1.1                          A bill for an act 
  1.2             relating to human services; appropriating money; 
  1.3             changing provisions for long-term care, health care 
  1.4             programs and provisions, including MA and GAMC, 
  1.5             MinnesotaCare, welfare reform, and regional treatment 
  1.6             centers; providing for the sale of certain nursing 
  1.7             home property; regulating compulsive gambling; 
  1.8             imposing penalties; amending Minnesota Statutes 1996, 
  1.9             sections 119B.24; 144.701, subdivisions 1, 2, and 4; 
  1.10            144.702, subdivisions 1, 2, and 8; 144A.09, 
  1.11            subdivision 1; 144A.44, subdivision 2; 214.03; 
  1.12            245.462, subdivisions 4 and 8; 245.4871, subdivision 
  1.13            4; 245A.03, by adding a subdivision; 245A.14, 
  1.14            subdivision 4; 256.014, subdivision 1; 256.969, 
  1.15            subdivisions 16 and 17; 256B.03, subdivision 3; 
  1.16            256B.04, by adding a subdivision; 256B.055, 
  1.17            subdivision 7, and by adding a subdivision; 256B.057, 
  1.18            subdivision 3a, and by adding subdivisions; 256B.0625, 
  1.19            subdivisions 7, 17, 19a, 20, 34, and by adding 
  1.20            subdivisions; 256B.0627, subdivision 4; 256B.0911, 
  1.21            subdivision 4; 256B.0916; 256B.41, subdivision 1; 
  1.22            256B.431, subdivisions 2b, 4, 11, 22, and by adding a 
  1.23            subdivision; 256B.501, subdivision 2; 256B.69, by 
  1.24            adding subdivisions; 256D.03, subdivision 4, and by 
  1.25            adding subdivisions; 256D.051, by adding a 
  1.26            subdivision; 256D.46, subdivision 2; 256I.04, 
  1.27            subdivisions 1, 3, and by adding a subdivision; 
  1.28            256I.05, subdivision 2; and 609.115, subdivision 9; 
  1.29            Minnesota Statutes 1997 Supplement, sections 60A.15, 
  1.30            subdivision 1; 62J.685; 62J.69, subdivisions 1, 2, and 
  1.31            by adding a subdivision; 62J.75; 103I.208, subdivision 
  1.32            2; 144.1494, subdivision 1; 144A.071, subdivision 4a; 
  1.33            171.29, subdivision 2; 214.32, subdivision 1; 245B.06, 
  1.34            subdivision 2; 256.01, subdivision 2; 256.031, 
  1.35            subdivision 6; 256.9657, subdivision 3; 256.9685, 
  1.36            subdivision 1; 256.9864; 256B.04, subdivision 18; 
  1.37            256B.056, subdivisions 1a and 4; 256B.06, subdivision 
  1.38            4; 256B.062; 256B.0625, subdivision 31a; 256B.0627, 
  1.39            subdivision 5; 256B.0645; 256B.0911, subdivisions 2 
  1.40            and 7; 256B.0913, subdivision 14; 256B.0915, 
  1.41            subdivisions 1d and 3; 256B.0951, by adding a 
  1.42            subdivision; 256B.431, subdivisions 3f and 26; 
  1.43            256B.433, subdivision 3a; 256B.434, subdivision 10; 
  1.44            256B.69, subdivisions 2 and 3a; 256B.692, subdivisions 
  1.45            2 and 5; 256B.77, subdivisions 3, 7a, 10, and 12; 
  1.46            256D.05, subdivision 8; 256J.02, subdivision 4; 
  2.1             256J.03; 256J.08, subdivisions 11, 26, 28, 40, 60, 68, 
  2.2             73, 83, and by adding subdivisions; 256J.09, 
  2.3             subdivisions 6 and 9; 256J.11, subdivision 2, as 
  2.4             amended; 256J.12; 256J.14; 256J.15, subdivision 2; 
  2.5             256J.20, subdivisions 2 and 3; 256J.21; 256J.24, 
  2.6             subdivisions 1, 2, 3, 4, and by adding subdivisions; 
  2.7             256J.26, subdivisions 1, 2, 3, and 4; 256J.28, 
  2.8             subdivisions 1, 2, and by adding a subdivision; 
  2.9             256J.30, subdivisions 10 and 11; 256J.31, subdivisions 
  2.10            5 and 10; 256J.32, subdivisions 4, 6, and by adding a 
  2.11            subdivision; 256J.33, subdivisions 1 and 4; 256J.35; 
  2.12            256J.36; 256J.37, subdivisions 1, 2, 9, and by adding 
  2.13            subdivisions; 256J.38, subdivision 1; 256J.39, 
  2.14            subdivision 2; 256J.395; 256J.42; 256J.43; 256J.45, 
  2.15            subdivisions 1, 2, and by adding a subdivision; 
  2.16            256J.46, subdivisions 1, 2, and 2a; 256J.47, 
  2.17            subdivision 4; 256J.48, subdivisions 2, 3, and by 
  2.18            adding a subdivision; 256J.49, subdivision 4; 256J.50, 
  2.19            subdivision 5, and by adding a subdivision; 256J.52, 
  2.20            subdivision 4; 256J.54, subdivisions 2, 3, 4, and 5; 
  2.21            256J.55, subdivision 5; 256J.56; 256J.57, subdivision 
  2.22            1; 256J.645, subdivision 3; 256J.74, subdivision 2, 
  2.23            and by adding a subdivision; 256K.03, subdivision 5; 
  2.24            256L.01; 256L.02, subdivisions 2 and 3; 256L.03, 
  2.25            subdivisions 1, 3, 4, 5, and by adding subdivisions; 
  2.26            256L.04, subdivisions 1, 2, 7, 8, 9, 10, and by adding 
  2.27            subdivisions; 256L.05, subdivisions 2, 3, 4, and by 
  2.28            adding subdivisions; 256L.06, subdivision 3; 256L.07; 
  2.29            256L.09, subdivisions 2, 4, and 6; 256L.11, 
  2.30            subdivision 6; 256L.12, subdivision 5; 256L.15; 
  2.31            256L.17, by adding a subdivision; and 270A.03, 
  2.32            subdivision 5; Laws 1994, chapter 633, article 7, 
  2.33            section 3; Laws 1997, chapter 203, article 4, section 
  2.34            64; and article 9, section 21; chapter 207, section 7; 
  2.35            chapter 225, article 2, section 64; and chapter 248, 
  2.36            section 46, as amended; proposing coding for new law 
  2.37            in Minnesota Statutes, chapters 144; 145; 245; 256; 
  2.38            256B; 256D; 256J; and 256L; repealing Minnesota 
  2.39            Statutes 1996, sections 144.0721, subdivision 3a; 
  2.40            256.031, subdivisions 1, 2, 3, and 4; 256.032; 
  2.41            256.033, subdivisions 2, 3, 4, 5, and 6; 256.034; 
  2.42            256.035; 256.036; 256.0361; 256.047; 256.0475; 
  2.43            256.048; 256.049; and 256B.501, subdivision 3g; 
  2.44            Minnesota Statutes 1997 Supplement, sections 62J.685; 
  2.45            144.0721, subdivision 3; 256.031, subdivisions 5 and 
  2.46            6; 256.033, subdivisions 1 and 1a; 256B.057, 
  2.47            subdivision 1a; 256B.062; 256B.0913, subdivision 15; 
  2.48            256J.25; 256J.28, subdivision 4; 256J.32, subdivision 
  2.49            5; 256J.34, subdivision 5; 256J.76; 256L.04, 
  2.50            subdivisions 3, 4, 5, and 6; 256L.06, subdivisions 1 
  2.51            and 2; 256L.08; 256L.09, subdivision 3; 256L.13; and 
  2.52            256L.14; Laws 1997, chapter 85, article 1, sections 61 
  2.53            and 71; and article 3, section 55; Minnesota Rules 
  2.54            (Exempt), parts 9500.9100; 9500.9110; 9500.9120; 
  2.55            9500.9130; 9500.9140; 9500.9150; 9500.9160; 9500.9170; 
  2.56            9500.9180; 9500.9190; 9500.9200; 9500.9210; and 
  2.57            9500.9220. 
  2.58  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  2.59                             ARTICLE 1 
  2.60                           APPROPRIATIONS 
  2.61  Section 1.  [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 
  2.62     The sums shown in the columns marked "APPROPRIATIONS" are 
  2.63  appropriated from the general fund, or any other fund named, to 
  2.64  the agencies and for the purposes specified in the following 
  3.1   sections of this article, to be available for the fiscal years 
  3.2   indicated for each purpose.  The figures "1998" and "1999" where 
  3.3   used in this article, mean that the appropriation or 
  3.4   appropriations listed under them are available for the fiscal 
  3.5   year ending June 30, 1998, or June 30, 1999, respectively.  
  3.6   Where a dollar amount appears in parentheses, it means a 
  3.7   reduction of an appropriation.  
  3.8                           SUMMARY BY FUND 
  3.9   APPROPRIATIONS                                      BIENNIAL
  3.10                            1998          1999           TOTAL
  3.11  General            $ (119,518,000)$ (120,237,000)$ (239,755,000)
  3.12  State Government
  3.13  Special Revenue           113,000        224,000        337,000
  3.14  Health Care Access 
  3.15  Fund                    6,616,000       (255,000)     6,361,000
  3.16  TOTAL              $ (112,789,000)$ (120,268,000)$ (233,057,000)
  3.17                                             APPROPRIATIONS 
  3.18                                         Available for the Year 
  3.19                                             Ending June 30 
  3.20                                            1998         1999 
  3.21  Sec. 2.  COMMISSIONER OF 
  3.22  HUMAN SERVICES 
  3.23  Subdivision 1.  Total 
  3.24  Appropriation                     $ (112,902,000)$ (127,343,000)
  3.25                Summary by Fund
  3.26  General            (119,518,000) (126,579,000)
  3.27  Health Care Access    6,616,000      (764,000)
  3.28  This appropriation is taken from the 
  3.29  appropriation in Laws 1997, chapter 
  3.30  203, article 1, section 2. 
  3.31  The amounts that are added to or 
  3.32  reduced from the appropriation for each 
  3.33  program are specified in the following 
  3.34  subdivisions. 
  3.35  Subd. 2.  Agency Management 
  3.36                          -0-            80,000
  3.37  Subd. 3.  Children's Grants
  3.38                         (600,000)    2,771,000
  3.39  [CRISIS NURSERY PROGRAMS.] Of this 
  3.40  appropriation, $200,000 in fiscal year 
  3.41  1999 is from the general fund to the 
  3.42  commissioner to contract for technical 
  3.43  assistance with counties that are 
  3.44  interested in developing a crisis 
  3.45  nursery program.  The technical 
  3.46  assistance must be designed to assist 
  4.1   interested counties in building 
  4.2   capacity to develop and maintain a 
  4.3   crisis nursery program in the county.  
  4.4   The grant amounts to counties must 
  4.5   range from $10,000 to $20,000.  To be 
  4.6   eligible to receive a grant under this 
  4.7   program, the county must not have an 
  4.8   existing crisis nursery program and 
  4.9   must not be a metropolitan county, as 
  4.10  that term is defined in Minnesota 
  4.11  Statutes, section 473.121.  This 
  4.12  appropriation shall not become part of 
  4.13  base level funding for the 2000-2001 
  4.14  biennium. 
  4.15  [CHILDREN'S MENTAL HEALTH SERVICES.] 
  4.16  (1) Of this appropriation, $500,000 in 
  4.17  fiscal year 1999 from the general fund 
  4.18  is to the commissioner for the purpose 
  4.19  of awarding grants to counties for 
  4.20  children's mental health services. 
  4.21  (2) Funds shall be used to provide 
  4.22  services according to an individual 
  4.23  family community support plan as 
  4.24  described in Minnesota Statutes, 
  4.25  section 245.4881, subdivision 4.  The 
  4.26  plan must be developed using a process 
  4.27  that enhances consumer empowerment.  
  4.28  (3) In awarding grants to counties, the 
  4.29  commissioner shall follow the process 
  4.30  established in Minnesota Statutes, 
  4.31  section 245.4886, subdivision 2.  The 
  4.32  commissioner shall ensure that grant 
  4.33  funds are not used to replace existing 
  4.34  funds. 
  4.35  [INDIAN FAMILY PRESERVATION ACT.] Of 
  4.36  this appropriation, $100,000 from the 
  4.37  general fund for fiscal year 1999 is to 
  4.38  provide a grant under Minnesota 
  4.39  Statutes, section 257.3571, subdivision 
  4.40  1, to an Indian organization licensed 
  4.41  as an adoption agency.  The grant must 
  4.42  be used to provide primary support for 
  4.43  implementation of the Minnesota Indian 
  4.44  Family Preservation Act and compliance 
  4.45  with the Indian Child Welfare Act.  
  4.46  [FAMILY PRESERVATION PROGRAM TANF 
  4.47  FUNDING.] $10,000,000 of federal funds 
  4.48  shall be transferred from TANF to the 
  4.49  family preservation program in the 
  4.50  fiscal year beginning July 1, 1998. 
  4.51  Notwithstanding Minnesota Statutes, 
  4.52  section 256E.07, the commissioner shall 
  4.53  distribute this money according to the 
  4.54  family preservation formula in 
  4.55  Minnesota Statutes, section 256F.05, 
  4.56  subdivision 3.  Counties may use the 
  4.57  allocation for the purposes of family 
  4.58  preservation services, the child 
  4.59  protection assessments, and community 
  4.60  collaborations pilot program and the 
  4.61  concurrent permanency planning pilot 
  4.62  program provided county staff have 
  4.63  received necessary training and the 
  4.64  pilot programs have been approved by 
  4.65  the commissioner.  Prior to 
  4.66  distributing these funds to the 
  5.1   counties, the commissioner may allocate 
  5.2   up to $150,000 for departmental 
  5.3   administrative costs associated with 
  5.4   training county staff and approval of 
  5.5   county plans for the pilot programs.  
  5.6   Funds allocated to the counties must be 
  5.7   used in accordance with federal TANF 
  5.8   requirements and Minnesota Statutes, 
  5.9   chapter 256F.  
  5.10  Subd. 4.  Children's Services Management
  5.11  [SOCIAL SERVICES INFORMATION SYSTEM.] 
  5.12  Notwithstanding Laws 1997, chapter 203, 
  5.13  article 1, section 2, subdivision 4, 
  5.14  the appropriation in that subdivision 
  5.15  for the social services information 
  5.16  system shall become part of the base 
  5.17  for the biennium beginning July 1, 1999.
  5.18  Subd. 5.  Basic Health Care Grants
  5.19                      (67,836,000)  (88,240,000)
  5.20                Summary by Fund
  5.21  General             (74,644,000)  (84,818,000)
  5.22  Health Care Access    6,808,000    (3,422,000)
  5.23  The amounts that may be spent from this 
  5.24  appropriation for each purpose are as 
  5.25  follows: 
  5.26  (a) Minnesota Care Grants
  5.27  Health Care Access Fund
  5.28                        6,808,000    (3,422,000)
  5.29  [SUBSIDIZED FAMILY HEALTH COVERAGE.] 
  5.30  (1) Of this appropriation, $500,000 
  5.31  from the health care access fund in 
  5.32  fiscal year 1999 is to implement the 
  5.33  program described in Minnesota 
  5.34  Statutes, section 256L.07, subdivision 
  5.35  2, paragraph (b). 
  5.36  (2) The commissioner shall submit to 
  5.37  the health care financing 
  5.38  administration a plan to obtain federal 
  5.39  funding, according to section 
  5.40  2105(c)(3) of the Balanced Budget Act 
  5.41  of 1997, Public Law Number 105-33, to 
  5.42  subsidize health insurance coverage for 
  5.43  families who are ineligible for 
  5.44  MinnesotaCare under Minnesota Statutes, 
  5.45  section 256L.07, subdivision 2, 
  5.46  paragraph (b), due to the availability 
  5.47  of employer subsidized insurance for 
  5.48  which the employer pays 50 percent or 
  5.49  more of the cost of the coverage.  Upon 
  5.50  federal approval of the plan, the 
  5.51  commissioner shall implement a program 
  5.52  to pay the difference of the 
  5.53  MinnesotaCare sliding premium scale as 
  5.54  specified in Minnesota Statutes, 
  5.55  section 256L.08, up to a maximum of 
  5.56  five percent of a qualifying family's 
  5.57  income and the employee share of the 
  5.58  cost of health insurance coverage.  To 
  5.59  qualify, a family must meet all 
  6.1   MinnesotaCare eligibility criteria 
  6.2   according to Minnesota Statutes, 
  6.3   sections 256L.01 to 256L.18, except the 
  6.4   requirements of Minnesota Statutes, 
  6.5   section 256L.07, subdivision 2, 
  6.6   paragraph (b).  Implementation of the 
  6.7   program shall be limited to the funds 
  6.8   appropriated from the health care 
  6.9   access fund for the fiscal year ending 
  6.10  June 30, 1999. 
  6.11  (b) MA Basic Health Care Grants-
  6.12  Families and Children
  6.13  General             (23,231,000)  (38,768,000)
  6.14  [RESERVE ACCOUNT.] The commissioner 
  6.15  shall establish a reserve account for 
  6.16  the deposit of savings in prepaid 
  6.17  medical assistance and prepaid general 
  6.18  assistance medical care programs in 
  6.19  fiscal year 1999 as a result of the 
  6.20  delayed implementation of those 
  6.21  programs in certain counties.  The 
  6.22  savings, in the amount of $7,943,000 in 
  6.23  medical assistance and $2,964,000 in 
  6.24  general assistance medical care, shall 
  6.25  be used in fiscal year 2000 for costs 
  6.26  in the prepaid programs.  
  6.27  Notwithstanding section 7, this 
  6.28  paragraph shall not expire. 
  6.29  (c) MA Basic Health Care Grants- 
  6.30  Elderly and  Disabled
  6.31  General             (23,784,000)  (37,807,000)
  6.32  [MEDICAL EDUCATION RESEARCH TRUST FUND 
  6.33  BASE.] The appropriation in Laws 1997, 
  6.34  chapter 203, article 1. section 2, 
  6.35  subdivision 5, to the medical 
  6.36  assistance account for distribution to 
  6.37  medical assistance providers using the 
  6.38  methodology in Minnesota Statutes, 
  6.39  section 62J.69, shall become part of 
  6.40  the base for the biennium beginning 
  6.41  July 1, 1999, at the level of 
  6.42  $2,500,000 per year.  Notwithstanding 
  6.43  section 7, this paragraph shall not 
  6.44  expire. 
  6.45  (d) General Assistance Medical Care
  6.46  General             (27,629,000)   (8,243,000)
  6.47  [PRESCRIPTION DRUG BENEFIT.] (a) If, by 
  6.48  September 15, 1998, federal approval is 
  6.49  obtained to provide a prescription drug 
  6.50  benefit for qualified Medicare 
  6.51  beneficiaries at no less than 100 
  6.52  percent of the federal poverty 
  6.53  guidelines and service-limited Medicare 
  6.54  beneficiaries under Minnesota Statutes, 
  6.55  section 256B.057, subdivision 3a, at no 
  6.56  less than 120 percent of federal 
  6.57  poverty guidelines, the commissioner of 
  6.58  human services shall not implement the 
  6.59  senior citizen drug program under 
  6.60  Minnesota Statutes, section 256.955, 
  6.61  but shall implement a drug benefit in 
  6.62  accordance with the approved waiver.  
  7.1   Upon approval of this waiver, the total 
  7.2   appropriation for the senior citizen 
  7.3   drug program under Laws 1997, chapter 
  7.4   225, article 7, section 2, shall be 
  7.5   transferred to the medical assistance 
  7.6   account to supplement funding for the 
  7.7   federally approved coverage for 
  7.8   eligible persons. 
  7.9   (b) The commissioner may seek approval 
  7.10  for a higher copayment for eligible 
  7.11  persons above 100 percent of the 
  7.12  federal poverty guidelines. 
  7.13  (c) The commissioner shall report by 
  7.14  October 15, 1998, to the chairs of the 
  7.15  health and human services policy and 
  7.16  fiscal committees of the house and 
  7.17  senate whether the waiver referred to 
  7.18  in paragraph (a) has been approved and 
  7.19  will be implemented or whether the 
  7.20  state senior citizen drug program will 
  7.21  be implemented. 
  7.22  (d) If the commissioner does not 
  7.23  receive federal waiver approval at or 
  7.24  above the level of eligibility defined 
  7.25  in paragraph (b), the commissioner 
  7.26  shall implement the program under 
  7.27  Minnesota Statutes, section 256.955.  
  7.28  The commissioner may transfer funds 
  7.29  appropriated to implement the waiver to 
  7.30  the senior drug program account. 
  7.31  [HEALTH CARE ACCESS FUND TRANSFERS TO 
  7.32  THE GENERAL FUND.] Notwithstanding Laws 
  7.33  1997, chapter 203, article 1, section 
  7.34  2, subdivision 5, the commissioner 
  7.35  shall transfer funds from the health 
  7.36  care access fund to the general fund to 
  7.37  offset the projected savings to general 
  7.38  assistance medical care (GAMC) that 
  7.39  would result from the transition of 
  7.40  GAMC parents and adults without 
  7.41  children to MinnesotaCare.  For fiscal 
  7.42  year 1998, the amount transferred from 
  7.43  the health care access fund to the 
  7.44  general fund shall be $13,700,000.  The 
  7.45  amount of transfer for fiscal year 1999 
  7.46  shall be $2,659,000. 
  7.47  Subd. 6.  Basic Health Care Management
  7.48                         (192,000)    2,448,000
  7.49                Summary by Fund
  7.50  General                 -0-           874,000
  7.51  Health Care Access     (192,000)    1,574,000
  7.52  The amounts that may be spent from this 
  7.53  appropriation for each purpose are as 
  7.54  follows: 
  7.55  (a) Health Care Policy Administration
  7.56  General                 -0-           786,000
  7.57  Health Care Access     (192,000)       37,000
  8.1   [DELAY IN TRANSFERRING GAMC CLIENTS.] 
  8.2   Due to the delay in transferring GAMC 
  8.3   clients to MinnesotaCare until January 
  8.4   1, 2000, $192,000 in fiscal year 1998 
  8.5   health care access fund administrative 
  8.6   funds, appropriated in Laws 1997, 
  8.7   chapter 225, article 7, section 2, 
  8.8   subdivision 1, are canceled. 
  8.9   [HEALTH CARE MANUAL PRODUCTION COSTS.] 
  8.10  For the biennium ending June 30, 1999, 
  8.11  the difference between the cost of 
  8.12  producing and distributing the 
  8.13  department of human services health 
  8.14  care manual and the subsidized price 
  8.15  charged to individuals and private 
  8.16  entities on January 1, 1998, is 
  8.17  appropriated to the commissioner to 
  8.18  defray manual production and 
  8.19  distribution costs. 
  8.20  [TRANSFER.] For fiscal years 2000 and 
  8.21  2001, the commissioner of finance shall 
  8.22  transfer from the health care access 
  8.23  fund to the general fund an amount to 
  8.24  cover the expenditures associated with 
  8.25  the services provided to pregnant women 
  8.26  and children under the age of two 
  8.27  enrolled in the MinnesotaCare program.  
  8.28  Notwithstanding section 7, this 
  8.29  paragraph shall not expire.  
  8.30  [PAYMENTS FOR PREGNANT WOMEN AND 
  8.31  CHILDREN UNDER THE AGE OF TWO.] 
  8.32  Beginning in fiscal year 2000, the 
  8.33  expenditures for pregnant women and 
  8.34  children under the age of two enrolled 
  8.35  in the MinnesotaCare program shall be 
  8.36  paid out of the general fund.  
  8.37  Notwithstanding section 7, this 
  8.38  paragraph shall not expire.  
  8.39  [FEDERAL CONTINGENCY RESERVE LIMIT.] 
  8.40  Notwithstanding Minnesota Statutes, 
  8.41  section 16A.76, subdivision 2, the 
  8.42  federal contingency reserve limit shall 
  8.43  be reduced for fiscal years 1999, 2000, 
  8.44  and 2001 by the cumulative amount of 
  8.45  the expenditures associated with 
  8.46  services provided to pregnant women and 
  8.47  children enrolled in the MinnesotaCare 
  8.48  program in these fiscal years.  
  8.49  Notwithstanding section 7, this 
  8.50  paragraph shall not expire.  
  8.51  (b) Health Care Operations
  8.52  General                 -0-            88,000
  8.53  Health Care Access      -0-         1,537,000
  8.54  [MINNESOTACARE OUTREACH.] Unexpended 
  8.55  money in fiscal year 1998 for 
  8.56  MinnesotaCare outreach activities 
  8.57  appropriated in Laws 1997, chapter 225, 
  8.58  article 7, section 2, subdivision 1, 
  8.59  does not cancel, but is available for 
  8.60  those purposes in fiscal year 1999. 
  8.61  Subd. 7.  State-Operated Services
  9.1                           -0-           508,000
  9.2   The amounts that may be spent from this 
  9.3   appropriation for each purpose are as 
  9.4   follows: 
  9.5   (a) RTC Facilities
  9.6                           -0-           825,000
  9.7   [LEAVE LIABILITIES.] The accrued leave 
  9.8   liabilities of state employees 
  9.9   transferred to state-operated services 
  9.10  programs may be paid from the 
  9.11  appropriation for state-operated 
  9.12  services in Laws 1997, chapter 203, 
  9.13  article 1, section 2, subdivision 7a.  
  9.14  Funds set aside for this purpose shall 
  9.15  not exceed the amount of the actual 
  9.16  leave liability calculated as of June 
  9.17  30, 1999, and shall be available until 
  9.18  expended.  This paragraph is effective 
  9.19  the day following final enactment. 
  9.20  [GRAVE MARKERS.] Of the $195,000 
  9.21  retained by the commissioner out of the 
  9.22  $200,000 appropriation in Laws 1997, 
  9.23  chapter 203, article 1, section 2, 
  9.24  subdivision 7, paragraph (a), for grave 
  9.25  markers at regional treatment centers, 
  9.26  $29,250 is for community organizing, 
  9.27  coordination, fundraising, and 
  9.28  administration. 
  9.29  [RTC BUILDING AND SPACE ANALYSIS.] Of 
  9.30  this appropriation, $175,000 from the 
  9.31  general fund in fiscal year 1999 is for 
  9.32  the commissioner to conduct an analysis 
  9.33  of surplus land and buildings on the 
  9.34  regional treatment center campuses and 
  9.35  to develop recommendations for future 
  9.36  utilization of this property.  The 
  9.37  commissioner shall report to the 
  9.38  legislature by January 15, 1999, with 
  9.39  recommendations for an orderly process 
  9.40  to sell, lease, demolish, transfer, or 
  9.41  otherwise dispose of unneeded buildings 
  9.42  and land. 
  9.43  (b) State-Operated Community 
  9.44  Services - DD
  9.45                          -0-          (317,000)
  9.46  Subd. 8.  Continuing Care and 
  9.47  Community Support Grants
  9.48                      (35,100,000)  (22,107,000)
  9.49  The amounts that may be spent from this 
  9.50  appropriation for each purpose are as 
  9.51  follows: 
  9.52  (a) Community Services Block Grants
  9.53         130,000        280,000 
  9.54  [WILKIN COUNTY FLOOD COSTS.] Of this 
  9.55  appropriation, $130,000 for fiscal year 
  9.56  1998 is to reimburse Wilkin county for 
  9.57  flood-related human service and public 
 10.1   health costs which cannot be reimbursed 
 10.2   through any other source. 
 10.3   (b) Aging Adult Service Grants
 10.4          -0-            350,000 
 10.5   [METROPOLITAN AREA AGENCY ON AGING.] Of 
 10.6   this appropriation, $100,000 in fiscal 
 10.7   year 1999 from the general fund is for 
 10.8   the commissioner for the metropolitan 
 10.9   area agency on aging to provide 
 10.10  technical support and planning services 
 10.11  to enable older adults to remain living 
 10.12  in the community.  This appropriation 
 10.13  shall not cancel but is available until 
 10.14  expended. 
 10.15  [HOME SHARING.] Of this appropriation, 
 10.16  $250,000 in fiscal year 1999 is from 
 10.17  the general fund to the commissioner 
 10.18  for the home-sharing program under 
 10.19  Minnesota Statutes, section 256.973, 
 10.20  which links elderly, disabled, and 
 10.21  families together to share a home. 
 10.22  (c) Deaf and Hard-of-Hearing 
 10.23  Services Grants
 10.24         -0-            200,000 
 10.25  This appropriation is in addition to 
 10.26  the appropriation in Laws 1997, chapter 
 10.27  203, article 1, section 2, subdivision 
 10.28  8, paragraph (d), for a grant to a 
 10.29  nonprofit agency that currently 
 10.30  provides these services.  
 10.31  [SERVICES FOR DEAF-BLIND PERSONS.] Of 
 10.32  this appropriation, $200,000 in fiscal 
 10.33  year 1999 is for the following: 
 10.34  (1) $125,000 for a grant to Deaf Blind 
 10.35  Services Minnesota, Inc., in order to 
 10.36  provide services to deaf-blind children 
 10.37  and their families.  The services 
 10.38  include providing intervenors to assist 
 10.39  deaf-blind children in participating in 
 10.40  their community and providing family 
 10.41  education specialists to teach siblings 
 10.42  and parents skills to support the 
 10.43  deaf-blind child in the family. 
 10.44  (2) $75,000 is for a grant to Deaf 
 10.45  Blind Services Minnesota, Inc., and 
 10.46  Duluth Lighthouse for the Blind, Inc., 
 10.47  in order to provide assistance to 
 10.48  deaf-blind persons who are working 
 10.49  toward establishing and maintaining 
 10.50  independence. 
 10.51  (d) Mental Health Grants
 10.52         300,000      2,226,000 
 10.53  [FLOOD COSTS.] Of this appropriation, 
 10.54  $300,000 for fiscal year 1998 and 
 10.55  $1,000,000 for fiscal year 1999 is to 
 10.56  pay for flood-related mental health 
 10.57  services and to reimburse mental health 
 10.58  centers for the cost of disruptions in 
 11.1   the mental health centers' other 
 11.2   services that were caused by diversion 
 11.3   of staff to flood efforts.  Funding is 
 11.4   limited to costs for services which 
 11.5   cannot be reimbursed through any other 
 11.6   source in counties officially declared 
 11.7   as disaster areas. 
 11.8   [COMPULSIVE GAMBLING CARRYFORWARD.] 
 11.9   Unexpended funds appropriated to the 
 11.10  commissioner for compulsive gambling 
 11.11  programs for fiscal year 1998 do not 
 11.12  cancel but are available for these 
 11.13  purposes for fiscal year 1999. 
 11.14  (e) Developmental Disabilities
 11.15  Support Grants
 11.16         -0-             54,000 
 11.17  (f) Medical Assistance Long-Term 
 11.18  Care Waivers and Home Care
 11.19      (8,463,000)   (12,308,000) 
 11.20  [JANUARY 1, 1999, PROVIDER RATE 
 11.21  INCREASE.] (1) Effective for services 
 11.22  rendered on or after January 1, 1999, 
 11.23  the commissioner shall increase 
 11.24  reimbursement or allocation rates by 
 11.25  two percent, and county boards shall 
 11.26  adjust provider contracts as needed, 
 11.27  for home and community-based waiver 
 11.28  services for persons with mental 
 11.29  retardation or related conditions under 
 11.30  Minnesota Statutes, section 256B.501; 
 11.31  home and community-based waiver 
 11.32  services for the elderly under 
 11.33  Minnesota Statutes, section 256B.0915; 
 11.34  waivered services under community 
 11.35  alternatives for disabled individuals 
 11.36  under Minnesota Statutes, section 
 11.37  256B.49; community alternative care 
 11.38  waivered services under Minnesota 
 11.39  Statutes, section 256B.49; traumatic 
 11.40  brain injury waivered services under 
 11.41  Minnesota Statutes, section 256B.49; 
 11.42  nursing services and home health 
 11.43  services under Minnesota Statutes, 
 11.44  section 256B.0625, subdivision 6a; 
 11.45  personal care services and nursing 
 11.46  supervision of personal care services 
 11.47  under Minnesota Statutes, section 
 11.48  256B.0625, subdivision 19a; private 
 11.49  duty nursing services under Minnesota 
 11.50  Statutes, section 256B.0625, 
 11.51  subdivision 7; day training and 
 11.52  habilitation services for adults with 
 11.53  mental retardation or related 
 11.54  conditions under Minnesota Statutes, 
 11.55  sections 252.40 to 252.46; physical 
 11.56  therapy services under Minnesota 
 11.57  Statutes, sections 256B.0625, 
 11.58  subdivision 8, and 256D.03, subdivision 
 11.59  4; occupational therapy services under 
 11.60  Minnesota Statutes, sections 256B.0625, 
 11.61  subdivision 8a, and 256D.03, 
 11.62  subdivision 4; speech-language therapy 
 11.63  services under Minnesota Statutes, 
 11.64  section 256D.03, subdivision 4, and 
 11.65  Minnesota Rules, part 9505.0390; 
 12.1   respiratory therapy services under 
 12.2   Minnesota Statutes, section 256D.03, 
 12.3   subdivision 4, and Minnesota Rules, 
 12.4   part 9505.0295; dental services under 
 12.5   Minnesota Statutes, sections 256B.0625, 
 12.6   subdivision 9, and 256D.03, subdivision 
 12.7   4; alternative care services under 
 12.8   Minnesota Statutes, section 256B.0913; 
 12.9   adult residential program grants under 
 12.10  Minnesota Rules, parts 9535.2000 to 
 12.11  9535.3000; adult and family community 
 12.12  support grants under Minnesota Rules, 
 12.13  parts 9535.1700 to 9535.1760; and 
 12.14  semi-independent living services under 
 12.15  Minnesota Statutes, section 252.275, 
 12.16  including SILS funding under county 
 12.17  social services grants formerly funded 
 12.18  under Minnesota Statutes, chapter 256I. 
 12.19  (2) The commissioner shall increase 
 12.20  prepaid medical assistance program 
 12.21  capitation rates as appropriate to 
 12.22  reflect the rate increases in paragraph 
 12.23  (l). 
 12.24  (g) Medical Assistance Long-Term
 12.25  Care Facilities
 12.26     (18,272,000)   (18,426,000)
 12.27  [ICFs/MR AND NURSING FACILITY 
 12.28  FLOOD-RELATED REPORTING.] For the 
 12.29  reporting year ending December 31, 
 12.30  1997, for ICFs/MR that temporarily 
 12.31  admitted victims of the flood of 1997, 
 12.32  the resident days related to the 
 12.33  temporary placement of persons not 
 12.34  formally admitted who continued to be 
 12.35  billed under the evacuated facility's 
 12.36  provider number will not be counted in 
 12.37  the cost report submitted to calculate 
 12.38  October 1, 1998, rates, and the 
 12.39  additional expenditures will be 
 12.40  considered nonallowable. 
 12.41  For the reporting year ending September 
 12.42  30, 1997, for nursing facilities that 
 12.43  temporarily admitted victims of the 
 12.44  flood of 1997, the resident days 
 12.45  related to the temporary placement of 
 12.46  persons not formally admitted who 
 12.47  continued to be billed under the 
 12.48  evacuated facility's provider number 
 12.49  will not be counted in the cost report 
 12.50  submitted to calculate July 1, 1998, 
 12.51  rates, and the additional expenditures 
 12.52  will be considered nonallowable. 
 12.53  [NURSING HOME MORATORIUM EXCEPTIONS.] 
 12.54  Base level funding for medical 
 12.55  assistance long-term care facilities is 
 12.56  increased by $255,000 in fiscal year 
 12.57  2000 and by $278,000 in fiscal year 
 12.58  2001 for the additional medical 
 12.59  assistance costs of the nursing home 
 12.60  moratorium exceptions under Minnesota 
 12.61  Statutes, section 144A.071, subdivision 
 12.62  4a, paragraphs (w) and (x).  
 12.63  Notwithstanding the provisions of 
 12.64  section 7, this paragraph shall not 
 12.65  expire. 
 13.1   (h) Alternative Care Grants  
 13.2                           -0-        21,986,000
 13.3   (i) Group Residential Housing
 13.4                        (8,795,000)   (8,971,000)
 13.5   [SERVICES TO DEAF PERSONS WITH MENTAL 
 13.6   ILLNESS.] Of this appropriation, 
 13.7   $70,000 in fiscal year 1999 is for a 
 13.8   grant to a nonprofit agency that 
 13.9   currently serves deaf and 
 13.10  hard-of-hearing adults with mental 
 13.11  illness through residential programs 
 13.12  and supported housing outreach 
 13.13  activities to increase by five percent, 
 13.14  retroactive to July 1, 1997, the 
 13.15  compensation packages of staff at the 
 13.16  nonprofit agency that currently 
 13.17  provides these services. 
 13.18  (j) Chemical Dependency
 13.19  Entitlement Grants
 13.20                          -0-        (7,498,000)
 13.21  Subd. 9.  Continuing Care and
 13.22  Community Support Management
 13.23                          -0-            75,000
 13.24  [REGION 10 COMMISSION CARRYOVER 
 13.25  AUTHORITY.] Any unspent portion of the 
 13.26  appropriation to the commissioner in 
 13.27  Laws 1997, chapter 203, article 1, 
 13.28  section 2, subdivision 9, for the 
 13.29  region 10 quality assurance commission 
 13.30  for fiscal year 1998 shall not cancel 
 13.31  but shall be available for the 
 13.32  commission for fiscal year 1999. 
 13.33  [STUDY OF DAY TRAINING CAPITAL NEEDS.] 
 13.34  (a) Of this appropriation, $25,000 in 
 13.35  fiscal year 1999 is from the general 
 13.36  fund to the commissioner to conduct a 
 13.37  study to: 
 13.38  (1) determine the extent to which day 
 13.39  training and habilitation programs have 
 13.40  unmet capital improvement needs; 
 13.41  (2) ascertain the degree to which these 
 13.42  unmet capital needs impact consumers of 
 13.43  day training and habilitation programs; 
 13.44  (3) determine the state's role and 
 13.45  responsibility in meeting the capital 
 13.46  improvement needs of day training and 
 13.47  habilitation programs; and 
 13.48  (4) examine the relationship among the 
 13.49  state, counties, and community 
 13.50  resources in meeting the capital 
 13.51  improvement needs of day training and 
 13.52  habilitation programs. 
 13.53  (b) The commissioner shall report to 
 13.54  the legislature by January 15, 1999, 
 13.55  the results of the study along with 
 13.56  recommendations for involving the 
 14.1   state, counties, and community 
 14.2   resources in collaborative initiatives 
 14.3   to assist in meeting the capital 
 14.4   improvement needs of day training and 
 14.5   habilitation programs. 
 14.6   (c) This appropriation shall not become 
 14.7   part of base level funding for the 
 14.8   2000-2001 biennium. 
 14.9   Subd. 10.  Economic Support Grants
 14.10                       (9,174,000)  (23,997,000)
 14.11  The amounts that may be spent from this 
 14.12  appropriation for each purpose are as 
 14.13  follows: 
 14.14  (a) Assistance to Families Grants
 14.15                          -0-       (20,343,000)
 14.16  [FEDERAL TANF FUNDS.] Notwithstanding 
 14.17  any contrary provisions of Laws 1997, 
 14.18  chapter 203, article 1, section 2, 
 14.19  subdivision 12, federal TANF block 
 14.20  grant funds are appropriated to the 
 14.21  commissioner in amounts up to 
 14.22  $241,027,000 in fiscal year 1998 and 
 14.23  $294,860,000 in fiscal year 1999. 
 14.24  Additional federal TANF funds may be 
 14.25  expended but only to the extent that an 
 14.26  equal amount of state funds have been 
 14.27  transferred to the TANF reserve under 
 14.28  Minnesota Statutes, section 256J.03.  
 14.29  The commissioner may use TANF reserve 
 14.30  funds to meet TANF maintenance of 
 14.31  effort requirements and to offset 
 14.32  federal TANF block grants reduction.  
 14.33  Notwithstanding Minnesota Statutes, 
 14.34  section 256J.03, the commissioner shall 
 14.35  transfer $3,500,000 from the state TANF 
 14.36  reserve to the general fund for the 
 14.37  food stamp costs for legal noncitizens 
 14.38  who do not receive TANF benefits.  This 
 14.39  paragraph is effective the day 
 14.40  following final enactment. 
 14.41  (b) General Assistance
 14.42                       (6,933,000)     (905,000)
 14.43  (c) Minnesota Supplemental Aid
 14.44                       (2,241,000)   (2,749,000)
 14.45  Subd. 11.  Economic Support  
 14.46  Management
 14.47                          -0-         1,119,000
 14.48                Summary by Fund
 14.49  General                 -0-            35,000
 14.50  Health Care Access      -0-         1,084,000
 14.51  [EBT TRANSACTION COSTS.] Retailers 
 14.52  electing to integrate electronic 
 14.53  benefit transfer (EBT) with other 
 14.54  commercial systems, such as credit or 
 15.1   debit, on the retailer's own equipment, 
 15.2   shall be paid two cents by the 
 15.3   commissioner for each food stamp 
 15.4   withdrawal transaction. 
 15.5   Sec. 3.  COMMISSIONER OF HEALTH 
 15.6   Subdivision 1.  Total 
 15.7   Appropriation                            -0-          6,874,000
 15.8                 Summary by Fund
 15.9   General                 -0-         6,264,000
 15.10  State Government
 15.11  Special Revenue         -0-           101,000
 15.12  Health Care Access      -0-           509,000
 15.13  This appropriation is added to the 
 15.14  appropriation in Laws 1997, chapter 
 15.15  203, article 1, section 3. 
 15.16  The amounts that may be spent from this 
 15.17  appropriation for each program are 
 15.18  specified in the following subdivisions.
 15.19  Subd. 2.  Health Systems
 15.20  and Special Populations                  -0-          3,584,000
 15.21                Summary by Fund
 15.22  General                 -0-         3,075,000
 15.23  Health Care Access      -0-           509,000
 15.24  [FETAL ALCOHOL SYNDROME.] (a) of the 
 15.25  general fund appropriation, $3,000,000 
 15.26  is for the following: 
 15.27  (1) $750,000 to administer community 
 15.28  grants for fetal alcohol syndrome 
 15.29  prevention and intervention as defined 
 15.30  in Minnesota Statutes, section 
 15.31  145.9266, subdivision 4; 
 15.32  (2) $750,000 to expand maternal and 
 15.33  child service programs under Minnesota 
 15.34  Statutes, section 254A.17, subdivision 
 15.35  1; 
 15.36  (3) $750,000 to expand treatment 
 15.37  services and halfway houses for 
 15.38  pregnant women and women with children; 
 15.39  and 
 15.40  (4) $750,000 to develop and implement a 
 15.41  public awareness campaign. 
 15.42  (b) The commissioner shall transfer 
 15.43  money appropriated in paragraph (a) to 
 15.44  the appropriate agencies involved in 
 15.45  implementing fetal alcohol syndrome 
 15.46  initiatives. 
 15.47  [GRANTS TO MEDICAL CLINICS.] Of the 
 15.48  appropriation for fiscal year 1999 from 
 15.49  the health care access fund to the 
 15.50  commissioner, $250,000 is for grants to 
 15.51  medical clinics receiving federal funds 
 15.52  under Public Law Number 91-572, title X 
 16.1   of the Public Health Service Act.  The 
 16.2   appropriation of the funds under this 
 16.3   paragraph must comply with the same 
 16.4   requirements specified for the 
 16.5   allocation of the grants under 
 16.6   Minnesota Statutes, section 145.925. 
 16.7   [CONSUMER ADVISORY BOARD.] Of the 
 16.8   appropriation for fiscal year 1999 from 
 16.9   the general fund to the commissioner, 
 16.10  $75,000 is for a grant to the consumer 
 16.11  advisory board to use on expenses 
 16.12  incurred in arranging and conducting 
 16.13  board duties and compensation for the 
 16.14  members. 
 16.15  Subd. 3.  Health Protection             -0-          3,290,000
 16.16                Summary by Fund
 16.17  General                 -0-         3,189,000
 16.18  State Government 
 16.19  Special Revenue         -0-           101,000
 16.20  [RESPIRATORY DISEASE STUDY.] Of the 
 16.21  general fund appropriation, $250,000 is 
 16.22  to collect and analyze information 
 16.23  regarding the increased incidence of 
 16.24  respiratory diseases, including 
 16.25  mesothelioma and asbestosis, in 
 16.26  northeastern and central Minnesota to 
 16.27  determine the cause of these diseases.  
 16.28  None of the information released to the 
 16.29  commissioner will be individually 
 16.30  identifiable information unless prior 
 16.31  voluntary written consent is given by 
 16.32  the patient or employee, or if the 
 16.33  patient or employee is a minor, by the 
 16.34  parent or guardian of the patient or 
 16.35  employee. The commissioner shall also 
 16.36  make recommendations for the 
 16.37  implementation of a statewide 
 16.38  occupational respiratory disease 
 16.39  information system.  The commissioner 
 16.40  shall submit a report on the findings 
 16.41  and recommendations to the legislature 
 16.42  by January 15, 1999. 
 16.43  [LEAD-SAFE HOUSING.] Of this 
 16.44  appropriation, $50,000 in fiscal year 
 16.45  1999 from the general fund is to the 
 16.46  commissioner to create a lead-safe 
 16.47  housing certification program within 
 16.48  the private sector.  This appropriation 
 16.49  shall be used to recruit and train 
 16.50  individuals certified as independent 
 16.51  home inspectors and truth-in-sale-of 
 16.52  housing evaluators to be lead risk 
 16.53  assessors, and to subsidize the cost of 
 16.54  assessing and doing follow-up research 
 16.55  on 300 single family and rental units 
 16.56  that are demonstration cases for the 
 16.57  lead-safe property certification 
 16.58  program. 
 16.59  [CANCER SCREENING.] Of the general fund 
 16.60  appropriation, $910,000 is for 
 16.61  increased cancer screening and 
 16.62  diagnostic services for women, 
 16.63  particularly underserved women, and to 
 17.1   improve cancer screening rates for the 
 17.2   general population.  Of this amount, at 
 17.3   least $700,000 is for grants and up to 
 17.4   $210,000 is for technical assistance, 
 17.5   consultation, and outreach.  The grants 
 17.6   support local boards of health in 
 17.7   providing outreach and coordination and 
 17.8   reimburse health care providers for 
 17.9   screening and diagnostic tests. 
 17.10  [SEXUALLY TRANSMITTED DISEASE.](a) of 
 17.11  this appropriation, $350,000 in fiscal 
 17.12  year 1999 is from the general fund to 
 17.13  the commissioner to do the following, 
 17.14  in consultation with the HIV/STD 
 17.15  prevention task force and the 
 17.16  commissioner of children, families, and 
 17.17  learning: 
 17.18  (1) $150,000 to conduct a statewide 
 17.19  assessment of need and capacity to 
 17.20  prevent and treat sexually transmitted 
 17.21  diseases and prepare a comprehensive 
 17.22  plan for how to prevent and treat 
 17.23  sexually transmitted diseases, 
 17.24  including strategies for reducing 
 17.25  infection and for increasing access to 
 17.26  treatment; and 
 17.27  (2) $200,000 to conduct research on the 
 17.28  prevalence of sexually transmitted 
 17.29  diseases among populations at highest 
 17.30  risk for infection.  The research may 
 17.31  be done in collaboration with the 
 17.32  University of Minnesota and nonprofit 
 17.33  community health clinics. 
 17.34  (b) This appropriation shall not become 
 17.35  part of the base for the 2000-2001 
 17.36  biennium. 
 17.37  [DIABETES PREVENTION.] Of this 
 17.38  appropriation, $75,000 in fiscal year 
 17.39  1999 from the general fund is to the 
 17.40  commissioner for statewide activities 
 17.41  related to general diabetes prevention, 
 17.42  the development and dissemination of 
 17.43  prevention materials to health care 
 17.44  providers, and for other statewide 
 17.45  activities related to diabetes 
 17.46  prevention and control for targeted 
 17.47  populations who are at high risk for 
 17.48  developing diabetes or health 
 17.49  complications from diabetes. 
 17.50  Sec. 4.  HEALTH-RELATED BOARDS 
 17.51  Subdivision 1.  Total       
 17.52  Appropriation                            113,000        123,000 
 17.53  This appropriation is added to the 
 17.54  appropriation in Laws 1997, chapter 
 17.55  203, article 1, section 5. 
 17.56  [STATE GOVERNMENT SPECIAL REVENUE 
 17.57  FUND.] The appropriations in this 
 17.58  section are from the state government 
 17.59  special revenue fund. 
 17.60  [NO SPENDING IN EXCESS OF REVENUES.] 
 17.61  The commissioner of finance shall not 
 18.1   permit the allotment, encumbrance, or 
 18.2   expenditure of money appropriated in 
 18.3   this section in excess of the 
 18.4   anticipated biennial revenues or 
 18.5   accumulated surplus revenues from fees 
 18.6   collected by the boards.  Neither this 
 18.7   provision nor Minnesota Statutes, 
 18.8   section 214.06, applies to transfers 
 18.9   from the general contingent account. 
 18.10  Subd. 2.  Board of Medical  
 18.11  Practice                                  80,000         90,000
 18.12  Subd. 3.  Board of Veterinary 
 18.13  Medicine                                  33,000         33,000
 18.14  Sec. 5.  EMERGENCY MEDICAL
 18.15  SERVICES BOARD                           -0-             78,000 
 18.16  This appropriation is added to the 
 18.17  appropriation in Laws 1997, chapter 
 18.18  203, article 1, section 6. 
 18.19  [EMERGENCY MEDICAL SERVICES 
 18.20  COMMUNICATIONS NEEDS ASSESSMENT.] (a) 
 18.21  Of this appropriation, $78,000 in 
 18.22  fiscal year 1999 is from the general 
 18.23  fund to the board to conduct an 
 18.24  emergency medical services needs 
 18.25  assessment for areas outside the 
 18.26  seven-county metropolitan area.  The 
 18.27  assessment shall determine the current 
 18.28  status of and need for emergency 
 18.29  medical services communications 
 18.30  equipment.  All regional emergency 
 18.31  medical services programs designated by 
 18.32  the board under Minnesota Statutes, 
 18.33  section 144.8093, shall cooperate in 
 18.34  the preparation of the assessment. 
 18.35  (b) The appropriation for this project 
 18.36  shall be distributed through the 
 18.37  emergency medical services system fund 
 18.38  under Minnesota Statutes, section 
 18.39  144E.50, through a request-for-proposal 
 18.40  process.  The commissioner must select 
 18.41  a regional EMS program that receives at 
 18.42  least 20 percent of its funding from 
 18.43  nonstate sources to conduct the 
 18.44  assessment.  The request for proposals 
 18.45  must be issued by August 1, 1998. 
 18.46  (c) A final report with recommendations 
 18.47  shall be presented to the board and the 
 18.48  legislature by July 1, 1999. 
 18.49  (d) This appropriation shall not become 
 18.50  part of base level funding for the 
 18.51  2000-2001 biennium. 
 18.52  Sec. 6.  [CARRYOVER LIMITATION.] None 
 18.53  of the appropriations in this act which 
 18.54  are allowed to be carried forward from 
 18.55  fiscal year 1998 to fiscal year 1999 
 18.56  shall become part of the base level 
 18.57  funding for the 2000-2001 biennial 
 18.58  budget, unless specifically directed by 
 18.59  the legislature. 
 18.60  Sec. 7.  [SUNSET OF UNCODIFIED 
 18.61  LANGUAGE.] All uncodified language 
 19.1   contained in this article expires on 
 19.2   June 30, 1999, unless a different 
 19.3   expiration date is explicit. 
 19.4                              ARTICLE 2 
 19.5        HEALTH DEPARTMENT AND MISCELLANEOUS HEALTH PROVISIONS
 19.6      Section 1.  Minnesota Statutes 1997 Supplement, section 
 19.7   62J.685, is amended to read: 
 19.8      62J.685 [PRESCRIPTION DRUG PRICE DISCLOSURE.] 
 19.9      By January 1, 1998, and annually thereafter, a health plan 
 19.10  company or hospital licensed under chapter 144 must submit to 
 19.11  the attorney general commissioner of health the total amount of: 
 19.12  (1) aggregate purchases of prescription drugs, and (2) discount, 
 19.13  rebate, or other payment received during the previous calendar 
 19.14  year for aggregate purchases of prescription drugs, including 
 19.15  any fee associated with education, data collection, research, 
 19.16  training or market share movement received from a manufacturer 
 19.17  as defined under section 151.44, paragraph (c), or wholesale 
 19.18  drug distributor as defined under section 151.44, paragraph 
 19.19  (d).  The identification of individual manufacturers or 
 19.20  wholesalers or specific drugs is not required.  The attorney 
 19.21  general commissioner shall make this information available to 
 19.22  the public through the information clearinghouse under section 
 19.23  62J.2930. 
 19.24     Sec. 2.  Minnesota Statutes 1997 Supplement, section 
 19.25  62J.69, subdivision 1, is amended to read: 
 19.26     Subdivision 1.  [DEFINITIONS.] For purposes of this 
 19.27  section, the following definitions apply: 
 19.28     (a) "Medical education" means the accredited clinical 
 19.29  training of physicians (medical students and residents), doctor 
 19.30  of pharmacy practitioners, doctors of chiropractic, dentists, 
 19.31  advanced practice nurses (clinical nurse specialist, certified 
 19.32  registered nurse anesthetists, nurse practitioners, and 
 19.33  certified nurse midwives), and physician assistants. 
 19.34     (b) "Clinical training" means accredited training for the 
 19.35  health care practitioners listed in paragraph (a) that is funded 
 19.36  and was historically funded in part by inpatient patient care 
 19.37  revenues and that occurs in both either an inpatient and or 
 20.1   ambulatory patient care settings training site. 
 20.2      (c) "Trainee" means students involved in an accredited 
 20.3   clinical training program for medical education as defined in 
 20.4   paragraph (a). 
 20.5      (d) "Eligible trainee" means a student involved in an 
 20.6   accredited training program for medical education as defined in 
 20.7   paragraph (a), which meets the definition of clinical training 
 20.8   in paragraph (b), who is in a training site that is located in 
 20.9   Minnesota and which has a medical assistance provider number. 
 20.10     (e) "Health care research" means approved clinical, 
 20.11  outcomes, and health services investigations that are funded by 
 20.12  patient out-of-pocket expenses or a third-party payer. 
 20.13     (e) (f) "Commissioner" means the commissioner of health. 
 20.14     (f) (g) "Teaching institutions" means any hospital, medical 
 20.15  center, clinic, or other organization that currently sponsors or 
 20.16  conducts accredited medical education programs or clinical 
 20.17  research in Minnesota. 
 20.18     (h) "Accredited training" means training provided by a 
 20.19  program that is accredited through an organization recognized by 
 20.20  the department of education or the health care financing 
 20.21  administration as the official accrediting body for that program.
 20.22     (i) "Sponsoring institution" means a hospital, school, or 
 20.23  consortium that sponsors and maintains primary organizational 
 20.24  and financial responsibility for an accredited medical education 
 20.25  program in Minnesota and which is accountable to the accrediting 
 20.26  body. 
 20.27     Sec. 3.  Minnesota Statutes 1997 Supplement, section 
 20.28  62J.69, subdivision 2, is amended to read: 
 20.29     Subd. 2.  [ALLOCATION AND FUNDING FOR MEDICAL EDUCATION AND 
 20.30  RESEARCH.] (a) The commissioner may establish a trust fund for 
 20.31  the purposes of funding medical education and research 
 20.32  activities in the state of Minnesota. 
 20.33     (b) By January 1, 1997, the commissioner may appoint an 
 20.34  advisory committee to provide advice and oversight on the 
 20.35  distribution of funds from the medical education and research 
 20.36  trust fund.  If a committee is appointed, the commissioner 
 21.1   shall:  (1) consider the interest of all stakeholders when 
 21.2   selecting committee members; (2) select members that represent 
 21.3   both urban and rural interest; and (3) select members that 
 21.4   include ambulatory care as well as inpatient perspectives.  The 
 21.5   commissioner shall appoint to the advisory committee 
 21.6   representatives of the following groups:  medical researchers, 
 21.7   public and private academic medical centers, managed care 
 21.8   organizations, Blue Cross and Blue Shield of Minnesota, 
 21.9   commercial carriers, Minnesota Medical Association, Minnesota 
 21.10  Nurses Association, medical product manufacturers, employers, 
 21.11  and other relevant stakeholders, including consumers.  The 
 21.12  advisory committee is governed by section 15.059, for membership 
 21.13  terms and removal of members and will sunset on June 30, 1999. 
 21.14     (c) Eligible applicants for funds are accredited medical 
 21.15  education teaching institutions, consortia, and programs 
 21.16  operating in Minnesota.  Applications must be submitted by the 
 21.17  sponsoring institution on behalf of the teaching program, and 
 21.18  must be received by September 30 of each year for distribution 
 21.19  in January of the following year.  An application for funds must 
 21.20  include the following: 
 21.21     (1) the official name and address of the sponsoring 
 21.22  institution and the official name and address of the facility or 
 21.23  program programs on whose behalf the institution is applying for 
 21.24  funding; 
 21.25     (2) the name, title, and business address of those persons 
 21.26  responsible for administering the funds; 
 21.27     (3) the total number, type, and specialty orientation of 
 21.28  eligible Minnesota-based trainees in for each accredited medical 
 21.29  education program for which funds are being sought the type and 
 21.30  specialty orientation of trainees in the program, the name, 
 21.31  address, and medical assistance provider number of each training 
 21.32  site used in the program, the total number of trainees at each 
 21.33  site, and the total number of eligible trainees at each training 
 21.34  site; 
 21.35     (4) audited clinical training costs per trainee for each 
 21.36  medical education program where available or estimates of 
 22.1   clinical training costs based on audited financial data; 
 22.2      (5) a description of current sources of funding for medical 
 22.3   education costs including a description and dollar amount of all 
 22.4   state and federal financial support, including Medicare direct 
 22.5   and indirect payments; 
 22.6      (6) other revenue received for the purposes of clinical 
 22.7   training; and 
 22.8      (7) a statement identifying unfunded costs; and 
 22.9      (8) other supporting information the commissioner, with 
 22.10  advice from the advisory committee, determines is necessary for 
 22.11  the equitable distribution of funds. 
 22.12     (d) The commissioner shall distribute medical education 
 22.13  funds to all qualifying applicants based on the following basic 
 22.14  criteria:  (1) total medical education funds available; (2) 
 22.15  total eligible trainees in each eligible education program; and 
 22.16  (3) the statewide average cost per trainee, by type of trainee, 
 22.17  in each medical education program.  Funds distributed shall not 
 22.18  be used to displace current funding appropriations from federal 
 22.19  or state sources.  Funds shall be distributed to the sponsoring 
 22.20  institutions indicating the amount to be paid to each of the 
 22.21  sponsor's medical education programs based on the criteria in 
 22.22  this paragraph.  Sponsoring institutions which receive funds 
 22.23  from the trust fund must distribute approved funds to the 
 22.24  medical education program according to the commissioner's 
 22.25  approval letter.  Further, programs must distribute funds among 
 22.26  the sites of training based on the percentage of total program 
 22.27  training performed at each site. as specified in the 
 22.28  commissioner's approval letter.  Any funds not distributed as 
 22.29  directed by the commissioner's approval letter shall be returned 
 22.30  to the medical education and research trust fund within 30 days 
 22.31  of a notice from the commissioner.  The commissioner shall 
 22.32  distribute returned funds to the appropriate entities in 
 22.33  accordance with the commissioner's approval letter. 
 22.34     (e) Medical education programs receiving funds from the 
 22.35  trust fund must submit annual cost and program reports a medical 
 22.36  education and research grant verification report (GVR) through 
 23.1   the sponsoring institution based on criteria established by the 
 23.2   commissioner.  If the sponsoring institution fails to submit the 
 23.3   GVR by the stated deadline, or to request and meet the deadline 
 23.4   for an extension, the sponsoring institution is required to 
 23.5   return the full amount of the medical education and research 
 23.6   trust fund grant to the medical education and research trust 
 23.7   fund within 30 days of a notice from the commissioner.  The 
 23.8   commissioner shall distribute returned funds to the appropriate 
 23.9   entities in accordance with the commissioner's approval letter.  
 23.10  The reports must include:  
 23.11     (1) the total number of eligible trainees in the program; 
 23.12     (2) the programs and residencies funded, the amounts of 
 23.13  trust fund payments to each program, and within each program, 
 23.14  the percentage dollar amount distributed to each training site; 
 23.15  and 
 23.16     (3) the average cost per trainee and a detailed breakdown 
 23.17  of the components of those costs; 
 23.18     (4) other state or federal appropriations received for the 
 23.19  purposes of clinical training; 
 23.20     (5) other revenue received for the purposes of clinical 
 23.21  training; and 
 23.22     (6) other information the commissioner, with advice from 
 23.23  the advisory committee, deems appropriate to evaluate the 
 23.24  effectiveness of the use of funds for clinical training.  
 23.25     The commissioner, with advice from the advisory committee, 
 23.26  will provide an annual summary report to the legislature on 
 23.27  program implementation due February 15 of each year. 
 23.28     (f) The commissioner is authorized to distribute funds made 
 23.29  available through: 
 23.30     (1) voluntary contributions by employers or other entities; 
 23.31     (2) allocations for the department of human services to 
 23.32  support medical education and research; and 
 23.33     (3) other sources as identified and deemed appropriate by 
 23.34  the legislature for inclusion in the trust fund. 
 23.35     (g) The advisory committee shall continue to study and make 
 23.36  recommendations on:  
 24.1      (1) the funding of medical research consistent with work 
 24.2   currently mandated by the legislature and under way at the 
 24.3   department of health; and 
 24.4      (2) the costs and benefits associated with medical 
 24.5   education and research. 
 24.6      Sec. 4.  Minnesota Statutes 1997 Supplement, section 
 24.7   62J.69, is amended by adding a subdivision to read: 
 24.8      Subd. 4.  [TRANSFERS FROM THE COMMISSIONER OF HUMAN 
 24.9   SERVICES.] (a) The amount transferred in accordance with section 
 24.10  256B.69, subdivision 5c, shall be distributed to qualifying 
 24.11  applicants based on a distribution formula that reflects a 
 24.12  summation of two factors: 
 24.13     (1) an education factor, which is determined by the total 
 24.14  number of eligible trainees and the total statewide average 
 24.15  costs per trainee, by type of trainee, in each program; and 
 24.16     (2) a public program volume factor, which is determined by 
 24.17  the total volume of public program revenue received by each 
 24.18  training site as a percentage of all public program revenue 
 24.19  received by all training sites in the trust fund pool.  
 24.20     In this formula, the education factor shall be weighted at 
 24.21  50 percent and the public program volume factor shall be 
 24.22  weighted at 50 percent. 
 24.23     (b) Public program revenue for the above formula shall 
 24.24  include revenue from medical assistance, prepaid medical 
 24.25  assistance, general assistance medical care, and prepaid general 
 24.26  assistance medical care. 
 24.27     (c) Training sites that receive no public program revenue 
 24.28  shall be ineligible for payments from the prepaid medical 
 24.29  assistance program transfer pool. 
 24.30     Sec. 5.  Minnesota Statutes 1997 Supplement, section 
 24.31  62J.75, is amended to read: 
 24.32     62J.75 [CONSUMER ADVISORY BOARD.] 
 24.33     (a) The consumer advisory board consists of 18 members 
 24.34  appointed in accordance with paragraph (b).  All members must be 
 24.35  public, consumer members who: 
 24.36     (1) do not have and never had a material interest in either 
 25.1   the provision of health care services or in an activity directly 
 25.2   related to the provision of health care services, such as health 
 25.3   insurance sales or health plan administration; 
 25.4      (2) are not registered lobbyists; and 
 25.5      (3) are not currently responsible for or directly involved 
 25.6   in the purchasing of health insurance for a business or 
 25.7   organization. 
 25.8      (b) The governor, the speaker of the house of 
 25.9   representatives, and the subcommittee on committees of the 
 25.10  committee on rules and administration of the senate shall each 
 25.11  appoint two members.  The Indian affairs council, the council on 
 25.12  affairs of Chicano/Latino people, the council on Black 
 25.13  Minnesotans, the council on Asian-Pacific Minnesotans, 
 25.14  mid-Minnesota legal assistance, and the Minnesota chamber of 
 25.15  commerce shall each appoint one member.  The member appointed by 
 25.16  the Minnesota chamber of commerce must represent small business 
 25.17  interests.  The health care campaign of Minnesota, Minnesotans 
 25.18  for affordable health care, and consortium for citizens with 
 25.19  disabilities shall each appoint two members.  Members serve 
 25.20  without compensation or reimbursement for expenses. Members may 
 25.21  be compensated in accordance with section 15.059, subdivision 3. 
 25.22     (c) The board shall advise the commissioners of health and 
 25.23  commerce on the following: 
 25.24     (1) the needs of health care consumers and how to better 
 25.25  serve and educate the consumers on health care concerns and 
 25.26  recommend solutions to identified problems; and 
 25.27     (2) consumer protection issues in the self-insured market, 
 25.28  including, but not limited to, public education needs. 
 25.29     The board also may make recommendations to the legislature 
 25.30  on these issues. 
 25.31     (d) The board and this section expire June 30, 2001. 
 25.32     Sec. 6.  Minnesota Statutes 1997 Supplement, section 
 25.33  103I.208, subdivision 2, is amended to read: 
 25.34     Subd. 2.  [PERMIT FEE.] The permit fee to be paid by a 
 25.35  property owner is:  
 25.36     (1) for a well that is not in use under a maintenance 
 26.1   permit, $100 annually; 
 26.2      (2) for construction of a monitoring well, $120, which 
 26.3   includes the state core function fee; 
 26.4      (3) for a monitoring well that is unsealed under a 
 26.5   maintenance permit, $100 annually; 
 26.6      (4) for monitoring wells used as a leak detection device at 
 26.7   a single motor fuel retail outlet or, a single petroleum bulk 
 26.8   storage site excluding tank farms, or a single agricultural 
 26.9   chemical facility site, the construction permit fee is $120, 
 26.10  which includes the state core function fee, per site regardless 
 26.11  of the number of wells constructed on the site, and the annual 
 26.12  fee for a maintenance permit for unsealed monitoring wells is 
 26.13  $100 per site regardless of the number of monitoring wells 
 26.14  located on site; 
 26.15     (5) for a groundwater thermal exchange device, in addition 
 26.16  to the notification fee for wells, $120, which includes the 
 26.17  state core function fee; 
 26.18     (6) for a vertical heat exchanger, $120; 
 26.19     (7) for a dewatering well that is unsealed under a 
 26.20  maintenance permit, $100 annually for each well, except a 
 26.21  dewatering project comprising more than five wells shall be 
 26.22  issued a single permit for $500 annually for wells recorded on 
 26.23  the permit; and 
 26.24     (8) for excavating holes for the purpose of installing 
 26.25  elevator shafts, $120 for each hole. 
 26.26     Sec. 7.  Minnesota Statutes 1997 Supplement, section 
 26.27  144.1494, subdivision 1, is amended to read: 
 26.28     Subdivision 1.  [CREATION OF ACCOUNT.] A rural physician 
 26.29  education account is established in the health care access 
 26.30  fund.  The commissioner shall use money from the account to 
 26.31  establish a loan forgiveness program for medical residents 
 26.32  agreeing to practice in designated rural areas, as defined by 
 26.33  the commissioner.  Appropriations made to this account are 
 26.34  available until expended. 
 26.35     Sec. 8.  Minnesota Statutes 1996, section 144.701, 
 26.36  subdivision 1, is amended to read: 
 27.1      Subdivision 1.  [CONSUMER INFORMATION.] The commissioner of 
 27.2   health shall ensure that the total costs, total 
 27.3   revenues, overall utilization, and total services of each 
 27.4   hospital and each outpatient surgical center are reported to the 
 27.5   public in a form understandable to consumers.  
 27.6      Sec. 9.  Minnesota Statutes 1996, section 144.701, 
 27.7   subdivision 2, is amended to read: 
 27.8      Subd. 2.  [DATA FOR POLICY MAKING.] The commissioner of 
 27.9   health shall compile relevant financial and accounting, 
 27.10  utilization, and services data concerning hospitals and 
 27.11  outpatient surgical centers in order to have statistical 
 27.12  information available for legislative policy making. 
 27.13     Sec. 10.  Minnesota Statutes 1996, section 144.701, 
 27.14  subdivision 4, is amended to read: 
 27.15     Subd. 4.  [FILING FEES.] Each report which is required to 
 27.16  be submitted to the commissioner of health under sections 
 27.17  144.695 to 144.703 and which is not submitted to a voluntary, 
 27.18  nonprofit reporting organization in accordance with section 
 27.19  144.702 shall be accompanied by a filing fee in an amount 
 27.20  prescribed by rule of the commissioner of health.  Fees received 
 27.21  pursuant to this subdivision shall be deposited in the general 
 27.22  fund of the state treasury.  Upon the withdrawal of approval of 
 27.23  a reporting organization, or the decision of the commissioner to 
 27.24  not renew a reporting organization, fees collected under section 
 27.25  144.702 shall be submitted to the commissioner and deposited in 
 27.26  the general fund.  Fees received under this subdivision shall be 
 27.27  deposited in a revolving fund and are hereby appropriated to the 
 27.28  commissioner of health for the purposes of sections 144.695 to 
 27.29  144.703.  The commissioner shall report the termination or 
 27.30  nonrenewal of the voluntary reporting organization to the chair 
 27.31  of the health and human services subdivision of the 
 27.32  appropriations committee of the house of representatives, to the 
 27.33  chair of the health and human services division of the finance 
 27.34  committee of the senate, and the commissioner of finance. 
 27.35     Sec. 11.  Minnesota Statutes 1996, section 144.702, 
 27.36  subdivision 1, is amended to read: 
 28.1      Subdivision 1.  [REPORTING THROUGH A REPORTING 
 28.2   ORGANIZATION.] A hospital or outpatient surgical center may 
 28.3   agree to submit its financial, utilization, and services reports 
 28.4   to a voluntary, nonprofit reporting organization whose reporting 
 28.5   procedures have been approved by the commissioner of health in 
 28.6   accordance with this section.  Each report submitted under this 
 28.7   section shall be accompanied by a filing fee to the voluntary, 
 28.8   nonprofit reporting organization. 
 28.9      Sec. 12.  Minnesota Statutes 1996, section 144.702, 
 28.10  subdivision 2, is amended to read: 
 28.11     Subd. 2.  [APPROVAL OF ORGANIZATION'S REPORTING 
 28.12  PROCEDURES.] The commissioner of health may approve voluntary 
 28.13  reporting procedures consistent with written operating 
 28.14  requirements for the voluntary, nonprofit reporting organization 
 28.15  which shall be established annually by the commissioner.  These 
 28.16  written operating requirements shall specify reports, analyses, 
 28.17  and other deliverables to be produced by the voluntary, 
 28.18  nonprofit reporting organization, and the dates on which those 
 28.19  deliverables must be submitted to the commissioner.  These 
 28.20  written operating requirements shall specify deliverable dates 
 28.21  sufficient to enable the commissioner of health to process and 
 28.22  report health care cost information system data to the 
 28.23  commissioner of human services by August 15 of each year.  The 
 28.24  commissioner of health shall, by rule, prescribe standards for 
 28.25  submission of data by hospitals and outpatient surgical centers 
 28.26  to the voluntary, nonprofit reporting organization or to the 
 28.27  commissioner.  These standards shall provide for: 
 28.28     (a) the filing of appropriate financial, utilization, and 
 28.29  services information with the reporting organization; 
 28.30     (b) adequate analysis and verification of that financial, 
 28.31  utilization, and services information; and 
 28.32     (c) timely publication of the costs, revenues, and rates of 
 28.33  individual hospitals and outpatient surgical centers prior to 
 28.34  the effective date of any proposed rate increase.  The 
 28.35  commissioner of health shall annually review the procedures 
 28.36  approved pursuant to this subdivision. 
 29.1      Sec. 13.  Minnesota Statutes 1996, section 144.702, 
 29.2   subdivision 8, is amended to read: 
 29.3      Subd. 8.  [TERMINATION OR NONRENEWAL OF REPORTING 
 29.4   ORGANIZATION.] The commissioner may withdraw approval of any 
 29.5   voluntary, nonprofit reporting organization for failure on the 
 29.6   part of the voluntary, nonprofit reporting organization to 
 29.7   comply with the written operating requirements under subdivision 
 29.8   2.  Upon the effective date of the withdrawal, all funds 
 29.9   collected by the voluntary, nonprofit reporting organization 
 29.10  under section 144.701 144.702, subdivision 4 1, but not expended 
 29.11  shall be deposited in the general fund a revolving fund and are 
 29.12  hereby appropriated to the commissioner of health for the 
 29.13  purposes of sections 144.695 to 144.703. 
 29.14     The commissioner may choose not to renew approval of a 
 29.15  voluntary, nonprofit reporting organization if the organization 
 29.16  has failed to perform its obligations satisfactorily under the 
 29.17  written operating requirements under subdivision 2. 
 29.18     Sec. 14.  [144.7022] [ADMINISTRATIVE PENALTY ORDERS FOR 
 29.19  REPORTING ORGANIZATIONS.] 
 29.20     Subdivision 1.  [AUTHORIZATION.] The commissioner may issue 
 29.21  an order to the voluntary, nonprofit reporting organization 
 29.22  requiring violations to be corrected and administratively assess 
 29.23  monetary penalties for violations of this chapter or rules, 
 29.24  written operating requirements, orders, stipulation agreements, 
 29.25  settlements, or compliance agreements adopted, enforced, or 
 29.26  issued by the commissioner. 
 29.27     Subd. 2.  [CONTENTS OF ORDER.] An order assessing an 
 29.28  administrative penalty under this section must include: 
 29.29     (1) a concise statement of the facts alleged to constitute 
 29.30  a violation; 
 29.31     (2) a reference to the section of law, rule, written 
 29.32  operating requirement, order, stipulation agreement, settlement, 
 29.33  or compliance agreement that has been violated; 
 29.34     (3) a statement of the amount of the administrative penalty 
 29.35  to be imposed and the factors upon which the penalty is based; 
 29.36     (4) a statement of the corrective actions necessary to 
 30.1   correct the violation; and 
 30.2      (5) a statement of the right to request a hearing according 
 30.3   to sections 14.57 to 14.62. 
 30.4      Subd. 3.  [CONCURRENT CORRECTIVE ORDER.] The commissioner 
 30.5   may issue an order assessing an administrative penalty and 
 30.6   requiring the violations cited in the order be corrected within 
 30.7   30 calendar days from the date the order is received.  The 
 30.8   voluntary, nonprofit reporting organization that is subject to 
 30.9   the order shall provide to the commissioner before the 31st day 
 30.10  after the order was received, information demonstrating that the 
 30.11  violation has been corrected or that a corrective plan, 
 30.12  acceptable to the commissioner, has been developed.  The 
 30.13  commissioner shall determine whether the violation has been 
 30.14  corrected and notify the voluntary, nonprofit reporting 
 30.15  organization of the commissioner's determination. 
 30.16     Subd. 4.  [PENALTY.] If the commissioner determines that 
 30.17  the violation has been corrected or an acceptable corrective 
 30.18  plan has been developed, the penalty may be forgiven, except, 
 30.19  where there are repeated or serious violations, the commissioner 
 30.20  may issue an order with a penalty that will not be forgiven 
 30.21  after corrective action is taken.  Unless there is a request for 
 30.22  review of the order under subdivision 6 before the penalty is 
 30.23  due, the penalty is due and payable: 
 30.24     (1) on the 31st calendar day after the order was received, 
 30.25  if the voluntary, nonprofit reporting organization fails to 
 30.26  provide information to the commissioner showing that the 
 30.27  violation has been corrected or that appropriate steps have been 
 30.28  taken toward correcting the violation; 
 30.29     (2) on the 20th day after the voluntary, nonprofit 
 30.30  reporting organization receives the commissioner's determination 
 30.31  that the information provided is not sufficient to show that 
 30.32  either the violation has been corrected or that appropriate 
 30.33  steps have been taken toward correcting the violation; or 
 30.34     (3) on the 31st day after the order was received where the 
 30.35  penalty is for repeated or serious violations and, according to 
 30.36  the order issued, the penalty will not be forgiven after 
 31.1   corrective action is taken. 
 31.2      All penalties due under this section are payable to the 
 31.3   treasurer, state of Minnesota, and shall be credited to the 
 31.4   general fund. 
 31.5      Subd. 5.  [AMOUNT OF PENALTY; CONSIDERATIONS.] (a) The 
 31.6   maximum amount of an administrative penalty order is $5,000 for 
 31.7   each specific violation identified in an inspection, 
 31.8   investigation, or compliance review, up to an annual maximum 
 31.9   total for all violations of ten percent of the fees collected by 
 31.10  the voluntary, nonprofit reporting organization under section 
 31.11  144.702, subdivision 1.  The annual maximum is based on a 
 31.12  reporting year. 
 31.13     (b) In determining the amount of the administrative 
 31.14  penalty, the commissioner shall consider the following: 
 31.15     (1) the willfulness of the violation; 
 31.16     (2) the gravity of the violation; 
 31.17     (3) the history of past violations; 
 31.18     (4) the number of violations; 
 31.19     (5) the economic benefit gained by the person allowing or 
 31.20  committing the violation; and 
 31.21     (6) other factors as justice may require, if the 
 31.22  commissioner specifically identifies the additional factors in 
 31.23  the commissioner's order. 
 31.24     (c) In determining the amount of a penalty for a violation 
 31.25  subsequent to an initial violation under paragraph (a), the 
 31.26  commissioner shall also consider: 
 31.27     (1) the similarity of the most recent previous violation 
 31.28  and the violation to be penalized; 
 31.29     (2) the time elapsed since the last violation; and 
 31.30     (3) the response of the voluntary, nonprofit reporting 
 31.31  organization to the most recent previous violation. 
 31.32     Subd. 6.  [REQUEST FOR HEARING; HEARING; AND FINAL 
 31.33  ORDER.] A request for hearing must be in writing, delivered to 
 31.34  the commissioner by certified mail within 20 calendar days after 
 31.35  the receipt of the order, and specifically state the reasons for 
 31.36  seeking review of the order.  The commissioner must initiate a 
 32.1   hearing within 30 calendar days from the date of receipt of the 
 32.2   written request for hearing.  The hearing shall be conducted 
 32.3   pursuant to the contested case procedures in sections 14.57 to 
 32.4   14.62.  No earlier than ten calendar days after and within 30 
 32.5   calendar days of receipt of the presiding administrative law 
 32.6   judge's report, the commissioner shall, based on all relevant 
 32.7   facts, issue a final order modifying, vacating, or making the 
 32.8   original order permanent.  If, within 20 calendar days of 
 32.9   receipt of the original order, the voluntary, nonprofit 
 32.10  reporting organization fails to request a hearing in writing, 
 32.11  the order becomes the final order of the commissioner. 
 32.12     Subd. 7.  [REVIEW OF FINAL ORDER AND PAYMENT OF 
 32.13  PENALTY.] Once the commissioner issues a final order, any 
 32.14  penalty due under that order shall be paid within 30 calendar 
 32.15  days after the date of the final order, unless review of the 
 32.16  final order is requested.  The final order of the commissioner 
 32.17  may be appealed in the manner prescribed in sections 14.63 to 
 32.18  14.69.  If the final order is reviewed and upheld, the penalty 
 32.19  shall be paid 30 calendar days after the date of the decision of 
 32.20  the reviewing court.  Failure to request an administrative 
 32.21  hearing pursuant to subdivision 6 shall constitute a waiver of 
 32.22  the right to further agency or judicial review of the final 
 32.23  order. 
 32.24     Subd. 8.  [REINSPECTIONS AND EFFECT OF NONCOMPLIANCE.] If, 
 32.25  upon reinspection, or in the determination of the commissioner, 
 32.26  it is found that any deficiency specified in the order has not 
 32.27  been corrected or an acceptable corrective plan has not been 
 32.28  developed, the voluntary, nonprofit reporting organization is in 
 32.29  noncompliance.  The commissioner shall issue a notice of 
 32.30  noncompliance and may impose any additional remedy available 
 32.31  under this chapter. 
 32.32     Subd. 9.  [ENFORCEMENT.] The attorney general may proceed 
 32.33  on behalf of the commissioner to enforce penalties that are due 
 32.34  and payable under this section in any manner provided by law for 
 32.35  the collection of debts. 
 32.36     Subd. 10.  [TERMINATION OR NONRENEWAL OF REPORTING 
 33.1   ORGANIZATION.] The commissioner may withdraw or not renew 
 33.2   approval of any voluntary, nonprofit reporting organization for 
 33.3   failure on the part of the voluntary, nonprofit reporting 
 33.4   organization to pay penalties owed under this section. 
 33.5      Subd. 11.  [CUMULATIVE REMEDY.] The authority of the 
 33.6   commissioner to issue an administrative penalty order is in 
 33.7   addition to other lawfully available remedies. 
 33.8      Subd. 12.  [MEDIATION.] In addition to review under 
 33.9   subdivision 6, the commissioner is authorized to enter into 
 33.10  mediation concerning an order issued under this section if the 
 33.11  commissioner and the voluntary, nonprofit reporting organization 
 33.12  agree to mediation. 
 33.13     Sec. 15.  Minnesota Statutes 1996, section 144A.44, 
 33.14  subdivision 2, is amended to read: 
 33.15     Subd. 2.  [INTERPRETATION AND ENFORCEMENT OF RIGHTS.] These 
 33.16  rights are established for the benefit of persons who receive 
 33.17  home care services.  "Home care services" means home care 
 33.18  services as defined in section 144A.43, subdivision 3.  A home 
 33.19  care provider may not require a person to surrender these rights 
 33.20  as a condition of receiving services.  A guardian or conservator 
 33.21  or, when there is no guardian or conservator, a designated 
 33.22  person, may seek to enforce these rights.  This statement of 
 33.23  rights does not replace or diminish other rights and liberties 
 33.24  that may exist relative to persons receiving home care services, 
 33.25  persons providing home care services, or providers licensed 
 33.26  under Laws 1987, chapter 378.  A copy of these rights must be 
 33.27  provided to an individual at the time home care services are 
 33.28  initiated.  The copy shall also contain the address and phone 
 33.29  number of the office of health facility complaints and the 
 33.30  office of the ombudsman for older Minnesotans and a brief 
 33.31  statement describing how to file a complaint with that office 
 33.32  these offices.  Information about how to contact the office of 
 33.33  the ombudsman for older Minnesotans shall be included in notices 
 33.34  of change in client fees and in notices from home care providers 
 33.35  transferring or discontinuing services. 
 33.36     Sec. 16.  [145.926] [ABSTINENCE EDUCATION GRANT PROGRAM.] 
 34.1      The commissioner of health shall expend federal funds for 
 34.2   abstinence education programs provided under United States Code, 
 34.3   title 42, section 710, and state matching funds for abstinence 
 34.4   education programs only to an abstinence education program that 
 34.5   complies with the state plan that has been submitted to and 
 34.6   approved by the federal Department of Health and Human Services. 
 34.7      Sec. 17.  Minnesota Statutes 1996, section 214.03, is 
 34.8   amended to read: 
 34.9      214.03 [STANDARDIZED TESTS.] 
 34.10     (a) All state examining and licensing boards, other than 
 34.11  the state board of law examiners, the state board of 
 34.12  professional responsibility or any other board established by 
 34.13  the supreme court to regulate the practice of law and judicial 
 34.14  functions, shall use national standardized tests for the 
 34.15  objective, nonpractical portion of any examination given to 
 34.16  prospective licensees to the extent that such national 
 34.17  standardized tests are appropriate, except when the subject 
 34.18  matter of the examination relates to the application of 
 34.19  Minnesota law to the profession or calling being licensed.  
 34.20     (b) The health-related boards may establish an account in 
 34.21  the special revenue fund to deposit applicant payments for 
 34.22  national or regional standardized tests.  Money in the account 
 34.23  is appropriated to pay for the use of national or regional 
 34.24  standardized tests. 
 34.25     Sec. 18.  Minnesota Statutes 1997 Supplement, section 
 34.26  214.32, subdivision 1, is amended to read: 
 34.27     Subdivision 1.  [MANAGEMENT.] (a) A health professionals 
 34.28  services program committee is established, consisting of one 
 34.29  person appointed by each participating board, with each 
 34.30  participating board having one vote.  The committee shall 
 34.31  designate one board to provide administrative management of the 
 34.32  program, set the program budget and the pro rata share of 
 34.33  program expenses to be borne by each participating board, 
 34.34  provide guidance on the general operation of the program, 
 34.35  including hiring of program personnel, and ensure that the 
 34.36  program's direction is in accord with its authority.  No more 
 35.1   than half plus one of the members of the committee may be of one 
 35.2   gender.  If the participating boards change the board designated 
 35.3   to provide administrative management of the program, any 
 35.4   appropriation remaining for the program shall transfer to the 
 35.5   newly designated board.  The boards must inform the chairs of 
 35.6   the senate health and family security budget division and the 
 35.7   house health and human services finance division, and the 
 35.8   commissioner of finance of any change in administrative 
 35.9   management of the program and of the amount transferred to the 
 35.10  newly designated board.  
 35.11     (b) The designated board, upon recommendation of the health 
 35.12  professional services program committee, shall hire the program 
 35.13  manager and employees and pay expenses of the program from funds 
 35.14  appropriated for that purpose.  The designated board may apply 
 35.15  for grants to pay program expenses and may enter into contracts 
 35.16  on behalf of the program to carry out the purposes of the 
 35.17  program.  The participating boards shall enter into written 
 35.18  agreements with the designated board. 
 35.19     (c) An advisory committee is established to advise the 
 35.20  program committee consisting of: 
 35.21     (1) one member appointed by each of the following:  the 
 35.22  Minnesota Academy of Physician Assistants, the Minnesota Dental 
 35.23  Association, the Minnesota Chiropractic Association, the 
 35.24  Minnesota Licensed Practical Nurse Association, the Minnesota 
 35.25  Medical Association, the Minnesota Nurses Association, and the 
 35.26  Minnesota Podiatric Medicine Association; 
 35.27     (2) one member appointed by each of the professional 
 35.28  associations of the other professions regulated by a 
 35.29  participating board not specified in clause (1); and 
 35.30     (3) two public members, as defined by section 214.02.  
 35.31  Members of the advisory committee shall be appointed for two 
 35.32  years and members may be reappointed.  
 35.33     No more than half plus one of the members of the committee 
 35.34  may be of one gender. 
 35.35     The advisory committee expires June 30, 2001. 
 35.36     Sec. 19.  [REPORT BY THE UNIVERSITY OF MINNESOTA ACADEMIC 
 36.1   HEALTH CENTER.] 
 36.2      The University of Minnesota academic health center, after 
 36.3   consultation with the health care community and the medical 
 36.4   education and research costs advisory committee, is requested to 
 36.5   report to the commissioner of health and the legislative 
 36.6   commission on health care access by January 15, 1999, on plans 
 36.7   for the strategic direction and vision of the academic health 
 36.8   center.  The report shall address plans for the ongoing 
 36.9   assessment of health provider workforce needs; plans for the 
 36.10  ongoing assessment of the educational needs of health 
 36.11  professionals and the implications for their education and 
 36.12  training programs; and plans for ongoing, meaningful input from 
 36.13  the health care community on health-related research and 
 36.14  education programs administered by the academic health center. 
 36.15     Sec. 20.  [ADVICE AND RECOMMENDATIONS.] 
 36.16     The commissioners of health and commerce shall convene an 
 36.17  ad hoc advisory panel of selected representatives of health plan 
 36.18  companies, purchasers, and provider groups engaged in the 
 36.19  practice of health care in Minnesota, and interested 
 36.20  legislators.  This advisory panel shall meet and assist the 
 36.21  commissioners in developing measures to prevent discrimination 
 36.22  against providers and provider groups in managed care in 
 36.23  Minnesota and clarify the requirements of Minnesota Statutes, 
 36.24  section 62Q.23, paragraph (c).  Any such measures shall be 
 36.25  reported to the legislature prior to November 15, 1998.  
 36.26     Sec. 21.  [EFFECTIVE DATE.] 
 36.27     Section 20 is effective the day following final enactment. 
 36.28                             ARTICLE 3 
 36.29                           LONG-TERM CARE 
 36.30     Section 1.  Minnesota Statutes 1997 Supplement, section 
 36.31  144A.071, subdivision 4a, is amended to read: 
 36.32     Subd. 4a.  [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 
 36.33  best interest of the state to ensure that nursing homes and 
 36.34  boarding care homes continue to meet the physical plant 
 36.35  licensing and certification requirements by permitting certain 
 36.36  construction projects.  Facilities should be maintained in 
 37.1   condition to satisfy the physical and emotional needs of 
 37.2   residents while allowing the state to maintain control over 
 37.3   nursing home expenditure growth. 
 37.4      The commissioner of health in coordination with the 
 37.5   commissioner of human services, may approve the renovation, 
 37.6   replacement, upgrading, or relocation of a nursing home or 
 37.7   boarding care home, under the following conditions: 
 37.8      (a) to license or certify beds in a new facility 
 37.9   constructed to replace a facility or to make repairs in an 
 37.10  existing facility that was destroyed or damaged after June 30, 
 37.11  1987, by fire, lightning, or other hazard provided:  
 37.12     (i) destruction was not caused by the intentional act of or 
 37.13  at the direction of a controlling person of the facility; 
 37.14     (ii) at the time the facility was destroyed or damaged the 
 37.15  controlling persons of the facility maintained insurance 
 37.16  coverage for the type of hazard that occurred in an amount that 
 37.17  a reasonable person would conclude was adequate; 
 37.18     (iii) the net proceeds from an insurance settlement for the 
 37.19  damages caused by the hazard are applied to the cost of the new 
 37.20  facility or repairs; 
 37.21     (iv) the new facility is constructed on the same site as 
 37.22  the destroyed facility or on another site subject to the 
 37.23  restrictions in section 144A.073, subdivision 5; 
 37.24     (v) the number of licensed and certified beds in the new 
 37.25  facility does not exceed the number of licensed and certified 
 37.26  beds in the destroyed facility; and 
 37.27     (vi) the commissioner determines that the replacement beds 
 37.28  are needed to prevent an inadequate supply of beds. 
 37.29  Project construction costs incurred for repairs authorized under 
 37.30  this clause shall not be considered in the dollar threshold 
 37.31  amount defined in subdivision 2; 
 37.32     (b) to license or certify beds that are moved from one 
 37.33  location to another within a nursing home facility, provided the 
 37.34  total costs of remodeling performed in conjunction with the 
 37.35  relocation of beds does not exceed $750,000; 
 37.36     (c) to license or certify beds in a project recommended for 
 38.1   approval under section 144A.073; 
 38.2      (d) to license or certify beds that are moved from an 
 38.3   existing state nursing home to a different state facility, 
 38.4   provided there is no net increase in the number of state nursing 
 38.5   home beds; 
 38.6      (e) to certify and license as nursing home beds boarding 
 38.7   care beds in a certified boarding care facility if the beds meet 
 38.8   the standards for nursing home licensure, or in a facility that 
 38.9   was granted an exception to the moratorium under section 
 38.10  144A.073, and if the cost of any remodeling of the facility does 
 38.11  not exceed $750,000.  If boarding care beds are licensed as 
 38.12  nursing home beds, the number of boarding care beds in the 
 38.13  facility must not increase beyond the number remaining at the 
 38.14  time of the upgrade in licensure.  The provisions contained in 
 38.15  section 144A.073 regarding the upgrading of the facilities do 
 38.16  not apply to facilities that satisfy these requirements; 
 38.17     (f) to license and certify up to 40 beds transferred from 
 38.18  an existing facility owned and operated by the Amherst H. Wilder 
 38.19  Foundation in the city of St. Paul to a new unit at the same 
 38.20  location as the existing facility that will serve persons with 
 38.21  Alzheimer's disease and other related disorders.  The transfer 
 38.22  of beds may occur gradually or in stages, provided the total 
 38.23  number of beds transferred does not exceed 40.  At the time of 
 38.24  licensure and certification of a bed or beds in the new unit, 
 38.25  the commissioner of health shall delicense and decertify the 
 38.26  same number of beds in the existing facility.  As a condition of 
 38.27  receiving a license or certification under this clause, the 
 38.28  facility must make a written commitment to the commissioner of 
 38.29  human services that it will not seek to receive an increase in 
 38.30  its property-related payment rate as a result of the transfers 
 38.31  allowed under this paragraph; 
 38.32     (g) to license and certify nursing home beds to replace 
 38.33  currently licensed and certified boarding care beds which may be 
 38.34  located either in a remodeled or renovated boarding care or 
 38.35  nursing home facility or in a remodeled, renovated, newly 
 38.36  constructed, or replacement nursing home facility within the 
 39.1   identifiable complex of health care facilities in which the 
 39.2   currently licensed boarding care beds are presently located, 
 39.3   provided that the number of boarding care beds in the facility 
 39.4   or complex are decreased by the number to be licensed as nursing 
 39.5   home beds and further provided that, if the total costs of new 
 39.6   construction, replacement, remodeling, or renovation exceed ten 
 39.7   percent of the appraised value of the facility or $200,000, 
 39.8   whichever is less, the facility makes a written commitment to 
 39.9   the commissioner of human services that it will not seek to 
 39.10  receive an increase in its property-related payment rate by 
 39.11  reason of the new construction, replacement, remodeling, or 
 39.12  renovation.  The provisions contained in section 144A.073 
 39.13  regarding the upgrading of facilities do not apply to facilities 
 39.14  that satisfy these requirements; 
 39.15     (h) to license as a nursing home and certify as a nursing 
 39.16  facility a facility that is licensed as a boarding care facility 
 39.17  but not certified under the medical assistance program, but only 
 39.18  if the commissioner of human services certifies to the 
 39.19  commissioner of health that licensing the facility as a nursing 
 39.20  home and certifying the facility as a nursing facility will 
 39.21  result in a net annual savings to the state general fund of 
 39.22  $200,000 or more; 
 39.23     (i) to certify, after September 30, 1992, and prior to July 
 39.24  1, 1993, existing nursing home beds in a facility that was 
 39.25  licensed and in operation prior to January 1, 1992; 
 39.26     (j) to license and certify new nursing home beds to replace 
 39.27  beds in a facility condemned acquired by the Minneapolis 
 39.28  Community Development Agency as part of an economic 
 39.29  redevelopment plan activities in a city of the first class, 
 39.30  provided the new facility is located within one mile three miles 
 39.31  of the site of the old facility.  Operating and property costs 
 39.32  for the new facility must be determined and allowed 
 39.33  under existing reimbursement rules section 256B.431 or 256B.434; 
 39.34     (k) to license and certify up to 20 new nursing home beds 
 39.35  in a community-operated hospital and attached convalescent and 
 39.36  nursing care facility with 40 beds on April 21, 1991, that 
 40.1   suspended operation of the hospital in April 1986.  The 
 40.2   commissioner of human services shall provide the facility with 
 40.3   the same per diem property-related payment rate for each 
 40.4   additional licensed and certified bed as it will receive for its 
 40.5   existing 40 beds; 
 40.6      (l) to license or certify beds in renovation, replacement, 
 40.7   or upgrading projects as defined in section 144A.073, 
 40.8   subdivision 1, so long as the cumulative total costs of the 
 40.9   facility's remodeling projects do not exceed $750,000; 
 40.10     (m) to license and certify beds that are moved from one 
 40.11  location to another for the purposes of converting up to five 
 40.12  four-bed wards to single or double occupancy rooms in a nursing 
 40.13  home that, as of January 1, 1993, was county-owned and had a 
 40.14  licensed capacity of 115 beds; 
 40.15     (n) to allow a facility that on April 16, 1993, was a 
 40.16  106-bed licensed and certified nursing facility located in 
 40.17  Minneapolis to layaway all of its licensed and certified nursing 
 40.18  home beds.  These beds may be relicensed and recertified in a 
 40.19  newly-constructed teaching nursing home facility affiliated with 
 40.20  a teaching hospital upon approval by the legislature.  The 
 40.21  proposal must be developed in consultation with the interagency 
 40.22  committee on long-term care planning.  The beds on layaway 
 40.23  status shall have the same status as voluntarily delicensed and 
 40.24  decertified beds, except that beds on layaway status remain 
 40.25  subject to the surcharge in section 256.9657.  This layaway 
 40.26  provision expires July 1, 1998; 
 40.27     (o) to allow a project which will be completed in 
 40.28  conjunction with an approved moratorium exception project for a 
 40.29  nursing home in southern Cass county and which is directly 
 40.30  related to that portion of the facility that must be repaired, 
 40.31  renovated, or replaced, to correct an emergency plumbing problem 
 40.32  for which a state correction order has been issued and which 
 40.33  must be corrected by August 31, 1993; 
 40.34     (p) to allow a facility that on April 16, 1993, was a 
 40.35  368-bed licensed and certified nursing facility located in 
 40.36  Minneapolis to layaway, upon 30 days prior written notice to the 
 41.1   commissioner, up to 30 of the facility's licensed and certified 
 41.2   beds by converting three-bed wards to single or double 
 41.3   occupancy.  Beds on layaway status shall have the same status as 
 41.4   voluntarily delicensed and decertified beds except that beds on 
 41.5   layaway status remain subject to the surcharge in section 
 41.6   256.9657, remain subject to the license application and renewal 
 41.7   fees under section 144A.07 and shall be subject to a $100 per 
 41.8   bed reactivation fee.  In addition, at any time within three 
 41.9   years of the effective date of the layaway, the beds on layaway 
 41.10  status may be: 
 41.11     (1) relicensed and recertified upon relocation and 
 41.12  reactivation of some or all of the beds to an existing licensed 
 41.13  and certified facility or facilities located in Pine River, 
 41.14  Brainerd, or International Falls; provided that the total 
 41.15  project construction costs related to the relocation of beds 
 41.16  from layaway status for any facility receiving relocated beds 
 41.17  may not exceed the dollar threshold provided in subdivision 2 
 41.18  unless the construction project has been approved through the 
 41.19  moratorium exception process under section 144A.073; 
 41.20     (2) relicensed and recertified, upon reactivation of some 
 41.21  or all of the beds within the facility which placed the beds in 
 41.22  layaway status, if the commissioner has determined a need for 
 41.23  the reactivation of the beds on layaway status. 
 41.24     The property-related payment rate of a facility placing 
 41.25  beds on layaway status must be adjusted by the incremental 
 41.26  change in its rental per diem after recalculating the rental per 
 41.27  diem as provided in section 256B.431, subdivision 3a, paragraph 
 41.28  (d).  The property-related payment rate for a facility 
 41.29  relicensing and recertifying beds from layaway status must be 
 41.30  adjusted by the incremental change in its rental per diem after 
 41.31  recalculating its rental per diem using the number of beds after 
 41.32  the relicensing to establish the facility's capacity day 
 41.33  divisor, which shall be effective the first day of the month 
 41.34  following the month in which the relicensing and recertification 
 41.35  became effective.  Any beds remaining on layaway status more 
 41.36  than three years after the date the layaway status became 
 42.1   effective must be removed from layaway status and immediately 
 42.2   delicensed and decertified; 
 42.3      (q) to license and certify beds in a renovation and 
 42.4   remodeling project to convert 12 four-bed wards into 24 two-bed 
 42.5   rooms, expand space, and add improvements in a nursing home 
 42.6   that, as of January 1, 1994, met the following conditions:  the 
 42.7   nursing home was located in Ramsey county; had a licensed 
 42.8   capacity of 154 beds; and had been ranked among the top 15 
 42.9   applicants by the 1993 moratorium exceptions advisory review 
 42.10  panel.  The total project construction cost estimate for this 
 42.11  project must not exceed the cost estimate submitted in 
 42.12  connection with the 1993 moratorium exception process; 
 42.13     (r) to license and certify up to 117 beds that are 
 42.14  relocated from a licensed and certified 138-bed nursing facility 
 42.15  located in St. Paul to a hospital with 130 licensed hospital 
 42.16  beds located in South St. Paul, provided that the nursing 
 42.17  facility and hospital are owned by the same or a related 
 42.18  organization and that prior to the date the relocation is 
 42.19  completed the hospital ceases operation of its inpatient 
 42.20  hospital services at that hospital.  After relocation, the 
 42.21  nursing facility's status under section 256B.431, subdivision 
 42.22  2j, shall be the same as it was prior to relocation.  The 
 42.23  nursing facility's property-related payment rate resulting from 
 42.24  the project authorized in this paragraph shall become effective 
 42.25  no earlier than April 1, 1996.  For purposes of calculating the 
 42.26  incremental change in the facility's rental per diem resulting 
 42.27  from this project, the allowable appraised value of the nursing 
 42.28  facility portion of the existing health care facility physical 
 42.29  plant prior to the renovation and relocation may not exceed 
 42.30  $2,490,000; 
 42.31     (s) to license and certify two beds in a facility to 
 42.32  replace beds that were voluntarily delicensed and decertified on 
 42.33  June 28, 1991; 
 42.34     (t) to allow 16 licensed and certified beds located on July 
 42.35  1, 1994, in a 142-bed nursing home and 21-bed boarding care home 
 42.36  facility in Minneapolis, notwithstanding the licensure and 
 43.1   certification after July 1, 1995, of the Minneapolis facility as 
 43.2   a 147-bed nursing home facility after completion of a 
 43.3   construction project approved in 1993 under section 144A.073, to 
 43.4   be laid away upon 30 days' prior written notice to the 
 43.5   commissioner.  Beds on layaway status shall have the same status 
 43.6   as voluntarily delicensed or decertified beds except that they 
 43.7   shall remain subject to the surcharge in section 256.9657.  The 
 43.8   16 beds on layaway status may be relicensed as nursing home beds 
 43.9   and recertified at any time within five years of the effective 
 43.10  date of the layaway upon relocation of some or all of the beds 
 43.11  to a licensed and certified facility located in Watertown, 
 43.12  provided that the total project construction costs related to 
 43.13  the relocation of beds from layaway status for the Watertown 
 43.14  facility may not exceed the dollar threshold provided in 
 43.15  subdivision 2 unless the construction project has been approved 
 43.16  through the moratorium exception process under section 144A.073. 
 43.17     The property-related payment rate of the facility placing 
 43.18  beds on layaway status must be adjusted by the incremental 
 43.19  change in its rental per diem after recalculating the rental per 
 43.20  diem as provided in section 256B.431, subdivision 3a, paragraph 
 43.21  (d).  The property-related payment rate for the facility 
 43.22  relicensing and recertifying beds from layaway status must be 
 43.23  adjusted by the incremental change in its rental per diem after 
 43.24  recalculating its rental per diem using the number of beds after 
 43.25  the relicensing to establish the facility's capacity day 
 43.26  divisor, which shall be effective the first day of the month 
 43.27  following the month in which the relicensing and recertification 
 43.28  became effective.  Any beds remaining on layaway status more 
 43.29  than five years after the date the layaway status became 
 43.30  effective must be removed from layaway status and immediately 
 43.31  delicensed and decertified; 
 43.32     (u) to license and certify beds that are moved within an 
 43.33  existing area of a facility or to a newly constructed addition 
 43.34  which is built for the purpose of eliminating three- and 
 43.35  four-bed rooms and adding space for dining, lounge areas, 
 43.36  bathing rooms, and ancillary service areas in a nursing home 
 44.1   that, as of January 1, 1995, was located in Fridley and had a 
 44.2   licensed capacity of 129 beds; 
 44.3      (v) to relocate 36 beds in Crow Wing county and four beds 
 44.4   from Hennepin county to a 160-bed facility in Crow Wing county, 
 44.5   provided all the affected beds are under common ownership; 
 44.6      (w) to license and certify a total replacement project of 
 44.7   up to 49 beds located in Norman county that are relocated from a 
 44.8   nursing home destroyed by flood and whose residents were 
 44.9   relocated to other nursing homes.  The operating cost payment 
 44.10  rates for the new nursing facility shall be determined based on 
 44.11  the interim and settle-up payment provisions of Minnesota Rules, 
 44.12  part 9549.0057, and the reimbursement provisions of section 
 44.13  256B.431, except that subdivision 26, paragraphs (a) and (b), 
 44.14  shall not apply until the second rate year after the settle-up 
 44.15  cost report is filed.  Property-related reimbursement rates 
 44.16  shall be determined under section 256B.431, taking into account 
 44.17  any federal or state flood-related loans or grants provided to 
 44.18  the facility; 
 44.19     (x) to license and certify a total replacement project of 
 44.20  up to 129 beds located in Polk county that are relocated from a 
 44.21  nursing home destroyed by flood and whose residents were 
 44.22  relocated to other nursing homes.  The operating cost payment 
 44.23  rates for the new nursing facility shall be determined based on 
 44.24  the interim and settle-up payment provisions of Minnesota Rules, 
 44.25  part 9549.0057, and the reimbursement provisions of section 
 44.26  256B.431, except that subdivision 26, paragraphs (a) and (b), 
 44.27  shall not apply until the second rate year after the settle-up 
 44.28  cost report is filed.  Property-related reimbursement rates 
 44.29  shall be determined under section 256B.431, taking into account 
 44.30  any federal or state flood-related loans or grants provided to 
 44.31  the facility; or 
 44.32     (y) to license and certify beds in a renovation and 
 44.33  remodeling project to convert 13 three-bed wards into 13 two-bed 
 44.34  rooms and 13 single-bed rooms, expand space, and add 
 44.35  improvements in a nursing home that, as of January 1, 1994, met 
 44.36  the following conditions:  the nursing home was located in 
 45.1   Ramsey county, was not owned by a hospital corporation, had a 
 45.2   licensed capacity of 64 beds, and had been ranked among the top 
 45.3   15 applicants by the 1993 moratorium exceptions advisory review 
 45.4   panel.  The total project construction cost estimate for this 
 45.5   project must not exceed the cost estimate submitted in 
 45.6   connection with the 1993 moratorium exception process.; or 
 45.7      (z) to allow the commissioner of human services to license 
 45.8   an additional 36 beds to provide residential services for the 
 45.9   physically handicapped under Minnesota Rules, parts 9570.2000 to 
 45.10  9570.3400, in a 198-bed nursing home located in Red Wing, and to 
 45.11  allow the commissioner of health to license and certify nursing 
 45.12  home beds to replace a 74-bed nursing home in Waite Park 
 45.13  operated under common ownership with the Red Wing facility, 
 45.14  provided that the new facility is located within five miles of 
 45.15  the existing site in Waite Park.  The commissioner of health may 
 45.16  license and certify an additional 20 beds at the new site 
 45.17  provided that the licensed capacity at the Red Wing site is 
 45.18  decreased by at least 30 beds. 
 45.19     Sec. 2.  Minnesota Statutes 1996, section 144A.09, 
 45.20  subdivision 1, is amended to read: 
 45.21     Subdivision 1.  [SPIRITUAL MEANS FOR HEALING.] No rule 
 45.22  established Sections 144A.04, subdivision 5, and 144A.18 to 
 45.23  144A.27, and rules adopted under sections 144A.01 to 144A.16 
 45.24  other than a rule relating to sanitation and safety of premises, 
 45.25  to cleanliness of operation, or to physical equipment shall do 
 45.26  not apply to a nursing home conducted by and for the adherents 
 45.27  of any recognized church or religious denomination for the 
 45.28  purpose of providing care and treatment for those who select and 
 45.29  depend upon spiritual means through prayer alone, in lieu of 
 45.30  medical care, for healing.  
 45.31     Sec. 3.  Minnesota Statutes 1997 Supplement, section 
 45.32  256B.431, subdivision 3f, is amended to read: 
 45.33     Subd. 3f.  [PROPERTY COSTS AFTER JULY 1, 1988.] (a)  
 45.34  [INVESTMENT PER BED LIMIT.] For the rate year beginning July 1, 
 45.35  1988, the replacement-cost-new per bed limit must be $32,571 per 
 45.36  licensed bed in multiple bedrooms and $48,857 per licensed bed 
 46.1   in a single bedroom.  For the rate year beginning July 1, 1989, 
 46.2   the replacement-cost-new per bed limit for a single bedroom must 
 46.3   be $49,907 adjusted according to Minnesota Rules, part 
 46.4   9549.0060, subpart 4, item A, subitem (1).  Beginning January 1, 
 46.5   1990, the replacement-cost-new per bed limits must be adjusted 
 46.6   annually as specified in Minnesota Rules, part 9549.0060, 
 46.7   subpart 4, item A, subitem (1).  Beginning January 1, 1991, the 
 46.8   replacement-cost-new per bed limits will be adjusted annually as 
 46.9   specified in Minnesota Rules, part 9549.0060, subpart 4, item A, 
 46.10  subitem (1), except that the index utilized will be the Bureau 
 46.11  of the Census:  Composite fixed-weighted price index as 
 46.12  published in the C30 Report, Value of New Construction Put in 
 46.13  Place. 
 46.14     (b)  [RENTAL FACTOR.] For the rate year beginning July 1, 
 46.15  1988, the commissioner shall increase the rental factor as 
 46.16  established in Minnesota Rules, part 9549.0060, subpart 8, item 
 46.17  A, by 6.2 percent rounded to the nearest 100th percent for the 
 46.18  purpose of reimbursing nursing facilities for soft costs and 
 46.19  entrepreneurial profits not included in the cost valuation 
 46.20  services used by the state's contracted appraisers.  For rate 
 46.21  years beginning on or after July 1, 1989, the rental factor is 
 46.22  the amount determined under this paragraph for the rate year 
 46.23  beginning July 1, 1988. 
 46.24     (c)  [OCCUPANCY FACTOR.] For rate years beginning on or 
 46.25  after July 1, 1988, in order to determine property-related 
 46.26  payment rates under Minnesota Rules, part 9549.0060, for all 
 46.27  nursing facilities except those whose average length of stay in 
 46.28  a skilled level of care within a nursing facility is 180 days or 
 46.29  less, the commissioner shall use 95 percent of capacity days.  
 46.30  For a nursing facility whose average length of stay in a skilled 
 46.31  level of care within a nursing facility is 180 days or less, the 
 46.32  commissioner shall use the greater of resident days or 80 
 46.33  percent of capacity days but in no event shall the divisor 
 46.34  exceed 95 percent of capacity days. 
 46.35     (d)  [EQUIPMENT ALLOWANCE.] For rate years beginning on 
 46.36  July 1, 1988, and July 1, 1989, the commissioner shall add ten 
 47.1   cents per resident per day to each nursing facility's 
 47.2   property-related payment rate.  The ten-cent property-related 
 47.3   payment rate increase is not cumulative from rate year to rate 
 47.4   year.  For the rate year beginning July 1, 1990, the 
 47.5   commissioner shall increase each nursing facility's equipment 
 47.6   allowance as established in Minnesota Rules, part 9549.0060, 
 47.7   subpart 10, by ten cents per resident per day.  For rate years 
 47.8   beginning on or after July 1, 1991, the adjusted equipment 
 47.9   allowance must be adjusted annually for inflation as in 
 47.10  Minnesota Rules, part 9549.0060, subpart 10, item E.  For the 
 47.11  rate period beginning October 1, 1992, the equipment allowance 
 47.12  for each nursing facility shall be increased by 28 percent.  For 
 47.13  rate years beginning after June 30, 1993, the allowance must be 
 47.14  adjusted annually for inflation. 
 47.15     (e)  [POST CHAPTER 199 RELATED-ORGANIZATION DEBTS AND 
 47.16  INTEREST EXPENSE.] For rate years beginning on or after July 1, 
 47.17  1990, Minnesota Rules, part 9549.0060, subpart 5, item E, shall 
 47.18  not apply to outstanding related organization debt incurred 
 47.19  prior to May 23, 1983, provided that the debt was an allowable 
 47.20  debt under Minnesota Rules, parts 9510.0010 to 9510.0480, the 
 47.21  debt is subject to repayment through annual principal payments, 
 47.22  and the nursing facility demonstrates to the commissioner's 
 47.23  satisfaction that the interest rate on the debt was less than 
 47.24  market interest rates for similar arms-length transactions at 
 47.25  the time the debt was incurred.  If the debt was incurred due to 
 47.26  a sale between family members, the nursing facility must also 
 47.27  demonstrate that the seller no longer participates in the 
 47.28  management or operation of the nursing facility.  Debts meeting 
 47.29  the conditions of this paragraph are subject to all other 
 47.30  provisions of Minnesota Rules, parts 9549.0010 to 9549.0080. 
 47.31     (f)  [BUILDING CAPITAL ALLOWANCE FOR NURSING FACILITIES 
 47.32  WITH OPERATING LEASES.] For rate years beginning on or after 
 47.33  July 1, 1990, a nursing facility with operating lease costs 
 47.34  incurred for the nursing facility's buildings shall receive its 
 47.35  building capital allowance computed in accordance with Minnesota 
 47.36  Rules, part 9549.0060, subpart 8.  If an operating lease 
 48.1   provides that the lessee's rent is adjusted to recognize 
 48.2   improvements made by the lessor and related debt, the costs for 
 48.3   capital improvements and related debt shall be allowed in the 
 48.4   computation of the lessee's building capital allowance, provided 
 48.5   that reimbursement for these costs under an operating lease 
 48.6   shall not exceed the rate otherwise paid. 
 48.7      Sec. 4.  Minnesota Statutes 1996, section 256B.431, 
 48.8   subdivision 4, is amended to read: 
 48.9      Subd. 4.  [SPECIAL RATES.] (a) For the rate years beginning 
 48.10  July 1, 1983, and July 1, 1984, a newly constructed nursing 
 48.11  facility or one with a capacity increase of 50 percent or more 
 48.12  may, upon written application to the commissioner, receive an 
 48.13  interim payment rate for reimbursement for property-related 
 48.14  costs calculated pursuant to the statutes and rules in effect on 
 48.15  May 1, 1983, and for operating costs negotiated by the 
 48.16  commissioner based upon the 60th percentile established for the 
 48.17  appropriate group under subdivision 2a, to be effective from the 
 48.18  first day a medical assistance recipient resides in the facility 
 48.19  or for the added beds.  For newly constructed nursing facilities 
 48.20  which are not included in the calculation of the 60th percentile 
 48.21  for any group, subdivision 2f, the commissioner shall establish 
 48.22  by rule procedures for determining interim operating cost 
 48.23  payment rates and interim property-related cost payment rates.  
 48.24  The interim payment rate shall not be in effect for more than 17 
 48.25  months.  The commissioner shall establish, by emergency and 
 48.26  permanent rules, procedures for determining the interim rate and 
 48.27  for making a retroactive cost settle-up after the first year of 
 48.28  operation; the cost settled operating cost per diem shall not 
 48.29  exceed 110 percent of the 60th percentile established for the 
 48.30  appropriate group.  Until procedures determining operating cost 
 48.31  payment rates according to mix of resident needs are 
 48.32  established, the commissioner shall establish by rule procedures 
 48.33  for determining payment rates for nursing facilities which 
 48.34  provide care under a lesser care level than the level for which 
 48.35  the nursing facility is certified.  
 48.36     (b) For the rate years beginning on or after July 1, 1985, 
 49.1   a newly constructed nursing facility or one with a capacity 
 49.2   increase of 50 percent or more may, upon written application to 
 49.3   the commissioner, receive an interim payment rate for 
 49.4   reimbursement for property related costs, operating costs, and 
 49.5   real estate taxes and special assessments calculated under rules 
 49.6   promulgated by the commissioner. 
 49.7      (c) For rate years beginning on or after July 1, 1983, the 
 49.8   commissioner may exclude from a provision of 12 MCAR S 2.050 any 
 49.9   facility that is licensed by the commissioner of health only as 
 49.10  a boarding care home, certified by the commissioner of health as 
 49.11  an intermediate care facility, is licensed by the commissioner 
 49.12  of human services under Minnesota Rules, parts 9520.0500 to 
 49.13  9520.0690, and has less than five percent of its licensed 
 49.14  boarding care capacity reimbursed by the medical assistance 
 49.15  program.  Until a permanent rule to establish the payment rates 
 49.16  for facilities meeting these criteria is promulgated, the 
 49.17  commissioner shall establish the medical assistance payment rate 
 49.18  as follows:  
 49.19     (1) The desk audited payment rate in effect on June 30, 
 49.20  1983, remains in effect until the end of the facility's fiscal 
 49.21  year.  The commissioner shall not allow any amendments to the 
 49.22  cost report on which this desk audited payment rate is based.  
 49.23     (2) For each fiscal year beginning between July 1, 1983, 
 49.24  and June 30, 1985, the facility's payment rate shall be 
 49.25  established by increasing the desk audited operating cost 
 49.26  payment rate determined in clause (1) at an annual rate of five 
 49.27  percent.  
 49.28     (3) For fiscal years beginning on or after July 1, 1985, 
 49.29  but before January 1, 1988, the facility's payment rate shall be 
 49.30  established by increasing the facility's payment rate in the 
 49.31  facility's prior fiscal year by the increase indicated by the 
 49.32  consumer price index for Minneapolis and St. Paul.  
 49.33     (4) For the fiscal year beginning on January 1, 1988, the 
 49.34  facility's payment rate must be established using the following 
 49.35  method:  The commissioner shall divide the real estate taxes and 
 49.36  special assessments payable as stated in the facility's current 
 50.1   property tax statement by actual resident days to compute a real 
 50.2   estate tax and special assessment per diem.  Next, the prior 
 50.3   year's payment rate must be adjusted by the higher of (1) the 
 50.4   percentage change in the consumer price index (CPI-U U.S. city 
 50.5   average) as published by the Bureau of Labor Statistics between 
 50.6   the previous two Septembers, new series index (1967-100), or (2) 
 50.7   2.5 percent, to determine an adjusted payment rate.  The 
 50.8   facility's payment rate is the adjusted prior year's payment 
 50.9   rate plus the real estate tax and special assessment per diem. 
 50.10     (5) For fiscal years beginning on or after January 1, 1989, 
 50.11  the facility's payment rate must be established using the 
 50.12  following method:  The commissioner shall divide the real estate 
 50.13  taxes and special assessments payable as stated in the 
 50.14  facility's current property tax statement by actual resident 
 50.15  days to compute a real estate tax and special assessment per 
 50.16  diem.  Next, the prior year's payment rate less the real estate 
 50.17  tax and special assessment per diem must be adjusted by the 
 50.18  higher of (1) the percentage change in the consumer price index 
 50.19  (CPI-U U.S. city average) as published by the Bureau of Labor 
 50.20  Statistics between the previous two Septembers, new series index 
 50.21  (1967-100), or (2) 2.5 percent, to determine an adjusted payment 
 50.22  rate.  The facility's payment rate is the adjusted payment rate 
 50.23  plus the real estate tax and special assessment per diem. 
 50.24     (6) For the purpose of establishing payment rates under 
 50.25  this paragraph, the facility's rate and reporting years coincide 
 50.26  with the facility's fiscal year.  
 50.27     (d) A facility that meets the criteria of paragraph (c) 
 50.28  shall submit annual cost reports on forms prescribed by the 
 50.29  commissioner.  
 50.30     (e) (c) For the rate year beginning July 1, 1985, each 
 50.31  nursing facility total payment rate must be effective two 
 50.32  calendar months from the first day of the month after the 
 50.33  commissioner issues the rate notice to the nursing facility.  
 50.34  From July 1, 1985, until the total payment rate becomes 
 50.35  effective, the commissioner shall make payments to each nursing 
 50.36  facility at a temporary rate that is the prior rate year's 
 51.1   operating cost payment rate increased by 2.6 percent plus the 
 51.2   prior rate year's property-related payment rate and the prior 
 51.3   rate year's real estate taxes and special assessments payment 
 51.4   rate.  The commissioner shall retroactively adjust the 
 51.5   property-related payment rate and the real estate taxes and 
 51.6   special assessments payment rate to July 1, 1985, but must not 
 51.7   retroactively adjust the operating cost payment rate. 
 51.8      (f) (d) For the purposes of Minnesota Rules, part 
 51.9   9549.0060, subpart 13, item F, the following types of 
 51.10  transactions shall not be considered a sale or reorganization of 
 51.11  a provider entity: 
 51.12     (1) the sale or transfer of a nursing facility upon death 
 51.13  of an owner; 
 51.14     (2) the sale or transfer of a nursing facility due to 
 51.15  serious illness or disability of an owner as defined under the 
 51.16  social security act; 
 51.17     (3) the sale or transfer of the nursing facility upon 
 51.18  retirement of an owner at 62 years of age or older; 
 51.19     (4) any transaction in which a partner, owner, or 
 51.20  shareholder acquires an interest or share of another partner, 
 51.21  owner, or shareholder in a nursing facility business provided 
 51.22  the acquiring partner, owner, or shareholder has less than 50 
 51.23  percent ownership after the acquisition; 
 51.24     (5) a sale and leaseback to the same licensee which does 
 51.25  not constitute a change in facility license; 
 51.26     (6) a transfer of an interest to a trust; 
 51.27     (7) gifts or other transfers for no consideration; 
 51.28     (8) a merger of two or more related organizations; 
 51.29     (9) a transfer of interest in a facility held in 
 51.30  receivership; 
 51.31     (10) a change in the legal form of doing business other 
 51.32  than a publicly held organization which becomes privately held 
 51.33  or vice versa; 
 51.34     (11) the addition of a new partner, owner, or shareholder 
 51.35  who owns less than 20 percent of the nursing facility or the 
 51.36  issuance of stock; or 
 52.1      (12) an involuntary transfer including foreclosure, 
 52.2   bankruptcy, or assignment for the benefit of creditors. 
 52.3      Any increase in allowable debt or allowable interest 
 52.4   expense or other cost incurred as a result of the foregoing 
 52.5   transactions shall be a nonallowable cost for purposes of 
 52.6   reimbursement under Minnesota Rules, parts 9549.0010 to 
 52.7   9549.0080. 
 52.8      Sec. 5.  Minnesota Statutes 1996, section 256B.431, 
 52.9   subdivision 11, is amended to read: 
 52.10     Subd. 11.  [SPECIAL PROPERTY RATE SETTING PROCEDURES FOR 
 52.11  CERTAIN NURSING FACILITIES.] (a) Notwithstanding Minnesota 
 52.12  Rules, part 9549.0060, subpart 13, item H, to the contrary, for 
 52.13  the rate year beginning July 1, 1990, a nursing facility leased 
 52.14  prior to January 1, 1986, and currently subject to adverse 
 52.15  licensure action under section 144A.04, subdivision 4, paragraph 
 52.16  (a), or section 144A.11, subdivision 2, and whose ownership 
 52.17  changes prior to July 1, 1990, shall be allowed a 
 52.18  property-related payment equal to the lesser of its current 
 52.19  lease obligation divided by its capacity days as determined in 
 52.20  Minnesota Rules, part 9549.0060, subpart 11, as modified by 
 52.21  subdivision 3f, paragraph (c), or the frozen property-related 
 52.22  payment rate in effect for the rate year beginning July 1, 
 52.23  1989.  For rate years beginning on or after July 1, 1991, the 
 52.24  property-related payment rate shall be its rental rate computed 
 52.25  using the previous owner's allowable principal and interest 
 52.26  expense as allowed by the department prior to that prior owner's 
 52.27  sale and lease-back transaction of December 1985. 
 52.28     (b) Notwithstanding other provisions of applicable law, a 
 52.29  nursing facility licensed for 122 beds on January 1, 1998, and 
 52.30  located in Columbia Heights shall have its property-related 
 52.31  payment rate set under this subdivision.  The commissioner shall 
 52.32  make a rate adjustment by adding $2.41 to the facility's July 1, 
 52.33  1997, property-related payment rate.  The adjusted 
 52.34  property-related payment rate shall be effective for rate years 
 52.35  beginning on or after July 1, 1998.  The adjustment in this 
 52.36  paragraph shall remain in effect as long as the facility's rates 
 53.1   are set under this section.  If the facility participates in the 
 53.2   alternative payment system under section 256B.434, the 
 53.3   adjustment in this paragraph shall be included in the facility's 
 53.4   contract payment rate.  If historical rates or property costs 
 53.5   recognized under this section become the basis for future 
 53.6   medical assistance payments to the facility under a managed 
 53.7   care, capitation, or other alternative payment system, the 
 53.8   adjustment in this paragraph shall be included in the 
 53.9   computation of the facility's payments. 
 53.10     Sec. 6.  Minnesota Statutes 1996, section 256B.431, 
 53.11  subdivision 22, is amended to read: 
 53.12     Subd. 22.  [CHANGES TO NURSING FACILITY REIMBURSEMENT.] The 
 53.13  nursing facility reimbursement changes in paragraphs (a) to (e) 
 53.14  apply to Minnesota Rules, parts 9549.0010 to 9549.0080, and this 
 53.15  section, and are effective for rate years beginning on or after 
 53.16  July 1, 1993, unless otherwise indicated. 
 53.17     (a) In addition to the approved pension or profit sharing 
 53.18  plans allowed by the reimbursement rule, the commissioner shall 
 53.19  allow those plans specified in Internal Revenue Code, sections 
 53.20  403(b) and 408(k). 
 53.21     (b) The commissioner shall allow as workers' compensation 
 53.22  insurance costs under section 256B.421, subdivision 14, the 
 53.23  costs of workers' compensation coverage obtained under the 
 53.24  following conditions: 
 53.25     (1) a plan approved by the commissioner of commerce as a 
 53.26  Minnesota group or individual self-insurance plan as provided in 
 53.27  section 79A.03; 
 53.28     (2) a plan in which: 
 53.29     (i) the nursing facility, directly or indirectly, purchases 
 53.30  workers' compensation coverage in compliance with section 
 53.31  176.181, subdivision 2, from an authorized insurance carrier; 
 53.32     (ii) a related organization to the nursing facility 
 53.33  reinsures the workers' compensation coverage purchased, directly 
 53.34  or indirectly, by the nursing facility; and 
 53.35     (iii) all of the conditions in clause (4) are met; 
 53.36     (3) a plan in which: 
 54.1      (i) the nursing facility, directly or indirectly, purchases 
 54.2   workers' compensation coverage in compliance with section 
 54.3   176.181, subdivision 2, from an authorized insurance carrier; 
 54.4      (ii) the insurance premium is calculated retrospectively, 
 54.5   including a maximum premium limit, and paid using the paid loss 
 54.6   retro method; and 
 54.7      (iii) all of the conditions in clause (4) are met; 
 54.8      (4) additional conditions are: 
 54.9      (i) the costs of the plan are allowable under the federal 
 54.10  Medicare program; 
 54.11     (ii) the reserves for the plan are maintained in an account 
 54.12  controlled and administered by a person which is not a related 
 54.13  organization to the nursing facility; 
 54.14     (iii) the reserves for the plan cannot be used, directly or 
 54.15  indirectly, as collateral for debts incurred or other 
 54.16  obligations of the nursing facility or related organizations to 
 54.17  the nursing facility; 
 54.18     (iv) if the plan provides workers' compensation coverage 
 54.19  for non-Minnesota nursing facilities, the plan's cost 
 54.20  methodology must be consistent among all nursing facilities 
 54.21  covered by the plan, and if reasonable, is allowed 
 54.22  notwithstanding any reimbursement laws regarding cost allocation 
 54.23  to the contrary; 
 54.24     (v) central, affiliated, corporate, or nursing facility 
 54.25  costs related to their administration of the plan are costs 
 54.26  which must remain in the nursing facility's administrative cost 
 54.27  category and must not be allocated to other cost categories; and 
 54.28     (vi) required security deposits, whether in the form of 
 54.29  cash, investments, securities, assets, letters of credit, or in 
 54.30  any other form are not allowable costs for purposes of 
 54.31  establishing the facilities payment rate.; and 
 54.32     (vii) for rate years beginning on or after July 1, 1998, a 
 54.33  group of nursing facilities related by common ownership that 
 54.34  self-insures workers' compensation may allocate its directly 
 54.35  identified costs of self-insuring its Minnesota nursing facility 
 54.36  workers among those nursing facilities in the group that are 
 55.1   reimbursed under this section or section 256B.434.  The method 
 55.2   of cost allocation shall be based on each nursing facility's 
 55.3   total allowable salaries and wages to that of the nursing 
 55.4   facility group's total allowable salaries and wages, then 
 55.5   similarly allocated within each nursing facility's operating 
 55.6   cost categories.  The costs associated with the administration 
 55.7   of the group's self-insurance plan must remain classified in the 
 55.8   nursing facility's administrative cost category.  A written 
 55.9   request of the nursing facility group's election to use this 
 55.10  alternate method of allocation of self-insurance costs must be 
 55.11  received by the commissioner no later than May 1, 1998, to take 
 55.12  effect July 1, 1998, or no later than December 31 of any year to 
 55.13  take effect the following rate year, or such costs shall 
 55.14  continue to be allocated under the existing cost allocation 
 55.15  methods.  Once a nursing facility group elects this method of 
 55.16  cost allocation for its workers' compensation self-insurance 
 55.17  costs, it shall remain in effect until such time as the group no 
 55.18  longer self-insures these costs; 
 55.19     (5) any costs allowed pursuant to clauses (1) to (3) are 
 55.20  subject to the following requirements: 
 55.21     (i) if the nursing facility is sold or otherwise ceases 
 55.22  operations, the plan's reserves must be subject to an 
 55.23  actuarially based settle-up after 36 months from the date of 
 55.24  sale or the date on which operations ceased.  The facility's 
 55.25  medical assistance portion of the total excess plan reserves 
 55.26  must be paid to the state within 30 days following the date on 
 55.27  which excess plan reserves are determined; 
 55.28     (ii) any distribution of excess plan reserves made to or 
 55.29  withdrawals made by the nursing facility or a related 
 55.30  organization are applicable credits and must be used to reduce 
 55.31  the nursing facility's workers' compensation insurance costs in 
 55.32  the reporting period in which a distribution or withdrawal is 
 55.33  received; 
 55.34     (iii) if reimbursement for the plan is sought under the 
 55.35  federal Medicare program, and is audited pursuant to the 
 55.36  Medicare program, the nursing facility must provide a copy of 
 56.1   Medicare's final audit report, including attachments and 
 56.2   exhibits, to the commissioner within 30 days of receipt by the 
 56.3   nursing facility or any related organization.  The commissioner 
 56.4   shall implement the audit findings associated with the plan upon 
 56.5   receipt of Medicare's final audit report.  The department's 
 56.6   authority to implement the audit findings is independent of its 
 56.7   authority to conduct a field audit. 
 56.8      (c) In the determination of incremental increases in the 
 56.9   nursing facility's rental rate as required in subdivisions 14 to 
 56.10  21, except for a refinancing permitted under subdivision 19, the 
 56.11  commissioner must adjust the nursing facility's property-related 
 56.12  payment rate for both incremental increases and decreases in 
 56.13  recomputations of its rental rate; 
 56.14     (d) A nursing facility's administrative cost limitation 
 56.15  must be modified as follows: 
 56.16     (1) if the nursing facility's licensed beds exceed 195 
 56.17  licensed beds, the general and administrative cost category 
 56.18  limitation shall be 13 percent; 
 56.19     (2) if the nursing facility's licensed beds are more than 
 56.20  150 licensed beds, but less than 196 licensed beds, the general 
 56.21  and administrative cost category limitation shall be 14 percent; 
 56.22  or 
 56.23     (3) if the nursing facility's licensed beds is less than 
 56.24  151 licensed beds, the general and administrative cost category 
 56.25  limitation shall remain at 15 percent. 
 56.26     (e) The care related operating rate shall be increased by 
 56.27  eight cents to reimburse facilities for unfunded federal 
 56.28  mandates, including costs related to hepatitis B vaccinations. 
 56.29     (f) For rate years beginning on or after July 1, 1998, a 
 56.30  group of nursing facilities related by common ownership that 
 56.31  self-insures group health, dental, or life insurance may 
 56.32  allocate its directly identified costs of self-insuring its 
 56.33  Minnesota nursing facility workers among those nursing 
 56.34  facilities in the group that are reimbursed under this section 
 56.35  or section 256B.434.  The method of cost allocation shall be 
 56.36  based on each nursing facility's total allowable salaries and 
 57.1   wages to that of the nursing facility group's total allowable 
 57.2   salaries and wages, then similarly allocated within each nursing 
 57.3   facility's operating cost categories.  The costs associated with 
 57.4   the administration of the group's self-insurance plan must 
 57.5   remain classified in the nursing facility's administrative cost 
 57.6   category.  A written request of the nursing facility group's 
 57.7   election to use this alternate method of allocation of 
 57.8   self-insurance costs must be received by the commissioner no 
 57.9   later than May 1, 1998, to take effect July 1, 1998, or no later 
 57.10  than December 31 of any year to take effect the following rate 
 57.11  year, or those self-insurance costs shall continue to be 
 57.12  allocated under the existing cost allocation methods.  Once a 
 57.13  nursing facility group elects this method of cost allocation for 
 57.14  its group health, dental, or life insurance self-insurance 
 57.15  costs, it shall remain in effect until such time as the group no 
 57.16  longer self-insures these costs. 
 57.17     Sec. 7.  Minnesota Statutes 1997 Supplement, section 
 57.18  256B.431, subdivision 26, is amended to read: 
 57.19     Subd. 26.  [CHANGES TO NURSING FACILITY REIMBURSEMENT 
 57.20  BEGINNING JULY 1, 1997.] The nursing facility reimbursement 
 57.21  changes in paragraphs (a) to (f) shall apply in the sequence 
 57.22  specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 
 57.23  this section, beginning July 1, 1997. 
 57.24     (a) For rate years beginning on or after July 1, 1997, the 
 57.25  commissioner shall limit a nursing facility's allowable 
 57.26  operating per diem for each case mix category for each rate year.
 57.27  The commissioner shall group nursing facilities into two groups, 
 57.28  freestanding and nonfreestanding, within each geographic group, 
 57.29  using their operating cost per diem for the case mix A 
 57.30  classification.  A nonfreestanding nursing facility is a nursing 
 57.31  facility whose other operating cost per diem is subject to the 
 57.32  hospital attached, short length of stay, or the rule 80 limits.  
 57.33  All other nursing facilities shall be considered freestanding 
 57.34  nursing facilities.  The commissioner shall then array all 
 57.35  nursing facilities in each grouping by their allowable case mix 
 57.36  A operating cost per diem.  In calculating a nursing facility's 
 58.1   operating cost per diem for this purpose, the commissioner shall 
 58.2   exclude the raw food cost per diem related to providing special 
 58.3   diets that are based on religious beliefs, as determined in 
 58.4   subdivision 2b, paragraph (h).  For those nursing facilities in 
 58.5   each grouping whose case mix A operating cost per diem: 
 58.6      (1) is at or below the median of the array, the 
 58.7   commissioner shall limit the nursing facility's allowable 
 58.8   operating cost per diem for each case mix category to the lesser 
 58.9   of the prior reporting year's allowable operating cost per diem 
 58.10  as specified in Laws 1996, chapter 451, article 3, section 11, 
 58.11  paragraph (h), plus the inflation factor as established in 
 58.12  paragraph (d), clause (2), increased by two percentage points, 
 58.13  or the current reporting year's corresponding allowable 
 58.14  operating cost per diem; or 
 58.15     (2) is above the median of the array, the commissioner 
 58.16  shall limit the nursing facility's allowable operating cost per 
 58.17  diem for each case mix category to the lesser of the prior 
 58.18  reporting year's allowable operating cost per diem as specified 
 58.19  in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 
 58.20  plus the inflation factor as established in paragraph (d), 
 58.21  clause (2), increased by one percentage point, or the current 
 58.22  reporting year's corresponding allowable operating cost per diem.
 58.23     For rate years beginning on or after July 1, 1999, if a 
 58.24  facility reports a reduction in costs because of a credit or 
 58.25  refund received based on costs from prior reporting years, the 
 58.26  limit shall be increased in the second rate year following that 
 58.27  reporting year by the amount of the reduction divided by the 
 58.28  resident days used to compute the rate of the second following 
 58.29  rate year. 
 58.30     (b) For rate years beginning on or after July 1, 1997, the 
 58.31  commissioner shall limit the allowable operating cost per diem 
 58.32  for high cost nursing facilities.  After application of the 
 58.33  limits in paragraph (a) to each nursing facility's operating 
 58.34  cost per diem, the commissioner shall group nursing facilities 
 58.35  into two groups, freestanding or nonfreestanding, within each 
 58.36  geographic group.  A nonfreestanding nursing facility is a 
 59.1   nursing facility whose other operating cost per diem are subject 
 59.2   to hospital attached, short length of stay, or rule 80 limits.  
 59.3   All other nursing facilities shall be considered freestanding 
 59.4   nursing facilities.  The commissioner shall then array all 
 59.5   nursing facilities within each grouping by their allowable case 
 59.6   mix A operating cost per diem.  In calculating a nursing 
 59.7   facility's operating cost per diem for this purpose, the 
 59.8   commissioner shall exclude the raw food cost per diem related to 
 59.9   providing special diets that are based on religious beliefs, as 
 59.10  determined in subdivision 2b, paragraph (h).  For those nursing 
 59.11  facilities in each grouping whose case mix A operating cost per 
 59.12  diem exceeds 1.0 standard deviation above the median, the 
 59.13  commissioner shall reduce their allowable operating cost per 
 59.14  diem by three percent.  For those nursing facilities in each 
 59.15  grouping whose case mix A operating cost per diem exceeds 0.5 
 59.16  standard deviation above the median but is less than or equal to 
 59.17  1.0 standard deviation above the median, the commissioner shall 
 59.18  reduce their allowable operating cost per diem by two percent.  
 59.19  However, in no case shall a nursing facility's operating cost 
 59.20  per diem be reduced below its grouping's limit established at 
 59.21  0.5 standard deviations above the median. 
 59.22     (c) For rate years beginning on or after July 1, 1997, the 
 59.23  commissioner shall determine a nursing facility's efficiency 
 59.24  incentive by first computing the allowable difference, which is 
 59.25  the lesser of $4.50 or the amount by which the facility's other 
 59.26  operating cost limit exceeds its nonadjusted other operating 
 59.27  cost per diem for that rate year.  The commissioner shall 
 59.28  compute the efficiency incentive by: 
 59.29     (1) subtracting the allowable difference from $4.50 and 
 59.30  dividing the result by $4.50; 
 59.31     (2) multiplying 0.20 by the ratio resulting from clause 
 59.32  (1), and then; 
 59.33     (3) adding 0.50 to the result from clause (2); and 
 59.34     (4) multiplying the result from clause (3) times the 
 59.35  allowable difference. 
 59.36     The nursing facility's efficiency incentive payment shall 
 60.1   be the lesser of $2.25 or the product obtained in clause (4). 
 60.2      (d) For rate years beginning on or after July 1, 1997, the 
 60.3   forecasted price index for a nursing facility's allowable 
 60.4   operating cost per diem shall be determined under clauses (1) 
 60.5   and (2) using the change in the Consumer Price Index-All Items 
 60.6   (United States city average) (CPI-U) as forecasted by Data 
 60.7   Resources, Inc.  The commissioner shall use the indices as 
 60.8   forecasted in the fourth quarter of the calendar year preceding 
 60.9   the rate year, subject to subdivision 2l, paragraph (c).  
 60.10     (1) The CPI-U forecasted index for allowable operating cost 
 60.11  per diem shall be based on the 21-month period from the midpoint 
 60.12  of the nursing facility's reporting year to the midpoint of the 
 60.13  rate year following the reporting year. 
 60.14     (2) For rate years beginning on or after July 1, 1997, the 
 60.15  forecasted index for operating cost limits referred to in 
 60.16  subdivision 21, paragraph (b), shall be based on the CPI-U for 
 60.17  the 12-month period between the midpoints of the two reporting 
 60.18  years preceding the rate year. 
 60.19     (e) After applying these provisions for the respective rate 
 60.20  years, the commissioner shall index these allowable operating 
 60.21  cost per diem by the inflation factor provided for in paragraph 
 60.22  (d), clause (1), and add the nursing facility's efficiency 
 60.23  incentive as computed in paragraph (c). 
 60.24     (f) For rate years beginning on or after July 1, 1997, the 
 60.25  total operating cost payment rates for a nursing facility shall 
 60.26  be the greater of the total operating cost payment rates 
 60.27  determined under this section or the total operating cost 
 60.28  payment rates in effect on June 30, 1997, subject to rate 
 60.29  adjustments due to field audit or rate appeal resolution.  This 
 60.30  provision shall not apply to subsequent field audit adjustments 
 60.31  of the nursing facility's operating cost rates for rate years 
 60.32  beginning on or after July 1, 1997. 
 60.33     (g) For the rate years beginning on July 1, 1997, and July 
 60.34  1, 1998, and July 1, 1999, a nursing facility licensed for 40 
 60.35  beds effective May 1, 1992, with a subsequent increase of 20 
 60.36  Medicare/Medicaid certified beds, effective January 26, 1993, in 
 61.1   accordance with an increase in licensure is exempt from 
 61.2   paragraphs (a) and (b). 
 61.3      (h) For a nursing facility whose construction project was 
 61.4   authorized according to section 144A.073, subdivision 5, 
 61.5   paragraph (g), the operating cost payment rates for the third 
 61.6   location shall be determined based on Minnesota Rules, part 
 61.7   9549.0057.  Paragraphs (a) and (b) shall not apply until the 
 61.8   second rate year after the settle-up cost report is filed.  
 61.9   Notwithstanding subdivision 2b, paragraph (g), real estate taxes 
 61.10  and special assessments payable by the third location, a 
 61.11  501(c)(3) nonprofit corporation, shall be included in the 
 61.12  payment rates determined under this subdivision for all 
 61.13  subsequent rate years. 
 61.14     (i) For the rate year beginning July 1, 1997, the 
 61.15  commissioner shall compute the payment rate for a nursing 
 61.16  facility licensed for 94 beds on September 30, 1996, that 
 61.17  applied in October 1993 for approval of a total replacement 
 61.18  under the moratorium exception process in section 144A.073, and 
 61.19  completed the approved replacement in June 1995, with other 
 61.20  operating cost spend-up limit under paragraph (a), increased by 
 61.21  $3.98, and after computing the facility's payment rate according 
 61.22  to this section, the commissioner shall make a one-year positive 
 61.23  rate adjustment of $3.19 for operating costs related to the 
 61.24  newly constructed total replacement, without application of 
 61.25  paragraphs (a) and (b).  The facility's per diem, before the 
 61.26  $3.19 adjustment, shall be used as the prior reporting year's 
 61.27  allowable operating cost per diem for payment rate calculation 
 61.28  for the rate year beginning July 1, 1998.  A facility described 
 61.29  in this paragraph is exempt from paragraph (b) for the rate 
 61.30  years beginning July 1, 1997, and July 1, 1998. 
 61.31     (j) For the purpose of applying the limit stated in 
 61.32  paragraph (a), a nursing facility in Kandiyohi county licensed 
 61.33  for 86 beds that was granted hospital-attached status on 
 61.34  December 1, 1994, shall have the prior year's allowable 
 61.35  care-related per diem increased by $3.207 and the prior year's 
 61.36  other operating cost per diem increased by $4.777 before adding 
 62.1   the inflation in paragraph (d), clause (2), for the rate year 
 62.2   beginning on July 1, 1997. 
 62.3      (k) For the purpose of applying the limit stated in 
 62.4   paragraph (a), a 117 bed nursing facility located in Pine county 
 62.5   shall have the prior year's allowable other operating cost per 
 62.6   diem increased by $1.50 before adding the inflation in paragraph 
 62.7   (d), clause (2), for the rate year beginning on July 1, 1997. 
 62.8      (l) For the purpose of applying the limit under paragraph 
 62.9   (a), a nursing facility in Hibbing licensed for 192 beds shall 
 62.10  have the prior year's allowable other operating cost per diem 
 62.11  increased by $2.67 before adding the inflation in paragraph (d), 
 62.12  clause (2), for the rate year beginning July 1, 1997. 
 62.13     Sec. 8.  Minnesota Statutes 1996, section 256B.431, is 
 62.14  amended by adding a subdivision to read: 
 62.15     Subd. 27.  [CHANGES TO NURSING FACILITY REIMBURSEMENT 
 62.16  BEGINNING JULY 1, 1998.] (a) For the purpose of applying the 
 62.17  limit stated in subdivision 26, paragraph (a), a nursing 
 62.18  facility in Hennepin county licensed for 181 beds on September 
 62.19  30, 1996, shall have the prior year's allowable care-related per 
 62.20  diem increased by $1.455 and the prior year's other operating 
 62.21  cost per diem increased by $0.439 before adding the inflation in 
 62.22  subdivision 26, paragraph (d), clause (2), for the rate year 
 62.23  beginning on July 1, 1998. 
 62.24     (b) For the purpose of applying the limit stated in 
 62.25  subdivision 26, paragraph (a), a nursing facility in Hennepin 
 62.26  county licensed for 161 beds on September 30, 1996, shall have 
 62.27  the prior year's allowable care-related per diem increased by 
 62.28  $1.154 and the prior year's other operating cost per diem 
 62.29  increased by $0.256 before adding the inflation in subdivision 
 62.30  26, paragraph (d), clause (2), for the rate year beginning on 
 62.31  July 1, 1998. 
 62.32     (c) For the purpose of applying the limit stated in 
 62.33  subdivision 26, paragraph (a), a nursing facility in Ramsey 
 62.34  county licensed for 176 beds on September 30, 1996, shall have 
 62.35  the prior year's allowable care-related per diem increased by 
 62.36  $0.803 and the prior year's other operating cost per diem 
 63.1   increased by $0.272 before adding the inflation in subdivision 
 63.2   26, paragraph (d), clause (2), for the rate year beginning on 
 63.3   July 1, 1998. 
 63.4      (d) For the purpose of applying the limit stated in 
 63.5   subdivision 26, paragraph (a), a nursing facility in Brown 
 63.6   county licensed for 86 beds on September 30, 1996, shall have 
 63.7   the prior year's allowable care-related per diem increased by 
 63.8   $0.850 and the prior year's other operating cost per diem 
 63.9   increased by $0.275 before adding the inflation in subdivision 
 63.10  26, paragraph (d), clause (2), for the rate year beginning on 
 63.11  July 1, 1998. 
 63.12     (e) For the rate year beginning July 1, 1998, the 
 63.13  commissioner shall compute the payment rate for a nursing 
 63.14  facility, which was licensed for 110 beds on September 8, 1996, 
 63.15  was granted approval in January 1994 for a replacement and 
 63.16  remodeling project under the moratorium exception process in 
 63.17  section 144A.073, and completed the approved replacement and 
 63.18  remodeling project in April 1997, by computing the facility's 
 63.19  payment rate for the rate year beginning July 1, 1998, according 
 63.20  to this section, and then making a one-year positive rate 
 63.21  adjustment of 48 cents for increased real estate taxes resulting 
 63.22  from completion of the moratorium exception project, without 
 63.23  application of subdivision 26, paragraphs (a) and (b). 
 63.24     (f) For the rate year beginning July 1, 1998, the 
 63.25  commissioner shall compute the payment rate for a nursing 
 63.26  facility exempted from care-related limits under subdivision 2b, 
 63.27  paragraph (d), clause (2), with a minimum of three-quarters of 
 63.28  its beds licensed to provide residential services for the 
 63.29  physically handicapped under Minnesota Rules, parts 9570.2000 to 
 63.30  9570.3400, with the care-related spend-up limit under 
 63.31  subdivision 26, paragraph (a), increased by $13.21 for the rate 
 63.32  year beginning July 1, 1998, without application of subdivision 
 63.33  26, paragraph (b).  For rate years beginning on or after July 1, 
 63.34  1999, the commissioner shall exclude that amount in calculating 
 63.35  the facility's operating cost per diem for purposes of applying 
 63.36  subdivision 26, paragraph (b). 
 64.1      (g) For the rate year beginning July 1, 1998, a nursing 
 64.2   facility in Canby, Minnesota, licensed for 75 beds shall be 
 64.3   reimbursed without the limitation imposed under subdivision 26, 
 64.4   paragraph (a), and for rate years beginning on or after July 1, 
 64.5   1999, its base costs shall be calculated on the basis of its 
 64.6   September 30, 1997, cost report. 
 64.7      (h) The nursing facility reimbursement changes in 
 64.8   paragraphs (i) and (j) shall apply in the sequence specified in 
 64.9   this section and Minnesota Rules, parts 9549.0010 to 9549.0080, 
 64.10  beginning July 1, 1998. 
 64.11     (i) For rate years beginning on or after July 1, 1998, the 
 64.12  operating cost limits established in subdivisions 2, 2b, 2i, 3c, 
 64.13  and 22, paragraph (d), and any previously effective 
 64.14  corresponding limits in law or rule shall not apply, except that 
 64.15  these cost limits shall still be calculated for purposes of 
 64.16  determining efficiency incentive per diems.  For rate years 
 64.17  beginning on or after July 1, 1998, the total operating cost 
 64.18  payment rates for a nursing facility shall be the greater of the 
 64.19  total operating cost payment rates determined under this section 
 64.20  or the total operating cost payment rates in effect on June 30, 
 64.21  1998, subject to rate adjustments due to field audit or rate 
 64.22  appeal resolution.  
 64.23     (j) For rate years beginning on or after July 1, 1998, the 
 64.24  operating cost per diem referred to in subdivision 26, paragraph 
 64.25  (a), clauses (1) and (2), is the sum of the care-related and 
 64.26  other operating per diems for a given case mix class.  Any 
 64.27  reductions to the combined operating per diem shall be divided 
 64.28  proportionately between the care-related and other operating per 
 64.29  diems. 
 64.30     Sec. 9.  Minnesota Statutes 1997 Supplement, section 
 64.31  256B.433, subdivision 3a, is amended to read: 
 64.32     Subd. 3a.  [EXEMPTION FROM REQUIREMENT FOR SEPARATE THERAPY 
 64.33  BILLING.] The provisions of subdivision 3 do not apply to 
 64.34  nursing facilities that are reimbursed according to the 
 64.35  provisions of section 256B.431 and are located in a county 
 64.36  participating in the prepaid medical assistance 
 65.1   program.  Nursing facilities that are reimbursed according to 
 65.2   the provisions of section 256B.434 and are located in a county 
 65.3   participating in the prepaid medical assistance program are 
 65.4   exempt from the maximum therapy rent revenue provisions of 
 65.5   subdivision 3, paragraph (c). 
 65.6      Sec. 10.  Minnesota Statutes 1997 Supplement, section 
 65.7   256B.434, subdivision 10, is amended to read: 
 65.8      Subd. 10.  [EXEMPTIONS.] (a) To the extent permitted by 
 65.9   federal law, (1) a facility that has entered into a contract 
 65.10  under this section is not required to file a cost report, as 
 65.11  defined in Minnesota Rules, part 9549.0020, subpart 13, for any 
 65.12  year after the base year that is the basis for the calculation 
 65.13  of the contract payment rate for the first rate year of the 
 65.14  alternative payment demonstration project contract; and (2) a 
 65.15  facility under contract is not subject to audits of historical 
 65.16  costs or revenues, or paybacks or retroactive adjustments based 
 65.17  on these costs or revenues, except audits, paybacks, or 
 65.18  adjustments relating to the cost report that is the basis for 
 65.19  calculation of the first rate year under the contract. 
 65.20     (b) A facility that is under contract with the commissioner 
 65.21  under this section is not subject to the moratorium on licensure 
 65.22  or certification of new nursing home beds in section 144A.071, 
 65.23  unless the project results in a net increase in bed capacity or 
 65.24  involves relocation of beds from one site to another.  Contract 
 65.25  payment rates must not be adjusted to reflect any additional 
 65.26  costs that a nursing facility incurs as a result of a 
 65.27  construction project undertaken under this paragraph.  In 
 65.28  addition, as a condition of entering into a contract under this 
 65.29  section, a nursing facility must agree that any future medical 
 65.30  assistance payments for nursing facility services will not 
 65.31  reflect any additional costs attributable to the sale of a 
 65.32  nursing facility under this section and to construction 
 65.33  undertaken under this paragraph that otherwise would not be 
 65.34  authorized under the moratorium in section 144A.073.  Nothing in 
 65.35  this section prevents a nursing facility participating in the 
 65.36  alternative payment demonstration project under this section 
 66.1   from seeking approval of an exception to the moratorium through 
 66.2   the process established in section 144A.073, and if approved the 
 66.3   facility's rates shall be adjusted to reflect the cost of the 
 66.4   project.  Nothing in this section prevents a nursing facility 
 66.5   participating in the alternative payment demonstration project 
 66.6   from seeking legislative approval of an exception to the 
 66.7   moratorium under section 144A.071, and, if enacted, the 
 66.8   facility's rates shall be adjusted to reflect the cost of the 
 66.9   project. 
 66.10     (c) Notwithstanding section 256B.48, subdivision 6, 
 66.11  paragraphs (c), (d), and (e), and pursuant to any terms and 
 66.12  conditions contained in the facility's contract, a nursing 
 66.13  facility that is under contract with the commissioner under this 
 66.14  section is in compliance with section 256B.48, subdivision 6, 
 66.15  paragraph (b), if the facility is Medicare certified. 
 66.16     (d) Notwithstanding paragraph (a), if by April 1, 1996, the 
 66.17  health care financing administration has not approved a required 
 66.18  waiver, or the health care financing administration otherwise 
 66.19  requires cost reports to be filed prior to the waiver's 
 66.20  approval, the commissioner shall require a cost report for the 
 66.21  rate year. 
 66.22     (e) A facility that is under contract with the commissioner 
 66.23  under this section shall be allowed to change therapy 
 66.24  arrangements from an unrelated vendor to a related vendor during 
 66.25  the term of the contract.  The commissioner may develop 
 66.26  reasonable requirements designed to prevent an increase in 
 66.27  therapy utilization for residents enrolled in the medical 
 66.28  assistance program. 
 66.29     Sec. 11.  [256B.435] [NURSING FACILITY REIMBURSEMENT SYSTEM 
 66.30  EFFECTIVE JULY 1, 2000.] 
 66.31     Subdivision 1.  [IN GENERAL.] Effective July 1, 2000, the 
 66.32  commissioner shall implement a performance-based contracting 
 66.33  system to replace the current method of setting operating cost 
 66.34  payment rates under sections 256B.431 and 256B.434 and Minnesota 
 66.35  Rules, parts 9549.0010 to 9549.0080.  A nursing facility in 
 66.36  operation on May 1, 1998, with payment rates not established 
 67.1   under section 256B.431 or 256B.434 on that date, is ineligible 
 67.2   for this performance-based contracting system.  In determining 
 67.3   prospective payment rates of nursing facility services, the 
 67.4   commissioner shall distinguish between operating costs and 
 67.5   property-related costs.  The operating cost portion of the 
 67.6   payment rates shall be indexed annually by an inflation factor 
 67.7   as specified in subdivision 3, and according to section 
 67.8   256B.431, subdivision 2i, paragraph (c).  Property-related 
 67.9   payment rates, including real estate taxes and special 
 67.10  assessments, shall be determined under section 256B.431 or 
 67.11  256B.434. 
 67.12     Subd. 2.  [CONTRACT PROVISIONS.] (a) The performance-based 
 67.13  contract with each nursing facility must include provisions that:
 67.14     (1) apply the resident case mix assessment provisions of 
 67.15  Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 
 67.16  another assessment system, with the goal of moving to a single 
 67.17  assessment system; 
 67.18     (2) monitor resident outcomes through various methods, such 
 67.19  as quality indicators based on the minimum data set and other 
 67.20  utilization and performance measures; 
 67.21     (3) require the establishment and use of a continuous 
 67.22  quality improvement process that integrates information from 
 67.23  quality indicators and regular resident and family satisfaction 
 67.24  interviews; 
 67.25     (4) require annual reporting of facility statistical 
 67.26  information, including resident days by case mix category, 
 67.27  productive nursing hours, wages and benefits, and raw food costs 
 67.28  for use by the commissioner in the development of facility 
 67.29  profiles that include trends in payment and service utilization; 
 67.30     (5) require from each nursing facility an annual certified 
 67.31  audited financial statement consisting of a balance sheet, 
 67.32  income and expense statements, and an opinion from either a 
 67.33  licensed or certified public accountant, if a certified audit 
 67.34  was prepared, or unaudited financial statements if no certified 
 67.35  audit was prepared; and 
 67.36     (6) establish additional requirements and penalties for 
 68.1   nursing facilities not meeting the standards set forth in the 
 68.2   performance-based contract. 
 68.3      (b) The commissioner may develop additional incentive-based 
 68.4   payments for achieving outcomes specified in each contract.  The 
 68.5   specified facility-specific outcomes must be measurable and 
 68.6   approved by the commissioner. 
 68.7      (c) The commissioner may also contract with nursing 
 68.8   facilities in other ways through requests for proposals, 
 68.9   including contracts on a risk or nonrisk basis, with nursing 
 68.10  facilities or consortia of nursing facilities, to provide 
 68.11  comprehensive long-term care coverage on a premium or capitated 
 68.12  basis. 
 68.13     Subd. 3.  [PAYMENT RATE PROVISIONS.] (a) For rate years 
 68.14  beginning on or after July 1, 2000, the commissioner shall 
 68.15  determine operating cost payment rates for each licensed and 
 68.16  certified nursing facility by indexing its operating cost 
 68.17  payment rates in effect on June 30, 2000, for inflation.  The 
 68.18  inflation factor to be used must be based on the change in the 
 68.19  Consumer Price Index-All Items, United States city average 
 68.20  (CPI-U) as forecasted by Data Resources, Inc. in the fourth 
 68.21  quarter preceding the rate year.  The CPI-U forecasted index for 
 68.22  operating cost payment rates shall be based on the 12-month 
 68.23  period from the midpoint of the nursing facility's prior rate 
 68.24  year to the midpoint of the rate year for which the operating 
 68.25  payment rate is being determined. 
 68.26     (b) Beginning July 1, 2000, each nursing facility subject 
 68.27  to a performance-based contract under this section shall choose 
 68.28  one of two methods of payment for property-related costs: 
 68.29     (1) the method established in section 256B.434; or 
 68.30     (2) the method established in section 256B.431.  Once the 
 68.31  nursing facility has made its election, that election shall 
 68.32  remain in effect for at least four years or until an alternative 
 68.33  property payment system is developed. 
 68.34     Sec. 12.  [256B.5011] [ICF/MR REIMBURSEMENT SYSTEM 
 68.35  EFFECTIVE OCTOBER 1, 2000.] 
 68.36     Subdivision 1.  [IN GENERAL.] Effective October 1, 2000, 
 69.1   the commissioner shall implement a performance-based contracting 
 69.2   system to replace the current method of setting total cost 
 69.3   payment rates under section 256B.501 and Minnesota Rules, parts 
 69.4   9553.0010 to 9553.0080.  In determining prospective payment 
 69.5   rates of intermediate care facilities for persons with mental 
 69.6   retardation or related conditions, the commissioner shall index 
 69.7   each facility's total payment rate by an inflation factor as 
 69.8   described in subdivision 3.  The commissioner of finance shall 
 69.9   include annual inflation adjustments in operating costs for 
 69.10  intermediate care facilities for persons with mental retardation 
 69.11  and related conditions as a budget change request in each 
 69.12  biennial detailed expenditure budget submitted to the 
 69.13  legislature under section 16A.11. 
 69.14     Subd. 2.  [CONTRACT PROVISIONS.] The performance-based 
 69.15  contract with each intermediate care facility must include 
 69.16  provisions for: 
 69.17     (1) modifying payments when significant changes occur in 
 69.18  the needs of the consumers; 
 69.19     (2) monitoring service quality using performance indicators 
 69.20  that measure consumer outcomes; 
 69.21     (3) the establishment and use of continuous quality 
 69.22  improvement processes using the results attained through service 
 69.23  quality monitoring; 
 69.24     (4) the annual reporting of facility statistical 
 69.25  information on all supervisory personnel, direct care personnel, 
 69.26  specialized support personnel, hours, wages and benefits, 
 69.27  staff-to-consumer ratios, and staffing patterns; 
 69.28     (5) annual aggregate facility financial information or an 
 69.29  annual certified audited financial statement, including a 
 69.30  balance sheet and income and expense statements for each 
 69.31  facility, if a certified audit was prepared; and 
 69.32     (6) additional requirements and penalties for intermediate 
 69.33  care facilities not meeting the standards set forth in the 
 69.34  performance-based contract. 
 69.35     Subd. 3.  [PAYMENT RATE PROVISIONS.] For rate years 
 69.36  beginning on or after October 1, 2000, the commissioner shall 
 70.1   determine the total payment rate for each licensed and certified 
 70.2   intermediate care facility by indexing the total payment rate in 
 70.3   effect on September 30, 2000, for inflation.  The inflation 
 70.4   factor to be used must be based on the change in the Consumer 
 70.5   Price Index-All Items (United States city average) (CPI-U) as 
 70.6   forecasted by Data Resources, Inc. in the first quarter of the 
 70.7   calendar year during which the rate year begins.  The CPI-U 
 70.8   forecasted index for total payment rates shall be based on the 
 70.9   12-month period from the midpoint of the ICF/MR's prior rate 
 70.10  year to the midpoint of the rate year for which the operating 
 70.11  payment rate is being determined. 
 70.12     Sec. 13.  Minnesota Statutes 1996, section 256B.69, is 
 70.13  amended by adding a subdivision to read: 
 70.14     Subd. 26.  [CONTINUATION OF PAYMENTS THROUGH 
 70.15  DISCHARGE.] (a) In the event a medical assistance recipient or 
 70.16  beneficiary enrolled in a health plan under this section is 
 70.17  denied nursing facility services after residing in the facility 
 70.18  for more than 180 days, any denial of medical assistance payment 
 70.19  to a provider under this section shall be prospective only and 
 70.20  payments to the provider shall continue until the resident is 
 70.21  discharged or 30 days after the effective date of the service 
 70.22  denial, whichever is sooner. 
 70.23     (b) For a medical assistance recipient or beneficiary who 
 70.24  is enrolled in a health plan and who has resided in the nursing 
 70.25  facility for less than 180 days, when a decision to terminate 
 70.26  nursing facility services is made by the health plan, any appeal 
 70.27  of the health plan decision must be made under subdivisions 11 
 70.28  and 18, and section 256.045, subdivision 3, paragraph (a).  A 
 70.29  decision may not be appealed under section 144A.135.  All other 
 70.30  appeals of termination of nursing facility services shall be 
 70.31  made under section 144A.135. 
 70.32     Sec. 14.  Minnesota Statutes 1996, section 256I.04, 
 70.33  subdivision 1, is amended to read: 
 70.34     Subdivision 1.  [INDIVIDUAL ELIGIBILITY REQUIREMENTS.] An 
 70.35  individual is eligible for and entitled to a group residential 
 70.36  housing payment to be made on the individual's behalf if the 
 71.1   county agency has approved the individual's residence in a group 
 71.2   residential housing setting and the individual meets the 
 71.3   requirements in paragraph (a) or (b).  
 71.4      (a) The individual is aged, blind, or is over 18 years of 
 71.5   age and disabled as determined under the criteria used by the 
 71.6   title II program of the Social Security Act, and meets the 
 71.7   resource restrictions and standards of the supplemental security 
 71.8   income program, and the individual's countable income after 
 71.9   deducting the (1) exclusions and disregards of the SSI 
 71.10  program and, (2) the medical assistance personal needs allowance 
 71.11  under section 256B.35, and (3) an amount equal to the allocation 
 71.12  of income to a spouse living in the community under the 
 71.13  provisions of section 256B.0915, subdivision 2, is less than the 
 71.14  monthly rate specified in the county agency's agreement with the 
 71.15  provider of group residential housing in which the individual 
 71.16  resides.  
 71.17     (b) The individual meets a category of eligibility under 
 71.18  section 256D.05, subdivision 1, paragraph (a), and the 
 71.19  individual's resources are less than the standards specified by 
 71.20  section 256D.08, and the individual's countable income as 
 71.21  determined under sections 256D.01 to 256D.21, less the medical 
 71.22  assistance personal needs allowance under section 256B.35 is 
 71.23  less than the monthly rate specified in the county agency's 
 71.24  agreement with the provider of group residential housing in 
 71.25  which the individual resides. 
 71.26     Sec. 15.  Minnesota Statutes 1996, section 256I.04, 
 71.27  subdivision 3, is amended to read: 
 71.28     Subd. 3.  [MORATORIUM ON THE DEVELOPMENT OF GROUP 
 71.29  RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 
 71.30  into agreements for new group residential housing beds with 
 71.31  total rates in excess of the MSA equivalent rate except:  (1) 
 71.32  for group residential housing establishments meeting the 
 71.33  requirements of subdivision 2a, clause (2) with department 
 71.34  approval; (2) for group residential housing establishments 
 71.35  licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 
 71.36  provided the facility is needed to meet the census reduction 
 72.1   targets for persons with mental retardation or related 
 72.2   conditions at regional treatment centers; (3) to ensure 
 72.3   compliance with the federal Omnibus Budget Reconciliation Act 
 72.4   alternative disposition plan requirements for inappropriately 
 72.5   placed persons with mental retardation or related conditions or 
 72.6   mental illness; (4) up to 80 beds in a single, specialized 
 72.7   facility located in Hennepin county that will provide housing 
 72.8   for chronic inebriates who are repetitive users of 
 72.9   detoxification centers and are refused placement in emergency 
 72.10  shelters because of their state of intoxication., and planning 
 72.11  for the specialized facility must have been initiated before 
 72.12  July 1, 1991, in anticipation of receiving a grant from the 
 72.13  housing finance agency under section 462A.05, subdivision 20a, 
 72.14  paragraph (b); or (5) notwithstanding the provisions of 
 72.15  subdivision 2a, for up to 180 200 supportive housing units in 
 72.16  Anoka, Dakota, Hennepin, or Ramsey county for homeless adults 
 72.17  with a mental illness, a history of substance abuse, or human 
 72.18  immunodeficiency virus or acquired immunodeficiency syndrome.  
 72.19  For purposes of this section, "homeless adult" means a person 
 72.20  who is living on the street or in a shelter or is evicted from a 
 72.21  dwelling unit or discharged from a regional treatment center, 
 72.22  community hospital, or residential treatment program and has no 
 72.23  appropriate housing available and lacks the resources and 
 72.24  support necessary to access appropriate housing.  At least 70 
 72.25  percent of the supportive housing units must serve homeless 
 72.26  adults with mental illness, substance abuse problems, or human 
 72.27  immunodeficiency virus or acquired immunodeficiency syndrome who 
 72.28  are about to be or, within the previous six months, has been 
 72.29  discharged from a regional treatment center, or a 
 72.30  state-contracted psychiatric bed in a community hospital, or a 
 72.31  residential mental health or chemical dependency treatment 
 72.32  program.  If a person meets the requirements of subdivision 1, 
 72.33  paragraph (a), and receives a federal Section 8 or state housing 
 72.34  subsidy, the group residential housing rate for that person is 
 72.35  limited to the supplementary rate under section 256I.05, 
 72.36  subdivision 1a, and is determined by subtracting the amount of 
 73.1   the person's countable income that exceeds the MSA equivalent 
 73.2   rate from the group residential housing supplementary rate.  A 
 73.3   resident in a demonstration project site who no longer 
 73.4   participates in the demonstration program shall retain 
 73.5   eligibility for a group residential housing payment in an amount 
 73.6   determined under section 256I.06, subdivision 8, using the MSA 
 73.7   equivalent rate.  Service funding under section 256I.05, 
 73.8   subdivision 1a, will end June 30, 1997, if federal matching 
 73.9   funds are available and the services can be provided through a 
 73.10  managed care entity.  If federal matching funds are not 
 73.11  available, then service funding will continue under section 
 73.12  256I.05, subdivision 1a.  
 73.13     (b) A county agency may enter into a group residential 
 73.14  housing agreement for beds with rates in excess of the MSA 
 73.15  equivalent rate in addition to those currently covered under a 
 73.16  group residential housing agreement if the additional beds are 
 73.17  only a replacement of beds with rates in excess of the MSA 
 73.18  equivalent rate which have been made available due to closure of 
 73.19  a setting, a change of licensure or certification which removes 
 73.20  the beds from group residential housing payment, or as a result 
 73.21  of the downsizing of a group residential housing setting.  The 
 73.22  transfer of available beds from one county to another can only 
 73.23  occur by the agreement of both counties. 
 73.24     Sec. 16.  Minnesota Statutes 1996, section 256I.04, is 
 73.25  amended by adding a subdivision to read: 
 73.26     Subd. 4.  [RENTAL ASSISTANCE.] For participants in the 
 73.27  Minnesota supportive housing demonstration program under 
 73.28  subdivision 3, paragraph (a), clause (5), notwithstanding the 
 73.29  provisions of section 256I.06, subdivision 8, the amount of the 
 73.30  group residential housing payment for room and board must be 
 73.31  calculated by subtracting 30 percent of the recipient's adjusted 
 73.32  income as defined by the United States Department of Housing and 
 73.33  Urban Development for the Section 8 program from the fair market 
 73.34  rent established for the recipient's living unit by the federal 
 73.35  Department of Housing and Urban Development.  This payment shall 
 73.36  be regarded as a state housing subsidy for the purposes of 
 74.1   subdivision 3.  Notwithstanding the provisions of section 
 74.2   256I.06, subdivision 6, the recipient's countable income will 
 74.3   only be adjusted when a change of greater than $100 in a month 
 74.4   occurs or upon annual redetermination of eligibility, whichever 
 74.5   is sooner.  The supportive housing demonstration program with 
 74.6   rental assistance shall be evaluated by an independent evaluator 
 74.7   to determine the cost effectiveness of the program in serving 
 74.8   its formerly homeless disabled clientele.  The evaluation and 
 74.9   report shall be submitted to the commissioner of human services 
 74.10  no later than December 31, 1998.  The commissioner is directed 
 74.11  to study the feasibility of developing a rental assistance 
 74.12  program to serve persons traditionally served in group 
 74.13  residential housing settings and report to the legislature by 
 74.14  February 15, 1999. 
 74.15     Sec. 17.  Minnesota Statutes 1996, section 256I.05, 
 74.16  subdivision 2, is amended to read: 
 74.17     Subd. 2.  [MONTHLY RATES; EXEMPTIONS.] The maximum group 
 74.18  residential housing rate does not apply to a residence that on 
 74.19  August 1, 1984, was licensed by the commissioner of health only 
 74.20  as a boarding care home, certified by the commissioner of health 
 74.21  as an intermediate care facility, and licensed by the 
 74.22  commissioner of human services under Minnesota Rules, parts 
 74.23  9520.0500 to 9520.0690.  Notwithstanding the provisions of 
 74.24  subdivision 1c, the rate paid to a facility reimbursed under 
 74.25  this subdivision shall be determined under Minnesota Rules, 
 74.26  parts 9510.0010 to 9510.0480 9549.0010 to 9549.0080, or under 
 74.27  section 256B.434 if the facility is accepted by the commissioner 
 74.28  for participation in the alternative payment demonstration 
 74.29  project. 
 74.30     Sec. 18.  Laws 1997, chapter 207, section 7, is amended to 
 74.31  read: 
 74.32     Sec. 7.  [PRIVATE SALE OF TAX-FORFEITED LAND; CARLTON 
 74.33  COUNTY.] 
 74.34     (a) Notwithstanding Minnesota Statutes, sections 92.45 and 
 74.35  282.018, subdivision 1, and the public sale provisions of 
 74.36  Minnesota Statutes, chapter 282, Carlton county may sell by 
 75.1   private sale the tax-forfeited land described in paragraph (d) 
 75.2   under the remaining provisions of Minnesota Statutes, chapter 
 75.3   282. 
 75.4      (b) The land described in paragraph (d) may be sold by 
 75.5   private sale.  The consideration for the conveyance must include 
 75.6   the taxes due on the property and any penalties, interest, and 
 75.7   costs shall be the appraised value of the land.  If the lands 
 75.8   are sold, the conveyance must reserve to the state a 
 75.9   conservation perpetual easement, in a form prescribed by the 
 75.10  commissioner of natural resources, for the land within 100 feet 
 75.11  of the ordinary high water level of Slaughterhouse creek for 
 75.12  public angler access and stream habitat protection and 
 75.13  enhancement for the benefit of the state of Minnesota, 
 75.14  department of natural resources, over the following lands: 
 75.15     A strip of land lying in the North 6.66 acres of the West 
 75.16  Half of the Northeast Quarter of the Southwest Quarter of 
 75.17  Section 6, Township 48 North, Range 16 West, Carlton county.  
 75.18  Said strip lying 100 feet on each side of the centerline of 
 75.19  Slaughterhouse Creek. 
 75.20     (c) The conveyance must be in a form approved by the 
 75.21  attorney general. 
 75.22     (d) The land to be conveyed is located in Carlton county 
 75.23  and is described as: 
 75.24     North 6.66 acres of the West Half of the Northeast Quarter 
 75.25  of the Southwest Quarter, subject to pipeline easement, Section 
 75.26  6, Township 48 North, Range 16 West, City of Carlton. 
 75.27     (e) Carlton county has determined that this sale best 
 75.28  serves the land management interests of Carlton county. 
 75.29     Sec. 19.  [STUDY OF COSTS AND IMPACT OF REGULATION OF 
 75.30  ASSISTED LIVING HOME CARE PROVIDER LICENSEES.] 
 75.31     The legislature recommends that by January 15, 1999, the 
 75.32  legislative auditor, in consultation with owners and operators 
 75.33  of registered housing establishments under Minnesota Statutes, 
 75.34  chapter 144D, consumers of registered housing and services, and 
 75.35  representatives of elderly housing associations, report to the 
 75.36  health and human services policy and fiscal committees of the 
 76.1   house and senate on the costs incurred under rules, as proposed 
 76.2   by the commissioner of health, to implement Laws 1997, chapter 
 76.3   113, section 6, and: 
 76.4      (1) provide an analysis of the implications of added 
 76.5   regulatory costs to the affordability, accessibility, and 
 76.6   quality of elderly housing; and 
 76.7      (2) provide recommendations for alternatives to added home 
 76.8   care regulation for registered with services settings. 
 76.9      Sec. 20.  [RECOMMENDATIONS TO IMPLEMENT NEW REIMBURSEMENT 
 76.10  SYSTEM.] 
 76.11     (a) By January 15, 1999, the commissioner shall make 
 76.12  recommendations to the chairs of the health and human services 
 76.13  policy and fiscal committees on the repeal of specific statutes 
 76.14  and rules as well as any other additional recommendations 
 76.15  related to implementation of sections 11 and 12. 
 76.16     (b) In developing recommendations for nursing facility 
 76.17  reimbursement, the commissioner shall consider making each 
 76.18  nursing facility's total payment rates, both operating and 
 76.19  property rate components, prospective.  The commissioner shall 
 76.20  involve nursing facility industry and consumer representatives 
 76.21  in the development of these recommendations. 
 76.22     (c) In making recommendations for ICF/MR reimbursement, the 
 76.23  commissioner may consider methods of establishing payment rates 
 76.24  that take into account individual client costs and needs, 
 76.25  include provisions to establish links between performance 
 76.26  indicators and reimbursement and other performance incentives, 
 76.27  and allow local control over resources necessary for local 
 76.28  agencies to set rates and contract with ICF/MR facilities.  In 
 76.29  addition, the commissioner may establish methods that provide 
 76.30  information to consumers regarding service quality as measured 
 76.31  by performance indicators.  The commissioner shall involve 
 76.32  ICF/MR industry and consumer representatives in the development 
 76.33  of these recommendations. 
 76.34     Sec. 21.  [APPROVAL EXTENDED.] 
 76.35     Notwithstanding Minnesota Statutes, section 144A.073, 
 76.36  subdivision 3, the commissioner of health shall grant an 
 77.1   additional 18 months of approval for a proposed exception to the 
 77.2   nursing home licensure and certification moratorium, if the 
 77.3   proposal is to replace a 96-bed nursing home facility in Carlton 
 77.4   county and if initial approval for the proposal was granted in 
 77.5   November 1996. 
 77.6      Sec. 22.  [EFFECTIVE DATE.] 
 77.7      Section 21 is effective the day following final enactment. 
 77.8                              ARTICLE 4 
 77.9                         HEALTH CARE PROGRAMS 
 77.10     Section 1.  Minnesota Statutes 1997 Supplement, section 
 77.11  171.29, subdivision 2, is amended to read: 
 77.12     Subd. 2.  [FEES, ALLOCATION.] (a) A person whose driver's 
 77.13  license has been revoked as provided in subdivision 1, except 
 77.14  under section 169.121 or 169.123, shall pay a $30 fee before the 
 77.15  driver's license is reinstated. 
 77.16     (b) A person whose driver's license has been revoked as 
 77.17  provided in subdivision 1 under section 169.121 or 169.123 shall 
 77.18  pay a $250 fee plus a $10 surcharge before the driver's license 
 77.19  is reinstated.  The $250 fee is to be credited as follows: 
 77.20     (1) Twenty percent shall be credited to the trunk highway 
 77.21  fund. 
 77.22     (2) Fifty-five percent shall be credited to the general 
 77.23  fund. 
 77.24     (3) Eight percent shall be credited to a separate account 
 77.25  to be known as the bureau of criminal apprehension account.  
 77.26  Money in this account may be appropriated to the commissioner of 
 77.27  public safety and the appropriated amount shall be apportioned 
 77.28  80 percent for laboratory costs and 20 percent for carrying out 
 77.29  the provisions of section 299C.065. 
 77.30     (4) Twelve percent shall be credited to a separate account 
 77.31  to be known as the alcohol-impaired driver education account.  
 77.32  Money in the account is appropriated as follows: 
 77.33     (i) The first $200,000 in a fiscal year is to the 
 77.34  commissioner of children, families, and learning for programs in 
 77.35  elementary and secondary schools. 
 77.36     (ii) The remainder credited in a fiscal year is 
 78.1   appropriated to the commissioner of transportation to be spent 
 78.2   as grants to the Minnesota highway safety center at St. Cloud 
 78.3   State University for programs relating to alcohol and highway 
 78.4   safety education in elementary and secondary schools. 
 78.5      (5) Five percent shall be credited to a separate account to 
 78.6   be known as the traumatic brain injury and spinal cord injury 
 78.7   account.  $100,000 is annually appropriated from the account to 
 78.8   the commissioner of human services for traumatic brain injury 
 78.9   case management services.  The remaining money in the account is 
 78.10  annually appropriated to the commissioner of health to be used 
 78.11  as follows:  35 percent for a contract with a qualified 
 78.12  community-based organization to provide information, resources, 
 78.13  and support to assist persons with traumatic brain injury and 
 78.14  their families to access services, and 65 percent to establish 
 78.15  and maintain the traumatic brain injury and spinal cord injury 
 78.16  registry created in section 144.662 and to reimburse the 
 78.17  commissioner of economic security for the reasonable cost of 
 78.18  services provided under section 268A.03, clause (o).  For the 
 78.19  purposes of this clause, a "qualified community-based 
 78.20  organization" is a private, not-for-profit organization of 
 78.21  consumers of traumatic brain injury services and their family 
 78.22  members.  The organization must be registered with the United 
 78.23  States Internal Revenue Service under the provisions of section 
 78.24  501(c)(3) as a tax exempt organization and must have as its 
 78.25  purpose: 
 78.26     (1) the promotion of public, family, survivor, and 
 78.27  professional awareness of the incidence and consequences of 
 78.28  traumatic brain injury; 
 78.29     (2) the provision of a network of support for persons with 
 78.30  traumatic brain injury, their families, and friends; 
 78.31     (3) the development and support of programs and services to 
 78.32  prevent traumatic brain injury; 
 78.33     (4) the establishment of education programs for persons 
 78.34  with traumatic brain injury; and 
 78.35     (5) the empowerment of persons with traumatic brain injury 
 78.36  through participation in its governance. 
 79.1      (c) The $10 surcharge shall be credited to a separate 
 79.2   account to be known as the remote electronic alcohol monitoring 
 79.3   pilot program account.  The commissioner shall transfer the 
 79.4   balance of this account to the commissioner of finance on a 
 79.5   monthly basis for deposit in the general fund. 
 79.6      Sec. 2.  Minnesota Statutes 1996, section 245.462, 
 79.7   subdivision 4, is amended to read: 
 79.8      Subd. 4.  [CASE MANAGER.] (a) "Case manager" means an 
 79.9   individual employed by the county or other entity authorized by 
 79.10  the county board to provide case management services specified 
 79.11  in section 245.4711.  A case manager must have a bachelor's 
 79.12  degree in one of the behavioral sciences or related fields from 
 79.13  an accredited college or university and have at least 2,000 
 79.14  hours of supervised experience in the delivery of services to 
 79.15  adults with mental illness, must be skilled in the process of 
 79.16  identifying and assessing a wide range of client needs, and must 
 79.17  be knowledgeable about local community resources and how to use 
 79.18  those resources for the benefit of the client.  The case manager 
 79.19  shall meet in person with a mental health professional at least 
 79.20  once each month to obtain clinical supervision of the case 
 79.21  manager's activities.  Case managers with a bachelor's degree 
 79.22  but without 2,000 hours of supervised experience in the delivery 
 79.23  of services to adults with mental illness must complete 40 hours 
 79.24  of training approved by the commissioner of human services in 
 79.25  case management skills and in the characteristics and needs of 
 79.26  adults with serious and persistent mental illness and must 
 79.27  receive clinical supervision regarding individual service 
 79.28  delivery from a mental health professional at least once each 
 79.29  week until the requirement of 2,000 hours of supervised 
 79.30  experience is met.  Clinical supervision must be documented in 
 79.31  the client record. 
 79.32     Until June 30, 1999, a refugee an immigrant who does not 
 79.33  have the qualifications specified in this subdivision may 
 79.34  provide case management services to adult refugees immigrants 
 79.35  with serious and persistent mental illness who are members of 
 79.36  the same ethnic group as the case manager if the person:  (1) is 
 80.1   actively pursuing credits toward the completion of a bachelor's 
 80.2   degree in one of the behavioral sciences or a related field from 
 80.3   an accredited college or university; (2) completes 40 hours of 
 80.4   training as specified in this subdivision; and (3) receives 
 80.5   clinical supervision at least once a week until the requirements 
 80.6   of obtaining a bachelor's degree and 2,000 hours of supervised 
 80.7   experience this subdivision are met. 
 80.8      (b) The commissioner may approve waivers submitted by 
 80.9   counties to allow case managers without a bachelor's degree but 
 80.10  with 6,000 hours of supervised experience in the delivery of 
 80.11  services to adults with mental illness if the person: 
 80.12     (1) meets the qualifications for a mental health 
 80.13  practitioner in subdivision 26; 
 80.14     (2) has completed 40 hours of training approved by the 
 80.15  commissioner in case management skills and in the 
 80.16  characteristics and needs of adults with serious and persistent 
 80.17  mental illness; and 
 80.18     (3) demonstrates that the 6,000 hours of supervised 
 80.19  experience are in identifying functional needs of persons with 
 80.20  mental illness, coordinating assessment information and making 
 80.21  referrals to appropriate service providers, coordinating a 
 80.22  variety of services to support and treat persons with mental 
 80.23  illness, and monitoring to ensure appropriate provision of 
 80.24  services.  The county board is responsible to verify that all 
 80.25  qualifications, including content of supervised experience, have 
 80.26  been met.  
 80.27     Sec. 3.  Minnesota Statutes 1996, section 245.462, 
 80.28  subdivision 8, is amended to read: 
 80.29     Subd. 8.  [DAY TREATMENT SERVICES.] "Day treatment," "day 
 80.30  treatment services," or "day treatment program" means a 
 80.31  structured program of treatment and care provided to an adult in 
 80.32  or by:  (1) a hospital accredited by the joint commission on 
 80.33  accreditation of health organizations and licensed under 
 80.34  sections 144.50 to 144.55; (2) a community mental health center 
 80.35  under section 245.62; or (3) an entity that is under contract 
 80.36  with the county board to operate a program that meets the 
 81.1   requirements of section 245.4712, subdivision 2, and Minnesota 
 81.2   Rules, parts 9505.0170 to 9505.0475.  Day treatment consists of 
 81.3   group psychotherapy and other intensive therapeutic services 
 81.4   that are provided at least one day a week for a minimum 
 81.5   three-hour time block by a multidisciplinary staff under the 
 81.6   clinical supervision of a mental health professional.  The 
 81.7   services are aimed at stabilizing the adult's mental health 
 81.8   status, providing mental health services, and developing and 
 81.9   improving the adult's independent living and socialization 
 81.10  skills.  The goal of day treatment is to reduce or relieve 
 81.11  mental illness and to enable the adult to live in the 
 81.12  community.  Day treatment services are not a part of inpatient 
 81.13  or residential treatment services.  Day treatment services are 
 81.14  distinguished from day care by their structured therapeutic 
 81.15  program of psychotherapy services.  The commissioner may limit 
 81.16  medical assistance reimbursement for day treatment to 15 hours 
 81.17  per week per person instead of the three hours per day per 
 81.18  person specified in Minnesota Rules, part 9505.0323, subpart 15. 
 81.19     Sec. 4.  Minnesota Statutes 1996, section 245.4871, 
 81.20  subdivision 4, is amended to read: 
 81.21     Subd. 4.  [CASE MANAGER.] (a) "Case manager" means an 
 81.22  individual employed by the county or other entity authorized by 
 81.23  the county board to provide case management services specified 
 81.24  in subdivision 3 for the child with severe emotional disturbance 
 81.25  and the child's family.  A case manager must have experience and 
 81.26  training in working with children. 
 81.27     (b) A case manager must: 
 81.28     (1) have at least a bachelor's degree in one of the 
 81.29  behavioral sciences or a related field from an accredited 
 81.30  college or university; 
 81.31     (2) have at least 2,000 hours of supervised experience in 
 81.32  the delivery of mental health services to children; 
 81.33     (3) have experience and training in identifying and 
 81.34  assessing a wide range of children's needs; and 
 81.35     (4) be knowledgeable about local community resources and 
 81.36  how to use those resources for the benefit of children and their 
 82.1   families. 
 82.2      (c) The case manager may be a member of any professional 
 82.3   discipline that is part of the local system of care for children 
 82.4   established by the county board. 
 82.5      (d) The case manager must meet in person with a mental 
 82.6   health professional at least once each month to obtain clinical 
 82.7   supervision. 
 82.8      (e) Case managers with a bachelor's degree but without 
 82.9   2,000 hours of supervised experience in the delivery of mental 
 82.10  health services to children with emotional disturbance must: 
 82.11     (1) begin 40 hours of training approved by the commissioner 
 82.12  of human services in case management skills and in the 
 82.13  characteristics and needs of children with severe emotional 
 82.14  disturbance before beginning to provide case management 
 82.15  services; and 
 82.16     (2) receive clinical supervision regarding individual 
 82.17  service delivery from a mental health professional at least once 
 82.18  each week until the requirement of 2,000 hours of experience is 
 82.19  met. 
 82.20     (f) Clinical supervision must be documented in the child's 
 82.21  record.  When the case manager is not a mental health 
 82.22  professional, the county board must provide or contract for 
 82.23  needed clinical supervision. 
 82.24     (g) The county board must ensure that the case manager has 
 82.25  the freedom to access and coordinate the services within the 
 82.26  local system of care that are needed by the child. 
 82.27     (h) Until June 30, 1999, a refugee who does not have the 
 82.28  qualifications specified in this subdivision may provide case 
 82.29  management services to child refugees with severe emotional 
 82.30  disturbance of the same ethnic group as the refugee if the 
 82.31  person:  
 82.32     (1) is actively pursuing credits toward the completion of a 
 82.33  bachelor's degree in one of the behavioral sciences or related 
 82.34  fields at an accredited college or university; 
 82.35     (2) completes 40 hours of training as specified in this 
 82.36  subdivision; and 
 83.1      (3) receives clinical supervision at least once a week 
 83.2   until the requirements of obtaining a bachelor's degree and 
 83.3   2,000 hours of supervised experience are met. 
 83.4      (i) The commissioner may approve waivers submitted by 
 83.5   counties to allow case managers without a bachelor's degree but 
 83.6   with 6,000 hours of supervised experience in the delivery of 
 83.7   services to children with severe emotional disturbance if the 
 83.8   person: 
 83.9      (1) meets the qualifications for a mental health 
 83.10  practitioner in subdivision 26; 
 83.11     (2) has completed 40 hours of training approved by the 
 83.12  commissioner in case management skills and in the 
 83.13  characteristics and needs of children with severe emotional 
 83.14  disturbance; and 
 83.15     (3) demonstrates that the 6,000 hours of supervised 
 83.16  experience are in identifying functional needs of children with 
 83.17  severe emotional disturbance, coordinating assessment 
 83.18  information and making referrals to appropriate service 
 83.19  providers, coordinating a variety of services to support and 
 83.20  treat children with severe emotional disturbance, and monitoring 
 83.21  to ensure appropriate provision of services.  The county board 
 83.22  is responsible to verify that all qualifications, including 
 83.23  content of supervised experience, have been met. 
 83.24     Sec. 5.  [256.9364] [POST-KIDNEY TRANSPLANT DRUG PROGRAM.] 
 83.25     Subdivision 1.  [ESTABLISHMENT.] The commissioner of human 
 83.26  services shall establish and administer a program to pay for 
 83.27  costs of drugs prescribed exclusively for post-kidney transplant 
 83.28  maintenance when those costs are not otherwise reimbursed by a 
 83.29  third-party payer.  The commissioner may contract with a 
 83.30  nonprofit entity to administer this program.  
 83.31     Subd. 2.  [ELIGIBILITY REQUIREMENTS.] To be eligible for 
 83.32  the program, an applicant must satisfy the following 
 83.33  requirements:  
 83.34     (1) the applicant's family gross income must not exceed 275 
 83.35  percent of the federal poverty level; and 
 83.36     (2) the applicant must be a Minnesota resident who has 
 84.1   resided in Minnesota for at least 12 months.  
 84.2   An applicant shall not be excluded because the applicant 
 84.3   received the transplant outside the state of Minnesota, so long 
 84.4   as the other requirements are met. 
 84.5      Subd. 3.  [PAYMENT AMOUNTS.] (a) The amount of the payments 
 84.6   made for each eligible recipient shall be based on the following:
 84.7      (1) available funds; and 
 84.8      (2) the cost of the post-kidney transplant maintenance 
 84.9   drugs.  
 84.10     (b) The payment rate under this program must be no greater 
 84.11  than the medical assistance reimbursement rate for the 
 84.12  prescribed drug. 
 84.13     (c) Payments shall be made to or on behalf of an eligible 
 84.14  recipient for the cost of the post-kidney transplant maintenance 
 84.15  drugs that is not covered, reimbursed, or eligible for 
 84.16  reimbursement by any other third party or government entity, 
 84.17  including, but not limited to, private or group health 
 84.18  insurance, medical assistance, Medicare, the Veterans 
 84.19  Administration, the senior citizen drug program established 
 84.20  under section 256.955, or under any waiver arrangement received 
 84.21  by the state to provide a prescription drug benefit for 
 84.22  qualified Medicare beneficiaries or service-limited Medicare 
 84.23  beneficiaries.  
 84.24     (d) The commissioner may restrict or categorize payments to 
 84.25  meet the appropriation allocated for this program. 
 84.26     (e) Any cost of the post-kidney transplant maintenance 
 84.27  drugs that is not reimbursed under this program is the 
 84.28  responsibility of the program recipient. 
 84.29     Subd. 4.  [DRUG FORMULARY.] The commissioner shall maintain 
 84.30  a drug formulary that includes all drugs eligible for 
 84.31  reimbursement by the program.  The commissioner may use the drug 
 84.32  formulary established under section 256B.0625, subdivision 13.  
 84.33  The commissioner shall establish an internal review procedure 
 84.34  for updating the formulary that allows for the addition and 
 84.35  deletion of drugs to the formulary.  The drug formulary must be 
 84.36  reviewed at least quarterly per fiscal year. 
 85.1      Subd. 5.  [PRIVATE DONATIONS.] The commissioner may accept 
 85.2   funding from other public or private sources. 
 85.3      Subd. 6.  [SUNSET.] This program expires on July 1, 2000. 
 85.4      Sec. 6.  Minnesota Statutes 1997 Supplement, section 
 85.5   256.9657, subdivision 3, is amended to read: 
 85.6      Subd. 3.  [HEALTH MAINTENANCE ORGANIZATION; COMMUNITY 
 85.7   INTEGRATED SERVICE NETWORK SURCHARGE.] (a) Effective October 1, 
 85.8   1992, each health maintenance organization with a certificate of 
 85.9   authority issued by the commissioner of health under chapter 62D 
 85.10  and each community integrated service network licensed by the 
 85.11  commissioner under chapter 62N shall pay to the commissioner of 
 85.12  human services a surcharge equal to six-tenths of one percent of 
 85.13  the total premium revenues of the health maintenance 
 85.14  organization or community integrated service network as reported 
 85.15  to the commissioner of health according to the schedule in 
 85.16  subdivision 4.  
 85.17     (b) For purposes of this subdivision, total premium revenue 
 85.18  means: 
 85.19     (1) premium revenue recognized on a prepaid basis from 
 85.20  individuals and groups for provision of a specified range of 
 85.21  health services over a defined period of time which is normally 
 85.22  one month, excluding premiums paid to a health maintenance 
 85.23  organization or community integrated service network from the 
 85.24  Federal Employees Health Benefit Program; 
 85.25     (2) premiums from Medicare wrap-around subscribers for 
 85.26  health benefits which supplement Medicare coverage; 
 85.27     (3) Medicare revenue, as a result of an arrangement between 
 85.28  a health maintenance organization or a community integrated 
 85.29  service network and the health care financing administration of 
 85.30  the federal Department of Health and Human Services, for 
 85.31  services to a Medicare beneficiary, excluding Medicare revenue 
 85.32  that states are prohibited from taxing under sections 4001 and 
 85.33  4002 of Public Law Number 105-33 received by a health 
 85.34  maintenance organization or community integrated service network 
 85.35  through risk sharing or Medicare Choice + contracts; and 
 85.36     (4) medical assistance revenue, as a result of an 
 86.1   arrangement between a health maintenance organization or 
 86.2   community integrated service network and a Medicaid state 
 86.3   agency, for services to a medical assistance beneficiary. 
 86.4      If advance payments are made under clause (1) or (2) to the 
 86.5   health maintenance organization or community integrated service 
 86.6   network for more than one reporting period, the portion of the 
 86.7   payment that has not yet been earned must be treated as a 
 86.8   liability. 
 86.9      (c) When a health maintenance organization or community 
 86.10  integrated service network merges or consolidates with or is 
 86.11  acquired by another health maintenance organization or community 
 86.12  integrated service network, the surviving corporation or the new 
 86.13  corporation shall be responsible for the annual surcharge 
 86.14  originally imposed on each of the entities or corporations 
 86.15  subject to the merger, consolidation, or acquisition, regardless 
 86.16  of whether one of the entities or corporations does not retain a 
 86.17  certificate of authority under chapter 62D or a license under 
 86.18  chapter 62N. 
 86.19     (d) Effective July 1 of each year, the surviving 
 86.20  corporation's or the new corporation's surcharge shall be based 
 86.21  on the revenues earned in the second previous calendar year by 
 86.22  all of the entities or corporations subject to the merger, 
 86.23  consolidation, or acquisition regardless of whether one of the 
 86.24  entities or corporations does not retain a certificate of 
 86.25  authority under chapter 62D or a license under chapter 62N until 
 86.26  the total premium revenues of the surviving corporation include 
 86.27  the total premium revenues of all the merged entities as 
 86.28  reported to the commissioner of health. 
 86.29     (e) When a health maintenance organization or community 
 86.30  integrated service network, which is subject to liability for 
 86.31  the surcharge under this chapter, transfers, assigns, sells, 
 86.32  leases, or disposes of all or substantially all of its property 
 86.33  or assets, liability for the surcharge imposed by this chapter 
 86.34  is imposed on the transferee, assignee, or buyer of the health 
 86.35  maintenance organization or community integrated service network.
 86.36     (f) In the event a health maintenance organization or 
 87.1   community integrated service network converts its licensure to a 
 87.2   different type of entity subject to liability for the surcharge 
 87.3   under this chapter, but survives in the same or substantially 
 87.4   similar form, the surviving entity remains liable for the 
 87.5   surcharge regardless of whether one of the entities or 
 87.6   corporations does not retain a certificate of authority under 
 87.7   chapter 62D or a license under chapter 62N. 
 87.8      (g) The surcharge assessed to a health maintenance 
 87.9   organization or community integrated service network ends when 
 87.10  the entity ceases providing services for premiums and the 
 87.11  cessation is not connected with a merger, consolidation, 
 87.12  acquisition, or conversion. 
 87.13     Sec. 7.  Minnesota Statutes 1997 Supplement, section 
 87.14  256.9685, subdivision 1, is amended to read: 
 87.15     Subdivision 1.  [AUTHORITY.] The commissioner shall 
 87.16  establish procedures for determining medical assistance and 
 87.17  general assistance medical care payment rates under a 
 87.18  prospective payment system for inpatient hospital services in 
 87.19  hospitals that qualify as vendors of medical assistance.  The 
 87.20  commissioner shall establish, by rule, procedures for 
 87.21  implementing this section and sections 256.9686, 256.969, and 
 87.22  256.9695.  The medical assistance payment rates must be based on 
 87.23  methods and standards that the commissioner finds are adequate 
 87.24  to provide for the costs that must be incurred for the care of 
 87.25  recipients in efficiently and economically operated hospitals.  
 87.26  Services must meet the requirements of section 256B.04, 
 87.27  subdivision 15, or 256D.03, subdivision 7, paragraph (b), to be 
 87.28  eligible for payment. 
 87.29     Sec. 8.  Minnesota Statutes 1996, section 256.969, 
 87.30  subdivision 16, is amended to read: 
 87.31     Subd. 16.  [INDIAN HEALTH SERVICE FACILITIES.] Indian 
 87.32  health service Facilities of the Indian health service and 
 87.33  facilities operated by a tribe or tribal organization under 
 87.34  funding authorized by title III of the Indian Self-Determination 
 87.35  and Education Assistance Act, Public Law Number 93-638, or by 
 87.36  United States Code, title 25, chapter 14, subchapter II, 
 88.1   sections 450f to 450n, are exempt from the rate establishment 
 88.2   methods required by this section and shall be reimbursed at 
 88.3   charges as limited to the amount allowed under federal law paid 
 88.4   according to the rate published by the United States assistant 
 88.5   secretary for health under authority of United States Code, 
 88.6   title 42, sections 248A and 248B.  
 88.7      Sec. 9.  Minnesota Statutes 1996, section 256.969, 
 88.8   subdivision 17, is amended to read: 
 88.9      Subd. 17.  [OUT-OF-STATE HOSPITALS IN LOCAL TRADE AREAS.] 
 88.10  Out-of-state hospitals that are located within a Minnesota local 
 88.11  trade area and that have more than 20 admissions in the base 
 88.12  year shall have rates established using the same procedures and 
 88.13  methods that apply to Minnesota hospitals.  For this subdivision 
 88.14  and subdivision 18, local trade area means a county contiguous 
 88.15  to Minnesota and located in a metropolitan statistical area as 
 88.16  determined by Medicare for October 1 prior to the most current 
 88.17  rebased rate year.  Hospitals that are not required by law to 
 88.18  file information in a format necessary to establish rates shall 
 88.19  have rates established based on the commissioner's estimates of 
 88.20  the information.  Relative values of the diagnostic categories 
 88.21  shall not be redetermined under this subdivision until required 
 88.22  by rule.  Hospitals affected by this subdivision shall then be 
 88.23  included in determining relative values.  However, hospitals 
 88.24  that have rates established based upon the commissioner's 
 88.25  estimates of information shall not be included in determining 
 88.26  relative values.  This subdivision is effective for hospital 
 88.27  fiscal years beginning on or after July 1, 1988.  A hospital 
 88.28  shall provide the information necessary to establish rates under 
 88.29  this subdivision at least 90 days before the start of the 
 88.30  hospital's fiscal year. 
 88.31     Sec. 10.  Minnesota Statutes 1996, section 256B.03, 
 88.32  subdivision 3, is amended to read: 
 88.33     Subd. 3.  [AMERICAN INDIAN HEALTH FUNDING TRIBAL PURCHASING 
 88.34  MODEL.] Notwithstanding subdivision 1 and sections 256B.0625 and 
 88.35  256D.03, subdivision 4, paragraph (f) (i), the commissioner may 
 88.36  make payments to federally recognized Indian tribes with a 
 89.1   reservation in the state to provide medical assistance and 
 89.2   general assistance medical care to Indians, as defined under 
 89.3   federal law, who reside on or near the reservation.  The 
 89.4   payments may be made in the form of a block grant or other 
 89.5   payment mechanism determined in consultation with the tribe.  
 89.6   Any alternative payment mechanism agreed upon by the tribes and 
 89.7   the commissioner under this subdivision is not dependent upon 
 89.8   county or health plan agreement but is intended to create a 
 89.9   direct payment mechanism between the state and the tribe for the 
 89.10  administration of the medical assistance program and general 
 89.11  assistance medical care programs, and for covered services.  
 89.12     A tribe that implements a purchasing model under this 
 89.13  subdivision shall report to the commissioner at least annually 
 89.14  on the operation of the model.  The commissioner and the tribe 
 89.15  shall cooperatively determine the data elements, format, and 
 89.16  timetable for the report. 
 89.17     For purposes of this subdivision, "Indian tribe" means a 
 89.18  tribe, band, or nation, or other organized group or community of 
 89.19  Indians that is recognized as eligible for the special programs 
 89.20  and services provided by the United States to Indians because of 
 89.21  their status as Indians and for which a reservation exists as is 
 89.22  consistent with Public Law Number 100-485, as amended. 
 89.23     Payments under this subdivision may not result in an 
 89.24  increase in expenditures that would not otherwise occur in the 
 89.25  medical assistance program under this chapter or the general 
 89.26  assistance medical care program under chapter 256D. 
 89.27     Sec. 11.  [256B.038] [PROVIDER RATE INCREASES AFTER JUNE 
 89.28  30, 1999.] 
 89.29     (a) For fiscal years beginning on or after July 1, 1999, 
 89.30  the commissioner shall consider increasing payment rates for the 
 89.31  services listed in paragraph (b) by indexing the rates in effect 
 89.32  for inflation based on the change in the Consumer Price 
 89.33  Index-All Items (United States city average)(CPI-U) as 
 89.34  forecasted by Data Resources, Inc., in the fourth quarter of the 
 89.35  prior year for the calendar year during which the rate increase 
 89.36  occurs. 
 90.1      (b) The rate increases in paragraph (a) shall apply to home 
 90.2   and community-based waiver services for persons with mental 
 90.3   retardation or related conditions under section 256B.501; home 
 90.4   and community-based waiver services for the elderly under 
 90.5   section 256B.0915; waivered services under community 
 90.6   alternatives for disabled individuals under section 256B.49; 
 90.7   community alternative care waivered services under section 
 90.8   256B.49; traumatic brain injury waivered services under section 
 90.9   256B.49; nursing services and home health services under section 
 90.10  256B.0625, subdivision 6a; personal care services and nursing 
 90.11  supervision of personal care services under section 256B.0625, 
 90.12  subdivision 19a; private duty nursing services under section 
 90.13  256B.0625, subdivision 7; day training and habilitation services 
 90.14  for adults with mental retardation or related conditions under 
 90.15  sections 252.40 to 252.46; physical therapy services under 
 90.16  sections 256B.0625, subdivision 8, and 256D.03, subdivision 4; 
 90.17  occupational therapy services under sections 256B.0625, 
 90.18  subdivision 8a, and 256D.03, subdivision 4; speech-language 
 90.19  therapy services under section 256D.03, subdivision 4, and 
 90.20  Minnesota Rules, part 9505.0390; respiratory therapy services 
 90.21  under section 256D.03, subdivision 4, and Minnesota Rules, part 
 90.22  9505.0295; physician services under section 256B.0625, 
 90.23  subdivision 3; dental services under sections 256B.0625, 
 90.24  subdivision 9, and 256D.03, subdivision 4; alternative care 
 90.25  services under section 256B.0913; adult residential program 
 90.26  grants under Minnesota Rules, parts 9535.2000 to 9535.3000; 
 90.27  adult and family community support grants under Minnesota Rules, 
 90.28  parts 9535.1700 to 9535.1760; and semi-independent living 
 90.29  services under section 252.275, including SILS funding under 
 90.30  county social services grants formerly funded under chapter 256I.
 90.31     (c) The commissioner shall increase prepaid medical 
 90.32  assistance program capitation rates as appropriate to reflect 
 90.33  the rate increases in this section. 
 90.34     (d) In implementing this section, the commissioner shall 
 90.35  consider proposing a schedule to equalize rates paid by 
 90.36  different programs for the same service. 
 91.1      Sec. 12.  Minnesota Statutes 1996, section 256B.04, is 
 91.2   amended by adding a subdivision to read: 
 91.3      Subd. 19.  [INFORMATION PROVIDED IN SEVERAL 
 91.4   LANGUAGES.] Upon request, the commissioner shall provide 
 91.5   applications and other information regarding medical assistance, 
 91.6   including all notices and disclosures provided to applicants and 
 91.7   recipients, in English, Spanish, Vietnamese, and Hmong.  
 91.8   Reasonable effort must be made to provide this information to 
 91.9   other non-English-speaking applicants and recipients. 
 91.10     Sec. 13.  Minnesota Statutes 1996, section 256B.055, 
 91.11  subdivision 7, is amended to read: 
 91.12     Subd. 7.  [AGED, BLIND, OR DISABLED PERSONS.] Medical 
 91.13  assistance may be paid for a person who meets the categorical 
 91.14  eligibility requirements of the supplemental security income 
 91.15  program or, who would meet those requirements except for excess 
 91.16  income or assets, and who meets the other eligibility 
 91.17  requirements of this section.  
 91.18     Effective February 1, 1989, and to the extent allowed by 
 91.19  federal law the commissioner shall deduct state and federal 
 91.20  income taxes and federal insurance contributions act payments 
 91.21  withheld from the individual's earned income in determining 
 91.22  eligibility under this subdivision. 
 91.23     Sec. 14.  Minnesota Statutes 1996, section 256B.055, is 
 91.24  amended by adding a subdivision to read: 
 91.25     Subd. 7a.  [SPECIAL CATEGORY FOR DISABLED 
 91.26  CHILDREN.] Medical assistance may be paid for a person who is 
 91.27  under age 18 and who meets income and asset eligibility 
 91.28  requirements of the Supplemental Security Income program if the 
 91.29  person was receiving Supplemental Security Income payments on 
 91.30  the date of enactment of section 211(a) of Public Law Number 
 91.31  104-193, the Personal Responsibility and Work Opportunity Act of 
 91.32  1996, and the person would have continued to receive such 
 91.33  payments except for the change in the childhood disability 
 91.34  criteria in section 211(a) of Public Law Number 104-193. 
 91.35     Sec. 15.  Minnesota Statutes 1997 Supplement, section 
 91.36  256B.056, subdivision 1a, is amended to read: 
 92.1      Subd. 1a.  [INCOME AND ASSETS GENERALLY.] Unless 
 92.2   specifically required by state law or rule or federal law or 
 92.3   regulation, the methodologies used in counting income and assets 
 92.4   to determine eligibility for medical assistance for persons 
 92.5   whose eligibility category is based on blindness, disability, or 
 92.6   age of 65 or more years, the methodologies for the supplemental 
 92.7   security income program shall be used, except that payments made 
 92.8   according to a court order for the support of children shall be 
 92.9   excluded from income in an amount not to exceed the difference 
 92.10  between the applicable income standard used in the state's 
 92.11  medical assistance program for aged, blind, and disabled persons 
 92.12  and the applicable income standard used in the state's medical 
 92.13  assistance program for families with children.  Exclusion of 
 92.14  court-ordered child support payments is subject to the condition 
 92.15  that if there has been a change in the financial circumstances 
 92.16  of the person with the legal obligation to pay support since the 
 92.17  support order was entered, the person with the legal obligation 
 92.18  to pay support has petitioned for modification of the support 
 92.19  order.  For families and children, which includes all other 
 92.20  eligibility categories, the methodologies under the state's AFDC 
 92.21  plan in effect as of July 16, 1996, as required by the Personal 
 92.22  Responsibility and Work Opportunity Reconciliation Act of 1996 
 92.23  (PRWORA), Public Law Number 104-193, shall be used.  Effective 
 92.24  upon federal approval, in-kind contributions to, and payments 
 92.25  made on behalf of, a recipient, by an obligor, in satisfaction 
 92.26  of or in addition to a temporary or permanent order for child 
 92.27  support or maintenance, shall be considered income to the 
 92.28  recipient.  For these purposes, a "methodology" does not include 
 92.29  an asset or income standard, or accounting method, or method of 
 92.30  determining effective dates. 
 92.31     Sec. 16.  Minnesota Statutes 1997 Supplement, section 
 92.32  256B.056, subdivision 4, is amended to read: 
 92.33     Subd. 4.  [INCOME.] To be eligible for medical assistance, 
 92.34  a person must not have, or anticipate receiving, semiannual 
 92.35  income in excess of 120 percent of the income standards by 
 92.36  family size used under the aid to families with dependent 
 93.1   children state plan as of July 16, 1996, as required by the 
 93.2   Personal Responsibility and Work Opportunity Reconciliation Act 
 93.3   of 1996 (PRWORA), Public Law Number 104-193, except 
 93.4   that eligible under section 256B.055, subdivision 7, and 
 93.5   families and children may have an income up to 133-1/3 percent 
 93.6   of the AFDC income standard in effect under the July 16, 1996, 
 93.7   AFDC state plan.  For rate years beginning on or after July 1, 
 93.8   1999, the commissioner shall consider increasing the base AFDC 
 93.9   standard in effect July 16, 1996, by an amount equal to the 
 93.10  percentage increase in the Consumer Price Index for all urban 
 93.11  consumers for the previous calendar year.  In computing income 
 93.12  to determine eligibility of persons who are not residents of 
 93.13  long-term care facilities, the commissioner shall disregard 
 93.14  increases in income as required by Public Law Numbers 94-566, 
 93.15  section 503; 99-272; and 99-509.  Veterans aid and attendance 
 93.16  benefits and Veterans Administration unusual medical expense 
 93.17  payments are considered income to the recipient. 
 93.18     Sec. 17.  Minnesota Statutes 1996, section 256B.057, 
 93.19  subdivision 3a, is amended to read: 
 93.20     Subd. 3a.  [ELIGIBILITY FOR PAYMENT OF MEDICARE PART B 
 93.21  PREMIUMS.] A person who would otherwise be eligible as a 
 93.22  qualified Medicare beneficiary under subdivision 3, except the 
 93.23  person's income is in excess of the limit, is eligible for 
 93.24  medical assistance reimbursement of Medicare Part B premiums if 
 93.25  the person's income is less than 110 120 percent of the official 
 93.26  federal poverty guidelines for the applicable family size.  The 
 93.27  income limit shall increase to 120 percent of the official 
 93.28  federal poverty guidelines for the applicable family size on 
 93.29  January 1, 1995. 
 93.30     Sec. 18.  Minnesota Statutes 1996, section 256B.057, is 
 93.31  amended by adding a subdivision to read: 
 93.32     Subd. 3b.  [QUALIFYING INDIVIDUALS.] Beginning July 1, 
 93.33  1998, to the extent of the federal allocation to Minnesota, a 
 93.34  person, who would otherwise be eligible as a qualified Medicare 
 93.35  beneficiary under subdivision 3, except that the person's income 
 93.36  is in excess of the limit, is eligible as a qualifying 
 94.1   individual according to the following criteria: 
 94.2      (1) if the person's income is greater than 120 percent, but 
 94.3   less than 135 percent of the official federal poverty guidelines 
 94.4   for the applicable family size, the person is eligible for 
 94.5   medical assistance reimbursement of Medicare Part B premiums; or 
 94.6      (2) if the person's income is greater than 135 percent but 
 94.7   less than 175 percent of the official federal poverty guidelines 
 94.8   for the applicable family size, the person is eligible for 
 94.9   medical assistance reimbursement of that portion of the Medicare 
 94.10  Part B premium attributable to an increase in Part B 
 94.11  expenditures which resulted from the shift of home care services 
 94.12  from Medicare Part A to Medicare Part B under Public Law Number 
 94.13  105-33, section 4732, the Balanced Budget Act of 1997. 
 94.14     The commissioner shall limit enrollment of qualifying 
 94.15  individuals under this subdivision according to the requirements 
 94.16  of Public Law Number 105-33, section 4732. 
 94.17     Sec. 19.  Minnesota Statutes 1997 Supplement, section 
 94.18  256B.06, subdivision 4, is amended to read: 
 94.19     Subd. 4.  [CITIZENSHIP REQUIREMENTS.] (a) Eligibility for 
 94.20  medical assistance is limited to citizens of the United States, 
 94.21  qualified noncitizens as defined in this subdivision, and other 
 94.22  persons residing lawfully in the United States. 
 94.23     (b) "Qualified noncitizen" means a person who meets one of 
 94.24  the following immigration criteria: 
 94.25     (1) admitted for lawful permanent residence according to 
 94.26  United States Code, title 8; 
 94.27     (2) admitted to the United States as a refugee according to 
 94.28  United States Code, title 8, section 1157; 
 94.29     (3) granted asylum according to United States Code, title 
 94.30  8, section 1158; 
 94.31     (4) granted withholding of deportation according to United 
 94.32  States Code, title 8, section 1253(h); 
 94.33     (5) paroled for a period of at least one year according to 
 94.34  United States Code, title 8, section 1182(d)(5); 
 94.35     (6) granted conditional entrant status according to United 
 94.36  States Code, title 8, section 1153(a)(7); or 
 95.1      (7) determined to be a battered noncitizen by the United 
 95.2   States Attorney General according to the Illegal Immigration 
 95.3   Reform and Immigrant Responsibility Act of 1996, title V of the 
 95.4   Omnibus Consolidated Appropriations Bill, Public Law Number 
 95.5   104-200; 
 95.6      (8) is a child of a noncitizen determined to be a battered 
 95.7   noncitizen by the United States Attorney General according to 
 95.8   the Illegal Immigration Reform and Immigrant Responsibility Act 
 95.9   of 1996, title V, of the Omnibus Consolidated Appropriations 
 95.10  Bill, Public Law Number 104-200; or 
 95.11     (9) determined to be a Cuban or Haitian entrant as defined 
 95.12  in section 501(e) of Public Law Number 96-422, the Refugee 
 95.13  Education Assistance Act of 1980. 
 95.14     (c) All qualified noncitizens who were residing in the 
 95.15  United States before August 22, 1996, who otherwise meet the 
 95.16  eligibility requirements of chapter 256B, are eligible for 
 95.17  medical assistance with federal financial participation. 
 95.18     (d) All qualified noncitizens who entered the United States 
 95.19  on or after August 22, 1996, and who otherwise meet the 
 95.20  eligibility requirements of chapter 256B, are eligible for 
 95.21  medical assistance with federal financial participation through 
 95.22  November 30, 1996. 
 95.23     Beginning December 1, 1996, qualified noncitizens who 
 95.24  entered the United States on or after August 22, 1996, and who 
 95.25  otherwise meet the eligibility requirements of chapter 256B are 
 95.26  eligible for medical assistance with federal participation for 
 95.27  five years if they meet one of the following criteria: 
 95.28     (i) refugees admitted to the United States according to 
 95.29  United States Code, title 8, section 1157; 
 95.30     (ii) persons granted asylum according to United States 
 95.31  Code, title 8, section 1158; 
 95.32     (iii) persons granted withholding of deportation according 
 95.33  to United States Code, title 8, section 1253(h); 
 95.34     (iv) veterans of the United States Armed Forces with an 
 95.35  honorable discharge for a reason other than noncitizen status, 
 95.36  their spouses and unmarried minor dependent children; or 
 96.1      (v) persons on active duty in the United States Armed 
 96.2   Forces, other than for training, their spouses and unmarried 
 96.3   minor dependent children. 
 96.4      Beginning December 1, 1996, qualified noncitizens who do 
 96.5   not meet one of the criteria in items (i) to (v) are eligible 
 96.6   for medical assistance without federal financial participation 
 96.7   as described in paragraph (j). 
 96.8      (e) Noncitizens who are not qualified noncitizens as 
 96.9   defined in paragraph (b), who are lawfully residing in the 
 96.10  United States and who otherwise meet the eligibility 
 96.11  requirements of chapter 256B, are eligible for medical 
 96.12  assistance under clauses (1) to (3).  These individuals must 
 96.13  cooperate with the Immigration and Naturalization Service to 
 96.14  pursue any applicable immigration status, including citizenship, 
 96.15  that would qualify them for medical assistance with federal 
 96.16  financial participation. 
 96.17     (1) Persons who were medical assistance recipients on 
 96.18  August 22, 1996, are eligible for medical assistance with 
 96.19  federal financial participation through December 31, 1996. 
 96.20     (2) Beginning January 1, 1997, persons described in clause 
 96.21  (1) are eligible for medical assistance without federal 
 96.22  financial participation as described in paragraph (j). 
 96.23     (3) Beginning December 1, 1996, persons residing in the 
 96.24  United States prior to August 22, 1996, who were not receiving 
 96.25  medical assistance and persons who arrived on or after August 
 96.26  22, 1996, are eligible for medical assistance without federal 
 96.27  financial participation as described in paragraph (j). 
 96.28     (f) Nonimmigrants who otherwise meet the eligibility 
 96.29  requirements of chapter 256B are eligible for the benefits as 
 96.30  provided in paragraphs (g) to (i).  For purposes of this 
 96.31  subdivision, a "nonimmigrant" is a person in one of the classes 
 96.32  listed in United States Code, title 8, section 1101(a)(15). 
 96.33     (g) Payment shall also be made for care and services that 
 96.34  are furnished to noncitizens, regardless of immigration status, 
 96.35  who otherwise meet the eligibility requirements of chapter 256B, 
 96.36  if such care and services are necessary for the treatment of an 
 97.1   emergency medical condition, except for organ transplants and 
 97.2   related care and services and routine prenatal care.  
 97.3      (h) For purposes of this subdivision, the term "emergency 
 97.4   medical condition" means a medical condition that meets the 
 97.5   requirements of United States Code, title 42, section 1396b(v). 
 97.6      (i) Pregnant noncitizens who are undocumented or 
 97.7   nonimmigrants, who otherwise meet the eligibility requirements 
 97.8   of chapter 256B, are eligible for medical assistance payment 
 97.9   without federal financial participation for care and services 
 97.10  through the period of pregnancy, and 60 days postpartum, except 
 97.11  for labor and delivery.  
 97.12     (j) Qualified noncitizens as described in paragraph (d), 
 97.13  and all other noncitizens lawfully residing in the United States 
 97.14  as described in paragraph (e), who are ineligible for medical 
 97.15  assistance with federal financial participation and who 
 97.16  otherwise meet the eligibility requirements of chapter 256B and 
 97.17  of this paragraph, are eligible for medical assistance without 
 97.18  federal financial participation.  Qualified noncitizens as 
 97.19  described in paragraph (d) are only eligible for medical 
 97.20  assistance without federal financial participation for five 
 97.21  years from their date of entry into the United States.  
 97.22     (k) The commissioner shall submit to the legislature by 
 97.23  December 31, 1998, a report on the number of recipients and cost 
 97.24  of coverage of care and services made according to paragraphs 
 97.25  (i) and (j). 
 97.26     Sec. 20.  Minnesota Statutes 1996, section 256B.0625, is 
 97.27  amended by adding a subdivision to read: 
 97.28     Subd. 3a.  [GENDER REASSIGNMENT SURGERY.] Gender 
 97.29  reassignment surgery and other gender reassignment medical 
 97.30  procedures including drug therapy for gender reassignment are 
 97.31  not medically necessary. 
 97.32     Sec. 21.  Minnesota Statutes 1996, section 256B.0625, 
 97.33  subdivision 7, is amended to read: 
 97.34     Subd. 7.  [PRIVATE DUTY NURSING.] Medical assistance covers 
 97.35  private duty nursing services in a recipient's home.  Recipients 
 97.36  who are authorized to receive private duty nursing services in 
 98.1   their home may use approved hours outside of the home during 
 98.2   hours when normal life activities take them outside of their 
 98.3   home and when, without the provision of private duty nursing, 
 98.4   their health and safety would be jeopardized.  To use private 
 98.5   duty nursing services at school, the recipient or responsible 
 98.6   party must provide written authorization in the care plan 
 98.7   identifying the chosen provider and the daily amount of services 
 98.8   to be used at school.  Medical assistance does not cover private 
 98.9   duty nursing services for residents of a hospital, nursing 
 98.10  facility, intermediate care facility, or a health care facility 
 98.11  licensed by the commissioner of health, except as authorized in 
 98.12  section 256B.64 for ventilator-dependent recipients in hospitals 
 98.13  or unless a resident who is otherwise eligible is on leave from 
 98.14  the facility and the facility either pays for the private duty 
 98.15  nursing services or forgoes the facility per diem for the leave 
 98.16  days that private duty nursing services are used.  Total hours 
 98.17  of service and payment allowed for services outside the home 
 98.18  cannot exceed that which is otherwise allowed in an in-home 
 98.19  setting according to section 256B.0627.  All private duty 
 98.20  nursing services must be provided according to the limits 
 98.21  established under section 256B.0627.  Private duty nursing 
 98.22  services may not be reimbursed if the nurse is the spouse of the 
 98.23  recipient or the parent or foster care provider of a recipient 
 98.24  who is under age 18, or the recipient's legal guardian. 
 98.25     Sec. 22.  Minnesota Statutes 1996, section 256B.0625, 
 98.26  subdivision 17, is amended to read: 
 98.27     Subd. 17.  [TRANSPORTATION COSTS.] (a) Medical assistance 
 98.28  covers transportation costs incurred solely for obtaining 
 98.29  emergency medical care or transportation costs incurred by 
 98.30  nonambulatory persons in obtaining emergency or nonemergency 
 98.31  medical care when paid directly to an ambulance company, common 
 98.32  carrier, or other recognized providers of transportation 
 98.33  services.  For the purpose of this subdivision, a person who is 
 98.34  incapable of transport by taxicab or bus shall be considered to 
 98.35  be nonambulatory. 
 98.36     (b) Medical assistance covers special transportation, as 
 99.1   defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 
 99.2   if the provider receives and maintains a current physician's 
 99.3   order by the recipient's attending physician certifying that the 
 99.4   recipient has a physical or mental impairment that would 
 99.5   prohibit the recipient from safely accessing and using a bus, 
 99.6   taxi, other commercial transportation, or private automobile.  
 99.7   Special transportation includes driver-assisted service to 
 99.8   eligible individuals.  Driver-assisted service includes 
 99.9   passenger pickup at and return to the individual's residence or 
 99.10  place of business, assistance with admittance of the individual 
 99.11  to the medical facility, and assistance in passenger securement 
 99.12  or in securing of wheelchairs or stretchers in the vehicle.  The 
 99.13  commissioner shall establish maximum medical assistance 
 99.14  reimbursement rates for special transportation services for 
 99.15  persons who need a wheelchair lift van or stretcher-equipped 
 99.16  vehicle and for those who do not need a wheelchair lift van or 
 99.17  stretcher-equipped vehicle.  The average of these two rates per 
 99.18  trip must not exceed $14 $16 for the base rate and $1.10 $1.30 
 99.19  per mile.  Special transportation provided to nonambulatory 
 99.20  persons who do not need a wheelchair lift van or 
 99.21  stretcher-equipped vehicle, may be reimbursed at a lower rate 
 99.22  than special transportation provided to persons who need a 
 99.23  wheelchair lift van or stretcher-equipped vehicle. 
 99.24     Sec. 23.  Minnesota Statutes 1996, section 256B.0625, is 
 99.25  amended by adding a subdivision to read: 
 99.26     Subd. 17a.  [PAYMENT FOR AMBULANCE SERVICES.] Effective for 
 99.27  services rendered on or after July 1, 1999, medical assistance 
 99.28  payments for ambulance services shall be increased by ten 
 99.29  percent.  
 99.30     Sec. 24.  Minnesota Statutes 1996, section 256B.0625, 
 99.31  subdivision 19a, is amended to read: 
 99.32     Subd. 19a.  [PERSONAL CARE SERVICES.] Medical assistance 
 99.33  covers personal care services in a recipient's home.  To qualify 
 99.34  for personal care services, recipients or responsible parties 
 99.35  must be able to identify the recipient's needs, direct and 
 99.36  evaluate task accomplishment, and provide for health and 
100.1   safety.  Approved hours may be used outside the home when normal 
100.2   life activities take them outside the home and when, without the 
100.3   provision of personal care, their health and safety would be 
100.4   jeopardized.  To use personal care services at school, the 
100.5   recipient or responsible party must provide written 
100.6   authorization in the care plan identifying the chosen provider 
100.7   and the daily amount of services to be used at school.  Total 
100.8   hours for services, whether actually performed inside or outside 
100.9   the recipient's home, cannot exceed that which is otherwise 
100.10  allowed for personal care services in an in-home setting 
100.11  according to section 256B.0627.  Medical assistance does not 
100.12  cover personal care services for residents of a hospital, 
100.13  nursing facility, intermediate care facility, health care 
100.14  facility licensed by the commissioner of health, or unless a 
100.15  resident who is otherwise eligible is on leave from the facility 
100.16  and the facility either pays for the personal care services or 
100.17  forgoes the facility per diem for the leave days that personal 
100.18  care services are used.  All personal care services must be 
100.19  provided according to section 256B.0627.  Personal care services 
100.20  may not be reimbursed if the personal care assistant is the 
100.21  spouse or legal guardian of the recipient or the parent of a 
100.22  recipient under age 18, or the responsible party or the foster 
100.23  care provider of a recipient who cannot direct the recipient's 
100.24  own care unless, in the case of a foster care provider, a county 
100.25  or state case manager visits the recipient as needed, but not 
100.26  less than every six months, to monitor the health and safety of 
100.27  the recipient and to ensure the goals of the care plan are met.  
100.28  Parents of adult recipients, adult children of the recipient or 
100.29  adult siblings of the recipient may be reimbursed for personal 
100.30  care services if they are not the recipient's legal guardian and 
100.31  are granted a waiver under section 256B.0627. 
100.32     Sec. 25.  Minnesota Statutes 1996, section 256B.0625, 
100.33  subdivision 20, is amended to read: 
100.34     Subd. 20.  [MENTAL ILLNESS HEALTH CASE MANAGEMENT.] (a) To 
100.35  the extent authorized by rule of the state agency, medical 
100.36  assistance covers case management services to persons with 
101.1   serious and persistent mental illness or subject to federal 
101.2   approval, and children with severe emotional disturbance.  
101.3   Services provided under this section must meet the relevant 
101.4   standards in sections 245.461 to 245.4888, the Comprehensive 
101.5   Adult and Children's Mental Health Acts, Minnesota Rules, parts 
101.6   9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10. 
101.7      (b) Entities meeting program standards set out in rules 
101.8   governing family community support services as defined in 
101.9   section 245.4871, subdivision 17, are eligible for medical 
101.10  assistance reimbursement for case management services for 
101.11  children with severe emotional disturbance when these services 
101.12  meet the program standards in Minnesota Rules, parts 9520.0900 
101.13  to 9520.0926 and 9505.0322, excluding subpart 6 subparts 6 and 
101.14  10. 
101.15     (b) In counties where fewer than 50 percent of children 
101.16  estimated to be eligible under medical assistance to receive 
101.17  case management services for children with severe emotional 
101.18  disturbance actually receive these services in state fiscal year 
101.19  1995, community mental health centers serving those counties, 
101.20  entities meeting program standards in Minnesota Rules, parts 
101.21  9520.0570 to 9520.0870, and other entities authorized by the 
101.22  commissioner are eligible for medical assistance reimbursement 
101.23  for case management services for children with severe emotional 
101.24  disturbance when these services meet the program standards in 
101.25  Minnesota Rules, parts 9520.0900 to 9520.0926 and 9505.0322, 
101.26  excluding subpart 6. 
101.27     (c) Medical assistance and MinnesotaCare payment for mental 
101.28  health case management shall be made on a monthly basis.  In 
101.29  order to receive payment for an eligible child, the provider 
101.30  must document at least a face-to-face contact with the child, 
101.31  the child's parents, or the child's legal representative.  To 
101.32  receive payment for an eligible adult, the provider must 
101.33  document at least a face-to-face contact with the adult or the 
101.34  adult's legal representative. 
101.35     (d) Payment for mental health case management provided by 
101.36  county or state staff shall be based on the monthly rate 
102.1   methodology under section 256B.094, subdivision 6, paragraph 
102.2   (b), with separate rates calculated for child welfare and mental 
102.3   health, and within mental health, separate rates for children 
102.4   and adults. 
102.5      (e) Payment for mental health case management provided by 
102.6   county-contracted vendors shall be based on a monthly rate 
102.7   negotiated by the host county.  The negotiated rate must not 
102.8   exceed the rate charged by the vendor for the same service to 
102.9   other payers.  If the service is provided by a team of 
102.10  contracted vendors, the county may negotiate a team rate with a 
102.11  vendor who is a member of the team.  The team shall determine 
102.12  how to distribute the rate among its members.  No reimbursement 
102.13  received by contracted vendors shall be returned to the county, 
102.14  except to reimburse the county for advance funding provided by 
102.15  the county to the vendor. 
102.16     (f) If the service is provided by a team which includes 
102.17  contracted vendors and county or state staff, the costs for 
102.18  county or state staff participation in the team shall be 
102.19  included in the rate for county-provided services.  In this 
102.20  case, the contracted vendor and the county may each receive 
102.21  separate payment for services provided by each entity in the 
102.22  same month.  
102.23     (g) The commissioner shall calculate the nonfederal share 
102.24  of actual medical assistance and general assistance medical care 
102.25  payments for each county, based on the higher of calendar year 
102.26  1995 or 1996, by service date, project that amount forward to 
102.27  1999, and transfer the result from medical assistance and 
102.28  general assistance medical care to each county's mental health 
102.29  grants under sections 245.4886 and 256E.12 for calendar year 
102.30  1999.  The minimum amount added to each county's mental health 
102.31  grant shall be $3,000 per year for children and $5,000 per year 
102.32  for adults.  The commissioner may reduce the statewide growth 
102.33  factor in order to fund these minimums.  The total amount 
102.34  transferred shall become part of the base for future mental 
102.35  health grants for each county. 
102.36     (h) Any net increase in revenue to the county as a result 
103.1   of the change in this section must be used to provide expanded 
103.2   mental health services as defined in sections 245.461 to 
103.3   245.4888, the Comprehensive Adult and Children's Mental Health 
103.4   Acts, excluding inpatient and residential treatment.  For 
103.5   adults, increased revenue may also be used for services and 
103.6   consumer supports which are part of adult mental health projects 
103.7   approved under Laws 1997, chapter 203, article 7, section 25.  
103.8   For children, increased revenue may also be used for respite 
103.9   care and nonresidential individualized rehabilitation services 
103.10  as defined in section 245.492, subdivisions 17 and 23.  
103.11  "Increased revenue" has the meaning given in Minnesota Rules, 
103.12  part 9520.0903, subpart 3.  
103.13     (i) Notwithstanding section 256B.19, subdivision 1, the 
103.14  nonfederal share of costs for mental health case management 
103.15  shall be provided by the recipient's county of responsibility, 
103.16  as defined in sections 256G.01 to 256G.12, from sources other 
103.17  than federal funds or funds used to match other federal funds.  
103.18     (j) The commissioner may suspend, reduce, or terminate the 
103.19  reimbursement to a provider that does not meet the reporting or 
103.20  other requirements of this section.  The county of 
103.21  responsibility, as defined in sections 256G.01 to 256G.12, is 
103.22  responsible for any federal disallowances.  The county may share 
103.23  this responsibility with its contracted vendors.  
103.24     (k) The commissioner shall set aside a portion of the 
103.25  federal funds earned under this section to repay the special 
103.26  revenue maximization account under section 256.01, subdivision 
103.27  2, clause (15).  The repayment is limited to: 
103.28     (1) the costs of developing and implementing this section; 
103.29  and 
103.30     (2) programming the information systems. 
103.31     (l) Notwithstanding section 256.025, subdivision 2, 
103.32  payments to counties for case management expenditures under this 
103.33  section shall only be made from federal earnings from services 
103.34  provided under this section.  Payments to contracted vendors 
103.35  shall include both the federal earnings and the county share. 
103.36     (m) Notwithstanding section 256B.041, county payments for 
104.1   the cost of mental health case management services provided by 
104.2   county or state staff shall not be made to the state treasurer.  
104.3   For the purposes of mental health case management services 
104.4   provided by county or state staff under this section, the 
104.5   centralized disbursement of payments to counties under section 
104.6   256B.041 consists only of federal earnings from services 
104.7   provided under this section. 
104.8      (n) Case management services under this subdivision do not 
104.9   include therapy, treatment, legal, or outreach services. 
104.10     (o) If the recipient is a resident of a nursing facility, 
104.11  intermediate care facility, or hospital, and the recipient's 
104.12  institutional care is paid by medical assistance, payment for 
104.13  case management services under this subdivision is limited to 
104.14  the last 30 days of the recipient's residency in that facility 
104.15  and may not exceed more than two months in a calendar year. 
104.16     (p) Payment for case management services under this 
104.17  subdivision shall not duplicate payments made under other 
104.18  program authorities for the same purpose. 
104.19     (q) For each calendar year beginning with the calendar year 
104.20  2001, the amount of state funds for each county determined under 
104.21  paragraph (g) shall be adjusted by the county's percentage 
104.22  change in the average number of clients per month who received 
104.23  case management under this section during the fiscal year that 
104.24  ended six months prior to the calendar year in question, in 
104.25  comparison to the prior fiscal year. 
104.26     Sec. 26.  Minnesota Statutes 1997 Supplement, section 
104.27  256B.0625, subdivision 31a, is amended to read: 
104.28     Subd. 31a.  [AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 
104.29  SYSTEMS.] (a) Medical assistance covers augmentative and 
104.30  alternative communication systems consisting of electronic or 
104.31  nonelectronic devices and the related components necessary to 
104.32  enable a person with severe expressive communication limitations 
104.33  to produce or transmit messages or symbols in a manner that 
104.34  compensates for that disability. 
104.35     (b) By January 1, 1998, the commissioner, in cooperation 
104.36  with the commissioner of administration, shall establish an 
105.1   augmentative and alternative communication system purchasing 
105.2   program within a state agency or by contract with a qualified 
105.3   private entity.  The purpose of this service is to facilitate 
105.4   ready availability of the augmentative and alternative 
105.5   communication systems needed to meet the needs of persons with 
105.6   severe expressive communication limitations in an efficient and 
105.7   cost-effective manner.  This program shall: 
105.8      (1) coordinate purchase and rental of augmentative and 
105.9   alternative communication systems; 
105.10     (2) negotiate agreements with manufacturers and vendors for 
105.11  purchase of components of these systems, for warranty coverage, 
105.12  and for repair service; 
105.13     (3) when efficient and cost-effective, maintain and 
105.14  refurbish if needed, an inventory of components of augmentative 
105.15  and alternative communication systems for short- or long-term 
105.16  loan to recipients; 
105.17     (4) facilitate training sessions for service providers, 
105.18  consumers, and families on augmentative and alternative 
105.19  communication systems; and 
105.20     (5) develop a recycling program for used augmentative and 
105.21  alternative communications systems to be reissued and used for 
105.22  trials and short-term use, when appropriate. 
105.23     The availability of components of augmentative and 
105.24  alternative communication systems through this program is 
105.25  subject to prior authorization requirements established under 
105.26  subdivision 25 Until the volume of systems purchased increases 
105.27  to allow a discount price, the commissioner shall reimburse 
105.28  augmentative and alternative communication manufacturers and 
105.29  vendors at the manufacturer's suggested retail price for 
105.30  augmentative and alternative communication systems and related 
105.31  components.  The commissioner shall separately reimburse 
105.32  providers for purchasing and integrating individual 
105.33  communication systems which are unavailable as a package from an 
105.34  augmentative and alternative communication vendor. 
105.35     (c) Reimbursement rates established by this purchasing 
105.36  program are not subject to Minnesota Rules, part 9505.0445, item 
106.1   S or T. 
106.2      Sec. 27.  Minnesota Statutes 1996, section 256B.0625, 
106.3   subdivision 34, is amended to read: 
106.4      Subd. 34.  [AMERICAN INDIAN HEALTH SERVICES FACILITIES.] 
106.5   Medical assistance payments to American Indian health services 
106.6   facilities for outpatient medical services billed after June 30, 
106.7   1990, must be facilities of the Indian health service and 
106.8   facilities operated by a tribe or tribal organization under 
106.9   funding authorized by United States Code, title 25, sections 
106.10  450f to 450n, or title III of the Indian Self-Determination and 
106.11  Education Assistance Act, Public Law Number 93-638, shall be at 
106.12  the option of the facility in accordance with the rate published 
106.13  by the United States Assistant Secretary for Health under the 
106.14  authority of United States Code, title 42, sections 248(a) and 
106.15  249(b).  General assistance medical care payments to facilities 
106.16  of the American Indian health services and facilities operated 
106.17  by a tribe or tribal organization for the provision of 
106.18  outpatient medical care services billed after June 30, 1990, 
106.19  must be in accordance with the general assistance medical care 
106.20  rates paid for the same services when provided in a facility 
106.21  other than an American a facility of the Indian health 
106.22  service or a facility operated by a tribe or tribal organization.
106.23     Sec. 28.  Minnesota Statutes 1996, section 256B.0627, 
106.24  subdivision 4, is amended to read: 
106.25     Subd. 4.  [PERSONAL CARE SERVICES.] (a) The personal care 
106.26  services that are eligible for payment are the following:  
106.27     (1) bowel and bladder care; 
106.28     (2) skin care to maintain the health of the skin; 
106.29     (3) repetitive maintenance range of motion, muscle 
106.30  strengthening exercises, and other tasks specific to maintaining 
106.31  a recipient's optimal level of function; 
106.32     (4) respiratory assistance; 
106.33     (5) transfers and ambulation; 
106.34     (6) bathing, grooming, and hairwashing necessary for 
106.35  personal hygiene; 
106.36     (7) turning and positioning; 
107.1      (8) assistance with furnishing medication that is 
107.2   self-administered; 
107.3      (9) application and maintenance of prosthetics and 
107.4   orthotics; 
107.5      (10) cleaning medical equipment; 
107.6      (11) dressing or undressing; 
107.7      (12) assistance with eating and meal preparation and 
107.8   necessary grocery shopping; 
107.9      (13) accompanying a recipient to obtain medical diagnosis 
107.10  or treatment; 
107.11     (14) assisting, monitoring, or prompting the recipient to 
107.12  complete the services in clauses (1) to (13); 
107.13     (15) redirection, monitoring, and observation that are 
107.14  medically necessary and an integral part of completing the 
107.15  personal care services described in clauses (1) to (14); 
107.16     (16) redirection and intervention for behavior, including 
107.17  observation and monitoring; 
107.18     (17) interventions for seizure disorders, including 
107.19  monitoring and observation if the recipient has had a seizure 
107.20  that requires intervention within the past three months; and 
107.21     (18) tracheostomy suctioning using a clean procedure if the 
107.22  procedure is properly delegated by a registered nurse.  Before 
107.23  this procedure can be delegated to a personal care assistant, a 
107.24  registered nurse must determine that the tracheostomy suctioning 
107.25  can be accomplished utilizing a clean rather than a sterile 
107.26  procedure and must ensure that the personal care assistant has 
107.27  been taught the proper procedure; and 
107.28     (19) incidental household services that are an integral 
107.29  part of a personal care service described in clauses (1) to 
107.30  (17) (18). 
107.31  For purposes of this subdivision, monitoring and observation 
107.32  means watching for outward visible signs that are likely to 
107.33  occur and for which there is a covered personal care service or 
107.34  an appropriate personal care intervention.  For purposes of this 
107.35  subdivision, a clean procedure refers to a procedure that 
107.36  reduces the numbers of microorganisms or prevents or reduces the 
108.1   transmission of microorganisms from one person or place to 
108.2   another.  A clean procedure may be used beginning 14 days after 
108.3   insertion. 
108.4      (b) The personal care services that are not eligible for 
108.5   payment are the following:  
108.6      (1) services not ordered by the physician; 
108.7      (2) assessments by personal care provider organizations or 
108.8   by independently enrolled registered nurses; 
108.9      (3) services that are not in the service plan; 
108.10     (4) services provided by the recipient's spouse, legal 
108.11  guardian for an adult or child recipient, or parent of a 
108.12  recipient under age 18; 
108.13     (5) services provided by a foster care provider of a 
108.14  recipient who cannot direct the recipient's own care, unless 
108.15  monitored by a county or state case manager under section 
108.16  256B.0625, subdivision 19a; 
108.17     (6) services provided by the residential or program license 
108.18  holder in a residence for more than four persons; 
108.19     (7) services that are the responsibility of a residential 
108.20  or program license holder under the terms of a service agreement 
108.21  and administrative rules; 
108.22     (8) sterile procedures; 
108.23     (9) injections of fluids into veins, muscles, or skin; 
108.24     (10) services provided by parents of adult recipients, 
108.25  adult children or adult siblings of the recipient, unless these 
108.26  relatives meet one of the following hardship criteria and the 
108.27  commissioner waives this requirement: 
108.28     (i) the relative resigns from a part-time or full-time job 
108.29  to provide personal care for the recipient; 
108.30     (ii) the relative goes from a full-time to a part-time job 
108.31  with less compensation to provide personal care for the 
108.32  recipient; 
108.33     (iii) the relative takes a leave of absence without pay to 
108.34  provide personal care for the recipient; 
108.35     (iv) the relative incurs substantial expenses by providing 
108.36  personal care for the recipient; or 
109.1      (v) because of labor conditions or intermittent hours of 
109.2   care needed, the relative is needed in order to provide an 
109.3   adequate number of qualified personal care assistants to meet 
109.4   the medical needs of the recipient; 
109.5      (11) homemaker services that are not an integral part of a 
109.6   personal care services; 
109.7      (12) home maintenance, or chore services; 
109.8      (13) services not specified under paragraph (a); and 
109.9      (14) services not authorized by the commissioner or the 
109.10  commissioner's designee. 
109.11     Sec. 29.  Minnesota Statutes 1997 Supplement, section 
109.12  256B.0627, subdivision 5, is amended to read: 
109.13     Subd. 5.  [LIMITATION ON PAYMENTS.] Medical assistance 
109.14  payments for home care services shall be limited according to 
109.15  this subdivision.  
109.16     (a)  [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 
109.17  recipient may receive the following home care services during a 
109.18  calendar year: 
109.19     (1) any initial assessment; 
109.20     (2) up to two reassessments per year done to determine a 
109.21  recipient's need for personal care services; and 
109.22     (3) up to five skilled nurse visits.  
109.23     (b)  [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 
109.24  services above the limits in paragraph (a) must receive the 
109.25  commissioner's prior authorization, except when: 
109.26     (1) the home care services were required to treat an 
109.27  emergency medical condition that if not immediately treated 
109.28  could cause a recipient serious physical or mental disability, 
109.29  continuation of severe pain, or death.  The provider must 
109.30  request retroactive authorization no later than five working 
109.31  days after giving the initial service.  The provider must be 
109.32  able to substantiate the emergency by documentation such as 
109.33  reports, notes, and admission or discharge histories; 
109.34     (2) the home care services were provided on or after the 
109.35  date on which the recipient's eligibility began, but before the 
109.36  date on which the recipient was notified that the case was 
110.1   opened.  Authorization will be considered if the request is 
110.2   submitted by the provider within 20 working days of the date the 
110.3   recipient was notified that the case was opened; 
110.4      (3) a third-party payor for home care services has denied 
110.5   or adjusted a payment.  Authorization requests must be submitted 
110.6   by the provider within 20 working days of the notice of denial 
110.7   or adjustment.  A copy of the notice must be included with the 
110.8   request; 
110.9      (4) the commissioner has determined that a county or state 
110.10  human services agency has made an error; or 
110.11     (5) the professional nurse determines an immediate need for 
110.12  up to 40 skilled nursing or home health aide visits per calendar 
110.13  year and submits a request for authorization within 20 working 
110.14  days of the initial service date, and medical assistance is 
110.15  determined to be the appropriate payer. 
110.16     (c)  [RETROACTIVE AUTHORIZATION.] A request for retroactive 
110.17  authorization will be evaluated according to the same criteria 
110.18  applied to prior authorization requests.  
110.19     (d)  [ASSESSMENT AND SERVICE PLAN.] Assessments under 
110.20  section 256B.0627, subdivision 1, paragraph (a), shall be 
110.21  conducted initially, and at least annually thereafter, in person 
110.22  with the recipient and result in a completed service plan using 
110.23  forms specified by the commissioner.  Within 30 days of 
110.24  recipient or responsible party request for home care services, 
110.25  the assessment, the service plan, and other information 
110.26  necessary to determine medical necessity such as diagnostic or 
110.27  testing information, social or medical histories, and hospital 
110.28  or facility discharge summaries shall be submitted to the 
110.29  commissioner.  For personal care services: 
110.30     (1) The amount and type of service authorized based upon 
110.31  the assessment and service plan will follow the recipient if the 
110.32  recipient chooses to change providers.  
110.33     (2) If the recipient's medical need changes, the 
110.34  recipient's provider may assess the need for a change in service 
110.35  authorization and request the change from the county public 
110.36  health nurse.  Within 30 days of the request, the public health 
111.1   nurse will determine whether to request the change in services 
111.2   based upon the provider assessment, or conduct a home visit to 
111.3   assess the need and determine whether the change is appropriate. 
111.4      (3) To continue to receive personal care services when the 
111.5   recipient displays no significant change, the county public 
111.6   health nurse has the option to review with the commissioner, or 
111.7   the commissioner's designee, the service plan on record and 
111.8   receive authorization for up to an additional 12 months at a 
111.9   time for up to three years. after the first year, the recipient 
111.10  or the responsible party, in conjunction with the public health 
111.11  nurse, may complete a service update on forms developed by the 
111.12  commissioner.  The service update may substitute for the annual 
111.13  reassessment described in subdivision 1. 
111.14     (e)  [PRIOR AUTHORIZATION.] The commissioner, or the 
111.15  commissioner's designee, shall review the assessment, the 
111.16  service plan, and any additional information that is submitted.  
111.17  The commissioner shall, within 30 days after receiving a 
111.18  complete request, assessment, and service plan, authorize home 
111.19  care services as follows:  
111.20     (1)  [HOME HEALTH SERVICES.] All home health services 
111.21  provided by a licensed nurse or a home health aide must be prior 
111.22  authorized by the commissioner or the commissioner's designee.  
111.23  Prior authorization must be based on medical necessity and 
111.24  cost-effectiveness when compared with other care options.  When 
111.25  home health services are used in combination with personal care 
111.26  and private duty nursing, the cost of all home care services 
111.27  shall be considered for cost-effectiveness.  The commissioner 
111.28  shall limit nurse and home health aide visits to no more than 
111.29  one visit each per day. 
111.30     (2)  [PERSONAL CARE SERVICES.] (i) All personal care 
111.31  services and registered nurse supervision must be prior 
111.32  authorized by the commissioner or the commissioner's designee 
111.33  except for the assessments established in paragraph (a).  The 
111.34  amount of personal care services authorized must be based on the 
111.35  recipient's home care rating.  A child may not be found to be 
111.36  dependent in an activity of daily living if because of the 
112.1   child's age an adult would either perform the activity for the 
112.2   child or assist the child with the activity and the amount of 
112.3   assistance needed is similar to the assistance appropriate for a 
112.4   typical child of the same age.  Based on medical necessity, the 
112.5   commissioner may authorize: 
112.6      (A) up to two times the average number of direct care hours 
112.7   provided in nursing facilities for the recipient's comparable 
112.8   case mix level; or 
112.9      (B) up to three times the average number of direct care 
112.10  hours provided in nursing facilities for recipients who have 
112.11  complex medical needs or are dependent in at least seven 
112.12  activities of daily living and need physical assistance with 
112.13  eating or have a neurological diagnosis; or 
112.14     (C) up to 60 percent of the average reimbursement rate, as 
112.15  of July 1, 1991, for care provided in a regional treatment 
112.16  center for recipients who have Level I behavior, plus any 
112.17  inflation adjustment as provided by the legislature for personal 
112.18  care service; or 
112.19     (D) up to the amount the commissioner would pay, as of July 
112.20  1, 1991, plus any inflation adjustment provided for home care 
112.21  services, for care provided in a regional treatment center for 
112.22  recipients referred to the commissioner by a regional treatment 
112.23  center preadmission evaluation team.  For purposes of this 
112.24  clause, home care services means all services provided in the 
112.25  home or community that would be included in the payment to a 
112.26  regional treatment center; or 
112.27     (E) up to the amount medical assistance would reimburse for 
112.28  facility care for recipients referred to the commissioner by a 
112.29  preadmission screening team established under section 256B.0911 
112.30  or 256B.092; and 
112.31     (F) a reasonable amount of time for the provision of 
112.32  nursing supervision of personal care services.  
112.33     (ii) The number of direct care hours shall be determined 
112.34  according to the annual cost report submitted to the department 
112.35  by nursing facilities.  The average number of direct care hours, 
112.36  as established by May 1, 1992, shall be calculated and 
113.1   incorporated into the home care limits on July 1, 1992.  These 
113.2   limits shall be calculated to the nearest quarter hour. 
113.3      (iii) The home care rating shall be determined by the 
113.4   commissioner or the commissioner's designee based on information 
113.5   submitted to the commissioner by the county public health nurse 
113.6   on forms specified by the commissioner.  The home care rating 
113.7   shall be a combination of current assessment tools developed 
113.8   under sections 256B.0911 and 256B.501 with an addition for 
113.9   seizure activity that will assess the frequency and severity of 
113.10  seizure activity and with adjustments, additions, and 
113.11  clarifications that are necessary to reflect the needs and 
113.12  conditions of recipients who need home care including children 
113.13  and adults under 65 years of age.  The commissioner shall 
113.14  establish these forms and protocols under this section and shall 
113.15  use an advisory group, including representatives of recipients, 
113.16  providers, and counties, for consultation in establishing and 
113.17  revising the forms and protocols. 
113.18     (iv) A recipient shall qualify as having complex medical 
113.19  needs if the care required is difficult to perform and because 
113.20  of recipient's medical condition requires more time than 
113.21  community-based standards allow or requires more skill than 
113.22  would ordinarily be required and the recipient needs or has one 
113.23  or more of the following: 
113.24     (A) daily tube feedings; 
113.25     (B) daily parenteral therapy; 
113.26     (C) wound or decubiti care; 
113.27     (D) postural drainage, percussion, nebulizer treatments, 
113.28  suctioning, tracheotomy care, oxygen, mechanical ventilation; 
113.29     (E) catheterization; 
113.30     (F) ostomy care; 
113.31     (G) quadriplegia; or 
113.32     (H) other comparable medical conditions or treatments the 
113.33  commissioner determines would otherwise require institutional 
113.34  care.  
113.35     (v) A recipient shall qualify as having Level I behavior if 
113.36  there is reasonable supporting evidence that the recipient 
114.1   exhibits, or that without supervision, observation, or 
114.2   redirection would exhibit, one or more of the following 
114.3   behaviors that cause, or have the potential to cause: 
114.4      (A) injury to the recipient's own body; 
114.5      (B) physical injury to other people; or 
114.6      (C) destruction of property. 
114.7      (vi) Time authorized for personal care relating to Level I 
114.8   behavior in subclause (v), items (A) to (C), shall be based on 
114.9   the predictability, frequency, and amount of intervention 
114.10  required. 
114.11     (vii) A recipient shall qualify as having Level II behavior 
114.12  if the recipient exhibits on a daily basis one or more of the 
114.13  following behaviors that interfere with the completion of 
114.14  personal care services under subdivision 4, paragraph (a): 
114.15     (A) unusual or repetitive habits; 
114.16     (B) withdrawn behavior; or 
114.17     (C) offensive behavior. 
114.18     (viii) A recipient with a home care rating of Level II 
114.19  behavior in subclause (vii), items (A) to (C), shall be rated as 
114.20  comparable to a recipient with complex medical needs under 
114.21  subclause (iv).  If a recipient has both complex medical needs 
114.22  and Level II behavior, the home care rating shall be the next 
114.23  complex category up to the maximum rating under subclause (i), 
114.24  item (B). 
114.25     (3)  [PRIVATE DUTY NURSING SERVICES.] All private duty 
114.26  nursing services shall be prior authorized by the commissioner 
114.27  or the commissioner's designee.  Prior authorization for private 
114.28  duty nursing services shall be based on medical necessity and 
114.29  cost-effectiveness when compared with alternative care options.  
114.30  The commissioner may authorize medically necessary private duty 
114.31  nursing services in quarter-hour units when: 
114.32     (i) the recipient requires more individual and continuous 
114.33  care than can be provided during a nurse visit; or 
114.34     (ii) the cares are outside of the scope of services that 
114.35  can be provided by a home health aide or personal care assistant.
114.36     The commissioner may authorize: 
115.1      (A) up to two times the average amount of direct care hours 
115.2   provided in nursing facilities statewide for case mix 
115.3   classification "K" as established by the annual cost report 
115.4   submitted to the department by nursing facilities in May 1992; 
115.5      (B) private duty nursing in combination with other home 
115.6   care services up to the total cost allowed under clause (2); 
115.7      (C) up to 16 hours per day if the recipient requires more 
115.8   nursing than the maximum number of direct care hours as 
115.9   established in item (A) and the recipient meets the hospital 
115.10  admission criteria established under Minnesota Rules, parts 
115.11  9505.0500 to 9505.0540.  
115.12     The commissioner may authorize up to 16 hours per day of 
115.13  medically necessary private duty nursing services or up to 24 
115.14  hours per day of medically necessary private duty nursing 
115.15  services until such time as the commissioner is able to make a 
115.16  determination of eligibility for recipients who are 
115.17  cooperatively applying for home care services under the 
115.18  community alternative care program developed under section 
115.19  256B.49, or until it is determined by the appropriate regulatory 
115.20  agency that a health benefit plan is or is not required to pay 
115.21  for appropriate medically necessary health care services.  
115.22  Recipients or their representatives must cooperatively assist 
115.23  the commissioner in obtaining this determination.  Recipients 
115.24  who are eligible for the community alternative care program may 
115.25  not receive more hours of nursing under this section than would 
115.26  otherwise be authorized under section 256B.49. 
115.27     (4)  [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 
115.28  ventilator-dependent, the monthly medical assistance 
115.29  authorization for home care services shall not exceed what the 
115.30  commissioner would pay for care at the highest cost hospital 
115.31  designated as a long-term hospital under the Medicare program.  
115.32  For purposes of this clause, home care services means all 
115.33  services provided in the home that would be included in the 
115.34  payment for care at the long-term hospital.  
115.35  "Ventilator-dependent" means an individual who receives 
115.36  mechanical ventilation for life support at least six hours per 
116.1   day and is expected to be or has been dependent for at least 30 
116.2   consecutive days.  
116.3      (f)  [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 
116.4   or the commissioner's designee shall determine the time period 
116.5   for which a prior authorization shall be effective.  If the 
116.6   recipient continues to require home care services beyond the 
116.7   duration of the prior authorization, the home care provider must 
116.8   request a new prior authorization.  Under no circumstances, 
116.9   other than the exceptions in paragraph (b), shall a prior 
116.10  authorization be valid prior to the date the commissioner 
116.11  receives the request or for more than 12 months.  A recipient 
116.12  who appeals a reduction in previously authorized home care 
116.13  services may continue previously authorized services, other than 
116.14  temporary services under paragraph (h), pending an appeal under 
116.15  section 256.045.  The commissioner must provide a detailed 
116.16  explanation of why the authorized services are reduced in amount 
116.17  from those requested by the home care provider.  
116.18     (g)  [APPROVAL OF HOME CARE SERVICES.] The commissioner or 
116.19  the commissioner's designee shall determine the medical 
116.20  necessity of home care services, the level of caregiver 
116.21  according to subdivision 2, and the institutional comparison 
116.22  according to this subdivision, the cost-effectiveness of 
116.23  services, and the amount, scope, and duration of home care 
116.24  services reimbursable by medical assistance, based on the 
116.25  assessment, primary payer coverage determination information as 
116.26  required, the service plan, the recipient's age, the cost of 
116.27  services, the recipient's medical condition, and diagnosis or 
116.28  disability.  The commissioner may publish additional criteria 
116.29  for determining medical necessity according to section 256B.04. 
116.30     (h)  [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 
116.31  The agency nurse, the independently enrolled private duty nurse, 
116.32  or county public health nurse may request a temporary 
116.33  authorization for home care services by telephone.  The 
116.34  commissioner may approve a temporary level of home care services 
116.35  based on the assessment, and service or care plan information, 
116.36  and primary payer coverage determination information as required.
117.1   Authorization for a temporary level of home care services 
117.2   including nurse supervision is limited to the time specified by 
117.3   the commissioner, but shall not exceed 45 days, unless extended 
117.4   because the county public health nurse has not completed the 
117.5   required assessment and service plan, or the commissioner's 
117.6   determination has not been made.  The level of services 
117.7   authorized under this provision shall have no bearing on a 
117.8   future prior authorization. 
117.9      (i)  [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 
117.10  Home care services provided in an adult or child foster care 
117.11  setting must receive prior authorization by the department 
117.12  according to the limits established in paragraph (a). 
117.13     The commissioner may not authorize: 
117.14     (1) home care services that are the responsibility of the 
117.15  foster care provider under the terms of the foster care 
117.16  placement agreement and administrative rules.  Requests for home 
117.17  care services for recipients residing in a foster care setting 
117.18  must include the foster care placement agreement and 
117.19  determination of difficulty of care; 
117.20     (2) personal care services when the foster care license 
117.21  holder is also the personal care provider or personal care 
117.22  assistant unless the recipient can direct the recipient's own 
117.23  care, or case management is provided as required in section 
117.24  256B.0625, subdivision 19a; 
117.25     (3) personal care services when the responsible party is an 
117.26  employee of, or under contract with, or has any direct or 
117.27  indirect financial relationship with the personal care provider 
117.28  or personal care assistant, unless case management is provided 
117.29  as required in section 256B.0625, subdivision 19a; 
117.30     (4) home care services when the number of foster care 
117.31  residents is greater than four unless the county responsible for 
117.32  the recipient's foster placement made the placement prior to 
117.33  April 1, 1992, requests that home care services be provided, and 
117.34  case management is provided as required in section 256B.0625, 
117.35  subdivision 19a; or 
117.36     (5) home care services when combined with foster care 
118.1   payments, other than room and board payments that exceed the 
118.2   total amount that public funds would pay for the recipient's 
118.3   care in a medical institution. 
118.4      Sec. 30.  Minnesota Statutes 1997 Supplement, section 
118.5   256B.0645, is amended to read: 
118.6      256B.0645 [PROVIDER PAYMENTS; RETROACTIVE CHANGES IN 
118.7   ELIGIBILITY.] 
118.8      Payment to a provider for a health care service provided to 
118.9   a general assistance medical care recipient who is later 
118.10  determined eligible for medical assistance or MinnesotaCare 
118.11  according to section 256L.14 for the period in which the health 
118.12  care service was provided, shall be considered payment in full, 
118.13  and shall not may be adjusted due to the change in eligibility.  
118.14  This section applies does not apply to both fee-for-service 
118.15  payments and payments made to health plans on a prepaid 
118.16  capitated basis. 
118.17     Sec. 31.  Minnesota Statutes 1997 Supplement, section 
118.18  256B.0911, subdivision 2, is amended to read: 
118.19     Subd. 2.  [PERSONS REQUIRED TO BE SCREENED; EXEMPTIONS.] 
118.20  All applicants to Medicaid certified nursing facilities must be 
118.21  screened prior to admission, regardless of income, assets, or 
118.22  funding sources, except the following: 
118.23     (1) patients who, having entered acute care facilities from 
118.24  certified nursing facilities, are returning to a certified 
118.25  nursing facility; 
118.26     (2) residents transferred from other certified nursing 
118.27  facilities located within the state of Minnesota; 
118.28     (3) individuals who have a contractual right to have their 
118.29  nursing facility care paid for indefinitely by the veteran's 
118.30  administration; 
118.31     (4) individuals who are enrolled in the Ebenezer/Group 
118.32  Health social health maintenance organization project, or 
118.33  enrolled in a demonstration project under section 256B.69, 
118.34  subdivision 18 8, at the time of application to a nursing home; 
118.35     (5) individuals previously screened and currently being 
118.36  served under the alternative care program or under a home and 
119.1   community-based services waiver authorized under section 1915(c) 
119.2   of the Social Security Act; or 
119.3      (6) individuals who are admitted to a certified nursing 
119.4   facility for a short-term stay, which, based upon a physician's 
119.5   certification, is expected to be 14 days or less in duration, 
119.6   and who have been screened and approved for nursing facility 
119.7   admission within the previous six months.  This exemption 
119.8   applies only if the screener determines at the time of the 
119.9   initial screening of the six-month period that it is appropriate 
119.10  to use the nursing facility for short-term stays and that there 
119.11  is an adequate plan of care for return to the home or 
119.12  community-based setting.  If a stay exceeds 14 days, the 
119.13  individual must be referred no later than the first county 
119.14  working day following the 14th resident day for a screening, 
119.15  which must be completed within five working days of the 
119.16  referral.  Payment limitations in subdivision 7 will apply to an 
119.17  individual found at screening to not meet the level of care 
119.18  criteria for admission to a certified nursing facility. 
119.19     Regardless of the exemptions in clauses (2) to (6), persons 
119.20  who have a diagnosis or possible diagnosis of mental illness, 
119.21  mental retardation, or a related condition must receive a 
119.22  preadmission screening before admission unless the admission 
119.23  prior to screening is authorized by the local mental health 
119.24  authority or the local developmental disabilities case manager, 
119.25  or unless authorized by the county agency according to Public 
119.26  Law Number 101-508. 
119.27     Before admission to a Medicaid certified nursing home or 
119.28  boarding care home, all persons must be screened and approved 
119.29  for admission through an assessment process.  The nursing 
119.30  facility is authorized to conduct case mix assessments which are 
119.31  not conducted by the county public health nurse under Minnesota 
119.32  Rules, part 9549.0059.  The designated county agency is 
119.33  responsible for distributing the quality assurance and review 
119.34  form for all new applicants to nursing homes. 
119.35     Other persons who are not applicants to nursing facilities 
119.36  must be screened if a request is made for a screening. 
120.1      Sec. 32.  Minnesota Statutes 1996, section 256B.0911, 
120.2   subdivision 4, is amended to read: 
120.3      Subd. 4.  [RESPONSIBILITIES OF THE COUNTY AND THE SCREENING 
120.4   TEAM.] (a) The county shall: 
120.5      (1) provide information and education to the general public 
120.6   regarding availability of the preadmission screening program; 
120.7      (2) accept referrals from individuals, families, human 
120.8   service and health professionals, and hospital and nursing 
120.9   facility personnel; 
120.10     (3) assess the health, psychological, and social needs of 
120.11  referred individuals and identify services needed to maintain 
120.12  these persons in the least restrictive environments; 
120.13     (4) determine if the individual screened needs nursing 
120.14  facility level of care; 
120.15     (5) assess specialized service needs based upon an 
120.16  evaluation by: 
120.17     (i) a qualified independent mental health professional for 
120.18  persons with a primary or secondary diagnosis of a serious 
120.19  mental illness; and 
120.20     (ii) a qualified mental retardation professional for 
120.21  persons with a primary or secondary diagnosis of mental 
120.22  retardation or related conditions.  For purposes of this clause, 
120.23  a qualified mental retardation professional must meet the 
120.24  standards for a qualified mental retardation professional in 
120.25  Code of Federal Regulations, title 42, section 483.430; 
120.26     (6) make recommendations for individuals screened regarding 
120.27  cost-effective community services which are available to the 
120.28  individual; 
120.29     (7) make recommendations for individuals screened regarding 
120.30  nursing home placement when there are no cost-effective 
120.31  community services available; 
120.32     (8) develop an individual's community care plan and provide 
120.33  follow-up services as needed; and 
120.34     (9) prepare and submit reports that may be required by the 
120.35  commissioner of human services. 
120.36     (b) The screener shall document that the most 
121.1   cost-effective alternatives available were offered to the 
121.2   individual or the individual's legal representative.  For 
121.3   purposes of this section, "cost-effective alternatives" means 
121.4   community services and living arrangements that cost the same or 
121.5   less than nursing facility care. 
121.6      (c) Screeners shall adhere to the level of care criteria 
121.7   for admission to a certified nursing facility established under 
121.8   section 144.0721.  
121.9      (d) For persons who are eligible for medical assistance or 
121.10  who would be eligible within 180 days of admission to a nursing 
121.11  facility and who are admitted to a nursing facility, the nursing 
121.12  facility must include a screener or the case manager in the 
121.13  discharge planning process for those individuals who the team 
121.14  has determined have discharge potential.  The screener or the 
121.15  case manager must ensure a smooth transition and follow-up for 
121.16  the individual's return to the community. 
121.17     Screeners shall cooperate with other public and private 
121.18  agencies in the community, in order to offer a variety of 
121.19  cost-effective services to the disabled and elderly.  The 
121.20  screeners shall encourage the use of volunteers from families, 
121.21  religious organizations, social clubs, and similar civic and 
121.22  service organizations to provide services. 
121.23     Sec. 33.  Minnesota Statutes 1997 Supplement, section 
121.24  256B.0911, subdivision 7, is amended to read: 
121.25     Subd. 7.  [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 
121.26  (a) Medical assistance reimbursement for nursing facilities 
121.27  shall be authorized for a medical assistance recipient only if a 
121.28  preadmission screening has been conducted prior to admission or 
121.29  the local county agency has authorized an exemption.  Medical 
121.30  assistance reimbursement for nursing facilities shall not be 
121.31  provided for any recipient who the local screener has determined 
121.32  does not meet the level of care criteria for nursing facility 
121.33  placement or, if indicated, has not had a level II PASARR 
121.34  evaluation completed unless an admission for a recipient with 
121.35  mental illness is approved by the local mental health authority 
121.36  or an admission for a recipient with mental retardation or 
122.1   related condition is approved by the state mental retardation 
122.2   authority.  The county preadmission screening team may deny 
122.3   certified nursing facility admission using the level of care 
122.4   criteria established under section 144.0721 and deny medical 
122.5   assistance reimbursement for certified nursing facility care.  
122.6   Persons receiving care in a certified nursing facility or 
122.7   certified boarding care home who are reassessed by the 
122.8   commissioner of health according to section 144.0722 and 
122.9   determined to no longer meet the level of care criteria for a 
122.10  certified nursing facility or certified boarding care home may 
122.11  no longer remain a resident in the certified nursing facility or 
122.12  certified boarding care home and must be relocated to the 
122.13  community if the persons were admitted on or after July 1, 1998. 
122.14     (b) Persons receiving services under section 256B.0913, 
122.15  subdivisions 1 to 14, or 256B.0915 who are reassessed and found 
122.16  to not meet the level of care criteria for admission to a 
122.17  certified nursing facility or certified boarding care home may 
122.18  no longer receive these services if persons were admitted to the 
122.19  program on or after July 1, 1998.  The commissioner shall make a 
122.20  request to the health care financing administration for a waiver 
122.21  allowing screening team approval of Medicaid payments for 
122.22  certified nursing facility care.  An individual has a choice and 
122.23  makes the final decision between nursing facility placement and 
122.24  community placement after the screening team's recommendation, 
122.25  except as provided in paragraphs (b) and (c).  
122.26     (c) The local county mental health authority or the state 
122.27  mental retardation authority under Public Law Numbers 100-203 
122.28  and 101-508 may prohibit admission to a nursing facility, if the 
122.29  individual does not meet the nursing facility level of care 
122.30  criteria or needs specialized services as defined in Public Law 
122.31  Numbers 100-203 and 101-508.  For purposes of this section, 
122.32  "specialized services" for a person with mental retardation or a 
122.33  related condition means "active treatment" as that term is 
122.34  defined in Code of Federal Regulations, title 42, section 
122.35  483.440(a)(1). 
122.36     (d) Upon the receipt by the commissioner of approval by the 
123.1   Secretary of Health and Human Services of the waiver requested 
123.2   under paragraph (a), the local screener shall deny medical 
123.3   assistance reimbursement for nursing facility care for an 
123.4   individual whose long-term care needs can be met in a 
123.5   community-based setting and whose cost of community-based home 
123.6   care services is less than 75 percent of the average payment for 
123.7   nursing facility care for that individual's case mix 
123.8   classification, and who is either: 
123.9      (i) a current medical assistance recipient being screened 
123.10  for admission to a nursing facility; or 
123.11     (ii) an individual who would be eligible for medical 
123.12  assistance within 180 days of entering a nursing facility and 
123.13  who meets a nursing facility level of care. 
123.14     (e) Appeals from the screening team's recommendation or the 
123.15  county agency's final decision shall be made according to 
123.16  section 256.045, subdivision 3. 
123.17     Sec. 34.  Minnesota Statutes 1997 Supplement, section 
123.18  256B.0913, subdivision 14, is amended to read: 
123.19     Subd. 14.  [REIMBURSEMENT AND RATE ADJUSTMENTS.] (a) 
123.20  Reimbursement for expenditures for the alternative care services 
123.21  as approved by the client's case manager shall be through the 
123.22  invoice processing procedures of the department's Medicaid 
123.23  Management Information System (MMIS).  To receive reimbursement, 
123.24  the county or vendor must submit invoices within 12 months 
123.25  following the date of service.  The county agency and its 
123.26  vendors under contract shall not be reimbursed for services 
123.27  which exceed the county allocation. 
123.28     (b) If a county collects less than 50 percent of the client 
123.29  premiums due under subdivision 12, the commissioner may withhold 
123.30  up to three percent of the county's final alternative care 
123.31  program allocation determined under subdivisions 10 and 11. 
123.32     (c) For fiscal years beginning on or after July 1, 1993, 
123.33  the commissioner of human services shall not provide automatic 
123.34  annual inflation adjustments for alternative care services.  The 
123.35  commissioner of finance shall include as a budget change request 
123.36  in each biennial detailed expenditure budget submitted to the 
124.1   legislature under section 16A.11 annual adjustments in 
124.2   reimbursement rates for alternative care services based on the 
124.3   forecasted percentage change in the Home Health Agency Market 
124.4   Basket of Operating Costs, for the fiscal year beginning July 1, 
124.5   compared to the previous fiscal year, unless otherwise adjusted 
124.6   by statute.  The Home Health Agency Market Basket of Operating 
124.7   Costs is published by Data Resources, Inc.  The forecast to be 
124.8   used is the one published for the calendar quarter beginning 
124.9   January 1, six months prior to the beginning of the fiscal year 
124.10  for which rates are set. 
124.11     (d) The county shall negotiate individual rates with 
124.12  vendors and may be reimbursed for actual costs up to the greater 
124.13  of the county's current approved rate or 60 percent of the 
124.14  maximum rate in fiscal year 1994 and 65 percent of the maximum 
124.15  rate in fiscal year 1995 for each alternative care service.  
124.16  Notwithstanding any other rule or statutory provision to the 
124.17  contrary, the commissioner shall not be authorized to increase 
124.18  rates by an annual inflation factor, unless so authorized by the 
124.19  legislature. 
124.20     (e) (d) On July 1, 1993, the commissioner shall increase 
124.21  the maximum rate for home delivered meals to $4.50 per meal. 
124.22     Sec. 35.  Minnesota Statutes 1997 Supplement, section 
124.23  256B.0915, subdivision 1d, is amended to read: 
124.24     Subd. 1d.  [POSTELIGIBILITY TREATMENT OF INCOME AND 
124.25  RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the 
124.26  provisions of section 256B.056, the commissioner shall make the 
124.27  following amendment to the medical assistance elderly waiver 
124.28  program effective July 1, 1997 1999, or upon federal approval, 
124.29  whichever is later. 
124.30     A recipient's maintenance needs will be an amount equal to 
124.31  the Minnesota supplemental aid equivalent rate as defined in 
124.32  section 256I.03, subdivision 5, plus the medical assistance 
124.33  personal needs allowance as defined in section 256B.35, 
124.34  subdivision 1, paragraph (a), when applying posteligibility 
124.35  treatment of income rules to the gross income of elderly waiver 
124.36  recipients, except for individuals whose income is in excess of 
125.1   the special income standard according to Code of Federal 
125.2   Regulations, title 42, section 435.236.  Recipient maintenance 
125.3   needs shall be adjusted under this provision each July 1. 
125.4      (b) The commissioner of human services shall secure 
125.5   approval of additional elderly waiver slots sufficient to serve 
125.6   persons who will qualify under the revised income standard 
125.7   described in paragraph (a) before implementing section 
125.8   256B.0913, subdivision 16. 
125.9      (c) In implementing this subdivision, the commissioner 
125.10  shall consider allowing persons who would otherwise be eligible 
125.11  for the alternative care program but would qualify for the 
125.12  elderly waiver with a spenddown to remain on the alternative 
125.13  care program. 
125.14     Sec. 36.  Minnesota Statutes 1997 Supplement, section 
125.15  256B.0915, subdivision 3, is amended to read: 
125.16     Subd. 3.  [LIMITS OF CASES, RATES, REIMBURSEMENT, AND 
125.17  FORECASTING.] (a) The number of medical assistance waiver 
125.18  recipients that a county may serve must be allocated according 
125.19  to the number of medical assistance waiver cases open on July 1 
125.20  of each fiscal year.  Additional recipients may be served with 
125.21  the approval of the commissioner. 
125.22     (b) The monthly limit for the cost of waivered services to 
125.23  an individual waiver client shall be the statewide average 
125.24  payment rate of the case mix resident class to which the waiver 
125.25  client would be assigned under the medical assistance case mix 
125.26  reimbursement system.  If medical supplies and equipment or 
125.27  adaptations are or will be purchased for an elderly waiver 
125.28  services recipient, the costs may be prorated on a monthly basis 
125.29  throughout the year in which they are purchased.  If the monthly 
125.30  cost of a recipient's other waivered services exceeds the 
125.31  monthly limit established in this paragraph, the annual cost of 
125.32  the waivered services shall be determined.  In this event, the 
125.33  annual cost of waivered services shall not exceed 12 times the 
125.34  monthly limit calculated in this paragraph.  The statewide 
125.35  average payment rate is calculated by determining the statewide 
125.36  average monthly nursing home rate, effective July 1 of the 
126.1   fiscal year in which the cost is incurred, less the statewide 
126.2   average monthly income of nursing home residents who are age 65 
126.3   or older, and who are medical assistance recipients in the month 
126.4   of March of the previous state fiscal year.  The annual cost 
126.5   divided by 12 of elderly or disabled waivered services for a 
126.6   person who is a nursing facility resident at the time of 
126.7   requesting a determination of eligibility for elderly or 
126.8   disabled waivered services shall be the greater of the monthly 
126.9   payment for:  (i) the resident class assigned under Minnesota 
126.10  Rules, parts 9549.0050 to 9549.0059, for that resident in the 
126.11  nursing facility where the resident currently resides; or (ii) 
126.12  the statewide average payment of the case mix resident class to 
126.13  which the resident would be assigned under the medical 
126.14  assistance case mix reimbursement system, provided that the 
126.15  limit under this clause only applies to persons discharged from 
126.16  a nursing facility and found eligible for waivered services on 
126.17  or after July 1, 1997.  The following costs must be included in 
126.18  determining the total monthly costs for the waiver client: 
126.19     (1) cost of all waivered services, including extended 
126.20  medical supplies and equipment; and 
126.21     (2) cost of skilled nursing, home health aide, and personal 
126.22  care services reimbursable by medical assistance.  
126.23     (c) Medical assistance funding for skilled nursing 
126.24  services, private duty nursing, home health aide, and personal 
126.25  care services for waiver recipients must be approved by the case 
126.26  manager and included in the individual care plan. 
126.27     (d) For both the elderly waiver and the nursing facility 
126.28  disabled waiver, a county may purchase extended supplies and 
126.29  equipment without prior approval from the commissioner when 
126.30  there is no other funding source and the supplies and equipment 
126.31  are specified in the individual's care plan as medically 
126.32  necessary to enable the individual to remain in the community 
126.33  according to the criteria in Minnesota Rules, part 9505.0210, 
126.34  items A and B.  A county is not required to contract with a 
126.35  provider of supplies and equipment if the monthly cost of the 
126.36  supplies and equipment is less than $250.  
127.1      (e) For the fiscal year beginning on July 1, 1993, and for 
127.2   subsequent fiscal years, the commissioner of human services 
127.3   shall not provide automatic annual inflation adjustments for 
127.4   home and community-based waivered services.  The commissioner of 
127.5   finance shall include as a budget change request in each 
127.6   biennial detailed expenditure budget submitted to the 
127.7   legislature under section 16A.11, annual adjustments in 
127.8   reimbursement rates for home and community-based waivered 
127.9   services, based on the forecasted percentage change in the Home 
127.10  Health Agency Market Basket of Operating Costs, for the fiscal 
127.11  year beginning July 1, compared to the previous fiscal year, 
127.12  unless otherwise adjusted by statute.  The Home Health Agency 
127.13  Market Basket of Operating Costs is published by Data Resources, 
127.14  Inc.  The forecast to be used is the one published for the 
127.15  calendar quarter beginning January 1, six months prior to the 
127.16  beginning of the fiscal year for which rates are set.  The adult 
127.17  foster care rate shall be considered a difficulty of care 
127.18  payment and shall not include room and board. 
127.19     (f) The adult foster care daily rate for the elderly and 
127.20  disabled waivers shall be negotiated between the county agency 
127.21  and the foster care provider.  The rate established under this 
127.22  section shall not exceed the state average monthly nursing home 
127.23  payment for the case mix classification to which the individual 
127.24  receiving foster care is assigned; the rate must allow for other 
127.25  waiver and medical assistance home care services to be 
127.26  authorized by the case manager. 
127.27     (g) (f) The assisted living and residential care service 
127.28  rates for elderly and community alternatives for disabled 
127.29  individuals (CADI) waivers shall be made to the vendor as a 
127.30  monthly rate negotiated with the county agency based on an 
127.31  individualized service plan for each resident.  The rate shall 
127.32  not exceed the nonfederal share of the greater of either the 
127.33  statewide or any of the geographic groups' weighted average 
127.34  monthly medical assistance nursing facility payment rate of the 
127.35  case mix resident class to which the elderly or disabled client 
127.36  would be assigned under Minnesota Rules, parts 9549.0050 to 
128.1   9549.0059, unless the services are provided by a home care 
128.2   provider licensed by the department of health and are provided 
128.3   in a building that is registered as a housing with services 
128.4   establishment under chapter 144D and that provides 24-hour 
128.5   supervision.  For alternative care assisted living projects 
128.6   established under Laws 1988, chapter 689, article 2, section 
128.7   256, monthly rates may not exceed 65 percent of the greater of 
128.8   either the statewide or any of the geographic groups' weighted 
128.9   average monthly medical assistance nursing facility payment rate 
128.10  for the case mix resident class to which the elderly or disabled 
128.11  client would be assigned under Minnesota Rules, parts 9549.0050 
128.12  to 9549.0059.  The rate may not cover direct rent or food costs. 
128.13     (h) (g) The county shall negotiate individual rates with 
128.14  vendors and may be reimbursed for actual costs up to the greater 
128.15  of the county's current approved rate or 60 percent of the 
128.16  maximum rate in fiscal year 1994 and 65 percent of the maximum 
128.17  rate in fiscal year 1995 for each service within each program. 
128.18     (i) (h) On July 1, 1993, the commissioner shall increase 
128.19  the maximum rate for home-delivered meals to $4.50 per meal. 
128.20     (j) (i) Reimbursement for the medical assistance recipients 
128.21  under the approved waiver shall be made from the medical 
128.22  assistance account through the invoice processing procedures of 
128.23  the department's Medicaid Management Information System (MMIS), 
128.24  only with the approval of the client's case manager.  The budget 
128.25  for the state share of the Medicaid expenditures shall be 
128.26  forecasted with the medical assistance budget, and shall be 
128.27  consistent with the approved waiver.  
128.28     (k) (j) Beginning July 1, 1991, the state shall reimburse 
128.29  counties according to the payment schedule in section 256.025 
128.30  for the county share of costs incurred under this subdivision on 
128.31  or after January 1, 1991, for individuals who are receiving 
128.32  medical assistance. 
128.33     (l) (k) For the community alternatives for disabled 
128.34  individuals waiver, and nursing facility disabled waivers, 
128.35  county may use waiver funds for the cost of minor adaptations to 
128.36  a client's residence or vehicle without prior approval from the 
129.1   commissioner if there is no other source of funding and the 
129.2   adaptation: 
129.3      (1) is necessary to avoid institutionalization; 
129.4      (2) has no utility apart from the needs of the client; and 
129.5      (3) meets the criteria in Minnesota Rules, part 9505.0210, 
129.6   items A and B.  
129.7   For purposes of this subdivision, "residence" means the client's 
129.8   own home, the client's family residence, or a family foster 
129.9   home.  For purposes of this subdivision, "vehicle" means the 
129.10  client's vehicle, the client's family vehicle, or the client's 
129.11  family foster home vehicle. 
129.12     (m) (l) The commissioner shall establish a maximum rate 
129.13  unit for baths provided by an adult day care provider that are 
129.14  not included in the provider's contractual daily or hourly rate. 
129.15  This maximum rate must equal the home health aide extended rate 
129.16  and shall be paid for baths provided to clients served under the 
129.17  elderly and disabled waivers. 
129.18     Sec. 37.  Minnesota Statutes 1996, section 256B.0916, is 
129.19  amended to read: 
129.20     256B.0916 [EXPANSION OF HOME AND COMMUNITY-BASED SERVICES; 
129.21  MANAGEMENT AND ALLOCATION RESPONSIBILITIES.] 
129.22     (a) The commissioner shall expand availability of home and 
129.23  community-based services for persons with mental retardation and 
129.24  related conditions to the extent allowed by federal law and 
129.25  regulation and shall assist counties in transferring persons 
129.26  from semi-independent living services to home and 
129.27  community-based services.  The commissioner may transfer funds 
129.28  from the state semi-independent living services account 
129.29  available under section 252.275, subdivision 8, and state 
129.30  community social services aids available under section 256E.15 
129.31  to the medical assistance account to pay for the nonfederal 
129.32  share of nonresidential and residential home and community-based 
129.33  services authorized under section 256B.092 for persons 
129.34  transferring from semi-independent living services. 
129.35     (b) Upon federal approval, county boards are not 
129.36  responsible for funding semi-independent living services as a 
130.1   social service for those persons who have transferred to the 
130.2   home and community-based waiver program as a result of the 
130.3   expansion under this subdivision.  The county responsibility for 
130.4   those persons transferred shall be assumed under section 
130.5   256B.092.  Notwithstanding the provisions of section 252.275, 
130.6   the commissioner shall continue to allocate funds under that 
130.7   section for semi-independent living services and county boards 
130.8   shall continue to fund services under sections 256E.06 and 
130.9   256E.14 for those persons who cannot access home and 
130.10  community-based services under section 256B.092. 
130.11     (c) Eighty percent of the state funds made available to the 
130.12  commissioner under section 252.275 as a result of persons 
130.13  transferring from the semi-independent living services program 
130.14  to the home and community-based services program shall be used 
130.15  to fund additional persons in the semi-independent living 
130.16  services program. 
130.17     (d) Beginning August 1, 1998, the commissioner shall issue 
130.18  an annual report on the home and community-based waiver for 
130.19  persons with mental retardation or related conditions, that 
130.20  includes a list of the counties in which less than 95 percent of 
130.21  the allocation provided, excluding the county waivered services 
130.22  reserve, has been committed for two or more quarters during the 
130.23  previous state fiscal year.  For each listed county, the report 
130.24  shall include the amount of funds allocated but not used, the 
130.25  number and ages of individuals screened and waiting for 
130.26  services, the services needed, a description of the technical 
130.27  assistance provided by the commissioner to assist the counties 
130.28  in jointly planning with other counties in order to serve more 
130.29  persons, and additional actions which will be taken to serve 
130.30  those screened and waiting for services. 
130.31     (e) The commissioner shall make available to interested 
130.32  parties, upon request, financial information by county including 
130.33  the amount of resources allocated for the home and 
130.34  community-based waiver for persons with mental retardation and 
130.35  related conditions, the resources committed, the number of 
130.36  persons screened and waiting for services, the type of services 
131.1   requested by those waiting, and the amount of allocated 
131.2   resources not committed. 
131.3      Sec. 38.  Minnesota Statutes 1997 Supplement, section 
131.4   256B.0951, is amended by adding a subdivision to read: 
131.5      Subd. 4a.  [WAIVER OF RULES.] The commissioner of health 
131.6   may exempt residents of intermediate care facilities for persons 
131.7   with mental retardation (ICFs/MR) who participate in the 
131.8   three-year quality assurance pilot project established in 
131.9   section 256B.095 from the requirements of Minnesota Rules, part 
131.10  4665, upon approval by the federal government of a waiver of 
131.11  federal certification requirements for ICFs/MR.  The 
131.12  commissioners of health and human services shall apply for any 
131.13  necessary waivers as soon as practicable and shall submit the 
131.14  concept paper to the federal government by June 1, 1998. 
131.15     Sec. 39.  Minnesota Statutes 1996, section 256B.41, 
131.16  subdivision 1, is amended to read: 
131.17     Subdivision 1.  [AUTHORITY.] The commissioner shall 
131.18  establish, by rule, procedures for determining rates for care of 
131.19  residents of nursing facilities which qualify as vendors of 
131.20  medical assistance, and for implementing the provisions of this 
131.21  section and sections 256B.421, 256B.431, 256B.432, 256B.433, 
131.22  256B.47, 256B.48, 256B.50, and 256B.502.  The procedures shall 
131.23  be based on methods and standards that the commissioner finds 
131.24  are adequate to provide for the costs that must be incurred for 
131.25  the care of residents in efficiently and economically operated 
131.26  nursing facilities and shall specify the costs that are 
131.27  allowable for establishing payment rates through medical 
131.28  assistance. 
131.29     Sec. 40.  Minnesota Statutes 1996, section 256B.431, 
131.30  subdivision 2b, is amended to read: 
131.31     Subd. 2b.  [OPERATING COSTS, AFTER JULY 1, 1985.] (a) For 
131.32  rate years beginning on or after July 1, 1985, the commissioner 
131.33  shall establish procedures for determining per diem 
131.34  reimbursement for operating costs.  
131.35     (b) The commissioner shall contract with an econometric 
131.36  firm with recognized expertise in and access to national 
132.1   economic change indices that can be applied to the appropriate 
132.2   cost categories when determining the operating cost payment rate.
132.3      (c) The commissioner shall analyze and evaluate each 
132.4   nursing facility's cost report of allowable operating costs 
132.5   incurred by the nursing facility during the reporting year 
132.6   immediately preceding the rate year for which the payment rate 
132.7   becomes effective.  
132.8      (d) The commissioner shall establish limits on actual 
132.9   allowable historical operating cost per diems based on cost 
132.10  reports of allowable operating costs for the reporting year that 
132.11  begins October 1, 1983, taking into consideration relevant 
132.12  factors including resident needs, geographic location, and size 
132.13  of the nursing facility, and the costs that must be incurred for 
132.14  the care of residents in an efficiently and economically 
132.15  operated nursing facility.  In developing the geographic groups 
132.16  for purposes of reimbursement under this section, the 
132.17  commissioner shall ensure that nursing facilities in any county 
132.18  contiguous to the Minneapolis-St. Paul seven-county metropolitan 
132.19  area are included in the same geographic group.  The limits 
132.20  established by the commissioner shall not be less, in the 
132.21  aggregate, than the 60th percentile of total actual allowable 
132.22  historical operating cost per diems for each group of nursing 
132.23  facilities established under subdivision 1 based on cost reports 
132.24  of allowable operating costs in the previous reporting year.  
132.25  For rate years beginning on or after July 1, 1989, facilities 
132.26  located in geographic group I as described in Minnesota Rules, 
132.27  part 9549.0052, on January 1, 1989, may choose to have the 
132.28  commissioner apply either the care related limits or the other 
132.29  operating cost limits calculated for facilities located in 
132.30  geographic group II, or both, if either of the limits calculated 
132.31  for the group II facilities is higher.  The efficiency incentive 
132.32  for geographic group I nursing facilities must be calculated 
132.33  based on geographic group I limits.  The phase-in must be 
132.34  established utilizing the chosen limits.  For purposes of these 
132.35  exceptions to the geographic grouping requirements, the 
132.36  definitions in Minnesota Rules, parts 9549.0050 to 9549.0059 
133.1   (Emergency), and 9549.0010 to 9549.0080, apply.  The limits 
133.2   established under this paragraph remain in effect until the 
133.3   commissioner establishes a new base period.  Until the new base 
133.4   period is established, the commissioner shall adjust the limits 
133.5   annually using the appropriate economic change indices 
133.6   established in paragraph (e).  In determining allowable 
133.7   historical operating cost per diems for purposes of setting 
133.8   limits and nursing facility payment rates, the commissioner 
133.9   shall divide the allowable historical operating costs by the 
133.10  actual number of resident days, except that where a nursing 
133.11  facility is occupied at less than 90 percent of licensed 
133.12  capacity days, the commissioner may establish procedures to 
133.13  adjust the computation of the per diem to an imputed occupancy 
133.14  level at or below 90 percent.  The commissioner shall establish 
133.15  efficiency incentives as appropriate.  The commissioner may 
133.16  establish efficiency incentives for different operating cost 
133.17  categories.  The commissioner shall consider establishing 
133.18  efficiency incentives in care related cost categories.  The 
133.19  commissioner may combine one or more operating cost categories 
133.20  and may use different methods for calculating payment rates for 
133.21  each operating cost category or combination of operating cost 
133.22  categories.  For the rate year beginning on July 1, 1985, the 
133.23  commissioner shall: 
133.24     (1) allow nursing facilities that have an average length of 
133.25  stay of 180 days or less in their skilled nursing level of care, 
133.26  125 percent of the care related limit and 105 percent of the 
133.27  other operating cost limit established by rule; and 
133.28     (2) exempt nursing facilities licensed on July 1, 1983, by 
133.29  the commissioner to provide residential services for the 
133.30  physically handicapped under Minnesota Rules, parts 9570.2000 to 
133.31  9570.3600, from the care related limits and allow 105 percent of 
133.32  the other operating cost limit established by rule. 
133.33     For the purpose of calculating the other operating cost 
133.34  efficiency incentive for nursing facilities referred to in 
133.35  clause (1)  or (2), the commissioner shall use the other 
133.36  operating cost limit established by rule before application of 
134.1   the 105 percent. 
134.2      (e) The commissioner shall establish a composite index or 
134.3   indices by determining the appropriate economic change 
134.4   indicators to be applied to specific operating cost categories 
134.5   or combination of operating cost categories.  
134.6      (f) Each nursing facility shall receive an operating cost 
134.7   payment rate equal to the sum of the nursing facility's 
134.8   operating cost payment rates for each operating cost category.  
134.9   The operating cost payment rate for an operating cost category 
134.10  shall be the lesser of the nursing facility's historical 
134.11  operating cost in the category increased by the appropriate 
134.12  index established in paragraph (e) for the operating cost 
134.13  category plus an efficiency incentive established pursuant to 
134.14  paragraph (d) or the limit for the operating cost category 
134.15  increased by the same index.  If a nursing facility's actual 
134.16  historic operating costs are greater than the prospective 
134.17  payment rate for that rate year, there shall be no retroactive 
134.18  cost settle-up.  In establishing payment rates for one or more 
134.19  operating cost categories, the commissioner may establish 
134.20  separate rates for different classes of residents based on their 
134.21  relative care needs.  
134.22     (g) The commissioner shall include the reported actual real 
134.23  estate tax liability or payments in lieu of real estate tax of 
134.24  each nursing facility as an operating cost of that nursing 
134.25  facility.  Allowable costs under this subdivision for payments 
134.26  made by a nonprofit nursing facility that are in lieu of real 
134.27  estate taxes shall not exceed the amount which the nursing 
134.28  facility would have paid to a city or township and county for 
134.29  fire, police, sanitation services, and road maintenance costs 
134.30  had real estate taxes been levied on that property for those 
134.31  purposes.  For rate years beginning on or after July 1, 1987, 
134.32  the reported actual real estate tax liability or payments in 
134.33  lieu of real estate tax of nursing facilities shall be adjusted 
134.34  to include an amount equal to one-half of the dollar change in 
134.35  real estate taxes from the prior year.  The commissioner shall 
134.36  include a reported actual special assessment, and reported 
135.1   actual license fees required by the Minnesota department of 
135.2   health, for each nursing facility as an operating cost of that 
135.3   nursing facility.  For rate years beginning on or after July 1, 
135.4   1989, the commissioner shall include a nursing facility's 
135.5   reported public employee retirement act contribution for the 
135.6   reporting year as apportioned to the care-related operating cost 
135.7   categories and other operating cost categories multiplied by the 
135.8   appropriate composite index or indices established pursuant to 
135.9   paragraph (e) as costs under this paragraph.  Total adjusted 
135.10  real estate tax liability, payments in lieu of real estate tax, 
135.11  actual special assessments paid, the indexed public employee 
135.12  retirement act contribution, and license fees paid as required 
135.13  by the Minnesota department of health, for each nursing facility 
135.14  (1) shall be divided by actual resident days in order to compute 
135.15  the operating cost payment rate for this operating cost 
135.16  category, (2) shall not be used to compute the care-related 
135.17  operating cost limits or other operating cost limits established 
135.18  by the commissioner, and (3) shall not be increased by the 
135.19  composite index or indices established pursuant to paragraph 
135.20  (e), unless otherwise indicated in this paragraph. 
135.21     (h) For rate years beginning on or after July 1, 1987, the 
135.22  commissioner shall adjust the rates of a nursing facility that 
135.23  meets the criteria for the special dietary needs of its 
135.24  residents and the requirements in section 31.651.  The 
135.25  adjustment for raw food cost shall be the difference between the 
135.26  nursing facility's allowable historical raw food cost per diem 
135.27  and 115 percent of the median historical allowable raw food cost 
135.28  per diem of the corresponding geographic group. 
135.29     The rate adjustment shall be reduced by the applicable 
135.30  phase-in percentage as provided under subdivision 2h. 
135.31     (i) For the cost report year ending September 30, 1996, and 
135.32  for all subsequent reporting years, certified nursing facilities 
135.33  must identify, differentiate, and record resident day statistics 
135.34  for residents in case mix classification A who, on or after July 
135.35  1, 1996, meet the modified level of care criteria in section 
135.36  144.0721.  The resident day statistics shall be separated into 
136.1   case mix classification A-1 for any resident day meeting the 
136.2   high-function class A level of care criteria and case mix 
136.3   classification A-2 for other case mix class A resident days. 
136.4      Sec. 41.  Minnesota Statutes 1996, section 256B.501, 
136.5   subdivision 2, is amended to read: 
136.6      Subd. 2.  [AUTHORITY.] The commissioner shall establish 
136.7   procedures and rules for determining rates for care of residents 
136.8   of intermediate care facilities for persons with mental 
136.9   retardation or related conditions which qualify as providers of 
136.10  medical assistance and waivered services.  Approved rates shall 
136.11  be established on the basis of methods and standards that the 
136.12  commissioner finds adequate to provide for the costs that must 
136.13  be incurred for the quality care of residents in efficiently and 
136.14  economically operated facilities and services.  The procedures 
136.15  shall specify the costs that are allowable for payment through 
136.16  medical assistance.  The commissioner may use experts from 
136.17  outside the department in the establishment of the procedures. 
136.18     Sec. 42.  Minnesota Statutes 1997 Supplement, section 
136.19  256B.69, subdivision 2, is amended to read: 
136.20     Subd. 2.  [DEFINITIONS.] For the purposes of this section, 
136.21  the following terms have the meanings given.  
136.22     (a) "Commissioner" means the commissioner of human services.
136.23  For the remainder of this section, the commissioner's 
136.24  responsibilities for methods and policies for implementing the 
136.25  project will be proposed by the project advisory committees and 
136.26  approved by the commissioner.  
136.27     (b) "Demonstration provider" means a health maintenance 
136.28  organization or, community integrated service network, or 
136.29  accountable provider network authorized and operating under 
136.30  chapter 62D or, 62N, or 62T that participates in the 
136.31  demonstration project according to criteria, standards, methods, 
136.32  and other requirements established for the project and approved 
136.33  by the commissioner.  Notwithstanding the above, Itasca county 
136.34  may continue to participate as a demonstration provider until 
136.35  July 1, 2000. 
136.36     (c) "Eligible individuals" means those persons eligible for 
137.1   medical assistance benefits as defined in sections 256B.055, 
137.2   256B.056, and 256B.06. 
137.3      (d) "Limitation of choice" means suspending freedom of 
137.4   choice while allowing eligible individuals to choose among the 
137.5   demonstration providers.  
137.6      (e) This paragraph supersedes paragraph (c) as long as the 
137.7   Minnesota health care reform waiver remains in effect.  When the 
137.8   waiver expires, this paragraph expires and the commissioner of 
137.9   human services shall publish a notice in the State Register and 
137.10  notify the revisor of statutes.  "Eligible individuals" means 
137.11  those persons eligible for medical assistance benefits as 
137.12  defined in sections 256B.055, 256B.056, and 256B.06.  
137.13  Notwithstanding sections 256B.055, 256B.056, and 256B.06, an 
137.14  individual who becomes ineligible for the program because of 
137.15  failure to submit income reports or recertification forms in a 
137.16  timely manner, shall remain enrolled in the prepaid health plan 
137.17  and shall remain eligible to receive medical assistance coverage 
137.18  through the last day of the month following the month in which 
137.19  the enrollee became ineligible for the medical assistance 
137.20  program. 
137.21     Sec. 43.  Minnesota Statutes 1997 Supplement, section 
137.22  256B.69, subdivision 3a, is amended to read: 
137.23     Subd. 3a.  [COUNTY AUTHORITY.] (a) The commissioner, when 
137.24  implementing the general assistance medical care, or medical 
137.25  assistance prepayment program within a county, must include the 
137.26  county board in the process of development, approval, and 
137.27  issuance of the request for proposals to provide services to 
137.28  eligible individuals within the proposed county.  County boards 
137.29  must be given reasonable opportunity to make recommendations 
137.30  regarding the development, issuance, review of responses, and 
137.31  changes needed in the request for proposals.  The commissioner 
137.32  must provide county boards the opportunity to review each 
137.33  proposal based on the identification of community needs under 
137.34  chapters 145A and 256E and county advocacy activities.  If a 
137.35  county board finds that a proposal does not address certain 
137.36  community needs, the county board and commissioner shall 
138.1   continue efforts for improving the proposal and network prior to 
138.2   the approval of the contract.  The county board shall make 
138.3   recommendations regarding the approval of local networks and 
138.4   their operations to ensure adequate availability and access to 
138.5   covered services.  The provider or health plan must respond 
138.6   directly to county advocates and the state prepaid medical 
138.7   assistance ombudsperson regarding service delivery and must be 
138.8   accountable to the state regarding contracts with medical 
138.9   assistance and general assistance medical care funds.  The 
138.10  county board may recommend a maximum number of participating 
138.11  health plans after considering the size of the enrolling 
138.12  population; ensuring adequate access and capacity; considering 
138.13  the client and county administrative complexity; and considering 
138.14  the need to promote the viability of locally developed health 
138.15  plans.  The county board or a single entity representing a group 
138.16  of county boards and the commissioner shall mutually select 
138.17  health plans for participation at the time of initial 
138.18  implementation of the prepaid medical assistance program in that 
138.19  county or group of counties and at the time of contract renewal. 
138.20  The commissioner shall also seek input for contract requirements 
138.21  from the county or single entity representing a group of county 
138.22  boards at each contract renewal and incorporate those 
138.23  recommendations into the contract negotiation process.  The 
138.24  commissioner, in conjunction with the county board, shall 
138.25  actively seek to develop a mutually agreeable timetable prior to 
138.26  the development of the request for proposal, but counties must 
138.27  agree to initial enrollment beginning on or before January 1, 
138.28  1999, in either the prepaid medical assistance and general 
138.29  assistance medical care programs or county-based purchasing 
138.30  under section 256B.692.  At least 90 days before enrollment in 
138.31  the medical assistance and general assistance medical care 
138.32  prepaid programs begins in a county in which the prepaid 
138.33  programs have not been established, the commissioner shall 
138.34  provide a report to the chairs of senate and house committees 
138.35  having jurisdiction over state health care programs which 
138.36  verifies that the commissioner complied with the requirements 
139.1   for county involvement that are specified in this subdivision. 
139.2      (b) The commissioner shall seek a federal waiver to allow a 
139.3   fee-for-service plan option to MinnesotaCare enrollees.  The 
139.4   commissioner shall develop an increase of the premium fees 
139.5   required under section 256L.06 up to 20 percent of the premium 
139.6   fees for the enrollees who elect the fee-for-service option.  
139.7   Prior to implementation, the commissioner shall submit this fee 
139.8   schedule to the chair and ranking minority member of the senate 
139.9   health care committee, the senate health care and family 
139.10  services funding division, the house of representatives health 
139.11  and human services committee, and the house of representatives 
139.12  health and human services finance division. 
139.13     (c) At the option of the county board, the board may 
139.14  develop contract requirements related to the achievement of 
139.15  local public health goals to meet the health needs of medical 
139.16  assistance and general assistance medical care enrollees.  These 
139.17  requirements must be reasonably related to the performance of 
139.18  health plan functions and within the scope of the medical 
139.19  assistance and general assistance medical care benefit sets.  If 
139.20  the county board and the commissioner mutually agree to such 
139.21  requirements, the department shall include such requirements in 
139.22  all health plan contracts governing the prepaid medical 
139.23  assistance and general assistance medical care programs in that 
139.24  county at initial implementation of the program in that county 
139.25  and at the time of contract renewal.  The county board may 
139.26  participate in the enforcement of the contract provisions 
139.27  related to local public health goals. 
139.28     (d) For counties in which prepaid medical assistance and 
139.29  general assistance medical care programs have not been 
139.30  established, the commissioner shall not implement those programs 
139.31  if a county board submits acceptable and timely preliminary and 
139.32  final proposals under section 256B.692, until county-based 
139.33  purchasing is no longer operational in that county.  For 
139.34  counties in which prepaid medical assistance and general 
139.35  assistance medical care programs are in existence on or after 
139.36  September 1, 1997, the commissioner must terminate contracts 
140.1   with health plans according to section 256B.692, subdivision 5, 
140.2   if the county board submits and the commissioner accepts 
140.3   preliminary and final proposals according to that subdivision.  
140.4   The commissioner is not required to terminate contracts that 
140.5   begin on or after September 1, 1997, according to section 
140.6   256B.692 until two years have elapsed from the date of initial 
140.7   enrollment. 
140.8      (e) In the event that a county board or a single entity 
140.9   representing a group of county boards and the commissioner 
140.10  cannot reach agreement regarding:  (i) the selection of 
140.11  participating health plans in that county; (ii) contract 
140.12  requirements; or (iii) implementation and enforcement of county 
140.13  requirements including provisions regarding local public health 
140.14  goals, the commissioner shall resolve all disputes after taking 
140.15  into account the recommendations of a three-person mediation 
140.16  panel.  The panel shall be composed of one designee of the 
140.17  president of the association of Minnesota counties, one designee 
140.18  of the commissioner of human services, and one designee of the 
140.19  commissioner of health. 
140.20     (f) If a county which elects to implement county-based 
140.21  purchasing ceases to implement county-based purchasing, it is 
140.22  prohibited from assuming the responsibility of county-based 
140.23  purchasing for a period of five years from the date it 
140.24  discontinues purchasing. 
140.25     (g) Notwithstanding the requirement in this subdivision 
140.26  that a county must agree to initial enrollment on or before 
140.27  January 1, 1999, the commissioner shall grant a delay of up to 
140.28  nine months in the implementation of the county-based purchasing 
140.29  authorized in section 256B.692 if the county or group of 
140.30  counties has submitted a preliminary proposal for county-based 
140.31  purchasing by September 1, 1997, has not already implemented the 
140.32  prepaid medical assistance program before January 1, 1998, and 
140.33  has submitted a written request for the delay to the 
140.34  commissioner by July 1, 1998.  In order for the delay to be 
140.35  continued, the county or group of counties must also submit to 
140.36  the commissioner the following information by December 1, 1998.  
141.1   The information must: 
141.2      (1) identify the proposed date of implementation, not later 
141.3   than October 1, 1999; 
141.4      (2) include copies of the county board resolutions which 
141.5   demonstrate the continued commitment to the implementation of 
141.6   county-based purchasing by the proposed date.  County board 
141.7   authorization may remain contingent on the submission of a final 
141.8   proposal which meets the requirements of section 256B.692, 
141.9   subdivision 5, paragraph (b); 
141.10     (3) demonstrate the establishment of a governance structure 
141.11  between the participating counties and describe how the 
141.12  fiduciary responsibilities of county-based purchasing will be 
141.13  allocated between the counties, if more than one county is 
141.14  involved in the proposal; 
141.15     (4) describe how the risk of a deficit will be managed in 
141.16  the event expenditures are greater than total capitation 
141.17  payments.  This description must identify how any of the 
141.18  following strategies will be used: 
141.19     (i) risk contracts with licensed health plans; 
141.20     (ii) risk arrangements with providers who are not licensed 
141.21  health plans; 
141.22     (iii) risk arrangements with other licensed insurance 
141.23  entities; and 
141.24     (iv) funding from other county resources; 
141.25     (5) include, if county-based purchasing will not contract 
141.26  with licensed health plans or provider networks, letters of 
141.27  interest from local providers in at least the categories of 
141.28  hospital, physician, mental health, and pharmacy which express 
141.29  interest in contracting for services.  These letters must 
141.30  recognize any risk transfer identified in clause (4), item (ii); 
141.31  and 
141.32     (6) describe the options being considered to obtain the 
141.33  administrative services required in section 256B.692, 
141.34  subdivision 3, clauses (3) and (5). 
141.35     (h) For counties which receive a delay under this 
141.36  subdivision, the final proposals required under section 
142.1   256B.692, subdivision 5, paragraph (b), must be submitted at 
142.2   least six months prior to the requested implementation date.  
142.3   Authority to implement county-based purchasing remains 
142.4   contingent on approval of the final proposal as required under 
142.5   section 256B.692. 
142.6      Sec. 44.  Minnesota Statutes 1996, section 256B.69, is 
142.7   amended by adding a subdivision to read: 
142.8      Subd. 25.  [EXEMPTION FROM ENROLLMENT.] (a) Beginning on or 
142.9   after January 1, 1999, for American Indian recipients of medical 
142.10  assistance who live on or near a reservation, as defined in Code 
142.11  of Federal Regulations, title 42, section 36.22(a)(6), and who 
142.12  are required to enroll with a demonstration provider under 
142.13  subdivision 4, medical assistance shall cover health care 
142.14  services provided at American Indian health services facilities 
142.15  and facilities operated by a tribe or tribal organization under 
142.16  funding authorized by United States Code, title 25, sections 
142.17  450f to 450n, or title III of the Indian Self-Determination and 
142.18  Education Assistance Act, Public Law Number 93-638, if those 
142.19  services would otherwise be covered under section 256B.0625.  
142.20  Payments for services provided under this subdivision shall be 
142.21  made on a fee-for-service basis, and may, at the option of the 
142.22  tribe or tribal organization, be made in accordance with rates 
142.23  authorized under sections 256.959, subdivision 16, and 
142.24  256B.0625, subdivision 34.  Implementation of this purchasing 
142.25  model is contingent on federal approval. 
142.26     (b) For purposes of this subdivision, "American Indian" has 
142.27  the meaning given to persons to whom services will be provided 
142.28  for in Code of Federal Regulations, title 42, section 36.12. 
142.29     (c) This subdivision also applies to American Indian 
142.30  recipients of general assistance medical care and to the prepaid 
142.31  general assistance medical care program under section 256D.03, 
142.32  subdivision 4, paragraph (d).  
142.33     (d) The commissioner of human services, in consultation 
142.34  with the tribal governments, shall develop a plan for tribes to 
142.35  assist in the enrollment process for American Indian recipients 
142.36  enrolled in the prepaid medical assistance program under this 
143.1   section or the prepaid general assistance program under section 
143.2   256D.03, subdivision 4, paragraph (d).  This plan also shall 
143.3   address how tribes will be included in ensuring the coordination 
143.4   of care for American Indian recipients between Indian health 
143.5   service or tribal providers and other providers. 
143.6      Sec. 45.  Minnesota Statutes 1997 Supplement, section 
143.7   256B.692, subdivision 2, is amended to read: 
143.8      Subd. 2.  [DUTIES OF THE COMMISSIONER OF HEALTH.] 
143.9   Notwithstanding chapters 62D and 62N, a county that elects to 
143.10  purchase medical assistance and general assistance medical care 
143.11  in return for a fixed sum without regard to the frequency or 
143.12  extent of services furnished to any particular enrollee is not 
143.13  required to obtain a certificate of authority under chapter 62D 
143.14  or 62N.  A county that elects to purchase medical assistance and 
143.15  general assistance medical care services under this section must 
143.16  satisfy the commissioner of health that the requirements of 
143.17  chapter 62D, applicable to health maintenance organizations, or 
143.18  chapter 62N, applicable to community integrated service 
143.19  networks, will be met.  A county must also assure the 
143.20  commissioner of health that the requirements of section sections 
143.21  62J.041; 62J.48; 62J.71 to 62J.73; 62M.01 to 62M.16; all 
143.22  applicable provisions of chapter 62Q, including sections 62Q.07; 
143.23  62Q.075; 62Q.105; 62Q.1055; 62Q.106; 62Q.11; 62Q.12; 62Q.135; 
143.24  62Q.14; 62Q.145; 62Q.19; 62Q.23, paragraph (c); 62Q.30; 62Q.43; 
143.25  62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.64; and 72A.201 
143.26  will be met.  All enforcement and rulemaking powers available 
143.27  under chapters 62D and, 62J, 62M, 62N, and 62Q are hereby 
143.28  granted to the commissioner of health with respect to counties 
143.29  that purchase medical assistance and general assistance medical 
143.30  care services under this section. 
143.31     Sec. 46.  Minnesota Statutes 1997 Supplement, section 
143.32  256B.692, subdivision 5, is amended to read: 
143.33     Subd. 5.  [COUNTY PROPOSALS.] (a) On or before September 1, 
143.34  1997, a county board that wishes to purchase or provide health 
143.35  care under this section must submit a preliminary proposal that 
143.36  substantially demonstrates the county's ability to meet all the 
144.1   requirements of this section in response to criteria for 
144.2   proposals issued by the department on or before July 1, 1997.  
144.3   Counties submitting preliminary proposals must establish a local 
144.4   planning process that involves input from medical assistance and 
144.5   general assistance medical care recipients, recipient advocates, 
144.6   providers and representatives of local school districts, labor, 
144.7   and tribal government to advise on the development of a final 
144.8   proposal and its implementation.  
144.9      (b) The county board must submit a final proposal on or 
144.10  before July 1, 1998, that demonstrates the ability to meet all 
144.11  the requirements of this section, including beginning enrollment 
144.12  on January 1, 1999, unless a delay has been granted under 
144.13  section 256B.69, subdivision 3a, paragraph (g).  
144.14     (c) After January 1, 1999, for a county in which the 
144.15  prepaid medical assistance program is in existence, the county 
144.16  board must submit a preliminary proposal at least 15 months 
144.17  prior to termination of health plan contracts in that county and 
144.18  a final proposal six months prior to the health plan contract 
144.19  termination date in order to begin enrollment after the 
144.20  termination.  Nothing in this section shall impede or delay 
144.21  implementation or continuation of the prepaid medical assistance 
144.22  and general assistance medical care programs in counties for 
144.23  which the board does not submit a proposal, or submits a 
144.24  proposal that is not in compliance with this section. 
144.25     (d) The commissioner is not required to terminate contracts 
144.26  for the prepaid medical assistance and prepaid general 
144.27  assistance medical care programs that begin on or after 
144.28  September 1, 1997, in a county for which a county board has 
144.29  submitted a proposal under this paragraph, until two years have 
144.30  elapsed from the date of initial enrollment in the prepaid 
144.31  medical assistance and prepaid general assistance medical care 
144.32  programs. 
144.33     Sec. 47.  Minnesota Statutes 1997 Supplement, section 
144.34  256B.77, subdivision 3, is amended to read: 
144.35     Subd. 3.  [ASSURANCES TO THE COMMISSIONER OF HEALTH.] A 
144.36  county authority that elects to participate in a demonstration 
145.1   project for people with disabilities under this section is not 
145.2   required to obtain a certificate of authority under chapter 62D 
145.3   or 62N.  A county authority that elects to participate in a 
145.4   demonstration project for people with disabilities under this 
145.5   section must assure the commissioner of health that the 
145.6   requirements of chapters 62D and 62N, and section 256B.692, 
145.7   subdivision 2, are met.  All enforcement and rulemaking powers 
145.8   available under chapters 62D and, 62J, 62M, 62N, and 62Q are 
145.9   granted to the commissioner of health with respect to the county 
145.10  authorities that contract with the commissioner to purchase 
145.11  services in a demonstration project for people with disabilities 
145.12  under this section. 
145.13     Sec. 48.  Minnesota Statutes 1997 Supplement, section 
145.14  256B.77, subdivision 7a, is amended to read: 
145.15     Subd. 7a.  [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 
145.16  for the demonstration project as provided in this subdivision. 
145.17     (b) "Eligible individuals" means those persons living in 
145.18  the demonstration site who are eligible for medical assistance 
145.19  and are disabled based on a disability determination under 
145.20  section 256B.055, subdivisions 7 and 12, or who are eligible for 
145.21  medical assistance and have been diagnosed as having: 
145.22     (1) serious and persistent mental illness as defined in 
145.23  section 245.462, subdivision 20; 
145.24     (2) severe emotional disturbance as defined in section 
145.25  245.487, subdivision 6; or 
145.26     (3) mental retardation, or being a mentally retarded person 
145.27  as defined in section 252A.02, or a related condition as defined 
145.28  in section 252.27, subdivision 1a. 
145.29  Other individuals may be included at the option of the county 
145.30  authority based on agreement with the commissioner. 
145.31     (c) Eligible individuals residing on a federally recognized 
145.32  Indian reservation may be excluded from participation in the 
145.33  demonstration project at the discretion of the tribal government 
145.34  based on agreement with the commissioner, in consultation with 
145.35  the county authority. 
145.36     (d) Eligible individuals include individuals in excluded 
146.1   time status, as defined in chapter 256G.  Enrollees in excluded 
146.2   time at the time of enrollment shall remain in excluded time 
146.3   status as long as they live in the demonstration site and shall 
146.4   be eligible for 90 days after placement outside the 
146.5   demonstration site if they move to excluded time status in a 
146.6   county within Minnesota other than their county of financial 
146.7   responsibility. 
146.8      (e) A person who is a sexual psychopathic personality as 
146.9   defined in section 253B.02, subdivision 18a, or a sexually 
146.10  dangerous person as defined in section 253B.02, subdivision 18b, 
146.11  is excluded from enrollment in the demonstration project. 
146.12     Sec. 49.  Minnesota Statutes 1997 Supplement, section 
146.13  256B.77, subdivision 10, is amended to read: 
146.14     Subd. 10.  [CAPITATION PAYMENT.] (a) The commissioner shall 
146.15  pay a capitation payment to the county authority and, when 
146.16  applicable under subdivision 6, paragraph (a), to the service 
146.17  delivery organization for each medical assistance eligible 
146.18  enrollee.  The commissioner shall develop capitation payment 
146.19  rates for the initial contract period for each demonstration 
146.20  site in consultation with an independent actuary, to ensure that 
146.21  the cost of services under the demonstration project does not 
146.22  exceed the estimated cost for medical assistance services for 
146.23  the covered population under the fee-for-service system for the 
146.24  demonstration period.  For each year of the demonstration 
146.25  project, the capitation payment rate shall be based on 96 
146.26  percent of the projected per person costs that would otherwise 
146.27  have been paid under medical assistance fee-for-service during 
146.28  each of those years.  Rates shall be adjusted within the limits 
146.29  of the available risk adjustment technology, as mandated by 
146.30  section 62Q.03.  In addition, the commissioner shall implement 
146.31  appropriate risk and savings sharing provisions with county 
146.32  administrative entities and, when applicable under subdivision 
146.33  6, paragraph (a), service delivery organizations within the 
146.34  projected budget limits.  Capitation rates shall be adjusted, at 
146.35  least annually, to include any rate increases and payments for 
146.36  expanded or newly covered services for eligible individuals.  
147.1   The initial demonstration project rate shall include an amount 
147.2   in addition to the fee-for-service payments to adjust for 
147.3   underutilization of dental services.  Any savings beyond those 
147.4   allowed for the county authority, county administrative entity, 
147.5   or service delivery organization shall be first used to meet the 
147.6   unmet needs of eligible individuals.  Payments to providers 
147.7   participating in the project are exempt from the requirements of 
147.8   sections 256.966 and 256B.03, subdivision 2. 
147.9      (b) The commissioner shall monitor and evaluate annually 
147.10  the effect of the discount on consumers, the county authority, 
147.11  and providers of disability services.  Findings shall be 
147.12  reported and recommendations made, as appropriate, to ensure 
147.13  that the discount effect does not adversely affect the ability 
147.14  of the county administrative entity or providers of services to 
147.15  provide appropriate services to eligible individuals, and does 
147.16  not result in cost shifting of eligible individuals to the 
147.17  county authority. 
147.18     Sec. 50.  Minnesota Statutes 1997 Supplement, section 
147.19  256B.77, subdivision 12, is amended to read: 
147.20     Subd. 12.  [SERVICE COORDINATION.] (a) For purposes of this 
147.21  section, "service coordinator" means an individual selected by 
147.22  the enrollee or the enrollee's legal representative and 
147.23  authorized by the county administrative entity or service 
147.24  delivery organization to work in partnership with the enrollee 
147.25  to develop, coordinate, and in some instances, provide supports 
147.26  and services identified in the personal support plan.  Service 
147.27  coordinators may only provide services and supports if the 
147.28  enrollee is informed of potential conflicts of interest, is 
147.29  given alternatives, and gives informed consent.  Eligible 
147.30  service coordinators are individuals age 18 or older who meet 
147.31  the qualifications as described in paragraph (b).  Enrollees, 
147.32  their legal representatives, or their advocates are eligible to 
147.33  be service coordinators if they have the capabilities to perform 
147.34  the activities and functions outlined in paragraph (b).  
147.35  Providers licensed under chapter 245A to provide residential 
147.36  services, or providers who are providing residential services 
148.1   covered under the group residential housing program may not act 
148.2   as service coordinator for enrollees for whom they provide 
148.3   residential services.  This does not apply to providers of 
148.4   short-term detoxification services.  Each county administrative 
148.5   entity or service delivery organization may develop further 
148.6   criteria for eligible vendors of service coordination during the 
148.7   demonstration period and shall determine whom it contracts with 
148.8   or employs to provide service coordination.  County 
148.9   administrative entities and service delivery organizations may 
148.10  pay enrollees or their advocates or legal representatives for 
148.11  service coordination activities. 
148.12     (b) The service coordinator shall act as a facilitator, 
148.13  working in partnership with the enrollee to ensure that their 
148.14  needs are identified and addressed.  The level of involvement of 
148.15  the service coordinator shall depend on the needs and desires of 
148.16  the enrollee.  The service coordinator shall have the knowledge, 
148.17  skills, and abilities to, and is responsible for: 
148.18     (1) arranging for an initial assessment, and periodic 
148.19  reassessment as necessary, of supports and services based on the 
148.20  enrollee's strengths, needs, choices, and preferences in life 
148.21  domain areas; 
148.22     (2) developing and updating the personal support plan based 
148.23  on relevant ongoing assessment; 
148.24     (3) arranging for and coordinating the provisions of 
148.25  supports and services, including knowledgeable and skilled 
148.26  specialty services and prevention and early intervention 
148.27  services, within the limitations negotiated with the county 
148.28  administrative entity or service delivery organization; 
148.29     (4) assisting the enrollee and the enrollee's legal 
148.30  representative, if any, to maximize informed choice of and 
148.31  control over services and supports and to exercise the 
148.32  enrollee's rights and advocate on behalf of the enrollee; 
148.33     (5) monitoring the progress toward achieving the enrollee's 
148.34  outcomes in order to evaluate and adjust the timeliness and 
148.35  adequacy of the implementation of the personal support plan; 
148.36     (6) facilitating meetings and effectively collaborating 
149.1   with a variety of agencies and persons, including attending 
149.2   individual family service plan and individual education plan 
149.3   meetings when requested by the enrollee or the enrollee's legal 
149.4   representative; 
149.5      (7) soliciting and analyzing relevant information; 
149.6      (8) communicating effectively with the enrollee and with 
149.7   other individuals participating in the enrollee's plan; 
149.8      (9) educating and communicating effectively with the 
149.9   enrollee about good health care practices and risk to the 
149.10  enrollee's health with certain behaviors; 
149.11     (10) having knowledge of basic enrollee protection 
149.12  requirements, including data privacy; 
149.13     (11) informing, educating, and assisting the enrollee in 
149.14  identifying available service providers and accessing needed 
149.15  resources and services beyond the limitations of the medical 
149.16  assistance benefit set covered services; and 
149.17     (12) providing other services as identified in the personal 
149.18  support plan.  
149.19     (c) For the demonstration project, the qualifications and 
149.20  standards for service coordination in this section shall replace 
149.21  comparable existing provisions of existing statutes and rules 
149.22  governing case management for eligible individuals. 
149.23     (d) The provisions of this subdivision apply only to the 
149.24  demonstration sites that begin implementation on July 1, 
149.25  1998 designated by the commissioner under subdivision 5.  All 
149.26  other demonstration sites must comply with laws and rules 
149.27  governing case management services for eligible individuals in 
149.28  effect when the site begins the demonstration project. 
149.29     Sec. 51.  Minnesota Statutes 1996, section 256D.03, 
149.30  subdivision 4, is amended to read: 
149.31     Subd. 4.  [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 
149.32  For a person who is eligible under subdivision 3, paragraph (a), 
149.33  clause (3), general assistance medical care covers, except as 
149.34  provided in paragraph (c): 
149.35     (1) inpatient hospital services; 
149.36     (2) outpatient hospital services; 
150.1      (3) services provided by Medicare certified rehabilitation 
150.2   agencies; 
150.3      (4) prescription drugs and other products recommended 
150.4   through the process established in section 256B.0625, 
150.5   subdivision 13; 
150.6      (5) equipment necessary to administer insulin and 
150.7   diagnostic supplies and equipment for diabetics to monitor blood 
150.8   sugar level; 
150.9      (6) eyeglasses and eye examinations provided by a physician 
150.10  or optometrist; 
150.11     (7) hearing aids; 
150.12     (8) prosthetic devices; 
150.13     (9) laboratory and X-ray services; 
150.14     (10) physician's services; 
150.15     (11) medical transportation; 
150.16     (12) chiropractic services as covered under the medical 
150.17  assistance program; 
150.18     (13) podiatric services; 
150.19     (14) dental services; 
150.20     (15) outpatient services provided by a mental health center 
150.21  or clinic that is under contract with the county board and is 
150.22  established under section 245.62; 
150.23     (16) day treatment services for mental illness provided 
150.24  under contract with the county board; 
150.25     (17) prescribed medications for persons who have been 
150.26  diagnosed as mentally ill as necessary to prevent more 
150.27  restrictive institutionalization; 
150.28     (18) case management services for a person with serious and 
150.29  persistent mental illness who would be eligible for medical 
150.30  assistance except that the person resides in an institution for 
150.31  mental diseases; 
150.32     (19) psychological services, medical supplies and 
150.33  equipment, and Medicare premiums, coinsurance and deductible 
150.34  payments; 
150.35     (20) (19) medical equipment not specifically listed in this 
150.36  paragraph when the use of the equipment will prevent the need 
151.1   for costlier services that are reimbursable under this 
151.2   subdivision; 
151.3      (21) (20) services performed by a certified pediatric nurse 
151.4   practitioner, a certified family nurse practitioner, a certified 
151.5   adult nurse practitioner, a certified obstetric/gynecological 
151.6   nurse practitioner, or a certified geriatric nurse practitioner 
151.7   in independent practice, if the services are otherwise covered 
151.8   under this chapter as a physician service, and if the service is 
151.9   within the scope of practice of the nurse practitioner's license 
151.10  as a registered nurse, as defined in section 148.171; and 
151.11     (22) (21) services of a certified public health nurse or a 
151.12  registered nurse practicing in a public health nursing clinic 
151.13  that is a department of, or that operates under the direct 
151.14  authority of, a unit of government, if the service is within the 
151.15  scope of practice of the public health nurse's license as a 
151.16  registered nurse, as defined in section 148.171.  
151.17     (b) Except as provided in paragraph (c), for a recipient 
151.18  who is eligible under subdivision 3, paragraph (a), clause (1) 
151.19  or (2), general assistance medical care covers the services 
151.20  listed in paragraph (a) with the exception of special 
151.21  transportation services. 
151.22     (c) Gender reassignment surgery and related services are 
151.23  not covered services under this subdivision unless the 
151.24  individual began receiving gender reassignment services prior to 
151.25  July 1, 1995.  
151.26     (d) In order to contain costs, the commissioner of human 
151.27  services shall select vendors of medical care who can provide 
151.28  the most economical care consistent with high medical standards 
151.29  and shall where possible contract with organizations on a 
151.30  prepaid capitation basis to provide these services.  The 
151.31  commissioner shall consider proposals by counties and vendors 
151.32  for prepaid health plans, competitive bidding programs, block 
151.33  grants, or other vendor payment mechanisms designed to provide 
151.34  services in an economical manner or to control utilization, with 
151.35  safeguards to ensure that necessary services are provided.  
151.36  Before implementing prepaid programs in counties with a county 
152.1   operated or affiliated public teaching hospital or a hospital or 
152.2   clinic operated by the University of Minnesota, the commissioner 
152.3   shall consider the risks the prepaid program creates for the 
152.4   hospital and allow the county or hospital the opportunity to 
152.5   participate in the program in a manner that reflects the risk of 
152.6   adverse selection and the nature of the patients served by the 
152.7   hospital, provided the terms of participation in the program are 
152.8   competitive with the terms of other participants considering the 
152.9   nature of the population served.  Payment for services provided 
152.10  pursuant to this subdivision shall be as provided to medical 
152.11  assistance vendors of these services under sections 256B.02, 
152.12  subdivision 8, and 256B.0625.  For payments made during fiscal 
152.13  year 1990 and later years, the commissioner shall consult with 
152.14  an independent actuary in establishing prepayment rates, but 
152.15  shall retain final control over the rate methodology.  
152.16  Notwithstanding the provisions of subdivision 3, an individual 
152.17  who becomes ineligible for general assistance medical care 
152.18  because of failure to submit income reports or recertification 
152.19  forms in a timely manner, shall remain enrolled in the prepaid 
152.20  health plan and shall remain eligible for general assistance 
152.21  medical care coverage through the last day of the month in which 
152.22  the enrollee became ineligible for general assistance medical 
152.23  care. 
152.24     (e) The commissioner of human services may reduce payments 
152.25  provided under sections 256D.01 to 256D.21 and 261.23 in order 
152.26  to remain within the amount appropriated for general assistance 
152.27  medical care, within the following restrictions.: 
152.28     (i) For the period July 1, 1985 to December 31, 1985, 
152.29  reductions below the cost per service unit allowable under 
152.30  section 256.966, are permitted only as follows:  payments for 
152.31  inpatient and outpatient hospital care provided in response to a 
152.32  primary diagnosis of chemical dependency or mental illness may 
152.33  be reduced no more than 30 percent; payments for all other 
152.34  inpatient hospital care may be reduced no more than 20 percent.  
152.35  Reductions below the payments allowable under general assistance 
152.36  medical care for the remaining general assistance medical care 
153.1   services allowable under this subdivision may be reduced no more 
153.2   than ten percent. 
153.3      (ii) For the period January 1, 1986 to December 31, 1986, 
153.4   reductions below the cost per service unit allowable under 
153.5   section 256.966 are permitted only as follows:  payments for 
153.6   inpatient and outpatient hospital care provided in response to a 
153.7   primary diagnosis of chemical dependency or mental illness may 
153.8   be reduced no more than 20 percent; payments for all other 
153.9   inpatient hospital care may be reduced no more than 15 percent.  
153.10  Reductions below the payments allowable under general assistance 
153.11  medical care for the remaining general assistance medical care 
153.12  services allowable under this subdivision may be reduced no more 
153.13  than five percent. 
153.14     (iii) For the period January 1, 1987 to June 30, 1987, 
153.15  reductions below the cost per service unit allowable under 
153.16  section 256.966 are permitted only as follows:  payments for 
153.17  inpatient and outpatient hospital care provided in response to a 
153.18  primary diagnosis of chemical dependency or mental illness may 
153.19  be reduced no more than 15 percent; payments for all other 
153.20  inpatient hospital care may be reduced no more than ten 
153.21  percent.  Reductions below the payments allowable under medical 
153.22  assistance for the remaining general assistance medical care 
153.23  services allowable under this subdivision may be reduced no more 
153.24  than five percent.  
153.25     (iv) For the period July 1, 1987 to June 30, 1988, 
153.26  reductions below the cost per service unit allowable under 
153.27  section 256.966 are permitted only as follows:  payments for 
153.28  inpatient and outpatient hospital care provided in response to a 
153.29  primary diagnosis of chemical dependency or mental illness may 
153.30  be reduced no more than 15 percent; payments for all other 
153.31  inpatient hospital care may be reduced no more than five percent.
153.32  Reductions below the payments allowable under medical assistance 
153.33  for the remaining general assistance medical care services 
153.34  allowable under this subdivision may be reduced no more than 
153.35  five percent. 
153.36     (v) For the period July 1, 1988 to June 30, 1989, 
154.1   reductions below the cost per service unit allowable under 
154.2   section 256.966 are permitted only as follows:  payments for 
154.3   inpatient and outpatient hospital care provided in response to a 
154.4   primary diagnosis of chemical dependency or mental illness may 
154.5   be reduced no more than 15 percent; payments for all other 
154.6   inpatient hospital care may not be reduced.  Reductions below 
154.7   the payments allowable under medical assistance for the 
154.8   remaining general assistance medical care services allowable 
154.9   under this subdivision may be reduced no more than five percent. 
154.10     (f) There shall be no copayment required of any recipient 
154.11  of benefits for any services provided under this subdivision.  A 
154.12  hospital receiving a reduced payment as a result of this section 
154.13  may apply the unpaid balance toward satisfaction of the 
154.14  hospital's bad debts. 
154.15     (f) (g) Any county may, from its own resources, provide 
154.16  medical payments for which state payments are not made. 
154.17     (g) (h) Chemical dependency services that are reimbursed 
154.18  under chapter 254B must not be reimbursed under general 
154.19  assistance medical care. 
154.20     (h) (i) The maximum payment for new vendors enrolled in the 
154.21  general assistance medical care program after the base year 
154.22  shall be determined from the average usual and customary charge 
154.23  of the same vendor type enrolled in the base year. 
154.24     (i) (j) The conditions of payment for services under this 
154.25  subdivision are the same as the conditions specified in rules 
154.26  adopted under chapter 256B governing the medical assistance 
154.27  program, unless otherwise provided by statute or rule. 
154.28     Sec. 52.  Minnesota Statutes 1996, section 256D.03, is 
154.29  amended by adding a subdivision to read: 
154.30     Subd. 9.  [PAYMENT FOR AMBULANCE SERVICES.] Effective for 
154.31  services rendered on or after July 1, 1999, general assistance 
154.32  medical care payments for ambulance services shall be increased 
154.33  by ten percent. 
154.34     Sec. 53.  Minnesota Statutes 1996, section 256D.03, is 
154.35  amended by adding a subdivision to read: 
154.36     Subd. 10.  [INFORMATION PROVIDED IN SEVERAL 
155.1   LANGUAGES.] Upon request, the commissioner shall provide 
155.2   applications and other information regarding general assistance 
155.3   medical care, including all notices and disclosures provided to 
155.4   applicants and recipients, in English, Spanish, Vietnamese, and 
155.5   Hmong.  Reasonable effort must be made to provide this 
155.6   information to other non-English-speaking applicants and 
155.7   recipients. 
155.8      Sec. 54.  Laws 1997, chapter 203, article 4, section 64, is 
155.9   amended to read:  
155.10     Sec. 64.  [STUDY OF ELDERLY WAIVER EXPANSION.] 
155.11     The commissioner of human services shall appoint a task 
155.12  force that includes representatives of counties, health plans, 
155.13  consumers, and legislators to study the impact of the expansion 
155.14  of the elderly waiver program under section 4 and to make 
155.15  recommendations for any changes in law necessary to facilitate 
155.16  an efficient and equitable relationship between the elderly 
155.17  waiver program and the Minnesota senior health options project.  
155.18  Based on the results of the task force study, the commissioner 
155.19  may seek any federal waivers needed to improve the relationship 
155.20  between the elderly waiver and the Minnesota senior health 
155.21  options project.  The commissioner shall report the results of 
155.22  the task force study to the legislature by January 15, 1998 July 
155.23  1, 2000. 
155.24     Sec. 55.  [ELIMINATION OF CASE MIX SCORES.] 
155.25     It is the intent of the legislature to repeal the unneeded, 
155.26  unused, and costly requirement that persons with mental 
155.27  retardation be assessed by case mix scores for the following 
155.28  reasons:  the scores are incomplete measures of a person's 
155.29  needs, the scores are exempt from the rate setting process at 
155.30  least to October 1, 1999, and the department of human services 
155.31  has no plans to use the instrument in a managed care/capitated 
155.32  payment arrangement. 
155.33     Sec. 56.  [OFFSET OF HMO SURCHARGE.] 
155.34     Beginning October 1, 1998, and ending December 31, 1998, 
155.35  the commissioner of human services shall offset monthly charges 
155.36  for the health maintenance organization surcharge by the monthly 
156.1   amount the health maintenance organization overpaid from August 
156.2   1, 1997, to September 30, 1998, due to taxation of Medicare 
156.3   revenues prohibited by Minnesota Statutes, section 256.9657, 
156.4   subdivision 3. 
156.5      Sec. 57.  [MR/RC WAIVER PROPOSAL.] 
156.6      By November 15, 1998, the commissioner of human services 
156.7   shall provide to the chairs of the house health and human 
156.8   services finance division and the senate health and family 
156.9   security finance division a detailed budget proposal for 
156.10  providing services under the home and community-based waiver for 
156.11  persons with mental retardation or related conditions to those 
156.12  individuals who are screened and waiting for services. 
156.13     Sec. 58.  [HIV HEALTH CARE ACCESS STUDY.] 
156.14     The commissioner of human services shall study, in 
156.15  consultation with the commissioner of health and a task force of 
156.16  affected community stakeholders, the impact of positive patient 
156.17  responses to new HIV treatment on re-entry to the workplace, 
156.18  including, but not limited to, addressing continued access to 
156.19  health care and disability benefits.  The commissioner shall 
156.20  submit a report on the study with recommendations to the 
156.21  legislature by January 15, 1999. 
156.22     Sec. 59.  [MENTAL HEALTH REPORT.] 
156.23     (a) By December 1, 1998, the commissioner of human services 
156.24  shall report to the legislature on recommendations to maximize 
156.25  federal funding for mental health services for children and 
156.26  adults.  In developing the recommendations, the commissioner 
156.27  shall seek advice from a children's and adults' mental health 
156.28  services stakeholders advisory group including representatives 
156.29  of state and county government, private and state-operated 
156.30  mental health providers, mental health consumers, family 
156.31  members, and advocates. 
156.32     (b) The report shall include a proposal developed in 
156.33  conjunction with the counties that does not shift caseload 
156.34  growth to counties after July 1, 1999, and recommendations on 
156.35  whether the state should directly participate in medical 
156.36  assistance mental health case management by funding a portion of 
157.1   the nonfederal share of Medicaid. 
157.2      Sec. 60.  [AFFILIATION OF THE HEALTH-RELATED OMBUDSMAN AND 
157.3   ADVOCACY SERVICES.] 
157.4      The ombudsman for mental health and mental retardation, the 
157.5   ombudsman for older Minnesotans, the Minnesota managed care/PMAP 
157.6   ombudsman, and the office of health care consumer assistance, 
157.7   advocacy, and information shall enter into an interagency 
157.8   agreement to create a formal affiliation of the health-related 
157.9   ombudsman and advocacy services. 
157.10     Sec. 61.  [CONSUMER PRICE INDEX REPORT.] 
157.11     By January 15, 1999, and each year thereafter, the 
157.12  commissioner of human services shall report to the chair of the 
157.13  senate health and family security budget division and the chair 
157.14  of the house health and human services budget division on the 
157.15  cost of increasing the income standard under Minnesota Statutes, 
157.16  section 256B.056, subdivision 4, and the provider rates under 
157.17  Minnesota Statutes, section 256B.038, by an amount equal to the 
157.18  percentage increase in the Consumer Price Index for all urban 
157.19  consumers for the previous calendar year. 
157.20     Sec. 62.  [REPEALER.] 
157.21     Minnesota Statutes 1996, section 144.0721, subdivision 3a; 
157.22  and Minnesota Statutes 1997 Supplement, sections 144.0721, 
157.23  subdivision 3; and 256B.0913, subdivision 15, are repealed.  
157.24  Minnesota Statutes 1996, section 256B.501, subdivision 3g, is 
157.25  repealed effective October 1, 2000. 
157.26     Sec. 63.  [EFFECTIVE DATES.] 
157.27     (a) Section 6 is effective retroactive to August 1, 1997.  
157.28     (b) Sections 14 and 19 are effective retroactive to July 1, 
157.29  1997. 
157.30     (c) Sections 9, 12, 25, 51, and 53 are effective January 1, 
157.31  1999. 
157.32     (d) Section 30 is effective for changes in eligibility that 
157.33  occur on or after July 1, 1998. 
157.34     (e) Sections 43 and 46 are effective the day following 
157.35  final enactment. 
157.36                             ARTICLE 5 
158.1                            MINNESOTACARE 
158.2      Section 1.  Minnesota Statutes 1997 Supplement, section 
158.3   60A.15, subdivision 1, is amended to read: 
158.4      Subdivision 1.  [DOMESTIC AND FOREIGN COMPANIES.] (a) On or 
158.5   before April 1, June 1, and December 1 of each year, every 
158.6   domestic and foreign company, including town and farmers' mutual 
158.7   insurance companies, domestic mutual insurance companies, marine 
158.8   insurance companies, health maintenance organizations, community 
158.9   integrated service networks, and nonprofit health service plan 
158.10  corporations, shall pay to the commissioner of revenue 
158.11  installments equal to one-third of the insurer's total estimated 
158.12  tax for the current year.  Except as provided in paragraphs (d), 
158.13  (e), (h), and (i), installments must be based on a sum equal to 
158.14  two percent of the premiums described in paragraph (b). 
158.15     (b) Installments under paragraph (a), (d), or (e) are 
158.16  percentages of gross premiums less return premiums on all direct 
158.17  business received by the insurer in this state, or by its agents 
158.18  for it, in cash or otherwise, during such year. 
158.19     (c) Failure of a company to make payments of at least 
158.20  one-third of either (1) the total tax paid during the previous 
158.21  calendar year or (2) 80 percent of the actual tax for the 
158.22  current calendar year shall subject the company to the penalty 
158.23  and interest provided in this section, unless the total tax for 
158.24  the current tax year is $500 or less. 
158.25     (d) For health maintenance organizations, nonprofit health 
158.26  service plan corporations, and community integrated service 
158.27  networks, the installments must be based on an amount determined 
158.28  under paragraph (h) or (i). 
158.29     (e) For purposes of computing installments for town and 
158.30  farmers' mutual insurance companies and for mutual property 
158.31  casualty companies with total assets on December 31, 1989, of 
158.32  $1,600,000,000 or less, the following rates apply: 
158.33     (1) for all life insurance, two percent; 
158.34     (2) for town and farmers' mutual insurance companies and 
158.35  for mutual property and casualty companies with total assets of 
158.36  $5,000,000 or less, on all other coverages, one percent; and 
159.1      (3) for mutual property and casualty companies with total 
159.2   assets on December 31, 1989, of $1,600,000,000 or less, on all 
159.3   other coverages, 1.26 percent. 
159.4      (f) If the aggregate amount of premium tax payments under 
159.5   this section and the fire marshal tax payments under section 
159.6   299F.21 made during a calendar year is equal to or exceeds 
159.7   $120,000, all tax payments in the subsequent calendar year must 
159.8   be paid by means of a funds transfer as defined in section 
159.9   336.4A-104, paragraph (a).  The funds transfer payment date, as 
159.10  defined in section 336.4A-401, must be on or before the date the 
159.11  payment is due.  If the date the payment is due is not a funds 
159.12  transfer business day, as defined in section 336.4A-105, 
159.13  paragraph (a), clause (4), the payment date must be on or before 
159.14  the funds transfer business day next following the date the 
159.15  payment is due.  
159.16     (g) Premiums under medical assistance, general assistance 
159.17  medical care, the MinnesotaCare program, and the Minnesota 
159.18  comprehensive health insurance plan and all payments, revenues, 
159.19  and reimbursements received from the federal government for 
159.20  Medicare-related coverage as defined in section 62A.31, 
159.21  subdivision 3, paragraph (e), are not subject to tax under this 
159.22  section. 
159.23     (h) For calendar years 1998 and 1999, the installments for 
159.24  health maintenance organizations, community integrated service 
159.25  networks, and nonprofit health service plan corporations must be 
159.26  based on an amount equal to one percent of premiums described 
159.27  under paragraph (b).  Health maintenance organizations, 
159.28  community integrated service networks, and nonprofit health 
159.29  service plan corporations that have met the cost containment 
159.30  goals established under section 62J.04 in the individual and 
159.31  small employer market for calendar year 1996 are exempt from 
159.32  payment of the tax imposed under this section for premiums paid 
159.33  after March 30, 1997, and before April 1, 1998.  Health 
159.34  maintenance organizations, community integrated service 
159.35  networks, and nonprofit health service plan corporations that 
159.36  have met the cost containment goals established under section 
160.1   62J.04 in the individual and small employer market for calendar 
160.2   year 1997 are exempt from payment of the tax imposed under this 
160.3   section for premiums paid after March 30, 1998, and before April 
160.4   1, 1999.  
160.5      (i) For calendar years after 1999, the commissioner of 
160.6   finance shall determine the balance of the health care access 
160.7   fund on September 1 of each year beginning September 1, 1999.  
160.8   If the commissioner determines that there is no structural 
160.9   deficit for the next fiscal year, no tax shall be imposed under 
160.10  paragraph (d) for the following calendar year.  If the 
160.11  commissioner determines that there will be a structural deficit 
160.12  in the fund for the following fiscal year, then the 
160.13  commissioner, in consultation with the commissioner of revenue, 
160.14  shall determine the amount needed to eliminate the structural 
160.15  deficit and a tax shall be imposed under paragraph (d) for the 
160.16  following calendar year.  The commissioner shall determine the 
160.17  rate of the tax as either one-quarter of one percent, one-half 
160.18  of one percent, three-quarters of one percent, or one percent of 
160.19  premiums described in paragraph (b), whichever is the lowest of 
160.20  those rates that the commissioner determines will produce 
160.21  sufficient revenue to eliminate the projected structural 
160.22  deficit.  The commissioner of finance shall publish in the State 
160.23  Register by October 1 of each year the amount of tax to be 
160.24  imposed for the following calendar year.  In determining the 
160.25  structural balance of the health care access fund for fiscal 
160.26  years 2000 and 2001, the commissioner shall disregard the 
160.27  transfer amount from the health care access fund to the general 
160.28  fund for expenditures associated with the services provided to 
160.29  pregnant women and children under the age of two enrolled in the 
160.30  MinnesotaCare program.  
160.31     (j) In approving the premium rates as required in sections 
160.32  62L.08, subdivision 8, and 62A.65, subdivision 3, the 
160.33  commissioners of health and commerce shall ensure that any 
160.34  exemption from the tax as described in paragraphs (h) and (i) is 
160.35  reflected in the premium rate. 
160.36     Sec. 2.  Minnesota Statutes 1997 Supplement, section 
161.1   256B.04, subdivision 18, is amended to read: 
161.2      Subd. 18.  [APPLICATIONS FOR MEDICAL ASSISTANCE.] The state 
161.3   agency may take applications for medical assistance and conduct 
161.4   eligibility determinations for MinnesotaCare enrollees who are 
161.5   required to apply for medical assistance according to section 
161.6   256L.03, subdivision 3, paragraph (b). 
161.7      Sec. 3.  Minnesota Statutes 1996, section 256B.057, is 
161.8   amended by adding a subdivision to read: 
161.9      Subd. 7.  [WAIVER OF MAINTENANCE OF EFFORT 
161.10  REQUIREMENT.] Unless a federal waiver of the maintenance of 
161.11  effort requirement of section 2105(d) of title XXI of the 
161.12  Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 
161.13  at Large, volume 111, page 251, is granted by the federal 
161.14  Department of Health and Human Services by September 30, 1998, 
161.15  eligibility for children under age 21 must be determined without 
161.16  regard to asset standards established in section 256B.056, 
161.17  subdivision 3.  The commissioner of human services shall publish 
161.18  a notice in the State Register upon receipt of a federal waiver. 
161.19     Sec. 4.  Minnesota Statutes 1997 Supplement, section 
161.20  256D.03, subdivision 3, is amended to read: 
161.21     Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
161.22  (a) General assistance medical care may be paid for any person 
161.23  who is not eligible for medical assistance under chapter 256B, 
161.24  including eligibility for medical assistance based on a 
161.25  spenddown of excess income according to section 256B.056, 
161.26  subdivision 5, or MinnesotaCare as defined in clause (4) (5), 
161.27  except as provided in paragraph (b); and: 
161.28     (1) who is receiving assistance under section 256D.05, 
161.29  except for families with children who are eligible under 
161.30  Minnesota family investment program-statewide (MFIP-S), who is 
161.31  having a payment made on the person's behalf under sections 
161.32  256I.01 to 256I.06, or who resides in group residential housing 
161.33  as defined in chapter 256I and can meet a spenddown using the 
161.34  cost of remedial services received through group residential 
161.35  housing; or 
161.36     (2)(i) who is a resident of Minnesota; and whose equity in 
162.1   assets is not in excess of $1,000 per assistance unit.  Exempt 
162.2   assets, the reduction of excess assets, and the waiver of excess 
162.3   assets must conform to the medical assistance program in chapter 
162.4   256B, with the following exception:  the maximum amount of 
162.5   undistributed funds in a trust that could be distributed to or 
162.6   on behalf of the beneficiary by the trustee, assuming the full 
162.7   exercise of the trustee's discretion under the terms of the 
162.8   trust, must be applied toward the asset maximum; and 
162.9      (ii) who has countable income not in excess of the 
162.10  assistance standards established in section 256B.056, 
162.11  subdivision 4, or whose excess income is spent down according to 
162.12  section 256B.056, subdivision 5, using a six-month budget 
162.13  period.  The method for calculating earned income disregards and 
162.14  deductions for a person who resides with a dependent child under 
162.15  age 21 shall follow section 256B.056, subdivision 1a.  However, 
162.16  if a disregard of $30 and one-third of the remainder has been 
162.17  applied to the wage earner's income, the disregard shall not be 
162.18  applied again until the wage earner's income has not been 
162.19  considered in an eligibility determination for general 
162.20  assistance, general assistance medical care, medical assistance, 
162.21  or MFIP-S for 12 consecutive months.  The earned income and work 
162.22  expense deductions for a person who does not reside with a 
162.23  dependent child under age 21 shall be the same as the method 
162.24  used to determine eligibility for a person under section 
162.25  256D.06, subdivision 1, except the disregard of the first $50 of 
162.26  earned income is not allowed; or 
162.27     (3) who would be eligible for medical assistance except 
162.28  that the person resides in a facility that is determined by the 
162.29  commissioner or the federal Health Care Financing Administration 
162.30  to be an institution for mental diseases.; 
162.31     (4) who is receiving care and rehabilitation services from 
162.32  a nonprofit center established to serve victims of torture.  
162.33  These individuals are eligible for general assistance medical 
162.34  care only for the period during which they are receiving 
162.35  services from the center.  During this period of eligibility, 
162.36  individuals eligible under this clause shall not be required to 
163.1   participate in prepaid general assistance medical care; or 
163.2      (4) (5) beginning July 1, 1998 January 1, 2000, applicants 
163.3   or recipients who meet all eligibility requirements of 
163.4   MinnesotaCare as defined in sections 256L.01 to 256L.16, and are:
163.5      (i) adults with dependent children under 21 whose gross 
163.6   family income is equal to or less than 275 percent of the 
163.7   federal poverty guidelines; or 
163.8      (ii) adults without children with earned income and whose 
163.9   family gross income is between 75 percent of the federal poverty 
163.10  guidelines and the amount set by section 256L.04, subdivision 7, 
163.11  shall be terminated from general assistance medical care upon 
163.12  enrollment in MinnesotaCare. 
163.13     (b) For services rendered on or after July 1, 1997, 
163.14  eligibility is limited to one month prior to application if the 
163.15  person is determined eligible in the prior month.  A 
163.16  redetermination of eligibility must occur every 12 months.  
163.17  Beginning July 1, 1998 January 1, 2000, Minnesota health care 
163.18  program applications completed by recipients and applicants who 
163.19  are persons described in paragraph (a), clause (4) (5), may be 
163.20  returned to the county agency to be forwarded to the department 
163.21  of human services or sent directly to the department of human 
163.22  services for enrollment in MinnesotaCare.  If all other 
163.23  eligibility requirements of this subdivision are met, 
163.24  eligibility for general assistance medical care shall be 
163.25  available in any month during which a MinnesotaCare eligibility 
163.26  determination and enrollment are pending.  Upon notification of 
163.27  eligibility for MinnesotaCare, notice of termination for 
163.28  eligibility for general assistance medical care shall be sent to 
163.29  an applicant or recipient.  If all other eligibility 
163.30  requirements of this subdivision are met, eligibility for 
163.31  general assistance medical care shall be available until 
163.32  enrollment in MinnesotaCare subject to the provisions of 
163.33  paragraph (d). 
163.34     (c) The date of an initial Minnesota health care program 
163.35  application necessary to begin a determination of eligibility 
163.36  shall be the date the applicant has provided a name, address, 
164.1   and social security number, signed and dated, to the county 
164.2   agency or the department of human services.  If the applicant is 
164.3   unable to provide an initial application when health care is 
164.4   delivered due to a medical condition or disability, a health 
164.5   care provider may act on the person's behalf to complete the 
164.6   initial application.  The applicant must complete the remainder 
164.7   of the application and provide necessary verification before 
164.8   eligibility can be determined.  The county agency must assist 
164.9   the applicant in obtaining verification if necessary. 
164.10     (d) County agencies are authorized to use all automated 
164.11  databases containing information regarding recipients' or 
164.12  applicants' income in order to determine eligibility for general 
164.13  assistance medical care or MinnesotaCare.  Such use shall be 
164.14  considered sufficient in order to determine eligibility and 
164.15  premium payments by the county agency. 
164.16     (e) General assistance medical care is not available for a 
164.17  person in a correctional facility unless the person is detained 
164.18  by law for less than one year in a county correctional or 
164.19  detention facility as a person accused or convicted of a crime, 
164.20  or admitted as an inpatient to a hospital on a criminal hold 
164.21  order, and the person is a recipient of general assistance 
164.22  medical care at the time the person is detained by law or 
164.23  admitted on a criminal hold order and as long as the person 
164.24  continues to meet other eligibility requirements of this 
164.25  subdivision.  
164.26     (f) General assistance medical care is not available for 
164.27  applicants or recipients who do not cooperate with the county 
164.28  agency to meet the requirements of medical assistance.  General 
164.29  assistance medical care is limited to payment of emergency 
164.30  services only for applicants or recipients as described in 
164.31  paragraph (a), clause (4) (5), whose MinnesotaCare coverage is 
164.32  denied or terminated for nonpayment of premiums as required by 
164.33  sections 256L.06 to 256L.08 and 256L.07.  
164.34     (g) In determining the amount of assets of an individual, 
164.35  there shall be included any asset or interest in an asset, 
164.36  including an asset excluded under paragraph (a), that was given 
165.1   away, sold, or disposed of for less than fair market value 
165.2   within the 60 months preceding application for general 
165.3   assistance medical care or during the period of eligibility.  
165.4   Any transfer described in this paragraph shall be presumed to 
165.5   have been for the purpose of establishing eligibility for 
165.6   general assistance medical care, unless the individual furnishes 
165.7   convincing evidence to establish that the transaction was 
165.8   exclusively for another purpose.  For purposes of this 
165.9   paragraph, the value of the asset or interest shall be the fair 
165.10  market value at the time it was given away, sold, or disposed 
165.11  of, less the amount of compensation received.  For any 
165.12  uncompensated transfer, the number of months of ineligibility, 
165.13  including partial months, shall be calculated by dividing the 
165.14  uncompensated transfer amount by the average monthly per person 
165.15  payment made by the medical assistance program to skilled 
165.16  nursing facilities for the previous calendar year.  The 
165.17  individual shall remain ineligible until this fixed period has 
165.18  expired.  The period of ineligibility may exceed 30 months, and 
165.19  a reapplication for benefits after 30 months from the date of 
165.20  the transfer shall not result in eligibility unless and until 
165.21  the period of ineligibility has expired.  The period of 
165.22  ineligibility begins in the month the transfer was reported to 
165.23  the county agency, or if the transfer was not reported, the 
165.24  month in which the county agency discovered the transfer, 
165.25  whichever comes first.  For applicants, the period of 
165.26  ineligibility begins on the date of the first approved 
165.27  application. 
165.28     (h) When determining eligibility for any state benefits 
165.29  under this subdivision, the income and resources of all 
165.30  noncitizens shall be deemed to include their sponsor's income 
165.31  and resources as defined in the Personal Responsibility and Work 
165.32  Opportunity Reconciliation Act of 1996, title IV, Public Law 
165.33  Number 104-193, sections 421 and 422, and subsequently set out 
165.34  in federal rules. 
165.35     (i) (1) An undocumented noncitizen or a nonimmigrant is 
165.36  ineligible for general assistance medical care other than 
166.1   emergency services.  For purposes of this subdivision, a 
166.2   nonimmigrant is an individual in one or more of the classes 
166.3   listed in United States Code, title 8, section 1101(a)(15), and 
166.4   an undocumented noncitizen is an individual who resides in the 
166.5   United States without the approval or acquiescence of the 
166.6   Immigration and Naturalization Service. 
166.7      (j) (2) This paragraph does not apply to a child under age 
166.8   18, to a Cuban or Haitian entrant as defined in Public Law 
166.9   Number 96-422, section 501(e)(1) or (2)(a), or to a noncitizen 
166.10  who is aged, blind, or disabled as defined in Code of Federal 
166.11  Regulations, title 42, sections 435.520, 435.530, 435.531, 
166.12  435.540, and 435.541, or to an individual eligible for general 
166.13  assistance medical care under paragraph (a), clause (4), who 
166.14  cooperates with the Immigration and Naturalization Service to 
166.15  pursue any applicable immigration status, including citizenship, 
166.16  that would qualify the individual for medical assistance with 
166.17  federal financial participation. 
166.18     (k) (3) For purposes of paragraphs (f) and (i) this 
166.19  paragraph, "emergency services" has the meaning given in Code of 
166.20  Federal Regulations, title 42, section 440.255(b)(1), except 
166.21  that it also means services rendered because of suspected or 
166.22  actual pesticide poisoning. 
166.23     (l) (j) Notwithstanding any other provision of law, a 
166.24  noncitizen who is ineligible for medical assistance due to the 
166.25  deeming of a sponsor's income and resources, is ineligible for 
166.26  general assistance medical care. 
166.27     Sec. 5.  Minnesota Statutes 1997 Supplement, section 
166.28  256L.01, is amended to read: 
166.29     256L.01 [DEFINITIONS.] 
166.30     Subdivision 1.  [SCOPE.] For purposes of sections 256L.01 
166.31  to 256L.10 256L.18, the following terms shall have the meanings 
166.32  given them. 
166.33     Subd. 1a.  [CHILD.] "Child" means an individual under 21 
166.34  years of age, including the unborn child of a pregnant woman, an 
166.35  emancipated minor, and an emancipated minor's spouse. 
166.36     Subd. 2.  [COMMISSIONER.] "Commissioner" means the 
167.1   commissioner of human services. 
167.2      Subd. 3.  [ELIGIBLE PROVIDERS.] "Eligible providers" means 
167.3   those health care providers who provide covered health services 
167.4   to medical assistance recipients under rules established by the 
167.5   commissioner for that program.  
167.6      Subd. 3a.  [FAMILY WITH CHILDREN.] (a) "Family with 
167.7   children" means: 
167.8      (1) parents, their children, and dependent siblings 
167.9   residing in the same household; or 
167.10     (2) grandparents, foster parents, relative caretakers as 
167.11  defined in the medical assistance program, or legal guardians; 
167.12  their wards who are children; and dependent siblings residing in 
167.13  the same household.  
167.14     (b) The term includes children and dependent siblings who 
167.15  are temporarily absent from the household in settings such as 
167.16  schools, camps, or visitation with noncustodial parents.  
167.17     (c) For purposes of this subdivision, a dependent sibling 
167.18  means an unmarried child who is a full-time student under the 
167.19  age of 25 years who is financially dependent upon a parent, 
167.20  grandparent, foster parent, relative caretaker, or legal 
167.21  guardian.  Proof of school enrollment is required. 
167.22     Subd. 4.  [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] "Gross 
167.23  individual or gross family income" for farm and nonfarm 
167.24  self-employed means income calculated using as the baseline the 
167.25  adjusted gross income reported on the applicant's federal income 
167.26  tax form for the previous year and adding back in reported 
167.27  depreciation, carryover loss, and net operating loss amounts 
167.28  that apply to the business in which the family is currently 
167.29  engaged.  Applicants shall report the most recent financial 
167.30  situation of the family if it has changed from the period of 
167.31  time covered by the federal income tax form.  The report may be 
167.32  in the form of percentage increase or decrease. 
167.33     Subd. 5.  [INCOME.] "Income" has the meaning given for 
167.34  earned and unearned income for families and children in the 
167.35  medical assistance program, according to the state's aid to 
167.36  families with dependent children plan in effect as of July 16, 
168.1   1996.  The definition does not include medical assistance income 
168.2   methodologies and deeming requirements.  The earned income of 
168.3   full-time and part-time students under age 19 is not counted as 
168.4   income.  Public assistance payments and supplemental security 
168.5   income are not excluded income. 
168.6      Sec. 6.  Minnesota Statutes 1997 Supplement, section 
168.7   256L.02, subdivision 2, is amended to read: 
168.8      Subd. 2.  [COMMISSIONER'S DUTIES.] The commissioner shall 
168.9   establish an office for the state administration of this plan.  
168.10  The plan shall be used to provide covered health services for 
168.11  eligible persons.  Payment for these services shall be made to 
168.12  all eligible providers.  The commissioner shall adopt rules to 
168.13  administer the MinnesotaCare program.  The commissioner shall 
168.14  establish marketing efforts to encourage potentially eligible 
168.15  persons to receive information about the program and about other 
168.16  medical care programs administered or supervised by the 
168.17  department of human services.  A toll-free telephone number must 
168.18  be used to provide information about medical programs and to 
168.19  promote access to the covered services.  
168.20     Upon request, the commissioner shall provide applications 
168.21  and other information regarding the MinnesotaCare program, 
168.22  including all notices and disclosures provided to applicants and 
168.23  enrollees, in English, Spanish, Vietnamese, and Hmong.  
168.24  Reasonable efforts must be made to provide this information to 
168.25  other non-English-speaking applicants and enrollees. 
168.26     Sec. 7.  Minnesota Statutes 1997 Supplement, section 
168.27  256L.02, subdivision 3, is amended to read: 
168.28     Subd. 3.  [FINANCIAL MANAGEMENT.] (a) The commissioner 
168.29  shall manage spending for the MinnesotaCare program in a manner 
168.30  that maintains a minimum reserve in accordance with section 
168.31  16A.76.  As part of each state revenue and expenditure forecast, 
168.32  the commissioner must make a quarterly an assessment of the 
168.33  expected expenditures for the covered services for the remainder 
168.34  of the current biennium and for the following biennium.  The 
168.35  estimated expenditure, including the reserve requirements 
168.36  described in section 16A.76, shall be compared to an estimate of 
169.1   the revenues that will be deposited available in the health care 
169.2   access fund.  Based on this comparison, and after consulting 
169.3   with the chairs of the house ways and means committee and the 
169.4   senate finance committee, and the legislative commission on 
169.5   health care access, the commissioner shall, as necessary, make 
169.6   the adjustments specified in paragraph (b) to ensure that 
169.7   expenditures remain within the limits of available revenues for 
169.8   the remainder of the current biennium and for the following 
169.9   biennium.  The commissioner shall not hire additional staff 
169.10  using appropriations from the health care access fund until the 
169.11  commissioner of finance makes a determination that the 
169.12  adjustments implemented under paragraph (b) are sufficient to 
169.13  allow MinnesotaCare expenditures to remain within the limits of 
169.14  available revenues for the remainder of the current biennium and 
169.15  for the following biennium. 
169.16     (b) The adjustments the commissioner shall use must be 
169.17  implemented in this order:  first, stop enrollment of single 
169.18  adults and households without children; second, upon 45 days' 
169.19  notice, stop coverage of single adults and households without 
169.20  children already enrolled in the MinnesotaCare program; third, 
169.21  upon 90 days' notice, decrease the premium subsidy amounts by 
169.22  ten percent for families with gross annual income above 200 
169.23  percent of the federal poverty guidelines; fourth, upon 90 days' 
169.24  notice, decrease the premium subsidy amounts by ten percent for 
169.25  families with gross annual income at or below 200 percent; and 
169.26  fifth, require applicants to be uninsured for at least six 
169.27  months prior to eligibility in the MinnesotaCare program.  If 
169.28  these measures are insufficient to limit the expenditures to the 
169.29  estimated amount of revenue, the commissioner shall further 
169.30  limit enrollment or decrease premium subsidies. 
169.31     Sec. 8.  Minnesota Statutes 1997 Supplement, section 
169.32  256L.03, subdivision 1, is amended to read: 
169.33     Subdivision 1.  [COVERED HEALTH SERVICES.] "Covered health 
169.34  services" means the health services reimbursed under chapter 
169.35  256B, with the exception of inpatient hospital services, special 
169.36  education services, private duty nursing services, adult dental 
170.1   care services other than preventive services, orthodontic 
170.2   services, nonemergency medical transportation services, personal 
170.3   care assistant and case management services, nursing home or 
170.4   intermediate care facilities services, inpatient mental health 
170.5   services, and chemical dependency services.  Effective July 1, 
170.6   1998, adult dental care for nonpreventive services with the 
170.7   exception of orthodontic services is available to persons who 
170.8   qualify under section 256L.04, subdivisions 1 to 7, or 256L.13, 
170.9   with family gross income equal to or less than 175 percent of 
170.10  the federal poverty guidelines.  Outpatient mental health 
170.11  services covered under the MinnesotaCare program are limited to 
170.12  diagnostic assessments, psychological testing, explanation of 
170.13  findings, medication management by a physician, day treatment, 
170.14  partial hospitalization, and individual, family, and group 
170.15  psychotherapy. 
170.16     No public funds shall be used for coverage of abortion 
170.17  under MinnesotaCare except where the life of the female would be 
170.18  endangered or substantial and irreversible impairment of a major 
170.19  bodily function would result if the fetus were carried to term; 
170.20  or where the pregnancy is the result of rape or incest. 
170.21     Covered health services shall be expanded as provided in 
170.22  this section. 
170.23     Sec. 9.  Minnesota Statutes 1997 Supplement, section 
170.24  256L.03, is amended by adding a subdivision to read: 
170.25     Subd. 1a.  [COVERED SERVICES FOR PREGNANT WOMEN AND 
170.26  CHILDREN UNDER MINNESOTACARE HEALTH CARE REFORM 
170.27  WAIVER.] Children and pregnant women are eligible for coverage 
170.28  of all services that are eligible for reimbursement under the 
170.29  medical assistance program according to chapter 256B.  Pregnant 
170.30  women and children are exempt from the provisions of subdivision 
170.31  5, regarding copayments.  Pregnant women and children who are 
170.32  lawfully residing in the United States but who are not 
170.33  "qualified noncitizens" under title IV of the Personal 
170.34  Responsibility and Work Opportunity Reconciliation Act of 1996, 
170.35  Public Law Number 104-193, Statutes at Large, volume 110, page 
170.36  2105, are eligible for coverage of all services provided under 
171.1   the medical assistance program according to chapter 256B. 
171.2      Sec. 10.  Minnesota Statutes 1997 Supplement, section 
171.3   256L.03, is amended by adding a subdivision to read: 
171.4      Subd. 1b.  [PREGNANT WOMEN; ELIGIBILITY FOR FULL MEDICAL 
171.5   ASSISTANCE SERVICES.] A woman who is enrolled in MinnesotaCare 
171.6   when her pregnancy is diagnosed is eligible for coverage of all 
171.7   services provided under the medical assistance program according 
171.8   to chapter 256B retroactive to the date the pregnancy is 
171.9   medically diagnosed.  Copayments totaling $30 or more, paid 
171.10  after the date the pregnancy is diagnosed, shall be refunded. 
171.11     Sec. 11.  Minnesota Statutes 1997 Supplement, section 
171.12  256L.03, subdivision 3, is amended to read: 
171.13     Subd. 3.  [INPATIENT HOSPITAL SERVICES.] (a) Beginning July 
171.14  1, 1993, Covered health services shall include inpatient 
171.15  hospital services, including inpatient hospital mental health 
171.16  services and inpatient hospital and residential chemical 
171.17  dependency treatment, subject to those limitations necessary to 
171.18  coordinate the provision of these services with eligibility 
171.19  under the medical assistance spenddown.  Prior to July 1, 1997, 
171.20  the inpatient hospital benefit for adult enrollees is subject to 
171.21  an annual benefit limit of $10,000.  Effective July 1, 1997, The 
171.22  inpatient hospital benefit for adult enrollees who qualify under 
171.23  section 256L.04, subdivision 7, or who qualify under section 
171.24  256L.04, subdivisions 1 to 6 and 2, or 256L.13 with family gross 
171.25  income that exceeds 175 percent of the federal poverty 
171.26  guidelines and who are not pregnant, is subject to an annual 
171.27  limit of $10,000.  
171.28     (b) Enrollees who qualify under section 256L.04, 
171.29  subdivision 7, or who qualify under section 256L.04, 
171.30  subdivisions 1 to 6, or 256L.13 with family gross income that 
171.31  exceeds 175 percent of the federal poverty guidelines and who 
171.32  are not pregnant, and are determined by the commissioner to have 
171.33  a basis of eligibility for medical assistance shall apply for 
171.34  and cooperate with the requirements of medical assistance by the 
171.35  last day of the third month following admission to an inpatient 
171.36  hospital.  If an enrollee fails to apply for medical assistance 
172.1   within this time period, the enrollee and the enrollee's family 
172.2   shall be disenrolled from the plan and they may not reenroll 
172.3   until 12 calendar months have elapsed.  Enrollees and enrollees' 
172.4   families disenrolled for not applying for or not cooperating 
172.5   with medical assistance may not reenroll. 
172.6      (c) Admissions for inpatient hospital services paid for 
172.7   under section 256L.11, subdivision 3, must be certified as 
172.8   medically necessary in accordance with Minnesota Rules, parts 
172.9   9505.0500 to 9505.0540, except as provided in clauses (1) and 
172.10  (2): 
172.11     (1) all admissions must be certified, except those 
172.12  authorized under rules established under section 254A.03, 
172.13  subdivision 3, or approved under Medicare; and 
172.14     (2) payment under section 256L.11, subdivision 3, shall be 
172.15  reduced by five percent for admissions for which certification 
172.16  is requested more than 30 days after the day of admission.  The 
172.17  hospital may not seek payment from the enrollee for the amount 
172.18  of the payment reduction under this clause. 
172.19     (d) Any enrollee or family member of an enrollee who has 
172.20  previously been permanently disenrolled from MinnesotaCare for 
172.21  not applying for and cooperating with medical assistance shall 
172.22  be eligible to reenroll if 12 calendar months have elapsed since 
172.23  the date of disenrollment. 
172.24     Sec. 12.  Minnesota Statutes 1997 Supplement, section 
172.25  256L.03, is amended by adding a subdivision to read: 
172.26     Subd. 3a.  [INTERPRETER SERVICES.] Covered services include 
172.27  sign and spoken language interpreter services that assist an 
172.28  enrollee in obtaining covered health care services. 
172.29     Sec. 13.  Minnesota Statutes 1997 Supplement, section 
172.30  256L.03, subdivision 4, is amended to read: 
172.31     Subd. 4.  [COORDINATION WITH MEDICAL ASSISTANCE.] The 
172.32  commissioner shall coordinate the provision of hospital 
172.33  inpatient services under the MinnesotaCare program with enrollee 
172.34  eligibility under the medical assistance spenddown, and shall 
172.35  apply to the secretary of health and human services for any 
172.36  necessary federal waivers or approvals. 
173.1      Sec. 14.  Minnesota Statutes 1997 Supplement, section 
173.2   256L.03, subdivision 5, is amended to read: 
173.3      Subd. 5.  [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 
173.4   benefit plan shall include the following copayments and 
173.5   coinsurance requirements:  
173.6      (1) ten percent of the paid charges for inpatient hospital 
173.7   services for adult enrollees not eligible for medical 
173.8   assistance, subject to an annual inpatient out-of-pocket maximum 
173.9   of $1,000 per individual and $3,000 per family; 
173.10     (2) $3 per prescription for adult enrollees; 
173.11     (3) $25 for eyeglasses for adult enrollees; and 
173.12     (4) effective July 1, 1998, 50 percent of the 
173.13  fee-for-service rate for adult dental care services other than 
173.14  preventive care services for persons eligible under section 
173.15  256L.04, subdivisions 1 to 7, or 256L.13, with income equal to 
173.16  or less than 175 percent of the federal poverty guidelines. 
173.17     Prior to July 1, 1997, enrollees who are not eligible for 
173.18  medical assistance with or without a spenddown shall be 
173.19  financially responsible for the coinsurance amount and amounts 
173.20  which exceed the $10,000 benefit limit.  Effective July 1, 1997, 
173.21  adult enrollees who qualify under section 256L.04, subdivision 
173.22  7, or who qualify under section 256L.04, subdivisions 1 to 6, or 
173.23  256L.13 with family gross income that exceeds 175 percent of the 
173.24  federal poverty guidelines and who are not pregnant, and who are 
173.25  not eligible for medical assistance with or without a spenddown, 
173.26  shall be financially responsible for the coinsurance amount and 
173.27  amounts which exceed the $10,000 inpatient hospital benefit 
173.28  limit. 
173.29     When a MinnesotaCare enrollee becomes a member of a prepaid 
173.30  health plan, or changes from one prepaid health plan to another 
173.31  during a calendar year, any charges submitted towards the 
173.32  $10,000 annual inpatient benefit limit, and any out-of-pocket 
173.33  expenses incurred by the enrollee for inpatient services, that 
173.34  were submitted or incurred prior to enrollment, or prior to the 
173.35  change in health plans, shall be disregarded. 
173.36     Sec. 15.  Minnesota Statutes 1997 Supplement, section 
174.1   256L.04, subdivision 1, is amended to read: 
174.2      Subdivision 1.  [CHILDREN; EXPANSION AND CONTINUATION OF 
174.3   ELIGIBILITY FAMILIES WITH CHILDREN.] (a) [CHILDREN.] Prior to 
174.4   October 1, 1992, "eligible persons" means children who are one 
174.5   year of age or older but less than 18 years of age who have 
174.6   gross family incomes that are equal to or less than 185 percent 
174.7   of the federal poverty guidelines and who are not eligible for 
174.8   medical assistance without a spenddown under chapter 256B and 
174.9   who are not otherwise insured for the covered services.  The 
174.10  period of eligibility extends from the first day of the month in 
174.11  which the child's first birthday occurs to the last day of the 
174.12  month in which the child becomes 18 years old.  Families with 
174.13  children with family income equal to or less than 275 percent of 
174.14  the federal poverty guidelines for the applicable family size 
174.15  shall be eligible for MinnesotaCare according to this section.  
174.16  All other provisions of sections 256L.01 to 256L.18, including 
174.17  the insurance-related barriers to enrollment under section 
174.18  256L.07, shall apply unless otherwise specified. 
174.19     (b) [EXPANSION OF ELIGIBILITY.] Eligibility for 
174.20  MinnesotaCare shall be expanded as provided in subdivisions 3 to 
174.21  7, except children who meet the criteria in this subdivision 
174.22  shall continue to be enrolled pursuant to this subdivision.  The 
174.23  enrollment requirements in this paragraph apply to enrollment 
174.24  under subdivisions 1 to 7.  Parents who enroll in the 
174.25  MinnesotaCare program must also enroll their children and 
174.26  dependent siblings, if the children and their dependent siblings 
174.27  are eligible.  Children and dependent siblings may be enrolled 
174.28  separately without enrollment by parents.  However, if one 
174.29  parent in the household enrolls, both parents must enroll, 
174.30  unless other insurance is available.  If one child from a family 
174.31  is enrolled, all children must be enrolled, unless other 
174.32  insurance is available.  If one spouse in a household enrolls, 
174.33  the other spouse in the household must also enroll, unless other 
174.34  insurance is available.  Families cannot choose to enroll only 
174.35  certain uninsured members.  For purposes of this section, a 
174.36  "dependent sibling" means an unmarried child who is a full-time 
175.1   student under the age of 25 years who is financially dependent 
175.2   upon a parent.  Proof of school enrollment will be required.  
175.3      (c)  [CONTINUATION OF ELIGIBILITY.] Individuals who 
175.4   initially enroll in the MinnesotaCare program under the 
175.5   eligibility criteria in subdivisions 3 to 7 remain eligible for 
175.6   the MinnesotaCare program, regardless of age, place of 
175.7   residence, or the presence or absence of children in the same 
175.8   household, as long as all other eligibility criteria are met and 
175.9   residence in Minnesota and continuous enrollment in the 
175.10  MinnesotaCare program or medical assistance are maintained.  In 
175.11  order for either parent or either spouse in a household to 
175.12  remain enrolled, both must remain enrolled, unless other 
175.13  insurance is available. 
175.14     Sec. 16.  Minnesota Statutes 1997 Supplement, section 
175.15  256L.04, subdivision 2, is amended to read: 
175.16     Subd. 2.  [COOPERATION IN ESTABLISHING THIRD PARTY 
175.17  LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 
175.18  eligible for MinnesotaCare, individuals and families must 
175.19  cooperate with the state agency to identify potentially liable 
175.20  third party payers and assist the state in obtaining third party 
175.21  payments.  "Cooperation" includes, but is not limited to, 
175.22  identifying any third party who may be liable for care and 
175.23  services provided under MinnesotaCare to the enrollee, providing 
175.24  relevant information to assist the state in pursuing a 
175.25  potentially liable third party, and completing forms necessary 
175.26  to recover third party payments. 
175.27     (b) A parent, guardian, or child enrolled in the 
175.28  MinnesotaCare program must cooperate with the department of 
175.29  human services and the local agency in establishing the 
175.30  paternity of an enrolled child and in obtaining medical care 
175.31  support and payments for the child and any other person for whom 
175.32  the person can legally assign rights, in accordance with 
175.33  applicable laws and rules governing the medical assistance 
175.34  program.  A child shall not be ineligible for or disenrolled 
175.35  from the MinnesotaCare program solely because the child's parent 
175.36  or guardian fails to cooperate in establishing paternity or 
176.1   obtaining medical support. 
176.2      Sec. 17.  Minnesota Statutes 1997 Supplement, section 
176.3   256L.04, subdivision 7, is amended to read: 
176.4      Subd. 7.  [ADDITION OF SINGLE ADULTS AND HOUSEHOLDS WITH NO 
176.5   CHILDREN.] (a) Beginning October 1, 1994, the definition of 
176.6   "eligible persons" is expanded to include all individuals and 
176.7   households with no children who have gross family incomes that 
176.8   are equal to or less than 125 percent of the federal poverty 
176.9   guidelines and who are not eligible for medical assistance 
176.10  without a spenddown under chapter 256B.  
176.11     (b) Beginning July 1, 1997, The definition of eligible 
176.12  persons is expanded to include includes all individuals and 
176.13  households with no children who have gross family incomes that 
176.14  are equal to or less than 175 percent of the federal poverty 
176.15  guidelines and who are not eligible for medical assistance 
176.16  without a spenddown under chapter 256B. 
176.17     (c) All eligible persons under paragraphs (a) and (b) are 
176.18  eligible for coverage through the MinnesotaCare program but must 
176.19  pay a premium as determined under sections 256L.07 and 256L.08.  
176.20  Individuals and families whose income is greater than the limits 
176.21  established under section 256L.08 may not enroll in the 
176.22  MinnesotaCare program. 
176.23     Sec. 18.  Minnesota Statutes 1997 Supplement, section 
176.24  256L.04, is amended by adding a subdivision to read: 
176.25     Subd. 7a.  [INELIGIBILITY.] Applicants whose income is 
176.26  greater than the limits established under this section may not 
176.27  enroll in the MinnesotaCare program. 
176.28     Sec. 19.  Minnesota Statutes 1997 Supplement, section 
176.29  256L.04, subdivision 8, is amended to read: 
176.30     Subd. 8.  [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 
176.31  ASSISTANCE.] (a) Individuals who apply for MinnesotaCare receive 
176.32  supplemental security income or retirement, survivors, or 
176.33  disability benefits due to a disability, or other 
176.34  disability-based pension, who qualify under section 256L.04, 
176.35  subdivision 7, but who are potentially eligible for medical 
176.36  assistance without a spenddown shall be allowed to enroll in 
177.1   MinnesotaCare for a period of 60 days, so long as the applicant 
177.2   meets all other conditions of eligibility.  The commissioner 
177.3   shall identify and refer the applications of such individuals to 
177.4   their county social service agency.  The county and the 
177.5   commissioner shall cooperate to ensure that the individuals 
177.6   obtain medical assistance coverage for any months for which they 
177.7   are eligible. 
177.8      (b) The enrollee must cooperate with the county social 
177.9   service agency in determining medical assistance eligibility 
177.10  within the 60-day enrollment period.  Enrollees who do not apply 
177.11  for and cooperate with medical assistance within the 60-day 
177.12  enrollment period, and their other family members, shall be 
177.13  disenrolled from the plan within one calendar month.  Persons 
177.14  disenrolled for nonapplication for medical assistance may not 
177.15  reenroll until they have obtained a medical assistance 
177.16  eligibility determination for the family member or members who 
177.17  were referred to the county agency.  Persons disenrolled for 
177.18  noncooperation with medical assistance may not reenroll until 
177.19  they have cooperated with the county agency and have obtained a 
177.20  medical assistance eligibility determination. 
177.21     (c) Beginning January 1, 2000, counties that choose to 
177.22  become MinnesotaCare enrollment sites shall consider 
177.23  MinnesotaCare applications of individuals described in paragraph 
177.24  (a) to also be applications for medical assistance and shall 
177.25  first determine whether medical assistance eligibility exists.  
177.26  Adults with children with family income under 175 percent of the 
177.27  federal poverty guidelines for the applicable family size, 
177.28  pregnant women, and children who qualify under subdivision 1 who 
177.29  are potentially eligible for medical assistance without a 
177.30  spenddown may choose to enroll in either MinnesotaCare or 
177.31  medical assistance. 
177.32     (d) The commissioner shall redetermine provider payments 
177.33  made under MinnesotaCare to the appropriate medical assistance 
177.34  payments for those enrollees who subsequently become eligible 
177.35  for medical assistance. 
177.36     Sec. 20.  Minnesota Statutes 1997 Supplement, section 
178.1   256L.04, subdivision 9, is amended to read: 
178.2      Subd. 9.  [GENERAL ASSISTANCE MEDICAL CARE.] A person 
178.3   cannot have coverage under both MinnesotaCare and general 
178.4   assistance medical care in the same month.  Eligibility for 
178.5   MinnesotaCare cannot be replaced by eligibility for general 
178.6   assistance medical care, and eligibility for general assistance 
178.7   medical care cannot be replaced by eligibility for MinnesotaCare.
178.8      Sec. 21.  Minnesota Statutes 1997 Supplement, section 
178.9   256L.04, subdivision 10, is amended to read: 
178.10     Subd. 10.  [SPONSOR'S INCOME AND RESOURCES DEEMED 
178.11  AVAILABLE; DOCUMENTATION.] When determining eligibility for any 
178.12  federal or state benefits under sections 256L.01 to 256L.16 
178.13  256L.18, the income and resources of all noncitizens whose 
178.14  sponsor signed an affidavit of support as defined under United 
178.15  States Code, title 8, section 1183a, shall be deemed to include 
178.16  their sponsors' income and resources as defined in the Personal 
178.17  Responsibility and Work Opportunity Reconciliation Act of 1996, 
178.18  title IV, Public Law Number 104-193, sections 421 and 422, and 
178.19  subsequently set out in federal rules.  To be eligible for the 
178.20  program, noncitizens must provide documentation of their 
178.21  immigration status. 
178.22     Sec. 22.  Minnesota Statutes 1997 Supplement, section 
178.23  256L.04, is amended by adding a subdivision to read: 
178.24     Subd. 12.  [PERSONS IN DETENTION.] An applicant residing in 
178.25  a correctional or detention facility is not eligible for 
178.26  MinnesotaCare.  An enrollee residing in a correctional or 
178.27  detention facility is not eligible at renewal of eligibility 
178.28  under section 256L.05, subdivision 3b. 
178.29     Sec. 23.  Minnesota Statutes 1997 Supplement, section 
178.30  256L.04, is amended by adding a subdivision to read: 
178.31     Subd. 13.  [FAMILIES WITH GRANDPARENTS, RELATIVE 
178.32  CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] In families 
178.33  that include a grandparent, relative caretaker as defined in the 
178.34  medical assistance program, foster parent, or legal guardian, 
178.35  the grandparent, relative caretaker, foster parent, or legal 
178.36  guardian may apply as a family or may apply separately for the 
179.1   children.  If the caretaker applies separately for the children, 
179.2   only the children's income is counted.  If the grandparent, 
179.3   relative caretaker, foster parent, or legal guardian applies 
179.4   with the family, their income is included in the gross family 
179.5   income for determining eligibility and premium amount. 
179.6      Sec. 24.  Minnesota Statutes 1997 Supplement, section 
179.7   256L.05, is amended by adding a subdivision to read: 
179.8      Subd. 1a.  [PERSON AUTHORIZED TO APPLY ON APPLICANT'S 
179.9   BEHALF.] A family member who is age 18 or over or who is an 
179.10  authorized representative, as defined in the medical assistance 
179.11  program, may apply on an applicant's behalf. 
179.12     Sec. 25.  Minnesota Statutes 1997 Supplement, section 
179.13  256L.05, subdivision 2, is amended to read: 
179.14     Subd. 2.  [COMMISSIONER'S DUTIES.] The commissioner shall 
179.15  use individuals' social security numbers as identifiers for 
179.16  purposes of administering the plan and conduct data matches to 
179.17  verify income.  Applicants shall submit evidence of individual 
179.18  and family income, earned and unearned, including such as the 
179.19  most recent income tax return, wage slips, or other 
179.20  documentation that is determined by the commissioner as 
179.21  necessary to verify income eligibility.  The commissioner shall 
179.22  perform random audits to verify reported income and 
179.23  eligibility.  The commissioner may execute data sharing 
179.24  arrangements with the department of revenue and any other 
179.25  governmental agency in order to perform income verification 
179.26  related to eligibility and premium payment under the 
179.27  MinnesotaCare program. 
179.28     Sec. 26.  Minnesota Statutes 1997 Supplement, section 
179.29  256L.05, subdivision 3, is amended to read: 
179.30     Subd. 3.  [EFFECTIVE DATE OF COVERAGE.] The effective date 
179.31  of coverage is the first day of the month following the month in 
179.32  which eligibility is approved and the first premium payment has 
179.33  been received.  As provided in section 256B.057, coverage for 
179.34  newborns is automatic from the date of birth and must be 
179.35  coordinated with other health coverage.  The effective date of 
179.36  coverage for eligible newborns or eligible newly adoptive 
180.1   children added to a family receiving covered health services is 
180.2   the date of entry into the family.  The effective date of 
180.3   coverage for other new recipients added to the family receiving 
180.4   covered health services is the first day of the month following 
180.5   the month in which eligibility is approved and the first premium 
180.6   payment has been received or at renewal, whichever the family 
180.7   receiving covered health services prefers.  All eligibility 
180.8   criteria must be met by the family at the time the new family 
180.9   member is added.  The income of the new family member is 
180.10  included with the family's gross income and the adjusted premium 
180.11  begins in the month the new family member is added.  The premium 
180.12  must be received eight working days prior to the end of the 
180.13  month for coverage to begin the following month.  Benefits are 
180.14  not available until the day following discharge if an enrollee 
180.15  is hospitalized on the first day of coverage.  Notwithstanding 
180.16  any other law to the contrary, benefits under sections 256L.01 
180.17  to 256L.10 256L.18 are secondary to a plan of insurance or 
180.18  benefit program under which an eligible person may have coverage 
180.19  and the commissioner shall use cost avoidance techniques to 
180.20  ensure coordination of any other health coverage for eligible 
180.21  persons.  The commissioner shall identify eligible persons who 
180.22  may have coverage or benefits under other plans of insurance or 
180.23  who become eligible for medical assistance. 
180.24     Sec. 27.  Minnesota Statutes 1997 Supplement, section 
180.25  256L.05, is amended by adding a subdivision to read: 
180.26     Subd. 3a.  [RENEWAL OF ELIGIBILITY.] An enrollee's 
180.27  eligibility must be renewed every 12 months.  The 12-month 
180.28  period begins in the month after the month the application is 
180.29  approved.  Individuals who initially enroll in the MinnesotaCare 
180.30  program under section 256L.04, subdivision 1 or 7, remain 
180.31  eligible for the MinnesotaCare program regardless of age, place 
180.32  of residence, or the presence or absence of children in the same 
180.33  household, as long as all other eligibility criteria are met, 
180.34  and residence in Minnesota and continuous enrollment in the 
180.35  MinnesotaCare program are maintained.  
180.36     Sec. 28.  Minnesota Statutes 1997 Supplement, section 
181.1   256L.05, is amended by adding a subdivision to read: 
181.2      Subd. 3b.  [REAPPLICATION.] Families and individuals must 
181.3   reapply after a lapse in coverage of one calendar month or more 
181.4   and must meet all eligibility criteria. 
181.5      Sec. 29.  Minnesota Statutes 1997 Supplement, section 
181.6   256L.05, subdivision 4, is amended to read: 
181.7      Subd. 4.  [APPLICATION PROCESSING.] The commissioner of 
181.8   human services shall determine an applicant's eligibility for 
181.9   MinnesotaCare no more than 30 days from the date that the 
181.10  application is received by the department of human services.  
181.11  Beginning January 1, 2000, this requirement also applies to 
181.12  local county human services agencies that determine eligibility 
181.13  for MinnesotaCare.  To prevent processing delays, applicants 
181.14  who, from the information provided on the application, appear to 
181.15  meet eligibility requirements shall be enrolled.  The enrollee 
181.16  must provide all required verifications within 30 days of 
181.17  enrollment or coverage from the program shall be terminated.  
181.18  Enrollees who are determined to be ineligible when verifications 
181.19  are provided shall be disenrolled from the program. 
181.20     Sec. 30.  Minnesota Statutes 1997 Supplement, section 
181.21  256L.06, subdivision 3, is amended to read: 
181.22     Subd. 3.  [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 
181.23  Premiums are dedicated to the commissioner for MinnesotaCare.  
181.24  The commissioner shall make an annual redetermination of 
181.25  continued eligibility and identify people who may become 
181.26  eligible for medical assistance.  
181.27     (b) The commissioner shall develop and implement procedures 
181.28  to:  (1) require enrollees to report changes in income; (2) 
181.29  adjust sliding scale premium payments, based upon changes in 
181.30  enrollee income; and (3) disenroll enrollees from MinnesotaCare 
181.31  for failure to pay required premiums.  Failure to pay includes 
181.32  payment with a dishonored check.  The commissioner may demand a 
181.33  guaranteed form of payment as the only means to replace a 
181.34  dishonored check. 
181.35     (c) Premiums are calculated on a calendar month basis and 
181.36  may be paid on a monthly, quarterly, or annual basis, with the 
182.1   first payment due upon notice from the commissioner of the 
182.2   premium amount required.  Premium payment is required before 
182.3   enrollment is complete and to maintain eligibility in 
182.4   MinnesotaCare.  
182.5      (d) Nonpayment of the premium will result in disenrollment 
182.6   from the plan within one calendar month after the due date.  
182.7   Persons disenrolled for nonpayment or who voluntarily terminate 
182.8   coverage from the program may not reenroll until four calendar 
182.9   months have elapsed.  Persons disenrolled for nonpayment or who 
182.10  voluntarily terminate coverage from the program may not reenroll 
182.11  for four calendar months unless the person demonstrates good 
182.12  cause for nonpayment.  Good cause does not exist if a person 
182.13  chooses to pay other family expenses instead of the premium.  
182.14  The commissioner shall define good cause in rule. 
182.15     Sec. 31.  Minnesota Statutes 1997 Supplement, section 
182.16  256L.07, is amended to read: 
182.17     256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON 
182.18  SLIDING SCALE.] 
182.19     Subdivision 1.  [GENERAL REQUIREMENTS.] Families and 
182.20  individuals who enroll on or after October 1, 1992, are eligible 
182.21  for subsidized premium payments based on a sliding scale under 
182.22  section 256L.08 only if the family or individual meets the 
182.23  requirements in subdivisions 2 and 3.  Children already enrolled 
182.24  in the children's health plan as of September 30, 1992, eligible 
182.25  under section 256L.04, subdivision 1, paragraph (a), children 
182.26  who enroll in the MinnesotaCare program after September 30, 
182.27  1992, pursuant to Laws 1992, chapter 549, article 4, section 17, 
182.28  and children who enroll under section 256L.04, subdivision 6, 
182.29  are eligible for subsidized premium payments without meeting 
182.30  these requirements, as long as they maintain continuous coverage 
182.31  in the MinnesotaCare plan or medical assistance. (a) Children 
182.32  enrolled in the original children's health plan as of September 
182.33  30, 1992, children who enrolled in the MinnesotaCare program 
182.34  after September 30, 1992, pursuant to Laws 1992, chapter 549, 
182.35  article 4, section 17, and children who have family gross 
182.36  incomes that are equal to or less than 150 percent of the 
183.1   federal poverty guidelines are eligible for subsidized premium 
183.2   payments without meeting the requirements of subdivision 2, as 
183.3   long as they maintain continuous coverage in the MinnesotaCare 
183.4   program or medical assistance. 
183.5      (b) Families and individuals who initially enrolled in 
183.6   MinnesotaCare under section 256L.04, and whose income increases 
183.7   above the limits established in section 256L.08, may continue 
183.8   enrollment and pay the full cost of coverage.  Families enrolled 
183.9   in MinnesotaCare under section 256L.04, subdivision 1, whose 
183.10  income increases above 275 percent of the federal poverty 
183.11  guidelines, are no longer eligible for the program and shall be 
183.12  disenrolled by the commissioner. Individuals enrolled in 
183.13  MinnesotaCare under section 256L.04, subdivision 7, whose income 
183.14  increases above 175 percent of the federal poverty guidelines 
183.15  are no longer eligible for the program and shall be disenrolled 
183.16  by the commissioner.  For persons disenrolled under this 
183.17  subdivision, MinnesotaCare coverage terminates the last day of 
183.18  the calendar month following the month in which the commissioner 
183.19  determines that the income of a family or individual, determined 
183.20  over a four-month period as required by section 256L.08, exceeds 
183.21  program income limits.  Persons disenrolled under this 
183.22  subdivision may enter the transition pool established under 
183.23  section 256L.19.  
183.24     Subd. 2.  [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 
183.25  COVERAGE.] (a) To be eligible for subsidized premium payments 
183.26  based on a sliding scale, a family or individual must not have 
183.27  access to subsidized health coverage through an employer, and 
183.28  must not have had access to subsidized health coverage through 
183.29  an employer for the 18 months prior to application for 
183.30  subsidized coverage under the MinnesotaCare program.  The 
183.31  requirement that the family or individual must not have had 
183.32  access to employer-subsidized coverage during the previous 18 
183.33  months does not apply if:  (1) employer-subsidized coverage was 
183.34  lost due to the death of an employee or divorce; (2) 
183.35  employer-subsidized coverage was lost because an individual 
183.36  became ineligible for coverage as a child or dependent; or (3) 
184.1   employer-subsidized coverage was lost for reasons that would not 
184.2   disqualify the individual for unemployment benefits under 
184.3   section 268.09 and the family or individual has not had access 
184.4   to employer-subsidized coverage since the loss of coverage.  If 
184.5   employer-subsidized coverage was lost for reasons that 
184.6   disqualify an individual for unemployment benefits under section 
184.7   268.09, children of that individual are exempt from the 
184.8   requirement of no access to employer subsidized coverage for the 
184.9   18 months prior to application, as long as the children have not 
184.10  had access to employer subsidized coverage since the 
184.11  disqualifying event.  The requirement that the.  A family or 
184.12  individual must not have had access to employer-subsidized 
184.13  coverage during the previous 18 months does apply if whose 
184.14  employer-subsidized coverage is lost due to an employer 
184.15  terminating health care coverage as an employee benefit during 
184.16  the previous 18 months is not eligible.  
184.17     (b) For purposes of this requirement, subsidized health 
184.18  coverage means health coverage for which the employer pays at 
184.19  least 50 percent of the cost of coverage for the employee, 
184.20  excluding dependent coverage or dependent, or a higher 
184.21  percentage as specified by the commissioner.  Children are 
184.22  eligible for employer-subsidized coverage through either parent, 
184.23  including the noncustodial parent.  The commissioner must treat 
184.24  employer contributions to Internal Revenue Code Section 125 
184.25  plans and any other employer benefits intended to pay health 
184.26  care costs as qualified employer subsidies toward the cost of 
184.27  health coverage for employees for purposes of this subdivision. 
184.28     Subd. 3.  [PERIOD UNINSURED OTHER HEALTH COVERAGE.] To be 
184.29  eligible for subsidized premium payments based on a sliding 
184.30  scale, (a) Families and individuals initially enrolled in the 
184.31  MinnesotaCare program under section 256L.04, subdivisions 5 and 
184.32  7, must have had no health coverage while enrolled or for at 
184.33  least four months prior to application and renewal.  Children 
184.34  enrolled in the original children's health plan and children in 
184.35  families with income equal to or less than 150 percent of the 
184.36  federal poverty guidelines, who have other health insurance, are 
185.1   eligible if the other health coverage meets the requirements of 
185.2   Minnesota Rules, part 9506.0020, subpart 3, item B.  The 
185.3   commissioner may change this eligibility criterion for sliding 
185.4   scale premiums in order to remain within the limits of available 
185.5   appropriations.  The requirement of at least four months of no 
185.6   health coverage prior to application for the MinnesotaCare 
185.7   program does not apply to: newborns. 
185.8      (1) families, children, and individuals who apply for the 
185.9   MinnesotaCare program upon termination from or as required by 
185.10  the medical assistance program, general assistance medical care 
185.11  program, or coverage under a regional demonstration project for 
185.12  the uninsured funded under section 256B.73, the Hennepin county 
185.13  assured care program, or the Group Health, Inc., community 
185.14  health plan; 
185.15     (2) families and individuals initially enrolled under 
185.16  section 256L.04, subdivisions 1, paragraph (a), and 3; 
185.17     (3) children enrolled pursuant to Laws 1992, chapter 549, 
185.18  article 4, section 17; or 
185.19     (4) individuals currently serving or who have served in the 
185.20  military reserves, and dependents of these individuals, if these 
185.21  individuals:  (i) reapply for MinnesotaCare coverage after a 
185.22  period of active military service during which they had been 
185.23  covered by the Civilian Health and Medical Program of the 
185.24  Uniformed Services (CHAMPUS); (ii) were covered under 
185.25  MinnesotaCare immediately prior to obtaining coverage under 
185.26  CHAMPUS; and (iii) have maintained continuous coverage. 
185.27     (b) For purposes of this section, medical assistance, 
185.28  general assistance medical care, and civilian health and medical 
185.29  program of the uniformed service, CHAMPUS, are not considered 
185.30  insurance or health coverage. 
185.31     (c) For purposes of this section, Medicare part A or B 
185.32  coverage under title XVIII of the Social Security Act, United 
185.33  States Code, title 42, sections 1395c to 1395w-4, is considered 
185.34  health coverage.  An applicant or enrollee may not refuse 
185.35  Medicare coverage to establish eligibility for MinnesotaCare. 
185.36     Sec. 32.  Minnesota Statutes 1997 Supplement, section 
186.1   256L.09, subdivision 2, is amended to read: 
186.2      Subd. 2.  [RESIDENCY REQUIREMENT.] (a) Prior to July 1, 
186.3   1997, to be eligible for health coverage under the MinnesotaCare 
186.4   program, families and individuals must be permanent residents of 
186.5   Minnesota.  
186.6      (b) Effective July 1, 1997, To be eligible for health 
186.7   coverage under the MinnesotaCare program, adults without 
186.8   children must be permanent residents of Minnesota. 
186.9      (c) Effective July 1, 1997, (b) To be eligible for health 
186.10  coverage under the MinnesotaCare program, pregnant women, 
186.11  families, and children must meet the residency requirements as 
186.12  provided by Code of Federal Regulations, title 42, section 
186.13  435.403, except that the provisions of section 256B.056, 
186.14  subdivision 1, shall apply upon receipt of federal approval. 
186.15     Sec. 33.  Minnesota Statutes 1997 Supplement, section 
186.16  256L.09, subdivision 4, is amended to read: 
186.17     Subd. 4.  [ELIGIBILITY AS MINNESOTA RESIDENT.] (a) For 
186.18  purposes of this section, a permanent Minnesota resident is a 
186.19  person who has demonstrated, through persuasive and objective 
186.20  evidence, that the person is domiciled in the state and intends 
186.21  to live in the state permanently. 
186.22     (b) To be eligible as a permanent resident, all applicants 
186.23  an applicant must demonstrate the requisite intent to live in 
186.24  the state permanently by: 
186.25     (1) showing that the applicant maintains a residence at a 
186.26  verified address other than a place of public accommodation, 
186.27  through the use of evidence of residence described in section 
186.28  256D.02, subdivision 12a, clause (1); 
186.29     (2) demonstrating that the applicant has been continuously 
186.30  domiciled in the state for no less than 180 days immediately 
186.31  before the application; and 
186.32     (3) signing an affidavit declaring that (A) the applicant 
186.33  currently resides in the state and intends to reside in the 
186.34  state permanently; and (B) the applicant did not come to the 
186.35  state for the primary purpose of obtaining medical coverage or 
186.36  treatment. 
187.1      (c) A person who is temporarily absent from the state does 
187.2   not lose eligibility for MinnesotaCare.  "Temporarily absent 
187.3   from the state" means the person is out of the state for a 
187.4   temporary purpose and intends to return when the purpose of the 
187.5   absence has been accomplished.  A person is not temporarily 
187.6   absent from the state if another state has determined that the 
187.7   person is a resident for any purpose.  If temporarily absent 
187.8   from the state, the person must follow the requirements of the 
187.9   health plan in which he or she is enrolled to receive services. 
187.10     Sec. 34.  Minnesota Statutes 1997 Supplement, section 
187.11  256L.09, subdivision 6, is amended to read: 
187.12     Subd. 6.  [12-MONTH PREEXISTING EXCLUSION.] If the 180-day 
187.13  requirement in subdivision 4, paragraph (b), clause (2), is 
187.14  determined by a court to be unconstitutional, the commissioner 
187.15  of human services shall impose a 12-month preexisting condition 
187.16  exclusion on coverage for persons who have been domiciled in the 
187.17  state for less than 180 days.  
187.18     Sec. 35.  Minnesota Statutes 1997 Supplement, section 
187.19  256L.11, subdivision 6, is amended to read: 
187.20     Subd. 6.  [ENROLLEES 18 OR OLDER.] Payment by the 
187.21  MinnesotaCare program for inpatient hospital services provided 
187.22  to MinnesotaCare enrollees eligible under section 256L.04, 
187.23  subdivision 7, or who qualify under section 256L.04, 
187.24  subdivisions 1 to 6 and 2, or 256L.13 with family gross income 
187.25  that exceeds 175 percent of the federal poverty guidelines and 
187.26  who are not pregnant, who are 18 years old or older on the date 
187.27  of admission to the inpatient hospital must be in accordance 
187.28  with paragraphs (a) and (b).  Payment for adults who are not 
187.29  pregnant and are eligible under section 256L.04, subdivisions 
187.30  1 to 6 and 2, or 256L.13, and whose incomes are equal to or less 
187.31  than 175 percent of the federal poverty guidelines, shall be as 
187.32  provided for under paragraph (c).  
187.33     (a) If the medical assistance rate minus any copayment 
187.34  required under section 256L.03, subdivision 4, is less than or 
187.35  equal to the amount remaining in the enrollee's benefit limit 
187.36  under section 256L.03, subdivision 3, payment must be the 
188.1   medical assistance rate minus any copayment required under 
188.2   section 256L.03, subdivision 4.  The hospital must not seek 
188.3   payment from the enrollee in addition to the copayment.  The 
188.4   MinnesotaCare payment plus the copayment must be treated as 
188.5   payment in full. 
188.6      (b) If the medical assistance rate minus any copayment 
188.7   required under section 256L.03, subdivision 4, is greater than 
188.8   the amount remaining in the enrollee's benefit limit under 
188.9   section 256L.03, subdivision 3, payment must be the lesser of: 
188.10     (1) the amount remaining in the enrollee's benefit limit; 
188.11  or 
188.12     (2) charges submitted for the inpatient hospital services 
188.13  less any copayment established under section 256L.03, 
188.14  subdivision 4. 
188.15     The hospital may seek payment from the enrollee for the 
188.16  amount by which usual and customary charges exceed the payment 
188.17  under this paragraph.  If payment is reduced under section 
188.18  256L.03, subdivision 3, paragraph (c) (b), the hospital may not 
188.19  seek payment from the enrollee for the amount of the reduction. 
188.20     (c) For admissions occurring during the period of July 1, 
188.21  1997, through June 30, 1998, for adults who are not pregnant and 
188.22  are eligible under section 256L.04, subdivisions 1 to 6 and 
188.23  2, or 256L.13, and whose incomes are equal to or less than 175 
188.24  percent of the federal poverty guidelines, the commissioner 
188.25  shall pay hospitals directly, up to the medical assistance 
188.26  payment rate, for inpatient hospital benefits in excess of the 
188.27  $10,000 annual inpatient benefit limit. 
188.28     Sec. 36.  Minnesota Statutes 1997 Supplement, section 
188.29  256L.12, subdivision 5, is amended to read: 
188.30     Subd. 5.  [ELIGIBILITY FOR OTHER STATE PROGRAMS.] 
188.31  MinnesotaCare enrollees who become eligible for medical 
188.32  assistance or general assistance medical care will remain in the 
188.33  same managed care plan if the managed care plan has a contract 
188.34  for that population.  Effective January 1, 1998, MinnesotaCare 
188.35  enrollees who were formerly eligible for general assistance 
188.36  medical care pursuant to section 256D.03, subdivision 3, within 
189.1   six months of MinnesotaCare enrollment and were enrolled in a 
189.2   prepaid health plan pursuant to section 256D.03, subdivision 4, 
189.3   paragraph (d), must remain in the same managed care plan if the 
189.4   managed care plan has a contract for that population.  Contracts 
189.5   between the department of human services and managed care plans 
189.6   must include MinnesotaCare, and medical assistance and may, at 
189.7   the option of the commissioner of human services, also include 
189.8   general assistance medical care.  Managed care plans must 
189.9   participate in the MinnesotaCare and general assistance medical 
189.10  care programs under a contract with the department of human 
189.11  services in service areas where they participate in the medical 
189.12  assistance program. 
189.13     Sec. 37.  Minnesota Statutes 1997 Supplement, section 
189.14  256L.15, is amended to read: 
189.15     256L.15 [PREMIUMS.] 
189.16     Subdivision 1.  [PREMIUM DETERMINATION.] Families and with 
189.17  children enrolled according to sections 256L.13 to 256L.16 and 
189.18  individuals shall pay a premium determined according to a 
189.19  sliding fee based on the cost of coverage as a percentage of the 
189.20  family's gross family income.  Pregnant women and children under 
189.21  age two are exempt from the provisions of section 256L.06, 
189.22  subdivision 3, paragraph (b), clause (3), requiring 
189.23  disenrollment for failure to pay premiums.  For pregnant women, 
189.24  this exemption continues until the first day of the month 
189.25  following the 60th day postpartum.  Women who remain enrolled 
189.26  during pregnancy or the postpartum period, despite nonpayment of 
189.27  premiums, shall be disenrolled on the first of the month 
189.28  following the 60th day postpartum for the penalty period that 
189.29  otherwise applies under section 256L.06, unless they begin 
189.30  paying premiums. 
189.31     Subd. 1a.  [PAYMENT OPTIONS.] The commissioner may offer 
189.32  the following payment options to an enrollee: 
189.33     (1) payment by check; 
189.34     (2) payment by credit card; 
189.35     (3) payment by recurring automatic checking withdrawal; 
189.36     (4) payment by one-time electronic transfer of funds; 
190.1      (5) payment by wage withholding with the consent of the 
190.2   employer and the employee; or 
190.3      (6) payment by using state tax refund payments. 
190.4      At application or reapplication, a MinnesotaCare applicant 
190.5   or enrollee may authorize the commissioner to use the Revenue 
190.6   Recapture Act in chapter 270A to collect funds from the 
190.7   applicant's or enrollee's state income tax refund for the 
190.8   purposes of meeting all or part of the applicant's or enrollee's 
190.9   MinnesotaCare premium obligation for the forthcoming year.  The 
190.10  applicant or enrollee may authorize the commissioner to apply 
190.11  for the state working family tax credit on behalf of the 
190.12  applicant or enrollee.  The setoff due under this subdivision 
190.13  shall not be subject to the $10 fee under section 270A.07, 
190.14  subdivision 1.  
190.15     Subd. 1b.  [PAYMENTS NONREFUNDABLE.] MinnesotaCare premiums 
190.16  are not refundable. 
190.17     Subd. 2.  [SLIDING SCALE TO DETERMINE PERCENTAGE OF GROSS 
190.18  INDIVIDUAL OR FAMILY INCOME.] The commissioner shall establish a 
190.19  sliding fee scale to determine the percentage of 
190.20  gross individual or family income that households at different 
190.21  income levels must pay to obtain coverage through the 
190.22  MinnesotaCare program.  The sliding fee scale must be based on 
190.23  the enrollee's gross individual or family income during the 
190.24  previous four months.  The sliding fee scale begins with a 
190.25  premium of 1.5 percent of gross individual or family income for 
190.26  individuals or families with incomes below the limits for the 
190.27  medical assistance program for families and children and 
190.28  proceeds through the following evenly spaced steps:  1.8, 2.3, 
190.29  3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 percent.  These percentages are 
190.30  matched to evenly spaced income steps ranging from the medical 
190.31  assistance income limit for families and children to 275 percent 
190.32  of the federal poverty guidelines for the applicable family 
190.33  size.  The sliding fee scale and percentages are not subject to 
190.34  the provisions of chapter 14.  If a family or individual reports 
190.35  increased income after enrollment, premiums shall not be 
190.36  adjusted until eligibility renewal.  
191.1      Subd. 3.  [EXCEPTIONS TO SLIDING SCALE.] An annual premium 
191.2   of $48 is required for all children who are eligible according 
191.3   to section 256L.13, subdivision 4 in families with income at or 
191.4   less than 150 percent of federal poverty guidelines. 
191.5      Sec. 38.  Minnesota Statutes 1997 Supplement, section 
191.6   256L.17, is amended by adding a subdivision to read: 
191.7      Subd. 6.  [WAIVER OF MAINTENANCE OF EFFORT 
191.8   REQUIREMENT.] Unless a federal waiver of the maintenance of 
191.9   effort requirements of section 2105(d) of title XXI of the 
191.10  Balanced Budget Act of 1997, Public Law Number 105-33, Statutes 
191.11  at Large, volume 111, page 251, is granted by the federal 
191.12  Department of Health and Human Services by September 30, 1998, 
191.13  this section does not apply to children.  The commissioner shall 
191.14  publish a notice in the State Register upon receipt of a federal 
191.15  waiver. 
191.16     Sec. 39.  [256L.19] [TRANSITION POOL FOR MINNESOTACARE 
191.17  ENROLLEES.] 
191.18     Subdivision 1.  [CREATION.] The commissioner of human 
191.19  services shall create a purchasing pool for MinnesotaCare 
191.20  enrollees whose income is at or above 275 percent of the federal 
191.21  poverty guidelines. 
191.22     Subd. 2.  [HEALTH PLAN COVERAGE.] Any managed care plan 
191.23  that participates in the MinnesotaCare program through a 
191.24  contract with the department of human services must offer a 
191.25  group product to the pool established under subdivision 1 with 
191.26  guaranteed issuance and with a waiver of any preexisting 
191.27  condition limitations.  The coverage offered must be equivalent 
191.28  to a qualified benefit plan under section 62E.06 offered by a 
191.29  health maintenance organization. 
191.30     Subd. 3.  [RATES.] (a) The rates offered for this coverage 
191.31  must meet the requirements of section 62L.08. 
191.32     (b) All premiums for this coverage shall be the 
191.33  responsibility of the enrollee.  No state subsidies shall be 
191.34  provided. 
191.35     Sec. 40.  Minnesota Statutes 1997 Supplement, section 
191.36  270A.03, subdivision 5, is amended to read: 
192.1      Subd. 5.  [DEBT.] "Debt" means a legal obligation of a 
192.2   natural person to pay a fixed and certain amount of money, which 
192.3   equals or exceeds $25 and which is due and payable to a claimant 
192.4   agency.  The term includes criminal fines imposed under section 
192.5   609.10 or 609.125 and restitution.  A debt may arise under a 
192.6   contractual or statutory obligation, a court order, or other 
192.7   legal obligation, but need not have been reduced to judgment.  
192.8      A debt includes any legal obligation of a current recipient 
192.9   of assistance which is based on overpayment of an assistance 
192.10  grant where that payment is based on a client waiver or an 
192.11  administrative or judicial finding of an intentional program 
192.12  violation; or where the debt is owed to a program wherein the 
192.13  debtor is not a client at the time notification is provided to 
192.14  initiate recovery under this chapter and the debtor is not a 
192.15  current recipient of food stamps, transitional child care, or 
192.16  transitional medical assistance. 
192.17     A debt does not include any legal obligation to pay a 
192.18  claimant agency for medical care, including hospitalization if 
192.19  the income of the debtor at the time when the medical care was 
192.20  rendered does not exceed the following amount: 
192.21     (1) for an unmarried debtor, an income of $6,400 or less; 
192.22     (2) for a debtor with one dependent, an income of $8,200 or 
192.23  less; 
192.24     (3) for a debtor with two dependents, an income of $9,700 
192.25  or less; 
192.26     (4) for a debtor with three dependents, an income of 
192.27  $11,000 or less; 
192.28     (5) for a debtor with four dependents, an income of $11,600 
192.29  or less; and 
192.30     (6) for a debtor with five or more dependents, an income of 
192.31  $12,100 or less.  
192.32     The income amounts in this subdivision shall be adjusted 
192.33  for inflation for debts incurred in calendar years 1991 and 
192.34  thereafter.  The dollar amount of each income level that applied 
192.35  to debts incurred in the prior year shall be increased in the 
192.36  same manner as provided in section 290.06, subdivision 2d, for 
193.1   the expansion of the tax rate brackets. 
193.2      Debt also includes an agreement to pay a MinnesotaCare 
193.3   premium, regardless of the dollar amount of the premium 
193.4   authorized under section 256L.15, subdivision 1a. 
193.5      Sec. 41.  Laws 1997, chapter 225, article 2, section 64, is 
193.6   amended to read: 
193.7      Sec. 64.  [EFFECTIVE DATE.] 
193.8      Section 8 is effective for payments made for MinnesotaCare 
193.9   services on or after July 1, 1996.  Section 23 is effective the 
193.10  day following final enactment.  Section 46 is effective January 
193.11  1, 1998, and applies to high deductible health plans issued or 
193.12  renewed on or after that date. 
193.13     Sec. 42.  [FEDERAL EARNED INCOME TAX CREDIT.] 
193.14     The commissioner of human services shall seek a federal 
193.15  waiver from the appropriate federal agency to allow the state to 
193.16  use the federal earned income tax credit for payment of state 
193.17  subsidized health care premiums. 
193.18     Sec. 43.  [INPATIENT HOSPITAL COPAYMENT.] 
193.19     If federal approval of a waiver to obtain federal Medicaid 
193.20  funding for coverage provided to parents enrolled in the 
193.21  MinnesotaCare program is contingent upon not applying the 
193.22  inpatient hospital services copayment under section 256L.03, 
193.23  subdivision 5, clause (1), the inpatient hospital services 
193.24  copayment shall not be applied to enrollees for whom the state 
193.25  receives federal Medicaid funding.  
193.26     Sec. 44.  [AUTHORIZATION TO SUBMIT PLANS AND REQUESTS FOR 
193.27  WAIVERS TO OBTAIN FEDERAL FUNDS UNDER TITLE XXI.] 
193.28     (a) The commissioner of human services is authorized to 
193.29  claim enhanced federal matching funds available under sections 
193.30  2105(a)(2) and 2110 of the Balanced Budget Act of 1997, Public 
193.31  Law Number 105-33, for any and all state or local expenditures 
193.32  eligible as child health assistance for targeted low-income 
193.33  children and health service initiatives for low-income 
193.34  children.  If required by federal law or regulation, the 
193.35  commissioner is authorized to establish accounts, make 
193.36  appropriate payments, and receive reimbursement from any and all 
194.1   state and local entities providing child health assistance or 
194.2   health services for low-income children in order to obtain 
194.3   federal matching funds.  Federal matching funds received under 
194.4   this section shall be deposited in the health care access fund.  
194.5      (b) The commissioner of human services shall submit to the 
194.6   health care financing administration all necessary plans or 
194.7   requests for waivers in order to obtain enhanced matching funds 
194.8   under the state children's health insurance program for 
194.9   expenditures made under the MinnesotaCare program.  The 
194.10  commissioner shall report to the 1999 legislature all changes to 
194.11  the MinnesotaCare program that may be required in order to 
194.12  receive enhanced matching funds. 
194.13     Sec. 45.  [REVISOR'S INSTRUCTION.] 
194.14     In each section of Minnesota Statutes referred to in column 
194.15  A, the revisor of statutes shall delete the reference in column 
194.16  B and insert the reference in column C. 
194.17     Column A            Column B            Column C
194.18     256B.057, subd. 1a  256L.08             256L.15
194.19     256B.0645           256L.14             256L.03, subd. 1a
194.20     256L.16             256L.14             256L.03, subd. 1a
194.21     Sec. 46.  [REPEALER.] 
194.22     Minnesota Statutes 1997 Supplement, sections 256B.057, 
194.23  subdivision 1a; 256L.04, subdivisions 3, 4, 5, and 6; 256L.06, 
194.24  subdivisions 1 and 2; 256L.08; 256L.09, subdivision 3; 256L.13; 
194.25  and 256L.14, are repealed. 
194.26     Sec. 47.  [EFFECTIVE DATE.] 
194.27     Sections 2, 4 to 11, 13 to 37, 40, 45, and 46 are effective 
194.28  January 1, 1999.  Sections 3 and 38 are effective September 30, 
194.29  1998.  Sections 12, 41, 42, 43, and 44 are effective the day 
194.30  following final enactment. 
194.31                             ARTICLE 6 
194.32                           WELFARE REFORM 
194.33     Section 1.  Minnesota Statutes 1996, section 119B.24, is 
194.34  amended to read: 
194.35     119B.24 [DUTIES OF COMMISSIONER.] 
194.36     In addition to the powers and duties already conferred by 
195.1   law, the commissioner of children, families, and learning shall: 
195.2      (1) by September 1, 1998, and every five years thereafter, 
195.3   survey and report on all components of the child care system, 
195.4   including, but not limited to, availability of licensed child 
195.5   care slots, the number of children in various kinds of child 
195.6   care settings, staff wages, rate of staff turnover, 
195.7   qualifications of child care workers, cost of child care by type 
195.8   of service and ages of children, and child care availability 
195.9   through school systems; 
195.10     (2) by September 1, 1998, and every five years thereafter, 
195.11  survey and report on the extent to which existing child care 
195.12  services fulfill the need for child care, giving particular 
195.13  attention to the need for part-time care and for care of 
195.14  infants, sick children, children with special needs, low-income 
195.15  children, toddlers, and school-age children; 
195.16     (3) administer the child care fund, including the sliding 
195.17  fee program authorized under sections 119B.01 to 119B.16; 
195.18     (4) monitor the child care resource and referral programs 
195.19  established under section 119B.19; and 
195.20     (5) encourage child care providers to participate in a 
195.21  nationally recognized accreditation system for early childhood 
195.22  programs.  The commissioner shall reimburse licensed child care 
195.23  providers for one-half of the direct cost of accreditation fees, 
195.24  upon successful completion of accreditation. 
195.25     The commissioner may enter into contractual agreements with 
195.26  a federally recognized Indian tribe with a reservation in 
195.27  Minnesota to carry out any of the responsibilities of county 
195.28  human service agencies to the extent necessary for the tribe to 
195.29  operate a child care assistance program under the supervision of 
195.30  the commissioner. 
195.31     Funding to support services under section 119B.03 may be 
195.32  transferred to the federally recognized Indian tribe with a 
195.33  reservation in Minnesota from allocations available to counties 
195.34  in which reservation boundaries lie.  When funding is 
195.35  transferred, the amount shall be commensurate to estimates of 
195.36  the proportion of reservation residents to the total population 
196.1   of county residents with characteristics identified in section 
196.2   119B.03. 
196.3      Sec. 2.  Minnesota Statutes 1996, section 245A.03, is 
196.4   amended by adding a subdivision to read: 
196.5      Subd. 2b.  [EXCEPTION.] The provision in subdivision 2, 
196.6   clause (2), does not apply to: 
196.7      (1) a child care provider who as an applicant for licensure 
196.8   or as a license holder has received a license denial under 
196.9   section 245A.05, a fine under section 245A.06, or a sanction 
196.10  under section 245A.07 from the commissioner that has not been 
196.11  reversed on appeal; or 
196.12     (2) a child care provider, or a child care provider who has 
196.13  a household member who, as a result of a licensing process, has 
196.14  a disqualification under this chapter that has not been set 
196.15  aside by the commissioner. 
196.16     Sec. 3.  Minnesota Statutes 1996, section 245A.14, 
196.17  subdivision 4, is amended to read: 
196.18     Subd. 4.  [SPECIAL FAMILY DAY CARE HOMES.] (a) 
196.19  Nonresidential child care programs serving 14 or fewer children 
196.20  that are conducted at a location other than the license holder's 
196.21  own residence shall be licensed under this section and the rules 
196.22  governing family day care or group family day care if:  
196.23     (a) (1) the license holder is the primary provider of care; 
196.24     (b) and the nonresidential child care program is conducted 
196.25  in a dwelling that is located on a residential lot; and or 
196.26     (c) the license holder complies with all other requirements 
196.27  of sections 245A.01 to 245A.15 and the rules governing family 
196.28  day care or group family day care. 
196.29     (2) the license holder is an employer who may or may not be 
196.30  the primary provider of care, and the purpose for the child care 
196.31  program is to provide child care services to children of the 
196.32  license holder's employees.  
196.33     (b) Notwithstanding section 245A.16, subdivision 1, the 
196.34  commissioner shall not delegate the authority to licensing 
196.35  facilities under this section to county agencies or other 
196.36  private agencies. 
197.1      Sec. 4.  Minnesota Statutes 1997 Supplement, section 
197.2   245B.06, subdivision 2, is amended to read: 
197.3      Subd. 2.  [RISK MANAGEMENT PLAN.] The license holder must 
197.4   develop and document in writing a risk management plan that 
197.5   incorporates the individual abuse prevention plan as required in 
197.6   chapter 245C section 245A.65.  License holders jointly providing 
197.7   services to a consumer shall coordinate and use the resulting 
197.8   assessment of risk areas for the development of this plan.  Upon 
197.9   initiation of services, the license holder will have in place an 
197.10  initial risk management plan that identifies areas in which the 
197.11  consumer is vulnerable, including health, safety, and 
197.12  environmental issues and the supports the provider will have in 
197.13  place to protect the consumer and to minimize these risks.  The 
197.14  plan must be changed based on the needs of the individual 
197.15  consumer and reviewed at least annually. 
197.16     Sec. 5.  Minnesota Statutes 1997 Supplement, section 
197.17  256.01, subdivision 2, is amended to read: 
197.18     Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
197.19  section 241.021, subdivision 2, the commissioner of human 
197.20  services shall: 
197.21     (1) Administer and supervise all forms of public assistance 
197.22  provided for by state law and other welfare activities or 
197.23  services as are vested in the commissioner.  Administration and 
197.24  supervision of human services activities or services includes, 
197.25  but is not limited to, assuring timely and accurate distribution 
197.26  of benefits, completeness of service, and quality program 
197.27  management.  In addition to administering and supervising human 
197.28  services activities vested by law in the department, the 
197.29  commissioner shall have the authority to: 
197.30     (a) require county agency participation in training and 
197.31  technical assistance programs to promote compliance with 
197.32  statutes, rules, federal laws, regulations, and policies 
197.33  governing human services; 
197.34     (b) monitor, on an ongoing basis, the performance of county 
197.35  agencies in the operation and administration of human services, 
197.36  enforce compliance with statutes, rules, federal laws, 
198.1   regulations, and policies governing welfare services and promote 
198.2   excellence of administration and program operation; 
198.3      (c) develop a quality control program or other monitoring 
198.4   program to review county performance and accuracy of benefit 
198.5   determinations; 
198.6      (d) require county agencies to make an adjustment to the 
198.7   public assistance benefits issued to any individual consistent 
198.8   with federal law and regulation and state law and rule and to 
198.9   issue or recover benefits as appropriate; 
198.10     (e) delay or deny payment of all or part of the state and 
198.11  federal share of benefits and administrative reimbursement 
198.12  according to the procedures set forth in section 256.017; and 
198.13     (f) make contracts with and grants to public and private 
198.14  agencies and organizations, both profit and nonprofit, and 
198.15  individuals, using appropriated funds; and 
198.16     (g) enter into contractual agreements with federally 
198.17  recognized Indian tribes with a reservation in Minnesota to the 
198.18  extent necessary for the tribe to operate a federally approved 
198.19  family assistance program or any other program under the 
198.20  supervision of the commissioner.  The commissioner may establish 
198.21  necessary accounts for the purposes of receiving and disbursing 
198.22  funds as necessary for the operation of the programs. 
198.23     (2) Inform county agencies, on a timely basis, of changes 
198.24  in statute, rule, federal law, regulation, and policy necessary 
198.25  to county agency administration of the programs. 
198.26     (3) Administer and supervise all child welfare activities; 
198.27  promote the enforcement of laws protecting handicapped, 
198.28  dependent, neglected and delinquent children, and children born 
198.29  to mothers who were not married to the children's fathers at the 
198.30  times of the conception nor at the births of the children; 
198.31  license and supervise child-caring and child-placing agencies 
198.32  and institutions; supervise the care of children in boarding and 
198.33  foster homes or in private institutions; and generally perform 
198.34  all functions relating to the field of child welfare now vested 
198.35  in the state board of control. 
198.36     (4) Administer and supervise all noninstitutional service 
199.1   to handicapped persons, including those who are visually 
199.2   impaired, hearing impaired, or physically impaired or otherwise 
199.3   handicapped.  The commissioner may provide and contract for the 
199.4   care and treatment of qualified indigent children in facilities 
199.5   other than those located and available at state hospitals when 
199.6   it is not feasible to provide the service in state hospitals. 
199.7      (5) Assist and actively cooperate with other departments, 
199.8   agencies and institutions, local, state, and federal, by 
199.9   performing services in conformity with the purposes of Laws 
199.10  1939, chapter 431. 
199.11     (6) Act as the agent of and cooperate with the federal 
199.12  government in matters of mutual concern relative to and in 
199.13  conformity with the provisions of Laws 1939, chapter 431, 
199.14  including the administration of any federal funds granted to the 
199.15  state to aid in the performance of any functions of the 
199.16  commissioner as specified in Laws 1939, chapter 431, and 
199.17  including the promulgation of rules making uniformly available 
199.18  medical care benefits to all recipients of public assistance, at 
199.19  such times as the federal government increases its participation 
199.20  in assistance expenditures for medical care to recipients of 
199.21  public assistance, the cost thereof to be borne in the same 
199.22  proportion as are grants of aid to said recipients. 
199.23     (7) Establish and maintain any administrative units 
199.24  reasonably necessary for the performance of administrative 
199.25  functions common to all divisions of the department. 
199.26     (8) Act as designated guardian of both the estate and the 
199.27  person of all the wards of the state of Minnesota, whether by 
199.28  operation of law or by an order of court, without any further 
199.29  act or proceeding whatever, except as to persons committed as 
199.30  mentally retarded.  For children under the guardianship of the 
199.31  commissioner whose interests would be best served by adoptive 
199.32  placement, the commissioner may contract with a licensed 
199.33  child-placing agency to provide adoption services.  A contract 
199.34  with a licensed child-placing agency must be designed to 
199.35  supplement existing county efforts and may not replace existing 
199.36  county programs, unless the replacement is agreed to by the 
200.1   county board and the appropriate exclusive bargaining 
200.2   representative or the commissioner has evidence that child 
200.3   placements of the county continue to be substantially below that 
200.4   of other counties. 
200.5      (9) Act as coordinating referral and informational center 
200.6   on requests for service for newly arrived immigrants coming to 
200.7   Minnesota. 
200.8      (10) The specific enumeration of powers and duties as 
200.9   hereinabove set forth shall in no way be construed to be a 
200.10  limitation upon the general transfer of powers herein contained. 
200.11     (11) Establish county, regional, or statewide schedules of 
200.12  maximum fees and charges which may be paid by county agencies 
200.13  for medical, dental, surgical, hospital, nursing and nursing 
200.14  home care and medicine and medical supplies under all programs 
200.15  of medical care provided by the state and for congregate living 
200.16  care under the income maintenance programs. 
200.17     (12) Have the authority to conduct and administer 
200.18  experimental projects to test methods and procedures of 
200.19  administering assistance and services to recipients or potential 
200.20  recipients of public welfare.  To carry out such experimental 
200.21  projects, it is further provided that the commissioner of human 
200.22  services is authorized to waive the enforcement of existing 
200.23  specific statutory program requirements, rules, and standards in 
200.24  one or more counties.  The order establishing the waiver shall 
200.25  provide alternative methods and procedures of administration, 
200.26  shall not be in conflict with the basic purposes, coverage, or 
200.27  benefits provided by law, and in no event shall the duration of 
200.28  a project exceed four years.  It is further provided that no 
200.29  order establishing an experimental project as authorized by the 
200.30  provisions of this section shall become effective until the 
200.31  following conditions have been met: 
200.32     (a) The secretary of health, education, and welfare of the 
200.33  United States has agreed, for the same project, to waive state 
200.34  plan requirements relative to statewide uniformity. 
200.35     (b) A comprehensive plan, including estimated project 
200.36  costs, shall be approved by the legislative advisory commission 
201.1   and filed with the commissioner of administration.  
201.2      (13) According to federal requirements, establish 
201.3   procedures to be followed by local welfare boards in creating 
201.4   citizen advisory committees, including procedures for selection 
201.5   of committee members. 
201.6      (14) Allocate federal fiscal disallowances or sanctions 
201.7   which are based on quality control error rates for the aid to 
201.8   families with dependent children, Minnesota family investment 
201.9   program-statewide, medical assistance, or food stamp program in 
201.10  the following manner:  
201.11     (a) One-half of the total amount of the disallowance shall 
201.12  be borne by the county boards responsible for administering the 
201.13  programs.  For the medical assistance, MFIP-S, and AFDC 
201.14  programs, disallowances shall be shared by each county board in 
201.15  the same proportion as that county's expenditures for the 
201.16  sanctioned program are to the total of all counties' 
201.17  expenditures for the AFDC, MFIP-S, and medical assistance 
201.18  programs.  For the food stamp program, sanctions shall be shared 
201.19  by each county board, with 50 percent of the sanction being 
201.20  distributed to each county in the same proportion as that 
201.21  county's administrative costs for food stamps are to the total 
201.22  of all food stamp administrative costs for all counties, and 50 
201.23  percent of the sanctions being distributed to each county in the 
201.24  same proportion as that county's value of food stamp benefits 
201.25  issued are to the total of all benefits issued for all 
201.26  counties.  Each county shall pay its share of the disallowance 
201.27  to the state of Minnesota.  When a county fails to pay the 
201.28  amount due hereunder, the commissioner may deduct the amount 
201.29  from reimbursement otherwise due the county, or the attorney 
201.30  general, upon the request of the commissioner, may institute 
201.31  civil action to recover the amount due. 
201.32     (b) Notwithstanding the provisions of paragraph (a), if the 
201.33  disallowance results from knowing noncompliance by one or more 
201.34  counties with a specific program instruction, and that knowing 
201.35  noncompliance is a matter of official county board record, the 
201.36  commissioner may require payment or recover from the county or 
202.1   counties, in the manner prescribed in paragraph (a), an amount 
202.2   equal to the portion of the total disallowance which resulted 
202.3   from the noncompliance, and may distribute the balance of the 
202.4   disallowance according to paragraph (a).  
202.5      (15) Develop and implement special projects that maximize 
202.6   reimbursements and result in the recovery of money to the 
202.7   state.  For the purpose of recovering state money, the 
202.8   commissioner may enter into contracts with third parties.  Any 
202.9   recoveries that result from projects or contracts entered into 
202.10  under this paragraph shall be deposited in the state treasury 
202.11  and credited to a special account until the balance in the 
202.12  account reaches $1,000,000.  When the balance in the account 
202.13  exceeds $1,000,000, the excess shall be transferred and credited 
202.14  to the general fund.  All money in the account is appropriated 
202.15  to the commissioner for the purposes of this paragraph. 
202.16     (16) Have the authority to make direct payments to 
202.17  facilities providing shelter to women and their children 
202.18  according to section 256D.05, subdivision 3.  Upon the written 
202.19  request of a shelter facility that has been denied payments 
202.20  under section 256D.05, subdivision 3, the commissioner shall 
202.21  review all relevant evidence and make a determination within 30 
202.22  days of the request for review regarding issuance of direct 
202.23  payments to the shelter facility.  Failure to act within 30 days 
202.24  shall be considered a determination not to issue direct payments.
202.25     (17) Have the authority to establish and enforce the 
202.26  following county reporting requirements:  
202.27     (a) The commissioner shall establish fiscal and statistical 
202.28  reporting requirements necessary to account for the expenditure 
202.29  of funds allocated to counties for human services programs.  
202.30  When establishing financial and statistical reporting 
202.31  requirements, the commissioner shall evaluate all reports, in 
202.32  consultation with the counties, to determine if the reports can 
202.33  be simplified or the number of reports can be reduced. 
202.34     (b) The county board shall submit monthly or quarterly 
202.35  reports to the department as required by the commissioner.  
202.36  Monthly reports are due no later than 15 working days after the 
203.1   end of the month.  Quarterly reports are due no later than 30 
203.2   calendar days after the end of the quarter, unless the 
203.3   commissioner determines that the deadline must be shortened to 
203.4   20 calendar days to avoid jeopardizing compliance with federal 
203.5   deadlines or risking a loss of federal funding.  Only reports 
203.6   that are complete, legible, and in the required format shall be 
203.7   accepted by the commissioner.  
203.8      (c) If the required reports are not received by the 
203.9   deadlines established in clause (b), the commissioner may delay 
203.10  payments and withhold funds from the county board until the next 
203.11  reporting period.  When the report is needed to account for the 
203.12  use of federal funds and the late report results in a reduction 
203.13  in federal funding, the commissioner shall withhold from the 
203.14  county boards with late reports an amount equal to the reduction 
203.15  in federal funding until full federal funding is received.  
203.16     (d) A county board that submits reports that are late, 
203.17  illegible, incomplete, or not in the required format for two out 
203.18  of three consecutive reporting periods is considered 
203.19  noncompliant.  When a county board is found to be noncompliant, 
203.20  the commissioner shall notify the county board of the reason the 
203.21  county board is considered noncompliant and request that the 
203.22  county board develop a corrective action plan stating how the 
203.23  county board plans to correct the problem.  The corrective 
203.24  action plan must be submitted to the commissioner within 45 days 
203.25  after the date the county board received notice of noncompliance.
203.26     (e) The final deadline for fiscal reports or amendments to 
203.27  fiscal reports is one year after the date the report was 
203.28  originally due.  If the commissioner does not receive a report 
203.29  by the final deadline, the county board forfeits the funding 
203.30  associated with the report for that reporting period and the 
203.31  county board must repay any funds associated with the report 
203.32  received for that reporting period. 
203.33     (f) The commissioner may not delay payments, withhold 
203.34  funds, or require repayment under paragraph (c) or (e) if the 
203.35  county demonstrates that the commissioner failed to provide 
203.36  appropriate forms, guidelines, and technical assistance to 
204.1   enable the county to comply with the requirements.  If the 
204.2   county board disagrees with an action taken by the commissioner 
204.3   under paragraph (c) or (e), the county board may appeal the 
204.4   action according to sections 14.57 to 14.69. 
204.5      (g) Counties subject to withholding of funds under 
204.6   paragraph (c) or forfeiture or repayment of funds under 
204.7   paragraph (e) shall not reduce or withhold benefits or services 
204.8   to clients to cover costs incurred due to actions taken by the 
204.9   commissioner under paragraph (c) or (e). 
204.10     (18) Allocate federal fiscal disallowances or sanctions for 
204.11  audit exceptions when federal fiscal disallowances or sanctions 
204.12  are based on a statewide random sample for the foster care 
204.13  program under title IV-E of the Social Security Act, United 
204.14  States Code, title 42, in direct proportion to each county's 
204.15  title IV-E foster care maintenance claim for that period. 
204.16     (19) Be responsible for ensuring the detection, prevention, 
204.17  investigation, and resolution of fraudulent activities or 
204.18  behavior by applicants, recipients, and other participants in 
204.19  the human services programs administered by the department. 
204.20     (20) Require county agencies to identify overpayments, 
204.21  establish claims, and utilize all available and cost-beneficial 
204.22  methodologies to collect and recover these overpayments in the 
204.23  human services programs administered by the department. 
204.24     (21) Have the authority to administer a drug rebate program 
204.25  for drugs purchased pursuant to the senior citizen drug program 
204.26  established under section 256.955 after the beneficiary's 
204.27  satisfaction of any deductible established in the program.  The 
204.28  commissioner shall require a rebate agreement from all 
204.29  manufacturers of covered drugs as defined in section 256B.0625, 
204.30  subdivision 13.  For each drug, the amount of the rebate shall 
204.31  be equal to the basic rebate as defined for purposes of the 
204.32  federal rebate program in United States Code, title 42, section 
204.33  1396r-8(c)(1).  This basic rebate shall be applied to 
204.34  single-source and multiple-source drugs.  The manufacturers must 
204.35  provide full payment within 30 days of receipt of the state 
204.36  invoice for the rebate within the terms and conditions used for 
205.1   the federal rebate program established pursuant to section 1927 
205.2   of title XIX of the Social Security Act.  The manufacturers must 
205.3   provide the commissioner with any information necessary to 
205.4   verify the rebate determined per drug.  The rebate program shall 
205.5   utilize the terms and conditions used for the federal rebate 
205.6   program established pursuant to section 1927 of title XIX of the 
205.7   Social Security Act. 
205.8      Sec. 6.  Minnesota Statutes 1996, section 256.014, 
205.9   subdivision 1, is amended to read: 
205.10     Subdivision 1.  [ESTABLISHMENT OF SYSTEMS.] The 
205.11  commissioner of human services shall establish and enhance 
205.12  computer systems necessary for the efficient operation of the 
205.13  programs the commissioner supervises, including: 
205.14     (1) management and administration of the food stamp and 
205.15  income maintenance programs, including the electronic 
205.16  distribution of benefits; 
205.17     (2) management and administration of the child support 
205.18  enforcement program; and 
205.19     (3) administration of medical assistance and general 
205.20  assistance medical care. 
205.21     The commissioner shall distribute the nonfederal share of 
205.22  the costs of operating and maintaining the systems to the 
205.23  commissioner and to the counties participating in the system in 
205.24  a manner that reflects actual system usage, except that the 
205.25  nonfederal share of the costs of the MAXIS computer system and 
205.26  child support enforcement systems shall be borne entirely by the 
205.27  commissioner.  Development costs must not be assessed against 
205.28  county agencies. 
205.29     The commissioner may enter into contractual agreements with 
205.30  federally recognized Indian tribes with a reservation in 
205.31  Minnesota to participate in state-operated computer systems 
205.32  related to the management and administration of the food stamp, 
205.33  income maintenance, child support enforcement, and medical 
205.34  assistance and general assistance medical care programs to the 
205.35  extent necessary for the tribe to operate a federally approved 
205.36  family assistance program or any other program under the 
206.1   supervision of the commissioner. 
206.2      Sec. 7.  Minnesota Statutes 1997 Supplement, section 
206.3   256.031, subdivision 6, is amended to read: 
206.4      Subd. 6.  [END OF FIELD TRIALS.] (a) Upon agreement with 
206.5   the federal government, the field trials of the Minnesota family 
206.6   investment plan will end June 30, 1998.  
206.7      (b) Families in the comparison group under subdivision 3, 
206.8   paragraph (d), clause (i), receiving aid to families with 
206.9   dependent children under sections 256.72 to 256.87, and STRIDE 
206.10  services under section 256.736 will continue in those programs 
206.11  until June 30, 1998.  After June 30, 1998, families who cease 
206.12  receiving assistance under the Minnesota family investment plan 
206.13  and comparison group families who cease receiving assistance 
206.14  under AFDC and STRIDE who are eligible for the Minnesota family 
206.15  investment program-statewide (MFIP-S), medical assistance, 
206.16  general assistance medical care, or the food stamp program shall 
206.17  be placed with their consent on the programs for which they are 
206.18  eligible. 
206.19     (c) Families who cease receiving assistance under the MFIP 
206.20  and comparison families who cease receiving assistance under 
206.21  AFDC and STRIDE who are ineligible for MFIP-S due to increased 
206.22  income from employment, or increased child or spousal support or 
206.23  a combination of employment income and child or spousal support, 
206.24  will be eligible for extended medical assistance under section 
206.25  256B.0635.  For the purpose of determining receipt of extended 
206.26  medical assistance, receipt of AFDC and MFIP will be the same as 
206.27  receipt of MFIP-S. 
206.28     Sec. 8.  Minnesota Statutes 1997 Supplement, section 
206.29  256.9864, is amended to read: 
206.30     256.9864 [REPORTS BY RECIPIENT.] 
206.31     (a) An assistance unit with a recent work history or with 
206.32  earned income shall report monthly to the county agency on 
206.33  income received and other circumstances affecting eligibility or 
206.34  assistance amounts.  All other assistance units shall report on 
206.35  income and other circumstances affecting eligibility and 
206.36  assistance amounts, as specified by the state agency. 
207.1      (b) An assistance unit required to submit a report on the 
207.2   form designated by the commissioner and within ten days of the 
207.3   due date or the date of the significant change, whichever is 
207.4   later, or otherwise report significant changes which would 
207.5   affect eligibility or assistance amounts, is considered to have 
207.6   continued its application for assistance effective the date the 
207.7   required report is received by the county agency, if a complete 
207.8   report is received within a calendar month in which assistance 
207.9   was received, except that no assistance shall be paid for the 
207.10  period beginning with the end of the month in which the report 
207.11  was due and ending with the date the report was received by the 
207.12  county agency. 
207.13     Sec. 9.  Minnesota Statutes 1997 Supplement, section 
207.14  256B.062, is amended to read: 
207.15     256B.062 [CONTINUED ELIGIBILITY.] 
207.16     Medical assistance may be paid for persons who received aid 
207.17  to families with dependent children in at least three of the six 
207.18  months preceding the month in which the person became ineligible 
207.19  for aid to families with dependent children, if the 
207.20  ineligibility was due to an increase in hours of employment or 
207.21  employment income or due to the loss of an earned income 
207.22  disregard.  A person who is eligible for extended medical 
207.23  assistance is entitled to six months of assistance without 
207.24  reapplication, unless the assistance unit ceases to include a 
207.25  dependent child.  For a person under 21 years of age, medical 
207.26  assistance may not be discontinued within the six-month period 
207.27  of extended eligibility until it has been determined that the 
207.28  person is not otherwise eligible for medical assistance.  
207.29  Medical assistance may be continued for an additional six months 
207.30  if the person meets all requirements for the additional six 
207.31  months, according to Title XIX of the Social Security Act, as 
207.32  amended by section 303 of the Family Support Act of 1988, Public 
207.33  Law Number 100-485.  This section is repealed effective March 31 
207.34  July 1, 1998.  
207.35     Sec. 10.  Minnesota Statutes 1997 Supplement, section 
207.36  256D.05, subdivision 8, is amended to read: 
208.1      Subd. 8.  [CITIZENSHIP.] (a) Effective July 1, 1997, 
208.2   citizenship requirements for applicants and recipients under 
208.3   sections 256D.01 to 256D.03, subdivision 2, and 256D.04 to 
208.4   256D.21 shall be determined the same as under section 256J.11, 
208.5   except that legal noncitizens who are applicants or recipients 
208.6   must have been residents of Minnesota on March 1, 1997.  Legal 
208.7   noncitizens who arrive in Minnesota after March 1, 1997, and 
208.8   become elderly or disabled after that date, and are otherwise 
208.9   eligible for general assistance can receive benefits under this 
208.10  section.  The income and assets of sponsors of noncitizens shall 
208.11  be deemed available to general assistance applicants and 
208.12  recipients according to the Personal Responsibility and Work 
208.13  Opportunity Reconciliation Act of 1996, Public Law Number 
208.14  104-193, title IV, sections 421 and 422, and subsequently set 
208.15  out in federal rules. 
208.16     (b) As a condition of eligibility, each legal adult 
208.17  noncitizen in the assistance unit who has resided in the country 
208.18  for four years or more and who is under 70 years of age must: 
208.19     (1) be enrolled in a literacy class, English as a second 
208.20  language class, or a citizen class; 
208.21     (2) be applying for admission to a literacy class, English 
208.22  as a second language class, and is on a waiting list; 
208.23     (3) be in the process of applying for a waiver from the 
208.24  Immigration and Naturalization Service of the English language 
208.25  or civics requirements of the citizenship test; 
208.26     (4) have submitted an application for citizenship to the 
208.27  Immigration and Naturalization Service and is waiting for a 
208.28  testing date or a subsequent swearing in ceremony; or 
208.29     (5) have been denied citizenship due to a failure to pass 
208.30  the test after two attempts or because of an inability to 
208.31  understand the rights and responsibilities of becoming a United 
208.32  States citizen, as documented by the Immigration and 
208.33  Naturalization Service or the county. 
208.34     If the county social service agency determines that a legal 
208.35  noncitizen subject to the requirements of this subdivision will 
208.36  require more than one year of English language training, then 
209.1   the requirements of clause (1) or (2) shall be imposed after the 
209.2   legal noncitizen has resided in the country for three years.  
209.3   Individuals who reside in a facility licensed under chapter 
209.4   144A, 144D, 245A, or 256I are exempt from the requirements of 
209.5   this section. 
209.6      Sec. 11.  Minnesota Statutes 1996, section 256D.051, is 
209.7   amended by adding a subdivision to read: 
209.8      Subd. 19.  [WAIVER OF SERVICE COST REIMBURSEMENT LIMIT FOR 
209.9   PARTICIPANTS WITH SIGNIFICANT BARRIERS TO EMPLOYMENT.] To the 
209.10  extent of available resources, the commissioner may waive the 
209.11  $400 service cost limit specified in subdivision 6 for county 
209.12  agencies that propose to provide enhanced services under the 
209.13  food stamp employment and training program for hard-to-employ 
209.14  individuals.  A "hard-to-employ individual" is defined as: 
209.15     (1) a recipient of general assistance under chapter 256D; 
209.16  or 
209.17     (2) an individual with at least two of the following three 
209.18  barriers to employment: 
209.19     (i) the individual has not completed secondary school or 
209.20  obtained a certificate of general equivalency, and has low 
209.21  skills in reading or mathematics; 
209.22     (ii) the individual requires substance abuse treatment for 
209.23  employment; and 
209.24     (iii) the individual has a poor work history. 
209.25     To obtain a waiver, the county agency must submit a waiver 
209.26  request to the commissioner.  The request must specify:  
209.27     (1) the number of hard-to-employ individuals the agency 
209.28  plans to serve; and 
209.29     (2) the nature of the enhanced employment and training 
209.30  services the agency will provide. 
209.31     Sec. 12.  [256D.053] [MINNESOTA FOOD ASSISTANCE PROGRAM.] 
209.32     Subdivision 1.  [PROGRAM ESTABLISHED.] For the period of 
209.33  July 1, 1998, to June 30, 1999, the Minnesota food assistance 
209.34  program is established to provide food assistance to legal 
209.35  noncitizens residing in this state who are ineligible to 
209.36  participate in the federal Food Stamp Program solely due to the 
210.1   provisions of section 402 or 403 of Public Law Number 104-193, 
210.2   as authorized by Title VII of the 1997 Emergency Supplemental 
210.3   Appropriations Act, Public Law Number 105-18. 
210.4      Subd. 2.  [ELIGIBILITY REQUIREMENTS.] To be eligible for 
210.5   the Minnesota food assistance program, all of the following 
210.6   conditions must be met: 
210.7      (1) the applicant must meet the initial and ongoing 
210.8   eligibility requirements for the federal Food Stamp Program, 
210.9   except for the applicant's ineligible immigration status; 
210.10     (2) the applicant must be either a qualified noncitizen as 
210.11  defined in section 256J.08, subdivision 73, or a noncitizen 
210.12  otherwise residing lawfully in the United States; 
210.13     (3) the applicant must be a resident of the state; and 
210.14     (4) the applicant must not be receiving assistance under 
210.15  the MFIP-S or the work first program. 
210.16     Subd. 3.  [PROGRAM ADMINISTRATION.] (a) The rules for the 
210.17  Minnesota food assistance program shall follow exactly the 
210.18  regulations for the federal Food Stamp Program, except for the 
210.19  provisions pertaining to immigration status under sections 402 
210.20  or 403 of Public Law Number 104-193. 
210.21     (b) The county agency shall use the income, budgeting, and 
210.22  benefit allotment regulations of the federal Food Stamp Program 
210.23  to calculate an eligible recipient's monthly Minnesota food 
210.24  assistance program benefit.  Until September 30, 1998, eligible 
210.25  recipients under this subdivision shall receive the average per 
210.26  person food stamp issuance in Minnesota in the fiscal year 
210.27  ending June 30, 1997.  Beginning October 1, 1998, eligible 
210.28  recipients shall receive the same level of benefits as those 
210.29  provided by the federal Food Stamp Program to similarly situated 
210.30  citizen recipients.  The monthly Minnesota food assistance 
210.31  program benefits shall not exceed an amount equal to the amount 
210.32  of federal Food Stamp Program benefits the household would 
210.33  receive if all members of the household were eligible for the 
210.34  federal Food Stamp Program. 
210.35     (c) Minnesota food assistance program benefits must be 
210.36  disregarded as income in all programs that do not count food 
211.1   stamps as income. 
211.2      (d) The county agency must redetermine a Minnesota food 
211.3   assistance program recipient's eligibility for the federal Food 
211.4   Stamp Program when the agency receives information that the 
211.5   recipient's legal immigration status has changed in such a way 
211.6   that would make the recipient potentially eligible for the 
211.7   federal Food Stamp Program. 
211.8      (e) Until October 1, 1998, the commissioner may provide 
211.9   benefits under this section in cash. 
211.10     Subd. 4.  [STATE PLAN REQUIRED.] The commissioner shall 
211.11  submit a state plan to the secretary of agriculture to allow the 
211.12  commissioner to purchase federal Food Stamp Program benefits for 
211.13  each Minnesota food assistance program recipient who is 
211.14  ineligible to participate in the federal Food Stamp Program 
211.15  solely due to the provisions of section 402 or 403 of Public Law 
211.16  Number 104-193, as authorized by Title VII of the 1997 Emergency 
211.17  Supplemental Appropriations Act, Public Law Number 105-18.  The 
211.18  commissioner shall enter into a contract as necessary with the 
211.19  secretary to use the existing federal Food Stamp Program 
211.20  benefits delivery system for the purposes of administering the 
211.21  Minnesota food assistance program under this section. 
211.22     Sec. 13.  Minnesota Statutes 1996, section 256D.46, 
211.23  subdivision 2, is amended to read: 
211.24     Subd. 2.  [INCOME AND RESOURCE TEST.] All income and 
211.25  resources available to the recipient must be considered in 
211.26  determining the recipient's ability to meet the emergency need.  
211.27  Property that can be liquidated in time to resolve the emergency 
211.28  and income, (excluding Minnesota supplemental aid issued for 
211.29  current month's need) an amount equal to the Minnesota 
211.30  supplemental aid standard of assistance, that is normally 
211.31  disregarded or excluded under the Minnesota supplemental aid 
211.32  program must be considered available to meet the emergency need. 
211.33     Sec. 14.  Minnesota Statutes 1997 Supplement, section 
211.34  256J.02, subdivision 4, is amended to read: 
211.35     Subd. 4.  [AUTHORITY TO TRANSFER.] Subject to limitations 
211.36  of title I of Public Law Number 104-193, the Personal 
212.1   Responsibility and Work Opportunity Reconciliation Act of 
212.2   1996, as amended, the legislature may transfer money from the 
212.3   TANF block grant to the child care fund under chapter 119B, or 
212.4   the Title XX block grant under section 256E.07. 
212.5      Sec. 15.  Minnesota Statutes 1997 Supplement, section 
212.6   256J.03, is amended to read: 
212.7      256J.03 [TANF RESERVE ACCOUNT.] 
212.8      Subdivision 1.  The Minnesota family investment 
212.9   program-statewide/TANF TANF reserve account is created in the 
212.10  state treasury.  Funds retained or deposited in the TANF reserve 
212.11  shall include:  (1) funds designated by the legislature and; (2) 
212.12  unexpended state funds resulting from the acceleration of TANF 
212.13  expenditures under subdivision 2; (3) earnings available from 
212.14  the federal TANF block grant appropriated to the commissioner 
212.15  but not expended in the biennium beginning July 1, 1997, shall 
212.16  be retained; and (4) TANF funds available in fiscal years 1998, 
212.17  1999, 2000, and 2001 that are not spent or not budgeted to be 
212.18  spent in those years. 
212.19     Funds deposited in the reserve account to must be expended 
212.20  for the Minnesota family investment program-statewide in fiscal 
212.21  year 2000 and subsequent fiscal years and directly related state 
212.22  programs for the purposes in subdivision 3. 
212.23     Subd. 2.  [AUTHORIZATION TO ACCELERATE EXPENDITURE OF TANF 
212.24  FUNDS.] The commissioner may expend federal TANF block grant 
212.25  funds in excess of appropriated levels for the purpose of 
212.26  accelerating federal funding of the MFIP program.  By the end of 
212.27  the fiscal year in which the additional federal expenditures are 
212.28  made, the commissioner must deposit into the reserve account an 
212.29  amount of unexpended state funds appropriated for assistance to 
212.30  families grants, AFDC, and MFIP equal to the additional federal 
212.31  expenditures.  Reserve funds may be spent as TANF appropriations 
212.32  if insufficient TANF funds are available because of acceleration.
212.33     Subd. 3.  [ALLOWED TRANSFER PURPOSE.] Funds from the 
212.34  reserve account may be used for the following purposes: 
212.35     (1) unanticipated TANF block grant maintenance of effort 
212.36  shortfalls; 
213.1      (2) MFIP cost increases due to reduced federal revenues and 
213.2   federal law changes; 
213.3      (3) one-half of the MFIP general fund cost increase in 
213.4   fiscal year 2000 and subsequent fiscal years due to caseload 
213.5   increases over fiscal year 1999; and 
213.6      (4) transfers allowed under section 256J.02, subdivision 4. 
213.7      Sec. 16.  Minnesota Statutes 1997 Supplement, section 
213.8   256J.08, subdivision 11, is amended to read: 
213.9      Subd. 11.  [CAREGIVER.] "Caregiver" means a minor child's 
213.10  natural or adoptive parent or parents and stepparent who live in 
213.11  the home with the minor child.  For purposes of determining 
213.12  eligibility for this program, caregiver also means any of the 
213.13  following individuals, if adults, who live with and provide care 
213.14  and support to a minor child when the minor child's natural or 
213.15  adoptive parent or parents or stepparents do not reside in the 
213.16  same home:  legal custodians custodian or guardian, grandfather, 
213.17  grandmother, brother, sister, stepfather, stepmother, 
213.18  stepbrother, stepsister, uncle, aunt, first cousin, nephew, 
213.19  niece, person of preceding generation as denoted by prefixes of 
213.20  "great," "great-great," or "great-great-great," or a spouse of 
213.21  any person named in the above groups even after the marriage 
213.22  ends by death or divorce. 
213.23     Sec. 17.  Minnesota Statutes 1997 Supplement, section 
213.24  256J.08, is amended by adding a subdivision to read: 
213.25     Subd. 24a.  [DISQUALIFIED.] "Disqualified" means being 
213.26  ineligible to receive MFIP-S due to noncooperation with program 
213.27  requirements.  Except for persons whose disqualification is 
213.28  based on fraud, a disqualified person can take action to correct 
213.29  the reason for ineligibility.  
213.30     Sec. 18.  Minnesota Statutes 1997 Supplement, section 
213.31  256J.08, subdivision 26, is amended to read: 
213.32     Subd. 26.  [EARNED INCOME.] "Earned income" means cash or 
213.33  in-kind income earned through the receipt of wages, salary, 
213.34  commissions, profit from employment activities, net profit from 
213.35  self-employment activities, payments made by an employer for 
213.36  regularly accrued vacation or sick leave, and any other profit 
214.1   from activity earned through effort or labor.  The income must 
214.2   be in return for, or as a result of, legal activity.  
214.3      Sec. 19.  Minnesota Statutes 1997 Supplement, section 
214.4   256J.08, subdivision 28, is amended to read: 
214.5      Subd. 28.  [EMERGENCY.] "Emergency" means a situation or a 
214.6   set of circumstances that causes or threatens to cause 
214.7   destitution to a minor child family with a child under age 21.  
214.8      Sec. 20.  Minnesota Statutes 1997 Supplement, section 
214.9   256J.08, subdivision 40, is amended to read: 
214.10     Subd. 40.  [GROSS EARNED INCOME.] "Gross earned income" 
214.11  means earned income from employment before mandatory and 
214.12  voluntary payroll deductions.  Gross earned income includes 
214.13  salaries, wages, tips, gratuities, commissions, incentive 
214.14  payments from work or training programs, payments made by an 
214.15  employer for regularly accrued vacation or sick leave, and 
214.16  profits from other activity earned by an individual's effort or 
214.17  labor.  Gross earned income includes uniform and meal allowances 
214.18  if federal income tax is deducted from the allowance.  Gross 
214.19  earned income includes flexible work benefits received from an 
214.20  employer if the employee has the option of receiving the benefit 
214.21  or benefits in cash.  For self-employment, gross earned income 
214.22  is the nonexcluded income minus expenses for the business.  
214.23     Sec. 21.  Minnesota Statutes 1997 Supplement, section 
214.24  256J.08, is amended by adding a subdivision to read: 
214.25     Subd. 50a.  [INTERSTATE TRANSITIONAL STANDARD.] "Interstate 
214.26  transitional standard" means a combination of the cash 
214.27  assistance a family with no other income would have received in 
214.28  the state of previous residence and the Minnesota food portion 
214.29  for the appropriate size family. 
214.30     Sec. 22.  Minnesota Statutes 1997 Supplement, section 
214.31  256J.08, is amended by adding a subdivision to read: 
214.32     Subd. 51a.  [LEGAL CUSTODIAN.] "Legal custodian" means any 
214.33  person who is under a legal obligation to provide care for a 
214.34  minor and who is in fact providing care for a minor.  For an 
214.35  Indian child, "custodian" means any Indian person who has legal 
214.36  custody of an Indian child under tribal law or custom, under 
215.1   state law, or to whom temporary physical care, custody, and 
215.2   control has been transferred by the parent of the child, as 
215.3   provided in section 257.351, subdivision 8. 
215.4      Sec. 23.  Minnesota Statutes 1997 Supplement, section 
215.5   256J.08, subdivision 60, is amended to read: 
215.6      Subd. 60.  [MINOR CHILD.] "Minor child" means a child who 
215.7   is living in the same home of a parent or other caregiver, is 
215.8   not the parent of a child in the home, and is either less than 
215.9   18 years of age or is under the age of 19 years and is regularly 
215.10  attending as a full-time student and is expected to complete a 
215.11  high school or in a secondary school or pursuing a full-time 
215.12  secondary level course of vocational or technical training 
215.13  designed to fit students for gainful employment before reaching 
215.14  age 19. 
215.15     Sec. 24.  Minnesota Statutes 1997 Supplement, section 
215.16  256J.08, is amended by adding a subdivision to read: 
215.17     Subd. 61a.  [NONCUSTODIAL PARENT.] "Noncustodial parent" 
215.18  means a minor child's parent who does not live in the same home 
215.19  as the child.  
215.20     Sec. 25.  Minnesota Statutes 1997 Supplement, section 
215.21  256J.08, subdivision 68, is amended to read: 
215.22     Subd. 68.  [PERSONAL PROPERTY.] "Personal property" means 
215.23  an item of value that is not real property, including the value 
215.24  of a contract for deed held by a seller, assets held in trust on 
215.25  behalf of members of an assistance unit, cash surrender value of 
215.26  life insurance, value of a prepaid burial, savings account, 
215.27  value of stocks and bonds, and value of retirement accounts. 
215.28     Sec. 26.  Minnesota Statutes 1997 Supplement, section 
215.29  256J.08, subdivision 73, is amended to read: 
215.30     Subd. 73.  [QUALIFIED NONCITIZEN.] "Qualified noncitizen" 
215.31  means a person: 
215.32     (1) who was lawfully admitted for permanent residence 
215.33  pursuant to United States Code, title 8; 
215.34     (2) who was admitted to the United States as a refugee 
215.35  pursuant to United States Code, title 8; section 1157; 
215.36     (3) whose deportation is being withheld pursuant to United 
216.1   States Code, title 8, section 1253(h); 
216.2      (4) who was paroled for a period of at least one year 
216.3   pursuant to United States Code, title 8, section 1182(d)(5); 
216.4      (5) who was granted conditional entry pursuant to United 
216.5   State Code, title 8, section 1153(a)(7); 
216.6      (6) who was granted asylum pursuant to United States Code, 
216.7   title 8, section 1158; or 
216.8      (7) determined to be a battered noncitizen by the United 
216.9   States Attorney General according to the Illegal Immigration 
216.10  Reform and Immigrant Responsibility Act of 1996, Title V of the 
216.11  Omnibus Consolidated Appropriations Bill, Public Law Number 
216.12  104-208; or 
216.13     (8) who was admitted as a Cuban or Haitian entrant. 
216.14     Sec. 27.  Minnesota Statutes 1997 Supplement, section 
216.15  256J.08, is amended by adding a subdivision to read: 
216.16     Subd. 82a.  [SHELTER COSTS.] "Shelter costs" means rent, 
216.17  manufactured home lot rental costs, or monthly principal, 
216.18  interest, insurance premiums, and property taxes due for 
216.19  mortgages or contracts for deed. 
216.20     Sec. 28.  Minnesota Statutes 1997 Supplement, section 
216.21  256J.08, subdivision 83, is amended to read: 
216.22     Subd. 83.  [SIGNIFICANT CHANGE.] "Significant change" means 
216.23  a decline in gross income of 35 36 percent or more from the 
216.24  income used to determine the grant for the current month. 
216.25     Sec. 29.  Minnesota Statutes 1997 Supplement, section 
216.26  256J.09, subdivision 6, is amended to read: 
216.27     Subd. 6.  [INVALID REASON FOR DELAY.] A county agency must 
216.28  not delay a decision on eligibility or delay issuing the 
216.29  assistance payment except to establish state residence as 
216.30  provided in section 256J.12 by: 
216.31     (1) treating the 30-day processing period as a waiting 
216.32  period; 
216.33     (2) delaying approval or issuance of the assistance payment 
216.34  pending the decision of the county board; or 
216.35     (3) awaiting the result of a referral to a county agency in 
216.36  another county when the county receiving the application does 
217.1   not believe it is the county of financial responsibility. 
217.2      Sec. 30.  Minnesota Statutes 1997 Supplement, section 
217.3   256J.09, subdivision 9, is amended to read: 
217.4      Subd. 9.  [ADDENDUM TO AN EXISTING APPLICATION.] (a) An 
217.5   addendum to an existing application must be used to add persons 
217.6   to an assistance unit regardless of whether the persons being 
217.7   added are required to be in the assistance unit.  When a person 
217.8   is added by addendum to an assistance unit, eligibility for that 
217.9   person begins on the first of the month the addendum was filed 
217.10  except as provided in section 256J.74, subdivision 2, clause (1).
217.11     (b) An overpayment must be determined when a change in 
217.12  household composition is not reported within the deadlines in 
217.13  section 256J.30, subdivision 9.  Any overpayment must be 
217.14  calculated from the month of the change including the needs, 
217.15  income, and assets of any individual who is required to be 
217.16  included in the assistance unit under section 256J.24, 
217.17  subdivision 2.  Individuals not included in the assistance unit 
217.18  who are identified in section 256J.37, subdivisions 1 to 2, must 
217.19  have their income and assets considered when determining the 
217.20  amount of the overpayment. 
217.21     Sec. 31.  Minnesota Statutes 1997 Supplement, section 
217.22  256J.11, subdivision 2, as amended by Laws 1997, Third Special 
217.23  Session chapter 1, is amended to read: 
217.24     Subd. 2.  [NONCITIZENS; FOOD PORTION.] (a) For the period 
217.25  September 1, 1997, to October 31, 1997, noncitizens who do not 
217.26  meet one of the exemptions in section 412 of the Personal 
217.27  Responsibility and Work Opportunity Reconciliation Act of 1996, 
217.28  but were residing in this state as of July 1, 1997, are eligible 
217.29  for the 6/10 of the average value of food stamps for the same 
217.30  family size and composition until MFIP-S is operative in the 
217.31  noncitizen's county of financial responsibility and thereafter, 
217.32  the 6/10 of the food portion of MFIP-S.  However, federal food 
217.33  stamp dollars cannot be used to fund the food portion of MFIP-S 
217.34  benefits for an individual under this subdivision. 
217.35     (b) For the period November 1, 1997, to June 30, 1998 1999, 
217.36  noncitizens who do not meet one of the exemptions in section 412 
218.1   of the Personal Responsibility and Work Opportunity 
218.2   Reconciliation Act of 1996, but were residing in this state as 
218.3   of July 1, 1997, and are receiving cash assistance under the 
218.4   AFDC, family general assistance, MFIP or MFIP-S programs are 
218.5   eligible for the average value of food stamps for the same 
218.6   family size and composition until MFIP-S is operative in the 
218.7   noncitizen's county of financial responsibility and thereafter, 
218.8   the food portion of MFIP-S.  However, federal food stamp dollars 
218.9   cannot be used to fund the food portion of MFIP-S benefits for 
218.10  an individual under this subdivision.  The assistance provided 
218.11  under this subdivision, which is designated as a supplement to 
218.12  replace lost benefits under the federal food stamp program, must 
218.13  be disregarded as income in all programs that do not count food 
218.14  stamps as income where the commissioner has the authority to 
218.15  make the income disregard determination for the program. 
218.16     (c) The commissioner shall submit a state plan to the 
218.17  secretary of agriculture to allow the commissioner to purchase 
218.18  federal Food Stamp Program benefits in an amount equal to the 
218.19  MFIP-S food portion for each legal noncitizen receiving MFIP-S 
218.20  assistance who is ineligible to participate in the federal Food 
218.21  Stamp Program solely due to the provisions of section 402 or 403 
218.22  of Public Law Number 104-193, as authorized by Title VII of the 
218.23  1997 Emergency Supplemental Appropriations Act, Public Law 
218.24  Number 105-18.  The commissioner shall enter into a contract as 
218.25  necessary with the secretary to use the existing federal Food 
218.26  Stamp Program benefits delivery system for the purposes of 
218.27  administering the food portion of MFIP-S under this subdivision. 
218.28     Sec. 32.  Minnesota Statutes 1997 Supplement, section 
218.29  256J.12, is amended to read: 
218.30     256J.12 [MINNESOTA RESIDENCE.] 
218.31     Subdivision 1.  [SIMPLE RESIDENCY.] To be eligible for AFDC 
218.32  or MFIP-S, whichever is in effect, a family an assistance unit 
218.33  must have established residency in this state which means 
218.34  the family assistance unit is present in the state and intends 
218.35  to remain here.  A person who lives in this state and who 
218.36  entered this state with a job commitment or to seek employment 
219.1   in this state, whether or not that person is currently employed, 
219.2   meets the criteria in this subdivision.  
219.3      Subd. 1a.  [30-DAY RESIDENCY REQUIREMENT.] A family An 
219.4   assistance unit is considered to have established residency in 
219.5   this state only when a child or caregiver has resided in this 
219.6   state for at least 30 days with the intention of making the 
219.7   person's home here and not for any temporary purpose.  The birth 
219.8   of a child in Minnesota to a member of the assistance unit does 
219.9   not automatically meet the 30-day residency requirement for the 
219.10  members of the assistance unit.  Time spent in a shelter for 
219.11  battered women shall count toward satisfying the 30-day 
219.12  residency requirement. 
219.13     Subd. 2.  [EXCEPTIONS.] (a) A county shall waive the 30-day 
219.14  residency requirement where unusual hardship would result from 
219.15  denial of assistance. 
219.16     (b) For purposes of this section, unusual hardship means a 
219.17  family an assistance unit: 
219.18     (1) is without alternative shelter; or 
219.19     (2) is without available resources for food. 
219.20     (c) For purposes of this subdivision, the following 
219.21  definitions apply (1) "metropolitan statistical area" is as 
219.22  defined by the U.S. Census Bureau; (2) "alternative shelter" 
219.23  includes any shelter that is located within the metropolitan 
219.24  statistical area containing the county and for which the family 
219.25  is eligible, provided the family assistance unit does not have 
219.26  to travel more than 20 miles to reach the shelter and has access 
219.27  to transportation to the shelter.  Clause (2) does not apply to 
219.28  counties in the Minneapolis-St. Paul metropolitan statistical 
219.29  area. 
219.30     (d) Applicants meet the residency requirement if they once 
219.31  resided in Minnesota and: 
219.32     (1) joined the United States armed services, returned to 
219.33  Minnesota within 30 days of leaving the armed services, and 
219.34  intend to remain in Minnesota; or 
219.35     (2) left to attend school in another state, paid 
219.36  nonresident tuition or Minnesota tuition rates under a 
220.1   reciprocity agreement, and returned to Minnesota within 30 days 
220.2   of graduation with the intent to remain in Minnesota. 
220.3      (e) The 30-day residence requirement is met when: 
220.4      (1) a minor child or a minor caregiver moves from another 
220.5   state to the residence of a relative caregiver; 
220.6      (2) the minor caregiver applies for and receives family 
220.7   cash assistance; 
220.8      (3) the relative caregiver chooses not to be part of the 
220.9   MFIP-S assistance unit; and 
220.10     (4) the relative caregiver has resided in Minnesota for at 
220.11  least 30 days prior to the date the assistance unit applies for 
220.12  cash assistance.  
220.13     (f) Ineligible mandatory unit members who have resided in 
220.14  Minnesota for 12 months immediately before the date of 
220.15  application meet eligibility for the Minnesota payment standard 
220.16  for the other assistance unit members. 
220.17     Subd. 2a.  [MIGRANT WORKERS.] Migrant workers, as defined 
220.18  in section 256J.08, and their immediate families are exempt from 
220.19  the requirements of subdivisions 1 and 1a, provided the migrant 
220.20  worker provides verification that the migrant family worked in 
220.21  this state within the last 12 months and earned at least $1,000 
220.22  in gross wages during the time the migrant worker worked in this 
220.23  state. 
220.24     Subd. 3.  [PAYMENT PLAN FOR NEW RESIDENTS.] Assistance paid 
220.25  to an eligible family assistance unit in which all members have 
220.26  resided in this state for fewer than 12 consecutive calendar 
220.27  months immediately preceding the date of application shall be at 
220.28  the standard and in the form specified in section 256J.43. 
220.29     Subd. 4.  [SEVERABILITY CLAUSE.] If any subdivision in this 
220.30  section is enjoined from implementation or found 
220.31  unconstitutional by any court of competent jurisdiction, the 
220.32  remaining subdivisions shall remain valid and shall be given 
220.33  full effect. 
220.34     Sec. 33.  Minnesota Statutes 1997 Supplement, section 
220.35  256J.14, is amended to read: 
220.36     256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 
221.1      (a) The definitions in this paragraph only apply to this 
221.2   subdivision. 
221.3      (1) "Household of a parent, legal guardian, or other adult 
221.4   relative" means the place of residence of: 
221.5      (i) a natural or adoptive parent; 
221.6      (ii) a legal guardian according to appointment or 
221.7   acceptance under section 260.242, 525.615, or 525.6165, and 
221.8   related laws; or 
221.9      (iii) a caregiver as defined in section 256J.08, 
221.10  subdivision 11; or 
221.11     (iv) an appropriate adult relative designated by a county 
221.12  agency. 
221.13     (2) "Adult-supervised supportive living arrangement" means 
221.14  a private family setting which assumes responsibility for the 
221.15  care and control of the minor parent and minor child, or other 
221.16  living arrangement, not including a public institution, licensed 
221.17  by the commissioner of human services which ensures that the 
221.18  minor parent receives adult supervision and supportive services, 
221.19  such as counseling, guidance, independent living skills 
221.20  training, or supervision. 
221.21     (b) A minor parent and the minor child who is in the care 
221.22  of the minor parent must reside in the household of a parent, 
221.23  legal guardian, other appropriate adult relative, or other 
221.24  caregiver, or in an adult-supervised supportive living 
221.25  arrangement in order to receive MFIP-S unless: 
221.26     (1) the minor parent has no living parent, other 
221.27  appropriate adult relative, or legal guardian whose whereabouts 
221.28  is known; 
221.29     (2) no living parent, other appropriate adult relative, or 
221.30  legal guardian of the minor parent allows the minor parent to 
221.31  live in the parent's, appropriate other adult relative's, or 
221.32  legal guardian's home; 
221.33     (3) the minor parent lived apart from the minor parent's 
221.34  own parent or legal guardian for a period of at least one year 
221.35  before either the birth of the minor child or the minor parent's 
221.36  application for MFIP-S; 
222.1      (4) the physical or emotional health or safety of the minor 
222.2   parent or minor child would be jeopardized if the minor parent 
222.3   and the minor child resided in the same residence with the minor 
222.4   parent's parent, other appropriate adult relative, or legal 
222.5   guardian; or 
222.6      (5) an adult supervised supportive living arrangement is 
222.7   not available for the minor parent and the dependent child in 
222.8   the county in which the minor parent and child currently resides 
222.9   reside.  If an adult supervised supportive living arrangement 
222.10  becomes available within the county, the minor parent and child 
222.11  must reside in that arrangement. 
222.12     (c) Minor applicants must be informed orally and in writing 
222.13  about the eligibility requirements and their rights and 
222.14  obligations under the MFIP-S program.  The county must advise 
222.15  the minor of the possible exemptions and specifically ask 
222.16  whether one or more of these exemptions is applicable.  If the 
222.17  minor alleges one or more of these exemptions, then the county 
222.18  must assist the minor in obtaining the necessary verifications 
222.19  to determine whether or not these exemptions apply. 
222.20     (d) If the county worker has reason to suspect that the 
222.21  physical or emotional health or safety of the minor parent or 
222.22  minor child would be jeopardized if they resided with the minor 
222.23  parent's parent, other adult relative, or legal guardian, then 
222.24  the county worker must make a referral to child protective 
222.25  services to determine if paragraph (b), clause (4), applies.  A 
222.26  new determination by the county worker is not necessary if one 
222.27  has been made within the last six months, unless there has been 
222.28  a significant change in circumstances which justifies a new 
222.29  referral and determination. 
222.30     (e) If a minor parent is not living with a parent or, legal 
222.31  guardian, or other adult relative due to paragraph (b), clause 
222.32  (1), (2), or (4), the minor parent must reside, when possible, 
222.33  in a living arrangement that meets the standards of paragraph 
222.34  (a), clause (2). 
222.35     (f) When a minor parent and minor child live with another a 
222.36  parent, other adult relative, legal guardian, or in an 
223.1   adult-supervised supportive living arrangement, MFIP-S must be 
223.2   paid, when possible, in the form of a protective payment on 
223.3   behalf of the minor parent and minor child in accordance with 
223.4   according to section 256J.39, subdivisions 2 to 4. 
223.5      Sec. 34.  Minnesota Statutes 1997 Supplement, section 
223.6   256J.15, subdivision 2, is amended to read: 
223.7      Subd. 2.  [ELIGIBILITY DURING LABOR DISPUTES.] To receive 
223.8   assistance under MFIP-S, a member of an assistance unit who is 
223.9   on strike must have been an MFIP-S participant on the day before 
223.10  the strike, or have been eligible for MFIP-S on the day before 
223.11  the strike. 
223.12     The county agency must count the striker's prestrike 
223.13  earnings as current earnings.  When a member of an assistance 
223.14  unit who is not in the bargaining unit that voted for the strike 
223.15  does not cross the picket line for fear of personal injury, the 
223.16  assistance unit member is not a striker.  Except for a member of 
223.17  an assistance unit who is not in the bargaining unit that voted 
223.18  for the strike and who does not cross the picket line for fear 
223.19  of personal injury, a significant change cannot be invoked as a 
223.20  result of a labor dispute.  To receive assistance when a member 
223.21  of an assistance unit is on strike, or when an individual 
223.22  identified in section 256J.37, subdivisions 1 to 2, whose income 
223.23  and assets must be considered when determining eligibility for 
223.24  the unit is on strike, the assistance unit must have been 
223.25  receiving or been eligible for MFIP-S on the day before the 
223.26  strike.  The county agency must count the striker's prestrike 
223.27  earnings as current earnings.  A significant change cannot be 
223.28  invoked when a member of an assistance unit, or an individual 
223.29  identified in section 256J.37, subdivisions 1 to 2, is on 
223.30  strike.  A member of an assistance unit, or an individual 
223.31  identified in section 256J.37, subdivisions 1 and 2, is not 
223.32  considered a striker when that person is not in the bargaining 
223.33  unit that voted for the strike and does not cross the picket 
223.34  line for fear of personal injury. 
223.35     Sec. 35.  Minnesota Statutes 1997 Supplement, section 
223.36  256J.20, subdivision 2, is amended to read: 
224.1      Subd. 2.  [REAL PROPERTY LIMITATIONS.] Ownership of real 
224.2   property by an applicant or participant is subject to the 
224.3   limitations in paragraphs (a) and (b). 
224.4      (a) A county agency shall exclude the homestead of an 
224.5   applicant or participant according to clauses (1) to (4) (5): 
224.6      (1) an applicant or participant who is purchasing real 
224.7   property through a contract for deed and using that property as 
224.8   a home is considered the owner of real property; 
224.9      (2) the total amount of land that can be excluded under 
224.10  this subdivision is limited to surrounding property which is not 
224.11  separated from the home by intervening property owned by 
224.12  others.  Additional property must be assessed as to its legal 
224.13  and actual availability according to subdivision 1; 
224.14     (3) when real property that has been used as a home by a 
224.15  participant is sold, the county agency must treat the cash 
224.16  proceeds from the sale as excluded property for six months when 
224.17  the participant intends to reinvest the proceeds in another home 
224.18  and maintains those proceeds, unused for other purposes, in a 
224.19  separate account; and 
224.20     (4) when the homestead is jointly owned, but the client 
224.21  does not reside in it because of legal separation, pending 
224.22  divorce, or battering or abuse by the spouse or partner, the 
224.23  homestead is excluded; and 
224.24     (5) the homestead shall continue to be excluded if it is 
224.25  temporarily unoccupied due to employment, illness, or a 
224.26  county-approved employability plan.  The education, training, or 
224.27  job search must be within the state, but can be outside the 
224.28  immediate geographic area.  A homestead temporarily unoccupied 
224.29  because it is not habitable due to a casualty or natural 
224.30  disaster is excluded.  The homestead is excluded during periods 
224.31  only if the client intends to return to it. 
224.32     (b) The equity value of real property that is not excluded 
224.33  under paragraph (a) and which is legally available must be 
224.34  applied against the limits in subdivision 3.  When the equity 
224.35  value of the real property exceeds the limits under subdivision 
224.36  3, the applicant or participant may qualify to receive 
225.1   assistance when the applicant or participant continues to make a 
225.2   good faith effort to sell the property and signs a legally 
225.3   binding agreement to repay the amount of assistance, less child 
225.4   support collected by the agency.  Repayment must be made within 
225.5   five working days after the property is sold.  Repayment to the 
225.6   county agency must be in the amount of assistance received or 
225.7   the proceeds of the sale, whichever is less. 
225.8      Sec. 36.  Minnesota Statutes 1997 Supplement, section 
225.9   256J.20, subdivision 3, is amended to read: 
225.10     Subd. 3.  [OTHER PROPERTY LIMITATIONS.] To be eligible for 
225.11  MFIP-S, the equity value of all nonexcluded real and personal 
225.12  property of the assistance unit must not exceed $2,000 for 
225.13  applicants and $5,000 for ongoing recipients participants.  The 
225.14  value of assets in clauses (1) to (18) must be excluded when 
225.15  determining the equity value of real and personal property: 
225.16     (1) a licensed vehicles vehicle up to a total market loan 
225.17  value of less than or equal to $7,500.  The county agency shall 
225.18  apply any excess market loan value as if it were equity value to 
225.19  the asset limit described in this section.  If the assistance 
225.20  unit owns more than one licensed vehicle, the county agency 
225.21  shall determine the vehicle with the highest market loan value 
225.22  and count only the market loan value over $7,500.  The county 
225.23  agency shall count the market loan value of all other vehicles 
225.24  and apply this amount as if it were equity value to the asset 
225.25  limit described in this section.  The value of special equipment 
225.26  for a handicapped member of the assistance unit is excluded.  To 
225.27  establish the market loan value of vehicles, a county agency 
225.28  must use the N.A.D.A. Official Used Car Guide, Midwest Edition, 
225.29  for newer model cars.  The N.A.D.A. Official Used Car Guide, 
225.30  Midwest Edition, is incorporated by reference.  When a vehicle 
225.31  is not listed in the guidebook, or when the applicant or 
225.32  participant disputes the loan value listed in the guidebook as 
225.33  unreasonable given the condition of the particular vehicle, the 
225.34  county agency may require the applicant or participant to 
225.35  document the loan value by securing a written statement from a 
225.36  motor vehicle dealer licensed under section 168.27, stating the 
226.1   amount that the dealer would pay to purchase the vehicle.  The 
226.2   county agency shall reimburse the applicant or participant for 
226.3   the cost of a written statement that documents a lower loan 
226.4   value.  If the loan value exceeds $7,500, the county agency 
226.5   shall determine the equity value of the vehicle and exclude a 
226.6   vehicle with a total equity value of less than or equal to 
226.7   $7,500.  "Equity value" is equal to loan value minus any 
226.8   outstanding encumbrances; 
226.9      (2) the value of life insurance policies for members of the 
226.10  assistance unit; 
226.11     (3) one burial plot per member of an assistance unit; 
226.12     (4) the value of personal property needed to produce earned 
226.13  income, including tools, implements, farm animals, inventory, 
226.14  business loans, business checking and savings accounts used at 
226.15  least annually and used exclusively for the operation of a 
226.16  self-employment business, and any motor vehicles if the vehicles 
226.17  are essential for the self-employment business; 
226.18     (5) the value of personal property not otherwise specified 
226.19  which is commonly used by household members in day-to-day living 
226.20  such as clothing, necessary household furniture, equipment, and 
226.21  other basic maintenance items essential for daily living; 
226.22     (6) the value of real and personal property owned by a 
226.23  recipient of Supplemental Security Income or Minnesota 
226.24  supplemental aid; 
226.25     (7) the value of corrective payments, but only for the 
226.26  month in which the payment is received and for the following 
226.27  month; 
226.28     (8) a mobile home used by an applicant or participant as 
226.29  the applicant's or participant's home; 
226.30     (9) money in a separate escrow account that is needed to 
226.31  pay real estate taxes or insurance and that is used for this 
226.32  purpose; 
226.33     (10) money held in escrow to cover employee FICA, employee 
226.34  tax withholding, sales tax withholding, employee worker 
226.35  compensation, business insurance, property rental, property 
226.36  taxes, and other costs that are paid at least annually, but less 
227.1   often than monthly; 
227.2      (11) monthly assistance and, emergency assistance, and 
227.3   diversionary payments for the current month's needs; 
227.4      (12) the value of school loans, grants, or scholarships for 
227.5   the period they are intended to cover; 
227.6      (13) payments listed in section 256J.21, subdivision 2, 
227.7   clause (9), which are held in escrow for a period not to exceed 
227.8   three months to replace or repair personal or real property; 
227.9      (14) income received in a budget month through the end of 
227.10  the budget payment month; 
227.11     (15) savings from earned income of a minor child or a minor 
227.12  parent that are set aside in a separate account designated 
227.13  specifically for future education or employment costs; 
227.14     (16) the federal earned income tax credit and, Minnesota 
227.15  working family credit, state and federal income tax refunds, 
227.16  state homeowners' credit, and state renters' credit in the month 
227.17  received and the following month; 
227.18     (17) payments excluded under federal law as long as those 
227.19  payments are held in a separate account from any nonexcluded 
227.20  funds; and 
227.21     (18) money received by a participant of the corps to career 
227.22  program under section 84.0887, subdivision 2, paragraph (b), as 
227.23  a postservice benefit under the federal Americorps Act. 
227.24     Sec. 37.  Minnesota Statutes 1997 Supplement, section 
227.25  256J.21, is amended to read: 
227.26     256J.21 [INCOME LIMITATIONS.] 
227.27     Subdivision 1.  [INCOME INCLUSIONS.] To determine MFIP-S 
227.28  eligibility, the county agency must evaluate income received by 
227.29  members of an assistance unit, or by other persons whose income 
227.30  is considered available to the assistance unit, and only count 
227.31  income that is available to the member of the assistance unit.  
227.32  Income is available if the individual has legal access to the 
227.33  income.  All payments, unless specifically excluded in 
227.34  subdivision 2, must be counted as income. 
227.35     Subd. 2.  [INCOME EXCLUSIONS.] (a) The following must be 
227.36  excluded in determining a family's available income: 
228.1      (1) payments for basic care, difficulty of care, and 
228.2   clothing allowances received for providing family foster care to 
228.3   children or adults under Minnesota Rules, parts 9545.0010 to 
228.4   9545.0260 and 9555.5050 to 9555.6265, and payments received and 
228.5   used for care and maintenance of a third-party beneficiary who 
228.6   is not a household member; 
228.7      (2) reimbursements for employment training received through 
228.8   the Job Training Partnership Act, United States Code, title 29, 
228.9   chapter 19, sections 1501 to 1792b; 
228.10     (3) reimbursement for out-of-pocket expenses incurred while 
228.11  performing volunteer services, jury duty, or employment; 
228.12     (4) all educational assistance, except the county agency 
228.13  must count graduate student teaching assistantships, 
228.14  fellowships, and other similar paid work as earned income and, 
228.15  after allowing deductions for any unmet and necessary 
228.16  educational expenses, shall count scholarships or grants awarded 
228.17  to graduate students that do not require teaching or research as 
228.18  unearned income; 
228.19     (5) loans, regardless of purpose, from public or private 
228.20  lending institutions, governmental lending institutions, or 
228.21  governmental agencies; 
228.22     (6) loans from private individuals, regardless of purpose, 
228.23  provided an applicant or participant documents that the lender 
228.24  expects repayment; 
228.25     (7)(i) state and federal income tax refunds; and 
228.26     (ii) federal income tax refunds; 
228.27     (8) state and (i) federal earned income credits; 
228.28     (ii) Minnesota working family credits; 
228.29     (iii) state homeowners' credits; 
228.30     (iv) state renters' credits; and 
228.31     (v) federal or state tax rebates; 
228.32     (9) funds received for reimbursement, replacement, or 
228.33  rebate of personal or real property when these payments are made 
228.34  by public agencies, awarded by a court, solicited through public 
228.35  appeal, or made as a grant by a federal agency, state or local 
228.36  government, or disaster assistance organizations, subsequent to 
229.1   a presidential declaration of disaster; 
229.2      (10) the portion of an insurance settlement that is used to 
229.3   pay medical, funeral, and burial expenses, or to repair or 
229.4   replace insured property; 
229.5      (11) reimbursements for medical expenses that cannot be 
229.6   paid by medical assistance; 
229.7      (12) payments by a vocational rehabilitation program 
229.8   administered by the state under chapter 268A, except those 
229.9   payments that are for current living expenses; 
229.10     (13) in-kind income, including any payments directly made 
229.11  by a third party to a provider of goods and services; 
229.12     (14) assistance payments to correct underpayments, but only 
229.13  for the month in which the payment is received; 
229.14     (15) emergency assistance payments; 
229.15     (16) funeral and cemetery payments as provided by section 
229.16  256.935; 
229.17     (17) nonrecurring cash gifts of $30 or less, not exceeding 
229.18  $30 per participant in a calendar month; 
229.19     (18) any form of energy assistance payment made through 
229.20  Public Law Number 97-35, Low-Income Home Energy Assistance Act 
229.21  of 1981, payments made directly to energy providers by other 
229.22  public and private agencies, and any form of credit or rebate 
229.23  payment issued by energy providers; 
229.24     (19) Supplemental Security Income, including retroactive 
229.25  payments; 
229.26     (20) Minnesota supplemental aid, including retroactive 
229.27  payments; 
229.28     (21) proceeds from the sale of real or personal property; 
229.29     (22) adoption assistance payments under section 259.67; 
229.30     (23) state-funded family subsidy program payments made 
229.31  under section 252.32 to help families care for children with 
229.32  mental retardation or related conditions; 
229.33     (24) interest payments and dividends from property that is 
229.34  not excluded from and that does not exceed the asset limit; 
229.35     (25) rent rebates; 
229.36     (26) income earned by a minor caregiver or minor child who 
230.1   is at least a half-time student in an approved secondary 
230.2   education program; 
230.3      (27) income earned by a caregiver under age 20 who is at 
230.4   least a half-time student in an approved secondary education 
230.5   program; 
230.6      (28) MFIP-S child care payments under section 119B.05; 
230.7      (29) all other payments made through MFIP-S to support a 
230.8   caregiver's pursuit of greater self-support; 
230.9      (30) income a participant receives related to shared living 
230.10  expenses; 
230.11     (31) reverse mortgages; 
230.12     (32) benefits provided by the Child Nutrition Act of 1966, 
230.13  United States Code, title 42, chapter 13A, sections 1771 to 
230.14  1790; 
230.15     (33) benefits provided by the women, infants, and children 
230.16  (WIC) nutrition program, United States Code, title 42, chapter 
230.17  13A, section 1786; 
230.18     (34) benefits from the National School Lunch Act, United 
230.19  States Code, title 42, chapter 13, sections 1751 to 1769e; 
230.20     (35) relocation assistance for displaced persons under the 
230.21  Uniform Relocation Assistance and Real Property Acquisition 
230.22  Policies Act of 1970, United States Code, title 42, chapter 61, 
230.23  subchapter II, section 4636, or the National Housing Act, United 
230.24  States Code, title 12, chapter 13, sections 1701 to 1750jj; 
230.25     (36) benefits from the Trade Act of 1974, United States 
230.26  Code, title 19, chapter 12, part 2, sections 2271 to 2322; 
230.27     (37) war reparations payments to Japanese Americans and 
230.28  Aleuts under United States Code, title 50, sections 1989 to 
230.29  1989d; 
230.30     (38) payments to veterans or their dependents as a result 
230.31  of legal settlements regarding Agent Orange or other chemical 
230.32  exposure under Public Law Number 101-239, section 10405, 
230.33  paragraph (a)(2)(E); 
230.34     (39) income that is otherwise specifically excluded from 
230.35  the MFIP-S program consideration in federal law, state law, or 
230.36  federal regulation; 
231.1      (40) security and utility deposit refunds; 
231.2      (41) American Indian tribal land settlements excluded under 
231.3   Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 
231.4   Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 
231.5   reservations and payments to members of the White Earth Band, 
231.6   under United States Code, title 25, chapter 9, section 331, and 
231.7   chapter 16, section 1407; 
231.8      (42) all income of the minor parent's parent and stepparent 
231.9   when determining the grant for the minor parent in households 
231.10  that include a minor parent living with a parent or stepparent 
231.11  on MFIP-S with other dependent children; and 
231.12     (43) income of the minor parent's parent and stepparent 
231.13  equal to 200 percent of the federal poverty guideline for a 
231.14  family size not including the minor parent and the minor 
231.15  parent's child in households that include a minor parent living 
231.16  with a parent or stepparent not on MFIP-S when determining the 
231.17  grant for the minor parent.  The remainder of income is deemed 
231.18  as specified in section 256J.37, subdivision 1 1b; 
231.19     (44) payments made to children eligible for relative 
231.20  custody assistance under section 257.85; 
231.21     (45) vendor payments for goods and services made on behalf 
231.22  of a client unless the client has the option of receiving the 
231.23  payment in cash; and 
231.24     (46) the principal portion of a contract for deed payment. 
231.25     Subd. 3.  [INITIAL INCOME TEST.] The county agency shall 
231.26  determine initial eligibility by considering all earned and 
231.27  unearned income that is not excluded under subdivision 2.  To be 
231.28  eligible for MFIP-S, the assistance unit's countable income 
231.29  minus the disregards in paragraphs (a) and (b) must be below the 
231.30  transitional standard of assistance according to section 256J.24 
231.31  for that size assistance unit. 
231.32     (a) The initial eligibility determination must disregard 
231.33  the following items: 
231.34     (1) the employment disregard is 18 percent of the gross 
231.35  earned income whether or not the member is working full time or 
231.36  part time; 
232.1      (2) dependent care costs must be deducted from gross earned 
232.2   income for the actual amount paid for dependent care up to the a 
232.3   maximum disregard allowed of $200 per month for each child less 
232.4   than two years of age, and $175 per month for each child two 
232.5   years of age and older under this chapter and chapter 119B; and 
232.6      (3) all payments made according to a court order 
232.7   for spousal support or the support of children not living in the 
232.8   assistance unit's household shall be disregarded from the income 
232.9   of the person with the legal obligation to pay support, provided 
232.10  that, if there has been a change in the financial circumstances 
232.11  of the person with the legal obligation to pay support since the 
232.12  support order was entered, the person with the legal obligation 
232.13  to pay support has petitioned for a modification of the support 
232.14  order; and 
232.15     (4) an allocation for the unmet need of an ineligible 
232.16  spouse or an ineligible child under the age of 21 for whom the 
232.17  caregiver is financially responsible and who lives with the 
232.18  caregiver according to section 256J.36. 
232.19     (b) Notwithstanding paragraph (a), when determining initial 
232.20  eligibility for applicants who have applicant units when at 
232.21  least one member has received AFDC, family general assistance, 
232.22  MFIP, MFIP-R, work first, or MFIP-S in this state within four 
232.23  months of the most recent application for MFIP-S, the employment 
232.24  disregard for all unit members is 36 percent of the gross earned 
232.25  income. 
232.26     After initial eligibility is established, the assistance 
232.27  payment calculation is based on the monthly income test. 
232.28     Subd. 4.  [MONTHLY INCOME TEST AND DETERMINATION OF 
232.29  ASSISTANCE PAYMENT.] The county agency shall determine ongoing 
232.30  eligibility and the assistance payment amount according to the 
232.31  monthly income test.  To be eligible for MFIP-S, the result of 
232.32  the computations in paragraphs (a) to (e) must be at least $1. 
232.33     (a) Apply a 36 percent income disregard to gross earnings 
232.34  and subtract this amount from the family wage level.  If the 
232.35  difference is equal to or greater than the transitional 
232.36  standard, the assistance payment is equal to the transitional 
233.1   standard.  If the difference is less than the transitional 
233.2   standard, the assistance payment is equal to the difference.  
233.3   The employment disregard in this paragraph must be deducted 
233.4   every month there is earned income. 
233.5      (b) All payments made according to a court order 
233.6   for spousal support or the support of children not living in the 
233.7   assistance unit's household must be disregarded from the income 
233.8   of the person with the legal obligation to pay support, provided 
233.9   that, if there has been a change in the financial circumstances 
233.10  of the person with the legal obligation to pay support since the 
233.11  support order was entered, the person with the legal obligation 
233.12  to pay support has petitioned for a modification of the court 
233.13  order. 
233.14     (c) An allocation for the unmet need of an ineligible 
233.15  spouse or an ineligible child under the age of 21 for whom the 
233.16  caregiver is financially responsible and who lives with the 
233.17  caregiver according to section 256J.36. 
233.18     (d) Subtract unearned income dollar for dollar from the 
233.19  transitional standard to determine the assistance payment amount.
233.20     (d) (e) When income is both earned and unearned, the amount 
233.21  of the assistance payment must be determined by first treating 
233.22  gross earned income as specified in paragraph (a).  After 
233.23  determining the amount of the assistance payment under paragraph 
233.24  (a), unearned income must be subtracted from that amount dollar 
233.25  for dollar to determine the assistance payment amount. 
233.26     (e) (f) When the monthly income is greater than the 
233.27  transitional or family wage level standard after applicable 
233.28  deductions and the income will only exceed the standard for one 
233.29  month, the county agency must suspend the assistance payment for 
233.30  the payment month. 
233.31     Subd. 5.  [DISTRIBUTION OF INCOME.] The income of all 
233.32  members of the assistance unit must be counted.  Income may also 
233.33  be deemed from ineligible persons to the assistance unit.  
233.34  Income must be attributed to the person who earns it or to the 
233.35  assistance unit according to paragraphs (a) to (c). 
233.36     (a) Funds distributed from a trust, whether from the 
234.1   principal holdings or sale of trust property or from the 
234.2   interest and other earnings of the trust holdings, must be 
234.3   considered income when the income is legally available to an 
234.4   applicant or participant.  Trusts are presumed legally available 
234.5   unless an applicant or participant can document that the trust 
234.6   is not legally available. 
234.7      (b) Income from jointly owned property must be divided 
234.8   equally among property owners unless the terms of ownership 
234.9   provide for a different distribution. 
234.10     (c) Deductions are not allowed from the gross income of a 
234.11  financially responsible household member or by the members of an 
234.12  assistance unit to meet a current or prior debt. 
234.13     Sec. 38.  Minnesota Statutes 1997 Supplement, section 
234.14  256J.24, subdivision 1, is amended to read: 
234.15     Subdivision 1.  [MFIP-S ASSISTANCE UNIT.] An MFIP-S 
234.16  assistance unit is either a group of individuals with at least 
234.17  one minor child who live together whose needs, assets, and 
234.18  income are considered together and who receive MFIP-S 
234.19  assistance, or a pregnant woman and her spouse who receives 
234.20  receive MFIP-S assistance.  
234.21     Individuals identified in subdivision 2 must be included in 
234.22  the MFIP-S assistance unit.  Individuals identified in 
234.23  subdivision 3 must be excluded from the assistance unit are 
234.24  ineligible to receive MFIP-S.  Individuals identified in 
234.25  subdivision 4 may be included in the assistance unit at their 
234.26  option.  Individuals not included in the assistance unit who are 
234.27  identified in section 256J.37, subdivision subdivisions 1 or to 
234.28  2, must have their income and assets considered when determining 
234.29  eligibility and benefits for an MFIP-S assistance unit.  All 
234.30  assistance unit members, whether mandatory or elective, who live 
234.31  together and for whom one caregiver or two caregivers apply must 
234.32  be included in a single assistance unit. 
234.33     Sec. 39.  Minnesota Statutes 1997 Supplement, section 
234.34  256J.24, subdivision 2, is amended to read: 
234.35     Subd. 2.  [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 
234.36  for minor caregivers and their children who are must be in a 
235.1   separate assistance unit from the other persons in the 
235.2   household, when the following individuals live together, they 
235.3   must be included in the assistance unit: 
235.4      (1) a minor child, including a pregnant minor; 
235.5      (2) the minor child's siblings, half-siblings, and 
235.6   step-siblings; and 
235.7      (3) the minor child's natural, adoptive parents, and 
235.8   stepparents; and 
235.9      (4) the spouse of a pregnant woman.  
235.10     Sec. 40.  Minnesota Statutes 1997 Supplement, section 
235.11  256J.24, subdivision 3, is amended to read: 
235.12     Subd. 3.  [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 
235.13  ASSISTANCE UNIT.] The following individuals must be excluded 
235.14  from an assistance unit who are part of the assistance unit 
235.15  determined under subdivision 2 are ineligible to receive MFIP-S: 
235.16     (1) individuals receiving Supplemental Security Income or 
235.17  Minnesota supplemental aid; 
235.18     (2) individuals living at home while performing 
235.19  court-imposed, unpaid community service work due to a criminal 
235.20  conviction; 
235.21     (3) individuals disqualified from the food stamp program or 
235.22  MFIP-S, until the disqualification ends; 
235.23     (4) children on whose behalf federal, state, or local 
235.24  foster care payments under title IV-E of the Social Security Act 
235.25  are made, except as provided in section sections 256J.13, 
235.26  subdivision 2, and 256J.74, subdivision 2; and 
235.27     (5) children receiving ongoing monthly adoption assistance 
235.28  payments under section 269.67 259.67. 
235.29     The exclusion of a person under this subdivision does not 
235.30  alter the mandatory assistance unit composition. 
235.31     Sec. 41.  Minnesota Statutes 1997 Supplement, section 
235.32  256J.24, subdivision 4, is amended to read: 
235.33     Subd. 4.  [INDIVIDUALS WHO MAY ELECT TO BE INCLUDED IN THE 
235.34  ASSISTANCE UNIT.] (a) The minor child's eligible caregiver may 
235.35  choose to be in the assistance unit, if the caregiver is not 
235.36  required to be in the assistance unit under subdivision 2.  If 
236.1   the relative caregiver chooses to be in the assistance unit, 
236.2   that person's spouse must also be in the unit. 
236.3      (b) Any minor child not related as a sibling, stepsibling, 
236.4   or adopted sibling to the minor child in the unit, but for whom 
236.5   there is an eligible caregiver may elect to be in the unit. 
236.6      (c) A foster care provider of a minor child who is 
236.7   receiving federal, state, or local foster care maintenance 
236.8   payments may elect to receive MFIP-S if the provider meets the 
236.9   definition of caregiver under section 256J.08, subdivision 11.  
236.10  If the provider chooses to receive MFIP-S, the spouse of the 
236.11  provider must also be included in the assistance unit with the 
236.12  provider.  The provider and spouse are eligible for assistance 
236.13  even though the only minor child living in the provider's home 
236.14  is receiving foster care maintenance payments. 
236.15     (d) The adult caregiver or caregivers of a minor parent are 
236.16  eligible to be a separate assistance unit from the minor parent 
236.17  and the minor parent's child when: 
236.18     (1) the adult caregiver or caregivers have no other minor 
236.19  children in the household; 
236.20     (2) the minor parent and the minor parent's child are 
236.21  living together with the adult caregiver or caregivers; and 
236.22     (3) the minor parent and the minor parent's child receive 
236.23  MFIP-S or would be eligible to receive MFIP-S if they were not 
236.24  receiving SSI benefits. 
236.25     Sec. 42.  Minnesota Statutes 1997 Supplement, section 
236.26  256J.24, is amended by adding a subdivision to read: 
236.27     Subd. 5a.  [FOOD PORTION OF MFIP-S TRANSITIONAL 
236.28  STANDARD.] The commissioner shall increase the food portion of 
236.29  the MFIP-S transitional standard by October 1 each year 
236.30  beginning October 1998 to reflect the cost-of-living adjustments 
236.31  to the Food Stamp Program.  The commissioner shall annually 
236.32  publish in the State Register the transitional standard for an 
236.33  assistance unit of sizes 1 to 10. 
236.34     Sec. 43.  Minnesota Statutes 1997 Supplement, section 
236.35  256J.24, is amended by adding a subdivision to read: 
236.36     Subd. 8.  [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE 
237.1   UNITS.] Payments for shelter and utilities up to the amount of 
237.2   MFIP-S benefits for which the assistance unit is eligible shall 
237.3   be vendor paid for as many months as the assistance unit is 
237.4   eligible or six months, whichever comes first.  The residual 
237.5   amount of the grant after vendor payment, if any, must be paid 
237.6   to the MFIP-S caregiver. 
237.7      Sec. 44.  Minnesota Statutes 1997 Supplement, section 
237.8   256J.26, subdivision 1, is amended to read: 
237.9      Subdivision 1.  [PERSON CONVICTED OF DRUG OFFENSES.] (a) 
237.10  Applicants or recipients participants who have been convicted of 
237.11  a drug offense after July 1, 1997, may, if otherwise eligible, 
237.12  receive AFDC or MFIP-S benefits subject to the following 
237.13  conditions: 
237.14     (1) Benefits for the entire assistance unit must be paid in 
237.15  vendor form for shelter and utilities during any time the 
237.16  applicant is part of the assistance unit;. 
237.17     (2) The convicted applicant or recipient participant shall 
237.18  be subject to random drug testing as a condition of continued 
237.19  eligibility and is subject to sanctions under section 256J.46 
237.20  following any positive test for an illegal controlled substance, 
237.21  except that the grant must continue to be vendor paid under 
237.22  clause (1).  
237.23     For purposes of this subdivision, section 256J.46 is 
237.24  effective July 1, 1997. 
237.25     This subdivision also applies to persons who receive food 
237.26  stamps under section 115 of the Personal Responsibility and Work 
237.27  Opportunity Reconciliation Act of 1996.  is subject to the 
237.28  following sanctions: 
237.29     (i) for failing a drug test the first time, the 
237.30  participant's grant shall be reduced by ten percent of the 
237.31  MFIP-S transitional standard or the interstate transitional 
237.32  standard, whichever is applicable, prior to making vendor 
237.33  payments for shelter and utility costs; or 
237.34     (ii) for failing a drug test more than once, the residual 
237.35  amount of the participant's grant after making vendor payments 
237.36  for shelter and utility costs, if any, must be reduced by an 
238.1   amount equal to 30 percent of the MFIP-S transitional standard 
238.2   or the interstate transitional standard, whichever is applicable.
238.3      (b) Applicants or participants who have been convicted of a 
238.4   drug offense after July 1, 1997, may, if otherwise eligible, 
238.5   receive food stamps if the convicted applicant or participant is 
238.6   subject to random drug testing as a condition of continued 
238.7   eligibility.  Following a positive test for an illegal 
238.8   controlled substance, the applicant is subject to the following 
238.9   sanctions: 
238.10     (1) for failing a drug test the first time, food stamps 
238.11  shall be reduced by ten percent of the applicable food stamp 
238.12  allotment; and 
238.13     (2) for failing a drug test more than once, food stamps 
238.14  shall be reduced by an amount equal to 30 percent of the 
238.15  applicable food stamp allotment.  
238.16     (b) (c) For the purposes of this subdivision, "drug offense"
238.17  means a conviction that occurred after July 1, 1997, of sections 
238.18  152.021 to 152.025, 152.0261, or 152.096.  Drug offense also 
238.19  means a conviction in another jurisdiction of the possession, 
238.20  use, or distribution of a controlled substance, or conspiracy to 
238.21  commit any of these offenses, if the offense occurred after July 
238.22  1, 1997, and the conviction is a felony offense in that 
238.23  jurisdiction, or in the case of New Jersey, a high misdemeanor. 
238.24     Sec. 45.  Minnesota Statutes 1997 Supplement, section 
238.25  256J.26, subdivision 2, is amended to read: 
238.26     Subd. 2.  [PAROLE VIOLATORS.] An individual violating a 
238.27  condition of probation or parole or supervised release imposed 
238.28  under federal law or the law of any state is ineligible to 
238.29  receive disqualified from receiving AFDC or MFIP-S. 
238.30     Sec. 46.  Minnesota Statutes 1997 Supplement, section 
238.31  256J.26, subdivision 3, is amended to read: 
238.32     Subd. 3.  [FLEEING FELONS.] An individual who is fleeing to 
238.33  avoid prosecution, or custody, or confinement after conviction 
238.34  for a crime that is a felony under the laws of the jurisdiction 
238.35  from which the individual flees, or in the case of New Jersey, 
238.36  is a high misdemeanor, is ineligible to receive disqualified 
239.1   from receiving AFDC or MFIP-S. 
239.2      Sec. 47.  Minnesota Statutes 1997 Supplement, section 
239.3   256J.26, subdivision 4, is amended to read: 
239.4      Subd. 4.  [DENIAL OF ASSISTANCE FOR TEN YEARS TO A PERSON 
239.5   FOUND TO HAVE FRAUDULENTLY MISREPRESENTED RESIDENCY.] An 
239.6   individual who is convicted in federal or state court of having 
239.7   made a fraudulent statement or representation with respect to 
239.8   the place of residence of the individual in order to receive 
239.9   assistance simultaneously from two or more states is ineligible 
239.10  to receive disqualified from receiving AFDC or MFIP-S for ten 
239.11  years beginning on the date of the conviction. 
239.12     Sec. 48.  Minnesota Statutes 1997 Supplement, section 
239.13  256J.28, subdivision 1, is amended to read: 
239.14     Subdivision 1.  [EXPEDITED ISSUANCE OF FOOD STAMP 
239.15  ASSISTANCE.] The following households are entitled to expedited 
239.16  issuance of food stamp assistance: 
239.17     (1) households with less than $150 in monthly gross income 
239.18  provided their liquid assets do not exceed $100; 
239.19     (2) migrant or seasonal farm worker households who are 
239.20  destitute as defined in Code of Federal Regulations, title 7, 
239.21  subtitle B, chapter 2, subchapter C, part 273, section 273.10, 
239.22  paragraph (e)(3), provided their liquid assets do not exceed 
239.23  $100; and 
239.24     (3) eligible households whose combined monthly gross income 
239.25  and liquid resources are less than the household's monthly rent 
239.26  or mortgage and utilities. 
239.27     The benefits issued through expedited issuance of food 
239.28  stamp assistance must be deducted from the amount of the full 
239.29  monthly MFIP-S assistance payment and a supplemental payment for 
239.30  the difference must be issued. For any month an individual 
239.31  receives expedited Food Stamp Program benefits, the individual 
239.32  is not eligible for the MFIP-S food portion of assistance. 
239.33     Sec. 49.  Minnesota Statutes 1997 Supplement, section 
239.34  256J.28, subdivision 2, is amended to read: 
239.35     Subd. 2.  [FOOD STAMPS FOR HOUSEHOLD MEMBERS NOT IN THE 
239.36  ASSISTANCE UNIT.] (a) For household members who purchase and 
240.1   prepare food with the MFIP-S assistance unit but are not part of 
240.2   the assistance unit, the county agency must determine a separate 
240.3   food stamp benefit based on regulations agreed upon with the 
240.4   United States Department of Agriculture. 
240.5      (b) This subdivision does not apply to optional members who 
240.6   have chosen not to be in the assistance unit. 
240.7      (c) (b) Fair hearing requirements for persons who receive 
240.8   food stamps under this subdivision are governed by section 
240.9   256.045, and Code of Federal Regulations, title 7, subtitle B, 
240.10  chapter II, part 273, section 273.15. 
240.11     Sec. 50.  Minnesota Statutes 1997 Supplement, section 
240.12  256J.28, is amended by adding a subdivision to read: 
240.13     Subd. 5.  [FOOD STAMPS FOR PERSONS RESIDING IN A BATTERED 
240.14  WOMAN'S SHELTER.] Members of an MFIP-S assistance unit residing 
240.15  in a battered woman's shelter may receive food stamps or the 
240.16  food portion twice in a month if the unit that initially 
240.17  received the food stamps or food portion included the alleged 
240.18  abuser. 
240.19     Sec. 51.  Minnesota Statutes 1997 Supplement, section 
240.20  256J.30, subdivision 10, is amended to read: 
240.21     Subd. 10.  [COOPERATION WITH HEALTH CARE BENEFITS.] (a) The 
240.22  caregiver of a minor child must cooperate with the county agency 
240.23  to identify and provide information to assist the county agency 
240.24  in pursuing third-party liability for medical services. 
240.25     (b) A caregiver must assign to the department any rights to 
240.26  health insurance policy benefits the caregiver has during the 
240.27  period of MFIP-S eligibility. 
240.28     (c) A caregiver must identify any third party who may be 
240.29  liable for care and services available under the medical 
240.30  assistance program on behalf of the applicant or participant and 
240.31  all other assistance unit members. 
240.32     (d) When a participant refuses to identify any third party 
240.33  who may be liable for care and services, the recipient must be 
240.34  sanctioned as provided in section 256J.46, subdivision 1.  The 
240.35  recipient is also ineligible for medical assistance for a 
240.36  minimum of one month and until the recipient cooperates with the 
241.1   requirements of this subdivision. 
241.2      Sec. 52.  Minnesota Statutes 1997 Supplement, section 
241.3   256J.30, subdivision 11, is amended to read: 
241.4      Subd. 11.  [REQUIREMENT TO ASSIGN SUPPORT AND MAINTENANCE 
241.5   RIGHTS.] To be eligible An assistance unit is ineligible for 
241.6   MFIP-S, unless the caregiver must assign assigns all rights to 
241.7   child support and spousal maintenance benefits according 
241.8   to sections 256.74, subdivision 5, and section 256.741, if 
241.9   enacted. 
241.10     Sec. 53.  Minnesota Statutes 1997 Supplement, section 
241.11  256J.31, subdivision 5, is amended to read: 
241.12     Subd. 5.  [MAILING OF NOTICE.] The notice of adverse action 
241.13  shall be issued according to paragraphs (a) to (c). 
241.14     (a) A county agency shall mail a notice of adverse action 
241.15  at least ten days before the effective date of the adverse 
241.16  action, except as provided in paragraphs (b) and (c). 
241.17     (b) A county agency must mail a notice of adverse action at 
241.18  least five days before the effective date of the adverse action 
241.19  when the county agency has factual information that requires an 
241.20  action to reduce, suspend, or terminate assistance based on 
241.21  probable fraud. 
241.22     (c) A county agency shall mail a notice of adverse action 
241.23  before or on the effective date of the adverse action when the 
241.24  county agency: 
241.25     (1) receives the caregiver's signed monthly MFIP-S 
241.26  household report form that includes information that requires 
241.27  payment reduction, suspension, or termination; 
241.28     (2) is informed of the death of a participant or the payee; 
241.29     (3) receives a signed statement from the caregiver that 
241.30  assistance is no longer wanted; 
241.31     (4) receives a signed statement from the caregiver that 
241.32  provides information that requires the termination or reduction 
241.33  of assistance; 
241.34     (5) verifies that a member of the assistance unit is absent 
241.35  from the home and does not meet temporary absence provisions in 
241.36  section 256J.13; 
242.1      (6) verifies that a member of the assistance unit has 
242.2   entered a regional treatment center or a licensed residential 
242.3   facility for medical or psychological treatment or 
242.4   rehabilitation; 
242.5      (7) verifies that a member of an assistance unit has been 
242.6   placed in foster care, and the provisions of section 256J.13, 
242.7   subdivision 2, paragraph (b) (c), clause (2), do not apply; 
242.8      (8) verifies that a member of an assistance unit has been 
242.9   approved to receive assistance by another state; or 
242.10     (9) cannot locate a caregiver. 
242.11     Sec. 54.  Minnesota Statutes 1997 Supplement, section 
242.12  256J.31, subdivision 10, is amended to read: 
242.13     Subd. 10.  [PROTECTION FROM GARNISHMENT.] MFIP-S grants or 
242.14  earnings of a caregiver while participating in full or part-time 
242.15  employment or training shall be protected from garnishment.  
242.16  This protection for earnings shall extend for a period of six 
242.17  months from the date of termination from MFIP-S. 
242.18     Sec. 55.  Minnesota Statutes 1997 Supplement, section 
242.19  256J.32, subdivision 4, is amended to read: 
242.20     Subd. 4.  [FACTORS TO BE VERIFIED.] The county agency shall 
242.21  verify the following at application: 
242.22     (1) identity of adults; 
242.23     (2) presence of the minor child in the home, if 
242.24  questionable; 
242.25     (3) relationship of a minor child to caregivers in the 
242.26  assistance unit; 
242.27     (4) age, if necessary to determine MFIP-S eligibility; 
242.28     (5) immigration status; 
242.29     (6) social security number in accordance with according to 
242.30  the requirements of section 256J.30, subdivision 12; 
242.31     (7) income; 
242.32     (8) self-employment expenses used as a deduction; 
242.33     (9) source and purpose of deposits and withdrawals from 
242.34  business accounts; 
242.35     (10) spousal support and child support payments made to 
242.36  persons outside the household; 
243.1      (11) real property; 
243.2      (12) vehicles; 
243.3      (13) checking and savings accounts; 
243.4      (14) savings certificates, savings bonds, stocks, and 
243.5   individual retirement accounts; 
243.6      (15) pregnancy, if related to eligibility; 
243.7      (16) inconsistent information, if related to eligibility; 
243.8      (17) medical insurance; 
243.9      (18) anticipated graduation date of an 18-year-old; 
243.10     (19) burial accounts; 
243.11     (20) school attendance, if related to eligibility; and 
243.12     (21) residence; 
243.13     (22) a claim of domestic violence if used as a basis for a 
243.14  deferral or exemption from the 60-month time limit in section 
243.15  256J.42 or employment and training services requirements in 
243.16  section 256J.56; and 
243.17     (23) disability if used as an exemption from employment and 
243.18  training services requirements under section 256J.56. 
243.19     Sec. 56.  Minnesota Statutes 1997 Supplement, section 
243.20  256J.32, subdivision 6, is amended to read: 
243.21     Subd. 6.  [RECERTIFICATION.] The county agency shall 
243.22  recertify eligibility in an annual face-to-face interview with 
243.23  the participant and verify the following: 
243.24     (1) presence of the minor child in the home, if 
243.25  questionable; 
243.26     (2) income, unless excluded, including self-employment 
243.27  expenses used as a deduction or deposits or withdrawals from 
243.28  business accounts; 
243.29     (3) assets when the value is within $200 of the asset 
243.30  limit; and 
243.31     (4) inconsistent information, if related to eligibility.  
243.32     Sec. 57.  Minnesota Statutes 1997 Supplement, section 
243.33  256J.32, is amended by adding a subdivision to read: 
243.34     Subd. 7.  [NOTICE TO UNDOCUMENTED PERSONS; RELEASE OF 
243.35  PRIVATE DATA.] County agencies in consultation with the 
243.36  commissioner of human services shall provide notification to 
244.1   undocumented persons regarding the release of personal data to 
244.2   the Immigration and Naturalization Service and develop protocol 
244.3   regarding the release or sharing of data about undocumented 
244.4   persons with the Immigration and Naturalization Service as 
244.5   required under sections 404, 434, and 411A of the Personal 
244.6   Responsibility and Work Opportunity Reconciliation Act of 1996.  
244.7      Sec. 58.  Minnesota Statutes 1997 Supplement, section 
244.8   256J.33, subdivision 1, is amended to read: 
244.9      Subdivision 1.  [DETERMINATION OF ELIGIBILITY.] A county 
244.10  agency must determine MFIP-S eligibility prospectively for a 
244.11  payment month based on retrospectively assessing income and the 
244.12  county agency's best estimate of the circumstances that will 
244.13  exist in the payment month. 
244.14     Except as described in section 256J.34, subdivision 1, when 
244.15  prospective eligibility exists, a county agency must calculate 
244.16  the amount of the assistance payment using retrospective 
244.17  budgeting.  To determine MFIP-S eligibility and the assistance 
244.18  payment amount, a county agency must apply countable income, 
244.19  described in section 256J.37, subdivisions 3 to 10, received by 
244.20  members of an assistance unit or by other persons whose income 
244.21  is counted for the assistance unit, described under sections 
244.22  256J.21 and 256J.37, subdivisions 1 and to 2. 
244.23     This income must be applied to the transitional standard or 
244.24  family wage standard subject to this section and sections 
244.25  256J.34 to 256J.36.  Income received in a calendar month and not 
244.26  otherwise excluded under section 256J.21, subdivision 2, must be 
244.27  applied to the needs of an assistance unit. 
244.28     Sec. 59.  Minnesota Statutes 1997 Supplement, section 
244.29  256J.33, subdivision 4, is amended to read: 
244.30     Subd. 4.  [MONTHLY INCOME TEST.] A county agency must apply 
244.31  the monthly income test retrospectively for each month of MFIP-S 
244.32  eligibility.  An assistance unit is not eligible when the 
244.33  countable income equals or exceeds the transitional standard or 
244.34  the family wage level for the assistance unit.  The income 
244.35  applied against the monthly income test must include: 
244.36     (1) gross earned income from employment, prior to mandatory 
245.1   payroll deductions, voluntary payroll deductions, wage 
245.2   authorizations, and after the disregards in section 256J.21, 
245.3   subdivision 3 4, and the allocations in section 256J.36, unless 
245.4   the employment income is specifically excluded under section 
245.5   256J.21, subdivision 2; 
245.6      (2) gross earned income from self-employment less 
245.7   deductions for self-employment expenses in section 256J.37, 
245.8   subdivision 5, but prior to any reductions for personal or 
245.9   business state and federal income taxes, personal FICA, personal 
245.10  health and life insurance, and after the disregards in section 
245.11  256J.21, subdivision 3 4, and the allocations in section 
245.12  256J.36; 
245.13     (3) unearned income after deductions for allowable expenses 
245.14  in section 256J.37, subdivision 9, and allocations in section 
245.15  256J.36, unless the income has been specifically excluded in 
245.16  section 256J.21, subdivision 2; 
245.17     (4) gross earned income from employment as determined under 
245.18  clause (1) which is received by a member of an assistance unit 
245.19  who is a minor child or minor caregiver and less than a 
245.20  half-time student; 
245.21     (5) child support and spousal support received or 
245.22  anticipated to be received by an assistance unit; 
245.23     (6) the income of a parent when that parent is not included 
245.24  in the assistance unit; 
245.25     (7) the income of an eligible relative and spouse who seek 
245.26  to be included in the assistance unit; and 
245.27     (8) the unearned income of a minor child included in the 
245.28  assistance unit. 
245.29     Sec. 60.  Minnesota Statutes 1997 Supplement, section 
245.30  256J.35, is amended to read: 
245.31     256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 
245.32     Except as provided in paragraphs (a) to (c) (d), the amount 
245.33  of an assistance payment is equal to the difference between the 
245.34  transitional standard or the Minnesota family wage level in 
245.35  section 256J.24, whichever is less, and countable income. 
245.36     (a) When MFIP-S eligibility exists for the month of 
246.1   application, the amount of the assistance payment for the month 
246.2   of application must be prorated from the date of application or 
246.3   the date all other eligibility factors are met for that 
246.4   applicant, whichever is later.  This provision applies when an 
246.5   applicant loses at least one day of MFIP-S eligibility. 
246.6      (b) MFIP-S overpayments to an assistance unit must be 
246.7   recouped according to section 256J.38, subdivision 4. 
246.8      (c) An initial assistance payment must not be made to an 
246.9   applicant who is not eligible on the date payment is made. 
246.10     (d) An individual whose needs have been otherwise provided 
246.11  for in another state, in whole or in part by county, state, or 
246.12  federal dollars during a month, is ineligible to receive MFIP-S 
246.13  for the month. 
246.14     Sec. 61.  Minnesota Statutes 1997 Supplement, section 
246.15  256J.36, is amended to read: 
246.16     256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 
246.17  MEMBERS.] 
246.18     Except as prohibited in paragraphs (a) and (b), an 
246.19  allocation of income is allowed from the caregiver's income to 
246.20  meet the unmet need of an ineligible spouse or an ineligible 
246.21  child under the age of 21 for whom the caregiver is financially 
246.22  responsible who also lives with the caregiver.  An allocation is 
246.23  allowed from the caregiver's income to meet the need of an 
246.24  ineligible or excluded person.  That allocation is allowed in an 
246.25  amount up to the difference between the MFIP-S family allowance 
246.26  transitional standard for the assistance unit when that excluded 
246.27  or ineligible person is included in the assistance unit and the 
246.28  MFIP-S family allowance for the assistance unit when 
246.29  the excluded or ineligible person is not included in the 
246.30  assistance unit.  These allocations must be deducted from the 
246.31  caregiver's counted earnings and from unearned income subject to 
246.32  paragraphs (a) and (b). 
246.33     (a) Income of a minor child in the assistance unit must not 
246.34  be allocated to meet the need of a an ineligible person who is 
246.35  not a member of the assistance unit, including the child's 
246.36  parent, even when that parent is the payee of the child's income.
247.1      (b) Income of an assistance unit a caregiver must not be 
247.2   allocated to meet the needs of a disqualified person ineligible 
247.3   for failure to cooperate with program requirements including 
247.4   child support requirements, a person ineligible due to fraud, or 
247.5   a relative caregiver and the caregiver's spouse who opt out of 
247.6   the assistance unit. 
247.7      Sec. 62.  Minnesota Statutes 1997 Supplement, section 
247.8   256J.37, subdivision 1, is amended to read: 
247.9      Subdivision 1.  [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 
247.10  MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 
247.11  the income of ineligible household members must be deemed after 
247.12  allowing the following disregards: 
247.13     (1) the first 18 percent of the excluded ineligible family 
247.14  member's gross earned income; 
247.15     (2) amounts the ineligible person actually paid to 
247.16  individuals not living in the same household but whom the 
247.17  ineligible person claims or could claim as dependents for 
247.18  determining federal personal income tax liability; 
247.19     (3) child or spousal support paid to a person who lives 
247.20  outside of the household all payments made by the ineligible 
247.21  person according to a court order for spousal support or the 
247.22  support of children not living in the assistance unit's 
247.23  household, provided that, if there has been a change in the 
247.24  financial circumstances of the ineligible person since the 
247.25  support order was entered, the ineligible person has petitioned 
247.26  for a modification of the support order; and 
247.27     (4) an amount for the needs of the ineligible person and 
247.28  other persons who live in the household but are not included in 
247.29  the assistance unit and are or could be claimed by an ineligible 
247.30  person as dependents for determining federal personal income tax 
247.31  liability.  This amount is equal to the difference between the 
247.32  MFIP-S need transitional standard when the excluded ineligible 
247.33  person is included in the assistance unit and the MFIP-S need 
247.34  transitional standard when the excluded ineligible person is not 
247.35  included in the assistance unit. 
247.36     Sec. 63.  Minnesota Statutes 1997 Supplement, section 
248.1   256J.37, is amended by adding a subdivision to read: 
248.2      Subd. 1a.  [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 
248.3   income of disqualified members must be deemed after allowing the 
248.4   following disregards: 
248.5      (1) the first 18 percent of the disqualified member's gross 
248.6   earned income; 
248.7      (2) amounts the disqualified member actually paid to 
248.8   individuals not living in the same household but whom the 
248.9   disqualified member claims or could claim as dependents for 
248.10  determining federal personal income tax liability; 
248.11     (3) all payments made by the disqualified member according 
248.12  to a court order for spousal support or the support of children 
248.13  or a spouse not living in the assistance unit's household, 
248.14  provided that, if there has been a change in the financial 
248.15  circumstances of the disqualified member's legal obligation to 
248.16  pay support since the support order was entered, the 
248.17  disqualified member has petitioned for a modification of the 
248.18  support order; and 
248.19     (4) an amount for the needs of other persons who live in 
248.20  the household but are not included in the assistance unit and 
248.21  are or could be claimed by the disqualified member as dependents 
248.22  for determining federal personal income tax liability.  This 
248.23  amount is equal to the difference between the MFIP-S 
248.24  transitional standard when the ineligible person is included in 
248.25  the assistance unit and the MFIP-S transitional standard when 
248.26  the ineligible person is not included in the assistance unit.  
248.27  An amount shall not be allowed for the needs of a disqualified 
248.28  member.  
248.29     Sec. 64.  Minnesota Statutes 1997 Supplement, section 
248.30  256J.37, is amended by adding a subdivision to read: 
248.31     Subd. 1b.  [DEEMED INCOME FROM PARENTS OF MINOR 
248.32  CAREGIVERS.] In households where minor caregivers live with a 
248.33  parent or parents who do not receive MFIP-S, the income of the 
248.34  parents must be deemed after allowing the following disregards: 
248.35     (1) income of the parents equal to 200 percent of the 
248.36  federal poverty guideline for a family size not including the 
249.1   minor parent and the minor parent's child in the household 
249.2   according to section 256J.21, subdivision 2, clause (43); 
249.3      (2) 18 percent of the parent's gross earned income; 
249.4      (3) amounts the parents actually paid to individuals not 
249.5   living in the same household but whom the parents claim or could 
249.6   claim as dependents for determining federal personal income tax 
249.7   liability; and 
249.8      (4) all payments made by parents according to a court order 
249.9   for spousal support or the support of children or spouse not 
249.10  living in the parent's household, provided that, if there has 
249.11  been a change in the financial circumstances of the parent's 
249.12  legal obligation to pay support since the support order was 
249.13  entered, the parents have petitioned for a modification of the 
249.14  support order.  
249.15     Sec. 65.  Minnesota Statutes 1997 Supplement, section 
249.16  256J.37, subdivision 2, is amended to read: 
249.17     Subd. 2.  [DEEMED INCOME AND ASSETS OF SPONSOR OF 
249.18  NONCITIZENS.] All income and assets of a sponsor, or sponsor's 
249.19  spouse, who executed an affidavit of support for a noncitizen 
249.20  must be deemed to be unearned income of the noncitizen as 
249.21  specified in the Personal Responsibility and Work Opportunity 
249.22  Reconciliation Act of 1996, title IV, Public Law Number 104-193, 
249.23  sections 421 and 422, and subsequently set out in federal 
249.24  rules.  If a noncitizen applies for or receives MFIP-S, the 
249.25  county must deem the income and assets of the noncitizen's 
249.26  sponsor and the sponsor's spouse who have signed an affidavit of 
249.27  support for the noncitizen as specified in Public Law Number 
249.28  104-193, title IV, sections 421 and 422, the Personal 
249.29  Responsibility and Work Opportunity Reconciliation Act of 1996.  
249.30  The income of a sponsor and the sponsor's spouse is considered 
249.31  unearned income of the noncitizen.  The assets of a sponsor and 
249.32  the sponsor's spouse are considered available assets of the 
249.33  noncitizen.  
249.34     Sec. 66.  Minnesota Statutes 1997 Supplement, section 
249.35  256J.37, subdivision 9, is amended to read: 
249.36     Subd. 9.  [UNEARNED INCOME.] (a) The county agency must 
250.1   apply unearned income, including housing subsidies as in 
250.2   paragraph (b), to the transitional standard.  When determining 
250.3   the amount of unearned income, the county agency must deduct the 
250.4   costs necessary to secure payments of unearned income.  These 
250.5   costs include legal fees, medical fees, and mandatory deductions 
250.6   such as federal and state income taxes. 
250.7      (b) Effective July 1, 1998 1999, the county agency shall 
250.8   count $100 of the value of public and assisted rental subsidies 
250.9   provided through the Department of Housing and Urban Development 
250.10  (HUD) as unearned income.  The full amount of the subsidy must 
250.11  be counted as unearned income when the subsidy is less than $100.
250.12     Sec. 67.  Minnesota Statutes 1997 Supplement, section 
250.13  256J.38, subdivision 1, is amended to read: 
250.14     Subdivision 1.  [SCOPE OF OVERPAYMENT.] When a participant 
250.15  or former participant receives an overpayment due to agency, 
250.16  client, or ATM error, or due to assistance received while an 
250.17  appeal is pending and the participant or former participant is 
250.18  determined ineligible for assistance or for less assistance than 
250.19  was received, the county agency must recoup or recover the 
250.20  overpayment under using the conditions of this 
250.21  section. following methods:  
250.22     (1) reconstruct each affected budget month and 
250.23  corresponding payment month; 
250.24     (2) use the policies and procedures that were in effect for 
250.25  the payment month; and 
250.26     (3) do not allow employment disregards in section 256J.21, 
250.27  subdivision 3 or 4, in the calculation of the overpayment when 
250.28  the unit has not reported within two calendar months following 
250.29  the end of the month in which the income was received. 
250.30     Sec. 68.  Minnesota Statutes 1997 Supplement, section 
250.31  256J.39, subdivision 2, is amended to read: 
250.32     Subd. 2.  [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 
250.33  paying assistance directly to a participant may be used when: 
250.34     (1) a county agency determines that a vendor payment is the 
250.35  most effective way to resolve an emergency situation pertaining 
250.36  to basic needs; 
251.1      (2) a caregiver makes a written request to the county 
251.2   agency asking that part or all of the assistance payment be 
251.3   issued by protective or vendor payments for shelter and utility 
251.4   service only.  The caregiver may withdraw this request in 
251.5   writing at any time; 
251.6      (3) a caregiver has exhibited a continuing pattern of 
251.7   mismanaging funds as determined by the county agency; 
251.8      (4) the vendor payment is part of a sanction under section 
251.9   256J.46, subdivision 2; or 
251.10     (5) (4) the vendor payment is required under section 
251.11  256J.24 256J.26 or 256J.43; 
251.12     (5) protective payments are required for minor parents 
251.13  under section 256J.14; or 
251.14     (6) a caregiver has exhibited a continuing pattern of 
251.15  mismanaging funds as determined by the county agency. 
251.16     The director of a county agency must approve a proposal for 
251.17  protective or vendor payment for money mismanagement when there 
251.18  is a pattern of mismanagement under clause (6).  During the time 
251.19  a protective or vendor payment is being made, the county agency 
251.20  must provide services designed to alleviate the causes of the 
251.21  mismanagement. 
251.22     The continuing need for and method of payment must be 
251.23  documented and reviewed every 12 months.  The director of a 
251.24  county agency must approve the continuation of protective or 
251.25  vendor payments. when it appears that the need for protective or 
251.26  vendor payments will continue or is likely to continue beyond 
251.27  two years because the county agency's efforts have not resulted 
251.28  in sufficiently improved use of assistance on behalf of the 
251.29  minor child, judicial appointment of a legal guardian or other 
251.30  legal representative must be sought by the county agency.  
251.31     Sec. 69.  Minnesota Statutes 1997 Supplement, section 
251.32  256J.395, is amended to read: 
251.33     256J.395 [VENDOR PAYMENT OF RENT SHELTER COSTS AND 
251.34  UTILITIES.] 
251.35     Subdivision 1.  [VENDOR PAYMENT.] (a) Effective July 1, 
251.36  1997, when a county is required to provide assistance to 
252.1   a recipient participant in vendor form for rent shelter costs 
252.2   and utilities under this chapter, or chapter 256, 256D, or 256K, 
252.3   the cost of utilities for a given family may be assumed to be: 
252.4      (1) the average of the actual monthly cost of utilities for 
252.5   that family for the prior 12 months at the family's current 
252.6   residence, if applicable; 
252.7      (2) the monthly plan amount, if any, set by the local 
252.8   utilities for that family at the family's current residence; or 
252.9      (3) the estimated monthly utility costs for the dwelling in 
252.10  which the family currently resides. 
252.11     (b) For purposes of this section, "utility" means any of 
252.12  the following:  municipal water and sewer service; electric, 
252.13  gas, or heating fuel service; or wood, if that is the heating 
252.14  source. 
252.15     (c) In any instance where a vendor payment for rent is 
252.16  directed to a landlord not legally entitled to the payment, the 
252.17  county social services agency shall immediately institute 
252.18  proceedings to collect the amount of the vendored rent payment, 
252.19  which shall be considered a debt under section 270A.03, 
252.20  subdivision 5. 
252.21     Subd. 2.  [VENDOR PAYMENT NOTIFICATION.] (a) When a county 
252.22  agency is required to provide assistance to a participant in 
252.23  vendor payment form for shelter costs or utilities under 
252.24  subdivision 1, and the participant does not give the agency the 
252.25  information needed to pay the vendor, the county agency shall 
252.26  notify the participant of the intent to terminate assistance by 
252.27  mail at least ten days before the effective date of the adverse 
252.28  action. 
252.29     (b) The notice of action shall include a request for 
252.30  information about: 
252.31     (1) the amount of the participant's shelter costs or 
252.32  utilities; 
252.33     (2) the due date of the shelter costs or utilities; and 
252.34     (3) the name and address of the landlord, contract for deed 
252.35  holder, mortgage company, and utility vendor. 
252.36     (c) If the participant fails to provide the requested 
253.1   information by the effective date of the adverse action, the 
253.2   county must terminate the MFIP-S grant.  If the applicant or 
253.3   participant verifies they do not have shelter costs or utility 
253.4   obligations, the county shall not terminate assistance if the 
253.5   assistance unit is otherwise eligible. 
253.6      Sec. 70.  Minnesota Statutes 1997 Supplement, section 
253.7   256J.42, is amended to read: 
253.8      256J.42 [60-MONTH TIME LIMIT.] 
253.9      Subdivision 1.  [TIME LIMIT.] (a) Except for the exemptions 
253.10  in this section and in section 256J.11, subdivision 2, an 
253.11  assistance unit in which any adult caregiver has received 60 
253.12  months of cash assistance funded in whole or in part by the TANF 
253.13  block grant in this or any other state or United States 
253.14  territory, MFIP-S, AFDC, or family general assistance, funded in 
253.15  whole or in part by state appropriations, is ineligible to 
253.16  receive MFIP-S.  Any cash assistance funded with TANF dollars in 
253.17  this or any other state or United States territory, or MFIP-S 
253.18  assistance funded in whole or in part by state appropriations, 
253.19  that was received by the unit on or after the date TANF was 
253.20  implemented, including any assistance received in states or 
253.21  United States territories of prior residence, counts toward the 
253.22  60-month limitation.  The 60-month limit applies to a minor who 
253.23  is the head of a household or who is married to the head of a 
253.24  household except under subdivision 5.  The 60-month time period 
253.25  does not need to be consecutive months for this provision to 
253.26  apply.  
253.27     (b) Months before July 1998 in which individuals receive 
253.28  assistance as part of an MFIP, MFIP-R, or MFIP or MFIP-R 
253.29  comparison group family under sections 256.031 to 256.0361 or 
253.30  sections 256.047 to 256.048 are not included in the 60-month 
253.31  time limit. 
253.32     Subd. 2.  [ASSISTANCE FROM ANOTHER STATE.] An individual 
253.33  whose needs have been otherwise provided for in another state, 
253.34  in whole or in part by the TANF block grant during a month, is 
253.35  ineligible to receive MFIP-S for the month. 
253.36     Subd. 3.  [ADULTS LIVING ON AN INDIAN RESERVATION.] In 
254.1   determining the number of months for which an adult has received 
254.2   assistance under MFIP-S, the county agency must disregard any 
254.3   month during which the adult lived on an Indian reservation if, 
254.4   during the month:  
254.5      (1) at least 1,000 individuals were living on the 
254.6   reservation; and 
254.7      (2) at least 50 percent of the adults living on the 
254.8   reservation were unemployed not employed. 
254.9      Subd. 4.  [VICTIMS OF DOMESTIC VIOLENCE.] Any cash 
254.10  assistance received by an assistance unit in a month when a 
254.11  caregiver is complying with a safety plan under the MFIP-S 
254.12  employment and training component does not count toward the 
254.13  60-month limitation on assistance. 
254.14     Subd. 5.  [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 
254.15  assistance received by an assistance unit does not count toward 
254.16  the 60-month limit on assistance during a month in which 
254.17  the parental caregiver is in the category in section 256J.56, 
254.18  clause (1).  The exemption applies for the period of time the 
254.19  caregiver belongs to one of the categories specified in this 
254.20  subdivision. 
254.21     (b) From July 1, 1997, until the date MFIP-S is operative 
254.22  in the caregiver's county of financial responsibility, any cash 
254.23  assistance received by a caregiver who is complying with 
254.24  sections 256.73, subdivision 5a, and 256.736, if applicable, 
254.25  does not count toward the 60-month limit on assistance.  
254.26  Thereafter, any cash assistance received by a minor caregiver 
254.27  who is complying with the requirements of sections 256J.14 and 
254.28  256J.54, if applicable, does not count towards the 60-month 
254.29  limit on assistance. 
254.30     (c) The receipt of diversionary assistance or emergency 
254.31  assistance does not count toward the 60-month limit. 
254.32     (d) Any cash assistance received by an 18- or 19-year-old 
254.33  caregiver who is complying with the requirements of section 
254.34  256J.54 does not count toward the 60-month limit. 
254.35     Sec. 71.  Minnesota Statutes 1997 Supplement, section 
254.36  256J.43, is amended to read: 
255.1      256J.43 [INTERSTATE PAYMENT STANDARDS.] 
255.2      Subdivision 1.  [PAYMENT.] (a) Effective July 1, 1997, the 
255.3   amount of assistance paid to an eligible family unit in which 
255.4   all members have resided in this state for fewer than 12 
255.5   consecutive calendar months immediately preceding the date of 
255.6   application shall be the lesser of either the payment interstate 
255.7   transitional standard that would have been received by 
255.8   the family assistance unit from the state of immediate prior 
255.9   residence, or the amount calculated in accordance with AFDC or 
255.10  MFIP-S standards.  The lesser payment must continue until 
255.11  the family assistance unit meets the 12-month requirement.  An 
255.12  assistance unit that has not resided in Minnesota for 12 months 
255.13  from the date of application is not exempt from the interstate 
255.14  payment provisions solely because a child is born in Minnesota 
255.15  to a member of the assistance unit.  Payment must be calculated 
255.16  by applying this state's budgeting policies, and the unit's net 
255.17  income must be deducted from the payment standard in the other 
255.18  state or in this state, whichever is lower.  Payment shall be 
255.19  made in vendor form for rent shelter and utilities, up to the 
255.20  limit of the grant amount, and residual amounts, if any, shall 
255.21  be paid directly to the assistance unit. 
255.22     (b) During the first 12 months a family an assistance unit 
255.23  resides in this state, the number of months that a family unit 
255.24  is eligible to receive AFDC or MFIP-S benefits is limited to the 
255.25  number of months the family assistance unit would have been 
255.26  eligible to receive similar benefits in the state of immediate 
255.27  prior residence. 
255.28     (c) This policy applies whether or not the family 
255.29  assistance unit received similar benefits while residing in the 
255.30  state of previous residence. 
255.31     (d) When a family an assistance unit moves to this state 
255.32  from another state where the family assistance unit has 
255.33  exhausted that state's time limit for receiving benefits under 
255.34  that state's TANF program, the family unit will not be eligible 
255.35  to receive any AFDC or MFIP-S benefits in this state for 12 
255.36  months from the date the family assistance unit moves here. 
256.1      (e) For the purposes of this section, "state of immediate 
256.2   prior residence" means: 
256.3      (1) the state in which the applicant declares the applicant 
256.4   spent the most time in the 30 days prior to moving to this 
256.5   state; or 
256.6      (2) the state in which an applicant who is a migrant worker 
256.7   maintains a home. 
256.8      (f) The commissioner shall annually verify and update all 
256.9   other states' payment standards as they are to be in effect in 
256.10  July of each year. 
256.11     (g) Applicants must provide verification of their state of 
256.12  immediate prior residence, in the form of tax statements, a 
256.13  driver's license, automobile registration, rent receipts, or 
256.14  other forms of verification approved by the commissioner. 
256.15     (h) Migrant workers, as defined in section 256J.08, and 
256.16  their immediate families are exempt from this section, provided 
256.17  the migrant worker provides verification that the migrant family 
256.18  worked in this state within the last 12 months and earned at 
256.19  least $1,000 in gross wages during the time the migrant worker 
256.20  worked in this state. 
256.21     Subd. 2.  [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 
256.22  assistance unit that has met the requirements of section 
256.23  256J.12, the number of months that the assistance unit receives 
256.24  benefits under the interstate payment standards in this section 
256.25  is not affected by an absence from Minnesota for fewer than 30 
256.26  consecutive days. 
256.27     (b) For an assistance unit that has met the requirements of 
256.28  section 256J.12, the number of months that the assistance unit 
256.29  receives benefits under the interstate payment standards in this 
256.30  section is not affected by an absence from Minnesota for more 
256.31  than 30 consecutive days but fewer than 90 consecutive days, 
256.32  provided the assistance unit continues to maintain a residence 
256.33  in Minnesota during the period of absence. 
256.34     Subd. 3.  [EXCEPTIONS TO THE INTERSTATE PAYMENT 
256.35  POLICY.] Applicants who lived in another state in the 12 months 
256.36  previous to application for assistance are exempt from the 
257.1   interstate payment policy for the months that a member of the 
257.2   unit: 
257.3      (1) served in the United States armed services, provided 
257.4   the person returned to Minnesota within 30 days of leaving the 
257.5   armed forces, and intends to remain in Minnesota; 
257.6      (2) attended school in another state, paid nonresident 
257.7   tuition or Minnesota tuition rates under a reciprocity 
257.8   agreement, provided the person left Minnesota specifically to 
257.9   attend school and returned to Minnesota within 30 days of 
257.10  graduation with the intent to remain in Minnesota; or 
257.11     (3) meets the following criteria: 
257.12     (i) a minor child or a minor caregiver moves from another 
257.13  state to the residence of a relative caregiver; 
257.14     (ii) the minor caregiver applies for and receives family 
257.15  cash assistance; 
257.16     (iii) the relative caregiver chooses not to be part of the 
257.17  MFIP-S assistance unit; and 
257.18     (iv) the relative caregiver has resided in Minnesota for at 
257.19  least 12 months from the date the assistance unit applies for 
257.20  cash assistance. 
257.21     Subd. 4.  [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 
257.22  mandatory unit members who have resided in Minnesota for 12 
257.23  months immediately before the date of application meet 
257.24  eligibility for the Minnesota payment standard for the other 
257.25  assistance unit members.  
257.26     Sec. 72.  Minnesota Statutes 1997 Supplement, section 
257.27  256J.45, subdivision 1, is amended to read: 
257.28     Subdivision 1.  [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 
257.29  county agency must provide each MFIP-S caregiver with a 
257.30  face-to-face orientation.  The caregiver must attend the 
257.31  orientation.  The county agency must inform the caregiver that 
257.32  failure to attend the orientation is considered a first an 
257.33  occurrence of noncompliance with program requirements, and will 
257.34  result in the imposition of a sanction under section 
257.35  256J.46.  If the client complies with the orientation 
257.36  requirement prior to the effective date of the sanction, the 
258.1   orientation sanction shall be lifted.  
258.2      Sec. 73.  Minnesota Statutes 1997 Supplement, section 
258.3   256J.45, subdivision 2, is amended to read: 
258.4      Subd. 2.  [GENERAL INFORMATION.] The MFIP-S orientation 
258.5   must consist of a presentation that informs caregivers of: 
258.6      (1) the necessity to obtain immediate employment; 
258.7      (2) the work incentives under MFIP-S; 
258.8      (3) the requirement to comply with the employment plan and 
258.9   other requirements of the employment and training services 
258.10  component of MFIP-S; 
258.11     (4) the consequences for failing to comply with the 
258.12  employment plan and other program requirements; 
258.13     (5) the rights, responsibilities, and obligations of 
258.14  participants; 
258.15     (6) the types and locations of child care services 
258.16  available through the county agency; 
258.17     (7) the availability and the benefits of the early 
258.18  childhood health and developmental screening under sections 
258.19  123.701 to 123.74; 
258.20     (8) the caregiver's eligibility for transition year child 
258.21  care assistance under section 119B.05; 
258.22     (9) the caregiver's eligibility for extended medical 
258.23  assistance when the caregiver loses eligibility for MFIP-S due 
258.24  to increased earnings or increased child or spousal support; and 
258.25     (10) the caregiver's option to choose an employment and 
258.26  training provider and information about each provider, including 
258.27  but not limited to, services offered, program components, job 
258.28  placement rates, job placement wages, and job retention rates; 
258.29     (11) the caregiver's option to request approval of an 
258.30  education and training plan pursuant to section 256J.52; and 
258.31     (12) the work study programs available under the higher 
258.32  educational system. 
258.33     Sec. 74.  Minnesota Statutes 1997 Supplement, section 
258.34  256J.45, is amended by adding a subdivision to read: 
258.35     Subd. 3.  [GOOD CAUSE EXEMPTIONS FOR NOT ATTENDING 
258.36  ORIENTATION.] (a) The county agency shall not impose the 
259.1   sanction under section 256J.46 if it determines that the 
259.2   participant has good cause for failing to attend orientation.  
259.3   Good cause exists when: 
259.4      (1) appropriate child care is not available; 
259.5      (2) the participant is ill or injured; 
259.6      (3) a family member is ill and needs care by the 
259.7   participant that prevents the participant from attending 
259.8   orientation; 
259.9      (4) the caregiver is unable to secure necessary 
259.10  transportation; 
259.11     (5) the caregiver is in an emergency situation that 
259.12  prevents orientation attendance; 
259.13     (6) the orientation conflicts with the caregiver's work, 
259.14  training, or school schedule; or 
259.15     (7) the caregiver documents other verifiable impediments to 
259.16  orientation attendance beyond the caregiver's control.  
259.17     (b) Counties must work with clients to provide child care 
259.18  and transportation necessary to ensure a caregiver has every 
259.19  opportunity to attend orientation. 
259.20     Sec. 75.  Minnesota Statutes 1997 Supplement, section 
259.21  256J.46, subdivision 1, is amended to read: 
259.22     Subdivision 1.  [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 
259.23  WITH PROGRAM REQUIREMENTS.] (a) The following participants are 
259.24  subject to a sanction under this subdivision: 
259.25     (1) a participant who fails without good cause to comply 
259.26  with the requirements of this chapter, and who is not subject to 
259.27  a sanction under subdivision 2, shall be subject to a sanction 
259.28  as provided in this subdivision; and 
259.29     (2) a participant who has not complied with the orientation 
259.30  requirement before the effective date of the sanction.  
259.31     A sanction under this subdivision becomes effective ten 
259.32  days after the required notice is given.  For purposes of this 
259.33  subdivision, each month that a participant fails to comply with 
259.34  a requirement of this chapter shall be considered a separate 
259.35  occurrence of noncompliance.  A participant who has had one or 
259.36  more sanctions imposed must remain in compliance with the 
260.1   provisions of this chapter for six months in order for a 
260.2   subsequent occurrence of noncompliance to be considered a first 
260.3   occurrence.  
260.4      (b) Sanctions for noncompliance shall be imposed as follows:
260.5      (1) For the first occurrence of noncompliance by a 
260.6   participant in a single-parent household or by one participant 
260.7   in a two-parent household, the participant's family's grant 
260.8   shall be reduced by ten percent of the applicable MFIP-S 
260.9   transitional standard or the interstate transitional standard 
260.10  for an assistance unit of the same size, whichever is 
260.11  applicable, with the residual paid to the participant.  The 
260.12  reduction in the grant amount must be in effect for a minimum of 
260.13  one month and shall be removed in the month following the month 
260.14  that the participant returns to compliance or in the month 
260.15  following the minimum one-month sanction, whichever is later. 
260.16     (2) For a second or subsequent occurrence of noncompliance, 
260.17  or when both participants in a two-parent household are out of 
260.18  compliance at the same time, the participant's rent family's 
260.19  shelter costs shall be vendor paid up to the amount of the cash 
260.20  portion of the MFIP-S grant for which the participant's 
260.21  assistance unit is eligible.  At county option, 
260.22  the participant's family's utilities may also be vendor paid up 
260.23  to the amount of the cash portion of the MFIP-S grant remaining 
260.24  after vendor payment of the participant's rent family's shelter 
260.25  costs.  The vendor payment of rent and, if in effect, utilities, 
260.26  must be in effect for six months from the date that a sanction 
260.27  is imposed under this clause.  The residual amount of the grant 
260.28  after vendor payment, if any, must be reduced by an amount equal 
260.29  to 30 percent of the applicable MFIP-S transitional standard, or 
260.30  the interstate transitional standard for an assistance unit of 
260.31  the same size, whichever is applicable, before the residual is 
260.32  paid to the participant family.  The reduction in the grant 
260.33  amount must be in effect for a minimum of one month and shall be 
260.34  removed in the month following the month that the a participant 
260.35  in a one-parent household returns to compliance or in the month 
260.36  following the minimum one-month sanction, whichever is later.  
261.1   In a two-parent household, the grant reduction shall be removed 
261.2   in the month following the month both participants return to 
261.3   compliance or in the month following the minimum one-month 
261.4   sanction, whichever is later.  The vendor payment of 
261.5   rent shelter costs and, if applicable, utilities shall be 
261.6   removed six months after the month in which the 
261.7   participant returns or participants return to compliance. 
261.8      (c) No later than during the second month that a sanction 
261.9   under paragraph (b), clause (2), is in effect due to 
261.10  noncompliance with employment services, the participant's case 
261.11  file must be reviewed to determine if: 
261.12     (i) the continued noncompliance can be explained and 
261.13  mitigated by providing a needed preemployment activity, as 
261.14  defined in section 256J.49, subdivision 13, clause (16); 
261.15     (ii) the participant qualifies for a good cause exception 
261.16  under section 256J.57; or 
261.17     (iii) the participant qualifies for an exemption under 
261.18  section 256J.56. 
261.19     If the lack of an identified activity can explain the 
261.20  noncompliance, the county must work with the participant to 
261.21  provide the identified activity, and the county must restore the 
261.22  participant's grant amount to the full amount for which the 
261.23  assistance unit is eligible.  The grant must be restored 
261.24  retroactively to the first day of the month in which the 
261.25  participant was found to lack preemployment activities or to 
261.26  qualify for an exemption or good cause exception. 
261.27     If the participant is found to qualify for a good cause 
261.28  exception or an exemption, the county must restore the 
261.29  participant's grant to the full amount for which the assistance 
261.30  unit is eligible.  If the participant's grant is restored under 
261.31  this paragraph, the vendor payment of rent and if applicable, 
261.32  utilities, shall be removed six months after the month in which 
261.33  the sanction was imposed and the county must consider a 
261.34  subsequent occurrence of noncompliance to be a first occurrence. 
261.35     Sec. 76.  Minnesota Statutes 1997 Supplement, section 
261.36  256J.46, subdivision 2, is amended to read: 
262.1      Subd. 2.  [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 
262.2   REQUIREMENTS.] The grant of an MFIP-S caregiver who refuses to 
262.3   cooperate, as determined by the child support enforcement 
262.4   agency, with support requirements under section 256.741, if 
262.5   enacted, shall be subject to sanction as specified in this 
262.6   subdivision.  The assistance unit's grant must be reduced by 25 
262.7   percent of the applicable transitional standard.  The residual 
262.8   amount of the grant, if any, must be paid to the caregiver.  A 
262.9   sanction under this subdivision becomes effective ten days after 
262.10  the required notice is given.  The sanction must be in effect 
262.11  for a minimum of one month and shall be removed only when the 
262.12  caregiver cooperates with the support requirements or in the 
262.13  month following the minimum one-month sanction, whichever is 
262.14  later.  Each month that an MFIP-S caregiver fails to comply with 
262.15  the requirements of section 256.741 must be considered a 
262.16  separate occurrence of noncompliance.  An MFIP-S caregiver who 
262.17  has had one or more sanctions imposed must remain in compliance 
262.18  with the requirements of section 256.741 for six months in order 
262.19  for a subsequent sanction to be considered a first occurrence. 
262.20     Sec. 77.  Minnesota Statutes 1997 Supplement, section 
262.21  256J.46, subdivision 2a, is amended to read: 
262.22     Subd. 2a.  [DUAL SANCTIONS.] (a) Notwithstanding the 
262.23  provisions of subdivisions 1 and 2, for a participant subject to 
262.24  a sanction for refusal to comply with child support requirements 
262.25  under subdivision 2 and subject to a concurrent sanction for 
262.26  refusal to cooperate with other program requirements under 
262.27  subdivision 1, sanctions shall be imposed in the manner 
262.28  prescribed in this subdivision. 
262.29     A participant who has had one or more sanctions imposed 
262.30  under this subdivision must remain in compliance with the 
262.31  provisions of this chapter for six months in order for a 
262.32  subsequent occurrence of noncompliance to be considered a first 
262.33  occurrence.  Any vendor payment of rent shelter costs or 
262.34  utilities under this subdivision must remain in effect for six 
262.35  months after the month in which the participant is no longer 
262.36  subject to sanction under subdivision 1. 
263.1      (b) If the participant was subject to sanction for: 
263.2      (i) noncompliance under subdivision 1 before being subject 
263.3   to sanction for noncooperation under subdivision 2; or 
263.4      (ii) noncooperation under subdivision 2 before being 
263.5   subject to sanction for noncompliance under subdivision 1; 
263.6   the participant shall be sanctioned as provided in subdivision 
263.7   1, paragraph (b), clause (2), and the requirement that the 
263.8   county conduct a review as specified in subdivision 1, paragraph 
263.9   (c), remains in effect. 
263.10     (c) A participant who first becomes subject to sanction 
263.11  under both subdivisions 1 and 2 in the same month is subject to 
263.12  sanction as follows: 
263.13     (i) in the first month of noncompliance and noncooperation, 
263.14  the participant's grant must be reduced by 25 percent of the 
263.15  applicable transitional standard, with any residual amount paid 
263.16  to the participant; 
263.17     (ii) in the second and subsequent months of noncompliance 
263.18  and noncooperation, the participant shall be sanctioned as 
263.19  provided in subdivision 1, paragraph (b), clause (2). 
263.20     The requirement that the county conduct a review as 
263.21  specified in subdivision 1, paragraph (c), remains in effect. 
263.22     (d) A participant remains subject to sanction under 
263.23  subdivision 2 if the participant: 
263.24     (i) returns to compliance and is no longer subject to 
263.25  sanction under subdivision 1; or 
263.26     (ii) has the sanction under subdivision 1, paragraph (b), 
263.27  removed upon completion of the review under subdivision 1, 
263.28  paragraph (c). 
263.29     A participant remains subject to sanction under subdivision 
263.30  1, paragraph (b), if the participant cooperates and is no longer 
263.31  subject to sanction under subdivision 2. 
263.32     Sec. 78.  Minnesota Statutes 1997 Supplement, section 
263.33  256J.47, subdivision 4, is amended to read: 
263.34     Subd. 4.  [INELIGIBILITY FOR MFIP-S; EMERGENCY ASSISTANCE; 
263.35  AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of diversionary 
263.36  assistance, the family is ineligible for MFIP-S, emergency 
264.1   assistance, and emergency general assistance for a period of 
264.2   time.  To determine the period of ineligibility, the county 
264.3   shall use the following formula:  regardless of household 
264.4   changes, the county agency must calculate the number of days of 
264.5   ineligibility by dividing the diversionary assistance issued by 
264.6   the transitional standard a family of the same size and 
264.7   composition would have received under MFIP-S, or if applicable 
264.8   the interstate transitional standard, multiplied by 30, 
264.9   truncating the result.  The ineligibility period begins the date 
264.10  the diversionary assistance is issued. 
264.11     Sec. 79.  Minnesota Statutes 1997 Supplement, section 
264.12  256J.48, subdivision 2, is amended to read: 
264.13     Subd. 2.  [ELIGIBILITY.] Notwithstanding other eligibility 
264.14  provisions of this chapter, any family without resources 
264.15  immediately available to meet emergency needs identified in 
264.16  subdivision 3 shall be eligible for an emergency grant under the 
264.17  following conditions: 
264.18     (1) a family member has resided in this state for at least 
264.19  30 days; 
264.20     (2) the family is without resources immediately available 
264.21  to meet emergency needs; 
264.22     (3) assistance is necessary to avoid destitution or provide 
264.23  emergency shelter arrangements; and 
264.24     (4) the family's destitution or need for shelter or 
264.25  utilities did not arise because the child or relative caregiver 
264.26  refused without good cause under section 256J.57 to accept 
264.27  employment or training for employment in this state or another 
264.28  state; and 
264.29     (5) at least one child or pregnant woman in the emergency 
264.30  assistance unit meets MFIP-S citizenship requirements in section 
264.31  256J.11. 
264.32     Sec. 80.  Minnesota Statutes 1997 Supplement, section 
264.33  256J.48, is amended by adding a subdivision to read: 
264.34     Subd. 2a.  [MIGRANT WORKER ELIGIBILITY.] Notwithstanding 
264.35  other eligibility provisions of this chapter, migrant workers, 
264.36  as defined in section 256J.08, and their immediate families, who 
265.1   meet the eligibility requirements in subdivision 2, except the 
265.2   30-day residency requirement, are eligible for emergency 
265.3   assistance, if the migrant worker provides verification to the 
265.4   county agency that the migrant worker worked in this state 
265.5   within the last 12 months and earned at least $1,000 in gross 
265.6   wages during the time the migrant worker worked in this state. 
265.7      Sec. 81.  Minnesota Statutes 1997 Supplement, section 
265.8   256J.48, subdivision 3, is amended to read: 
265.9      Subd. 3.  [EMERGENCY NEEDS.] Emergency needs are limited to 
265.10  the following: 
265.11     (a)  [RENT.] A county agency may deny assistance to prevent 
265.12  eviction from rented or leased shelter of an otherwise eligible 
265.13  applicant when the county agency determines that an applicant's 
265.14  anticipated income will not cover continued payment for shelter, 
265.15  subject to conditions in clauses (1) to (3): 
265.16     (1) a county agency must not deny assistance when an 
265.17  applicant can document that the applicant is unable to locate 
265.18  habitable shelter, unless the county agency can document that 
265.19  one or more habitable shelters are available in the community 
265.20  that will result in at least a 20 percent reduction in monthly 
265.21  expense for shelter and that this shelter will be cost-effective 
265.22  for the applicant; 
265.23     (2) when no alternative shelter can be identified by either 
265.24  the applicant or the county agency, the county agency shall not 
265.25  deny assistance because anticipated income will not cover rental 
265.26  obligation; and 
265.27     (3) when cost-effective alternative shelter is identified, 
265.28  the county agency shall issue assistance for moving expenses as 
265.29  provided in paragraph (d) (e). 
265.30     (b)  [DEFINITIONS.] For purposes of paragraph (a), the 
265.31  following definitions apply (1) "metropolitan statistical area" 
265.32  is as defined by the United States Census Bureau; (2) 
265.33  "alternative shelter" includes any shelter that is located 
265.34  within the metropolitan statistical area containing the county 
265.35  and for which the applicant is eligible, provided the applicant 
265.36  does not have to travel more than 20 miles to reach the shelter 
266.1   and has access to transportation to the shelter.  Clause (2) 
266.2   does not apply to counties in the Minneapolis-St. Paul 
266.3   metropolitan statistical area. 
266.4      (c)  [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 
266.5   agency shall issue assistance for mortgage or contract for deed 
266.6   arrearages on behalf of an otherwise eligible applicant 
266.7   according to clauses (1) to (4): 
266.8      (1) assistance for arrearages must be issued only when a 
266.9   home is owned, occupied, and maintained by the applicant; 
266.10     (2) assistance for arrearages must be issued only when no 
266.11  subsequent foreclosure action is expected within the 12 months 
266.12  following the issuance; 
266.13     (3) assistance for arrearages must be issued only when an 
266.14  applicant has been refused refinancing through a bank or other 
266.15  lending institution and the amount payable, when combined with 
266.16  any payments made by the applicant, will be accepted by the 
266.17  creditor as full payment of the arrearage; 
266.18     (4) costs paid by a family which are counted toward the 
266.19  payment requirements in this clause are:  principle principal 
266.20  and interest payments on mortgages or contracts for deed, 
266.21  balloon payments, homeowner's insurance payments, manufactured 
266.22  home lot rental payments, and tax or special assessment payments 
266.23  related to the homestead.  Costs which are not counted include 
266.24  closing costs related to the sale or purchase of real property. 
266.25     To be eligible for assistance for costs specified in clause 
266.26  (4) which are outstanding at the time of foreclosure, an 
266.27  applicant must have paid at least 40 percent of the family's 
266.28  gross income toward these costs in the month of application and 
266.29  the 11-month period immediately preceding the month of 
266.30  application. 
266.31     When an applicant is eligible under clause (4), a county 
266.32  agency shall issue assistance up to a maximum of four times the 
266.33  MFIP-S transitional standard for a comparable assistance unit. 
266.34     (d)  [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 
266.35  issue assistance for damage or utility deposits when necessary 
266.36  to alleviate the emergency.  The county may require that 
267.1   assistance paid in the form of a damage deposit or a utility 
267.2   deposit, less any amount retained by the landlord to remedy a 
267.3   tenant's default in payment of rent or other funds due to the 
267.4   landlord under a rental agreement, or to restore the premises to 
267.5   the condition at the commencement of the tenancy, ordinary wear 
267.6   and tear excepted, be returned to the county when the individual 
267.7   vacates the premises or be paid to the recipient's new landlord 
267.8   as a vendor payment.  The county may require that assistance 
267.9   paid in the form of a utility deposit less any amount retained 
267.10  to satisfy outstanding utility costs be returned to the county 
267.11  when the person vacates the premises, or be paid for the 
267.12  person's new housing unit as a vendor payment.  The vendor 
267.13  payment of returned funds shall not be considered a new use of 
267.14  emergency assistance. 
267.15     (e)  [MOVING EXPENSES.] A county agency shall issue 
267.16  assistance for expenses incurred when a family must move to a 
267.17  different shelter according to clauses (1) to (4): 
267.18     (1) moving expenses include the cost to transport personal 
267.19  property belonging to a family, the cost for utility connection, 
267.20  and the cost for securing different shelter; 
267.21     (2) moving expenses must be paid only when the county 
267.22  agency determines that a move is cost-effective; 
267.23     (3) moving expenses must be paid at the request of an 
267.24  applicant, but only when destitution or threatened destitution 
267.25  exists; and 
267.26     (4) moving expenses must be paid when a county agency 
267.27  denies assistance to prevent an eviction because the county 
267.28  agency has determined that an applicant's anticipated income 
267.29  will not cover continued shelter obligation in paragraph (a). 
267.30     (f)  [HOME REPAIRS.] A county agency shall pay for repairs 
267.31  to the roof, foundation, wiring, heating system, chimney, and 
267.32  water and sewer system of a home that is owned and lived in by 
267.33  an applicant. 
267.34     The applicant shall document, and the county agency shall 
267.35  verify the need for and method of repair. 
267.36     The payment must be cost-effective in relation to the 
268.1   overall condition of the home and in relation to the cost and 
268.2   availability of alternative housing. 
268.3      (g)  [UTILITY COSTS.] Assistance for utility costs must be 
268.4   made when an otherwise eligible family has had a termination or 
268.5   is threatened with a termination of municipal water and sewer 
268.6   service, electric, gas or heating fuel service, or lacks wood 
268.7   when that is the heating source, subject to the conditions in 
268.8   clauses (1) and (2): 
268.9      (1) a county agency must not issue assistance unless the 
268.10  county agency receives confirmation from the utility provider 
268.11  that assistance combined with payment by the applicant will 
268.12  continue or restore the utility; and 
268.13     (2) a county agency shall not issue assistance for utility 
268.14  costs unless a family paid at least eight percent of the 
268.15  family's gross income toward utility costs due during the 
268.16  preceding 12 months. 
268.17     Clauses (1) and (2) must not be construed to prevent the 
268.18  issuance of assistance when a county agency must take immediate 
268.19  and temporary action necessary to protect the life or health of 
268.20  a child. 
268.21     (h)  [SPECIAL DIETS.] Effective January 1, 1998, a county 
268.22  shall pay for special diets or dietary items for MFIP-S 
268.23  participants.  Persons receiving emergency assistance funds for 
268.24  special diets or dietary items are also eligible to receive 
268.25  emergency assistance for shelter and utility emergencies, if 
268.26  otherwise eligible.  The need for special diets or dietary items 
268.27  must be prescribed by a licensed physician.  Costs for special 
268.28  diets shall be determined as percentages of the allotment for a 
268.29  one-person household under the Thrifty Food Plan as defined by 
268.30  the United States Department of Agriculture.  The types of diets 
268.31  and the percentages of the Thrifty Food Plan that are covered 
268.32  are as follows: 
268.33     (1) high protein diet, at least 80 grams daily, 25 percent 
268.34  of Thrifty Food Plan; 
268.35     (2) controlled protein diet, 40 to 60 grams and requires 
268.36  special products, 100 percent of Thrifty Food Plan; 
269.1      (3) controlled protein diet, less than 40 grams and 
269.2   requires special products, 125 percent of Thrifty Food Plan; 
269.3      (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 
269.4      (5) high residue diet, 20 percent of Thrifty Food Plan; 
269.5      (6) pregnancy and lactation diet, 35 percent of Thrifty 
269.6   Food Plan; 
269.7      (7) gluten-free diet, 25 percent of Thrifty Food Plan; 
269.8      (8) lactose-free diet, 25 percent of Thrifty Food Plan; 
269.9      (9) antidumping diet, 15 percent of Thrifty Food Plan; 
269.10     (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 
269.11     (11) ketogenic diet, 25 percent of Thrifty Food Plan. 
269.12     Sec. 82.  Minnesota Statutes 1997 Supplement, section 
269.13  256J.49, subdivision 4, is amended to read: 
269.14     Subd. 4.  [EMPLOYMENT AND TRAINING SERVICE PROVIDER.] 
269.15  "Employment and training service provider" means: 
269.16     (1) a public, private, or nonprofit employment and training 
269.17  agency certified by the commissioner of economic security under 
269.18  sections 268.0122, subdivision 3, and 268.871, subdivision 1, or 
269.19  is approved under section 256J.51 and is included in the county 
269.20  plan submitted under section 256J.50, subdivision 7; or 
269.21     (2) a public, private, or nonprofit agency that is not 
269.22  certified by the commissioner under clause (1), but with which a 
269.23  county has contracted to provide employment and training 
269.24  services and which is included in the county's plan submitted 
269.25  under section 256J.50, subdivision 7; or 
269.26     (3) a county agency, if the county is certified under 
269.27  clause (1) has opted to provide employment and training services 
269.28  and the county has indicated that fact in the plan submitted 
269.29  under section 256J.50, subdivision 7. 
269.30     Notwithstanding section 268.871, an employment and training 
269.31  services provider meeting this definition may deliver employment 
269.32  and training services under this chapter. 
269.33     Sec. 83.  Minnesota Statutes 1997 Supplement, section 
269.34  256J.50, subdivision 5, is amended to read: 
269.35     Subd. 5.  [PARTICIPATION REQUIREMENTS FOR SINGLE-PARENT AND 
269.36  TWO-PARENT CASES.] (a) A county must establish a uniform 
270.1   schedule for requiring participation by single parents.  
270.2   Mandatory participation must be required within six months of 
270.3   eligibility for cash assistance.  For two-parent cases, 
270.4   participation is required concurrent with the receipt of MFIP-S 
270.5   cash assistance. 
270.6      (b) Beginning January 1, 1998, with the exception of 
270.7   caregivers required to attend high school under the provisions 
270.8   of section 256J.54, subdivision 5, MFIP caregivers, upon 
270.9   completion of the secondary assessment, must develop an 
270.10  employment plan and participate in work activities. 
270.11     (c) In single-parent families with no children under six 
270.12  years of age, the job counselor and the caregiver must develop 
270.13  an employment plan that includes 20 to 35 hours per week of work 
270.14  activities for the period January 1, 1998, to September 30, 
270.15  1998; 25 to 35 hours of work activities per week in federal 
270.16  fiscal year 1999; and 30 to 35 hours per week of work activities 
270.17  in federal fiscal year 2000 and thereafter. 
270.18     (d) In single-parent families with a child under six years 
270.19  of age, the job counselor and the caregiver must develop an 
270.20  employment plan that includes 20 to 35 hours per week of work 
270.21  activities. 
270.22     (e) In two-parent families, the job counselor and the 
270.23  caregivers must develop employment plans.  
270.24     (f) Notwithstanding paragraphs (c) to (e), an MFIP 
270.25  caregiver who is meeting the hourly work participation 
270.26  requirements under the Personal Responsibility and Work 
270.27  Opportunity Reconciliation Act of 1996 through employment and is 
270.28  enrolled in training or education that meets the requirements of 
270.29  section 256J.53, subdivision 2, concurrent with employment, 
270.30  cannot be required to work additional hours under this section. 
270.31     Sec. 84.  Minnesota Statutes 1997 Supplement, section 
270.32  256J.50, is amended by adding a subdivision to read: 
270.33     Subd. 10.  [REQUIRED NOTIFICATION TO VICTIMS OF DOMESTIC 
270.34  VIOLENCE.] County agencies and their contractors must provide 
270.35  universal notification to all applicants and recipients of 
270.36  MFIP-S that: 
271.1      (1) referrals to counseling and supportive services are 
271.2   available for victims of domestic violence; 
271.3      (2) nonpermanent resident battered individuals married to 
271.4   United States citizens or permanent residents may be eligible to 
271.5   petition for permanent residency under the Violence Against 
271.6   Women Act, and that referrals to appropriate legal services are 
271.7   available; 
271.8      (3) victims of domestic violence are exempt from the 
271.9   60-month limit on assistance while the individual is complying 
271.10  with an approved safety plan, as defined in section 256J.49, 
271.11  subdivision 11; and 
271.12     (4) victims of domestic violence may choose to be exempt or 
271.13  deferred from work requirements for up to 12 months while the 
271.14  individual is complying with an approved safety plan as defined 
271.15  in section 256J.49, subdivision 11.  
271.16     Notification must be in writing and orally at the time of 
271.17  application and recertification, when the individual is referred 
271.18  to the title IV-D child support agency, and at the beginning of 
271.19  any job training or work placement assistance program. 
271.20     Sec. 85.  Minnesota Statutes 1997 Supplement, section 
271.21  256J.52, subdivision 4, is amended to read: 
271.22     Subd. 4.  [SECONDARY ASSESSMENT.] (a) The job counselor 
271.23  must conduct a secondary assessment for those participants who: 
271.24     (1) in the judgment of the job counselor, have barriers to 
271.25  obtaining employment that will not be overcome with a job search 
271.26  support plan under subdivision 3; 
271.27     (2) have completed eight weeks of job search under 
271.28  subdivision 3 without obtaining suitable employment; or 
271.29     (3) have not received a secondary assessment, are working 
271.30  at least 20 hours per week, and the participant, job counselor, 
271.31  or county agency requests a secondary assessment; or 
271.32     (4) have an existing plan or are already involved in 
271.33  training or education activities under section 256J.55, 
271.34  subdivision 5. 
271.35     (b) In the secondary assessment the job counselor must 
271.36  evaluate the participant's skills and prior work experience, 
272.1   family circumstances, interests and abilities, need for 
272.2   preemployment activities, supportive or educational services, 
272.3   and the extent of any barriers to employment.  The job counselor 
272.4   must use the information gathered through the secondary 
272.5   assessment to develop an employment plan under subdivision 5. 
272.6      (c) The provider shall make available to participants 
272.7   information regarding additional vendors or resources which 
272.8   provide employment and training services that may be available 
272.9   to the participant under a plan developed under this section.  
272.10  The information must include a brief summary of services 
272.11  provided and related performance indicators.  Performance 
272.12  indicators must include, but are not limited to, the average 
272.13  time to complete program offerings, placement rates, entry and 
272.14  average wages, and retention rates.  To be included in the 
272.15  information given to participants, a vendor or resource must 
272.16  provide counties with relevant information in the format 
272.17  required by the county. 
272.18     Sec. 86.  Minnesota Statutes 1997 Supplement, section 
272.19  256J.54, subdivision 2, is amended to read: 
272.20     Subd. 2.  [RESPONSIBILITY FOR ASSESSMENT AND EMPLOYMENT 
272.21  PLAN.] For caregivers who are under age 18 without a high school 
272.22  diploma or its equivalent, the assessment under subdivision 1 
272.23  and the employment plan under subdivision 3 must be completed by 
272.24  the social services agency under section 257.33.  For caregivers 
272.25  who are age 18 or 19 without a high school diploma or its 
272.26  equivalent, the assessment under subdivision 1 and the 
272.27  employment plan under subdivision 3 must be completed by the job 
272.28  counselor.  The social services agency or the job counselor 
272.29  shall consult with representatives of educational agencies that 
272.30  are required to assist in developing educational plans under 
272.31  section 126.235. 
272.32     Sec. 87.  Minnesota Statutes 1997 Supplement, section 
272.33  256J.54, subdivision 3, is amended to read: 
272.34     Subd. 3.  [EDUCATIONAL OPTION DEVELOPED.] If the job 
272.35  counselor or county social services agency identifies an 
272.36  appropriate educational option for a caregiver under the age of 
273.1   20 without a high school diploma or its equivalent, it the job 
273.2   counselor or agency must develop an employment plan which 
273.3   reflects the identified option.  The plan must specify that 
273.4   participation in an educational activity is required, what 
273.5   school or educational program is most appropriate, the services 
273.6   that will be provided, the activities the caregiver will take 
273.7   part in, including child care and supportive services, the 
273.8   consequences to the caregiver for failing to participate or 
273.9   comply with the specified requirements, and the right to appeal 
273.10  any adverse action.  The employment plan must, to the extent 
273.11  possible, reflect the preferences of the caregiver. 
273.12     Sec. 88.  Minnesota Statutes 1997 Supplement, section 
273.13  256J.54, subdivision 4, is amended to read: 
273.14     Subd. 4.  [NO APPROPRIATE EDUCATIONAL OPTION.] If the job 
273.15  counselor determines that there is no appropriate educational 
273.16  option for a caregiver who is age 18 or 19 without a high school 
273.17  diploma or its equivalent, the job counselor must develop an 
273.18  employment plan, as defined in section 256J.49, subdivision 5, 
273.19  for the caregiver.  If the county social services agency 
273.20  determines that school attendance is not appropriate for a 
273.21  caregiver under age 18 without a high school diploma or its 
273.22  equivalent, the county agency shall refer the caregiver to 
273.23  social services for services as provided in section 257.33. 
273.24     Sec. 89.  Minnesota Statutes 1997 Supplement, section 
273.25  256J.54, subdivision 5, is amended to read: 
273.26     Subd. 5.  [SCHOOL ATTENDANCE REQUIRED.] (a) Notwithstanding 
273.27  the provisions of section 256J.56, minor parents, or 18- or 
273.28  19-year-old parents without a high school diploma or its 
273.29  equivalent must attend school unless: 
273.30     (1) transportation services needed to enable the caregiver 
273.31  to attend school are not available; 
273.32     (2) appropriate child care services needed to enable the 
273.33  caregiver to attend school are not available; 
273.34     (3) the caregiver is ill or incapacitated seriously enough 
273.35  to prevent attendance at school; or 
273.36     (4) the caregiver is needed in the home because of the 
274.1   illness or incapacity of another member of the household.  This 
274.2   includes a caregiver of a child who is younger than six weeks of 
274.3   age. 
274.4      (b) The caregiver must be enrolled in a secondary school 
274.5   and meeting the school's attendance requirements.  The county, 
274.6   social service agency, or job counselor must verify that the 
274.7   caregiver is meeting the school's attendance requirements at 
274.8   least once per quarter.  An enrolled caregiver is considered to 
274.9   be meeting the attendance requirements when the school is not in 
274.10  regular session, including during holiday and summer breaks. 
274.11     Sec. 90.  Minnesota Statutes 1997 Supplement, section 
274.12  256J.55, subdivision 5, is amended to read: 
274.13     Subd. 5.  [OPTION TO UTILIZE EXISTING PLAN.] With job 
274.14  counselor approval, if a participant is already complying with a 
274.15  job search support or employment plan that was developed for a 
274.16  different program or is already involved in education or 
274.17  training activities, the participant may utilize that plan and 
274.18  that program's services, subject to the requirements of 
274.19  subdivision 3, to be in compliance with sections 256J.52 to 
274.20  256J.57 so long as the plan meets, or is modified to meet, the 
274.21  requirements of those sections. 
274.22     Sec. 91.  Minnesota Statutes 1997 Supplement, section 
274.23  256J.56, is amended to read: 
274.24     256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 
274.25  EXEMPTIONS.] 
274.26     An MFIP-S caregiver is exempt from the requirements of 
274.27  sections 256J.52 to 256J.55 if the caregiver belongs to any of 
274.28  the following groups: 
274.29     (1) individuals who are age 60 or older; 
274.30     (2) individuals who are suffering from a professionally 
274.31  certified permanent or temporary illness, injury, or incapacity 
274.32  which is expected to continue for more than 30 days and which 
274.33  prevents the person from obtaining or retaining employment.  
274.34  Persons in this category with a temporary illness, injury, or 
274.35  incapacity must be reevaluated at least quarterly; 
274.36     (3) caregivers whose presence in the home is required 
275.1   because of the professionally certified illness or incapacity of 
275.2   another member in the assistance unit, a relative in the 
275.3   household, or a foster child in the household; 
275.4      (4) women who are pregnant, if the pregnancy has resulted 
275.5   in a professionally certified incapacity that prevents the woman 
275.6   from obtaining or retaining employment; 
275.7      (5) caregivers of a child under the age of one year who 
275.8   personally provide full-time care for the child.  This exemption 
275.9   may be used for only 12 months in a lifetime.  In two-parent 
275.10  households, only one parent or other relative may qualify for 
275.11  this exemption; 
275.12     (6) individuals who are single parents or one parent in a 
275.13  two-parent family employed at least 40 hours per week or at 
275.14  least 30 hours per week and engaged in job search for at least 
275.15  an additional ten 35 hours per week; 
275.16     (7) individuals experiencing a personal or family crisis 
275.17  that makes them incapable of participating in the program, as 
275.18  determined by the county agency.  If the participant does not 
275.19  agree with the county agency's determination, the participant 
275.20  may seek professional certification, as defined in section 
275.21  256J.08, that the participant is incapable of participating in 
275.22  the program. 
275.23     Persons in this exemption category must be reevaluated 
275.24  every 60 days; or 
275.25     (8) second parents in two-parent families, provided the 
275.26  second parent is employed for 20 or more hours per week provided 
275.27  the first parent is employed at least 35 hours per week. 
275.28     A caregiver who is exempt under clause (5) must enroll in 
275.29  and attend an early childhood and family education class, a 
275.30  parenting class, or some similar activity, if available, during 
275.31  the period of time the caregiver is exempt under this section.  
275.32  Notwithstanding section 256J.46, failure to attend the required 
275.33  activity shall not result in the imposition of a sanction. 
275.34     Sec. 92.  Minnesota Statutes 1997 Supplement, section 
275.35  256J.57, subdivision 1, is amended to read: 
275.36     Subdivision 1.  [GOOD CAUSE FOR FAILURE TO COMPLY.] The 
276.1   county agency shall not impose the sanction under section 
276.2   256J.46 if it determines that the participant has good cause for 
276.3   failing to comply with the requirements of section 256J.45 or 
276.4   sections 256J.52 to 256J.55.  Good cause exists when: 
276.5      (1) appropriate child care is not available; 
276.6      (2) the job does not meet the definition of suitable 
276.7   employment; 
276.8      (3) the participant is ill or injured; 
276.9      (4) a family member of the assistance unit, a relative in 
276.10  the household, or a foster child in the household is ill and 
276.11  needs care by the participant that prevents the participant from 
276.12  complying with the job search support plan or employment plan; 
276.13     (5) the parental caregiver is unable to secure necessary 
276.14  transportation; 
276.15     (6) the parental caregiver is in an emergency situation 
276.16  that prevents compliance with the job search support plan or 
276.17  employment plan; 
276.18     (7) the schedule of compliance with the job search support 
276.19  plan or employment plan conflicts with judicial proceedings; 
276.20     (8) the parental caregiver is already participating in 
276.21  acceptable work activities; 
276.22     (9) the employment plan requires an educational program for 
276.23  a caregiver under age 20, but the educational program is not 
276.24  available; 
276.25     (10) activities identified in the job search support plan 
276.26  or employment plan are not available; 
276.27     (11) the parental caregiver is willing to accept suitable 
276.28  employment, but suitable employment is not available; or 
276.29     (12) the parental caregiver documents other verifiable 
276.30  impediments to compliance with the job search support plan or 
276.31  employment plan beyond the parental caregiver's control. 
276.32     Sec. 93.  Minnesota Statutes 1997 Supplement, section 
276.33  256J.645, subdivision 3, is amended to read: 
276.34     Subd. 3.  [FUNDING.] If the commissioner and an Indian 
276.35  tribe are parties to an agreement under this subdivision, the 
276.36  agreement may annually provide to the Indian tribe the funding 
277.1   amount in clause (1) or (2): 
277.2      (1) if the Indian tribe operated a tribal STRIDE program 
277.3   during state fiscal year 1997, the amount to be provided is the 
277.4   amount the Indian tribe received from the state for operation of 
277.5   its tribal STRIDE program in state fiscal year 1997, except that 
277.6   the amount provided for a fiscal year may increase or decrease 
277.7   in the same proportion that the total amount of state and 
277.8   federal funds available for MFIP-S employment and training 
277.9   services increased or decreased that fiscal year; or 
277.10     (2) if the Indian tribe did not operate a tribal STRIDE 
277.11  program during state fiscal year 1997, the commissioner may 
277.12  provide to the Indian tribe for the first year of operations the 
277.13  amount determined by multiplying the state allocation for MFIP-S 
277.14  employment and training services to each county agency in the 
277.15  Indian tribe's service delivery area by the percentage of MFIP-S 
277.16  recipients in that county who were members of the Indian tribe 
277.17  during the previous state fiscal year.  The resulting amount 
277.18  shall also be the amount that the commissioner may provide to 
277.19  the Indian tribe annually thereafter through an agreement under 
277.20  this subdivision, except that the amount provided for a fiscal 
277.21  year may increase or decrease in the same proportion that the 
277.22  total amount of state and federal funds available for MFIP-S 
277.23  employment and training services increased or decreased that 
277.24  fiscal year. 
277.25     Sec. 94.  Minnesota Statutes 1997 Supplement, section 
277.26  256J.74, subdivision 2, is amended to read: 
277.27     Subd. 2.  [CONCURRENT ELIGIBILITY, LIMITATIONS.] A county 
277.28  agency must not count an applicant or participant as a member of 
277.29  more than one assistance unit in a given payment month, except 
277.30  as provided in clauses (1) and (2). 
277.31     (1) A participant who is a member of an assistance unit in 
277.32  this state is eligible to be included in a second assistance 
277.33  unit in the first full month that after the month the 
277.34  participant leaves the first assistance unit and lives with 
277.35  a joins the second assistance unit. 
277.36     (2) An applicant whose needs are met through foster care 
278.1   that is reimbursed under title IV-E of the Social Security Act 
278.2   for the first part of an application month is eligible to 
278.3   receive assistance for the remaining part of the month in which 
278.4   the applicant returns home.  Title IV-E payments and adoption 
278.5   assistance payments must be considered prorated payments rather 
278.6   than a duplication of MFIP-S need. 
278.7      Sec. 95.  Minnesota Statutes 1997 Supplement, section 
278.8   256J.74, is amended by adding a subdivision to read: 
278.9      Subd. 5.  [FOOD STAMPS.] For any month an individual 
278.10  receives Food Stamp Program benefits, the individual is not 
278.11  eligible for the MFIP-S food portion of assistance, except under 
278.12  section 256J.28, subdivision 5. 
278.13     Sec. 96.  [256J.77] [AGING OF CASH BENEFITS.] 
278.14     Cash benefits under chapters 256D, 256J, and 256K by 
278.15  warrants or electronic benefit transfer that have not been 
278.16  accessed within 90 days of issuance shall be canceled.  Cash 
278.17  benefits may be replaced after they are canceled, for up to one 
278.18  year after the date of issuance, if failure to do so would place 
278.19  the client or family at risk.  For purposes of this section, 
278.20  "accessed" means cashing a warrant or making at least one 
278.21  withdrawal from benefits deposited in an electronic benefit 
278.22  account. 
278.23     Sec. 97.  Minnesota Statutes 1997 Supplement, section 
278.24  256K.03, subdivision 5, is amended to read: 
278.25     Subd. 5.  [EXEMPTION CATEGORIES.] (a) The applicant will be 
278.26  exempt from the job search requirements and development of a job 
278.27  search plan and an employability development plan under 
278.28  subdivisions 3, 4, and 8 if the applicant belongs to any of the 
278.29  following groups: 
278.30     (1) caregivers under age 20 who have not completed a high 
278.31  school education and are attending high school on a full-time 
278.32  basis; 
278.33     (2) individuals who are age 60 or older; 
278.34     (3) (2) individuals who are suffering from a professionally 
278.35  certified permanent or temporary illness, injury, or incapacity 
278.36  which is expected to continue for more than 30 days and which 
279.1   prevents the person from obtaining or retaining employment.  
279.2   Persons in this category with a temporary illness, injury, or 
279.3   incapacity must be reevaluated at least quarterly; 
279.4      (4) (3) caregivers whose presence in the home is needed 
279.5   because of the professionally certified illness or incapacity of 
279.6   another member in the assistance unit, a relative in the 
279.7   household, or a foster child in the household; 
279.8      (5) (4) women who are pregnant, if it the pregnancy has 
279.9   been medically verified resulted in a professionally certified 
279.10  incapacity that the child is expected to be born within the next 
279.11  six months prevents the woman from obtaining and retaining 
279.12  employment; 
279.13     (6) (5) caregivers or other caregiver relatives of a child 
279.14  under the age of three one year who personally provide full-time 
279.15  care for the child.  This exemption may be used for only 12 
279.16  months in a lifetime.  In two-parent households, only one parent 
279.17  or other relative may qualify for this exemption; 
279.18     (7) (6) individuals who are single parents or one parent in 
279.19  a two-parent family employed at least 30 35 hours per week; 
279.20     (8) individuals for whom participation would require a 
279.21  round trip commuting time by available transportation of more 
279.22  than two hours, excluding transporting of children for child 
279.23  care; 
279.24     (9) individuals for whom lack of proficiency in English is 
279.25  a barrier to employment, provided such individuals are 
279.26  participating in an intensive program which lasts no longer than 
279.27  six months and is designed to remedy their language deficiency; 
279.28     (10) individuals who, because of advanced age or lack of 
279.29  ability, are incapable of gaining proficiency in English, as 
279.30  determined by the county social worker, shall continue to be 
279.31  exempt under this subdivision and are not subject to the 
279.32  requirement that they be participating in a language program; 
279.33     (11) (7) individuals under such duress that they are 
279.34  incapable of participating in the program, as determined by the 
279.35  county social worker experiencing a personal or family crisis 
279.36  that makes them incapable of participating in the program, as 
280.1   determined by the county agency.  If the participant does not 
280.2   agree with the county agency's determination, the participant 
280.3   may seek professional certification, as defined in section 
280.4   256J.08, that the participant is incapable of participating in 
280.5   the program.  Persons in this exemption category must be 
280.6   reevaluated every 60 days; or 
280.7      (12) individuals in need of refresher courses for purposes 
280.8   of obtaining professional certification or licensure. 
280.9      (b) In a two-parent family, only one caregiver may be 
280.10  exempted under paragraph (a), clauses (4) and (6). 
280.11     (8) second parents in two-parent families employed for 20 
280.12  or more hours per week provided the first parent is employed at 
280.13  least 35 hours per week. 
280.14     (b) A caregiver who is exempt under clause (5) must enroll 
280.15  in and attend an early childhood and family education class, a 
280.16  parenting class, or some similar activity, if available, during 
280.17  the period of time the caregiver is exempt under this section.  
280.18  Notwithstanding section 256J.46, failure to attend the required 
280.19  activity shall not result in the imposition of a sanction. 
280.20     Sec. 98.  Laws 1997, chapter 203, article 9, section 21, is 
280.21  amended to read: 
280.22     Sec. 21.  [INELIGIBILITY FOR STATE FUNDED PROGRAMS UNSPENT 
280.23  STATE MONEY.] 
280.24     (a) Beginning July 1, 1999, the following persons will be 
280.25  ineligible for general assistance and general assistance medical 
280.26  care under Minnesota Statutes, chapter 256D, group residential 
280.27  housing under Minnesota Statutes, chapter 256I, and MFIP-S 
280.28  assistance under Minnesota Statutes, chapter 256J, funded with 
280.29  state money: 
280.30     (1) persons who are terminated from or denied Supplemental 
280.31  Security Income due to the 1996 changes in the federal law 
280.32  making persons whose alcohol or drug addiction is a material 
280.33  factor contributing to the person's disability ineligible for 
280.34  Supplemental Security Income, and are eligible for general 
280.35  assistance under Minnesota Statutes, section 256D.05, 
280.36  subdivision 1, paragraph (a), clause (17), general assistance 
281.1   medical care under Minnesota Statutes, chapter 256D, or group 
281.2   residential housing under Minnesota Statutes, chapter 256I; 
281.3      (2) legal noncitizens who are ineligible for Supplemental 
281.4   Security Income due to the 1996 changes in federal law making 
281.5   certain noncitizens ineligible for these programs due to their 
281.6   noncitizen status; and 
281.7      (3) legal noncitizens who are eligible for MFIP-S 
281.8   assistance, either the cash assistance portion or the food 
281.9   assistance portion, funded entirely with state money. 
281.10     (b) State money that remains unspent on June 30, 1999, due 
281.11  to changes in federal law enacted after May 12, 1997, that 
281.12  reduce state spending for legal noncitizens or for persons whose 
281.13  alcohol or drug addiction is a material factor contributing to 
281.14  the person's disability, or enacted after February 1, 1998, that 
281.15  reduce state spending for food benefits for legal noncitizens 
281.16  shall not cancel and shall be deposited in the TANF reserve 
281.17  account. 
281.18     Sec. 99.  Laws 1997, chapter 248, section 46, as amended by 
281.19  Laws 1997, First Special Session chapter 5, section 10, is 
281.20  amended to read: 
281.21     Sec. 46.  [UNLICENSED CHILD CARE PROVIDERS; INTERIM 
281.22  EXPANSION.] 
281.23     (a) Notwithstanding Minnesota Statutes, section 245A.03, 
281.24  subdivision 2, clause (2), until June 30, 1999, nonresidential 
281.25  child care programs or services that are provided by an 
281.26  unrelated individual to persons from two or three other 
281.27  unrelated families are excluded from the licensure provisions of 
281.28  Minnesota Statutes, chapter 245A, provided that: 
281.29     (1) the individual provides services at any one time to no 
281.30  more than four children who are unrelated to the individual; 
281.31     (2) no more than two of the children are under two years of 
281.32  age; and 
281.33     (3) the total number of children being cared for at any one 
281.34  time does not exceed five. 
281.35     (b) Paragraph (a), clauses (1) to (3), do not apply to: 
281.36     (1) nonresidential programs that are provided by an 
282.1   unrelated individual to persons from a single related family.; 
282.2      (2) a child care provider whose child care services meet 
282.3   the criteria in paragraph (a), clauses (1) to (3), but who 
282.4   chooses to apply for licensure; 
282.5      (3) a child care provider who, as an applicant for 
282.6   licensure or as a license holder, has received a license denial 
282.7   under Minnesota Statutes, section 245A.05, a fine under 
282.8   Minnesota Statutes, section 245A.06, or a sanction under 
282.9   Minnesota Statutes, section 245A.07 from the commissioner that 
282.10  has not been reversed on appeal; or 
282.11     (4) a child care provider, or a child care provider who has 
282.12  a household member who, as a result of a licensing process, has 
282.13  a disqualification under Minnesota Statutes, chapter 245A, that 
282.14  has not been set aside by the commissioner. 
282.15     Sec. 100.  [REPEALER.] 
282.16     (a) Minnesota Statutes 1997 Supplement, section 256J.28, 
282.17  subdivision 4, is repealed effective January 1, 1998.  
282.18     (b) Minnesota Statutes 1997 Supplement, sections 256J.25; 
282.19  and 256J.76; Laws 1997, chapter 85, article 1, sections 61 and 
282.20  71, and article 3, section 55, are repealed. 
282.21     (c) Minnesota Statutes 1996, sections 256.031, subdivisions 
282.22  1, 2, 3, and 4; 256.032; 256.033, subdivisions 2, 3, 4, 5, and 
282.23  6; 256.034; 256.035; 256.036; 256.0361; 256.047; 256.0475; 
282.24  256.048; and 256.049; and Minnesota Statutes 1997 Supplement, 
282.25  sections 256.031, subdivisions 5 and 6; 256.033, subdivisions 1 
282.26  and 1a; 256B.062; 256J.32, subdivision 5; and 256J.34, 
282.27  subdivision 5, are repealed effective July 1, 1998. 
282.28     (d) Minnesota Rules (Exempt), parts 9500.9100; 9500.9110; 
282.29  9500.9120; 9500.9130; 9500.9140; 9500.9150; 9500.9160; 
282.30  9500.9170; 9500.9180; 9500.9190; 9500.9200; 9500.9210; and 
282.31  9500.9220, are repealed effective July 1, 1998. 
282.32     Sec. 101.  [EFFECTIVE DATE.] 
282.33     Sections 1, 2, 5, 6, 80, and 99 are effective the day 
282.34  following final enactment. 
282.35     Section 43 is effective for all applications for the 
282.36  Minnesota family investment program-statewide made on or after 
283.1   July 1, 1998. 
283.2                              ARTICLE 7 
283.3                      REGIONAL TREATMENT CENTERS 
283.4      Section 1.  [CONVEYANCE OF STATE LAND; ANOKA COUNTY.] 
283.5      Subdivision 1.  [CONVEYANCE AUTHORIZED.] Notwithstanding 
283.6   Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 
283.7   subdivision 3, or any other law to the contrary, the 
283.8   commissioner of administration may convey all, or any part of, 
283.9   the land and associated buildings described in subdivision 3 to 
283.10  Anoka county after the commissioner of human services declares 
283.11  said property surplus to its needs. 
283.12     Subd. 2.  [FORM.] (a) The conveyance shall be in a form 
283.13  approved by the attorney general. 
283.14     (b) The conveyance is subject to a scenic easement, as 
283.15  defined in Minnesota Statutes, section 103F.311, subdivision 6, 
283.16  to be under the custodial control of the commissioner of natural 
283.17  resources, on that portion of the conveyed land that is 
283.18  designated for inclusion in the wild and scenic river system 
283.19  under Minnesota Statutes, section 103F.325.  The scenic easement 
283.20  shall allow for continued use of the structures located within 
283.21  the easement and for development of a walking path within the 
283.22  easement. 
283.23     (c) The conveyance shall restrict use of the land to 
283.24  governmental, including recreational, purposes and shall provide 
283.25  that ownership of any portion of the land that ceases to be used 
283.26  for such purposes shall revert to the state of Minnesota. 
283.27     (d) The commissioner of administration may convey any part 
283.28  of the property described in subdivision 3 any time after the 
283.29  land is declared surplus by the commissioner of human services 
283.30  and the execution and recording of the scenic easement under 
283.31  paragraph (b) has been completed. 
283.32     (e) Notwithstanding any law, regulation, or ordinance to 
283.33  the contrary, the instrument of conveyance to Anoka county may 
283.34  be recorded in the office of the Anoka county recorder without 
283.35  compliance with any subdivision requirement. 
283.36     Subd. 3.  [LAND DESCRIPTION.] Subject to right-of-way for 
284.1   Grant Street, Northview Lane, Garfield Street, 5th Avenue, and 
284.2   state trunk highway No. 288, also known as 4th Avenue, the land 
284.3   to be conveyed may include all, or part of, that which is 
284.4   described as follows: 
284.5      (1) all that part of Government Lots 3 and 4 and that part 
284.6   of the Southeast Quarter of the Southwest Quarter, all in 
284.7   Section 31, Township 32 North, Range 24 West, Anoka county, 
284.8   Minnesota, described as follows: 
284.9      Beginning at the southwest corner of said Southeast Quarter 
284.10     of the Southwest Quarter of Section 31; thence North 13 
284.11     degrees 16 minutes 11 seconds East, assumed bearing, 473.34 
284.12     feet; thence North 07 degrees 54 minutes 43 seconds East 
284.13     186.87 feet; thence North 14 degrees 08 minutes 33 seconds 
284.14     West 154.77 feet; thence North 62 degrees 46 minutes 44 
284.15     seconds West 526.92 feet; thence North 25 degrees 45 
284.16     minutes 30 seconds East 74.43 feet; thence northerly 88.30 
284.17     feet along a tangential curve concave to the west having a 
284.18     radius of 186.15 feet and a central angle of 27 degrees 10 
284.19     minutes 50 seconds; thence North 01 degrees 25 minutes 20 
284.20     seconds West, tangent to said curve, 140.53 feet; thence 
284.21     North 71 degrees 56 minutes 34 seconds West to the 
284.22     southeasterly shoreline of the Rum river; thence 
284.23     southwesterly along said shoreline to the south line of 
284.24     said Government Lot 4; thence easterly along said south 
284.25     line to the point of beginning.  For the purpose of this 
284.26     description the south line of said Southeast Quarter of the 
284.27     Southwest Quarter of Section 31 has an assumed bearing of 
284.28     North 89 degrees 08 minutes 19 seconds East; 
284.29     (2) Government Lot 1, Section 6, Township 31 North, Range 
284.30  24 West, Anoka county, Minnesota; EXCEPT that part platted as 
284.31  Grant Properties, Anoka county, Minnesota; ALSO EXCEPT that part 
284.32  lying southerly of the westerly extension of the south line of 
284.33  Block 6, Woodbury's Addition to the city of Anoka, Anoka county, 
284.34  Minnesota, and lying westerly of the west line of said plat of 
284.35  Grant Properties, said line also being the centerline of 4th 
284.36  Avenue; 
285.1      (3) all that part of said Block 6, Woodbury's Addition to 
285.2   the city of Anoka lying westerly of Northview 1st Addition, 
285.3   Anoka county, Minnesota; 
285.4      (4) all that part of said Northview 1st Addition lying 
285.5   westerly of the east line of Lots 11 through 20, Block 1, 
285.6   inclusive, thereof; and 
285.7      (5) all that part of the Northeast Quarter of the Northwest 
285.8   Quarter of said Section 6, Township 31 North, Range 24 West, 
285.9   Anoka county, Minnesota, lying northerly of the centerline of 
285.10  Grant Street as defined by said plat of Grant Properties and 
285.11  lying westerly of said east line of Lots 11 through 20, Block 1, 
285.12  inclusive, Northview 1st Addition and said line's extension 
285.13  north and south. 
285.14     Subd. 4.  [DETERMINATION.] The commissioner of human 
285.15  services has determined that the land described in subdivision 3 
285.16  will no longer be needed for the Anoka metro regional treatment 
285.17  center upon the completion of the state facilities currently 
285.18  under construction and the completion of renovation work to 
285.19  state buildings that are not located on the land described in 
285.20  subdivision 3.  The state's land and building management 
285.21  interests may best be served by conveying all, or part of, the 
285.22  land and associated buildings located on the land described in 
285.23  subdivision 3. 
285.24     Sec. 2.  [CONVEYANCE OF STATE LAND; CROW WING COUNTY.] 
285.25     Subdivision 1.  [CONVEYANCE AUTHORIZED.] Notwithstanding 
285.26  Minnesota Statutes, sections 92.45, 94.09, 94.10, and 103F.335, 
285.27  subdivision 3, or any other law to the contrary, the 
285.28  commissioner of administration may convey all, or any part of, 
285.29  the land and the state building located on the land described in 
285.30  subdivision 3, to Crow Wing county after the commissioner of 
285.31  human services declares the property surplus to its needs. 
285.32     Subd. 2.  [FORM.] (a) The conveyance shall be in a form 
285.33  approved by the attorney general. 
285.34     (b) The conveyance shall restrict use of the land to county 
285.35  governmental purposes, including community corrections programs, 
285.36  and shall provide that ownership of any portion of the land or 
286.1   building that ceases to be used for such purposes shall revert 
286.2   to the state of Minnesota. 
286.3      Subd. 3.  [LAND DESCRIPTION.] That part of the Northeast 
286.4   Quarter (NE l/4) of Section 30, Township 45 North, Range 30 
286.5   West, Crow Wing county, Minnesota, described as follows: 
286.6      Commencing at the southeast corner of said Northeast 
286.7      quarter; thence North 00 degrees 46 minutes 05 seconds 
286.8      West, bearing based on the Crow Wing county Coordinate 
286.9      Database NAD 83/94, 1520.06 feet along the east line of 
286.10     said Northeast quarter to the point of beginning; thence 
286.11     continue North 00 degrees 46 minutes 05 seconds West 634.14 
286.12     feet along said east line of the Northeast quarter; thence 
286.13     South 89 degrees 13 minutes 20 seconds West 550.00 feet; 
286.14     thence South 18 degrees 57 minutes 23 seconds East 115.59 
286.15     feet; thence South 42 degrees 44 minutes 39 seconds East 
286.16     692.37 feet; thence South 62 degrees 46 minutes 19 seconds 
286.17     East 20.24 feet; thence North 89 degrees 13 minutes 55 
286.18     seconds East 33.00 feet to the point of beginning.  
286.19     Containing 4.69 acres, more or less.  Subject to the 
286.20     right-of-way of the Township road along the east side 
286.21     thereof, subject to other easements, reservations, and 
286.22     restrictions of record, if any. 
286.23     Subd. 4.  [DETERMINATION.] The commissioner of human 
286.24  services has determined that the land, and the building on this 
286.25  land, described in subdivision 3 will not be needed for future 
286.26  operations of the Brainerd regional human services center. 
286.27                             ARTICLE 8 
286.28                        COMPULSIVE GAMBLING 
286.29     Section 1.  [245.982] [PROGRAM SUPPORT.] 
286.30     In order to address the problem of gambling in this state, 
286.31  the compulsive gambling fund should attempt to assess the 
286.32  beneficiaries of gambling, on a percentage basis according to 
286.33  the revenue they receive from gambling, for the costs of 
286.34  programs to help problem gamblers and their families.  In that 
286.35  light, the governor is requested to contact the chairs of the 11 
286.36  tribal governments in this state and request a contribution of 
287.1   funds for the compulsive gambling program.  The governor should 
287.2   seek a total supplemental contribution of $643,000.  Funds 
287.3   received from the tribal governments in this state shall be 
287.4   deposited in the Indian gaming revolving account to offset the 
287.5   appropriations contained in section 9. 
287.6      Sec. 2.  [245.983] [PUBLIC AWARENESS.] 
287.7      The commissioner of human services shall establish a public 
287.8   service campaign using program funds and leveraging media 
287.9   contributions to create public awareness of the problems 
287.10  associated with gambling.  This public service campaign should 
287.11  operate in conjunction with other prevention efforts of the 
287.12  compulsive gambling program. 
287.13     Sec. 3.  Minnesota Statutes 1996, section 609.115, 
287.14  subdivision 9, is amended to read: 
287.15     Subd. 9.  [COMPULSIVE GAMBLING ASSESSMENT REQUIRED.] (a) If 
287.16  a person is convicted of a felony for theft under section 
287.17  609.52, embezzlement of public funds under section 609.54, or 
287.18  forgery under section 609.625, 609.63, or 609.631, the probation 
287.19  officer shall determine in the report prepared under subdivision 
287.20  1 whether or not compulsive gambling contributed to the 
287.21  commission of the offense.  If so, the report shall contain the 
287.22  results of a compulsive gambling assessment conducted in 
287.23  accordance with this subdivision.  The probation officer shall 
287.24  make an appointment for the offender to undergo the assessment 
287.25  if so indicated. 
287.26     (b) The compulsive gambling assessment report must include 
287.27  a recommended level of treatment for the offender if the 
287.28  assessor concludes that the offender is in need of compulsive 
287.29  gambling treatment.  The assessment must be conducted by an 
287.30  assessor qualified under section 245.98, subdivision 2a, to 
287.31  perform these assessments or to provide compulsive gambling 
287.32  treatment.  An assessor providing a compulsive gambling 
287.33  assessment may not have any direct or shared financial interest 
287.34  or referral relationship resulting in shared financial gain with 
287.35  a treatment provider.  If an independent assessor is not 
287.36  available, the probation officer may use the services of an 
288.1   assessor with a financial interest or referral relationship as 
288.2   authorized under rules adopted by the commissioner of human 
288.3   services under section 245.98, subdivision 2a. 
288.4      (c) The commissioner of human services shall reimburse the 
288.5   assessor for the costs associated with a compulsive gambling 
288.6   assessment at a rate established by the commissioner up to a 
288.7   maximum of $100 for each assessment.  The commissioner shall 
288.8   reimburse these costs after receiving written verification from 
288.9   the probation officer that the assessment was performed and 
288.10  found acceptable. 
288.11     Sec. 4.  Laws 1994, chapter 633, article 7, section 3, is 
288.12  amended to read: 
288.13     Sec. 3.  [INDIAN GAMING REVOLVING ACCOUNT.] 
288.14     Funds received from the attorney general Indian tribal 
288.15  governments and the Minnesota state lottery shall deposit be 
288.16  deposited in a separate account in the state treasury all money 
288.17  received from Indian tribal governments for the purpose of 
288.18  defraying the attorney general's costs in providing legal 
288.19  services with respect to Indian gaming.  Money in the account is 
288.20  appropriated to the attorney general for that 
288.21  purpose contributing to the compulsive gambling program. 
288.22     Sec. 5.  [PREVALENCE STUDY.] 
288.23     The compulsive gambling program shall provide baseline 
288.24  prevalence studies to identify those at highest risk of 
288.25  developing a compulsive gambling problem, including a 
288.26  replication in 1999 of the 1994 adult prevalence survey.  
288.27     Sec. 6.  [BANKRUPTCY STUDY.] 
288.28     The commissioner of human services, in consultation with 
288.29  the attorney general and commissioner of commerce, shall study 
288.30  changes in financial, bankruptcy, and credit laws that would 
288.31  protect innocent victims who are financially linked to a 
288.32  compulsive gambler, and shall report to the legislature by 
288.33  December 15, 1998. 
288.34     Sec. 7.  [EXTENDING ASSESSMENTS TO BANKRUPTCY AND FAMILY 
288.35  COURT PROCEEDINGS.] 
288.36     The commissioner of human services shall study whether 
289.1   problem gambling assessments should be provided or required for 
289.2   individuals involved in bankruptcy or family court proceedings, 
289.3   and report to the legislature by December 15, 1998. 
289.4      Sec. 8.  [HEALTH CARE.] 
289.5      The commissioners of health and commerce shall report to 
289.6   the legislature by December 15, 1998, on whether compulsive 
289.7   gambling treatment should be considered a addictive disorder 
289.8   treatment under current health care statutes.  
289.9      Sec. 9.  [COMPULSIVE GAMBLING APPROPRIATIONS.] 
289.10     In addition to any other appropriations, $332,000 is 
289.11  appropriated in fiscal year 1999 from the Minnesota lottery 
289.12  prize fund for the compulsive gambling program.  In addition, up 
289.13  to $643,000 is appropriated from the lottery prize fund to the 
289.14  compulsive gambling program if funds required under Minnesota 
289.15  Statutes, section 245.982, are not available.  The funds are 
289.16  appropriated from the Indian gaming revolving account to the 
289.17  commissioner of human services, unless otherwise specified below.
289.18     Of the funds appropriated under this section, $670,000 in 
289.19  fiscal year 1999 is appropriated to the commissioner of human 
289.20  services for the establishment of fee-for-service projects.  
289.21  Fee-for-service funds under this appropriation may be awarded on 
289.22  a per-client basis to existing treatment centers and may be in 
289.23  addition to grants the centers currently receive.  Baseline 
289.24  grants based on the last fiscal year client numbers and units of 
289.25  services provided constitute minimum appropriations to existing 
289.26  treatment centers, and upon meeting the contracted level of 
289.27  services, the treatment centers are eligible for fee-for-service 
289.28  funds on a per-client basis in addition to grants.  
289.29     Of the funds appropriated under this section, $20,000 in 
289.30  fiscal year 1999 is appropriated to the commissioner of human 
289.31  services for purposes of the bankruptcy study under section 6 
289.32  and the bankruptcy and family court assessment study under 
289.33  section 7, and $10,000 in fiscal year 1999 is appropriated to 
289.34  the commissioner of health for purposes of the health care study 
289.35  under section 8. 
289.36     Of the funds appropriated under this section, $225,000 in 
290.1   fiscal year 1999 is appropriated for the operation of prevention 
290.2   and education programs aimed at helping adult and adolescent 
290.3   gamblers, and for the completion of a prevalence study 
290.4   replication; of the appropriation under this paragraph, up to 
290.5   $50,000 may be appropriated to the commissioner of human 
290.6   services for purposes of the public awareness campaign under 
290.7   section 2. 
290.8      Of the funds appropriated under this section, $50,000 in 
290.9   fiscal year 1999 is appropriated for operation of the hotline. 
290.10     Sec. 10.  [APPROPRIATION.] 
290.11     Subdivision 1.  [PROJECT TURNABOUT.] $500,000 is 
290.12  appropriated for fiscal year 1999 to the commissioner of human 
290.13  services from the Minnesota lottery prize fund to be used for 
290.14  Project Turnabout in Granite Falls.  This appropriation shall 
290.15  not become part of the base appropriation for the 2000-2001 
290.16  biennium. 
290.17     Subd. 2.  [LOCAL MATCH.] There must be a local match before 
290.18  money appropriated is released by the commissioner to Project 
290.19  Turnabout.  The facility shall receive state funds equal to the 
290.20  amount of local matching funds received.