1.1                          A bill for an act 
  1.2             relating to human services; modifying payment rate 
  1.3             determination for intermediate care facilities; 
  1.4             requiring a local system needs planning process; 
  1.5             establishing a statewide advisory committee; amending 
  1.6             Minnesota Statutes 1998, sections 252.28, subdivisions 
  1.7             1 and 3a; and 256B.5011, subdivisions 1 and 2; 
  1.8             proposing coding for new law in Minnesota Statutes, 
  1.9             chapters 252; and 256B; repealing Minnesota Statutes 
  1.10            1998, sections 144.0723; 256B.501, subdivision 3g; and 
  1.11            256B.5011, subdivision 3. 
  1.12  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.13     Section 1.  Minnesota Statutes 1998, section 252.28, 
  1.14  subdivision 1, is amended to read: 
  1.15     Subdivision 1.  [DETERMINATIONS; REDETERMINATIONS.] In 
  1.16  conjunction with the appropriate county boards, the commissioner 
  1.17  of human services shall determine, and shall redetermine at 
  1.18  least every four years, the need, location, size, and program of 
  1.19  public and private residential services and day training and 
  1.20  habilitation services for persons with mental retardation or 
  1.21  related conditions.  This subdivision does not apply to 
  1.22  semi-independent living services and residential-based 
  1.23  habilitation services provided to four or fewer persons at a 
  1.24  single site funded as home and community-based services.  A 
  1.25  determination of need shall not be required for a change in 
  1.26  ownership.  
  1.27     Sec. 2.  Minnesota Statutes 1998, section 252.28, 
  1.28  subdivision 3a, is amended to read: 
  2.1      Subd. 3a.  [LICENSING EXCEPTION.] Notwithstanding the 
  2.2   provisions of subdivision 3, the commissioner may license 
  2.3   service sites, each accommodating up to six residents moving 
  2.4   from a 48-bed intermediate care facility for persons with mental 
  2.5   retardation or related conditions located in Dakota county that 
  2.6   is closing under section 252.292.  Notwithstanding the 
  2.7   provisions of any other Minnesota law or rule, the rate 
  2.8   provisions of section 256I.05, subdivision 1, apply to this 
  2.9   exception. 
  2.10     Sec. 3.  [252.282] [ICF/MR LOCAL SYSTEM NEEDS PLANNING.] 
  2.11     Subdivision 1.  [HOST COUNTY RESPONSIBILITY.] (a) For 
  2.12  purposes of this section, "local system needs planning" means 
  2.13  the determination of need for ICF/MR services by program type, 
  2.14  location, demographics, and size of licensed services for 
  2.15  persons with developmental disabilities or related conditions. 
  2.16     (b) This section does not apply to semi-independent living 
  2.17  services and residential-based habilitation services funded as 
  2.18  home and community-based services. 
  2.19     (c) In collaboration with the commissioner and ICF/MR 
  2.20  providers, counties shall complete a local system needs planning 
  2.21  process for each ICF/MR facility.  Counties shall evaluate the 
  2.22  preferences and needs of persons with developmental disabilities 
  2.23  to determine resource demands through a systematic assessment 
  2.24  and planning process by May 15, 2000, and by July 1 every two 
  2.25  years thereafter beginning in 2001. 
  2.26     (d) A local system needs planning process shall be 
  2.27  undertaken more frequently when the needs or preferences of 
  2.28  consumers change significantly to require reformation of the 
  2.29  resources available to persons with developmental disabilities. 
  2.30     (e) A local system needs plan shall be amended anytime 
  2.31  recommendations for modifications to existing ICF/MR services 
  2.32  are made to the host county, including recommendations for: 
  2.33     (1) closure; 
  2.34     (2) relocation of services; 
  2.35     (3) downsizing; 
  2.36     (4) rate adjustments exceeding 90 days duration to address 
  3.1   access; or 
  3.2      (5) modification of existing services for which a change in 
  3.3   the framework of service delivery is advocated. 
  3.4      Subd. 2.  [CONSUMER NEEDS AND PREFERENCES.] In conducting 
  3.5   the local system needs planning process, the host county must 
  3.6   use information from the individual service plans of persons for 
  3.7   whom the county is financially responsible and of persons from 
  3.8   other counties for whom the county has agreed to be the host 
  3.9   county.  The determination of services and supports offered 
  3.10  within the county shall be based on the preferences and needs of 
  3.11  consumers.  The host county shall also consider the community 
  3.12  social services plan, waiting lists, and other sources that 
  3.13  identify unmet needs for services.  A review of ICF/MR facility 
  3.14  licensing and certification surveys, substantiated maltreatment 
  3.15  reports, and established service standards shall be employed to 
  3.16  assess the performance of providers and shall be considered in 
  3.17  the county's recommendations.  Consumer satisfaction surveys may 
  3.18  also be considered in this process. 
  3.19     Subd. 3.  [RECOMMENDATIONS.] (a) Upon completion of the 
  3.20  local system needs planning assessment, the host county shall 
  3.21  make recommendations by May 15, 2000, and by July 1 every two 
  3.22  years thereafter beginning in 2001.  If no change is 
  3.23  recommended, a copy of the assessment along with corresponding 
  3.24  documentation shall be provided to the commissioner by July 1 
  3.25  prior to the contract year. 
  3.26     (b) Except as provided in section 252.292, subdivision 4, 
  3.27  recommendations regarding closures, relocations, or downsizings 
  3.28  that include a rate increase and recommendations regarding rate 
  3.29  adjustments exceeding 90 days shall be submitted to the 
  3.30  statewide advisory committee for review and determination, along 
  3.31  with the assessment, plan, and corresponding budget. 
  3.32     (c) Recommendations for closures, relocations, and 
  3.33  downsizings that do not include a rate increase and for 
  3.34  modification of existing services for which a change in the 
  3.35  framework of service delivery is necessary shall be provided to 
  3.36  the commissioner by July 1 prior to the contract year or at 
  4.1   least 90 days prior to the anticipated change, along with the 
  4.2   assessment and corresponding documentation. 
  4.3      Subd. 4.  [THE STATEWIDE ADVISORY COMMITTEE.] (a) The 
  4.4   commissioner shall appoint a five-member statewide advisory 
  4.5   committee.  The advisory committee shall include representatives 
  4.6   of providers and counties and the commissioner or the 
  4.7   commissioner's designee.  The committee expires June 30, 2003, 
  4.8   and is subject to section 15.0599.  
  4.9      (b) The criteria for ranking proposals, already developed 
  4.10  in 1997 by a task force authorized by the legislature, shall be 
  4.11  adopted and incorporated into the decision-making process.  
  4.12  Specific guidelines, including time frame for submission of 
  4.13  requests, shall be established and announced through the State 
  4.14  Register, and all requests shall be considered in comparison to 
  4.15  each other and the ranking criteria.  The advisory committee 
  4.16  shall review and recommend requests for facility rate 
  4.17  adjustments to address closures, downsizing, relocation, or 
  4.18  access needs within the county and shall forward recommendations 
  4.19  and documentation to the commissioner.  The committee shall 
  4.20  ensure that: 
  4.21     (1) applications are in compliance with applicable state 
  4.22  and federal law and with the state plan; and 
  4.23     (2) cost projections for the proposed service are within 
  4.24  fiscal limitations. 
  4.25     (c) The advisory committee shall review proposals and 
  4.26  submit recommendations to the commissioner within 60 days 
  4.27  following the published deadline for submission under 
  4.28  subdivision 5. 
  4.29     Subd. 5.  [RESPONSIBILITIES OF THE COMMISSIONER.] (a) In 
  4.30  collaboration with counties, providers, and the statewide 
  4.31  advisory committee, the commissioner shall ensure that services 
  4.32  recognize the preferences and needs of persons with 
  4.33  developmental disabilities and related conditions through a 
  4.34  recurring systemic review and assessment of ICF/MR facilities 
  4.35  within the state. 
  4.36     (b) The commissioner shall publish a notice in the state 
  5.1   register twice each calendar year to announce the opportunity 
  5.2   for counties or providers to submit requests for rate 
  5.3   adjustments associated with plans for downsizing, relocation, 
  5.4   and closure of ICF/MR facilities. 
  5.5      (c) The commissioner shall designate funding parameters to 
  5.6   counties and to the statewide advisory committee for the overall 
  5.7   implementation of system needs within the fiscal resources 
  5.8   allocated by the legislature. 
  5.9      (d) The commissioner shall contract with ICF/MR providers.  
  5.10  The initial contracts shall cover the period from October 1, 
  5.11  2000, to December 31, 2001.  Subsequent contracts shall be for 
  5.12  two-year periods beginning January 1, 2002. 
  5.13     Sec. 4.  Minnesota Statutes 1998, section 256B.5011, 
  5.14  subdivision 1, is amended to read: 
  5.15     Subdivision 1.  [IN GENERAL.] Effective October 1, 2000, 
  5.16  the commissioner shall implement a performance-based contracting 
  5.17  system to replace the current method of setting total cost 
  5.18  payment rates under section 256B.501 and Minnesota Rules, parts 
  5.19  9553.0010 to 9553.0080.  In determining prospective payment 
  5.20  rates of intermediate care facilities for persons with mental 
  5.21  retardation or related conditions, the commissioner shall index 
  5.22  each facility's total operating payment rate by an inflation 
  5.23  factor as described in subdivision 3 section 256B.5012.  The 
  5.24  commissioner of finance shall include annual inflation 
  5.25  adjustments in operating costs for intermediate care facilities 
  5.26  for persons with mental retardation and related conditions as a 
  5.27  budget change request in each biennial detailed expenditure 
  5.28  budget submitted to the legislature under section 16A.11. 
  5.29     Sec. 5.  Minnesota Statutes 1998, section 256B.5011, 
  5.30  subdivision 2, is amended to read: 
  5.31     Subd. 2.  [CONTRACT PROVISIONS.] (a) The 
  5.32  performance-based service contract with each intermediate care 
  5.33  facility must include provisions for: 
  5.34     (1) modifying payments when significant changes occur in 
  5.35  the needs of the consumers; 
  5.36     (2) monitoring service quality using performance indicators 
  6.1   that measure consumer outcomes; 
  6.2      (3) the establishment and use of continuous quality 
  6.3   improvement processes using the results attained through service 
  6.4   quality monitoring; 
  6.5      (4) the annual reporting of facility statistical 
  6.6   information on all supervisory personnel, direct care personnel, 
  6.7   specialized support personnel, hours, wages and benefits, 
  6.8   staff-to-consumer ratios, and staffing patterns 
  6.9      (3) appropriate and necessary statistical information 
  6.10  required by the commissioner; 
  6.11     (5) (4) annual aggregate facility financial information or 
  6.12  an annual certified audited financial statement, including a 
  6.13  balance sheet and income and expense statements for each 
  6.14  facility, if a certified audit was prepared; and 
  6.15     (6) (5) additional requirements and penalties for 
  6.16  intermediate care facilities not meeting the standards set forth 
  6.17  in the performance-based service contract. 
  6.18     (b) The commissioner shall recommend to the legislature by 
  6.19  January 15, 2000, whether the contract should include service 
  6.20  quality monitoring that may utilize performance indicators that 
  6.21  measure consumer and program outcomes.  Performance measurement 
  6.22  shall not increase or duplicate regulatory requirements. 
  6.23     Sec. 6.  [256B.5012] [ICF/MR PAYMENT SYSTEM 
  6.24  IMPLEMENTATION.] 
  6.25     Subdivision 1.  [TOTAL PAYMENT RATE.] The total payment 
  6.26  rate effective October 1, 2000, for existing ICF/MR facilities 
  6.27  is the total of the operating payment rate and the property 
  6.28  payment rate plus inflation factors as defined in this section.  
  6.29  The initial rate year shall run from October 1, 2000, through 
  6.30  December 31, 2001.  Subsequent rate years shall run from January 
  6.31  1 through December 31 beginning in the year 2002. 
  6.32     Subd. 2.  [OPERATING PAYMENT RATE.] (a) The operating 
  6.33  payment rate equals the facility's total payment rate in effect 
  6.34  on September 30, 2000, minus the property rate.  The operating 
  6.35  payment rate includes the special operating rate and the 
  6.36  efficiency incentive in effect as of September 30, 2000.  The 
  7.1   operating payment shall be increased for each rate year by the 
  7.2   annual percentage change in the Consumer Price Index-All Items 
  7.3   (United States City Average) (CPI-U), as forecasted by Data 
  7.4   Resources, Inc., in the second quarter of the calendar year 
  7.5   preceding the start of each rate year.  In the case of the 
  7.6   initial rate year beginning October 1, 2000, and continuing 
  7.7   through December 31, 2001, the percentage change shall be based 
  7.8   on the percentage change in the CPI-U for the 15-month period 
  7.9   beginning October 1, 2000, as forecast by Data Resources, Inc., 
  7.10  in the first quarter of 2000. 
  7.11     (b) Effective October 1, 2000, the operating payment rate 
  7.12  shall be adjusted to reflect an occupancy rate equal to 100 
  7.13  percent of the facility's capacity days as of September 30, 2000.
  7.14     Subd. 3.  [PROPERTY PAYMENT RATE.] (a) The property payment 
  7.15  rate effective October 1, 2000, is based on the facility's 
  7.16  property payment rate in effect on September 30, 2000.  
  7.17  Effective October 1, 2000, a facility minimum property rate of 
  7.18  $8.13 shall be applied to all existing ICF/MR facilities.  
  7.19  Facilities with a property payment rate effective September 30, 
  7.20  2000, which is below the minimum property rate shall receive an 
  7.21  increase effective October 1, 2000, equal to the difference 
  7.22  between the minimum property payment rate and the property 
  7.23  payment rate in effect as of September 30, 2000.  Facilities 
  7.24  with a property payment rate at or above the minimum property 
  7.25  payment rate effective September 30, 2000, shall have no change 
  7.26  in their property payment rate effective October 1, 2000. 
  7.27     (b) Facility property payment rates shall be increased 
  7.28  annually for inflation, effective January 1, 2002.  The increase 
  7.29  shall be based on each facility's property payment rate in 
  7.30  effect on September 30, 2000.  Property payment rates effective 
  7.31  September 30, 2000, shall be arrayed from highest to lowest 
  7.32  before applying the minimum property payment rate in paragraph 
  7.33  (a).  For property payment rates at the 90th percentile or 
  7.34  above, the annual inflation increase shall be zero.  For 
  7.35  property payment rates below the 90th percentile but equal to or 
  7.36  above the 75th percentile, the annual inflation increase shall 
  8.1   be one percent.  For property payment rates below the 75th 
  8.2   percentile, the annual inflation increase shall be two percent.  
  8.3      Sec. 7.  [256B.5013] [PAYMENT RATE ADJUSTMENTS.] 
  8.4      Subdivision 1.  [VARIABLE RATE ADJUSTMENTS.] When there is 
  8.5   a documented increase in the resource needs of a current ICF/MR 
  8.6   recipient or recipients, or a person is admitted to a facility 
  8.7   who requires additional resources, the county of financial 
  8.8   responsibility may approve an enhanced rate for one or more 
  8.9   persons in the facility.  Resource needs directly attributable 
  8.10  to an individual that may be considered under the variable rate 
  8.11  adjustment include increased direct staff hours and other 
  8.12  specialized services, equipment, and human resources.  The 
  8.13  guidelines in paragraphs (a) to (d) apply for the payment rate 
  8.14  adjustments under this section. 
  8.15     (a) All persons must be screened according to section 
  8.16  256B.092, subdivisions 7 and 8, prior to implementation of the 
  8.17  new payment system and annually thereafter.  Screening data 
  8.18  shall be analyzed to develop broad profiles of the functional 
  8.19  characteristics of recipients.  Three components shall be used 
  8.20  to distinguish recipients based on the following broad profiles: 
  8.21     (1) functional ability to care for and maintain one's own 
  8.22  basic needs; 
  8.23     (2) the intensity of any aggressive or destructive 
  8.24  behavior; and 
  8.25     (3) any history of obstructive behavior in combination with 
  8.26  a diagnosis of psychosis or neurosis.  
  8.27     The profile groups shall be used to link resource needs to 
  8.28  funding.  The resource profile shall determine the level of 
  8.29  funding that may be authorized by the county.  The county of 
  8.30  financial responsibility may approve a rate adjustment for an 
  8.31  individual.  The commissioner shall recommend to the legislature 
  8.32  by January 15, 2000, a methodology using the profile groups to 
  8.33  determine variable rates.  The variable rate must be applied to 
  8.34  expenses related to increased direct staff hours and other 
  8.35  specialized services, equipment, and human resources.  This 
  8.36  variable rate component plus the facility's current operating 
  9.1   payment rate equals the individual's total operating payment 
  9.2   rate. 
  9.3      (b) A recipient must be screened by the county of financial 
  9.4   responsibility using the developmental disabilities screening 
  9.5   document completed immediately prior to approval of a variable 
  9.6   rate by the county.  A comparison of the updated screening and 
  9.7   the previous screening must demonstrate an increase in resource 
  9.8   needs. 
  9.9      (c) Rate adjustments projected to exceed the authorized 
  9.10  funding level associated with the person's profile must be 
  9.11  submitted to the commissioner. 
  9.12     (d) The new rate approved through this process shall not be 
  9.13  averaged across all persons living at a facility but shall be an 
  9.14  individual rate.  The county of financial responsibility must 
  9.15  indicate the projected length of time that the additional 
  9.16  funding may be needed by the individual.  The need to continue 
  9.17  an individual variable rate must be reviewed at the end of the 
  9.18  anticipated duration of need but at least annually through the 
  9.19  completion of the developmental disabilities screening document. 
  9.20     Subd. 2.  [OTHER PAYMENT RATE ADJUSTMENTS.] Facility total 
  9.21  payment rates may be adjusted by the host county, with 
  9.22  authorization from a statewide advisory committee, if, through 
  9.23  the local system needs planning process, it is determined that a 
  9.24  need exists to amend the package of purchased services with a 
  9.25  resulting increase or decrease in costs.  Except as provided in 
  9.26  section 252.292, subdivision 4, if a provider demonstrates that 
  9.27  the loss of revenues caused by the downsizing or closure of a 
  9.28  facility cannot be absorbed by the facility based on current 
  9.29  operations, the host county or the provider may submit a request 
  9.30  to the statewide advisory committee for a facility base rate 
  9.31  adjustment. 
  9.32     Subd. 3.  [RELOCATION.] (a) Property rates for all 
  9.33  facilities relocated after December 31, 1997, and up to and 
  9.34  including October 1, 2000, shall have the full annual costs of 
  9.35  relocation included in their October 1, 2000, property rate.  
  9.36  The property rate for the relocated home is subject to the costs 
 10.1   that were allowable under Minnesota Rules, chapter 9553, and the 
 10.2   investment per bed limitation for newly constructed or newly 
 10.3   established class B facilities.  
 10.4      (b) In ensuing years, all relocated homes shall be subject 
 10.5   to the investment per bed limit for newly constructed or newly 
 10.6   established class B facilities under section 256B.501, 
 10.7   subdivision 11.  The limits shall be adjusted on January 1 of 
 10.8   each year by the percentage increase in the construction index 
 10.9   published by the Bureau of Economic Analysis of the United 
 10.10  States Department of Commerce in the Survey of Current Business 
 10.11  Statistics in October of the previous two years.  Facilities 
 10.12  that are relocated within the investment per bed limit may be 
 10.13  approved by the statewide advisory committee.  Costs for 
 10.14  relocation of a facility that exceed the investment per bed 
 10.15  limit must be absorbed by the facility. 
 10.16     (c) The payment rate shall take effect when the new 
 10.17  facility is licensed and certified by the commissioner of 
 10.18  health.  Rates for facilities that are relocated after December 
 10.19  31, 1997, through October 1, 2000, shall be adjusted to reflect 
 10.20  the full inclusion of the relocation costs, subject to the 
 10.21  investment per bed limit in paragraph (b).  The investment per 
 10.22  bed limit calculated rate for the year in which the facility was 
 10.23  relocated shall be the investment per bed limit used. 
 10.24     Subd. 4.  [TEMPORARY RATE ADJUSTMENTS TO ADDRESS OCCUPANCY 
 10.25  AND ACCESS.] If a facility is operating at less than 100 percent 
 10.26  occupancy on September 30, 2000, or if a recipient is discharged 
 10.27  from a facility, the commissioner shall adjust the total payment 
 10.28  rate for up to 90 days for the remaining recipients.  This 
 10.29  mechanism shall not be used to pay for hospital or therapeutic 
 10.30  leave days beyond the maximums allowed.  Facility payment 
 10.31  adjustments exceeding 90 days to address a demonstrated need for 
 10.32  access must be submitted to the statewide advisory committee 
 10.33  with a local system needs assessment, plan, and budget for 
 10.34  review and recommendation. 
 10.35     Sec. 8.  [256B.5014] [FINANCIAL REPORTING.] 
 10.36     All facilities shall maintain financial records and shall 
 11.1   provide annual income and expense reports to the commissioner of 
 11.2   human services on a form prescribed by the commissioner no later 
 11.3   than April 30 of each year in order to receive medical 
 11.4   assistance payments.  The reports for the reporting year ending 
 11.5   December 31 must include: 
 11.6      (1) salaries and related expenses, including program 
 11.7   salaries, administrative salaries, other salaries, payroll 
 11.8   taxes, and fringe benefits; 
 11.9      (2) general operating expenses, including supplies, 
 11.10  training, repairs, purchased services and consultants, 
 11.11  utilities, food, licenses and fees, real estate taxes, 
 11.12  insurance, and working capital interest; 
 11.13     (3) property related costs, including depreciation, capital 
 11.14  debt interest, rent, and leases; and 
 11.15     (4) total annual resident days. 
 11.16     Sec. 9.  [256B.5015] [PASS-THROUGH OF TRAINING AND 
 11.17  HABILITATION SERVICES COSTS.] 
 11.18     Training and habilitation services costs shall be paid as a 
 11.19  pass-through payment at the lowest rate paid for the comparable 
 11.20  services at that site under sections 252.40 to 252.47.  The 
 11.21  pass-through payments for training and habilitation services 
 11.22  shall be paid separately by the commissioner and shall not be 
 11.23  included in the computation of the total payment rate. 
 11.24     Sec. 10.  [ICF/MR REIMBURSEMENT EFFECTIVE OCTOBER 1, 1999.] 
 11.25     (a) For the rate year beginning October 1, 1999, the 
 11.26  commissioner of human services shall exempt an intermediate care 
 11.27  facility for persons with mental retardation from reductions to 
 11.28  the payment rates under Minnesota Statutes, section 256B.501, 
 11.29  subdivision 5b, paragraph (d), clause (6), if the facility: 
 11.30     (1) has had a settle-up payment rate established in the 
 11.31  reporting year preceding the rate year for the one-time rate 
 11.32  adjustment; 
 11.33     (2) is a newly established facility; 
 11.34     (3) is an A to B conversion that has been converted under 
 11.35  Minnesota Statutes, section 252.292, since rate year 1990; 
 11.36     (4) has a payment rate subject to a community conversion 
 12.1   project under Minnesota Statutes, section 252.292; 
 12.2      (5) has a payment rate established under Minnesota 
 12.3   Statutes, section 245A.12 or 245A.13; or 
 12.4      (6) is a facility created by the relocation of more than 25 
 12.5   percent of the capacity of a related facility during the 
 12.6   reporting year. 
 12.7      (b) Notwithstanding any contrary provision in Minnesota 
 12.8   Statutes, section 256B.501, for the rate year beginning October 
 12.9   1, 1999, the commissioner of human services shall, for purposes 
 12.10  of the spend-up limit, array facilities within each grouping 
 12.11  established under Minnesota Statutes, section 256B.501, 
 12.12  subdivision 5b, paragraph (d), clause (4), by each facility's 
 12.13  cost per resident day.  A facility's cost per resident day shall 
 12.14  be determined by dividing its allowable historical general 
 12.15  operating cost for the reporting year by the facility's resident 
 12.16  days for the reporting year.  Facilities with a cost per 
 12.17  resident day at or above the median shall be limited to the 
 12.18  lesser of: 
 12.19     (1) the current reporting year's cost per resident day; or 
 12.20     (2) the prior report year's cost per resident day plus the 
 12.21  inflation factor established under Minnesota Statutes, section 
 12.22  256B.501, subdivision 3c, clause (2), increased by three 
 12.23  percentage points.  In no case shall the amount of this 
 12.24  reduction exceed:  (i) three percent for a facility with a 
 12.25  licensed capacity greater than 16 beds; (ii) two percent for a 
 12.26  facility with a licensed capacity of nine to 16 beds; and (iii) 
 12.27  one percent for a facility with a licensed capacity of eight or 
 12.28  fewer beds. 
 12.29     (c) The commissioner shall not apply the limits established 
 12.30  under Minnesota Statutes, section 256B.501, subdivision 5b, 
 12.31  paragraph (d), clause (8), for the rate year beginning October 
 12.32  1, 1999. 
 12.33     (d) Notwithstanding paragraphs (b) and (c), the 
 12.34  commissioner must utilize facility payment rates based on the 
 12.35  laws in effect for October 1, 1998, payment rates and use the 
 12.36  resulting allowable operating cost per diems as the basis for 
 13.1   the spend-up limits for the rate year beginning October 1, 1999. 
 13.2      Sec. 11.  [REPEALER.] 
 13.3      (a) Minnesota Statutes 1998, sections 144.0723; and 
 13.4   256B.5011, subdivision 3, are repealed. 
 13.5      (b) Minnesota Statutes 1998, section 256B.501, subdivision 
 13.6   3g, is repealed effective October 1, 2000.