1.1                          A bill for an act 
  1.2             relating to human services; modifying provisions for 
  1.3             certain government data; modifying the Human Services 
  1.4             Licensing Act; modifying certain hearing provisions; 
  1.5             modifying provisions for reporting maltreatment of 
  1.6             vulnerable adults; modifying continuing care 
  1.7             provisions; modifying moratorium on certification of 
  1.8             nursing home beds; modifying certain case manager 
  1.9             training requirements; modifying certain medical 
  1.10            assistance provisions; modifying provisions for 
  1.11            interstate contracts for mental health services; 
  1.12            designating state agent to carry out responsibilities 
  1.13            under the Ryan White Comprehensive Aids Resources 
  1.14            Emergency Act; waiving prior authorization for certain 
  1.15            drugs used to treat mental illness; providing for 
  1.16            certain deaf-blind services; requiring a case 
  1.17            management study; providing for identification of 
  1.18            deceased individuals; establishing a donated dental 
  1.19            services program; modifying provisions for certain 
  1.20            health-related licenses; modifying commissioner's 
  1.21            duties; appropriating money; amending Minnesota 
  1.22            Statutes 2000, sections 13.41, subdivision 1; 13.46, 
  1.23            subdivision 3; 103H.251, subdivision 1; 144.05, by 
  1.24            adding a subdivision; 147B.02, subdivision 9; 150A.06, 
  1.25            by adding a subdivision; 245.462, subdivision 4; 
  1.26            245.4871, subdivision 4; 245.50, subdivisions 1, 2, 5; 
  1.27            245A.02, by adding subdivisions; 245A.035, subdivision 
  1.28            3; 245A.04, by adding subdivisions; 256.01, by adding 
  1.29            a subdivision; 256.9657, subdivision 1; 256B.0625, 
  1.30            subdivision 35, by adding a subdivision; 256B.0915, 
  1.31            subdivisions 4, 6, by adding a subdivision; 256B.431, 
  1.32            subdivisions 14, 30, by adding a subdivision; 
  1.33            256B.5012, subdivision 2; 626.557, subdivision 3a; 
  1.34            Minnesota Statutes 2001 Supplement, sections 13.46, 
  1.35            subdivisions 1, 4; 144A.071, subdivision 1a; 144A.36, 
  1.36            subdivision 1; 149A.90, subdivision 1; 245A.03, 
  1.37            subdivision 2; 245A.04, subdivisions 3, 3a, 3b; 
  1.38            245A.07, subdivisions 2a, 3; 245A.144; 245A.16, 
  1.39            subdivision 1; 256.045, subdivisions 3b, 4; 256B.0625, 
  1.40            subdivision 13; 256B.0627, subdivision 10; 256B.0911, 
  1.41            subdivisions 4b, 4d; 256B.0913, subdivisions 4, 5, 8, 
  1.42            10, 12, 14; 256B.0915, subdivisions 3, 5; 256B.0924, 
  1.43            subdivision 6; 256B.0951, subdivisions 7, 8; 256B.431, 
  1.44            subdivisions 2e, 33; 256B.437, subdivisions 3, 6, by 
  1.45            adding a subdivision; 256B.438, subdivision 1; 
  1.46            256B.69, subdivision 5b; 256B.76; 626.556, subdivision 
  2.1             10i; 626.557, subdivision 9d; proposing coding for new 
  2.2             law in Minnesota Statutes, chapters 144; 245A; 
  2.3             repealing Minnesota Statutes 2000, section 147B.01, 
  2.4             subdivisions 8, 15; Minnesota Statutes 2001 
  2.5             Supplement, section 256B.0621, subdivision 1. 
  2.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  2.7                              ARTICLE 1 
  2.8                              LICENSING 
  2.9      Section 1.  Minnesota Statutes 2000, section 13.41, 
  2.10  subdivision 1, is amended to read: 
  2.11     Subdivision 1.  [DEFINITION.] As used in this section 
  2.12  "licensing agency" means any board, department or agency of this 
  2.13  state which is given the statutory authority to issue 
  2.14  professional or other types of licenses, except the various 
  2.15  agencies primarily administered by the commissioner of human 
  2.16  services.  Data pertaining to persons or agencies licensed or 
  2.17  registered under authority of the commissioner of human services 
  2.18  shall be administered pursuant to section 13.46~~, subdivision 4~~. 
  2.19     Sec. 2.  Minnesota Statutes 2001 Supplement, section 13.46, 
  2.20  subdivision 1, is amended to read: 
  2.21     Subdivision 1.  [DEFINITIONS.] As used in this section: 
  2.22     (a) "Individual" means an individual according to section 
  2.23  13.02, subdivision 8, but does not include a vendor of services. 
  2.24     (b) "Program" includes all programs for which authority is 
  2.25  vested in a component of the welfare system according to statute 
  2.26  or federal law, including, but not limited to, the aid to 
  2.27  families with dependent children program formerly codified in 
  2.28  sections 256.72 to 256.87, Minnesota Family Investment Program, 
  2.29  medical assistance, general assistance, general assistance 
  2.30  medical care, and child support collections.  
  2.31     (c) "Welfare system" includes the department of human 
  2.32  services, local social services agencies, county welfare 
  2.33  agencies, private licensing agencies, the public authority 
  2.34  responsible for child support enforcement, human services 
  2.35  boards, community mental health center boards, state hospitals, 
  2.36  state nursing homes, the ombudsman for mental health and mental 
  2.37  retardation, and persons, agencies, institutions, organizations, 
  2.38  and other entities under contract to any of the above agencies 
  3.1   to the extent specified in the contract. 
  3.2      (d) "Mental health data" means data on individual clients 
  3.3   and patients of community mental health centers, established 
  3.4   under section 245.62, mental health divisions of counties and 
  3.5   other providers under contract to deliver mental health 
  3.6   services, or the ombudsman for mental health and mental 
  3.7   retardation. 
  3.8      (e) "Fugitive felon" means a person who has been convicted 
  3.9   of a felony and who has escaped from confinement or violated the 
  3.10  terms of probation or parole for that offense. 
  3.11     (f) "Private licensing agency" means an agency licensed by 
  3.12  the commissioner of human services under chapter 245A to perform 
  3.13  the duties under section 245A.16. 
  3.14     Sec. 3.  Minnesota Statutes 2000, section 13.46, 
  3.15  subdivision 3, is amended to read: 
  3.16     Subd. 3.  [INVESTIGATIVE DATA.] (a) Data on persons, 
  3.17  including data on vendors of services and data on licensees, 
  3.18  that is collected, maintained, used, or disseminated by the 
  3.19  welfare system in an investigation, authorized by statute and 
  3.20  relating to the enforcement of rules or law, is confidential 
  3.21  data on individuals pursuant to section 13.02, subdivision 3, or 
  3.22  protected nonpublic data not on individuals pursuant to section 
  3.23  13.02, subdivision 13, and shall not be disclosed except: 
  3.24     ~~(a)~~ (1) pursuant to section 13.05; 
  3.25     ~~(b)~~ (2) pursuant to statute or valid court order; 
  3.26     ~~(c)~~ (3) to a party named in a civil or criminal proceeding, 
  3.27  administrative or judicial, for preparation of defense; or 
  3.28     ~~(d)~~ (4) to provide notices required or permitted by statute.
  3.29     The data referred to in this subdivision shall be 
  3.30  classified as public data upon its submission to an 
  3.31  administrative law judge or court in an administrative or 
  3.32  judicial proceeding.  Inactive welfare investigative data shall 
  3.33  be treated as provided in section 13.39, subdivision 3.  
  3.34     (b) Notwithstanding any other provision in law, the 
  3.35  commissioner of human services shall provide all active and 
  3.36  inactive investigative data, including the name of the reporter 
  4.1   of alleged maltreatment under section 626.556 or 626.557, to the 
  4.2   ombudsman for mental health and retardation upon the request of 
  4.3   the ombudsman. 
  4.4      Sec. 4.  Minnesota Statutes 2001 Supplement, section 13.46, 
  4.5   subdivision 4, is amended to read: 
  4.6      Subd. 4.  [LICENSING DATA.] (a) As used in this subdivision:
  4.7      (1) "licensing data" means all data collected, maintained, 
  4.8   used, or disseminated by the welfare system pertaining to 
  4.9   persons licensed or registered or who apply for licensure or 
  4.10  registration or who formerly were licensed or registered under 
  4.11  the authority of the commissioner of human services; 
  4.12     (2) "client" means a person who is receiving services from 
  4.13  a licensee or from an applicant for licensure; and 
  4.14     (3) "personal and personal financial data" means social 
  4.15  security numbers, identity of and letters of reference, 
  4.16  insurance information, reports from the bureau of criminal 
  4.17  apprehension, health examination reports, and social/home 
  4.18  studies. 
  4.19     (b)(1) Except as provided in paragraph (c), the following 
  4.20  data on current and former licensees are public:  name, address, 
  4.21  telephone number of licensees, date of receipt of a completed 
  4.22  application, dates of licensure, licensed capacity, type of 
  4.23  client preferred, variances granted, type of dwelling, name and 
  4.24  relationship of other family members, previous license history, 
  4.25  class of license, and the existence and status of complaints.  
  4.26  When a correction order or fine has been issued, a license is 
  4.27  suspended, immediately suspended, revoked, denied, or made 
  4.28  conditional, or a complaint is resolved, the following data on 
  4.29  current and former licensees are public:  the substance and 
  4.30  investigative findings of the complaint, licensing violation, or 
  4.31  substantiated maltreatment; the record of informal resolution of 
  4.32  a licensing violation; orders of hearing; findings of fact; 
  4.33  conclusions of law; specifications of the final correction 
  4.34  order, fine, suspension, immediate suspension, revocation, 
  4.35  denial, or conditional license contained in the record of 
  4.36  licensing action; and the status of any appeal of these 
  5.1   actions.  When an individual licensee is a substantiated 
  5.2   perpetrator of maltreatment, and the substantiated maltreatment 
  5.3   is a reason for the licensing action, the identity of the 
  5.4   licensee as a perpetrator is public data.  For purposes of this 
  5.5   clause, a person is a substantiated perpetrator if the 
  5.6   maltreatment determination has been upheld under section 
  5.7   626.556, subdivision 10i, 626.557, subdivision 9d, or 256.045, 
  5.8   or an individual or facility has not timely exercised appeal 
  5.9   rights under these sections. 
  5.10     (2) For applicants who withdraw their application prior to 
  5.11  licensure or denial of a license, the following data are 
  5.12  public:  the name of the applicant, the city and county in which 
  5.13  the applicant was seeking licensure, the dates of the 
  5.14  commissioner's receipt of the initial application and completed 
  5.15  application, the type of license sought, and the date of 
  5.16  withdrawal of the application. 
  5.17     (3) For applicants who are denied a license, the following 
  5.18  data are public:  the name of the applicant, the city and county 
  5.19  in which the applicant was seeking licensure, the dates of the 
  5.20  commissioner's receipt of the initial application and completed 
  5.21  application, the type of license sought, the date of denial of 
  5.22  the application, the nature of the basis for the denial, and the 
  5.23  status of any appeal of the denial. 
  5.24     (4) The following data on persons subject to 
  5.25  disqualification under section 245A.04 in connection with a 
  5.26  license to provide family day care for children, child care 
  5.27  center services, foster care for children in the provider's 
  5.28  home, or foster care or day care services for adults in the 
  5.29  provider's home, are public:  the nature of any disqualification 
  5.30  set aside under section 245A.04, subdivision 3b, and the reasons 
  5.31  for setting aside the disqualification; and the reasons for 
  5.32  granting any variance under section 245A.04, subdivision 9. 
  5.33     (5) When maltreatment is substantiated under section 
  5.34  626.556 or 626.557 and the victim and the substantiated 
  5.35  perpetrator are affiliated with a program licensed under chapter 
  5.36  245A, the commissioner of human services, local social services 
  6.1   agency, or county welfare agency may inform the license holder 
  6.2   where the maltreatment occurred of the identity of the 
  6.3   substantiated perpetrator and the victim. 
  6.4      (c) The following are private data on individuals under 
  6.5   section 13.02, subdivision 12, or nonpublic data under section 
  6.6   13.02, subdivision 9:  personal and personal financial data on 
  6.7   family day care program and family foster care program 
  6.8   applicants and licensees and their family members who provide 
  6.9   services under the license. 
  6.10     (d) The following are private data on individuals:  the 
  6.11  identity of persons who have made reports concerning licensees 
  6.12  or applicants that appear in inactive investigative data, and 
  6.13  the records of clients or employees of the licensee or applicant 
  6.14  for licensure whose records are received by the licensing agency 
  6.15  for purposes of review or in anticipation of a contested 
  6.16  matter.  The names of reporters under sections 626.556 and 
  6.17  626.557 may be disclosed only as provided in section 626.556, 
  6.18  subdivision 11, or 626.557, subdivision 12b. 
  6.19     (e) Data classified as private, confidential, nonpublic, or 
  6.20  protected nonpublic under this subdivision become public data if 
  6.21  submitted to a court or administrative law judge as part of a 
  6.22  disciplinary proceeding in which there is a public hearing 
  6.23  concerning a license which has been suspended, immediately 
  6.24  suspended, revoked, or denied. 
  6.25     (f) Data generated in the course of licensing 
  6.26  investigations that relate to an alleged violation of law are 
  6.27  investigative data under subdivision 3. 
  6.28     (g) Data that are not public data collected, maintained, 
  6.29  used, or disseminated under this subdivision that relate to or 
  6.30  are derived from a report as defined in section 626.556, 
  6.31  subdivision 2, or 626.5572, subdivision 18, are subject to the 
  6.32  destruction provisions of sections 626.556, subdivision 11c, and 
  6.33  626.557, subdivision 12b.  
  6.34     (h) Upon request, not public data collected, maintained, 
  6.35  used, or disseminated under this subdivision that relate to or 
  6.36  are derived from a report of substantiated maltreatment as 
  7.1   defined in section 626.556 or 626.557 may be exchanged with the 
  7.2   department of health for purposes of completing background 
  7.3   studies pursuant to section 144.057 and with the department of 
  7.4   corrections for purposes of completing background studies 
  7.5   pursuant to section 241.021. 
  7.6      (i) Data on individuals collected according to licensing 
  7.7   activities under chapter 245A, and data on individuals collected 
  7.8   by the commissioner of human services according to maltreatment 
  7.9   investigations under sections 626.556 and 626.557, may be shared 
  7.10  with the department of human rights, the department of health, 
  7.11  the department of corrections, the ombudsman for mental health 
  7.12  and retardation, and the individual's professional regulatory 
  7.13  board when there is reason to believe that laws or standards 
  7.14  under the jurisdiction of those agencies may have been violated. 
  7.15     (j) In addition to the notice of determinations required 
  7.16  under section 626.556, subdivision 10f, if the commissioner or 
  7.17  the local social services agency has determined that an 
  7.18  individual is a substantiated perpetrator of maltreatment of a 
  7.19  child based on sexual abuse, as defined in section 626.556, 
  7.20  subdivision 2, and the commissioner or local social services 
  7.21  agency knows that the individual is a person responsible for a 
  7.22  child's care in another facility, the commissioner or local 
  7.23  social services agency shall notify the head of that facility of 
  7.24  this determination.  The notification must include an 
  7.25  explanation of the individual's available appeal rights and the 
  7.26  status of any appeal.  If a notice is given under this 
  7.27  paragraph, the government entity making the notification shall 
  7.28  provide a copy of the notice to the individual who is the 
  7.29  subject of the notice. 
  7.30     Sec. 5.  Minnesota Statutes 2000, section 245A.02, is 
  7.31  amended by adding a subdivision to read: 
  7.32     Subd. 2a.  [ADULT DAY CARE.] "Adult day care" means a 
  7.33  program operating less than 24 hours per day that provides 
  7.34  functionally impaired adults with an individualized and 
  7.35  coordinated set of services including health services, social 
  7.36  services, and nutritional services that are directed at 
  8.1   maintaining or improving the participants' capabilities for 
  8.2   self-care.  Adult day care does not include programs where 
  8.3   adults gather or congregate primarily for purposes of 
  8.4   socialization, education, supervision, caregiver respite, 
  8.5   religious expression, exercise, or nutritious meals. 
  8.6      Sec. 6.  Minnesota Statutes 2000, section 245A.02, is 
  8.7   amended by adding a subdivision to read: 
  8.8      Subd. 2b.  [ANNUAL OR ANNUALLY.] "Annual" or "annually" 
  8.9   means prior to or within the same month of the subsequent 
  8.10  calendar year. 
  8.11     Sec. 7.  Minnesota Statutes 2001 Supplement, section 
  8.12  245A.03, subdivision 2, is amended to read: 
  8.13     Subd. 2.  [EXCLUSION FROM LICENSURE.] (a) This chapter does 
  8.14  not apply to: 
  8.15     (1) residential or nonresidential programs that are 
  8.16  provided to a person by an individual who is related unless the 
  8.17  residential program is a child foster care placement made by a 
  8.18  local social services agency or a licensed child-placing agency, 
  8.19  except as provided in subdivision 2a; 
  8.20     (2) nonresidential programs that are provided by an 
  8.21  unrelated individual to persons from a single related family; 
  8.22     (3) residential or nonresidential programs that are 
  8.23  provided to adults who do not abuse chemicals or who do not have 
  8.24  a chemical dependency, a mental illness, mental retardation or a 
  8.25  related condition, a functional impairment, or a physical 
  8.26  handicap; 
  8.27     (4) sheltered workshops or work activity programs that are 
  8.28  certified by the commissioner of economic security; 
  8.29     (5) programs for children enrolled in kindergarten to the 
  8.30  12th grade and prekindergarten special education in a school as 
  8.31  defined in section 120A.22, subdivision 4, and programs serving 
  8.32  children in combined special education and regular 
  8.33  prekindergarten programs that are operated or assisted by the 
  8.34  commissioner of children, families, and learning; 
  8.35     (6) nonresidential programs primarily for children that 
  8.36  provide care or supervision, without charge for ten or fewer 
  9.1   days a year, and for periods of less than three hours a day 
  9.2   while the child's parent or legal guardian is in the same 
  9.3   building as the nonresidential program or present within another 
  9.4   building that is directly contiguous to the building in which 
  9.5   the nonresidential program is located; 
  9.6      (7) nursing homes or hospitals licensed by the commissioner 
  9.7   of health except as specified under section 245A.02; 
  9.8      (8) board and lodge facilities licensed by the commissioner 
  9.9   of health that provide services for five or more persons whose 
  9.10  primary diagnosis is mental illness who have refused an 
  9.11  appropriate residential program offered by a county agency~~.~~  
  9.12  ~~This exclusion expires on July 1, 1990~~; 
  9.13     (9) homes providing programs for persons placed there by a 
  9.14  licensed agency for legal adoption, unless the adoption is not 
  9.15  completed within two years; 
  9.16     (10) programs licensed by the commissioner of corrections; 
  9.17     (11) recreation programs for children or adults that 
  9.18  operate for fewer than 40 calendar days in a calendar year or 
  9.19  programs operated by a park and recreation board of a city of 
  9.20  the first class whose primary purpose is to provide social and 
  9.21  recreational activities to school age children, provided the 
  9.22  program is approved by the park and recreation board; 
  9.23     (12) programs operated by a school as defined in section 
  9.24  120A.22, subdivision 4, whose primary purpose is to provide 
  9.25  child care to school-age children, provided the program is 
  9.26  approved by the district's school board; 
  9.27     (13) Head Start nonresidential programs which operate for 
  9.28  less than 31 days in each calendar year; 
  9.29     (14) noncertified boarding care homes unless they provide 
  9.30  services for five or more persons whose primary diagnosis is 
  9.31  mental illness or mental retardation; 
  9.32     (15) nonresidential programs for nonhandicapped children 
  9.33  provided for a cumulative total of less than 30 days in any 
  9.34  12-month period; 
  9.35     (16) residential programs for persons with mental illness, 
  9.36  that are located in hospitals, until the commissioner adopts 
 10.1   appropriate rules; 
 10.2      (17) the religious instruction of school-age children; 
 10.3   Sabbath or Sunday schools; or the congregate care of children by 
 10.4   a church, congregation, or religious society during the period 
 10.5   used by the church, congregation, or religious society for its 
 10.6   regular worship; 
 10.7      (18) camps licensed by the commissioner of health under 
 10.8   Minnesota Rules, chapter 4630; 
 10.9      (19) mental health outpatient services for adults with 
 10.10  mental illness or children with emotional disturbance; 
 10.11     (20) residential programs serving school-age children whose 
 10.12  sole purpose is cultural or educational exchange, until the 
 10.13  commissioner adopts appropriate rules; 
 10.14     (21) unrelated individuals who provide out-of-home respite 
 10.15  care services to persons with mental retardation or related 
 10.16  conditions from a single related family for no more than 90 days 
 10.17  in a 12-month period and the respite care services are for the 
 10.18  temporary relief of the person's family or legal representative; 
 10.19     (22) respite care services provided as a home and 
 10.20  community-based service to a person with mental retardation or a 
 10.21  related condition, in the person's primary residence; 
 10.22     (23) community support services programs as defined in 
 10.23  section 245.462, subdivision 6, and family community support 
 10.24  services as defined in section 245.4871, subdivision 17; 
 10.25     (24) the placement of a child by a birth parent or legal 
 10.26  guardian in a preadoptive home for purposes of adoption as 
 10.27  authorized by section 259.47; 
 10.28     (25) settings registered under chapter 144D which provide 
 10.29  home care services licensed by the commissioner of health to 
 10.30  fewer than seven adults; or 
 10.31     (26) consumer-directed community support service funded 
 10.32  under the Medicaid waiver for persons with mental retardation 
 10.33  and related conditions when the individual who provided the 
 10.34  service is:  
 10.35     (i) the same individual who is the direct payee of these 
 10.36  specific waiver funds or paid by a fiscal agent, fiscal 
 11.1   intermediary, or employer of record; and 
 11.2      (ii) not otherwise under the control of a residential or 
 11.3   nonresidential program that is required to be licensed under 
 11.4   this chapter when providing the service. 
 11.5      For purposes of clause (6), a building is directly 
 11.6   contiguous to a building in which a nonresidential program is 
 11.7   located if it shares a common wall with the building in which 
 11.8   the nonresidential program is located or is attached to that 
 11.9   building by skyway, tunnel, atrium, or common roof. 
 11.10     (b) Nothing in this chapter shall be construed to require 
 11.11  licensure for any services provided and funded according to an 
 11.12  approved federal waiver plan where licensure is specifically 
 11.13  identified as not being a condition for the services and funding.
 11.14     Sec. 8.  Minnesota Statutes 2000, section 245A.035, 
 11.15  subdivision 3, is amended to read: 
 11.16     Subd. 3.  [REQUIREMENTS FOR EMERGENCY LICENSE.] Before an 
 11.17  emergency license may be issued, the following requirements must 
 11.18  be met: 
 11.19     (1) the county agency must conduct an initial inspection of 
 11.20  the premises where the foster care is to be provided to ensure 
 11.21  the health and safety of any child placed in the home.  The 
 11.22  county agency shall conduct the inspection using a form 
 11.23  developed by the commissioner; 
 11.24     (2) at the time of the inspection or placement, whichever 
 11.25  is earlier, the relative being considered for an emergency 
 11.26  license shall receive an application form for a child foster 
 11.27  care license; ~~and~~ 
 11.28     (3) whenever possible, prior to placing the child in the 
 11.29  relative's home, the relative being considered for an emergency 
 11.30  license shall provide the information required by section 
 11.31  245A.04, subdivision 3, paragraph (b); and 
 11.32     (4) if the county determines, prior to the issuance of an 
 11.33  emergency license, that anyone requiring a background study may 
 11.34  be disqualified under section 245A.04, and the disqualification 
 11.35  is one which the commissioner cannot set aside, an emergency 
 11.36  license shall not be issued. 
 12.1      Sec. 9.  Minnesota Statutes 2001 Supplement, section 
 12.2   245A.04, subdivision 3, is amended to read: 
 12.3      Subd. 3.  [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 
 12.4   (a) Individuals and organizations that are required in statute 
 12.5   to initiate background studies under this section shall comply 
 12.6   with the following requirements: 
 12.7      (1) Applicants for licensure, license holders, and other 
 12.8   entities as provided in this section must submit completed 
 12.9   background study forms to the commissioner before individuals 
 12.10  specified in paragraph (c), clauses (1) to (4), (6), and (7), 
 12.11  begin positions allowing direct contact in any licensed program. 
 12.12     (2) Applicants and license holders under the jurisdiction 
 12.13  of other state agencies who are required in other statutory 
 12.14  sections to initiate background studies under this section must 
 12.15  submit completed background study forms to the commissioner 
 12.16  prior to the background study subject beginning in a position 
 12.17  allowing direct contact in the licensed program, or where 
 12.18  applicable, prior to being employed. 
 12.19     (3) Organizations required to initiate background studies 
 12.20  under section 256B.0627 for individuals described in paragraph 
 12.21  (c), clause (5), must submit a completed background study form 
 12.22  to the commissioner before those individuals begin a position 
 12.23  allowing direct contact with persons served by the 
 12.24  organization.  The commissioner shall recover the cost of these 
 12.25  background studies through a fee of no more than $12 per study 
 12.26  charged to the organization responsible for submitting the 
 12.27  background study form.  The fees collected under this paragraph 
 12.28  are appropriated to the commissioner for the purpose of 
 12.29  conducting background studies.  
 12.30     Upon receipt of the background study forms from the 
 12.31  entities in clauses (1) to (3), the commissioner shall complete 
 12.32  the background study as specified under this section and provide 
 12.33  notices required in subdivision 3a.  Unless otherwise specified, 
 12.34  the subject of a background study may have direct contact with 
 12.35  persons served by a program after the background study form is 
 12.36  mailed or submitted to the commissioner pending notification of 
 13.1   the study results under subdivision 3a.  A county agency may 
 13.2   accept a background study completed by the commissioner under 
 13.3   this section in place of the background study required under 
 13.4   section 245A.16, subdivision 3, in programs with joint licensure 
 13.5   as home and community-based services and adult foster care for 
 13.6   people with developmental disabilities when the license holder 
 13.7   does not reside in the foster care residence and the subject of 
 13.8   the study has been continuously affiliated with the license 
 13.9   holder since the date of the commissioner's study. 
 13.10     (b) The definitions in this paragraph apply only to 
 13.11  subdivisions 3 to 3e. 
 13.12     (1) "Background study" means the review of records 
 13.13  conducted by the commissioner to determine whether a subject is 
 13.14  disqualified from direct contact with persons served by a 
 13.15  program, and where specifically provided in statutes, whether a 
 13.16  subject is disqualified from having access to persons served by 
 13.17  a program. 
 13.18     (2) "Continuous, direct supervision" means an individual is 
 13.19  within sight or hearing of the supervising person to the extent 
 13.20  that supervising person is capable at all times of intervening 
 13.21  to protect the health and safety of the persons served by the 
 13.22  program. 
 13.23     (3) "Contractor" means any person, regardless of employer, 
 13.24  who is providing program services for hire under the control of 
 13.25  the provider. 
 13.26     (4) "Direct contact" means providing face-to-face care, 
 13.27  training, supervision, counseling, consultation, or medication 
 13.28  assistance to persons served by the program. 
 13.29     (5) "Reasonable cause" means information or circumstances 
 13.30  exist which provide the commissioner with articulable suspicion 
 13.31  that further pertinent information may exist concerning a 
 13.32  subject.  The commissioner has reasonable cause when, but not 
 13.33  limited to, the commissioner has received a report from the 
 13.34  subject, the license holder, or a third party indicating that 
 13.35  the subject has a history that would disqualify the person or 
 13.36  that may pose a risk to the health or safety of persons 
 14.1   receiving services. 
 14.2      (6) "Subject of a background study" means an individual on 
 14.3   whom a background study is required or completed. 
 14.4      (c) The applicant, license holder, registrant under section 
 14.5   144A.71, subdivision 1, bureau of criminal apprehension, 
 14.6   commissioner of health, and county agencies, after written 
 14.7   notice to the individual who is the subject of the study, shall 
 14.8   help with the study by giving the commissioner criminal 
 14.9   conviction data and reports about the maltreatment of adults 
 14.10  substantiated under section 626.557 and the maltreatment of 
 14.11  minors in licensed programs substantiated under section 
 14.12  626.556.  If a background study is initiated by an applicant or 
 14.13  license holder and the applicant or license holder receives 
 14.14  information about a possible criminal or maltreatment history of 
 14.15  an individual who is the subject of a background study, the 
 14.16  applicant or license holder must immediately provide the 
 14.17  information to the commissioner.  The individuals to be studied 
 14.18  shall include: 
 14.19     (1) the applicant; 
 14.20     (2) persons age 13 and over living in the household where 
 14.21  the licensed program will be provided; 
 14.22     (3) current employees or contractors of the applicant who 
 14.23  will have direct contact with persons served by the facility, 
 14.24  agency, or program; 
 14.25     (4) volunteers or student volunteers who have direct 
 14.26  contact with persons served by the program to provide program 
 14.27  services, if the contact is not ~~directly supervised by the~~ 
 14.28  ~~individuals~~ under the continuous, direct supervision by an 
 14.29  individual listed in clause (1) or (3); 
 14.30     (5) any person required under section 256B.0627 to have a 
 14.31  background study completed under this section; 
 14.32     (6) persons ages 10 to 12 living in the household where the 
 14.33  licensed services will be provided when the commissioner has 
 14.34  reasonable cause; and 
 14.35     (7) persons who, without providing direct contact services 
 14.36  at a licensed program, may have unsupervised access to children 
 15.1   or vulnerable adults receiving services from the program 
 15.2   licensed to provide family child care for children, foster care 
 15.3   for children in the provider's own home, or foster care or day 
 15.4   care services for adults in the provider's own home when the 
 15.5   commissioner has reasonable cause. 
 15.6      (d) According to paragraph (c), clauses (2) and (6), the 
 15.7   commissioner shall review records from the juvenile courts.  For 
 15.8   persons under paragraph (c), clauses (1), (3), (4), (5), and 
 15.9   (7), who are ages 13 to 17, the commissioner shall review 
 15.10  records from the juvenile courts when the commissioner has 
 15.11  reasonable cause.  The juvenile courts shall help with the study 
 15.12  by giving the commissioner existing juvenile court records on 
 15.13  individuals described in paragraph (c), clauses (2), (6), and 
 15.14  (7), relating to delinquency proceedings held within either the 
 15.15  five years immediately preceding the background study or the 
 15.16  five years immediately preceding the individual's 18th birthday, 
 15.17  whichever time period is longer.  The commissioner shall destroy 
 15.18  juvenile records obtained pursuant to this subdivision when the 
 15.19  subject of the records reaches age 23. 
 15.20     (e) Beginning August 1, 2001, the commissioner shall 
 15.21  conduct all background studies required under this chapter and 
 15.22  initiated by supplemental nursing services agencies registered 
 15.23  under section 144A.71, subdivision 1.  Studies for the agencies 
 15.24  must be initiated annually by each agency.  The commissioner 
 15.25  shall conduct the background studies according to this chapter.  
 15.26  The commissioner shall recover the cost of the background 
 15.27  studies through a fee of no more than $8 per study, charged to 
 15.28  the supplemental nursing services agency.  The fees collected 
 15.29  under this paragraph are appropriated to the commissioner for 
 15.30  the purpose of conducting background studies. 
 15.31     (f) For purposes of this section, a finding that a 
 15.32  delinquency petition is proven in juvenile court shall be 
 15.33  considered a conviction in state district court. 
 15.34     (g) A study of an individual in paragraph (c), clauses (1) 
 15.35  to (7), shall be conducted at least upon application for initial 
 15.36  license for all license types or registration under section 
 16.1   144A.71, subdivision 1, and at reapplication for a license ~~or~~ 
 16.2   ~~registration~~ for family child care, child foster care, and adult 
 16.3   foster care.  The commissioner is not required to conduct a 
 16.4   study of an individual at the time of reapplication for a 
 16.5   license or if the individual has been continuously affiliated 
 16.6   with a foster care provider licensed by the commissioner of 
 16.7   human services and registered under chapter 144D, other than a 
 16.8   family day care or foster care license, if:  (i) a study of the 
 16.9   individual was conducted either at the time of initial licensure 
 16.10  or when the individual became affiliated with the license 
 16.11  holder; (ii) the individual has been continuously affiliated 
 16.12  with the license holder since the last study was conducted; and 
 16.13  (iii) the procedure described in paragraph (j) has been 
 16.14  implemented and was in effect continuously since the last study 
 16.15  was conducted.  For the purposes of this section, a physician 
 16.16  licensed under chapter 147 is considered to be continuously 
 16.17  affiliated upon the license holder's receipt from the 
 16.18  commissioner of health or human services of the physician's 
 16.19  background study results.  For individuals who are required to 
 16.20  have background studies under paragraph (c) and who have been 
 16.21  continuously affiliated with a foster care provider that is 
 16.22  licensed in more than one county, criminal conviction data may 
 16.23  be shared among those counties in which the foster care programs 
 16.24  are licensed.  A county agency's receipt of criminal conviction 
 16.25  data from another county agency shall meet the criminal data 
 16.26  background study requirements of this section. 
 16.27     (h) The commissioner may also conduct studies on 
 16.28  individuals specified in paragraph (c), clauses (3) and (4), 
 16.29  when the studies are initiated by: 
 16.30     (i) personnel pool agencies; 
 16.31     (ii) temporary personnel agencies; 
 16.32     (iii) educational programs that train persons by providing 
 16.33  direct contact services in licensed programs; and 
 16.34     (iv) professional services agencies that are not licensed 
 16.35  and which contract with licensed programs to provide direct 
 16.36  contact services or individuals who provide direct contact 
 17.1   services. 
 17.2      (i) Studies on individuals in paragraph (h), items (i) to 
 17.3   (iv), must be initiated annually by these agencies, programs, 
 17.4   and individuals.  Except as provided in paragraph (a), clause 
 17.5   (3), no applicant, license holder, or individual who is the 
 17.6   subject of the study shall pay any fees required to conduct the 
 17.7   study. 
 17.8      (1) At the option of the licensed facility, rather than 
 17.9   initiating another background study on an individual required to 
 17.10  be studied who has indicated to the licensed facility that a 
 17.11  background study by the commissioner was previously completed, 
 17.12  the facility may make a request to the commissioner for 
 17.13  documentation of the individual's background study status, 
 17.14  provided that: 
 17.15     (i) the facility makes this request using a form provided 
 17.16  by the commissioner; 
 17.17     (ii) in making the request the facility informs the 
 17.18  commissioner that either: 
 17.19     (A) the individual has been continuously affiliated with a 
 17.20  licensed facility since the individual's previous background 
 17.21  study was completed, or since October 1, 1995, whichever is 
 17.22  shorter; or 
 17.23     (B) the individual is affiliated only with a personnel pool 
 17.24  agency, a temporary personnel agency, an educational program 
 17.25  that trains persons by providing direct contact services in 
 17.26  licensed programs, or a professional services agency that is not 
 17.27  licensed and which contracts with licensed programs to provide 
 17.28  direct contact services or individuals who provide direct 
 17.29  contact services; and 
 17.30     (iii) the facility provides notices to the individual as 
 17.31  required in paragraphs (a) to (j), and that the facility is 
 17.32  requesting written notification of the individual's background 
 17.33  study status from the commissioner.  
 17.34     (2) The commissioner shall respond to each request under 
 17.35  paragraph (1) with a written or electronic notice to the 
 17.36  facility and the study subject.  If the commissioner determines 
 18.1   that a background study is necessary, the study shall be 
 18.2   completed without further request from a licensed agency or 
 18.3   notifications to the study subject.  
 18.4      (3) When a background study is being initiated by a 
 18.5   licensed facility or a foster care provider that is also 
 18.6   registered under chapter 144D, a study subject affiliated with 
 18.7   multiple licensed facilities may attach to the background study 
 18.8   form a cover letter indicating the additional facilities' names, 
 18.9   addresses, and background study identification numbers.  When 
 18.10  the commissioner receives such notices, each facility identified 
 18.11  by the background study subject shall be notified of the study 
 18.12  results.  The background study notice sent to the subsequent 
 18.13  agencies shall satisfy those facilities' responsibilities for 
 18.14  initiating a background study on that individual. 
 18.15     (j) If an individual who is affiliated with a program or 
 18.16  facility regulated by the department of human services or 
 18.17  department of health or who is affiliated with any type of home 
 18.18  care agency or provider of personal care assistance services, is 
 18.19  convicted of a crime constituting a disqualification under 
 18.20  subdivision 3d, the probation officer or corrections agent shall 
 18.21  notify the commissioner of the conviction.  For the purpose of 
 18.22  this paragraph, "conviction" has the meaning given it in section 
 18.23  609.02, subdivision 5.  The commissioner, in consultation with 
 18.24  the commissioner of corrections, shall develop forms and 
 18.25  information necessary to implement this paragraph and shall 
 18.26  provide the forms and information to the commissioner of 
 18.27  corrections for distribution to local probation officers and 
 18.28  corrections agents.  The commissioner shall inform individuals 
 18.29  subject to a background study that criminal convictions for 
 18.30  disqualifying crimes will be reported to the commissioner by the 
 18.31  corrections system.  A probation officer, corrections agent, or 
 18.32  corrections agency is not civilly or criminally liable for 
 18.33  disclosing or failing to disclose the information required by 
 18.34  this paragraph.  Upon receipt of disqualifying information, the 
 18.35  commissioner shall provide the notifications required in 
 18.36  subdivision 3a, as appropriate to agencies on record as having 
 19.1   initiated a background study or making a request for 
 19.2   documentation of the background study status of the individual.  
 19.3   This paragraph does not apply to family day care and child 
 19.4   foster care programs. 
 19.5      (k) The individual who is the subject of the study must 
 19.6   provide the applicant or license holder with sufficient 
 19.7   information to ensure an accurate study including the 
 19.8   individual's first, middle, and last name and all other names by 
 19.9   which the individual has been known; home address, city, county, 
 19.10  and state of residence for the past five years; zip code; sex; 
 19.11  date of birth; and driver's license number or state 
 19.12  identification number.  The applicant or license holder shall 
 19.13  provide this information about an individual in paragraph (c), 
 19.14  clauses (1) to (7), on forms prescribed by the commissioner.  By 
 19.15  January 1, 2000, for background studies conducted by the 
 19.16  department of human services, the commissioner shall implement a 
 19.17  system for the electronic transmission of:  (1) background study 
 19.18  information to the commissioner; and (2) background study 
 19.19  results to the license holder.  The commissioner may request 
 19.20  additional information of the individual, which shall be 
 19.21  optional for the individual to provide, such as the individual's 
 19.22  social security number or race. 
 19.23     (l) For programs directly licensed by the commissioner, a 
 19.24  study must include information related to names of substantiated 
 19.25  perpetrators of maltreatment of vulnerable adults that has been 
 19.26  received by the commissioner as required under section 626.557, 
 19.27  subdivision 9c, paragraph (i), and the commissioner's records 
 19.28  relating to the maltreatment of minors in licensed programs, 
 19.29  information from juvenile courts as required in paragraph (c) 
 19.30  for persons listed in paragraph (c), clauses (2), (6), and (7), 
 19.31  and information from the bureau of criminal apprehension.  For 
 19.32  child foster care, adult foster care, and family day care homes, 
 19.33  the study must include information from the county agency's 
 19.34  record of substantiated maltreatment of adults, and the 
 19.35  maltreatment of minors, information from juvenile courts as 
 19.36  required in paragraph (c) for persons listed in paragraph (c), 
 20.1   clauses (2), (6), and (7), and information from the bureau of 
 20.2   criminal apprehension.  The commissioner may also review arrest 
 20.3   and investigative information from the bureau of criminal 
 20.4   apprehension, the commissioner of health, a county attorney, 
 20.5   county sheriff, county agency, local chief of police, other 
 20.6   states, the courts, or the Federal Bureau of Investigation if 
 20.7   the commissioner has reasonable cause to believe the information 
 20.8   is pertinent to the disqualification of an individual listed in 
 20.9   paragraph (c), clauses (1) to (7).  The commissioner is not 
 20.10  required to conduct more than one review of a subject's records 
 20.11  from the Federal Bureau of Investigation if a review of the 
 20.12  subject's criminal history with the Federal Bureau of 
 20.13  Investigation has already been completed by the commissioner and 
 20.14  there has been no break in the subject's affiliation with the 
 20.15  license holder who initiated the background study. 
 20.16     (m) When the commissioner has reasonable cause to believe 
 20.17  that further pertinent information may exist on the subject, the 
 20.18  subject shall provide a set of classifiable fingerprints 
 20.19  obtained from an authorized law enforcement agency.  For 
 20.20  purposes of requiring fingerprints, the commissioner shall be 
 20.21  considered to have reasonable cause under, but not limited to, 
 20.22  the following circumstances: 
 20.23     (1) information from the bureau of criminal apprehension 
 20.24  indicates that the subject is a multistate offender; 
 20.25     (2) information from the bureau of criminal apprehension 
 20.26  indicates that multistate offender status is undetermined; or 
 20.27     (3) the commissioner has received a report from the subject 
 20.28  or a third party indicating that the subject has a criminal 
 20.29  history in a jurisdiction other than Minnesota. 
 20.30     (n) The failure or refusal of an applicant, license holder, 
 20.31  or registrant under section 144A.71, subdivision 1, to cooperate 
 20.32  with the commissioner is reasonable cause to disqualify a 
 20.33  subject, deny a license application or immediately suspend, 
 20.34  suspend, or revoke a license or registration.  Failure or 
 20.35  refusal of an individual to cooperate with the study is just 
 20.36  cause for denying or terminating employment of the individual if 
 21.1   the individual's failure or refusal to cooperate could cause the 
 21.2   applicant's application to be denied or the license holder's 
 21.3   license to be immediately suspended, suspended, or revoked. 
 21.4      (o) The commissioner shall not consider an application to 
 21.5   be complete until all of the information required to be provided 
 21.6   under this subdivision has been received.  
 21.7      (p) No person in paragraph (c), clauses (1) to (7), who is 
 21.8   disqualified as a result of this section may be retained by the 
 21.9   agency in a position involving direct contact with persons 
 21.10  served by the program ~~or in a position allowing~~ and no person in 
 21.11  paragraph (c), clauses (2), (6), and (7), or as provided 
 21.12  elsewhere in statute who is disqualified as a result of this 
 21.13  section may be allowed access to persons served by the 
 21.14  program ~~as provided for in statutes~~, unless the commissioner has 
 21.15  provided written notice to the agency stating that: 
 21.16     (1) the individual may remain in direct contact during the 
 21.17  period in which the individual may request reconsideration as 
 21.18  provided in subdivision 3a, paragraph (b), clause (2) or (3); 
 21.19     (2) the individual's disqualification has been set aside 
 21.20  for that agency as provided in subdivision 3b, paragraph (b); or 
 21.21     (3) the license holder has been granted a variance for the 
 21.22  disqualified individual under subdivision 3e. 
 21.23     (q) Termination of affiliation with persons in paragraph 
 21.24  (c), clauses (1) to (7), made in good faith reliance on a notice 
 21.25  of disqualification provided by the commissioner shall not 
 21.26  subject the applicant or license holder to civil liability. 
 21.27     (r) The commissioner may establish records to fulfill the 
 21.28  requirements of this section. 
 21.29     (s) The commissioner may not disqualify an individual 
 21.30  subject to a study under this section because that person has, 
 21.31  or has had, a mental illness as defined in section 245.462, 
 21.32  subdivision 20. 
 21.33     (t) An individual subject to disqualification under this 
 21.34  subdivision has the applicable rights in subdivision 3a, 3b, or 
 21.35  3c. 
 21.36     (u) For the purposes of background studies completed by 
 22.1   tribal organizations performing licensing activities otherwise 
 22.2   required of the commissioner under this chapter, after obtaining 
 22.3   consent from the background study subject, tribal licensing 
 22.4   agencies shall have access to criminal history data in the same 
 22.5   manner as county licensing agencies and private licensing 
 22.6   agencies under this chapter. 
 22.7      Sec. 10.  Minnesota Statutes 2001 Supplement, section 
 22.8   245A.04, subdivision 3a, is amended to read: 
 22.9      Subd. 3a.  [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 
 22.10  STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) Within 15 
 22.11  working days, the commissioner shall notify the applicant, 
 22.12  license holder, or registrant under section 144A.71, subdivision 
 22.13  1, and the individual who is the subject of the study, in 
 22.14  writing or by electronic transmission, of the results of the 
 22.15  study or that more time is needed to complete the study.  When 
 22.16  the study is completed, a notice that the study was undertaken 
 22.17  and completed shall be maintained in the personnel files of the 
 22.18  program.  For studies on individuals pertaining to a license to 
 22.19  provide family day care or group family day care, foster care 
 22.20  for children in the provider's own home, or foster care or day 
 22.21  care services for adults in the provider's own home, the 
 22.22  commissioner is not required to provide a separate notice of the 
 22.23  background study results to the individual who is the subject of 
 22.24  the study unless the study results in a disqualification of the 
 22.25  individual. 
 22.26     The commissioner shall notify the individual studied if the 
 22.27  information in the study indicates the individual is 
 22.28  disqualified from direct contact with persons served by the 
 22.29  program.  The commissioner shall disclose the information 
 22.30  causing disqualification and instructions on how to request a 
 22.31  reconsideration of the disqualification to the individual 
 22.32  studied.  An applicant or license holder who is not the subject 
 22.33  of the study shall be informed that the commissioner has found 
 22.34  information that disqualifies the subject from direct contact 
 22.35  with persons served by the program.  However, only the 
 22.36  individual studied must be informed of the information contained 
 23.1   in the subject's background study unless the basis for the 
 23.2   disqualification is failure to cooperate, substantiated 
 23.3   maltreatment under section 626.556 or 626.557, the Data 
 23.4   Practices Act provides for release of the information, or the 
 23.5   individual studied authorizes the release of the information.  
 23.6   When a disqualification is based on the subject's failure to 
 23.7   cooperate with the background study or substantiated 
 23.8   maltreatment under section 626.556 or 626.557, the agency that 
 23.9   initiated the study shall be informed by the commissioner of the 
 23.10  reason for the disqualification. 
 23.11     (b) Except as provided in subdivision 3d, paragraph (b), if 
 23.12  the commissioner determines that the individual studied has a 
 23.13  disqualifying characteristic, the commissioner shall review the 
 23.14  information immediately available and make a determination as to 
 23.15  the subject's immediate risk of harm to persons served by the 
 23.16  program where the individual studied will have direct contact.  
 23.17  The commissioner shall consider all relevant information 
 23.18  available, including the following factors in determining the 
 23.19  immediate risk of harm:  the recency of the disqualifying 
 23.20  characteristic; the recency of discharge from probation for the 
 23.21  crimes; the number of disqualifying characteristics; the 
 23.22  intrusiveness or violence of the disqualifying characteristic; 
 23.23  the vulnerability of the victim involved in the disqualifying 
 23.24  characteristic; and the similarity of the victim to the persons 
 23.25  served by the program where the individual studied will have 
 23.26  direct contact.  The commissioner may determine that the 
 23.27  evaluation of the information immediately available gives the 
 23.28  commissioner reason to believe one of the following: 
 23.29     (1) The individual poses an imminent risk of harm to 
 23.30  persons served by the program where the individual studied will 
 23.31  have direct contact.  If the commissioner determines that an 
 23.32  individual studied poses an imminent risk of harm to persons 
 23.33  served by the program where the individual studied will have 
 23.34  direct contact, the individual and the license holder must be 
 23.35  sent a notice of disqualification.  The commissioner shall order 
 23.36  the license holder to immediately remove the individual studied 
 24.1   from direct contact.  The notice to the individual studied must 
 24.2   include an explanation of the basis of this determination. 
 24.3      (2) The individual poses a risk of harm requiring 
 24.4   continuous, direct supervision while providing direct contact 
 24.5   services during the period in which the subject may request a 
 24.6   reconsideration.  If the commissioner determines that an 
 24.7   individual studied poses a risk of harm that requires 
 24.8   continuous, direct supervision, the individual and the license 
 24.9   holder must be sent a notice of disqualification.  The 
 24.10  commissioner shall order the license holder to immediately 
 24.11  remove the individual studied from direct contact services or 
 24.12  assure that the individual studied is ~~within sight or hearing~~ 
 24.13  under the continuous, direct supervision of another staff person 
 24.14  when providing direct contact services during the period in 
 24.15  which the individual may request a reconsideration of the 
 24.16  disqualification.  If the individual studied does not submit a 
 24.17  timely request for reconsideration, or the individual submits a 
 24.18  timely request for reconsideration, but the disqualification is 
 24.19  not set aside for that license holder, the license holder will 
 24.20  be notified of the disqualification and ordered to immediately 
 24.21  remove the individual from any position allowing direct contact 
 24.22  with persons receiving services from the license holder. 
 24.23     (3) The individual does not pose an imminent risk of harm 
 24.24  or a risk of harm requiring continuous, direct supervision while 
 24.25  providing direct contact services during the period in which the 
 24.26  subject may request a reconsideration.  If the commissioner 
 24.27  determines that an individual studied does not pose a risk of 
 24.28  harm that requires continuous, direct supervision, only the 
 24.29  individual must be sent a notice of disqualification.  The 
 24.30  license holder must be sent a notice that more time is needed to 
 24.31  complete the individual's background study.  If the individual 
 24.32  studied submits a timely request for reconsideration, and if the 
 24.33  disqualification is set aside for that license holder, the 
 24.34  license holder will receive the same notification received by 
 24.35  license holders in cases where the individual studied has no 
 24.36  disqualifying characteristic.  If the individual studied does 
 25.1   not submit a timely request for reconsideration, or the 
 25.2   individual submits a timely request for reconsideration, but the 
 25.3   disqualification is not set aside for that license holder, the 
 25.4   license holder will be notified of the disqualification and 
 25.5   ordered to immediately remove the individual from any position 
 25.6   allowing direct contact with persons receiving services from the 
 25.7   license holder.  
 25.8      (c) County licensing agencies performing duties under this 
 25.9   subdivision may develop an alternative system for determining 
 25.10  the subject's immediate risk of harm to persons served by the 
 25.11  program, providing the notices under paragraph (b), and 
 25.12  documenting the action taken by the county licensing agency.  
 25.13  Each county licensing agency's implementation of the alternative 
 25.14  system is subject to approval by the commissioner.  
 25.15  Notwithstanding this alternative system, county licensing 
 25.16  agencies shall complete the requirements of paragraph (a). 
 25.17     Sec. 11.  Minnesota Statutes 2001 Supplement, section 
 25.18  245A.04, subdivision 3b, is amended to read: 
 25.19     Subd. 3b.  [RECONSIDERATION OF DISQUALIFICATION.] (a) The 
 25.20  individual who is the subject of the disqualification may 
 25.21  request a reconsideration of the disqualification.  
 25.22     The individual must submit the request for reconsideration 
 25.23  to the commissioner in writing.  A request for reconsideration 
 25.24  for an individual who has been sent a notice of disqualification 
 25.25  under subdivision 3a, paragraph (b), clause (1) or (2), must be 
 25.26  submitted within 30 calendar days of the disqualified 
 25.27  individual's receipt of the notice of disqualification.  Upon 
 25.28  showing that the information in clause (1) or (2) cannot be 
 25.29  obtained within 30 days, the disqualified individual may request 
 25.30  additional time, not to exceed 30 days, to obtain that 
 25.31  information.  A request for reconsideration for an individual 
 25.32  who has been sent a notice of disqualification under subdivision 
 25.33  3a, paragraph (b), clause (3), must be submitted within 15 
 25.34  calendar days of the disqualified individual's receipt of the 
 25.35  notice of disqualification.  An individual who was determined to 
 25.36  have maltreated a child under section 626.556 or a vulnerable 
 26.1   adult under section 626.557, and who was disqualified under this 
 26.2   section on the basis of serious or recurring maltreatment, may 
 26.3   request reconsideration of both the maltreatment and the 
 26.4   disqualification determinations.  The request for 
 26.5   reconsideration of the maltreatment determination and the 
 26.6   disqualification must be submitted within 30 calendar days of 
 26.7   the individual's receipt of the notice of disqualification.  
 26.8   Removal of a disqualified individual from direct contact shall 
 26.9   be ordered if the individual does not request reconsideration 
 26.10  within the prescribed time, and for an individual who submits a 
 26.11  timely request for reconsideration, if the disqualification is 
 26.12  not set aside.  The individual must present information showing 
 26.13  that: 
 26.14     (1) the information the commissioner relied upon in 
 26.15  determining that the underlying conduct giving rise to the 
 26.16  disqualification occurred, and for maltreatment, that the 
 26.17  maltreatment was serious or recurring, is incorrect ~~or~~ 
 26.18  ~~inaccurate.  If the basis of a reconsideration request is that a~~ 
 26.19  ~~maltreatment determination or disposition under section 626.556~~ 
 26.20  ~~or 626.557 is incorrect, and the commissioner has issued a final~~ 
 26.21  ~~order in an appeal of that determination or disposition under~~ 
 26.22  ~~section 256.045 or 245A.08, subdivision 5, the commissioner's~~ 
 26.23  ~~order is conclusive on the issue of maltreatment.  If the~~ 
 26.24  ~~individual did not request reconsideration of the maltreatment~~ 
 26.25  ~~determination, the maltreatment determination is deemed~~ 
 26.26  ~~conclusive~~; or 
 26.27     (2) the subject of the study does not pose a risk of harm 
 26.28  to any person served by the applicant, license holder, or 
 26.29  registrant under section 144A.71, subdivision 1. 
 26.30     (b) The commissioner shall rescind the disqualification if 
 26.31  the commissioner finds that the information relied on to 
 26.32  disqualify the subject is incorrect.  The commissioner may set 
 26.33  aside the disqualification under this section if the 
 26.34  commissioner finds that the individual does not pose a risk of 
 26.35  harm to any person served by the applicant, license holder, or 
 26.36  registrant under section 144A.71, subdivision 1.  In determining 
 27.1   that an individual does not pose a risk of harm, the 
 27.2   commissioner shall consider the nature, severity, and 
 27.3   consequences of the event or events that lead to 
 27.4   disqualification, whether there is more than one disqualifying 
 27.5   event, the age and vulnerability of the victim at the time of 
 27.6   the event, the harm suffered by the victim, the similarity 
 27.7   between the victim and persons served by the program, the time 
 27.8   elapsed without a repeat of the same or similar event, 
 27.9   documentation of successful completion by the individual studied 
 27.10  of training or rehabilitation pertinent to the event, and any 
 27.11  other information relevant to reconsideration.  In reviewing a 
 27.12  disqualification under this section, the commissioner shall give 
 27.13  preeminent weight to the safety of each person to be served by 
 27.14  the license holder, applicant, or registrant under section 
 27.15  144A.71, subdivision 1, over the interests of the license 
 27.16  holder, applicant, or registrant under section 144A.71, 
 27.17  subdivision 1. 
 27.18     (c) Unless the information the commissioner relied on in 
 27.19  disqualifying an individual is incorrect, the commissioner may 
 27.20  not set aside the disqualification of an individual in 
 27.21  connection with a license to provide family day care for 
 27.22  children, foster care for children in the provider's own home, 
 27.23  or foster care or day care services for adults in the provider's 
 27.24  own home if: 
 27.25     (1) less than ten years have passed since the discharge of 
 27.26  the sentence imposed for the offense; and the individual has 
 27.27  been convicted of a violation of any offense listed in sections 
 27.28  609.20 (manslaughter in the first degree), 609.205 (manslaughter 
 27.29  in the second degree), criminal vehicular homicide under 609.21 
 27.30  (criminal vehicular homicide and injury), 609.215 (aiding 
 27.31  suicide or aiding attempted suicide), felony violations under 
 27.32  609.221 to 609.2231 (assault in the first, second, third, or 
 27.33  fourth degree), 609.713 (terroristic threats), 609.235 (use of 
 27.34  drugs to injure or to facilitate crime), 609.24 (simple 
 27.35  robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 
 27.36  609.255 (false imprisonment), 609.561 or 609.562 (arson in the 
 28.1   first or second degree), 609.71 (riot), burglary in the first or 
 28.2   second degree under 609.582 (burglary), 609.66 (dangerous 
 28.3   weapon), 609.665 (spring guns), 609.67 (machine guns and 
 28.4   short-barreled shotguns), 609.749 (harassment; stalking), 
 28.5   152.021 or 152.022 (controlled substance crime in the first or 
 28.6   second degree), 152.023, subdivision 1, clause (3) or (4), or 
 28.7   subdivision 2, clause (4) (controlled substance crime in the 
 28.8   third degree), 152.024, subdivision 1, clause (2), (3), or (4) 
 28.9   (controlled substance crime in the fourth degree), 609.224, 
 28.10  subdivision 2, paragraph (c) (fifth-degree assault by a 
 28.11  caregiver against a vulnerable adult), 609.228 (great bodily 
 28.12  harm caused by distribution of drugs), 609.23 (mistreatment of 
 28.13  persons confined), 609.231 (mistreatment of residents or 
 28.14  patients), 609.2325 (criminal abuse of a vulnerable adult), 
 28.15  609.233 (criminal neglect of a vulnerable adult), 609.2335 
 28.16  (financial exploitation of a vulnerable adult), 609.234 (failure 
 28.17  to report), 609.265 (abduction), 609.2664 to 609.2665 
 28.18  (manslaughter of an unborn child in the first or second degree), 
 28.19  609.267 to 609.2672 (assault of an unborn child in the first, 
 28.20  second, or third degree), 609.268 (injury or death of an unborn 
 28.21  child in the commission of a crime), 617.293 (disseminating or 
 28.22  displaying harmful material to minors), a felony level 
 28.23  conviction involving alcohol or drug use, a gross misdemeanor 
 28.24  offense under 609.324, subdivision 1 (other prohibited acts), a 
 28.25  gross misdemeanor offense under 609.378 (neglect or endangerment 
 28.26  of a child), a gross misdemeanor offense under 609.377 
 28.27  (malicious punishment of a child), 609.72, subdivision 3 
 28.28  (disorderly conduct against a vulnerable adult); or an attempt 
 28.29  or conspiracy to commit any of these offenses, as each of these 
 28.30  offenses is defined in Minnesota Statutes; or an offense in any 
 28.31  other state, the elements of which are substantially similar to 
 28.32  the elements of any of the foregoing offenses; 
 28.33     (2) regardless of how much time has passed since the 
 28.34  involuntary termination of parental rights under section 
 28.35  260C.301 or the discharge of the sentence imposed for the 
 28.36  offense, the individual was convicted of a violation of any 
 29.1   offense listed in sections 609.185 to 609.195 (murder in the 
 29.2   first, second, or third degree), 609.2661 to 609.2663 (murder of 
 29.3   an unborn child in the first, second, or third degree), a felony 
 29.4   offense under 609.377 (malicious punishment of a child), a 
 29.5   felony offense under 609.324, subdivision 1 (other prohibited 
 29.6   acts), a felony offense under 609.378 (neglect or endangerment 
 29.7   of a child), 609.322 (solicitation, inducement, and promotion of 
 29.8   prostitution), 609.342 to 609.345 (criminal sexual conduct in 
 29.9   the first, second, third, or fourth degree), 609.352 
 29.10  (solicitation of children to engage in sexual conduct), 617.246 
 29.11  (use of minors in a sexual performance), 617.247 (possession of 
 29.12  pictorial representations of a minor), 609.365 (incest), a 
 29.13  felony offense under sections 609.2242 and 609.2243 (domestic 
 29.14  assault), a felony offense of spousal abuse, a felony offense of 
 29.15  child abuse or neglect, a felony offense of a crime against 
 29.16  children, or an attempt or conspiracy to commit any of these 
 29.17  offenses as defined in Minnesota Statutes, or an offense in any 
 29.18  other state, the elements of which are substantially similar to 
 29.19  any of the foregoing offenses; 
 29.20     (3) within the seven years preceding the study, the 
 29.21  individual committed an act that constitutes maltreatment of a 
 29.22  child under section 626.556, subdivision 10e, and that resulted 
 29.23  in substantial bodily harm as defined in section 609.02, 
 29.24  subdivision 7a, or substantial mental or emotional harm as 
 29.25  supported by competent psychological or psychiatric evidence; or 
 29.26     (4) within the seven years preceding the study, the 
 29.27  individual was determined under section 626.557 to be the 
 29.28  perpetrator of a substantiated incident of maltreatment of a 
 29.29  vulnerable adult that resulted in substantial bodily harm as 
 29.30  defined in section 609.02, subdivision 7a, or substantial mental 
 29.31  or emotional harm as supported by competent psychological or 
 29.32  psychiatric evidence. 
 29.33     In the case of any ground for disqualification under 
 29.34  clauses (1) to (4), if the act was committed by an individual 
 29.35  other than the applicant, license holder, or registrant under 
 29.36  section 144A.71, subdivision 1, residing in the applicant's or 
 30.1   license holder's home, or the home of a registrant under section 
 30.2   144A.71, subdivision 1, the applicant, license holder, or 
 30.3   registrant under section 144A.71, subdivision 1, may seek 
 30.4   reconsideration when the individual who committed the act no 
 30.5   longer resides in the home.  
 30.6      The disqualification periods provided under clauses (1), 
 30.7   (3), and (4) are the minimum applicable disqualification 
 30.8   periods.  The commissioner may determine that an individual 
 30.9   should continue to be disqualified from licensure or 
 30.10  registration under section 144A.71, subdivision 1, because the 
 30.11  license holder, applicant, or registrant under section 144A.71, 
 30.12  subdivision 1, poses a risk of harm to a person served by that 
 30.13  individual after the minimum disqualification period has passed. 
 30.14     (d) The commissioner shall respond in writing or by 
 30.15  electronic transmission to all reconsideration requests for 
 30.16  which the basis for the request is that the information relied 
 30.17  upon by the commissioner to disqualify is incorrect or 
 30.18  inaccurate within 30 working days of receipt of a request and 
 30.19  all relevant information.  If the basis for the request is that 
 30.20  the individual does not pose a risk of harm, the commissioner 
 30.21  shall respond to the request within 15 working days after 
 30.22  receiving the request for reconsideration and all relevant 
 30.23  information.  If the request is based on both the correctness or 
 30.24  accuracy of the information relied on to disqualify the 
 30.25  individual and the risk of harm, the commissioner shall respond 
 30.26  to the request within 45 working days after receiving the 
 30.27  request for reconsideration and all relevant information.  If 
 30.28  the disqualification is set aside, the commissioner shall notify 
 30.29  the applicant or license holder in writing or by electronic 
 30.30  transmission of the decision. 
 30.31     (e) Except as provided in subdivision 3c, if a 
 30.32  disqualification for which reconsideration was requested is not 
 30.33  set aside or is not rescinded, an individual who was 
 30.34  disqualified on the basis of a preponderance of evidence that 
 30.35  the individual committed an act or acts that meet the definition 
 30.36  of any of the crimes ~~lists~~ listed in subdivision 3d, paragraph 
 31.1   (a), clauses (1) to (4); or for failure to make required reports 
 31.2   under section 626.556, subdivision 3, or 626.557, subdivision 3, 
 31.3   pursuant to subdivision 3d, paragraph (a), clause (4), may 
 31.4   request a fair hearing under section 256.045.  Except as 
 31.5   provided under subdivision 3c, the ~~commissioner's final order~~ 
 31.6   ~~for an individual under this paragraph is conclusive on the~~ 
 31.7   ~~issue of maltreatment and disqualification, including for~~ 
 31.8   ~~purposes of subsequent studies conducted under subdivision 3,~~ 
 31.9   ~~and~~ fair hearing is the only administrative appeal of the final 
 31.10  agency determination, specifically, including a challenge to the 
 31.11  accuracy and completeness of data under section 13.04.  
 31.12     (f) Except as provided under subdivision 3c, if an 
 31.13  individual was disqualified on the basis of a determination of 
 31.14  maltreatment under section 626.556 or 626.557, which was serious 
 31.15  or recurring, and the individual has requested reconsideration 
 31.16  of the maltreatment determination under section 626.556, 
 31.17  subdivision 10i, or 626.557, subdivision 9d, and also requested 
 31.18  reconsideration of the disqualification under this subdivision, 
 31.19  reconsideration of the maltreatment determination and 
 31.20  reconsideration of the disqualification shall be consolidated 
 31.21  into a single reconsideration.  For maltreatment and 
 31.22  disqualification determinations made by county agencies, the 
 31.23  consolidated reconsideration shall be conducted by the county 
 31.24  agency.  If the county agency has disqualified an individual on 
 31.25  multiple bases, one of which is a county maltreatment 
 31.26  determination for which the individual has a right to request 
 31.27  reconsideration, the county shall conduct the reconsideration of 
 31.28  all disqualifications.  Except as provided under subdivision 3c, 
 31.29  if an individual who was disqualified on the basis of serious or 
 31.30  recurring maltreatment requests a fair hearing on the 
 31.31  maltreatment determination under section 626.556, subdivision 
 31.32  10i, or 626.557, subdivision 9d, and requests a fair hearing on 
 31.33  the disqualification, which has not been set aside or rescinded 
 31.34  under this subdivision, the scope of the fair hearing under 
 31.35  section 256.045 shall include the maltreatment determination and 
 31.36  the disqualification.  Except as provided under subdivision 
 32.1   3c, ~~the commissioner's final order for an individual under this~~ 
 32.2   ~~paragraph is conclusive on the issue of maltreatment and~~ 
 32.3   ~~disqualification, including for purposes of subsequent studies~~ 
 32.4   ~~conducted under subdivision 3, and~~ a fair hearing is the only 
 32.5   administrative appeal of the final agency determination, 
 32.6   specifically, including a challenge to the accuracy and 
 32.7   completeness of data under section 13.04. 
 32.8      Sec. 12.  Minnesota Statutes 2000, section 245A.04, is 
 32.9   amended by adding a subdivision to read: 
 32.10     Subd. 3f.  [CONCLUSIVE DETERMINATIONS OR DISPOSITIONS.] 
 32.11  Unless otherwise specified in statute, the following 
 32.12  determinations or dispositions are deemed conclusive: 
 32.13     (1) a maltreatment determination or disposition under 
 32.14  section 626.556 or 626.557, if: 
 32.15     (i) the commissioner has issued a final order in an appeal 
 32.16  of that determination or disposition under section 245A.08, 
 32.17  subdivision 5, or 256.045; 
 32.18     (ii) the individual did not request reconsideration of the 
 32.19  maltreatment determination or disposition under section 626.556 
 32.20  or 626.557; or 
 32.21     (iii) the individual did not request a hearing of the 
 32.22  maltreatment determination or disposition under section 256.045; 
 32.23  and 
 32.24     (2) a determination that the information relied upon to 
 32.25  disqualify an individual under subdivision 3d, was correct based 
 32.26  on serious or recurring maltreatment; or 
 32.27     (3) a preponderance of evidence shows that the individual 
 32.28  committed an act or acts that meet the definition of any of the 
 32.29  crimes listed in subdivision 3d, paragraph (a), clauses (1) to 
 32.30  (4); or the individual's failure to make required reports under 
 32.31  section 626.556, subdivision 3, or 626.557, subdivision 3, if: 
 32.32     (i) the commissioner has issued a final order in an appeal 
 32.33  of that determination under section 245A.08, subdivision 5, or 
 32.34  256.045, or a court has issued a final decision; 
 32.35     (ii) the individual did not request reconsideration of the 
 32.36  disqualification under this section; or 
 33.1      (iii) the individual did not request a hearing on the 
 33.2   disqualification under section 256.045. 
 33.3      Sec. 13.  Minnesota Statutes 2000, section 245A.04, is 
 33.4   amended by adding a subdivision to read: 
 33.5      Subd. 3g.  [PRESENTING FALSE INFORMATION FOR A BACKGROUND 
 33.6   STUDY; HIRING DISQUALIFIED PERSONS.] (a) A person who 
 33.7   intentionally presents, causes to be presented, or prepares with 
 33.8   knowledge or reason to believe that it will be presented, to the 
 33.9   commissioner of human services or the commissioner of health, 
 33.10  for purposes of a background study under this section, any 
 33.11  information that contains a false representation as to any 
 33.12  material fact regarding the applicant's name, address, sex, date 
 33.13  of birth, drivers license number, or criminal history is guilty 
 33.14  of a crime and may be sentenced as provided in paragraph (c). 
 33.15     (b) An entity that is required to conduct a background 
 33.16  check under this section that employs an individual after 
 33.17  receiving notice from the commissioner of human services, 
 33.18  health, or corrections that the individual is disqualified under 
 33.19  law from being employed and must be removed, is guilty of a 
 33.20  crime and may be sentenced as provided in paragraph (c). 
 33.21     (c) A person or entity that violates this section may be 
 33.22  sentenced to imprisonment for not more than one year or to 
 33.23  payment of a fine of not more than $3,000 or both. 
 33.24     <h>[EFFECTIVE DATE.]</h> This section is effective August 1, 2002, 
 33.25  and applies to crimes committed on or after that date. 
 33.26     Sec. 14.  Minnesota Statutes 2001 Supplement, section 
 33.27  245A.07, subdivision 2a, is amended to read: 
 33.28     Subd. 2a.  [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 
 33.29  Within five working days of receipt of the license holder's 
 33.30  timely appeal, the commissioner shall request assignment of an 
 33.31  administrative law judge.  The request must include a proposed 
 33.32  date, time, and place of a hearing.  A hearing must be conducted 
 33.33  by an administrative law judge within 30 calendar days of the 
 33.34  request for assignment, unless an extension is requested by 
 33.35  either party and granted by the administrative law judge for 
 33.36  good cause.  The commissioner shall issue a notice of hearing by 
 34.1   certified mail at least ten working days before the hearing.  
 34.2   The scope of the hearing shall be limited solely to the issue of 
 34.3   whether the temporary immediate suspension should remain in 
 34.4   effect pending the commissioner's final order under section 
 34.5   245A.08, regarding a licensing sanction issued under subdivision 
 34.6   3 following the immediate suspension.  The burden of proof in 
 34.7   expedited hearings under this subdivision shall be limited to 
 34.8   the commissioner's demonstration that reasonable cause exists to 
 34.9   believe that the license holder's actions or failure to comply 
 34.10  with applicable law or rule poses an imminent risk of harm to 
 34.11  the health, safety, or rights of persons served by the program.  
 34.12     (b) The administrative law judge shall issue findings of 
 34.13  fact, conclusions, and a recommendation within ten working days 
 34.14  from the date of hearing.  The commissioner's final order shall 
 34.15  be issued within ten working days from receipt of the 
 34.16  recommendation of the administrative law judge.  Within 90 
 34.17  calendar days after a final order affirming an immediate 
 34.18  suspension, the commissioner shall make a determination 
 34.19  regarding whether a final licensing sanction shall be issued 
 34.20  under subdivision 3.  The license holder shall continue to be 
 34.21  prohibited from operation of the program during this 90-day 
 34.22  period.  
 34.23     (c) When the final order under paragraph (b) affirms an 
 34.24  immediate suspension, and a final licensing sanction is issued 
 34.25  under subdivision 3, and the license holder appeals that 
 34.26  sanction, the license holder continues to be prohibited from 
 34.27  operation of the program pending a final commissioner's order 
 34.28  under section 245A.08, subdivision 5, regarding the final 
 34.29  licensing sanction. 
 34.30     Sec. 15.  Minnesota Statutes 2001 Supplement, section 
 34.31  245A.07, subdivision 3, is amended to read: 
 34.32     Subd. 3.  [LICENSE SUSPENSION, REVOCATION, OR FINE.] The 
 34.33  commissioner may suspend or revoke a license, or impose a fine 
 34.34  if a license holder fails to comply fully with applicable laws 
 34.35  or rules, or knowingly withholds relevant information from or 
 34.36  gives false or misleading information to the commissioner in 
 35.1   connection with an application for a license, in connection with 
 35.2   the background study status of an individual, or during an 
 35.3   investigation.  A license holder who has had a license 
 35.4   suspended, revoked, or has been ordered to pay a fine must be 
 35.5   given notice of the action by certified mail.  The notice must 
 35.6   be mailed to the address shown on the application or the last 
 35.7   known address of the license holder.  The notice must state the 
 35.8   reasons the license was suspended, revoked, or a fine was 
 35.9   ordered. 
 35.10     (a) If the license was suspended or revoked, the notice 
 35.11  must inform the license holder of the right to a contested case 
 35.12  hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 
 35.13  1400.8612 and successor rules.  The license holder may appeal an 
 35.14  order suspending or revoking a license.  The appeal of an order 
 35.15  suspending or revoking a license must be made in writing by 
 35.16  certified mail and must be received by the commissioner within 
 35.17  ten calendar days after the license holder receives notice that 
 35.18  the license has been suspended or revoked.  Except as provided 
 35.19  in subdivision 2a, paragraph (c), a timely appeal of an order 
 35.20  suspending or revoking a license shall stay the suspension or 
 35.21  revocation until the commissioner issues a final order.  
 35.22     (b)(1) If the license holder was ordered to pay a fine, the 
 35.23  notice must inform the license holder of the responsibility for 
 35.24  payment of fines and the right to a contested case hearing under 
 35.25  chapter 14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and 
 35.26  successor rules.  The appeal of an order to pay a fine must be 
 35.27  made in writing by certified mail and must be received by the 
 35.28  commissioner within ten calendar days after the license holder 
 35.29  receives notice that the fine has been ordered.  
 35.30     (2) The license holder shall pay the fines assessed on or 
 35.31  before the payment date specified.  If the license holder fails 
 35.32  to fully comply with the order, the commissioner may issue a 
 35.33  second fine or suspend the license until the license holder 
 35.34  complies.  If the license holder receives state funds, the 
 35.35  state, county, or municipal agencies or departments responsible 
 35.36  for administering the funds shall withhold payments and recover 
 36.1   any payments made while the license is suspended for failure to 
 36.2   pay a fine.  A timely appeal shall stay payment of the fine 
 36.3   until the commissioner issues a final order.  
 36.4      (3) A license holder shall promptly notify the commissioner 
 36.5   of human services, in writing, when a violation specified in the 
 36.6   order to forfeit a fine is corrected.  If upon reinspection the 
 36.7   commissioner determines that a violation has not been corrected 
 36.8   as indicated by the order to forfeit a fine, the commissioner 
 36.9   may issue a second fine.  The commissioner shall notify the 
 36.10  license holder by certified mail that a second fine has been 
 36.11  assessed.  The license holder may appeal the second fine as 
 36.12  provided under this subdivision. 
 36.13     (4) Fines shall be assessed as follows:  the license holder 
 36.14  shall forfeit $1,000 for each determination of maltreatment of a 
 36.15  child under section 626.556 or the maltreatment of a vulnerable 
 36.16  adult under section 626.557; the license holder shall forfeit 
 36.17  $200 for each occurrence of a violation of law or rule governing 
 36.18  matters of health, safety, or supervision, including but not 
 36.19  limited to the provision of adequate staff-to-child or adult 
 36.20  ratios, and failure to submit a background study; and the 
 36.21  license holder shall forfeit $100 for each occurrence of a 
 36.22  violation of law or rule other than those subject to a $1,000 or 
 36.23  $200 fine above.  For purposes of this section, "occurrence" 
 36.24  means each violation identified in the commissioner's fine order.
 36.25     (5) When a fine has been assessed, the license holder may 
 36.26  not avoid payment by closing, selling, or otherwise transferring 
 36.27  the licensed program to a third party.  In such an event, the 
 36.28  license holder will be personally liable for payment.  In the 
 36.29  case of a corporation, each controlling individual is personally 
 36.30  and jointly liable for payment.  
 36.31     Sec. 16.  [245A.085] [CONSOLIDATION OF HEARINGS; 
 36.32  RECONSIDERATION.] 
 36.33     Hearings authorized under this chapter and sections 
 36.34  256.045, 626.556, and 626.557, shall be consolidated if feasible 
 36.35  and in accordance with other applicable statutes and rules.  
 36.36  Reconsideration under sections 245A.04, subdivision 3c; 626.556, 
 37.1   subdivision 10i; and 626.557, subdivision 9d, shall also be 
 37.2   consolidated if feasible. 
 37.3      Sec. 17.  Minnesota Statutes 2001 Supplement, section 
 37.4   245A.144, is amended to read: 
 37.5      245A.144 [REDUCTION OF RISK OF SUDDEN INFANT DEATH SYNDROME 
 37.6   IN CHILD CARE PROGRAMS.] 
 37.7      License holders must ensure that before staff persons, 
 37.8   caregivers, and helpers assist in the care of infants, they 
 37.9   receive training on reducing the risk of sudden infant death 
 37.10  syndrome.  The training on reducing the risk of sudden infant 
 37.11  death syndrome may be provided as orientation training under 
 37.12  Minnesota Rules, part 9503.0035, subpart 1, as initial training 
 37.13  under Minnesota Rules, part 9502.0385, subpart 2, as in-service 
 37.14  training under Minnesota Rules, part 9503.0035, subpart 4, or as 
 37.15  ongoing training under Minnesota Rules, part 9502.0385, subpart 
 37.16  3.  Training required under this section must be at least one 
 37.17  hour in length and must be completed at least once every five 
 37.18  years.  At a minimum, the training must address the risk factors 
 37.19  related to sudden infant death syndrome, means of reducing the 
 37.20  risk of sudden infant death syndrome in child care, and license 
 37.21  holder communication with parents regarding reducing the risk of 
 37.22  sudden infant death syndrome.  Training for family and group 
 37.23  family child care providers must be approved by the county 
 37.24  licensing agency according to Minnesota Rules, part 9502.0385. 
 37.25     Sec. 18.  [245A.151] [FIRE MARSHAL INSPECTION.] 
 37.26     When the requirements for licensure under this chapter 
 37.27  require a fire marshal to inspect a facility for compliance with 
 37.28  the Minnesota Uniform Fire Code under section 299F.011, a local 
 37.29  fire code inspector may conduct the inspection.  If a community 
 37.30  does not have a local fire code inspector, a local fire code 
 37.31  inspector from another community may conduct the inspection and 
 37.32  may charge an applicant or license holder a fee for the actual 
 37.33  cost of the inspection not to exceed $50 per inspection.  
 37.34     Sec. 19.  Minnesota Statutes 2001 Supplement, section 
 37.35  245A.16, subdivision 1, is amended to read: 
 37.36     Subdivision 1.  [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 
 38.1   County agencies and private agencies that have been designated 
 38.2   or licensed by the commissioner to perform licensing functions 
 38.3   and activities under section 245A.04, to recommend denial of 
 38.4   applicants under section 245A.05, to issue correction orders, to 
 38.5   issue variances, and recommend a conditional license under 
 38.6   section 245A.06, or to recommend suspending or revoking a 
 38.7   license or issuing a fine under section 245A.07, shall comply 
 38.8   with rules and directives of the commissioner governing those 
 38.9   functions and with this section.  The following variances are 
 38.10  excluded from the delegation of variance authority and may be 
 38.11  issued only by the commissioner: 
 38.12     (1) dual licensure of family child care and child foster 
 38.13  care, dual licensure of child and adult foster care, and adult 
 38.14  foster care and family child care; 
 38.15     (2) adult foster care maximum capacity; 
 38.16     (3) adult foster care minimum age requirement; 
 38.17     (4) child foster care maximum age requirement; 
 38.18     (5) variances regarding disqualified individuals except 
 38.19  that county agencies may issue variances under section 245A.04, 
 38.20  subdivision 3e, regarding disqualified individuals when the 
 38.21  county is responsible for conducting a consolidated 
 38.22  reconsideration according to section 245A.04, subdivision 3b, 
 38.23  paragraph (f), of a county maltreatment determination and a 
 38.24  disqualification based on serious or recurring maltreatment; and 
 38.25     (6) the required presence of a caregiver in the adult 
 38.26  foster care residence during normal sleeping hours. 
 38.27     (b) County agencies must report information about 
 38.28  disqualification reconsiderations under section 245A.04, 
 38.29  subdivision 3b, paragraph (f), and variances granted under 
 38.30  paragraph (a), clause (5), to the commissioner at least monthly 
 38.31  in a format prescribed by the commissioner. 
 38.32     (c) For family day care programs, the commissioner may 
 38.33  authorize licensing reviews every two years after a licensee has 
 38.34  had at least one annual review. 
 38.35     Sec. 20.  Minnesota Statutes 2001 Supplement, section 
 38.36  256.045, subdivision 3b, is amended to read: 
 39.1      Subd. 3b.  [STANDARD OF EVIDENCE FOR MALTREATMENT AND 
 39.2   DISQUALIFICATION HEARINGS.] (a) The state human services referee 
 39.3   shall determine that maltreatment has occurred if a 
 39.4   preponderance of evidence exists to support the final 
 39.5   disposition under sections 626.556 and 626.557.  For purposes of 
 39.6   hearings regarding disqualification, the state human services 
 39.7   referee shall affirm the proposed disqualification in an appeal 
 39.8   under subdivision 3, paragraph (a), clause (9), if a 
 39.9   preponderance of the evidence shows the individual has:  
 39.10     (1) committed maltreatment under section 626.556 or 
 39.11  626.557, which is serious or recurring; 
 39.12     (2) committed an act or acts meeting the definition of any 
 39.13  of the crimes listed in section 245A.04, subdivision 3d, 
 39.14  paragraph (a), clauses (1) to (4); or 
 39.15     (3) failed to make required reports under section 626.556 
 39.16  or 626.557, for incidents in which~~:~~  
 39.17     ~~(i)~~ the final disposition under section 626.556 or 626.557 
 39.18  was substantiated maltreatment~~; and~~ 
 39.19     ~~(ii) the maltreatment was recurring or serious; or~~ 
 39.20  ~~substantiated serious or recurring maltreatment of a minor under~~ 
 39.21  ~~section 626.556 or of a vulnerable adult under section 626.557~~ 
 39.22  ~~for which there is a preponderance of evidence that the~~ 
 39.23  ~~maltreatment occurred, and that the subject was responsible for~~ 
 39.24  ~~the maltreatment~~ that was serious or recurring.  
 39.25     (b) If the disqualification is affirmed, the state human 
 39.26  services referee shall determine whether the individual poses a 
 39.27  risk of harm in accordance with the requirements of section 
 39.28  245A.04, subdivision 3b. 
 39.29     (c) The state human services referee shall recommend an 
 39.30  order to the commissioner of health, children, families, and 
 39.31  learning, or human services, as applicable, who shall issue a 
 39.32  final order.  The commissioner shall affirm, reverse, or modify 
 39.33  the final disposition.  Any order of the commissioner issued in 
 39.34  accordance with this subdivision is conclusive upon the parties 
 39.35  unless appeal is taken in the manner provided in subdivision 7.  
 39.36  ~~Except as provided under section 245A.04, subdivisions 3b,~~ 
 40.1   ~~paragraphs (e) and (f), and 3c,~~ In any licensing appeal under 
 40.2   chapter 245A and sections 144.50 to 144.58 and 144A.02 to 
 40.3   144A.46, the commissioner's determination as to maltreatment is 
 40.4   conclusive as provided under section 245A.04, subdivision 3f. 
 40.5      Sec. 21.  Minnesota Statutes 2001 Supplement, section 
 40.6   256.045, subdivision 4, is amended to read: 
 40.7      Subd. 4.  [CONDUCT OF HEARINGS.] (a) All hearings held 
 40.8   pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 
 40.9   according to the provisions of the federal Social Security Act 
 40.10  and the regulations implemented in accordance with that act to 
 40.11  enable this state to qualify for federal grants-in-aid, and 
 40.12  according to the rules and written policies of the commissioner 
 40.13  of human services.  County agencies shall install equipment 
 40.14  necessary to conduct telephone hearings.  A state human services 
 40.15  referee may schedule a telephone conference hearing when the 
 40.16  distance or time required to travel to the county agency offices 
 40.17  will cause a delay in the issuance of an order, or to promote 
 40.18  efficiency, or at the mutual request of the parties.  Hearings 
 40.19  may be conducted by telephone conferences unless the applicant, 
 40.20  recipient, former recipient, person, or facility contesting 
 40.21  maltreatment objects.  The hearing shall not be held earlier 
 40.22  than five days after filing of the required notice with the 
 40.23  county or state agency.  The state human services referee shall 
 40.24  notify all interested persons of the time, date, and location of 
 40.25  the hearing at least five days before the date of the hearing.  
 40.26  Interested persons may be represented by legal counsel or other 
 40.27  representative of their choice, including a provider of therapy 
 40.28  services, at the hearing and may appear personally, testify and 
 40.29  offer evidence, and examine and cross-examine witnesses.  The 
 40.30  applicant, recipient, former recipient, person, or facility 
 40.31  contesting maltreatment shall have the opportunity to examine 
 40.32  the contents of the case file and all documents and records to 
 40.33  be used by the county or state agency at the hearing at a 
 40.34  reasonable time before the date of the hearing and during the 
 40.35  hearing.  In hearings under subdivision 3, paragraph (a), 
 40.36  clauses (4), (8), and (9), either party may subpoena the private 
 41.1   data relating to the investigation prepared by the agency under 
 41.2   section 626.556 or 626.557 that is not otherwise accessible 
 41.3   under section 13.04, provided the identity of the reporter may 
 41.4   not be disclosed. 
 41.5      (b) The private data obtained by subpoena in a hearing 
 41.6   under subdivision 3, paragraph (a), clause (4), (8), or (9), 
 41.7   must be subject to a protective order which prohibits its 
 41.8   disclosure for any other purpose outside the hearing provided 
 41.9   for in this section without prior order of the district court.  
 41.10  Disclosure without court order is punishable by a sentence of 
 41.11  not more than 90 days imprisonment or a fine of not more than 
 41.12  $700, or both.  These restrictions on the use of private data do 
 41.13  not prohibit access to the data under section 13.03, subdivision 
 41.14  6.  Except for appeals under subdivision 3, paragraph (a), 
 41.15  clauses (4), (5), (8), and (9), upon request, the county agency 
 41.16  shall provide reimbursement for transportation, child care, 
 41.17  photocopying, medical assessment, witness fee, and other 
 41.18  necessary and reasonable costs incurred by the applicant, 
 41.19  recipient, or former recipient in connection with the appeal.  
 41.20  All evidence, except that privileged by law, commonly accepted 
 41.21  by reasonable people in the conduct of their affairs as having 
 41.22  probative value with respect to the issues shall be submitted at 
 41.23  the hearing and such hearing shall not be "a contested case" 
 41.24  within the meaning of section 14.02, subdivision 3.  The agency 
 41.25  must present its evidence prior to or at the hearing, and may 
 41.26  not submit evidence after the hearing except by agreement of the 
 41.27  parties at the hearing, provided the petitioner has the 
 41.28  opportunity to respond. 
 41.29     (c) In hearings under subdivision 3, paragraph (a), clauses 
 41.30  (4), (8), and (9), involving determinations of maltreatment or 
 41.31  disqualification made by more than one county agency, by a 
 41.32  county agency and a state agency, or by more than one state 
 41.33  agency, the hearings may be consolidated into a single fair 
 41.34  hearing upon the consent of all parties and the state human 
 41.35  services referee. 
 41.36     Sec. 22.  Minnesota Statutes 2001 Supplement, section 
 42.1   626.556, subdivision 10i, is amended to read: 
 42.2      Subd. 10i.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
 42.3   DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 
 42.4   SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 
 42.5   provided under paragraph (e), an individual or facility that the 
 42.6   commissioner of human services, a local social service agency, 
 42.7   or the commissioner of children, families, and learning 
 42.8   determines has maltreated a child, an interested person acting 
 42.9   on behalf of the child, regardless of the determination, who 
 42.10  contests the investigating agency's final determination 
 42.11  regarding maltreatment, may request the investigating agency to 
 42.12  reconsider its final determination regarding maltreatment.  The 
 42.13  request for reconsideration must be submitted in writing to the 
 42.14  investigating agency within 15 calendar days after receipt of 
 42.15  notice of the final determination regarding maltreatment or, if 
 42.16  the request is made by an interested person who is not entitled 
 42.17  to notice, within 15 days after receipt of the notice by the 
 42.18  parent or guardian of the child.  Effective January 1, 2002, an 
 42.19  individual who was determined to have maltreated a child under 
 42.20  this section and who was disqualified on the basis of serious or 
 42.21  recurring maltreatment under section 245A.04, subdivision 3d, 
 42.22  may request reconsideration of the maltreatment determination 
 42.23  and the disqualification.  The request for reconsideration of 
 42.24  the maltreatment determination and the disqualification must be 
 42.25  submitted within 30 calendar days of the individual's receipt of 
 42.26  the notice of disqualification under section 245A.04, 
 42.27  subdivision 3a. 
 42.28     (b) Except as provided under paragraphs (e) and (f), if the 
 42.29  investigating agency denies the request or fails to act upon the 
 42.30  request within 15 calendar days after receiving the request for 
 42.31  reconsideration, the person or facility entitled to a fair 
 42.32  hearing under section 256.045 may submit to the commissioner of 
 42.33  human services or the commissioner of children, families, and 
 42.34  learning a written request for a hearing under that section.  
 42.35  Section 256.045 also governs hearings requested to contest a 
 42.36  final determination of the commissioner of children, families, 
 43.1   and learning.  For reports involving maltreatment of a child in 
 43.2   a facility, an interested person acting on behalf of the child 
 43.3   may request a review by the child maltreatment review panel 
 43.4   under section 256.022 if the investigating agency denies the 
 43.5   request or fails to act upon the request or if the interested 
 43.6   person contests a reconsidered determination.  The investigating 
 43.7   agency shall notify persons who request reconsideration of their 
 43.8   rights under this paragraph.  The request must be submitted in 
 43.9   writing to the review panel and a copy sent to the investigating 
 43.10  agency within 30 calendar days of receipt of notice of a denial 
 43.11  of a request for reconsideration or of a reconsidered 
 43.12  determination.  The request must specifically identify the 
 43.13  aspects of the agency determination with which the person is 
 43.14  dissatisfied. 
 43.15     (c) If, as a result of a reconsideration or review, the 
 43.16  investigating agency changes the final determination of 
 43.17  maltreatment, that agency shall notify the parties specified in 
 43.18  subdivisions 10b, 10d, and 10f. 
 43.19     (d) Except as provided under paragraph (f), if an 
 43.20  individual or facility contests the investigating agency's final 
 43.21  determination regarding maltreatment by requesting a fair 
 43.22  hearing under section 256.045, the commissioner of human 
 43.23  services shall assure that the hearing is conducted and a 
 43.24  decision is reached within 90 days of receipt of the request for 
 43.25  a hearing.  The time for action on the decision may be extended 
 43.26  for as many days as the hearing is postponed or the record is 
 43.27  held open for the benefit of either party. 
 43.28     (e) Effective January 1, 2002, if an individual was 
 43.29  disqualified under section 245A.04, subdivision 3d, on the basis 
 43.30  of a determination of maltreatment, which was serious or 
 43.31  recurring, and the individual has requested reconsideration of 
 43.32  the maltreatment determination under paragraph (a) and requested 
 43.33  reconsideration of the disqualification under section 245A.04, 
 43.34  subdivision 3b, reconsideration of the maltreatment 
 43.35  determination and reconsideration of the disqualification shall 
 43.36  be consolidated into a single reconsideration.  If 
 44.1   reconsideration of the maltreatment determination is denied or 
 44.2   the disqualification is not set aside or rescinded under section 
 44.3   245A.04, subdivision 3b, the individual may request a fair 
 44.4   hearing under section 256.045.  If an individual ~~disqualified on~~ 
 44.5   ~~the basis of a determination of maltreatment, which was serious~~ 
 44.6   ~~or recurring~~ requests a fair hearing ~~under paragraph (b)~~ on the 
 44.7   maltreatment determination and the disqualification, the scope 
 44.8   of the fair hearing shall include both the maltreatment 
 44.9   determination and the disqualification. 
 44.10     (f) Effective January 1, 2002, if a maltreatment 
 44.11  determination or a disqualification based on serious or 
 44.12  recurring maltreatment is the basis for a denial of a license 
 44.13  under section 245A.05 or a licensing sanction under section 
 44.14  245A.07, the license holder has the right to a contested case 
 44.15  hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 
 44.16  1400.8612 and successor rules.  As provided for under section 
 44.17  245A.08, subdivision 2a, the scope of the contested case hearing 
 44.18  shall include the maltreatment determination, disqualification, 
 44.19  and licensing sanction or denial of a license.  In such cases, a 
 44.20  fair hearing regarding the maltreatment determination shall not 
 44.21  be conducted under paragraph (b).  If the disqualified subject 
 44.22  is an individual other than the license holder and upon whom a 
 44.23  background study must be conducted under section 245A.04, 
 44.24  subdivision 3, the hearings of all parties may be consolidated 
 44.25  into a single contested case hearing upon consent of all parties 
 44.26  and the administrative law judge. 
 44.27     (g) For purposes of this subdivision, "interested person 
 44.28  acting on behalf of the child" means a parent or legal guardian; 
 44.29  stepparent; grandparent; guardian ad litem; adult stepbrother, 
 44.30  stepsister, or sibling; or adult aunt or uncle; unless the 
 44.31  person has been determined to be the perpetrator of the 
 44.32  maltreatment. 
 44.33     Sec. 23.  Minnesota Statutes 2000, section 626.557, 
 44.34  subdivision 3a, is amended to read: 
 44.35     Subd. 3a.  [REPORT NOT REQUIRED.] The following events are 
 44.36  not required to be reported under this section:  
 45.1      (a) A circumstance where federal law specifically prohibits 
 45.2   a person from disclosing patient identifying information in 
 45.3   connection with a report of suspected maltreatment, unless the 
 45.4   vulnerable adult, or the vulnerable adult's guardian, 
 45.5   conservator, or legal representative, has consented to 
 45.6   disclosure in a manner which conforms to federal requirements.  
 45.7   Facilities whose patients or residents are covered by such a 
 45.8   federal law shall seek consent to the disclosure of suspected 
 45.9   maltreatment from each patient or resident, or a guardian, 
 45.10  conservator, or legal representative, upon the patient's or 
 45.11  resident's admission to the facility.  Persons who are 
 45.12  prohibited by federal law from reporting an incident of 
 45.13  suspected maltreatment shall immediately seek consent to make a 
 45.14  report.  
 45.15     (b) Verbal or physical aggression occurring between 
 45.16  patients, residents, or clients of a facility, or self-abusive 
 45.17  behavior by these persons does not constitute abuse unless the 
 45.18  behavior causes serious harm.  The operator of the facility or a 
 45.19  designee shall record incidents of aggression and self-abusive 
 45.20  behavior to facilitate review by licensing agencies and county 
 45.21  and local welfare agencies. 
 45.22     (c) Accidents as defined in section 626.5572, subdivision 3.
 45.23     (d) Events occurring in a facility that result from an 
 45.24  individual's ~~single mistake~~ error in the provision of 
 45.25  therapeutic conduct to a vulnerable adult, as ~~defined~~ provided 
 45.26  in section 626.5572, subdivision 17, paragraph (c), clause (4). 
 45.27     (e) Nothing in this section shall be construed to require a 
 45.28  report of financial exploitation, as defined in section 
 45.29  626.5572, subdivision 9, solely on the basis of the transfer of 
 45.30  money or property by gift or as compensation for services 
 45.31  rendered. 
 45.32     Sec. 24.  Minnesota Statutes 2001 Supplement, section 
 45.33  626.557, subdivision 9d, is amended to read: 
 45.34     Subd. 9d.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
 45.35  DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 
 45.36  SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 
 46.1   provided under paragraph (e), any individual or facility which a 
 46.2   lead agency determines has maltreated a vulnerable adult, or the 
 46.3   vulnerable adult or an interested person acting on behalf of the 
 46.4   vulnerable adult, regardless of the lead agency's determination, 
 46.5   who contests the lead agency's final disposition of an 
 46.6   allegation of maltreatment, may request the lead agency to 
 46.7   reconsider its final disposition.  The request for 
 46.8   reconsideration must be submitted in writing to the lead agency 
 46.9   within 15 calendar days after receipt of notice of final 
 46.10  disposition or, if the request is made by an interested person 
 46.11  who is not entitled to notice, within 15 days after receipt of 
 46.12  the notice by the vulnerable adult or the vulnerable adult's 
 46.13  legal guardian.  An individual who was determined to have 
 46.14  maltreated a vulnerable adult under this section and who was 
 46.15  disqualified on the basis of serious or recurring maltreatment 
 46.16  under section 245A.04, subdivision 3d, may request 
 46.17  reconsideration of the maltreatment determination and the 
 46.18  disqualification.  The request for reconsideration of the 
 46.19  maltreatment determination and the disqualification must be 
 46.20  submitted within 30 calendar days of the individual's receipt of 
 46.21  the notice of disqualification under section 245A.04, 
 46.22  subdivision 3a. 
 46.23     (b) Except as provided under paragraphs (e) and (f), if the 
 46.24  lead agency denies the request or fails to act upon the request 
 46.25  within 15 calendar days after receiving the request for 
 46.26  reconsideration, the person or facility entitled to a fair 
 46.27  hearing under section 256.045, may submit to the commissioner of 
 46.28  human services a written request for a hearing under that 
 46.29  statute.  The vulnerable adult, or an interested person acting 
 46.30  on behalf of the vulnerable adult, may request a review by the 
 46.31  vulnerable adult maltreatment review panel under section 256.021 
 46.32  if the lead agency denies the request or fails to act upon the 
 46.33  request, or if the vulnerable adult or interested person 
 46.34  contests a reconsidered disposition.  The lead agency shall 
 46.35  notify persons who request reconsideration of their rights under 
 46.36  this paragraph.  The request must be submitted in writing to the 
 47.1   review panel and a copy sent to the lead agency within 30 
 47.2   calendar days of receipt of notice of a denial of a request for 
 47.3   reconsideration or of a reconsidered disposition.  The request 
 47.4   must specifically identify the aspects of the agency 
 47.5   determination with which the person is dissatisfied.  
 47.6      (c) If, as a result of a reconsideration or review, the 
 47.7   lead agency changes the final disposition, it shall notify the 
 47.8   parties specified in subdivision 9c, paragraph (d). 
 47.9      (d) For purposes of this subdivision, "interested person 
 47.10  acting on behalf of the vulnerable adult" means a person 
 47.11  designated in writing by the vulnerable adult to act on behalf 
 47.12  of the vulnerable adult, or a legal guardian or conservator or 
 47.13  other legal representative, a proxy or health care agent 
 47.14  appointed under chapter 145B or 145C, or an individual who is 
 47.15  related to the vulnerable adult, as defined in section 245A.02, 
 47.16  subdivision 13. 
 47.17     (e) If an individual was disqualified under section 
 47.18  245A.04, subdivision 3d, on the basis of a determination of 
 47.19  maltreatment, which was serious or recurring, and the individual 
 47.20  has requested reconsideration of the maltreatment determination 
 47.21  under paragraph (a) and reconsideration of the disqualification 
 47.22  under section 245A.04, subdivision 3b, reconsideration of the 
 47.23  maltreatment determination and requested reconsideration of the 
 47.24  disqualification shall be consolidated into a single 
 47.25  reconsideration.  If reconsideration of the maltreatment 
 47.26  determination is denied or if the disqualification is not set 
 47.27  aside or rescinded under section 245A.04, subdivision 3b, the 
 47.28  individual may request a fair hearing under section 256.045.  If 
 47.29  an individual ~~who was disqualified on the basis of serious or~~ 
 47.30  ~~recurring maltreatment~~ requests a fair hearing ~~under paragraph~~ 
 47.31  ~~(b)~~ on the maltreatment determination and the disqualification, 
 47.32  the scope of the fair hearing shall include both the 
 47.33  maltreatment determination and the disqualification. 
 47.34     (f) If a maltreatment determination or a disqualification 
 47.35  based on serious or recurring maltreatment is the basis for a 
 47.36  denial of a license under section 245A.05 or a licensing 
 48.1   sanction under section 245A.07, the license holder has the right 
 48.2   to a contested case hearing under chapter 14 and Minnesota 
 48.3   Rules, parts 1400.8510 to 1400.8612 and successor rules.  As 
 48.4   provided for under section 245A.08, the scope of the contested 
 48.5   case hearing shall include the maltreatment determination, 
 48.6   disqualification, and licensing sanction or denial of a 
 48.7   license.  In such cases, a fair hearing shall not be conducted 
 48.8   under paragraph (b).  If the disqualified subject is an 
 48.9   individual other than the license holder and upon whom a 
 48.10  background study must be conducted under section 245A.04, 
 48.11  subdivision 3, the hearings of all parties may be consolidated 
 48.12  into a single contested case hearing upon consent of all parties 
 48.13  and the administrative law judge. 
 48.14     (g) Until August 1, 2002, an individual or facility that 
 48.15  was determined by the commissioner of human services or the 
 48.16  commissioner of health to be responsible for neglect under 
 48.17  section 626.5572, subdivision 17, after October 1, 1995, and 
 48.18  before August 1, 2001, that believes that the finding of neglect 
 48.19  does not meet an amended definition of neglect may request a 
 48.20  reconsideration of the determination of neglect.  The 
 48.21  commissioner of human services or the commissioner of health 
 48.22  shall mail a notice to the last known address of individuals who 
 48.23  are eligible to seek this reconsideration.  The request for 
 48.24  reconsideration must state how the established findings no 
 48.25  longer meet the elements of the definition of neglect.  The 
 48.26  commissioner shall review the request for reconsideration and 
 48.27  make a determination within 15 calendar days.  The 
 48.28  commissioner's decision on this reconsideration is the final 
 48.29  agency action. 
 48.30     (1) For purposes of compliance with the data destruction 
 48.31  schedule under subdivision 12b, paragraph (d), when a finding of 
 48.32  substantiated maltreatment has been changed as a result of a 
 48.33  reconsideration under this paragraph, the date of the original 
 48.34  finding of a substantiated maltreatment must be used to 
 48.35  calculate the destruction date. 
 48.36     (2) For purposes of any background studies under section 
 49.1   245A.04, when a determination of substantiated maltreatment has 
 49.2   been changed as a result of a reconsideration under this 
 49.3   paragraph, any prior disqualification of the individual under 
 49.4   section 245A.04 that was based on this determination of 
 49.5   maltreatment shall be rescinded, and for future background 
 49.6   studies under section 245A.04 the commissioner must not use the 
 49.7   previous determination of substantiated maltreatment as a basis 
 49.8   for disqualification or as a basis for referring the 
 49.9   individual's maltreatment history to a health-related licensing 
 49.10  board under section 245A.04, subdivision 3d, paragraph (b). 
 49.11                             ARTICLE 2 
 49.12                      CONTINUING CARE PROGRAMS 
 49.13     Section 1.  Minnesota Statutes 2001 Supplement, section 
 49.14  144A.071, subdivision 1a, is amended to read: 
 49.15     Subd. 1a.  [DEFINITIONS.] For purposes of sections 144A.071 
 49.16  to 144A.073, the following terms have the meanings given them: 
 49.17     (a) "Attached fixtures" has the meaning given in Minnesota 
 49.18  Rules, part 9549.0020, subpart 6. 
 49.19     (b) "Buildings" has the meaning given in Minnesota Rules, 
 49.20  part 9549.0020, subpart 7. 
 49.21     (c) "Capital assets" has the meaning given in section 
 49.22  256B.421, subdivision 16. 
 49.23     (d) "Commenced construction" means that all of the 
 49.24  following conditions were met:  the final working drawings and 
 49.25  specifications were approved by the commissioner of health; the 
 49.26  construction contracts were let; a timely construction schedule 
 49.27  was developed, stipulating dates for beginning, achieving 
 49.28  various stages, and completing construction; and all zoning and 
 49.29  building permits were applied for. 
 49.30     (e) "Completion date" means the date on which a certificate 
 49.31  of occupancy is issued for a construction project, or if a 
 49.32  certificate of occupancy is not required, the date on which the 
 49.33  construction project is available for facility use. 
 49.34     (f) "Construction" means any erection, building, 
 49.35  alteration, reconstruction, modernization, or improvement 
 49.36  necessary to comply with the nursing home licensure rules. 
 50.1      (g) "Construction project" means: 
 50.2      (1) a capital asset addition to, or replacement of a 
 50.3   nursing home or certified boarding care home that results in new 
 50.4   space or the remodeling of or renovations to existing facility 
 50.5   space; 
 50.6      (2) the remodeling or renovation of existing facility space 
 50.7   the use of which is modified as a result of the project 
 50.8   described in clause (1).  This existing space and the project 
 50.9   described in clause (1) must be used for the functions as 
 50.10  designated on the construction plans on completion of the 
 50.11  project described in clause (1) for a period of not less than 24 
 50.12  months; or 
 50.13     (3) capital asset additions or replacements that are 
 50.14  completed within 12 months before or after the completion date 
 50.15  of the project described in clause (1). 
 50.16     (h) "New licensed" or "new certified beds" means: 
 50.17     (1) newly constructed beds in a facility or the 
 50.18  construction of a new facility that would increase the total 
 50.19  number of licensed nursing home beds or certified boarding care 
 50.20  or nursing home beds in the state; or 
 50.21     (2) newly licensed nursing home beds or newly certified 
 50.22  boarding care or nursing home beds that result from remodeling 
 50.23  of the facility that involves relocation of beds but does not 
 50.24  result in an increase in the total number of beds, except when 
 50.25  the project involves the upgrade of boarding care beds to 
 50.26  nursing home beds, as defined in section 144A.073, subdivision 
 50.27  1.  "Remodeling" includes any of the type of conversion, 
 50.28  renovation, replacement, or upgrading projects as defined in 
 50.29  section 144A.073, subdivision 1. 
 50.30     (i) "Project construction costs" means the cost of the 
 50.31  facility capital asset additions, replacements, renovations, or 
 50.32  remodeling projects, construction site preparation costs, and 
 50.33  related soft costs.  Project construction costs include the cost 
 50.34  of any remodeling or renovation of existing facility space which 
 50.35  is modified as a result of the construction project.  Project 
 50.36  construction costs also includes the cost of new technology 
 51.1   implemented as part of the construction project.  Project 
 51.2   construction costs also include the cost of new technology 
 51.3   implemented as part of the construction project and depreciable 
 51.4   equipment directly identified to the project.  Any new 
 51.5   technology and depreciable equipment included in the project 
 51.6   construction costs shall, at the written election of the 
 51.7   facility, be included in the facility's appraised value for 
 51.8   purposes of Minnesota Rules, part 9549.0020, subpart 5, and debt 
 51.9   incurred for its purchase shall be included as allowable debt 
 51.10  for purposes of Minnesota Rules, part 9549.0060, subpart 5, 
 51.11  items A and C.  Any new technology and depreciable equipment 
 51.12  included in the project construction costs that the facility 
 51.13  elects not to include in its appraised value and allowable debts 
 51.14  shall be treated as provided in section 256B.431, subdivision 
 51.15  17, paragraph (b).  Written election under this paragraph must 
 51.16  be included in the facility's request for the rate change 
 51.17  related to the project, and this election may not be changed. 
 51.18     (j) "Technology" means information systems or devices that 
 51.19  make documentation, charting, and staff time more efficient or 
 51.20  encourage and allow for care through alternative settings 
 51.21  including, but not limited to, touch screens, monitors, 
 51.22  hand-helds, swipe cards, motion detectors, pagers, telemedicine, 
 51.23  medication dispensers, and equipment to monitor vital signs and 
 51.24  self-injections, and to observe skin and other conditions. 
 51.25     Sec. 2.  Minnesota Statutes 2001 Supplement, section 
 51.26  144A.36, subdivision 1, is amended to read: 
 51.27     Subdivision 1.  [DEFINITIONS.] "Eligible nursing home" 
 51.28  means any nursing home licensed under sections 144A.01 to 
 51.29  144A.155 ~~and~~ or a boarding care facility, certified by the 
 51.30  appropriate authority under United States Code, title 42, 
 51.31  sections 1396-1396p, to participate as a vendor in the medical 
 51.32  assistance program established under chapter 256B. 
 51.33     Sec. 3.  Minnesota Statutes 2000, section 245.462, 
 51.34  subdivision 4, is amended to read: 
 51.35     Subd. 4.  [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 
 51.36  management service provider" means a case manager or case 
 52.1   manager associate employed by the county or other entity 
 52.2   authorized by the county board to provide case management 
 52.3   services specified in section 245.4711.  
 52.4      (b) A case manager must: 
 52.5      (1) be skilled in the process of identifying and assessing 
 52.6   a wide range of client needs; 
 52.7      (2) be knowledgeable about local community resources and 
 52.8   how to use those resources for the benefit of the client; 
 52.9      (3) have a bachelor's degree in one of the behavioral 
 52.10  sciences or related fields including, but not limited to, social 
 52.11  work, psychology, or nursing from an accredited college or 
 52.12  university or meet the requirements of paragraph (c); and 
 52.13     (4) meet the supervision and continuing education 
 52.14  requirements described in paragraphs (d), (e), and (f), as 
 52.15  applicable.  
 52.16     (c) Case managers without a bachelor's degree must meet one 
 52.17  of the requirements in clauses (1) to (3):  
 52.18     (1) have three or four years of experience as a case 
 52.19  manager associate as defined in this section; 
 52.20     (2) be a registered nurse without a bachelor's degree and 
 52.21  have a combination of specialized training in psychiatry and 
 52.22  work experience consisting of community interaction and 
 52.23  involvement or community discharge planning in a mental health 
 52.24  setting totaling three years; or 
 52.25     (3) be a person who qualified as a case manager under the 
 52.26  1998 department of human service waiver provision and meet the 
 52.27  continuing education and mentoring requirements in this section. 
 52.28     (d) A case manager with at least 2,000 hours of supervised 
 52.29  experience in the delivery of services to adults with mental 
 52.30  illness must receive regular ongoing supervision and clinical 
 52.31  supervision totaling 38 hours per year of which at least one 
 52.32  hour per month must be clinical supervision regarding individual 
 52.33  service delivery with a case management supervisor.  The 
 52.34  remaining 26 hours of supervision may be provided by a case 
 52.35  manager with two years of experience.  Group supervision may not 
 52.36  constitute more than one-half of the required supervision 
 53.1   hours.  Clinical supervision must be documented in the client 
 53.2   record. 
 53.3      (e) A case manager without 2,000 hours of supervised 
 53.4   experience in the delivery of services to adults with mental 
 53.5   illness must: 
 53.6      (1) receive clinical supervision regarding individual 
 53.7   service delivery from a mental health professional at least one 
 53.8   hour per week until the requirement of 2,000 hours of experience 
 53.9   is met; and 
 53.10     (2) complete 40 hours of training approved by the 
 53.11  commissioner in case management skills and the characteristics 
 53.12  and needs of adults with serious and persistent mental illness.  
 53.13     (f) A case manager who is not licensed, registered, or 
 53.14  certified by a health-related licensing board must receive 30 
 53.15  hours of continuing education and training in mental illness and 
 53.16  mental health services ~~annually~~ every two years. 
 53.17     (g) A case manager associate (CMA) must: 
 53.18     (1) work under the direction of a case manager or case 
 53.19  management supervisor; 
 53.20     (2) be at least 21 years of age; 
 53.21     (3) have at least a high school diploma or its equivalent; 
 53.22  and 
 53.23     (4) meet one of the following criteria: 
 53.24     (i) have an associate of arts degree in one of the 
 53.25  behavioral sciences or human services; 
 53.26     (ii) be a registered nurse without a bachelor's degree; 
 53.27     (iii) within the previous ten years, have three years of 
 53.28  life experience with serious and persistent mental illness as 
 53.29  defined in section 245.462, subdivision 20; or as a child had 
 53.30  severe emotional disturbance as defined in section 245.4871, 
 53.31  subdivision 6; or have three years life experience as a primary 
 53.32  caregiver to an adult with serious and persistent mental illness 
 53.33  within the previous ten years; 
 53.34     (iv) have 6,000 hours work experience as a nondegreed state 
 53.35  hospital technician; or 
 53.36     (v) be a mental health practitioner as defined in section 
 54.1   245.462, subdivision 17, clause (2). 
 54.2      Individuals meeting one of the criteria in items (i) to 
 54.3   (iv), may qualify as a case manager after four years of 
 54.4   supervised work experience as a case manager associate.  
 54.5   Individuals meeting the criteria in item (v), may qualify as a 
 54.6   case manager after three years of supervised experience as a 
 54.7   case manager associate. 
 54.8      (h) A case management associate must meet the following 
 54.9   supervision, mentoring, and continuing education requirements:  
 54.10     (1) have 40 hours of preservice training described under 
 54.11  paragraph (e), clause (2); 
 54.12     (2) receive at least 40 hours of continuing education in 
 54.13  mental illness and mental health services annually; and 
 54.14     (3) receive at least five hours of mentoring per week from 
 54.15  a case management mentor.  
 54.16  A "case management mentor" means a qualified, practicing case 
 54.17  manager or case management supervisor who teaches or advises and 
 54.18  provides intensive training and clinical supervision to one or 
 54.19  more case manager associates.  Mentoring may occur while 
 54.20  providing direct services to consumers in the office or in the 
 54.21  field and may be provided to individuals or groups of case 
 54.22  manager associates.  At least two mentoring hours per week must 
 54.23  be individual and face-to-face. 
 54.24     (i) A case management supervisor must meet the criteria for 
 54.25  mental health professionals, as specified in section 245.462, 
 54.26  subdivision 18. 
 54.27     (j) An immigrant who does not have the qualifications 
 54.28  specified in this subdivision may provide case management 
 54.29  services to adult immigrants with serious and persistent mental 
 54.30  illness who are members of the same ethnic group as the case 
 54.31  manager if the person:  
 54.32     (1) is currently enrolled in and is actively pursuing 
 54.33  credits toward the completion of a bachelor's degree in one of 
 54.34  the behavioral sciences or a related field including, but not 
 54.35  limited to, social work, psychology, or nursing from an 
 54.36  accredited college or university; 
 55.1      (2) completes 40 hours of training as specified in this 
 55.2   subdivision; and 
 55.3      (3) receives clinical supervision at least once a week 
 55.4   until the requirements of this subdivision are met. 
 55.5      Sec. 4.  Minnesota Statutes 2000, section 245.4871, 
 55.6   subdivision 4, is amended to read: 
 55.7      Subd. 4.  [CASE MANAGEMENT SERVICE PROVIDER.] (a) "Case 
 55.8   management service provider" means a case manager or case 
 55.9   manager associate employed by the county or other entity 
 55.10  authorized by the county board to provide case management 
 55.11  services specified in subdivision 3 for the child with severe 
 55.12  emotional disturbance and the child's family.  
 55.13     (b) A case manager must: 
 55.14     (1) have experience and training in working with children; 
 55.15     (2) have at least a bachelor's degree in one of the 
 55.16  behavioral sciences or a related field including, but not 
 55.17  limited to, social work, psychology, or nursing from an 
 55.18  accredited college or university or meet the requirements of 
 55.19  paragraph (d); 
 55.20     (3) have experience and training in identifying and 
 55.21  assessing a wide range of children's needs; 
 55.22     (4) be knowledgeable about local community resources and 
 55.23  how to use those resources for the benefit of children and their 
 55.24  families; and 
 55.25     (5) meet the supervision and continuing education 
 55.26  requirements of paragraphs (e), (f), and (g), as applicable. 
 55.27     (c) A case manager may be a member of any professional 
 55.28  discipline that is part of the local system of care for children 
 55.29  established by the county board. 
 55.30     (d) A case manager without a bachelor's degree must meet 
 55.31  one of the requirements in clauses (1) to (3):  
 55.32     (1) have three or four years of experience as a case 
 55.33  manager associate; 
 55.34     (2) be a registered nurse without a bachelor's degree who 
 55.35  has a combination of specialized training in psychiatry and work 
 55.36  experience consisting of community interaction and involvement 
 56.1   or community discharge planning in a mental health setting 
 56.2   totaling three years; or 
 56.3      (3) be a person who qualified as a case manager under the 
 56.4   1998 department of human services waiver provision and meets the 
 56.5   continuing education, supervision, and mentoring requirements in 
 56.6   this section. 
 56.7      (e) A case manager with at least 2,000 hours of supervised 
 56.8   experience in the delivery of mental health services to children 
 56.9   must receive regular ongoing supervision and clinical 
 56.10  supervision totaling 38 hours per year, of which at least one 
 56.11  hour per month must be clinical supervision regarding individual 
 56.12  service delivery with a case management supervisor.  The other 
 56.13  26 hours of supervision may be provided by a case manager with 
 56.14  two years of experience.  Group supervision may not constitute 
 56.15  more than one-half of the required supervision hours. 
 56.16     (f) A case manager without 2,000 hours of supervised 
 56.17  experience in the delivery of mental health services to children 
 56.18  with emotional disturbance must: 
 56.19     (1) begin 40 hours of training approved by the commissioner 
 56.20  of human services in case management skills and in the 
 56.21  characteristics and needs of children with severe emotional 
 56.22  disturbance before beginning to provide case management 
 56.23  services; and 
 56.24     (2) receive clinical supervision regarding individual 
 56.25  service delivery from a mental health professional at least one 
 56.26  hour each week until the requirement of 2,000 hours of 
 56.27  experience is met. 
 56.28     (g) A case manager who is not licensed, registered, or 
 56.29  certified by a health-related licensing board must receive 30 
 56.30  hours of continuing education and training in severe emotional 
 56.31  disturbance and mental health services ~~annually~~ every two years. 
 56.32     (h) Clinical supervision must be documented in the child's 
 56.33  record.  When the case manager is not a mental health 
 56.34  professional, the county board must provide or contract for 
 56.35  needed clinical supervision. 
 56.36     (i) The county board must ensure that the case manager has 
 57.1   the freedom to access and coordinate the services within the 
 57.2   local system of care that are needed by the child. 
 57.3      (j) A case manager associate (CMA) must: 
 57.4      (1) work under the direction of a case manager or case 
 57.5   management supervisor; 
 57.6      (2) be at least 21 years of age; 
 57.7      (3) have at least a high school diploma or its equivalent; 
 57.8   and 
 57.9      (4) meet one of the following criteria: 
 57.10     (i) have an associate of arts degree in one of the 
 57.11  behavioral sciences or human services; 
 57.12     (ii) be a registered nurse without a bachelor's degree; 
 57.13     (iii) have three years of life experience as a primary 
 57.14  caregiver to a child with serious emotional disturbance as 
 57.15  defined in section 245.4871, subdivision 6, within the previous 
 57.16  ten years; 
 57.17     (iv) have 6,000 hours work experience as a nondegreed state 
 57.18  hospital technician; or 
 57.19     (v) be a mental health practitioner as defined in 
 57.20  subdivision 26, clause (2). 
 57.21     Individuals meeting one of the criteria in items (i) to 
 57.22  (iv) may qualify as a case manager after four years of 
 57.23  supervised work experience as a case manager associate.  
 57.24  Individuals meeting the criteria in item (v) may qualify as a 
 57.25  case manager after three years of supervised experience as a 
 57.26  case manager associate. 
 57.27     (k) Case manager associates must meet the following 
 57.28  supervision, mentoring, and continuing education requirements; 
 57.29     (1) have 40 hours of preservice training described under 
 57.30  paragraph (f), clause (1); 
 57.31     (2) receive at least 40 hours of continuing education in 
 57.32  severe emotional disturbance and mental health service annually; 
 57.33  and 
 57.34     (3) receive at least five hours of mentoring per week from 
 57.35  a case management mentor.  A "case management mentor" means a 
 57.36  qualified, practicing case manager or case management supervisor 
 58.1   who teaches or advises and provides intensive training and 
 58.2   clinical supervision to one or more case manager associates.  
 58.3   Mentoring may occur while providing direct services to consumers 
 58.4   in the office or in the field and may be provided to individuals 
 58.5   or groups of case manager associates.  At least two mentoring 
 58.6   hours per week must be individual and face-to-face. 
 58.7      (l) A case management supervisor must meet the criteria for 
 58.8   a mental health professional as specified in section 245.4871, 
 58.9   subdivision 27. 
 58.10     (m) An immigrant who does not have the qualifications 
 58.11  specified in this subdivision may provide case management 
 58.12  services to child immigrants with severe emotional disturbance 
 58.13  of the same ethnic group as the immigrant if the person:  
 58.14     (1) is currently enrolled in and is actively pursuing 
 58.15  credits toward the completion of a bachelor's degree in one of 
 58.16  the behavioral sciences or related fields at an accredited 
 58.17  college or university; 
 58.18     (2) completes 40 hours of training as specified in this 
 58.19  subdivision; and 
 58.20     (3) receives clinical supervision at least once a week 
 58.21  until the requirements of obtaining a bachelor's degree and 
 58.22  2,000 hours of supervised experience are met. 
 58.23     Sec. 5.  Minnesota Statutes 2000, section 245.50, 
 58.24  subdivision 1, is amended to read: 
 58.25     Subdivision 1.  [DEFINITIONS.] For purposes of this 
 58.26  section, the following terms have the meanings given them. 
 58.27     (a) "Bordering state" means Iowa, North Dakota, South 
 58.28  Dakota, or Wisconsin. 
 58.29     (b) "Receiving agency ~~or facility~~" means a public or 
 58.30  private hospital, mental health center, or other person or 
 58.31  organization ~~authorized by a state to provide~~ which provides 
 58.32  mental health services under this section to individuals from a 
 58.33  state other than the state in which the agency is located. 
 58.34     (c) "Receiving state" means the state in which a receiving 
 58.35  agency is located. 
 58.36     (d) "Sending agency" means a state or county agency which 
 59.1   sends an individual to a bordering state for treatment under 
 59.2   this section. 
 59.3      (e) "Sending state" means the state in which the sending 
 59.4   agency is located. 
 59.5      Sec. 6.  Minnesota Statutes 2000, section 245.50, 
 59.6   subdivision 2, is amended to read: 
 59.7      Subd. 2.  [PURPOSE AND AUTHORITY.] (a) The purpose of this 
 59.8   section is to enable appropriate treatment to be provided to 
 59.9   individuals, across state lines from the individual's state of 
 59.10  residence, in qualified facilities that are closer to the homes 
 59.11  of individuals than are facilities available in the individual's 
 59.12  home state. 
 59.13     (b) Unless prohibited by another law and subject to the 
 59.14  exceptions listed in subdivision 3, a county board or the 
 59.15  commissioner of human services may contract with an agency or 
 59.16  facility in a bordering state for mental health services for 
 59.17  residents of Minnesota, and a Minnesota mental health agency or 
 59.18  facility may contract to provide services to residents of 
 59.19  bordering states.  Except as provided in subdivision 5, a person 
 59.20  who receives services in another state under this section is 
 59.21  subject to the laws of the state in which services are 
 59.22  provided.  A person who will receive services in another state 
 59.23  under this section must be informed of the consequences of 
 59.24  receiving services in another state, including the implications 
 59.25  of the differences in state laws, to the extent the individual 
 59.26  will be subject to the laws of the receiving state. 
 59.27     Sec. 7.  Minnesota Statutes 2000, section 245.50, 
 59.28  subdivision 5, is amended to read: 
 59.29     Subd. 5.  [SPECIAL CONTRACTS; ~~WISCONSIN~~ BORDERING 
 59.30  STATES.] ~~The commissioner of the Minnesota department of human~~ 
 59.31  ~~services must enter into negotiations with appropriate personnel~~ 
 59.32  ~~at the Wisconsin department of health and social services and~~ 
 59.33  ~~must develop an agreement that conforms to the requirements of~~ 
 59.34  ~~subdivision 4, to enable the placement in Minnesota of patients~~ 
 59.35  ~~who are on emergency holds or who have been involuntarily~~ 
 59.36  ~~committed as mentally ill or chemically dependent in Wisconsin~~ 
 60.1   ~~and to enable the temporary placement in Wisconsin of patients~~ 
 60.2   ~~who are on emergency holds in Minnesota under section 253B.05,~~ 
 60.3   ~~provided that the Minnesota courts retain jurisdiction over~~ 
 60.4   ~~Minnesota patients, and the state of Wisconsin affords to~~ 
 60.5   ~~Minnesota patients the rights under Minnesota law.  Persons~~ 
 60.6   ~~committed by the Wisconsin courts and placed in Minnesota~~ 
 60.7   ~~facilities shall continue to be in the legal custody of~~ 
 60.8   ~~Wisconsin and Wisconsin's laws governing length of commitment,~~ 
 60.9   ~~reexaminations, and extension of commitment shall continue to~~ 
 60.10  ~~apply to these residents.  In all other respects, Wisconsin~~ 
 60.11  ~~residents placed in Minnesota facilities are subject to~~ 
 60.12  ~~Minnesota laws.  The agreement must specify that responsibility~~ 
 60.13  ~~for payment for the cost of care of Wisconsin residents shall~~ 
 60.14  ~~remain with the state of Wisconsin and the cost of care of~~ 
 60.15  ~~Minnesota residents shall remain with the state of Minnesota.~~  
 60.16  ~~The commissioner shall be assisted by attorneys from the~~ 
 60.17  ~~Minnesota attorney general's office in negotiating and~~ 
 60.18  ~~finalizing this agreement.  The agreement shall be completed so~~ 
 60.19  ~~as to permit placement of Wisconsin residents in Minnesota~~ 
 60.20  ~~facilities and Minnesota residents in Wisconsin facilities~~ 
 60.21  ~~beginning July 1, 1994.~~ (a) An individual who is detained, 
 60.22  committed, or placed on an involuntary basis under chapter 253B 
 60.23  may be confined or treated in a bordering state pursuant to a 
 60.24  contract under this section.  An individual who is detained, 
 60.25  committed, or placed on an involuntary basis under the civil law 
 60.26  of a bordering state may be confined or treated in Minnesota 
 60.27  pursuant to a contract under this section.  A peace or health 
 60.28  officer who is acting under the authority of the sending state 
 60.29  may transport an individual to a receiving agency that provides 
 60.30  services pursuant to a contract under this section, and may 
 60.31  transport the individual back to the sending state under the 
 60.32  laws of the sending state.  Court orders valid under the law of 
 60.33  the sending state are granted recognition and reciprocity in the 
 60.34  receiving state for individuals covered by a contract under this 
 60.35  section to the extent that the court orders relate to 
 60.36  confinement for treatment or care of mental illness.  Such 
 61.1   treatment or care may address other conditions that may be 
 61.2   co-occurring with the mental illness.  These court orders are 
 61.3   not subject to legal challenge in the courts of the receiving 
 61.4   state.  Individuals who are detained, committed, or placed under 
 61.5   the law of a sending state and who are transferred to a 
 61.6   receiving state under this section continue to be in the legal 
 61.7   custody of the authority responsible for them under the law of 
 61.8   the sending state.  Except in emergencies, those individuals may 
 61.9   not be transferred, removed, or furloughed from a receiving 
 61.10  agency without the specific approval of the authority 
 61.11  responsible for them under the law of the sending state. 
 61.12     (b) While in the receiving state pursuant to a contract 
 61.13  under this section, an individual shall be subject to the 
 61.14  sending state's laws and rules relating to length of 
 61.15  confinement, reexaminations, and extensions of confinement.  No 
 61.16  individual may be sent to another state pursuant to a contract 
 61.17  under this section until the receiving state has enacted a law 
 61.18  recognizing the validity and applicability of this section. 
 61.19     (c) If an individual receiving services pursuant to a 
 61.20  contract under this section leaves the receiving agency without 
 61.21  permission and the individual is subject to involuntary 
 61.22  confinement under the law of the sending state, the receiving 
 61.23  agency shall use all reasonable means to return the individual 
 61.24  to the receiving agency.  The receiving agency shall immediately 
 61.25  report the absence to the sending agency.  The receiving state 
 61.26  has the primary responsibility for, and the authority to direct, 
 61.27  the return of these individuals within its borders and is liable 
 61.28  for the cost of the action to the extent that it would be liable 
 61.29  for costs of its own resident. 
 61.30     (d) Responsibility for payment for the cost of care remains 
 61.31  with the sending agency. 
 61.32     (e) This subdivision also applies to county contracts under 
 61.33  subdivision 2 which include emergency care and treatment 
 61.34  provided to a county resident in a bordering state. 
 61.35     Sec. 8.  Minnesota Statutes 2000, section 256.01, is 
 61.36  amended by adding a subdivision to read: 
 62.1      Subd. 20.  [RYAN WHITE COMPREHENSIVE AIDS RESOURCES 
 62.2   EMERGENCY ACT.] The commissioner shall act as the designated 
 62.3   state agent for carrying out responsibilities required under 
 62.4   Title II of the federal Ryan White Comprehensive AIDS Resources 
 62.5   Emergency (CARE) Act.  These responsibilities include: 
 62.6      (1) coordinating statewide HIV/AIDS needs assessment 
 62.7   activities; 
 62.8      (2) developing the state's plan to meet identified health 
 62.9   and support service needs of people living with HIV/AIDS; 
 62.10     (3) administering federal funds designed to provide 
 62.11  comprehensive health and support services to persons living with 
 62.12  HIV/AIDS; 
 62.13     (4) administering federal funds designated for the AIDS 
 62.14  drug assistance program (ADAP); 
 62.15     (5) collecting rebates from pharmaceutical manufacturers on 
 62.16  drugs purchased with federal ADAP funds; and 
 62.17     (6) utilizing ADAP rebate funds in accordance with 
 62.18  guidelines of the federal Health Resources and Services 
 62.19  Administration. 
 62.20  Rebates collected under this subdivision shall be deposited into 
 62.21  the ADAP account in the special revenue fund and are 
 62.22  appropriated to the commissioner for purposes of this 
 62.23  subdivision. 
 62.24     Sec. 9.  Minnesota Statutes 2000, section 256.9657, 
 62.25  subdivision 1, is amended to read: 
 62.26     Subdivision 1.  [NURSING HOME LICENSE SURCHARGE.] (a) 
 62.27  Effective July 1, 1993, each non-state-operated nursing home 
 62.28  licensed under chapter 144A shall pay to the commissioner an 
 62.29  annual surcharge according to the schedule in subdivision 4.  
 62.30  The surcharge shall be calculated as $620 per licensed bed.  If 
 62.31  the number of licensed beds is reduced, the surcharge shall be 
 62.32  based on the number of remaining licensed beds the second month 
 62.33  following the receipt of timely notice by the commissioner of 
 62.34  human services that beds have been delicensed.  The nursing home 
 62.35  must notify the commissioner of health in writing when beds are 
 62.36  delicensed.  The commissioner of health must notify the 
 63.1   commissioner of human services within ten working days after 
 63.2   receiving written notification.  If the notification is received 
 63.3   by the commissioner of human services by the 15th of the month, 
 63.4   the invoice for the second following month must be reduced to 
 63.5   recognize the delicensing of beds.  Beds on layaway status 
 63.6   continue to be subject to the surcharge.  The commissioner of 
 63.7   human services must acknowledge a medical care surcharge appeal 
 63.8   within 30 days of receipt of the written appeal from the 
 63.9   provider. 
 63.10     (b) Effective July 1, 1994, the surcharge in paragraph (a) 
 63.11  shall be increased to $625. 
 63.12     (c) Between April 1, 2002, and August 15, 2003, a facility 
 63.13  governed by this subdivision may elect to assume full 
 63.14  participation in the medical assistance program by agreeing to 
 63.15  comply with all of the requirements of the medical assistance 
 63.16  program, including the rate equalization law in section 256B.48, 
 63.17  subdivision 1, paragraph (a), and all other requirements 
 63.18  established in law or rule, and to begin intake of new medical 
 63.19  assistance recipients.  Rates will be determined under Minnesota 
 63.20  Rules, parts 9549.0010 to 9549.0080.  Notwithstanding section 
 63.21  256B.431, subdivision 27, paragraph (i), rate calculations will 
 63.22  be subject to limits as prescribed in rule and law.  Other than 
 63.23  the adjustments in sections 256B.431, subdivisions 30 and 32; 
 63.24  256B.437, subdivision 3, paragraph (b); Minnesota Rules, part 
 63.25  9549.0057, and any other applicable legislation enacted prior to 
 63.26  the finalization of rates, facilities assuming full 
 63.27  participation in medical assistance under this paragraph are not 
 63.28  eligible for any rate adjustments until the July 1 following 
 63.29  their settle-up period. 
 63.30     <h>[EFFECTIVE DATE.]</h> This section is effective April 1, 2002. 
 63.31     Sec. 10.  Minnesota Statutes 2001 Supplement, section 
 63.32  256B.0625, subdivision 13, is amended to read: 
 63.33     Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs, 
 63.34  except for fertility drugs when specifically used to enhance 
 63.35  fertility, if prescribed by a licensed practitioner and 
 63.36  dispensed by a licensed pharmacist, by a physician enrolled in 
 64.1   the medical assistance program as a dispensing physician, or by 
 64.2   a physician or a nurse practitioner employed by or under 
 64.3   contract with a community health board as defined in section 
 64.4   145A.02, subdivision 5, for the purposes of communicable disease 
 64.5   control.  The commissioner, after receiving recommendations from 
 64.6   professional medical associations and professional pharmacist 
 64.7   associations, shall designate a formulary committee to advise 
 64.8   the commissioner on the names of drugs for which payment is 
 64.9   made, recommend a system for reimbursing providers on a set fee 
 64.10  or charge basis rather than the present system, and develop 
 64.11  methods encouraging use of generic drugs when they are less 
 64.12  expensive and equally effective as trademark drugs.  The 
 64.13  formulary committee shall consist of nine members, four of whom 
 64.14  shall be physicians who are not employed by the department of 
 64.15  human services, and a majority of whose practice is for persons 
 64.16  paying privately or through health insurance, three of whom 
 64.17  shall be pharmacists who are not employed by the department of 
 64.18  human services, and a majority of whose practice is for persons 
 64.19  paying privately or through health insurance, a consumer 
 64.20  representative, and a nursing home representative.  Committee 
 64.21  members shall serve three-year terms and shall serve without 
 64.22  compensation.  Members may be reappointed once.  
 64.23     (b) The commissioner shall establish a drug formulary.  Its 
 64.24  establishment and publication shall not be subject to the 
 64.25  requirements of the Administrative Procedure Act, but the 
 64.26  formulary committee shall review and comment on the formulary 
 64.27  contents.  The formulary committee shall review and recommend 
 64.28  drugs which require prior authorization.  The formulary 
 64.29  committee may recommend drugs for prior authorization directly 
 64.30  to the commissioner, as long as opportunity for public input is 
 64.31  provided.  Prior authorization may be requested by the 
 64.32  commissioner based on medical and clinical criteria before 
 64.33  certain drugs are eligible for payment.  Before a drug may be 
 64.34  considered for prior authorization at the request of the 
 64.35  commissioner:  
 64.36     (1) the drug formulary committee must develop criteria to 
 65.1   be used for identifying drugs; the development of these criteria 
 65.2   is not subject to the requirements of chapter 14, but the 
 65.3   formulary committee shall provide opportunity for public input 
 65.4   in developing criteria; 
 65.5      (2) the drug formulary committee must hold a public forum 
 65.6   and receive public comment for an additional 15 days; and 
 65.7      (3) the commissioner must provide information to the 
 65.8   formulary committee on the impact that placing the drug on prior 
 65.9   authorization will have on the quality of patient care and 
 65.10  information regarding whether the drug is subject to clinical 
 65.11  abuse or misuse.  Prior authorization may be required by the 
 65.12  commissioner before certain formulary drugs are eligible for 
 65.13  payment.  The formulary shall not include:  
 65.14     (i) drugs or products for which there is no federal 
 65.15  funding; 
 65.16     (ii) over-the-counter drugs, except for antacids, 
 65.17  acetaminophen, family planning products, aspirin, insulin, 
 65.18  products for the treatment of lice, vitamins for adults with 
 65.19  documented vitamin deficiencies, vitamins for children under the 
 65.20  age of seven and pregnant or nursing women, and any other 
 65.21  over-the-counter drug identified by the commissioner, in 
 65.22  consultation with the drug formulary committee, as necessary, 
 65.23  appropriate, and cost-effective for the treatment of certain 
 65.24  specified chronic diseases, conditions or disorders, and this 
 65.25  determination shall not be subject to the requirements of 
 65.26  chapter 14; 
 65.27     (iii) anorectics, except that medically necessary 
 65.28  anorectics shall be covered for a recipient previously diagnosed 
 65.29  as having pickwickian syndrome and currently diagnosed as having 
 65.30  diabetes and being morbidly obese; 
 65.31     (iv) drugs for which medical value has not been 
 65.32  established; and 
 65.33     (v) drugs from manufacturers who have not signed a rebate 
 65.34  agreement with the Department of Health and Human Services 
 65.35  pursuant to section 1927 of title XIX of the Social Security Act.
 65.36     The commissioner shall publish conditions for prohibiting 
 66.1   payment for specific drugs after considering the formulary 
 66.2   committee's recommendations.  An honorarium of $100 per meeting 
 66.3   and reimbursement for mileage shall be paid to each committee 
 66.4   member in attendance.  
 66.5      (c) The basis for determining the amount of payment shall 
 66.6   be the lower of the actual acquisition costs of the drugs plus a 
 66.7   fixed dispensing fee; the maximum allowable cost set by the 
 66.8   federal government or by the commissioner plus the fixed 
 66.9   dispensing fee; or the usual and customary price charged to the 
 66.10  public.  The pharmacy dispensing fee shall be $3.65, except that 
 66.11  the dispensing fee for intravenous solutions which must be 
 66.12  compounded by the pharmacist shall be $8 per bag, $14 per bag 
 66.13  for cancer chemotherapy products, and $30 per bag for total 
 66.14  parenteral nutritional products dispensed in one liter 
 66.15  quantities, or $44 per bag for total parenteral nutritional 
 66.16  products dispensed in quantities greater than one liter.  Actual 
 66.17  acquisition cost includes quantity and other special discounts 
 66.18  except time and cash discounts.  The actual acquisition cost of 
 66.19  a drug shall be estimated by the commissioner, at average 
 66.20  wholesale price minus nine percent, except that where a drug has 
 66.21  had its wholesale price reduced as a result of the actions of 
 66.22  the National Association of Medicaid Fraud Control Units, the 
 66.23  estimated actual acquisition cost shall be the reduced average 
 66.24  wholesale price, without the nine percent deduction.  The 
 66.25  maximum allowable cost of a multisource drug may be set by the 
 66.26  commissioner and it shall be comparable to, but no higher than, 
 66.27  the maximum amount paid by other third-party payors in this 
 66.28  state who have maximum allowable cost programs.  The 
 66.29  commissioner shall set maximum allowable costs for multisource 
 66.30  drugs that are not on the federal upper limit list as described 
 66.31  in United States Code, title 42, chapter 7, section 1396r-8(e), 
 66.32  the Social Security Act, and Code of Federal Regulations, title 
 66.33  42, part 447, section 447.332.  Establishment of the amount of 
 66.34  payment for drugs shall not be subject to the requirements of 
 66.35  the Administrative Procedure Act.  An additional dispensing fee 
 66.36  of $.30 may be added to the dispensing fee paid to pharmacists 
 67.1   for legend drug prescriptions dispensed to residents of 
 67.2   long-term care facilities when a unit dose blister card system, 
 67.3   approved by the department, is used.  Under this type of 
 67.4   dispensing system, the pharmacist must dispense a 30-day supply 
 67.5   of drug.  The National Drug Code (NDC) from the drug container 
 67.6   used to fill the blister card must be identified on the claim to 
 67.7   the department.  The unit dose blister card containing the drug 
 67.8   must meet the packaging standards set forth in Minnesota Rules, 
 67.9   part 6800.2700, that govern the return of unused drugs to the 
 67.10  pharmacy for reuse.  The pharmacy provider will be required to 
 67.11  credit the department for the actual acquisition cost of all 
 67.12  unused drugs that are eligible for reuse.  Over-the-counter 
 67.13  medications must be dispensed in the manufacturer's unopened 
 67.14  package.  The commissioner may permit the drug clozapine to be 
 67.15  dispensed in a quantity that is less than a 30-day supply.  
 67.16  Whenever a generically equivalent product is available, payment 
 67.17  shall be on the basis of the actual acquisition cost of the 
 67.18  generic drug, unless the prescriber specifically indicates 
 67.19  "dispense as written - brand necessary" on the prescription as 
 67.20  required by section 151.21, subdivision 2. 
 67.21     (d) For purposes of this subdivision, "multisource drugs" 
 67.22  means covered outpatient drugs, excluding innovator multisource 
 67.23  drugs for which there are two or more drug products, which: 
 67.24     (1) are related as therapeutically equivalent under the 
 67.25  Food and Drug Administration's most recent publication of 
 67.26  "Approved Drug Products with Therapeutic Equivalence 
 67.27  Evaluations"; 
 67.28     (2) are pharmaceutically equivalent and bioequivalent as 
 67.29  determined by the Food and Drug Administration; and 
 67.30     (3) are sold or marketed in Minnesota. 
 67.31  "Innovator multisource drug" means a multisource drug that was 
 67.32  originally marketed under an original new drug application 
 67.33  approved by the Food and Drug Administration. 
 67.34     (e) The basis for determining the amount of payment for 
 67.35  drugs administered in an outpatient setting shall be the lower 
 67.36  of the usual and customary cost submitted by the provider; the 
 68.1   average wholesale price minus five percent; or the maximum 
 68.2   allowable cost set by the federal government under United States 
 68.3   Code, title 42, chapter 7, section 1396r-8(e), and Code of 
 68.4   Federal Regulations, title 42, section 447.332, or by the 
 68.5   commissioner under paragraph (c). 
 68.6      (f) Prior authorization shall not be required or utilized 
 68.7   for any antipsychotic drug prescribed for the treatment of 
 68.8   mental illness where there is no generically equivalent drug 
 68.9   available unless the commissioner determines that prior 
 68.10  authorization is necessary for patient safety.  This paragraph 
 68.11  applies to any supplemental drug rebate program established or 
 68.12  administered by the commissioner. 
 68.13     (g) Prior authorization shall not be required or utilized 
 68.14  for any antihemophilic factor drug prescribed for the treatment 
 68.15  of hemophilia and blood disorders where there is no generically 
 68.16  equivalent drug available unless the commissioner determines 
 68.17  that prior authorization is necessary for patient safety.  This 
 68.18  paragraph applies to any supplemental drug rebate program 
 68.19  established or administered by the commissioner. 
 68.20     Sec. 11.  Minnesota Statutes 2000, section 256B.0625, 
 68.21  subdivision 35, is amended to read: 
 68.22     Subd. 35.  [FAMILY COMMUNITY SUPPORT SERVICES.] (a) Medical 
 68.23  assistance covers family community support services as defined 
 68.24  in section 245.4871, subdivision 17.  In addition to the 
 68.25  provisions of section 245.4871, and to the extent authorized by 
 68.26  rules promulgated by the state agency, medical assistance covers 
 68.27  the following services as family community support services: 
 68.28     (1) services identified in an individual treatment plan 
 68.29  when provided by a trained mental health behavioral aide under 
 68.30  the direction of a mental health practitioner or mental health 
 68.31  professional; 
 68.32     (2) mental health crisis intervention and crisis 
 68.33  stabilization services provided outside of hospital inpatient 
 68.34  settings; and 
 68.35     (3) the therapeutic components of preschool and therapeutic 
 68.36  camp programs. 
 69.1      (b) Notwithstanding the provisions of Minnesota Rules, 
 69.2   parts 9505.0324, subpart 2, 9505.0326, subpart 2, and 9505.0327, 
 69.3   subpart 2, a provider of family community support services, 
 69.4   home-based mental health services, or therapeutic support of 
 69.5   foster care services under contract with a county may continue 
 69.6   to provide existing services, and may provide new services, to a 
 69.7   child if that child is placed in foster care, or the child and 
 69.8   family relocate, outside the original county of residence. 
 69.9      Sec. 12.  Minnesota Statutes 2000, section 256B.0625, is 
 69.10  amended by adding a subdivision to read: 
 69.11     Subd. 44.  [TARGETED CASE MANAGEMENT SERVICES.] Medical 
 69.12  assistance covers case management services for vulnerable adults 
 69.13  and adults with developmental disabilities, as provided under 
 69.14  section 256B.0924. 
 69.15     Sec. 13.  Minnesota Statutes 2001 Supplement, section 
 69.16  256B.0627, subdivision 10, is amended to read: 
 69.17     Subd. 10.  [FISCAL INTERMEDIARY OPTION AVAILABLE FOR 
 69.18  PERSONAL CARE ASSISTANT SERVICES.] (a) The commissioner may 
 69.19  allow a recipient of personal care assistant services to use a 
 69.20  fiscal intermediary to assist the recipient in paying and 
 69.21  accounting for medically necessary covered personal care 
 69.22  assistant services authorized in subdivision 4 and within the 
 69.23  payment parameters of subdivision 5.  Unless otherwise provided 
 69.24  in this subdivision, all other statutory and regulatory 
 69.25  provisions relating to personal care assistant services apply to 
 69.26  a recipient using the fiscal intermediary option. 
 69.27     (b) The recipient or responsible party shall: 
 69.28     (1) recruit, hire, and terminate a qualified professional, 
 69.29  if a qualified professional is requested by the recipient or 
 69.30  responsible party; 
 69.31     (2) verify and document the credentials of the qualified 
 69.32  professional, if a qualified professional is requested by the 
 69.33  recipient or responsible party; 
 69.34     (3) develop a service plan based on physician orders and 
 69.35  public health nurse assessment with the assistance of a 
 69.36  qualified professional, if a qualified professional is requested 
 70.1   by the recipient or responsible party, that addresses the health 
 70.2   and safety of the recipient; 
 70.3      (4) recruit, hire, and terminate the personal care 
 70.4   assistant; 
 70.5      (5) orient and train the personal care assistant with 
 70.6   assistance as needed from the qualified professional; 
 70.7      (6) supervise and evaluate the personal care assistant with 
 70.8   assistance as needed from the recipient's physician or the 
 70.9   qualified professional; 
 70.10     (7) monitor and verify in writing and report to the fiscal 
 70.11  intermediary the number of hours worked by the personal care 
 70.12  assistant and the qualified professional; and 
 70.13     (8) enter into a written agreement, as specified in 
 70.14  paragraph (f). 
 70.15     (c) The duties of the fiscal intermediary shall be to: 
 70.16     (1) bill the medical assistance program for personal care 
 70.17  assistant and qualified professional services; 
 70.18     (2) request and secure background checks on personal care 
 70.19  assistants and qualified professionals according to section 
 70.20  245A.04; 
 70.21     (3) pay the personal care assistant and qualified 
 70.22  professional based on actual hours of services provided; 
 70.23     (4) withhold and pay all applicable federal and state 
 70.24  taxes; 
 70.25     (5) verify and keep records of hours worked by the personal 
 70.26  care assistant and qualified professional; 
 70.27     (6) make the arrangements and pay unemployment insurance, 
 70.28  taxes, workers' compensation, liability insurance, and other 
 70.29  benefits, if any; 
 70.30     (7) enroll in the medical assistance program as a fiscal 
 70.31  intermediary; and 
 70.32     (8) enter into a written agreement as specified in 
 70.33  paragraph (f) before services are provided. 
 70.34     (d) The fiscal intermediary: 
 70.35     (1) may not be related to the recipient, qualified 
 70.36  professional, or the personal care assistant; 
 71.1      (2) must ensure arm's length transactions with the 
 71.2   recipient and personal care assistant; and 
 71.3      (3) shall be considered a joint employer of the personal 
 71.4   care assistant and qualified professional to the extent 
 71.5   specified in this section. 
 71.6      The fiscal intermediary or owners of the entity that 
 71.7   provides fiscal intermediary services under this subdivision 
 71.8   must pass a criminal background check as required in section 
 71.9   256B.0627, subdivision 1, paragraph (e). 
 71.10     (e) If the recipient or responsible party requests a 
 71.11  qualified professional, the qualified professional providing 
 71.12  assistance to the recipient shall meet the qualifications 
 71.13  specified in section 256B.0625, subdivision 19c.  The qualified 
 71.14  professional shall assist the recipient in developing and 
 71.15  revising a plan to meet the recipient's needs, as assessed by 
 71.16  the public health nurse.  In performing this function, the 
 71.17  qualified professional must visit the recipient in the 
 71.18  recipient's home at least once annually.  The qualified 
 71.19  professional must report any suspected abuse, neglect, or 
 71.20  financial exploitation of the recipient to the appropriate 
 71.21  authorities.  
 71.22     (f) The fiscal intermediary, recipient or responsible 
 71.23  party, personal care assistant, and qualified professional shall 
 71.24  enter into a written agreement before services are started.  The 
 71.25  agreement shall include: 
 71.26     (1) the duties of the recipient, qualified professional, 
 71.27  personal care assistant, and fiscal agent based on paragraphs 
 71.28  (a) to (e); 
 71.29     (2) the salary and benefits for the personal care assistant 
 71.30  and the qualified professional; 
 71.31     (3) the administrative fee of the fiscal intermediary and 
 71.32  services paid for with that fee, including background check 
 71.33  fees; 
 71.34     (4) procedures to respond to billing or payment complaints; 
 71.35  and 
 71.36     (5) procedures for hiring and terminating the personal care 
 72.1   assistant and the qualified professional. 
 72.2      (g) The rates paid for personal care assistant 
 72.3   services, shared care services, qualified professional services, 
 72.4   and fiscal intermediary services under this subdivision shall be 
 72.5   the same rates paid for personal care assistant services and 
 72.6   qualified professional services under subdivision 2 
 72.7   respectively.  Except for the administrative fee of the fiscal 
 72.8   intermediary specified in paragraph (f), the remainder of the 
 72.9   rates paid to the fiscal intermediary must be used to pay for 
 72.10  the salary and benefits for the personal care assistant or the 
 72.11  qualified professional. 
 72.12     (h) As part of the assessment defined in subdivision 1, the 
 72.13  following conditions must be met to use or continue use of a 
 72.14  fiscal intermediary: 
 72.15     (1) the recipient must be able to direct the recipient's 
 72.16  own care, or the responsible party for the recipient must be 
 72.17  readily available to direct the care of the personal care 
 72.18  assistant; 
 72.19     (2) the recipient or responsible party must be 
 72.20  knowledgeable of the health care needs of the recipient and be 
 72.21  able to effectively communicate those needs; 
 72.22     (3) a face-to-face assessment must be conducted by the 
 72.23  local county public health nurse at least annually, or when 
 72.24  there is a significant change in the recipient's condition or 
 72.25  change in the need for personal care assistant services; 
 72.26     (4) ~~the recipient cannot select the shared services option~~ 
 72.27  ~~as specified in subdivision 8~~ recipients who choose to use the 
 72.28  shared care option as specified in subdivision 8 must utilize 
 72.29  the same fiscal intermediary; and 
 72.30     (5) parties must be in compliance with the written 
 72.31  agreement specified in paragraph (f). 
 72.32     (i) The commissioner shall deny, revoke, or suspend the 
 72.33  authorization to use the fiscal intermediary option if: 
 72.34     (1) it has been determined by the qualified professional or 
 72.35  local county public health nurse that the use of this option 
 72.36  jeopardizes the recipient's health and safety; 
 73.1      (2) the parties have failed to comply with the written 
 73.2   agreement specified in paragraph (f); or 
 73.3      (3) the use of the option has led to abusive or fraudulent 
 73.4   billing for personal care assistant services.  
 73.5      The recipient or responsible party may appeal the 
 73.6   commissioner's action according to section 256.045.  The denial, 
 73.7   revocation, or suspension to use the fiscal intermediary option 
 73.8   shall not affect the recipient's authorized level of personal 
 73.9   care assistant services as determined in subdivision 5. 
 73.10     Sec. 14.  Minnesota Statutes 2001 Supplement, section 
 73.11  256B.0911, subdivision 4b, is amended to read: 
 73.12     Subd. 4b.  [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 
 73.13  Exemptions from the federal screening requirements outlined in 
 73.14  subdivision 4a, paragraphs (b) and (c), are limited to: 
 73.15     (1) a person who, having entered an acute care facility 
 73.16  from a certified nursing facility, is returning to a certified 
 73.17  nursing facility; ~~and~~ 
 73.18     (2) a person transferring from one certified nursing 
 73.19  facility in Minnesota to another certified nursing facility in 
 73.20  Minnesota; and 
 73.21     (3) a person, 21 years of age or older, who satisfies the 
 73.22  following criteria, as specified in Code of Federal Regulations, 
 73.23  title 42, section 483.106(b)(2): 
 73.24     (i) the person is admitted to a nursing facility directly 
 73.25  from a hospital after receiving acute inpatient care at the 
 73.26  hospital; 
 73.27     (ii) the person requires nursing facility services for the 
 73.28  same condition for which care was provided in the hospital; and 
 73.29     (iii) the attending physician has certified before the 
 73.30  nursing facility admission that the person is likely to receive 
 73.31  less than 30 days of nursing facility services. 
 73.32     (b) Persons who are exempt from preadmission screening for 
 73.33  purposes of level of care determination include: 
 73.34     (1) persons described in paragraph (a); 
 73.35     (2) an individual who has a contractual right to have 
 73.36  nursing facility care paid for indefinitely by the veterans' 
 74.1   administration; 
 74.2      (3) an individual enrolled in a demonstration project under 
 74.3   section 256B.69, subdivision 8, at the time of application to a 
 74.4   nursing facility; 
 74.5      (4) an individual currently being served under the 
 74.6   alternative care program or under a home and community-based 
 74.7   services waiver authorized under section 1915(c) of the federal 
 74.8   Social Security Act; and 
 74.9      (5) individuals admitted to a certified nursing facility 
 74.10  for a short-term stay, which is expected to be 14 days or less 
 74.11  in duration based upon a physician's certification, and who have 
 74.12  been assessed and approved for nursing facility admission within 
 74.13  the previous six months.  This exemption applies only if the 
 74.14  consultation team member determines at the time of the initial 
 74.15  assessment of the six-month period that it is appropriate to use 
 74.16  the nursing facility for short-term stays and that there is an 
 74.17  adequate plan of care for return to the home or community-based 
 74.18  setting.  If a stay exceeds 14 days, the individual must be 
 74.19  referred no later than the first county working day following 
 74.20  the 14th resident day for a screening, which must be completed 
 74.21  within five working days of the referral.  The payment 
 74.22  limitations in subdivision 7 apply to an individual found at 
 74.23  screening to not meet the level of care criteria for admission 
 74.24  to a certified nursing facility. 
 74.25     (c) Persons admitted to a Medicaid-certified nursing 
 74.26  facility from the community on an emergency basis as described 
 74.27  in paragraph (d) or from an acute care facility on a nonworking 
 74.28  day must be screened the first working day after admission. 
 74.29     (d) Emergency admission to a nursing facility prior to 
 74.30  screening is permitted when all of the following conditions are 
 74.31  met: 
 74.32     (1) a person is admitted from the community to a certified 
 74.33  nursing or certified boarding care facility during county 
 74.34  nonworking hours; 
 74.35     (2) a physician has determined that delaying admission 
 74.36  until preadmission screening is completed would adversely affect 
 75.1   the person's health and safety; 
 75.2      (3) there is a recent precipitating event that precludes 
 75.3   the client from living safely in the community, such as 
 75.4   sustaining an injury, sudden onset of acute illness, or a 
 75.5   caregiver's inability to continue to provide care; 
 75.6      (4) the attending physician has authorized the emergency 
 75.7   placement and has documented the reason that the emergency 
 75.8   placement is recommended; and 
 75.9      (5) the county is contacted on the first working day 
 75.10  following the emergency admission. 
 75.11  Transfer of a patient from an acute care hospital to a nursing 
 75.12  facility is not considered an emergency except for a person who 
 75.13  has received hospital services in the following situations: 
 75.14  hospital admission for observation, care in an emergency room 
 75.15  without hospital admission, or following hospital 24-hour bed 
 75.16  care. 
 75.17     (e) A nursing facility must provide a written notice to 
 75.18  persons who satisfy the criteria in paragraph (a), clause (3), 
 75.19  regarding the person's right to request and receive long-term 
 75.20  care consultation services as defined in subdivision 1a.  The 
 75.21  notice must be provided prior to the person's discharge from the 
 75.22  facility and in a format specified by the commissioner. 
 75.23     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
 75.24  following final enactment.  
 75.25     Sec. 15.  Minnesota Statutes 2001 Supplement, section 
 75.26  256B.0911, subdivision 4d, is amended to read: 
 75.27     Subd. 4d.  [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 
 75.28  YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 
 75.29  ensure that individuals with disabilities or chronic illness are 
 75.30  served in the most integrated setting appropriate to their needs 
 75.31  and have the necessary information to make informed choices 
 75.32  about home and community-based service options. 
 75.33     (b) Individuals under 65 years of age who are admitted to a 
 75.34  nursing facility from a hospital must be screened prior to 
 75.35  admission as outlined in subdivisions 4a through 4c. 
 75.36     (c) Individuals under 65 years of age who are admitted to 
 76.1   nursing facilities with only a telephone screening must receive 
 76.2   a face-to-face assessment from the long-term care consultation 
 76.3   team member of the county in which the facility is located or 
 76.4   from the recipient's county case manager within 20 working days 
 76.5   of admission. 
 76.6      (d) Individuals under 65 years of age who are admitted to a 
 76.7   nursing facility without preadmission screening according to the 
 76.8   exemption described in subdivision 4b, paragraph (a), clause 
 76.9   (3), and who remain in the facility longer than 30 days must 
 76.10  receive a face-to-face assessment within 40 days of admission.  
 76.11     (e) At the face-to-face assessment, the long-term care 
 76.12  consultation team member or county case manager must perform the 
 76.13  activities required under subdivision 3b. 
 76.14     ~~(e)~~ (f) For individuals under 21 years of age, a screening 
 76.15  interview which recommends nursing facility admission must be 
 76.16  face-to-face and approved by the commissioner before the 
 76.17  individual is admitted to the nursing facility. 
 76.18     ~~(f)~~ (g) In the event that an individual under 65 years of 
 76.19  age is admitted to a nursing facility on an emergency basis, the 
 76.20  county must be notified of the admission on the next working 
 76.21  day, and a face-to-face assessment as described in paragraph (c) 
 76.22  must be conducted within 20 working days of admission. 
 76.23     ~~(g)~~ (h) At the face-to-face assessment, the long-term care 
 76.24  consultation team member or the case manager must present 
 76.25  information about home and community-based options so the 
 76.26  individual can make informed choices.  If the individual chooses 
 76.27  home and community-based services, the long-term care 
 76.28  consultation team member or case manager must complete a written 
 76.29  relocation plan within 20 working days of the visit.  The plan 
 76.30  shall describe the services needed to move out of the facility 
 76.31  and a time line for the move which is designed to ensure a 
 76.32  smooth transition to the individual's home and community. 
 76.33     ~~(h)~~ (i) An individual under 65 years of age residing in a 
 76.34  nursing facility shall receive a face-to-face assessment at 
 76.35  least every 12 months to review the person's service choices and 
 76.36  available alternatives unless the individual indicates, in 
 77.1   writing, that annual visits are not desired.  In this case, the 
 77.2   individual must receive a face-to-face assessment at least once 
 77.3   every 36 months for the same purposes. 
 77.4      ~~(i)~~ (j) Notwithstanding the provisions of subdivision 6, 
 77.5   the commissioner may pay county agencies directly for 
 77.6   face-to-face assessments for individuals under 65 years of age 
 77.7   who are being considered for placement or residing in a nursing 
 77.8   facility. 
 77.9      <h>[EFFECTIVE DATE.]</h> This section is effective the day 
 77.10  following final enactment. 
 77.11     Sec. 16.  Minnesota Statutes 2001 Supplement, section 
 77.12  256B.0913, subdivision 4, is amended to read: 
 77.13     Subd. 4.  [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 
 77.14  NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 
 77.15  under the alternative care program is available to persons who 
 77.16  meet the following criteria: 
 77.17     (1) the person has been determined by a community 
 77.18  assessment under section 256B.0911 to be a person who would 
 77.19  require the level of care provided in a nursing facility, but 
 77.20  for the provision of services under the alternative care 
 77.21  program; 
 77.22     (2) the person is age 65 or older; 
 77.23     (3) the person would be eligible for medical assistance 
 77.24  within 180 days of admission to a nursing facility; 
 77.25     (4) the person is not ineligible for the medical assistance 
 77.26  program due to an asset transfer penalty; 
 77.27     (5) the person needs services that are not funded through 
 77.28  other state or federal funding; and 
 77.29     (6) the monthly cost of the alternative care services 
 77.30  funded by the program for this person does not exceed 75 percent 
 77.31  of the statewide weighted average monthly nursing facility rate 
 77.32  of the case mix resident class to which the individual 
 77.33  alternative care client would be assigned under Minnesota Rules, 
 77.34  parts 9549.0050 to 9549.0059, less the recipient's maintenance 
 77.35  needs allowance as described in section 256B.0915, subdivision 
 77.36  1d, paragraph (a), until the first day of the state fiscal year 
 78.1   in which the resident assessment system, under section 256B.437, 
 78.2   for nursing home rate determination is implemented.  Effective 
 78.3   on the first day of the state fiscal year in which a resident 
 78.4   assessment system, under section 256B.437, for nursing home rate 
 78.5   determination is implemented and the first day of each 
 78.6   subsequent state fiscal year, the monthly cost of alternative 
 78.7   care services for this person shall not exceed the alternative 
 78.8   care monthly cap for the case mix resident class to which the 
 78.9   alternative care client would be assigned under Minnesota Rules, 
 78.10  parts 9549.0050 to 9549.0059, which was in effect on the last 
 78.11  day of the previous state fiscal year, and adjusted by the 
 78.12  greater of any legislatively adopted home and community-based 
 78.13  services cost-of-living percentage increase or any legislatively 
 78.14  adopted statewide percent rate increase for nursing facilities.  
 78.15  This monthly limit does not prohibit the alternative care client 
 78.16  from payment for additional services, but in no case may the 
 78.17  cost of additional services purchased under this section exceed 
 78.18  the difference between the client's monthly service limit 
 78.19  defined under section 256B.0915, subdivision 3, and the 
 78.20  alternative care program monthly service limit defined in this 
 78.21  paragraph.  If medical supplies and equipment or environmental 
 78.22  modifications are or will be purchased for an alternative care 
 78.23  services recipient, the costs may be prorated on a monthly basis 
 78.24  for up to 12 consecutive months beginning with the month of 
 78.25  purchase.  If the monthly cost of a recipient's other 
 78.26  alternative care services exceeds the monthly limit established 
 78.27  in this paragraph, the annual cost of the alternative care 
 78.28  services shall be determined.  In this event, the annual cost of 
 78.29  alternative care services shall not exceed 12 times the monthly 
 78.30  limit described in this paragraph. 
 78.31     (b) Alternative care funding under this subdivision is not 
 78.32  available for a person who is a medical assistance recipient or 
 78.33  who would be eligible for medical assistance without a spenddown 
 78.34  or waiver obligation.  A person whose initial application for 
 78.35  medical assistance is being processed may be served under the 
 78.36  alternative care program for a period up to 60 days.  If the 
 79.1   individual is found to be eligible for medical assistance, 
 79.2   medical assistance must be billed for services payable under the 
 79.3   federally approved elderly waiver plan and delivered from the 
 79.4   date the individual was found eligible for the federally 
 79.5   approved elderly waiver plan.  Notwithstanding this provision, 
 79.6   upon federal approval, alternative care funds may not be used to 
 79.7   pay for any service the cost of which is payable by medical 
 79.8   assistance or which is used by a recipient to meet a medical 
 79.9   assistance income spenddown or waiver obligation.  
 79.10     (c) Alternative care funding is not available for a person 
 79.11  who resides in a licensed nursing home, certified boarding care 
 79.12  home, hospital, or intermediate care facility, except for case 
 79.13  management services which are provided in support of the 
 79.14  discharge planning process to a nursing home resident or 
 79.15  certified boarding care home resident ~~who is ineligible for case~~ 
 79.16  ~~management funded by medical assistance~~. 
 79.17     Sec. 17.  Minnesota Statutes 2001 Supplement, section 
 79.18  256B.0913, subdivision 5, is amended to read: 
 79.19     Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
 79.20  Alternative care funding may be used for payment of costs of: 
 79.21     (1) adult foster care; 
 79.22     (2) adult day care; 
 79.23     (3) home health aide; 
 79.24     (4) homemaker services; 
 79.25     (5) personal care; 
 79.26     (6) case management; 
 79.27     (7) respite care; 
 79.28     (8) assisted living; 
 79.29     (9) residential care services; 
 79.30     (10) care-related supplies and equipment; 
 79.31     (11) meals delivered to the home; 
 79.32     (12) transportation; 
 79.33     (13) ~~skilled~~ nursing services; 
 79.34     (14) chore services; 
 79.35     (15) companion services; 
 79.36     (16) nutrition services; 
 80.1      (17) training for direct informal caregivers; 
 80.2      (18) ~~telemedicine~~ telehome care devices to monitor 
 80.3   recipients in their own homes as an alternative to hospital 
 80.4   care, nursing home care, or home visits; 
 80.5      (19) other services which includes discretionary funds and 
 80.6   direct cash payments to clients, following approval by the 
 80.7   commissioner, subject to the provisions of paragraph (j).  Total 
 80.8   annual payments for "other services" for all clients within a 
 80.9   county may not exceed ~~either ten~~ 25 percent of that county's 
 80.10  annual alternative care program base allocation ~~or $5,000,~~ 
 80.11  ~~whichever is greater.  In no case shall this amount exceed the~~ 
 80.12  ~~county's total annual alternative care program base allocation~~; 
 80.13  and 
 80.14     (20) environmental modifications. 
 80.15     (b) The county agency must ensure that the funds are not 
 80.16  used to supplant services available through other public 
 80.17  assistance or services programs. 
 80.18     (c) Unless specified in statute, the ~~service~~ services, 
 80.19  service definitions, and standards for alternative care services 
 80.20  shall be the same as the ~~service~~ services, service definitions, 
 80.21  and standards specified in the federally approved elderly waiver 
 80.22  plan.  Except for the county agencies' approval of direct cash 
 80.23  payments to clients as described in paragraph (j) or for a 
 80.24  provider of supplies and equipment when the monthly cost of the 
 80.25  supplies and equipment is less than $250, persons or agencies 
 80.26  must be employed by or under a contract with the county agency 
 80.27  or the public health nursing agency of the local board of health 
 80.28  in order to receive funding under the alternative care program.  
 80.29  Supplies and equipment may be purchased from a vendor not 
 80.30  certified to participate in the Medicaid program if the cost for 
 80.31  the item is less than that of a Medicaid vendor.  
 80.32     (d) The adult foster care rate shall be considered a 
 80.33  difficulty of care payment and shall not include room and 
 80.34  board.  The adult foster care rate shall be negotiated between 
 80.35  the county agency and the foster care provider.  The alternative 
 80.36  care payment for the foster care service in combination with the 
 81.1   payment for other alternative care services, including case 
 81.2   management, must not exceed the limit specified in subdivision 
 81.3   4, paragraph (a), clause (6). 
 81.4      (e) Personal care services must meet the service standards 
 81.5   defined in the federally approved elderly waiver plan, except 
 81.6   that a county agency may contract with a client's relative who 
 81.7   meets the relative hardship waiver requirement as defined in 
 81.8   section 256B.0627, subdivision 4, paragraph (b), clause (10), to 
 81.9   provide personal care services if the county agency ensures 
 81.10  supervision of this service by a ~~registered nurse or mental~~ 
 81.11  ~~health practitioner~~ qualified professional as defined in section 
 81.12  256B.0625, subdivision 19c.  
 81.13     (f) For purposes of this section, residential care services 
 81.14  are services which are provided to individuals living in 
 81.15  residential care homes.  Residential care homes are currently 
 81.16  licensed as board and lodging establishments and are registered 
 81.17  with the department of health as providing special services 
 81.18  under section 157.17 and are not subject to registration under 
 81.19  chapter 144D.  Residential care services are defined as 
 81.20  "supportive services" and "health-related services."  
 81.21  "Supportive services" means the provision of up to 24-hour 
 81.22  supervision and oversight.  Supportive services includes:  (1) 
 81.23  transportation, when provided by the residential care home only; 
 81.24  (2) socialization, when socialization is part of the plan of 
 81.25  care, has specific goals and outcomes established, and is not 
 81.26  diversional or recreational in nature; (3) assisting clients in 
 81.27  setting up meetings and appointments; (4) assisting clients in 
 81.28  setting up medical and social services; (5) providing assistance 
 81.29  with personal laundry, such as carrying the client's laundry to 
 81.30  the laundry room.  Assistance with personal laundry does not 
 81.31  include any laundry, such as bed linen, that is included in the 
 81.32  room and board rate.  "Health-related services" are limited to 
 81.33  minimal assistance with dressing, grooming, and bathing and 
 81.34  providing reminders to residents to take medications that are 
 81.35  self-administered or providing storage for medications, if 
 81.36  requested.  Individuals receiving residential care services 
 82.1   cannot receive homemaking services funded under this section.  
 82.2      (g) For the purposes of this section, "assisted living" 
 82.3   refers to supportive services provided by a single vendor to 
 82.4   clients who reside in the same apartment building of three or 
 82.5   more units which are not subject to registration under chapter 
 82.6   144D and are licensed by the department of health as a class A 
 82.7   home care provider or a class E home care provider.  Assisted 
 82.8   living services are defined as up to 24-hour supervision, and 
 82.9   oversight, supportive services as defined in clause (1), 
 82.10  individualized home care aide tasks as defined in clause (2), 
 82.11  and individualized home management tasks as defined in clause 
 82.12  (3) provided to residents of a residential center living in 
 82.13  their units or apartments with a full kitchen and bathroom.  A 
 82.14  full kitchen includes a stove, oven, refrigerator, food 
 82.15  preparation counter space, and a kitchen utensil storage 
 82.16  compartment.  Assisted living services must be provided by the 
 82.17  management of the residential center or by providers under 
 82.18  contract with the management or with the county. 
 82.19     (1) Supportive services include:  
 82.20     (i) socialization, when socialization is part of the plan 
 82.21  of care, has specific goals and outcomes established, and is not 
 82.22  diversional or recreational in nature; 
 82.23     (ii) assisting clients in setting up meetings and 
 82.24  appointments; and 
 82.25     (iii) providing transportation, when provided by the 
 82.26  residential center only.  
 82.27     (2) Home care aide tasks means:  
 82.28     (i) preparing modified diets, such as diabetic or low 
 82.29  sodium diets; 
 82.30     (ii) reminding residents to take regularly scheduled 
 82.31  medications or to perform exercises; 
 82.32     (iii) household chores in the presence of technically 
 82.33  sophisticated medical equipment or episodes of acute illness or 
 82.34  infectious disease; 
 82.35     (iv) household chores when the resident's care requires the 
 82.36  prevention of exposure to infectious disease or containment of 
 83.1   infectious disease; and 
 83.2      (v) assisting with dressing, oral hygiene, hair care, 
 83.3   grooming, and bathing, if the resident is ambulatory, and if the 
 83.4   resident has no serious acute illness or infectious disease.  
 83.5   Oral hygiene means care of teeth, gums, and oral prosthetic 
 83.6   devices.  
 83.7      (3) Home management tasks means:  
 83.8      (i) housekeeping; 
 83.9      (ii) laundry; 
 83.10     (iii) preparation of regular snacks and meals; and 
 83.11     (iv) shopping.  
 83.12     Individuals receiving assisted living services shall not 
 83.13  receive both assisted living services and homemaking services.  
 83.14  Individualized means services are chosen and designed 
 83.15  specifically for each resident's needs, rather than provided or 
 83.16  offered to all residents regardless of their illnesses, 
 83.17  disabilities, or physical conditions.  Assisted living services 
 83.18  as defined in this section shall not be authorized in boarding 
 83.19  and lodging establishments licensed according to sections 
 83.20  157.011 and 157.15 to 157.22. 
 83.21     (h) For establishments registered under chapter 144D, 
 83.22  assisted living services under this section means either the 
 83.23  services described in paragraph (g) and delivered by a class E 
 83.24  home care provider licensed by the department of health or the 
 83.25  services described under section 144A.4605 and delivered by an 
 83.26  assisted living home care provider or a class A home care 
 83.27  provider licensed by the commissioner of health. 
 83.28     (i) Payment for assisted living services and residential 
 83.29  care services shall be a monthly rate negotiated and authorized 
 83.30  by the county agency based on an individualized service plan for 
 83.31  each resident and may not cover direct rent or food costs.  
 83.32     (1) The individualized monthly negotiated payment for 
 83.33  assisted living services as described in paragraph (g) or (h), 
 83.34  and residential care services as described in paragraph (f), 
 83.35  shall not exceed the nonfederal share in effect on July 1 of the 
 83.36  state fiscal year for which the rate limit is being calculated 
 84.1   of the greater of either the statewide or any of the geographic 
 84.2   groups' weighted average monthly nursing facility payment rate 
 84.3   of the case mix resident class to which the alternative care 
 84.4   eligible client would be assigned under Minnesota Rules, parts 
 84.5   9549.0050 to 9549.0059, less the maintenance needs allowance as 
 84.6   described in section 256B.0915, subdivision 1d, paragraph (a), 
 84.7   until the first day of the state fiscal year in which a resident 
 84.8   assessment system, under section 256B.437, of nursing home rate 
 84.9   determination is implemented.  Effective on the first day of the 
 84.10  state fiscal year in which a resident assessment system, under 
 84.11  section 256B.437, of nursing home rate determination is 
 84.12  implemented and the first day of each subsequent state fiscal 
 84.13  year, the individualized monthly negotiated payment for the 
 84.14  services described in this clause shall not exceed the limit 
 84.15  described in this clause which was in effect on the last day of 
 84.16  the previous state fiscal year and which has been adjusted by 
 84.17  the greater of any legislatively adopted home and 
 84.18  community-based services cost-of-living percentage increase or 
 84.19  any legislatively adopted statewide percent rate increase for 
 84.20  nursing facilities. 
 84.21     (2) The individualized monthly negotiated payment for 
 84.22  assisted living services described under section 144A.4605 and 
 84.23  delivered by a provider licensed by the department of health as 
 84.24  a class A home care provider or an assisted living home care 
 84.25  provider and provided in a building that is registered as a 
 84.26  housing with services establishment under chapter 144D and that 
 84.27  provides 24-hour supervision in combination with the payment for 
 84.28  other alternative care services, including case management, must 
 84.29  not exceed the limit specified in subdivision 4, paragraph (a), 
 84.30  clause (6). 
 84.31     (j) A county agency may make payment from their alternative 
 84.32  care program allocation for "other services" which include use 
 84.33  of "discretionary funds" for services that are not otherwise 
 84.34  defined in this section and direct cash payments to the client 
 84.35  for the purpose of purchasing the services.  The following 
 84.36  provisions apply to payments under this paragraph: 
 85.1      (1) a cash payment to a client under this provision cannot 
 85.2   exceed ~~80 percent of~~ the monthly payment limit for that client 
 85.3   as specified in subdivision 4, paragraph (a), clause (6); 
 85.4      (2) a county may not approve any cash payment for a client 
 85.5   who meets either of the following: 
 85.6      (i) has been assessed as having a dependency in 
 85.7   orientation, unless the client has an authorized 
 85.8   representative.  An "authorized representative" means an 
 85.9   individual who is at least 18 years of age and is designated by 
 85.10  the person or the person's legal representative to act on the 
 85.11  person's behalf.  This individual may be a family member, 
 85.12  guardian, representative payee, or other individual designated 
 85.13  by the person or the person's legal representative, if any, to 
 85.14  assist in purchasing and arranging for supports; or 
 85.15     (ii) is concurrently receiving adult foster care, 
 85.16  residential care, or assisted living services; 
 85.17     (3) cash payments to a person or a person's family will be 
 85.18  provided through a monthly payment and be in the form of cash, 
 85.19  voucher, or direct county payment to a vendor.  Fees or premiums 
 85.20  assessed to the person for eligibility for health and human 
 85.21  services are not reimbursable through this service option.  
 85.22  Services and goods purchased through cash payments must be 
 85.23  identified in the person's individualized care plan and must 
 85.24  meet all of the following criteria: 
 85.25     (i) they must be over and above the normal cost of caring 
 85.26  for the person if the person did not have functional 
 85.27  limitations; 
 85.28     (ii) they must be directly attributable to the person's 
 85.29  functional limitations; 
 85.30     (iii) they must have the potential to be effective at 
 85.31  meeting the goals of the program; 
 85.32     (iv) they must be consistent with the needs identified in 
 85.33  the individualized service plan.  The service plan shall specify 
 85.34  the needs of the person and family, the form and amount of 
 85.35  payment, the items and services to be reimbursed, and the 
 85.36  arrangements for management of the individual grant; and 
 86.1      (v) the person, the person's family, or the legal 
 86.2   representative shall be provided sufficient information to 
 86.3   ensure an informed choice of alternatives.  The local agency 
 86.4   shall document this information in the person's care plan, 
 86.5   including the type and level of expenditures to be reimbursed; 
 86.6      (4) the state of Minnesota, county, lead agency under 
 86.7   contract, or tribal government under contract to administer the 
 86.8   alternative care program shall not be liable for damages, 
 86.9   injuries, or liabilities sustained through the purchase of 
 86.10  direct supports or goods by the person, the person's family, or 
 86.11  the authorized representative with funds received through the 
 86.12  cash payments under this section.  Liabilities include, but are 
 86.13  not limited to, workers' compensation, the Federal Insurance 
 86.14  Contributions Act (FICA), or the Federal Unemployment Tax Act 
 86.15  (FUTA); 
 86.16     (5) persons receiving grants under this section shall have 
 86.17  the following responsibilities: 
 86.18     (i) spend the grant money in a manner consistent with their 
 86.19  individualized service plan with the local agency; 
 86.20     (ii) notify the local agency of any necessary changes in 
 86.21  the grant expenditures; 
 86.22     (iii) arrange and pay for supports; and 
 86.23     (iv) inform the local agency of areas where they have 
 86.24  experienced difficulty securing or maintaining supports; and 
 86.25     (6) the county shall report client outcomes, services, and 
 86.26  costs under this paragraph in a manner prescribed by the 
 86.27  commissioner. 
 86.28     ~~(k) Upon implementation of direct cash payments to clients~~ 
 86.29  ~~under this section, any person determined eligible for the~~ 
 86.30  ~~alternative care program who chooses a cash payment approved by~~ 
 86.31  ~~the county agency shall receive the cash payment under this~~ 
 86.32  ~~section and not under section 256.476 unless the person was~~ 
 86.33  ~~receiving a consumer support grant under section 256.476 before~~ 
 86.34  ~~implementation of direct cash payments under this section.~~ 
 86.35     Sec. 18.  Minnesota Statutes 2001 Supplement, section 
 86.36  256B.0913, subdivision 8, is amended to read: 
 87.1      Subd. 8.  [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 
 87.2   case manager shall implement the plan of care for each 
 87.3   alternative care client and ensure that a client's service needs 
 87.4   and eligibility are reassessed at least every 12 months.  The 
 87.5   plan shall include any services prescribed by the individual's 
 87.6   attending physician as necessary to allow the individual to 
 87.7   remain in a community setting.  In developing the individual's 
 87.8   care plan, the case manager should include the use of volunteers 
 87.9   from families and neighbors, religious organizations, social 
 87.10  clubs, and civic and service organizations to support the formal 
 87.11  home care services.  The county shall be held harmless for 
 87.12  damages or injuries sustained through the use of volunteers 
 87.13  under this subdivision including workers' compensation 
 87.14  liability.  The lead agency shall provide documentation in each 
 87.15  individual's plan of care and, if requested, to the commissioner 
 87.16  that the most cost-effective alternatives available have been 
 87.17  offered to the individual and that the individual was free to 
 87.18  choose among available qualified providers, both public and 
 87.19  private.  The case manager must give the individual a ten-day 
 87.20  written notice of any ~~decrease in or~~ denial, termination, or 
 87.21  reduction of alternative care services. 
 87.22     (b) If the county administering alternative care services 
 87.23  is different than the county of financial responsibility, the 
 87.24  care plan may be implemented without the approval of the county 
 87.25  of financial responsibility. 
 87.26     Sec. 19.  Minnesota Statutes 2001 Supplement, section 
 87.27  256B.0913, subdivision 10, is amended to read: 
 87.28     Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
 87.29  appropriation for fiscal years 1992 and beyond shall cover only 
 87.30  alternative care eligible clients.  ~~Prior to~~ By July 1 of each 
 87.31  year, the commissioner shall allocate to county agencies the 
 87.32  state funds available for alternative care for persons eligible 
 87.33  under subdivision 2. 
 87.34     (b) The adjusted base for each county is the county's 
 87.35  current fiscal year base allocation plus any targeted funds 
 87.36  approved during the current fiscal year.  Calculations for 
 88.1   paragraphs (c) and (d) are to be made as follows:  for each 
 88.2   county, the determination of alternative care program 
 88.3   expenditures shall be based on payments for services rendered 
 88.4   from April 1 through March 31 in the base year, to the extent 
 88.5   that claims have been submitted and paid by June 1 of that year. 
 88.6      (c) If the alternative care program expenditures as defined 
 88.7   in paragraph (b) are 95 percent or more of the county's adjusted 
 88.8   base allocation, the allocation for the next fiscal year is 100 
 88.9   percent of the adjusted base, plus inflation to the extent that 
 88.10  inflation is included in the state budget. 
 88.11     (d) If the alternative care program expenditures as defined 
 88.12  in paragraph (b) are less than 95 percent of the county's 
 88.13  adjusted base allocation, the allocation for the next fiscal 
 88.14  year is the adjusted base allocation less the amount of unspent 
 88.15  funds below the 95 percent level. 
 88.16     (e) If the annual legislative appropriation for the 
 88.17  alternative care program is inadequate to fund the combined 
 88.18  county allocations for a biennium, the commissioner shall 
 88.19  distribute to each county the entire annual appropriation as 
 88.20  that county's percentage of the computed base as calculated in 
 88.21  paragraphs (c) and (d). 
 88.22     Sec. 20.  Minnesota Statutes 2001 Supplement, section 
 88.23  256B.0913, subdivision 12, is amended to read: 
 88.24     Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
 88.25  all alternative care eligible clients to help pay for the cost 
 88.26  of participating in the program.  The amount of the premium for 
 88.27  the alternative care client shall be determined as follows: 
 88.28     (1) when the alternative care client's income less 
 88.29  recurring and predictable medical expenses is greater than the 
 88.30  recipient's maintenance needs allowance as defined in section 
 88.31  256B.0915, subdivision 1d, paragraph (a), but less than 150 
 88.32  percent of the federal poverty guideline effective on July 1 of 
 88.33  the state fiscal year in which the premium is being computed, 
 88.34  and total assets are less than $10,000, the fee is zero; 
 88.35     (2) when the alternative care client's income less 
 88.36  recurring and predictable medical expenses is greater than 150 
 89.1   percent of the federal poverty guideline effective on July 1 of 
 89.2   the state fiscal year in which the premium is being computed, 
 89.3   and total assets are less than $10,000, the fee is 25 percent of 
 89.4   the cost of alternative care services or the difference between 
 89.5   150 percent of the federal poverty guideline effective on July 1 
 89.6   of the state fiscal year in which the premium is being computed 
 89.7   and the client's income less recurring and predictable medical 
 89.8   expenses, whichever is less; and 
 89.9      (3) when the alternative care client's total assets are 
 89.10  greater than $10,000, the fee is 25 percent of the cost of 
 89.11  alternative care services.  
 89.12     For married persons, total assets are defined as the total 
 89.13  marital assets less the estimated community spouse asset 
 89.14  allowance, under section 256B.059, if applicable.  For married 
 89.15  persons, total income is defined as the client's income less the 
 89.16  monthly spousal allotment, under section 256B.058. 
 89.17     All alternative care services except case management shall 
 89.18  be included in the estimated costs for the purpose of 
 89.19  determining 25 percent of the costs. 
 89.20     ~~The monthly premium shall be calculated based on the cost~~ 
 89.21  ~~of the first full month of alternative care services and shall~~ 
 89.22  ~~continue unaltered until the next reassessment is completed or~~ 
 89.23  ~~at the end of 12 months, whichever comes first.~~  Premiums are 
 89.24  due and payable each month alternative care services are 
 89.25  received unless the actual cost of the services is less than the 
 89.26  premium. 
 89.27     (b) The fee shall be waived by the commissioner when: 
 89.28     (1) a person who is residing in a nursing facility is 
 89.29  receiving case management only; 
 89.30     (2) a person is applying for medical assistance; 
 89.31     (3) a married couple is requesting an asset assessment 
 89.32  under the spousal impoverishment provisions; 
 89.33     (4) a person is found eligible for alternative care, but is 
 89.34  not yet receiving alternative care services; or 
 89.35     (5) a person's fee under paragraph (a) is less than $25. 
 89.36     (c) The county agency must record in the state's receivable 
 90.1   system the client's assessed premium amount or the reason the 
 90.2   premium has been waived.  The commissioner will bill and collect 
 90.3   the premium from the client.  Money collected must be deposited 
 90.4   in the general fund and is appropriated to the commissioner for 
 90.5   the alternative care program.  The client must supply the county 
 90.6   with the client's social security number at the time of 
 90.7   application.  The county shall supply the commissioner with the 
 90.8   client's social security number and other information the 
 90.9   commissioner requires to collect the premium from the client.  
 90.10  The commissioner shall collect unpaid premiums using the Revenue 
 90.11  Recapture Act in chapter 270A and other methods available to the 
 90.12  commissioner.  The commissioner may require counties to inform 
 90.13  clients of the collection procedures that may be used by the 
 90.14  state if a premium is not paid.  This paragraph does not apply 
 90.15  to alternative care pilot projects authorized in Laws 1993, 
 90.16  First Special Session chapter 1, article 5, section 133, if a 
 90.17  county operating under the pilot project reports the following 
 90.18  dollar amounts to the commissioner quarterly: 
 90.19     (1) total premiums billed to clients; 
 90.20     (2) total collections of premiums billed; and 
 90.21     (3) balance of premiums owed by clients. 
 90.22  If a county does not adhere to these reporting requirements, the 
 90.23  commissioner may terminate the billing, collecting, and 
 90.24  remitting portions of the pilot project and require the county 
 90.25  involved to operate under the procedures set forth in this 
 90.26  paragraph. 
 90.27     ~~(d) The commissioner shall begin to adopt emergency or~~ 
 90.28  ~~permanent rules governing client premiums within 30 days after~~ 
 90.29  ~~July 1, 1991, including criteria for determining when services~~ 
 90.30  ~~to a client must be terminated due to failure to pay a premium.~~  
 90.31     Sec. 21.  Minnesota Statutes 2001 Supplement, section 
 90.32  256B.0913, subdivision 14, is amended to read: 
 90.33     Subd. 14.  [PROVIDER REQUIREMENTS, PAYMENT, AND RATE 
 90.34  ADJUSTMENTS.] (a) Unless otherwise specified in statute, 
 90.35  providers must be enrolled in the state's Minnesota health care 
 90.36  program and abide by the requirements for provider participation 
 91.1   according to Minnesota Rules, part 9505.0195. 
 91.2      (b) Payment for provided alternative care services as 
 91.3   approved by the client's case manager shall ~~be~~ occur through the 
 91.4   invoice processing procedures of the department's Medicaid 
 91.5   Management Information System (MMIS).  To receive payment, the 
 91.6   county or vendor must submit invoices within 12 months following 
 91.7   the date of service.  The county agency and its vendors under 
 91.8   contract shall not be reimbursed for services which exceed the 
 91.9   county allocation. 
 91.10     ~~(b)~~ (c) The county shall negotiate individual rates with 
 91.11  vendors and may authorize service payment for actual costs up to 
 91.12  the county's current approved rate.  Notwithstanding any other 
 91.13  rule or statutory provision to the contrary, the commissioner 
 91.14  shall not be authorized to increase rates by an annual inflation 
 91.15  factor, unless so authorized by the legislature.  To improve 
 91.16  access to community services and eliminate payment disparities 
 91.17  between the alternative care program and the elderly waiver 
 91.18  program, the commissioner shall establish statewide maximum 
 91.19  service rate limits and eliminate county-specific service rate 
 91.20  limits. 
 91.21     (1) Effective July 1, 2001, for service rate limits, except 
 91.22  those in subdivision 5, paragraphs (d) and (i), the rate limit 
 91.23  for each service shall be the greater of the alternative care 
 91.24  statewide maximum rate or the elderly waiver statewide maximum 
 91.25  rate. 
 91.26     (2) Counties may negotiate individual service rates with 
 91.27  vendors for actual costs up to the statewide maximum service 
 91.28  rate limit. 
 91.29     Sec. 22.  Minnesota Statutes 2001 Supplement, section 
 91.30  256B.0915, subdivision 3, is amended to read: 
 91.31     Subd. 3.  [LIMITS OF CASES, RATES, PAYMENTS, AND 
 91.32  FORECASTING.] (a) The number of medical assistance waiver 
 91.33  recipients that a county may serve must be allocated according 
 91.34  to the number of medical assistance waiver cases open on July 1 
 91.35  of each fiscal year.  Additional recipients may be served with 
 91.36  the approval of the commissioner. 
 92.1      (b) The monthly limit for the cost of waivered services to 
 92.2   an individual elderly waiver client shall be the weighted 
 92.3   average monthly nursing facility rate of the case mix resident 
 92.4   class to which the elderly waiver client would be assigned under 
 92.5   Minnesota Rules, parts 9549.0050 to 9549.0059, less the 
 92.6   recipient's maintenance needs allowance as described in 
 92.7   subdivision 1d, paragraph (a), until the first day of the state 
 92.8   fiscal year in which the resident assessment system as described 
 92.9   in section 256B.437 for nursing home rate determination is 
 92.10  implemented.  Effective on the first day of the state fiscal 
 92.11  year in which the resident assessment system as described in 
 92.12  section 256B.437 for nursing home rate determination is 
 92.13  implemented and the first day of each subsequent state fiscal 
 92.14  year, the monthly limit for the cost of waivered services to an 
 92.15  individual elderly waiver client shall be the rate of the case 
 92.16  mix resident class to which the waiver client would be assigned 
 92.17  under Minnesota Rules, parts 9549.0050 to 9549.0059, in effect 
 92.18  on the last day of the previous state fiscal year, adjusted by 
 92.19  the greater of any legislatively adopted home and 
 92.20  community-based services cost-of-living percentage increase or 
 92.21  any legislatively adopted statewide percent rate increase for 
 92.22  nursing facilities. 
 92.23     (c) If extended medical supplies and equipment or 
 92.24  environmental modifications are or will be purchased for an 
 92.25  elderly waiver client, the costs may be prorated for up to 12 
 92.26  consecutive months beginning with the month of purchase.  If the 
 92.27  monthly cost of a recipient's waivered services exceeds the 
 92.28  monthly limit established in paragraph (b), the annual cost of 
 92.29  all waivered services shall be determined.  In this event, the 
 92.30  annual cost of all waivered services shall not exceed 12 times 
 92.31  the monthly limit of waivered services as described in paragraph 
 92.32  (b).  
 92.33     (d) For a person who is a nursing facility resident at the 
 92.34  time of requesting a determination of eligibility for elderly 
 92.35  waivered services, a monthly conversion limit for the cost of 
 92.36  elderly waivered services may be requested.  The monthly 
 93.1   conversion limit for the cost of elderly waiver services shall 
 93.2   be the resident class assigned under Minnesota Rules, parts 
 93.3   9549.0050 to 9549.0059, for that resident in the nursing 
 93.4   facility where the resident currently resides until July 1 of 
 93.5   the state fiscal year in which the resident assessment system as 
 93.6   described in section 256B.437 for nursing home rate 
 93.7   determination is implemented.  Effective on July 1 of the state 
 93.8   fiscal year in which the resident assessment system as described 
 93.9   in section 256B.437 for nursing home rate determination is 
 93.10  implemented, the monthly conversion limit for the cost of 
 93.11  elderly waiver services shall be the per diem nursing facility 
 93.12  rate as determined by the resident assessment system as 
 93.13  described in section 256B.437 for that resident in the nursing 
 93.14  facility where the resident currently resides multiplied by 365 
 93.15  and divided by 12, less the recipient's maintenance needs 
 93.16  allowance as described in subdivision 1d.  The initially 
 93.17  approved conversion rate may be adjusted by the greater of any 
 93.18  subsequent legislatively adopted home and community-based 
 93.19  services cost-of-living percentage increase or any subsequent 
 93.20  legislatively adopted statewide percentage rate increase for 
 93.21  nursing facilities.  The limit under this clause only applies to 
 93.22  persons discharged from a nursing facility after a minimum 
 93.23  30-day stay and found eligible for waivered services on or after 
 93.24  July 1, 1997.  The following costs must be included in 
 93.25  determining the total monthly costs for the waiver client: 
 93.26     (1) cost of all waivered services, including extended 
 93.27  medical supplies and equipment and environmental modifications; 
 93.28  and 
 93.29     (2) cost of skilled nursing, home health aide, and personal 
 93.30  care services reimbursable by medical assistance.  
 93.31     (e) Medical assistance funding for skilled nursing 
 93.32  services, private duty nursing, home health aide, and personal 
 93.33  care services for waiver recipients must be approved by the case 
 93.34  manager and included in the individual care plan. 
 93.35     (f) A county is not required to contract with a provider of 
 93.36  supplies and equipment if the monthly cost of the supplies and 
 94.1   equipment is less than $250.  
 94.2      (g) The adult foster care rate shall be considered a 
 94.3   difficulty of care payment and shall not include room and 
 94.4   board.  The adult foster care service rate shall be negotiated 
 94.5   between the county agency and the foster care provider.  The 
 94.6   elderly waiver payment for the foster care service in 
 94.7   combination with the payment for all other elderly waiver 
 94.8   services, including case management, must not exceed the limit 
 94.9   specified in paragraph (b). 
 94.10     (h) Payment for assisted living service shall be a monthly 
 94.11  rate negotiated and authorized by the county agency based on an 
 94.12  individualized service plan for each resident and may not cover 
 94.13  direct rent or food costs. 
 94.14     (1) The individualized monthly negotiated payment for 
 94.15  assisted living services as described in section 256B.0913, 
 94.16  subdivision 5, paragraph (g) or (h), and residential care 
 94.17  services as described in section 256B.0913, subdivision 5, 
 94.18  paragraph (f), shall not exceed the nonfederal share, in effect 
 94.19  on July 1 of the state fiscal year for which the rate limit is 
 94.20  being calculated, of the greater of either the statewide or any 
 94.21  of the geographic groups' weighted average monthly nursing 
 94.22  facility rate of the case mix resident class to which the 
 94.23  elderly waiver eligible client would be assigned under Minnesota 
 94.24  Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 
 94.25  allowance as described in subdivision 1d, paragraph (a), until 
 94.26  the July 1 of the state fiscal year in which the resident 
 94.27  assessment system as described in section 256B.437 for nursing 
 94.28  home rate determination is implemented.  Effective on July 1 of 
 94.29  the state fiscal year in which the resident assessment system as 
 94.30  described in section 256B.437 for nursing home rate 
 94.31  determination is implemented and July 1 of each subsequent state 
 94.32  fiscal year, the individualized monthly negotiated payment for 
 94.33  the services described in this clause shall not exceed the limit 
 94.34  described in this clause which was in effect on June 30 of the 
 94.35  previous state fiscal year and which has been adjusted by the 
 94.36  greater of any legislatively adopted home and community-based 
 95.1   services cost-of-living percentage increase or any legislatively 
 95.2   adopted statewide percent rate increase for nursing facilities. 
 95.3      (2) The individualized monthly negotiated payment for 
 95.4   assisted living services described in section 144A.4605 and 
 95.5   delivered by a provider licensed by the department of health as 
 95.6   a class A home care provider or an assisted living home care 
 95.7   provider and provided in a building that is registered as a 
 95.8   housing with services establishment under chapter 144D and that 
 95.9   provides 24-hour supervision in combination with the payment for 
 95.10  other elderly waiver services, including case management, must 
 95.11  not exceed the limit specified in paragraph (b). 
 95.12     (i) The county shall negotiate individual service rates 
 95.13  with vendors and may authorize payment for actual costs up to 
 95.14  the county's current approved rate.  Persons or agencies must be 
 95.15  employed by or under a contract with the county agency or the 
 95.16  public health nursing agency of the local board of health in 
 95.17  order to receive funding under the elderly waiver program, 
 95.18  except as a provider of supplies and equipment when the monthly 
 95.19  cost of the supplies and equipment is less than $250.  
 95.20     (j) Reimbursement for the medical assistance recipients 
 95.21  under the approved waiver shall be made from the medical 
 95.22  assistance account through the invoice processing procedures of 
 95.23  the department's Medicaid Management Information System (MMIS), 
 95.24  only with the approval of the client's case manager.  The budget 
 95.25  for the state share of the Medicaid expenditures shall be 
 95.26  forecasted with the medical assistance budget, and shall be 
 95.27  consistent with the approved waiver.  
 95.28     (k) To improve access to community services and eliminate 
 95.29  payment disparities between the alternative care program and the 
 95.30  elderly waiver, the commissioner shall establish statewide 
 95.31  maximum service rate limits and eliminate county-specific 
 95.32  service rate limits. 
 95.33     (1) Effective July 1, 2001, for service rate limits, except 
 95.34  those described or defined in paragraphs (g) and (h), the rate 
 95.35  limit for each service shall be the greater of the alternative 
 95.36  care statewide maximum rate or the elderly waiver statewide 
 96.1   maximum rate. 
 96.2      (2) Counties may negotiate individual service rates with 
 96.3   vendors for actual costs up to the statewide maximum service 
 96.4   rate limit. 
 96.5      (l) Beginning July 1, 1991, the state shall reimburse 
 96.6   counties according to the payment schedule in section 256.025 
 96.7   for the county share of costs incurred under this subdivision on 
 96.8   or after January 1, 1991, for individuals who are receiving 
 96.9   medical assistance. 
 96.10     Sec. 23.  Minnesota Statutes 2000, section 256B.0915, 
 96.11  subdivision 4, is amended to read: 
 96.12     Subd. 4.  [TERMINATION NOTICE.] The case manager must give 
 96.13  the individual a ten-day written notice of any ~~decrease in~~ 
 96.14  denial, reduction, or termination of waivered services. 
 96.15     Sec. 24.  Minnesota Statutes 2001 Supplement, section 
 96.16  256B.0915, subdivision 5, is amended to read: 
 96.17     Subd. 5.  [ASSESSMENTS AND REASSESSMENTS FOR WAIVER 
 96.18  CLIENTS.] Each client shall receive an initial assessment of 
 96.19  strengths, informal supports, and need for services in 
 96.20  accordance with section 256B.0911, subdivisions 3, 3a, and 3b.  
 96.21  A reassessment of a client served under the elderly waiver must 
 96.22  be conducted at least every 12 months and at other times when 
 96.23  the case manager determines that there has been significant 
 96.24  change in the client's functioning.  This may include instances 
 96.25  where the client is discharged from the hospital.  
 96.26     Sec. 25.  Minnesota Statutes 2000, section 256B.0915, 
 96.27  subdivision 6, is amended to read: 
 96.28     Subd. 6.  [IMPLEMENTATION OF CARE PLAN.] Each elderly 
 96.29  waiver client shall be provided a copy of a written care plan 
 96.30  that meets the requirements outlined in section 256B.0913, 
 96.31  subdivision 8.  If the county administering waivered services is 
 96.32  different than the county of financial responsibility, the care 
 96.33  plan may be implemented without the approval of the county of 
 96.34  financial responsibility. 
 96.35     Sec. 26.  Minnesota Statutes 2000, section 256B.0915, is 
 96.36  amended by adding a subdivision to read: 
 97.1      Subd. 8.  [SERVICES AND SUPPORTS.] (a) Services and 
 97.2   supports shall meet the requirements set out in United States 
 97.3   Code, title 42, section 1396n. 
 97.4      (b) Services and supports shall promote consumer choice and 
 97.5   be arranged and provided consistent with individualized, written 
 97.6   care plans. 
 97.7      (c) The state of Minnesota, county, or tribal government 
 97.8   under contract to administer the elderly waiver shall not be 
 97.9   liable for damages, injuries, or liabilities sustained through 
 97.10  the purchase of direct supports or goods by the person, the 
 97.11  person's family, or the authorized representatives with funds 
 97.12  received through consumer directed community support services 
 97.13  under the federally approved waiver plan.  Liabilities include, 
 97.14  but are not limited to, workers' compensation liability, the 
 97.15  Federal Insurance Contributions Act (FICA), or the Federal 
 97.16  Unemployment Tax Act (FUTA). 
 97.17     Sec. 27.  Minnesota Statutes 2001 Supplement, section 
 97.18  256B.0924, subdivision 6, is amended to read: 
 97.19     Subd. 6.  [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 
 97.20  Medical assistance and MinnesotaCare payment for targeted case 
 97.21  management shall be made on a monthly basis.  In order to 
 97.22  receive payment for an eligible adult, the provider must 
 97.23  document at least one contact per month and not more than two 
 97.24  consecutive months without a face-to-face contact with the adult 
 97.25  or the adult's legal representative, family, primary caregiver, 
 97.26  or other relevant persons identified as necessary to the 
 97.27  development or implementation of the goals of the personal 
 97.28  service plan. 
 97.29     (b) Payment for targeted case management provided by county 
 97.30  staff under this subdivision shall be based on the monthly rate 
 97.31  methodology under section 256B.094, subdivision 6, paragraph 
 97.32  (b), calculated as one combined average rate together with adult 
 97.33  mental health case management under section 256B.0625, 
 97.34  subdivision 20, except for calendar year 2002.  In calendar year 
 97.35  2002, the rate for case management under this section shall be 
 97.36  the same as the rate for adult mental health case management in 
 98.1   effect as of December 31, 2001.  Billing and payment must 
 98.2   identify the recipient's primary population group to allow 
 98.3   tracking of revenues. 
 98.4      (c) Payment for targeted case management provided by 
 98.5   county-contracted vendors shall be based on a monthly rate 
 98.6   negotiated by the host county.  The negotiated rate must not 
 98.7   exceed the rate charged by the vendor for the same service to 
 98.8   other payers.  If the service is provided by a team of 
 98.9   contracted vendors, the county may negotiate a team rate with a 
 98.10  vendor who is a member of the team.  The team shall determine 
 98.11  how to distribute the rate among its members.  No reimbursement 
 98.12  received by contracted vendors shall be returned to the county, 
 98.13  except to reimburse the county for advance funding provided by 
 98.14  the county to the vendor. 
 98.15     (d) If the service is provided by a team that includes 
 98.16  contracted vendors and county staff, the costs for county staff 
 98.17  participation on the team shall be included in the rate for 
 98.18  county-provided services.  In this case, the contracted vendor 
 98.19  and the county may each receive separate payment for services 
 98.20  provided by each entity in the same month.  In order to prevent 
 98.21  duplication of services, the county must document, in the 
 98.22  recipient's file, the need for team targeted case management and 
 98.23  a description of the different roles of the team members. 
 98.24     (e) Notwithstanding section 256B.19, subdivision 1, the 
 98.25  nonfederal share of costs for targeted case management shall be 
 98.26  provided by the recipient's county of responsibility, as defined 
 98.27  in sections 256G.01 to 256G.12, from sources other than federal 
 98.28  funds or funds used to match other federal funds. 
 98.29     (f) The commissioner may suspend, reduce, or terminate 
 98.30  reimbursement to a provider that does not meet the reporting or 
 98.31  other requirements of this section.  The county of 
 98.32  responsibility, as defined in sections 256G.01 to 256G.12, is 
 98.33  responsible for any federal disallowances.  The county may share 
 98.34  this responsibility with its contracted vendors. 
 98.35     (g) The commissioner shall set aside five percent of the 
 98.36  federal funds received under this section for use in reimbursing 
 99.1   the state for costs of developing and implementing this section. 
 99.2      (h) Notwithstanding section 256.025, subdivision 2, 
 99.3   payments to counties for targeted case management expenditures 
 99.4   under this section shall only be made from federal earnings from 
 99.5   services provided under this section.  Payments to contracted 
 99.6   vendors shall include both the federal earnings and the county 
 99.7   share. 
 99.8      (i) Notwithstanding section 256B.041, county payments for 
 99.9   the cost of case management services provided by county staff 
 99.10  shall not be made to the state treasurer.  For the purposes of 
 99.11  targeted case management services provided by county staff under 
 99.12  this section, the centralized disbursement of payments to 
 99.13  counties under section 256B.041 consists only of federal 
 99.14  earnings from services provided under this section. 
 99.15     (j) If the recipient is a resident of a nursing facility, 
 99.16  intermediate care facility, or hospital, and the recipient's 
 99.17  institutional care is paid by medical assistance, payment for 
 99.18  targeted case management services under this subdivision is 
 99.19  limited to the last 180 days of the recipient's residency in 
 99.20  that facility and may not exceed more than six months in a 
 99.21  calendar year. 
 99.22     (k) Payment for targeted case management services under 
 99.23  this subdivision shall not duplicate payments made under other 
 99.24  program authorities for the same purpose. 
 99.25     (l) Any growth in targeted case management services and 
 99.26  cost increases under this section shall be the responsibility of 
 99.27  the counties. 
 99.28     Sec. 28.  Minnesota Statutes 2001 Supplement, section 
 99.29  256B.0951, subdivision 7, is amended to read: 
 99.30     Subd. 7.  [WAIVER OF RULES.] If a federal waiver is 
 99.31  approved under subdivision 8, the commissioner of health may 
 99.32  exempt residents of intermediate care facilities for persons 
 99.33  with mental retardation (ICFs/MR) who participate in the 
 99.34  ~~three-year~~ alternative quality assurance ~~pilot~~ project 
 99.35  established in section 256B.095 from the requirements of 
 99.36  Minnesota Rules, chapter 4665~~, upon approval by the federal~~ 
100.1   ~~government of a waiver of federal certification requirements for~~ 
100.2   ~~ICFs/MR~~.  
100.3      Sec. 29.  Minnesota Statutes 2001 Supplement, section 
100.4   256B.0951, subdivision 8, is amended to read: 
100.5      Subd. 8.  [FEDERAL WAIVER.] The commissioner of human 
100.6   services shall seek ~~federal authority to waive provisions of~~ 
100.7   ~~intermediate care facilities for persons with mental retardation~~ 
100.8   ~~(ICFs/MR) regulations to enable the demonstration and evaluation~~ 
100.9   ~~of the alternative quality assurance system for ICFs/MR under~~ 
100.10  ~~the project.  The commissioner of human services shall apply for~~ 
100.11  ~~any necessary waivers as soon as practicable.~~ a federal waiver 
100.12  to allow intermediate care facilities for persons with mental 
100.13  retardation (ICFs/MR) in Region 10 of Minnesota to participate 
100.14  in the alternative licensing system.  If it is necessary for 
100.15  purposes of participation in this alternative licensing system 
100.16  for a facility to be decertified as an ICF/MR facility according 
100.17  to the terms of the federal waiver, when the facility seeks 
100.18  recertification under the provisions of ICF/MR regulations at 
100.19  the end of the demonstration project, it will not be considered 
100.20  a new ICF/MR as defined under section 252.291 provided the 
100.21  licensed capacity of the facility did not increase during its 
100.22  participation in the alternative licensing system.  The 
100.23  provisions of sections 252.82, 252.292, and 256B.5011 to 
100.24  256B.5015 will remain applicable for counties in Region 10 of 
100.25  Minnesota and the ICFs/MR located within those counties 
100.26  notwithstanding a county's participation in the alternative 
100.27  licensing system. 
100.28     Sec. 30.  Minnesota Statutes 2001 Supplement, section 
100.29  256B.431, subdivision 2e, is amended to read: 
100.30     Subd. 2e.  [CONTRACTS FOR SERVICES FOR VENTILATOR-DEPENDENT 
100.31  PERSONS.] The commissioner may ~~contract~~ negotiate with a nursing 
100.32  facility eligible to receive medical assistance payments to 
100.33  provide services to a ventilator-dependent person identified by 
100.34  the commissioner according to criteria developed by the 
100.35  commissioner, including:  
100.36     (1) nursing facility care has been recommended for the 
101.1   person by a preadmission screening team; 
101.2      (2) the person has been hospitalized and no longer requires 
101.3   inpatient acute care hospital services; and 
101.4      (3) the commissioner has determined that necessary services 
101.5   for the person cannot be provided under existing nursing 
101.6   facility rates.  
101.7      ~~The commissioner may issue a request for proposals to~~ 
101.8   ~~provide services to a ventilator-dependent person to nursing~~ 
101.9   ~~facilities eligible to receive medical assistance payments and~~ 
101.10  ~~shall select nursing facilities from among respondents according~~ 
101.11  ~~to criteria developed by the commissioner, including:~~  
101.12     ~~(1) the cost-effectiveness and appropriateness of services;~~ 
101.13     ~~(2) the nursing facility's compliance with federal and~~ 
101.14  ~~state licensing and certification standards; and~~ 
101.15     ~~(3) the proximity of the nursing facility to a~~ 
101.16  ~~ventilator-dependent person identified by the commissioner who~~ 
101.17  ~~requires nursing facility placement.~~  
101.18     The commissioner may negotiate an adjustment to the 
101.19  operating cost payment rate for a nursing facility ~~selected by~~ 
101.20  ~~the commissioner from among respondents to the request for~~ 
101.21  ~~proposals~~ with a resident who is ventilator-dependent, for that 
101.22  resident.  The negotiated adjustment must reflect only the 
101.23  actual additional cost of meeting the specialized care needs of 
101.24  a ventilator-dependent person identified by the commissioner for 
101.25  whom necessary services cannot be provided under existing 
101.26  nursing facility rates and which are not otherwise covered under 
101.27  Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to 
101.28  9505.0475.  For persons who are initially admitted to a nursing 
101.29  facility before July 1, 2001, and have their payment rate under 
101.30  this subdivision negotiated after July 1, 2001, the negotiated 
101.31  payment rate must not exceed 200 percent of the highest multiple 
101.32  bedroom payment rate for the facility, as initially established 
101.33  by the commissioner for the rate year for case mix 
101.34  classification K; or, upon implementation of the RUGs-based case 
101.35  mix system, 200 percent of the highest RUGs rate.  For persons 
101.36  initially admitted to a nursing facility on or after July 1, 
102.1   2001, the negotiated payment rate must not exceed 300 percent of 
102.2   the facility's multiple bedroom payment rate for case mix 
102.3   classification K; or, upon implementation of the RUGs-based case 
102.4   mix system, 300 percent of the highest RUGs rate.  The 
102.5   negotiated adjustment shall not affect the payment rate charged 
102.6   to private paying residents under the provisions of section 
102.7   256B.48, subdivision 1.  
102.8      Sec. 31.  Minnesota Statutes 2000, section 256B.431, 
102.9   subdivision 14, is amended to read: 
102.10     Subd. 14.  [LIMITATIONS ON SALES OF NURSING FACILITIES.] 
102.11  (a) For rate periods beginning on October 1, 1992, and for rate 
102.12  years beginning after June 30, 1993, a nursing facility's 
102.13  property-related payment rate as established under subdivision 
102.14  13 shall be adjusted by either paragraph (b) or (c) for the sale 
102.15  of the nursing facility, including sales occurring after June 
102.16  30, 1992, as provided in this subdivision. 
102.17     (b) If the nursing facility's property-related payment rate 
102.18  under subdivision 13 prior to sale is greater than the nursing 
102.19  facility's rental rate under Minnesota Rules, parts 9549.0010 to 
102.20  9549.0080, and this section prior to sale, the nursing 
102.21  facility's property-related payment rate after sale shall be the 
102.22  greater of its property-related payment rate under subdivision 
102.23  13 prior to sale or its rental rate under Minnesota Rules, parts 
102.24  9549.0010 to 9549.0080, and this section calculated after sale. 
102.25     (c) If the nursing facility's property-related payment rate 
102.26  under subdivision 13 prior to sale is equal to or less than the 
102.27  nursing facility's rental rate under Minnesota Rules, parts 
102.28  9549.0010 to 9549.0080, and this section prior to sale, the 
102.29  nursing facility's property-related payment rate after sale 
102.30  shall be the nursing facility's property-related payment rate 
102.31  under subdivision 13 plus the difference between its rental rate 
102.32  calculated under Minnesota Rules, parts 9549.0010 to 9549.0080, 
102.33  and this section prior to sale and its rental rate calculated 
102.34  under Minnesota Rules, parts 9549.0010 to 9549.0080, and this 
102.35  section calculated after sale. 
102.36     (d) For purposes of this subdivision, "sale" means the 
103.1   purchase of a nursing facility's capital assets with cash or 
103.2   debt.  The term sale does not include a stock purchase of a 
103.3   nursing facility or any of the following transactions:  
103.4      (1) a sale and leaseback to the same licensee that does not 
103.5   constitute a change in facility license; 
103.6      (2) a transfer of an interest to a trust; 
103.7      (3) gifts or other transfers for no consideration; 
103.8      (4) a merger of two or more related organizations; 
103.9      (5) a change in the legal form of doing business, other 
103.10  than a publicly held organization that becomes privately held or 
103.11  vice versa; 
103.12     (6) the addition of a new partner, owner, or shareholder 
103.13  who owns less than 20 percent of the nursing facility or the 
103.14  issuance of stock; and 
103.15     (7) a sale, merger, reorganization, or any other transfer 
103.16  of interest between related organizations other than those 
103.17  permitted in this section.  
103.18     (e) For purposes of this subdivision, "sale" includes the 
103.19  sale or transfer of a nursing facility to a close relative as 
103.20  defined in Minnesota Rules, part 9549.0020, subpart 38, item C, 
103.21  upon the death of an owner, due to serious illness or 
103.22  disability, as defined under the Social Security Act, under 
103.23  United States Code, title 42, section 423(d)(1)(A), or upon 
103.24  retirement of an owner from the business of owning or operating 
103.25  a nursing home at 62 years of age or older.  For sales to a 
103.26  close relative allowed under this paragraph, otherwise 
103.27  nonallowable debt resulting from seller financing of all or a 
103.28  portion of the debt resulting from the sale shall be allowed and 
103.29  shall not be subject to Minnesota Rules, part 9549.0060, subpart 
103.30  5, item E, provided that in addition to existing requirements 
103.31  for allowance of debt and interest, the debt is subject to 
103.32  repayment through annual principal payments and the interest 
103.33  rate on the related organization debt does not exceed three 
103.34  percentage points above the posted yield for standard 
103.35  conventional fixed rate mortgages of the Federal Home Loan 
103.36  Mortgage Corporation for delivery in 60 days in effect on the 
104.1   day of sale.  If at any time, the seller forgives the related 
104.2   organization debt allowed under this paragraph for other than 
104.3   equal amount of payment on that debt, then the buyer shall pay 
104.4   to the state the total revenue received by the nursing facility 
104.5   after the sale attributable to the amount of allowable debt 
104.6   which has been forgiven.  Any assignment, sale, or transfer of 
104.7   the debt instrument entered into by the close relatives, either 
104.8   directly or indirectly, which grants to the close relative buyer 
104.9   the right to receive all or a portion of the payments under the 
104.10  debt instrument shall, effective on the date of the transfer, 
104.11  result in the prospective reduction in the corresponding portion 
104.12  of the allowable debt and interest expense.  Upon the death of 
104.13  the close relative seller, any remaining balance of the close 
104.14  relative debt must be refinanced and such refinancing shall be 
104.15  subject to the provisions of Minnesota Rules, part 9549.0060, 
104.16  subpart 7, item G.  This paragraph shall not apply to sales 
104.17  occurring on or after June 30, 1997.  
104.18     (f) For purposes of this subdivision, "effective date of 
104.19  sale" means the later of either the date on which legal title to 
104.20  the capital assets is transferred or the date on which closing 
104.21  for the sale occurred.  
104.22     (g) The effective day for the property-related payment rate 
104.23  determined under this subdivision shall be the first day of the 
104.24  month following the month in which the effective date of sale 
104.25  occurs or October 1, 1992, whichever is later, provided that the 
104.26  notice requirements under section 256B.47, subdivision 2, have 
104.27  been met. 
104.28     (h) Notwithstanding Minnesota Rules, part 9549.0060, 
104.29  subparts 5, item A, subitems (3) and (4), and 7, items E and F, 
104.30  the commissioner shall limit the total allowable debt and 
104.31  related interest for sales occurring after June 30, 1992, to the 
104.32  sum of clauses (1) to (3):  
104.33     (1) the historical cost of capital assets, as of the 
104.34  nursing facility's most recent previous effective date of sale 
104.35  or, if there has been no previous sale, the nursing facility's 
104.36  initial historical cost of constructing capital assets; 
105.1      (2) the average annual capital asset additions after 
105.2   deduction for capital asset deletions, not including 
105.3   depreciations; and 
105.4      (3) one-half of the allowed inflation on the nursing 
105.5   facility's capital assets.  The commissioner shall compute the 
105.6   allowed inflation as described in paragraph ~~(h)~~ (i). 
105.7      (i) For purposes of computing the amount of allowed 
105.8   inflation, the commissioner must apply the following principles: 
105.9      (1) the lesser of the Consumer Price Index for all urban 
105.10  consumers or the Dodge Construction Systems Costs for Nursing 
105.11  Homes for any time periods during which both are available must 
105.12  be used.  If the Dodge Construction Systems Costs for Nursing 
105.13  Homes becomes unavailable, the commissioner shall substitute the 
105.14  index in subdivision 3f, or such other index as the secretary of 
105.15  the health care financing administration may designate; 
105.16     (2) the amount of allowed inflation to be applied to the 
105.17  capital assets in paragraph (g), clauses (1) and (2), must be 
105.18  computed separately; 
105.19     (3) the amount of allowed inflation must be determined on 
105.20  an annual basis, prorated on a monthly basis for partial years 
105.21  and if the initial month of use is not determinable for a 
105.22  capital asset, then one-half of that calendar year shall be used 
105.23  for purposes of prorating; 
105.24     (4) the amount of allowed inflation to be applied to the 
105.25  capital assets in paragraph (g), clauses (1) and (2), must not 
105.26  exceed 300 percent of the total capital assets in any one of 
105.27  those clauses; and 
105.28     (5) the allowed inflation must be computed starting with 
105.29  the month following the nursing facility's most recent previous 
105.30  effective date of sale or, if there has been no previous sale, 
105.31  the month following the date of the nursing facility's initial 
105.32  occupancy, and ending with the month preceding the effective 
105.33  date of sale. 
105.34     (j) If the historical cost of a capital asset is not 
105.35  readily available for the date of the nursing facility's most 
105.36  recent previous sale or if there has been no previous sale for 
106.1   the date of the nursing facility's initial occupancy, then the 
106.2   commissioner shall limit the total allowable debt and related 
106.3   interest after sale to the extent recognized by the Medicare 
106.4   intermediary after the sale.  For a nursing facility that has no 
106.5   historical capital asset cost data available and does not have 
106.6   allowable debt and interest calculated by the Medicare 
106.7   intermediary, the commissioner shall use the historical cost of 
106.8   capital asset data from the point in time for which capital 
106.9   asset data is recorded in the nursing facility's audited 
106.10  financial statements. 
106.11     (k) The limitations in this subdivision apply only to debt 
106.12  resulting from a sale of a nursing facility occurring after June 
106.13  30, 1992, including debt assumed by the purchaser of the nursing 
106.14  facility. 
106.15     Sec. 32.  Minnesota Statutes 2000, section 256B.431, 
106.16  subdivision 30, is amended to read: 
106.17     Subd. 30.  [BED LAYAWAY AND DELICENSURE.] (a) For rate 
106.18  years beginning on or after July 1, 2000, a nursing facility 
106.19  reimbursed under this section which has placed beds on layaway 
106.20  shall, for purposes of application of the downsizing incentive 
106.21  in subdivision 3a, paragraph ~~(d)~~ (c), and calculation of the 
106.22  rental per diem, have those beds given the same effect as if the 
106.23  beds had been delicensed so long as the beds remain on layaway.  
106.24  At the time of a layaway, a facility may change its single bed 
106.25  election for use in calculating capacity days under Minnesota 
106.26  Rules, part 9549.0060, subpart 11.  The property payment rate 
106.27  increase shall be effective the first day of the month following 
106.28  the month in which the layaway of the beds becomes effective 
106.29  under section 144A.071, subdivision 4b. 
106.30     (b) For rate years beginning on or after July 1, 2000, 
106.31  notwithstanding any provision to the contrary under section 
106.32  256B.434, a nursing facility reimbursed under that section which 
106.33  has placed beds on layaway shall, for so long as the beds remain 
106.34  on layaway, be allowed to: 
106.35     (1) aggregate the applicable investment per bed limits 
106.36  based on the number of beds licensed immediately prior to 
107.1   entering the alternative payment system; 
107.2      (2) retain or change the facility's single bed election for 
107.3   use in calculating capacity days under Minnesota Rules, part 
107.4   9549.0060, subpart 11; and 
107.5      (3) establish capacity days based on the number of beds 
107.6   immediately prior to the layaway and the number of beds after 
107.7   the layaway. 
107.8   The commissioner shall increase the facility's property payment 
107.9   rate by the incremental increase in the rental per diem 
107.10  resulting from the recalculation of the facility's rental per 
107.11  diem applying only the changes resulting from the layaway of 
107.12  beds and clauses (1), (2), and (3).  If a facility reimbursed 
107.13  under section 256B.434 completes a moratorium exception project 
107.14  after its base year, the base year property rate shall be the 
107.15  moratorium project property rate.  The base year rate shall be 
107.16  inflated by the factors in section 256B.434, subdivision 4, 
107.17  paragraph (c).  The property payment rate increase shall be 
107.18  effective the first day of the month following the month in 
107.19  which the layaway of the beds becomes effective. 
107.20     (c) If a nursing facility removes a bed from layaway status 
107.21  in accordance with section 144A.071, subdivision 4b, the 
107.22  commissioner shall establish capacity days based on the number 
107.23  of licensed and certified beds in the facility not on layaway 
107.24  and shall reduce the nursing facility's property payment rate in 
107.25  accordance with paragraph (b). 
107.26     (d) For the rate years beginning on or after July 1, 2000, 
107.27  notwithstanding any provision to the contrary under section 
107.28  256B.434, a nursing facility reimbursed under that section, 
107.29  which has delicensed beds after July 1, 2000, by giving notice 
107.30  of the delicensure to the commissioner of health according to 
107.31  the notice requirements in section 144A.071, subdivision 4b, 
107.32  shall be allowed to: 
107.33     (1) aggregate the applicable investment per bed limits 
107.34  based on the number of beds licensed immediately prior to 
107.35  entering the alternative payment system; 
107.36     (2) retain or change the facility's single bed election for 
108.1   use in calculating capacity days under Minnesota Rules, part 
108.2   9549.0060, subpart 11; and 
108.3      (3) establish capacity days based on the number of beds 
108.4   immediately prior to the delicensure and the number of beds 
108.5   after the delicensure. 
108.6   The commissioner shall increase the facility's property payment 
108.7   rate by the incremental increase in the rental per diem 
108.8   resulting from the recalculation of the facility's rental per 
108.9   diem applying only the changes resulting from the delicensure of 
108.10  beds and clauses (1), (2), and (3).  If a facility reimbursed 
108.11  under section 256B.434 completes a moratorium exception project 
108.12  after its base year, the base year property rate shall be the 
108.13  moratorium project property rate.  The base year rate shall be 
108.14  inflated by the factors in section 256B.434, subdivision 4, 
108.15  paragraph (c).  The property payment rate increase shall be 
108.16  effective the first day of the month following the month in 
108.17  which the delicensure of the beds becomes effective. 
108.18     (e) For nursing facilities reimbursed under this section or 
108.19  section 256B.434, any beds placed on layaway shall not be 
108.20  included in calculating facility occupancy as it pertains to 
108.21  leave days defined in Minnesota Rules, part 9505.0415. 
108.22     (f) For nursing facilities reimbursed under this section or 
108.23  section 256B.434, the rental rate calculated after placing beds 
108.24  on layaway may not be less than the rental rate prior to placing 
108.25  beds on layaway. 
108.26     (g) A nursing facility receiving a rate adjustment as a 
108.27  result of this section shall comply with section 256B.47, 
108.28  subdivision 2. 
108.29     (h) A facility that does not utilize the space made 
108.30  available as a result of bed layaway or delicensure under this 
108.31  subdivision to reduce the number of beds per room or provide 
108.32  more common space for nursing facility uses or perform other 
108.33  activities related to the operation of the nursing facility 
108.34  shall have its property rate increase calculated under this 
108.35  subdivision reduced by the ratio of the square footage made 
108.36  available that is not used for these purposes to the total 
109.1   square footage made available as a result of bed layaway or 
109.2   delicensure. 
109.3      Sec. 33.  Minnesota Statutes 2001 Supplement, section 
109.4   256B.431, subdivision 33, is amended to read: 
109.5      Subd. 33.  [STAGED REDUCTION IN RATE DISPARITIES.] (a) For 
109.6   the rate years beginning July 1, 2001, and July 1, 2002, the 
109.7   commissioner shall adjust the operating payment rates for 
109.8   low-rate nursing facilities reimbursed under this section or 
109.9   section 256B.434.  
109.10     (b) For the rate year beginning July 1, 2001, for each case 
109.11  mix level, if the amount computed under subdivision ~~32~~ 31 is 
109.12  less than the amount in clause (1), the commissioner shall make 
109.13  available the lesser of the amount in clause (1) or an increase 
109.14  of ten percent over the rate in effect on June 30, 2001, as an 
109.15  adjustment to the operating payment rate.  For the rate year 
109.16  beginning July 1, 2002, for each case mix level, if the amount 
109.17  computed under subdivision ~~32~~ 31 is less than the amount in 
109.18  clause (2), the commissioner shall make available the lesser of 
109.19  the amount in clause (2) or an increase of ten percent over the 
109.20  rate in effect on June 30, 2002, as an adjustment to the 
109.21  operating payment rate.  For purposes of this subdivision, 
109.22  nursing facilities shall be considered to be metro if they are 
109.23  located in Anoka, Carver, Dakota, Hennepin, Olmsted, Ramsey, 
109.24  Scott, or Washington counties; or in the cities of Moorhead or 
109.25  Breckenridge; or in St. Louis county, north of Toivola and south 
109.26  of Cook; or in Itasca county, east of a north south line two 
109.27  miles west of Grand Rapids:  
109.28     (1) Operating Payment Rate Target Level for July 1, 2001: 
109.29      Case Mix Classification        Metro       Nonmetro
109.30                A                    $ 76.00     $ 68.13
109.31                B                    $ 83.40     $ 74.46
109.32                C                    $ 91.67     $ 81.63
109.33                D                    $ 99.51     $ 88.04
109.34                E                    $107.46     $ 94.87
109.35                F                    $107.96     $ 95.29
109.36                G                    $114.67     $100.98
110.1                 H                    $126.99     $111.31
110.2                 I                    $131.42     $115.06
110.3                 J                    $138.34     $120.85
110.4                 K                    $152.26     $133.10
110.5      (2) Operating Payment Rate Target Level for July 1, 2002: 
110.6       Case Mix Classification        Metro       Nonmetro
110.7                 A                    $ 78.28     $ 70.51
110.8                 B                    $ 85.91     $ 77.16
110.9                 C                    $ 94.42     $ 84.62
110.10                D                    $102.50     $ 91.42
110.11                E                    $110.68     $ 98.40
110.12                F                    $111.20     $ 98.84
110.13                G                    $118.11     $104.77
110.14                H                    $130.80     $115.64
110.15                I                    $135.38     $119.50
110.16                J                    $142.49     $125.38
110.17                K                    $156.85     $137.77
110.18     Sec. 34.  Minnesota Statutes 2000, section 256B.431, is 
110.19  amended by adding a subdivision to read: 
110.20     Subd. 37.  [DESIGNATION OF AREAS TO RECEIVE METROPOLITAN 
110.21  RATES.] For rate years beginning on or after July 1, 2003, 
110.22  nursing facilities located in areas designated as metropolitan 
110.23  areas by the federal Office of Management and Budget using 
110.24  census bureau data shall be part of the metropolitan array for 
110.25  purposes of calculating a median, determining a historical base 
110.26  reimbursement rate, or otherwise establishing a statistical 
110.27  measure of nursing facility payment rates, in order to:  
110.28     (1) determine future rate increases under this section, 
110.29  section 256B.434, or any other section; and 
110.30     (2) establish nursing facility reimbursement rates for the 
110.31  new nursing facility reimbursement system developed under Laws 
110.32  2001, First Special Session chapter 9, article 5, section 35.  
110.33     Sec. 35.  Minnesota Statutes 2001 Supplement, section 
110.34  256B.437, subdivision 3, is amended to read: 
110.35     Subd. 3.  [APPLICATIONS FOR PLANNED CLOSURE OF NURSING 
110.36  FACILITIES.] (a) By August 15, 2001, the commissioner of human 
111.1   services shall implement and announce a program for closure or 
111.2   partial closure of nursing facilities.  Names and identifying 
111.3   information provided in response to the announcement shall 
111.4   remain private unless approved, according to the timelines 
111.5   established in the plan.  The announcement must specify: 
111.6      (1) the criteria in subdivision 4 that will be used by the 
111.7   commissioner to approve or reject applications; 
111.8      (2) ~~a requirement for the submission of a letter of intent~~ 
111.9   ~~before the submission of an application;~~ 
111.10     ~~(3)~~ the information that must accompany an application; and 
111.11     ~~(4)~~ (3) that applications may combine planned closure rate 
111.12  adjustments with moratorium exception funding, in which case a 
111.13  single application may serve both purposes. 
111.14  Between August 1, 2001, and June 30, 2003, the commissioner may 
111.15  approve planned closures of up to 5,140 nursing facility beds, 
111.16  less the number of ~~licensed~~ beds delicensed in facilities ~~that~~ 
111.17  ~~close~~ during the same time period without approved closure plans 
111.18  or that have notified the commissioner of health of their intent 
111.19  to close without an approved closure plan. 
111.20     (b) A facility or facilities reimbursed under section 
111.21  256B.431 or 256B.434 with a closure plan approved by the 
111.22  commissioner under subdivision 5 may assign a planned closure 
111.23  rate adjustment to another facility or facilities that are not 
111.24  closing or in the case of a partial closure, to the facility 
111.25  undertaking the partial closure.  A facility may also elect to 
111.26  have a planned closure rate adjustment shared equally by the 
111.27  five nursing facilities with the lowest total operating payment 
111.28  rates in the state development region designated under section 
111.29  462.385, in which the facility that is closing is located.  The 
111.30  planned closure rate adjustment must be calculated under 
111.31  subdivision 6.  Facilities that ~~close~~ delicense beds without a 
111.32  closure plan, or whose closure plan is not approved by the 
111.33  commissioner, are not eligible to assign a planned closure rate 
111.34  adjustment under subdivision 6~~.~~, unless they are delicensing 
111.35  five or fewer beds, or less than six percent of their total 
111.36  licensed bed capacity, whichever is greater.  Facilities 
112.1   delicensing, in any three-month period, five or fewer beds or 
112.2   less than six percent of their total licensed bed capacity, 
112.3   whichever is greater, without an approved closure plan are 
112.4   eligible to assign the amount calculated under subdivision 6 to 
112.5   themselves, if the facilities are located in a county that is in 
112.6   the top three quartiles when ranked on nursing facility beds per 
112.7   thousand individuals age 65 and older.  When facilities are 
112.8   delicensing more than five beds, or six percent or more of their 
112.9   total licensed bed capacity, whichever is greater, and if they 
112.10  do not have an approved closure plan or are not eligible for the 
112.11  adjustment under subdivision 6, the commissioner shall calculate 
112.12  the amount the facility or facilities would have been eligible 
112.13  to assign under subdivision 6, and shall use this amount to 
112.14  provide equal rate adjustments to the five nursing facilities 
112.15  with the lowest total operating payment rates in the state 
112.16  development region designated under section 462.385, in which 
112.17  the facility or facilities that ~~closed is~~ delicense beds are 
112.18  located. 
112.19     (c) To be considered for approval, an application must 
112.20  include: 
112.21     (1) a description of the proposed closure plan, which must 
112.22  include identification of the facility or facilities to receive 
112.23  a planned closure rate adjustment ~~and the amount and timing of a~~ 
112.24  ~~planned closure rate adjustment proposed for each facility~~; 
112.25     (2) the proposed timetable for any proposed closure, 
112.26  including the proposed dates for announcement to residents, 
112.27  commencement of closure, and completion of closure; 
112.28     (3) if available, the proposed relocation plan for current 
112.29  residents of any facility designated for closure.  ~~The proposed~~ 
112.30  If a relocation plan is not available, the application must 
112.31  include a statement agreeing to develop a relocation plan ~~must~~ 
112.32  ~~be~~ designed to comply with ~~all applicable state and federal~~ 
112.33  ~~statutes and regulations, including, but not limited to,~~ section 
112.34  144A.161; 
112.35     (4) a description of the relationship between the nursing 
112.36  facility that is proposed for closure and the nursing facility 
113.1   or facilities proposed to receive the planned closure rate 
113.2   adjustment.  If these facilities are not under common ownership, 
113.3   copies of any contracts, purchase agreements, or other documents 
113.4   establishing a relationship or proposed relationship must be 
113.5   provided; 
113.6      (5) documentation, in a format approved by the 
113.7   commissioner, that all the nursing facilities receiving a 
113.8   planned closure rate adjustment under the plan have accepted 
113.9   joint and several liability for recovery of overpayments under 
113.10  section 256B.0641, subdivision 2, for the facilities designated 
113.11  for closure under the plan; and 
113.12     (6) an explanation of how the application coordinates with 
113.13  planning efforts under subdivision 2.  If the planning group 
113.14  does not support a level of nursing facility closures that the 
113.15  commissioner considers to be reasonable, the commissioner may 
113.16  approve a planned closure proposal without its support. 
113.17     (d) The application must address the criteria listed in 
113.18  subdivision 4. 
113.19     Sec. 36.  Minnesota Statutes 2001 Supplement, section 
113.20  256B.437, subdivision 6, is amended to read: 
113.21     Subd. 6.  [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 
113.22  commissioner of human services shall calculate the amount of the 
113.23  planned closure rate adjustment available under subdivision 3, 
113.24  paragraph (b), for up to 5,140 beds according to clauses (1) to 
113.25  (4): 
113.26     (1) the amount available is the net reduction of nursing 
113.27  facility beds multiplied by $2,080; 
113.28     (2) the total number of beds in the nursing facility or 
113.29  facilities receiving the planned closure rate adjustment must be 
113.30  identified; 
113.31     (3) capacity days are determined by multiplying the number 
113.32  determined under clause (2) by 365; and 
113.33     (4) the planned closure rate adjustment is the amount 
113.34  available in clause (1), divided by capacity days determined 
113.35  under clause (3). 
113.36     (b) A planned closure rate adjustment under this section is 
114.1   effective on the first day of the month following completion of 
114.2   closure of the facility designated for closure in the 
114.3   application and becomes part of the nursing facility's total 
114.4   operating payment rate. 
114.5      (c) Applicants may use the planned closure rate adjustment 
114.6   to allow for a property payment for a new nursing facility or an 
114.7   addition to an existing nursing facility or as an operating 
114.8   payment rate adjustment.  Applications approved under this 
114.9   subdivision are exempt from other requirements for moratorium 
114.10  exceptions under section 144A.073, subdivisions 2 and 3. 
114.11     (d) Upon the request of a closing facility, the 
114.12  commissioner must allow the facility a closure rate adjustment 
114.13  as provided under section 144A.161, subdivision 10. 
114.14     (e) If the per bed dollar amount specified in paragraph 
114.15  (a), clause (1) is increased, the commissioner shall recalculate 
114.16  planned closure rate adjustments for facilities that delicense 
114.17  beds under this section on or after July 1, 2001, to reflect the 
114.18  increase in the per bed dollar amount.  The recalculated planned 
114.19  closure rate adjustment shall be effective from the date the per 
114.20  bed dollar amount is increased. 
114.21     (f) A facility that has received a planned closure rate 
114.22  adjustment may reassign it to another facility that is under the 
114.23  same ownership at any time within three years of its effective 
114.24  date.  The amount of the adjustment shall be computed according 
114.25  to paragraph (a). 
114.26     Sec. 37.  Minnesota Statutes 2001 Supplement, section 
114.27  256B.437, is amended by adding a subdivision to read: 
114.28     Subd. 9.  [TRANSFER OF BEDS.] The board of commissioners of 
114.29  Saint Louis county may amend their planned closure rate 
114.30  adjustment application to allow up to 50 beds of a 159-licensed 
114.31  bed county-owned nursing facility that is in the process of 
114.32  closing to be transferred to a hospital-attached nursing 
114.33  facility in Aurora and up to 50 beds to a 235-bed nursing 
114.34  facility in Duluth, and may also assign all or a portion of the 
114.35  planned closure rate adjustment that would be received as a 
114.36  result of closure to the Aurora facility or the Duluth facility. 
115.1      Sec. 38.  Minnesota Statutes 2001 Supplement, section 
115.2   256B.438, subdivision 1, is amended to read: 
115.3      Subdivision 1.  [SCOPE.] This section establishes the 
115.4   method and criteria used to determine resident reimbursement 
115.5   classifications based upon the assessments of residents of 
115.6   nursing homes and boarding care homes whose payment rates are 
115.7   established under section 256B.431, 256B.434, or 256B.435.  
115.8   Resident reimbursement classifications shall be established 
115.9   according to the 34 group, resource utilization groups, version 
115.10  III or RUG-III model as described in section 144.0724.  
115.11  Reimbursement classifications established under this section 
115.12  shall be implemented after June 30, 2002, but no later than 
115.13  January 1, 2003.  Reimbursement classifications established 
115.14  under this section shall be implemented no earlier than six 
115.15  weeks after the commissioner mails notices of payment rates to 
115.16  the facilities. 
115.17     Sec. 39.  Minnesota Statutes 2000, section 256B.5012, 
115.18  subdivision 2, is amended to read: 
115.19     Subd. 2.  [OPERATING PAYMENT RATE.] (a) The operating 
115.20  payment rate equals the facility's total payment rate in effect 
115.21  on September 30, 2000, minus the property rate.  The operating 
115.22  payment rate includes the special operating rate and the 
115.23  efficiency incentive in effect as of September 30, 2000.  Within 
115.24  the limits of appropriations specifically for this purpose, the 
115.25  operating payment shall be increased for each rate year by the 
115.26  annual percentage change in the Employment Cost Index for 
115.27  Private Industry Workers - Total Compensation, as forecasted by 
115.28  the commissioner of finance's economic consultant, in the second 
115.29  quarter of the calendar year preceding the start of each rate 
115.30  year.  In the case of the initial rate year beginning October 1, 
115.31  2000, and continuing through December 31, 2001, the percentage 
115.32  change shall be based on the percentage change in the Employment 
115.33  Cost Index for Private Industry Workers - Total Compensation for 
115.34  the 15-month period beginning October 1, 2000, as forecast by 
115.35  Data Resources, Inc., in the first quarter of 2000. 
115.36     (b) Effective October 1, 2000, the operating payment rate 
116.1   shall be adjusted to reflect an occupancy rate equal to 100 
116.2   percent of the facility's capacity days as of September 30, 2000.
116.3      (c) Effective July 1, 2001, the operating payment rate 
116.4   shall be adjusted for the increases in the department of health 
116.5   licensing fees that were authorized in Laws 2001, First Special 
116.6   Session chapter 9, article 1, section 30. 
116.7      Sec. 40.  Minnesota Statutes 2001 Supplement, section 
116.8   256B.76, is amended to read: 
116.9      256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
116.10     (a) Effective for services rendered on or after October 1, 
116.11  1992, the commissioner shall make payments for physician 
116.12  services as follows: 
116.13     (1) payment for level one Health Care Finance 
116.14  Administration's common procedural coding system (HCPCS) codes 
116.15  titled "office and other outpatient services," "preventive 
116.16  medicine new and established patient," "delivery, antepartum, 
116.17  and postpartum care," "critical care," cesarean delivery and 
116.18  pharmacologic management provided to psychiatric patients, and 
116.19  HCPCS level three codes for enhanced services for prenatal high 
116.20  risk, shall be paid at the lower of (i) submitted charges, or 
116.21  (ii) 25 percent above the rate in effect on June 30, 1992.  If 
116.22  the rate on any procedure code within these categories is 
116.23  different than the rate that would have been paid under the 
116.24  methodology in section 256B.74, subdivision 2, then the larger 
116.25  rate shall be paid; 
116.26     (2) payments for all other services shall be paid at the 
116.27  lower of (i) submitted charges, or (ii) 15.4 percent above the 
116.28  rate in effect on June 30, 1992; 
116.29     (3) all physician rates shall be converted from the 50th 
116.30  percentile of 1982 to the 50th percentile of 1989, less the 
116.31  percent in aggregate necessary to equal the above increases 
116.32  except that payment rates for home health agency services shall 
116.33  be the rates in effect on September 30, 1992; 
116.34     (4) effective for services rendered on or after January 1, 
116.35  2000, payment rates for physician and professional services 
116.36  shall be increased by three percent over the rates in effect on 
117.1   December 31, 1999, except for home health agency and family 
117.2   planning agency services; and 
117.3      (5) the increases in clause (4) shall be implemented 
117.4   January 1, 2000, for managed care. 
117.5      (b) Effective for services rendered on or after October 1, 
117.6   1992, the commissioner shall make payments for dental services 
117.7   as follows: 
117.8      (1) dental services shall be paid at the lower of (i) 
117.9   submitted charges, or (ii) 25 percent above the rate in effect 
117.10  on June 30, 1992; 
117.11     (2) dental rates shall be converted from the 50th 
117.12  percentile of 1982 to the 50th percentile of 1989, less the 
117.13  percent in aggregate necessary to equal the above increases; 
117.14     (3) effective for services rendered on or after January 1, 
117.15  2000, payment rates for dental services shall be increased by 
117.16  three percent over the rates in effect on December 31, 1999; 
117.17     (4) the commissioner shall award grants to community 
117.18  clinics or other nonprofit community organizations, political 
117.19  subdivisions, professional associations, or other organizations 
117.20  that demonstrate the ability to provide dental services 
117.21  effectively to public program recipients.  Grants may be used to 
117.22  fund the costs related to coordinating access for recipients, 
117.23  developing and implementing patient care criteria, upgrading or 
117.24  establishing new facilities, acquiring furnishings or equipment, 
117.25  recruiting new providers, or other development costs that will 
117.26  improve access to dental care in a region.  In awarding grants, 
117.27  the commissioner shall give priority to applicants that plan to 
117.28  serve areas of the state in which the number of dental providers 
117.29  is not currently sufficient to meet the needs of recipients of 
117.30  public programs or uninsured individuals.  The commissioner 
117.31  shall consider the following in awarding the grants: 
117.32     (i) potential to successfully increase access to an 
117.33  underserved population; 
117.34     (ii) the ability to raise matching funds; 
117.35     (iii) the long-term viability of the project to improve 
117.36  access beyond the period of initial funding; 
118.1      (iv) the efficiency in the use of the funding; and 
118.2      (v) the experience of the proposers in providing services 
118.3   to the target population. 
118.4      The commissioner shall monitor the grants and may terminate 
118.5   a grant if the grantee does not increase dental access for 
118.6   public program recipients.  The commissioner shall consider 
118.7   grants for the following: 
118.8      (i) implementation of new programs or continued expansion 
118.9   of current access programs that have demonstrated success in 
118.10  providing dental services in underserved areas; 
118.11     (ii) a pilot program for utilizing hygienists outside of a 
118.12  traditional dental office to provide dental hygiene services; 
118.13  and 
118.14     (iii) a program that organizes a network of volunteer 
118.15  dentists, establishes a system to refer eligible individuals to 
118.16  volunteer dentists, and through that network provides donated 
118.17  dental care services to public program recipients or uninsured 
118.18  individuals; 
118.19     (5) beginning October 1, 1999, the payment for tooth 
118.20  sealants and fluoride treatments shall be the lower of (i) 
118.21  submitted charge, or (ii) 80 percent of median 1997 charges; 
118.22     (6) the increases listed in clauses (3) and (5) shall be 
118.23  implemented January 1, 2000, for managed care; and 
118.24     (7) effective for services provided on or after January 1, 
118.25  2002, payment for diagnostic examinations and dental x-rays 
118.26  provided to children under age 21 shall be the lower of (i) the 
118.27  submitted charge, or (ii) 85 percent of median 1999 charges.  
118.28     (c) Effective for dental services rendered on or after 
118.29  January 1, 2002, the commissioner may, within the limits of 
118.30  available appropriation, increase reimbursements to dentists and 
118.31  dental clinics deemed by the commissioner to be critical access 
118.32  dental providers.  Reimbursement to a critical access dental 
118.33  provider may be increased by not more than 50 percent above the 
118.34  reimbursement rate that would otherwise be paid to the 
118.35  provider.  Payments to health plan companies shall be adjusted 
118.36  to reflect increased reimbursements to critical access dental 
119.1   providers as approved by the commissioner.  In determining which 
119.2   dentists and dental clinics shall be deemed critical access 
119.3   dental providers, the commissioner shall review: 
119.4      (1) the utilization rate in the service area in which the 
119.5   dentist or dental clinic operates for dental services to 
119.6   patients covered by medical assistance, general assistance 
119.7   medical care, or MinnesotaCare as their primary source of 
119.8   coverage; 
119.9      (2) the level of services provided by the dentist or dental 
119.10  clinic to patients covered by medical assistance, general 
119.11  assistance medical care, or MinnesotaCare as their primary 
119.12  source of coverage; and 
119.13     (3) whether the level of services provided by the dentist 
119.14  or dental clinic is critical to maintaining adequate levels of 
119.15  patient access within the service area. 
119.16  In the absence of a critical access dental provider in a service 
119.17  area, the commissioner may designate a dentist or dental clinic 
119.18  as a critical access dental provider if the dentist or dental 
119.19  clinic is willing to provide care to patients covered by medical 
119.20  assistance, general assistance medical care, or MinnesotaCare at 
119.21  a level which significantly increases access to dental care in 
119.22  the service area. 
119.23     (d) Effective July 1, 2001, the medical assistance rates 
119.24  for outpatient mental health services provided by an entity that 
119.25  operates: 
119.26     (1) a Medicare-certified comprehensive outpatient 
119.27  rehabilitation facility; and 
119.28     (2) a facility that was certified prior to January 1, 1993, 
119.29  with at least 33 percent of the clients receiving rehabilitation 
119.30  services in the most recent calendar year are medical assistance 
119.31  recipients, will be increased by 38 percent, when those services 
119.32  are provided within the comprehensive outpatient rehabilitation 
119.33  facility and provided to residents of nursing facilities owned 
119.34  by the entity. 
119.35     (e) An entity that operates both a Medicare certified 
119.36  comprehensive outpatient rehabilitation facility and a facility 
120.1   which was certified prior to January 1, 1993, that is licensed 
120.2   under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
120.3   whom at least 33 percent of the clients receiving rehabilitation 
120.4   services in the most recent calendar year are medical assistance 
120.5   recipients, shall be reimbursed by the commissioner for 
120.6   rehabilitation services at rates that are 38 percent greater 
120.7   than the maximum reimbursement rate allowed under paragraph (a), 
120.8   clause (2), when those services are (1) provided within the 
120.9   comprehensive outpatient rehabilitation facility and (2) 
120.10  provided to residents of nursing facilities owned by the entity. 
120.11     Sec. 41.  [PILOT PROGRAM FOR DEAF-BLIND SERVICES.] 
120.12     (a) The commissioners of human services; children, 
120.13  families, and learning; and state services for the blind shall 
120.14  meet with deaf-blind citizens, parents of deaf-blind children, 
120.15  and the Minnesota commission serving deaf and hard-of-hearing 
120.16  individuals to determine which agency can most efficiently and 
120.17  effectively develop and administer a pilot program for 
120.18  consumer-directed services to provide needed services to 
120.19  deaf-blind adults, children, and their families. 
120.20     (b) The planning for this pilot program must proceed using 
120.21  current appropriations.  The agency that develops the pilot 
120.22  program described in paragraph (a) shall provide a report to the 
120.23  senate and house of representatives policy and fiscal committees 
120.24  having jurisdiction over human services issues by January 1, 
120.25  2003, that addresses future funding for the program.  The report 
120.26  shall include the program proposal, recommendations, and a 
120.27  fiscal note. 
120.28     Sec. 42.  [SERVICES FOR DEAF-BLIND PERSONS.] 
120.29     (a) Effective for fiscal years beginning on or after July 
120.30  1, 2003, the commissioner of human services shall combine the 
120.31  existing $1,000,000 biennial base level funding for deaf-blind 
120.32  services into a single grant program.  Within the limits of the 
120.33  appropriation for this purpose, each biennium at least $350,000 
120.34  shall be awarded for services to deaf-blind children and their 
120.35  families and at least $250,000 shall be awarded for services to 
120.36  deaf-blind adults. 
121.1      (b) The commissioner may make grants to organizations for: 
121.2      (1) services provided by the organizations; or 
121.3      (2) consumer-directed services. 
121.4      (c) Any entity that is able to satisfy the grant criteria 
121.5   is eligible to receive a grant under paragraph (a). 
121.6      (d) Deaf-blind service providers are not required to, but 
121.7   may, provide intervenor services as part of the service package 
121.8   provided with grant funds under this section. 
121.9      Sec. 43.  [FEASIBILITY ASSESSMENT OF MEDICAL ASSISTANCE 
121.10  EXPANSION TO COVER DEAF-BLIND SERVICES.] 
121.11     (a) The commissioner of human services shall study and 
121.12  report to the legislature by January 15, 2003, with a 
121.13  feasibility assessment of the costs and policy implications, 
121.14  including the necessity of federal waivers, to expand benefits 
121.15  covered under medical assistance and under medical assistance 
121.16  waiver programs to include the following services for deaf-blind 
121.17  persons: 
121.18     (1) sign language interpreters; 
121.19     (2) intervenors; 
121.20     (3) support service persons; 
121.21     (4) orientation and mobility services; and 
121.22     (5) rehabilitation teaching services. 
121.23  Any costs related to this study shall be paid out of base-level 
121.24  funding to the commissioner for deaf and hard of hearing grants. 
121.25     (b) Notwithstanding Laws 2001, First Special Session, 
121.26  chapter 9, article 17, section 10, subdivision 3, the 
121.27  commissioner of human services may transfer deaf and hard of 
121.28  hearing grants to operations for purposes of paragraph (a).  
121.29     Sec. 44.  [CASE MANAGEMENT STUDY.] 
121.30     The commissioner of human services shall study case 
121.31  management services for persons with disabilities, in 
121.32  consultation with consumers, consumer advocates, and local 
121.33  social service agencies.  The commissioner shall report to the 
121.34  chairs and ranking minority members of the house and senate 
121.35  committees having jurisdiction over health and human services 
121.36  policy and funding, by January 15, 2003, on strategies that: 
122.1      (1) streamline administration; 
122.2      (2) improve case management service availability across the 
122.3   state; 
122.4      (3) enhance consumer access to needed services and 
122.5   supports; 
122.6      (4) improve accountability and the use of performance 
122.7   measures; 
122.8      (5) provide for consumer choice of vendor; and 
122.9      (6) improve the financing of case management services. 
122.10     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
122.11  following final enactment. 
122.12     Sec. 45.  [REPEALER; TARGETED CASE MANAGEMENT.] 
122.13     Minnesota Statutes 2001 Supplement, section 256B.0621, 
122.14  subdivision 1, is repealed. 
122.15                             ARTICLE 3 
122.16                           MISCELLANEOUS 
122.17     Section 1.  Minnesota Statutes 2000, section 103H.251, 
122.18  subdivision 1, is amended to read: 
122.19     Subdivision 1.  [METHODS.] (a) The ~~commissioner of~~ 
122.20  ~~agriculture for pollution resulting from agricultural chemicals~~ 
122.21  ~~and practices and the~~ pollution control agency ~~for other~~ 
122.22  ~~pollutants~~ shall evaluate the detection of pollutants, other 
122.23  than pollutants resulting from agricultural chemicals and 
122.24  practices, in groundwater of the state.  The detection of 
122.25  pollutants resulting from agricultural chemicals and practices 
122.26  in groundwater shall be evaluated according to section 
122.27  144.3705.  Evaluation of the detection may include collection 
122.28  technique, sampling handling technique, laboratory practices, 
122.29  other quality control practices, climatological conditions, and 
122.30  potential pollutant sources.  
122.31     (b) If conditions indicate a likelihood of the detection of 
122.32  the pollutant or pollutant breakdown product to be a common 
122.33  detection, the commissioner of agriculture for pollutants 
122.34  resulting from agricultural chemicals and practices or the 
122.35  pollution control agency for other pollutants must begin 
122.36  development of best management practices and continue to monitor 
123.1   for the pollutant or pollutant breakdown products. 
123.2      Sec. 2.  Minnesota Statutes 2000, section 144.05, is 
123.3   amended by adding a subdivision to read: 
123.4      Subd. 4.  [IDENTIFICATION OF DECEASED INDIVIDUALS.] Upon 
123.5   receiving notice under section 149A.90, subdivision 1, of the 
123.6   death of an individual who cannot be identified, the 
123.7   commissioner must post on the department's Web site information 
123.8   regarding the individual for purposes of obtaining information 
123.9   that may aid in identifying the individual and for purposes of 
123.10  notifying relatives who may be seeking the individual.  The 
123.11  information must remain on the Web site continuously until the 
123.12  person's identity is determined. 
123.13     Sec. 3.  [144.129] [DONATED DENTAL SERVICES.] 
123.14     Subdivision 1.  [ESTABLISHMENT.] A donated dental services 
123.15  program is established in which dentists who volunteer their 
123.16  services without compensation provide dental care to public 
123.17  program recipients and the uninsured.  The program shall be 
123.18  developed and operated by the Minnesota dental association, or 
123.19  another appropriate and qualified organization, as determined by 
123.20  the commissioner.  The program shall: 
123.21     (1) establish a network of volunteer dentists, including 
123.22  dental specialties, to donate dental services to eligible 
123.23  individuals; 
123.24     (2) provide, in consultation with the commissioner of 
123.25  health, information to participating dentists on serving diverse 
123.26  populations and rights and responsibilities under the Americans 
123.27  With Disabilities Act and the Minnesota Human Rights Act; 
123.28     (3) establish a system to refer eligible individuals to the 
123.29  appropriate volunteer dentists; 
123.30     (4) develop and implement a public awareness campaign to 
123.31  educate eligible individuals about the availability of the 
123.32  program; and 
123.33     (5) establish, in consultation with the commissioner of 
123.34  health, specific performance and outcome measures that the 
123.35  program must meet. 
123.36     Subd. 2.  [REPORT.] The organization shall provide an 
124.1   annual report to the house and senate committees having 
124.2   jurisdiction over health and human services that: 
124.3      (1) accounts for state funding received by the program; 
124.4      (2) documents the number of individuals served by the 
124.5   program and the number of dentists participating as program 
124.6   providers; and 
124.7      (3) provides data on meeting the specific performance and 
124.8   outcome measures. 
124.9      Sec. 4.  [144.3705] [EVALUATION OF DETECTION OF POLLUTANTS 
124.10  RESULTING FROM AGRICULTURAL CHEMICALS AND PRACTICES.] 
124.11     The commissioner of health shall evaluate the detection of 
124.12  pollutants resulting from agricultural chemicals and practices 
124.13  in the groundwater of the state.  Evaluation of the detection 
124.14  may include collection technique, sampling handling technique, 
124.15  laboratory practices, other quality control practices, 
124.16  climatological conditions, and potential pollutant sources. 
124.17     Sec. 5.  Minnesota Statutes 2000, section 147B.02, 
124.18  subdivision 9, is amended to read: 
124.19     Subd. 9.  [RENEWAL.] (a) To renew a license an applicant 
124.20  must: 
124.21     (1) annually, or as determined by the board, complete a 
124.22  renewal application on a form provided by the board; 
124.23     (2) submit the renewal fee; 
124.24     (3) ~~provide evidence annually of one hour of continuing~~ 
124.25  ~~education in the subject of infection control, including blood~~ 
124.26  ~~borne pathogen diseases;~~ 
124.27     ~~(4)~~ provide documentation of current and active NCCAOM 
124.28  certification; or 
124.29     ~~(5)~~ (4) if licensed under subdivision 5 or 6, meet the same 
124.30  NCCAOM professional development activity requirements as those 
124.31  licensed under subdivision 7. 
124.32     (b) An applicant shall submit any additional information 
124.33  requested by the board to clarify information presented in the 
124.34  renewal application.  The information must be submitted within 
124.35  30 days after the board's request, or the renewal request is 
124.36  nullified. 
125.1      Sec. 6.  Minnesota Statutes 2001 Supplement, section 
125.2   149A.90, subdivision 1, is amended to read: 
125.3      Subdivision 1.  [DEATH RECORD.] (a) Except as provided in 
125.4   this section, a death record must be completed and filed for 
125.5   every known death by the mortician, funeral director, or other 
125.6   person lawfully in charge of the disposition of the body. 
125.7      (b) If the body is that of an individual whose identity is 
125.8   unknown, the person in charge of the disposition of the body 
125.9   must notify the commissioner for purposes of compliance with 
125.10  section 144.05, subdivision 4. 
125.11     Sec. 7.  Minnesota Statutes 2000, section 150A.06, is 
125.12  amended by adding a subdivision to read: 
125.13     Subd. 2c.  [GUEST LICENSE OR REGISTRATION.] (a) The board 
125.14  shall grant a guest license to practice as a dentist or dental 
125.15  hygienist or a guest registration to practice as a dental 
125.16  assistant if the following conditions are met: 
125.17     (1) the dentist, dental hygienist, or dental assistant is 
125.18  currently licensed or registered in good standing in North 
125.19  Dakota, South Dakota, Iowa, or Wisconsin; 
125.20     (2) the dentist, dental hygienist, or dental assistant is 
125.21  currently engaged in the practice of that person's respective 
125.22  profession in North Dakota, South Dakota, Iowa, or Wisconsin; 
125.23     (3) the dentist, dental hygienist, or dental assistant is 
125.24  seeking to practice in a public health setting in Minnesota that 
125.25  (i) is approved by the board; (ii) was established by a 
125.26  nonprofit organization that is tax exempt under section 
125.27  501(c)(3) of the Internal Revenue Code of 1986; and (iii) 
125.28  provides dental care to patients who have difficulty accessing 
125.29  dental care; 
125.30     (4) the dentist, dental hygienist, or dental assistant 
125.31  agrees to treat indigent patients who meet the eligibility 
125.32  criteria established by the clinic; and 
125.33     (5) the dentist, dental hygienist, or dental assistant has 
125.34  applied to the board for a guest license or registration, 
125.35  providing evidence of being currently licensed or registered in 
125.36  good standing in North Dakota, South Dakota, Iowa, or Wisconsin, 
126.1   and has paid a nonrefundable license fee to the board of $50. 
126.2      (b) A dentist, dental hygienist, or dental assistant 
126.3   practicing under a guest license or registration may only 
126.4   practice at a single, specific location in Minnesota.  A guest 
126.5   license or registration must be renewed annually with the board 
126.6   and an annual renewal fee of $50 must be paid to the board.  If 
126.7   the clinic in Minnesota at which a dentist, dental hygienist, or 
126.8   dental assistant seeks to practice permanently ceases operation, 
126.9   the guest license or registration issued under this subdivision 
126.10  is automatically revoked. 
126.11     (c) A dentist, dental hygienist, or dental assistant 
126.12  practicing under a guest license or registration under this 
126.13  subdivision shall have the same obligations as a dentist, dental 
126.14  hygienist, or dental assistant who is licensed in Minnesota and 
126.15  shall be subject to the laws and rules of Minnesota and the 
126.16  regulatory authority of the board.  If the board suspends or 
126.17  revokes the guest license or registration of, or otherwise 
126.18  disciplines, a dentist, dental hygienist, or dental assistant 
126.19  practicing under this subdivision, the board shall promptly 
126.20  report such disciplinary action to the dentist's, dental 
126.21  hygienist's, or dental assistant's regulatory board in the 
126.22  border state. 
126.23     <h>[EFFECTIVE DATE.]</h> This section is effective the day 
126.24  following final enactment. 
126.25     Sec. 8.  Minnesota Statutes 2001 Supplement, section 
126.26  256B.69, subdivision 5b, is amended to read: 
126.27     Subd. 5b.  [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 
126.28  prepaid medical assistance and general assistance medical care 
126.29  program contract rates set by the commissioner under subdivision 
126.30  5 and effective on or after January 1, 1998, capitation rates 
126.31  for nonmetropolitan counties shall on a weighted average be no 
126.32  less than 88 percent of the capitation rates for metropolitan 
126.33  counties, excluding Hennepin county.  The commissioner shall 
126.34  make a pro rata adjustment in capitation rates paid to counties 
126.35  other than nonmetropolitan counties in order to make this 
126.36  provision budget neutral.  The commissioner, in consultation 
127.1   with a health care actuary, shall evaluate the regional rate 
127.2   relationships based on actual health plan costs for Minnesota 
127.3   health care programs.  The commissioner may establish, based on 
127.4   the actuary's recommendation, new rate regions that recognize 
127.5   metropolitan areas outside of the seven-county metropolitan area.
127.6      (b) For prepaid medical assistance program contract rates 
127.7   set by the commissioner under subdivision 5 and effective on or 
127.8   after January 1, 2001, capitation rates for nonmetropolitan 
127.9   counties shall, on a weighted average, be no less than 89 
127.10  percent of the capitation rates for metropolitan counties, 
127.11  excluding Hennepin county. 
127.12     (c) This subdivision shall not affect the nongeographically 
127.13  based risk adjusted rates established under section 62Q.03, 
127.14  subdivision 5a. 
127.15     Sec. 9.  [APPROPRIATION.] 
127.16     In fiscal year 2003 only, $75,000 of the general fund 
127.17  appropriations for HIV/AIDS grants that are no longer needed as 
127.18  a result of greater than anticipated collections under the AIDS 
127.19  drug assistance program rebate must be transferred to the 
127.20  commissioner of health and is appropriated for a grant to the 
127.21  Minnesota dental association, or another appropriate and 
127.22  qualified organization, as determined by the commissioner, to 
127.23  develop and operate the donated dental services program under 
127.24  section 3.  The grant may be used for administrative or 
127.25  technical support. 
127.26     Sec. 10.  [REPEALER.] 
127.27     Minnesota Statutes 2000, section 147B.01, subdivisions 8 
127.28  and 15, are repealed.