1.1                          A bill for an act 
  1.2             relating to human services; appropriating money for 
  1.3             the departments of human services and health, the 
  1.4             veterans nursing homes board, the health-related 
  1.5             boards, the emergency medical services board, the 
  1.6             council on disability, the ombudsman for mental health 
  1.7             and mental retardation, and the ombudsman for 
  1.8             families; establishing the state board of physical 
  1.9             therapy; amending Minnesota Statutes 1998, sections 
  1.10            13.99, subdivision 38a, and by adding a subdivision; 
  1.11            16A.76, subdivision 2; 16C.10, subdivision 5; 60A.15, 
  1.12            subdivision 1; 62A.045; 62E.11, by adding a 
  1.13            subdivision; 62J.69; 116L.02; 125A.08; 125A.21, 
  1.14            subdivision 1; 125A.74, subdivisions 1 and 2; 144.065; 
  1.15            144.148; 144.1761, subdivision 1; 144.99, subdivision 
  1.16            1, and by adding a subdivision; 144A.073, subdivision 
  1.17            5; 144A.10, by adding subdivisions; 144A.46, 
  1.18            subdivision 2; 144D.01, subdivision 4; 144E.001, by 
  1.19            adding subdivisions; 144E.10, subdivision 1; 144E.11, 
  1.20            by adding a subdivision; 144E.16, subdivision 4; 
  1.21            144E.18; 144E.27, by adding subdivisions; 144E.50, by 
  1.22            adding a subdivision; 145.924; 145.9255, subdivisions 
  1.23            1 and 4; 145A.02, subdivision 10; 145.9255, 
  1.24            subdivisions 1 and 4; 148.5194, subdivisions 2, 3, 4, 
  1.25            and by adding a subdivision; 148.66; 148.67; 148.70; 
  1.26            148.705; 148.71; 148.72, subdivisions 1, 2, and 4; 
  1.27            148.73; 148.74; 148.75; 148.76; 148.78; 148B.32, 
  1.28            subdivision 1; 150A.10, subdivision 1; 214.01, 
  1.29            subdivision 2; 245.462, subdivisions 4 and 17; 
  1.30            245.4711, subdivision 1; 245.4712, subdivision 2; 
  1.31            245.4871, subdivisions 4 and 26; 245.4881, subdivision 
  1.32            1; 245A.04, subdivision 3a; 245A.08, subdivision 5; 
  1.33            245A.30; 245B.05, subdivision 7; 245B.07, subdivisions 
  1.34            5, 8, and 10; 246.18, subdivision 6; 252.28, 
  1.35            subdivision 1; 252.291, by adding a subdivision; 
  1.36            252.32, subdivision 3a; 252.46, subdivision 6; 
  1.37            253B.045, by adding subdivisions; 253B.07, subdivision 
  1.38            1; 253B.185, by adding a subdivision; 254B.01, by 
  1.39            adding a subdivision; 254B.03, subdivision 2; 254B.04, 
  1.40            subdivision 1; 254B.05, subdivision 1; 256.01, 
  1.41            subdivision 2; 256.015, subdivisions 1 and 3; 256.87, 
  1.42            subdivision 1a; 256.955, subdivisions 3, 4, 7, 8, and 
  1.43            9; 256.9685, subdivision 1a; 256.969, subdivision 1; 
  1.44            256B.04, subdivision 16, and by adding a subdivision; 
  1.45            256B.042, subdivisions 1, 2, and 3; 256B.055, 
  1.46            subdivision 3a; 256B.056, subdivision 4; 256B.057, 
  2.1             subdivision 3, and by adding a subdivision; 256B.0575; 
  2.2             256B.061; 256B.0625, subdivisions 6a, 8, 8a, 13, 19c, 
  2.3             20, 26, 28, 30, 32, 35, and by adding subdivisions; 
  2.4             256B.0627, subdivisions 1, 2, 4, 5, 8, and by adding 
  2.5             subdivisions; 256B.0635, subdivision 3; 256B.064, 
  2.6             subdivisions 1a, 1b, 1c, 2, and by adding a 
  2.7             subdivision; 256B.0911, subdivision 6; 256B.0913, 
  2.8             subdivisions 5, 10, 12, and 16; 256B.0917, subdivision 
  2.9             8; 256B.094, subdivisions 3, 5, and 6; 256B.37, 
  2.10            subdivision 2; 256B.431, subdivisions 2i, 17, 26, and 
  2.11            by adding a subdivision; 256B.434, subdivisions 3, 4, 
  2.12            13, and by adding a subdivision; 256B.435; 256B.48, 
  2.13            subdivisions 1, 1a, 1b, and 6; 256B.50, subdivision 
  2.14            1e; 256B.501, subdivision 8a, and by adding a 
  2.15            subdivision; 256B.5011, subdivisions 1 and 2; 256B.69, 
  2.16            subdivisions 3a, 5b, 6a, 6b, and by adding 
  2.17            subdivisions; 256B.692, subdivision 2; 256B.75; 
  2.18            256B.76; 256B.77, subdivisions 7a, 8, and by adding 
  2.19            subdivisions; 256D.03, subdivisions 3, 4, and 8; 
  2.20            256D.051, subdivision 2a, and by adding a subdivision; 
  2.21            256D.053, subdivision 1; 256D.06, subdivision 5; 
  2.22            256F.03, subdivision 5; 256F.05, subdivision 8; 
  2.23            256F.10, subdivisions 1, 4, 6, 7, 8, 9, and 10; 
  2.24            256I.04, subdivision 3; 256I.05, subdivisions 1 and 
  2.25            1a; 256J.08, subdivisions 11, 24, 65, 82, 83, 86a, and 
  2.26            by adding subdivisions; 256J.11, subdivisions 2 and 3; 
  2.27            256J.12, subdivisions 1a and 2; 256J.14; 256J.20, 
  2.28            subdivision 3; 256J.21, subdivisions 2, 3, and 4; 
  2.29            256J.24, subdivisions 2, 3, 7, 8, 9, and by adding a 
  2.30            subdivision; 256J.26, subdivision 1; 256J.30, 
  2.31            subdivisions 2, 7, 8, and 9; 256J.31, subdivisions 5 
  2.32            and 12; 256J.32, subdivisions 4 and 6; 256J.33; 
  2.33            256J.34, subdivisions 1, 3, and 4; 256J.35; 256J.36; 
  2.34            256J.37, subdivisions 1, 1a, 2, 9, and 10; 256J.38, 
  2.35            subdivision 4; 256J.42, subdivisions 1, 5, and by 
  2.36            adding a subdivision; 256J.43; 256J.45, subdivision 1; 
  2.37            256J.46, subdivisions 1, 2, and 2a; 256J.47, 
  2.38            subdivision 4; 256J.48, subdivisions 2 and 3; 256J.50, 
  2.39            subdivision 1; 256J.515; 256J.52, subdivisions 1, 4, 
  2.40            8, and by adding a subdivision; 256J.55, subdivision 
  2.41            4; 256J.56; 256J.57, subdivision 1; 256J.62, 
  2.42            subdivisions 1, 6, 7, 8, 9, and by adding a 
  2.43            subdivision; 256J.67, subdivision 4; 256J.74, 
  2.44            subdivision 2; 256J.76, subdivisions 1, 2, and 4; 
  2.45            256L.03, subdivisions 5 and 6; 256L.04, subdivisions 
  2.46            2, 7, 8, 11, and 13; 256L.05, subdivision 4, and by 
  2.47            adding a subdivision; 256L.06, subdivision 3; 256L.07; 
  2.48            256L.15, subdivisions 1, 1b, 2, and 3; 257.071, 
  2.49            subdivisions 1, 1a, 1c, 1d, 1e, 3, and 4; 257.66, 
  2.50            subdivision 3; 257.75, subdivision 2; 257.85, 
  2.51            subdivisions 2, 3, 4, 5, 6, 7, 9, and 11; 259.29, 
  2.52            subdivision 2; 259.67, subdivisions 6 and 7; 259.73; 
  2.53            259.85, subdivisions 2, 3, and 5; 259.89, by adding a 
  2.54            subdivision; 260.011, subdivision 2; 260.012; 260.015, 
  2.55            subdivisions 2a, 13, and 29; 260.131, subdivision 1a; 
  2.56            260.133, subdivisions 1 and 2; 260.135, by adding a 
  2.57            subdivision; 260.172, subdivision 1, and by adding a 
  2.58            subdivision; 260.181, subdivision 3; 260.191, 
  2.59            subdivisions 1, 1a, 1b, and 3b; 260.192; 260.221, 
  2.60            subdivisions 1, 1a, 1b, 1c, 3, and 5; 326.40, 
  2.61            subdivisions 2, 4, and 5; 518.10; 518.158, 
  2.62            subdivisions 1 and 2; 518.551, by adding a 
  2.63            subdivision; 518.5853, by adding a subdivision; 
  2.64            626.556, subdivisions 2, 3, 4, 7, 10, 10b, 10d, 10e, 
  2.65            10f, 10i, 10j, 11, 11b, 11c, and by adding a 
  2.66            subdivision; and 626.558, subdivision 1; Laws 1995, 
  2.67            chapter 178, article 2, section 46, subdivision 10; 
  2.68            chapter 207, article 8, section 41, as amended; Laws 
  2.69            1997, chapter 203, article 9, section 19; Laws 1998, 
  2.70            chapter 407, article 7, section 2, subdivision 3; 
  2.71            proposing coding for new law in Minnesota Statutes, 
  3.1             chapters 10; 62J; 116L; 137; 144; 144A; 144E; 148; 
  3.2             214; 245; 246; 252; 254A; 256; 256B; 256J; and 626; 
  3.3             proposing coding for new law as Minnesota Statutes, 
  3.4             chapter 256M; repealing Minnesota Statutes 1998, 
  3.5             sections 62J.77; 62J.78; 62J.79; 144.0723; 144E.16, 
  3.6             subdivisions 1, 2, 3, and 6; 144E.17; 144E.25; 
  3.7             144E.30, subdivisions 1, 2, and 6; 145.46; 256B.434, 
  3.8             subdivision 17; 256B.501, subdivision 3g; 256B.5011, 
  3.9             subdivision 3; 256B.74, subdivisions 2 and 5; 
  3.10            256D.051, subdivisions 6 and 19; 256D.053, subdivision 
  3.11            4; 256J.03; 256J.30, subdivision 6; 256J.53, 
  3.12            subdivision 4; 256J.62, subdivisions 2, 3, and 5; 
  3.13            257.071, subdivisions 8 and 10; and 462A.208; Laws 
  3.14            1997, chapter 85, article 1, section 63; chapter 203, 
  3.15            article 4, section 55; chapter 225, article 6, section 
  3.16            8; Laws 1998, chapter 407, article 2, section 104; 
  3.17            Minnesota Rules, parts 4690.0100, subparts 4, 13, 15, 
  3.18            19, 20, 21, 22, 23, 24, 26, 27, and 29; 4690.0300; 
  3.19            4690.0400; 4690.0500; 4690.0600; 4690.0700; 4690.0800, 
  3.20            subparts 1 and 2; 4690.0900; 4690.1000; 4690.1100; 
  3.21            4690.1200; 4690.1300; 4690.1600; 4690.1700; 4690.2100; 
  3.22            4690.2200, subparts 1, 3, 4, and 5; 4690.2300; 
  3.23            4690.2400, subparts 1, 2, and 3; 4690.2500; 4690.2900; 
  3.24            4690.3000; 4690.3700; 4690.3900; 4690.4000; 4690.4100; 
  3.25            4690.4200; 4690.4300; 4690.4400; 4690.4500; 4690.4600; 
  3.26            4690.4700; 4690.4800; 4690.4900; 4690.5000; 4690.5100; 
  3.27            4690.5200; 4690.5300; 4690.5400; 4690.5500; 4690.5700; 
  3.28            4690.5800; 4690.5900; 4690.6000; 4690.6100; 4690.6200; 
  3.29            4690.6300; 4690.6400; 4690.6500; 4690.6600; 4690.6700; 
  3.30            4690.6800; 4690.7000; 4690.7100; 4690.7200; 4690.7300; 
  3.31            4690.7400; 4690.7500; 4690.7600; 4690.7700; 4690.7800; 
  3.32            4690.8300, subparts 1, 2, 3, 4, and 5; and 4735.5000. 
  3.33  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  3.34                             ARTICLE 1 
  3.35                           APPROPRIATIONS 
  3.36  Section 1.  [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 
  3.37     The sums shown in the columns marked "APPROPRIATIONS" are 
  3.38  appropriated from the general fund, or any other fund named, to 
  3.39  the agencies and for the purposes specified in the following 
  3.40  sections of this article, to be available for the fiscal years 
  3.41  indicated for each purpose.  The figures "2000" and "2001" where 
  3.42  used in this article, mean that the appropriation or 
  3.43  appropriations listed under them are available for the fiscal 
  3.44  year ending June 30, 2000, or June 30, 2001, respectively.  
  3.45  Where a dollar amount appears in parentheses, it means a 
  3.46  reduction of an appropriation.  
  3.47                          SUMMARY BY FUND 
  3.48  APPROPRIATIONS                                      BIENNIAL
  3.49                            2000          2001           TOTAL
  3.50  General          $2,648,495,000 $2,777,133,000 $5,425,628,000
  3.51  State Government
  3.52  Special Revenue      36,447,000     36,158,000     72,605,000
  4.1   Health Care
  4.2   Access              149,417,000    188,885,000    338,302,000
  4.3   Metropolitan 
  4.4   Landfill Contingency
  4.5   Action Fund             196,000        199,000        395,000
  4.6   Trunk Highway         1,726,000      1,773,000      3,499,000
  4.7   Lottery Prize         1,660,000      1,550,000      3,210,000
  4.8   TOTAL            $2,837,941,000 $3,005,698,000 $5,843,639,000
  4.9   [SPENDING TAILS CAP.] (a) The 
  4.10  commissioner of finance shall make 
  4.11  transfers and base reductions described 
  4.12  in clauses (1) and (2) below to reduce 
  4.13  the recognized fund balance 
  4.14  expenditures including planning 
  4.15  estimates, if any, for fiscal years 
  4.16  2002 and 2003 to $6,247,197,000, 
  4.17  provided that the reductions shall not 
  4.18  exceed $42,000,000: 
  4.19  (1) Notwithstanding any contrary 
  4.20  provision in section 2, subdivision 10, 
  4.21  paragraph (a), of this article, 
  4.22  $12,000,000 in fiscal year 2002 and 
  4.23  $12,000,000 in fiscal year 2003 shall 
  4.24  be transferred from the federal TANF 
  4.25  block grant to the state's federal 
  4.26  Title XX block grant to be allocated 
  4.27  according to the community social 
  4.28  services aids formula in Minnesota 
  4.29  Statutes, section 256E.06, and the base 
  4.30  funding level for the community social 
  4.31  services block grant shall be reduced 
  4.32  by $12,000,000 in fiscal year 2002 and 
  4.33  fiscal year 2003. 
  4.34  (2) If full implementation of clause 
  4.35  (1) does not produce sufficient 
  4.36  reductions, notwithstanding any 
  4.37  contrary provision in article 10, 
  4.38  section 7, of this act, in fiscal year 
  4.39  2002 the first $6,000,000 in earnings 
  4.40  credited to the tobacco prevention 
  4.41  endowment fund shall be appropriated to 
  4.42  the commissioner of finance and 
  4.43  transferred to the general fund, and in 
  4.44  fiscal year 2003 the first $12,000,000 
  4.45  in earnings credited to the tobacco 
  4.46  prevention endowment fund shall be 
  4.47  appropriated to the commissioner of 
  4.48  finance and transferred to the general 
  4.49  fund. 
  4.50  (b) The spending cap of $6,247,197,000 
  4.51  shall be adjusted upward by an amount 
  4.52  equivalent to additional spending and 
  4.53  applicable planning estimates, if any, 
  4.54  approved after December 31, 1999, for 
  4.55  activities funded in this article. 
  4.56  (c) This provision shall not take 
  4.57  effect if the recognized fund balance 
  4.58  expenditures including planning 
  4.59  estimates, if any, for the activities 
  4.60  referenced in paragraph (b) are 
  4.61  determined by the commissioner of 
  4.62  finance at any time between May 1, 
  5.1   1999, and March 31, 2001, to be below 
  5.2   $6,247,197,000. 
  5.3                                              APPROPRIATIONS 
  5.4                                          Available for the Year 
  5.5                                              Ending June 30 
  5.6                                             2000         2001 
  5.7   Sec. 2.  COMMISSIONER OF 
  5.8   HUMAN SERVICES 
  5.9   Subdivision 1.  Total 
  5.10  Appropriation                     $2,696,741,000 $2,863,722,000
  5.11                Summary by Fund
  5.12  General           2,555,853,000 2,683,303,000
  5.13  State Government
  5.14  Special Revenue         485,000       507,000
  5.15  Health Care 
  5.16  Access              138,743,000   178,362,000
  5.17  Lottery Prize         1,660,000     1,550,000
  5.18  Subd. 2.  Agency Management 
  5.19  General              28,661,000    28,961,000
  5.20  State Government
  5.21  Special Revenue         371,000       392,000
  5.22  Health Care 
  5.23  Access                3,268,000     3,321,000
  5.24  The amounts that may be spent from the 
  5.25  appropriation for each purpose are as 
  5.26  follows: 
  5.27  (a) Financial Operations 
  5.28  General               7,433,000     7,569,000
  5.29  Health Care
  5.30  Access                  691,000       702,000
  5.31  [RECEIPTS FOR SYSTEMS PROJECTS.] 
  5.32  Appropriations and federal receipts for 
  5.33  information system projects for MAXIS, 
  5.34  electronic benefit system, social 
  5.35  services information system, child 
  5.36  support enforcement, and Minnesota 
  5.37  Medicaid information system (MMIS II) 
  5.38  must be deposited in the state system 
  5.39  account authorized in Minnesota 
  5.40  Statutes, section 256.014.  Money 
  5.41  appropriated for computer projects 
  5.42  approved by the information policy 
  5.43  office, funded by the legislature, and 
  5.44  approved by the commissioner of finance 
  5.45  may be transferred from one project to 
  5.46  another and from development to 
  5.47  operations as the commissioner of human 
  5.48  services considers necessary.  Any 
  5.49  unexpended balance in the appropriation 
  5.50  for these projects does not cancel but 
  5.51  is available for ongoing development 
  5.52  and operations. 
  5.53  (b) Legal & Regulation Operations 
  6.1   General               6,579,000     6,671,000
  6.2   State Government
  6.3   Special Revenue         371,000       392,000
  6.4   Health Care
  6.5   Access                  141,000       145,000
  6.6   [REIMBURSEMENT OF COUNTY COSTS.] Of the 
  6.7   general fund appropriation, $10,000 is 
  6.8   for the commissioner for the biennium 
  6.9   beginning July 1, 1999, to reimburse 
  6.10  counties for the legal and related 
  6.11  costs of contesting through the 
  6.12  administrative and judicial systems 
  6.13  decisions that affect state spending 
  6.14  but not county spending on programs 
  6.15  administered or financed by the 
  6.16  commissioner.  The commissioner may 
  6.17  reimburse expenses that occurred on or 
  6.18  after January 1, 1998. 
  6.19  (c) Management Operations 
  6.20  General              14,649,000    14,721,000
  6.21  Health Care
  6.22  Access                2,436,000     2,474,000
  6.23  [COMMUNICATION COSTS.] The commissioner 
  6.24  shall continue to operate the 
  6.25  department of human services 
  6.26  communication systems account 
  6.27  established in Laws 1993, First Special 
  6.28  Session chapter 1, article 1, section 
  6.29  2, subdivision 2, to manage shared 
  6.30  communication costs necessary for the 
  6.31  operation of the programs the 
  6.32  commissioner supervises.  A 
  6.33  communications account may also be 
  6.34  established for each regional treatment 
  6.35  center which operates communication 
  6.36  systems.  Each account shall be used to 
  6.37  manage shared communication costs 
  6.38  necessary for the operation of programs 
  6.39  the commissioner supervises.  The 
  6.40  commissioner may distribute the costs 
  6.41  of operating and maintaining 
  6.42  communication systems to participants 
  6.43  in a manner that reflects actual 
  6.44  usage.  Costs may include acquisition, 
  6.45  licensing, insurance, maintenance, 
  6.46  repair, staff time, and other costs as 
  6.47  determined by the commissioner.  
  6.48  Nonprofit organizations and state, 
  6.49  county, and local government agencies 
  6.50  involved in the operation of programs 
  6.51  the commissioner supervises may 
  6.52  participate in the use of the 
  6.53  department's communication technology 
  6.54  and share in the cost of operation.  
  6.55  The commissioner may accept on behalf 
  6.56  of the state any gift, bequest, devise, 
  6.57  or personal property of any kind, or 
  6.58  money tendered to the state for any 
  6.59  lawful purpose pertaining to the 
  6.60  communication activities of the 
  6.61  department.  Any money received for 
  6.62  this purpose must be deposited in the 
  6.63  department of human services 
  6.64  communication systems accounts.  Money 
  7.1   collected by the commissioner for the 
  7.2   use of communication systems must be 
  7.3   deposited in the state communication 
  7.4   systems account and is appropriated to 
  7.5   the commissioner for purposes of this 
  7.6   section. 
  7.7   [ISSUANCE OPERATIONS CENTER.] Payments 
  7.8   to the commissioner from other 
  7.9   governmental units and private 
  7.10  enterprises for (1) services performed 
  7.11  by the issuance operations center, or 
  7.12  (2) reports generated by the payment 
  7.13  and eligibility systems must be 
  7.14  deposited in the state systems account 
  7.15  authorized in Minnesota Statutes, 
  7.16  section 256.014.  These payments are 
  7.17  appropriated to the commissioner for 
  7.18  the operation of the issuance center or 
  7.19  system, in accordance with Minnesota 
  7.20  Statutes, section 256.014. 
  7.21  Subd. 3.  Children's Grants
  7.22  General              52,845,000    54,931,000
  7.23  Subd. 4.  Children's Services Management
  7.24  General               3,350,000     3,140,000
  7.25  Subd. 5.  Basic Health Care Grants
  7.26                Summary by Fund
  7.27  General             869,070,000   919,566,000
  7.28  Health Care
  7.29  Access              117,877,000   155,573,000
  7.30  The amounts that may be spent from this 
  7.31  appropriation for each purpose are as 
  7.32  follows: 
  7.33  (a) Minnesota Care Grants-
  7.34  Health Care
  7.35  Access              117,877,000   155,573,000
  7.36  [MINNESOTACARE PROGRAM EXPANSION.] Of 
  7.37  this appropriation, $5,442,000 in 
  7.38  fiscal year 2001 is from the health 
  7.39  care access fund to the commissioner 
  7.40  for the eligibility expansion of the 
  7.41  MinnesotaCare program up to 275 percent 
  7.42  of the federal poverty guidelines for 
  7.43  single adults and households without 
  7.44  children. 
  7.45  [SUBSIDIZED EMPLOYER HEALTH COVERAGE.] 
  7.46  Of this appropriation, $4,059,000 in 
  7.47  the biennium is from the health care 
  7.48  access fund to the commissioner for the 
  7.49  subsidized employer health coverage 
  7.50  program described in Minnesota 
  7.51  Statutes, chapter 256M, if enacted. 
  7.52  [MINNESOTACARE OUTREACH FEDERAL 
  7.53  MATCHING FUNDS.] Any federal matching 
  7.54  funds received as a result of the 
  7.55  MinnesotaCare outreach activities 
  7.56  authorized by Laws 1997, chapter 225, 
  7.57  article 7, section 2, subdivision 1, 
  8.1   shall be deposited in the health care 
  8.2   access fund and dedicated to the 
  8.3   commissioner to be used for those 
  8.4   outreach purposes. 
  8.5   [FEDERAL RECEIPTS FOR ADMINISTRATION.] 
  8.6   Receipts received as a result of 
  8.7   federal participation pertaining to 
  8.8   administrative costs of the Minnesota 
  8.9   health care reform waiver shall be 
  8.10  deposited as nondedicated revenue in 
  8.11  the health care access fund.  Receipts 
  8.12  received as a result of federal 
  8.13  participation pertaining to grants 
  8.14  shall be deposited in the federal fund 
  8.15  and shall offset health care access 
  8.16  funds for payments to providers. 
  8.17  [HEALTH CARE ACCESS FUND.] The 
  8.18  commissioner may expend money 
  8.19  appropriated from the health care 
  8.20  access fund for MinnesotaCare in either 
  8.21  fiscal year of the biennium. 
  8.22  (b) MA Basic Health Care Grants-
  8.23  Families and Children
  8.24  General             307,413,000   321,562,000
  8.25  (c) MA Basic Health Care Grants- 
  8.26  Elderly & Disabled
  8.27  General             405,535,000   452,901,000
  8.28  [PUBLIC HEALTH NURSE ASSESSMENT.] The 
  8.29  reimbursement for public health nurse 
  8.30  visits relating to the provision of 
  8.31  personal care services under Minnesota 
  8.32  Statutes, sections 256B.0625, 
  8.33  subdivision 19a, and 256B.0627, is 
  8.34  $210.50 for a face-to-face assessment 
  8.35  visit, $105.25 for each service update, 
  8.36  and $105.25 for each request for a 
  8.37  temporary service increase.  These 
  8.38  rates shall be adjusted based on rate 
  8.39  increases approved by the legislature 
  8.40  for cost-of-living or wage enhancements 
  8.41  for personal care assistant services. 
  8.42  [SURCHARGE COMPLIANCE.] In the event 
  8.43  that federal financial participation in 
  8.44  the Minnesota medical assistance 
  8.45  program is reduced as a result of a 
  8.46  determination that the surcharge and 
  8.47  intergovernmental transfers governed by 
  8.48  Minnesota Statutes, sections 256.9657 
  8.49  and 256B.19 are out of compliance with 
  8.50  United States Code, title 42, section 
  8.51  1396b(w), or its implementing 
  8.52  regulations or with any other federal 
  8.53  law designed to restrict provider tax 
  8.54  programs or intergovernmental 
  8.55  transfers, the commissioner shall 
  8.56  appeal the determination to the fullest 
  8.57  extent permitted by law and may ratably 
  8.58  reduce all medical assistance and 
  8.59  general assistance medical care 
  8.60  payments to providers other than the 
  8.61  state of Minnesota in order to 
  8.62  eliminate any shortfall resulting from 
  8.63  the reduced federal funding.  Any 
  9.1   amount later recovered through the 
  9.2   appeals process shall be used to 
  9.3   reimburse providers for any ratable 
  9.4   reductions taken. 
  9.5   [BLOOD PRODUCTS LITIGATION.] To the 
  9.6   extent permitted by federal law, 
  9.7   Minnesota Statutes, section 256.015, 
  9.8   256B.042, and 256B.15, are waived as 
  9.9   necessary for the limited purpose of 
  9.10  resolving the state's claims in 
  9.11  connection with In re Factor VIII or IX 
  9.12  Concentrate Blood Products Litigation, 
  9.13  MDL-986, No. 93-C7452 (N.D.III.). 
  9.14  (d) General Assistance Medical Care
  9.15  General             142,502,000   128,921,000
  9.16  (e) Basic Health Care - Nonentitlement
  9.17  General              13,620,000    16,182,000
  9.18  [DENTAL ACCESS GRANT.] Of this 
  9.19  appropriation, $75,000 is from the 
  9.20  general fund to the commissioner in 
  9.21  fiscal year 2000 for a grant to a 
  9.22  nonprofit dental provider group 
  9.23  operating a dental clinic in Clay 
  9.24  county.  The grant must be used to 
  9.25  increase access to dental services for 
  9.26  recipients of medical assistance, 
  9.27  general assistance medical care, and 
  9.28  the MinnesotaCare program in the 
  9.29  northwest area of the state.  This 
  9.30  appropriation is available the day 
  9.31  following final enactment. 
  9.32  [SENIOR DRUG PROGRAM PREMIUM 
  9.33  REIMBURSEMENT.] Of this appropriation, 
  9.34  $118,000 in fiscal year 2000 is to the 
  9.35  commissioner to refund to current 
  9.36  enrollees the balance of their annual 
  9.37  premiums on a pro rata basis for the 
  9.38  months remaining in their first 
  9.39  12-month annual enrollment cycle. 
  9.40  Subd. 6.  Basic Health Care Management
  9.41  General              23,360,000    23,576,000
  9.42  Health Care
  9.43  Access               16,285,000    18,150,000
  9.44  The amounts that may be spent from this 
  9.45  appropriation for each purpose are as 
  9.46  follows: 
  9.47  (a) Health Care Policy Administration
  9.48  General               3,076,000     3,157,000
  9.49  Health Care 
  9.50  Access                  570,000       582,000
  9.51  [CONSUMER SATISFACTION SURVEY.] Any 
  9.52  federal matching money received through 
  9.53  the medical assistance program for the 
  9.54  consumer satisfaction survey is 
  9.55  appropriated to the commissioner for 
  9.56  this purpose.  The commissioner may 
 10.1   expend the federal money received for 
 10.2   the consumer satisfaction survey in 
 10.3   either year of the biennium. 
 10.4   (b) Health Care Operations
 10.5   General              20,284,000    20,419,000
 10.6   Health Care
 10.7   Access               15,715,000    17,568,000
 10.8   [MINNESOTACARE STAFF.] Of this 
 10.9   appropriation, $2,121,000 for fiscal 
 10.10  year 2000 and $1,465,000 for fiscal 
 10.11  year 2001 is from the health care 
 10.12  access fund to the commissioner for 
 10.13  staff and other administrative services 
 10.14  associated with improving MinnesotaCare 
 10.15  processing and caseload management.  Of 
 10.16  this appropriation, $965,000 shall 
 10.17  become part of the base. 
 10.18  [PREPAID MEDICAL PROGRAMS.] The 
 10.19  nonfederal share of the prepaid medical 
 10.20  assistance program fund, which has been 
 10.21  appropriated to fund county managed 
 10.22  care advocacy and enrollment operating 
 10.23  costs, shall be disbursed as grants 
 10.24  using either a reimbursement or block 
 10.25  grant mechanism and may also be 
 10.26  transferred between grants and nongrant 
 10.27  administration costs with approval of 
 10.28  the commissioner of finance. 
 10.29  Subd. 7.  State-Operated Services
 10.30  General             206,785,000   211,902,000
 10.31  The amounts that may be spent from this 
 10.32  appropriation for each purpose are as 
 10.33  follows: 
 10.34  (a) SOS-Campus Based Programs
 10.35  General             185,552,000   190,043,000
 10.36  [DAY TRAINING SERVICES.] In order to 
 10.37  ensure eligible individuals have access 
 10.38  to day training and habilitation 
 10.39  services, the regional treatment 
 10.40  centers, the Minnesota extended 
 10.41  treatment options program, and 
 10.42  state-operated community services 
 10.43  operating according to Minnesota 
 10.44  Statutes, section 252.50, are exempt 
 10.45  from the provisions of Minnesota 
 10.46  Statutes, section 252.41, subdivision 
 10.47  9, clause (2).  Notwithstanding section 
 10.48  13, this provision shall not expire. 
 10.49  [MITIGATION RELATED TO DEVELOPMENTAL 
 10.50  DISABILITIES DOWNSIZING.] Money 
 10.51  appropriated to finance mitigation 
 10.52  expenses related to the downsizing of 
 10.53  regional treatment center developmental 
 10.54  disabilities programs may be 
 10.55  transferred between fiscal years within 
 10.56  the biennium. 
 10.57  [REGIONAL TREATMENT CENTER CHEMICAL 
 10.58  DEPENDENCY PROGRAMS.] When the 
 11.1   operations of the regional treatment 
 11.2   center chemical dependency fund created 
 11.3   in Minnesota Statutes, section 246.18, 
 11.4   subdivision 2, are impeded by projected 
 11.5   cash deficiencies resulting from delays 
 11.6   in the receipt of grants, dedicated 
 11.7   income, or other similar receivables, 
 11.8   and when the deficiencies would be 
 11.9   corrected within the budget period 
 11.10  involved, the commissioner of finance 
 11.11  may transfer general fund cash reserves 
 11.12  into this account as necessary to meet 
 11.13  cash demands.  The cash flow transfers 
 11.14  must be returned to the general fund in 
 11.15  the fiscal year that the transfer was 
 11.16  made.  Any interest earned on general 
 11.17  fund cash flow transfers accrues to the 
 11.18  general fund and not the regional 
 11.19  treatment center chemical dependency 
 11.20  fund. 
 11.21  [LEAVE LIABILITIES.] The accrued leave 
 11.22  liabilities of state employees 
 11.23  transferred to state-operated community 
 11.24  services programs may be paid from the 
 11.25  appropriation in this subdivision for 
 11.26  state-operated services.  Funds set 
 11.27  aside for this purpose shall not exceed 
 11.28  the amount of the actual leave 
 11.29  liability calculated as of June 30, 
 11.30  2000, and shall be available until 
 11.31  expended. 
 11.32  [REGIONAL TREATMENT CENTER 
 11.33  RESTRUCTURING.] For purposes of 
 11.34  restructuring the regional treatment 
 11.35  centers and state nursing homes, any 
 11.36  regional treatment center or state 
 11.37  nursing home employee whose position is 
 11.38  to be eliminated shall be afforded the 
 11.39  options provided in applicable 
 11.40  collective bargaining agreements.  All 
 11.41  salary and mitigation allocations from 
 11.42  fiscal year 2000 shall be carried 
 11.43  forward into fiscal year 2001.  
 11.44  Provided there is no conflict with any 
 11.45  collective bargaining agreement, any 
 11.46  regional treatment center or state 
 11.47  nursing home position reduction must 
 11.48  only be accomplished through 
 11.49  mitigation, attrition, transfer, and 
 11.50  other measures as provided in state or 
 11.51  applicable collective bargaining 
 11.52  agreements and in Minnesota Statutes, 
 11.53  section 252.50, subdivision 11, and not 
 11.54  through layoff. 
 11.55  [REGIONAL TREATMENT CENTER POPULATION.] 
 11.56  If the resident population at the 
 11.57  regional treatment centers is projected 
 11.58  to be higher than the estimates upon 
 11.59  which the medical assistance forecast 
 11.60  and budget recommendations for the 
 11.61  2000-2001 biennium is based, the amount 
 11.62  of the medical assistance appropriation 
 11.63  that is attributable to the cost of 
 11.64  services that would have been provided 
 11.65  as an alternative to regional treatment 
 11.66  center services, including resources 
 11.67  for community placements and waivered 
 11.68  services for persons with mental 
 12.1   retardation and related conditions, is 
 12.2   transferred to the residential 
 12.3   facilities appropriation. 
 12.4   [REPAIRS AND BETTERMENTS.] The 
 12.5   commissioner may transfer unencumbered 
 12.6   appropriation balances between fiscal 
 12.7   years for the state residential 
 12.8   facilities repairs and betterments 
 12.9   account and special equipment. 
 12.10  [PROJECT LABOR.] Wages for project 
 12.11  labor may be paid by the commissioner 
 12.12  out of repairs and betterments money if 
 12.13  the individual is to be engaged in a 
 12.14  construction project or a repair 
 12.15  project of short-term and nonrecurring 
 12.16  nature.  Compensation for project labor 
 12.17  shall be based on the prevailing wage 
 12.18  rates, as defined in Minnesota 
 12.19  Statutes, section 177.42, subdivision 
 12.20  6.  Project laborers are excluded from 
 12.21  the provisions of Minnesota Statutes, 
 12.22  sections 43A.22 to 43A.30, and shall 
 12.23  not be eligible for state-paid 
 12.24  insurance and benefits. 
 12.25  [DEVELOPMENTAL DISABILITIES CRISIS 
 12.26  UNIT.] The commissioner shall establish 
 12.27  a 16-bed developmental disabilities 
 12.28  crisis unit at the Brainerd regional 
 12.29  treatment center to provide short-term 
 12.30  crisis services to community-based 
 12.31  residents of state and private programs 
 12.32  for persons with mental retardation or 
 12.33  related conditions. 
 12.34  [LOCAL FIRE DEPARTMENT FUNDING.] (a) 
 12.35  The St. Peter Human Services Center 
 12.36  shall continue funding for fiscal year 
 12.37  2000 to the local fire department in an 
 12.38  amount equal to the funding provided to 
 12.39  the local fire department in the 1999 
 12.40  fiscal year. 
 12.41  (b) The Moose Lake Sexual Psychopathic 
 12.42  Personality Treatment Center shall 
 12.43  resume funding for fiscal year 2000 to 
 12.44  the local fire department in an amount 
 12.45  equal to one-half of the amount paid in 
 12.46  the last fiscal year the former Moose 
 12.47  Lake Human Services Center provided 
 12.48  funding to the local fire department.  
 12.49  (c) The commissioner of human services, 
 12.50  in consultation with the St. Peter and 
 12.51  Moose Lake fire departments, shall 
 12.52  report to the legislature by January 
 12.53  15, 2000, on the fiscal impact, and any 
 12.54  other relevant impact on the local 
 12.55  communities, of continuing or 
 12.56  discontinuing the funding to the local 
 12.57  fire departments. 
 12.58  (b) State-Operated Community
 12.59  Services - Northeast Minnesota
 12.60  Mental Health Services
 12.61  General               3,983,000     4,055,000
 12.62  (c) State-Operated Community 
 13.1   Services - Statewide DD Supports
 13.2   General              15,493,000    16,047,000
 13.3   (d) State-Operated Services - 
 13.4   Enterprise Activities 
 13.5   General               1,757,000     1,757,000
 13.6   Subd. 8.  Continuing Care and 
 13.7   Community Support Grants
 13.8   General           1,171,727,000 1,253,915,000
 13.9   Lottery Prize         1,518,000     1,408,000
 13.10  The amounts that may be spent from this 
 13.11  appropriation for each purpose are as 
 13.12  follows: 
 13.13  (a) Community Social Services
 13.14  Block Grants
 13.15      42,597,000     43,498,000 
 13.16  [CSSA TRADITIONAL APPROPRIATION.] 
 13.17  Notwithstanding Minnesota Statutes, 
 13.18  section 256E.06, subdivisions 1 and 2, 
 13.19  the appropriations available under that 
 13.20  section in fiscal years 2000 and 2001 
 13.21  must be distributed to each county 
 13.22  proportionately to the aid received by 
 13.23  the county in calendar year 1998.  The 
 13.24  commissioner, in consultation with 
 13.25  counties, shall study the formula 
 13.26  limitations in subdivision 2 of that 
 13.27  section, and report findings and any 
 13.28  recommendations for revision of the 
 13.29  CSSA formula and its formula limitation 
 13.30  provisions to the legislature by 
 13.31  January 15, 2000. 
 13.32  (b) Consumer Support Grants
 13.33       1,123,000      1,123,000 
 13.34  (c) Aging Adult Service Grants
 13.35       8,134,000      7,745,000 
 13.36  [LIVING-AT-HOME/BLOCK NURSE PROGRAM.] 
 13.37  Of the general fund appropriation, 
 13.38  $60,000 in fiscal year 2000 and $60,000 
 13.39  in fiscal year 2001 is for the 
 13.40  commissioner to provide funding to 
 13.41  three additional living-at-home/block 
 13.42  nurse programs.  This appropriation 
 13.43  shall become part of the base for the 
 13.44  2002-2003 biennium. 
 13.45  [AREA AGENCIES ON AGING.] Of this 
 13.46  appropriation, $70,000 in fiscal year 
 13.47  2000 and $70,000 in fiscal year 2001 is 
 13.48  from the general fund to the 
 13.49  commissioner to be distributed to area 
 13.50  agencies on aging to provide technical 
 13.51  support and planning services to enable 
 13.52  older adults to remain living in the 
 13.53  community.  The appropriation shall be 
 13.54  disbursed among area agencies in 
 13.55  proportion to the number of citizens 
 14.1   over 60 years of age living in each 
 14.2   region.  This appropriation shall 
 14.3   become part of the base for the 
 14.4   2002-2003 biennium. 
 14.5   [MINNESOTA SENIOR SERVICE CORPS.] Of 
 14.6   this appropriation, $160,000 for the 
 14.7   biennium is from the general fund to 
 14.8   the commissioner for the following 
 14.9   purposes: 
 14.10  (a) $40,000 in fiscal year 2000 and 
 14.11  $40,000 in fiscal year 2001 is to 
 14.12  increase the hourly stipend by ten 
 14.13  cents per hour in the foster 
 14.14  grandparent program, the retired and 
 14.15  senior volunteer program, and the 
 14.16  senior companion program. 
 14.17  (b) $40,000 in fiscal year 2000 and 
 14.18  $40,000 in fiscal year 2001 is for a 
 14.19  grant to the tri-valley opportunity 
 14.20  council in Crookston to expand services 
 14.21  in the ten-county area of northwestern 
 14.22  Minnesota. 
 14.23  (c) This appropriation shall become 
 14.24  part of the base for the 2002-2003 
 14.25  biennium.
 14.26  [SUPPLEMENTAL NUTRITION FUNDING.] Of 
 14.27  this appropriation, $150,000 in fiscal 
 14.28  year 2000 is to the commissioner for 
 14.29  grants to three counties that financed 
 14.30  congregate and home-delivered meals 
 14.31  locally prior to county participation 
 14.32  in the nutrition program of the Older 
 14.33  Americans Act.  
 14.34  [HEALTH INSURANCE COUNSELING.] Of this 
 14.35  appropriation, $100,000 in fiscal year 
 14.36  2000 and $100,000 in fiscal year 2001 
 14.37  is from the general fund to the 
 14.38  commissioner to transfer to the board 
 14.39  on aging for the purpose of awarding 
 14.40  health insurance counseling and 
 14.41  assistance grants to the area agencies 
 14.42  on aging providing state-funded health 
 14.43  insurance counseling services.  Access 
 14.44  to health insurance counseling programs 
 14.45  shall be provided by the senior linkage 
 14.46  line service of the board on aging and 
 14.47  the area agencies on aging. The board 
 14.48  on aging shall explore opportunities 
 14.49  for obtaining alternative funding from 
 14.50  nonstate sources, including 
 14.51  contributions from individuals seeking 
 14.52  health insurance counseling services. 
 14.53  (d) Deaf and Hard-of-Hearing 
 14.54  Services Grants
 14.55       1,949,000      1,970,000 
 14.56  [DEAF AND HARD-OF-HEARING ADULTS WITH 
 14.57  MENTAL ILLNESS.] Of this appropriation, 
 14.58  $200,000 in fiscal year 2000 and 
 14.59  $200,000 in fiscal year 2001 is from 
 14.60  the general fund to the commissioner 
 14.61  for the following purposes: 
 15.1   (a) $100,000 in fiscal year 2000 and 
 15.2   $100,000 in fiscal year 2001 is for a 
 15.3   grant to a nonprofit agency that 
 15.4   currently serves deaf and 
 15.5   hard-of-hearing adults with mental 
 15.6   illness through residential programs 
 15.7   and supported housing outreach to 
 15.8   operate a community-support program for 
 15.9   persons with mental illness that is 
 15.10  communicatively accessible for persons 
 15.11  who are deaf or hard-of-hearing. 
 15.12  (b) $100,000 in fiscal year 2000 and 
 15.13  $100,000 in fiscal year 2001 is for 
 15.14  grants to provide specialized 
 15.15  community-based mental health services 
 15.16  for the deaf and hard-of-hearing 
 15.17  residing outside the seven-county 
 15.18  metropolitan area.  Services provided 
 15.19  under these grants may use remote 
 15.20  access technology for delivering mental 
 15.21  health services via teleconferencing 
 15.22  from a centralized site. 
 15.23  (c) These appropriations shall become 
 15.24  part of the base for the 2002-2003 
 15.25  biennium. 
 15.26  [MOBILITY SPECIALIST FOR DEAF-BLIND 
 15.27  PEOPLE.] Of this appropriation, $60,000 
 15.28  in fiscal year 2000 and $60,000 in 
 15.29  fiscal year 2001 is from the general 
 15.30  fund to the commissioner for a grant to 
 15.31  DeafBlind Services Minnesota to hire an 
 15.32  orientation and mobility specialist to 
 15.33  work with deaf-blind people.  The 
 15.34  specialist shall provide services to 
 15.35  deaf-blind Minnesotans and training to 
 15.36  teachers and rehabilitation counselors 
 15.37  statewide.  Any amount of this 
 15.38  appropriation that is not expended in 
 15.39  the first year shall not cancel but 
 15.40  shall be available for the second year. 
 15.41  This appropriation shall not become 
 15.42  part of the base for the 2002-2003 
 15.43  biennium. 
 15.44  [MINNESOTA COMMISSION SERVING DEAF AND 
 15.45  HARD-OF-HEARING.] Of this 
 15.46  appropriation, $50,000 in fiscal year 
 15.47  2000 and $50,000 in fiscal year 2001 is 
 15.48  from the general fund to the 
 15.49  commissioner for the Minnesota 
 15.50  commission serving deaf and 
 15.51  hard-of-hearing people.  This 
 15.52  appropriation may be used for 
 15.53  communication access, printing, travel, 
 15.54  supplies, and equipment, but shall not 
 15.55  be used for staff compensation.  This 
 15.56  appropriation shall become part of the 
 15.57  base for the 2002-2003 biennium. 
 15.58  (e) Mental Health Grants
 15.59  General          45,154,000     46,537,000 
 15.60  Lottery Prize     1,518,000      1,408,000 
 15.61  [CRISIS HOUSING.] Of the general fund 
 15.62  appropriation, $126,000 in fiscal year 
 15.63  2000 and $174,000 in fiscal year 2001 
 16.1   is to the commissioner for the adult 
 16.2   mental illness crisis housing 
 16.3   assistance program.  This appropriation 
 16.4   shall become part of the base for the 
 16.5   2002-2003 biennium. 
 16.6   Of this appropriation, $250,000 in 
 16.7   fiscal year 2000 and $250,000 in fiscal 
 16.8   year 2001 is from the lottery prize 
 16.9   fund to the commissioner for purposes 
 16.10  of the compulsive gambling program.  
 16.11  This shall become part of the base 
 16.12  level appropriation. 
 16.13  With the funds appropriated for the 
 16.14  compulsive gambling program, the 
 16.15  commissioner of human services shall 
 16.16  ensure that a continuum of therapeutic 
 16.17  services is available throughout the 
 16.18  state through a fee-for-service model 
 16.19  integrated with, and maintaining, the 
 16.20  existing network of grant-supported 
 16.21  group treatment centers.  The 
 16.22  commissioner shall also ensure the 
 16.23  continuation of the toll-free hotline, 
 16.24  public awareness and education, 
 16.25  gambling assessments, and appropriate 
 16.26  prevalence studies and research.  The 
 16.27  commissioner shall ensure that the 
 16.28  compulsive gambling program provides 
 16.29  for prevention, intervention, and 
 16.30  treatment for underserved populations 
 16.31  and high-risk or vulnerable populations.
 16.32  [ADOLESCENT COMPULSIVE GAMBLING GRANT.] 
 16.33  $150,000 in fiscal year 2000 and 
 16.34  $150,000 in fiscal year 2001 is 
 16.35  appropriated from the lottery prize 
 16.36  fund created under Minnesota Statutes, 
 16.37  section 349A.10, subdivision 2, to the 
 16.38  commissioner for the purposes of a 
 16.39  grant to a compulsive gambling council 
 16.40  located in St. Louis county for a 
 16.41  statewide compulsive gambling 
 16.42  prevention and education project for 
 16.43  adolescents. 
 16.44  [COMPULSIVE GAMBLING INPATIENT 
 16.45  TREATMENT.] $110,000 the first year is 
 16.46  from the lottery prize fund for a grant 
 16.47  to Project Turnabout in Granite Falls 
 16.48  to provide compulsive gambling 
 16.49  treatment and education.  The 
 16.50  appropriation is available until June 
 16.51  30, 2001, and must not become part of 
 16.52  the base appropriation. 
 16.53  (f) Developmental Disabilities
 16.54  Community Support Grants
 16.55     8,323,000      9,458,000 
 16.56  [CRISIS INTERVENTION PROJECT.] Of this 
 16.57  appropriation, $40,000 in fiscal year 
 16.58  2000 is to the commissioner for the 
 16.59  action, support, and prevention project 
 16.60  of southeastern Minnesota. 
 16.61  (g) Medical Assistance Long-Term 
 16.62  Care Waivers and Home Care
 17.1      347,130,000    409,142,000 
 17.2   [PROVIDER RATE INCREASES.] (a) The 
 17.3   commissioner shall increase 
 17.4   reimbursement rates by four percent the 
 17.5   first year of the biennium and by three 
 17.6   percent the second year for the 
 17.7   providers listed in paragraph (b).  The 
 17.8   increases shall be effective for 
 17.9   services rendered on or after July 1 of 
 17.10  each year. 
 17.11  (b) The rate increases described in 
 17.12  this section shall be provided to home 
 17.13  and community-based waivered services 
 17.14  for persons with mental retardation or 
 17.15  related conditions under Minnesota 
 17.16  Statutes, section 256B.501; home and 
 17.17  community-based waivered services for 
 17.18  the elderly under Minnesota Statutes, 
 17.19  section 256B.0915; waivered services 
 17.20  under community alternatives for 
 17.21  disabled individuals under Minnesota 
 17.22  Statutes, section 256B.49; community 
 17.23  alternative care waivered services 
 17.24  under Minnesota Statutes, section 
 17.25  256B.49; traumatic brain injury 
 17.26  waivered services under Minnesota 
 17.27  Statutes, section 256B.49; nursing 
 17.28  services and home health services under 
 17.29  Minnesota Statutes, section 256B.0625, 
 17.30  subdivision 6a; personal care services 
 17.31  and nursing supervision of personal 
 17.32  care services under Minnesota Statutes, 
 17.33  section 256B.0625, subdivision 19a; 
 17.34  private-duty nursing services under 
 17.35  Minnesota Statutes, section 256B.0625, 
 17.36  subdivision 7; day training and 
 17.37  habilitation services for adults with 
 17.38  mental retardation or related 
 17.39  conditions under Minnesota Statutes, 
 17.40  sections 252.40 to 252.46; alternative 
 17.41  care services under Minnesota Statutes, 
 17.42  section 256B.0913; adult residential 
 17.43  program grants under Minnesota Rules, 
 17.44  parts 9535.2000 to 9535.3000; adult and 
 17.45  family community support grants under 
 17.46  Minnesota Rules, parts 9535.1700 to 
 17.47  9535.1760; semi-independent living 
 17.48  services under Minnesota Statutes, 
 17.49  section 252.275, including SILS funding 
 17.50  under county social services grants 
 17.51  formerly funded under Minnesota 
 17.52  Statutes, chapter 256I; community 
 17.53  support services for deaf and 
 17.54  hard-of-hearing adults with mental 
 17.55  illness who use or wish to use sign 
 17.56  language as their primary means of 
 17.57  communication; and the group 
 17.58  residential housing supplementary 
 17.59  service rate under Minnesota Statutes, 
 17.60  section 256I.05, subdivision 1a. 
 17.61  (c) Providers that receive a rate 
 17.62  increase under this section shall use 
 17.63  at least 90 percent of the additional 
 17.64  revenue to increase the wages paid to 
 17.65  employees other than the administrator 
 17.66  and central office staff and for 
 17.67  payroll taxes associated with these 
 17.68  wage increases. 
 18.1   (d) A copy of the provider's plan for 
 18.2   complying with paragraph (c) must be 
 18.3   made available to all employees.  This 
 18.4   must be done by giving each employee a 
 18.5   copy or by posting it in an area of the 
 18.6   provider's operation to which all 
 18.7   employees have access.  If an employee 
 18.8   does not receive the salary adjustment 
 18.9   described in the plan and is unable to 
 18.10  resolve the problem with the provider, 
 18.11  the employee may contact the employee's 
 18.12  union representative.  If the employee 
 18.13  is not covered by a collective 
 18.14  bargaining agreement, the employee may 
 18.15  contact the commissioner at a phone 
 18.16  number provided by the commissioner and 
 18.17  included in the provider's plan. 
 18.18  (e) Section 13, sunset of uncodified 
 18.19  language, does not apply to this 
 18.20  provision. 
 18.21  [COUNTY WAIVERED SERVICES RESERVE.] 
 18.22  Notwithstanding the provisions of 
 18.23  Minnesota Statutes, section 256B.092, 
 18.24  subdivision 4, and Minnesota Rules, 
 18.25  part 9525.1830, subpart 2, the 
 18.26  commissioner may approve written 
 18.27  procedures and criteria for the 
 18.28  allocation of home and community-based 
 18.29  waivered services funding for persons 
 18.30  with mental retardation or related 
 18.31  conditions which enables a county to 
 18.32  maintain a reserve resource account.  
 18.33  The reserve resource account may not 
 18.34  exceed five percent of the county 
 18.35  agency's total annual allocation of 
 18.36  home and community-based waivered 
 18.37  services funds.  The reserve may be 
 18.38  utilized to ensure the county's ability 
 18.39  to meet the changing needs of current 
 18.40  recipients, to ensure the health and 
 18.41  safety needs of current recipients, or 
 18.42  to provide short-term emergency 
 18.43  intervention care to eligible waiver 
 18.44  recipients. 
 18.45  (h) Medical Assistance Long-Term
 18.46  Care Facilities
 18.47     545,560,000    557,620,000 
 18.48  [MORATORIUM EXCEPTIONS.] Of this 
 18.49  appropriation, $250,000 in fiscal year 
 18.50  2000 and $250,000 in fiscal year 2001 
 18.51  is from the general fund to the 
 18.52  commissioner for the medical assistance 
 18.53  costs of moratorium exceptions approved 
 18.54  by the commissioner of health under 
 18.55  Minnesota Statutes, section 144A.073.  
 18.56  Unexpended money appropriated for 
 18.57  fiscal year 2000 shall not cancel but 
 18.58  shall be available for fiscal year 2001.
 18.59  [NURSING FACILITY OPERATED BY THE RED 
 18.60  LAKE BAND OF CHIPPEWA INDIANS.] (1) The 
 18.61  medical assistance payment rates for 
 18.62  the 47-bed nursing facility operated by 
 18.63  the Red Lake Band of Chippewa Indians 
 18.64  must be calculated according to 
 18.65  allowable reimbursement costs under the 
 19.1   medical assistance program, as 
 19.2   specified in Minnesota Statutes, 
 19.3   section 246.50, and are subject to the 
 19.4   facility-specific Medicare upper limits.
 19.5   (2) In addition, the commissioner shall 
 19.6   make available a salary adjustment 
 19.7   effective July 1, 1999, that is equal 
 19.8   to four percent of total salaries, 
 19.9   related payroll taxes, and fringe 
 19.10  benefits, excluding general and 
 19.11  administrative costs, divided by the 
 19.12  number of total resident days and a 
 19.13  salary adjustment effective July 1, 
 19.14  2000, that is equal to three percent of 
 19.15  total salaries, related payroll taxes, 
 19.16  and fringe benefits, excluding general 
 19.17  and administrative costs, divided by 
 19.18  the number of total resident days.  The 
 19.19  commissioner must use the facility's 
 19.20  final 1998 and 1999 Medicare cost 
 19.21  reports, respectively, to calculate the 
 19.22  rate adjustment.  The rate adjustment 
 19.23  shall be available based on a plan 
 19.24  submitted and approved according to 
 19.25  Minnesota Statutes, section 256B.431, 
 19.26  subdivision 28.  Section 13, sunset of 
 19.27  uncodified language, does not apply to 
 19.28  this paragraph. 
 19.29  (i) Alternative Care Grants  
 19.30  General              60,873,000    59,981,000
 19.31  [ALTERNATIVE CARE TRANSFER.] Any money 
 19.32  allocated to the alternative care 
 19.33  program that is not spent for the 
 19.34  purposes indicated does not cancel but 
 19.35  shall be transferred to the medical 
 19.36  assistance account. 
 19.37  [PREADMISSION SCREENING AMOUNT.] The 
 19.38  preadmission screening payment to all 
 19.39  counties shall continue at the payment 
 19.40  amount in effect for fiscal year 1999. 
 19.41  [ALTERNATIVE CARE APPROPRIATION.] The 
 19.42  commissioner may expend the money 
 19.43  appropriated for the alternative care 
 19.44  program for that purpose in either year 
 19.45  of the biennium. 
 19.46  (j) Group Residential Housing
 19.47  General              67,131,000    71,491,000
 19.48  [GROUP RESIDENTIAL FACILITY FOR WOMEN 
 19.49  IN RAMSEY COUNTY.] (a) Notwithstanding 
 19.50  Minnesota Statutes 1998, section 
 19.51  256I.05, subdivision 1d, the new group 
 19.52  residential facility for women in 
 19.53  Ramsey county, with approval by the 
 19.54  county agency, may negotiate a 
 19.55  supplementary service rate in addition 
 19.56  to the board and lodging rate for 
 19.57  facilities licensed and registered by 
 19.58  the Minnesota department of health 
 19.59  under Minnesota Statutes, section 
 19.60  15.17.  The supplementary service rate 
 19.61  shall not exceed $564 per person per 
 19.62  month and the total rate may not exceed 
 20.1   $1,177 per person per month. 
 20.2   (b) Of the general fund appropriation, 
 20.3   $19,000 in fiscal year 2000 and $38,000 
 20.4   in fiscal year 2001 is to the 
 20.5   commissioner for the costs associated 
 20.6   with paragraph (a).  This appropriation 
 20.7   shall become part of the base for the 
 20.8   2002-2003 biennium. 
 20.9   [ELDERLY HOUSING AND SERVICES NEEDS 
 20.10  STUDY.] The commissioner shall study 
 20.11  and report to the legislature by 
 20.12  January 15, 2000, with a comprehensive 
 20.13  plan for the provision of housing and 
 20.14  services to low-income elderly 
 20.15  persons.  The plan must incorporate 
 20.16  existing state and county programs and 
 20.17  funding options and identify unmet 
 20.18  needs for arrangements that provide 
 20.19  seniors with a combination of housing 
 20.20  and services.  The report must analyze 
 20.21  the impact the plan may have on 
 20.22  existing institutional health care 
 20.23  providers and on state and county 
 20.24  budgets.  The study shall be conducted 
 20.25  in cooperation with the commissioner of 
 20.26  housing finance and with local public 
 20.27  housing authorities and housing and 
 20.28  redevelopment officials. 
 20.29  (k) Chemical Dependency
 20.30  Entitlement Grants
 20.31  General              37,250,000    38,847,000
 20.32  (l) Chemical Dependency 
 20.33  Nonentitlement Grants
 20.34  General               6,503,000     6,503,000
 20.35  [CHEMICAL DEPENDENCY SERVICES.] Of this 
 20.36  appropriation, $499,000 in fiscal year 
 20.37  2000 is to the commissioner for 
 20.38  chemical dependency services to persons 
 20.39  who qualify under Minnesota Statutes, 
 20.40  section 254B.04, subdivision 1, 
 20.41  paragraph (b). 
 20.42  [REPEAT DWI OFFENDER PROGRAM.] Of this 
 20.43  appropriation, $100,000 in fiscal year 
 20.44  2000 and $100,000 in fiscal year 2001 
 20.45  is for the commissioner to pay for 
 20.46  chemical dependency treatment for 
 20.47  participants in the Camp Ripley repeat 
 20.48  DWI offender program at Brainerd 
 20.49  regional human services center.  
 20.50  Payment to the Brainerd regional human 
 20.51  services center may only be authorized 
 20.52  from this appropriation after all 
 20.53  potential public and private 
 20.54  third-party payers have been billed and 
 20.55  a determination made that the 
 20.56  participant is not eligible for 
 20.57  reimbursement of the treatment costs.  
 20.58  This appropriation shall not become 
 20.59  part of the base for the 2002-2003 
 20.60  biennium. 
 20.61  Subd. 9.  Continuing Care and
 20.62  Community Support Management
 21.1   General              17,084,000    17,384,000
 21.2   Lottery Prize           142,000       142,000
 21.3   State Government
 21.4   Special Revenue         114,000       115,000
 21.5   [MINNESOTA SENIOR HEALTH OPTIONS 
 21.6   PROJECT.] Of this appropriation, up to 
 21.7   $200,000 may be transferred to the 
 21.8   Minnesota senior health options project 
 21.9   special revenue account during the 
 21.10  biennium ending June 30, 2001, to serve 
 21.11  as matching funds. 
 21.12  [PERSONS WITH BRAIN INJURIES.] (a) The 
 21.13  commissioner shall study and report to 
 21.14  the legislature by January 15, 2000, on 
 21.15  the status of persons with brain 
 21.16  injuries residing in public and private 
 21.17  institutions.  The report shall include 
 21.18  information on lengths of stay, ages of 
 21.19  institutionalized persons, and on the 
 21.20  supports and services needed to allow 
 21.21  these persons to return to their 
 21.22  communities. 
 21.23  (b) The commissioner shall apply to the 
 21.24  Health Care Financing Administration 
 21.25  for a grant to carry out a 
 21.26  demonstration project to transition 
 21.27  disabled persons out of nursing homes.  
 21.28  The project must: 
 21.29  (1) identify persons with brain 
 21.30  injuries and other disabled persons 
 21.31  residing in nursing homes who could 
 21.32  live successfully in the community with 
 21.33  appropriate supports; 
 21.34  (2) develop community-based services 
 21.35  and supports for institutionalized 
 21.36  persons; 
 21.37  (3) eliminate incentives to keep these 
 21.38  persons in institutions; 
 21.39  (4) foster the independence of 
 21.40  institutionalized persons by involving 
 21.41  them in the selection and management of 
 21.42  community-based services, such as 
 21.43  personal care assistance; 
 21.44  (5) develop innovative funding 
 21.45  arrangements to enable funding to 
 21.46  follow the individual; and 
 21.47  (6) empower disabled persons, families, 
 21.48  and advocacy groups by including them 
 21.49  in the design and implementation of 
 21.50  service delivery models that maximize 
 21.51  consumer choice and direction. 
 21.52  (c) Paragraph (b) is effective the day 
 21.53  following final enactment. 
 21.54  Subd. 10.  Economic Support Grants
 21.55  General             144,124,000   127,674,000
 22.1   [GIFTS.] Notwithstanding Minnesota 
 22.2   Statutes, chapter 7, the commissioner 
 22.3   may accept on behalf of the state 
 22.4   additional funding from sources other 
 22.5   than state funds for the purpose of 
 22.6   financing the cost of assistance 
 22.7   program grants or nongrant 
 22.8   administration.  All additional funding 
 22.9   is appropriated to the commissioner for 
 22.10  use as designated by the grantee of 
 22.11  funding. 
 22.12  [CHILD SUPPORT PAYMENT CENTER 
 22.13  RECOUPMENT ACCOUNT.] The child support 
 22.14  payment center is authorized to 
 22.15  establish an account to cover checks 
 22.16  issued in error or in cases where 
 22.17  insufficient funds are available to pay 
 22.18  the checks.  All recoupments against 
 22.19  payments from the account must be 
 22.20  deposited in the child support payment 
 22.21  center recoupment account and are 
 22.22  appropriated to the commissioner for 
 22.23  the purposes of the account.  Any 
 22.24  unexpended balance in the account does 
 22.25  not cancel, but is available until 
 22.26  expended. 
 22.27  The amounts that may be spent from this 
 22.28  appropriation for each purpose are as 
 22.29  follows: 
 22.30  (a) Assistance to Families Grants
 22.31  General              64,870,000    66,117,000
 22.32  [FEDERAL TANF FUNDS.] (1) Federal 
 22.33  Temporary Assistance for Needy Families 
 22.34  block grant funds authorized under 
 22.35  title I, Public Law Number 104-193, the 
 22.36  Personal Responsibility and Work 
 22.37  Opportunity Reconciliation Act of 1996, 
 22.38  and awarded in federal fiscal years 
 22.39  1997 to 2002 are appropriated to the 
 22.40  commissioner in amounts up to 
 22.41  $307,140,000 is fiscal year 2000 and 
 22.42  $306,974,000 in fiscal year 2001. 
 22.43  (2) Of the amounts in clause (1), 
 22.44  $45,700,000 the first year and 
 22.45  $45,125,000 the second year is 
 22.46  transferred to the state's federal 
 22.47  child care and development fund block 
 22.48  grant, and is appropriated to the 
 22.49  commissioner of children, families, and 
 22.50  learning.  Of these amounts, 
 22.51  $45,000,000 in each year is for the 
 22.52  purposes of Minnesota Statutes, section 
 22.53  119B.03, and $700,000 the first year 
 22.54  and $125,000 the second year is for 
 22.55  child care development activities 
 22.56  required under the federal child care 
 22.57  and development fund.  In fiscal years 
 22.58  2002 and 2003 the transfer shall be 
 22.59  $15,000,000 per year for the purposes 
 22.60  of Minnesota Statutes, section 119B.03. 
 22.61  (3) Of the amounts in clause (1), 
 22.62  $15,000,000 is transferred each year of 
 22.63  the biennium to the state's federal 
 22.64  Title XX block grant.  Notwithstanding 
 23.1   the provisions of Minnesota Statutes, 
 23.2   section 256E.07, in each year of the 
 23.3   biennium the commissioner shall 
 23.4   allocate $15,000,000 of the state's 
 23.5   Title XX block grant funds based on the 
 23.6   community social services aids formula 
 23.7   in Minnesota Statutes, section 
 23.8   256E.06.  The commissioner shall ensure 
 23.9   that money allocated to counties under 
 23.10  this provision is used according to the 
 23.11  requirements of United States Code, 
 23.12  title 42, section 604(d)(3)(B).  Any 
 23.13  reductions to the amount of the 
 23.14  community social services block grant 
 23.15  in fiscal year 2000 or 2001 as a result 
 23.16  of these actions are one-time 
 23.17  reductions and shall not reduce the 
 23.18  base for the CSSA block grant for the 
 23.19  2002-2003 biennial budget. 
 23.20  (4) Of the amounts in clause (1), 
 23.21  $10,000,000 is transferred each year 
 23.22  from the state's federal TANF block 
 23.23  grant to the state's federal Title XX 
 23.24  block grant.  In each year $140,000 is 
 23.25  for grants according to Minnesota 
 23.26  Statutes, section 257.3571, subdivision 
 23.27  2a, to the Indian child welfare defense 
 23.28  corporation to promote statewide 
 23.29  compliance with the Indian Child 
 23.30  Welfare Act of 1978; $4,650,000 is for 
 23.31  grants to counties for concurrent 
 23.32  permanency planning; and $5,210,000 is 
 23.33  for the commissioner to distribute 
 23.34  according to the formula in Minnesota 
 23.35  Statutes, section 256E.07.  The 
 23.36  commissioner shall ensure that money 
 23.37  allocated under this clause is used 
 23.38  according to the requirements of United 
 23.39  States Code, title 42, section 
 23.40  604(d)(3)(B).  In fiscal years 2002 and 
 23.41  2003, $9,860,000 per year is for the 
 23.42  commissioner to distribute according to 
 23.43  the formula in Minnesota Statutes, 
 23.44  section 256E.07, and $140,000 per year 
 23.45  is for grants according to Minnesota 
 23.46  Statutes, section 257.3571, subdivision 
 23.47  2a, to the Indian child welfare defense 
 23.48  corporation to promote statewide 
 23.49  compliance with the Indian Child 
 23.50  Welfare Act of 1978. 
 23.51  (5) Of the amounts in clause (1), 
 23.52  $20,000,000 each year is for increased 
 23.53  employment and training efforts and 
 23.54  shall be expended as follows: 
 23.55  (a) $5,000,000 each year is for the 
 23.56  commissioner to provide employment 
 23.57  services to MFIP participants who face 
 23.58  serious and multiple barriers to 
 23.59  employment. 
 23.60  (b) $140,000 each year is for a grant 
 23.61  to the new chance program.  The new 
 23.62  chance program shall provide 
 23.63  comprehensive services through a 
 23.64  private, nonprofit agency to young 
 23.65  parents in Hennepin county who have 
 23.66  dropped out of school and are receiving 
 23.67  public assistance.  The program 
 24.1   administrator shall report annually to 
 24.2   the commissioner on skills development, 
 24.3   education, job training, and job 
 24.4   placement outcomes for program 
 24.5   participants.  This appropriation is 
 24.6   available for either year of the 
 24.7   biennium. 
 24.8   (c) $400,000 each year is for grants to 
 24.9   counties to operate the parents fair 
 24.10  share program to assist unemployed, 
 24.11  noncustodial parents with job search 
 24.12  and parenting skills. 
 24.13  (d) $1,500,000 each year is to be 
 24.14  transferred to the job skills 
 24.15  partnership board for the health care 
 24.16  and human services worker training and 
 24.17  retention program. 
 24.18  (e) $12,960,000 each year is to 
 24.19  increase employment and training 
 24.20  services grants for MFIP. 
 24.21  (f) These appropriations shall become 
 24.22  part of the base for the 2002-2003 
 24.23  biennium. 
 24.24  (6) Of the amounts in clause (1), 
 24.25  $1,094,000 in fiscal year 2000 and 
 24.26  $1,676,000 in fiscal year 2001 is 
 24.27  transferred from the state's federal 
 24.28  TANF block grant to the state's federal 
 24.29  child care and development fund block 
 24.30  grant, and is appropriated to the 
 24.31  commissioner of children, families, and 
 24.32  learning for the purposes of Minnesota 
 24.33  Statutes, section 119B.05. 
 24.34  (7) Of the amounts in clause (1), 
 24.35  $1,500,000 for the biennium is for the 
 24.36  purposes of creating and expanding 
 24.37  adult-supervised supportive living 
 24.38  arrangements under Minnesota Statutes, 
 24.39  section 256J.14.  The commissioner 
 24.40  shall request proposals from interested 
 24.41  parties that have knowledge and 
 24.42  experience in the area of adolescent 
 24.43  housing, and award grants for the 
 24.44  purpose of either expanding existing 
 24.45  living arrangements or creating new 
 24.46  living arrangements.  Minor parents who 
 24.47  are MFIP participants shall be given 
 24.48  priority for housing, and excess living 
 24.49  arrangements may be used by minor 
 24.50  parents who are not MFIP participants. 
 24.51  [EMPLOYMENT SERVICES CARRYOVER.] 
 24.52  General fund and federal TANF block 
 24.53  grant appropriations for employment 
 24.54  services that remain unexpended 
 24.55  subsequent to the reallocation process 
 24.56  required in Minnesota Statutes, section 
 24.57  256J.62, do not cancel but are 
 24.58  available for these purposes in fiscal 
 24.59  year 2001. 
 24.60  [CASH BENEFITS IN ADVANCE.] The 
 24.61  commissioner, with the advance approval 
 24.62  of the commissioner of finance, is 
 24.63  authorized to issue cash assistance 
 25.1   benefits up to three days before the 
 25.2   first day of each month, including 
 25.3   three days before the start of each 
 25.4   state fiscal year.  Of the money 
 25.5   appropriated for cash assistance grants 
 25.6   for each fiscal year, up to three 
 25.7   percent of the annual state 
 25.8   appropriation is available to the 
 25.9   commissioner in the previous fiscal 
 25.10  year.  If that amount is insufficient 
 25.11  for the costs incurred, an additional 
 25.12  amount of the appropriation as needed 
 25.13  may be transferred with the advance 
 25.14  approval of the commissioner of 
 25.15  finance.  This paragraph is effective 
 25.16  the day following final enactment. 
 25.17  (b) Work Grants              
 25.18  General              12,031,000    12,031,000
 25.19  (c) Aid to Families With     
 25.20  Dependent Children and Other
 25.21  Assistance
 25.22  General               1,053,000     1,119,000
 25.23  (d) Child Support Enforcement
 25.24  General               5,371,000     5,455,000
 25.25  [CHILD SUPPORT PAYMENT CENTER.] 
 25.26  Payments to the commissioner from other 
 25.27  governmental units, private 
 25.28  enterprises, and individuals for 
 25.29  services performed by the child support 
 25.30  payment center must be deposited in the 
 25.31  state systems account authorized under 
 25.32  Minnesota Statutes, section 256.014.  
 25.33  These payments are appropriated to the 
 25.34  commissioner for the operation of the 
 25.35  child support payment center or system, 
 25.36  according to Minnesota Statutes, 
 25.37  section 256.014. 
 25.38  [EXPEDITED PROCESS.] Appropriations 
 25.39  relating to the operation of the 
 25.40  administrative process under Minnesota 
 25.41  Statutes 1998, section 518.5511, may be 
 25.42  used for the expedited child support 
 25.43  hearing process.  Appropriations for 
 25.44  the second year of the biennium are 
 25.45  available in the first year, but only 
 25.46  to the extent that the costs of the 
 25.47  expedited child support hearing process 
 25.48  exceed the base budget for the 
 25.49  administrative process because of an 
 25.50  increase in the number of orders in the 
 25.51  process.  The commissioner shall 
 25.52  include cost reimbursement claims for 
 25.53  the child support expedited process in 
 25.54  the department's federal cost 
 25.55  reimbursement claim process according 
 25.56  to federal law.  Federal dollars earned 
 25.57  under these claims are appropriated to 
 25.58  the commissioner and shall be disbursed 
 25.59  according to department procedures and 
 25.60  schedules. 
 25.61  [FATHER PROJECT.] (a) The commissioner 
 25.62  shall waive the enforcement of any 
 26.1   existing specific statutory program 
 26.2   requirements, administrative rules, and 
 26.3   standards, including the relevant 
 26.4   provisions of the following sections of 
 26.5   Minnesota Statutes: 
 26.6   (1) 256.741, subdivision 2, paragraph 
 26.7   (a); 
 26.8   (2) 256J.30, subdivision 11; 
 26.9   (3) 256J.33, subdivision 4, clause (5); 
 26.10  and 
 26.11  (4) 256J.34, subdivision 1, paragraph 
 26.12  (d). 
 26.13  The waivers permitted under this 
 26.14  paragraph are for the limited purposes 
 26.15  of allowing the entire amount of child 
 26.16  support payments to be passed through 
 26.17  for the children of individuals 
 26.18  participating in the FATHER project and 
 26.19  excluding child support payments paid 
 26.20  by FATHER participants as income for 
 26.21  MFIP participants who receive the child 
 26.22  support payments.  The waiver authority 
 26.23  granted by this section sunsets on July 
 26.24  1, 2002. 
 26.25  (b) Of this appropriation, $12,000 in 
 26.26  fiscal year 2000 and $96,000 in fiscal 
 26.27  year 2001 is to offset the increased 
 26.28  costs to the state for reimbursing the 
 26.29  federal government for their share of 
 26.30  child support collections relating to 
 26.31  the implementation of the waivers under 
 26.32  paragraph (a).  This appropriation is 
 26.33  available until expended and is 
 26.34  available only to the extent that it is 
 26.35  completely reimbursed by money provided 
 26.36  by the private philanthropical 
 26.37  community. 
 26.38  (e) General Assistance
 26.39  General              33,927,000    14,973,000
 26.40  [TRANSFERS FROM STATE TANF RESERVE.] 
 26.41  $4,666,000 in fiscal year 2000 is 
 26.42  transferred from the state TANF reserve 
 26.43  account to the general fund. 
 26.44  [GENERAL ASSISTANCE STANDARD.] The 
 26.45  commissioner shall set the monthly 
 26.46  standard of assistance for general 
 26.47  assistance units consisting of an adult 
 26.48  recipient who is childless and 
 26.49  unmarried or living apart from his or 
 26.50  her parents or a legal guardian at 
 26.51  $203.  The commissioner may reduce this 
 26.52  amount in accordance with Laws 1997, 
 26.53  chapter 85, article 3, section 54. 
 26.54  (f) Minnesota Supplemental Aid
 26.55  General              25,767,000    26,874,000
 26.56  (g) Refugee Services         
 26.57  General               1,105,000     1,105,000
 27.1   Subd. 11.  Economic Support  
 27.2   Management
 27.3   General              38,847,000    42,254,000
 27.4   Health Care
 27.5   Access                1,313,000     1,318,000
 27.6   The amounts that may be spent from this 
 27.7   appropriation for each purpose are as 
 27.8   follows: 
 27.9   (a) Economic Support Policy  
 27.10  Administration
 27.11  General               7,100,000     6,951,000
 27.12  [FOOD STAMP ADMINISTRATIVE 
 27.13  REIMBURSEMENT.] The commissioner shall 
 27.14  reduce quarterly food stamp 
 27.15  administrative reimbursement to 
 27.16  counties in fiscal years 1999, 2000, 
 27.17  and 2001 by the amount that the United 
 27.18  States Department of Health and Human 
 27.19  Services determines to be the county 
 27.20  random moment study share of the food 
 27.21  stamp adjustment under Public Law 
 27.22  Number 105-185.  The reductions shall 
 27.23  be allocated to each county in 
 27.24  proportion to each county's 
 27.25  contribution, if any, to the amount of 
 27.26  the adjustment.  Any adjustment to 
 27.27  medical assistance administrative 
 27.28  reimbursement that is based on the 
 27.29  United States Department of Health and 
 27.30  Human Services' determinations under 
 27.31  Public Law Number 105-185 shall be 
 27.32  distributed to counties in the same 
 27.33  manner.  This provision is effective 
 27.34  the day following final enactment. 
 27.35  [SPENDING AUTHORITY FOR FOOD STAMP 
 27.36  ENHANCED FUNDING.] In the event that 
 27.37  Minnesota qualifies for United States 
 27.38  Department of Agriculture Food and 
 27.39  Nutrition Services Food Stamp Program 
 27.40  enhanced funding beginning in federal 
 27.41  fiscal year 1998, the money is 
 27.42  appropriated to the commissioner for 
 27.43  the purposes of the program.  The 
 27.44  commissioner may retain 25 percent of 
 27.45  the enhanced funding, with the 
 27.46  remaining 75 percent divided among the 
 27.47  counties according to a formula that 
 27.48  takes into account each county's impact 
 27.49  on the statewide food stamp error rate. 
 27.50  [ELIGIBILITY DETERMINATION FUNDING.] 
 27.51  Increased federal funds for the costs 
 27.52  of eligibility determination and other 
 27.53  permitted activities that are available 
 27.54  to the state through section 114 of the 
 27.55  Personal Responsibility and Work 
 27.56  Opportunity Reconciliation Act, Public 
 27.57  Law Number 104-193, are appropriated to 
 27.58  the commissioner. 
 27.59  (b) Economic Support Operations  
 27.60  General              31,747,000    35,303,000
 28.1   Health Care 
 28.2   Access                1,303,000     1,318,000
 28.3   [FRAUD PREVENTION AND CONTROL FUNDING.] 
 28.4   Unexpended funds appropriated for the 
 28.5   provision of program integrity 
 28.6   activities for fiscal year 2000 are 
 28.7   also available to the commissioner to 
 28.8   fund fraud prevention and control 
 28.9   initiatives, and do not cancel but are 
 28.10  available to the commissioner for these 
 28.11  purposes for fiscal year 2001.  
 28.12  Unexpended funds may be transferred 
 28.13  between the fraud prevention 
 28.14  investigation program and fraud control 
 28.15  programs to promote the provisions of 
 28.16  Minnesota Statutes, sections 256.983 
 28.17  and 256.9861. 
 28.18  Sec. 3.  COMMISSIONER OF HEALTH 
 28.19  Subdivision 1.  Total 
 28.20  Appropriation                        100,129,000     99,611,000
 28.21                Summary by Fund
 28.22  General              63,673,000    63,814,000
 28.23  Metropolitan 
 28.24  Landfill Contingency
 28.25  Action Fund             196,000       199,000
 28.26  State Government
 28.27  Special Revenue      25,586,000    25,075,000
 28.28  Health Care
 28.29  Access               10,674,000    10,523,000
 28.30  [LANDFILL CONTINGENCY.] The 
 28.31  appropriation from the metropolitan 
 28.32  landfill contingency action fund is for 
 28.33  monitoring well water supplies and 
 28.34  conducting health assessments in the 
 28.35  metropolitan area. 
 28.36  [MINIMUM GRANT LEVELS.] The total level 
 28.37  of grants awarded by the commissioner 
 28.38  to local public health boards or 
 28.39  authorities under the community health 
 28.40  services act and under the maternal and 
 28.41  child health program shall not be less 
 28.42  than the amount awarded by the 
 28.43  commissioner in calendar year 1998.  On 
 28.44  January 15 of each year, the 
 28.45  commissioner of finance shall report to 
 28.46  the chairs of the house health and 
 28.47  human services finance committee and 
 28.48  the senate health and family security 
 28.49  budget division and give assurances 
 28.50  that the awards under these programs 
 28.51  meet this test. 
 28.52  Subd. 2.  Health Systems
 28.53  and Special Populations               67,453,000     66,577,000
 28.54                Summary by Fund
 28.55  General              46,673,000    46,499,000
 28.56  State Government
 28.57  Special Revenue      10,202,000     9,653,000
 29.1   Health Care 
 29.2   Access               10,578,000    10,425,000
 29.3   [STATE VITAL STATISTICS REDESIGN 
 29.4   PROJECT ACCOUNT.] The amount 
 29.5   appropriated from the state government 
 29.6   special revenue fund in Laws 1997, 
 29.7   chapter 203, article 1, section 3, 
 29.8   subdivision 2, for the vital records 
 29.9   redesign project is available for 
 29.10  development and implementation costs 
 29.11  until expended.  
 29.12  [WIC TRANSFERS.] The general fund 
 29.13  appropriation for the women, infants, 
 29.14  and children (WIC) food supplement 
 29.15  program is available for either year of 
 29.16  the biennium.  Transfers of these funds 
 29.17  between fiscal years must either be to 
 29.18  maximize federal funds or to minimize 
 29.19  fluctuations in the number of program 
 29.20  participants. 
 29.21  [MINNESOTA CHILDREN WITH SPECIAL HEALTH 
 29.22  NEEDS CARRYOVER.] General fund 
 29.23  appropriations for treatment services 
 29.24  in the services for Minnesota children 
 29.25  with special health needs program are 
 29.26  available for either year of the 
 29.27  biennium. 
 29.28  [FAMILY PLANNING GRANTS.] The 
 29.29  commissioner must allocate to each 
 29.30  organization receiving funds under 
 29.31  Minnesota Statutes, section 145.925, on 
 29.32  July 1, 1999, the same proportion of 
 29.33  grant funds for the 2000 to 2001 grant 
 29.34  funding cycle as the organization 
 29.35  received for the 1998 to 1999 grant 
 29.36  funding cycle, not to exceed the amount 
 29.37  received for the 1998 to 1999 grant 
 29.38  cycle, provided that the organization 
 29.39  submits revised goals, objectives, 
 29.40  methodologies, and budgets. 
 29.41  [FEE CHANGES.] When setting fees for 
 29.42  the speech language pathologist and 
 29.43  audiologist registration system 
 29.44  established under Minnesota Statutes, 
 29.45  sections 148.511 to 148.5196, the 
 29.46  commissioner is exempt from Minnesota 
 29.47  Statutes, section 16A.1285, subdivision 
 29.48  2. 
 29.49  [SUICIDE PREVENTION PROGRAM.] Of this 
 29.50  appropriation, $50,000 in fiscal year 
 29.51  2000 and $50,000 in fiscal year 2001 is 
 29.52  from the general fund to the 
 29.53  commissioner for the establishment of a 
 29.54  suicide prevention program. 
 29.55  [FAMILY PRACTICE RESIDENCY PROGRAM.] Of 
 29.56  the general fund appropriation, 
 29.57  $300,000 in fiscal year 2000 is to the 
 29.58  commissioner to make a grant to the 
 29.59  city of Duluth for a family practice 
 29.60  residency program for northeastern 
 29.61  Minnesota. 
 29.62  [UNCOMPENSATED CARE.] The commissioner 
 30.1   shall study and report to the 
 30.2   legislature by January 15, 2000, with: 
 30.3   (1) statistical information on the 
 30.4   amount of uncompensated health care 
 30.5   provided in Minnesota, the types of 
 30.6   care provided, the settings in which 
 30.7   the care is provided, and, if known, 
 30.8   the most common reasons why the care is 
 30.9   uncompensated; and 
 30.10  (2) recommendations for reducing the 
 30.11  level of uncompensated care, including, 
 30.12  but not limited to, methods to enroll 
 30.13  eligible persons in public health care 
 30.14  programs through simplification of the 
 30.15  application process and other efforts. 
 30.16  [RURAL AREA PHARMACY FINANCIAL 
 30.17  ASSISTANCE.] (a) Of this appropriation, 
 30.18  $500,000 in fiscal year 2000 and 
 30.19  $500,000 in fiscal year 2001 is from 
 30.20  the health care access fund to the 
 30.21  commissioner to award financial 
 30.22  assistance grants to pharmacies in 
 30.23  rural areas designated as sole 
 30.24  community pharmacies. 
 30.25  (b) A pharmacy advisory committee shall 
 30.26  be established jointly by the 
 30.27  commissioner, the University of 
 30.28  Minnesota college of pharmacy, and a 
 30.29  statewide pharmacist association 
 30.30  representing all pharmacy practice 
 30.31  settings.  The advisory committee shall 
 30.32  establish criteria for determining sole 
 30.33  community pharmacies in rural areas.  
 30.34  (c) In selecting pharmacies to receive 
 30.35  grants, the commissioner shall take 
 30.36  into account the extent of local 
 30.37  support for the pharmacy.  Evidence of 
 30.38  local support may include statements 
 30.39  issued by a local government entity, 
 30.40  such as a city or county, and loans, 
 30.41  grants, or donations to the pharmacy 
 30.42  from local government entities, private 
 30.43  organizations, or individuals. 
 30.44  (d) The commissioner shall determine 
 30.45  the amount of the award to be given to 
 30.46  each eligible pharmacy based on the 
 30.47  pharmacy's total operating losses as a 
 30.48  percentage of total operating revenue 
 30.49  for two of the previous three most 
 30.50  recent consecutive fiscal years.  For 
 30.51  purposes of calculating a pharmacy's 
 30.52  operating loss margin, total operating 
 30.53  revenue does not include grant funding 
 30.54  provided under this section.  The 
 30.55  available funds shall be disbursed 
 30.56  proportionately based on the operating 
 30.57  loss margins of all eligible pharmacies.
 30.58  (e) This appropriation shall not become 
 30.59  part of the base for the 2002-2003 
 30.60  biennium. 
 30.61  [RURAL HOSPITAL CAPITAL IMPROVEMENT 
 30.62  GRANT PROGRAM.] Of this appropriation, 
 30.63  $2,867,000 for each fiscal year is from 
 31.1   the health care access fund to the 
 31.2   commissioner for the rural hospital 
 31.3   capital improvement grant program 
 31.4   described in Minnesota Statutes, 
 31.5   section 144.148. This appropriation 
 31.6   shall not become part of the base for 
 31.7   the 2002-2003 biennium. 
 31.8   [MINIMUM DATA SET ACCESS.] The 
 31.9   commissioner, in cooperation with the 
 31.10  commissioner of administration, shall 
 31.11  attempt to obtain access to information 
 31.12  from the Health Care Financing 
 31.13  Administration that is provided by 
 31.14  nursing facilities to the federal 
 31.15  minimum data set database.  If access 
 31.16  is obtained, the commissioner shall 
 31.17  make minimum data set data available on 
 31.18  a quarterly basis to industry trade 
 31.19  associations for use in quality 
 31.20  improvement efforts and comparative 
 31.21  analysis.  Minimum data set data shall 
 31.22  be provided to the associations in 
 31.23  summary aggregate form without patient 
 31.24  identifiers to protect resident 
 31.25  privacy.  The commissioner may charge a 
 31.26  fee for the actual cost of accessing 
 31.27  and reproducing these documents. 
 31.28  [REPORT ON SIDE RAIL USE AND NONUSE IN 
 31.29  NURSING HOMES.] The commissioner shall 
 31.30  report to the chairs of the house 
 31.31  health and human services committee and 
 31.32  the senate health and family security 
 31.33  committee by December 15, 1999, with 
 31.34  information from all available data 
 31.35  gathered on the incidence of patient 
 31.36  deaths, serious injuries, and falls 
 31.37  involving the use or nonuse of side 
 31.38  rails and alternative interventions in 
 31.39  long-term care facilities during the 
 31.40  last five years for which data is 
 31.41  available.  The report shall include, 
 31.42  but not be limited to, an analysis of: 
 31.43  (1) data on the number of deaths 
 31.44  arising from side rail entanglements 
 31.45  and information about bed, mattress, 
 31.46  and rail combinations used; the form of 
 31.47  monitoring device used; and resident 
 31.48  characteristics and conditions; and 
 31.49  (2) data on the incidence of resident 
 31.50  falls, serious injury, or death and the 
 31.51  prevalence of physical restraint use in 
 31.52  resident and patient care practice to 
 31.53  determine if there is a correlation 
 31.54  between resident falls, serious 
 31.55  injuries, or deaths and the use or 
 31.56  nonuse of physical restraints. 
 31.57  The commissioner shall work 
 31.58  cooperatively with the long-term care 
 31.59  industry to share and utilize the 
 31.60  information and analysis in the report 
 31.61  to identify and promote best care 
 31.62  practices. 
 31.63  [NURSING FACILITY DEFICIENCY FINES.] 
 31.64  The commissioner, in cooperation with 
 31.65  the commissioner of human services, 
 32.1   shall apply to the federal government 
 32.2   for a waiver to allow the use of fines 
 32.3   collected for nursing facility 
 32.4   deficiencies to train nursing facility 
 32.5   staff regarding health department 
 32.6   expectations and inspection standards. 
 32.7   [NURSING HOME MORATORIUM REPORT.] In 
 32.8   preparing the report required by 
 32.9   Minnesota Statutes, section 144A.071, 
 32.10  subdivision 5, the commissioner and the 
 32.11  commissioner of human services shall 
 32.12  analyze the adequacy of the supply of 
 32.13  nursing home beds by measuring the 
 32.14  ability of hospitals to promptly 
 32.15  discharge patients to a nursing home 
 32.16  within the hospital's primary service 
 32.17  area.  If it is determined that a 
 32.18  shortage of beds exists, the report 
 32.19  shall present a plan to correct the 
 32.20  service deficits.  The report shall 
 32.21  also analyze the impact of assisted 
 32.22  living services on the medical 
 32.23  assistance utilization of nursing homes.
 32.24  Subd. 3.  Health Protection          27,795,000     28,028,000
 32.25                Summary by Fund
 32.26  General              12,396,000    12,592,000
 32.27  Metro Landfill
 32.28  Contingency             196,000       199,000
 32.29  State Government 
 32.30  Special Revenue      15,203,000    15,237,000
 32.31  [OCCUPATIONAL RESPIRATORY DISEASE 
 32.32  INFORMATION SYSTEM.] Unexpended funds 
 32.33  appropriated in Laws 1998, chapter 407, 
 32.34  article 1, section 3, subdivision 3, to 
 32.35  design an occupational respiratory 
 32.36  disease information system do not 
 32.37  cancel but are available until 
 32.38  expended.  This provision is effective 
 32.39  the day following final enactment. 
 32.40  [HIV/STD.] Of the general fund 
 32.41  appropriation, $150,000 in fiscal year 
 32.42  2000 and $150,000 in fiscal year 2001 
 32.43  is to the commissioner for activities 
 32.44  described under Minnesota Statutes, 
 32.45  sections 144.065 and 144.066, of which 
 32.46  no less than 65 percent shall be 
 32.47  distributed as grants under Minnesota 
 32.48  Statutes, section 144.066, to 
 32.49  demonstrate effective integration of 
 32.50  STD and HIV prevention education to 
 32.51  reach adolescents with the highest 
 32.52  health risks, including youth of 
 32.53  color.  This appropriation shall become 
 32.54  part of the base for the 2002-2003 
 32.55  biennium. 
 32.56  [STD SCREENING.] Of this appropriation, 
 32.57  $125,000 in fiscal year 2000 and 
 32.58  $125,000 in fiscal year 2001 is from 
 32.59  the general fund to the commissioner 
 32.60  for grants to boards of health, state 
 32.61  agencies, state councils, and nonprofit 
 32.62  corporations to expand access to free 
 33.1   STD screening.  When making grants, the 
 33.2   commissioner shall give priority to 
 33.3   grantees that provide services to 
 33.4   youth.  This appropriation shall become 
 33.5   part of the base for the 2002-2003 
 33.6   biennium. 
 33.7   Subd. 4.  Management and
 33.8   Support Services                      4,881,000      5,006,000
 33.9                 Summary by Fund
 33.10  General               4,604,000     4,723,000
 33.11  State Government
 33.12  Special Revenue         181,000       185,000
 33.13  Health Care
 33.14  Access                   96,000        98,000
 33.15  [AT-RISK POPULATIONS.] Of the general 
 33.16  fund appropriation, $400,000 in fiscal 
 33.17  year 2000 and $400,000 in fiscal year 
 33.18  2001 is for grants to local health 
 33.19  agencies to conduct a health needs 
 33.20  assessment that is specific to 
 33.21  populations of color or other at-risk 
 33.22  populations.  This appropriation shall 
 33.23  not become part of the base for the 
 33.24  2002-2003 biennium. 
 33.25  Sec. 4.  VETERANS NURSING   
 33.26  HOMES BOARD                           26,121,000     27,103,000 
 33.27  [ALLOWANCE FOR FOOD.] The allowance for 
 33.28  food may be adjusted annually to 
 33.29  reflect changes in the producer price 
 33.30  index, as prepared by the United States 
 33.31  Bureau of Labor Statistics, with the 
 33.32  approval of the commissioner of 
 33.33  finance.  Adjustments for fiscal year 
 33.34  2000 and fiscal year 2001 must be based 
 33.35  on the June 1998 and June 1999 producer 
 33.36  price index respectively, but the 
 33.37  adjustment must be prorated if it would 
 33.38  require money in excess of the 
 33.39  appropriation. 
 33.40  [IMPROVEMENTS USING DONATED MONEY.] 
 33.41  Notwithstanding Minnesota Statutes, 
 33.42  section 16B.30, the board may make and 
 33.43  maintain the following improvements to 
 33.44  the veterans homes using money donated 
 33.45  for those purposes: 
 33.46  (1) a picnic pavilion at the 
 33.47  Minneapolis veterans home; 
 33.48  (2) walking trails at the Hastings 
 33.49  veterans home; 
 33.50  (3) walking trails and landscaping at 
 33.51  the Silver Bay veterans home; 
 33.52  (4) an entrance canopy at the Fergus 
 33.53  Falls veterans home; and 
 33.54  (5) a suspended wooden dining deck at 
 33.55  the Luverne veterans home. 
 33.56  [ASSET PRESERVATION; FACILITY REPAIR.] 
 34.1   Of the general fund appropriation, 
 34.2   $1,190,000 each year is for asset 
 34.3   preservation and facility repair.  The 
 34.4   appropriations are available in either 
 34.5   year of the biennium and may be used 
 34.6   for abatement and repair at the Luverne 
 34.7   home.  This appropriation shall become 
 34.8   part of the board's base level funding 
 34.9   for the 2002-2003 biennium. 
 34.10  [VETERANS HOMES SPECIAL REVENUE 
 34.11  ACCOUNT.] The general fund 
 34.12  appropriations made to the board shall 
 34.13  be transferred to a veterans homes 
 34.14  special revenue account in the special 
 34.15  revenue fund in the same manner as 
 34.16  other receipts are deposited according 
 34.17  to Minnesota Statutes, section 198.34, 
 34.18  and are appropriated to the board for 
 34.19  the operation of board facilities and 
 34.20  programs. 
 34.21  [SETTING COST OF CARE.] (a) The board 
 34.22  may set the cost of care at the Fergus 
 34.23  Falls facility for fiscal year 2000 
 34.24  based on the cost of average skilled 
 34.25  nursing care provided to residents of 
 34.26  the Minneapolis veterans home for 
 34.27  fiscal year 2000. 
 34.28  (b) The cost of care for the 
 34.29  domiciliary residents at the 
 34.30  Minneapolis veterans home and the 
 34.31  skilled nursing care residents at the 
 34.32  Luverne nursing home for fiscal year 
 34.33  2000 and fiscal year 2001 shall be 
 34.34  calculated based on 100 percent 
 34.35  occupancy at each facility. 
 34.36  [LICENSED BED CAPACITY FOR MINNEAPOLIS 
 34.37  VETERANS HOME.] The commissioner of 
 34.38  health shall not reduce the licensed 
 34.39  bed capacity for the Minneapolis 
 34.40  veterans home pending completion of the 
 34.41  project authorized by Laws 1990, 
 34.42  chapter 610, article 1, section 9, 
 34.43  subdivision 3. 
 34.44  [LUVERNE ENVIRONMENTAL QUALITY.] Of 
 34.45  this appropriation, $591,000 in fiscal 
 34.46  year 2000 is from the general fund to 
 34.47  the board to ensure an adequate 
 34.48  staffing complement during the repairs 
 34.49  at the Luverne home.  Of that amount, 
 34.50  $229,000 is available the day following 
 34.51  final enactment. 
 34.52  Sec. 5.  HEALTH-RELATED BOARDS 
 34.53  Subdivision 1.  Total       
 34.54  Appropriation                         10,376,000     10,576,000 
 34.55  [STATE GOVERNMENT SPECIAL REVENUE 
 34.56  FUND.] The appropriations in this 
 34.57  section are from the state government 
 34.58  special revenue fund. 
 34.59  [NO SPENDING IN EXCESS OF REVENUES.] 
 34.60  The commissioner of finance shall not 
 34.61  permit the allotment, encumbrance, or 
 34.62  expenditure of money appropriated in 
 35.1   this section in excess of the 
 35.2   anticipated biennial revenues or 
 35.3   accumulated surplus revenues from fees 
 35.4   collected by the boards.  Neither this 
 35.5   provision nor Minnesota Statutes, 
 35.6   section 214.06, applies to transfers 
 35.7   from the general contingent account. 
 35.8   [CENTRALIZED LICENSING FUNCTION.] The 
 35.9   health-related licensing boards shall 
 35.10  develop a plan to centralize their 
 35.11  licensing functions within the 
 35.12  administrative services unit and report 
 35.13  to the legislature by January 15, 
 35.14  2000.  If the plan is not submitted: 
 35.15  (1) the appropriations in this section 
 35.16  to the board of medical practice and 
 35.17  the board of nursing for licensing and 
 35.18  disciplinary systems for fiscal year 
 35.19  2001 shall not be expended; and 
 35.20  (2) three percent of the appropriations 
 35.21  in this section for fiscal year 2001 
 35.22  for the board of chiropractic 
 35.23  examiners, the board of dietetic and 
 35.24  nutrition practice, the board of 
 35.25  marriage and family therapy, the board 
 35.26  of nursing home administrators, the 
 35.27  board of optometry, the board of 
 35.28  pharmacy, the board of podiatry, the 
 35.29  board of psychology, the board of 
 35.30  social work, and the board of 
 35.31  veterinary medicine, shall not be 
 35.32  expended. 
 35.33  Subd. 2.  Board of Chiropractic 
 35.34  Examiners                                350,000        361,000
 35.35  Subd. 3.  Board of Dentistry             783,000        806,000
 35.36  Subd. 4.  Board of Dietetic
 35.37  and Nutrition Practice                    92,000         95,000
 35.38  Subd. 5.  Board of Marriage and 
 35.39  Family Therapy                           107,000        111,000
 35.40  Subd. 6.  Board of Medical  
 35.41  Practice                               3,696,000      3,778,000
 35.42  Subd. 7.  Board of Nursing             2,202,000      2,245,000
 35.43  Subd. 8.  Board of Nursing 
 35.44  Home Administrators                      548,000        566,000
 35.45  [HEALTH PROFESSIONAL SERVICES 
 35.46  ACTIVITY.] Of these appropriations, 
 35.47  $368,000 the first year and $380,000 
 35.48  the second year are for the Health 
 35.49  Professional Services Activity. 
 35.50  Subd. 9.  Board of Optometry              87,000         90,000
 35.51  Subd. 10.  Board of Pharmacy           1,125,000      1,137,000
 35.52  [ADMINISTRATIVE SERVICES UNIT.] Of this 
 35.53  appropriation, $259,000 the first year 
 35.54  and $270,000 the second year are for 
 35.55  the health boards administrative 
 35.56  services unit.  The administrative 
 35.57  services unit may receive and expend 
 36.1   reimbursements for services performed 
 36.2   for other agencies. 
 36.3   Subd. 11.  Board of Podiatry              41,000         42,000
 36.4   Subd. 12.  Board of Psychology           556,000        534,000
 36.5   [PART-TIME POSITIONS FUNDING.] Of this 
 36.6   appropriation, $34,000 in fiscal year 
 36.7   2000 is from the special revenue fund 
 36.8   to the board to fund two part-time 
 36.9   positions previously funded through the 
 36.10  legislative advisory commission and for 
 36.11  a budget shortage due to position 
 36.12  reallocations.  This appropriation is 
 36.13  available the day following final 
 36.14  enactment. 
 36.15  Subd. 13.  Board of Social Work          641,000        658,000
 36.16  Subd. 14.  Board of Veterinary 
 36.17  Medicine                                 148,000        153,000
 36.18  Sec. 6.  EMERGENCY MEDICAL
 36.19  SERVICES BOARD                         2,420,000      2,467,000 
 36.20                Summary by Fund
 36.21  General                 694,000       694,000
 36.22  Trunk Highway         1,726,000     1,773,000
 36.23  [COMPREHENSIVE ADVANCED LIFE SUPPORT.] 
 36.24  Of the general fund appropriation, 
 36.25  $108,000 in fiscal year 2000 and 
 36.26  $108,000 in fiscal year 2001 is to the 
 36.27  board to establish a comprehensive 
 36.28  advanced life support educational 
 36.29  program to train rural medical 
 36.30  personnel, including physicians, 
 36.31  physician assistants, nurses, and 
 36.32  allied health care providers, in a team 
 36.33  approach to anticipate, recognize, and 
 36.34  treat life-threatening emergencies 
 36.35  before serious injury or cardiac arrest 
 36.36  occurs.  This appropriation shall 
 36.37  become part of the base for the 
 36.38  2002-2003 biennium. 
 36.39  [EMERGENCY MEDICAL SERVICES GRANTS.] Of 
 36.40  the appropriation from the trunk 
 36.41  highway fund, $18,000 in fiscal year 
 36.42  2000 and $36,000 in fiscal year 2001 is 
 36.43  to the board for grants to regional 
 36.44  emergency medical services programs.  
 36.45  This appropriation shall become part of 
 36.46  the base for the 2002-2003 biennium. 
 36.47  Sec. 7.  COUNCIL ON DISABILITY           650,000        670,000
 36.48  Sec. 8.  OMBUDSMAN FOR MENTAL 
 36.49  HEALTH AND MENTAL RETARDATION          1,338,000      1,378,000
 36.50  Sec. 9.  OMBUDSMAN
 36.51  FOR FAMILIES                             166,000        171,000
 36.52  Sec. 10.  TRANSFERS 
 36.53  Subdivision 1.  Grant Programs
 36.54  The commissioner of human services, 
 37.1   with the approval of the commissioner 
 37.2   of finance, and after notification of 
 37.3   the chair of the senate health and 
 37.4   family security budget division and the 
 37.5   chair of the house health and human 
 37.6   services finance committee, may 
 37.7   transfer unencumbered appropriation 
 37.8   balances for the biennium ending June 
 37.9   30, 2001, within fiscal years among the 
 37.10  MFIP, general assistance, general 
 37.11  assistance medical care, medical 
 37.12  assistance, Minnesota supplemental aid, 
 37.13  and group residential housing programs, 
 37.14  and the entitlement portion of the 
 37.15  chemical dependency consolidated 
 37.16  treatment fund, and between fiscal 
 37.17  years of the biennium. 
 37.18  Subd. 2.  Approval Required
 37.19  Positions, salary money, and nonsalary 
 37.20  administrative money may be transferred 
 37.21  within the departments of human 
 37.22  services and health and within the 
 37.23  programs operated by the veterans 
 37.24  nursing homes board as the 
 37.25  commissioners and the board consider 
 37.26  necessary, with the advance approval of 
 37.27  the commissioner of finance.  The 
 37.28  commissioner or the board shall inform 
 37.29  the chairs of the house health and 
 37.30  human services finance committee and 
 37.31  the senate health and family security 
 37.32  budget division quarterly about 
 37.33  transfers made under this provision. 
 37.34  Sec. 11.  PROVISIONS
 37.35  (a) Money appropriated to the 
 37.36  commissioner of human services for the 
 37.37  purchase of provisions must be used 
 37.38  solely for that purpose.  Money 
 37.39  provided and not used for the purchase 
 37.40  of provisions must be canceled into the 
 37.41  fund from which appropriated, except 
 37.42  that money provided and not used for 
 37.43  the purchase of provisions because of 
 37.44  population decreases may be transferred 
 37.45  and used for the purchase of drugs and 
 37.46  medical and hospital supplies and 
 37.47  equipment with the approval of the 
 37.48  commissioner of finance after 
 37.49  notification of the chairs of the house 
 37.50  health and human services finance 
 37.51  committee and the senate health and 
 37.52  family security budget division. 
 37.53  (b) For fiscal year 2000, the allowance 
 37.54  for food may be adjusted to the 
 37.55  equivalent of the 75th percentile of 
 37.56  the comparable raw food costs for 
 37.57  community nursing homes as reported to 
 37.58  the commissioner of human services.  
 37.59  For fiscal year 2001, an adjustment may 
 37.60  be made to reflect the annual change in 
 37.61  the United States Bureau of Labor 
 37.62  Statistics producer price index as of 
 37.63  June 2000 with the approval of the 
 37.64  commissioner of finance.  The 
 37.65  adjustments for either year must be 
 37.66  prorated if they would require money in 
 38.1   excess of this appropriation. 
 38.2   Sec. 12.  CARRYOVER LIMITATION
 38.3   None of the appropriations in this act 
 38.4   which are allowed to be carried forward 
 38.5   from fiscal year 2000 to fiscal year 
 38.6   2001 shall become part of the base 
 38.7   level funding for the 2002-2003 
 38.8   biennial budget, unless specifically 
 38.9   directed by the legislature. 
 38.10  Sec. 13.  SUNSET OF UNCODIFIED LANGUAGE
 38.11  All uncodified language contained in 
 38.12  this article expires on June 30, 2001, 
 38.13  unless a different expiration date is 
 38.14  explicit. 
 38.15     Sec. 14. [REPEALER.] 
 38.16     Minnesota Statutes 1998, section 256J.03, is repealed 
 38.17  effective July 2, 1999.  Section 13, sunset of uncodified 
 38.18  language, does not apply to this section. 
 38.19                             ARTICLE 2
 38.20                         HEALTH DEPARTMENT
 38.21     Section 1.  [62J.535] [UNIFORM BILLING REQUIREMENTS.] 
 38.22     Subdivision 1.  [DEVELOPMENT OF UNIFORM BILLING 
 38.23  TRANSACTIONS.] The commissioners of commerce and health shall 
 38.24  adopt uniform billing standards that comply with Public Law 
 38.25  Number 104-91 enacted by Congress on August 21, 1996.  The 
 38.26  uniform billing standards shall apply to all paper and 
 38.27  electronic claim transactions and shall apply to all Minnesota 
 38.28  payers, including government programs.  
 38.29     Subd. 2.  [COMPLIANCE.] Concurrent with the effective dates 
 38.30  established under Public Law Number 104-91 for uniform 
 38.31  electronic billing standards, all health care providers must 
 38.32  conform to the uniform billing standards developed by the 
 38.33  commissioners of commerce and health. 
 38.34     Sec. 2.  Minnesota Statutes 1998, section 144.065, is 
 38.35  amended to read: 
 38.36     144.065 [VENEREAL DISEASE TREATMENT CENTERS PREVENTION AND 
 38.37  TREATMENT OF SEXUALLY TRANSMITTED INFECTIONS.] 
 38.38     The state commissioner of health shall assist local health 
 38.39  agencies and organizations throughout the state with the 
 38.40  development and maintenance of services for the detection and 
 39.1   treatment of venereal diseases sexually transmitted infections.  
 39.2   These services shall provide for research, screening and 
 39.3   diagnosis, treatment, case finding, investigation, and the 
 39.4   dissemination of appropriate educational information.  The state 
 39.5   commissioner of health shall promulgate rules relative to 
 39.6   determine the composition of such services and shall establish a 
 39.7   method of providing funds to local health agencies boards of 
 39.8   health as defined in section 145A.02, subdivision 2, state 
 39.9   agencies, state councils, and organizations nonprofit 
 39.10  corporations, which offer such services.  The state commissioner 
 39.11  of health shall provide technical assistance to such agencies 
 39.12  and organizations in accordance with the needs of the local 
 39.13  area.  Planning and implementation of services, and technical 
 39.14  assistance may be conducted in collaboration with boards of 
 39.15  health; state agencies, including the University of Minnesota 
 39.16  and the department of children, families, and learning; state 
 39.17  councils; nonprofit organizations; and representatives of 
 39.18  affected populations.  
 39.19     Sec. 3.  [144.066] [SEXUALLY TRANSMITTED INFECTIONS 
 39.20  PREVENTION AND TREATMENT GRANTS.] 
 39.21     The commissioner may award grants to boards of health as 
 39.22  defined in section 145A.02, subdivision 2, state agencies, state 
 39.23  councils, or nonprofit corporations to provide services 
 39.24  described in section 144.065 to populations most vulnerable to 
 39.25  sexually transmitted infections as determined by current 
 39.26  epidemiological research. 
 39.27     Sec. 4.  [144.1201] [DEFINITIONS.] 
 39.28     Subdivision 1.  [APPLICABILITY.] For purposes of sections 
 39.29  144.1201 to 144.1204, the terms defined in this section have the 
 39.30  meanings given to them. 
 39.31     Subd. 2.  [BY-PRODUCT NUCLEAR MATERIAL.] "By-product 
 39.32  nuclear material" means a radioactive material, other than 
 39.33  special nuclear material, yielded in or made radioactive by 
 39.34  exposure to radiation created incident to the process of 
 39.35  producing or utilizing special nuclear material. 
 39.36     Subd. 3.  [RADIATION.] "Radiation" means ionizing radiation 
 40.1   and includes alpha rays; beta rays; gamma rays; x-rays; high 
 40.2   energy neutrons, protons, or electrons; and other atomic 
 40.3   particles. 
 40.4      Subd. 4.  [RADIOACTIVE MATERIAL.] "Radioactive material" 
 40.5   means a matter that emits radiation.  Radioactive material 
 40.6   includes special nuclear material, source nuclear material, and 
 40.7   by-product nuclear material. 
 40.8      Subd. 5.  [SOURCE NUCLEAR MATERIAL.] "Source nuclear 
 40.9   material" means uranium or thorium, or a combination thereof, in 
 40.10  any physical or chemical form; or ores that contain by weight 
 40.11  1/20 of one percent (0.05 percent) or more of uranium, thorium, 
 40.12  or a combination thereof.  Source nuclear material does not 
 40.13  include special nuclear material. 
 40.14     Subd. 6.  [SPECIAL NUCLEAR MATERIAL.] "Special nuclear 
 40.15  material" means: 
 40.16     (1) plutonium, uranium enriched in the isotope 233 or in 
 40.17  the isotope 235, and any other material that the Nuclear 
 40.18  Regulatory Commission determines to be special nuclear material 
 40.19  according to United States Code, title 42, section 2071, except 
 40.20  that source nuclear material is not included; and 
 40.21     (2) a material artificially enriched by any of the 
 40.22  materials listed in clause (1), except that source nuclear 
 40.23  material is not included. 
 40.24     Sec. 5.  [144.1202] [UNITED STATES NUCLEAR REGULATORY 
 40.25  COMMISSION AGREEMENT.] 
 40.26     Subdivision 1.  [AGREEMENT AUTHORIZED.] In order to have a 
 40.27  comprehensive program to protect the public from radiation 
 40.28  hazards, the governor, on behalf of the state, is authorized to 
 40.29  enter into agreements with the United States Nuclear Regulatory 
 40.30  Commission under the Atomic Energy Act of 1954, section 274b, as 
 40.31  amended.  The agreement shall provide for the discontinuance of 
 40.32  portions of the Nuclear Regulatory Commission's licensing and 
 40.33  related regulatory authority over by-product, source, and 
 40.34  special nuclear materials, and the assumption of regulatory 
 40.35  authority over these materials by the state. 
 40.36     Subd. 2.  [HEALTH DEPARTMENT DESIGNATED LEAD.] The 
 41.1   department of health is designated as the lead agency to pursue 
 41.2   an agreement on behalf of the governor and for any assumption of 
 41.3   specified licensing and regulatory authority from the Nuclear 
 41.4   Regulatory Commission under an agreement with the commission.  
 41.5   The commissioner of health shall establish an advisory group to 
 41.6   assist in preparing the state to meet the requirements for 
 41.7   reaching an agreement.  The commissioner may adopt rules to 
 41.8   allow the state to assume regulatory authority under an 
 41.9   agreement under this section, including the licensing and 
 41.10  regulation of radioactive materials.  Any regulatory authority 
 41.11  assumed by the state includes the ability to set and collect 
 41.12  fees. 
 41.13     Subd. 3.  [TRANSITION.] A person who, on the effective date 
 41.14  of an agreement under this section, possesses a Nuclear 
 41.15  Regulatory Commission license that is subject to the agreement 
 41.16  is deemed to possess a similar license issued by the department 
 41.17  of health.  A department of health license obtained under this 
 41.18  subdivision expires on the expiration date specified in the 
 41.19  federal license. 
 41.20     Subd. 4.  [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 
 41.21  agreement entered into before August 2, 2002, must remain in 
 41.22  effect until terminated under the Atomic Energy Act of 1954, 
 41.23  United States Code, title 42, section 2021, paragraph (j).  The 
 41.24  governor may not enter into an initial agreement with the 
 41.25  Nuclear Regulatory Commission after August 1, 2002.  If an 
 41.26  agreement is not entered into by August 1, 2002, any rules 
 41.27  adopted under this section are repealed effective August 1, 2002.
 41.28     (b) An agreement authorized under subdivision 1 must be 
 41.29  approved by law before it may be implemented. 
 41.30     Sec. 6.  [144.1203] [TRAINING; RULEMAKING.] 
 41.31     The commissioner shall adopt rules to ensure that 
 41.32  individuals handling or utilizing radioactive materials under 
 41.33  the terms of a license issued by the commissioner under section 
 41.34  144.1202 have proper training and qualifications to do so.  The 
 41.35  rules adopted must be at least as stringent as federal 
 41.36  regulations on proper training and qualifications adopted by the 
 42.1   Nuclear Regulatory Commission.  Rules adopted under this section 
 42.2   may incorporate federal regulations by reference. 
 42.3      Sec. 7.  [144.1204] [SURETY REQUIREMENTS.] 
 42.4      Subdivision 1.  [FINANCIAL ASSURANCE REQUIRED.] The 
 42.5   commissioner may require an applicant for a license under 
 42.6   section 144.1202, or a person who was formerly licensed by the 
 42.7   Nuclear Regulatory Commission and is now subject to sections 
 42.8   144.1201 to 144.1204, to post financial assurances to ensure the 
 42.9   completion of all requirements established by the commissioner 
 42.10  for the decontamination, closure, decommissioning, and 
 42.11  reclamation of sites, structures, and equipment used in 
 42.12  conjunction with activities related to licensure.  The financial 
 42.13  assurances posted must be sufficient to restore the site to 
 42.14  unrestricted future use and must be sufficient to provide for 
 42.15  surveillance and care when radioactive materials remain at the 
 42.16  site after the licensed activities cease.  The commissioner may 
 42.17  establish financial assurance criteria by rule.  In establishing 
 42.18  such criteria, the commissioner may consider: 
 42.19     (1) the chemical and physical form of the licensed 
 42.20  radioactive material; 
 42.21     (2) the quantity of radioactive material authorized; 
 42.22     (3) the particular radioisotopes authorized and their 
 42.23  subsequent radiotoxicity; 
 42.24     (4) the method in which the radioactive material is held, 
 42.25  used, stored, processed, transferred, or disposed of; and 
 42.26     (5) the potential costs of decontamination, treatment, or 
 42.27  disposal of a licensee's equipment and facilities. 
 42.28     Subd. 2.  [ACCEPTABLE FINANCIAL ASSURANCES.] The 
 42.29  commissioner may, by rule, establish types of financial 
 42.30  assurances that meet the requirements of this section.  Such 
 42.31  financial assurances may include bank letters of credit, 
 42.32  deposits of cash, or deposits of government securities. 
 42.33     Subd. 3.  [TRUST AGREEMENTS.] Financial assurances must be 
 42.34  established together with trust agreements.  Both the financial 
 42.35  assurances and the trust agreements must be in a form and 
 42.36  substance that meet requirements established by the commissioner.
 43.1      Subd. 4.  [EXEMPTIONS.] The commissioner is authorized to 
 43.2   exempt from the requirements of this section, by rule, any 
 43.3   category of licensee upon a determination by the commissioner 
 43.4   that an exemption does not result in a significant risk to the 
 43.5   public health or safety or to the environment and does not pose 
 43.6   a financial risk to the state. 
 43.7      Subd. 5.  [OTHER REMEDIES UNAFFECTED.] Nothing in this 
 43.8   section relieves a licensee of a civil liability incurred, nor 
 43.9   may this section be construed to relieve the licensee of 
 43.10  obligations to prevent or mitigate the consequences of improper 
 43.11  handling or abandonment of radioactive materials. 
 43.12     Sec. 8.  Minnesota Statutes 1998, section 144.148, is 
 43.13  amended to read: 
 43.14     144.148 [RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT AND LOAN 
 43.15  PROGRAM.] 
 43.16     Subdivision 1.  [DEFINITION.] (a) For purposes of this 
 43.17  section, the following definitions apply. 
 43.18     (b) "Eligible rural hospital" means a any nonfederal, 
 43.19  general acute care hospital that: 
 43.20     (1) is either located in a rural area, as defined in the 
 43.21  federal Medicare regulations, Code of Federal Regulations, title 
 43.22  42, section 405.1041, or located in a community with a 
 43.23  population of less than 5,000, according to United States Census 
 43.24  Bureau Statistics, outside the seven-county metropolitan area; 
 43.25     (2) has 50 or fewer licensed hospital beds with a net 
 43.26  hospital operating margin not greater than two percent in the 
 43.27  two fiscal years prior to application; and 
 43.28     (3) is 25 miles or more from another hospital not for 
 43.29  profit. 
 43.30     (c) "Eligible project" means a modernization project to 
 43.31  update, remodel, or replace aging hospital facilities and 
 43.32  equipment necessary to maintain the operations of a hospital. 
 43.33     Subd. 2.  [PROGRAM.] The commissioner of health shall award 
 43.34  rural hospital capital improvement grants or loans to eligible 
 43.35  rural hospitals.  A grant or loan shall not exceed 
 43.36  $1,500,000 $300,000 per hospital.  Grants or loans shall be 
 44.1   interest free.  An eligible rural hospital may apply the funds 
 44.2   retroactively to capital improvements made during the two fiscal 
 44.3   years preceding the fiscal year in which the grant or loan was 
 44.4   received, provided the hospital met the eligibility criteria 
 44.5   during that time period Prior to the receipt of any grant, the 
 44.6   hospital must certify to the commissioner that at least 
 44.7   one-quarter of the grant amount, which may include in-kind 
 44.8   services, is available for the same purposes from nonstate 
 44.9   resources.  
 44.10     Subd. 3.  [APPLICATIONS.] Eligible hospitals seeking a 
 44.11  grant or loan shall apply to the commissioner.  Applications 
 44.12  must include a description of the problem that the proposed 
 44.13  project will address, a description of the project including 
 44.14  construction and remodeling drawings or specifications, sources 
 44.15  of funds for the project, uses of funds for the project, the 
 44.16  results expected, and a plan to maintain or operate any facility 
 44.17  or equipment included in the project.  The applicant must 
 44.18  describe achievable objectives, a timetable, and roles and 
 44.19  capabilities of responsible individuals and organization.  
 44.20  Applicants must submit to the commissioner evidence that 
 44.21  competitive bidding was used to select contractors for the 
 44.22  project.  
 44.23     Subd. 4.  [CONSIDERATION OF APPLICATIONS.] The commissioner 
 44.24  shall review each application to determine whether or not the 
 44.25  hospital's application is complete and whether the hospital and 
 44.26  the project are eligible for a grant or loan.  In evaluating 
 44.27  applications, the commissioner shall score each application on a 
 44.28  100 point scale, assigning:  a maximum of 40 points for an 
 44.29  applicant's clarity and thoroughness in describing the problem 
 44.30  and the project; a maximum of 40 points for the extent to which 
 44.31  the applicant has demonstrated that it has made adequate 
 44.32  provisions to assure proper and efficient operation of the 
 44.33  facility once the project is completed; and a maximum of 20 
 44.34  points for the extent to which the proposed project is 
 44.35  consistent with the hospital's capital improvement plan or 
 44.36  strategic plan.  The commissioner may also take into account 
 45.1   other relevant factors.  During application review, the 
 45.2   commissioner may request additional information about a proposed 
 45.3   project, including information on project cost.  Failure to 
 45.4   provide the information requested disqualifies a loan an 
 45.5   applicant. 
 45.6      Subd. 5.  [PROGRAM OVERSIGHT.] The commissioner of health 
 45.7   shall review audited financial information of the hospital to 
 45.8   assess eligibility.  The commissioner shall determine the amount 
 45.9   of a grant or loan to be given to an eligible rural hospital 
 45.10  based on the relative score of each eligible hospital's 
 45.11  application and the funds available to the commissioner.  The 
 45.12  grant or loan shall be used to update, remodel, or replace aging 
 45.13  facilities and equipment necessary to maintain the operations of 
 45.14  the hospital.  The commissioner may collect, from the hospitals 
 45.15  receiving grants, any information necessary to evaluate the 
 45.16  program.  
 45.17     Subd. 6.  [LOAN PAYMENT.] Loans shall be repaid as provided 
 45.18  in this subdivision over a period of 15 years.  In those years 
 45.19  when an eligible rural hospital experiences a positive net 
 45.20  operating margin in excess of two percent, the eligible rural 
 45.21  hospital shall pay to the state one-half of the excess above two 
 45.22  percent, up to the yearly payment amount based upon a loan 
 45.23  period of 15 years.  If the amount paid back in any year is less 
 45.24  than the yearly payment amount, or if no payment is required 
 45.25  because the eligible rural hospital does not experience a 
 45.26  positive net operating margin in excess of two percent, the 
 45.27  amount unpaid for that year shall be forgiven by the state 
 45.28  without any financial penalty.  As a condition of receiving an 
 45.29  award through this program, eligible hospitals must agree to any 
 45.30  and all collection activities the commissioner finds necessary 
 45.31  to collect loan payments in those years a payment is due. 
 45.32     Subd. 7.  [ACCOUNTING TREATMENT.] The commissioner of 
 45.33  finance shall record as grants in the state accounting system 
 45.34  funds obligated by this section.  Loan payments received under 
 45.35  this section shall be deposited in the health care access fund. 
 45.36     Subd. 8.  [EXPIRATION.] This section expires June 30, 
 46.1   1999 2001. 
 46.2      Sec. 9.  Minnesota Statutes 1998, section 144.99, 
 46.3   subdivision 1, is amended to read: 
 46.4      Subdivision 1.  [REMEDIES AVAILABLE.] The provisions of 
 46.5   chapters 103I and 157 and sections 115.71 to 115.77; 144.12, 
 46.6   subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), 
 46.7   (14), and (15); 144.1201 to 144.1204; 144.121; 144.1222; 144.35; 
 46.8   144.381 to 144.385; 144.411 to 144.417; 144.495; 144.71 to 
 46.9   144.74; 144.9501 to 144.9509; 144.992; 326.37 to 326.45; 326.57 
 46.10  to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all 
 46.11  rules, orders, stipulation agreements, settlements, compliance 
 46.12  agreements, licenses, registrations, certificates, and permits 
 46.13  adopted or issued by the department or under any other law now 
 46.14  in force or later enacted for the preservation of public health 
 46.15  may, in addition to provisions in other statutes, be enforced 
 46.16  under this section. 
 46.17     Sec. 10.  Minnesota Statutes 1998, section 144.99, is 
 46.18  amended by adding a subdivision to read: 
 46.19     Subd. 12.  [SECURING RADIOACTIVE MATERIALS.] (a) In the 
 46.20  event of an emergency that poses a danger to the public health, 
 46.21  the commissioner shall have the authority to impound radioactive 
 46.22  materials and the associated shielding in the possession of a 
 46.23  person who fails to abide by the provisions of the statutes, 
 46.24  rules, and any other item listed in subdivision 1.  If 
 46.25  impounding the source of these materials is impractical, the 
 46.26  commissioner shall have the authority to lock or otherwise 
 46.27  secure a facility that contains the source of such materials, 
 46.28  but only the portions of the facility as is necessary to protect 
 46.29  the public health.  An action taken under this paragraph is 
 46.30  effective for up to 72 hours.  The commissioner must seek an 
 46.31  injunction or take other administrative action to secure 
 46.32  radioactive materials beyond the initial 72-hour period. 
 46.33     (b) The commissioner may release impounded radioactive 
 46.34  materials and the associated shielding to the owner of the 
 46.35  radioactive materials and associated shielding, upon terms and 
 46.36  conditions that are in accordance with the provisions of 
 47.1   statutes, rules, and other items listed in subdivision 1.  In 
 47.2   the alternative, the commissioner may bring an action in a court 
 47.3   of competent jurisdiction for an order directing the disposal of 
 47.4   impounded radioactive materials and associated shielding or 
 47.5   directing other disposition as necessary to protect the public 
 47.6   health and safety and the environment.  The costs of 
 47.7   decontamination, transportation, burial, disposal, or other 
 47.8   disposition shall be borne by the owner or licensee of the 
 47.9   radioactive materials and shielding or by any other person who 
 47.10  has used the radioactive materials and shielding for business 
 47.11  purposes. 
 47.12     Sec. 11.  Minnesota Statutes 1998, section 145.924, is 
 47.13  amended to read: 
 47.14     145.924 [AIDS PREVENTION GRANTS.] 
 47.15     (a) The commissioner may award grants to boards of health 
 47.16  as defined in section 145A.02, subdivision 2, state agencies, 
 47.17  state councils, or nonprofit corporations to provide evaluation 
 47.18  and counseling services to populations at risk for acquiring 
 47.19  human immunodeficiency virus infection, including, but not 
 47.20  limited to, minorities, adolescents, intravenous drug users, and 
 47.21  homosexual men. 
 47.22     (b) The commissioner may award grants to agencies 
 47.23  experienced in providing services to communities of color, for 
 47.24  the design of innovative outreach and education programs for 
 47.25  targeted groups within the community who may be at risk of 
 47.26  acquiring the human immunodeficiency virus infection, including 
 47.27  intravenous drug users and their partners, adolescents, gay and 
 47.28  bisexual individuals and women.  Grants shall be awarded on a 
 47.29  request for proposal basis and shall include funds for 
 47.30  administrative costs.  Priority for grants shall be given to 
 47.31  agencies or organizations that have experience in providing 
 47.32  service to the particular community which the grantee proposes 
 47.33  to serve; that have policymakers representative of the targeted 
 47.34  population; that have experience in dealing with issues relating 
 47.35  to HIV/AIDS; and that have the capacity to deal effectively with 
 47.36  persons of differing sexual orientations.  For purposes of this 
 48.1   paragraph, the "communities of color" are:  the American-Indian 
 48.2   community; the Hispanic community; the African-American 
 48.3   community; and the Asian-Pacific community. 
 48.4      (c) All state grants under this section for programs 
 48.5   targeted to adolescents shall include the promotion of 
 48.6   abstinence from sexual activity outside of marriage. 
 48.7      Sec. 12.  Minnesota Statutes 1998, section 145.9255, 
 48.8   subdivision 1, is amended to read: 
 48.9      Subdivision 1.  [ESTABLISHMENT.] The commissioner of 
 48.10  health, in consultation with a representative from Minnesota 
 48.11  planning, the commissioner of human services, and the 
 48.12  commissioner of children, families, and learning, shall develop 
 48.13  and implement the Minnesota education now and babies later (MN 
 48.14  ENABL) program, targeted to adolescents ages 12 to 14, with the 
 48.15  goal of reducing the incidence of adolescent pregnancy in the 
 48.16  state and promoting abstinence until marriage.  The program must 
 48.17  provide a multifaceted, primary prevention, community health 
 48.18  promotion approach to educating and supporting adolescents in 
 48.19  the decision to postpone sexual involvement modeled after the 
 48.20  ENABL program in California.  The commissioner of health shall 
 48.21  consult with the chief of the health education section of the 
 48.22  California department of health services for general guidance in 
 48.23  developing and implementing the program. 
 48.24     Sec. 13.  Minnesota Statutes 1998, section 145.9255, 
 48.25  subdivision 4, is amended to read: 
 48.26     Subd. 4.  [PROGRAM COMPONENTS.] The program must include 
 48.27  the following four major components: 
 48.28     (a) A community organization component in which the 
 48.29  community-based local contractors shall include: 
 48.30     (1) use of a postponing sexual involvement education 
 48.31  curriculum targeted to boys and girls ages 12 to 14 in schools 
 48.32  and/or community settings; 
 48.33     (2) planning and implementing community organization 
 48.34  strategies to convey and reinforce the MN ENABL message of 
 48.35  postponing sexual involvement, including activities promoting 
 48.36  awareness and involvement of parents and other primary 
 49.1   caregivers/significant adults, schools, and community; and 
 49.2      (3) development of local media linkages.  
 49.3      (b) A statewide, comprehensive media and public relations 
 49.4   campaign to promote changes in sexual attitudes and behaviors, 
 49.5   and reinforce the message of postponing adolescent sexual 
 49.6   involvement promoting abstinence from sexual activity until 
 49.7   marriage. 
 49.8      The commissioner of health, in consultation with the 
 49.9   commissioner of children, families, and learning, shall contract 
 49.10  with the attorney general's office to develop and implement the 
 49.11  media and public relations campaign.  In developing the 
 49.12  campaign, the attorney general's office shall coordinate and 
 49.13  consult with representatives from ethnic and local communities 
 49.14  to maximize effectiveness of the social marketing approach to 
 49.15  health promotion among the culturally diverse population of the 
 49.16  state.  The development and implementation of the campaign is 
 49.17  subject to input and approval by the commissioner of health. 
 49.18     The local community-based contractors shall collaborate and 
 49.19  coordinate efforts with other community organizations and 
 49.20  interested persons to provide school and community-wide 
 49.21  promotional activities that support and reinforce the message of 
 49.22  the MN ENABL curriculum. 
 49.23     (c) An evaluation component which evaluates the process and 
 49.24  the impact of the program. 
 49.25     The "process evaluation" must provide information to the 
 49.26  state on the breadth and scope of the program.  The evaluation 
 49.27  must identify program areas that might need modification and 
 49.28  identify local MN ENABL contractor strategies and procedures 
 49.29  which are particularly effective.  Contractors must keep 
 49.30  complete records on the demographics of clients served, number 
 49.31  of direct education sessions delivered and other appropriate 
 49.32  statistics, and must document exactly how the program was 
 49.33  implemented.  The commissioner may select contractor sites for 
 49.34  more in-depth case studies. 
 49.35     The "impact evaluation" must provide information to the 
 49.36  state on the impact of the different components of the MN ENABL 
 50.1   program and an assessment of the impact of the program on 
 50.2   adolescents' related sexual knowledge, attitudes, and 
 50.3   risk-taking behavior. 
 50.4      The commissioner shall compare the MN ENABL evaluation 
 50.5   information and data with similar evaluation data from other 
 50.6   states pursuing a similar adolescent pregnancy prevention 
 50.7   program modeled after ENABL and use the information to improve 
 50.8   MN ENABL and build on aspects of the program that have 
 50.9   demonstrated a delay in adolescent sexual involvement. 
 50.10     (d) A training component requiring the commissioner of 
 50.11  health, in consultation with the commissioner of children, 
 50.12  families, and learning, to provide comprehensive uniform 
 50.13  training to the local MN ENABL community-based local contractors 
 50.14  and the direct education program staff.  
 50.15     The local community-based contractors may use adolescent 
 50.16  leaders slightly older than the adolescents in the program to 
 50.17  impart the message to postpone sexual involvement provided: 
 50.18     (1) the contractor follows a protocol for adult 
 50.19  mentors/leaders and older adolescent leaders established by the 
 50.20  commissioner of health; 
 50.21     (2) the older adolescent leader is accompanied by an adult 
 50.22  leader; and 
 50.23     (3) the contractor uses the curriculum as directed and 
 50.24  required by the commissioner of the department of health to 
 50.25  implement this part of the program.  The commissioner of health 
 50.26  shall provide technical assistance to community-based local 
 50.27  contractors. 
 50.28     Sec. 14.  Minnesota Statutes 1998, section 148.5194, 
 50.29  subdivision 2, is amended to read: 
 50.30     Subd. 2.  [BIENNIAL REGISTRATION FEE.] The fee for initial 
 50.31  registration and biennial registration, temporary registration, 
 50.32  or renewal is $160 $200.  
 50.33     Sec. 15.  Minnesota Statutes 1998, section 148.5194, 
 50.34  subdivision 3, is amended to read: 
 50.35     Subd. 3.  [BIENNIAL REGISTRATION FEE FOR DUAL REGISTRATION 
 50.36  AS A SPEECH-LANGUAGE PATHOLOGIST AND AUDIOLOGIST.] The fee for 
 51.1   initial registration and biennial registration, temporary 
 51.2   registration, or renewal is $160 $200.  
 51.3      Sec. 16.  Minnesota Statutes 1998, section 148.5194, is 
 51.4   amended by adding a subdivision to read: 
 51.5      Subd. 3a.  [SURCHARGE FEE.] For a period of four years 
 51.6   following the effective date of this subdivision, an applicant 
 51.7   for registration or registration renewal must pay a surcharge 
 51.8   fee of $25 in addition to any other fees due upon registration 
 51.9   or registration renewal. 
 51.10     Sec. 17.  Minnesota Statutes 1998, section 148.5194, 
 51.11  subdivision 4, is amended to read: 
 51.12     Subd. 4.  [PENALTY FEE FOR LATE RENEWALS.] The penalty fee 
 51.13  for late submission of a renewal application is $15 $45.  
 51.14     Sec. 18.  Minnesota Statutes 1998, section 326.40, 
 51.15  subdivision 2, is amended to read: 
 51.16     Subd. 2.  [MASTER PLUMBER'S LICENSE; BOND AND; INSURANCE 
 51.17  REQUIREMENTS.] The applicant for a master plumber license may 
 51.18  give bond to the state in the total penal sum of $2,000 
 51.19  conditioned upon the faithful and lawful performance of all work 
 51.20  entered upon within the state.  Any person contracting to do 
 51.21  plumbing work must give bond to the state in the amount of 
 51.22  $25,000.  The bond shall be for the benefit of persons injured 
 51.23  or suffering financial loss by reason of failure of performance 
 51.24  to comply with the requirements of the plumbing code.  The term 
 51.25  of the bond shall be concurrent with the term of the license.  
 51.26  The A bond given to the state shall be filed with the secretary 
 51.27  of state and shall be in lieu of all other license bonds to any 
 51.28  political subdivision required for plumbing work.  The bond 
 51.29  shall be written by a corporate surety licensed to do business 
 51.30  in the state. 
 51.31     In addition, each applicant for a master plumber license or 
 51.32  renewal thereof, may provide evidence of public liability 
 51.33  insurance, including products liability insurance with limits of 
 51.34  at least $50,000 per person and $100,000 per occurrence and 
 51.35  property damage insurance with limits of at least $10,000.  The 
 51.36  insurance shall be written by an insurer licensed to do business 
 52.1   in the state of Minnesota and each licensed master plumber shall 
 52.2   maintain on file with the state commissioner of health a 
 52.3   certificate evidencing the insurance providing that the 
 52.4   insurance shall not be canceled without the insurer first giving 
 52.5   15 days written notice to the commissioner.  The term of the 
 52.6   insurance shall be concurrent with the term of the license.  The 
 52.7   certificate shall be in lieu of all other certificates required 
 52.8   by any political subdivision for licensing purposes. 
 52.9      Sec. 19.  Minnesota Statutes 1998, section 326.40, 
 52.10  subdivision 4, is amended to read: 
 52.11     Subd. 4.  [ALTERNATIVE COMPLIANCE.] Compliance with the 
 52.12  local bond requirements of a locale within which work is to be 
 52.13  performed shall be deemed to satisfy the bond and insurance 
 52.14  requirements of subdivision 2, provided the local ordinance 
 52.15  requires at least a $25,000 bond. 
 52.16     Sec. 20.  Minnesota Statutes 1998, section 326.40, 
 52.17  subdivision 5, is amended to read: 
 52.18     Subd. 5.  [FEE.] The state commissioner of health may 
 52.19  charge each applicant for a master plumber license or for a 
 52.20  renewal of a master plumber license and an additional fee person 
 52.21  giving bond an annual bond filing fee commensurate with the cost 
 52.22  of administering the bond and insurance requirements of 
 52.23  subdivision 2. 
 52.24     Sec. 21.  [REPEALER.] 
 52.25     (a) Minnesota Statutes 1998, sections 62J.77; 62J.78; 
 52.26  62J.79; and 145.46, are repealed. 
 52.27     (b) Laws 1998, chapter 407, article 2, section 104, is 
 52.28  repealed. 
 52.29                             ARTICLE 3
 52.30                           LONG-TERM CARE
 52.31     Section 1.  Minnesota Statutes 1998, section 144A.073, 
 52.32  subdivision 5, is amended to read: 
 52.33     Subd. 5.  [REPLACEMENT RESTRICTIONS.] (a) Proposals 
 52.34  submitted or approved under this section involving replacement 
 52.35  must provide for replacement of the facility on the existing 
 52.36  site except as allowed in this subdivision.  
 53.1      (b) Facilities located in a metropolitan statistical area 
 53.2   other than the Minneapolis-St. Paul seven-county metropolitan 
 53.3   area may relocate to a site within the same census tract or a 
 53.4   contiguous census tract.  
 53.5      (c) Facilities located in the Minneapolis-St. Paul 
 53.6   seven-county metropolitan area may relocate to a site within the 
 53.7   same or contiguous health planning area as adopted in March 1982 
 53.8   by the metropolitan council.  
 53.9      (d) Facilities located outside a metropolitan statistical 
 53.10  area may relocate to a site within the same city or township, or 
 53.11  within a contiguous township.  
 53.12     (e) A facility relocated to a different site under 
 53.13  paragraph (b), (c), or (d) must not be relocated to a site more 
 53.14  than six miles from the existing site. 
 53.15     (f) The relocation of part of an existing first facility to 
 53.16  a second location, under paragraphs (d) and (e), may include the 
 53.17  relocation to the second location of up to four beds from part 
 53.18  of an existing third facility located in a township contiguous 
 53.19  to the location of the first facility.  The six-mile limit in 
 53.20  paragraph (e) does not apply to this relocation from the third 
 53.21  facility. 
 53.22     (g) For proposals approved on January 13, 1994, under this 
 53.23  section involving the replacement of 102 licensed and certified 
 53.24  beds, the relocation of the existing first facility to the 
 53.25  second and third locations new location under paragraphs (d) and 
 53.26  (e) may include the relocation of up to 50 percent of the 75 
 53.27  beds of the existing first facility to each of the locations.  
 53.28  The six-mile limit in paragraph (e) does not apply to this 
 53.29  relocation to the third location.  Notwithstanding subdivision 
 53.30  3, construction of this project may be commenced any time prior 
 53.31  to January 1, 1996. 
 53.32     Sec. 2.  Minnesota Statutes 1998, section 144A.10, is 
 53.33  amended by adding a subdivision to read: 
 53.34     Subd. 1a.  [TRAINING AND EDUCATION FOR NURSING FACILITY 
 53.35  PROVIDERS.] The commissioner of health must establish and 
 53.36  implement a prescribed process and program for providing 
 54.1   training and education to providers licensed by the department 
 54.2   of health, either by itself or in conjunction with the industry 
 54.3   trade associations, before using any new regulatory guideline, 
 54.4   regulation, interpretation, program letter or memorandum, or any 
 54.5   other materials used in surveyor training to survey licensed 
 54.6   providers.  The process should include, but is not limited to, 
 54.7   the following key components: 
 54.8      (1) facilitate the implementation of immediate revisions to 
 54.9   any course curriculum for nursing assistants which reflect any 
 54.10  new standard of care practice that has been adopted or 
 54.11  referenced by the health department concerning the issue in 
 54.12  question; 
 54.13     (2) conduct training of long-term care providers and health 
 54.14  department survey inspectors either jointly or during the same 
 54.15  time frame on the department's new expectations; and 
 54.16     (3) within available resources the commissioner shall 
 54.17  cooperate in the development of clinical standards, work with 
 54.18  vendors of supplies and services regarding hazards, and identify 
 54.19  research of interest to the long-term care community.  
 54.20     <i>(Effective date:  Section 2 (144A.10, subd. 1a) is</i> 
 54.21  <i>effective the day following final enactment.)</i> 
 54.22     Sec. 3.  Minnesota Statutes 1998, section 144A.10, is 
 54.23  amended by adding a subdivision to read: 
 54.24     Subd. 11.  [DATA ON FOLLOW-UP SURVEYS.] (a) If requested, 
 54.25  and not prohibited by federal law, the commissioner shall make 
 54.26  available to the nursing home associations and the public 
 54.27  photocopies of statements of deficiencies and related letters 
 54.28  from the department pertaining to federal certification 
 54.29  surveys.  The commissioner may charge for the actual cost of 
 54.30  reproduction of these documents. 
 54.31     (b) The commissioner shall also make available on a 
 54.32  quarterly basis aggregate data for all statements of 
 54.33  deficiencies issued after federal certification follow-up 
 54.34  surveys related to surveys that were conducted in the quarter 
 54.35  prior to the immediately preceding quarter.  The data shall 
 54.36  include the number of facilities with deficiencies, the total 
 55.1   number of deficiencies, the number of facilities that did not 
 55.2   have any deficiencies, the number of facilities for which a 
 55.3   resurvey or follow-up survey was not performed, and the average 
 55.4   number of days between the follow-up or resurvey and the exit 
 55.5   date of the preceding survey. 
 55.6      <i>(Effective date:  Section 3 (144A.10, subd. 11) is</i> 
 55.7   <i>effective the day following final enactment.)</i> 
 55.8      Sec. 4.  Minnesota Statutes 1998, section 144A.10, is 
 55.9   amended by adding a subdivision to read: 
 55.10     Subd. 12.  [NURSE AIDE TRAINING WAIVERS.] Because any 
 55.11  disruption or delay in the training and registration of nurse 
 55.12  aides may reduce access to care in certified facilities, the 
 55.13  commissioner shall grant all possible waivers for the 
 55.14  continuation of an approved nurse aide training and competency 
 55.15  evaluation program or nurse aide training program or competency 
 55.16  evaluation program conducted by or on the site of any certified 
 55.17  nursing facility or skilled nursing facility that would 
 55.18  otherwise lose approval for the program or programs.  The 
 55.19  commissioner shall take into consideration the distance to other 
 55.20  training programs, the frequency of other training programs, and 
 55.21  the impact that the loss of the onsite training will have on the 
 55.22  nursing facility's ability to recruit and train nurse aides. 
 55.23     <i>(Effective date:  Section 4 (144A.10, subd. 12) is</i> 
 55.24  <i>effective the day following final enactment.)</i> 
 55.25     Sec. 5.  Minnesota Statutes 1998, section 144A.10, is 
 55.26  amended by adding a subdivision to read: 
 55.27     Subd. 13.  [IMMEDIATE JEOPARDY.] When conducting survey 
 55.28  certification and enforcement activities related to regular, 
 55.29  expanded, or extended surveys under Code of Federal Regulations, 
 55.30  title 42, part 488, the commissioner may not issue a finding of 
 55.31  immediate jeopardy unless the specific event or omission that 
 55.32  constitutes the violation of the requirements of participation 
 55.33  poses an imminent risk of life-threatening or serious injury to 
 55.34  a resident.  The commissioner may not issue any findings of 
 55.35  immediate jeopardy after the conclusion of a regular, expanded, 
 55.36  or extended survey unless the survey team identified the 
 56.1   deficient practice or practices that constitute immediate 
 56.2   jeopardy and the residents at risk prior to the close of the 
 56.3   exit conference. 
 56.4      <i>(Effective date:  Section 5 (144A.10, subd. 13) is</i> 
 56.5   <i>effective the day following final enactment.)</i> 
 56.6      Sec. 6.  Minnesota Statutes 1998, section 144A.10, is 
 56.7   amended by adding a subdivision to read: 
 56.8      Subd. 14.  [INFORMAL DISPUTE RESOLUTION.] The commissioner 
 56.9   shall respond in writing to a request from a nursing facility 
 56.10  certified under the federal Medicare and Medicaid programs for 
 56.11  an informal dispute resolution within 30 days of the exit date 
 56.12  of the facility's survey.  The commissioner's response shall 
 56.13  identify the commissioner's decision regarding the continuation 
 56.14  of each deficiency citation challenged by the nursing facility, 
 56.15  as well as a statement of any changes in findings, level of 
 56.16  severity or scope, and proposed remedies or sanctions for each 
 56.17  deficiency citation. 
 56.18     <i>(Effective date:  Section 6 (144A.10, subd. 14) is</i> 
 56.19  <i>effective the day following final enactment.)</i> 
 56.20     Sec. 7.  [144A.102] [USE OF CIVIL MONEY PENALTIES; WAIVER 
 56.21  FROM STATE AND FEDERAL RULES AND REGULATIONS.] 
 56.22     By January 2000, the commissioner of health shall work with 
 56.23  providers to examine state and federal rules and regulations 
 56.24  governing the provision of care in licensed nursing facilities 
 56.25  and apply for federal waivers and identify necessary changes in 
 56.26  state law to:  
 56.27     (1) allow the use of civil money penalties imposed upon 
 56.28  nursing facilities to abate any deficiencies identified in a 
 56.29  nursing facility's plan of correction; and 
 56.30     (2) stop the accrual of any fine imposed by the health 
 56.31  department when a follow-up inspection survey is not conducted 
 56.32  by the department within the regulatory deadline. 
 56.33     <i>(Effective date:  Section 7 (144A.102) is effective the day</i> 
 56.34  <i>following final enactment.)</i> 
 56.35     Sec. 8.  Minnesota Statutes 1998, section 144D.01, 
 56.36  subdivision 4, is amended to read: 
 57.1      Subd. 4.  [HOUSING WITH SERVICES ESTABLISHMENT OR 
 57.2   ESTABLISHMENT.] "Housing with services establishment" or 
 57.3   "establishment" means an establishment providing sleeping 
 57.4   accommodations to one or more adult residents, at least 80 
 57.5   percent of which are 55 years of age or older, and offering or 
 57.6   providing, for a fee, one or more regularly scheduled 
 57.7   health-related services or two or more regularly scheduled 
 57.8   supportive services, whether offered or provided directly by the 
 57.9   establishment or by another entity arranged for by the 
 57.10  establishment. 
 57.11     Housing with services establishment does not include: 
 57.12     (1) a nursing home licensed under chapter 144A; 
 57.13     (2) a hospital, certified boarding care home, or supervised 
 57.14  living facility licensed under sections 144.50 to 144.56; 
 57.15     (3) a board and lodging establishment licensed under 
 57.16  chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, 
 57.17  9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to 
 57.18  9530.4450, or under chapter 245B; 
 57.19     (4) a board and lodging establishment which serves as a 
 57.20  shelter for battered women or other similar purpose; 
 57.21     (5) a family adult foster care home licensed by the 
 57.22  department of human services; 
 57.23     (6) private homes in which the residents are related by 
 57.24  kinship, law, or affinity with the providers of services; 
 57.25     (7) residential settings for persons with mental 
 57.26  retardation or related conditions in which the services are 
 57.27  licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or 
 57.28  applicable successor rules or laws; 
 57.29     (8) a home-sharing arrangement such as when an elderly or 
 57.30  disabled person or single-parent family makes lodging in a 
 57.31  private residence available to another person in exchange for 
 57.32  services or rent, or both; 
 57.33     (9) a duly organized condominium, cooperative, common 
 57.34  interest community, or owners' association of the foregoing 
 57.35  where at least 80 percent of the units that comprise the 
 57.36  condominium, cooperative, or common interest community are 
 58.1   occupied by individuals who are the owners, members, or 
 58.2   shareholders of the units; or 
 58.3      (10) services for persons with developmental disabilities 
 58.4   that are provided under a license according to Minnesota Rules, 
 58.5   parts 9525.2000 to 9525.2140 in effect until January 1, 1998, or 
 58.6   under chapter 245B. 
 58.7      Sec. 9.  Minnesota Statutes 1998, section 252.28, 
 58.8   subdivision 1, is amended to read: 
 58.9      Subdivision 1.  [DETERMINATIONS; REDETERMINATIONS.] In 
 58.10  conjunction with the appropriate county boards, the commissioner 
 58.11  of human services shall determine, and shall redetermine at 
 58.12  least every four years, the need, location, size, and program of 
 58.13  public and private residential services and day training and 
 58.14  habilitation services for persons with mental retardation or 
 58.15  related conditions.  This subdivision does not apply to 
 58.16  semi-independent living services and residential-based 
 58.17  habilitation services provided to four or fewer persons at a 
 58.18  single site funded as home and community-based services.  A 
 58.19  determination of need shall not be required for a change in 
 58.20  ownership.  
 58.21     Sec. 10.  [252.282] [ICF/MR LOCAL SYSTEM NEEDS PLANNING.] 
 58.22     Subdivision 1.  [HOST COUNTY RESPONSIBILITY.] (a) For 
 58.23  purposes of this section, "local system needs planning" means 
 58.24  the determination of need for ICF/MR services by program type, 
 58.25  location, demographics, and size of licensed services for 
 58.26  persons with developmental disabilities or related conditions. 
 58.27     (b) This section does not apply to semi-independent living 
 58.28  services and residential-based habilitation services funded as 
 58.29  home and community-based services. 
 58.30     (c) In collaboration with the commissioner and ICF/MR 
 58.31  providers, counties shall complete a local system needs planning 
 58.32  process for each ICF/MR facility.  Counties shall evaluate the 
 58.33  preferences and needs of persons with developmental disabilities 
 58.34  to determine resource demands through a systematic assessment 
 58.35  and planning process by May 15, 2000, and by July 1 every two 
 58.36  years thereafter beginning in 2001. 
 59.1      (d) A local system needs planning process shall be 
 59.2   undertaken more frequently when the needs or preferences of 
 59.3   consumers change significantly to require reformation of the 
 59.4   resources available to persons with developmental disabilities. 
 59.5      (e) A local system needs plan shall be amended anytime 
 59.6   recommendations for modifications to existing ICF/MR services 
 59.7   are made to the host county, including recommendations for: 
 59.8      (1) closure; 
 59.9      (2) relocation of services; 
 59.10     (3) downsizing; 
 59.11     (4) rate adjustments exceeding 90 days duration to address 
 59.12  access; or 
 59.13     (5) modification of existing services for which a change in 
 59.14  the framework of service delivery is advocated. 
 59.15     Subd. 2.  [CONSUMER NEEDS AND PREFERENCES.] In conducting 
 59.16  the local system needs planning process, the host county must 
 59.17  use information from the individual service plans of persons for 
 59.18  whom the county is financially responsible and of persons from 
 59.19  other counties for whom the county has agreed to be the host 
 59.20  county.  The determination of services and supports offered 
 59.21  within the county shall be based on the preferences and needs of 
 59.22  consumers.  The host county shall also consider the community 
 59.23  social services plan, waiting lists, and other sources that 
 59.24  identify unmet needs for services.  A review of ICF/MR facility 
 59.25  licensing and certification surveys, substantiated maltreatment 
 59.26  reports, and established service standards shall be employed to 
 59.27  assess the performance of providers and shall be considered in 
 59.28  the county's recommendations.  Consumer satisfaction surveys may 
 59.29  also be considered in this process. 
 59.30     Subd. 3.  [RECOMMENDATIONS.] (a) Upon completion of the 
 59.31  local system needs planning assessment, the host county shall 
 59.32  make recommendations by May 15, 2000, and by July 1 every two 
 59.33  years thereafter beginning in 2001.  If no change is 
 59.34  recommended, a copy of the assessment along with corresponding 
 59.35  documentation shall be provided to the commissioner by July 1 
 59.36  prior to the contract year. 
 60.1      (b) Except as provided in section 252.292, subdivision 4, 
 60.2   recommendations regarding closures, relocations, or downsizings 
 60.3   that include a rate increase and recommendations regarding rate 
 60.4   adjustments exceeding 90 days shall be submitted to the 
 60.5   statewide advisory committee for review and determination, along 
 60.6   with the assessment, plan, and corresponding budget. 
 60.7      (c) Recommendations for closures, relocations, and 
 60.8   downsizings that do not include a rate increase and for 
 60.9   modification of existing services for which a change in the 
 60.10  framework of service delivery is necessary shall be provided to 
 60.11  the commissioner by July 1 prior to the contract year or at 
 60.12  least 90 days prior to the anticipated change, along with the 
 60.13  assessment and corresponding documentation. 
 60.14     Subd. 4.  [THE STATEWIDE ADVISORY COMMITTEE.] (a) The 
 60.15  commissioner shall appoint a five-member statewide advisory 
 60.16  committee.  The advisory committee shall include representatives 
 60.17  of providers and counties and the commissioner or the 
 60.18  commissioner's designee. 
 60.19     (b) The criteria for ranking proposals, already developed 
 60.20  in 1997 by a task force authorized by the legislature, shall be 
 60.21  adopted and incorporated into the decision-making process.  
 60.22  Specific guidelines, including time frame for submission of 
 60.23  requests, shall be established and announced through the State 
 60.24  Register, and all requests shall be considered in comparison to 
 60.25  each other and the ranking criteria.  The advisory committee 
 60.26  shall review and recommend requests for facility rate 
 60.27  adjustments to address closures, downsizing, relocation, or 
 60.28  access needs within the county and shall forward recommendations 
 60.29  and documentation to the commissioner.  The committee shall 
 60.30  ensure that: 
 60.31     (1) applications are in compliance with applicable state 
 60.32  and federal law and with the state plan; and 
 60.33     (2) cost projections for the proposed service are within 
 60.34  fiscal limitations. 
 60.35     (c) The advisory committee shall review proposals and 
 60.36  submit recommendations to the commissioner within 60 days 
 61.1   following the published deadline for submission under 
 61.2   subdivision 5. 
 61.3      Subd. 5.  [RESPONSIBILITIES OF THE COMMISSIONER.] (a) In 
 61.4   collaboration with counties, providers, and the statewide 
 61.5   advisory committee, the commissioner shall ensure that services 
 61.6   recognize the preferences and needs of persons with 
 61.7   developmental disabilities and related conditions through a 
 61.8   recurring systemic review and assessment of ICF/MR facilities 
 61.9   within the state. 
 61.10     (b) The commissioner shall publish a notice in the State 
 61.11  Register twice each calendar year to announce the opportunity 
 61.12  for counties or providers to submit requests for rate 
 61.13  adjustments associated with plans for downsizing, relocation, 
 61.14  and closure of ICF/MR facilities. 
 61.15     (c) The commissioner shall designate funding parameters to 
 61.16  counties and to the statewide advisory committee for the overall 
 61.17  implementation of system needs within the fiscal resources 
 61.18  allocated by the legislature. 
 61.19     (d) The commissioner shall contract with ICF/MR providers.  
 61.20  The second contracts shall cover the period from October 1, 
 61.21  2001, to December 31, 2002.  Subsequent contracts shall be for 
 61.22  two-year periods beginning January 1, 2003. 
 61.23     Sec. 11.  Minnesota Statutes 1998, section 252.291, is 
 61.24  amended by adding a subdivision to read: 
 61.25     Subd. 2a.  [EXCEPTION FOR LAKE OWASSO PROJECT.] (a) The 
 61.26  commissioner shall authorize and grant a license under chapter 
 61.27  245A to a new intermediate care facility for persons with mental 
 61.28  retardation effective January 1, 2000, under the following 
 61.29  circumstances: 
 61.30     (1) the new facility replaces an existing 64-bed 
 61.31  intermediate care facility for the mentally retarded located in 
 61.32  Ramsey county; 
 61.33     (2) the new facility is located upon a parcel of land 
 61.34  contiguous to the parcel upon which the existing 64-bed facility 
 61.35  is located; 
 61.36     (3) the new facility is comprised of no more than eight 
 62.1   twin home style buildings and an administration building; 
 62.2      (4) the total licensed bed capacity of the facility does 
 62.3   not exceed 64 beds; and 
 62.4      (5) the existing 64-bed facility is demolished. 
 62.5      (b) The medical assistance payment rate for the new 
 62.6   facility shall be the higher of the rate specified in paragraph 
 62.7   (c) or as otherwise provided by law. 
 62.8      (c) The new facility shall be considered a newly 
 62.9   established facility for rate setting purposes, and shall be 
 62.10  eligible for the investment per bed limit specified in section 
 62.11  256B.501, subdivision 11, paragraph (c), and the interest 
 62.12  expense limitation specified in section 256B.501, subdivision 
 62.13  11, paragraph (d).  Notwithstanding section 256B.5011, the newly 
 62.14  established facility's initial payment rate shall be set 
 62.15  according to Minnesota Rules, part 9553.0075, and shall not be 
 62.16  subject to the provisions of section 256B.501, subdivision 5b. 
 62.17     Sec. 12.  Minnesota Statutes 1998, section 256B.0911, 
 62.18  subdivision 6, is amended to read: 
 62.19     Subd. 6.  [PAYMENT FOR PREADMISSION SCREENING.] (a) The 
 62.20  total screening payment for each county must be paid monthly by 
 62.21  certified nursing facilities in the county.  The monthly amount 
 62.22  to be paid by each nursing facility for each fiscal year must be 
 62.23  determined by dividing the county's annual allocation for 
 62.24  screenings by 12 to determine the monthly payment and allocating 
 62.25  the monthly payment to each nursing facility based on the number 
 62.26  of licensed beds in the nursing facility. 
 62.27     (b) The commissioner shall include the total annual payment 
 62.28  for screening for each nursing facility according to section 
 62.29  256B.431, subdivision 2b, paragraph (g), or 256B.435. 
 62.30     (c) Payments for screening activities are available to the 
 62.31  county or counties to cover staff salaries and expenses to 
 62.32  provide the screening function.  The lead agency shall employ, 
 62.33  or contract with other agencies to employ, within the limits of 
 62.34  available funding, sufficient personnel to conduct the 
 62.35  preadmission screening activity while meeting the state's 
 62.36  long-term care outcomes and objectives as defined in section 
 63.1   256B.0917, subdivision 1.  The local agency shall be accountable 
 63.2   for meeting local objectives as approved by the commissioner in 
 63.3   the CSSA biennial plan. 
 63.4      (c) (d) Notwithstanding section 256B.0641, overpayments 
 63.5   attributable to payment of the screening costs under the medical 
 63.6   assistance program may not be recovered from a facility.  
 63.7      (d) (e) The commissioner of human services shall amend the 
 63.8   Minnesota medical assistance plan to include reimbursement for 
 63.9   the local screening teams. 
 63.10     Sec. 13.  Minnesota Statutes 1998, section 256B.0913, 
 63.11  subdivision 5, is amended to read: 
 63.12     Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
 63.13  Alternative care funding may be used for payment of costs of: 
 63.14     (1) adult foster care; 
 63.15     (2) adult day care; 
 63.16     (3) home health aide; 
 63.17     (4) homemaker services; 
 63.18     (5) personal care; 
 63.19     (6) case management; 
 63.20     (7) respite care; 
 63.21     (8) assisted living; 
 63.22     (9) residential care services; 
 63.23     (10) care-related supplies and equipment; 
 63.24     (11) meals delivered to the home; 
 63.25     (12) transportation; 
 63.26     (13) skilled nursing; 
 63.27     (14) chore services; 
 63.28     (15) companion services; 
 63.29     (16) nutrition services; 
 63.30     (17) training for direct informal caregivers; and 
 63.31     (18) telemedicine devices to monitor recipients in their 
 63.32  own homes as an alternative to hospital care, nursing home care, 
 63.33  or home visits.; and 
 63.34     (19) other services including direct cash payments to 
 63.35  clients, approved by the county agency, subject to the 
 63.36  provisions of paragraph (m).  Total annual payments for other 
 64.1   services for all clients within a county may not exceed either 
 64.2   ten percent of that county's annual alternative care program 
 64.3   base allocation or $5,000, whichever is greater.  In no case 
 64.4   shall this amount exceed the county's total annual alternative 
 64.5   care program base allocation. 
 64.6      (b) The county agency must ensure that the funds are used 
 64.7   only to supplement and not supplant services available through 
 64.8   other public assistance or services programs. 
 64.9      (c) Unless specified in statute, the service standards for 
 64.10  alternative care services shall be the same as the service 
 64.11  standards defined in the elderly waiver.  Except for the county 
 64.12  agencies' approval of direct cash payments to clients, persons 
 64.13  or agencies must be employed by or under a contract with the 
 64.14  county agency or the public health nursing agency of the local 
 64.15  board of health in order to receive funding under the 
 64.16  alternative care program. 
 64.17     (d) The adult foster care rate shall be considered a 
 64.18  difficulty of care payment and shall not include room and 
 64.19  board.  The adult foster care daily rate shall be negotiated 
 64.20  between the county agency and the foster care provider.  The 
 64.21  rate established under this section shall not exceed 75 percent 
 64.22  of the state average monthly nursing home payment for the case 
 64.23  mix classification to which the individual receiving foster care 
 64.24  is assigned, and it must allow for other alternative care 
 64.25  services to be authorized by the case manager. 
 64.26     (e) Personal care services may be provided by a personal 
 64.27  care provider organization.  A county agency may contract with a 
 64.28  relative of the client to provide personal care services, but 
 64.29  must ensure nursing supervision.  Covered personal care services 
 64.30  defined in section 256B.0627, subdivision 4, must meet 
 64.31  applicable standards in Minnesota Rules, part 9505.0335. 
 64.32     (f) A county may use alternative care funds to purchase 
 64.33  medical supplies and equipment without prior approval from the 
 64.34  commissioner when:  (1) there is no other funding source; (2) 
 64.35  the supplies and equipment are specified in the individual's 
 64.36  care plan as medically necessary to enable the individual to 
 65.1   remain in the community according to the criteria in Minnesota 
 65.2   Rules, part 9505.0210, item A; and (3) the supplies and 
 65.3   equipment represent an effective and appropriate use of 
 65.4   alternative care funds.  A county may use alternative care funds 
 65.5   to purchase supplies and equipment from a non-Medicaid certified 
 65.6   vendor if the cost for the items is less than that of a Medicaid 
 65.7   vendor.  A county is not required to contract with a provider of 
 65.8   supplies and equipment if the monthly cost of the supplies and 
 65.9   equipment is less than $250.  
 65.10     (g) For purposes of this section, residential care services 
 65.11  are services which are provided to individuals living in 
 65.12  residential care homes.  Residential care homes are currently 
 65.13  licensed as board and lodging establishments and are registered 
 65.14  with the department of health as providing special services.  
 65.15  Residential care services are defined as "supportive services" 
 65.16  and "health-related services."  "Supportive services" means the 
 65.17  provision of up to 24-hour supervision and oversight.  
 65.18  Supportive services includes:  (1) transportation, when provided 
 65.19  by the residential care center only; (2) socialization, when 
 65.20  socialization is part of the plan of care, has specific goals 
 65.21  and outcomes established, and is not diversional or recreational 
 65.22  in nature; (3) assisting clients in setting up meetings and 
 65.23  appointments; (4) assisting clients in setting up medical and 
 65.24  social services; (5) providing assistance with personal laundry, 
 65.25  such as carrying the client's laundry to the laundry room.  
 65.26  Assistance with personal laundry does not include any laundry, 
 65.27  such as bed linen, that is included in the room and board rate.  
 65.28  Health-related services are limited to minimal assistance with 
 65.29  dressing, grooming, and bathing and providing reminders to 
 65.30  residents to take medications that are self-administered or 
 65.31  providing storage for medications, if requested.  Individuals 
 65.32  receiving residential care services cannot receive both personal 
 65.33  care services and residential care services.  
 65.34     (h) For the purposes of this section, "assisted living" 
 65.35  refers to supportive services provided by a single vendor to 
 65.36  clients who reside in the same apartment building of three or 
 66.1   more units which are not subject to registration under chapter 
 66.2   144D.  Assisted living services are defined as up to 24-hour 
 66.3   supervision, and oversight, supportive services as defined in 
 66.4   clause (1), individualized home care aide tasks as defined in 
 66.5   clause (2), and individualized home management tasks as defined 
 66.6   in clause (3) provided to residents of a residential center 
 66.7   living in their units or apartments with a full kitchen and 
 66.8   bathroom.  A full kitchen includes a stove, oven, refrigerator, 
 66.9   food preparation counter space, and a kitchen utensil storage 
 66.10  compartment.  Assisted living services must be provided by the 
 66.11  management of the residential center or by providers under 
 66.12  contract with the management or with the county. 
 66.13     (1) Supportive services include:  
 66.14     (i) socialization, when socialization is part of the plan 
 66.15  of care, has specific goals and outcomes established, and is not 
 66.16  diversional or recreational in nature; 
 66.17     (ii) assisting clients in setting up meetings and 
 66.18  appointments; and 
 66.19     (iii) providing transportation, when provided by the 
 66.20  residential center only.  
 66.21     Individuals receiving assisted living services will not 
 66.22  receive both assisted living services and homemaking or personal 
 66.23  care services.  Individualized means services are chosen and 
 66.24  designed specifically for each resident's needs, rather than 
 66.25  provided or offered to all residents regardless of their 
 66.26  illnesses, disabilities, or physical conditions.  
 66.27     (2) Home care aide tasks means:  
 66.28     (i) preparing modified diets, such as diabetic or low 
 66.29  sodium diets; 
 66.30     (ii) reminding residents to take regularly scheduled 
 66.31  medications or to perform exercises; 
 66.32     (iii) household chores in the presence of technically 
 66.33  sophisticated medical equipment or episodes of acute illness or 
 66.34  infectious disease; 
 66.35     (iv) household chores when the resident's care requires the 
 66.36  prevention of exposure to infectious disease or containment of 
 67.1   infectious disease; and 
 67.2      (v) assisting with dressing, oral hygiene, hair care, 
 67.3   grooming, and bathing, if the resident is ambulatory, and if the 
 67.4   resident has no serious acute illness or infectious disease.  
 67.5   Oral hygiene means care of teeth, gums, and oral prosthetic 
 67.6   devices.  
 67.7      (3) Home management tasks means:  
 67.8      (i) housekeeping; 
 67.9      (ii) laundry; 
 67.10     (iii) preparation of regular snacks and meals; and 
 67.11     (iv) shopping.  
 67.12     Assisted living services as defined in this section shall 
 67.13  not be authorized in boarding and lodging establishments 
 67.14  licensed according to sections 157.011 and 157.15 to 157.22. 
 67.15     (i) For establishments registered under chapter 144D, 
 67.16  assisted living services under this section means the services 
 67.17  described and licensed under section 144A.4605. 
 67.18     (j) For the purposes of this section, reimbursement for 
 67.19  assisted living services and residential care services shall be 
 67.20  a monthly rate negotiated and authorized by the county agency 
 67.21  based on an individualized service plan for each resident. The 
 67.22  rate shall not exceed the nonfederal share of the greater of 
 67.23  either the statewide or any of the geographic groups' weighted 
 67.24  average monthly medical assistance nursing facility payment rate 
 67.25  of the case mix resident class to which the 180-day eligible 
 67.26  client would be assigned under Minnesota Rules, parts 9549.0050 
 67.27  to 9549.0059, unless the services are provided by a home care 
 67.28  provider licensed by the department of health and are provided 
 67.29  in a building that is registered as a housing with services 
 67.30  establishment under chapter 144D and that provides 24-hour 
 67.31  supervision. 
 67.32     (k) For purposes of this section, companion services are 
 67.33  defined as nonmedical care, supervision and oversight, provided 
 67.34  to a functionally impaired adult.  Companions may assist the 
 67.35  individual with such tasks as meal preparation, laundry and 
 67.36  shopping, but do not perform these activities as discrete 
 68.1   services.  The provision of companion services does not entail 
 68.2   hands-on medical care.  Providers may also perform light 
 68.3   housekeeping tasks which are incidental to the care and 
 68.4   supervision of the recipient.  This service must be approved by 
 68.5   the case manager as part of the care plan.  Companion services 
 68.6   must be provided by individuals or nonprofit organizations who 
 68.7   are under contract with the local agency to provide the 
 68.8   service.  Any person related to the waiver recipient by blood, 
 68.9   marriage or adoption cannot be reimbursed under this service.  
 68.10  Persons providing companion services will be monitored by the 
 68.11  case manager. 
 68.12     (l) For purposes of this section, training for direct 
 68.13  informal caregivers is defined as a classroom or home course of 
 68.14  instruction which may include:  transfer and lifting skills, 
 68.15  nutrition, personal and physical cares, home safety in a home 
 68.16  environment, stress reduction and management, behavioral 
 68.17  management, long-term care decision making, care coordination 
 68.18  and family dynamics.  The training is provided to an informal 
 68.19  unpaid caregiver of a 180-day eligible client which enables the 
 68.20  caregiver to deliver care in a home setting with high levels of 
 68.21  quality.  The training must be approved by the case manager as 
 68.22  part of the individual care plan.  Individuals, agencies, and 
 68.23  educational facilities which provide caregiver training and 
 68.24  education will be monitored by the case manager. 
 68.25     (m) A county agency may make payment from their alternative 
 68.26  care program allocation for other services provided to an 
 68.27  alternative care program recipient if those services prevent, 
 68.28  shorten, or delay institutionalization.  These services may 
 68.29  include direct cash payments to the recipient for the purpose of 
 68.30  purchasing the recipient's services.  The following provisions 
 68.31  apply to payments under this paragraph: 
 68.32     (1) a cash payment to a client under this provision cannot 
 68.33  exceed 80 percent of the monthly payment limit for that client 
 68.34  as specified in subdivision 4, paragraph (a), clause (7); 
 68.35     (2) a county may not approve any cash payment for a client 
 68.36  who has been assessed as having a dependency in orientation, 
 69.1   unless the client has an authorized representative under section 
 69.2   256.476, subdivision 2, paragraph (g), or for a client who is 
 69.3   concurrently receiving adult foster care, residential care, or 
 69.4   assisted living services; 
 69.5      (3) any service approved under this section must be a 
 69.6   service which meets the purpose and goals of the program as 
 69.7   listed in subdivision 1; 
 69.8      (4) cash payments must also meet the criteria in section 
 69.9   256.476, subdivision 4, paragraph (b), and recipients of cash 
 69.10  grants must meet the requirements in section 256.476, 
 69.11  subdivision 10; and 
 69.12     (5) the county shall report client outcomes, services, and 
 69.13  costs under this paragraph in a manner prescribed by the 
 69.14  commissioner. 
 69.15  Upon implementation of direct cash payments to clients under 
 69.16  this section, any person determined eligible for the alternative 
 69.17  care program who chooses a cash payment approved by the county 
 69.18  agency shall receive the cash payment under this section and not 
 69.19  under section 256.476 unless the person was receiving a consumer 
 69.20  support grant under section 256.476 before implementation of 
 69.21  direct cash payments under this section. 
 69.22     Sec. 14.  Minnesota Statutes 1998, section 256B.0913, 
 69.23  subdivision 10, is amended to read: 
 69.24     Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
 69.25  appropriation for fiscal years 1992 and beyond shall cover only 
 69.26  180-day eligible clients. 
 69.27     (b) Prior to July 1 of each year, the commissioner shall 
 69.28  allocate to county agencies the state funds available for 
 69.29  alternative care for persons eligible under subdivision 2.  The 
 69.30  allocation for fiscal year 1992 shall be calculated using a base 
 69.31  that is adjusted to exclude the medical assistance share of 
 69.32  alternative care expenditures.  The adjusted base is calculated 
 69.33  by multiplying each county's allocation for fiscal year 1991 by 
 69.34  the percentage of county alternative care expenditures for 
 69.35  180-day eligible clients.  The percentage is determined based on 
 69.36  expenditures for services rendered in fiscal year 1989 or 
 70.1   calendar year 1989, whichever is greater. 
 70.2      (c) If the county expenditures for 180-day eligible clients 
 70.3   are 95 percent or more of its adjusted base allocation, the 
 70.4   allocation for the next fiscal year is 100 percent of the 
 70.5   adjusted base, plus inflation to the extent that inflation is 
 70.6   included in the state budget. 
 70.7      (d) If the county expenditures for 180-day eligible clients 
 70.8   are less than 95 percent of its adjusted base allocation, the 
 70.9   allocation for the next fiscal year is the adjusted base 
 70.10  allocation less the amount of unspent funds below the 95 percent 
 70.11  level. 
 70.12     (e) For fiscal year 1992 only, a county may receive an 
 70.13  increased allocation if annualized service costs for the month 
 70.14  of May 1991 for 180-day eligible clients are greater than the 
 70.15  allocation otherwise determined.  A county may apply for this 
 70.16  increase by reporting projected expenditures for May to the 
 70.17  commissioner by June 1, 1991.  The amount of the allocation may 
 70.18  exceed the amount calculated in paragraph (b).  The projected 
 70.19  expenditures for May must be based on actual 180-day eligible 
 70.20  client caseload and the individual cost of clients' care plans.  
 70.21  If a county does not report its expenditures for May, the amount 
 70.22  in paragraph (c) or (d) shall be used. 
 70.23     (f) Calculations for paragraphs (c) and (d) are to be made 
 70.24  as follows:  for each county, the determination of expenditures 
 70.25  shall be based on payments for services rendered from April 1 
 70.26  through March 31 in the base year, to the extent that claims 
 70.27  have been submitted by June 1 of that year.  Calculations for 
 70.28  paragraphs (c) and (d) must also include the funds transferred 
 70.29  to the consumer support grant program for clients who have 
 70.30  transferred to that program from April 1 through March 31 in the 
 70.31  base year.  
 70.32     (g) For the biennium ending June 30, 2001, the allocation 
 70.33  of state funds to county agencies shall be calculated as 
 70.34  described in paragraphs (c) and (d).  If the annual legislative 
 70.35  appropriation for the alternative care program is inadequate to 
 70.36  fund the combined county allocations for fiscal year 2000 or 
 71.1   2001, the commissioner shall distribute to each county the 
 71.2   entire annual appropriation as that county's percentage of the 
 71.3   computed base as calculated in paragraph (f). 
 71.4      Sec. 15.  Minnesota Statutes 1998, section 256B.0913, 
 71.5   subdivision 12, is amended to read: 
 71.6      Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
 71.7   all 180-day eligible clients to help pay for the cost of 
 71.8   participating in the program.  The amount of the premium for the 
 71.9   alternative care client shall be determined as follows: 
 71.10     (1) when the alternative care client's income less 
 71.11  recurring and predictable medical expenses is greater than the 
 71.12  medical assistance income standard but less than 150 percent of 
 71.13  the federal poverty guideline, and total assets are less than 
 71.14  $6,000 $10,000, the fee is zero; 
 71.15     (2) when the alternative care client's income less 
 71.16  recurring and predictable medical expenses is greater than 150 
 71.17  percent of the federal poverty guideline, and total assets are 
 71.18  less than $6,000 $10,000, the fee is 25 percent of the cost of 
 71.19  alternative care services or the difference between 150 percent 
 71.20  of the federal poverty guideline and the client's income less 
 71.21  recurring and predictable medical expenses, whichever is less; 
 71.22  and 
 71.23     (3) when the alternative care client's total assets are 
 71.24  greater than $6,000 $10,000, the fee is 25 percent of the cost 
 71.25  of alternative care services.  
 71.26     For married persons, total assets are defined as the total 
 71.27  marital assets less the estimated community spouse asset 
 71.28  allowance, under section 256B.059, if applicable.  For married 
 71.29  persons, total income is defined as the client's income less the 
 71.30  monthly spousal allotment, under section 256B.058. 
 71.31     All alternative care services except case management shall 
 71.32  be included in the estimated costs for the purpose of 
 71.33  determining 25 percent of the costs. 
 71.34     The monthly premium shall be calculated based on the cost 
 71.35  of the first full month of alternative care services and shall 
 71.36  continue unaltered until the next reassessment is completed or 
 72.1   at the end of 12 months, whichever comes first.  Premiums are 
 72.2   due and payable each month alternative care services are 
 72.3   received unless the actual cost of the services is less than the 
 72.4   premium. 
 72.5      (b) The fee shall be waived by the commissioner when: 
 72.6      (1) a person who is residing in a nursing facility is 
 72.7   receiving case management only; 
 72.8      (2) a person is applying for medical assistance; 
 72.9      (3) a married couple is requesting an asset assessment 
 72.10  under the spousal impoverishment provisions; 
 72.11     (4) a person is a medical assistance recipient, but has 
 72.12  been approved for alternative care-funded assisted living 
 72.13  services; 
 72.14     (5) a person is found eligible for alternative care, but is 
 72.15  not yet receiving alternative care services; or 
 72.16     (6) a person's fee under paragraph (a) is less than $25. 
 72.17     (c) The county agency must collect the premium from the 
 72.18  client and forward the amounts collected to the commissioner in 
 72.19  the manner and at the times prescribed by the commissioner.  
 72.20  Money collected must be deposited in the general fund and is 
 72.21  appropriated to the commissioner for the alternative care 
 72.22  program.  The client must supply the county with the client's 
 72.23  social security number at the time of application.  If a client 
 72.24  fails or refuses to pay the premium due, the county shall supply 
 72.25  the commissioner with the client's social security number and 
 72.26  other information the commissioner requires to collect the 
 72.27  premium from the client.  The commissioner shall collect unpaid 
 72.28  premiums using the Revenue Recapture Act in chapter 270A and 
 72.29  other methods available to the commissioner.  The commissioner 
 72.30  may require counties to inform clients of the collection 
 72.31  procedures that may be used by the state if a premium is not 
 72.32  paid.  
 72.33     (d) The commissioner shall begin to adopt emergency or 
 72.34  permanent rules governing client premiums within 30 days after 
 72.35  July 1, 1991, including criteria for determining when services 
 72.36  to a client must be terminated due to failure to pay a premium.  
 73.1      Sec. 16.  Minnesota Statutes 1998, section 256B.0913, 
 73.2   subdivision 16, is amended to read: 
 73.3      Subd. 16.  [CONVERSION OF ENROLLMENT.] Upon approval of the 
 73.4   elderly waiver amendments described in section 256B.0915, 
 73.5   subdivision 1d, persons currently receiving services shall have 
 73.6   their eligibility for the elderly waiver program determined 
 73.7   under section 256B.0915.  Persons currently receiving 
 73.8   alternative care services whose income is under the special 
 73.9   income standard according to Code of Federal Regulations, title 
 73.10  42, section 435.236, who are eligible for the elderly waiver 
 73.11  program shall be transferred to that program and shall receive 
 73.12  priority access to elderly waiver slots for six months after 
 73.13  implementation of this subdivision, except that persons whose 
 73.14  income is above the maintenance needs amount described in 
 73.15  section 256B.0915, subdivision 1d, paragraph (a), shall have the 
 73.16  option of remaining in the alternative care program.  Persons 
 73.17  currently enrolled in the alternative care program who are not 
 73.18  eligible for the elderly waiver program shall continue to be 
 73.19  eligible for the alternative care program as long as continuous 
 73.20  eligibility is maintained.  Continued eligibility for the 
 73.21  alternative care program shall be reviewed every six months.  
 73.22  Persons who apply for the alternative care program after 
 73.23  approval of the elderly waiver amendments in section 256B.0915, 
 73.24  subdivision 1d, are not eligible for alternative care if they 
 73.25  would qualify for the elderly waiver, with or without a 
 73.26  spenddown.  Persons who apply for the alternative care program 
 73.27  after approval of the elderly waiver amendments in section 
 73.28  256B.0915, subdivision 1d, whose income is under the special 
 73.29  income standard according to Code of Federal Regulations, title 
 73.30  42, section 435.236, are not eligible for alternative care if 
 73.31  they would qualify for the elderly waiver, except that persons 
 73.32  whose income is above the maintenance needs amount described in 
 73.33  section 256B.0915, subdivision 1d, paragraph (a), shall have the 
 73.34  option of remaining in the alternative care program. 
 73.35     Sec. 17.  Minnesota Statutes 1998, section 256B.431, 
 73.36  subdivision 2i, is amended to read: 
 74.1      Subd. 2i.  [OPERATING COSTS AFTER JULY 1, 1988.] (a)  
 74.2   [OTHER OPERATING COST LIMITS.] For the rate year beginning July 
 74.3   1, 1988, the commissioner shall increase the other operating 
 74.4   cost limits established in Minnesota Rules, part 9549.0055, 
 74.5   subpart 2, item E, to 110 percent of the median of the array of 
 74.6   allowable historical other operating cost per diems and index 
 74.7   these limits as in Minnesota Rules, part 9549.0056, subparts 3 
 74.8   and 4.  The limits must be established in accordance with 
 74.9   subdivision 2b, paragraph (d).  For rate years beginning on or 
 74.10  after July 1, 1989, the adjusted other operating cost limits 
 74.11  must be indexed as in Minnesota Rules, part 9549.0056, subparts 
 74.12  3 and 4.  For the rate period beginning October 1, 1992, and for 
 74.13  rate years beginning after June 30, 1993, the amount of the 
 74.14  surcharge under section 256.9657, subdivision 1, shall be 
 74.15  included in the plant operations and maintenance operating cost 
 74.16  category.  The surcharge shall be an allowable cost for the 
 74.17  purpose of establishing the payment rate. 
 74.18     (b) [CARE-RELATED OPERATING COST LIMITS.] For the rate year 
 74.19  beginning July 1, 1988, the commissioner shall increase the 
 74.20  care-related operating cost limits established in Minnesota 
 74.21  Rules, part 9549.0055, subpart 2, items A and B, to 125 percent 
 74.22  of the median of the array of the allowable historical case mix 
 74.23  operating cost standardized per diems and the allowable 
 74.24  historical other care-related operating cost per diems and index 
 74.25  those limits as in Minnesota Rules, part 9549.0056, subparts 1 
 74.26  and 2.  The limits must be established in accordance with 
 74.27  subdivision 2b, paragraph (d).  For rate years beginning on or 
 74.28  after July 1, 1989, the adjusted care-related limits must be 
 74.29  indexed as in Minnesota Rules, part 9549.0056, subparts 1 and 2. 
 74.30     (c) [SALARY ADJUSTMENT PER DIEM.] Effective July 1, 1998, 
 74.31  to June 30, 2000, the commissioner shall make available the 
 74.32  salary adjustment per diem calculated in clause (1) or (2) to 
 74.33  the total operating cost payment rate of each nursing facility 
 74.34  reimbursed under this section or section 256B.434.  The salary 
 74.35  adjustment per diem for each nursing facility must be determined 
 74.36  as follows:  
 75.1      (1) For each nursing facility that reports salaries for 
 75.2   registered nurses, licensed practical nurses, and aides, 
 75.3   orderlies and attendants separately, the commissioner shall 
 75.4   determine the salary adjustment per diem by multiplying the 
 75.5   total salaries, payroll taxes, and fringe benefits allowed in 
 75.6   each operating cost category, except management fees and 
 75.7   administrator and central office salaries and the related 
 75.8   payroll taxes and fringe benefits, by 3.0 percent and then 
 75.9   dividing the resulting amount by the nursing facility's actual 
 75.10  resident days. 
 75.11     (2) For each nursing facility that does not report salaries 
 75.12  for registered nurses, licensed practical nurses, aides, 
 75.13  orderlies, and attendants separately, the salary adjustment per 
 75.14  diem is the weighted average salary adjustment per diem increase 
 75.15  determined under clause (1).  
 75.16     (3) A nursing facility may apply for the salary adjustment 
 75.17  per diem calculated under clauses (1) and (2).  The application 
 75.18  must be made to the commissioner and contain a plan by which the 
 75.19  nursing facility will distribute the salary adjustment to 
 75.20  employees of the nursing facility.  In order to apply for a 
 75.21  salary adjustment, a nursing facility reimbursed under section 
 75.22  256B.434, must report the information required by clause (1) or 
 75.23  (2) in the application, in the manner specified by the 
 75.24  commissioner.  For nursing facilities in which the employees are 
 75.25  represented by an exclusive bargaining representative, an 
 75.26  agreement negotiated and agreed to by the employer and the 
 75.27  exclusive bargaining representative, after July 1, 1998, may 
 75.28  constitute the plan for the salary distribution.  The 
 75.29  commissioner shall review the plan to ensure that the salary 
 75.30  adjustment per diem is used solely to increase the compensation 
 75.31  of nursing home facility employees.  To be eligible, a facility 
 75.32  must submit its plan for the salary distribution by December 31, 
 75.33  1998.  If a facility's plan for salary distribution is effective 
 75.34  for its employees after July 1, 1998, the salary adjustment cost 
 75.35  per diem shall be effective the same date as its plan. 
 75.36     (4) Additional costs incurred by nursing facilities as a 
 76.1   result of this salary adjustment are not allowable costs for 
 76.2   purposes of the September 30, 1998, cost report. 
 76.3      (d)  [NEW BASE YEAR.] The commissioner shall establish new 
 76.4   base years for both the reporting year ending September 30, 
 76.5   1989, and the reporting year ending September 30, 1990.  In 
 76.6   establishing new base years, the commissioner must take into 
 76.7   account:  
 76.8      (1) statutory changes made in geographic groups; 
 76.9      (2) redefinitions of cost categories; and 
 76.10     (3) reclassification, pass-through, or exemption of certain 
 76.11  costs such as Public Employee Retirement Act contributions. 
 76.12     (e) (d) [NEW BASE YEAR.] The commissioner shall establish a 
 76.13  new base year for the reporting years ending September 30, 1991, 
 76.14  and September 30, 1992.  In establishing a new base year, the 
 76.15  commissioner must take into account:  
 76.16     (1) statutory changes made in geographic groups; 
 76.17     (2) redefinitions of cost categories; and 
 76.18     (3) reclassification, pass-through, or exemption of certain 
 76.19  costs. 
 76.20     Sec. 18.  Minnesota Statutes 1998, section 256B.431, 
 76.21  subdivision 17, is amended to read: 
 76.22     Subd. 17.  [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.] 
 76.23  (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3, 
 76.24  for rate periods beginning on October 1, 1992, and for rate 
 76.25  years beginning after June 30, 1993, a nursing facility that (1) 
 76.26  has completed a construction project approved under section 
 76.27  144A.071, subdivision 4a, clause (m); (2) has completed a 
 76.28  construction project approved under section 144A.071, 
 76.29  subdivision 4a, and effective after June 30, 1995; or (3) has 
 76.30  completed a renovation, replacement, or upgrading project 
 76.31  approved under the moratorium exception process in section 
 76.32  144A.073 shall be reimbursed for costs directly identified to 
 76.33  that project as provided in subdivision 16 and this subdivision. 
 76.34     (b) Notwithstanding Minnesota Rules, part 9549.0060, 
 76.35  subparts 5, item A, subitems (1) and (3), and 7, item D, 
 76.36  allowable interest expense on debt shall include: 
 77.1      (1) interest expense on debt related to the cost of 
 77.2   purchasing or replacing depreciable equipment, excluding 
 77.3   vehicles, not to exceed six percent of the total historical cost 
 77.4   of the project; and 
 77.5      (2) interest expense on debt related to financing or 
 77.6   refinancing costs, including costs related to points, loan 
 77.7   origination fees, financing charges, legal fees, and title 
 77.8   searches; and issuance costs including bond discounts, bond 
 77.9   counsel, underwriter's counsel, corporate counsel, printing, and 
 77.10  financial forecasts.  Allowable debt related to items in this 
 77.11  clause shall not exceed seven percent of the total historical 
 77.12  cost of the project.  To the extent these costs are financed, 
 77.13  the straight-line amortization of the costs in this clause is 
 77.14  not an allowable cost; and 
 77.15     (3) interest on debt incurred for the establishment of a 
 77.16  debt reserve fund, net of the interest earned on the debt 
 77.17  reserve fund. 
 77.18     (c) Debt incurred for costs under paragraph (b) is not 
 77.19  subject to Minnesota Rules, part 9549.0060, subpart 5, item A, 
 77.20  subitem (5) or (6). 
 77.21     (d) The incremental increase in a nursing facility's rental 
 77.22  rate, determined under Minnesota Rules, parts 9549.0010 to 
 77.23  9549.0080, and this section, resulting from the acquisition of 
 77.24  allowable capital assets, and allowable debt and interest 
 77.25  expense under this subdivision shall be added to its 
 77.26  property-related payment rate and shall be effective on the 
 77.27  first day of the month following the month in which the 
 77.28  moratorium project was completed. 
 77.29     (e) Notwithstanding subdivision 3f, paragraph (a), for rate 
 77.30  periods beginning on October 1, 1992, and for rate years 
 77.31  beginning after June 30, 1993, the replacement-costs-new per bed 
 77.32  limit to be used in Minnesota Rules, part 9549.0060, subpart 4, 
 77.33  item B, for a nursing facility that has completed a renovation, 
 77.34  replacement, or upgrading project that has been approved under 
 77.35  the moratorium exception process in section 144A.073, or that 
 77.36  has completed an addition to or replacement of buildings, 
 78.1   attached fixtures, or land improvements for which the total 
 78.2   historical cost exceeds the lesser of $150,000 or ten percent of 
 78.3   the most recent appraised value, must be $47,500 per licensed 
 78.4   bed in multiple-bed rooms and $71,250 per licensed bed in a 
 78.5   single-bed room.  These amounts must be adjusted annually as 
 78.6   specified in subdivision 3f, paragraph (a), beginning January 1, 
 78.7   1993. 
 78.8      (f) A nursing facility that completes a project identified 
 78.9   in this subdivision and, as of April 17, 1992, has not been 
 78.10  mailed a rate notice with a special appraisal for a completed 
 78.11  project, or completes a project after April 17, 1992, but before 
 78.12  September 1, 1992, may elect either to request a special 
 78.13  reappraisal with the corresponding adjustment to the 
 78.14  property-related payment rate under the laws in effect on June 
 78.15  30, 1992, or to submit their capital asset and debt information 
 78.16  after that date and obtain the property-related payment rate 
 78.17  adjustment under this section, but not both. 
 78.18     (g) For purposes of this paragraph, a total replacement 
 78.19  means the complete replacement of the nursing facility's 
 78.20  physical plant through the construction of a new physical plant 
 78.21  or the transfer of the nursing facility's license from one 
 78.22  physical plant location to another.  For total replacement 
 78.23  projects completed on or after July 1, 1992, the commissioner 
 78.24  shall compute the incremental change in the nursing facility's 
 78.25  rental per diem, for rate years beginning on or after July 1, 
 78.26  1995, by replacing its appraised value, including the historical 
 78.27  capital asset costs, and the capital debt and interest costs 
 78.28  with the new nursing facility's allowable capital asset costs 
 78.29  and the related allowable capital debt and interest costs.  If 
 78.30  the new nursing facility has decreased its licensed capacity, 
 78.31  the aggregate investment per bed limit in subdivision 3a, 
 78.32  paragraph (d), shall apply.  If the new nursing facility has 
 78.33  retained a portion of the original physical plant for nursing 
 78.34  facility usage, then a portion of the appraised value prior to 
 78.35  the replacement must be retained and included in the calculation 
 78.36  of the incremental change in the nursing facility's rental per 
 79.1   diem.  For purposes of this part, the original nursing facility 
 79.2   means the nursing facility prior to the total replacement 
 79.3   project.  The portion of the appraised value to be retained 
 79.4   shall be calculated according to clauses (1) to (3): 
 79.5      (1) The numerator of the allocation ratio shall be the 
 79.6   square footage of the area in the original physical plant which 
 79.7   is being retained for nursing facility usage. 
 79.8      (2) The denominator of the allocation ratio shall be the 
 79.9   total square footage of the original nursing facility physical 
 79.10  plant. 
 79.11     (3) Each component of the nursing facility's allowable 
 79.12  appraised value prior to the total replacement project shall be 
 79.13  multiplied by the allocation ratio developed by dividing clause 
 79.14  (1) by clause (2). 
 79.15     In the case of either type of total replacement as 
 79.16  authorized under section 144A.071 or 144A.073, the provisions of 
 79.17  this subdivision shall also apply.  For purposes of the 
 79.18  moratorium exception authorized under section 144A.071, 
 79.19  subdivision 4a, paragraph (s), if the total replacement involves 
 79.20  the renovation and use of an existing health care facility 
 79.21  physical plant, the new allowable capital asset costs and 
 79.22  related debt and interest costs shall include first the 
 79.23  allowable capital asset costs and related debt and interest 
 79.24  costs of the renovation, to which shall be added the allowable 
 79.25  capital asset costs of the existing physical plant prior to the 
 79.26  renovation, and if reported by the facility, the related 
 79.27  allowable capital debt and interest costs. 
 79.28     (h) Notwithstanding Minnesota Rules, part 9549.0060, 
 79.29  subpart 11, item C, subitem (2), for a total replacement, as 
 79.30  defined in paragraph (g), authorized under section 144A.071 or 
 79.31  144A.073 after July 1, 1999, the replacement costs new per bed 
 79.32  limit shall be $74,280 per licensed bed in multiple-bed rooms, 
 79.33  $92,850 per licensed bed in semiprivate rooms with a fixed 
 79.34  partition separating the resident beds, and $111,420 per 
 79.35  licensed bed in single rooms.  Minnesota Rules, part 9549.0060, 
 79.36  subpart 11, item C, subitem (2), does not apply.  These amounts 
 80.1   must be adjusted annually as specified in subdivision 3f, 
 80.2   paragraph (a), beginning January 1, 2000.  
 80.3      (i) For a total replacement, as defined in paragraph (g), 
 80.4   authorized under section 144A.073 for a 96-bed nursing home in 
 80.5   Carlton county, the replacement costs new per bed limit shall be 
 80.6   $74,280 per licensed bed in multiple-bed rooms, $92,850 per 
 80.7   licensed bed in semiprivate rooms with a fixed partition 
 80.8   separating the resident's beds, and $111,420 per licensed bed in 
 80.9   a single room.  Minnesota Rules, part 9549.0060, subpart 11, 
 80.10  item C, subitem (2), does not apply.  The resulting maximum 
 80.11  allowable replacement costs new multiplied by 1.25 shall 
 80.12  constitute the project's dollar threshold for purposes of 
 80.13  application of the limit set forth in section 144A.073, 
 80.14  subdivision 2.  The commissioner of health may waive the 
 80.15  requirements of section 144A.073, subdivision 3b, paragraph (b), 
 80.16  clause (2), on the condition that the other requirements of that 
 80.17  paragraph are met. 
 80.18     Sec. 19.  Minnesota Statutes 1998, section 256B.431, 
 80.19  subdivision 26, is amended to read: 
 80.20     Subd. 26.  [CHANGES TO NURSING FACILITY REIMBURSEMENT 
 80.21  BEGINNING JULY 1, 1997.] The nursing facility reimbursement 
 80.22  changes in paragraphs (a) to (f) shall apply in the sequence 
 80.23  specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 
 80.24  this section, beginning July 1, 1997. 
 80.25     (a) For rate years beginning on or after July 1, 1997, the 
 80.26  commissioner shall limit a nursing facility's allowable 
 80.27  operating per diem for each case mix category for each rate year.
 80.28  The commissioner shall group nursing facilities into two groups, 
 80.29  freestanding and nonfreestanding, within each geographic group, 
 80.30  using their operating cost per diem for the case mix A 
 80.31  classification.  A nonfreestanding nursing facility is a nursing 
 80.32  facility whose other operating cost per diem is subject to the 
 80.33  hospital attached, short length of stay, or the rule 80 limits.  
 80.34  All other nursing facilities shall be considered freestanding 
 80.35  nursing facilities.  The commissioner shall then array all 
 80.36  nursing facilities in each grouping by their allowable case mix 
 81.1   A operating cost per diem.  In calculating a nursing facility's 
 81.2   operating cost per diem for this purpose, the commissioner shall 
 81.3   exclude the raw food cost per diem related to providing special 
 81.4   diets that are based on religious beliefs, as determined in 
 81.5   subdivision 2b, paragraph (h).  For those nursing facilities in 
 81.6   each grouping whose case mix A operating cost per diem: 
 81.7      (1) is at or below the median of the array, the 
 81.8   commissioner shall limit the nursing facility's allowable 
 81.9   operating cost per diem for each case mix category to the lesser 
 81.10  of the prior reporting year's allowable operating cost per diem 
 81.11  as specified in Laws 1996, chapter 451, article 3, section 11, 
 81.12  paragraph (h), plus the inflation factor as established in 
 81.13  paragraph (d), clause (2), increased by two percentage points, 
 81.14  or the current reporting year's corresponding allowable 
 81.15  operating cost per diem; or 
 81.16     (2) is above the median of the array, the commissioner 
 81.17  shall limit the nursing facility's allowable operating cost per 
 81.18  diem for each case mix category to the lesser of the prior 
 81.19  reporting year's allowable operating cost per diem as specified 
 81.20  in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 
 81.21  plus the inflation factor as established in paragraph (d), 
 81.22  clause (2), increased by one percentage point, or the current 
 81.23  reporting year's corresponding allowable operating cost per diem.
 81.24     For purposes of paragraph (a), if a nursing facility 
 81.25  reports on its cost report a reduction in cost due to a refund 
 81.26  or credit for a rate year beginning on or after July 1, 1998, 
 81.27  the commissioner shall increase that facility's spend-up limit 
 81.28  for the rate year following the current rate year by the amount 
 81.29  of the cost reduction divided by its resident days for the 
 81.30  reporting year preceding the rate year in which the adjustment 
 81.31  is to be made. 
 81.32     (b) For rate years beginning on or after July 1, 1997, the 
 81.33  commissioner shall limit the allowable operating cost per diem 
 81.34  for high cost nursing facilities.  After application of the 
 81.35  limits in paragraph (a) to each nursing facility's operating 
 81.36  cost per diem, the commissioner shall group nursing facilities 
 82.1   into two groups, freestanding or nonfreestanding, within each 
 82.2   geographic group.  A nonfreestanding nursing facility is a 
 82.3   nursing facility whose other operating cost per diem are subject 
 82.4   to hospital attached, short length of stay, or rule 80 limits.  
 82.5   All other nursing facilities shall be considered freestanding 
 82.6   nursing facilities.  The commissioner shall then array all 
 82.7   nursing facilities within each grouping by their allowable case 
 82.8   mix A operating cost per diem.  In calculating a nursing 
 82.9   facility's operating cost per diem for this purpose, the 
 82.10  commissioner shall exclude the raw food cost per diem related to 
 82.11  providing special diets that are based on religious beliefs, as 
 82.12  determined in subdivision 2b, paragraph (h).  For those nursing 
 82.13  facilities in each grouping whose case mix A operating cost per 
 82.14  diem exceeds 1.0 standard deviation above the median, the 
 82.15  commissioner shall reduce their allowable operating cost per 
 82.16  diem by three percent.  For those nursing facilities in each 
 82.17  grouping whose case mix A operating cost per diem exceeds 0.5 
 82.18  standard deviation above the median but is less than or equal to 
 82.19  1.0 standard deviation above the median, the commissioner shall 
 82.20  reduce their allowable operating cost per diem by two percent.  
 82.21  However, in no case shall a nursing facility's operating cost 
 82.22  per diem be reduced below its grouping's limit established at 
 82.23  0.5 standard deviations above the median. 
 82.24     (c) For rate years beginning on or after July 1, 1997, the 
 82.25  commissioner shall determine a nursing facility's efficiency 
 82.26  incentive by first computing the allowable difference, which is 
 82.27  the lesser of $4.50 or the amount by which the facility's other 
 82.28  operating cost limit exceeds its nonadjusted other operating 
 82.29  cost per diem for that rate year.  The commissioner shall 
 82.30  compute the efficiency incentive by: 
 82.31     (1) subtracting the allowable difference from $4.50 and 
 82.32  dividing the result by $4.50; 
 82.33     (2) multiplying 0.20 by the ratio resulting from clause 
 82.34  (1), and then; 
 82.35     (3) adding 0.50 to the result from clause (2); and 
 82.36     (4) multiplying the result from clause (3) times the 
 83.1   allowable difference. 
 83.2      The nursing facility's efficiency incentive payment shall 
 83.3   be the lesser of $2.25 or the product obtained in clause (4). 
 83.4      (d) For rate years beginning on or after July 1, 1997, the 
 83.5   forecasted price index for a nursing facility's allowable 
 83.6   operating cost per diem shall be determined under clauses (1) 
 83.7   and (2) using the change in the Consumer Price Index-All Items 
 83.8   (United States city average) (CPI-U) as forecasted by Data 
 83.9   Resources, Inc.  The commissioner shall use the indices as 
 83.10  forecasted in the fourth quarter of the calendar year preceding 
 83.11  the rate year, subject to subdivision 2l, paragraph (c).  
 83.12     (1) The CPI-U forecasted index for allowable operating cost 
 83.13  per diem shall be based on the 21-month period from the midpoint 
 83.14  of the nursing facility's reporting year to the midpoint of the 
 83.15  rate year following the reporting year. 
 83.16     (2) For rate years beginning on or after July 1, 1997, the 
 83.17  forecasted index for operating cost limits referred to in 
 83.18  subdivision 21, paragraph (b), shall be based on the CPI-U for 
 83.19  the 12-month period between the midpoints of the two reporting 
 83.20  years preceding the rate year. 
 83.21     (e) After applying these provisions for the respective rate 
 83.22  years, the commissioner shall index these allowable operating 
 83.23  cost per diem by the inflation factor provided for in paragraph 
 83.24  (d), clause (1), and add the nursing facility's efficiency 
 83.25  incentive as computed in paragraph (c). 
 83.26     (f) For rate years beginning on or after July 1, 1997, the 
 83.27  total operating cost payment rates for a nursing facility shall 
 83.28  be the greater of the total operating cost payment rates 
 83.29  determined under this section or the total operating cost 
 83.30  payment rates in effect on June 30, 1997, subject to rate 
 83.31  adjustments due to field audit or rate appeal resolution.  This 
 83.32  provision shall not apply to subsequent field audit adjustments 
 83.33  of the nursing facility's operating cost rates for rate years 
 83.34  beginning on or after July 1, 1997. 
 83.35     (g) For the rate years beginning on July 1, 1997, July 1, 
 83.36  1998, and July 1, 1999, a nursing facility licensed for 40 beds 
 84.1   effective May 1, 1992, with a subsequent increase of 20 
 84.2   Medicare/Medicaid certified beds, effective January 26, 1993, in 
 84.3   accordance with an increase in licensure is exempt from 
 84.4   paragraphs (a) and (b). 
 84.5      (h) For a nursing facility whose construction project was 
 84.6   authorized according to section 144A.073, subdivision 5, 
 84.7   paragraph (g), the operating cost payment rates for the third 
 84.8   new location shall be determined based on Minnesota Rules, part 
 84.9   9549.0057.  The relocation allowed under section 144A.073, 
 84.10  subdivision 5, paragraph (g), and the rate determination allowed 
 84.11  under this paragraph must meet the cost neutrality requirements 
 84.12  of section 144A.073, subdivision 3c.  Paragraphs (a) and (b) 
 84.13  shall not apply until the second rate year after the settle-up 
 84.14  cost report is filed.  Notwithstanding subdivision 2b, paragraph 
 84.15  (g), real estate taxes and special assessments payable by 
 84.16  the third new location, a 501(c)(3) nonprofit corporation, shall 
 84.17  be included in the payment rates determined under this 
 84.18  subdivision for all subsequent rate years. 
 84.19     (i) For the rate year beginning July 1, 1997, the 
 84.20  commissioner shall compute the payment rate for a nursing 
 84.21  facility licensed for 94 beds on September 30, 1996, that 
 84.22  applied in October 1993 for approval of a total replacement 
 84.23  under the moratorium exception process in section 144A.073, and 
 84.24  completed the approved replacement in June 1995, with other 
 84.25  operating cost spend-up limit under paragraph (a), increased by 
 84.26  $3.98, and after computing the facility's payment rate according 
 84.27  to this section, the commissioner shall make a one-year positive 
 84.28  rate adjustment of $3.19 for operating costs related to the 
 84.29  newly constructed total replacement, without application of 
 84.30  paragraphs (a) and (b).  The facility's per diem, before the 
 84.31  $3.19 adjustment, shall be used as the prior reporting year's 
 84.32  allowable operating cost per diem for payment rate calculation 
 84.33  for the rate year beginning July 1, 1998.  A facility described 
 84.34  in this paragraph is exempt from paragraph (b) for the rate 
 84.35  years beginning July 1, 1997, and July 1, 1998. 
 84.36     (j) For the purpose of applying the limit stated in 
 85.1   paragraph (a), a nursing facility in Kandiyohi county licensed 
 85.2   for 86 beds that was granted hospital-attached status on 
 85.3   December 1, 1994, shall have the prior year's allowable 
 85.4   care-related per diem increased by $3.207 and the prior year's 
 85.5   other operating cost per diem increased by $4.777 before adding 
 85.6   the inflation in paragraph (d), clause (2), for the rate year 
 85.7   beginning on July 1, 1997. 
 85.8      (k) For the purpose of applying the limit stated in 
 85.9   paragraph (a), a 117 bed nursing facility located in Pine county 
 85.10  shall have the prior year's allowable other operating cost per 
 85.11  diem increased by $1.50 before adding the inflation in paragraph 
 85.12  (d), clause (2), for the rate year beginning on July 1, 1997. 
 85.13     (l) For the purpose of applying the limit under paragraph 
 85.14  (a), a nursing facility in Hibbing licensed for 192 beds shall 
 85.15  have the prior year's allowable other operating cost per diem 
 85.16  increased by $2.67 before adding the inflation in paragraph (d), 
 85.17  clause (2), for the rate year beginning July 1, 1997. 
 85.18     Sec. 20.  Minnesota Statutes 1998, section 256B.431, is 
 85.19  amended by adding a subdivision to read: 
 85.20     Subd. 28.  [NURSING FACILITY RATE INCREASES BEGINNING JULY 
 85.21  1, 1999, AND JULY 1, 2000.] (a) For the rate year beginning July 
 85.22  1, 1999, the commissioner shall make available an operating 
 85.23  payment rate increase equal to four percent.  The commissioner 
 85.24  shall make available salary adjustments equal to 4.75 percent in 
 85.25  each category except management fees and administrator and 
 85.26  central office, which shall be used solely to increase wages or 
 85.27  pay payroll taxes associated with these wage increases, and 
 85.28  shall use the remainder of the amount appropriated by the 
 85.29  legislature to increase per diem payment rates in all operating 
 85.30  rate categories not subject to the 4.75 percent increase. 
 85.31     (b) For the rate year beginning July 1, 2000, the 
 85.32  commissioner shall make available an operating payment rate 
 85.33  increase equal to three percent.  The commissioner shall make 
 85.34  available salary adjustments equal to 3.5 percent in each 
 85.35  category except management fees and administrator and central 
 85.36  office, which shall be used solely to increase wages or pay 
 86.1   payroll taxes associated with these wage increases, and shall 
 86.2   use the remainder of the amount appropriated to increase per 
 86.3   diem payment rates in all operating rate categories not subject 
 86.4   to the 3.5 percent increase. 
 86.5      (c) Effective July 1, 1999, to June 30, 2001, the 
 86.6   commissioner shall make available the salary adjustment per diem 
 86.7   calculated in clause (1) or (2) to the total operating cost 
 86.8   payment rate of each nursing facility reimbursed under this 
 86.9   section or section 256B.434.  The salary adjustment per diem for 
 86.10  each nursing facility must be determined as follows:  
 86.11     (1) for each nursing facility that reports salaries for 
 86.12  registered nurses, licensed practical nurses, and aides, 
 86.13  orderlies, and attendants separately, the commissioner shall 
 86.14  determine the salary adjustment per diem by multiplying the 
 86.15  total salaries, payroll taxes, and fringe benefits allowed in 
 86.16  each operating cost category, except management fees and 
 86.17  administrator and central office salaries and the related 
 86.18  payroll taxes and fringe benefits, by 4.75 percent and 3.5 
 86.19  percent respectively, and then dividing the resulting amount by 
 86.20  the nursing facility's actual resident days; 
 86.21     (2) for each nursing facility that does not report salaries 
 86.22  for registered nurses, licensed practical nurses, aides, 
 86.23  orderlies, and attendants separately, the salary adjustment per 
 86.24  diem is the weighted average salary adjustment per diem increase 
 86.25  determined under clause (1); 
 86.26     (3) a nursing facility may apply for the salary adjustment 
 86.27  per diem calculated under clauses (1) and (2).  The application 
 86.28  must be made to the commissioner and contain a plan by which the 
 86.29  nursing facility will distribute the salary adjustment to 
 86.30  employees of the nursing facility.  In order to apply for a 
 86.31  salary adjustment, a nursing facility reimbursed under section 
 86.32  256B.434 must report the information required by clause (1) or 
 86.33  (2) in the application, in the manner specified by the 
 86.34  commissioner.  For nursing facilities in which the employees are 
 86.35  represented by an exclusive bargaining representative, an 
 86.36  agreement negotiated and agreed to by the employer and the 
 87.1   exclusive bargaining representative may constitute the plan for 
 87.2   the salary distribution.  The commissioner shall review the plan 
 87.3   to ensure that the salary adjustment per diem is used solely to 
 87.4   increase the wages of nursing home facility employees and pay 
 87.5   payroll taxes associated with these increased wages.  To be 
 87.6   eligible, a facility must submit its plan for the salary 
 87.7   distribution by December 31 each year.  A facility may amend its 
 87.8   plan for the second rate year by submitting a revised plan by 
 87.9   December 31, 2000.  If a facility's plan for salary distribution 
 87.10  is effective for its employees after July 1 of the year that the 
 87.11  funds are available, the salary adjustment cost per diem shall 
 87.12  be effective the same date as its plan; and 
 87.13     (4) additional costs incurred by nursing facilities as a 
 87.14  result of this salary adjustment are not allowable costs for 
 87.15  purposes of the September 30, 1999, or September 30, 2000, cost 
 87.16  report. 
 87.17     (d) A copy of the approved distribution plan must be made 
 87.18  available to all employees.  This must be done by giving each 
 87.19  employee a copy or by posting it in an area of the nursing 
 87.20  facility to which all employees have access.  If an employee 
 87.21  does not receive the salary adjustment described in their 
 87.22  facility's approved plan and is unable to resolve the problem 
 87.23  with the facility's management, the employee may contact the 
 87.24  employee's union representative.  If the employee is not covered 
 87.25  by a collective bargaining agreement, the employee may contact 
 87.26  the commissioner at a phone number provided by the commissioner 
 87.27  and included in the approved plan. 
 87.28     (e) For the rate year beginning July 1, 1999, the following 
 87.29  nursing facilities shall be allowed a rate increase equal to 67 
 87.30  percent of the rate increase that would be allowed if 
 87.31  subdivision 26, paragraph (a), was not applied: 
 87.32     (1) a nursing facility in Carver county licensed for 33 
 87.33  nursing home beds and four boarding care beds; 
 87.34     (2) a nursing facility in Faribault county licensed for 159 
 87.35  nursing home beds on September 30, 1998; and 
 87.36     (3) a nursing facility in Houston county licensed for 68 
 88.1   nursing home beds on September 30, 1998. 
 88.2      (f) For the rate year beginning July 1, 1999, the following 
 88.3   nursing facilities shall be allowed a rate increase equal to 67 
 88.4   percent of the rate increase that would be allowed if 
 88.5   subdivision 26, paragraphs (a) and (b), were not applied: 
 88.6      (1) a nursing facility in Chisago county licensed for 135 
 88.7   nursing home beds on September 30, 1998; and 
 88.8      (2) a nursing facility in Murray county licensed for 62 
 88.9   nursing home beds on September 30, 1998. 
 88.10     (g) For the rate year beginning July 1, 1999, a nursing 
 88.11  facility in Hennepin county licensed for 134 beds on September 
 88.12  30, 1998, shall: 
 88.13     (1) have the prior year's allowable care-related per diem 
 88.14  increased by $3.93 and the prior year's other operating cost per 
 88.15  diem increased by $1.69 before adding the inflation in 
 88.16  subdivision 26, paragraph (d), clause (2); and 
 88.17     (2) be allowed a rate increase equal to 67 percent of the 
 88.18  rate increase that would be allowed if subdivision 26, 
 88.19  paragraphs (a) and (b), were not applied. 
 88.20     Sec. 21.  Minnesota Statutes 1998, section 256B.434, 
 88.21  subdivision 3, is amended to read: 
 88.22     Subd. 3.  [DURATION AND TERMINATION OF CONTRACTS.] (a) 
 88.23  Subject to available resources, the commissioner may begin to 
 88.24  execute contracts with nursing facilities November 1, 1995. 
 88.25     (b) All contracts entered into under this section are for a 
 88.26  term of one year.  Either party may terminate a contract at any 
 88.27  time without cause by providing 30 90 calendar days advance 
 88.28  written notice to the other party.  The decision to terminate a 
 88.29  contract is not appealable.  If neither party provides written 
 88.30  notice of termination the contract shall be renegotiated for 
 88.31  additional one-year terms, for up to a total of four consecutive 
 88.32  one-year terms Notwithstanding section 16C.05, subdivision 2, 
 88.33  paragraph (a), clause (5), the contract shall be renegotiated 
 88.34  for additional one-year terms unless either party provides 
 88.35  written notice of termination.  The provisions of the contract 
 88.36  shall be renegotiated annually by the parties prior to the 
 89.1   expiration date of the contract.  The parties may voluntarily 
 89.2   renegotiate the terms of the contract at any time by mutual 
 89.3   agreement. 
 89.4      (c) If a nursing facility fails to comply with the terms of 
 89.5   a contract, the commissioner shall provide reasonable notice 
 89.6   regarding the breach of contract and a reasonable opportunity 
 89.7   for the facility to come into compliance.  If the facility fails 
 89.8   to come into compliance or to remain in compliance, the 
 89.9   commissioner may terminate the contract.  If a contract is 
 89.10  terminated, the contract payment remains in effect for the 
 89.11  remainder of the rate year in which the contract was terminated, 
 89.12  but in all other respects the provisions of this section do not 
 89.13  apply to that facility effective the date the contract is 
 89.14  terminated.  The contract shall contain a provision governing 
 89.15  the transition back to the cost-based reimbursement system 
 89.16  established under section 256B.431, subdivision 25, and 
 89.17  Minnesota Rules, parts 9549.0010 to 9549.0080.  A contract 
 89.18  entered into under this section may be amended by mutual 
 89.19  agreement of the parties. 
 89.20     Sec. 22.  Minnesota Statutes 1998, section 256B.434, 
 89.21  subdivision 4, is amended to read: 
 89.22     Subd. 4.  [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 
 89.23  nursing facilities which have their payment rates determined 
 89.24  under this section rather than section 256B.431, subdivision 25, 
 89.25  the commissioner shall establish a rate under this subdivision.  
 89.26  The nursing facility must enter into a written contract with the 
 89.27  commissioner. 
 89.28     (b) A nursing facility's case mix payment rate for the 
 89.29  first rate year of a facility's contract under this section is 
 89.30  the payment rate the facility would have received under section 
 89.31  256B.431, subdivision 25. 
 89.32     (c) A nursing facility's case mix payment rates for the 
 89.33  second and subsequent years of a facility's contract under this 
 89.34  section are the previous rate year's contract payment rates plus 
 89.35  an inflation adjustment.  The index for the inflation adjustment 
 89.36  must be based on the change in the Consumer Price Index-All 
 90.1   Items (United States City average) (CPI-U) forecasted by Data 
 90.2   Resources, Inc., as forecasted in the fourth quarter of the 
 90.3   calendar year preceding the rate year.  The inflation adjustment 
 90.4   must be based on the 12-month period from the midpoint of the 
 90.5   previous rate year to the midpoint of the rate year for which 
 90.6   the rate is being determined.  This paragraph shall not apply 
 90.7   for the rate years beginning July 1, 1999, and July 1, 2000. 
 90.8      (d) The commissioner shall develop additional 
 90.9   incentive-based payments of up to five percent above the 
 90.10  standard contract rate for achieving outcomes specified in each 
 90.11  contract.  The specified facility-specific outcomes must be 
 90.12  measurable and approved by the commissioner.  The commissioner 
 90.13  may establish, for each contract, various levels of achievement 
 90.14  within an outcome.  After the outcomes have been specified the 
 90.15  commissioner shall assign various levels of payment associated 
 90.16  with achieving the outcome.  Any incentive-based payment cancels 
 90.17  if there is a termination of the contract.  In establishing the 
 90.18  specified outcomes and related criteria the commissioner shall 
 90.19  consider the following state policy objectives: 
 90.20     (1) improved cost effectiveness and quality of life as 
 90.21  measured by improved clinical outcomes; 
 90.22     (2) successful diversion or discharge to community 
 90.23  alternatives; 
 90.24     (3) decreased acute care costs; 
 90.25     (4) improved consumer satisfaction; 
 90.26     (5) the achievement of quality; or 
 90.27     (6) any additional outcomes proposed by a nursing facility 
 90.28  that the commissioner finds desirable. 
 90.29     Sec. 23.  Minnesota Statutes 1998, section 256B.434, is 
 90.30  amended by adding a subdivision to read: 
 90.31     Subd. 4a.  [FACILITY RATE INCREASES.] For the rate year 
 90.32  beginning July 1, 1999, the nursing facilities described in 
 90.33  clauses (1) to (4) shall receive the rate increases indicated.  
 90.34  The increases provided under this subdivision shall be included 
 90.35  in the facility's total payment rates for the purpose of 
 90.36  determining future rates under this section or any other section:
 91.1      (1) a nursing facility in Becker county licensed for 102 
 91.2   nursing home beds on September 30, 1998, shall receive an 
 91.3   increase of $1.30 in its case mix class A payment rate; an 
 91.4   increase of $1.33 in its case mix class B payment rate; an 
 91.5   increase of $1.36 in its case mix class C payment rate; an 
 91.6   increase of $1.39 in its case mix class D payment rate; an 
 91.7   increase of $1.42 in its case mix class E payment rate; an 
 91.8   increase of $1.42 in its case mix class F payment rate; an 
 91.9   increase of $1.45 in its case mix class G payment rate; an 
 91.10  increase of $1.49 in its case mix class H payment rate; an 
 91.11  increase of $1.51 in its case mix class I payment rate; an 
 91.12  increase of $1.54 in its case mix class J payment rate; and an 
 91.13  increase of $1.59 in its case mix class K payment rate; 
 91.14     (2) a nursing facility in Chisago county licensed for 101 
 91.15  nursing home beds on September 30, 1998, shall receive an 
 91.16  increase of $3.67 in each case mix payment rate; 
 91.17     (3) a nursing facility in Canby, licensed for 75 beds shall 
 91.18  have its property-related per diem rate increased by $1.21.  
 91.19  This increase shall be recognized in the facility's contract 
 91.20  payment rate under this section; and 
 91.21     (4) a nursing facility in Golden Valley with all its beds 
 91.22  licensed to provide residential rehabilitative services to young 
 91.23  adults under Minnesota Rules, parts 9570.2000 to 9570.3400, 
 91.24  shall have the payment rate computed according to this section 
 91.25  increased by $14.83.  
 91.26     Sec. 24.  Minnesota Statutes 1998, section 256B.434, 
 91.27  subdivision 13, is amended to read: 
 91.28     Subd. 13.  [PAYMENT SYSTEM REFORM ADVISORY COMMITTEE.] (a) 
 91.29  The commissioner, in consultation with an advisory committee, 
 91.30  shall study options for reforming the regulatory and 
 91.31  reimbursement system for nursing facilities to reduce the level 
 91.32  of regulation, reporting, and procedural requirements, and to 
 91.33  provide greater flexibility and incentives to stimulate 
 91.34  competition and innovation.  The advisory committee shall 
 91.35  include, at a minimum, representatives from the long-term care 
 91.36  provider community, the department of health, and consumers of 
 92.1   long-term care services.  The advisory committee sunsets on June 
 92.2   30, 1997.  Among other things, the commissioner shall consider 
 92.3   the feasibility and desirability of changing from a 
 92.4   certification requirement to an accreditation requirement for 
 92.5   participation in the medical assistance program, options to 
 92.6   encourage early discharge of short-term residents through the 
 92.7   provision of intensive therapy, and further modifications needed 
 92.8   in rate equalization.  The commissioner shall also include 
 92.9   detailed recommendations for a permanent managed care payment 
 92.10  system to replace the contractual alternative payment 
 92.11  demonstration project authorized under this section.  The 
 92.12  commissioner shall submit a report with findings and 
 92.13  recommendations to the legislature by January 15, 1997. 
 92.14     (b) If a permanent managed care payment system has not been 
 92.15  enacted into law by July 1, 1997, the commissioner shall develop 
 92.16  and implement a transition plan to enable nursing facilities 
 92.17  under contract with the commissioner under this section to 
 92.18  revert to the cost-based payment system at the expiration of the 
 92.19  alternative payment demonstration project.  The commissioner 
 92.20  shall include in the alternative payment demonstration project 
 92.21  contracts entered into under this section a provision to permit 
 92.22  an amendment to the contract to be made after July 1, 1997, 
 92.23  governing the transition back to the cost-based payment system.  
 92.24  The transition plan and contract amendments are not subject to 
 92.25  rulemaking requirements.  
 92.26     Sec. 25.  Minnesota Statutes 1998, section 256B.435, is 
 92.27  amended to read: 
 92.28     256B.435 [NURSING FACILITY REIMBURSEMENT SYSTEM EFFECTIVE 
 92.29  JULY 1, 2000 2001.] 
 92.30     Subdivision 1.  [IN GENERAL.] Effective July 1, 2000 2001, 
 92.31  the commissioner shall implement a performance-based contracting 
 92.32  system to replace the current method of setting operating cost 
 92.33  payment rates under sections 256B.431 and 256B.434 and Minnesota 
 92.34  Rules, parts 9549.0010 to 9549.0080.  Operating cost payment 
 92.35  rates for newly established facilities under Minnesota Rules, 
 92.36  part 9549.0057, shall be established using section 256B.431 and 
 93.1   Minnesota Rules, parts 9549.0010 to 9549.0070.  A nursing 
 93.2   facility in operation on May 1, 1998, with payment rates not 
 93.3   established under section 256B.431 or 256B.434 on that date, is 
 93.4   ineligible for this performance-based contracting system.  In 
 93.5   determining prospective payment rates of nursing facility 
 93.6   services, the commissioner shall distinguish between operating 
 93.7   costs and property-related costs.  The commissioner of finance 
 93.8   shall include an annual inflationary adjustment in operating 
 93.9   costs for nursing facilities using the inflation factor 
 93.10  specified in subdivision 3 and funding for incentive-based 
 93.11  payments as a budget change request in each biennial detailed 
 93.12  expenditure budget submitted to the legislature under section 
 93.13  16A.11.  Property related payment rates, including real estate 
 93.14  taxes and special assessments, shall be determined under section 
 93.15  256B.431 or 256B.434 or under a new property-related 
 93.16  reimbursement system, if one is implemented by the commissioner 
 93.17  under subdivision 3.  The commissioner shall present additional 
 93.18  recommendations for performance-based contracting for nursing 
 93.19  facilities to the legislature by February 15, 2000, in the 
 93.20  following specific areas: 
 93.21     (1) development of an interim default payment mechanism for 
 93.22  nursing facilities that do not respond to the state's request 
 93.23  for proposal but wish to continue participation in the medical 
 93.24  assistance program, and nursing facilities the state does not 
 93.25  select in the request for proposal process, and nursing 
 93.26  facilities whose contract has been canceled; 
 93.27     (2) development of criteria for facilities to earn 
 93.28  performance-based incentive payments based on relevant outcomes 
 93.29  negotiated by nursing facilities and the commissioner and that 
 93.30  recognize both continuous quality efforts and quality 
 93.31  improvement; 
 93.32     (3) development of criteria and a process under which 
 93.33  nursing facilities can request rate adjustments for low base 
 93.34  rates, geographic disparities, or other reasons; 
 93.35     (4) development of a dispute resolution mechanism for 
 93.36  nursing facilities that are denied a contract, denied incentive 
 94.1   payments, or denied a rate adjustment; 
 94.2      (5) development of a property payment system to address the 
 94.3   capital needs of nursing facilities that will be funded with 
 94.4   additional appropriations; 
 94.5      (6) establishment of a transitional plan to move from dual 
 94.6   assessment instruments to the federally mandated resident 
 94.7   assessment system, whereby the financial impact for each 
 94.8   facility would be budget neutral; 
 94.9      (7) identification of net cost implications for facilities 
 94.10  and to the department of preparing for and implementing 
 94.11  performance-based contracting or any proposed alternative 
 94.12  system; 
 94.13     (8) identification of facility financial and statistical 
 94.14  reporting requirements; and 
 94.15     (9) identification of exemptions from current regulations 
 94.16  and statutes applicable under performance-based contracting.  
 94.17     Subd. 1a.  [REQUESTS FOR PROPOSALS.] (a) For nursing 
 94.18  facilities with rates established under section 256B.434 on 
 94.19  January 1, 2001, the commissioner shall renegotiate contracts 
 94.20  without requiring a response to a request for proposal, 
 94.21  notwithstanding the solicitation process described in chapter 
 94.22  16C. 
 94.23     (b) Prior to July 1, 2001, the commissioner shall publish 
 94.24  in the State Register a request for proposals to provide nursing 
 94.25  facility services according to this section.  The commissioner 
 94.26  will consider proposals from all nursing facilities that have 
 94.27  payment rates established under section 256B.431.  The 
 94.28  commissioner must respond to all proposals in a timely manner. 
 94.29     (c) In issuing a request for proposals, the commissioner 
 94.30  may develop reasonable requirements which, in the judgment of 
 94.31  the commissioner, are necessary to protect residents or ensure 
 94.32  that the performance-based contracting system furthers the 
 94.33  interests of the state of Minnesota.  The request for proposals 
 94.34  may include, but need not be limited to: 
 94.35     (1) a requirement that a nursing facility make reasonable 
 94.36  efforts to maximize Medicare payments on behalf of eligible 
 95.1   residents; 
 95.2      (2) requirements designed to prevent inappropriate or 
 95.3   illegal discrimination against residents enrolled in the medical 
 95.4   assistance program as compared to private paying residents; 
 95.5      (3) requirements designed to ensure that admissions to a 
 95.6   nursing facility are appropriate and that reasonable efforts are 
 95.7   made to place residents in home and community-based settings 
 95.8   when appropriate; 
 95.9      (4) a requirement to agree to participate in the 
 95.10  development of data collection systems and outcome-based 
 95.11  standards.  Among other requirements specified by the 
 95.12  commissioner, each facility entering into a contract may be 
 95.13  required to pay an annual fee not to exceed $1,000.  The 
 95.14  commissioner must use revenue generated from the fees to 
 95.15  contract with a qualified consultant or contractor to develop 
 95.16  data collection systems and outcome-based contracting standards; 
 95.17     (5) a requirement that Medicare-certified contractors agree 
 95.18  to maintain Medicare cost reports and to submit them to the 
 95.19  commissioner upon request, or at times specified by the 
 95.20  commissioner; and that contractors that are not 
 95.21  Medicare-certified agree to maintain a uniform cost report in a 
 95.22  format established by the commissioner and to submit the report 
 95.23  to the commissioner upon request, or at times specified by the 
 95.24  commissioner; 
 95.25     (6) a requirement that demonstrates willingness and ability 
 95.26  to develop and maintain data collection and retrieval systems to 
 95.27  measure outcomes; and 
 95.28     (7) a requirement to provide all information and assurances 
 95.29  required by the terms and conditions of the federal waiver or 
 95.30  federal approval. 
 95.31     (d) In addition to the information and assurances contained 
 95.32  in the submitted proposals, the commissioner may consider the 
 95.33  following criteria in developing the terms of the contract: 
 95.34     (1) the facility's history of compliance with federal and 
 95.35  state laws and rules.  A facility deemed to be in substantial 
 95.36  compliance with federal and state laws and rules is eligible to 
 96.1   respond to a request for proposals.  A facility's compliance 
 96.2   history shall not be the sole determining factor in situations 
 96.3   where the facility has been sold and the new owners have 
 96.4   submitted a proposal; 
 96.5      (2) whether the facility has a record of excessive 
 96.6   licensure fines or sanctions or fraudulent cost reports; 
 96.7      (3) the facility's financial history and solvency; and 
 96.8      (4) other factors identified by the commissioner deemed 
 96.9   relevant to developing the terms of the contract, including a 
 96.10  determination that a contract with a particular facility is not 
 96.11  in the best interests of the residents of the facility or the 
 96.12  state of Minnesota. 
 96.13     (e) Notwithstanding the requirements of the solicitation 
 96.14  process described in chapter 16C, the commissioner may contract 
 96.15  with nursing facilities established according to section 
 96.16  144A.073 without issuing a request for proposals. 
 96.17     (f) Notwithstanding subdivision 1, after July 1, 2001, the 
 96.18  commissioner may contract with additional nursing facilities, 
 96.19  according to requests for proposals. 
 96.20     Subd. 2.  [CONTRACT PROVISIONS.] (a) The performance-based 
 96.21  contract with each nursing facility must include provisions that:
 96.22     (1) apply the resident case mix assessment provisions of 
 96.23  Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 
 96.24  another assessment system, with the goal of moving to a single 
 96.25  assessment system; 
 96.26     (2) monitor resident outcomes through various methods, such 
 96.27  as quality indicators based on the minimum data set and other 
 96.28  utilization and performance measures; 
 96.29     (3) require the establishment and use of a continuous 
 96.30  quality improvement process that integrates information from 
 96.31  quality indicators and regular resident and family satisfaction 
 96.32  interviews; 
 96.33     (4) require annual reporting of facility statistical 
 96.34  information, including resident days by case mix category, 
 96.35  productive nursing hours, wages and benefits, and raw food costs 
 96.36  for use by the commissioner in the development of facility 
 97.1   profiles that include trends in payment and service utilization; 
 97.2      (5) require from each nursing facility an annual certified 
 97.3   audited financial statement consisting of a balance sheet, 
 97.4   income and expense statements, and an opinion from either a 
 97.5   licensed or certified public accountant, if a certified audit 
 97.6   was prepared, or unaudited financial statements if no certified 
 97.7   audit was prepared; and 
 97.8      (6) specify the method for resolving disputes; and 
 97.9      (7) establish additional requirements and penalties for 
 97.10  nursing facilities not meeting the standards set forth in the 
 97.11  performance-based contract. 
 97.12     (b) The commissioner may develop additional incentive-based 
 97.13  payments for achieving specified outcomes specified in each 
 97.14  contract.  The specified facility-specific outcomes must be 
 97.15  measurable and approved by the commissioner.  
 97.16     (c) The commissioner may also contract with nursing 
 97.17  facilities in other ways through requests for proposals, 
 97.18  including contracts on a risk or nonrisk basis, with nursing 
 97.19  facilities or consortia of nursing facilities, to provide 
 97.20  comprehensive long-term care coverage on a premium or capitated 
 97.21  basis. 
 97.22     (d) The commissioner may negotiate different contract terms 
 97.23  for different nursing facilities. 
 97.24     Subd. 2a.  [DURATION AND TERMINATION OF CONTRACTS.] (a) All 
 97.25  contracts entered into under this section are for a term of one 
 97.26  year.  Either party may terminate this contract at any time 
 97.27  without cause by providing 90 calendar days' advance written 
 97.28  notice to the other party.  Notwithstanding section 16C.05, 
 97.29  subdivisions 2, paragraph (a), and 5, if neither party provides 
 97.30  written notice of termination, the contract shall be 
 97.31  renegotiated for additional one-year terms or the terms of the 
 97.32  existing contract will be extended for one year.  The provisions 
 97.33  of the contract shall be renegotiated annually by the parties 
 97.34  prior to the expiration date of the contract.  The parties may 
 97.35  voluntarily renegotiate the terms of the contract at any time by 
 97.36  mutual agreement. 
 98.1      (b) If a nursing facility fails to comply with the terms of 
 98.2   a contract, the commissioner shall provide reasonable notice 
 98.3   regarding the breach of contract and a reasonable opportunity 
 98.4   for the facility to come into compliance.  If the facility fails 
 98.5   to come into compliance or to remain in compliance, the 
 98.6   commissioner may terminate the contract.  If a contract is 
 98.7   terminated, provisions of section 256B.48, subdivision 1a, shall 
 98.8   apply. 
 98.9      Subd. 3.  [PAYMENT RATE PROVISIONS.] (a) For rate years 
 98.10  beginning on or after July 1, 2000 2001, within the limits of 
 98.11  appropriations specifically for this purpose, the commissioner 
 98.12  shall determine operating cost payment rates for each licensed 
 98.13  and certified nursing facility by indexing its operating cost 
 98.14  payment rates in effect on June 30, 2000 2001, for inflation.  
 98.15  The inflation factor to be used must be based on the change in 
 98.16  the Consumer Price Index-All Items, United States city average 
 98.17  (CPI-U) as forecasted by Data Resources, Inc. in the fourth 
 98.18  quarter preceding the rate year.  For rate years beginning on or 
 98.19  after July 1, 2001, the inflation factor must be based on the 
 98.20  change in the Employment Cost Index for Private Industry Workers 
 98.21  - Total Compensation as forecasted by Data Resources, Inc., in 
 98.22  the fourth quarter preceding the rate year.  The CPI-U 
 98.23  forecasted index for operating cost payment rates shall be based 
 98.24  on the 12-month period from the midpoint of the nursing 
 98.25  facility's prior rate year to the midpoint of the rate year for 
 98.26  which the operating payment rate is being determined.  The 
 98.27  operating cost payment rate to be inflated shall be the total 
 98.28  payment rate in effect on June 30, 2001, minus the portion 
 98.29  determined to be the property-related payment rate, minus the 
 98.30  per diem amount of the preadmission screening cost included in 
 98.31  the nursing facility's last payment rate established under 
 98.32  section 256B.431. 
 98.33     (b) Beginning July 1, 2000, each nursing facility subject 
 98.34  to a performance-based contract under this section shall choose 
 98.35  one of two methods of payment for property-related costs: 
 98.36     (1) the method established in section 256B.434; or 
 99.1      (2) the method established in section 256B.431. 
 99.2      Once the nursing facility has made the election in this 
 99.3   paragraph, that election shall remain in effect for at least 
 99.4   four years or until an alternative property payment system is 
 99.5   developed.  A per diem amount for preadmission screening will be 
 99.6   added onto the contract payment rates according to the method of 
 99.7   distribution of county allocation described in section 
 99.8   256B.0911, subdivision 6, paragraph (a). 
 99.9      (c) For rate years beginning on or after July 1, 2000 2001, 
 99.10  the commissioner may implement a new method of payment for 
 99.11  property-related costs that addresses the capital needs of 
 99.12  facilities.  Notwithstanding paragraph (b), The new property 
 99.13  payment system or systems, if implemented, shall replace the 
 99.14  current method methods of setting property payment rates under 
 99.15  sections 256B.431 and 256B.434. 
 99.16     Subd. 4.  [CONTRACT PAYMENT RATES; APPEALS.] If an appeal 
 99.17  is pending concerning the cost-based payment rates that are the 
 99.18  basis for the calculation of the payment rate under this 
 99.19  section, the commissioner and the nursing facility may agree on 
 99.20  an interim contract rate to be used until the appeal is 
 99.21  resolved.  When the appeal is resolved, the contract rate must 
 99.22  be adjusted retroactively according to the appeal decision. 
 99.23     Subd. 5.  [CONSUMER PROTECTION.] In addition to complying 
 99.24  with all applicable laws regarding consumer protection, as a 
 99.25  condition of entering into a contract under this section, a 
 99.26  nursing facility must agree to: 
 99.27     (1) establish resident grievance procedures; 
 99.28     (2) establish expedited grievance procedures to resolve 
 99.29  complaints made by short-stay residents; and 
 99.30     (3) make available to residents and families a copy of the 
 99.31  performance-based contract and outcomes to be achieved. 
 99.32     Subd. 6.  [CONTRACTS ARE VOLUNTARY.] Participation of 
 99.33  nursing facilities in the medical assistance program is 
 99.34  voluntary.  The terms and procedures governing the 
 99.35  performance-based contract are determined under this section and 
 99.36  through negotiations between the commissioner and nursing 
100.1   facilities.  
100.2      Subd. 7.  [FEDERAL REQUIREMENTS.] The commissioner shall 
100.3   implement the performance-based contracting system subject to 
100.4   any required federal waivers or approval and in a manner that is 
100.5   consistent with federal requirements.  If a provision of this 
100.6   section is inconsistent with a federal requirement, the federal 
100.7   requirement supersedes the inconsistent provision.  The 
100.8   commissioner shall seek federal approval and request waivers as 
100.9   necessary to implement this section. 
100.10     Subd. 8.  [QUALITY MEASURES.] On or after July 1, 1999, the 
100.11  commissioner shall implement quality measures, as they are 
100.12  developed, for nursing facilities reimbursed under this section, 
100.13  section 256B.431, or 256B.434, and shall publicly disclose the 
100.14  findings of these measures.  Quality measures the commissioner 
100.15  may consider include the measures of nursing facility 
100.16  performance in clauses (1) to (6): 
100.17     (1) quality indicator measures of clinical outcomes; 
100.18     (2) findings of the department of health in licensing and 
100.19  certification surveys, complaint investigations, and case mix 
100.20  reviews; 
100.21     (3) measures of the nursing facility's impact on the 
100.22  quality of life of residents; 
100.23     (4) standardized measures of consumer satisfaction; 
100.24     (5) measures of progress on quality improvement; and 
100.25     (6) additional measures proposed by nursing facilities that 
100.26  the commissioner finds desirable. 
100.27     Sec. 26.  Minnesota Statutes 1998, section 256B.48, 
100.28  subdivision 1, is amended to read: 
100.29     Subdivision 1.  [PROHIBITED PRACTICES.] A nursing facility 
100.30  is not eligible to receive medical assistance payments unless it 
100.31  refrains from all of the following: 
100.32     (a) Charging private paying residents rates for similar 
100.33  services which exceed those which are approved by the state 
100.34  agency for medical assistance recipients as determined by the 
100.35  prospective desk audit rate, except under the following 
100.36  circumstances:  the nursing facility may (1) charge private 
101.1   paying residents a higher rate for a private room, and (2) 
101.2   charge for special services which are not included in the daily 
101.3   rate if medical assistance residents are charged separately at 
101.4   the same rate for the same services in addition to the daily 
101.5   rate paid by the commissioner.  Services covered by the payment 
101.6   rate must be the same regardless of payment source.  Special 
101.7   services, if offered, must be available to all residents in all 
101.8   areas of the nursing facility and charged separately at the same 
101.9   rate.  Residents are free to select or decline special 
101.10  services.  Special services must not include services which must 
101.11  be provided by the nursing facility in order to comply with 
101.12  licensure or certification standards and that if not provided 
101.13  would result in a deficiency or violation by the nursing 
101.14  facility.  Services beyond those required to comply with 
101.15  licensure or certification standards must not be charged 
101.16  separately as a special service if they were included in the 
101.17  payment rate for the previous reporting year.  A nursing 
101.18  facility that charges a private paying resident a rate in 
101.19  violation of this clause is subject to an action by the state of 
101.20  Minnesota or any of its subdivisions or agencies for civil 
101.21  damages.  A private paying resident or the resident's legal 
101.22  representative has a cause of action for civil damages against a 
101.23  nursing facility that charges the resident rates in violation of 
101.24  this clause.  The damages awarded shall include three times the 
101.25  payments that result from the violation, together with costs and 
101.26  disbursements, including reasonable attorneys' fees or their 
101.27  equivalent.  A private paying resident or the resident's legal 
101.28  representative, the state, subdivision or agency, or a nursing 
101.29  facility may request a hearing to determine the allowed rate or 
101.30  rates at issue in the cause of action.  Within 15 calendar days 
101.31  after receiving a request for such a hearing, the commissioner 
101.32  shall request assignment of an administrative law judge under 
101.33  sections 14.48 to 14.56 to conduct the hearing as soon as 
101.34  possible or according to agreement by the parties.  The 
101.35  administrative law judge shall issue a report within 15 calendar 
101.36  days following the close of the hearing.  The prohibition set 
102.1   forth in this clause shall not apply to facilities licensed as 
102.2   boarding care facilities which are not certified as skilled or 
102.3   intermediate care facilities level I or II for reimbursement 
102.4   through medical assistance. 
102.5      (b) Requiring (1) Charging, soliciting, accepting, or 
102.6   receiving from an applicant for admission to the facility, or 
102.7   the guardian or conservator from anyone acting in behalf of the 
102.8   applicant, as a condition of admission, to pay expediting the 
102.9   admission, or as a requirement for the individual's continued 
102.10  stay, any fee or, deposit in excess of $100, gift, money, 
102.11  donation, or other consideration not otherwise required as 
102.12  payment under the state plan.  Nothing in this clause would 
102.13  prohibit discharge for nonpayment of services in accordance with 
102.14  state and federal regulations; 
102.15     (2) requiring an individual, or anyone acting in behalf of 
102.16  the individual, to loan any money to the nursing facility, or; 
102.17     (3) requiring an individual, or anyone acting in behalf of 
102.18  the individual, to promise to leave all or part of the 
102.19  applicant's individual's estate to the facility; or 
102.20     (4) requiring a third-party guarantee of payment to the 
102.21  facility as a condition of admission, expedited admission, or 
102.22  continued stay in the facility.  
102.23     (c) requiring any resident of the nursing facility to 
102.24  utilize a vendor of health care services chosen by the nursing 
102.25  facility. 
102.26     (d) Providing differential treatment on the basis of status 
102.27  with regard to public assistance.  
102.28     (e) Discriminating in admissions, services offered, or room 
102.29  assignment on the basis of status with regard to public 
102.30  assistance or refusal to purchase special services.  Admissions 
102.31  discrimination shall include, but is not limited to:  
102.32     (1) basing admissions decisions upon assurance by the 
102.33  applicant to the nursing facility, or the applicant's guardian 
102.34  or conservator, that the applicant is neither eligible for nor 
102.35  will seek public assistance for payment of nursing facility care 
102.36  costs; and 
103.1      (2) engaging in preferential selection from waiting lists 
103.2   based on an applicant's ability to pay privately or an 
103.3   applicant's refusal to pay for a special service. 
103.4      The collection and use by a nursing facility of financial 
103.5   information of any applicant pursuant to a preadmission 
103.6   screening program established by law shall not raise an 
103.7   inference that the nursing facility is utilizing that 
103.8   information for any purpose prohibited by this paragraph.  
103.9      (f) Requiring any vendor of medical care as defined by 
103.10  section 256B.02, subdivision 7, who is reimbursed by medical 
103.11  assistance under a separate fee schedule, to pay any amount 
103.12  based on utilization or service levels or any portion of the 
103.13  vendor's fee to the nursing facility except as payment for 
103.14  renting or leasing space or equipment or purchasing support 
103.15  services from the nursing facility as limited by section 
103.16  256B.433.  All agreements must be disclosed to the commissioner 
103.17  upon request of the commissioner.  Nursing facilities and 
103.18  vendors of ancillary services that are found to be in violation 
103.19  of this provision shall each be subject to an action by the 
103.20  state of Minnesota or any of its subdivisions or agencies for 
103.21  treble civil damages on the portion of the fee in excess of that 
103.22  allowed by this provision and section 256B.433.  Damages awarded 
103.23  must include three times the excess payments together with costs 
103.24  and disbursements including reasonable attorney's fees or their 
103.25  equivalent.  
103.26     (g) Refusing, for more than 24 hours, to accept a resident 
103.27  returning to the same bed or a bed certified for the same level 
103.28  of care, in accordance with a physician's order authorizing 
103.29  transfer, after receiving inpatient hospital services. 
103.30     The prohibitions set forth in clause (b) shall not apply to 
103.31  a retirement facility with more than 325 beds including at least 
103.32  150 licensed nursing facility beds and which:  
103.33     (1) is owned and operated by an organization tax-exempt 
103.34  under section 290.05, subdivision 1, clause (i); and 
103.35     (2) accounts for all of the applicant's assets which are 
103.36  required to be assigned to the facility so that only expenses 
104.1   for the cost of care of the applicant may be charged against the 
104.2   account; and 
104.3      (3) agrees in writing at the time of admission to the 
104.4   facility to permit the applicant, or the applicant's guardian, 
104.5   or conservator, to examine the records relating to the 
104.6   applicant's account upon request, and to receive an audited 
104.7   statement of the expenditures charged against the applicant's 
104.8   individual account upon request; and 
104.9      (4) agrees in writing at the time of admission to the 
104.10  facility to permit the applicant to withdraw from the facility 
104.11  at any time and to receive, upon withdrawal, the balance of the 
104.12  applicant's individual account. 
104.13     For a period not to exceed 180 days, the commissioner may 
104.14  continue to make medical assistance payments to a nursing 
104.15  facility or boarding care home which is in violation of this 
104.16  section if extreme hardship to the residents would result.  In 
104.17  these cases the commissioner shall issue an order requiring the 
104.18  nursing facility to correct the violation.  The nursing facility 
104.19  shall have 20 days from its receipt of the order to correct the 
104.20  violation.  If the violation is not corrected within the 20-day 
104.21  period the commissioner may reduce the payment rate to the 
104.22  nursing facility by up to 20 percent.  The amount of the payment 
104.23  rate reduction shall be related to the severity of the violation 
104.24  and shall remain in effect until the violation is corrected.  
104.25  The nursing facility or boarding care home may appeal the 
104.26  commissioner's action pursuant to the provisions of chapter 14 
104.27  pertaining to contested cases.  An appeal shall be considered 
104.28  timely if written notice of appeal is received by the 
104.29  commissioner within 20 days of notice of the commissioner's 
104.30  proposed action.  
104.31     In the event that the commissioner determines that a 
104.32  nursing facility is not eligible for reimbursement for a 
104.33  resident who is eligible for medical assistance, the 
104.34  commissioner may authorize the nursing facility to receive 
104.35  reimbursement on a temporary basis until the resident can be 
104.36  relocated to a participating nursing facility.  
105.1      Certified beds in facilities which do not allow medical 
105.2   assistance intake on July 1, 1984, or after shall be deemed to 
105.3   be decertified for purposes of section 144A.071 only.  
105.4      Sec. 27.  Minnesota Statutes 1998, section 256B.48, 
105.5   subdivision 1a, is amended to read: 
105.6      Subd. 1a.  [TERMINATION.] If a nursing facility terminates 
105.7   its participation in the medical assistance program, whether 
105.8   voluntarily or involuntarily, the commissioner may authorize the 
105.9   nursing facility to receive continued medical assistance 
105.10  reimbursement only on a temporary basis until medical assistance 
105.11  residents can be relocated to nursing facilities participating 
105.12  in the medical assistance program. 
105.13     Sec. 28.  Minnesota Statutes 1998, section 256B.48, 
105.14  subdivision 1b, is amended to read: 
105.15     Subd. 1b.  [EXCEPTION.] Notwithstanding any agreement 
105.16  between a nursing facility and the department of human services 
105.17  or the provisions of this section or section 256B.411, other 
105.18  than subdivision 1a, the commissioner may authorize continued 
105.19  medical assistance payments to a nursing facility which ceased 
105.20  intake of medical assistance recipients prior to July 1, 1983, 
105.21  and which charges private paying residents rates that exceed 
105.22  those permitted by subdivision 1, paragraph (a), for (i) 
105.23  residents who resided in the nursing facility before July 1, 
105.24  1983, or (ii)  residents for whom the commissioner or any 
105.25  predecessors of the commissioner granted a permanent individual 
105.26  waiver prior to October 1, 1983.  Nursing facilities seeking 
105.27  continued medical assistance payments under this subdivision 
105.28  shall make the reports required under subdivision 2, except that 
105.29  on or after December 31, 1985, the financial statements required 
105.30  need not be audited by or contain the opinion of a certified 
105.31  public accountant or licensed public accountant, but need only 
105.32  be reviewed by a certified public accountant or licensed public 
105.33  accountant.  In the event that the state is determined by the 
105.34  federal government to be no longer eligible for the federal 
105.35  share of medical assistance payments made to a nursing facility 
105.36  under this subdivision, the commissioner may cease medical 
106.1   assistance payments, under this subdivision, to that nursing 
106.2   facility.  Between October 1, 1992, and July 1, 1993, a facility 
106.3   governed by this subdivision may elect to resume full 
106.4   participation in the medical assistance program by agreeing to 
106.5   comply with all of the requirements of the medical assistance 
106.6   program, including the rate equalization law in subdivision 1, 
106.7   paragraph (a), and all other requirements established in law or 
106.8   rule, and to resume intake of new medical assistance recipients. 
106.9      Sec. 29.  Minnesota Statutes 1998, section 256B.48, 
106.10  subdivision 6, is amended to read: 
106.11     Subd. 6.  [MEDICARE CERTIFICATION.] (a) [DEFINITION.] For 
106.12  purposes of this subdivision, "nursing facility" means a nursing 
106.13  facility that is certified as a skilled nursing facility or, 
106.14  after September 30, 1990, a nursing facility licensed under 
106.15  chapter 144A that is certified as a nursing facility.  
106.16     (b) [MEDICARE PARTICIPATION REQUIRED.] All nursing 
106.17  facilities shall participate in Medicare part A and part B 
106.18  unless, after submitting an application, Medicare certification 
106.19  is denied by the federal health care financing administration.  
106.20  Medicare review shall be conducted at the time of the annual 
106.21  medical assistance review.  Charges for Medicare-covered 
106.22  services provided to residents who are simultaneously eligible 
106.23  for medical assistance and Medicare must be billed to Medicare 
106.24  part A or part B before billing medical assistance.  Medical 
106.25  assistance may be billed only for charges not reimbursed by 
106.26  Medicare.  
106.27     (c) [UNTIL SEPTEMBER 30, 1990.] Until September 30, 1990, a 
106.28  nursing facility satisfies the requirements of paragraph (b) 
106.29  if:  (1) at least 50 percent of the facility's beds that are 
106.30  licensed under section 144A and certified as skilled nursing 
106.31  beds under the medical assistance program are Medicare 
106.32  certified; or (2) if a nursing facility's beds are licensed 
106.33  under section 144A, and some are medical assistance certified as 
106.34  skilled nursing beds and others are medical assistance certified 
106.35  as intermediate care facility I beds, at least 50 percent of the 
106.36  facility's total skilled nursing beds and intermediate care 
107.1   facility I beds or 100 percent of its skilled nursing beds, 
107.2   whichever is less, are Medicare certified. 
107.3      (d) [AFTER SEPTEMBER 30, 1990.] After September 30, 1990, a 
107.4   nursing facility satisfies the requirements of paragraph (b) if 
107.5   at least 50 percent of the facility's beds certified as nursing 
107.6   facility beds under the medical assistance program are Medicare 
107.7   certified. 
107.8      (e) (d) [CONFLICT WITH MEDICARE DISTINCT PART 
107.9   REQUIREMENTS.] At the request of a facility, the commissioner of 
107.10  human services may reduce the 50 percent Medicare participation 
107.11  requirement in paragraphs paragraph (c) and (d) to no less than 
107.12  20 percent if the commissioner of health determines that, due to 
107.13  the facility's physical plant configuration, the facility cannot 
107.14  satisfy Medicare distinct part requirements at the 50 percent 
107.15  certification level.  To receive a reduction in the 
107.16  participation requirement, a facility must demonstrate that the 
107.17  reduction will not adversely affect access of Medicare-eligible 
107.18  residents to Medicare-certified beds. 
107.19     (f) (e) [INSTITUTIONS FOR MENTAL DISEASE.] The commissioner 
107.20  may grant exceptions to the requirements of paragraph (b) for 
107.21  nursing facilities that are designated as institutions for 
107.22  mental disease. 
107.23     (g) (f) [NOTICE OF RIGHTS.] The commissioner shall inform 
107.24  recipients of their rights under this subdivision and section 
107.25  144.651, subdivision 29. 
107.26     Sec. 30.  Minnesota Statutes 1998, section 256B.50, 
107.27  subdivision 1e, is amended to read: 
107.28     Subd. 1e.  [ATTORNEY'S FEES AND COSTS.] (a) Notwithstanding 
107.29  section 15.472, paragraph (a), for an issue appealed under 
107.30  subdivision 1, the prevailing party in a contested case 
107.31  proceeding or, if appealed, in subsequent judicial review, must 
107.32  be awarded reasonable attorney's fees and costs incurred in 
107.33  litigating the appeal, if the prevailing party shows that the 
107.34  position of the opposing party was not substantially justified.  
107.35  The procedures for awarding fees and costs set forth in section 
107.36  15.474 must be followed in determining the prevailing party's 
108.1   fees and costs except as otherwise provided in this 
108.2   subdivision.  For purposes of this subdivision, "costs" means 
108.3   subpoena fees and mileage, transcript costs, court reporter 
108.4   fees, witness fees, postage and delivery costs, photocopying and 
108.5   printing costs, amounts charged the commissioner by the office 
108.6   of administrative hearings, and direct administrative costs of 
108.7   the department; and "substantially justified" means that a 
108.8   position had a reasonable basis in law and fact, based on the 
108.9   totality of the circumstances prior to and during the contested 
108.10  case proceeding and subsequent review. 
108.11     (b) When an award is made to the department under this 
108.12  subdivision, attorney fees must be calculated at the cost to the 
108.13  department.  When an award is made to a provider under this 
108.14  subdivision, attorney fees must be calculated at the rate 
108.15  charged to the provider except that attorney fees awarded must 
108.16  be the lesser of the attorney's normal hourly fee or $100 per 
108.17  hour. 
108.18     (c) In contested case proceedings involving more than one 
108.19  issue, the administrative law judge shall determine what portion 
108.20  of each party's attorney fees and costs is related to the issue 
108.21  or issues on which it prevailed and for which it is entitled to 
108.22  an award.  In making that determination, the administrative law 
108.23  judge shall consider the amount of time spent on each issue, the 
108.24  precedential value of the issue, the complexity of the issue, 
108.25  and other factors deemed appropriate by the administrative law 
108.26  judge.  
108.27     (d) When the department prevails on an issue involving more 
108.28  than one provider, the administrative law judge shall allocate 
108.29  the total amount of any award for attorney fees and costs among 
108.30  the providers.  In determining the allocation, the 
108.31  administrative law judge shall consider each provider's monetary 
108.32  interest in the issue and other factors deemed appropriate by 
108.33  the administrative law judge.  
108.34     (e) Attorney fees and costs awarded to the department for 
108.35  proceedings under this subdivision must not be reported or 
108.36  treated as allowable costs on the provider's cost report.  
109.1      (f) Fees and costs awarded to a provider for proceedings 
109.2   under this subdivision must be reimbursed to them by reporting 
109.3   the amount of fees and costs awarded as allowable costs on the 
109.4   provider's cost report for the reporting year in which they were 
109.5   awarded.  Fees and costs reported pursuant to this subdivision 
109.6   must be included in the general and administrative cost category 
109.7   but are not subject to categorical or overall cost limitations 
109.8   established in rule or statute within 120 days of the final 
109.9   decision on the award of attorney fees and costs. 
109.10     (g) If the provider fails to pay the awarded attorney fees 
109.11  and costs within 120 days of the final decision on the award of 
109.12  attorney fees and costs, the department may collect the amount 
109.13  due through any method available to it for the collection of 
109.14  medical assistance overpayments to providers.  Interest charges 
109.15  must be assessed on balances outstanding after 120 days of the 
109.16  final decision on the award of attorney fees and costs.  The 
109.17  annual interest rate charged must be the rate charged by the 
109.18  commissioner of revenue for late payment of taxes that is in 
109.19  effect on the 121st day after the final decision on the award of 
109.20  attorney fees and costs.  
109.21     (h) Amounts collected by the commissioner pursuant to this 
109.22  subdivision must be deemed to be recoveries pursuant to section 
109.23  256.01, subdivision 2, clause (15). 
109.24     (i) This subdivision applies to all contested case 
109.25  proceedings set on for hearing by the commissioner on or after 
109.26  April 29, 1988, regardless of the date the appeal was filed. 
109.27     Sec. 31.  Minnesota Statutes 1998, section 256B.501, is 
109.28  amended by adding a subdivision to read: 
109.29     Subd. 13.  [ICF/MR RATE INCREASES BEGINNING OCTOBER 1, 
109.30  1999, AND OCTOBER 1, 2000.] (a) For the rate year beginning 
109.31  October 1, 1999, the commissioner shall make available an 
109.32  operating payment rate increase equal to four percent.  The 
109.33  commissioner shall make available salary adjustments equal to 
109.34  4.75 percent in each category except management fees and 
109.35  administrator and central office, which shall be used solely to 
109.36  increase wages or pay payroll taxes associated with these wage 
110.1   increases, and shall use the remainder of the amount 
110.2   appropriated by the legislature to increase per diem payment 
110.3   rates in all operating rate categories not subject to the 4.75 
110.4   percent increase. 
110.5      (b) For the rate year beginning October 1, 2000, the 
110.6   commissioner shall make available an operating payment rate 
110.7   increase equal to three percent.  The commissioner shall make 
110.8   available salary adjustments equal to 3.5 percent in each 
110.9   category except management fees and administrator and central 
110.10  office, which shall be used solely to increase wages or pay 
110.11  payroll taxes associated with these wage increases, and shall 
110.12  use the remainder of the amount appropriated by the legislature 
110.13  to increase per diem payment rates in all operating rate 
110.14  categories not subject to the 3.5 percent increase. 
110.15     (c) Effective October 1, 1999, to September 30, 2001, the 
110.16  commissioner shall make available the appropriate salary 
110.17  adjustment cost per diem calculated in paragraphs (e) to (j) to 
110.18  the total operating cost payment rate of each facility subject 
110.19  to reimbursement under this section, section 256B.5011, and Laws 
110.20  1993, First Special Session chapter 1, article 4, section 11.  
110.21  The salary adjustment cost per diem must be determined according 
110.22  to paragraphs (d) to (j). 
110.23     (d) A state-operated community service, and any facility 
110.24  whose payment rates are governed by closure agreements, 
110.25  receivership agreements, or Minnesota Rules, part 9553.0075, are 
110.26  not eligible for a salary adjustment otherwise granted under 
110.27  this subdivision.  For purposes of the salary adjustment per 
110.28  diem computation and reviews in this subdivision, the term 
110.29  "salary adjustment cost" means the facility's allowable program 
110.30  operating cost category employee training expenses, and the 
110.31  facility's allowable salaries, payroll taxes, and fringe 
110.32  benefits.  The term does not include these same salary-related 
110.33  costs for both administrative or central office employees. 
110.34     For the purpose of determining the amount of salary 
110.35  adjustment to be granted under this subdivision, the 
110.36  commissioner must use the most recent cost report that has been 
111.1   subject to desk audit. 
111.2      (e) For the rate year beginning October 1, 1999, each 
111.3   facility shall receive a salary adjustment cost per diem equal 
111.4   to its salary adjustment costs multiplied by 4.75 percent, and 
111.5   then divided by the facility's resident days.  
111.6      (f) For the rate year beginning October 1, 2000, each 
111.7   facility shall receive a salary adjustment cost per diem equal 
111.8   to its salary adjustment costs multiplied by 3.5 percent, and 
111.9   then divided by the facility's resident days. 
111.10     (g) A facility may apply for the salary adjustment per diem 
111.11  calculated under this subdivision.  The application must be made 
111.12  to the commissioner and contain a plan by which the facility 
111.13  will distribute the salary adjustment to employees of the 
111.14  facility.  For facilities in which the employees are represented 
111.15  by an exclusive bargaining representative, an agreement 
111.16  negotiated and agreed to by the employer and the exclusive 
111.17  bargaining representative may constitute the plan for the salary 
111.18  distribution.  The commissioner shall review the plan to ensure 
111.19  that the salary adjustment per diem is used solely to increase 
111.20  the wages of facility employees and pay payroll taxes associated 
111.21  with these increased wages.  To be eligible, a facility must 
111.22  submit its plan for the salary distribution by December 31 of 
111.23  each year.  A facility may amend its plan for the second rate 
111.24  year by submitting a revised plan by December 31, 2000.  If a 
111.25  facility's plan for salary distribution is effective for its 
111.26  employees after October 1 of the year that the funds are 
111.27  available, the salary adjustment cost per diem shall be 
111.28  effective the same date as its plan. 
111.29     (h) Additional costs incurred by facilities as a result of 
111.30  this salary adjustment are not allowable costs for purposes of 
111.31  the December 31, 1999, or December 31, 2000, cost report. 
111.32     (i) In order to apply for a salary adjustment, a facility 
111.33  reimbursed under section 256B.5011 or Laws 1993, First Special 
111.34  Session chapter 1, article 4, section 11, must report the 
111.35  information referred to in paragraph (a) in the application, in 
111.36  the manner specified by the commissioner. 
112.1      (j) A copy of the approved distribution plan must be made 
112.2   available to all employees.  This must be done by giving each 
112.3   employee a copy or by posting it in an area of the facility to 
112.4   which all employees have access.  If an employee does not 
112.5   receive the salary adjustment described in their facility's 
112.6   approved plan and is unable to resolve the problem with the 
112.7   facility's management, the employee may contact the employee's 
112.8   union representative.  If the employee is not covered by a 
112.9   collective bargaining agreement, the employee may contact the 
112.10  commissioner at a telephone number provided by the commissioner 
112.11  and included in the approved plan. 
112.12     Sec. 32.  Minnesota Statutes 1998, section 256B.5011, 
112.13  subdivision 1, is amended to read: 
112.14     Subdivision 1.  [IN GENERAL.] Effective October 1, 2000, 
112.15  the commissioner shall implement a performance-based contracting 
112.16  system to replace the current method of setting total cost 
112.17  payment rates under section 256B.501 and Minnesota Rules, parts 
112.18  9553.0010 to 9553.0080.  In determining prospective payment 
112.19  rates of intermediate care facilities for persons with mental 
112.20  retardation or related conditions, the commissioner shall index 
112.21  each facility's total operating payment rate by an inflation 
112.22  factor as described in subdivision 3 section 256B.5012.  The 
112.23  commissioner of finance shall include annual inflation 
112.24  adjustments in operating costs for intermediate care facilities 
112.25  for persons with mental retardation and related conditions as a 
112.26  budget change request in each biennial detailed expenditure 
112.27  budget submitted to the legislature under section 16A.11. 
112.28     Sec. 33.  Minnesota Statutes 1998, section 256B.5011, 
112.29  subdivision 2, is amended to read: 
112.30     Subd. 2.  [CONTRACT PROVISIONS.] (a) The 
112.31  performance-based service contract with each intermediate care 
112.32  facility must include provisions for: 
112.33     (1) modifying payments when significant changes occur in 
112.34  the needs of the consumers; 
112.35     (2) monitoring service quality using performance indicators 
112.36  that measure consumer outcomes; 
113.1      (3) the establishment and use of continuous quality 
113.2   improvement processes using the results attained through service 
113.3   quality monitoring; 
113.4      (4) the annual reporting of facility statistical 
113.5   information on all supervisory personnel, direct care personnel, 
113.6   specialized support personnel, hours, wages and benefits, 
113.7   staff-to-consumer ratios, and staffing patterns 
113.8      (3) appropriate and necessary statistical information 
113.9   required by the commissioner; 
113.10     (5) (4) annual aggregate facility financial information or 
113.11  an annual certified audited financial statement, including a 
113.12  balance sheet and income and expense statements for each 
113.13  facility, if a certified audit was prepared; and 
113.14     (6) (5) additional requirements and penalties for 
113.15  intermediate care facilities not meeting the standards set forth 
113.16  in the performance-based service contract. 
113.17     (b) The commissioner shall recommend to the legislature by 
113.18  January 15, 2000, whether the contract should include service 
113.19  quality monitoring that may utilize performance indicators that 
113.20  measure consumer and program outcomes.  Performance measurement 
113.21  shall not increase or duplicate regulatory requirements. 
113.22     Sec. 34.  [256B.5012] [ICF/MR PAYMENT SYSTEM 
113.23  IMPLEMENTATION.] 
113.24     Subdivision 1.  [TOTAL PAYMENT RATE.] The total payment 
113.25  rate effective October 1, 2001, for existing ICF/MR facilities 
113.26  is the total of the operating payment rate and the property 
113.27  payment rate plus inflation factors as defined in this section.  
113.28  The initial rate year shall run from October 1, 2001, through 
113.29  December 31, 2002.  Subsequent rate years shall run from January 
113.30  1 through December 31 beginning in the year 2003. 
113.31     Subd. 2.  [OPERATING PAYMENT RATE.] (a) The operating 
113.32  payment rate equals the facility's total payment rate in effect 
113.33  on September 30, 2001, minus the property rate.  The operating 
113.34  payment rate includes the special operating rate and the 
113.35  efficiency incentive in effect as of September 30, 2001.  Within 
113.36  the limits of appropriations specifically for this purpose, the 
114.1   operating payment shall be increased for each rate year by the 
114.2   annual percentage change in the Employment Cost Index for 
114.3   Private Industry Workers - Total Compensation, as forecasted by 
114.4   Data Resources, Inc., in the second quarter of the calendar year 
114.5   preceding the start of each rate year.  In the case of the 
114.6   initial rate year beginning October 1, 2001, and continuing 
114.7   through December 31, 2002, the percentage change shall be based 
114.8   on the percentage change in the Employment Cost Index for 
114.9   Private Industry Workers - Total Compensation for the 15-month 
114.10  period beginning October 1, 2001, as forecast by Data Resources, 
114.11  Inc., in the first quarter of 2001. 
114.12     (b) Effective October 1, 2000, the operating payment rate 
114.13  shall be adjusted to reflect an occupancy rate equal to 100 
114.14  percent of the facility's capacity days as of September 30, 2000.
114.15     Subd. 3.  [PROPERTY PAYMENT RATE.] (a) The property payment 
114.16  rate effective October 1, 2000, is based on the facility's 
114.17  property payment rate in effect on September 30, 2000.  
114.18  Effective October 1, 2000, a facility minimum property rate of 
114.19  $8.13 shall be applied to all existing ICF/MR facilities.  
114.20  Facilities with a property payment rate effective September 30, 
114.21  2000, which is below the minimum property rate shall receive an 
114.22  increase effective October 1, 2000, equal to the difference 
114.23  between the minimum property payment rate and the property 
114.24  payment rate in effect as of September 30, 2000.  Facilities 
114.25  with a property payment rate at or above the minimum property 
114.26  payment rate effective September 30, 2000, shall have no change 
114.27  in their property payment rate effective October 1, 2000. 
114.28     (b) Within the limits of appropriations specifically for 
114.29  this purpose, facility property payment rates shall be increased 
114.30  annually for inflation, effective January 1, 2002.  The increase 
114.31  shall be based on each facility's property payment rate in 
114.32  effect on September 30, 2000.  Property payment rates effective 
114.33  September 30, 2000, shall be arrayed from highest to lowest 
114.34  before applying the minimum property payment rate in paragraph 
114.35  (a).  For property payment rates at the 90th percentile or 
114.36  above, the annual inflation increase shall be zero.  For 
115.1   property payment rates below the 90th percentile but equal to or 
115.2   above the 75th percentile, the annual inflation increase shall 
115.3   be one percent.  For property payment rates below the 75th 
115.4   percentile, the annual inflation increase shall be two percent.  
115.5      Sec. 35.  [256B.5013] [PAYMENT RATE ADJUSTMENTS.] 
115.6      Subdivision 1.  [VARIABLE RATE ADJUSTMENTS.] When there is 
115.7   a documented increase in the resource needs of a current ICF/MR 
115.8   recipient or recipients, or a person is admitted to a facility 
115.9   who requires additional resources, the county of financial 
115.10  responsibility may approve an enhanced rate for one or more 
115.11  persons in the facility.  Resource needs directly attributable 
115.12  to an individual that may be considered under the variable rate 
115.13  adjustment include increased direct staff hours and other 
115.14  specialized services, equipment, and human resources.  The 
115.15  guidelines in paragraphs (a) to (d) apply for the payment rate 
115.16  adjustments under this section. 
115.17     (a) All persons must be screened according to section 
115.18  256B.092, subdivisions 7 and 8, prior to implementation of the 
115.19  new payment system and annually thereafter.  Screening data 
115.20  shall be analyzed to develop broad profiles of the functional 
115.21  characteristics of recipients.  Three components shall be used 
115.22  to distinguish recipients based on the following broad profiles: 
115.23     (1) functional ability to care for and maintain one's own 
115.24  basic needs; 
115.25     (2) the intensity of any aggressive or destructive 
115.26  behavior; and 
115.27     (3) any history of obstructive behavior in combination with 
115.28  a diagnosis of psychosis or neurosis.  
115.29     The profile groups shall be used to link resource needs to 
115.30  funding.  The resource profile shall determine the level of 
115.31  funding that may be authorized by the county.  The county of 
115.32  financial responsibility may approve a rate adjustment for an 
115.33  individual.  The commissioner shall recommend to the legislature 
115.34  by January 15, 2000, a methodology using the profile groups to 
115.35  determine variable rates.  The variable rate must be applied to 
115.36  expenses related to increased direct staff hours and other 
116.1   specialized services, equipment, and human resources.  This 
116.2   variable rate component plus the facility's current operating 
116.3   payment rate equals the individual's total operating payment 
116.4   rate. 
116.5      (b) A recipient must be screened by the county of financial 
116.6   responsibility using the developmental disabilities screening 
116.7   document completed immediately prior to approval of a variable 
116.8   rate by the county.  A comparison of the updated screening and 
116.9   the previous screening must demonstrate an increase in resource 
116.10  needs. 
116.11     (c) Rate adjustments projected to exceed the authorized 
116.12  funding level associated with the person's profile must be 
116.13  submitted to the commissioner. 
116.14     (d) The new rate approved through this process shall not be 
116.15  averaged across all persons living at a facility but shall be an 
116.16  individual rate.  The county of financial responsibility must 
116.17  indicate the projected length of time that the additional 
116.18  funding may be needed by the individual.  The need to continue 
116.19  an individual variable rate must be reviewed at the end of the 
116.20  anticipated duration of need but at least annually through the 
116.21  completion of the developmental disabilities screening document. 
116.22     Subd. 2.  [OTHER PAYMENT RATE ADJUSTMENTS.] Facility total 
116.23  payment rates may be adjusted by the host county, with 
116.24  authorization from a statewide advisory committee, if, through 
116.25  the local system needs planning process, it is determined that a 
116.26  need exists to amend the package of purchased services with a 
116.27  resulting increase or decrease in costs.  Except as provided in 
116.28  section 252.292, subdivision 4, if a provider demonstrates that 
116.29  the loss of revenues caused by the downsizing or closure of a 
116.30  facility cannot be absorbed by the facility based on current 
116.31  operations, the host county or the provider may submit a request 
116.32  to the statewide advisory committee for a facility base rate 
116.33  adjustment. 
116.34     Subd. 3.  [RELOCATION.] (a) Property rates for all 
116.35  facilities relocated after December 31, 1997, and up to and 
116.36  including October 1, 2000, shall have the full annual costs of 
117.1   relocation included in their October 1, 2000, property rate.  
117.2   The property rate for the relocated home is subject to the costs 
117.3   that were allowable under Minnesota Rules, chapter 9553, and the 
117.4   investment per bed limitation for newly constructed or newly 
117.5   established class B facilities.  
117.6      (b) In ensuing years, all relocated homes shall be subject 
117.7   to the investment per bed limit for newly constructed or newly 
117.8   established class B facilities under section 256B.501, 
117.9   subdivision 11.  The limits shall be adjusted on January 1 of 
117.10  each year by the percentage increase in the construction index 
117.11  published by the Bureau of Economic Analysis of the United 
117.12  States Department of Commerce in the Survey of Current Business 
117.13  Statistics in October of the previous two years.  Facilities 
117.14  that are relocated within the investment per bed limit may be 
117.15  approved by the statewide advisory committee.  Costs for 
117.16  relocation of a facility that exceed the investment per bed 
117.17  limit must be absorbed by the facility. 
117.18     (c) The payment rate shall take effect when the new 
117.19  facility is licensed and certified by the commissioner of 
117.20  health.  Rates for facilities that are relocated after December 
117.21  31, 1997, through October 1, 2000, shall be adjusted to reflect 
117.22  the full inclusion of the relocation costs, subject to the 
117.23  investment per bed limit in paragraph (b).  The investment per 
117.24  bed limit calculated rate for the year in which the facility was 
117.25  relocated shall be the investment per bed limit used. 
117.26     Subd. 4.  [TEMPORARY RATE ADJUSTMENTS TO ADDRESS OCCUPANCY 
117.27  AND ACCESS.] If a facility is operating at less than 100 percent 
117.28  occupancy on September 30, 2000, or if a recipient is discharged 
117.29  from a facility, the commissioner shall adjust the total payment 
117.30  rate for up to 90 days for the remaining recipients.  This 
117.31  mechanism shall not be used to pay for hospital or therapeutic 
117.32  leave days beyond the maximums allowed.  Facility payment 
117.33  adjustments exceeding 90 days to address a demonstrated need for 
117.34  access must be submitted to the statewide advisory committee 
117.35  with a local system needs assessment, plan, and budget for 
117.36  review and recommendation. 
118.1      Sec. 36.  [256B.5014] [FINANCIAL REPORTING.] 
118.2      All facilities shall maintain financial records and shall 
118.3   provide annual income and expense reports to the commissioner of 
118.4   human services on a form prescribed by the commissioner no later 
118.5   than April 30 of each year in order to receive medical 
118.6   assistance payments.  The reports for the reporting year ending 
118.7   December 31 must include: 
118.8      (1) salaries and related expenses, including program 
118.9   salaries, administrative salaries, other salaries, payroll 
118.10  taxes, and fringe benefits; 
118.11     (2) general operating expenses, including supplies, 
118.12  training, repairs, purchased services and consultants, 
118.13  utilities, food, licenses and fees, real estate taxes, 
118.14  insurance, and working capital interest; 
118.15     (3) property related costs, including depreciation, capital 
118.16  debt interest, rent, and leases; and 
118.17     (4) total annual resident days. 
118.18     Sec. 37.  [256B.5015] [PASS-THROUGH OF TRAINING AND 
118.19  HABILITATION SERVICES COSTS.] 
118.20     Training and habilitation services costs shall be paid as a 
118.21  pass-through payment at the lowest rate paid for the comparable 
118.22  services at that site under sections 252.40 to 252.46.  The 
118.23  pass-through payments for training and habilitation services 
118.24  shall be paid separately by the commissioner and shall not be 
118.25  included in the computation of the total payment rate. 
118.26     Sec. 38.  Minnesota Statutes 1998, section 256B.69, 
118.27  subdivision 6a, is amended to read: 
118.28     Subd. 6a.  [NURSING HOME SERVICES.] (a) Notwithstanding 
118.29  Minnesota Rules, part 9500.1457, subpart 1, item B, up to 90 
118.30  days of nursing facility services as defined in section 
118.31  256B.0625, subdivision 2, which are provided in a nursing 
118.32  facility certified by the Minnesota department of health for 
118.33  services provided and eligible for payment under Medicaid, shall 
118.34  be covered under the prepaid medical assistance program for 
118.35  individuals who are not residing in a nursing facility at the 
118.36  time of enrollment in the prepaid medical assistance program.  
119.1   Liability for coverage of nursing facility services by a 
119.2   participating health plan is limited to 365 days for any person 
119.3   enrolled under the prepaid medical assistance program. 
119.4      (b) For individuals enrolled in the Minnesota senior health 
119.5   options project authorized under subdivision 23, nursing 
119.6   facility services shall be covered according to the terms and 
119.7   conditions of the federal waiver agreement governing that 
119.8   demonstration project. 
119.9      Sec. 39.  Minnesota Statutes 1998, section 256B.69, 
119.10  subdivision 6b, is amended to read: 
119.11     Subd. 6b.  [ELDERLY HOME AND COMMUNITY-BASED WAIVER 
119.12  SERVICES.] Notwithstanding Minnesota Rules, part 9500.1457, 
119.13  subpart 1, item C, elderly waiver services shall be covered 
119.14  under the prepaid medical assistance program for all individuals 
119.15  who are eligible according to section 256B.0915.  (a) For 
119.16  individuals enrolled in the Minnesota senior health options 
119.17  project authorized under subdivision 23, elderly waiver services 
119.18  shall be covered according to the terms and conditions of the 
119.19  federal waiver agreement governing that demonstration project. 
119.20     (b) For individuals under age 65 with physical disabilities 
119.21  but without a primary diagnosis of mental illness or 
119.22  developmental disabilities, except for related conditions, 
119.23  enrolled in the Minnesota senior health options project 
119.24  authorized under subdivision 23, home and community-based waiver 
119.25  services shall be covered according to the terms and conditions 
119.26  of the federal agreement governing that demonstration project. 
119.27     Sec. 40.  Minnesota Statutes 1998, section 256I.04, 
119.28  subdivision 3, is amended to read: 
119.29     Subd. 3.  [MORATORIUM ON THE DEVELOPMENT OF GROUP 
119.30  RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 
119.31  into agreements for new group residential housing beds with 
119.32  total rates in excess of the MSA equivalent rate except:  (1) 
119.33  for group residential housing establishments meeting the 
119.34  requirements of subdivision 2a, clause (2) with department 
119.35  approval; (2) for group residential housing establishments 
119.36  licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 
120.1   provided the facility is needed to meet the census reduction 
120.2   targets for persons with mental retardation or related 
120.3   conditions at regional treatment centers; (3) to ensure 
120.4   compliance with the federal Omnibus Budget Reconciliation Act 
120.5   alternative disposition plan requirements for inappropriately 
120.6   placed persons with mental retardation or related conditions or 
120.7   mental illness; (4) up to 80 beds in a single, specialized 
120.8   facility located in Hennepin county that will provide housing 
120.9   for chronic inebriates who are repetitive users of 
120.10  detoxification centers and are refused placement in emergency 
120.11  shelters because of their state of intoxication, and planning 
120.12  for the specialized facility must have been initiated before 
120.13  July 1, 1991, in anticipation of receiving a grant from the 
120.14  housing finance agency under section 462A.05, subdivision 20a, 
120.15  paragraph (b); or (5) notwithstanding the provisions of 
120.16  subdivision 2a, for up to 190 supportive housing units in Anoka, 
120.17  Dakota, Hennepin, or Ramsey county for homeless adults with a 
120.18  mental illness, a history of substance abuse, or human 
120.19  immunodeficiency virus or acquired immunodeficiency syndrome.  
120.20  For purposes of this section, "homeless adult" means a person 
120.21  who is living on the street or in a shelter or discharged from a 
120.22  regional treatment center, community hospital, or residential 
120.23  treatment program and has no appropriate housing available and 
120.24  lacks the resources and support necessary to access appropriate 
120.25  housing.  At least 70 percent of the supportive housing units 
120.26  must serve homeless adults with mental illness, substance abuse 
120.27  problems, or human immunodeficiency virus or acquired 
120.28  immunodeficiency syndrome who are about to be or, within the 
120.29  previous six months, has been discharged from a regional 
120.30  treatment center, or a state-contracted psychiatric bed in a 
120.31  community hospital, or a residential mental health or chemical 
120.32  dependency treatment program.  If a person meets the 
120.33  requirements of subdivision 1, paragraph (a), and receives a 
120.34  federal or state housing subsidy, the group residential housing 
120.35  rate for that person is limited to the supplementary rate under 
120.36  section 256I.05, subdivision 1a, and is determined by 
121.1   subtracting the amount of the person's countable income that 
121.2   exceeds the MSA equivalent rate from the group residential 
121.3   housing supplementary rate.  A resident in a demonstration 
121.4   project site who no longer participates in the demonstration 
121.5   program shall retain eligibility for a group residential housing 
121.6   payment in an amount determined under section 256I.06, 
121.7   subdivision 8, using the MSA equivalent rate.  Service funding 
121.8   under section 256I.05, subdivision 1a, will end June 30, 1997, 
121.9   if federal matching funds are available and the services can be 
121.10  provided through a managed care entity.  If federal matching 
121.11  funds are not available, then service funding will continue 
121.12  under section 256I.05, subdivision 1a.; or (6) for group 
121.13  residential housing beds in settings meeting the requirements of 
121.14  subdivision 2a, paragraph (a), clause (3), which are used 
121.15  exclusively for recipients receiving home and community-based 
121.16  waiver services under sections 256B.0915, 256B.092, subdivision 
121.17  5, 256B.093, and 256B.49, and who resided in a nursing facility 
121.18  for the six months immediately prior to the month of entry into 
121.19  the group residential housing setting.  The group residential 
121.20  housing rate for these beds must be set so that the monthly 
121.21  group residential housing payment for an individual occupying 
121.22  the bed when combined with the nonfederal share of services 
121.23  delivered under the waiver for that person does not exceed the 
121.24  nonfederal share of the monthly medical assistance payment made 
121.25  for the person to the nursing facility in which the person 
121.26  resided prior to entry into the group residential housing 
121.27  establishment.  The rate may not exceed the MSA equivalent rate 
121.28  plus $426.37 for any case. 
121.29     (b) A county agency may enter into a group residential 
121.30  housing agreement for beds with rates in excess of the MSA 
121.31  equivalent rate in addition to those currently covered under a 
121.32  group residential housing agreement if the additional beds are 
121.33  only a replacement of beds with rates in excess of the MSA 
121.34  equivalent rate which have been made available due to closure of 
121.35  a setting, a change of licensure or certification which removes 
121.36  the beds from group residential housing payment, or as a result 
122.1   of the downsizing of a group residential housing setting.  The 
122.2   transfer of available beds from one county to another can only 
122.3   occur by the agreement of both counties. 
122.4      Sec. 41.  Minnesota Statutes 1998, section 256I.05, 
122.5   subdivision 1, is amended to read: 
122.6      Subdivision 1.  [MAXIMUM RATES.] Monthly room and board 
122.7   rates negotiated by a county agency for a recipient living in 
122.8   group residential housing must not exceed the MSA equivalent 
122.9   rate specified under section 256I.03, subdivision 5, with the 
122.10  exception that a county agency may negotiate a supplementary 
122.11  room and board rate that exceeds the MSA equivalent rate by up 
122.12  to $426.37 for recipients of waiver services under title XIX of 
122.13  the Social Security Act.  This exception is subject to the 
122.14  following conditions: 
122.15     (1) that the Secretary of Health and Human Services has not 
122.16  approved a state request to include room and board costs which 
122.17  exceed the MSA equivalent rate in an individual's set of waiver 
122.18  services under title XIX of the Social Security Act; or 
122.19     (2) that the Secretary of Health and Human Services has 
122.20  approved the inclusion of room and board costs which exceed the 
122.21  MSA equivalent rate, but in an amount that is insufficient to 
122.22  cover costs which are included in a group residential housing 
122.23  agreement in effect on June 30, 1994; and 
122.24     (3) the amount of the rate that is above the MSA equivalent 
122.25  rate has been approved by the commissioner. the setting is 
122.26  licensed by the commissioner of human services under Minnesota 
122.27  Rules, parts 9555.5050 to 9555.6265; 
122.28     (2) the setting is not the primary residence of the license 
122.29  holder and in which the license holder is not the primary 
122.30  caregiver; and 
122.31     (3) beginning January 1, 2000, the average supplementary 
122.32  room and board rate in a county for a calendar year may not 
122.33  exceed the average supplementary room and board rate for that 
122.34  county in effect on January 1, 2000.  If a county has not 
122.35  negotiated supplementary room and board rates for any facilities 
122.36  located in the county as of January 1, 2000, it may submit a 
123.1   supplementary room and board rate request with budget 
123.2   information for a facility to the commissioner for approval.  
123.3   The county agency may at any time negotiate a higher or lower 
123.4   room and board rate than the average supplementary room and 
123.5   board rate that would otherwise be paid under this subdivision. 
123.6      Sec. 42.  Minnesota Statutes 1998, section 256I.05, 
123.7   subdivision 1a, is amended to read: 
123.8      Subd. 1a.  [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 
123.9   the provisions of section 256I.04, subdivision 3, in addition to 
123.10  the room and board rate specified in subdivision 1, the county 
123.11  agency may negotiate a payment not to exceed $426.37 for other 
123.12  services necessary to provide room and board provided by the 
123.13  group residence if the residence is licensed by or registered by 
123.14  the department of health, or licensed by the department of human 
123.15  services to provide services in addition to room and board, and 
123.16  if the provider of services is not also concurrently receiving 
123.17  funding for services for a recipient under a home and 
123.18  community-based waiver under title XIX of the Social Security 
123.19  Act; or funding from the medical assistance program under 
123.20  section 256B.0627, subdivision 4, for personal care services for 
123.21  residents in the setting; or residing in a setting which 
123.22  receives funding under Minnesota Rules, parts 9535.2000 to 
123.23  9535.3000.  If funding is available for other necessary services 
123.24  through a home and community-based waiver, or personal care 
123.25  services under section 256B.0627, subdivision 4, then the GRH 
123.26  rate is limited to the rate set in subdivision 1.  Unless 
123.27  otherwise provided in law, in no case may the supplementary 
123.28  service rate plus the supplementary room and board rate exceed 
123.29  $426.37.  The registration and licensure requirement does not 
123.30  apply to establishments which are exempt from state licensure 
123.31  because they are located on Indian reservations and for which 
123.32  the tribe has prescribed health and safety requirements.  
123.33  Service payments under this section may be prohibited under 
123.34  rules to prevent the supplanting of federal funds with state 
123.35  funds.  The commissioner shall pursue the feasibility of 
123.36  obtaining the approval of the Secretary of Health and Human 
124.1   Services to provide home and community-based waiver services 
124.2   under title XIX of the Social Security Act for residents who are 
124.3   not eligible for an existing home and community-based waiver due 
124.4   to a primary diagnosis of mental illness or chemical dependency 
124.5   and shall apply for a waiver if it is determined to be 
124.6   cost-effective.  
124.7      (b) The commissioner is authorized to make cost-neutral 
124.8   transfers from the GRH fund for beds under this section to other 
124.9   funding programs administered by the department after 
124.10  consultation with the county or counties in which the affected 
124.11  beds are located.  The commissioner may also make cost-neutral 
124.12  transfers from the GRH fund to county human service agencies for 
124.13  beds permanently removed from the GRH census under a plan 
124.14  submitted by the county agency and approved by the 
124.15  commissioner.  The commissioner shall report the amount of any 
124.16  transfers under this provision annually to the legislature. 
124.17     (c) The provisions of paragraph (b) do not apply to a 
124.18  facility that has its reimbursement rate established under 
124.19  section 256B.431, subdivision 4, paragraph (c). 
124.20     Sec. 43.  [ICF/MR REIMBURSEMENT EFFECTIVE OCTOBER 1, 1999.] 
124.21     (a) For the rate year beginning October 1, 1999, the 
124.22  commissioner of human services shall exempt an intermediate care 
124.23  facility for persons with mental retardation from reductions to 
124.24  the payment rates under Minnesota Statutes, section 256B.501, 
124.25  subdivision 5b, paragraph (d), clause (6), if the facility: 
124.26     (1) has had a settle-up payment rate established in the 
124.27  reporting year preceding the rate year for the one-time rate 
124.28  adjustment; 
124.29     (2) is a newly established facility; 
124.30     (3) is an A to B conversion that has been converted under 
124.31  Minnesota Statutes, section 252.292, since rate year 1990; 
124.32     (4) has a payment rate subject to a community conversion 
124.33  project under Minnesota Statutes, section 252.292; 
124.34     (5) has a payment rate established under Minnesota 
124.35  Statutes, section 245A.12 or 245A.13; or 
124.36     (6) is a facility created by the relocation of more than 25 
125.1   percent of the capacity of a related facility during the 
125.2   reporting year. 
125.3      (b) Notwithstanding any contrary provision in Minnesota 
125.4   Statutes, section 256B.501, for the rate year beginning October 
125.5   1, 1999, the commissioner of human services shall, for purposes 
125.6   of the spend-up limit, array facilities within each grouping 
125.7   established under Minnesota Statutes, section 256B.501, 
125.8   subdivision 5b, paragraph (d), clause (4), by each facility's 
125.9   cost per resident day.  A facility's cost per resident day shall 
125.10  be determined by dividing its allowable historical general 
125.11  operating cost for the reporting year by the facility's resident 
125.12  days for the reporting year.  Facilities with a cost per 
125.13  resident day at or above the median shall be limited to the 
125.14  lesser of: 
125.15     (1) the current reporting year's cost per resident day; or 
125.16     (2) the prior report year's cost per resident day plus the 
125.17  inflation factor established under Minnesota Statutes, section 
125.18  256B.501, subdivision 3c, clause (2), increased by three 
125.19  percentage points.  In no case shall the amount of this 
125.20  reduction exceed:  (i) three percent for a facility with a 
125.21  licensed capacity greater than 16 beds; (ii) two percent for a 
125.22  facility with a licensed capacity of nine to 16 beds; and (iii) 
125.23  one percent for a facility with a licensed capacity of eight or 
125.24  fewer beds. 
125.25     (c) The commissioner shall not apply the limits established 
125.26  under Minnesota Statutes, section 256B.501, subdivision 5b, 
125.27  paragraph (d), clause (8), for the rate year beginning October 
125.28  1, 1999. 
125.29     (d) Notwithstanding paragraphs (b) and (c), the 
125.30  commissioner must utilize facility payment rates based on the 
125.31  laws in effect for October 1, 1998, payment rates and use the 
125.32  resulting allowable operating cost per diems as the basis for 
125.33  the spend-up limits for the rate year beginning October 1, 1999. 
125.34     Sec. 44.  [DEADLINE EXTENSION.] 
125.35     Notwithstanding Minnesota Statutes, section 144A.073, 
125.36  subdivision 3, the commissioner of health shall extend approval 
126.1   to May 31, 2000, for a total replacement of a 96-bed nursing 
126.2   home located in Carlton county previously approved under 
126.3   Minnesota Statutes, section 144A.073. 
126.4      Sec. 45.  [STATE LICENSURE CONFLICTS WITH FEDERAL 
126.5   REGULATIONS.] 
126.6      Notwithstanding the provisions of Minnesota Rules, part 
126.7   4658.0520, an incontinent resident must be checked according to 
126.8   a specific time interval written in the resident's care plan.  
126.9   The resident's attending physician must authorize in writing any 
126.10  interval longer than two hours. 
126.11     <i>(Effective date:  Section 45 (State Licensure) is effective</i> 
126.12  <i>the day following final enactment.)</i> 
126.13     Sec. 46.  [REPEALER.] 
126.14     (a) Minnesota Statutes 1998, sections 144.0723; and 
126.15  256B.5011, subdivision 3, are repealed. 
126.16     (b) Minnesota Statutes 1998, section 256B.434, subdivision 
126.17  17, is repealed effective July 1, 1999.  
126.18     (c) Minnesota Statutes 1998, section 256B.501, subdivision 
126.19  3g, is repealed effective October 1, 2000.  
126.20     (d) Laws 1997, chapter 203, article 4, section 55, is 
126.21  repealed. 
126.22     (e) Section 45 is repealed effective July 1, 2001. 
126.23     Sec. 47.  [EFFECTIVE DATE.] 
126.24     When preparing the conference committee report for adoption 
126.25  by the legislature, the revisor shall combine all effective date 
126.26  notations in this article into this effective date section. 
126.27                             ARTICLE 4
126.28                        HEALTH CARE PROGRAMS
126.29     Section 1.  Minnesota Statutes 1998, section 16A.76, 
126.30  subdivision 2, is amended to read: 
126.31     Subd. 2.  [RESERVE FINANCING.] The funds in reserve shall 
126.32  be equal to the amount of federal financial participation 
126.33  received since July 1, 1995, for services and administrative 
126.34  activities funded by the health care access fund up to a reserve 
126.35  limit of $150,000,000 $80,000,000.  Investment income attributed 
126.36  to the federal contingency reserve balances shall also be 
127.1   included in the total reserve amount. 
127.2      Sec. 2.  Minnesota Statutes 1998, section 60A.15, 
127.3   subdivision 1, is amended to read: 
127.4      Subdivision 1.  [DOMESTIC AND FOREIGN COMPANIES.] (a) On or 
127.5   before April 1, June 1, and December 1 of each year, every 
127.6   domestic and foreign company, including town and farmers' mutual 
127.7   insurance companies, domestic mutual insurance companies, marine 
127.8   insurance companies, health maintenance organizations, community 
127.9   integrated service networks, and nonprofit health service plan 
127.10  corporations, shall pay to the commissioner of revenue 
127.11  installments equal to one-third of the insurer's total estimated 
127.12  tax for the current year.  Except as provided in paragraphs (d), 
127.13  (e), (h), and (i), installments must be based on a sum equal to 
127.14  two percent of the premiums described in paragraph (b). 
127.15     (b) Installments under paragraph (a), (d), or (e) are 
127.16  percentages of gross premiums less return premiums on all direct 
127.17  business received by the insurer in this state, or by its agents 
127.18  for it, in cash or otherwise, during such year. 
127.19     (c) Failure of a company to make payments of at least 
127.20  one-third of either (1) the total tax paid during the previous 
127.21  calendar year or (2) 80 percent of the actual tax for the 
127.22  current calendar year shall subject the company to the penalty 
127.23  and interest provided in this section, unless the total tax for 
127.24  the current tax year is $500 or less. 
127.25     (d) For health maintenance organizations, nonprofit health 
127.26  service plan corporations, and community integrated service 
127.27  networks, the installments must be based on an amount determined 
127.28  under paragraph (h) or (i). 
127.29     (e) For purposes of computing installments for town and 
127.30  farmers' mutual insurance companies and for mutual property 
127.31  casualty companies with total assets on December 31, 1989, of 
127.32  $1,600,000,000 or less, the following rates apply: 
127.33     (1) for all life insurance, two percent; 
127.34     (2) for town and farmers' mutual insurance companies and 
127.35  for mutual property and casualty companies with total assets of 
127.36  $5,000,000 or less, on all other coverages, one percent; and 
128.1      (3) for mutual property and casualty companies with total 
128.2   assets on December 31, 1989, of $1,600,000,000 or less, on all 
128.3   other coverages, 1.26 percent. 
128.4      (f) If the aggregate amount of premium tax payments under 
128.5   this section and the fire marshal tax payments under section 
128.6   299F.21 made during a calendar year is equal to or exceeds 
128.7   $120,000, all tax payments in the subsequent calendar year must 
128.8   be paid by means of a funds transfer as defined in section 
128.9   336.4A-104, paragraph (a).  The funds transfer payment date, as 
128.10  defined in section 336.4A-401, must be on or before the date the 
128.11  payment is due.  If the date the payment is due is not a funds 
128.12  transfer business day, as defined in section 336.4A-105, 
128.13  paragraph (a), clause (4), the payment date must be on or before 
128.14  the funds transfer business day next following the date the 
128.15  payment is due.  
128.16     (g) Premiums under medical assistance, general assistance 
128.17  medical care, the MinnesotaCare program, and the Minnesota 
128.18  comprehensive health insurance plan and all payments, revenues, 
128.19  and reimbursements received from the federal government for 
128.20  Medicare-related coverage as defined in section 62A.31, 
128.21  subdivision 3, paragraph (e), are not subject to tax under this 
128.22  section. 
128.23     (h) For calendar years 1997, 1998, and 1999, 2000, and 2001 
128.24  the installments for health maintenance organizations, community 
128.25  integrated service networks, and nonprofit health service plan 
128.26  corporations must be based on an amount equal to one percent of 
128.27  premiums described under paragraph (b).  Health maintenance 
128.28  organizations, community integrated service networks, and 
128.29  nonprofit health service plan corporations that have met the 
128.30  cost containment goals established under section 62J.04 in the 
128.31  individual and small employer market for calendar year 1996 are 
128.32  exempt from payment of the tax imposed under this section for 
128.33  premiums paid after March 30, 1997, and before April 1, 1998.  
128.34  Health maintenance organizations, community integrated service 
128.35  networks, and nonprofit health service plan corporations that 
128.36  have met the cost containment goals established under section 
129.1   62J.04 in the individual and small employer market for calendar 
129.2   year 1997 are exempt from payment of the tax imposed under this 
129.3   section for premiums paid after March 30, 1998, and before April 
129.4   1, 1999.  Health maintenance organizations, community integrated 
129.5   service networks, and nonprofit health service plan corporations 
129.6   that have met the cost containment goals established under 
129.7   section 62J.04 in the individual and small employer market for 
129.8   calendar year 1998 are exempt from payment of the tax imposed 
129.9   under this section for premiums paid after March 30, 1999, and 
129.10  before January 1, 2000 2002.  
129.11     (i) For calendar years after 1999 2001, the commissioner of 
129.12  finance shall determine the balance of the health care access 
129.13  fund on September 1 of each year beginning September 1, 1999 
129.14  2001.  If the commissioner determines that there is no 
129.15  structural deficit for the next fiscal year, no tax shall be 
129.16  imposed under paragraph (d) for the following calendar year.  If 
129.17  the commissioner determines that there will be a structural 
129.18  deficit in the fund for the following fiscal year, then the 
129.19  commissioner, in consultation with the commissioner of revenue, 
129.20  shall determine the amount needed to eliminate the structural 
129.21  deficit and a tax shall be imposed under paragraph (d) for the 
129.22  following calendar year.  The commissioner shall determine the 
129.23  rate of the tax as either one-quarter of one percent, one-half 
129.24  of one percent, three-quarters of one percent, or one percent of 
129.25  premiums described in paragraph (b), whichever is the lowest of 
129.26  those rates that the commissioner determines will produce 
129.27  sufficient revenue to eliminate the projected structural 
129.28  deficit.  The commissioner of finance shall publish in the State 
129.29  Register by October 1 of each year the amount of tax to be 
129.30  imposed for the following calendar year.  In determining the 
129.31  structural balance of the health care access fund for fiscal 
129.32  years 2000 and 2001, the commissioner shall disregard the 
129.33  transfer amount from the health care access fund to the general 
129.34  fund for expenditures associated with the services provided to 
129.35  pregnant women and children under the age of two enrolled in the 
129.36  MinnesotaCare program. 
130.1      (j) In approving the premium rates as required in sections 
130.2   62L.08, subdivision 8, and 62A.65, subdivision 3, the 
130.3   commissioners of health and commerce shall ensure that any 
130.4   exemption from the tax as described in paragraphs (h) and (i) is 
130.5   reflected in the premium rate. 
130.6      Sec. 3.  Minnesota Statutes 1998, section 62A.045, is 
130.7   amended to read: 
130.8      62A.045 [PAYMENTS ON BEHALF OF ENROLLEES IN GOVERNMENT 
130.9   HEALTH PROGRAMS.] 
130.10     (a) No health plan issued or renewed to provide coverage to 
130.11  a Minnesota resident shall contain any provision denying or 
130.12  reducing benefits because services are rendered to a person who 
130.13  is eligible for or receiving medical benefits pursuant to title 
130.14  XIX of the Social Security Act (Medicaid) in this or any other 
130.15  state; chapter 256; 256B; or 256D or services pursuant to 
130.16  section 252.27; 256L.01 to 256L.10; 260.251, subdivision 1a; or 
130.17  393.07, subdivision 1 or 2.  No health carrier providing 
130.18  benefits under plans covered by this section shall use 
130.19  eligibility for medical programs named in this section as an 
130.20  underwriting guideline or reason for nonacceptance of the risk. 
130.21     (b) If payment for covered expenses has been made under 
130.22  state medical programs for health care items or services 
130.23  provided to an individual, and a third party has a legal 
130.24  liability to make payments, the rights of payment and appeal of 
130.25  an adverse coverage decision for the individual, or in the case 
130.26  of a child their responsible relative or caretaker, will be 
130.27  subrogated to the state and/or its authorized agent agency.  The 
130.28  state agency may assert its subrogation rights to payment under 
130.29  this section within three years of the date the service was 
130.30  rendered.  For purposes of this section, "state agency" includes 
130.31  prepaid health plans under contract with the department 
130.32  according to sections 256B.69, 256D.03, subdivision 4, paragraph 
130.33  (d), and 256L.12; children's mental health collaboratives under 
130.34  section 245.493; demonstration projects for persons with 
130.35  disabilities under section 256B.77; nursing homes under the 
130.36  alternative payment demonstration project under section 
131.1   256B.434; and county-based purchasing entities under section 
131.2   256B.692.  
131.3      (c) Notwithstanding any law to the contrary, when a person 
131.4   covered by a health plan receives medical benefits according to 
131.5   any statute listed in this section, payment for covered services 
131.6   or notice of denial for services billed by the provider must be 
131.7   issued directly to the provider.  If a person was receiving 
131.8   medical benefits through the department of human services at the 
131.9   time a service was provided, the provider must indicate this 
131.10  benefit coverage on any claim forms submitted by the provider to 
131.11  the health carrier for those services.  If the commissioner of 
131.12  human services notifies the health carrier that the commissioner 
131.13  has made payments to the provider, payment for benefits or 
131.14  notices of denials issued by the health carrier must be issued 
131.15  directly to the commissioner.  Submission by the department to 
131.16  the health carrier of the claim on a department of human 
131.17  services claim form is proper notice and shall be considered 
131.18  proof of payment of the claim to the provider and supersedes any 
131.19  contract requirements of the health carrier relating to the form 
131.20  of submission.  Liability to the insured for coverage is 
131.21  satisfied to the extent that payments for those benefits are 
131.22  made by the health carrier to the provider or the commissioner 
131.23  as required by this section. 
131.24     (d) When a state agency has acquired the rights of an 
131.25  individual eligible for medical programs named in this section 
131.26  and has health benefits coverage through a health carrier, the 
131.27  health carrier shall not impose requirements that are different 
131.28  from requirements applicable to an agent or assignee of any 
131.29  other individual covered. 
131.30     (e) For the purpose of this section, health plan includes 
131.31  coverage offered by community integrated service networks, any 
131.32  plan governed under the federal Employee Retirement Income 
131.33  Security Act of 1974 (ERISA), United States Code, title 29, 
131.34  sections 1001 to 1461, and coverage offered under the exclusions 
131.35  listed in section 62A.011, subdivision 3, clauses (2), (6), (9), 
131.36  (10), and (12).  
132.1      Sec. 4.  Minnesota Statutes 1998, section 125A.08, is 
132.2   amended to read: 
132.3      125A.08 [SCHOOL DISTRICT OBLIGATIONS.] 
132.4      (a) As defined in this section, to the extent required by 
132.5   federal law as of July 1, 1999 2000, every district must ensure 
132.6   the following: 
132.7      (1) all students with disabilities are provided the special 
132.8   instruction and services which are appropriate to their needs.  
132.9   Where the individual education plan team has determined 
132.10  appropriate goals and objectives based on the student's needs, 
132.11  including the extent to which the student can be included in the 
132.12  least restrictive environment, and where there are essentially 
132.13  equivalent and effective instruction, related services, or 
132.14  assistive technology devices available to meet the student's 
132.15  needs, cost to the district may be among the factors considered 
132.16  by the team in choosing how to provide the appropriate services, 
132.17  instruction, or devices that are to be made part of the 
132.18  student's individual education plan.  The individual education 
132.19  plan team shall consider and may authorize services covered by 
132.20  medical assistance according to section 256B.0625, subdivision 
132.21  26.  The student's needs and the special education instruction 
132.22  and services to be provided must be agreed upon through the 
132.23  development of an individual education plan.  The plan must 
132.24  address the student's need to develop skills to live and work as 
132.25  independently as possible within the community.  By grade 9 or 
132.26  age 14, the plan must address the student's needs for transition 
132.27  from secondary services to post-secondary education and 
132.28  training, employment, community participation, recreation, and 
132.29  leisure and home living.  In developing the plan, districts must 
132.30  inform parents of the full range of transitional goals and 
132.31  related services that should be considered.  The plan must 
132.32  include a statement of the needed transition services, including 
132.33  a statement of the interagency responsibilities or linkages or 
132.34  both before secondary services are concluded; 
132.35     (2) children with a disability under age five and their 
132.36  families are provided special instruction and services 
133.1   appropriate to the child's level of functioning and needs; 
133.2      (3) children with a disability and their parents or 
133.3   guardians are guaranteed procedural safeguards and the right to 
133.4   participate in decisions involving identification, assessment 
133.5   including assistive technology assessment, and educational 
133.6   placement of children with a disability; 
133.7      (4) eligibility and needs of children with a disability are 
133.8   determined by an initial assessment or reassessment, which may 
133.9   be completed using existing data under United States Code, title 
133.10  20, section 33, et seq.; 
133.11     (5) to the maximum extent appropriate, children with a 
133.12  disability, including those in public or private institutions or 
133.13  other care facilities, are educated with children who are not 
133.14  disabled, and that special classes, separate schooling, or other 
133.15  removal of children with a disability from the regular 
133.16  educational environment occurs only when and to the extent that 
133.17  the nature or severity of the disability is such that education 
133.18  in regular classes with the use of supplementary services cannot 
133.19  be achieved satisfactorily; 
133.20     (6) in accordance with recognized professional standards, 
133.21  testing and evaluation materials, and procedures used for the 
133.22  purposes of classification and placement of children with a 
133.23  disability are selected and administered so as not to be 
133.24  racially or culturally discriminatory; and 
133.25     (7) the rights of the child are protected when the parents 
133.26  or guardians are not known or not available, or the child is a 
133.27  ward of the state. 
133.28     (b) For paraprofessionals employed to work in programs for 
133.29  students with disabilities, the school board in each district 
133.30  shall ensure that: 
133.31     (1) before or immediately upon employment, each 
133.32  paraprofessional develops sufficient knowledge and skills in 
133.33  emergency procedures, building orientation, roles and 
133.34  responsibilities, confidentiality, vulnerability, and 
133.35  reportability, among other things, to begin meeting the needs of 
133.36  the students with whom the paraprofessional works; 
134.1      (2) annual training opportunities are available to enable 
134.2   the paraprofessional to continue to further develop the 
134.3   knowledge and skills that are specific to the students with whom 
134.4   the paraprofessional works, including understanding 
134.5   disabilities, following lesson plans, and implementing follow-up 
134.6   instructional procedures and activities; and 
134.7      (3) a districtwide process obligates each paraprofessional 
134.8   to work under the ongoing direction of a licensed teacher and, 
134.9   where appropriate and possible, the supervision of a school 
134.10  nurse. 
134.11     <i>(Effective date:  Section 4 (125A.08) is effective July 1,</i> 
134.12  <i>2000.)</i> 
134.13     Sec. 5.  Minnesota Statutes 1998, section 125A.21, 
134.14  subdivision 1, is amended to read: 
134.15     Subdivision 1.  [OBLIGATION TO PAY.] Nothing in sections 
134.16  125A.03 to 125A.24 and 125A.65 relieves an insurer or similar 
134.17  third party from an otherwise valid obligation to pay, or 
134.18  changes the validity of an obligation to pay, for services 
134.19  rendered to a child with a disability, and the child's family.  
134.20  A school district shall pay the nonfederal share of medical 
134.21  assistance services provided according to section 256B.0625, 
134.22  subdivision 26.  Eligible expenditures must not be made from 
134.23  federal funds or funds used to match other federal funds.  Any 
134.24  federal disallowances are the responsibility of the school 
134.25  district.  A school district may pay or reimburse copayments, 
134.26  coinsurance, deductibles, and other enrollee cost-sharing 
134.27  amounts, on behalf of the student or family, in connection with 
134.28  health and related services provided under an individual 
134.29  educational plan.  
134.30     <i>(Effective date:  Section 5 (125A.21) is effective July 1,</i> 
134.31  <i>2000.)</i> 
134.32     Sec. 6.  Minnesota Statutes 1998, section 125A.74, 
134.33  subdivision 1, is amended to read: 
134.34     Subdivision 1.  [ELIGIBILITY.] A district may enroll as a 
134.35  provider in the medical assistance program and receive medical 
134.36  assistance payments for covered special education services 
135.1   provided to persons eligible for medical assistance under 
135.2   chapter 256B.  To receive medical assistance payments, the 
135.3   district must pay the nonfederal share of medical assistance 
135.4   services provided according to section 256B.0625, subdivision 
135.5   26, and comply with relevant provisions of state and federal 
135.6   statutes and regulations governing the medical assistance 
135.7   program. 
135.8      <i>(Effective date:  Section 6 (125A.74, subd. 1) is effective</i> 
135.9   <i>July 1, 2000.)</i> 
135.10     Sec. 7.  Minnesota Statutes 1998, section 125A.74, 
135.11  subdivision 2, is amended to read: 
135.12     Subd. 2.  [FUNDING.] A district that provides a covered 
135.13  service to an eligible person and complies with relevant 
135.14  requirements of the medical assistance program is entitled to 
135.15  receive payment for the service provided, including that portion 
135.16  of the payment services that will subsequently be reimbursed by 
135.17  the federal government, in the same manner as other medical 
135.18  assistance providers.  The school district is not required to 
135.19  provide matching funds or pay part of the costs of the service, 
135.20  as long as the rate charged for the service does not exceed 
135.21  medical assistance limits that apply to all medical assistance 
135.22  providers. 
135.23     <i>(Effective date:  Section 7 (125A.74, subd. 2) is effective</i> 
135.24  <i>July 1, 2000.)</i> 
135.25     Sec. 8.  [214.045] [COORDINATION WITH BOARD OF TEACHING.] 
135.26     The commissioner of health and the health-related licensing 
135.27  boards must coordinate with the board of teaching when modifying 
135.28  licensure requirements for regulated persons in order to have 
135.29  consistent regulatory requirements for personnel who perform 
135.30  services in schools. 
135.31     Sec. 9.  Minnesota Statutes 1998, section 245.462, 
135.32  subdivision 17, is amended to read: 
135.33     Subd. 17.  [MENTAL HEALTH PRACTITIONER.] "Mental health 
135.34  practitioner" means a person providing services to persons with 
135.35  mental illness who is qualified in at least one of the following 
135.36  ways:  
136.1      (1) holds a bachelor's degree in one of the behavioral 
136.2   sciences or related fields from an accredited college or 
136.3   university and: 
136.4      (i) has at least 2,000 hours of supervised experience in 
136.5   the delivery of services to persons with mental illness; or 
136.6      (ii) is fluent in the non-English language of the ethnic 
136.7   group to which at least 50 percent of the practitioner's clients 
136.8   belong, completes 40 hours of training in the delivery of 
136.9   services to persons with mental illness, and receives clinical 
136.10  supervision from a mental health professional at least once a 
136.11  week until the requirement of 2,000 hours of supervised 
136.12  experience is met; 
136.13     (2) has at least 6,000 hours of supervised experience in 
136.14  the delivery of services to persons with mental illness; 
136.15     (3) is a graduate student in one of the behavioral sciences 
136.16  or related fields and is formally assigned by an accredited 
136.17  college or university to an agency or facility for clinical 
136.18  training; or 
136.19     (4) holds a master's or other graduate degree in one of the 
136.20  behavioral sciences or related fields from an accredited college 
136.21  or university and has less than 4,000 hours post-master's 
136.22  experience in the treatment of mental illness.  
136.23     Sec. 10.  Minnesota Statutes 1998, section 245.4871, 
136.24  subdivision 26, is amended to read: 
136.25     Subd. 26.  [MENTAL HEALTH PRACTITIONER.] "Mental health 
136.26  practitioner" means a person providing services to children with 
136.27  emotional disturbances.  A mental health practitioner must have 
136.28  training and experience in working with children.  A mental 
136.29  health practitioner must be qualified in at least one of the 
136.30  following ways:  
136.31     (1) holds a bachelor's degree in one of the behavioral 
136.32  sciences or related fields from an accredited college or 
136.33  university and:  
136.34     (i) has at least 2,000 hours of supervised experience in 
136.35  the delivery of mental health services to children with 
136.36  emotional disturbances; or 
137.1      (ii) is fluent in the non-English language of the ethnic 
137.2   group to which at least 50 percent of the practitioner's clients 
137.3   belong, completes 40 hours of training in the delivery of 
137.4   services to children with emotional disturbances, and receives 
137.5   clinical supervision from a mental health professional at least 
137.6   once a week until the requirement of 2,000 hours of supervised 
137.7   experience is met; 
137.8      (2) has at least 6,000 hours of supervised experience in 
137.9   the delivery of mental health services to children with 
137.10  emotional disturbances; 
137.11     (3) is a graduate student in one of the behavioral sciences 
137.12  or related fields and is formally assigned by an accredited 
137.13  college or university to an agency or facility for clinical 
137.14  training; or 
137.15     (4) holds a master's or other graduate degree in one of the 
137.16  behavioral sciences or related fields from an accredited college 
137.17  or university and has less than 4,000 hours post-master's 
137.18  experience in the treatment of emotional disturbance. 
137.19     Sec. 11.  [245.99] [ADULT MENTAL ILLNESS CRISIS HOUSING 
137.20  ASSISTANCE PROGRAM.] 
137.21     Subdivision 1.  [CREATION.] The adult mental illness crisis 
137.22  housing assistance program is established. 
137.23     Subd. 2.  [RENTAL ASSISTANCE.] The program shall pay up to 
137.24  90 days of housing assistance for persons with a serious and 
137.25  persistent mental illness who require inpatient or residential 
137.26  care for stabilization.  The commissioner of human services may 
137.27  extend the length of assistance on a case-by-case basis. 
137.28     Subd. 3.  [ELIGIBILITY.] Housing assistance under this 
137.29  section is available only to persons of low or moderate income 
137.30  as determined by the commissioner of human services. 
137.31     Subd. 4.  [ADMINISTRATION.] The commissioner may contract 
137.32  with organizations or government units experienced in housing 
137.33  assistance to operate the program under this section. 
137.34     Sec. 12.  Minnesota Statutes 1998, section 245A.04, 
137.35  subdivision 3a, is amended to read: 
137.36     Subd. 3a.  [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 
138.1   STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 
138.2   commissioner shall notify the applicant or license holder and 
138.3   the individual who is the subject of the study, in writing or by 
138.4   electronic transmission, of the results of the study.  When the 
138.5   study is completed, a notice that the study was undertaken and 
138.6   completed shall be maintained in the personnel files of the 
138.7   program.  For studies on individuals pertaining to a license to 
138.8   provide family day care or group family day care, foster care 
138.9   for children in the provider's own home, or foster care or day 
138.10  care services for adults in the provider's own home, the 
138.11  commissioner is not required to provide a separate notice of the 
138.12  background study results to the individual who is the subject of 
138.13  the study unless the study results in a disqualification of the 
138.14  individual. 
138.15     The commissioner shall notify the individual studied if the 
138.16  information in the study indicates the individual is 
138.17  disqualified from direct contact with persons served by the 
138.18  program.  The commissioner shall disclose the information 
138.19  causing disqualification and instructions on how to request a 
138.20  reconsideration of the disqualification to the individual 
138.21  studied.  An applicant or license holder who is not the subject 
138.22  of the study shall be informed that the commissioner has found 
138.23  information that disqualifies the subject from direct contact 
138.24  with persons served by the program.  However, only the 
138.25  individual studied must be informed of the information contained 
138.26  in the subject's background study unless the only basis for the 
138.27  disqualification is failure to cooperate, the Data Practices Act 
138.28  provides for release of the information, or the individual 
138.29  studied authorizes the release of the information. 
138.30     (b) If the commissioner determines that the individual 
138.31  studied has a disqualifying characteristic, the commissioner 
138.32  shall review the information immediately available and make a 
138.33  determination as to the subject's immediate risk of harm to 
138.34  persons served by the program where the individual studied will 
138.35  have direct contact.  The commissioner shall consider all 
138.36  relevant information available, including the following factors 
139.1   in determining the immediate risk of harm:  the recency of the 
139.2   disqualifying characteristic; the recency of discharge from 
139.3   probation for the crimes; the number of disqualifying 
139.4   characteristics; the intrusiveness or violence of the 
139.5   disqualifying characteristic; the vulnerability of the victim 
139.6   involved in the disqualifying characteristic; and the similarity 
139.7   of the victim to the persons served by the program where the 
139.8   individual studied will have direct contact.  The commissioner 
139.9   may determine that the evaluation of the information immediately 
139.10  available gives the commissioner reason to believe one of the 
139.11  following: 
139.12     (1) The individual poses an imminent risk of harm to 
139.13  persons served by the program where the individual studied will 
139.14  have direct contact.  If the commissioner determines that an 
139.15  individual studied poses an imminent risk of harm to persons 
139.16  served by the program where the individual studied will have 
139.17  direct contact, the individual and the license holder must be 
139.18  sent a notice of disqualification.  The commissioner shall order 
139.19  the license holder to immediately remove the individual studied 
139.20  from direct contact.  The notice to the individual studied must 
139.21  include an explanation of the basis of this determination. 
139.22     (2) The individual poses a risk of harm requiring 
139.23  continuous supervision while providing direct contact services 
139.24  during the period in which the subject may request a 
139.25  reconsideration.  If the commissioner determines that an 
139.26  individual studied poses a risk of harm that requires continuous 
139.27  supervision, the individual and the license holder must be sent 
139.28  a notice of disqualification.  The commissioner shall order the 
139.29  license holder to immediately remove the individual studied from 
139.30  direct contact services or assure that the individual studied is 
139.31  within sight or hearing of another staff person when providing 
139.32  direct contact services during the period in which the 
139.33  individual may request a reconsideration of the 
139.34  disqualification.  If the individual studied does not submit a 
139.35  timely request for reconsideration, or the individual submits a 
139.36  timely request for reconsideration, but the disqualification is 
140.1   not set aside for that license holder, the license holder will 
140.2   be notified of the disqualification and ordered to immediately 
140.3   remove the individual from any position allowing direct contact 
140.4   with persons receiving services from the license holder. 
140.5      (3) The individual does not pose an imminent risk of harm 
140.6   or a risk of harm requiring continuous supervision while 
140.7   providing direct contact services during the period in which the 
140.8   subject may request a reconsideration.  If the commissioner 
140.9   determines that an individual studied does not pose a risk of 
140.10  harm that requires continuous supervision, only the individual 
140.11  must be sent a notice of disqualification.  The license holder 
140.12  must be sent a notice that more time is needed to complete the 
140.13  individual's background study.  If the individual studied 
140.14  submits a timely request for reconsideration, and if the 
140.15  disqualification is set aside for that license holder, the 
140.16  license holder will receive the same notification received by 
140.17  license holders in cases where the individual studied has no 
140.18  disqualifying characteristic.  If the individual studied does 
140.19  not submit a timely request for reconsideration, or the 
140.20  individual submits a timely request for reconsideration, but the 
140.21  disqualification is not set aside for that license holder, the 
140.22  license holder will be notified of the disqualification and 
140.23  ordered to immediately remove the individual from any position 
140.24  allowing direct contact with persons receiving services from the 
140.25  license holder.  
140.26     (c) County licensing agencies performing duties under this 
140.27  subdivision may develop an alternative system for determining 
140.28  the subject's immediate risk of harm to persons served by the 
140.29  program, providing the notices under paragraph (b), and 
140.30  documenting the action taken by the county licensing agency.  
140.31  Each county licensing agency's implementation of the alternative 
140.32  system is subject to approval by the commissioner.  
140.33  Notwithstanding this alternative system, county licensing 
140.34  agencies shall complete the requirements of paragraph (a). 
140.35     Sec. 13.  Minnesota Statutes 1998, section 245A.08, 
140.36  subdivision 5, is amended to read: 
141.1      Subd. 5.  [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 
141.2   considering the findings of fact, conclusions, and 
141.3   recommendations of the administrative law judge, the 
141.4   commissioner shall issue a final order.  The commissioner shall 
141.5   consider, but shall not be bound by, the recommendations of the 
141.6   administrative law judge.  The appellant must be notified of the 
141.7   commissioner's final order as required by chapter 14.  The 
141.8   notice must also contain information about the appellant's 
141.9   rights under chapter 14.  The institution of proceedings for 
141.10  judicial review of the commissioner's final order shall not stay 
141.11  the enforcement of the final order except as provided in section 
141.12  14.65.  A license holder and each controlling individual of a 
141.13  license holder whose license has been revoked because of 
141.14  noncompliance with applicable law or rule must not be granted a 
141.15  license for five years following the revocation.  An applicant 
141.16  whose application was denied must not be granted a license for 
141.17  two years following a denial, unless the applicant's subsequent 
141.18  application contains new information which constitutes a 
141.19  substantial change in the conditions that caused the previous 
141.20  denial. 
141.21     Sec. 14.  Minnesota Statutes 1998, section 245B.05, 
141.22  subdivision 7, is amended to read: 
141.23     Subd. 7.  [REPORTING INCIDENTS AND EMERGENCIES.] The 
141.24  license holder must report the following incidents to the 
141.25  consumer's legal representative, caregiver, and case manager 
141.26  within 24 hours of the occurrence, or within 24 hours of receipt 
141.27  of the information: 
141.28     (1) the death of a consumer; 
141.29     (2) any medical emergencies, unexpected serious illnesses, 
141.30  or accidents that require physician treatment or 
141.31  hospitalization; 
141.32     (3) a consumer's unauthorized absence; or 
141.33     (4) any fires and incidents involving a law enforcement 
141.34  agency. 
141.35     Death or serious injury of the consumer must also be 
141.36  reported to the commissioner department of human services 
142.1   licensing division and the ombudsman, as required under sections 
142.2   245.91 and 245.94, subdivision 2a. 
142.3      Sec. 15.  Minnesota Statutes 1998, section 245B.07, 
142.4   subdivision 5, is amended to read: 
142.5      Subd. 5.  [STAFF ORIENTATION.] (a) Within 60 days of hiring 
142.6   staff who provide direct service, the license holder must 
142.7   provide 30 hours of staff orientation.  Direct care staff must 
142.8   complete 15 of the 30 hours orientation before providing any 
142.9   unsupervised direct service to a consumer.  If the staff person 
142.10  has received orientation training from a license holder licensed 
142.11  under this chapter, or provides semi-independent living services 
142.12  only, the 15-hour requirement may be reduced to eight hours.  
142.13  The total orientation of 30 hours may be reduced to 15 hours if 
142.14  the staff person has previously received orientation training 
142.15  from a license holder licensed under this chapter. 
142.16     (b) The 30 hours of orientation must combine supervised 
142.17  on-the-job training with coverage of the following material: 
142.18     (1) review of the consumer's service plans and risk 
142.19  management plan to achieve an understanding of the consumer as a 
142.20  unique individual; 
142.21     (2) review and instruction on the license holder's policies 
142.22  and procedures, including their location and access; 
142.23     (3) emergency procedures; 
142.24     (4) explanation of specific job functions, including 
142.25  implementing objectives from the consumer's individual service 
142.26  plan; 
142.27     (5) explanation of responsibilities related to section 
142.28  245A.65; sections 626.556 and 626.557, governing maltreatment 
142.29  reporting and service planning for children and vulnerable 
142.30  adults; and section 245.825, governing use of aversive and 
142.31  deprivation procedures; 
142.32     (6) medication administration as it applies to the 
142.33  individual consumer, from a training curriculum developed by a 
142.34  health services professional described in section 245B.05, 
142.35  subdivision 5, and when the consumer meets the criteria of 
142.36  having overriding health care needs, then medication 
143.1   administration taught by a health services professional.  Staff 
143.2   may administer medications only after they demonstrate the 
143.3   ability, as defined in the license holder's medication 
143.4   administration policy and procedures.  Once a consumer with 
143.5   overriding health care needs is admitted, staff will be provided 
143.6   with remedial training as deemed necessary by the license holder 
143.7   and the health professional to meet the needs of that consumer. 
143.8      For purposes of this section, overriding health care needs 
143.9   means a health care condition that affects the service options 
143.10  available to the consumer because the condition requires: 
143.11     (i) specialized or intensive medical or nursing 
143.12  supervision; and 
143.13     (ii) nonmedical service providers to adapt their services 
143.14  to accommodate the health and safety needs of the consumer; 
143.15     (7) consumer rights; and 
143.16     (8) other topics necessary as determined by the consumer's 
143.17  individual service plan or other areas identified by the license 
143.18  holder. 
143.19     (c) The license holder must document each employee's 
143.20  orientation received. 
143.21     Sec. 16.  Minnesota Statutes 1998, section 245B.07, 
143.22  subdivision 8, is amended to read: 
143.23     Subd. 8.  [POLICIES AND PROCEDURES.] The license holder 
143.24  must develop and implement the policies and procedures in 
143.25  paragraphs (1) to (3). 
143.26     (1) policies and procedures that promote consumer health 
143.27  and safety by ensuring: 
143.28     (i) consumer safety in emergency situations as identified 
143.29  in section 245B.05, subdivision 7; 
143.30     (ii) consumer health through sanitary practices; 
143.31     (iii) safe transportation, when the license holder is 
143.32  responsible for transportation of consumers, with provisions for 
143.33  handling emergency situations; 
143.34     (iv) a system of recordkeeping for both individuals and the 
143.35  organization, for review of incidents and emergencies, and 
143.36  corrective action if needed; 
144.1      (v) a plan for responding to and reporting all emergencies, 
144.2   including deaths, medical emergencies, illnesses, accidents, 
144.3   missing consumers, fires, severe weather and natural disasters, 
144.4   bomb threats, and other threats; 
144.5      (vi) safe medication administration as identified in 
144.6   section 245B.05, subdivision 5, incorporating an observed skill 
144.7   assessment to ensure that staff demonstrate the ability to 
144.8   administer medications consistent with the license holder's 
144.9   policy and procedures; 
144.10     (vii) psychotropic medication monitoring when the consumer 
144.11  is prescribed a psychotropic medication, including the use of 
144.12  the psychotropic medication use checklist.  If the 
144.13  responsibility for implementing the psychotropic medication use 
144.14  checklist has not been assigned in the individual service plan 
144.15  and the consumer lives in a licensed site, the residential 
144.16  license holder shall be designated; and 
144.17     (viii) criteria for admission or service initiation 
144.18  developed by the license holder; 
144.19     (2) policies and procedures that protect consumer rights 
144.20  and privacy by ensuring: 
144.21     (i) consumer data privacy, in compliance with the Minnesota 
144.22  Data Practices Act, chapter 13; and 
144.23     (ii) that complaint procedures provide consumers with a 
144.24  simple process to bring grievances and consumers receive a 
144.25  response to the grievance within a reasonable time period.  The 
144.26  license holder must provide a copy of the program's grievance 
144.27  procedure and time lines for addressing grievances.  The 
144.28  program's grievance procedure must permit consumers served by 
144.29  the program and the authorized representatives to bring a 
144.30  grievance to the highest level of authority in the program; and 
144.31     (3) policies and procedures that promote continuity and 
144.32  quality of consumer supports by ensuring: 
144.33     (i) continuity of care and service coordination, including 
144.34  provisions for service termination, temporary service 
144.35  suspension, and efforts made by the license holder to coordinate 
144.36  services with other vendors who also provide support to the 
145.1   consumer.  The policy must include the following requirements: 
145.2      (A) the license holder must notify the consumer or 
145.3   consumer's legal representative and the consumer's case manager 
145.4   in writing of the intended termination or temporary service 
145.5   suspension and the consumer's right to seek a temporary order 
145.6   staying the termination or suspension of service according to 
145.7   the procedures in section 256.045, subdivision 4a or subdivision 
145.8   6, paragraph (c); 
145.9      (B) notice of the proposed termination of services, 
145.10  including those situations that began with a temporary service 
145.11  suspension, must be given at least 60 days before the proposed 
145.12  termination is to become effective, unless services are 
145.13  temporarily suspended according to the license holder's written 
145.14  temporary service suspension procedures, in which case notice 
145.15  must be given as soon as possible; 
145.16     (C) the license holder must provide information requested 
145.17  by the consumer or consumer's legal representative or case 
145.18  manager when services are temporarily suspended or upon notice 
145.19  of termination; 
145.20     (D) use of temporary service suspension procedures are 
145.21  restricted to situations in which the consumer's behavior causes 
145.22  immediate and serious danger to the health and safety of the 
145.23  individual or others; 
145.24     (E) prior to giving notice of service termination or 
145.25  temporary service suspension, the license holder must document 
145.26  actions taken to minimize or eliminate the need for service 
145.27  termination or temporary service suspension; and 
145.28     (F) during the period of temporary service suspension, the 
145.29  license holder will work with the appropriate county agency to 
145.30  develop reasonable alternatives to protect the individual and 
145.31  others; and 
145.32     (ii) quality services measured through a program evaluation 
145.33  process including regular evaluations of consumer satisfaction 
145.34  and sharing the results of the evaluations with the consumers 
145.35  and legal representatives. 
145.36     Sec. 17.  Minnesota Statutes 1998, section 245B.07, 
146.1   subdivision 10, is amended to read: 
146.2      Subd. 10.  [CONSUMER FUNDS.] (a) The license holder must 
146.3   ensure that consumers retain the use and availability of 
146.4   personal funds or property unless restrictions are justified in 
146.5   the consumer's individual service plan. 
146.6      (b) The license holder must ensure separation of resident 
146.7   consumer funds from funds of the license holder, the residential 
146.8   program, or program staff. 
146.9      (c) Whenever the license holder assists a consumer with the 
146.10  safekeeping of funds or other property, the license holder 
146.11  must have written authorization to do so by the consumer or the 
146.12  consumer's legal representative and the case manager.  In 
146.13  addition, the license holder must: 
146.14     (1) document receipt and disbursement of the consumer's 
146.15  funds or the property, and include the signature of the 
146.16  consumer, conservator, or payee; 
146.17     (2) provide a statement at least quarterly itemizing 
146.18  annually survey, document, and implement the preferences of the 
146.19  consumer, consumer's legal representative, and the case manager 
146.20  for frequency of receiving a statement that itemizes receipts 
146.21  and disbursements of resident consumer funds or other property; 
146.22  and 
146.23     (3) return to the consumer upon the consumer's request, 
146.24  funds and property in the license holder's possession subject to 
146.25  restrictions in the consumer's individual service plan, as soon 
146.26  as possible, but no later than three working days after the date 
146.27  of the request. 
146.28     (d) License holders and program staff must not: 
146.29     (1) borrow money from a consumer; 
146.30     (2) purchase personal items from a consumer; 
146.31     (3) sell merchandise or personal services to a consumer; 
146.32     (4) require a resident consumer to purchase items for which 
146.33  the license holder is eligible for reimbursement; or 
146.34     (5) use resident consumer funds in a manner that would 
146.35  violate section 256B.04, or any rules promulgated under that 
146.36  section. 
147.1      Sec. 18.  Minnesota Statutes 1998, section 252.32, 
147.2   subdivision 3a, is amended to read: 
147.3      Subd. 3a.  [REPORTS AND ALLOCATIONS.] (a) The commissioner 
147.4   shall specify requirements for quarterly fiscal and annual 
147.5   program reports according to section 256.01, subdivision 2, 
147.6   paragraph (17).  Program reports shall include data which will 
147.7   enable the commissioner to evaluate program effectiveness and to 
147.8   audit compliance.  The commissioner shall reimburse county costs 
147.9   on a quarterly basis. 
147.10     (b) Beginning January 1, 1998, The commissioner shall 
147.11  allocate state funds made available under this section to county 
147.12  social service agencies on a calendar year basis.  The 
147.13  commissioner shall allocate to each county first in amounts 
147.14  equal to each county's guaranteed floor as described in clause 
147.15  (1), and second, any remaining funds, after the allocation of 
147.16  funds to the newly participating counties as provided for in 
147.17  clause (3), shall be allocated in proportion to each county's 
147.18  total number of families receiving a grant on July 1 of the most 
147.19  recent calendar year will be allocated to county agencies to 
147.20  support children in their family homes.  
147.21     (1) Each county's guaranteed floor shall be calculated as 
147.22  follows:  
147.23     (i) 95 percent of the county's allocation received in the 
147.24  preceding calendar year.  For the calendar year 1998 allocation, 
147.25  the preceding calendar year shall be considered to be double the 
147.26  six-month allocation as provided in clause (2); 
147.27     (ii) when the amount of funds available for allocation is 
147.28  less than the amount available in the preceding year, each 
147.29  county's previous year allocation shall be reduced in proportion 
147.30  to the reduction in statewide funding, for the purpose of 
147.31  establishing the guaranteed floor.  
147.32     (2) For the period July 1, 1997, to December 31, 1997, the 
147.33  commissioner shall allocate to each county an amount equal to 
147.34  the actual, state approved grants issued to the families for the 
147.35  month of January 1997, multiplied by six.  This six-month 
147.36  allocation shall be combined with the calendar year 1998 
148.1   allocation and be administered as an 18-month allocation.  
148.2      (3) At the commissioner's discretion, funds may be 
148.3   allocated to any nonparticipating county that requests an 
148.4   allocation under this section.  Allocations to newly 
148.5   participating counties are dependent upon the availability of 
148.6   funds, as determined by the actual expenditure amount of the 
148.7   participating counties for the most recently completed calendar 
148.8   year.  
148.9      (4) The commissioner shall regularly review the use of 
148.10  family support fund allocations by county.  The commissioner may 
148.11  reallocate unexpended or unencumbered money at any time to those 
148.12  counties that have a demonstrated need for additional funding.  
148.13     (c) County allocations under this section will be adjusted 
148.14  for transfers that occur according to section 256.476 or when 
148.15  the county of financial responsibility changes according to 
148.16  chapter 256G for eligible recipients. 
148.17     Sec. 19.  Minnesota Statutes 1998, section 256.01, 
148.18  subdivision 2, is amended to read: 
148.19     Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
148.20  section 241.021, subdivision 2, the commissioner of human 
148.21  services shall: 
148.22     (1) Administer and supervise all forms of public assistance 
148.23  provided for by state law and other welfare activities or 
148.24  services as are vested in the commissioner.  Administration and 
148.25  supervision of human services activities or services includes, 
148.26  but is not limited to, assuring timely and accurate distribution 
148.27  of benefits, completeness of service, and quality program 
148.28  management.  In addition to administering and supervising human 
148.29  services activities vested by law in the department, the 
148.30  commissioner shall have the authority to: 
148.31     (a) require county agency participation in training and 
148.32  technical assistance programs to promote compliance with 
148.33  statutes, rules, federal laws, regulations, and policies 
148.34  governing human services; 
148.35     (b) monitor, on an ongoing basis, the performance of county 
148.36  agencies in the operation and administration of human services, 
149.1   enforce compliance with statutes, rules, federal laws, 
149.2   regulations, and policies governing welfare services and promote 
149.3   excellence of administration and program operation; 
149.4      (c) develop a quality control program or other monitoring 
149.5   program to review county performance and accuracy of benefit 
149.6   determinations; 
149.7      (d) require county agencies to make an adjustment to the 
149.8   public assistance benefits issued to any individual consistent 
149.9   with federal law and regulation and state law and rule and to 
149.10  issue or recover benefits as appropriate; 
149.11     (e) delay or deny payment of all or part of the state and 
149.12  federal share of benefits and administrative reimbursement 
149.13  according to the procedures set forth in section 256.017; 
149.14     (f) make contracts with and grants to public and private 
149.15  agencies and organizations, both profit and nonprofit, and 
149.16  individuals, using appropriated funds; and 
149.17     (g) enter into contractual agreements with federally 
149.18  recognized Indian tribes with a reservation in Minnesota to the 
149.19  extent necessary for the tribe to operate a federally approved 
149.20  family assistance program or any other program under the 
149.21  supervision of the commissioner.  The commissioner shall consult 
149.22  with the affected county or counties in the contractual 
149.23  agreement negotiations, if the county or counties wish to be 
149.24  included, in order to avoid the duplication of county and tribal 
149.25  assistance program services.  The commissioner may establish 
149.26  necessary accounts for the purposes of receiving and disbursing 
149.27  funds as necessary for the operation of the programs. 
149.28     (2) Inform county agencies, on a timely basis, of changes 
149.29  in statute, rule, federal law, regulation, and policy necessary 
149.30  to county agency administration of the programs. 
149.31     (3) Administer and supervise all child welfare activities; 
149.32  promote the enforcement of laws protecting handicapped, 
149.33  dependent, neglected and delinquent children, and children born 
149.34  to mothers who were not married to the children's fathers at the 
149.35  times of the conception nor at the births of the children; 
149.36  license and supervise child-caring and child-placing agencies 
150.1   and institutions; supervise the care of children in boarding and 
150.2   foster homes or in private institutions; and generally perform 
150.3   all functions relating to the field of child welfare now vested 
150.4   in the state board of control. 
150.5      (4) Administer and supervise all noninstitutional service 
150.6   to handicapped persons, including those who are visually 
150.7   impaired, hearing impaired, or physically impaired or otherwise 
150.8   handicapped.  The commissioner may provide and contract for the 
150.9   care and treatment of qualified indigent children in facilities 
150.10  other than those located and available at state hospitals when 
150.11  it is not feasible to provide the service in state hospitals. 
150.12     (5) Assist and actively cooperate with other departments, 
150.13  agencies and institutions, local, state, and federal, by 
150.14  performing services in conformity with the purposes of Laws 
150.15  1939, chapter 431. 
150.16     (6) Act as the agent of and cooperate with the federal 
150.17  government in matters of mutual concern relative to and in 
150.18  conformity with the provisions of Laws 1939, chapter 431, 
150.19  including the administration of any federal funds granted to the 
150.20  state to aid in the performance of any functions of the 
150.21  commissioner as specified in Laws 1939, chapter 431, and 
150.22  including the promulgation of rules making uniformly available 
150.23  medical care benefits to all recipients of public assistance, at 
150.24  such times as the federal government increases its participation 
150.25  in assistance expenditures for medical care to recipients of 
150.26  public assistance, the cost thereof to be borne in the same 
150.27  proportion as are grants of aid to said recipients. 
150.28     (7) Establish and maintain any administrative units 
150.29  reasonably necessary for the performance of administrative 
150.30  functions common to all divisions of the department. 
150.31     (8) Act as designated guardian of both the estate and the 
150.32  person of all the wards of the state of Minnesota, whether by 
150.33  operation of law or by an order of court, without any further 
150.34  act or proceeding whatever, except as to persons committed as 
150.35  mentally retarded.  For children under the guardianship of the 
150.36  commissioner whose interests would be best served by adoptive 
151.1   placement, the commissioner may contract with a licensed 
151.2   child-placing agency to provide adoption services.  A contract 
151.3   with a licensed child-placing agency must be designed to 
151.4   supplement existing county efforts and may not replace existing 
151.5   county programs, unless the replacement is agreed to by the 
151.6   county board and the appropriate exclusive bargaining 
151.7   representative or the commissioner has evidence that child 
151.8   placements of the county continue to be substantially below that 
151.9   of other counties. 
151.10     (9) Act as coordinating referral and informational center 
151.11  on requests for service for newly arrived immigrants coming to 
151.12  Minnesota. 
151.13     (10) The specific enumeration of powers and duties as 
151.14  hereinabove set forth shall in no way be construed to be a 
151.15  limitation upon the general transfer of powers herein contained. 
151.16     (11) Establish county, regional, or statewide schedules of 
151.17  maximum fees and charges which may be paid by county agencies 
151.18  for medical, dental, surgical, hospital, nursing and nursing 
151.19  home care and medicine and medical supplies under all programs 
151.20  of medical care provided by the state and for congregate living 
151.21  care under the income maintenance programs. 
151.22     (12) Have the authority to conduct and administer 
151.23  experimental projects to test methods and procedures of 
151.24  administering assistance and services to recipients or potential 
151.25  recipients of public welfare.  To carry out such experimental 
151.26  projects, it is further provided that the commissioner of human 
151.27  services is authorized to waive the enforcement of existing 
151.28  specific statutory program requirements, rules, and standards in 
151.29  one or more counties.  The order establishing the waiver shall 
151.30  provide alternative methods and procedures of administration, 
151.31  shall not be in conflict with the basic purposes, coverage, or 
151.32  benefits provided by law, and in no event shall the duration of 
151.33  a project exceed four years.  It is further provided that no 
151.34  order establishing an experimental project as authorized by the 
151.35  provisions of this section shall become effective until the 
151.36  following conditions have been met: 
152.1      (a) The secretary of health, education, and welfare of the 
152.2   United States has agreed, for the same project, to waive state 
152.3   plan requirements relative to statewide uniformity. 
152.4      (b) A comprehensive plan, including estimated project 
152.5   costs, shall be approved by the legislative advisory commission 
152.6   and filed with the commissioner of administration.  
152.7      (13) According to federal requirements, establish 
152.8   procedures to be followed by local welfare boards in creating 
152.9   citizen advisory committees, including procedures for selection 
152.10  of committee members. 
152.11     (14) Allocate federal fiscal disallowances or sanctions 
152.12  which are based on quality control error rates for the aid to 
152.13  families with dependent children, Minnesota family investment 
152.14  program-statewide, medical assistance, or food stamp program in 
152.15  the following manner:  
152.16     (a) One-half of the total amount of the disallowance shall 
152.17  be borne by the county boards responsible for administering the 
152.18  programs.  For the medical assistance, MFIP-S, and AFDC 
152.19  programs, disallowances shall be shared by each county board in 
152.20  the same proportion as that county's expenditures for the 
152.21  sanctioned program are to the total of all counties' 
152.22  expenditures for the AFDC, MFIP-S, and medical assistance 
152.23  programs.  For the food stamp program, sanctions shall be shared 
152.24  by each county board, with 50 percent of the sanction being 
152.25  distributed to each county in the same proportion as that 
152.26  county's administrative costs for food stamps are to the total 
152.27  of all food stamp administrative costs for all counties, and 50 
152.28  percent of the sanctions being distributed to each county in the 
152.29  same proportion as that county's value of food stamp benefits 
152.30  issued are to the total of all benefits issued for all 
152.31  counties.  Each county shall pay its share of the disallowance 
152.32  to the state of Minnesota.  When a county fails to pay the 
152.33  amount due hereunder, the commissioner may deduct the amount 
152.34  from reimbursement otherwise due the county, or the attorney 
152.35  general, upon the request of the commissioner, may institute 
152.36  civil action to recover the amount due. 
153.1      (b) Notwithstanding the provisions of paragraph (a), if the 
153.2   disallowance results from knowing noncompliance by one or more 
153.3   counties with a specific program instruction, and that knowing 
153.4   noncompliance is a matter of official county board record, the 
153.5   commissioner may require payment or recover from the county or 
153.6   counties, in the manner prescribed in paragraph (a), an amount 
153.7   equal to the portion of the total disallowance which resulted 
153.8   from the noncompliance, and may distribute the balance of the 
153.9   disallowance according to paragraph (a).  
153.10     (15) Develop and implement special projects that maximize 
153.11  reimbursements and result in the recovery of money to the 
153.12  state.  For the purpose of recovering state money, the 
153.13  commissioner may enter into contracts with third parties.  Any 
153.14  recoveries that result from projects or contracts entered into 
153.15  under this paragraph shall be deposited in the state treasury 
153.16  and credited to a special account until the balance in the 
153.17  account reaches $1,000,000.  When the balance in the account 
153.18  exceeds $1,000,000, the excess shall be transferred and credited 
153.19  to the general fund.  All money in the account is appropriated 
153.20  to the commissioner for the purposes of this paragraph. 
153.21     (16) Have the authority to make direct payments to 
153.22  facilities providing shelter to women and their children 
153.23  according to section 256D.05, subdivision 3.  Upon the written 
153.24  request of a shelter facility that has been denied payments 
153.25  under section 256D.05, subdivision 3, the commissioner shall 
153.26  review all relevant evidence and make a determination within 30 
153.27  days of the request for review regarding issuance of direct 
153.28  payments to the shelter facility.  Failure to act within 30 days 
153.29  shall be considered a determination not to issue direct payments.
153.30     (17) Have the authority to establish and enforce the 
153.31  following county reporting requirements:  
153.32     (a) The commissioner shall establish fiscal and statistical 
153.33  reporting requirements necessary to account for the expenditure 
153.34  of funds allocated to counties for human services programs.  
153.35  When establishing financial and statistical reporting 
153.36  requirements, the commissioner shall evaluate all reports, in 
154.1   consultation with the counties, to determine if the reports can 
154.2   be simplified or the number of reports can be reduced. 
154.3      (b) The county board shall submit monthly or quarterly 
154.4   reports to the department as required by the commissioner.  
154.5   Monthly reports are due no later than 15 working days after the 
154.6   end of the month.  Quarterly reports are due no later than 30 
154.7   calendar days after the end of the quarter, unless the 
154.8   commissioner determines that the deadline must be shortened to 
154.9   20 calendar days to avoid jeopardizing compliance with federal 
154.10  deadlines or risking a loss of federal funding.  Only reports 
154.11  that are complete, legible, and in the required format shall be 
154.12  accepted by the commissioner.  
154.13     (c) If the required reports are not received by the 
154.14  deadlines established in clause (b), the commissioner may delay 
154.15  payments and withhold funds from the county board until the next 
154.16  reporting period.  When the report is needed to account for the 
154.17  use of federal funds and the late report results in a reduction 
154.18  in federal funding, the commissioner shall withhold from the 
154.19  county boards with late reports an amount equal to the reduction 
154.20  in federal funding until full federal funding is received.  
154.21     (d) A county board that submits reports that are late, 
154.22  illegible, incomplete, or not in the required format for two out 
154.23  of three consecutive reporting periods is considered 
154.24  noncompliant.  When a county board is found to be noncompliant, 
154.25  the commissioner shall notify the county board of the reason the 
154.26  county board is considered noncompliant and request that the 
154.27  county board develop a corrective action plan stating how the 
154.28  county board plans to correct the problem.  The corrective 
154.29  action plan must be submitted to the commissioner within 45 days 
154.30  after the date the county board received notice of noncompliance.
154.31     (e) The final deadline for fiscal reports or amendments to 
154.32  fiscal reports is one year after the date the report was 
154.33  originally due.  If the commissioner does not receive a report 
154.34  by the final deadline, the county board forfeits the funding 
154.35  associated with the report for that reporting period and the 
154.36  county board must repay any funds associated with the report 
155.1   received for that reporting period. 
155.2      (f) The commissioner may not delay payments, withhold 
155.3   funds, or require repayment under paragraph (c) or (e) if the 
155.4   county demonstrates that the commissioner failed to provide 
155.5   appropriate forms, guidelines, and technical assistance to 
155.6   enable the county to comply with the requirements.  If the 
155.7   county board disagrees with an action taken by the commissioner 
155.8   under paragraph (c) or (e), the county board may appeal the 
155.9   action according to sections 14.57 to 14.69. 
155.10     (g) Counties subject to withholding of funds under 
155.11  paragraph (c) or forfeiture or repayment of funds under 
155.12  paragraph (e) shall not reduce or withhold benefits or services 
155.13  to clients to cover costs incurred due to actions taken by the 
155.14  commissioner under paragraph (c) or (e). 
155.15     (18) Allocate federal fiscal disallowances or sanctions for 
155.16  audit exceptions when federal fiscal disallowances or sanctions 
155.17  are based on a statewide random sample for the foster care 
155.18  program under title IV-E of the Social Security Act, United 
155.19  States Code, title 42, in direct proportion to each county's 
155.20  title IV-E foster care maintenance claim for that period. 
155.21     (19) Be responsible for ensuring the detection, prevention, 
155.22  investigation, and resolution of fraudulent activities or 
155.23  behavior by applicants, recipients, and other participants in 
155.24  the human services programs administered by the department. 
155.25     (20) Require county agencies to identify overpayments, 
155.26  establish claims, and utilize all available and cost-beneficial 
155.27  methodologies to collect and recover these overpayments in the 
155.28  human services programs administered by the department. 
155.29     (21) Have the authority to administer a drug rebate program 
155.30  for drugs purchased pursuant to the senior citizen drug program 
155.31  established under section 256.955 after the beneficiary's 
155.32  satisfaction of any deductible established in the program.  The 
155.33  commissioner shall require a rebate agreement from all 
155.34  manufacturers of covered drugs as defined in section 256B.0625, 
155.35  subdivision 13.  For each drug, the amount of the rebate shall 
155.36  be equal to the basic rebate as defined for purposes of the 
156.1   federal rebate program in United States Code, title 42, section 
156.2   1396r-8(c)(1).  This basic rebate shall be applied to 
156.3   single-source and multiple-source drugs.  The manufacturers must 
156.4   provide full payment within 30 days of receipt of the state 
156.5   invoice for the rebate within the terms and conditions used for 
156.6   the federal rebate program established pursuant to section 1927 
156.7   of title XIX of the Social Security Act.  The manufacturers must 
156.8   provide the commissioner with any information necessary to 
156.9   verify the rebate determined per drug.  The rebate program shall 
156.10  utilize the terms and conditions used for the federal rebate 
156.11  program established pursuant to section 1927 of title XIX of the 
156.12  Social Security Act. 
156.13     (22) Incorporate cost reimbursement claims from First Call 
156.14  Minnesota into the federal cost reimbursement claiming processes 
156.15  of the department according to federal law, rule, and 
156.16  regulations.  Any reimbursement received is appropriated to the 
156.17  commissioner and shall be disbursed to First Call Minnesota 
156.18  according to normal department payment schedules. 
156.19     Sec. 20.  Minnesota Statutes 1998, section 256.015, 
156.20  subdivision 1, is amended to read: 
156.21     Subdivision 1.  [STATE AGENCY HAS LIEN.] When the state 
156.22  agency provides, pays for, or becomes liable for medical care or 
156.23  furnishes subsistence or other payments to a person, the agency 
156.24  shall have a lien for the cost of the care and payments on any 
156.25  and all causes of action or recovery rights under any policy, 
156.26  plan, or contract providing benefits for health care or injury 
156.27  which accrue to the person to whom the care or payments were 
156.28  furnished, or to the person's legal representatives, as a result 
156.29  of the occurrence that necessitated the medical care, 
156.30  subsistence, or other payments.  For purposes of this section, 
156.31  "state agency" includes authorized agents of the state agency 
156.32  prepaid health plans under contract with the commissioner 
156.33  according to sections 256B.69, 256D.03, subdivision 4, paragraph 
156.34  (d), and 256L.12; children's mental health collaboratives under 
156.35  section 245.493; demonstration projects for persons with 
156.36  disabilities under section 256B.77; nursing homes under the 
157.1   alternative payment demonstration project under section 
157.2   256B.434; and county-based purchasing entities under section 
157.3   256B.692. 
157.4      Sec. 21.  Minnesota Statutes 1998, section 256.015, 
157.5   subdivision 3, is amended to read: 
157.6      Subd. 3.  [PROSECUTOR.] The attorney general, or the 
157.7   appropriate county attorney acting at the direction of the 
157.8   attorney general, shall represent the state agency commissioner 
157.9   to enforce the lien created under this section or, if no action 
157.10  has been brought, may initiate and prosecute an independent 
157.11  action on behalf of the state agency commissioner against a 
157.12  person, firm, or corporation that may be liable to the person to 
157.13  whom the care or payment was furnished. 
157.14     Any prepaid health plan providing services under sections 
157.15  256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
157.16  children's mental health collaboratives under section 245.493; 
157.17  demonstration projects for persons with disabilities under 
157.18  section 256B.77; nursing homes under the alternative payment 
157.19  demonstration project under section 256B.434; or the 
157.20  county-based purchasing entity providing services under section 
157.21  256B.692 may retain legal representation to enforce their lien 
157.22  created under this section or, if no action has been brought, 
157.23  may initiate and prosecute an independent action on their behalf 
157.24  against a person, firm, or corporation that may be liable to the 
157.25  person to whom the care or payment was furnished.  
157.26     Sec. 22.  [256.028] [TAX REBATES.] 
157.27     Any federal or state tax rebate received by a recipient of 
157.28  a public assistance program shall not be counted as income or as 
157.29  an asset for purposes of any of the public assistance programs 
157.30  under this chapter or any other chapter, including, but not 
157.31  limited to, chapter 256B, 256D, 256E, 256I, 256J, or 256L to the 
157.32  extent permitted under federal law. 
157.33     Sec. 23.  Minnesota Statutes 1998, section 256.955, 
157.34  subdivision 3, is amended to read: 
157.35     Subd. 3.  [PRESCRIPTION DRUG COVERAGE.] Coverage under the 
157.36  program is limited to prescription drugs covered under the 
158.1   medical assistance program as described in section 256B.0625, 
158.2   subdivision 13, subject to a maximum deductible of $300 
158.3   annually, except drugs cleared by the FDA shall be available to 
158.4   qualified senior citizens enrolled in the program without 
158.5   restriction when prescribed for medically accepted indication as 
158.6   defined in the federal rebate program under section 1927 of 
158.7   title XIX of the federal Social Security Act.  Coverage under 
158.8   the program shall be limited to those prescription drugs that: 
158.9      (1) are covered under the medical assistance program as 
158.10  described in section 256B.0625, subdivision 13; and 
158.11     (2) are provided by manufacturers that have fully executed 
158.12  senior drug rebate agreements with the commissioner and comply 
158.13  with such agreements. 
158.14     Sec. 24.  Minnesota Statutes 1998, section 256.955, 
158.15  subdivision 4, is amended to read: 
158.16     Subd. 4.  [APPLICATION PROCEDURES AND COORDINATION WITH 
158.17  MEDICAL ASSISTANCE.] Applications and information on the program 
158.18  must be made available at county social service agencies, health 
158.19  care provider offices, and agencies and organizations serving 
158.20  senior citizens.  Senior citizens shall submit applications and 
158.21  any information specified by the commissioner as being necessary 
158.22  to verify eligibility directly to the county social service 
158.23  agencies:  
158.24     (1) beginning January 1, 1999, the county social service 
158.25  agency shall determine medical assistance spenddown eligibility 
158.26  of individuals who qualify for the senior citizen drug program 
158.27  of individuals; and 
158.28     (2) program payments will be used to reduce the spenddown 
158.29  obligations of individuals who are determined to be eligible for 
158.30  medical assistance with a spenddown as defined in section 
158.31  256B.056, subdivision 5. 
158.32  Seniors who are eligible for medical assistance with a spenddown 
158.33  shall be financially responsible for the deductible amount up to 
158.34  the satisfaction of the spenddown.  No deductible applies once 
158.35  the spenddown has been met.  Payments to providers for 
158.36  prescription drugs for persons eligible under this subdivision 
159.1   shall be reduced by the deductible.  
159.2      County social service agencies shall determine an 
159.3   applicant's eligibility for the program within 30 days from the 
159.4   date the application is received.  Eligibility begins the month 
159.5   after approval. 
159.6      Sec. 25.  Minnesota Statutes 1998, section 256.955, 
159.7   subdivision 7, is amended to read: 
159.8      Subd. 7.  [COST SHARING.] (a) Enrollees shall pay an annual 
159.9   premium of $120.  
159.10     (b) Program enrollees must satisfy a $300 $420 annual 
159.11  deductible, based upon expenditures for prescription drugs, to 
159.12  be paid as follows: 
159.13     (1) $25 $35 monthly deductible for persons with a monthly 
159.14  spenddown; or 
159.15     (2) $150 $210 biannual deductible for persons with a 
159.16  six-month spenddown.  
159.17     <i>(Effective date:  Section 25 (256.955, subd. 7) is</i> 
159.18  <i>effective the day following final enactment.)</i> 
159.19     Sec. 26.  Minnesota Statutes 1998, section 256.955, 
159.20  subdivision 8, is amended to read: 
159.21     Subd. 8.  [REPORT.] The commissioner shall annually report 
159.22  to the legislature on the senior citizen drug program.  The 
159.23  report must include demographic information on enrollees, 
159.24  per-prescription expenditures, total program expenditures, 
159.25  hospital and nursing home costs avoided by enrollees, any 
159.26  savings to medical assistance and Medicare resulting from the 
159.27  provision of prescription drug coverage under Medicare by health 
159.28  maintenance organizations, other public and private options for 
159.29  drug assistance to the senior population, any hardships caused 
159.30  by the annual premium and deductible, and any recommendations 
159.31  for changes in the senior drug program. 
159.32     Sec. 27.  Minnesota Statutes 1998, section 256.955, 
159.33  subdivision 9, is amended to read: 
159.34     Subd. 9.  [PROGRAM LIMITATION.] The commissioner shall 
159.35  administer the senior drug program so that the costs total no 
159.36  more than funds appropriated plus the drug rebate proceeds.  
160.1   Senior drug program rebate revenues are appropriated to the 
160.2   commissioner and shall be expended to augment funding of the 
160.3   senior drug program.  New enrollment shall cease if the 
160.4   commissioner determines that, given current enrollment, costs of 
160.5   the program will exceed appropriated funds and rebate proceeds.  
160.6   This section shall be repealed upon federal approval of the 
160.7   waiver to allow the commissioner to provide prescription drug 
160.8   coverage for qualified Medicare beneficiaries whose income is 
160.9   less than 150 percent of the federal poverty guidelines. 
160.10     Sec. 28.  Minnesota Statutes 1998, section 256.9685, 
160.11  subdivision 1a, is amended to read: 
160.12     Subd. 1a.  [ADMINISTRATIVE RECONSIDERATION.] 
160.13  Notwithstanding sections 256B.04, subdivision 15, and 256D.03, 
160.14  subdivision 7, the commissioner shall establish an 
160.15  administrative reconsideration process for appeals of inpatient 
160.16  hospital services determined to be medically unnecessary.  A 
160.17  physician or hospital may request a reconsideration of the 
160.18  decision that inpatient hospital services are not medically 
160.19  necessary by submitting a written request for review to the 
160.20  commissioner within 30 days after receiving notice of the 
160.21  decision.  The reconsideration process shall take place prior to 
160.22  the procedures of subdivision 1b and shall be conducted by 
160.23  physicians that are independent of the case under 
160.24  reconsideration.  A majority decision by the physicians is 
160.25  necessary to make a determination that the services were not 
160.26  medically necessary.  
160.27     Sec. 29.  Minnesota Statutes 1998, section 256.969, 
160.28  subdivision 1, is amended to read: 
160.29     Subdivision 1.  [HOSPITAL COST INDEX.] (a) The hospital 
160.30  cost index shall be the change in the Consumer Price Index-All 
160.31  Items (United States city average) (CPI-U) forecasted by Data 
160.32  Resources, Inc.  The commissioner shall use the indices as 
160.33  forecasted in the third quarter of the calendar year prior to 
160.34  the rate year.  The hospital cost index may be used to adjust 
160.35  the base year operating payment rate through the rate year on an 
160.36  annually compounded basis.  
161.1      (b) For fiscal years beginning on or after July 1, 1993, 
161.2   the commissioner of human services shall not provide automatic 
161.3   annual inflation adjustments for hospital payment rates under 
161.4   medical assistance, nor under general assistance medical care, 
161.5   except that the inflation adjustments under paragraph (a) for 
161.6   medical assistance, excluding general assistance medical care, 
161.7   shall apply through calendar year 1999 2001.  The index for 
161.8   calendar year 2000 shall be reduced 2.5 percentage points to 
161.9   recover overprojections of the index from 1994 to 1996.  The 
161.10  commissioner of finance shall include as a budget change request 
161.11  in each biennial detailed expenditure budget submitted to the 
161.12  legislature under section 16A.11 annual adjustments in hospital 
161.13  payment rates under medical assistance and general assistance 
161.14  medical care, based upon the hospital cost index. 
161.15     Sec. 30.  Minnesota Statutes 1998, section 256B.04, 
161.16  subdivision 16, is amended to read: 
161.17     Subd. 16.  [PERSONAL CARE SERVICES.] (a) Notwithstanding 
161.18  any contrary language in this paragraph, the commissioner of 
161.19  human services and the commissioner of health shall jointly 
161.20  promulgate rules to be applied to the licensure of personal care 
161.21  services provided under the medical assistance program.  The 
161.22  rules shall consider standards for personal care services that 
161.23  are based on the World Institute on Disability's recommendations 
161.24  regarding personal care services.  These rules shall at a 
161.25  minimum consider the standards and requirements adopted by the 
161.26  commissioner of health under section 144A.45, which the 
161.27  commissioner of human services determines are applicable to the 
161.28  provision of personal care services, in addition to other 
161.29  standards or modifications which the commissioner of human 
161.30  services determines are appropriate. 
161.31     The commissioner of human services shall establish an 
161.32  advisory group including personal care consumers and providers 
161.33  to provide advice regarding which standards or modifications 
161.34  should be adopted.  The advisory group membership must include 
161.35  not less than 15 members, of which at least 60 percent must be 
161.36  consumers of personal care services and representatives of 
162.1   recipients with various disabilities and diagnoses and ages.  At 
162.2   least 51 percent of the members of the advisory group must be 
162.3   recipients of personal care. 
162.4      The commissioner of human services may contract with the 
162.5   commissioner of health to enforce the jointly promulgated 
162.6   licensure rules for personal care service providers. 
162.7      Prior to final promulgation of the joint rule the 
162.8   commissioner of human services shall report preliminary findings 
162.9   along with any comments of the advisory group and a plan for 
162.10  monitoring and enforcement by the department of health to the 
162.11  legislature by February 15, 1992. 
162.12     Limits on the extent of personal care services that may be 
162.13  provided to an individual must be based on the 
162.14  cost-effectiveness of the services in relation to the costs of 
162.15  inpatient hospital care, nursing home care, and other available 
162.16  types of care.  The rules must provide, at a minimum:  
162.17     (1) that agencies be selected to contract with or employ 
162.18  and train staff to provide and supervise the provision of 
162.19  personal care services; 
162.20     (2) that agencies employ or contract with a qualified 
162.21  applicant that a qualified recipient proposes to the agency as 
162.22  the recipient's choice of assistant; 
162.23     (3) that agencies bill the medical assistance program for a 
162.24  personal care service by a personal care assistant and 
162.25  supervision by the registered nurse a qualified professional 
162.26  supervising the personal care assistant unless the recipient 
162.27  selects the fiscal agent option under section 256B.0627, 
162.28  subdivision 10; 
162.29     (4) that agencies establish a grievance mechanism; and 
162.30     (5) that agencies have a quality assurance program.  
162.31     (b) The commissioner may waive the requirement for the 
162.32  provision of personal care services through an agency in a 
162.33  particular county, when there are less than two agencies 
162.34  providing services in that county and shall waive the 
162.35  requirement for personal care assistants required to join an 
162.36  agency for the first time during 1993 when personal care 
163.1   services are provided under a relative hardship waiver under 
163.2   section 256B.0627, subdivision 4, paragraph (b), clause (7), and 
163.3   at least two agencies providing personal care services have 
163.4   refused to employ or contract with the independent personal care 
163.5   assistant. 
163.6      Sec. 31.  Minnesota Statutes 1998, section 256B.04, is 
163.7   amended by adding a subdivision to read: 
163.8      Subd. 19.  [PERFORMANCE DATA REPORTING UNIT.] The 
163.9   commissioner of human services shall establish a performance 
163.10  data reporting unit that serves counties and the state.  The 
163.11  department shall support this unit and provide technical 
163.12  assistance and access to the data warehouse.  The performance 
163.13  data reporting unit, which will operate within the department's 
163.14  central office and consist of both county and department staff, 
163.15  shall provide performance data reports to individual counties, 
163.16  share expertise from counties and the department perspective, 
163.17  and participate in joint planning to link with county databases 
163.18  and other county data sources in order to provide information on 
163.19  services provided to public clients from state, federal, and 
163.20  county funding sources.  The performance data reporting unit 
163.21  shall provide counties both individual and group summary level 
163.22  standard or unique reports on health care eligibility and 
163.23  services provided to clients for whom they have financial 
163.24  responsibility. 
163.25     Sec. 32.  Minnesota Statutes 1998, section 256B.042, 
163.26  subdivision 1, is amended to read: 
163.27     Subdivision 1.  [LIEN FOR COST OF CARE.] When the state 
163.28  agency provides, pays for, or becomes liable for medical care, 
163.29  it shall have a lien for the cost of the care upon any and all 
163.30  causes of action or recovery rights under any policy, plan, or 
163.31  contract providing benefits for health care or injury, which 
163.32  accrue to the person to whom the care was furnished, or to the 
163.33  person's legal representatives, as a result of the illness or 
163.34  injuries which necessitated the medical care.  For purposes of 
163.35  this section, "state agency" includes prepaid health plans under 
163.36  contract with the commissioner according to sections 256B.69, 
164.1   256D.03, subdivision 4, paragraph (d), and 256L.12; children's 
164.2   mental health collaboratives under section 245.493; 
164.3   demonstration projects for persons with disabilities under 
164.4   section 256B.77; nursing facilities under the alternative 
164.5   payment demonstration project under section 256B.434; and 
164.6   county-based purchasing entities under section 256B.692.  
164.7      Sec. 33.  Minnesota Statutes 1998, section 256B.042, 
164.8   subdivision 2, is amended to read: 
164.9      Subd. 2.  [LIEN ENFORCEMENT.] (a) The state agency may 
164.10  perfect and enforce its lien by following the procedures set 
164.11  forth in sections 514.69, 514.70 and 514.71, and its verified 
164.12  lien statement shall be filed with the appropriate court 
164.13  administrator in the county of financial responsibility.  The 
164.14  verified lien statement shall contain the following:  the name 
164.15  and address of the person to whom medical care was furnished, 
164.16  the date of injury, the name and address of the vendor or 
164.17  vendors furnishing medical care, the dates of the service, the 
164.18  amount claimed to be due for the care, and, to the best of the 
164.19  state agency's knowledge, the names and addresses of all 
164.20  persons, firms, or corporations claimed to be liable for damages 
164.21  arising from the injuries.  This section shall not affect the 
164.22  priority of any attorney's lien.  
164.23     (b) The state agency is not subject to any limitations 
164.24  period referred to in section 514.69 or 514.71 and has one year 
164.25  from the date notice is first received by it under subdivision 
164.26  4, paragraph (c), even if the notice is untimely, or one year 
164.27  from the date medical bills are first paid by the state agency, 
164.28  whichever is later, to file its verified lien statement.  The 
164.29  state agency may commence an action to enforce the lien within 
164.30  one year of (1) the date the notice required by subdivision 4, 
164.31  paragraph (c), is received or (2) the date the recipient's cause 
164.32  of action is concluded by judgment, award, settlement, or 
164.33  otherwise, whichever is later.  For purposes of this section, 
164.34  "state agency" includes authorized agents of the state agency. 
164.35     (c) If the notice required in subdivision 4 is not provided 
164.36  by any of the parties to the claim at any stage of the claim, 
165.1   the state agency will have one year from the date the state 
165.2   agency learns of the lack of notice to commence an action.  If 
165.3   amounts on the claim or cause of action are paid and the amount 
165.4   required to be paid to the state agency under subdivision 5, is 
165.5   not paid to the state agency, the state agency may commence an 
165.6   action to recover on the lien against any or all of the parties 
165.7   or entities which have either paid or received the payments. 
165.8      Sec. 34.  Minnesota Statutes 1998, section 256B.042, 
165.9   subdivision 3, is amended to read: 
165.10     Subd. 3.  The attorney general, or the appropriate county 
165.11  attorney acting at the direction of the attorney general, shall 
165.12  represent the state agency commissioner to enforce the lien 
165.13  created under this section or, if no action has been brought, 
165.14  may initiate and prosecute an independent action on behalf of 
165.15  the state agency commissioner against a person, firm, or 
165.16  corporation that may be liable to the person to whom the care 
165.17  was furnished. 
165.18     Any prepaid health plan providing services under sections 
165.19  256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
165.20  children's mental health collaboratives under section 245.493; 
165.21  demonstration projects for persons with disabilities under 
165.22  section 256B.77; nursing homes under the alternative payment 
165.23  demonstration project under section 256B.434; or the 
165.24  county-based purchasing entity providing services under section 
165.25  256B.692 may retain legal representation to enforce their lien 
165.26  created under this section or, if no action has been brought, 
165.27  may initiate and prosecute an independent action on their behalf 
165.28  against a person, firm, or corporation that may be liable to the 
165.29  person to whom the care or payment was furnished.  
165.30     Sec. 35.  Minnesota Statutes 1998, section 256B.055, 
165.31  subdivision 3a, is amended to read: 
165.32     Subd. 3a.  [MFIP-S FAMILIES; FAMILIES ELIGIBLE UNDER PRIOR 
165.33  AFDC RULES.] (a) Beginning January 1, 1998, or on the date that 
165.34  MFIP-S is implemented in counties, medical assistance may be 
165.35  paid for a person receiving public assistance under the MFIP-S 
165.36  program. 
166.1      (b) Beginning January 1, 1998, medical assistance may be 
166.2   paid for a person who would have been eligible for public 
166.3   assistance under the income and resource standards and 
166.4   deprivation requirements, or who would have been eligible but 
166.5   for excess income or assets, under the state's AFDC plan in 
166.6   effect as of July 16, 1996, as required by the Personal 
166.7   Responsibility and Work Opportunity Reconciliation Act of 1996 
166.8   (PRWORA), Public Law Number 104-193. 
166.9      Sec. 36.  Minnesota Statutes 1998, section 256B.056, 
166.10  subdivision 4, is amended to read: 
166.11     Subd. 4.  [INCOME.] To be eligible for medical assistance, 
166.12  a person eligible under section 256B.055, subdivision 7, not 
166.13  receiving supplemental security income program payments, and 
166.14  families and children may have an income up to 133-1/3 percent 
166.15  of the AFDC income standard in effect under the July 16, 1996, 
166.16  AFDC state plan.  For rate years beginning on or after July 1, 
166.17  1999, the commissioner shall consider increasing Effective July 
166.18  1, 2000, the base AFDC standard in effect on July 16, 1996, by 
166.19  an amount equal to the percent change in the Consumer Price 
166.20  Index for all urban consumers for the previous October compared 
166.21  to one year earlier shall be increased by two percent.  
166.22  Effective January 1, 2000, and each successive January, 
166.23  recipients of supplemental security income may have an income up 
166.24  to the supplemental security income standard in effect on that 
166.25  date.  In computing income to determine eligibility of persons 
166.26  who are not residents of long-term care facilities, the 
166.27  commissioner shall disregard increases in income as required by 
166.28  Public Law Numbers 94-566, section 503; 99-272; and 99-509.  
166.29  Veterans aid and attendance benefits and Veterans Administration 
166.30  unusual medical expense payments are considered income to the 
166.31  recipient. 
166.32     Sec. 37.  Minnesota Statutes 1998, section 256B.057, 
166.33  subdivision 3, is amended to read: 
166.34     Subd. 3.  [QUALIFIED MEDICARE BENEFICIARIES.] A person who 
166.35  is entitled to Part A Medicare benefits, whose income is equal 
166.36  to or less than 85 100 percent of the federal poverty 
167.1   guidelines, and whose assets are no more than twice the asset 
167.2   limit used to determine eligibility for the supplemental 
167.3   security income program, is eligible for medical assistance 
167.4   reimbursement of Part A and Part B premiums, Part A and Part B 
167.5   coinsurance and deductibles, and cost-effective premiums for 
167.6   enrollment with a health maintenance organization or a 
167.7   competitive medical plan under section 1876 of the Social 
167.8   Security Act.  The income limit shall be increased to 90 percent 
167.9   of the federal poverty guidelines on January 1, 1990; and to 100 
167.10  percent on January 1, 1991.  Reimbursement of the Medicare 
167.11  coinsurance and deductibles, when added to the amount paid by 
167.12  Medicare, must not exceed the total rate the provider would have 
167.13  received for the same service or services if the person were a 
167.14  medical assistance recipient with Medicare coverage.  Increases 
167.15  in benefits under Title II of the Social Security Act shall not 
167.16  be counted as income for purposes of this subdivision until the 
167.17  first day of the second full month following publication of the 
167.18  change in the federal poverty guidelines. 
167.19     Sec. 38.  Minnesota Statutes 1998, section 256B.057, is 
167.20  amended by adding a subdivision to read: 
167.21     Subd. 9.  [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 
167.22  assistance may be paid for a person who is employed and who: 
167.23     (1) meets the definition of disabled under the supplemental 
167.24  security income program; 
167.25     (2) meets the asset limits in paragraph (b); and 
167.26     (3) pays a premium, if required, under paragraph (c).  
167.27  Any spousal income or assets shall be disregarded for purposes 
167.28  of eligibility and premium determinations. 
167.29     (b) For purposes of determining eligibility under this 
167.30  subdivision, a person's assets must not exceed $20,000, 
167.31  excluding: 
167.32     (1) all assets excluded under section 256B.06; 
167.33     (2) retirement accounts, including individual accounts, 
167.34  401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 
167.35     (3) medical expense accounts set up through the person's 
167.36  employer. 
168.1      (c) A person whose earned and unearned income is equal to 
168.2   or greater than 200 percent of federal poverty guidelines for 
168.3   the applicable family size must pay a premium to be eligible for 
168.4   medical assistance.  The premium shall be equal to ten percent 
168.5   of the person's gross earned and unearned income above 200 
168.6   percent of federal poverty guidelines for the applicable family 
168.7   size up to the cost of coverage. 
168.8      (d) A person's eligibility and premium shall be determined 
168.9   by the local county agency.  Premiums must be paid to the 
168.10  commissioner.  All premiums are dedicated to the commissioner. 
168.11     (e) Any required premium shall be determined at application 
168.12  and redetermined annually at recertification or when a change in 
168.13  income occurs. 
168.14     (f) The first premium payment is due upon notification from 
168.15  the commissioner of the premium amount required.  Premiums may 
168.16  be paid in installments at the discretion of the commissioner. 
168.17     (g) Nonpayment of the premium shall result in denial or 
168.18  termination of medical assistance unless the person demonstrates 
168.19  good cause for nonpayment.  Good cause exists if the 
168.20  requirements specified in Minnesota Rules, part 9506.0040, 
168.21  subpart 7, items B to D, are met.  Nonpayment shall include 
168.22  payment with a returned, refused, or dishonored instrument.  The 
168.23  commissioner may require a guaranteed form of payment as the 
168.24  only means to replace a returned, refused, or dishonored 
168.25  instrument.  
168.26     Sec. 39.  Minnesota Statutes 1998, section 256B.0575, is 
168.27  amended to read: 
168.28     256B.0575 [AVAILABILITY OF INCOME FOR INSTITUTIONALIZED 
168.29  PERSONS.] 
168.30     When an institutionalized person is determined eligible for 
168.31  medical assistance, the income that exceeds the deductions in 
168.32  paragraphs (a) and (b) must be applied to the cost of 
168.33  institutional care.  
168.34     (a) The following amounts must be deducted from the 
168.35  institutionalized person's income in the following order: 
168.36     (1) the personal needs allowance under section 256B.35 or, 
169.1   for a veteran who does not have a spouse or child, or a 
169.2   surviving spouse of a veteran having no child, the amount of an 
169.3   improved pension received from the veteran's administration not 
169.4   exceeding $90 per month; 
169.5      (2) the personal allowance for disabled individuals under 
169.6   section 256B.36; 
169.7      (3) if the institutionalized person has a legally appointed 
169.8   guardian or conservator, five percent of the recipient's gross 
169.9   monthly income up to $100 as reimbursement for guardianship or 
169.10  conservatorship services; 
169.11     (4) a monthly income allowance determined under section 
169.12  256B.058, subdivision 2, but only to the extent income of the 
169.13  institutionalized spouse is made available to the community 
169.14  spouse; 
169.15     (5) a monthly allowance for children under age 18 which, 
169.16  together with the net income of the children, would provide 
169.17  income equal to the medical assistance standard for families and 
169.18  children according to section 256B.056, subdivision 4, for a 
169.19  family size that includes only the minor children.  This 
169.20  deduction applies only if the children do not live with the 
169.21  community spouse and only to the extent that the deduction is 
169.22  not included in the personal needs allowance under section 
169.23  256B.35, subdivision 1, as child support garnished under a court 
169.24  order; 
169.25     (6) a monthly family allowance for other family members, 
169.26  equal to one-third of the difference between 122 percent of the 
169.27  federal poverty guidelines and the monthly income for that 
169.28  family member; 
169.29     (7) reparations payments made by the Federal Republic of 
169.30  Germany and reparations payments made by the Netherlands for 
169.31  victims of Nazi persecution between 1940 and 1945; and 
169.32     (8) all other exclusions from income for institutionalized 
169.33  persons as mandated by federal law; and 
169.34     (9) amounts for reasonable expenses incurred for necessary 
169.35  medical or remedial care for the institutionalized spouse that 
169.36  are not medical assistance covered expenses and that are not 
170.1   subject to payment by a third party.  
170.2      For purposes of clause (6), "other family member" means a 
170.3   person who resides with the community spouse and who is a minor 
170.4   or dependent child, dependent parent, or dependent sibling of 
170.5   either spouse.  "Dependent" means a person who could be claimed 
170.6   as a dependent for federal income tax purposes under the 
170.7   Internal Revenue Code. 
170.8      (b) Income shall be allocated to an institutionalized 
170.9   person for a period of up to three calendar months, in an amount 
170.10  equal to the medical assistance standard for a family size of 
170.11  one if:  
170.12     (1) a physician certifies that the person is expected to 
170.13  reside in the long-term care facility for three calendar months 
170.14  or less; 
170.15     (2) if the person has expenses of maintaining a residence 
170.16  in the community; and 
170.17     (3) if one of the following circumstances apply:  
170.18     (i) the person was not living together with a spouse or a 
170.19  family member as defined in paragraph (a) when the person 
170.20  entered a long-term care facility; or 
170.21     (ii) the person and the person's spouse become 
170.22  institutionalized on the same date, in which case the allocation 
170.23  shall be applied to the income of one of the spouses.  
170.24  For purposes of this paragraph, a person is determined to be 
170.25  residing in a licensed nursing home, regional treatment center, 
170.26  or medical institution if the person is expected to remain for a 
170.27  period of one full calendar month or more. 
170.28     Sec. 40.  Minnesota Statutes 1998, section 256B.061, is 
170.29  amended to read: 
170.30     256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 
170.31     (a) If any individual has been determined to be eligible 
170.32  for medical assistance, it will be made available for care and 
170.33  services included under the plan and furnished in or after the 
170.34  third month before the month in which the individual made 
170.35  application for such assistance, if such individual was, or upon 
170.36  application would have been, eligible for medical assistance at 
171.1   the time the care and services were furnished.  The commissioner 
171.2   may limit, restrict, or suspend the eligibility of an individual 
171.3   for up to one year upon that individual's conviction of a 
171.4   criminal offense related to application for or receipt of 
171.5   medical assistance benefits. 
171.6      (b) On the basis of information provided on the completed 
171.7   application, an applicant who meets the following criteria shall 
171.8   be determined eligible beginning in the month of application: 
171.9      (1) whose gross income is less than 90 percent of the 
171.10  applicable income standard; 
171.11     (2) whose total liquid assets are less than 90 percent of 
171.12  the asset limit; 
171.13     (3) does not reside in a long-term care facility; and 
171.14     (4) meets all other eligibility requirements. 
171.15  The applicant must provide all required verifications within 30 
171.16  days' notice of the eligibility determination or eligibility 
171.17  shall be terminated. 
171.18     Sec. 41.  Minnesota Statutes 1998, section 256B.0625, is 
171.19  amended by adding a subdivision to read: 
171.20     Subd. 3b.  [TELEMEDICINE.] Medical assistance covers 
171.21  telemedicine consultations.  Telemedicine consultations must be 
171.22  via two-way, interactive video or store and forward technology.  
171.23  Store and forward technology includes telemedicine consultations 
171.24  that do not occur in real time via synchronous transmissions, 
171.25  and that do not require a face-to-face encounter with the 
171.26  patient for all or any part of the telemedicine consultation.  
171.27  The patient record must include a written opinion from the 
171.28  consulting physician providing the telemedicine consultation.  A 
171.29  communication between two physicians that consists solely of a 
171.30  telephone conversation is not a telemedicine consultation.  
171.31  Coverage is limited to three telemedicine consultations per 
171.32  recipient per calendar week.  Telemedicine consultations shall 
171.33  be paid at the full allowable rate.  
171.34     <i>(Effective date:  Section 41 (256B.0625, subd. 3b) is</i> 
171.35  <i>effective for services rendered on or after July 1, 1999.)</i> 
171.36     Sec. 42.  Minnesota Statutes 1998, section 256B.0625, is 
172.1   amended by adding a subdivision to read: 
172.2      Subd. 3c.  [CONSULTATION SERVICES BY PHYSICIANS 
172.3   SPECIALIZING IN THE TREATMENT OF CHILD ABUSE AND 
172.4   NEGLECT.] Medical assistance covers consultation services by 
172.5   physicians specializing in the treatment of child abuse and 
172.6   neglect.  Alternative media formats may be used when the patient 
172.7   is a child being examined for potential abuse or neglect, the 
172.8   consulting physician is a specialist in the treatment of child 
172.9   abuse and neglect, and the use of two-way, interactive video or 
172.10  the occurrence of a second exam would be medically 
172.11  contraindicated for the child. 
172.12     Sec. 43.  Minnesota Statutes 1998, section 256B.0625, 
172.13  subdivision 6a, is amended to read: 
172.14     Subd. 6a.  [HOME HEALTH SERVICES.] Home health services are 
172.15  those services specified in Minnesota Rules, part 9505.0290. 
172.16  Medical assistance covers home health services at a recipient's 
172.17  home residence.  Medical assistance does not cover home health 
172.18  services for residents of a hospital, nursing facility, or 
172.19  intermediate care facility, or a health care facility licensed 
172.20  by the commissioner of health, unless the program is funded 
172.21  under a home and community-based services waiver or unless the 
172.22  commissioner of human services has prior authorized skilled 
172.23  nurse visits for less than 90 days for a resident at an 
172.24  intermediate care facility for persons with mental retardation, 
172.25  to prevent an admission to a hospital or nursing facility or 
172.26  unless a resident who is otherwise eligible is on leave from the 
172.27  facility and the facility either pays for the home health 
172.28  services or forgoes the facility per diem for the leave days 
172.29  that home health services are used.  Home health services must 
172.30  be provided by a Medicare certified home health agency.  All 
172.31  nursing and home health aide services must be provided according 
172.32  to section 256B.0627. 
172.33     Sec. 44.  Minnesota Statutes 1998, section 256B.0625, 
172.34  subdivision 8, is amended to read: 
172.35     Subd. 8.  [PHYSICAL THERAPY.] Medical assistance covers 
172.36  physical therapy and related services, including specialized 
173.1   maintenance therapy.  Services provided by a physical therapy 
173.2   assistant shall be reimbursed at the same rate as services 
173.3   performed by a physical therapist when the services of the 
173.4   physical therapy assistant are provided under the direction of a 
173.5   physical therapist who is on the premises.  Services provided by 
173.6   a physical therapy assistant that are provided under the 
173.7   direction of a physical therapist who is not on the premises 
173.8   shall be reimbursed at 65 percent of the physical therapist rate.
173.9      Sec. 45.  Minnesota Statutes 1998, section 256B.0625, 
173.10  subdivision 8a, is amended to read: 
173.11     Subd. 8a.  [OCCUPATIONAL THERAPY.] Medical assistance 
173.12  covers occupational therapy and related services, including 
173.13  specialized maintenance therapy.  Services provided by an 
173.14  occupational therapy assistant shall be reimbursed at the same 
173.15  rate as services performed by an occupational therapist when the 
173.16  services of the occupational therapy assistant are provided 
173.17  under the direction of the occupational therapist who is on the 
173.18  premises.  Services provided by an occupational therapy 
173.19  assistant that are provided under the direction of an 
173.20  occupational therapist who is not on the premises shall be 
173.21  reimbursed at 65 percent of the occupational therapist rate. 
173.22     Sec. 46.  Minnesota Statutes 1998, section 256B.0625, is 
173.23  amended by adding a subdivision to read: 
173.24     Subd. 8b.  [SPEECH LANGUAGE PATHOLOGY SERVICES.] Medical 
173.25  assistance covers speech language pathology and related 
173.26  services, including specialized maintenance therapy. 
173.27     Sec. 47.  Minnesota Statutes 1998, section 256B.0625, is 
173.28  amended by adding a subdivision to read: 
173.29     Subd. 8c.  [CARE MANAGEMENT; REHABILITATION SERVICES.] (a) 
173.30  Effective July 1, 1999, one-time thresholds shall replace annual 
173.31  thresholds for provision of rehabilitation services described in 
173.32  subdivisions 8, 8a, and 8b.  The one-time thresholds will be the 
173.33  same in amount and description as the thresholds prescribed by 
173.34  the department of human services health care programs provider 
173.35  manual for calendar year 1997, except they will not be renewed 
173.36  annually, and they will include sensory skills and cognitive 
174.1   training skills. 
174.2      (b) A care management approach for authorization of 
174.3   services beyond the threshold shall be instituted in conjunction 
174.4   with the one-time thresholds.  The care management approach 
174.5   shall require the provider and the department rehabilitation 
174.6   reviewer to work together directly through written 
174.7   communication, or telephone communication when appropriate, to 
174.8   establish a medically necessary care management plan. 
174.9      (c) The commissioner shall implement an expedited five-day 
174.10  turnaround time to review authorization requests for recipients 
174.11  who need emergency rehabilitation services and who have 
174.12  exhausted their one-time threshold limit for those services. 
174.13     Sec. 48.  Minnesota Statutes 1998, section 256B.0625, is 
174.14  amended by adding a subdivision to read: 
174.15     Subd. 9a.  [DENTAL HYGIENIST SERVICES.] Medical assistance 
174.16  covers preventive dental services provided by dental hygienists 
174.17  if the services are otherwise covered under this chapter as 
174.18  dental services, and if the services are within the scope of 
174.19  practice of a licensed dental hygienist, as defined in section 
174.20  150A.05. 
174.21     Sec. 49.  Minnesota Statutes 1998, section 256B.0625, 
174.22  subdivision 13, is amended to read: 
174.23     Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs, 
174.24  except for fertility drugs when specifically used to enhance 
174.25  fertility, if prescribed by a licensed practitioner and 
174.26  dispensed by a licensed pharmacist, by a physician enrolled in 
174.27  the medical assistance program as a dispensing physician, or by 
174.28  a physician or a nurse practitioner employed by or under 
174.29  contract with a community health board as defined in section 
174.30  145A.02, subdivision 5, for the purposes of communicable disease 
174.31  control.  The commissioner, after receiving recommendations from 
174.32  professional medical associations and professional pharmacist 
174.33  associations, shall designate a formulary committee to advise 
174.34  the commissioner on the names of drugs for which payment is 
174.35  made, recommend a system for reimbursing providers on a set fee 
174.36  or charge basis rather than the present system, and develop 
175.1   methods encouraging use of generic drugs when they are less 
175.2   expensive and equally effective as trademark drugs.  The 
175.3   formulary committee shall consist of nine members, four of whom 
175.4   shall be physicians who are not employed by the department of 
175.5   human services, and a majority of whose practice is for persons 
175.6   paying privately or through health insurance, three of whom 
175.7   shall be pharmacists who are not employed by the department of 
175.8   human services, and a majority of whose practice is for persons 
175.9   paying privately or through health insurance, a consumer 
175.10  representative, and a nursing home representative.  Committee 
175.11  members shall serve three-year terms and shall serve without 
175.12  compensation.  Members may be reappointed once.  
175.13     (b) The commissioner shall establish a drug formulary.  Its 
175.14  establishment and publication shall not be subject to the 
175.15  requirements of the Administrative Procedure Act, but the 
175.16  formulary committee shall review and comment on the formulary 
175.17  contents.  The formulary committee shall review and recommend 
175.18  drugs which require prior authorization.  The formulary 
175.19  committee may recommend drugs for prior authorization directly 
175.20  to the commissioner, as long as opportunity for public input is 
175.21  provided.  Prior authorization may be requested by the 
175.22  commissioner based on medical and clinical criteria before 
175.23  certain drugs are eligible for payment.  Before a drug may be 
175.24  considered for prior authorization at the request of the 
175.25  commissioner:  
175.26     (1) the drug formulary committee must develop criteria to 
175.27  be used for identifying drugs; the development of these criteria 
175.28  is not subject to the requirements of chapter 14, but the 
175.29  formulary committee shall provide opportunity for public input 
175.30  in developing criteria; 
175.31     (2) the drug formulary committee must hold a public forum 
175.32  and receive public comment for an additional 15 days; and 
175.33     (3) the commissioner must provide information to the 
175.34  formulary committee on the impact that placing the drug on prior 
175.35  authorization will have on the quality of patient care and 
175.36  information regarding whether the drug is subject to clinical 
176.1   abuse or misuse.  Prior authorization may be required by the 
176.2   commissioner before certain formulary drugs are eligible for 
176.3   payment.  The formulary shall not include:  
176.4      (i) drugs or products for which there is no federal 
176.5   funding; 
176.6      (ii) over-the-counter drugs, except for antacids, 
176.7   acetaminophen, family planning products, aspirin, insulin, 
176.8   products for the treatment of lice, vitamins for adults with 
176.9   documented vitamin deficiencies, vitamins for children under the 
176.10  age of seven and pregnant or nursing women, and any other 
176.11  over-the-counter drug identified by the commissioner, in 
176.12  consultation with the drug formulary committee, as necessary, 
176.13  appropriate, and cost-effective for the treatment of certain 
176.14  specified chronic diseases, conditions or disorders, and this 
176.15  determination shall not be subject to the requirements of 
176.16  chapter 14; 
176.17     (iii) anorectics, except that medically necessary 
176.18  anorectics shall be covered for a recipient previously diagnosed 
176.19  as having pickwickian syndrome and currently diagnosed as having 
176.20  diabetes and being morbidly obese; 
176.21     (iv) drugs for which medical value has not been 
176.22  established; and 
176.23     (v) drugs from manufacturers who have not signed a rebate 
176.24  agreement with the Department of Health and Human Services 
176.25  pursuant to section 1927 of title XIX of the Social Security Act 
176.26  and who have not signed an agreement with the state for drugs 
176.27  purchased pursuant to the senior citizen drug program 
176.28  established under section 256.955. 
176.29     The commissioner shall publish conditions for prohibiting 
176.30  payment for specific drugs after considering the formulary 
176.31  committee's recommendations.  
176.32     (c) The basis for determining the amount of payment shall 
176.33  be the lower of the actual acquisition costs of the drugs plus a 
176.34  fixed dispensing fee; the maximum allowable cost set by the 
176.35  federal government or by the commissioner plus the fixed 
176.36  dispensing fee; or the usual and customary price charged to the 
177.1   public.  The pharmacy dispensing fee shall be $3.65.  Actual 
177.2   acquisition cost includes quantity and other special discounts 
177.3   except time and cash discounts.  The actual acquisition cost of 
177.4   a drug shall be estimated by the commissioner, at average 
177.5   wholesale price minus nine percent.  The maximum allowable cost 
177.6   of a multisource drug may be set by the commissioner and it 
177.7   shall be comparable to, but no higher than, the maximum amount 
177.8   paid by other third-party payors in this state who have maximum 
177.9   allowable cost programs.  The commissioner shall set maximum 
177.10  allowable costs for multisource drugs that are not on the 
177.11  federal upper limit list as described in United States Code, 
177.12  title 42, chapter 7, section 1396r-8(e), the Social Security 
177.13  Act, and Code of Federal Regulations, title 42, part 447, 
177.14  section 447.332.  Establishment of the amount of payment for 
177.15  drugs shall not be subject to the requirements of the 
177.16  Administrative Procedure Act.  An additional dispensing fee of 
177.17  $.30 may be added to the dispensing fee paid to pharmacists for 
177.18  legend drug prescriptions dispensed to residents of long-term 
177.19  care facilities when a unit dose blister card system, approved 
177.20  by the department, is used.  Under this type of dispensing 
177.21  system, the pharmacist must dispense a 30-day supply of drug.  
177.22  The National Drug Code (NDC) from the drug container used to 
177.23  fill the blister card must be identified on the claim to the 
177.24  department.  The unit dose blister card containing the drug must 
177.25  meet the packaging standards set forth in Minnesota Rules, part 
177.26  6800.2700, that govern the return of unused drugs to the 
177.27  pharmacy for reuse.  The pharmacy provider will be required to 
177.28  credit the department for the actual acquisition cost of all 
177.29  unused drugs that are eligible for reuse.  Over-the-counter 
177.30  medications must be dispensed in the manufacturer's unopened 
177.31  package.  The commissioner may permit the drug clozapine to be 
177.32  dispensed in a quantity that is less than a 30-day supply.  
177.33  Whenever a generically equivalent product is available, payment 
177.34  shall be on the basis of the actual acquisition cost of the 
177.35  generic drug, unless the prescriber specifically indicates 
177.36  "dispense as written - brand necessary" on the prescription as 
178.1   required by section 151.21, subdivision 2. 
178.2      (d) For purposes of this subdivision, "multisource drugs" 
178.3   means covered outpatient drugs, excluding innovator multisource 
178.4   drugs for which there are two or more drug products, which: 
178.5      (1) are related as therapeutically equivalent under the 
178.6   Food and Drug Administration's most recent publication of 
178.7   "Approved Drug Products with Therapeutic Equivalence 
178.8   Evaluations"; 
178.9      (2) are pharmaceutically equivalent and bioequivalent as 
178.10  determined by the Food and Drug Administration; and 
178.11     (3) are sold or marketed in Minnesota. 
178.12  "Innovator multisource drug" means a multisource drug that was 
178.13  originally marketed under an original new drug application 
178.14  approved by the Food and Drug Administration. 
178.15     Sec. 50.  Minnesota Statutes 1998, section 256B.0625, 
178.16  subdivision 19c, is amended to read: 
178.17     Subd. 19c.  [PERSONAL CARE.] Medical assistance covers 
178.18  personal care services provided by an individual who is 
178.19  qualified to provide the services according to subdivision 19a 
178.20  and section 256B.0627, where the services are prescribed by a 
178.21  physician in accordance with a plan of treatment and are 
178.22  supervised by a registered nurse the recipient under the fiscal 
178.23  agent option according to section 256B.0627, subdivision 10, or 
178.24  a qualified professional.  "Qualified professional" means a 
178.25  mental health professional as defined in section 245.462, 
178.26  subdivision 18, or 245.4871, subdivision 26; or a registered 
178.27  nurse as defined in sections 148.171 to 148.285.  As part of the 
178.28  assessment, the county public health nurse will consult with the 
178.29  recipient or responsible party and identify the most appropriate 
178.30  person to provide supervision of the personal care assistant.  
178.31  The qualified professional shall perform the duties described in 
178.32  Minnesota Rules, part 9505.0335, subpart 4.  
178.33     Sec. 51.  Minnesota Statutes 1998, section 256B.0625, 
178.34  subdivision 26, is amended to read: 
178.35     Subd. 26.  [SPECIAL EDUCATION SERVICES.] (a) Medical 
178.36  assistance covers medical services identified in a recipient's 
179.1   individualized education plan and covered under the medical 
179.2   assistance state plan.  Covered services include occupational 
179.3   therapy, physical therapy, speech-language therapy, clinical 
179.4   psychological services, nursing services, school psychological 
179.5   services, school social work services, personal care assistants 
179.6   serving as management aides, assistive technology devices, 
179.7   transportation services, and other services covered under the 
179.8   medical assistance state plan.  Mental health services eligible 
179.9   for medical assistance reimbursement must be provided through a 
179.10  children's mental health collaborative where a collaborative 
179.11  exists.  The services may be provided by a Minnesota school 
179.12  district that is enrolled as a medical assistance provider or 
179.13  its subcontractor, and only if the services meet all the 
179.14  requirements otherwise applicable if the service had been 
179.15  provided by a provider other than a school district, in the 
179.16  following areas:  medical necessity, physician's orders, 
179.17  documentation, personnel qualifications, and prior authorization 
179.18  requirements.  The nonfederal share of costs for services 
179.19  provided under this subdivision is the responsibility of the 
179.20  local school district as provided in section 125A.74.  Services 
179.21  listed in a child's individual education plan are eligible for 
179.22  medical assistance reimbursement only if those services meet 
179.23  criteria for federal financial participation under the Medicaid 
179.24  program.  
179.25     (b) Approval of health-related services for inclusion in 
179.26  the individual education plan does not require prior 
179.27  authorization for purposes of reimbursement under this chapter.  
179.28  The commissioner may require physician review and approval of 
179.29  the plan not more than once annually or upon any modification of 
179.30  the individual education plan that reflects a change in 
179.31  health-related services. 
179.32     (c) Services of a speech-language pathologist provided 
179.33  under this section are covered notwithstanding Minnesota Rules, 
179.34  part 9505.0390, subpart 1, item L, if the person: 
179.35     (1) holds a masters degree in speech-language pathology; 
179.36     (2) is licensed by the Minnesota board of teaching as an 
180.1   educational speech-language pathologist; and 
180.2      (3) either has a certificate of clinical competence from 
180.3   the American Speech and Hearing Association, has completed the 
180.4   equivalent educational requirements and work experience 
180.5   necessary for the certificate or has completed the academic 
180.6   program and is acquiring supervised work experience to qualify 
180.7   for the certificate. 
180.8      (d) Medical assistance coverage for medically necessary 
180.9   services provided under other subdivisions in this section may 
180.10  not be denied solely on the basis that the same or similar 
180.11  services are covered under this subdivision. 
180.12     (e) The commissioner shall develop and implement package 
180.13  rates, bundled rates, or per diem rates for special education 
180.14  services under which separately covered services are grouped 
180.15  together and billed as a unit in order to reduce administrative 
180.16  complexity.  
180.17     (f) The commissioner shall develop a cost-based payment 
180.18  structure for payment of these services.  
180.19     (g) Effective July 1, 2000, medical assistance services 
180.20  provided under an individual education plan or an individual 
180.21  family service plan by local school districts shall not count 
180.22  against medical assistance authorization thresholds for that 
180.23  child. 
180.24     <i>(Effective date:  Section 51 (256B.0625, subd. 26) is</i> 
180.25  <i>effective July 1, 2000.)</i> 
180.26     Sec. 52.  Minnesota Statutes 1998, section 256B.0625, 
180.27  subdivision 28, is amended to read: 
180.28     Subd. 28.  [CERTIFIED NURSE PRACTITIONER SERVICES.] Medical 
180.29  assistance covers services performed by a certified pediatric 
180.30  nurse practitioner, a certified family nurse practitioner, a 
180.31  certified adult nurse practitioner, a certified 
180.32  obstetric/gynecological nurse practitioner, a certified neonatal 
180.33  nurse practitioner, or a certified geriatric nurse practitioner 
180.34  in independent practice, if the services are otherwise covered 
180.35  under this chapter as a physician service, are provided on an 
180.36  inpatient basis and are not part of the cost for inpatient 
181.1   services included in the operating payment rate, and if the 
181.2   service is are within the scope of practice of the nurse 
181.3   practitioner's license as a registered nurse, as defined in 
181.4   section 148.171. 
181.5      Sec. 53.  Minnesota Statutes 1998, section 256B.0625, 
181.6   subdivision 30, is amended to read: 
181.7      Subd. 30.  [OTHER CLINIC SERVICES.] (a) Medical assistance 
181.8   covers rural health clinic services, federally qualified health 
181.9   center services, nonprofit community health clinic services, 
181.10  public health clinic services, and the services of a clinic 
181.11  meeting the criteria established in rule by the commissioner.  
181.12  Rural health clinic services and federally qualified health 
181.13  center services mean services defined in United States Code, 
181.14  title 42, section 1396d(a)(2)(B) and (C).  Payment for rural 
181.15  health clinic and federally qualified health center services 
181.16  shall be made according to applicable federal law and regulation.
181.17     (b) A federally qualified health center that is beginning 
181.18  initial operation shall submit an estimate of budgeted costs and 
181.19  visits for the initial reporting period in the form and detail 
181.20  required by the commissioner.  A federally qualified health 
181.21  center that is already in operation shall submit an initial 
181.22  report using actual costs and visits for the initial reporting 
181.23  period.  Within 90 days of the end of its reporting period, a 
181.24  federally qualified health center shall submit, in the form and 
181.25  detail required by the commissioner, a report of its operations, 
181.26  including allowable costs actually incurred for the period and 
181.27  the actual number of visits for services furnished during the 
181.28  period, and other information required by the commissioner.  
181.29  Federally qualified health centers that file Medicare cost 
181.30  reports shall provide the commissioner with a copy of the most 
181.31  recent Medicare cost report filed with the Medicare program 
181.32  intermediary for the reporting year which support the costs 
181.33  claimed on their cost report to the state. 
181.34     (c) In order to continue cost-based payment under the 
181.35  medical assistance program according to paragraphs (a) and (b), 
181.36  a federally qualified health center or rural health clinic must 
182.1   apply for designation as an essential community provider within 
182.2   six months of final adoption of rules by the department of 
182.3   health according to section 62Q.19, subdivision 7.  For those 
182.4   federally qualified health centers and rural health clinics that 
182.5   have applied for essential community provider status within the 
182.6   six-month time prescribed, medical assistance payments will 
182.7   continue to be made according to paragraphs (a) and (b) for the 
182.8   first three years after application.  For federally qualified 
182.9   health centers and rural health clinics that either do not apply 
182.10  within the time specified above or who have had essential 
182.11  community provider status for three years, medical assistance 
182.12  payments for health services provided by these entities shall be 
182.13  according to the same rates and conditions applicable to the 
182.14  same service provided by health care providers that are not 
182.15  federally qualified health centers or rural health clinics.  
182.16  This paragraph takes effect only if the Minnesota health care 
182.17  reform waiver is approved by the federal government, and remains 
182.18  in effect for as long as the Minnesota health care reform waiver 
182.19  remains in effect.  When the waiver expires, this paragraph 
182.20  expires, and the commissioner of human services shall publish a 
182.21  notice in the State Register and notify the revisor of statutes. 
182.22     (d) Effective July 1, 1999, the provisions of paragraph (c) 
182.23  requiring a federally qualified health center or a rural health 
182.24  clinic to make application for an essential community provider 
182.25  designation in order to have cost-based payments made according 
182.26  to paragraphs (a) and (b) no longer apply. 
182.27     (e) Effective January 1, 2000, payments made according to 
182.28  paragraphs (a) and (b) shall be limited to the cost phase-out 
182.29  schedule of the Balanced Budget Act of 1997. 
182.30     Sec. 54.  Minnesota Statutes 1998, section 256B.0625, 
182.31  subdivision 32, is amended to read: 
182.32     Subd. 32.  [NUTRITIONAL PRODUCTS.] (a) Medical assistance 
182.33  covers nutritional products needed for nutritional 
182.34  supplementation because solid food or nutrients thereof cannot 
182.35  be properly absorbed by the body or needed for treatment of 
182.36  phenylketonuria, hyperlysinemia, maple syrup urine disease, a 
183.1   combined allergy to human milk, cow's milk, and soy formula, or 
183.2   any other childhood or adult diseases, conditions, or disorders 
183.3   identified by the commissioner as requiring a similarly 
183.4   necessary nutritional product.  Nutritional products needed for 
183.5   the treatment of a combined allergy to human milk, cow's milk, 
183.6   and soy formula require prior authorization.  Separate payment 
183.7   shall not be made for nutritional products for residents of 
183.8   long-term care facilities.  Payment for dietary requirements is 
183.9   a component of the per diem rate paid to these facilities. 
183.10     (b) The commissioner shall designate a nutritional 
183.11  supplementation products advisory committee to advise the 
183.12  commissioner on nutritional supplementation products for which 
183.13  payment is made.  The committee shall consist of nine members, 
183.14  one of whom shall be a physician, one of whom shall be a 
183.15  pharmacist, two of whom shall be registered dietitians, one of 
183.16  whom shall be a public health nurse, one of whom shall be a 
183.17  representative of a home health care agency, one of whom shall 
183.18  be a provider of long-term care services, and two of whom shall 
183.19  be consumers of nutritional supplementation products.  Committee 
183.20  members shall serve two-year terms and shall serve without 
183.21  compensation. 
183.22     (c) The advisory committee shall review and recommend 
183.23  nutritional supplementation products which require prior 
183.24  authorization.  The commissioner shall develop procedures for 
183.25  the operation of the advisory committee so that the advisory 
183.26  committee operates in a manner parallel to the drug formulary 
183.27  committee. 
183.28     Sec. 55.  Minnesota Statutes 1998, section 256B.0625, 
183.29  subdivision 35, is amended to read: 
183.30     Subd. 35.  [FAMILY COMMUNITY SUPPORT SERVICES.] Medical 
183.31  assistance covers family community support services as defined 
183.32  in section 245.4871, subdivision 17.  In addition to the 
183.33  provisions of section 245.4871, and to the extent authorized by 
183.34  rules promulgated by the state agency, medical assistance covers 
183.35  the following services as family community support services: 
183.36     (1) services identified in an individual treatment plan 
184.1   when provided by a trained behavioral aide under the direction 
184.2   of a mental health practitioner or mental health professional; 
184.3      (2) mental health crisis intervention and crisis 
184.4   stabilization services provided outside of hospital inpatient 
184.5   settings; and 
184.6      (3) the therapeutic components of preschool and therapeutic 
184.7   camp programs. 
184.8      Sec. 56.  Minnesota Statutes 1998, section 256B.0625, is 
184.9   amended by adding a subdivision to read: 
184.10     Subd. 41.  [MENTAL HEALTH PROFESSIONAL.] Notwithstanding 
184.11  Minnesota Rules, part 9505.0175, subpart 28, the definition of a 
184.12  mental health professional shall include a person who is 
184.13  qualified as specified in section 245.462, subdivision 18, 
184.14  clause (5); or 245.4871, subdivision 27, clause (5), for the 
184.15  purpose of this section and Minnesota Rules, parts 9505.0170 to 
184.16  9505.0475. 
184.17     Sec. 57.  Minnesota Statutes 1998, section 256B.0625, is 
184.18  amended by adding a subdivision to read: 
184.19     Subd. 42.  [LANGUAGE INTERPRETER SERVICES.] (a) Medical 
184.20  assistance covers language interpreter services provided in 
184.21  conjunction with another covered health service. 
184.22     (b) The commissioner shall establish reimbursement 
184.23  standards for interpreter services as follows: 
184.24     (1) a per visit maximum rate shall be established; and 
184.25     (2) services shall be reimbursed in 15-minute increments. 
184.26     Sec. 58.  Minnesota Statutes 1998, section 256B.0627, 
184.27  subdivision 1, is amended to read: 
184.28     Subdivision 1.  [DEFINITION.] (a) "Assessment" means a 
184.29  review and evaluation of a recipient's need for home care 
184.30  services conducted in person.  Assessments for private duty 
184.31  nursing shall be conducted by a registered private duty nurse.  
184.32  Assessments for home health agency services shall be conducted 
184.33  by a home health agency nurse.  Assessments for personal 
184.34  care assistant services shall be conducted by the county public 
184.35  health nurse or a certified public health nurse under contract 
184.36  with the county.  An initial assessment for personal care 
185.1   services is conducted on individuals who are requesting personal 
185.2   care services or for those consumers who have never had a public 
185.3   health nurse assessment.  The initial A face-to-face assessment 
185.4   must include:  a face-to-face health status assessment and 
185.5   determination of baseline need, evaluation of service outcomes, 
185.6   collection of initial case data, identification of appropriate 
185.7   services and service plan development or modification, 
185.8   coordination of initial services, referrals and follow-up to 
185.9   appropriate payers and community resources, completion of 
185.10  required reports, obtaining service authorization, and consumer 
185.11  education.  A reassessment visit face-to-face assessment for 
185.12  personal care services is conducted on those recipients who have 
185.13  never had a county public health nurse assessment.  A 
185.14  face-to-face assessment must occur at least annually or when 
185.15  there is a significant change in consumer the recipient's 
185.16  condition and or when there is a change in the need for personal 
185.17  care assistant services.  The reassessment visit A service 
185.18  update may substitute for the annual face-to-face assessment 
185.19  when there is not a significant change in recipient condition or 
185.20  a change in the need for personal care assistant service.  A 
185.21  service update or review for temporary increase includes a 
185.22  review of initial baseline data, evaluation of service outcomes, 
185.23  redetermination of service need, modification of service plan 
185.24  and appropriate referrals, update of initial forms, obtaining 
185.25  service authorization, and on going consumer education.  
185.26  Assessments for medical assistance home care services for mental 
185.27  retardation or related conditions and alternative care services 
185.28  for developmentally disabled home and community-based waivered 
185.29  recipients may be conducted by the county public health nurse to 
185.30  ensure coordination and avoid duplication.  Assessments must be 
185.31  completed on forms provided by the commissioner within 30 days 
185.32  of a request for home care services by a recipient or 
185.33  responsible party. 
185.34     (b) "Care plan" means a written description of personal 
185.35  care assistant services developed by the agency nurse qualified 
185.36  professional with the recipient or responsible party to be used 
186.1   by the personal care assistant with a copy provided to the 
186.2   recipient or responsible party. 
186.3      (c) "Home care services" means a health service, determined 
186.4   by the commissioner as medically necessary, that is ordered by a 
186.5   physician and documented in a service plan that is reviewed by 
186.6   the physician at least once every 60 62 days for the provision 
186.7   of home health services, or private duty nursing, or at least 
186.8   once every 365 days for personal care.  Home care services are 
186.9   provided to the recipient at the recipient's residence that is a 
186.10  place other than a hospital or long-term care facility or as 
186.11  specified in section 256B.0625.  
186.12     (d) "Medically necessary" has the meaning given in 
186.13  Minnesota Rules, parts 9505.0170 to 9505.0475.  
186.14     (e) "Personal care assistant" means a person who:  (1) is 
186.15  at least 18 years old, except for persons 16 to 18 years of age 
186.16  who participated in a related school-based job training program 
186.17  or have completed a certified home health aide competency 
186.18  evaluation; (2) is able to effectively communicate with the 
186.19  recipient and personal care provider organization; (3) effective 
186.20  July 1, 1996, has completed one of the training requirements as 
186.21  specified in Minnesota Rules, part 9505.0335, subpart 3, items A 
186.22  to D; (4) has the ability to, and provides covered personal care 
186.23  services according to the recipient's care plan, responds 
186.24  appropriately to recipient needs, and reports changes in the 
186.25  recipient's condition to the supervising registered nurse 
186.26  qualified professional; (5) is not a consumer of personal care 
186.27  services; and (6) is subject to criminal background checks and 
186.28  procedures specified in section 245A.04.  An individual who has 
186.29  been convicted of a crime specified in Minnesota Rules, part 
186.30  4668.0020, subpart 14, or a comparable crime in another 
186.31  jurisdiction is disqualified from being a personal care 
186.32  assistant, unless the individual meets the rehabilitation 
186.33  criteria specified in Minnesota Rules, part 4668.0020, subpart 
186.34  15. 
186.35     (f) "Personal care provider organization" means an 
186.36  organization enrolled to provide personal care services under 
187.1   the medical assistance program that complies with the 
187.2   following:  (1) owners who have a five percent interest or more, 
187.3   and managerial officials are subject to a background study as 
187.4   provided in section 245A.04.  This applies to currently enrolled 
187.5   personal care provider organizations and those agencies seeking 
187.6   enrollment as a personal care provider organization.  An 
187.7   organization will be barred from enrollment if an owner or 
187.8   managerial official of the organization has been convicted of a 
187.9   crime specified in section 245A.04, or a comparable crime in 
187.10  another jurisdiction, unless the owner or managerial official 
187.11  meets the reconsideration criteria specified in section 245A.04; 
187.12  (2) the organization must maintain a surety bond and liability 
187.13  insurance throughout the duration of enrollment and provides 
187.14  proof thereof.  The insurer must notify the department of human 
187.15  services of the cancellation or lapse of policy; and (3) the 
187.16  organization must maintain documentation of services as 
187.17  specified in Minnesota Rules, part 9505.2175, subpart 7, as well 
187.18  as evidence of compliance with personal care assistant training 
187.19  requirements. 
187.20     (g) "Responsible party" means an individual residing with a 
187.21  recipient of personal care services who is capable of providing 
187.22  the supportive care necessary to assist the recipient to live in 
187.23  the community, is at least 18 years old, and is not a personal 
187.24  care assistant.  Responsible parties who are parents of minors 
187.25  or guardians of minors or incapacitated persons may delegate the 
187.26  responsibility to another adult during a temporary absence of at 
187.27  least 24 hours but not more than six months.  The person 
187.28  delegated as a responsible party must be able to meet the 
187.29  definition of responsible party, except that the delegated 
187.30  responsible party is required to reside with the recipient only 
187.31  while serving as the responsible party.  Foster care license 
187.32  holders may be designated the responsible party for residents of 
187.33  the foster care home if case management is provided as required 
187.34  in section 256B.0625, subdivision 19a.  For persons who, as of 
187.35  April 1, 1992, are sharing personal care services in order to 
187.36  obtain the availability of 24-hour coverage, an employee of the 
188.1   personal care provider organization may be designated as the 
188.2   responsible party if case management is provided as required in 
188.3   section 256B.0625, subdivision 19a. 
188.4      (h) "Service plan" means a written description of the 
188.5   services needed based on the assessment developed by the nurse 
188.6   who conducts the assessment together with the recipient or 
188.7   responsible party.  The service plan shall include a description 
188.8   of the covered home care services, frequency and duration of 
188.9   services, and expected outcomes and goals.  The recipient and 
188.10  the provider chosen by the recipient or responsible party must 
188.11  be given a copy of the completed service plan within 30 calendar 
188.12  days of the request for home care services by the recipient or 
188.13  responsible party. 
188.14     (i) "Skilled nurse visits" are provided in a recipient's 
188.15  residence under a plan of care or service plan that specifies a 
188.16  level of care which the nurse is qualified to provide.  These 
188.17  services are: 
188.18     (1) nursing services according to the written plan of care 
188.19  or service plan and accepted standards of medical and nursing 
188.20  practice in accordance with chapter 148; 
188.21     (2) services which due to the recipient's medical condition 
188.22  may only be safely and effectively provided by a registered 
188.23  nurse or a licensed practical nurse; 
188.24     (3) assessments performed only by a registered nurse; and 
188.25     (4) teaching and training the recipient, the recipient's 
188.26  family, or other caregivers requiring the skills of a registered 
188.27  nurse or licensed practical nurse.  
188.28     Sec. 59.  Minnesota Statutes 1998, section 256B.0627, 
188.29  subdivision 2, is amended to read: 
188.30     Subd. 2.  [SERVICES COVERED.] Home care services covered 
188.31  under this section include:  
188.32     (1) nursing services under section 256B.0625, subdivision 
188.33  6a; 
188.34     (2) private duty nursing services under section 256B.0625, 
188.35  subdivision 7; 
188.36     (3) home health aide services under section 256B.0625, 
189.1   subdivision 6a; 
189.2      (4) personal care services under section 256B.0625, 
189.3   subdivision 19a; 
189.4      (5) nursing supervision of personal care assistant services 
189.5   provided by a qualified professional under section 256B.0625, 
189.6   subdivision 19a; and 
189.7      (6) consulting professional of personal care assistant 
189.8   services under the fiscal agent option as specified in 
189.9   subdivision 10; 
189.10     (7) face-to-face assessments by county public health nurses 
189.11  for services under section 256B.0625, subdivision 19a; and 
189.12     (8) service updates and review of temporary increases for 
189.13  personal care assistant services by the county public health 
189.14  nurse for services under section 256B.0625, subdivision 19a. 
189.15     Sec. 60.  Minnesota Statutes 1998, section 256B.0627, 
189.16  subdivision 4, is amended to read: 
189.17     Subd. 4.  [PERSONAL CARE SERVICES.] (a) The personal care 
189.18  services that are eligible for payment are the following:  
189.19     (1) bowel and bladder care; 
189.20     (2) skin care to maintain the health of the skin; 
189.21     (3) repetitive maintenance range of motion, muscle 
189.22  strengthening exercises, and other tasks specific to maintaining 
189.23  a recipient's optimal level of function; 
189.24     (4) respiratory assistance; 
189.25     (5) transfers and ambulation; 
189.26     (6) bathing, grooming, and hairwashing necessary for 
189.27  personal hygiene; 
189.28     (7) turning and positioning; 
189.29     (8) assistance with furnishing medication that is 
189.30  self-administered; 
189.31     (9) application and maintenance of prosthetics and 
189.32  orthotics; 
189.33     (10) cleaning medical equipment; 
189.34     (11) dressing or undressing; 
189.35     (12) assistance with eating and meal preparation and 
189.36  necessary grocery shopping; 
190.1      (13) accompanying a recipient to obtain medical diagnosis 
190.2   or treatment; 
190.3      (14) assisting, monitoring, or prompting the recipient to 
190.4   complete the services in clauses (1) to (13); 
190.5      (15) redirection, monitoring, and observation that are 
190.6   medically necessary and an integral part of completing the 
190.7   personal care services described in clauses (1) to (14); 
190.8      (16) redirection and intervention for behavior, including 
190.9   observation and monitoring; 
190.10     (17) interventions for seizure disorders, including 
190.11  monitoring and observation if the recipient has had a seizure 
190.12  that requires intervention within the past three months; 
190.13     (18) tracheostomy suctioning using a clean procedure if the 
190.14  procedure is properly delegated by a registered nurse.  Before 
190.15  this procedure can be delegated to a personal care assistant, a 
190.16  registered nurse must determine that the tracheostomy suctioning 
190.17  can be accomplished utilizing a clean rather than a sterile 
190.18  procedure and must ensure that the personal care assistant has 
190.19  been taught the proper procedure; and 
190.20     (19) incidental household services that are an integral 
190.21  part of a personal care service described in clauses (1) to (18).
190.22  For purposes of this subdivision, monitoring and observation 
190.23  means watching for outward visible signs that are likely to 
190.24  occur and for which there is a covered personal care service or 
190.25  an appropriate personal care intervention.  For purposes of this 
190.26  subdivision, a clean procedure refers to a procedure that 
190.27  reduces the numbers of microorganisms or prevents or reduces the 
190.28  transmission of microorganisms from one person or place to 
190.29  another.  A clean procedure may be used beginning 14 days after 
190.30  insertion. 
190.31     (b) The personal care services that are not eligible for 
190.32  payment are the following:  
190.33     (1) services not ordered by the physician; 
190.34     (2) assessments by personal care provider organizations or 
190.35  by independently enrolled registered nurses; 
190.36     (3) services that are not in the service plan; 
191.1      (4) services provided by the recipient's spouse, legal 
191.2   guardian for an adult or child recipient, or parent of a 
191.3   recipient under age 18; 
191.4      (5) services provided by a foster care provider of a 
191.5   recipient who cannot direct the recipient's own care, unless 
191.6   monitored by a county or state case manager under section 
191.7   256B.0625, subdivision 19a; 
191.8      (6) services provided by the residential or program license 
191.9   holder in a residence for more than four persons; 
191.10     (7) services that are the responsibility of a residential 
191.11  or program license holder under the terms of a service agreement 
191.12  and administrative rules; 
191.13     (8) sterile procedures; 
191.14     (9) injections of fluids into veins, muscles, or skin; 
191.15     (10) services provided by parents of adult recipients, 
191.16  adult children, or adult siblings of the recipient, unless these 
191.17  relatives meet one of the following hardship criteria and the 
191.18  commissioner waives this requirement: 
191.19     (i) the relative resigns from a part-time or full-time job 
191.20  to provide personal care for the recipient; 
191.21     (ii) the relative goes from a full-time to a part-time job 
191.22  with less compensation to provide personal care for the 
191.23  recipient; 
191.24     (iii) the relative takes a leave of absence without pay to 
191.25  provide personal care for the recipient; 
191.26     (iv) the relative incurs substantial expenses by providing 
191.27  personal care for the recipient; or 
191.28     (v) because of labor conditions, special language needs, or 
191.29  intermittent hours of care needed, the relative is needed in 
191.30  order to provide an adequate number of qualified personal care 
191.31  assistants to meet the medical needs of the recipient; 
191.32     (11) homemaker services that are not an integral part of a 
191.33  personal care services; 
191.34     (12) home maintenance, or chore services; 
191.35     (13) services not specified under paragraph (a); and 
191.36     (14) services not authorized by the commissioner or the 
192.1   commissioner's designee. 
192.2      Sec. 61.  Minnesota Statutes 1998, section 256B.0627, 
192.3   subdivision 5, is amended to read: 
192.4      Subd. 5.  [LIMITATION ON PAYMENTS.] Medical assistance 
192.5   payments for home care services shall be limited according to 
192.6   this subdivision.  
192.7      (a)  [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 
192.8   recipient may receive the following home care services during a 
192.9   calendar year: 
192.10     (1) any initial assessment up to two face-to-face 
192.11  assessments to determine a recipient's need for personal care 
192.12  assistant services; 
192.13     (2) up to two reassessments per year one service update 
192.14  done to determine a recipient's need for personal care services; 
192.15  and 
192.16     (3) up to five skilled nurse visits.  
192.17     (b)  [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 
192.18  services above the limits in paragraph (a) must receive the 
192.19  commissioner's prior authorization, except when: 
192.20     (1) the home care services were required to treat an 
192.21  emergency medical condition that if not immediately treated 
192.22  could cause a recipient serious physical or mental disability, 
192.23  continuation of severe pain, or death.  The provider must 
192.24  request retroactive authorization no later than five working 
192.25  days after giving the initial service.  The provider must be 
192.26  able to substantiate the emergency by documentation such as 
192.27  reports, notes, and admission or discharge histories; 
192.28     (2) the home care services were provided on or after the 
192.29  date on which the recipient's eligibility began, but before the 
192.30  date on which the recipient was notified that the case was 
192.31  opened.  Authorization will be considered if the request is 
192.32  submitted by the provider within 20 working days of the date the 
192.33  recipient was notified that the case was opened; 
192.34     (3) a third-party payor for home care services has denied 
192.35  or adjusted a payment.  Authorization requests must be submitted 
192.36  by the provider within 20 working days of the notice of denial 
193.1   or adjustment.  A copy of the notice must be included with the 
193.2   request; 
193.3      (4) the commissioner has determined that a county or state 
193.4   human services agency has made an error; or 
193.5      (5) the professional nurse determines an immediate need for 
193.6   up to 40 skilled nursing or home health aide visits per calendar 
193.7   year and submits a request for authorization within 20 working 
193.8   days of the initial service date, and medical assistance is 
193.9   determined to be the appropriate payer. 
193.10     (c)  [RETROACTIVE AUTHORIZATION.] A request for retroactive 
193.11  authorization will be evaluated according to the same criteria 
193.12  applied to prior authorization requests.  
193.13     (d)  [ASSESSMENT AND SERVICE PLAN.] Assessments under 
193.14  section 256B.0627, subdivision 1, paragraph (a), shall be 
193.15  conducted initially, and at least annually thereafter, in person 
193.16  with the recipient and result in a completed service plan using 
193.17  forms specified by the commissioner.  Within 30 days of 
193.18  recipient or responsible party request for home care services, 
193.19  the assessment, the service plan, and other information 
193.20  necessary to determine medical necessity such as diagnostic or 
193.21  testing information, social or medical histories, and hospital 
193.22  or facility discharge summaries shall be submitted to the 
193.23  commissioner.  For personal care services: 
193.24     (1) The amount and type of service authorized based upon 
193.25  the assessment and service plan will follow the recipient if the 
193.26  recipient chooses to change providers.  
193.27     (2) If the recipient's medical need changes, the 
193.28  recipient's provider may assess the need for a change in service 
193.29  authorization and request the change from the county public 
193.30  health nurse.  Within 30 days of the request, the public health 
193.31  nurse will determine whether to request the change in services 
193.32  based upon the provider assessment, or conduct a home visit to 
193.33  assess the need and determine whether the change is appropriate. 
193.34     (3) To continue to receive personal care services after the 
193.35  first year, the recipient or the responsible party, in 
193.36  conjunction with the public health nurse, may complete a service 
194.1   update on forms developed by the commissioner according to 
194.2   criteria and procedures in subdivision 1.  The service update 
194.3   may substitute for the annual reassessment described in 
194.4   subdivision 1. 
194.5      (e)  [PRIOR AUTHORIZATION.] The commissioner, or the 
194.6   commissioner's designee, shall review the assessment, the 
194.7   service update, request for temporary services, service plan, 
194.8   and any additional information that is submitted.  The 
194.9   commissioner shall, within 30 days after receiving a complete 
194.10  request, assessment, and service plan, authorize home care 
194.11  services as follows:  
194.12     (1)  [HOME HEALTH SERVICES.] All home health services 
194.13  provided by a licensed nurse or a home health aide must be prior 
194.14  authorized by the commissioner or the commissioner's designee.  
194.15  Prior authorization must be based on medical necessity and 
194.16  cost-effectiveness when compared with other care options.  When 
194.17  home health services are used in combination with personal care 
194.18  and private duty nursing, the cost of all home care services 
194.19  shall be considered for cost-effectiveness.  The commissioner 
194.20  shall limit nurse and home health aide visits to no more than 
194.21  one visit each per day. 
194.22     (2)  [PERSONAL CARE SERVICES.] (i) All personal care 
194.23  services and registered nurse supervision by a qualified 
194.24  professional must be prior authorized by the commissioner or the 
194.25  commissioner's designee except for the assessments established 
194.26  in paragraph (a).  The amount of personal care services 
194.27  authorized must be based on the recipient's home care rating.  A 
194.28  child may not be found to be dependent in an activity of daily 
194.29  living if because of the child's age an adult would either 
194.30  perform the activity for the child or assist the child with the 
194.31  activity and the amount of assistance needed is similar to the 
194.32  assistance appropriate for a typical child of the same age.  
194.33  Based on medical necessity, the commissioner may authorize: 
194.34     (A) up to two times the average number of direct care hours 
194.35  provided in nursing facilities for the recipient's comparable 
194.36  case mix level; or 
195.1      (B) up to three times the average number of direct care 
195.2   hours provided in nursing facilities for recipients who have 
195.3   complex medical needs or are dependent in at least seven 
195.4   activities of daily living and need physical assistance with 
195.5   eating or have a neurological diagnosis; or 
195.6      (C) up to 60 percent of the average reimbursement rate, as 
195.7   of July 1, 1991, for care provided in a regional treatment 
195.8   center for recipients who have Level I behavior, plus any 
195.9   inflation adjustment as provided by the legislature for personal 
195.10  care service; or 
195.11     (D) up to the amount the commissioner would pay, as of July 
195.12  1, 1991, plus any inflation adjustment provided for home care 
195.13  services, for care provided in a regional treatment center for 
195.14  recipients referred to the commissioner by a regional treatment 
195.15  center preadmission evaluation team.  For purposes of this 
195.16  clause, home care services means all services provided in the 
195.17  home or community that would be included in the payment to a 
195.18  regional treatment center; or 
195.19     (E) up to the amount medical assistance would reimburse for 
195.20  facility care for recipients referred to the commissioner by a 
195.21  preadmission screening team established under section 256B.0911 
195.22  or 256B.092; and 
195.23     (F) a reasonable amount of time for the provision of 
195.24  nursing supervision by a qualified professional of personal care 
195.25  services.  
195.26     (ii) The number of direct care hours shall be determined 
195.27  according to the annual cost report submitted to the department 
195.28  by nursing facilities.  The average number of direct care hours, 
195.29  as established by May 1, 1992, shall be calculated and 
195.30  incorporated into the home care limits on July 1, 1992.  These 
195.31  limits shall be calculated to the nearest quarter hour. 
195.32     (iii) The home care rating shall be determined by the 
195.33  commissioner or the commissioner's designee based on information 
195.34  submitted to the commissioner by the county public health nurse 
195.35  on forms specified by the commissioner.  The home care rating 
195.36  shall be a combination of current assessment tools developed 
196.1   under sections 256B.0911 and 256B.501 with an addition for 
196.2   seizure activity that will assess the frequency and severity of 
196.3   seizure activity and with adjustments, additions, and 
196.4   clarifications that are necessary to reflect the needs and 
196.5   conditions of recipients who need home care including children 
196.6   and adults under 65 years of age.  The commissioner shall 
196.7   establish these forms and protocols under this section and shall 
196.8   use an advisory group, including representatives of recipients, 
196.9   providers, and counties, for consultation in establishing and 
196.10  revising the forms and protocols. 
196.11     (iv) A recipient shall qualify as having complex medical 
196.12  needs if the care required is difficult to perform and because 
196.13  of recipient's medical condition requires more time than 
196.14  community-based standards allow or requires more skill than 
196.15  would ordinarily be required and the recipient needs or has one 
196.16  or more of the following: 
196.17     (A) daily tube feedings; 
196.18     (B) daily parenteral therapy; 
196.19     (C) wound or decubiti care; 
196.20     (D) postural drainage, percussion, nebulizer treatments, 
196.21  suctioning, tracheotomy care, oxygen, mechanical ventilation; 
196.22     (E) catheterization; 
196.23     (F) ostomy care; 
196.24     (G) quadriplegia; or 
196.25     (H) other comparable medical conditions or treatments the 
196.26  commissioner determines would otherwise require institutional 
196.27  care.  
196.28     (v) A recipient shall qualify as having Level I behavior if 
196.29  there is reasonable supporting evidence that the recipient 
196.30  exhibits, or that without supervision, observation, or 
196.31  redirection would exhibit, one or more of the following 
196.32  behaviors that cause, or have the potential to cause: 
196.33     (A) injury to the recipient's own body; 
196.34     (B) physical injury to other people; or 
196.35     (C) destruction of property. 
196.36     (vi) Time authorized for personal care relating to Level I 
197.1   behavior in subclause (v), items (A) to (C), shall be based on 
197.2   the predictability, frequency, and amount of intervention 
197.3   required. 
197.4      (vii) A recipient shall qualify as having Level II behavior 
197.5   if the recipient exhibits on a daily basis one or more of the 
197.6   following behaviors that interfere with the completion of 
197.7   personal care services under subdivision 4, paragraph (a): 
197.8      (A) unusual or repetitive habits; 
197.9      (B) withdrawn behavior; or 
197.10     (C) offensive behavior. 
197.11     (viii) A recipient with a home care rating of Level II 
197.12  behavior in subclause (vii), items (A) to (C), shall be rated as 
197.13  comparable to a recipient with complex medical needs under 
197.14  subclause (iv).  If a recipient has both complex medical needs 
197.15  and Level II behavior, the home care rating shall be the next 
197.16  complex category up to the maximum rating under subclause (i), 
197.17  item (B). 
197.18     (3)  [PRIVATE DUTY NURSING SERVICES.] All private duty 
197.19  nursing services shall be prior authorized by the commissioner 
197.20  or the commissioner's designee.  Prior authorization for private 
197.21  duty nursing services shall be based on medical necessity and 
197.22  cost-effectiveness when compared with alternative care options.  
197.23  The commissioner may authorize medically necessary private duty 
197.24  nursing services in quarter-hour units when: 
197.25     (i) the recipient requires more individual and continuous 
197.26  care than can be provided during a nurse visit; or 
197.27     (ii) the cares are outside of the scope of services that 
197.28  can be provided by a home health aide or personal care assistant.
197.29     The commissioner may authorize: 
197.30     (A) up to two times the average amount of direct care hours 
197.31  provided in nursing facilities statewide for case mix 
197.32  classification "K" as established by the annual cost report 
197.33  submitted to the department by nursing facilities in May 1992; 
197.34     (B) private duty nursing in combination with other home 
197.35  care services up to the total cost allowed under clause (2); 
197.36     (C) up to 16 hours per day if the recipient requires more 
198.1   nursing than the maximum number of direct care hours as 
198.2   established in item (A) and the recipient meets the hospital 
198.3   admission criteria established under Minnesota Rules, parts 
198.4   9505.0500 to 9505.0540.  
198.5      The commissioner may authorize up to 16 hours per day of 
198.6   medically necessary private duty nursing services or up to 24 
198.7   hours per day of medically necessary private duty nursing 
198.8   services until such time as the commissioner is able to make a 
198.9   determination of eligibility for recipients who are 
198.10  cooperatively applying for home care services under the 
198.11  community alternative care program developed under section 
198.12  256B.49, or until it is determined by the appropriate regulatory 
198.13  agency that a health benefit plan is or is not required to pay 
198.14  for appropriate medically necessary health care services.  
198.15  Recipients or their representatives must cooperatively assist 
198.16  the commissioner in obtaining this determination.  Recipients 
198.17  who are eligible for the community alternative care program may 
198.18  not receive more hours of nursing under this section than would 
198.19  otherwise be authorized under section 256B.49. 
198.20     (4)  [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 
198.21  ventilator-dependent, the monthly medical assistance 
198.22  authorization for home care services shall not exceed what the 
198.23  commissioner would pay for care at the highest cost hospital 
198.24  designated as a long-term hospital under the Medicare program.  
198.25  For purposes of this clause, home care services means all 
198.26  services provided in the home that would be included in the 
198.27  payment for care at the long-term hospital.  
198.28  "Ventilator-dependent" means an individual who receives 
198.29  mechanical ventilation for life support at least six hours per 
198.30  day and is expected to be or has been dependent for at least 30 
198.31  consecutive days.  
198.32     (f)  [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 
198.33  or the commissioner's designee shall determine the time period 
198.34  for which a prior authorization shall be effective.  If the 
198.35  recipient continues to require home care services beyond the 
198.36  duration of the prior authorization, the home care provider must 
199.1   request a new prior authorization.  Under no circumstances, 
199.2   other than the exceptions in paragraph (b), shall a prior 
199.3   authorization be valid prior to the date the commissioner 
199.4   receives the request or for more than 12 months.  A recipient 
199.5   who appeals a reduction in previously authorized home care 
199.6   services may continue previously authorized services, other than 
199.7   temporary services under paragraph (h), pending an appeal under 
199.8   section 256.045.  The commissioner must provide a detailed 
199.9   explanation of why the authorized services are reduced in amount 
199.10  from those requested by the home care provider.  
199.11     (g)  [APPROVAL OF HOME CARE SERVICES.] The commissioner or 
199.12  the commissioner's designee shall determine the medical 
199.13  necessity of home care services, the level of caregiver 
199.14  according to subdivision 2, and the institutional comparison 
199.15  according to this subdivision, the cost-effectiveness of 
199.16  services, and the amount, scope, and duration of home care 
199.17  services reimbursable by medical assistance, based on the 
199.18  assessment, primary payer coverage determination information as 
199.19  required, the service plan, the recipient's age, the cost of 
199.20  services, the recipient's medical condition, and diagnosis or 
199.21  disability.  The commissioner may publish additional criteria 
199.22  for determining medical necessity according to section 256B.04. 
199.23     (h)  [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 
199.24  The agency nurse, the independently enrolled private duty nurse, 
199.25  or county public health nurse may request a temporary 
199.26  authorization for home care services by telephone.  The 
199.27  commissioner may approve a temporary level of home care services 
199.28  based on the assessment, and service or care plan information, 
199.29  and primary payer coverage determination information as required.
199.30  Authorization for a temporary level of home care services 
199.31  including nurse supervision is limited to the time specified by 
199.32  the commissioner, but shall not exceed 45 days, unless extended 
199.33  because the county public health nurse has not completed the 
199.34  required assessment and service plan, or the commissioner's 
199.35  determination has not been made.  The level of services 
199.36  authorized under this provision shall have no bearing on a 
200.1   future prior authorization. 
200.2      (i)  [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 
200.3   Home care services provided in an adult or child foster care 
200.4   setting must receive prior authorization by the department 
200.5   according to the limits established in paragraph (a). 
200.6      The commissioner may not authorize: 
200.7      (1) home care services that are the responsibility of the 
200.8   foster care provider under the terms of the foster care 
200.9   placement agreement and administrative rules.  Requests for home 
200.10  care services for recipients residing in a foster care setting 
200.11  must include the foster care placement agreement and 
200.12  determination of difficulty of care; 
200.13     (2) personal care services when the foster care license 
200.14  holder is also the personal care provider or personal care 
200.15  assistant unless the recipient can direct the recipient's own 
200.16  care, or case management is provided as required in section 
200.17  256B.0625, subdivision 19a; 
200.18     (3) personal care services when the responsible party is an 
200.19  employee of, or under contract with, or has any direct or 
200.20  indirect financial relationship with the personal care provider 
200.21  or personal care assistant, unless case management is provided 
200.22  as required in section 256B.0625, subdivision 19a; 
200.23     (4) home care services when the number of foster care 
200.24  residents is greater than four unless the county responsible for 
200.25  the recipient's foster placement made the placement prior to 
200.26  April 1, 1992, requests that home care services be provided, and 
200.27  case management is provided as required in section 256B.0625, 
200.28  subdivision 19a; or 
200.29     (5) home care services when combined with foster care 
200.30  payments, other than room and board payments that exceed the 
200.31  total amount that public funds would pay for the recipient's 
200.32  care in a medical institution. 
200.33     Sec. 62.  Minnesota Statutes 1998, section 256B.0627, 
200.34  subdivision 8, is amended to read: 
200.35     Subd. 8.  [SHARED PERSONAL CARE ASSISTANT SERVICES; SHARED 
200.36  CARE.] (a) Medical assistance payments for shared personal care 
201.1   assistance shared care services shall be limited according to 
201.2   this subdivision. 
201.3      (b) Recipients of personal care assistant services may 
201.4   share staff and the commissioner shall provide a rate system for 
201.5   shared personal care assistant services.  For two persons 
201.6   sharing care services, the rate paid to a provider shall not 
201.7   exceed 1-1/2 times the rate paid for serving a single 
201.8   individual, and for three persons sharing care services, the 
201.9   rate paid to a provider shall not exceed twice the rate paid for 
201.10  serving a single individual.  These rates apply only to 
201.11  situations in which all recipients were present and received 
201.12  shared care services on the date for which the service is 
201.13  billed.  No more than three persons may receive shared care 
201.14  services from a personal care assistant in a single setting. 
201.15     (c) Shared care service is the provision of personal care 
201.16  services by a personal care assistant to two or three recipients 
201.17  at the same time and in the same setting.  For the purposes of 
201.18  this subdivision, "setting" means: 
201.19     (1) the home or foster care home of one of the individual 
201.20  recipients; or 
201.21     (2) a child care program in which all recipients served by 
201.22  one personal care assistant are participating, which is licensed 
201.23  under chapter 245A or operated by a local school district or 
201.24  private school.  
201.25     The provisions of this subdivision do not apply when a 
201.26  personal care assistant is caring for multiple recipients in 
201.27  more than one setting. 
201.28     (d) The recipient or the recipient's responsible party, in 
201.29  conjunction with the county public health nurse, shall determine:
201.30     (1) whether shared care personal care assistant services is 
201.31  an appropriate option based on the individual needs and 
201.32  preferences of the recipient; and 
201.33     (2) the amount of shared care services allocated as part of 
201.34  the overall authorization of personal care services. 
201.35     The recipient or the responsible party, in conjunction with 
201.36  the supervising registered nurse qualified professional, shall 
202.1   approve arrange the setting, and grouping, and arrangement of 
202.2   shared care services based on the individual needs and 
202.3   preferences of the recipients.  Decisions on the selection of 
202.4   recipients to share care services must be based on the ages of 
202.5   the recipients, compatibility, and coordination of their care 
202.6   needs. 
202.7      (e) The following items must be considered by the recipient 
202.8   or the responsible party and the supervising nurse qualified 
202.9   professional, and documented in the recipient's care plan health 
202.10  service record: 
202.11     (1) the additional qualifications needed by the personal 
202.12  care assistant to provide care to several recipients in the same 
202.13  setting; 
202.14     (2) the additional training and supervision needed by the 
202.15  personal care assistant to ensure that the needs of the 
202.16  recipient are met appropriately and safely.  The provider must 
202.17  provide on-site supervision by a registered nurse qualified 
202.18  professional within the first 14 days of shared care services, 
202.19  and monthly thereafter; 
202.20     (3) the setting in which the shared care services will be 
202.21  provided; 
202.22     (4) the ongoing monitoring and evaluation of the 
202.23  effectiveness and appropriateness of the service and process 
202.24  used to make changes in service or setting; and 
202.25     (5) a contingency plan which accounts for absence of the 
202.26  recipient in a shared care services setting due to illness or 
202.27  other circumstances and staffing contingencies. 
202.28     (f) The provider must offer the recipient or the 
202.29  responsible party the option of shared or individual one-on-one 
202.30  personal care assistant care services.  The recipient or the 
202.31  responsible party can withdraw from participating in a shared 
202.32  care services arrangement at any time. 
202.33     (g) In addition to documentation requirements under 
202.34  Minnesota Rules, part 9505.2175, a personal care provider must 
202.35  meet documentation requirements for shared personal 
202.36  care assistant services and must document the following in the 
203.1   health service record for each individual recipient sharing care 
203.2   services: 
203.3      (1) authorization permission by the recipient or the 
203.4   recipient's responsible party, if any, for the maximum number of 
203.5   shared care services hours per week chosen by the recipient; 
203.6      (2) authorization permission by the recipient or the 
203.7   recipient's responsible party, if any, for personal 
203.8   care assistant services provided outside the recipient's 
203.9   residence; 
203.10     (3) authorization permission by the recipient or the 
203.11  recipient's responsible party, if any, for others to receive 
203.12  shared care services in the recipient's residence; 
203.13     (4) revocation by the recipient or the recipient's 
203.14  responsible party, if any, of the shared care service 
203.15  authorization, or the shared care service to be provided to 
203.16  others in the recipient's residence, or the shared care service 
203.17  to be provided outside the recipient's residence; 
203.18     (5) supervision of the shared care personal care assistant 
203.19  services by the supervisory nurse qualified professional, 
203.20  including the date, time of day, number of hours spent 
203.21  supervising the provision of shared care services, whether the 
203.22  supervision was face-to-face or another method of supervision, 
203.23  changes in the recipient's condition, shared care services 
203.24  scheduling issues and recommendations; 
203.25     (6) documentation by the personal care assistant qualified 
203.26  professional of telephone calls or other discussions with 
203.27  the supervisory nurse personal care assistant regarding services 
203.28  being provided to the recipient; and 
203.29     (7) daily documentation of the shared care services 
203.30  provided by each identified personal care assistant including: 
203.31     (i) the names of each recipient receiving shared care 
203.32  services together; 
203.33     (ii) the setting for the day's care shared services, 
203.34  including the starting and ending times that the recipient 
203.35  received shared care services; and 
203.36     (iii) notes by the personal care assistant regarding 
204.1   changes in the recipient's condition, problems that may arise 
204.2   from the sharing of care services, scheduling issues, care 
204.3   issues, and other notes as required by the supervising nurse 
204.4   qualified professional. 
204.5      (h) Unless otherwise provided in this subdivision, all 
204.6   other statutory and regulatory provisions relating to personal 
204.7   care services apply to shared care services. 
204.8      Nothing in this subdivision shall be construed to reduce 
204.9   the total number of hours authorized for an individual recipient.
204.10     Sec. 63.  Minnesota Statutes 1998, section 256B.0627, is 
204.11  amended by adding a subdivision to read: 
204.12     Subd. 9.  [FLEXIBLE USE OF PERSONAL CARE ASSISTANT 
204.13  HOURS.] (a) The commissioner may allow for the flexible use of 
204.14  personal care assistant hours.  "Flexible use" means the 
204.15  scheduled use of authorized hours of personal care assistant 
204.16  services, which vary within the length of the service 
204.17  authorization in order to more effectively meet the needs and 
204.18  schedule of the recipient.  Recipients may use their approved 
204.19  hours flexibly within the service authorization period for 
204.20  medically necessary covered services specified in the assessment 
204.21  required in subdivision 1.  The flexible use of authorized hours 
204.22  does not increase the total amount of authorized hours available 
204.23  to a recipient as determined under subdivision 5.  The 
204.24  commissioner shall not authorize additional personal care 
204.25  assistant services to supplement a service authorization that is 
204.26  exhausted before the end date under a flexible service use plan, 
204.27  unless the county public health nurse determines a change in 
204.28  condition and a need for increased services is established. 
204.29     (b) The recipient or responsible party, together with the 
204.30  county public health nurse, shall determine whether flexible use 
204.31  is an appropriate option based on the needs and preferences of 
204.32  the recipient or responsible party, and, if appropriate, must 
204.33  ensure that the allocation of hours covers the ongoing needs of 
204.34  the recipient over the entire service authorization period.  As 
204.35  part of the assessment and service planning process, the 
204.36  recipient or responsible party must work with the county public 
205.1   health nurse to develop a written month-to-month plan of the 
205.2   projected use of personal care assistant services that is part 
205.3   of the service plan and ensures that the: 
205.4      (1) health and safety needs of the recipient will be met; 
205.5      (2) total annual authorization will not exceed before the 
205.6   end date; and 
205.7      (3) how actual use of hours will be monitored.  
205.8      (c) If the actual use of personal care assistant service 
205.9   varies significantly from the use projected in the plan, the 
205.10  written plan must be promptly updated by the recipient or 
205.11  responsible party and the county public health nurse. 
205.12     (d) The recipient or responsible party, together with the 
205.13  provider, must work to monitor and document the use of 
205.14  authorized hours and ensure that a recipient is able to manage 
205.15  services effectively throughout the authorized period.  The 
205.16  provider must ensure that the month-to-month plan is 
205.17  incorporated into the care plan.  Upon request of the recipient 
205.18  or responsible party, the provider must furnish regular updates 
205.19  to the recipient or responsible party on the amount of personal 
205.20  care assistant services used.  
205.21     (e) The recipient or responsible party can revoke the 
205.22  authorization for flexible use of hours by notifying the 
205.23  provider and county public health nurse in writing. 
205.24     (f) If the requirements in paragraphs (a) to (e) have not 
205.25  substantially been met, the commissioner shall deny, revoke, or 
205.26  suspend the authorization to use authorized hours flexibly.  The 
205.27  recipient or responsible party may appeal the commissioner's 
205.28  action according to section 256.045.  The denial, revocation, or 
205.29  suspension to use the flexible hours option shall not affect the 
205.30  recipient's authorized level of personal care assistant services 
205.31  as determined under subdivision 5. 
205.32     Sec. 64.  Minnesota Statutes 1998, section 256B.0627, is 
205.33  amended by adding a subdivision to read: 
205.34     Subd. 10.  [FISCAL AGENT OPTION AVAILABLE FOR PERSONAL CARE 
205.35  ASSISTANT SERVICES.] (a) "Fiscal agent option" is an option that 
205.36  allows the recipient to: 
206.1      (1) use a fiscal agent instead of a personal care provider 
206.2   organization; 
206.3      (2) supervise the personal care assistant; and 
206.4      (3) use a consulting professional. 
206.5      The commissioner may allow a recipient of personal care 
206.6   assistant services to use a fiscal agent to assist the recipient 
206.7   in paying and accounting for medically necessary covered 
206.8   personal care assistant services authorized in subdivision 4 and 
206.9   within the payment parameters of subdivision 5, unless otherwise 
206.10  provided in this subdivision, all other statutory and regulatory 
206.11  provisions relating to personal care services apply to a 
206.12  recipient using the fiscal agent option. 
206.13     (b) The recipient or responsible party shall: 
206.14     (1) hire and terminate the personal care assistant and 
206.15  consulting professional with the fiscal agent; 
206.16     (2) recruit the personal care assistant and consulting 
206.17  professional and orient and train the personal care assistant in 
206.18  areas that do not require professional delegation as determined 
206.19  by the county public health nurse; 
206.20     (3) supervise and evaluate the personal care assistant in 
206.21  areas that do not require professional delegation as determined 
206.22  by the county public health nurse; 
206.23     (4) cooperate with a consulting professional and implement 
206.24  recommendations pertaining to the health and safety of the 
206.25  recipient; 
206.26     (5) hire a qualified professional to train and supervise 
206.27  the performance of delegated tasks done by the personal care 
206.28  assistant; 
206.29     (6) monitor services and verify in writing the hours worked 
206.30  by the personal care assistant and the consulting professional; 
206.31     (7) develop and revise a care plan with assistance from a 
206.32  consulting professional; 
206.33     (8) verify and document the credentials of the consulting 
206.34  professional; and 
206.35     (9) enter into a written agreement as specified in 
206.36  paragraph (f). 
207.1      (c) The duties of the fiscal agent shall be to: 
207.2      (1) bill the medical assistance program for personal care 
207.3   assistant and consulting professional services; 
207.4      (2) request and secure background checks on personal care 
207.5   assistants and consulting professionals according to section 
207.6   245A.04; 
207.7      (3) pay the personal care assistant and consulting 
207.8   professional based on actual hours of services provided; 
207.9      (4) withhold and pay all applicable federal and state 
207.10  taxes; 
207.11     (5) verify and document hours worked by the personal care 
207.12  assistant and consulting professional; 
207.13     (6) make the arrangements and pay unemployment insurance, 
207.14  taxes, workers' compensation, liability insurance, and other 
207.15  benefits, if any; 
207.16     (7) enroll in the medical assistance program as a fiscal 
207.17  agent; and 
207.18     (8) enter into a written agreement as specified in 
207.19  paragraph (f) before services are provided. 
207.20     (d) The fiscal agent: 
207.21     (1) may not be related to the recipient, consulting 
207.22  professional, or the personal care assistant; 
207.23     (2) must ensure arm's length transactions with the 
207.24  recipient and personal care assistant; and 
207.25     (3) shall be considered a joint employer of the personal 
207.26  care assistant and consulting professional to the extent 
207.27  specified in this section. 
207.28     The fiscal agent or owners of the entity that provides 
207.29  fiscal agent services under this subdivision must pass a 
207.30  criminal background check as required in section 256B.0627, 
207.31  subdivision 1, paragraph (e). 
207.32     (e) The consulting professional providing assistance to the 
207.33  recipient shall meet the qualifications specified in section 
207.34  256B.0625, subdivision 19c.  The consulting professional shall 
207.35  assist the recipient in developing and revising a plan to meet 
207.36  the recipient's assessed needs and supervise the performance of 
208.1   delegated tasks, as determined by the public health nurse.  In 
208.2   performing this function, the consulting professional must visit 
208.3   the recipient in the recipient's home at least once annually.  
208.4   The consulting professional must report to the local county 
208.5   public health nurse concerns relating to the health and safety 
208.6   of the recipient, and any suspected abuse, neglect, or financial 
208.7   exploitation of the recipient to the appropriate authorities.  
208.8      (f) The fiscal agent, recipient, or responsible party, 
208.9   personal care assistant, and consulting professional shall enter 
208.10  into a written agreement before services are started.  The 
208.11  agreement shall include: 
208.12     (1) the duties of the recipient, consulting professional, 
208.13  personal care assistant, and fiscal agent based on paragraphs 
208.14  (a) to (e); 
208.15     (2) the salary and benefits for the personal care assistant 
208.16  and those providing professional consultation; 
208.17     (3) the administrative fee of the fiscal agent and services 
208.18  paid for with that fee, including background check fees; 
208.19     (4) procedures to respond to billing or payment complaints; 
208.20  and 
208.21     (5) procedures for hiring and terminating the personal care 
208.22  assistant and those providing professional consultation. 
208.23     (g) The rates paid for personal care services and fiscal 
208.24  agency services under this subdivision shall be the same rates 
208.25  paid for personal care services and qualified professional 
208.26  services under subdivision 2 respectively.  Except for the 
208.27  administrative fee of the fiscal agent specified in paragraph 
208.28  (f), the remainder of the rates paid to the fiscal agent must be 
208.29  used to pay for the salary and benefits for the personal care 
208.30  assistant or those providing professional consultation. 
208.31     (h) As part of the assessment defined in subdivision 1, the 
208.32  following conditions must be met to use or continue use of a 
208.33  fiscal agent: 
208.34     (1) the recipient must be able to direct the recipient's 
208.35  own care, or the responsible party for the recipient must be 
208.36  readily available to direct the care of the personal care 
209.1   assistant; 
209.2      (2) the recipient or responsible party must be 
209.3   knowledgeable of the health care needs of the recipient and be 
209.4   able to effectively communicate those needs; 
209.5      (3) a face-to-face assessment must be conducted by the 
209.6   local county public health nurse at least annually or when there 
209.7   is a significant change in the recipient's condition or change 
209.8   in the need for personal care assistant services.  The county 
209.9   public health nurse will determine the services that require 
209.10  professional delegation, if any, and the amount and frequency of 
209.11  related supervision; 
209.12     (4) the recipient cannot select the shared services option 
209.13  as specified in subdivision 8; and 
209.14     (5) parties must be in compliance with the written 
209.15  agreement specified in paragraph (e). 
209.16     (i) The commissioner shall deny, revoke, or suspend the 
209.17  authorization to use the fiscal agent option if: 
209.18     (1) it has been determined by the consulting professional 
209.19  or local county public health nurse that the use of this option 
209.20  jeopardizes the recipient's health and safety; 
209.21     (2) the parties have failed to comply with the written 
209.22  agreement specified in paragraph (e); or 
209.23     (3) the use of the option has led to abusive or fraudulent 
209.24  billing for personal care assistant services.  
209.25     The recipient or responsible party may appeal the 
209.26  commissioner's action according to section 256.045.  The denial, 
209.27  revocation, or suspension to use the fiscal agent option shall 
209.28  not affect the recipient's authorized level of personal care 
209.29  assistant services as determined in subdivision 5. 
209.30     <i>(Effective date:  Section 64 (256B.0627, subd. 10) is</i> 
209.31  <i>effective upon federal approval.)</i> 
209.32     Sec. 65.  Minnesota Statutes 1998, section 256B.0627, is 
209.33  amended by adding a subdivision to read: 
209.34     Subd. 11.  [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 
209.35  Medical assistance payments for shared private duty nursing 
209.36  services by a private duty nurse shall be limited according to 
210.1   this subdivision.  For the purposes of this section, "private 
210.2   duty nursing agency" means an agency licensed under chapter 144A 
210.3   to provide private duty nursing services. 
210.4      (b) Recipients of private duty nursing services may share 
210.5   nursing staff and the commissioner shall provide a rate 
210.6   methodology for shared private duty nursing.  For two persons 
210.7   sharing nursing care, the rate paid to a provider shall not 
210.8   exceed 1.5 times the nonwaivered private duty nursing rates paid 
210.9   for serving a single individual who is not ventilator dependent, 
210.10  by a registered nurse or licensed practical nurse.  These rates 
210.11  apply only to situations in which both recipients are present 
210.12  and receive shared private duty nursing care on the date for 
210.13  which the service is billed.  No more than two persons may 
210.14  receive shared private duty nursing services from a private duty 
210.15  nurse in a single setting. 
210.16     (c) Shared private duty nursing care is the provision of 
210.17  nursing services by a private duty nurse to two recipients at 
210.18  the same time and in the same setting.  For the purposes of this 
210.19  subdivision, "setting" means: 
210.20     (1) the home or foster care home of one of the individual 
210.21  recipients; or 
210.22     (2) a child care program licensed under chapter 245A or 
210.23  operated by a local school district or private school; or 
210.24     (3) an adult day care service licensed under chapter 245A. 
210.25     This subdivision does not apply when a private duty nurse 
210.26  is caring for multiple recipients in more than one setting. 
210.27     (d) The recipient or the recipient's legal representative, 
210.28  and the recipient's physician, in conjunction with the home 
210.29  health care agency, shall determine: 
210.30     (1) whether shared private duty nursing care is an 
210.31  appropriate option based on the individual needs and preferences 
210.32  of the recipient; and 
210.33     (2) the amount of shared private duty nursing services 
210.34  authorized as part of the overall authorization of nursing 
210.35  services. 
210.36     (e) The recipient or the recipient's legal representative, 
211.1   in conjunction with the private duty nursing agency, shall 
211.2   approve the setting, grouping, and arrangement of shared private 
211.3   duty nursing care based on the individual needs and preferences 
211.4   of the recipients.  Decisions on the selection of recipients to 
211.5   share services must be based on the ages of the recipients, 
211.6   compatibility, and coordination of their care needs. 
211.7      (f) The following items must be considered by the recipient 
211.8   or the recipient's legal representative and the private duty 
211.9   nursing agency, and documented in the recipient's health service 
211.10  record: 
211.11     (1) the additional training needed by the private duty 
211.12  nurse to provide care to several recipients in the same setting 
211.13  and to ensure that the needs of the recipients are met 
211.14  appropriately and safely; 
211.15     (2) the setting in which the shared private duty nursing 
211.16  care will be provided; 
211.17     (3) the ongoing monitoring and evaluation of the 
211.18  effectiveness and appropriateness of the service and process 
211.19  used to make changes in service or setting; 
211.20     (4) a contingency plan which accounts for absence of the 
211.21  recipient in a shared private duty nursing setting due to 
211.22  illness or other circumstances; 
211.23     (5) staffing backup contingencies in the event of employee 
211.24  illness or absence; and 
211.25     (6) arrangements for additional assistance to respond to 
211.26  urgent or emergency care needs of the recipients. 
211.27     (g) The provider must offer the recipient or responsible 
211.28  party the option of shared or one-on-one private duty nursing 
211.29  services.  The recipient or responsible party can withdraw from 
211.30  participating in a shared service arrangement at any time. 
211.31     (h) The private duty nursing agency must document the 
211.32  following in the health service record for each individual 
211.33  recipient sharing private duty nursing care: 
211.34     (1) permission by the recipient or the recipient's legal 
211.35  representative for the maximum number of shared nursing care 
211.36  hours per week chosen by the recipient; 
212.1      (2) permission by the recipient or the recipient's legal 
212.2   representative for shared private duty nursing services provided 
212.3   outside the recipient's residence; 
212.4      (3) permission by the recipient or the recipient's legal 
212.5   representative for others to receive shared private duty nursing 
212.6   services in the recipient's residence; 
212.7      (4) revocation by the recipient or the recipient's legal 
212.8   representative of the shared private duty nursing care 
212.9   authorization, or the shared care to be provided to others in 
212.10  the recipient's residence, or the shared private duty nursing 
212.11  services to be provided outside the recipient's residence; and 
212.12     (5) daily documentation of the shared private duty nursing 
212.13  services provided by each identified private duty nurse, 
212.14  including: 
212.15     (i) the names of each recipient receiving shared private 
212.16  duty nursing services together; 
212.17     (ii) the setting for the shared services, including the 
212.18  starting and ending times that the recipient received shared 
212.19  private duty nursing care; and 
212.20     (iii) notes by the private duty nurse regarding changes in 
212.21  the recipient's condition, problems that may arise from the 
212.22  sharing of private duty nursing services, and scheduling and 
212.23  care issues. 
212.24     (i) Unless otherwise provided in this subdivision, all 
212.25  other statutory and regulatory provisions relating to private 
212.26  duty nursing services apply to shared private duty nursing 
212.27  services. 
212.28     Nothing in this subdivision shall be construed to reduce 
212.29  the total number of private duty nursing hours authorized for an 
212.30  individual recipient under subdivision 5. 
212.31     Sec. 66.  Minnesota Statutes 1998, section 256B.0635, 
212.32  subdivision 3, is amended to read: 
212.33     Subd. 3.  [MEDICAL ASSISTANCE FOR MFIP-S PARTICIPANTS WHO 
212.34  OPT TO DISCONTINUE MONTHLY CASH ASSISTANCE.] Upon federal 
212.35  approval, Medical assistance is available to persons who 
212.36  received MFIP-S in at least three of the six months preceding 
213.1   the month in which the person opted opt to discontinue receiving 
213.2   MFIP-S cash assistance under section 256J.31, subdivision 12.  A 
213.3   person who is eligible for medical assistance under this section 
213.4   may receive medical assistance without reapplication as long as 
213.5   the person meets MFIP-S eligibility requirements, unless the 
213.6   assistance unit does not include a dependent child.  Medical 
213.7   assistance may be paid pursuant to subdivisions 1 and 2 for 
213.8   persons who are no longer eligible for MFIP-S due to increased 
213.9   employment or child support.  A person may be eligible for 
213.10  MinnesotaCare due to increased employment or child support, and 
213.11  as such must be informed of the option to transition onto 
213.12  MinnesotaCare. 
213.13     Sec. 67.  Minnesota Statutes 1998, section 256B.064, 
213.14  subdivision 1a, is amended to read: 
213.15     Subd. 1a.  [GROUNDS FOR MONETARY RECOVERY AND SANCTIONS 
213.16  AGAINST VENDORS.] The commissioner may seek monetary recovery 
213.17  and impose sanctions against vendors a vendor of medical care 
213.18  for any of the following:  fraud, theft, or abuse in connection 
213.19  with the provision of medical care to recipients of public 
213.20  assistance; a pattern of presentment of false or duplicate 
213.21  claims or claims for services not medically necessary; a pattern 
213.22  of making false statements of material facts for the purpose of 
213.23  obtaining greater compensation than that to which the vendor is 
213.24  legally entitled; suspension or termination as a Medicare 
213.25  vendor; refusal to grant the state agency access during regular 
213.26  business hours to examine all records necessary to disclose the 
213.27  extent of services provided to program recipients and 
213.28  appropriateness of claims for payment; failure to comply with a 
213.29  commissioner's order to repay an overpayment; failure to comply 
213.30  with a settlement agreement; failure to comply with the 
213.31  disclosure requirements of section 256B.0646; and any reason for 
213.32  which a vendor could be excluded from participation in the 
213.33  Medicare program under section 1128, 1128A, or 1866(b)(2) of the 
213.34  Social Security Act.  The determination of services not 
213.35  medically necessary may be made by the commissioner in 
213.36  consultation with a peer advisory task force appointed by the 
214.1   commissioner on the recommendation of appropriate professional 
214.2   organizations.  The task force expires as provided in section 
214.3   15.059, subdivision 5. 
214.4      Sec. 68.  Minnesota Statutes 1998, section 256B.064, 
214.5   subdivision 1b, is amended to read: 
214.6      Subd. 1b.  [SANCTIONS AVAILABLE.] The commissioner may 
214.7   impose the following sanctions for the conduct described in 
214.8   subdivision 1a:  referral to the appropriate state licensing 
214.9   board, suspension or withholding of payments to a vendor, and 
214.10  suspending or terminating participation in the 
214.11  program.  Regardless of imposition of sanctions, the 
214.12  commissioner may make a referral to the appropriate state 
214.13  licensing board. 
214.14     Sec. 69.  Minnesota Statutes 1998, section 256B.064, 
214.15  subdivision 1c, is amended to read: 
214.16     Subd. 1c.  [GROUNDS FOR AND METHODS OF MONETARY RECOVERY.] 
214.17  The commissioner may obtain monetary recovery from a vendor who 
214.18  has been improperly paid either as a result of conduct described 
214.19  in subdivision 1a or as a result of a vendor or department 
214.20  error, regardless of whether the error was 
214.21  intentional.  Patterns need not be proven as a precondition to 
214.22  monetary recovery of erroneous or false claims, duplicate 
214.23  claims, claims for services not medically necessary, or claims 
214.24  based on false statements.  The commissioner may obtain monetary 
214.25  recovery using methods, including but not limited to the 
214.26  following:  assessing and recovering money improperly paid and 
214.27  debiting from future payments any money improperly 
214.28  paid.  Patterns need not be proven as a precondition to monetary 
214.29  recovery of erroneous or false claims, duplicate claims, claims 
214.30  for services not medically necessary, or claims based on false 
214.31  statements.  The commissioner shall charge interest on money to 
214.32  be recovered if the recovery is to be made by installment 
214.33  payments or debits, except when the monetary recovery is of an 
214.34  overpayment that resulted from a department error.  The interest 
214.35  charged shall be the rate established by the commissioner of 
214.36  revenue under section 270.75.  
215.1      Sec. 70.  Minnesota Statutes 1998, section 256B.064, is 
215.2   amended by adding a subdivision to read: 
215.3      Subd. 1e.  [SANCTIONS AND MONETARY RECOVERY AGAINST RELATED 
215.4   VENDORS.] In a situation where the commissioner is authorized by 
215.5   this section to impose sanctions against or make monetary 
215.6   recovery from a vendor of medical care, the commissioner may 
215.7   also take such action against other vendors that have common 
215.8   control or ownership with the vendor.  A vendor has common 
215.9   control or ownership with another vendor if:  
215.10     (1) one or more persons have a direct or indirect ownership 
215.11  or control interest in both vendors; 
215.12     (2) one vendor has a direct or indirect ownership or 
215.13  control interest in the other vendor; 
215.14     (3) the vendors have interlocking management or ownership; 
215.15  interrelated business interests among family members; or shared 
215.16  facilities, equipment, and use of employees; or 
215.17     (4) one of the vendors is a new business entity created in 
215.18  connection with the termination of the other vendor, and the 
215.19  vendors have the same or similar management, ownership, or 
215.20  principal employees. 
215.21     Sec. 71.  Minnesota Statutes 1998, section 256B.064, 
215.22  subdivision 2, is amended to read: 
215.23     Subd. 2.  [IMPOSITION OF MONETARY RECOVERY AND SANCTIONS.] 
215.24  (a) The commissioner shall determine any monetary amounts to be 
215.25  recovered and the sanction sanctions to be imposed upon a vendor 
215.26  of medical care for conduct described by subdivision 1a under 
215.27  this section.  Except as provided in paragraph (b), neither a 
215.28  monetary recovery nor a sanction will be imposed by the 
215.29  commissioner without prior notice and an opportunity for a 
215.30  hearing, according to chapter 14, on the commissioner's proposed 
215.31  action, provided that the commissioner may suspend or reduce 
215.32  payment to a vendor of medical care, except a nursing home or 
215.33  convalescent care facility, after notice and prior to the 
215.34  hearing if in the commissioner's opinion that action is 
215.35  necessary to protect the public welfare and the interests of the 
215.36  program. 
216.1      (b) Except for a nursing home or convalescent care 
216.2   facility, the commissioner may withhold or reduce payments to a 
216.3   vendor of medical care without providing advance notice of such 
216.4   withholding or reduction if either any of the following occurs: 
216.5      (1) the vendor is convicted of a crime involving the 
216.6   conduct described in subdivision 1a; or 
216.7      (2) the commissioner receives reliable evidence of fraud or 
216.8   willful misrepresentation by the vendor.; or 
216.9      (3) the vendor has requested that prior authorization for 
216.10  the vendor's clients be changed to another provider, and: 
216.11     (i) the vendor is under investigation for fraud; 
216.12     (ii) the vendor has received or is appealing a notice of 
216.13  agency action seeking monetary recovery under this section; or 
216.14     (iii) the vendor has an established overpayment debt owed 
216.15  to the commissioner. 
216.16     (c) The commissioner must send notice of the withholding or 
216.17  reduction of payments under paragraph (b) within five days of 
216.18  taking such action.  The notice must: 
216.19     (1) state that payments are being withheld according to 
216.20  paragraph (b); 
216.21     (2) except in the case of a conviction for conduct 
216.22  described in subdivision 1a, state that the withholding is for a 
216.23  temporary period and cite the circumstances under which 
216.24  withholding will be terminated; 
216.25     (3) identify the types of claims to which the withholding 
216.26  applies; and 
216.27     (4) inform the vendor of the right to submit written 
216.28  evidence for consideration by the commissioner. 
216.29     The withholding or reduction of payments will not continue 
216.30  after the commissioner determines there is insufficient evidence 
216.31  of fraud or willful misrepresentation by the vendor, or after 
216.32  legal proceedings relating to the alleged fraud or willful 
216.33  misrepresentation are completed, unless the commissioner has 
216.34  sent notice of intention to impose monetary recovery or 
216.35  sanctions under paragraph (a). 
216.36     (d) Upon receipt of a notice under paragraph (a) that a 
217.1   monetary recovery or sanction is to be imposed, a vendor may 
217.2   request a contested case, as defined in section 14.02, 
217.3   subdivision 3, by filing with the commissioner a written request 
217.4   of appeal.  The appeal request must be received by the 
217.5   commissioner no later than 30 days after the date the 
217.6   notification of monetary recovery or sanction was mailed to the 
217.7   vendor.  The appeal request must specify: 
217.8      (1) each disputed item, the reason for the dispute, and an 
217.9   estimate of the dollar amount involved for each disputed item; 
217.10     (2) the computation that the vendor believes is correct; 
217.11     (3) the authority in statute or rule upon which the vendor 
217.12  relies for each disputed item; 
217.13     (4) the name and address of the person or entity with whom 
217.14  contacts may be made regarding the appeal; and 
217.15     (5) other information required by the commissioner. 
217.16     Sec. 72.  [256B.0646] [OWNERSHIP AND CONTROL DISCLOSURE.] 
217.17     Subdivision 1.  [DEFINITIONS.] The definitions in this 
217.18  subdivision apply to this chapter and chapter 256. 
217.19     (a) "Indirect ownership interest" means an ownership 
217.20  interest in an entity that has an ownership interest in a vendor 
217.21  of medical care.  Indirect ownership interest also includes an 
217.22  ownership interest in an entity that has an indirect ownership 
217.23  interest in a vendor of medical care. 
217.24     (b) "Managing employee" means a general manager, business 
217.25  manager, administrator, director, or other individual who for 
217.26  pay or otherwise exercises operational or managerial control 
217.27  over, or directly or indirectly conducts the day-to-day 
217.28  operation of, a vendor of medical care. 
217.29     (c) "Ownership interest" means the possession of equity in 
217.30  the capital, stock, or profits of a vendor of medical care. 
217.31     (d) "Person" means an individual, corporation, partnership, 
217.32  association, or legal entity, however organized. 
217.33     (e) "Person with ownership or control interest" means a 
217.34  person that: 
217.35     (1) has an ownership interest equal to five percent or more 
217.36  in a vendor of medical care; 
218.1      (2) has an indirect ownership interest equal to five 
218.2   percent or more in a vendor of medical care; 
218.3      (3) has a combination of direct and indirect ownership 
218.4   interests equal to five percent or more in a vendor of medical 
218.5   care; 
218.6      (4) owns an interest of five percent or more in any 
218.7   mortgage, deed of trust, note, or other obligation secured by a 
218.8   vendor of medical care, if that interest equals at least five 
218.9   percent of the value of the property or assets of a vendor of 
218.10  medical care; 
218.11     (5) is an officer or director of a vendor of medical care 
218.12  that is organized as a corporation; 
218.13     (6) is a partner of a vendor of medical care that is 
218.14  organized as a partnership; or 
218.15     (7) is a managing employee of a vendor of medical care. 
218.16     (f) "Provider" means a vendor of medical care who is 
218.17  enrolled as a provider in the medical assistance program, 
218.18  general assistance program, or MinnesotaCare. 
218.19     Subd. 2.  [DETERMINATION OF OWNERSHIP OR CONTROL.] (a) A 
218.20  prospective or current program provider must disclose the 
218.21  information on ownership and control specified in paragraph 
218.22  (b).  The information must be disclosed on a form provided by 
218.23  the commissioner.  The disclosure form must be submitted: 
218.24     (1) no later than December 31, 1999, if the provider is 
218.25  enrolled in the program on the effective date of this section; 
218.26     (2) when a vendor applies for enrollment as a program 
218.27  provider; 
218.28     (3) when an enrolled provider requests a change of address 
218.29  or provider name; and 
218.30     (4) when required by a schedule established by the 
218.31  commissioner for the regular updating of disclosures.  The 
218.32  schedule must not require updating of disclosures more 
218.33  frequently than once a year. 
218.34     (b) A disclosure of information on ownership and control 
218.35  required by paragraph (a) shall consist of the following 
218.36  information about the prospective or current program provider: 
219.1      (1) the name and address of each person or entity with an 
219.2   ownership or control interest in the provider; 
219.3      (2) the name and address of each of the provider's managing 
219.4   employees; 
219.5      (3) whether any of the persons named due to clause (1) or 
219.6   (2) are related to one another as spouses, siblings, parents, 
219.7   child, aunt, uncle, niece, nephew, grandchild, or grandparent, 
219.8   and, if so, the names of the persons and their relationship; 
219.9      (4) the names of any other program providers or vendors in 
219.10  which a person named due to clause (1) also has an ownership or 
219.11  control interest; and 
219.12     (5) for any entity named due to clause (1) that is a 
219.13  corporation, the names and addresses of its officers and 
219.14  directors.  In addition, for each such corporation, the 
219.15  following must be attached to the disclosure:  a full and 
219.16  complete copy of its articles of incorporation and bylaws and 
219.17  any amendments and, if a corporation is foreign to this state, a 
219.18  copy of its certificate of authority to do business in this 
219.19  state. 
219.20     (c) Failure to disclose the information on ownership and 
219.21  control when required by paragraph (a) shall be grounds for 
219.22  denial or termination of provider enrollment. 
219.23     Sec. 73.  Minnesota Statutes 1998, section 256B.0917, 
219.24  subdivision 8, is amended to read: 
219.25     Subd. 8.  [LIVING-AT-HOME/BLOCK NURSE PROGRAM GRANT.] (a) 
219.26  The organization awarded the contract under subdivision 7, shall 
219.27  develop and administer a grant program to establish or expand up 
219.28  to 27 30 community-based organizations that will implement 
219.29  living-at-home/block nurse programs that are designed to enable 
219.30  senior citizens to live as independently as possible in their 
219.31  homes and in their communities.  At least one-half of the 
219.32  programs must be in counties outside the seven-county 
219.33  metropolitan area.  Nonprofit organizations and units of local 
219.34  government are eligible to apply for grants to establish the 
219.35  community organizations that will implement living-at-home/block 
219.36  nurse programs.  In awarding grants, the organization awarded 
220.1   the contract under subdivision 7 shall give preference to 
220.2   nonprofit organizations and units of local government from 
220.3   communities that: 
220.4      (1) have high nursing home occupancy rates; 
220.5      (2) have a shortage of health care professionals; 
220.6      (3) are located in counties adjacent to, or are located in, 
220.7   counties with existing living-at-home/block nurse programs; and 
220.8      (4) meet other criteria established by LAH/BN, Inc., in 
220.9   consultation with the commissioner. 
220.10     (b) Grant applicants must also meet the following criteria: 
220.11     (1) the local community demonstrates a readiness to 
220.12  establish a community model of care, including the formation of 
220.13  a board of directors, advisory committee, or similar group, of 
220.14  which at least two-thirds is comprised of community citizens 
220.15  interested in community-based care for older persons; 
220.16     (2) the program has sponsorship by a credible, 
220.17  representative organization within the community; 
220.18     (3) the program has defined specific geographic boundaries 
220.19  and defined its organization, staffing and coordination/delivery 
220.20  of services; 
220.21     (4) the program demonstrates a team approach to 
220.22  coordination and care, ensuring that the older adult 
220.23  participants, their families, the formal and informal providers 
220.24  are all part of the effort to plan and provide services; and 
220.25     (5) the program provides assurances that all community 
220.26  resources and funding will be coordinated and that other funding 
220.27  sources will be maximized, including a person's own resources. 
220.28     (c) Grant applicants must provide a minimum of five percent 
220.29  of total estimated development costs from local community 
220.30  funding.  Grants shall be awarded for four-year periods, and the 
220.31  base amount shall not exceed $80,000 per applicant for the grant 
220.32  period.  The organization under contract may increase the grant 
220.33  amount for applicants from communities that have socioeconomic 
220.34  characteristics that indicate a higher level of need for 
220.35  assistance.  Subject to the availability of funding, grants and 
220.36  grant renewals awarded or entered into on or after July 1, 1997, 
221.1   shall be renewed by LAH/BN, Inc. every four years, unless 
221.2   LAH/BN, Inc. determines that the grant recipient has not 
221.3   satisfactorily operated the living-at-home/block nurse program 
221.4   in compliance with the requirements of paragraphs (b) and (d).  
221.5   Grants provided to living-at-home/block nurse programs under 
221.6   this paragraph may be used for both program development and the 
221.7   delivery of services. 
221.8      (d) Each living-at-home/block nurse program shall be 
221.9   designed by representatives of the communities being served to 
221.10  ensure that the program addresses the specific needs of the 
221.11  community residents.  The programs must be designed to: 
221.12     (1) incorporate the basic community, organizational, and 
221.13  service delivery principles of the living-at-home/block nurse 
221.14  program model; 
221.15     (2) provide senior citizens with registered nurse directed 
221.16  assessment, provision and coordination of health and personal 
221.17  care services on a sliding fee basis as an alternative to 
221.18  expensive nursing home care; 
221.19     (3) provide information, support services, homemaking 
221.20  services, counseling, and training for the client and family 
221.21  caregivers; 
221.22     (4) encourage the development and use of respite care, 
221.23  caregiver support, and in-home support programs, such as adult 
221.24  foster care and in-home adult day care; 
221.25     (5) encourage neighborhood residents and local 
221.26  organizations to collaborate in meeting the needs of senior 
221.27  citizens in their communities; 
221.28     (6) recruit, train, and direct the use of volunteers to 
221.29  provide informal services and other appropriate support to 
221.30  senior citizens and their caregivers; and 
221.31     (7) provide coordination and management of formal and 
221.32  informal services to senior citizens and their families using 
221.33  less expensive alternatives.  
221.34     Sec. 74.  Minnesota Statutes 1998, section 256B.37, 
221.35  subdivision 2, is amended to read: 
221.36     Subd. 2.  [CIVIL ACTION FOR RECOVERY.] To recover under 
222.1   this section, the attorney general, or the appropriate county 
222.2   attorney, acting upon direction from the attorney general, may 
222.3   institute or join a civil action to enforce the subrogation 
222.4   rights of the commissioner established under this section.  
222.5      Any prepaid health plan providing services under sections 
222.6   256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
222.7   children's mental health collaboratives under section 245.493; 
222.8   demonstration projects for persons with disabilities under 
222.9   section 256B.77; nursing homes under the alternative payment 
222.10  demonstration project under section 256B.434; or the 
222.11  county-based purchasing entity providing services under section 
222.12  256B.692 may retain legal representation to enforce the 
222.13  subrogation rights created under this section or, if no action 
222.14  has been brought, may initiate and prosecute an independent 
222.15  action on their behalf against a person, firm, or corporation 
222.16  that may be liable to the person to whom the care or payment was 
222.17  furnished.  
222.18     Sec. 75.  Minnesota Statutes 1998, section 256B.501, 
222.19  subdivision 8a, is amended to read: 
222.20     Subd. 8a.  [PAYMENT FOR PERSONS WITH SPECIAL NEEDS FOR 
222.21  CRISIS INTERVENTION SERVICES.] State-operated, Community-based 
222.22  crisis services provided in accordance with section 252.50, 
222.23  subdivision 7, to authorized by the commissioner or the 
222.24  commissioner's designee for a resident of an intermediate care 
222.25  facility for persons with mental retardation (ICF/MR) reimbursed 
222.26  under this section shall be paid by medical assistance in 
222.27  accordance with the paragraphs (a) to (h) (g). 
222.28     (a) "Crisis services" means the specialized services listed 
222.29  in clauses (1) to (3) provided to prevent the recipient from 
222.30  requiring placement in a more restrictive institutional setting 
222.31  such as an inpatient hospital or regional treatment center and 
222.32  to maintain the recipient in the present community setting. 
222.33     (1) The crisis services provider shall assess the 
222.34  recipient's behavior and environment to identify factors 
222.35  contributing to the crisis. 
222.36     (2) The crisis services provider shall develop a 
223.1   recipient-specific intervention plan in coordination with the 
223.2   service planning team and provide recommendations for revisions 
223.3   to the individual service plan if necessary to prevent or 
223.4   minimize the likelihood of future crisis situations.  The 
223.5   intervention plan shall include a transition plan to aid the 
223.6   recipient in returning to the community-based ICF/MR if the 
223.7   recipient is receiving residential crisis services.  
223.8      (3) The crisis services provider shall consult with and 
223.9   provide training and ongoing technical assistance to the 
223.10  recipient's service providers to aid in the implementation of 
223.11  the intervention plan and revisions to the individual service 
223.12  plan. 
223.13     (b) "Residential crisis services" means crisis services 
223.14  that are provided to a recipient admitted to the crisis services 
223.15  foster care setting an alternative, state-licensed site approved 
223.16  by the commissioner, because the ICF/MR receiving reimbursement 
223.17  under this section is not able, as determined by the 
223.18  commissioner, to provide the intervention and protection of the 
223.19  recipient and others living with the recipient that is necessary 
223.20  to prevent the recipient from requiring placement in a more 
223.21  restrictive institutional setting. 
223.22     (c) Residential crisis services providers must be licensed 
223.23  by maintain a license from the commissioner under section 
223.24  245A.03 to provide foster care, must exclusively provide for the 
223.25  residence when providing crisis services for short-term crisis 
223.26  intervention, and must not be located in a private residence. 
223.27     (d) Payment rates are determined annually for each crisis 
223.28  services provider based on cost of care for each provider as 
223.29  defined in section 246.50.  Interim payment rates are calculated 
223.30  on a per diem basis by dividing the projected cost of providing 
223.31  care by the projected number of contact days for the fiscal 
223.32  year, as estimated by the commissioner.  Final payment rates are 
223.33  calculated by dividing the actual cost of providing care by the 
223.34  actual number of contact days in the applicable fiscal 
223.35  year shall be established consistent with county negotiated 
223.36  crisis intervention services.  
224.1      (e) Payment shall be made for each contact day.  "Contact 
224.2   day" means any day in which the crisis services provider has 
224.3   face-to-face contact with the recipient or any of the 
224.4   recipient's medical assistance service providers for the purpose 
224.5   of providing crisis services as defined in paragraph (c). 
224.6      (f) Payment for residential crisis services is limited to 
224.7   21 days, unless an additional period is authorized by the 
224.8   commissioner or part of an approved regional plan.  The 
224.9   additional period may not exceed 21 days. 
224.10     (g) (f) Payment for crisis services shall be made only for 
224.11  services provided while the ICF/MR receiving reimbursement under 
224.12  this section: 
224.13     (1) has a shared services agreement with the crisis 
224.14  services provider in effect in accordance with under section 
224.15  246.57; and 
224.16     (2) has reassigned payment for the provision of the crisis 
224.17  services under this subdivision to the commissioner in 
224.18  accordance with Code of Federal Regulations, title 42, section 
224.19  447.10(e); and 
224.20     (3) has executed a cooperative agreement with the crisis 
224.21  services provider to implement the intervention plan and 
224.22  revisions to the individual service plan as necessary to prevent 
224.23  or minimize the likelihood of future crisis situations, to 
224.24  maintain the recipient in the present community setting, and to 
224.25  prevent the recipient from requiring a more restrictive 
224.26  institutional setting. 
224.27     (h) (g) Payment to the ICF/MR receiving reimbursement under 
224.28  this section shall be made for up to 18 therapeutic leave days 
224.29  during which the recipient is receiving residential crisis 
224.30  services, if the ICF/MR is otherwise eligible to receive payment 
224.31  for a therapeutic leave day under Minnesota Rules, part 
224.32  9505.0415.  Payment under this paragraph shall be terminated if 
224.33  the commissioner determines that the ICF/MR is not meeting the 
224.34  terms of the cooperative shared service agreement under 
224.35  paragraph (g) (f) or that the recipient will not return to the 
224.36  ICF/MR. 
225.1      Sec. 76.  Minnesota Statutes 1998, section 256B.69, 
225.2   subdivision 3a, is amended to read: 
225.3      Subd. 3a.  [COUNTY AUTHORITY.] (a) The commissioner, when 
225.4   implementing the general assistance medical care, or medical 
225.5   assistance prepayment program within a county, must include the 
225.6   county board in the process of development, approval, and 
225.7   issuance of the request for proposals to provide services to 
225.8   eligible individuals within the proposed county.  County boards 
225.9   must be given reasonable opportunity to make recommendations 
225.10  regarding the development, issuance, review of responses, and 
225.11  changes needed in the request for proposals.  The commissioner 
225.12  must provide county boards the opportunity to review each 
225.13  proposal based on the identification of community needs under 
225.14  chapters 145A and 256E and county advocacy activities.  If a 
225.15  county board finds that a proposal does not address certain 
225.16  community needs, the county board and commissioner shall 
225.17  continue efforts for improving the proposal and network prior to 
225.18  the approval of the contract.  The county board shall make 
225.19  recommendations regarding the approval of local networks and 
225.20  their operations to ensure adequate availability and access to 
225.21  covered services.  The provider or health plan must respond 
225.22  directly to county advocates and the state prepaid medical 
225.23  assistance ombudsperson regarding service delivery and must be 
225.24  accountable to the state regarding contracts with medical 
225.25  assistance and general assistance medical care funds.  The 
225.26  county board may recommend a maximum number of participating 
225.27  health plans after considering the size of the enrolling 
225.28  population; ensuring adequate access and capacity; considering 
225.29  the client and county administrative complexity; and considering 
225.30  the need to promote the viability of locally developed health 
225.31  plans.  The county board or a single entity representing a group 
225.32  of county boards and the commissioner shall mutually select 
225.33  health plans for participation at the time of initial 
225.34  implementation of the prepaid medical assistance program in that 
225.35  county or group of counties and at the time of contract renewal. 
225.36  The commissioner shall also seek input for contract requirements 
226.1   from the county or single entity representing a group of county 
226.2   boards at each contract renewal and incorporate those 
226.3   recommendations into the contract negotiation process.  The 
226.4   commissioner, in conjunction with the county board, shall 
226.5   actively seek to develop a mutually agreeable timetable prior to 
226.6   the development of the request for proposal, but counties must 
226.7   agree to initial enrollment beginning on or before January 1, 
226.8   1999, in either the prepaid medical assistance and general 
226.9   assistance medical care programs or county-based purchasing 
226.10  under section 256B.692.  At least 90 days before enrollment in 
226.11  the medical assistance and general assistance medical care 
226.12  prepaid programs begins in a county in which the prepaid 
226.13  programs have not been established, the commissioner shall 
226.14  provide a report to the chairs of senate and house committees 
226.15  having jurisdiction over state health care programs which 
226.16  verifies that the commissioner complied with the requirements 
226.17  for county involvement that are specified in this subdivision. 
226.18     (b) The commissioner shall seek a federal waiver to allow a 
226.19  fee-for-service plan option to MinnesotaCare enrollees.  The 
226.20  commissioner shall develop an increase of the premium fees 
226.21  required under section 256L.06 up to 20 percent of the premium 
226.22  fees for the enrollees who elect the fee-for-service option.  
226.23  Prior to implementation, the commissioner shall submit this fee 
226.24  schedule to the chair and ranking minority member of the senate 
226.25  health care committee, the senate health care and family 
226.26  services funding division, the house of representatives health 
226.27  and human services committee, and the house of representatives 
226.28  health and human services finance division. 
226.29     (c) At the option of the county board, the board may 
226.30  develop contract requirements related to the achievement of 
226.31  local public health goals to meet the health needs of medical 
226.32  assistance and general assistance medical care enrollees.  These 
226.33  requirements must be reasonably related to the performance of 
226.34  health plan functions and within the scope of the medical 
226.35  assistance and general assistance medical care benefit sets.  If 
226.36  the county board and the commissioner mutually agree to such 
227.1   requirements, the department shall include such requirements in 
227.2   all health plan contracts governing the prepaid medical 
227.3   assistance and general assistance medical care programs in that 
227.4   county at initial implementation of the program in that county 
227.5   and at the time of contract renewal.  The county board may 
227.6   participate in the enforcement of the contract provisions 
227.7   related to local public health goals. 
227.8      (d) For counties in which prepaid medical assistance and 
227.9   general assistance medical care programs have not been 
227.10  established, the commissioner shall not implement those programs 
227.11  if a county board submits acceptable and timely preliminary and 
227.12  final proposals under section 256B.692, until county-based 
227.13  purchasing is no longer operational in that county.  For 
227.14  counties in which prepaid medical assistance and general 
227.15  assistance medical care programs are in existence on or after 
227.16  September 1, 1997, the commissioner must terminate contracts 
227.17  with health plans according to section 256B.692, subdivision 5, 
227.18  if the county board submits and the commissioner accepts 
227.19  preliminary and final proposals according to that subdivision.  
227.20  The commissioner is not required to terminate contracts that 
227.21  begin on or after September 1, 1997, according to section 
227.22  256B.692 until two years have elapsed from the date of initial 
227.23  enrollment. 
227.24     (e) In the event that a county board or a single entity 
227.25  representing a group of county boards and the commissioner 
227.26  cannot reach agreement regarding:  (i) the selection of 
227.27  participating health plans in that county; (ii) contract 
227.28  requirements; or (iii) implementation and enforcement of county 
227.29  requirements including provisions regarding local public health 
227.30  goals, the commissioner shall resolve all disputes after taking 
227.31  into account the recommendations of a three-person mediation 
227.32  panel.  The panel shall be composed of one designee of the 
227.33  president of the association of Minnesota counties, one designee 
227.34  of the commissioner of human services, and one designee of the 
227.35  commissioner of health. 
227.36     (f) If a county which elects to implement county-based 
228.1   purchasing ceases to implement county-based purchasing, it is 
228.2   prohibited from assuming the responsibility of county-based 
228.3   purchasing for a period of five years from the date it 
228.4   discontinues purchasing. 
228.5      (g) Notwithstanding the requirement in this subdivision 
228.6   that a county must agree to initial enrollment on or before 
228.7   January 1, 1999, the commissioner shall grant a delay of up to 
228.8   nine months in the implementation of the county-based purchasing 
228.9   authorized in section 256B.692 until federal waiver authority 
228.10  and approval has been granted, if the county or group of 
228.11  counties has submitted a preliminary proposal for county-based 
228.12  purchasing by September 1, 1997, has not already implemented the 
228.13  prepaid medical assistance program before January 1, 1998, and 
228.14  has submitted a written request for the delay to the 
228.15  commissioner by July 1, 1998.  In order for the delay to be 
228.16  continued, the county or group of counties must also submit to 
228.17  the commissioner the following information by December 1, 1998.  
228.18  The information must: 
228.19     (1) identify the proposed date of implementation, not later 
228.20  than October 1, 1999 as determined under section 256B.692, 
228.21  subdivision 5; 
228.22     (2) include copies of the county board resolutions which 
228.23  demonstrate the continued commitment to the implementation of 
228.24  county-based purchasing by the proposed date.  County board 
228.25  authorization may remain contingent on the submission of a final 
228.26  proposal which meets the requirements of section 256B.692, 
228.27  subdivision 5, paragraph (b); 
228.28     (3) demonstrate actions taken for the establishment of a 
228.29  governance structure between the participating counties and 
228.30  describe how the fiduciary responsibilities of county-based 
228.31  purchasing will be allocated between the counties, if more than 
228.32  one county is involved in the proposal; 
228.33     (4) describe how the risk of a deficit will be managed in 
228.34  the event expenditures are greater than total capitation 
228.35  payments.  This description must identify how any of the 
228.36  following strategies will be used: 
229.1      (i) risk contracts with licensed health plans; 
229.2      (ii) risk arrangements with providers who are not licensed 
229.3   health plans; 
229.4      (iii) risk arrangements with other licensed insurance 
229.5   entities; and 
229.6      (iv) funding from other county resources; 
229.7      (5) include, if county-based purchasing will not contract 
229.8   with licensed health plans or provider networks, letters of 
229.9   interest from local providers in at least the categories of 
229.10  hospital, physician, mental health, and pharmacy which express 
229.11  interest in contracting for services.  These letters must 
229.12  recognize any risk transfer identified in clause (4), item (ii); 
229.13  and 
229.14     (6) describe the options being considered to obtain the 
229.15  administrative services required in section 256B.692, 
229.16  subdivision 3, clauses (3) and (5). 
229.17     (h) For counties which receive a delay under this 
229.18  subdivision, the final proposals required under section 
229.19  256B.692, subdivision 5, paragraph (b), must be submitted at 
229.20  least six months prior to the requested implementation date.  
229.21  Authority to implement county-based purchasing remains 
229.22  contingent on approval of the final proposal as required under 
229.23  section 256B.692. 
229.24     (i) If the commissioner is unable to provide 
229.25  county-specific, individual-level fee-for-service claims to 
229.26  counties by June 4, 1998, the commissioner shall grant a delay 
229.27  under paragraph (g) of up to 12 months in the implementation of 
229.28  county-based purchasing, and shall require implementation not 
229.29  later than January 1, 2000.  In order to receive an extension of 
229.30  the proposed date of implementation under this paragraph, a 
229.31  county or group of counties must submit a written request for 
229.32  the extension to the commissioner by August 1, 1998, must submit 
229.33  the information required under paragraph (g) by December 1, 
229.34  1998, and must submit a final proposal as provided under 
229.35  paragraph (h). 
229.36     (j) Notwithstanding other requirements of this subdivision, 
230.1   the commissioner shall not require the implementation of the 
230.2   county-based purchasing authorized in section 256B.692 until six 
230.3   months after federal waiver approval has been obtained for 
230.4   county-based purchasing if the county or counties have submitted 
230.5   the final plan as required in section 256B.692, subdivision 5.  
230.6   The commissioner shall allow the county or counties who 
230.7   submitted information under section 256B.692, subdivision 5, to 
230.8   submit supplemental or additional information which was not 
230.9   possible to submit by April 1, 1999.  A county or counties shall 
230.10  continue to submit the required information and substantive 
230.11  detail necessary to obtain a prompt response and waiver 
230.12  approval.  If amendments to the final plan are necessary due to 
230.13  the terms and conditions of the waiver approval, the 
230.14  commissioner shall allow the county or group of counties 60 days 
230.15  to make the necessary amendment to the final plan and shall not 
230.16  require implementation of the county-based purchasing until six 
230.17  months after the revised final plan has been submitted.  
230.18     Sec. 77.  Minnesota Statutes 1998, section 256B.69, is 
230.19  amended by adding a subdivision to read: 
230.20     Subd. 3b.  [PROVISION OF DATA TO COUNTY BOARDS.] The 
230.21  commissioner, in consultation with representatives of county 
230.22  boards of commissioners, shall identify program information and 
230.23  data necessary on an ongoing basis for county boards to:  
230.24     (1) make recommendations to the commissioner related to 
230.25  state purchasing under the prepaid medical assistance program; 
230.26  and 
230.27     (2) effectively administer county-based purchasing.  
230.28  This information and data must include, but is not limited to, 
230.29  county-specific fee-for-service and prepaid health plan claims 
230.30  information.  This data must not include identifiable 
230.31  individual-level claims.  
230.32     Sec. 78.  Minnesota Statutes 1998, section 256B.69, is 
230.33  amended by adding a subdivision to read: 
230.34     Subd. 4b.  [INDIVIDUAL EDUCATION PLAN AND INDIVIDUALIZED 
230.35  FAMILY SERVICE PLAN SERVICES.] The commissioner shall amend the 
230.36  federal waiver allowing the state to separate out individual 
231.1   education plan and individualized family service plan services 
231.2   for children enrolled in the prepaid medical assistance program 
231.3   and the MinnesotaCare program.  Effective July 1, 1999, or upon 
231.4   federal approval, medical assistance coverage of eligible 
231.5   individual education plan and individualized family service plan 
231.6   services shall not be included in the capitated services for 
231.7   children enrolled in health plans through the prepaid medical 
231.8   assistance program and the MinnesotaCare program.  Upon federal 
231.9   approval, local school districts shall bill the commissioner for 
231.10  these services, and claims shall be paid on a fee-for-service 
231.11  basis. 
231.12     Sec. 79.  Minnesota Statutes 1998, section 256B.69, 
231.13  subdivision 5b, is amended to read: 
231.14     Subd. 5b.  [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 
231.15  prepaid medical assistance and general assistance medical care 
231.16  program contract rates set by the commissioner under subdivision 
231.17  5 and effective on or after January 1, 1998, capitation rates 
231.18  for nonmetropolitan counties shall on a weighted average be no 
231.19  less than 88 percent of the capitation rates for metropolitan 
231.20  counties, excluding Hennepin county.  The commissioner shall 
231.21  make a pro rata adjustment in capitation rates paid to counties 
231.22  other than nonmetropolitan counties in order to make this 
231.23  provision budget neutral.  
231.24     (b) For prepaid medical assistance program contract rates 
231.25  set by the commissioner under subdivision 5 and effective on or 
231.26  after January 1, 2001, capitation rates for nonmetropolitan 
231.27  counties shall, on a weighted average, be no less than 89 
231.28  percent of the capitation rates for metropolitan counties, 
231.29  excluding Hennepin county. 
231.30     Sec. 80.  Minnesota Statutes 1998, section 256B.69, is 
231.31  amended by adding a subdivision to read: 
231.32     Subd. 5e.  [MEDICAL EDUCATION AND RESEARCH PAYMENTS.] For 
231.33  the calendar years 1999, 2000, and 2001, a hospital that 
231.34  participates in funding the federal share of the medical 
231.35  education and research trust fund payment under Laws 1998, 
231.36  chapter 407, article 1, section 3, shall not be held liable for 
232.1   any amounts attributable to this payment above the charge limit 
232.2   of section 256.969, subdivision 3a.  The commissioner of human 
232.3   services shall assume liability for any corresponding federal 
232.4   share of the payments above the charge limit. 
232.5      Sec. 81.  Minnesota Statutes 1998, section 256B.692, 
232.6   subdivision 2, is amended to read: 
232.7      Subd. 2.  [DUTIES OF THE COMMISSIONER OF HEALTH.] (a) 
232.8   Notwithstanding chapters 62D and 62N, a county that elects to 
232.9   purchase medical assistance and general assistance medical care 
232.10  in return for a fixed sum without regard to the frequency or 
232.11  extent of services furnished to any particular enrollee is not 
232.12  required to obtain a certificate of authority under chapter 62D 
232.13  or 62N.  The county board of commissioners is the governing body 
232.14  of a county-based purchasing program.  In a multicounty 
232.15  arrangement, the governing body is a joint powers board 
232.16  established under section 471.59.  
232.17     (b) A county that elects to purchase medical assistance and 
232.18  general assistance medical care services under this section must 
232.19  satisfy the commissioner of health that the requirements for 
232.20  assurance of consumer protection, provider protection, and 
232.21  fiscal solvency of chapter 62D, applicable to health maintenance 
232.22  organizations, or chapter 62N, applicable to community 
232.23  integrated service networks, will be met.  
232.24     (c) A county must also assure the commissioner of health 
232.25  that the requirements of sections 62J.041; 62J.48; 62J.71 to 
232.26  62J.73; 62M.01 to 62M.16; all applicable provisions of chapter 
232.27  62Q, including sections 62Q.07; 62Q.075; 62Q.105; 62Q.1055; 
232.28  62Q.106; 62Q.11; 62Q.12; 62Q.135; 62Q.14; 62Q.145; 62Q.19; 
232.29  62Q.23, paragraph (c); 62Q.30; 62Q.43; 62Q.47; 62Q.50; 62Q.52 to 
232.30  62Q.56; 62Q.58; 62Q.64; and 72A.201 will be met.  
232.31     (d) All enforcement and rulemaking powers available under 
232.32  chapters 62D, 62J, 62M, 62N, and 62Q are hereby granted to the 
232.33  commissioner of health with respect to counties that purchase 
232.34  medical assistance and general assistance medical care services 
232.35  under this section.  
232.36     (e) The commissioner, in consultation with county 
233.1   government, shall develop administrative and financial reporting 
233.2   requirements for county-based purchasing programs relating to 
233.3   sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 
233.4   62N.31, and other sections as necessary, that are specific to 
233.5   county administrative, accounting, and reporting systems and 
233.6   consistent with other statutory requirements of counties.  
233.7      Sec. 82.  Minnesota Statutes 1998, section 256B.75, is 
233.8   amended to read: 
233.9      256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 
233.10     (a) For outpatient hospital facility fee payments for 
233.11  services rendered on or after October 1, 1992, the commissioner 
233.12  of human services shall pay the lower of (1) submitted charge, 
233.13  or (2) 32 percent above the rate in effect on June 30, 1992, 
233.14  except for those services for which there is a federal maximum 
233.15  allowable payment.  Effective for services rendered on or after 
233.16  January 1, 2000, payment rates for nonsurgical outpatient 
233.17  hospital facility fees and emergency room facility fees shall be 
233.18  increased by eight percent over the rates in effect on December 
233.19  31, 1999, except for those services for which there is a federal 
233.20  maximum allowable payment.  Services for which there is a 
233.21  federal maximum allowable payment shall be paid at the lower of 
233.22  (1) submitted charge, or (2) the federal maximum allowable 
233.23  payment.  Total aggregate payment for outpatient hospital 
233.24  facility fee services shall not exceed the Medicare upper 
233.25  limit.  If it is determined that a provision of this section 
233.26  conflicts with existing or future requirements of the United 
233.27  States government with respect to federal financial 
233.28  participation in medical assistance, the federal requirements 
233.29  prevail.  The commissioner may, in the aggregate, prospectively 
233.30  reduce payment rates to avoid reduced federal financial 
233.31  participation resulting from rates that are in excess of the 
233.32  Medicare upper limitations. 
233.33     (b) Notwithstanding paragraph (a), payment for outpatient, 
233.34  emergency, and ambulatory surgery hospital facility fee services 
233.35  for critical access hospitals designated under section 144.1483, 
233.36  clause (11), shall be paid on a cost-based payment system that 
234.1   is based on the cost-finding methods and allowable costs of the 
234.2   Medicare program. 
234.3      <i>(Effective date:  Section 82 (256B.75, paragraph (b)) is</i> 
234.4   <i>effective for services rendered on or after July 1, 1999.)</i> 
234.5      Sec. 83.  Minnesota Statutes 1998, section 256B.76, is 
234.6   amended to read: 
234.7      256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
234.8      (a) The physician reimbursement increase provided in 
234.9   section 256B.74, subdivision 2, shall not be implemented.  
234.10  Effective for services rendered on or after October 1, 1992, the 
234.11  commissioner shall make payments for physician services as 
234.12  follows: 
234.13     (1) payment for level one Health Care Finance 
234.14  Administration's common procedural coding system (HCPCS) codes 
234.15  titled "office and other outpatient services," "preventive 
234.16  medicine new and established patient," "delivery, antepartum, 
234.17  and postpartum care," "critical care," Caesarean delivery and 
234.18  pharmacologic management provided to psychiatric patients, and 
234.19  HCPCS level three codes for enhanced services for prenatal high 
234.20  risk, shall be paid at the lower of (i) submitted charges, or 
234.21  (ii) 25 percent above the rate in effect on June 30, 1992.  If 
234.22  the rate on any procedure code within these categories is 
234.23  different than the rate that would have been paid under the 
234.24  methodology in section 256B.74, subdivision 2, then the larger 
234.25  rate shall be paid; 
234.26     (2) payments for all other services shall be paid at the 
234.27  lower of (i) submitted charges, or (ii) 15.4 percent above the 
234.28  rate in effect on June 30, 1992; and 
234.29     (3) all physician rates shall be converted from the 50th 
234.30  percentile of 1982 to the 50th percentile of 1989, less the 
234.31  percent in aggregate necessary to equal the above increases 
234.32  except that payment rates for home health agency services shall 
234.33  be the rates in effect on September 30, 1992.; 
234.34     (4) effective for services rendered on or after January 1, 
234.35  2000, payment rates for physician and professional services 
234.36  shall be increased by 3.5 percent over the rates in effect on 
235.1   December 31, 1999, except for home health agency services; and 
235.2      (5) the increases in clause (4) shall be implemented 
235.3   January 1, 2000, for managed care. 
235.4      (b) The dental reimbursement increase provided in section 
235.5   256B.74, subdivision 5, shall not be implemented.  Effective for 
235.6   services rendered on or after October 1, 1992, the commissioner 
235.7   shall make payments for dental services as follows: 
235.8      (1) dental services shall be paid at the lower of (i) 
235.9   submitted charges, or (ii) 25 percent above the rate in effect 
235.10  on June 30, 1992; and 
235.11     (2) dental rates shall be converted from the 50th 
235.12  percentile of 1982 to the 50th percentile of 1989, less the 
235.13  percent in aggregate necessary to equal the above increases.; 
235.14     (3) effective for services rendered on or after January 1, 
235.15  2000, payment rates for dental services shall be increased by 
235.16  3.5 percent over the rates in effect on December 31, 1999; 
235.17     (4) the commissioner shall increase payments by 20 percent 
235.18  over the October 1, 1999, fee-for-service rates, for those 
235.19  fee-for-service providers for whom public programs under medical 
235.20  assistance, general assistance medical care, and MinnesotaCare 
235.21  account for 20 percent or more of their practice; 
235.22     (5) the commissioner shall award grants to community 
235.23  clinics or other nonprofit community organizations which will 
235.24  increase the availability of dental services to public program 
235.25  recipients.  These grants may be used to fund the costs related 
235.26  to coordinating access for recipients, developing and 
235.27  implementing patient care criteria, establishing new or 
235.28  upgrading existing facilities, acquiring furnishings or 
235.29  equipment, recruiting new providers, or other development costs 
235.30  that will improve access to dental care in that region.  The 
235.31  commissioner shall consider the following in awarding the 
235.32  grants:  (i) potential to successfully increase access to an 
235.33  underserved population; (ii) the ability to raise matching 
235.34  funds; (iii) the long-term viability of the project to improve 
235.35  access beyond the period of initial funding; (iv) the efficiency 
235.36  in the use of the funding; and (v) the experience of the 
236.1   proposers in providing services to the target population.  The 
236.2   commissioner shall monitor the grants and may terminate a grant 
236.3   if the grantee does not increase dental access for public 
236.4   program recipients; 
236.5      (6) the commissioner shall fund two initiatives to improve 
236.6   dental access that will allow the commissioner to increase rates 
236.7   if the percentage of public program recipients with at least one 
236.8   dental visit per year increases; 
236.9      (7) beginning October 1, 1999, the payment for tooth 
236.10  sealants and fluoride treatments shall be the lower of (i) 
236.11  submitted charge, or (ii) 80 percent of median 1997 charges; and 
236.12     (8) the increases listed in clauses (3), (4), and (7) shall 
236.13  be implemented January 1, 2000, for managed care. 
236.14     (c) An entity that operates both a Medicare certified 
236.15  comprehensive outpatient rehabilitation facility and a facility 
236.16  which was certified prior to January 1, 1993, that is licensed 
236.17  under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
236.18  whom at least 33 percent of the clients receiving rehabilitation 
236.19  services in the most recent calendar year are medical assistance 
236.20  recipients, shall be reimbursed by the commissioner for 
236.21  rehabilitation services at rates that are 38 percent greater 
236.22  than the maximum reimbursement rate allowed under paragraph (a), 
236.23  clause (2), when those services are (1) provided within the 
236.24  comprehensive outpatient rehabilitation facility and (2) 
236.25  provided to residents of nursing facilities owned by the entity. 
236.26     Sec. 84.  [256B.765] [PROVIDER RATE INCREASES.] 
236.27     (a) Effective July 1, 2001, within the limits of 
236.28  appropriations specifically for this purpose, the commissioner 
236.29  shall provide an annual inflation adjustment for the providers 
236.30  listed in paragraph (c).  The index for the inflation adjustment 
236.31  must be based on the change in the Employment Cost Index for 
236.32  Private Industry Workers - Total Compensation forecasted by Data 
236.33  Resources, Inc., as forecasted in the fourth quarter of the 
236.34  calendar year preceding the fiscal year.  The commissioner shall 
236.35  increase reimbursement or allocation rates by the percentage of 
236.36  this adjustment, and county boards shall adjust provider 
237.1   contracts as needed. 
237.2      (b) The commissioner of finance shall include an annual 
237.3   inflationary adjustment in reimbursement rates for the providers 
237.4   listed in paragraph (c) using the inflation factor specified in 
237.5   paragraph (a) as a budget change request in each biennial 
237.6   detailed expenditure budget submitted to the legislature under 
237.7   section 16A.11. 
237.8      (c) The annual adjustment under paragraph (a) shall be 
237.9   provided for home and community-based waiver services for 
237.10  persons with mental retardation or related conditions under 
237.11  section 256B.501; home and community-based waiver services for 
237.12  the elderly under section 256B.0915; waivered services under 
237.13  community alternatives for disabled individuals under section 
237.14  256B.49; community alternative care waivered services under 
237.15  section 256B.49; traumatic brain injury waivered services under 
237.16  section 256B.49; nursing services and home health services under 
237.17  section 256B.0625, subdivision 6a; personal care services and 
237.18  nursing supervision of personal care services under section 
237.19  256B.0625, subdivision 19a; private duty nursing services under 
237.20  section 256B.0625, subdivision 7; day training and habilitation 
237.21  services for adults with mental retardation or related 
237.22  conditions under sections 252.40 to 252.46; physical therapy 
237.23  services under sections 256B.0625, subdivision 8, and 256D.03, 
237.24  subdivision 4; occupational therapy services under sections 
237.25  256B.0625, subdivision 8a, and 256D.03, subdivision 4; 
237.26  speech-language therapy services under section 256D.03, 
237.27  subdivision 4, and Minnesota Rules, part 9505.0390; respiratory 
237.28  therapy services under section 256D.03, subdivision 4, and 
237.29  Minnesota Rules, part 9505.0295; alternative care services under 
237.30  section 256B.0913; adult residential program grants under 
237.31  Minnesota Rules, parts 9535.2000 to 9535.3000; adult and family 
237.32  community support grants under Minnesota Rules, parts 9535.1700 
237.33  to 9535.1760; semi-independent living services under section 
237.34  252.275 including SILS funding under county social services 
237.35  grants formerly funded under chapter 256I; and community support 
237.36  services for deaf and hard-of-hearing adults with mental illness 
238.1   who use or wish to use sign language as their primary means of 
238.2   communication. 
238.3      (d) At least 75 percent of the rate increase provided under 
238.4   this section must be used to increase the wages and benefits of 
238.5   employees other than administrators and central office 
238.6   employees.  Providers must submit a plan to the commissioner 
238.7   annually describing how the increase is being utilized. 
238.8      Sec. 85.  Minnesota Statutes 1998, section 256B.77, 
238.9   subdivision 7a, is amended to read: 
238.10     Subd. 7a.  [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 
238.11  for the demonstration project as provided in this subdivision. 
238.12     (b) "Eligible individuals" means those persons living in 
238.13  the demonstration site who are eligible for medical assistance 
238.14  and are disabled based on a disability determination under 
238.15  section 256B.055, subdivisions 7 and 12, or who are eligible for 
238.16  medical assistance and have been diagnosed as having: 
238.17     (1) serious and persistent mental illness as defined in 
238.18  section 245.462, subdivision 20; 
238.19     (2) severe emotional disturbance as defined in section 
238.20  245.487 245.4871, subdivision 6; or 
238.21     (3) mental retardation, or being a mentally retarded person 
238.22  as defined in section 252A.02, or a related condition as defined 
238.23  in section 252.27, subdivision 1a. 
238.24  Other individuals may be included at the option of the county 
238.25  authority based on agreement with the commissioner. 
238.26     (c) Eligible individuals residing on a federally recognized 
238.27  Indian reservation may be excluded from participation in the 
238.28  demonstration project at the discretion of the tribal government 
238.29  based on agreement with the commissioner, in consultation with 
238.30  the county authority. 
238.31     (d) Eligible individuals include individuals in excluded 
238.32  time status, as defined in chapter 256G.  Enrollees in excluded 
238.33  time at the time of enrollment shall remain in excluded time 
238.34  status as long as they live in the demonstration site and shall 
238.35  be eligible for 90 days after placement outside the 
238.36  demonstration site if they move to excluded time status in a 
239.1   county within Minnesota other than their county of financial 
239.2   responsibility. 
239.3      (e) (d) A person who is a sexual psychopathic personality 
239.4   as defined in section 253B.02, subdivision 18a, or a sexually 
239.5   dangerous person as defined in section 253B.02, subdivision 18b, 
239.6   is excluded from enrollment in the demonstration project. 
239.7      Sec. 86.  Minnesota Statutes 1998, section 256B.77, is 
239.8   amended by adding a subdivision to read: 
239.9      Subd. 7b.  [AMERICAN INDIAN RECIPIENTS.] (a) Beginning on 
239.10  or after July 1, 1999, for American Indian recipients of medical 
239.11  assistance who are required to enroll with a county 
239.12  administrative entity or service delivery organization under 
239.13  subdivision 7, medical assistance shall cover health care 
239.14  services provided at American Indian health services facilities 
239.15  and facilities operated by a tribe or tribal organization under 
239.16  funding authorized by United States Code, title 25, sections 
239.17  450f to 450n, or title III of the Indian Self-Determination and 
239.18  Education Assistance Act, Public Law Number 93-638, if those 
239.19  services would otherwise be covered under section 256B.0625.  
239.20  Payments for services provided under this subdivision shall be 
239.21  made on a fee-for-service basis, and may, at the option of the 
239.22  tribe or tribal organization, be made according to rates 
239.23  authorized under sections 256.969, subdivision 16, and 
239.24  256B.0625, subdivision 34.  Implementation of this purchasing 
239.25  model is contingent on federal approval. 
239.26     (b) The commissioner of human services, in consultation 
239.27  with tribal governments, shall develop a plan for tribes to 
239.28  assist in the enrollment process for American Indian recipients 
239.29  enrolled in the demonstration project for people with 
239.30  disabilities under this section.  This plan also shall address 
239.31  how tribes will be included in ensuring the coordination of care 
239.32  for American Indian recipients between Indian health service or 
239.33  tribal providers and other providers. 
239.34     (c) For purposes of this subdivision, "American Indian" has 
239.35  the meaning given to persons to whom services will be provided 
239.36  for in Code of Federal Regulations, title 42, section 36.12. 
240.1      Sec. 87.  Minnesota Statutes 1998, section 256B.77, 
240.2   subdivision 8, is amended to read: 
240.3      Subd. 8.  [RESPONSIBILITIES OF THE COUNTY ADMINISTRATIVE 
240.4   ENTITY.] (a) The county administrative entity shall meet the 
240.5   requirements of this subdivision, unless the county authority or 
240.6   the commissioner, with written approval of the county authority, 
240.7   enters into a service delivery contract with a service delivery 
240.8   organization for any or all of the requirements contained in 
240.9   this subdivision. 
240.10     (b) The county administrative entity shall enroll eligible 
240.11  individuals regardless of health or disability status. 
240.12     (c) The county administrative entity shall provide all 
240.13  enrollees timely access to the medical assistance benefit set.  
240.14  Alternative services and additional services are available to 
240.15  enrollees at the option of the county administrative entity and 
240.16  may be provided if specified in the personal support plan.  
240.17  County authorities are not required to seek prior authorization 
240.18  from the department as required by the laws and rules governing 
240.19  medical assistance. 
240.20     (d) The county administrative entity shall cover necessary 
240.21  services as a result of an emergency without prior 
240.22  authorization, even if the services were rendered outside of the 
240.23  provider network. 
240.24     (e) The county administrative entity shall authorize 
240.25  necessary and appropriate services when needed and requested by 
240.26  the enrollee or the enrollee's legal representative in response 
240.27  to an urgent situation.  Enrollees shall have 24-hour access to 
240.28  urgent care services coordinated by experienced disability 
240.29  providers who have information about enrollees' needs and 
240.30  conditions. 
240.31     (f) The county administrative entity shall accept the 
240.32  capitation payment from the commissioner in return for the 
240.33  provision of services for enrollees. 
240.34     (g) The county administrative entity shall maintain 
240.35  internal grievance and complaint procedures, including an 
240.36  expedited informal complaint process in which the county 
241.1   administrative entity must respond to verbal complaints within 
241.2   ten calendar days, and a formal grievance process, in which the 
241.3   county administrative entity must respond to written complaints 
241.4   within 30 calendar days. 
241.5      (h) The county administrative entity shall provide a 
241.6   certificate of coverage, upon enrollment, to each enrollee and 
241.7   the enrollee's legal representative, if any, which describes the 
241.8   benefits covered by the county administrative entity, any 
241.9   limitations on those benefits, and information about providers 
241.10  and the service delivery network.  This information must also be 
241.11  made available to prospective enrollees.  This certificate must 
241.12  be approved by the commissioner. 
241.13     (i) The county administrative entity shall present evidence 
241.14  of an expedited process to approve exceptions to benefits, 
241.15  provider network restrictions, and other plan limitations under 
241.16  appropriate circumstances. 
241.17     (j) The county administrative entity shall provide 
241.18  enrollees or their legal representatives with written notice of 
241.19  their appeal rights under subdivision 16, and of ombudsman and 
241.20  advocacy programs under subdivisions 13 and 14, at the following 
241.21  times:  upon enrollment, upon submission of a written complaint, 
241.22  when a service is reduced, denied, or terminated, or when 
241.23  renewal of authorization for ongoing service is refused. 
241.24     (k) The county administrative entity shall determine 
241.25  immediate needs, including services, support, and assessments, 
241.26  within 30 calendar days of after enrollment, or within a shorter 
241.27  time frame if specified in the intergovernmental contract. 
241.28     (l) The county administrative entity shall assess the need 
241.29  for services of new enrollees within 60 calendar days of after 
241.30  enrollment, or within a shorter time frame if specified in the 
241.31  intergovernmental contract, and periodically reassess the need 
241.32  for services for all enrollees. 
241.33     (m) The county administrative entity shall ensure the 
241.34  development of a personal support plan for each person within 60 
241.35  calendar days of enrollment, or within a shorter time frame if 
241.36  specified in the intergovernmental contract, unless otherwise 
242.1   agreed to by the enrollee and the enrollee's legal 
242.2   representative, if any.  Until a personal support plan is 
242.3   developed and agreed to by the enrollee, enrollees must have 
242.4   access to the same amount, type, setting, duration, and 
242.5   frequency of covered services that they had at the time of 
242.6   enrollment unless other covered services are needed.  For an 
242.7   enrollee who is not receiving covered services at the time of 
242.8   enrollment and for enrollees whose personal support plan is 
242.9   being revised, access to the medical assistance benefit set must 
242.10  be assured until a personal support plan is developed or 
242.11  revised.  If an enrollee chooses not to develop a personal 
242.12  support plan, the enrollee will be subject to the network and 
242.13  prior authorization requirements of the county administrative 
242.14  entity or service delivery organization 60 days after 
242.15  enrollment.  An enrollee can choose to have a personal support 
242.16  plan developed at any time.  The personal support plan must be 
242.17  based on choices, preferences, and assessed needs and strengths 
242.18  of the enrollee.  The service coordinator shall develop the 
242.19  personal support plan, in consultation with the enrollee or the 
242.20  enrollee's legal representative and other individuals requested 
242.21  by the enrollee.  The personal support plan must be updated as 
242.22  needed or as requested by the enrollee.  Enrollees may choose 
242.23  not to have a personal support plan. 
242.24     (n) The county administrative entity shall ensure timely 
242.25  authorization, arrangement, and continuity of needed and covered 
242.26  supports and services. 
242.27     (o) The county administrative entity shall offer service 
242.28  coordination that fulfills the responsibilities under 
242.29  subdivision 12 and is appropriate to the enrollee's needs, 
242.30  choices, and preferences, including a choice of service 
242.31  coordinator. 
242.32     (p) The county administrative entity shall contract with 
242.33  schools and other agencies as appropriate to provide otherwise 
242.34  covered medically necessary medical assistance services as 
242.35  described in an enrollee's individual family support plan, as 
242.36  described in sections 125A.26 to 125A.48, or individual 
243.1   education plan, as described in chapter 125A. 
243.2      (q) The county administrative entity shall develop and 
243.3   implement strategies, based on consultation with affected 
243.4   groups, to respect diversity and ensure culturally competent 
243.5   service delivery in a manner that promotes the physical, social, 
243.6   psychological, and spiritual well-being of enrollees and 
243.7   preserves the dignity of individuals, families, and their 
243.8   communities. 
243.9      (r) When an enrollee changes county authorities, county 
243.10  administrative entities shall ensure coordination with the 
243.11  entity that is assuming responsibility for administering the 
243.12  medical assistance benefit set to ensure continuity of supports 
243.13  and services for the enrollee. 
243.14     (s) The county administrative entity shall comply with 
243.15  additional requirements as specified in the intergovernmental 
243.16  contract.  
243.17     (t) To the extent that alternatives are approved under 
243.18  subdivision 17, county administrative entities must provide for 
243.19  the health and safety of enrollees and protect the rights to 
243.20  privacy and to provide informed consent. 
243.21     Sec. 88.  Minnesota Statutes 1998, section 256B.77, is 
243.22  amended by adding a subdivision to read: 
243.23     Subd. 27.  [SERVICE COORDINATION TRANSITION.] Demonstration 
243.24  sites designated under subdivision 5, with the permission of an 
243.25  eligible individual, may implement the provisions of subdivision 
243.26  12 beginning 60 calendar days prior to an individual's 
243.27  enrollment.  This implementation may occur prior to the 
243.28  enrollment of eligible individuals, but is restricted to 
243.29  eligible individuals. 
243.30     Sec. 89.  Minnesota Statutes 1998, section 256D.03, 
243.31  subdivision 3, is amended to read: 
243.32     Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
243.33  (a) General assistance medical care may be paid for any person 
243.34  who is not eligible for medical assistance under chapter 256B, 
243.35  including eligibility for medical assistance based on a 
243.36  spenddown of excess income according to section 256B.056, 
244.1   subdivision 5, or MinnesotaCare as defined in paragraph (b), 
244.2   except as provided in paragraph (c); and: 
244.3      (1) who is receiving assistance under section 256D.05, 
244.4   except for families with children who are eligible under 
244.5   Minnesota family investment program-statewide (MFIP-S), who is 
244.6   having a payment made on the person's behalf under sections 
244.7   256I.01 to 256I.06, or who resides in group residential housing 
244.8   as defined in chapter 256I and can meet a spenddown using the 
244.9   cost of remedial services received through group residential 
244.10  housing; or 
244.11     (2)(i) who is a resident of Minnesota; and whose equity in 
244.12  assets is not in excess of $1,000 per assistance unit.  Exempt 
244.13  assets, the reduction of excess assets, and the waiver of excess 
244.14  assets must conform to the medical assistance program in chapter 
244.15  256B, with the following exception:  the maximum amount of 
244.16  undistributed funds in a trust that could be distributed to or 
244.17  on behalf of the beneficiary by the trustee, assuming the full 
244.18  exercise of the trustee's discretion under the terms of the 
244.19  trust, must be applied toward the asset maximum; and 
244.20     (ii) who has countable income not in excess of the 
244.21  assistance standards established in section 256B.056, 
244.22  subdivision 4, or whose excess income is spent down according to 
244.23  section 256B.056, subdivision 5, using a six-month budget 
244.24  period.  The method for calculating earned income disregards and 
244.25  deductions for a person who resides with a dependent child under 
244.26  age 21 shall follow section 256B.056, subdivision 1a.  However, 
244.27  if a disregard of $30 and one-third of the remainder has been 
244.28  applied to the wage earner's income, the disregard shall not be 
244.29  applied again until the wage earner's income has not been 
244.30  considered in an eligibility determination for general 
244.31  assistance, general assistance medical care, medical assistance, 
244.32  or MFIP-S for 12 consecutive months.  The earned income and work 
244.33  expense deductions for a person who does not reside with a 
244.34  dependent child under age 21 shall be the same as the method 
244.35  used to determine eligibility for a person under section 
244.36  256D.06, subdivision 1, except the disregard of the first $50 of 
245.1   earned income is not allowed; 
245.2      (3) who would be eligible for medical assistance except 
245.3   that the person resides in a facility that is determined by the 
245.4   commissioner or the federal Health Care Financing Administration 
245.5   to be an institution for mental diseases; or 
245.6      (4) who is ineligible for medical assistance under chapter 
245.7   256B or general assistance medical care under any other 
245.8   provision of this section, and is receiving care and 
245.9   rehabilitation services from a nonprofit center established to 
245.10  serve victims of torture.  These individuals are eligible for 
245.11  general assistance medical care only for the period during which 
245.12  they are receiving services from the center.  During this period 
245.13  of eligibility, individuals eligible under this clause shall not 
245.14  be required to participate in prepaid general assistance medical 
245.15  care.  
245.16     (b) Beginning January 1, 2000, applicants or recipients who 
245.17  meet all eligibility requirements of MinnesotaCare as defined in 
245.18  sections 256L.01 to 256L.16, and are: 
245.19     (i) adults with dependent children under 21 whose gross 
245.20  family income is equal to or less than 275 percent of the 
245.21  federal poverty guidelines; or 
245.22     (ii) adults without children with earned income and whose 
245.23  family gross income is between 75 percent of the federal poverty 
245.24  guidelines and the amount set by section 256L.04, subdivision 7, 
245.25  shall be terminated from general assistance medical care upon 
245.26  enrollment in MinnesotaCare. 
245.27     (c) For services rendered on or after July 1, 1997, 
245.28  eligibility is limited to one month prior to application if the 
245.29  person is determined eligible in the prior month.  A 
245.30  redetermination of eligibility must occur every 12 months.  
245.31  Beginning January 1, 2000, Minnesota health care program 
245.32  applications completed by recipients and applicants who are 
245.33  persons described in paragraph (b), may be returned to the 
245.34  county agency to be forwarded to the department of human 
245.35  services or sent directly to the department of human services 
245.36  for enrollment in MinnesotaCare.  If all other eligibility 
246.1   requirements of this subdivision are met, eligibility for 
246.2   general assistance medical care shall be available in any month 
246.3   during which a MinnesotaCare eligibility determination and 
246.4   enrollment are pending.  Upon notification of eligibility for 
246.5   MinnesotaCare, notice of termination for eligibility for general 
246.6   assistance medical care shall be sent to an applicant or 
246.7   recipient.  If all other eligibility requirements of this 
246.8   subdivision are met, eligibility for general assistance medical 
246.9   care shall be available until enrollment in MinnesotaCare 
246.10  subject to the provisions of paragraph (e). 
246.11     (d) The date of an initial Minnesota health care program 
246.12  application necessary to begin a determination of eligibility 
246.13  shall be the date the applicant has provided a name, address, 
246.14  and social security number, signed and dated, to the county 
246.15  agency or the department of human services.  If the applicant is 
246.16  unable to provide an initial application when health care is 
246.17  delivered due to a medical condition or disability, a health 
246.18  care provider may act on the person's behalf to complete the 
246.19  initial application.  The applicant must complete the remainder 
246.20  of the application and provide necessary verification before 
246.21  eligibility can be determined.  The county agency must assist 
246.22  the applicant in obtaining verification if necessary.  On the 
246.23  basis of information provided on the completed application, an 
246.24  applicant who meets the following criteria shall be determined 
246.25  eligible beginning in the month of application: 
246.26     (1) has gross income less than 90 percent of the applicable 
246.27  income standard; 
246.28     (2) has liquid assets that total within $300 of the asset 
246.29  standard; 
246.30     (3) does not reside in a long-term care facility; and 
246.31     (4) meets all other eligibility requirements. 
246.32  The applicant must provide all required verifications within 30 
246.33  days' notice of the eligibility determination or eligibility 
246.34  shall be terminated. 
246.35     (e) County agencies are authorized to use all automated 
246.36  databases containing information regarding recipients' or 
247.1   applicants' income in order to determine eligibility for general 
247.2   assistance medical care or MinnesotaCare.  Such use shall be 
247.3   considered sufficient in order to determine eligibility and 
247.4   premium payments by the county agency. 
247.5      (f) General assistance medical care is not available for a 
247.6   person in a correctional facility unless the person is detained 
247.7   by law for less than one year in a county correctional or 
247.8   detention facility as a person accused or convicted of a crime, 
247.9   or admitted as an inpatient to a hospital on a criminal hold 
247.10  order, and the person is a recipient of general assistance 
247.11  medical care at the time the person is detained by law or 
247.12  admitted on a criminal hold order and as long as the person 
247.13  continues to meet other eligibility requirements of this 
247.14  subdivision.  
247.15     (g) General assistance medical care is not available for 
247.16  applicants or recipients who do not cooperate with the county 
247.17  agency to meet the requirements of medical assistance.  General 
247.18  assistance medical care is limited to payment of emergency 
247.19  services only for applicants or recipients as described in 
247.20  paragraph (b), whose MinnesotaCare coverage is denied or 
247.21  terminated for nonpayment of premiums as required by sections 
247.22  256L.06 and 256L.07.  
247.23     (h) In determining the amount of assets of an individual, 
247.24  there shall be included any asset or interest in an asset, 
247.25  including an asset excluded under paragraph (a), that was given 
247.26  away, sold, or disposed of for less than fair market value 
247.27  within the 60 months preceding application for general 
247.28  assistance medical care or during the period of eligibility.  
247.29  Any transfer described in this paragraph shall be presumed to 
247.30  have been for the purpose of establishing eligibility for 
247.31  general assistance medical care, unless the individual furnishes 
247.32  convincing evidence to establish that the transaction was 
247.33  exclusively for another purpose.  For purposes of this 
247.34  paragraph, the value of the asset or interest shall be the fair 
247.35  market value at the time it was given away, sold, or disposed 
247.36  of, less the amount of compensation received.  For any 
248.1   uncompensated transfer, the number of months of ineligibility, 
248.2   including partial months, shall be calculated by dividing the 
248.3   uncompensated transfer amount by the average monthly per person 
248.4   payment made by the medical assistance program to skilled 
248.5   nursing facilities for the previous calendar year.  The 
248.6   individual shall remain ineligible until this fixed period has 
248.7   expired.  The period of ineligibility may exceed 30 months, and 
248.8   a reapplication for benefits after 30 months from the date of 
248.9   the transfer shall not result in eligibility unless and until 
248.10  the period of ineligibility has expired.  The period of 
248.11  ineligibility begins in the month the transfer was reported to 
248.12  the county agency, or if the transfer was not reported, the 
248.13  month in which the county agency discovered the transfer, 
248.14  whichever comes first.  For applicants, the period of 
248.15  ineligibility begins on the date of the first approved 
248.16  application. 
248.17     (i) When determining eligibility for any state benefits 
248.18  under this subdivision, the income and resources of all 
248.19  noncitizens shall be deemed to include their sponsor's income 
248.20  and resources as defined in the Personal Responsibility and Work 
248.21  Opportunity Reconciliation Act of 1996, title IV, Public Law 
248.22  Number 104-193, sections 421 and 422, and subsequently set out 
248.23  in federal rules. 
248.24     (j)(1) An undocumented noncitizen or a nonimmigrant is 
248.25  ineligible for general assistance medical care other than 
248.26  emergency services.  For purposes of this subdivision, a 
248.27  nonimmigrant is an individual in one or more of the classes 
248.28  listed in United States Code, title 8, section 1101(a)(15), and 
248.29  an undocumented noncitizen is an individual who resides in the 
248.30  United States without the approval or acquiescence of the 
248.31  Immigration and Naturalization Service. 
248.32     (2) This paragraph does not apply to a child under age 18, 
248.33  to a Cuban or Haitian entrant as defined in Public Law Number 
248.34  96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 
248.35  aged, blind, or disabled as defined in Code of Federal 
248.36  Regulations, title 42, sections 435.520, 435.530, 435.531, 
249.1   435.540, and 435.541, or effective October 1, 1998, to an 
249.2   individual eligible for general assistance medical care under 
249.3   paragraph (a), clause (4), who cooperates with the Immigration 
249.4   and Naturalization Service to pursue any applicable immigration 
249.5   status, including citizenship, that would qualify the individual 
249.6   for medical assistance with federal financial participation. 
249.7      (3) For purposes of this paragraph, "emergency services" 
249.8   has the meaning given in Code of Federal Regulations, title 42, 
249.9   section 440.255(b)(1), except that it also means services 
249.10  rendered because of suspected or actual pesticide poisoning. 
249.11     (k) Notwithstanding any other provision of law, a 
249.12  noncitizen who is ineligible for medical assistance due to the 
249.13  deeming of a sponsor's income and resources, is ineligible for 
249.14  general assistance medical care. 
249.15     Sec. 90.  Minnesota Statutes 1998, section 256D.03, 
249.16  subdivision 4, is amended to read: 
249.17     Subd. 4.  [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 
249.18  For a person who is eligible under subdivision 3, paragraph (a), 
249.19  clause (3), general assistance medical care covers, except as 
249.20  provided in paragraph (c): 
249.21     (1) inpatient hospital services; 
249.22     (2) outpatient hospital services; 
249.23     (3) services provided by Medicare certified rehabilitation 
249.24  agencies; 
249.25     (4) prescription drugs and other products recommended 
249.26  through the process established in section 256B.0625, 
249.27  subdivision 13; 
249.28     (5) equipment necessary to administer insulin and 
249.29  diagnostic supplies and equipment for diabetics to monitor blood 
249.30  sugar level; 
249.31     (6) eyeglasses and eye examinations provided by a physician 
249.32  or optometrist; 
249.33     (7) hearing aids; 
249.34     (8) prosthetic devices; 
249.35     (9) laboratory and X-ray services; 
249.36     (10) physician's services; 
250.1      (11) medical transportation; 
250.2      (12) chiropractic services as covered under the medical 
250.3   assistance program; 
250.4      (13) podiatric services; 
250.5      (14) dental services; 
250.6      (15) outpatient services provided by a mental health center 
250.7   or clinic that is under contract with the county board and is 
250.8   established under section 245.62; 
250.9      (16) day treatment services for mental illness provided 
250.10  under contract with the county board; 
250.11     (17) prescribed medications for persons who have been 
250.12  diagnosed as mentally ill as necessary to prevent more 
250.13  restrictive institutionalization; 
250.14     (18) psychological services, medical supplies and 
250.15  equipment, and Medicare premiums, coinsurance and deductible 
250.16  payments; 
250.17     (19) medical equipment not specifically listed in this 
250.18  paragraph when the use of the equipment will prevent the need 
250.19  for costlier services that are reimbursable under this 
250.20  subdivision; 
250.21     (20) services performed by a certified pediatric nurse 
250.22  practitioner, a certified family nurse practitioner, a certified 
250.23  adult nurse practitioner, a certified obstetric/gynecological 
250.24  nurse practitioner, a certified neonatal nurse practitioner, or 
250.25  a certified geriatric nurse practitioner in independent 
250.26  practice, if the services are otherwise covered under this 
250.27  chapter as a physician service, are provided on an inpatient 
250.28  basis and are not part of the cost for inpatient services 
250.29  included in the operating payment rate, and if the service is 
250.30  within the scope of practice of the nurse practitioner's license 
250.31  as a registered nurse, as defined in section 148.171; and 
250.32     (21) services of a certified public health nurse or a 
250.33  registered nurse practicing in a public health nursing clinic 
250.34  that is a department of, or that operates under the direct 
250.35  authority of, a unit of government, if the service is within the 
250.36  scope of practice of the public health nurse's license as a 
251.1   registered nurse, as defined in section 148.171; 
251.2      (22) telemedicine consultations via two-way, interactive 
251.3   video or store and forward technology.  Store and forward 
251.4   technology includes telemedicine consultations that do not occur 
251.5   in real time via synchronous transmissions and that do not 
251.6   require a face-to-face encounter with the patient for all or any 
251.7   part of any such telemedicine consultation.  The patient record 
251.8   must include a written opinion from the consulting physician 
251.9   providing the telemedicine consultation.  A communication 
251.10  between two physicians that consists solely of a telephone 
251.11  conversation is not a telemedicine consultation.  Coverage is 
251.12  limited to three telemedicine consultations per recipient per 
251.13  calendar week.  Telemedicine consultations shall be paid at the 
251.14  full allowable rate; and 
251.15     (23) language interpreter services provided in conjunction 
251.16  with another covered health service.  Interpreter services 
251.17  provided under this subdivision must satisfy the requirements of 
251.18  section 256B.0625, subdivision 42.  
251.19     (b) Except as provided in paragraph (c), for a recipient 
251.20  who is eligible under subdivision 3, paragraph (a), clause (1) 
251.21  or (2), general assistance medical care covers the services 
251.22  listed in paragraph (a) with the exception of special 
251.23  transportation services. 
251.24     (c) Gender reassignment surgery and related services are 
251.25  not covered services under this subdivision unless the 
251.26  individual began receiving gender reassignment services prior to 
251.27  July 1, 1995.  
251.28     (d) In order to contain costs, the commissioner of human 
251.29  services shall select vendors of medical care who can provide 
251.30  the most economical care consistent with high medical standards 
251.31  and shall where possible contract with organizations on a 
251.32  prepaid capitation basis to provide these services.  The 
251.33  commissioner shall consider proposals by counties and vendors 
251.34  for prepaid health plans, competitive bidding programs, block 
251.35  grants, or other vendor payment mechanisms designed to provide 
251.36  services in an economical manner or to control utilization, with 
252.1   safeguards to ensure that necessary services are provided.  
252.2   Before implementing prepaid programs in counties with a county 
252.3   operated or affiliated public teaching hospital or a hospital or 
252.4   clinic operated by the University of Minnesota, the commissioner 
252.5   shall consider the risks the prepaid program creates for the 
252.6   hospital and allow the county or hospital the opportunity to 
252.7   participate in the program in a manner that reflects the risk of 
252.8   adverse selection and the nature of the patients served by the 
252.9   hospital, provided the terms of participation in the program are 
252.10  competitive with the terms of other participants considering the 
252.11  nature of the population served.  Payment for services provided 
252.12  pursuant to this subdivision shall be as provided to medical 
252.13  assistance vendors of these services under sections 256B.02, 
252.14  subdivision 8, and 256B.0625.  For payments made during fiscal 
252.15  year 1990 and later years, the commissioner shall consult with 
252.16  an independent actuary in establishing prepayment rates, but 
252.17  shall retain final control over the rate methodology.  
252.18  Notwithstanding the provisions of subdivision 3, an individual 
252.19  who becomes ineligible for general assistance medical care 
252.20  because of failure to submit income reports or recertification 
252.21  forms in a timely manner, shall remain enrolled in the prepaid 
252.22  health plan and shall remain eligible for general assistance 
252.23  medical care coverage through the last day of the month in which 
252.24  the enrollee became ineligible for general assistance medical 
252.25  care. 
252.26     (e) The commissioner of human services may reduce payments 
252.27  provided under sections 256D.01 to 256D.21 and 261.23 in order 
252.28  to remain within the amount appropriated for general assistance 
252.29  medical care, within the following restrictions: 
252.30     (i) For the period July 1, 1985 to December 31, 1985, 
252.31  reductions below the cost per service unit allowable under 
252.32  section 256.966, are permitted only as follows:  payments for 
252.33  inpatient and outpatient hospital care provided in response to a 
252.34  primary diagnosis of chemical dependency or mental illness may 
252.35  be reduced no more than 30 percent; payments for all other 
252.36  inpatient hospital care may be reduced no more than 20 percent.  
253.1   Reductions below the payments allowable under general assistance 
253.2   medical care for the remaining general assistance medical care 
253.3   services allowable under this subdivision may be reduced no more 
253.4   than ten percent. 
253.5      (ii) For the period January 1, 1986 to December 31, 1986, 
253.6   reductions below the cost per service unit allowable under 
253.7   section 256.966 are permitted only as follows:  payments for 
253.8   inpatient and outpatient hospital care provided in response to a 
253.9   primary diagnosis of chemical dependency or mental illness may 
253.10  be reduced no more than 20 percent; payments for all other 
253.11  inpatient hospital care may be reduced no more than 15 percent.  
253.12  Reductions below the payments allowable under general assistance 
253.13  medical care for the remaining general assistance medical care 
253.14  services allowable under this subdivision may be reduced no more 
253.15  than five percent. 
253.16     (iii) For the period January 1, 1987 to June 30, 1987, 
253.17  reductions below the cost per service unit allowable under 
253.18  section 256.966 are permitted only as follows:  payments for 
253.19  inpatient and outpatient hospital care provided in response to a 
253.20  primary diagnosis of chemical dependency or mental illness may 
253.21  be reduced no more than 15 percent; payments for all other 
253.22  inpatient hospital care may be reduced no more than ten 
253.23  percent.  Reductions below the payments allowable under medical 
253.24  assistance for the remaining general assistance medical care 
253.25  services allowable under this subdivision may be reduced no more 
253.26  than five percent.  
253.27     (iv) For the period July 1, 1987 to June 30, 1988, 
253.28  reductions below the cost per service unit allowable under 
253.29  section 256.966 are permitted only as follows:  payments for 
253.30  inpatient and outpatient hospital care provided in response to a 
253.31  primary diagnosis of chemical dependency or mental illness may 
253.32  be reduced no more than 15 percent; payments for all other 
253.33  inpatient hospital care may be reduced no more than five percent.
253.34  Reductions below the payments allowable under medical assistance 
253.35  for the remaining general assistance medical care services 
253.36  allowable under this subdivision may be reduced no more than 
254.1   five percent. 
254.2      (v) For the period July 1, 1988 to June 30, 1989, 
254.3   reductions below the cost per service unit allowable under 
254.4   section 256.966 are permitted only as follows:  payments for 
254.5   inpatient and outpatient hospital care provided in response to a 
254.6   primary diagnosis of chemical dependency or mental illness may 
254.7   be reduced no more than 15 percent; payments for all other 
254.8   inpatient hospital care may not be reduced.  Reductions below 
254.9   the payments allowable under medical assistance for the 
254.10  remaining general assistance medical care services allowable 
254.11  under this subdivision may be reduced no more than five percent. 
254.12     (f) (e) There shall be no copayment required of any 
254.13  recipient of benefits for any services provided under this 
254.14  subdivision.  A hospital receiving a reduced payment as a result 
254.15  of this section may apply the unpaid balance toward satisfaction 
254.16  of the hospital's bad debts. 
254.17     (g) (f) Any county may, from its own resources, provide 
254.18  medical payments for which state payments are not made. 
254.19     (h) (g) Chemical dependency services that are reimbursed 
254.20  under chapter 254B must not be reimbursed under general 
254.21  assistance medical care. 
254.22     (i) (h) The maximum payment for new vendors enrolled in the 
254.23  general assistance medical care program after the base year 
254.24  shall be determined from the average usual and customary charge 
254.25  of the same vendor type enrolled in the base year. 
254.26     (j) (i) The conditions of payment for services under this 
254.27  subdivision are the same as the conditions specified in rules 
254.28  adopted under chapter 256B governing the medical assistance 
254.29  program, unless otherwise provided by statute or rule. 
254.30     <i>(Effective date:  Section 90 (256D.03, subd. 4) is</i> 
254.31  <i>effective for services rendered on or after July 1, 1999.)</i> 
254.32     Sec. 91.  Minnesota Statutes 1998, section 256D.03, 
254.33  subdivision 8, is amended to read: 
254.34     Subd. 8.  [PRIVATE INSURANCE POLICIES.] (a) Private 
254.35  accident and health care coverage for medical services is 
254.36  primary coverage and must be exhausted before general assistance 
255.1   medical care is paid.  When a person who is otherwise eligible 
255.2   for general assistance medical care has private accident or 
255.3   health care coverage, including a prepaid health plan, the 
255.4   private health care benefits available to the person must be 
255.5   used first and to the fullest extent.  General assistance 
255.6   medical care payment will not be made when either covered 
255.7   charges are paid in full by a third party or the provider has an 
255.8   agreement to accept payment for less than charges as payment in 
255.9   full.  Payment for patients that are simultaneously covered by 
255.10  general assistance medical care and a liable third party other 
255.11  than Medicare will be determined as the lesser of clauses (1) to 
255.12  (3): 
255.13     (1) the patient liability according to the provider/insurer 
255.14  agreement; 
255.15     (2) covered charges minus the third party payment amount; 
255.16  or 
255.17     (3) the general assistance medical care rate minus the 
255.18  third party payment amount. 
255.19  A negative difference will not be implemented. 
255.20     (b) When a parent or a person with an obligation of support 
255.21  has enrolled in a prepaid health care plan under section 
255.22  518.171, subdivision 1, the commissioner of human services shall 
255.23  limit the recipient of general assistance medical care to the 
255.24  benefits payable under that prepaid health care plan to the 
255.25  extent that services available under general assistance medical 
255.26  care are also available under the prepaid health care plan.  
255.27     (c) Upon furnishing general assistance medical care or 
255.28  general assistance to any person having private accident or 
255.29  health care coverage, or having a cause of action arising out of 
255.30  an occurrence that necessitated the payment of assistance, the 
255.31  state agency shall be subrogated, to the extent of the cost of 
255.32  medical care, subsistence, or other payments furnished, to any 
255.33  rights the person may have under the terms of the coverage or 
255.34  under the cause of action.  For purposes of this subdivision, 
255.35  "state agency" includes prepaid health plans under contract with 
255.36  the commissioner according to sections 256B.69, 256D.03, 
256.1   subdivision 4, paragraph (d), and 256L.12; children's mental 
256.2   health collaboratives under section 245.493; demonstration 
256.3   projects for persons with disabilities under section 256B.77; 
256.4   nursing homes under the alternative payment demonstration 
256.5   project under section 256B.434; and county-based purchasing 
256.6   entities under section 256B.692. 
256.7      This right of subrogation includes all portions of the 
256.8   cause of action, notwithstanding any settlement allocation or 
256.9   apportionment that purports to dispose of portions of the cause 
256.10  of action not subject to subrogation.  
256.11     (d) To recover under this section, the attorney general or 
256.12  the appropriate county attorney, acting upon direction from the 
256.13  attorney general, may institute or join a civil action to 
256.14  enforce the subrogation rights the commissioner established 
256.15  under this section.  
256.16     Any prepaid health plan providing services under sections 
256.17  256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
256.18  children's mental health collaboratives under section 245.493; 
256.19  demonstration projects for persons with disabilities under 
256.20  section 256B.77; nursing homes under the alternative payment 
256.21  demonstration project under section 256B.434; or the 
256.22  county-based purchasing entity providing services under section 
256.23  256B.692 may retain legal representation to enforce the 
256.24  subrogation rights created under this section or, if no action 
256.25  has been brought, may initiate and prosecute an independent 
256.26  action on their behalf against a person, firm, or corporation 
256.27  that may be liable to the person to whom the care or payment was 
256.28  furnished. 
256.29     (e) The state agency must be given notice of monetary 
256.30  claims against a person, firm, or corporation that may be liable 
256.31  in damages, or otherwise obligated to pay part or all of the 
256.32  costs related to an injury when the state agency has paid or 
256.33  become liable for the cost of care or payments related to the 
256.34  injury.  Notice must be given as follows:  
256.35     (i) Applicants for general assistance or general assistance 
256.36  medical care shall notify the state or county agency of any 
257.1   possible claims when they submit the application.  Recipients of 
257.2   general assistance or general assistance medical care shall 
257.3   notify the state or county agency of any possible claims when 
257.4   those claims arise.  
257.5      (ii) A person providing medical care services to a 
257.6   recipient of general assistance medical care shall notify the 
257.7   state agency when the person has reason to believe that a third 
257.8   party may be liable for payment of the cost of medical care.  
257.9      (iii) A person who is party to a claim upon which the state 
257.10  agency may be entitled to subrogation under this section shall 
257.11  notify the state agency of its potential subrogation claim 
257.12  before filing a claim, commencing an action, or negotiating a 
257.13  settlement.  A person who is a party to a claim includes the 
257.14  plaintiff, the defendants, and any other party to the cause of 
257.15  action. 
257.16     Notice given to the county agency is not sufficient to meet 
257.17  the requirements of paragraphs (b) and (c).  
257.18     (f) Upon any judgment, award, or settlement of a cause of 
257.19  action, or any part of it, upon which the state agency has a 
257.20  subrogation right, including compensation for liquidated, 
257.21  unliquidated, or other damages, reasonable costs of collection, 
257.22  including attorney fees, must be deducted first.  The full 
257.23  amount of general assistance or general assistance medical care 
257.24  paid to or on behalf of the person as a result of the injury 
257.25  must be deducted next and paid to the state agency.  The rest 
257.26  must be paid to the public assistance recipient or other 
257.27  plaintiff.  The plaintiff, however, must receive at least 
257.28  one-third of the net recovery after attorney fees and collection 
257.29  costs. 
257.30     Sec. 92.  Minnesota Statutes 1998, section 256L.03, 
257.31  subdivision 5, is amended to read: 
257.32     Subd. 5.  [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 
257.33  benefit plan shall include the following copayments and 
257.34  coinsurance requirements for all enrollees except parents and 
257.35  relative caretakers of children under the age of 21 in 
257.36  households with income at or below 175 percent of the federal 
258.1   poverty guidelines and pregnant women and children under the age 
258.2   of 21:  
258.3      (1) ten percent of the paid charges for inpatient hospital 
258.4   services for adult enrollees, subject to an annual inpatient 
258.5   out-of-pocket maximum of $1,000 per individual and $3,000 per 
258.6   family; 
258.7      (2) $3 per prescription for adult enrollees; 
258.8      (3) $25 for eyeglasses for adult enrollees; and 
258.9      (4) effective July 1, 1998, 50 percent of the 
258.10  fee-for-service rate for adult dental care services other than 
258.11  preventive care services for persons eligible under section 
258.12  256L.04, subdivisions 1 to 7, with income equal to or less than 
258.13  175 percent of the federal poverty guidelines. 
258.14     Effective July 1, 1997, adult enrollees with family gross 
258.15  income that exceeds 175 percent of the federal poverty 
258.16  guidelines and who are not pregnant shall be financially 
258.17  responsible for the coinsurance amount and amounts which exceed 
258.18  the $10,000 inpatient hospital benefit limit. 
258.19     When a MinnesotaCare enrollee becomes a member of a prepaid 
258.20  health plan, or changes from one prepaid health plan to another 
258.21  during a calendar year, any charges submitted towards the 
258.22  $10,000 annual inpatient benefit limit, and any out-of-pocket 
258.23  expenses incurred by the enrollee for inpatient services, that 
258.24  were submitted or incurred prior to enrollment, or prior to the 
258.25  change in health plans, shall be disregarded. 
258.26     Sec. 93.  Minnesota Statutes 1998, section 256L.03, 
258.27  subdivision 6, is amended to read: 
258.28     Subd. 6.  [LIEN.] When the state agency provides, pays for, 
258.29  or becomes liable for covered health services, the agency shall 
258.30  have a lien for the cost of the covered health services upon any 
258.31  and all causes of action accruing to the enrollee, or to the 
258.32  enrollee's legal representatives, as a result of the occurrence 
258.33  that necessitated the payment for the covered health services.  
258.34  All liens under this section shall be subject to the provisions 
258.35  of section 256.015.  For purposes of this subdivision, "state 
258.36  agency" includes authorized agents of the state agency prepaid 
259.1   health plans under contract with the commissioner according to 
259.2   sections 256B.69, 256D.03, subdivision 4, paragraph (d), and 
259.3   256L.12; and county-based purchasing entities under section 
259.4   256B.692. 
259.5      Sec. 94.  Minnesota Statutes 1998, section 256L.04, 
259.6   subdivision 2, is amended to read: 
259.7      Subd. 2.  [COOPERATION IN ESTABLISHING THIRD-PARTY 
259.8   LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 
259.9   eligible for MinnesotaCare, individuals and families must 
259.10  cooperate with the state agency to identify potentially liable 
259.11  third-party payers and assist the state in obtaining third-party 
259.12  payments.  "Cooperation" includes, but is not limited to, 
259.13  identifying any third party who may be liable for care and 
259.14  services provided under MinnesotaCare to the enrollee, providing 
259.15  relevant information to assist the state in pursuing a 
259.16  potentially liable third party, and completing forms necessary 
259.17  to recover third-party payments. 
259.18     (b) A parent, guardian, relative caretaker, or child 
259.19  enrolled in the MinnesotaCare program must cooperate with the 
259.20  department of human services and the local agency in 
259.21  establishing the paternity of an enrolled child and in obtaining 
259.22  medical care support and payments for the child and any other 
259.23  person for whom the person can legally assign rights, in 
259.24  accordance with applicable laws and rules governing the medical 
259.25  assistance program.  A child shall not be ineligible for or 
259.26  disenrolled from the MinnesotaCare program solely because the 
259.27  child's parent, relative caretaker, or guardian fails to 
259.28  cooperate in establishing paternity or obtaining medical support.
259.29     Sec. 95.  Minnesota Statutes 1998, section 256L.04, 
259.30  subdivision 7, is amended to read: 
259.31     Subd. 7.  [SINGLE ADULTS AND HOUSEHOLDS WITH NO CHILDREN.] 
259.32  The definition of eligible persons includes all individuals and 
259.33  households with no children who have gross family incomes that 
259.34  are equal to or less than 175 275 percent of the federal poverty 
259.35  guidelines. 
259.36     <i>(Effective date:  Section 95 (256L.04, subd. 7) is</i> 
260.1   <i>effective July 1, 2000.)</i> 
260.2      Sec. 96.  Minnesota Statutes 1998, section 256L.04, 
260.3   subdivision 8, is amended to read: 
260.4      Subd. 8.  [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 
260.5   ASSISTANCE.] (a) Individuals who receive supplemental security 
260.6   income or retirement, survivors, or disability benefits due to a 
260.7   disability, or other disability-based pension, who qualify under 
260.8   subdivision 7, but who are potentially eligible for medical 
260.9   assistance without a spenddown shall be allowed to enroll in 
260.10  MinnesotaCare for a period of 60 days, so long as the applicant 
260.11  meets all other conditions of eligibility.  The commissioner 
260.12  shall identify and refer the applications of such individuals to 
260.13  their county social service agency.  The county and the 
260.14  commissioner shall cooperate to ensure that the individuals 
260.15  obtain medical assistance coverage for any months for which they 
260.16  are eligible. 
260.17     (b) The enrollee must cooperate with the county social 
260.18  service agency in determining medical assistance eligibility 
260.19  within the 60-day enrollment period.  Enrollees who do not 
260.20  cooperate with medical assistance within the 60-day enrollment 
260.21  period shall be disenrolled from the plan within one calendar 
260.22  month.  Persons disenrolled for nonapplication for medical 
260.23  assistance may not reenroll until they have obtained a medical 
260.24  assistance eligibility determination.  Persons disenrolled for 
260.25  noncooperation with medical assistance may not reenroll until 
260.26  they have cooperated with the county agency and have obtained a 
260.27  medical assistance eligibility determination. 
260.28     (c) Beginning January 1, 2000, counties that choose to 
260.29  become MinnesotaCare enrollment sites shall consider 
260.30  MinnesotaCare applications of individuals described in paragraph 
260.31  (a) to also be applications for medical assistance and shall 
260.32  first determine whether medical assistance eligibility exists.  
260.33  Adults with children with family income under 175 percent of the 
260.34  federal poverty guidelines for the applicable family size, 
260.35  pregnant women, and children who qualify under subdivision 1 
260.36  Applicants who are potentially eligible for medical assistance 
261.1   without a spenddown, except for those described in paragraph 
261.2   (a), may choose to enroll in either MinnesotaCare or medical 
261.3   assistance. 
261.4      (d) The commissioner shall redetermine provider payments 
261.5   made under MinnesotaCare to the appropriate medical assistance 
261.6   payments for those enrollees who subsequently become eligible 
261.7   for medical assistance. 
261.8      Sec. 97.  Minnesota Statutes 1998, section 256L.04, 
261.9   subdivision 11, is amended to read: 
261.10     Subd. 11.  [MINNESOTACARE OUTREACH.] (a) The commissioner 
261.11  shall award grants to public or private organizations to provide 
261.12  information on the importance of maintaining insurance coverage 
261.13  and on how to obtain coverage through the MinnesotaCare program 
261.14  in areas of the state with high uninsured populations.  
261.15     (b) In awarding the grants, the commissioner shall consider 
261.16  the following: 
261.17     (1) geographic areas and populations with high uninsured 
261.18  rates; 
261.19     (2) the ability to raise matching funds; and 
261.20     (3) the ability to contact or serve eligible populations. 
261.21     The commissioner shall monitor the grants and may terminate 
261.22  a grant if the outreach effort does not increase the 
261.23  MinnesotaCare program enrollment in medical assistance, general 
261.24  assistance medical care, or the MinnesotaCare program. 
261.25     Sec. 98.  Minnesota Statutes 1998, section 256L.04, 
261.26  subdivision 13, is amended to read: 
261.27     Subd. 13.  [FAMILIES WITH GRANDPARENTS, RELATIVE 
261.28  CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] Beginning 
261.29  January 1, 1999, in families that include a grandparent, 
261.30  relative caretaker as defined in the medical assistance program, 
261.31  foster parent, or legal guardian, the grandparent, relative 
261.32  caretaker, foster parent, or legal guardian may apply as a 
261.33  family or may apply separately for the children.  If the 
261.34  caretaker applies separately for the children, only the 
261.35  children's income is counted and the provisions of subdivision 
261.36  1, paragraph (b), do not apply.  If the grandparent, relative 
262.1   caretaker, foster parent, or legal guardian applies with the 
262.2   children, their income is included in the gross family income 
262.3   for determining eligibility and premium amount. 
262.4      Sec. 99.  Minnesota Statutes 1998, section 256L.05, is 
262.5   amended by adding a subdivision to read: 
262.6      Subd. 3c.  [RETROACTIVE COVERAGE.] Notwithstanding 
262.7   subdivision 3, the effective date of coverage shall be the first 
262.8   day of the month following termination from medical assistance 
262.9   or general assistance medical care for families and individuals 
262.10  who are eligible for MinnesotaCare and who submitted a written 
262.11  request to the commissioner for MinnesotaCare within 30 days of 
262.12  receiving notification of termination from medical assistance or 
262.13  general assistance medical care. 
262.14     Sec. 100.  Minnesota Statutes 1998, section 256L.05, 
262.15  subdivision 4, is amended to read: 
262.16     Subd. 4.  [APPLICATION PROCESSING.] The commissioner of 
262.17  human services shall determine an applicant's eligibility for 
262.18  MinnesotaCare no more than 30 days from the date that the 
262.19  application is received by the department of human services.  
262.20  Beginning January 1, 2000, this requirement also applies to 
262.21  local county human services agencies that determine eligibility 
262.22  for MinnesotaCare.  Once annually at application or 
262.23  reenrollment, to prevent processing delays, applicants or 
262.24  enrollees who, from the information provided on the application, 
262.25  appear to meet eligibility requirements shall be enrolled upon 
262.26  timely payment of premiums.  The enrollee must provide all 
262.27  required verifications within 30 days of enrollment notification 
262.28  of the eligibility determination or coverage from the program 
262.29  shall be terminated.  Enrollees who are determined to be 
262.30  ineligible when verifications are provided shall be disenrolled 
262.31  from the program. 
262.32     Sec. 101.  Minnesota Statutes 1998, section 256L.06, 
262.33  subdivision 3, is amended to read: 
262.34     Subd. 3.  [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 
262.35  Premiums are dedicated to the commissioner for MinnesotaCare. 
262.36     (b) The commissioner shall develop and implement procedures 
263.1   to:  (1) require enrollees to report changes in income; (2) 
263.2   adjust sliding scale premium payments, based upon changes in 
263.3   enrollee income; and (3) disenroll enrollees from MinnesotaCare 
263.4   for failure to pay required premiums.  Beginning July 1, 1998, 
263.5   Failure to pay includes payment with a dishonored check and, a 
263.6   returned automatic bank withdrawal, or a refused credit card or 
263.7   debit card payment.  The commissioner may demand a guaranteed 
263.8   form of payment, including a cashier's check or a money order, 
263.9   as the only means to replace a dishonored check, returned, or 
263.10  refused payment. 
263.11     (c) Premiums are calculated on a calendar month basis and 
263.12  may be paid on a monthly, quarterly, or annual basis, with the 
263.13  first payment due upon notice from the commissioner of the 
263.14  premium amount required.  The commissioner shall inform 
263.15  applicants and enrollees of these premium payment options. 
263.16  Premium payment is required before enrollment is complete and to 
263.17  maintain eligibility in MinnesotaCare.  
263.18     (d) Nonpayment of the premium will result in disenrollment 
263.19  from the plan within one calendar month after the due date.  
263.20  Persons disenrolled for nonpayment or who voluntarily terminate 
263.21  coverage from the program may not reenroll until four calendar 
263.22  months have elapsed.  Persons disenrolled for nonpayment who pay 
263.23  all past due premiums as well as current premiums due, within 20 
263.24  days of disenrollment, shall be reenrolled for the next month.  
263.25  Persons disenrolled for nonpayment or who voluntarily terminate 
263.26  coverage from the program may not reenroll for four calendar 
263.27  months unless the person demonstrates good cause for 
263.28  nonpayment.  Good cause does not exist if a person chooses to 
263.29  pay other family expenses instead of the premium.  The 
263.30  commissioner shall define good cause in rule. 
263.31     Sec. 102.  Minnesota Statutes 1998, section 256L.07, is 
263.32  amended to read: 
263.33     256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON 
263.34  SLIDING SCALE MINNESOTACARE.] 
263.35     Subdivision 1.  [GENERAL REQUIREMENTS.] (a) Children 
263.36  enrolled in the original children's health plan as of September 
264.1   30, 1992, children who enrolled in the MinnesotaCare program 
264.2   after September 30, 1992, pursuant to Laws 1992, chapter 549, 
264.3   article 4, section 17, and children who have family gross 
264.4   incomes that are equal to or less than 150 percent of the 
264.5   federal poverty guidelines are eligible for subsidized premium 
264.6   payments without meeting the requirements of subdivision 2, as 
264.7   long as they maintain continuous coverage in the MinnesotaCare 
264.8   program or medical assistance.  Children who apply for 
264.9   MinnesotaCare on or after the implementation date of the 
264.10  employer-subsidized health coverage program as described in Laws 
264.11  1998, chapter 407, article 5, section 45, who have family gross 
264.12  incomes that are equal to or less than 150 percent of the 
264.13  federal poverty guidelines, must meet the requirements of 
264.14  subdivision 2 to be eligible for MinnesotaCare. 
264.15     (b) Families and individuals enrolled in MinnesotaCare 
264.16  under section 256L.04, subdivision 1 or 7, whose income 
264.17  increases above 275 percent of the federal poverty guidelines, 
264.18  are no longer eligible for the program and shall be disenrolled 
264.19  by the commissioner.  Individuals enrolled in MinnesotaCare 
264.20  under section 256L.04, subdivision 7, whose income increases 
264.21  above 175 percent of the federal poverty guidelines are no 
264.22  longer eligible for the program and shall be disenrolled by the 
264.23  commissioner.  For persons disenrolled under this subdivision, 
264.24  MinnesotaCare coverage terminates the last day of the calendar 
264.25  month following the month in which the commissioner determines 
264.26  that the income of a family or individual, determined over a 
264.27  four-month period as required by section 256L.15, subdivision 2, 
264.28  exceeds program income limits.  
264.29     (c) Notwithstanding paragraph (b), individuals and families 
264.30  may remain enrolled in MinnesotaCare if ten percent of their 
264.31  annual income is less than the annual premium for a policy with 
264.32  a $500 deductible available through the Minnesota comprehensive 
264.33  health association.  Individuals and families who are no longer 
264.34  eligible for MinnesotaCare under this subdivision shall be given 
264.35  an 18-month notice period from the date that ineligibility is 
264.36  determined before disenrollment.  
265.1      <i>(Effective date:  Section 102 (256L.07, subd. 1) is</i> 
265.2   <i>effective July 1, 2000.)</i> 
265.3      Subd. 2.  [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 
265.4   COVERAGE.] (a) To be eligible for subsidized premium payments 
265.5   based on a sliding scale, a family or individual must not have 
265.6   access to subsidized health coverage through an employer and 
265.7   must not have had access to employer-subsidized coverage through 
265.8   a current employer for 18 months prior to application or 
265.9   reapplication.  A family or individual whose employer-subsidized 
265.10  coverage is lost due to an employer terminating health care 
265.11  coverage as an employee benefit during the previous 18 months is 
265.12  not eligible.  
265.13     (b) For purposes of this requirement, subsidized health 
265.14  coverage means health coverage for which the employer pays at 
265.15  least 50 percent of the cost of coverage for the employee or 
265.16  dependent, or a higher percentage as specified by the 
265.17  commissioner.  Children are eligible for employer-subsidized 
265.18  coverage through either parent, including the noncustodial 
265.19  parent.  The commissioner must treat employer contributions to 
265.20  Internal Revenue Code Section 125 plans and any other employer 
265.21  benefits intended to pay health care costs as qualified employer 
265.22  subsidies toward the cost of health coverage for employees for 
265.23  purposes of this subdivision. 
265.24     Subd. 3.  [OTHER HEALTH COVERAGE.] (a) Families and 
265.25  individuals enrolled in the MinnesotaCare program must have no 
265.26  health coverage while enrolled or for at least four months prior 
265.27  to application and renewal.  Children enrolled in the original 
265.28  children's health plan and children in families with income 
265.29  equal to or less than 150 percent of the federal poverty 
265.30  guidelines, who have other health insurance, are eligible if the 
265.31  other health coverage meets the requirements of Minnesota Rules, 
265.32  part 9506.0020, subpart 3, item B. coverage: 
265.33     (1) lacks two or more of the following: 
265.34     (i) basic hospital insurance; 
265.35     (ii) medical-surgical insurance; 
265.36     (iii) prescription drug coverage; 
266.1      (iv) dental coverage; or 
266.2      (v) vision coverage; 
266.3      (2) requires a deductible of $100 or more per person per 
266.4   year; or 
266.5      (3) lacks coverage because the child has exceeded the 
266.6   maximum coverage for a particular diagnosis or the policy 
266.7   excludes a particular diagnosis. 
266.8      The commissioner may change this eligibility criterion for 
266.9   sliding scale premiums in order to remain within the limits of 
266.10  available appropriations.  The requirement of no health coverage 
266.11  does not apply to newborns.  The requirement of no other health 
266.12  coverage for at least four months prior to application does not 
266.13  apply to families with children when a parent has been 
266.14  determined to be in need of chemical dependency treatment 
266.15  pursuant to an assessment conducted by the county under section 
266.16  626.556, subdivision 10, or a case plan under section 257.071 or 
266.17  260.191, subdivision 1e. 
266.18     (b) For purposes of this section, Medical assistance, 
266.19  general assistance medical care, and civilian health and medical 
266.20  program of the uniformed service, CHAMPUS, are not considered 
266.21  insurance or health coverage for purposes of the four-month 
266.22  requirement described in this subdivision. 
266.23     (c) For purposes of this section subdivision, Medicare Part 
266.24  A or B coverage under title XVIII of the Social Security Act, 
266.25  United States Code, title 42, sections 1395c to 1395w-4, is 
266.26  considered health coverage.  An applicant or enrollee may not 
266.27  refuse Medicare coverage to establish eligibility for 
266.28  MinnesotaCare. 
266.29     (d) Applicants who were recipients of medical assistance or 
266.30  general assistance medical care within one month of application 
266.31  must meet the provisions of this subdivision and subdivision 2. 
266.32     (e) This subdivision does not apply to children who are no 
266.33  longer eligible for the subsidized employer health coverage 
266.34  program described in chapter 256M due to employment termination. 
266.35     <i>(Effective date:  Section 102 (256L.07, subd. 3) is</i> 
266.36  <i>effective 30 days following federal approval of the state plan</i> 
267.1   <i>under title XXI and of the section 1115 waiver request in</i> 
267.2   <i>section 118, paragraph (a).)</i> 
267.3      Subd. 4.  [FAMILIES WITH CHILDREN IN NEED OF CHEMICAL 
267.4   DEPENDENCY TREATMENT.] Premiums for families with children when 
267.5   a parent has been determined to be in need of chemical 
267.6   dependency treatment pursuant to an assessment conducted by the 
267.7   county under section 626.556, subdivision 10, or a case plan 
267.8   under section 257.071 or 260.191, subdivision 1e, who are 
267.9   eligible for MinnesotaCare under section 256L.04, subdivision 1, 
267.10  shall be paid by the county of residence of the person in need 
267.11  of treatment for one year from the date the family is determined 
267.12  to be eligible or if the family is currently enrolled in 
267.13  MinnesotaCare from the date the person is determined to be in 
267.14  need of chemical dependency treatment.  Upon renewal, the family 
267.15  is responsible for any premiums owed under section 256L.15.  If 
267.16  the family is not currently enrolled in MinnesotaCare, the local 
267.17  county human services agency shall determine whether the family 
267.18  appears to meet the eligibility requirements and shall assist 
267.19  the family in applying for the MinnesotaCare program. 
267.20     Sec. 103.  Minnesota Statutes 1998, section 256L.15, 
267.21  subdivision 1, is amended to read: 
267.22     Subdivision 1.  [PREMIUM DETERMINATION.] Families with 
267.23  children and individuals shall pay a premium determined 
267.24  according to a sliding fee based on the cost of coverage as a 
267.25  percentage of the family's gross family income.  Pregnant women 
267.26  and children under age two are exempt from the provisions of 
267.27  section 256L.06, subdivision 3, paragraph (b), clause (3), 
267.28  requiring disenrollment for failure to pay premiums.  For 
267.29  pregnant women, this exemption continues until the first day of 
267.30  the month following the 60th day postpartum.  Women who remain 
267.31  enrolled during pregnancy or the postpartum period, despite 
267.32  nonpayment of premiums, shall be disenrolled on the first of the 
267.33  month following the 60th day postpartum for the penalty period 
267.34  that otherwise applies under section 256L.06, unless they begin 
267.35  paying premiums. 
267.36     Sec. 104.  Minnesota Statutes 1998, section 256L.15, 
268.1   subdivision 1b, is amended to read: 
268.2      Subd. 1b.  [PAYMENTS NONREFUNDABLE.] Only MinnesotaCare 
268.3   premiums are not refundable paid for future months of coverage 
268.4   for which a health plan capitation fee has not been paid may be 
268.5   refunded. 
268.6      Sec. 105.  Minnesota Statutes 1998, section 256L.15, 
268.7   subdivision 2, is amended to read: 
268.8      Subd. 2.  [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 
268.9   GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 
268.10  establish a sliding fee scale to determine the percentage of 
268.11  gross individual or family income that households at different 
268.12  income levels must pay to obtain coverage through the 
268.13  MinnesotaCare program.  The sliding fee scale must be based on 
268.14  the enrollee's gross individual or family income during the 
268.15  previous four months.  The sliding fee scale must contain 
268.16  separate tables based on enrollment of one, two, or three or 
268.17  more persons.  The sliding fee scale begins with a premium of 
268.18  1.5 percent of gross individual or family income for individuals 
268.19  or families with incomes below the limits for the medical 
268.20  assistance program for families and children in effect on 
268.21  January 1, 1999, and proceeds through the following evenly 
268.22  spaced steps:  1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 
268.23  percent.  These percentages are matched to evenly spaced income 
268.24  steps ranging from the medical assistance income limit for 
268.25  families and children in effect on January 1, 1999, to 275 
268.26  percent of the federal poverty guidelines for the applicable 
268.27  family size, up to a family size of five.  The sliding fee scale 
268.28  for a family of five must be used for families of more than 
268.29  five.  The sliding fee scale and percentages are not subject to 
268.30  the provisions of chapter 14.  If a family or individual reports 
268.31  increased income after enrollment, premiums shall not be 
268.32  adjusted until eligibility renewal. 
268.33     (b) Enrolled individuals and families whose gross annual 
268.34  income increases above 275 percent of the federal poverty 
268.35  guideline shall pay the maximum premium.  The maximum premium is 
268.36  defined as a base charge for one, two, or three or more 
269.1   enrollees so that if all MinnesotaCare cases paid the maximum 
269.2   premium, the total revenue would equal the total cost of 
269.3   MinnesotaCare medical coverage and administration.  In this 
269.4   calculation, administrative costs shall be assumed to equal ten 
269.5   percent of the total.  The costs of medical coverage for 
269.6   pregnant women and children under age two and the enrollees in 
269.7   these groups shall be excluded from the total.  The maximum 
269.8   premium for two enrollees shall be twice the maximum premium for 
269.9   one, and the maximum premium for three or more enrollees shall 
269.10  be three times the maximum premium for one. 
269.11     Sec. 106.  Minnesota Statutes 1998, section 256L.15, 
269.12  subdivision 3, is amended to read: 
269.13     Subd. 3.  [EXCEPTIONS TO SLIDING SCALE.] An annual premium 
269.14  of $48 is required for all children in families with income at 
269.15  or less than 150 percent of federal poverty guidelines.  The 
269.16  commissioner may reduce the annual premium to $30 for families 
269.17  who choose to pay the premium on an annual basis. 
269.18            SUBSIDIZED EMPLOYER HEALTH COVERAGE PROGRAM 
269.19     Sec. 107.  [256M.01] [DEFINITIONS.] 
269.20     Subdivision 1.  [APPLICABILITY.] For purposes of this 
269.21  chapter, the terms defined in this section have the meanings 
269.22  given them. 
269.23     Subd. 2.  [COMMISSIONER.] "Commissioner" means the 
269.24  commissioner of human services. 
269.25     Subd. 3.  [EMPLOYER-SUBSIDIZED HEALTH 
269.26  COVERAGE.] "Employer-subsidized health coverage" has the meaning 
269.27  provided in section 256L.07, subdivision 2, paragraph (b). 
269.28     <i>(Effective date:  Section 107 (256M.01) is effective 30</i> 
269.29  <i>days following federal approval of the state plan under title</i> 
269.30  <i>XXI and of the section 1115 waiver request in section 117,</i> 
269.31  <i>paragraph (a).)</i> 
269.32     Sec. 108.  [256M.03] [ELIGIBILITY FOR EMPLOYER-SUBSIDIZED 
269.33  COVERAGE.] 
269.34     Subdivision 1.  [GENERAL REQUIREMENTS.] (a) A child who is 
269.35  under the age of 19 and whose family gross income is equal to or 
269.36  less than 275 percent of the federal poverty guidelines for the 
270.1   applicable family size and who would otherwise be eligible for 
270.2   coverage under the MinnesotaCare program, except for the 
270.3   insurance-related barriers to enrollment under section 256L.07, 
270.4   subdivisions 2 and 3, is eligible for subsidized payment of the 
270.5   employee share of the employer-subsidized dependent health 
270.6   coverage available to the child's family in accordance with 
270.7   section 256M.05.  
270.8      (b) To be eligible under this section, a child must not be 
270.9   covered under employer-subsidized dependent health coverage at 
270.10  the time of application.  
270.11     Subd. 2.  [EMPLOYER-SUBSIDIZED HEALTH COVERAGE.] To be 
270.12  eligible for the premium payment under this chapter, the 
270.13  employer-subsidized coverage offered to employees must meet the 
270.14  benchmark coverage selected by the commissioner in accordance 
270.15  with section 2103 of title XXI of the Social Security Act, 
270.16  unless federal approval is received for the number two qualified 
270.17  plan described in section 62E.06 or its actuarial equivalent.  
270.18  The commissioner shall select the benchmark option with the 
270.19  lowest actuarial value in section 2103(b) of title XXI of the 
270.20  Social Security Act. 
270.21     Subd. 3.  [LOW-COST HEALTH PLAN OPTION.] If an employer 
270.22  offers more than one health plan option to employees, 
270.23  eligibility for subsidized premium payments shall be limited to 
270.24  the lowest cost health plan option offered that serves the 
270.25  geographic area in which the eligible child resides. 
270.26     Subd. 4.  [PROBATIONARY PERIOD.] If an employer has a 
270.27  probationary period during which an employee or an employee's 
270.28  dependent is not eligible for employer-subsidized health 
270.29  coverage, the employee's dependent shall not be considered 
270.30  eligible under this section until the employer's probationary 
270.31  period is over. 
270.32     <i>(Effective date:  Section 108 (256M.03) is effective 30</i> 
270.33  <i>days following approval of the state plan under title XXI and of</i> 
270.34  <i>the section 1115 waiver request described in section 117,</i> 
270.35  <i>paragraph (a).)</i> 
270.36     Sec. 109.  [256M.05] [PAYMENTS.] 
271.1      Subdivision 1.  [PREMIUMS.] Children who are eligible under 
271.2   section 256M.03 shall pay a premium in accordance with the 
271.3   MinnesotaCare sliding premium scale as specified in section 
271.4   256L.15, except that children in families with income at or 
271.5   below 150 percent of the federal poverty guidelines for the 
271.6   applicable family size, shall not be required to pay an amount 
271.7   in excess of the maximum monthly charge allowable under title 
271.8   XXI of the Social Security Act, section 2103(e)(3)(A).  The 
271.9   commissioner shall inform the employer and the employee of the 
271.10  premium owed by each eligible employee and the subsidy amount to 
271.11  be paid by the department of human services.  The employee shall 
271.12  pay the employer the premium owed.  The employer may deduct the 
271.13  premium from the employee's paycheck. 
271.14     Subd. 2.  [PAYMENT TO EMPLOYER.] The commissioner shall pay 
271.15  the employer the difference between the premiums paid by the 
271.16  employee as specified under subdivision 1 and the cost of the 
271.17  employee share of the employer-subsidized health coverage.  
271.18  Payment of the employee share is limited to the amount of the 
271.19  premium attributable to the cost of dependent coverage for the 
271.20  eligible children, unless the amount of the premium for 
271.21  dependent coverage does not differentiate between adult and 
271.22  child dependents.  
271.23     Subd. 3.  [PAYMENTS TO HEALTH CARE PROVIDERS.] Any 
271.24  copayments, deductibles, or coinsurance owed on behalf of an 
271.25  eligible child under the employer's health plan shall be paid by 
271.26  the commissioner to the health care provider.  Payment shall be 
271.27  made according to the usual and customary charges established 
271.28  under the employer's health plan.  The family is responsible for 
271.29  notifying the health care provider that they are covered under 
271.30  the subsidized employer health coverage program.  The provider 
271.31  must bill the commissioner for any copayment, deductible, or 
271.32  coinsurance owed by the family for covered services provided to 
271.33  the eligible child by the health care provider.  Upon the 
271.34  submission of a bill, the commissioner must promptly pay the 
271.35  provider the amount of any copay, deductible, or coinsurance 
271.36  owed on behalf of an eligible child plus an administrative fee 
272.1   equal to one percent of the total amount paid by the 
272.2   commissioner.  
272.3      <i>(Effective date:  Section 109 (256M.05) is effective 30</i> 
272.4   <i>days following federal approval of the state plan under title</i> 
272.5   <i>XXI and of the section 1115 waiver request in section 117,</i> 
272.6   <i>paragraph (a).)</i> 
272.7      Sec. 110.  [256M.07] [APPLICATIONS.] 
272.8      Subdivision 1.  [AVAILABILITY.] Applicants may apply to the 
272.9   commissioner or to the licensed insurance broker who provides 
272.10  employee benefits to their employer.  The licensed insurance 
272.11  broker shall accept applications and forward them to the 
272.12  commissioner for processing.  
272.13     Subd. 2.  [PROCESSING.] The commissioner shall determine an 
272.14  applicant's initial eligibility.  Applicants who from the 
272.15  information provided on the application appear to meet the 
272.16  eligibility requirements shall be enrolled without income 
272.17  verification.  
272.18     Subd. 3.  [RENEWAL OF ELIGIBILITY.] An enrollee's 
272.19  eligibility must be renewed every 12 months.  Renewal of 
272.20  eligibility may be completed by the licensed insurance broker.  
272.21  Renewal applications must include income verification 
272.22  information.  
272.23     Subd. 4.  [OUTREACH.] Any licensed insurance broker who 
272.24  refers a family to the MinnesotaCare program in the process of 
272.25  determining eligibility under this section shall be paid by the 
272.26  commissioner a one-time application fee of $25 per referral if 
272.27  any member of the family is determined to be eligible for the 
272.28  MinnesotaCare program. 
272.29     Subd. 5.  [ADMINISTRATION.] The commissioner may contract 
272.30  with a private entity to administer the subsidized employer 
272.31  health coverage program. 
272.32     <i>(Effective date:  Section 110 (256M.07) is effective 30</i> 
272.33  <i>days following federal approval of the state plan under title</i> 
272.34  <i>XXI and of the section 1115 waiver request in section 117,</i> 
272.35  <i>paragraph (a).)</i> 
272.36     Sec. 111.  Minnesota Statutes 1998, section 626.556, 
273.1   subdivision 10i, is amended to read: 
273.2      Subd. 10i.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
273.3   DETERMINATION OF MALTREATMENT.] (a) An individual or facility 
273.4   that the commissioner or a local social service agency 
273.5   determines has maltreated a child, or the child's designee, 
273.6   regardless of the determination, who contests the investigating 
273.7   agency's final determination regarding maltreatment, may request 
273.8   the investigating agency to reconsider its final determination 
273.9   regarding maltreatment.  The request for reconsideration must be 
273.10  submitted in writing to the investigating agency within 15 
273.11  calendar days after receipt of notice of the final determination 
273.12  regarding maltreatment.  
273.13     (b) If the investigating agency denies the request or fails 
273.14  to act upon the request within 15 calendar days after receiving 
273.15  the request for reconsideration, the person or facility entitled 
273.16  to a fair hearing under section 256.045 may submit to the 
273.17  commissioner of human services a written request for a hearing 
273.18  under that section. 
273.19     (c) If, as a result of the reconsideration, the 
273.20  investigating agency changes the final determination of 
273.21  maltreatment, that agency shall notify the parties specified in 
273.22  subdivisions 10b, 10d, and 10f. 
273.23     (d) If an individual or facility contests the investigating 
273.24  agency's final determination regarding maltreatment by 
273.25  requesting a fair hearing under section 256.045, the 
273.26  commissioner of human services shall assure that the hearing is 
273.27  conducted and a decision is reached within 90 days of receipt of 
273.28  the request for a hearing.  The time for action on the decision 
273.29  may be extended for as many days as the hearing is postponed or 
273.30  the record is held open for the benefit of either party. 
273.31     Sec. 112.  Laws 1995, chapter 178, article 2, section 46, 
273.32  subdivision 10, is amended to read: 
273.33     Subd. 10.  [ADDITIONAL WAIVER REQUEST FOR EMPLOYED DISABLED 
273.34  PERSONS.] The commissioner shall seek a federal waiver in order 
273.35  to implement a work incentive for disabled persons eligible for 
273.36  medical assistance who are not residents of long-term care 
274.1   facilities when determining their eligibility for medical 
274.2   assistance.  The waiver shall request authorization to establish 
274.3   a medical assistance earned income disregard for employed 
274.4   disabled persons who, but for earned income, are eligible for 
274.5   SSDI and who receive require personal care assistance under the 
274.6   Medical Assistance Program.  The disregard shall be equivalent 
274.7   to the threshold amount applied to persons who qualify under 
274.8   section 1619(b) of the Social Security Act, except that when a 
274.9   disabled person's earned income reaches the maximum income 
274.10  permitted at the threshold under section 1619(b), the person 
274.11  shall retain medical assistance eligibility and must contribute 
274.12  to the costs of medical care on a sliding fee basis. 
274.13     Sec. 113.  [CHARITY CARE DATA COLLECTION.] 
274.14     The commissioner of health shall determine a definition for 
274.15  charity care and bad debt that distinguishes these two terms for 
274.16  inpatient and ambulatory care.  The commissioner shall use these 
274.17  definitions as a basis for collecting data on uncompensated care 
274.18  in hospitals, surgical centers, and health care clinics located 
274.19  within the seven-county metropolitan area.  
274.20     Sec. 114.  [MINNESOTACARE APPLICATION SIMPLIFICATION.] 
274.21     The commissioner of human services shall develop a one page 
274.22  preapplication form for the MinnesotaCare program and may 
274.23  develop a pilot project that involves using this form in 
274.24  community health clinics, community health offices, and 
274.25  disproportionate share hospitals to determine the feasibility of 
274.26  using a one page application form for MinnesotaCare.  As part of 
274.27  this pilot project, the commissioner shall track the number of 
274.28  individuals determined to be eligible from the preapplication 
274.29  form, the number determined to be eligible upon the completion 
274.30  of the full application, and for families with children the cost 
274.31  of providing the care to those found eligible. 
274.32     Sec. 115.  [EXPANSION OF SPECIAL EDUCATION SERVICES.] 
274.33     The commissioner of human services shall examine 
274.34  opportunities to expand the scope of providers eligible for 
274.35  reimbursement for medical assistance services listed in a 
274.36  child's individual education plan based on state and federal 
275.1   requirements for provider qualifications.  The commissioner 
275.2   shall complete these activities, in consultation with the 
275.3   commissioner of children, families, and learning, by December 
275.4   1999 and seek necessary federal approval. 
275.5      Sec. 116.  [HOME-BASED MENTAL HEALTH SERVICES.] 
275.6      By January 1, 2000, the commissioner of human services 
275.7   shall amend Minnesota Rules under the expedited process of 
275.8   Minnesota Statutes, section 14.389, to effect the following 
275.9   changes: 
275.10     (1) amend Minnesota Rules, part 9505.0324, subpart 2, to 
275.11  permit a county board to contract with any agency qualified 
275.12  under Minnesota Rules, part 9505.0324, subparts 4 and 5, as an 
275.13  eligible provider of home-based mental health services; 
275.14     (2) amend Minnesota Rules, part 9505.0324, subpart 2, to 
275.15  permit children's mental health collaboratives approved by the 
275.16  children's cabinet under Minnesota Statutes, section 245.493, to 
275.17  provide or to contract with any agency qualified under Minnesota 
275.18  Rules, part 9505.0324, subparts 4 and 5, as an eligible provider 
275.19  of home-based mental health services. 
275.20     Sec. 117.  [AMENDING MEDICAL ASSISTANCE RULES.] 
275.21     By January 1, 2001, the commissioner of human services 
275.22  shall amend Minnesota Rules, parts 9505.0323; 9505.0324; 
275.23  9505.0326; and 9505.0327, as necessary to implement the changes 
275.24  outlined in Minnesota Statutes, section 256B.0625, subdivision 
275.25  35. 
275.26     Sec. 118.  [WAIVER REQUEST.] 
275.27     (a) The commissioner of human services shall seek federal 
275.28  approval for a waiver under section 1115 of the Social Security 
275.29  Act to obtain federal financial participation under title XIX 
275.30  for children in the subsidized employer health coverage program 
275.31  whose premium obligation under the MinnesotaCare sliding premium 
275.32  scale would exceed five percent of gross family income. 
275.33     (b) The commissioner of human services shall seek federal 
275.34  approval for a waiver under section 1115 of the Social Security 
275.35  Act to allow, at the family's option, federal financial 
275.36  participation under title XIX for subsidized employer health 
276.1   coverage for a Medicaid-eligible child who has a sibling 
276.2   eligible for the subsidized employer health coverage program. 
276.3      (c) The commissioner of human services shall seek federal 
276.4   approval for a waiver under title XXI of the Social Security Act 
276.5   for authority to obtain federal financial participation for 
276.6   health coverage for the employee's spouse when an employer 
276.7   offers family coverage. 
276.8      (d) The commissioner of human services shall seek federal 
276.9   approval for a modification of the health care reform waiver 
276.10  under section 1115 of the Social Security Act to permit the use 
276.11  of copayments instead of premium payments for low-income 
276.12  enrollees in the MinnesotaCare program. 
276.13     Sec. 119.  [MEDICARE SUPPLEMENTAL COVERAGE FOR LOW-INCOME 
276.14  SENIORS.] 
276.15     The commissioner of health, in consultation with the 
276.16  commissioners of human services and commerce, shall study the 
276.17  extent and type of Medicare supplemental coverage for low-income 
276.18  seniors.  The commissioner shall also study the qualified 
276.19  Medicare beneficiaries eligible under Minnesota Statutes, 
276.20  section 256B.057, subdivision 3, in terms of developing a 
276.21  comprehensive set of services to supplement Medicare that these 
276.22  individuals may need to ensure independence and control of their 
276.23  lives.  The commissioner shall make recommendations on the 
276.24  cost-effectiveness of expanding the benefits offered to 
276.25  qualified Medicare beneficiaries including the feasibility of 
276.26  the state providing health care coverage options to low-income 
276.27  seniors that would provide a comprehensive set of services and 
276.28  would build on existing or new Medicare products.  The 
276.29  commissioner shall also study the fiscal impact of mandating 
276.30  coverage for Medicare supplemental products to include long-term 
276.31  care services, including home health services, homemaker 
276.32  services, and nursing facilities services and the fiscal 
276.33  implications of the state paying the premiums for this coverage 
276.34  for low-income seniors, including potential savings to the 
276.35  medical assistance program.  The commissioner shall report to 
276.36  the legislature on the findings of the study with any 
277.1   recommendations by January 15, 2000. 
277.2      Sec. 120.  [DENTAL ACCESS STUDY.] 
277.3      The commissioner of human services, in consultation with 
277.4   the commissioner of health, dental care providers, community 
277.5   clinics, client advocacy groups, and counties, shall review the 
277.6   dental access problem, evaluate the effects of the dental access 
277.7   initiatives adopted by the 1999 legislature, and make 
277.8   recommendations on other actions that could improve dental 
277.9   access for public program recipients.  The commissioner shall 
277.10  submit a progress report by January 15, 2000, and a final report 
277.11  to the legislature by January 15, 2001.  
277.12     Sec. 121.  [REPORT ON RATE SETTING AND RISK ADJUSTMENT.] 
277.13     The commissioner of human services shall report to the 
277.14  legislature, by January 15, 2000, on the current rate setting 
277.15  process for state prepaid health care programs, rate setting and 
277.16  risk adjustment methods in other states, and the results of the 
277.17  application of risk adjustment on a trial basis in Minnesota for 
277.18  calendar year 1999.  The report must also present an analysis of 
277.19  the feasibility of requiring prepaid health plans to report 
277.20  vendor costs rather than charges, an analysis of capitation rate 
277.21  equalization for MinnesotaCare and the prepaid medical 
277.22  assistance program, an analysis of the fiscal impact on state 
277.23  and county government if Minnesota Statutes 1998, section 
277.24  256B.69, subdivision 5d is repealed, and recommendations for 
277.25  providing actuarial and market analyses related to setting 
277.26  prepaid health plan rates to the legislature on a timely basis 
277.27  that would allow this information to be used in the 
277.28  appropriations process. 
277.29     Sec. 122.  [REPORT ON PREPAID MEDICAL ASSISTANCE PROGRAM.] 
277.30     The commissioner of human services shall present 
277.31  recommendations to the legislature, by December 15, 1999, on 
277.32  methods for implementing county board authority under the 
277.33  prepaid medical assistance program.  
277.34     Sec. 123.  [PHYSICIAN AND PROFESSIONAL SERVICES PAYMENT 
277.35  METHODOLOGY CONVERSION.] 
277.36     The commissioner of human services shall submit a proposal 
278.1   to the legislature by January 15, 2000, detailing the medical 
278.2   assistance physician and professional services payment 
278.3   methodology conversion to resource based relative value scale. 
278.4      Sec. 124.  [REPEALER.] 
278.5      Minnesota Statutes 1998, sections 256B.74, subdivisions 2 
278.6   and 5; and 462A.208, are repealed. 
278.7      Sec. 125.  [EFFECTIVE DATE.] 
278.8      When preparing the conference committee report for adoption 
278.9   by the legislature, the revisor shall combine all effective date 
278.10  notations in this article into this effective date section. 
278.11                             ARTICLE 5
278.12                      STATE-OPERATED SERVICES;
278.13        CHEMICAL DEPENDENCY; MENTAL HEALTH; LAND CONVEYANCES
278.14     Section 1.  Minnesota Statutes 1998, section 16C.10, 
278.15  subdivision 5, is amended to read: 
278.16     Subd. 5.  [SPECIFIC PURCHASES.] The solicitation process 
278.17  described in this chapter is not required for acquisition of the 
278.18  following: 
278.19     (1) merchandise for resale purchased under policies 
278.20  determined by the commissioner; 
278.21     (2) farm and garden products which, as determined by the 
278.22  commissioner, may be purchased at the prevailing market price on 
278.23  the date of sale; 
278.24     (3) goods and services from the Minnesota correctional 
278.25  facilities; 
278.26     (4) goods and services from rehabilitation facilities and 
278.27  sheltered workshops that are certified by the commissioner of 
278.28  economic security; 
278.29     (5) goods and services for use by a community-based 
278.30  residential facility operated by the commissioner of human 
278.31  services; 
278.32     (6) goods purchased at auction or when submitting a sealed 
278.33  bid at auction provided that before authorizing such an action, 
278.34  the commissioner consult with the requesting agency to determine 
278.35  a fair and reasonable value for the goods considering factors 
278.36  including, but not limited to, costs associated with submitting 
279.1   a bid, travel, transportation, and storage.  This fair and 
279.2   reasonable value must represent the limit of the state's bid; 
279.3   and 
279.4      (7) utility services where no competition exists or where 
279.5   rates are fixed by law or ordinance. 
279.6      Sec. 2.  Minnesota Statutes 1998, section 245.462, 
279.7   subdivision 4, is amended to read: 
279.8      Subd. 4.  [CASE MANAGER MANAGEMENT SERVICE PROVIDER.] (a) 
279.9   "Case manager management service provider" means an individual a 
279.10  case manager or case manager associate employed by the county or 
279.11  other entity authorized by the county board to provide case 
279.12  management services specified in section 245.4711.  
279.13     A case manager must have a bachelor's degree in one of the 
279.14  behavioral sciences or related fields including, but not limited 
279.15  to, social work, psychology, or nursing from an accredited 
279.16  college or university and.  A case manager must have at least 
279.17  2,000 hours of supervised experience in the delivery of services 
279.18  to adults with mental illness, must be skilled in the process of 
279.19  identifying and assessing a wide range of client needs, and must 
279.20  be knowledgeable about local community resources and how to use 
279.21  those resources for the benefit of the client.  The case manager 
279.22  shall meet in person with a mental health professional at least 
279.23  once each month to obtain clinical supervision of the case 
279.24  manager's activities.  Case managers with a bachelor's degree 
279.25  but without 2,000 hours of supervised experience in the delivery 
279.26  of services to adults with mental illness must complete 40 hours 
279.27  of training approved by the commissioner of human services in 
279.28  case management skills and in the characteristics and needs of 
279.29  adults with serious and persistent mental illness and must 
279.30  receive clinical supervision regarding individual service 
279.31  delivery from a mental health professional at least once each 
279.32  week until the requirement of 2,000 hours of supervised 
279.33  experience is met.  Clinical supervision must be documented in 
279.34  the client record. 
279.35     (b) Supervision for a case manager during the first year of 
279.36  service providing case management services shall be one hour per 
280.1   week of clinical supervision from a case management supervisor.  
280.2   After the first year, the case manager shall receive regular 
280.3   ongoing supervision totaling 38 hours per year, of which at 
280.4   least one hour per month must be clinical supervision regarding 
280.5   individual service delivery with a case management supervisor.  
280.6   The remainder may be provided by a case manager with two years 
280.7   of experience.  Group supervision may not constitute more than 
280.8   one-half of the required supervision hours.  Clinical 
280.9   supervision must be documented in the client record. 
280.10     (c) A case manager with a bachelor's degree who is not 
280.11  licensed, registered, or certified by a health-related licensing 
280.12  board must receive 30 hours of continuing education and training 
280.13  in mental illness and mental health services annually.  
280.14     (d) A case manager with a bachelor's degree but without 
280.15  2,000 hours of supervised experience described in paragraph (a), 
280.16  must complete 40 hours of training approved by the commissioner 
280.17  covering case management skills and the characteristics and 
280.18  needs of adults with serious and persistent mental illness.  
280.19     (e) Case managers without a bachelor's degree must meet one 
280.20  of the requirements in clauses (1) to (3):  
280.21     (1) have three or four years of experience as a case 
280.22  manager associate; 
280.23     (2) be a registered nurse without a bachelor's degree and 
280.24  have a combination of specialized training in psychiatry and 
280.25  work experience consisting of community interaction and 
280.26  involvement or community discharge planning in a mental health 
280.27  setting totaling three years; or 
280.28     (3) be a person who qualified as a case manager under the 
280.29  1998 department of human services federal waiver provision and 
280.30  meet the continuing education and mentoring requirements in this 
280.31  section.  
280.32     (f) A case manager associate must work under the direction 
280.33  of a case manager or case management supervisor and must be 21 
280.34  years of age.  A case manager associate must also have a high 
280.35  school diploma and meet one of the following criteria: 
280.36     (1) have an associate of arts degree in one of the 
281.1   behavioral sciences or human services; 
281.2      (2) be a registered nurse without a bachelor's degree; 
281.3      (3) within the previous ten years, have three years of life 
281.4   experience with serious and persistent mental illness as defined 
281.5   in section 245.462, subdivision 20, or as a child had severe 
281.6   emotional disturbance, as defined in section 245.4871, 
281.7   subdivision 6, or three years of life experience as a primary 
281.8   caregiver to an adult with serious and persistent mental illness 
281.9   within the previous ten years; 
281.10     (4) have 6,000 hours work experience as a nondegreed state 
281.11  hospital technician; or 
281.12     (5) be a mental health practitioner as defined in section 
281.13  245.462, subdivision 17, clause (2). 
281.14     Individuals meeting one of the criteria in clauses (1) to 
281.15  (4) may qualify as a case manager after four years of supervised 
281.16  work experience as a case manager associate.  Individuals 
281.17  meeting the criteria in clause (5) may qualify as a case manager 
281.18  after three years of supervised experience as a case manager 
281.19  associate. 
281.20     Case management associates must have 40 hours preservice 
281.21  training under paragraph (d) and receive at least 40 hours of 
281.22  continuing education in mental illness and mental health 
281.23  services annually.  Case manager associates shall receive at 
281.24  least five hours of mentoring per week from a case management 
281.25  mentor.  A "case management mentor" means a qualified, 
281.26  practicing case manager or case management supervisor who 
281.27  teaches or advises and provides intensive training and clinical 
281.28  supervision to one or more case manager associates.  Mentoring 
281.29  may occur while providing direct services to consumers in the 
281.30  office or in the field and may be provided to individuals or 
281.31  groups of case manager associates.  At least two mentoring hours 
281.32  per week must be individual and face-to-face. 
281.33     (g) A case management supervisor must meet the criteria for 
281.34  mental health professionals, as specified in section 245.462, 
281.35  subdivision 18. 
281.36     Until June 30, 1999, (h) An immigrant who does not have the 
282.1   qualifications specified in this subdivision may provide case 
282.2   management services to adult immigrants with serious and 
282.3   persistent mental illness who are members of the same ethnic 
282.4   group as the case manager if the person:  (1) is currently 
282.5   enrolled in and is actively pursuing credits toward the 
282.6   completion of a bachelor's degree in one of the behavioral 
282.7   sciences or a related field including, but not limited to, 
282.8   social work, psychology, or nursing from an accredited college 
282.9   or university; (2) completes 40 hours of training as specified 
282.10  in this subdivision; and (3) receives clinical supervision at 
282.11  least once a week until the requirements of this subdivision are 
282.12  met. 
282.13     (b) The commissioner may approve waivers submitted by 
282.14  counties to allow case managers without a bachelor's degree but 
282.15  with 6,000 hours of supervised experience in the delivery of 
282.16  services to adults with mental illness if the person: 
282.17     (1) meets the qualifications for a mental health 
282.18  practitioner in subdivision 26; 
282.19     (2) has completed 40 hours of training approved by the 
282.20  commissioner in case management skills and in the 
282.21  characteristics and needs of adults with serious and persistent 
282.22  mental illness; and 
282.23     (3) demonstrates that the 6,000 hours of supervised 
282.24  experience are in identifying functional needs of persons with 
282.25  mental illness, coordinating assessment information and making 
282.26  referrals to appropriate service providers, coordinating a 
282.27  variety of services to support and treat persons with mental 
282.28  illness, and monitoring to ensure appropriate provision of 
282.29  services.  The county board is responsible to verify that all 
282.30  qualifications, including content of supervised experience, have 
282.31  been met.  
282.32     Sec. 3.  Minnesota Statutes 1998, section 245.462, 
282.33  subdivision 17, is amended to read: 
282.34     Subd. 17.  [MENTAL HEALTH PRACTITIONER.] "Mental health 
282.35  practitioner" means a person providing services to persons with 
282.36  mental illness who is qualified in at least one of the following 
283.1   ways:  
283.2      (1) holds a bachelor's degree in one of the behavioral 
283.3   sciences or related fields from an accredited college or 
283.4   university and: 
283.5      (i) has at least 2,000 hours of supervised experience in 
283.6   the delivery of services to persons with mental illness; or 
283.7      (ii) is fluent in the non-English language of the ethnic 
283.8   group to which at least 50 percent of the practitioner's clients 
283.9   belong, completes 40 hours of training in the delivery of 
283.10  services to persons with mental illness, and receives clinical 
283.11  supervision from a mental health professional at least once a 
283.12  week until the requirement of 2,000 hours of supervised 
283.13  experience is met; 
283.14     (2) has at least 6,000 hours of supervised experience in 
283.15  the delivery of services to persons with mental illness; 
283.16     (3) is a graduate student in one of the behavioral sciences 
283.17  or related fields and is formally assigned by an accredited 
283.18  college or university to an agency or facility for clinical 
283.19  training; or 
283.20     (4) holds a master's or other graduate degree in one of the 
283.21  behavioral sciences or related fields from an accredited college 
283.22  or university and has less than 4,000 hours post-master's 
283.23  experience in the treatment of mental illness. 
283.24     Sec. 4.  Minnesota Statutes 1998, section 245.4711, 
283.25  subdivision 1, is amended to read: 
283.26     Subdivision 1.  [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 
283.27  (a) By January 1, 1989, the county board shall provide case 
283.28  management services for all adults with serious and persistent 
283.29  mental illness who are residents of the county and who request 
283.30  or consent to the services and to each adult for whom the court 
283.31  appoints a case manager.  Staffing ratios must be sufficient to 
283.32  serve the needs of the clients.  The case manager must meet the 
283.33  requirements in section 245.462, subdivision 4.  
283.34     (b) Case management services provided to adults with 
283.35  serious and persistent mental illness eligible for medical 
283.36  assistance must be billed to the medical assistance program 
284.1   under sections 256B.02, subdivision 8, and 256B.0625. 
284.2      (c) Case management services are eligible for reimbursement 
284.3   under the medical assistance program.  Costs associated with 
284.4   mentoring, supervision, and continuing education may be included 
284.5   in the reimbursement rate methodology used for case management 
284.6   services under the medical assistance program. 
284.7      Sec. 5.  Minnesota Statutes 1998, section 245.4712, 
284.8   subdivision 2, is amended to read: 
284.9      Subd. 2.  [DAY TREATMENT SERVICES PROVIDED.] (a) Day 
284.10  treatment services must be developed as a part of the community 
284.11  support services available to adults with serious and persistent 
284.12  mental illness residing in the county.  Adults may be required 
284.13  to pay a fee according to section 245.481.  Day treatment 
284.14  services must be designed to:  
284.15     (1) provide a structured environment for treatment; 
284.16     (2) provide support for residing in the community; 
284.17     (3) prevent placement in settings that are more intensive, 
284.18  costly, or restrictive than necessary and appropriate to meet 
284.19  client need; 
284.20     (4) coordinate with or be offered in conjunction with a 
284.21  local education agency's special education program; and 
284.22     (5) operate on a continuous basis throughout the year.  
284.23     (b) For purposes of complying with medical assistance 
284.24  requirements, an adult day treatment program may choose among 
284.25  the methods of clinical supervision specified in: 
284.26     (1) Minnesota Rules, part 9505.0323, subpart 1, item F; 
284.27     (2) Minnesota Rules, part 9505.0324, subpart 6, item F; or 
284.28     (3) Minnesota Rules, part 9520.0800, subparts 2 to 6. 
284.29     A day treatment program may demonstrate compliance with 
284.30  these clinical supervision requirements by obtaining 
284.31  certification from the commissioner under Minnesota Rules, parts 
284.32  9520.0750 to 9520.0870, or by documenting in its own records 
284.33  that it complies with one of the above methods. 
284.34     (c) County boards may request a waiver from including day 
284.35  treatment services if they can document that:  
284.36     (1) an alternative plan of care exists through the county's 
285.1   community support services for clients who would otherwise need 
285.2   day treatment services; 
285.3      (2) day treatment, if included, would be duplicative of 
285.4   other components of the community support services; and 
285.5      (3) county demographics and geography make the provision of 
285.6   day treatment services cost ineffective and infeasible.  
285.7      Sec. 6.  Minnesota Statutes 1998, section 245.4871, 
285.8   subdivision 4, is amended to read: 
285.9      Subd. 4.  [CASE MANAGER MANAGEMENT SERVICE PROVIDER.] (a) 
285.10  "Case manager management service provider" means an individual a 
285.11  case manager or case manager associate employed by the county or 
285.12  other entity authorized by the county board to provide case 
285.13  management services specified in subdivision 3 for the child 
285.14  with severe emotional disturbance and the child's family.  A 
285.15  case manager must have experience and training in working with 
285.16  children. 
285.17     (b) A case manager must: 
285.18     (1) have at least a bachelor's degree in one of the 
285.19  behavioral sciences or a related field including, but not 
285.20  limited to, social work, psychology, or nursing from an 
285.21  accredited college or university; 
285.22     (2) have at least 2,000 hours of supervised experience in 
285.23  the delivery of mental health services to children; 
285.24     (3) have experience and training in identifying and 
285.25  assessing a wide range of children's needs; and 
285.26     (4) be knowledgeable about local community resources and 
285.27  how to use those resources for the benefit of children and their 
285.28  families. 
285.29     (c) The case manager may be a member of any professional 
285.30  discipline that is part of the local system of care for children 
285.31  established by the county board. 
285.32     (d) The case manager must meet in person with a mental 
285.33  health professional at least once each month to obtain clinical 
285.34  supervision shall receive regular ongoing supervision totaling 
285.35  38 hours per year, of which at least one hour per month must be 
285.36  clinical supervision regarding individual service delivery with 
286.1   a case management supervisor.  The remainder may be provided by 
286.2   a case manager with two years of experience.  Group supervision 
286.3   may not constitute more than one-half of the required 
286.4   supervision hours. 
286.5      (e) Case managers with a bachelor's degree but without 
286.6   2,000 hours of supervised experience in the delivery of mental 
286.7   health services to children with emotional disturbance must: 
286.8      (1) begin 40 hours of training approved by the commissioner 
286.9   of human services in case management skills and in the 
286.10  characteristics and needs of children with severe emotional 
286.11  disturbance before beginning to provide case management 
286.12  services; and 
286.13     (2) receive clinical supervision regarding individual 
286.14  service delivery from a mental health professional at least once 
286.15  one hour each week until the requirement of 2,000 hours of 
286.16  experience is met. 
286.17     (f) Clinical supervision must be documented in the child's 
286.18  record.  When the case manager is not a mental health 
286.19  professional, the county board must provide or contract for 
286.20  needed clinical supervision. 
286.21     (g) The county board must ensure that the case manager has 
286.22  the freedom to access and coordinate the services within the 
286.23  local system of care that are needed by the child. 
286.24     (h) Case managers who have a bachelor's degree but are not 
286.25  licensed, registered, or certified by a health-related licensing 
286.26  board must receive 30 hours of continuing education and training 
286.27  in severe emotional disturbance and mental health services 
286.28  annually. 
286.29     (i) Case managers without a bachelor's degree must meet one 
286.30  of the requirements in clauses (1) to (3): 
286.31     (1) have three or four years of experience as a case 
286.32  manager associate; 
286.33     (2) be a registered nurse without a bachelor's degree who 
286.34  has a combination of specialized training in psychiatry and work 
286.35  experience consisting of community interaction and involvement 
286.36  or community discharge planning in a mental health setting 
287.1   totaling three years; or 
287.2      (3) be a person who qualified as a case manager under the 
287.3   1998 department of human services federal waiver provision and 
287.4   meets the continuing education and mentoring requirements in 
287.5   this section. 
287.6      (j) A case manager associate (CMA) must work under the 
287.7   direction of a case manager or case management supervisor and 
287.8   must be 21 years of age.  A case manager associate must also 
287.9   have a high school diploma and meet one of the following 
287.10  criteria: 
287.11     (1) have an associate of arts degree in one of the 
287.12  behavioral sciences or human services; 
287.13     (2) be a registered nurse without a bachelor's degree; 
287.14     (3) have three years of life experience as a primary 
287.15  caregiver to a child with serious emotional disturbance as 
287.16  defined in section 245.4871, subdivision 6, within the last ten 
287.17  years; 
287.18     (4) have 6,000 hours work experience as a nondegreed state 
287.19  hospital technician; or 
287.20     (5) be a mental health practitioner as defined in section 
287.21  245.462, subdivision 17, clause (2). 
287.22     Individuals meeting one of the criteria in clauses (1) to 
287.23  (4) may qualify as a case manager after four years of supervised 
287.24  work experience as a case manager associate.  Individuals 
287.25  meeting the criteria in clause (5) may qualify as a case manager 
287.26  after three years of supervised experience as a case manager 
287.27  associate. 
287.28     Case manager associates must have 40 hours of preservice 
287.29  training under paragraph (e), clause (1), and receive at least 
287.30  40 hours of continuing education in severe emotional disturbance 
287.31  and mental health service annually.  Case manager associates 
287.32  shall receive at least five hours of mentoring per week from a 
287.33  case management mentor.  A "case management mentor" means a 
287.34  qualified, practicing case manager or case management supervisor 
287.35  who teaches or advises and provides intensive training and 
287.36  clinical supervision to one or more case manager associates.  
288.1   Mentoring may occur while providing direct services to consumers 
288.2   in the office or in the field and may be provided to individuals 
288.3   or groups of case manager associates.  At least two mentoring 
288.4   hours per week must be individual and face-to-face. 
288.5      (k) A case management supervisor must meet the criteria for 
288.6   a mental health professional as specified in section 245.4871, 
288.7   subdivision 27. 
288.8      Until June 30, 1999, (l) An immigrant who does not have the 
288.9   qualifications specified in this subdivision may provide case 
288.10  management services to child immigrants with severe emotional 
288.11  disturbance of the same ethnic group as the immigrant if the 
288.12  person:  
288.13     (1) is currently enrolled in and is actively pursuing 
288.14  credits toward the completion of a bachelor's degree in one of 
288.15  the behavioral sciences or related fields at an accredited 
288.16  college or university; 
288.17     (2) completes 40 hours of training as specified in this 
288.18  subdivision; and 
288.19     (3) receives clinical supervision at least once a week 
288.20  until the requirements of obtaining a bachelor's degree and 
288.21  2,000 hours of supervised experience are met. 
288.22     (i) The commissioner may approve waivers submitted by 
288.23  counties to allow case managers without a bachelor's degree but 
288.24  with 6,000 hours of supervised experience in the delivery of 
288.25  services to children with severe emotional disturbance if the 
288.26  person: 
288.27     (1) meets the qualifications for a mental health 
288.28  practitioner in subdivision 26; 
288.29     (2) has completed 40 hours of training approved by the 
288.30  commissioner in case management skills and in the 
288.31  characteristics and needs of children with severe emotional 
288.32  disturbance; and 
288.33     (3) demonstrates that the 6,000 hours of supervised 
288.34  experience are in identifying functional needs of children with 
288.35  severe emotional disturbance, coordinating assessment 
288.36  information and making referrals to appropriate service 
289.1   providers, coordinating a variety of services to support and 
289.2   treat children with severe emotional disturbance, and monitoring 
289.3   to ensure appropriate provision of services.  The county board 
289.4   is responsible to verify that all qualifications, including 
289.5   content of supervised experience, have been met. 
289.6      Sec. 7.  Minnesota Statutes 1998, section 245.4871, 
289.7   subdivision 26, is amended to read: 
289.8      Subd. 26.  [MENTAL HEALTH PRACTITIONER.] "Mental health 
289.9   practitioner" means a person providing services to children with 
289.10  emotional disturbances.  A mental health practitioner must have 
289.11  training and experience in working with children.  A mental 
289.12  health practitioner must be qualified in at least one of the 
289.13  following ways:  
289.14     (1) holds a bachelor's degree in one of the behavioral 
289.15  sciences or related fields from an accredited college or 
289.16  university and:  
289.17     (i) has at least 2,000 hours of supervised experience in 
289.18  the delivery of mental health services to children with 
289.19  emotional disturbances; or 
289.20     (ii) is fluent in the non-English language of the ethnic 
289.21  group to which at least 50 percent of the practitioner's clients 
289.22  belong, completes 40 hours of training in the delivery of 
289.23  services to children with emotional disturbances, and receives 
289.24  clinical supervision from a mental health professional at least 
289.25  once a week until the requirement of 2,000 hours of supervised 
289.26  experience is met; 
289.27     (2) has at least 6,000 hours of supervised experience in 
289.28  the delivery of mental health services to children with 
289.29  emotional disturbances; 
289.30     (3) is a graduate student in one of the behavioral sciences 
289.31  or related fields and is formally assigned by an accredited 
289.32  college or university to an agency or facility for clinical 
289.33  training; or 
289.34     (4) holds a master's or other graduate degree in one of the 
289.35  behavioral sciences or related fields from an accredited college 
289.36  or university and has less than 4,000 hours post-master's 
290.1   experience in the treatment of emotional disturbance. 
290.2      Sec. 8.  Minnesota Statutes 1998, section 245.4881, 
290.3   subdivision 1, is amended to read: 
290.4      Subdivision 1.  [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 
290.5   (a) By April 1, 1992, the county board shall provide case 
290.6   management services for each child with severe emotional 
290.7   disturbance who is a resident of the county and the child's 
290.8   family who request or consent to the services.  Staffing ratios 
290.9   must be sufficient to serve the needs of the clients.  The case 
290.10  manager must meet the requirements in section 245.4871, 
290.11  subdivision 4.  
290.12     (b) Except as permitted by law and the commissioner under 
290.13  demonstration projects, case management services provided to 
290.14  children with severe emotional disturbance eligible for medical 
290.15  assistance must be billed to the medical assistance program 
290.16  under sections 256B.02, subdivision 8, and 256B.0625. 
290.17     (c) Case management services are eligible for reimbursement 
290.18  under the medical assistance program.  Costs of mentoring, 
290.19  supervision, and continuing education may be included in the 
290.20  reimbursement rate methodology used for case management services 
290.21  under the the medical assistance program. 
290.22     Sec. 9.  [246.0136] [TRANSITION OF REGIONAL TREATMENT 
290.23  CENTERS AND OTHER STATE-OPERATED SERVICES.] 
290.24     Beginning with the 2000-2001 biennium the commissioner of 
290.25  human services is directed to establish enterprise activities 
290.26  within state-operated services.  Enterprise activities are 
290.27  defined as the range of services needed by people with 
290.28  disabilities, which are delivered by state employees, and are 
290.29  fully funded by public or private third-party health insurance 
290.30  or other revenue sources that are available to the client that 
290.31  provide reimbursement for the care provided.  State-operated 
290.32  services shall specialize in caring for vulnerable people for 
290.33  whom no other providers are available or for whom state-operated 
290.34  services may be the provider selected by the payer.  The 
290.35  commissioner shall determine prior to the biennial budget 
290.36  request the programs or services within state-operated services 
291.1   that may be transitioned to enterprise activities.  Prior to the 
291.2   implementation of the enterprise activity, the commissioner 
291.3   shall demonstrate that there is public or private third-party 
291.4   health insurance or other revenue available to the individuals 
291.5   served, that the revenues collected fully fund the services, and 
291.6   that there are sufficient funds for cash flow purposes.  In 
291.7   subsequent biennia the base state appropriation for 
291.8   state-operated services will be reduced proportionate to the 
291.9   size of the enterprise activity.  Implementation of enterprise 
291.10  activities shall not limit access to services by vulnerable 
291.11  populations served by state-operated services. 
291.12     Implementation will include consultation with stakeholders 
291.13  including county boards, county social service agencies, 
291.14  consumers, families, advocates, local mental health advisory 
291.15  councils, local private and public providers, representatives of 
291.16  state public employee bargaining units, and other affected state 
291.17  and local agencies.  All enterprise activities must conform with 
291.18  collective bargaining agreements negotiated on behalf of 
291.19  employees by their exclusive representatives.  Implementation 
291.20  shall include consideration of: 
291.21     (1) creating public or private partnerships to facilitate 
291.22  client access to needed services; 
291.23     (2) administrative simplification and efficiencies 
291.24  throughout the state-operated services system; 
291.25     (3) creating a public group practice for state-operated 
291.26  medical staff to increase flexibility in meeting client needs 
291.27  and maximize third-party reimbursement; 
291.28     (4) converting or disposing of buildings not utilized and 
291.29  surplus land; and 
291.30     (5) exploring the efficiencies and benefits of establishing 
291.31  state-operated services as an independent state agency. 
291.32     The commissioner of human services shall submit a report to 
291.33  the legislature each January throughout a six-year 
291.34  implementation period. 
291.35     Sec. 10.  Minnesota Statutes 1998, section 246.18, 
291.36  subdivision 6, is amended to read: 
292.1      Subd. 6.  [COLLECTIONS DEDICATED.] Except for 
292.2   state-operated programs and services funded through a direct 
292.3   appropriation from the legislature, money received within the 
292.4   regional treatment center system for the following 
292.5   state-operated services is dedicated to the commissioner for the 
292.6   provision of those services: 
292.7      (1) community-based residential and day training and 
292.8   habilitation services for mentally retarded persons; 
292.9      (2) community health clinic services; 
292.10     (3) accredited hospital outpatient department services; 
292.11     (4) certified rehabilitation agency and rehabilitation 
292.12  hospital services; or 
292.13     (5) community-based transitional support services for 
292.14  adults with serious and persistent mental illness.  Except for 
292.15  state-operated programs funded through a direct appropriation 
292.16  from the legislature, any state-operated program or service 
292.17  established and operated as an enterprise activity, shall retain 
292.18  the revenues earned in an interest-bearing account. 
292.19     When the commissioner determines the intent to transition 
292.20  from a direct appropriation to enterprise activity, all 
292.21  collections for the targeted state-operated service shall be 
292.22  retained and deposited into an interest-bearing account.  At the 
292.23  end of the fiscal year, prior to establishing the enterprise 
292.24  activity, collections up to the amount of the appropriation for 
292.25  the targeted service shall be deposited to the general fund.  
292.26  All funds in excess of the amount of the appropriation will be 
292.27  retained and used by the enterprise activity for cash flow 
292.28  purposes. 
292.29     These funds must be deposited in the state treasury in a 
292.30  revolving account and funds in the revolving account are 
292.31  appropriated to the commissioner to operate the services 
292.32  authorized, and any unexpended balances do not cancel but are 
292.33  available until spent. 
292.34     Sec. 11.  Minnesota Statutes 1998, section 252.46, 
292.35  subdivision 6, is amended to read: 
292.36     Subd. 6.  [VARIANCES.] (a) A variance from the minimum or 
293.1   maximum payment rates in subdivisions 2 and 3 may be granted by 
293.2   the commissioner when the vendor requests and the county board 
293.3   submits to the commissioner a written variance request on forms 
293.4   supplied by the commissioner with the recommended payment rates. 
293.5      (b) A variance to the rate maximum may be utilized for 
293.6   costs associated with compliance with state administrative 
293.7   rules, compliance with court orders, capital costs required for 
293.8   continued licensure, increased insurance costs, start-up and 
293.9   conversion costs for supported employment, direct service staff 
293.10  salaries and benefits, transportation, and other program related 
293.11  costs when any one of the criteria criterion in clauses (1) to 
293.12  (4) is also met: 
293.13     (1) change is necessary to comply with licensing citations; 
293.14     (2) a licensed vendor currently serving fewer than 70 
293.15  persons with payment rates of 80 percent or less of the 
293.16  statewide average rates and with clients meeting the behavioral 
293.17  or medical criteria under clause (3) approved by the 
293.18  commissioner as a significant program change under section 
293.19  252.28; 
293.20     (3) (1) A determination of need under section 252.28 is 
293.21  approved for a significant program change is approved by the 
293.22  commissioner under section 252.28 that is necessary for a vendor 
293.23  to provide authorized services to a new client or clients with 
293.24  very severe self-injurious or assaultive behavior, or medical 
293.25  conditions requiring delivery of physician-prescribed medical 
293.26  interventions requiring one-to-one staffing for at least 15 
293.27  minutes each time they are performed, or to a new client or 
293.28  clients directly discharged to the vendor's program from a 
293.29  regional treatment center; or 
293.30     (4) there is a need to maintain required staffing levels in 
293.31  order to provide authorized services approved by the 
293.32  commissioner under section 252.28, that is necessitated by a 
293.33  significant and permanent decrease in licensed capacity or 
293.34  clientele. 
293.35     The county shall review the adequacy of services provided 
293.36  by vendors whose payment rates are 80 percent or more of the 
294.1   statewide average rates and 50 percent or more of the vendor's 
294.2   clients meet the behavioral or medical criteria in clause (3). 
294.3      A variance under this paragraph may be approved only if the 
294.4   costs to the medical assistance program do not exceed the 
294.5   medical assistance costs for all clients served by the 
294.6   alternatives and all clients remaining in the existing services. 
294.7   one or more clients who meet one or more of the following 
294.8   criteria: 
294.9      (a) the client is a new client and: 
294.10     (i) exhibits severe behavior as indicated on the screening 
294.11  document; 
294.12     (ii) periodically requires one-to-one staff time for at 
294.13  least 15 minutes at a time to deliver physician prescribed 
294.14  medical interventions; or 
294.15     (iii) has been discharged directly to the vendor's program 
294.16  from a regional treatment center or the Minnesota extended 
294.17  treatment option. 
294.18     (b) the client is an existing client who has developed one 
294.19  of the following changed circumstances which increases costs 
294.20  that are not covered by the vendor's current rate, and for whom 
294.21  a significant program change is necessary to ensure the 
294.22  continued provision of authorized services to that client: 
294.23     (i) severe behavior as indicated on the screening document; 
294.24     (ii) a medical condition periodically requiring one-to-one 
294.25  staff time for at least 15 minutes at a time to deliver 
294.26  physician prescribed medical interventions; or 
294.27     (iii) a permanent decrease in skill functioning, as 
294.28  verified by medical reports or assessments; 
294.29     (2) A licensing determination requires a program change 
294.30  that the vendor cannot comply with due to funding restraints; 
294.31     (3) A determination of need under section 252.28 is 
294.32  approved for a significant and permanent decrease in licensed 
294.33  capacity and the vendor demonstrates the need to retain certain 
294.34  staffing levels to serve the remaining clients; or 
294.35     (4) In cases where conditions in clauses (1) to (3) do not 
294.36  apply, but a determination of need under section 252.28 is 
295.1   approved for an unusual circumstance which exists that 
295.2   significantly impacts the type or amount of services delivered, 
295.3   as evidenced by documentation presented by the vendor and with 
295.4   the concurrence of the commissioner.  
295.5      (b) (c) A variance to the rate minimum may be granted when: 
295.6      (1) the county board contracts for increased services from 
295.7   a vendor and for some or all individuals receiving services from 
295.8   the vendor lower per unit fixed costs result; or 
295.9      (2) when the actual costs of delivering authorized service 
295.10  over a 12-month contract period have decreased. 
295.11     (c) (d) The written variance request under this subdivision 
295.12  must include documentation that all the following criteria have 
295.13  been met: 
295.14     (1) The commissioner and the county board have both 
295.15  conducted a review and have identified a need for a change in 
295.16  the payment rates and recommended an effective date for the 
295.17  change in the rate. 
295.18     (2) The vendor documents efforts to reallocate current 
295.19  staff and any additional staffing needs cannot be met by using 
295.20  temporary special needs rate exceptions under Minnesota Rules, 
295.21  parts 9510.1020 to 9510.1140. 
295.22     (3) The vendor documents that financial resources have been 
295.23  reallocated before applying for a variance.  No variance may be 
295.24  granted for equipment, supplies, or other capital expenditures 
295.25  when depreciation expense for repair and replacement of such 
295.26  items is part of the current rate. 
295.27     (4) For variances related to loss of clientele, the vendor 
295.28  documents the other program and administrative expenses, if any, 
295.29  that have been reduced. 
295.30     (5) The county board submits verification of the conditions 
295.31  for which the variance is requested, a description of the nature 
295.32  and cost of the proposed changes, and how the county will 
295.33  monitor the use of money by the vendor to make necessary changes 
295.34  in services.  
295.35     (6) The county board's recommended payment rates do not 
295.36  exceed 95 percent of the greater of 125 percent of the current 
296.1   statewide median or 125 percent of the regional average payment 
296.2   rates, whichever is higher, for each of the regional commission 
296.3   districts under sections 462.381 to 462.396 in which the vendor 
296.4   is located except for the following:  when a variance is 
296.5   recommended to allow authorized service delivery to new clients 
296.6   with severe self-injurious or assaultive behaviors or with 
296.7   medical conditions requiring delivery of physician prescribed 
296.8   medical interventions, or to persons being directly discharged 
296.9   from a regional treatment center or Minnesota extended treatment 
296.10  options to the vendor's program, those persons must be assigned 
296.11  a payment rate of 200 percent of the current statewide average 
296.12  rates.  All other clients receiving services from the vendor 
296.13  must be assigned a payment rate equal to the vendor's current 
296.14  rate unless the vendor's current rate exceeds 95 percent of 125 
296.15  percent of the statewide median or 125 percent of the regional 
296.16  average payment rates, whichever is higher.  When the vendor's 
296.17  rates exceed 95 percent of 125 percent of the statewide median 
296.18  or 125 percent of the regional average rates, the maximum rates 
296.19  assigned to all other clients must be equal to the greater of 95 
296.20  percent of 125 percent of the statewide median or 125 percent of 
296.21  the regional average rates.  The maximum payment rate that may 
296.22  be recommended for the vendor under these conditions is 
296.23  determined by multiplying the number of clients at each limit by 
296.24  the rate corresponding to that limit and then dividing the sum 
296.25  by the total number of clients. 
296.26     (d) (e) The commissioner shall have 60 calendar days from 
296.27  the date of the receipt of the complete request to accept or 
296.28  reject it, or the request shall be deemed to have been granted.  
296.29  If the commissioner rejects the request, the commissioner shall 
296.30  state in writing the specific objections to the request and the 
296.31  reasons for its rejection. 
296.32     Sec. 12.  Minnesota Statutes 1998, section 253B.045, is 
296.33  amended by adding a subdivision to read: 
296.34     Subd. 5.  [HEALTH PLAN COMPANY; DEFINITION.] For purposes 
296.35  of this section, "health plan company" has the meaning given it 
296.36  in section 62Q.01, subdivision 4, and also includes a 
297.1   demonstration provider as defined in section 256B.69, 
297.2   subdivision 2, paragraph (b), a county or group of counties 
297.3   participating in county-based purchasing according to section 
297.4   256B.692, and a children's mental health collaborative under 
297.5   contract to provide medical assistance for individuals enrolled 
297.6   in the prepaid medical assistance and MinnesotaCare programs 
297.7   according to sections 245.493 to 245.496. 
297.8      Sec. 13.  Minnesota Statutes 1998, section 253B.045, is 
297.9   amended by adding a subdivision to read: 
297.10     Subd. 6.  [COVERAGE.] A health plan company must provide 
297.11  coverage, according to the terms of the policy, contract, or 
297.12  certificate of coverage, for all medically necessary covered 
297.13  services as determined by section 62Q.53 provided to an enrollee 
297.14  that are ordered by the court under this chapter. 
297.15     Sec. 14.  Minnesota Statutes 1998, section 253B.07, 
297.16  subdivision 1, is amended to read: 
297.17     Subdivision 1.  [PREPETITION SCREENING.] (a) Prior to 
297.18  filing a petition for commitment of or early intervention for a 
297.19  proposed patient, an interested person shall apply to the 
297.20  designated agency in the county of the proposed patient's 
297.21  residence or presence for conduct of a preliminary 
297.22  investigation, except when the proposed patient has been 
297.23  acquitted of a crime under section 611.026 and the county 
297.24  attorney is required to file a petition for commitment.  The 
297.25  designated agency shall appoint a screening team to conduct an 
297.26  investigation which shall include:  
297.27     (i) a personal interview with the proposed patient and 
297.28  other individuals who appear to have knowledge of the condition 
297.29  of the proposed patient.  If the proposed patient is not 
297.30  interviewed, reasons must be documented; 
297.31     (ii) identification and investigation of specific alleged 
297.32  conduct which is the basis for application; 
297.33     (iii) identification, exploration, and listing of the 
297.34  reasons for rejecting or recommending alternatives to 
297.35  involuntary placement; and 
297.36     (iv) in the case of a commitment based on mental illness, 
298.1   the following information, if it is known or available:  
298.2   information that may be relevant to the administration of 
298.3   neuroleptic medications, if necessary, including the existence 
298.4   of a declaration under section 253B.03, subdivision 6d, or a 
298.5   health care directive under chapter 145C or a guardian, 
298.6   conservator, proxy, or agent with authority to make health care 
298.7   decisions for the proposed patient; information regarding the 
298.8   capacity of the proposed patient to make decisions regarding 
298.9   administration of neuroleptic medication; and whether the 
298.10  proposed patient is likely to consent or refuse consent to 
298.11  administration of the medication.; and 
298.12     (v) seeking input from the proposed patient's health plan 
298.13  company to provide the court with information about services the 
298.14  enrollee needs and the "least restrictive alternatives." 
298.15     (b) In conducting the investigation required by this 
298.16  subdivision, the screening team shall have access to all 
298.17  relevant medical records of proposed patients currently in 
298.18  treatment facilities.  Data collected pursuant to this clause 
298.19  shall be considered private data on individuals.  The 
298.20  prepetition screening report is not admissible in any court 
298.21  proceedings unrelated to the commitment proceedings. 
298.22     (c) When the prepetition screening team recommends 
298.23  commitment, a written report shall be sent to the county 
298.24  attorney for the county in which the petition is to be filed. 
298.25     (d) The prepetition screening team shall refuse to support 
298.26  a petition if the investigation does not disclose evidence 
298.27  sufficient to support commitment.  Notice of the prepetition 
298.28  screening team's decision shall be provided to the prospective 
298.29  petitioner.  
298.30     (e) If the interested person wishes to proceed with a 
298.31  petition contrary to the recommendation of the prepetition 
298.32  screening team, application may be made directly to the county 
298.33  attorney, who may determine whether or not to proceed with the 
298.34  petition.  Notice of the county attorney's determination shall 
298.35  be provided to the interested party.  
298.36     (f) If the proposed patient has been acquitted of a crime 
299.1   under section 611.026, the county attorney shall apply to the 
299.2   designated county agency in the county in which the acquittal 
299.3   took place for a preliminary investigation unless substantially 
299.4   the same information relevant to the proposed patient's current 
299.5   mental condition, as could be obtained by a preliminary 
299.6   investigation, is part of the court record in the criminal 
299.7   proceeding or is contained in the report of a mental examination 
299.8   conducted in connection with the criminal proceeding.  If a 
299.9   court petitions for commitment pursuant to the rules of criminal 
299.10  or juvenile procedure or a county attorney petitions pursuant to 
299.11  acquittal of a criminal charge under section 611.026, the 
299.12  prepetition investigation, if required by this section, shall be 
299.13  completed within seven days after the filing of the petition.  
299.14     Sec. 15.  Minnesota Statutes 1998, section 253B.185, is 
299.15  amended by adding a subdivision to read: 
299.16     Subd. 5.  [AFTERCARE AND CASE MANAGEMENT.] The state, in 
299.17  collaboration with the designated agency, is responsible for 
299.18  arranging and funding the aftercare and case management services 
299.19  for persons under commitment as sexual psychopathic 
299.20  personalities and sexually dangerous persons discharged after 
299.21  July 1, 1999. 
299.22     Sec. 16.  Minnesota Statutes 1998, section 254B.01, is 
299.23  amended by adding a subdivision to read: 
299.24     Subd. 7.  [ROOM AND BOARD RATE.] "Room and board rate" 
299.25  means a rate set for shelter, fuel, food, utilities, household 
299.26  supplies, and other costs necessary to provide room and board 
299.27  for a person in need of chemical dependency services. 
299.28     Sec. 17.  Minnesota Statutes 1998, section 254B.03, 
299.29  subdivision 2, is amended to read: 
299.30     Subd. 2.  [CHEMICAL DEPENDENCY SERVICES FUND PAYMENT.] (a) 
299.31  Payment from the chemical dependency fund is limited to payments 
299.32  for services other than detoxification that, if located outside 
299.33  of federally recognized tribal lands, would be required to be 
299.34  licensed by the commissioner as a chemical dependency treatment 
299.35  or rehabilitation program under sections 245A.01 to 245A.16, and 
299.36  services other than detoxification provided in another state 
300.1   that would be required to be licensed as a chemical dependency 
300.2   program if the program were in the state.  Out of state vendors 
300.3   must also provide the commissioner with assurances that the 
300.4   program complies substantially with state licensing requirements 
300.5   and possesses all licenses and certifications required by the 
300.6   host state to provide chemical dependency treatment.  Hospitals 
300.7   may apply for and receive licenses to be eligible vendors, 
300.8   notwithstanding the provisions of section 245A.03.  Except for 
300.9   chemical dependency transitional rehabilitation programs, 
300.10  vendors receiving payments from the chemical dependency fund 
300.11  must not require copayment from a recipient of benefits for 
300.12  services provided under this subdivision.  Payment from the 
300.13  chemical dependency fund shall be made for necessary room and 
300.14  board costs provided by vendors certified according to section 
300.15  254B.05, or in a community hospital licensed by the commissioner 
300.16  of the department of health according to sections 144.50 to 
300.17  144.56 to a client who is: 
300.18     (1) determined to meet the criteria for placement in a 
300.19  residential chemical dependency treatment program according to 
300.20  rules adopted under section 254A.03, subdivision 3; and 
300.21     (2) concurrently receiving a chemical dependency treatment 
300.22  service in a program licensed by the commissioner and reimbursed 
300.23  by the chemical dependency fund. 
300.24     (b) A county may, from its own resources, provide chemical 
300.25  dependency services for which state payments are not made.  A 
300.26  county may elect to use the same invoice procedures and obtain 
300.27  the same state payment services as are used for chemical 
300.28  dependency services for which state payments are made under this 
300.29  section if county payments are made to the state in advance of 
300.30  state payments to vendors.  When a county uses the state system 
300.31  for payment, the commissioner shall make monthly billings to the 
300.32  county using the most recent available information to determine 
300.33  the anticipated services for which payments will be made in the 
300.34  coming month.  Adjustment of any overestimate or underestimate 
300.35  based on actual expenditures shall be made by the state agency 
300.36  by adjusting the estimate for any succeeding month. 
301.1      (c) The commissioner shall coordinate chemical dependency 
301.2   services and determine whether there is a need for any proposed 
301.3   expansion of chemical dependency treatment services.  The 
301.4   commissioner shall deny vendor certification to any provider 
301.5   that has not received prior approval from the commissioner for 
301.6   the creation of new programs or the expansion of existing 
301.7   program capacity.  The commissioner shall consider the 
301.8   provider's capacity to obtain clients from outside the state 
301.9   based on plans, agreements, and previous utilization history, 
301.10  when determining the need for new treatment services. 
301.11     Sec. 18.  Minnesota Statutes 1998, section 254B.05, 
301.12  subdivision 1, is amended to read: 
301.13     Subdivision 1.  [LICENSURE REQUIRED.] Programs licensed by 
301.14  the commissioner are eligible vendors.  Hospitals may apply for 
301.15  and receive licenses to be eligible vendors, notwithstanding the 
301.16  provisions of section 245A.03.  American Indian programs located 
301.17  on federally recognized tribal lands that provide chemical 
301.18  dependency primary treatment, extended care, transitional 
301.19  residence, or outpatient treatment services, and are licensed by 
301.20  tribal government are eligible vendors.  Detoxification programs 
301.21  are not eligible vendors.  Programs that are not licensed as a 
301.22  chemical dependency residential or nonresidential treatment 
301.23  program by the commissioner or by tribal government are not 
301.24  eligible vendors.  To be eligible for payment under the 
301.25  Consolidated Chemical Dependency Treatment Fund, a vendor of a 
301.26  chemical dependency service must participate in the Drug and 
301.27  Alcohol Abuse Normative Evaluation System and the treatment 
301.28  accountability plan. 
301.29     Effective January 1, 2000, vendors of room and board are 
301.30  eligible for chemical dependency fund payment if the vendor:  
301.31     (1) is certified by the county or tribal governing body as 
301.32  having rules prohibiting residents bringing chemicals into the 
301.33  facility or using chemicals while residing in the facility and 
301.34  provide consequences for infractions of those rules; 
301.35     (2) has a current contract with a county or tribal 
301.36  governing body; 
302.1      (3) is determined to meet applicable health and safety 
302.2   requirements; 
302.3      (4) is not a jail or prison; and 
302.4      (5) is not concurrently receiving funds under chapter 256I 
302.5   for the recipient. 
302.6      Sec. 19.  Minnesota Statutes 1998, section 256B.0625, 
302.7   subdivision 20, is amended to read: 
302.8      Subd. 20.  [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 
302.9   extent authorized by rule of the state agency, medical 
302.10  assistance covers case management services to persons with 
302.11  serious and persistent mental illness and children with severe 
302.12  emotional disturbance.  Services provided under this section 
302.13  must meet the relevant standards in sections 245.461 to 
302.14  245.4888, the Comprehensive Adult and Children's Mental Health 
302.15  Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 
302.16  9505.0322, excluding subpart 10. 
302.17     (b) Entities meeting program standards set out in rules 
302.18  governing family community support services as defined in 
302.19  section 245.4871, subdivision 17, are eligible for medical 
302.20  assistance reimbursement for case management services for 
302.21  children with severe emotional disturbance when these services 
302.22  meet the program standards in Minnesota Rules, parts 9520.0900 
302.23  to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 
302.24     (c) Medical assistance and MinnesotaCare payment for mental 
302.25  health case management shall be made on a monthly basis.  In 
302.26  order to receive payment for an eligible child, the provider 
302.27  must document at least a face-to-face contact with the child, 
302.28  the child's parents, or the child's legal representative.  To 
302.29  receive payment for an eligible adult, the provider must 
302.30  document: 
302.31     (1) at least a face-to-face contact with the adult or the 
302.32  adult's legal representative; or 
302.33     (2) at least a telephone contact with the adult or the 
302.34  adult's legal representative and document a face-to-face contact 
302.35  with the adult or the adult's legal representative within the 
302.36  preceding two months. 
303.1      (d) Payment for mental health case management provided by 
303.2   county or state staff shall be based on the monthly rate 
303.3   methodology under section 256B.094, subdivision 6, paragraph 
303.4   (b), with separate rates calculated for child welfare and mental 
303.5   health, and within mental health, separate rates for children 
303.6   and adults. 
303.7      (e) Payment for mental health case management provided by 
303.8   county-contracted vendors shall be based on a monthly rate 
303.9   negotiated by the host county.  The negotiated rate must not 
303.10  exceed the rate charged by the vendor for the same service to 
303.11  other payers.  If the service is provided by a team of 
303.12  contracted vendors, the county may negotiate a team rate with a 
303.13  vendor who is a member of the team.  The team shall determine 
303.14  how to distribute the rate among its members.  No reimbursement 
303.15  received by contracted vendors shall be returned to the county, 
303.16  except to reimburse the county for advance funding provided by 
303.17  the county to the vendor. 
303.18     (f) If the service is provided by a team which includes 
303.19  contracted vendors and county or state staff, the costs for 
303.20  county or state staff participation in the team shall be 
303.21  included in the rate for county-provided services.  In this 
303.22  case, the contracted vendor and the county may each receive 
303.23  separate payment for services provided by each entity in the 
303.24  same month.  In order to prevent duplication of services, the 
303.25  county must document, in the recipient's file, the need for team 
303.26  case management and a description of the roles of the team 
303.27  members. 
303.28     (g) The commissioner shall calculate the nonfederal share 
303.29  of actual medical assistance and general assistance medical care 
303.30  payments for each county, based on the higher of calendar year 
303.31  1995 or 1996, by service date, project that amount forward to 
303.32  1999, and transfer one-half of the result from medical 
303.33  assistance and general assistance medical care to each county's 
303.34  mental health grants under sections 245.4886 and 256E.12 for 
303.35  calendar year 1999.  The annualized minimum amount added to each 
303.36  county's mental health grant shall be $3,000 per year for 
304.1   children and $5,000 per year for adults.  The commissioner may 
304.2   reduce the statewide growth factor in order to fund these 
304.3   minimums.  The annualized total amount transferred shall become 
304.4   part of the base for future mental health grants for each county.
304.5      (h) Any net increase in revenue to the county as a result 
304.6   of the change in this section must be used to provide expanded 
304.7   mental health services as defined in sections 245.461 to 
304.8   245.4888, the Comprehensive Adult and Children's Mental Health 
304.9   Acts, excluding inpatient and residential treatment.  For 
304.10  adults, increased revenue may also be used for services and 
304.11  consumer supports which are part of adult mental health projects 
304.12  approved under Laws 1997, chapter 203, article 7, section 25.  
304.13  For children, increased revenue may also be used for respite 
304.14  care and nonresidential individualized rehabilitation services 
304.15  as defined in section 245.492, subdivisions 17 and 23.  
304.16  "Increased revenue" has the meaning given in Minnesota Rules, 
304.17  part 9520.0903, subpart 3.  
304.18     (i) Notwithstanding section 256B.19, subdivision 1, the 
304.19  nonfederal share of costs for mental health case management 
304.20  shall be provided by the recipient's county of responsibility, 
304.21  as defined in sections 256G.01 to 256G.12, from sources other 
304.22  than federal funds or funds used to match other federal funds.  
304.23     (j) The commissioner may suspend, reduce, or terminate the 
304.24  reimbursement to a provider that does not meet the reporting or 
304.25  other requirements of this section.  The county of 
304.26  responsibility, as defined in sections 256G.01 to 256G.12, is 
304.27  responsible for any federal disallowances.  The county may share 
304.28  this responsibility with its contracted vendors.  
304.29     (k) The commissioner shall set aside a portion of the 
304.30  federal funds earned under this section to repay the special 
304.31  revenue maximization account under section 256.01, subdivision 
304.32  2, clause (15).  The repayment is limited to: 
304.33     (1) the costs of developing and implementing this section; 
304.34  and 
304.35     (2) programming the information systems. 
304.36     (l) Notwithstanding section 256.025, subdivision 2, 
305.1   payments to counties for case management expenditures under this 
305.2   section shall only be made from federal earnings from services 
305.3   provided under this section.  Payments to contracted vendors 
305.4   shall include both the federal earnings and the county share. 
305.5      (m) Notwithstanding section 256B.041, county payments for 
305.6   the cost of mental health case management services provided by 
305.7   county or state staff shall not be made to the state treasurer.  
305.8   For the purposes of mental health case management services 
305.9   provided by county or state staff under this section, the 
305.10  centralized disbursement of payments to counties under section 
305.11  256B.041 consists only of federal earnings from services 
305.12  provided under this section. 
305.13     (n) Case management services under this subdivision do not 
305.14  include therapy, treatment, legal, or outreach services. 
305.15     (o) If the recipient is a resident of a nursing facility, 
305.16  intermediate care facility, or hospital, and the recipient's 
305.17  institutional care is paid by medical assistance, payment for 
305.18  case management services under this subdivision is limited to 
305.19  the last 30 days of the recipient's residency in that facility 
305.20  and may not exceed more than two months in a calendar year. 
305.21     (p) Payment for case management services under this 
305.22  subdivision shall not duplicate payments made under other 
305.23  program authorities for the same purpose. 
305.24     (q) By July 1, 2000, the commissioner shall evaluate the 
305.25  effectiveness of the changes required by this section, including 
305.26  changes in number of persons receiving mental health case 
305.27  management, changes in hours of service per person, and changes 
305.28  in caseload size. 
305.29     (r) For each calendar year beginning with the calendar year 
305.30  2001, the annualized amount of state funds for each county 
305.31  determined under paragraph (g) shall be adjusted by the county's 
305.32  percentage change in the average number of clients per month who 
305.33  received case management under this section during the fiscal 
305.34  year that ended six months prior to the calendar year in 
305.35  question, in comparison to the prior fiscal year. 
305.36     (s) For counties receiving the minimum allocation of $3,000 
306.1   or $5,000 described in paragraph (g), the adjustment in 
306.2   paragraph (r) shall be determined so that the county receives 
306.3   the higher of the following amounts: 
306.4      (1) a continuation of the minimum allocation in paragraph 
306.5   (g); or 
306.6      (2) an amount based on that county's average number of 
306.7   clients per month who received case management under this 
306.8   section during the fiscal year that ended six months prior to 
306.9   the calendar year in question, in comparison to the prior fiscal 
306.10  year, times the average statewide grant per person per month for 
306.11  counties not receiving the minimum allocation. 
306.12     (t) The adjustments in paragraphs (r) and (s) shall be 
306.13  calculated separately for children and adults. 
306.14     Sec. 20.  Laws 1995, chapter 207, article 8, section 41, as 
306.15  amended by Laws 1997, chapter 203, article 7, section 25, is 
306.16  amended to read: 
306.17     Sec. 41.  [PILOT PROJECTS INITIATIVES TO TEST PROVIDE 
306.18  ALTERNATIVES TO DELIVERY OF ADULT MENTAL HEALTH SERVICES.] 
306.19     Subdivision 1.  [AUTHORIZATION FOR PILOT PROJECTS ADULT 
306.20  MENTAL HEALTH INITIATIVES.] The commissioner of human services 
306.21  may approve pilot projects adult mental health initiatives to 
306.22  test provide alternatives to or the enhanced enhance 
306.23  coordination of the delivery of mental health services required 
306.24  under the Minnesota comprehensive adult mental health act, 
306.25  Minnesota Statutes, sections 245.461 to 245.486. 
306.26     Subd. 2.  [PROGRAM DESIGN AND IMPLEMENTATION.] (a) The 
306.27  pilot projects adult mental health initiatives shall be 
306.28  established to design, plan, and improve the mental health 
306.29  service delivery system for adults with serious and persistent 
306.30  mental illness that would: 
306.31     (1) provide an expanded array of services from which 
306.32  clients can choose services appropriate to their needs; 
306.33     (2) be based on purchasing strategies that improve access 
306.34  and coordinate services without cost shifting; 
306.35     (3) incorporate existing state facilities and resources 
306.36  into the community mental health infrastructure through creative 
307.1   partnerships with local vendors; and 
307.2      (4) utilize existing categorical funding streams and 
307.3   reimbursement sources in combined and creative ways, except 
307.4   appropriations to regional treatment centers and all funds that 
307.5   are attributable to the operation of state-operated services are 
307.6   excluded unless appropriated specifically by the legislature for 
307.7   a purpose consistent with this section. 
307.8      (b) All projects initiatives funded by January 1, 1997, 
307.9   must complete the planning phase and be operational by June 30, 
307.10  1997; all projects funded by January 1, 1998, must be 
307.11  operational by June 30, 1998.  
307.12     Subd. 3.  [PROGRAM EVALUATION.] Evaluation of each project 
307.13  initiative will be based on outcome evaluation criteria 
307.14  negotiated with each project prior to implementation. 
307.15     Subd. 4.  [NOTICE OF PROJECT DISCONTINUATION.] Each project 
307.16  initiative may be discontinued for any reason by the project's 
307.17  initiative's managing entity or the commissioner of human 
307.18  services, after 90 days' written notice to the other party. 
307.19     Subd. 5.  [PLANNING FOR PILOT PROJECTS ADULT MENTAL HEALTH 
307.20  INITIATIVES.] Each local plan for a pilot project an initiative 
307.21  must be developed under the direction of the county board, or 
307.22  multiple county boards acting jointly, as the local mental 
307.23  health authority.  The planning process for each 
307.24  pilot initiative shall include, but not be limited to, mental 
307.25  health consumers, families, advocates, local mental health 
307.26  advisory councils, local and state providers, representatives of 
307.27  state and local public employee bargaining units, and the 
307.28  department of human services.  As part of the planning process, 
307.29  the county board or boards shall designate a managing entity 
307.30  responsible for receipt of funds and management of the pilot 
307.31  project initiative. 
307.32     Subd. 6.  [DUTIES OF COMMISSIONER.] (a) For purposes of the 
307.33  pilot projects adult mental health initiatives, the commissioner 
307.34  shall facilitate integration of funds or other resources as 
307.35  needed and requested by each project initiative.  These 
307.36  resources may include: 
308.1      (1) residential services funds administered under Minnesota 
308.2   Rules, parts 9535.2000 to 9535.3000, in an amount to be 
308.3   determined by mutual agreement between the project's 
308.4   initiative's managing entity and the commissioner of human 
308.5   services after an examination of the county's historical 
308.6   utilization of facilities located both within and outside of the 
308.7   county and licensed under Minnesota Rules, parts 9520.0500 to 
308.8   9520.0690; 
308.9      (2) community support services funds administered under 
308.10  Minnesota Rules, parts 9535.1700 to 9535.1760; 
308.11     (3) other mental health special project funds; 
308.12     (4) medical assistance, general assistance medical care, 
308.13  MinnesotaCare and group residential housing if requested by the 
308.14  project's initiative's managing entity, and if the commissioner 
308.15  determines this would be consistent with the state's overall 
308.16  health care reform efforts; and 
308.17     (5) regional treatment center nonfiscal resources to the 
308.18  extent agreed to by the project's initiative's managing entity 
308.19  and the regional treatment center. 
308.20     (b) The commissioner shall consider the following criteria 
308.21  in awarding start-up and implementation grants for the pilot 
308.22  projects adult mental health initiatives: 
308.23     (1) the ability of the proposed projects initiatives to 
308.24  accomplish the objectives described in subdivision 2; 
308.25     (2) the size of the target population to be served; and 
308.26     (3) geographical distribution. 
308.27     (c) The commissioner shall review overall status of the 
308.28  projects at least every two years and recommend any legislative 
308.29  changes needed by January 15 of each odd-numbered year. 
308.30     (d) The commissioner may waive administrative rule 
308.31  requirements which are incompatible with the implementation of 
308.32  the pilot project adult mental health initiatives. 
308.33     (e) (d) The commissioner may exempt the participating 
308.34  counties from fiscal sanctions for noncompliance with 
308.35  requirements in laws and rules which are incompatible with the 
308.36  implementation of the pilot project adult mental health 
309.1   initiative. 
309.2      (f) (e) The commissioner may award grants to an entity 
309.3   designated by a county board or group of county boards to pay 
309.4   for start-up and implementation costs of the pilot project adult 
309.5   mental health initiative. 
309.6      Subd. 7.  [DUTIES OF COUNTY BOARD.] The county board, or 
309.7   other entity which is approved to administer a pilot project an 
309.8   adult mental health initiative, shall: 
309.9      (1) administer the project in a manner which is consistent 
309.10  with the objectives described in subdivision 2 and the planning 
309.11  process described in subdivision 5; 
309.12     (2) assure that no one is denied services for which they 
309.13  would otherwise be eligible; and 
309.14     (3) provide the commissioner of human services with timely 
309.15  and pertinent information through the following methods: 
309.16     (i) submission of community social services act plans and 
309.17  plan amendments; 
309.18     (ii) submission of social services expenditure and grant 
309.19  reconciliation reports, based on a coding format to be 
309.20  determined by mutual agreement between the project's 
309.21  initiative's managing entity and the commissioner; and 
309.22     (iii) submission of data and participation in an evaluation 
309.23  of the pilot projects adult mental health initiatives, to be 
309.24  designed cooperatively by the commissioner and the projects 
309.25  initiatives. 
309.26     Sec. 21.  Laws 1997, chapter 203, article 9, section 19, is 
309.27  amended to read: 
309.28     Sec. 19.  [TRANSITION FOR THE COMPULSIVE GAMBLING TREATMENT 
309.29  PROGRAM.] 
309.30     The commissioner of human services shall conduct a 
309.31  transition of treatment programs for compulsive gambling from 
309.32  the treatment center model to a model in which reimbursement for 
309.33  treatment of an individual compulsive gambler from an approved 
309.34  provider is on a fee-for-service basis on the following schedule:
309.35     (1) one-third of compulsive gamblers treated through the 
309.36  program must receive services paid for from the individual 
310.1   treatment reimbursement model beginning October 1, 1997; 
310.2      (2) two-thirds of compulsive gamblers treated through the 
310.3   program must receive services paid for from the individual 
310.4   treatment reimbursement model beginning July 1, 1998; and 
310.5      (3) 100 percent of compulsive gamblers treated through the 
310.6   program must receive treatment paid for from the individual 
310.7   treatment reimbursement model beginning July 1, 1999 2000. 
310.8      Sec. 22.  Laws 1998, chapter 407, article 7, section 2, 
310.9   subdivision 3, is amended to read: 
310.10     Subd. 3.  [LAND DESCRIPTION.] That part of the Northeast 
310.11  Quarter (NE l/4) of Section 30 29, Township 45 North, Range 30 
310.12  West, Crow Wing county, Minnesota, described as follows: 
310.13     Commencing at the southeast corner of said Northeast 
310.14     quarter; thence North 00 degrees 46 minutes 05 seconds 
310.15     West, bearing based on the Crow Wing county Coordinate 
310.16     Database NAD 83/94, 1520.06 feet along the east line of 
310.17     said Northeast quarter to the point of beginning; thence 
310.18     continue North 00 degrees 46 minutes 05 seconds West 634.14 
310.19     feet along said east line of the Northeast quarter; thence 
310.20     South 89 degrees 13 minutes 20 seconds West 550.00 feet; 
310.21     thence South 18 degrees 57 minutes 23 seconds East 115.59 
310.22     feet; thence South 42 degrees 44 minutes 39 seconds East 
310.23     692.37 feet; thence South 62 degrees 46 minutes 19 seconds 
310.24     East 20.24 feet; thence North 89 degrees 13 minutes 55 
310.25     seconds East 33.00 feet to the point of beginning.  
310.26     Containing 4.69 acres, more or less.  Subject to the 
310.27     right-of-way of the Township road along the east side 
310.28     thereof, subject to other easements, reservations, and 
310.29     restrictions of record, if any. 
310.30     Sec. 23.  [ESTABLISHMENT AND PURPOSE OF THE SUPPORTIVE 
310.31  HOUSING AND MANAGED CARE PILOT PROJECT.] 
310.32     Subdivision 1.  [ESTABLISHMENT AND PURPOSE.] If funding is 
310.33  available, the commissioner of human services may establish a 
310.34  supportive housing and managed care pilot project to determine 
310.35  whether integrating the delivery of housing, supportive 
310.36  services, and health care into a single, flexible program will 
311.1   reduce public expenditures on homeless individuals, increase 
311.2   their employment rates, and provide a new alternative to 
311.3   providing services to a hard-to-serve population. 
311.4      The commissioner of human services may create a block grant 
311.5   program for counties for the purpose of providing rent subsidies 
311.6   and supportive services to eligible individuals.  Minimum 
311.7   project and application requirements may be developed by the 
311.8   commissioner in cooperation with counties and their nonprofit 
311.9   partners with the goal to provide the maximum flexibility in 
311.10  program design.  If any funds are available, the funds must be 
311.11  coordinated with health care services for eligible individuals. 
311.12     Subd. 2.  [COUNTY ELIGIBILITY.] If the commissioner 
311.13  establishes the pilot project under subdivision 1, a county may 
311.14  request funding for the purposes of the pilot project if the 
311.15  county: 
311.16     (1) agrees to develop, in cooperation with nonprofit 
311.17  partners, a supportive housing and managed care pilot project 
311.18  that integrates the delivery of housing, support services, and 
311.19  health care for eligible individuals or agrees to contract with 
311.20  an existing integrated program; and 
311.21     (2) develops a method for evaluating the quality of the 
311.22  integrated services provided and the amount of any resulting 
311.23  cost savings to the county and state. 
311.24     Subd. 3.  [PARTICIPANT ELIGIBILITY.] In order to be 
311.25  eligible for the pilot project, a county must determine that an 
311.26  individual: 
311.27     (1) meets the eligibility requirements of the group 
311.28  residential housing program under Minnesota Statutes, section 
311.29  256I.04, subdivision 1; 
311.30     (2) is a homeless person or a person at risk of 
311.31  homelessness.  For purposes of this pilot project, "homeless 
311.32  person" means a person who is living, or at imminent risk of 
311.33  living, on the street, in a shelter, or is evicted from a 
311.34  dwelling or discharged from a regional human services center, 
311.35  community hospital, or residential treatment program, and has no 
311.36  appropriate housing available and lacks the resources necessary 
312.1   to access permanent housing as determined by the county 
312.2   requesting funding under the pilot project; and 
312.3      (3) is a person with mental illness, a history of substance 
312.4   abuse, or a person with HIV. 
312.5      Subd. 4.  [FUNDING.] If the commissioner establishes the 
312.6   pilot project under subdivision 1, a county may request funding 
312.7   from the commissioner for a specified number of eligible 
312.8   participants for the pilot project.  The commissioner shall 
312.9   review the request for compliance with subdivisions 1 to 3 and 
312.10  may approve or disapprove the request.  The commissioner shall 
312.11  transfer funding to be allocated to participating counties as a 
312.12  block grant and paid on a monthly basis. 
312.13     Subd. 5.  [REPORT.] If the commissioner establishes the 
312.14  pilot project under subdivision 1, participating counties and 
312.15  the commissioner of human services shall collaborate to prepare 
312.16  and issue an annual report beginning December 1, 2001, to the 
312.17  appropriate committee chairs in the senate and house on the use 
312.18  of state resources, including other funds leveraged for this 
312.19  initiative, the status of individuals being served in the pilot 
312.20  project, and the cost-effectiveness of the pilot project.  The 
312.21  commissioner shall provide data that may be needed to evaluate 
312.22  the pilot project to counties that request the data. 
312.23     Subd. 6.  [SUNSET.] The pilot project shall sunset June 30, 
312.24  2005. 
312.25     Sec. 24.  [CONVEYANCE OF STATE LANDS TO COUNTY OF ISANTI.] 
312.26     (a) Notwithstanding Minnesota Statutes, sections 94.09 to 
312.27  94.16, the commissioner of human services, through the 
312.28  commissioner of administration, may transfer to the county of 
312.29  Isanti the lands described in paragraph (c), for no 
312.30  consideration.  The commissioner of human services and the 
312.31  county may attach to the transfer conditions that they agree are 
312.32  appropriate, including conditions that relate to water and sewer 
312.33  service.  The deed to convey the property must contain a clause 
312.34  that the property shall revert to the state if the property 
312.35  ceases to be used for a public purpose. 
312.36     (b) The conveyance must be in a form approved by the 
313.1   attorney general. 
313.2      (c) The land that may be transferred consists of 21.9 
313.3   acres, more or less, and is described as follows: 
313.4      That part of the Southwest Quarter of the Southeast Quarter 
313.5      and that part of Government Lot 4, both in Section 32, 
313.6      Township 36, Range 23, Isanti County, Minnesota, described 
313.7      jointly as follows:  Commencing at the southwest corner of 
313.8      the Southwest Quarter of the Southeast Quarter of Section 
313.9      32; thence North 89 degrees 45 minutes 12 seconds East, 
313.10     assumed bearing, along the south line of said SW 1/4 of SE 
313.11     1/4, a distance of 609.48 feet; thence North 1 degree 30 
313.12     minutes 30 seconds West, a distance of 149.17 feet to the 
313.13     point of beginning of the parcel to be herein described; 
313.14     thence continuing North 1 degrees 30 minutes 30 seconds 
313.15     West, a distance of 1113.59 feet; thence South 89 degrees 
313.16     59 minutes 36 seconds West, a distance of 496.41 feet; 
313.17     thence southwesterly along a tangential curve concave to 
313.18     the southeast, radius 318.10 feet, central angle 90 degrees 
313.19     16 minutes 37 seconds, for an arc length of 501.21 feet; 
313.20     thence South 0 degrees 17 minutes 01 seconds East, tangent 
313.21     to said curve, for a distance of 86.59 feet; thence 
313.22     southerly along a tangential curve concave to the west, 
313.23     radius 398.10 feet, central angle 29 degrees 47 minutes 02 
313.24     seconds, for an arc length of 206.94 feet; thence south 29 
313.25     degrees 30 minutes 01 seconds West, tangent to said curve, 
313.26     for a distance of 34.23 feet; thence southerly along a 
313.27     tangential curve concave to the east, radius 318.10 feet, 
313.28     central angle 29 degrees 49 minutes 32 seconds, for an arc 
313.29     length of 165.59 feet; thence South 0 degrees 19 minutes 31 
313.30     seconds East, tangent to said curve for a distance of 
313.31     320.65 feet to the point of intersection with a line that 
313.32     bears West (North 90 degrees 00 minutes West) from the 
313.33     point of beginning; thence East (North 90 degrees 00 
313.34     minutes East), a distance of 951.22 feet to the point of 
313.35     beginning. 
313.36     Subject to the existing city of Cambridge water main 
314.1      easement. 
314.2      (d) The county of Isanti may use the land for economic 
314.3   development.  Economic development is a public purpose within 
314.4   the meaning of the term as used in Laws 1990, chapter 610, 
314.5   article 1, section 12, subdivision 5, and sales or conveyances 
314.6   to private parties shall be considered economic development.  
314.7   Property conveyed by the state under this section shall not 
314.8   revert to the state if it is conveyed or otherwise encumbered by 
314.9   the county as part of the county economic development activity. 
314.10     Sec. 25.  [CONVEYANCE OF STATE LAND TO CITY OF CAMBRIDGE.] 
314.11     (a) Notwithstanding Minnesota Statutes, sections 94.09 to 
314.12  94.16, the commissioner of human services, through the 
314.13  commissioner of administration, may transfer to the city of 
314.14  Cambridge the lands described in paragraph (c), for no 
314.15  consideration.  The commissioner of human services and the city 
314.16  may attach to the transfer conditions that they agree are 
314.17  appropriate, including conditions that relate to water and sewer 
314.18  service.  The deed to convey the property must contain a clause 
314.19  that the property shall revert to the state if the property 
314.20  ceases to be used for a public purpose. 
314.21     (b) The conveyance must be in a form approved by the 
314.22  attorney general. 
314.23     (c) Subject to the right-of-way for state trunk highway No. 
314.24  293 and south Dellwood street and subject to other easements, 
314.25  reservations, road or street right-of-ways, and restrictions of 
314.26  record, if any, the land to be conveyed may include all or part 
314.27  of any of the parcels described as follows: 
314.28     (1) that part of the Northeast Quarter of the Northeast 
314.29     Quarter of Section 5, Township 35, Range 23, Isanti County, 
314.30     Minnesota, lying north of a line drawn parallel with and 50 
314.31     feet north of the center line of State Highway No. 293, as 
314.32     laid out and constructed and lying westerly of the 
314.33     following described line: 
314.34     Commencing at a point where the West line of the 
314.35     right-of-way of the Great Northern Railway Company 
314.36     (presently the Burlington Northern and Santa Fe Railway) 
315.1      intersects the North line of said Section 5, said point now 
315.2      being the intersection of the North line of said Section 5 
315.3      with the center line of State Trunk Highway No. 65 as now 
315.4      laid out and constructed (presently known as South Main 
315.5      Street); thence on a bearing of West and along the North 
315.6      line of said Section 5 a distance of 539.5 feet to the 
315.7      point of beginning of the line to be herein described; 
315.8      thence on a bearing of South, a distance of 451.75 feet to 
315.9      the point of intersection with a line drawn parallel with 
315.10     and distant 50 feet north of the center line of State 
315.11     Highway No. 293, as laid out and constructed and there 
315.12     terminating.  Containing 1/4 acre, more or less. 
315.13     (2) that part of the Northwest Quarter of the Southeast 
315.14     Quarter and that part of Governments Lots 3 and 4, all in 
315.15     Section 32, Township 36, Range 23, Isanti County, 
315.16     Minnesota, described jointly as follows: 
315.17     Commencing at the East quarter corner of Section 32, 
315.18     Township 36, Range 23, Isanti County, Minnesota; thence 
315.19     South 89 degrees 44 minutes 35 seconds West, assumed 
315.20     bearing, along the east-west quarter line of said Section 
315.21     32, a distance of 2251.43 feet; thence South 1 degree 48 
315.22     minutes 40 seconds East, a distance of 344.47 feet to the 
315.23     south line of Lot 30 of Auditor's Subdivision No. 9; thence 
315.24     South 89 degrees 35 minutes 5 seconds West, along said 
315.25     south line and the westerly projection thereof, a distance 
315.26     of 740.00 feet to the point of beginning of the parcel to 
315.27     be herein described; thence North 89 degrees 35 minutes, 05 
315.28     seconds East, retracing the last described course, a 
315.29     distance of 534.66 feet to the northwest corner of the 
315.30     recorded plat of RIVERWOOD VILLAGE; thence South 2 degrees 
315.31     40 minutes 50 seconds East, a distance of 338.38 feet, 
315.32     along the westerly line of said RIVERWOOD VILLAGE to the 
315.33     southwest corner of said RIVERWOOD VILLAGE; thence North 89 
315.34     degrees 44 minutes 50 seconds East, along the south line of 
315.35     said RIVERWOOD VILLAGE, a distance of 1074.56 feet; thence 
315.36     South 3 degrees 35 minutes 15 seconds East, a distance of 
316.1      258.66 feet; thence southwesterly along a tangential curve 
316.2      concave to the northwest, radius 318.10 feet, central angle 
316.3      93 degrees 34 minutes 51 seconds for an arc length of 
316.4      519.56 feet; thence South 89 degrees 59 minutes 37 seconds 
316.5      West tangent to said curve for a distance of 825.86 feet; 
316.6      thence southwesterly along a tangential curve concave to 
316.7      the southeast, radius 398.10 feet, central angle 70 degrees 
316.8      55 minutes 13 seconds, for an arc length of 492.76 feet; 
316.9      thence South 89 degrees 51 minutes 30 seconds West, not 
316.10     tangent to the last described curve for a distance of 
316.11     523.31 feet; thence South 1 degree 57 minutes 33 seconds 
316.12     West, a distance of 29.59 feet; thence South 89 degrees 57 
316.13     minutes 55 seconds West, a distance of 1020 feet, more or 
316.14     less, to the easterly shoreline of the Rum River; thence 
316.15     northerly along said easterly shoreline to the point of 
316.16     intersection with a line that bears North 45 degrees 24 
316.17     minutes 55 seconds West from the point of beginning; thence 
316.18     South 45 degrees 24 minutes 55 seconds East, along said 
316.19     line, a distance of 180 feet, more or less, to the point of 
316.20     beginning.  Containing 48 acres, more or less. 
316.21     (3) that part of the Northwest Quarter of the Northeast 
316.22     Quarter and that part of the Northeast Quarter of the 
316.23     Northwest Quarter, both in Section 5, Township 35, Range 
316.24     23, Isanti County, Minnesota, described jointly as follows: 
316.25     Beginning at the northwest corner of the NW 1/4 of NE 1/4 
316.26     of Section 5; thence North 89 degrees 45 minutes 12 seconds 
316.27     East, assumed bearing, along the north line of said NW 1/4 
316.28     of NE 1/4, a distance of 1321.82 feet to the northeast 
316.29     corner of said NW 1/4 of NE 1/4 thence South 4 degrees 04 
316.30     minutes 02 seconds West, along the east line of said NW 1/4 
316.31     of NE 1/4, a distance of 452.83 feet; thence South 89 
316.32     degrees 45 minutes 02 seconds West, a distance of 1393.6 
316.33     feet; thence northwesterly, along a nontangential curve 
316.34     concave to the northeast, radius 318.17 feet, central angle 
316.35     75 degrees 28 minutes 03 seconds, for an arc length of 
316.36     419.08 feet (the chord of said curve bears North 38 degrees 
317.1      03 minutes 32 seconds West and has a length of 389.44 
317.2      feet); thence North 0 degrees 19 minutes 31 seconds West, 
317.3      tangent to said curve, for a distance of 142.65 feet to the 
317.4      north line of the NE 1/4 of NW 1/4 of said Section 5; 
317.5      thence North 89 degrees 32 minutes 15 seconds East, along 
317.6      said north line, a distance of 344.81 feet to the point of 
317.7      beginning.  Containing 16 acres, more or less.  
317.8      (4) that part of the Southwest Quarter of the Southeast 
317.9      Quarter, that part of the Northwest Quarter of the 
317.10     Southeast Quarter and that part of Government Lot 4, all in 
317.11     Section 32, Township 36, Range 23, Isanti County, 
317.12     Minnesota, described jointly as follows: 
317.13     Beginning at the southwest corner of the SW 1/4 of SE 1/4 
317.14     of Section 32; thence North 89 degrees 45 minutes 12 
317.15     seconds East, assumed bearing, along the south line of said 
317.16     SW 1/4 of SE 1/4, a distance of 1321.82 feet to the 
317.17     southeast corner of said SW 1/4 of SE 1/4 thence North 2 
317.18     degrees 40 minutes 49 seconds West, along the east line of 
317.19     said SW 1/4 of SE 1/4 and along the east line of the NW 1/4 
317.20     of SE 1/4, a distance of 1465.32 feet; thence southwesterly 
317.21     along a nontangential curve concave to the northwest, 
317.22     radius 398.10 feet, central angle 60 degrees 52 minutes 54 
317.23     seconds, for an arc length of 423.02 feet (said curve has a 
317.24     chord that bears South 59 degrees 33 minutes 09 seconds 
317.25     West and a chord length of 403.40 feet); thence South 89 
317.26     degrees 59 minutes 37 seconds West, tangent to said curve, 
317.27     for a distance of 825.68 feet; thence southwesterly along a 
317.28     tangential curve concave to the southeast, radius 318.10 
317.29     feet, central angle 90 degrees 16 minutes 37 seconds, for 
317.30     an arc length of 501.21 feet; thence South 0 degrees 17 
317.31     minutes 01 seconds East, tangent to said curve, for a 
317.32     distance of 86.59 feet; thence southerly along a tangential 
317.33     curve concave to the West, radius 398.10 feet, central 
317.34     angle 29 degrees 47 minutes 02 seconds, for an arc length 
317.35     of 206.94 feet; thence South 29 degrees 30 minutes 01 
317.36     seconds West tangent to said curve, for a distance of 34.23 
318.1      feet; thence southerly along a tangential curve concave to 
318.2      the east, radius 318.20 feet, central angle 29 degrees 49 
318.3      minutes 32 seconds for an arc length of 165.59 feet; thence 
318.4      South 0 degrees 19 minutes 31 seconds East, tangent to said 
318.5      curve, for a distance of 475.17 feet to the south line of 
318.6      Government Lot 4, Section 32; thence North 89 degrees 32 
318.7      minutes 15 seconds East, along said south line, a distance 
318.8      of 344.81 feet to the point of beginning.  Containing 44.9 
318.9      acres, more or less. 
318.10     EXCEPTING THEREFROM that parcel described on Quit Claim 
318.11     Deed from the State of Minnesota to Wilfred R. and June E. 
318.12     Norman, filed in Book 92 of Deeds, page 647, in the office 
318.13     of the County Recorder, Isanti County, Minnesota.  
318.14     ALSO EXCEPTING THEREFROM that parcel described on Quit 
318.15     Claim Deed from the State of Minnesota to Frank C. Brody 
318.16     and Lorraine D.S. Brody, filed in Book 102 of Deeds, page 
318.17     232, in the office of the County Recorder, Isanti County, 
318.18     Minnesota. 
318.19     (d) The city of Cambridge may use the land for economic 
318.20  development.  Economic development is a public purpose within 
318.21  the meaning of the term as used in Laws 1990, chapter 610, 
318.22  article 1, section 12, subdivision 5, and sales or conveyances 
318.23  to private parties shall be considered economic development.  
318.24  Property conveyed by the state under this section shall not 
318.25  revert to the state if it is conveyed or otherwise encumbered by 
318.26  the city as a part of the city economic development activity. 
318.27     Sec. 26.  [CONVEYANCE OF CITY LAND TO STATE OF MINNESOTA.] 
318.28     (a) The commissioner of administration may accept all, or 
318.29  any part of, the land described in paragraph (d) from the city 
318.30  of Cambridge, after the city council passes a resolution which 
318.31  declares the property is surplus to its needs. 
318.32     (b) The conveyance shall be in a form approved by the 
318.33  attorney general. 
318.34     (c) The conveyance may be subject to a scenic easement, as 
318.35  defined in Minnesota Statutes, section 103F.311, subdivision 6.  
318.36  The easement shall be under the custodial control of the 
319.1   commissioner of natural resources and only required on the 
319.2   portion of conveyed land that is designated for inclusion in the 
319.3   wild and scenic river system under Minnesota Statutes, section 
319.4   103F.325.  The scenic easement shall allow for continued use of 
319.5   any existing structures located within the easement and for 
319.6   development of walking paths or trails within the easement. 
319.7      (d) Subject to the right-of-way for state trunk highway No. 
319.8   293, and subject to other easements, reservations, street 
319.9   right-of-ways, and restrictions of record, if any, the land to 
319.10  be conveyed may include all, or part of, the parcel described as 
319.11  follows: 
319.12     That part of Government Lot 4 and that part of the 
319.13     Northeast Quarter of the Northwest Quarter, all in Section 
319.14     5, Township 35, Range 23, Isanti County, Minnesota, 
319.15     described jointly as follows:  Commencing at the Northeast 
319.16     corner of the Northwest Quarter of Section 5, thence South 
319.17     89 degrees 47 minutes 10 seconds West, assumed bearing 
319.18     along the north line of the Northwest Quarter of Section 5, 
319.19     a distance of 656.00 feet to the point of beginning of the 
319.20     parcel to be herein described, thence South 00 degrees 03 
319.21     minutes 35 seconds East, a distance of 350.00 feet, thence 
319.22     South 89 degrees 47 minutes 10 seconds West, parallel with 
319.23     the north line of said Northwest Quarter of Section 5 to 
319.24     the easterly shoreline of the Rum River, thence 
319.25     northeasterly along said easterly shoreline to the north 
319.26     line of the Northwest Quarter of Section 5, thence North 89 
319.27     degrees 47 minutes 10 seconds East, along said north line 
319.28     to the point of beginning. 
319.29                             ARTICLE 6 
319.30                        ASSISTANCE PROGRAMS 
319.31     Section 1.  Minnesota Statutes 1998, section 256D.051, 
319.32  subdivision 2a, is amended to read: 
319.33     Subd. 2a.  [DUTIES OF COMMISSIONER.] In addition to any 
319.34  other duties imposed by law, the commissioner shall: 
319.35     (1) based on this section and section 256D.052 and Code of 
319.36  Federal Regulations, title 7, section 273.7, supervise the 
320.1   administration of food stamp employment and training services to 
320.2   county agencies; 
320.3      (2) disburse money appropriated for food stamp employment 
320.4   and training services to county agencies based upon the county's 
320.5   costs as specified in section 256D.06 256D.051, subdivision 6c; 
320.6      (3) accept and supervise the disbursement of any funds that 
320.7   may be provided by the federal government or from other sources 
320.8   for use in this state for food stamp employment and training 
320.9   services; 
320.10     (4) cooperate with other agencies including any agency of 
320.11  the United States or of another state in all matters concerning 
320.12  the powers and duties of the commissioner under this section and 
320.13  section 256D.052; and 
320.14     (5) in cooperation with the commissioner of economic 
320.15  security, ensure that each component of an employment and 
320.16  training program carried out under this section is delivered 
320.17  through a statewide workforce development system, unless the 
320.18  component is not available locally through such a system. 
320.19     Sec. 2.  Minnesota Statutes 1998, section 256D.051, is 
320.20  amended by adding a subdivision to read: 
320.21     Subd. 6c.  [PROGRAM FUNDING.] Within the limits of 
320.22  available resources, the commissioner shall reimburse the actual 
320.23  costs of county agencies and their employment and training 
320.24  service providers for the provision of food stamp employment and 
320.25  training services, including participant support services, 
320.26  direct program services, and program administrative activities.  
320.27  No more than 15 percent of program funds may be used for 
320.28  administrative activities.  The county agency may expend county 
320.29  funds in excess of the limits of this subdivision without state 
320.30  reimbursement. 
320.31     Program funds shall be allocated based on the county's 
320.32  average number of food stamp cases as compared to the statewide 
320.33  total number of such cases.  The average number of cases shall 
320.34  be based on counts of cases as of March 31, June 30, September 
320.35  30, and December 31 of the previous calendar year.  The 
320.36  commissioner may reallocate unexpended money appropriated under 
321.1   this section to those county agencies that demonstrate a need 
321.2   for additional funds. 
321.3      Sec. 3.  Minnesota Statutes 1998, section 256D.053, 
321.4   subdivision 1, is amended to read: 
321.5      Subdivision 1.  [PROGRAM ESTABLISHED.] For the period of 
321.6   July 1, 1998, to June 30, 1999, The Minnesota food assistance 
321.7   program is established to provide food assistance to legal 
321.8   noncitizens residing in this state who are ineligible to 
321.9   participate in the federal Food Stamp Program solely due to the 
321.10  provisions of section 402 or 403 of Public Law Number 104-193, 
321.11  as authorized by Title VII of the 1997 Emergency Supplemental 
321.12  Appropriations Act, Public Law Number 105-18, and as amended by 
321.13  Public Law Number 105-185. 
321.14     Sec. 4.  Minnesota Statutes 1998, section 256D.06, 
321.15  subdivision 5, is amended to read: 
321.16     Subd. 5.  Any applicant, otherwise eligible for general 
321.17  assistance and possibly eligible for maintenance benefits from 
321.18  any other source shall (a) make application for those benefits 
321.19  within 30 days of the general assistance application; and (b) 
321.20  execute an interim assistance authorization agreement on a form 
321.21  as directed by the commissioner.  The commissioner shall review 
321.22  a denial of an application for other maintenance benefits and 
321.23  may require a recipient of general assistance to file an appeal 
321.24  of the denial if appropriate.  If found eligible for benefits 
321.25  from other sources, and a payment received from another source 
321.26  relates to the period during which general assistance was also 
321.27  being received, the recipient shall be required to reimburse the 
321.28  county agency for the interim assistance paid.  Reimbursement 
321.29  shall not exceed the amount of general assistance paid during 
321.30  the time period to which the other maintenance benefits apply 
321.31  and shall not exceed the state standard applicable to that time 
321.32  period.  The commissioner shall adopt rules authorizing county 
321.33  agencies or other client representatives to retain from the 
321.34  amount recovered under an interim assistance agreement 25 
321.35  percent plus actual reasonable fees, costs, and disbursements of 
321.36  appeals and litigation, of providing special assistance to the 
322.1   recipient in processing the recipient's claim for maintenance 
322.2   benefits from another source.  The money retained under this 
322.3   section shall be from the state share of the recovery.  The 
322.4   commissioner or the county agency may contract with qualified 
322.5   persons to provide the special assistance.  The rules adopted by 
322.6   the commissioner shall include the methods by which county 
322.7   agencies shall identify, refer, and assist recipients who may be 
322.8   eligible for benefits under federal programs for the disabled.  
322.9   This subdivision does not require repayment of per diem payments 
322.10  made to shelters for battered women pursuant to section 256D.05, 
322.11  subdivision 3. 
322.12     Sec. 5.  Minnesota Statutes 1998, section 256J.08, 
322.13  subdivision 11, is amended to read: 
322.14     Subd. 11.  [CAREGIVER.] "Caregiver" means a minor child's 
322.15  natural or adoptive parent or parents and stepparent who live in 
322.16  the home with the minor child.  For purposes of determining 
322.17  eligibility for this program, caregiver also means any of the 
322.18  following individuals, if adults, who live with and provide care 
322.19  and support to a minor child when the minor child's natural or 
322.20  adoptive parent or parents or stepparents do not reside in the 
322.21  same home:  legal custodian or guardian, grandfather, 
322.22  grandmother, brother, sister, half-brother, half-sister, 
322.23  stepbrother, stepsister, uncle, aunt, first cousin or first 
322.24  cousin once removed, nephew, niece, person of preceding 
322.25  generation as denoted by prefixes of "great," "great-great," or 
322.26  "great-great-great," or a spouse of any person named in the 
322.27  above groups even after the marriage ends by death or divorce. 
322.28     Sec. 6.  Minnesota Statutes 1998, section 256J.08, 
322.29  subdivision 24, is amended to read: 
322.30     Subd. 24.  [DISREGARD.] "Disregard" means earned income 
322.31  that is not counted when determining initial eligibility or 
322.32  ongoing eligibility and calculating the amount of the assistance 
322.33  payment for participants.  The commissioner shall determine the 
322.34  amount of the disregard according to section 256J.24, 
322.35  subdivision 10. 
322.36     Sec. 7.  Minnesota Statutes 1998, section 256J.08, is 
323.1   amended by adding a subdivision to read: 
323.2      Subd. 28a.  [ENCUMBRANCE.] "Encumbrance" means a legal 
323.3   claim against real or personal property that is payable upon the 
323.4   sale of that property. 
323.5      Sec. 8.  Minnesota Statutes 1998, section 256J.08, is 
323.6   amended by adding a subdivision to read: 
323.7      Subd. 55a.  [MFIP STANDARD OF NEED.] "MFIP standard of need"
323.8   means the appropriate standard used to determine MFIP benefit 
323.9   payments for the MFIP unit and applies to: 
323.10     (1) the transitional standard, sections 256J.08, 
323.11  subdivision 85, and 256J.24, subdivision 5; 
323.12     (2) the shared household standard, section 256J.24, 
323.13  subdivision 9; and 
323.14     (3) the interstate transition standard, section 256J.43. 
323.15     Sec. 9.  Minnesota Statutes 1998, section 256J.08, 
323.16  subdivision 65, is amended to read: 
323.17     Subd. 65.  [PARTICIPANT.] "Participant" means a person who 
323.18  is currently receiving cash assistance and or the food portion 
323.19  available through MFIP-S MFIP as funded by TANF and the food 
323.20  stamp program.  A person who fails to withdraw or access 
323.21  electronically any portion of the person's cash and food 
323.22  assistance payment by the end of the payment month, who makes a 
323.23  written request for closure before the first of a payment month 
323.24  and repays cash and food assistance electronically issued for 
323.25  that payment month within that payment month, or who returns any 
323.26  uncashed assistance check and food coupons and withdraws from 
323.27  the program is not a participant.  A person who withdraws a cash 
323.28  or food assistance payment by electronic transfer or receives 
323.29  and cashes a cash an MFIP assistance check or food coupons and 
323.30  is subsequently determined to be ineligible for assistance for 
323.31  that period of time is a participant, regardless whether that 
323.32  assistance is repaid.  The term "participant" includes the 
323.33  caregiver relative and the minor child whose needs are included 
323.34  in the assistance payment.  A person in an assistance unit who 
323.35  does not receive a cash and food assistance payment because the 
323.36  person has been suspended from MFIP-S or because the person's 
324.1   need falls below the $10 minimum payment level MFIP is a 
324.2   participant. 
324.3      Sec. 10.  Minnesota Statutes 1998, section 256J.08, 
324.4   subdivision 82, is amended to read: 
324.5      Subd. 82.  [SANCTION.] "Sanction" means the reduction of a 
324.6   family's assistance payment by a specified percentage of 
324.7   the applicable transitional MFIP standard of need because:  a 
324.8   nonexempt participant fails to comply with the requirements of 
324.9   sections 256J.52 to 256J.55; a parental caregiver fails without 
324.10  good cause to cooperate with the child support enforcement 
324.11  requirements; or a participant fails to comply with the 
324.12  insurance, tort liability, or other requirements of this chapter.
324.13     Sec. 11.  Minnesota Statutes 1998, section 256J.08, 
324.14  subdivision 83, is amended to read: 
324.15     Subd. 83.  [SIGNIFICANT CHANGE.] "Significant change" means 
324.16  a decline in gross income of 36 percent the amount of the 
324.17  disregard as defined in subdivision 24 or more from the income 
324.18  used to determine the grant for the current month. 
324.19     Sec. 12.  Minnesota Statutes 1998, section 256J.08, 
324.20  subdivision 86a, is amended to read: 
324.21     Subd. 86a.  [UNRELATED MEMBER.] "Unrelated member" means an 
324.22  individual in the household who does not meet the definition of 
324.23  an eligible caregiver, but does not include an individual who 
324.24  provides child care to a child in the assistance unit. 
324.25     Sec. 13.  Minnesota Statutes 1998, section 256J.11, 
324.26  subdivision 2, is amended to read: 
324.27     Subd. 2.  [NONCITIZENS; FOOD PORTION.] (a) For the period 
324.28  September 1, 1997, to October 31, 1997, noncitizens who do not 
324.29  meet one of the exemptions in section 412 of the Personal 
324.30  Responsibility and Work Opportunity Reconciliation Act of 1996, 
324.31  but were residing in this state as of July 1, 1997, are eligible 
324.32  for the 6/10 of the average value of food stamps for the same 
324.33  family size and composition until MFIP-S is operative in the 
324.34  noncitizen's county of financial responsibility and thereafter, 
324.35  the 6/10 of the food portion of MFIP-S.  However, federal food 
324.36  stamp dollars cannot be used to fund the food portion of MFIP-S 
325.1   benefits for an individual under this subdivision. 
325.2      (b) For the period November 1, 1997, to June 30, 1999, 
325.3   noncitizens who do not meet one of the exemptions in section 412 
325.4   of the Personal Responsibility and Work Opportunity 
325.5   Reconciliation Act of 1996, and are receiving cash assistance 
325.6   under the AFDC, family general assistance, MFIP or MFIP-S 
325.7   programs are eligible for the average value of food stamps for 
325.8   the same family size and composition until MFIP-S is operative 
325.9   in the noncitizen's county of financial responsibility and 
325.10  thereafter, the food portion of MFIP-S.  However, federal food 
325.11  stamp dollars cannot be used to fund the food portion of MFIP-S 
325.12  benefits for an individual under this subdivision State dollars 
325.13  shall fund the food portion of a noncitizen's MFIP benefits when 
325.14  federal food stamp dollars cannot be used to fund those 
325.15  benefits.  The assistance provided under this subdivision, which 
325.16  is designated as a supplement to replace lost benefits under the 
325.17  federal food stamp program, must be disregarded as income in all 
325.18  programs that do not count food stamps as income where the 
325.19  commissioner has the authority to make the income disregard 
325.20  determination for the program. 
325.21     (c) The commissioner shall submit a state plan to the 
325.22  secretary of agriculture to allow the commissioner to purchase 
325.23  federal Food Stamp Program benefits in an amount equal to the 
325.24  MFIP-S food portion for each legal noncitizen receiving MFIP-S 
325.25  assistance who is ineligible to participate in the federal Food 
325.26  Stamp Program solely due to the provisions of section 402 or 403 
325.27  of Public Law Number 104-193, as authorized by Title VII of the 
325.28  1997 Emergency Supplemental Appropriations Act, Public Law 
325.29  Number 105-18.  The commissioner shall enter into a contract as 
325.30  necessary with the secretary to use the existing federal Food 
325.31  Stamp Program benefits delivery system for the purposes of 
325.32  administering the food portion of MFIP-S under this subdivision. 
325.33     Sec. 14.  Minnesota Statutes 1998, section 256J.11, 
325.34  subdivision 3, is amended to read: 
325.35     Subd. 3.  [BENEFITS FUNDED WITH STATE MONEY.] Legal adult 
325.36  noncitizens who have resided in the country for four years or 
326.1   more as a lawful permanent resident, whose benefits are funded 
326.2   entirely with state money, and who are under 70 years of age, 
326.3   must, as a condition of eligibility: 
326.4      (1) be enrolled in a literacy class, English as a second 
326.5   language class, or a citizen class; 
326.6      (2) be applying for admission to a literacy class, English 
326.7   as a second language class, and is on a waiting list; 
326.8      (3) be in the process of applying for a waiver from the 
326.9   Immigration and Naturalization Service of the English language 
326.10  or civics requirements of the citizenship test; 
326.11     (4) have submitted an application for citizenship to the 
326.12  Immigration and Naturalization Service and is waiting for a 
326.13  testing date or a subsequent swearing in ceremony; or 
326.14     (5) have been denied citizenship due to a failure to pass 
326.15  the test after two attempts or because of an inability to 
326.16  understand the rights and responsibilities of becoming a United 
326.17  States citizen, as documented by the Immigration and 
326.18  Naturalization Service or the county. 
326.19     If the county social service agency determines that a legal 
326.20  noncitizen subject to the requirements of this subdivision will 
326.21  require more than one year of English language training, then 
326.22  the requirements of clause (1) or (2) shall be imposed after the 
326.23  legal noncitizen has resided in the country for three years.  
326.24  Individuals who reside in a facility licensed under chapter 
326.25  144A, 144D, 245A, or 256I are exempt from the requirements of 
326.26  this subdivision. 
326.27     Sec. 15.  Minnesota Statutes 1998, section 256J.12, 
326.28  subdivision 1a, is amended to read: 
326.29     Subd. 1a.  [30-DAY RESIDENCY REQUIREMENT.] An assistance 
326.30  unit is considered to have established residency in this state 
326.31  only when a child or caregiver has resided in this state for at 
326.32  least 30 consecutive days with the intention of making the 
326.33  person's home here and not for any temporary purpose.  The birth 
326.34  of a child in Minnesota to a member of the assistance unit does 
326.35  not automatically establish the residency in this state under 
326.36  this subdivision of the other members of the assistance unit.  
327.1   Time spent in a shelter for battered women shall count toward 
327.2   satisfying the 30-day residency requirement. 
327.3      Sec. 16.  Minnesota Statutes 1998, section 256J.12, 
327.4   subdivision 2, is amended to read: 
327.5      Subd. 2.  [EXCEPTIONS.] (a) A county shall waive the 30-day 
327.6   residency requirement where unusual hardship would result from 
327.7   denial of assistance. 
327.8      (b) For purposes of this section, unusual hardship means an 
327.9   assistance unit: 
327.10     (1) is without alternative shelter; or 
327.11     (2) is without available resources for food. 
327.12     (c) For purposes of this subdivision, the following 
327.13  definitions apply (1) "metropolitan statistical area" is as 
327.14  defined by the U.S. Census Bureau; (2) "alternative shelter" 
327.15  includes any shelter that is located within the metropolitan 
327.16  statistical area containing the county and for which the family 
327.17  is eligible, provided the assistance unit does not have to 
327.18  travel more than 20 miles to reach the shelter and has access to 
327.19  transportation to the shelter.  Clause (2) does not apply to 
327.20  counties in the Minneapolis-St. Paul metropolitan statistical 
327.21  area. 
327.22     (d) Applicants are considered to meet the residency 
327.23  requirement under subdivision 1a if they once resided in 
327.24  Minnesota and: 
327.25     (1) joined the United States armed services, returned to 
327.26  Minnesota within 30 days of leaving the armed services, and 
327.27  intend to remain in Minnesota; or 
327.28     (2) left to attend school in another state, paid 
327.29  nonresident tuition or Minnesota tuition rates under a 
327.30  reciprocity agreement, and returned to Minnesota within 30 days 
327.31  of graduation with the intent to remain in Minnesota. 
327.32     (e) The 30-day residence requirement is met when: 
327.33     (1) a minor child or a minor caregiver moves from another 
327.34  state to the residence of a relative caregiver; and 
327.35     (2) the minor caregiver applies for and receives family 
327.36  cash assistance; 
328.1      (3) the relative caregiver chooses not to be part of the 
328.2   MFIP-S assistance unit; and 
328.3      (4) the relative caregiver has resided in Minnesota for at 
328.4   least 30 days prior to the date the assistance unit applies for 
328.5   cash assistance.  
328.6      (f) Ineligible mandatory unit members who have resided in 
328.7   Minnesota for 12 months immediately before the unit's date of 
328.8   application establish the other assistance unit members' 
328.9   eligibility for the MFIP-S transitional standard. 
328.10     (2) the relative caregiver has resided in Minnesota for at 
328.11  least 30 consecutive days and:  
328.12     (i) the minor caregiver applies for and receives MFIP; or 
328.13     (ii) the relative caregiver applies for assistance for the 
328.14  minor child but does not choose to be a member of the MFIP 
328.15  assistance unit. 
328.16     Sec. 17.  Minnesota Statutes 1998, section 256J.14, is 
328.17  amended to read: 
328.18     256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 
328.19     (a) The definitions in this paragraph only apply to this 
328.20  subdivision. 
328.21     (1) "Household of a parent, legal guardian, or other adult 
328.22  relative" means the place of residence of: 
328.23     (i) a natural or adoptive parent; 
328.24     (ii) a legal guardian according to appointment or 
328.25  acceptance under section 260.242, 525.615, or 525.6165, and 
328.26  related laws; 
328.27     (iii) a caregiver as defined in section 256J.08, 
328.28  subdivision 11; or 
328.29     (iv) an appropriate adult relative designated by a county 
328.30  agency. 
328.31     (2) "Adult-supervised supportive living arrangement" means 
328.32  a private family setting which assumes responsibility for the 
328.33  care and control of the minor parent and minor child, or other 
328.34  living arrangement, not including a public institution, licensed 
328.35  by the commissioner of human services which ensures that the 
328.36  minor parent receives adult supervision and supportive services, 
329.1   such as counseling, guidance, independent living skills 
329.2   training, or supervision. 
329.3      (b) A minor parent and the minor child who is in the care 
329.4   of the minor parent must reside in the household of a parent, 
329.5   legal guardian, other adult relative, or in an adult-supervised 
329.6   supportive living arrangement in order to receive MFIP-S MFIP 
329.7   unless: 
329.8      (1) the minor parent has no living parent, other adult 
329.9   relative, or legal guardian whose whereabouts is known; 
329.10     (2) no living parent, other adult relative, or legal 
329.11  guardian of the minor parent allows the minor parent to live in 
329.12  the parent's, other adult relative's, or legal guardian's home; 
329.13     (3) the minor parent lived apart from the minor parent's 
329.14  own parent or legal guardian for a period of at least one year 
329.15  before either the birth of the minor child or the minor parent's 
329.16  application for MFIP-S MFIP; 
329.17     (4) the physical or emotional health or safety of the minor 
329.18  parent or minor child would be jeopardized if the minor parent 
329.19  and the minor child resided in the same residence with the minor 
329.20  parent's parent, other adult relative, or legal guardian; or 
329.21     (5) an adult supervised supportive living arrangement is 
329.22  not available for the minor parent and child in the county in 
329.23  which the minor parent and child currently reside.  If an adult 
329.24  supervised supportive living arrangement becomes available 
329.25  within the county, the minor parent and child must reside in 
329.26  that arrangement. 
329.27     (c) Minor applicants must be informed orally and in writing 
329.28  about the eligibility requirements and their rights and 
329.29  obligations under the MFIP-S MFIP program.  The county must 
329.30  advise the minor of the possible exemptions and specifically ask 
329.31  whether one or more of these exemptions is applicable.  If the 
329.32  minor alleges one or more of these exemptions, then the county 
329.33  must assist the minor in obtaining the necessary verifications 
329.34  to determine whether or not these exemptions apply. 
329.35     (d) If the county worker has reason to suspect that the 
329.36  physical or emotional health or safety of the minor parent or 
330.1   minor child would be jeopardized if they resided with the minor 
330.2   parent's parent, other adult relative, or legal guardian, then 
330.3   the county worker must make a referral to child protective 
330.4   services to determine if paragraph (b), clause (4), applies.  A 
330.5   new determination by the county worker is not necessary if one 
330.6   has been made within the last six months, unless there has been 
330.7   a significant change in circumstances which justifies a new 
330.8   referral and determination. 
330.9      (e) If a minor parent is not living with a parent, legal 
330.10  guardian, or other adult relative due to paragraph (b), clause 
330.11  (1), (2), or (4), the minor parent must reside, when possible, 
330.12  in a living arrangement that meets the standards of paragraph 
330.13  (a), clause (2). 
330.14     (f) When a minor parent and minor child live with a parent, 
330.15  other adult relative, legal guardian, or in an adult-supervised 
330.16  supportive Regardless of living arrangement, MFIP-S MFIP must be 
330.17  paid, when possible, in the form of a protective payment on 
330.18  behalf of the minor parent and minor child according to section 
330.19  256J.39, subdivisions 2 to 4. 
330.20     Sec. 18.  Minnesota Statutes 1998, section 256J.20, 
330.21  subdivision 3, is amended to read: 
330.22     Subd. 3.  [OTHER PROPERTY LIMITATIONS.] To be eligible for 
330.23  MFIP-S MFIP, the equity value of all nonexcluded real and 
330.24  personal property of the assistance unit must not exceed $2,000 
330.25  for applicants and $5,000 for ongoing participants.  The value 
330.26  of assets in clauses (1) to (20) must be excluded when 
330.27  determining the equity value of real and personal property: 
330.28     (1) a licensed vehicle up to a loan value of less than or 
330.29  equal to $7,500.  The county agency shall apply any excess loan 
330.30  value as if it were equity value to the asset limit described in 
330.31  this section.  If the assistance unit owns more than one 
330.32  licensed vehicle, the county agency shall determine the vehicle 
330.33  with the highest loan value and count only the loan value over 
330.34  $7,500, excluding:  (i) the value of one vehicle per physically 
330.35  disabled person when the vehicle is needed to transport the 
330.36  disabled unit member; this exclusion does not apply to mentally 
331.1   disabled people; (ii) the value of special equipment for a 
331.2   handicapped member of the assistance unit; and (iii) any vehicle 
331.3   used for long-distance travel, other than daily commuting, for 
331.4   the employment of a unit member. 
331.5      The county agency shall count the loan value of all other 
331.6   vehicles and apply this amount as if it were equity value to the 
331.7   asset limit described in this section.  The value of special 
331.8   equipment for a handicapped member of the assistance unit is 
331.9   excluded.  To establish the loan value of vehicles, a county 
331.10  agency must use the N.A.D.A. Official Used Car Guide, Midwest 
331.11  Edition, for newer model cars.  When a vehicle is not listed in 
331.12  the guidebook, or when the applicant or participant disputes the 
331.13  loan value listed in the guidebook as unreasonable given the 
331.14  condition of the particular vehicle, the county agency may 
331.15  require the applicant or participant document the loan value by 
331.16  securing a written statement from a motor vehicle dealer 
331.17  licensed under section 168.27, stating the amount that the 
331.18  dealer would pay to purchase the vehicle.  The county agency 
331.19  shall reimburse the applicant or participant for the cost of a 
331.20  written statement that documents a lower loan value; 
331.21     (2) the value of life insurance policies for members of the 
331.22  assistance unit; 
331.23     (3) one burial plot per member of an assistance unit; 
331.24     (4) the value of personal property needed to produce earned 
331.25  income, including tools, implements, farm animals, inventory, 
331.26  business loans, business checking and savings accounts used at 
331.27  least annually and used exclusively for the operation of a 
331.28  self-employment business, and any motor vehicles if at least 50 
331.29  percent of the vehicle's use is to produce income and if the 
331.30  vehicles are essential for the self-employment business; 
331.31     (5) the value of personal property not otherwise specified 
331.32  which is commonly used by household members in day-to-day living 
331.33  such as clothing, necessary household furniture, equipment, and 
331.34  other basic maintenance items essential for daily living; 
331.35     (6) the value of real and personal property owned by a 
331.36  recipient of Supplemental Security Income or Minnesota 
332.1   supplemental aid; 
332.2      (7) the value of corrective payments, but only for the 
332.3   month in which the payment is received and for the following 
332.4   month; 
332.5      (8) a mobile home or other vehicle used by an applicant or 
332.6   participant as the applicant's or participant's home; 
332.7      (9) money in a separate escrow account that is needed to 
332.8   pay real estate taxes or insurance and that is used for this 
332.9   purpose; 
332.10     (10) money held in escrow to cover employee FICA, employee 
332.11  tax withholding, sales tax withholding, employee worker 
332.12  compensation, business insurance, property rental, property 
332.13  taxes, and other costs that are paid at least annually, but less 
332.14  often than monthly; 
332.15     (11) monthly assistance, emergency assistance, and 
332.16  diversionary payments for the current month's needs; 
332.17     (12) the value of school loans, grants, or scholarships for 
332.18  the period they are intended to cover; 
332.19     (13) payments listed in section 256J.21, subdivision 2, 
332.20  clause (9), which are held in escrow for a period not to exceed 
332.21  three months to replace or repair personal or real property; 
332.22     (14) income received in a budget month through the end of 
332.23  the payment month; 
332.24     (15) savings from earned income of a minor child or a minor 
332.25  parent that are set aside in a separate account designated 
332.26  specifically for future education or employment costs; 
332.27     (16) the federal earned income credit, Minnesota working 
332.28  family credit, state and federal income tax refunds, state 
332.29  homeowners and renters credits under chapter 290A, property tax 
332.30  rebates under Laws 1997, chapter 231, article 1, section 16, and 
332.31  other federal or state tax rebates in the month received and the 
332.32  following month; 
332.33     (17) payments excluded under federal law as long as those 
332.34  payments are held in a separate account from any nonexcluded 
332.35  funds; 
332.36     (18) money received by a participant of the corps to career 
333.1   program under section 84.0887, subdivision 2, paragraph (b), as 
333.2   a postservice benefit under the federal Americorps Act; 
333.3      (19) the assets of children ineligible to receive MFIP-S 
333.4   MFIP benefits because foster care or adoption assistance 
333.5   payments are made on their behalf; and 
333.6      (20) the assets of persons whose income is excluded under 
333.7   section 256J.21, subdivision 2, clause (43). 
333.8      Sec. 19.  Minnesota Statutes 1998, section 256J.21, 
333.9   subdivision 2, is amended to read: 
333.10     Subd. 2.  [INCOME EXCLUSIONS.] (a) The following must be 
333.11  excluded in determining a family's available income: 
333.12     (1) payments for basic care, difficulty of care, and 
333.13  clothing allowances received for providing family foster care to 
333.14  children or adults under Minnesota Rules, parts 9545.0010 to 
333.15  9545.0260 and 9555.5050 to 9555.6265, and payments received and 
333.16  used for care and maintenance of a third-party beneficiary who 
333.17  is not a household member; 
333.18     (2) reimbursements for employment training received through 
333.19  the Job Training Partnership Act, United States Code, title 29, 
333.20  chapter 19, sections 1501 to 1792b; 
333.21     (3) reimbursement for out-of-pocket expenses incurred while 
333.22  performing volunteer services, jury duty, or employment, or 
333.23  informal carpooling arrangements directly related to employment; 
333.24     (4) all educational assistance, except the county agency 
333.25  must count graduate student teaching assistantships, 
333.26  fellowships, and other similar paid work as earned income and, 
333.27  after allowing deductions for any unmet and necessary 
333.28  educational expenses, shall count scholarships or grants awarded 
333.29  to graduate students that do not require teaching or research as 
333.30  unearned income; 
333.31     (5) loans, regardless of purpose, from public or private 
333.32  lending institutions, governmental lending institutions, or 
333.33  governmental agencies; 
333.34     (6) loans from private individuals, regardless of purpose, 
333.35  provided an applicant or participant documents that the lender 
333.36  expects repayment; 
334.1      (7)(i) state income tax refunds; and 
334.2      (ii) federal income tax refunds; 
334.3      (8)(i) federal earned income credits; 
334.4      (ii) Minnesota working family credits; 
334.5      (iii) state homeowners and renters credits under chapter 
334.6   290A; and 
334.7      (iv) property tax rebates under Laws 1997, chapter 231, 
334.8   article 1, section 16; and 
334.9      (v) other federal or state tax rebates; 
334.10     (9) funds received for reimbursement, replacement, or 
334.11  rebate of personal or real property when these payments are made 
334.12  by public agencies, awarded by a court, solicited through public 
334.13  appeal, or made as a grant by a federal agency, state or local 
334.14  government, or disaster assistance organizations, subsequent to 
334.15  a presidential declaration of disaster; 
334.16     (10) the portion of an insurance settlement that is used to 
334.17  pay medical, funeral, and burial expenses, or to repair or 
334.18  replace insured property; 
334.19     (11) reimbursements for medical expenses that cannot be 
334.20  paid by medical assistance; 
334.21     (12) payments by a vocational rehabilitation program 
334.22  administered by the state under chapter 268A, except those 
334.23  payments that are for current living expenses; 
334.24     (13) in-kind income, including any payments directly made 
334.25  by a third party to a provider of goods and services; 
334.26     (14) assistance payments to correct underpayments, but only 
334.27  for the month in which the payment is received; 
334.28     (15) emergency assistance payments; 
334.29     (16) funeral and cemetery payments as provided by section 
334.30  256.935; 
334.31     (17) nonrecurring cash gifts of $30 or less, not exceeding 
334.32  $30 per participant in a calendar month; 
334.33     (18) any form of energy assistance payment made through 
334.34  Public Law Number 97-35, Low-Income Home Energy Assistance Act 
334.35  of 1981, payments made directly to energy providers by other 
334.36  public and private agencies, and any form of credit or rebate 
335.1   payment issued by energy providers; 
335.2      (19) Supplemental Security Income, including retroactive 
335.3   payments; 
335.4      (20) Minnesota supplemental aid, including retroactive 
335.5   payments; 
335.6      (21) proceeds from the sale of real or personal property; 
335.7      (22) adoption assistance payments under section 259.67; 
335.8      (23) state-funded family subsidy program payments made 
335.9   under section 252.32 to help families care for children with 
335.10  mental retardation or related conditions; 
335.11     (24) interest payments and dividends from property that is 
335.12  not excluded from and that does not exceed the asset limit; 
335.13     (25) rent rebates; 
335.14     (26) income earned by a minor caregiver or, minor child 
335.15  through age 6, or a minor child who is at least a half-time 
335.16  student in an approved elementary or secondary education 
335.17  program; 
335.18     (27) income earned by a caregiver under age 20 who is at 
335.19  least a half-time student in an approved elementary or secondary 
335.20  education program; 
335.21     (28) MFIP-S MFIP child care payments under section 119B.05; 
335.22     (29) all other payments made through MFIP-S MFIP to support 
335.23  a caregiver's pursuit of greater self-support; 
335.24     (30) income a participant receives related to shared living 
335.25  expenses; 
335.26     (31) reverse mortgages; 
335.27     (32) benefits provided by the Child Nutrition Act of 1966, 
335.28  United States Code, title 42, chapter 13A, sections 1771 to 
335.29  1790; 
335.30     (33) benefits provided by the women, infants, and children 
335.31  (WIC) nutrition program, United States Code, title 42, chapter 
335.32  13A, section 1786; 
335.33     (34) benefits from the National School Lunch Act, United 
335.34  States Code, title 42, chapter 13, sections 1751 to 1769e; 
335.35     (35) relocation assistance for displaced persons under the 
335.36  Uniform Relocation Assistance and Real Property Acquisition 
336.1   Policies Act of 1970, United States Code, title 42, chapter 61, 
336.2   subchapter II, section 4636, or the National Housing Act, United 
336.3   States Code, title 12, chapter 13, sections 1701 to 1750jj; 
336.4      (36) benefits from the Trade Act of 1974, United States 
336.5   Code, title 19, chapter 12, part 2, sections 2271 to 2322; 
336.6      (37) war reparations payments to Japanese Americans and 
336.7   Aleuts under United States Code, title 50, sections 1989 to 
336.8   1989d; 
336.9      (38) payments to veterans or their dependents as a result 
336.10  of legal settlements regarding Agent Orange or other chemical 
336.11  exposure under Public Law Number 101-239, section 10405, 
336.12  paragraph (a)(2)(E); 
336.13     (39) income that is otherwise specifically excluded from 
336.14  the MFIP-S program MFIP consideration in federal law, state law, 
336.15  or federal regulation; 
336.16     (40) security and utility deposit refunds; 
336.17     (41) American Indian tribal land settlements excluded under 
336.18  Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 
336.19  Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 
336.20  reservations and payments to members of the White Earth Band, 
336.21  under United States Code, title 25, chapter 9, section 331, and 
336.22  chapter 16, section 1407; 
336.23     (42) all income of the minor parent's parent parents and 
336.24  stepparent stepparents when determining the grant for the minor 
336.25  parent in households that include a minor parent living with a 
336.26  parent parents or stepparent stepparents on MFIP-S MFIP with 
336.27  other children; and 
336.28     (43) income of the minor parent's parent parents and 
336.29  stepparent stepparents equal to 200 percent of the federal 
336.30  poverty guideline for a family size not including the minor 
336.31  parent and the minor parent's child in households that include a 
336.32  minor parent living with a parent parents or stepparent 
336.33  stepparents not on MFIP-S MFIP when determining the grant for 
336.34  the minor parent.  The remainder of income is deemed as 
336.35  specified in section 256J.37, subdivision 1b; 
336.36     (44) payments made to children eligible for relative 
337.1   custody assistance under section 257.85; 
337.2      (45) vendor payments for goods and services made on behalf 
337.3   of a client unless the client has the option of receiving the 
337.4   payment in cash; and 
337.5      (46) the principal portion of a contract for deed payment. 
337.6      Sec. 20.  Minnesota Statutes 1998, section 256J.21, 
337.7   subdivision 3, is amended to read: 
337.8      Subd. 3.  [INITIAL INCOME TEST.] The county agency shall 
337.9   determine initial eligibility by considering all earned and 
337.10  unearned income that is not excluded under subdivision 2.  To be 
337.11  eligible for MFIP-S MFIP, the assistance unit's countable income 
337.12  minus the disregards in paragraphs (a) and (b) must be below the 
337.13  transitional standard of assistance according to section 256J.24 
337.14  for that size assistance unit. 
337.15     (a) The initial eligibility determination must disregard 
337.16  the following items: 
337.17     (1) the employment disregard is 18 percent of the gross 
337.18  earned income whether or not the member is working full time or 
337.19  part time; 
337.20     (2) dependent care costs must be deducted from gross earned 
337.21  income for the actual amount paid for dependent care up to a 
337.22  maximum of $200 per month for each child less than two years of 
337.23  age, and $175 per month for each child two years of age and 
337.24  older under this chapter and chapter 119B; 
337.25     (3) all payments made according to a court order for 
337.26  spousal support or the support of children not living in the 
337.27  assistance unit's household shall be disregarded from the income 
337.28  of the person with the legal obligation to pay support, provided 
337.29  that, if there has been a change in the financial circumstances 
337.30  of the person with the legal obligation to pay support since the 
337.31  support order was entered, the person with the legal obligation 
337.32  to pay support has petitioned for a modification of the support 
337.33  order; and 
337.34     (4) an allocation for the unmet need of an ineligible 
337.35  spouse or an ineligible child under the age of 21 for whom the 
337.36  caregiver is financially responsible and who lives with the 
338.1   caregiver according to section 256J.36. 
338.2      (b) Notwithstanding paragraph (a), when determining initial 
338.3   eligibility for applicant units when at least one member has 
338.4   received AFDC, family general assistance, MFIP, MFIP-R, work 
338.5   first, or MFIP-S MFIP in this state within four months of the 
338.6   most recent application for MFIP-S MFIP, apply the employment 
338.7   disregard as defined in section 256J.08, subdivision 24, for all 
338.8   unit members is 36 percent of the gross earned income. 
338.9      After initial eligibility is established, the assistance 
338.10  payment calculation is based on the monthly income test. 
338.11     Sec. 21.  Minnesota Statutes 1998, section 256J.21, 
338.12  subdivision 4, is amended to read: 
338.13     Subd. 4.  [MONTHLY INCOME TEST AND DETERMINATION OF 
338.14  ASSISTANCE PAYMENT.] The county agency shall determine ongoing 
338.15  eligibility and the assistance payment amount according to the 
338.16  monthly income test.  To be eligible for MFIP-S MFIP, the result 
338.17  of the computations in paragraphs (a) to (e) must be at least $1.
338.18     (a) Apply a 36 percent an income disregard as defined in 
338.19  section 256J.08, subdivision 24, to gross earnings and subtract 
338.20  this amount from the family wage level.  If the difference is 
338.21  equal to or greater than the transitional MFIP standard of need, 
338.22  the assistance payment is equal to the transitional MFIP 
338.23  standard of need.  If the difference is less than 
338.24  the transitional MFIP standard of need, the assistance payment 
338.25  is equal to the difference.  The employment disregard in this 
338.26  paragraph must be deducted every month there is earned income. 
338.27     (b) All payments made according to a court order for 
338.28  spousal support or the support of children not living in the 
338.29  assistance unit's household must be disregarded from the income 
338.30  of the person with the legal obligation to pay support, provided 
338.31  that, if there has been a change in the financial circumstances 
338.32  of the person with the legal obligation to pay support since the 
338.33  support order was entered, the person with the legal obligation 
338.34  to pay support has petitioned for a modification of the court 
338.35  order. 
338.36     (c) An allocation for the unmet need of an ineligible 
339.1   spouse or an ineligible child under the age of 21 for whom the 
339.2   caregiver is financially responsible and who lives with the 
339.3   caregiver must be made according to section 256J.36. 
339.4      (d) Subtract unearned income dollar for dollar from 
339.5   the transitional MFIP standard of need to determine the 
339.6   assistance payment amount. 
339.7      (e) When income is both earned and unearned, the amount of 
339.8   the assistance payment must be determined by first treating 
339.9   gross earned income as specified in paragraph (a).  After 
339.10  determining the amount of the assistance payment under paragraph 
339.11  (a), unearned income must be subtracted from that amount dollar 
339.12  for dollar to determine the assistance payment amount. 
339.13     (f) When the monthly income is greater than the 
339.14  transitional or family wage level MFIP standard of need after 
339.15  applicable deductions and the income will only exceed the 
339.16  standard for one month, the county agency must suspend the 
339.17  assistance payment for the payment month. 
339.18     Sec. 22.  Minnesota Statutes 1998, section 256J.24, 
339.19  subdivision 2, is amended to read: 
339.20     Subd. 2.  [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 
339.21  for minor caregivers and their children who must be in a 
339.22  separate assistance unit from the other persons in the 
339.23  household, when the following individuals live together, they 
339.24  must be included in the assistance unit: 
339.25     (1) a minor child, including a pregnant minor; 
339.26     (2) the minor child's minor siblings, minor half-siblings, 
339.27  and minor step-siblings; 
339.28     (3) the minor child's natural parents, adoptive parents, 
339.29  and stepparents; and 
339.30     (4) the spouse of a pregnant woman.  
339.31     Sec. 23.  Minnesota Statutes 1998, section 256J.24, 
339.32  subdivision 3, is amended to read: 
339.33     Subd. 3.  [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 
339.34  ASSISTANCE UNIT.] (a) The following individuals who are part of 
339.35  the assistance unit determined under subdivision 2 are 
339.36  ineligible to receive MFIP-S MFIP: 
340.1      (1) individuals receiving Supplemental Security Income or 
340.2   Minnesota supplemental aid; 
340.3      (2) individuals living at home while performing 
340.4   court-imposed, unpaid community service work due to a criminal 
340.5   conviction; 
340.6      (3) individuals disqualified from the food stamp program or 
340.7   MFIP-S MFIP, until the disqualification ends; 
340.8      (4) (3) children on whose behalf federal, state or local 
340.9   foster care payments are made, except as provided in sections 
340.10  256J.13, subdivision 2, and 256J.74, subdivision 2; and 
340.11     (5) (4) children receiving ongoing monthly adoption 
340.12  assistance payments under section 259.67.  
340.13     (b) The exclusion of a person under this subdivision does 
340.14  not alter the mandatory assistance unit composition. 
340.15     Sec. 24.  Minnesota Statutes 1998, section 256J.24, 
340.16  subdivision 7, is amended to read: 
340.17     Subd. 7.  [FAMILY WAGE LEVEL STANDARD.] The family wage 
340.18  level standard is 110 percent of the transitional standard under 
340.19  subdivision 5 and is the standard used when there is earned 
340.20  income in the assistance unit.  As specified in section 256J.21, 
340.21  earned income is subtracted from the family wage level to 
340.22  determine the amount of the assistance payment.  Not including 
340.23  the family wage level standard, assistance payments may not 
340.24  exceed the shared household standard or the transitional MFIP 
340.25  standard of need for the assistance unit, whichever is less. 
340.26     Sec. 25.  Minnesota Statutes 1998, section 256J.24, 
340.27  subdivision 8, is amended to read: 
340.28     Subd. 8.  [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE UNITS.] 
340.29  Except for assistance units with nonparental caregivers, 
340.30  payments for shelter up to the amount of the cash portion 
340.31  of MFIP-S MFIP benefits for which the assistance unit is 
340.32  eligible shall be vendor paid for as many months as the 
340.33  assistance unit is eligible or six months, whichever comes 
340.34  first.  The residual amount of the grant after vendor payment, 
340.35  if any, must be paid to the MFIP-S MFIP caregiver. 
340.36     Sec. 26.  Minnesota Statutes 1998, section 256J.24, 
341.1   subdivision 9, is amended to read: 
341.2      Subd. 9.  [SHARED HOUSEHOLD STANDARD; MFIP-S MFIP.] (a) 
341.3   Except as prohibited in paragraph (b), the county agency must 
341.4   use the shared household standard when the household includes 
341.5   one or more unrelated members, as that term is defined in 
341.6   section 256J.08, subdivision 86a.  The county agency must use 
341.7   the shared household standard, unless a member of the assistance 
341.8   unit is a victim of domestic violence and has an approved safety 
341.9   plan, regardless of the number of unrelated members in the 
341.10  household. 
341.11     (b) The county agency must not use the shared household 
341.12  standard when all unrelated members are one of the following: 
341.13     (1) a recipient of public assistance benefits, including 
341.14  food stamps, Supplemental Security Income, adoption assistance, 
341.15  relative custody assistance, or foster care payments; 
341.16     (2) a roomer or boarder, or a person to whom the assistance 
341.17  unit is paying room or board; 
341.18     (3) a minor child under the age of 18; 
341.19     (4) a minor caregiver living with the minor caregiver's 
341.20  parents or in an approved supervised living arrangement; or 
341.21     (5) a caregiver who is not the parent of the minor child in 
341.22  the assistance unit; or 
341.23     (6) an individual who provides child care to a child in the 
341.24  MFIP assistance unit. 
341.25     (c) The shared household standard must be discontinued if 
341.26  it is not approved by the United States Department of 
341.27  Agriculture under the MFIP-S MFIP waiver. 
341.28     Sec. 27.  Minnesota Statutes 1998, section 256J.24, is 
341.29  amended by adding a subdivision to read: 
341.30     Subd. 10.  [MFIP EXIT LEVEL.] In state fiscal years 2000 
341.31  and 2001, the commissioner shall adjust the MFIP earned income 
341.32  disregard to ensure that participants do not lose eligibility 
341.33  for MFIP until their income reaches at least 120 percent of the 
341.34  federal poverty guidelines in effect in October of each fiscal 
341.35  year.  Adjustments to the disregard shall be based on a 
341.36  household size of three and shall be implemented at the same 
342.1   time as the October food stamp cost-of-living adjustment is 
342.2   reflected in the food portion of MFIP transitional standard as 
342.3   required under subdivision 5a. 
342.4      Sec. 28.  Minnesota Statutes 1998, section 256J.26, 
342.5   subdivision 1, is amended to read: 
342.6      Subdivision 1.  [PERSON CONVICTED OF DRUG OFFENSES.] (a) 
342.7   Applicants or participants who have been convicted of a drug 
342.8   offense committed after July 1, 1997, may, if otherwise 
342.9   eligible, receive AFDC or MFIP-S MFIP benefits subject to the 
342.10  following conditions: 
342.11     (1) Benefits for the entire assistance unit must be paid in 
342.12  vendor form for shelter and utilities during any time the 
342.13  applicant is part of the assistance unit. 
342.14     (2) The convicted applicant or participant shall be subject 
342.15  to random drug testing as a condition of continued eligibility 
342.16  and following any positive test for an illegal controlled 
342.17  substance is subject to the following sanctions: 
342.18     (i) for failing a drug test the first time, the 
342.19  participant's grant shall be reduced by ten percent of the 
342.20  MFIP-S transitional MFIP standard of need, the shared household 
342.21  standard, or the interstate transitional standard, whichever is 
342.22  applicable prior to making vendor payments for shelter and 
342.23  utility costs; or 
342.24     (ii) for failing a drug test two or more times, the 
342.25  residual amount of the participant's grant after making vendor 
342.26  payments for shelter and utility costs, if any, must be reduced 
342.27  by an amount equal to 30 percent of the MFIP-S transitional 
342.28  standard, the shared household standard, or the interstate 
342.29  transitional standard, whichever is applicable MFIP standard of 
342.30  need. 
342.31     (3) A participant who fails an initial drug test and is 
342.32  under a sanction due to other MFIP program requirements is 
342.33  subject to the sanction in clause (2)(ii). 
342.34     (b) Applicants requesting only food stamps or participants 
342.35  receiving only food stamps, who have been convicted of a drug 
342.36  offense that occurred after July 1, 1997, may, if otherwise 
343.1   eligible, receive food stamps if the convicted applicant or 
343.2   participant is subject to random drug testing as a condition of 
343.3   continued eligibility.  Following a positive test for an illegal 
343.4   controlled substance, the applicant is subject to the following 
343.5   sanctions: 
343.6      (1) for failing a drug test the first time, food stamps 
343.7   shall be reduced by ten percent of the applicable food stamp 
343.8   allotment; and 
343.9      (2) for failing a drug test two or more times, food stamps 
343.10  shall be reduced by an amount equal to 30 percent of the 
343.11  applicable food stamp allotment.  
343.12     (c) For the purposes of this subdivision, "drug offense" 
343.13  means a conviction an offense that occurred after July 1, 1997, 
343.14  of sections 152.021 to 152.025, 152.0261, or 152.096.  Drug 
343.15  offense also means a conviction in another jurisdiction of the 
343.16  possession, use, or distribution of a controlled substance, or 
343.17  conspiracy to commit any of these offenses, if the offense 
343.18  occurred after July 1, 1997, and the conviction is a felony 
343.19  offense in that jurisdiction, or in the case of New Jersey, a 
343.20  high misdemeanor. 
343.21     Sec. 29.  Minnesota Statutes 1998, section 256J.30, 
343.22  subdivision 2, is amended to read: 
343.23     Subd. 2.  [REQUIREMENT TO APPLY FOR OTHER BENEFITS.] An 
343.24  applicant or participant must apply for, accept if eligible, and 
343.25  follow through with appealing any denials of eligibility for 
343.26  benefits from other programs for which the applicant or 
343.27  participant is potentially eligible and which would, if 
343.28  received, offset assistance payments.  An applicant's or 
343.29  participant's failure to complete application for these benefits 
343.30  without good cause results in denial or termination of 
343.31  assistance.  Good cause for failure to apply for these benefits 
343.32  is allowed when circumstances beyond the control of the 
343.33  applicant or participant prevent the applicant or participant 
343.34  from making an application. 
343.35     Sec. 30.  Minnesota Statutes 1998, section 256J.30, 
343.36  subdivision 7, is amended to read: 
344.1      Subd. 7.  [DUE DATE OF MFIP-S MFIP HOUSEHOLD REPORT FORM.] 
344.2   An MFIP-S MFIP household report form must be received by the 
344.3   county agency by the eighth calendar day of the month following 
344.4   the reporting period covered by the form.  When the eighth 
344.5   calendar day of the month falls on a weekend or holiday, 
344.6   the MFIP-S MFIP household report form must be received by the 
344.7   county agency the first working day that follows the eighth 
344.8   calendar day.  The county agency must send a notice of 
344.9   termination because of a late or incomplete MFIP-S household 
344.10  report form. 
344.11     Sec. 31.  Minnesota Statutes 1998, section 256J.30, 
344.12  subdivision 8, is amended to read: 
344.13     Subd. 8.  [LATE MFIP-S MFIP HOUSEHOLD REPORT FORMS.] 
344.14  Paragraphs (a) to (d) apply to the reporting requirements in 
344.15  subdivision 7. 
344.16     (a) When a caregiver submits the county agency receives an 
344.17  incomplete MFIP-S MFIP household report form before the last 
344.18  working day of the month on which a ten-day notice of 
344.19  termination can be issued, the county agency must immediately 
344.20  return the incomplete form on or before the ten-day notice 
344.21  deadline or any previously sent ten-day notice of termination is 
344.22  invalid and clearly state what the caregiver must do for the 
344.23  form to be complete. 
344.24     (b) When a complete MFIP-S household report form is not 
344.25  received by a county agency before the last ten days of the 
344.26  month in which the form is due, the county agency must send The 
344.27  automated eligibility system must send a notice of proposed 
344.28  termination of assistance to the assistance unit if a complete 
344.29  MFIP household report form is not received by a county agency.  
344.30  The automated notice must be mailed to the caregiver by 
344.31  approximately the 16th of the month.  When a caregiver submits 
344.32  an incomplete form on or after the date a notice of proposed 
344.33  termination has been sent, the termination is valid unless the 
344.34  caregiver submits a complete form before the end of the month. 
344.35     (c) An assistance unit required to submit an MFIP-S MFIP 
344.36  household report form is considered to have continued its 
345.1   application for assistance if a complete MFIP-S MFIP household 
345.2   report form is received within a calendar month after the month 
345.3   in which assistance was received the form was due and assistance 
345.4   shall be paid for the period beginning with the first day of the 
345.5   month in which the report was due that calendar month. 
345.6      (d) A county agency must allow good cause exemptions from 
345.7   the reporting requirements under subdivisions 5 and 6 when any 
345.8   of the following factors cause a caregiver to fail to provide 
345.9   the county agency with a completed MFIP-S MFIP household report 
345.10  form before the end of the month in which the form is due: 
345.11     (1) an employer delays completion of employment 
345.12  verification; 
345.13     (2) a county agency does not help a caregiver complete the 
345.14  MFIP-S MFIP household report form when the caregiver asks for 
345.15  help; 
345.16     (3) a caregiver does not receive an MFIP-S MFIP household 
345.17  report form due to mistake on the part of the department or the 
345.18  county agency or due to a reported change in address; 
345.19     (4) a caregiver is ill, or physically or mentally 
345.20  incapacitated; or 
345.21     (5) some other circumstance occurs that a caregiver could 
345.22  not avoid with reasonable care which prevents the caregiver from 
345.23  providing a completed MFIP-S MFIP household report form before 
345.24  the end of the month in which the form is due. 
345.25     Sec. 32.  Minnesota Statutes 1998, section 256J.30, 
345.26  subdivision 9, is amended to read: 
345.27     Subd. 9.  [CHANGES THAT MUST BE REPORTED.] A caregiver must 
345.28  report the changes or anticipated changes specified in clauses 
345.29  (1) to (16) within ten days of the date they occur, within ten 
345.30  days of the date the caregiver learns that the change will 
345.31  occur, at the time of the periodic recertification of 
345.32  eligibility under section 256J.32, subdivision 6, or within 
345.33  eight calendar days of a reporting period as in subdivision 5 or 
345.34  6, whichever occurs first.  A caregiver must report other 
345.35  changes at the time of the periodic recertification of 
345.36  eligibility under section 256J.32, subdivision 6, or at the end 
346.1   of a reporting period under subdivision 5 or 6, as applicable.  
346.2   A caregiver must make these reports in writing to the county 
346.3   agency.  When a county agency could have reduced or terminated 
346.4   assistance for one or more payment months if a delay in 
346.5   reporting a change specified under clauses (1) to (16) had not 
346.6   occurred, the county agency must determine whether a timely 
346.7   notice under section 256J.31, subdivision 4, could have been 
346.8   issued on the day that the change occurred.  When a timely 
346.9   notice could have been issued, each month's overpayment 
346.10  subsequent to that notice must be considered a client error 
346.11  overpayment under section 256J.38.  Calculation of overpayments 
346.12  for late reporting under clause (17) is specified in section 
346.13  256J.09, subdivision 9.  Changes in circumstances which must be 
346.14  reported within ten days must also be reported on the MFIP-S 
346.15  MFIP household report form for the reporting period in which 
346.16  those changes occurred.  Within ten days, a caregiver must 
346.17  report: 
346.18     (1) a change in initial employment; 
346.19     (2) a change in initial receipt of unearned income; 
346.20     (3) a recurring change in unearned income; 
346.21     (4) a nonrecurring change of unearned income that exceeds 
346.22  $30; 
346.23     (5) the receipt of a lump sum; 
346.24     (6) an increase in assets that may cause the assistance 
346.25  unit to exceed asset limits; 
346.26     (7) a change in the physical or mental status of an 
346.27  incapacitated member of the assistance unit if the physical or 
346.28  mental status is the basis of exemption from an MFIP-S work and 
346.29  training MFIP employment services program; 
346.30     (8) a change in employment status; 
346.31     (9) a change in household composition, including births, 
346.32  returns to and departures from the home of assistance unit 
346.33  members and financially responsible persons, or a change in the 
346.34  custody of a minor child information affecting an exception 
346.35  under section 256J.24, subdivision 9; 
346.36     (10) a change in health insurance coverage; 
347.1      (11) the marriage or divorce of an assistance unit member; 
347.2      (12) the death of a parent, minor child, or financially 
347.3   responsible person; 
347.4      (13) a change in address or living quarters of the 
347.5   assistance unit; 
347.6      (14) the sale, purchase, or other transfer of property; 
347.7      (15) a change in school attendance of a custodial parent or 
347.8   an employed child; and 
347.9      (16) filing a lawsuit, a workers' compensation claim, or a 
347.10  monetary claim against a third party; and 
347.11     (17) a change in household composition, including births, 
347.12  returns to and departures from the home of assistance unit 
347.13  members and financially responsible persons, or a change in the 
347.14  custody of a minor child. 
347.15     Sec. 33.  Minnesota Statutes 1998, section 256J.31, 
347.16  subdivision 5, is amended to read: 
347.17     Subd. 5.  [MAILING OF NOTICE.] The notice of adverse action 
347.18  shall be issued according to paragraphs (a) to (c) (d). 
347.19     (a) A county agency shall mail a notice of adverse action 
347.20  must be mailed at least ten days before the effective date of 
347.21  the adverse action, except as provided in paragraphs (b) and (c) 
347.22  to (d). 
347.23     (b) A county agency must mail a notice of adverse action at 
347.24  least five days before the effective date of the adverse action 
347.25  when the county agency has factual information that requires an 
347.26  action to reduce, suspend, or terminate assistance based on 
347.27  probable fraud. 
347.28     (c) A county agency shall mail A notice of adverse action 
347.29  before or on the effective date of the adverse action must be 
347.30  mailed no later than four working days before the end of the 
347.31  month when the county agency: 
347.32     (1) receives the caregiver's signed monthly MFIP-S 
347.33  household report form that includes information that requires 
347.34  payment reduction, suspension, or termination; 
347.35     (2) is informed of the death of a participant the only 
347.36  caregiver or the payee in an assistance unit; 
348.1      (3) (2) receives a signed statement from the caregiver that 
348.2   assistance is no longer wanted; 
348.3      (4) receives a signed statement from the caregiver that 
348.4   provides information that requires the termination or reduction 
348.5   of assistance (3) has factual information to reduce, suspend, or 
348.6   terminate assistance based on the failure to timely report 
348.7   changes; 
348.8      (5) verifies that a member of the assistance unit is absent 
348.9   from the home and does not meet temporary absence provisions in 
348.10  section 256J.13; 
348.11     (6) (4) verifies that a member of the assistance unit has 
348.12  entered a regional treatment center or a licensed residential 
348.13  facility for medical or psychological treatment or 
348.14  rehabilitation; 
348.15     (7) (5) verifies that a member of an assistance unit has 
348.16  been removed from the home as a result of a judicial 
348.17  determination or placed in foster care, and the provisions of 
348.18  section 256J.13, subdivision 2, paragraph (c), clause (2), do 
348.19  not apply; 
348.20     (8) verifies that a member of an assistance unit has been 
348.21  approved to receive assistance by another state; or 
348.22     (9) (6) cannot locate a caregiver. 
348.23     (c) A notice of adverse action must be mailed for a payment 
348.24  month when the caregiver makes a written request for closure 
348.25  before the first of that payment month. 
348.26     (d) A notice of adverse action must be mailed before the 
348.27  effective date of the adverse action when the county agency 
348.28  receives the caregiver's signed and completed MFIP household 
348.29  report form or recertification form that includes information 
348.30  that requires payment reduction, suspension, or termination. 
348.31     Sec. 34.  Minnesota Statutes 1998, section 256J.31, 
348.32  subdivision 12, is amended to read: 
348.33     Subd. 12.  [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 
348.34  participant who is not in vendor payment status may discontinue 
348.35  receipt of the cash assistance portion of MFIP-S MFIP assistance 
348.36  grant and retain eligibility for child care assistance under 
349.1   section 119B.05 and for medical assistance under sections 
349.2   256B.055, subdivision 3a, and 256B.0635.  For the months a 
349.3   participant chooses to discontinue the receipt of the cash 
349.4   portion of the MFIP grant, the assistance unit accrues months of 
349.5   eligibility to be applied toward eligibility for child care 
349.6   under section 119B.05 and for medical assistance under sections 
349.7   256B.055, subdivision 3a, and 256B.0635. 
349.8      Sec. 35.  Minnesota Statutes 1998, section 256J.32, 
349.9   subdivision 4, is amended to read: 
349.10     Subd. 4.  [FACTORS TO BE VERIFIED.] The county agency shall 
349.11  verify the following at application: 
349.12     (1) identity of adults; 
349.13     (2) presence of the minor child in the home, if 
349.14  questionable; 
349.15     (3) relationship of a minor child to caregivers in the 
349.16  assistance unit; 
349.17     (4) age, if necessary to determine MFIP-S MFIP eligibility; 
349.18     (5) immigration status; 
349.19     (6) social security number according to the requirements of 
349.20  section 256J.30, subdivision 12; 
349.21     (7) income; 
349.22     (8) self-employment expenses used as a deduction; 
349.23     (9) source and purpose of deposits and withdrawals from 
349.24  business accounts; 
349.25     (10) spousal support and child support payments made to 
349.26  persons outside the household; 
349.27     (11) real property; 
349.28     (12) vehicles; 
349.29     (13) checking and savings accounts; 
349.30     (14) savings certificates, savings bonds, stocks, and 
349.31  individual retirement accounts; 
349.32     (15) pregnancy, if related to eligibility; 
349.33     (16) inconsistent information, if related to eligibility; 
349.34     (17) medical insurance; 
349.35     (18) anticipated graduation date of an 18-year-old; 
349.36     (19) burial accounts; 
350.1      (20) (19) school attendance, if related to eligibility; 
350.2      (21) (20) residence; 
350.3      (22) (21) a claim of domestic violence if used as a basis 
350.4   for a deferral or exemption from the 60-month time limit in 
350.5   section 256J.42 or employment and training services requirements 
350.6   in section 256J.56; and 
350.7      (23) (22) disability if used as an exemption from 
350.8   employment and training services requirements under section 
350.9   256J.56; and 
350.10     (23) information needed to establish an exception under 
350.11  section 256J.24, subdivision 9. 
350.12     Sec. 36.  Minnesota Statutes 1998, section 256J.32, 
350.13  subdivision 6, is amended to read: 
350.14     Subd. 6.  [RECERTIFICATION.] The county agency shall 
350.15  recertify eligibility in an annual face-to-face interview with 
350.16  the participant and verify the following: 
350.17     (1) presence of the minor child in the home, if 
350.18  questionable; 
350.19     (2) income, unless excluded, including self-employment 
350.20  expenses used as a deduction or deposits or withdrawals from 
350.21  business accounts; 
350.22     (3) assets when the value is within $200 of the asset 
350.23  limit; and 
350.24     (4) information to establish an exception under section 
350.25  256J.24, subdivision 9, if questionable; and 
350.26     (5) inconsistent information, if related to eligibility.  
350.27     Sec. 37.  Minnesota Statutes 1998, section 256J.33, is 
350.28  amended to read: 
350.29     256J.33 [PROSPECTIVE AND RETROSPECTIVE DETERMINATION OF 
350.30  MFIP-S MFIP ELIGIBILITY.] 
350.31     Subdivision 1.  [DETERMINATION OF ELIGIBILITY.] A county 
350.32  agency must determine MFIP-S MFIP eligibility prospectively for 
350.33  a payment month based on retrospectively assessing income and 
350.34  the county agency's best estimate of the circumstances that will 
350.35  exist in the payment month. 
350.36     Except as described in section 256J.34, subdivision 1, when 
351.1   prospective eligibility exists, a county agency must calculate 
351.2   the amount of the assistance payment using retrospective 
351.3   budgeting.  To determine MFIP-S MFIP eligibility and the 
351.4   assistance payment amount, a county agency must apply countable 
351.5   income, described in section 256J.37, subdivisions 3 to 10, 
351.6   received by members of an assistance unit or by other persons 
351.7   whose income is counted for the assistance unit, described under 
351.8   sections 256J.21 and 256J.37, subdivisions 1 to 2. 
351.9      This income must be applied to the transitional MFIP 
351.10  standard, shared household standard, of need or family 
351.11  wage standard level subject to this section and sections 256J.34 
351.12  to 256J.36.  Income received in a calendar month and not 
351.13  otherwise excluded under section 256J.21, subdivision 2, must be 
351.14  applied to the needs of an assistance unit. 
351.15     Subd. 2.  [PROSPECTIVE ELIGIBILITY.] A county agency must 
351.16  determine whether the eligibility requirements that pertain to 
351.17  an assistance unit, including those in sections 256J.11 to 
351.18  256J.15 and 256J.20, will be met prospectively for the payment 
351.19  month.  Except for the provisions in section 256J.34, 
351.20  subdivision 1, the income test will be applied retrospectively. 
351.21     Subd. 3.  [RETROSPECTIVE ELIGIBILITY.] After the first two 
351.22  months of MFIP-S MFIP eligibility, a county agency must continue 
351.23  to determine whether an assistance unit is prospectively 
351.24  eligible for the payment month by looking at all factors other 
351.25  than income and then determine whether the assistance unit is 
351.26  retrospectively income eligible by applying the monthly income 
351.27  test to the income from the budget month.  When the monthly 
351.28  income test is not satisfied, the assistance payment must be 
351.29  suspended when ineligibility exists for one month or ended when 
351.30  ineligibility exists for more than one month. 
351.31     Subd. 4.  [MONTHLY INCOME TEST.] A county agency must apply 
351.32  the monthly income test retrospectively for each month of MFIP-S 
351.33  MFIP eligibility.  An assistance unit is not eligible when the 
351.34  countable income equals or exceeds the transitional MFIP 
351.35  standard, the shared household standard, of need or the family 
351.36  wage level for the assistance unit.  The income applied against 
352.1   the monthly income test must include: 
352.2      (1) gross earned income from employment, prior to mandatory 
352.3   payroll deductions, voluntary payroll deductions, wage 
352.4   authorizations, and after the disregards in section 256J.21, 
352.5   subdivision 4, and the allocations in section 256J.36, unless 
352.6   the employment income is specifically excluded under section 
352.7   256J.21, subdivision 2; 
352.8      (2) gross earned income from self-employment less 
352.9   deductions for self-employment expenses in section 256J.37, 
352.10  subdivision 5, but prior to any reductions for personal or 
352.11  business state and federal income taxes, personal FICA, personal 
352.12  health and life insurance, and after the disregards in section 
352.13  256J.21, subdivision 4, and the allocations in section 256J.36; 
352.14     (3) unearned income after deductions for allowable expenses 
352.15  in section 256J.37, subdivision 9, and allocations in section 
352.16  256J.36, unless the income has been specifically excluded in 
352.17  section 256J.21, subdivision 2; 
352.18     (4) gross earned income from employment as determined under 
352.19  clause (1) which is received by a member of an assistance unit 
352.20  who is a minor child or minor caregiver and less than a 
352.21  half-time student; 
352.22     (5) child support and spousal support received or 
352.23  anticipated to be received by an assistance unit; 
352.24     (6) the income of a parent when that parent is not included 
352.25  in the assistance unit; 
352.26     (7) the income of an eligible relative and spouse who seek 
352.27  to be included in the assistance unit; and 
352.28     (8) the unearned income of a minor child included in the 
352.29  assistance unit. 
352.30     Subd. 5.  [WHEN TO TERMINATE ASSISTANCE.] When an 
352.31  assistance unit is ineligible for MFIP-S MFIP assistance for two 
352.32  consecutive months, the county agency must terminate MFIP-S MFIP 
352.33  assistance. 
352.34     Sec. 38.  Minnesota Statutes 1998, section 256J.34, 
352.35  subdivision 1, is amended to read: 
352.36     Subdivision 1.  [PROSPECTIVE BUDGETING.] A county agency 
353.1   must use prospective budgeting to calculate the assistance 
353.2   payment amount for the first two months for an applicant who has 
353.3   not received assistance in this state for at least one payment 
353.4   month preceding the first month of payment under a current 
353.5   application.  Notwithstanding subdivision 3, paragraph (a), 
353.6   clause (2), a county agency must use prospective budgeting for 
353.7   the first two months for a person who applies to be added to an 
353.8   assistance unit.  Prospective budgeting is not subject to 
353.9   overpayments or underpayments unless fraud is determined under 
353.10  section 256.98. 
353.11     (a) The county agency must apply the income received or 
353.12  anticipated in the first month of MFIP-S MFIP eligibility 
353.13  against the need of the first month.  The county agency must 
353.14  apply the income received or anticipated in the second month 
353.15  against the need of the second month. 
353.16     (b) When the assistance payment for any part of the first 
353.17  two months is based on anticipated income, the county agency 
353.18  must base the initial assistance payment amount on the 
353.19  information available at the time the initial assistance payment 
353.20  is made. 
353.21     (c) The county agency must determine the assistance payment 
353.22  amount for the first two months of MFIP-S MFIP eligibility by 
353.23  budgeting both recurring and nonrecurring income for those two 
353.24  months. 
353.25     (d) The county agency must budget the child support income 
353.26  received or anticipated to be received by an assistance unit to 
353.27  determine the assistance payment amount from the month of 
353.28  application through the date in which MFIP-S MFIP eligibility is 
353.29  determined and assistance is authorized.  Child support income 
353.30  which has been budgeted to determine the assistance payment in 
353.31  the initial two months is considered nonrecurring income.  An 
353.32  assistance unit must forward any payment of child support to the 
353.33  child support enforcement unit of the county agency following 
353.34  the date in which assistance is authorized. 
353.35     Sec. 39.  Minnesota Statutes 1998, section 256J.34, 
353.36  subdivision 3, is amended to read: 
354.1      Subd. 3.  [ADDITIONAL USES OF RETROSPECTIVE BUDGETING.] 
354.2   Notwithstanding subdivision 1, the county agency must use 
354.3   retrospective budgeting to calculate the monthly assistance 
354.4   payment amount for the first two months under paragraphs (a) and 
354.5   (b). 
354.6      (a) The county agency must use retrospective budgeting to 
354.7   determine the amount of the assistance payment in the first two 
354.8   months of MFIP-S MFIP eligibility: 
354.9      (1) when an assistance unit applies for assistance for the 
354.10  same month for which assistance has been interrupted, the 
354.11  interruption in eligibility is less than one payment month, the 
354.12  assistance payment for the preceding month was issued in this 
354.13  state, and the assistance payment for the immediately preceding 
354.14  month was determined retrospectively; or 
354.15     (2) when a person applies in order to be added to an 
354.16  assistance unit, that assistance unit has received assistance in 
354.17  this state for at least the two preceding months, and that 
354.18  person has been living with and has been financially responsible 
354.19  for one or more members of that assistance unit for at least the 
354.20  two preceding months. 
354.21     (b) Except as provided in clauses (1) to (4), the county 
354.22  agency must use retrospective budgeting and apply income 
354.23  received in the budget month by an assistance unit and by a 
354.24  financially responsible household member who is not included in 
354.25  the assistance unit against the appropriate transitional or 
354.26  family wage level MFIP standard of need or family wage level to 
354.27  determine the assistance payment to be issued for the payment 
354.28  month. 
354.29     (1) When a source of income ends prior to the third payment 
354.30  month, that income is not considered in calculating the 
354.31  assistance payment for that month.  When a source of income ends 
354.32  prior to the fourth payment month, that income is not considered 
354.33  when determining the assistance payment for that month. 
354.34     (2) When a member of an assistance unit or a financially 
354.35  responsible household member leaves the household of the 
354.36  assistance unit, the income of that departed household member is 
355.1   not budgeted retrospectively for any full payment month in which 
355.2   that household member does not live with that household and is 
355.3   not included in the assistance unit. 
355.4      (3) When an individual is removed from an assistance unit 
355.5   because the individual is no longer a minor child, the income of 
355.6   that individual is not budgeted retrospectively for payment 
355.7   months in which that individual is not a member of the 
355.8   assistance unit, except that income of an ineligible child in 
355.9   the household must continue to be budgeted retrospectively 
355.10  against the child's needs when the parent or parents of that 
355.11  child request allocation of their income against any unmet needs 
355.12  of that ineligible child. 
355.13     (4) When a person ceases to have financial responsibility 
355.14  for one or more members of an assistance unit, the income of 
355.15  that person is not budgeted retrospectively for the payment 
355.16  months which follow the month in which financial responsibility 
355.17  ends. 
355.18     Sec. 40.  Minnesota Statutes 1998, section 256J.34, 
355.19  subdivision 4, is amended to read: 
355.20     Subd. 4.  [SIGNIFICANT CHANGE IN GROSS INCOME.] The county 
355.21  agency must recalculate the assistance payment when an 
355.22  assistance unit experiences a significant change, as defined in 
355.23  section 256J.08, resulting in a reduction in the gross income 
355.24  received in the payment month from the gross income received in 
355.25  the budget month.  The county agency must issue a supplemental 
355.26  assistance payment based on the county agency's best estimate of 
355.27  the assistance unit's income and circumstances for the payment 
355.28  month.  Budget adjustments Supplemental assistance payments that 
355.29  result from significant changes are limited to two in a 12-month 
355.30  period regardless of the reason for the change.  Budget 
355.31  adjustments Notwithstanding any other statute or rule of law, 
355.32  supplementary assistance payments shall not be made when the 
355.33  significant change in income is the result of receipt of a lump 
355.34  sum, receipt of an extra paycheck, business fluctuation in 
355.35  self-employment income, or an assistance unit member's 
355.36  participation in a strike or other labor action.  Supplementary 
356.1   assistance payments due to a significant change in the amount of 
356.2   direct support received must not be made after the date the 
356.3   assistance unit is required to forward support to the child 
356.4   support enforcement unit under subdivision 1, paragraph (d). 
356.5      Sec. 41.  Minnesota Statutes 1998, section 256J.35, is 
356.6   amended to read: 
356.7      256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 
356.8      Except as provided in paragraphs (a) to (d) (c), the amount 
356.9   of an assistance payment is equal to the difference between the 
356.10  transitional MFIP standard, shared household standard, of need 
356.11  or the Minnesota family wage level in section 256J.24, whichever 
356.12  is less, and countable income. 
356.13     (a) When MFIP-S MFIP eligibility exists for the month of 
356.14  application, the amount of the assistance payment for the month 
356.15  of application must be prorated from the date of application or 
356.16  the date all other eligibility factors are met for that 
356.17  applicant, whichever is later.  This provision applies when an 
356.18  applicant loses at least one day of MFIP-S MFIP eligibility. 
356.19     (b) MFIP-S MFIP overpayments to an assistance unit must be 
356.20  recouped according to section 256J.38, subdivision 4. 
356.21     (c) An initial assistance payment must not be made to an 
356.22  applicant who is not eligible on the date payment is made. 
356.23     (d) An individual whose needs have been otherwise provided 
356.24  for in another state, in whole or in part by county, state, or 
356.25  federal dollars during a month, is ineligible to receive MFIP-S 
356.26  for the month. 
356.27     Sec. 42.  Minnesota Statutes 1998, section 256J.36, is 
356.28  amended to read: 
356.29     256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 
356.30  MEMBERS.] 
356.31     Except as prohibited in paragraphs (a) and (b), an 
356.32  allocation of income is allowed from the caregiver's income to 
356.33  meet the unmet need of an ineligible spouse or an ineligible 
356.34  child under the age of 21 for whom the caregiver is financially 
356.35  responsible who also lives with the caregiver.  That allocation 
356.36  is allowed in an amount up to the difference between the MFIP-S 
357.1   transitional MFIP standard of need for the assistance unit when 
357.2   that ineligible person is included in the assistance unit and 
357.3   the MFIP-S family allowance MFIP standard of need for the 
357.4   assistance unit when the ineligible person is not included in 
357.5   the assistance unit.  These allocations must be deducted from 
357.6   the caregiver's counted earnings and from unearned income 
357.7   subject to paragraphs (a) and (b). 
357.8      (a) Income of a minor child in the assistance unit must not 
357.9   be allocated to meet the need of an ineligible person, including 
357.10  the child's parent, even when that parent is the payee of the 
357.11  child's income. 
357.12     (b) Income of a caregiver must not be allocated to meet the 
357.13  needs of a disqualified person. 
357.14     Sec. 43.  Minnesota Statutes 1998, section 256J.37, 
357.15  subdivision 1, is amended to read: 
357.16     Subdivision 1.  [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 
357.17  MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 
357.18  the income of ineligible household members must be deemed after 
357.19  allowing the following disregards: 
357.20     (1) the first 18 percent of the ineligible family member's 
357.21  gross earned income; 
357.22     (2) amounts the ineligible person actually paid to 
357.23  individuals not living in the same household but whom the 
357.24  ineligible person claims or could claim as dependents for 
357.25  determining federal personal income tax liability; 
357.26     (3) all payments made by the ineligible person according to 
357.27  a court order for spousal support or the support of children not 
357.28  living in the assistance unit's household, provided that, if 
357.29  there has been a change in the financial circumstances of the 
357.30  ineligible person since the support order was entered, the 
357.31  ineligible person has petitioned for a modification of the 
357.32  support order; and 
357.33     (4) an amount for the needs of the ineligible person and 
357.34  other persons who live in the household but are not included in 
357.35  the assistance unit and are or could be claimed by an ineligible 
357.36  person as dependents for determining federal personal income tax 
358.1   liability.  This amount is equal to the difference between the 
358.2   MFIP-S transitional MFIP standard of need when the ineligible 
358.3   person is included in the assistance unit and the MFIP-S 
358.4   transitional MFIP standard of need when the ineligible person is 
358.5   not included in the assistance unit. 
358.6      Sec. 44.  Minnesota Statutes 1998, section 256J.37, 
358.7   subdivision 1a, is amended to read: 
358.8      Subd. 1a.  [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 
358.9   income of disqualified members must be deemed after allowing the 
358.10  following disregards: 
358.11     (1) the first 18 percent of the disqualified member's gross 
358.12  earned income; 
358.13     (2) amounts the disqualified member actually paid to 
358.14  individuals not living in the same household but whom the 
358.15  disqualified member claims or could claim as dependents for 
358.16  determining federal personal income tax liability; 
358.17     (3) all payments made by the disqualified member according 
358.18  to a court order for spousal support or the support of children 
358.19  not living in the assistance unit's household, provided that, if 
358.20  there has been a change in the financial circumstances of the 
358.21  disqualified member's legal obligation to pay support since the 
358.22  support order was entered, the disqualified member has 
358.23  petitioned for a modification of the support order; and 
358.24     (4) an amount for the needs of other persons who live in 
358.25  the household but are not included in the assistance unit and 
358.26  are or could be claimed by the disqualified member as dependents 
358.27  for determining federal personal income tax liability.  This 
358.28  amount is equal to the difference between the MFIP-S 
358.29  transitional MFIP standard of need when the ineligible person is 
358.30  included in the assistance unit and the MFIP-S transitional MFIP 
358.31  standard of need when the ineligible person is not included in 
358.32  the assistance unit.  An amount shall not be allowed for the 
358.33  needs of a disqualified member. 
358.34     Sec. 45.  Minnesota Statutes 1998, section 256J.37, 
358.35  subdivision 2, is amended to read: 
358.36     Subd. 2.  [DEEMED INCOME AND ASSETS OF SPONSOR OF 
359.1   NONCITIZENS.] If a noncitizen applies for or receives MFIP-S, 
359.2   the county must deem the income and assets of the noncitizen's 
359.3   sponsor and the sponsor's spouse who have signed an affidavit of 
359.4   support for the noncitizen as specified in Public Law Number 
359.5   104-193, title IV, sections 421 and 422, the Personal 
359.6   Responsibility and Work Opportunity Reconciliation Act of 1996.  
359.7   The income of a sponsor and the sponsor's spouse is considered 
359.8   unearned income of the noncitizen.  The assets of a sponsor and 
359.9   the sponsor's spouse are considered available assets of the 
359.10  noncitizen.  (a) If a noncitizen applies for or receives MFIP, 
359.11  the county must deem the income and assets of the noncitizen's 
359.12  sponsor and the sponsor's spouse as provided in this paragraph 
359.13  and paragraph (b) or (c), whichever is applicable.  The deemed 
359.14  income of a sponsor and the sponsor's spouse is considered 
359.15  unearned income of the noncitizen.  The deemed assets of a 
359.16  sponsor and the sponsor's spouse are considered available assets 
359.17  of the noncitizen. 
359.18     (b) The income and assets of a sponsor who signed an 
359.19  affidavit of support under title IV, sections 421, 422, and 423, 
359.20  of Public Law Number 104-193, the Personal Responsibility and 
359.21  Work Opportunity Reconciliation Act of 1996, and the income and 
359.22  assets of the sponsor's spouse, must be deemed to the noncitizen 
359.23  to the extent required by those sections of Public Law Number 
359.24  104-193. 
359.25     (c) The income and assets of a sponsor and the sponsor's 
359.26  spouse to whom the provisions of paragraph (b) do not apply must 
359.27  be deemed to the noncitizen to the full extent allowed under 
359.28  title V, section 5505, of Public Law Number 105-33, the Balanced 
359.29  Budget Act of 1997. 
359.30     Sec. 46.  Minnesota Statutes 1998, section 256J.37, 
359.31  subdivision 9, is amended to read: 
359.32     Subd. 9.  [UNEARNED INCOME.] (a) The county agency must 
359.33  apply unearned income to the transitional applicable MFIP 
359.34  standard.  When determining the amount of unearned income, the 
359.35  county agency must deduct the costs necessary to secure payments 
359.36  of unearned income.  These costs include legal fees, medical 
360.1   fees, and mandatory deductions such as federal and state income 
360.2   taxes. 
360.3      (b) Effective July 1, 1999, the county agency shall count 
360.4   $100 of the value of public and assisted rental subsidies 
360.5   provided through the Department of Housing and Urban Development 
360.6   (HUD) as unearned income.  The full amount of the subsidy must 
360.7   be counted as unearned income when the subsidy is less than $100.
360.8      Sec. 47.  Minnesota Statutes 1998, section 256J.37, 
360.9   subdivision 10, is amended to read: 
360.10     Subd. 10.  [TREATMENT OF LUMP SUMS.] (a) The county agency 
360.11  must treat lump-sum payments as earned or unearned income.  If 
360.12  the lump-sum payment is included in the category of income 
360.13  identified in subdivision 9, it must be treated as unearned 
360.14  income.  A lump sum is counted as income in the month received 
360.15  and budgeted either prospectively or retrospectively depending 
360.16  on the budget cycle at the time of receipt.  When an individual 
360.17  receives a lump-sum payment, that lump sum must be combined with 
360.18  all other earned and unearned income received in the same budget 
360.19  month, and it must be applied according to paragraphs (a) to 
360.20  (c). A lump sum may not be carried over into subsequent months.  
360.21  Any funds that remain in the third month after the month of 
360.22  receipt are counted in the asset limit. 
360.23     (b) For a lump sum received by an applicant during the 
360.24  first two months, prospective budgeting is used to determine the 
360.25  payment and the lump sum must be combined with other earned or 
360.26  unearned income received and budgeted in that prospective month. 
360.27     (c) For a lump sum received by a participant after the 
360.28  first two months of MFIP-S MFIP eligibility, the lump sum must 
360.29  be combined with other income received in that budget month, and 
360.30  the combined amount must be applied retrospectively against the 
360.31  applicable payment month. 
360.32     (d) When a lump sum, combined with other income under 
360.33  paragraphs (b) and (c), is less than the transitional MFIP 
360.34  standard of need for the applicable appropriate payment month, 
360.35  the assistance payment must be reduced according to the amount 
360.36  of the countable income.  When the countable income is greater 
361.1   than the transitional MFIP standard or the family wage 
361.2   standard or family wage level, the assistance payment must be 
361.3   suspended for the payment month. 
361.4      Sec. 48.  Minnesota Statutes 1998, section 256J.38, 
361.5   subdivision 4, is amended to read: 
361.6      Subd. 4.  [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 
361.7   participant may voluntarily repay, in part or in full, an 
361.8   overpayment even if assistance is reduced under this 
361.9   subdivision, until the total amount of the overpayment is 
361.10  repaid.  When an overpayment occurs due to fraud, the county 
361.11  agency must recover ten percent of the transitional applicable 
361.12  standard or the amount of the monthly assistance payment, 
361.13  whichever is less.  When a nonfraud overpayment occurs, the 
361.14  county agency must recover three percent of the transitional 
361.15  MFIP standard of need or the amount of the monthly assistance 
361.16  payment, whichever is less.  
361.17     Sec. 49.  Minnesota Statutes 1998, section 256J.42, 
361.18  subdivision 1, is amended to read: 
361.19     Subdivision 1.  [TIME LIMIT.] (a) Except for the exemptions 
361.20  in this section and in section 256J.11, subdivision 2, an 
361.21  assistance unit in which any adult caregiver has received 60 
361.22  months of cash assistance funded in whole or in part by the TANF 
361.23  block grant in this or any other state or United States 
361.24  territory, MFIP-S or from a tribal TANF program, MFIP, AFDC, or 
361.25  family general assistance, funded in whole or in part by state 
361.26  appropriations, is ineligible to receive MFIP-S MFIP.  Any cash 
361.27  assistance funded with TANF dollars in this or any other state 
361.28  or United States territory, or from a tribal TANF program, or 
361.29  MFIP-S MFIP assistance funded in whole or in part by state 
361.30  appropriations, that was received by the unit on or after the 
361.31  date TANF was implemented, including any assistance received in 
361.32  states or United States territories of prior residence, counts 
361.33  toward the 60-month limitation.  The 60-month limit applies to a 
361.34  minor who is the head of a household or who is married to the 
361.35  head of a household except under subdivision 5.  The 60-month 
361.36  time period does not need to be consecutive months for this 
362.1   provision to apply.  
362.2      (b) The months before July 1998 in which individuals 
362.3   receive received assistance as part of the field trials as an 
362.4   MFIP, MFIP-R, or MFIP or MFIP-R comparison group family under 
362.5   sections 256.031 to 256.0361 or sections 256.047 to 256.048 are 
362.6   not included in the 60-month time limit. 
362.7      Sec. 50.  Minnesota Statutes 1998, section 256J.42, 
362.8   subdivision 5, is amended to read: 
362.9      Subd. 5.  [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 
362.10  assistance received by an assistance unit does not count toward 
362.11  the 60-month limit on assistance during a month in which the 
362.12  caregiver is in the category in section 256J.56, paragraph (a), 
362.13  clause (1). The exemption applies for the period of time the 
362.14  caregiver belongs to one of the categories specified in this 
362.15  subdivision. 
362.16     (b) From July 1, 1997, until the date MFIP-S MFIP is 
362.17  operative in the caregiver's county of financial responsibility, 
362.18  any cash assistance received by a caregiver who is complying 
362.19  with sections 256.73, subdivision 5a, and 256.736, if 
362.20  applicable, does not count toward the 60-month limit on 
362.21  assistance.  Thereafter, any cash assistance received by a minor 
362.22  caregiver who is complying with the requirements of sections 
362.23  256J.14 and 256J.54, if applicable, does not count towards the 
362.24  60-month limit on assistance. 
362.25     (c) Any diversionary assistance or emergency assistance 
362.26  received does not count toward the 60-month limit. 
362.27     (d) Any cash assistance received by an 18- or 19-year-old 
362.28  caregiver who is complying with the requirements of section 
362.29  256J.54 does not count toward the 60-month limit. 
362.30     Sec. 51.  Minnesota Statutes 1998, section 256J.42, is 
362.31  amended by adding a subdivision to read: 
362.32     Subd. 6.  [FAMILIES WITH INCAPACITATED MEMBERS.] Any cash 
362.33  assistance received by a caregiver does not count toward the 
362.34  60-month limit on assistance during a month in which a caregiver 
362.35  qualifies for an exemption from MFIP-S work requirements because 
362.36  the caregiver: 
363.1      (1) is suffering from a professionally certified permanent 
363.2   injury or incapacity which is expected to continue for more than 
363.3   30 days and which prevents the person from obtaining or 
363.4   retaining employment; or 
363.5      (2) is required to care for another member in the household 
363.6   who has a professionally certified illness or incapacity that is 
363.7   expected to last for more than 30 days and the caregiver's 
363.8   presence replaces other specialized care arrangements. 
363.9      Sec. 52.  Minnesota Statutes 1998, section 256J.43, is 
363.10  amended to read: 
363.11     256J.43 [INTERSTATE PAYMENT TRANSITIONAL STANDARDS.] 
363.12     Subdivision 1.  [PAYMENT.] (a) Effective July 1, 1997, the 
363.13  amount of assistance paid to an eligible unit in which all 
363.14  members have resided in this state for fewer than 12 consecutive 
363.15  calendar months immediately preceding the date of application 
363.16  shall be the lesser of either the interstate transitional 
363.17  standard that would have been received by the assistance unit 
363.18  from the state of immediate prior residence, or the amount 
363.19  calculated in accordance with AFDC or MFIP-S MFIP standards.  
363.20  The lesser payment must continue until the assistance unit meets 
363.21  the 12-month requirement.  An assistance unit that has not 
363.22  resided in Minnesota for 12 months from the date of application 
363.23  is not exempt from the interstate payment transitional standards 
363.24  provisions solely because a child is born in Minnesota to a 
363.25  member of the assistance unit.  Payment must be calculated by 
363.26  applying this state's MFIP's budgeting policies, and the unit's 
363.27  net income must be deducted from the payment standard in the 
363.28  other state or the MFIP transitional or shared household 
363.29  standard in this state, whichever is lower.  Payment shall be 
363.30  made in vendor form for shelter and utilities, up to the limit 
363.31  of the grant amount, and residual amounts, if any, shall be paid 
363.32  directly to the assistance unit. 
363.33     (b) During the first 12 months an assistance unit resides 
363.34  in this state, the number of months that a unit is eligible to 
363.35  receive AFDC or MFIP-S MFIP benefits is limited to the number of 
363.36  months the assistance unit would have been eligible to receive 
364.1   similar benefits in the state of immediate prior residence. 
364.2      (c) This policy applies whether or not the assistance unit 
364.3   received similar benefits while residing in the state of 
364.4   previous residence. 
364.5      (d) When an assistance unit moves to this state from 
364.6   another state where the assistance unit has exhausted that 
364.7   state's time limit for receiving benefits under that state's 
364.8   TANF program, the unit will not be eligible to receive any AFDC 
364.9   or MFIP-S MFIP benefits in this state for 12 months from the 
364.10  date the assistance unit moves here. 
364.11     (e) For the purposes of this section, "state of immediate 
364.12  prior residence" means: 
364.13     (1) the state in which the applicant declares the applicant 
364.14  spent the most time in the 30 days prior to moving to this 
364.15  state; or 
364.16     (2) the state in which an applicant who is a migrant worker 
364.17  maintains a home. 
364.18     (f) The commissioner shall annually verify and update all 
364.19  other states' payment standards as they are to be in effect in 
364.20  July of each year. 
364.21     (g) Applicants must provide verification of their state of 
364.22  immediate prior residence, in the form of tax statements, a 
364.23  driver's license, automobile registration, rent receipts, or 
364.24  other forms of verification approved by the commissioner. 
364.25     (h) Migrant workers, as defined in section 256J.08, and 
364.26  their immediate families are exempt from this section, provided 
364.27  the migrant worker provides verification that the migrant family 
364.28  worked in this state within the last 12 months and earned at 
364.29  least $1,000 in gross wages during the time the migrant worker 
364.30  worked in this state. 
364.31     Subd. 2.  [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 
364.32  assistance unit that has met the requirements of section 
364.33  256J.12, the number of months that the assistance unit receives 
364.34  benefits under the interstate payment transitional standards in 
364.35  this section is not affected by an absence from Minnesota for 
364.36  fewer than 30 consecutive days. 
365.1      (b) For an assistance unit that has met the requirements of 
365.2   section 256J.12, the number of months that the assistance unit 
365.3   receives benefits under the interstate payment transitional 
365.4   standards in this section is not affected by an absence from 
365.5   Minnesota for more than 30 consecutive days but fewer than 90 
365.6   consecutive days, provided the assistance unit continues to 
365.7   maintain a residence in Minnesota during the period of absence. 
365.8      Subd. 3.  [EXCEPTIONS TO THE INTERSTATE PAYMENT POLICY.] 
365.9   Applicants who lived in another state in the 12 months prior to 
365.10  applying for assistance are exempt from the interstate payment 
365.11  policy for the months that a member of the unit: 
365.12     (1) served in the United States armed services, provided 
365.13  the person returned to Minnesota within 30 days of leaving the 
365.14  armed forces, and intends to remain in Minnesota; 
365.15     (2) attended school in another state, paid nonresident 
365.16  tuition or Minnesota tuition rates under a reciprocity 
365.17  agreement, provided the person left Minnesota specifically to 
365.18  attend school and returned to Minnesota within 30 days of 
365.19  graduation with the intent to remain in Minnesota; or 
365.20     (3) meets the following criteria: 
365.21     (i) a minor child or a minor caregiver moves from another 
365.22  state to the residence of a relative caregiver; 
365.23     (ii) the minor caregiver applies for and receives family 
365.24  cash assistance; 
365.25     (iii) the relative caregiver chooses not to be part of the 
365.26  MFIP-S MFIP assistance unit; and 
365.27     (iv) the relative caregiver has resided in Minnesota for at 
365.28  least 12 months from the date the assistance unit applies for 
365.29  cash assistance. 
365.30     Subd. 4.  [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 
365.31  mandatory unit members who have resided in Minnesota for 12 
365.32  months immediately before the unit's date of application 
365.33  establish the other assistance unit members' eligibility for the 
365.34  MFIP-S MFIP transitional standard, shared household or family 
365.35  wage level, whichever is applicable. 
365.36     Sec. 53.  Minnesota Statutes 1998, section 256J.45, 
366.1   subdivision 1, is amended to read: 
366.2      Subdivision 1.  [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 
366.3   county agency must provide each MFIP-S MFIP caregiver who is not 
366.4   exempt under section 256J.56, paragraph (a), clause (6) or (8), 
366.5   with a face-to-face orientation.  The caregiver must attend the 
366.6   orientation.  The county agency must inform the caregiver 
366.7   caregivers who are not exempt under section 256J.56, paragraph 
366.8   (a), clause (6) or (8), that failure to attend the orientation 
366.9   is considered an occurrence of noncompliance with program 
366.10  requirements, and will result in the imposition of a sanction 
366.11  under section 256J.46.  If the client complies with the 
366.12  orientation requirement prior to the first day of the month in 
366.13  which the grant reduction is proposed to occur, the orientation 
366.14  sanction shall be lifted.  
366.15     Sec. 54.  Minnesota Statutes 1998, section 256J.46, 
366.16  subdivision 1, is amended to read: 
366.17     Subdivision 1.  [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 
366.18  WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 
366.19  good cause to comply with the requirements of this chapter, and 
366.20  who is not subject to a sanction under subdivision 2, shall be 
366.21  subject to a sanction as provided in this subdivision. 
366.22     A sanction under this subdivision becomes effective the 
366.23  month following the month in which a required notice is given.  
366.24  A sanction must not be imposed when a participant comes into 
366.25  compliance with the requirements for orientation under section 
366.26  256J.45 or third-party liability for medical services under 
366.27  section 256J.30, subdivision 10, prior to the effective date of 
366.28  the sanction.  A sanction must not be imposed when a participant 
366.29  comes into compliance with the requirements for employment and 
366.30  training services under sections 256J.49 to 256J.72 ten days 
366.31  prior to the effective date of the sanction.  For purposes of 
366.32  this subdivision, each month that a participant fails to comply 
366.33  with a requirement of this chapter shall be considered a 
366.34  separate occurrence of noncompliance.  A participant who has had 
366.35  one or more sanctions imposed must remain in compliance with the 
366.36  provisions of this chapter for six months in order for a 
367.1   subsequent occurrence of noncompliance to be considered a first 
367.2   occurrence.  
367.3      (b) Sanctions for noncompliance shall be imposed as follows:
367.4      (1) For the first occurrence of noncompliance by a 
367.5   participant in a single-parent household or by one participant 
367.6   in a two-parent household, the assistance unit's grant shall be 
367.7   reduced by ten percent of the MFIP-S transitional MFIP standard, 
367.8   the shared household standard, or the interstate transitional 
367.9   standard of need for an assistance unit of the same size, 
367.10  whichever is applicable, with the residual grant paid to the 
367.11  participant.  The reduction in the grant amount must be in 
367.12  effect for a minimum of one month and shall be removed in the 
367.13  month following the month that the participant returns to 
367.14  compliance.  
367.15     (2) For a second or subsequent occurrence of noncompliance, 
367.16  or when both participants in a two-parent household are out of 
367.17  compliance at the same time, the assistance unit's shelter costs 
367.18  shall be vendor paid up to the amount of the cash portion of the 
367.19  MFIP-S MFIP grant for which the participant's assistance unit is 
367.20  eligible.  At county option, the assistance unit's utilities may 
367.21  also be vendor paid up to the amount of the cash portion of the 
367.22  MFIP-S MFIP grant remaining after vendor payment of the 
367.23  assistance unit's shelter costs.  The residual amount of the 
367.24  grant after vendor payment, if any, must be reduced by an amount 
367.25  equal to 30 percent of the MFIP-S transitional MFIP standard, 
367.26  the shared household standard, or the interstate transitional 
367.27  standard of need for an assistance unit of the same size, 
367.28  whichever is applicable, before the residual grant is paid to 
367.29  the assistance unit.  The reduction in the grant amount must be 
367.30  in effect for a minimum of one month and shall be removed in the 
367.31  month following the month that a participant in a one-parent 
367.32  household returns to compliance.  In a two-parent household, the 
367.33  grant reduction must be in effect for a minimum of one month and 
367.34  shall be removed in the month following the month both 
367.35  participants return to compliance.  The vendor payment of 
367.36  shelter costs and, if applicable, utilities shall be removed six 
368.1   months after the month in which the participant or participants 
368.2   return to compliance. 
368.3      (c) No later than during the second month that a sanction 
368.4   under paragraph (b), clause (2), is in effect due to 
368.5   noncompliance with employment services, the participant's case 
368.6   file must be reviewed to determine if: 
368.7      (i) the continued noncompliance can be explained and 
368.8   mitigated by providing a needed preemployment activity, as 
368.9   defined in section 256J.49, subdivision 13, clause (16); 
368.10     (ii) the participant qualifies for a good cause exception 
368.11  under section 256J.57; or 
368.12     (iii) the participant qualifies for an exemption under 
368.13  section 256J.56. 
368.14     If the lack of an identified activity can explain the 
368.15  noncompliance, the county must work with the participant to 
368.16  provide the identified activity, and the county must restore the 
368.17  participant's grant amount to the full amount for which the 
368.18  assistance unit is eligible.  The grant must be restored 
368.19  retroactively to the first day of the month in which the 
368.20  participant was found to lack preemployment activities or to 
368.21  qualify for an exemption or good cause exception. 
368.22     If the participant is found to qualify for a good cause 
368.23  exception or an exemption, the county must restore the 
368.24  participant's grant to the full amount for which the assistance 
368.25  unit is eligible.  
368.26     Sec. 55.  Minnesota Statutes 1998, section 256J.46, 
368.27  subdivision 2, is amended to read: 
368.28     Subd. 2.  [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 
368.29  REQUIREMENTS.] The grant of an MFIP-S MFIP caregiver who refuses 
368.30  to cooperate, as determined by the child support enforcement 
368.31  agency, with support requirements under section 256.741, shall 
368.32  be subject to sanction as specified in this subdivision.  The 
368.33  assistance unit's grant must be reduced by 25 percent of the 
368.34  applicable transitional MFIP standard of need.  The residual 
368.35  amount of the grant, if any, must be paid to the caregiver.  A 
368.36  sanction under this subdivision becomes effective the first 
369.1   month following the month in which a required notice is given.  
369.2   A sanction must not be imposed when a caregiver comes into 
369.3   compliance with the requirements under section 256.741 prior to 
369.4   the effective date of the sanction.  The sanction shall be 
369.5   removed in the month following the month that the caregiver 
369.6   cooperates with the support requirements.  Each month that 
369.7   an MFIP-S MFIP caregiver fails to comply with the requirements 
369.8   of section 256.741 must be considered a separate occurrence of 
369.9   noncompliance.  An MFIP-S MFIP caregiver who has had one or more 
369.10  sanctions imposed must remain in compliance with the 
369.11  requirements of section 256.741 for six months in order for a 
369.12  subsequent sanction to be considered a first occurrence. 
369.13     Sec. 56.  Minnesota Statutes 1998, section 256J.46, 
369.14  subdivision 2a, is amended to read: 
369.15     Subd. 2a.  [DUAL SANCTIONS.] (a) Notwithstanding the 
369.16  provisions of subdivisions 1 and 2, for a participant subject to 
369.17  a sanction for refusal to comply with child support requirements 
369.18  under subdivision 2 and subject to a concurrent sanction for 
369.19  refusal to cooperate with other program requirements under 
369.20  subdivision 1, sanctions shall be imposed in the manner 
369.21  prescribed in this subdivision. 
369.22     A participant who has had one or more sanctions imposed 
369.23  under this subdivision must remain in compliance with the 
369.24  provisions of this chapter for six months in order for a 
369.25  subsequent occurrence of noncompliance to be considered a first 
369.26  occurrence.  Any vendor payment of shelter costs or utilities 
369.27  under this subdivision must remain in effect for six months 
369.28  after the month in which the participant is no longer subject to 
369.29  sanction under subdivision 1. 
369.30     (b) If the participant was subject to sanction for: 
369.31     (i) noncompliance under subdivision 1 before being subject 
369.32  to sanction for noncooperation under subdivision 2; or 
369.33     (ii) noncooperation under subdivision 2 before being 
369.34  subject to sanction for noncompliance under subdivision 1; 
369.35  the participant shall be sanctioned as provided in subdivision 
369.36  1, paragraph (b), clause (2), and the requirement that the 
370.1   county conduct a review as specified in subdivision 1, paragraph 
370.2   (c), remains in effect. 
370.3      (c) A participant who first becomes subject to sanction 
370.4   under both subdivisions 1 and 2 in the same month is subject to 
370.5   sanction as follows: 
370.6      (i) in the first month of noncompliance and noncooperation, 
370.7   the participant's grant must be reduced by 25 percent of the 
370.8   applicable transitional MFIP standard of need, with any residual 
370.9   amount paid to the participant; 
370.10     (ii) in the second and subsequent months of noncompliance 
370.11  and noncooperation, the participant shall be sanctioned as 
370.12  provided in subdivision 1, paragraph (b), clause (2). 
370.13     The requirement that the county conduct a review as 
370.14  specified in subdivision 1, paragraph (c), remains in effect. 
370.15     (d) A participant remains subject to sanction under 
370.16  subdivision 2 if the participant: 
370.17     (i) returns to compliance and is no longer subject to 
370.18  sanction under subdivision 1; or 
370.19     (ii) has the sanction under subdivision 1, paragraph (b), 
370.20  removed upon completion of the review under subdivision 1, 
370.21  paragraph (c). 
370.22     A participant remains subject to sanction under subdivision 
370.23  1, paragraph (b), if the participant cooperates and is no longer 
370.24  subject to sanction under subdivision 2. 
370.25     Sec. 57.  Minnesota Statutes 1998, section 256J.47, 
370.26  subdivision 4, is amended to read: 
370.27     Subd. 4.  [INELIGIBILITY FOR MFIP-S MFIP; EMERGENCY 
370.28  ASSISTANCE; AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of 
370.29  diversionary assistance, the family is ineligible for MFIP-S 
370.30  MFIP, emergency assistance, and emergency general assistance for 
370.31  a period of time.  To determine the period of ineligibility, the 
370.32  county shall use the following formula:  regardless of household 
370.33  changes, the county agency must calculate the number of days of 
370.34  ineligibility by dividing the diversionary assistance issued by 
370.35  the transitional MFIP standard of need a family of the same size 
370.36  and composition would have received under MFIP-S, or if 
371.1   applicable the interstate transitional standard, MFIP multiplied 
371.2   by 30, truncating the result.  The ineligibility period begins 
371.3   the date the diversionary assistance is issued. 
371.4      Sec. 58.  Minnesota Statutes 1998, section 256J.48, 
371.5   subdivision 2, is amended to read: 
371.6      Subd. 2.  [ELIGIBILITY.] Notwithstanding other eligibility 
371.7   provisions of this chapter, any family without resources 
371.8   immediately available to meet emergency needs identified in 
371.9   subdivision 3 shall be eligible for an emergency grant under the 
371.10  following conditions: 
371.11     (1) a family member has resided in this state for at least 
371.12  30 days; 
371.13     (2) the family is without resources immediately available 
371.14  to meet emergency needs; 
371.15     (3) assistance is necessary to avoid destitution or provide 
371.16  emergency shelter arrangements; 
371.17     (4) the family's destitution or need for shelter or 
371.18  utilities did not arise because the assistance unit is under 
371.19  sanction, the caregiver is disqualified, or the child or 
371.20  relative caregiver refused without good cause under section 
371.21  256J.57 to accept employment or training for employment in this 
371.22  state or another state; and 
371.23     (5) at least one child or pregnant woman in the emergency 
371.24  assistance unit meets MFIP-S MFIP citizenship requirements in 
371.25  section 256J.11. 
371.26     Sec. 59.  Minnesota Statutes 1998, section 256J.48, 
371.27  subdivision 3, is amended to read: 
371.28     Subd. 3.  [EMERGENCY NEEDS.] Emergency needs are limited to 
371.29  the following: 
371.30     (a)  [RENT.] A county agency may deny assistance to prevent 
371.31  eviction from rented or leased shelter of an otherwise eligible 
371.32  applicant when the county agency determines that an applicant's 
371.33  anticipated income will not cover continued payment for shelter, 
371.34  subject to conditions in clauses (1) to (3): 
371.35     (1) a county agency must not deny assistance when an 
371.36  applicant can document that the applicant is unable to locate 
372.1   habitable shelter, unless the county agency can document that 
372.2   one or more habitable shelters are available in the community 
372.3   that will result in at least a 20 percent reduction in monthly 
372.4   expense for shelter and that this shelter will be cost-effective 
372.5   for the applicant; 
372.6      (2) when no alternative shelter can be identified by either 
372.7   the applicant or the county agency, the county agency shall not 
372.8   deny assistance because anticipated income will not cover rental 
372.9   obligation; and 
372.10     (3) when cost-effective alternative shelter is identified, 
372.11  the county agency shall issue assistance for moving expenses as 
372.12  provided in paragraph (e). 
372.13     (b)  [DEFINITIONS.] For purposes of paragraph (a), the 
372.14  following definitions apply (1) "metropolitan statistical area" 
372.15  is as defined by the United States Census Bureau; (2) 
372.16  "alternative shelter" includes any shelter that is located 
372.17  within the metropolitan statistical area containing the county 
372.18  and for which the applicant is eligible, provided the applicant 
372.19  does not have to travel more than 20 miles to reach the shelter 
372.20  and has access to transportation to the shelter.  Clause (2) 
372.21  does not apply to counties in the Minneapolis-St. Paul 
372.22  metropolitan statistical area. 
372.23     (c)  [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 
372.24  agency shall issue assistance for mortgage or contract for deed 
372.25  arrearages on behalf of an otherwise eligible applicant 
372.26  according to clauses (1) to (4): 
372.27     (1) assistance for arrearages must be issued only when a 
372.28  home is owned, occupied, and maintained by the applicant; 
372.29     (2) assistance for arrearages must be issued only when no 
372.30  subsequent foreclosure action is expected within the 12 months 
372.31  following the issuance; 
372.32     (3) assistance for arrearages must be issued only when an 
372.33  applicant has been refused refinancing through a bank or other 
372.34  lending institution and the amount payable, when combined with 
372.35  any payments made by the applicant, will be accepted by the 
372.36  creditor as full payment of the arrearage; 
373.1      (4) costs paid by a family which are counted toward the 
373.2   payment requirements in this clause are:  principal and interest 
373.3   payments on mortgages or contracts for deed, balloon payments, 
373.4   homeowner's insurance payments, manufactured home lot rental 
373.5   payments, and tax or special assessment payments related to the 
373.6   homestead.  Costs which are not counted include closing costs 
373.7   related to the sale or purchase of real property. 
373.8      To be eligible for assistance for costs specified in clause 
373.9   (4) which are outstanding at the time of foreclosure, an 
373.10  applicant must have paid at least 40 percent of the family's 
373.11  gross income toward these costs in the month of application and 
373.12  the 11-month period immediately preceding the month of 
373.13  application. 
373.14     When an applicant is eligible under clause (4), a county 
373.15  agency shall issue assistance up to a maximum of four times the 
373.16  MFIP-S transitional MFIP standard of need for a comparable 
373.17  assistance unit. 
373.18     (d)  [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 
373.19  issue assistance for damage or utility deposits when necessary 
373.20  to alleviate the emergency.  The county may require that 
373.21  assistance paid in the form of a damage deposit, less any amount 
373.22  retained by the landlord to remedy a tenant's default in payment 
373.23  of rent or other funds due to the landlord under a rental 
373.24  agreement, or to restore the premises to the condition at the 
373.25  commencement of the tenancy, ordinary wear and tear excepted, be 
373.26  returned to the county when the individual vacates the premises 
373.27  or be paid to the recipient's new landlord as a vendor payment.  
373.28  The county may require that assistance paid in the form of a 
373.29  utility deposit less any amount retained to satisfy outstanding 
373.30  utility costs be returned to the county when the person vacates 
373.31  the premises, or be paid for the person's new housing unit as a 
373.32  vendor payment.  The vendor payment of returned funds shall not 
373.33  be considered a new use of emergency assistance. 
373.34     (e)  [MOVING EXPENSES.] A county agency shall issue 
373.35  assistance for expenses incurred when a family must move to a 
373.36  different shelter according to clauses (1) to (4): 
374.1      (1) moving expenses include the cost to transport personal 
374.2   property belonging to a family, the cost for utility connection, 
374.3   and the cost for securing different shelter; 
374.4      (2) moving expenses must be paid only when the county 
374.5   agency determines that a move is cost-effective; 
374.6      (3) moving expenses must be paid at the request of an 
374.7   applicant, but only when destitution or threatened destitution 
374.8   exists; and 
374.9      (4) moving expenses must be paid when a county agency 
374.10  denies assistance to prevent an eviction because the county 
374.11  agency has determined that an applicant's anticipated income 
374.12  will not cover continued shelter obligation in paragraph (a). 
374.13     (f)  [HOME REPAIRS.] A county agency shall pay for repairs 
374.14  to the roof, foundation, wiring, heating system, chimney, and 
374.15  water and sewer system of a home that is owned and lived in by 
374.16  an applicant. 
374.17     The applicant shall document, and the county agency shall 
374.18  verify the need for and method of repair. 
374.19     The payment must be cost-effective in relation to the 
374.20  overall condition of the home and in relation to the cost and 
374.21  availability of alternative housing. 
374.22     (g)  [UTILITY COSTS.] Assistance for utility costs must be 
374.23  made when an otherwise eligible family has had a termination or 
374.24  is threatened with a termination of municipal water and sewer 
374.25  service, electric, gas or heating fuel service, refuse removal 
374.26  service, or lacks wood when that is the heating source, subject 
374.27  to the conditions in clauses (1) and (2): 
374.28     (1) a county agency must not issue assistance unless the 
374.29  county agency receives confirmation from the utility provider 
374.30  that assistance combined with payment by the applicant will 
374.31  continue or restore the utility; and 
374.32     (2) a county agency shall not issue assistance for utility 
374.33  costs unless a family paid at least eight percent of the 
374.34  family's gross income toward utility costs due during the 
374.35  preceding 12 months. 
374.36     Clauses (1) and (2) must not be construed to prevent the 
375.1   issuance of assistance when a county agency must take immediate 
375.2   and temporary action necessary to protect the life or health of 
375.3   a child. 
375.4      (h)  [SPECIAL DIETS.] Effective January 1, 1998, a county 
375.5   shall pay for special diets or dietary items for MFIP-S MFIP 
375.6   participants.  Persons receiving emergency assistance funds for 
375.7   special diets or dietary items are also eligible to receive 
375.8   emergency assistance for shelter and utility emergencies, if 
375.9   otherwise eligible.  The need for special diets or dietary items 
375.10  must be prescribed by a licensed physician.  Costs for special 
375.11  diets shall be determined as percentages of the allotment for a 
375.12  one-person household under the Thrifty Food Plan as defined by 
375.13  the United States Department of Agriculture.  The types of diets 
375.14  and the percentages of the Thrifty Food Plan that are covered 
375.15  are as follows: 
375.16     (1) high protein diet, at least 80 grams daily, 25 percent 
375.17  of Thrifty Food Plan; 
375.18     (2) controlled protein diet, 40 to 60 grams and requires 
375.19  special products, 100 percent of Thrifty Food Plan; 
375.20     (3) controlled protein diet, less than 40 grams and 
375.21  requires special products, 125 percent of Thrifty Food Plan; 
375.22     (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 
375.23     (5) high residue diet, 20 percent of Thrifty Food Plan; 
375.24     (6) pregnancy and lactation diet, 35 percent of Thrifty 
375.25  Food Plan; 
375.26     (7) gluten-free diet, 25 percent of Thrifty Food Plan; 
375.27     (8) lactose-free diet, 25 percent of Thrifty Food Plan; 
375.28     (9) antidumping diet, 15 percent of Thrifty Food Plan; 
375.29     (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 
375.30     (11) ketogenic diet, 25 percent of Thrifty Food Plan. 
375.31     Sec. 60.  Minnesota Statutes 1998, section 256J.50, 
375.32  subdivision 1, is amended to read: 
375.33     Subdivision 1.  [EMPLOYMENT AND TRAINING SERVICES COMPONENT 
375.34  OF MFIP-S MFIP.] (a) By January 1, 1998, each county must 
375.35  develop and implement an employment and training services 
375.36  component of MFIP-S MFIP which is designed to put participants 
376.1   on the most direct path to unsubsidized employment.  
376.2   Participation in these services is mandatory for all MFIP-S MFIP 
376.3   caregivers, unless the caregiver is exempt under section 256J.56.
376.4      (b) A county may provide employment and training services 
376.5   to MFIP-S caregivers who are exempt from the employment and 
376.6   training services component but volunteer for the services. A 
376.7   county must provide employment and training services under 
376.8   sections 256J.515 to 256J.74 within 30 days after the 
376.9   caregiver's participation becomes mandatory under subdivision 5. 
376.10     Sec. 61.  Minnesota Statutes 1998, section 256J.515, is 
376.11  amended to read: 
376.12     256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 
376.13     During the first meeting with participants, job counselors 
376.14  must ensure that an overview of employment and training services 
376.15  is provided that: 
376.16     (1) stresses the necessity and opportunity of immediate 
376.17  employment; 
376.18     (2) outlines the job search resources offered; 
376.19     (3) outlines education or training opportunities available; 
376.20     (4) describes the range of work activities, including 
376.21  activities under section 256J.49, subdivision 13, clause (18), 
376.22  that are allowable under MFIP-S MFIP to meet the individual 
376.23  needs of participants; 
376.24     (5) explains the requirements to comply with an employment 
376.25  plan; 
376.26     (6) explains the consequences for failing to comply; and 
376.27     (7) explains the services that are available to support job 
376.28  search and work and education. 
376.29     Failure to attend the overview of employment and training 
376.30  services without good cause results in the imposition of a 
376.31  sanction under section 256J.46. 
376.32     Sec. 62.  Minnesota Statutes 1998, section 256J.52, 
376.33  subdivision 1, is amended to read: 
376.34     Subdivision 1.  [APPLICATION LIMITED TO CERTAIN 
376.35  PARTICIPANTS.] This section applies to participants receiving 
376.36  MFIP-S MFIP assistance who are not exempt under section 256J.56, 
377.1   and to caregivers who volunteer for employment and training 
377.2   services under section 256J.50. 
377.3      Sec. 63.  Minnesota Statutes 1998, section 256J.52, 
377.4   subdivision 4, is amended to read: 
377.5      Subd. 4.  [SECONDARY ASSESSMENT.] (a) The job counselor 
377.6   must conduct a secondary assessment for those participants who: 
377.7      (1) in the judgment of the job counselor, have barriers to 
377.8   obtaining employment that will not be overcome with a job search 
377.9   support plan under subdivision 3; 
377.10     (2) have completed eight weeks of job search under 
377.11  subdivision 3 without obtaining suitable employment; 
377.12     (3) have not received a secondary assessment, are working 
377.13  at least 20 hours per week, and the participant, job counselor, 
377.14  or county agency requests a secondary assessment; or 
377.15     (4) have an existing job search plan or employment plan 
377.16  developed for another program or are already involved in 
377.17  training or education activities under section 256J.55, 
377.18  subdivision 5. 
377.19     (b) In the secondary assessment the job counselor must 
377.20  evaluate the participant's skills and prior work experience, 
377.21  family circumstances, interests and abilities, need for 
377.22  preemployment activities, supportive or educational services, 
377.23  and the extent of any barriers to employment.  Failure to 
377.24  complete a secondary assessment shall result in the imposition 
377.25  of a sanction as specified in sections 256J.46 and 256J.57.  The 
377.26  job counselor must use the information gathered through the 
377.27  secondary assessment to develop an employment plan under 
377.28  subdivision 5. 
377.29     (c) In the secondary assessment the job counselor may 
377.30  require the participant to complete a professional medical 
377.31  substance abuse or psychological assessment as a component of 
377.32  the secondary assessment when the job counselor has a reasonable 
377.33  belief, based on objective evidence, that a participant's 
377.34  ability to obtain and retain suitable employment is impaired by 
377.35  a medical condition.  The job counselor must ensure that 
377.36  appropriate services are available to participants to 
378.1   accommodate any disabilities identified by an assessment.  Data 
378.2   gathered as part of a professional assessment shall be 
378.3   classified and disclosed in accordance with the data practices 
378.4   provisions specified in section 13.46. 
378.5      (d) The provider shall make available to participants 
378.6   information regarding additional vendors or resources which 
378.7   provide employment and training services that may be available 
378.8   to the participant under a plan developed under this section.  
378.9   The information must include a brief summary of services 
378.10  provided and related performance indicators.  Performance 
378.11  indicators must include, but are not limited to, the average 
378.12  time to complete program offerings, placement rates, entry and 
378.13  average wages, and retention rates.  To be included in the 
378.14  information given to participants, a vendor or resource must 
378.15  provide counties with relevant information in the format 
378.16  required by the county. 
378.17     Sec. 64.  Minnesota Statutes 1998, section 256J.52, is 
378.18  amended by adding a subdivision to read: 
378.19     Subd. 5a.  [BASIC EDUCATION ACTIVITIES IN 
378.20  PLAN.] Participants with low skills in reading or mathematics 
378.21  who are proficient only at or below an eighth-grade level must 
378.22  be allowed to include basic education activities or an English 
378.23  as a second language program in a job search support plan or an 
378.24  employment plan, whichever is applicable. 
378.25     Sec. 65.  Minnesota Statutes 1998, section 256J.52, 
378.26  subdivision 8, is amended to read: 
378.27     Subd. 8.  [ADMINISTRATIVE SUPPORT FOR POSTEMPLOYMENT 
378.28  EDUCATION AND TRAINING.] After a caregiver receiving MFIP-S MFIP 
378.29  has been employed for six consecutive months, during which time 
378.30  the caregiver works on average more than 20 hours per week, or 
378.31  if the job counselor determines that the caregiver is not likely 
378.32  to exit MFIP within 12 months because the caregiver's current 
378.33  employment offers limited opportunities for advancement, the 
378.34  caregiver's job counselor shall inform the caregiver that the 
378.35  caregiver may request a secondary assessment described in 
378.36  subdivision 4 and shall provide information about: 
379.1      (1) explore, investigate, and examine potential training 
379.2   options, which may be through the caregiver's current employer, 
379.3   the Minnesota job skills partnership, other employers, technical 
379.4   colleges or other educational institutions, nonprofit 
379.5   organizations, county services, state agencies, or any other 
379.6   resource available that will enhance the caregiver's skills and 
379.7   improve the potential for increase earnings; 
379.8      (2) present part-time education and training options 
379.9   available to the caregiver that are consistent with the 
379.10  caregiver's interests and career path; and 
379.11     (2) (3) provide information about child care and 
379.12  transportation resources available to support postemployment 
379.13  education and training; and 
379.14     (4) ensure that the caregiver is apprised of the training 
379.15  options and is allowed to pursue ongoing training needed to 
379.16  achieve self-sufficiency. 
379.17     Sec. 66.  [256J.535] [SUPPORTING PARENTS MAKING 
379.18  SATISFACTORY PROGRESS IN EDUCATION AND TRAINING.] 
379.19     For each semester or quarter, whichever is applicable, that 
379.20  a participant is enrolled in a post-secondary education or 
379.21  training program and is maintaining a 2.5 grade point average, 
379.22  on a 4.0 scale, the number of months the participant maintained 
379.23  a 2.5 grade point average shall be added prospectively to the 
379.24  total number of months the participant has remaining on 
379.25  assistance.  The participant must provide verification of the 
379.26  2.5 grade point average to the county agency after each 
379.27  applicable semester or quarter.  A participant may take 
379.28  advantage of this section for no more than a total of 36 months. 
379.29     Sec. 67.  Minnesota Statutes 1998, section 256J.55, 
379.30  subdivision 4, is amended to read: 
379.31     Subd. 4.  [CHOICE OF PROVIDER.] A participant MFIP 
379.32  caregivers must be able to choose from at least two employment 
379.33  and training service providers, unless the county has 
379.34  demonstrated to the commissioner that the provision of multiple 
379.35  employment and training service providers would result in 
379.36  financial hardship for the county, or the county is utilizing a 
380.1   workforce center as specified in section 256J.50, subdivision 
380.2   8.  Both parents in a two-parent family must choose the same 
380.3   employment and training service provider unless a special need, 
380.4   such as bilingual services, is identified but not available 
380.5   through one service provider. 
380.6      Sec. 68.  Minnesota Statutes 1998, section 256J.56, is 
380.7   amended to read: 
380.8      256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 
380.9   EXEMPTIONS.] 
380.10     (a) An MFIP-S MFIP caregiver is exempt from the 
380.11  requirements of sections 256J.52 to 256J.55 if the caregiver 
380.12  belongs to any of the following groups: 
380.13     (1) individuals who are age 60 or older; 
380.14     (2) individuals who are suffering from a professionally 
380.15  certified permanent or temporary illness, injury, or incapacity 
380.16  which is expected to continue for more than 30 days and which 
380.17  prevents the person from obtaining or retaining employment.  
380.18  Persons in this category with a temporary illness, injury, or 
380.19  incapacity must be reevaluated at least quarterly; 
380.20     (3) caregivers whose presence in the home is required 
380.21  because of the professionally certified illness or incapacity of 
380.22  another member in the assistance unit, a relative in the 
380.23  household, or a foster child in the household; 
380.24     (4) women who are pregnant, if the pregnancy has resulted 
380.25  in a professionally certified incapacity that prevents the woman 
380.26  from obtaining or retaining employment; 
380.27     (5) caregivers of a child under the age of one year who 
380.28  personally provide full-time care for the child.  This exemption 
380.29  may be used for only 12 months in a lifetime.  In two-parent 
380.30  households, only one parent or other relative may qualify for 
380.31  this exemption; 
380.32     (6) individuals who are single parents, or one parent in a 
380.33  two-parent family, employed at least 35 hours per week; 
380.34     (7) individuals experiencing a personal or family crisis 
380.35  that makes them incapable of participating in the program, as 
380.36  determined by the county agency.  If the participant does not 
381.1   agree with the county agency's determination, the participant 
381.2   may seek professional certification, as defined in section 
381.3   256J.08, that the participant is incapable of participating in 
381.4   the program. 
381.5      Persons in this exemption category must be reevaluated 
381.6   every 60 days; or 
381.7      (8) second parents in two-parent families employed for 20 
381.8   or more hours per week, provided the first parent is employed at 
381.9   least 35 hours per week. 
381.10     A caregiver who is exempt under clause (5) must enroll in 
381.11  and attend an early childhood and family education class, a 
381.12  parenting class, or some similar activity, if available, during 
381.13  the period of time the caregiver is exempt under this section.  
381.14  Notwithstanding section 256J.46, failure to attend the required 
381.15  activity shall not result in the imposition of a sanction. 
381.16     (b) The county agency must provide employment and training 
381.17  services to MFIP-S MFIP caregivers who are exempt under this 
381.18  section, but who volunteer to participate.  Exempt volunteers 
381.19  may request approval for any work activity under section 
381.20  256J.49, subdivision 13.  The hourly participation requirements 
381.21  for nonexempt caregivers under section 256J.50, subdivision 5, 
381.22  do not apply to exempt caregivers who volunteer to participate. 
381.23     Sec. 69.  Minnesota Statutes 1998, section 256J.57, 
381.24  subdivision 1, is amended to read: 
381.25     Subdivision 1.  [GOOD CAUSE FOR FAILURE TO COMPLY.] The 
381.26  county agency shall not impose the sanction under section 
381.27  256J.46 if it determines that the participant has good cause for 
381.28  failing to comply with the requirements of sections 256J.52 to 
381.29  256J.55.  Good cause exists when: 
381.30     (1) appropriate child care is not available; 
381.31     (2) the job does not meet the definition of suitable 
381.32  employment; 
381.33     (3) the participant is ill or injured; 
381.34     (4) a member of the assistance unit, a relative in the 
381.35  household, or a foster child in the household is ill and needs 
381.36  care by the participant that prevents the participant from 
382.1   complying with the job search support plan or employment plan; 
382.2      (5) the parental caregiver is unable to secure necessary 
382.3   transportation; 
382.4      (6) the parental caregiver is in an emergency situation 
382.5   that prevents compliance with the job search support plan or 
382.6   employment plan; 
382.7      (7) the schedule of compliance with the job search support 
382.8   plan or employment plan conflicts with judicial proceedings; 
382.9      (8) a mandatory MFIP meeting is scheduled during a time 
382.10  that conflicts with a judicial proceeding or a meeting related 
382.11  to a juvenile court matter, or a participant's work schedule; 
382.12     (9) the parental caregiver is already participating in 
382.13  acceptable work activities; 
382.14     (9) (10) the employment plan requires an educational 
382.15  program for a caregiver under age 20, but the educational 
382.16  program is not available; 
382.17     (10) (11) activities identified in the job search support 
382.18  plan or employment plan are not available; 
382.19     (11) (12) the parental caregiver is willing to accept 
382.20  suitable employment, but suitable employment is not available; 
382.21  or 
382.22     (12) (13) the parental caregiver documents other verifiable 
382.23  impediments to compliance with the job search support plan or 
382.24  employment plan beyond the parental caregiver's control. 
382.25     The job counselor shall work with the participant to 
382.26  reschedule mandatory meetings for individuals who fall under 
382.27  clauses (1), (3), (4), (5), (6), (7), and (8). 
382.28     Sec. 70.  [256J.58] [SUPPORTING WORKING FAMILIES.] 
382.29     Subdivision 1.  [WORK REQUIRED.] To reward and support 
382.30  caregivers who are earning income and working the number of 
382.31  hours required under section 256J.50, subdivision 5, months in 
382.32  which the caregiver has reported weekly hours of employment 
382.33  equal to or greater than the work requirement will not count 
382.34  toward the 60-month lifetime limit on assistance. 
382.35     Subd. 2.  [MONTHS COUNTED.] Count each month of MFIP cash 
382.36  benefits received in this state for purposes of the 60-month 
383.1   lifetime limit, except as follows: 
383.2      (1) do not count a month in which a single-parent caregiver 
383.3   who does not have a child under six years of age has earnings 
383.4   that average 30 hours or more per week; 
383.5      (2) do not count a month in which the caregivers in a 
383.6   two-parent family have earnings that average 55 hours or more 
383.7   per week; and 
383.8      (3) do not count a month in which a single-parent caregiver 
383.9   who has a child under six years of age has earnings that average 
383.10  20 hours or more per week. 
383.11     Sec. 71.  Minnesota Statutes 1998, section 256J.62, 
383.12  subdivision 1, is amended to read: 
383.13     Subdivision 1.  [ALLOCATION.] Money appropriated for MFIP-S 
383.14  MFIP employment and training services must be allocated to 
383.15  counties and eligible tribal providers as specified in this 
383.16  section. 
383.17     Sec. 72.  Minnesota Statutes 1998, section 256J.62, is 
383.18  amended by adding a subdivision to read: 
383.19     Subd. 2a.  [CASELOAD-BASED FUNDS ALLOCATION.] Effective for 
383.20  state fiscal year 2000, and for all subsequent years, money 
383.21  shall be allocated to counties and eligible tribal providers 
383.22  based on their average number of MFIP cases as a proportion of 
383.23  the statewide total number of MFIP cases:  
383.24     (1) the average number of cases must be based upon counts 
383.25  of MFIP or tribal TANF cases as of March 31, June 30, September 
383.26  30, and December 31 of the previous calendar year, less the 
383.27  number of child only cases and cases where all the caregivers 
383.28  are age 60 or over.  Two-parent cases, with the exception of 
383.29  those with a caregiver age 60 or over, will be multiplied by a 
383.30  factor of two; 
383.31     (2) the MFIP or tribal TANF case count for each eligible 
383.32  tribal provider shall be based upon the number of MFIP or tribal 
383.33  TANF cases who are enrolled in, or are eligible for enrollment 
383.34  in their reservation; and the case must be an active MFIP case; 
383.35  and the case members must reside within the tribal program's 
383.36  service delivery area; 
384.1      (3) MFIP or tribal TANF cases counted for determining 
384.2   allocations to tribal providers shall be removed from the case 
384.3   counts of the respective counties where they reside to prevent 
384.4   duplicate counts; 
384.5      (4) prior to allocating funds to counties and tribal 
384.6   providers, $1,000,000 shall be set aside to allow the 
384.7   commissioner to use these set-aside funds to provide funding to 
384.8   county or tribal providers who experience an unforeseen influx 
384.9   of participants or other emergent situations beyond their 
384.10  control; and 
384.11     (5) the commissioner shall use a portion of the funds in 
384.12  clause (4) to offset a reduction in funds allocated to any 
384.13  county between state fiscal year 1999 and state fiscal year 2000 
384.14  that results from the adjustment in clause (3).  The funding 
384.15  provided under this clause must reduce by half the reduction for 
384.16  state fiscal year 2000 that any county would otherwise 
384.17  experience in the absence of this clause. 
384.18  Any funds specified in this clause that remain unspent by March 
384.19  31 of each year shall be reallocated out to county and tribal 
384.20  providers using the funding formula detailed in clauses (1) to 
384.21  (5). 
384.22     Sec. 73.  Minnesota Statutes 1998, section 256J.62, 
384.23  subdivision 6, is amended to read: 
384.24     Subd. 6.  [BILINGUAL EMPLOYMENT AND TRAINING SERVICES TO 
384.25  REFUGEES.] Funds appropriated to cover the costs of bilingual 
384.26  employment and training services to refugees shall be allocated 
384.27  to county agencies as follows: 
384.28     (1) for state fiscal year 1998, the allocation shall be 
384.29  based on the county's proportion of the total statewide number 
384.30  of AFDC refugee cases in the previous fiscal year.  Counties 
384.31  with less than one percent of the statewide number of AFDC, 
384.32  MFIP-R, or MFIP refugee cases shall not receive an allocation of 
384.33  bilingual employment and training services funds; and 
384.34     (2) for each subsequent fiscal year, the allocation shall 
384.35  be based on the county's proportion of the total statewide 
384.36  number of MFIP-S MFIP refugee cases in the previous fiscal year. 
385.1   Counties with less than one percent of the statewide number of 
385.2   MFIP-S MFIP refugee cases shall not receive an allocation of 
385.3   bilingual employment and training services funds. 
385.4      Sec. 74.  Minnesota Statutes 1998, section 256J.62, 
385.5   subdivision 7, is amended to read: 
385.6      Subd. 7.  [WORK LITERACY LANGUAGE PROGRAMS.] Funds 
385.7   appropriated to cover the costs of work literacy language 
385.8   programs to non-English-speaking recipients shall be allocated 
385.9   to county agencies as follows: 
385.10     (1) for state fiscal year 1998, the allocation shall be 
385.11  based on the county's proportion of the total statewide number 
385.12  of AFDC or MFIP cases in the previous fiscal year where the lack 
385.13  of English is a barrier to employment.  Counties with less than 
385.14  two percent of the statewide number of AFDC or MFIP cases where 
385.15  the lack of English is a barrier to employment shall not receive 
385.16  an allocation of the work literacy language program funds; and 
385.17     (2) for each subsequent fiscal year, the allocation shall 
385.18  be based on the county's proportion of the total statewide 
385.19  number of MFIP-S MFIP cases in the previous fiscal year where 
385.20  the lack of English is a barrier to employment.  Counties with 
385.21  less than two percent of the statewide number of MFIP-S MFIP 
385.22  cases where the lack of English is a barrier to employment shall 
385.23  not receive an allocation of the work literacy language program 
385.24  funds. 
385.25     Sec. 75.  Minnesota Statutes 1998, section 256J.62, 
385.26  subdivision 8, is amended to read: 
385.27     Subd. 8.  [REALLOCATION.] The commissioner of human 
385.28  services shall review county agency expenditures of MFIP-S MFIP 
385.29  employment and training services funds at the end of the third 
385.30  quarter of the first year of the biennium and each quarter after 
385.31  that and may reallocate unencumbered or unexpended money 
385.32  appropriated under this section to those county agencies that 
385.33  can demonstrate a need for additional money. 
385.34     Sec. 76.  Minnesota Statutes 1998, section 256J.62, 
385.35  subdivision 9, is amended to read: 
385.36     Subd. 9.  [CONTINUATION OF CERTAIN SERVICES.] At the 
386.1   request of the caregiver, the county may continue to provide 
386.2   case management, counseling or other support services to a 
386.3   participant following the participant's achievement of the 
386.4   employment goal, for up to six months following termination of 
386.5   the participant's eligibility for MFIP-S MFIP. 
386.6      A county may expend funds for a specific employment and 
386.7   training service for the duration of that service to a 
386.8   participant if the funds are obligated or expended prior to the 
386.9   participant losing MFIP-S MFIP eligibility. 
386.10     Sec. 77.  Minnesota Statutes 1998, section 256J.67, 
386.11  subdivision 4, is amended to read: 
386.12     Subd. 4.  [EMPLOYMENT PLAN.] (a) The caretaker's employment 
386.13  plan must include the length of time needed in the work 
386.14  experience program, the need to continue job-seeking activities 
386.15  while participating in work experience, and the caregiver's 
386.16  employment goals. 
386.17     (b) After each six months of a caregiver's participation in 
386.18  a work experience job placement, and at the conclusion of each 
386.19  work experience assignment under this section, the county agency 
386.20  shall reassess and revise, as appropriate, the caregiver's 
386.21  employment plan. 
386.22     (c) A caregiver may claim good cause under section 256J.57, 
386.23  subdivision 1, for failure to cooperate with a work experience 
386.24  job placement.  
386.25     (d) The county agency shall limit the maximum number of 
386.26  hours any participant may work under this section to the amount 
386.27  of the transitional MFIP standard of need divided by the federal 
386.28  or applicable state minimum wage, whichever is higher.  After a 
386.29  participant has been assigned to a position for nine months, the 
386.30  participant may not continue in that assignment unless the 
386.31  maximum number of hours a participant works is no greater than 
386.32  the amount of the transitional MFIP standard of need divided by 
386.33  the rate of pay for individuals employed in the same or similar 
386.34  occupations by the same employer at the same site.  This limit 
386.35  does not apply if it would prevent a participant from counting 
386.36  toward the federal work participation rate. 
387.1      Sec. 78.  Minnesota Statutes 1998, section 256J.74, 
387.2   subdivision 2, is amended to read: 
387.3      Subd. 2.  [CONCURRENT ELIGIBILITY, LIMITATIONS.] (a) An 
387.4   individual whose needs have been otherwise provided for in 
387.5   another state, in whole or in part by county, state, or federal 
387.6   dollars during a month, is ineligible to receive MFIP for the 
387.7   month.  
387.8      (b) A county agency must not count an applicant or 
387.9   participant as a member of more than one assistance unit in this 
387.10  state in a given payment month, except as provided in clauses 
387.11  (1) and (2). 
387.12     (1) A participant who is a member of an assistance unit in 
387.13  this state is eligible to be included in a second assistance 
387.14  unit the first full month after the month the participant joins 
387.15  the second unit. 
387.16     (2) An applicant whose needs are met through federal, 
387.17  state, or local foster care that is reimbursed under title IV-E 
387.18  of the Social Security Act payments for the first part of an 
387.19  application month is eligible to receive assistance for the 
387.20  remaining part of the month in which the applicant returns 
387.21  home.  Title IV-E Foster care payments and adoption assistance 
387.22  payments must be considered prorated payments rather than a 
387.23  duplication of MFIP-S MFIP need. 
387.24     Sec. 79.  [256J.751] [COUNTY PERFORMANCE MANAGEMENT.] 
387.25     (a) The commissioner shall report quarterly to all counties 
387.26  each county's performance on the following measures: 
387.27     (1) percent of MFIP caseload working in paid employment; 
387.28     (2) percent of MFIP caseload receiving only the food 
387.29  portion of assistance; 
387.30     (3) number of MFIP cases that have left assistance; 
387.31     (4) federal participation requirements as specified in 
387.32  title 1 of Public Law Number 104-193; and 
387.33     (5) median placement wage rate. 
387.34     (b) By January 1, 2000, the commissioner shall, in 
387.35  consultation with counties, develop measures for county 
387.36  performance in addition to those in paragraph (a).  In 
388.1   developing these measures, the commissioner must consider: 
388.2      (1) a measure for MFIP cases that leave assistance due to 
388.3   employment; 
388.4      (2) job retention after participants leave MFIP; and 
388.5      (3) participant's earnings at a follow-up point after the 
388.6   participant has left MFIP. 
388.7      (c) If sanctions occur for failure to meet the performance 
388.8   standards specified in title 1 of Public Law Number 104-193 of 
388.9   the Personal Responsibility and Work Opportunity Act of 1996, 
388.10  the state shall pay 88 percent of the sanction.  The remaining 
388.11  12 percent of the sanction will be paid by the counties.  The 
388.12  county portion of the sanction will be distributed across all 
388.13  counties in proportion to each county's percentage of the MFIP 
388.14  average monthly caseload during the period for which the 
388.15  sanction was applied. 
388.16     (d) If a county fails to meet the performance standards 
388.17  specified in title 1 of Public Law Number 104-193 of the 
388.18  Personal Responsibility and Work Opportunity Act of 1996 for any 
388.19  year, the commissioner shall work with counties to organize a 
388.20  joint state-county technical assistance team to work with the 
388.21  county.  The commissioner shall coordinate any technical 
388.22  assistance with other departments and agencies including the 
388.23  departments of economic security and children, families, and 
388.24  learning as necessary to achieve the purpose of this paragraph. 
388.25     Sec. 80.  Minnesota Statutes 1998, section 256J.76, 
388.26  subdivision 1, is amended to read: 
388.27     Subdivision 1.  [ADMINISTRATIVE FUNCTIONS.] Beginning July 
388.28  1, 1997, counties will receive federal funds from the TANF block 
388.29  grant for use in supporting eligibility, fraud control, and 
388.30  other related administrative functions.  The federal funds 
388.31  available for distribution, as determined by the commissioner, 
388.32  must be an amount equal to federal administrative aid 
388.33  distributed for fiscal year 1996 under titles IV-A and IV-F of 
388.34  the Social Security Act in effect prior to October 1, 1996.  
388.35  This amount must include the amount paid for local 
388.36  collaboratives under sections 245.4932 and 256F.13, but must not 
389.1   include administrative aid associated with child care under 
389.2   section 119B.05, with emergency assistance intensive family 
389.3   preservation services under section 256.8711, with 
389.4   administrative activities as part of the employment and training 
389.5   services under section 256.736, or with fraud prevention 
389.6   investigation activities under section 256.983.  Before July 15, 
389.7   1999, a county may ask for a review of the commissioner's 
389.8   determination when the county believes fiscal year 1996 
389.9   information was inaccurate or incomplete.  By August 15, 1999, 
389.10  the commissioner must adjust that county's base when the 
389.11  commissioner has determined that inaccurate or incomplete 
389.12  information was used to develop that base.  The commissioner 
389.13  shall adjust the county's 1999 allocation amount to reflect the 
389.14  base change. 
389.15     Sec. 81.  Minnesota Statutes 1998, section 256J.76, 
389.16  subdivision 2, is amended to read: 
389.17     Subd. 2.  [ALLOCATION OF COUNTY FUNDS.] (a) The 
389.18  commissioner shall determine and allocate the funds available to 
389.19  each county, on a calendar year basis, proportional to the 
389.20  amount paid to each county for fiscal year 1996, excluding the 
389.21  amount paid for local collaboratives under sections 245.4932 and 
389.22  256F.13.  For the period beginning July 1, 1997, and ending 
389.23  December 31, 1998, each county shall receive 150 percent of its 
389.24  base year allocation. 
389.25     (b) Beginning January 1, 2000, the commissioner shall 
389.26  allocate funds made available under this section on a calendar 
389.27  year basis to each county first, in amounts equal to each 
389.28  county's guaranteed floor as described in clause (1), second, to 
389.29  provide an allocation of up to $2,000 to each county as provided 
389.30  for in clause (2), and third, any remaining funds shall be 
389.31  allocated in proportion to the sum of each county's average 
389.32  monthly MFIP cases plus ten percent of each county's average 
389.33  monthly MFIP recipients with budgeted earnings as determined by 
389.34  the most recent calendar year data available. 
389.35     (1) Each county's guaranteed floor shall be calculated as 
389.36  follows: 
390.1      (i) 90 percent of that county's allocation in the preceding 
390.2   calendar year; or 
390.3      (ii) when the amount of funds available is less than the 
390.4   guaranteed floor, each county's allocation shall be equal to the 
390.5   previous calendar year allocation reduced by the same percentage 
390.6   that the statewide allocation was reduced. 
390.7      (2) Each county shall be allocated up to $2,000.  If, after 
390.8   application of the guaranteed floor, funds are insufficient to 
390.9   provide $2,000 per county, each county's allocation under this 
390.10  clause shall be an equal share of remaining funds available. 
390.11     Sec. 82.  Minnesota Statutes 1998, section 256J.76, 
390.12  subdivision 4, is amended to read: 
390.13     Subd. 4.  [REPORTING REQUIREMENT AND REIMBURSEMENT.] The 
390.14  commissioner shall specify requirements for reporting according 
390.15  to section 256.01, subdivision 2, paragraph (17).  Each county 
390.16  shall be reimbursed at a rate of 50 percent of eligible 
390.17  expenditures up to the limit of its allocation.  The 
390.18  commissioner shall regularly review each county's eligible 
390.19  expenditures compared to its allocation.  The commissioner may 
390.20  reallocate funds at any time, from counties which have not or 
390.21  will not have expended their allocations, to counties that have 
390.22  eligible expenditures in excess of their allocation. 
390.23     Sec. 83.  [STUDY OF EXTENSIONS TO 60-MONTH LIMIT.] 
390.24     By January 15, 2000, the commissioner of human services 
390.25  shall submit to the legislature recommendations regarding how to 
390.26  implement any extension of assistance to MFIP families that 
390.27  includes an adult caregiver who has received 60 months of cash 
390.28  assistance funded in whole or in part by the TANF block grant. 
390.29     Sec. 84.  [UNIVERSITY OF MINNESOTA MFIP PILOT PROJECT.] 
390.30     Notwithstanding Minnesota Statutes, section 256J.53, 
390.31  subdivision 1, job counselors may approve employment plans that 
390.32  include the University of Minnesota student parent MFIP 
390.33  program.  Plans must support participation in the program and 
390.34  require participants to accept the job guaranteed by the 
390.35  University of Minnesota, or a comparably paid job, at the end of 
390.36  the second year of education. 
391.1      Sec. 85.  [REVIEW OF MINNESOTA SUPPLEMENTAL AID SPECIAL 
391.2   DIET ALLOWANCE; REPORT.] 
391.3      The commissioner of human services shall review the 
391.4   Minnesota supplemental aid special diet allowance under 
391.5   Minnesota Statutes, section 256D.44, subdivision 5, and provide 
391.6   a report to the appropriate senate and house committee chairs by 
391.7   December 1, 1999, which contains updated special diet allowance 
391.8   rates. 
391.9      Sec. 86.  [MFIP WORKERS' COMPENSATION CLAIMS.] 
391.10     The commissioner of human services, with the assistance of 
391.11  the commissioner of labor and industry, shall provide the 
391.12  members of the senate and house policy committees having 
391.13  jurisdiction over issues related to the departments of human 
391.14  services and labor and industry with the number of MFIP 
391.15  participants who filed workers' compensation claims in fiscal 
391.16  year 1999.  The information is due by February 1, 2000. 
391.17     Sec. 87.  [REPEALER.] 
391.18     Minnesota Statutes 1998, sections 256D.051, subdivisions 6 
391.19  and 19; 256D.053, subdivision 4; 256J.03; 256J.30, subdivision 
391.20  6; 256J.53, subdivision 4; and 256J.62, subdivisions 2, 3, and 
391.21  5; and Laws 1997, chapter 85, article 1, section 63, are 
391.22  repealed. 
391.23                             ARTICLE 7
391.24                           CHILD SUPPORT
391.25     Section 1.  Minnesota Statutes 1998, section 256.87, 
391.26  subdivision 1a, is amended to read: 
391.27     Subd. 1a.  [CONTINUING SUPPORT CONTRIBUTIONS.] In addition 
391.28  to granting the county or state agency a money judgment, the 
391.29  court may, upon a motion or order to show cause, order 
391.30  continuing support contributions by a parent found able to 
391.31  reimburse the county or state agency.  The order shall be 
391.32  effective for the period of time during which the recipient 
391.33  receives public assistance from any county or state agency and 
391.34  thereafter.  The order shall require support according to 
391.35  chapter 518 and include the names and social security numbers of 
391.36  the father, mother, and the child or children.  An order for 
392.1   continuing contributions is reinstated without further hearing 
392.2   upon notice to the parent by any county or state agency that 
392.3   public assistance, as defined in section 256.741, is again being 
392.4   provided for the child of the parent.  The notice shall be in 
392.5   writing and shall indicate that the parent may request a hearing 
392.6   for modification of the amount of support or maintenance. 
392.7      Sec. 2.  Minnesota Statutes 1998, section 257.66, 
392.8   subdivision 3, is amended to read: 
392.9      Subd. 3.  [JUDGMENT; ORDER.] The judgment or order shall 
392.10  contain provisions concerning the duty of support, the custody 
392.11  of the child, the name of the child, the social security number 
392.12  of the mother, father, and child, if known at the time of 
392.13  adjudication, visitation privileges with the child, the 
392.14  furnishing of bond or other security for the payment of the 
392.15  judgment, or any other matter in the best interest of the 
392.16  child.  Custody and visitation and all subsequent motions 
392.17  related to them shall proceed and be determined under section 
392.18  257.541.  The remaining matters and all subsequent motions 
392.19  related to them shall proceed and be determined in accordance 
392.20  with chapter 518.  The judgment or order may direct the 
392.21  appropriate party to pay all or a proportion of the reasonable 
392.22  expenses of the mother's pregnancy and confinement, including 
392.23  the mother's lost wages due to medical necessity, after 
392.24  consideration of the relevant facts, including the relative 
392.25  financial means of the parents; the earning ability of each 
392.26  parent; and any health insurance policies held by either parent, 
392.27  or by a spouse or parent of the parent, which would provide 
392.28  benefits for the expenses incurred by the mother during her 
392.29  pregnancy and confinement.  Pregnancy and confinement expenses 
392.30  and genetic testing costs, submitted by the public authority, 
392.31  are admissible as evidence without third-party foundation 
392.32  testimony and constitute prima facie evidence of the amounts 
392.33  incurred for those services or for the genetic testing.  
392.34  Remedies available for the collection and enforcement of child 
392.35  support apply to confinement costs and are considered additional 
392.36  child support. 
393.1      Sec. 3.  Minnesota Statutes 1998, section 257.75, 
393.2   subdivision 2, is amended to read: 
393.3      Subd. 2.  [REVOCATION OF RECOGNITION.] A recognition may be 
393.4   revoked in a writing signed by the mother or father before a 
393.5   notary public and filed with the state registrar of vital 
393.6   statistics within the earlier of 30 60 days after the 
393.7   recognition is executed or the date of an administrative or 
393.8   judicial hearing relating to the child in which the revoking 
393.9   party is a party to the related action.  A joinder in a 
393.10  recognition may be revoked in a writing signed by the man who 
393.11  executed the joinder and filed with the state registrar of vital 
393.12  statistics within 30 60 days after the joinder is executed.  
393.13  Upon receipt of a revocation of the recognition of parentage or 
393.14  joinder in a recognition, the state registrar of vital 
393.15  statistics shall forward a copy of the revocation to the 
393.16  nonrevoking parent, or, in the case of a joinder in a 
393.17  recognition, to the mother and father who executed the 
393.18  recognition.  
393.19     Sec. 4.  Minnesota Statutes 1998, section 518.10, is 
393.20  amended to read: 
393.21     518.10 [REQUISITES OF PETITION.] 
393.22     The petition for dissolution of marriage or legal 
393.23  separation shall state and allege: 
393.24     (a) the name, address, and, in circumstances in which child 
393.25  support or spousal maintenance will be addressed, social 
393.26  security number of the petitioner and any prior or other name 
393.27  used by the petitioner; 
393.28     (b) the name and, if known, the address and, in 
393.29  circumstances in which child support or spousal maintenance will 
393.30  be addressed, social security number of the respondent and any 
393.31  prior or other name used by the respondent and known to the 
393.32  petitioner; 
393.33     (c) the place and date of the marriage of the parties; 
393.34     (d) in the case of a petition for dissolution, that either 
393.35  the petitioner or the respondent or both:  
393.36     (1) has resided in this state for not less than 180 days 
394.1   immediately preceding the commencement of the proceeding, or 
394.2      (2) has been a member of the armed services and has been 
394.3   stationed in this state for not less than 180 days immediately 
394.4   preceding the commencement of the proceeding, or 
394.5      (3) has been a domiciliary of this state for not less than 
394.6   180 days immediately preceding the commencement of the 
394.7   proceeding; 
394.8      (e) the name at the time of the petition and any prior or 
394.9   other name, social security number, age, and date of birth of 
394.10  each living minor or dependent child of the parties born before 
394.11  the marriage or born or adopted during the marriage and a 
394.12  reference to, and the expected date of birth of, a child of the 
394.13  parties conceived during the marriage but not born; 
394.14     (f) whether or not a separate proceeding for dissolution, 
394.15  legal separation, or custody is pending in a court in this state 
394.16  or elsewhere; 
394.17     (g) in the case of a petition for dissolution, that there 
394.18  has been an irretrievable breakdown of the marriage 
394.19  relationship; 
394.20     (h) in the case of a petition for legal separation, that 
394.21  there is a need for a decree of legal separation; 
394.22     (i) any temporary or permanent maintenance, child support, 
394.23  child custody, disposition of property, attorneys' fees, costs 
394.24  and disbursements applied for without setting forth the amounts; 
394.25  and 
394.26     (j) whether an order for protection under chapter 518B or a 
394.27  similar law of another state that governs the parties or a party 
394.28  and a minor child of the parties is in effect and, if so, the 
394.29  district court or similar jurisdiction in which it was entered. 
394.30     The petition shall be verified by the petitioner or 
394.31  petitioners, and its allegations established by competent 
394.32  evidence. 
394.33     Sec. 5.  Minnesota Statutes 1998, section 518.551, is 
394.34  amended by adding a subdivision to read: 
394.35     Subd. 15.  [LICENSE SUSPENSION.] (a) Upon motion of an 
394.36  obligee or the public authority, which has been properly served 
395.1   on the obligor by first class mail at the last known address or 
395.2   in person, and if at a hearing, the court finds that (1) the 
395.3   obligor is in arrears in court-ordered child support or 
395.4   maintenance payments, or both, in an amount equal to or greater 
395.5   than three times the obligor's total monthly support and 
395.6   maintenance payments and is not in compliance with a written 
395.7   payment agreement regarding both current support and arrearages, 
395.8   or (2) has failed, after receiving notice, to comply with a 
395.9   subpoena relating to a paternity or child support proceeding, 
395.10  the court may direct the commissioner of natural resources to 
395.11  suspend or bar receipt of the obligor's recreational license or 
395.12  licenses. 
395.13     (b) For purposes of this subdivision, a recreational 
395.14  license includes all licenses, permits, and stamps issued 
395.15  centrally by the commissioner of natural resources under 
395.16  sections 97B.301, 97B.401, 97B.501, 97B.515, 97B.601, 97B.715, 
395.17  97B.721, 97B.801, 97C.301, and 97C.305. 
395.18     (c) An obligor whose recreational license or licenses have 
395.19  been suspended or barred may provide proof to the court that the 
395.20  obligor is in compliance with all written payment agreements 
395.21  regarding both current support and arrearages.  Within 15 days 
395.22  of receipt of that proof, the court shall notify the 
395.23  commissioner of natural resources that the obligor's 
395.24  recreational license or licenses should no longer be suspended 
395.25  nor should receipt be barred. 
395.26     Sec. 6.  Minnesota Statutes 1998, section 518.5853, is 
395.27  amended by adding a subdivision to read: 
395.28     Subd. 11.  [COLLECTIONS UNIT RECOUPMENT ACCOUNT.] The 
395.29  commissioner of human services may establish a revolving account 
395.30  to cover funds issued in error due to insufficient funds or 
395.31  other reasons.  Appropriations for this purpose and all 
395.32  recoupments against payments from the account shall be deposited 
395.33  in the collections unit's recoupment account and are 
395.34  appropriated to the commissioner.  Any unexpended balance in the 
395.35  account does not cancel, but is available until expended. 
395.36     Sec. 7.  [CHILD SUPPORT ARREARAGE FORGIVENESS REPORT.] 
396.1      The commissioner of human services shall examine the 
396.2   feasibility of forgiving child support arrears in a fair and 
396.3   consistent manner and shall develop child support arrearage 
396.4   forgiveness policies to be used throughout the state.  Also, the 
396.5   commissioner shall explore the possibility of forwarding a 
396.6   portion of, or the entire amount of, the current child support 
396.7   payment to the custodial parent in order to bridge the child 
396.8   support with the family.  The information must be in a report to 
396.9   the chairs of the appropriate senate and house committees and 
396.10  their members by December 1, 1999. 
396.11                             ARTICLE 8
396.12                        CHILD PROTECTION AND 
396.13               RELATED MAXIMIZATION OF FEDERAL FUNDS 
396.14     Section 1.  Minnesota Statutes 1998, section 144.1761, 
396.15  subdivision 1, is amended to read: 
396.16     Subdivision 1.  [REQUEST.] (a) Whenever an adopted person 
396.17  requests the state registrar to disclose the information on the 
396.18  adopted person's original birth certificate, the state registrar 
396.19  shall act in accordance with the provisions of section 259.89. 
396.20     (b) The state registrar shall provide a copy of an adopted 
396.21  person's original birth certificate to an authorized 
396.22  representative of a federally recognized American Indian tribe 
396.23  for the sole purpose of determining the adopted person's 
396.24  eligibility for enrollment or membership.  Information contained 
396.25  on the birth certificate may not be used to provide the adopted 
396.26  person information about the person's birth parents except as 
396.27  provided in this section or section 259.83. 
396.28     Sec. 2.  Minnesota Statutes 1998, section 245A.30, is 
396.29  amended to read: 
396.30     245A.30 [LICENSING PROHIBITION FOR CERTAIN JUVENILE 
396.31  FACILITIES.] 
396.32     The commissioner may not: 
396.33     (1) issue any license under Minnesota Rules, parts 
396.34  9545.0905 to 9545.1125, for the residential placement of 
396.35  juveniles at a facility if the facility accepts juveniles who 
396.36  reside outside of Minnesota without an agreement with the entity 
397.1   placing the juvenile at the facility that obligates the entity 
397.2   to pay the educational and medical expenses of the juvenile; or 
397.3      (2) renew a license under Minnesota Rules, parts 9545.0905 
397.4   to 9545.1125, for the residential placement of juveniles if the 
397.5   facility accepts juveniles who reside outside of Minnesota 
397.6   without an agreement with the entity placing the juvenile at the 
397.7   facility that obligates the entity to pay the educational and 
397.8   medical expenses of the juvenile. 
397.9      <i>(Effective Date:  Section 2 (245A.30) is effective July 1,</i> 
397.10  <i>2000.)</i> 
397.11     Sec. 3.  [254A.175] [CHEMICAL DEPENDENCY TREATMENT MODELS 
397.12  FOR FAMILIES WITH POTENTIAL CHILD PROTECTION PROBLEMS.] 
397.13     The commissioner shall explore and experiment with 
397.14  different chemical dependency service models for parents with 
397.15  children who are found to be in need of chemical dependency 
397.16  treatment pursuant to an assessment under section 626.556, 
397.17  subdivision 10, or a case plan under section 257.071 or 260.191, 
397.18  subdivision 1e.  The commissioner shall tailor services to 
397.19  better serve this high-risk population, which may include 
397.20  long-term treatment that allows the children to stay with the 
397.21  parent at the treatment facility. 
397.22     Sec. 4.  Minnesota Statutes 1998, section 254B.04, 
397.23  subdivision 1, is amended to read: 
397.24     Subdivision 1.  [ELIGIBILITY.] (a) Persons eligible for 
397.25  benefits under Code of Federal Regulations, title 25, part 20, 
397.26  persons eligible for medical assistance benefits under sections 
397.27  256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, 
397.28  or who meet the income standards of section 256B.056, 
397.29  subdivision 4, and persons eligible for general assistance 
397.30  medical care under section 256D.03, subdivision 3, are entitled 
397.31  to chemical dependency fund services.  State money appropriated 
397.32  for this paragraph must be placed in a separate account 
397.33  established for this purpose.  
397.34     Persons with dependent children who are determined to be in 
397.35  need of chemical dependency treatment pursuant to an assessment 
397.36  under section 626.556, subdivision 10, or a case plan under 
398.1   section 257.071 or 260.191, subdivision 1e, shall be assisted by 
398.2   the local agency to access needed treatment services.  Treatment 
398.3   services must be appropriate for the individual or family, which 
398.4   may include long-term care treatment or treatment in a facility 
398.5   that allows the dependent children to stay in the treatment 
398.6   facility.  The county shall pay for out-of-home placement costs, 
398.7   if applicable. 
398.8      (b) A person not entitled to services under paragraph (a), 
398.9   but with family income that is less than 60 percent of the state 
398.10  median income for a family of like size and composition, shall 
398.11  be eligible to receive chemical dependency fund services within 
398.12  the limit of funds available after persons entitled to services 
398.13  under paragraph (a) have been served.  If notified by the state 
398.14  agency of limited funds, a county must give preferential 
398.15  treatment to persons with dependent children who are in need of 
398.16  chemical dependency treatment pursuant to an assessment under 
398.17  section 626.556, subdivision 10, or a case plan under section 
398.18  257.071 or 260.191, subdivision 1e.  A county may spend money 
398.19  from its own sources to serve persons under this paragraph.  
398.20  State money appropriated for this paragraph must be placed in a 
398.21  separate account established for this purpose. 
398.22     (c) Persons whose income is between 60 percent and 115 
398.23  percent of the state median income shall be eligible for 
398.24  chemical dependency services on a sliding fee basis, within the 
398.25  limit of funds available, after persons entitled to services 
398.26  under paragraph (a) and persons eligible for services under 
398.27  paragraph (b) have been served.  Persons eligible under this 
398.28  paragraph must contribute to the cost of services according to 
398.29  the sliding fee scale established under subdivision 3.  A county 
398.30  may spend money from its own sources to provide services to 
398.31  persons under this paragraph.  State money appropriated for this 
398.32  paragraph must be placed in a separate account established for 
398.33  this purpose. 
398.34     Sec. 5.  Minnesota Statutes 1998, section 256.01, 
398.35  subdivision 2, is amended to read: 
398.36     Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
399.1   section 241.021, subdivision 2, the commissioner of human 
399.2   services shall: 
399.3      (1) Administer and supervise all forms of public assistance 
399.4   provided for by state law and other welfare activities or 
399.5   services as are vested in the commissioner.  Administration and 
399.6   supervision of human services activities or services includes, 
399.7   but is not limited to, assuring timely and accurate distribution 
399.8   of benefits, completeness of service, and quality program 
399.9   management.  In addition to administering and supervising human 
399.10  services activities vested by law in the department, the 
399.11  commissioner shall have the authority to: 
399.12     (a) require county agency participation in training and 
399.13  technical assistance programs to promote compliance with 
399.14  statutes, rules, federal laws, regulations, and policies 
399.15  governing human services; 
399.16     (b) monitor, on an ongoing basis, the performance of county 
399.17  agencies in the operation and administration of human services, 
399.18  enforce compliance with statutes, rules, federal laws, 
399.19  regulations, and policies governing welfare services and promote 
399.20  excellence of administration and program operation; 
399.21     (c) develop a quality control program or other monitoring 
399.22  program to review county performance and accuracy of benefit 
399.23  determinations; 
399.24     (d) require county agencies to make an adjustment to the 
399.25  public assistance benefits issued to any individual consistent 
399.26  with federal law and regulation and state law and rule and to 
399.27  issue or recover benefits as appropriate; 
399.28     (e) delay or deny payment of all or part of the state and 
399.29  federal share of benefits and administrative reimbursement 
399.30  according to the procedures set forth in section 256.017; 
399.31     (f) make contracts with and grants to public and private 
399.32  agencies and organizations, both profit and nonprofit, and 
399.33  individuals, using appropriated funds; and 
399.34     (g) enter into contractual agreements with federally 
399.35  recognized Indian tribes with a reservation in Minnesota to the 
399.36  extent necessary for the tribe to operate a federally approved 
400.1   family assistance program or any other program under the 
400.2   supervision of the commissioner.  The commissioner shall consult 
400.3   with the affected county or counties in the contractual 
400.4   agreement negotiations, if the county or counties wish to be 
400.5   included, in order to avoid the duplication of county and tribal 
400.6   assistance program services.  The commissioner may establish 
400.7   necessary accounts for the purposes of receiving and disbursing 
400.8   funds as necessary for the operation of the programs. 
400.9      (2) Inform county agencies, on a timely basis, of changes 
400.10  in statute, rule, federal law, regulation, and policy necessary 
400.11  to county agency administration of the programs. 
400.12     (3) Administer and supervise all child welfare activities; 
400.13  promote the enforcement of laws protecting handicapped, 
400.14  dependent, neglected and delinquent children, and children born 
400.15  to mothers who were not married to the children's fathers at the 
400.16  times of the conception nor at the births of the children; 
400.17  license and supervise child-caring and child-placing agencies 
400.18  and institutions; supervise the care of children in boarding and 
400.19  foster homes or in private institutions; and generally perform 
400.20  all functions relating to the field of child welfare now vested 
400.21  in the state board of control. 
400.22     (4) Administer and supervise all noninstitutional service 
400.23  to handicapped persons, including those who are visually 
400.24  impaired, hearing impaired, or physically impaired or otherwise 
400.25  handicapped.  The commissioner may provide and contract for the 
400.26  care and treatment of qualified indigent children in facilities 
400.27  other than those located and available at state hospitals when 
400.28  it is not feasible to provide the service in state hospitals. 
400.29     (5) Assist and actively cooperate with other departments, 
400.30  agencies and institutions, local, state, and federal, by 
400.31  performing services in conformity with the purposes of Laws 
400.32  1939, chapter 431. 
400.33     (6) Act as the agent of and cooperate with the federal 
400.34  government in matters of mutual concern relative to and in 
400.35  conformity with the provisions of Laws 1939, chapter 431, 
400.36  including the administration of any federal funds granted to the 
401.1   state to aid in the performance of any functions of the 
401.2   commissioner as specified in Laws 1939, chapter 431, and 
401.3   including the promulgation of rules making uniformly available 
401.4   medical care benefits to all recipients of public assistance, at 
401.5   such times as the federal government increases its participation 
401.6   in assistance expenditures for medical care to recipients of 
401.7   public assistance, the cost thereof to be borne in the same 
401.8   proportion as are grants of aid to said recipients. 
401.9      (7) Establish and maintain any administrative units 
401.10  reasonably necessary for the performance of administrative 
401.11  functions common to all divisions of the department. 
401.12     (8) Act as designated guardian of both the estate and the 
401.13  person of all the wards of the state of Minnesota, whether by 
401.14  operation of law or by an order of court, without any further 
401.15  act or proceeding whatever, except as to persons committed as 
401.16  mentally retarded.  For children under the guardianship of the 
401.17  commissioner whose interests would be best served by adoptive 
401.18  placement, the commissioner may contract with a licensed 
401.19  child-placing agency to provide adoption services.  A contract 
401.20  with a licensed child-placing agency must be designed to 
401.21  supplement existing county efforts and may not replace existing 
401.22  county programs, unless the replacement is agreed to by the 
401.23  county board and the appropriate exclusive bargaining 
401.24  representative or the commissioner has evidence that child 
401.25  placements of the county continue to be substantially below that 
401.26  of other counties.  Funds encumbered and obligated under an 
401.27  agreement for a specific child shall remain available until the 
401.28  terms of the agreement are fulfilled or the agreement is 
401.29  terminated. 
401.30     (9) Act as coordinating referral and informational center 
401.31  on requests for service for newly arrived immigrants coming to 
401.32  Minnesota. 
401.33     (10) The specific enumeration of powers and duties as 
401.34  hereinabove set forth shall in no way be construed to be a 
401.35  limitation upon the general transfer of powers herein contained. 
401.36     (11) Establish county, regional, or statewide schedules of 
402.1   maximum fees and charges which may be paid by county agencies 
402.2   for medical, dental, surgical, hospital, nursing and nursing 
402.3   home care and medicine and medical supplies under all programs 
402.4   of medical care provided by the state and for congregate living 
402.5   care under the income maintenance programs. 
402.6      (12) Have the authority to conduct and administer 
402.7   experimental projects to test methods and procedures of 
402.8   administering assistance and services to recipients or potential 
402.9   recipients of public welfare.  To carry out such experimental 
402.10  projects, it is further provided that the commissioner of human 
402.11  services is authorized to waive the enforcement of existing 
402.12  specific statutory program requirements, rules, and standards in 
402.13  one or more counties.  The order establishing the waiver shall 
402.14  provide alternative methods and procedures of administration, 
402.15  shall not be in conflict with the basic purposes, coverage, or 
402.16  benefits provided by law, and in no event shall the duration of 
402.17  a project exceed four years.  It is further provided that no 
402.18  order establishing an experimental project as authorized by the 
402.19  provisions of this section shall become effective until the 
402.20  following conditions have been met: 
402.21     (a) The secretary of health, education, and welfare of the 
402.22  United States has agreed, for the same project, to waive state 
402.23  plan requirements relative to statewide uniformity. 
402.24     (b) A comprehensive plan, including estimated project 
402.25  costs, shall be approved by the legislative advisory commission 
402.26  and filed with the commissioner of administration.  
402.27     (13) According to federal requirements, establish 
402.28  procedures to be followed by local welfare boards in creating 
402.29  citizen advisory committees, including procedures for selection 
402.30  of committee members. 
402.31     (14) Allocate federal fiscal disallowances or sanctions 
402.32  which are based on quality control error rates for the aid to 
402.33  families with dependent children, Minnesota family investment 
402.34  program-statewide, medical assistance, or food stamp program in 
402.35  the following manner:  
402.36     (a) One-half of the total amount of the disallowance shall 
403.1   be borne by the county boards responsible for administering the 
403.2   programs.  For the medical assistance, MFIP-S, and AFDC 
403.3   programs, disallowances shall be shared by each county board in 
403.4   the same proportion as that county's expenditures for the 
403.5   sanctioned program are to the total of all counties' 
403.6   expenditures for the AFDC, MFIP-S, and medical assistance 
403.7   programs.  For the food stamp program, sanctions shall be shared 
403.8   by each county board, with 50 percent of the sanction being 
403.9   distributed to each county in the same proportion as that 
403.10  county's administrative costs for food stamps are to the total 
403.11  of all food stamp administrative costs for all counties, and 50 
403.12  percent of the sanctions being distributed to each county in the 
403.13  same proportion as that county's value of food stamp benefits 
403.14  issued are to the total of all benefits issued for all 
403.15  counties.  Each county shall pay its share of the disallowance 
403.16  to the state of Minnesota.  When a county fails to pay the 
403.17  amount due hereunder, the commissioner may deduct the amount 
403.18  from reimbursement otherwise due the county, or the attorney 
403.19  general, upon the request of the commissioner, may institute 
403.20  civil action to recover the amount due. 
403.21     (b) Notwithstanding the provisions of paragraph (a), if the 
403.22  disallowance results from knowing noncompliance by one or more 
403.23  counties with a specific program instruction, and that knowing 
403.24  noncompliance is a matter of official county board record, the 
403.25  commissioner may require payment or recover from the county or 
403.26  counties, in the manner prescribed in paragraph (a), an amount 
403.27  equal to the portion of the total disallowance which resulted 
403.28  from the noncompliance, and may distribute the balance of the 
403.29  disallowance according to paragraph (a).  
403.30     (15) Develop and implement special projects that maximize 
403.31  reimbursements and result in the recovery of money to the 
403.32  state.  For the purpose of recovering state money, the 
403.33  commissioner may enter into contracts with third parties.  Any 
403.34  recoveries that result from projects or contracts entered into 
403.35  under this paragraph shall be deposited in the state treasury 
403.36  and credited to a special account until the balance in the 
404.1   account reaches $1,000,000.  When the balance in the account 
404.2   exceeds $1,000,000, the excess shall be transferred and credited 
404.3   to the general fund.  All money in the account is appropriated 
404.4   to the commissioner for the purposes of this paragraph. 
404.5      (16) Have the authority to make direct payments to 
404.6   facilities providing shelter to women and their children 
404.7   according to section 256D.05, subdivision 3.  Upon the written 
404.8   request of a shelter facility that has been denied payments 
404.9   under section 256D.05, subdivision 3, the commissioner shall 
404.10  review all relevant evidence and make a determination within 30 
404.11  days of the request for review regarding issuance of direct 
404.12  payments to the shelter facility.  Failure to act within 30 days 
404.13  shall be considered a determination not to issue direct payments.
404.14     (17) Have the authority to establish and enforce the 
404.15  following county reporting requirements:  
404.16     (a) The commissioner shall establish fiscal and statistical 
404.17  reporting requirements necessary to account for the expenditure 
404.18  of funds allocated to counties for human services programs.  
404.19  When establishing financial and statistical reporting 
404.20  requirements, the commissioner shall evaluate all reports, in 
404.21  consultation with the counties, to determine if the reports can 
404.22  be simplified or the number of reports can be reduced. 
404.23     (b) The county board shall submit monthly or quarterly 
404.24  reports to the department as required by the commissioner.  
404.25  Monthly reports are due no later than 15 working days after the 
404.26  end of the month.  Quarterly reports are due no later than 30 
404.27  calendar days after the end of the quarter, unless the 
404.28  commissioner determines that the deadline must be shortened to 
404.29  20 calendar days to avoid jeopardizing compliance with federal 
404.30  deadlines or risking a loss of federal funding.  Only reports 
404.31  that are complete, legible, and in the required format shall be 
404.32  accepted by the commissioner.  
404.33     (c) If the required reports are not received by the 
404.34  deadlines established in clause (b), the commissioner may delay 
404.35  payments and withhold funds from the county board until the next 
404.36  reporting period.  When the report is needed to account for the 
405.1   use of federal funds and the late report results in a reduction 
405.2   in federal funding, the commissioner shall withhold from the 
405.3   county boards with late reports an amount equal to the reduction 
405.4   in federal funding until full federal funding is received.  
405.5      (d) A county board that submits reports that are late, 
405.6   illegible, incomplete, or not in the required format for two out 
405.7   of three consecutive reporting periods is considered 
405.8   noncompliant.  When a county board is found to be noncompliant, 
405.9   the commissioner shall notify the county board of the reason the 
405.10  county board is considered noncompliant and request that the 
405.11  county board develop a corrective action plan stating how the 
405.12  county board plans to correct the problem.  The corrective 
405.13  action plan must be submitted to the commissioner within 45 days 
405.14  after the date the county board received notice of noncompliance.
405.15     (e) The final deadline for fiscal reports or amendments to 
405.16  fiscal reports is one year after the date the report was 
405.17  originally due.  If the commissioner does not receive a report 
405.18  by the final deadline, the county board forfeits the funding 
405.19  associated with the report for that reporting period and the 
405.20  county board must repay any funds associated with the report 
405.21  received for that reporting period. 
405.22     (f) The commissioner may not delay payments, withhold 
405.23  funds, or require repayment under paragraph (c) or (e) if the 
405.24  county demonstrates that the commissioner failed to provide 
405.25  appropriate forms, guidelines, and technical assistance to 
405.26  enable the county to comply with the requirements.  If the 
405.27  county board disagrees with an action taken by the commissioner 
405.28  under paragraph (c) or (e), the county board may appeal the 
405.29  action according to sections 14.57 to 14.69. 
405.30     (g) Counties subject to withholding of funds under 
405.31  paragraph (c) or forfeiture or repayment of funds under 
405.32  paragraph (e) shall not reduce or withhold benefits or services 
405.33  to clients to cover costs incurred due to actions taken by the 
405.34  commissioner under paragraph (c) or (e). 
405.35     (18) Allocate federal fiscal disallowances or sanctions for 
405.36  audit exceptions when federal fiscal disallowances or sanctions 
406.1   are based on a statewide random sample for the foster care 
406.2   program under title IV-E of the Social Security Act, United 
406.3   States Code, title 42, in direct proportion to each county's 
406.4   title IV-E foster care maintenance claim for that period. 
406.5      (19) Be responsible for ensuring the detection, prevention, 
406.6   investigation, and resolution of fraudulent activities or 
406.7   behavior by applicants, recipients, and other participants in 
406.8   the human services programs administered by the department. 
406.9      (20) Require county agencies to identify overpayments, 
406.10  establish claims, and utilize all available and cost-beneficial 
406.11  methodologies to collect and recover these overpayments in the 
406.12  human services programs administered by the department. 
406.13     (21) Have the authority to administer a drug rebate program 
406.14  for drugs purchased pursuant to the senior citizen drug program 
406.15  established under section 256.955 after the beneficiary's 
406.16  satisfaction of any deductible established in the program.  The 
406.17  commissioner shall require a rebate agreement from all 
406.18  manufacturers of covered drugs as defined in section 256B.0625, 
406.19  subdivision 13.  For each drug, the amount of the rebate shall 
406.20  be equal to the basic rebate as defined for purposes of the 
406.21  federal rebate program in United States Code, title 42, section 
406.22  1396r-8(c)(1).  This basic rebate shall be applied to 
406.23  single-source and multiple-source drugs.  The manufacturers must 
406.24  provide full payment within 30 days of receipt of the state 
406.25  invoice for the rebate within the terms and conditions used for 
406.26  the federal rebate program established pursuant to section 1927 
406.27  of title XIX of the Social Security Act.  The manufacturers must 
406.28  provide the commissioner with any information necessary to 
406.29  verify the rebate determined per drug.  The rebate program shall 
406.30  utilize the terms and conditions used for the federal rebate 
406.31  program established pursuant to section 1927 of title XIX of the 
406.32  Social Security Act. 
406.33     Sec. 6.  Minnesota Statutes 1998, section 256B.0625, is 
406.34  amended by adding a subdivision to read: 
406.35     Subd. 41.  [RESIDENTIAL SERVICES FOR CHILDREN WITH SEVERE 
406.36  EMOTIONAL DISTURBANCE.] Medical assistance covers rehabilitative 
407.1   services in accordance with section 256B.0945 that are provided 
407.2   by a county through a residential facility, for children who 
407.3   have been diagnosed with severe emotional disturbance and have 
407.4   been determined to require the level of care provided in a 
407.5   residential facility. 
407.6      <i>(Effective Date:  Section 6 (256B.0625, adding subdivision</i> 
407.7   <i>41) is effective July 1, 2000.)</i> 
407.8      Sec. 7.  Minnesota Statutes 1998, section 256B.094, 
407.9   subdivision 3, is amended to read: 
407.10     Subd. 3.  [COORDINATION AND PROVISION OF SERVICES.] (a) In 
407.11  a county or reservation where a prepaid medical assistance 
407.12  provider has contracted under section 256B.031 or 256B.69 to 
407.13  provide mental health services, the case management provider 
407.14  shall coordinate with the prepaid provider to ensure that all 
407.15  necessary mental health services required under the contract are 
407.16  provided to recipients of case management services. 
407.17     (b) When the case management provider determines that a 
407.18  prepaid provider is not providing mental health services as 
407.19  required under the contract, the case management provider shall 
407.20  assist the recipient to appeal the prepaid provider's denial 
407.21  pursuant to section 256.045, and may make other arrangements for 
407.22  provision of the covered services.  
407.23     (c) The case management provider may bill the provider of 
407.24  prepaid health care services for any mental health services 
407.25  provided to a recipient of case management services which the 
407.26  county or tribal social services arranges for or provides and 
407.27  which are included in the prepaid provider's contract, and which 
407.28  were determined to be medically necessary as a result of an 
407.29  appeal pursuant to section 256.045.  The prepaid provider must 
407.30  reimburse the mental health provider, at the prepaid provider's 
407.31  standard rate for that service, for any services delivered under 
407.32  this subdivision. 
407.33     (d) If the county or tribal social services has not 
407.34  obtained prior authorization for this service, or an appeal 
407.35  results in a determination that the services were not medically 
407.36  necessary, the county or tribal social services may not seek 
408.1   reimbursement from the prepaid provider.  
408.2      Sec. 8.  Minnesota Statutes 1998, section 256B.094, 
408.3   subdivision 5, is amended to read: 
408.4      Subd. 5.  [CASE MANAGER.] To provide case management 
408.5   services, a case manager must be employed or contracted by and 
408.6   authorized by the case management provider to provide case 
408.7   management services and meet all requirements under section 
408.8   256F.10. 
408.9      Sec. 9.  Minnesota Statutes 1998, section 256B.094, 
408.10  subdivision 6, is amended to read: 
408.11     Subd. 6.  [MEDICAL ASSISTANCE REIMBURSEMENT OF CASE 
408.12  MANAGEMENT SERVICES.] (a) Medical assistance reimbursement for 
408.13  services under this section shall be made on a monthly basis.  
408.14  Payment is based on face-to-face or telephone contacts between 
408.15  the case manager and the client, client's family, primary 
408.16  caregiver, legal representative, or other relevant person 
408.17  identified as necessary to the development or implementation of 
408.18  the goals of the individual service plan regarding the status of 
408.19  the client, the individual service plan, or the goals for the 
408.20  client.  These contacts must meet the minimum standards in 
408.21  clauses (1) and (2):  
408.22     (1) there must be a face-to-face contact at least once a 
408.23  month except as provided in clause (2); and 
408.24     (2) for a client placed outside of the county of financial 
408.25  responsibility in an excluded time facility under section 
408.26  256G.02, subdivision 6, or through the Interstate Compact on the 
408.27  Placement of Children, section 257.40, and the placement in 
408.28  either case is more than 60 miles beyond the county or 
408.29  reservation boundaries, there must be at least one contact per 
408.30  month and not more than two consecutive months without a 
408.31  face-to-face contact. 
408.32     (b) Except as provided in paragraph (c), the payment rate 
408.33  is established using time study data on activities of provider 
408.34  service staff and reports required under sections 245.482, 
408.35  256.01, subdivision 2, paragraph (17), and 256E.08, subdivision 
408.36  8. 
409.1      (c) For tribes, payment may be in accordance with section 
409.2   256B.0625 for child welfare targeted case management provided by 
409.3   Indian health services and facilities operated by a tribe or 
409.4   tribal organization. 
409.5      (d) Payment for case management provided by vendors 
409.6   contracted by the county or by tribal social services shall be 
409.7   based on a monthly rate negotiated by the host county or tribal 
409.8   social services.  The negotiated rate must not exceed the rate 
409.9   charged by the vendor for the same service to other payers.  If 
409.10  the service is provided by a team of contracted vendors, the 
409.11  county or tribal social services may negotiate a team rate with 
409.12  a vendor who is a member of the team.  The team shall determine 
409.13  how to distribute the rate among its members.  No reimbursement 
409.14  received by contracted vendors shall be returned to the county 
409.15  or tribal social services, except to reimburse the county or 
409.16  tribal social services for advance funding provided by the 
409.17  county or tribal social services to the vendor. 
409.18     (e) If the service is provided by a team that includes 
409.19  contracted vendors and county or tribal social services staff, 
409.20  the costs for county or tribal social services staff 
409.21  participation in the team shall be included in the rate for 
409.22  county or tribal social services-provided services.  In this 
409.23  case, the contracted vendor and the county or tribal social 
409.24  services may each receive separate payment for services provided 
409.25  by each entity in the same month.  In order to prevent 
409.26  duplication of services, each entity must document, in the 
409.27  recipient's file, the need for team case management and a 
409.28  description of the roles and services of the team members. 
409.29     Separate payment rates may be established for different 
409.30  groups of providers to maximize reimbursement as determined by 
409.31  the commissioner.  The payment rate will be reviewed annually 
409.32  and revised periodically to be consistent with the most recent 
409.33  time study and other data.  Payment for services will be made 
409.34  upon submission of a valid claim and verification of proper 
409.35  documentation described in subdivision 7.  Federal 
409.36  administrative revenue earned through the time study or other 
410.1   method of reimbursement under paragraph (c) shall be distributed 
410.2   according to earnings, to counties, reservations, or groups of 
410.3   counties or reservations which have the same payment rate under 
410.4   this subdivision, and to the group of counties or reservations 
410.5   which are not certified providers under section 256F.10.  The 
410.6   commissioner shall modify the requirements set out in Minnesota 
410.7   Rules, parts 9550.0300 to 9550.0370, as necessary to accomplish 
410.8   this. 
410.9      Sec. 10.  [256B.0945] [RESIDENTIAL SERVICES FOR CHILDREN 
410.10  WITH SEVERE EMOTIONAL DISTURBANCE.] 
410.11     Subdivision 1.  [PROVIDER QUALIFICATIONS.] Counties must 
410.12  arrange to provide residential services for children with severe 
410.13  emotional disturbance according to section 245.4882 and this 
410.14  section.  Services must be provided by a facility that is 
410.15  licensed according to section 245.4882 and administrative rules 
410.16  promulgated thereunder, and under contract with the county. 
410.17  Facilities providing services under subdivision 2, paragraph(a), 
410.18  must be accredited as a psychiatric facility by the Joint 
410.19  Commission on Accreditation of Healthcare Organizations, the 
410.20  Commission on Accreditation of Rehabilitation Facilities, or the 
410.21  Council on Accreditation.  Accreditation is not required for 
410.22  facilities providing services under subdivision 2, paragraph (b).
410.23     Subd. 2.  [COVERED SERVICES.] All services must be included 
410.24  in a child's individualized treatment or collaborative family 
410.25  service plan as defined in chapter 245.  
410.26     (a) For facilities that are institutions for mental 
410.27  diseases according to statute and regulation or are not 
410.28  institutions for mental diseases but choose to provide services 
410.29  under this paragraph, medical assistance covers the full 
410.30  contract rate, including room and board if the services meet the 
410.31  requirements of Code of Federal Regulations, title 42, section 
410.32  440.160.  
410.33     (b) For facilities that are not institutions for mental 
410.34  diseases according to federal statute and regulation and are not 
410.35  providing services under paragraph (a), medical assistance 
410.36  covers mental health related services that are required to be 
411.1   provided by a residential facility under section 245.4882 and 
411.2   administrative rules promulgated thereunder, except for room and 
411.3   board. 
411.4      Subd. 3.  [CENTRALIZED DISBURSEMENT OF MEDICAL ASSISTANCE 
411.5   PAYMENTS.] Notwithstanding section 256B.041, county payments for 
411.6   the cost of residential services provided under this section 
411.7   shall not be made to the state treasurer. 
411.8      Subd. 4.  [PAYMENT RATES.] (a) Notwithstanding sections 
411.9   256.025, subdivision 2; 256B.19; and 256B.041, payments to 
411.10  counties for residential services provided by a residential 
411.11  facility shall only be made of federal earnings for services 
411.12  provided under this section, and the nonfederal share of costs 
411.13  for services provided under this section shall be paid by the 
411.14  county from sources other than federal funds or funds used to 
411.15  match other federal funds.  Total annual payments for federal 
411.16  earnings shall not exceed the federal medical assistance 
411.17  percentage matching rate multiplied by the total county 
411.18  expenditures for services provided under section 245.4882 for 
411.19  either (1) the calendar year 1999 or (2) the average annual 
411.20  expenditures for the calendar years 1995 to 1999, whichever is 
411.21  greater.  Payment to counties for services provided according to 
411.22  subdivision 2, paragraph (a), shall be the federal share of the 
411.23  contract rate.  Payment to counties for services provided 
411.24  according to subdivision 2, paragraph (b), shall be a proportion 
411.25  of the per day contract rate that relates to rehabilitative 
411.26  mental health services and shall not include payment for costs 
411.27  or services that are billed to the IV-E program as room and 
411.28  board.  
411.29     (b) The commissioner shall set aside a portion of the 
411.30  federal funds earned under this section to cover the state costs 
411.31  of two staff positions and support costs necessary in 
411.32  administering this section.  Any unexpended funds from the 
411.33  set-aside shall be distributed to the counties in proportion to 
411.34  their earnings under this section. 
411.35     Subd. 5.  [QUALITY MEASURES.] Counties must collect and 
411.36  report to the commissioner information on outcomes for services 
412.1   provided under this section using standardized tools that 
412.2   measure functioning, living stability, and parent and child 
412.3   satisfaction consistent with the goals of sections 245.4876, 
412.4   subdivision 1, and 256F.01.  The commissioner shall designate 
412.5   standardized tools to be used and shall collect and analyze 
412.6   individualized outcome data on a statewide basis and report to 
412.7   the legislature by December 1, 2003.  The commissioner shall 
412.8   provide standardized tools that measure child and adolescent 
412.9   functional assessment for intake and discharge, child behavior, 
412.10  residential living environment and placement stability, and 
412.11  satisfaction for youth and family members. 
412.12     Subd. 6.  [FEDERAL EARNINGS.] Use of new federal funding 
412.13  earned from services provided under this section is limited to:  
412.14     (1) increasing prevention and early intervention and 
412.15  supportive services to meet the mental health and child welfare 
412.16  needs of the children and families in the system of care; 
412.17     (2) replacing reductions in federal IV-E reimbursement 
412.18  resulting from new medical assistance coverage; and 
412.19     (3) paying the nonfederal share of additional provider 
412.20  costs due to accreditation and new program standards necessary 
412.21  for Medicaid reimbursement.  
412.22  For purposes of this section, early intervention and supportive 
412.23  services include alternative responses to child maltreatment 
412.24  reports under chapter 626 and services outlined in sections 
412.25  245.4875, subdivision 2, children's mental health, and 256F.05, 
412.26  subdivision 8, family preservation services.  
412.27     Subd. 7.  [MAINTENANCE OF EFFORT.] (a) Counties that 
412.28  receive payment under this section must maintain a level of 
412.29  expenditures such that each year's county expenditures for early 
412.30  intervention and supportive services is at least equal to that 
412.31  county's average expenditures for those services for calendar 
412.32  years 1998 and 1999.  For purposes of this section, "county 
412.33  expenditures" are the total expenditures for those services 
412.34  minus the state and federal revenues specifically designated for 
412.35  these services. 
412.36     (b) The commissioner may waive the requirements in 
413.1   paragraph (a) if any of the conditions specified in section 
413.2   256F.13, subdivision 1, paragraph (a), clause (4), items (i) to 
413.3   (iv), are met.  
413.4      Subd. 8.  [REPORTS.] The commissioner shall review county 
413.5   expenditures annually using reports required under sections 
413.6   245.482; 256.01, subdivision 2, clause (17); and 256E.08, 
413.7   subdivision 8, to ensure that counties meet their obligation 
413.8   under subdivision 7, and that the base level of expenditures for 
413.9   mental health and child welfare early intervention and family 
413.10  support services and children's mental health residential 
413.11  treatment is continued from sources other than federal funds 
413.12  earned under this section. 
413.13     Subd. 9.  [SANCTIONS.] The commissioner may suspend, 
413.14  reduce, or terminate the federal reimbursement to a county that 
413.15  does not meet one or all of the requirements of this section. 
413.16     Subd. 10.  [RECOMMENDATIONS.] The commissioner shall 
413.17  provide recommendations to the legislature by January 15, 2000, 
413.18  regarding any amendments to this section that may be necessary 
413.19  or advisable prior to implementation. 
413.20     <i>(Effective Date:  Section 10 (256B.0945) is effective July</i> 
413.21  <i>1, 2000.)</i> 
413.22     Sec. 11.  Minnesota Statutes 1998, section 256F.03, 
413.23  subdivision 5, is amended to read: 
413.24     Subd. 5.  [FAMILY-BASED SERVICES.] "Family-based services" 
413.25  means one or more of the services described in paragraphs (a) 
413.26  to (f) (e) provided to families primarily in their own home for 
413.27  a limited time.  
413.28     (a)  [CRISIS SERVICES.] "Crisis services" means 
413.29  professional services provided within 24 hours of referral to 
413.30  alleviate a family crisis and to offer an alternative to placing 
413.31  a child outside the family home.  The services are intensive and 
413.32  time limited.  The service may offer transition to other 
413.33  appropriate community-based services. 
413.34     (b)  [COUNSELING SERVICES.] "Counseling services" means 
413.35  professional family counseling provided to alleviate individual 
413.36  and family dysfunction; provide an alternative to placing a 
414.1   child outside the family home; or permit a child to return 
414.2   home.  The duration, frequency, and intensity of the service is 
414.3   determined in the individual or family service plan. 
414.4      (c)  [LIFE MANAGEMENT SKILLS SERVICES.] "Life management 
414.5   skills services" means paraprofessional services that teach 
414.6   family members skills in such areas as parenting, budgeting, 
414.7   home management, and communication.  The goal is to strengthen 
414.8   family skills as an alternative to placing a child outside the 
414.9   family home or to permit a child to return home.  A social 
414.10  worker shall coordinate these services within the family case 
414.11  plan. 
414.12     (d)  [CASE COORDINATION SERVICES.] "Case coordination 
414.13  services" means professional services provided to an individual, 
414.14  family, or caretaker as an alternative to placing a child 
414.15  outside the family home, to permit a child to return home, or to 
414.16  stabilize the long-term or permanent placement of a child.  
414.17  Coordinated services are provided directly, are arranged, or are 
414.18  monitored to meet the needs of a child and family.  The 
414.19  duration, frequency, and intensity of services is determined in 
414.20  the individual or family service plan. 
414.21     (e)  [MENTAL HEALTH SERVICES.] "Mental health services" 
414.22  means the professional services defined in section 245.4871, 
414.23  subdivision 31. 
414.24     (f) (e)  [EARLY INTERVENTION SERVICES.] "Early intervention 
414.25  services" means family-based intervention services designed to 
414.26  help at-risk families avoid crisis situations. 
414.27     Sec. 12.  Minnesota Statutes 1998, section 256F.05, 
414.28  subdivision 8, is amended to read: 
414.29     Subd. 8.  [USES OF FAMILY PRESERVATION FUND GRANTS.] (a) A 
414.30  county which has not demonstrated that year that its family 
414.31  preservation core services are developed as provided in 
414.32  subdivision 1a, must use its family preservation fund grant 
414.33  exclusively for family preservation services defined in section 
414.34  256F.03, subdivision 5, paragraphs (a), (b), (c), and (e) (d). 
414.35     (b) A county which has demonstrated that year that its 
414.36  family preservation core services are developed becomes eligible 
415.1   either to continue using its family preservation fund grant as 
415.2   provided in paragraph (a), or to exercise the expanded service 
415.3   option under paragraph (c). 
415.4      (c) The expanded service option permits an eligible county 
415.5   to use its family preservation fund grant for child welfare 
415.6   preventive services.  For purposes of this section, child 
415.7   welfare preventive services are those services directed toward a 
415.8   specific child or family that further the goals of section 
415.9   256F.01 and include assessments, family preservation services, 
415.10  service coordination, community-based treatment, crisis nursery 
415.11  services when the parents retain custody and there is no 
415.12  voluntary placement agreement with a child-placing agency, 
415.13  respite care except when it is provided under a medical 
415.14  assistance waiver, home-based services, and other related 
415.15  services.  For purposes of this section, child welfare 
415.16  preventive services shall not include shelter care or other 
415.17  placement services under the authority of the court or public 
415.18  agency to address an emergency.  To exercise this option, an 
415.19  eligible county must notify the commissioner in writing of its 
415.20  intention to do so no later than 30 days into the quarter during 
415.21  which it intends to begin or select this option in its county 
415.22  plan, as provided in section 256F.04, subdivision 2.  Effective 
415.23  with the first day of that quarter the grant period in which 
415.24  this option is selected, the county must maintain its base level 
415.25  of expenditures for child welfare preventive services and use 
415.26  the family preservation fund to expand them.  The base level of 
415.27  expenditures for a county shall be that established under 
415.28  section 256F.10, subdivision 7.  For counties which have no such 
415.29  base established, a comparable base shall be established with 
415.30  the base year being the calendar year ending at least two 
415.31  calendar quarters before the first calendar quarter in which the 
415.32  county exercises its expanded service option.  The commissioner 
415.33  shall, at the request of the counties, reduce, suspend, or 
415.34  eliminate either or both of a county's obligations to continue 
415.35  the base level of expenditures and to expand child welfare 
415.36  preventive services under extraordinary circumstances.  
416.1      (d) Notwithstanding paragraph (a), a county that is 
416.2   participating in the child protection assessments or 
416.3   investigations community collaboration pilot program under 
416.4   section 626.5560, or in the concurrent permanency planning pilot 
416.5   program under section 257.0711, may use its family preservation 
416.6   fund grant for those programs. 
416.7      Sec. 13.  Minnesota Statutes 1998, section 256F.10, 
416.8   subdivision 1, is amended to read: 
416.9      Subdivision 1.  [ELIGIBILITY.] Persons under 21 years of 
416.10  age who are eligible to receive medical assistance are eligible 
416.11  for child welfare targeted case management services under 
416.12  section 256B.094 and this section if they have received an 
416.13  assessment and have been determined by the local county or 
416.14  tribal social services agency to be:  
416.15     (1) at risk of placement or in placement as described in 
416.16  section 257.071, subdivision 1; 
416.17     (2) at risk of maltreatment or experiencing maltreatment as 
416.18  defined in section 626.556, subdivision 10e; or 
416.19     (3) in need of protection or services as defined in section 
416.20  260.015, subdivision 2a.  
416.21     Sec. 14.  Minnesota Statutes 1998, section 256F.10, 
416.22  subdivision 4, is amended to read: 
416.23     Subd. 4.  [PROVIDER QUALIFICATIONS AND CERTIFICATION 
416.24  STANDARDS.] The commissioner must certify each provider before 
416.25  enrolling it as a child welfare targeted case management 
416.26  provider of services under section 256B.094 and this section.  
416.27  The certification process shall examine the provider's ability 
416.28  to meet the qualification requirements and certification 
416.29  standards in this subdivision and other federal and state 
416.30  requirements of this service.  A certified child welfare 
416.31  targeted case management provider is an enrolled medical 
416.32  assistance provider who is determined by the commissioner to 
416.33  have all of the following: 
416.34     (1) the legal authority to provide public welfare under 
416.35  sections 393.01, subdivision 7, and 393.07 or a federally 
416.36  recognized Indian tribe; 
417.1      (2) the demonstrated capacity and experience to provide the 
417.2   components of case management to coordinate and link community 
417.3   resources needed by the eligible population; 
417.4      (3) administrative capacity and experience in serving the 
417.5   target population for whom it will provide services and in 
417.6   ensuring quality of services under state and federal 
417.7   requirements; 
417.8      (4) the legal authority to provide complete investigative 
417.9   and protective services under section 626.556, subdivision 10, 
417.10  and child welfare and foster care services under section 393.07, 
417.11  subdivisions 1 and 2, or a federally recognized Indian tribe; 
417.12     (5) a financial management system that provides accurate 
417.13  documentation of services and costs under state and federal 
417.14  requirements; and 
417.15     (6) the capacity to document and maintain individual case 
417.16  records under state and federal requirements. 
417.17     Sec. 15.  Minnesota Statutes 1998, section 256F.10, 
417.18  subdivision 6, is amended to read: 
417.19     Subd. 6.  [DISTRIBUTION OF NEW FEDERAL REVENUE.] (a) Except 
417.20  for portion set aside in paragraph (b), the federal funds earned 
417.21  under this section and section 256B.094 by counties providers 
417.22  shall be paid to each county provider based on its earnings, and 
417.23  must be used by each county provider to expand preventive child 
417.24  welfare services. 
417.25  If a county or tribal social services agency chooses to be a 
417.26  provider of child welfare targeted case management and if that 
417.27  county or tribal social services agency also joins a local 
417.28  children's mental health collaborative as authorized by the 1993 
417.29  legislature, then the federal reimbursement received by the 
417.30  county or tribal social services agency for providing child 
417.31  welfare targeted case management services to children served by 
417.32  the local collaborative shall be transferred by the county or 
417.33  tribal social services agency to the integrated fund.  The 
417.34  federal reimbursement transferred to the integrated fund by the 
417.35  county or tribal social services agency must not be used for 
417.36  residential care other than respite care described under 
418.1   subdivision 7, paragraph (d). 
418.2      (b) The commissioner shall set aside a portion of the 
418.3   federal funds earned under this section to repay the special 
418.4   revenue maximization account under section 256.01, subdivision 
418.5   2, clause (15).  The repayment is limited to: 
418.6      (1) the costs of developing and implementing this section 
418.7   and sections 256.8711 and 256B.094; 
418.8      (2) programming the information systems; and 
418.9      (3) the lost federal revenue for the central office claim 
418.10  directly caused by the implementation of these sections. 
418.11     Any unexpended funds from the set aside under this 
418.12  paragraph shall be distributed to counties providers according 
418.13  to paragraph (a). 
418.14     Sec. 16.  Minnesota Statutes 1998, section 256F.10, 
418.15  subdivision 7, is amended to read: 
418.16     Subd. 7.  [EXPANSION OF SERVICES AND BASE LEVEL OF 
418.17  EXPENDITURES.] (a) Counties and tribal social services must 
418.18  continue the base level of expenditures for preventive child 
418.19  welfare services from either or both of any state, county, or 
418.20  federal funding source, which, in the absence of federal funds 
418.21  earned under this section, would have been available for these 
418.22  services.  The commissioner shall review the county or tribal 
418.23  social services expenditures annually using reports required 
418.24  under sections 245.482, 256.01, subdivision 2, paragraph 17, and 
418.25  256E.08, subdivision 8, to ensure that the base level of 
418.26  expenditures for preventive child welfare services is continued 
418.27  from sources other than the federal funds earned under this 
418.28  section. 
418.29     (b) The commissioner may reduce, suspend, or eliminate 
418.30  either or both of a county's or tribal social services' 
418.31  obligations to continue the base level of expenditures and to 
418.32  expand child welfare preventive services if the commissioner 
418.33  determines that one or more of the following conditions apply to 
418.34  that county or reservation: 
418.35     (1) imposition of levy limits that significantly reduce 
418.36  available social service funds; 
419.1      (2) reduction in the net tax capacity of the taxable 
419.2   property within a county or reservation that significantly 
419.3   reduces available social service funds; 
419.4      (3) reduction in the number of children under age 19 in the 
419.5   county or reservation by 25 percent when compared with the 
419.6   number in the base year using the most recent data provided by 
419.7   the state demographer's office; or 
419.8      (4) termination of the federal revenue earned under this 
419.9   section. 
419.10     (c) The commissioner may suspend for one year either or 
419.11  both of a county's or tribal social services' obligations to 
419.12  continue the base level of expenditures and to expand child 
419.13  welfare preventive services if the commissioner determines that 
419.14  in the previous year one or more of the following conditions 
419.15  applied to that county or reservation: 
419.16     (1) the total number of children in placement under 
419.17  sections 257.071 and 393.07, subdivisions 1 and 2, has been 
419.18  reduced by 50 percent from the total number in the base year; or 
419.19     (2) the average number of children in placement under 
419.20  sections 257.071 and 393.07, subdivisions 1 and 2, on the last 
419.21  day of each month is equal to or less than one child per 1,000 
419.22  children in the county or reservation. 
419.23     (d) For the purposes of this section, child welfare 
419.24  preventive services are those services directed toward a 
419.25  specific child or family that further the goals of section 
419.26  256F.01 and include assessments, family preservation services, 
419.27  service coordination, community-based treatment, crisis nursery 
419.28  services when the parents retain custody and there is no 
419.29  voluntary placement agreement with a child-placing agency, 
419.30  respite care except when it is provided under a medical 
419.31  assistance waiver, home-based services, and other related 
419.32  services.  For the purposes of this section, child welfare 
419.33  preventive services shall not include shelter care placements 
419.34  under the authority of the court or public agency to address an 
419.35  emergency, residential services except for respite care, child 
419.36  care for the purposes of employment and training, adult 
420.1   services, services other than child welfare targeted case 
420.2   management when they are provided under medical assistance, 
420.3   placement services, or activities not directed toward a specific 
420.4   child or family.  Respite care must be planned, routine care to 
420.5   support the continuing residence of the child with its family or 
420.6   long-term primary caretaker and must not be provided to address 
420.7   an emergency. 
420.8      (e) For the counties and tribal social services beginning 
420.9   to claim federal reimbursement for services under this section 
420.10  and section 256B.094, the base year is the calendar year ending 
420.11  at least two calendar quarters before the first calendar quarter 
420.12  in which the county provider begins claiming reimbursement.  For 
420.13  the purposes of this section, the base level of expenditures is 
420.14  the level of county or tribal social services expenditures in 
420.15  the base year for eligible child welfare preventive services 
420.16  described in this subdivision. 
420.17     Sec. 17.  Minnesota Statutes 1998, section 256F.10, 
420.18  subdivision 8, is amended to read: 
420.19     Subd. 8.  [PROVIDER RESPONSIBILITIES.] (a) Notwithstanding 
420.20  section 256B.19, subdivision 1, for the purposes of child 
420.21  welfare targeted case management under section 256B.094 and this 
420.22  section, the nonfederal share of costs shall be provided by the 
420.23  provider of child welfare targeted case management from sources 
420.24  other than federal funds or funds used to match other federal 
420.25  funds, except when allowed by federal law or agreement. 
420.26     (b) Provider expenditures eligible for federal 
420.27  reimbursement under this section must not be made from federal 
420.28  funds or funds used to match other federal funds, except when 
420.29  allowed by federal law or agreement. 
420.30     (c) The commissioner may suspend, reduce, or terminate the 
420.31  federal reimbursement to a provider that does not meet the 
420.32  reporting or other requirements of section 256B.094 and this 
420.33  section.  The county or reservation is responsible for any 
420.34  federal disallowances.  The county or reservation may share this 
420.35  responsibility with its contracted vendors. 
420.36     Sec. 18.  Minnesota Statutes 1998, section 256F.10, 
421.1   subdivision 9, is amended to read: 
421.2      Subd. 9.  [PAYMENTS.] Notwithstanding section 256.025, 
421.3   subdivision 2, payments to certified providers for child welfare 
421.4   targeted case management expenditures under section 256B.094 and 
421.5   this section shall only be made of federal earnings from 
421.6   services provided under section 256B.094 and this 
421.7   section.  Payments to contracted vendors shall include both the 
421.8   federal earnings and the nonfederal share. 
421.9      Sec. 19.  Minnesota Statutes 1998, section 256F.10, 
421.10  subdivision 10, is amended to read: 
421.11     Subd. 10.  [CENTRALIZED DISBURSEMENT OF MEDICAL ASSISTANCE 
421.12  PAYMENTS.] Notwithstanding section 256B.041, county provider 
421.13  payments for the cost of child welfare targeted case management 
421.14  services shall not be made to the state treasurer.  For the 
421.15  purposes of child welfare targeted case management services 
421.16  under section 256B.094 and this section, the centralized 
421.17  disbursement of payments to providers under section 256B.041 
421.18  consists only of federal earnings from services provided under 
421.19  section 256B.094 and this section. 
421.20     Sec. 20.  Minnesota Statutes 1998, section 257.071, 
421.21  subdivision 1, is amended to read: 
421.22     Subdivision 1.  [PLACEMENT; PLAN.] (a) A case plan shall be 
421.23  prepared within 30 days after any child is placed in a 
421.24  residential facility by court order or by the voluntary release 
421.25  of the child by the parent or parents.  
421.26     For purposes of this section, a residential facility means 
421.27  any group home, family foster home or other publicly supported 
421.28  out-of-home residential facility, including any out-of-home 
421.29  residential facility under contract with the state, county or 
421.30  other political subdivision, or any agency thereof, to provide 
421.31  those services or foster care as defined in section 260.015, 
421.32  subdivision 7.  
421.33     (b) When a child is in placement, the responsible local 
421.34  social services agency shall make diligent efforts to identify, 
421.35  locate, and, where appropriate, offer services to both parents 
421.36  of the child.  If a noncustodial or nonadjudicated parent is 
422.1   willing and capable of providing for the day-to-day care of the 
422.2   child, the local social services agency may seek authority from 
422.3   the custodial parent or the court to have that parent assume 
422.4   day-to-day care of the child.  If a parent is not an adjudicated 
422.5   parent, the local social services agency shall require the 
422.6   nonadjudicated parent to cooperate with paternity establishment 
422.7   procedures as part of the case plan. 
422.8      (c) If, after assessment, the local social services agency 
422.9   determines that the child cannot be in the day-to-day care of 
422.10  either parent, the agency shall prepare a case plan addressing 
422.11  the conditions that each parent must mitigate before the child 
422.12  could be in that parent's day-to-day care. 
422.13     (d) If, after the provision of services following a case 
422.14  plan under this section and ordered by the juvenile court, the 
422.15  child cannot return to the care of the parent from whom the 
422.16  child was removed or who had legal custody at the time the child 
422.17  was placed in foster care, the agency may petition on behalf of 
422.18  a noncustodial parent to establish legal custody with that 
422.19  parent under section 260.191, subdivision 3b.  If paternity has 
422.20  not already been established, it may be established in the same 
422.21  proceeding in the manner provided for under this chapter. 
422.22     The responsible social services agency may be relieved of 
422.23  the requirement to locate and offer services to both parents by 
422.24  the juvenile court upon a finding of good cause after the filing 
422.25  of a petition under section 260.131. 
422.26     (e) For the purposes of this section, a case plan means a 
422.27  written document which is ordered by the court or which is 
422.28  prepared by the social service services agency responsible for 
422.29  the residential facility placement and is signed by the parent 
422.30  or parents, or other custodian, of the child, the child's legal 
422.31  guardian, the social service services agency responsible for the 
422.32  residential facility placement, and, if possible, the child.  
422.33  The document shall be explained to all persons involved in its 
422.34  implementation, including the child who has signed the document, 
422.35  and shall set forth: 
422.36     (1) the specific reasons for the placement of the child in 
423.1   a residential facility, including a description of the problems 
423.2   or conditions in the home of the parent or parents which 
423.3   necessitated removal of the child from home; 
423.4      (2) the specific actions to be taken by the parent or 
423.5   parents of the child to eliminate or correct the problems or 
423.6   conditions identified in clause (1), and the time period during 
423.7   which the actions are to be taken; 
423.8      (3) the financial responsibilities and obligations, if any, 
423.9   of the parents for the support of the child during the period 
423.10  the child is in the residential facility; 
423.11     (4) the visitation rights and obligations of the parent or 
423.12  parents or other relatives as defined in section 260.181, if 
423.13  such visitation is consistent with the best interest of the 
423.14  child, during the period the child is in the residential 
423.15  facility; 
423.16     (5) the social and other supportive services to be provided 
423.17  to the parent or parents of the child, the child, and the 
423.18  residential facility during the period the child is in the 
423.19  residential facility; 
423.20     (6) the date on which the child is expected to be returned 
423.21  to and safely maintained in the home of the parent or parents or 
423.22  placed for adoption or otherwise permanently removed from the 
423.23  care of the parent by court order; 
423.24     (7) the nature of the effort to be made by the social 
423.25  service services agency responsible for the placement to reunite 
423.26  the family; and 
423.27     (8) notice to the parent or parents: 
423.28     (i) that placement of the child in foster care may result 
423.29  in termination of parental rights but only after notice and a 
423.30  hearing as provided in chapter 260.; and 
423.31     (ii) in cases where the agency has determined that both 
423.32  reasonable efforts to reunify the child with the parents, and 
423.33  reasonable efforts to place the child in a permanent home away 
423.34  from the parent that may become legally permanent are 
423.35  appropriate, notice of: 
423.36     (A) time limits on the length of placement and of 
424.1   reunification services; 
424.2      (B) the nature of the services available to the parent; 
424.3      (C) the consequences to the parent and the child if the 
424.4   parent fails or is unable to use services to correct the 
424.5   circumstances that led to the child's placement; 
424.6      (D) the first consideration for relative placement; and 
424.7      (E) the benefit to the child in getting the child out of 
424.8   residential care as soon as possible, preferably by returning 
424.9   the child home, but if that is not possible, through a permanent 
424.10  legal placement of the child away from the parent; 
424.11     (9) a permanency hearing under section 260.191, subdivision 
424.12  3b, or a termination of parental rights hearing under sections 
424.13  260.221 to 260.245, where the agency asks the court to find that 
424.14  the child should be permanently placed away from the parent and 
424.15  includes documentation of the steps taken by the responsible 
424.16  social services agency to find an adoptive family or other 
424.17  permanent legal placement for the child, to place the child with 
424.18  an adoptive family, a fit and willing relative through an award 
424.19  of permanent legal and physical custody, or in another planned 
424.20  and permanent legal placement.  The documentation must include 
424.21  child specific recruitment efforts; and 
424.22     (10) if the court has issued an order terminating the 
424.23  rights of both parents of the child or of the only known, living 
424.24  parent of the child, documentation of steps to finalize the 
424.25  adoption or legal guardianship of the child. 
424.26     (f) The parent or parents and the child each shall have the 
424.27  right to legal counsel in the preparation of the case plan and 
424.28  shall be informed of the right at the time of placement of the 
424.29  child.  The child shall also have the right to a guardian ad 
424.30  litem.  If unable to employ counsel from their own resources, 
424.31  the court shall appoint counsel upon the request of the parent 
424.32  or parents or the child or the child's legal guardian.  The 
424.33  parent or parents may also receive assistance from any person or 
424.34  social service services agency in preparation of the case plan. 
424.35     After the plan has been agreed upon by the parties 
424.36  involved, the foster parents shall be fully informed of the 
425.1   provisions of the case plan and shall be provided a copy of the 
425.2   plan. 
425.3      (g) When an agency accepts a child for placement, the 
425.4   agency shall determine whether the child has had a physical 
425.5   examination by or under the direction of a licensed physician 
425.6   within the 12 months immediately preceding the date when the 
425.7   child came into the agency's care.  If there is documentation 
425.8   that the child has had such an examination within the last 12 
425.9   months, the agency is responsible for seeing that the child has 
425.10  another physical examination within one year of the documented 
425.11  examination and annually in subsequent years.  If the agency 
425.12  determines that the child has not had a physical examination 
425.13  within the 12 months immediately preceding placement, the agency 
425.14  shall ensure that the child has the examination within 30 days 
425.15  of coming into the agency's care and once a year in subsequent 
425.16  years. 
425.17     Sec. 21.  Minnesota Statutes 1998, section 257.071, 
425.18  subdivision 1a, is amended to read: 
425.19     Subd. 1a.  [PLACEMENT DECISIONS BASED ON BEST INTEREST OF 
425.20  THE CHILD.] (a) The policy of the state of Minnesota is to 
425.21  ensure that the child's best interests are met by requiring an 
425.22  individualized determination of the needs of the child and of 
425.23  how the selected placement will serve the needs of the child 
425.24  being placed.  The authorized child-placing agency shall place a 
425.25  child, released by court order or by voluntary release by the 
425.26  parent or parents, in a family foster home selected by 
425.27  considering placement with relatives and important friends 
425.28  consistent with section 260.181, subdivision 3.  
425.29     (b) Among the factors the agency shall consider in 
425.30  determining the needs of the child are those specified under 
425.31  section 260.181, subdivision 3, paragraph (b).  
425.32     (c) Placement of a child cannot be delayed or denied based 
425.33  on race, color, or national origin of the foster parent or the 
425.34  child.  Whenever possible, Siblings should be placed together 
425.35  for foster care and adoption at the earliest possible time 
425.36  unless it is determined not to be in the best interests of a 
426.1   sibling or unless it is not possible after appropriate efforts 
426.2   by the responsible social services agency.  
426.3      Sec. 22.  Minnesota Statutes 1998, section 257.071, 
426.4   subdivision 1c, is amended to read: 
426.5      Subd. 1c.  [NOTICE BEFORE VOLUNTARY PLACEMENT.] The local 
426.6   social service services agency shall inform a parent considering 
426.7   voluntary placement of a child who is not developmentally 
426.8   disabled or emotionally handicapped of the following: 
426.9      (1) the parent and the child each has a right to separate 
426.10  legal counsel before signing a voluntary placement agreement, 
426.11  but not to counsel appointed at public expense; 
426.12     (2) the parent is not required to agree to the voluntary 
426.13  placement, and a parent who enters a voluntary placement 
426.14  agreement may at any time request that the agency return the 
426.15  child.  If the parent so requests, the child must be returned 
426.16  within 24 hours of the receipt of the request; 
426.17     (3) evidence gathered during the time the child is 
426.18  voluntarily placed may be used at a later time as the basis for 
426.19  a petition alleging that the child is in need of protection or 
426.20  services or as the basis for a petition seeking termination of 
426.21  parental rights or other permanent placement of the child away 
426.22  from the parent; 
426.23     (4) if the local social service services agency files a 
426.24  petition alleging that the child is in need of protection or 
426.25  services or a petition seeking the termination of parental 
426.26  rights or other permanent placement of the child away from the 
426.27  parent, the parent would have the right to appointment of 
426.28  separate legal counsel and the child would have a right to the 
426.29  appointment of counsel and a guardian ad litem as provided by 
426.30  law, and that counsel will be appointed at public expense if 
426.31  they are unable to afford counsel; and 
426.32     (5) the timelines and procedures for review of voluntary 
426.33  placements under subdivision 3, and the effect the time spent in 
426.34  voluntary placement on the scheduling of a permanent placement 
426.35  determination hearing under section 260.191, subdivision 3b.  
426.36     Sec. 23.  Minnesota Statutes 1998, section 257.071, 
427.1   subdivision 1d, is amended to read: 
427.2      Subd. 1d.  [RELATIVE SEARCH; NATURE.] (a) As soon as 
427.3   possible, but in any event within six months after a child is 
427.4   initially placed in a residential facility, the local social 
427.5   services agency shall identify any relatives of the child and 
427.6   notify them of the need for a foster care home for the child and 
427.7   of the possibility of the need for a permanent out-of-home 
427.8   placement of the child.  Relatives should also be notified that 
427.9   a decision not to be a placement resource at the beginning of 
427.10  the case may affect the relative being considered for placement 
427.11  of the child with that relative later.  The relatives must be 
427.12  notified that they must keep the local social services agency 
427.13  informed of their current address in order to receive notice 
427.14  that a permanent placement is being sought for the child.  A 
427.15  relative who fails to provide a current address to the local 
427.16  social services agency forfeits the right to notice of the 
427.17  possibility of permanent placement.  If the child's parent 
427.18  refuses to give the responsible social services agency 
427.19  information sufficient to identify relatives of the child, the 
427.20  agency shall determine whether the parent's refusal is in the 
427.21  child's best interests.  If the agency determines the parent's 
427.22  refusal is not in the child's best interests, the agency shall 
427.23  file a petition under section 260.131, and shall ask the 
427.24  juvenile court to order the parent to provide the necessary 
427.25  information. 
427.26     (b) Unless relieved of this duty by the court because the 
427.27  child is placed with an appropriate relative who wishes to 
427.28  provide a permanent home for the child or the child is placed 
427.29  with a foster home that has committed to being the permanent 
427.30  legal placement for the child and the responsible social 
427.31  services agency approves of that foster home for permanent 
427.32  placement of the child, when the agency determines that it is 
427.33  necessary to prepare for the permanent placement determination 
427.34  hearing, or in anticipation of filing a termination of parental 
427.35  rights petition, the agency shall send notice to the relatives, 
427.36  any adult with whom the child is currently residing, any adult 
428.1   with whom the child has resided for one year or longer in the 
428.2   past, and any adults who have maintained a relationship or 
428.3   exercised visitation with the child as identified in the agency 
428.4   case plan.  The notice must state that a permanent home is 
428.5   sought for the child and that the individuals receiving the 
428.6   notice may indicate to the agency their interest in providing a 
428.7   permanent home.  The notice must state that within 30 days of 
428.8   receipt of the notice an individual receiving the notice must 
428.9   indicate to the agency the individual's interest in providing a 
428.10  permanent home for the child or that the individual may lose the 
428.11  opportunity to be considered for a permanent placement.  This 
428.12  notice need not be sent if the child is placed with an 
428.13  appropriate relative who wishes to provide a permanent home for 
428.14  the child. 
428.15     Sec. 24.  Minnesota Statutes 1998, section 257.071, 
428.16  subdivision 1e, is amended to read: 
428.17     Subd. 1e.  [CHANGE IN PLACEMENT.] If a child is removed 
428.18  from a permanent placement disposition authorized under section 
428.19  260.191, subdivision 3b, within one year after the placement was 
428.20  made: 
428.21     (1) the child must be returned to the residential facility 
428.22  where the child was placed immediately preceding the permanent 
428.23  placement; or 
428.24     (2) the court shall hold a hearing within ten days after 
428.25  the child is taken into custody removed from the permanent 
428.26  placement to determine where the child is to be placed.  A 
428.27  guardian ad litem must be appointed for the child for this 
428.28  hearing. 
428.29     Sec. 25.  Minnesota Statutes 1998, section 257.071, 
428.30  subdivision 3, is amended to read: 
428.31     Subd. 3.  [REVIEW OF VOLUNTARY PLACEMENTS.] Except as 
428.32  provided in subdivision 4, if the child has been placed in a 
428.33  residential facility pursuant to a voluntary release by the 
428.34  parent or parents, and is not returned home within 90 days after 
428.35  initial placement in the residential facility, the social 
428.36  service services agency responsible for the placement shall: 
429.1      (1) return the child to the home of the parent or parents; 
429.2   or 
429.3      (2) file a petition according to section 260.131, 
429.4   subdivision 1, which may: 
429.5      (i) ask the court to review the placement and approve it 
429.6   for up to extend the placement for an additional 90 days.; 
429.7      (ii) ask the court to order continued out-of-home placement 
429.8   according to sections 260.172 and 260.191; or 
429.9      (iii) ask the court to terminate parental rights under 
429.10  section 260.221. 
429.11     The case plan must be updated when a petition is filed and 
429.12  must include a specific plan for permanency, which may include a 
429.13  time line for returning the child home or a plan for permanent 
429.14  placement of the child away from the parent, or both.  
429.15     If the court approves the extension continued out-of-home 
429.16  placement for up to 90 more days, at the end of the 
429.17  second court-approved 90-day period, the child must be returned 
429.18  to the parent's home, unless a petition is.  If the child is not 
429.19  returned home, the responsible social services agency must 
429.20  proceed on the petition filed for a alleging the child in need 
429.21  of protection or services or the petition for termination of 
429.22  parental rights.  The court must find a statutory basis to order 
429.23  the placement of the child under section 260.172; 260.191; or 
429.24  260.241. 
429.25     Sec. 26.  Minnesota Statutes 1998, section 257.071, 
429.26  subdivision 4, is amended to read: 
429.27     Subd. 4.  [REVIEW OF DEVELOPMENTALLY DISABLED AND 
429.28  EMOTIONALLY HANDICAPPED CHILD PLACEMENTS.] If a developmentally 
429.29  disabled child, as that term is defined in United States Code, 
429.30  title 42, section 6001 (7), as amended through December 31, 
429.31  1979, or a child diagnosed with an emotional handicap as defined 
429.32  in section 252.27, subdivision 1a, has been placed in a 
429.33  residential facility pursuant to a voluntary release by the 
429.34  child's parent or parents because of the child's handicapping 
429.35  conditions or need for long-term residential treatment or 
429.36  supervision, the social service services agency responsible for 
430.1   the placement shall bring a petition for review of the child's 
430.2   foster care status, pursuant to section 260.131, subdivision 1a, 
430.3   rather than a after the child has been in placement for six 
430.4   months.  If a child is in placement due solely to the child's 
430.5   handicapping condition and custody of the child is not 
430.6   transferred to the responsible social services agency under 
430.7   section 260.191, subdivision 1, paragraph (a), clause (2), no 
430.8   petition as is required by section 260.191, subdivision 3b, 
430.9   after the child has been in foster care for six months or, in 
430.10  the case of a child with an emotional handicap, after the child 
430.11  has been in a residential facility for six months.  Whenever a 
430.12  petition for review is brought pursuant to this subdivision, a 
430.13  guardian ad litem shall be appointed for the child. 
430.14     Sec. 27.  Minnesota Statutes 1998, section 257.85, 
430.15  subdivision 2, is amended to read: 
430.16     Subd. 2.  [SCOPE.] The provisions of this section apply to 
430.17  those situations in which the legal and physical custody of a 
430.18  child is established with a relative or important friend with 
430.19  whom the child has resided or had significant contact according 
430.20  to section 260.191, subdivision 3b, by a court order issued on 
430.21  or after July 1, 1997.  
430.22     Sec. 28.  Minnesota Statutes 1998, section 257.85, 
430.23  subdivision 3, is amended to read: 
430.24     Subd. 3.  [DEFINITIONS.] For purposes of this section, the 
430.25  terms defined in this subdivision have the meanings given them. 
430.26     (a) "AFDC or MFIP standard" means the monthly standard of 
430.27  need used to calculate assistance under the AFDC program, the 
430.28  transitional standard used to calculate assistance under the 
430.29  MFIP-S program, or, if neither of those is applicable permanent 
430.30  legal and physical custody of the child is given to a relative 
430.31  custodian residing outside of Minnesota, the analogous 
430.32  transitional standard or standard of need used to calculate 
430.33  assistance under the MFIP or MFIP-R programs TANF program of the 
430.34  state where the relative custodian lives. 
430.35     (b) "Local agency" means the local social service services 
430.36  agency with legal custody of a child prior to the transfer of 
431.1   permanent legal and physical custody to a relative. 
431.2      (c) "Permanent legal and physical custody" means permanent 
431.3   legal and physical custody ordered by a Minnesota juvenile court 
431.4   under section 260.191, subdivision 3b. 
431.5      (d) "Relative" means an individual, other than a parent, 
431.6   who is related to a child by blood, marriage, or adoption. 
431.7      (e) "Relative custodian" means a relative of a child for 
431.8   whom the relative person who has permanent legal and physical 
431.9   custody of a child.  When siblings, including half-siblings and 
431.10  step siblings, are placed together in the permanent legal and 
431.11  physical custody of a relative of one of the siblings, the 
431.12  person receiving permanent legal and physical custody of the 
431.13  siblings is considered a relative custodian of all of the 
431.14  siblings for purposes of this section. 
431.15     (f) "Relative custody assistance agreement" means an 
431.16  agreement entered into between a local agency and the relative 
431.17  of a child person who has been or will be awarded permanent 
431.18  legal and physical custody of the a child. 
431.19     (g) "Relative custody assistance payment" means a monthly 
431.20  cash grant made to a relative custodian pursuant to a relative 
431.21  custody assistance agreement and in an amount calculated under 
431.22  subdivision 7. 
431.23     (h) "Remains in the physical custody of the relative 
431.24  custodian" means that the relative custodian is providing 
431.25  day-to-day care for the child and that the child lives with the 
431.26  relative custodian; absence from the relative custodian's home 
431.27  for a period of more than 120 days raises a presumption that the 
431.28  child no longer remains in the physical custody of the relative 
431.29  custodian. 
431.30     Sec. 29.  Minnesota Statutes 1998, section 257.85, 
431.31  subdivision 4, is amended to read: 
431.32     Subd. 4.  [DUTIES OF LOCAL AGENCY.] (a) When a local agency 
431.33  seeks a court order under section 260.191, subdivision 3b, to 
431.34  establish permanent legal and physical custody of a child with a 
431.35  relative or important friend with whom the child has resided or 
431.36  had significant contact, or if such an order is issued by the 
432.1   court, the local agency shall perform the duties in this 
432.2   subdivision. 
432.3      (b) As soon as possible after the local agency determines 
432.4   that it will seek to establish permanent legal and physical 
432.5   custody of the child with a relative or, if the agency did not 
432.6   seek to establish custody, as soon as possible after the 
432.7   issuance of the court order establishing custody, the local 
432.8   agency shall inform the relative custodian about the relative 
432.9   custody assistance program, including eligibility criteria and 
432.10  payment levels.  Anytime prior to, but not later than seven days 
432.11  after, the date the court issues the order establishing 
432.12  permanent legal and physical custody of the child with a 
432.13  relative, the local agency shall determine whether the 
432.14  eligibility criteria in subdivision 6 are met to allow the 
432.15  relative custodian to receive relative custody assistance.  Not 
432.16  later than seven days after determining whether the eligibility 
432.17  criteria are met, the local agency shall inform the relative 
432.18  custodian of its determination and of the process for appealing 
432.19  that determination under subdivision 9. 
432.20     (c) If the local agency determines that the relative 
432.21  custodian is eligible to receive relative custody assistance, 
432.22  the local agency shall prepare the relative custody assistance 
432.23  agreement and ensure that it meets the criteria of subdivision 6.
432.24     (d) The local agency shall make monthly payments to the 
432.25  relative custodian as set forth in the relative custody 
432.26  assistance agreement.  On a quarterly basis and on a form to be 
432.27  provided by the commissioner, the local agency shall make claims 
432.28  for reimbursement from the commissioner for relative custody 
432.29  assistance payments made. 
432.30     (e) For a relative custody assistance agreement that is in 
432.31  place for longer than one year, and as long as the agreement 
432.32  remains in effect, the local agency shall send an annual 
432.33  affidavit form to the relative custodian of the eligible child 
432.34  within the month before the anniversary date of the agreement.  
432.35  The local agency shall monitor whether the annual affidavit is 
432.36  returned by the relative custodian within 30 days following the 
433.1   anniversary date of the agreement.  The local agency shall 
433.2   review the affidavit and any other information in its possession 
433.3   to ensure continuing eligibility for relative custody assistance 
433.4   and that the amount of payment made according to the agreement 
433.5   is correct. 
433.6      (f) When the local agency determines that a relative 
433.7   custody assistance agreement should be terminated or modified, 
433.8   it shall provide notice of the proposed termination or 
433.9   modification to the relative custodian at least ten days before 
433.10  the proposed action along with information about the process for 
433.11  appealing the proposed action. 
433.12     Sec. 30.  Minnesota Statutes 1998, section 257.85, 
433.13  subdivision 5, is amended to read: 
433.14     Subd. 5.  [RELATIVE CUSTODY ASSISTANCE AGREEMENT.] (a) A 
433.15  relative custody assistance agreement will not be effective, 
433.16  unless it is signed by the local agency and the relative 
433.17  custodian no later than 30 days after the date of the order 
433.18  establishing permanent legal and physical custody with the 
433.19  relative, except that a local agency may enter into a relative 
433.20  custody assistance agreement with a relative custodian more than 
433.21  30 days after the date of the order if it certifies that the 
433.22  delay in entering the agreement was through no fault of the 
433.23  relative custodian.  There must be a separate agreement for each 
433.24  child for whom the relative custodian is receiving relative 
433.25  custody assistance. 
433.26     (b) Regardless of when the relative custody assistance 
433.27  agreement is signed by the local agency and relative custodian, 
433.28  the effective date of the agreement shall be the date of the 
433.29  order establishing permanent legal and physical custody. 
433.30     (c) If MFIP-S is not the applicable program for a child at 
433.31  the time that a relative custody assistance agreement is entered 
433.32  on behalf of the child, when MFIP-S becomes the applicable 
433.33  program, if the relative custodian had been receiving custody 
433.34  assistance payments calculated based upon a different program, 
433.35  the amount of relative custody assistance payment under 
433.36  subdivision 7 shall be recalculated under the MFIP-S program. 
434.1      (d) The relative custody assistance agreement shall be in a 
434.2   form specified by the commissioner and shall include provisions 
434.3   relating to the following: 
434.4      (1) the responsibilities of all parties to the agreement; 
434.5      (2) the payment terms, including the financial 
434.6   circumstances of the relative custodian, the needs of the child, 
434.7   the amount and calculation of the relative custody assistance 
434.8   payments, and that the amount of the payments shall be 
434.9   reevaluated annually; 
434.10     (3) the effective date of the agreement, which shall also 
434.11  be the anniversary date for the purpose of submitting the annual 
434.12  affidavit under subdivision 8; 
434.13     (4) that failure to submit the affidavit as required by 
434.14  subdivision 8 will be grounds for terminating the agreement; 
434.15     (5) the agreement's expected duration, which shall not 
434.16  extend beyond the child's eighteenth birthday; 
434.17     (6) any specific known circumstances that could cause the 
434.18  agreement or payments to be modified, reduced, or terminated and 
434.19  the relative custodian's appeal rights under subdivision 9; 
434.20     (7) that the relative custodian must notify the local 
434.21  agency within 30 days of any of the following: 
434.22     (i) a change in the child's status; 
434.23     (ii) a change in the relationship between the relative 
434.24  custodian and the child; 
434.25     (iii) a change in composition or level of income of the 
434.26  relative custodian's family; 
434.27     (iv) a change in eligibility or receipt of benefits under 
434.28  AFDC, MFIP-S, or other assistance program; and 
434.29     (v) any other change that could affect eligibility for or 
434.30  amount of relative custody assistance; 
434.31     (8) that failure to provide notice of a change as required 
434.32  by clause (7) will be grounds for terminating the agreement; 
434.33     (9) that the amount of relative custody assistance is 
434.34  subject to the availability of state funds to reimburse the 
434.35  local agency making the payments; 
434.36     (10) that the relative custodian may choose to temporarily 
435.1   stop receiving payments under the agreement at any time by 
435.2   providing 30 days' notice to the local agency and may choose to 
435.3   begin receiving payments again by providing the same notice but 
435.4   any payments the relative custodian chooses not to receive are 
435.5   forfeit; and 
435.6      (11) that the local agency will continue to be responsible 
435.7   for making relative custody assistance payments under the 
435.8   agreement regardless of the relative custodian's place of 
435.9   residence. 
435.10     Sec. 31.  Minnesota Statutes 1998, section 257.85, 
435.11  subdivision 6, is amended to read: 
435.12     Subd. 6.  [ELIGIBILITY CRITERIA.] A local agency shall 
435.13  enter into a relative custody assistance agreement under 
435.14  subdivision 5 if it certifies that the following criteria are 
435.15  met: 
435.16     (1) the juvenile court has determined or is expected to 
435.17  determine that the child, under the former or current custody of 
435.18  the local agency, cannot return to the home of the child's 
435.19  parents; 
435.20     (2) the court, upon determining that it is in the child's 
435.21  best interests, has issued or is expected to issue an order 
435.22  transferring permanent legal and physical custody of the child 
435.23  to the relative; and 
435.24     (3) the child either: 
435.25     (i) is a member of a sibling group to be placed together; 
435.26  or 
435.27     (ii) has a physical, mental, emotional, or behavioral 
435.28  disability that will require financial support. 
435.29     When the local agency bases its certification that the 
435.30  criteria in clause (1) or (2) are met upon the expectation that 
435.31  the juvenile court will take a certain action, the relative 
435.32  custody assistance agreement does not become effective until and 
435.33  unless the court acts as expected. 
435.34     Sec. 32.  Minnesota Statutes 1998, section 257.85, 
435.35  subdivision 7, is amended to read: 
435.36     Subd. 7.  [AMOUNT OF RELATIVE CUSTODY ASSISTANCE PAYMENTS.] 
436.1   (a) The amount of a monthly relative custody assistance payment 
436.2   shall be determined according to the provisions of this 
436.3   paragraph. 
436.4      (1) The total maximum assistance rate is equal to the base 
436.5   assistance rate plus, if applicable, the supplemental assistance 
436.6   rate. 
436.7      (i) The base assistance rate is equal to the maximum amount 
436.8   that could be received as basic maintenance for a child of the 
436.9   same age under the adoption assistance program. 
436.10     (ii) The local agency shall determine whether the child has 
436.11  physical, mental, emotional, or behavioral disabilities that 
436.12  require care, supervision, or structure beyond that ordinarily 
436.13  provided in a family setting to children of the same age such 
436.14  that the child would be eligible for supplemental maintenance 
436.15  payments under the adoption assistance program if an adoption 
436.16  assistance agreement were entered on the child's behalf.  If the 
436.17  local agency determines that the child has such a disability, 
436.18  the supplemental assistance rate shall be the maximum amount of 
436.19  monthly supplemental maintenance payment that could be received 
436.20  on behalf of a child of the same age, disabilities, and 
436.21  circumstances under the adoption assistance program. 
436.22     (2) The net maximum assistance rate is equal to the total 
436.23  maximum assistance rate from clause (1) less the following 
436.24  offsets: 
436.25     (i) if the child is or will be part of an assistance unit 
436.26  receiving an AFDC, MFIP-S, or other MFIP grant or a grant from a 
436.27  similar program of another state, the portion of the AFDC or 
436.28  MFIP standard relating to the child as calculated under 
436.29  paragraph (b), clause (2); 
436.30     (ii) Supplemental Security Income payments received by or 
436.31  on behalf of the child; 
436.32     (iii) veteran's benefits received by or on behalf of the 
436.33  child; and 
436.34     (iv) any other income of the child, including child support 
436.35  payments made on behalf of the child. 
436.36     (3) The relative custody assistance payment to be made to 
437.1   the relative custodian shall be a percentage of the net maximum 
437.2   assistance rate calculated in clause (2) based upon the gross 
437.3   income of the relative custodian's family, including the child 
437.4   for whom the relative custodian has permanent legal and physical 
437.5   custody.  In no case shall the amount of the relative custody 
437.6   assistance payment exceed that which the child could qualify for 
437.7   under the adoption assistance program if an adoption assistance 
437.8   agreement were entered on the child's behalf.  The relative 
437.9   custody assistance payment shall be calculated as follows: 
437.10     (i) if the relative custodian's gross family income is less 
437.11  than or equal to 200 percent of federal poverty guidelines, the 
437.12  relative custody assistance payment shall be the full amount of 
437.13  the net maximum assistance rate; 
437.14     (ii) if the relative custodian's gross family income is 
437.15  greater than 200 percent and less than or equal to 225 percent 
437.16  of federal poverty guidelines, the relative custody assistance 
437.17  payment shall be 80 percent of the net maximum assistance rate; 
437.18     (iii) if the relative custodian's gross family income is 
437.19  greater than 225 percent and less than or equal to 250 percent 
437.20  of federal poverty guidelines, the relative custody assistance 
437.21  payment shall be 60 percent of the net maximum assistance rate; 
437.22     (iv) if the relative custodian's gross family income is 
437.23  greater than 250 percent and less than or equal to 275 percent 
437.24  of federal poverty guidelines, the relative custody assistance 
437.25  payment shall be 40 percent of the net maximum assistance rate; 
437.26     (v) if the relative custodian's gross family income is 
437.27  greater than 275 percent and less than or equal to 300 percent 
437.28  of federal poverty guidelines, the relative custody assistance 
437.29  payment shall be 20 percent of the net maximum assistance rate; 
437.30  or 
437.31     (vi) if the relative custodian's gross family income is 
437.32  greater than 300 percent of federal poverty guidelines, no 
437.33  relative custody assistance payment shall be made. 
437.34     (b) This paragraph specifies the provisions pertaining to 
437.35  the relationship between relative custody assistance and AFDC, 
437.36  MFIP-S, or other MFIP programs The following provisions cover 
438.1   the relationship between relative custody assistance and 
438.2   assistance programs: 
438.3      (1) The relative custodian of a child for whom the relative 
438.4   custodian is receiving relative custody assistance is expected 
438.5   to seek whatever assistance is available for the child 
438.6   through the AFDC, MFIP-S, or other MFIP, if the relative 
438.7   custodian resides in a state other than Minnesota, similar 
438.8   programs of that state.  If a relative custodian fails to apply 
438.9   for assistance through AFDC, MFIP-S, or other MFIP program for 
438.10  which the child is eligible, the child's portion of the AFDC or 
438.11  MFIP standard will be calculated as if application had been made 
438.12  and assistance received;. 
438.13     (2) The portion of the AFDC or MFIP standard relating to 
438.14  each child for whom relative custody assistance is being 
438.15  received shall be calculated as follows: 
438.16     (i) determine the total AFDC or MFIP standard for the 
438.17  assistance unit; 
438.18     (ii) determine the amount that the AFDC or MFIP standard 
438.19  would have been if the assistance unit had not included the 
438.20  children for whom relative custody assistance is being received; 
438.21     (iii) subtract the amount determined in item (ii) from the 
438.22  amount determined in item (i); and 
438.23     (iv) divide the result in item (iii) by the number of 
438.24  children for whom relative custody assistance is being received 
438.25  that are part of the assistance unit; or. 
438.26     (3) If a child for whom relative custody assistance is 
438.27  being received is not eligible for assistance through the AFDC, 
438.28  MFIP-S, or other MFIP similar programs of another state, the 
438.29  portion of AFDC or MFIP standard relating to that child shall be 
438.30  equal to zero. 
438.31     Sec. 33.  Minnesota Statutes 1998, section 257.85, 
438.32  subdivision 9, is amended to read: 
438.33     Subd. 9.  [RIGHT OF APPEAL.] A relative custodian who 
438.34  enters or seeks to enter into a relative custody assistance 
438.35  agreement with a local agency has the right to appeal to the 
438.36  commissioner according to section 256.045 when the local agency 
439.1   establishes, denies, terminates, or modifies the agreement.  
439.2   Upon appeal, the commissioner may review only: 
439.3      (1) whether the local agency has met the legal requirements 
439.4   imposed by this chapter for establishing, denying, terminating, 
439.5   or modifying the agreement; 
439.6      (2) whether the amount of the relative custody assistance 
439.7   payment was correctly calculated under the method in subdivision 
439.8   7; 
439.9      (3) whether the local agency paid for correct time periods 
439.10  under the relative custody assistance agreement; 
439.11     (4) whether the child remains in the physical custody of 
439.12  the relative custodian; 
439.13     (5) whether the local agency correctly calculated modified 
439.14  the amount of the supplemental assistance rate based on a change 
439.15  in the child's physical, mental, emotional, or behavioral needs, 
439.16  or based on the relative custodian's failure to document provide 
439.17  documentation, after the local agency has requested such 
439.18  documentation, that the continuing need for the supplemental 
439.19  assistance rate after the local agency has requested such 
439.20  documentation child continues to have physical, mental, 
439.21  emotional, or behavioral needs that support the current amount 
439.22  of relative custody assistance; and 
439.23     (6) whether the local agency correctly calculated modified 
439.24  or terminated the amount of relative custody assistance based on 
439.25  a change in the gross income of the relative custodian's family 
439.26  or based on the relative custodian's failure to provide 
439.27  documentation of the gross income of the relative custodian's 
439.28  family after the local agency has requested such documentation. 
439.29     Sec. 34.  Minnesota Statutes 1998, section 257.85, 
439.30  subdivision 11, is amended to read: 
439.31     Subd. 11.  [FINANCIAL CONSIDERATIONS.] (a) Payment of 
439.32  relative custody assistance under a relative custody assistance 
439.33  agreement is subject to the availability of state funds and 
439.34  payments may be reduced or suspended on order of the 
439.35  commissioner if insufficient funds are available. 
439.36     (b) Upon receipt from a local agency of a claim for 
440.1   reimbursement, the commissioner shall reimburse the local agency 
440.2   in an amount equal to 100 percent of the relative custody 
440.3   assistance payments provided to relative custodians.  The local 
440.4   agency may not seek and the commissioner shall not provide 
440.5   reimbursement for the administrative costs associated with 
440.6   performing the duties described in subdivision 4. 
440.7      (c) For the purposes of determining eligibility or payment 
440.8   amounts under the AFDC, MFIP-S, and other MFIP programs, 
440.9   relative custody assistance payments shall be considered 
440.10  excluded in determining the family's available income. 
440.11     Sec. 35.  Minnesota Statutes 1998, section 259.29, 
440.12  subdivision 2, is amended to read: 
440.13     Subd. 2.  [PLACEMENT WITH RELATIVE OR, FRIEND, OR MARRIED 
440.14  COUPLE.] The authorized child-placing agency shall consider 
440.15  placement, consistent with the child's best interests and in the 
440.16  following order, with (1) a relative or relatives of the 
440.17  child, or (2) an important friend with whom the child has 
440.18  resided or had significant contact, or (3) a married 
440.19  couple.  Considering these placement options shall not delay the 
440.20  placement of any child.  Nothing in this section prohibits the 
440.21  placement of a child with an unmarried person.  In implementing 
440.22  this section, an authorized child-placing agency may disclose 
440.23  private or confidential data, as defined in section 13.02, to 
440.24  relatives of the child for the purpose of locating a suitable 
440.25  adoptive home.  The agency shall disclose only data that is 
440.26  necessary to facilitate implementing the preference.  
440.27     If the child's birth parent or parents explicitly request 
440.28  that placement with relatives or important friends not be 
440.29  considered, the authorized child-placing agency shall honor that 
440.30  request consistent with the best interests of the child. 
440.31     If the child's birth parent or parents express a preference 
440.32  for placing the child in an adoptive home of the same or a 
440.33  similar religious background to that of the birth parent or 
440.34  parents, the agency shall place the child with a family that 
440.35  meets the birth parent's religious preference.  
440.36     This subdivision does not affect the Indian Child Welfare 
441.1   Act, United States Code, title 25, sections 1901 to 1923, and 
441.2   the Minnesota Indian Family Preservation Act, sections 257.35 to 
441.3   257.3579. 
441.4      Sec. 36.  Minnesota Statutes 1998, section 259.67, 
441.5   subdivision 6, is amended to read: 
441.6      Subd. 6.  [RIGHT OF APPEAL.] (a) The adoptive parents have 
441.7   the right to appeal to the commissioner pursuant to section 
441.8   256.045, when the commissioner denies, discontinues, or modifies 
441.9   the agreement.  
441.10     (b) Adoptive parents who believe that their adopted child 
441.11  was incorrectly denied adoption assistance, or who did not seek 
441.12  adoption assistance on the child's behalf because of being 
441.13  provided with inaccurate or insufficient information about the 
441.14  child or the adoption assistance program, may request a hearing 
441.15  under section 256.045.  Notwithstanding subdivision 2, the 
441.16  purpose of the hearing shall be to determine whether, under 
441.17  standards established by the federal Department of Health and 
441.18  Human Services, the circumstances surrounding the child's 
441.19  adoption warrant making an adoption assistance agreement on 
441.20  behalf of the child after the final decree of adoption has been 
441.21  issued.  The commissioner shall enter into an adoption 
441.22  assistance agreement on the child's behalf if it is determined 
441.23  that:  (1) at the time of the adoption and at the time the 
441.24  request for a hearing was submitted the child was eligible for 
441.25  adoption assistance under United States Code, title 42, chapter 
441.26  7, subchapter IV, part E, sections 670 to 679a, at the time of 
441.27  the adoption and at the time the request for a hearing was 
441.28  submitted but, because of extenuating circumstances, did not 
441.29  receive or for state funded adoption assistance under 
441.30  subdivision 4; and (2) an adoption assistance agreement was not 
441.31  entered into on behalf of the child before the final decree of 
441.32  adoption because of extenuating circumstances as the term is 
441.33  used in the standards established by the federal Department of 
441.34  Health and Human Services.  An adoption assistance agreement 
441.35  made under this paragraph shall be effective the date the 
441.36  request for a hearing was received by the commissioner or the 
442.1   local agency. 
442.2      Sec. 37.  Minnesota Statutes 1998, section 259.67, 
442.3   subdivision 7, is amended to read: 
442.4      Subd. 7.  [REIMBURSEMENT OF COSTS.] (a) Subject to rules of 
442.5   the commissioner, and the provisions of this subdivision 
442.6   a Minnesota-licensed child-placing agency licensed in Minnesota 
442.7   or any other state, or local social services agency shall 
442.8   receive a reimbursement from the commissioner equal to 100 
442.9   percent of the reasonable and appropriate cost of providing 
442.10  adoption services for a child certified as eligible for adoption 
442.11  assistance under subdivision 4.  Such assistance may include 
442.12  adoptive family recruitment, counseling, and special training 
442.13  when needed.  A Minnesota-licensed child-placing agency licensed 
442.14  in Minnesota or any other state shall receive reimbursement for 
442.15  adoption services it purchases for or directly provides to an 
442.16  eligible child.  A local social services agency shall receive 
442.17  such reimbursement only for adoption services it purchases for 
442.18  an eligible child. 
442.19     (b) A Minnesota-licensed child-placing agency licensed in 
442.20  Minnesota or any other state or local social services agency 
442.21  seeking reimbursement under this subdivision shall enter into a 
442.22  reimbursement agreement with the commissioner before providing 
442.23  adoption services for which reimbursement is sought.  No 
442.24  reimbursement under this subdivision shall be made to an agency 
442.25  for services provided prior to entering a reimbursement 
442.26  agreement.  Separate reimbursement agreements shall be made for 
442.27  each child and separate records shall be kept on each child for 
442.28  whom a reimbursement agreement is made.  Funds encumbered and 
442.29  obligated under such an agreement for the child remain available 
442.30  until the terms of the agreement are fulfilled or the agreement 
442.31  is terminated. 
442.32     (c) When a local social services agency uses a purchase of 
442.33  service agreement to provide services reimbursable under a 
442.34  reimbursement agreement, the commissioner may make reimbursement 
442.35  payments directly to the agency providing the service if direct 
442.36  reimbursement is specified by the purchase of service agreement, 
443.1   and if the request for reimbursement is submitted by the local 
443.2   social services agency along with a verification that the 
443.3   service was provided. 
443.4      Sec. 38.  Minnesota Statutes 1998, section 259.73, is 
443.5   amended to read: 
443.6      259.73 [REIMBURSEMENT OF NONRECURRING ADOPTION EXPENSES.] 
443.7      The commissioner of human services shall provide 
443.8   reimbursement of up to $2,000 to the adoptive parent or parents 
443.9   for costs incurred in adopting a child with special needs.  The 
443.10  commissioner shall determine the child's eligibility for 
443.11  adoption expense reimbursement under title IV-E of the Social 
443.12  Security Act, United States Code, title 42, sections 670 to 
443.13  676.  To be reimbursed, costs must be reasonable, necessary, and 
443.14  directly related to the legal adoption of the child. 
443.15     Sec. 39.  Minnesota Statutes 1998, section 259.85, 
443.16  subdivision 2, is amended to read: 
443.17     Subd. 2.  [ELIGIBILITY CRITERIA.] A child may be certified 
443.18  by the local social service services agency as eligible for a 
443.19  postadoption service grant after a final decree of adoption and 
443.20  before the child's 18th birthday if: 
443.21     (a) (1) the child was a ward of the commissioner or a 
443.22  Minnesota licensed child-placing agency before adoption; 
443.23     (b) (2) the child had special needs at the time of adoption.
443.24  For the purposes of this section, "special needs" means a child 
443.25  who had a physical, mental, emotional, or behavioral disability 
443.26  at the time of an adoption or has a preadoption background to 
443.27  which the current development of such disabilities can be 
443.28  attributed; and 
443.29     (c) (3) the adoptive parents have exhausted all other 
443.30  available resources.  Available resources include public income 
443.31  support programs, medical assistance, health insurance coverage, 
443.32  services available through community resources, and any other 
443.33  private or public benefits or resources available to the family 
443.34  or to the child to meet the child's special needs; and 
443.35     (4) the child is under 18 years of age or, if the child is 
443.36  under 22 years of age and remains dependent on the adoptive 
444.1   parent or parents for care and financial support and is enrolled 
444.2   in a secondary education program as a full-time student.  
444.3      Sec. 40.  Minnesota Statutes 1998, section 259.85, 
444.4   subdivision 3, is amended to read: 
444.5      Subd. 3.  [CERTIFICATION STATEMENT.] The local social 
444.6   service services agency shall certify a child's eligibility for 
444.7   a postadoption service grant in writing to the commissioner.  
444.8   The certification statement shall include:  
444.9      (1) a description and history of the special needs upon 
444.10  which eligibility is based; and 
444.11     (2) separate certification for each of the eligibility 
444.12  criteria under subdivision 2, that the criteria is met; and 
444.13     (3) applicable supporting documentation including: 
444.14     (i) the child's individual service plan; 
444.15     (ii) medical, psychological, or special education 
444.16  evaluations; 
444.17     (iii) documentation that all other resources have been 
444.18  exhausted; and 
444.19     (iv) an estimate of the costs necessary to meet the special 
444.20  needs of the child.  
444.21     Sec. 41.  Minnesota Statutes 1998, section 259.85, 
444.22  subdivision 5, is amended to read: 
444.23     Subd. 5.  [GRANT PAYMENTS.] The amount of the postadoption 
444.24  service grant payment shall be based on the special needs of the 
444.25  child and the determination that other resources to meet those 
444.26  special needs are not available.  The amount of any grant 
444.27  payments shall be based on the severity of the child's 
444.28  disability and the effect of the disability on the family and 
444.29  must not exceed $10,000 annually.  Adoptive parents are eligible 
444.30  for grant payments until their child's 18th birthday, or if the 
444.31  child is under 22 years of age and remains dependent on the 
444.32  adoptive parent or parents for care and financial support and is 
444.33  enrolled in a secondary education program as a full-time student.
444.34     Permissible expenses that may be paid from grants shall be 
444.35  limited to:  
444.36     (1) medical expenses not covered by the family's health 
445.1   insurance or medical assistance; 
445.2      (2) therapeutic expenses, including individual and family 
445.3   therapy; and 
445.4      (3) nonmedical services, items, or equipment required to 
445.5   meet the special needs of the child.  
445.6      The grants under this section shall not be used for 
445.7   maintenance for out-of-home placement of the child in substitute 
445.8   care. 
445.9      Sec. 42.  Minnesota Statutes 1998, section 259.89, is 
445.10  amended by adding a subdivision to read: 
445.11     Subd. 6.  [DETERMINATION OF ELIGIBILITY FOR ENROLLMENT OR 
445.12  MEMBERSHIP IN A FEDERALLY RECOGNIZED AMERICAN INDIAN TRIBE.] The 
445.13  state registrar shall provide a copy of an adopted person's 
445.14  original birth certificate to an authorized representative of a 
445.15  federally recognized American Indian tribe for the sole purpose 
445.16  of determining the adopted person's eligibility for enrollment 
445.17  or membership in the tribe. 
445.18     Sec. 43.  Minnesota Statutes 1998, section 260.011, 
445.19  subdivision 2, is amended to read: 
445.20     Subd. 2.  (a) The paramount consideration in all 
445.21  proceedings concerning a child alleged or found to be in need of 
445.22  protection or services is the health, safety, and best interests 
445.23  of the child.  In proceedings involving an American Indian 
445.24  child, as defined in section 257.351, subdivision 6, the best 
445.25  interests of the child must be determined consistent with 
445.26  sections 257.35 to 257.3579 and the Indian Child Welfare Act, 
445.27  United States Code, title 25, sections 1901 to 1923.  The 
445.28  purpose of the laws relating to juvenile courts is to secure for 
445.29  each child alleged or adjudicated in need of protection or 
445.30  services and under the jurisdiction of the court, the care and 
445.31  guidance, preferably in the child's own home, as will best serve 
445.32  the spiritual, emotional, mental, and physical welfare of the 
445.33  child; to provide judicial procedures which protect the welfare 
445.34  of the child; to preserve and strengthen the child's family ties 
445.35  whenever possible and in the child's best interests, removing 
445.36  the child from the custody of parents only when the child's 
446.1   welfare or safety cannot be adequately safeguarded without 
446.2   removal; and, when removal from the child's own family is 
446.3   necessary and in the child's best interests, to secure for the 
446.4   child custody, care and discipline as nearly as possible 
446.5   equivalent to that which should have been given by the parents.  
446.6      (b) The purpose of the laws relating to termination of 
446.7   parental rights is to ensure that: 
446.8      (1) when required and appropriate, reasonable efforts have 
446.9   been made by the social service services agency to reunite the 
446.10  child with the child's parents in a placement home that is safe 
446.11  and permanent; and 
446.12     (2) if placement with the parents is not reasonably 
446.13  foreseeable, to secure for the child a safe and permanent 
446.14  placement, preferably with adoptive parents or a fit and willing 
446.15  relative through transfer of permanent legal and physical 
446.16  custody to that relative. 
446.17     Nothing in this section requires reasonable efforts to be 
446.18  made in circumstances where the court has determined that the 
446.19  child has been subjected to egregious harm or the parental 
446.20  rights of the parent to a sibling have been involuntarily 
446.21  terminated. 
446.22     The paramount consideration in all proceedings for the 
446.23  termination of parental rights is the best interests of the 
446.24  child.  In proceedings involving an American Indian child, as 
446.25  defined in section 257.351, subdivision 6, the best interests of 
446.26  the child must be determined consistent with the Indian Child 
446.27  Welfare Act of 1978, United States Code, title 25, section 1901, 
446.28  et seq.  
446.29     (c) The purpose of the laws relating to children alleged or 
446.30  adjudicated to be delinquent is to promote the public safety and 
446.31  reduce juvenile delinquency by maintaining the integrity of the 
446.32  substantive law prohibiting certain behavior and by developing 
446.33  individual responsibility for lawful behavior.  This purpose 
446.34  should be pursued through means that are fair and just, that 
446.35  recognize the unique characteristics and needs of children, and 
446.36  that give children access to opportunities for personal and 
447.1   social growth.  
447.2      (d) The laws relating to juvenile courts shall be liberally 
447.3   construed to carry out these purposes.  
447.4      Sec. 44.  Minnesota Statutes 1998, section 260.012, is 
447.5   amended to read: 
447.6      260.012 [DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY 
447.7   REUNIFICATION; REASONABLE EFFORTS.] 
447.8      (a) If Once a child alleged to be in need of protection or 
447.9   services is under the court's jurisdiction, the court shall 
447.10  ensure that reasonable efforts including culturally appropriate 
447.11  services by the social service services agency are made to 
447.12  prevent placement or to eliminate the need for removal and to 
447.13  reunite the child with the child's family at the earliest 
447.14  possible time, consistent with the best interests, safety, and 
447.15  protection of the child.  The court may, upon motion and 
447.16  hearing, order the cessation of reasonable efforts if the court 
447.17  finds that provision of services or further services for the 
447.18  purpose of rehabilitation and reunification is futile and 
447.19  therefore unreasonable under the circumstances.  In determining 
447.20  reasonable efforts to be made with respect to a child and in 
447.21  making those reasonable efforts, the child's health and safety 
447.22  must be of paramount concern.  Reasonable efforts for 
447.23  rehabilitation and reunification are not required if upon a 
447.24  determination by the court determines that: 
447.25     (1) a termination of parental rights petition has been 
447.26  filed stating a prima facie case that: 
447.27     (i) the parent has subjected the a child to egregious harm 
447.28  as defined in section 260.015, subdivision 29, or; 
447.29     (ii) the parental rights of the parent to a sibling another 
447.30  child have been terminated involuntarily; or 
447.31     (iii) the child is an abandoned infant under section 
447.32  260.221, subdivision 1a, paragraph (a), clause (2); 
447.33     (2) the county attorney has filed a determination not to 
447.34  proceed with a termination of parental rights petition on these 
447.35  grounds was made under section 260.221, subdivision 1b, 
447.36  paragraph (b), and a permanency hearing is held within 30 days 
448.1   of the determination.; or 
448.2      (3) a termination of parental rights petition or other 
448.3   petition according to section 260.191, subdivision 3b, has been 
448.4   filed alleging a prima facie case that the provision of services 
448.5   or further services for the purpose of reunification is futile 
448.6   and therefore unreasonable under the circumstances. 
448.7      In the case of an Indian child, in proceedings under 
448.8   sections 260.172, 260.191, and 260.221 the juvenile court must 
448.9   make findings and conclusions consistent with the Indian Child 
448.10  Welfare Act of 1978, United States Code, title 25, section 1901 
448.11  et seq., as to the provision of active efforts.  If a child is 
448.12  under the court's delinquency jurisdiction, it shall be the duty 
448.13  of the court to ensure that reasonable efforts are made to 
448.14  reunite the child with the child's family at the earliest 
448.15  possible time, consistent with the best interests of the child 
448.16  and the safety of the public. 
448.17     (b) "Reasonable efforts" means the exercise of due 
448.18  diligence by the responsible social service services agency to 
448.19  use appropriate and available services to meet the needs of the 
448.20  child and the child's family in order to prevent removal of the 
448.21  child from the child's family; or upon removal, services to 
448.22  eliminate the need for removal and reunite the family.  
448.23     (1) Services may include those listed under section 
448.24  256F.07, subdivision 3, and other appropriate services available 
448.25  in the community.  
448.26     (2) At each stage of the proceedings where the court is 
448.27  required to review the appropriateness of the responsible social 
448.28  services agency's reasonable efforts, the social service 
448.29  services agency has the burden of demonstrating that it has made 
448.30  reasonable efforts, or that provision of services or further 
448.31  services for the purpose of rehabilitation and reunification is 
448.32  futile and therefore unreasonable under the circumstances. or 
448.33  that reasonable efforts aimed at reunification are not required 
448.34  under this section.  The agency may meet this burden by stating 
448.35  facts in a sworn petition filed under section 260.131, or by 
448.36  filing an affidavit summarizing the agency's reasonable efforts 
449.1   or facts the agency believes demonstrate there is no need for 
449.2   reasonable efforts to reunify the parent and child. 
449.3      (3) No reasonable efforts for reunification are required 
449.4   when the court makes a determination under paragraph (a) unless, 
449.5   after a hearing according to section 260.155, the court finds 
449.6   there is not clear and convincing evidence of the facts upon 
449.7   which the court based its prima facie determination.  In this 
449.8   case, the court may proceed under section 260.235.  
449.9   Reunification of a surviving child with a parent is not required 
449.10  if the parent has been convicted of: 
449.11     (1) (i) a violation of, or an attempt or conspiracy to 
449.12  commit a violation of, sections 609.185 to 609.20; 609.222, 
449.13  subdivision 2; or 609.223 in regard to another child of the 
449.14  parent; 
449.15     (2) (ii) a violation of section 609.222, subdivision 2; or 
449.16  609.223, in regard to the surviving child; or 
449.17     (3) (iii) a violation of, or an attempt or conspiracy to 
449.18  commit a violation of, United States Code, title 18, section 
449.19  1111(a) or 1112(a), in regard to another child of the parent. 
449.20     (c) The juvenile court, in proceedings under sections 
449.21  260.172, 260.191, and 260.221 shall make findings and 
449.22  conclusions as to the provision of reasonable efforts.  When 
449.23  determining whether reasonable efforts have been made, the court 
449.24  shall consider whether services to the child and family were: 
449.25     (1) relevant to the safety and protection of the child; 
449.26     (2) adequate to meet the needs of the child and family; 
449.27     (3) culturally appropriate; 
449.28     (4) available and accessible; 
449.29     (5) consistent and timely; and 
449.30     (6) realistic under the circumstances. 
449.31     In the alternative, the court may determine that provision 
449.32  of services or further services for the purpose of 
449.33  rehabilitation is futile and therefore unreasonable under the 
449.34  circumstances or that reasonable efforts are not required as 
449.35  provided in paragraph (a). 
449.36     (d) This section does not prevent out-of-home placement for 
450.1   treatment of a child with a mental disability when the child's 
450.2   diagnostic assessment or individual treatment plan indicates 
450.3   that appropriate and necessary treatment cannot be effectively 
450.4   provided outside of a residential or inpatient treatment program.
450.5      (e) If continuation of reasonable efforts described in 
450.6   paragraph (b) is determined by the court to be inconsistent with 
450.7   the permanency permanent plan for the child, or upon a 
450.8   determination under paragraph (a), reasonable efforts must be 
450.9   made to place the child in a timely manner in accordance with 
450.10  the permanency permanent plan ordered by the court and to 
450.11  complete whatever steps are necessary to finalize the permanency 
450.12  permanent plan for the child.  
450.13     (f) Reasonable efforts to place a child for adoption or in 
450.14  another permanent placement may be made concurrently with 
450.15  reasonable efforts as described in paragraphs (a) and (b).  When 
450.16  the responsible social services agency decides to concurrently 
450.17  make reasonable efforts for both reunification and permanent 
450.18  placement away from the parent under paragraphs (a) and (b), the 
450.19  agency shall disclose its decision and both plans for concurrent 
450.20  reasonable efforts to all parties and the court.  When the 
450.21  agency discloses its decision to proceed on both plans for 
450.22  reunification and permanent placement away from the parent, the 
450.23  court's review of the agency's reasonable efforts shall include 
450.24  the agency's efforts under paragraphs (a) and (b). 
450.25     Sec. 45.  Minnesota Statutes 1998, section 260.015, 
450.26  subdivision 2a, is amended to read: 
450.27     Subd. 2a.  [CHILD IN NEED OF PROTECTION OR SERVICES.] 
450.28  "Child in need of protection or services" means a child who is 
450.29  in need of protection or services because the child: 
450.30     (1) is abandoned or without parent, guardian, or custodian; 
450.31     (2)(i) has been a victim of physical or sexual abuse, (ii) 
450.32  resides with or has resided with a victim of domestic child 
450.33  abuse as defined in subdivision 24, (iii) resides with or would 
450.34  reside with a perpetrator of domestic child abuse or child abuse 
450.35  as defined in subdivision 28, or (iv) is a victim of emotional 
450.36  maltreatment as defined in subdivision 5a; 
451.1      (3) is without necessary food, clothing, shelter, 
451.2   education, or other required care for the child's physical or 
451.3   mental health or morals because the child's parent, guardian, or 
451.4   custodian is unable or unwilling to provide that care; 
451.5      (4) is without the special care made necessary by a 
451.6   physical, mental, or emotional condition because the child's 
451.7   parent, guardian, or custodian is unable or unwilling to provide 
451.8   that care, including a child in voluntary placement according to 
451.9   release of the parent under section 257.071, subdivision 4; 
451.10     (5) is medically neglected, which includes, but is not 
451.11  limited to, the withholding of medically indicated treatment 
451.12  from a disabled infant with a life-threatening condition.  The 
451.13  term "withholding of medically indicated treatment" means the 
451.14  failure to respond to the infant's life-threatening conditions 
451.15  by providing treatment, including appropriate nutrition, 
451.16  hydration, and medication which, in the treating physician's or 
451.17  physicians' reasonable medical judgment, will be most likely to 
451.18  be effective in ameliorating or correcting all conditions, 
451.19  except that the term does not include the failure to provide 
451.20  treatment other than appropriate nutrition, hydration, or 
451.21  medication to an infant when, in the treating physician's or 
451.22  physicians' reasonable medical judgment: 
451.23     (i) the infant is chronically and irreversibly comatose; 
451.24     (ii) the provision of the treatment would merely prolong 
451.25  dying, not be effective in ameliorating or correcting all of the 
451.26  infant's life-threatening conditions, or otherwise be futile in 
451.27  terms of the survival of the infant; or 
451.28     (iii) the provision of the treatment would be virtually 
451.29  futile in terms of the survival of the infant and the treatment 
451.30  itself under the circumstances would be inhumane; 
451.31     (6) is one whose parent, guardian, or other custodian for 
451.32  good cause desires to be relieved of the child's care and 
451.33  custody, including a child in placement according to voluntary 
451.34  release by the parent under section 257.071, subdivision 3; 
451.35     (7) has been placed for adoption or care in violation of 
451.36  law; 
452.1      (8) is without proper parental care because of the 
452.2   emotional, mental, or physical disability, or state of 
452.3   immaturity of the child's parent, guardian, or other custodian; 
452.4      (9) is one whose behavior, condition, or environment is 
452.5   such as to be injurious or dangerous to the child or others.  An 
452.6   injurious or dangerous environment may include, but is not 
452.7   limited to, the exposure of a child to criminal activity in the 
452.8   child's home; 
452.9      (10) is experiencing growth delays, which may be referred 
452.10  to as failure to thrive, that have been diagnosed by a physician 
452.11  and are due to parental neglect; 
452.12     (11) has engaged in prostitution as defined in section 
452.13  609.321, subdivision 9; 
452.14     (12) has committed a delinquent act or a juvenile petty 
452.15  offense before becoming ten years old; 
452.16     (13) is a runaway; 
452.17     (14) is an habitual truant; 
452.18     (15) has been found incompetent to proceed or has been 
452.19  found not guilty by reason of mental illness or mental 
452.20  deficiency in connection with a delinquency proceeding, a 
452.21  certification under section 260.125, an extended jurisdiction 
452.22  juvenile prosecution, or a proceeding involving a juvenile petty 
452.23  offense; 
452.24     (16) is one whose custodial parent's parental rights to 
452.25  another child have been involuntarily terminated within the past 
452.26  five years; or 
452.27     (17) has been found by the court to have committed domestic 
452.28  abuse perpetrated by a minor under Laws 1997, chapter 239, 
452.29  article 10, sections 2 to 26, has been ordered excluded from the 
452.30  child's parent's home by an order for protection/minor 
452.31  respondent, and the parent or guardian is either unwilling or 
452.32  unable to provide an alternative safe living arrangement for the 
452.33  child. 
452.34     Sec. 46.  Minnesota Statutes 1998, section 260.015, 
452.35  subdivision 13, is amended to read: 
452.36     Subd. 13.  [RELATIVE.] "Relative" means a parent, 
453.1   stepparent, grandparent, brother, sister, uncle, or aunt of the 
453.2   minor.  This relationship may be by blood or marriage.  For an 
453.3   Indian child, relative includes members of the extended family 
453.4   as defined by the law or custom of the Indian child's tribe or, 
453.5   in the absence of laws or custom, nieces, nephews, or first or 
453.6   second cousins, as provided in the Indian Child Welfare Act of 
453.7   1978, United States Code, title 25, section 1903.  For purposes 
453.8   of dispositions, relative has the meaning given in section 
453.9   260.181, subdivision 3. child in need of protection or services 
453.10  proceedings, termination of parental rights proceedings, and 
453.11  permanency proceedings under section 260.191, subdivision 3b, 
453.12  relative means a person related to the child by blood, marriage, 
453.13  or adoption, or an individual who is an important friend with 
453.14  whom the child has resided or had significant contact. 
453.15     Sec. 47.  Minnesota Statutes 1998, section 260.015, 
453.16  subdivision 29, is amended to read: 
453.17     Subd. 29.  [EGREGIOUS HARM.] "Egregious harm" means the 
453.18  infliction of bodily harm to a child or neglect of a child which 
453.19  demonstrates a grossly inadequate ability to provide minimally 
453.20  adequate parental care.  The egregious harm need not have 
453.21  occurred in the state or in the county where a termination of 
453.22  parental rights action is otherwise properly venued.  Egregious 
453.23  harm includes, but is not limited to: 
453.24     (1) conduct towards a child that constitutes a violation of 
453.25  sections 609.185 to 609.21, 609.222, subdivision 2, 609.223, or 
453.26  any other similar law of any other state; 
453.27     (2) the infliction of "substantial bodily harm" to a child, 
453.28  as defined in section 609.02, subdivision 7a; 
453.29     (3) conduct towards a child that constitutes felony 
453.30  malicious punishment of a child under section 609.377; 
453.31     (4) conduct towards a child that constitutes felony 
453.32  unreasonable restraint of a child under section 609.255, 
453.33  subdivision 3; 
453.34     (5) conduct towards a child that constitutes felony neglect 
453.35  or endangerment of a child under section 609.378; 
453.36     (6) conduct towards a child that constitutes assault under 
454.1   section 609.221, 609.222, or 609.223; 
454.2      (7) conduct towards a child that constitutes solicitation, 
454.3   inducement, or promotion of, or receiving profit derived from 
454.4   prostitution under section 609.322; 
454.5      (8) conduct toward a child that constitutes murder or 
454.6   voluntary manslaughter as defined by United States Code, title 
454.7   18, section 1111(a) or 1112(a); or 
454.8      (9) conduct toward a child that constitutes aiding or 
454.9   abetting, attempting, conspiring, or soliciting to commit a 
454.10  murder or voluntary manslaughter that constitutes a violation of 
454.11  United States Code, title 18, section 1111(a) or 1112(a); or 
454.12     (10) conduct toward a child that constitutes criminal 
454.13  sexual conduct under sections 609.342 to 609.345. 
454.14     Sec. 48.  Minnesota Statutes 1998, section 260.131, 
454.15  subdivision 1a, is amended to read: 
454.16     Subd. 1a.  [REVIEW OF FOSTER CARE STATUS.] The social 
454.17  service services agency responsible for the placement of a child 
454.18  in a residential facility, as defined in section 257.071, 
454.19  subdivision 1, pursuant to a voluntary release by the child's 
454.20  parent or parents may bring a petition in juvenile court to 
454.21  review the foster care status of the child in the manner 
454.22  provided in this section.  The responsible social services 
454.23  agency shall file either a petition alleging the child to be in 
454.24  need of protection or services or a petition to terminate 
454.25  parental rights. 
454.26     (a) In the case of a child in voluntary placement according 
454.27  to section 257.071, subdivision 3, the petition shall be filed 
454.28  within 90 days of the date of the voluntary placement agreement 
454.29  and shall state the reasons why the child is in placement, the 
454.30  progress on the case plan required under section 257.071, 
454.31  subdivision 1, and the statutory basis for the petition under 
454.32  section 260.015, subdivision 2a, or 260.221. 
454.33     (1) In the case of a petition filed under this paragraph, 
454.34  if all parties agree and the court finds it is in the best 
454.35  interests of the child, the court may find the petition states a 
454.36  prima facie case that: 
455.1      (i) the child's needs are being met; 
455.2      (ii) the placement of the child in foster care is in the 
455.3   best interests of the child; and 
455.4      (iii) the child will be returned home in the next six 
455.5   months. 
455.6      (2) If the court makes findings under paragraph (1), the 
455.7   court shall approve the voluntary arrangement and continue the 
455.8   matter for up to six more months to ensure the child returns to 
455.9   the parents' home.  The responsible social services agency shall:
455.10     (i) report to the court when the child returns home and the 
455.11  progress made by the parent on the case plan required under 
455.12  section 257.071, in which case the court shall dismiss 
455.13  jurisdiction; 
455.14     (ii) report to the court that the child has not returned 
455.15  home, in which case the matter shall be returned to the court 
455.16  for further proceedings under section 260.155; or 
455.17     (iii) if any party does not agree to continue the matter 
455.18  under paragraph (1) and this paragraph, the matter shall proceed 
455.19  under section 260.155. 
455.20     (b) In the case of a child in voluntary placement according 
455.21  to section 257.071, subdivision 4, the petition shall be filed 
455.22  within six months of the date of the voluntary placement 
455.23  agreement and shall state the date of the voluntary placement 
455.24  agreement, the nature of the child's developmental delay or 
455.25  emotional handicap, the plan for the ongoing care of the child, 
455.26  the parents' participation in the plan, and the statutory basis 
455.27  for the petition. 
455.28     (1) In the case of petitions filed under this paragraph, 
455.29  the court may find, based on the contents of the sworn petition, 
455.30  and the agreement of all parties, including the child, where 
455.31  appropriate, that the voluntary arrangement is in the best 
455.32  interests of the child, approve the voluntary arrangement, and 
455.33  dismiss the matter from further jurisdiction.  The court shall 
455.34  give notice to the responsible social services agency that the 
455.35  matter must be returned to the court for further review if the 
455.36  child remains in placement after 12 months. 
456.1      (2) If any party, including the child, disagrees with the 
456.2   voluntary arrangement, the court shall proceed under section 
456.3   260.155. 
456.4      Sec. 49.  Minnesota Statutes 1998, section 260.133, 
456.5   subdivision 1, is amended to read: 
456.6      Subdivision 1.  [PETITION.] The local welfare agency may 
456.7   bring an emergency petition on behalf of minor family or 
456.8   household members seeking relief from acts of domestic child 
456.9   abuse.  The petition shall be brought according to section 
456.10  260.131 and shall allege the existence of or immediate and 
456.11  present danger of domestic child abuse, and shall be accompanied 
456.12  by an affidavit made under oath stating the specific facts and 
456.13  circumstances from which relief is sought.  The court has 
456.14  jurisdiction over the parties to a domestic child abuse matter 
456.15  notwithstanding that there is a parent in the child's household 
456.16  who is willing to enforce the court's order and accept services 
456.17  on behalf of the family. 
456.18     Sec. 50.  Minnesota Statutes 1998, section 260.133, 
456.19  subdivision 2, is amended to read: 
456.20     Subd. 2.  [TEMPORARY ORDER.] (a) If it appears from the 
456.21  notarized petition or by sworn affidavit that there are 
456.22  reasonable grounds to believe the child is in immediate and 
456.23  present danger of domestic child abuse, the court may grant an 
456.24  ex parte temporary order for protection, pending a full 
456.25  hearing pursuant to section 260.135, which must be held not 
456.26  later than 14 days after service of the ex parte order on the 
456.27  respondent.  The court may grant relief as it deems proper, 
456.28  including an order:  
456.29     (1) restraining any party from committing acts of domestic 
456.30  child abuse; or 
456.31     (2) excluding the alleged abusing party from the dwelling 
456.32  which the family or household members share or from the 
456.33  residence of the child.  
456.34     However, (b) No order excluding the alleged abusing party 
456.35  from the dwelling may be issued unless the court finds that:  
456.36     (1) the order is in the best interests of the child or 
457.1   children remaining in the dwelling; and 
457.2      (2) a parent remaining adult family or in the child's 
457.3   household member is able to care adequately for the child or 
457.4   children in the absence of the excluded party and to seek 
457.5   appropriate assistance in enforcing the provisions of the order. 
457.6      (c) Before the temporary order is issued, the local welfare 
457.7   agency shall advise the court and the other parties who are 
457.8   present that appropriate social services will be provided to the 
457.9   family or household members during the effective period of the 
457.10  order.  The petition shall identify the parent remaining in the 
457.11  child's household under paragraph (b), clause (2).  
457.12     An ex parte temporary order for protection shall be 
457.13  effective for a fixed period not to exceed 14 days.  Within five 
457.14  days of the issuance of the temporary order, the petitioner 
457.15  shall file a petition with the court pursuant to section 
457.16  260.131, alleging that the child is in need of protection or 
457.17  services and the court shall give docket priority to the 
457.18  petition.  
457.19     The court may renew the temporary order for protection one 
457.20  time for a fixed period not to exceed 14 days if a petition 
457.21  alleging that the child is in need of protection or services has 
457.22  been filed with the court and if the court determines, upon 
457.23  informal review of the case file, that the renewal is 
457.24  appropriate.  If the court determines that the petition states a 
457.25  prima facie case that there are reasonable grounds to believe 
457.26  that the child is in immediate danger of domestic child abuse or 
457.27  child abuse without the court's order, at the hearing pursuant 
457.28  to section 260.135, the court may continue its order issued 
457.29  under this subdivision pending trial under section 260.155. 
457.30     Sec. 51.  Minnesota Statutes 1998, section 260.135, is 
457.31  amended by adding a subdivision to read: 
457.32     Subd. 1a.  After a petition has been filed alleging a child 
457.33  to be in need of protection or services and unless the persons 
457.34  named in clauses (1) to (4) voluntarily appear or are summoned 
457.35  according to subdivision 1, the court shall issue a notice to: 
457.36     (1) an adjudicated or presumed father of the child; 
458.1      (2) an alleged father of the child; 
458.2      (3) a noncustodial mother; and 
458.3      (4) a grandparent with the right to participate under 
458.4   section 260.155, subdivision 1a. 
458.5      Sec. 52.  Minnesota Statutes 1998, section 260.172, 
458.6   subdivision 1, is amended to read: 
458.7      Subdivision 1.  [HEARING AND RELEASE REQUIREMENTS.] (a) If 
458.8   a child was taken into custody under section 260.165, 
458.9   subdivision 1, clause (a) or (c)(2), the court shall hold a 
458.10  hearing within 72 hours of the time the child was taken into 
458.11  custody, excluding Saturdays, Sundays, and holidays, to 
458.12  determine whether the child should continue in custody.  
458.13     (b) In all other cases, the court shall hold a detention 
458.14  hearing: 
458.15     (1) within 36 hours of the time the child was taken into 
458.16  custody, excluding Saturdays, Sundays, and holidays, if the 
458.17  child is being held at a juvenile secure detention facility or 
458.18  shelter care facility; or 
458.19     (2) within 24 hours of the time the child was taken into 
458.20  custody, excluding Saturdays, Sundays, and holidays, if the 
458.21  child is being held at an adult jail or municipal lockup.  
458.22     (c) Unless there is reason to believe that the child would 
458.23  endanger self or others, not return for a court hearing, run 
458.24  away from the child's parent, guardian, or custodian or 
458.25  otherwise not remain in the care or control of the person to 
458.26  whose lawful custody the child is released, or that the child's 
458.27  health or welfare would be immediately endangered, the child 
458.28  shall be released to the custody of a parent, guardian, 
458.29  custodian, or other suitable person, subject to reasonable 
458.30  conditions of release including, but not limited to, a 
458.31  requirement that the child undergo a chemical use assessment as 
458.32  provided in section 260.151, subdivision 1.  In determining 
458.33  whether the child's health or welfare would be immediately 
458.34  endangered, the court shall consider whether the child would 
458.35  reside with a perpetrator of domestic child abuse.  In a 
458.36  proceeding regarding a child in need of protection or services, 
459.1   the court, before determining whether a child should continue in 
459.2   custody, shall also make a determination, consistent with 
459.3   section 260.012 as to whether reasonable efforts, or in the case 
459.4   of an Indian child, active efforts, according to the Indian 
459.5   Child Welfare Act of 1978, United States Code, title 25, section 
459.6   1912(d), were made to prevent placement or to reunite the child 
459.7   with the child's family, or that reasonable efforts were not 
459.8   possible.  The court shall also determine whether there are 
459.9   available services that would prevent the need for further 
459.10  detention. 
459.11     If the court finds the social services agency's preventive 
459.12  or reunification efforts have not been reasonable but further 
459.13  preventive or reunification efforts could not permit the child 
459.14  to safely remain at home, the court may nevertheless authorize 
459.15  or continue the removal of the child. 
459.16     The court may determine (d) At the detention hearing, or at 
459.17  any time prior to an adjudicatory hearing, that reasonable 
459.18  efforts are not required because the facts, if proved, will 
459.19  demonstrate that the parent has subjected the child to egregious 
459.20  harm as defined in section 260.015, subdivision 29, or the 
459.21  parental rights of the parent to a sibling of the child have 
459.22  been terminated involuntarily. and upon notice and request of 
459.23  the county attorney, the court shall make the following 
459.24  determinations: 
459.25     (1) whether a termination of parental rights petition has 
459.26  been filed stating a prima facie case that: 
459.27     (i) the parent has subjected a child to egregious harm as 
459.28  defined in section 260.015, subdivision 29; 
459.29     (ii) the parental rights of the parent to another child 
459.30  have been involuntarily terminated; or 
459.31     (iii) the child is an abandoned infant under section 
459.32  260.221, subdivision 1a, paragraph (a), clause (2); 
459.33     (2) that the county attorney has determined not to proceed 
459.34  with a termination of parental rights petition under section 
459.35  260.221, subdivision 1b; or 
459.36     (3) whether a termination of parental rights petition or 
460.1   other petition according to section 260.191, subdivision 3b, has 
460.2   been filed alleging a prima facie case that the provision of 
460.3   services or further services for the purpose of rehabilitation 
460.4   and reunification is futile and therefore unreasonable under the 
460.5   circumstances. 
460.6      If the court determines that the county attorney is not 
460.7   proceeding with a termination of parental rights petition under 
460.8   section 260.221, subdivision 1b, but is proceeding with a 
460.9   petition under section 260.191, subdivision 3b, the court shall 
460.10  schedule a permanency hearing within 30 days.  If the county 
460.11  attorney has filed a petition under section 260.221, subdivision 
460.12  1b, the court shall schedule a trial under section 260.155 
460.13  within 90 days of the filing of the petition. 
460.14     (e) If the court determines the child should be ordered 
460.15  into out-of-home placement and the child's parent refuses to 
460.16  give information to the responsible social services agency 
460.17  regarding the child's father or relatives of the child, the 
460.18  court may order the parent to disclose the names, addresses, 
460.19  telephone numbers, and other identifying information to the 
460.20  local social services agency for the purpose of complying with 
460.21  the requirements of sections 257.071, 257.072, and 260.135. 
460.22     Sec. 53.  Minnesota Statutes 1998, section 260.172, is 
460.23  amended by adding a subdivision to read: 
460.24     Subd. 5.  [CASE PLAN.] (a) A case plan required under 
460.25  section 257.071 shall be filed with the court within 30 days of 
460.26  the filing of a petition alleging the child to be in need of 
460.27  protection or services under section 260.131. 
460.28     (b) Upon the filing of the case plan, the court may approve 
460.29  the case plan based on the allegations contained in the 
460.30  petition.  A parent may agree to comply with the terms of the 
460.31  case plan filed with the court. 
460.32     (c) Upon notice and motion by a parent who agrees to comply 
460.33  with the terms of a case plan, the court may modify the case and 
460.34  order the responsible social services agency to provide other or 
460.35  additional services for reunification, if reunification efforts 
460.36  are required, and the court determines the agency's case plan 
461.1   inadequate under section 260.012. 
461.2      (d) Unless the parent agrees to comply with the terms of 
461.3   the case plan, the court may not order a parent to comply with 
461.4   the provisions of the case plan until the court makes a 
461.5   determination under section 260.191, subdivision 1. 
461.6      Sec. 54.  Minnesota Statutes 1998, section 260.181, 
461.7   subdivision 3, is amended to read: 
461.8      Subd. 3.  [PROTECTION OF CHILD'S BEST INTERESTS.] (a) The 
461.9   policy of the state is to ensure that the best interests of 
461.10  children are met by requiring individualized determinations of 
461.11  the needs of the child and of how the selected placement will 
461.12  serve the needs of the child in foster care placements.  
461.13     (b) Among the factors to be considered in determining the 
461.14  needs of the child are:  
461.15     (1) the child's current functioning and behaviors; 
461.16     (2) the medical, educational, and developmental needs of 
461.17  the child; 
461.18     (3) the child's history and past experience; 
461.19     (4) the child's religious and cultural needs; 
461.20     (5) the child's connection with a community, school, and 
461.21  church; 
461.22     (6) the child's interests and talents; 
461.23     (7) the child's relationship to current caretakers, 
461.24  parents, siblings, and relatives; and 
461.25     (8) the reasonable preference of the child, if the court, 
461.26  or in the case of a voluntary placement the child-placing 
461.27  agency, deems the child to be of sufficient age to express 
461.28  preferences.  
461.29     (c) The court, in transferring legal custody of any child 
461.30  or appointing a guardian for the child under the laws relating 
461.31  to juvenile courts, shall consider placement, consistent with 
461.32  the child's best interests and in the following order, in the 
461.33  legal custody or guardianship of an individual who (1) is 
461.34  related to the child by blood, marriage, or adoption, or (2) is 
461.35  an important friend with whom the child has resided or had 
461.36  significant contact, or (3) is a married couple.  Considering 
462.1   these placement options shall not delay the placement of any 
462.2   child.  Nothing in this section prohibits the placement of a 
462.3   child with an unmarried person.  Placement of a child cannot be 
462.4   delayed or denied based on race, color, or national origin of 
462.5   the foster parent or the child.  Whenever possible, siblings 
462.6   should be placed together unless it is determined not to be in 
462.7   the best interests of a sibling. 
462.8      (d) If the child's birth parent or parents explicitly 
462.9   request that a relative or important friend not be considered, 
462.10  the court shall honor that request if it is consistent with the 
462.11  best interests of the child. 
462.12     If the child's birth parent or parents express a preference 
462.13  for placing the child in a foster or adoptive home of the same 
462.14  or a similar religious background to that of the birth parent or 
462.15  parents, the court shall order placement of the child with an 
462.16  individual who meets the birth parent's religious preference.  
462.17     (e) This subdivision does not affect the Indian Child 
462.18  Welfare Act, United States Code, title 25, sections 1901 to 
462.19  1923, and the Minnesota Indian Family Preservation Act, sections 
462.20  257.35 to 257.3579. 
462.21     Sec. 55.  Minnesota Statutes 1998, section 260.191, 
462.22  subdivision 1, is amended to read: 
462.23     Subdivision 1.  [DISPOSITIONS.] (a) If the court finds that 
462.24  the child is in need of protection or services or neglected and 
462.25  in foster care, it shall enter an order making any of the 
462.26  following dispositions of the case: 
462.27     (1) place the child under the protective supervision of the 
462.28  local social services agency or child-placing agency in the 
462.29  child's own home of a parent of the child under conditions 
462.30  prescribed by the court directed to the correction of the 
462.31  child's need for protection or services;, or: 
462.32     (i) the court may order the child into the home of a parent 
462.33  who does not otherwise have legal custody of the child, however, 
462.34  an order under this section does not confer legal custody on 
462.35  that parent; 
462.36     (ii) if the court orders the child into the home of a 
463.1   father who is not adjudicated, he must cooperate with paternity 
463.2   establishment proceedings regarding the child in the appropriate 
463.3   jurisdiction as one of the conditions prescribed by the court 
463.4   for the child to continue in his home; 
463.5      (iii) the court may order the child into the home of a 
463.6   noncustodial parent with conditions and may also order both the 
463.7   noncustodial and the custodial parent to comply with the 
463.8   requirements of a case plan under subdivision 1a; 
463.9      (2) transfer legal custody to one of the following: 
463.10     (i) a child-placing agency; or 
463.11     (ii) the local social services agency. 
463.12     In placing a child whose custody has been transferred under 
463.13  this paragraph, the agencies shall follow the order of 
463.14  preference stated in requirements of section 260.181, 
463.15  subdivision 3; 
463.16     (3) if the child is in need of special treatment and care 
463.17  for reasons of physical or mental health, the court may order 
463.18  the child's parent, guardian, or custodian to provide it.  If 
463.19  the parent, guardian, or custodian fails or is unable to provide 
463.20  this treatment or care, the court may order it provided.  The 
463.21  court shall not transfer legal custody of the child for the 
463.22  purpose of obtaining special treatment or care solely because 
463.23  the parent is unable to provide the treatment or care.  If the 
463.24  court's order for mental health treatment is based on a 
463.25  diagnosis made by a treatment professional, the court may order 
463.26  that the diagnosing professional not provide the treatment to 
463.27  the child if it finds that such an order is in the child's best 
463.28  interests; or 
463.29     (4) if the court believes that the child has sufficient 
463.30  maturity and judgment and that it is in the best interests of 
463.31  the child, the court may order a child 16 years old or older to 
463.32  be allowed to live independently, either alone or with others as 
463.33  approved by the court under supervision the court considers 
463.34  appropriate, if the county board, after consultation with the 
463.35  court, has specifically authorized this dispositional 
463.36  alternative for a child. 
464.1      (b) If the child was adjudicated in need of protection or 
464.2   services because the child is a runaway or habitual truant, the 
464.3   court may order any of the following dispositions in addition to 
464.4   or as alternatives to the dispositions authorized under 
464.5   paragraph (a): 
464.6      (1) counsel the child or the child's parents, guardian, or 
464.7   custodian; 
464.8      (2) place the child under the supervision of a probation 
464.9   officer or other suitable person in the child's own home under 
464.10  conditions prescribed by the court, including reasonable rules 
464.11  for the child's conduct and the conduct of the parents, 
464.12  guardian, or custodian, designed for the physical, mental, and 
464.13  moral well-being and behavior of the child; or with the consent 
464.14  of the commissioner of corrections, place the child in a group 
464.15  foster care facility which is under the commissioner's 
464.16  management and supervision; 
464.17     (3) subject to the court's supervision, transfer legal 
464.18  custody of the child to one of the following: 
464.19     (i) a reputable person of good moral character.  No person 
464.20  may receive custody of two or more unrelated children unless 
464.21  licensed to operate a residential program under sections 245A.01 
464.22  to 245A.16; or 
464.23     (ii) a county probation officer for placement in a group 
464.24  foster home established under the direction of the juvenile 
464.25  court and licensed pursuant to section 241.021; 
464.26     (4) require the child to pay a fine of up to $100.  The 
464.27  court shall order payment of the fine in a manner that will not 
464.28  impose undue financial hardship upon the child; 
464.29     (5) require the child to participate in a community service 
464.30  project; 
464.31     (6) order the child to undergo a chemical dependency 
464.32  evaluation and, if warranted by the evaluation, order 
464.33  participation by the child in a drug awareness program or an 
464.34  inpatient or outpatient chemical dependency treatment program; 
464.35     (7) if the court believes that it is in the best interests 
464.36  of the child and of public safety that the child's driver's 
465.1   license or instruction permit be canceled, the court may order 
465.2   the commissioner of public safety to cancel the child's license 
465.3   or permit for any period up to the child's 18th birthday.  If 
465.4   the child does not have a driver's license or permit, the court 
465.5   may order a denial of driving privileges for any period up to 
465.6   the child's 18th birthday.  The court shall forward an order 
465.7   issued under this clause to the commissioner, who shall cancel 
465.8   the license or permit or deny driving privileges without a 
465.9   hearing for the period specified by the court.  At any time 
465.10  before the expiration of the period of cancellation or denial, 
465.11  the court may, for good cause, order the commissioner of public 
465.12  safety to allow the child to apply for a license or permit, and 
465.13  the commissioner shall so authorize; 
465.14     (8) order that the child's parent or legal guardian deliver 
465.15  the child to school at the beginning of each school day for a 
465.16  period of time specified by the court; or 
465.17     (9) require the child to perform any other activities or 
465.18  participate in any other treatment programs deemed appropriate 
465.19  by the court.  
465.20     To the extent practicable, the court shall enter a 
465.21  disposition order the same day it makes a finding that a child 
465.22  is in need of protection or services or neglected and in foster 
465.23  care, but in no event more than 15 days after the finding unless 
465.24  the court finds that the best interests of the child will be 
465.25  served by granting a delay.  If the child was under eight years 
465.26  of age at the time the petition was filed, the disposition order 
465.27  must be entered within ten days of the finding and the court may 
465.28  not grant a delay unless good cause is shown and the court finds 
465.29  the best interests of the child will be served by the delay. 
465.30     (c) If a child who is 14 years of age or older is 
465.31  adjudicated in need of protection or services because the child 
465.32  is a habitual truant and truancy procedures involving the child 
465.33  were previously dealt with by a school attendance review board 
465.34  or county attorney mediation program under section 260A.06 or 
465.35  260A.07, the court shall order a cancellation or denial of 
465.36  driving privileges under paragraph (b), clause (7), for any 
466.1   period up to the child's 18th birthday. 
466.2      (d) In the case of a child adjudicated in need of 
466.3   protection or services because the child has committed domestic 
466.4   abuse and been ordered excluded from the child's parent's home, 
466.5   the court shall dismiss jurisdiction if the court, at any time, 
466.6   finds the parent is able or willing to provide an alternative 
466.7   safe living arrangement for the child, as defined in Laws 1997, 
466.8   chapter 239, article 10, section 2. 
466.9      Sec. 56.  Minnesota Statutes 1998, section 260.191, 
466.10  subdivision 1a, is amended to read: 
466.11     Subd. 1a.  [WRITTEN FINDINGS.] Any order for a disposition 
466.12  authorized under this section shall contain written findings of 
466.13  fact to support the disposition and case plan ordered, and shall 
466.14  also set forth in writing the following information: 
466.15     (a) Why the best interests and safety of the child are 
466.16  served by the disposition and case plan ordered; 
466.17     (b) What alternative dispositions or services under the 
466.18  case plan were considered by the court and why such dispositions 
466.19  or services were not appropriate in the instant case; 
466.20     (c) How the court's disposition complies with the 
466.21  requirements of section 260.181, subdivision 3; and 
466.22     (d) Whether reasonable efforts consistent with section 
466.23  260.012 were made to prevent or eliminate the necessity of the 
466.24  child's removal and to reunify the family after removal.  The 
466.25  court's findings must include a brief description of what 
466.26  preventive and reunification efforts were made and why further 
466.27  efforts could not have prevented or eliminated the necessity of 
466.28  removal or that reasonable efforts were not required under 
466.29  section 260.012 or 260.172, subdivision 1. 
466.30     If the court finds that the social services agency's 
466.31  preventive or reunification efforts have not been reasonable but 
466.32  that further preventive or reunification efforts could not 
466.33  permit the child to safely remain at home, the court may 
466.34  nevertheless authorize or continue the removal of the child. 
466.35     Sec. 57.  Minnesota Statutes 1998, section 260.191, 
466.36  subdivision 1b, is amended to read: 
467.1      Subd. 1b.  [DOMESTIC CHILD ABUSE.] (a) If the court finds 
467.2   that the child is a victim of domestic child abuse, as defined 
467.3   in section 260.015, subdivision 24, it may order any of the 
467.4   following dispositions of the case in addition to or as 
467.5   alternatives to the dispositions authorized under subdivision 1: 
467.6      (1) restrain any party from committing acts of domestic 
467.7   child abuse; 
467.8      (2) exclude the abusing party from the dwelling which the 
467.9   family or household members share or from the residence of the 
467.10  child; 
467.11     (3) on the same basis as is provided in chapter 518, 
467.12  establish temporary visitation with regard to minor children of 
467.13  the adult family or household members; 
467.14     (4) on the same basis as is provided in chapter 518, 
467.15  establish temporary support or maintenance for a period of 30 
467.16  days for minor children or a spouse; 
467.17     (5) provide counseling or other social services for the 
467.18  family or household members; or 
467.19     (6) order the abusing party to participate in treatment or 
467.20  counseling services.  
467.21     Any relief granted by the order for protection shall be for 
467.22  a fixed period not to exceed one year.  
467.23     However, (b) No order excluding the abusing party from the 
467.24  dwelling may be issued unless the court finds that:  
467.25     (1) the order is in the best interests of the child or 
467.26  children remaining in the dwelling; 
467.27     (2) a remaining adult family or household member is able to 
467.28  care adequately for the child or children in the absence of the 
467.29  excluded party; and 
467.30     (3) the local welfare agency has developed a plan to 
467.31  provide appropriate social services to the remaining family or 
467.32  household members.  
467.33     (c) Upon a finding that the remaining parent is able to 
467.34  care adequately for the child and enforce an order excluding the 
467.35  abusing party from the home and that the provision of supportive 
467.36  services by the responsible social services agency is no longer 
468.1   necessary, the responsible social services agency may be 
468.2   dismissed as a party to the proceedings.  Orders entered 
468.3   regarding the abusing party remain in full force and effect and 
468.4   may be renewed by the remaining parent as necessary for the 
468.5   continued protection of the child for specified periods of time, 
468.6   not to exceed one year. 
468.7      Sec. 58.  Minnesota Statutes 1998, section 260.191, 
468.8   subdivision 3b, is amended to read: 
468.9      Subd. 3b.  [REVIEW OF COURT ORDERED PLACEMENTS; PERMANENT 
468.10  PLACEMENT DETERMINATION.] (a) Except for cases where the child 
468.11  is in placement due solely to the child's status as 
468.12  developmentally delayed under United States Code, title 42, 
468.13  section 6001(7), or emotionally handicapped under section 252.27 
468.14  and where custody has not been transferred to the responsible 
468.15  social services agency, the court shall conduct a hearing to 
468.16  determine the permanent status of a child not later than 12 
468.17  months after the child is placed out of the home of the parent, 
468.18  except that if the child was under eight years of age at the 
468.19  time the petition was filed, the hearing must be conducted no 
468.20  later than six months after the child is placed out of the home 
468.21  of the parent. 
468.22     For purposes of this subdivision, the date of the child's 
468.23  placement out of the home of the parent is the earlier of the 
468.24  first court-ordered placement or 60 days after the date on which 
468.25  the child has been voluntarily placed out of the home. 
468.26     For purposes of this subdivision, 12 months is calculated 
468.27  as follows: 
468.28     (1) during the pendency of a petition alleging that a child 
468.29  is in need of protection or services, all time periods when a 
468.30  child is placed out of the home of the parent are cumulated; 
468.31     (2) if a child has been placed out of the home of the 
468.32  parent within the previous five years in connection with one or 
468.33  more prior petitions for a child in need of protection or 
468.34  services, the lengths of all prior time periods when the child 
468.35  was placed out of the home within the previous five years and 
468.36  under the current petition, are cumulated.  If a child under 
469.1   this clause has been out of the home for 12 months or more, the 
469.2   court, if it is in the best interests of the child and for 
469.3   compelling reasons, may extend the total time the child may 
469.4   continue out of the home under the current petition up to an 
469.5   additional six months before making a permanency determination.  
469.6      (b) Unless the responsible social services agency 
469.7   recommends return of the child to the custodial parent or 
469.8   parents, not later than ten 30 days prior to this hearing, the 
469.9   responsible social service services agency shall file pleadings 
469.10  in juvenile court to establish the basis for the juvenile court 
469.11  to order permanent placement determination of the child 
469.12  according to paragraph (d).  Notice of the hearing and copies of 
469.13  the pleadings must be provided pursuant to section 260.141.  If 
469.14  a termination of parental rights petition is filed before the 
469.15  date required for the permanency planning determination and 
469.16  there is a trial under section 260.155 scheduled on that 
469.17  petition within 90 days of the filing of the petition, no 
469.18  hearing need be conducted under this subdivision. 
469.19     (c) At the conclusion of the hearing, the court shall 
469.20  determine whether order the child is to be returned home or, if 
469.21  not, what order a permanent placement is consistent with in the 
469.22  child's best interests.  The "best interests of the child" means 
469.23  all relevant factors to be considered and evaluated. 
469.24     (c) (d) At a hearing under this subdivision, if the child 
469.25  was under eight years of age at the time the petition was filed 
469.26  alleging the child in need of protection or services, the court 
469.27  shall review the progress of the case and the case plan, 
469.28  including the provision of services.  The court may order the 
469.29  local social service services agency to show cause why it should 
469.30  not file a termination of parental rights petition.  Cause may 
469.31  include, but is not limited to, the following conditions: 
469.32     (1) the parents or guardians have maintained regular 
469.33  contact with the child, the parents are complying with the 
469.34  court-ordered case plan, and the child would benefit from 
469.35  continuing this relationship; 
469.36     (2) grounds for termination under section 260.221 do not 
470.1   exist; or 
470.2      (3) the permanent plan for the child is transfer of 
470.3   permanent legal and physical custody to a relative.  When the 
470.4   permanent plan for the child is transfer of permanent legal and 
470.5   physical custody to a relative, a petition supporting the plan 
470.6   shall be filed in juvenile court within 30 days of the hearing 
470.7   required under this subdivision and a hearing on the petition 
470.8   held within 30 days of the filing of the pleadings. 
470.9      (d) (e) If the child is not returned to the home, the court 
470.10  must order one of the following dispositions available for 
470.11  permanent placement determination are: 
470.12     (1) permanent legal and physical custody to a relative in 
470.13  the best interests of the child.  In transferring permanent 
470.14  legal and physical custody to a relative, the juvenile court 
470.15  shall follow the standards and procedures applicable under 
470.16  chapter 257 or 518.  An order establishing permanent legal or 
470.17  physical custody under this subdivision must be filed with the 
470.18  family court.  A transfer of legal and physical custody includes 
470.19  responsibility for the protection, education, care, and control 
470.20  of the child and decision making on behalf of the child.  The 
470.21  social service services agency may petition on behalf of the 
470.22  proposed custodian; 
470.23     (2) termination of parental rights and adoption; unless the 
470.24  social service services agency shall file has already filed a 
470.25  petition for termination of parental rights under section 
470.26  260.231, the court may order such a petition filed and all the 
470.27  requirements of sections 260.221 to 260.245 remain applicable.  
470.28  An adoption completed subsequent to a determination under this 
470.29  subdivision may include an agreement for communication or 
470.30  contact under section 259.58; or 
470.31     (3) long-term foster care; transfer of legal custody and 
470.32  adoption are preferred permanency options for a child who cannot 
470.33  return home.  The court may order a child into long-term foster 
470.34  care only if it finds that neither an award of legal and 
470.35  physical custody to a relative, nor termination of parental 
470.36  rights nor adoption is in the child's best interests.  Further, 
471.1   the court may only order long-term foster care for the child 
471.2   under this section if it finds the following: 
471.3      (i) the child has reached age 12 and reasonable efforts by 
471.4   the responsible social service services agency have failed to 
471.5   locate an adoptive family for the child; or 
471.6      (ii) the child is a sibling of a child described in clause 
471.7   (i) and the siblings have a significant positive relationship 
471.8   and are ordered into the same long-term foster care home; or 
471.9      (4) foster care for a specified period of time may be 
471.10  ordered only if: 
471.11     (i) the sole basis for an adjudication that a the child is 
471.12  in need of protection or services is that the child is a 
471.13  runaway, is an habitual truant, or committed a delinquent act 
471.14  before age ten the child's behavior; and 
471.15     (ii) the court finds that foster care for a specified 
471.16  period of time is in the best interests of the child. 
471.17     (e) In ordering a permanent placement of a child, the court 
471.18  must be governed by the best interests of the child, including a 
471.19  review of the relationship between the child and relatives and 
471.20  the child and other important persons with whom the child has 
471.21  resided or had significant contact. 
471.22     (f) Once a permanent placement determination has been made 
471.23  and permanent placement has been established, further court 
471.24  reviews and dispositional hearings are only necessary if the 
471.25  placement is made under paragraph (d), clause (4), review is 
471.26  otherwise required by federal law, an adoption has not yet been 
471.27  finalized, or there is a disruption of the permanent or 
471.28  long-term placement.  
471.29     (g) An order under this subdivision must include the 
471.30  following detailed findings: 
471.31     (1) how the child's best interests are served by the order; 
471.32     (2) the nature and extent of the responsible social service 
471.33  services agency's reasonable efforts, or, in the case of an 
471.34  Indian child, active efforts, to reunify the child with the 
471.35  parent or parents; 
471.36     (3) the parent's or parents' efforts and ability to use 
472.1   services to correct the conditions which led to the out-of-home 
472.2   placement; and 
472.3      (4) whether the conditions which led to the out-of-home 
472.4   placement have been corrected so that the child can return home; 
472.5   and 
472.6      (5) if the child cannot be returned home, whether there is 
472.7   a substantial probability of the child being able to return home 
472.8   in the next six months.  
472.9      (h) An order for permanent legal and physical custody of a 
472.10  child may be modified under sections 518.18 and 518.185.  The 
472.11  social service services agency is a party to the proceeding and 
472.12  must receive notice.  An order for long-term foster care is 
472.13  reviewable upon motion and a showing by the parent of a 
472.14  substantial change in the parent's circumstances such that the 
472.15  parent could provide appropriate care for the child and that 
472.16  removal of the child from the child's permanent placement and 
472.17  the return to the parent's care would be in the best interest of 
472.18  the child. 
472.19     (i) The court shall issue an order required under this 
472.20  section within 15 days of the close of the proceedings.  The 
472.21  court may extend issuing the order an additional 15 days when 
472.22  necessary in the interests of justice and the best interests of 
472.23  the child. 
472.24     Sec. 59.  Minnesota Statutes 1998, section 260.192, is 
472.25  amended to read: 
472.26     260.192 [DISPOSITIONS; VOLUNTARY FOSTER CARE PLACEMENTS.] 
472.27     Unless the court disposes of the petition under section 
472.28  260.131, subdivision 1a, upon a petition for review of the 
472.29  foster care status of a child, the court may:  
472.30     (a) In the case of a petition required to be filed under 
472.31  section 257.071, subdivision 3, find that the child's needs are 
472.32  being met, that the child's placement in foster care is in the 
472.33  best interests of the child, and that the child will be returned 
472.34  home in the next six months, in which case the court shall 
472.35  approve the voluntary arrangement and continue the matter for 
472.36  six months to assure the child returns to the parent's home.  
473.1      (b) In the case of a petition required to be filed under 
473.2   section 257.071, subdivision 4, find that the child's needs are 
473.3   being met and that the child's placement in foster care is in 
473.4   the best interests of the child, in which case the court shall 
473.5   approve the voluntary arrangement.  The court shall order the 
473.6   social service agency responsible for the placement to bring a 
473.7   petition under section 260.131, subdivision 1 or 1a, as 
473.8   appropriate, within 12 months. 
473.9      (c) Find that the child's needs are not being met, in which 
473.10  case the court shall order the social service services agency or 
473.11  the parents to take whatever action is necessary and feasible to 
473.12  meet the child's needs, including, when appropriate, the 
473.13  provision by the social service services agency of services to 
473.14  the parents which would enable the child to live at home, and 
473.15  order a disposition under section 260.191. 
473.16     (d) (b) Find that the child has been abandoned by parents 
473.17  financially or emotionally, or that the developmentally disabled 
473.18  child does not require out-of-home care because of the 
473.19  handicapping condition, in which case the court shall order the 
473.20  social service services agency to file an appropriate petition 
473.21  pursuant to sections 260.131, subdivision 1, or 260.231. 
473.22     Nothing in this section shall be construed to prohibit 
473.23  bringing a petition pursuant to section 260.131, subdivision 1 
473.24  or 2, sooner than required by court order pursuant to this 
473.25  section. 
473.26     Sec. 60.  Minnesota Statutes 1998, section 260.221, 
473.27  subdivision 1, is amended to read: 
473.28     Subdivision 1.  [VOLUNTARY AND INVOLUNTARY.] The juvenile 
473.29  court may upon petition, terminate all rights of a parent to a 
473.30  child: 
473.31     (a) with the written consent of a parent who for good cause 
473.32  desires to terminate parental rights; or 
473.33     (b) if it finds that one or more of the following 
473.34  conditions exist: 
473.35     (1) that the parent has abandoned the child; 
473.36     (2) that the parent has substantially, continuously, or 
474.1   repeatedly refused or neglected to comply with the duties 
474.2   imposed upon that parent by the parent and child relationship, 
474.3   including but not limited to providing the child with necessary 
474.4   food, clothing, shelter, education, and other care and control 
474.5   necessary for the child's physical, mental, or emotional health 
474.6   and development, if the parent is physically and financially 
474.7   able, and either reasonable efforts by the social service 
474.8   services agency have failed to correct the conditions that 
474.9   formed the basis of the petition or reasonable efforts would be 
474.10  futile and therefore unreasonable; 
474.11     (3) that a parent has been ordered to contribute to the 
474.12  support of the child or financially aid in the child's birth and 
474.13  has continuously failed to do so without good cause.  This 
474.14  clause shall not be construed to state a grounds for termination 
474.15  of parental rights of a noncustodial parent if that parent has 
474.16  not been ordered to or cannot financially contribute to the 
474.17  support of the child or aid in the child's birth; 
474.18     (4) that a parent is palpably unfit to be a party to the 
474.19  parent and child relationship because of a consistent pattern of 
474.20  specific conduct before the child or of specific conditions 
474.21  directly relating to the parent and child relationship either of 
474.22  which are determined by the court to be of a duration or nature 
474.23  that renders the parent unable, for the reasonably foreseeable 
474.24  future, to care appropriately for the ongoing physical, mental, 
474.25  or emotional needs of the child.  It is presumed that a parent 
474.26  is palpably unfit to be a party to the parent and child 
474.27  relationship upon a showing that: 
474.28     (i) the child was adjudicated in need of protection or 
474.29  services due to circumstances described in section 260.015, 
474.30  subdivision 2a, clause (1), (2), (3), (5), or (8); and 
474.31     (ii) the parent's parental rights to one or more other 
474.32  children were involuntarily terminated under clause (1), (2), 
474.33  (4), or (7), or under clause (5) if the child was initially 
474.34  determined to be in need of protection or services due to 
474.35  circumstances described in section 260.015, subdivision 2a, 
474.36  clause (1), (2), (3), (5), or (8); 
475.1      (5) that following upon a determination of neglect or 
475.2   dependency, or of a child's need for protection or services the 
475.3   child's placement out of the home, reasonable efforts, under the 
475.4   direction of the court, have failed to correct the conditions 
475.5   leading to the determination child's placement.  It is presumed 
475.6   that reasonable efforts under this clause have failed upon a 
475.7   showing that: 
475.8      (i) a child has resided out of the parental home under 
475.9   court order for a cumulative period of more than one year within 
475.10  a five-year period following an adjudication of dependency, 
475.11  neglect, need for protection or services under section 260.015, 
475.12  subdivision 2a, clause (1), (2), (3), (6), (8), or (9), or 
475.13  neglected and in foster care, and an order for disposition under 
475.14  section 260.191, including adoption of the case plan required by 
475.15  section 257.071; 12 months within the preceding 22 months.  In 
475.16  the case of a child under age eight at the time the petition was 
475.17  filed alleging the child to be in need of protection or 
475.18  services, the presumption arises when the child has resided out 
475.19  of the parental home under court order for six months unless the 
475.20  parent has maintained regular contact with the child and the 
475.21  parent is complying with the case plan; 
475.22     (ii) the court has approved a case plan required under 
475.23  section 257.071 and filed with the court under section 260.172; 
475.24     (iii) conditions leading to the determination 
475.25  will out-of-home placement have not be been corrected within 
475.26  the reasonably foreseeable future.  It is presumed that 
475.27  conditions leading to a child's out-of-home placement will have 
475.28  not be been corrected in the reasonably foreseeable future upon 
475.29  a showing that the parent or parents have not substantially 
475.30  complied with the court's orders and a reasonable case plan, and 
475.31  the conditions which led to the out-of-home placement have not 
475.32  been corrected; and 
475.33     (iii) (iv) reasonable efforts have been made by the social 
475.34  service services agency to rehabilitate the parent and reunite 
475.35  the family. 
475.36     This clause does not prohibit the termination of parental 
476.1   rights prior to one year, or in the case of a child under age 
476.2   eight, within six months after a child has been placed out of 
476.3   the home. 
476.4      It is also presumed that reasonable efforts have failed 
476.5   under this clause upon a showing that: 
476.6      (i) (A) the parent has been diagnosed as chemically 
476.7   dependent by a professional certified to make the diagnosis; 
476.8      (ii) (B) the parent has been required by a case plan to 
476.9   participate in a chemical dependency treatment program; 
476.10     (iii) (C) the treatment programs offered to the parent were 
476.11  culturally, linguistically, and clinically appropriate; 
476.12     (iv) (D) the parent has either failed two or more times to 
476.13  successfully complete a treatment program or has refused at two 
476.14  or more separate meetings with a caseworker to participate in a 
476.15  treatment program; and 
476.16     (v) (E) the parent continues to abuse chemicals.  
476.17  Provided, that this presumption applies only to parents required 
476.18  by a case plan to participate in a chemical dependency treatment 
476.19  program on or after July 1, 1990; 
476.20     (6) that a child has experienced egregious harm in the 
476.21  parent's care which is of a nature, duration, or chronicity that 
476.22  indicates a lack of regard for the child's well-being, such that 
476.23  a reasonable person would believe it contrary to the best 
476.24  interest of the child or of any child to be in the parent's 
476.25  care; 
476.26     (7) that in the case of a child born to a mother who was 
476.27  not married to the child's father when the child was conceived 
476.28  nor when the child was born the person is not entitled to notice 
476.29  of an adoption hearing under section 259.49 and the person has 
476.30  not registered with the fathers' adoption registry under section 
476.31  259.52; 
476.32     (8) that the child is neglected and in foster care; or 
476.33     (9) that the parent has been convicted of a crime listed in 
476.34  section 260.012, paragraph (b), clauses (1) to (3). 
476.35     In an action involving an American Indian child, sections 
476.36  257.35 to 257.3579 and the Indian Child Welfare Act, United 
477.1   States Code, title 25, sections 1901 to 1923, control to the 
477.2   extent that the provisions of this section are inconsistent with 
477.3   those laws. 
477.4      Sec. 61.  Minnesota Statutes 1998, section 260.221, 
477.5   subdivision 1a, is amended to read: 
477.6      Subd. 1a.  [EVIDENCE OF ABANDONMENT.] For purposes of 
477.7   subdivision 1, paragraph (b), clause (1): 
477.8      (a) Abandonment is presumed when: 
477.9      (1) the parent has had no contact with the child on a 
477.10  regular basis and not demonstrated consistent interest in the 
477.11  child's well-being for six months and the social service 
477.12  services agency has made reasonable efforts to facilitate 
477.13  contact, unless the parent establishes that an extreme financial 
477.14  or physical hardship or treatment for mental disability or 
477.15  chemical dependency or other good cause prevented the parent 
477.16  from making contact with the child.  This presumption does not 
477.17  apply to children whose custody has been determined under 
477.18  chapter 257 or 518; or 
477.19     (2) the child is an infant under two years of age and has 
477.20  been deserted by the parent under circumstances that show an 
477.21  intent not to return to care for the child. 
477.22     The court is not prohibited from finding abandonment in the 
477.23  absence of the presumptions in clauses (1) and (2). 
477.24     (b) The following are prima facie evidence of abandonment 
477.25  where adoption proceedings are pending and there has been a 
477.26  showing that the person was not entitled to notice of an 
477.27  adoption proceeding under section 259.49: 
477.28     (1) failure to register with the fathers' adoption registry 
477.29  under section 259.52; or 
477.30     (2) if the person registered with the fathers' adoption 
477.31  registry under section 259.52: 
477.32     (i) filing a denial of paternity within 30 days of receipt 
477.33  of notice under section 259.52, subdivision 8; 
477.34     (ii) failing to timely file an intent to claim parental 
477.35  rights with entry of appearance form within 30 days of receipt 
477.36  of notice under section 259.52, subdivision 10; or 
478.1      (iii) timely filing an intent to claim parental rights with 
478.2   entry of appearance form within 30 days of receipt of notice 
478.3   under section 259.52, subdivision 10, but failing to initiate a 
478.4   paternity action within 30 days of receiving the fathers' 
478.5   adoption registry notice where there has been no showing of good 
478.6   cause for the delay. 
478.7      Sec. 62.  Minnesota Statutes 1998, section 260.221, 
478.8   subdivision 1b, is amended to read: 
478.9      Subd. 1b.  [REQUIRED TERMINATION OF PARENTAL RIGHTS.] (a) 
478.10  The county attorney shall file a termination of parental rights 
478.11  petition within 30 days of the responsible social services 
478.12  agency determining that a child's placement in out-of-home care 
478.13  if the child has been subjected to egregious harm as defined in 
478.14  section 260.015, subdivision 29, is determined to be the sibling 
478.15  of another child of the parent who was subjected to egregious 
478.16  harm, or is an abandoned infant as defined in subdivision 1a, 
478.17  paragraph (a), clause (2).  The local social services agency 
478.18  shall concurrently identify, recruit, process, and approve an 
478.19  adoptive family for the child.  If a termination of parental 
478.20  rights petition has been filed by another party, the local 
478.21  social services agency shall be joined as a party to the 
478.22  petition.  If criminal charges have been filed against a parent 
478.23  arising out of the conduct alleged to constitute egregious harm, 
478.24  the county attorney shall determine which matter should proceed 
478.25  to trial first, consistent with the best interests of the child 
478.26  and subject to the defendant's right to a speedy trial. 
478.27     (b) This requirement does not apply if the county attorney 
478.28  determines and files with the court its determination that: 
478.29     (1) a petition for transfer of permanent legal and physical 
478.30  custody to a relative is in the best interests of the child or 
478.31  there is under section 260.191, subdivision 3b, including a 
478.32  determination that the transfer is in the best interests of the 
478.33  child; or 
478.34     (2) a petition alleging the child, and where appropriate, 
478.35  the child's siblings, to be in need of protection or services 
478.36  accompanied by a case plan prepared by the responsible social 
479.1   services agency documenting a compelling reason documented by 
479.2   the local social services agency that why filing the a 
479.3   termination of parental rights petition would not be in the best 
479.4   interests of the child. 
479.5      Sec. 63.  Minnesota Statutes 1998, section 260.221, 
479.6   subdivision 1c, is amended to read: 
479.7      Subd. 1c.  [CURRENT FOSTER CARE CHILDREN.] Except for cases 
479.8   where the child is in placement due solely to the child's status 
479.9   as developmentally delayed under United States Code, title 42, 
479.10  section 6001(7), or emotionally handicapped under section 
479.11  252.27, and where custody has not been transferred to the 
479.12  responsible social services agency, the county attorney shall 
479.13  file a termination of parental rights petition or other a 
479.14  petition to support another permanent placement proceeding under 
479.15  section 260.191, subdivision 3b, for all children determined to 
479.16  be in need of protection or services who are placed in 
479.17  out-of-home care for reasons other than care or treatment of the 
479.18  child's disability, and who are in out-of-home placement on 
479.19  April 21, 1998, and have been in out-of-home care for 15 of the 
479.20  most recent 22 months.  This requirement does not apply if there 
479.21  is a compelling reason documented in a case plan filed with the 
479.22  court for determining that filing a termination of parental 
479.23  rights petition or other permanency petition would not be in the 
479.24  best interests of the child or if the responsible social 
479.25  services agency has not provided reasonable efforts necessary 
479.26  for the safe return of the child, if reasonable efforts are 
479.27  required.  
479.28     Sec. 64.  Minnesota Statutes 1998, section 260.221, 
479.29  subdivision 3, is amended to read: 
479.30     Subd. 3.  [WHEN PRIOR FINDING REQUIRED.] For purposes of 
479.31  subdivision 1, clause (b), no prior judicial finding of 
479.32  dependency, neglect, need for protection or services, or 
479.33  neglected and in foster care is required, except as provided in 
479.34  subdivision 1, clause (b), item (5). 
479.35     Sec. 65.  Minnesota Statutes 1998, section 260.221, 
479.36  subdivision 5, is amended to read: 
480.1      Subd. 5.  [FINDINGS REGARDING REASONABLE EFFORTS.] In any 
480.2   proceeding under this section, the court shall make specific 
480.3   findings: 
480.4      (1) regarding the nature and extent of efforts made by the 
480.5   social service services agency to rehabilitate the parent and 
480.6   reunite the family; or 
480.7      (2) that provision of services or further services for the 
480.8   purpose of rehabilitation and reunification is futile and 
480.9   therefore unreasonable under the circumstances; or 
480.10     (3) that reasonable efforts at reunification are not 
480.11  required as provided under section 260.012. 
480.12     Sec. 66.  Minnesota Statutes 1998, section 518.158, 
480.13  subdivision 1, is amended to read: 
480.14     Subdivision 1.  [FACTORS.] (a) It is presumed to be in the 
480.15  best interests of the child for the court to grant temporary 
480.16  custody to a relative under subdivision 2 if a minor child has 
480.17  resided with the relative for a period of 12 months or more and 
480.18  the following circumstances exist without good cause: 
480.19     (1) the parent has had no contact with the child on a 
480.20  regular basis and no demonstrated, consistent participation in 
480.21  the child's well-being for six months; or 
480.22     (2) the parent, during the time the child resided with the 
480.23  relative, has refused or neglected to comply with the duties 
480.24  imposed upon the parent by the parent and child relationship, 
480.25  including but not limited to providing the child necessary food, 
480.26  clothing, shelter, health care, education, and other care and 
480.27  control necessary for the child's physical, mental, or emotional 
480.28  health and development. 
480.29     (b) It is also presumed to be in the best interests of the 
480.30  child for the court to grant temporary custody to a relative 
480.31  under subdivision 2 if the relative has permanent custody of a 
480.32  sibling of the child and: 
480.33     (1) the child is currently residing with the relative and a 
480.34  factor in paragraph (a), clause (1) or (2), is present, 
480.35  regardless of duration; or 
480.36     (2) the application alleges an immediate and present danger 
481.1   to the physical safety of the child in the home of the parent. 
481.2      Sec. 67.  Minnesota Statutes 1998, section 518.158, 
481.3   subdivision 2, is amended to read: 
481.4      Subd. 2.  [EMERGENCY CUSTODY HEARING.] If the parent seeks 
481.5   to remove the child from the home of the relative or if the 
481.6   relative seeks to remove the child from the home of the parent 
481.7   and the applicable factors in subdivision 1 exist, the relative 
481.8   may apply for an ex parte temporary order for custody of the 
481.9   child.  The application must include an affidavit made under 
481.10  oath that states with particularity the specific facts and 
481.11  circumstances on which the application is based.  The court 
481.12  shall grant temporary custody if it finds, based on the 
481.13  application, that the applicable factors in subdivision 1 
481.14  exist.  If it finds that the factors in subdivision 1 do not 
481.15  exist, the court shall order that the child be returned to or 
481.16  remain with the parent.  An ex parte temporary custody order 
481.17  under this subdivision is effective for a fixed period not to 
481.18  exceed 14 days.  A temporary custody hearing under this chapter 
481.19  must be set for not later than seven days after issuance of the 
481.20  ex parte temporary custody order, except that if the ex parte 
481.21  temporary custody order is based on the grounds under 
481.22  subdivision 1, paragraph (b), clause (2), the temporary custody 
481.23  hearing must be set for not later than 72 hours, excluding 
481.24  Saturdays, Sundays, and holidays, after issuance of the order.  
481.25  The parent must be promptly served with a copy of the ex parte 
481.26  order and the petition and notice of the date for the hearing. 
481.27     Sec. 68.  [626.5551] [ALTERNATIVE RESPONSE PROGRAMS FOR 
481.28  CHILD PROTECTION ASSESSMENTS OR INVESTIGATIONS.] 
481.29     Subdivision 1.  [PROGRAMS AUTHORIZED.] (a) A county may 
481.30  establish a program that uses alternative responses to reports 
481.31  of child maltreatment under section 626.556, as provided in this 
481.32  section. 
481.33     (b) Alternative responses may include a family assessment 
481.34  and services approach under which the local welfare agency 
481.35  assesses the risk of abuse and neglect and the service needs of 
481.36  the family and arranges for appropriate services, diversions, 
482.1   referral for services, or other response identified in the plan 
482.2   under subdivision 4. 
482.3      (c) This section may not be used for reports of 
482.4   maltreatment in facilities required to be licensed under 
482.5   sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or 
482.6   chapter 245B, or in a school as defined in sections 120A.05, 
482.7   subdivisions 9, 11, and 13; and 124D.10, or in a nonlicensed 
482.8   personal care provider association as defined in sections 
482.9   256B.04, subdivision 16, and 256B.0625, subdivision 19a. 
482.10     Subd. 2.  [USE OF ALTERNATIVE RESPONSE OR 
482.11  INVESTIGATION.] (a) Upon receipt of a report under section 
482.12  626.556, the local welfare agency in a county that has 
482.13  established an alternative response program under this section 
482.14  shall determine whether to conduct an investigation under 
482.15  section 626.556 or to use an alternative response as appropriate 
482.16  to prevent or provide a remedy for child maltreatment.  
482.17     (b) The local welfare agency may conduct an investigation 
482.18  of any report, but shall conduct an investigation of reports 
482.19  that, if true, would mean that the child has experienced, or is 
482.20  at risk of experiencing, serious physical injury, sexual abuse, 
482.21  abandonment, or neglect that substantially endangers the child's 
482.22  physical or mental health, including growth delays, which may be 
482.23  referred to as failure to thrive, that have been diagnosed by a 
482.24  physician and are due to parental neglect, or conduct that would 
482.25  be a violation of, or an attempt to commit a violation of: 
482.26     (1) section 609.185; 609.19; or 609.195 (murder in the 
482.27  first, second, or third degree); 
482.28     (2) section 609.20 or 609.205 (manslaughter in the first or 
482.29  second degree); 
482.30     (3) section 609.221; 609.222; or 609.223 (assault in the 
482.31  first, second, or third degree); 
482.32     (4) section 609.322 (solicitation, inducement, and 
482.33  promotion of prostitution); 
482.34     (5) sections 609.342 to 609.3451 (criminal sexual conduct); 
482.35     (6) section 609.352 (solicitation of children to engage in 
482.36  sexual conduct); 
483.1      (7) section 609.377 or 609.378 (malicious punishment or 
483.2   neglect or endangerment of a child); or 
483.3      (8) section 617.246 (use of minor in sexual performance). 
483.4      (c) In addition, in all cases the local welfare agency 
483.5   shall notify the appropriate law enforcement agency as provided 
483.6   in section 626.556, subdivision 3. 
483.7      (d) The local welfare agency shall begin an immediate 
483.8   investigation under section 626.556 if at any time when it is 
483.9   using an alternative response it determines that an 
483.10  investigation is required under paragraph (b) or would otherwise 
483.11  be appropriate.  The local welfare agency may use an alternative 
483.12  response to a report that was initially referred for an 
483.13  investigation if the agency determines that a complete 
483.14  investigation is not required.  In determining that a complete 
483.15  investigation is not required, the local welfare agency must 
483.16  document the reason for terminating the investigation and 
483.17  consult with: 
483.18     (1) the local law enforcement agency, if the local law 
483.19  enforcement is involved, and notify the county attorney of the 
483.20  decision to terminate the investigation; or 
483.21     (2) the county attorney, if the local law enforcement is 
483.22  not involved. 
483.23     Subd. 3.  [DOCUMENTATION.] When a case in which an 
483.24  alternative response was used is closed, the local welfare 
483.25  agency shall document the outcome of the approach, including a 
483.26  description of the response and services provided and the 
483.27  removal or reduction of risk to the child, if it existed.  
483.28  Records maintained under this section must contain the 
483.29  documentation and must be retained for at least four years. 
483.30     Subd. 4.  [PLAN.] The county community social service plan 
483.31  required under section 256E.09 must address the extent that the 
483.32  county will use the alternative response program authorized 
483.33  under this section, based on the availability of new federal 
483.34  funding that is earned and other available revenue sources to 
483.35  fund the additional cost to the county of using the program.  To 
483.36  the extent the county uses the program, the county must include 
484.1   the program in the community social service plan and in the 
484.2   program evaluation under section 256E.10.  The plan must address 
484.3   alternative responses and services that will be used for the 
484.4   program and protocols for determining the appropriate response 
484.5   to reports under section 626.556 and address how the protocols 
484.6   comply with the guidelines of the commissioner under subdivision 
484.7   5. 
484.8      Subd. 5.  [COMMISSIONER OF HUMAN SERVICES TO DEVELOP 
484.9   GUIDELINES.] The commissioner of human services, in consultation 
484.10  with county representatives, may develop guidelines defining 
484.11  alternative responses and setting out procedures for family 
484.12  assessment and service delivery under this section.  The 
484.13  commissioner may also develop guidelines for counties regarding 
484.14  the provisions of section 626.556 that continue to apply when 
484.15  using an alternative response under this section.  The 
484.16  commissioner may also develop forms, best practice guidelines, 
484.17  and training to assist counties in implementing alternative 
484.18  responses under this section. 
484.19     Sec. 69.  Minnesota Statutes 1998, section 626.556, 
484.20  subdivision 2, is amended to read: 
484.21     Subd. 2.  [DEFINITIONS.] As used in this section, the 
484.22  following terms have the meanings given them unless the specific 
484.23  content indicates otherwise: 
484.24     (a) "Sexual abuse" means the subjection of a child by a 
484.25  person responsible for the child's care, by a person who has a 
484.26  significant relationship to the child, as defined in section 
484.27  609.341, or by a person in a position of authority, as defined 
484.28  in section 609.341, subdivision 10, to any act which constitutes 
484.29  a violation of section 609.342 (criminal sexual conduct in the 
484.30  first degree), 609.343 (criminal sexual conduct in the second 
484.31  degree), 609.344 (criminal sexual conduct in the third 
484.32  degree), or 609.345 (criminal sexual conduct in the fourth 
484.33  degree), or 609.3451 (criminal sexual conduct in the fifth 
484.34  degree).  Sexual abuse also includes any act which involves a 
484.35  minor which constitutes a violation of prostitution offenses 
484.36  under sections 609.321 to 609.324 or 617.246.  Sexual abuse 
485.1   includes threatened sexual abuse.  
485.2      (b) "Person responsible for the child's care" means (1) an 
485.3   individual functioning within the family unit and having 
485.4   responsibilities for the care of the child such as a parent, 
485.5   guardian, or other person having similar care responsibilities, 
485.6   or (2) an individual functioning outside the family unit and 
485.7   having responsibilities for the care of the child such as a 
485.8   teacher, school administrator, or other lawful custodian of a 
485.9   child having either full-time or short-term care 
485.10  responsibilities including, but not limited to, day care, 
485.11  babysitting whether paid or unpaid, counseling, teaching, and 
485.12  coaching.  
485.13     (c) "Neglect" means: 
485.14     (1) failure by a person responsible for a child's care to 
485.15  supply a child with necessary food, clothing, shelter or, 
485.16  health, medical, or other care required for the child's physical 
485.17  or mental health when reasonably able to do so,; 
485.18     (2) failure to protect a child from conditions or actions 
485.19  which imminently and seriously endanger the child's physical or 
485.20  mental health when reasonably able to do so, or; 
485.21     (3) failure to provide for necessary supervision or child 
485.22  care arrangements appropriate for a child after considering 
485.23  factors as the child's age, mental ability, physical condition, 
485.24  length of absence, or environment, when the child is unable to 
485.25  care for the child's own basic needs or safety, or the basic 
485.26  needs or safety of another child in their care; 
485.27     (4) failure to take steps to ensure that a child is 
485.28  educated in accordance with state law. to ensure that the child 
485.29  is educated as defined in sections 120A.22 and 260.155, 
485.30  subdivision 9; 
485.31     (5) nothing in this section shall be construed to mean that 
485.32  a child is neglected solely because the child's parent, 
485.33  guardian, or other person responsible for the child's care in 
485.34  good faith selects and depends upon spiritual means or prayer 
485.35  for treatment or care of disease or remedial care of the child 
485.36  in lieu of medical care; except that a parent, guardian, or 
486.1   caretaker, or a person mandated to report pursuant to 
486.2   subdivision 3, has a duty to report if a lack of medical care 
486.3   may cause serious danger to the child's health.  This section 
486.4   does not impose upon persons, not otherwise legally responsible 
486.5   for providing a child with necessary food, clothing, shelter, 
486.6   education, or medical care, a duty to provide that care.; 
486.7      Neglect includes (6) prenatal exposure to a controlled 
486.8   substance, as defined in section 253B.02, subdivision 2, used by 
486.9   the mother for a nonmedical purpose, as evidenced by withdrawal 
486.10  symptoms in the child at birth, results of a toxicology test 
486.11  performed on the mother at delivery or the child at birth, or 
486.12  medical effects or developmental delays during the child's first 
486.13  year of life that medically indicate prenatal exposure to a 
486.14  controlled substance.; 
486.15     Neglect also means (7) "medical neglect" as defined in 
486.16  section 260.015, subdivision 2a, clause (5).; 
486.17     (8) that the parent or other person responsible for the 
486.18  care of the child: 
486.19     (i) engages in violent behavior that demonstrates a 
486.20  disregard for the well being of the child as indicated by action 
486.21  that could reasonably result in serious physical, mental, or 
486.22  threatened injury, or emotional damage to the child; 
486.23     (ii) engages in repeated domestic assault that would 
486.24  constitute a violation of section 609.2242, subdivision 2 or 4; 
486.25     (iii) commits domestic assault that would constitute a 
486.26  violation of section 609.2242 within sight or sound of the 
486.27  child; or 
486.28     (iv) subjects the child to ongoing domestic violence in the 
486.29  home environment because of actions of an abuser that are likely 
486.30  to have a detrimental effect on the well being of the child; 
486.31     (9) chronic and severe use of alcohol or a controlled 
486.32  substance by a parent or person responsible for the care of the 
486.33  child that adversely affects the child's basic needs and safety; 
486.34  or 
486.35     (10) emotional harm from a pattern of behavior which 
486.36  contributes to impaired emotional functioning of the child which 
487.1   may be demonstrated by a substantial and observable effect in 
487.2   the child's behavior, emotional response, or cognition that is 
487.3   not within the normal range for the child's age and stage of 
487.4   development, with due regard to the child's culture. 
487.5      (d) "Physical abuse" means any physical or injury, mental 
487.6   injury, or threatened injury, inflicted by a person responsible 
487.7   for the child's care on a child other than by accidental means, 
487.8   or any physical or mental injury that cannot reasonably be 
487.9   explained by the child's history of injuries, or any aversive 
487.10  and deprivation procedures that have not been authorized under 
487.11  section 245.825.  Abuse does not include reasonable and moderate 
487.12  physical discipline of a child administered by a parent or legal 
487.13  guardian which does not result in an injury.  Actions which are 
487.14  not reasonable and moderate include, but are not limited to: 
487.15     (1) throwing, kicking, burning, biting, or cutting a child; 
487.16     (2) striking a child with a closed fist; 
487.17     (3) shaking a child under age three; 
487.18     (4) striking or other actions which result in any 
487.19  nonaccidental injury to a child under 18 months of age; 
487.20     (5) unreasonable interference with a child's breathing; 
487.21     (6) threatening a child with a weapon, as defined in 
487.22  section 609.02, subdivision 6; 
487.23     (7) striking a child under age one on the face or head; 
487.24     (8) purposely giving a child poison, alcohol, or dangerous, 
487.25  harmful, or controlled substances which were not prescribed for 
487.26  the child by a practitioner, in order to control or punish the 
487.27  child; or other substances that substantially affect the child's 
487.28  behavior, motor coordination, or judgment or that results in 
487.29  sickness or internal injury, or subjects the child to medical 
487.30  procedures that would be unnecessary if the child were not 
487.31  exposed to the substances; or 
487.32     (9) unreasonable physical confinement or restraint not 
487.33  permitted under section 609.379, including but not limited to 
487.34  tying, caging, or chaining. 
487.35     (e) "Report" means any report received by the local welfare 
487.36  agency, police department, or county sheriff pursuant to this 
488.1   section. 
488.2      (f) "Facility" means a licensed or unlicensed day care 
488.3   facility, residential facility, agency, hospital, sanitarium, or 
488.4   other facility or institution required to be licensed pursuant 
488.5   to under sections 144.50 to 144.58, 241.021, or 245A.01 to 
488.6   245A.16., or chapter 245B; or a school as defined in sections 
488.7   120A.05, subdivisions 9, 11, and 13; and 124D.10; or a 
488.8   nonlicensed personal care provider organization as defined in 
488.9   sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.
488.10     (g) "Operator" means an operator or agency as defined in 
488.11  section 245A.02.  
488.12     (h) "Commissioner" means the commissioner of human services.
488.13     (i) "Assessment" includes authority to interview the child, 
488.14  the person or persons responsible for the child's care, the 
488.15  alleged perpetrator, and any other person with knowledge of the 
488.16  abuse or neglect for the purpose of gathering the facts, 
488.17  assessing the risk to the child, and formulating a plan.  
488.18     (j) "Practice of social services," for the purposes of 
488.19  subdivision 3, includes but is not limited to employee 
488.20  assistance counseling and the provision of guardian ad litem and 
488.21  visitation expeditor services.  
488.22     (k) "Mental injury" means an injury to the psychological 
488.23  capacity or emotional stability of a child as evidenced by an 
488.24  observable or substantial impairment in the child's ability to 
488.25  function within a normal range of performance and behavior with 
488.26  due regard to the child's culture or harm to a child's 
488.27  psychological or intellectual functioning which now, or in the 
488.28  future, is likely to be evidenced by serious mental, behavioral, 
488.29  or personality disorder, including severe anxiety, depression, 
488.30  withdrawal, severe aggressive behavior, seriously delayed 
488.31  development or similarly serious dysfunctional behavior when 
488.32  caused by a statement, overt act, omission, condition, or status 
488.33  of the child's caretaker.  
488.34     (l) "Threatened injury" means a statement, overt act, 
488.35  condition, or status that represents a substantial risk of 
488.36  physical or sexual abuse or mental injury. 
489.1      (m) Persons who conduct assessments or investigations under 
489.2   this section shall take into account accepted child-rearing 
489.3   practices of the culture in which a child participates, which 
489.4   are not injurious to the child's health, welfare, and safety. 
489.5      Sec. 70.  Minnesota Statutes 1998, section 626.556, 
489.6   subdivision 3, is amended to read: 
489.7      Subd. 3.  [PERSONS MANDATED TO REPORT.] (a) A person who 
489.8   knows or has reason to believe a child is being neglected or 
489.9   physically or sexually abused, as defined in subdivision 2, or 
489.10  has been neglected or physically or sexually abused within the 
489.11  preceding three years, shall immediately report the information 
489.12  to the local welfare agency, agency responsible for assessing or 
489.13  investigating the report, police department, or the county 
489.14  sheriff if the person is:  
489.15     (1) a professional or professional's delegate who is 
489.16  engaged in the practice of the healing arts, social services, 
489.17  hospital administration, psychological or psychiatric treatment, 
489.18  child care, education, or law enforcement; or 
489.19     (2) employed as a member of the clergy and received the 
489.20  information while engaged in ministerial duties, provided that a 
489.21  member of the clergy is not required by this subdivision to 
489.22  report information that is otherwise privileged under section 
489.23  595.02, subdivision 1, paragraph (c).  
489.24     The police department or the county sheriff, upon receiving 
489.25  a report, shall immediately notify the local welfare agency or 
489.26  agency responsible for assessing or investigating the report, 
489.27  orally and in writing.  The local welfare agency, or agency 
489.28  responsible for assessing or investigating the report, upon 
489.29  receiving a report, shall immediately notify the local police 
489.30  department or the county sheriff orally and in writing.  The 
489.31  county sheriff and the head of every local welfare agency, 
489.32  agency responsible for assessing or investigating reports, and 
489.33  police department shall each designate a person within their 
489.34  agency, department, or office who is responsible for ensuring 
489.35  that the notification duties of this paragraph and paragraph (b) 
489.36  are carried out.  Nothing in this subdivision shall be construed 
490.1   to require more than one report from any institution, facility, 
490.2   school, or agency. 
490.3      (b) Any person may voluntarily report to the local welfare 
490.4   agency, agency responsible for assessing or investigating the 
490.5   report, police department, or the county sheriff if the person 
490.6   knows, has reason to believe, or suspects a child is being or 
490.7   has been neglected or subjected to physical or sexual abuse.  
490.8   The police department or the county sheriff, upon receiving a 
490.9   report, shall immediately notify the local welfare agency or 
490.10  agency responsible for assessing or investigating the report, 
490.11  orally and in writing.  The local welfare agency or agency 
490.12  responsible for assessing or investigating the report, upon 
490.13  receiving a report, shall immediately notify the local police 
490.14  department or the county sheriff orally and in writing. 
490.15     (c) A person mandated to report physical or sexual child 
490.16  abuse or neglect occurring within a licensed facility shall 
490.17  report the information to the agency responsible for licensing 
490.18  the facility under sections 144.50 to 144.58; 241.021; 245A.01 
490.19  to 245A.16; or 245B, or a school as defined in sections 120A.05, 
490.20  subdivisions 9, 11, and 13; and 124D.10; or a nonlicensed 
490.21  personal care provider organization as defined in sections 
490.22  256B.04, subdivision 16; and 256B.0625, subdivision 19. A health 
490.23  or corrections agency receiving a report may request the local 
490.24  welfare agency to provide assistance pursuant to subdivisions 
490.25  10, 10a, and 10b. 
490.26     (d) Any person mandated to report shall receive a summary 
490.27  of the disposition of any report made by that 
490.28  reporter, including whether the case has been opened for child 
490.29  protection or other services, or if a referral has been made to 
490.30  a community organization, unless release would be detrimental to 
490.31  the best interests of the child.  Any person who is not mandated 
490.32  to report shall, upon request to the local welfare agency, 
490.33  receive a concise summary of the disposition of any report made 
490.34  by that reporter, unless release would be detrimental to the 
490.35  best interests of the child. 
490.36     (e) For purposes of this subdivision, "immediately" means 
491.1   as soon as possible but in no event longer than 24 hours. 
491.2      Sec. 71.  Minnesota Statutes 1998, section 626.556, is 
491.3   amended by adding a subdivision to read: 
491.4      Subd. 3b.  [AGENCY RESPONSIBLE FOR ASSESSING OR 
491.5   INVESTIGATING REPORTS OF MALTREATMENT.] 
491.6      The following agencies are the administrative agencies 
491.7   responsible for assessing or investigating reports of alleged 
491.8   child maltreatment in facilities made under this section: 
491.9      (1) the county local welfare agency is the agency 
491.10  responsible for assessing or investigating allegations of 
491.11  maltreatment in child foster care, family child care, and 
491.12  legally unlicensed child care and in juvenile correctional 
491.13  facilities licensed under section 241.021 located in the local 
491.14  welfare agency's county; 
491.15     (2) the department of human services is the agency 
491.16  responsible for assessing or investigating allegations of 
491.17  maltreatment in facilities licensed under chapters 245A and 
491.18  245B, except for child foster care and family child care; and 
491.19     (3) the department of health is the agency responsible for 
491.20  assessing or investigating allegations of child maltreatment in 
491.21  facilities licensed under sections 144.50 to 144.58, and in 
491.22  unlicensed home health care. 
491.23     Sec. 72.  Minnesota Statutes 1998, section 626.556, 
491.24  subdivision 4, is amended to read: 
491.25     Subd. 4.  [IMMUNITY FROM LIABILITY.] (a) The following 
491.26  persons are immune from any civil or criminal liability that 
491.27  otherwise might result from their actions, if they are acting in 
491.28  good faith: 
491.29     (1) any person making a voluntary or mandated report under 
491.30  subdivision 3 or under section 626.5561 or assisting in an 
491.31  assessment under this section or under section 626.5561; 
491.32     (2) any person with responsibility for performing duties 
491.33  under this section or supervisor employed by a local welfare 
491.34  agency or, the commissioner of an agency responsible for 
491.35  operating or supervising a licensed or unlicensed day care 
491.36  facility, residential facility, agency, hospital, sanitarium, or 
492.1   other facility or institution required to be licensed under 
492.2   sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or 245B, 
492.3   or a school as defined in sections 120A.05, subdivisions 9, 11, 
492.4   and 13; and 124D.10; or a nonlicensed personal care provider 
492.5   organization as defined in sections 256B.04, subdivision 16; and 
492.6   256B.0625, subdivision 19a, complying with subdivision 10d; and 
492.7      (3) any public or private school, facility as defined in 
492.8   subdivision 2, or the employee of any public or private school 
492.9   or facility who permits access by a local welfare agency or 
492.10  local law enforcement agency and assists in an investigation or 
492.11  assessment pursuant to subdivision 10 or under section 626.5561. 
492.12     (b) A person who is a supervisor or person with 
492.13  responsibility for performing duties under this section employed 
492.14  by a local welfare agency or the commissioner complying with 
492.15  subdivisions 10 and 11 or section 626.5561 or any related rule 
492.16  or provision of law is immune from any civil or criminal 
492.17  liability that might otherwise result from the person's actions, 
492.18  if the person is (1) acting in good faith and exercising due 
492.19  care, or (2) acting in good faith and following the information 
492.20  collection procedures established under subdivision 10, 
492.21  paragraphs (h), (i), and (j). 
492.22     (c) This subdivision does not provide immunity to any 
492.23  person for failure to make a required report or for committing 
492.24  neglect, physical abuse, or sexual abuse of a child. 
492.25     (d) If a person who makes a voluntary or mandatory report 
492.26  under subdivision 3 prevails in a civil action from which the 
492.27  person has been granted immunity under this subdivision, the 
492.28  court may award the person attorney fees and costs. 
492.29     Sec. 73.  Minnesota Statutes 1998, section 626.556, 
492.30  subdivision 7, is amended to read: 
492.31     Subd. 7.  [REPORT.] An oral report shall be made 
492.32  immediately by telephone or otherwise.  An oral report made by a 
492.33  person required under subdivision 3 to report shall be followed 
492.34  within 72 hours, exclusive of weekends and holidays, by a report 
492.35  in writing to the appropriate police department, the county 
492.36  sheriff or local welfare agency, unless the appropriate agency 
493.1   has informed the reporter that the oral information does not 
493.2   constitute a report under subdivision 10.  Any report shall be 
493.3   of sufficient content to identify the child, any person believed 
493.4   to be responsible for the abuse or neglect of the child if the 
493.5   person is known, the nature and extent of the abuse or neglect 
493.6   and the name and address of the reporter.  If requested, the 
493.7   local welfare agency shall inform the reporter within ten days 
493.8   after the report is made, either orally or in writing, whether 
493.9   the report was accepted for assessment or investigation.  
493.10  Written reports received by a police department or the county 
493.11  sheriff shall be forwarded immediately to the local welfare 
493.12  agency.  The police department or the county sheriff may keep 
493.13  copies of reports received by them.  Copies of written reports 
493.14  received by a local welfare department shall be forwarded 
493.15  immediately to the local police department or the county sheriff.
493.16     A written copy of a report maintained by personnel of 
493.17  agencies, other than welfare or law enforcement agencies, which 
493.18  are subject to chapter 13 shall be confidential.  An individual 
493.19  subject of the report may obtain access to the original report 
493.20  as provided by subdivision 11. 
493.21     Sec. 74.  Minnesota Statutes 1998, section 626.556, 
493.22  subdivision 10, is amended to read: 
493.23     Subd. 10.  [DUTIES OF LOCAL WELFARE AGENCY AND LOCAL LAW 
493.24  ENFORCEMENT AGENCY UPON RECEIPT OF A REPORT.] (a) If the report 
493.25  alleges neglect, physical abuse, or sexual abuse by a parent, 
493.26  guardian, or individual functioning within the family unit as a 
493.27  person responsible for the child's care, the local welfare 
493.28  agency shall immediately conduct an assessment and screening for 
493.29  substance abuse and offer protective social services for 
493.30  purposes of preventing further abuses, safeguarding and 
493.31  enhancing the welfare of the abused or neglected minor, and 
493.32  preserving family life whenever possible.  If the report alleges 
493.33  a violation of a criminal statute involving sexual abuse, 
493.34  physical abuse, or neglect or endangerment, under section 
493.35  609.378, the local law enforcement agency and local welfare 
493.36  agency shall coordinate the planning and execution of their 
494.1   respective investigation and assessment efforts to avoid a 
494.2   duplication of fact-finding efforts and multiple interviews.  
494.3   Each agency shall prepare a separate report of the results of 
494.4   its investigation.  In cases of alleged child maltreatment 
494.5   resulting in death, the local agency may rely on the 
494.6   fact-finding efforts of a law enforcement investigation to make 
494.7   a determination of whether or not maltreatment occurred.  When 
494.8   necessary the local welfare agency shall seek authority to 
494.9   remove the child from the custody of a parent, guardian, or 
494.10  adult with whom the child is living.  In performing any of these 
494.11  duties, the local welfare agency shall maintain appropriate 
494.12  records.  
494.13     If the screening for substance abuse indicates abuse of 
494.14  alcohol or other drugs, the local welfare agency shall conduct a 
494.15  chemical use assessment pursuant to Minnesota Rules, part 
494.16  9530.6615.  The local welfare agency shall report the 
494.17  determination of the chemical use assessment, and the 
494.18  recommendations and referrals for alcohol and other drug 
494.19  treatment services to the state authority on alcohol and drug 
494.20  abuse. 
494.21     (b) When a local agency receives a report or otherwise has 
494.22  information indicating that a child who is a client, as defined 
494.23  in section 245.91, has been the subject of physical abuse, 
494.24  sexual abuse, or neglect at an agency, facility, or program as 
494.25  defined in section 245.91, it shall, in addition to its other 
494.26  duties under this section, immediately inform the ombudsman 
494.27  established under sections 245.91 to 245.97. 
494.28     (c) Authority of the local welfare agency responsible for 
494.29  assessing the child abuse or neglect report and of the local law 
494.30  enforcement agency for investigating the alleged abuse or 
494.31  neglect includes, but is not limited to, authority to interview, 
494.32  without parental consent, the alleged victim and any other 
494.33  minors who currently reside with or who have resided with the 
494.34  alleged offender.  The interview may take place at school or at 
494.35  any facility or other place where the alleged victim or other 
494.36  minors might be found or the child may be transported to, and 
495.1   the interview conducted at, a place appropriate for the 
495.2   interview of a child designated by the local welfare agency or 
495.3   law enforcement agency.  The interview may take place outside 
495.4   the presence of the alleged offender or parent, legal custodian, 
495.5   guardian, or school official.  Except as provided in this 
495.6   paragraph, the parent, legal custodian, or guardian shall be 
495.7   notified by the responsible local welfare or law enforcement 
495.8   agency no later than the conclusion of the investigation or 
495.9   assessment that this interview has occurred.  Notwithstanding 
495.10  rule 49.02 of the Minnesota rules of procedure for juvenile 
495.11  courts, the juvenile court may, after hearing on an ex parte 
495.12  motion by the local welfare agency, order that, where reasonable 
495.13  cause exists, the agency withhold notification of this interview 
495.14  from the parent, legal custodian, or guardian.  If the interview 
495.15  took place or is to take place on school property, the order 
495.16  shall specify that school officials may not disclose to the 
495.17  parent, legal custodian, or guardian the contents of the 
495.18  notification of intent to interview the child on school 
495.19  property, as provided under this paragraph, and any other 
495.20  related information regarding the interview that may be a part 
495.21  of the child's school record.  A copy of the order shall be sent 
495.22  by the local welfare or law enforcement agency to the 
495.23  appropriate school official. 
495.24     (d) When the local welfare or local law enforcement agency 
495.25  determines that an interview should take place on school 
495.26  property, written notification of intent to interview the child 
495.27  on school property must be received by school officials prior to 
495.28  the interview.  The notification shall include the name of the 
495.29  child to be interviewed, the purpose of the interview, and a 
495.30  reference to the statutory authority to conduct an interview on 
495.31  school property.  For interviews conducted by the local welfare 
495.32  agency, the notification shall be signed by the chair of the 
495.33  local social services agency or the chair's designee.  The 
495.34  notification shall be private data on individuals subject to the 
495.35  provisions of this paragraph.  School officials may not disclose 
495.36  to the parent, legal custodian, or guardian the contents of the 
496.1   notification or any other related information regarding the 
496.2   interview until notified in writing by the local welfare or law 
496.3   enforcement agency that the investigation or assessment has been 
496.4   concluded.  Until that time, the local welfare or law 
496.5   enforcement agency shall be solely responsible for any 
496.6   disclosures regarding the nature of the assessment or 
496.7   investigation.  
496.8      Except where the alleged offender is believed to be a 
496.9   school official or employee, the time and place, and manner of 
496.10  the interview on school premises shall be within the discretion 
496.11  of school officials, but the local welfare or law enforcement 
496.12  agency shall have the exclusive authority to determine who may 
496.13  attend the interview.  The conditions as to time, place, and 
496.14  manner of the interview set by the school officials shall be 
496.15  reasonable and the interview shall be conducted not more than 24 
496.16  hours after the receipt of the notification unless another time 
496.17  is considered necessary by agreement between the school 
496.18  officials and the local welfare or law enforcement agency.  
496.19  Where the school fails to comply with the provisions of this 
496.20  paragraph, the juvenile court may order the school to comply.  
496.21  Every effort must be made to reduce the disruption of the 
496.22  educational program of the child, other students, or school 
496.23  staff when an interview is conducted on school premises.  
496.24     (e) Where the alleged offender or a person responsible for 
496.25  the care of the alleged victim or other minor prevents access to 
496.26  the victim or other minor by the local welfare agency, the 
496.27  juvenile court may order the parents, legal custodian, or 
496.28  guardian to produce the alleged victim or other minor for 
496.29  questioning by the local welfare agency or the local law 
496.30  enforcement agency outside the presence of the alleged offender 
496.31  or any person responsible for the child's care at reasonable 
496.32  places and times as specified by court order.  
496.33     (f) Before making an order under paragraph (e), the court 
496.34  shall issue an order to show cause, either upon its own motion 
496.35  or upon a verified petition, specifying the basis for the 
496.36  requested interviews and fixing the time and place of the 
497.1   hearing.  The order to show cause shall be served personally and 
497.2   shall be heard in the same manner as provided in other cases in 
497.3   the juvenile court.  The court shall consider the need for 
497.4   appointment of a guardian ad litem to protect the best interests 
497.5   of the child.  If appointed, the guardian ad litem shall be 
497.6   present at the hearing on the order to show cause.  
497.7      (g) The commissioner, the ombudsman for mental health and 
497.8   mental retardation, the local welfare agencies responsible for 
497.9   investigating reports, and the local law enforcement agencies 
497.10  have the right to enter facilities as defined in subdivision 2 
497.11  and to inspect and copy the facility's records, including 
497.12  medical records, as part of the investigation.  Notwithstanding 
497.13  the provisions of chapter 13, they also have the right to inform 
497.14  the facility under investigation that they are conducting an 
497.15  investigation, to disclose to the facility the names of the 
497.16  individuals under investigation for abusing or neglecting a 
497.17  child, and to provide the facility with a copy of the report and 
497.18  the investigative findings. 
497.19     (h) The local welfare agency shall collect available and 
497.20  relevant information to ascertain whether maltreatment occurred 
497.21  and whether protective services are needed.  Information 
497.22  collected includes, when relevant, information with regard to 
497.23  the person reporting the alleged maltreatment, including the 
497.24  nature of the reporter's relationship to the child and to the 
497.25  alleged offender, and the basis of the reporter's knowledge for 
497.26  the report; the child allegedly being maltreated; the alleged 
497.27  offender; the child's caretaker; and other collateral sources 
497.28  having relevant information related to the alleged 
497.29  maltreatment.  The local welfare agency may make a determination 
497.30  of no maltreatment early in an assessment, and close the case 
497.31  and retain immunity, if the collected information shows no basis 
497.32  for a full assessment or investigation. 
497.33     Information relevant to the assessment or investigation 
497.34  must be asked for, and may include: 
497.35     (1) the child's sex and age, prior reports of maltreatment, 
497.36  information relating to developmental functioning, credibility 
498.1   of the child's statement, and whether the information provided 
498.2   under this clause is consistent with other information collected 
498.3   during the course of the assessment or investigation; 
498.4      (2) the alleged offender's age, a record check for prior 
498.5   reports of maltreatment, and criminal charges and convictions.  
498.6   The local welfare agency must provide the alleged offender with 
498.7   an opportunity to make a statement.  The alleged offender may 
498.8   submit supporting documentation relevant to the assessment or 
498.9   investigation; 
498.10     (3) collateral source information regarding the alleged 
498.11  maltreatment and care of the child.  Collateral information 
498.12  includes, when relevant:  (i) a medical examination of the 
498.13  child; (ii) prior medical records relating to the alleged 
498.14  maltreatment or the care of the child and an interview with the 
498.15  treating professionals; and (iii) interviews with the child's 
498.16  caretakers, including the child's parent, guardian, foster 
498.17  parent, child care provider, teachers, counselors, family 
498.18  members, relatives, and other persons who may have knowledge 
498.19  regarding the alleged maltreatment and the care of the child; 
498.20  and 
498.21     (4) information on the existence of domestic abuse and 
498.22  violence in the home of the child, and substance abuse. 
498.23     Nothing in this paragraph precludes the local welfare 
498.24  agency from collecting other relevant information necessary to 
498.25  conduct the assessment or investigation.  Notwithstanding the 
498.26  data's classification in the possession of any other agency, 
498.27  data acquired by the local welfare agency during the course of 
498.28  the assessment or investigation are private data on individuals 
498.29  and must be maintained in accordance with subdivision 11. 
498.30     (i) In the initial stages of an assessment or 
498.31  investigation, the local welfare agency shall conduct a 
498.32  face-to-face observation of the child reported to be maltreated 
498.33  and a face-to-face interview of the alleged offender.  The 
498.34  interview with the alleged offender may be postponed if it would 
498.35  jeopardize an active law enforcement investigation. 
498.36     (j) The local welfare agency shall use a question and 
499.1   answer interviewing format with questioning as nondirective as 
499.2   possible to elicit spontaneous responses.  The following 
499.3   interviewing methods and procedures must be used whenever 
499.4   possible when collecting information: 
499.5      (1) audio recordings of all interviews with witnesses and 
499.6   collateral sources; and 
499.7      (2) in cases of alleged sexual abuse, audio-video 
499.8   recordings of each interview with the alleged victim and child 
499.9   witnesses. 
499.10     Sec. 75.  Minnesota Statutes 1998, section 626.556, 
499.11  subdivision 10b, is amended to read: 
499.12     Subd. 10b.  [DUTIES OF COMMISSIONER; NEGLECT OR ABUSE IN 
499.13  FACILITY.] (a) This section applies to the commissioners of 
499.14  human services and health.  The commissioner of the agency 
499.15  responsible for assessing or investigating the report shall 
499.16  immediately investigate if the report alleges that: 
499.17     (1) a child who is in the care of a facility as defined in 
499.18  subdivision 2 is neglected, physically abused, or sexually 
499.19  abused by an individual in that facility, or has been so 
499.20  neglected or abused by an individual in that facility within the 
499.21  three years preceding the report; or 
499.22     (2) a child was neglected, physically abused, or sexually 
499.23  abused by an individual in a facility defined in subdivision 2, 
499.24  while in the care of that facility within the three years 
499.25  preceding the report.  
499.26     The commissioner of the agency responsible for assessing or 
499.27  investigating the report shall arrange for the transmittal to 
499.28  the commissioner of reports received by local agencies and may 
499.29  delegate to a local welfare agency the duty to investigate 
499.30  reports.  In conducting an investigation under this section, the 
499.31  commissioner has the powers and duties specified for local 
499.32  welfare agencies under this section.  The commissioner of the 
499.33  agency responsible for assessing or investigating the report or 
499.34  local welfare agency may interview any children who are or have 
499.35  been in the care of a facility under investigation and their 
499.36  parents, guardians, or legal custodians. 
500.1      (b) Prior to any interview, the commissioner of the agency 
500.2   responsible for assessing or investigating the report or local 
500.3   welfare agency shall notify the parent, guardian, or legal 
500.4   custodian of a child who will be interviewed in the manner 
500.5   provided for in subdivision 10d, paragraph (a).  If reasonable 
500.6   efforts to reach the parent, guardian, or legal custodian of a 
500.7   child in an out-of-home placement have failed, the child may be 
500.8   interviewed if there is reason to believe the interview is 
500.9   necessary to protect the child or other children in the 
500.10  facility.  The commissioner of the agency responsible for 
500.11  assessing or investigating the report or local agency must 
500.12  provide the information required in this subdivision to the 
500.13  parent, guardian, or legal custodian of a child interviewed 
500.14  without parental notification as soon as possible after the 
500.15  interview.  When the investigation is completed, any parent, 
500.16  guardian, or legal custodian notified under this subdivision 
500.17  shall receive the written memorandum provided for in subdivision 
500.18  10d, paragraph (c). 
500.19     (c) In conducting investigations under this subdivision the 
500.20  commissioner or local welfare agency shall obtain access to 
500.21  information consistent with subdivision 10, paragraphs (h), (i), 
500.22  and (j). 
500.23     (d) Except for foster care and family child care, the 
500.24  commissioner has the primary responsibility for the 
500.25  investigations and notifications required under subdivisions 10d 
500.26  and 10f for reports that allege maltreatment related to the care 
500.27  provided by or in facilities licensed by the commissioner.  The 
500.28  commissioner may request assistance from the local 
500.29  social service services agency. 
500.30     Sec. 76.  Minnesota Statutes 1998, section 626.556, 
500.31  subdivision 10d, is amended to read: 
500.32     Subd. 10d.  [NOTIFICATION OF NEGLECT OR ABUSE IN FACILITY.] 
500.33  (a) When a report is received that alleges neglect, physical 
500.34  abuse, or sexual abuse of a child while in the care of a 
500.35  facility required to be licensed pursuant to chapter 245A, 
500.36  licensed or unlicensed day care facility, residential facility, 
501.1   agency, hospital, sanitarium, or other facility or institution 
501.2   required to be licensed according to sections 144.50 to 144.58; 
501.3   241.021; or 245A.01 to 245A.16; or chapter 245B, or a school as 
501.4   defined in sections 120A.05, subdivisions 9, 11, and 13; and 
501.5   124D.10; or a nonlicensed personal care provider organization as 
501.6   defined in section 256B.04, subdivision 16, and 256B.0625, 
501.7   subdivision 19a, the commissioner of the agency responsible for 
501.8   assessing or investigating the report or local welfare agency 
501.9   investigating the report shall provide the following information 
501.10  to the parent, guardian, or legal custodian of a child alleged 
501.11  to have been neglected, physically abused, or sexually abused:  
501.12  the name of the facility; the fact that a report alleging 
501.13  neglect, physical abuse, or sexual abuse of a child in the 
501.14  facility has been received; the nature of the alleged neglect, 
501.15  physical abuse, or sexual abuse; that the agency is conducting 
501.16  an investigation; any protective or corrective measures being 
501.17  taken pending the outcome of the investigation; and that a 
501.18  written memorandum will be provided when the investigation is 
501.19  completed. 
501.20     (b) The commissioner of the agency responsible for 
501.21  assessing or investigating the report or local welfare agency 
501.22  may also provide the information in paragraph (a) to the parent, 
501.23  guardian, or legal custodian of any other child in the facility 
501.24  if the investigative agency knows or has reason to believe the 
501.25  alleged neglect, physical abuse, or sexual abuse has occurred. 
501.26  In determining whether to exercise this authority, the 
501.27  commissioner of the agency responsible for assessing or 
501.28  investigating the report or local welfare agency shall consider 
501.29  the seriousness of the alleged neglect, physical abuse, or 
501.30  sexual abuse; the number of children allegedly neglected, 
501.31  physically abused, or sexually abused; the number of alleged 
501.32  perpetrators; and the length of the investigation.  The facility 
501.33  shall be notified whenever this discretion is exercised. 
501.34     (c) When the commissioner of the agency responsible for 
501.35  assessing or investigating the report or local welfare agency 
501.36  has completed its investigation, every parent, guardian, or 
502.1   legal custodian notified of the investigation by the 
502.2   commissioner or local welfare agency shall be provided with the 
502.3   following information in a written memorandum:  the name of the 
502.4   facility investigated; the nature of the alleged neglect, 
502.5   physical abuse, or sexual abuse; the investigator's name; a 
502.6   summary of the investigation findings; a statement whether 
502.7   maltreatment was found; and the protective or corrective 
502.8   measures that are being or will be taken.  The memorandum shall 
502.9   be written in a manner that protects the identity of the 
502.10  reporter and the child and shall not contain the name, or to the 
502.11  extent possible, reveal the identity of the alleged perpetrator 
502.12  or of those interviewed during the investigation.  The 
502.13  commissioner or local welfare agency shall also provide the 
502.14  written memorandum to the parent, guardian, or legal custodian 
502.15  of each child in the facility if maltreatment is determined to 
502.16  exist. 
502.17     Sec. 77.  Minnesota Statutes 1998, section 626.556, 
502.18  subdivision 10e, is amended to read: 
502.19     Subd. 10e.  [DETERMINATIONS.] Upon the conclusion of every 
502.20  assessment or investigation it conducts, the local welfare 
502.21  agency shall make two determinations:  first, whether 
502.22  maltreatment has occurred; and second, whether child protective 
502.23  services are needed.  When maltreatment is determined in an 
502.24  investigation involving a facility, the investigating agency 
502.25  shall also determine whether the facility or individual was 
502.26  responsible for the maltreatment using the mitigating factors in 
502.27  paragraph (d).  Determinations under this subdivision must be 
502.28  made based on a preponderance of the evidence. 
502.29     (a) For the purposes of this subdivision, "maltreatment" 
502.30  means any of the following acts or omissions committed by a 
502.31  person responsible for the child's care: 
502.32     (1) physical abuse as defined in subdivision 2, paragraph 
502.33  (d); 
502.34     (2) neglect as defined in subdivision 2, paragraph (c); 
502.35     (3) sexual abuse as defined in subdivision 2, paragraph 
502.36  (a); or 
503.1      (4) mental injury as defined in subdivision 2, paragraph 
503.2   (k). 
503.3      (b) For the purposes of this subdivision, a determination 
503.4   that child protective services are needed means that the local 
503.5   welfare agency has documented conditions during the assessment 
503.6   or investigation sufficient to cause a child protection worker, 
503.7   as defined in section 626.559, subdivision 1, to conclude that a 
503.8   child is at significant risk of maltreatment if protective 
503.9   intervention is not provided and that the individuals 
503.10  responsible for the child's care have not taken or are not 
503.11  likely to take actions to protect the child from maltreatment or 
503.12  risk of maltreatment. 
503.13     (c) This subdivision does not mean that maltreatment has 
503.14  occurred solely because the child's parent, guardian, or other 
503.15  person responsible for the child's care in good faith selects 
503.16  and depends upon spiritual means or prayer for treatment or care 
503.17  of disease or remedial care of the child, in lieu of medical 
503.18  care.  However, if lack of medical care may result in serious 
503.19  danger to the child's health, the local welfare agency may 
503.20  ensure that necessary medical services are provided to the child.
503.21     (d) When determining whether the facility or individual is 
503.22  the responsible party for determined maltreatment in a facility, 
503.23  the investigating agency shall consider at least the following 
503.24  mitigating factors: 
503.25     (1) whether the actions of the facility or the individual 
503.26  caregivers were according to, and followed the terms of, an 
503.27  erroneous physician order, prescription, individual care plan, 
503.28  or directive; however, this is not a mitigating factor when the 
503.29  facility or caregiver was responsible for the issuance of the 
503.30  erroneous order, prescription, individual care plan, or 
503.31  directive or knew or should have known of the errors and took no 
503.32  reasonable measures to correct the defect before administering 
503.33  care; 
503.34     (2) comparative responsibility between the facility, other 
503.35  caregivers, and requirements placed upon an employee, including 
503.36  the facility's compliance with related regulatory standards and 
504.1   the adequacy of facility policies and procedures, facility 
504.2   training, an individual's participation in the training, the 
504.3   caregiver's supervision, and facility staffing levels and the 
504.4   scope of the individual employee's authority and discretion; and 
504.5      (3) whether the facility or individual followed 
504.6   professional standards in exercising professional judgment. 
504.7      (e) The commissioner shall work with the maltreatment of 
504.8   minors advisory committee established under Laws 1997, chapter 
504.9   203, to make recommendations to further specify the kinds of 
504.10  acts or omissions that constitute physical abuse, neglect, 
504.11  sexual abuse, or mental injury.  The commissioner shall submit 
504.12  the recommendation and any legislation needed by January 15, 
504.13  1999.  Individual counties may implement more detailed 
504.14  definitions or criteria that indicate which allegations to 
504.15  investigate, as long as a county's policies are consistent with 
504.16  the definitions in the statutes and rules and are approved by 
504.17  the county board.  Each local welfare agency shall periodically 
504.18  inform mandated reporters under subdivision 3 who work in the 
504.19  county of the definitions of maltreatment in the statutes and 
504.20  rules and any additional definitions or criteria that have been 
504.21  approved by the county board. 
504.22     Sec. 78.  Minnesota Statutes 1998, section 626.556, 
504.23  subdivision 10f, is amended to read: 
504.24     Subd. 10f.  [NOTICE OF DETERMINATIONS.] Within ten working 
504.25  days of the conclusion of an assessment, the local welfare 
504.26  agency or agency responsible for assessing or investigating the 
504.27  report shall notify the parent or guardian of the child, the 
504.28  person determined to be maltreating the child, and if 
504.29  applicable, the director of the facility, of the determination 
504.30  and a summary of the specific reasons for the determination.  
504.31  The notice must also include a certification that the 
504.32  information collection procedures under subdivision 10, 
504.33  paragraphs (h), (i), and (j), were followed and a notice of the 
504.34  right of a data subject to obtain access to other private data 
504.35  on the subject collected, created, or maintained under this 
504.36  section.  In addition, the notice shall include the length of 
505.1   time that the records will be kept under subdivision 11c.  The 
505.2   investigating agency shall notify the parent or guardian of the 
505.3   child who is the subject of the report, and any person or 
505.4   facility determined to have maltreated a child, of their appeal 
505.5   rights under this section. 
505.6      Sec. 79.  Minnesota Statutes 1998, section 626.556, 
505.7   subdivision 10j, is amended to read: 
505.8      Subd. 10j.  [RELEASE OF DATA TO MANDATED REPORTERS.] A 
505.9   local social service services or child protection agency may 
505.10  provide relevant private data on individuals obtained under this 
505.11  section to mandated reporters who have an ongoing responsibility 
505.12  for the health, education, or welfare of a child affected by the 
505.13  data, in the best interests of the child.  The commissioner 
505.14  shall consult with the maltreatment of minors advisory committee 
505.15  to develop criteria for determining which records may be shared 
505.16  with mandated reporters under this subdivision.  Mandated 
505.17  reporters with ongoing responsibility for the health, education, 
505.18  or welfare of a child affected by the data include the child's 
505.19  teachers or other appropriate school personnel, foster parents, 
505.20  health care providers, respite care workers, therapists, social 
505.21  workers, child care providers, residential care staff, crisis 
505.22  nursery staff, probation officers, and court services 
505.23  personnel.  Under this section, a mandated reporter need not 
505.24  have made the report to be considered a person with ongoing 
505.25  responsibility for the health, education, or welfare of a child 
505.26  affected by the data. 
505.27     Sec. 80.  Minnesota Statutes 1998, section 626.556, 
505.28  subdivision 11, is amended to read: 
505.29     Subd. 11.  [RECORDS.] (a) Except as provided in paragraph 
505.30  (b) and subdivisions 10b, 10d, 10g, and 11b, all records 
505.31  concerning individuals maintained by a local welfare agency or 
505.32  agency responsible for assessing or investigating the report 
505.33  under this section, including any written reports filed under 
505.34  subdivision 7, shall be private data on individuals, except 
505.35  insofar as copies of reports are required by subdivision 7 to be 
505.36  sent to the local police department or the county sheriff.  
506.1   Reports maintained by any police department or the county 
506.2   sheriff shall be private data on individuals except the reports 
506.3   shall be made available to the investigating, petitioning, or 
506.4   prosecuting authority, including county medical examiners or 
506.5   county coroners.  Section 13.82, subdivisions 5, 5a, and 5b, 
506.6   apply to law enforcement data other than the reports.  The local 
506.7   social services agency or agency responsible for assessing or 
506.8   investigating the report shall make available to the 
506.9   investigating, petitioning, or prosecuting authority, including 
506.10  county medical examiners or county coroners or their 
506.11  professional delegates, any records which contain information 
506.12  relating to a specific incident of neglect or abuse which is 
506.13  under investigation, petition, or prosecution and information 
506.14  relating to any prior incidents of neglect or abuse involving 
506.15  any of the same persons.  The records shall be collected and 
506.16  maintained in accordance with the provisions of chapter 13.  In 
506.17  conducting investigations and assessments pursuant to this 
506.18  section, the notice required by section 13.04, subdivision 2, 
506.19  need not be provided to a minor under the age of ten who is the 
506.20  alleged victim of abuse or neglect.  An individual subject of a 
506.21  record shall have access to the record in accordance with those 
506.22  sections, except that the name of the reporter shall be 
506.23  confidential while the report is under assessment or 
506.24  investigation except as otherwise permitted by this 
506.25  subdivision.  Any person conducting an investigation or 
506.26  assessment under this section who intentionally discloses the 
506.27  identity of a reporter prior to the completion of the 
506.28  investigation or assessment is guilty of a misdemeanor.  After 
506.29  the assessment or investigation is completed, the name of the 
506.30  reporter shall be confidential.  The subject of the report may 
506.31  compel disclosure of the name of the reporter only with the 
506.32  consent of the reporter or upon a written finding by the court 
506.33  that the report was false and that there is evidence that the 
506.34  report was made in bad faith.  This subdivision does not alter 
506.35  disclosure responsibilities or obligations under the rules of 
506.36  criminal procedure. 
507.1      (b) Upon request of the legislative auditor, data on 
507.2   individuals maintained under this section must be released to 
507.3   the legislative auditor in order for the auditor to fulfill the 
507.4   auditor's duties under section 3.971.  The auditor shall 
507.5   maintain the data in accordance with chapter 13. 
507.6      Sec. 81.  Minnesota Statutes 1998, section 626.556, 
507.7   subdivision 11b, is amended to read: 
507.8      Subd. 11b.  [DATA RECEIVED FROM LAW ENFORCEMENT.] Active 
507.9   law enforcement investigative data received by a local welfare 
507.10  agency or agency responsible for assessing or investigating the 
507.11  report under this section are confidential data on individuals.  
507.12  When this data become inactive in the law enforcement agency, 
507.13  the data are private data on individuals. 
507.14     Sec. 82.  Minnesota Statutes 1998, section 626.556, 
507.15  subdivision 11c, is amended to read: 
507.16     Subd. 11c.  [WELFARE, COURT SERVICES AGENCY, AND SCHOOL 
507.17  RECORDS MAINTAINED.] Notwithstanding sections 138.163 and 
507.18  138.17, records maintained or records derived from reports of 
507.19  abuse by local welfare agencies, agencies responsible for 
507.20  assessing or investigating the report, court services agencies, 
507.21  or schools under this section shall be destroyed as provided in 
507.22  paragraphs (a) to (d) by the responsible authority. 
507.23     (a) If upon assessment or investigation there is no 
507.24  determination of maltreatment or the need for child protective 
507.25  services, the records must be maintained for a period of four 
507.26  years.  Records under this paragraph may not be used for 
507.27  employment, background checks, or purposes other than to assist 
507.28  in future risk and safety assessments. 
507.29     (b) All records relating to reports which, upon assessment 
507.30  or investigation, indicate either maltreatment or a need for 
507.31  child protective services shall be maintained for at least ten 
507.32  years after the date of the final entry in the case record. 
507.33     (c) All records regarding a report of maltreatment, 
507.34  including any notification of intent to interview which was 
507.35  received by a school under subdivision 10, paragraph (d), shall 
507.36  be destroyed by the school when ordered to do so by the agency 
508.1   conducting the assessment or investigation.  The agency shall 
508.2   order the destruction of the notification when other records 
508.3   relating to the report under investigation or assessment are 
508.4   destroyed under this subdivision. 
508.5      (d) Private or confidential data released to a court 
508.6   services agency under subdivision 10h must be destroyed by the 
508.7   court services agency when ordered to do so by the local welfare 
508.8   agency that released the data.  The local welfare agency or 
508.9   agency responsible for assessing or investigating the report 
508.10  shall order destruction of the data when other records relating 
508.11  to the assessment or investigation are destroyed under this 
508.12  subdivision. 
508.13     Sec. 83.  Minnesota Statutes 1998, section 626.558, 
508.14  subdivision 1, is amended to read: 
508.15     Subdivision 1.  [ESTABLISHMENT OF THE TEAM.] A county shall 
508.16  establish a multidisciplinary child protection team that may 
508.17  include, but not be limited to, the director of the local 
508.18  welfare agency or designees, the county attorney or designees, 
508.19  the county sheriff or designees, representatives of health and 
508.20  education, representatives of mental health or other appropriate 
508.21  human service or community-based agencies, and parent groups.  
508.22  As used in this section, a "community-based agency" may include, 
508.23  but is not limited to, schools, social service agencies, family 
508.24  service and mental health collaboratives, early childhood and 
508.25  family education programs, Head Start, or other agencies serving 
508.26  children and families.  A member of the team must be designated 
508.27  as the lead person of the team responsible for coordinating its 
508.28  activities with battered women's programs and services. 
508.29     Sec. 84.  [AMEND CHEMICAL DEPENDENCY ASSESSMENT CRITERIA.] 
508.30     Subdivision 1.  [CHILD PROTECTION.] The commissioner of 
508.31  human services shall amend the assessment criteria under 
508.32  Minnesota Rules, part 9530.6600, specifically Minnesota Rules, 
508.33  part 9530.6615, to include assessment criteria that addresses 
508.34  issues related to parents who have open child protection cases 
508.35  due, in part, to chemical abuse.  In amending this rule part, 
508.36  the commissioner shall use the expedited rulemaking process 
509.1   under Minnesota Statutes, section 14.389, and assure that 
509.2   notification provisions are in accordance with federal law.  
509.3      Subd. 2.  [PREGNANCY.] The commissioner of human services 
509.4   shall amend Minnesota Rules, part 9530.6605, to address 
509.5   pregnancy as a risk factor in determining the need for chemical 
509.6   dependency treatment. 
509.7      Sec. 85.  [REHABILITATION SERVICES OPTION FOR ADULTS WITH 
509.8   MENTAL ILLNESS OR OTHER CONDITIONS.] 
509.9      The commissioner of human services, in consultation with 
509.10  the association of Minnesota counties and other stakeholders, 
509.11  shall design a proposal to add rehabilitation services to the 
509.12  state medical assistance plan for adults with mental illness or 
509.13  other debilitating conditions, including, but not limited to, 
509.14  chemical dependency. 
509.15     Sec. 86.  [TARGETED CASE MANAGEMENT FOR VULNERABLE ADULTS.] 
509.16     The commissioner of human services, in consultation with 
509.17  the association of Minnesota counties and other stakeholders, 
509.18  shall design a proposal to provide medical assistance coverage 
509.19  for targeted case management service activities for adults 
509.20  receiving services through a county or state agency that are in 
509.21  need of service coordination, including, but not limited to, 
509.22  people age 65 and older; people in need of adult protective 
509.23  services; people applying for financial assistance; people who 
509.24  have chemical dependency; and other people who require community 
509.25  social services under Minnesota Statutes, chapter 256E. 
509.26     Sec. 87.  [RECOMMENDATIONS TO THE LEGISLATURE.] 
509.27     The commissioner of human services shall submit to the 
509.28  legislature design and implementation recommendations for the 
509.29  proposals required in sections 85 and 86, including draft 
509.30  legislation, by January 15, 2000, for implementation by July 1, 
509.31  2000.  The proposals shall not include requirements for 
509.32  maintenance of effort and expanded expenditures concerning 
509.33  federal reimbursements earned in these programs. 
509.34     Sec. 88.  [INSTRUCTION TO REVISOR.] 
509.35     The revisor of statutes shall delete the references to 
509.36  Minnesota Statutes, section 260.181, and substitute a reference 
510.1   to Minnesota Statutes, section 260.015, subdivision 13, in the 
510.2   following sections:  Minnesota Statutes, sections 245A.035, 
510.3   subdivision 1; 257.071, subdivision 1; 260.191, subdivision 1d; 
510.4   and 260.191, subdivision 1e. 
510.5      Sec. 89.  [REPEALER.] 
510.6      Minnesota Statutes 1998, section 257.071, subdivisions 8 
510.7   and 10, are repealed. 
510.8      Sec. 90.  [EFFECTIVE DATE.] 
510.9      When preparing the conference committee report for adoption 
510.10  by the legislature, the revisor shall combine all effective date 
510.11  notations in this article into this effective date section. 
510.12                             ARTICLE 9
510.13                         HEALTH OCCUPATIONS
510.14     Section 1.  Minnesota Statutes 1998, section 13.99, 
510.15  subdivision 38a, is amended to read: 
510.16     Subd. 38a.  [AMBULANCE SERVICE DATA.] Data required to be 
510.17  reported by ambulance services under section 144E.17, 
510.18  subdivision 1, 144E.123 are classified under that section. 
510.19     Sec. 2.  Minnesota Statutes 1998, section 13.99, is amended 
510.20  by adding a subdivision to read: 
510.21     Subd. 39b.  [EMT, EMT-I, EMT-P, OR FIRST RESPONDER 
510.22  MISCONDUCT.] Reports of emergency medical technician, emergency 
510.23  medical technician-intermediate, emergency medical 
510.24  technician-paramedic, or first responder misconduct are 
510.25  classified under section 144E.305, subdivision 3. 
510.26     Sec. 3.  Minnesota Statutes 1998, section 144A.46, 
510.27  subdivision 2, is amended to read: 
510.28     Subd. 2.  [EXEMPTIONS.] The following individuals or 
510.29  organizations are exempt from the requirement to obtain a home 
510.30  care provider license: 
510.31     (1) a person who is licensed as a registered nurse under 
510.32  sections 148.171 to 148.285 and who independently provides 
510.33  nursing services in the home without any contractual or 
510.34  employment relationship to a home care provider or other 
510.35  organization; 
510.36     (2) a personal care assistant who provides services to only 
511.1   one individual under the medical assistance program as 
511.2   authorized under sections 256B.0625, subdivision 19, and 
511.3   256B.04, subdivision 16; 
511.4      (3) a person or organization that exclusively offers, 
511.5   provides, or arranges for personal care assistant services to 
511.6   only one individual under the medical assistance program as 
511.7   authorized under sections 256B.0625, subdivision 19, and 
511.8   256B.04, subdivision 16; 
511.9      (4) a person who is registered licensed under sections 
511.10  148.65 to 148.78 and who independently provides physical therapy 
511.11  services in the home without any contractual or employment 
511.12  relationship to a home care provider or other organization; 
511.13     (5) a provider that is licensed by the commissioner of 
511.14  human services to provide semi-independent living services under 
511.15  Minnesota Rules, parts 9525.0500 to 9525.0660 when providing 
511.16  home care services to a person with a developmental disability; 
511.17     (6) a provider that is licensed by the commissioner of 
511.18  human services to provide home and community-based services 
511.19  under Minnesota Rules, parts 9525.2000 to 9525.2140 when 
511.20  providing home care services to a person with a developmental 
511.21  disability; 
511.22     (7) a person or organization that provides only home 
511.23  management services, if the person or organization is registered 
511.24  under section 144A.461; or 
511.25     (8) a person who is licensed as a social worker under 
511.26  sections 148B.18 to 148B.289 and who provides social work 
511.27  services in the home independently and not through any 
511.28  contractual or employment relationship with a home care provider 
511.29  or other organization. 
511.30     An exemption under this subdivision does not excuse the 
511.31  individual from complying with applicable provisions of the home 
511.32  care bill of rights. 
511.33     Sec. 4.  Minnesota Statutes 1998, section 144E.001, is 
511.34  amended by adding a subdivision to read: 
511.35     Subd. 1a.  [ADVANCED AIRWAY MANAGEMENT.] "Advanced airway 
511.36  management" means insertion of an endotracheal tube or creation 
512.1   of a surgical airway.  
512.2      Sec. 5.  Minnesota Statutes 1998, section 144E.001, is 
512.3   amended by adding a subdivision to read: 
512.4      Subd. 1b.  [ADVANCED LIFE SUPPORT.] "Advanced life support" 
512.5   means rendering basic life support and rendering intravenous 
512.6   therapy, drug therapy, intubation, and defibrillation as 
512.7   outlined in the United States Department of Transportation 
512.8   emergency medical technician-paramedic curriculum or its 
512.9   equivalent, as approved by the board. 
512.10     Sec. 6.  Minnesota Statutes 1998, section 144E.001, is 
512.11  amended by adding a subdivision to read: 
512.12     Subd. 3a.  [AMBULANCE SERVICE PERSONNEL.] "Ambulance 
512.13  service personnel" means individuals who are authorized by a 
512.14  licensed ambulance service to provide emergency care for the 
512.15  ambulance service and are: 
512.16     (1) EMTs, EMT-Is, or EMT-Ps; 
512.17     (2) Minnesota registered nurses who are:  (i) EMTs, are 
512.18  currently practicing nursing, and have passed a paramedic 
512.19  practical skills test, as approved by the board and administered 
512.20  by a training program approved by the board; (ii) on the roster 
512.21  of an ambulance service on or before January 1, 2000; or (iii) 
512.22  after petitioning the board, deemed by the board to have 
512.23  training and skills equivalent to an EMT, as determined on a 
512.24  case-by-case basis; or 
512.25     (3) Minnesota registered physician assistants who are:  (i) 
512.26  EMTs, are currently practicing as physician assistants, and have 
512.27  passed a paramedic practical skills test, as approved by the 
512.28  board and administered by a training program approved by the 
512.29  board; (ii) on the roster of an ambulance service on or before 
512.30  January 1, 2000; or (iii) after petitioning the board, deemed by 
512.31  the board to have training and skills equivalent to an EMT, as 
512.32  determined on a case-by-case basis. 
512.33     Sec. 7.  Minnesota Statutes 1998, section 144E.001, is 
512.34  amended by adding a subdivision to read: 
512.35     Subd. 4a.  [BASIC AIRWAY MANAGEMENT.] "Basic airway 
512.36  management" means:  
513.1      (1) resuscitation by mouth-to-mouth, mouth-to-mask, bag 
513.2   valve mask, or oxygen powered ventilators; or 
513.3      (2) insertion of an oropharyngeal, nasal pharyngeal, 
513.4   esophageal obturator airway, esophageal tracheal airway, or 
513.5   esophageal gastric tube airway. 
513.6      Sec. 8.  Minnesota Statutes 1998, section 144E.001, is 
513.7   amended by adding a subdivision to read: 
513.8      Subd. 4b.  [BASIC LIFE SUPPORT.] "Basic life support" means 
513.9   rendering basic-level emergency care, including, but not limited 
513.10  to, basic airway management, cardiopulmonary resuscitation, 
513.11  controlling shock and bleeding, and splinting fractures, as 
513.12  outlined in the United States Department of Transportation 
513.13  emergency medical technician-basic curriculum or its equivalent, 
513.14  as approved by the board. 
513.15     Sec. 9.  Minnesota Statutes 1998, section 144E.001, is 
513.16  amended by adding a subdivision to read: 
513.17     Subd. 5a.  [CLINICAL TRAINING SITE.] "Clinical training 
513.18  site" means a licensed health care facility. 
513.19     Sec. 10.  Minnesota Statutes 1998, section 144E.001, is 
513.20  amended by adding a subdivision to read: 
513.21     Subd. 5b.  [DEFIBRILLATOR.] "Defibrillator" means an 
513.22  automatic, semiautomatic, or manual device that delivers an 
513.23  electric shock at a preset voltage to the myocardium through the 
513.24  chest wall and that is used to restore the normal cardiac rhythm 
513.25  and rate when the heart has stopped beating or is fibrillating. 
513.26     Sec. 11.  Minnesota Statutes 1998, section 144E.001, is 
513.27  amended by adding a subdivision to read: 
513.28     Subd. 5c.  [EMERGENCY MEDICAL TECHNICIAN OR EMT.] 
513.29  "Emergency medical technician" or "EMT" means a person who has 
513.30  successfully completed the United States Department of 
513.31  Transportation emergency medical technician-basic course or its 
513.32  equivalent, as approved by the board, and has been issued valid 
513.33  certification by the board. 
513.34     Sec. 12.  Minnesota Statutes 1998, section 144E.001, is 
513.35  amended by adding a subdivision to read: 
513.36     Subd. 5d.  [EMERGENCY MEDICAL TECHNICIAN-INTERMEDIATE OR 
514.1   EMT-I.] "Emergency medical technician-intermediate" or "EMT-I" 
514.2   means a person who has successfully completed the United States 
514.3   Department of Transportation emergency medical 
514.4   technician-intermediate course or its equivalent, as approved by 
514.5   the board, and has been issued valid certification by the board. 
514.6      Sec. 13.  Minnesota Statutes 1998, section 144E.001, is 
514.7   amended by adding a subdivision to read: 
514.8      Subd. 5e.  [EMERGENCY MEDICAL TECHNICIAN-PARAMEDIC OR 
514.9   EMT-P.] "Emergency medical technician-paramedic" or "EMT-P" 
514.10  means a person who has successfully completed the United States 
514.11  Department of Transportation emergency medical technician 
514.12  course-paramedic or its equivalent, as approved by the board, 
514.13  and has been issued valid certification by the board. 
514.14     Sec. 14.  Minnesota Statutes 1998, section 144E.001, is 
514.15  amended by adding a subdivision to read: 
514.16     Subd. 5f.  [EMERGENCY MEDICAL TECHNICIAN INSTRUCTOR.] 
514.17  "Emergency medical technician instructor" means a person who has 
514.18  been certified by the board to teach an EMT, EMT-I, or EMT-P 
514.19  course. 
514.20     Sec. 15.  Minnesota Statutes 1998, section 144E.001, is 
514.21  amended by adding a subdivision to read: 
514.22     Subd. 8a.  [MEDICAL CONTROL.] "Medical control" means 
514.23  direction by a physician or a physician's designee of 
514.24  out-of-hospital emergency medical care. 
514.25     Sec. 16.  Minnesota Statutes 1998, section 144E.001, is 
514.26  amended by adding a subdivision to read: 
514.27     Subd. 9a.  [PART-TIME ADVANCED LIFE SUPPORT.] "Part-time 
514.28  advanced life support" means rendering basic life support and 
514.29  advanced life support for less than 24 hours of every day. 
514.30     Sec. 17.  Minnesota Statutes 1998, section 144E.001, is 
514.31  amended by adding a subdivision to read: 
514.32     Subd. 9b.  [PHYSICIAN.] "Physician" means a person licensed 
514.33  to practice medicine under chapter 147. 
514.34     Sec. 18.  Minnesota Statutes 1998, section 144E.001, is 
514.35  amended by adding a subdivision to read: 
514.36     Subd. 9c.  [PHYSICIAN ASSISTANT.] "Physician assistant" 
515.1   means a person registered to practice as a physician assistant 
515.2   under chapter 147A. 
515.3      Sec. 19.  Minnesota Statutes 1998, section 144E.001, is 
515.4   amended by adding a subdivision to read: 
515.5      Subd. 9d.  [PREHOSPITAL CARE DATA.] "Prehospital care data" 
515.6   means information collected by ambulance service personnel about 
515.7   the circumstances related to an emergency response and patient 
515.8   care activities provided by the ambulance service personnel in a 
515.9   prehospital setting. 
515.10     Sec. 20.  Minnesota Statutes 1998, section 144E.001, is 
515.11  amended by adding a subdivision to read: 
515.12     Subd. 11.  [PROGRAM MEDICAL DIRECTOR.] "Program medical 
515.13  director" means a physician who is responsible for ensuring an 
515.14  accurate and thorough presentation of the medical content of an 
515.15  emergency care training program; certifying that each student 
515.16  has successfully completed the training course; and in 
515.17  conjunction with the program coordinator, planning the clinical 
515.18  training. 
515.19     Sec. 21.  Minnesota Statutes 1998, section 144E.001, is 
515.20  amended by adding a subdivision to read: 
515.21     Subd. 12.  [REGISTERED NURSE.] "Registered nurse" means a 
515.22  person licensed to practice professional nursing under chapter 
515.23  148. 
515.24     Sec. 22.  Minnesota Statutes 1998, section 144E.001, is 
515.25  amended by adding a subdivision to read: 
515.26     Subd. 13.  [STANDING ORDER.] "Standing order" means a type 
515.27  of medical protocol that provides specific, written orders for 
515.28  actions, techniques, or drug administration when communication 
515.29  has not been established for direct medical control. 
515.30     Sec. 23.  Minnesota Statutes 1998, section 144E.001, is 
515.31  amended by adding a subdivision to read: 
515.32     Subd. 14.  [TRAINING PROGRAM COORDINATOR.] "Training 
515.33  program coordinator" means an individual who serves as the 
515.34  administrator of an emergency care training program and who is 
515.35  responsible for planning, conducting, and evaluating the 
515.36  program; selecting students and certified instructors; 
516.1   documenting and maintaining records; developing a curriculum; 
516.2   and assisting in the coordination of examination sessions and 
516.3   clinical training. 
516.4      Sec. 24.  Minnesota Statutes 1998, section 144E.10, 
516.5   subdivision 1, is amended to read: 
516.6      Subdivision 1.  [LICENSE REQUIRED.] No natural person, 
516.7   partnership, association, corporation, or unit of government may 
516.8   operate an ambulance service within this state unless it 
516.9   possesses a valid license to do so issued by the board.  The 
516.10  license shall specify the base of operations, the primary 
516.11  service area, and the type or types of ambulance service for 
516.12  which the licensee is licensed.  The licensee shall obtain a new 
516.13  license if it wishes to expand its primary service area, or to 
516.14  provide a new type or types of service.  The cost of licenses 
516.15  shall be in an amount prescribed by the board pursuant to 
516.16  section 144E.05.  Licenses shall expire and be renewed in 
516.17  accordance with rules adopted by the board. 
516.18     Sec. 25.  [144E.101] [AMBULANCE SERVICE REQUIREMENTS.] 
516.19     Subdivision 1.  [PERSONNEL.] (a) No publicly or privately 
516.20  owned ambulance service shall be operated in the state unless 
516.21  its ambulance service personnel are certified, appropriate to 
516.22  the type of ambulance service being provided, according to 
516.23  section 144E.28 or meet the staffing criteria specific to the 
516.24  type of ambulance service. 
516.25     (b) An ambulance service shall have a medical director as 
516.26  provided under section 144E.265. 
516.27     Subd. 2.  [PATIENT CARE.] When a patient is being 
516.28  transported, at least one of the ambulance service personnel 
516.29  must be in the patient compartment.  If advanced life support 
516.30  procedures are required, an EMT-P, a registered nurse qualified 
516.31  under section 144E.001, subdivision 3a, clause (2), item (i), or 
516.32  a physician assistant qualified under section 144E.001, 
516.33  subdivision 3a, clause (3), item (i), shall be in the patient 
516.34  compartment. 
516.35     Subd. 3.  [CONTINUAL SERVICE.] An ambulance service shall 
516.36  offer service 24 hours per day every day of the year, unless 
517.1   otherwise authorized under subdivisions 8 and 9. 
517.2      Subd. 4.  [DENIAL OF SERVICE PROHIBITED.] An ambulance 
517.3   service shall not deny prehospital care to a person needing 
517.4   emergency ambulance service because of inability to pay or 
517.5   because of the source of payment for services if the need 
517.6   develops within the licensee's primary service area or when 
517.7   responding to a mutual aid call.  Transport for the patient may 
517.8   be limited to the closest appropriate emergency medical facility.
517.9      Subd. 5.  [TYPES OF SERVICE.] The board shall regulate the 
517.10  following types of ambulance service: 
517.11     (1) basic life support; 
517.12     (2) advanced life support; 
517.13     (3) part-time advanced life support; and 
517.14     (4) specialized life support. 
517.15     Subd. 6.  [BASIC LIFE SUPPORT.] (a) A basic life support 
517.16  ambulance shall be staffed by at least two ambulance service 
517.17  personnel, at least one of which must be an EMT, who provide a 
517.18  level of care so as to ensure that: 
517.19     (1) life-threatening situations and potentially serious 
517.20  injuries are recognized; 
517.21     (2) patients are protected from additional hazards; 
517.22     (3) basic treatment to reduce the seriousness of emergency 
517.23  situations is administered; and 
517.24     (4) patients are transported to an appropriate medical 
517.25  facility for treatment. 
517.26     (b) A basic life support service shall provide basic airway 
517.27  management.  
517.28     (c) By January 1, 2001, a basic life support service shall 
517.29  provide automatic defibrillation, as provided in section 
517.30  144E.103, subdivision 1, paragraph (b).  
517.31     (d) A basic life support service licensee's medical 
517.32  director may authorize the ambulance service personnel to carry 
517.33  and to use medical antishock trousers and to perform intravenous 
517.34  infusion if the ambulance service personnel have been properly 
517.35  trained. 
517.36     Subd. 7.  [ADVANCED LIFE SUPPORT.] (a) An advanced life 
518.1   support ambulance shall be staffed by at least: 
518.2      (1) one EMT and one EMT-P; 
518.3      (2) one EMT and one registered nurse who is an EMT, is 
518.4   currently practicing nursing, and has passed a paramedic 
518.5   practical skills test approved by the board and administered by 
518.6   a training program; or 
518.7      (3) one EMT and one physician assistant who is an EMT, is 
518.8   currently practicing as a physician assistant, and has passed a 
518.9   paramedic practical skills test approved by the board and 
518.10  administered by a training program. 
518.11     (b) An advanced life support service shall provide basic 
518.12  life support, as specified under subdivision 6, paragraph (a), 
518.13  advanced airway management, manual defibrillation, and 
518.14  administration of intravenous fluids and pharmaceuticals. 
518.15     (c) In addition to providing advanced life support, an 
518.16  advanced life support service may staff additional ambulances to 
518.17  provide basic life support according to subdivision 6.  When 
518.18  routinely staffed and equipped as a basic life support service 
518.19  according to subdivision 6 and section 144E.103, subdivision 1, 
518.20  the vehicle shall not be marked as advanced life support.  
518.21     (d) An ambulance service providing advanced life support 
518.22  shall have a written agreement with its medical director to 
518.23  ensure medical control for patient care 24 hours a day, seven 
518.24  days a week.  The terms of the agreement shall include a written 
518.25  policy on the administration of medical control for the 
518.26  service.  The policy shall address the following issues:  
518.27     (i) two-way communication for physician direction of 
518.28  ambulance service personnel; 
518.29     (ii) patient triage, treatment, and transport; 
518.30     (iii) use of standing orders; and 
518.31     (iv) the means by which medical control will be provided 24 
518.32  hours a day. 
518.33     The agreement shall be signed by the licensee's medical 
518.34  director and the licensee or the licensee's designee and 
518.35  maintained in the files of the licensee. 
518.36     (e) When an ambulance service provides advanced life 
519.1   support, the authority of an EMT-P, Minnesota registered 
519.2   nurse-EMT, or Minnesota registered physician assistant-EMT to 
519.3   determine the delivery of patient care prevails over the 
519.4   authority of an EMT. 
519.5      Subd. 8.  [PART-TIME ADVANCED LIFE SUPPORT.] (a) A 
519.6   part-time advanced life support service shall meet the staffing 
519.7   requirements under subdivision 7, paragraph (a); provide service 
519.8   as required under subdivision 7, paragraph (b), for less than 24 
519.9   hours every day; and meet the equipment requirements specified 
519.10  in section 144E.103.  
519.11     (b) A part-time advanced life support service shall have a 
519.12  written agreement with its medical director to ensure medical 
519.13  control for patient care during the time the service offers 
519.14  advanced life support.  The terms of the agreement shall include 
519.15  a written policy on the administration of medical control for 
519.16  the service and address the issues specified in subdivision 7, 
519.17  paragraph (d). 
519.18     Subd. 9.  [SPECIALIZED LIFE SUPPORT.] A specialized life 
519.19  support service shall provide basic or advanced life support as 
519.20  designated by the board, and shall be restricted by the board to:
519.21     (1) operation less than 24 hours of every day; 
519.22     (2) designated segments of the population; 
519.23     (3) certain types of medical conditions; or 
519.24     (4) air ambulance service that includes fixed-wing and 
519.25  rotor-wing. 
519.26     Subd. 10.  [DRIVER.] A driver of an ambulance must possess 
519.27  a current driver's license issued by any state and must have 
519.28  attended an emergency vehicle driving course approved by the 
519.29  licensee.  The emergency vehicle driving course must include 
519.30  actual driving experience. 
519.31     Subd. 11.  [PERSONNEL ROSTER AND FILES.] (a) An ambulance 
519.32  service shall maintain: 
519.33     (1) at least two ambulance service personnel on a written 
519.34  on-call schedule; 
519.35     (2) a current roster of its ambulance service personnel, 
519.36  including the name, address, and qualifications of its ambulance 
520.1   service personnel; and 
520.2      (3) files documenting personnel qualifications. 
520.3      (b) A licensee shall maintain in its files the name and 
520.4   address of its medical director and a written statement signed 
520.5   by the medical director indicating acceptance of the 
520.6   responsibilities specified in section 144E.265, subdivision 2. 
520.7      Subd. 12.  [MUTUAL AID AGREEMENT.] A licensee shall have a 
520.8   written agreement with at least one neighboring licensed 
520.9   ambulance service for coverage during times when the licensee's 
520.10  ambulances are not available for service in its primary service 
520.11  area.  The agreement must specify the duties and 
520.12  responsibilities of the agreeing parties.  A copy of each mutual 
520.13  aid agreement shall be maintained in the files of the licensee. 
520.14     Subd. 13.  [SERVICE OUTSIDE PRIMARY SERVICE AREA.] A 
520.15  licensee may provide its services outside of its primary service 
520.16  area only if requested by a transferring physician or ambulance 
520.17  service licensed to provide service in the primary service area 
520.18  when it can reasonably be expected that: 
520.19     (1) the response is required by the immediate medical need 
520.20  of an individual; and 
520.21     (2) the ambulance service licensed to provide service in 
520.22  the primary service area is unavailable for appropriate response.
520.23     Sec. 26.  [144E.103] [EQUIPMENT.] 
520.24     Subdivision 1.  [GENERAL REQUIREMENTS.] (a) Every ambulance 
520.25  in service for patient care shall carry, at a minimum:  
520.26     (1) oxygen; 
520.27     (2) airway maintenance equipment in various sizes to 
520.28  accommodate all age groups; 
520.29     (3) splinting equipment in various sizes to accommodate all 
520.30  age groups; 
520.31     (4) dressings, bandages, and bandaging equipment; 
520.32     (5) an emergency obstetric kit; 
520.33     (6) equipment to determine vital signs in various sizes to 
520.34  accommodate all age groups; 
520.35     (7) a stretcher; 
520.36     (8) a defibrillator; and 
521.1      (9) a fire extinguisher. 
521.2      (b) A basic life support service has until January 1, 2000, 
521.3   to equip each ambulance in service for patient care with a 
521.4   defibrillator. 
521.5      Subd. 2.  [ADVANCED LIFE SUPPORT REQUIREMENTS.] In addition 
521.6   to the requirements in subdivision 1, an ambulance used in 
521.7   providing advanced life support must carry drugs and drug 
521.8   administration equipment and supplies as approved by the 
521.9   licensee's medical director. 
521.10     Subd. 3.  [STORAGE.] All equipment carried in an ambulance 
521.11  must be securely stored. 
521.12     Subd. 4.  [SAFETY RESTRAINTS.] An ambulance must be 
521.13  equipped with safety straps for the stretcher and seat belts in 
521.14  the patient compartment for the patient and ambulance personnel. 
521.15     Sec. 27.  Minnesota Statutes 1998, section 144E.11, is 
521.16  amended by adding a subdivision to read: 
521.17     Subd. 9.  [RENEWAL REQUIREMENTS.] An ambulance service 
521.18  license expires two years from the date of licensure.  An 
521.19  ambulance service must apply to the board for license renewal at 
521.20  least one month prior to the expiration date of the license and 
521.21  must submit:  
521.22     (1) an application prescribed by the board specifying any 
521.23  changes from the information provided for prior licensure and 
521.24  any other information requested by the board to clarify 
521.25  incomplete or ambiguous information presented in the 
521.26  application; and 
521.27     (2) the appropriate fee as required under section 144E.29.  
521.28     Sec. 28.  [144E.121] [AIR AMBULANCE SERVICE REQUIREMENTS.] 
521.29     Subdivision 1.  [AVIATION COMPLIANCE.] An air ambulance 
521.30  service must comply with the regulations of the Federal Aviation 
521.31  Administration and the rules of the Minnesota department of 
521.32  transportation, aeronautics division. 
521.33     Subd. 2.  [PERSONNEL.] (a) With the exception of pilots, 
521.34  each of the air ambulance emergency medical personnel must: 
521.35     (1) possess current certification, appropriate to the type 
521.36  of ambulance service being provided, according to section 
522.1   144E.28, be a registered nurse, or be a physician assistant; and 
522.2      (2) be trained to use the equipment on the air ambulance.  
522.3      (b) Emergency medical personnel for an air ambulance 
522.4   service must receive training approved by the licensee's medical 
522.5   director that includes instruction in the physiological changes 
522.6   due to decreased atmospheric pressure, acceleration, vibration, 
522.7   and changes in altitude; medical conditions requiring special 
522.8   precautions; and contraindications to air transport. 
522.9      (c) A licensee's medical director must sign and file a 
522.10  statement with the licensee that each of its emergency medical 
522.11  personnel has successfully completed the training under 
522.12  paragraph (b). 
522.13     (d) A licensee shall retain documentation of compliance 
522.14  with this subdivision in its files. 
522.15     Subd. 3.  [EQUIPMENT.] An air ambulance must carry 
522.16  equipment appropriate to the level of service being provided.  
522.17  Equipment that is not permanently stored on or in an air 
522.18  ambulance must be kept separate from the air ambulance in a 
522.19  modular prepackaged form.  
522.20     Sec. 29.  [144E.123] [PREHOSPITAL CARE DATA.] 
522.21     Subdivision 1.  [COLLECTION AND MAINTENANCE.] A licensee 
522.22  shall collect and provide prehospital care data to the board in 
522.23  a manner prescribed by the board.  At a minimum, the data must 
522.24  include items identified by the board that are part of the 
522.25  National Uniform Emergency Medical Services Data Set.  A 
522.26  licensee shall maintain prehospital care data for every response.
522.27     Subd. 2.  [COPY TO RECEIVING HOSPITAL.] If a patient is 
522.28  transported to a hospital, a copy of the ambulance report 
522.29  delineating prehospital medical care given shall be provided to 
522.30  the receiving hospital. 
522.31     Subd. 3.  [REVIEW.] Prehospital care data may be reviewed 
522.32  by the board or its designees.  The data shall be classified as 
522.33  private data on individuals under chapter 13, the Minnesota 
522.34  Government Data Practices Act. 
522.35     Subd. 4.  [PENALTY.] Failure to report all information 
522.36  required by the board under this section shall constitute 
523.1   grounds for license revocation. 
523.2      Sec. 30.  [144E.125] [OPERATIONAL PROCEDURES.] 
523.3      A licensee shall establish and implement written procedures 
523.4   for responding to ambulance service complaints, maintaining 
523.5   ambulances and equipment, procuring and storing drugs, and 
523.6   controlling infection.  The licensee shall maintain the 
523.7   procedures in its files. 
523.8      Sec. 31.  [144E.127] [INTERHOSPITAL TRANSFER.] 
523.9      When transporting a patient from one licensed hospital to 
523.10  another, a licensee may substitute for one of the required 
523.11  ambulance service personnel, a physician, a registered nurse, or 
523.12  physician's assistant who has been trained to use the equipment 
523.13  in the ambulance and is knowledgeable of the licensee's 
523.14  ambulance service protocols. 
523.15     Sec. 32.  Minnesota Statutes 1998, section 144E.16, 
523.16  subdivision 4, is amended to read: 
523.17     Subd. 4.  [TYPES OF SERVICES TO BE REGULATED.] (a) The 
523.18  board may adopt rules needed to regulate ambulance services in 
523.19  the following areas: 
523.20     (1) applications for licensure; 
523.21     (2) personnel qualifications and staffing standards; 
523.22     (3) quality of life support treatment; 
523.23     (4) restricted treatments and procedures; 
523.24     (5) equipment standards; 
523.25     (6) ambulance standards; 
523.26     (7) communication standards, equipment performance and 
523.27  maintenance, and radio frequency assignments; 
523.28     (8) advertising; 
523.29     (9) scheduled ambulance services; 
523.30     (10) ambulance services in time of disaster; 
523.31     (11) basic, intermediate, advanced, and refresher emergency 
523.32  care course programs; 
523.33     (12) continuing education requirements; 
523.34     (13) trip reports; 
523.35     (14) license fees, vehicle fees, and expiration dates; and 
523.36     (15) waivers and variances. 
524.1      (b) These rules shall apply to the following types of 
524.2   ambulance service: 
524.3      (1) basic ambulance service that provides a level of care 
524.4   to ensure that life-threatening situations and potentially 
524.5   serious injuries can be recognized, patients will be protected 
524.6   from additional hazards, basic treatment to reduce the 
524.7   seriousness of emergency situations will be administered, and 
524.8   patients will be transported to an appropriate medical facility 
524.9   for treatment; 
524.10     (2) intermediate ambulance service that provides (i) basic 
524.11  ambulance service, and (ii) intravenous infusions or 
524.12  defibrillation or both; 
524.13     (3) advanced ambulance service that provides (i) basic 
524.14  ambulance service, and (ii) advanced airway management, 
524.15  defibrillation, and administration of intravenous fluids and 
524.16  pharmaceuticals.  Vehicles of advanced ambulance service 
524.17  licensees not equipped or staffed at the advanced ambulance 
524.18  service level shall not be identified to the public as capable 
524.19  of providing advanced ambulance service; 
524.20     (4) specialized ambulance service that provides basic, 
524.21  intermediate, or advanced service as designated by the board, 
524.22  and is restricted by the board to (i) less than 24 hours of 
524.23  every day, (ii) designated segments of the population, or (iii) 
524.24  certain types of medical conditions; and 
524.25     (5) air ambulance service, that includes fixed-wing and 
524.26  helicopter, and is specialized ambulance service. 
524.27     Until rules are promulgated, the current provisions of 
524.28  Minnesota Rules shall govern these services. 
524.29     Sec. 33.  Minnesota Statutes 1998, section 144E.18, is 
524.30  amended to read: 
524.31     144E.18 [INSPECTIONS.] 
524.32     The board may inspect ambulance services as frequently as 
524.33  deemed necessary to determine whether an ambulance service is in 
524.34  compliance with sections 144E.001 to 144E.33 and rules adopted 
524.35  under those sections.  These inspections shall be for the 
524.36  purpose of determining whether the ambulance and equipment is 
525.1   clean and in proper working order and whether the operator is in 
525.2   compliance with sections 144E.001 to 144E.16 and any rules that 
525.3   the board adopts related to sections 144E.001 to 144E.16.  The 
525.4   board may review at any time documentation required to be on 
525.5   file with a licensee. 
525.6      Sec. 34.  [144E.19] [DISCIPLINARY ACTION.] 
525.7      Subdivision 1.  [SUSPENSION; REVOCATION; NONRENEWAL.] The 
525.8   board may suspend, revoke, refuse to renew, or place conditions 
525.9   on the license of a licensee upon finding that the licensee has 
525.10  violated a provision of this chapter or rules adopted under this 
525.11  chapter or has ceased to provide the service for which the 
525.12  licensee is licensed. 
525.13     Subd. 2.  [NOTICE; CONTESTED CASE.] (a) Before taking 
525.14  action under subdivision 1, the board shall give notice to a 
525.15  licensee of the right to a contested case hearing under chapter 
525.16  14.  If a licensee requests a contested case hearing within 30 
525.17  days after receiving notice, the board shall initiate a 
525.18  contested case hearing according to chapter 14. 
525.19     (b) The administrative law judge shall issue a report and 
525.20  recommendation within 30 days after closing the contested case 
525.21  hearing record.  The board shall issue a final order within 30 
525.22  days after receipt of the administrative law judge's report. 
525.23     Subd. 3.  [TEMPORARY SUSPENSION.] (a) In addition to any 
525.24  other remedy provided by law, the board may temporarily suspend 
525.25  the license of a licensee after conducting a preliminary inquiry 
525.26  to determine whether the board believes that the licensee has 
525.27  violated a statute or rule that the board is empowered to 
525.28  enforce and determining that the continued provision of service 
525.29  by the licensee would create an imminent risk to public health 
525.30  or harm to others. 
525.31     (b) A temporary suspension order prohibiting a licensee 
525.32  from providing ambulance service shall give notice of the right 
525.33  to a preliminary hearing according to paragraph (d) and shall 
525.34  state the reasons for the entry of the temporary suspension 
525.35  order. 
525.36     (c) Service of a temporary suspension order is effective 
526.1   when the order is served on the licensee personally or by 
526.2   certified mail, which is complete upon receipt, refusal, or 
526.3   return for nondelivery to the most recent address provided to 
526.4   the board for the licensee. 
526.5      (d) At the time the board issues a temporary suspension 
526.6   order, the board shall schedule a hearing, to be held before a 
526.7   group of its members designated by the board, that shall begin 
526.8   within 60 days after issuance of the temporary suspension order 
526.9   or within 15 working days of the date of the board's receipt of 
526.10  a request for a hearing from a licensee, whichever is sooner.  
526.11  The hearing shall be on the sole issue of whether there is a 
526.12  reasonable basis to continue, modify, or lift the temporary 
526.13  suspension.  A hearing under this paragraph is not subject to 
526.14  chapter 14.  
526.15     (e) Evidence presented by the board or licensee may be in 
526.16  the form of an affidavit.  The licensee or the licensee's 
526.17  designee may appear for oral argument. 
526.18     (f) Within five working days of the hearing, the board 
526.19  shall issue its order and, if the suspension is continued, 
526.20  notify the licensee of the right to a contested case hearing 
526.21  under chapter 14.  
526.22     (g) If a licensee requests a contested case hearing within 
526.23  30 days after receiving notice under paragraph (f), the board 
526.24  shall initiate a contested case hearing according to chapter 14. 
526.25  The administrative law judge shall issue a report and 
526.26  recommendation within 30 days after the closing of the contested 
526.27  case hearing record.  The board shall issue a final order within 
526.28  30 days after receipt of the administrative law judge's report. 
526.29     Sec. 35.  [144E.265] [MEDICAL DIRECTOR.] 
526.30     Subdivision 1.  [REQUIREMENTS.] A medical director shall: 
526.31     (1) be currently licensed as a physician in this state; 
526.32     (2) have experience in, and knowledge of, emergency care of 
526.33  acutely ill or traumatized patients; and 
526.34     (3) be familiar with the design and operation of local, 
526.35  regional, and state emergency medical service systems. 
526.36     Subd. 2.  [RESPONSIBILITIES.] Responsibilities of the 
527.1   medical director shall include, but are not limited to: 
527.2      (1) approving standards for training and orientation of 
527.3   personnel that impact patient care; 
527.4      (2) approving standards for purchasing equipment and 
527.5   supplies that impact patient care; 
527.6      (3) establishing standing orders for prehospital care; 
527.7      (4) approving triage, treatment, and transportation 
527.8   protocols; 
527.9      (5) participating in the development and operation of 
527.10  continuous quality improvement programs including, but not 
527.11  limited to, case review and resolution of patient complaints; 
527.12     (6) establishing procedures for the administration of 
527.13  drugs; and 
527.14     (7) maintaining the quality of care according to the 
527.15  standards and procedures established under clauses (1) to (6). 
527.16     Subd. 3.  [ANNUAL ASSESSMENT; AMBULANCE SERVICE.] Annually, 
527.17  the medical director or the medical director's designee shall 
527.18  assess the practical skills of each person on the ambulance 
527.19  service roster and sign a statement verifying the proficiency of 
527.20  each person.  The statements shall be maintained in the 
527.21  licensee's files.  
527.22     Sec. 36.  Minnesota Statutes 1998, section 144E.27, is 
527.23  amended by adding a subdivision to read: 
527.24     Subd. 5.  [DENIAL, SUSPENSION, REVOCATION.] (a) The board 
527.25  may deny, suspend, revoke, place conditions on, or refuse to 
527.26  renew the registration of an individual who the board determines:
527.27     (1) violates sections 144E.001 to 144E.33 or the rules 
527.28  adopted under those sections; 
527.29     (2) misrepresents or falsifies information on an 
527.30  application form for registration; 
527.31     (3) is convicted or pleads guilty or nolo contendere to any 
527.32  felony; any gross misdemeanor relating to assault, sexual 
527.33  misconduct, or the illegal use of drugs or alcohol; or any 
527.34  misdemeanor relating to sexual misconduct or the illegal use of 
527.35  drugs or alcohol; 
527.36     (4) is actually or potentially unable to provide emergency 
528.1   medical services with reasonable skill and safety to patients by 
528.2   reason of illness, use of alcohol, drugs, chemicals, or any 
528.3   other material, or as a result of any mental or physical 
528.4   condition; 
528.5      (5) engages in unethical conduct, including, but not 
528.6   limited to, conduct likely to deceive, defraud, or harm the 
528.7   public, or demonstrating a willful or careless disregard for the 
528.8   health, welfare, or safety of the public; or 
528.9      (6) maltreats or abandons a patient. 
528.10     (b) Before taking action under paragraph (a), the board 
528.11  shall give notice to an individual of the right to a contested 
528.12  case hearing under chapter 14.  If an individual requests a 
528.13  contested case hearing within 30 days after receiving notice, 
528.14  the board shall initiate a contested case hearing according to 
528.15  chapter 14. 
528.16     (c) The administrative law judge shall issue a report and 
528.17  recommendation within 30 days after closing the contested case 
528.18  hearing record.  The board shall issue a final order within 30 
528.19  days after receipt of the administrative law judge's report. 
528.20     (d) After six months from the board's decision to deny, 
528.21  revoke, place conditions on, or refuse renewal of an 
528.22  individual's registration for disciplinary action, the 
528.23  individual shall have the opportunity to apply to the board for 
528.24  reinstatement. 
528.25     Sec. 37.  Minnesota Statutes 1998, section 144E.27, is 
528.26  amended by adding a subdivision to read: 
528.27     Subd. 6.  [TEMPORARY SUSPENSION.] (a) In addition to any 
528.28  other remedy provided by law, the board may temporarily suspend 
528.29  the registration of an individual after conducting a preliminary 
528.30  inquiry to determine whether the board believes that the 
528.31  individual has violated a statute or rule that the board is 
528.32  empowered to enforce and determining that the continued 
528.33  provision of service by the individual would create an imminent 
528.34  risk to public health or harm to others.  
528.35     (b) A temporary suspension order prohibiting an individual 
528.36  from providing emergency medical care shall give notice of the 
529.1   right to a preliminary hearing according to paragraph (d) and 
529.2   shall state the reasons for the entry of the temporary 
529.3   suspension order. 
529.4      (c) Service of a temporary suspension order is effective 
529.5   when the order is served on the individual personally or by 
529.6   certified mail, which is complete upon receipt, refusal, or 
529.7   return for nondelivery to the most recent address provided to 
529.8   the board for the individual. 
529.9      (d) At the time the board issues a temporary suspension 
529.10  order, the board shall schedule a hearing, to be held before a 
529.11  group of its members designated by the board, that shall begin 
529.12  within 60 days after issuance of the temporary suspension order 
529.13  or within 15 working days of the date of the board's receipt of 
529.14  a request for a hearing from the individual, whichever is 
529.15  sooner.  The hearing shall be on the sole issue of whether there 
529.16  is a reasonable basis to continue, modify, or lift the temporary 
529.17  suspension.  A hearing under this paragraph is not subject to 
529.18  chapter 14. 
529.19     (e) Evidence presented by the board or the individual may 
529.20  be in the form of an affidavit.  The individual or the 
529.21  individual's designee may appear for oral argument. 
529.22     (f) Within five working days of the hearing, the board 
529.23  shall issue its order and, if the suspension is continued, 
529.24  notify the individual of the right to a contested case hearing 
529.25  under chapter 14. 
529.26     (g) If an individual requests a contested case hearing 
529.27  within 30 days after receiving notice under paragraph (f), the 
529.28  board shall initiate a contested case hearing according to 
529.29  chapter 14.  The administrative law judge shall issue a report 
529.30  and recommendation within 30 days after the closing of the 
529.31  contested case hearing record.  The board shall issue a final 
529.32  order within 30 days after receipt of the administrative law 
529.33  judge's report.  
529.34     Sec. 38.  [144E.28] [CERTIFICATION OF EMT, EMT-I, AND 
529.35  EMT-P.] 
529.36     Subdivision 1.  [REQUIREMENTS.] To be eligible for 
530.1   certification by the board as an EMT, EMT-I, or EMT-P, an 
530.2   individual shall: 
530.3      (1) successfully complete the United States Department of 
530.4   Transportation course, or its equivalent as approved by the 
530.5   board, specific to the EMT, EMT-I, or EMT-P classification; 
530.6      (2) pass the written and practical examinations approved by 
530.7   the board and administered by the board or its designee, 
530.8   specific to the EMT, EMT-I, or EMT-P classification; and 
530.9      (3) submit the appropriate fee as required under section 
530.10  144E.29. 
530.11     Subd. 2.  [EXPIRATION DATES.] Certification expiration 
530.12  dates are as follows: 
530.13     (1) for initial certification granted between January 1 and 
530.14  June 30 of an even-numbered year, the expiration date is March 
530.15  31 of the next even-numbered year; 
530.16     (2) for initial certification granted between July 1 and 
530.17  December 31 of an even-numbered year, the expiration date is 
530.18  March 31 of the second odd-numbered year; 
530.19     (3) for initial certification granted between January 1 and 
530.20  June 30 of an odd-numbered year, the expiration date is March 31 
530.21  of the next odd-numbered year; and 
530.22     (4) for initial certification granted between July 1 and 
530.23  December 31 of an odd-numbered year, the expiration date is 
530.24  March 31 of the second even-numbered year. 
530.25     Subd. 3.  [RECIPROCITY.] The board may certify an 
530.26  individual who possesses a current National Registry of 
530.27  Emergency Medical Technicians registration from another 
530.28  jurisdiction and submits the appropriate fee as required under 
530.29  section 144E.29.  The board certification classification shall 
530.30  be the same as the National Registry's classification.  
530.31  Certification shall be for the duration of the applicant's 
530.32  registration period in another jurisdiction, not to exceed two 
530.33  years. 
530.34     Subd. 4.  [FORMS OF DISCIPLINARY ACTION.] When the board 
530.35  finds that a person certified under this section has violated a 
530.36  provision or provisions of subdivision 5, it may do one or more 
531.1   of the following:  
531.2      (1) revoke the certification; 
531.3      (2) suspend the certification; 
531.4      (3) refuse to renew the certification; 
531.5      (4) impose limitations or conditions on the person's 
531.6   performance of regulated duties, including the imposition of 
531.7   retraining or rehabilitation requirements; the requirement to 
531.8   work under supervision; or the conditioning of continued 
531.9   practice on demonstration of knowledge or skills by appropriate 
531.10  examination or other review of skill and competence; 
531.11     (5) order the person to provide unremunerated professional 
531.12  service under supervision at a designated public hospital, 
531.13  clinic, or other health care institution; or 
531.14     (6) censure or reprimand the person. 
531.15     Subd. 5.  [DENIAL, SUSPENSION, REVOCATION.] (a) The board 
531.16  may take any action authorized in subdivision 4 against an 
531.17  individual who the board determines: 
531.18     (1) violates sections 144E.001 to 144E.33 or the rules 
531.19  adopted under those sections; 
531.20     (2) misrepresents or falsifies information on an 
531.21  application form for certification; 
531.22     (3) is convicted or pleads guilty or nolo contendere to any 
531.23  felony; any gross misdemeanor relating to assault, sexual 
531.24  misconduct, or the illegal use of drugs or alcohol; or any 
531.25  misdemeanor relating to sexual misconduct or the illegal use of 
531.26  drugs or alcohol; 
531.27     (4) is actually or potentially unable to provide emergency 
531.28  medical services with reasonable skill and safety to patients by 
531.29  reason of illness, use of alcohol, drugs, chemicals, or any 
531.30  other material, or as a result of any mental or physical 
531.31  condition; 
531.32     (5) engages in unethical conduct, including, but not 
531.33  limited to, conduct likely to deceive, defraud, or harm the 
531.34  public or demonstrating a willful or careless disregard for the 
531.35  health, welfare, or safety of the public; or 
531.36     (6) maltreats or abandons a patient. 
532.1      (b) Before taking action under paragraph (a), the board 
532.2   shall give notice to an individual of the right to a contested 
532.3   case hearing under chapter 14.  If an individual requests a 
532.4   contested case hearing within 30 days after receiving notice, 
532.5   the board shall initiate a contested case hearing according to 
532.6   chapter 14 and no disciplinary action shall be taken at that 
532.7   time. 
532.8      (c) The administrative law judge shall issue a report and 
532.9   recommendation within 30 days after closing the contested case 
532.10  hearing record.  The board shall issue a final order within 30 
532.11  days after receipt of the administrative law judge's report. 
532.12     (d) After six months from the board's decision to deny, 
532.13  revoke, place conditions on, or refuse renewal of an 
532.14  individual's certification for disciplinary action, the 
532.15  individual shall have the opportunity to apply to the board for 
532.16  reinstatement. 
532.17     Subd. 6.  [TEMPORARY SUSPENSION.] (a) In addition to any 
532.18  other remedy provided by law, the board may temporarily suspend 
532.19  the certification of an individual after conducting a 
532.20  preliminary inquiry to determine whether the board believes that 
532.21  the individual has violated a statute or rule that the board is 
532.22  empowered to enforce and determining that the continued 
532.23  provision of service by the individual would create an imminent 
532.24  risk to public health or harm to others.  
532.25     (b) A temporary suspension order prohibiting an individual 
532.26  from providing emergency medical care shall give notice of the 
532.27  right to a preliminary hearing according to paragraph (d) and 
532.28  shall state the reasons for the entry of the temporary 
532.29  suspension order. 
532.30     (c) Service of a temporary suspension order is effective 
532.31  when the order is served on the individual personally or by 
532.32  certified mail, which is complete upon receipt, refusal, or 
532.33  return for nondelivery to the most recent address provided to 
532.34  the board for the individual. 
532.35     (d) At the time the board issues a temporary suspension 
532.36  order, the board shall schedule a hearing, to be held before a 
533.1   group of its members designated by the board, that shall begin 
533.2   within 60 days after issuance of the temporary suspension order 
533.3   or within 15 working days of the date of the board's receipt of 
533.4   a request for a hearing from the individual, whichever is 
533.5   sooner.  The hearing shall be on the sole issue of whether there 
533.6   is a reasonable basis to continue, modify, or lift the temporary 
533.7   suspension.  A hearing under this paragraph is not subject to 
533.8   chapter 14. 
533.9      (e) Evidence presented by the board or the individual may 
533.10  be in the form of an affidavit.  The individual or individual's 
533.11  designee may appear for oral argument. 
533.12     (f) Within five working days of the hearing, the board 
533.13  shall issue its order and, if the suspension is continued, 
533.14  notify the individual of the right to a contested case hearing 
533.15  under chapter 14. 
533.16     (g) If an individual requests a contested case hearing 
533.17  within 30 days of receiving notice under paragraph (f), the 
533.18  board shall initiate a contested case hearing according to 
533.19  chapter 14.  The administrative law judge shall issue a report 
533.20  and recommendation within 30 days after the closing of the 
533.21  contested case hearing record.  The board shall issue a final 
533.22  order within 30 days after receipt of the administrative law 
533.23  judge's report.  
533.24     Subd. 7.  [RENEWAL.] (a) Before the expiration date of 
533.25  certification, an applicant for renewal of certification as an 
533.26  EMT shall:  
533.27     (1) successfully complete a course in cardiopulmonary 
533.28  resuscitation that is approved by the board or the licensee's 
533.29  medical director; 
533.30     (2) take the United States Department of Transportation EMT 
533.31  refresher course and successfully pass the practical skills test 
533.32  portion of the course, or successfully complete 48 hours of 
533.33  continuing education in EMT programs that are consistent with 
533.34  the United States Department of Transportation National Standard 
533.35  Curriculum or its equivalent as approved by the board or as 
533.36  approved by the licensee's medical director and pass a practical 
534.1   skills test approved by the board and administered by a training 
534.2   program approved by the board.  Twenty-four of the 48 hours must 
534.3   include at least four hours of instruction in each of the 
534.4   following six categories: 
534.5      (i) airway management and resuscitation procedures; 
534.6      (ii) circulation, bleeding control, and shock; 
534.7      (iii) human anatomy and physiology, patient assessment, and 
534.8   medical emergencies; 
534.9      (iv) injuries involving musculoskeletal, nervous, 
534.10  digestive, and genito-urinary systems; 
534.11     (v) environmental emergencies and rescue techniques; and 
534.12     (vi) emergency childbirth and other special situations; and 
534.13     (3) submit the appropriate fee as required under section 
534.14  144E.29.  
534.15     (b) Before the expiration date of certification, an 
534.16  applicant for renewal of certification as an EMT-I or EMT-P 
534.17  shall:  
534.18     (1) for an EMT-I, successfully complete a course in 
534.19  cardiopulmonary resuscitation that is approved by the board or 
534.20  the licensee's medical director and for an EMT-P, successfully 
534.21  complete a course in advanced cardiac life support that is 
534.22  approved by the board or the licensee's medical director; 
534.23     (2) successfully complete 48 hours of continuing education 
534.24  in emergency medical training programs, appropriate to the level 
534.25  of the applicant's EMT-I or EMT-P certification, that are 
534.26  consistent with the United States Department of Transportation 
534.27  National Standard Curriculum or its equivalent as approved by 
534.28  the board or as approved by the licensee's medical director.  An 
534.29  applicant may take the United States Department of 
534.30  Transportation Emergency Medical Technician refresher course or 
534.31  its equivalent without the written or practical test as approved 
534.32  by the board, and as appropriate to the applicant's level of 
534.33  certification, as part of the 48 hours of continuing education.  
534.34  Each hour of the refresher course counts toward the 48-hour 
534.35  continuing education requirement; and 
534.36     (3) submit the appropriate fee required under section 
535.1   144E.29.  
535.2      (c) Certification shall be renewed every two years. 
535.3      (d) If the applicant does not meet the renewal requirements 
535.4   under this subdivision, the applicant's certification expires. 
535.5      Subd. 8.  [REINSTATEMENT.] (a) Within four years of a 
535.6   certification expiration date, a person whose certification has 
535.7   expired under subdivision 7, paragraph (d), may have the 
535.8   certification reinstated upon submission of evidence to the 
535.9   board of training equivalent to the continuing education 
535.10  requirements of subdivision 7 and upon payment of the 
535.11  certification fee. 
535.12     (b) If more than four years have passed since a certificate 
535.13  expiration date, an applicant must complete the initial 
535.14  certification process required under subdivision 1. 
535.15     Sec. 39.  [144E.283] [EMT INSTRUCTOR CERTIFICATION.] 
535.16     Subdivision 1.  [QUALIFICATIONS.] The board shall grant 
535.17  certification as an emergency medical technician instructor to 
535.18  an applicant who files a completed application and furnishes 
535.19  evidence satisfactory to the board that the applicant:  
535.20     (1) possesses valid certification, registration, or 
535.21  licensure as an EMT, EMT-I, EMT-P, physician, physician's 
535.22  assistant, or registered nurse; 
535.23     (2) has two years of active emergency medical practical 
535.24  experience; 
535.25     (3) is recommended by a medical director of a licensed 
535.26  hospital, ambulance service, or training program approved by the 
535.27  board; 
535.28     (4) successfully completes the United States Department of 
535.29  Transportation Emergency Medical Services Instructor Training 
535.30  Program or its equivalent as approved by the board; and 
535.31     (5) submits the appropriate fee as required under section 
535.32  144E.29. 
535.33     Subd. 2.  [EXPIRATION.] Certification expires two years 
535.34  from the date of the initial certification and must be renewed 
535.35  every two years. 
535.36     Subd. 3.  [RENEWAL.] (a) An applicant shall submit an 
536.1   application to the board for renewal at least three months prior 
536.2   to the expiration date of the certification and must furnish 
536.3   evidence satisfactory to the board that the applicant: 
536.4      (1) complies with the requirements of subdivision 1; 
536.5      (2) has at least 40 hours of experience as an instructor in 
536.6   an emergency medical technician course approved by the board 
536.7   under section 144E.285; and 
536.8      (3) has attended at least eight hours of continuing 
536.9   education encompassing the course topics of the United States 
536.10  Department of Transportation National Standard Curriculum for an 
536.11  Emergency Medical Services Instructor Training Program or its 
536.12  equivalent as approved by the board. 
536.13     (b) An emergency medical technician instructor whose 
536.14  certification expires for nonrenewal must obtain a new 
536.15  certification by applying to the board and meeting the 
536.16  requirements of subdivision 1. 
536.17     Sec. 40.  [144E.285] [TRAINING PROGRAMS.] 
536.18     Subdivision 1.  [APPROVAL REQUIRED.] (a) All training 
536.19  programs for an EMT, EMT-I, or EMT-P must be approved by the 
536.20  board. 
536.21     (b) To be approved by the board, a training program must: 
536.22     (1) submit an application prescribed by the board that 
536.23  includes: 
536.24     (i) type and length of course to be offered; 
536.25     (ii) names, addresses, and qualifications of the program 
536.26  medical director, program training coordinator, and certified 
536.27  instructors; 
536.28     (iii) names and addresses of clinical sites, including a 
536.29  contact person and telephone number; 
536.30     (iv) admission criteria for students; and 
536.31     (v) materials and equipment to be used; 
536.32     (2) for each course, implement the most current version of 
536.33  the United States Department of Transportation curriculum or its 
536.34  equivalent as determined by the board applicable to EMT, EMT-I, 
536.35  or EMT-P training; 
536.36     (3) have a program medical director and a program 
537.1   coordinator; 
537.2      (4) utilize instructors certified under section 144E.283 
537.3   for teaching at least 50 percent of the course content.  The 
537.4   remaining 50 percent of the course may be taught by guest 
537.5   lecturers approved by the training program coordinator or 
537.6   medical director; 
537.7      (5) have at least one instructor for every ten students at 
537.8   the practical skill stations; 
537.9      (6) maintain a written agreement with a licensed hospital 
537.10  or licensed ambulance service designating a clinical training 
537.11  site; 
537.12     (7) retain documentation of program approval by the board, 
537.13  course outline, and student information; 
537.14     (8) notify the board of the starting date of a course prior 
537.15  to the beginning of a course; and 
537.16     (9) submit the appropriate fee as required under section 
537.17  144E.29.  
537.18     Subd. 2.  [EMT-P REQUIREMENTS.] (a) In addition to the 
537.19  requirements under subdivision 1, paragraph (b), a training 
537.20  program applying for approval to teach EMT-P curriculum must be 
537.21  administered by an educational institution accredited by the 
537.22  Commission of Accreditation of Allied Health Education Programs 
537.23  (CAAHEP). 
537.24     (b) An EMT-P training program that is administered by an 
537.25  educational institution not accredited by CAAHEP, but that is in 
537.26  the process of completing the accreditation process, may be 
537.27  granted provisional approval by the board upon verification of 
537.28  submission of its self-study report and the appropriate review 
537.29  fee to CAAHEP. 
537.30     (c) An educational institution that discontinues its 
537.31  participation in the accreditation process must notify the board 
537.32  immediately and provisional approval shall be withdrawn. 
537.33     Subd. 3.  [EXPIRATION.] Training program approval shall 
537.34  expire two years from the date of approval. 
537.35     Subd. 4.  [REAPPROVAL.] A training program shall apply to 
537.36  the board for reapproval at least three months prior to the 
538.1   expiration date of its approval and must: 
538.2      (1) submit an application prescribed by the board 
538.3   specifying any changes from the information provided for prior 
538.4   approval and any other information requested by the board to 
538.5   clarify incomplete or ambiguous information presented in the 
538.6   application; and 
538.7      (2) comply with the requirements under subdivision 1, 
538.8   paragraph (b), clauses (2) to (8). 
538.9      Subd. 5.  [DISCIPLINARY ACTION.] (a) The board may deny, 
538.10  suspend, revoke, place conditions on, or refuse to renew 
538.11  approval of a training program that the board determines: 
538.12     (1) violated subdivisions 1 to 4 or rules adopted under 
538.13  sections 144E.001 to 144E.33; or 
538.14     (2) misrepresented or falsified information on an 
538.15  application form provided by the board. 
538.16     (b) Before taking action under paragraph (a), the board 
538.17  shall give notice to a training program of the right to a 
538.18  contested case hearing under chapter 14.  If a training program 
538.19  requests a contested case hearing within 30 days after receiving 
538.20  notice, the board shall initiate a contested case hearing 
538.21  according to chapter 14. 
538.22     (c) The administrative law judge shall issue a report and 
538.23  recommendation within 30 days after closing the contested case 
538.24  hearing record.  The board shall issue a final order within 30 
538.25  days after receipt of the administrative law judge's report. 
538.26     (d) After six months from the board's decision to deny, 
538.27  revoke, place conditions on, or refuse approval of a training 
538.28  program for disciplinary action, the training program shall have 
538.29  the opportunity to apply to the board for reapproval.  
538.30     Subd. 6.  [TEMPORARY SUSPENSION.] (a) In addition to any 
538.31  other remedy provided by law, the board may temporarily suspend 
538.32  approval of the training program after conducting a preliminary 
538.33  inquiry to determine whether the board believes that the 
538.34  training program has violated a statute or rule that the board 
538.35  is empowered to enforce and determining that the continued 
538.36  provision of service by the training program would create an 
539.1   imminent risk to public health or harm to others. 
539.2      (b) A temporary suspension order prohibiting the training 
539.3   program from providing emergency medical care training shall 
539.4   give notice of the right to a preliminary hearing according to 
539.5   paragraph (d) and shall state the reasons for the entry of the 
539.6   temporary suspension order. 
539.7      (c) Service of a temporary suspension order is effective 
539.8   when the order is served on the training program personally or 
539.9   by certified mail, which is complete upon receipt, refusal, or 
539.10  return for nondelivery to the most recent address provided to 
539.11  the board for the training program. 
539.12     (d) At the time the board issues a temporary suspension 
539.13  order, the board shall schedule a hearing, to be held before a 
539.14  group of its members designated by the board, that shall begin 
539.15  within 60 days after issuance of the temporary suspension order 
539.16  or within 15 working days of the date of the board's receipt of 
539.17  a request for a hearing from the training program, whichever is 
539.18  sooner.  The hearing shall be on the sole issue of whether there 
539.19  is a reasonable basis to continue, modify, or lift the temporary 
539.20  suspension.  A hearing under this paragraph is not subject to 
539.21  chapter 14. 
539.22     (e) Evidence presented by the board or the individual may 
539.23  be in the form of an affidavit.  The training program or counsel 
539.24  of record may appear for oral argument. 
539.25     (f) Within five working days of the hearing, the board 
539.26  shall issue its order and, if the suspension is continued, 
539.27  notify the training program of the right to a contested case 
539.28  hearing under chapter 14. 
539.29     (g) If a training program requests a contested case hearing 
539.30  within 30 days of receiving notice under paragraph (f), the 
539.31  board shall initiate a contested case hearing according to 
539.32  chapter 14.  The administrative law judge shall issue a report 
539.33  and recommendation within 30 days after the closing of the 
539.34  contested case hearing record.  The board shall issue a final 
539.35  order within 30 days after receipt of the administrative law 
539.36  judge's report. 
540.1      Subd. 7.  [AUDIT.] The board may audit training programs 
540.2   approved by the board.  The audit may include, but is not 
540.3   limited to, investigation of complaints, course inspection, 
540.4   classroom observation, review of instructor qualifications, and 
540.5   student interviews. 
540.6      Sec. 41.  [144E.286] [EXAMINER QUALIFICATIONS FOR EMERGENCY 
540.7   MEDICAL TECHNICIAN TESTING.] 
540.8      Subdivision 1.  [EMT TESTING.] An examiner testing basic 
540.9   level EMT practical skills must: 
540.10     (1) be certified as an EMT, EMT-I, or EMT-P; 
540.11     (2) have two years or 4,000 hours' experience in emergency 
540.12  medical care; 
540.13     (3) be certified in basic cardiac life support; and 
540.14     (4) be approved by the board. 
540.15     Subd. 2.  [EMT-I OR EMT-P TESTING.] (a) An examiner testing 
540.16  EMT-I or EMT-P level practical skills must be approved by the 
540.17  board and: 
540.18     (1) be a physician or registered nurse; or 
540.19     (2) be a certified EMT-P, have two years or 4,000 hours' 
540.20  experience in emergency medical care and be certified in basic 
540.21  cardiac life support. 
540.22     (b) A physician must be available to answer questions 
540.23  relating to the evaluation of skill performance at the practical 
540.24  examination. 
540.25     Sec. 42.  [144E.29] [FEES.] 
540.26     (a) The board shall charge the following fees: 
540.27     (1) initial application for and renewal of an ambulance 
540.28  service license, $150; 
540.29     (2) each ambulance operated by a licensee, $96.  The 
540.30  licensee shall pay an additional $96 fee for the full licensing 
540.31  period or $8 per month for any fraction of the period for each 
540.32  ambulance added to the ambulance service during the licensing 
540.33  period; 
540.34     (3) initial application for and renewal of certification as 
540.35  an EMT instructor, $10; 
540.36     (4) initial application for and renewal of approval for a 
541.1   training program, $100; and 
541.2      (5) duplicate of an original license, certification, or 
541.3   approval, $25.  
541.4      (b) With the exception of paragraph (a), clause (5), all 
541.5   fees are for a two-year period.  All fees are nonrefundable.  
541.6      (c) Fees collected by the board shall be deposited as 
541.7   nondedicated receipts in the trunk highway fund. 
541.8      Sec. 43.  [144E.305] [REPORTING MISCONDUCT.] 
541.9      Subdivision 1.  [VOLUNTARY REPORTING.] A person who has 
541.10  knowledge of any conduct constituting grounds for discipline 
541.11  under section 144E.27, subdivision 5, or 144E.28, subdivision 4, 
541.12  may report the alleged violation to the board. 
541.13     Subd. 2.  [MANDATORY REPORTING.] (a) A licensee shall 
541.14  report to the board conduct by a first responder, EMT, EMT-I, or 
541.15  EMT-P that they reasonably believe constitutes grounds for 
541.16  disciplinary action under section 144E.27, subdivision 5, or 
541.17  144E.28, subdivision 4.  
541.18     (b) A licensee shall report to the board any dismissal from 
541.19  employment of a first responder, EMT, EMT-I, or EMT-P.  A 
541.20  licensee shall report the resignation of a first responder, EMT, 
541.21  EMT-I, or EMT-P before the conclusion of any disciplinary 
541.22  proceeding or before commencement of formal charges but after 
541.23  the first responder, EMT, EMT-I, or EMT-P has knowledge that 
541.24  formal charges are contemplated or in preparation. 
541.25     Subd. 3.  [IMMUNITY.] (a) An individual, licensee, health 
541.26  care facility, business, or organization is immune from civil 
541.27  liability or criminal prosecution for submitting in good faith a 
541.28  report to the board under subdivision 1 or 2 or for otherwise 
541.29  reporting in good faith to the board violations or alleged 
541.30  violations of sections 144E.001 to 144E.33.  Reports are 
541.31  classified as confidential data on individuals or protected 
541.32  nonpublic data under section 13.02 while an investigation is 
541.33  active.  Except for the board's final determination, all 
541.34  communications or information received by or disclosed to the 
541.35  board relating to disciplinary matters of any person or entity 
541.36  subject to the board's regulatory jurisdiction are confidential 
542.1   and privileged and any disciplinary hearing shall be closed to 
542.2   the public. 
542.3      (b) Members of the board, persons employed by the board, 
542.4   persons engaged in the investigation of violations and in the 
542.5   preparation and management of charges of violations of sections 
542.6   144E.001 to 144E.33 on behalf of the board, and persons 
542.7   participating in the investigation regarding charges of 
542.8   violations are immune from civil liability and criminal 
542.9   prosecution for any actions, transactions, or publications, made 
542.10  in good faith, in the execution of, or relating to, their duties 
542.11  under sections 144E.001 to 144E.33. 
542.12     (c) For purposes of this section, a member of the board is 
542.13  considered a state employee under section 3.736, subdivision 9.  
542.14     Sec. 44.  [144E.31] [CORRECTION ORDER AND FINES.] 
542.15     Subdivision 1.  [CORRECTION ORDER.] (a) If the board finds 
542.16  that a licensee or training program has failed to comply with an 
542.17  applicable law or rule and the violation does not imminently 
542.18  endanger the public's health or safety, the board may issue a 
542.19  correction order to the licensee or training program. 
542.20     (b) The correction order shall state: 
542.21     (1) the conditions that constitute a violation of the law 
542.22  or rule; 
542.23     (2) the specific law or rule violated; and 
542.24     (3) the time allowed to correct the violation. 
542.25     Subd. 2.  [RECONSIDERATION.] (a) If the licensee or 
542.26  training program believes that the contents of the board's 
542.27  correction order are in error, the licensee or training program 
542.28  may ask the board to reconsider the parts of the correction 
542.29  order that are alleged to be in error. 
542.30     (b) The request for reconsideration must: 
542.31     (1) be in writing; 
542.32     (2) be delivered by certified mail; 
542.33     (3) specify the parts of the correction order that are 
542.34  alleged to be in error; 
542.35     (4) explain why they are in error; and 
542.36     (5) include documentation to support the allegation of 
543.1   error. 
543.2      (c) A request for reconsideration does not stay any 
543.3   provision or requirement of the correction order.  The board's 
543.4   disposition of a request for reconsideration is final and not 
543.5   subject to appeal under chapter 14. 
543.6      Subd. 3.  [FINE.] (a) The board may order a fine 
543.7   concurrently with the issuance of a correction order, or after 
543.8   the licensee or training program has not corrected the violation 
543.9   within the time specified in the correction order. 
543.10     (b) A licensee or training program that is ordered to pay a 
543.11  fine shall be notified of the order by certified mail.  The 
543.12  notice shall be mailed to the address shown on the application 
543.13  or the last known address of the licensee or training program.  
543.14  The notice shall state the reasons the fine was ordered and 
543.15  shall inform the licensee or training program of the right to a 
543.16  contested case hearing under chapter 14.  
543.17     (c) A licensee or training program may appeal the order to 
543.18  pay a fine by notifying the board by certified mail within 15 
543.19  calendar days after receiving the order.  A timely appeal shall 
543.20  stay payment of the fine until the board issues a final order. 
543.21     (d) A licensee or training program shall pay the fine 
543.22  assessed on or before the payment date specified in the board's 
543.23  order.  If a licensee or training program fails to fully comply 
543.24  with the order, the board shall suspend the license or cancel 
543.25  approval until there is full compliance with the order. 
543.26     (e) Fines shall be assessed as follows: 
543.27     (1) $150 for violation of section 144E.123; 
543.28     (2) $400 for violation of sections 144E.06, 144E.07, 
543.29  144E.101, 144E.103, 144E.121, 144E.125, 144E.265, 144E.285, and 
543.30  144E.305; 
543.31     (3) $750 for violation of rules adopted under section 
543.32  144E.16, subdivision 4, clause (8); and 
543.33     (4) $50 for violation of all other sections under this 
543.34  chapter or rules adopted under this chapter that are not 
543.35  specifically enumerated in clauses (1) to (3). 
543.36     (f) Fines collected by the board shall be deposited as 
544.1   nondedicated receipts in the trunk highway fund. 
544.2      Subd. 4.  [ADDITIONAL PENALTIES.] This section does not 
544.3   prohibit the board from suspending, revoking, placing conditions 
544.4   on, or refusing to renew a licensee's license or a training 
544.5   program's approval in addition to ordering a fine. 
544.6      Sec. 45.  [144E.33] [PENALTY.] 
544.7      A person who violates a provision of sections 144E.001 to 
544.8   144E.33 is guilty of a misdemeanor.  
544.9      Sec. 46.  Minnesota Statutes 1998, section 144E.50, is 
544.10  amended by adding a subdivision to read: 
544.11     Subd. 6.  [AUDITS.] (a) Each regional emergency medical 
544.12  services board designated by the emergency medical services 
544.13  regulatory board shall be audited biennially by an independent 
544.14  auditor who is either a state or local government auditor or a 
544.15  certified public accountant who meets the independence standards 
544.16  specified by the General Accounting Office for audits of 
544.17  governmental organizations, programs, activities, and 
544.18  functions.  The audit shall cover all funds received by the 
544.19  regional board, including but not limited to, funds appropriated 
544.20  under this section, section 144E.52, and section 169.686, 
544.21  subdivision 3.  Expenses associated with the audit are the 
544.22  responsibility of the regional board. 
544.23     (b) The audit specified in paragraph (a) shall be performed 
544.24  within 60 days following the close of the biennium.  Copies of 
544.25  the audit and any accompanying materials shall be filed by 
544.26  October 1 of each odd-numbered year, beginning in 1999, with the 
544.27  emergency medical services regulatory board, the legislative 
544.28  auditor, and the state auditor. 
544.29     (c) If the audit is not conducted as required in paragraph 
544.30  (a) or copies filed as required in paragraph (b), or if the 
544.31  audit determines that funds were not spent in accordance with 
544.32  this chapter, the emergency medical services regulatory board 
544.33  shall immediately reduce funding to the regional emergency 
544.34  medical services board as follows: 
544.35     (1) if an audit was not conducted or if an audit was 
544.36  conducted but copies were not provided as required, funding 
545.1   shall be reduced by 100 percent; and 
545.2      (2) if an audit was conducted and copies provided, and the 
545.3   audit identifies expenditures made that are not in compliance 
545.4   with this chapter, funding shall be reduced by the amount in 
545.5   question plus ten percent.  
545.6   A funding reduction under this paragraph is effective for the 
545.7   fiscal year in which the reduction is taken and the following 
545.8   fiscal year. 
545.9      (d) The emergency medical services regulatory board shall 
545.10  distribute any funds withheld from a regional board under 
545.11  paragraph (c) to the remaining regional boards on a pro rata 
545.12  basis.  
545.13     Sec. 47.  Minnesota Statutes 1998, section 145A.02, 
545.14  subdivision 10, is amended to read: 
545.15     Subd. 10.  [EMERGENCY MEDICAL CARE.] "Emergency medical 
545.16  care" means activities intended to protect the health of persons 
545.17  suffering a medical emergency and to ensure rapid and effective 
545.18  emergency medical treatment.  These activities include the 
545.19  coordination or provision of training, cooperation with public 
545.20  safety agencies, communications, life-support transportation as 
545.21  defined under section 144E.16 sections 144E.06 to 144E.19, 
545.22  public information and involvement, and system management. 
545.23     Sec. 48.  Minnesota Statutes 1998, section 148.66, is 
545.24  amended to read: 
545.25     148.66 [STATE BOARD OF MEDICAL PRACTICE PHYSICAL THERAPY, 
545.26  DUTIES.] 
545.27     The state board of medical practice, as now or hereafter 
545.28  constituted, hereinafter termed "the board," in the manner 
545.29  hereinafter provided, physical therapy established under section 
545.30  148.67 shall administer the provisions of this law sections 
545.31  148.65 to 148.78.  As used in sections 148.65 to 148.78, "board" 
545.32  means the state board of physical therapy.  
545.33     The board shall: 
545.34     (1) adopt rules necessary to administer and enforce 
545.35  sections 148.65 to 148.78; 
545.36     (2) administer, coordinate, and enforce sections 148.65 to 
546.1   148.78; 
546.2      (3) evaluate the qualifications of applicants; 
546.3      (4) issue subpoenas, examine witnesses, and administer 
546.4   oaths; 
546.5      (5) conduct hearings and keep records and minutes necessary 
546.6   to the orderly administration of sections 148.65 to 148.78; 
546.7      (6) investigate persons engaging in practices that violate 
546.8   sections 148.65 to 148.78; and 
546.9      (7) adopt rules under chapter 14 prescribing a code of 
546.10  ethics for licensees. 
546.11     Sec. 49.  Minnesota Statutes 1998, section 148.67, is 
546.12  amended to read: 
546.13     148.67 [STATE BOARD OF PHYSICAL THERAPY COUNCIL; MEMBERSHIP 
546.14  APPOINTMENTS, VACANCIES, REMOVALS.] 
546.15     Subdivision 1.  [BOARD OF PHYSICAL THERAPY APPOINTED.] The 
546.16  board of medical practice shall governor shall appoint a state 
546.17  board of physical therapy council in carrying out the provisions 
546.18  of this law to administer sections 148.65 to 148.78, regarding 
546.19  the qualifications and examination of physical therapists.  
546.20  The council board shall consist of seven nine members, citizens 
546.21  and residents of the state of Minnesota, composed of three four 
546.22  physical therapists, two one licensed and registered doctors 
546.23  doctor of medicine and surgery, one being a professor or 
546.24  associate or assistant professor from a program in physical 
546.25  therapy approved by the board of medical practice, one aide or 
546.26  assistant to a physical therapist and one public member.  The 
546.27  council shall expire, and the terms, compensation and removal of 
546.28  members shall be as provided in section 15.059., one physical 
546.29  therapy assistant and three public members.  The four physical 
546.30  therapist members must be licensed physical therapists in this 
546.31  state.  Each of the four physical therapist members must have at 
546.32  least five years' experience in physical therapy practice, 
546.33  physical therapy administration, or physical therapy education.  
546.34  The five years' experience must immediately precede appointment. 
546.35  Membership terms, compensation of members, removal of members, 
546.36  filling of membership vacancies, and fiscal year and reporting 
547.1   requirements shall be as provided in sections 214.07 to 214.09.  
547.2   The provision of staff, administrative services, and office 
547.3   space; the review and processing of complaints; the setting of 
547.4   board fees; and other provisions relating to board operations 
547.5   shall be as provided in chapter 214.  Each member of the board 
547.6   shall file with the secretary of state the constitutional oath 
547.7   of office before beginning the term of office.  
547.8      Subd. 2.  [RECOMMENDATIONS FOR APPOINTMENT.] Prior to the 
547.9   end of the term of a member of the board, or within 60 days 
547.10  after a position on the board becomes vacant, the Minnesota 
547.11  Chapter of the American Physical Therapy Association and other 
547.12  interested persons and organizations may recommend to the 
547.13  governor members qualified to serve on the board.  The governor 
547.14  may appoint members to the board from the list of persons 
547.15  recommended or from among other qualified candidates.  
547.16     Sec. 50.  [148.691] [OFFICERS; EXECUTIVE DIRECTOR.] 
547.17     Subdivision 1.  [OFFICERS OF THE BOARD.] The board shall 
547.18  elect from its members a president, a vice-president, and a 
547.19  secretary-treasurer.  Each shall serve for one year or until a 
547.20  successor is elected and qualifies.  The board shall appoint and 
547.21  employ an executive secretary.  A majority of the board, 
547.22  including one officer, constitutes a quorum at a meeting.  
547.23     Subd. 2.  [BOARD AUTHORITY TO HIRE.] The board may employ 
547.24  persons needed to carry out its work.  
547.25     Subd. 3.  [DISCLOSURE.] Subject to the exceptions listed in 
547.26  this subdivision, all communications or information received by 
547.27  or disclosed to the board relating to any person or matter 
547.28  subject to its regulatory jurisdiction are confidential and 
547.29  privileged and any disciplinary hearing shall be closed to the 
547.30  public.  
547.31     (a) Upon application of a party in a proceeding before the 
547.32  board, the board shall produce and permit the inspection and 
547.33  copying, by or on behalf of the moving party, of any designated 
547.34  documents or papers relevant to the proceedings, in accordance 
547.35  with the provisions of rule 34, Minnesota Rules of Civil 
547.36  Procedure.  
548.1      (b) If the board imposes disciplinary measures of any kind, 
548.2   whether by contested case or by settlement agreement, the name 
548.3   and business address of the licensee, the nature of the 
548.4   misconduct, and the action taken by the board are public data.  
548.5   If disciplinary action is taken by settlement agreement, the 
548.6   entire agreement is public data.  The board shall decide 
548.7   disciplinary matters, whether by settlement or by contested 
548.8   case, by roll call vote.  The votes are public data.  
548.9      (c) The board shall exchange information with other 
548.10  licensing boards, agencies, or departments within the state, as 
548.11  required under section 214.10, subdivision 8, paragraph (d), and 
548.12  may release information in the reports required under section 
548.13  214.10, subdivision 8, paragraph (b). 
548.14     (d) The board shall upon request furnish to a person who 
548.15  made a complaint, a description of the activities and actions of 
548.16  the board relating to that complaint, a summary of the results 
548.17  of an investigation of that complaint, and the reasons for 
548.18  actions taken by the board. 
548.19     Sec. 51.  Minnesota Statutes 1998, section 148.70, is 
548.20  amended to read: 
548.21     148.70 [APPLICANTS, QUALIFICATIONS.] 
548.22     It shall be the duty of The board of medical practice with 
548.23  the advice and assistance of the physical therapy council to 
548.24  pass upon physical therapy must: 
548.25     (1) establish the qualifications of applicants for 
548.26  registration, licensing and continuing education requirements 
548.27  for reregistration, relicensing; 
548.28     (2) provide for and conduct all examinations following 
548.29  satisfactory completion of all didactic requirements,; 
548.30     (3) determine the applicants who successfully pass the 
548.31  examination,; and 
548.32     (4) duly register such applicants license an applicant 
548.33  after the applicant has presented evidence satisfactory to the 
548.34  board that the applicant has completed a an accredited physical 
548.35  therapy educational program of education or continuing education 
548.36  approved by the board. 
549.1      The passing score for examinations taken after July 1, 
549.2   1995, shall be based on objective, numerical standards, as 
549.3   established by a nationally recognized board approved testing 
549.4   service. 
549.5      Sec. 52.  Minnesota Statutes 1998, section 148.705, is 
549.6   amended to read: 
549.7      148.705 [APPLICATION.] 
549.8      An applicant for registration licensing as a physical 
549.9   therapist shall file a written application on forms provided by 
549.10  the board together with a fee in the amount set by the board, no 
549.11  portion of which shall be returned.  No portion of the fee is 
549.12  refundable.  
549.13     An approved program for physical therapists shall include 
549.14  the following:  
549.15     (a) (1) a minimum of 60 academic semester credits or its 
549.16  equivalent from an accredited college, including courses in the 
549.17  biological and physical sciences; and 
549.18     (b) (2) an accredited course in physical therapy education 
549.19  which has provided adequate instruction in the basic sciences, 
549.20  clinical sciences, and physical therapy theory and procedures, 
549.21  as determined by the board.  In determining whether or not a 
549.22  course in physical therapy is approved, the board may take into 
549.23  consideration the accreditation of such schools by the 
549.24  appropriate council of the American Medical Association, the 
549.25  American Physical Therapy Association, or the Canadian Medical 
549.26  Association.  
549.27     Sec. 53.  Minnesota Statutes 1998, section 148.71, is 
549.28  amended to read: 
549.29     148.71 [REGISTRATION LICENSING.] 
549.30     Subdivision 1.  [QUALIFIED APPLICANT.] The state board 
549.31  of medical practice physical therapy shall register license as a 
549.32  physical therapist and shall furnish a certificate of 
549.33  registration license to each an applicant who successfully 
549.34  passes an examination provided for in sections 148.65 to 148.78 
549.35  for registration licensing as a physical therapist and who is 
549.36  otherwise qualified as required herein in sections 148.65 to 
550.1   148.78. 
550.2      Subd. 2.  [TEMPORARY PERMIT.] (a) The board may, upon 
550.3   payment of a fee set by the board, issue a temporary permit to 
550.4   practice physical therapy under supervision to a physical 
550.5   therapist who is a graduate of an approved school of physical 
550.6   therapy and qualified for admission to examination for 
550.7   registration licensing as a physical therapist.  A temporary 
550.8   permit to practice physical therapy under supervision may be 
550.9   issued only once and cannot be renewed.  It expires 90 days 
550.10  after the next examination for registration licensing given by 
550.11  the board or on the date on which the board, after examination 
550.12  of the applicant, grants or denies the applicant a registration 
550.13  license to practice, whichever occurs first.  A temporary permit 
550.14  expires on the first day the board begins its next examination 
550.15  for registration license after the permit is issued if the 
550.16  holder does not submit to examination on that date.  The holder 
550.17  of a temporary permit to practice physical therapy under 
550.18  supervision may practice physical therapy as defined in section 
550.19  148.65 if the entire practice is under the supervision of a 
550.20  person holding a valid registration license to practice physical 
550.21  therapy in this state.  The supervision shall be direct, 
550.22  immediate, and on premises. 
550.23     (b) A physical therapist from another state who is licensed 
550.24  or otherwise registered in good standing as a physical therapist 
550.25  by that state and meets the requirements for registration 
550.26  licensing under section 148.72 does not require supervision to 
550.27  practice physical therapy while holding a temporary permit in 
550.28  this state.  The temporary permit remains valid only until the 
550.29  meeting of the board at which the application for registration 
550.30  licensing is considered. 
550.31     Subd. 3.  [FOREIGN-TRAINED PHYSICAL THERAPISTS; TEMPORARY 
550.32  PERMITS.] (a) The board of medical practice may issue a 
550.33  temporary permit to a foreign-trained physical therapist who: 
550.34     (1) is enrolled in a supervised physical therapy 
550.35  traineeship that meets the requirements under paragraph (b); 
550.36     (2) has completed a physical therapy education program 
551.1   equivalent to that under section 148.705 and Minnesota Rules, 
551.2   part 5601.0800, subpart 2; 
551.3      (3) has achieved a score of at least 550 on the test of 
551.4   English as a foreign language or a score of at least 85 on the 
551.5   Minnesota battery test; and 
551.6      (4) has paid a nonrefundable fee set by the board. 
551.7      A foreign-trained physical therapist must have the 
551.8   temporary permit before beginning a traineeship. 
551.9      (b) A supervised physical therapy traineeship must: 
551.10     (1) be at least six months; 
551.11     (2) be at a board-approved facility; 
551.12     (3) provide a broad base of clinical experience to the 
551.13  foreign-trained physical therapist including a variety of 
551.14  physical agents, therapeutic exercises, evaluation procedures, 
551.15  and patient diagnoses; 
551.16     (4) be supervised by a physical therapist who has at least 
551.17  three years of clinical experience and is registered licensed 
551.18  under subdivision 1; and 
551.19     (5) be approved by the board before the foreign-trained 
551.20  physical therapist begins the traineeship. 
551.21     (c) A temporary permit is effective on the first day of a 
551.22  traineeship and expires 90 days after the next examination for 
551.23  registration licensing given by the board following successful 
551.24  completion of the traineeship or on the date on which the board, 
551.25  after examination of the applicant, grants or denies the 
551.26  applicant a registration license to practice, whichever occurs 
551.27  first. 
551.28     (d) A foreign-trained physical therapist must successfully 
551.29  complete a traineeship to be registered licensed as a physical 
551.30  therapist under subdivision 1.  The traineeship may be waived 
551.31  for a foreign-trained physical therapist who is licensed or 
551.32  otherwise registered in good standing in another state and has 
551.33  successfully practiced physical therapy in that state under the 
551.34  supervision of a licensed or registered physical therapist for 
551.35  at least six months at a facility that meets the requirements 
551.36  under paragraph (b), clauses (2) and (3). 
552.1      (e) A temporary permit will not be issued to a 
552.2   foreign-trained applicant who has been issued a temporary permit 
552.3   for longer than six months in any other state. 
552.4      Sec. 54.  Minnesota Statutes 1998, section 148.72, 
552.5   subdivision 1, is amended to read: 
552.6      Subdivision 1.  [ISSUANCE OF REGISTRATION LICENSE WITHOUT 
552.7   EXAMINATION.] On payment to the board of a fee in the amount set 
552.8   by the board and on submission of a written application on forms 
552.9   provided by the board, the board shall issue registration a 
552.10  license without examination to a person who is licensed or 
552.11  otherwise registered as a physical therapist by another state of 
552.12  the United States of America, its possessions, or the District 
552.13  of Columbia, if the board determines that the requirements for 
552.14  licensure licensing or registration in the state, possession, or 
552.15  District are equal to, or greater than, the requirements set 
552.16  forth in sections 148.65 to 148.78. 
552.17     Sec. 55.  Minnesota Statutes 1998, section 148.72, 
552.18  subdivision 2, is amended to read: 
552.19     Subd. 2.  [CERTIFICATE OF REGISTRATION LICENSE.] The board 
552.20  may issue a certificate of registration to a physical therapist 
552.21  license without examination to an applicant who presents 
552.22  evidence satisfactory to the board of having passed an 
552.23  examination recognized by the board, if the board determines the 
552.24  standards of the other state or foreign country are determined 
552.25  by the board to be as high as equal to those of this state.  At 
552.26  the time of making an Upon application, the applicant shall pay 
552.27  to the board a fee in the amount set by the board,.  No portion 
552.28  of which shall be returned the fee is refundable.  
552.29     Sec. 56.  Minnesota Statutes 1998, section 148.72, 
552.30  subdivision 4, is amended to read: 
552.31     Subd. 4.  [ISSUANCE OF REGISTRATION LICENSE AFTER 
552.32  EXAMINATION.] The board shall issue a certificate of 
552.33  registration license to each an applicant who passes the 
552.34  examination in accordance with according to standards 
552.35  established by the board and who is not disqualified to 
552.36  receive registration a license under the provisions of section 
553.1   148.75.  
553.2      Sec. 57.  Minnesota Statutes 1998, section 148.73, is 
553.3   amended to read: 
553.4      148.73 [RENEWALS.] 
553.5      Every registered licensed physical therapist shall, during 
553.6   each January, apply to the board for an extension 
553.7   of registration a license and pay a fee in the amount set by the 
553.8   board.  The extension of registration the license is contingent 
553.9   upon demonstration that the continuing education requirements 
553.10  set by the board under section 148.70 have been satisfied. 
553.11     Sec. 58.  Minnesota Statutes 1998, section 148.74, is 
553.12  amended to read: 
553.13     148.74 [RULES.] 
553.14     The board is authorized to may adopt rules as may be 
553.15  necessary needed to carry out the purposes of sections 148.65 to 
553.16  148.78.  The secretary secretary-treasurer of the board shall 
553.17  keep a record of proceedings under these sections and a register 
553.18  of all persons registered licensed under it.  The register shall 
553.19  show the name, address, date and number of registration the 
553.20  license, and the renewal thereof of the license.  Any other 
553.21  interested person in the state may obtain a copy of such the 
553.22  list on request to the board upon payment of paying an amount as 
553.23  may be fixed by the board, which.  The amount shall not exceed 
553.24  the cost of the list so furnished.  The board shall provide 
553.25  blanks, books, certificates, and stationery and assistance as is 
553.26  necessary for the transaction of the to transact business of the 
553.27  board and the physical therapy council hereunder, and.  All 
553.28  money received by the board under sections 148.65 to 148.78 
553.29  shall be paid into the state treasury as provided for by law.  
553.30  The board shall set by rule the amounts of the application fee 
553.31  and the annual registration licensing fee.  The fees collected 
553.32  by the board must be sufficient to cover the costs of 
553.33  administering sections 148.65 to 148.78. 
553.34     Sec. 59.  [148.745] [MALPRACTICE HISTORY.] 
553.35     Subdivision 1.  [SUBMISSION.] A person desiring to practice 
553.36  physical therapy in this state who has previously practiced in 
554.1   another state shall submit the following additional information 
554.2   with the license application for the five-year period of active 
554.3   practice preceding the date of filing such application: 
554.4      (a) The name and address of the person's professional 
554.5   liability insurer in the other state. 
554.6      (b) The number, date, and disposition of any malpractice 
554.7   settlement or award made to the plaintiff relating to the 
554.8   quality of services provided. 
554.9      Subd. 2.  [BOARD ACTION.] The board shall give due 
554.10  consideration to the information submitted pursuant to section 
554.11  148.72 and this section.  An applicant who willfully submits 
554.12  incorrect information shall be subject to disciplinary action 
554.13  pursuant to section 148.75. 
554.14     Sec. 60.  Minnesota Statutes 1998, section 148.75, is 
554.15  amended to read: 
554.16     148.75 [CERTIFICATES LICENSES; DENIAL, SUSPENSION, 
554.17  REVOCATION.] 
554.18     (a) The state board of medical practice physical therapy 
554.19  may refuse to grant registration a license to any physical 
554.20  therapist, or may suspend or revoke the registration license of 
554.21  any physical therapist for any of the following grounds:  
554.22     (a) (1) using drugs or intoxicating liquors to an extent 
554.23  which affects professional competence; 
554.24     (b) been convicted (2) conviction of a felony; 
554.25     (c) (3) conviction for violating any state or federal 
554.26  narcotic law; 
554.27     (d) procuring, aiding or abetting a criminal abortion; 
554.28     (e) registration (4) obtaining a license or attempted 
554.29  registration attempting to obtain a license by fraud or 
554.30  deception; 
554.31     (f) (5) conduct unbecoming a person registered licensed as 
554.32  a physical therapist or conduct detrimental to the best 
554.33  interests of the public; 
554.34     (g) (6) gross negligence in the practice of physical 
554.35  therapy as a physical therapist; 
554.36     (h) (7) treating human ailments by physical therapy after 
555.1   an initial 30-day period of patient admittance to treatment has 
555.2   lapsed, except by the order or referral of a person licensed in 
555.3   this state to in the practice of medicine as defined in section 
555.4   147.081, the practice of chiropractic as defined in section 
555.5   148.01, the practice of podiatry as defined in section 153.01, 
555.6   or the practice of dentistry as defined in section 150A.05 and 
555.7   whose license is in good standing; or when a previous diagnosis 
555.8   exists indicating an ongoing condition warranting physical 
555.9   therapy treatment, subject to periodic review defined by board 
555.10  of medical practice physical therapy rule; 
555.11     (i) (8) treating human ailments, without referral, by 
555.12  physical therapy treatment without first having practiced one 
555.13  year under a physician's orders as verified by the board's 
555.14  records; 
555.15     (j) failure (9) failing to consult with the patient's 
555.16  health care provider who prescribed the physical therapy 
555.17  treatment if the treatment is altered by the physical therapist 
555.18  from the original written order.  The provision does not include 
555.19  written orders specifying orders to "evaluate and treat"; 
555.20     (k) (10) treating human ailments other than by physical 
555.21  therapy unless duly licensed or registered to do so under the 
555.22  laws of this state; 
555.23     (l) (11) inappropriate delegation to a physical therapist 
555.24  assistant or inappropriate task assignment to an aide or 
555.25  inadequate supervision of either level of supportive personnel; 
555.26     (m) treating human ailments other than by performing 
555.27  physical therapy procedures unless duly licensed or registered 
555.28  to do so under the laws of this state; 
555.29     (n) (12) practicing as a physical therapist performing 
555.30  medical diagnosis, the practice of medicine as defined in 
555.31  section 147.081, or the practice of chiropractic as defined in 
555.32  section 148.01; 
555.33     (o) failure (13) failing to comply with a reasonable 
555.34  request to obtain appropriate clearance for mental or physical 
555.35  conditions which that would interfere with the ability to 
555.36  practice physical therapy, and which that may be potentially 
556.1   harmful to patients; 
556.2      (p) (14) dividing fees with, or paying or promising to pay 
556.3   a commission or part of the fee to, any person who contacts the 
556.4   physical therapist for consultation or sends patients to the 
556.5   physical therapist for treatment; 
556.6      (q) (15) engaging in an incentive payment arrangement, 
556.7   other than that prohibited by clause (p) (14), that tends to 
556.8   promote physical therapy overutilization overuse, whereby that 
556.9   allows the referring person or person who controls the 
556.10  availability of physical therapy services to a client profits to 
556.11  profit unreasonably as a result of patient treatment; 
556.12     (r) (16) practicing physical therapy and failing to refer 
556.13  to a licensed health care professional any a patient whose 
556.14  medical condition at the time of evaluation has been determined 
556.15  by the physical therapist to be beyond the scope of practice of 
556.16  a physical therapist; and 
556.17     (s) failure (17) failing to report to the board other 
556.18  registered licensed physical therapists who violate this section.
556.19     (b) A certificate of registration license to practice as a 
556.20  physical therapist is suspended if (1) a guardian of the person 
556.21  of the physical therapist is appointed by order of a court 
556.22  pursuant to sections 525.54 to 525.61, for reasons other than 
556.23  the minority of the physical therapist; or (2) the physical 
556.24  therapist is committed by order of a court pursuant to chapter 
556.25  253B.  The certificate of registration license remains suspended 
556.26  until the physical therapist is restored to capacity by a court 
556.27  and, upon petition by the physical therapist, the suspension is 
556.28  terminated by the board of medical practice physical therapy 
556.29  after a hearing.  
556.30     Sec. 61.  Minnesota Statutes 1998, section 148.76, is 
556.31  amended to read: 
556.32     148.76 [PROHIBITED CONDUCT.] 
556.33     Subdivision 1.  No person shall:  
556.34     (1) provide physical therapy unless the person is licensed 
556.35  as a physical therapist under sections 148.65 to 148.78; 
556.36     (a) (2) use the title of physical therapist without a 
557.1   certificate of registration license as a physical therapist 
557.2   issued pursuant to the provisions of under sections 148.65 to 
557.3   148.78; 
557.4      (b) (3) in any manner hold out as a physical therapist, or 
557.5   use in connection with the person's name the words or letters 
557.6   Physical Therapist, Physiotherapist, Physical Therapy 
557.7   Technician, Registered Physical Therapist, Licensed Physical 
557.8   Therapist, P.T., P.T.T., R.P.T., L.P.T., or any letters, words, 
557.9   abbreviations or insignia indicating or implying that the person 
557.10  is a physical therapist, without a certificate of registration 
557.11  license as a physical therapist issued pursuant to the 
557.12  provisions of under sections 148.65 to 148.78.  To do so is a 
557.13  gross misdemeanor; 
557.14     (c) (4) employ fraud or deception in applying for or 
557.15  securing a certificate of registration license as a physical 
557.16  therapist.  
557.17     Nothing contained in sections 148.65 to 148.78 shall 
557.18  prohibit any prohibits a person licensed or registered in this 
557.19  state under another law from carrying out the therapy or 
557.20  practice for which the person is duly licensed or registered. 
557.21     Subd. 2.  No physical therapist may: 
557.22     (a) (1) treat human ailments by physical therapy after an 
557.23  initial 30-day period of patient admittance to treatment has 
557.24  lapsed, except by the order or referral of a person licensed in 
557.25  this state to practice medicine as defined in section 147.081, 
557.26  the practice of chiropractic as defined in section 148.01, the 
557.27  practice of podiatry as defined in section 153.01, the practice 
557.28  of dentistry as defined in section 150A.05, or the practice of 
557.29  advanced practice nursing as defined in section 62A.15, 
557.30  subdivision 3a, when orders or referrals are made in 
557.31  collaboration with a physician, chiropractor, podiatrist, or 
557.32  dentist, and whose license is in good standing; or when a 
557.33  previous diagnosis exists indicating an ongoing condition 
557.34  warranting physical therapy treatment, subject to periodic 
557.35  review defined by board of medical practice physical therapy 
557.36  rule; 
558.1      (b) (2) treat human ailments by physical therapy treatment 
558.2   without first having practiced one year under a physician's 
558.3   orders as verified by the board's records; 
558.4      (c) utilize (3) use any chiropractic manipulative technique 
558.5   whose end is the chiropractic adjustment of an abnormal 
558.6   articulation of the body; and 
558.7      (d) (4) treat human ailments other than by physical therapy 
558.8   unless duly licensed or registered to do so under the laws of 
558.9   this state. 
558.10     Sec. 62.  Minnesota Statutes 1998, section 148.78, is 
558.11  amended to read: 
558.12     148.78 [PROSECUTION, ALLEGATIONS.] 
558.13     In the prosecution of any person for violation of sections 
558.14  148.65 to 148.78 as specified in section 148.76, it shall not be 
558.15  necessary to allege or prove want of a valid certificate of 
558.16  registration license as a physical therapist, but shall be a 
558.17  matter of defense to be established by the accused. 
558.18     Sec. 63.  Minnesota Statutes 1998, section 148B.32, 
558.19  subdivision 1, is amended to read: 
558.20     Subdivision 1.  [UNLICENSED PRACTICE PROHIBITED.] After 
558.21  adoption of rules by the board implementing sections 148B.29 to 
558.22  148B.39, no individual shall engage in marriage and family 
558.23  therapy practice unless that individual holds a valid license 
558.24  issued under sections 148B.29 to 148B.39. 
558.25     Marriage and family therapists may not be reimbursed under 
558.26  medical assistance, chapter 256B, except to the extent such care 
558.27  is reimbursed under section 256B.0625, subdivision 5, or when 
558.28  marriage and family therapists are employed by a managed care 
558.29  organization with a contract to provide mental health care to 
558.30  medical assistance enrollees, and are reimbursed through the 
558.31  managed care organization. 
558.32     Sec. 64.  Minnesota Statutes 1998, section 150A.10, 
558.33  subdivision 1, is amended to read: 
558.34     Subdivision 1.  [DENTAL HYGIENISTS.] (a) Any licensed 
558.35  dentist, public institution, or school authority may obtain 
558.36  services from a licensed dental hygienist.  Such licensed dental 
559.1   hygienist may provide those services defined in section 150A.05, 
559.2   subdivision 1a.  Such services shall not include the 
559.3   establishment of a final diagnosis or treatment plan for a 
559.4   dental patient.  Such services shall be provided under 
559.5   supervision of a licensed dentist.  Any licensed dentist who 
559.6   shall permit any dental service by a dental hygienist other than 
559.7   those authorized by the board of dentistry, shall be deemed to 
559.8   be violating the provisions of sections 150A.01 to 150A.12, and 
559.9   any such unauthorized dental service by a dental hygienist shall 
559.10  constitute a violation of sections 150A.01 to 150A.12.  
559.11     (b) Notwithstanding paragraph (a), a licensed dental 
559.12  hygienist may provide those services defined in section 150A.05, 
559.13  subdivision 1a, clauses (1) and (2), and in Minnesota Rules, 
559.14  part 3100.8700, subpart 1, without the supervision of a licensed 
559.15  dentist if the following circumstances are met: 
559.16     (1) the services are authorized by a licensed dentist; 
559.17     (2) the services are performed on a limited access patient; 
559.18  and 
559.19     (3) a licensed dentist reviews the dental hygienist's 
559.20  findings. 
559.21  For purposes of this paragraph, "limited access patient" means a 
559.22  patient who, due to age, disability, or geographic location, is 
559.23  unable to receive regular dental services in a dental office.  
559.24  Services that are authorized by a licensed dentist under this 
559.25  paragraph may be performed by a licensed dental hygienist 
559.26  without the presence of a dentist and may be performed at a 
559.27  location other than the usual place of practice of the dentist 
559.28  or dental hygienist.  
559.29     Sec. 65.  Minnesota Statutes 1998, section 214.01, 
559.30  subdivision 2, is amended to read: 
559.31     Subd. 2.  [HEALTH-RELATED LICENSING BOARD.] "Health-related 
559.32  licensing board" means the board of examiners of nursing home 
559.33  administrators established pursuant to section 144A.19, the 
559.34  board of medical practice created pursuant to section 147.01, 
559.35  the board of nursing created pursuant to section 148.181, the 
559.36  board of chiropractic examiners established pursuant to section 
560.1   148.02, the board of optometry established pursuant to section 
560.2   148.52, the board of physical therapy established pursuant to 
560.3   section 148.67, the board of psychology established pursuant to 
560.4   section 148.90, the board of social work pursuant to section 
560.5   148B.19, the board of marriage and family therapy pursuant to 
560.6   section 148B.30, the office of mental health practice 
560.7   established pursuant to section 148B.61, the alcohol and drug 
560.8   counselors licensing advisory council established pursuant to 
560.9   section 148C.02, the board of dietetics and nutrition practice 
560.10  established under section 148.622, the board of dentistry 
560.11  established pursuant to section 150A.02, the board of pharmacy 
560.12  established pursuant to section 151.02, the board of podiatric 
560.13  medicine established pursuant to section 153.02, and the board 
560.14  of veterinary medicine, established pursuant to section 156.01.  
560.15     Sec. 66.  [INITIAL APPOINTMENTS TO BOARD.] 
560.16     Notwithstanding Minnesota Statutes, section 148.67, the 
560.17  first physical therapist members appointed to the board may be 
560.18  registered physical therapists. 
560.19     Sec. 67.  [REVISOR'S INSTRUCTION.] 
560.20     In each section of Minnesota Statutes referred to in column 
560.21  A, the revisor of statutes shall delete the reference in column 
560.22  B and insert the reference in column C. 
560.23       Column A             Column B      Column C 
560.24       144E.10, subd. 2     144E.16       144E.101 to 144E.127
560.25       144E.12              144E.16       144E.121 to 144E.127 
560.26       144E.13              144E.16       144E.101 to 144E.127 
560.27       144E.14              144E.16       144E.101 to 144E.127 
560.28       144E.35, subd. 1     144E.16       144E.285 
560.29       144E.41              144E.16       144E.265 or 144E.28 
560.30       353.64, subd. 10     144E.16       144E.28
560.31       147A.09, subd. 2     144E.16,      144E.127 
560.32                             subd. 2,
560.33                             para. (c)
560.34     Sec. 68.  [REPEALER.] 
560.35     Minnesota Statutes 1998, sections 144E.16, subdivisions 1, 
560.36  2, 3, and 6; 144E.17; 144E.25; and 144E.30, subdivisions 1, 2, 
561.1   and 6, are repealed.  Minnesota Rules, parts 4690.0100, subparts 
561.2   4, 13, 15, 19, 20, 21, 22, 23, 24, 26, 27, and 29; 4690.0300; 
561.3   4690.0400; 4690.0500; 4690.0600; 4690.0700; 4690.0800, subparts 
561.4   1 and 2; 4690.0900; 4690.1000; 4690.1100; 4690.1200; 4690.1300; 
561.5   4690.1600; 4690.1700; 4690.2100; 4690.2200, subparts 1, 3, 4, 
561.6   and 5; 4690.2300; 4690.2400, subparts 1, 2, and 3; 4690.2500; 
561.7   4690.2900; 4690.3000; 4690.3700; 4690.3900; 4690.4000; 
561.8   4690.4100; 4690.4200; 4690.4300; 4690.4400; 4690.4500; 
561.9   4690.4600; 4690.4700; 4690.4800; 4690.4900; 4690.5000; 
561.10  4690.5100; 4690.5200; 4690.5300; 4690.5400; 4690.5500; 
561.11  4690.5700; 4690.5800; 4690.5900; 4690.6000; 4690.6100; 
561.12  4690.6200; 4690.6300; 4690.6400; 4690.6500; 4690.6600; 
561.13  4690.6700; 4690.6800; 4690.7000; 4690.7100; 4690.7200; 
561.14  4690.7300; 4690.7400; 4690.7500; 4690.7600; 4690.7700; 
561.15  4690.7800; 4690.8300, subparts 1, 2, 3, 4, and 5; and 4735.5000, 
561.16  are repealed. 
561.17                             ARTICLE 10
561.18                    TOBACCO SETTLEMENT PAYMENTS 
561.19     Section 1.  [10.57] [MINNESOTA FAMILIES FOUNDATION.] 
561.20     Subdivision 1.  [ESTABLISHMENT.] The legislature finds that 
561.21  the Minnesota families foundation will foster a public-private 
561.22  partnership that will provide improved services to clients, a 
561.23  more effective coordination of services, and a more efficient 
561.24  allocation of resources.  The Minnesota families foundation is a 
561.25  nonprofit foundation established to support self-sufficiency and 
561.26  reduce long-term dependency on government.  The foundation shall 
561.27  operate as a supporting organization under chapter 317A and the 
561.28  Internal Revenue Code, section 509(a).  The foundation is not 
561.29  subject to chapters 13, 14, 16A, 16B, 16C, 43A, and 179A. 
561.30     Subd. 2.  [BOARD MEMBERSHIP.] The foundation shall be 
561.31  governed by a 15-member board of directors consisting of: 
561.32     (1) four members who are not state employees, appointed by 
561.33  the governor; 
561.34     (2) four members who are not members of the legislature, 
561.35  two of whom are appointed by the senate and two of whom are 
561.36  appointed by the house of representatives; and 
562.1      (3) seven members appointed by the board itself. 
562.2      Subd. 3.  [TERMS; COMPENSATION; REMOVAL.] (a) Board members 
562.3   appointed by the governor and the legislature shall serve during 
562.4   the term of the appointing authority.  The governor and the 
562.5   legislature shall make initial appointments of board members, as 
562.6   specified in subdivision 2, as soon as possible after the 
562.7   effective date of this section.  Initially appointed board 
562.8   members' terms shall begin on July 1, 1999.  Two of the 
562.9   governor's initial appointments shall be for two-year terms.  
562.10  Subsequent appointments shall be made at the beginning of each 
562.11  regular session of the legislature.  The board members appointed 
562.12  by the governor and the legislature shall appoint seven board 
562.13  members no later than January 1, 2000.  Board members appointed 
562.14  by the board shall serve four-year terms.  A vacancy on the 
562.15  board shall be filled for the unexpired portion of the term in 
562.16  the same manner as the original appointment. 
562.17     (b) Board members shall be reimbursed for reasonable 
562.18  out-of-pocket expenses actually incurred. 
562.19     (c) Board members must disclose fully to the board of 
562.20  directors whenever they may have a conflict of interest within 
562.21  the meaning of section 317A.255, subdivision 2.  
562.22     (d) Liability of board members shall be governed by section 
562.23  317A.257. 
562.24     Subd. 4.  [ORGANIZATION.] The board of directors shall 
562.25  adopt bylaws necessary for the conduct of the business of the 
562.26  foundation.  The board shall select a chairperson from its 
562.27  members, and any other officers the board deems necessary.  
562.28  Board meetings shall be open to the public, and all grants, 
562.29  contracts, and meeting minutes of the foundation shall be 
562.30  available to the public. 
562.31     Subd. 5.  [EXECUTIVE DIRECTOR; EMPLOYEES OF THE 
562.32  FOUNDATION.] (a) The board members appointed by the governor and 
562.33  the legislature shall convene prior to January 1, 2000, and hire 
562.34  an executive director.  The executive director shall serve at 
562.35  the pleasure of the board of directors.  The executive director 
562.36  shall serve as a nonvoting member of the board.  The executive 
563.1   director's compensation shall be capped at 95 percent of the 
563.2   governor's salary. 
563.3      (b) The executive director shall oversee the daily 
563.4   operations of the foundation, including the hiring of necessary 
563.5   staff.  Employees of the foundation are not state employees. 
563.6      (c) The executive director shall prepare an annual budget 
563.7   for the foundation for review and approval by the board of 
563.8   directors. 
563.9      (d) To the extent that the board of directors makes funds 
563.10  available, the commissioner of finance shall provide 
563.11  administrative support to the foundation until June 30, 2000, 
563.12  including but not limited to processing of payroll for the 
563.13  executive director and foundation staff, payment of expenses to 
563.14  board members, and payment of rent.  The board of directors 
563.15  shall make up to $200,000 available to the commissioner of 
563.16  finance to cover payroll, expenses of board members, rent, and 
563.17  other administrative expenses incurred to support the foundation 
563.18  in fiscal year 2000. 
563.19     Subd. 6.  [FOUNDATION FUNDS.] (a) The board of directors 
563.20  shall be responsible for managing the investment of the 
563.21  foundation funds as follows: 
563.22     (1) the foundation funds shall be audited annually by an 
563.23  independent certified public accountant in accordance with 
563.24  generally accepted accounting principles; 
563.25     (2) the foundation funds shall be invested and managed 
563.26  according to rules applicable to trust investments, as provided 
563.27  in the Minnesota Prudent Investor Act, sections 501B.151 and 
563.28  501B.152; 
563.29     (3) reasonable and necessary administrative and investment 
563.30  expenses directly associated with the management and investment 
563.31  of the foundation funds may be paid from the foundation trusts; 
563.32  and 
563.33     (4) according to limits established by the board and 
563.34  consistent with the limitations in the Uniform Management of 
563.35  Institutional Funds Act, sections 309.62 to 309.71, earnings on 
563.36  foundation funds shall be expended to cover administrative 
564.1   expenses of the foundation and grant awards under subdivision 7. 
564.2      (b) The board may contract with a third party, including 
564.3   the state board of investment, to carry out the provisions of 
564.4   paragraph (a). 
564.5      (c) The foundation may accept gifts from private donors.  
564.6   Such gifts to the foundation must be accounted for and expended 
564.7   in a manner consistent with this section. 
564.8      Subd. 7.  [FOUNDATION GRANTS.] (a) Beginning July 1, 2000, 
564.9   the foundation shall provide grants to nonprofit, 
564.10  community-based organizations for activities that: 
564.11     (1) are flexible and innovative and that close the gap 
564.12  between dependence on government and independence from 
564.13  government programs; 
564.14     (2) support the efforts of working families and working 
564.15  individuals to remain self-sufficient by building assets that 
564.16  promote healthy family functioning and stability; 
564.17     (3) will ensure that core public sector efforts to 
564.18  encourage self-sufficiency have every opportunity to succeed; 
564.19     (4) focus resources in a way that can demonstrate impact on 
564.20  a single goal or a single set of goals; 
564.21     (5) have demonstrated success in reducing future government 
564.22  expenditures; 
564.23     (6) contribute to increasing the understanding of the 
564.24  development of young children's brains or to developing new 
564.25  methods to increase the effectiveness of stimulation and 
564.26  educational activities that will improve brain development in 
564.27  young children; or 
564.28     (7) enhance public education, awareness, and understanding 
564.29  necessary for the promotion and encouragement of activities and 
564.30  decisions that protect and stimulate young children's 
564.31  development. 
564.32     (b) All grantees must match funds received from the 
564.33  foundation, dollar for dollar.  The match may include up to 25 
564.34  percent in kind.  The match cannot be made with federal, state, 
564.35  or local government funds except in collaborative projects 
564.36  between governmental entities and the private sector. 
565.1      (c) The foundation grants must not be used as a substitute 
565.2   for traditional state or local sources of funding activities for 
565.3   families and young children, but the endowment fund may be used 
565.4   to supplement traditional state or local sources, including 
565.5   sources used to support the activities described in this 
565.6   subdivision. 
565.7      Subd. 8.  [REPORTS TO THE LEGISLATURE.] (a) The foundation 
565.8   shall annually report to the governor and the legislature on 
565.9   January 15 of each year.  The report must include: 
565.10     (1) a financial report that details the foundation's 
565.11  earnings; 
565.12     (2) an expense report detailing the amounts and purposes 
565.13  for which funds were expended; 
565.14     (3) a list of grant awards; 
565.15     (4) a report on the performance results of these grants; 
565.16  and 
565.17     (5) a copy of the independent audit reports for the two 
565.18  previous years. 
565.19     (b) The foundation shall also report to the governor and 
565.20  the legislature on January 15, 2000.  This report shall include 
565.21  a copy of the foundation's mission statement, bylaws, and 
565.22  policies adopted by the board of directors; and a financial 
565.23  report that details the foundation's returns and the amounts and 
565.24  purposes for which funds were expended. 
565.25     Subd. 9.  [DISSOLUTION OF THE FOUNDATION.] By June 30, 
565.26  2009, the foundation shall transfer all foundation assets to the 
565.27  commissioner of finance, who shall record them as assets of the 
565.28  general fund and cause them to be liquidated or invested, as 
565.29  appropriate, by the state board of investment.  On June 30, 
565.30  2009, the foundation is dissolved.  If the legal status of the 
565.31  foundation or the foundation funds is successfully challenged in 
565.32  state or federal court, the foundation must be dissolved and the 
565.33  assets likewise returned to commissioner of finance for credit 
565.34  to the general fund and investment by the state board of 
565.35  investment. 
565.36     (<i>Effective Date:  Section 1 (10.57) is effective the day</i> 
566.1   <i>following final enactment.</i>) 
566.2      Sec. 2.  Minnesota Statutes 1998, section 62J.69, is 
566.3   amended to read: 
566.4      62J.69 [MEDICAL EDUCATION AND RESEARCH TRUST FUND.] 
566.5      Subdivision 1.  [DEFINITIONS.] For purposes of this 
566.6   section, the following definitions apply: 
566.7      (a) "Medical education" means the accredited clinical 
566.8   training of physicians (medical students and residents), doctor 
566.9   of pharmacy practitioners, doctors of chiropractic, dentists, 
566.10  advanced practice nurses (clinical nurse specialist, certified 
566.11  registered nurse anesthetists, nurse practitioners, and 
566.12  certified nurse midwives), and physician assistants. 
566.13     (b) "Clinical training" means accredited training for the 
566.14  health care practitioners listed in paragraph (a) that is funded 
566.15  in part by patient care revenues and that occurs in either an 
566.16  inpatient or ambulatory patient care training site. 
566.17     (c) "Trainee" means students involved in an accredited 
566.18  clinical training program for medical education as defined in 
566.19  paragraph (a). 
566.20     (d) "Eligible trainee" means a student involved in an 
566.21  accredited training program for medical education as defined in 
566.22  paragraph (a), which meets the definition of clinical training 
566.23  in paragraph (b), who is in a training site that is located in 
566.24  Minnesota and which has a medical assistance provider number. 
566.25     (e) "Health care research" means approved clinical, 
566.26  outcomes, and health services investigations that are funded by 
566.27  patient out-of-pocket expenses or a third-party payer. 
566.28     (f) "Commissioner" means the commissioner of health. 
566.29     (g) (f) "Teaching institutions" means any hospital, medical 
566.30  center, clinic, or other organization that currently sponsors or 
566.31  conducts accredited medical education programs or clinical 
566.32  research in Minnesota. 
566.33     (h) (g) "Accredited training" means training provided by a 
566.34  program that is accredited through an organization recognized by 
566.35  the department of education or the health care financing 
566.36  administration as the official accrediting body for that program.
567.1      (i) (h) "Sponsoring institution" means a hospital, school, 
567.2   or consortium located in Minnesota that sponsors and maintains 
567.3   primary organizational and financial responsibility for an 
567.4   accredited medical education program in Minnesota and which is 
567.5   accountable to the accrediting body. 
567.6      Subd. 1a.  [ADVISORY COMMITTEE.] The commissioner shall 
567.7   appoint an advisory committee to provide advice and oversight on 
567.8   the distribution of funds from the medical education and 
567.9   research endowment fund.  If a committee is appointed, the 
567.10  commissioner shall:  
567.11     (1) consider the interest of all stakeholders when 
567.12  selecting committee members; 
567.13     (2) select members that represent both urban and rural 
567.14  interests; and 
567.15     (3) select members that include ambulatory care as well as 
567.16  inpatient perspectives.  
567.17  The commissioner shall appoint to the advisory committee 
567.18  representatives of the following groups:  medical researchers; 
567.19  public and private academic medical centers, including a 
567.20  representative from each academic center offering an accredited 
567.21  training program for physicians, pharmacists, chiropractors, 
567.22  dentists, and nurses; managed care organizations; Blue Cross and 
567.23  Blue Shield of Minnesota; commercial carriers; Minnesota Medical 
567.24  Association; Minnesota Nurses Association; Minnesota 
567.25  Chiropractic Association; medical product manufacturers; 
567.26  employers; and other relevant stakeholders, including 
567.27  consumers.  The advisory committee is governed by section 15.059 
567.28  for membership terms and removal of members, and expires on June 
567.29  30, 2001. 
567.30     Subd. 2.  [ALLOCATION AND FUNDING FOR MEDICAL EDUCATION AND 
567.31  RESEARCH.] (a) The commissioner may establish a trust fund for 
567.32  the purposes of funding medical education and research 
567.33  activities in the state of Minnesota. 
567.34     (b) By January 1, 1997, the commissioner may appoint an 
567.35  advisory committee to provide advice and oversight on the 
567.36  distribution of funds from the medical education and research 
568.1   trust fund.  If a committee is appointed, the commissioner 
568.2   shall:  (1) consider the interest of all stakeholders when 
568.3   selecting committee members; (2) select members that represent 
568.4   both urban and rural interest; and (3) select members that 
568.5   include ambulatory care as well as inpatient perspectives.  The 
568.6   commissioner shall appoint to the advisory committee 
568.7   representatives of the following groups:  medical researchers, 
568.8   public and private academic medical centers, managed care 
568.9   organizations, Blue Cross and Blue Shield of Minnesota, 
568.10  commercial carriers, Minnesota Medical Association, Minnesota 
568.11  Nurses Association, medical product manufacturers, employers, 
568.12  and other relevant stakeholders, including consumers.  The 
568.13  advisory committee is governed by section 15.059, for membership 
568.14  terms and removal of members and will sunset on June 30, 1999. 
568.15     (c) Eligible applicants for funds are accredited medical 
568.16  education teaching institutions, consortia, and programs 
568.17  operating in Minnesota.  Applications must be submitted by the 
568.18  sponsoring institution on behalf of the teaching program, and 
568.19  must be received by September 30 of each year for distribution 
568.20  in January of the following year.  An application for funds must 
568.21  include the following: 
568.22     (1) the official name and address of the sponsoring 
568.23  institution and the official name and address of the facility or 
568.24  programs on whose behalf the institution is applying for 
568.25  funding; 
568.26     (2) the name, title, and business address of those persons 
568.27  responsible for administering the funds; 
568.28     (3) for each accredited medical education program for which 
568.29  funds are being sought the type and specialty orientation of 
568.30  trainees in the program, the name, address, and medical 
568.31  assistance provider number of each training site used in the 
568.32  program, the total number of trainees at each site, and the 
568.33  total number of eligible trainees at each training site; 
568.34     (4) audited clinical training costs per trainee for each 
568.35  medical education program where available or estimates of 
568.36  clinical training costs based on audited financial data; 
569.1      (5) a description of current sources of funding for medical 
569.2   education costs including a description and dollar amount of all 
569.3   state and federal financial support, including Medicare direct 
569.4   and indirect payments; 
569.5      (6) other revenue received for the purposes of clinical 
569.6   training; and 
569.7      (7) other supporting information the commissioner, with 
569.8   advice from the advisory committee, determines is necessary for 
569.9   the equitable distribution of funds. 
569.10     (d) (b) The commissioner shall distribute medical education 
569.11  funds to all qualifying applicants based on the following basic 
569.12  criteria:  (1) total medical education funds available; (2) 
569.13  total eligible trainees in each eligible education program; and 
569.14  (3) the statewide average cost per trainee, by type of trainee, 
569.15  in each medical education program; (4) the degree to which the 
569.16  applicant's training programs are funded with patient care 
569.17  revenues; (5) the degree to which the training of eligible 
569.18  trainees takes place in patient care settings that face 
569.19  increased financial pressure as a result of competition with 
569.20  nonteaching patient care entities; and (6) whether the eligible 
569.21  education program emphasizes primary care or specialties that 
569.22  are in undersupply in Minnesota.  Funds distributed shall not be 
569.23  used to displace current funding appropriations from federal or 
569.24  state sources.  Funds shall be distributed to the sponsoring 
569.25  institutions indicating the amount to be paid to each of the 
569.26  sponsor's medical education programs based on the criteria in 
569.27  this paragraph.  Sponsoring institutions which receive funds 
569.28  from the trust fund must distribute approved funds to the 
569.29  medical education program according to the commissioner's 
569.30  approval letter.  Further, programs must distribute funds among 
569.31  the sites of training as specified in the commissioner's 
569.32  approval letter.  Any funds not distributed as directed by the 
569.33  commissioner's approval letter shall be returned to the medical 
569.34  education and research trust fund within 30 days of a notice 
569.35  from the commissioner.  The commissioner shall distribute 
569.36  returned funds to the appropriate entities in accordance with 
570.1   the commissioner's approval letter. 
570.2      (e) (c) Medical education programs receiving funds from the 
570.3   trust fund must submit a medical education and research grant 
570.4   verification report (GVR) through the sponsoring institution 
570.5   based on criteria established by the commissioner.  If the 
570.6   sponsoring institution fails to submit the GVR by the stated 
570.7   deadline, or to request and meet the deadline for an extension, 
570.8   the sponsoring institution is required to return the full amount 
570.9   of the medical education and research trust fund grant to the 
570.10  medical education and research trust fund within 30 days of a 
570.11  notice from the commissioner.  The commissioner shall distribute 
570.12  returned funds to the appropriate entities in accordance with 
570.13  the commissioner's approval letter.  The reports must include:  
570.14     (1) the total number of eligible trainees in the program; 
570.15     (2) the programs and residencies funded, the amounts of 
570.16  trust fund payments to each program, and within each program, 
570.17  the dollar amount distributed to each training site; and 
570.18     (3) other information the commissioner, with advice from 
570.19  the advisory committee, deems appropriate to evaluate the 
570.20  effectiveness of the use of funds for clinical training.  
570.21     The commissioner, with advice from the advisory committee, 
570.22  will provide an annual summary report to the legislature on 
570.23  program implementation due February 15 of each year. 
570.24     (f) (d) The commissioner is authorized to distribute funds 
570.25  made available through: 
570.26     (1) voluntary contributions by employers or other entities; 
570.27     (2) allocations for the department of human services to 
570.28  support medical education and research; and 
570.29     (3) other sources as identified and deemed appropriate by 
570.30  the legislature for inclusion in the trust fund. 
570.31     (g) The advisory committee shall continue to study and make 
570.32  recommendations on:  
570.33     (1) the funding of medical research consistent with work 
570.34  currently mandated by the legislature and under way at the 
570.35  department of health; and 
570.36     (2) the costs and benefits associated with medical 
571.1   education and research. 
571.2      Subd. 3.  [MEDICAL ASSISTANCE AND GENERAL ASSISTANCE 
571.3   SERVICE.] The commissioner of health, in consultation with the 
571.4   medical education and research costs advisory committee, shall 
571.5   develop a system to recognize those teaching programs which 
571.6   serve higher numbers or high proportions of public program 
571.7   recipients and shall report to the legislative commission on 
571.8   health care access by January 15, 1998, on an allocation formula 
571.9   to implement this system. 
571.10     Subd. 4.  [TRANSFERS FROM THE COMMISSIONER OF HUMAN 
571.11  SERVICES.] (a) The amount transferred according to section 
571.12  256B.69, subdivision 5c, shall be distributed by the 
571.13  commissioner to qualifying applicants based on a distribution 
571.14  formula that reflects a summation of two factors: 
571.15     (1) an education factor, which is determined by the total 
571.16  number of eligible trainees and the total statewide average 
571.17  costs per trainee, by type of trainee, in each program; and 
571.18     (2) a public program volume factor, which is determined by 
571.19  the total volume of public program revenue received by each 
571.20  training site as a percentage of all public program revenue 
571.21  received by all training sites in the trust fund pool.  
571.22     In this formula, the education factor shall be weighted at 
571.23  50 percent and the public program volume factor shall be 
571.24  weighted at 50 percent. 
571.25     (b) Public program revenue for the formula in paragraph (a) 
571.26  shall include revenue from medical assistance, prepaid medical 
571.27  assistance, general assistance medical care, and prepaid general 
571.28  assistance medical care. 
571.29     (c) Training sites that receive no public program revenue 
571.30  shall be ineligible for payments from the prepaid medical 
571.31  assistance program transfer pool. 
571.32     Subd. 5.  [REVIEW OF ELIGIBLE PROVIDERS.] (a) Provider 
571.33  groups added after January 1, 1998, to the list of providers 
571.34  eligible for the trust fund shall not receive funding from the 
571.35  trust fund without prior evaluation by the commissioner and the 
571.36  medical education and research costs advisory committee.  The 
572.1   evaluation shall consider the degree to which the training of 
572.2   the provider group: 
572.3      (1) takes place in patient care settings, which are 
572.4   consistent with the purposes of this section; 
572.5      (2) is funded with patient care revenues; 
572.6      (3) takes place in patient care settings, which face 
572.7   increased financial pressure as a result of competition with 
572.8   nonteaching patient care entities; and 
572.9      (4) emphasizes primary care or specialties, which are in 
572.10  undersupply in Minnesota. 
572.11     Results of this evaluation shall be reported to the 
572.12  legislative commission on health care access.  The legislative 
572.13  commission on health care access must approve funding for the 
572.14  provider group prior to their receiving any funding from the 
572.15  trust fund.  In the event that a reviewed provider group is not 
572.16  approved by the legislative commission on health care access, 
572.17  trainees in that provider group shall be considered ineligible 
572.18  trainees for the trust fund distribution. 
572.19     (b) The commissioner and the medical education and research 
572.20  costs advisory committee may also review the eligible list of 
572.21  provider groups, which were added to the eligible list of 
572.22  provider groups prior to January 1, 1998, to assure that the 
572.23  trust fund money continues to be is distributed consistent with 
572.24  the purpose of this section. The results of any such reviews 
572.25  must be reported to the legislative commission on health care 
572.26  access.  Trainees in provider groups, which were added prior to 
572.27  January 1, 1998, and which are reviewed by the commissioner and 
572.28  the medical education and research costs advisory committee, 
572.29  shall be considered eligible trainees for purposes of the trust 
572.30  fund distribution unless and until the legislative commission on 
572.31  health care access disapproves their eligibility, in which case 
572.32  they shall be considered ineligible trainees. 
572.33     (<i>Effective Date:  Section 2 (62J.69) is effective the day</i> 
572.34  <i>following final enactment.</i>) 
572.35     Sec. 3.  [62J.691] [MEDICAL EDUCATION AND RESEARCH 
572.36  ENDOWMENT FUND.] 
573.1      Subdivision 1.  [CREATION.] The medical education and 
573.2   research endowment fund is created as an account in the state 
573.3   treasury.  The commissioner of finance shall credit to the fund 
573.4   20.25 percent of the tobacco settlement payments received by the 
573.5   state on January 3, 2000, January 2, 2001, January 2, 2002, and 
573.6   January 2, 2003, as a result of the settlement of the lawsuit 
573.7   styled as State v. Philip Morris Inc., No. C1-94-8565 (Minnesota 
573.8   District Court, Second Judicial District).  The state board of 
573.9   investment shall invest the fund under section 11A.24.  All 
573.10  earnings of the fund must be credited to the fund.  The 
573.11  principal of the fund must be maintained inviolate.  
573.12     Subd. 2.  [ENDOWMENT FUND EXPENDITURES.] (a) Earnings of 
573.13  the fund, up to five percent of the fair market value of the 
573.14  fund on the preceding July 1, shall be spent for medical 
573.15  education and research activities in the state of Minnesota.  
573.16     (b) Beginning July 1, 2000, and on July 1 of each year 
573.17  thereafter, 50 percent of the amount in paragraph (a) is 
573.18  appropriated from the fund to the commissioner of health to be 
573.19  distributed for medical education under section 62J.69.  
573.20     (c) Beginning July 1, 2000, and July 1 of each year 
573.21  thereafter, 25 percent of the amount in paragraph (a) is 
573.22  appropriated from the fund to the commissioner of health to be 
573.23  distributed for medical research according to the 
573.24  recommendations submitted under section 62J.692.  
573.25     (d) Beginning July 1, 2000, and on July 1 of each year 
573.26  thereafter, 25 percent of the amount in paragraph (a) may be 
573.27  appropriated by another law for the instructional costs of 
573.28  health professional programs at publicly funded academic health 
573.29  centers.  
573.30     Subd. 3.  [AUDITS REQUIRED.] The legislative auditor shall 
573.31  audit endowment fund expenditures to ensure that the money is 
573.32  spent for the purposes set out in this section. 
573.33     Subd. 4.  [SUNSET.] The medical education and research 
573.34  endowment fund expires June 30, 2015.  Upon expiration, the 
573.35  commissioner of finance shall transfer the principal and any 
573.36  remaining interest to the general fund. 
574.1      (<i>Effective Date:  Section 3 (62J.691) is effective the day</i> 
574.2   <i>following final enactment.</i>) 
574.3      Sec. 4.  [62J.692] [MEDICAL RESEARCH.] 
574.4      The commissioner of health, in consultation with the 
574.5   medical education and research costs advisory committee, shall 
574.6   make recommendations for a process for the submission, review, 
574.7   and approval of research grant applications.  The process shall 
574.8   give priority for grants to applications that are intended to 
574.9   gather preliminary data for submission for a subsequent proposal 
574.10  for funding from a federal agency or foundation, which awards 
574.11  research money on a competitive, peer-reviewed basis.  Grant 
574.12  recipients must be able to demonstrate the ability to comply 
574.13  with federal regulations on human subjects research in 
574.14  accordance with Code of Federal Regulations, title 45, section 
574.15  46, and shall conduct the proposed research.  Grants may be 
574.16  awarded to the University of Minnesota, the Mayo clinic, or any 
574.17  other public or private organization in the state involved in 
574.18  medical research.  The commissioner shall report to the 
574.19  legislature by January 15, 2000, with recommendations. 
574.20     (<i>Effective Date:  Section 4 (62J.692) is effective the day</i> 
574.21  <i>following final enactment.</i>) 
574.22     Sec. 5.  [62J.82] [HEALTH CARE FUND.] 
574.23     The health care fund is created as an account in the state 
574.24  treasury.  The commissioner of finance shall credit to the fund 
574.25  $38,000,000 of each tobacco settlement payment received by the 
574.26  state in the month of December, beginning December 2003, as a 
574.27  result of the settlement of the lawsuit styled as State v. 
574.28  Philip Morris Inc., No. C1-94-8565 (Minnesota District Court, 
574.29  Second Judicial District).  The state board of investment shall 
574.30  invest the fund under section 11A.24.  All earnings of the fund 
574.31  must be credited to the fund. 
574.32     (<i>Effective Date:  Section 5 (62J.82) is effective the day</i> 
574.33  <i>following final enactment.</i>) 
574.34     Sec. 6.  [137.44] [HEALTH PROFESSIONAL EDUCATION BUDGET 
574.35  PLAN.] 
574.36     The board of regents is requested to adopt a biennial 
575.1   budget plan for making expenditures from the medical education 
575.2   and research endowment fund dedicated for the instructional 
575.3   costs of health professional programs at publicly funded 
575.4   academic health centers.  The budget plan may be submitted as 
575.5   part of the University of Minnesota's biennial budget request. 
575.6      (<i>Effective Date:  Section 6 (137.44) is effective the day</i> 
575.7   <i>following final enactment.</i>) 
575.8      Sec. 7.  [144.395] [TOBACCO PREVENTION ENDOWMENT FUND.] 
575.9      Subdivision 1.  [CREATION.] The tobacco prevention 
575.10  endowment fund is created as an account in the state treasury.  
575.11  The commissioner of finance shall credit to the fund 50 percent 
575.12  of the tobacco settlement payments received by the state on 
575.13  January 3, 2000, January 2, 2001, January 2, 2002, and January 
575.14  2, 2003, as a result of the settlement of the lawsuit styled as 
575.15  State v. Philip Morris Inc., No. C1-94-8565 (Minnesota District 
575.16  Court, Second Judicial District).  The state board of investment 
575.17  shall invest the fund under section 11A.24.  All earnings of the 
575.18  fund must be credited to the fund.  The principal of the fund 
575.19  must be maintained inviolate.  
575.20     Subd. 2.  [ENDOWMENT FUND EXPENDITURES.] (a) Earnings from 
575.21  the fund shall be spent to reduce the human and economic 
575.22  consequences of tobacco use through tobacco prevention 
575.23  measures.  Beginning July 1, 2000, and on July 1 of each year 
575.24  thereafter, earnings from the fund, up to five percent of the 
575.25  fair market value of the fund on the preceding July 1 and up to 
575.26  a prorated five percent of deposits received during the 
575.27  preceding year, are appropriated from the fund to the 
575.28  commissioner of health, who shall pay that amount to the 
575.29  Minnesota partnership for action against tobacco.  
575.30     (b) Minnesota partnership for action against tobacco shall 
575.31  use the amounts received for tobacco use prevention measures, 
575.32  except that a maximum of $200,000 of the first year's 
575.33  appropriation and $300,000 of each annual appropriation 
575.34  thereafter may be used for staffing and other expenses related 
575.35  to this section.  Members of the board of directors of the 
575.36  partnership, and members of any advisory committees appointed by 
576.1   the board to make recommendations for implementing tobacco use 
576.2   prevention efforts, may be reimbursed for reasonable expenses 
576.3   actually incurred in connection with activities related to 
576.4   carrying out this section, but not for expenses reimbursed from 
576.5   any other source.  
576.6      (c) The Minnesota partnership for action against tobacco 
576.7   shall not award any grants from the annual appropriations 
576.8   received under this subdivision to any project in which a 
576.9   partnership board member or staff member has a substantial 
576.10  financial interest. 
576.11     Subd. 3.  [AUDITS REQUIRED.] The legislative auditor shall 
576.12  audit endowment fund expenditures to ensure that the money is 
576.13  spent for tobacco prevention measures.  
576.14     Subd. 4.  [REPORT.] (a) The Minnesota partnership for 
576.15  action against tobacco must submit an annual report to the 
576.16  legislature by January 15 of each year, beginning in 2001, on 
576.17  prevention measures and initiatives undertaken during the 
576.18  preceding year.  The report must include: 
576.19     (1) an accounting of expenses, detailing the amounts and 
576.20  purposes for which money was spent; 
576.21     (2) a list of grant awards; 
576.22     (3) a report on the results of the tobacco prevention 
576.23  measures; 
576.24     (4) a copy of the legislative auditor's report; and 
576.25     (5) how the statewide prevention efforts have been 
576.26  coordinated and delivered through local public health agencies. 
576.27     (b) The initial report submitted under this subdivision 
576.28  must include a copy of the partnership's bylaws and tobacco 
576.29  prevention policies or plans adopted by the board of directors. 
576.30     Subd. 5.  [SUNSET.] The tobacco prevention endowment fund 
576.31  expires on June 30, 2010.  Upon expiration, the commissioner of 
576.32  finance shall transfer the principal and any remaining interest 
576.33  to the general fund. 
576.34     (<i>Effective Date:  Section 7 (144.395) is effective the day</i> 
576.35  <i>following final enactment.</i>) 
576.36     Sec. 8.  [256.956] [SENIOR PRESCRIPTION DRUG ENDOWMENT 
577.1   FUND.] 
577.2      Subdivision 1.  [CREATION.] The senior prescription drug 
577.3   endowment fund is created as an account in the state treasury.  
577.4   The commissioner of finance shall credit to the fund 6.75 
577.5   percent of the tobacco settlement payments received by the state 
577.6   on January 3, 2000, January 2, 2001, January 2, 2002, and 
577.7   January 2, 2003, as a result of the settlement of the lawsuit 
577.8   styled as State v. Philip Morris Inc., No. C1-94-8565 (Minnesota 
577.9   District Court, Second Judicial District).  The state board of 
577.10  investment shall invest the fund under section 11A.24.  All 
577.11  earnings of the fund must be credited to the fund.  
577.12     Subd. 2.  [EXPENDITURES.] (a) As part of each biennial and 
577.13  supplemental budget, the commissioner of finance shall forecast 
577.14  the cost of providing coverage to the enrollees of the senior 
577.15  citizen drug program under section 256.955 whose income is 
577.16  between 120 percent and 200 percent of the federal poverty 
577.17  guidelines and for the disabled.  The commissioner of finance 
577.18  shall recognize the projected costs of the program in the fund 
577.19  balance. 
577.20     (b) Beginning July 1, 2000, and on July 1 of each year 
577.21  thereafter, a sum equal to the projected costs as determined in 
577.22  paragraph (a) for the following fiscal year is appropriated from 
577.23  the fund to the commissioner of human services to be used for 
577.24  the senior citizen drug program. 
577.25     (<i>Effective Date:  Section 8 (256.956) is effective the day</i> 
577.26  <i>following final enactment.</i>) 
577.27     Sec. 9.  [APPROPRIATIONS.] 
577.28     (a) $93,312,000 is appropriated from the general fund to 
577.29  the commissioner of finance for transfer to the medical 
577.30  education and research endowment fund in the fiscal year ending 
577.31  June 30, 1999. 
577.32     (b) $105,984,000 is appropriated from the general fund to 
577.33  the commissioner of finance for payment to the Minnesota 
577.34  families foundation in the fiscal year ending June 30, 1999. 
577.35     (c) $230,400,000 is appropriated from the general fund to 
577.36  the commissioner of finance for transfer to the tobacco 
578.1   prevention endowment fund in the fiscal year ending June 30, 
578.2   1999. 
578.3      (d) $31,104,000 is appropriated from the general fund to 
578.4   the commissioner of finance for transfer to the senior 
578.5   prescription drug endowment fund in the fiscal year ending June 
578.6   30, 1999. 
578.7      (e) Of the tobacco settlement payments received by the 
578.8   state on January 3, 2000, January 2, 2001, January 2, 2002, and 
578.9   January 2, 2003, as a result of the settlement of the lawsuit 
578.10  styled as State v. Philip Morris Inc., No. C1-94-8565 (Minnesota 
578.11  District Court, Second Judicial District), 23 percent is 
578.12  appropriated to the commissioner of finance for payment to the 
578.13  Minnesota families foundation. 
578.14     Sec. 10.  [EFFECTIVE DATE.] 
578.15     When preparing the conference committee report for adoption 
578.16  by the legislature, the revisor shall combine all effective date 
578.17  notations in this article into this effective date section. 
578.18                             ARTICLE 11 
578.19                           MISCELLANEOUS 
578.20     Section 1.  Minnesota Statutes 1998, section 62E.11, is 
578.21  amended by adding a subdivision to read: 
578.22     Subd. 13.  [STATE FUNDING; EFFECT ON PREMIUM RATES OF 
578.23  MEMBERS.] In approving the premium rates as required in sections 
578.24  62A.65, subdivision 3; and 62L.08, subdivision 8, the 
578.25  commissioners of health and commerce shall ensure that any 
578.26  appropriation to reduce the annual assessment made on the 
578.27  contributing members to cover the costs of the Minnesota 
578.28  comprehensive health insurance plan as required under this 
578.29  section is reflected in the premium rates charged by each 
578.30  contributing member. 
578.31     Sec. 2.  Minnesota Statutes 1998, section 116L.02, is 
578.32  amended to read: 
578.33     116L.02 [JOB SKILLS PARTNERSHIP PROGRAM.] 
578.34     (a) The Minnesota job skills partnership program is created 
578.35  to act as a catalyst to bring together employers with specific 
578.36  training needs with educational or other nonprofit institutions 
579.1   which can design programs to fill those needs.  The partnership 
579.2   shall work closely with employers to train and place workers in 
579.3   identifiable positions as well as assisting educational or other 
579.4   nonprofit institutions in developing training programs that 
579.5   coincide with current and future employer requirements.  The 
579.6   partnership shall provide grants to educational or other 
579.7   nonprofit institutions for the purpose of training displaced 
579.8   workers.  A participating business must match the grant-in-aid 
579.9   made by the Minnesota job skills partnership.  The match may be 
579.10  in the form of funding, equipment, or faculty. 
579.11     (b) The partnership program shall administer the health 
579.12  care and human services worker training and retention program 
579.13  under sections 116L.10 to 116L.15. 
579.14     Sec. 3.  [116L.10] [PROGRAM ESTABLISHED.] 
579.15     A health care and human services worker training and 
579.16  retention program is established to: 
579.17     (1) alleviate critical worker shortages confronting 
579.18  specific geographical areas of the state, specific health care 
579.19  and human services industries, or specific providers when 
579.20  employers are not currently offering sufficient worker training 
579.21  and retention options and are unable to do so because of the 
579.22  limited size of the employer, economic circumstances, or other 
579.23  limiting factors described in the grant application and verified 
579.24  by the board; and 
579.25     (2) increase opportunities for current and potential direct 
579.26  care employees to qualify for advanced employment in the health 
579.27  care or human services fields through experience, training, and 
579.28  education. 
579.29     Sec. 4.  [116L.11] [DEFINITIONS.] 
579.30     Subdivision 1.  [SCOPE.] For the purposes of sections 
579.31  116L.10 to 116L.15, the terms defined in this section have the 
579.32  meanings given them unless the context clearly indicates 
579.33  otherwise. 
579.34     Subd. 2.  [ELIGIBLE EMPLOYER.] "Eligible employer" means a 
579.35  nursing facility, small rural hospital, intermediate care 
579.36  facility for persons with mental retardation or related 
580.1   conditions, waivered services provider, home health services 
580.2   provider, personal care assistant services provider, 
580.3   semi-independent living services provider, day training and 
580.4   habilitation services provider, or similar provider of health 
580.5   care or human services. 
580.6      Subd. 3.  [POTENTIAL EMPLOYEE TARGET GROUPS.] "Potential 
580.7   employee target groups" means high school students, past and 
580.8   present recipients of Minnesota family investment program 
580.9   benefits, immigrants, senior citizens, current health care and 
580.10  human services workers, and persons who are underemployed or 
580.11  unemployed. 
580.12     Subd. 4.  [QUALIFYING CONSORTIUM.] "Qualifying consortium" 
580.13  means an entity that may include a public or private institution 
580.14  of higher education, work force center, county, and one or more 
580.15  eligible employers, but must include a public or private 
580.16  institution of higher education and one or more eligible 
580.17  employers. 
580.18     Sec. 5.  [116L.12] [FUNDING MECHANISM.] 
580.19     Subdivision 1.  [APPLICATIONS.] A qualifying consortium 
580.20  shall apply to the board in the manner specified by the board. 
580.21     Subd. 2.  [FISCAL REQUIREMENTS.] The application must 
580.22  specify how the consortium will make maximum use of available 
580.23  federal and state training, education, and employment funds to 
580.24  minimize the need for training and retention grants.  A 
580.25  consortium must designate a lead agency as the fiscal agent for 
580.26  reporting, claiming, and receiving payments.  An institution of 
580.27  higher learning may be designated as a lead agency, but the 
580.28  governing board of a multicampus higher education system may not 
580.29  be given that designation. 
580.30     Subd. 3.  [PROGRAM TARGETS.] Applications for grants must 
580.31  describe targeted employers or types of employers and must 
580.32  describe the specific critical work force shortage the program 
580.33  is designed to alleviate.  Programs may be limited 
580.34  geographically or be statewide.  The application must include 
580.35  verification that in the process of determining that a critical 
580.36  work force shortage exists in the target area, the applicant has:
581.1      (1) consulted available data on worker shortages; 
581.2      (2) conferred with other employers in the target area; and 
581.3      (3) compared shortages in the target area with shortages at 
581.4   the regional or statewide level. 
581.5      Subd. 4.  [GRANTS.] Within the limits of available 
581.6   appropriations, the board shall make grants to qualifying 
581.7   consortia to operate local, regional, or statewide training and 
581.8   retention programs.  Grant awards must establish specific, 
581.9   measurable outcomes and timelines for achieving those outcomes. 
581.10     Subd. 5.  [LOCAL MATCH REQUIREMENTS.] A consortium must 
581.11  provide at least a 50 percent match from local resources for 
581.12  money appropriated under this section.  The local match 
581.13  requirement may be reduced for consortia that include a 
581.14  relatively large number of small employers whose financial 
581.15  contribution has been reduced in accordance with section 116L.15.
581.16  In-kind services and expenditures under section 116L.13, 
581.17  subdivision 2, may be used to meet this local match 
581.18  requirement.  The grant application must specify the financial 
581.19  contribution from each member of the consortium. 
581.20     Subd. 6.  [INELIGIBLE WORKER CATEGORIES.] Grants shall not 
581.21  be made to alleviate shortages of physicians, physician 
581.22  assistants, or advanced practice nurses. 
581.23     Subd. 7.  [EVALUATION.] The board shall evaluate the 
581.24  success of consortia that receive grants in achieving expected 
581.25  outcomes and shall report to the legislature annually.  The 
581.26  report must compare consortia in terms of overall program costs, 
581.27  costs per client, retention rates, advancement rates, and other 
581.28  outcome measurements established in the grantmaking process.  
581.29  The first report shall be due on March 15, 2000, and on January 
581.30  15 annually in succeeding years.  The report shall include any 
581.31  recommendations from the board to modify the grant program. 
581.32     Sec. 6.  [116L.13] [PROGRAM REQUIREMENTS.] 
581.33     Subdivision 1.  [MARKETING AND RECRUITMENT.] A qualifying 
581.34  consortium must implement a marketing and outreach strategy to 
581.35  recruit into the health care and human services fields persons 
581.36  from one or more of the potential employee target groups.  
582.1   Recruitment strategies must include a screening process to 
582.2   evaluate whether potential employees may be disqualified as the 
582.3   result of a required background check or are otherwise unlikely 
582.4   to succeed in the position for which they are being recruited. 
582.5      Subd. 2.  [RECRUITMENT AND RETENTION INCENTIVES.] Employer 
582.6   members of a consortium must provide incentives to train and 
582.7   retain employees.  These incentives may include, but are not 
582.8   limited to: 
582.9      (1) paid salary during initial training periods, but only 
582.10  if specifically approved by the board, which must certify that 
582.11  the employer has not formerly paid employees during the initial 
582.12  training period and is unable to do so because of the employer's 
582.13  limited size, financial condition, or other factors; 
582.14     (2) scholarship programs under which a specified amount is 
582.15  deposited into an educational account for the employee for each 
582.16  hour worked, which may include contributions on behalf of an 
582.17  employee to an Edvest account under Minnesota Statutes, sections 
582.18  136A.241 to 136A.245; 
582.19     (3) the provision of advanced education to employees so 
582.20  that they may qualify for advanced positions in the health care 
582.21  or human services fields.  This education may be provided at the 
582.22  employer's site, at the site of a nearby employer, or at a local 
582.23  educational institution or other site.  Preference shall be 
582.24  given to grantees that offer flexible advanced training to 
582.25  employees at convenient sites, allow workers time off with pay 
582.26  during the work day to participate, and provide education at no 
582.27  cost to students or through employer-based scholarships that pay 
582.28  expenses prior to the start of classes rather than upon 
582.29  completion; 
582.30     (4) work maturity or soft skills training, adult basic 
582.31  education, English as a second language instruction, and basic 
582.32  computer orientation for persons with limited previous 
582.33  attachment to the work force due to a lack of these skills; 
582.34     (5) child care subsidies during training or educational 
582.35  activities; 
582.36     (6) transportation to training and education programs; and 
583.1      (7) programs to coordinate efforts by employer members of 
583.2   the consortium to share staff among employers where feasible, to 
583.3   pool employee and employer benefit contributions in order to 
583.4   enhance benefit packages, and to coordinate education and 
583.5   training opportunities for staff in order to increase the 
583.6   availability and flexibility of education and training programs. 
583.7      Subd. 3.  [WORK HOUR LIMITS.] High school students 
583.8   participating in a training and retention program shall not be 
583.9   permitted to work more than 20 hours per week when school is in 
583.10  session. 
583.11     Sec. 7.  [116L.14] [CAREER ENHANCEMENT REQUIREMENTS.] 
583.12     All consortium members must work cooperatively to establish 
583.13  and maintain a career ladder program under which direct care 
583.14  staff have the opportunity to advance along a career development 
583.15  path that includes regular educational opportunities, 
583.16  coordination between job duties and educational opportunities, 
583.17  and a planned series of promotions for which qualified employees 
583.18  will be eligible. 
583.19     Sec. 8.  [116L.15] [SMALL EMPLOYER PROTECTION.] 
583.20     Grantees must guarantee that small employers, including 
583.21  licensed personal care assistant organizations, be allowed to 
583.22  participate in consortium programs.  The financial contribution 
583.23  required from a small employer must be adjusted to reflect the 
583.24  employer's financial circumstances. 
583.25     Sec. 9.  [REPEALER.] 
583.26     Laws 1997, chapter 225, article 6, section 8, is repealed. 
583.27     Sec. 10.  [EFFECTIVE DATE.] 
583.28     Section 9 is effective the day following final enactment.