.19 (b) A county or city may not withdraw from a joint powers 512.20 community health board during the first two calendar years 512.21 following that county's or city's initial adoption of the joint 512.22 powers agreement. 512.23 (c) The withdrawal of a county or city from a community 512.24 health board does not affect the eligibility for thecommunity512.25health subsidylocal public health grant of any remaining county 512.26 or city for one calendar year following the effective date of 512.27 withdrawal. 512.28 (d)The amount of additional annual payment for calendar512.29year 1985 made pursuant to Minnesota Statutes 1984, section512.30145.921, subdivision 4, must be subtracted from the subsidy for512.31a county that, due to withdrawal from a community health board,512.32ceases to meet the terms and conditions under which that512.33additional annual payment was madeThe local public health grant 512.34 for a county that chooses to withdraw from a multicounty 512.35 community health board shall be reduced by the amount of the 512.36 local partnership incentive under section 145A.131, subdivision 513.1 2, paragraph (c). 513.2 Sec. 19. Minnesota Statutes 2002, section 145A.10, 513.3 subdivision 2, is amended to read: 513.4 Subd. 2. [PREEMPTION.] (a) Not later than 365 days after 513.5 theapproval of a community health plan by the513.6commissionerformation of a community health board, any other 513.7 board of health within the community health service area for 513.8 which the plan has been prepared must cease operation, except as 513.9 authorized in a joint powers agreement under section 145A.03, 513.10 subdivision 2, or delegation agreement under section 145A.07, 513.11 subdivision 2, or as otherwise allowed by this subdivision. 513.12 (b) This subdivision does not preempt or otherwise change 513.13 the powers and duties of any city or county eligible forsubsidy513.14 a local public health grant under section 145A.09. 513.15 (c) This subdivision does not preempt the authority to 513.16 operate a community health services program of any city of the 513.17 first or second class operating an existing program of community 513.18 health services located within a county with a population of 513.19 300,000 or more persons until the city council takes action to 513.20 allow the county to preempt the city's powers and duties. 513.21 Sec. 20. Minnesota Statutes 2002, section 145A.10, is 513.22 amended by adding a subdivision to read: 513.23 Subd. 5a. [DUTIES.] (a) Consistent with the guidelines and 513.24 standards established under section 145A.12, and with input from 513.25 the community, the community health board shall: 513.26 (1) establish local public health priorities based on an 513.27 assessment of community health needs and assets; and 513.28 (2) determine the mechanisms by which the community health 513.29 board will address the local public health priorities 513.30 established under clause (1) and achieve the statewide outcomes 513.31 established under sections 145.8821 and 145A.12, subdivision 7, 513.32 within the limits of available funding. In determining the 513.33 mechanisms to address local public health priorities and achieve 513.34 statewide outcomes, the community health board shall seek public 513.35 input or consider the recommendations of the community health 513.36 advisory committee and the following essential public health 514.1 services: 514.2 (i) monitor health status to identify community health 514.3 problems; 514.4 (ii) diagnose and investigate problems and health hazards 514.5 in the community; 514.6 (iii) inform, educate, and empower people about health 514.7 issues; 514.8 (iv) mobilize community partnerships to identify and solve 514.9 health problems; 514.10 (v) develop policies and plans that support individual and 514.11 community health efforts; 514.12 (vi) enforce laws and regulations that protect health and 514.13 ensure safety; 514.14 (vii) link people to needed personal health care services; 514.15 (viii) ensure a competent public health and personal health 514.16 care workforce; 514.17 (ix) evaluate effectiveness, accessibility, and quality of 514.18 personal and population-based health services; and 514.19 (x) research for new insights and innovative solutions to 514.20 health problems. 514.21 (b) By February 1, 2005, and every five years thereafter, 514.22 each community health board that receives a local public health 514.23 grant under section 145A.131 shall notify the commissioner in 514.24 writing of the statewide outcomes established under sections 514.25 145.8821 and 145A.12, subdivision 7, that the board will address 514.26 and the local priorities established under paragraph (a) that 514.27 the board will address. 514.28 (c) Each community health board receiving a local public 514.29 health grant under section 145A.131 must submit an annual report 514.30 to the commissioner documenting progress toward the achievement 514.31 of statewide outcomes established under sections 145.8821 and 514.32 145A.12, subdivision 7, and the local public health priorities 514.33 established under paragraph (a), using reporting standards and 514.34 procedures established by the commissioner and in compliance 514.35 with all applicable federal requirements. If a community health 514.36 board has identified additional local priorities for use of the 515.1 local public health grant since the last notification of 515.2 outcomes and priorities under paragraph (b), the community 515.3 health board shall notify the commissioner of the additional 515.4 local public health priorities in the annual report. 515.5 Sec. 21. Minnesota Statutes 2002, section 145A.10, 515.6 subdivision 10, is amended to read: 515.7 Subd. 10. [STATE AND LOCAL ADVISORY COMMITTEES.] (a) A 515.8 state community health advisory committee is established to 515.9 advise, consult with, and make recommendations to the 515.10 commissioner on the development, maintenance, funding, and 515.11 evaluation of community health services. Each community health 515.12 board may appoint a member to serve on the committee. The 515.13 committee must meet at least quarterly, and special meetings may 515.14 be called by the committee chair or a majority of the members. 515.15 Members or their alternates mayreceive a per diem and mustbe 515.16 reimbursed for travel and other necessary expenses while engaged 515.17 in their official duties. 515.18 (b) The city councils or county boards that have 515.19 established or are members of a community health boardmustmay 515.20 appoint a community health advisory committee to advise, consult 515.21 with, and make recommendations to the community health board on 515.22matters relating to the development, maintenance, funding, and515.23evaluation of community health services. The committee must515.24consist of at least five members and must be generally515.25representative of the population and health care providers of515.26the community health service area. The committee must meet at515.27least three times a year and at the call of the chair or a515.28majority of the members. Members may receive a per diem and515.29reimbursement for travel and other necessary expenses while515.30engaged in their official duties.515.31(c) State and local advisory committees must adopt bylaws515.32or operating procedures that specify the length of terms of515.33membership, procedures for assuring that no more than half of515.34these terms expire during the same year, and other matters515.35relating to the conduct of committee business. Bylaws or515.36operating procedures may allow one alternate to be appointed for516.1each member of a state or local advisory committee. Alternates516.2may be given full or partial powers and duties of membersthe 516.3 duties under subdivision 5a. 516.4 Sec. 22. Minnesota Statutes 2002, section 145A.11, 516.5 subdivision 2, is amended to read: 516.6 Subd. 2. [CONSIDERATION OFCOMMUNITY HEALTH PLANLOCAL 516.7 PUBLIC HEALTH PRIORITIES AND STATEWIDE OUTCOMES IN TAX LEVY.] In 516.8 levying taxes authorized under section 145A.08, subdivision 3, a 516.9 city council or county board that has formed or is a member of a 516.10 community health board must consider the income and expenditures 516.11 required to meetthe objectives of the community health plan for516.12its arealocal public health priorities established under 516.13 section 145A.10, subdivision 5a, and statewide outcomes 516.14 established under section 145A.12, subdivision 7. 516.15 Sec. 23. Minnesota Statutes 2002, section 145A.11, 516.16 subdivision 4, is amended to read: 516.17 Subd. 4. [ORDINANCES RELATING TO COMMUNITY HEALTH 516.18 SERVICES.] A city council or county board that has established 516.19 or is a member of a community health board may by ordinance 516.20 adopt and enforce minimum standards for services provided 516.21 according to sections 145A.02 and 145A.10, subdivision 5. An 516.22 ordinance must not conflict with state law or with more 516.23 stringent standards established either by rule of an agency of 516.24 state government or by the provisions of the charter or 516.25 ordinances of any city organized under section 145A.09, 516.26 subdivision 4. 516.27 Sec. 24. Minnesota Statutes 2002, section 145A.12, 516.28 subdivision 1, is amended to read: 516.29 Subdivision 1. [ADMINISTRATIVE AND PROGRAM SUPPORT.] The 516.30 commissioner must assist community health boards in the 516.31 development, administration, and implementation of community 516.32 health services. This assistance may consist of but is not 516.33 limited to: 516.34 (1) informational resources, consultation, and training to 516.35 help community health boards plan, develop, integrate, provide 516.36 and evaluate community health services; and 517.1 (2) administrative and program guidelines and standards, 517.2 developed with the advice of the state community health advisory 517.3 committee.Adoption of these guidelines by a community health517.4board is not a prerequisite for plan approval as prescribed in517.5subdivision 4.517.6 Sec. 25. Minnesota Statutes 2002, section 145A.12, 517.7 subdivision 2, is amended to read: 517.8 Subd. 2. [PERSONNEL STANDARDS.] In accordance with chapter 517.9 14, and in consultation with the state community health advisory 517.10 committee, the commissioner may adopt rules to set standards for 517.11 administrative and program personnel to ensure competence in 517.12 administration and planningand in each program area defined in517.13section 145A.02. 517.14 Sec. 26. Minnesota Statutes 2002, section 145A.12, is 517.15 amended by adding a subdivision to read: 517.16 Subd. 7. [STATEWIDE OUTCOMES.] (a) The commissioner, in 517.17 consultation with the state community health advisory committee 517.18 established under section 145A.10, subdivision 10, paragraph 517.19 (a), shall establish statewide outcomes for local public health 517.20 grant funds allocated to community health boards between January 517.21 1, 2004, and December 31, 2005. 517.22 (b) At least one statewide outcome must be established in 517.23 each of the following public health areas: 517.24 (1) preventing diseases; 517.25 (2) protecting against environmental hazards; 517.26 (3) preventing injuries; 517.27 (4) promoting healthy behavior; 517.28 (5) responding to disasters; and 517.29 (6) ensuring access to health services. 517.30 (c) The commissioner shall use Minnesota's public health 517.31 goals established under section 62J.212 and the essential public 517.32 health services under section 145A.10, subdivision 5a, as a 517.33 basis for the development of statewide outcomes. 517.34 (d) The statewide maternal and child health outcomes 517.35 established under section 145.8821 shall be included as 517.36 statewide outcomes under this section. 518.1 (e) By December 31, 2004, and every five years thereafter, 518.2 the commissioner, in consultation with the state community 518.3 health advisory committee established under section 145A.10, 518.4 subdivision 10, paragraph (a), and the maternal and child health 518.5 advisory task force established under section 145.881, shall 518.6 develop statewide outcomes for the local public health grant 518.7 established under section 145A.131, based on state and local 518.8 assessment data regarding the health of Minnesota residents, the 518.9 essential public health services under section 145A.10, and 518.10 current Minnesota public health goals established under section 518.11 62J.212. 518.12 Sec. 27. Minnesota Statutes 2002, section 145A.13, is 518.13 amended by adding a subdivision to read: 518.14 Subd. 4. [EXPIRATION.] This section expires January 1, 518.15 2004. 518.16 Sec. 28. [145A.131] [LOCAL PUBLIC HEALTH GRANT.] 518.17 Subdivision 1. [FUNDING FORMULA FOR COMMUNITY HEALTH 518.18 BOARDS.] (a) Base funding for each community health board 518.19 eligible for a local public health grant under section 145A.09, 518.20 subdivision 2, shall be determined by each community health 518.21 board's fiscal year 2003 allocations, prior to unallotment, for 518.22 the following grant programs: community health services 518.23 subsidy; state and federal maternal and child health special 518.24 projects grants; family home visiting grants, TANF MN ENABL 518.25 grants, TANF youth risk behavior grants, and available women, 518.26 infants, and children grant funds in fiscal year 2003, prior to 518.27 unallotment, distributed based on the proportion of WIC 518.28 participants served in fiscal year 2003 within the CHS service 518.29 area. 518.30 (b) Base funding for a community health board eligible for 518.31 a local public health grant under section 145A.09, subdivision 518.32 2, as determined in paragraph (a), shall be adjusted by the 518.33 percentage difference between the base, as calculated in 518.34 paragraph (a), and the funding available for the local public 518.35 health grant. 518.36 (c) Multicounty community health boards shall receive a 519.1 local partnership base of up to $5,000 per year for each county 519.2 included in the community health board. 519.3 (d) The state community health advisory committee may 519.4 recommend a formula to the commissioner to use in distributing 519.5 state and federal funds to community health boards organized and 519.6 operating under sections 145A.09 to 145A.131 to achieve locally 519.7 identified priorities under section 145A.12, subdivision 7, by 519.8 July 1, 2004, for use in distributing funds to community health 519.9 boards beginning January 1, 2006, and thereafter. 519.10 Subd. 2. [LOCAL MATCH.] (a) A community health board that 519.11 receives a local public health grant shall provide at least a 75 519.12 percent match for the state funds received through the local 519.13 public health grant described in subdivision 1, and subject to 519.14 paragraphs (b) to (d). 519.15 (b) Eligible funds must be used to meet match requirements. 519.16 Eligible funds include funds from local property taxes, 519.17 reimbursements from third parties, fees, other local funds, and 519.18 donations or nonfederal grants that are used for community 519.19 health services described in section 145A.02, subdivision 6. 519.20 (c) When the amount of local matching funds for a community 519.21 health board is less than the amount required under paragraph 519.22 (a), the local public health grant provided for that community 519.23 health board under this section shall be reduced proportionally. 519.24 (d) A city organized under the provision of sections 519.25 145A.09 to 145A.131 that levies a tax for provision of community 519.26 health services is exempt from any county levy for the same 519.27 services to the extent of the levy imposed by the city. 519.28 Subd. 3. [ACCOUNTABILITY.] (a) Community health boards 519.29 accepting local public health grants must document progress 519.30 toward the statewide outcomes established in section 145A.12, 519.31 subdivision 7, to maintain eligibility to receive the local 519.32 public health grant. 519.33 (b) In determining whether or not the community health 519.34 board is documenting progress toward statewide outcomes, the 519.35 commissioner shall consider the following factors: 519.36 (1) whether the community health board has documented 520.1 progress to meeting essential local activities related to the 520.2 statewide outcomes, as specified in the grant agreement; 520.3 (2) the effort put forth by the community health board 520.4 toward the selected statewide outcomes; 520.5 (3) whether the community health board has previously 520.6 failed to document progress toward selected statewide outcomes 520.7 under this section; 520.8 (4) the amount of funding received by the community health 520.9 board to address the statewide outcomes; and 520.10 (5) other factors as the commissioner may require, if the 520.11 commissioner specifically identifies the additional factors in 520.12 the commissioner's written notice of determination. 520.13 (c) If the commissioner determines that a community health 520.14 board has not by the applicable deadline documented progress 520.15 toward the selected statewide outcomes established under section 520.16 145.8821 or 145A.12, subdivision 7, the commissioner shall 520.17 notify the community health board in writing and recommend 520.18 specific actions that the community health board should take 520.19 over the following 12 months to maintain eligibility for the 520.20 local public health grant. 520.21 (d) During the 12 months following the written 520.22 notification, the commissioner shall provide administrative and 520.23 program support to assist the community health board in taking 520.24 the actions recommended in the written notification. 520.25 (e) If the community health board has not taken the 520.26 specific actions recommended by the commissioner within 12 520.27 months following written notification, the commissioner may 520.28 determine not to distribute funds to the community health board 520.29 under section 145A.12, subdivision 2, for the next fiscal year. 520.30 (f) If the commissioner determines not to distribute funds 520.31 for the next fiscal year, the commissioner must give the 520.32 community health board written notice of this determination and 520.33 allow the community health board to appeal the determination in 520.34 writing. 520.35 (g) If the commissioner determines not to distribute funds 520.36 for the next fiscal year to a community health board that has 521.1 not documented progress toward the statewide outcomes and not 521.2 taken the actions recommended by the commissioner, the 521.3 commissioner may retain local public health grant funds that the 521.4 community health board would have otherwise received and 521.5 directly carry out essential local activities to meet the 521.6 statewide outcomes, or contract with other units of government 521.7 or community-based organizations to carry out essential local 521.8 activities related to the statewide outcomes. 521.9 (h) If the community health board that does not document 521.10 progress toward the statewide outcomes is a city, the 521.11 commissioner shall distribute the local public health funds that 521.12 would have been allocated to that city to the county in which 521.13 the city is located, if that county is part of a community 521.14 health board. 521.15 (i) The commissioner shall establish a reporting system by 521.16 which community health boards will document their progress 521.17 toward statewide outcomes. This system will be developed in 521.18 consultation with the state community health services advisory 521.19 committee established in section 145A.10, subdivision 10, 521.20 paragraph (a), and the maternal and the child health advisory 521.21 committee established in section 145.881. 521.22 Subd. 4. [RESPONSIBILITY OF COMMISSIONER TO ENSURE A 521.23 STATEWIDE PUBLIC HEALTH SYSTEM.] If a county withdraws from a 521.24 community health board and operates as a board of health or if a 521.25 community health board elects not to accept the local public 521.26 health grant, the commissioner may retain the amount of funding 521.27 that would have been allocated to the community health board 521.28 using the formula described in subdivision 1 and assume 521.29 responsibility for public health activities to meet the 521.30 statewide outcomes in the geographic area served by the board of 521.31 health or community health board. The commissioner may elect to 521.32 directly provide public health activities to meet the statewide 521.33 outcomes or contract with other units of government or with 521.34 community-based organizations. If a city that is currently a 521.35 community health board withdraws from a community health board 521.36 or elects not to accept the local public health grant, the local 522.1 public health grant funds that would have been allocated to that 522.2 city shall be distributed to the county in which the city is 522.3 located, if the county is part of a community health board. 522.4 Subd. 5. [LOCAL PUBLIC HEALTH PRIORITIES.] Community 522.5 health boards may use their local public health grant to address 522.6 local public health priorities identified under section 145A.10, 522.7 subdivision 5a. 522.8 Sec. 29. Minnesota Statutes 2002, section 145A.14, 522.9 subdivision 2, is amended to read: 522.10 Subd. 2. [INDIAN HEALTH GRANTS.] (a) The commissioner may 522.11 make special grants tocommunity health boards toestablish, 522.12 operate, or subsidize clinic facilities and services to furnish 522.13 health services for American Indians who reside off reservations. 522.14 (b)To qualify for a grant under this subdivision the522.15community health plan submitted by the community health board522.16must contain a proposal for the delivery of the services and522.17documentation that representatives of the Indian community522.18affected by the plan were involved in its development.522.19(c)Applicants must submit for approval a plan and budget 522.20 for the use of the funds in the form and detail specified by the 522.21 commissioner. 522.22(d)(c) Applicants must keep records, including records of 522.23 expenditures to be audited, as the commissioner specifies. 522.24 Sec. 30. Minnesota Statutes 2002, section 145A.14, is 522.25 amended by adding a subdivision to read: 522.26 Subd. 2a. [TRIBAL GOVERNMENTS.] (a) Of the funding 522.27 available for local public health grants, $1,500,000 per year is 522.28 available to tribal governments for: 522.29 (1) maternal and child health activities under section 522.30 145.882, subdivision 7; 522.31 (2) activities to reduce health disparities under section 522.32 145.928, subdivision 10; and 522.33 (3) emergency preparedness. 522.34 (b) The commissioner, in consultation with tribal 522.35 governments, shall establish a formula for distributing the 522.36 funds and developing the outcomes to be measured. 523.1 Sec. 31. [REVISOR'S INSTRUCTION.] 523.2 (a) The revisor of statutes shall delete "145A.13" and 523.3 insert "145A.131" in Minnesota Statutes, sections 145A.03, 523.4 subdivision 1; 145A.04, subdivision 4; 145A.10, subdivision 1; 523.5 256E.03, subdivision 2; 383B.221, subdivision 2; and 402.02, 523.6 subdivision 2. 523.7 (b) For sections in Minnesota Statutes and Minnesota Rules 523.8 affected by the repealed sections in this article, the revisor 523.9 shall delete internal cross-references where appropriate and 523.10 make changes necessary to correct the punctuation, grammar, or 523.11 structure of the remaining text and preserve its meaning. 523.12 Sec. 32. [REPEALER.] 523.13 (a) Minnesota Statutes 2002, sections 144.401; 145.882, 523.14 subdivisions 4, 5, 6, and 8; 145.883, subdivisions 4 and 7; 523.15 145.884; 145.885; 145.886; 145.888; 145.889; 145.890; 145A.02, 523.16 subdivisions 9, 10, 11, 12, 13, and 14; 145A.09, subdivision 6; 523.17 145A.10, subdivisions 5, 6, and 8; 145A.11, subdivision 3; 523.18 145A.12, subdivisions 3, 4, and 5; 145A.14, subdivisions 3 and 523.19 4; and 145A.17, subdivision 2, are repealed. 523.20 (b) Minnesota Rules, parts 4736.0010; 4736.0020; 4736.0030; 523.21 4736.0040; 4736.0050; 4736.0060; 4736.0070; 4736.0080; 523.22 4736.0090; 4736.0120; and 4736.0130, are repealed effective 523.23 January 1, 2004. 523.24 (c) Minnesota Rules, parts 4705.0100; 4705.0200; 4705.0300; 523.25 4705.0400; 4705.0500; 4705.0600; 4705.0700; 4705.0800; 523.26 4705.0900; 4705.1000; 4705.1100; 4705.1200; 4705.1300; 523.27 4705.1400; 4705.1500; and 4705.1600, are repealed effective June 523.28 30, 2004. 523.29 ARTICLE 9 523.30 CHILD CARE AND MISCELLANEOUS PROVISIONS 523.31 Section 1. Minnesota Statutes 2002, section 119B.011, 523.32 subdivision 5, is amended to read: 523.33 Subd. 5. [CHILD CARE.] "Child care" means the care of a 523.34 child by someone other than a parentor, stepparent, legal 523.35 guardian, eligible relative caregiver, or the spouses of any of 523.36 the foregoing in or outside the child's own home for gain or 524.1 otherwise, on a regular basis, for any part of a 24-hour day. 524.2 Sec. 2. Minnesota Statutes 2002, section 119B.011, 524.3 subdivision 6, is amended to read: 524.4 Subd. 6. [CHILD CARE FUND.] "Child care fund" means a 524.5 program under this chapter providing: 524.6 (1) financial assistance for child care to parents engaged 524.7 in employment, job search, or education and training leading to 524.8 employment, or an at-home infant care subsidy; and 524.9 (2) grants to develop, expand, and improve the access and 524.10 availability of child care services statewide. 524.11 Sec. 3. Minnesota Statutes 2002, section 119B.011, 524.12 subdivision 15, is amended to read: 524.13 Subd. 15. [INCOME.] "Income" means earned or unearned 524.14 income received by all family members, including public 524.15 assistance cash benefitsand at-home infant care subsidy524.16payments, unless specifically excluded and child support and 524.17 maintenance distributed to the family under section 256.741, 524.18 subdivision 15. The following are excluded from income: funds 524.19 used to pay for health insurance premiums for family members, 524.20 Supplemental Security Income, scholarships, work-study income, 524.21 and grants that cover costs or reimbursement for tuition, fees, 524.22 books, and educational supplies; student loans for tuition, 524.23 fees, books, supplies, and living expenses; state and federal 524.24 earned income tax credits; assistance specifically excluded as 524.25 income by law; in-kind income such as food stamps, energy 524.26 assistance, foster care assistance, medical assistance, child 524.27 care assistance, and housing subsidies; earned income of 524.28 full-time or part-time students up to the age of 19, who have 524.29 not earned a high school diploma or GED high school equivalency 524.30 diploma including earnings from summer employment; grant awards 524.31 under the family subsidy program; nonrecurring lump sum income 524.32 only to the extent that it is earmarked and used for the purpose 524.33 for which it is paid; and any income assigned to the public 524.34 authority according to section 256.741. 524.35 Sec. 4. Minnesota Statutes 2002, section 119B.011, 524.36 subdivision 19, is amended to read: 525.1 Subd. 19. [PROVIDER.] "Provider" means: (1) an individual 525.2 or child care center or facility, either licensed or unlicensed, 525.3 providing legal child care services as defined under section 525.4 245A.03; or (2) an individual or child care center or facility 525.5 holding a valid child care license issued by another state or a 525.6 tribe and providing child care services in the licensing state 525.7 or in the area under the licensing tribe's jurisdiction. A 525.8 legally unlicensedregisteredfamily child care provider must be 525.9 at least 18 years of age, and not a member of the MFIP 525.10 assistance unit or a member of the family receiving child care 525.11 assistance to be authorized under this chapter. 525.12 Sec. 5. Minnesota Statutes 2002, section 119B.011, is 525.13 amended by adding a subdivision to read: 525.14 Subd. 19a. [REGISTRATION.] "Registration" means the 525.15 process used by a county to determine whether the provider 525.16 selected by a family applying for or receiving child care 525.17 assistance to care for that family's children meets the 525.18 requirements necessary for payment of child care assistance for 525.19 care provided by that provider. 525.20 Sec. 6. Minnesota Statutes 2002, section 119B.011, 525.21 subdivision 20, is amended to read: 525.22 Subd. 20. [TRANSITION YEAR FAMILIES.] (a) "Transition year 525.23 families" means families who have received MFIP assistance, or 525.24 who were eligible to receive MFIP assistance after choosing to 525.25 discontinue receipt of the cash portion of MFIP assistance under 525.26 section 256J.31, subdivision 12, for at least three of the last 525.27 six months before losing eligibility for MFIP or families 525.28 participating in work first under chapter 256K who meet the 525.29 requirements of section 256K.07. Transition year child care may 525.30 be used to support employment or job search. Transition year 525.31 child care is not available to families who have been 525.32 disqualified from MFIP due to fraud. 525.33 (b) "Transition year extension year families" means 525.34 families who have completed their transition year of child care 525.35 assistance under this subdivision and who are eligible for, but 525.36 on a waiting list for, services under section 119B.03. For 526.1 purposes of sections 119B.03, subdivision 3, and 119B.05, 526.2 subdivision 1, clause (2), families participating in extended 526.3 transition year shall not be considered transition year 526.4 families. Transition year extension child care may be used to 526.5 support employment or a job search that meets the requirements 526.6 of section 119B.10 for the length of time necessary for families 526.7 to be moved from the basic sliding fee waiting list into the 526.8 basic sliding fee program. 526.9 Sec. 7. Minnesota Statutes 2002, section 119B.011, 526.10 subdivision 21, is amended to read: 526.11 Subd. 21. [RECOUPMENT OF OVERPAYMENTS.] "Recoupment of 526.12 overpayments" means the reduction of child care assistance 526.13 payments to an eligible family or a child care provider in order 526.14 to correct an overpaymentto the family even when the526.15overpayment is due to agency error or other circumstances526.16outside the responsibility or control of the familyof child 526.17 care assistance. 526.18 Sec. 8. Minnesota Statutes 2002, section 119B.02, 526.19 subdivision 1, is amended to read: 526.20 Subdivision 1. [CHILD CARE SERVICES.] The commissioner 526.21 shall develop standards for county and human services boards to 526.22 provide child care services to enable eligible families to 526.23 participate in employment, training, or education programs. 526.24 Within the limits of available appropriations, the commissioner 526.25 shall distribute money to counties to reduce the costs of child 526.26 care for eligible families. The commissioner shall adopt rules 526.27 to govern the program in accordance with this section. The 526.28 rules must establish a sliding schedule of fees for parents 526.29 receiving child care services. The rules shall provide that 526.30 funds received as a lump sum payment of child support arrearages 526.31 shall not be counted as income to a family in the month received 526.32 but shall be prorated over the 12 months following receipt and 526.33 added to the family income during those months.In the rules526.34adopted under this section, county and human services boards526.35shall be authorized to establish policies for payment of child526.36care spaces for absent children, when the payment is required by527.1the child's regular provider. The rules shall not set a maximum527.2number of days for which absence payments can be made, but527.3instead shall direct the county agency to set limits and pay for527.4absences according to the prevailing market practice in the527.5county. County policies for payment of absences shall be527.6subject to the approval of the commissioner.The commissioner 527.7 shall maximize the use of federal money under title I and title 527.8 IV of Public Law Number 104-193, the Personal Responsibility and 527.9 Work Opportunity Reconciliation Act of 1996, and other programs 527.10 that provide federal or state reimbursement for child care 527.11 services for low-income families who are in education, training, 527.12 job search, or other activities allowed under those programs. 527.13 Money appropriated under this section must be coordinated with 527.14 the programs that provide federal reimbursement for child care 527.15 services to accomplish this purpose. Federal reimbursement 527.16 obtained must be allocated to the county that spent money for 527.17 child care that is federally reimbursable under programs that 527.18 provide federal reimbursement for child care services. The 527.19 counties shall use the federal money to expand child care 527.20 services. The commissioner may adopt rules under chapter 14 to 527.21 implement and coordinate federal program requirements. 527.22 Sec. 9. [119B.025] [DUTIES OF COUNTIES.] 527.23 Subdivision 1. [FACTORS WHICH MUST BE VERIFIED.] (a) The 527.24 county shall verify the following at all initial child care 527.25 applications using the universal application: 527.26 (1) identity of adults; 527.27 (2) presence of the minor child in the home, if 527.28 questionable; 527.29 (3) relationship of minor child to the parent, stepparent, 527.30 legal guardian, eligible relative caretaker, or the spouses of 527.31 any of the foregoing; 527.32 (4) age; 527.33 (5) immigration status, if related to eligibility; 527.34 (6) social security number, if given; 527.35 (7) income; 527.36 (8) spousal support and child support payments made to 528.1 persons outside the household; 528.2 (9) residence; and 528.3 (10) inconsistent information, if related to eligibility. 528.4 (b) If a family did not use the universal application to 528.5 apply for child care assistance, the family must complete the 528.6 universal application at its next eligibility redetermination 528.7 and the county must verify the factors listed in paragraph (a) 528.8 as part of that redetermination. Once a family has completed a 528.9 universal application, the county shall use the redetermination 528.10 form described in paragraph (c) for that family's subsequent 528.11 redeterminations. 528.12 (c) The commissioner shall develop a recertification form 528.13 to redetermine eligibility that minimizes paperwork for the 528.14 county and the participant. 528.15 Subd. 2. [SOCIAL SECURITY NUMBERS.] The county must 528.16 request social security numbers from all applicants for child 528.17 care assistance under this chapter. A county may not deny child 528.18 care assistance solely on the basis of failure of an applicant 528.19 to report a social security number. 528.20 Sec. 10. Minnesota Statutes 2002, section 119B.03, 528.21 subdivision 4, is amended to read: 528.22 Subd. 4. [FUNDING PRIORITY.] (a) First priority for child 528.23 care assistance under the basic sliding fee program must be 528.24 given to eligible non-MFIP families who do not have a high 528.25 school or general equivalency diploma or who need remedial and 528.26 basic skill courses in order to pursue employment or to pursue 528.27 education leading to employment and who need child care 528.28 assistance to participate in the education program. Within this 528.29 priority, the following subpriorities must be used: 528.30 (1) child care needs of minor parents; 528.31 (2) child care needs of parents under 21 years of age; and 528.32 (3) child care needs of other parents within the priority 528.33 group described in this paragraph. 528.34 (b) Second priority must be given to parents who have 528.35 completed their MFIP or work first transition year. 528.36 (c) Third priority must be given to families who are 529.1 eligible for portable basic sliding fee assistance through the 529.2 portability pool under subdivision 9. 529.3 (d) Families under paragraph (b) must be added to the basic 529.4 sliding fee waiting list on the date they begin transition year 529.5 under section 119B.011, subdivision 20, and must be moved into 529.6 basic sliding fee as soon as possible after they complete their 529.7 transition year. 529.8 Sec. 11. Minnesota Statutes 2002, section 119B.03, 529.9 subdivision 9, is amended to read: 529.10 Subd. 9. [PORTABILITY POOL.] (a) The commissioner shall 529.11 establish a pool of up to five percent of the annual 529.12 appropriation for the basic sliding fee program to provide 529.13 continuous child care assistance for eligible families who move 529.14 between Minnesota counties. At the end of each allocation 529.15 period, any unspent funds in the portability pool must be used 529.16 for assistance under the basic sliding fee program. If 529.17 expenditures from the portability pool exceed the amount of 529.18 money available, the reallocation pool must be reduced to cover 529.19 these shortages. 529.20 (b) To be eligible for portable basic sliding fee 529.21 assistance, a family that has moved from a county in which it 529.22 was receiving basic sliding fee assistance to a county with a 529.23 waiting list for the basic sliding fee program must: 529.24 (1) meet the income and eligibility guidelines for the 529.25 basic sliding fee program; and 529.26 (2) notify the new county of residence within3060 days of 529.27 moving andapply for basic sliding fee assistance insubmit 529.28 information to the new county of residence to verify eligibility 529.29 for the basic sliding fee program. 529.30 (c) The receiving county must: 529.31 (1) accept administrative responsibility for applicants for 529.32 portable basic sliding fee assistance at the end of the two 529.33 months of assistance under the Unitary Residency Act; 529.34 (2) continue basic sliding fee assistance for the lesser of 529.35 six months or until the family is able to receive assistance 529.36 under the county's regular basic sliding program; and 530.1 (3) notify the commissioner through the quarterly reporting 530.2 process of any family that meets the criteria of the portable 530.3 basic sliding fee assistance pool. 530.4 Sec. 12. Minnesota Statutes 2002, section 119B.05, 530.5 subdivision 1, is amended to read: 530.6 Subdivision 1. [ELIGIBLE PARTICIPANTS.] Families eligible 530.7 for child care assistance under the MFIP child care program are: 530.8 (1) MFIP participants who are employed or in job search and 530.9 meet the requirements of section 119B.10; 530.10 (2) persons who are members of transition year families 530.11 under section 119B.011, subdivision 20, and meet the 530.12 requirements of section 119B.10; 530.13 (3) families who are participating in employment 530.14 orientation or job search, or other employment or training 530.15 activities that are included in an approved employability 530.16 development plan under chapter 256K; 530.17 (4) MFIP families who are participating in work job search, 530.18 job support, employment, or training activities as required in 530.19 their job search support or employment plan, or in appeals, 530.20 hearings, assessments, or orientations according to chapter 530.21 256J; 530.22 (5) MFIP families who are participating in social services 530.23 activities under chapter 256J or 256K as required in their 530.24 employment plan approved according to chapter 256J or 256K;and530.25 (6) families who are participating in programs as required 530.26 in tribal contracts under section 119B.02, subdivision 2, or 530.27 256.01, subdivision 2; and 530.28 (7) families who are participating in the transition year 530.29 extension under section 119B.011, subdivsion 20, paragraph (a). 530.30 Sec. 13. Minnesota Statutes 2002, section 119B.08, 530.31 subdivision 3, is amended to read: 530.32 Subd. 3. [CHILD CARE FUND PLAN.] The county and designated 530.33 administering agency shall submit a biennial child care fund 530.34 plan to the commissioneran annual child care fund plan in its530.35biennial community social services plan. The commissioner shall 530.36 establish the dates by which the county must submit the plans. 531.1 The plan shall include: 531.2 (1)a narrative of the total program for child care531.3services, including all policies and procedures that affect531.4eligible families and are used to administer the child care531.5funds;531.6(2) the methods used by the county to inform eligible531.7families of the availability of child care assistance and531.8related services;531.9(3) the provider rates paid for all children with special531.10needs by provider type;531.11(4) the county prioritization policy for all eligible531.12families under the basic sliding fee program; and531.13(5) othera description of strategies to coordinate and 531.14 maximize public and private community resources, including 531.15 school districts, health care facilities, government agencies, 531.16 neighborhood organizations, and other resources knowledgeable in 531.17 early childhood development, in particular to coordinate child 531.18 care assistance with existing community-based programs and 531.19 service providers including child care resource and referral 531.20 programs, early childhood family education, school readiness, 531.21 Head Start, local interagency early intervention committees, 531.22 special education services, early childhood screening, and other 531.23 early childhood care and education services and programs to the 531.24 extent possible, to foster collaboration among agencies and 531.25 other community-based programs that provide flexible, 531.26 family-focused services to families with young children and to 531.27 facilitate transition into kindergarten. The county must 531.28 describe a method by which to share information, responsibility, 531.29 and accountability among service and program providers; 531.30 (2) a description of procedures and methods to be used to 531.31 make copies of the proposed state plan reasonably available to 531.32 the public, including members of the public particularly 531.33 interested in child care policies such as parents, child care 531.34 providers, culturally specific service organizations, child care 531.35 resource and referral programs, interagency early intervention 531.36 committees, potential collaborative partners and agencies 532.1 involved in the provision of care and education to young 532.2 children, and allowing sufficient time for public review and 532.3 comment; and 532.4 (3) information as requested by the department to ensure 532.5 compliance with the child care fund statutes and rules 532.6 promulgated by the commissioner. 532.7 The commissioner shall notify counties within6090 days of 532.8 the date the plan is submitted whether the plan is approved or 532.9 the corrections or information needed to approve the plan. The 532.10 commissioner shall withhold a county's allocation until it has 532.11 an approved plan. Plans not approved by the end of the second 532.12 quarter after the plan is due may result in a 25 percent 532.13 reduction in allocation. Plans not approved by the end of the 532.14 third quarter after the plan is due may result in a 100 percent 532.15 reduction in the allocation to the county. Counties are to 532.16 maintain services despite any reduction in their allocation due 532.17 to plans not being approved. 532.18 Sec. 14. Minnesota Statutes 2002, section 119B.09, 532.19 subdivision 1, is amended to read: 532.20 Subdivision 1. [GENERAL ELIGIBILITY REQUIREMENTS FOR ALL 532.21 APPLICANTS FOR CHILD CARE ASSISTANCE.] (a) Child care services 532.22 must be available to families who need child care to find or 532.23 keep employment or to obtain the training or education necessary 532.24 to find employment and who: 532.25 (1) meet the requirements of section 119B.05; receive MFIP 532.26 assistance; and are participating in employment and training 532.27 services under chapter 256J or 256K; 532.28 (2) have household income below the eligibility levels for 532.29 MFIP; or 532.30 (3) have household incomewithin a range established by the532.31commissionerless than or equal to 175 percent of the federal 532.32 poverty guidelines, adjusted for family size, at program entry 532.33 and less than 250 percent of the federal poverty guidelines, 532.34 adjusted for family size, at program exit. 532.35 (b) Child care services must be made available as in-kind 532.36 services. 533.1 (c) All applicants for child care assistance and families 533.2 currently receiving child care assistance must be assisted and 533.3 required to cooperate in establishment of paternity and 533.4 enforcement of child support obligations for all children in the 533.5 family as a condition of program eligibility. For purposes of 533.6 this section, a family is considered to meet the requirement for 533.7 cooperation when the family complies with the requirements of 533.8 section 256.741. 533.9 Sec. 15. Minnesota Statutes 2002, section 119B.09, 533.10 subdivision 2, is amended to read: 533.11 Subd. 2. [SLIDING FEE.] Child care services to 533.12 familieswith incomes in the commissioner's established range533.13 must be made available on a sliding fee basis.The upper limit533.14of the range must be neither less than 70 percent nor more than533.1590 percent of the state median income for a family of four,533.16adjusted for family size.533.17 Sec. 16. Minnesota Statutes 2002, section 119B.09, 533.18 subdivision 7, is amended to read: 533.19 Subd. 7. [DATE OF ELIGIBILITY FOR ASSISTANCE.] (a) The 533.20 date of eligibility for child care assistance under this chapter 533.21 is the later of the date the application was signed; the 533.22 beginning date of employment, education, or training; or the 533.23 date a determination has been made that the applicant is a 533.24 participant in employment and training services under Minnesota 533.25 Rules, part 3400.0080, subpart 2a, or chapter 256J or 256K.The533.26date of eligibility for the basic sliding fee at-home infant533.27child care program is the later of the date the infant is born533.28or, in a county with a basic sliding fee waiting list, the date533.29the family applies for at-home infant child care.533.30 (b)Payment ceases for a family under the at-home infant533.31child care program when a family has used a total of 12 months533.32of assistance as specified under section 119B.061.Payment of 533.33 child care assistance for employed persons on MFIP is effective 533.34 the date of employment or the date of MFIP eligibility, 533.35 whichever is later. Payment of child care assistance for MFIP 533.36 or work first participants in employment and training services 534.1 is effective the date of commencement of the services or the 534.2 date of MFIP or work first eligibility, whichever is later. 534.3 Payment of child care assistance for transition year child care 534.4 must be made retroactive to the date of eligibility for 534.5 transition year child care. 534.6 Sec. 17. Minnesota Statutes 2002, section 119B.09, is 534.7 amended by adding a subdivision to read: 534.8 Subd. 9. [LICENSED AND LEGAL NONLICENSED FAMILY CHILD CARE 534.9 PROVIDERS; ASSISTANCE.] Licensed and legal nonlicensed family 534.10 child care providers are not eligible to receive child care 534.11 assistance subsidies under this chapter for their own children 534.12 or children in their custody. 534.13 Sec. 18. Minnesota Statutes 2002, section 119B.09, is 534.14 amended by adding a subdivision to read: 534.15 Subd. 10. [PAYMENT OF FUNDS.] All federal, state, and 534.16 local child care funds must be paid directly to the parent when 534.17 a provider cares for children in the children's own home. In 534.18 all other cases, all federal, state, and local child care funds 534.19 must be paid directly to the child care provider, either 534.20 licensed or legal nonlicensed, on behalf of the eligible family. 534.21 Sec. 19. Minnesota Statutes 2002, section 119B.11, 534.22 subdivision 2a, is amended to read: 534.23 Subd. 2a. [RECOVERY OF OVERPAYMENTS.] (a) An amount of 534.24 child care assistance paid to a recipient in excess of the 534.25 payment due is recoverable by the county agency under paragraphs 534.26 (b) and (c), even when the overpayment was caused by agency 534.27 error or circumstances outside the responsibility and control of 534.28 the family or provider. 534.29 (b) An overpayment must be recouped or recovered from the 534.30 family if the overpayment benefited the family by causing the 534.31 family to pay less for child care expenses than the family 534.32 otherwise would have been required to pay under child care 534.33 assistance program requirements. If the family remains eligible 534.34 for child care assistance, the overpayment must be recovered 534.35 through recoupment as identified in Minnesota Rules, 534.36 part3400.0140, subpart 193400.0187, except that the 535.1 overpayments must be calculated and collected on a service 535.2 period basis. If the family no longer remains eligible for 535.3 child care assistance, the county may choose to initiate efforts 535.4 to recover overpayments from the family for overpayment less 535.5 than $50. If the overpayment is greater than or equal to $50, 535.6 the county shall seek voluntary repayment of the overpayment 535.7 from the family. If the county is unable to recoup the 535.8 overpayment through voluntary repayment, the county shall 535.9 initiate civil court proceedings to recover the overpayment 535.10 unless the county's costs to recover the overpayment will exceed 535.11 the amount of the overpayment. A family with an outstanding 535.12 debt under this subdivision is not eligible for child care 535.13 assistance until: (1) the debt is paid in full; or (2) 535.14 satisfactory arrangements are made with the county to retire the 535.15 debt consistent with the requirements of this chapter and 535.16 Minnesota Rules, chapter 3400, and the family is in compliance 535.17 with the arrangements. 535.18 (c) The county must recover an overpayment from a provider 535.19 if the overpayment did not benefit the family by causing it to 535.20 receive more child care assistance or to pay less for child care 535.21 expenses than the family otherwise would have been eligible to 535.22 receive or required to pay under child care assistance program 535.23 requirements, and benefited the provider by causing the provider 535.24 to receive more child care assistance than otherwise would have 535.25 been paid on the family's behalf under child care assistance 535.26 program requirements. If the provider continues to care for 535.27 children receiving child care assistance, the overpayment must 535.28 be recovered through reductions in child care assistance 535.29 payments for services as described in an agreement with the 535.30 county. The provider may not charge families using that 535.31 provider more to cover the cost of recouping the overpayment. 535.32 If the provider no longer cares for children receiving child 535.33 care assistance, the county may choose to initiate efforts to 535.34 recover overpayments of less than $50 from the provider. If the 535.35 overpayment is greater than or equal to $50, the county shall 535.36 seek voluntary repayment of the overpayment from the provider. 536.1 If the county is unable to recoup the overpayment through 536.2 voluntary repayment, the county shall initiate civil court 536.3 proceedings to recover the overpayment unless the county's costs 536.4 to recover the overpayment will exceed the amount of the 536.5 overpayment. A provider with an outstanding debt under this 536.6 subdivision is not eligible to care for children receiving child 536.7 care assistance until: (1) the debt is paid in full; or (2) 536.8 satisfactory arrangements are made with the county to retire the 536.9 debt consistent with the requirements of this chapter and 536.10 Minnesota Rules, chapter 3400, and the provider is in compliance 536.11 with the arrangements. 536.12 (d) When both the family and the provider acted together to 536.13 intentionally cause the overpayment, both the family and the 536.14 provider are jointly liable for the overpayment regardless of 536.15 who benefited from the overpayment. The county must recover the 536.16 overpayment as provided in paragraphs (b) and (c). When the 536.17 family or the provider is in compliance with a repayment 536.18 agreement, the party in compliance is eligible to receive child 536.19 care assistance or to care for children receiving child care 536.20 assistance despite the other party's noncompliance with 536.21 repayment arrangements. 536.22 Sec. 20. Minnesota Statutes 2002, section 119B.12, 536.23 subdivision 2, is amended to read: 536.24 Subd. 2. [PARENT FEE.] A family must be assessed a parent 536.25 fee for each service period. A family'smonthlyparent fee must 536.26 be a fixed percentage of its annual gross income. Parent fees 536.27 must apply to families eligible for child care assistance under 536.28 sections 119B.03 and 119B.05. Income must be as defined in 536.29 section 119B.011, subdivision 15. The fixed percent is based on 536.30 the relationship of the family's annual gross income to 100 536.31 percent ofstate median incomethe annual federal poverty 536.32 guidelines.Beginning January 1, 1998, parent fees must begin536.33at 75 percent of the poverty level. The minimum parent fees for536.34families between 75 percent and 100 percent of poverty level536.35must be $5 per month.Parent fees mustbe established in rule536.36and mustprovide for graduated movement to full payment. 537.1 Sec. 21. [119B.125] [PROVIDER REQUIREMENTS.] 537.2 Subdivision 1. [AUTHORIZATION.] Except as provided in 537.3 subdivision 5, a county must authorize the provider chosen by an 537.4 applicant or a participant before the county can authorize 537.5 payment for care provided by that provider. The commissioner 537.6 must establish the requirements necessary for authorization of 537.7 providers. 537.8 Subd. 2. [PERSONS WHO CANNOT BE AUTHORIZED.] (a) A person 537.9 who meets any of the conditions under paragraphs (b) to (n) must 537.10 not be authorized as a legal nonlicensed family child care 537.11 provider. For purposes of this subdivision, a finding that a 537.12 delinquency petition is proven in juvenile court must be 537.13 considered a conviction in state district court. 537.14 (b) The person has been convicted of one of the following 537.15 offenses or has admitted to committing or a preponderance of the 537.16 evidence indicates that the person has committed an act that 537.17 meets the definition of one of the following offenses: sections 537.18 609.185 to 609.195, murder in the first, second, or third 537.19 degree; 609.2661 to 609.2663, murder of an unborn child in the 537.20 first, second, or third degree; 609.322, solicitation, 537.21 inducement, or promotion of prostitution; 609.323, receiving 537.22 profit from prostitution; 609.342 to 609.345, criminal sexual 537.23 conduct in the first, second, third, or fourth degree; 609.352, 537.24 solicitation of children to engage in sexual conduct; 609.365, 537.25 incest; 609.377, felony malicious punishment of a child; 537.26 617.246, use of minors in sexual performance; 617.247, 537.27 possession of pictorial representation of a minor; 609.2242 to 537.28 609.2243, felony domestic assault; a felony offense of spousal 537.29 abuse; a felony offense of child abuse or neglect; a felony 537.30 offense of a crime against children; or an attempt or conspiracy 537.31 to commit any of these offenses as defined in Minnesota 537.32 Statutes; or an offense in any other state or country where the 537.33 elements are substantially similar to any of the offenses listed 537.34 in this paragraph. 537.35 (c) Less than 15 years have passed since the discharge of 537.36 the sentence imposed for the offense and the person has received 538.1 a felony conviction for one of the following offenses, or the 538.2 person has admitted to committing or a preponderance of the 538.3 evidence indicates that the person has committed an act that 538.4 meets the definition of a felony conviction for one of the 538.5 following offenses: sections 609.20 to 609.205, manslaughter in 538.6 the first or second degree; 609.21, criminal vehicular homicide; 538.7 609.215, aiding suicide or aiding attempted suicide; 609.221 to 538.8 609.2231, assault in the first, second, third, or fourth degree; 538.9 609.224, repeat offenses of fifth degree assault; 609.228, great 538.10 bodily harm caused by distribution of drugs; 609.2325, criminal 538.11 abuse of a vulnerable adult; 609.2335, financial exploitation of 538.12 a vulnerable adult; 609.235, use of drugs to injure or 538.13 facilitate a crime; 609.24, simple robbery; 617.241, repeat 538.14 offenses of obscene materials and performances; 609.245, 538.15 aggravated robbery; 609.25, kidnapping; 609.255, false 538.16 imprisonment; 609.2664 to 609.2665, manslaughter of an unborn 538.17 child in the first or second degree; 609.267 to 609.2672, 538.18 assault of an unborn child in the first, second, or third 538.19 degree; 609.268, injury or death of an unborn child in the 538.20 commission of a crime; 609.27, coercion; 609.275, attempt to 538.21 coerce; 609.324, subdivision 1, other prohibited acts, minor 538.22 engaged in prostitution; 609.3451, repeat offenses of criminal 538.23 sexual conduct in the fifth degree; 609.378, neglect or 538.24 endangerment of a child; 609.52, theft; 609.521, possession of 538.25 shoplifting gear; 609.561 to 609.563, arson in the first, 538.26 second, or third degree; 609.582, burglary in the first, second, 538.27 third, or fourth degree; 609.625, aggravated forgery; 609.63, 538.28 forgery; 609.631, check forgery, offering a forged check; 538.29 609.635, obtaining signature by false pretenses; 609.66, 538.30 dangerous weapon; 609.665, setting a spring gun; 609.67, 538.31 unlawfully owning, possessing, or operating a machine gun; 538.32 609.687, adulteration; 609.71, riot; 609.713, terrorist threats; 538.33 609.749, harassment, stalking; 260.221, grounds for termination 538.34 of parental rights; 152.021 to 152.022, controlled substance 538.35 crime in the first or second degree; 152.023, subdivision 1, 538.36 clause (3) or (4), or 152.023, subdivision 2, clause (4), 539.1 controlled substance crime in third degree; 152.024, subdivision 539.2 1, clause (2), (3), or (4), controlled substance crime in fourth 539.3 degree; 617.23, repeat offenses of indecent exposure; an attempt 539.4 or conspiracy to commit any of these offenses as defined in 539.5 Minnesota Statutes; or an offense in any other state or country 539.6 where the elements are substantially similar to any of the 539.7 offenses listed in this paragraph. 539.8 (d) Less than ten years have passed since the discharge of 539.9 the sentence imposed for the offense and the person has received 539.10 a gross misdemeanor conviction for one of the following offenses 539.11 or the person has admitted to committing or a preponderance of 539.12 the evidence indicates that the person has committed an act that 539.13 meets the definition of a gross misdemeanor conviction for one 539.14 of the following offenses: sections 609.224, fifth degree 539.15 assault; 609.2242 to 609.2243, domestic assault; 518B.01, 539.16 subdivision 14, violation of an order for protection; 609.3451, 539.17 fifth degree criminal sexual conduct; 609.746, repeat offenses 539.18 of interference with privacy; 617.23, repeat offenses of 539.19 indecent exposure; 617.241, obscene materials and performances; 539.20 617.243, indecent literature, distribution; 617.293, 539.21 disseminating or displaying harmful material to minors; 609.71, 539.22 riot; 609.66, dangerous weapons; 609.749, harassment, stalking; 539.23 609.224, subdivision 2, paragraph (c), fifth degree assault 539.24 against a vulnerable adult by a caregiver; 609.23, mistreatment 539.25 of persons confined; 609.231, mistreatment of residents or 539.26 patients; 609.2325, criminal abuse of a vulnerable adult; 539.27 609.2335, financial exploitation of a vulnerable adult; 609.233, 539.28 criminal neglect of a vulnerable adult; 609.234, failure to 539.29 report maltreatment of a vulnerable adult; 609.72, subdivision 539.30 3, disorderly conduct against a vulnerable adult; 609.265, 539.31 abduction; 609.378, neglect or endangerment of a child; 609.377, 539.32 malicious punishment of a child; 609.324, subdivision 1a, other 539.33 prohibited acts, minor engaged in prostitution; 609.33, 539.34 disorderly house; 609.52, theft; 609.582, burglary in the first, 539.35 second, third, or fourth degree; 609.631, check forgery, 539.36 offering a forged check; 609.275, attempt to coerce; an attempt 540.1 or conspiracy to commit any of these offenses as defined in 540.2 Minnesota Statutes; or an offense in any other state or country 540.3 where the elements are substantially similar to any of the 540.4 offenses listed in this paragraph. 540.5 (e) Less than seven years have passed since the discharge 540.6 of the sentence imposed for the offense and the person has 540.7 received a misdemeanor conviction for one of the following 540.8 offenses or the person has admitted to committing or a 540.9 preponderance of the evidence indicates that the person has 540.10 committed an act that meets the definition of a misdemeanor 540.11 conviction for one of the following offenses: sections 609.224, 540.12 fifth degree assault; 609.2242, domestic assault; 518B.01, 540.13 violation of an order for protection; 609.3232, violation of an 540.14 order for protection; 609.746, interference with privacy; 540.15 609.79, obscene or harassing telephone calls; 609.795, letter, 540.16 telegram, or package, opening, harassment; 617.23, indecent 540.17 exposure; 609.2672, assault of an unborn child, third degree; 540.18 617.293, dissemination and display of harmful materials to 540.19 minors; 609.66, dangerous weapons; 609.665, spring guns; an 540.20 attempt or conspiracy to commit any of these offenses as defined 540.21 in Minnesota Statutes; or an offense in any other state or 540.22 country where the elements are substantially similar to any of 540.23 the offenses listed in this paragraph. 540.24 (f) The person has been identified by the county's child 540.25 protection agency or by the statewide child protection database 540.26 as the person allegedly responsible for physical or sexual abuse 540.27 of a child within the last seven years. 540.28 (g) The person has been identified by the county's adult 540.29 protection agency or by the statewide adult protection database 540.30 as the person responsible for abuse or neglect of a vulnerable 540.31 adult within the last seven years. 540.32 (h) The person has refused to give written consent for 540.33 disclosure of criminal history records. 540.34 (i) The person has been denied a family child care license 540.35 or has received a fine or a sanction as a licensed child care 540.36 provider that has not been reversed on appeal. 541.1 (j) The person has a family child care licensing 541.2 disqualification that has not been set aside. 541.3 (k) The person has admitted or a county has found that 541.4 there is a preponderance of evidence that fraudulent information 541.5 was given to the county for application purposes or was used in 541.6 submitting bills for payment. 541.7 (l) The person has been convicted or there is a 541.8 preponderance of evidence of the crime of theft by wrongfully 541.9 obtaining public assistance. 541.10 (m) The person has a household member age 13 or older who 541.11 has access to children during the hours that care is provided 541.12 and who meets one of the conditions listed in paragraphs (b) to 541.13 (l). 541.14 (n) The person has a household member ages ten to 12 who 541.15 has access to children during the hours that care is provided; 541.16 information or circumstances exist which provide the county with 541.17 articulable suspicion that further pertinent information may 541.18 exist showing the household member meets one of the conditions 541.19 listed in paragraphs (b) to (l); and the household member 541.20 actually meets one of the conditions listed in paragraphs (b) to 541.21 (l). 541.22 Subd. 3. [AUTHORIZATION EXCEPTION.] When a county denies a 541.23 person authorization as a legal nonlicensed family child care 541.24 provider under subdivision 2, the county later may authorize 541.25 that person as a provider if the following conditions are met: 541.26 (1) after receiving notice of the denial of the 541.27 authorization, the person applies for and obtains a valid child 541.28 care license issued under chapter 245A, issued by a tribe, or 541.29 issued by another state; 541.30 (2) the person maintains the valid child care license; and 541.31 (3) the person is providing child care in the state of 541.32 licensure or in the area under the jurisdiction of the licensing 541.33 tribe. 541.34 Subd. 4. [UNSAFE CARE.] A county may deny authorization as 541.35 a child care provider to any applicant or rescind authorization 541.36 of any provider when the county knows or has reason to believe 542.1 that the provider is unsafe or that the circumstances of the 542.2 chosen child care arrangement are unsafe. The county must 542.3 include the conditions under which a provider or care 542.4 arrangement will be determined to be unsafe in the county's 542.5 child care fund plan under section 119B.08, subdivision 3. 542.6 Subd. 5. [PROVISIONAL PAYMENT.] After a county receives a 542.7 completed application from a provider, the county may issue 542.8 provisional authorization and payment to the provider during the 542.9 time needed to determine whether to give final authorization to 542.10 the provider. 542.11 Subd. 6. [RECORD KEEPING REQUIREMENT.] All providers must 542.12 keep daily attendance records for children receiving child care 542.13 assistance and must make those records available immediately to 542.14 the county upon request. The daily attendance records must be 542.15 retained for six years after the date of service. A county may 542.16 deny authorization as a child care provider to any applicant or 542.17 rescind authorization of any provider when the county knows or 542.18 has reason to believe that the provider has not complied with 542.19 the record keeping requirement in this subdivision. 542.20 Sec. 22. Minnesota Statutes 2002, section 119B.13, 542.21 subdivision 1, is amended to read: 542.22 Subdivision 1. [SUBSIDY RESTRICTIONS.] The maximum rate 542.23 paid for child care assistance under the child care fund may not 542.24 exceed the 75th percentile rate for like-care arrangements in 542.25 the county as surveyed by the commissioner. A rate which 542.26 includes a provider bonus paid under subdivision 2 or a special 542.27 needs rate paid under subdivision 3 may be in excess of the 542.28 maximum rate allowed under this subdivision. The department 542.29 shall monitor the effect of this paragraph on provider rates. 542.30 The county shall pay the provider's full charges for every child 542.31 in care up to the maximum established. The commissioner shall 542.32 determine the maximum rate for each type of care on an hourly, 542.33 full-day, and weekly basis, including special needs and 542.34 handicapped care. Not less than once every two years, the 542.35 commissioner shall evaluate market practices for payment of 542.36 absences and shall establish policies for payment of absent days 543.1 that reflect current market practice. 543.2 When the provider charge is greater than the maximum 543.3 provider rate allowed, the parent is responsible for payment of 543.4 the difference in the rates in addition to any family copayment 543.5 fee. 543.6 Sec. 23. Minnesota Statutes 2002, section 119B.13, is 543.7 amended by adding a subdivision to read: 543.8 Subd. 1b. [LEGAL NONLICENSED FAMILY CHILD CARE PROVIDER 543.9 RATES.] (a) Legal nonlicensed family child care providers 543.10 receiving reimbursement under this chapter must be paid on an 543.11 hourly basis for care provided to families receiving assistance. 543.12 (b) The maximum rate paid to legal nonlicensed family child 543.13 care providers must be 80 percent of the county maximum hourly 543.14 rate for licensed family child care providers. In counties 543.15 where the maximum hourly rate for licensed family child care 543.16 providers is higher than the maximum weekly rate for those 543.17 providers divided by 50, the maximum hourly rate that may be 543.18 paid to legal nonlicensed family child care providers is the 543.19 rate equal to the maximum weekly rate for licensed family child 543.20 care providers divided by 50 and then multiplied by 0.80. 543.21 (c) A rate which includes a provider bonus paid under 543.22 subdivision 2 or a special needs rate paid under subdivision 3 543.23 may be in excess of the maximum rate allowed under this 543.24 subdivision. 543.25 (d) Legal nonlicensed family child care providers receiving 543.26 reimbursement under this chapter may not be paid registration 543.27 fees for families receiving assistance. 543.28 Sec. 24. Minnesota Statutes 2002, section 119B.13, 543.29 subdivision 6, is amended to read: 543.30 Subd. 6. [PROVIDER PAYMENTS.] (a) Counties or the state 543.31 shall make vendor payments to the child care provider or pay the 543.32 parent directly for eligible child care expenses. 543.33 (b) If payments for child care assistance are made to 543.34 providers, the provider shall bill the county for services 543.35 provided within ten days of the end of themonth ofservice 543.36 period. If bills are submittedin accordance with the544.1provisions of this subdivisionwithin ten days of the end of the 544.2 service period, a county or the state shall issue payment to the 544.3 provider of child care under the child care fund within 30 days 544.4 of receivingan invoicea bill from the provider. Counties or 544.5 the state may establish policies that make payments on a more 544.6 frequent basis. 544.7 (c) All bills must be submitted within 60 days of the last 544.8 date of service on the bill. A county may pay a bill submitted 544.9 more than 60 days after the last date of service if the provider 544.10 shows good cause why the bill was not submitted within 60 days. 544.11 Good cause must be defined in the county's child care fund plan 544.12 under section 119B.08, subdivision 3, and the definition of good 544.13 cause must include county error. A county may not pay any bill 544.14 submitted more than a year after the last date of service on the 544.15 bill. 544.16 (d) A county may stop payment issued to a provider or may 544.17 refuse to pay a bill submitted by a provider if: 544.18 (1) the provider admits to intentionally giving the county 544.19 materially false information on the provider's billing forms; or 544.20 (2) a county finds by a preponderance of the evidence that 544.21 the provider intentionally gave the county materially false 544.22 information on the provider's billing forms. 544.23 (e) A county's payment policies must be included in the 544.24 county's child care plan under section 119B.08, subdivision 3. 544.25 If payments are made by the state, in addition to being in 544.26 compliance with this subdivision, the payments must be made in 544.27 compliance with section 16A.124. 544.28 Sec. 25. Minnesota Statutes 2002, section 119B.16, is 544.29 amended by adding a subdivision to read: 544.30 Subd. 1a. [FAIR HEARING ALLOWED FOR PROVIDERS.] (a) This 544.31 subdivision applies to providers caring for children receiving 544.32 child care assistance. 544.33 (b) A provider to whom a county agency has assigned 544.34 responsibility for an overpayment may request a fair hearing in 544.35 accordance with section 256.045 for the limited purpose of 544.36 challenging the assignment of responsibility for the overpayment 545.1 and the amount of the overpayment. The scope of the fair 545.2 hearing does not include the issues of whether the provider 545.3 wrongfully obtained public assistance in violation of section 545.4 256.98 or was properly disqualified under section 256.98, 545.5 subdivision 8, paragraph (c), unless the fair hearing has been 545.6 combined with an administrative disqualification hearing brought 545.7 against the provider under section 256.046. 545.8 Sec. 26. Minnesota Statutes 2002, section 119B.16, is 545.9 amended by adding a subdivision to read: 545.10 Subd. 1b. [JOINT FAIR HEARINGS.] When a provider requests 545.11 a fair hearing under subdivision 1a, the family in whose case 545.12 the overpayment was created must be made a party to the fair 545.13 hearing. All other issues raised by the family must be resolved 545.14 in the same proceeding. When a family requests a fair hearing 545.15 and claims that the county should have assigned responsibility 545.16 for an overpayment to a provider, the provider must be made a 545.17 party to the fair hearing. The referee assigned to a fair 545.18 hearing may join a family or a provider as a party to the fair 545.19 hearing whenever joinder of that party is necessary to fully and 545.20 fairly resolve overpayment issues raised in the appeal. 545.21 Sec. 27. Minnesota Statutes 2002, section 119B.16, 545.22 subdivision 2, is amended to read: 545.23 Subd. 2. [INFORMAL CONFERENCE.] The county agency shall 545.24 offer an informal conference to applicants and recipients 545.25 adversely affected by an agency action to attempt to resolve the 545.26 dispute. The county agency shall offer an informal conference 545.27 to providers to whom the county agency has assigned 545.28 responsibility for an overpayment in an attempt to resolve the 545.29 dispute. The county agency or the provider may ask the family 545.30 in whose case the overpayment arose to participate in the 545.31 informal conference, but the family may refuse to do so. The 545.32 county agency shall advise adversely affected applicantsand, 545.33 recipients, and providers that a request for a conference with 545.34 the agency is optional and does not delay or replace the right 545.35 to a fair hearing. 545.36 Sec. 28. Minnesota Statutes 2002, section 119B.19, 546.1 subdivision 7, is amended to read: 546.2 Subd. 7. [CHILD CARE RESOURCE AND REFERRAL PROGRAMS.] 546.3 Within each region, a child care resource and referral program 546.4 must: 546.5 (1) maintain one database of all existing child care 546.6 resources and services and one database of family referrals; 546.7 (2) provide a child care referral service for families; 546.8 (3) develop resources to meet the child care service needs 546.9 of families; 546.10 (4) increase the capacity to provide culturally responsive 546.11 child care services; 546.12 (5) coordinate professional development opportunities for 546.13 child care and school-age care providers; 546.14 (6) administer and award child care services grants; 546.15 (7) administer and provide loans for child development 546.16 education and training;and546.17 (8) cooperate with the Minnesota Child Care Resource and 546.18 Referral Network and its member programs to develop effective 546.19 child care services and child care resources; and 546.20 (9) assist in fostering coordination, collaboration, and 546.21 planning among child care programs and community programs such 546.22 as school readiness, Head Start, early childhood family 546.23 education, local interagency early intervention committees, 546.24 early childhood screening, special education services, and other 546.25 early childhood care and education services and programs that 546.26 provide flexible, family-focused services to families with young 546.27 children to the extent possible. 546.28 Sec. 29. Minnesota Statutes 2002, section 119B.21, 546.29 subdivision 11, is amended to read: 546.30 Subd. 11. [STATEWIDE ADVISORY TASK FORCE.] The 546.31 commissioner may convene a statewide advisory task force to 546.32 advise the commissioner on statewide grants or other child care 546.33 issues. The following groups must be represented: family child 546.34 care providers, child care center programs, school-age care 546.35 providers, parents who use child care services, health services, 546.36 social services, Head Start, public schools, school-based early 547.1 childhood programs, special education programs, employers, and 547.2 other citizens with demonstrated interest in child care issues. 547.3 Additional members may be appointed by the commissioner. The 547.4 commissioner may compensate members for their travel, child 547.5 care, and child care provider substitute expenses for attending 547.6 task force meetings. The commissioner may also pay a stipend to 547.7 parent representatives for participating in task force meetings. 547.8 Sec. 30. Minnesota Statutes 2002, section 119B.23, 547.9 subdivision 3, is amended to read: 547.10 Subd. 3. [BIENNIAL PLAN.] The county board shall 547.11 biennially develop a plan for the distribution of money for 547.12 child care services as part of thecommunity social services547.13plan described in section 256E.09child care fund plan under 547.14 section 119B.08. All licensed child care programs shall be 547.15 given written notice concerning the availability of money and 547.16 the application process. 547.17 Sec. 31. Minnesota Statutes 2002, section 256.046, 547.18 subdivision 1, is amended to read: 547.19 Subdivision 1. [HEARING AUTHORITY.] A local agency must 547.20 initiate an administrative fraud disqualification hearing for 547.21 individuals, including child care providers caring for children 547.22 receiving child care assistance, accused of wrongfully obtaining 547.23 assistance or intentional program violations, in lieu of a 547.24 criminal action when it has not been pursued, in the aid to 547.25 families with dependent children program formerly codified in 547.26 sections 256.72 to 256.87, MFIP, child care assistance programs, 547.27 general assistance, family general assistance program formerly 547.28 codified in section 256D.05, subdivision 1, clause (15), 547.29 Minnesota supplemental aid, medical care, or food stamp 547.30 programs. The hearing is subject to the requirements of section 547.31 256.045 and the requirements in Code of Federal Regulations, 547.32 title 7, section 273.16, for the food stamp program and title 547.33 45, section 235.112, as of September 30, 1995, for the cash 547.34 grantand, medical care programs, and child care assistance 547.35 under chapter 119B. 547.36 Sec. 32. Minnesota Statutes 2002, section 256.0471, 548.1 subdivision 1, is amended to read: 548.2 Subdivision 1. [QUALIFYING OVERPAYMENT.] Any overpayment 548.3 for assistance granted undersection 119B.05chapter 119B, the 548.4 MFIP program formerly codified under sections 256.031 to 548.5 256.0361, and the AFDC program formerly codified under sections 548.6 256.72 to 256.871; chapters 256B, 256D, 256I, 256J, and 256K; 548.7 and the food stamp program, except agency error claims, become a 548.8 judgment by operation of law 90 days after the notice of 548.9 overpayment is personally served upon the recipient in a manner 548.10 that is sufficient under rule 4.03(a) of the Rules of Civil 548.11 Procedure for district courts, or by certified mail, return 548.12 receipt requested. This judgment shall be entitled to full 548.13 faith and credit in this and any other state. 548.14 Sec. 33. Minnesota Statutes 2002, section 256.98, 548.15 subdivision 8, is amended to read: 548.16 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 548.17 found to be guilty of wrongfully obtaining assistance by a 548.18 federal or state court or by an administrative hearing 548.19 determination, or waiver thereof, through a disqualification 548.20 consent agreement, or as part of any approved diversion plan 548.21 under section 401.065, or any court-ordered stay which carries 548.22 with it any probationary or other conditions, in the Minnesota 548.23 family investment program, the food stamp program, the general 548.24 assistance program, the group residential housing program, or 548.25 the Minnesota supplemental aid program shall be disqualified 548.26 from that program. In addition, any person disqualified from 548.27 the Minnesota family investment program shall also be 548.28 disqualified from the food stamp program. The needs of that 548.29 individual shall not be taken into consideration in determining 548.30 the grant level for that assistance unit: 548.31 (1) for one year after the first offense; 548.32 (2) for two years after the second offense; and 548.33 (3) permanently after the third or subsequent offense. 548.34 The period of program disqualification shall begin on the 548.35 date stipulated on the advance notice of disqualification 548.36 without possibility of postponement for administrative stay or 549.1 administrative hearing and shall continue through completion 549.2 unless and until the findings upon which the sanctions were 549.3 imposed are reversed by a court of competent jurisdiction. The 549.4 period for which sanctions are imposed is not subject to 549.5 review. The sanctions provided under this subdivision are in 549.6 addition to, and not in substitution for, any other sanctions 549.7 that may be provided for by law for the offense involved. A 549.8 disqualification established through hearing or waiver shall 549.9 result in the disqualification period beginning immediately 549.10 unless the person has become otherwise ineligible for 549.11 assistance. If the person is ineligible for assistance, the 549.12 disqualification period begins when the person again meets the 549.13 eligibility criteria of the program from which they were 549.14 disqualified and makes application for that program. 549.15 (b) A family receiving assistance through child care 549.16 assistance programs under chapter 119B with a family member who 549.17 is found to be guilty of wrongfully obtaining child care 549.18 assistance by a federal court, state court, or an administrative 549.19 hearing determination or waiver, through a disqualification 549.20 consent agreement, as part of an approved diversion plan under 549.21 section 401.065, or a court-ordered stay with probationary or 549.22 other conditions, is disqualified from child care assistance 549.23 programs. The disqualifications must be for periods of three 549.24 months, six months, and two years for the first, second, and 549.25 third offenses respectively. Subsequent violations must result 549.26 in permanent disqualification. During the disqualification 549.27 period, disqualification from any child care program must extend 549.28 to all child care programs and must be immediately applied. 549.29 (c) A provider caring for children receiving assistance 549.30 through child care assistance programs under chapter 119B is 549.31 disqualified from receiving payment for child care services from 549.32 the child care assistance program under chapter 119B when the 549.33 provider is found to have wrongfully obtained child care 549.34 assistance by a federal court, state court, or an administrative 549.35 hearing determination or waiver under section 256.046, through a 549.36 disqualification consent agreement, as part of an approved 550.1 diversion plan under section 401.065, or a court-ordered stay 550.2 with probationary or other conditions. The disqualification 550.3 must be for a period of one year for the first offense and two 550.4 years for the second offense. Any subsequent violation must 550.5 result in permanent disqualification. The disqualification 550.6 period must be imposed immediately after a determination is made 550.7 under this paragraph. During the disqualification period, the 550.8 provider is disqualified from receiving payment from any child 550.9 care program under chapter 119B. 550.10 Sec. 34. [DIRECTION TO COMMISSIONER; PROVIDER RATES.] 550.11 The provider rates determined under Minnesota Statutes, 550.12 section 119B.13, for fiscal year 2003 and implemented on July 1, 550.13 2002, are to be continued in effect through June 30, 2005. The 550.14 commissioner of human services is directed to evaluate the costs 550.15 of child care in Minnesota, to examine the differences in the 550.16 cost of child care in rural and metropolitan areas, and to make 550.17 recommendations to the legislature for containing future cost 550.18 increases in the child care program under Minnesota Statutes, 550.19 chapter 119B, in a manner that complies with federal child care 550.20 and development block grant requirements for promoting parental 550.21 choice and permits the department to track the effect of rate 550.22 changes on child care assistance program costs, the availability 550.23 of different types of care throughout the state, the length of 550.24 waiting lists, and the care options available to program 550.25 participants. The commissioner shall also examine the 550.26 allocation formula under Minnesota Statutes, section 119B.03, 550.27 and make recommendations to the legislature in order to create a 550.28 more equitable formula. The commissioner shall consider the 550.29 impact any recommendations might have on work incentives for low 550.30 and middle income families and possible changes to MFIP child 550.31 care, basic sliding fee child care, and the dependent care tax 550.32 credit. The commissioner shall make recommendations to the 550.33 legislature by January 15, 2005. 550.34 The commissioner shall also study the relationship between 550.35 child care assistance subsidies and tax credits or tax 550.36 incentives related to child care expenses, and include this 551.1 information in the January 15, 2005, report to the legislature 551.2 under this section. 551.3 Sec. 35. [CHILD CARE WAITING LIST.] 551.4 Notwithstanding Minnesota Statutes, section 119B.03, 551.5 subdivision 6, the commissioner may manage the child care 551.6 assistance waiting list under Minnesota Statutes, section 551.7 119B.03, subdivision 2, on a regional or statewide basis in 551.8 order to ensure that families listed under higher priority 551.9 categories, as determined by Minnesota Statutes, section 551.10 119B.03, subdivision 4, are served before families listed under 551.11 lower priority categories. 551.12 Sec. 36. [CHILD CARE ASSISTANCE PARENT FEE SCHEDULE.] 551.13 Notwithstanding Minnesota Rules, part 3400.0100, subpart 4, 551.14 the parent fee schedule is as follows: 551.15 Income Range Co-payment (as a percentage of 551.16 (as a percentage of the adjusted gross income) 551.17 federal poverty guidelines) 551.18 0-74.99% $ 0/month 551.19 75.00-99.99% $10/month 551.20 100.00-104.99% 3.85% 551.21 105.00-109.99% 3.85% 551.22 110.00-114.99% 3.85% 551.23 115.00-119.99% 3.85% 551.24 120.00-124.99% 4.29% 551.25 125.00-139.99% 4.29% 551.26 140.00-144.99% 4.73% 551.27 145.00-149.99% 4.73% 551.28 150.00-154.99% 4.73% 551.29 155.00-159.99% 5.65% 551.30 160.00-164.99% 5.65% 551.31 165.00-169.99% 6.56% 551.32 170.00-174.99% 7.00% 551.33 175.00-179.99% 7.44% 551.34 180.00-184.99% 8.31% 551.35 185.00-189.99% 8.75% 551.36 190.00-194.99% 9.19% 552.1 195.00-199.99% 10.06% 552.2 200.00-209.99% 12.25% 552.3 210.00-224.99% 16.10% 552.4 225.00-229.99% 17.15% 552.5 230.00-234.99% 19.25% 552.6 235.00-239.99% 19.78% 552.7 240.00-244.99% 21.35% 552.8 245.00-249.99% 22.00% 552.9 250% ineligible 552.10 A family's monthly co-payment fee is the fixed percentage 552.11 established for the income range multiplied by the highest 552.12 possible income within that income range. 552.13 Sec. 37. [ELIGIBILITY FOR FAMILIES WITH HOUSEHOLD INCOME 552.14 GREATER THAN 250 PERCENT OF THE FEDERAL POVERTY GUIDELINES.] 552.15 Families receiving child care assistance on July 1, 2003, 552.16 who have household income greater than 250 percent of the 552.17 federal poverty guidelines, adjusted for family size, are 552.18 eligible to continue receiving child care assistance until the 552.19 family's next eligibility redetermination. 552.20 Sec. 38. [REPEALER.] 552.21 (a) Minnesota Statutes 2002, sections 119B.061 and 119B.13, 552.22 subdivision 2, are repealed. 552.23 (b) Laws 2000, chapter 489, article 1, section 36, and Laws 552.24 2001, First Special Session chapter 3, article 1, section 16, 552.25 are repealed. 552.26 ARTICLE 10 552.27 CHILD SUPPORT FEDERAL COMPLIANCE 552.28 Section 1. Minnesota Statutes 2002, section 13.69, 552.29 subdivision 1, is amended to read: 552.30 Subdivision 1. [CLASSIFICATIONS.] (a) The following 552.31 government data of the department of public safety are private 552.32 data: 552.33 (1) medical data on driving instructors, licensed drivers, 552.34 and applicants for parking certificates and special license 552.35 plates issued to physically handicapped persons; 552.36 (2) other data on holders of a disability certificate under 553.1 section 169.345, except that data that are not medical data may 553.2 be released to law enforcement agencies; 553.3 (3) social security numbers in driver's license and motor 553.4 vehicle registration records, except that social security 553.5 numbers must be provided to the department of revenue for 553.6 purposes of tax administrationand, the department of labor and 553.7 industry for purposes of workers' compensation administration 553.8 and enforcement, and the department of natural resources for 553.9 purposes of license application administration; and 553.10 (4) data on persons listed as standby or temporary 553.11 custodians under section 171.07, subdivision 11, except that the 553.12 data must be released to: 553.13 (i) law enforcement agencies for the purpose of verifying 553.14 that an individual is a designated caregiver; or 553.15 (ii) law enforcement agencies who state that the license 553.16 holder is unable to communicate at that time and that the 553.17 information is necessary for notifying the designated caregiver 553.18 of the need to care for a child of the license holder. 553.19 The department may release the social security number only 553.20 as provided in clause (3) and must not sell or otherwise provide 553.21 individual social security numbers or lists of social security 553.22 numbers for any other purpose. 553.23 (b) The following government data of the department of 553.24 public safety are confidential data: data concerning an 553.25 individual's driving ability when that data is received from a 553.26 member of the individual's family. 553.27 Sec. 2. [97A.482] [LICENSE APPLICATIONS; COLLECTION OF 553.28 SOCIAL SECURITY NUMBERS.] 553.29 (a) All applicants for individual noncommercial game and 553.30 fish licenses under this chapter and chapters 97B and 97C must 553.31 include the applicant's social security number on the license 553.32 application. If an applicant does not have a social security 553.33 number, the applicant must certify that the applicant does not 553.34 have a social security number. 553.35 (b) The social security numbers collected by the 553.36 commissioner on game and fish license applications are private 554.1 data under section 13.49, subdivision 1, and must be provided by 554.2 the commissioner to the commissioner of human services for child 554.3 support enforcement purposes. Title IV-D of the Social Security 554.4 Act, United States Code, title 42, section 666(a)(13), requires 554.5 the collection of social security numbers on game and fish 554.6 license applications for child support enforcement purposes. 554.7 Sec. 3. Minnesota Statutes 2002, section 171.06, 554.8 subdivision 3, is amended to read: 554.9 Subd. 3. [CONTENTS OF APPLICATION; OTHER INFORMATION.] (a) 554.10 An application must: 554.11 (1) state the full name, date of birth, sex, and residence 554.12 address of the applicant; 554.13 (2) as may be required by the commissioner, contain a 554.14 description of the applicant and any other facts pertaining to 554.15 the applicant, the applicant's driving privileges, and the 554.16 applicant's ability to operate a motor vehicle with safety; 554.17 (3)for a class C, class B, or class A driver's license,554.18 state: 554.19 (i) the applicant's social security numberor, for a class554.20D driver's license, have a space for the applicant's social554.21security number and state that providing the number is optional,554.22or otherwise convey that the applicant is not required to enter554.23the social security number; or 554.24 (ii) if the applicant does not have a social security 554.25 number and is applying for a Minnesota identification card, 554.26 instruction permit, or class D provisional or driver's license, 554.27 that the applicant certifies that the applicant does not have a 554.28 social security number; 554.29 (4) contain a space where the applicant may indicate a 554.30 desire to make an anatomical gift according to paragraph (b); 554.31 and 554.32 (5) contain a notification to the applicant of the 554.33 availability of a living will/health care directive designation 554.34 on the license under section 171.07, subdivision 7. 554.35 (b) If the applicant does not indicate a desire to make an 554.36 anatomical gift when the application is made, the applicant must 555.1 be offered a donor document in accordance with section 171.07, 555.2 subdivision 5. The application must contain statements 555.3 sufficient to comply with the requirements of the Uniform 555.4 Anatomical Gift Act (1987), sections 525.921 to 525.9224, so 555.5 that execution of the application or donor document will make 555.6 the anatomical gift as provided in section 171.07, subdivision 555.7 5, for those indicating a desire to make an anatomical gift. 555.8 The application must be accompanied by information describing 555.9 Minnesota laws regarding anatomical gifts and the need for and 555.10 benefits of anatomical gifts, and the legal implications of 555.11 making an anatomical gift, including the law governing 555.12 revocation of anatomical gifts. The commissioner shall 555.13 distribute a notice that must accompany all applications for and 555.14 renewals of a driver's license or Minnesota identification 555.15 card. The notice must be prepared in conjunction with a 555.16 Minnesota organ procurement organization that is certified by 555.17 the federal Department of Health and Human Services and must 555.18 include: 555.19 (1) a statement that provides a fair and reasonable 555.20 description of the organ donation process, the care of the donor 555.21 body after death, and the importance of informing family members 555.22 of the donation decision; and 555.23 (2) a telephone number in a certified Minnesota organ 555.24 procurement organization that may be called with respect to 555.25 questions regarding anatomical gifts. 555.26 (c) The application must be accompanied also by information 555.27 containing relevant facts relating to: 555.28 (1) the effect of alcohol on driving ability; 555.29 (2) the effect of mixing alcohol with drugs; 555.30 (3) the laws of Minnesota relating to operation of a motor 555.31 vehicle while under the influence of alcohol or a controlled 555.32 substance; and 555.33 (4) the levels of alcohol-related fatalities and accidents 555.34 in Minnesota and of arrests for alcohol-related violations. 555.35 Sec. 4. Minnesota Statutes 2002, section 171.07, is 555.36 amended by adding a subdivision to read: 556.1 Subd. 14. [USE OF SOCIAL SECURITY NUMBER.] An applicant's 556.2 social security number must not be displayed, encrypted, or 556.3 encoded on the driver's license or Minnesota identification card 556.4 or included in a magnetic strip or bar code used to store data 556.5 on the license or Minnesota identification card. The social 556.6 security number must not be used as a Minnesota driver's license 556.7 or identification number. 556.8 Sec. 5. Minnesota Statutes 2002, section 518.551, 556.9 subdivision 12, is amended to read: 556.10 Subd. 12. [OCCUPATIONAL LICENSE SUSPENSION.] (a) Upon 556.11 motion of an obligee, if the court finds that the obligor is or 556.12 may be licensed by a licensing board listed in section 214.01 or 556.13 other state, county, or municipal agency or board that issues an 556.14 occupational license and the obligor is in arrears in 556.15 court-ordered child support or maintenance payments or both in 556.16 an amount equal to or greater than three times the obligor's 556.17 total monthly support and maintenance payments and is not in 556.18 compliance with a written payment agreement pursuant to section 556.19 518.553 that is approved by the court, a child support 556.20 magistrate, or the public authority, the court shall direct the 556.21 licensing board or other licensing agency to suspend the license 556.22 under section 214.101. The court's order must be stayed for 90 556.23 days in order to allow the obligor to execute a written payment 556.24 agreement pursuant to section 518.553. The payment agreement 556.25 must be approved by either the court or the public authority 556.26 responsible for child support enforcement. If the obligor has 556.27 not executed or is not in compliance with a written payment 556.28 agreement pursuant to section 518.553 after the 90 days expires, 556.29 the court's order becomes effective. If the obligor is a 556.30 licensed attorney, the court shall report the matter to the 556.31 lawyers professional responsibility board for appropriate action 556.32 in accordance with the rules of professional conduct. The 556.33 remedy under this subdivision is in addition to any other 556.34 enforcement remedy available to the court. 556.35 (b) If a public authority responsible for child support 556.36 enforcement finds that the obligor is or may be licensed by a 557.1 licensing board listed in section 214.01 or other state, county, 557.2 or municipal agency or board that issues an occupational license 557.3 and the obligor is in arrears in court-ordered child support or 557.4 maintenance payments or both in an amount equal to or greater 557.5 than three times the obligor's total monthly support and 557.6 maintenance payments and is not in compliance with a written 557.7 payment agreement pursuant to section 518.553 that is approved 557.8 by the court, a child support magistrate, or the public 557.9 authority, the court or the public authority shall direct the 557.10 licensing board or other licensing agency to suspend the license 557.11 under section 214.101. If the obligor is a licensed attorney, 557.12 the public authority may report the matter to the lawyers 557.13 professional responsibility board for appropriate action in 557.14 accordance with the rules of professional conduct. The remedy 557.15 under this subdivision is in addition to any other enforcement 557.16 remedy available to the public authority. 557.17 (c) At least 90 days before notifying a licensing authority 557.18 or the lawyers professional responsibility board under paragraph 557.19 (b), the public authority shall mail a written notice to the 557.20 license holder addressed to the license holder's last known 557.21 address that the public authority intends to seek license 557.22 suspension under this subdivision and that the license holder 557.23 must request a hearing within 30 days in order to contest the 557.24 suspension. If the license holder makes a written request for a 557.25 hearing within 30 days of the date of the notice, a court 557.26 hearing or a hearing under section 484.702 must be held. 557.27 Notwithstanding any law to the contrary, the license holder must 557.28 be served with 14 days' notice in writing specifying the time 557.29 and place of the hearing and the allegations against the license 557.30 holder. The notice may be served personally or by mail. If the 557.31 public authority does not receive a request for a hearing within 557.32 30 days of the date of the notice, and the obligor does not 557.33 execute a written payment agreement pursuant to section 518.553 557.34 that is approved by the public authority within 90 days of the 557.35 date of the notice, the public authority shall direct the 557.36 licensing board or other licensing agency to suspend the 558.1 obligor's license under paragraph (b), or shall report the 558.2 matter to the lawyers professional responsibility board. 558.3 (d) The public authority or the court shall notify the 558.4 lawyers professional responsibility board for appropriate action 558.5 in accordance with the rules of professional responsibility 558.6 conduct or order the licensing board or licensing agency to 558.7 suspend the license if the judge finds that: 558.8 (1) the person is licensed by a licensing board or other 558.9 state agency that issues an occupational license; 558.10 (2) the person has not made full payment of arrearages 558.11 found to be due by the public authority; and 558.12 (3) the person has not executed or is not in compliance 558.13 with a payment plan approved by the court, a child support 558.14 magistrate, or the public authority. 558.15 (e) Within 15 days of the date on which the obligor either 558.16 makes full payment of arrearages found to be due by the court or 558.17 public authority or executes and initiates good faith compliance 558.18 with a written payment plan approved by the court, a child 558.19 support magistrate, or the public authority, the court, a child 558.20 support magistrate, or the public authority responsible for 558.21 child support enforcement shall notify the licensing board or 558.22 licensing agency or the lawyers professional responsibility 558.23 board that the obligor is no longer ineligible for license 558.24 issuance, reinstatement, or renewal under this subdivision. 558.25 (f) In addition to the criteria established under this 558.26 section for the suspension of an obligor's occupational license, 558.27 a court, a child support magistrate, or the public authority may 558.28 direct the licensing board or other licensing agency to suspend 558.29 the license of a party who has failed, after receiving notice, 558.30 to comply with a subpoena relating to a paternity or child 558.31 support proceeding. Notice to an obligor of intent to suspend 558.32 must be served by first class mail at the obligor's last known 558.33 address. The notice must inform the obligor of the right to 558.34 request a hearing. If the obligor makes a written request 558.35 within ten days of the date of the hearing, a hearing must be 558.36 held. At the hearing, the only issues to be considered are 559.1 mistake of fact and whether the obligor received the subpoena. 559.2 (g) The license of an obligor who fails to remain in 559.3 compliance with an approved written payment agreement may be 559.4 suspended.Notice to the obligor of an intent to suspend under559.5this paragraph must be served by first class mail at the559.6obligor's last known address and must include a notice of559.7hearing. The notice must be served upon the obligor not less559.8than ten days before the date of the hearing.Prior to 559.9 suspending a license for noncompliance with an approved written 559.10 payment agreement, the public authority must mail to the 559.11 obligor's last known address a written notice that (1) the 559.12 public authority intends to seek suspension of the obligor's 559.13 occupational license under this paragraph, and (2) the obligor 559.14 must request a hearing, within 30 days of the date of the 559.15 notice, to contest the suspension. If, within 30 days of the 559.16 date of the notice, the public authority does not receive a 559.17 written request for a hearing and the obligor does not comply 559.18 with an approved written payment agreement, the public authority 559.19 must direct the licensing board or other licensing agency to 559.20 suspend the obligor's license under paragraph (b), and, if the 559.21 obligor is a licensed attorney, must report the matter to the 559.22 lawyers professional responsibility board. If the obligor makes 559.23 a written request for a hearing within 30 days of the date of 559.24 the notice, a court hearing must be held. Notwithstanding any 559.25 law to the contrary, the obligor must be served with 14 days' 559.26 notice in writing specifying the time and place of the hearing 559.27 and the allegations against the obligor. The notice may be 559.28 served personally or by mail to the obligor's last known 559.29 address. If the obligor appears at the hearing and thejudge559.30 court determines that the obligor has failed to comply with an 559.31 approved written payment agreement, thejudge shallcourt or 559.32 public authority must notify the occupational licensing board or 559.33 other licensing agency to suspend the obligor's license under 559.34 paragraph(c)(b) and, if the obligor is a licensed attorney, 559.35 must report the matter to the lawyers professional 559.36 responsibility board. If the obligor fails to appear at the 560.1 hearing, thepublic authority maycourt or public authority must 560.2 notify the occupationalorlicensing board or other licensing 560.3 agency to suspend the obligor's license under paragraph(c)(b), 560.4 and if the obligor is a licensed attorney, must report the 560.5 matter to the lawyers professional responsibility board. 560.6 Sec. 6. Minnesota Statutes 2002, section 518.551, 560.7 subdivision 13, is amended to read: 560.8 Subd. 13. [DRIVER'S LICENSE SUSPENSION.] (a) Upon motion 560.9 of an obligee, which has been properly served on the obligor and 560.10 upon which there has been an opportunity for hearing, if a court 560.11 finds that the obligor has been or may be issued a driver's 560.12 license by the commissioner of public safety and the obligor is 560.13 in arrears in court-ordered child support or maintenance 560.14 payments, or both, in an amount equal to or greater than three 560.15 times the obligor's total monthly support and maintenance 560.16 payments and is not in compliance with a written payment 560.17 agreement pursuant to section 518.553 that is approved by the 560.18 court, a child support magistrate, or the public authority, the 560.19 court shall order the commissioner of public safety to suspend 560.20 the obligor's driver's license. The court's order must be 560.21 stayed for 90 days in order to allow the obligor to execute a 560.22 written payment agreement pursuant to section 518.553. The 560.23 payment agreement must be approved by either the court or the 560.24 public authority responsible for child support enforcement. If 560.25 the obligor has not executed or is not in compliance with a 560.26 written payment agreement pursuant to section 518.553 after the 560.27 90 days expires, the court's order becomes effective and the 560.28 commissioner of public safety shall suspend the obligor's 560.29 driver's license. The remedy under this subdivision is in 560.30 addition to any other enforcement remedy available to the 560.31 court. An obligee may not bring a motion under this paragraph 560.32 within 12 months of a denial of a previous motion under this 560.33 paragraph. 560.34 (b) If a public authority responsible for child support 560.35 enforcement determines that the obligor has been or may be 560.36 issued a driver's license by the commissioner of public safety 561.1 and the obligor is in arrears in court-ordered child support or 561.2 maintenance payments or both in an amount equal to or greater 561.3 than three times the obligor's total monthly support and 561.4 maintenance payments and not in compliance with a written 561.5 payment agreement pursuant to section 518.553 that is approved 561.6 by the court, a child support magistrate, or the public 561.7 authority, the public authority shall direct the commissioner of 561.8 public safety to suspend the obligor's driver's license. The 561.9 remedy under this subdivision is in addition to any other 561.10 enforcement remedy available to the public authority. 561.11 (c) At least 90 days prior to notifying the commissioner of 561.12 public safety according to paragraph (b), the public authority 561.13 must mail a written notice to the obligor at the obligor's last 561.14 known address, that it intends to seek suspension of the 561.15 obligor's driver's license and that the obligor must request a 561.16 hearing within 30 days in order to contest the suspension. If 561.17 the obligor makes a written request for a hearing within 30 days 561.18 of the date of the notice, a court hearing must be held. 561.19 Notwithstanding any law to the contrary, the obligor must be 561.20 served with 14 days' notice in writing specifying the time and 561.21 place of the hearing and the allegations against the obligor. 561.22 The notice must include information that apprises the obligor of 561.23 the requirement to develop a written payment agreement that is 561.24 approved by a court, a child support magistrate, or the public 561.25 authority responsible for child support enforcement regarding 561.26 child support, maintenance, and any arrearages in order to avoid 561.27 license suspension. The notice may be served personally or by 561.28 mail. If the public authority does not receive a request for a 561.29 hearing within 30 days of the date of the notice, and the 561.30 obligor does not execute a written payment agreement pursuant to 561.31 section 518.553 that is approved by the public authority within 561.32 90 days of the date of the notice, the public authority shall 561.33 direct the commissioner of public safety to suspend the 561.34 obligor's driver's license under paragraph (b). 561.35 (d) At a hearing requested by the obligor under paragraph 561.36 (c), and on finding that the obligor is in arrears in 562.1 court-ordered child support or maintenance payments or both in 562.2 an amount equal to or greater than three times the obligor's 562.3 total monthly support and maintenance payments, the district 562.4 court or child support magistrate shall order the commissioner 562.5 of public safety to suspend the obligor's driver's license or 562.6 operating privileges unless the court or child support 562.7 magistrate determines that the obligor has executed and is in 562.8 compliance with a written payment agreement pursuant to section 562.9 518.553 that is approved by the court, a child support 562.10 magistrate, or the public authority. 562.11 (e) An obligor whose driver's license or operating 562.12 privileges are suspended may: 562.13 (1) provide proof to the public authority responsible for 562.14 child support enforcement that the obligor is in compliance with 562.15 all written payment agreements pursuant to section 518.553; 562.16 (2) bring a motion for reinstatement of the driver's 562.17 license. At the hearing, if the court or child support 562.18 magistrate orders reinstatement of the driver's license, the 562.19 court or child support magistrate must establish a written 562.20 payment agreement pursuant to section 518.553; or 562.21 (3) seek a limited license under section 171.30. A limited 562.22 license issued to an obligor under section 171.30 expires 90 562.23 days after the date it is issued. 562.24 Within 15 days of the receipt of that proof or a court 562.25 order, the public authority shall inform the commissioner of 562.26 public safety that the obligor's driver's license or operating 562.27 privileges should no longer be suspended. 562.28 (f) On January 15, 1997, and every two years after that, 562.29 the commissioner of human services shall submit a report to the 562.30 legislature that identifies the following information relevant 562.31 to the implementation of this section: 562.32 (1) the number of child support obligors notified of an 562.33 intent to suspend a driver's license; 562.34 (2) the amount collected in payments from the child support 562.35 obligors notified of an intent to suspend a driver's license; 562.36 (3) the number of cases paid in full and payment agreements 563.1 executed in response to notification of an intent to suspend a 563.2 driver's license; 563.3 (4) the number of cases in which there has been 563.4 notification and no payments or payment agreements; 563.5 (5) the number of driver's licenses suspended; 563.6 (6) the cost of implementation and operation of the 563.7 requirements of this section; and 563.8 (7) the number of limited licenses issued and number of 563.9 cases in which payment agreements are executed and cases are 563.10 paid in full following issuance of a limited license. 563.11 (g) In addition to the criteria established under this 563.12 section for the suspension of an obligor's driver's license, a 563.13 court, a child support magistrate, or the public authority may 563.14 direct the commissioner of public safety to suspend the license 563.15 of a party who has failed, after receiving notice, to comply 563.16 with a subpoena relating to a paternity or child support 563.17 proceeding. Notice to an obligor of intent to suspend must be 563.18 served by first class mail at the obligor's last known address. 563.19 The notice must inform the obligor of the right to request a 563.20 hearing. If the obligor makes a written request within ten days 563.21 of the date of the hearing, a hearing must be held. At the 563.22 hearing, the only issues to be considered are mistake of fact 563.23 and whether the obligor received the subpoena. 563.24 (h) The license of an obligor who fails to remain in 563.25 compliance with an approved written payment agreement may be 563.26 suspended.Notice to the obligor of an intent to suspend under563.27this paragraph must be served by first class mail at the563.28obligor's last known address and must include a notice of563.29hearing. The notice must be served upon the obligor not less563.30than ten days before the date of the hearing.Prior to 563.31 suspending a license for noncompliance with an approved written 563.32 payment agreement, the public authority must mail to the 563.33 obligor's last known address a written notice that (1) the 563.34 public authority intends to seek suspension of the obligor's 563.35 driver's license under this paragraph, and (2) the obligor must 563.36 request a hearing, within 30 days of the date of the notice, to 564.1 contest the suspension. If, within 30 days of the date of the 564.2 notice, the public authority does not receive a written request 564.3 for a hearing and the obligor does not comply with an approved 564.4 written payment agreement, the public authority must direct the 564.5 department of public safety to suspend the obligor's license 564.6 under paragraph (b). If the obligor makes a written request for 564.7 a hearing within 30 days of the date of the notice, a court 564.8 hearing must be held. Notwithstanding any law to the contrary, 564.9 the obligor must be served with 14 days' notice in writing 564.10 specifying the time and place of the hearing and the allegations 564.11 against the obligor. The notice may be served personally or by 564.12 mail at the obligor's last known address. If the obligor 564.13 appears at the hearing and thejudgecourt determines that the 564.14 obligor has failed to comply with an approved written payment 564.15 agreement, thejudgecourt or public authority shall notify the 564.16 department of public safety to suspend the obligor's license 564.17 under paragraph(c)(b). If the obligor fails to appear at the 564.18 hearing, thepublic authority maycourt or public authority must 564.19 notify the department of public safety to suspend the obligor's 564.20 license under paragraph(c)(b). 564.21 Sec. 7. Laws 1997, chapter 245, article 2, section 11, is 564.22 amended to read: 564.23 Sec. 11. [FEDERAL FUNDS FOR VISITATION AND ACCESS.] 564.24 The commissioner of human services may accept on behalf of 564.25 the state any federal funding received under Public Law Number 564.26 104-193 for access and visitation programs, andshall transfer564.27these funds to the state court administrator for the cooperation564.28for the children pilot project and the parent education program564.29under Minnesota Statutes, section 518.571must administer the 564.30 funds for the activities allowed under federal law. The 564.31 commissioner may distribute the funds on a competitive basis and 564.32 must monitor, evaluate, and report on the access and visitation 564.33 programs in accordance with any applicable regulations. 564.34 Sec. 8. [EFFECTIVE DATE.] 564.35 Sections 1 to 4 are effective August 1, 2003. 564.36 ARTICLE 11 565.1 COMMUNITY SERVICES ACT 565.2 Section 1. [256M.01] [CITATION.] 565.3 Sections 256M.01 to 256M.80 may be cited as the "Children 565.4 and Community Services Act." This act establishes a fund to 565.5 address the needs of children, adolescents, and adults within 565.6 each county in accordance with a service plan entered into by 565.7 the board of county commissioners of each county and the 565.8 commissioner. The service plan shall specify the outcomes to be 565.9 achieved, the general strategies to be employed, and the 565.10 respective state and county roles. The service plan shall be 565.11 reviewed and updated every two years, or sooner if both the 565.12 state and the county deem it necessary. 565.13 Sec. 2. [256M.10] [DEFINITIONS.] 565.14 Subdivision 1. [SCOPE.] For the purposes of sections 565.15 256M.01 to 256M.80, the terms defined in this section have the 565.16 meanings given them. 565.17 Subd. 2. [CHILDREN AND COMMUNITY SERVICES.] (a) "Children 565.18 and community services" means services provided or arranged for 565.19 by county boards for children, adolescents and other individuals 565.20 in transition from childhood to adulthood, and adults who 565.21 experience dependency, abuse, neglect, poverty, disability, 565.22 chronic health conditions, or other factors, including ethnicity 565.23 and race, that may result in poor outcomes or disparities, as 565.24 well as services for family members to support those individuals. 565.25 These services may be provided by professionals or 565.26 nonprofessionals, including the person's natural supports in the 565.27 community. 565.28 (b) Children and community services do not include services 565.29 under the public assistance programs known as the Minnesota 565.30 family investment program, Minnesota supplemental aid, medical 565.31 assistance, general assistance, general assistance medical care, 565.32 MinnesotaCare, or community health services. 565.33 Subd. 3. [COMMISSIONER.] "Commissioner" means the 565.34 commissioner of human services. 565.35 Subd. 4. [COUNTY BOARD.] "County board" means the board of 565.36 county commissioners in each county. 566.1 Subd. 5. [FORMER CHILDREN'S SERVICES AND COMMUNITY SERVICE 566.2 GRANTS.] "Former children's services and community service 566.3 grants" means allocations for the following grants: 566.4 (1) community social service grants under sections 252.24, 566.5 256E.06, and 256E.14; 566.6 (2) family preservation grants under section 256F.05, 566.7 subdivision 3; 566.8 (3) concurrent permanency planning grants under section 566.9 260C.213, subdivision 5; 566.10 (4) social service block grants (Title XX) under section 566.11 256E.07; and 566.12 (5) children's mental health grants under sections 245.4886 566.13 and 260.152. 566.14 Subd. 6. [HUMAN SERVICES BOARD.] "Human services board" 566.15 means a board established under section 402.02; Laws 1974, 566.16 chapter 293; or Laws 1976, chapter 340. 566.17 Sec. 3. [256M.20] [DUTIES OF COMMISSIONER OF HUMAN 566.18 SERVICES.] 566.19 Subdivision 1. [GENERAL SUPERVISION.] Each year the 566.20 commissioner shall allocate funds to each county with an 566.21 approved service plan according to section 256M.40 and service 566.22 plans under section 256M.30. The funds shall be used to address 566.23 the needs of children, adolescents, and adults. The 566.24 commissioner, in consultation with counties, shall provide 566.25 technical assistance and evaluate county performance in 566.26 achieving outcomes. 566.27 Subd. 2. [ADDITIONAL DUTIES.] The commissioner shall: 566.28 (1) provide necessary information and assistance to each 566.29 county for establishing baselines and desired improvements on 566.30 mental health, safety, permanency, and well-being for children 566.31 and adolescents; 566.32 (2) provide training, technical assistance, and other 566.33 supports to each county board to assist in needs assessment, 566.34 planning, implementation, and monitoring of outcomes and service 566.35 quality; 566.36 (3) use data collection, evaluation of service outcomes, 567.1 and the review and approval of county service plans to supervise 567.2 county performance in the delivery of children and community 567.3 services; 567.4 (4) specify requirements for reports, including fiscal 567.5 reports to account for funds distributed; 567.6 (5) request waivers from federal programs as necessary to 567.7 implement this act; and 567.8 (6) have authority under sections 14.055 and 14.056 to 567.9 grant a variance to existing state rules as needed to eliminate 567.10 barriers to achieving desired outcomes. 567.11 Subd. 3. [SANCTIONS.] The commissioner shall establish and 567.12 maintain a monitoring program designed to reduce the possibility 567.13 of noncompliance with federal laws and federal regulations that 567.14 may result in federal fiscal sanctions. If a county is not 567.15 complying with federal law or federal regulation and the 567.16 noncompliance may result in federal fiscal sanctions, the 567.17 commissioner may withhold a portion of the county's share of 567.18 state and federal funds for that program. The amount withheld 567.19 must be equal to the percentage difference between the level of 567.20 compliance maintained by the county and the level of compliance 567.21 required by the federal regulations, multiplied by the county's 567.22 share of state and federal funds for the program. The state and 567.23 federal funds may be withheld until the county is found to be in 567.24 compliance with all federal laws or federal regulations 567.25 applicable to the program. If a county remains out of 567.26 compliance for more than six consecutive months, the 567.27 commissioner may reallocate the withheld funds to counties that 567.28 are in compliance with the federal regulations. 567.29 Subd. 4. [CORRECTIVE ACTION PROCEDURE.] The commissioner 567.30 must comply with the following procedures when reducing county 567.31 funds under subdivision 3. 567.32 (a) The commissioner shall notify the county, by certified 567.33 mail, of the statute, rule, federal law, or federal regulation 567.34 with which the county has not complied. 567.35 (b) The commissioner shall give the county 30 days to 567.36 demonstrate to the commissioner that the county is in compliance 568.1 with the statute, rule, federal law, or federal regulation cited 568.2 in the notice or to develop a corrective action plan to address 568.3 the problem. Upon request from the county, the commissioner 568.4 shall provide technical assistance to the county in developing a 568.5 corrective action plan. The county shall have 30 days from the 568.6 date the technical assistance is provided to develop the 568.7 corrective action plan. 568.8 (c) The commissioner shall take no further action if the 568.9 county demonstrates compliance with the statute, rule, federal 568.10 law, or federal regulation cited in the notice. 568.11 (d) The commissioner shall review and approve or disapprove 568.12 the corrective action plan within 30 days after the commissioner 568.13 receives the corrective action plan. 568.14 (e) If the commissioner approves the corrective action plan 568.15 submitted by the county, the county has 90 days after the date 568.16 of approval to implement the corrective action plan. 568.17 (f) If the county fails to demonstrate compliance or fails 568.18 to implement the corrective action plan approved by the 568.19 commissioner, the commissioner may reduce the county's share of 568.20 state or federal funds according to subdivision 3. 568.21 Sec. 4. [256M.30] [SERVICE PLAN.] 568.22 Subdivision 1. [SERVICE PLAN SUBMITTED TO COMMISSIONER.] 568.23 Effective January 1, 2004, and each two-year period thereafter, 568.24 each county must have a biennial service plan approved by the 568.25 commissioner in order to receive funds. Counties may submit 568.26 multicounty or regional service plans. 568.27 Subd. 2. [CONTENTS.] The service plan shall be completed 568.28 in a form prescribed by the commissioner. The plan must include: 568.29 (1) a statement of the needs of the children, adolescents, 568.30 and adults who experience the conditions defined in section 568.31 256M.10, subdivision 2, paragraph (a), and strengths and 568.32 resources available in the community to address those needs; 568.33 (2) strategies the county will pursue to achieve the 568.34 performance targets. Strategies must include specification of 568.35 how funds under this section and other community resources will 568.36 be used to achieve desired performance targets; 569.1 (3) a description of the county's process to solicit public 569.2 input and a summary of that input; 569.3 (4) beginning with the service plans submitted for the 569.4 period from January 1, 2006, through December 21, 2007, 569.5 performance targets on statewide indicators for each county to 569.6 measure outcomes of children's mental health, and child safety, 569.7 permanency, and well-being. The commissioner shall consult with 569.8 counties and other stakeholders to develop these indicators and 569.9 collect baseline data to inform the establishment of individual 569.10 county performance targets for the 2006-2007 biennium and 569.11 subsequent plans; and 569.12 (5) a budget for services to be provided with funds under 569.13 this section. The county must budget at least 40 percent of 569.14 funds appropriated under sections 256M.01 to 256M.80 for 569.15 services to ensure the mental health, safety, permanency, and 569.16 well-being of children from low-income families. The 569.17 commissioner may reduce the portion of child and community 569.18 services funds that must be budgeted by a county for services to 569.19 children in low-income families if: 569.20 (i) the incidence of children in low-income families within 569.21 the county's population is significantly below the statewide 569.22 median; or 569.23 (ii) the county has successfully achieved past performance 569.24 targets for children's mental health, and child safety, 569.25 permanency, and well-being and its proposed service plan is 569.26 judged by the commissioner to provide an adequate level of 569.27 service to the population with less funding. 569.28 Subd. 3. [CONTINUITY OF SERVICES.] In developing the plan 569.29 required under this section, a county shall endeavor, within the 569.30 limits of funds available, to consider the continuing need for 569.31 services and programs for children and persons with disabilities 569.32 that were funded by the former children's services and community 569.33 service grants. 569.34 Subd. 4. [INFORMATION.] The commissioner shall provide 569.35 each county with information and technical assistance needed to 569.36 complete the service plan, including: information on children's 570.1 mental health, and child safety, permanency, and well-being in 570.2 the county; comparisons with other counties; baseline 570.3 performance on outcome measures; and promising program practices. 570.4 Subd. 5. [TIMELINES.] The preliminary service plan must be 570.5 submitted to the commissioner by October 15, 2003, and October 570.6 15 of every two years thereafter. 570.7 Subd. 6. [PUBLIC COMMENT.] The county board must determine 570.8 how citizens in the county will participate in the development 570.9 of the service plan and provide opportunities for such 570.10 participation. The county must allow a period of no less than 570.11 30 days prior to the submission of the plan to the commissioner 570.12 to solicit comments from the public on the contents of the plan. 570.13 Subd. 7. [COMMISSIONER'S RESPONSIBILITIES.] The 570.14 commissioner must, within 60 days of receiving each county 570.15 service plan, inform the county if the service plan has been 570.16 approved. If the service plan is not approved, the commissioner 570.17 must inform the county of any revisions needed for approval. 570.18 Sec. 5. [256M.40] [STATE CHILDREN AND COMMUNITY SERVICES 570.19 GRANT ALLOCATION.] 570.20 Subdivision 1. [FORMULA.] The commissioner shall allocate 570.21 state funds appropriated for children and community services 570.22 grants to each county board on a calendar year basis in an 570.23 amount determined according to the formula in paragraphs (a) to 570.24 (c). 570.25 (a) For July 1, 2003, through December 31, 2003, the 570.26 commissioner shall allocate funds to each county equal to that 570.27 county's allocation for the grants under section 256M.10, 570.28 subdivision 5, for calendar year 2003 less payments made on or 570.29 before June 30, 2003. 570.30 (b) For calendar year 2004 and 2005, the commissioner shall 570.31 allocate available funds to each county in proportion to that 570.32 county's share of the calendar year 2003 allocations for the 570.33 grants under section 256M.10, subdivision 5. 570.34 (c) For calendar year 2006 and each calendar year 570.35 thereafter, the commissioner shall allocate available funds to 570.36 each county in proportion to that county's share in the 571.1 preceding calendar year. 571.2 Subd. 2. [PROJECT OF REGIONAL SIGNIFICANCE; STUDY.] The 571.3 commissioner shall study whether and how to dedicate a portion 571.4 of the allocated funds for projects of regional significance. 571.5 The study shall include an analysis of the amount of annual 571.6 funding to be dedicated for projects of regional significance 571.7 and what efforts these projects must support. The commissioner 571.8 shall submit a report to the chairs of the house and senate 571.9 committees with jurisdiction over children and community 571.10 services grants by January 15, 2005. The commissioner of 571.11 finance, in preparing the proposed biennial budget for fiscal 571.12 years 2006 and 2007, is instructed to include $25 million each 571.13 year in funding for projects of regional significance under this 571.14 chapter. 571.15 Subd. 3. [PAYMENTS.] Calendar year allocations under 571.16 subdivision 1 shall be paid to counties on or before July 10 of 571.17 each year. 571.18 Sec. 6. [256M.50] [FEDERAL CHILDREN AND COMMUNITY SERVICES 571.19 GRANT ALLOCATION.] 571.20 In federal fiscal year 2004 and subsequent years, money for 571.21 social services received from the federal government to 571.22 reimburse counties for social service expenditures according to 571.23 Title XX of the Social Security Act shall be allocated to each 571.24 county according to section 256M.40, except for funds allocated 571.25 for administrative purposes and migrant day care. 571.26 Sec. 7. [256M.60] [DUTIES OF COUNTY BOARDS.] 571.27 Subdivision 1. [RESPONSIBILITIES.] The county board of 571.28 each county shall be responsible for administration and funding 571.29 of children and community services as defined in section 571.30 256M.10, subdivision 1. Each county board shall singly or in 571.31 combination with other county boards use funds available to the 571.32 county under this act to carry out these responsibilities. The 571.33 county board shall coordinate and facilitate the effective use 571.34 of formal and informal helping systems to best support and 571.35 nurture children, adolescents, and adults within the county who 571.36 experience dependency, abuse, neglect, poverty, disability, 572.1 chronic health conditions, or other factors, including ethnicity 572.2 and race, that may result in poor outcomes or disparities, as 572.3 well as services for family members to support such 572.4 individuals. This includes assisting individuals to function at 572.5 the highest level of ability while maintaining family and 572.6 community relationships to the greatest extent possible. 572.7 Subd. 2. [DAY TRAINING AND HABILITATION SERVICES; 572.8 ALTERNATIVE HABILITATION SERVICES.] To the extent provided in 572.9 the county service plan under section 256M.30, the county board 572.10 of each county shall be responsible for providing day training 572.11 and habilitation services or alternative habilitation services 572.12 during the day for persons with developmental disabilities to 572.13 the extent this is required by the person's individualized 572.14 service plan. 572.15 Subd. 3. [REPORTS.] The county board shall provide 572.16 necessary reports and data as required by the commissioner. 572.17 Subd. 4. [CONTRACTS FOR SERVICES.] The county board may 572.18 contract with a human services board, a multicounty board 572.19 established by a joint powers agreement, other political 572.20 subdivisions, a children's mental health collaborative, a family 572.21 services collaborative, or private organizations in discharging 572.22 its duties. 572.23 Subd. 5. [EXEMPTION FROM LIABILITY.] The state of 572.24 Minnesota, the county boards, or the agencies acting on behalf 572.25 of the county boards in the implementation and administration of 572.26 children and community services shall not be liable for damages, 572.27 injuries, or liabilities sustained through the purchase of 572.28 services by the individual, the individual's family, or the 572.29 authorized representative under this section. 572.30 Subd. 6. [FEES FOR SERVICES.] The county board may 572.31 establish a schedule of fees based upon clients' ability to pay 572.32 to be charged to recipients of children and community services. 572.33 Payment, in whole or in part, for services may be accepted from 572.34 any person except that no fee may be charged to persons or 572.35 families whose adjusted gross household income is below the 572.36 federal poverty level. When services are provided to any 573.1 person, including a recipient of aids administered by the 573.2 federal, state, or county government, payment of any charges due 573.3 may be billed to and accepted from a public assistance agency or 573.4 from any public or private corporation. 573.5 Sec. 8. [256M.70] [FISCAL LIMITATIONS.] 573.6 Subdivision 1. [DEMONSTRATION OF REASONABLE EFFORT.] The 573.7 county shall make reasonable efforts to comply with all children 573.8 and community services requirements. For the purposes of this 573.9 section, a county is making reasonable efforts if the county has 573.10 made efforts to comply with requirements within the limits of 573.11 available funding, including efforts to identify and apply for 573.12 commonly available state and federal funding for services. 573.13 Subd. 2. [IDENTIFICATION OF SERVICES TO BE PROVIDED.] If a 573.14 county has made reasonable efforts to provide services according 573.15 to the service plan under section 256M.30, but funds 573.16 appropriated for purposes of sections 256M.01 to 256M.80 are 573.17 insufficient, then the county may limit services that do not 573.18 meet the following criteria while giving the highest funding 573.19 priority to clauses (1), (2), and (3): 573.20 (1) services needed to protect individuals from 573.21 maltreatment, abuse, and neglect; 573.22 (2) emergency and crisis services needed to protect clients 573.23 from physical, emotional, or psychological harm; 573.24 (3) services that maintain a person in the person's home or 573.25 least restrictive setting; 573.26 (4) assessment of persons applying for services and 573.27 referral to appropriate services when necessary; 573.28 (5) public guardianship services; 573.29 (6) case management for persons with developmental 573.30 disabilities, children with serious emotional disturbances, and 573.31 adults with serious and persistent mental illness; and 573.32 (7) fulfilling licensing responsibilities delegated to the 573.33 county by the commissioner under section 245A.16. 573.34 Subd. 3. [DENIAL, REDUCTION, OR TERMINATION OF SERVICES 573.35 DUE TO FISCAL LIMITATIONS.] Before a county denies, reduces, or 573.36 terminates services to an individual due to fiscal limitations, 574.1 the county must meet the requirements in this section. The 574.2 county must notify the individual and the individual's guardian 574.3 in writing of the reason for the denial, reduction, or 574.4 termination of services and must inform the individual and the 574.5 individual's guardian in writing that the county will, upon 574.6 request, meet to discuss alternatives before services are 574.7 terminated or reduced. 574.8 Sec. 9. [256M.80] [PROGRAM EVALUATION.] 574.9 Subdivision 1. [COUNTY EVALUATION.] Each county shall 574.10 submit to the commissioner data from the past calendar year on 574.11 the outcomes and performance indicators in the service plan. 574.12 The commissioner shall prescribe standard methods to be used by 574.13 the counties in providing the data. The data shall be submitted 574.14 no later than March 1 of each year, beginning with March 1, 2005. 574.15 Subd. 2. [STATEWIDE EVALUATION.] Six months after the end 574.16 of the first full calendar year and annually thereafter, the 574.17 commissioner shall prepare a report on the counties' progress in 574.18 improving the outcomes of children, adolescents, and adults 574.19 related to mental health, safety, permanency, and well-being. 574.20 This report shall be disseminated throughout the state. 574.21 Sec. 10. [256M.90] [GRANTS AND PURCHASE OF SERVICE 574.22 CONTRACTS.] 574.23 Subdivision 1. [AUTHORITY.] The local agency may purchase 574.24 community social services by grant or purchase of service 574.25 contract from agencies or individuals approved as vendors. 574.26 Subd. 2. [DUTIES OF LOCAL AGENCY.] The local agency must: 574.27 (1) use a written grant or purchase of service contract 574.28 when purchasing community social services. Every grant and 574.29 purchase of service contract must be completed, signed, and 574.30 approved by all parties to the agreement, including the county 574.31 board, unless the county board has designated the local agency 574.32 to sign on its behalf. No service shall be provided before the 574.33 effective date of the grant or purchase of service contract; 574.34 (2) determine a client's eligibility for purchased 574.35 services, or delegate the responsibility for making the 574.36 preliminary determination to the approved vendor under the terms 575.1 of the grant or purchase of service contract; 575.2 (3) ensure the development of an individual social service 575.3 plan based on the client's needs; 575.4 (4) monitor purchased services and evaluate grants and 575.5 contracts on the basis of client outcomes; and 575.6 (5) purchase only from approved vendors. 575.7 Subd. 3. [LOCAL AGENCY CRITERIA.] When the local agency 575.8 chooses to purchase community social services from a vendor that 575.9 is not subject to state licensing laws or department rules, the 575.10 local agency must establish written criteria for vendor approval 575.11 to ensure the health, safety, and well being of clients. 575.12 Subd. 4. [CASE RECORDS AND REPORTING REQUIREMENTS.] Case 575.13 records and data reporting requirements for grants and purchased 575.14 services are the same as case record and data reporting 575.15 requirements for direct services. 575.16 Subd. 5. [FILES.] The local agency must keep an 575.17 administrative file for each grant and contract. 575.18 Subd. 6. [CONTRACTING WITHIN AND ACROSS COUNTY LINES; LEAD 575.19 COUNTY CONTRACTS.] Paragraphs (a) to (e) govern contracting 575.20 within and across county lines and lead county contracts. 575.21 (a) Once a local agency and an approved vendor execute a 575.22 contract that meets the requirements of this subdivision, the 575.23 contract governs all other purchases of service from the vendor 575.24 by all other local agencies for the term of the contract. The 575.25 local agency that negotiated and entered into the contract 575.26 becomes the lead county for the contract. 575.27 (b) When the local agency in the county where a vendor is 575.28 located wants to purchase services from that vendor and the 575.29 vendor has no contract with the local agency or any other 575.30 county, the local agency must negotiate and execute a contract 575.31 with the vendor. 575.32 (c) When a local agency in one county wants to purchase 575.33 services from a vendor located in another county, it must notify 575.34 the local agency in the county where the vendor is located. 575.35 Within 30 days of being notified, the local agency in the 575.36 vendor's county must: 576.1 (1) if it has a contract with the vendor, send a copy to 576.2 the inquiring agency; 576.3 (2) if there is a contract with the vendor for which 576.4 another local agency is the lead county, identify the lead 576.5 county to the inquiring agency; or 576.6 (3) if no local agency has a contract with the vendor, 576.7 inform the inquiring agency whether it will negotiate a contract 576.8 and become the lead county. If the agency where the vendor is 576.9 located will not negotiate a contract with the vendor because of 576.10 concerns related to clients' health and safety, the agency must 576.11 share those concerns with the inquiring agency. 576.12 (d) If the local agency in the county where the vendor is 576.13 located declines to negotiate a contract with the vendor or 576.14 fails to respond within 30 days of receiving the notification 576.15 under paragraph (c), the inquiring agency is authorized to 576.16 negotiate a contract and must notify the local agency that 576.17 declined or failed to respond. 576.18 (e) When the inquiring county under paragraph (d) becomes 576.19 the lead county for a contract and the contract expires and 576.20 needs to be renegotiated, that county must again follow the 576.21 requirements under paragraph (c) and notify the local agency 576.22 where the vendor is located. The local agency where the vendor 576.23 is located has the option of becoming the lead county for the 576.24 new contract. If the local agency does not exercise the option, 576.25 paragraph (d) applies. 576.26 (f) This subdivision does not affect the requirement to 576.27 seek county concurrence under section 256B.092, subdivision 8a, 576.28 when the services are to be purchased for a person with mental 576.29 retardation or a related condition or under section 245.4711, 576.30 subdivision 3, when the services to be purchased are for an 576.31 adult with serious and persistent mental illness. 576.32 Subd. 7. [CONTRACTS WITH COMMUNITY MENTAL HEALTH 576.33 BOARDS.] A local agency within the geographic area served by a 576.34 community mental health board authorized by sections 245.61 to 576.35 245.69, may contract directly with the community mental health 576.36 board. However, if a local agency outside of the geographic 577.1 area served by a community mental health board wishes to 577.2 purchase services from the board, the local agency must follow 577.3 the requirements under subdivision 6. 577.4 Subd. 8. [PLACEMENT AGREEMENTS.] A placement agreement 577.5 must be used for residential services. Placement agreements are 577.6 valid when signed by authorized representatives of the facility 577.7 and the county of financial responsibility. If the county of 577.8 financial responsibility and the county where the approved 577.9 vendor is located are not the same, the county of financial 577.10 responsibility must, if requested, mail a copy of the placement 577.11 agreement to the county where the approved vendor is providing 577.12 the service and to the lead county within ten calendar days 577.13 after the date on which the placement agreement is signed. The 577.14 placement agreement must specify that the service will be 577.15 provided in accordance with the individual service plan as 577.16 required and must specify the unit cost, the date of placement, 577.17 and the date for the review of the placement. A placement 577.18 agreement may also be used for nonresidential services. 577.19 Sec. 11. [REVISOR'S INSTRUCTION.] 577.20 For sections in Minnesota Statutes and Minnesota Rules 577.21 affected by the repealed sections in this article, the revisor 577.22 shall delete internal cross-references where appropriate and 577.23 make changes necessary to correct the punctuation, grammar, or 577.24 structure of the remaining text and preserve its meaning. 577.25 Sec. 12. [REPEALER.] 577.26 (a) Minnesota Statutes 2002, sections 245.478; 245.4886; 577.27 245.4888; 245.496; 254A.17; 256E.01; 256E.02; 256E.03; 256E.04; 577.28 256E.05; 256E.06; 256E.07; 256E.08; 256E.081; 256E.09; 256E.10; 577.29 256E.11; 256E.115; 256E.13; 256E.14; 256E.15; 256F.01; 256F.02; 577.30 256F.03; 256F.04; 256F.05; 256F.06; 256F.07; 256F.08; 256F.11; 577.31 256F.12; 256F.14; 257.075; 257.81; 260.152; and 626.562, are 577.32 repealed. 577.33 (b) Minnesota Rules, parts 9550.0010; 9550.0020; 9550.0030; 577.34 9550.0040; 9550.0050; 9550.0060; 9550.0070; 9550.0080; 577.35 9550.0090; 9550.0091; 9550.0092; and 9550.0093, are repealed. 577.36 ARTICLE 12 578.1 HEALTH CARE 578.2 Section 1. Minnesota Statutes 2002, section 62J.692, 578.3 subdivision 8, is amended to read: 578.4 Subd. 8. [FEDERAL FINANCIAL PARTICIPATION.] (a) The 578.5 commissioner of human services shall seek to maximize federal 578.6 financial participation in payments for medical education and 578.7 research costs. If the commissioner of human services 578.8 determines that federal financial participation is available for 578.9 the medical education and research, the commissioner of health 578.10 shall transfer to the commissioner of human services the amount 578.11 of state funds necessary to maximize the federal funds 578.12 available. The amount transferred to the commissioner of human 578.13 services, plus the amount of federal financial participation, 578.14 shall be distributed to medical assistance providers in 578.15 accordance with the distribution methodology described in 578.16 subdivision 4. 578.17 (b) For the purposes of paragraph (a), the commissioner 578.18 shall use physician clinic rates where possible to maximize 578.19 federal financial participation. 578.20 Sec. 2. Minnesota Statutes 2002, section 256.01, 578.21 subdivision 2, is amended to read: 578.22 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 578.23 section 241.021, subdivision 2, the commissioner of human 578.24 services shall: 578.25 (1) Administer and supervise all forms of public assistance 578.26 provided for by state law and other welfare activities or 578.27 services as are vested in the commissioner. Administration and 578.28 supervision of human services activities or services includes, 578.29 but is not limited to, assuring timely and accurate distribution 578.30 of benefits, completeness of service, and quality program 578.31 management. In addition to administering and supervising human 578.32 services activities vested by law in the department, the 578.33 commissioner shall have the authority to: 578.34 (a) require county agency participation in training and 578.35 technical assistance programs to promote compliance with 578.36 statutes, rules, federal laws, regulations, and policies 579.1 governing human services; 579.2 (b) monitor, on an ongoing basis, the performance of county 579.3 agencies in the operation and administration of human services, 579.4 enforce compliance with statutes, rules, federal laws, 579.5 regulations, and policies governing welfare services and promote 579.6 excellence of administration and program operation; 579.7 (c) develop a quality control program or other monitoring 579.8 program to review county performance and accuracy of benefit 579.9 determinations; 579.10 (d) require county agencies to make an adjustment to the 579.11 public assistance benefits issued to any individual consistent 579.12 with federal law and regulation and state law and rule and to 579.13 issue or recover benefits as appropriate; 579.14 (e) delay or deny payment of all or part of the state and 579.15 federal share of benefits and administrative reimbursement 579.16 according to the procedures set forth in section 256.017; 579.17 (f) make contracts with and grants to public and private 579.18 agencies and organizations, both profit and nonprofit, and 579.19 individuals, using appropriated funds; and 579.20 (g) enter into contractual agreements with federally 579.21 recognized Indian tribes with a reservation in Minnesota to the 579.22 extent necessary for the tribe to operate a federally approved 579.23 family assistance program or any other program under the 579.24 supervision of the commissioner. The commissioner shall consult 579.25 with the affected county or counties in the contractual 579.26 agreement negotiations, if the county or counties wish to be 579.27 included, in order to avoid the duplication of county and tribal 579.28 assistance program services. The commissioner may establish 579.29 necessary accounts for the purposes of receiving and disbursing 579.30 funds as necessary for the operation of the programs. 579.31 (2) Inform county agencies, on a timely basis, of changes 579.32 in statute, rule, federal law, regulation, and policy necessary 579.33 to county agency administration of the programs. 579.34 (3) Administer and supervise all child welfare activities; 579.35 promote the enforcement of laws protecting handicapped, 579.36 dependent, neglected and delinquent children, and children born 580.1 to mothers who were not married to the children's fathers at the 580.2 times of the conception nor at the births of the children; 580.3 license and supervise child-caring and child-placing agencies 580.4 and institutions; supervise the care of children in boarding and 580.5 foster homes or in private institutions; and generally perform 580.6 all functions relating to the field of child welfare now vested 580.7 in the state board of control. 580.8 (4) Administer and supervise all noninstitutional service 580.9 to handicapped persons, including those who are visually 580.10 impaired, hearing impaired, or physically impaired or otherwise 580.11 handicapped. The commissioner may provide and contract for the 580.12 care and treatment of qualified indigent children in facilities 580.13 other than those located and available at state hospitals when 580.14 it is not feasible to provide the service in state hospitals. 580.15 (5) Assist and actively cooperate with other departments, 580.16 agencies and institutions, local, state, and federal, by 580.17 performing services in conformity with the purposes of Laws 580.18 1939, chapter 431. 580.19 (6) Act as the agent of and cooperate with the federal 580.20 government in matters of mutual concern relative to and in 580.21 conformity with the provisions of Laws 1939, chapter 431, 580.22 including the administration of any federal funds granted to the 580.23 state to aid in the performance of any functions of the 580.24 commissioner as specified in Laws 1939, chapter 431, and 580.25 including the promulgation of rules making uniformly available 580.26 medical care benefits to all recipients of public assistance, at 580.27 such times as the federal government increases its participation 580.28 in assistance expenditures for medical care to recipients of 580.29 public assistance, the cost thereof to be borne in the same 580.30 proportion as are grants of aid to said recipients. 580.31 (7) Establish and maintain any administrative units 580.32 reasonably necessary for the performance of administrative 580.33 functions common to all divisions of the department. 580.34 (8) Act as designated guardian of both the estate and the 580.35 person of all the wards of the state of Minnesota, whether by 580.36 operation of law or by an order of court, without any further 581.1 act or proceeding whatever, except as to persons committed as 581.2 mentally retarded. For children under the guardianship of the 581.3 commissioner whose interests would be best served by adoptive 581.4 placement, the commissioner may contract with a licensed 581.5 child-placing agency or a Minnesota tribal social services 581.6 agency to provide adoption services. A contract with a licensed 581.7 child-placing agency must be designed to supplement existing 581.8 county efforts and may not replace existing county programs, 581.9 unless the replacement is agreed to by the county board and the 581.10 appropriate exclusive bargaining representative or the 581.11 commissioner has evidence that child placements of the county 581.12 continue to be substantially below that of other counties. 581.13 Funds encumbered and obligated under an agreement for a specific 581.14 child shall remain available until the terms of the agreement 581.15 are fulfilled or the agreement is terminated. 581.16 (9) Act as coordinating referral and informational center 581.17 on requests for service for newly arrived immigrants coming to 581.18 Minnesota. 581.19 (10) The specific enumeration of powers and duties as 581.20 hereinabove set forth shall in no way be construed to be a 581.21 limitation upon the general transfer of powers herein contained. 581.22 (11) Establish county, regional, or statewide schedules of 581.23 maximum fees and charges which may be paid by county agencies 581.24 for medical, dental, surgical, hospital, nursing and nursing 581.25 home care and medicine and medical supplies under all programs 581.26 of medical care provided by the state and for congregate living 581.27 care under the income maintenance programs. 581.28 (12) Have the authority to conduct and administer 581.29 experimental projects to test methods and procedures of 581.30 administering assistance and services to recipients or potential 581.31 recipients of public welfare. To carry out such experimental 581.32 projects, it is further provided that the commissioner of human 581.33 services is authorized to waive the enforcement of existing 581.34 specific statutory program requirements, rules, and standards in 581.35 one or more counties. The order establishing the waiver shall 581.36 provide alternative methods and procedures of administration, 582.1 shall not be in conflict with the basic purposes, coverage, or 582.2 benefits provided by law, and in no event shall the duration of 582.3 a project exceed four years. It is further provided that no 582.4 order establishing an experimental project as authorized by the 582.5 provisions of this section shall become effective until the 582.6 following conditions have been met: 582.7 (a) The secretary of health and human services of the 582.8 United States has agreed, for the same project, to waive state 582.9 plan requirements relative to statewide uniformity. 582.10 (b) A comprehensive plan, including estimated project 582.11 costs, shall be approved by the legislative advisory commission 582.12 and filed with the commissioner of administration. 582.13 (13) According to federal requirements, establish 582.14 procedures to be followed by local welfare boards in creating 582.15 citizen advisory committees, including procedures for selection 582.16 of committee members. 582.17 (14) Allocate federal fiscal disallowances or sanctions 582.18 which are based on quality control error rates for the aid to 582.19 families with dependent children program formerly codified in 582.20 sections 256.72 to 256.87, medical assistance, or food stamp 582.21 program in the following manner: 582.22 (a) One-half of the total amount of the disallowance shall 582.23 be borne by the county boards responsible for administering the 582.24 programs. For the medical assistance and the AFDC program 582.25 formerly codified in sections 256.72 to 256.87, disallowances 582.26 shall be shared by each county board in the same proportion as 582.27 that county's expenditures for the sanctioned program are to the 582.28 total of all counties' expenditures for the AFDC program 582.29 formerly codified in sections 256.72 to 256.87, and medical 582.30 assistance programs. For the food stamp program, sanctions 582.31 shall be shared by each county board, with 50 percent of the 582.32 sanction being distributed to each county in the same proportion 582.33 as that county's administrative costs for food stamps are to the 582.34 total of all food stamp administrative costs for all counties, 582.35 and 50 percent of the sanctions being distributed to each county 582.36 in the same proportion as that county's value of food stamp 583.1 benefits issued are to the total of all benefits issued for all 583.2 counties. Each county shall pay its share of the disallowance 583.3 to the state of Minnesota. When a county fails to pay the 583.4 amount due hereunder, the commissioner may deduct the amount 583.5 from reimbursement otherwise due the county, or the attorney 583.6 general, upon the request of the commissioner, may institute 583.7 civil action to recover the amount due. 583.8 (b) Notwithstanding the provisions of paragraph (a), if the 583.9 disallowance results from knowing noncompliance by one or more 583.10 counties with a specific program instruction, and that knowing 583.11 noncompliance is a matter of official county board record, the 583.12 commissioner may require payment or recover from the county or 583.13 counties, in the manner prescribed in paragraph (a), an amount 583.14 equal to the portion of the total disallowance which resulted 583.15 from the noncompliance, and may distribute the balance of the 583.16 disallowance according to paragraph (a). 583.17 (15) Develop and implement special projects that maximize 583.18 reimbursements and result in the recovery of money to the 583.19 state. For the purpose of recovering state money, the 583.20 commissioner may enter into contracts with third parties. Any 583.21 recoveries that result from projects or contracts entered into 583.22 under this paragraph shall be deposited in the state treasury 583.23 and credited to a special account until the balance in the 583.24 account reaches $1,000,000. When the balance in the account 583.25 exceeds $1,000,000, the excess shall be transferred and credited 583.26 to the general fund. All money in the account is appropriated 583.27 to the commissioner for the purposes of this paragraph. 583.28 (16) Have the authority to make direct payments to 583.29 facilities providing shelter to women and their children 583.30 according to section 256D.05, subdivision 3. Upon the written 583.31 request of a shelter facility that has been denied payments 583.32 under section 256D.05, subdivision 3, the commissioner shall 583.33 review all relevant evidence and make a determination within 30 583.34 days of the request for review regarding issuance of direct 583.35 payments to the shelter facility. Failure to act within 30 days 583.36 shall be considered a determination not to issue direct payments. 584.1 (17) Have the authority to establish and enforce the 584.2 following county reporting requirements: 584.3 (a) The commissioner shall establish fiscal and statistical 584.4 reporting requirements necessary to account for the expenditure 584.5 of funds allocated to counties for human services programs. 584.6 When establishing financial and statistical reporting 584.7 requirements, the commissioner shall evaluate all reports, in 584.8 consultation with the counties, to determine if the reports can 584.9 be simplified or the number of reports can be reduced. 584.10 (b) The county board shall submit monthly or quarterly 584.11 reports to the department as required by the commissioner. 584.12 Monthly reports are due no later than 15 working days after the 584.13 end of the month. Quarterly reports are due no later than 30 584.14 calendar days after the end of the quarter, unless the 584.15 commissioner determines that the deadline must be shortened to 584.16 20 calendar days to avoid jeopardizing compliance with federal 584.17 deadlines or risking a loss of federal funding. Only reports 584.18 that are complete, legible, and in the required format shall be 584.19 accepted by the commissioner. 584.20 (c) If the required reports are not received by the 584.21 deadlines established in clause (b), the commissioner may delay 584.22 payments and withhold funds from the county board until the next 584.23 reporting period. When the report is needed to account for the 584.24 use of federal funds and the late report results in a reduction 584.25 in federal funding, the commissioner shall withhold from the 584.26 county boards with late reports an amount equal to the reduction 584.27 in federal funding until full federal funding is received. 584.28 (d) A county board that submits reports that are late, 584.29 illegible, incomplete, or not in the required format for two out 584.30 of three consecutive reporting periods is considered 584.31 noncompliant. When a county board is found to be noncompliant, 584.32 the commissioner shall notify the county board of the reason the 584.33 county board is considered noncompliant and request that the 584.34 county board develop a corrective action plan stating how the 584.35 county board plans to correct the problem. The corrective 584.36 action plan must be submitted to the commissioner within 45 days 585.1 after the date the county board received notice of noncompliance. 585.2 (e) The final deadline for fiscal reports or amendments to 585.3 fiscal reports is one year after the date the report was 585.4 originally due. If the commissioner does not receive a report 585.5 by the final deadline, the county board forfeits the funding 585.6 associated with the report for that reporting period and the 585.7 county board must repay any funds associated with the report 585.8 received for that reporting period. 585.9 (f) The commissioner may not delay payments, withhold 585.10 funds, or require repayment under paragraph (c) or (e) if the 585.11 county demonstrates that the commissioner failed to provide 585.12 appropriate forms, guidelines, and technical assistance to 585.13 enable the county to comply with the requirements. If the 585.14 county board disagrees with an action taken by the commissioner 585.15 under paragraph (c) or (e), the county board may appeal the 585.16 action according to sections 14.57 to 14.69. 585.17 (g) Counties subject to withholding of funds under 585.18 paragraph (c) or forfeiture or repayment of funds under 585.19 paragraph (e) shall not reduce or withhold benefits or services 585.20 to clients to cover costs incurred due to actions taken by the 585.21 commissioner under paragraph (c) or (e). 585.22 (18) Allocate federal fiscal disallowances or sanctions for 585.23 audit exceptions when federal fiscal disallowances or sanctions 585.24 are based on a statewide random sample for the foster care 585.25 program under title IV-E of the Social Security Act, United 585.26 States Code, title 42, in direct proportion to each county's 585.27 title IV-E foster care maintenance claim for that period. 585.28 (19) Be responsible for ensuring the detection, prevention, 585.29 investigation, and resolution of fraudulent activities or 585.30 behavior by applicants, recipients, and other participants in 585.31 the human services programs administered by the department. 585.32 (20) Require county agencies to identify overpayments, 585.33 establish claims, and utilize all available and cost-beneficial 585.34 methodologies to collect and recover these overpayments in the 585.35 human services programs administered by the department. 585.36 (21) Have the authority to administer a drug rebate program 586.1 for drugs purchased pursuant to the prescription drug program 586.2 established under section 256.955 after the beneficiary's 586.3 satisfaction of any deductible established in the program. The 586.4 commissioner shall require a rebate agreement from all 586.5 manufacturers of covered drugs as defined in section 256B.0625, 586.6 subdivision 13. Rebate agreements for prescription drugs 586.7 delivered on or after July 1, 2002, must include rebates for 586.8 individuals covered under the prescription drug program who are 586.9 under 65 years of age. For each drug, the amount of the rebate 586.10 shall be equal to thebasicrebate as defined for purposes of 586.11 the federal rebate program in United States Code, title 42, 586.12 section 1396r-8(c)(1).This basic rebate shall be applied to586.13single-source and multiple-source drugs.The manufacturers must 586.14 provide full payment within 30 days of receipt of the state 586.15 invoice for the rebate within the terms and conditions used for 586.16 the federal rebate program established pursuant to section 1927 586.17 of title XIX of the Social Security Act. The manufacturers must 586.18 provide the commissioner with any information necessary to 586.19 verify the rebate determined per drug. The rebate program shall 586.20 utilize the terms and conditions used for the federal rebate 586.21 program established pursuant to section 1927 of title XIX of the 586.22 Social Security Act. 586.23 (22) Have the authority to administer the federal drug 586.24 rebate program for drugs purchased under the medical assistance 586.25 program as allowed by section 1927 of title XIX of the Social 586.26 Security Act and according to the terms and conditions of 586.27 section 1927. Rebates shall be collected for all drugs that 586.28 have been dispensed or administered in an outpatient setting and 586.29 that are from manufacturers who have signed a rebate agreement 586.30 with the United States Department of Health and Human Services. 586.31 (23) Have the authority to administer a supplemental drug 586.32 rebate program for drugs purchased under the medical assistance 586.33 program. The commissioner may enter into supplemental rebate 586.34 contracts with pharmaceutical manufacturers and may require 586.35 prior authorization for drugs that are from manufacturers that 586.36 have not signed a supplemental rebate contract. Prior 587.1 authorization of drugs shall be subject to the provisions of 587.2 section 256B.0625, subdivision 13. 587.3 (24) Operate the department's communication systems account 587.4 established in Laws 1993, First Special Session chapter 1, 587.5 article 1, section 2, subdivision 2, to manage shared 587.6 communication costs necessary for the operation of the programs 587.7 the commissioner supervises. A communications account may also 587.8 be established for each regional treatment center which operates 587.9 communications systems. Each account must be used to manage 587.10 shared communication costs necessary for the operations of the 587.11 programs the commissioner supervises. The commissioner may 587.12 distribute the costs of operating and maintaining communication 587.13 systems to participants in a manner that reflects actual usage. 587.14 Costs may include acquisition, licensing, insurance, 587.15 maintenance, repair, staff time and other costs as determined by 587.16 the commissioner. Nonprofit organizations and state, county, 587.17 and local government agencies involved in the operation of 587.18 programs the commissioner supervises may participate in the use 587.19 of the department's communications technology and share in the 587.20 cost of operation. The commissioner may accept on behalf of the 587.21 state any gift, bequest, devise or personal property of any 587.22 kind, or money tendered to the state for any lawful purpose 587.23 pertaining to the communication activities of the department. 587.24 Any money received for this purpose must be deposited in the 587.25 department's communication systems accounts. Money collected by 587.26 the commissioner for the use of communication systems must be 587.27 deposited in the state communication systems account and is 587.28 appropriated to the commissioner for purposes of this section. 587.29 (25) Receive any federal matching money that is made 587.30 available through the medical assistance program for the 587.31 consumer satisfaction survey. Any federal money received for 587.32 the survey is appropriated to the commissioner for this 587.33 purpose. The commissioner may expend the federal money received 587.34 for the consumer satisfaction survey in either year of the 587.35 biennium. 587.36 (26) Incorporate cost reimbursement claims from First Call 588.1 Minnesota and Greater Twin Cities United Way into the federal 588.2 cost reimbursement claiming processes of the department 588.3 according to federal law, rule, and regulations. Any 588.4 reimbursement received is appropriated to the commissioner and 588.5 shall be disbursed to First Call Minnesota and Greater Twin 588.6 Cities United Way according to normal department payment 588.7 schedules. 588.8 (27) Develop recommended standards for foster care homes 588.9 that address the components of specialized therapeutic services 588.10 to be provided by foster care homes with those services. 588.11 Sec. 3. Minnesota Statutes 2002, section 256.046, 588.12 subdivision 1, is amended to read: 588.13 Subdivision 1. [HEARING AUTHORITY.] A local agency must 588.14 initiate an administrative fraud disqualification hearing for 588.15 individuals accused of wrongfully obtaining assistance or 588.16 intentional program violations, in lieu of a criminal action 588.17 when it has not been pursued, in the aid to families with 588.18 dependent children program formerly codified in sections 256.72 588.19 to 256.87, MFIP, child care assistance programs, general 588.20 assistance, family general assistance program formerly codified 588.21 in section 256D.05, subdivision 1, clause (15), Minnesota 588.22 supplemental aid,medical care, orfood stamp programs, general 588.23 assistance medical care, MinnesotaCare for adults without 588.24 children, and upon federal approval, all categories of medical 588.25 assistance and remaining categories of MinnesotaCare except for 588.26 children through age 18. The hearing is subject to the 588.27 requirements of section 256.045 and the requirements in Code of 588.28 Federal Regulations, title 7, section 273.16, for the food stamp 588.29 program and title 45, section 235.112, as of September 30, 1995, 588.30 for the cash grant and medical care programs. 588.31 Sec. 4. [256.954] [PRESCRIPTION DRUG DISCOUNT PROGRAM.] 588.32 Subdivision 1. [ESTABLISHMENT; ADMINISTRATION.] The 588.33 commissioner of human services shall establish and administer 588.34 the prescription drug discount program, effective July 1, 2005. 588.35 Subd. 2. [COMMISSIONER'S AUTHORITY.] The commissioner 588.36 shall administer a drug rebate program for drugs purchased 589.1 according to the prescription drug discount program. The 589.2 commissioner shall require a rebate agreement from all 589.3 manufacturers of covered drugs as defined in section 256B.0625, 589.4 subdivision 13. For each drug, the amount of the rebate shall 589.5 be equal to the rebate as defined for purposes of the federal 589.6 rebate program in United States Code, title 42, section 589.7 1396r-8. The rebate program shall utilize the terms and 589.8 conditions used for the federal rebate program established 589.9 according to section 1927 of title XIX of the federal Social 589.10 Security Act. 589.11 Subd. 3. [DEFINITIONS.] For the purpose of this section, 589.12 the following terms have the meanings given them: 589.13 (a) "Commissioner" means the commissioner of human services. 589.14 (b) "Manufacturer" means a manufacturer as defined in 589.15 section 151.44, paragraph (c). 589.16 (c) "Covered prescription drug" means a prescription drug 589.17 as defined in section 151.44, paragraph (d), that is covered 589.18 under medical assistance as described in section 256B.0625, 589.19 subdivision 13, and that is provided by a manufacturer that has 589.20 a fully executed rebate agreement with the commissioner under 589.21 this section and complies with that agreement. 589.22 (d) "Health carrier" means an insurance company licensed 589.23 under chapter 60A to offer, sell, or issue an individual or 589.24 group policy of accident and sickness insurance as defined in 589.25 section 62A.01; a nonprofit health service plan corporation 589.26 operating under chapter 62C; a health maintenance organization 589.27 operating under chapter 62D; a joint self-insurance employee 589.28 health plan operating under chapter 62H; a community integrated 589.29 systems network licensed under chapter 62N; a fraternal benefit 589.30 society operating under chapter 64B; a city, county, school 589.31 district, or other political subdivision providing self-insured 589.32 health coverage under section 461.617 or sections 471.98 to 589.33 471.982; and a self-funded health plan under the Employee 589.34 Retirement Income Security Act of 1974, as amended. 589.35 (e) "Participating pharmacy" means a pharmacy as defined in 589.36 section 151.01, subdivision 2, that agrees to participate in the 590.1 prescription drug discount program. 590.2 (f) "Enrolled individual" means a person who is eligible 590.3 for the program under subdivision 4 and has enrolled in the 590.4 program according to subdivision 5. 590.5 Subd. 4. [ELIGIBLE PERSONS.] To be eligible for the 590.6 program, an applicant must: 590.7 (1) be a permanent resident of Minnesota as defined in 590.8 section 256L.09, subdivision 4; 590.9 (2) not be enrolled in medical assistance, general 590.10 assistance medical care, MinnesotaCare, or the prescription drug 590.11 program under section 256.955; 590.12 (3) not be enrolled in and have currently available 590.13 prescription drug coverage under a health plan offered by a 590.14 health carrier or under a pharmacy benefit program offered by a 590.15 pharmaceutical manufacturer; 590.16 (4) not be enrolled in and have currently available 590.17 prescription drug coverage under a Medicare supplement plan, as 590.18 defined in sections 62A.31 to 62A.44, or policies, contracts, or 590.19 certificates that supplement Medicare issued by health 590.20 maintenance organizations or those policies, contracts, or 590.21 certificates governed by section 1833 or 1876 of the federal 590.22 Social Security Act, United States Code, title 42, section 1395, 590.23 et. seq., as amended; and 590.24 (5) have a gross household income that does not exceed 250 590.25 percent of the federal poverty guidelines. 590.26 Subd. 5. [APPLICATION PROCEDURE.] (a) Applications and 590.27 information on the program must be made available at county 590.28 social services agencies, health care provider offices, and 590.29 agencies and organizations serving senior citizens. Individuals 590.30 shall submit applications and any information specified by the 590.31 commissioner as being necessary to verify eligibility directly 590.32 to the commissioner. The commissioner shall determine an 590.33 applicant's eligibility for the program within 30 days from the 590.34 date the application is received. Eligibility begins the month 590.35 after approval. 590.36 (b) The commissioner shall develop an application form that 591.1 does not exceed one page in length and requires information 591.2 necessary to determine eligibility for the program. 591.3 Subd. 6. [PARTICIPATING PHARMACY.] According to a valid 591.4 prescription, a participating pharmacy must sell a covered 591.5 prescription drug to an enrolled individual at the pharmacy's 591.6 usual and customary retail price, minus an amount that is equal 591.7 to the rebate amount described in subdivision 8, plus the amount 591.8 of any administrative fee and switch fee established by the 591.9 commissioner under subdivision 10. Each participating pharmacy 591.10 shall provide the commissioner with all information necessary to 591.11 administer the program, including, but not limited to, 591.12 information on prescription drug sales to enrolled individuals 591.13 and usual and customary retail prices. 591.14 Subd. 7. [NOTIFICATION OF REBATE AMOUNT.] The commissioner 591.15 shall notify each drug manufacturer, each calendar quarter or 591.16 according to a schedule to be established by the commissioner, 591.17 of the amount of the rebate owed on the prescription drugs sold 591.18 by participating pharmacies to enrolled individuals. 591.19 Subd. 8. [PROVISION OF REBATE.] To the extent that a 591.20 manufacturer's prescription drugs are prescribed to a resident 591.21 of this state, the manufacturer must provide a rebate equal to 591.22 the rebate provided under the medical assistance program for any 591.23 prescription drug distributed by the manufacturer that is 591.24 purchased by an enrolled individual at a participating 591.25 pharmacy. The manufacturer must provide full payment within 30 591.26 days of receipt of the state invoice for the rebate, or 591.27 according to a schedule to be established by the commissioner. 591.28 The commissioner shall deposit all rebates received into the 591.29 Minnesota prescription drug dedicated fund established under 591.30 subdivision 11. The manufacturer must provide the commissioner 591.31 with any information necessary to verify the rebate determined 591.32 per drug. 591.33 Subd. 9. [PAYMENT TO PHARMACIES.] The commissioner shall 591.34 distribute on a biweekly basis an amount that is equal to an 591.35 amount collected under subdivision 8 to each participating 591.36 pharmacy based on the prescription drugs sold by that pharmacy 592.1 to enrolled individuals, minus the amount of the administrative 592.2 fee established by the commissioner under subdivision 10. 592.3 Subd. 10. [ADMINISTRATIVE FEE; SWITCH FEE.] (a) The 592.4 commissioner shall establish a reasonable administrative fee 592.5 that covers the commissioner's expenses for enrollment, 592.6 processing claims, and distributing rebates under this program. 592.7 (b) The commissioner shall establish a reasonable switch 592.8 fee that covers expenses incurred by pharmacies in formatting 592.9 for electronic submission claims for prescription drugs sold to 592.10 enrolled individuals. 592.11 Subd. 11. [DEDICATED FUND; CREATION; USE OF FUND.] (a) The 592.12 Minnesota prescription drug dedicated fund is established as an 592.13 account in the state treasury. The commissioner of finance 592.14 shall credit to the dedicated fund all rebates paid under 592.15 subdivision 8, any federal funds received for the program, and 592.16 any appropriations or allocations designated for the fund. The 592.17 commissioner of finance shall ensure that fund money is invested 592.18 under section 11A.25. All money earned by the fund must be 592.19 credited to the fund. The fund shall earn a proportionate share 592.20 of the total state annual investment income. 592.21 (b) Money in the fund is appropriated to the commissioner 592.22 of human services to reimburse participating pharmacies for 592.23 prescription drug discounts provided to enrolled individuals 592.24 under this section, to reimburse the commissioner of human 592.25 services for costs related to enrollment, processing claims, 592.26 distributing rebates, and for other reasonable administrative 592.27 costs related to administration of the prescription drug 592.28 discount program, and to repay the appropriation provided for 592.29 this section. The commissioner must administer the program so 592.30 that the costs total no more than funds appropriated plus the 592.31 drug rebate proceeds. 592.32 Subd. 12. [EXPIRATION.] This section expires upon the 592.33 effective date of an expanded prescription drug benefit under 592.34 Medicare. 592.35 [EFFECTIVE DATE.] This section is effective July 1, 2005. 592.36 Sec. 5. Minnesota Statutes 2002, section 256.955, 593.1 subdivision 2a, is amended to read: 593.2 Subd. 2a. [ELIGIBILITY.] An individual satisfying the 593.3 following requirements and the requirements described in 593.4 subdivision 2, paragraph (d), is eligible for the prescription 593.5 drug program: 593.6 (1) is at least 65 years of age or older; and 593.7 (2) is eligible as a qualified Medicare beneficiary 593.8 according to section 256B.057, subdivision 3,or 3a,or 3b,593.9clause (1),or is eligible under section 256B.057, subdivision 593.10 3,or 3a,or 3b, clause (1),and is also eligible for medical 593.11 assistance or general assistance medical care with a spenddown 593.12 as defined in section 256B.056, subdivision 5. 593.13 Sec. 6. Minnesota Statutes 2002, section 256.955, 593.14 subdivision 3, is amended to read: 593.15 Subd. 3. [PRESCRIPTION DRUG COVERAGE.] Coverage under the 593.16 program shall be limited to those prescription drugs that: 593.17 (1) are covered under the medical assistance program as 593.18 described in section 256B.0625, subdivision 13;and593.19 (2) are provided by manufacturers that have fully executed 593.20 senior drug rebate agreements with the commissioner and comply 593.21 with such agreements; and 593.22 (3) for a specific enrollee, are not covered under an 593.23 assistance program offered by a pharmaceutical manufacturer, as 593.24 determined by the board on aging under section 256.975, 593.25 subdivision 9, except that this shall not apply to qualified 593.26 individuals under this section who are also eligible for medical 593.27 assistance with a spenddown as described in subdivision 2a, 593.28 clause (2), and subdivision 2b, clause (2). 593.29 [EFFECTIVE DATE.] This section is effective 90 days after 593.30 implementation by the board of aging of the prescription drug 593.31 assistance program under section 256.975, subdivision 9. 593.32 Sec. 7. Minnesota Statutes 2002, section 256.955, is 593.33 amended by adding a subdivision to read: 593.34 Subd. 4a. [REFERRALS TO PRESCRIPTION DRUG ASSISTANCE 593.35 PROGRAM.] County social service agencies, in coordination with 593.36 the commissioner and the Minnesota board on aging, shall refer 594.1 individuals applying to the prescription drug program, or 594.2 enrolled in the prescription drug program, to the prescription 594.3 drug assistance program for all required prescription drugs that 594.4 the board on aging determines, under section 256.975, 594.5 subdivision 9, are covered under an assistance program offered 594.6 by a pharmaceutical manufacturer. Applicants and enrollees 594.7 referred to the prescription drug assistance program remain 594.8 eligible for coverage under the prescription drug program of all 594.9 prescription drugs covered under subdivision 3. The board on 594.10 aging shall phase-in participation of enrollees, over a period 594.11 of 90 days, after implementation of the program under section 594.12 256.975, subdivision 9. This subdivision does not apply to 594.13 individuals who are also eligible for medical assistance with a 594.14 spenddown as defined in section 256B.056, subdivision 5. 594.15 [EFFECTIVE DATE.] This section is effective 90 days after 594.16 implementation by the board of aging of the prescription drug 594.17 assistance program under section 256.975, subdivision 9. 594.18 Sec. 8. Minnesota Statutes 2002, section 256.969, 594.19 subdivision 2b, is amended to read: 594.20 Subd. 2b. [OPERATING PAYMENT RATES.] In determining 594.21 operating payment rates for admissions occurring on or after the 594.22 rate year beginning January 1, 1991, and every two years after, 594.23 or more frequently as determined by the commissioner, the 594.24 commissioner shall obtain operating data from an updated base 594.25 year and establish operating payment rates per admission for 594.26 each hospital based on the cost-finding methods and allowable 594.27 costs of the Medicare program in effect during the base year. 594.28 Rates under the general assistance medical care, medical 594.29 assistance, and MinnesotaCare programs shall not be rebased to 594.30 more current data on January 1, 1997, and January 1, 2005. The 594.31 base year operating payment rate per admission is standardized 594.32 by the case mix index and adjusted by the hospital cost index, 594.33 relative values, and disproportionate population adjustment. 594.34 The cost and charge data used to establish operating rates shall 594.35 only reflect inpatient services covered by medical assistance 594.36 and shall not include property cost information and costs 595.1 recognized in outlier payments. 595.2 Sec. 9. Minnesota Statutes 2002, section 256.969, 595.3 subdivision 3a, is amended to read: 595.4 Subd. 3a. [PAYMENTS.] (a) Acute care hospital billings 595.5 under the medical assistance program must not be submitted until 595.6 the recipient is discharged. However, the commissioner shall 595.7 establish monthly interim payments for inpatient hospitals that 595.8 have individual patient lengths of stay over 30 days regardless 595.9 of diagnostic category. Except as provided in section 256.9693, 595.10 medical assistance reimbursement for treatment of mental illness 595.11 shall be reimbursed based on diagnostic classifications. 595.12 Individual hospital payments established under this section and 595.13 sections 256.9685, 256.9686, and 256.9695, in addition to third 595.14 party and recipient liability, for discharges occurring during 595.15 the rate year shall not exceed, in aggregate, the charges for 595.16 the medical assistance covered inpatient services paid for the 595.17 same period of time to the hospital. This payment limitation 595.18 shall be calculated separately for medical assistance and 595.19 general assistance medical care services. The limitation on 595.20 general assistance medical care shall be effective for 595.21 admissions occurring on or after July 1, 1991. Services that 595.22 have rates established under subdivision 11 or 12, must be 595.23 limited separately from other services. After consulting with 595.24 the affected hospitals, the commissioner may consider related 595.25 hospitals one entity and may merge the payment rates while 595.26 maintaining separate provider numbers. The operating and 595.27 property base rates per admission or per day shall be derived 595.28 from the best Medicare and claims data available when rates are 595.29 established. The commissioner shall determine the best Medicare 595.30 and claims data, taking into consideration variables of recency 595.31 of the data, audit disposition, settlement status, and the 595.32 ability to set rates in a timely manner. The commissioner shall 595.33 notify hospitals of payment rates by December 1 of the year 595.34 preceding the rate year. The rate setting data must reflect the 595.35 admissions data used to establish relative values. Base year 595.36 changes from 1981 to the base year established for the rate year 596.1 beginning January 1, 1991, and for subsequent rate years, shall 596.2 not be limited to the limits ending June 30, 1987, on the 596.3 maximum rate of increase under subdivision 1. The commissioner 596.4 may adjust base year cost, relative value, and case mix index 596.5 data to exclude the costs of services that have been 596.6 discontinued by the October 1 of the year preceding the rate 596.7 year or that are paid separately from inpatient services. 596.8 Inpatient stays that encompass portions of two or more rate 596.9 years shall have payments established based on payment rates in 596.10 effect at the time of admission unless the date of admission 596.11 preceded the rate year in effect by six months or more. In this 596.12 case, operating payment rates for services rendered during the 596.13 rate year in effect and established based on the date of 596.14 admission shall be adjusted to the rate year in effect by the 596.15 hospital cost index. 596.16 (b) For fee-for-service admissions occurring on or after 596.17 July 1, 2002, the total payment, before third-party liability 596.18 and spenddown, made to hospitals for inpatient services is 596.19 reduced by .5 percent from the current statutory rates. 596.20 (c) In addition to the reduction in paragraph (b), the 596.21 total payment for fee-for-service admissions occurring on or 596.22 after July 1, 2003, made to hospitals for inpatient services 596.23 before third-party liability and spenddown, is reduced five 596.24 percent from the current statutory rates. Mental health 596.25 services within diagnosis related groups 424 to 432, and 596.26 facilities defined under subdivision 16 are excluded from this 596.27 paragraph. 596.28 Sec. 10. Minnesota Statutes 2002, section 256.969, is 596.29 amended by adding a subdivision to read: 596.30 Subd. 8b. [ADMISSIONS FOR PERSONS WHO APPLY DURING 596.31 HOSPITALIZATION.] For admissions for individuals under section 596.32 256D.03, subdivision 3, paragraph (a), clause (2), that occur 596.33 before the date of eligibility, payment for the days that the 596.34 patient is eligible shall be established according to the 596.35 methods of subdivision 14. 596.36 [EFFECTIVE DATE.] This section is effective October 1, 2003. 597.1 Sec. 11. Minnesota Statutes 2002, section 256.975, is 597.2 amended by adding a subdivision to read: 597.3 Subd. 9. [PRESCRIPTION DRUG ASSISTANCE.] (a) The Minnesota 597.4 board on aging shall establish and administer a prescription 597.5 drug assistance program to assist individuals in accessing 597.6 programs offered by pharmaceutical manufacturers that provide 597.7 free or discounted prescription drugs or provide coverage for 597.8 prescription drugs. The board shall use computer software 597.9 programs to: 597.10 (1) list eligibility requirements for pharmaceutical 597.11 assistance programs offered by manufacturers; 597.12 (2) list drugs that are included in a supplemental rebate 597.13 contract between the commissioner and a pharmaceutical 597.14 manufacturer under section 256.01, subdivision 2, clause (23); 597.15 and 597.16 (3) link individuals with the pharmaceutical assistance 597.17 programs most appropriate for the individual. The board shall 597.18 make information on the prescription drug assistance program 597.19 available to interested individuals and health care providers 597.20 and shall coordinate the program with the statewide information 597.21 and assistance service provided through the Senior LinkAge Line 597.22 under subdivision 7. 597.23 (b) The board shall work with the commissioner and county 597.24 social service agencies to coordinate the enrollment of 597.25 individuals who are referred to the prescription drug assistance 597.26 program from the prescription drug program, as required under 597.27 section 256.955, subdivision 4a. 597.28 Sec. 12. Minnesota Statutes 2002, section 256.98, 597.29 subdivision 3, is amended to read: 597.30 Subd. 3. [AMOUNT OF ASSISTANCE INCORRECTLY PAID.] The 597.31 amount of the assistance incorrectly paid under this section is: 597.32 (a) the difference between the amount of assistance 597.33 actually received on the basis of misrepresented or concealed 597.34 facts and the amount to which the recipient would have been 597.35 entitled had the specific concealment or misrepresentation not 597.36 occurred. Unless required by law, rule, or regulation, earned 598.1 income disregards shall not be applied to earnings not reported 598.2 by the recipient; or 598.3 (b) equal to all payments for health care services, 598.4 including capitation payments made to a health plan, made on 598.5 behalf of a person enrolled in MinnesotaCare, medical 598.6 assistance, or general assistance medical care, for which the 598.7 person was not entitled due to the concealment or 598.8 misrepresentation of facts. 598.9 Sec. 13. Minnesota Statutes 2002, section 256.98, 598.10 subdivision 4, is amended to read: 598.11 Subd. 4. [RECOVERY OF ASSISTANCE.] The amount of 598.12 assistance determined to have been incorrectly paid is 598.13 recoverable from: 598.14 (1) the recipient or the recipient's estate by the county 598.15 or the state as a debt due the county or the state or both; and 598.16 (2) any person found to have taken independent action to 598.17 establish eligibility for, conspired with, or aided and abetted, 598.18 any recipient of public assistance found to have been 598.19 incorrectly paid. 598.20 The obligations established under this subdivision shall be 598.21 joint and several and shall extend to all cases involving client 598.22 error as well as cases involving wrongfully obtained assistance. 598.23 MinnesotaCare participants who have been found to have 598.24 wrongfully obtained assistance as described in subdivision 1, 598.25 but who otherwise remain eligible for the program, may agree to 598.26 have their MinnesotaCare premiums increased by an amount equal 598.27 to ten percent of their premiums or $10 per month, whichever is 598.28 greater, until the debt is satisfied. 598.29 Sec. 14. Minnesota Statutes 2002, section 256.98, 598.30 subdivision 8, is amended to read: 598.31 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 598.32 found to be guilty of wrongfully obtaining assistance by a 598.33 federal or state court or by an administrative hearing 598.34 determination, or waiver thereof, through a disqualification 598.35 consent agreement, or as part of any approved diversion plan 598.36 under section 401.065, or any court-ordered stay which carries 599.1 with it any probationary or other conditions, in the Minnesota 599.2 family investment program, the food stamp program, the general 599.3 assistance program, the group residential housing program, or 599.4 the Minnesota supplemental aid program shall be disqualified 599.5 from that program. In addition, any person disqualified from 599.6 the Minnesota family investment program shall also be 599.7 disqualified from the food stamp program. The needs of that 599.8 individual shall not be taken into consideration in determining 599.9 the grant level for that assistance unit: 599.10 (1) for one year after the first offense; 599.11 (2) for two years after the second offense; and 599.12 (3) permanently after the third or subsequent offense. 599.13 The period of program disqualification shall begin on the 599.14 date stipulated on the advance notice of disqualification 599.15 without possibility of postponement for administrative stay or 599.16 administrative hearing and shall continue through completion 599.17 unless and until the findings upon which the sanctions were 599.18 imposed are reversed by a court of competent jurisdiction. The 599.19 period for which sanctions are imposed is not subject to 599.20 review. The sanctions provided under this subdivision are in 599.21 addition to, and not in substitution for, any other sanctions 599.22 that may be provided for by law for the offense involved. A 599.23 disqualification established through hearing or waiver shall 599.24 result in the disqualification period beginning immediately 599.25 unless the person has become otherwise ineligible for 599.26 assistance. If the person is ineligible for assistance, the 599.27 disqualification period begins when the person again meets the 599.28 eligibility criteria of the program from which they were 599.29 disqualified and makes application for that program. 599.30 (b) A family receiving assistance through child care 599.31 assistance programs under chapter 119B with a family member who 599.32 is found to be guilty of wrongfully obtaining child care 599.33 assistance by a federal court, state court, or an administrative 599.34 hearing determination or waiver, through a disqualification 599.35 consent agreement, as part of an approved diversion plan under 599.36 section 401.065, or a court-ordered stay with probationary or 600.1 other conditions, is disqualified from child care assistance 600.2 programs. The disqualifications must be for periods of three 600.3 months, six months, and two years for the first, second, and 600.4 third offenses respectively. Subsequent violations must result 600.5 in permanent disqualification. During the disqualification 600.6 period, disqualification from any child care program must extend 600.7 to all child care programs and must be immediately applied. 600.8 (c) Any person found to be guilty of wrongfully obtaining 600.9 general assistance medical care, MinnesotaCare for adults 600.10 without children, and upon federal approval, all categories of 600.11 medical assistance and remaining categories of MinnesotaCare, 600.12 except for children through age 18, by a federal or state court 600.13 or by an administrative hearing determination, or waiver 600.14 thereof, through a disqualification consent agreement, or as 600.15 part of any approved diversion plan under section 401.065, or 600.16 any court-ordered stay which carries with it any probationary or 600.17 other conditions, is disqualified from that program. The period 600.18 of disqualification is one year after the first offense, two 600.19 years after the second offense, and permanently after the third 600.20 or subsequent offense. The period of program disqualification 600.21 shall begin on the date stipulated on the advance notice of 600.22 disqualification without possibility of postponement for 600.23 administrative stay or administrative hearing and shall continue 600.24 through completion unless and until the findings upon which the 600.25 sanctions were imposed are reversed by a court of competent 600.26 jurisdiction. The period for which sanctions are imposed is not 600.27 subject to review. The sanctions provided under this 600.28 subdivision are in addition to, and not in substitution for, any 600.29 other sanctions that may be provided for by law for the offense 600.30 involved. 600.31 Sec. 15. Minnesota Statutes 2002, section 256B.055, is 600.32 amended by adding a subdivision to read: 600.33 Subd. 13. [RESIDENTS OF INSTITUTIONS FOR MENTAL DISEASES.] 600.34 Beginning October 1, 2003, persons who would be eligible for 600.35 medical assistance under this chapter but for residing in a 600.36 facility that is determined by the commissioner or the federal 601.1 Centers for Medicare and Medicaid Services to be an institution 601.2 for mental diseases are eligible for medical assistance without 601.3 federal financial participation, except that coverage shall not 601.4 include payment for a nursing facility determined to be an 601.5 institution for mental diseases. 601.6 Sec. 16. Minnesota Statutes 2002, section 256B.056, 601.7 subdivision 1a, is amended to read: 601.8 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 601.9 specifically required by state law or rule or federal law or 601.10 regulation, the methodologies used in counting income and assets 601.11 to determine eligibility for medical assistance for persons 601.12 whose eligibility category is based on blindness, disability, or 601.13 age of 65 or more years, the methodologies for the supplemental 601.14 security income program shall be used. Increases in benefits 601.15 under title II of the Social Security Act shall not be counted 601.16 as income for purposes of this subdivision until July 1 of each 601.17 year. Effective upon federal approval, for children eligible 601.18 under section 256B.055, subdivision 12, or for home and 601.19 community-based waiver services whose eligibility for medical 601.20 assistance is determined without regard to parental income, 601.21 child support payments, including any payments made by an 601.22 obligor in satisfaction of or in addition to a temporary or 601.23 permanent order for child support, and social security payments 601.24 are not counted as income. For families and children, which 601.25 includes all other eligibility categories, the methodologies 601.26 under the state's AFDC plan in effect as of July 16, 1996, as 601.27 required by the Personal Responsibility and Work Opportunity 601.28 Reconciliation Act of 1996 (PRWORA), Public LawNumber104-193, 601.29 shall be used, except that effectiveJuly 1, 2002, the $90 and601.30$30 and one-third earned income disregards shall not apply and601.31the disregard specified in subdivision 1c shall applyOctober 1, 601.32 2003, the earned income disregards and deductions are limited to 601.33 those in subdivision 1c. For these purposes, a "methodology" 601.34 does not include an asset or income standard, or accounting 601.35 method, or method of determining effective dates. 601.36 Sec. 17. Minnesota Statutes 2002, section 256B.056, 602.1 subdivision 1c, is amended to read: 602.2 Subd. 1c. [FAMILIES WITH CHILDREN INCOME METHODOLOGY.] 602.3 (a)(1) For children ages one to five whose eligibility is 602.4 determined under section 256B.057, subdivision 2, 21 percent of 602.5 countable earned income shall be disregarded for up to four 602.6 months. This clause expires July 1, 2003. 602.7 (2) For applications processed within one calendar month 602.8 prior to the date clause (1) expires, eligibility shall be 602.9 determined by applying the income standards and methodologies in 602.10 effect prior to the date of the expiration for any months in the 602.11 six-month budget period before the expiration date and the 602.12 income standards and methodologies in effect on the expiration 602.13 date for any months in the six-month budget period on or after 602.14 that date. The income standards for each month shall be added 602.15 together and compared to the applicant's total countable income 602.16 for the six-month budget period to determine eligibility. 602.17 (3) For children ages one through 18 whose eligibility is 602.18 determined under section 256B.057, subdivision 2, the following 602.19 deductions shall be applied to income counted toward the child's 602.20 eligibility as allowed under the state's AFDC plan in effect as 602.21 of July 16, 1996: $90 work expense, dependent care, and child 602.22 support paid under court order. This clause is effective 602.23 October 1, 2003. 602.24 (b) For families with children whose eligibility is 602.25 determined using the standard specified in section 256B.056, 602.26 subdivision 4, paragraph (c), 17 percent of countable earned 602.27 income shall be disregarded for up to four months and the 602.28 following deductions shall be applied to each individual's 602.29 income counted toward eligibility as allowed under the state's 602.30 AFDC plan in effect as of July 16, 1996: dependent care and 602.31 child support paid under court order. 602.32 (c) If the four month disregard in paragraph (b) has been 602.33 applied to the wage earner's income for four months, the 602.34 disregard shall not be applied again until the wage earner's 602.35 income has not been considered in determining medical assistance 602.36 eligibility for 12 consecutive months. 603.1 [EFFECTIVE DATE.] The amendments to paragraphs (b) and (c) 603.2 are effective July 1, 2003. 603.3 Sec. 18. Minnesota Statutes 2002, section 256B.056, 603.4 subdivision 3c, is amended to read: 603.5 Subd. 3c. [ASSET LIMITATIONS FOR FAMILIES AND CHILDREN.] A 603.6 household of two or more persons must not own more than 603.7$30,000$20,000 in total net assets, and a household of one 603.8 person must not own more than$15,000$10,000 in total net 603.9 assets. In addition to these maximum amounts, an eligible 603.10 individual or family may accrue interest on these amounts, but 603.11 they must be reduced to the maximum at the time of an 603.12 eligibility redetermination. The value of assets that are not 603.13 considered in determining eligibility for medical assistance for 603.14 families and children is the value of those assets excluded 603.15 under the AFDC state plan as of July 16, 1996, as required by 603.16 the Personal Responsibility and Work Opportunity Reconciliation 603.17 Act of 1996 (PRWORA), Public LawNumber104-193, with the 603.18 following exceptions: 603.19 (1) household goods and personal effects are not 603.20 considered; 603.21 (2) capital and operating assets of a trade or business up 603.22 to $200,000 are not considered; 603.23 (3) one motor vehicle is excluded for each person of legal 603.24 driving age who is employed or seeking employment; 603.25 (4) one burial plot and all other burial expenses equal to 603.26 the supplemental security income program asset limit are not 603.27 considered for each individual; 603.28 (5) court-ordered settlements up to $10,000 are not 603.29 considered; 603.30 (6) individual retirement accounts and funds are not 603.31 considered; and 603.32 (7) assets owned by children are not considered. 603.33 Sec. 19. Minnesota Statutes 2002, section 256B.057, 603.34 subdivision 1, is amended to read: 603.35 Subdivision 1. [PREGNANT WOMEN AND INFANTS.] (a)(1) An 603.36 infant less than one year of ageor a pregnant woman who has604.1written verification of a positive pregnancy test from a604.2physician or licensed registered nurse,is eligible for medical 604.3 assistance if countable family income is equal to or less than 604.4 275 percent of the federal poverty guideline for the same family 604.5 size. A pregnant woman who has written verification of a 604.6 positive pregnancy test from a physician or licensed registered 604.7 nurse is eligible for medical assistance if countable family 604.8 income is equal to or less than 200 percent of the federal 604.9 poverty guideline for the same family size. For purposes of 604.10 this subdivision, "countable family income" means the amount of 604.11 income considered available using the methodology of the AFDC 604.12 program under the state's AFDC plan as of July 16, 1996, as 604.13 required by the Personal Responsibility and Work Opportunity 604.14 Reconciliation Act of 1996 (PRWORA), Public LawNumber104-193, 604.15 except for the earned income disregard and employment deductions. 604.16 (2) For applications processed within one calendar month 604.17 prior to the effective date, eligibility shall be determined by 604.18 applying the income standards and methodologies in effect prior 604.19 to the effective date for any months in the six-month budget 604.20 period before that date and the income standards and 604.21 methodologies in effect on the effective date for any months in 604.22 the six-month budget period on or after that date. The income 604.23 standards for each month shall be added together and compared to 604.24 the applicant's total countable income for the six-month budget 604.25 period to determine eligibility. 604.26 (b)(1) An amount equal to the amount of earned income 604.27 exceeding 275 percent of the federal poverty guideline, up to a 604.28 maximum of the amount by which the combined total of 185 percent 604.29 of the federal poverty guideline plus the earned income 604.30 disregards and deductions of the AFDC program under the state's 604.31 AFDC plan as of July 16, 1996, as required by the Personal 604.32 Responsibility and Work Opportunity Reconciliation Act of 1996 604.33 (PRWORA), Public LawNumber104-193, exceeds 275 percent of the 604.34 federal poverty guideline will be deducted for pregnant women 604.35 and infants less than one year of age. This clause expires July 604.36 1, 2003. 605.1 (2) For applications processed within one calendar month 605.2 prior to the date clause (1) expires, eligibility shall be 605.3 determined by applying the income standards and methodologies in 605.4 effect prior to the date of the expiration for any months in the 605.5 six-month budget period before the expiration date and the 605.6 income standards and methodologies in effect on the expiration 605.7 date for any months in the six-month budget period on or after 605.8 that date. The income standards for each month shall be added 605.9 together and compared to the applicant's total countable income 605.10 for the six-month budget period to determine eligibility. 605.11 (c) Dependent care and child support paid under court order 605.12 shall be deducted from the countable income of pregnant women. 605.13(b)(d) An infant born on or after January 1, 1991, to a 605.14 woman who was eligible for and receiving medical assistance on 605.15 the date of the child's birth shall continue to be eligible for 605.16 medical assistance without redetermination until the child's 605.17 first birthday, as long as the child remains in the woman's 605.18 household. 605.19 [EFFECTIVE DATE.] This section is effective February 1, 605.20 2004, or upon federal approval, whichever is later, except where 605.21 a different date is specified in the text. 605.22 Sec. 20. Minnesota Statutes 2002, section 256B.057, 605.23 subdivision 2, is amended to read: 605.24 Subd. 2. [CHILDREN.] (a) Except as specified in 605.25 subdivision 1b, effectiveJuly 1, 2002October 1, 2003, a child 605.26 one through 18 years of age in a family whose countable income 605.27 is no greater than170150 percent of the federal poverty 605.28 guidelines for the same family size, is eligible for medical 605.29 assistance. 605.30 (b) For applications processed within one calendar month 605.31 prior to the effective date, eligibility shall be determined by 605.32 applying the income standards and methodologies in effect prior 605.33 to the effective date for any months in the six-month budget 605.34 period before that date and the income standards and 605.35 methodologies in effect on the effective date for any months in 605.36 the six-month budget period on or after that date. The income 606.1 standards for each month shall be added together and compared to 606.2 the applicant's total countable income for the six-month budget 606.3 period to determine eligibility. 606.4 Sec. 21. Minnesota Statutes 2002, section 256B.057, 606.5 subdivision 3b, is amended to read: 606.6 Subd. 3b. [QUALIFYING INDIVIDUALS.] Beginning July 1, 606.7 1998,to the extent of the federal allocation to Minnesota606.8 contingent upon federal funding, a person who would otherwise be 606.9 eligible as a qualified Medicare beneficiary under subdivision 606.10 3, except that the person's income is in excess of the limit, is 606.11 eligible as a qualifying individual according to the following 606.12 criteria: 606.13 (1) if the person's income is greater than 120 percent, but 606.14 less than 135 percent of the official federal poverty guidelines 606.15 for the applicable family size, the person is eligible for 606.16 medical assistance reimbursement of Medicare Part B premiums; or 606.17 (2) if the person's income is equal to or greater than 135 606.18 percent but less than 175 percent of the official federal 606.19 poverty guidelines for the applicable family size, the person is 606.20 eligible for medical assistance reimbursement of that portion of 606.21 the Medicare Part B premium attributable to an increase in Part 606.22 B expenditures which resulted from the shift of home care 606.23 services from Medicare Part A to Medicare Part B under Public 606.24 LawNumber105-33, section 4732, the Balanced Budget Act of 1997. 606.25 The commissioner shall limit enrollment of qualifying 606.26 individuals under this subdivision according to the requirements 606.27 of Public LawNumber105-33, section 4732. 606.28 [EFFECTIVE DATE.] This section is effective July 1, 2003. 606.29 Sec. 22. Minnesota Statutes 2002, section 256B.057, 606.30 subdivision 9, is amended to read: 606.31 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 606.32 assistance may be paid for a person who is employed and who: 606.33 (1) meets the definition of disabled under the supplemental 606.34 security income program; 606.35 (2) is at least 16 but less than 65 years of age; 606.36 (3) meets the asset limits in paragraph (b); and 607.1 (4) effective November 1, 2003, pays a premium, if607.2required,and other obligations under paragraph(c)(d). 607.3 Any spousal income or assets shall be disregarded for purposes 607.4 of eligibility and premium determinations. 607.5 After the month of enrollment, a person enrolled in medical 607.6 assistance under this subdivision who: 607.7 (1) is temporarily unable to work and without receipt of 607.8 earned income due to a medical condition, as verified by a 607.9 physician, may retain eligibility for up to four calendar 607.10 months; or 607.11 (2) effective January 1, 2004, loses employment for reasons 607.12 not attributable to the enrollee, may retain eligibility for up 607.13 to four consecutive months after the month of job loss. To 607.14 receive a four-month extension, enrollees must verify the 607.15 medical condition or provide notification of job loss. All 607.16 other eligibility requirements must be met and the enrollee must 607.17 pay all calculated premium costs for continued eligibility. 607.18 (b) For purposes of determining eligibility under this 607.19 subdivision, a person's assets must not exceed $20,000, 607.20 excluding: 607.21 (1) all assets excluded under section 256B.056; 607.22 (2) retirement accounts, including individual accounts, 607.23 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 607.24 (3) medical expense accounts set up through the person's 607.25 employer. 607.26 (c)(1) Effective January 1, 2004, for purposes of 607.27 eligibility, there will be a $65 earned income disregard. To be 607.28 eligible, a person applying for medical assistance under this 607.29 subdivision must have earned income above the disregard level. 607.30 (2) Effective January 1, 2004, to be considered earned 607.31 income, Medicare, social security, and applicable state and 607.32 federal income taxes must be withheld. To be eligible, a person 607.33 must document earned income tax withholding. 607.34 (d)(1) A person whose earned and unearned income is equal 607.35 to or greater than 100 percent of federal poverty guidelines for 607.36 the applicable family size must pay a premium to be eligible for 608.1 medical assistance under this subdivision. The premium shall be 608.2 based on the person's gross earned and unearned income and the 608.3 applicable family size using a sliding fee scale established by 608.4 the commissioner, which begins at one percent of income at 100 608.5 percent of the federal poverty guidelines and increases to 7.5 608.6 percent of income for those with incomes at or above 300 percent 608.7 of the federal poverty guidelines. Annual adjustments in the 608.8 premium schedule based upon changes in the federal poverty 608.9 guidelines shall be effective for premiums due in July of each 608.10 year. 608.11 (2) Effective January 1, 2004, all enrollees must pay a 608.12 premium to be eligible for medical assistance under this 608.13 subdivision. An enrollee shall pay the greater of a $35 premium 608.14 or the premium calculated in clause (1). 608.15 (3) Effective November 1, 2003, all enrollees who receive 608.16 unearned income must pay one-half of one percent of unearned 608.17 income in addition to the premium amount. 608.18 (4) Effective November 1, 2003, for enrollees whose income 608.19 does not exceed 200 percent of the federal poverty guidelines 608.20 and who are also enrolled in Medicare, the commissioner must 608.21 reimburse the enrollee for Medicare Part B premiums under 608.22 section 256B.0625, subdivision 15, paragraph (a). 608.23(d)(e) A person's eligibility and premium shall be 608.24 determined by the local county agency. Premiums must be paid to 608.25 the commissioner. All premiums are dedicated to the 608.26 commissioner. 608.27(e)(f) Any required premium shall be determined at 608.28 application and redeterminedannually at recertificationat the 608.29 enrollee's six-month income review or when a change in income or 608.30familyhousehold sizeoccursis reported. Enrollees must report 608.31 any change in income or household size within ten days of when 608.32 the change occurs. A decreased premium resulting from a 608.33 reported change in income or household size shall be effective 608.34 the first day of the next available billing month after the 608.35 change is reported. Except for changes occurring from annual 608.36 cost-of-living increases, a change resulting in an increased 609.1 premium shall not affect the premium amount until the next 609.2 six-month review. 609.3(f)(g) Premium payment is due upon notification from the 609.4 commissioner of the premium amount required. Premiums may be 609.5 paid in installments at the discretion of the commissioner. 609.6(g)(h) Nonpayment of the premium shall result in denial or 609.7 termination of medical assistance unless the person demonstrates 609.8 good cause for nonpayment. Good cause exists if the 609.9 requirements specified in Minnesota Rules, part 9506.0040, 609.10 subpart 7, items B to D, are met. Except when an installment 609.11 agreement is accepted by the commissioner, all persons 609.12 disenrolled for nonpayment of a premium must pay any past due 609.13 premiums as well as current premiums due prior to being 609.14 reenrolled. Nonpayment shall include payment with a returned, 609.15 refused, or dishonored instrument. The commissioner may require 609.16 a guaranteed form of payment as the only means to replace a 609.17 returned, refused, or dishonored instrument. 609.18 [EFFECTIVE DATE.] This section is effective November 1, 609.19 2003, except that the amendments to Minnesota Statutes 2002, 609.20 section 256B.057, subdivision 9, paragraphs (f) and (h), are 609.21 effective July 1, 2003. 609.22 Sec. 23. Minnesota Statutes 2002, section 256B.057, 609.23 subdivision 10, is amended to read: 609.24 Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 609.25 CERVICAL CANCER.] (a) Medical assistance may be paid for a 609.26 person who: 609.27 (1) has been screened for breast or cervical cancer by the 609.28 Minnesota breast and cervical cancer control program, and 609.29 program funds have been used to pay for the person's screening; 609.30 (2) according to the person's treating health professional, 609.31 needs treatment, including diagnostic services necessary to 609.32 determine the extent and proper course of treatment, for breast 609.33 or cervical cancer, including precancerous conditions and early 609.34 stage cancer; 609.35 (3) meets the income eligibility guidelines for the 609.36 Minnesota breast and cervical cancer control program; 610.1 (4) is under age 65; 610.2 (5) is not otherwise eligible for medical assistance under 610.3 United States Code, title 42, section 1396(a)(10)(A)(i); and 610.4 (6) is not otherwise covered under creditable coverage, as 610.5 defined under United States Code, title 42, section 610.6300gg(c)1396a(aa). 610.7 (b) Medical assistance provided for an eligible person 610.8 under this subdivision shall be limited to services provided 610.9 during the period that the person receives treatment for breast 610.10 or cervical cancer. 610.11 (c) A person meeting the criteria in paragraph (a) is 610.12 eligible for medical assistance without meeting the eligibility 610.13 criteria relating to income and assets in section 256B.056, 610.14 subdivisions 1a to 5b. 610.15 Sec. 24. Minnesota Statutes 2002, section 256B.0595, 610.16 subdivision 1, is amended to read: 610.17 Subdivision 1. [PROHIBITED TRANSFERS.] (a) For transfers 610.18 of assets made on or before August 10, 1993, if a person or the 610.19 person's spouse has given away, sold, or disposed of, for less 610.20 than fair market value, any asset or interest therein, except 610.21 assets other than the homestead that are excluded under the 610.22 supplemental security program, within 30 months before or any 610.23 time after the date of institutionalization if the person has 610.24 been determined eligible for medical assistance, or within 30 610.25 months before or any time after the date of the first approved 610.26 application for medical assistance if the person has not yet 610.27 been determined eligible for medical assistance, the person is 610.28 ineligible for long-term care services for the period of time 610.29 determined under subdivision 2. 610.30 (b) Effective for transfers made after August 10, 1993, a 610.31 person, a person's spouse, or any person, court, or 610.32 administrative body with legal authority to act in place of, on 610.33 behalf of, at the direction of, or upon the request of the 610.34 person or person's spouse, may not give away, sell, or dispose 610.35 of, for less than fair market value, any asset or interest 610.36 therein, except assets other than the homestead that are 611.1 excluded under the supplemental security income program, for the 611.2 purpose of establishing or maintaining medical assistance 611.3 eligibility. This applies to all transfers, including those 611.4 made by a community spouse after the month in which the 611.5 institutionalized spouse is determined eligible for medical 611.6 assistance. For purposes of determining eligibility for 611.7 long-term care services, any transfer of such assets within 36 611.8 months before or any time after an institutionalized person 611.9 applies for medical assistance, or 36 months before or any time 611.10 after a medical assistance recipient becomes institutionalized, 611.11 for less than fair market value may be considered. Any such 611.12 transfer is presumed to have been made for the purpose of 611.13 establishing or maintaining medical assistance eligibility and 611.14 the person is ineligible for long-term care services for the 611.15 period of time determined under subdivision 2, unless the person 611.16 furnishes convincing evidence to establish that the transaction 611.17 was exclusively for another purpose, or unless the transfer is 611.18 permitted under subdivision 3 or 4. Notwithstanding the 611.19 provisions of this paragraph, in the case of payments from a 611.20 trust or portions of a trust that are considered transfers of 611.21 assets under federal law, any transfers made within 60 months 611.22 before or any time after an institutionalized person applies for 611.23 medical assistance and within 60 months before or any time after 611.24 a medical assistance recipient becomes institutionalized, may be 611.25 considered. 611.26 (c) This section applies to transfers, for less than fair 611.27 market value, of income or assets, including assets that are 611.28 considered income in the month received, such as inheritances, 611.29 court settlements, and retroactive benefit payments or income to 611.30 which the person or the person's spouse is entitled but does not 611.31 receive due to action by the person, the person's spouse, or any 611.32 person, court, or administrative body with legal authority to 611.33 act in place of, on behalf of, at the direction of, or upon the 611.34 request of the person or the person's spouse. 611.35 (d) This section applies to payments for care or personal 611.36 services provided by a relative, unless the compensation was 612.1 stipulated in a notarized, written agreement which was in 612.2 existence when the service was performed, the care or services 612.3 directly benefited the person, and the payments made represented 612.4 reasonable compensation for the care or services provided. A 612.5 notarized written agreement is not required if payment for the 612.6 services was made within 60 days after the service was provided. 612.7 (e) This section applies to the portion of any asset or 612.8 interest that a person, a person's spouse, or any person, court, 612.9 or administrative body with legal authority to act in place of, 612.10 on behalf of, at the direction of, or upon the request of the 612.11 person or the person's spouse, transfers to any annuity that 612.12 exceeds the value of the benefit likely to be returned to the 612.13 person or spouse while alive, based on estimated life expectancy 612.14 using the life expectancy tables employed by the supplemental 612.15 security income program to determine the value of an agreement 612.16 for services for life. The commissioner may adopt rules 612.17 reducing life expectancies based on the need for long-term 612.18 care. This section applies to an annuity described in this 612.19 paragraph purchased on or after March 1, 2002, that: 612.20 (1) is not purchased from an insurance company or financial 612.21 institution that is subject to licensing or regulation by the 612.22 Minnesota department of commerce or a similar regulatory agency 612.23 of another state; 612.24 (2) does not pay out principal and interest in equal 612.25 monthly installments; or 612.26 (3) does not begin payment at the earliest possible date 612.27 after annuitization. 612.28 (f) For purposes of this section, long-term care services 612.29 include services in a nursing facility, services that are 612.30 eligible for payment according to section 256B.0625, subdivision 612.31 2, because they are provided in a swing bed, intermediate care 612.32 facility for persons with mental retardation, and home and 612.33 community-based services provided pursuant to sections 612.34 256B.0915, 256B.092, and 256B.49. For purposes of this 612.35 subdivision and subdivisions 2, 3, and 4, "institutionalized 612.36 person" includes a person who is an inpatient in a nursing 613.1 facility or in a swing bed, or intermediate care facility for 613.2 persons with mental retardation or who is receiving home and 613.3 community-based services under sections 256B.0915, 256B.092, and 613.4 256B.49. 613.5 [EFFECTIVE DATE.] This section is effective July 1, 2003. 613.6 Sec. 25. Minnesota Statutes 2002, section 256B.0595, is 613.7 amended by adding a subdivision to read: 613.8 Subd. 1b. [PROHIBITED TRANSFERS.] (a) Notwithstanding any 613.9 contrary provisions of this section, this subdivision applies to 613.10 transfers involving recipients of medical assistance that are 613.11 made on or after July 1, 2003, and to all transfers involving 613.12 persons who apply for medical assistance on or after July 1, 613.13 2003, if the transfer occurred within 72 months before the 613.14 person applies for medical assistance, except that this 613.15 subdivision does not apply to transfers made prior to July 1, 613.16 2003. A person, a person's spouse, or any person, court, or 613.17 administrative body with legal authority to act in place of, on 613.18 behalf of, at the direction of, or upon the request of the 613.19 person or the person's spouse, may not give away, sell, dispose 613.20 of, or reduce ownership or control of any income, asset, or 613.21 interest therein for less than fair market value for the purpose 613.22 of establishing or maintaining medical assistance eligibility. 613.23 This applies to all transfers, including those made by a 613.24 community spouse after the month in which the institutionalized 613.25 spouse is determined eligible for medical assistance. For 613.26 purposes of determining eligibility for medical assistance 613.27 services, any transfer of such income or assets for less than 613.28 fair market value within 72 months before or any time after a 613.29 person applies for medical assistance may be considered. Any 613.30 such transfer is presumed to have been made for the purpose of 613.31 establishing or maintaining medical assistance eligibility, and 613.32 the person is ineligible for medical assistance services for the 613.33 period of time determined under subdivision 2b, unless the 613.34 person furnishes convincing evidence to establish that the 613.35 transaction was exclusively for another purpose or unless the 613.36 transfer is permitted under subdivision 3b or 4b. 614.1 (b) This section applies to transfers to trusts. The 614.2 commissioner shall determine valid trust purposes under this 614.3 section. Assets placed into a trust that is not for a valid 614.4 purpose shall always be considered available for the purposes of 614.5 medical assistance eligibility, regardless of when the trust is 614.6 established. 614.7 (c) This section applies to transfers of income or assets 614.8 for less than fair market value, including assets that are 614.9 considered income in the month received, such as inheritances, 614.10 court settlements, and retroactive benefit payments or income to 614.11 which the person or the person's spouse is entitled but does not 614.12 receive due to action by the person, the person's spouse, or any 614.13 person, court, or administrative body with legal authority to 614.14 act in place of, on behalf of, at the direction of, or upon the 614.15 request of the person or the person's spouse. 614.16 (d) This section applies to payments for care or personal 614.17 services provided by a relative, unless the compensation was 614.18 stipulated in a notarized written agreement that was in 614.19 existence when the service was performed, the care or services 614.20 directly benefited the person, and the payments made represented 614.21 reasonable compensation for the care or services provided. A 614.22 notarized written agreement is not required if payment for the 614.23 services was made within 60 days after the service was provided. 614.24 (e) This section applies to the portion of any income, 614.25 asset, or interest therein that a person, a person's spouse, or 614.26 any person, court, or administrative body with legal authority 614.27 to act in place of, on behalf of, at the direction of, or upon 614.28 the request of the person or the person's spouse, transfers to 614.29 any annuity that exceeds the value of the benefit likely to be 614.30 returned to the person or the person's spouse while alive, based 614.31 on estimated life expectancy, using the life expectancy tables 614.32 employed by the supplemental security income program, or based 614.33 on a shorter life expectancy if the annuitant had a medical 614.34 condition that would shorten the annuitant's life expectancy and 614.35 that was diagnosed before funds were placed into the annuity. 614.36 The agency may request and receive a physician's statement to 615.1 determine if the annuitant had a diagnosed medical condition 615.2 that would shorten the annuitant's life expectancy. If so, the 615.3 agency shall determine the expected value of the benefits based 615.4 upon the physician's statement instead of using a life 615.5 expectancy table. This section applies to an annuity described 615.6 in this paragraph purchased on or after March 1, 2002, that: 615.7 (1) is not purchased from an insurance company or financial 615.8 institution that is subject to licensing or regulation by the 615.9 Minnesota department of commerce or a similar regulatory agency 615.10 of another state; 615.11 (2) does not pay out principal and interest in equal 615.12 monthly installments; or 615.13 (3) does not begin payment at the earliest possible date 615.14 after annuitization. 615.15 (f) Transfers under this section shall affect 615.16 determinations of eligibility for all medical assistance 615.17 services or long-term care services, whichever receives federal 615.18 approval. 615.19 [EFFECTIVE DATE.] (a) This section is effective July 1, 615.20 2003, to the extent permitted by federal law. If any provision 615.21 of this section is prohibited by federal law, the provision 615.22 shall become effective when federal law is changed to permit its 615.23 application or a waiver is received. The commissioner of human 615.24 services shall notify the revisor of statutes when federal law 615.25 is enacted or a waiver or other federal approval is received and 615.26 publish a notice in the State Register. The commissioner must 615.27 include the notice in the first State Register published after 615.28 the effective date of the federal changes. 615.29 (b) If, by July 1, 2003, any provision of this section is 615.30 not effective because of prohibitions in federal law, the 615.31 commissioner of human services shall apply to the federal 615.32 government by August 1, 2003, for a waiver of those prohibitions 615.33 or other federal authority, and that provision shall become 615.34 effective upon receipt of a federal waiver or other federal 615.35 approval, notification to the revisor of statutes, and 615.36 publication of a notice in the State Register to that effect. 616.1 In applying for federal approval to extend the lookback period, 616.2 the commissioner shall seek the longest lookback period the 616.3 federal government will approve, not to exceed 72 months. 616.4 Sec. 26. Minnesota Statutes 2002, section 256B.0595, 616.5 subdivision 2, is amended to read: 616.6 Subd. 2. [PERIOD OF INELIGIBILITY.] (a) For any 616.7 uncompensated transfer occurring on or before August 10, 1993, 616.8 the number of months of ineligibility for long-term care 616.9 services shall be the lesser of 30 months, or the uncompensated 616.10 transfer amount divided by the average medical assistance rate 616.11 for nursing facility services in the state in effect on the date 616.12 of application. The amount used to calculate the average 616.13 medical assistance payment rate shall be adjusted each July 1 to 616.14 reflect payment rates for the previous calendar year. The 616.15 period of ineligibility begins with the month in which the 616.16 assets were transferred. If the transfer was not reported to 616.17 the local agency at the time of application, and the applicant 616.18 received long-term care services during what would have been the 616.19 period of ineligibility if the transfer had been reported, a 616.20 cause of action exists against the transferee for the cost of 616.21 long-term care services provided during the period of 616.22 ineligibility, or for the uncompensated amount of the transfer, 616.23 whichever is less. The action may be brought by the state or 616.24 the local agency responsible for providing medical assistance 616.25 under chapter 256G. The uncompensated transfer amount is the 616.26 fair market value of the asset at the time it was given away, 616.27 sold, or disposed of, less the amount of compensation received. 616.28 (b) For uncompensated transfers made after August 10, 1993, 616.29 the number of months of ineligibility for long-term care 616.30 services shall be the total uncompensated value of the resources 616.31 transferred divided by the average medical assistance rate for 616.32 nursing facility services in the state in effect on the date of 616.33 application. The amount used to calculate the average medical 616.34 assistance payment rate shall be adjusted each July 1 to reflect 616.35 payment rates for the previous calendar year. The period of 616.36 ineligibility begins with the first day of the month after the 617.1 month in which the assets were transferred except that if one or 617.2 more uncompensated transfers are made during a period of 617.3 ineligibility, the total assets transferred during the 617.4 ineligibility period shall be combined and a penalty period 617.5 calculated to begininon the first day of the month after the 617.6 month in which the first uncompensated transfer was made. If 617.7 the transfer was not reported to the local agencyat the time of617.8application, and the applicant received medical assistance 617.9 services during what would have been the period of ineligibility 617.10 if the transfer had been reported, a cause of action exists 617.11 against the transferee for the cost of medical assistance 617.12 services provided during the period of ineligibility, or for the 617.13 uncompensated amount of the transfer, whichever is less. The 617.14 action may be brought by the state or the local agency 617.15 responsible for providing medical assistance under chapter 617.16 256G. The uncompensated transfer amount is the fair market 617.17 value of the asset at the time it was given away, sold, or 617.18 disposed of, less the amount of compensation received. 617.19 Effective for transfers made on or after March 1, 1996, 617.20 involving persons who apply for medical assistance on or after 617.21 April 13, 1996, no cause of action exists for a transfer unless: 617.22 (1) the transferee knew or should have known that the 617.23 transfer was being made by a person who was a resident of a 617.24 long-term care facility or was receiving that level of care in 617.25 the community at the time of the transfer; 617.26 (2) the transferee knew or should have known that the 617.27 transfer was being made to assist the person to qualify for or 617.28 retain medical assistance eligibility; or 617.29 (3) the transferee actively solicited the transfer with 617.30 intent to assist the person to qualify for or retain eligibility 617.31 for medical assistance. 617.32 (c) If a calculation of a penalty period results in a 617.33 partial month, payments for long-term care services shall be 617.34 reduced in an amount equal to the fraction, except that in 617.35 calculating the value of uncompensated transfers, if the total 617.36 value of all uncompensated transfers made in a month not 618.1 included in an existing penalty period does not exceed $200, 618.2 then such transfers shall be disregarded for each month prior to 618.3 the month of application for or during receipt of medical 618.4 assistance. 618.5 [EFFECTIVE DATE.] Paragraph (b) of this section is 618.6 effective July 1, 2003. 618.7 Sec. 27. Minnesota Statutes 2002, section 256B.0595, is 618.8 amended by adding a subdivision to read: 618.9 Subd. 2b. [PERIOD OF INELIGIBILITY.] (a) Notwithstanding 618.10 any contrary provisions of this section, this subdivision 618.11 applies to transfers, including transfers to trusts, involving 618.12 recipients of medical assistance that are made on or after July 618.13 1, 2003, and to all transfers involving persons who apply for 618.14 medical assistance on or after July 1, 2003, regardless of when 618.15 the transfer occurred, except that this subdivision does not 618.16 apply to transfers made prior to July 1, 2003. For any 618.17 uncompensated transfer occurring within 72 months prior to the 618.18 date of application, at any time after application, or while 618.19 eligible, the number of months of cumulative ineligibility for 618.20 medical assistance services shall be the total uncompensated 618.21 value of the assets and income transferred divided by the 618.22 statewide average per-person nursing facility payment made by 618.23 the state in effect at the time a penalty for a transfer is 618.24 determined. The amount used to calculate the average per-person 618.25 nursing facility payment shall be adjusted each July 1 to 618.26 reflect average payments for the previous calendar year. For 618.27 applicants, the period of ineligibility begins with the month in 618.28 which the person applied for medical assistance and satisfied 618.29 all other requirements for eligibility, or the first month the 618.30 local agency becomes aware of the transfer and can give proper 618.31 notice, if later. For recipients, the period of ineligibility 618.32 begins in the first month after the month the agency becomes 618.33 aware of the transfer and can give proper notice, except that 618.34 penalty periods for transfers made during a period of 618.35 ineligibility as determined under this section shall begin in 618.36 the month following the existing period of ineligibility. If 619.1 the transfer was not reported to the local agency, and the 619.2 applicant received medical assistance services during what would 619.3 have been the period of ineligibility if the transfer had been 619.4 reported, a cause of action exists against the transferee for 619.5 the cost of medical assistance services provided during the 619.6 period of ineligibility or for the uncompensated amount of the 619.7 transfer that was not recovered from the transferor through the 619.8 implementation of a penalty period under this subdivision, 619.9 whichever is less. Recovery shall include the costs incurred 619.10 due to the action. The action may be brought by the state or 619.11 the local agency responsible for providing medical assistance 619.12 under chapter 256B. The total uncompensated value is the fair 619.13 market value of the income or asset at the time it was given 619.14 away, sold, or disposed of, less the amount of compensation 619.15 received. No cause of action exists for a transfer unless: 619.16 (1) the transferee knew or should have known that the 619.17 transfer was being made by a person who was a resident of a 619.18 long-term care facility or was receiving that level of care in 619.19 the community at the time of the transfer; 619.20 (2) the transferee knew or should have known that the 619.21 transfer was being made to assist the person to qualify for or 619.22 retain medical assistance eligibility; or 619.23 (3) the transferee actively solicited the transfer with 619.24 intent to assist the person to qualify for or retain eligibility 619.25 for medical assistance. 619.26 (b) If a calculation of a penalty period results in a 619.27 partial month, payments for medical assistance services shall be 619.28 reduced in an amount equal to the fraction, except that in 619.29 calculating the value of uncompensated transfers, if the total 619.30 value of all uncompensated transfers made in a month not 619.31 included in an existing penalty period does not exceed $200, 619.32 then such transfers shall be disregarded for each month prior to 619.33 the month of application for or during receipt of medical 619.34 assistance. 619.35 (c) Ineligibility under this section shall apply to medical 619.36 assistance services or long-term care services, whichever 620.1 receives federal approval. 620.2 [EFFECTIVE DATE.] (a) This section is effective July 1, 620.3 2003, to the extent permitted by federal law. If any provision 620.4 of this section is prohibited by federal law, the provision 620.5 shall become effective when federal law is changed to permit its 620.6 application or a waiver is received. The commissioner of human 620.7 services shall notify the revisor of statutes when federal law 620.8 is enacted or a waiver or other federal approval is received and 620.9 publish a notice in the State Register. The commissioner must 620.10 include the notice in the first State Register published after 620.11 the effective date of the federal changes. 620.12 (b) If, by July 1, 2003, any provision of this section is 620.13 not effective because of prohibitions in federal law, the 620.14 commissioner of human services shall apply to the federal 620.15 government by August 1, 2003, for a waiver of those prohibitions 620.16 or other federal authority, and that provision shall become 620.17 effective upon receipt of a federal waiver or other federal 620.18 approval, notification to the revisor of statutes, and 620.19 publication of a notice in the State Register to that effect. 620.20 In applying for federal approval to extend the lookback period, 620.21 the commissioner shall seek the longest lookback period the 620.22 federal government will approve, not to exceed 72 months. 620.23 Sec. 28. Minnesota Statutes 2002, section 256B.0595, is 620.24 amended by adding a subdivision to read: 620.25 Subd. 3b. [HOMESTEAD EXCEPTION TO TRANSFER 620.26 PROHIBITION.] (a) This subdivision applies to transfers 620.27 involving recipients of medical assistance that are made on or 620.28 after July 1, 2003, and to all transfers involving persons who 620.29 apply for medical assistance on or after July 1, 2003, 620.30 regardless of when the transfer occurred, except that this 620.31 subdivision does not apply to transfers made prior to July 1, 620.32 2003. A person is not ineligible for medical assistance 620.33 services due to a transfer of assets for less than fair market 620.34 value as described in subdivision 1b, if the asset transferred 620.35 was a homestead, and: 620.36 (1) a satisfactory showing is made that the individual 621.1 intended to dispose of the homestead at fair market value or for 621.2 other valuable consideration; or 621.3 (2) the local agency grants a waiver of a penalty resulting 621.4 from a transfer for less than fair market value because denial 621.5 of eligibility would cause undue hardship for the individual and 621.6 there exists an imminent threat to the individual's health and 621.7 well-being. Whenever an applicant or recipient is denied 621.8 eligibility because of a transfer for less than fair market 621.9 value, the local agency shall notify the applicant or recipient 621.10 that the applicant or recipient may request a waiver of the 621.11 penalty if the denial of eligibility will cause undue hardship. 621.12 In evaluating a waiver, the local agency shall take into account 621.13 whether the individual was the victim of financial exploitation, 621.14 whether the individual has made reasonable efforts to recover 621.15 the transferred property or resource, and other factors relevant 621.16 to a determination of hardship. If the local agency does not 621.17 approve a hardship waiver, the local agency shall issue a 621.18 written notice to the individual stating the reasons for the 621.19 denial and the process for appealing the local agency's decision. 621.20 (b) When a waiver is granted under paragraph (a), clause 621.21 (2), a cause of action exists against the person to whom the 621.22 homestead was transferred for that portion of medical assistance 621.23 services granted within 72 months of the date the transferor 621.24 applied for medical assistance and satisfied all other 621.25 requirements for eligibility or the amount of the uncompensated 621.26 transfer, whichever is less, together with the costs incurred 621.27 due to the action. The action shall be brought by the state 621.28 unless the state delegates this responsibility to the local 621.29 agency responsible for providing medical assistance under 621.30 chapter 256B. 621.31 [EFFECTIVE DATE.] (a) This section is effective July 1, 621.32 2003, to the extent permitted by federal law. If any provision 621.33 of this section is prohibited by federal law, the provision 621.34 shall become effective when federal law is changed to permit its 621.35 application or a waiver is received. The commissioner of human 621.36 services shall notify the revisor of statutes when federal law 622.1 is enacted or a waiver or other federal approval is received and 622.2 publish a notice in the State Register. The commissioner must 622.3 include the notice in the first State Register published after 622.4 the effective date of the federal changes. 622.5 (b) If, by July 1, 2003, any provision of this section is 622.6 not effective because of prohibitions in federal law, the 622.7 commissioner of human services shall apply to the federal 622.8 government by August 1, 2003, for a waiver of those prohibitions 622.9 or other federal authority, and that provision shall become 622.10 effective upon receipt of a federal waiver or other federal 622.11 approval, notification to the revisor of statutes, and 622.12 publication of a notice in the State Register to that effect. 622.13 In applying for federal approval to extend the lookback period, 622.14 the commissioner shall seek the longest lookback period the 622.15 federal government will approve, not to exceed 72 months. 622.16 Sec. 29. Minnesota Statutes 2002, section 256B.0595, is 622.17 amended by adding a subdivision to read: 622.18 Subd. 4b. [OTHER EXCEPTIONS TO TRANSFER PROHIBITION.] This 622.19 subdivision applies to transfers involving recipients of medical 622.20 assistance that are made on or after July 1, 2003, and to all 622.21 transfers involving persons who apply for medical assistance on 622.22 or after July 1, 2003, regardless of when the transfer occurred, 622.23 except that this subdivision does not apply to transfers made 622.24 prior to July 1, 2003. A person or a person's spouse who made a 622.25 transfer prohibited by subdivision 1b is not ineligible for 622.26 medical assistance services if one of the following conditions 622.27 applies: 622.28 (1) the assets or income were transferred to the 622.29 individual's spouse or to another for the sole benefit of the 622.30 spouse, except that after eligibility is established and the 622.31 assets have been divided between the spouses as part of the 622.32 asset allowance under section 256B.059, no further transfers 622.33 between spouses may be made; 622.34 (2) the institutionalized spouse, prior to being 622.35 institutionalized, transferred assets or income to a spouse, 622.36 provided that the spouse to whom the assets or income were 623.1 transferred does not then transfer those assets or income to 623.2 another person for less than fair market value. At the time 623.3 when one spouse is institutionalized, assets must be allocated 623.4 between the spouses as provided under section 256B.059; 623.5 (3) the assets or income were transferred to a trust for 623.6 the sole benefit of the individual's child who is blind or 623.7 permanently and totally disabled as determined in the 623.8 supplemental security income program and the trust reverts to 623.9 the state upon the disabled child's death to the extent the 623.10 medical assistance has paid for services for the grantor or 623.11 beneficiary of the trust. This clause applies to a trust 623.12 established after the commissioner publishes a notice in the 623.13 State Register that the commissioner has been authorized to 623.14 implement this clause due to a change in federal law or the 623.15 approval of a federal waiver; 623.16 (4) a satisfactory showing is made that the individual 623.17 intended to dispose of the assets or income either at fair 623.18 market value or for other valuable consideration; or 623.19 (5) the local agency determines that denial of eligibility 623.20 for medical assistance services would cause undue hardship and 623.21 grants a waiver of a penalty resulting from a transfer for less 623.22 than fair market value because there exists an imminent threat 623.23 to the individual's health and well-being. Whenever an 623.24 applicant or recipient is denied eligibility because of a 623.25 transfer for less than fair market value, the local agency shall 623.26 notify the applicant or recipient that the applicant or 623.27 recipient may request a waiver of the penalty if the denial of 623.28 eligibility will cause undue hardship. In evaluating a waiver, 623.29 the local agency shall take into account whether the individual 623.30 was the victim of financial exploitation, whether the individual 623.31 has made reasonable efforts to recover the transferred property 623.32 or resource, and other factors relevant to a determination of 623.33 hardship. If the local agency does not approve a hardship 623.34 waiver, the local agency shall issue a written notice to the 623.35 individual stating the reasons for the denial and the process 623.36 for appealing the local agency's decision. When a waiver is 624.1 granted, a cause of action exists against the person to whom the 624.2 assets were transferred for that portion of medical assistance 624.3 services granted within 72 months of the date the transferor 624.4 applied for medical assistance and satisfied all other 624.5 requirements for eligibility, or the amount of the uncompensated 624.6 transfer, whichever is less, together with the costs incurred 624.7 due to the action. The action shall be brought by the state 624.8 unless the state delegates this responsibility to the local 624.9 agency responsible for providing medical assistance under this 624.10 chapter. 624.11 [EFFECTIVE DATE.] (a) This section is effective July 1, 624.12 2003, to the extent permitted by federal law. If any provision 624.13 of this section is prohibited by federal law, the provision 624.14 shall become effective when federal law is changed to permit its 624.15 application or a waiver is received. The commissioner of human 624.16 services shall notify the revisor of statutes when federal law 624.17 is enacted or a waiver or other federal approval is received and 624.18 publish a notice in the State Register. The commissioner must 624.19 include the notice in the first State Register published after 624.20 the effective date of the federal changes. 624.21 (b) If, by July 1, 2003, any provision of this section is 624.22 not effective because of prohibitions in federal law, the 624.23 commissioner of human services shall apply to the federal 624.24 government by August 1, 2003, for a waiver of those prohibitions 624.25 or other federal authority, and that provision shall become 624.26 effective upon receipt of a federal waiver or other federal 624.27 approval, notification to the revisor of statutes, and 624.28 publication of a notice in the State Register to that effect. 624.29 In applying for federal approval to extend the lookback period, 624.30 the commissioner shall seek the longest lookback period the 624.31 federal government will approve, not to exceed 72 months. 624.32 Sec. 30. [256B.0596] [MENTAL HEALTH CASE MANAGEMENT.] 624.33 Counties shall contract with eligible providers willing to 624.34 provide mental health case management services under section 624.35 256B.0625, subdivision 20. In order to be eligible, in addition 624.36 to general provider requirements under this chapter, the 625.1 provider must: 625.2 (1) be willing to provide the mental health case management 625.3 services; and 625.4 (2) have a minimum of at least one contact with the client 625.5 per week. 625.6 Sec. 31. Minnesota Statutes 2002, section 256B.06, 625.7 subdivision 4, is amended to read: 625.8 Subd. 4. [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 625.9 medical assistance is limited to citizens of the United States, 625.10 qualified noncitizens as defined in this subdivision, and other 625.11 persons residing lawfully in the United States. 625.12 (b) "Qualified noncitizen" means a person who meets one of 625.13 the following immigration criteria: 625.14 (1) admitted for lawful permanent residence according to 625.15 United States Code, title 8; 625.16 (2) admitted to the United States as a refugee according to 625.17 United States Code, title 8, section 1157; 625.18 (3) granted asylum according to United States Code, title 625.19 8, section 1158; 625.20 (4) granted withholding of deportation according to United 625.21 States Code, title 8, section 1253(h); 625.22 (5) paroled for a period of at least one year according to 625.23 United States Code, title 8, section 1182(d)(5); 625.24 (6) granted conditional entrant status according to United 625.25 States Code, title 8, section 1153(a)(7); 625.26 (7) determined to be a battered noncitizen by the United 625.27 States Attorney General according to the Illegal Immigration 625.28 Reform and Immigrant Responsibility Act of 1996, title V of the 625.29 Omnibus Consolidated Appropriations Bill, Public LawNumber625.30 104-200; 625.31 (8) is a child of a noncitizen determined to be a battered 625.32 noncitizen by the United States Attorney General according to 625.33 the Illegal Immigration Reform and Immigrant Responsibility Act 625.34 of 1996, title V, of the Omnibus Consolidated Appropriations 625.35 Bill, Public LawNumber104-200; or 625.36 (9) determined to be a Cuban or Haitian entrant as defined 626.1 in section 501(e) of Public LawNumber96-422, the Refugee 626.2 Education Assistance Act of 1980. 626.3 (c) All qualified noncitizens who were residing in the 626.4 United States before August 22, 1996, who otherwise meet the 626.5 eligibility requirements of chapter 256B, are eligible for 626.6 medical assistance with federal financial participation. 626.7 (d) All qualified noncitizens who entered the United States 626.8 on or after August 22, 1996, and who otherwise meet the 626.9 eligibility requirements of chapter 256B, are eligible for 626.10 medical assistance with federal financial participation through 626.11 November 30, 1996. 626.12 Beginning December 1, 1996, qualified noncitizens who 626.13 entered the United States on or after August 22, 1996, and who 626.14 otherwise meet the eligibility requirements of chapter 256B are 626.15 eligible for medical assistance with federal participation for 626.16 five years if they meet one of the following criteria: 626.17 (i) refugees admitted to the United States according to 626.18 United States Code, title 8, section 1157; 626.19 (ii) persons granted asylum according to United States 626.20 Code, title 8, section 1158; 626.21 (iii) persons granted withholding of deportation according 626.22 to United States Code, title 8, section 1253(h); 626.23 (iv) veterans of the United States Armed Forces with an 626.24 honorable discharge for a reason other than noncitizen status, 626.25 their spouses and unmarried minor dependent children; or 626.26 (v) persons on active duty in the United States Armed 626.27 Forces, other than for training, their spouses and unmarried 626.28 minor dependent children. 626.29 Beginning December 1, 1996, qualified noncitizens who do 626.30 not meet one of the criteria in items (i) to (v) are eligible 626.31 for medical assistance without federal financial participation 626.32 as described in paragraph (j). 626.33 (e) Noncitizens who are not qualified noncitizens as 626.34 defined in paragraph (b), who are lawfully residing in the 626.35 United States and who otherwise meet the eligibility 626.36 requirements of chapter 256B, are eligible for medical 627.1 assistance under clauses (1) to (3). These individuals must 627.2 cooperate with the Immigration and Naturalization Service to 627.3 pursue any applicable immigration status, including citizenship, 627.4 that would qualify them for medical assistance with federal 627.5 financial participation. 627.6 (1) Persons who were medical assistance recipients on 627.7 August 22, 1996, are eligible for medical assistance with 627.8 federal financial participation through December 31, 1996. 627.9 (2) Beginning January 1, 1997, persons described in clause 627.10 (1) are eligible for medical assistance without federal 627.11 financial participation as described in paragraph (j). 627.12 (3) Beginning December 1, 1996, persons residing in the 627.13 United States prior to August 22, 1996, who were not receiving 627.14 medical assistance and persons who arrived on or after August 627.15 22, 1996, are eligible for medical assistance without federal 627.16 financial participation as described in paragraph (j). 627.17 (f) Nonimmigrants who otherwise meet the eligibility 627.18 requirements of chapter 256B are eligible for the benefits as 627.19 provided in paragraphs (g) to (i). For purposes of this 627.20 subdivision, a "nonimmigrant" is a person in one of the classes 627.21 listed in United States Code, title 8, section 1101(a)(15). 627.22 (g) Payment shall also be made for care and services that 627.23 are furnished to noncitizens, regardless of immigration status, 627.24 who otherwise meet the eligibility requirements of chapter 256B, 627.25 if such care and services are necessary for the treatment of an 627.26 emergency medical condition, except for organ transplants and 627.27 related care and services and routine prenatal care. 627.28 (h) For purposes of this subdivision, the term "emergency 627.29 medical condition" means a medical condition that meets the 627.30 requirements of United States Code, title 42, section 1396b(v). 627.31 (i) Pregnant noncitizens who are undocumented or 627.32 nonimmigrants, who otherwise meet the eligibility requirements 627.33 of chapter 256B, are eligible for medical assistance payment 627.34 without federal financial participation for care and services 627.35 through the period of pregnancy, and 60 days postpartum, except 627.36 for labor and delivery. 628.1 (j) Qualified noncitizens as described in paragraph (d), 628.2 and all other noncitizens lawfully residing in the United States 628.3 as described in paragraph (e), who are ineligible for medical 628.4 assistance with federal financial participation and who 628.5 otherwise meet the eligibility requirements of chapter 256B and 628.6 of this paragraph, are eligible for medical assistance without 628.7 federal financial participation. Qualified noncitizens as 628.8 described in paragraph (d) are only eligible for medical 628.9 assistance without federal financial participation for five 628.10 years from their date of entry into the United States. 628.11 (k)The commissioner shall submit to the legislature by628.12December 31, 1998, a report on the number of recipients and cost628.13of coverage of care and services made according to paragraphs628.14(i) and (j).Beginning October 1, 2003, persons who are 628.15 receiving care and rehabilitation services from a nonprofit 628.16 center established to serve victims of torture and are otherwise 628.17 ineligible for medical assistance under chapter 256B or general 628.18 assistance medical care under section 256D.03 are eligible for 628.19 medical assistance without federal financial participation. 628.20 These individuals are eligible only for the period during which 628.21 they are receiving services from the center. Individuals 628.22 eligible under this clause shall not be required to participate 628.23 in prepaid medical assistance. 628.24 [EFFECTIVE DATE.] This section is effective July 1, 2003, 628.25 except where a different date is specified in the text. 628.26 Sec. 32. Minnesota Statutes 2002, section 256B.061, is 628.27 amended to read: 628.28 256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 628.29(a)If any individual has been determined to be eligible 628.30 for medical assistance, it will be made available for care and 628.31 services included under the plan and furnished in or after the 628.32 third month before the month in which the individual made 628.33 application for such assistance, if such individual was, or upon 628.34 application would have been, eligible for medical assistance at 628.35 the time the care and services were furnished. The commissioner 628.36 may limit, restrict, or suspend the eligibility of an individual 629.1 for up to one year upon that individual's conviction of a 629.2 criminal offense related to application for or receipt of 629.3 medical assistance benefits. 629.4(b) On the basis of information provided on the completed629.5application, an applicant who meets the following criteria shall629.6be determined eligible beginning in the month of application:629.7(1) whose gross income is less than 90 percent of the629.8applicable income standard;629.9(2) whose total liquid assets are less than 90 percent of629.10the asset limit;629.11(3) does not reside in a long-term care facility; and629.12(4) meets all other eligibility requirements.629.13The applicant must provide all required verifications within 30629.14days' notice of the eligibility determination or eligibility629.15shall be terminated.629.16 [EFFECTIVE DATE.] This section is effective July 1, 2003, 629.17 or upon federal approval, whichever is later. 629.18 Sec. 33. Minnesota Statutes 2002, section 256B.0625, 629.19 subdivision 5a, is amended to read: 629.20 Subd. 5a. [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY 629.21 SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.](a)629.22 [COVERAGE.] Medical assistance covers home-based intensive early 629.23 intervention behavior therapy for children with autism spectrum 629.24 disorders, effective July 1, 2007. Children with autism 629.25 spectrum disorder, and their custodial parents or foster 629.26 parents, may access other covered services to treat autism 629.27 spectrum disorder, and are not required to receive intensive 629.28 early intervention behavior therapy services under this 629.29 subdivision. Intensive early intervention behavior therapy does 629.30 not include coverage for services to treat developmental 629.31 disorders of language, early onset psychosis, Rett's disorder, 629.32 selective mutism, social anxiety disorder, stereotypic movement 629.33 disorder, dementia, obsessive compulsive disorder, schizoid 629.34 personality disorder, avoidant personality disorder, or reactive 629.35 attachment disorder. If a child with autism spectrum disorder 629.36 is diagnosed to have one or more of these conditions, intensive 630.1 early intervention behavior therapy includes coverage only for 630.2 services necessary to treat the autism spectrum disorder. 630.3(b)Subd. 5b. [PURPOSE OF INTENSIVE EARLY INTERVENTION 630.4 BEHAVIOR THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to 630.5 improve the child's behavioral functioning, to prevent 630.6 development of challenging behaviors, to eliminate autistic 630.7 behaviors, to reduce the risk of out-of-home placement, and to 630.8 establish independent typical functioning in language and social 630.9 behavior. The procedures used to accomplish these goals are 630.10 based upon research in applied behavior analysis. 630.11(c)Subd. 5c. [ELIGIBLE CHILDREN.] A child is eligible to 630.12 initiate IEIBTS if, the child meets the additional eligibility 630.13 criteria in paragraph (d) and in a diagnostic assessment by a 630.14 mental health professional who is not under the employ of the 630.15 service provider, the child: 630.16 (1) is found to have an autism spectrum disorder; 630.17 (2) has a current IQ of either untestable, or at least 30; 630.18 (3) if nonverbal, initiated behavior therapy by 42 months 630.19 of age; 630.20 (4) if verbal, initiated behavior therapy by 48 months of 630.21 age; or 630.22 (5) if having an IQ of at least 50, initiated behavior 630.23 therapy by 84 months of age. 630.24 To continue after six-month individualized treatment plan (ITP) 630.25 reviews, at least one of the child's custodial parents or foster 630.26 parents must participate in an average of at least five hours of 630.27 documented behavior therapy per week for six months, and 630.28 consistently implement behavior therapy recommendations 24 hours 630.29 a day. To continue after six-month individualized treatment 630.30 plan (ITP) reviews, the child must show documented progress 630.31 toward mastery of six-month benchmark behavior objectives. The 630.32 maximum number of months during which services may be billed is 630.33 54, or up to the month of August in the first year in which the 630.34 child completes first grade, whichever comes last. If 630.35 significant progress towards treatment goals has not been 630.36 achieved after 24 months of treatment, treatment must be 631.1 discontinued. 631.2(d)Subd. 5d. [ADDITIONAL ELIGIBILITY CRITERIA.] A child 631.3 is eligible to initiate IEIBTS if: 631.4 (1) in medical and diagnostic assessments by medical and 631.5 mental health professionals, it is determined that the child 631.6 does not have severe or profound mental retardation; 631.7 (2) an accurate assessment of the child's hearing has been 631.8 performed, including audiometry if the brain stem auditory 631.9 evokes response; 631.10 (3) a blood lead test has been performed prior to 631.11 initiation of treatment; and 631.12 (4) an EEG or neurologic evaluation is done, prior to 631.13 initiation of treatment, if the child has a history of staring 631.14 spells or developmental regression. 631.15(e)Subd. 5e. [COVERED SERVICES.] The focus of IEIBTS must 631.16 be to treat the principal diagnostic features of the autism 631.17 spectrum disorder. All IEIBTS must be delivered by a team of 631.18 practitioners under the consistent supervision of a single 631.19 clinical supervisor. A mental health professional must develop 631.20 the ITP for IEIBTS. The ITP must include six-month benchmark 631.21 behavior objectives. All behavior therapy must be based upon 631.22 research in applied behavior analysis, with an emphasis upon 631.23 positive reinforcement of carefully task-analyzed skills for 631.24 optimum rates of progress. All behavior therapy must be 631.25 consistently applied and generalized throughout the 24-hour day 631.26 and seven-day week by all of the child's regular care 631.27 providers. When placing the child in school activities, a 631.28 majority of the peers must have no mental health diagnosis, and 631.29 the child must have sufficient social skills to succeed with 80 631.30 percent of the school activities. Reactive consequences, such 631.31 as redirection, correction, positive practice, or time-out, must 631.32 be used only when necessary to improve the child's success when 631.33 proactive procedures alone have not been effective. IEIBTS must 631.34 be delivered by a team of behavior therapy practitioners who are 631.35 employed under the direction of the same agency. The team may 631.36 deliver up to 200 billable hours per year of direct clinical 632.1 supervisor services, up to 700 billable hours per year of senior 632.2 behavior therapist services, and up to 1,800 billable hours per 632.3 year of direct behavior therapist services. A one-hour clinical 632.4 review meeting for the child, parents, and staff must be 632.5 scheduled 50 weeks a year, at which behavior therapy is reviewed 632.6 and planned. At least one-quarter of the annual clinical 632.7 supervisor billable hours shall consist of on-site clinical 632.8 meeting time. At least one-half of the annual senior behavior 632.9 therapist billable hours shall consist of direct services to the 632.10 child or parents. All of the behavioral therapist billable 632.11 hours shall consist of direct on-site services to the child or 632.12 parents. None of the senior behavior therapist billable hours 632.13 or behavior therapist billable hours shall consist of clinical 632.14 meeting time. If there is any regression of the autistic 632.15 spectrum disorder after 12 months of therapy, a neurologic 632.16 consultation must be performed. 632.17(f)Subd. 5f. [PROVIDER QUALIFICATIONS.] The provider 632.18 agency must be capable of delivering consistent applied behavior 632.19 analysis (ABA) based behavior therapy in the home. The site 632.20 director of the agency must be a mental health professional and 632.21 a board certified behavior analyst certified by the behavior 632.22 analyst certification board. Each clinical supervisor must be a 632.23 certified associate behavior analyst certified by the behavior 632.24 analyst certification board or have equivalent experience in 632.25 applied behavior analysis. 632.26(g)Subd. 5g. [SUPERVISION REQUIREMENTS.] (1) Each 632.27 behavior therapist practitioner must be continuously supervised 632.28 while in the home until the practitioner has mastered 632.29 competencies for independent practice. Each behavior therapist 632.30 must have mastered three credits of academic content and 632.31 practice in an applied behavior analysis sequence at an 632.32 accredited university before providing more than 12 months of 632.33 therapy. A college degree or minimum hours of experience are 632.34 not required. Each behavior therapist must continue training 632.35 through weekly direct observation by the senior behavior 632.36 therapist, through demonstrated performance in clinical meetings 633.1 with the clinical supervisor, and annual training in applied 633.2 behavior analysis. 633.3 (2) Each senior behavior therapist practitioner must have 633.4 mastered the senior behavior therapy competencies, completed one 633.5 year of practice as a behavior therapist, and six months of 633.6 co-therapy training with another senior behavior therapist or 633.7 have an equivalent amount of experience in applied behavior 633.8 analysis. Each senior behavior therapist must have mastered 12 633.9 credits of academic content and practice in an applied behavior 633.10 analysis sequence at an accredited university before providing 633.11 more than 12 months of senior behavior therapy. Each senior 633.12 behavior therapist must continue training through demonstrated 633.13 performance in clinical meetings with the clinical supervisor, 633.14 and annual training in applied behavior analysis. 633.15 (3) Each clinical supervisor practitioner must have 633.16 mastered the clinical supervisor and family consultation 633.17 competencies, completed two years of practice as a senior 633.18 behavior therapist and one year of co-therapy training with 633.19 another clinical supervisor, or equivalent experience in applied 633.20 behavior analysis. Each clinical supervisor must continue 633.21 training through annual training in applied behavior analysis. 633.22(h)Subd. 5h. [PLACE OF SERVICE.] IEIBTS are provided 633.23 primarily in the child's home and community. Services may be 633.24 provided in the child's natural school or preschool classroom, 633.25 home of a relative, natural recreational setting, or day care. 633.26(i)Subd. 5i. [PRIOR AUTHORIZATION REQUIREMENTS.] Prior 633.27 authorization shall be required for services provided after 200 633.28 hours of clinical supervisor, 700 hours of senior behavior 633.29 therapist, or 1,800 hours of behavior therapist services per 633.30 year. 633.31(j)Subd. 5j. [PAYMENT RATES.] The following payment rates 633.32 apply: 633.33 (1) for an IEIBTS clinical supervisor practitioner under 633.34 supervision of a mental health professional, the lower of the 633.35 submitted charge or $67 per hour unit; 633.36 (2) for an IEIBTS senior behavior therapist practitioner 634.1 under supervision of a mental health professional, the lower of 634.2 the submitted charge or $37 per hour unit; or 634.3 (3) for an IEIBTS behavior therapist practitioner under 634.4 supervision of a mental health professional, the lower of the 634.5 submitted charge or $27 per hour unit. 634.6 An IEIBTS practitioner may receive payment for travel time which 634.7 exceeds 50 minutes one-way. The maximum payment allowed will be 634.8 $0.51 per minute for up to a maximum of 300 hours per year. 634.9 For any week during which the above charges are made to 634.10 medical assistance, payments for the following services are 634.11 excluded: supervising mental health professional hours and 634.12 personal care attendant, home-based mental health, 634.13 family-community support, or mental health behavioral aide hours. 634.14(k)Subd. 5k. [REPORT.] The commissioner shall collect 634.15 evidence of the effectiveness of intensive early intervention 634.16 behavior therapy services and present a report to the 634.17 legislature by July 1,20062010. 634.18 Sec. 34. Minnesota Statutes 2002, section 256B.0625, 634.19 subdivision 9, is amended to read: 634.20 Subd. 9. [DENTAL SERVICES.] (a) Medical assistance covers 634.21 dental services. Dental services include, with prior 634.22 authorization, fixed bridges that are cost-effective for persons 634.23 who cannot use removable dentures because of their medical 634.24 condition. 634.25 (b) Coverage of dental services for adults age 21 and over 634.26 who are not pregnant is subject to a $500 annual benefit limit 634.27 and covered services are limited to: 634.28 (1) diagnostic and preventative services; 634.29 (2) basic restorative services; and 634.30 (3) emergency services. 634.31 Emergency services, dentures, and extractions related to 634.32 dentures are not included in the $500 annual benefit limit. 634.33 Sec. 35. Minnesota Statutes 2002, section 256B.0625, 634.34 subdivision 13, is amended to read: 634.35 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 634.36 except for fertility drugs when specifically used to enhance 635.1 fertility, if prescribed by a licensed practitioner and 635.2 dispensed by a licensed pharmacist, by a physician enrolled in 635.3 the medical assistance program as a dispensing physician, or by 635.4 a physician or a nurse practitioner employed by or under 635.5 contract with a community health board as defined in section 635.6 145A.02, subdivision 5, for the purposes of communicable disease 635.7 control. 635.8 (b) The dispensed quantity of a prescription drug must not 635.9 exceed a 34-day supply, unless authorized by the commissioner. 635.10 (c) Medical assistance covers the following 635.11 over-the-counter drugs when prescribed by a licensed 635.12 practitioner or by a licensed pharmacist who meets standards 635.13 established by the commissioner, in consultation with the board 635.14 of pharmacy: antacids, acetaminophen, family planning products, 635.15 aspirin, insulin, products for the treatment of lice, vitamins 635.16 for adults with documented vitamin deficiencies, vitamins for 635.17 children under the age of seven and pregnant or nursing women, 635.18 and any other over-the-counter drug identified by the 635.19 commissioner, in consultation with the formulary committee, as 635.20 necessary, appropriate, and cost-effective for the treatment of 635.21 certain specified chronic diseases, conditions, or disorders, 635.22 and this determination shall not be subject to the requirements 635.23 of chapter 14. A pharmacist may prescribe over-the-counter 635.24 medications as provided under this paragraph for purposes of 635.25 receiving reimbursement under Medicaid. When prescribing 635.26 over-the-counter drugs under this paragraph, licensed 635.27 pharmacists must consult with the recipient to determine 635.28 necessity, provide drug counseling, review drug therapy for 635.29 potential adverse interactions, and make referrals as needed to 635.30 other health care professionals. 635.31 Subd. 13c. [FORMULARY COMMITTEE.] The commissioner, after 635.32 receiving recommendations from professional medical associations 635.33 and professionalpharmacistpharmacy associations, and consumer 635.34 groups shall designate a formulary committee toadvise the635.35commissioner on the names of drugs for which payment is made,635.36recommend a system for reimbursing providers on a set fee or636.1charge basis rather than the present system, and develop methods636.2encouraging use of generic drugs when they are less expensive636.3and equally effective as trademark drugs. The formulary636.4committee shall consist of nine members, four of whom shall be636.5physicians who are not employed by the department of human636.6services, and a majority of whose practice is for persons paying636.7privately or through health insurance, three of whom shall be636.8pharmacists who are not employed by the department of human636.9services, and a majority of whose practice is for persons paying636.10privately or through health insurance, a consumer636.11representative, and a nursing home representativecarry out 636.12 duties as described in subdivisions 13 to 13g. The formulary 636.13 committee shall be comprised of four licensed physicians 636.14 actively engaged in the practice of medicine in Minnesota one of 636.15 whom must be actively engaged in the treatment of persons with 636.16 mental illness; at least three licensed pharmacists actively 636.17 engaged in the practice of pharmacy in Minnesota; and one 636.18 consumer representative; the remainder to be made up of health 636.19 care professionals who are licensed in their field and have 636.20 recognized knowledge in the clinically appropriate prescribing, 636.21 dispensing, and monitoring of covered outpatient drugs. Members 636.22 of the formulary committee shall not be employed by the 636.23 department of human services. Committee members shall serve 636.24 three-year terms andshall serve without compensation. Members636.25 may be reappointedonceby the commissioner. The formulary 636.26 committee shall meet at least quarterly. The commissioner may 636.27 require more frequent formulary committee meetings as needed. 636.28 An honorarium of $100 per meeting and reimbursement for mileage 636.29 shall be paid to each committee member in attendance. 636.30 Subd. 13d. [DRUG FORMULARY.](b)The commissioner shall 636.31 establish a drug formulary. Its establishment and publication 636.32 shall not be subject to the requirements of the Administrative 636.33 Procedure Act, but the formulary committee shall review and 636.34 comment on the formulary contents. 636.35 The formulary shall not include: 636.36(i)(1) drugs or products for which there is no federal 637.1 funding; 637.2(ii)(2) over-the-counter drugs, exceptfor antacids,637.3acetaminophen, family planning products, aspirin, insulin,637.4products for the treatment of lice, vitamins for adults with637.5documented vitamin deficiencies, vitamins for children under the637.6age of seven and pregnant or nursing women, and any other637.7over-the-counter drug identified by the commissioner, in637.8consultation with the drug formulary committee, as necessary,637.9appropriate, and cost-effective for the treatment of certain637.10specified chronic diseases, conditions or disorders, and this637.11determination shall not be subject to the requirements of637.12chapter 14as provided in subdivision 13; 637.13(iii) anorectics, except that medically necessary637.14anorectics shall be covered for a recipient previously diagnosed637.15as having pickwickian syndrome and currently diagnosed as having637.16diabetes and being morbidly obese(3) drugs used for weight 637.17 loss, except that medically necessary lipase inhibitors may be 637.18 covered for a recipient with type II diabetes; 637.19(iv)(4) drugs for which medical value has not been 637.20 established; and 637.21(v)(5) drugs from manufacturers who have not signed a 637.22 rebate agreement with the Department of Health and Human 637.23 Services pursuant to section 1927 of title XIX of the Social 637.24 Security Act. 637.25The commissioner shall publish conditions for prohibiting637.26payment for specific drugs after considering the formulary637.27committee's recommendations. An honorarium of $100 per meeting637.28and reimbursement for mileage shall be paid to each committee637.29member in attendance.637.30 Subd. 13e. [PAYMENT RATES.](c)(a) The basis for 637.31 determining the amount of payment shall be the lower of the 637.32 actual acquisition costs of the drugs plus a fixed dispensing 637.33 fee; the maximum allowable cost set by the federal government or 637.34 by the commissioner plus the fixed dispensing fee; or the usual 637.35 and customary price charged to the public. The amount of 637.36 payment basis must be reduced to reflect all discount amounts 638.1 applied to the charge by any provider/insurer agreement or 638.2 contract for submitted charges to medical assistance programs. 638.3 The net submitted charge may not be greater than the patient 638.4 liability for the service. The pharmacy dispensing fee shall be 638.5 $3.65, except that the dispensing fee for intravenous solutions 638.6 which must be compounded by the pharmacist shall be $8 per bag, 638.7 $14 per bag for cancer chemotherapy products, and $30 per bag 638.8 for total parenteral nutritional products dispensed in one liter 638.9 quantities, or $44 per bag for total parenteral nutritional 638.10 products dispensed in quantities greater than one liter. Actual 638.11 acquisition cost includes quantity and other special discounts 638.12 except time and cash discounts. The actual acquisition cost of 638.13 a drug shall be estimated by the commissioner, at average 638.14 wholesale price minusnine11.5 percent, except that where a 638.15 drug has had its wholesale price reduced as a result of the 638.16 actions of the National Association of Medicaid Fraud Control 638.17 Units, the estimated actual acquisition cost shall be the 638.18 reduced average wholesale price, without thenine11.5 percent 638.19 deduction. The maximum allowable cost of a multisource drug may 638.20 be set by the commissioner and it shall be comparable to, but no 638.21 higher than, the maximum amount paid by other third-party payors 638.22 in this state who have maximum allowable cost programs.The638.23commissioner shall set maximum allowable costs for multisource638.24drugs that are not on the federal upper limit list as described638.25in United States Code, title 42, chapter 7, section 1396r-8(e),638.26the Social Security Act, and Code of Federal Regulations, title638.2742, part 447, section 447.332.Establishment of the amount of 638.28 payment for drugs shall not be subject to the requirements of 638.29 the Administrative Procedure Act. 638.30 (b) An additional dispensing fee of $.30 may be added to 638.31 the dispensing fee paid to pharmacists for legend drug 638.32 prescriptions dispensed to residents of long-term care 638.33 facilities when a unit dose blister card system, approved by the 638.34 department, is used. Under this type of dispensing system, the 638.35 pharmacist must dispense a 30-day supply of drug. The National 638.36 Drug Code (NDC) from the drug container used to fill the blister 639.1 card must be identified on the claim to the department. The 639.2 unit dose blister card containing the drug must meet the 639.3 packaging standards set forth in Minnesota Rules, part 639.4 6800.2700, that govern the return of unused drugs to the 639.5 pharmacy for reuse. The pharmacy provider will be required to 639.6 credit the department for the actual acquisition cost of all 639.7 unused drugs that are eligible for reuse. Over-the-counter 639.8 medications must be dispensed in the manufacturer's unopened 639.9 package. The commissioner may permit the drug clozapine to be 639.10 dispensed in a quantity that is less than a 30-day supply. 639.11 (c) Whenever a generically equivalent product is available, 639.12 payment shall be on the basis of the actual acquisition cost of 639.13 the generic drug,unless the prescriber specifically indicates639.14"dispense as written - brand necessary" on the prescription as639.15required by section 151.21, subdivision 2or on the maximum 639.16 allowable cost established by the commissioner. 639.17 (d)For purposes of this subdivision, "multisource drugs"639.18means covered outpatient drugs, excluding innovator multisource639.19drugs for which there are two or more drug products, which:639.20(1) are related as therapeutically equivalent under the639.21Food and Drug Administration's most recent publication of639.22"Approved Drug Products with Therapeutic Equivalence639.23Evaluations";639.24(2) are pharmaceutically equivalent and bioequivalent as639.25determined by the Food and Drug Administration; and639.26(3) are sold or marketed in Minnesota.639.27"Innovator multisource drug" means a multisource drug that was639.28originally marketed under an original new drug application639.29approved by the Food and Drug Administration.639.30(e)The basis for determining the amount of payment for 639.31 drugs administered in an outpatient setting shall be the lower 639.32 of the usual and customary cost submitted by the provider, the 639.33 average wholesale price minus five percent, or the maximum 639.34 allowable cost set by the federal government under United States 639.35 Code, title 42, chapter 7, section 1396r-8(e), and Code of 639.36 Federal Regulations, title 42, section 447.332, or by the 640.1 commissioner under paragraphs (a) to (c). 640.2 Subd. 13f. [PRIOR AUTHORIZATION.] (a) The formulary 640.3 committee shall review and recommend drugs which require prior 640.4 authorization.The formulary committee may recommend drugs for640.5prior authorization directly to the commissioner, as long as640.6opportunity for public input is provided. Prior authorization640.7may be requested by the commissioner based on medical and640.8clinical criteria and on cost before certain drugs are eligible640.9for payment. Before a drug may be considered for prior640.10authorization at the request of the commissioner:640.11(1) the drug formulary committee must develop criteria to640.12be used for identifying drugs; the development of these criteria640.13is not subject to the requirements of chapter 14, but the640.14formulary committee shall provide opportunity for public input640.15in developing criteria;640.16(2) the drug formulary committee must hold a public forum640.17and receive public comment for an additional 15 days;640.18(3) the drug formulary committee must consider data from640.19the state Medicaid program if such data is available; and640.20(4) the commissioner must provide information to the640.21formulary committee on the impact that placing the drug on prior640.22authorization will have on the quality of patient care and on640.23program costs, and information regarding whether the drug is640.24subject to clinical abuse or misuse.640.25Prior authorization may be required by the commissioner640.26before certain formulary drugs are eligible for payment. If640.27prior authorization of a drug is required by the commissioner,640.28the commissioner must provide a 30-day notice period before640.29implementing the prior authorization. If a prior authorization640.30request is denied by the department, the recipient may appeal640.31the denial in accordance with section 256.045. If an appeal is640.32filed, the drug must be provided without prior authorization640.33until a decision is made on the appeal.640.34(f) The basis for determining the amount of payment for640.35drugs administered in an outpatient setting shall be the lower640.36of the usual and customary cost submitted by the provider; the641.1average wholesale price minus five percent; or the maximum641.2allowable cost set by the federal government under United States641.3Code, title 42, chapter 7, section 1396r-8(e), and Code of641.4Federal Regulations, title 42, section 447.332, or by the641.5commissioner under paragraph (c).641.6(g) Prior authorization shall not be required or utilized641.7for any antipsychotic drug prescribed for the treatment of641.8mental illness where there is no generically equivalent drug641.9available unless the commissioner determines that prior641.10authorization is necessary for patient safety. This paragraph641.11applies to any supplemental drug rebate program established or641.12administered by the commissioner.The formulary committee shall 641.13 establish general criteria to be used for the prior 641.14 authorization of brand-name drugs for which generically 641.15 equivalent drugs are available, but the committee is not 641.16 required to review each brand-name drug for which a generically 641.17 equivalent drug is available. 641.18 (b) Prior authorization may be required by the commissioner 641.19 before certain formulary drugs are eligible for payment. The 641.20 formulary committee may recommend drugs for prior authorization 641.21 directly to the commissioner. The commissioner may also request 641.22 that the formulary committee review a drug for prior 641.23 authorization. Before the commissioner may require prior 641.24 authorization for a drug: 641.25 (1) the commissioner must provide information to the 641.26 formulary committee on the impact that placing the drug on prior 641.27 authorization may have on the quality of patient care and on 641.28 program costs, information regarding whether the drug is subject 641.29 to clinical abuse or misuse, and relevant data from the state 641.30 Medicaid program if such data is available; 641.31 (2) the formulary committee must review the drug, taking 641.32 into account medical and clinical data and the information 641.33 provided by the commissioner; and 641.34 (3) the formulary committee must hold a public forum and 641.35 receive public comment for an additional 15 days. 641.36 The commissioner must provide a 15-day notice period before 642.1 implementing the prior authorization. 642.2 (c) Prior authorization shall not be required or utilized 642.3 for any atypical antipsychotic drug prescribed for the treatment 642.4 of mental illness if: 642.5 (1) there is no generically equivalent drug available; and 642.6 (2) the drug was initially prescribed for the recipient 642.7 prior to July 1, 2003; or 642.8 (3) the drug is part of the recipient's current course of 642.9 treatment. 642.10 This paragraph applies to any multistate preferred drug list or 642.11 supplemental drug rebate program established or administered by 642.12 the commissioner. 642.13(h)(d) Prior authorization shall not be required or 642.14 utilized for any antihemophilic factor drug prescribed for the 642.15 treatment of hemophilia and blood disorders where there is no 642.16 generically equivalent drug availableunless the commissioner642.17determines that prior authorization is necessary for patient642.18safety. This paragraph applies toif the prior authorization is 642.19 used in conjunction with any supplemental drug rebate program or 642.20 multistate preferred drug list established or administered by 642.21 the commissioner. This paragraph expires July 1,20032005. 642.22 (e) The commissioner may require prior authorization for 642.23 brand name drugs whenever a generically equivalent product is 642.24 available, even if the prescriber specifically indicates 642.25 "dispense as written-brand necessary" on the prescription as 642.26 required by section 151.21, subdivision 2. 642.27 Subd. 13g. [PREFERRED DRUG LIST.] (a) The commissioner 642.28 shall adopt and implement a preferred drug list by January 1, 642.29 2004. The commissioner may enter into a contract with a vendor 642.30 or one or more states for the purpose of participating in a 642.31 multistate preferred drug list and supplemental rebate program. 642.32 The commissioner shall ensure that any contract meets all 642.33 federal requirements and maximizes federal financial 642.34 participation. The commissioner shall publish the preferred 642.35 drug list annually in the State Register and shall maintain an 642.36 accurate and up-to-date list on the agency Web site. 643.1 (b) The commissioner may add to, delete from, and otherwise 643.2 modify the preferred drug list, after consulting with the 643.3 formulary committee and appropriate medical specialists and 643.4 providing public notice and the opportunity for public comment. 643.5 (c) The commissioner shall adopt and administer the 643.6 preferred drug list as part of the administration of the 643.7 supplemental drug rebate program. Reimbursement for 643.8 prescription drugs not on the preferred drug list may be subject 643.9 to prior authorization, unless the drug manufacturer signs a 643.10 supplemental rebate contract. 643.11 (d) For purposes of this subdivision, "preferred drug list" 643.12 means a list of prescription drugs within designated therapeutic 643.13 classes selected by the commissioner, for which prior 643.14 authorization based on the identity of the drug or class is not 643.15 required. 643.16 (e) The commissioner shall seek any federal waivers or 643.17 approvals necessary to implement this subdivision. 643.18 [EFFECTIVE DATE.] This section is effective July 1, 2003. 643.19 Sec. 36. Minnesota Statutes 2002, section 256B.0625, 643.20 subdivision 17, is amended to read: 643.21 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 643.22 covers transportation costs incurred solely for obtaining 643.23 emergency medical care or transportation costs incurred by 643.24nonambulatoryeligible persons in obtaining emergency or 643.25 nonemergency medical care when paid directly to an ambulance 643.26 company, common carrier, or other recognized providers of 643.27 transportation services.For the purpose of this subdivision, a643.28person who is incapable of transport by taxicab or bus shall be643.29considered to be nonambulatory.643.30 (b) Medical assistance covers special transportation, as 643.31 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 643.32 if theprovider receives and maintains a current physician's643.33order by the recipient's attending physician certifying that the643.34 recipient has a physical or mental impairment that would 643.35 prohibit the recipient from safely accessing and using a bus, 643.36 taxi, other commercial transportation, or private automobile. 644.1 The commissioner may use an order by the recipient's attending 644.2 physician to certify that the recipient requires special 644.3 transportation services. Special transportation includes 644.4 driver-assisted service to eligible individuals. 644.5 Driver-assisted service includes passenger pickup at and return 644.6 to the individual's residence or place of business, assistance 644.7 with admittance of the individual to the medical facility, and 644.8 assistance in passenger securement or in securing of wheelchairs 644.9 or stretchers in the vehicle.The commissioner shall establish644.10maximum medical assistance reimbursement rates for special644.11transportation services for persons who need a644.12wheelchair-accessible van or stretcher-accessible vehicle and644.13for those who do not need a wheelchair-accessible van or644.14stretcher-accessible vehicle. The average of these two rates644.15per trip must not exceed $15 for the base rate and $1.40 per644.16mile. Special transportation provided to nonambulatory persons644.17who do not need a wheelchair-accessible van or644.18stretcher-accessible vehicle, may be reimbursed at a lower rate644.19than special transportation provided to persons who need a644.20wheelchair-accessible van or stretcher-accessible644.21vehicle.Special transportation providers must obtain written 644.22 documentation from the health care service provider who is 644.23 serving the recipient being transported, identifying the time 644.24 that the recipient arrived. Special transportation providers 644.25 may not bill for separate base rates for the continuation of a 644.26 trip beyond the original destination. Special transportation 644.27 providers must take recipients to the nearest appropriate health 644.28 care provider, using the most direct route available. The 644.29 maximum medical assistance reimbursement rates for special 644.30 transportation services are: 644.31 (1) $18 for the base rate and $1.40 per mile for services 644.32 to eligible persons who need a wheelchair-accessible van; 644.33 (2) $12 for the base rate and $1.35 per mile for services 644.34 to eligible persons who do not need a wheelchair-accessible van; 644.35 and 644.36 (3) $36 for the base rate and $1.40 per mile, and an 645.1 attendant rate of $9 per trip, for services to eligible persons 645.2 who need a stretcher-accessible vehicle. 645.3 Sec. 37. [256B.0631] [MEDICAL ASSISTANCE CO-PAYMENTS.] 645.4 Subdivision 1. [CO-PAYMENTS.] (a) Except as provided in 645.5 subdivision 2, the medical assistance benefit plan shall include 645.6 the following co-payments for all recipients, effective for 645.7 services provided on or after October 1, 2003: 645.8 (1) $3 per nonpreventive visit. For purposes of this 645.9 subdivision, a visit means an episode of service which is 645.10 required because of a recipient's symptoms, diagnosis, or 645.11 established illness, and which is delivered in an ambulatory 645.12 setting by a physician or physician ancillary, chiropractor, 645.13 podiatrist, nurse midwife, advanced practice nurse, audiologist, 645.14 optician, or optometrist; 645.15 (2) $3 for eyeglasses; 645.16 (3) $6 for nonemergency visits to a hospital-based 645.17 emergency room; and 645.18 (4) $3 per brand-name drug prescription and $1 per generic 645.19 drug prescription, subject to a $20 per month maximum for 645.20 prescription drug co-payments. No co-payments shall apply to 645.21 antipsychotic drugs when used for the treatment of mental 645.22 illness. 645.23 (b) Recipients of medical assistance are responsible for 645.24 all co-payments in this subdivision. 645.25 Subd. 2. [EXCEPTIONS.] Co-payments shall be subject to the 645.26 following exceptions: 645.27 (1) children under the age of 21; 645.28 (2) pregnant women for services that relate to the 645.29 pregnancy or any other medical condition that may complicate the 645.30 pregnancy; 645.31 (3) recipients expected to reside for at least 30 days in a 645.32 hospital, nursing home, or intermediate care facility for the 645.33 mentally retarded; 645.34 (4) recipients receiving hospice care; 645.35 (5) 100 percent federally funded services provided by an 645.36 Indian health service; 646.1 (6) emergency services; 646.2 (7) family planning services; 646.3 (8) services that are paid by Medicare, resulting in the 646.4 medical assistance program paying for the coinsurance and 646.5 deductible; and 646.6 (9) co-payments that exceed one per day per provider for 646.7 nonpreventive visits, eyeglasses, and nonemergency visits to a 646.8 hospital-based emergency room. 646.9 Subd. 3. [COLLECTION.] The medical assistance 646.10 reimbursement to the provider shall be reduced by the amount of 646.11 the co-payment, except that reimbursement for prescription drugs 646.12 shall not be reduced once a recipient has reached the $20 per 646.13 month maximum for prescription drug co-payments. The provider 646.14 collects the co-payment from the recipient. Providers may not 646.15 deny services to recipients who are unable to pay the 646.16 co-payment, except as provided in subdivision 4. 646.17 Subd. 4. [UNCOLLECTED DEBT.] If it is the routine business 646.18 practice of a provider to refuse service to an individual with 646.19 uncollected debt, the provider may include uncollected 646.20 co-payments under this section. A provider must give advance 646.21 notice to a recipient with uncollected debt before services can 646.22 be denied. 646.23 Sec. 38. Minnesota Statutes 2002, section 256B.0635, 646.24 subdivision 1, is amended to read: 646.25 Subdivision 1. [INCREASED EMPLOYMENT.] (a) Until June 30, 646.26 2002, medical assistance may be paid for persons who received 646.27 MFIP or medical assistance for families and children in at least 646.28 three of six months preceding the month in which the person 646.29 became ineligible for MFIP or medical assistance, if the 646.30 ineligibility was due to an increase in hours of employment or 646.31 employment income or due to the loss of an earned income 646.32 disregard. In addition, to receive continued assistance under 646.33 this section, persons who received medical assistance for 646.34 families and children but did not receive MFIP must have had 646.35 income less than or equal to the assistance standard for their 646.36 family size under the state's AFDC plan in effect as of July 16, 647.1 1996, increased by three percent effective July 1, 2000, at the 647.2 time medical assistance eligibility began. A person who is 647.3 eligible for extended medical assistance is entitled to six 647.4 months of assistance without reapplication, unless the 647.5 assistance unit ceases to include a dependent child. For a 647.6 person under 21 years of age, medical assistance may not be 647.7 discontinued within the six-month period of extended eligibility 647.8 until it has been determined that the person is not otherwise 647.9 eligible for medical assistance. Medical assistance may be 647.10 continued for an additional six months if the person meets all 647.11 requirements for the additional six months, according to title 647.12 XIX of the Social Security Act, as amended by section 303 of the 647.13 Family Support Act of 1988, Public LawNumber100-485. 647.14 (b) Beginning July 1, 2002, contingent upon federal 647.15 funding, medical assistance for families and children may be 647.16 paid for persons who were eligible under section 256B.055, 647.17 subdivision 3a, in at least three of six months preceding the 647.18 month in which the person became ineligible under that section 647.19 if the ineligibility was due to an increase in hours of 647.20 employment or employment income or due to the loss of an earned 647.21 income disregard. A person who is eligible for extended medical 647.22 assistance is entitled to six months of assistance without 647.23 reapplication, unless the assistance unit ceases to include a 647.24 dependent child, except medical assistance may not be 647.25 discontinued for that dependent child under 21 years of age 647.26 within the six-month period of extended eligibility until it has 647.27 been determined that the person is not otherwise eligible for 647.28 medical assistance. Medical assistance may be continued for an 647.29 additional six months if the person meets all requirements for 647.30 the additional six months, according to title XIX of the Social 647.31 Security Act, as amended by section 303 of the Family Support 647.32 Act of 1988, Public LawNumber100-485. 647.33 [EFFECTIVE DATE.] This section is effective July 1, 2003. 647.34 Sec. 39. Minnesota Statutes 2002, section 256B.0635, 647.35 subdivision 2, is amended to read: 647.36 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.] (a) Until 648.1 June 30, 2002, medical assistance may be paid for persons who 648.2 received MFIP or medical assistance for families and children in 648.3 at least three of the six months preceding the month in which 648.4 the person became ineligible for MFIP or medical assistance, if 648.5 the ineligibility was the result of the collection of child or 648.6 spousal support under part D of title IV of the Social Security 648.7 Act. In addition, to receive continued assistance under this 648.8 section, persons who received medical assistance for families 648.9 and children but did not receive MFIP must have had income less 648.10 than or equal to the assistance standard for their family size 648.11 under the state's AFDC plan in effect as of July 16, 1996, 648.12 increased by three percent effective July 1, 2000, at the time 648.13 medical assistance eligibility began. A person who is eligible 648.14 for extended medical assistance under this subdivision is 648.15 entitled to four months of assistance without reapplication, 648.16 unless the assistance unit ceases to include a dependent child, 648.17 except medical assistance may not be discontinued for that 648.18 dependent child under 21 years of age within the four-month 648.19 period of extended eligibility until it has been determined that 648.20 the person is not otherwise eligible for medical assistance. 648.21 (b) Beginning July 1, 2002, contingent upon federal 648.22 funding, medical assistance for families and children may be 648.23 paid for persons who were eligible under section 256B.055, 648.24 subdivision 3a, in at least three of the six months preceding 648.25 the month in which the person became ineligible under that 648.26 section if the ineligibility was the result of the collection of 648.27 child or spousal support under part D of title IV of the Social 648.28 Security Act. A person who is eligible for extended medical 648.29 assistance under this subdivision is entitled to four months of 648.30 assistance without reapplication, unless the assistance unit 648.31 ceases to include a dependent child, except medical assistance 648.32 may not be discontinued for that dependent child under 21 years 648.33 of age within the four-month period of extended eligibility 648.34 until it has been determined that the person is not otherwise 648.35 eligible for medical assistance. 648.36 [EFFECTIVE DATE.] This section is effective July 1, 2003. 649.1 Sec. 40. Minnesota Statutes 2002, section 256B.15, 649.2 subdivision 1, is amended to read: 649.3 Subdivision 1. [POLICY, APPLICABILITY, PURPOSE, AND 649.4 CONSTRUCTION; DEFINITION.] (a) It is the policy of this state 649.5 that individuals or couples, either or both of whom participate 649.6 in the medical assistance program, use their own assets to pay 649.7 their share of the total cost of their care during or after 649.8 their enrollment in the program according to applicable federal 649.9 law and the laws of this state. The following provisions apply: 649.10 (1) subdivisions 1c to 1k shall not apply to claims arising 649.11 under this section which are presented under section 525.313; 649.12 (2) the provisions of subdivisions 1c to 1k expanding the 649.13 interests included in an estate for purposes of recovery under 649.14 this section give effect to the provisions of United States 649.15 Code, title 42, section 1396p, governing recoveries, but do not 649.16 give rise to any express or implied liens in favor of any other 649.17 parties not named in these provisions; 649.18 (3) the continuation of a recipient's life estate or joint 649.19 tenancy interest in real property after the recipient's death 649.20 for the purpose of recovering medical assistance under this 649.21 section modifies common law principles holding that these 649.22 interests terminate on the death of the holder; 649.23 (4) all laws, rules, and regulations governing or involved 649.24 with a recovery of medical assistance shall be liberally 649.25 construed to accomplish their intended purposes; 649.26 (5) a deceased recipient's life estate and joint tenancy 649.27 interests continued under this section shall be owned by the 649.28 remaindermen or surviving joint tenants as their interests may 649.29 appear on the date of the recipient's death. They shall not be 649.30 merged into the remainder interest or the interests of the 649.31 surviving joint tenants by reason of ownership. They shall be 649.32 subject to the provisions of this section. Any conveyance, 649.33 transfer, sale, assignment, or encumbrance by a remainderman, a 649.34 surviving joint tenant, or their heirs, successors, and assigns 649.35 shall be deemed to include all of their interest in the deceased 649.36 recipient's life estate or joint tenancy interest continued 650.1 under this section; and 650.2 (6) the provisions of subdivisions 1c to 1k continuing a 650.3 recipient's joint tenancy interests in real property after the 650.4 recipient's death do not apply to a homestead owned of record, 650.5 on the date the recipient dies, by the recipient and the 650.6 recipient's spouse as joint tenants with a right of 650.7 survivorship. Homestead means the real property occupied by the 650.8 surviving joint tenant spouse as their sole residence on the 650.9 date the recipient dies and classified and taxed to the 650.10 recipient and surviving joint tenant spouse as homestead 650.11 property for property tax purposes in the calendar year in which 650.12 the recipient dies. For purposes of this exemption, real 650.13 property the recipient and their surviving joint tenant spouse 650.14 purchase solely with the proceeds from the sale of their prior 650.15 homestead, own of record as joint tenants, and qualify as 650.16 homestead property under section 273.124 in the calendar year in 650.17 which the recipient dies and prior to the recipient's death 650.18 shall be deemed to be real property classified and taxed to the 650.19 recipient and their surviving joint tenant spouse as homestead 650.20 property in the calendar year in which the recipient dies. The 650.21 surviving spouse, or any person with personal knowledge of the 650.22 facts, may provide an affidavit describing the homestead 650.23 property affected by this clause and stating facts showing 650.24 compliance with this clause. The affidavit shall be prima facie 650.25 evidence of the facts it states. 650.26 (b) For purposes of this section, "medical assistance" 650.27 includes the medical assistance program under this chapter and 650.28 the general assistance medical care program under chapter 256D, 650.29 but does not include the alternative care program for nonmedical 650.30 assistance recipients under section 256B.0913, subdivision 4. 650.31 [EFFECTIVE DATE.] This section is effective August 1, 2003, 650.32 and applies to estates of decedents who die on or after that 650.33 date. 650.34 Sec. 41. Minnesota Statutes 2002, section 256B.15, 650.35 subdivision 1a, is amended to read: 650.36 Subd. 1a. [ESTATES SUBJECT TO CLAIMS.] If a person 651.1 receives any medical assistance hereunder, on the person's 651.2 death, if single, or on the death of the survivor of a married 651.3 couple, either or both of whom received medical assistance, or 651.4 as otherwise provided for in this section, the total amount paid 651.5 for medical assistance rendered for the person and spouse shall 651.6 be filed as a claim against the estate of the person or the 651.7 estate of the surviving spouse in the court having jurisdiction 651.8 to probate the estate or to issue a decree of descent according 651.9 to sections 525.31 to 525.313. 651.10 A claim shall be filed if medical assistance was rendered 651.11 for either or both persons under one of the following 651.12 circumstances: 651.13 (a) the person was over 55 years of age, and received 651.14 services under this chapter, excluding alternative care; 651.15 (b) the person resided in a medical institution for six 651.16 months or longer, received services under this chapterexcluding651.17alternative care, and, at the time of institutionalization or 651.18 application for medical assistance, whichever is later, the 651.19 person could not have reasonably been expected to be discharged 651.20 and returned home, as certified in writing by the person's 651.21 treating physician. For purposes of this section only, a 651.22 "medical institution" means a skilled nursing facility, 651.23 intermediate care facility, intermediate care facility for 651.24 persons with mental retardation, nursing facility, or inpatient 651.25 hospital; or 651.26 (c) the person received general assistance medical care 651.27 services under chapter 256D. 651.28 The claim shall be considered an expense of the last 651.29 illness of the decedent for the purpose of section 524.3-805. 651.30 Any statute of limitations that purports to limit any county 651.31 agency or the state agency, or both, to recover for medical 651.32 assistance granted hereunder shall not apply to any claim made 651.33 hereunder for reimbursement for any medical assistance granted 651.34 hereunder. Notice of the claim shall be given to all heirs and 651.35 devisees of the decedent whose identity can be ascertained with 651.36 reasonable diligence. The notice must include procedures and 652.1 instructions for making an application for a hardship waiver 652.2 under subdivision 5; time frames for submitting an application 652.3 and determination; and information regarding appeal rights and 652.4 procedures. Counties are entitled to one-half of the nonfederal 652.5 share of medical assistance collections from estates that are 652.6 directly attributable to county effort. Counties are entitled 652.7 to ten percent of the collections for alternative care directly 652.8 attributable to county effort. 652.9 [EFFECTIVE DATE.] The amendments in this section relating 652.10 to the alternative care program are effective July 1, 2003, and 652.11 apply to the estates of decedents who die on or after that 652.12 date. The remaining amendments in this section are effective 652.13 August 1, 2003, and apply to the estates of decedents who die on 652.14 and after that date. 652.15 Sec. 42. Minnesota Statutes 2002, section 256B.15, is 652.16 amended by adding a subdivision to read: 652.17 Subd. 1c. [NOTICE OF POTENTIAL CLAIM.] (a) A state agency 652.18 with a claim or potential claim under this section may file a 652.19 notice of potential claim under this subdivision anytime before 652.20 or within one year after a medical assistance recipient dies. 652.21 The claimant shall be the state agency. A notice filed prior to 652.22 the recipient's death shall not take effect and shall not be 652.23 effective as notice until the recipient dies. A notice filed 652.24 after a recipient dies shall be effective from the time of 652.25 filing. 652.26 (b) The notice of claim shall be filed or recorded in the 652.27 real estate records in the office of the county recorder or 652.28 registrar of titles for each county in which any part of the 652.29 property is located. The recorder shall accept the notice for 652.30 recording or filing. The registrar of titles shall accept the 652.31 notice for filing if the recipient has a recorded interest in 652.32 the property. The registrar of titles shall not carry forward 652.33 to a new certificate of title any notice filed more than one 652.34 year from the date of the recipient's death. 652.35 (c) The notice must be dated, state the name of the 652.36 claimant, the medical assistance recipient's name and social 653.1 security number if filed before their death and their date of 653.2 death if filed after they die, the name and date of death of any 653.3 predeceased spouse of the medical assistance recipient for whom 653.4 a claim may exist, a statement that the claimant may have a 653.5 claim arising under this section, generally identify the 653.6 recipient's interest in the property, contain a legal 653.7 description for the property and whether it is abstract or 653.8 registered property, a statement of when the notice becomes 653.9 effective and the effect of the notice, be signed by an 653.10 authorized representative of the state agency, and may include 653.11 such other contents as the state agency may deem appropriate. 653.12 [EFFECTIVE DATE.] This section is effective August 1, 2003, 653.13 and applies to the estates of decedents who die on or after that 653.14 date. 653.15 Sec. 43. Minnesota Statutes 2002, section 256B.15, is 653.16 amended by adding a subdivision to read: 653.17 Subd. 1d. [EFFECT OF NOTICE.] From the time it takes 653.18 effect, the notice shall be notice to remaindermen, joint 653.19 tenants, or to anyone else owning or acquiring an interest in or 653.20 encumbrance against the property described in the notice that 653.21 the medical assistance recipient's life estate, joint tenancy, 653.22 or other interests in the real estate described in the notice: 653.23 (1) shall, in the case of life estate and joint tenancy 653.24 interests, continue to exist for purposes of this section, and 653.25 be subject to liens and claims as provided in this section; 653.26 (2) shall be subject to a lien in favor of the claimant 653.27 effective upon the death of the recipient and dealt with as 653.28 provided in this section; 653.29 (3) may be included in the recipient's estate, as defined 653.30 in this section; and 653.31 (4) may be subject to administration and all other 653.32 provisions of chapter 524 and may be sold, assigned, 653.33 transferred, or encumbered free and clear of their interest or 653.34 encumbrance to satisfy claims under this section. 653.35 [EFFECTIVE DATE.] This section is effective August 1, 2003, 653.36 and applies to the estates of decedents who die on or after that 654.1 date. 654.2 Sec. 44. Minnesota Statutes 2002, section 256B.15, is 654.3 amended by adding a subdivision to read: 654.4 Subd. 1e. [FULL OR PARTIAL RELEASE OF NOTICE.] (a) The 654.5 claimant may fully or partially release the notice and the lien 654.6 arising out of the notice of record in the real estate records 654.7 where the notice is filed or recorded at any time. The claimant 654.8 may give a full or partial release to extinguish any life 654.9 estates or joint tenancy interests which are or may be continued 654.10 under this section or whose existence or nonexistence may create 654.11 a cloud on the title to real property at any time whether or not 654.12 a notice has been filed. The recorder or registrar of titles 654.13 shall accept the release for recording or filing. If the 654.14 release is a partial release, it must include a legal 654.15 description of the property being released. 654.16 (b) At any time, the claimant may, at the claimant's 654.17 discretion, wholly or partially release, subordinate, modify, or 654.18 amend the recorded notice and the lien arising out of the notice. 654.19 [EFFECTIVE DATE.] This section is effective August 1, 2003, 654.20 and applies to the estates of decedents who die on or after that 654.21 date. 654.22 Sec. 45. Minnesota Statutes 2002, section 256B.15, is 654.23 amended by adding a subdivision to read: 654.24 Subd. 1f. [AGENCY LIEN.] (a) The notice shall constitute a 654.25 lien in favor of the department of human services against the 654.26 recipient's interests in the real estate it describes for a 654.27 period of 20 years from the date of filing or the date of the 654.28 recipient's death, whichever is later. Notwithstanding any law 654.29 or rule to the contrary, a recipient's life estate and joint 654.30 tenancy interests shall not end upon the recipient's death but 654.31 shall continue according to subdivisions 1h, 1i, and 1j. The 654.32 amount of the lien shall be equal to the total amount of the 654.33 claims that could be presented in the recipient's estate under 654.34 this section. 654.35 (b) If no estate has been opened for the deceased 654.36 recipient, any holder of an interest in the property may apply 655.1 to the lien holder for a statement of the amount of the lien or 655.2 for a full or partial release of the lien. The application 655.3 shall include the applicant's name, current mailing address, 655.4 current home and work telephone numbers, and a description of 655.5 their interest in the property, a legal description of the 655.6 recipient's interest in the property, and the deceased 655.7 recipient's name, date of birth, and social security number. 655.8 The lien holder shall send the applicant by certified mail, 655.9 return receipt requested, a written statement showing the amount 655.10 of the lien, whether the lien holder is willing to release the 655.11 lien and under what conditions, and inform them of the right to 655.12 a hearing under section 256.045. The lien holder shall have the 655.13 discretion to compromise and settle the lien upon any terms and 655.14 conditions the lien holder deems appropriate. 655.15 (c) Any holder of an interest in property subject to the 655.16 lien has a right to request a hearing under section 256.045 to 655.17 determine the validity, extent, or amount of the lien. The 655.18 request must be in writing, and must include the names, current 655.19 addresses, and home and business telephone numbers for all other 655.20 parties holding an interest in the property. A request for a 655.21 hearing by any holder of an interest in the property shall be 655.22 deemed to be a request for a hearing by all parties owning 655.23 interests in the property. Notice of the hearing shall be given 655.24 to the lien holder, the party filing the appeal, and all of the 655.25 other holders of interests in the property at the addresses 655.26 listed in the appeal by certified mail, return receipt 655.27 requested, or by ordinary mail. Any owner of an interest in the 655.28 property to whom notice of the hearing is mailed shall be deemed 655.29 to have waived any and all claims or defenses in respect to the 655.30 lien unless they appear and assert any claims or defenses at the 655.31 hearing. 655.32 (d) If the claim the lien secures could be filed under 655.33 subdivision 1h, the lien holder may collect, compromise, settle, 655.34 or release the lien upon any terms and conditions it deems 655.35 appropriate. If the claim the lien secures could be filed under 655.36 subdivision 1i or 1j, the lien may be adjusted or enforced to 656.1 the same extent had it been filed under subdivisions 1i and 1j, 656.2 and the provisions of subdivisions 1i, clause (f), and lj, 656.3 clause (d), shall apply to voluntary payment, settlement, or 656.4 satisfaction of the lien. 656.5 (e) If no probate proceedings have been commenced for the 656.6 recipient as of the date the lien holder executes a release of 656.7 the lien on a recipient's life estate or joint tenancy interest, 656.8 created for purposes of this section, the release shall 656.9 terminate the life estate or joint tenancy interest created 656.10 under this section as of the date it is recorded or filed to the 656.11 extent of the release. If the claimant executes a release for 656.12 purposes of extinguishing a life estate or a joint tenancy 656.13 interest created under this section to remove a cloud on title 656.14 to real property, the release shall have the effect of 656.15 extinguishing any life estate or joint tenancy interests in the 656.16 property it describes which may have been continued by reason of 656.17 this section retroactive to the date of death of the deceased 656.18 life tenant or joint tenant except as provided for in section 656.19 514.981, subdivision 6. 656.20 (f) If the deceased recipient's estate is probated, a claim 656.21 shall be filed under this section. The amount of the lien shall 656.22 be limited to the amount of the claim as finally allowed. If 656.23 the claim the lien secures is filed under subdivision 1h, the 656.24 lien may be released in full after any allowance of the claim 656.25 becomes final or according to any agreement to settle and 656.26 satisfy the claim. The release shall release the lien but shall 656.27 not extinguish or terminate the interest being released. If the 656.28 claim the lien secures is filed under subdivision 1i or 1j, the 656.29 lien shall be released after the lien under subdivision 1i or 1j 656.30 is filed or recorded, or settled according to any agreement to 656.31 settle and satisfy the claim. The release shall not extinguish 656.32 or terminate the interest being released. If the claim is 656.33 finally disallowed in full, the claimant shall release the 656.34 claimant's lien at the claimant's expense. 656.35 [EFFECTIVE DATE.] This section takes effect on August 1, 656.36 2003, and applies to the estates of decedents who die on or 657.1 after that date. 657.2 Sec. 46. Minnesota Statutes 2002, section 256B.15, is 657.3 amended by adding a subdivision to read: 657.4 Subd. 1g. [ESTATE PROPERTY.] Notwithstanding any law or 657.5 rule to the contrary, if a claim is presented under this 657.6 section, interests or the proceeds of interests in real property 657.7 a decedent owned as a life tenant or a joint tenant with a right 657.8 of survivorship shall be part of the decedent's estate, subject 657.9 to administration, and shall be dealt with as provided in this 657.10 section. 657.11 [EFFECTIVE DATE.] This section takes effect on August 1, 657.12 2003, and applies to the estates of decedents who die on or 657.13 after that date. 657.14 Sec. 47. Minnesota Statutes 2002, section 256B.15, is 657.15 amended by adding a subdivision to read: 657.16 Subd. 1h. [ESTATES OF SPECIFIC PERSONS RECEIVING MEDICAL 657.17 ASSISTANCE.] (a) For purposes of this section, paragraphs (b) to 657.18 (k) apply if a person received medical assistance for which a 657.19 claim may be filed under this section and died single, or the 657.20 surviving spouse of the couple and was not survived by any of 657.21 the persons described in subdivisions 3 and 4. 657.22 (b) For purposes of this section, the person's estate 657.23 consists of: (1) their probate estate; (2) all of the person's 657.24 interests or proceeds of those interests in real property the 657.25 person owned as a life tenant or as a joint tenant with a right 657.26 of survivorship at the time of the person's death; (3) all of 657.27 the person's interests or proceeds of those interests in 657.28 securities the person owned in beneficiary form as provided 657.29 under sections 524.6-301 to 524.6-311 at the time of the 657.30 person's death, to the extent they become part of the probate 657.31 estate under section 524.6-307; and (4) all of the person's 657.32 interests in joint accounts, multiple party accounts, and pay on 657.33 death accounts, or the proceeds of those accounts, as provided 657.34 under sections 524.6-201 to 524.6-214 at the time of the 657.35 person's death to the extent they become part of the probate 657.36 estate under section 524.6-207. Notwithstanding any law or rule 658.1 to the contrary, a state or county agency with a claim under 658.2 this section shall be a creditor under section 524.6-307. 658.3 (c) Notwithstanding any law or rule to the contrary, the 658.4 person's life estate or joint tenancy interest in real property 658.5 not subject to a medical assistance lien under sections 514.980 658.6 to 514.985 on the date of the person's death shall not end upon 658.7 the person's death and shall continue as provided in this 658.8 subdivision. The life estate in the person's estate shall be 658.9 that portion of the interest in the real property subject to the 658.10 life estate that is equal to the life estate percentage factor 658.11 for the life estate as listed in the Life Estate Mortality Table 658.12 of the health care program's manual for a person who was the age 658.13 of the medical assistance recipient on the date of the person's 658.14 death. The joint tenancy interest in real property in the 658.15 estate shall be equal to the fractional interest the person 658.16 would have owned in the jointly held interest in the property 658.17 had they and the other owners held title to the property as 658.18 tenants in common on the date the person died. 658.19 (d) The court upon its own motion, or upon motion by the 658.20 personal representative or any interested party, may enter an 658.21 order directing the remaindermen or surviving joint tenants and 658.22 their spouses, if any, to sign all documents, take all actions, 658.23 and otherwise fully cooperate with the personal representative 658.24 and the court to liquidate the decedent's life estate or joint 658.25 tenancy interests in the estate and deliver the cash or the 658.26 proceeds of those interests to the personal representative and 658.27 provide for any legal and equitable sanctions as the court deems 658.28 appropriate to enforce and carry out the order, including an 658.29 award of reasonable attorney fees. 658.30 (e) The personal representative may make, execute, and 658.31 deliver any conveyances or other documents necessary to convey 658.32 the decedent's life estate or joint tenancy interest in the 658.33 estate that are necessary to liquidate and reduce to cash the 658.34 decedent's interest or for any other purposes. 658.35 (f) Subject to administration, all costs, including 658.36 reasonable attorney fees, directly and immediately related to 659.1 liquidating the decedent's life estate or joint tenancy interest 659.2 in the decedent's estate, shall be paid from the gross proceeds 659.3 of the liquidation allocable to the decedent's interest and the 659.4 net proceeds shall be turned over to the personal representative 659.5 and applied to payment of the claim presented under this section. 659.6 (g) The personal representative shall bring a motion in the 659.7 district court in which the estate is being probated to compel 659.8 the remaindermen or surviving joint tenants to account for and 659.9 deliver to the personal representative all or any part of the 659.10 proceeds of any sale, mortgage, transfer, conveyance, or any 659.11 disposition of real property allocable to the decedent's life 659.12 estate or joint tenancy interest in the decedent's estate, and 659.13 do everything necessary to liquidate and reduce to cash the 659.14 decedent's interest and turn the proceeds of the sale or other 659.15 disposition over to the personal representative. The court may 659.16 grant any legal or equitable relief including, but not limited 659.17 to, ordering a partition of real estate under chapter 558 659.18 necessary to make the value of the decedent's life estate or 659.19 joint tenancy interest available to the estate for payment of a 659.20 claim under this section. 659.21 (h) Subject to administration, the personal representative 659.22 shall use all of the cash or proceeds of interests to pay an 659.23 allowable claim under this section. The remaindermen or 659.24 surviving joint tenants and their spouses, if any, may enter 659.25 into a written agreement with the personal representative or the 659.26 claimant to settle and satisfy obligations imposed at any time 659.27 before or after a claim is filed. 659.28 (i) The personal representative may, at their discretion, 659.29 provide any or all of the other owners, remaindermen, or 659.30 surviving joint tenants with an affidavit terminating the 659.31 decedent's estate's interest in real property the decedent owned 659.32 as a life tenant or as a joint tenant with others, if the 659.33 personal representative determines in good faith that neither 659.34 the decedent nor any of the decedent's predeceased spouses 659.35 received any medical assistance for which a claim could be filed 659.36 under this section, or if the personal representative has filed 660.1 an affidavit with the court that the estate has other assets 660.2 sufficient to pay a claim, as presented, or if there is a 660.3 written agreement under paragraph (h), or if the claim, as 660.4 allowed, has been paid in full or to the full extent of the 660.5 assets the estate has available to pay it. The affidavit may be 660.6 recorded in the office of the county recorder or filed in the 660.7 office of the registrar of titles for the county in which the 660.8 real property is located. Except as provided in section 660.9 514.981, subdivision 6, when recorded or filed, the affidavit 660.10 shall terminate the decedent's interest in real estate the 660.11 decedent owned as a life tenant or a joint tenant with others. 660.12 The affidavit shall: (1) be signed by the personal 660.13 representative; (2) identify the decedent and the interest being 660.14 terminated; (3) give recording information sufficient to 660.15 identify the instrument that created the interest in real 660.16 property being terminated; (4) legally describe the affected 660.17 real property; (5) state that the personal representative has 660.18 determined that neither the decedent nor any of the decedent's 660.19 predeceased spouses received any medical assistance for which a 660.20 claim could be filed under this section; (6) state that the 660.21 decedent's estate has other assets sufficient to pay the claim, 660.22 as presented, or that there is a written agreement between the 660.23 personal representative and the claimant and the other owners or 660.24 remaindermen or other joint tenants to satisfy the obligations 660.25 imposed under this subdivision; and (7) state that the affidavit 660.26 is being given to terminate the estate's interest under this 660.27 subdivision, and any other contents as may be appropriate. 660.28 The recorder or registrar of titles shall accept the affidavit 660.29 for recording or filing. The affidavit shall be effective as 660.30 provided in this section and shall constitute notice even if it 660.31 does not include recording information sufficient to identify 660.32 the instrument creating the interest it terminates. The 660.33 affidavit shall be conclusive evidence of the stated facts. 660.34 (j) The holder of a lien arising under subdivision 1c shall 660.35 release the lien at the holder's expense against an interest 660.36 terminated under paragraph (h) to the extent of the termination. 661.1 (k) If a lien arising under subdivision 1c is not released 661.2 under paragraph (j), prior to closing the estate, the personal 661.3 representative shall deed the interest subject to the lien to 661.4 the remaindermen or surviving joint tenants as their interests 661.5 may appear. Upon recording or filing, the deed shall work a 661.6 merger of the recipient's life estate or joint tenancy interest, 661.7 subject to the lien, into the remainder interest or interest the 661.8 decedent and others owned jointly. The lien shall attach to and 661.9 run with the property to the extent of the decedent's interest 661.10 at the time of the decedent's death. 661.11 [EFFECTIVE DATE.] This section takes effect on August 1, 661.12 2003, and applies to the estates of decedents who die on or 661.13 after that date. 661.14 Sec. 48. Minnesota Statutes 2002, section 256B.15, is 661.15 amended by adding a subdivision to read: 661.16 Subd. 1i. [ESTATES OF PERSONS RECEIVING MEDICAL ASSISTANCE 661.17 AND SURVIVED BY OTHERS.] (a) For purposes of this subdivision, 661.18 the person's estate consists of the person's probate estate and 661.19 all of the person's interests in real property the person owned 661.20 as a life tenant or a joint tenant at the time of the person's 661.21 death. 661.22 (b) Notwithstanding any law or rule to the contrary, this 661.23 subdivision applies if a person received medical assistance for 661.24 which a claim could be filed under this section but for the fact 661.25 the person was survived by a spouse or by a person listed in 661.26 subdivision 3, or if subdivision 4 applies to a claim arising 661.27 under this section. 661.28 (c) The person's life estate or joint tenancy interests in 661.29 real property not subject to a medical assistance lien under 661.30 sections 514.980 to 514.985 on the date of the person's death 661.31 shall not end upon death and shall continue as provided in this 661.32 subdivision. The life estate in the estate shall be the portion 661.33 of the interest in the property subject to the life estate that 661.34 is equal to the life estate percentage factor for the life 661.35 estate as listed in the Life Estate Mortality Table of the 661.36 health care program's manual for a person who was the age of the 662.1 medical assistance recipient on the date of the person's death. 662.2 The joint tenancy interest in the estate shall be equal to the 662.3 fractional interest the medical assistance recipient would have 662.4 owned in the jointly held interest in the property had they and 662.5 the other owners held title to the property as tenants in common 662.6 on the date the medical assistance recipient died. 662.7 (d) The county agency shall file a claim in the estate 662.8 under this section on behalf of the claimant who shall be the 662.9 commissioner of human services, notwithstanding that the 662.10 decedent is survived by a spouse or a person listed in 662.11 subdivision 3. The claim, as allowed, shall not be paid by the 662.12 estate and shall be disposed of as provided in this paragraph. 662.13 The personal representative or the court shall make, execute, 662.14 and deliver a lien in favor of the claimant on the decedent's 662.15 interest in real property in the estate in the amount of the 662.16 allowed claim on forms provided by the commissioner to the 662.17 county agency filing the lien. The lien shall bear interest as 662.18 provided under section 524.3-806, shall attach to the property 662.19 it describes upon filing or recording, and shall remain a lien 662.20 on the real property it describes for a period of 20 years from 662.21 the date it is filed or recorded. The lien shall be a 662.22 disposition of the claim sufficient to permit the estate to 662.23 close. 662.24 (e) The state or county agency shall file or record the 662.25 lien in the office of the county recorder or registrar of titles 662.26 for each county in which any of the real property is located. 662.27 The recorder or registrar of titles shall accept the lien for 662.28 filing or recording. All recording or filing fees shall be paid 662.29 by the department of human services. The recorder or registrar 662.30 of titles shall mail the recorded lien to the department of 662.31 human services. The lien need not be attested, certified, or 662.32 acknowledged as a condition of recording or filing. Upon 662.33 recording or filing of a lien against a life estate or a joint 662.34 tenancy interest, the interest subject to the lien shall merge 662.35 into the remainder interest or the interest the recipient and 662.36 others owned jointly. The lien shall attach to and run with the 663.1 property to the extent of the decedent's interest in the 663.2 property at the time of the decedent's death as determined under 663.3 this section. 663.4 (f) The department shall make no adjustment or recovery 663.5 under the lien until after the decedent's spouse, if any, has 663.6 died, and only at a time when the decedent has no surviving 663.7 child described in subdivision 3. The estate, any owner of an 663.8 interest in the property which is or may be subject to the lien, 663.9 or any other interested party, may voluntarily pay off, settle, 663.10 or otherwise satisfy the claim secured or to be secured by the 663.11 lien at any time before or after the lien is filed or recorded. 663.12 Such payoffs, settlements, and satisfactions shall be deemed to 663.13 be voluntary repayments of past medical assistance payments for 663.14 the benefit of the deceased recipient, and neither the process 663.15 of settling the claim, the payment of the claim, or the 663.16 acceptance of a payment shall constitute an adjustment or 663.17 recovery that is prohibited under this subdivision. 663.18 (g) The lien under this subdivision may be enforced or 663.19 foreclosed in the manner provided by law for the enforcement of 663.20 judgment liens against real estate or by a foreclosure by action 663.21 under chapter 581. When the lien is paid, satisfied, or 663.22 otherwise discharged, the state or county agency shall prepare 663.23 and file a release of lien at its own expense. No action to 663.24 foreclose the lien shall be commenced unless the lien holder has 663.25 first given 30 days' prior written notice to pay the lien to the 663.26 owners and parties in possession of the property subject to the 663.27 lien. The notice shall: (1) include the name, address, and 663.28 telephone number of the lien holder; (2) describe the lien; (3) 663.29 give the amount of the lien; (4) inform the owner or party in 663.30 possession that payment of the lien in full must be made to the 663.31 lien holder within 30 days after service of the notice or the 663.32 lien holder may begin proceedings to foreclose the lien; and (5) 663.33 be served by personal service, certified mail, return receipt 663.34 requested, ordinary first class mail, or by publishing it once 663.35 in a newspaper of general circulation in the county in which any 663.36 part of the property is located. Service of the notice shall be 664.1 complete upon mailing or publication. 664.2 [EFFECTIVE DATE.] This section takes effect August 1, 2003, 664.3 and applies to estates of decedents who die on or after that 664.4 date. 664.5 Sec. 49. Minnesota Statutes 2002, section 256B.15, is 664.6 amended by adding a subdivision to read: 664.7 Subd. 1j. [CLAIMS IN ESTATES OF DECEDENTS SURVIVED BY 664.8 OTHER SURVIVORS.] For purposes of this subdivision, the 664.9 provisions in subdivision 1i, paragraphs (a) to (c) apply. 664.10 (a) If payment of a claim filed under this section is 664.11 limited as provided in subdivision 4, and if the estate does not 664.12 have other assets sufficient to pay the claim in full, as 664.13 allowed, the personal representative or the court shall make, 664.14 execute, and deliver a lien on the property in the estate that 664.15 is exempt from the claim under subdivision 4 in favor of the 664.16 commissioner of human services on forms provided by the 664.17 commissioner to the county agency filing the claim. If the 664.18 estate pays a claim filed under this section in full from other 664.19 assets of the estate, no lien shall be filed against the 664.20 property described in subdivision 4. 664.21 (b) The lien shall be in an amount equal to the unpaid 664.22 balance of the allowed claim under this section remaining after 664.23 the estate has applied all other available assets of the estate 664.24 to pay the claim. The property exempt under subdivision 4 shall 664.25 not be sold, assigned, transferred, conveyed, encumbered, or 664.26 distributed until after the personal representative has 664.27 determined the estate has other assets sufficient to pay the 664.28 allowed claim in full, or until after the lien has been filed or 664.29 recorded. The lien shall bear interest as provided under 664.30 section 524.3-806, shall attach to the property it describes 664.31 upon filing or recording, and shall remain a lien on the real 664.32 property it describes for a period of 20 years from the date it 664.33 is filed or recorded. The lien shall be a disposition of the 664.34 claim sufficient to permit the estate to close. 664.35 (c) The state or county agency shall file or record the 664.36 lien in the office of the county recorder or registrar of titles 665.1 in each county in which any of the real property is located. 665.2 The department shall pay the filing fees. The lien need not be 665.3 attested, certified, or acknowledged as a condition of recording 665.4 or filing. The recorder or registrar of titles shall accept the 665.5 lien for filing or recording. 665.6 (d) The commissioner shall make no adjustment or recovery 665.7 under the lien until none of the persons listed in subdivision 4 665.8 are residing on the property or until the property is sold or 665.9 transferred. The estate or any owner of an interest in the 665.10 property that is or may be subject to the lien, or any other 665.11 interested party, may voluntarily pay off, settle, or otherwise 665.12 satisfy the claim secured or to be secured by the lien at any 665.13 time before or after the lien is filed or recorded. The 665.14 payoffs, settlements, and satisfactions shall be deemed to be 665.15 voluntary repayments of past medical assistance payments for the 665.16 benefit of the deceased recipient and neither the process of 665.17 settling the claim, the payment of the claim, or acceptance of a 665.18 payment shall constitute an adjustment or recovery that is 665.19 prohibited under this subdivision. 665.20 (e) A lien under this subdivision may be enforced or 665.21 foreclosed in the manner provided for by law for the enforcement 665.22 of judgment liens against real estate or by a foreclosure by 665.23 action under chapter 581. When the lien has been paid, 665.24 satisfied, or otherwise discharged, the claimant shall prepare 665.25 and file a release of lien at the claimant's expense. No action 665.26 to foreclose the lien shall be commenced unless the lien holder 665.27 has first given 30 days prior written notice to pay the lien to 665.28 the record owners of the property and the parties in possession 665.29 of the property subject to the lien. The notice shall: (1) 665.30 include the name, address, and telephone number of the lien 665.31 holder; (2) describe the lien; (3) give the amount of the lien; 665.32 (4) inform the owner or party in possession that payment of the 665.33 lien in full must be made to the lien holder within 30 days 665.34 after service of the notice or the lien holder may begin 665.35 proceedings to foreclose the lien; and (5) be served by personal 665.36 service, certified mail, return receipt requested, ordinary 666.1 first class mail, or by publishing it once in a newspaper of 666.2 general circulation in the county in which any part of the 666.3 property is located. Service shall be complete upon mailing or 666.4 publication. 666.5 (f) Upon filing or recording of a lien against a life 666.6 estate or joint tenancy interest under this subdivision, the 666.7 interest subject to the lien shall merge into the remainder 666.8 interest or the interest the decedent and others owned jointly, 666.9 effective on the date of recording and filing. The lien shall 666.10 attach to and run with the property to the extent of the 666.11 decedent's interest in the property at the time of the 666.12 decedent's death as determined under this section. 666.13 (g)(1) An affidavit may be provided by a personal 666.14 representative, at their discretion, stating the personal 666.15 representative has determined in good faith that a decedent 666.16 survived by a spouse or a person listed in subdivision 3, or by 666.17 a person listed in subdivision 4, or the decedent's predeceased 666.18 spouse did not receive any medical assistance giving rise to a 666.19 claim under this section, or that the real property described in 666.20 subdivision 4 is not needed to pay in full a claim arising under 666.21 this section. 666.22 (2) The affidavit shall: (i) describe the property and the 666.23 interest being extinguished; (ii) name the decedent and give the 666.24 date of death; (iii) state the facts listed in clause (1); (iv) 666.25 state that the affidavit is being filed to terminate the life 666.26 estate or joint tenancy interest created under this subdivision; 666.27 (v) be signed by the personal representative; and (vi) contain 666.28 any other information that the affiant deems appropriate. 666.29 (3) Except as provided in section 514.981, subdivision 6, 666.30 when the affidavit is filed or recorded, the life estate or 666.31 joint tenancy interest in real property that the affidavit 666.32 describes shall be terminated effective as of the date of filing 666.33 or recording. The termination shall be final and may not be set 666.34 aside for any reason. 666.35 [EFFECTIVE DATE.] This section takes effect on August 1, 666.36 2003, and applies to the estates of decedents who die on or 667.1 after that date. 667.2 Sec. 50. Minnesota Statutes 2002, section 256B.15, is 667.3 amended by adding a subdivision to read: 667.4 Subd. 1k. [FILING.] Any notice, lien, release, or other 667.5 document filed under subdivisions 1c to 1l, and any lien, 667.6 release of lien, or other documents relating to a lien filed 667.7 under subdivisions 1h, 1i, and 1j must be filed or recorded in 667.8 the office of the county recorder or registrar of titles, as 667.9 appropriate, in the county where the affected real property is 667.10 located. Notwithstanding section 386.77, the state or county 667.11 agency shall pay any applicable filing fee. An attestation, 667.12 certification, or acknowledgment is not required as a condition 667.13 of filing. If the property described in the filing is 667.14 registered property, the registrar of titles shall record the 667.15 filing on the certificate of title for each parcel of property 667.16 described in the filing. If the property described in the 667.17 filing is abstract property, the recorder shall file and index 667.18 the property in the county's grantor-grantee indexes and any 667.19 tract indexes the county maintains for each parcel of property 667.20 described in the filing. The recorder or registrar of titles 667.21 shall return the filed document to the party filing it at no 667.22 cost. If the party making the filing provides a duplicate copy 667.23 of the filing, the recorder or registrar of titles shall show 667.24 the recording or filing data on the copy and return it to the 667.25 party at no extra cost. 667.26 [EFFECTIVE DATE.] This section takes effect on August 1, 667.27 2003, and applies to the estates of decedents who die on or 667.28 after that date. 667.29 Sec. 51. Minnesota Statutes 2002, section 256B.15, 667.30 subdivision 3, is amended to read: 667.31 Subd. 3. [SURVIVING SPOUSE, MINOR, BLIND, OR DISABLED 667.32 CHILDREN.] If a decedentwhois survived by a spouse, or was 667.33 single,orwho wasthe surviving spouse of a married couple,and 667.34 is survived by a child who is under age 21 or blind or 667.35 permanently and totally disabled according to the supplemental 667.36 security income program criteria,noa claim shall be filed 668.1 against the estate according to this section. 668.2 [EFFECTIVE DATE.] This section is effective August 1, 2003, 668.3 and applies to decedents who die on or after that date. 668.4 Sec. 52. Minnesota Statutes 2002, section 256B.15, 668.5 subdivision 4, is amended to read: 668.6 Subd. 4. [OTHER SURVIVORS.] If the decedent who was single 668.7 or the surviving spouse of a married couple is survived by one 668.8 of the following persons, a claim exists against the estate in 668.9 an amount not to exceed the value of the nonhomestead property 668.10 included in the estate and the personal representative shall 668.11 make, execute, and deliver to the county agency a lien against 668.12 the homestead property in the estate for any unpaid balance of 668.13 the claim to the claimant as provided under this section: 668.14 (a) a sibling who resided in the decedent medical 668.15 assistance recipient's home at least one year before the 668.16 decedent's institutionalization and continuously since the date 668.17 of institutionalization; or 668.18 (b) a son or daughter or a grandchild who resided in the 668.19 decedent medical assistance recipient's home for at least two 668.20 years immediately before the parent's or grandparent's 668.21 institutionalization and continuously since the date of 668.22 institutionalization, and who establishes by a preponderance of 668.23 the evidence having provided care to the parent or grandparent 668.24 who received medical assistance, that the care was provided 668.25 before institutionalization, and that the care permitted the 668.26 parent or grandparent to reside at home rather than in an 668.27 institution. 668.28 [EFFECTIVE DATE.] This section is effective August 1, 2003, 668.29 and applies to decedents who die on or after that date. 668.30 Sec. 53. Minnesota Statutes 2002, section 256B.195, 668.31 subdivision 3, is amended to read: 668.32 Subd. 3. [PAYMENTS TO CERTAIN SAFETY NET PROVIDERS.] (a) 668.33 Effective July 15, 2001, the commissioner shall make the 668.34 following payments to the hospitals indicated after noon on the 668.35 15th of each month: 668.36 (1) to Hennepin County Medical Center, any federal matching 669.1 funds available to match the payments received by the medical 669.2 center under subdivision 2, to increase payments for medical 669.3 assistance admissions and to recognize higher medical assistance 669.4 costs in institutions that provide high levels of charity care; 669.5 and 669.6 (2) to Regions hospital, any federal matching funds 669.7 available to match the payments received by the hospital under 669.8 subdivision 2, to increase payments for medical assistance 669.9 admissions and to recognize higher medical assistance costs in 669.10 institutions that provide high levels of charity care. 669.11 (b) Effective July 15, 2001, the following percentages of 669.12 the transfers under subdivision 2 shall be retained by the 669.13 commissioner for deposit each month into the general fund: 669.14 (1) 18 percent, plus any federal matching funds, shall be 669.15 allocated for the following purposes: 669.16 (i) during the fiscal year beginning July 1, 2001, of the 669.17 amount available under this clause, 39.7 percent shall be 669.18 allocated to make increased hospital payments under section 669.19 256.969, subdivision 26; 34.2 percent shall be allocated to fund 669.20 the amounts due from small rural hospitals, as defined in 669.21 section 144.148, for overpayments under section 256.969, 669.22 subdivision 5a, resulting from a determination that medical 669.23 assistance and general assistance payments exceeded the charge 669.24 limit during the period from 1994 to 1997; and 26.1 percent 669.25 shall be allocated to the commissioner of health for rural 669.26 hospital capital improvement grants under section 144.148; and 669.27 (ii) during fiscal years beginning on or after July 1, 669.28 2002, of the amount available under this clause, 55 percent 669.29 shall be allocated to make increased hospital payments under 669.30 section 256.969, subdivision 26, and 45 percent shall be 669.31 allocated to the commissioner of health for rural hospital 669.32 capital improvement grants under section 144.148; and 669.33 (2) 11 percent shall be allocated to the commissioner of 669.34 health to fund community clinic grants under section 145.9268. 669.35 (c) This subdivision shall apply to fee-for-service 669.36 payments only and shall not increase capitation payments or 670.1 payments made based on average rates. 670.2 (d) Medical assistance rate or payment changes, including 670.3 those required to obtain federal financial participation under 670.4 section 62J.692, subdivision 8, shall precede the determination 670.5 of intergovernmental transfer amounts determined in this 670.6 subdivision. Participation in the intergovernmental transfer 670.7 program shall not result in the offset of any health care 670.8 provider's receipt of medical assistance payment increases other 670.9 than limits resulting from hospital-specific charge limits and 670.10 limits on disproportionate share hospital payments. 670.11 (e) Effective July 1, 2003, if the amount available for 670.12 allocation under paragraph (b) is greater than the amounts 670.13 available during March 2003, after any increase in 670.14 intergovernmental transfers and payments that result from 670.15 section 256.969, subdivision 3a, paragraph (c), are paid to the 670.16 general fund, any additional amounts available under this 670.17 subdivision after reimbursement of the transfers under 670.18 subdivision 2 shall be allocated to increase medical assistance 670.19 payments, subject to hospital-specific charge limits and limits 670.20 on disproportionate share hospital payments, as follows: 670.21 (1) if the payments under subdivision 5 are approved, the 670.22 amount shall be paid to the largest ten percent of hospitals as 670.23 measured by 2001 payments for medical assistance, general 670.24 assistance medical care, and MinnesotaCare in the nonstate 670.25 government hospital category. Payments shall be allocated 670.26 according to each hospital's proportionate share of the 2001 670.27 payments; or 670.28 (2) if the payments under subdivision 5 are not approved, 670.29 the amount shall be paid to the largest ten percent of hospitals 670.30 as measured by 2001 payments for medical assistance, general 670.31 assistance medical care, and MinnesotaCare in the nonstate 670.32 government category and to the largest ten percent of hospitals 670.33 as measured by payments for medical assistance, general 670.34 assistance medical care, and MinnesotaCare in the nongovernment 670.35 hospital category. Payments shall be allocated according to 670.36 each hospital's proportionate share of the 2001 payments in 671.1 their respective category of nonstate government and 671.2 nongovernment. The commissioner shall determine which hospitals 671.3 are in the nonstate government and nongovernment hospital 671.4 categories. 671.5 Sec. 54. Minnesota Statutes 2002, section 256B.195, 671.6 subdivision 5, is amended to read: 671.7 Subd. 5. [INCLUSION OF FAIRVIEW UNIVERSITY MEDICAL 671.8 CENTER.] (a) Upon federal approval of theinclusion of Fairview671.9University Medical Center in the nonstate government671.10categorypayments in paragraph (b), the commissioner shall 671.11 establish an intergovernmental transfer with the University of 671.12 Minnesota in an amount determined by the commissioner based on 671.13 theincrease in theamount of Medicare upper payment limitdue671.14solely to the inclusion of Fairview University Medical Center as671.15a nonstate government hospital and limitedavailable for 671.16 nongovernment hospitals adjusted by hospital-specific charge 671.17 limits and the amount available under the hospital-specific 671.18 disproportionate share limit. 671.19 (b) Effective July 1, 2003, the commissioner shall increase 671.20 payments for medical assistance admissions at Fairview 671.21 University Medical Center by 71 percent of the transfer plus any 671.22 federal matching payments on that amount, to increase payments 671.23 for medical assistance admissions and to recognize higher 671.24 medical assistance costs in institutions that provide high 671.25 levels of charity care.From this payment, Fairview University671.26Medical Center shall pay to the University of Minnesota the cost671.27of the transfer, on the same day the payment is received.671.28Eighteen percent of the transfer plus any federal matching671.29payments shall be used as specified in subdivision 3, paragraph671.30(b), clause (1). Payments under section 256.969, subdivision671.3126, may be increased above the 90 percent level specified in671.32that subdivision within the limits of additional funding671.33available under this subdivision. Eleven percent of the671.34transfer shall be used to increase the grants under section671.35145.9268Twenty-nine percent of the transfer plus federal 671.36 matching funds available as a result of the transfers in 672.1 subdivision 5 shall be paid to the largest ten percent of 672.2 hospitals in the nongovernment hospital category as measured by 672.3 2001 payments for medical assistance, general assistance medical 672.4 care, and MinnesotaCare. Payments shall be allocated according 672.5 to each hospital's proportionate share of the 2001 payments. 672.6 The commissioner shall determine which hospitals are in the 672.7 nongovernment hospital category. 672.8 Sec. 55. Minnesota Statutes 2002, section 256B.32, 672.9 subdivision 1, is amended to read: 672.10 Subdivision 1. [FACILITY FEE PAYMENT.] (a) The 672.11 commissioner shall establish a facility fee payment mechanism 672.12 that will pay a facility fee to all enrolled outpatient 672.13 hospitals for each emergency room or outpatient clinic visit 672.14 provided on or after July 1, 1989. This payment mechanism may 672.15 not result in an overall increase in outpatient payment rates. 672.16 This section does not apply to federally mandated maximum 672.17 payment limits, department approved program packages, or 672.18 services billed using a nonoutpatient hospital provider number. 672.19 (b) For fee-for-service services provided on or after July 672.20 1, 2002, the total payment, before third-party liability and 672.21 spenddown, made to hospitals for outpatient hospital facility 672.22 services is reduced by .5 percent from the current statutory 672.23 rates. 672.24 (c) In addition to the reduction in paragraph (b), the 672.25 total payment for fee-for-service services provided on or after 672.26 July 1, 2003, made to hospitals for outpatient hospital facility 672.27 services before third-party liability and spenddown, is reduced 672.28 five percent from the current statutory rates. Facilities 672.29 defined under section 256.969, subdivision 16, are excluded from 672.30 this paragraph. 672.31 Sec. 56. Minnesota Statutes 2002, section 256B.69, 672.32 subdivision 2, is amended to read: 672.33 Subd. 2. [DEFINITIONS.] For the purposes of this section, 672.34 the following terms have the meanings given. 672.35 (a) "Commissioner" means the commissioner of human services. 672.36 For the remainder of this section, the commissioner's 673.1 responsibilities for methods and policies for implementing the 673.2 project will be proposed by the project advisory committees and 673.3 approved by the commissioner. 673.4 (b) "Demonstration provider" means a health maintenance 673.5 organization, community integrated service network, or 673.6 accountable provider network authorized and operating under 673.7 chapter 62D, 62N, or 62T that participates in the demonstration 673.8 project according to criteria, standards, methods, and other 673.9 requirements established for the project and approved by the 673.10 commissioner. For purposes of this section, a county board, or 673.11 group of county boards operating under a joint powers agreement, 673.12 is considered a demonstration provider if the county or group of 673.13 county boards meets the requirements of section 256B.692. 673.14 Notwithstanding the above, Itasca county may continue to 673.15 participate as a demonstration provider until July 1, 2004. 673.16 (c) "Eligible individuals" means those persons eligible for 673.17 medical assistance benefits as defined in sections 256B.055, 673.18 256B.056, and 256B.06. 673.19 (d) "Limitation of choice" means suspending freedom of 673.20 choice while allowing eligible individuals to choose among the 673.21 demonstration providers. 673.22(e) This paragraph supersedes paragraph (c) as long as the673.23Minnesota health care reform waiver remains in effect. When the673.24waiver expires, this paragraph expires and the commissioner of673.25human services shall publish a notice in the State Register and673.26notify the revisor of statutes. "Eligible individuals" means673.27those persons eligible for medical assistance benefits as673.28defined in sections 256B.055, 256B.056, and 256B.06.673.29Notwithstanding sections 256B.055, 256B.056, and 256B.06, an673.30individual who becomes ineligible for the program because of673.31failure to submit income reports or recertification forms in a673.32timely manner, shall remain enrolled in the prepaid health plan673.33and shall remain eligible to receive medical assistance coverage673.34through the last day of the month following the month in which673.35the enrollee became ineligible for the medical assistance673.36program.674.1 [EFFECTIVE DATE.] This section is effective July 1, 2003, 674.2 or upon federal approval, whichever is later. 674.3 Sec. 57. Minnesota Statutes 2002, section 256B.69, 674.4 subdivision 4, is amended to read: 674.5 Subd. 4. [LIMITATION OF CHOICE.] (a) The commissioner 674.6 shall develop criteria to determine when limitation of choice 674.7 may be implemented in the experimental counties. The criteria 674.8 shall ensure that all eligible individuals in the county have 674.9 continuing access to the full range of medical assistance 674.10 services as specified in subdivision 6. 674.11 (b) The commissioner shall exempt the following persons 674.12 from participation in the project, in addition to those who do 674.13 not meet the criteria for limitation of choice: 674.14 (1) persons eligible for medical assistance according to 674.15 section 256B.055, subdivision 1; 674.16 (2) persons eligible for medical assistance due to 674.17 blindness or disability as determined by the social security 674.18 administration or the state medical review team, unless: 674.19 (i) they are 65 years of age or older; or 674.20 (ii) they reside in Itasca county or they reside in a 674.21 county in which the commissioner conducts a pilot project under 674.22 a waiver granted pursuant to section 1115 of the Social Security 674.23 Act; 674.24 (3) recipients who currently have private coverage through 674.25 a health maintenance organization; 674.26 (4) recipients who are eligible for medical assistance by 674.27 spending down excess income for medical expenses other than the 674.28 nursing facility per diem expense; 674.29 (5) recipients who receive benefits under the Refugee 674.30 Assistance Program, established under United States Code, title 674.31 8, section 1522(e); 674.32 (6) children who are both determined to be severely 674.33 emotionally disturbed and receiving case management services 674.34 according to section 256B.0625, subdivision 20; 674.35 (7) adults who are both determined to be seriously and 674.36 persistently mentally ill and received case management services 675.1 according to section 256B.0625, subdivision 20;and675.2 (8) persons eligible for medical assistance according to 675.3 section 256B.057, subdivision 10; and 675.4 (9) persons with access to cost-effective 675.5 employer-sponsored private health insurance or persons enrolled 675.6 in an individual health plan determined to be cost-effective 675.7 according to section 256B.0625, subdivision 15. 675.8 Children under age 21 who are in foster placement may enroll in 675.9 the project on an elective basis. Individuals excluded under 675.10 clauses (6) and (7) may choose to enroll on an elective 675.11 basis. The commissioner may enroll recipients in the prepaid 675.12 medical assistance program for seniors who are (1) age 65 and 675.13 over, and (2) eligible for medical assistance by spending down 675.14 excess income. 675.15 (c) The commissioner may allow persons with a one-month 675.16 spenddown who are otherwise eligible to enroll to voluntarily 675.17 enroll or remain enrolled, if they elect to prepay their monthly 675.18 spenddown to the state. 675.19 (d) The commissioner may require those individuals to 675.20 enroll in the prepaid medical assistance program who otherwise 675.21 would have been excluded under paragraph (b), clauses (1), (3), 675.22 and (8), and under Minnesota Rules, part 9500.1452, subpart 2, 675.23 items H, K, and L. 675.24 (e) Before limitation of choice is implemented, eligible 675.25 individuals shall be notified and after notification, shall be 675.26 allowed to choose only among demonstration providers. The 675.27 commissioner may assign an individual with private coverage 675.28 through a health maintenance organization, to the same health 675.29 maintenance organization for medical assistance coverage, if the 675.30 health maintenance organization is under contract for medical 675.31 assistance in the individual's county of residence. After 675.32 initially choosing a provider, the recipient is allowed to 675.33 change that choice only at specified times as allowed by the 675.34 commissioner. If a demonstration provider ends participation in 675.35 the project for any reason, a recipient enrolled with that 675.36 provider must select a new provider but may change providers 676.1 without cause once more within the first 60 days after 676.2 enrollment with the second provider. 676.3 Sec. 58. Minnesota Statutes 2002, section 256B.69, 676.4 subdivision 5, is amended to read: 676.5 Subd. 5. [PROSPECTIVE PER CAPITA PAYMENT.] The 676.6 commissioner shall establish the method and amount of payments 676.7 for services. The commissioner shall annually contract with 676.8 demonstration providers to provide services consistent with 676.9 these established methods and amounts for payment. 676.10 If allowed by the commissioner, a demonstration provider 676.11 may contract with an insurer, health care provider, nonprofit 676.12 health service plan corporation, or the commissioner, to provide 676.13 insurance or similar protection against the cost of care 676.14 provided by the demonstration provider or to provide coverage 676.15 against the risks incurred by demonstration providers under this 676.16 section. The recipients enrolled with a demonstration provider 676.17 are a permissible group under group insurance laws and chapter 676.18 62C, the Nonprofit Health Service Plan Corporations Act. Under 676.19 this type of contract, the insurer or corporation may make 676.20 benefit payments to a demonstration provider for services 676.21 rendered or to be rendered to a recipient. Any insurer or 676.22 nonprofit health service plan corporation licensed to do 676.23 business in this state is authorized to provide this insurance 676.24 or similar protection. 676.25 Payments to providers participating in the project are 676.26 exempt from the requirements of sections 256.966 and 256B.03, 676.27 subdivision 2. The commissioner shall complete development of 676.28 capitation rates for payments before delivery of services under 676.29 this section is begun. For payments made during calendar year 676.30 1990 and later years, the commissioner shall contract with an 676.31 independent actuary to establish prepayment rates. 676.32 By January 15, 1996, the commissioner shall report to the 676.33 legislature on the methodology used to allocate to participating 676.34 counties available administrative reimbursement for advocacy and 676.35 enrollment costs. The report shall reflect the commissioner's 676.36 judgment as to the adequacy of the funds made available and of 677.1 the methodology for equitable distribution of the funds. The 677.2 commissioner must involve participating counties in the 677.3 development of the report. 677.4 Beginning July 1, 2004, the commissioner may include 677.5 payments for elderly waiver services and 180 days of nursing 677.6 home care in capitation payments for the prepaid medical 677.7 assistance program for recipients age 65 and older. Payments 677.8 for elderly waiver services shall be made no earlier than the 677.9 month following the month in which services were received. 677.10 Sec. 59. Minnesota Statutes 2002, section 256B.69, 677.11 subdivision 5a, is amended to read: 677.12 Subd. 5a. [MANAGED CARE CONTRACTS.] (a) Managed care 677.13 contracts under this section and sections 256L.12 and 256D.03, 677.14 shall be entered into or renewed on a calendar year basis 677.15 beginning January 1, 1996. Managed care contracts which were in 677.16 effect on June 30, 1995, and set to renew on July 1, 1995, shall 677.17 be renewed for the period July 1, 1995 through December 31, 1995 677.18 at the same terms that were in effect on June 30, 1995. The 677.19 commissioner may issue separate contracts with requirements 677.20 specific to services to medical assistance recipients age 65 and 677.21 older. 677.22 (b) A prepaid health plan providing covered health services 677.23 for eligible persons pursuant to chapters 256B, 256D, and 256L, 677.24 is responsible for complying with the terms of its contract with 677.25 the commissioner. Requirements applicable to managed care 677.26 programs under chapters 256B, 256D, and 256L, established after 677.27 the effective date of a contract with the commissioner take 677.28 effect when the contract is next issued or renewed. 677.29 (c) Effective for services rendered on or after January 1, 677.30 2003, the commissioner shall withhold five percent of managed 677.31 care plan payments under this section for the prepaid medical 677.32 assistance and general assistance medical care programs pending 677.33 completion of performance targets. Each performance target must 677.34 be quantifiable, objective, measurable, and reasonably 677.35 attainable, except in the case of a performance target based on 677.36 a federal or state law or rule. Criteria for assessment of each 678.1 performance target must be outlined in writing prior to the 678.2 contract effective date. The withheld funds must be returned no 678.3 sooner than July of the following year if performance targets in 678.4 the contract are achieved. The commissioner may exclude special 678.5 demonstration projects under subdivision 23. A managed care 678.6 plan or a county-based purchasing plan under section 256B.692 678.7 may include as admitted assets under section 62D.044 any amount 678.8 withheld under this paragraph that is reasonably expected to be 678.9 returned. 678.10 [EFFECTIVE DATE.] This section is effective for services 678.11 rendered on or after July 1, 2003, except that the amendment to 678.12 paragraph (c) is effective for services rendered on or after 678.13 January 1, 2004. 678.14 Sec. 60. Minnesota Statutes 2002, section 256B.69, 678.15 subdivision 5c, is amended to read: 678.16 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) 678.17 Except as provided in paragraph (c), the commissioner of human 678.18 services shall transfer each year to the medical education and 678.19 research fund established under section 62J.692, the following: 678.20 (1) an amount equal to the reduction in the prepaid medical 678.21 assistance and prepaid general assistance medical care payments 678.22 as specified in this clause. Until January 1, 2002, the county 678.23 medical assistance and general assistance medical care 678.24 capitation base rate prior to plan specific adjustments and 678.25 after the regional rate adjustments under section 256B.69, 678.26 subdivision 5b, is reduced 6.3 percent for Hennepin county, two 678.27 percent for the remaining metropolitan counties, and no 678.28 reduction for nonmetropolitan Minnesota counties; and after 678.29 January 1, 2002, the county medical assistance and general 678.30 assistance medical care capitation base rate prior to plan 678.31 specific adjustments is reduced 6.3 percent for Hennepin county, 678.32 two percent for the remaining metropolitan counties, and 1.6 678.33 percent for nonmetropolitan Minnesota counties. Nursing 678.34 facility and elderly waiver payments and demonstration project 678.35 payments operating under subdivision 23 are excluded from this 678.36 reduction. The amount calculated under this clause shall not be 679.1 adjusted for periods already paid due to subsequent changes to 679.2 the capitation payments; 679.3 (2) beginning July 1,2001, $2,537,0002003, $2,157,000 679.4 from the capitation rates paid under this section plus any 679.5 federal matching funds on this amount; 679.6 (3) beginning July 1, 2002, an additional $12,700,000 from 679.7 the capitation rates paid under this section; and 679.8 (4) beginning July 1, 2003, an additional $4,700,000 from 679.9 the capitation rates paid under this section. 679.10 (b) This subdivision shall be effective upon approval of a 679.11 federal waiver which allows federal financial participation in 679.12 the medical education and research fund. 679.13 (c) Effective July 1, 2003, the amount reduced from the 679.14 prepaid general assistance medical care payments under paragraph 679.15 (a), clause (1), shall be transferred to the general fund. 679.16 Sec. 61. Minnesota Statutes 2002, section 256B.69, is 679.17 amended by adding a subdivision to read: 679.18 Subd. 5h. [PAYMENT REDUCTION.] In addition to the 679.19 reduction in subdivision 5g, the total payment made to managed 679.20 care plans under the medical assistance program is reduced 1.0 679.21 percent for services provided on or after October 1, 2003, and 679.22 an additional 1.0 percent for services provided on or after 679.23 January 1, 2004. This provision excludes payments for nursing 679.24 home services, home and community-based waivers, and payments to 679.25 demonstration projects for persons with disabilities. 679.26 Sec. 62. Minnesota Statutes 2002, section 256B.69, 679.27 subdivision 6a, is amended to read: 679.28 Subd. 6a. [NURSING HOME SERVICES.] (a) Notwithstanding 679.29 Minnesota Rules, part 9500.1457, subpart 1, item B, up to90180 679.30 days of nursing facility services as defined in section 679.31 256B.0625, subdivision 2, which are provided in a nursing 679.32 facility certified by the Minnesota department of health for 679.33 services provided and eligible for payment under Medicaid, shall 679.34 be covered under the prepaid medical assistance program for 679.35 individuals who are not residing in a nursing facility at the 679.36 time of enrollment in the prepaid medical assistance 680.1 program. The commissioner may develop a schedule to phase in 680.2 implementation of the 180-day provision. 680.3 (b) For individuals enrolled in the Minnesota senior health 680.4 options project authorized under subdivision 23, nursing 680.5 facility services shall be covered according to the terms and 680.6 conditions of the federal agreement governing that demonstration 680.7 project. 680.8 Sec. 63. Minnesota Statutes 2002, section 256B.69, 680.9 subdivision 6b, is amended to read: 680.10 Subd. 6b. [HOME AND COMMUNITY-BASED WAIVER SERVICES.] (a) 680.11 For individuals enrolled in the Minnesota senior health options 680.12 project authorized under subdivision 23, elderly waiver services 680.13 shall be covered according to the terms and conditions of the 680.14 federal agreement governing that demonstration project. 680.15 (b) For individuals under age 65 enrolled in demonstrations 680.16 authorized under subdivision 23, home and community-based waiver 680.17 services shall be covered according to the terms and conditions 680.18 of the federal agreement governing that demonstration project. 680.19 (c) Notwithstanding Minnesota Rules, part 9500.1457, 680.20 subpart 1, item C, elderly waiver services shall be covered 680.21 under the prepaid medical assistance program for all individuals 680.22 who are eligible according to section 256B.0915. The 680.23 commissioner may develop a schedule to phase in implementation 680.24 of these waiver services. 680.25 Sec. 64. Minnesota Statutes 2002, section 256B.69, is 680.26 amended by adding a subdivision to read: 680.27 Subd. 6d. [PRESCRIPTION DRUGS.] Effective January 1, 2004, 680.28 the commissioner may exclude or modify coverage for prescription 680.29 drugs from the prepaid managed care contracts entered into under 680.30 this section in order to increase savings to the state by 680.31 collecting additional prescription drug rebates. The contracts 680.32 must maintain incentives for the managed care plan to manage 680.33 drug costs and utilization and may require that the managed care 680.34 plans maintain an open drug formulary. In order to manage drug 680.35 costs and utilization, the contracts may authorize the managed 680.36 care plans to use preferred drug lists and prior authorization. 681.1 This subdivision is contingent on federal approval of the 681.2 managed care contract changes and the collection of additional 681.3 prescription drug rebates. 681.4 Sec. 65. Minnesota Statutes 2002, section 256B.69, 681.5 subdivision 8, is amended to read: 681.6 Subd. 8. [PREADMISSION SCREENING WAIVER.] Except as 681.7 applicable to the project's operation, the provisions of section 681.8 256B.0911 are waived for the purposes of this section for 681.9 recipients enrolled with demonstration providers or in the 681.10 prepaid medical assistance program for seniors. 681.11 Sec. 66. Minnesota Statutes 2002, section 256B.75, is 681.12 amended to read: 681.13 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 681.14 (a) For outpatient hospital facility fee payments for 681.15 services rendered on or after October 1, 1992, the commissioner 681.16 of human services shall pay the lower of (1) submitted charge, 681.17 or (2) 32 percent above the rate in effect on June 30, 1992, 681.18 except for those services for which there is a federal maximum 681.19 allowable payment. Effective for services rendered on or after 681.20 January 1, 2000, payment rates for nonsurgical outpatient 681.21 hospital facility fees and emergency room facility fees shall be 681.22 increased by eight percent over the rates in effect on December 681.23 31, 1999, except for those services for which there is a federal 681.24 maximum allowable payment. Services for which there is a 681.25 federal maximum allowable payment shall be paid at the lower of 681.26 (1) submitted charge, or (2) the federal maximum allowable 681.27 payment. Total aggregate payment for outpatient hospital 681.28 facility fee services shall not exceed the Medicare upper 681.29 limit. If it is determined that a provision of this section 681.30 conflicts with existing or future requirements of the United 681.31 States government with respect to federal financial 681.32 participation in medical assistance, the federal requirements 681.33 prevail. The commissioner may, in the aggregate, prospectively 681.34 reduce payment rates to avoid reduced federal financial 681.35 participation resulting from rates that are in excess of the 681.36 Medicare upper limitations. 682.1 (b) Notwithstanding paragraph (a), payment for outpatient, 682.2 emergency, and ambulatory surgery hospital facility fee services 682.3 for critical access hospitals designated under section 144.1483, 682.4 clause (11), shall be paid on a cost-based payment system that 682.5 is based on the cost-finding methods and allowable costs of the 682.6 Medicare program. 682.7 (c) Effective for services provided on or after July 1, 682.8 2003, rates that are based on the Medicare outpatient 682.9 prospective payment system shall be replaced by a budget neutral 682.10 prospective payment system that is derived using medical 682.11 assistance data. The commissioner shall provide a proposal to 682.12 the 2003 legislature to define and implement this provision. 682.13 (d) For fee-for-service services provided on or after July 682.14 1, 2002, the total payment, before third-party liability and 682.15 spenddown, made to hospitals for outpatient hospital facility 682.16 services is reduced by .5 percent from the current statutory 682.17 rate. 682.18 (e) In addition to the reduction in paragraph (d), the 682.19 total payment for fee-for-service services provided on or after 682.20 July 1, 2003, made to hospitals for outpatient hospital facility 682.21 services before third-party liability and spenddown, is reduced 682.22 five percent from the current statutory rates. Facilities 682.23 defined under section 256.969, subdivision 16, are excluded from 682.24 this paragraph. 682.25 Sec. 67. Minnesota Statutes 2002, section 256B.76, is 682.26 amended to read: 682.27 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 682.28 (a) Effective for services rendered on or after October 1, 682.29 1992, the commissioner shall make payments for physician 682.30 services as follows: 682.31 (1) payment for level one Centers for Medicare and Medicaid 682.32 Services' common procedural coding system codes titled "office 682.33 and other outpatient services," "preventive medicine new and 682.34 established patient," "delivery, antepartum, and postpartum 682.35 care," "critical care," cesarean delivery and pharmacologic 682.36 management provided to psychiatric patients, and level three 683.1 codes for enhanced services for prenatal high risk, shall be 683.2 paid at the lower of (i) submitted charges, or (ii) 25 percent 683.3 above the rate in effect on June 30, 1992. If the rate on any 683.4 procedure code within these categories is different than the 683.5 rate that would have been paid under the methodology in section 683.6 256B.74, subdivision 2, then the larger rate shall be paid; 683.7 (2) payments for all other services shall be paid at the 683.8 lower of (i) submitted charges, or (ii) 15.4 percent above the 683.9 rate in effect on June 30, 1992; 683.10 (3) all physician rates shall be converted from the 50th 683.11 percentile of 1982 to the 50th percentile of 1989, less the 683.12 percent in aggregate necessary to equal the above increases 683.13 except that payment rates for home health agency services shall 683.14 be the rates in effect on September 30, 1992; 683.15 (4) effective for services rendered on or after January 1, 683.16 2000, payment rates for physician and professional services 683.17 shall be increased by three percent over the rates in effect on 683.18 December 31, 1999, except for home health agency and family 683.19 planning agency services; and 683.20 (5) the increases in clause (4) shall be implemented 683.21 January 1, 2000, for managed care. 683.22 (b) Effective for services rendered on or after October 1, 683.23 1992, the commissioner shall make payments for dental services 683.24 as follows: 683.25 (1) dental services shall be paid at the lower of (i) 683.26 submitted charges, or (ii) 25 percent above the rate in effect 683.27 on June 30, 1992; 683.28 (2) dental rates shall be converted from the 50th 683.29 percentile of 1982 to the 50th percentile of 1989, less the 683.30 percent in aggregate necessary to equal the above increases; 683.31 (3) effective for services rendered on or after January 1, 683.32 2000, payment rates for dental services shall be increased by 683.33 three percent over the rates in effect on December 31, 1999; 683.34 (4) the commissioner shall award grants to community 683.35 clinics or other nonprofit community organizations, political 683.36 subdivisions, professional associations, or other organizations 684.1 that demonstrate the ability to provide dental services 684.2 effectively to public program recipients. Grants may be used to 684.3 fund the costs related to coordinating access for recipients, 684.4 developing and implementing patient care criteria, upgrading or 684.5 establishing new facilities, acquiring furnishings or equipment, 684.6 recruiting new providers, or other development costs that will 684.7 improve access to dental care in a region. In awarding grants, 684.8 the commissioner shall give priority to applicants that plan to 684.9 serve areas of the state in which the number of dental providers 684.10 is not currently sufficient to meet the needs of recipients of 684.11 public programs or uninsured individuals. The commissioner 684.12 shall consider the following in awarding the grants: 684.13 (i) potential to successfully increase access to an 684.14 underserved population; 684.15 (ii) the ability to raise matching funds; 684.16 (iii) the long-term viability of the project to improve 684.17 access beyond the period of initial funding; 684.18 (iv) the efficiency in the use of the funding; and 684.19 (v) the experience of the proposers in providing services 684.20 to the target population. 684.21 The commissioner shall monitor the grants and may terminate 684.22 a grant if the grantee does not increase dental access for 684.23 public program recipients. The commissioner shall consider 684.24 grants for the following: 684.25 (i) implementation of new programs or continued expansion 684.26 of current access programs that have demonstrated success in 684.27 providing dental services in underserved areas; 684.28 (ii) a pilot program for utilizing hygienists outside of a 684.29 traditional dental office to provide dental hygiene services; 684.30 and 684.31 (iii) a program that organizes a network of volunteer 684.32 dentists, establishes a system to refer eligible individuals to 684.33 volunteer dentists, and through that network provides donated 684.34 dental care services to public program recipients or uninsured 684.35 individuals; 684.36 (5) beginning October 1, 1999, the payment for tooth 685.1 sealants and fluoride treatments shall be the lower of (i) 685.2 submitted charge, or (ii) 80 percent of median 1997 charges; 685.3 (6) the increases listed in clauses (3) and (5) shall be 685.4 implemented January 1, 2000, for managed care; and 685.5 (7) effective for services provided on or after January 1, 685.6 2002, payment for diagnostic examinations and dental x-rays 685.7 provided to children under age 21 shall be the lower of (i) the 685.8 submitted charge, or (ii) 85 percent of median 1999 charges. 685.9 (c) Effective for dental services rendered on or after 685.10 January 1, 2002, the commissioner may, within the limits of 685.11 available appropriation, increase reimbursements to dentists and 685.12 dental clinics deemed by the commissioner to be critical access 685.13 dental providers. Reimbursement to a critical access dental 685.14 provider may be increased by not more than 50 percent above the 685.15 reimbursement rate that would otherwise be paid to the 685.16 provider. Payments to health plan companies shall be adjusted 685.17 to reflect increased reimbursements to critical access dental 685.18 providers as approved by the commissioner. In determining which 685.19 dentists and dental clinics shall be deemed critical access 685.20 dental providers, the commissioner shall review: 685.21 (1) the utilization rate in the service area in which the 685.22 dentist or dental clinic operates for dental services to 685.23 patients covered by medical assistance, general assistance 685.24 medical care, or MinnesotaCare as their primary source of 685.25 coverage; 685.26 (2) the level of services provided by the dentist or dental 685.27 clinic to patients covered by medical assistance, general 685.28 assistance medical care, or MinnesotaCare as their primary 685.29 source of coverage; and 685.30 (3) whether the level of services provided by the dentist 685.31 or dental clinic is critical to maintaining adequate levels of 685.32 patient access within the service area. 685.33 In the absence of a critical access dental provider in a service 685.34 area, the commissioner may designate a dentist or dental clinic 685.35 as a critical access dental provider if the dentist or dental 685.36 clinic is willing to provide care to patients covered by medical 686.1 assistance, general assistance medical care, or MinnesotaCare at 686.2 a level which significantly increases access to dental care in 686.3 the service area. 686.4 (d) Effective July 1, 2001, the medical assistance rates 686.5 for outpatient mental health services provided by an entity that 686.6 operates: 686.7 (1) a Medicare-certified comprehensive outpatient 686.8 rehabilitation facility; and 686.9 (2) a facility that was certified prior to January 1, 1993, 686.10 with at least 33 percent of the clients receiving rehabilitation 686.11 services in the most recent calendar year who are medical 686.12 assistance recipients, will be increased by 38 percent, when 686.13 those services are provided within the comprehensive outpatient 686.14 rehabilitation facility and provided to residents of nursing 686.15 facilities owned by the entity. 686.16 (e) An entity that operates both a Medicare certified 686.17 comprehensive outpatient rehabilitation facility and a facility 686.18 which was certified prior to January 1, 1993, that is licensed 686.19 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 686.20 whom at least 33 percent of the clients receiving rehabilitation 686.21 services in the most recent calendar year are medical assistance 686.22 recipients, shall be reimbursed by the commissioner for 686.23 rehabilitation services at rates that are 38 percent greater 686.24 than the maximum reimbursement rate allowed under paragraph (a), 686.25 clause (2), when those services are (1) provided within the 686.26 comprehensive outpatient rehabilitation facility and (2) 686.27 provided to residents of nursing facilities owned by the entity. 686.28 (f) Effective for services rendered on or after January 1, 686.29 2007, the commissioner shall make payments for physician and 686.30 professional services based on the Medicare relative value units 686.31 (RVUs). This change shall be budget neutral and the cost of 686.32 implementing RVUs will be incorporated in the established 686.33 conversion factor. 686.34 Sec. 68. Minnesota Statutes 2002, section 256D.03, 686.35 subdivision 3, is amended to read: 686.36 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 687.1 (a) General assistance medical care may be paid for any person 687.2 who is not eligible for medical assistance under chapter 256B, 687.3 including eligibility for medical assistance based on a 687.4 spenddown of excess income according to section 256B.056, 687.5 subdivision 5, or MinnesotaCare as defined in paragraph (b), 687.6 except as provided in paragraph (c);, and: 687.7 (1) who is receiving assistance under section 256D.05, 687.8 except for families with children who are eligible under 687.9 Minnesota family investment program (MFIP), or who is having a 687.10 payment made on the person's behalf under sections 256I.01 to 687.11 256I.06, or who resides in group residential housing as defined687.12in chapter 256I and can meet a spenddown using the cost of687.13remedial services received through group residential housing; or 687.14 (2)(i)who is a resident of Minnesota; and 687.15 (i) who has gross countable income not in excess of 75 687.16 percent of the federal poverty guidelines for the family size, 687.17 using a six-month budget period and whose equity in assets is 687.18 not in excess of $1,000 per assistance unit. Exempt assets, the 687.19 reduction of excess assets, and the waiver of excess assets must 687.20 conform to the medical assistance program inchapter687.21256Bsection 256B.056, subdivision 3, with the following 687.22 exception: the maximum amount of undistributed funds in a trust 687.23 that could be distributed to or on behalf of the beneficiary by 687.24 the trustee, assuming the full exercise of the trustee's 687.25 discretion under the terms of the trust, must be applied toward 687.26 the asset maximum;andor 687.27 (ii) who has gross countable incomenot in excessabove 75 687.28 percent ofthe assistance standards established in section687.29256B.056, subdivision 5c, paragraph (b), or whose excess income687.30is spent down to that standard using a six-month budget period.687.31The method for calculating earned income disregards and687.32deductions for a person who resides with a dependent child under687.33age 21 shall follow the AFDC income disregard and deductions in687.34effect under the July 16, 1996, AFDC state plan. The earned687.35income and work expense deductions for a person who does not687.36reside with a dependent child under age 21 shall be the same as688.1the method used to determine eligibility for a person under688.2section 256D.06, subdivision 1, except the disregard of the688.3first $50 of earned income is not allowed;688.4(3) who would be eligible for medical assistance except688.5that the person resides in a facility that is determined by the688.6commissioner or the federal Centers for Medicare and Medicaid688.7Services to be an institution for mental diseases; or688.8(4) who is ineligible for medical assistance under chapter688.9256B or general assistance medical care under any other688.10provision of this section, and is receiving care and688.11rehabilitation services from a nonprofit center established to688.12serve victims of torture. These individuals are eligible for688.13general assistance medical care only for the period during which688.14they are receiving services from the center. During this period688.15of eligibility, individuals eligible under this clause shall not688.16be required to participate in prepaid general assistance medical688.17carethe federal poverty guidelines but not in excess of 175 688.18 percent of the federal poverty guidelines for the family size, 688.19 using a six-month budget period, whose equity in assets is not 688.20 in excess of the limits in section 256B.056, subdivision 3c, and 688.21 who applies during an inpatient hospitalization. 688.22 (b)Beginning January 1, 2000,General assistance medical 688.23 care may not be paid for applicants or recipients who meet all 688.24 eligibility requirements of MinnesotaCare as defined in sections 688.25 256L.01 to 256L.16, and are:688.26(i)adults with dependent children under 21 whose gross 688.27 family income is equal to or less than 275 percent of the 688.28 federal poverty guidelines; or. 688.29(ii) adults without children with earned income and whose688.30family gross income is between 75 percent of the federal poverty688.31guidelines and the amount set by section 256L.04, subdivision 7,688.32shall be terminated from general assistance medical care upon688.33enrollment in MinnesotaCare. Earned income is deemed available688.34to family members as defined in section 256D.02, subdivision 8.688.35 (c) Forservices rendered on or after July 1, 1997,688.36eligibility is limited to one month prior to application if the689.1person is determined eligible in the prior monthapplications 689.2 received on or after October 1, 2003, eligibility may begin no 689.3 earlier than the date of application. For individuals eligible 689.4 under paragraph (a), clause (2), item (i), a redetermination of 689.5 eligibility must occur every 12 months. Individuals are 689.6 eligible under paragraph (a), clause (2), item (ii), only during 689.7 inpatient hospitalization but may reapply if there is a 689.8 subsequent period of inpatient hospitalization. Beginning 689.9 January 1, 2000, Minnesota health care program applications 689.10 completed by recipients and applicants who are persons described 689.11 in paragraph (b), may be returned to the county agency to be 689.12 forwarded to the department of human services or sent directly 689.13 to the department of human services for enrollment in 689.14 MinnesotaCare. If all other eligibility requirements of this 689.15 subdivision are met, eligibility for general assistance medical 689.16 care shall be available in any month during which a 689.17 MinnesotaCare eligibility determination and enrollment are 689.18 pending. Upon notification of eligibility for MinnesotaCare, 689.19 notice of termination for eligibility for general assistance 689.20 medical care shall be sent to an applicant or recipient. If all 689.21 other eligibility requirements of this subdivision are met, 689.22 eligibility for general assistance medical care shall be 689.23 available until enrollment in MinnesotaCare subject to the 689.24 provisions of paragraph (e). 689.25 (d) The date of an initial Minnesota health care program 689.26 application necessary to begin a determination of eligibility 689.27 shall be the date the applicant has provided a name, address, 689.28 and social security number, signed and dated, to the county 689.29 agency or the department of human services. If the applicant is 689.30 unable to providean initial applicationa name, address, social 689.31 security number, and signature when health care is delivered due 689.32 to a medical condition or disability, a health care provider may 689.33 act onthe person'san applicant's behalf tocomplete the689.34 establish the date of an initial Minnesota health care program 689.35 application by providing the county agency or department of 689.36 human services with provider identification and a temporary 690.1 unique identifier for the applicant. The applicant must 690.2 complete the remainder of the application and provide necessary 690.3 verification before eligibility can be determined. The county 690.4 agency must assist the applicant in obtaining verification if 690.5 necessary.On the basis of information provided on the690.6completed application, an applicant who meets the following690.7criteria shall be determined eligible beginning in the month of690.8application:690.9(1) has gross income less than 90 percent of the applicable690.10income standard;690.11(2) has liquid assets that total within $300 of the asset690.12standard;690.13(3) does not reside in a long-term care facility; and690.14(4) meets all other eligibility requirements.690.15The applicant must provide all required verifications within 30690.16days' notice of the eligibility determination or eligibility690.17shall be terminated.690.18 (e) County agencies are authorized to use all automated 690.19 databases containing information regarding recipients' or 690.20 applicants' income in order to determine eligibility for general 690.21 assistance medical care or MinnesotaCare. Such use shall be 690.22 considered sufficient in order to determine eligibility and 690.23 premium payments by the county agency. 690.24 (f) General assistance medical care is not available for a 690.25 person in a correctional facility unless the person is detained 690.26 by law for less than one year in a county correctional or 690.27 detention facility as a person accused or convicted of a crime, 690.28 or admitted as an inpatient to a hospital on a criminal hold 690.29 order, and the person is a recipient of general assistance 690.30 medical care at the time the person is detained by law or 690.31 admitted on a criminal hold order and as long as the person 690.32 continues to meet other eligibility requirements of this 690.33 subdivision. 690.34 (g) General assistance medical care is not available for 690.35 applicants or recipients who do not cooperate with the county 690.36 agency to meet the requirements of medical assistance.General691.1assistance medical care is limited to payment of emergency691.2services only for applicants or recipients as described in691.3paragraph (b), whose MinnesotaCare coverage is denied or691.4terminated for nonpayment of premiums as required by sections691.5256L.06 and 256L.07.691.6 (h) In determining the amount of assets of an 691.7 individual eligible under paragraph (a), clause (2), item (i), 691.8 there shall be included any asset or interest in an asset, 691.9 including an asset excluded under paragraph (a), that was given 691.10 away, sold, or disposed of for less than fair market value 691.11 within the 60 months preceding application for general 691.12 assistance medical care or during the period of eligibility. 691.13 Any transfer described in this paragraph shall be presumed to 691.14 have been for the purpose of establishing eligibility for 691.15 general assistance medical care, unless the individual furnishes 691.16 convincing evidence to establish that the transaction was 691.17 exclusively for another purpose. For purposes of this 691.18 paragraph, the value of the asset or interest shall be the fair 691.19 market value at the time it was given away, sold, or disposed 691.20 of, less the amount of compensation received. For any 691.21 uncompensated transfer, the number of months of ineligibility, 691.22 including partial months, shall be calculated by dividing the 691.23 uncompensated transfer amount by the average monthly per person 691.24 payment made by the medical assistance program to skilled 691.25 nursing facilities for the previous calendar year. The 691.26 individual shall remain ineligible until this fixed period has 691.27 expired. The period of ineligibility may exceed 30 months, and 691.28 a reapplication for benefits after 30 months from the date of 691.29 the transfer shall not result in eligibility unless and until 691.30 the period of ineligibility has expired. The period of 691.31 ineligibility begins in the month the transfer was reported to 691.32 the county agency, or if the transfer was not reported, the 691.33 month in which the county agency discovered the transfer, 691.34 whichever comes first. For applicants, the period of 691.35 ineligibility begins on the date of the first approved 691.36 application. 692.1 (i) When determining eligibility for any state benefits 692.2 under this subdivision, the income and resources of all 692.3 noncitizens shall be deemed to include their sponsor's income 692.4 and resources as defined in the Personal Responsibility and Work 692.5 Opportunity Reconciliation Act of 1996, title IV, Public Law 692.6 Number 104-193, sections 421 and 422, and subsequently set out 692.7 in federal rules. 692.8 (j)(1) AnUndocumentednoncitizen or a nonimmigrant692.9isnoncitizens and nonimmigrants are ineligible for general 692.10 assistance medical careother than emergency services, except an 692.11 individual eligible under paragraph (a), clause (4), remains 692.12 eligible through September 30, 2003. For purposes of this 692.13 subdivision, a nonimmigrant is an individual in one or more of 692.14 the classes listed in United States Code, title 8, section 692.15 1101(a)(15), and an undocumented noncitizen is an individual who 692.16 resides in the United States without the approval or 692.17 acquiescence of the Immigration and Naturalization Service. 692.18(2) This paragraph does not apply to a child under age 18,692.19to a Cuban or Haitian entrant as defined in Public Law Number692.2096-422, section 501(e)(1) or (2)(a), or to a noncitizen who is692.21aged, blind, or disabled as defined in Code of Federal692.22Regulations, title 42, sections 435.520, 435.530, 435.531,692.23435.540, and 435.541, or effective October 1, 1998, to an692.24individual eligible for general assistance medical care under692.25paragraph (a), clause (4), who cooperates with the Immigration692.26and Naturalization Service to pursue any applicable immigration692.27status, including citizenship, that would qualify the individual692.28for medical assistance with federal financial participation.692.29 (k)For purposes of paragraphs (g) and (j), "emergency692.30services" has the meaning given in Code of Federal Regulations,692.31title 42, section 440.255(b)(1), except that it also means692.32services rendered because of suspected or actual pesticide692.33poisoning.692.34(l)Notwithstanding any other provision of law, a 692.35 noncitizen who is ineligible for medical assistance due to the 692.36 deeming of a sponsor's income and resources, is ineligible for 693.1 general assistance medical care. 693.2 (l) Effective July 1, 2003, general assistance medical care 693.3 emergency services end. 693.4 [EFFECTIVE DATE.] (a) The amendments to paragraph (a), 693.5 clauses (1) to (4), and paragraphs (b), (c), and (h), are 693.6 effective October 1, 2003. For applications processed within 693.7 one calendar month prior to the effective date, eligibility will 693.8 be determined by applying the income standards and methodologies 693.9 in effect prior to the effective date for any months in the 693.10 six-month budget period before that date and the income 693.11 standards and methodologies in effect on the effective date for 693.12 any months in the six-month budget period on or after that 693.13 date. The income standards for each month will be added 693.14 together and compared to the applicant's total countable income 693.15 for the six-month budget period to determine eligibility. 693.16 (b) The amendments to paragraphs (d), (g), (j), and (k), 693.17 are effective July 1, 2003. 693.18 Sec. 69. Minnesota Statutes 2002, section 256D.03, 693.19 subdivision 4, is amended to read: 693.20 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] 693.21 (a)(i) For a person who is eligible under subdivision 3, 693.22 paragraph (a), clause(3)(2), item (i), general assistance 693.23 medical care covers, except as provided in paragraph (c): 693.24 (1) inpatient hospital services; 693.25 (2) outpatient hospital services; 693.26 (3) services provided by Medicare certified rehabilitation 693.27 agencies; 693.28 (4) prescription drugs and other products recommended 693.29 through the process established in section 256B.0625, 693.30 subdivision 13; 693.31 (5) equipment necessary to administer insulin and 693.32 diagnostic supplies and equipment for diabetics to monitor blood 693.33 sugar level; 693.34 (6) eyeglasses and eye examinations provided by a physician 693.35 or optometrist; 693.36 (7) hearing aids; 694.1 (8) prosthetic devices; 694.2 (9) laboratory and X-ray services; 694.3 (10) physician's services; 694.4 (11) medical transportation except special transportation; 694.5 (12) chiropractic services as covered under the medical 694.6 assistance program; 694.7 (13) podiatric services; 694.8 (14) dental services and dentures, subject to the 694.9 limitations specified in section 256B.0625, subdivision 9; 694.10 (15) outpatient services provided by a mental health center 694.11 or clinic that is under contract with the county board and is 694.12 established under section 245.62; 694.13 (16) day treatment services for mental illness provided 694.14 under contract with the county board; 694.15 (17) prescribed medications for persons who have been 694.16 diagnosed as mentally ill as necessary to prevent more 694.17 restrictive institutionalization; 694.18 (18) psychological services, medical supplies and 694.19 equipment, and Medicare premiums, coinsurance and deductible 694.20 payments; 694.21 (19) medical equipment not specifically listed in this 694.22 paragraph when the use of the equipment will prevent the need 694.23 for costlier services that are reimbursable under this 694.24 subdivision; 694.25 (20) services performed by a certified pediatric nurse 694.26 practitioner, a certified family nurse practitioner, a certified 694.27 adult nurse practitioner, a certified obstetric/gynecological 694.28 nurse practitioner, a certified neonatal nurse practitioner, or 694.29 a certified geriatric nurse practitioner in independent 694.30 practice, if (1) the service is otherwise covered under this 694.31 chapter as a physician service, (2) the service provided on an 694.32 inpatient basis is not included as part of the cost for 694.33 inpatient services included in the operating payment rate, and 694.34 (3) the service is within the scope of practice of the nurse 694.35 practitioner's license as a registered nurse, as defined in 694.36 section 148.171; 695.1 (21) services of a certified public health nurse or a 695.2 registered nurse practicing in a public health nursing clinic 695.3 that is a department of, or that operates under the direct 695.4 authority of, a unit of government, if the service is within the 695.5 scope of practice of the public health nurse's license as a 695.6 registered nurse, as defined in section 148.171; and 695.7 (22) telemedicine consultations, to the extent they are 695.8 covered under section 256B.0625, subdivision 3b. 695.9 (ii) Effective October 1, 2003, for a person who is 695.10 eligible under subdivision 3, paragraph (a), clause (2), item 695.11 (ii), general assistance medical care coverage is limited to 695.12 inpatient hospital services, including physician services 695.13 provided during the inpatient hospital stay. A $1,000 695.14 deductible is required for each inpatient hospitalization. 695.15 (b)Except as provided in paragraph (c), for a recipient695.16who is eligible under subdivision 3, paragraph (a), clause (1)695.17or (2), general assistance medical care covers the services695.18listed in paragraph (a) with the exception of special695.19transportation services.695.20(c)Gender reassignment surgery and related services are 695.21 not covered services under this subdivision unless the 695.22 individual began receiving gender reassignment services prior to 695.23 July 1, 1995. 695.24(d)(c) In order to contain costs, the commissioner of 695.25 human services shall select vendors of medical care who can 695.26 provide the most economical care consistent with high medical 695.27 standards and shall where possible contract with organizations 695.28 on a prepaid capitation basis to provide these services. The 695.29 commissioner shall consider proposals by counties and vendors 695.30 for prepaid health plans, competitive bidding programs, block 695.31 grants, or other vendor payment mechanisms designed to provide 695.32 services in an economical manner or to control utilization, with 695.33 safeguards to ensure that necessary services are provided. 695.34 Before implementing prepaid programs in counties with a county 695.35 operated or affiliated public teaching hospital or a hospital or 695.36 clinic operated by the University of Minnesota, the commissioner 696.1 shall consider the risks the prepaid program creates for the 696.2 hospital and allow the county or hospital the opportunity to 696.3 participate in the program in a manner that reflects the risk of 696.4 adverse selection and the nature of the patients served by the 696.5 hospital, provided the terms of participation in the program are 696.6 competitive with the terms of other participants considering the 696.7 nature of the population served. Payment for services provided 696.8 pursuant to this subdivision shall be as provided to medical 696.9 assistance vendors of these services under sections 256B.02, 696.10 subdivision 8, and 256B.0625. For payments made during fiscal 696.11 year 1990 and later years, the commissioner shall consult with 696.12 an independent actuary in establishing prepayment rates, but 696.13 shall retain final control over the rate methodology. 696.14Notwithstanding the provisions of subdivision 3, an individual696.15who becomes ineligible for general assistance medical care696.16because of failure to submit income reports or recertification696.17forms in a timely manner, shall remain enrolled in the prepaid696.18health plan and shall remain eligible for general assistance696.19medical care coverage through the last day of the month in which696.20the enrollee became ineligible for general assistance medical696.21care.696.22(e) There shall be no copayment required of any recipient696.23of benefits for any services provided under this subdivision.696.24A hospital receiving a reduced payment as a result of this696.25section may apply the unpaid balance toward satisfaction of the696.26hospital's bad debts.696.27 (d) Recipients eligible under subdivision 3, paragraph (a), 696.28 clause (2), item (i), shall pay the following co-payments for 696.29 services provided on or after October 1, 2003: 696.30 (1) $3 per nonpreventive visit. For purposes of this 696.31 subdivision, a visit means an episode of service which is 696.32 required because of a recipient's symptoms, diagnosis, or 696.33 established illness, and which is delivered in an ambulatory 696.34 setting by a physician or physician ancillary, chiropractor, 696.35 podiatrist, nurse midwife, mental health professional, advanced 696.36 practice nurse, physical therapist, occupational therapist, 697.1 speech therapist, audiologist, optician, or optometrist; 697.2 (2) $25 for eyeglasses; 697.3 (3) $25 for nonemergency visits to a hospital-based 697.4 emergency room; 697.5 (4) $3 per brand-name drug prescription and $1 per generic 697.6 drug prescription, subject to a $20 per month maximum for 697.7 prescription drug co-payments. No co-payments shall apply to 697.8 antipsychotic drugs when used for the treatment of mental 697.9 illness; and 697.10 (5) 50 percent coinsurance on basic restorative dental 697.11 services. 697.12 (e) Recipients of general assistance medical care are 697.13 responsible for all co-payments in this subdivision. The 697.14 general assistance medical care reimbursement to the provider 697.15 shall be reduced by the amount of the co-payment, except that 697.16 reimbursement for prescription drugs shall not be reduced once a 697.17 recipient has reached the $20 per month maximum for prescription 697.18 drug co-payments. The provider collects the co-payment from the 697.19 recipient. Providers may not deny services to recipients who 697.20 are unable to pay the co-payment, except as provided in 697.21 paragraph (f). 697.22 (f) If it is the routine business practice of a provider to 697.23 refuse service to an individual with uncollected debt, the 697.24 provider may include uncollected co-payments under this 697.25 section. A provider must give advance notice to a recipient 697.26 with uncollected debt before services can be denied. 697.27(f)(g) Any county may, from its own resources, provide 697.28 medical payments for which state payments are not made. 697.29(g)(h) Chemical dependency services that are reimbursed 697.30 under chapter 254B must not be reimbursed under general 697.31 assistance medical care. 697.32(h)(i) The maximum payment for new vendors enrolled in the 697.33 general assistance medical care program after the base year 697.34 shall be determined from the average usual and customary charge 697.35 of the same vendor type enrolled in the base year. 697.36(i)(j) The conditions of payment for services under this 698.1 subdivision are the same as the conditions specified in rules 698.2 adopted under chapter 256B governing the medical assistance 698.3 program, unless otherwise provided by statute or rule. 698.4 (k) Inpatient and outpatient payments shall be reduced by 698.5 five percent, effective July 1, 2003. This reduction is in 698.6 addition to the five percent reduction effective July 1, 2003, 698.7 and incorporated by reference in paragraph (i). 698.8 (l) Payments for all other health services except 698.9 inpatient, outpatient, and pharmacy services shall be reduced by 698.10 five percent, effective July 1, 2003. 698.11 (m) Payments to managed care plans shall be reduced by five 698.12 percent for services provided on or after October 1, 2003. 698.13 (n) A hospital receiving a reduced payment as a result of 698.14 this section may apply the unpaid balance toward satisfaction of 698.15 the hospital's bad debts. 698.16 [EFFECTIVE DATE.] This section is effective October 1, 698.17 2003, except that paragraph (c) is effective July 1, 2003. 698.18 Sec. 70. Minnesota Statutes 2002, section 256G.05, 698.19 subdivision 2, is amended to read: 698.20 Subd. 2. [NON-MINNESOTA RESIDENTS.] State residence is not 698.21 required for receiving emergency assistance in the Minnesota 698.22 supplemental aid program. The receipt of emergency assistance 698.23 must not be used as a factor in determining county or state 698.24 residence.Non-Minnesota residents are not eligible for698.25emergency general assistance medical care, except emergency698.26hospital services, and professional services incident to the698.27hospital services, for the treatment of acute trauma resulting698.28from an accident occurring in Minnesota. To be eligible under698.29this subdivision a non-Minnesota resident must verify that they698.30are not eligible for coverage under any other health care698.31program, including coverage from a program in their state of698.32residence.698.33 [EFFECTIVE DATE.] This section is effective July 1, 2003. 698.34 Sec. 71. Minnesota Statutes 2002, section 256L.03, 698.35 subdivision 1, is amended to read: 698.36 Subdivision 1. [COVERED HEALTH SERVICES.] For individuals 699.1 under section 256L.04, subdivision 7, with income no greater 699.2 than 75 percent of the federal poverty guidelines or for 699.3 families with children under section 256L.04, subdivision 1, all 699.4 subdivisions of this section apply. "Covered health services" 699.5 means the health services reimbursed under chapter 256B, with 699.6 the exception of inpatient hospital services, special education 699.7 services, private duty nursing services, adult dental care 699.8 services other thanpreventive servicesservices covered under 699.9 section 256B.0625, subdivision 9, paragraph (b), orthodontic 699.10 services, nonemergency medical transportation services, personal 699.11 care assistant and case management services, nursing home or 699.12 intermediate care facilities services, inpatient mental health 699.13 services, and chemical dependency services.Effective July 1,699.141998, adult dental care for nonpreventive services with the699.15exception of orthodontic services is available to persons who699.16qualify under section 256L.04, subdivisions 1 to 7, with family699.17gross income equal to or less than 175 percent of the federal699.18poverty guidelines.Outpatient mental health services covered 699.19 under the MinnesotaCare program are limited to diagnostic 699.20 assessments, psychological testing, explanation of findings, 699.21 medication management by a physician, day treatment, partial 699.22 hospitalization, and individual, family, and group psychotherapy. 699.23 No public funds shall be used for coverage of abortion 699.24 under MinnesotaCare except where the life of the female would be 699.25 endangered or substantial and irreversible impairment of a major 699.26 bodily function would result if the fetus were carried to term; 699.27 or where the pregnancy is the result of rape or incest. 699.28 Covered health services shall be expanded as provided in 699.29 this section. 699.30 [EFFECTIVE DATE.] This section is effective October 1, 2003. 699.31 Sec. 72. [256L.035] [LIMITED BENEFITS COVERAGE FOR CERTAIN 699.32 SINGLE ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.] 699.33 (a) "Covered health services" for individuals under section 699.34 256L.04, subdivision 7, with income above 75 percent, but not 699.35 exceeding 175 percent, of the federal poverty guideline means: 699.36 (1) inpatient hospitalization benefits with a ten percent 700.1 co-payment up to $1,000 and subject to an annual limitation of 700.2 $10,000; 700.3 (2) physician services provided during an inpatient stay; 700.4 and 700.5 (3) physician services not provided during an inpatient 700.6 stay, outpatient hospital services, chiropractic services, lab 700.7 and diagnostic services, and prescription drugs, subject to an 700.8 aggregate cap of $2,000 per calendar year and the following 700.9 co-payments: 700.10 (i) $50 co-pay per emergency room visit; 700.11 (ii) $3 co-pay per prescription drug; and 700.12 (iii) $5 co-pay per nonpreventive physician visit. 700.13 For purposes of this subdivision, "a visit" means an 700.14 episode of service which is required because of a recipient's 700.15 symptoms, diagnosis, or established illness, and which is 700.16 delivered in an ambulatory setting by a physician or physician 700.17 ancillary. 700.18 Enrollees are responsible for all co-payments in this 700.19 subdivision. 700.20 (b) The November 2006 MinnesotaCare forecast for the 700.21 biennium beginning July 1, 2007, shall assume an adjustment in 700.22 the aggregate cap on the services identified in paragraph (a), 700.23 clause (3), in $1,000 increments up to a maximum of $10,000, but 700.24 not less than $2,000, to the extent that the balance in the 700.25 health care access fund is sufficient in each year of the 700.26 biennium to pay for this benefit level. The aggregate cap shall 700.27 be adjusted according to the forecast. 700.28 (c) Reimbursement to the providers shall be reduced by the 700.29 amount of the co-payment, except that reimbursement for 700.30 prescription drugs shall not be reduced once a recipient has 700.31 reached the $20 per month maximum for prescription drug 700.32 co-payments. The provider collects the co-payment from the 700.33 recipient. Providers may not deny services to recipients who 700.34 are unable to pay the co-payment, except as provided in 700.35 paragraph (d). 700.36 (d) If it is the routine business practice of a provider to 701.1 refuse service to an individual with uncollected debt, the 701.2 provider may include uncollected co-payments under this 701.3 section. A provider must give advance notice to a recipient 701.4 with uncollected debt before services can be denied. 701.5 [EFFECTIVE DATE.] This section is effective October 1, 2003. 701.6 Sec. 73. Minnesota Statutes 2002, section 256L.04, 701.7 subdivision 1, is amended to read: 701.8 Subdivision 1. [FAMILIES WITH CHILDREN.] (a) Families with 701.9 children with family income equal to or less than 275 percent of 701.10 the federal poverty guidelines for the applicable family size 701.11 shall be eligible for MinnesotaCare according to this section. 701.12 All other provisions of sections 256L.01 to 256L.18, including 701.13 the insurance-related barriers to enrollment under section 701.14 256L.07, shall apply unless otherwise specified. 701.15 (b) Parents who enroll in the MinnesotaCare program must 701.16 also enroll their childrenand dependent siblings, if the 701.17 childrenand their dependent siblingsare eligible. Children 701.18and dependent siblingsmay be enrolled separately without 701.19 enrollment by parents. However, if one parent in the household 701.20 enrolls, both parents must enroll, unless other insurance is 701.21 available. If one child from a family is enrolled, all children 701.22 must be enrolled, unless other insurance is available. If one 701.23 spouse in a household enrolls, the other spouse in the household 701.24 must also enroll, unless other insurance is available. Families 701.25 cannot choose to enroll only certain uninsured members. 701.26 (c) Beginning October 1, 2003, the dependent sibling 701.27 definition no longer applies to the MinnesotaCare program. 701.28 These persons are no longer counted in the parental household 701.29 and may apply as a separate household. 701.30 (d) Beginning July 1, 2003, or upon federal approval, 701.31 whichever is later, parents are not eligible for MinnesotaCare 701.32 if their gross income exceeds $50,000. 701.33 [EFFECTIVE DATE.] This section is effective October 1, 701.34 2003, unless the statutory language specifies a different 701.35 effective date. 701.36 Sec. 74. Minnesota Statutes 2002, section 256L.04, 702.1 subdivision 10, is amended to read: 702.2 Subd. 10. [CITIZENSHIP REQUIREMENTS.] Eligibility for 702.3 MinnesotaCare is limited to citizens of the United States, 702.4 qualified noncitizens, and other persons residing lawfully in 702.5 the United States as described in section 256B.06, subdivision 702.6 4, paragraphs (a) to (e) and (j). Undocumented noncitizens and 702.7 nonimmigrants are ineligible for MinnesotaCare. For purposes of 702.8 this subdivision, a nonimmigrant is an individual in one or more 702.9 of the classes listed in United States Code, title 8, section 702.10 1101(a)(15), and an undocumented noncitizen is an individual who 702.11 resides in the United States without the approval or 702.12 acquiescence of the Immigration and Naturalization Service. 702.13 Subd. 10a. [SPONSOR'S INCOME AND RESOURCES DEEMED 702.14 AVAILABLE; DOCUMENTATION.] When determining eligibility for any 702.15 federal or state benefits under sections 256L.01 to 256L.18, the 702.16 income and resources of all noncitizens whose sponsor signed an 702.17 affidavit of support as defined under United States Code, title 702.18 8, section 1183a, shall be deemed to include their sponsors' 702.19 income and resources as defined in the Personal Responsibility 702.20 and Work Opportunity Reconciliation Act of 1996, title IV, 702.21 Public LawNumber104-193, sections 421 and 422, and 702.22 subsequently set out in federal rules. To be eligible for the 702.23 program, noncitizens must provide documentation of their 702.24 immigration status. 702.25 Sec. 75. Minnesota Statutes 2002, section 256L.05, 702.26 subdivision 3a, is amended to read: 702.27 Subd. 3a. [RENEWAL OF ELIGIBILITY.] (a) Beginning January 702.28 1, 1999, an enrollee's eligibility must be renewed every 12 702.29 months. The 12-month period begins in the month after the month 702.30 the application is approved. 702.31 (b) Beginning October 1, 2004, an enrollee's eligibility 702.32 must be renewed every six months. The first six-month period of 702.33 eligibility begins in the month after the month the application 702.34 is approved. Each new period of eligibility must take into 702.35 account any changes in circumstances that impact eligibility and 702.36 premium amount. An enrollee must provide all the information 703.1 needed to redetermine eligibility by the first day of the month 703.2 that ends the eligibility period. The premium for the new 703.3 period of eligibility must be received as provided in section 703.4 256L.06 in order for eligibility to continue. 703.5 Sec. 76. Minnesota Statutes 2002, section 256L.05, 703.6 subdivision 4, is amended to read: 703.7 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 703.8 human services shall determine an applicant's eligibility for 703.9 MinnesotaCare no more than 30 days from the date that the 703.10 application is received by the department of human services. 703.11 Beginning January 1, 2000, this requirement also applies to 703.12 local county human services agencies that determine eligibility 703.13 for MinnesotaCare.Once annually at application or703.14reenrollment, to prevent processing delays, applicants or703.15enrollees who, from the information provided on the application,703.16appear to meet eligibility requirements shall be enrolled upon703.17timely payment of premiums. The enrollee must provide all703.18required verifications within 30 days of notification of the703.19eligibility determination or coverage from the program shall be703.20terminated. Enrollees who are determined to be ineligible when703.21verifications are provided shall be disenrolled from the program.703.22 [EFFECTIVE DATE.] This section is effective July 1, 2003, 703.23 or upon federal approval, whichever is later. 703.24 Sec. 77. Minnesota Statutes 2002, section 256L.06, 703.25 subdivision 3, is amended to read: 703.26 Subd. 3. [COMMISSIONER'S DUTIES AND PAYMENT.] (a) Premiums 703.27 are dedicated to the commissioner for MinnesotaCare. 703.28 (b) The commissioner shall develop and implement procedures 703.29 to: (1) require enrollees to report changes in income; (2) 703.30 adjust sliding scale premium payments, based upon changes in 703.31 enrollee income; and (3) disenroll enrollees from MinnesotaCare 703.32 for failure to pay required premiums. Failure to pay includes 703.33 payment with a dishonored check, a returned automatic bank 703.34 withdrawal, or a refused credit card or debit card payment. The 703.35 commissioner may demand a guaranteed form of payment, including 703.36 a cashier's check or a money order, as the only means to replace 704.1 a dishonored, returned, or refused payment. 704.2 (c) Premiums are calculated on a calendar month basis and 704.3 may be paid on a monthly, quarterly, orannualsemiannual basis, 704.4 with the first payment due upon notice from the commissioner of 704.5 the premium amount required. The commissioner shall inform 704.6 applicants and enrollees of these premium payment options. 704.7 Premium payment is required before enrollment is complete and to 704.8 maintain eligibility in MinnesotaCare. Premium payments 704.9 received before noon are credited the same day. Premium 704.10 payments received after noon are credited on the next working 704.11 day. 704.12 (d) Nonpayment of the premium will result in disenrollment 704.13 from the plan effective for the calendar month for which the 704.14 premium was due. Persons disenrolled for nonpayment or who 704.15 voluntarily terminate coverage from the program may not reenroll 704.16 until four calendar months have elapsed. Persons disenrolled 704.17 for nonpayment who pay all past due premiums as well as current 704.18 premiums due, including premiums due for the period of 704.19 disenrollment, within 20 days of disenrollment, shall be 704.20 reenrolled retroactively to the first day of disenrollment. 704.21 Persons disenrolled for nonpayment or who voluntarily terminate 704.22 coverage from the program may not reenroll for four calendar 704.23 months unless the person demonstrates good cause for 704.24 nonpayment. Good cause does not exist if a person chooses to 704.25 pay other family expenses instead of the premium. The 704.26 commissioner shall define good cause in rule. 704.27 [EFFECTIVE DATE.] This section is effective October 1, 2004. 704.28 Sec. 78. Minnesota Statutes 2002, section 256L.07, 704.29 subdivision 1, is amended to read: 704.30 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 704.31 enrolled in the original children's health plan as of September 704.32 30, 1992, children who enrolled in the MinnesotaCare program 704.33 after September 30, 1992, pursuant to Laws 1992, chapter 549, 704.34 article 4, section 17, and children who have family gross 704.35 incomes that are equal to or less than175150 percent of the 704.36 federal poverty guidelines are eligible without meeting the 705.1 requirements of subdivision 2 and the four-month requirement in 705.2 subdivision 3, as long as they maintain continuous coverage in 705.3 the MinnesotaCare program or medical assistance. Children who 705.4 apply for MinnesotaCare on or after the implementation date of 705.5 the employer-subsidized health coverage program as described in 705.6 Laws 1998, chapter 407, article 5, section 45, who have family 705.7 gross incomes that are equal to or less than175150 percent of 705.8 the federal poverty guidelines, must meet the requirements of 705.9 subdivision 2 to be eligible for MinnesotaCare. 705.10 (b) Families enrolled in MinnesotaCare under section 705.11 256L.04, subdivision 1, whose income increases above 275 percent 705.12 of the federal poverty guidelines, are no longer eligible for 705.13 the program and shall be disenrolled by the commissioner. 705.14 Individuals enrolled in MinnesotaCare under section 256L.04, 705.15 subdivision 7, whose income increases above 175 percent of the 705.16 federal poverty guidelines are no longer eligible for the 705.17 program and shall be disenrolled by the commissioner. For 705.18 persons disenrolled under this subdivision, MinnesotaCare 705.19 coverage terminates the last day of the calendar month following 705.20 the month in which the commissioner determines that the income 705.21 of a family or individual exceeds program income limits. 705.22 (c)(1) Notwithstanding paragraph (b),individuals and705.23 families enrolled in MinnesotaCare under section 256L.04, 705.24 subdivision 1, may remain enrolled in MinnesotaCare if ten 705.25 percent of their annual income is less than the annual premium 705.26 for a policy with a $500 deductible available through the 705.27 Minnesota comprehensive health association.Individuals and705.28 Families who are no longer eligible for MinnesotaCare under this 705.29 subdivision shall be given an 18-month notice period from the 705.30 date that ineligibility is determined before 705.31 disenrollment. This clause expires February 1, 2004. 705.32 (2) Effective February 1, 2004, notwithstanding paragraph 705.33 (b), children may remain enrolled in MinnesotaCare if ten 705.34 percent of their annual family income is less than the annual 705.35 premium for a policy with a $500 deductible available through 705.36 the Minnesota comprehensive health association. Children who 706.1 are no longer eligible for MinnesotaCare under this clause shall 706.2 be given a 12-month notice period from the date that 706.3 ineligibility is determined before disenrollment. The premium 706.4 for children remaining eligible under this clause shall be the 706.5 maximum premium determined under section 256L.15, subdivision 2, 706.6 paragraph (b). 706.7 (d) Effective July 1, 2003, notwithstanding paragraphs (b) 706.8 and (c), parents are no longer eligible for MinnesotaCare if 706.9 gross household income exceeds $50,000. 706.10 [EFFECTIVE DATE.] The amendments to paragraph (a) are 706.11 effective July 1, 2003. The amendments to paragraph (c), clause 706.12 (1), are effective October 1, 2003. 706.13 Sec. 79. Minnesota Statutes 2002, section 256L.07, 706.14 subdivision 3, is amended to read: 706.15 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 706.16 individuals enrolled in the MinnesotaCare program must have no 706.17 health coverage while enrolled or for at least four months prior 706.18 to application and renewal. Children enrolled in the original 706.19 children's health plan and children in families with income 706.20 equal to or less than175150 percent of the federal poverty 706.21 guidelines, who have other health insurance, are eligible if the 706.22 coverage: 706.23 (1) lacks two or more of the following: 706.24 (i) basic hospital insurance; 706.25 (ii) medical-surgical insurance; 706.26 (iii) prescription drug coverage; 706.27 (iv) dental coverage; or 706.28 (v) vision coverage; 706.29 (2) requires a deductible of $100 or more per person per 706.30 year; or 706.31 (3) lacks coverage because the child has exceeded the 706.32 maximum coverage for a particular diagnosis or the policy 706.33 excludes a particular diagnosis. 706.34 The commissioner may change this eligibility criterion for 706.35 sliding scale premiums in order to remain within the limits of 706.36 available appropriations. The requirement of no health coverage 707.1 does not apply to newborns. 707.2 (b) Medical assistance, general assistance medical care, 707.3 and the Civilian Health and Medical Program of the Uniformed 707.4 Service, CHAMPUS, or other coverage provided under United States 707.5 Code, title 10, subtitle A, part II, chapter 55, are not 707.6 considered insurance or health coverage for purposes of the 707.7 four-month requirement described in this subdivision. 707.8 (c) For purposes of this subdivision, Medicare Part A or B 707.9 coverage under title XVIII of the Social Security Act, United 707.10 States Code, title 42, sections 1395c to 1395w-4, is considered 707.11 health coverage. An applicant or enrollee may not refuse 707.12 Medicare coverage to establish eligibility for MinnesotaCare. 707.13 (d) Applicants who were recipients of medical assistance or 707.14 general assistance medical care within one month of application 707.15 must meet the provisions of this subdivision and subdivision 2. 707.16 (e) Effective October 1, 2003, applicants who were 707.17 recipients of medical assistance and had cost-effective health 707.18 insurance which was paid for by medical assistance are exempt 707.19 from the four-month requirement under this section. 707.20 [EFFECTIVE DATE.] This section is effective July 1, 2003, 707.21 except where a different effective date is specified in the text. 707.22 Sec. 80. Minnesota Statutes 2002, section 256L.12, 707.23 subdivision 6, is amended to read: 707.24 Subd. 6. [COPAYMENTS AND BENEFIT LIMITS.] Enrollees are 707.25 responsible for all copayments insectionsections 256L.03, 707.26 subdivision45, and 256L.035, and shall pay copayments to the 707.27 managed care plan or to its participating providers. The 707.28 enrollee is also responsible for payment of inpatient hospital 707.29 charges which exceed the MinnesotaCare benefit limit. 707.30 Sec. 81. Minnesota Statutes 2002, section 256L.12, 707.31 subdivision 9, is amended to read: 707.32 Subd. 9. [RATE SETTING; PERFORMANCE WITHHOLDS.] (a) Rates 707.33 will be prospective, per capita, where possible. The 707.34 commissioner may allow health plans to arrange for inpatient 707.35 hospital services on a risk or nonrisk basis. The commissioner 707.36 shall consult with an independent actuary to determine 708.1 appropriate rates. 708.2 (b) For services rendered on or after January 1, 2003, to 708.3 December 31, 2003, the commissioner shall withhold .5 percent of 708.4 managed care plan payments under this section pending completion 708.5 of performance targets. The withheld funds must be returned no 708.6 sooner than July 1 and no later than July 31 of the following 708.7 year if performance targets in the contract are achieved. A 708.8 managed care plan may include as admitted assets under section 708.9 62D.044 any amount withheld under this paragraph that is 708.10 reasonably expected to be returned. 708.11 (c) For services rendered on or after January 1, 2004, the 708.12 commissioner shall withhold five percent of managed care plan 708.13 payments under this section pending completion of performance 708.14 targets. Each performance target must be quantifiable, 708.15 objective, measurable, and reasonably attainable, except in the 708.16 case of a performance target based on a federal or state law or 708.17 rule. Criteria for assessment of each performance target must 708.18 be outlined in writing prior to the contract effective date. 708.19 The withheld funds must be returned no sooner than July 1 and no 708.20 later than July 31 of the following calendar year if performance 708.21 targets in the contract are achieved. A managed care plan or a 708.22 county-based purchasing plan under section 256B.692 may include 708.23 as admitted assets under section 62D.044 any amount withheld 708.24 under this paragraph that is reasonably expected to be returned. 708.25 [EFFECTIVE DATE.] This section is effective for services 708.26 rendered on or after July 1, 2003, except as otherwise provided 708.27 in the statutory language. 708.28 Sec. 82. Minnesota Statutes 2002, section 256L.12, is 708.29 amending by adding a subdivision to read: 708.30 Subd. 9a. [RATE SETTING; RATABLE REDUCTION.] For services 708.31 rendered on or after October 1, 2003, the total payment made to 708.32 managed care plans under the MinnesotaCare program is reduced 708.33 1.0 percent. 708.34 Sec. 83. Minnesota Statutes 2002, section 256L.15, 708.35 subdivision 1, is amended to read: 708.36 Subdivision 1. [PREMIUM DETERMINATION.] (a) Families with 709.1 children and individuals shall pay a premium determined 709.2 according toa sliding fee based on a percentage of the family's709.3gross family incomesubdivision 2. 709.4 (b) Pregnant women and children under age two are exempt 709.5 from the provisions of section 256L.06, subdivision 3, paragraph 709.6 (b), clause (3), requiring disenrollment for failure to pay 709.7 premiums. For pregnant women, this exemption continues until 709.8 the first day of the month following the 60th day postpartum. 709.9 Women who remain enrolled during pregnancy or the postpartum 709.10 period, despite nonpayment of premiums, shall be disenrolled on 709.11 the first of the month following the 60th day postpartum for the 709.12 penalty period that otherwise applies under section 256L.06, 709.13 unless they begin paying premiums. 709.14 Sec. 84. Minnesota Statutes 2002, section 256L.15, 709.15 subdivision 2, is amended to read: 709.16 Subd. 2. [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 709.17 GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 709.18 establish a sliding fee scale to determine the percentage of 709.19 gross individual or family income that households at different 709.20 income levels must pay to obtain coverage through the 709.21 MinnesotaCare program. The sliding fee scale must be based on 709.22 the enrollee's gross individual or family income. The sliding 709.23 fee scale must contain separate tables based on enrollment of 709.24 one, two, or three or more persons. The sliding fee scale 709.25 begins with a premium of 1.5 percent of gross individual or 709.26 family income for individuals or families with incomes below the 709.27 limits for the medical assistance program for families and 709.28 children in effect on January 1, 1999, and proceeds through the 709.29 following evenly spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 709.30 7.4, and 8.8 percent. These percentages are matched to evenly 709.31 spaced income steps ranging from the medical assistance income 709.32 limit for families and children in effect on January 1, 1999, to 709.33 275 percent of the federal poverty guidelines for the applicable 709.34 family size, up to a family size of five. The sliding fee scale 709.35 for a family of five must be used for families of more than 709.36 five. Effective October 1, 2003, the commissioner shall 710.1 increase each percentage by 0.5 percentage points for enrollees 710.2 with income greater than 100 percent but not exceeding 200 710.3 percent of the federal poverty guidelines and shall increase 710.4 each percentage by 1.0 percentage points for families and 710.5 children with incomes greater than 200 percent of the federal 710.6 poverty guidelines. The sliding fee scale and percentages are 710.7 not subject to the provisions of chapter 14. If a family or 710.8 individual reports increased income after enrollment, premiums 710.9 shall not be adjusted until eligibility renewal. 710.10 (b)(1) Enrolledindividuals andfamilies whose gross annual 710.11 income increases above 275 percent of the federal poverty 710.12 guideline shall pay the maximum premium. This clause expires 710.13 effective February 1, 2004. 710.14 (2) Effective February 1, 2004, children in families whose 710.15 gross income is above 275 percent of the federal poverty 710.16 guidelines shall pay the maximum premium. 710.17 (3) The maximum premium is defined as a base charge for 710.18 one, two, or three or more enrollees so that if all 710.19 MinnesotaCare cases paid the maximum premium, the total revenue 710.20 would equal the total cost of MinnesotaCare medical coverage and 710.21 administration. In this calculation, administrative costs shall 710.22 be assumed to equal ten percent of the total. The costs of 710.23 medical coverage for pregnant women and children under age two 710.24 and the enrollees in these groups shall be excluded from the 710.25 total. The maximum premium for two enrollees shall be twice the 710.26 maximum premium for one, and the maximum premium for three or 710.27 more enrollees shall be three times the maximum premium for one. 710.28 [EFFECTIVE DATE.] The amendments to this section are 710.29 effective October 1, 2003, unless specified otherwise in the 710.30 statutory text. 710.31 Sec. 85. Minnesota Statutes 2002, section 256L.15, 710.32 subdivision 3, is amended to read: 710.33 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 710.34 of $48 is required for all children in families with income at 710.35 or less than175150 percent of federal poverty guidelines. 710.36 [EFFECTIVE DATE.] This section is effective July 1, 2003. 711.1 Sec. 86. Minnesota Statutes 2002, section 256L.17, 711.2 subdivision 2, is amended to read: 711.3 Subd. 2. [LIMIT ON TOTAL ASSETS.] (a) Effective July 1, 711.4 2002, or upon federal approval, whichever is later, in order to 711.5 be eligible for the MinnesotaCare program, a household of two or 711.6 more persons must not own more than$30,000$20,000 in total net 711.7 assets, and a household of one person must not own more 711.8 than$15,000$10,000 in total net assets. 711.9 (b) For purposes of this subdivision, assets are determined 711.10 according to section 256B.056, subdivision 3c. 711.11 [EFFECTIVE DATE.] This section is effective July 1, 2003. 711.12 Sec. 87. Minnesota Statutes 2002, section 295.53, 711.13 subdivision 1, is amended to read: 711.14 Subdivision 1. [EXEMPTIONS.] (a) The following payments 711.15 are excluded from the gross revenues subject to the hospital, 711.16 surgical center, or health care provider taxes under sections 711.17 295.50 to 295.57: 711.18 (1) payments received for services provided under the 711.19 Medicare program, including payments received from the 711.20 government, and organizations governed by sections 1833 and 1876 711.21 of title XVIII of the federal Social Security Act, United States 711.22 Code, title 42, section 1395, and enrollee deductibles, 711.23 coinsurance, and co-payments, whether paid by the Medicare 711.24 enrollee or by a Medicare supplemental coverage as defined in 711.25 section 62A.011, subdivision 3, clause (10). Payments for 711.26 services not covered by Medicare are taxable; 711.27 (2)medical assistance payments including payments received711.28directly from the government or from a prepaid plan;711.29(3)payments received for home health care services; 711.30(4)(3) payments received from hospitals or surgical 711.31 centers for goods and services on which liability for tax is 711.32 imposed under section 295.52 or the source of funds for the 711.33 payment is exempt under clause (1),(2), (7), (8),711.34(10)(7),(13)(10), or(20)(17); 711.35(5)(4) payments received from health care providers for 711.36 goods and services on which liability for tax is imposed under 712.1 this chapter or the source of funds for the payment is exempt 712.2 under clause (1),(2), (7), (8), (10)(7),(13)(10), 712.3 or(20)(17); 712.4(6)(5) amounts paid for legend drugs, other than 712.5 nutritional products, to a wholesale drug distributor who is 712.6 subject to tax under section 295.52, subdivision 3, reduced by 712.7 reimbursements received for legend drugs otherwise exempt under 712.8 this chapter; 712.9(7) payments received under the general assistance medical712.10care program including payments received directly from the712.11government or from a prepaid plan;712.12(8) payments received for providing services under the712.13MinnesotaCare program including payments received directly from712.14the government or from a prepaid plan and enrollee deductibles,712.15coinsurance, and copayments. For purposes of this clause,712.16coinsurance means the portion of payment that the enrollee is712.17required to pay for the covered service;712.18(9)(6) payments received by a health care provider or the 712.19 wholly owned subsidiary of a health care provider for care 712.20 provided outside Minnesota; 712.21(10)(7) payments received from the chemical dependency 712.22 fund under chapter 254B; 712.23(11)(8) payments received in the nature of charitable 712.24 donations that are not designated for providing patient services 712.25 to a specific individual or group; 712.26(12)(9) payments received for providing patient services 712.27 incurred through a formal program of health care research 712.28 conducted in conformity with federal regulations governing 712.29 research on human subjects. Payments received from patients or 712.30 from other persons paying on behalf of the patients are subject 712.31 to tax; 712.32(13)(10) payments received from any governmental agency 712.33 for services benefiting the public, not including payments made 712.34 by the government in its capacity as an employer or insurer or 712.35 payments made by the government for services provided under 712.36 medical assistance, general assistance medical care, or the 713.1 MinnesotaCare program; 713.2(14)(11) payments received for services provided by 713.3 community residential mental health facilities licensed under 713.4 Minnesota Rules, parts 9520.0500 to 9520.0690, community support 713.5 programs and family community support programs approved under 713.6 Minnesota Rules, parts 9535.1700 to 9535.1760, and community 713.7 mental health centers as defined in section 245.62, subdivision 713.8 2; 713.9(15)(12) government payments received by a regional 713.10 treatment center; 713.11(16)(13) payments received for hospice care services; 713.12(17)(14) payments received by a health care provider for 713.13 hearing aids and related equipment or prescription eyewear 713.14 delivered outside of Minnesota; 713.15(18)(15) payments received by an educational institution 713.16 from student tuition, student activity fees, health care service 713.17 fees, government appropriations, donations, or grants. Fee for 713.18 service payments and payments for extended coverage are taxable; 713.19(19)(16) payments received for services provided by: 713.20 assisted living programs and congregate housing programs; and 713.21(20)(17) payments received under the federal Employees 713.22 Health Benefits Act, United States Code, title 5, section 713.23 8909(f), as amended by the Omnibus Reconciliation Act of 1990. 713.24 (b) Payments received by wholesale drug distributors for 713.25 legend drugs sold directly to veterinarians or veterinary bulk 713.26 purchasing organizations are excluded from the gross revenues 713.27 subject to the wholesale drug distributor tax under sections 713.28 295.50 to 295.59. 713.29 [EFFECTIVE DATE.] This section is effective for services 713.30 rendered on or after January 1, 2004. 713.31 Sec. 88. Minnesota Statutes 2002, section 297I.15, 713.32 subdivision 1, is amended to read: 713.33 Subdivision 1. [GOVERNMENT PAYMENTS.] Premiums under 713.34medical assistance, general assistance medical care, the713.35MinnesotaCare program, andthe Minnesota comprehensive health 713.36 insurance plan and all payments, revenues, and reimbursements 714.1 received from the federal government for Medicare-related 714.2 coverage as defined in section 62A.31, subdivision 3, are not 714.3 subject to tax under this chapter. 714.4 [EFFECTIVE DATE.] This section is effective for premiums 714.5 paid to health carriers on or after January 1, 2004. 714.6 Sec. 89. Minnesota Statutes 2002, section 297I.15, 714.7 subdivision 4, is amended to read: 714.8 Subd. 4. [PREMIUMS PAID TO HEALTH CARRIERS BY STATE.] A 714.9 health carrier as defined in section 62A.011 is exempt from the 714.10 taxes imposed under this chapter on premiums paid to it by the 714.11 state. Premiums paid by the state under medical assistance, 714.12 general assistance medical care, and the MinnesotaCare program 714.13 are not exempt under this subdivision. 714.14 [EFFECTIVE DATE.] This section is effective for premiums 714.15 paid to health carriers on or after January 1, 2004. 714.16 Sec. 90. Minnesota Statutes 2002, section 514.981, 714.17 subdivision 6, is amended to read: 714.18 Subd. 6. [TIME LIMITS; CLAIM LIMITS; LIENS ON LIFE ESTATES 714.19 AND JOINT TENANCIES.] (a) A medical assistance lien is a lien on 714.20 the real property it describes for a period of ten years from 714.21 the date it attaches according to section 514.981, subdivision 714.22 2, paragraph (a), except as otherwise provided for in sections 714.23 514.980 to 514.985. The agency may renew a medical assistance 714.24 lien for an additional ten years from the date it would 714.25 otherwise expire by recording or filing a certificate of renewal 714.26 before the lien expires. The certificate shall be recorded or 714.27 filed in the office of the county recorder or registrar of 714.28 titles for the county in which the lien is recorded or filed. 714.29 The certificate must refer to the recording or filing data for 714.30 the medical assistance lien it renews. The certificate need not 714.31 be attested, certified, or acknowledged as a condition for 714.32 recording or filing. The registrar of titles or the recorder 714.33 shall file, record, index, and return the certificate of renewal 714.34 in the same manner as provided for medical assistance liens in 714.35 section 514.982, subdivision 2. 714.36 (b) A medical assistance lien is not enforceable against 715.1 the real property of an estate to the extent there is a 715.2 determination by a court of competent jurisdiction, or by an 715.3 officer of the court designated for that purpose, that there are 715.4 insufficient assets in the estate to satisfy the agency's 715.5 medical assistance lien in whole or in part because of the 715.6 homestead exemption under section 256B.15, subdivision 4, the 715.7 rights of the surviving spouse or minor children under section 715.8 524.2-403, paragraphs (a) and (b), or claims with a priority 715.9 under section 524.3-805, paragraph (a), clauses (1) to (4). For 715.10 purposes of this section, the rights of the decedent's adult 715.11 children to exempt property under section 524.2-403, paragraph 715.12 (b), shall not be considered costs of administration under 715.13 section 524.3-805, paragraph (a), clause (1). 715.14 (c) Notwithstanding any law or rule to the contrary, the 715.15 provisions in clauses (1) to (7) apply if a life estate subject 715.16 to a medical assistance lien ends according to its terms, or if 715.17 a medical assistance recipient who owns a life estate or any 715.18 interest in real property as a joint tenant that is subject to a 715.19 medical assistance lien dies. 715.20 (1) The medical assistance recipient's life estate or joint 715.21 tenancy interest in the real property shall not end upon the 715.22 recipient's death but shall merge into the remainder interest or 715.23 other interest in real property the medical assistance recipient 715.24 owned in joint tenancy with others. The medical assistance lien 715.25 shall attach to and run with the remainder or other interest in 715.26 the real property to the extent of the medical assistance 715.27 recipient's interest in the property at the time of the 715.28 recipient's death as determined under this section. 715.29 (2) If the medical assistance recipient's interest was a 715.30 life estate in real property, the lien shall be a lien against 715.31 the portion of the remainder equal to the percentage factor for 715.32 the life estate of a person the medical assistance recipient's 715.33 age on the date the life estate ended according to its terms or 715.34 the date of the medical assistance recipient's death as listed 715.35 in the Life Estate Mortality Table in the health care program's 715.36 manual. 716.1 (3) If the medical assistance recipient owned the interest 716.2 in real property in joint tenancy with others, the lien shall be 716.3 a lien against the portion of that interest equal to the 716.4 fractional interest the medical assistance recipient would have 716.5 owned in the jointly owned interest had the medical assistance 716.6 recipient and the other owners held title to that interest as 716.7 tenants in common on the date the medical assistance recipient 716.8 died. 716.9 (4) The medical assistance lien shall remain a lien against 716.10 the remainder or other jointly owned interest for the length of 716.11 time and be renewable as provided in paragraph (a). 716.12 (5) Subdivision 5, paragraphs (a), clause (4), (b), clauses 716.13 (1) and (2); and subdivision 6, paragraph (b), do not apply to 716.14 medical assistance liens which attach to interests in real 716.15 property as provided under this subdivision. 716.16 (6) The continuation of a medical assistance recipient's 716.17 life estate or joint tenancy interest in real property after the 716.18 medical assistance recipient's death for the purpose of 716.19 recovering medical assistance provided for in sections 514.980 716.20 to 514.985 modifies common law principles holding that these 716.21 interests terminate on the death of the holder. 716.22 (7) Notwithstanding any law or rule to the contrary, no 716.23 release, satisfaction, discharge, or affidavit under section 716.24 256B.15 shall extinguish or terminate the life estate or joint 716.25 tenancy interest of a medical assistance recipient subject to a 716.26 lien under sections 514.980 to 514.985 on the date the recipient 716.27 dies. 716.28 (8) The provisions of clauses (1) to (7) do not apply to a 716.29 homestead owned of record, on the date the recipient dies, by 716.30 the recipient and the recipient's spouse as joint tenants with a 716.31 right of survivorship. Homestead means the real property 716.32 occupied by the surviving joint tenant spouse as their sole 716.33 residence on the date the recipient dies and classified and 716.34 taxed to the recipient and surviving joint tenant spouse as 716.35 homestead property for property tax purposes in the calendar 716.36 year in which the recipient dies. For purposes of this 717.1 exemption, real property the recipient and their surviving joint 717.2 tenant spouse purchase solely with the proceeds from the sale of 717.3 their prior homestead, own of record as joint tenants, and 717.4 qualify as homestead property under section 273.124 in the 717.5 calendar year in which the recipient dies and prior to the 717.6 recipient's death shall be deemed to be real property classified 717.7 and taxed to the recipient and their surviving joint tenant 717.8 spouse as homestead property in the calendar year in which the 717.9 recipient dies. The surviving spouse, or any person with 717.10 personal knowledge of the facts, may provide an affidavit 717.11 describing the homestead property affected by this clause and 717.12 stating facts showing compliance with this clause. The 717.13 affidavit shall be prima facie evidence of the facts it states. 717.14 [EFFECTIVE DATE.] This section is effective August 1, 2003, 717.15 and applies to all medical assistance liens recorded or filed on 717.16 or after that date. 717.17 Sec. 91. Minnesota Statutes 2002, section 641.15, 717.18 subdivision 2, is amended to read: 717.19 Subd. 2. [MEDICAL AID.] Except as provided in section 717.20 466.101, the county board shall pay the costs of medical 717.21 services provided to prisoners. The amount paid by the Anoka 717.22 county board for a medical service shall not exceed the maximum 717.23 allowed medical assistance payment rate for the service, as 717.24 determined by the commissioner of human services. The county is 717.25 entitled to reimbursement from the prisoner for payment of 717.26 medical bills to the extent that the prisoner to whom the 717.27 medical aid was provided has the ability to pay the bills. The 717.28 prisoner shall, at a minimum, incur copayment obligations for 717.29 health care services provided by a county correctional 717.30 facility. The county board shall determine the copayment 717.31 amount. Notwithstanding any law to the contrary, the copayment 717.32 shall be deducted from any of the prisoner's funds held by the 717.33 county, to the extent possible. If there is a disagreement 717.34 between the county and a prisoner concerning the prisoner's 717.35 ability to pay, the court with jurisdiction over the defendant 717.36 shall determine the extent, if any, of the prisoner's ability to 718.1 pay for the medical services. If a prisoner is covered by 718.2 health or medical insurance or other health plan when medical 718.3 services are provided, the county providing the medical services 718.4 has a right of subrogation to be reimbursed by the insurance 718.5 carrier for all sums spent by it for medical services to the 718.6 prisoner that are covered by the policy of insurance or health 718.7 plan, in accordance with the benefits, limitations, exclusions, 718.8 provider restrictions, and other provisions of the policy or 718.9 health plan. The county may maintain an action to enforce this 718.10 subrogation right. The county does not have a right of 718.11 subrogation against the medical assistance program or the 718.12 general assistance medical care program. 718.13 Sec. 92. [PHARMACY PLUS WAIVER.] 718.14 (a) The commissioner of human services shall seek a 718.15 pharmacy plus federal waiver for the prescription drug program 718.16 in Minnesota Statutes, section 256.955, that uses the 718.17 accumulated savings from all pharmacy and asset transfer 718.18 provisions in this act and previously adopted pharmacy savings 718.19 strategies as the factor to prove fiscal neutrality. If the 718.20 waiver is approved and federal funds are received for the 718.21 prescription drug program, the commissioner shall expand 718.22 eligibility for the program in the following order: 718.23 (1) increase income eligibility up to 135 percent of the 718.24 federal poverty guidelines for individuals eligible under 718.25 Minnesota Statutes, section 256.955, subdivision 2a; and 718.26 (2) increase income eligibility up to 135 percent of the 718.27 federal poverty guidelines for individuals eligible under 718.28 Minnesota Statutes, section 256.955, subdivision 2b. 718.29 (b) If eligibility is increased, the commissioner shall 718.30 publish the new income eligibility levels for the program in the 718.31 State Register and shall inform the agencies and organizations 718.32 serving senior citizens and persons with disabilities. 718.33 Sec. 93. [REVIEW OF SPECIAL TRANSPORTATION ELIGIBILITY 718.34 CRITERIA AND POTENTIAL COST SAVINGS.] 718.35 The commissioner of human services, in consultation with 718.36 the commissioner of transportation and special transportation 719.1 service providers, shall review eligibility criteria for medical 719.2 assistance special transportation services and shall evaluate 719.3 whether the level of special transportation services provided 719.4 should be based on the degree of impairment of the client, as 719.5 well as the medical diagnosis. The commissioner shall also 719.6 evaluate methods for reducing the cost of special transportation 719.7 services, including, but not limited to: 719.8 (1) requiring providers to maintain a daily log book 719.9 confirming delivery of clients to medical facilities; 719.10 (2) requiring providers to implement commercially available 719.11 computer mapping programs to calculate mileage for purposes of 719.12 reimbursement; 719.13 (3) restricting special transportation service from being 719.14 provided solely for trips to pharmacies; 719.15 (4)modifying eligibility for special transportation; 719.16 (5) expanding alternatives to the use of special 719.17 transportation services; 719.18 (6) improving the process of certifying persons as eligible 719.19 for special transportation services; and 719.20 (7) examining the feasibility and benefits of licensing 719.21 special transportation providers. 719.22 The commissioner shall present recommendations for changes 719.23 in the eligibility criteria and potential cost-savings for 719.24 special transportation services to the chairs and ranking 719.25 minority members of the house and senate committees having 719.26 jurisdiction over health and human services spending by January 719.27 15, 2004. The commissioner is prohibited from using a broker or 719.28 coordinator to manage special transportation services until July 719.29 1, 2005, except for the purposes of checking for recipient 719.30 eligibility, authorizing recipients for appropriate level of 719.31 transportation, and monitoring provider compliance with 719.32 Minnesota Statutes, section 256B.0625, subdivision 17. This 719.33 prohibition does not apply to the purchase or management of 719.34 common carrier transportation. 719.35 Sec. 94. [FEDERAL APPROVAL.] 719.36 If the amendments to Minnesota Statutes, sections 256.046, 720.1 subdivision 1, and 256.98, subdivision 8, are not effective 720.2 because of prohibitions in federal law, the commissioner of 720.3 human services shall seek the federal waivers and authority 720.4 necessary to implement the provisions. 720.5 Sec. 95. [WITHHOLD EXEMPTION.] 720.6 The commissioner of human services may exempt from the five 720.7 percent withhold in Minnesota Statutes, section 256B.69, 720.8 subdivision 5a, paragraph (c), and the five percent withhold in 720.9 Minnesota Statutes, section 256L.12, subdivision 9, paragraph 720.10 (b), a managed care plan that has entered into a managed care 720.11 contract with the commissioner in accordance with Minnesota 720.12 Statutes, section 256B.69 or 256L.12, if the contract was the 720.13 initial contract between the managed care plan and the 720.14 commissioner, and it was entered into after January 1, 2000. 720.15 If an exemption is given, the exemption shall only apply 720.16 for the first five years of operation of the managed care plan. 720.17 Sec. 96. [DRUG PURCHASING PROGRAM.] 720.18 The commissioner of human services, in consultation with 720.19 other state agencies, shall evaluate whether participation in a 720.20 multistate or multiagency drug purchasing program can reduce 720.21 costs or improve the operations of the drug benefit programs 720.22 administered by the commissioner and other state agencies. The 720.23 commissioner shall also evaluate the possibility of contracting 720.24 with a vendor or other states for purposes of participating in a 720.25 multistate or multiagency drug purchasing program. The 720.26 commissioner shall submit the recommendations to the legislature 720.27 by January 15, 2004. 720.28 Sec. 97. [MAIL ORDER DISPENSING OF PRESCRIPTION DRUGS.] 720.29 The commissioner of human services shall assess the cost 720.30 savings that could be generated by the mail order dispensing of 720.31 prescription drugs to recipients of medical assistance, general 720.32 assistance medical care, and the prescription drug program. The 720.33 report shall include the viability of contracting with mail 720.34 order pharmacy vendors to provide mail order dispensing for 720.35 state public programs. The commissioner shall report to the 720.36 chairs and ranking minority members of the health and human 721.1 services finance committees by January 7, 2004. 721.2 Sec. 98. [NONPROFIT FOUNDATION GRANTS.] 721.3 (a) The commissioner of human services may accept grants or 721.4 donations from a nonprofit charitable foundation for the purpose 721.5 of increasing dental access in the medical assistance program. 721.6 (b) The commissioner may increase the critical access 721.7 dental payments under Minnesota Statutes, section 256B.76, 721.8 paragraph (c), and use any money received under paragraph (a) 721.9 for the nonfederal state share of the medical assistance cost. 721.10 Sec. 99. [PHARMACEUTICAL CARE DEMONSTRATION PROJECT.] 721.11 (a) The commissioner shall seek federal approval for a 721.12 demonstration project to provide culturally specific 721.13 pharmaceutical care to American Indian medical assistance 721.14 recipients who are age 55 and older. In developing the 721.15 demonstration project, the commissioner shall consult with 721.16 organizations and health care providers experienced in 721.17 developing and implementing culturally competent intervention 721.18 strategies to manage the use of prescription drugs, 721.19 over-the-counter drugs, other drug products, and native 721.20 therapies by American Indian elders. 721.21 (b) For purposes of this section, "pharmaceutical care" 721.22 means the provision of drug therapy and native therapy for the 721.23 purpose of improving a patient's quality of life by: (1) curing 721.24 a disease; (2) eliminating or reducing a patient's symptoms; (3) 721.25 arresting or slowing a disease process; or (4) preventing a 721.26 disease or a symptom. Pharmaceutical care involves the 721.27 documented process through which a pharmacist cooperates with a 721.28 patient and other professionals in designing, implementing, and 721.29 monitoring a therapeutic plan that is expected to produce 721.30 specific therapeutic outcomes, through the identification, 721.31 resolution, and prevention of drug-related problems. Nothing in 721.32 this project shall be construed to expand or modify the scope of 721.33 practice of the pharmacist as defined in Minnesota Statutes, 721.34 section 151.01, subdivision 27. 721.35 (c) Upon receipt of federal approval, the commissioner 721.36 shall report to the legislature for legislative approval for 722.1 implementation of the demonstration project. 722.2 Sec. 100. [HEALTH CARE PROGRAM REDUCTIONS.] 722.3 The commissioner of human services may implement changes to 722.4 the medical assistance, general assistance medical care, and 722.5 MinnesotaCare programs, which will result in a reduction in 722.6 state expenditures during the period of July 1, 2004, through 722.7 June 30, 2005. The commissioner may use the following options 722.8 to achieve this savings: 722.9 (1) require providers to use generally accepted clinical 722.10 practice guidelines for specific services; 722.11 (2) implement clinical care coordination programs, 722.12 including chronic and acute care disease management programs; 722.13 and 722.14 (3) volume purchase health services as established in 722.15 Minnesota Statutes, section 256B.04, subdivision 14, except that 722.16 special transportation services shall be subject to the 722.17 timelines established in Minnesota Statutes, section 256B.0625, 722.18 subdivision 17. 722.19 The commissioner shall notify the chairs of the house and 722.20 senate health and human services policy and finance committees 722.21 of any changes implemented as a result of this section. 722.22 Sec. 101. [REPEALER.] 722.23 (a) Minnesota Statutes 2002, sections 256.955, subdivision 722.24 8; and 256B.057, subdivision 1b, are repealed July 1, 2003. 722.25 (b) Minnesota Statutes 2002, section 256B.055, subdivision 722.26 10a, is repealed July 1, 2003, or upon federal approval, 722.27 whichever is later. 722.28 ARTICLE 13A 722.29 HEALTH AND HUMAN SERVICES FORECAST ADJUSTMENTS 722.30 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 722.31 The dollar amounts shown in the columns marked 722.32 "APPROPRIATIONS" are added to or, if shown in parentheses, are 722.33 subtracted from the appropriations in Laws 2001, First Special 722.34 Session chapter 9, as amended by Laws 2002, chapter 220, and 722.35 Laws 2002, chapter 374, and are appropriated from the general 722.36 fund, or any other fund named, to the agencies and for the 723.1 purposes specified in this article, to be available for the 723.2 fiscal year indicated for each purpose. The figure "2003" used 723.3 in this article means that the appropriation or appropriations 723.4 listed under it are available for the fiscal year ending June 723.5 30, 2003. 723.6 SUMMARY BY FUND 723.7 2003 723.8 General $103,756,000 723.9 Health Care Access (1,492,000) 723.10 Federal TANF 20,419,000 723.11 APPROPRIATIONS 723.12 Available for the Year 723.13 Ending June 30, 2003 723.14 Sec. 2. COMMISSIONER OF 723.15 HUMAN SERVICES 723.16 Subdivision 1. Total 723.17 Appropriation $128,203,000 723.18 Summary by Fund 723.19 General 109,276,000 723.20 Health Care Access (1,492,000) 723.21 Federal TANF 20,419,000 723.22 Subd. 2. Administrative 723.23 Reimbursement/Pass-through 1,180,000 723.24 Subd. 3. Basic Health Care 723.25 Grants 723.26 General 59,364,000 723.27 Health Care Access (1,492,000) 723.28 The amounts that may be spent from this 723.29 appropriation for each purpose are as 723.30 follows: 723.31 (a) MinnesotaCare Grants 723.32 Health Care Access (1,492,000) 723.33 (b) MA Basic Health Care Grants - 723.34 Families and Children 723.35 General 14,708,000 723.36 (c) MA Basic Health Care Grants - 723.37 Elderly and Disabled 723.38 General 15,137,000 723.39 (d) General Assistance Medical Care 723.40 Grants 723.41 General 29,519,000 724.1 Subd. 4. Continuing Care Grants 724.2 General 56,615,000 724.3 The amounts that may be spent from this 724.4 appropriation for each purpose are as 724.5 follows: 724.6 (a) Medical Assistance Long-Term Care 724.7 Waivers and Home Care Grants 724.8 General 57,388,000 724.9 (b) Medical Assistance Long-Term Care 724.10 Facilities Grants 724.11 General 678,000 724.12 (c) Group Residential Housing Grants 724.13 General (1,451,000) 724.14 Subd. 5. Economic Support Grants 724.15 General (6,703,000) 724.16 Federal TANF 19,239,000 724.17 The amounts that may be spent from the 724.18 appropriation for each purpose are as 724.19 follows: 724.20 (a) Assistance to Families Grants 724.21 General (9,306,000) 724.22 Federal TANF 19,239,000 724.23 (b) General Assistance Grants 724.24 General 3,491,000 724.25 (c) Minnesota Supplemental Aid Grants 724.26 General (888,000) 724.27 Sec. 3. COMMISSIONER OF HEALTH 724.28 Subdivision 1. Total Appropriation (5,520,000) 724.29 Summary by Fund 724.30 General (5,520,000) 724.31 Subd. 2. Access and Quality Improvement (5,520,000) 724.32 Sec. 4. [EFFECTIVE DATE.] 724.33 Sections 1 to 3 are effective the day following final 724.34 enactment. 724.35 ARTICLE 13B 724.36 DEPARTMENT OF CHILDREN, FAMILIES, AND LEARNING 724.37 FORECAST ADJUSTMENT 724.38 Section 1. [ADJUSTMENT.] 724.39 The dollar amounts shown are added to or, if shown in 725.1 parentheses, are subtracted from the appropriations in Laws 725.2 2001, First Special Session chapter 6, as amended by Laws 2002, 725.3 chapter 220, and Laws 2002, chapter 374, or other law, and are 725.4 appropriated from the general fund to the department of 725.5 children, families, and learning for the purposes specified in 725.6 this article, to be available for the fiscal year indicated for 725.7 each purpose. The figure "2003" used in this article means that 725.8 the appropriation or appropriations listed are available for the 725.9 fiscal year ending June 30, 2003. 725.10 2003 725.11 APPROPRIATION CHANGE 725.12 Sec. 2. APPROPRIATIONS; EARLY CHILDHOOD 725.13 AND FAMILY EDUCATION 725.14 MFIP Child Care 6,817,000 725.15 ARTICLE 13C 725.16 APPROPRIATIONS 725.17 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 725.18 The sums shown in the columns marked "APPROPRIATIONS" are 725.19 appropriated from the general fund, or any other fund named, to 725.20 the agencies and for the purposes specified in the sections of 725.21 this article, to be available for the fiscal years indicated for 725.22 each purpose. The figures "2004" and "2005" where used in this 725.23 article, mean that the appropriation or appropriations listed 725.24 under them are available for the fiscal year ending June 30, 725.25 2004, or June 30, 2005, respectively. Where a dollar amount 725.26 appears in parentheses, it means a reduction of an appropriation. 725.27 SUMMARY BY FUND 725.28 BIENNIAL 725.29 2004 2005 TOTAL 725.30 General $3,765,212,000 $3,727,319,000 $7,492,531,000 725.31 State Government 725.32 Special Revenue 45,337,000 45,104,000 90,441,000 725.33 Health Care 725.34 Access 294,090,000 308,525,000 602,615,000 725.35 Federal TANF 261,552,000 270,364,000 531,916,000 725.36 Lottery Prize 725.37 Fund 1,556,000 1,556,000 3,112,000 725.38 Special Revenue 3,340,000 3,340,000 6,680,000 726.1 TOTAL $4,371,087,000 $4,356,208,000 $8,727,295,000 726.2 APPROPRIATIONS 726.3 Available for the Year 726.4 Ending June 30 726.5 2004 2005 726.6 Sec. 2. COMMISSIONER OF 726.7 HUMAN SERVICES 726.8 Subdivision 1. Total 726.9 Appropriation $4,111,558,000 $4,110,496,000 726.10 Summary by Fund 726.11 General 3,566,163,000 3,541,854,000 726.12 State Government 726.13 Special Revenue 534,000 534,000 726.14 Health Care 726.15 Access 287,753,000 302,188,000 726.16 Federal TANF 255,552,000 264,364,000 726.17 Lottery Cash 726.18 Flow 1,556,000 1,556,000 726.19 [FEDERAL CONTINGENCY APPROPRIATION.] 726.20 (a) Any additional federal Medicaid 726.21 funds made available under title IV of 726.22 the federal Jobs and Growth Tax Relief 726.23 Reconciliation Act of 2003 are 726.24 appropriated to the commissioner of 726.25 human services for use in the state's 726.26 medical assistance and MinnesotaCare 726.27 programs. The commissioners of human 726.28 services and finance shall report to 726.29 the legislative advisory committee on 726.30 the additional federal Medicaid 726.31 matching funds that will be available 726.32 to the state. 726.33 (b) Contingent upon the availability of 726.34 these funds, the following policies 726.35 shall become effective and necessary 726.36 funds are appropriated for those 726.37 purposes: 726.38 (1) medical assistance and 726.39 MinnesotaCare eligibility and local 726.40 financial participation changes 726.41 provided for in this act may be 726.42 implemented prior to September 2, 2003, 726.43 or may be delayed as necessary to 726.44 maximize the use of federal funds 726.45 received under title IV of the Jobs and 726.46 Growth Tax Relief Reconciliation Act of 726.47 2003; 726.48 (2) the aggregate cap on the services 726.49 identified in Minnesota Statutes, 726.50 section 256L.035, paragraph (a), clause 726.51 (3), shall be increased from $2,000 to 726.52 $5,000. This increase shall expire at 726.53 the end of fiscal year 2007. Funds may 726.54 be transferred from the general fund to 726.55 the health care access fund as 726.56 necessary to implement this provision; 726.57 and 727.1 (3) the following payment shifts shall 727.2 not be implemented: 727.3 (i) MFIP payment shift found in 727.4 subdivision 11; 727.5 (ii) the county payment shift found in 727.6 subdivision 1; and 727.7 (iii) the delay in medical assistance 727.8 and general assistance medical care 727.9 fee-for-service payments found in 727.10 subdivision 6. 727.11 (c) Notwithstanding section 14, 727.12 paragraphs (a) and (b) shall expire 727.13 June 30, 2007. 727.14 [RECEIPTS FOR SYSTEMS PROJECTS.] 727.15 Appropriations and federal receipts for 727.16 information system projects for MAXIS, 727.17 PRISM, MMIS, and SSIS must be deposited 727.18 in the state system account authorized 727.19 in Minnesota Statutes, section 727.20 256.014. Money appropriated for 727.21 computer projects approved by the 727.22 Minnesota office of technology, funded 727.23 by the legislature, and approved by the 727.24 commissioner of finance may be 727.25 transferred from one project to another 727.26 and from development to operations as 727.27 the commissioner of human services 727.28 considers necessary. Any unexpended 727.29 balance in the appropriation for these 727.30 projects does not cancel but is 727.31 available for ongoing development and 727.32 operations. 727.33 [GIFTS.] Notwithstanding Minnesota 727.34 Statutes, chapter 7, the commissioner 727.35 may accept on behalf of the state 727.36 additional funding from sources other 727.37 than state funds for the purpose of 727.38 financing the cost of assistance 727.39 program grants or nongrant 727.40 administration. All additional funding 727.41 is appropriated to the commissioner for 727.42 use as designated by the grantor of 727.43 funding. 727.44 [SYSTEMS CONTINUITY.] In the event of 727.45 disruption of technical systems or 727.46 computer operations, the commissioner 727.47 may use available grant appropriations 727.48 to ensure continuity of payments for 727.49 maintaining the health, safety, and 727.50 well-being of clients served by 727.51 programs administered by the department 727.52 of human services. Grant funds must be 727.53 used in a manner consistent with the 727.54 original intent of the appropriation. 727.55 [NONFEDERAL SHARE TRANSFERS.] The 727.56 nonfederal share of activities for 727.57 which federal administrative 727.58 reimbursement is appropriated to the 727.59 commissioner may be transferred to the 727.60 special revenue fund. 727.61 [TANF FUNDS APPROPRIATED TO OTHER 727.62 ENTITIES.] Any expenditures from the 728.1 TANF block grant shall be expended in 728.2 accordance with the requirements and 728.3 limitations of part A of title IV of 728.4 the Social Security Act, as amended, 728.5 and any other applicable federal 728.6 requirement or limitation. Prior to 728.7 any expenditure of these funds, the 728.8 commissioner shall assure that funds 728.9 are expended in compliance with the 728.10 requirements and limitations of federal 728.11 law and that any reporting requirements 728.12 of federal law are met. It shall be 728.13 the responsibility of any entity to 728.14 which these funds are appropriated to 728.15 implement a memorandum of understanding 728.16 with the commissioner that provides the 728.17 necessary assurance of compliance prior 728.18 to any expenditure of funds. The 728.19 commissioner shall receipt TANF funds 728.20 appropriated to other state agencies 728.21 and coordinate all related interagency 728.22 accounting transactions necessary to 728.23 implement these appropriations. 728.24 Unexpended TANF funds appropriated to 728.25 any state, local, or nonprofit entity 728.26 cancel at the end of the state fiscal 728.27 year unless appropriating language 728.28 permits otherwise. 728.29 [TANF FUNDS TRANSFERRED TO OTHER 728.30 FEDERAL GRANTS.] The commissioner must 728.31 authorize transfers from TANF to other 728.32 federal block grants so that funds are 728.33 available to meet the annual 728.34 expenditure needs as appropriated. 728.35 Transfers may be authorized prior to 728.36 the expenditure year with the agreement 728.37 of the receiving entity. Transferred 728.38 funds must be expended in the year for 728.39 which the funds were appropriated 728.40 unless appropriation language permits 728.41 otherwise. In accelerating transfer 728.42 authorizations, the commissioner must 728.43 aim to preserve the future potential 728.44 transfer capacity from TANF to other 728.45 block grants. 728.46 [TANF MAINTENANCE OF EFFORT.] (a) In 728.47 order to meet the basic maintenance of 728.48 effort (MOE) requirements of the TANF 728.49 block grant specified under Code of 728.50 Federal Regulations, title 45, section 728.51 263.1, the commissioner may only report 728.52 nonfederal money expended for allowable 728.53 activities listed in the following 728.54 clauses as TANF/MOE expenditures: 728.55 (1) MFIP cash, diversionary work 728.56 program, and food assistance benefits 728.57 under Minnesota Statutes, chapter 256J; 728.58 (2) the child care assistance programs 728.59 under Minnesota Statutes, sections 728.60 119B.03 and 119B.05, and county child 728.61 care administrative costs under 728.62 Minnesota Statutes, section 119B.15; 728.63 (3) state and county MFIP 728.64 administrative costs under Minnesota 728.65 Statutes, chapters 256J and 256K; 729.1 (4) state, county, and tribal MFIP 729.2 employment services under Minnesota 729.3 Statutes, chapters 256J and 256K; 729.4 (5) expenditures made on behalf of 729.5 noncitizen MFIP recipients who qualify 729.6 for the medical assistance without 729.7 federal financial participation program 729.8 under Minnesota Statutes, section 729.9 256B.06, subdivision 4, paragraphs (d), 729.10 (e), and (j); and 729.11 (6) qualifying working family credit 729.12 expenditures under Minnesota Statutes, 729.13 section 290.0671. 729.14 (b) The commissioner shall ensure that 729.15 sufficient qualified nonfederal 729.16 expenditures are made each year to meet 729.17 the state's TANF/MOE requirements. For 729.18 the activities listed in paragraph (a), 729.19 clauses (2) to (6), the commissioner 729.20 may only report expenditures that are 729.21 excluded from the definition of 729.22 assistance under Code of Federal 729.23 Regulations, title 45, section 260.31. 729.24 (c) By August 31 of each year, the 729.25 commissioner shall make a preliminary 729.26 calculation to determine the likelihood 729.27 that the state will meet its annual 729.28 federal work participation requirement 729.29 under Code of Federal Regulations, 729.30 title 45, sections 261.21 and 261.23, 729.31 after adjustment for any caseload 729.32 reduction credit under Code of Federal 729.33 Regulations, title 45, section 261.41. 729.34 If the commissioner determines that the 729.35 state will meet its federal work 729.36 participation rate for the federal 729.37 fiscal year ending that September, the 729.38 commissioner may reduce the expenditure 729.39 under paragraph (a), clause (1), to the 729.40 extent allowed under Code of Federal 729.41 Regulations, title 45, section 729.42 263.1(a)(2). 729.43 (d) For fiscal years beginning with 729.44 state fiscal year 2003, the 729.45 commissioner shall assure that the 729.46 maintenance of effort used by the 729.47 commissioner of finance for the 729.48 February and November forecasts 729.49 required under Minnesota Statutes, 729.50 section 16A.103, contains expenditures 729.51 under paragraph (a), clause (1), equal 729.52 to at least 25 percent of the total 729.53 required under Code of Federal 729.54 Regulations, title 45, section 263.1. 729.55 (e) If nonfederal expenditures for the 729.56 programs and purposes listed in 729.57 paragraph (a) are insufficient to meet 729.58 the state's TANF/MOE requirements, the 729.59 commissioner shall recommend additional 729.60 allowable sources of nonfederal 729.61 expenditures to the legislature, if the 729.62 legislature is or will be in session to 729.63 take action to specify additional 729.64 sources of nonfederal expenditures for 729.65 TANF/MOE before a federal penalty is 730.1 imposed. The commissioner shall 730.2 otherwise provide notice to the 730.3 legislative commission on planning and 730.4 fiscal policy under paragraph (g). 730.5 (f) If the commissioner uses authority 730.6 granted under section 11, or similar 730.7 authority granted by a subsequent 730.8 legislature, to meet the state's 730.9 TANF/MOE requirement in a reporting 730.10 period, the commissioner shall inform 730.11 the chairs of the appropriate 730.12 legislative committees about all 730.13 transfers made under that authority for 730.14 this purpose. 730.15 (g) If the commissioner determines that 730.16 nonfederal expenditures under paragraph 730.17 (a) are insufficient to meet TANF/MOE 730.18 expenditure requirements, and if the 730.19 legislature is not or will not be in 730.20 session to take timely action to avoid 730.21 a federal penalty, the commissioner may 730.22 report nonfederal expenditures from 730.23 other allowable sources as TANF/MOE 730.24 expenditures after the requirements of 730.25 this paragraph are met. The 730.26 commissioner may report nonfederal 730.27 expenditures in addition to those 730.28 specified under paragraph (a) as 730.29 nonfederal TANF/MOE expenditures, but 730.30 only ten days after the commissioner of 730.31 finance has first submitted the 730.32 commissioner's recommendations for 730.33 additional allowable sources of 730.34 nonfederal TANF/MOE expenditures to the 730.35 members of the legislative commission 730.36 on planning and fiscal policy for their 730.37 review. 730.38 (h) The commissioner of finance shall 730.39 not incorporate any changes in federal 730.40 TANF expenditures or nonfederal 730.41 expenditures for TANF/MOE that may 730.42 result from reporting additional 730.43 allowable sources of nonfederal 730.44 TANF/MOE expenditures under the interim 730.45 procedures in paragraph (g) into the 730.46 February or November forecasts required 730.47 under Minnesota Statutes, section 730.48 16A.103, unless the commissioner of 730.49 finance has approved the additional 730.50 sources of expenditures under paragraph 730.51 (g). 730.52 (i) Minnesota Statutes, section 730.53 256.011, subdivision 3, which requires 730.54 that federal grants or aids secured or 730.55 obtained under that subdivision be used 730.56 to reduce any direct appropriations 730.57 provided by law, do not apply if the 730.58 grants or aids are federal TANF funds. 730.59 (j) Notwithstanding section 14, 730.60 paragraph (a), clauses (1) to (6), and 730.61 paragraphs (b) to (j) expire June 30, 730.62 2007. 730.63 [WORKING FAMILY CREDIT EXPENDITURES AS 730.64 TANF MOE.] The commissioner may claim 730.65 as TANF maintenance of effort up to the 731.1 following amounts of working family 731.2 credit expenditures for the following 731.3 fiscal years: 731.4 (1) fiscal year 2004, $7,013,000; 731.5 (2) fiscal year 2005, $25,133,000; 731.6 (3) fiscal year 2006, $6,942,000; and 731.7 (4) fiscal year 2007, $6,707,000. 731.8 [FISCAL YEAR 2003 APPROPRIATIONS 731.9 CARRYFORWARD.] Effective the day 731.10 following final enactment, 731.11 notwithstanding Minnesota Statutes, 731.12 section 16A.28, or any other law to the 731.13 contrary, state agencies and 731.14 constitutional offices may carry 731.15 forward unexpended and unencumbered 731.16 nongrant operating balances from fiscal 731.17 year 2003 general fund appropriations 731.18 into fiscal year 2004 to offset general 731.19 budget reductions. 731.20 [TRANSFER OF GRANT BALANCES.] Effective 731.21 the day following final enactment, the 731.22 commissioner of human services, with 731.23 the approval of the commissioner of 731.24 finance and after notification of the 731.25 chair of the senate health, human 731.26 services and corrections budget 731.27 division and the chair of the house of 731.28 representatives health and human 731.29 services finance committee, may 731.30 transfer unencumbered appropriation 731.31 balances for the biennium ending June 731.32 30, 2003, in fiscal year 2003 among the 731.33 MFIP, MFIP child care assistance under 731.34 Minnesota Statutes, section 119B.05, 731.35 general assistance, general assistance 731.36 medical care, medical assistance, 731.37 Minnesota supplemental aid, and group 731.38 residential housing programs, and the 731.39 entitlement portion of the chemical 731.40 dependency consolidated treatment fund, 731.41 and between fiscal years of the 731.42 biennium. 731.43 [TANF APPROPRIATION CANCELLATION.] 731.44 Notwithstanding the provisions of Laws 731.45 2000, chapter 488, article 1, section 731.46 16, any prior appropriations of TANF 731.47 funds to the department of trade and 731.48 economic development or to the job 731.49 skills partnership board or any 731.50 transfers of TANF funds from another 731.51 agency to the department of trade and 731.52 economic development or to the job 731.53 skills partnership board are not 731.54 available until expended, and if 731.55 unobligated as of June 30, 2003, these 731.56 appropriations or transfers shall 731.57 cancel to the TANF fund. 731.58 [SHIFT COUNTY PAYMENT.] The 731.59 commissioner shall make up to 100 731.60 percent of the calendar year 2005 731.61 payments to counties for developmental 731.62 disabilities semi-independent living 731.63 services grants, developmental 732.1 disabilities family support grants, and 732.2 adult mental health grants from fiscal 732.3 year 2006 appropriations. This is a 732.4 onetime payment shift. Calendar year 732.5 2006 and future payments for these 732.6 grants are not affected by this shift. 732.7 This provision expires June 30, 2006. 732.8 [CAPITATION RATE INCREASE.] Of the 732.9 health care access fund appropriations 732.10 to the University of Minnesota in the 732.11 higher education omnibus appropriation 732.12 bill, $2,157,000 in fiscal year 2004 732.13 and $2,157,000 in fiscal year 2005 are 732.14 to be used to increase the capitation 732.15 payments under Minnesota Statutes, 732.16 section 256B.69. Notwithstanding the 732.17 provisions of section 14, this 732.18 provision shall not expire. 732.19 Subd. 2. Agency Management 732.20 Summary by Fund 732.21 General 41,473,000 27,868,000 732.22 State Government 732.23 Special Revenue 415,000 415,000 732.24 Health Care Access 3,673,000 3,673,000 732.25 Federal TANF 320,000 320,000 732.26 The amounts that may be spent from the 732.27 appropriation for each purpose are as 732.28 follows: 732.29 (a) Financial Operations 732.30 General 8,751,000 9,056,000 732.31 Health Care Access 828,000 828,000 732.32 Federal TANF 220,000 220,000 732.33 [SPECIAL REVENUE FUND TRANSFER.] 732.34 Notwithstanding any law to the 732.35 contrary, excluding accounts authorized 732.36 under Minnesota Statutes, section 732.37 16A.1286, and chapter 254B, the 732.38 commissioner shall transfer $1,400,000 732.39 of uncommitted special revenue fund 732.40 balances to the general fund upon final 732.41 enactment. The actual transfers shall 732.42 be identified within the standard 732.43 information provided to the chairs of 732.44 the house health and human services 732.45 finance committee and the senate 732.46 health, human services, and corrections 732.47 budget division in December 2003. 732.48 (b) Legal and 732.49 Regulation Operations 732.50 General 7,896,000 8,168,000 732.51 State Government 732.52 Special Revenue 415,000 415,000 732.53 Health Care Access 244,000 244,000 733.1 Federal TANF 100,000 100,000 733.2 (c) Management Operations 733.3 General 17,373,000 3,076,000 733.4 Health Care Access 1,623,000 1,623,000 733.5 (d) Information Technology 733.6 Operations 733.7 General 7,453,000 7,568,000 733.8 Health Care Access 978,000 978,000 733.9 Subd. 3. Revenue and Pass-Through 733.10 Federal TANF 55,855,000 53,315,000 733.11 [TANF TRANSFER TO SOCIAL SERVICES BLOCK 733.12 GRANT.] $3,137,000 in fiscal year 2005 733.13 is appropriated to the commissioner for 733.14 the purposes of providing services for 733.15 families with children whose incomes 733.16 are at or below 200 percent of the 733.17 federal poverty guidelines. The 733.18 commissioner shall authorize a 733.19 sufficient transfer of funds from the 733.20 state's federal TANF block grant to the 733.21 state's federal social services block 733.22 grant to meet this appropriation. The 733.23 funds shall be distributed to counties 733.24 for the children and community services 733.25 grant according to the formula for the 733.26 state appropriations in Minnesota 733.27 Statutes, chapter 256M. 733.28 [TANF FUNDS FOR FISCAL YEAR 2006 AND 733.29 FISCAL YEAR 2007 REFINANCING.] 733.30 $12,692,000 in fiscal year 2006 and 733.31 $9,192,000 in fiscal year 2007 in TANF 733.32 funds are available to the commissioner 733.33 to replace general funds in the amount 733.34 of $12,692,000 in fiscal year 2006 and 733.35 $9,192,000 in fiscal year 2007 in 733.36 expenditures that may be counted toward 733.37 TANF maintenance of effort requirements 733.38 or as an allowable TANF expenditure. 733.39 [ADJUSTMENTS IN TANF TRANSFER TO CHILD 733.40 CARE AND DEVELOPMENT FUND.] Transfers 733.41 of TANF to the child care development 733.42 fund for the purposes of MFIP child 733.43 care assistance shall be reduced by 733.44 $116,000 in fiscal year 2004 and shall 733.45 be increased by $1,976,000 in fiscal 733.46 year 2005. 733.47 Subd. 4. Children's Services Grants 733.48 Summary by Fund 733.49 General 111,264,000 94,020,000 733.50 Federal TANF -0- 3,137,000 733.51 [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 733.52 Federal funds available during fiscal 733.53 year 2004 and fiscal year 2005, for 733.54 adoption incentive grants are 733.55 appropriated to the commissioner for 734.1 these purposes. 734.2 [ADOPTION ASSISTANCE AND RELATIVE 734.3 CUSTODY ASSISTANCE.] The commissioner 734.4 may transfer unencumbered appropriation 734.5 balances for adoption assistance and 734.6 relative custody assistance between 734.7 fiscal years and between programs. 734.8 [CHILDREN AND COMMUNITY SERVICES 734.9 GRANTS.] Counties shall not reduce 734.10 children and community service grant 734.11 expenditures for services to adults 734.12 with disabilities by more than the 734.13 overall percentage of the reduction in 734.14 the county's allocation of children and 734.15 community service grant funds when 734.16 compared to the county's calendar year 734.17 2003 allocation of former children's 734.18 services and community service grants 734.19 defined under Minnesota Statutes, 734.20 section 256M.10, subdivision 5. 734.21 [OUT-OF-HOME PLACEMENT.] Minnesota 734.22 youth who require out-of-home placement 734.23 through a corrections order must be 734.24 placed in a Minnesota program or 734.25 facility unless a program in a border 734.26 state is closer to the youth's home or 734.27 there is no vacancy in an appropriate 734.28 in-state program or facility. If no 734.29 appropriate, cost-effective regional or 734.30 in-state program is available, this 734.31 must be documented in the case plan 734.32 prior to placement in an out-of-state 734.33 facility. Justification for 734.34 out-of-state placement of Minnesota 734.35 youth must be included in reports to 734.36 the Minnesota department of corrections. 734.37 Subd. 5. Children's Services Management 734.38 General 5,221,000 5,283,000 734.39 Subd. 6. Basic Health Care Grants 734.40 Summary by Fund 734.41 General 1,499,941,000 1,533,016,000 734.42 Health Care Access 268,151,000 282,605,000 734.43 [UPDATING FEDERAL POVERTY GUIDELINES.] 734.44 Annual updates to the federal poverty 734.45 guidelines are effective each July 1, 734.46 following publication by the United 734.47 States Department of Health and Human 734.48 Services for health care programs under 734.49 Minnesota Statutes, chapters 256, 256B, 734.50 256D, and 256L. 734.51 The amounts that may be spent from this 734.52 appropriation for each purpose are as 734.53 follows: 734.54 (a) MinnesotaCare Grants 734.55 Health Care Access 267,401,000 281,855,000 734.56 [MINNESOTACARE FEDERAL RECEIPTS.] 734.57 Receipts received as a result of 735.1 federal participation pertaining to 735.2 administrative costs of the Minnesota 735.3 health care reform waiver shall be 735.4 deposited as nondedicated revenue in 735.5 the health care access fund. Receipts 735.6 received as a result of federal 735.7 participation pertaining to grants 735.8 shall be deposited in the federal fund 735.9 and shall offset health care access 735.10 funds for payments to providers. 735.11 [MINNESOTACARE FUNDING.] The 735.12 commissioner may expend money 735.13 appropriated from the health care 735.14 access fund for MinnesotaCare in either 735.15 fiscal year of the biennium. 735.16 (b) MA Basic Health Care Grants - 735.17 Families and Children 735.18 General 568,254,000 582,161,000 735.19 [SERVICES TO PREGNANT WOMEN.] The 735.20 commissioner shall use available 735.21 federal money for the State-Children's 735.22 Health Insurance Program for medical 735.23 assistance services provided to 735.24 pregnant women who are not otherwise 735.25 eligible for federal financial 735.26 participation beginning in fiscal year 735.27 2003. This federal money shall be 735.28 deposited in the federal fund and shall 735.29 offset general funds for payments to 735.30 providers. Notwithstanding section 14, 735.31 this paragraph shall not expire. 735.32 [MANAGED CARE RATE INCREASE.] (a) 735.33 Effective January 1, 2004, the 735.34 commissioner of human services shall 735.35 increase the total payments to managed 735.36 care plans under Minnesota Statutes, 735.37 section 256B.69, by an amount equal to 735.38 the cost increases to the managed care 735.39 plans from by the elimination of: (1) 735.40 the exemption from the taxes imposed 735.41 under Minnesota Statutes, section 735.42 297I.05, subdivision 5, for premiums 735.43 paid by the state for medical 735.44 assistance, general assistance medical 735.45 care, and the MinnesotaCare program; 735.46 and (2) the exemption of gross revenues 735.47 subject to the taxes imposed under 735.48 Minnesota Statutes, sections 295.50 to 735.49 295.57, for payments paid by the state 735.50 for services provided under medical 735.51 assistance, general assistance medical 735.52 care, and the MinnesotaCare program. 735.53 Any increase based on clause (2) must 735.54 be reflected in provider rates paid by 735.55 the managed care plan unless the 735.56 managed care plan is a staff model 735.57 health plan company. 735.58 (b) The commissioner of human services 735.59 shall increase by two percent the 735.60 fee-for-service payments under medical 735.61 assistance, general assistance medical 735.62 care, and the MinnesotaCare program for 735.63 services subject to the hospital, 735.64 surgical center, or health care 735.65 provider taxes under Minnesota 736.1 Statutes, sections 295.50 to 295.57, 736.2 effective for services rendered on or 736.3 after January 1, 2004. 736.4 (c) The commissioner of finance shall 736.5 transfer from the health care access 736.6 fund to the general fund the following 736.7 amounts in the fiscal years indicated: 736.8 2004, $16,587,000; 2005, $46,322,000; 736.9 2006, $49,413,000; and 2007, 736.10 $52,659,000. 736.11 (d) For fiscal years after 2007, the 736.12 commissioner of finance shall transfer 736.13 from the health care access fund to the 736.14 general fund an amount equal to the 736.15 revenue collected by the commissioner 736.16 of revenue on the following: 736.17 (1) gross revenues received by 736.18 hospitals, surgical centers, and health 736.19 care providers as payments for services 736.20 provided under medical assistance, 736.21 general assistance medical care, and 736.22 the MinnesotaCare program, including 736.23 payments received directly from the 736.24 state or from a prepaid plan, under 736.25 Minnesota Statutes, sections 295.50 to 736.26 295.57; and 736.27 (2) premiums paid by the state under 736.28 medical assistance, general assistance 736.29 medical care, and the MinnesotaCare 736.30 program under Minnesota Statutes, 736.31 section 297I.05, subdivision 5. 736.32 The commissioner of finance shall 736.33 monitor and adjust if necessary the 736.34 amount transferred each fiscal year 736.35 from the health care access fund to the 736.36 general fund to ensure that the amount 736.37 transferred equals the tax revenue 736.38 collected for the items described in 736.39 clauses (1) and (2) for that fiscal 736.40 year. 736.41 (e) Notwithstanding section 14, these 736.42 provisions shall not expire. 736.43 (c) MA Basic Health Care Grants - Elderly 736.44 and Disabled 736.45 General 695,421,000 741,605,000 736.46 [DELAY MEDICAL ASSISTANCE 736.47 FEE-FOR-SERVICE - ACUTE CARE.] The 736.48 following payments in fiscal year 2005 736.49 from the Medicaid Management 736.50 Information System that would otherwise 736.51 have been made to providers for medical 736.52 assistance and general assistance 736.53 medical care services shall be delayed 736.54 and included in the first payment in 736.55 fiscal year 2006: 736.56 (1) for hospitals, the last two 736.57 payments; and 736.58 (2) for nonhospital providers, the last 736.59 payment. 737.1 This payment delay shall not include 737.2 payments to skilled nursing facilities, 737.3 intermediate care facilities for mental 737.4 retardation, prepaid health plans, home 737.5 health agencies, personal care nursing 737.6 providers, and providers of only waiver 737.7 services. The provisions of Minnesota 737.8 Statutes, section 16A.124, shall not 737.9 apply to these delayed payments. 737.10 Notwithstanding section 14, this 737.11 provision shall not expire. 737.12 [DEAF AND HARD-OF-HEARING SERVICES.] 737.13 If, after making reasonable efforts, 737.14 the service provider for mental health 737.15 services to persons who are deaf or 737.16 hearing impaired is not able to earn 737.17 $227,000 through participation in 737.18 medical assistance intensive 737.19 rehabilitation services in fiscal year 737.20 2005, the commissioner shall transfer 737.21 $227,000 minus medical assistance 737.22 earnings achieved by the grantee to 737.23 deaf and hard-of-hearing grants to 737.24 enable the provider to continue 737.25 providing services to eligible persons. 737.26 (d) General Assistance Medical Care 737.27 Grants 737.28 General 223,960,000 196,617,000 737.29 (e) Health Care Grants - Other 737.30 Assistance 737.31 General 3,067,000 3,407,000 737.32 Health Care Access 750,000 750,000 737.33 [MINNESOTA PRESCRIPTION DRUG DEDICATED 737.34 FUND.] Of the general fund 737.35 appropriation, $284,000 in fiscal year 737.36 2005 is appropriated to the 737.37 commissioner for the prescription drug 737.38 dedicated fund established under the 737.39 prescription drug discount program. 737.40 [DENTAL ACCESS GRANTS CARRYOVER 737.41 AUTHORITY.] Any unspent portion of the 737.42 appropriation from the health care 737.43 access fund in fiscal years 2002 and 737.44 2003 for dental access grants under 737.45 Minnesota Statutes, section 256B.53, 737.46 shall not cancel but shall be allowed 737.47 to carry forward to be spent in the 737.48 biennium beginning July 1, 2003, for 737.49 these purposes. 737.50 [STOP-LOSS FUND ACCOUNT.] The 737.51 appropriation to the purchasing 737.52 alliance stop-loss fund account 737.53 established under Minnesota Statutes, 737.54 section 256.956, subdivision 2, for 737.55 fiscal years 2004 and 2005 shall only 737.56 be available for claim reimbursements 737.57 for qualifying enrollees who are 737.58 members of purchasing alliances that 737.59 meet the requirements described under 737.60 Minnesota Statutes, section 256.956, 737.61 subdivision 1, paragraph (f), clauses 737.62 (1), (2), and (3). 738.1 (f) Prescription Drug Program 738.2 General 9,239,000 9,226,000 738.3 [PRESCRIPTION DRUG ASSISTANCE PROGRAM.] 738.4 Of the general fund appropriation, 738.5 $702,000 in fiscal year 2004 and 738.6 $887,000 in fiscal year 2005 are for 738.7 the commissioner to establish and 738.8 administer the prescription drug 738.9 assistance program through the 738.10 Minnesota board on aging. 738.11 [REBATE REVENUE RECAPTURE.] Any funds 738.12 received by the state from a drug 738.13 manufacturer due to errors in the 738.14 pharmaceutical pricing used by the 738.15 manufacturer in determining the 738.16 prescription drug rebate are 738.17 appropriated to the commissioner to 738.18 augment funding of the prescription 738.19 drug program established in Minnesota 738.20 Statutes, section 256.955. 738.21 Subd. 7. Health Care Management 738.22 Summary by Fund 738.23 General 24,845,000 26,199,000 738.24 Health Care Access 14,522,000 14,533,000 738.25 The amounts that may be spent from this 738.26 appropriation for each purpose are as 738.27 follows: 738.28 (a) Health Care Policy Administration 738.29 General 5,523,000 7,223,000 738.30 Health Care Access 1,066,000 1,200,000 738.31 [PAYMENT CODE STUDY.] Of this 738.32 appropriation, $345,000 each year is 738.33 for a study to determine the 738.34 appropriateness of eliminating 738.35 reimbursement for certain payment codes 738.36 under medical assistance, general 738.37 assistance medical care, or 738.38 MinnesotaCare. As part of the study, 738.39 the commissioner shall also examine 738.40 covered services under the Minnesota 738.41 health care programs and make 738.42 recommendations on possible 738.43 modification of the services covered 738.44 under the program. The commissioner 738.45 shall report to the legislature by 738.46 January 15, 2005, with an analysis of 738.47 the feasibility of this approach, a 738.48 list of codes, if any, to be eliminated 738.49 from the payment system, and estimates 738.50 of savings to be obtained from this 738.51 approach. 738.52 [TRANSFERS FROM HEALTH CARE ACCESS 738.53 FUND.] (a) Notwithstanding Minnesota 738.54 Statutes, section 295.581, to the 738.55 extent available resources in the 738.56 health care access fund exceed 738.57 expenditures in that fund during fiscal 738.58 years 2005 to 2007, the excess annual 739.1 funds shall be transferred from the 739.2 health care access fund to the general 739.3 fund on June 30 of fiscal years 2005, 739.4 2006, and 2007. These transfers shall 739.5 not be reduced to accommodate 739.6 MinnesotaCare expansions. The 739.7 estimated amounts to be transferred are: 739.8 (1) in fiscal year 2005, $192,442,000; 739.9 (2) in fiscal year 2006, $52,943,000; 739.10 and 739.11 (3) in fiscal year 2007, $59,105,000. 739.12 These estimates shall be updated with 739.13 each forecast, but in no case shall the 739.14 transfers exceed the amounts listed in 739.15 clauses (1) to (3). 739.16 (b) The commissioner shall limit 739.17 transfers under paragraph (a) in order 739.18 to avoid implementation of Minnesota 739.19 Statutes, section 256L.02, subdivision 739.20 3, paragraph (b). 739.21 (c) For fiscal years 2004 to 2007, 739.22 MinnesotaCare shall be a forecasted 739.23 program and, if necessary, the 739.24 commissioner shall reduce transfers 739.25 under paragraph (a) to meet forecasted 739.26 expenditures. 739.27 (d) The department of human services in 739.28 recommending its 2007-2008 budget shall 739.29 consider the repayment of the amount 739.30 transferred in fiscal years 2006 and 739.31 2007 from the health care access fund 739.32 to the general fund to the health care 739.33 access fund. 739.34 (e) Notwithstanding section 14, this 739.35 section is in effect until June 30, 739.36 2007. 739.37 [MINNESOTACARE OUTREACH REIMBURSEMENT.] 739.38 Federal administrative reimbursement 739.39 resulting from MinnesotaCare outreach 739.40 is appropriated to the commissioner for 739.41 this activity. 739.42 [MINNESOTA SENIOR HEALTH OPTIONS 739.43 REIMBURSEMENT.] Federal administrative 739.44 reimbursement resulting from the 739.45 Minnesota senior health options project 739.46 is appropriated to the commissioner for 739.47 this activity. 739.48 [UTILIZATION REVIEW.] Federal 739.49 administrative reimbursement resulting 739.50 from prior authorization and inpatient 739.51 admission certification by a 739.52 professional review organization shall 739.53 be dedicated to the commissioner for 739.54 these purposes. A portion of these 739.55 funds must be used for activities to 739.56 decrease unnecessary pharmaceutical 739.57 costs in medical assistance. 739.58 (b) Health Care Operations 740.1 General 19,322,000 18,976,000 740.2 Health Care Access 13,456,000 13,333,000 740.3 [PREPAID MEDICAL PROGRAMS.] For all 740.4 counties in which the PMAP program has 740.5 been operating for 12 or more months, 740.6 state funding for the nonfederal share 740.7 of prepaid medical assistance program 740.8 administration costs for county managed 740.9 care advocacy and enrollment operations 740.10 is eliminated. State funding will 740.11 continue for these activities for 740.12 counties and tribes establishing new 740.13 PMAP programs for a maximum of 16 740.14 months (four months prior to beginning 740.15 PMAP enrollment and through the first 740.16 12 months of their PMAP program 740.17 operation). Those counties operating 740.18 PMAP programs for less than 12 months 740.19 can continue to receive state funding 740.20 for advocacy and enrollment activities 740.21 through their first year of operation. 740.22 Subd. 8. State-operated Services 740.23 General 195,062,000 186,775,000 740.24 [MITIGATION RELATED TO STATE-OPERATED 740.25 SERVICES RESTRUCTURING.] Money 740.26 appropriated to finance mitigation 740.27 expenses related to restructuring 740.28 state-operated services programs and 740.29 administrative services may be 740.30 transferred between fiscal years within 740.31 the biennium. 740.32 [REPAIRS AND BETTERMENTS.] The 740.33 commissioner may transfer unencumbered 740.34 appropriation balances between fiscal 740.35 years within the biennium for the state 740.36 residential facilities repairs and 740.37 betterments account and special 740.38 equipment. 740.39 [ONETIME REDUCTION TO DEDICATED 740.40 REVENUES.] (a) For fiscal year 2003 740.41 only, the commissioner shall transfer 740.42 $4,700,000 of state-operated services 740.43 fund balances from the accounts 740.44 indicated to the general fund as 740.45 follows: 740.46 (1) $3,200,000 from traumatic brain 740.47 injury enterprises; 740.48 (2) $1,000,000 from lease income; and 740.49 (3) $500,000 from ICF/MR depreciation. 740.50 (b) Paragraph (a) is effective the day 740.51 following final enactment. 740.52 Subd. 9. Continuing Care Grants 740.53 Summary by Fund 740.54 General 1,504,933,000 1,490,958,000 740.55 Lottery Prize Fund 1,408,000 1,408,000 741.1 The amounts that may be spent from this 741.2 appropriation for each purpose are as 741.3 follows: 741.4 (a) Community Social Services 741.5 General 496,000 371,000 741.6 (b) Aging and Adult Service Grant 741.7 General 12,998,000 13,951,000 741.8 [LONG-TERM CARE PROGRAM REDUCTIONS.] 741.9 For the biennium ending June 30, 2005, 741.10 state funding for the following state 741.11 long-term care programs is reduced by 741.12 15 percent from the level of state 741.13 funding provided on June 30, 2003: 741.14 SAIL project grants under Minnesota 741.15 Statutes, section 256B.0917; senior 741.16 nutrition programs under Minnesota 741.17 Statutes, section 256.9752; foster 741.18 grandparents program under Minnesota 741.19 Statutes, section 256.976; retired 741.20 senior volunteer program under 741.21 Minnesota Statutes, section 256.9753; 741.22 and the senior companion program under 741.23 Minnesota Statutes, section 256.977. 741.24 (c) Deaf and Hard-of-hearing 741.25 Service Grants 741.26 General 1,719,000 1,490,000 741.27 (d) Mental Health Grants 741.28 General 53,479,000 34,690,000 741.29 Lottery Prize Fund 1,408,000 1,408,000 741.30 [RESTRUCTURING OF ADULT MENTAL HEALTH 741.31 SERVICES.] The commissioner may make 741.32 transfers that do not increase the 741.33 state share of costs to effectively 741.34 implement the restructuring of adult 741.35 mental health services. 741.36 [COMPULSIVE GAMBLING.] Of the 741.37 appropriation from the lottery prize 741.38 fund, $250,000 each year is for the 741.39 following purposes: 741.40 (1) $100,000 each year is for a grant 741.41 to the Southeast Asian Problem Gambling 741.42 Consortium. The consortium must 741.43 provide statewide compulsive gambling 741.44 prevention and treatment services for 741.45 Lao, Hmong, Vietnamese, and Cambodian 741.46 families, adults, and adolescents. The 741.47 appropriation in this clause shall not 741.48 become part of base level funding for 741.49 the biennium beginning July 1, 2005. 741.50 Any unencumbered balance of the 741.51 appropriation in the first year does 741.52 not cancel but is available for the 741.53 second year; and 741.54 (2) $150,000 each year is for a grant 741.55 to a compulsive gambling council 741.56 located in St. Louis county. The 741.57 gambling council must provide a 742.1 statewide compulsive gambling 742.2 prevention and education project for 742.3 adolescents. Any unencumbered balance 742.4 of the appropriation in the first year 742.5 of the biennium does not cancel but is 742.6 available for the second year. 742.7 (e) Community Support Grants 742.8 General 12,523,000 9,093,000 742.9 [CENTERS FOR INDEPENDENT LIVING STUDY.] 742.10 The commissioner of human services, in 742.11 consultation with the commissioner of 742.12 economic security, the centers for 742.13 independent living, and consumer 742.14 representatives, shall study the 742.15 financing of the centers for 742.16 independent living authorized under 742.17 Minnesota Statutes, section 268A.11, 742.18 and make recommendations on options to 742.19 maximize federal financial 742.20 participation. Study components shall 742.21 include: 742.22 (1) the demographics of individuals 742.23 served by the centers for independent 742.24 living; 742.25 (2) the range of services the centers 742.26 for independent living provide to these 742.27 individuals; 742.28 (3) other publicly funded services 742.29 received by individuals supported by 742.30 the centers; and 742.31 (4) strategies for maximizing federal 742.32 financial participation for eligible 742.33 activities carried out by centers for 742.34 independent living. 742.35 The commissioner shall report with 742.36 fiscal and programmatic recommendations 742.37 to the chairs of the appropriate house 742.38 of representatives and senate finance 742.39 and policy committees by January 15, 742.40 2004. 742.41 (f) Medical Assistance Long-Term 742.42 Care Waivers and Home Care Grants 742.43 General 659,211,000 718,665,000 742.44 [RATE AND ALLOCATION DECREASES FOR 742.45 CONTINUING CARE PROGRAMS.] 742.46 Notwithstanding any law or rule to the 742.47 contrary, the commissioner of human 742.48 services shall decrease reimbursement 742.49 rates or reduce allocations to assure 742.50 the necessary reductions in state 742.51 spending for the providers or programs 742.52 listed in paragraphs (a) to (d). The 742.53 decreases are effective for services 742.54 rendered on or after July 1, 2003. 742.55 (a) Effective July 1, 2003, the 742.56 commissioner shall reduce payment rates 742.57 for services and individual or service 742.58 limits by one percent. The rate 742.59 decreases described in this section 743.1 must be applied to: 743.2 (1) home and community-based waivered 743.3 services for the elderly under 743.4 Minnesota Statutes, section 256B.0915; 743.5 (2) day training and habilitation 743.6 services for adults with mental 743.7 retardation or related conditions under 743.8 Minnesota Statutes, sections 252.40 to 743.9 252.46; 743.10 (3) the group residential housing 743.11 supplementary service rate under 743.12 Minnesota Statutes, section 256I.05, 743.13 subdivision 1a; 743.14 (4) chemical dependency residential and 743.15 nonresidential service rates under 743.16 Minnesota Statutes, section 245B.03; 743.17 (5) consumer support grants under 743.18 Minnesota Statutes, section 256.476; 743.19 and 743.20 (6) home and community-based services 743.21 for alternative care services under 743.22 Minnesota Statutes, section 256B.0913. 743.23 (b) The commissioner shall reduce 743.24 allocations made available to county 743.25 agencies for home and community-based 743.26 waivered services to assure a 743.27 one-percent reduction in state spending 743.28 for services rendered on or after July 743.29 1, 2003. The commissioner shall apply 743.30 the allocation decreases described in 743.31 this section to: 743.32 (1) persons with mental retardation or 743.33 related conditions under Minnesota 743.34 Statutes, section 256B.501; 743.35 (2) waivered services under community 743.36 alternatives for disabled individuals 743.37 under Minnesota Statutes, section 743.38 256B.49; 743.39 (3) community alternative care waivered 743.40 services under Minnesota Statutes, 743.41 section 256B.49; and 743.42 (4) traumatic brain injury waivered 743.43 services under Minnesota Statutes, 743.44 section 256B.49. 743.45 County agencies will be responsible for 743.46 100 percent of any spending in excess 743.47 of the allocation made by the 743.48 commissioner. Nothing in this section 743.49 shall be construed as reducing the 743.50 county's responsibility to offer and 743.51 make available feasible home and 743.52 community-based options to eligible 743.53 waiver recipients within the resources 743.54 allocated to them for that purpose. 743.55 (c) The commissioner shall reduce deaf 743.56 and hard-of-hearing grants by one 743.57 percent on July 1, 2003. 744.1 (d) Effective July 1, 2003, the 744.2 commissioner shall reduce payment rates 744.3 for each facility reimbursed under 744.4 Minnesota Statutes, section 256B.5012, 744.5 by decreasing the total operating 744.6 payment rate for intermediate care 744.7 facilities for the mentally retarded by 744.8 one percent. For each facility, the 744.9 commissioner shall multiply the 744.10 adjustment by the total payment rate, 744.11 excluding the property-related payment 744.12 rate, in effect on June 30, 2003. A 744.13 facility whose payment rates are 744.14 governed by closure agreements, 744.15 receivership agreements, or Minnesota 744.16 Rules, part 9553.0075, is not subject 744.17 to an adjustment otherwise taken under 744.18 this subdivision. 744.19 Notwithstanding section 14, these 744.20 adjustments shall not expire. 744.21 [REDUCE GROWTH IN MR/RC WAIVER.] The 744.22 commissioner shall reduce the growth in 744.23 the MR/RC waiver by not allocating the 744.24 300 additional diversion allocations 744.25 that are included in the February 2003 744.26 forecast for the fiscal years that 744.27 begin on July 1, 2003, and July 1, 2004. 744.28 [MANAGE THE GROWTH IN THE TBI WAIVER.] 744.29 During the fiscal years beginning on 744.30 July 1, 2003, and July 1, 2004, the 744.31 commissioner shall allocate money for 744.32 home and community-based programs 744.33 covered under Minnesota Statutes, 744.34 section 256B.49, to assure a reduction 744.35 in state spending that is equivalent to 744.36 limiting the caseload growth of the TBI 744.37 waiver to 150 in each year of the 744.38 biennium. Priorities for the 744.39 allocation of funds shall be for 744.40 individuals anticipated to be 744.41 discharged from institutional settings 744.42 or who are at imminent risk of a 744.43 placement in an institutional setting. 744.44 [TARGETED CASE MANAGEMENT FOR HOME CARE 744.45 RECIPIENTS.] Implementation of the 744.46 targeted case management benefit for 744.47 home care recipients, according to 744.48 Minnesota Statutes, section 256B.0621, 744.49 subdivisions 2, 3, 5, 6, 7, 9, and 10, 744.50 will be delayed until July 1, 2005. 744.51 [COMMON SERVICE MENU.] Implementation 744.52 of the common service menu option 744.53 within the home and community-based 744.54 waivers, according to Minnesota 744.55 Statutes, section 256B.49, subdivision 744.56 16, will be delayed until July 1, 2005. 744.57 [LIMITATION ON COMMUNITY ALTERNATIVES 744.58 FOR DISABLED INDIVIDUALS CASELOAD 744.59 GROWTH.] For the biennium ending June 744.60 30, 2005, the commissioner shall limit 744.61 the allocations made available in the 744.62 community alternatives for disabled 744.63 individuals waiver program in order not 744.64 to exceed average caseload growth of 95 744.65 per month from June 2003 program 745.1 levels, plus any additional 745.2 legislatively authorized program 745.3 growth. The commissioner shall 745.4 allocate available resources to achieve 745.5 the following outcomes: 745.6 (1) the establishment of feasible and 745.7 viable alternatives for persons in 745.8 institutional or hospital settings to 745.9 relocate to home and community-based 745.10 settings; 745.11 (2) the availability of timely 745.12 assistance to persons at imminent risk 745.13 of institutional or hospital placement 745.14 or whose health and safety is at 745.15 immediate risk; and 745.16 (3) the maximum provision of essential 745.17 community supports to eligible persons 745.18 in need of and waiting for home and 745.19 community-based service alternatives. 745.20 The commissioner may reallocate 745.21 resources from one county or region to 745.22 another if available funding in that 745.23 county or region is not likely to be 745.24 spent and the reallocation is necessary 745.25 to achieve the outcomes specified in 745.26 this paragraph. 745.27 (g) Medical Assistance Long-term 745.28 Care Facilities Grants 745.29 General 543,999,000 514,483,000 745.30 (h) Alternative Care Grants 745.31 General 75,206,000 66,351,000 745.32 [ALTERNATIVE CARE TRANSFER.] Any money 745.33 allocated to the alternative care 745.34 program that is not spent for the 745.35 purposes indicated does not cancel but 745.36 shall be transferred to the medical 745.37 assistance account. 745.38 [ALTERNATIVE CARE APPROPRIATION.] The 745.39 commissioner may expend the money 745.40 appropriated for the alternative care 745.41 program for that purpose in either year 745.42 of the biennium. 745.43 [ALTERNATIVE CARE IMPLEMENTATION OF 745.44 CHANGES TO FEES AND ELIGIBILITY.] 745.45 Changes to Minnesota Statutes, section 745.46 256B.0913, subdivision 4, paragraph 745.47 (d), and subdivision 12, are effective 745.48 July 1, 2003, for all persons found 745.49 eligible for the alternative care 745.50 program on or after July 1, 2003. All 745.51 recipients of alternative care funding 745.52 as of June 30, 2003, shall be subject 745.53 to Minnesota Statutes, section 745.54 256B.0913, subdivision 4, paragraph 745.55 (d), and subdivision 12, on the annual 745.56 reassessment and review of their 745.57 eligibility after July 1, 2003, but no 745.58 later than January 1, 2004. 745.59 (i) Group Residential Housing Grants 746.1 General 94,996,000 80,472,000 746.2 [GROUP RESIDENTIAL HOUSING COSTS 746.3 REFINANCED.] (1) Effective July 1, 746.4 2004, the commissioner shall increase 746.5 the home and community-based service 746.6 rates and county allocations provided 746.7 to programs for persons with 746.8 disabilities established under section 746.9 1915(c) of the Social Security Act to 746.10 the extent that these programs will be 746.11 paying for the costs above the rate 746.12 established in Minnesota Statutes, 746.13 section 256I.05, subdivision 1. 746.14 (2) For persons in receipt of services 746.15 under Minnesota Statutes, section 746.16 256B.0915, who reside in licensed adult 746.17 foster care beds for which a 746.18 supplemental room and board payment was 746.19 being made under Minnesota Statutes, 746.20 section 256I.05, subdivision 1, 746.21 counties may request an exception to 746.22 the individual caps specified in 746.23 Minnesota Statutes, section 256B.0915, 746.24 subdivision 3, paragraph (b), not to 746.25 exceed the difference between the 746.26 individual cap and the client's monthly 746.27 service expenditures plus the amount of 746.28 the supplemental room and board rate. 746.29 The county must submit a request to 746.30 exceed the individual cap to the 746.31 commissioner for approval. 746.32 (j) Chemical Dependency 746.33 Entitlement Grants 746.34 General 49,251,000 50,337,000 746.35 (k) Chemical Dependency Nonentitlement 746.36 Grants 746.37 General 1,055,000 1,055,000 746.38 Subd. 10. Continuing Care Management 746.39 Summary by Fund 746.40 General 21,697,000 21,206,000 746.41 State Government 746.42 Special Revenue 119,000 119,000 746.43 Lottery Prize Fund 148,000 148,000 746.44 [APPROPRIATION; REPORT ON LONG-TERM 746.45 CARE FINANCING REFORM.] Money 746.46 appropriated to the commissioner for 746.47 fiscal year 2004 for the report on 746.48 long-term care financing reform and 746.49 long-term care insurance purchase 746.50 incentives shall not cancel but shall 746.51 be available to the commissioner for 746.52 that purpose in fiscal year 2005. 746.53 Subd. 11. Economic Support Grants 746.54 Summary by Fund 746.55 General 122,647,000 117,198,000 747.1 Federal TANF 199,009,000 207,224,000 747.2 The amounts that may be spent from this 747.3 appropriation for each purpose are as 747.4 follows: 747.5 (a) Minnesota Family Investment Program 747.6 General 59,922,000 39,375,000 747.7 Federal TANF 106,535,000 110,543,000 747.8 (b) Work Grants 747.9 General 666,000 14,678,000 747.10 Federal TANF 92,474,000 96,681,000 747.11 [MFIP SUPPORT SERVICES COUNTY AND 747.12 TRIBAL ALLOCATION.] When determining 747.13 the funds available for the 747.14 consolidated MFIP support services 747.15 grant in the 18-month period ending 747.16 December 31, 2004, the commissioner 747.17 shall apportion the funds appropriated 747.18 for fiscal year 2005 in such manner as 747.19 necessary to provide $14,000,000 more 747.20 to counties and tribes for the period 747.21 ending December 31, 2004, than would 747.22 have been available had the funds been 747.23 evenly divided within the fiscal year 747.24 between the period before December 31, 747.25 2004, and the period after December 31, 747.26 2004. 747.27 For allocations for the calendar years 747.28 starting January 1, 2005, the 747.29 commissioner shall apportion the funds 747.30 appropriated for each fiscal year in 747.31 such manner as necessary to provide 747.32 $14,000,000 more to counties and tribes 747.33 for the period ending December 31 of 747.34 that year than would have been 747.35 available had the funds been evenly 747.36 divided within the fiscal year between 747.37 the period before December 31 and the 747.38 period after December 31. 747.39 (c) Economic Support Grants - Other 747.40 Assistance 747.41 General 3,358,000 3,463,000 747.42 [SUPPORTIVE HOUSING.] Of the general 747.43 fund appropriation, $500,000 each year 747.44 is to provide services to families who 747.45 are participating in the supportive 747.46 housing and managed care pilot project 747.47 under Minnesota Statutes, section 747.48 256K.25. This appropriation shall not 747.49 become part of base level funding for 747.50 the biennium beginning July 1, 2007. 747.51 (d) Child Support Enforcement Grants 747.52 General 3,571,000 3,503,000 747.53 (e) General Assistance Grants 747.54 General 24,901,000 24,732,000 748.1 [GENERAL ASSISTANCE STANDARD.] The 748.2 commissioner shall set the monthly 748.3 standard of assistance for general 748.4 assistance units consisting of an adult 748.5 recipient who is childless and 748.6 unmarried or living apart from parents 748.7 or a legal guardian at $203. The 748.8 commissioner may reduce this amount 748.9 according to Laws 1997, chapter 85, 748.10 article 3, section 54. 748.11 [EMERGENCY GENERAL ASSISTANCE.] The 748.12 amount appropriated for emergency 748.13 general assistance funds is limited to 748.14 no more than $7,889,812 in each fiscal 748.15 year of 2004 and 2005. Funds to 748.16 counties shall be allocated by the 748.17 commissioner using the allocation 748.18 method specified in Minnesota Statutes, 748.19 section 256D.06. 748.20 (f) Minnesota Supplemental Aid Grants 748.21 General 30,229,000 31,447,000 748.22 [EMERGENCY MINNESOTA SUPPLEMENTAL AID 748.23 FUNDS.] The amount appropriated for 748.24 emergency Minnesota supplemental aid 748.25 funds is limited to no more than 748.26 $1,138,707 in fiscal year 2004 and 748.27 $1,017,000 in fiscal year 2005. Funds 748.28 to counties shall be allocated by the 748.29 commissioner using the allocation 748.30 method specified in Minnesota Statutes, 748.31 section 256D.46. 748.32 Subd. 12. Economic Support 748.33 Management 748.34 Summary by Fund 748.35 General 39,080,000 39,331,000 748.36 Health Care Access 1,407,000 1,377,000 748.37 Federal TANF 368,000 368,000 748.38 The amounts that may be spent from this 748.39 appropriation for each purpose are as 748.40 follows: 748.41 (a) Economic Support 748.42 Policy Administration 748.43 General 5,360,000 5,587,000 748.44 Federal TANF 368,000 368,000 748.45 (b) Economic Support 748.46 Operations 748.47 General 33,720,000 33,744,000 748.48 Health Care Access 1,407,000 1,377,000 748.49 [SPENDING AUTHORITY FOR FOOD STAMPS 748.50 ENHANCED FUNDING.] In the event that 748.51 Minnesota qualifies for the U.S. 748.52 Department of Agriculture Food and 748.53 Nutrition Services Food Stamp Program 748.54 enhanced funding beginning in federal 749.1 fiscal year 2002, the funding is 749.2 appropriated to the commissioner. The 749.3 commissioner shall retain 25 percent of 749.4 the funding, with the other 75 percent 749.5 divided among the counties according to 749.6 a formula that takes into account each 749.7 county's impact on the statewide food 749.8 stamp error rate. 749.9 [CHILD SUPPORT PAYMENT CENTER.] 749.10 Payments to the commissioner from other 749.11 governmental units, private 749.12 enterprises, and individuals for 749.13 services performed by the child support 749.14 payment center must be deposited in the 749.15 state systems account authorized under 749.16 Minnesota Statutes, section 256.014. 749.17 These payments are appropriated to the 749.18 commissioner for the operation of the 749.19 child support payment center or system, 749.20 according to Minnesota Statutes, 749.21 section 256.014. 749.22 [CHILD SUPPORT COST RECOVERY FEES.] The 749.23 commissioner shall transfer $247,000 of 749.24 child support cost recovery fees 749.25 collected in fiscal year 2005 to the 749.26 PRISM special revenue account to offset 749.27 PRISM system costs of implementing the 749.28 fee. 749.29 [FINANCIAL INSTITUTION DATA MATCH AND 749.30 PAYMENT OF FEES.] The commissioner is 749.31 authorized to allocate up to $310,000 749.32 each year in fiscal year 2004 and 749.33 fiscal year 2005 from the PRISM special 749.34 revenue account to make payments to 749.35 financial institutions in exchange for 749.36 performing data matches between account 749.37 information held by financial 749.38 institutions and the public authority's 749.39 database of child support obligors as 749.40 authorized by Minnesota Statutes, 749.41 section 13B.06, subdivision 7. 749.42 [CONSISTENT ACCOUNTING FOR PROGRAMS TO 749.43 BE TRANSFERRED.] To ensure consistent 749.44 accounting, including forecasting, 749.45 budgeting, cost allocation, and 749.46 financial reporting, the commissioner 749.47 may establish accounts and processes in 749.48 the state's accounting system so the 749.49 programs being transferred from other 749.50 state agencies are integrated into the 749.51 department's standard accounting 749.52 policies and procedures. 749.53 Sec. 3. COMMISSIONER OF HEALTH 749.54 Subdivision 1. Total 749.55 Appropriation 104,995,000 106,328,000 749.56 Summary by Fund 749.57 General 59,842,000 61,438,000 749.58 State Government 749.59 Special Revenue 32,880,000 32,617,000 749.60 Health Care Access 6,273,000 6,273,000 750.1 Federal TANF 6,000,000 6,000,000 750.2 Subd. 2. Health Improvement 750.3 Summary by Fund 750.4 General 44,595,000 46,459,000 750.5 State Government 750.6 Special Revenue 1,987,000 1,987,000 750.7 Health Care Access 3,510,000 3,510,000 750.8 Federal TANF 6,000,000 6,000,000 750.9 [TOBACCO PREVENTION ENDOWMENT FUND 750.10 TRANSFERS.] (a) On July 1, 2003, the 750.11 commissioner of finance shall transfer 750.12 $4,000,000 from the tobacco use 750.13 prevention and local public health 750.14 endowment expendable trust fund to the 750.15 general fund. 750.16 (b) Notwithstanding Minnesota Statutes, 750.17 section 16A.62, any remaining 750.18 unexpended balance in the fund after 750.19 the transfer in paragraph (a) shall be 750.20 transferred to the miscellaneous 750.21 special revenue fund and dedicated to 750.22 the commissioner of health for local 750.23 tobacco prevention grants under 750.24 Minnesota Statutes, section 144.396, 750.25 subdivision 6. Of this amount the 750.26 commissioner may retain up to $150,000 750.27 for administration and evaluation costs. 750.28 (c) Of the general fund appropriation 750.29 for fiscal year 2005, $3,280,000 is to 750.30 the commissioner for the grants 750.31 specified in paragraph (b). 750.32 [TANF APPROPRIATIONS.] TANF funds 750.33 appropriated to the commissioner are 750.34 available for home visiting and 750.35 nutritional activities listed under 750.36 Minnesota Statutes, section 145.882, 750.37 subdivision 7, clauses (6) and (7), and 750.38 eliminating health disparities 750.39 activities under Minnesota Statutes, 750.40 section 145.928, subdivision 10. 750.41 Funding shall be distributed to 750.42 community health boards and tribal 750.43 governments based on the formula in 750.44 Minnesota Statutes, section 145A.131, 750.45 subdivisions 1 and 2. 750.46 [TANF CARRYFORWARD.] Any unexpended 750.47 balance of the TANF appropriation in 750.48 the first year of the biennium does not 750.49 cancel but is available for the second 750.50 year. 750.51 [MINNESOTA CHILDREN WITH SPECIAL HEALTH 750.52 NEEDS CARRYFORWARD.] General fund 750.53 appropriations for treatment services 750.54 in the services for Minnesota children 750.55 with special health needs program are 750.56 available for either year of the 750.57 biennium. 750.58 [TRANSFER OF ENDOWMENT FUNDS.] On July 751.1 1, 2003, the commissioner of finance 751.2 shall transfer the tobacco use 751.3 prevention and local public health 751.4 endowment fund and the medical 751.5 education endowment fund to the general 751.6 fund. 751.7 Subd. 3. Health Quality and 751.8 Access 751.9 Summary by Fund 751.10 General 868,000 606,000 751.11 State Government 751.12 Special Revenue 8,888,000 8,888,000 751.13 Health Care Access 2,763,000 2,763,000 751.14 [STATE GOVERNMENT SPECIAL REVENUE FUND 751.15 TRANSFERS.] On July 1, 2003, the 751.16 commissioner of finance shall transfer 751.17 $4,000,000 from the state government 751.18 special revenue fund to the general 751.19 fund. 751.20 [NURSING HOME RECEIVERSHIP COSTS.] In 751.21 the event that other funds are not 751.22 available, the commissioner is 751.23 authorized to expend up to $230,000 751.24 from the fiscal year 2003 state 751.25 government special revenue 751.26 appropriation for nursing home 751.27 regulation for those costs associated 751.28 with nursing home receiverships 751.29 necessary to protect the health and 751.30 safety of residents. The commissioner 751.31 shall assert claims against any and all 751.32 appropriate parties seeking 751.33 reimbursement of any funds expended. 751.34 This provision is effective the day 751.35 following final enactment. 751.36 [NURSING PROVIDERS WORK GROUP.] The 751.37 commissioner shall establish a working 751.38 group consisting of nursing home and 751.39 boarding care home providers, 751.40 representatives of nursing home 751.41 residents, and other health care 751.42 providers to review current licensure 751.43 provisions and evaluate the continued 751.44 appropriateness of these provisions. 751.45 The commissioner shall present 751.46 recommendations to the legislature by 751.47 November 1, 2004. 751.48 [MERC FUNDING.] Amounts in the medical 751.49 education and research costs (MERC) 751.50 special account not to exceed 751.51 $8,660,000 in fiscal year 2004 and 751.52 $8,616,000 in fiscal year 2005 are 751.53 appropriated to the commissioner for 751.54 medical education and research funding. 751.55 Subd. 4. Health Protection 751.56 Summary by Fund 751.57 General 9,130,000 9,130,000 751.58 State Government 752.1 Special Revenue 22,005,000 21,742,000 752.2 Subd. 5. Management and Support 752.3 Services 752.4 General 5,249,000 5,243,000 752.5 Sec. 4. VETERANS NURSING HOMES BOARD 752.6 General 30,030,000 30,030,000 752.7 [VETERANS HOMES SPECIAL REVENUE 752.8 ACCOUNT.] The general fund 752.9 appropriations made to the board may be 752.10 transferred to a veterans homes special 752.11 revenue account in the special revenue 752.12 fund in the same manner as other 752.13 receipts are deposited according to 752.14 Minnesota Statutes, section 198.34, and 752.15 are appropriated to the board for the 752.16 operation of board facilities and 752.17 programs. 752.18 Sec. 5. HEALTH-RELATED BOARDS 752.19 Subdivision 1. Total 752.20 Appropriation 11,441,000 11,471,000 752.21 Summary by Fund 752.22 State Government 752.23 Special Revenue 11,377,000 11,407,000 752.24 Health Care Access 64,000 64,000 752.25 [STATE GOVERNMENT SPECIAL REVENUE 752.26 FUND.] The appropriations in this 752.27 section are from the state government 752.28 special revenue fund, except where 752.29 noted. 752.30 [NO SPENDING IN EXCESS OF REVENUES.] 752.31 The commissioner of finance shall not 752.32 permit the allotment, encumbrance, or 752.33 expenditure of money appropriated in 752.34 this section in excess of the 752.35 anticipated biennial revenues or 752.36 accumulated surplus revenues from fees 752.37 collected by the boards. Neither this 752.38 provision nor Minnesota Statutes, 752.39 section 214.06, applies to transfers 752.40 from the general contingent account. 752.41 [STATE GOVERNMENT SPECIAL REVENUE FUND 752.42 TRANSFERS.] On July 1, 2003, the 752.43 commissioner of finance shall transfer 752.44 $7,500,000 from the state government 752.45 special revenue fund to the general 752.46 fund. Of this amount, $3,500,000 shall 752.47 be transferred from the health-related 752.48 boards and $4,000,000 shall be 752.49 transferred as designated by the 752.50 commissioner of finance. 752.51 Subd. 2. Board of Chiropractic 752.52 Examiners 384,000 384,000 752.53 [CONTESTED CASE EXPENSES.] In fiscal 752.54 year 2003, $70,000 in state government 752.55 special revenue funds is transferred 752.56 from Laws 2001, First Special Session 753.1 chapter 10, article 1, section 33, to 753.2 the board of chiropractic examiners to 753.3 pay for contested case activity. These 753.4 funds are available until September 30, 753.5 2003. 753.6 Subd. 3. Board of Dentistry 753.7 State Government Special 753.8 Revenue Fund 858,000 858,000 753.9 Health Care 753.10 Access Fund 64,000 64,000 753.11 Subd. 4. Board of Dietetic and 753.12 Nutrition Practice 101,000 101,000 753.13 Subd. 5. Board of Marriage and 753.14 Family Therapy 118,000 118,000 753.15 Subd. 6. Board of Medical 753.16 Practice 3,498,000 3,498,000 753.17 Subd. 7. Board of Nursing 2,405,000 2,405,000 753.18 Subd. 8. Board of Nursing 753.19 Home Administrators 198,000 198,000 753.20 Subd. 9. Board of Optometry 96,000 96,000 753.21 Subd. 10. Board of Pharmacy 1,386,000 1,386,000 753.22 [ADMINISTRATIVE SERVICES UNIT.] Of this 753.23 appropriation, $359,000 the first year 753.24 and $359,000 the second year are for 753.25 the health boards administrative 753.26 services unit. The administrative 753.27 services unit may receive and expend 753.28 reimbursements for services performed 753.29 for other agencies. 753.30 Subd. 11. Board of Physical 753.31 Therapy 197,000 197,000 753.32 Subd. 12. Board of Podiatry 45,000 45,000 753.33 Subd. 13. Board of Psychology 680,000 680,000 753.34 Subd. 14. Board of Social 753.35 Work 1,073,000 1,073,000 753.36 Subd. 15. Board of Veterinary 753.37 Medicine 163,000 163,000 753.38 Subd. 16. Board of Behavioral 753.39 Health and Therapy 175,000 205,000 753.40 [ADDITIONAL FUNDING.] This amount is 753.41 from the state government special 753.42 revenue fund and is in addition to the 753.43 appropriation in Laws 2003, chapter 753.44 118, section 27. Licensure fees will 753.45 be increased accordingly to reimburse 753.46 the fund balance. 753.47 Sec. 6. EMERGENCY MEDICAL SERVICES BOARD 753.48 Subdivision 1. Total 753.49 Appropriation 3,027,000 3,027,000 753.50 Summary by Fund 754.1 General 2,481,000 2,481,000 754.2 State Government 754.3 Special Revenue 546,000 546,000 754.4 [HEALTH PROFESSIONAL SERVICES 754.5 ACTIVITY.] $546,000 each year from the 754.6 state government special revenue fund 754.7 is for the health professional services 754.8 activity. 754.9 [COMPREHENSIVE ADVANCED LIFE SUPPORT 754.10 ADMINISTRATIVE COSTS.] Of the 754.11 appropriation for the comprehensive 754.12 advanced life support program, not more 754.13 than $5,000 each year may be retained 754.14 by the board for administrative costs. 754.15 [ROYALTY PAYMENTS DEDICATED TO BOARD.] 754.16 Royalty payments from the sale of the 754.17 Internet-based ambulance reporting 754.18 program are appropriated to the board 754.19 and shall remain available until 754.20 expended. Notwithstanding section 14, 754.21 this provision shall not expire. 754.22 [EMERGENCY MEDICAL SERVICES REGIONAL 754.23 GRANTS.] Of this appropriation, 754.24 $657,000 each year is for the purposes 754.25 of Minnesota Statutes, section 144E.50. 754.26 [AMBULANCE TRAINING GRANT CARRYFORWARD 754.27 AND TRANSFER.] (a) Effective for fiscal 754.28 year 2003 and succeeding fiscal years, 754.29 any unspent portion of the 754.30 appropriation for ambulance training 754.31 grants shall not cancel but shall carry 754.32 forward and be used in the following 754.33 fiscal year for the purposes of 754.34 Minnesota Statutes, section 144E.50. 754.35 The board shall not retain any portion 754.36 of the appropriation carried forward 754.37 for administrative costs. 754.38 (b) Notwithstanding section 14, this 754.39 provision shall not expire. 754.40 (c) This provision is effective the day 754.41 following final enactment. 754.42 Sec. 7. COUNCIL ON DISABILITY 754.43 General 500,000 500,000 754.44 Sec. 8. OMBUDSMAN FOR MENTAL HEALTH 754.45 AND MENTAL RETARDATION 754.46 General 1,462,000 1,462,000 754.47 Sec. 9. OMBUDSMAN FOR FAMILIES 754.48 General 245,000 245,000 754.49 Sec. 10. DEPARTMENT OF CHILDREN, 754.50 FAMILIES, AND LEARNING 754.51 Subdivision 1. Total 754.52 Appropriation $ 107,829,000 $ 92,649,000 754.53 Summary by Fund 755.1 General 104,489,000 89,309,000 755.2 State Special 755.3 Revenue 3,340,000 3,340,000 755.4 Subd. 2. Child Care 755.5 [BASIC SLIDING FEE CHILD CARE.] Of this 755.6 appropriation, $27,628,000 in fiscal 755.7 year 2004 and $18,771,000 in fiscal 755.8 year 2005 are for child care assistance 755.9 according to Minnesota Statutes, 755.10 section 119B.03. These appropriations 755.11 are available to be spent either year. 755.12 The fiscal years 2006 and 2007 general 755.13 fund base for basic sliding fee child 755.14 care is $30,312,000 each year. 755.15 [MFIP CHILD CARE.] Of this 755.16 appropriation, $69,543,000 in fiscal 755.17 year 2004 and $63,720,000 in fiscal 755.18 year 2005 are for MFIP child care. 755.19 [CHILD CARE PROGRAM INTEGRITY.] Of this 755.20 appropriation, $425,000 in fiscal year 755.21 2004, and $376,000 in fiscal year 2005 755.22 are for the administrative costs of 755.23 program integrity and fraud prevention 755.24 for child care assistance under 755.25 Minnesota Statutes, chapter 119B. 755.26 [CHILD CARE DEVELOPMENT.] Of this 755.27 appropriation, $1,115,000 in fiscal 755.28 year 2004, and $1,164,000 in fiscal 755.29 year 2005 are for child care 755.30 development grants according to 755.31 Minnesota Statutes, section 119B.21. 755.32 Subd. 3. Child Care Assistance 755.33 Special Revenue Account 3,340,000 3,340,000 755.34 [CHILD SUPPORT SPECIAL REVENUE 755.35 ACCOUNT.] Appropriations and transfers 755.36 in this subdivision are from the child 755.37 support collection payments in the 755.38 special revenue fund, pursuant to 755.39 Minnesota Statutes, section 119B.074. 755.40 The sums indicated are appropriated to 755.41 the department of children, families, 755.42 and learning for the fiscal years 755.43 designated. 755.44 [CHILD CARE ASSISTANCE.] Of this 755.45 appropriation, $3,340,000 in fiscal 755.46 year 2004, and $3,340,000 in fiscal 755.47 year 2005 are for child care assistance 755.48 according to Minnesota Statutes, 755.49 section 119B.03. 755.50 [SPECIAL REVENUE ACCOUNT UNOBLIGATED 755.51 FUND TRANSFER.] On July 1, 2003, the 755.52 commissioner of finance shall transfer 755.53 $1,800,000 from the special revenue 755.54 fund to the general fund. 755.55 Subd. 4. Child Care 755.56 Assistance TANF Funds 755.57 [FEDERAL TANF TRANSFERS.] The sums 755.58 indicated in this section are 755.59 transferred from the federal TANF fund 756.1 to the child care and development fund 756.2 and are appropriated to the department 756.3 of children, families, and learning for 756.4 the fiscal years indicated. The 756.5 commissioner shall ensure that all 756.6 transferred funds are expended 756.7 according to the child care and 756.8 development fund regulations and that 756.9 maximum allowable transferred funds are 756.10 used for the following programs: 756.11 (a) For basic sliding fee child care, 756.12 $17,686,000 in fiscal year 2004 and 756.13 $17,700,000 in fiscal year 2005 are for 756.14 child care assistance under Minnesota 756.15 Statutes, section 119B.03. 756.16 (b) For MFIP/TY, $7,312,000 in fiscal 756.17 year 2004 and $4,919,000 in fiscal year 756.18 2005 are for child care assistance 756.19 under Minnesota Statutes, section 756.20 119B.05. 756.21 (c) For child care development grants 756.22 under Minnesota Statutes, section 756.23 119B.21, $14,000 is available in fiscal 756.24 year 2004. 756.25 Subd. 5. Self-Sufficiency Programs 756.26 General 5,278,000 5,278,000 756.27 [MINNESOTA ECONOMIC OPPORTUNITY 756.28 GRANTS.] Of this appropriation, 756.29 $4,000,000 in fiscal year 2004 and 756.30 $4,000,000 in fiscal year 2005 are for 756.31 Minnesota economic opportunity grants. 756.32 Any balance in the first year does not 756.33 cancel but is available in the second 756.34 year. 756.35 [FOOD SHELF PROGRAMS.] Of this 756.36 appropriation, $1,278,000 in fiscal 756.37 year 2004 and $1,278,000 in fiscal year 756.38 2005 are for food shelf programs under 756.39 Minnesota Statutes, section 119A.44. 756.40 Any balance in the first year does not 756.41 cancel but is available in the second 756.42 year. 756.43 Subd. 6. Family Assets for Independence 756.44 500,000 -0- 756.45 Any balance in the first year does not 756.46 cancel but is available in the second 756.47 year. 756.48 Sec. 11. [TRANSFERS.] 756.49 Subdivision 1. [GRANTS.] The commissioner of human 756.50 services, with the approval of the commissioner of finance, and 756.51 after notification of the chair of the senate health, human 756.52 services and corrections budget division and the chair of the 756.53 house health and human services finance committee, may transfer 756.54 unencumbered appropriation balances for the biennium ending June 757.1 30, 2005, within fiscal years among the MFIP, general 757.2 assistance, general assistance medical care, medical assistance, 757.3 MFIP child care assistance under Minnesota Statutes, section 757.4 119B.05, Minnesota supplemental aid, and group residential 757.5 housing programs, and the entitlement portion of the chemical 757.6 dependency consolidated treatment fund, and between fiscal years 757.7 of the biennium. 757.8 Subd. 2. [ADMINISTRATION.] Positions, salary money, and 757.9 nonsalary administrative money may be transferred within the 757.10 departments of human services and health and within the programs 757.11 operated by the veterans nursing homes board as the 757.12 commissioners and the board consider necessary, with the advance 757.13 approval of the commissioner of finance. The commissioner or 757.14 the board shall inform the chairs of the house health and human 757.15 services finance committee and the senate health, human services 757.16 and corrections budget division quarterly about transfers made 757.17 under this provision. 757.18 Subd. 3. [PROHIBITED TRANSFERS.] Grant money shall not be 757.19 transferred to operations within the departments of human 757.20 services and health and within the programs operated by the 757.21 veterans nursing homes board without the approval of the 757.22 legislature. 757.23 Sec. 12. [INDIRECT COSTS NOT TO FUND PROGRAMS.] 757.24 The commissioners of health and of human services shall not 757.25 use indirect cost allocations to pay for the operational costs 757.26 of any program for which they are responsible. 757.27 Sec. 13. [CARRYOVER LIMITATION.] 757.28 The appropriations in this article which are allowed to be 757.29 carried forward from fiscal year 2004 to fiscal year 2005 shall 757.30 not become part of the base level funding for the 2006-2007 757.31 biennial budget, unless specifically directed by the legislature. 757.32 Sec. 14. [SUNSET OF UNCODIFIED LANGUAGE.] 757.33 All uncodified language contained in this article expires 757.34 on June 30, 2005, unless a different expiration date is explicit. 757.35 Sec. 15. [REPEALER.] 757.36 Laws 2002, chapter 374, article 9, section 8, is repealed 758.1 effective upon final enactment. 758.2 Sec. 16. [EFFECTIVE DATE.] 758.3 The provisions in this article are effective July 1, 2003, 758.4 unless a different effective date is specified.