1.1                          A bill for an act 
  1.2             relating to human services; modifying provisions in 
  1.3             health care programs; requiring a study of group 
  1.4             residential housing; clarifying medical assistance 
  1.5             coverage for employed persons with disabilities; 
  1.6             amending Minnesota Statutes 1999 Supplement, sections 
  1.7             256B.057, subdivision 9; 256B.0945, subdivisions 1, 2, 
  1.8             4, 5, 6, 7, 8, and 9; 256D.03, subdivision 3; and 
  1.9             256L.03, subdivision 5; Laws 1999, chapter 245, 
  1.10            article 8, section 84; repealing Laws 1998, chapter 
  1.11            407, article 5, section 44. 
  1.12  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.13     Section 1.  Minnesota Statutes 1999 Supplement, section 
  1.14  256B.057, subdivision 9, is amended to read: 
  1.15     Subd. 9.  [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 
  1.16  assistance may be paid for a person who is employed and who: 
  1.17     (1) meets the definition of disabled under the supplemental 
  1.18  security income program; 
  1.19     (2) is at least 16 but less than 65 years of age; 
  1.20     (3) meets the asset limits in paragraph (b); and 
  1.21     (3) (4) pays a premium, if required, under paragraph (c).  
  1.22  Any spousal income or assets shall be disregarded for purposes 
  1.23  of eligibility and premium determinations. 
  1.24     (b) For purposes of determining eligibility under this 
  1.25  subdivision, a person's assets must not exceed $20,000, 
  1.26  excluding: 
  1.27     (1) all assets excluded under section 256B.056; 
  1.28     (2) retirement accounts, including individual accounts, 
  2.1   401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 
  2.2      (3) medical expense accounts set up through the person's 
  2.3   employer. 
  2.4      (c) A person whose earned and unearned income is greater 
  2.5   than 200 percent of federal poverty guidelines for the 
  2.6   applicable family size must pay a premium to be eligible for 
  2.7   medical assistance.  The premium shall be equal to ten percent 
  2.8   of the person's gross earned and unearned income above 200 
  2.9   percent of federal poverty guidelines for the applicable family 
  2.10  size up to the cost of coverage. 
  2.11     (d) A person's eligibility and premium shall be determined 
  2.12  by the local county agency.  Premiums must be paid to the 
  2.13  commissioner.  All premiums are dedicated to the commissioner. 
  2.14     (e) Any required premium shall be determined at application 
  2.15  and redetermined annually at recertification or when a change in 
  2.16  income of or family size occurs. 
  2.17     (f) Premium payment is due upon notification from the 
  2.18  commissioner of the premium amount required.  Premiums may be 
  2.19  paid in installments at the discretion of the commissioner. 
  2.20     (g) Nonpayment of the premium shall result in denial or 
  2.21  termination of medical assistance unless the person demonstrates 
  2.22  good cause for nonpayment.  Good cause exists if the 
  2.23  requirements specified in Minnesota Rules, part 9506.0040, 
  2.24  subpart 7, items B to D, are met.  Nonpayment shall include 
  2.25  payment with a returned, refused, or dishonored instrument.  The 
  2.26  commissioner may require a guaranteed form of payment as the 
  2.27  only means to replace a returned, refused, or dishonored 
  2.28  instrument. 
  2.29     Sec. 2.  Minnesota Statutes 1999 Supplement, section 
  2.30  256B.0945, subdivision 1, is amended to read: 
  2.31     Subdivision 1.  [PROVIDER QUALIFICATIONS.] Counties must 
  2.32  arrange to provide residential services for children with severe 
  2.33  emotional disturbance according to section sections 245.4882, 
  2.34  245.4885, and this section.  Services must be provided by a 
  2.35  facility that is licensed according to section 245.4882 and 
  2.36  administrative rules promulgated thereunder, and under contract 
  3.1   with the county. Facilities providing services under subdivision 
  3.2   2, paragraph (a), must be accredited as a psychiatric facility 
  3.3   by the Joint Commission on Accreditation of Healthcare 
  3.4   Organizations, the Commission on Accreditation of Rehabilitation 
  3.5   Facilities, or the Council on Accreditation.  Accreditation is 
  3.6   not required for facilities providing services under subdivision 
  3.7   2, paragraph (b). 
  3.8      Sec. 3.  Minnesota Statutes 1999 Supplement, section 
  3.9   256B.0945, subdivision 2, is amended to read: 
  3.10     Subd. 2.  [COVERED SERVICES.] All services must be included 
  3.11  in a child's individualized treatment or collaborative family 
  3.12  service multiagency plan of care as defined in chapter 245.  
  3.13     (a) For facilities that are institutions for mental 
  3.14  diseases according to statute and regulation or are not 
  3.15  institutions for mental diseases but choose are approved by the 
  3.16  commissioner to provide services under this paragraph, medical 
  3.17  assistance covers the full contract rate, including room and 
  3.18  board if the services meet the requirements of Code of Federal 
  3.19  Regulations, title 42, section 440.160.  
  3.20     (b) For facilities that are not institutions for mental 
  3.21  diseases according to federal statute and regulation and are not 
  3.22  providing services under paragraph (a), medical assistance 
  3.23  covers mental health related services that are required to be 
  3.24  provided by a residential facility under section 245.4882 and 
  3.25  administrative rules promulgated thereunder, except for room and 
  3.26  board. 
  3.27     Sec. 4.  Minnesota Statutes 1999 Supplement, section 
  3.28  256B.0945, subdivision 4, is amended to read: 
  3.29     Subd. 4.  [PAYMENT RATES.] (a) Notwithstanding sections 
  3.30  256.025, subdivision 2; 256B.19; and 256B.041, payments to 
  3.31  counties for residential services provided by a residential 
  3.32  facility shall only be made of federal earnings for services 
  3.33  provided under this section, and the nonfederal share of costs 
  3.34  for services provided under this section shall be paid by the 
  3.35  county from sources other than federal funds or funds used to 
  3.36  match other federal funds.  Total annual payments for federal 
  4.1   earnings shall not exceed the federal medical assistance 
  4.2   percentage matching rate multiplied by the total county 
  4.3   expenditures for services provided under section 245.4882 for 
  4.4   either (1) the calendar year 1999 or (2) the average annual 
  4.5   expenditures for the calendar years 1995 to 1999, whichever is 
  4.6   greater.  Payment to counties for services provided according to 
  4.7   subdivision 2, paragraph (a), shall be the federal share of the 
  4.8   contract rate.  Payment to counties for services provided 
  4.9   according to subdivision 2, paragraph (b), shall be a proportion 
  4.10  of the per day contract rate that relates to rehabilitative 
  4.11  mental health services and shall not include payment for costs 
  4.12  or services that are billed to the IV-E program as room and 
  4.13  board.  
  4.14     (b) Annual earnings that exceed a county's limit as 
  4.15  established under paragraph (a) shall be retained by the 
  4.16  commissioner and managed as grants for community-based 
  4.17  children's mental health services under section 245.4886.  The 
  4.18  commissioner may target these grant funds as necessary to reduce 
  4.19  reliance on residential treatment of children with severe 
  4.20  emotional disturbance. 
  4.21     (c) (b) The commissioner shall set aside a portion not to 
  4.22  exceed five percent of the federal funds earned under this 
  4.23  section to cover the state costs of two staff positions and 
  4.24  support costs necessary in administering this section.  Any 
  4.25  unexpended funds from the set-aside shall be distributed to the 
  4.26  counties in proportion to their earnings under this section. 
  4.27     Sec. 5.  Minnesota Statutes 1999 Supplement, section 
  4.28  256B.0945, subdivision 5, is amended to read: 
  4.29     Subd. 5.  [QUALITY MEASURES.] Counties must collect and 
  4.30  report to the commissioner information on outcomes for services 
  4.31  provided under this section using standardized tools that 
  4.32  measure the impact of residential treatment programs on child 
  4.33  functioning and/or behavior, living stability, and parent and 
  4.34  child satisfaction consistent with the goals of sections 
  4.35  245.4876, subdivision 1, and 256F.01.  The commissioner shall 
  4.36  designate standardized tools to be used and shall collect and 
  5.1   analyze individualized outcome data on a statewide basis and 
  5.2   report to the legislature by December 1, 2003.  The commissioner 
  5.3   shall provide standardized tools that measure child and 
  5.4   adolescent functional assessment for intake and discharge, child 
  5.5   behavior, residential living environment and functionality, 
  5.6   placement stability, and satisfaction for youth and family 
  5.7   members. 
  5.8      Sec. 6.  Minnesota Statutes 1999 Supplement, section 
  5.9   256B.0945, subdivision 6, is amended to read: 
  5.10     Subd. 6.  [FEDERAL EARNINGS.] Use of new federal funding 
  5.11  earned from services provided under this section is limited to:  
  5.12     (1) increasing prevention and early intervention and 
  5.13  supportive services to meet the mental health and child welfare 
  5.14  needs of the children and families in the system of care; 
  5.15     (2) replacing reductions in federal IV-E reimbursement 
  5.16  resulting from new medical assistance coverage; and 
  5.17     (3) paying the nonfederal share of additional provider 
  5.18  costs due to accreditation and new program standards necessary 
  5.19  for Medicaid reimbursement; and 
  5.20     (4) paying for the costs of complying with the data 
  5.21  collection and reporting requirements contained in subdivision 5.
  5.22  For purposes of this section, prevention, early intervention, 
  5.23  and supportive services for children and families include 
  5.24  alternative responses to child maltreatment reports under 
  5.25  chapter 626 and nonresidential children's mental health services 
  5.26  outlined in sections section 245.4875, subdivision 2, children's 
  5.27  mental health, and family preservation services outlined in 
  5.28  section 256F.05, subdivision 8, family preservation services.  
  5.29     Sec. 7.  Minnesota Statutes 1999 Supplement, section 
  5.30  256B.0945, subdivision 7, is amended to read: 
  5.31     Subd. 7.  [MAINTENANCE OF EFFORT.] (a) Counties that 
  5.32  receive payment under this section must maintain a level of 
  5.33  expenditures such that each year's county expenditures 
  5.34  for prevention, early intervention, and supportive services for 
  5.35  children and families is at least equal to that county's average 
  5.36  expenditures for those services for calendar years 1998 and 
  6.1   1999.  For purposes of this section, "county expenditures" are 
  6.2   the total expenditures for those services minus the state and 
  6.3   federal revenues specifically designated for these services. 
  6.4      (b) The commissioner may waive the requirements in 
  6.5   paragraph (a) if any of the conditions specified in section 
  6.6   256F.13, subdivision 1, paragraph (a), clause (4), items (i) to 
  6.7   (iv), are met.  
  6.8      Sec. 8.  Minnesota Statutes 1999 Supplement, section 
  6.9   256B.0945, subdivision 8, is amended to read: 
  6.10     Subd. 8.  [REPORTS.] The commissioner shall review county 
  6.11  expenditures annually using reports required under sections 
  6.12  245.482; 256.01, subdivision 2, clause (17); and 256E.08, 
  6.13  subdivision 8, to ensure that counties meet their obligation 
  6.14  under subdivision 7, and that the base level of expenditures for 
  6.15  mental health and child welfare prevention, early intervention, 
  6.16  and family support supportive services for children and families 
  6.17  and children's mental health residential treatment is continued 
  6.18  from sources other than federal funds earned under this section. 
  6.19     Sec. 9.  Minnesota Statutes 1999 Supplement, section 
  6.20  256B.0945, subdivision 9, is amended to read: 
  6.21     Subd. 9.  [SANCTIONS.] The commissioner may suspend, 
  6.22  reduce, or terminate the federal reimbursement funds for 
  6.23  prevention, early intervention, and supportive services for 
  6.24  children and families up to the limit of federal revenue earned 
  6.25  under this section to a county that does not meet one or all of 
  6.26  the requirements of this section.  If the commissioner finds 
  6.27  evidence of children placed in residential treatment who do not 
  6.28  meet the criteria outlined in section 245.4885, subdivision 1, 
  6.29  the commissioner may take action to limit inappropriate 
  6.30  placements in residential treatment. 
  6.31     Sec. 10.  Minnesota Statutes 1999 Supplement, section 
  6.32  256D.03, subdivision 3, is amended to read: 
  6.33     Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
  6.34  (a) General assistance medical care may be paid for any person 
  6.35  who is not eligible for medical assistance under chapter 256B, 
  6.36  including eligibility for medical assistance based on a 
  7.1   spenddown of excess income according to section 256B.056, 
  7.2   subdivision 5, or MinnesotaCare as defined in paragraph (b), 
  7.3   except as provided in paragraph (c); and: 
  7.4      (1) who is receiving assistance under section 256D.05, 
  7.5   except for families with children who are eligible under 
  7.6   Minnesota family investment program-statewide (MFIP-S), who is 
  7.7   having a payment made on the person's behalf under sections 
  7.8   256I.01 to 256I.06, or who resides in group residential housing 
  7.9   as defined in chapter 256I and can meet a spenddown using the 
  7.10  cost of remedial services received through group residential 
  7.11  housing; or 
  7.12     (2)(i) who is a resident of Minnesota; and whose equity in 
  7.13  assets is not in excess of $1,000 per assistance unit.  Exempt 
  7.14  assets, the reduction of excess assets, and the waiver of excess 
  7.15  assets must conform to the medical assistance program in chapter 
  7.16  256B, with the following exception:  the maximum amount of 
  7.17  undistributed funds in a trust that could be distributed to or 
  7.18  on behalf of the beneficiary by the trustee, assuming the full 
  7.19  exercise of the trustee's discretion under the terms of the 
  7.20  trust, must be applied toward the asset maximum; and 
  7.21     (ii) who has countable income not in excess of the 
  7.22  assistance standards established in section 256B.056, 
  7.23  subdivision 4, or whose excess income is spent down according to 
  7.24  section 256B.056, subdivision 5, using a six-month budget 
  7.25  period.  The method for calculating earned income disregards and 
  7.26  deductions for a person who resides with a dependent child under 
  7.27  age 21 shall follow section 256B.056, subdivision 1a.  However, 
  7.28  if a disregard of $30 and one-third of the remainder has been 
  7.29  applied to the wage earner's income, the disregard shall not be 
  7.30  applied again until the wage earner's income has not been 
  7.31  considered in an eligibility determination for general 
  7.32  assistance, general assistance medical care, medical assistance, 
  7.33  or MFIP-S for 12 consecutive months.  The earned income and work 
  7.34  expense deductions for a person who does not reside with a 
  7.35  dependent child under age 21 shall be the same as the method 
  7.36  used to determine eligibility for a person under section 
  8.1   256D.06, subdivision 1, except the disregard of the first $50 of 
  8.2   earned income is not allowed; 
  8.3      (3) who would be eligible for medical assistance except 
  8.4   that the person resides in a facility that is determined by the 
  8.5   commissioner or the federal Health Care Financing Administration 
  8.6   to be an institution for mental diseases; or 
  8.7      (4) who is ineligible for medical assistance under chapter 
  8.8   256B or general assistance medical care under any other 
  8.9   provision of this section, and is receiving care and 
  8.10  rehabilitation services from a nonprofit center established to 
  8.11  serve victims of torture.  These individuals are eligible for 
  8.12  general assistance medical care only for the period during which 
  8.13  they are receiving services from the center.  During this period 
  8.14  of eligibility, individuals eligible under this clause shall not 
  8.15  be required to participate in prepaid general assistance medical 
  8.16  care.  
  8.17     (b) Beginning January 1, 2000, applicants or recipients who 
  8.18  meet all eligibility requirements of MinnesotaCare as defined in 
  8.19  sections 256L.01 to 256L.16, and are: 
  8.20     (i) adults with dependent children under 21 whose gross 
  8.21  family income is equal to or less than 275 percent of the 
  8.22  federal poverty guidelines; or 
  8.23     (ii) adults without children with earned income and whose 
  8.24  family gross income is between 75 percent of the federal poverty 
  8.25  guidelines and the amount set by section 256L.04, subdivision 7, 
  8.26  shall be terminated from general assistance medical care upon 
  8.27  enrollment in MinnesotaCare. 
  8.28     (c) For services rendered on or after July 1, 1997, 
  8.29  eligibility is limited to one month prior to application if the 
  8.30  person is determined eligible in the prior month.  A 
  8.31  redetermination of eligibility must occur every 12 months.  
  8.32  Beginning January 1, 2000, Minnesota health care program 
  8.33  applications completed by recipients and applicants who are 
  8.34  persons described in paragraph (b), may be returned to the 
  8.35  county agency to be forwarded to the department of human 
  8.36  services or sent directly to the department of human services 
  9.1   for enrollment in MinnesotaCare.  If all other eligibility 
  9.2   requirements of this subdivision are met, eligibility for 
  9.3   general assistance medical care shall be available in any month 
  9.4   during which a MinnesotaCare eligibility determination and 
  9.5   enrollment are pending.  Upon notification of eligibility for 
  9.6   MinnesotaCare, notice of termination for eligibility for general 
  9.7   assistance medical care shall be sent to an applicant or 
  9.8   recipient.  If all other eligibility requirements of this 
  9.9   subdivision are met, eligibility for general assistance medical 
  9.10  care shall be available until enrollment in MinnesotaCare 
  9.11  subject to the provisions of paragraph (e). 
  9.12     (d) The date of an initial Minnesota health care program 
  9.13  application necessary to begin a determination of eligibility 
  9.14  shall be the date the applicant has provided a name, address, 
  9.15  and social security number, signed and dated, to the county 
  9.16  agency or the department of human services.  If the applicant is 
  9.17  unable to provide an initial application when health care is 
  9.18  delivered due to a medical condition or disability, a health 
  9.19  care provider may act on the person's behalf to complete the 
  9.20  initial application.  The applicant must complete the remainder 
  9.21  of the application and provide necessary verification before 
  9.22  eligibility can be determined.  The county agency must assist 
  9.23  the applicant in obtaining verification if necessary.  On the 
  9.24  basis of information provided on the completed application, an 
  9.25  applicant who meets the following criteria shall be determined 
  9.26  eligible beginning in the month of application: 
  9.27     (1) has gross income less than 90 percent of the applicable 
  9.28  income standard; 
  9.29     (2) has liquid assets that total within $300 of the asset 
  9.30  standard; 
  9.31     (3) does not reside in a long-term care facility; and 
  9.32     (4) meets all other eligibility requirements. 
  9.33  The applicant must provide all required verifications within 30 
  9.34  days' notice of the eligibility determination or eligibility 
  9.35  shall be terminated. 
  9.36     (e) County agencies are authorized to use all automated 
 10.1   databases containing information regarding recipients' or 
 10.2   applicants' income in order to determine eligibility for general 
 10.3   assistance medical care or MinnesotaCare.  Such use shall be 
 10.4   considered sufficient in order to determine eligibility and 
 10.5   premium payments by the county agency. 
 10.6      (f) General assistance medical care is not available for a 
 10.7   person in a correctional facility unless the person is detained 
 10.8   by law for less than one year in a county correctional or 
 10.9   detention facility as a person accused or convicted of a crime, 
 10.10  or admitted as an inpatient to a hospital on a criminal hold 
 10.11  order, and the person is a recipient of general assistance 
 10.12  medical care at the time the person is detained by law or 
 10.13  admitted on a criminal hold order and as long as the person 
 10.14  continues to meet other eligibility requirements of this 
 10.15  subdivision.  
 10.16     (g) General assistance medical care is not available for 
 10.17  applicants or recipients who do not cooperate with the county 
 10.18  agency to meet the requirements of medical assistance.  General 
 10.19  assistance medical care is limited to payment of emergency 
 10.20  services only for applicants or recipients as described in 
 10.21  paragraph (b), whose MinnesotaCare coverage is denied or 
 10.22  terminated for nonpayment of premiums as required by sections 
 10.23  256L.06 and 256L.07.  
 10.24     (h) In determining the amount of assets of an individual, 
 10.25  there shall be included any asset or interest in an asset, 
 10.26  including an asset excluded under paragraph (a), that was given 
 10.27  away, sold, or disposed of for less than fair market value 
 10.28  within the 60 months preceding application for general 
 10.29  assistance medical care or during the period of eligibility.  
 10.30  Any transfer described in this paragraph shall be presumed to 
 10.31  have been for the purpose of establishing eligibility for 
 10.32  general assistance medical care, unless the individual furnishes 
 10.33  convincing evidence to establish that the transaction was 
 10.34  exclusively for another purpose.  For purposes of this 
 10.35  paragraph, the value of the asset or interest shall be the fair 
 10.36  market value at the time it was given away, sold, or disposed 
 11.1   of, less the amount of compensation received.  For any 
 11.2   uncompensated transfer, the number of months of ineligibility, 
 11.3   including partial months, shall be calculated by dividing the 
 11.4   uncompensated transfer amount by the average monthly per person 
 11.5   payment made by the medical assistance program to skilled 
 11.6   nursing facilities for the previous calendar year.  The 
 11.7   individual shall remain ineligible until this fixed period has 
 11.8   expired.  The period of ineligibility may exceed 30 months, and 
 11.9   a reapplication for benefits after 30 months from the date of 
 11.10  the transfer shall not result in eligibility unless and until 
 11.11  the period of ineligibility has expired.  The period of 
 11.12  ineligibility begins in the month the transfer was reported to 
 11.13  the county agency, or if the transfer was not reported, the 
 11.14  month in which the county agency discovered the transfer, 
 11.15  whichever comes first.  For applicants, the period of 
 11.16  ineligibility begins on the date of the first approved 
 11.17  application. 
 11.18     (i) When determining eligibility for any state benefits 
 11.19  under this subdivision, the income and resources of all 
 11.20  noncitizens shall be deemed to include their sponsor's income 
 11.21  and resources as defined in the Personal Responsibility and Work 
 11.22  Opportunity Reconciliation Act of 1996, title IV, Public Law 
 11.23  Number 104-193, sections 421 and 422, and subsequently set out 
 11.24  in federal rules. 
 11.25     (j)(1) An undocumented noncitizen or a nonimmigrant is 
 11.26  ineligible for general assistance medical care other than 
 11.27  emergency services.  For purposes of this subdivision, a 
 11.28  nonimmigrant is an individual in one or more of the classes 
 11.29  listed in United States Code, title 8, section 1101(a)(15), and 
 11.30  an undocumented noncitizen is an individual who resides in the 
 11.31  United States without the approval or acquiescence of the 
 11.32  Immigration and Naturalization Service. 
 11.33     (2) This paragraph does not apply to a child under age 18, 
 11.34  to a Cuban or Haitian entrant as defined in Public Law Number 
 11.35  96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 
 11.36  aged, blind, or disabled as defined in Code of Federal 
 12.1   Regulations, title 42, sections 435.520, 435.530, 435.531, 
 12.2   435.540, and 435.541, or effective October 1, 1998, to an 
 12.3   individual eligible for general assistance medical care under 
 12.4   paragraph (a), clause (4), who cooperates with the Immigration 
 12.5   and Naturalization Service to pursue any applicable immigration 
 12.6   status, including citizenship, that would qualify the individual 
 12.7   for medical assistance with federal financial participation. 
 12.8      (3) (k) For purposes of this paragraph paragraphs (g) and 
 12.9   (j), "emergency services" has the meaning given in Code of 
 12.10  Federal Regulations, title 42, section 440.255(b)(1), except 
 12.11  that it also means services rendered because of suspected or 
 12.12  actual pesticide poisoning. 
 12.13     (k) (l) Notwithstanding any other provision of law, a 
 12.14  noncitizen who is ineligible for medical assistance due to the 
 12.15  deeming of a sponsor's income and resources, is ineligible for 
 12.16  general assistance medical care. 
 12.17     Sec. 11.  Minnesota Statutes 1999 Supplement, section 
 12.18  256L.03, subdivision 5, is amended to read: 
 12.19     Subd. 5.  [COPAYMENTS AND COINSURANCE.] (a) Except as 
 12.20  provided in paragraphs (b) and (c), the MinnesotaCare benefit 
 12.21  plan shall include the following copayments and coinsurance 
 12.22  requirements for all enrollees except parents and relative 
 12.23  caretakers of children under the age of 21 in households with 
 12.24  income at or below 175 percent of the federal poverty guidelines 
 12.25  and pregnant women and children under the age of 21:  
 12.26     (1) ten percent of the paid charges for inpatient hospital 
 12.27  services for adult enrollees, subject to an annual inpatient 
 12.28  out-of-pocket maximum of $1,000 per individual and $3,000 per 
 12.29  family; 
 12.30     (2) $3 per prescription for adult enrollees; 
 12.31     (3) $25 for eyeglasses for adult enrollees; and 
 12.32     (4) effective July 1, 1998, 50 percent of the 
 12.33  fee-for-service rate for adult dental care services other than 
 12.34  preventive care services for persons eligible under section 
 12.35  256L.04, subdivisions 1 to 7, with income equal to or less than 
 12.36  175 percent of the federal poverty guidelines. 
 13.1      The exceptions described in this paragraph shall only be 
 13.2   implemented if required to obtain federal Medicaid funding for 
 13.3   these individuals and shall expire July 1, 2000. 
 13.4      (b) Effective July 1, 1997, Paragraph (a), clause (1), does 
 13.5   not apply to parents and relative caretakers of children under 
 13.6   the age of 21 in households with family income equal to or less 
 13.7   than 175 percent of the federal poverty guidelines.  Paragraph 
 13.8   (a), clause (1), does not apply to parents and relative 
 13.9   caretakers of children under the age of 21 in households with 
 13.10  family income greater than 175 percent of the federal poverty 
 13.11  guidelines for inpatient hospital admissions occurring on or 
 13.12  after January 1, 2001.  
 13.13     (c) Paragraph (a), clauses (1) to (4), do not apply to 
 13.14  pregnant women and children under the age of 21.  
 13.15     (d) Adult enrollees with family gross income that exceeds 
 13.16  175 percent of the federal poverty guidelines and who are not 
 13.17  pregnant shall be financially responsible for the coinsurance 
 13.18  amount, if applicable, and amounts which exceed the $10,000 
 13.19  inpatient hospital benefit limit. 
 13.20     (c) (e) When a MinnesotaCare enrollee becomes a member of a 
 13.21  prepaid health plan, or changes from one prepaid health plan to 
 13.22  another during a calendar year, any charges submitted towards 
 13.23  the $10,000 annual inpatient benefit limit, and any 
 13.24  out-of-pocket expenses incurred by the enrollee for inpatient 
 13.25  services, that were submitted or incurred prior to enrollment, 
 13.26  or prior to the change in health plans, shall be disregarded. 
 13.27     Sec. 12.  Laws 1999, chapter 245, article 8, section 84, is 
 13.28  amended to read: 
 13.29     Sec. 84.  [RECOMMENDATIONS TO THE LEGISLATURE.] 
 13.30     The commissioner of human services shall submit to the 
 13.31  legislature design and implementation recommendations for the 
 13.32  proposals required in sections 82 and 83, including draft 
 13.33  legislation, by January 15, 2000 2001, for implementation 
 13.34  by July 1, 2000 January 1, 2002, with respect to the proposal in 
 13.35  section 82 only.  The proposals shall not include requirements 
 13.36  for maintenance of effort and expanded expenditures concerning 
 14.1   federal reimbursements earned in these programs. 
 14.2      Sec. 13.  [OBSOLETE RULES.] 
 14.3      The commissioner shall amend or repeal obsolete provisions 
 14.4   of Minnesota Rules, parts 9505.0010 to 9505.0150, governing 
 14.5   eligibility for the medical assistance program, under the 
 14.6   expedited process of Minnesota Statutes, section 14.389, to 
 14.7   bring them into conformance with state and federal law. 
 14.8      Sec. 14.  [GROUP RESIDENTIAL HOUSING STUDY AND REPORT.] 
 14.9      The commissioner of human services, in consultation with 
 14.10  representatives of affected providers, consumers, and counties, 
 14.11  shall study and report to the legislature by January 15, 2001, 
 14.12  with recommendations concerning group residential housing (GRH) 
 14.13  expenditures that may be eligible for reimbursement under the 
 14.14  home and community-based waiver services program for persons 
 14.15  with mental retardation or related conditions (MR/RC waiver).  
 14.16  The report shall include: 
 14.17     (1) an assessment of consumer access to housing as a result 
 14.18  of the limits on GRH supplementary room and board rates adopted 
 14.19  in Laws 1999, chapter 245, article 3, section 40; 
 14.20     (2) an analysis of market rate housing costs for families 
 14.21  of comparable size to those funded under the GRH program; 
 14.22     (3) an analysis of the impact on GRH costs of providing 
 14.23  services and housing to persons with developmental disabilities, 
 14.24  including: 
 14.25     (i) a breakdown by level of client disability of GRH 
 14.26  expenditures for housing costs for persons with developmental 
 14.27  disabilities; 
 14.28     (ii) a breakdown by level of client disability of GRH 
 14.29  expenditures for service costs for persons with developmental 
 14.30  disabilities; 
 14.31     (iii) an analysis of differences in GRH expenditures for 
 14.32  persons with developmental disabilities compared to other GRH 
 14.33  residents; and 
 14.34     (iv) a determination of GRH expenditures that are a direct 
 14.35  result of a resident's disability; 
 14.36     (4) a determination of which services now paid for by the 
 15.1   GRH program may be eligible under the MR/RC waiver, and an 
 15.2   estimate of GRH costs that could be paid by the federal 
 15.3   government under the MR/RC waiver.  Prior to submission of the 
 15.4   report, the commissioner may begin the process of seeking 
 15.5   federal approval to fund current group residential housing 
 15.6   services under the MR/RC waiver; 
 15.7      (5) an assessment of the utilization of the food stamp 
 15.8   program and other federal benefit programs by GRH residents; 
 15.9      (6) an analysis of the methods other states utilize to 
 15.10  reimburse comparable room and board costs and service costs; and 
 15.11     (7) a compilation of current MR/RC waiver caps in Minnesota 
 15.12  counties, compared with actual MR/RC spending. 
 15.13     Sec. 15.  [REPEALER.] 
 15.14     Laws 1998, chapter 407, article 5, section 44, is repealed. 
 15.15     Sec. 16.  [EFFECTIVE DATE.] 
 15.16     Sections 11 and 13 are effective the day following final 
 15.17  enactment.