1.1                          A bill for an act 
  1.2             relating to human services; modifying provisions 
  1.3             relating to health department; health care; continuing 
  1.4             care and home care; consumer information and 
  1.5             assistance and community-based care; long-term care 
  1.6             reform and reimbursement; work force; regulation of 
  1.7             supplemental nursing services agencies; long-term 
  1.8             insurance; mental health and civil commitment; 
  1.9             assistance programs; licensing; appropriating money; 
  1.10            amending Minnesota Statutes 2000, sections 13.46, 
  1.11            subdivision 4; 62A.48, subdivision 4, by adding 
  1.12            subdivisions; 62S.01, by adding subdivisions; 62S.26; 
  1.13            103I.101, subdivision 6; 103I.112; 103I.208, 
  1.14            subdivisions 1, 2; 103I.235, subdivision 1; 103I.525, 
  1.15            subdivisions 2, 6, 8, 9; 103I.531, subdivisions 2, 6, 
  1.16            8, 9; 103I.535, subdivisions 2, 6, 8, 9; 103I.541, 
  1.17            subdivisions 2b, 4, 5; 103I.545; 121A.15, subdivision 
  1.18            6; 135A.14, by adding a subdivision; 144.057; 
  1.19            144.1202, subdivision 4; 144.122; 144.1222, by adding 
  1.20            a subdivision; 144.1464; 144.148, subdivision 2; 
  1.21            144.226, subdivision 4; 144.98, subdivision 3; 
  1.22            144A.071, subdivisions 1, 1a, 2, 4a; 144A.073, 
  1.23            subdivisions 2, 4; 144A.44, subdivision 1; 144A.62, 
  1.24            subdivisions 1, 2, 3, 4; 145.881, subdivision 2; 
  1.25            145.882, subdivision 7, by adding a subdivision; 
  1.26            145.885, subdivision 2; 145.924; 145.925, subdivisions 
  1.27            1, 1a; 145A.15, subdivision 1, by adding a 
  1.28            subdivision; 145A.16, subdivision 1, by adding a 
  1.29            subdivision; 148.212; 148B.21, subdivision 6a; 
  1.30            148B.22, subdivision 3; 157.16, subdivision 3; 157.22; 
  1.31            214.104; 245.462, subdivisions 8, 18, by adding a 
  1.32            subdivision; 245.4871, subdivisions 10, 27; 245.4876, 
  1.33            subdivision 1, by adding a subdivision; 245.4885, 
  1.34            subdivision 1; 245.4886, subdivision 1; 245.99, 
  1.35            subdivision 4; 245A.03, subdivision 2b; 245A.04, 
  1.36            subdivisions 3, 3a, 3b, 3c, 3d; 245A.05; 245A.06; 
  1.37            245A.07; 245A.08; 245A.13, subdivisions 7, 8; 245A.14, 
  1.38            by adding a subdivision; 245A.16, subdivision 1; 
  1.39            245B.08, subdivision 3; 246.57, by adding a 
  1.40            subdivision; 252.275, subdivision 4b; 252A.02, 
  1.41            subdivisions 12, 13, by adding a subdivision; 
  1.42            252A.111, subdivision 6; 252A.16, subdivision 1; 
  1.43            252A.19, subdivision 2; 252A.20, subdivision 1; 
  1.44            254B.02, subdivision 3; 254B.03, subdivision 1; 
  1.45            254B.04, subdivision 1; 254B.09, by adding a 
  1.46            subdivision; 256.01, subdivisions 2, 18, by adding a 
  2.1             subdivision; 256.045, subdivisions 3, 3b, 4; 256.476, 
  2.2             subdivisions 1, 2, 3, 4, 5, 8; 256.482, subdivision 8; 
  2.3             256.955, subdivision 2b; 256.9657, subdivision 2; 
  2.4             256.969, subdivisions 2b, 3a, by adding a subdivision; 
  2.5             256.973, by adding a subdivision; 256.975, by adding 
  2.6             subdivisions; 256B.04, by adding a subdivision; 
  2.7             256B.055, subdivision 3a; 256B.056, subdivisions 1a, 
  2.8             3, 4, 5; 256B.057, subdivision 9, by adding a 
  2.9             subdivision; 256B.0625, subdivisions 3b, 7, 13, 13a, 
  2.10            17, 17a, 18a, 19a, 19c, 20, 30, 34, by adding 
  2.11            subdivisions; 256B.0627, subdivisions 1, 2, 4, 5, 7, 
  2.12            8, 10, 11, by adding subdivisions; 256B.0635, 
  2.13            subdivisions 1, 2; 256B.0911, subdivisions 1, 3, 5, 6, 
  2.14            7, by adding subdivisions; 256B.0913, subdivisions 1, 
  2.15            2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14; 256B.0915, 
  2.16            subdivisions 1d, 3, 5; 256B.0916, subdivisions 1, 7, 
  2.17            9, by adding a subdivision; 256B.0917, subdivision 7; 
  2.18            256B.092, subdivisions 2a, 5; 256B.093, subdivision 3; 
  2.19            256B.095; 256B.0951, subdivisions 1, 3, 4, 5, 7, by 
  2.20            adding subdivisions; 256B.0952, subdivisions 1, 4; 
  2.21            256B.431, subdivision 17, by adding subdivisions; 
  2.22            256B.434, subdivisions 4, 10, by adding subdivisions; 
  2.23            256B.49, by adding subdivisions; 256B.501, by adding a 
  2.24            subdivision; 256B.69, subdivisions 4, 5, 5b, 23, by 
  2.25            adding a subdivision; 256B.75; 256B.76; 256D.03, 
  2.26            subdivisions 3, 4; 256D.053, subdivision 1; 256D.35, 
  2.27            by adding subdivisions; 256D.44, subdivision 5; 
  2.28            256I.05, subdivision 1e; 256J.09, subdivisions 1, 2, 
  2.29            3, by adding subdivisions; 256J.15, by adding a 
  2.30            subdivision; 256J.24, subdivision 10; 256J.26, 
  2.31            subdivision 1; 256J.31, subdivisions 4, 12; 256J.32, 
  2.32            subdivision 7a; 256J.42, by adding a subdivision; 
  2.33            256J.45, subdivision 1; 256J.46, subdivisions 1, 2a, 
  2.34            by adding a subdivision; 256J.50, subdivisions 1, 7; 
  2.35            256J.56; 256J.57, subdivision 2; 256J.62, subdivision 
  2.36            9; 256J.625, subdivisions 1, 2, 4; 256J.751; 256K.03, 
  2.37            subdivision 1; 256K.07; 256K.25, subdivisions 1, 3, 4, 
  2.38            5, 6; 256L.06, subdivision 3; 256L.12, subdivision 9, 
  2.39            by adding a subdivision; 256L.16; 268.0122, 
  2.40            subdivision 2; 626.556, subdivisions 3, 3c, 10b, 10i; 
  2.41            626.557, subdivisions 3, 9d; 626.5572, subdivision 17; 
  2.42            Laws 1995, chapter 178, article 2, section 36; Laws 
  2.43            1995, chapter 207, article 3, section 21, as amended; 
  2.44            Laws 1997, chapter 203, article 9, section 21, as 
  2.45            amended; Laws 1999, chapter 152, sections 1, 4; Laws 
  2.46            1999, chapter 245, article 3, section 45, as amended; 
  2.47            Laws 1999, chapter 245, article 4, section 110; 
  2.48            proposing coding for new law in Minnesota Statutes, 
  2.49            chapters 62S; 144; 144A; 145; 145A; 246; 256; 256B; 
  2.50            256I; 256J; 299A; repealing Minnesota Statutes 2000, 
  2.51            sections 144.0721, subdivision 1; 144.148, subdivision 
  2.52            8; 145.882, subdivisions 3, 4; 145.9245; 145.927; 
  2.53            252A.111, subdivision 3; 256.476, subdivision 7; 
  2.54            256B.037, subdivision 5; 256B.0635, subdivision 3; 
  2.55            256B.0911, subdivisions 2, 2a, 4, 8, 9; 256B.0912; 
  2.56            256B.0913, subdivisions 3, 15a, 15b, 15c, 16; 
  2.57            256B.0915, subdivisions 3a, 3b, 3c; 256B.0951, 
  2.58            subdivision 6; 256B.434, subdivision 5; 256B.49, 
  2.59            subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10; 256E.06, 
  2.60            subdivision 2b; 256J.42, subdivision 4; 256J.44; 
  2.61            256J.46, subdivision 1a; Laws 1995, chapter 178, 
  2.62            article 2, section 48, subdivision 6; Minnesota Rules, 
  2.63            parts 9505.2390; 9505.2395; 9505.2396; 9505.2400; 
  2.64            9505.2405; 9505.2410; 9505.2413; 9505.2415; 9505.2420; 
  2.65            9505.2425; 9505.2426; 9505.2430; 9505.2435; 9505.2440; 
  2.66            9505.2445; 9505.2450; 9505.2455; 9505.2458; 9505.2460; 
  2.67            9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 
  2.68            9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 
  2.69            9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 
  2.70            9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 
  2.71            9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 
  3.1             9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 
  3.2             9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 
  3.3             9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 
  3.4             9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 
  3.5             9505.3660; 9505.3670. 
  3.6   BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  3.7                              ARTICLE 1 
  3.8                          HEALTH DEPARTMENT 
  3.9      Section 1.  Minnesota Statutes 2000, section 103I.101, 
  3.10  subdivision 6, is amended to read: 
  3.11     Subd. 6.  [FEES FOR VARIANCES.] The commissioner shall 
  3.12  charge a nonrefundable application fee of $120 $150 to cover the 
  3.13  administrative cost of processing a request for a variance or 
  3.14  modification of rules adopted by the commissioner under this 
  3.15  chapter. 
  3.16     Sec. 2.  Minnesota Statutes 2000, section 103I.112, is 
  3.17  amended to read: 
  3.18     103I.112 [FEE EXEMPTIONS FOR STATE AND LOCAL GOVERNMENT.] 
  3.19     (a) The commissioner of health may not charge fees required 
  3.20  under this chapter to a federal agency, state agency, or a local 
  3.21  unit of government or to a subcontractor performing work for the 
  3.22  state agency or local unit of government.  
  3.23     (b) "Local unit of government" means a statutory or home 
  3.24  rule charter city, town, county, or soil and water conservation 
  3.25  district, watershed district, an organization formed for the 
  3.26  joint exercise of powers under section 471.59, a board of health 
  3.27  or community health board, or other special purpose district or 
  3.28  authority with local jurisdiction in water and related land 
  3.29  resources management. 
  3.30     Sec. 3.  Minnesota Statutes 2000, section 103I.208, 
  3.31  subdivision 1, is amended to read: 
  3.32     Subdivision 1.  [WELL NOTIFICATION FEE.] The well 
  3.33  notification fee to be paid by a property owner is:  
  3.34     (1) for a new well, $120 $150, which includes the state 
  3.35  core function fee; 
  3.36     (2) for a well sealing, $20 $30 for each well, which 
  3.37  includes the state core function fee, except that for monitoring 
  3.38  wells constructed on a single property, having depths within a 
  4.1   25 foot range, and sealed within 48 hours of start of 
  4.2   construction, a single fee of $20 $30; and 
  4.3      (3) for construction of a dewatering well, $120 $150, which 
  4.4   includes the state core function fee, for each well except a 
  4.5   dewatering project comprising five or more wells shall be 
  4.6   assessed a single fee of $600 $750 for the wells recorded on the 
  4.7   notification. 
  4.8      Sec. 4.  Minnesota Statutes 2000, section 103I.208, 
  4.9   subdivision 2, is amended to read: 
  4.10     Subd. 2.  [PERMIT FEE.] The permit fee to be paid by a 
  4.11  property owner is:  
  4.12     (1) for a well that is not in use under a maintenance 
  4.13  permit, $100 $125 annually; 
  4.14     (2) for construction of a monitoring well, $120 $150, which 
  4.15  includes the state core function fee; 
  4.16     (3) for a monitoring well that is unsealed under a 
  4.17  maintenance permit, $100 $125 annually; 
  4.18     (4) for monitoring wells used as a leak detection device at 
  4.19  a single motor fuel retail outlet, a single petroleum bulk 
  4.20  storage site excluding tank farms, or a single agricultural 
  4.21  chemical facility site, the construction permit fee 
  4.22  is $120 $150, which includes the state core function fee, per 
  4.23  site regardless of the number of wells constructed on the site, 
  4.24  and the annual fee for a maintenance permit for unsealed 
  4.25  monitoring wells is $100 $125 per site regardless of the number 
  4.26  of monitoring wells located on site; 
  4.27     (5) for a groundwater thermal exchange device, in addition 
  4.28  to the notification fee for wells, $120 $150, which includes the 
  4.29  state core function fee; 
  4.30     (6) for a vertical heat exchanger, $120 $150; 
  4.31     (7) for a dewatering well that is unsealed under a 
  4.32  maintenance permit, $100 $125 annually for each well, except a 
  4.33  dewatering project comprising more than five wells shall be 
  4.34  issued a single permit for $500 $625 annually for wells recorded 
  4.35  on the permit; and 
  4.36     (8) for excavating holes for the purpose of installing 
  5.1   elevator shafts, $120 $150 for each hole. 
  5.2      Sec. 5.  Minnesota Statutes 2000, section 103I.235, 
  5.3   subdivision 1, is amended to read: 
  5.4      Subdivision 1.  [DISCLOSURE OF WELLS TO BUYER.] (a) Before 
  5.5   signing an agreement to sell or transfer real property, the 
  5.6   seller must disclose in writing to the buyer information about 
  5.7   the status and location of all known wells on the property, by 
  5.8   delivering to the buyer either a statement by the seller that 
  5.9   the seller does not know of any wells on the property, or a 
  5.10  disclosure statement indicating the legal description and 
  5.11  county, and a map drawn from available information showing the 
  5.12  location of each well to the extent practicable.  In the 
  5.13  disclosure statement, the seller must indicate, for each well, 
  5.14  whether the well is in use, not in use, or sealed.  
  5.15     (b) At the time of closing of the sale, the disclosure 
  5.16  statement information, name and mailing address of the buyer, 
  5.17  and the quartile, section, township, and range in which each 
  5.18  well is located must be provided on a well disclosure 
  5.19  certificate signed by the seller or a person authorized to act 
  5.20  on behalf of the seller. 
  5.21     (c) A well disclosure certificate need not be provided if 
  5.22  the seller does not know of any wells on the property and the 
  5.23  deed or other instrument of conveyance contains the statement:  
  5.24  "The Seller certifies that the Seller does not know of any wells 
  5.25  on the described real property."  
  5.26     (d) If a deed is given pursuant to a contract for deed, the 
  5.27  well disclosure certificate required by this subdivision shall 
  5.28  be signed by the buyer or a person authorized to act on behalf 
  5.29  of the buyer.  If the buyer knows of no wells on the property, a 
  5.30  well disclosure certificate is not required if the following 
  5.31  statement appears on the deed followed by the signature of the 
  5.32  grantee or, if there is more than one grantee, the signature of 
  5.33  at least one of the grantees:  "The Grantee certifies that the 
  5.34  Grantee does not know of any wells on the described real 
  5.35  property."  The statement and signature of the grantee may be on 
  5.36  the front or back of the deed or on an attached sheet and an 
  6.1   acknowledgment of the statement by the grantee is not required 
  6.2   for the deed to be recordable. 
  6.3      (e) This subdivision does not apply to the sale, exchange, 
  6.4   or transfer of real property:  
  6.5      (1) that consists solely of a sale or transfer of severed 
  6.6   mineral interests; or 
  6.7      (2) that consists of an individual condominium unit as 
  6.8   described in chapters 515 and 515B. 
  6.9      (f) For an area owned in common under chapter 515 or 515B 
  6.10  the association or other responsible person must report to the 
  6.11  commissioner by July 1, 1992, the location and status of all 
  6.12  wells in the common area.  The association or other responsible 
  6.13  person must notify the commissioner within 30 days of any change 
  6.14  in the reported status of wells. 
  6.15     (g) For real property sold by the state under section 
  6.16  92.67, the lessee at the time of the sale is responsible for 
  6.17  compliance with this subdivision. 
  6.18     (h) If the seller fails to provide a required well 
  6.19  disclosure certificate, the buyer, or a person authorized to act 
  6.20  on behalf of the buyer, may sign a well disclosure certificate 
  6.21  based on the information provided on the disclosure statement 
  6.22  required by this section or based on other available information.
  6.23     (i) A county recorder or registrar of titles may not record 
  6.24  a deed or other instrument of conveyance dated after October 31, 
  6.25  1990, for which a certificate of value is required under section 
  6.26  272.115, or any deed or other instrument of conveyance dated 
  6.27  after October 31, 1990, from a governmental body exempt from the 
  6.28  payment of state deed tax, unless the deed or other instrument 
  6.29  of conveyance contains the statement made in accordance with 
  6.30  paragraph (c) or (d) or is accompanied by the well disclosure 
  6.31  certificate containing all the information required by paragraph 
  6.32  (b) or (d).  The county recorder or registrar of titles must not 
  6.33  accept a certificate unless it contains all the required 
  6.34  information.  The county recorder or registrar of titles shall 
  6.35  note on each deed or other instrument of conveyance accompanied 
  6.36  by a well disclosure certificate that the well disclosure 
  7.1   certificate was received.  The notation must include the 
  7.2   statement "No wells on property" if the disclosure certificate 
  7.3   states there are no wells on the property.  The well disclosure 
  7.4   certificate shall not be filed or recorded in the records 
  7.5   maintained by the county recorder or registrar of titles.  After 
  7.6   noting "No wells on property" on the deed or other instrument of 
  7.7   conveyance, the county recorder or registrar of titles shall 
  7.8   destroy or return to the buyer the well disclosure certificate.  
  7.9   The county recorder or registrar of titles shall collect from 
  7.10  the buyer or the person seeking to record a deed or other 
  7.11  instrument of conveyance, a fee of $20 $30 for receipt of a 
  7.12  completed well disclosure certificate.  By the tenth day of each 
  7.13  month, the county recorder or registrar of titles shall transmit 
  7.14  the well disclosure certificates to the commissioner of health.  
  7.15  By the tenth day after the end of each calendar quarter, the 
  7.16  county recorder or registrar of titles shall transmit to the 
  7.17  commissioner of health $17.50 $27.50 of the fee for each well 
  7.18  disclosure certificate received during the quarter.  The 
  7.19  commissioner shall maintain the well disclosure certificate for 
  7.20  at least six years.  The commissioner may store the certificate 
  7.21  as an electronic image.  A copy of that image shall be as valid 
  7.22  as the original. 
  7.23     (j) No new well disclosure certificate is required under 
  7.24  this subdivision if the buyer or seller, or a person authorized 
  7.25  to act on behalf of the buyer or seller, certifies on the deed 
  7.26  or other instrument of conveyance that the status and number of 
  7.27  wells on the property have not changed since the last previously 
  7.28  filed well disclosure certificate.  The following statement, if 
  7.29  followed by the signature of the person making the statement, is 
  7.30  sufficient to comply with the certification requirement of this 
  7.31  paragraph:  "I am familiar with the property described in this 
  7.32  instrument and I certify that the status and number of wells on 
  7.33  the described real property have not changed since the last 
  7.34  previously filed well disclosure certificate."  The 
  7.35  certification and signature may be on the front or back of the 
  7.36  deed or on an attached sheet and an acknowledgment of the 
  8.1   statement is not required for the deed or other instrument of 
  8.2   conveyance to be recordable. 
  8.3      (k) The commissioner in consultation with county recorders 
  8.4   shall prescribe the form for a well disclosure certificate and 
  8.5   provide well disclosure certificate forms to county recorders 
  8.6   and registrars of titles and other interested persons. 
  8.7      (l) Failure to comply with a requirement of this 
  8.8   subdivision does not impair: 
  8.9      (1) the validity of a deed or other instrument of 
  8.10  conveyance as between the parties to the deed or instrument or 
  8.11  as to any other person who otherwise would be bound by the deed 
  8.12  or instrument; or 
  8.13     (2) the record, as notice, of any deed or other instrument 
  8.14  of conveyance accepted for filing or recording contrary to the 
  8.15  provisions of this subdivision. 
  8.16     Sec. 6.  Minnesota Statutes 2000, section 103I.525, 
  8.17  subdivision 2, is amended to read: 
  8.18     Subd. 2.  [APPLICATION FEE.] The application fee for a well 
  8.19  contractor's license is $50 $75.  The commissioner may not act 
  8.20  on an application until the application fee is paid.  
  8.21     Sec. 7.  Minnesota Statutes 2000, section 103I.525, 
  8.22  subdivision 6, is amended to read: 
  8.23     Subd. 6.  [LICENSE FEE.] The fee for a well contractor's 
  8.24  license is $250, except the fee for an individual well 
  8.25  contractor's license is $50 $75. 
  8.26     Sec. 8.  Minnesota Statutes 2000, section 103I.525, 
  8.27  subdivision 8, is amended to read: 
  8.28     Subd. 8.  [RENEWAL.] (a) A licensee must file an 
  8.29  application and a renewal application fee to renew the license 
  8.30  by the date stated in the license.  
  8.31     (b) The renewal application fee shall be set by the 
  8.32  commissioner under section 16A.1285 for a well contractor's 
  8.33  license is $250.  
  8.34     (c) The renewal application must include information that 
  8.35  the applicant has met continuing education requirements 
  8.36  established by the commissioner by rule.  
  9.1      (d) At the time of the renewal, the commissioner must have 
  9.2   on file all properly completed well reports, well sealing 
  9.3   reports, reports of excavations to construct elevator shafts, 
  9.4   well permits, and well notifications for work conducted by the 
  9.5   licensee since the last license renewal. 
  9.6      Sec. 9.  Minnesota Statutes 2000, section 103I.525, 
  9.7   subdivision 9, is amended to read: 
  9.8      Subd. 9.  [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 
  9.9   to submit all information required for renewal in subdivision 8 
  9.10  or submits the application and information after the required 
  9.11  renewal date: 
  9.12     (1) the licensee must include an additional a late fee set 
  9.13  by the commissioner of $75; and 
  9.14     (2) the licensee may not conduct activities authorized by 
  9.15  the well contractor's license until the renewal application, 
  9.16  renewal application fee, late fee, and all other information 
  9.17  required in subdivision 8 are submitted. 
  9.18     Sec. 10.  Minnesota Statutes 2000, section 103I.531, 
  9.19  subdivision 2, is amended to read: 
  9.20     Subd. 2.  [APPLICATION FEE.] The application fee for a 
  9.21  limited well/boring contractor's license is $50 $75.  The 
  9.22  commissioner may not act on an application until the application 
  9.23  fee is paid.  
  9.24     Sec. 11.  Minnesota Statutes 2000, section 103I.531, 
  9.25  subdivision 6, is amended to read: 
  9.26     Subd. 6.  [LICENSE FEE.] The fee for a limited well/boring 
  9.27  contractor's license is $50 $75.  
  9.28     Sec. 12.  Minnesota Statutes 2000, section 103I.531, 
  9.29  subdivision 8, is amended to read: 
  9.30     Subd. 8.  [RENEWAL.] (a) A person must file an application 
  9.31  and a renewal application fee to renew the limited well/boring 
  9.32  contractor's license by the date stated in the license.  
  9.33     (b) The renewal application fee shall be set by the 
  9.34  commissioner under section 16A.1285 for a limited well/boring 
  9.35  contractor's license is $75.  
  9.36     (c) The renewal application must include information that 
 10.1   the applicant has met continuing education requirements 
 10.2   established by the commissioner by rule.  
 10.3      (d) At the time of the renewal, the commissioner must have 
 10.4   on file all properly completed well sealing reports, well 
 10.5   permits, vertical heat exchanger permits, and well notifications 
 10.6   for work conducted by the licensee since the last license 
 10.7   renewal. 
 10.8      Sec. 13.  Minnesota Statutes 2000, section 103I.531, 
 10.9   subdivision 9, is amended to read: 
 10.10     Subd. 9.  [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 
 10.11  to submit all information required for renewal in subdivision 8 
 10.12  or submits the application and information after the required 
 10.13  renewal date: 
 10.14     (1) the licensee must include an additional a late fee set 
 10.15  by the commissioner of $75; and 
 10.16     (2) the licensee may not conduct activities authorized by 
 10.17  the limited well/boring contractor's license until the renewal 
 10.18  application, renewal application fee, and late fee, and all 
 10.19  other information required in subdivision 8 are submitted. 
 10.20     Sec. 14.  Minnesota Statutes 2000, section 103I.535, 
 10.21  subdivision 2, is amended to read: 
 10.22     Subd. 2.  [APPLICATION FEE.] The application fee for an 
 10.23  elevator shaft contractor's license is $50 $75.  The 
 10.24  commissioner may not act on an application until the application 
 10.25  fee is paid. 
 10.26     Sec. 15.  Minnesota Statutes 2000, section 103I.535, 
 10.27  subdivision 6, is amended to read: 
 10.28     Subd. 6.  [LICENSE FEE.] The fee for an elevator shaft 
 10.29  contractor's license is $50 $75.  
 10.30     Sec. 16.  Minnesota Statutes 2000, section 103I.535, 
 10.31  subdivision 8, is amended to read: 
 10.32     Subd. 8.  [RENEWAL.] (a) A person must file an application 
 10.33  and a renewal application fee to renew the license by the date 
 10.34  stated in the license.  
 10.35     (b) The renewal application fee shall be set by the 
 10.36  commissioner under section 16A.1285 for an elevator shaft 
 11.1   contractor's license is $75.  
 11.2      (c) The renewal application must include information that 
 11.3   the applicant has met continuing education requirements 
 11.4   established by the commissioner by rule.  
 11.5      (d) At the time of renewal, the commissioner must have on 
 11.6   file all reports and permits for elevator shaft work conducted 
 11.7   by the licensee since the last license renewal. 
 11.8      Sec. 17.  Minnesota Statutes 2000, section 103I.535, 
 11.9   subdivision 9, is amended to read: 
 11.10     Subd. 9.  [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 
 11.11  to submit all information required for renewal in subdivision 8 
 11.12  or submits the application and information after the required 
 11.13  renewal date: 
 11.14     (1) the licensee must include an additional a late fee set 
 11.15  by the commissioner of $75; and 
 11.16     (2) the licensee may not conduct activities authorized by 
 11.17  the elevator shaft contractor's license until the renewal 
 11.18  application, renewal application fee, and late fee, and all 
 11.19  other information required in subdivision 8 are submitted. 
 11.20     Sec. 18.  Minnesota Statutes 2000, section 103I.541, 
 11.21  subdivision 2b, is amended to read: 
 11.22     Subd. 2b.  [APPLICATION FEE.] The application fee for a 
 11.23  monitoring well contractor registration is $50 $75.  The 
 11.24  commissioner may not act on an application until the application 
 11.25  fee is paid.  
 11.26     Sec. 19.  Minnesota Statutes 2000, section 103I.541, 
 11.27  subdivision 4, is amended to read: 
 11.28     Subd. 4.  [RENEWAL.] (a) A person must file an application 
 11.29  and a renewal application fee to renew the registration by the 
 11.30  date stated in the registration.  
 11.31     (b) The renewal application fee shall be set by the 
 11.32  commissioner under section 16A.1285 for a monitoring well 
 11.33  contractor's registration is $75.  
 11.34     (c) The renewal application must include information that 
 11.35  the applicant has met continuing education requirements 
 11.36  established by the commissioner by rule.  
 12.1      (d) At the time of the renewal, the commissioner must have 
 12.2   on file all well reports, well sealing reports, well permits, 
 12.3   and notifications for work conducted by the registered person 
 12.4   since the last registration renewal. 
 12.5      Sec. 20.  Minnesota Statutes 2000, section 103I.541, 
 12.6   subdivision 5, is amended to read: 
 12.7      Subd. 5.  [INCOMPLETE OR LATE RENEWAL.] If a registered 
 12.8   person submits a renewal application after the required renewal 
 12.9   date: 
 12.10     (1) the registered person must include an additional a late 
 12.11  fee set by the commissioner of $75; and 
 12.12     (2) the registered person may not conduct activities 
 12.13  authorized by the monitoring well contractor's registration 
 12.14  until the renewal application, renewal application fee, late 
 12.15  fee, and all other information required in subdivision 4 are 
 12.16  submitted. 
 12.17     Sec. 21.  Minnesota Statutes 2000, section 103I.545, is 
 12.18  amended to read: 
 12.19     103I.545 [REGISTRATION OF DRILLING MACHINES REQUIRED.] 
 12.20     Subdivision 1.  [DRILLING MACHINE.] (a) A person may not 
 12.21  use a drilling machine such as a cable tool, rotary tool, hollow 
 12.22  rod tool, or auger for a drilling activity requiring a license 
 12.23  or registration under this chapter unless the drilling machine 
 12.24  is registered with the commissioner.  
 12.25     (b) A person must apply for the registration on forms 
 12.26  prescribed by the commissioner and submit a $50 $75 registration 
 12.27  fee. 
 12.28     (c) A registration is valid for one year.  
 12.29     Subd. 2.  [PUMP HOIST.] (a) A person may not use a machine 
 12.30  such as a pump hoist for an activity requiring a license or 
 12.31  registration under this chapter to repair wells or borings, seal 
 12.32  wells or borings, or install pumps unless the machine is 
 12.33  registered with the commissioner.  
 12.34     (b) A person must apply for the registration on forms 
 12.35  prescribed by the commissioner and submit a $50 $75 registration 
 12.36  fee. 
 13.1      (c) A registration is valid for one year. 
 13.2      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002. 
 13.3      Sec. 22.  Minnesota Statutes 2000, section 121A.15, 
 13.4   subdivision 6, is amended to read: 
 13.5      Subd. 6.  [SUSPENSION OF IMMUNIZATION REQUIREMENT; 
 13.6   MODIFICATION TO SCHEDULE.] (a) The commissioner of health, on 
 13.7   finding that an immunization required pursuant to this section 
 13.8   is not necessary to protect the public's health, may suspend for 
 13.9   one year the requirement that children receive that immunization.
 13.10     (b) During portions of the year in which the legislature is 
 13.11  not meeting in regular or special session, the commissioner of 
 13.12  health may modify the immunization requirements of this section. 
 13.13  A modification made under this paragraph must be part of the 
 13.14  current immunization recommendations of each of the following 
 13.15  organizations:  the United States Public Health Service's 
 13.16  Advisory Committee on Immunization Practices, the American 
 13.17  Academy of Family Physicians, and the American Academy of 
 13.18  Pediatrics.  The commissioner shall modify the immunization 
 13.19  requirements through rulemaking using the expedited process in 
 13.20  section 14.389.  A rule adopted under this paragraph shall be in 
 13.21  effect until the adjournment of the next regular legislative 
 13.22  session held after the rule is adopted.  The commissioner shall 
 13.23  report to the legislature on any rules adopted under this 
 13.24  paragraph during the previous calendar year.  Such reports are 
 13.25  due by January 15 of the year following the calendar year in 
 13.26  which the rule is adopted, except that if a rule is adopted in 
 13.27  January, a report on that rule is due by February 15 of that 
 13.28  year. 
 13.29     Sec. 23.  Minnesota Statutes 2000, section 135A.14, is 
 13.30  amended by adding a subdivision to read: 
 13.31     Subd. 7.  [MODIFICATIONS TO SCHEDULE.] During portions of 
 13.32  the year in which the legislature is not meeting in regular or 
 13.33  special session, the commissioner of health may modify the 
 13.34  immunization requirements of this section.  A modification made 
 13.35  under this subdivision must be part of the current immunization 
 13.36  recommendations of each of the following organizations:  the 
 14.1   United States Public Health Service's Advisory Committee on 
 14.2   Immunization Practices, the American Academy of Family 
 14.3   Physicians, and the American Academy of Pediatrics.  The 
 14.4   commissioner shall modify the immunization requirements through 
 14.5   rulemaking using the expedited process in section 14.389.  A 
 14.6   rule adopted under this subdivision shall be in effect until the 
 14.7   adjournment of the next regular legislative session held after 
 14.8   the rule is adopted.  The commissioner shall report to the 
 14.9   legislature on any rules adopted under this subdivision during 
 14.10  the previous calendar year.  Such reports are due by January 15 
 14.11  of the year following the calendar year in which the rule is 
 14.12  adopted, except that if a rule is adopted in January, a report 
 14.13  on that rule is due by February 15 of that year. 
 14.14     Sec. 24.  Minnesota Statutes 2000, section 144.1202, 
 14.15  subdivision 4, is amended to read: 
 14.16     Subd. 4.  [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 
 14.17  agreement entered into before August 2, 2002 2003, must remain 
 14.18  in effect until terminated under the Atomic Energy Act of 1954, 
 14.19  United States Code, title 42, section 2021, paragraph (j).  The 
 14.20  governor may not enter into an initial agreement with the 
 14.21  Nuclear Regulatory Commission after August 1, 2002 2003.  If an 
 14.22  agreement is not entered into by August 1, 2002 2003, any rules 
 14.23  adopted under this section are repealed effective August 1, 2002 
 14.24  2003. 
 14.25     (b) An agreement authorized under subdivision 1 must be 
 14.26  approved by law before it may be implemented. 
 14.27     Sec. 25.  [144.1205] [RADIOACTIVE MATERIAL; SOURCE AND 
 14.28  SPECIAL NUCLEAR MATERIAL; FEES; INSPECTION.] 
 14.29     Subdivision 1.  [APPLICATION AND LICENSE RENEWAL FEE.] When 
 14.30  a license is required for radioactive material or source or 
 14.31  special nuclear material by a rule adopted under section 
 14.32  144.1202, subdivision 2, an application fee according to 
 14.33  subdivision 4 must be paid upon initial application for a 
 14.34  license.  The licensee must renew the license 60 days before the 
 14.35  expiration date of the license by paying a license renewal fee 
 14.36  equal to the application fee under subdivision 4.  The 
 15.1   expiration date of a license is the date set by the United 
 15.2   States Nuclear Regulatory Commission before transfer of the 
 15.3   licensing program under section 144.1202 and thereafter as 
 15.4   specified by rule of the commissioner of health. 
 15.5      Subd. 2.  [ANNUAL FEE.] A licensee must pay an annual fee 
 15.6   at least 60 days before the anniversary date of the issuance of 
 15.7   the license.  The annual fee is an amount equal to 80 percent of 
 15.8   the application fee under subdivision 4, rounded to the nearest 
 15.9   whole dollar. 
 15.10     Subd. 3.  [FEE CATEGORIES; INCORPORATION OF FEDERAL 
 15.11  LICENSING CATEGORIES.] (a) Fee categories under this section are 
 15.12  equivalent to the licensing categories used by the United States 
 15.13  Nuclear Regulatory Commission under Code of Federal Regulations, 
 15.14  title 10, parts 30 to 36, 39, 40, 70, 71, and 150, except as 
 15.15  provided in paragraph (b). 
 15.16     (b) The category of "Academic, small" is the type of 
 15.17  license required for the use of radioactive materials in a 
 15.18  teaching institution.  Radioactive materials are limited to ten 
 15.19  radionuclides not to exceed a total activity amount of one curie.
 15.20     Subd. 4.  [APPLICATION FEE.] A licensee must pay an 
 15.21  application fee as follows: 
 15.22  Radioactive material,  Application    U.S. Nuclear Regulatory
 15.23  source and             fee            Commission licensing
 15.24  special material                      category as reference
 15.26  Type A broadscope      $20,000        Medical institution type A
 15.27  Type B broadscope      $15,000        Research and development
 15.28                                        type B
 15.29  Type C broadscope      $10,000        Academic type C
 15.30  Medical use            $4,000         Medical
 15.31                                        Medical institution
 15.32                                        Medical private practice
 15.33  Mobile nuclear                                                 
 15.34  medical laboratory     $4,000         Mobile medical laboratory
 15.35  Medical special use                                     
 15.36  sealed sources         $6,000         Teletherapy
 16.1                                         High dose rate remote
 16.2                                         afterloaders
 16.3                                         Stereotactic
 16.4                                         radiosurgery devices
 16.5   In vitro testing       $2,300         In vitro testing
 16.6                                         laboratories
 16.7   Measuring gauge,
 16.8   sealed sources         $2,000         Fixed gauges
 16.9                                         Portable gauges
 16.10                                        Analytical instruments
 16.11                                        Measuring systems - other
 16.12  Gas chromatographs     $1,200         Gas chromatographs
 16.13  Manufacturing and 
 16.14  distribution           $14,700        Manufacturing and 
 16.15                                        distribution - other
 16.16  Distribution only      $8,800         Distribution of
 16.17                                        radioactive material
 16.18                                        for commercial use only
 16.19  Other services         $1,500         Other services
 16.20  Nuclear medicine 
 16.21  pharmacy               $4,100         Nuclear pharmacy
 16.22  Waste disposal         $9,400         Waste disposal service
 16.23                                        prepackage
 16.24                                        Waste disposal service
 16.25                                        processing/repackage
 16.26  Waste storage only     $7,000         To receive and store
 16.27                                        radioactive material waste
 16.28  Industrial
 16.29  radiography            $8,400         Industrial radiography
 16.30                                        fixed location
 16.31                                        Industrial radiography
 16.32                                        portable/temporary sites
 16.33  Irradiator - 
 16.34  self-shielded          $4,100         Irradiators self-shielded
 16.35                                        less than 10,000 curies
 16.36  Irradiator - 
 17.1   less than 10,000 Ci    $7,500         Irradiators less than
 17.2                                         10,000 curies
 17.3   Irradiator - 
 17.4   more than 10,000 Ci    $11,500        Irradiators greater than
 17.5                                         10,000 curies
 17.6   Research and
 17.7   development,
 17.8   no distribution        $4,100         Research and development
 17.9   Radioactive material 
 17.10  possession only        $1,000         By-product possession only
 17.11  Source material        $1,000         Source material shielding
 17.12  Special nuclear 
 17.13  material, less than 
 17.14  200 grams              $1,000         Special nuclear material
 17.15                                        plutonium-neutron sources
 17.16                                        less than 200 grams
 17.17  Pacemaker
 17.18  manufacturing          $1,000         Pacemaker by-product
 17.19                                        and/or special nuclear
 17.20                                        material - medical
 17.21                                        institution
 17.22  General license
 17.23  distribution           $2,100         General license
 17.24                                        distribution
 17.25  General license 
 17.26  distribution, exempt   $1,500         General license 
 17.27                                        distribution -
 17.28                                        certain exempt items
 17.29  Academic, small        $1,000         Possession limit of ten
 17.30                                        radionuclides, not to
 17.31                                        exceed a total of one curie
 17.32                                        of activity
 17.33  Veterinary             $2,000         Veterinary use
 17.34  Well logging           $5,000         Well logging
 17.35     Subd. 5.  [PENALTY FOR LATE PAYMENT.] An annual fee or a 
 17.36  license renewal fee submitted to the commissioner after the due 
 18.1   date specified by rule must be accompanied by an additional 
 18.2   amount equal to 25 percent of the fee due. 
 18.3      Subd. 6.  [INSPECTIONS.] The commissioner of health shall 
 18.4   make periodic safety inspections of the radioactive material and 
 18.5   source and special nuclear material of a licensee.  The 
 18.6   commissioner shall prescribe the frequency of safety inspections 
 18.7   by rule. 
 18.8      Subd. 7.  [RECOVERY OF REINSPECTION COST.] If the 
 18.9   commissioner finds serious violations of public health standards 
 18.10  during an inspection under subdivision 6, the licensee must pay 
 18.11  all costs associated with subsequent reinspection of the 
 18.12  source.  The costs shall be the actual costs incurred by the 
 18.13  commissioner and include, but are not limited to, labor, 
 18.14  transportation, per diem, materials, legal fees, testing, and 
 18.15  monitoring costs. 
 18.16     Subd. 8.  [RECIPROCITY FEE.] A licensee submitting an 
 18.17  application for reciprocal recognition of a materials license 
 18.18  issued by another agreement state or the United States Nuclear 
 18.19  Regulatory Commission for a period of 180 days or less during a 
 18.20  calendar year must pay one-half of the application fee specified 
 18.21  under subdivision 4.  For a period of 181 days or more, the 
 18.22  licensee must pay the entire application fee under subdivision 4.
 18.23     Subd. 9.  [FEES FOR LICENSE AMENDMENTS.] A licensee must 
 18.24  pay a fee to amend a license as follows: 
 18.25     (1) to amend a license requiring no license review 
 18.26  including, but not limited to, facility name change or removal 
 18.27  of a previously authorized user, no fee; 
 18.28     (2) to amend a license requiring review including, but not 
 18.29  limited to, addition of isotopes, procedure changes, new 
 18.30  authorized users, or a new radiation safety officer, $200; and 
 18.31     (3) to amend a license requiring review and a site visit 
 18.32  including, but not limited to, facility move or addition of 
 18.33  processes, $400. 
 18.34     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002. 
 18.35     Sec. 26.  Minnesota Statutes 2000, section 144.122, is 
 18.36  amended to read: 
 19.1      144.122 [LICENSE, PERMIT, AND SURVEY FEES.] 
 19.2      (a) The state commissioner of health, by rule, may 
 19.3   prescribe reasonable procedures and fees for filing with the 
 19.4   commissioner as prescribed by statute and for the issuance of 
 19.5   original and renewal permits, licenses, registrations, and 
 19.6   certifications issued under authority of the commissioner.  The 
 19.7   expiration dates of the various licenses, permits, 
 19.8   registrations, and certifications as prescribed by the rules 
 19.9   shall be plainly marked thereon.  Fees may include application 
 19.10  and examination fees and a penalty fee for renewal applications 
 19.11  submitted after the expiration date of the previously issued 
 19.12  permit, license, registration, and certification.  The 
 19.13  commissioner may also prescribe, by rule, reduced fees for 
 19.14  permits, licenses, registrations, and certifications when the 
 19.15  application therefor is submitted during the last three months 
 19.16  of the permit, license, registration, or certification period.  
 19.17  Fees proposed to be prescribed in the rules shall be first 
 19.18  approved by the department of finance.  All fees proposed to be 
 19.19  prescribed in rules shall be reasonable.  The fees shall be in 
 19.20  an amount so that the total fees collected by the commissioner 
 19.21  will, where practical, approximate the cost to the commissioner 
 19.22  in administering the program.  All fees collected shall be 
 19.23  deposited in the state treasury and credited to the state 
 19.24  government special revenue fund unless otherwise specifically 
 19.25  appropriated by law for specific purposes. 
 19.26     (b) The commissioner may charge a fee for voluntary 
 19.27  certification of medical laboratories and environmental 
 19.28  laboratories, and for environmental and medical laboratory 
 19.29  services provided by the department, without complying with 
 19.30  paragraph (a) or chapter 14.  Fees charged for environment and 
 19.31  medical laboratory services provided by the department must be 
 19.32  approximately equal to the costs of providing the services.  
 19.33     (c) The commissioner may develop a schedule of fees for 
 19.34  diagnostic evaluations conducted at clinics held by the services 
 19.35  for children with handicaps program.  All receipts generated by 
 19.36  the program are annually appropriated to the commissioner for 
 20.1   use in the maternal and child health program. 
 20.2      (d) The commissioner, for fiscal years 1996 and beyond, 
 20.3   shall set license fees for hospitals and nursing homes that are 
 20.4   not boarding care homes at the following levels: 
 20.5   Joint Commission on Accreditation of Healthcare 
 20.6   Organizations (JCAHO hospitals)      $1,017
 20.7                                        $7,055
 20.8   Non-JCAHO hospitals                  $762 plus $34 per bed
 20.9                                        $4,680 plus $234 per bed
 20.10  Nursing home                         $78 plus $19 per bed
 20.11                                       $183 plus $91 per bed
 20.12     For fiscal years 1996 and beyond, The commissioner shall 
 20.13  set license fees for outpatient surgical centers, boarding care 
 20.14  homes, and supervised living facilities at the following levels: 
 20.15  Outpatient surgical centers          $517
 20.16                                       $1,512
 20.17  Boarding care homes                  $78 plus $19 per bed
 20.18                                       $183 plus $91 per bed
 20.19  Supervised living facilities         $78 plus $19 per bed
 20.20                                       $183 plus $91 per bed.
 20.21     (e) Unless prohibited by federal law, the commissioner of 
 20.22  health shall charge applicants the following fees to cover the 
 20.23  cost of any initial certification surveys required to determine 
 20.24  a provider's eligibility to participate in the Medicare or 
 20.25  Medicaid program: 
 20.26  Prospective payment surveys for          $  900
 20.27  hospitals
 20.29  Swing bed surveys for nursing homes      $1,200
 20.31  Psychiatric hospitals                    $1,400
 20.33  Rural health facilities                  $1,100
 20.35  Portable X-ray providers                 $  500
 20.37  Home health agencies                     $1,800
 20.39  Outpatient therapy agencies              $  800
 20.41  End stage renal dialysis providers       $2,100
 20.43  Independent therapists                   $  800
 20.45  Comprehensive rehabilitation             $1,200
 20.46  outpatient facilities
 21.2   Hospice providers                        $1,700
 21.4   Ambulatory surgical providers            $1,800
 21.6   Hospitals                                $4,200
 21.8   Other provider categories or             Actual surveyor costs:
 21.9   additional resurveys required            average surveyor cost x
 21.10  to complete initial certification        number of hours for the
 21.11                                           survey process.
 21.12     These fees shall be submitted at the time of the 
 21.13  application for federal certification and shall not be 
 21.14  refunded.  All fees collected after the date that the imposition 
 21.15  of fees is not prohibited by federal law shall be deposited in 
 21.16  the state treasury and credited to the state government special 
 21.17  revenue fund. 
 21.18     Sec. 27.  Minnesota Statutes 2000, section 144.148, 
 21.19  subdivision 2, is amended to read: 
 21.20     Subd. 2.  [PROGRAM.] (a) The commissioner of health shall 
 21.21  award rural hospital capital improvement grants to eligible 
 21.22  rural hospitals.  Except as provided in paragraph (b), A grant 
 21.23  shall not exceed $300,000 per hospital. Prior to the receipt of 
 21.24  any grant, the hospital must certify to the commissioner that at 
 21.25  least one-quarter of the grant amount, which may include in-kind 
 21.26  services, is available for the same purposes from nonstate 
 21.27  resources.  
 21.28     (b) A grant shall not exceed $1,500,000 per eligible rural 
 21.29  hospital that also satisfies the following criteria: 
 21.30     (1) is the only hospital in a county; 
 21.31     (2) has 25 or fewer licensed hospital beds with a net 
 21.32  hospital operating margin not greater than an average of two 
 21.33  percent over the three fiscal years prior to application; 
 21.34     (3) is located in a medically underserved community (MUC) 
 21.35  or a health professional shortage area (HPSA); 
 21.36     (4) is located near a migrant worker employment site and 
 21.37  regularly treats significant numbers of migrant workers and 
 21.38  their families; and 
 21.39     (5) has not previously received a grant under this section 
 21.40  prior to July 1, 1999. 
 21.41     Sec. 28.  Minnesota Statutes 2000, section 144.226, 
 22.1   subdivision 4, is amended to read: 
 22.2      Subd. 4.  [VITAL RECORDS SURCHARGE.] In addition to any fee 
 22.3   prescribed under subdivision 1, there is a nonrefundable 
 22.4   surcharge of $3 $2 for each certified and noncertified birth or 
 22.5   death record, and for a certification that the record cannot be 
 22.6   found.  The local or state registrar shall forward this amount 
 22.7   to the state treasurer to be deposited into the state government 
 22.8   special revenue fund.  This surcharge shall not be charged under 
 22.9   those circumstances in which no fee for a birth or death record 
 22.10  is permitted under subdivision 1, paragraph (a).  This surcharge 
 22.11  requirement expires June 30, 2002. 
 22.12     Sec. 29.  [144.585] [HOSPITAL CHARITY CARE AID.] 
 22.13     Subdivision 1.  [PURPOSE.] The purpose of charity care aid 
 22.14  is to help offset excess charity care burdens at Minnesota acute 
 22.15  care, short-term hospitals. 
 22.16     Subd. 2.  [DEFINITIONS.] (a) For purposes of this section, 
 22.17  the terms in this subdivision have the meanings given to them. 
 22.18     (b) "Charity care" is the dollar amount of charity care 
 22.19  adjustments as determined under subdivision 3. 
 22.20     (c) "Cost-to-charge ratio" means a hospital's total 
 22.21  operating expenses over the sum of gross patient revenue and 
 22.22  other operating revenue, as reported to the commissioner of 
 22.23  health under rules adopted under sections 144.695 to 144.703.  
 22.24  The commissioner shall use the most recently available data to 
 22.25  calculate the cost-to-charge ratio. 
 22.26     Subd. 3.  [CHARITY CARE REPORTING.] (a) For a hospital to 
 22.27  report amounts as charity care adjustments, the hospital: 
 22.28     (1) must generate and record a charge; 
 22.29     (2) have a policy on the provision of charity care and must 
 22.30  communicate the policy to the public; 
 22.31     (3) have made a reasonable effort to identify a third party 
 22.32  payer, encourage the patient to enroll in public programs, and 
 22.33  should, to the extent possible, aid the patient in the 
 22.34  enrollment process; and 
 22.35     (4) ensure that the patient meets the charity care criteria 
 22.36  of this subdivision, which must be consistent with statewide 
 23.1   income standards set out in paragraph (c). 
 23.2      (b) In determining whether to classify care as charity 
 23.3   care, the hospital must consider the following: 
 23.4      (1) charity care may include services which the provider is 
 23.5   obligated to render independently of the ability to collect; 
 23.6      (2) charity care may include care provided to low-income 
 23.7   patients who meet the charity care income standards under 
 23.8   paragraph (c) and have partial coverage, but are unable to pay 
 23.9   the remainder of their medical bills.  This does not apply to 
 23.10  that portion of the bill which has been determined to be the 
 23.11  patient's responsibility after a partial charity care 
 23.12  classification; 
 23.13     (3) charity care may include care provided to low-income 
 23.14  patients who may qualify for a public health insurance program 
 23.15  and meet the statewide eligibility criteria for charity care, 
 23.16  but who do not complete the application process for public 
 23.17  insurance despite the facility's best efforts; 
 23.18     (4) charity care may include care to individuals whose 
 23.19  eligibility for charity care was determined through third party 
 23.20  services employed by the hospital for information gathering 
 23.21  purposes only; 
 23.22     (5) charity care may not include contractual allowances, 
 23.23  which is the difference between gross charges and payments 
 23.24  received under contractual arrangements with insurance companies 
 23.25  and payers; 
 23.26     (6) charity care may not include bad debt; 
 23.27     (7) charity care may not include what may be perceived as 
 23.28  underpayments for operating public programs; 
 23.29     (8) charity care may not include cases which are paid 
 23.30  through a charitable contribution through a third party or 
 23.31  facility-related foundation; 
 23.32     (9) charity care may not include unreimbursed costs of 
 23.33  basic or clinical research and of professional education and 
 23.34  training; 
 23.35     (10) charity care may not include professional courtesy 
 23.36  discounts; 
 24.1      (11) charity care may not include community service or 
 24.2   outreach activities; and 
 24.3      (12) charity care may not include services for patients 
 24.4   against whom collection actions where taken which result in a 
 24.5   credit report. 
 24.6      (c) The hospital must use the income standards in this 
 24.7   paragraph for determining charity care eligibility for reporting 
 24.8   purposes.  The hospital does not need to make a patient asset 
 24.9   determination in order to apply charity care income standards. 
 24.10     (1) Care to a patient with a family income at or below 150 
 24.11  percent of the Federal Poverty Guideline (FPG) may be reported 
 24.12  as full charity care or free care. 
 24.13     (2) The hospital's share of discounted charges for care to 
 24.14  a patient with family income below 275 percent of the FPG 
 24.15  qualifies for classification as charity care.  The following 
 24.16  sliding fee schedules apply: 
 24.17     income as     charges paid      corresponding
 24.18      % of FPG       by patient       charity care
 24.19      151-200%           20%               80%
 24.20      201-225%           40%               60%
 24.21      226-250%           60%               40%
 24.22      251-275%           80%               20%
 24.23     (3) Care to a patient is considered medical hardship when 
 24.24  qualified medical expenses, as defined for the purposes of 
 24.25  federal income tax deductibility, exceeds 30 percent of family 
 24.26  income.  Qualified medical expenses may be counted as charity 
 24.27  care in the amount that exceeds 30 percent of family income.  
 24.28  This clause applies even if the patient's family income exceeds 
 24.29  the charity care income standards in clauses (1) and (2). 
 24.30     Subd. 4.  [APPLICATION.] To be eligible for funds under 
 24.31  this section, hospitals must submit an application to the 
 24.32  commissioner of health by the deadline established by the 
 24.33  commissioner.  Applications must meet the criteria as 
 24.34  established by the commissioner, but must contain: 
 24.35     (1) the dollar amount of charity care in the previous year, 
 24.36  as defined in subdivision 3, paragraphs (b) and (c); 
 25.1      (2) a list with the most common diagnoses for which charity 
 25.2   care is provided; and 
 25.3      (3) descriptive aggregate statistics of the characteristics 
 25.4   of patients who receive charity care. 
 25.5      Subd. 5.  [ALLOCATION OF FUNDS.] A hospital's share of the 
 25.6   available charity care aid is equal to that hospital's share of 
 25.7   charity care relative to the total charity care provided by 
 25.8   applicants. 
 25.9      Sec. 30.  Minnesota Statutes 2000, section 144.98, 
 25.10  subdivision 3, is amended to read: 
 25.11     Subd. 3.  [FEES.] (a) An application for certification 
 25.12  under subdivision 1 must be accompanied by the biennial fee 
 25.13  specified in this subdivision.  The fees are for: 
 25.14     (1) nonrefundable base certification fee, $500 $1,200; and 
 25.15     (2) test category certification fees: 
 25.16  Test Category                                  Certification Fee
 25.17  Clean water program bacteriology                      $200 $600
 25.18  Safe drinking water program bacteriology                   $600
 25.19  Clean water program inorganic chemistry, 
 25.20    fewer than four constituents                        $100 $600
 25.21  Safe drinking water program inorganic chemistry, 
 25.22    four or more constituents                           $300 $600
 25.23  Clean water program chemistry metals, 
 25.24    fewer than four constituents                        $200 $800
 25.25  Safe drinking water program chemistry metals, 
 25.26    four or more constituents                           $500 $800
 25.27  Resource conservation and recovery program 
 25.28    chemistry metals                                         $800
 25.29  Clean water program volatile organic compounds      $600 $1,200
 25.30  Safe drinking water program 
 25.31    volatile organic compounds                             $1,200
 25.32  Resource conservation and recovery program 
 25.33    volatile organic compounds                             $1,200
 25.34  Underground storage tank program
 25.35    volatile organic compounds                             $1,200
 25.36  Clean water program other organic compounds         $600 $1,200
 26.1   Safe drinking water program other organic compounds      $1,200
 26.2   Resource conservation and recovery program
 26.3     other organic compounds                                $1,200
 26.4      (b) The total biennial certification fee is the base fee 
 26.5   plus the applicable test category fees.  The biennial 
 26.6   certification fee for a contract laboratory is 1.5 times the 
 26.7   total certification fee. 
 26.8      (c) Laboratories located outside of this state that require 
 26.9   an on-site survey will be assessed an additional $1,200 $2,500 
 26.10  fee. 
 26.11     (d) Fees must be set so that the total fees support the 
 26.12  laboratory certification program.  Direct costs of the 
 26.13  certification service include program administration, 
 26.14  inspections, the agency's general support costs, and attorney 
 26.15  general costs attributable to the fee function. 
 26.16     (e) A change fee shall be assessed if a laboratory requests 
 26.17  additional analytes or methods at any time other than when 
 26.18  applying for or renewing its certification.  The change fee is 
 26.19  equal to the test category certification fee for the analyte.  
 26.20     (f) A variance fee shall be assessed if a laboratory 
 26.21  requests and is granted a variance from a rule adopted under 
 26.22  this section.  The variance fee is $500 per variance. 
 26.23     (g) Refunds or credits shall not be made for analytes or 
 26.24  methods requested but not approved.  
 26.25     (h) Certification of a laboratory shall not be awarded 
 26.26  until all fees are paid. 
 26.27     Sec. 31.  Minnesota Statutes 2000, section 144A.44, 
 26.28  subdivision 1, is amended to read: 
 26.29     Subdivision 1.  [STATEMENT OF RIGHTS.] A person who 
 26.30  receives home care services has these rights: 
 26.31     (1) the right to receive written information about rights 
 26.32  in advance of receiving care or during the initial evaluation 
 26.33  visit before the initiation of treatment, including what to do 
 26.34  if rights are violated; 
 26.35     (2) the right to receive care and services according to a 
 26.36  suitable and up-to-date plan, and subject to accepted medical or 
 27.1   nursing standards, to take an active part in creating and 
 27.2   changing the plan and evaluating care and services; 
 27.3      (3) the right to be told in advance of receiving care about 
 27.4   the services that will be provided, the disciplines that will 
 27.5   furnish care, the frequency of visits proposed to be furnished, 
 27.6   other choices that are available, and the consequences of these 
 27.7   choices including the consequences of refusing these services; 
 27.8      (4) the right to be told in advance of any change in the 
 27.9   plan of care and to take an active part in any change; 
 27.10     (5) the right to refuse services or treatment; 
 27.11     (6) the right to know, in advance, any limits to the 
 27.12  services available from a provider, and the provider's grounds 
 27.13  for a termination of services; 
 27.14     (7) the right to know in advance of receiving care whether 
 27.15  the services are covered by health insurance, medical 
 27.16  assistance, or other health programs, the charges for services 
 27.17  that will not be covered by Medicare, and the charges that the 
 27.18  individual may have to pay; 
 27.19     (8) the right to know what the charges are for services, no 
 27.20  matter who will be paying the bill; 
 27.21     (9) the right to know that there may be other services 
 27.22  available in the community, including other home care services 
 27.23  and providers, and to know where to go for information about 
 27.24  these services; 
 27.25     (10) the right to choose freely among available providers 
 27.26  and to change providers after services have begun, within the 
 27.27  limits of health insurance, medical assistance, or other health 
 27.28  programs; 
 27.29     (11) the right to have personal, financial, and medical 
 27.30  information kept private, and to be advised of the provider's 
 27.31  policies and procedures regarding disclosure of such 
 27.32  information; 
 27.33     (12) the right to be allowed access to records and written 
 27.34  information from records in accordance with section 144.335; 
 27.35     (13) the right to be served by people who are properly 
 27.36  trained and competent to perform their duties; 
 28.1      (14) the right to be treated with courtesy and respect, and 
 28.2   to have the patient's property treated with respect; 
 28.3      (15) the right to be free from physical and verbal abuse; 
 28.4      (16) the right to reasonable, advance notice of changes in 
 28.5   services or charges, including at least ten days' advance notice 
 28.6   of the termination of a service by a provider, except in cases 
 28.7   where: 
 28.8      (i) the recipient of services engages in conduct that 
 28.9   alters the conditions of employment as specified in the 
 28.10  employment contract between the home care provider and the 
 28.11  individual providing home care services, or creates an abusive 
 28.12  or unsafe work environment for the individual providing home 
 28.13  care services; or 
 28.14     (ii) an emergency for the informal caregiver or a 
 28.15  significant change in the recipient's condition has resulted in 
 28.16  service needs that exceed the current service provider agreement 
 28.17  and that cannot be safely met by the home care provider; 
 28.18     (17) the right to a coordinated transfer when there will be 
 28.19  a change in the provider of services; 
 28.20     (18) the right to voice grievances regarding treatment or 
 28.21  care that is, or fails to be, furnished, or regarding the lack 
 28.22  of courtesy or respect to the patient or the patient's property; 
 28.23     (19) the right to know how to contact an individual 
 28.24  associated with the provider who is responsible for handling 
 28.25  problems and to have the provider investigate and attempt to 
 28.26  resolve the grievance or complaint; 
 28.27     (20) the right to know the name and address of the state or 
 28.28  county agency to contact for additional information or 
 28.29  assistance; and 
 28.30     (21) the right to assert these rights personally, or have 
 28.31  them asserted by the patient's family or guardian when the 
 28.32  patient has been judged incompetent, without retaliation. 
 28.33     Sec. 32.  [145.4241] [DEFINITIONS.] 
 28.34     Subdivision 1.  [APPLICABILITY.] As used in sections 
 28.35  145.4241 to 145.4246, the following terms have the meaning given 
 28.36  them. 
 29.1      Subd. 2.  [ABORTION.] "Abortion" means the use or 
 29.2   prescription of any instrument, medicine, drug, or any other 
 29.3   substance or device to intentionally terminate the pregnancy of 
 29.4   a female known to be pregnant, with an intention other than to 
 29.5   increase the probability of a live birth, to preserve the life 
 29.6   or health of the child after live birth, or to remove a dead 
 29.7   fetus.  
 29.8      Subd. 3.  [ATTEMPT TO PERFORM AN ABORTION.] "Attempt to 
 29.9   perform an abortion" means an act, or an omission of a 
 29.10  statutorily required act, that, under the circumstances as the 
 29.11  actor believes them to be, constitutes a substantial step in a 
 29.12  course of conduct planned to culminate in the performance of an 
 29.13  abortion in Minnesota in violation of sections 145.4241 to 
 29.14  145.4246. 
 29.15     Subd. 4.  [MEDICAL EMERGENCY.] "Medical emergency" means 
 29.16  any condition that, on the basis of the physician's good faith 
 29.17  clinical judgment, complicates the medical condition of a 
 29.18  pregnant female to the extent that: 
 29.19     (1) an immediate abortion of her pregnancy is necessary to 
 29.20  avert her death; or 
 29.21     (2) a 24-hour delay in performing an abortion creates a 
 29.22  serious risk of substantial and irreversible impairment of a 
 29.23  major bodily function.  
 29.24     Subd. 5.  [PHYSICIAN.] "Physician" means a person licensed 
 29.25  under chapter 147. 
 29.26     Subd. 6.  [PROBABLE GESTATIONAL AGE OF THE UNBORN 
 29.27  CHILD.] "Probable gestational age of the unborn child" means 
 29.28  what will, in the judgment of the physician, with reasonable 
 29.29  probability, be the gestational age of the unborn child at the 
 29.30  time the abortion is planned to be performed. 
 29.31     Sec. 33.  [145.4242] [INFORMED CONSENT.] 
 29.32     No abortion shall be performed in this state except with 
 29.33  the voluntary and informed consent of the female upon whom the 
 29.34  abortion is to be performed.  Except in the case of a medical 
 29.35  emergency, consent to an abortion is voluntary and informed only 
 29.36  if: 
 30.1      (1) the female is told the following, by telephone or in 
 30.2   person, by the physician who is to perform the abortion or by a 
 30.3   referring physician, at least 24 hours before the abortion: 
 30.4      (i) the name of the physician who will perform the 
 30.5   abortion; 
 30.6      (ii) the particular medical risks associated with the 
 30.7   particular abortion procedure to be employed including, when 
 30.8   medically accurate, the risks of infection, hemorrhage, breast 
 30.9   cancer, danger to subsequent pregnancies, and infertility; 
 30.10     (iii) the probable gestational age of the unborn child at 
 30.11  the time the abortion is to be performed; and 
 30.12     (iv) the medical risks associated with carrying her child 
 30.13  to term. 
 30.14     The information required by this clause may be provided by 
 30.15  telephone without conducting a physical examination or tests of 
 30.16  the patient, in which case the information required to be 
 30.17  provided may be based on facts supplied the physician by the 
 30.18  female and whatever other relevant information is reasonably 
 30.19  available to the physician.  It may not be provided by a tape 
 30.20  recording, but must be provided during a consultation in which 
 30.21  the physician is able to ask questions of the female and the 
 30.22  female is able to ask questions of the physician.  If a physical 
 30.23  examination, tests, or the availability of other information to 
 30.24  the physician subsequently indicate, in the medical judgment of 
 30.25  the physician, a revision of the information previously supplied 
 30.26  to the patient, that revised information may be communicated to 
 30.27  the patient at any time prior to the performance of the 
 30.28  abortion.  Nothing in this section may be construed to preclude 
 30.29  provision of required information in a language understood by 
 30.30  the patient through a translator; 
 30.31     (2) the female is informed, by telephone or in person, by 
 30.32  the physician who is to perform the abortion, by a referring 
 30.33  physician, or by an agent of either physician at least 24 hours 
 30.34  before the abortion: 
 30.35     (i) that medical assistance benefits may be available for 
 30.36  prenatal care, childbirth, and neonatal care; 
 31.1      (ii) that the father is liable to assist in the support of 
 31.2   her child, even in instances when the father has offered to pay 
 31.3   for the abortion; and 
 31.4      (iii) that she has the right to review the printed 
 31.5   materials described in section 145.4243.  The physician or the 
 31.6   physician's agent shall orally inform the female that the 
 31.7   materials have been provided by the state of Minnesota and that 
 31.8   they describe the unborn child and list agencies that offer 
 31.9   alternatives to abortion.  If the female chooses to view the 
 31.10  materials, they shall either be given to her at least 24 hours 
 31.11  before the abortion or mailed to her at least 72 hours before 
 31.12  the abortion by certified mail, restricted delivery to 
 31.13  addressee, which means the postal employee can only deliver the 
 31.14  mail to the addressee.  
 31.15     The information required by this clause may be provided by 
 31.16  a tape recording if provision is made to record or otherwise 
 31.17  register specifically whether the female does or does not choose 
 31.18  to review the printed materials; 
 31.19     (3) the female certifies in writing, prior to the abortion, 
 31.20  that the information described in this section has been 
 31.21  furnished her, and that she has been informed of her opportunity 
 31.22  to review the information referred to in clause (2); and 
 31.23     (4) prior to the performance of the abortion, the physician 
 31.24  who is to perform the abortion or the physician's agent receives 
 31.25  a copy of the written certification prescribed by clause (3). 
 31.26     Sec. 34.  [145.4243] [PRINTED INFORMATION.] 
 31.27     (a) Within 90 days after the effective date of sections 
 31.28  145.4241 to 145.4246, the department of health shall cause to be 
 31.29  published, in English and in each language that is the primary 
 31.30  language of two percent or more of the state's population, the 
 31.31  following printed materials in such a way as to ensure that the 
 31.32  information is easily comprehensible: 
 31.33     (1) geographically indexed materials designed to inform the 
 31.34  female of public and private agencies and services available to 
 31.35  assist a female through pregnancy, upon childbirth, and while 
 31.36  the child is dependent, including adoption agencies, which shall 
 32.1   include a comprehensive list of the agencies available, a 
 32.2   description of the services they offer, and a description of the 
 32.3   manner, including telephone numbers, in which they might be 
 32.4   contacted or, at the option of the department of health, printed 
 32.5   materials including a toll-free, 24-hours-a-day telephone number 
 32.6   that may be called to obtain, orally, such a list and 
 32.7   description of agencies in the locality of the caller and of the 
 32.8   services they offer; and 
 32.9      (2) materials designed to inform the female of the probable 
 32.10  anatomical and physiological characteristics of the unborn child 
 32.11  at two-week gestational increments from the time when a female 
 32.12  can be known to be pregnant to full term, including any relevant 
 32.13  information on the possibility of the unborn child's survival 
 32.14  and pictures or drawings representing the development of unborn 
 32.15  children at two-week gestational increments, provided that any 
 32.16  such pictures or drawings must contain the dimensions of the 
 32.17  fetus and must be realistic and appropriate for the stage of 
 32.18  pregnancy depicted.  The materials shall be objective, 
 32.19  nonjudgmental, and designed to convey only accurate scientific 
 32.20  information about the unborn child at the various gestational 
 32.21  ages.  The material shall also contain objective information 
 32.22  describing the methods of abortion procedures commonly employed, 
 32.23  the medical risks commonly associated with each procedure, the 
 32.24  possible detrimental psychological effects of abortion, the 
 32.25  medical risks commonly associated with each procedure, and the 
 32.26  medical risks commonly associated with carrying a child to term. 
 32.27     (b) The materials referred to in this section must be 
 32.28  printed in a typeface large enough to be clearly legible.  The 
 32.29  materials required under this section must be available at no 
 32.30  cost from the department of health upon request and in 
 32.31  appropriate number to any person, facility, or hospital.  
 32.32     Sec. 35.  [145.4244] [PROCEDURE IN CASE OF MEDICAL 
 32.33  EMERGENCY.] 
 32.34     When a medical emergency compels the performance of an 
 32.35  abortion, the physician shall inform the female, prior to the 
 32.36  abortion if possible, of the medical indications supporting the 
 33.1   physician's judgment that an abortion is necessary to avert her 
 33.2   death or that a 24-hour delay in conformance with section 
 33.3   145.4242 creates a serious risk of substantial and irreversible 
 33.4   impairment of a major bodily function. 
 33.5      Sec. 36.  [145.4245] [REMEDIES.] 
 33.6      Subdivision 1.  [CIVIL REMEDIES.] Any person upon whom an 
 33.7   abortion has been performed or the parent of a minor upon whom 
 33.8   an abortion has been performed may maintain an action against 
 33.9   the person who performed the abortion in knowing or reckless 
 33.10  violation of sections 145.4241 to 145.4246 for actual and 
 33.11  punitive damages.  Any person upon whom an abortion has been 
 33.12  attempted without complying with sections 145.4241 to 145.4246 
 33.13  may maintain an action against the person who attempted to 
 33.14  perform the abortion in knowing or reckless violation of 
 33.15  sections 145.4241 to 145.4246 for actual and punitive damages. 
 33.16     Subd. 2.  [ATTORNEY FEES.] If judgment is rendered in favor 
 33.17  of the plaintiff in any action described in this section, the 
 33.18  court shall also render judgment for a reasonable attorney's fee 
 33.19  in favor of the plaintiff against the defendant.  If judgment is 
 33.20  rendered in favor of the defendant and the court finds that the 
 33.21  plaintiff's suit was frivolous and brought in bad faith, the 
 33.22  court shall also render judgment for a reasonable attorney's fee 
 33.23  in favor of the defendant against the plaintiff. 
 33.24     Subd. 3.  [PROTECTION OF PRIVACY IN COURT PROCEEDINGS.] In 
 33.25  every civil action brought under sections 145.4241 to 145.4246, 
 33.26  the court shall rule whether the anonymity of any female upon 
 33.27  whom an abortion has been performed or attempted shall be 
 33.28  preserved from public disclosure if she does not give her 
 33.29  consent to such disclosure.  The court, upon motion or sua 
 33.30  sponte, shall make such a ruling and, upon determining that her 
 33.31  anonymity should be preserved, shall issue orders to the 
 33.32  parties, witnesses, and counsel and shall direct the sealing of 
 33.33  the record and exclusion of individuals from courtrooms or 
 33.34  hearing rooms to the extent necessary to safeguard her identity 
 33.35  from public disclosure.  Each order must be accompanied by 
 33.36  specific written findings explaining why the anonymity of the 
 34.1   female should be preserved from public disclosure, why the order 
 34.2   is essential to that end, how the order is narrowly tailored to 
 34.3   serve that interest, and why no reasonable, less restrictive 
 34.4   alternative exists.  In the absence of written consent of the 
 34.5   female upon whom an abortion has been performed or attempted, 
 34.6   anyone, other than a public official, who brings an action under 
 34.7   subdivision 1, shall do so under a pseudonym.  This section may 
 34.8   not be construed to conceal the identity of the plaintiff or of 
 34.9   witnesses from the defendant. 
 34.10     Sec. 37.  [145.4246] [SEVERABILITY.] 
 34.11     If any one or more provision, section, subsection, 
 34.12  sentence, clause, phrase, or word of sections 145.4241 to 
 34.13  145.4246 or the application thereof to any person or 
 34.14  circumstance is found to be unconstitutional, the same is hereby 
 34.15  declared to be severable and the balance of sections 145.4241 to 
 34.16  145.4246 shall remain effective notwithstanding such 
 34.17  unconstitutionality.  The legislature hereby declares that it 
 34.18  would have passed sections 145.4241 to 145.4246, and each 
 34.19  provision, section, subsection, sentence, clause, phrase, or 
 34.20  word thereof, irrespective of the fact that any one or more 
 34.21  provision, section, subsection, sentence, clause, phrase, or 
 34.22  word be declared unconstitutional. 
 34.23     Sec. 38.  Minnesota Statutes 2000, section 145.881, 
 34.24  subdivision 2, is amended to read: 
 34.25     Subd. 2.  [DUTIES.] The advisory task force shall meet on a 
 34.26  regular basis to perform the following duties:  
 34.27     (a) review and report on the health care needs of mothers 
 34.28  and children throughout the state of Minnesota; 
 34.29     (b) review and report on the type, frequency and impact of 
 34.30  maternal and child health care services provided to mothers and 
 34.31  children under existing maternal and child health care programs, 
 34.32  including programs administered by the commissioner of health; 
 34.33     (c) establish, review, and report to the commissioner a 
 34.34  list of program guidelines and criteria which the advisory task 
 34.35  force considers essential to providing an effective maternal and 
 34.36  child health care program to low income populations and high 
 35.1   risk persons and fulfilling the purposes defined in section 
 35.2   145.88; 
 35.3      (d) review staff recommendations of the department of 
 35.4   health regarding maternal and child health grant awards before 
 35.5   the awards are made; 
 35.6      (e) make recommendations to the commissioner for the use of 
 35.7   other federal and state funds available to meet maternal and 
 35.8   child health needs; 
 35.9      (f) make recommendations to the commissioner of health on 
 35.10  priorities for funding the following maternal and child health 
 35.11  services:  (1) prenatal, delivery and postpartum care, (2) 
 35.12  comprehensive health care for children, especially from birth 
 35.13  through five years of age, (3) adolescent health services, (4) 
 35.14  family planning services, (5) preventive dental care, (6) 
 35.15  special services for chronically ill and handicapped children 
 35.16  and (7) any other services which promote the health of mothers 
 35.17  and children; and 
 35.18     (g) make recommendations to the commissioner of health on 
 35.19  the process to distribute, award and administer the maternal and 
 35.20  child health block grant funds; and 
 35.21     (h) review the measures that are used to define the 
 35.22  variables of the funding distribution formula in section 
 35.23  145.882, subdivision 4a, every two years and make 
 35.24  recommendations to the commissioner of health for changes based 
 35.25  upon principles established by the advisory task force for this 
 35.26  purpose.  
 35.27     Sec. 39.  Minnesota Statutes 2000, section 145.882, is 
 35.28  amended by adding a subdivision to read: 
 35.29     Subd. 4a.  [ALLOCATION TO COMMUNITY HEALTH BOARDS.] (a) 
 35.30  Federal maternal and child health block grant money remaining 
 35.31  after distributions made under subdivision 2 and money 
 35.32  appropriated for allocation to community health boards must be 
 35.33  allocated according to paragraphs (b) to (d) to community health 
 35.34  boards as defined in section 145A.02, subdivision 5.  
 35.35     (b) All community health boards must receive 95 percent of 
 35.36  the funding awarded to them for the 1998-1999 funding cycle.  If 
 36.1   the amount of state and federal funding available is less than 
 36.2   95 percent of the amount awarded to community health boards for 
 36.3   the 1998-1999 funding cycle, the available funding must be 
 36.4   apportioned to reflect a proportional decrease for each 
 36.5   recipient. 
 36.6      (c) The federal and state funding remaining after 
 36.7   distributions made under paragraph (b) must be allocated to each 
 36.8   community health board based on the following three variables: 
 36.9      (1) 25 percent based on the maternal and child population 
 36.10  in the area served by the community health board; 
 36.11     (2) 50 percent based on the following factors, as 
 36.12  determined by averaging the data available for the three most 
 36.13  recent years: 
 36.14     (i) the proportion of infants in the area served by the 
 36.15  community health board whose weight at birth was less than 2,500 
 36.16  grams; 
 36.17     (ii) the proportion of mothers in the area served by the 
 36.18  community health board who received inadequate or no prenatal 
 36.19  care; 
 36.20     (iii) the proportion of births in the area served by the 
 36.21  community health board to women under age 19; and 
 36.22     (iv) the proportion of births in the area served by the 
 36.23  community health board to American Indian women and women of 
 36.24  color; and 
 36.25     (3) 25 percent based on the income of the maternal and 
 36.26  child population in the area served by the community health 
 36.27  board. 
 36.28     (d) Each variable must be expressed as a city or county 
 36.29  score consisting of the city or county frequency of each 
 36.30  variable in relation to the statewide frequency of the 
 36.31  variable.  A total score for each city or county jurisdiction 
 36.32  must be computed by totaling the scores of the three variables.  
 36.33  Each community health board must be allocated an amount equal to 
 36.34  the total score obtained for the city, county, or counties in 
 36.35  its area multiplied by the amount of money available. 
 36.36     Sec. 40.  Minnesota Statutes 2000, section 145.882, 
 37.1   subdivision 7, is amended to read: 
 37.2      Subd. 7.  [USE OF BLOCK GRANT MONEY.] (a) Maternal and 
 37.3   child health block grant money allocated to a community health 
 37.4   board or community health services area under this section must 
 37.5   be used for qualified programs for high risk and low-income 
 37.6   individuals.  Block grant money must be used for programs that: 
 37.7      (1) specifically address the highest risk populations, 
 37.8   particularly low-income and minority groups with a high rate of 
 37.9   infant mortality and children with low birth weight, by 
 37.10  providing services, including excluding prepregnancy family 
 37.11  planning services, calculated to produce measurable decreases in 
 37.12  infant mortality rates, instances of children with low birth 
 37.13  weight, and medical complications associated with pregnancy and 
 37.14  childbirth, including infant mortality, low birth rates, and 
 37.15  medical complications arising from chemical abuse by a mother 
 37.16  during pregnancy; 
 37.17     (2) specifically target pregnant women whose age, medical 
 37.18  condition, maternal history, or chemical abuse substantially 
 37.19  increases the likelihood of complications associated with 
 37.20  pregnancy and childbirth or the birth of a child with an 
 37.21  illness, disability, or special medical needs; 
 37.22     (3) specifically address the health needs of young children 
 37.23  who have or are likely to have a chronic disease or disability 
 37.24  or special medical needs, including physical, neurological, 
 37.25  emotional, and developmental problems that arise from chemical 
 37.26  abuse by a mother during pregnancy; 
 37.27     (4) provide family planning and preventive medical care, 
 37.28  excluding prepregnancy family planning services, for 
 37.29  specifically identified target populations, such as minority and 
 37.30  low-income teenagers, in a manner calculated to decrease the 
 37.31  occurrence of inappropriate pregnancy and minimize the risk of 
 37.32  complications associated with pregnancy and childbirth; or 
 37.33     (5) specifically address the frequency and severity of 
 37.34  childhood injuries and other child and adolescent health 
 37.35  problems in high-risk target populations by providing services, 
 37.36  excluding prepregnancy family planning services, calculated to 
 38.1   produce measurable decreases in mortality and 
 38.2   morbidity.  However, money may be used for this purpose only if 
 38.3   the community health board's application includes program 
 38.4   components for the purposes in clauses (1) to (4) in the 
 38.5   proposed geographic service area and the total expenditure for 
 38.6   injury-related programs under this clause does not exceed ten 
 38.7   percent of the total allocation under subdivision 3. 
 38.8      (b) Maternal and child health block grant money may be used 
 38.9   for purposes other than the purposes listed in this subdivision 
 38.10  only under the following conditions:  
 38.11     (1) the community health board or community health services 
 38.12  area can demonstrate that existing programs fully address the 
 38.13  needs of the highest risk target populations described in this 
 38.14  subdivision; or 
 38.15     (2) the money is used to continue projects that received 
 38.16  funding before creation of the maternal and child health block 
 38.17  grant in 1981. 
 38.18     (c) Projects that received funding before creation of the 
 38.19  maternal and child health block grant in 1981, must be allocated 
 38.20  at least the amount of maternal and child health special project 
 38.21  grant funds received in 1989, unless (1) the local board of 
 38.22  health provides equivalent alternative funding for the project 
 38.23  from another source; or (2) the local board of health 
 38.24  demonstrates that the need for the specific services provided by 
 38.25  the project has significantly decreased as a result of changes 
 38.26  in the demographic characteristics of the population, or other 
 38.27  factors that have a major impact on the demand for services.  If 
 38.28  the amount of federal funding to the state for the maternal and 
 38.29  child health block grant is decreased, these projects must 
 38.30  receive a proportional decrease as required in subdivision 1.  
 38.31  Increases in allocation amounts to local boards of health under 
 38.32  subdivision 4 may be used to increase funding levels for these 
 38.33  projects. 
 38.34     Sec. 41.  Minnesota Statutes 2000, section 145.885, 
 38.35  subdivision 2, is amended to read: 
 38.36     Subd. 2.  [ADDITIONAL REQUIREMENTS FOR COMMUNITY BOARDS OF 
 39.1   HEALTH.] Applications by community health boards as defined in 
 39.2   section 145A.02, subdivision 5, under section 145.882, 
 39.3   subdivision 3 4a, must also contain a summary of the process 
 39.4   used to develop the local program, including evidence that the 
 39.5   community health board notified local public and private 
 39.6   providers of the availability of funding through the community 
 39.7   health board for maternal and child health services; a list of 
 39.8   all public and private agency requests for grants submitted to 
 39.9   the community health board indicating which requests were 
 39.10  included in the grant application; and an explanation of how 
 39.11  priorities were established for selecting the requests to be 
 39.12  included in the grant application.  The community health board 
 39.13  shall include, with the grant application, a written statement 
 39.14  of the criteria to be applied to public and private agency 
 39.15  requests for funding. 
 39.16     Sec. 42.  Minnesota Statutes 2000, section 145.924, is 
 39.17  amended to read: 
 39.18     145.924 [AIDS PREVENTION GRANTS.] 
 39.19     Subdivision 1.  [GRANT AWARDS.] (a) The commissioner may 
 39.20  award grants to boards of health as defined in section 145A.02, 
 39.21  subdivision 2, state agencies, state councils, or nonprofit 
 39.22  corporations to provide evaluation and counseling services to 
 39.23  populations at risk for acquiring human immunodeficiency virus 
 39.24  infection, including, but not limited to, minorities, 
 39.25  adolescents, intravenous drug users, and homosexual men.  
 39.26     (b) The commissioner may award grants to agencies 
 39.27  experienced in providing services to communities of color, for 
 39.28  the design of innovative outreach and education programs for 
 39.29  targeted groups within the community who may be at risk of 
 39.30  acquiring the human immunodeficiency virus infection, including 
 39.31  intravenous drug users and their partners, adolescents, gay and 
 39.32  bisexual individuals and women.  Grants shall be awarded on a 
 39.33  request for proposal basis and shall include funds for 
 39.34  administrative costs.  Priority for grants shall be given to 
 39.35  agencies or organizations that have experience in providing 
 39.36  service to the particular community which the grantee proposes 
 40.1   to serve; that have policymakers representative of the targeted 
 40.2   population; that have experience in dealing with issues relating 
 40.3   to HIV/AIDS; and that have the capacity to deal effectively with 
 40.4   persons of differing sexual orientations.  For purposes of this 
 40.5   paragraph, the "communities of color" are:  the American-Indian 
 40.6   community; the Hispanic community; the African-American 
 40.7   community; and the Asian-Pacific community. 
 40.8      (c) All state grants awarded under this section subdivision 
 40.9   for programs targeted to adolescents shall include the promotion 
 40.10  of abstinence from sexual activity and drug use. 
 40.11     Subd. 2.  [OUTCOMES.] The commissioner, in consultation 
 40.12  with boards of health, agencies, councils, and nonprofit 
 40.13  organizations involved in human immunodeficiency virus infection 
 40.14  prevention efforts shall establish measurable outcomes to 
 40.15  determine the effectiveness of the grants provided under this 
 40.16  section in reducing the number of people who acquire human 
 40.17  immunodeficiency virus, the rates of infection, and average 
 40.18  numbers of sexual partners for populations served by grants 
 40.19  funded under this section. 
 40.20     Subd. 3.  [EVALUATION.] (a) Using the outcomes established 
 40.21  according to subdivision 2, the commissioner shall conduct a 
 40.22  biennial evaluation of activities funded under this section.  
 40.23  The evaluation must include: 
 40.24     (1) the effect of these activities on the number of people 
 40.25  who acquire human immunodeficiency virus and the rates of 
 40.26  infection; 
 40.27     (2) the effect of these activities on average numbers of 
 40.28  sexual partners for populations served by grants funded under 
 40.29  this section; and 
 40.30     (3) a longitudinal tracking of outcomes for targeted 
 40.31  populations who are served under subdivision 1, paragraphs (a) 
 40.32  and (b). 
 40.33     (b) Grant recipients shall cooperate with the commissioner 
 40.34  in the evaluation and shall provide the commissioner with the 
 40.35  information needed to conduct the evaluation.  Beginning January 
 40.36  15, 2003, the results of each evaluation must be submitted to 
 41.1   the chairs of the policy and finance committees in the house and 
 41.2   senate with jurisdiction over health and human services. 
 41.3      Sec. 43.  Minnesota Statutes 2000, section 145.925, 
 41.4   subdivision 1, is amended to read: 
 41.5      Subdivision 1.  [ELIGIBLE ORGANIZATIONS; PURPOSE.] The 
 41.6   commissioner of health may make special grants to cities, 
 41.7   counties, tribal governments, or groups of cities or, counties, 
 41.8   or nonprofit corporations or tribal governments to provide 
 41.9   prepregnancy family planning services. targeted to low-income 
 41.10  and minority populations.  A city, county, tribal government, or 
 41.11  group of cities, counties, or tribal governments that receives a 
 41.12  grant is responsible for ensuring that the grant funds are used 
 41.13  for services targeted to low-income and minority populations, 
 41.14  and must establish a goal for reducing specific pregnancy rates 
 41.15  in the service area.  In determining populations to serve and 
 41.16  services to provide, a city, county, tribal government, or group 
 41.17  of cities, counties, or tribal governments must consider the 
 41.18  spacing of pregnancies in low-income and minority populations in 
 41.19  the service area, teen birth rates in the service area, and the 
 41.20  needs of populations of color in the service area.  A city, 
 41.21  county, tribal government, or group of cities, counties, or 
 41.22  tribal governments may contract for the provision of 
 41.23  prepregnancy family planning services using grant funds provided 
 41.24  under this section only if the contract is specifically 
 41.25  authorized by the governing body of the city, county, or tribal 
 41.26  government that is contracting for the services. 
 41.27     Any organization or an affiliate of an organization which 
 41.28  provides abortions, promotes abortions, or directly refers for 
 41.29  abortions, shall be ineligible to receive funds under this 
 41.30  subdivision. 
 41.31     Sec. 44.  Minnesota Statutes 2000, section 145.925, 
 41.32  subdivision 1a, is amended to read: 
 41.33     Subd. 1a.  [FAMILY PLANNING SERVICES; DEFINED.] "Family 
 41.34  planning services" means counseling by trained personnel 
 41.35  regarding family planning; distribution of information relating 
 41.36  to family planning, referral to licensed physicians or local 
 42.1   health agencies for consultation, examination, medical 
 42.2   treatment, genetic counseling, and prescriptions for the purpose 
 42.3   of family planning; and the distribution of family planning 
 42.4   products, such as charts, thermometers, drugs, medical 
 42.5   preparations, and contraceptive devices.  Family planning 
 42.6   services do not include services that, directly or indirectly, 
 42.7   encourage, counsel, refer, or provide abortions or abortion 
 42.8   referrals.  For purposes of sections 145A.01 to 145A.14, family 
 42.9   planning shall mean voluntary action by individuals to prevent 
 42.10  or aid conception but does not include the performance, or make 
 42.11  referrals for encouragement of voluntary termination of 
 42.12  pregnancy services that, directly or indirectly, encourage, 
 42.13  counsel, refer, or provide abortions or abortion referrals.  
 42.14     Sec. 45.  [145.9257] [TEEN PREGNANCY PREVENTION.] 
 42.15     Subdivision 1.  [GOAL.] It is the goal of the state to 
 42.16  reduce teen pregnancy rates by 24 percent by 2006.  To do so, 
 42.17  the commissioner of health shall establish a grant program to 
 42.18  reduce the rates of unintended teen pregnancies in the state.  
 42.19  If this goal of reducing teen pregnancy rates by 24 percent is 
 42.20  not met by December 31, 2006, this section expires June 30, 
 42.21  2007.  No funds awarded under this section may be used for 
 42.22  medical services or family planning services or for services 
 42.23  that, directly or indirectly, encourage, counsel, refer, or 
 42.24  provide abortions or abortion referrals. 
 42.25     Any organization or an affiliate of an organization which 
 42.26  provides abortions, promotes abortions, or directly refers for 
 42.27  abortions, shall be ineligible to receive funds under this 
 42.28  section. 
 42.29     Subd. 2.  [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The 
 42.30  commissioner, in consultation with the commissioner of children, 
 42.31  families, and learning; the commissioner of human services; the 
 42.32  maternal and child health advisory task force under section 
 42.33  145.881; the Indian affairs council under section 3.922; the 
 42.34  council on affairs of Chicano/Latino people under section 
 42.35  3.9223; the council on Black Minnesotans under section 3.9225; 
 42.36  the council on Asian-Pacific Minnesotans under section 3.9226; 
 43.1   community health boards as defined in section 145A.02; tribal 
 43.2   governments; nonprofit community organizations; and others 
 43.3   interested in teen pregnancy prevention, shall develop and 
 43.4   implement a comprehensive, coordinated plan to reduce the number 
 43.5   of teen pregnancies. 
 43.6      Subd. 3.  [MEASURABLE OUTCOMES.] The commissioner, in 
 43.7   consultation with the commissioners and community partners 
 43.8   listed in subdivision 2, shall establish measurable outcomes to 
 43.9   achieve the goal specified in subdivision 1 and to determine the 
 43.10  effectiveness of the grants provided under this section in 
 43.11  reducing teen pregnancies.  The development of measurable 
 43.12  outcomes must be completed before any funds are distributed 
 43.13  under this section. 
 43.14     Subd. 4.  [STATEWIDE ASSESSMENT.] The commissioner shall 
 43.15  use and enhance current statewide assessments of teen pregnancy 
 43.16  risk behaviors and attitudes among youth to establish a baseline 
 43.17  to measure the statewide effect of teen pregnancy prevention 
 43.18  activities.  To the extent feasible, the commissioner shall 
 43.19  conduct the assessment so that the results may be compared to 
 43.20  national data. 
 43.21     Subd. 5.  [PROCESS.] The commissioner, in consultation with 
 43.22  the commissioners and community partners listed in subdivision 
 43.23  2, shall develop the criteria and procedures used to allocate 
 43.24  grants under this section.  In developing the criteria, the 
 43.25  commissioner shall establish an administrative cost limit for 
 43.26  grant recipients.  At the time a grant is awarded, the 
 43.27  commissioner shall provide a grant recipient with information on 
 43.28  the outcomes established according to subdivision 3. 
 43.29     Subd. 6.  [TEEN PREGNANCY PREVENTION DISPARITY GRANTS.] (a) 
 43.30  The commissioner shall award competitive grants to eligible 
 43.31  applicants for projects to reduce disparities in unintended teen 
 43.32  pregnancy rates for American Indians and populations of color, 
 43.33  as compared with unintended teen pregnancy rates for whites. 
 43.34     (b) No funds awarded under this subdivision may be used for 
 43.35  medical services or family planning services or for services 
 43.36  that, directly or indirectly, encourage, counsel, refer, or 
 44.1   provide abortions or abortion referrals. 
 44.2      Any organization or an affiliate of an organization which 
 44.3   provides abortions, promotes abortions, or directly refers for 
 44.4   abortions, shall be ineligible to receive funds under this 
 44.5   subdivision. 
 44.6      (c) Eligible applicants may include, but are not limited 
 44.7   to, nonprofit organizations, school districts, faith-based 
 44.8   organizations, community health boards, and tribal governments.  
 44.9   Applicants must submit proposals to the commissioner.  A 
 44.10  proposal must specify the strategies to be implemented and must 
 44.11  take into account the need for a coordinated, statewide teen 
 44.12  pregnancy prevention effort.  Strategies may include youth 
 44.13  development programs, after-school enrichment programs, youth 
 44.14  mentoring programs, academic support programs, and abstinence 
 44.15  until marriage education programs. 
 44.16     (d) The commissioner shall give priority to applicants who 
 44.17  demonstrate that their proposed project:  
 44.18     (1) emphasizes abstinence until marriage; 
 44.19     (2) is research-based or based on proven, effective 
 44.20  strategies; 
 44.21     (3) is designed to coordinate with related youth risk 
 44.22  behavior reduction activities; 
 44.23     (4) involves youth and parents in the project's development 
 44.24  and implementation; 
 44.25     (5) reflects racially and ethnically appropriate 
 44.26  approaches; and 
 44.27     (6) will be implemented through or with persons or 
 44.28  community-based organizations that reflect the race or ethnicity 
 44.29  of the population to be reached. 
 44.30     Subd. 7.  [HIGH-RISK COMMUNITY TEEN PREGNANCY PREVENTION 
 44.31  GRANTS.] (a) The commissioner shall award grants to communities 
 44.32  that have significant risk factors for teen pregnancies, that 
 44.33  currently have in place youth development programs, and that are 
 44.34  interested in expanding existing efforts to prevent teen 
 44.35  pregnancies. 
 44.36     (b) No funds awarded under this subdivision may be used for 
 45.1   medical services or family planning services or for services 
 45.2   that, directly or indirectly, encourage, counsel, refer, or 
 45.3   provide abortions or abortion referrals. 
 45.4      Any organization or an affiliate of an organization which 
 45.5   provides abortions, promotes abortions, or directly refers for 
 45.6   abortions, shall be ineligible to receive funds under this 
 45.7   subdivision. 
 45.8      (c) To be eligible for a grant under this subdivision, an 
 45.9   applicant must be a tribal government or a community health 
 45.10  board as defined in section 145A.02.  Applicants must submit 
 45.11  proposals to the commissioner.  A proposal must specify the 
 45.12  strategies to be implemented.  Strategies may include, but are 
 45.13  not limited to, youth development programs, youth mentoring 
 45.14  programs, academic support programs, and abstinence until 
 45.15  marriage education programs.  Applicants must demonstrate that a 
 45.16  proposed project: 
 45.17     (1) emphasizes abstinence until marriage; 
 45.18     (2) is research-based or based on proven, effective 
 45.19  strategies; 
 45.20     (3) is designed to coordinate with related youth risk 
 45.21  behavior reduction activities; 
 45.22     (4) involves youth and parents in the project's development 
 45.23  and implementation; 
 45.24     (5) reflects racially and ethnically appropriate 
 45.25  approaches; and 
 45.26     (6) will be implemented through or with persons or 
 45.27  community-based organizations that reflect the race or ethnicity 
 45.28  of the population to be reached. 
 45.29     (d) Grants may be awarded to up to 15 community health 
 45.30  boards and three tribal governments based on areas having the 
 45.31  highest risk factors for teen pregnancies.  The commissioner 
 45.32  shall award grants based on the following risk factors: 
 45.33     (1) the proportion of teens in the applicant's service area 
 45.34  who are sexually active; 
 45.35     (2) the proportion of births to teens in the applicant's 
 45.36  service area; and 
 46.1      (3) the proportion of births to teens who are American 
 46.2   Indian or of a population of color in the applicant's service 
 46.3   area. 
 46.4      Subd. 8.  [ADOLESCENT PARENT GRANTS.] The commissioner 
 46.5   shall transfer funds to the commissioner of children, families, 
 46.6   and learning to increase the number of adolescent parent grants 
 46.7   currently provided by the commissioner of children, families, 
 46.8   and learning under section 124D.33. 
 46.9      Subd. 9.  [COORDINATION.] The commissioner shall coordinate 
 46.10  the projects and initiatives funded under this section with 
 46.11  other efforts at the local, state, and national levels to avoid 
 46.12  duplication and promote complementary efforts. 
 46.13     Subd. 10.  [EVALUATION.] Using the outcomes established 
 46.14  according to subdivision 3, the commissioner shall conduct a 
 46.15  biennial evaluation of the impact of each teen pregnancy 
 46.16  prevention initiative in this section.  Grant recipients and the 
 46.17  commissioner of children, families, and learning shall cooperate 
 46.18  with the commissioner in the evaluation and shall provide the 
 46.19  commissioner with the information needed to conduct the 
 46.20  evaluation. 
 46.21     Subd. 11.  [REPORT.] By January 15, 2002, and January 15 of 
 46.22  each even-numbered year thereafter, the commissioner shall 
 46.23  submit a report to the legislature on the projects funded under 
 46.24  this section and the results of the biennial evaluation. 
 46.25     Sec. 46.  [145.9268] [COMMUNITY CLINIC GRANTS.] 
 46.26     Subdivision 1.  [DEFINITION.] For purposes of this section, 
 46.27  "eligible community clinic" means: 
 46.28     (1) a clinic that provides services under conditions as 
 46.29  defined in Minnesota Rules, part 9505.0255 or 9505.0380, and 
 46.30  utilizes a sliding fee scale to determine eligibility for 
 46.31  charity care; 
 46.32     (2) an Indian tribal government or Indian health service 
 46.33  unit; or 
 46.34     (3) a consortium of clinics comprised of entities under 
 46.35  clause (1) or (2). 
 46.36     Subd. 2.  [GRANTS AUTHORIZED.] The commissioner of health 
 47.1   shall award grants to eligible community clinics to improve the 
 47.2   ongoing viability of Minnesota's clinic-based safety net 
 47.3   providers.  Grants shall be awarded to support the capacity of 
 47.4   eligible community clinics to serve low-income populations, 
 47.5   reduce current or future uncompensated care burdens, or provide 
 47.6   for improved care delivery infrastructure. 
 47.7      Subd. 3.  [ALLOCATION OF GRANTS.] (a) To receive a grant 
 47.8   under this section, an eligible community clinic must submit an 
 47.9   application to the commissioner of health by the deadline 
 47.10  established by the commissioner.  A grant may be awarded upon 
 47.11  the signing of a grant contract. 
 47.12     (b) An application must be on a form and contain 
 47.13  information as specified by the commissioner but at a minimum 
 47.14  must contain: 
 47.15     (1) a description of the project for which grant funds will 
 47.16  be used; 
 47.17     (2) a description of the problem the proposed project will 
 47.18  address; and 
 47.19     (3) a description of achievable objectives, a workplan, and 
 47.20  a timeline for project completion. 
 47.21     (c) The commissioner shall review each application to 
 47.22  determine whether the application is complete and whether the 
 47.23  applicant and the project are eligible for a grant.  In 
 47.24  evaluating applications according to paragraph (e), the 
 47.25  commissioner shall establish criteria including, but not limited 
 47.26  to:  the priority level of the project; the applicant's 
 47.27  thoroughness and clarity in describing the problem; a 
 47.28  description of the applicant's proposed project; the manner in 
 47.29  which the applicant will demonstrate the effectiveness of the 
 47.30  project; and evidence of efficiencies and effectiveness gained 
 47.31  through collaborative efforts.  The commissioner may also take 
 47.32  into account other relevant factors, including, but not limited 
 47.33  to, the percentage for which uninsured patients represent the 
 47.34  applicant's patient base.  During application review, the 
 47.35  commissioner may request additional information about a proposed 
 47.36  project, including information on project cost.  Failure to 
 48.1   provide the information requested disqualifies an applicant. 
 48.2      (d) A grant awarded to an eligible community clinic may not 
 48.3   exceed $300,000 per eligible community clinic.  For an applicant 
 48.4   applying as a consortium of clinics, a grant may not exceed 
 48.5   $300,000 per clinic included in the consortium.  The 
 48.6   commissioner has discretion over the number of grants awarded. 
 48.7      (e) In determining which eligible community clinics will 
 48.8   receive grants under this section, the commissioner shall give 
 48.9   preference to those grant applications that show evidence of 
 48.10  collaboration with other eligible community clinics, hospitals, 
 48.11  health care providers, or community organizations.  In addition, 
 48.12  the commissioner shall give priority, in declining order, to 
 48.13  grant applications for projects that: 
 48.14     (1) establish, update, or improve information, data 
 48.15  collection, or billing systems; 
 48.16     (2) procure, modernize, remodel, or replace equipment used 
 48.17  an the delivery of direct patient care at a clinic; 
 48.18     (3) provide improvements for care delivery, such as 
 48.19  increased translation and interpretation services; 
 48.20     (4) provide a direct offset to expenses incurred for 
 48.21  charity care services; or 
 48.22     (5) other projects determined by the commissioner to 
 48.23  improve the ability of applicants to provide care to the 
 48.24  vulnerable populations they serve. 
 48.25     Subd. 4.  [EVALUATION.] The commissioner of health shall 
 48.26  evaluate the overall effectiveness of the grant program.  The 
 48.27  commissioner shall collect progress reports to evaluate the 
 48.28  grant program from the eligible community clinics receiving 
 48.29  grants. 
 48.30     Sec. 47.  [145.928] [ELIMINATING HEALTH DISPARITIES.] 
 48.31     Subdivision 1.  [GOAL; ESTABLISHMENT.] It is the goal of 
 48.32  the state, by 2010, to decrease by 50 percent the disparities in 
 48.33  infant mortality rates and adult and child immunization rates 
 48.34  for American Indians and populations of color, as compared with 
 48.35  rates for whites.  To do so and to achieve other measurable 
 48.36  outcomes, the commissioner of health shall establish a program 
 49.1   to close the gap in the health status of American Indians and 
 49.2   populations of color as compared with whites in the following 
 49.3   priority areas:  infant mortality, breast and cervical cancer 
 49.4   screening, HIV/AIDS and sexually transmitted infections, adult 
 49.5   and child immunizations, cardiovascular disease, diabetes, and 
 49.6   accidental injuries and violence.  If this goal of reducing 
 49.7   disparities in infant mortality rates and adult and child 
 49.8   immunization rates is not met by December 31, 2010, this section 
 49.9   expires June 30, 2011. 
 49.10     Subd. 2.  [STATE-COMMUNITY PARTNERSHIPS; PLAN.] The 
 49.11  commissioner, in partnership with culturally-based community 
 49.12  organizations; the Indian affairs council under section 3.922; 
 49.13  the council on affairs of Chicano/Latino people under section 
 49.14  3.9223; the council on Black Minnesotans under section 3.9225; 
 49.15  the council on Asian-Pacific Minnesotans under section 3.9226; 
 49.16  community health boards as defined in section 145A.02; and 
 49.17  tribal governments, shall develop and implement a comprehensive, 
 49.18  coordinated plan to reduce health disparities in the health 
 49.19  disparity priority areas identified in subdivision 1. 
 49.20     Subd. 3.  [MEASURABLE OUTCOMES.] The commissioner, in 
 49.21  consultation with the community partners listed in subdivision 
 49.22  2, shall establish measurable outcomes to achieve the goal 
 49.23  specified in subdivision 1 and to determine the effectiveness of 
 49.24  the grants and other activities funded under this section in 
 49.25  reducing health disparities in the priority areas identified in 
 49.26  subdivision 1.  The development of measurable outcomes must be 
 49.27  completed before any funds are distributed under this section. 
 49.28     Subd. 4.  [STATEWIDE ASSESSMENT.] The commissioner shall 
 49.29  enhance current data tools to ensure a statewide assessment of 
 49.30  the risk behaviors associated with the health disparity priority 
 49.31  areas identified in subdivision 1.  The statewide assessment 
 49.32  must be used to establish a baseline to measure the effect of 
 49.33  activities funded under this section.  To the extent feasible, 
 49.34  the commissioner shall conduct the assessment so that the 
 49.35  results may be compared to national data. 
 49.36     Subd. 5.  [TECHNICAL ASSISTANCE.] The commissioner shall 
 50.1   provide the necessary expertise to grant applicants to ensure 
 50.2   that submitted proposals are likely to be successful in reducing 
 50.3   the health disparities identified in subdivision 1.  The 
 50.4   commissioner shall provide grant recipients with guidance and 
 50.5   training on best or most promising strategies to use to reduce 
 50.6   the health disparities identified in subdivision 1.  The 
 50.7   commissioner shall also assist grant recipients in the 
 50.8   development of materials and procedures to evaluate local 
 50.9   community activities. 
 50.10     Subd. 6.  [PROCESS.] (a) The commissioner, in consultation 
 50.11  with the community partners listed in subdivision 2, shall 
 50.12  develop the criteria and procedures used to allocate grants 
 50.13  under this section.  In developing the criteria, the 
 50.14  commissioner shall establish an administrative cost limit for 
 50.15  grant recipients.  At the time a grant is awarded, the 
 50.16  commissioner must provide a grant recipient with information on 
 50.17  the outcomes established according to subdivision 3. 
 50.18     (b) A grant recipient must coordinate its activities to 
 50.19  reduce health disparities with other entities receiving funds 
 50.20  under this section that are in the grant recipient's service 
 50.21  area. 
 50.22     Subd. 7.  [COMMUNITY GRANT PROGRAM; IMMUNIZATION RATES AND 
 50.23  INFANT MORTALITY RATES.] (a) The commissioner shall award grants 
 50.24  to eligible applicants for local or regional projects and 
 50.25  initiatives directed at reducing health disparities in one or 
 50.26  both of the following priority areas: 
 50.27     (1) decreasing racial and ethnic disparities in infant 
 50.28  mortality rates; or 
 50.29     (2) increasing adult and child immunization rates in 
 50.30  nonwhite racial and ethnic populations. 
 50.31     (b) The commissioner may award up to 20 percent of the 
 50.32  funds available as planning grants.  Planning grants must be 
 50.33  used to address such areas as community assessment, coordination 
 50.34  activities, and development of community supported strategies. 
 50.35     (c) Eligible applicants may include, but are not limited 
 50.36  to, faith-based organizations, social service organizations, 
 51.1   community nonprofit organizations, community health boards, 
 51.2   tribal governments, and community clinics.  Applicants must 
 51.3   submit proposals to the commissioner.  A proposal must specify 
 51.4   the strategies to be implemented to address one or both of the 
 51.5   priority areas listed in paragraph (a) and must be targeted to 
 51.6   achieve the outcomes established according to subdivision 3. 
 51.7      (d) The commissioner shall give priority to applicants who 
 51.8   demonstrate that their proposed project or initiative: 
 51.9      (1) is supported by the community the applicant will serve; 
 51.10     (2) is research-based or based on promising strategies; 
 51.11     (3) is designed to complement other related community 
 51.12  activities; 
 51.13     (4) utilizes strategies that positively impact both 
 51.14  priority areas; 
 51.15     (5) reflects racially and ethnically appropriate 
 51.16  approaches; and 
 51.17     (6) will be implemented through or with community-based 
 51.18  organizations that reflect the race or ethnicity of the 
 51.19  population to be reached. 
 51.20     Subd. 8.  [COMMUNITY GRANT PROGRAM; OTHER HEALTH 
 51.21  DISPARITIES.] (a) The commissioner shall award grants to 
 51.22  eligible applicants for local or regional projects and 
 51.23  initiatives directed at reducing health disparities in one or 
 51.24  more of the following priority areas: 
 51.25     (1) decreasing racial and ethnic disparities in morbidity 
 51.26  and mortality rates from breast and cervical cancer; 
 51.27     (2) decreasing racial and ethnic disparities in morbidity 
 51.28  and mortality rates from HIV/AIDS and sexually transmitted 
 51.29  infections; 
 51.30     (3) decreasing racial and ethnic disparities in morbidity 
 51.31  and mortality rates from cardiovascular disease; 
 51.32     (4) decreasing racial and ethnic disparities in morbidity 
 51.33  and mortality rates from diabetes; or 
 51.34     (5) decreasing racial and ethnic disparities in morbidity 
 51.35  and mortality rates from accidental injuries or violence. 
 51.36     (b) The commissioner may award up to 20 percent of the 
 52.1   funds available as planning grants.  Planning grants must be 
 52.2   used to address such areas as community assessment, determining 
 52.3   community priority areas, coordination activities, and 
 52.4   development of community supported strategies. 
 52.5      (c) Eligible applicants may include, but are not limited 
 52.6   to, faith-based organizations, social service organizations, 
 52.7   community nonprofit organizations, community health boards, 
 52.8   tribal governments, and community clinics.  Applicants shall 
 52.9   submit proposals to the commissioner.  A proposal must specify 
 52.10  the strategies to be implemented to address one or more of the 
 52.11  priority areas listed in paragraph (a) and must be targeted to 
 52.12  achieve the outcomes established according to subdivision 3. 
 52.13     (d) The commissioner shall give priority to applicants who 
 52.14  demonstrate that their proposed project or initiative: 
 52.15     (1) is supported by the community the applicant will serve; 
 52.16     (2) is research-based or based on promising strategies; 
 52.17     (3) is designed to complement other related community 
 52.18  activities; 
 52.19     (4) utilizes strategies that positively impact more than 
 52.20  one priority area; 
 52.21     (5) reflects racially and ethnically appropriate 
 52.22  approaches; and 
 52.23     (6) will be implemented through or with community-based 
 52.24  organizations that reflect the race or ethnicity of the 
 52.25  population to be reached. 
 52.26     Subd. 9.  [REFUGEE AND IMMIGRANT HEALTH.] (a) The 
 52.27  commissioner shall distribute funds to community health boards 
 52.28  for health screening and follow-up services for tuberculosis for 
 52.29  refugees.  Funds shall be distributed based on the following 
 52.30  formula: 
 52.31     (1) $1,500 per refugee with pulmonary tuberculosis in the 
 52.32  community health board's service area; 
 52.33     (2) $500 per refugee with extrapulmonary tuberculosis in 
 52.34  the community health board's service area; 
 52.35     (3) $500 per month of directly observed therapy provided by 
 52.36  the community health board for each uninsured refugee with 
 53.1   pulmonary or extrapulmonary tuberculosis; and 
 53.2      (4) $50 per refugee in the community health board's service 
 53.3   area. 
 53.4      (b) Payments must be made at the end of each state fiscal 
 53.5   year.  The amount paid per tuberculosis case, per month of 
 53.6   directly observed therapy, and per refugee must be 
 53.7   proportionately increased or decreased to fit the actual amount 
 53.8   appropriated for that fiscal year. 
 53.9      Subd. 10.  [COORDINATION.] The commissioner shall 
 53.10  coordinate the projects and initiatives funded under this 
 53.11  section with other efforts at the local, state, or national 
 53.12  level to avoid duplication and promote complementary efforts. 
 53.13     Subd. 11.  [EVALUATION.] Using the outcomes established 
 53.14  according to subdivision 3, the commissioner shall conduct a 
 53.15  biennial evaluation of the community grant programs under 
 53.16  subdivisions 7 and 8.  Grant recipients shall cooperate with the 
 53.17  commissioner in the evaluation and shall provide the 
 53.18  commissioner with the information needed to conduct the 
 53.19  evaluation. 
 53.20     Subd. 12.  [REPORT.] By January 15, 2002, and January 15 of 
 53.21  each even-numbered year thereafter, the commissioner shall 
 53.22  submit a report to the legislature on the local community 
 53.23  projects and community health board activities funded under this 
 53.24  section.  The report must include information on grant 
 53.25  recipients, activities conducted using grant funds, and 
 53.26  evaluation data and outcome measures if available. 
 53.27     Sec. 48.  Minnesota Statutes 2000, section 145A.15, 
 53.28  subdivision 1, is amended to read: 
 53.29     Subdivision 1.  [ESTABLISHMENT.] (a) The commissioner of 
 53.30  health shall expand the current grant program to fund additional 
 53.31  projects designed to prevent child abuse and neglect and reduce 
 53.32  juvenile delinquency by promoting positive parenting, resiliency 
 53.33  in children, and a healthy beginning for children by providing 
 53.34  early intervention services for families in need.  Grant dollars 
 53.35  shall be available to train paraprofessionals to provide in-home 
 53.36  intervention services and to allow public health nurses to do 
 54.1   case management of services.  The grant program shall provide 
 54.2   early intervention services for families in need and will 
 54.3   include: 
 54.4      (1) expansion of current public health nurse and family 
 54.5   aide home visiting programs and public health home visiting 
 54.6   projects which prevent child abuse and neglect, prevent juvenile 
 54.7   delinquency, and build resiliency in children; 
 54.8      (2) early intervention to promote a healthy and nurturing 
 54.9   beginning; 
 54.10     (3) distribution of educational and public information 
 54.11  programs and materials in hospital maternity divisions, 
 54.12  well-baby clinics, obstetrical clinics, and community clinics; 
 54.13  and 
 54.14     (4) training of home visitors in skills necessary for 
 54.15  comprehensive home visiting which promotes a healthy and 
 54.16  nurturing beginning for the child. 
 54.17     (b) No new grants shall be awarded under this section after 
 54.18  June 30, 2001.  Grant contracts awarded and in effect under this 
 54.19  section as of July 1, 2001, shall continue until their 
 54.20  expiration date. 
 54.21     Sec. 49.  Minnesota Statutes 2000, section 145A.15, is 
 54.22  amended by adding a subdivision to read: 
 54.23     Subd. 5.  [EXPIRATION.] This section expires June 30, 2003. 
 54.24     Sec. 50.  Minnesota Statutes 2000, section 145A.16, 
 54.25  subdivision 1, is amended to read: 
 54.26     Subdivision 1.  [ESTABLISHMENT.] The commissioner shall 
 54.27  establish a grant program to fund universally offered home 
 54.28  visiting programs designed to serve all live births in 
 54.29  designated geographic areas.  The commissioner shall designate 
 54.30  the geographic area to be served by each program.  At least one 
 54.31  program must provide home visiting services to families within 
 54.32  the seven-county metropolitan area, and at least one program 
 54.33  must provide home visiting services to families outside the 
 54.34  metropolitan area.  The purpose of the program is to strengthen 
 54.35  families and to promote positive parenting and healthy child 
 54.36  development.  No new grants shall be awarded under this section 
 55.1   after June 30, 2001.  Competitive grant contracts awarded and in 
 55.2   effect under this section as of July 1, 2001, shall expire 
 55.3   December 31, 2003. 
 55.4      Sec. 51.  Minnesota Statutes 2000, section 145A.16, is 
 55.5   amended by adding a subdivision to read: 
 55.6      Subd. 10.  [EXPIRATION.] This section expires December 31, 
 55.7   2003. 
 55.8      Sec. 52.  [145A.17] [FAMILY HOME VISITING PROGRAMS.] 
 55.9      Subdivision 1.  [ESTABLISHMENT; GOALS.] The commissioner 
 55.10  shall establish a program to fund family home visiting programs 
 55.11  designed to foster a healthy beginning for children in families 
 55.12  at or below 200 percent of the federal poverty guidelines, 
 55.13  prevent child abuse and neglect, reduce juvenile delinquency, 
 55.14  promote positive parenting and resiliency in children, and 
 55.15  promote family health and economic self-sufficiency.  A program 
 55.16  funded under this section must serve families at or below 200 
 55.17  percent of the federal poverty guidelines, and other families 
 55.18  determined to be at risk for child abuse, neglect, or juvenile 
 55.19  delinquency.  Programs must give priority for services to 
 55.20  families considered to be in need of services, including but not 
 55.21  limited to families with: 
 55.22     (1) adolescent parents; 
 55.23     (2) a history of alcohol or other drug abuse; 
 55.24     (3) a history of child abuse, domestic abuse, or other 
 55.25  types of violence; 
 55.26     (4) a history of domestic abuse, rape, or other forms of 
 55.27  victimization; 
 55.28     (5) reduced cognitive functioning; 
 55.29     (6) a lack of knowledge of child growth and development 
 55.30  stages; 
 55.31     (7) low resiliency to adversities and environmental 
 55.32  stresses; or 
 55.33     (8) insufficient financial resources to meet family needs. 
 55.34     Subd. 2.  [ALLOCATION OF FUNDS.] The commissioner shall 
 55.35  distribute funds available under this section to community 
 55.36  health boards, as defined in section 145A.02, and to tribal 
 56.1   governments.  Funds shall be distributed to community health 
 56.2   boards as follows:  (1) each community health board shall 
 56.3   receive an allocation of $25,000 per year; and (2) remaining 
 56.4   funds available to community health boards shall be distributed 
 56.5   according to the formula in section 256J.625, subdivision 3.  
 56.6   The commissioner, in consultation with tribal governments, shall 
 56.7   establish a formula for distributing funds to tribal governments.
 56.8      Subd. 3.  [REQUIREMENTS FOR PROGRAMS; PROCESS.] (a) Before 
 56.9   a community health board or tribal government may receive an 
 56.10  allocation under subdivision 2, a community health board or 
 56.11  tribal government must submit a proposal to the commissioner 
 56.12  that includes identification, based on a community assessment, 
 56.13  of the populations at or below 200 percent of the federal 
 56.14  poverty guidelines that will be served and the other populations 
 56.15  that will be served.  Each program that receives funds must: 
 56.16     (1) use either a broad community-based or selective 
 56.17  community-based strategy to provide preventive and early 
 56.18  intervention home visiting services; 
 56.19     (2) offer a home visit by a trained home visitor.  If a 
 56.20  home visit is accepted, the first home visit must occur 
 56.21  prenatally or as soon after birth as possible and must include a 
 56.22  public health nursing assessment by a public health nurse; 
 56.23     (3) offer, at a minimum, information on infant care, child 
 56.24  growth and development, positive parenting, preventing diseases, 
 56.25  preventing exposure to environmental hazards, and support 
 56.26  services available in the community; 
 56.27     (4) provide information on and referrals to health care 
 56.28  services, if needed, including information on health care 
 56.29  coverage for which the child or family may be eligible; and 
 56.30  provide information on preventive services, developmental 
 56.31  assessments, and the availability of public assistance programs 
 56.32  as appropriate; 
 56.33     (5) recruit home visitors who will represent, to the extent 
 56.34  possible, the races, cultures, and languages spoken by families 
 56.35  that may be served; 
 56.36     (6) train and supervise home visitors in accordance with 
 57.1   the requirements established under subdivision 4; 
 57.2      (7) maximize resources and minimize duplication by 
 57.3   coordinating activities with local social and human services 
 57.4   organizations, education organizations, and other appropriate 
 57.5   governmental entities and community-based organizations and 
 57.6   agencies; and 
 57.7      (8) utilize appropriate racial and ethnic approaches to 
 57.8   providing home visiting services. 
 57.9      (b) Funds available under this section shall not be used 
 57.10  for medical services.  The commissioner shall establish an 
 57.11  administrative cost limit for recipients of funds.  The outcome 
 57.12  measures established under subdivision 6 must be specified to 
 57.13  recipients of funds at the time the funds are distributed. 
 57.14     Subd. 4.  [TRAINING.] The commissioner shall establish 
 57.15  training requirements for home visitors and minimum requirements 
 57.16  for supervision by a public health nurse.  The requirements for 
 57.17  nurses must be consistent with chapter 148.  Training must 
 57.18  include child development, positive parenting techniques, and 
 57.19  diverse cultural practices in child rearing and family systems. 
 57.20     Subd. 5.  [TECHNICAL ASSISTANCE.] The commissioner shall 
 57.21  provide administrative and technical assistance to each program, 
 57.22  including assistance in data collection and other activities 
 57.23  related to conducting short- and long-term evaluations of the 
 57.24  programs as required under subdivision 7.  The commissioner may 
 57.25  request research and evaluation support from the University of 
 57.26  Minnesota. 
 57.27     Subd. 6.  [OUTCOME MEASURES.] The commissioner shall 
 57.28  establish outcomes to determine the impact of family home 
 57.29  visiting programs funded under this section on the following 
 57.30  areas: 
 57.31     (1) appropriate utilization of preventive health care; 
 57.32     (2) rates of substantiated child abuse and neglect; 
 57.33     (3) rates of unintentional child injuries; and 
 57.34     (4) any additional qualitative goals and quantitative 
 57.35  measures established by the commissioner. 
 57.36     Subd. 7.  [EVALUATION.] Using the qualitative goals and 
 58.1   quantitative outcome measures established under subdivisions 1 
 58.2   and 6, the commissioner shall conduct ongoing evaluations of the 
 58.3   programs funded under this section.  Community health boards and 
 58.4   tribal governments shall cooperate with the commissioner in the 
 58.5   evaluations and shall provide the commissioner with the 
 58.6   information necessary to conduct the evaluations.  As part of 
 58.7   the ongoing evaluations, the commissioner shall rate the impact 
 58.8   of the programs on the outcome measures listed in subdivision 6, 
 58.9   and shall periodically determine whether home visiting programs 
 58.10  are the best way to achieve the qualitative goals established in 
 58.11  subdivision 1 and by the commissioner.  If the commissioner 
 58.12  determines that home visiting programs are not the best way to 
 58.13  achieve these goals, the commissioner shall provide the 
 58.14  legislature with alternative methods for achieving them. 
 58.15     Subd. 8.  [REPORT.] By January 15, 2002, and January 15 of 
 58.16  each even-numbered year thereafter, the commissioner shall 
 58.17  submit a report to the legislature on the family home visiting 
 58.18  programs funded under this section and on the results of the 
 58.19  evaluations conducted under subdivision 7. 
 58.20     Subd. 9.  [NO SUPPLANTING OF EXISTING FUNDS.] Funding 
 58.21  available under this section may be used only to supplement, not 
 58.22  to replace, nonstate funds being used for home visiting services 
 58.23  as of July 1, 2001. 
 58.24     Sec. 53.  Minnesota Statutes 2000, section 157.16, 
 58.25  subdivision 3, is amended to read: 
 58.26     Subd. 3.  [ESTABLISHMENT FEES; DEFINITIONS.] (a) The 
 58.27  following fees are required for food and beverage service 
 58.28  establishments, hotels, motels, lodging establishments, and 
 58.29  resorts licensed under this chapter.  Food and beverage service 
 58.30  establishments must pay the highest applicable fee under 
 58.31  paragraph (e), clause (1), (2), (3), or (4), and establishments 
 58.32  serving alcohol must pay the highest applicable fee under 
 58.33  paragraph (e), clause (6) or (7).  The license fee for new 
 58.34  operators previously licensed under this chapter for the same 
 58.35  calendar year is one-half of the appropriate annual license fee, 
 58.36  plus any penalty that may be required.  The license fee for 
 59.1   operators opening on or after October 1 is one-half of the 
 59.2   appropriate annual license fee, plus any penalty that may be 
 59.3   required.  The fees in paragraphs (b), (c), and (d) effective 
 59.4   until June 30, 2001, shall be phased up as specified in section 
 59.5   55 to the fee amounts effective beginning July 1, 2004.  
 59.6   Notwithstanding section 16A.1285, in fiscal years 2002, 2003, 
 59.7   and 2004, the commissioner shall regulate food and beverage 
 59.8   service establishments, hotels, motels, lodging establishments, 
 59.9   and resorts with the fees collected for that purpose. 
 59.10     (b) All food and beverage service establishments, except 
 59.11  special event food stands, and all hotels, motels, lodging 
 59.12  establishments, and resorts shall pay an annual base fee of $100 
 59.13  until June 30, 2001.  Effective July 1, 2004, the annual base 
 59.14  fee shall be $145. 
 59.15     (c) A special event food stand shall pay a flat fee of $30 
 59.16  annually until June 30, 2001.  Effective July 1, 2004, the 
 59.17  annual flat fee shall be $35.  "Special event food stand" means 
 59.18  a fee category where food is prepared or served in conjunction 
 59.19  with celebrations, county fairs, or special events from a 
 59.20  special event food stand as defined in section 157.15. 
 59.21     (d) In addition to the base fee in paragraph (b), each food 
 59.22  and beverage service establishment, other than a special event 
 59.23  food stand, and each hotel, motel, lodging establishment, and 
 59.24  resort shall pay an additional annual fee for each fee category 
 59.25  as specified in this paragraph: 
 59.26     (1) Limited food menu selection, $30 until June 30, 2001.  
 59.27  Effective July 1, 2004, the annual fee shall be $40.  "Limited 
 59.28  food menu selection" means a fee category that provides one or 
 59.29  more of the following: 
 59.30     (i) prepackaged food that receives heat treatment and is 
 59.31  served in the package; 
 59.32     (ii) frozen pizza that is heated and served; 
 59.33     (iii) a continental breakfast such as rolls, coffee, juice, 
 59.34  milk, and cold cereal; 
 59.35     (iv) soft drinks, coffee, or nonalcoholic beverages; or 
 59.36     (v) cleaning for eating, drinking, or cooking utensils, 
 60.1   when the only food served is prepared off site. 
 60.2      (2) Small establishment, including boarding establishments, 
 60.3   $55 until June 30, 2001.  Effective July 1, 2004, the annual fee 
 60.4   shall be $75.  "Small establishment" means a fee category that 
 60.5   has no salad bar and meets one or more of the following: 
 60.6      (i) possesses food service equipment that consists of no 
 60.7   more than a deep fat fryer, a grill, two hot holding containers, 
 60.8   and one or more microwave ovens; 
 60.9      (ii) serves dipped ice cream or soft serve frozen desserts; 
 60.10     (iii) serves breakfast in an owner-occupied bed and 
 60.11  breakfast establishment; 
 60.12     (iv) is a boarding establishment; or 
 60.13     (v) meets the equipment criteria in clause (3), item (i) or 
 60.14  (ii), and has a maximum patron seating capacity of not more than 
 60.15  50.  
 60.16     (3) Medium establishment, $150 until June 30, 2001.  
 60.17  Effective July 1, 2004, the annual fee shall be $210.  "Medium 
 60.18  establishment" means a fee category that meets one or more of 
 60.19  the following: 
 60.20     (i) possesses food service equipment that includes a range, 
 60.21  oven, steam table, salad bar, or salad preparation area; 
 60.22     (ii) possesses food service equipment that includes more 
 60.23  than one deep fat fryer, one grill, or two hot holding 
 60.24  containers; or 
 60.25     (iii) is an establishment where food is prepared at one 
 60.26  location and served at one or more separate locations. 
 60.27     Establishments meeting criteria in clause (2), item (v), 
 60.28  are not included in this fee category.  
 60.29     (4) Large establishment, $250 until June 30, 2001.  
 60.30  Effective July 1, 2004, the annual fee shall be $350.  "Large 
 60.31  establishment" means either: 
 60.32     (i) a fee category that (A) meets the criteria in clause 
 60.33  (3), items (i) or (ii), for a medium establishment, (B) seats 
 60.34  more than 175 people, and (C) offers the full menu selection an 
 60.35  average of five or more days a week during the weeks of 
 60.36  operation; or 
 61.1      (ii) a fee category that (A) meets the criteria in clause 
 61.2   (3), item (iii), for a medium establishment, and (B) prepares 
 61.3   and serves 500 or more meals per day. 
 61.4      (5) Other food and beverage service, including food carts, 
 61.5   mobile food units, seasonal temporary food stands, and seasonal 
 61.6   permanent food stands, $30 until June 30, 2001.  Effective July 
 61.7   1, 2004, the annual fee shall be $40. 
 61.8      (6) Beer or wine table service, $30 until June 30, 2001.  
 61.9   Effective July 1, 2004, the annual fee shall be $40.  "Beer or 
 61.10  wine table service" means a fee category where the only 
 61.11  alcoholic beverage service is beer or wine, served to customers 
 61.12  seated at tables. 
 61.13     (7) Alcoholic beverage service, other than beer or wine 
 61.14  table service, $75 until June 30, 2001.  Effective July 1, 2004, 
 61.15  the annual fee shall be $105. 
 61.16     "Alcohol beverage service, other than beer or wine table 
 61.17  service" means a fee category where alcoholic mixed drinks are 
 61.18  served or where beer or wine are served from a bar. 
 61.19     (8) Until June 30, 2001, lodging per sleeping accommodation 
 61.20  unit, $4, including hotels, motels, lodging establishments, and 
 61.21  resorts, up to a maximum of $400.  Effective July 1, 2004, 
 61.22  lodging per sleeping accommodation unit, $6, including hotels, 
 61.23  motels, lodging establishments, and resorts, up to a maximum of 
 61.24  $600.  "Lodging per sleeping accommodation unit" means a fee 
 61.25  category including the number of guest rooms, cottages, or other 
 61.26  rental units of a hotel, motel, lodging establishment, or 
 61.27  resort; or the number of beds in a dormitory. 
 61.28     (9) First public swimming pool, $100 until June 30, 2001; 
 61.29  each additional public swimming pool, $50 until June 30, 2001.  
 61.30  Effective July 1, 2004, first public swimming pool, $140; each 
 61.31  additional public swimming pool, $80.  "Public swimming pool" 
 61.32  means a fee category that has the meaning given in Minnesota 
 61.33  Rules, part 4717.0250, subpart 8. 
 61.34     (10) First spa, $50 until June 30, 2001; each additional 
 61.35  spa, $25 until June 30, 2001.  Effective July 1, 2004, first 
 61.36  spa, $80; each additional spa, $40.  "Spa pool" means a fee 
 62.1   category that has the meaning given in Minnesota Rules, part 
 62.2   4717.0250, subpart 9. 
 62.3      (11) Private sewer or water, $30 until June 30, 2001.  
 62.4   Effective July 1, 2004, private sewer or water, $40.  
 62.5   "Individual private water" means a fee category with a water 
 62.6   supply other than a community public water supply as defined in 
 62.7   Minnesota Rules, chapter 4720.  "Individual private sewer" means 
 62.8   a fee category with an individual sewage treatment system which 
 62.9   uses subsurface treatment and disposal. 
 62.10     (e) A fee is not required for a food and beverage service 
 62.11  establishment operated by a school as defined in sections 
 62.12  120A.05, subdivisions 9, 11, 13, and 17 and 120A.22. 
 62.13     (f) A fee of $150 for review of the construction plans must 
 62.14  accompany the initial license application for food and beverage 
 62.15  service establishments, hotels, motels, lodging establishments, 
 62.16  or resorts. 
 62.17     (g) (f) When existing food and beverage service 
 62.18  establishments, hotels, motels, lodging establishments, or 
 62.19  resorts are extensively remodeled, a fee of $150 must be 
 62.20  submitted with the remodeling plans. 
 62.21     (h) (g) Seasonal temporary food stands and special event 
 62.22  food stands are not required to submit construction or 
 62.23  remodeling plans for review. 
 62.24     Sec. 54.  Minnesota Statutes 2000, section 157.22, is 
 62.25  amended to read: 
 62.26     157.22 [EXEMPTIONS.] 
 62.27     This chapter shall not be construed to apply to: 
 62.28     (1) interstate carriers under the supervision of the United 
 62.29  States Department of Health and Human Services; 
 62.30     (2) any building constructed and primarily used for 
 62.31  religious worship; 
 62.32     (3) any building owned, operated, and used by a college or 
 62.33  university in accordance with health regulations promulgated by 
 62.34  the college or university under chapter 14; 
 62.35     (4) any person, firm, or corporation whose principal mode 
 62.36  of business is licensed under sections 28A.04 and 28A.05, is 
 63.1   exempt at that premises from licensure as a food or beverage 
 63.2   establishment; provided that the holding of any license pursuant 
 63.3   to sections 28A.04 and 28A.05 shall not exempt any person, firm, 
 63.4   or corporation from the applicable provisions of this chapter or 
 63.5   the rules of the state commissioner of health relating to food 
 63.6   and beverage service establishments; 
 63.7      (5) family day care homes and group family day care homes 
 63.8   governed by sections 245A.01 to 245A.16; 
 63.9      (6) nonprofit senior citizen centers for the sale of 
 63.10  home-baked goods; and 
 63.11     (7) food not prepared at an establishment and brought in by 
 63.12  individuals attending a potluck event for consumption at the 
 63.13  potluck event.  An organization sponsoring a potluck event under 
 63.14  this clause may advertise the potluck event to the public 
 63.15  through any means.  Individuals who are not members of an 
 63.16  organization sponsoring a potluck event under this clause may 
 63.17  attend the potluck event and consume the food at the event.  
 63.18  Licensed food establishments cannot be sponsors of potluck 
 63.19  events.  Potluck event food shall not be brought into a licensed 
 63.20  food establishment kitchen; and 
 63.21     (8) a home school in which a child is provided instruction 
 63.22  at home. 
 63.23     Sec. 55.  [ESTABLISHMENT FEES DURING TRANSITION PERIOD.] 
 63.24     For fiscal years 2002, 2003, and 2004, the following fees 
 63.25  shall apply to food and beverage service establishments, hotels, 
 63.26  motels, lodging establishments, and resorts for which fees are 
 63.27  established under Minnesota Statutes, section 157.16, 
 63.28  subdivision 3, paragraphs (b), (c), and (d): 
 63.29                          Fiscal Year   Fiscal Year   Fiscal Year
 63.30  Fee Category                2002          2003          2004
 63.31  Annual base fee, all      $111.25       $122.50       $133.75
 63.32  food and beverage
 63.33  service establishments
 63.34  except special event
 63.35  food stands and all
 63.36  hotels, motels, lodging
 64.1   establishments, and
 64.2   resorts
 64.3   Special event food        $ 31.25       $ 32.50       $ 33.75
 64.4   stand
 64.5   Establishment with        $ 32.50       $ 35.00       $ 37.50
 64.6   limited food menu
 64.7   selection
 64.8   Small establishment       $ 60.00       $ 65.00       $ 70.00
 64.9   Medium establishment      $165.00       $180.00       $195.00
 64.10  Large establishment       $275.00       $300.00       $325.00
 64.11  Other food and            $ 32.50       $ 35.00       $ 37.50
 64.12  beverage service
 64.13  Beer or wine table        $ 32.50       $ 35.00       $ 37.50
 64.14  service
 64.15  Alcoholic beverage        $ 82.50       $ 90.00       $ 97.50
 64.16  service other than
 64.17  beer or wine table
 64.18  service
 64.19  Lodging per sleeping    $4.50 per     $5.00 per     $5.50 per
 64.20  accommodation unit,    unit, $450    unit, $500    unit, $550
 64.21  up to a specified         maximum       maximum       maximum
 64.22  maximum
 64.23  First public              $110.00       $120.00       $130.00
 64.24  swimming pool
 64.25  Each additional           $ 57.50       $ 65.00       $ 72.50
 64.26  public swimming pool
 64.27  First spa                 $ 57.50       $ 65.00       $ 72.50
 64.28  Each additional spa       $ 28.75       $ 32.50       $ 36.25
 64.29  Private sewer or          $ 32.50       $ 35.00       $ 37.50
 64.30  water
 64.31     Sec. 56.  [REPEALER.] 
 64.32     (a) Minnesota Statutes 2000, sections 145.882, subdivisions 
 64.33  3 and 4; and 145.927, are repealed. 
 64.34     (b) Minnesota Statutes 2000, section 144.148, subdivision 
 64.35  8, is repealed. 
 64.36     <b>[EFFECTIVE DATE.]</b> Paragraph (b) of this section is 
 65.1   effective the day following final enactment. 
 65.2                              ARTICLE 2 
 65.3                             HEALTH CARE 
 65.4      Section 1.  Minnesota Statutes 2000, section 256.01, 
 65.5   subdivision 2, is amended to read: 
 65.6      Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
 65.7   section 241.021, subdivision 2, the commissioner of human 
 65.8   services shall: 
 65.9      (1) Administer and supervise all forms of public assistance 
 65.10  provided for by state law and other welfare activities or 
 65.11  services as are vested in the commissioner.  Administration and 
 65.12  supervision of human services activities or services includes, 
 65.13  but is not limited to, assuring timely and accurate distribution 
 65.14  of benefits, completeness of service, and quality program 
 65.15  management.  In addition to administering and supervising human 
 65.16  services activities vested by law in the department, the 
 65.17  commissioner shall have the authority to: 
 65.18     (a) require county agency participation in training and 
 65.19  technical assistance programs to promote compliance with 
 65.20  statutes, rules, federal laws, regulations, and policies 
 65.21  governing human services; 
 65.22     (b) monitor, on an ongoing basis, the performance of county 
 65.23  agencies in the operation and administration of human services, 
 65.24  enforce compliance with statutes, rules, federal laws, 
 65.25  regulations, and policies governing welfare services and promote 
 65.26  excellence of administration and program operation; 
 65.27     (c) develop a quality control program or other monitoring 
 65.28  program to review county performance and accuracy of benefit 
 65.29  determinations; 
 65.30     (d) require county agencies to make an adjustment to the 
 65.31  public assistance benefits issued to any individual consistent 
 65.32  with federal law and regulation and state law and rule and to 
 65.33  issue or recover benefits as appropriate; 
 65.34     (e) delay or deny payment of all or part of the state and 
 65.35  federal share of benefits and administrative reimbursement 
 65.36  according to the procedures set forth in section 256.017; 
 66.1      (f) make contracts with and grants to public and private 
 66.2   agencies and organizations, both profit and nonprofit, and 
 66.3   individuals, using appropriated funds; and 
 66.4      (g) enter into contractual agreements with federally 
 66.5   recognized Indian tribes with a reservation in Minnesota to the 
 66.6   extent necessary for the tribe to operate a federally approved 
 66.7   family assistance program or any other program under the 
 66.8   supervision of the commissioner.  The commissioner shall consult 
 66.9   with the affected county or counties in the contractual 
 66.10  agreement negotiations, if the county or counties wish to be 
 66.11  included, in order to avoid the duplication of county and tribal 
 66.12  assistance program services.  The commissioner may establish 
 66.13  necessary accounts for the purposes of receiving and disbursing 
 66.14  funds as necessary for the operation of the programs. 
 66.15     (2) Inform county agencies, on a timely basis, of changes 
 66.16  in statute, rule, federal law, regulation, and policy necessary 
 66.17  to county agency administration of the programs. 
 66.18     (3) Administer and supervise all child welfare activities; 
 66.19  promote the enforcement of laws protecting handicapped, 
 66.20  dependent, neglected and delinquent children, and children born 
 66.21  to mothers who were not married to the children's fathers at the 
 66.22  times of the conception nor at the births of the children; 
 66.23  license and supervise child-caring and child-placing agencies 
 66.24  and institutions; supervise the care of children in boarding and 
 66.25  foster homes or in private institutions; and generally perform 
 66.26  all functions relating to the field of child welfare now vested 
 66.27  in the state board of control. 
 66.28     (4) Administer and supervise all noninstitutional service 
 66.29  to handicapped persons, including those who are visually 
 66.30  impaired, hearing impaired, or physically impaired or otherwise 
 66.31  handicapped.  The commissioner may provide and contract for the 
 66.32  care and treatment of qualified indigent children in facilities 
 66.33  other than those located and available at state hospitals when 
 66.34  it is not feasible to provide the service in state hospitals. 
 66.35     (5) Assist and actively cooperate with other departments, 
 66.36  agencies and institutions, local, state, and federal, by 
 67.1   performing services in conformity with the purposes of Laws 
 67.2   1939, chapter 431. 
 67.3      (6) Act as the agent of and cooperate with the federal 
 67.4   government in matters of mutual concern relative to and in 
 67.5   conformity with the provisions of Laws 1939, chapter 431, 
 67.6   including the administration of any federal funds granted to the 
 67.7   state to aid in the performance of any functions of the 
 67.8   commissioner as specified in Laws 1939, chapter 431, and 
 67.9   including the promulgation of rules making uniformly available 
 67.10  medical care benefits to all recipients of public assistance, at 
 67.11  such times as the federal government increases its participation 
 67.12  in assistance expenditures for medical care to recipients of 
 67.13  public assistance, the cost thereof to be borne in the same 
 67.14  proportion as are grants of aid to said recipients. 
 67.15     (7) Establish and maintain any administrative units 
 67.16  reasonably necessary for the performance of administrative 
 67.17  functions common to all divisions of the department. 
 67.18     (8) Act as designated guardian of both the estate and the 
 67.19  person of all the wards of the state of Minnesota, whether by 
 67.20  operation of law or by an order of court, without any further 
 67.21  act or proceeding whatever, except as to persons committed as 
 67.22  mentally retarded.  For children under the guardianship of the 
 67.23  commissioner whose interests would be best served by adoptive 
 67.24  placement, the commissioner may contract with a licensed 
 67.25  child-placing agency to provide adoption services.  A contract 
 67.26  with a licensed child-placing agency must be designed to 
 67.27  supplement existing county efforts and may not replace existing 
 67.28  county programs, unless the replacement is agreed to by the 
 67.29  county board and the appropriate exclusive bargaining 
 67.30  representative or the commissioner has evidence that child 
 67.31  placements of the county continue to be substantially below that 
 67.32  of other counties.  Funds encumbered and obligated under an 
 67.33  agreement for a specific child shall remain available until the 
 67.34  terms of the agreement are fulfilled or the agreement is 
 67.35  terminated. 
 67.36     (9) Act as coordinating referral and informational center 
 68.1   on requests for service for newly arrived immigrants coming to 
 68.2   Minnesota. 
 68.3      (10) The specific enumeration of powers and duties as 
 68.4   hereinabove set forth shall in no way be construed to be a 
 68.5   limitation upon the general transfer of powers herein contained. 
 68.6      (11) Establish county, regional, or statewide schedules of 
 68.7   maximum fees and charges which may be paid by county agencies 
 68.8   for medical, dental, surgical, hospital, nursing and nursing 
 68.9   home care and medicine and medical supplies under all programs 
 68.10  of medical care provided by the state and for congregate living 
 68.11  care under the income maintenance programs. 
 68.12     (12) Have the authority to conduct and administer 
 68.13  experimental projects to test methods and procedures of 
 68.14  administering assistance and services to recipients or potential 
 68.15  recipients of public welfare.  To carry out such experimental 
 68.16  projects, it is further provided that the commissioner of human 
 68.17  services is authorized to waive the enforcement of existing 
 68.18  specific statutory program requirements, rules, and standards in 
 68.19  one or more counties.  The order establishing the waiver shall 
 68.20  provide alternative methods and procedures of administration, 
 68.21  shall not be in conflict with the basic purposes, coverage, or 
 68.22  benefits provided by law, and in no event shall the duration of 
 68.23  a project exceed four years.  It is further provided that no 
 68.24  order establishing an experimental project as authorized by the 
 68.25  provisions of this section shall become effective until the 
 68.26  following conditions have been met: 
 68.27     (a) The secretary of health and human services of the 
 68.28  United States has agreed, for the same project, to waive state 
 68.29  plan requirements relative to statewide uniformity. 
 68.30     (b) A comprehensive plan, including estimated project 
 68.31  costs, shall be approved by the legislative advisory commission 
 68.32  and filed with the commissioner of administration.  
 68.33     (13) According to federal requirements, establish 
 68.34  procedures to be followed by local welfare boards in creating 
 68.35  citizen advisory committees, including procedures for selection 
 68.36  of committee members. 
 69.1      (14) Allocate federal fiscal disallowances or sanctions 
 69.2   which are based on quality control error rates for the aid to 
 69.3   families with dependent children program formerly codified in 
 69.4   sections 256.72 to 256.87, medical assistance, or food stamp 
 69.5   program in the following manner:  
 69.6      (a) One-half of the total amount of the disallowance shall 
 69.7   be borne by the county boards responsible for administering the 
 69.8   programs.  For the medical assistance and the AFDC program 
 69.9   formerly codified in sections 256.72 to 256.87, disallowances 
 69.10  shall be shared by each county board in the same proportion as 
 69.11  that county's expenditures for the sanctioned program are to the 
 69.12  total of all counties' expenditures for the AFDC program 
 69.13  formerly codified in sections 256.72 to 256.87, and medical 
 69.14  assistance programs.  For the food stamp program, sanctions 
 69.15  shall be shared by each county board, with 50 percent of the 
 69.16  sanction being distributed to each county in the same proportion 
 69.17  as that county's administrative costs for food stamps are to the 
 69.18  total of all food stamp administrative costs for all counties, 
 69.19  and 50 percent of the sanctions being distributed to each county 
 69.20  in the same proportion as that county's value of food stamp 
 69.21  benefits issued are to the total of all benefits issued for all 
 69.22  counties.  Each county shall pay its share of the disallowance 
 69.23  to the state of Minnesota.  When a county fails to pay the 
 69.24  amount due hereunder, the commissioner may deduct the amount 
 69.25  from reimbursement otherwise due the county, or the attorney 
 69.26  general, upon the request of the commissioner, may institute 
 69.27  civil action to recover the amount due. 
 69.28     (b) Notwithstanding the provisions of paragraph (a), if the 
 69.29  disallowance results from knowing noncompliance by one or more 
 69.30  counties with a specific program instruction, and that knowing 
 69.31  noncompliance is a matter of official county board record, the 
 69.32  commissioner may require payment or recover from the county or 
 69.33  counties, in the manner prescribed in paragraph (a), an amount 
 69.34  equal to the portion of the total disallowance which resulted 
 69.35  from the noncompliance, and may distribute the balance of the 
 69.36  disallowance according to paragraph (a).  
 70.1      (15) Develop and implement special projects that maximize 
 70.2   reimbursements and result in the recovery of money to the 
 70.3   state.  For the purpose of recovering state money, the 
 70.4   commissioner may enter into contracts with third parties.  Any 
 70.5   recoveries that result from projects or contracts entered into 
 70.6   under this paragraph shall be deposited in the state treasury 
 70.7   and credited to a special account until the balance in the 
 70.8   account reaches $1,000,000.  When the balance in the account 
 70.9   exceeds $1,000,000, the excess shall be transferred and credited 
 70.10  to the general fund.  All money in the account is appropriated 
 70.11  to the commissioner for the purposes of this paragraph. 
 70.12     (16) Have the authority to make direct payments to 
 70.13  facilities providing shelter to women and their children 
 70.14  according to section 256D.05, subdivision 3.  Upon the written 
 70.15  request of a shelter facility that has been denied payments 
 70.16  under section 256D.05, subdivision 3, the commissioner shall 
 70.17  review all relevant evidence and make a determination within 30 
 70.18  days of the request for review regarding issuance of direct 
 70.19  payments to the shelter facility.  Failure to act within 30 days 
 70.20  shall be considered a determination not to issue direct payments.
 70.21     (17) Have the authority to establish and enforce the 
 70.22  following county reporting requirements:  
 70.23     (a) The commissioner shall establish fiscal and statistical 
 70.24  reporting requirements necessary to account for the expenditure 
 70.25  of funds allocated to counties for human services programs.  
 70.26  When establishing financial and statistical reporting 
 70.27  requirements, the commissioner shall evaluate all reports, in 
 70.28  consultation with the counties, to determine if the reports can 
 70.29  be simplified or the number of reports can be reduced. 
 70.30     (b) The county board shall submit monthly or quarterly 
 70.31  reports to the department as required by the commissioner.  
 70.32  Monthly reports are due no later than 15 working days after the 
 70.33  end of the month.  Quarterly reports are due no later than 30 
 70.34  calendar days after the end of the quarter, unless the 
 70.35  commissioner determines that the deadline must be shortened to 
 70.36  20 calendar days to avoid jeopardizing compliance with federal 
 71.1   deadlines or risking a loss of federal funding.  Only reports 
 71.2   that are complete, legible, and in the required format shall be 
 71.3   accepted by the commissioner.  
 71.4      (c) If the required reports are not received by the 
 71.5   deadlines established in clause (b), the commissioner may delay 
 71.6   payments and withhold funds from the county board until the next 
 71.7   reporting period.  When the report is needed to account for the 
 71.8   use of federal funds and the late report results in a reduction 
 71.9   in federal funding, the commissioner shall withhold from the 
 71.10  county boards with late reports an amount equal to the reduction 
 71.11  in federal funding until full federal funding is received.  
 71.12     (d) A county board that submits reports that are late, 
 71.13  illegible, incomplete, or not in the required format for two out 
 71.14  of three consecutive reporting periods is considered 
 71.15  noncompliant.  When a county board is found to be noncompliant, 
 71.16  the commissioner shall notify the county board of the reason the 
 71.17  county board is considered noncompliant and request that the 
 71.18  county board develop a corrective action plan stating how the 
 71.19  county board plans to correct the problem.  The corrective 
 71.20  action plan must be submitted to the commissioner within 45 days 
 71.21  after the date the county board received notice of noncompliance.
 71.22     (e) The final deadline for fiscal reports or amendments to 
 71.23  fiscal reports is one year after the date the report was 
 71.24  originally due.  If the commissioner does not receive a report 
 71.25  by the final deadline, the county board forfeits the funding 
 71.26  associated with the report for that reporting period and the 
 71.27  county board must repay any funds associated with the report 
 71.28  received for that reporting period. 
 71.29     (f) The commissioner may not delay payments, withhold 
 71.30  funds, or require repayment under paragraph (c) or (e) if the 
 71.31  county demonstrates that the commissioner failed to provide 
 71.32  appropriate forms, guidelines, and technical assistance to 
 71.33  enable the county to comply with the requirements.  If the 
 71.34  county board disagrees with an action taken by the commissioner 
 71.35  under paragraph (c) or (e), the county board may appeal the 
 71.36  action according to sections 14.57 to 14.69. 
 72.1      (g) Counties subject to withholding of funds under 
 72.2   paragraph (c) or forfeiture or repayment of funds under 
 72.3   paragraph (e) shall not reduce or withhold benefits or services 
 72.4   to clients to cover costs incurred due to actions taken by the 
 72.5   commissioner under paragraph (c) or (e). 
 72.6      (18) Allocate federal fiscal disallowances or sanctions for 
 72.7   audit exceptions when federal fiscal disallowances or sanctions 
 72.8   are based on a statewide random sample for the foster care 
 72.9   program under title IV-E of the Social Security Act, United 
 72.10  States Code, title 42, in direct proportion to each county's 
 72.11  title IV-E foster care maintenance claim for that period. 
 72.12     (19) Be responsible for ensuring the detection, prevention, 
 72.13  investigation, and resolution of fraudulent activities or 
 72.14  behavior by applicants, recipients, and other participants in 
 72.15  the human services programs administered by the department. 
 72.16     (20) Require county agencies to identify overpayments, 
 72.17  establish claims, and utilize all available and cost-beneficial 
 72.18  methodologies to collect and recover these overpayments in the 
 72.19  human services programs administered by the department. 
 72.20     (21) Have the authority to administer a drug rebate program 
 72.21  for drugs purchased pursuant to the prescription drug program 
 72.22  established under section 256.955 after the beneficiary's 
 72.23  satisfaction of any deductible established in the program.  The 
 72.24  commissioner shall require a rebate agreement from all 
 72.25  manufacturers of covered drugs as defined in section 256B.0625, 
 72.26  subdivision 13.  Rebate agreements for prescription drugs 
 72.27  delivered on or after July 1, 2002, must include rebates for 
 72.28  individuals covered under the prescription drug program who are 
 72.29  under 65 years of age.  For each drug, the amount of the rebate 
 72.30  shall be equal to the basic rebate as defined for purposes of 
 72.31  the federal rebate program in United States Code, title 42, 
 72.32  section 1396r-8(c)(1).  This basic rebate shall be applied to 
 72.33  single-source and multiple-source drugs.  The manufacturers must 
 72.34  provide full payment within 30 days of receipt of the state 
 72.35  invoice for the rebate within the terms and conditions used for 
 72.36  the federal rebate program established pursuant to section 1927 
 73.1   of title XIX of the Social Security Act.  The manufacturers must 
 73.2   provide the commissioner with any information necessary to 
 73.3   verify the rebate determined per drug.  The rebate program shall 
 73.4   utilize the terms and conditions used for the federal rebate 
 73.5   program established pursuant to section 1927 of title XIX of the 
 73.6   Social Security Act. 
 73.7      (22) Have the authority to administer the federal drug 
 73.8   rebate program for drugs purchased under the medical assistance 
 73.9   program as allowed by section 1927 of title XIX of the Social 
 73.10  Security Act and according to the terms and conditions of 
 73.11  section 1927.  Rebates shall be collected for all drugs that 
 73.12  have been dispensed or administered in an outpatient setting and 
 73.13  that are from manufacturers who have signed a rebate agreement 
 73.14  with the United States Department of Health and Human Services. 
 73.15     (22) (23) Operate the department's communication systems 
 73.16  account established in Laws 1993, First Special Session chapter 
 73.17  1, article 1, section 2, subdivision 2, to manage shared 
 73.18  communication costs necessary for the operation of the programs 
 73.19  the commissioner supervises.  A communications account may also 
 73.20  be established for each regional treatment center which operates 
 73.21  communications systems.  Each account must be used to manage 
 73.22  shared communication costs necessary for the operations of the 
 73.23  programs the commissioner supervises.  The commissioner may 
 73.24  distribute the costs of operating and maintaining communication 
 73.25  systems to participants in a manner that reflects actual usage. 
 73.26  Costs may include acquisition, licensing, insurance, 
 73.27  maintenance, repair, staff time and other costs as determined by 
 73.28  the commissioner.  Nonprofit organizations and state, county, 
 73.29  and local government agencies involved in the operation of 
 73.30  programs the commissioner supervises may participate in the use 
 73.31  of the department's communications technology and share in the 
 73.32  cost of operation.  The commissioner may accept on behalf of the 
 73.33  state any gift, bequest, devise or personal property of any 
 73.34  kind, or money tendered to the state for any lawful purpose 
 73.35  pertaining to the communication activities of the department.  
 73.36  Any money received for this purpose must be deposited in the 
 74.1   department's communication systems accounts.  Money collected by 
 74.2   the commissioner for the use of communication systems must be 
 74.3   deposited in the state communication systems account and is 
 74.4   appropriated to the commissioner for purposes of this section. 
 74.5      (23) (24) Receive any federal matching money that is made 
 74.6   available through the medical assistance program for the 
 74.7   consumer satisfaction survey.  Any federal money received for 
 74.8   the survey is appropriated to the commissioner for this 
 74.9   purpose.  The commissioner may expend the federal money received 
 74.10  for the consumer satisfaction survey in either year of the 
 74.11  biennium. 
 74.12     (24) (25) Incorporate cost reimbursement claims from First 
 74.13  Call Minnesota into the federal cost reimbursement claiming 
 74.14  processes of the department according to federal law, rule, and 
 74.15  regulations.  Any reimbursement received is appropriated to the 
 74.16  commissioner and shall be disbursed to First Call Minnesota 
 74.17  according to normal department payment schedules. 
 74.18     (25) (26) Develop recommended standards for foster care 
 74.19  homes that address the components of specialized therapeutic 
 74.20  services to be provided by foster care homes with those services.
 74.21     Sec. 2.  Minnesota Statutes 2000, section 256.955, 
 74.22  subdivision 2b, is amended to read: 
 74.23     Subd. 2b.  [ELIGIBILITY.] Effective July 1, 2002, an 
 74.24  individual satisfying the following requirements and the 
 74.25  requirements described in subdivision 2, paragraph (d), is 
 74.26  eligible for the prescription drug program: 
 74.27     (1) is under 65 years of age; and 
 74.28     (2) is eligible as a qualified Medicare beneficiary 
 74.29  according to section 256B.057, subdivision 3 or 3a, or is 
 74.30  eligible under section 256B.057, subdivision 3 or 3a, and is 
 74.31  also eligible for medical assistance or general assistance 
 74.32  medical care with a spenddown as defined in section 256B.056, 
 74.33  subdivision 5. 
 74.34     Sec. 3.  [256.956] [PURCHASING ALLIANCE STOP-LOSS FUND.] 
 74.35     Subdivision 1.  [DEFINITIONS.] For purposes of this 
 74.36  section, the following definitions apply:  
 75.1      (a) "Commissioner" means the commissioner of human services.
 75.2      (b) "Health plan" means a policy, contract, or certificate 
 75.3   issued by a health plan company to a qualifying purchasing 
 75.4   alliance.  Any health plan issued to the members of a qualifying 
 75.5   purchasing alliance must meet the requirements of chapter 62L.  
 75.6      (c) "Health plan company" means: 
 75.7      (1) a health carrier as defined under section 62A.011, 
 75.8   subdivision 2; 
 75.9      (2) a community integrated service network operating under 
 75.10  chapter 62N; or 
 75.11     (3) an accountable provider network operating under chapter 
 75.12  62T.  
 75.13     (d) "Qualifying employer" means an employer who: 
 75.14     (1) is a member of a qualifying purchasing alliance; 
 75.15     (2) has at least one employee but no more than ten 
 75.16  employees or is a sole proprietor or farmer; 
 75.17     (3) did not offer employer-subsidized health care coverage 
 75.18  to its employees for at least 12 months prior to joining the 
 75.19  purchasing alliance; and 
 75.20     (4) is offering health coverage through the purchasing 
 75.21  alliance to all employees who work at least 20 hours per week 
 75.22  unless the employee is eligible for Medicare. 
 75.23  For purposes of this subdivision, "employer-subsidized health 
 75.24  coverage" means health coverage for which the employer pays at 
 75.25  least 50 percent of the cost of coverage for the employee.  
 75.26     (e) "Qualifying enrollee" means an employee of a qualifying 
 75.27  employer or the employee's dependent covered by a health plan.  
 75.28     (f) "Qualifying purchasing alliance" means a purchasing 
 75.29  alliance as defined in section 62T.01, subdivision 2, that: 
 75.30     (1) meets the requirements of chapter 62T; 
 75.31     (2) services a geographic area located in outstate 
 75.32  Minnesota, excluding the city of Duluth; and 
 75.33     (3) is organized and operating before May 1, 2001. 
 75.34     The criteria used by the qualifying purchasing alliance for 
 75.35  membership must be approved by the commissioner of health.  A 
 75.36  qualifying purchasing alliance may begin enrolling qualifying 
 76.1   employers after July 1, 2001, with enrollment ending by December 
 76.2   31, 2003.  
 76.3      Subd. 2.  [CREATION OF ACCOUNT.] A purchasing alliance 
 76.4   stop-loss fund account is established in the general fund.  The 
 76.5   commissioner shall use the money to establish a stop-loss fund 
 76.6   from which a health plan company may receive reimbursement for 
 76.7   claims paid for qualifying enrollees.  The account consists of 
 76.8   money appropriated by the legislature.  Money from the account 
 76.9   must be used for the stop-loss fund.  
 76.10     Subd. 3.  [REIMBURSEMENT.] (a) A health plan company may 
 76.11  receive reimbursement from the fund for 90 percent of the 
 76.12  portion of the claim that exceeds $30,000 but not of the portion 
 76.13  that exceeds $100,000 in a calendar year for a qualifying 
 76.14  enrollee.  
 76.15     (b) Claims shall be reported and funds shall be distributed 
 76.16  on a calendar-year basis.  Claims shall be eligible for 
 76.17  reimbursement only for the calendar year in which the claims 
 76.18  were paid.  
 76.19     (c) Once claims paid on behalf of a qualifying enrollee 
 76.20  reach $100,000 in a given calendar year, no further claims may 
 76.21  be submitted for reimbursement on behalf of that enrollee in 
 76.22  that calendar year.  
 76.23     Subd. 4.  [REQUEST PROCESS.] (a) Each health plan company 
 76.24  must submit a request for reimbursement from the fund on a form 
 76.25  prescribed by the commissioner.  Requests for payment must be 
 76.26  submitted no later than April 1 following the end of the 
 76.27  calendar year for which the reimbursement request is being made, 
 76.28  beginning April 1, 2002. 
 76.29     (b) The commissioner may require a health plan company to 
 76.30  submit claims data as needed in connection with the 
 76.31  reimbursement request.  
 76.32     Subd. 5.  [DISTRIBUTION.] (a) The commissioner shall 
 76.33  calculate the total claims reimbursement amount for all 
 76.34  qualifying health plan companies for the calendar year for which 
 76.35  claims are being reported and shall distribute the stop-loss 
 76.36  funds on an annual basis.  
 77.1      (b) In the event that the total amount requested for 
 77.2   reimbursement by the health plan companies for a calendar year 
 77.3   exceeds the funds available for distribution for claims paid by 
 77.4   all health plan companies during the same calendar year, the 
 77.5   commissioner shall provide for the pro rata distribution of the 
 77.6   available funds.  Each health plan company shall be eligible to 
 77.7   receive only a proportionate amount of the available funds as 
 77.8   the health plan company's total eligible claims paid compares to 
 77.9   the total eligible claims paid by all health plan companies.  
 77.10     (c) In the event that funds available for distribution for 
 77.11  claims paid by all health plan companies during a calendar year 
 77.12  exceed the total amount requested for reimbursement by all 
 77.13  health plan companies during the same calendar year, any excess 
 77.14  funds shall be reallocated for distribution in the next calendar 
 77.15  year.  
 77.16     Subd. 6.  [DATA.] Upon the request of the commissioner, 
 77.17  each health plan company shall furnish such data as the 
 77.18  commissioner deems necessary to administer the fund.  The 
 77.19  commissioner may require that such data be submitted on a per 
 77.20  enrollee, aggregate, or categorical basis.  Any data submitted 
 77.21  under this section shall be classified as private data or 
 77.22  nonpublic data as defined in section 13.02. 
 77.23     Subd. 7.  [DELEGATION.] The commissioner may delegate any 
 77.24  or all of the commissioner's administrative duties to another 
 77.25  state agency or to a private contractor.  
 77.26     Subd. 8.  [REPORT.] The commissioner of commerce, in 
 77.27  consultation with the office of rural health and the qualifying 
 77.28  purchasing alliances, shall evaluate the extent to which the 
 77.29  purchasing alliance stop-loss fund increases the availability of 
 77.30  employer-subsidized health care coverage for residents residing 
 77.31  in the geographic areas served by the qualifying purchasing 
 77.32  alliances.  A preliminary report must be submitted to the 
 77.33  legislature by February 15, 2003, and a final report must be 
 77.34  submitted by February 15, 2004.  
 77.35     Subd. 9.  [SUNSET.] This section shall expire January 1, 
 77.36  2005. 
 78.1      Sec. 4.  [256.958] [RETIRED DENTIST PROGRAM.] 
 78.2      Subdivision 1.  [PROGRAM.] The commissioner of human 
 78.3   services shall establish a program to reimburse a retired 
 78.4   dentist for the dentist's license fee and for the cost of 
 78.5   malpractice insurance in exchange for the dentist providing 100 
 78.6   hours of dental services on a volunteer basis within a 12-month 
 78.7   period at a community dental clinic or a dental training clinic 
 78.8   located at a Minnesota state college or university.  
 78.9      Subd. 2.  [DOCUMENTATION.] Upon completion of the required 
 78.10  hours, the retired dentist shall submit to the commissioner the 
 78.11  following: 
 78.12     (1) documentation of service provided; 
 78.13     (2) the cost of malpractice insurance for the 12-month 
 78.14  period; and 
 78.15     (3) the cost of the license.  
 78.16     Subd. 3.  [REIMBURSEMENT.] Upon receipt of the information 
 78.17  described in subdivision 2, the commissioner shall provide 
 78.18  reimbursement to the retired dentist for the cost of malpractice 
 78.19  insurance for the previous 12-month period and the cost of the 
 78.20  license. 
 78.21     Sec. 5.  Minnesota Statutes 2000, section 256.9657, 
 78.22  subdivision 2, is amended to read: 
 78.23     Subd. 2.  [HOSPITAL SURCHARGE.] (a) Effective October 1, 
 78.24  1992, each Minnesota hospital except facilities of the federal 
 78.25  Indian Health Service and regional treatment centers shall pay 
 78.26  to the medical assistance account a surcharge equal to 1.4 
 78.27  percent of net patient revenues excluding net Medicare revenues 
 78.28  reported by that provider to the health care cost information 
 78.29  system according to the schedule in subdivision 4.  
 78.30     (b) Effective July 1, 1994, the surcharge under paragraph 
 78.31  (a) is increased to 1.56 percent. 
 78.32     (c) Notwithstanding the Medicare cost finding and allowable 
 78.33  cost principles, the hospital surcharge is not an allowable cost 
 78.34  for purposes of rate setting under sections 256.9685 to 256.9695.
 78.35     Sec. 6.  Minnesota Statutes 2000, section 256.969, 
 78.36  subdivision 2b, is amended to read: 
 79.1      Subd. 2b.  [OPERATING PAYMENT RATES.] In determining 
 79.2   operating payment rates for admissions occurring on or after the 
 79.3   rate year beginning January 1, 1991, and every two years after, 
 79.4   or more frequently as determined by the commissioner, the 
 79.5   commissioner shall obtain operating data from an updated base 
 79.6   year and, within the limits of available appropriations, 
 79.7   establish operating payment rates per admission for each 
 79.8   hospital based on the cost-finding methods and allowable costs 
 79.9   of the Medicare program in effect during the base year.  Rates 
 79.10  under the general assistance medical care, medical assistance, 
 79.11  and MinnesotaCare programs shall not be rebased to more current 
 79.12  data on January 1, 1997.  The base year operating payment rate 
 79.13  per admission is standardized by the case mix index and adjusted 
 79.14  by the hospital cost index, relative values, and 
 79.15  disproportionate population adjustment.  The cost and charge 
 79.16  data used to establish operating rates shall only reflect 
 79.17  inpatient services covered by medical assistance and shall not 
 79.18  include property cost information and costs recognized in 
 79.19  outlier payments. 
 79.20     Sec. 7.  Minnesota Statutes 2000, section 256.969, is 
 79.21  amended by adding a subdivision to read: 
 79.22     Subd. 26.  [GREATER MINNESOTA PAYMENT ADJUSTMENT AFTER JUNE 
 79.23  30, 2001.] (a) For admissions occurring after June 30, 2001, the 
 79.24  commissioner shall pay all medical assistance inpatient 
 79.25  fee-for-service admissions for the diagnosis-related groups 
 79.26  specified in paragraph (b) at hospitals located outside of the 
 79.27  seven-county metropolitan area at the higher of:  
 79.28     (1) the hospital's current payment rate for the diagnostic 
 79.29  category to which the diagnosis-related group belongs, exclusive 
 79.30  of disproportionate population adjustments received under 
 79.31  subdivision 9 and hospital payment adjustments received under 
 79.32  subdivision 23; or 
 79.33     (2) the rate in clause (1) plus a proportion of the 
 79.34  difference between the current average payment rate for that 
 79.35  diagnostic category for hospitals located within the 
 79.36  seven-county metropolitan area, exclusive of disproportionate 
 80.1   population adjustments received under subdivision 9 and hospital 
 80.2   payment adjustments received under subdivision 23, and the 
 80.3   current rate in clause (1).  This proportion shall be 12.5 
 80.4   percent for the fiscal year beginning July 1, 2001, and shall 
 80.5   increase by 12.5 percentage points for each of the next seven 
 80.6   fiscal years, such that the proportion is 100 percent for the 
 80.7   fiscal year beginning July 1, 2008. 
 80.8      (b) The reimbursement increases provided in paragraph (a) 
 80.9   apply to the following diagnosis-related groups as they fall 
 80.10  within the diagnostic categories: 
 80.11     (1) 370 C-section with complicating diagnosis; 
 80.12     (2) 371 C-section without complicating diagnosis; 
 80.13     (3) 372 vaginal delivery with complicating diagnosis; 
 80.14     (4) 373 vaginal delivery without complicating diagnosis; 
 80.15     (5) 386 extreme immaturity, weight greater than 1,500 
 80.16  grams; 
 80.17     (6) 388 full-term neonates with other problems; 
 80.18     (7) 390 prematurity without major problems; 
 80.19     (8) 391 normal newborn case; 
 80.20     (9) 385 neonate, died or transferred to another health care 
 80.21  facility; 
 80.22     (10) 425 acute adjustment reaction and psychosocial 
 80.23  dysfunctioning; 
 80.24     (11) 430 psychosis; 
 80.25     (12) 431 childhood mental disorders; and 
 80.26     (13) 164-167 appendectomy. 
 80.27     Sec. 8.  Minnesota Statutes 2000, section 256B.04, is 
 80.28  amended by adding a subdivision to read: 
 80.29     Subd. 1b.  [CONTRACT FOR SERVICES FOR AMERICAN INDIAN 
 80.30  CHILDREN.] Notwithstanding subdivision 1, the commissioner may 
 80.31  contract with federally recognized Indian tribes with a 
 80.32  reservation in Minnesota for the provision of early and periodic 
 80.33  screening, diagnosis, and treatment administrative services for 
 80.34  American Indian children, according to Code of Federal 
 80.35  Regulations, title 42, section 441, subpart B, and Minnesota 
 80.36  Rules, part 9505.1693 et seq., when the tribe chooses to provide 
 81.1   such services.  For purposes of this subdivision, "American 
 81.2   Indian" has the meaning given to persons to whom services will 
 81.3   be provided for in Code of Federal Regulations, title 42, 
 81.4   section 36.12.  Notwithstanding Minnesota Rules, part 9505.1748, 
 81.5   subpart 1, the commissioner, the local agency, and the tribe may 
 81.6   contract with any entity for the provision of early and periodic 
 81.7   screening, diagnosis, and treatment administrative services. 
 81.8      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
 81.9   following final enactment. 
 81.10     Sec. 9.  Minnesota Statutes 2000, section 256B.055, 
 81.11  subdivision 3a, is amended to read: 
 81.12     Subd. 3a.  [MFIP-S FAMILIES; FAMILIES ELIGIBLE UNDER PRIOR 
 81.13  AFDC RULES.] (a) Beginning January 1, 1998, or on the date that 
 81.14  MFIP-S is implemented in counties, medical assistance may be 
 81.15  paid for a person receiving public assistance under the MFIP-S 
 81.16  program.  Beginning July 1, 2002, medical assistance may be paid 
 81.17  for a person who would have been eligible, but for excess income 
 81.18  or assets, under the state's AFDC plan in effect as of July 16, 
 81.19  1996, with the base AFDC standard increased by three percent 
 81.20  effective July 1, 2000.  
 81.21     (b) Beginning January 1, 1998, July 1, 2002, medical 
 81.22  assistance may be paid for a person who would have been eligible 
 81.23  for public assistance under the income and resource assets 
 81.24  standards, or who would have been eligible but for excess income 
 81.25  or assets, under the state's AFDC plan in effect as of July 16, 
 81.26  1996, as required by the Personal Responsibility and Work 
 81.27  Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 
 81.28  Number 104-193 with the base AFDC rate increased by three 
 81.29  percent effective July 1, 2000.  
 81.30     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002. 
 81.31     Sec. 10.  Minnesota Statutes 2000, section 256B.056, 
 81.32  subdivision 1a, is amended to read: 
 81.33     Subd. 1a.  [INCOME AND ASSETS GENERALLY.] Unless 
 81.34  specifically required by state law or rule or federal law or 
 81.35  regulation, the methodologies used in counting income and assets 
 81.36  to determine eligibility for medical assistance for persons 
 82.1   whose eligibility category is based on blindness, disability, or 
 82.2   age of 65 or more years, the methodologies for the supplemental 
 82.3   security income program shall be used.  Effective upon federal 
 82.4   approval, for children eligible under section 256B.055, 
 82.5   subdivision 12, or for home and community-based waiver services 
 82.6   whose eligibility for medical assistance is determined without 
 82.7   regard to parental income, child support payments, including any 
 82.8   payments made by an obligor in satisfaction of or in addition to 
 82.9   a temporary or permanent order for child support, social 
 82.10  security payments, and other benefits for basic needs are not 
 82.11  counted as income.  For families and children, which includes 
 82.12  all other eligibility categories, the methodologies under the 
 82.13  state's AFDC plan in effect as of July 16, 1996, as required by 
 82.14  the Personal Responsibility and Work Opportunity Reconciliation 
 82.15  Act of 1996 (PRWORA), Public Law Number 104-193, shall be used.  
 82.16  Effective upon federal approval, in-kind contributions to, and 
 82.17  payments made on behalf of, a recipient, by an obligor, in 
 82.18  satisfaction of or in addition to a temporary or permanent order 
 82.19  for child support or maintenance, shall be considered income to 
 82.20  the recipient.  For these purposes, a "methodology" does not 
 82.21  include an asset or income standard, or accounting method, or 
 82.22  method of determining effective dates. 
 82.23     Sec. 11.  Minnesota Statutes 2000, section 256B.056, 
 82.24  subdivision 3, is amended to read: 
 82.25     Subd. 3.  [ASSET LIMITATIONS.] To be eligible for medical 
 82.26  assistance, a person must not individually own more than $3,000 
 82.27  in assets, or if a member of a household with two family 
 82.28  members, husband and wife, or parent and child, the household 
 82.29  must not own more than $6,000 in assets, plus $200 for each 
 82.30  additional legal dependent.  In addition to these maximum 
 82.31  amounts, an eligible individual or family may accrue interest on 
 82.32  these amounts, but they must be reduced to the maximum at the 
 82.33  time of an eligibility redetermination.  The accumulation of the 
 82.34  clothing and personal needs allowance according to section 
 82.35  256B.35 must also be reduced to the maximum at the time of the 
 82.36  eligibility redetermination.  The value of assets that are not 
 83.1   considered in determining eligibility for medical assistance is 
 83.2   the value of those assets excluded under the AFDC state plan as 
 83.3   of July 16, 1996, as required by the Personal Responsibility and 
 83.4   Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 
 83.5   Number 104-193, for families and children, and the supplemental 
 83.6   security income program for aged, blind, and disabled persons, 
 83.7   with the following exceptions: 
 83.8      (a) Household goods and personal effects are not considered.
 83.9      (b) Capital and operating assets of a trade or business 
 83.10  that the local agency determines are necessary to the person's 
 83.11  ability to earn an income are not considered. 
 83.12     (c) Motor vehicles are excluded to the same extent excluded 
 83.13  by the supplemental security income program. 
 83.14     (d) Assets designated as burial expenses are excluded to 
 83.15  the same extent excluded by the supplemental security income 
 83.16  program. 
 83.17     (e) Effective upon federal approval, for a person who no 
 83.18  longer qualifies as an employed person with a disability due to 
 83.19  loss of earnings, assets allowed while eligible for medical 
 83.20  assistance under section 256B.057, subdivision 9, are not 
 83.21  considered for 12 months, beginning with the first month of 
 83.22  ineligibility as an employed person with a disability, to the 
 83.23  extent that the person's total assets remain within the allowed 
 83.24  limits of section 256B.057, subdivision 9, paragraph (b). 
 83.25     Sec. 12.  Minnesota Statutes 2000, section 256B.056, 
 83.26  subdivision 4, is amended to read: 
 83.27     Subd. 4.  [INCOME.] (a) To be eligible for medical 
 83.28  assistance, a person eligible under section 256B.055, 
 83.29  subdivision subdivisions 7, 7a, and 12, not receiving 
 83.30  supplemental security income program payments, and may have 
 83.31  income up to the following specified percentages of the federal 
 83.32  poverty guidelines for the family size effective on April 1 of 
 83.33  each year: 
 83.34     (1) 80 percent, effective July 1, 2002; 
 83.35     (2) 90 percent, effective July 1, 2003; 
 83.36     (3) 100 percent, effective July 1, 2004. 
 84.1   Increases in benefits under title II of the Social Security Act 
 84.2   shall not be counted as income for purposes of this subdivision 
 84.3   until the first day of the second full month following 
 84.4   publication of the change in the federal poverty guidelines. 
 84.5      (b) To be eligible for medical assistance, families and 
 84.6   children may have an income up to 133-1/3 percent of the AFDC 
 84.7   income standard in effect under the July 16, 1996, AFDC state 
 84.8   plan.  Effective July 1, 2000, the base AFDC standard in effect 
 84.9   on July 16, 1996, shall be increased by three percent. Effective 
 84.10  January 1, 2000, and each successive January, recipients of 
 84.11  supplemental security income may have an income up to the 
 84.12  supplemental security income standard in effect on that date. 
 84.13     (c) Effective July 1, 2002, to be eligible for medical 
 84.14  assistance, families and children may have an income up to 100 
 84.15  percent of the federal poverty guidelines for the family size 
 84.16  effective on April 1 of each year. 
 84.17     (d) In computing income to determine eligibility of persons 
 84.18  under paragraphs (a) to (c) who are not residents of long-term 
 84.19  care facilities, the commissioner shall disregard increases in 
 84.20  income as required by Public Law Numbers 94-566, section 503; 
 84.21  99-272; and 99-509.  Veterans aid and attendance benefits and 
 84.22  Veterans Administration unusual medical expense payments are 
 84.23  considered income to the recipient. 
 84.24     Sec. 13.  Minnesota Statutes 2000, section 256B.056, 
 84.25  subdivision 5, is amended to read: 
 84.26     Subd. 5.  [EXCESS INCOME.] A person who has excess income 
 84.27  is eligible for medical assistance if the person has expenses 
 84.28  for medical care that are more than the amount of the person's 
 84.29  excess income, computed by deducting incurred medical expenses 
 84.30  from the excess income to reduce the excess to the income 
 84.31  standard specified in subdivision 4, except that if federal 
 84.32  authorization to use the standard in subdivision 4 is not 
 84.33  obtained, the medically needy standard for purposes of a 
 84.34  spenddown shall be 133 and 1/3 percent of the AFDC income 
 84.35  standard in effect under the July 16, 1996, AFDC state plan, 
 84.36  increased by three percent.  The person shall elect to have the 
 85.1   medical expenses deducted at the beginning of a one-month budget 
 85.2   period or at the beginning of a six-month budget period.  The 
 85.3   commissioner shall allow persons eligible for assistance on a 
 85.4   one-month spenddown basis under this subdivision to elect to pay 
 85.5   the monthly spenddown amount in advance of the month of 
 85.6   eligibility to the state agency in order to maintain eligibility 
 85.7   on a continuous basis.  If the recipient does not pay the 
 85.8   spenddown amount on or before the 20th of the month, the 
 85.9   recipient is ineligible for this option for the following 
 85.10  month.  The local agency shall code the Medicaid Management 
 85.11  Information System (MMIS) to indicate that the recipient has 
 85.12  elected this option.  The state agency shall convey recipient 
 85.13  eligibility information relative to the collection of the 
 85.14  spenddown to providers through the Electronic Verification 
 85.15  System (EVS).  A recipient electing advance payment must pay the 
 85.16  state agency the monthly spenddown amount on or before the 20th 
 85.17  of the month in order to be eligible for this option in the 
 85.18  following month.  
 85.19     Sec. 14.  Minnesota Statutes 2000, section 256B.057, 
 85.20  subdivision 9, is amended to read: 
 85.21     Subd. 9.  [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 
 85.22  assistance may be paid for a person who is employed and who: 
 85.23     (1) meets the definition of disabled under the supplemental 
 85.24  security income program; 
 85.25     (2) is at least 16 but less than 65 years of age; 
 85.26     (3) meets the asset limits in paragraph (b); and 
 85.27     (4) pays a premium, if required, under paragraph (c).  
 85.28  Any spousal income or assets shall be disregarded for purposes 
 85.29  of eligibility and premium determinations. 
 85.30     (b) For purposes of determining eligibility under this 
 85.31  subdivision, a person's assets must not exceed $20,000, 
 85.32  excluding: 
 85.33     (1) all assets excluded under section 256B.056; 
 85.34     (2) retirement accounts, including individual accounts, 
 85.35  401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 
 85.36     (3) medical expense accounts set up through the person's 
 86.1   employer. 
 86.2      (c) A person whose earned and unearned income is equal to 
 86.3   or greater than 200 100 percent of federal poverty guidelines 
 86.4   for the applicable family size must pay a premium to be eligible 
 86.5   for medical assistance under this subdivision.  The premium 
 86.6   shall be equal to ten percent of based on the person's gross 
 86.7   earned and unearned income above 200 percent of federal poverty 
 86.8   guidelines for and the applicable family size up to the cost of 
 86.9   coverage, using a sliding fee scale established by the 
 86.10  commissioner which begins at one percent of income at 100 
 86.11  percent of the federal poverty guidelines and gradually 
 86.12  increases to 7.5 percent of income for those with incomes at or 
 86.13  above 300 percent of the federal poverty guidelines. 
 86.14     (d) A person's eligibility and premium shall be determined 
 86.15  by the local county agency.  Premiums must be paid to the 
 86.16  commissioner.  All premiums are dedicated to the commissioner. 
 86.17     (e) Any required premium shall be determined at application 
 86.18  and redetermined annually at recertification or when a change in 
 86.19  income or family size occurs. 
 86.20     (f) Premium payment is due upon notification from the 
 86.21  commissioner of the premium amount required.  Premiums may be 
 86.22  paid in installments at the discretion of the commissioner. 
 86.23     (g) Nonpayment of the premium shall result in denial or 
 86.24  termination of medical assistance unless the person demonstrates 
 86.25  good cause for nonpayment.  Good cause exists if the 
 86.26  requirements specified in Minnesota Rules, part 9506.0040, 
 86.27  subpart 7, items B to D, are met.  Nonpayment shall include 
 86.28  payment with a returned, refused, or dishonored instrument.  The 
 86.29  commissioner may require a guaranteed form of payment as the 
 86.30  only means to replace a returned, refused, or dishonored 
 86.31  instrument. 
 86.32     <b>[EFFECTIVE DATE.]</b> This section is effective September 1, 
 86.33  2001. 
 86.34     Sec. 15.  Minnesota Statutes 2000, section 256B.057, is 
 86.35  amended by adding a subdivision to read: 
 86.36     Subd. 10.  [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 
 87.1   CERVICAL CANCER.] (a) Medical assistance may be paid for a 
 87.2   person who: 
 87.3      (1) has been screened for breast or cervical cancer by the 
 87.4   Minnesota breast and cervical cancer control program, and 
 87.5   program funds have been used to pay for the person's screening; 
 87.6      (2) according to the person's treating health professional, 
 87.7   needs treatment, including diagnostic services necessary to 
 87.8   determine the extent and proper course of treatment, for breast 
 87.9   or cervical cancer, including precancerous conditions and early 
 87.10  stage cancer; 
 87.11     (3) meets the income eligibility guidelines for the 
 87.12  Minnesota breast and cervical cancer control program; 
 87.13     (4) is under age 65; 
 87.14     (5) is not otherwise eligible for medical assistance under 
 87.15  United States Code, title 42, section 1396(a)(10)(A)(i); and 
 87.16     (6) is not otherwise covered under creditable coverage, as 
 87.17  defined under United States Code, title 42, section 300gg(c). 
 87.18     (b) Medical assistance provided for an eligible person 
 87.19  under this subdivision shall be limited to services provided 
 87.20  during the period that the person receives treatment for breast 
 87.21  or cervical cancer. 
 87.22     (c) A person meeting the criteria in paragraph (a) is 
 87.23  eligible for medical assistance without meeting the eligibility 
 87.24  criteria relating to income and assets in section 256B.056, 
 87.25  subdivisions 1a to 5b. 
 87.26     Sec. 16.  Minnesota Statutes 2000, section 256B.0625, 
 87.27  subdivision 3b, is amended to read: 
 87.28     Subd. 3b.  [TELEMEDICINE CONSULTATIONS.] (a) Medical 
 87.29  assistance covers telemedicine consultations.  Telemedicine 
 87.30  consultations must be made via two-way, interactive video or 
 87.31  store-and-forward technology.  Store-and-forward technology 
 87.32  includes telemedicine consultations that do not occur in real 
 87.33  time via synchronous transmissions, and that do not require a 
 87.34  face-to-face encounter with the patient for all or any part of 
 87.35  any such telemedicine consultation.  The patient record must 
 87.36  include a written opinion from the consulting physician 
 88.1   providing the telemedicine consultation.  A communication 
 88.2   between two physicians that consists solely of a telephone 
 88.3   conversation is not a telemedicine consultation.  Coverage is 
 88.4   limited to three telemedicine consultations per recipient per 
 88.5   calendar week.  Telemedicine consultations shall be paid at the 
 88.6   full allowable rate. 
 88.7      (b) This subdivision expires July 1, 2001.  
 88.8      Sec. 17.  Minnesota Statutes 2000, section 256B.0625, is 
 88.9   amended by adding a subdivision to read: 
 88.10     Subd. 5a.  [INTENSIVE EARLY INTERVENTION BEHAVIOR THERAPY 
 88.11  SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS.] (a) 
 88.12  [COVERAGE.] Medical assistance covers home-based intensive early 
 88.13  intervention behavior therapy for children with autism spectrum 
 88.14  disorders.  Children with autism spectrum disorder, and their 
 88.15  custodial parents or foster parents, may access other covered 
 88.16  services to treat autism spectrum disorder, and are not required 
 88.17  to receive intensive early intervention behavior therapy 
 88.18  services under this subdivision.  Intensive early intervention 
 88.19  behavior therapy does not include coverage for services to treat 
 88.20  developmental disorders of language, early onset psychosis, 
 88.21  Rett's disorder, selective mutism, social anxiety disorder, 
 88.22  stereotypic movement disorder, dementia, obsessive compulsive 
 88.23  disorder, schizoid personality disorder, avoidant personality 
 88.24  disorder, or reactive attachment disorder.  If a child with 
 88.25  autism spectrum disorder is diagnosed to have one or more of 
 88.26  these conditions, intensive early intervention behavior therapy 
 88.27  includes coverage only for services necessary to treat the 
 88.28  autism spectrum disorder. 
 88.29     (b) [PURPOSE OF INTENSIVE EARLY INTERVENTION BEHAVIOR 
 88.30  THERAPY SERVICES (IEIBTS).] The purpose of IEIBTS is to improve 
 88.31  the child's behavioral functioning, to prevent development of 
 88.32  challenging behaviors, to eliminate autistic behaviors, to 
 88.33  reduce the risk of out-of-home placement, and to establish 
 88.34  independent typical functioning in language and social 
 88.35  behavior.  The procedures used to accomplish these goals are 
 88.36  based upon research in applied behavior analysis. 
 89.1      (c) [ELIGIBLE CHILDREN.] A child is eligible to initiate 
 89.2   IEIBTS if, the child meets the additional eligibility criteria 
 89.3   in paragraph (d) and in a diagnostic assessment by a mental 
 89.4   health professional who is not under the employ of the service 
 89.5   provider, the child: 
 89.6      (1) is found to have an autism spectrum disorder; 
 89.7      (2) has a current IQ of either untestable, or at least 30; 
 89.8      (3) if nonverbal, initiated behavior therapy by 42 months 
 89.9   of age; 
 89.10     (4) if verbal, initiated behavior therapy by 48 months of 
 89.11  age; or 
 89.12     (5) if having an IQ of at least 50, initiated behavior 
 89.13  therapy by 84 months of age. 
 89.14  To continue in IEIBTS, at least one of the child's custodial 
 89.15  parents or foster parents must participate in an average of at 
 89.16  least five hours of documented behavior therapy per week for six 
 89.17  months, and consistently implement behavior therapy 
 89.18  recommendations 24 hours a day.  To continue after six-month 
 89.19  individualized treatment plan (ITP) reviews, the child must show 
 89.20  documented progress toward mastery of six-month benchmark 
 89.21  behavior objectives.  The maximum number of months during which 
 89.22  services may be billed is 54.  If significant progress towards 
 89.23  treatment goals has not been achieved after 24 months of 
 89.24  treatment, treatment must be discontinued. 
 89.25     (d) [ADDITIONAL ELIGIBLITY CRITERIA.] A child is eligible 
 89.26  to initiate IEIBTS if: 
 89.27     (1) in medical and diagnostic assessments by medical and 
 89.28  mental health professionals, it is determined that the child 
 89.29  does not have severe or profound mental retardation; 
 89.30     (2) an accurate assessment of the child's hearing has been 
 89.31  performed, including audiometry if the brain stem auditory 
 89.32  evokes response; 
 89.33     (3) a blood lead test has been performed prior to 
 89.34  initiation of treatment; and 
 89.35     (4) an EEG or neurologic evaluation is done, prior to 
 89.36  initiation of treatment, if the child has a history of staring 
 90.1   spells or developmental regression.  
 90.2      (e) [COVERED SERVICES.] The focus of IEIBTS must be to 
 90.3   treat the principal diagnostic features of the autism spectrum 
 90.4   disorder.  All IEIBTS must be delivered by a team of 
 90.5   practitioners under the consistent supervision of a single 
 90.6   clinical supervisor.  A mental health professional must develop 
 90.7   the ITP for IEIBTS.  The ITP must include six-month benchmark 
 90.8   behavior objectives.  All behavior therapy must be based upon 
 90.9   research in applied behavior analysis, with an emphasis upon 
 90.10  positive reinforcement of carefully task-analyzed skills for 
 90.11  optimum rates of progress.  All behavior therapy must be 
 90.12  consistently applied and generalized throughout the 24-hour day 
 90.13  and seven-day week by all of the child's regular care 
 90.14  providers.  When placing the child in school activities, a 
 90.15  majority of the peers must have no mental health diagnosis, and 
 90.16  the child must have sufficient social skills to succeed with 80 
 90.17  percent of the school activities.  Reactive consequences, such 
 90.18  as redirection, correction, positive practice, or time-out, must 
 90.19  be used only when necessary to improve the child's success when 
 90.20  proactive procedures alone have not been effective.  IEIBTS must 
 90.21  be delivered by a team of behavior therapy practitioners who are 
 90.22  employed under the direction of the same agency.  The team may 
 90.23  deliver up to 200 billable hours per year of direct clinical 
 90.24  supervisor services, up to 750 billable hours per year of senior 
 90.25  behavior therapist services, and up to 1,800 billable hours per 
 90.26  year of direct behavior therapist services.  A one-hour clinical 
 90.27  review meeting for the child, parents, and staff must be 
 90.28  scheduled 50 weeks a year, at which behavior therapy is reviewed 
 90.29  and planned.  At least one-quarter of the annual clinical 
 90.30  supervisor billable hours shall consist of on-site clinical 
 90.31  meeting time.  At least one-half of the annual senior behavior 
 90.32  therapist billable hours shall consist of direct services to the 
 90.33  child or parents.  All of the behavioral therapist billable 
 90.34  hours shall consist of direct on-site services to the child or 
 90.35  parents.  None of the senior behavior therapist billable hours 
 90.36  or behavior therapist billable hours shall consist of clinical 
 91.1   meeting time.  If there is any regression of the autistic 
 91.2   spectrum disorder after 12 months of therapy, a neurologic 
 91.3   consultation must be performed. 
 91.4      (f) [PROVIDER QUALIFICATIONS.] The provider agency must be 
 91.5   capable of delivering consistent applied behavior analysis 
 91.6   (ABA)-based behavior therapy in the home.  The site director of 
 91.7   the agency must be a mental health professional certified as a 
 91.8   behavior analyst by the Association for Behavior Analysis.  Each 
 91.9   clinical supervisor must be certified as a behavior analyst by 
 91.10  the Association for Behavior Analysis. 
 91.11     (g) [SUPERVISION REQUIREMENTS.] (1) Each behavior therapist 
 91.12  practitioner must be continuously supervised while in the home 
 91.13  until the practitioner has mastered competencies for independent 
 91.14  practice.  Each behavior therapist must have mastered three 
 91.15  credits of academic content and practice in an ABA sequence at 
 91.16  an accredited university.  A college degree or minimum hours of 
 91.17  experience are not required.  Each behavior therapist must 
 91.18  continue training through weekly direct observation by the 
 91.19  senior behavior therapist, through demonstrated performance in 
 91.20  clinical meetings with the clinical supervisor, and annual 
 91.21  training in ABA. 
 91.22     (2) Each senior behavior therapist practitioner must have 
 91.23  mastered the senior behavior therapy competencies, completed one 
 91.24  year of practice as a behavior therapist, and six months of 
 91.25  co-therapy training with another senior behavior therapist or 
 91.26  have an equivalent amount of experience in ABA.  Each senior 
 91.27  behavior therapist must have mastered 12 credits of academic 
 91.28  content and practice in an ABA sequence at an accredited 
 91.29  university.  Each senior behavior therapist must continue 
 91.30  training through demonstrated performance in clinical meetings 
 91.31  with the clinical supervisor, and annual training in ABA. 
 91.32     (3) Each clinical supervisor practitioner must have 
 91.33  mastered the clinical supervisor and family consultation 
 91.34  competencies, completed two years of practice as a senior 
 91.35  behavior therapist and one year of co-therapy training with 
 91.36  another clinical supervisor, or equivalent experience in ABA.  
 92.1   Each clinical supervisor must continue training through annual 
 92.2   training in ABA. 
 92.3      (h) [PLACE OF SERVICE.] IEIBTS are provided primarily in 
 92.4   the child's home and community.  Services may be provided in the 
 92.5   child's natural school or preschool classroom, home of a 
 92.6   relative, natural recreational setting, or day care. 
 92.7      (i) [PRIOR AUTHORIZATION REQUIREMENTS.] Prior authorization 
 92.8   shall be required for services provided after 200 hours of 
 92.9   clinical supervisor, 750 hours of senior behavior therapist, or 
 92.10  1,800 hours of behavior therapist services per year. 
 92.11     (j) [PAYMENT RATES.] The following payment rates apply: 
 92.12     (1) for an IEIBTS clinical supervisor practitioner under 
 92.13  supervision of a mental health professional, the lower of the 
 92.14  submitted charge or $137 per hour unit; 
 92.15     (2) for an IEIBTS senior behavior therapist practitioner 
 92.16  under supervision of a mental health professional, the lower of 
 92.17  the submitted charge or $56 per hour unit; or 
 92.18     (3) for an IEIBTS behavior therapist practitioner under 
 92.19  supervision of a mental health professional, the lower of the 
 92.20  submitted charge or $19 per hour unit. 
 92.21  An IEIBTS practitioner may receive payment for travel time which 
 92.22  exceeds 50 minutes one-way.  The maximum payment allowed will be 
 92.23  $0.51 per minute for up to a maximum of 300 hours per year. 
 92.24     For any week during which the above charges are made to 
 92.25  medical assistance, payments for the following services are 
 92.26  excluded:  supervising mental health professional hours and 
 92.27  personal care attendant, home-based mental health, 
 92.28  family-community support, or mental health behavioral aide hours.
 92.29     (k) [REPORT.] The commissioner shall collect evidence of 
 92.30  the effectiveness of intensive early intervention behavior 
 92.31  therapy services and present a report to the legislature by July 
 92.32  1, 2006. 
 92.33     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
 92.34     Sec. 18.  Minnesota Statutes 2000, section 256B.0625, 
 92.35  subdivision 13, is amended to read: 
 92.36     Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs, 
 93.1   except for fertility drugs when specifically used to enhance 
 93.2   fertility, if prescribed by a licensed practitioner and 
 93.3   dispensed by a licensed pharmacist, by a physician enrolled in 
 93.4   the medical assistance program as a dispensing physician, or by 
 93.5   a physician or a nurse practitioner employed by or under 
 93.6   contract with a community health board as defined in section 
 93.7   145A.02, subdivision 5, for the purposes of communicable disease 
 93.8   control.  The commissioner, after receiving recommendations from 
 93.9   professional medical associations and professional pharmacist 
 93.10  associations, shall designate a formulary committee to advise 
 93.11  the commissioner on the names of drugs for which payment is 
 93.12  made, recommend a system for reimbursing providers on a set fee 
 93.13  or charge basis rather than the present system, and develop 
 93.14  methods encouraging use of generic drugs when they are less 
 93.15  expensive and equally effective as trademark drugs.  The 
 93.16  formulary committee shall consist of nine members, four of whom 
 93.17  shall be physicians who are not employed by the department of 
 93.18  human services, and a majority of whose practice is for persons 
 93.19  paying privately or through health insurance, three of whom 
 93.20  shall be pharmacists who are not employed by the department of 
 93.21  human services, and a majority of whose practice is for persons 
 93.22  paying privately or through health insurance, a consumer 
 93.23  representative, and a nursing home representative.  Committee 
 93.24  members shall serve three-year terms and shall serve without 
 93.25  compensation.  Members may be reappointed once.  
 93.26     (b) The commissioner shall establish a drug formulary.  Its 
 93.27  establishment and publication shall not be subject to the 
 93.28  requirements of the Administrative Procedure Act, but the 
 93.29  formulary committee shall review and comment on the formulary 
 93.30  contents.  The formulary committee shall review and recommend 
 93.31  drugs which require prior authorization.  The formulary 
 93.32  committee may recommend drugs for prior authorization directly 
 93.33  to the commissioner, as long as opportunity for public input is 
 93.34  provided.  Prior authorization may be requested by the 
 93.35  commissioner based on medical and clinical criteria before 
 93.36  certain drugs are eligible for payment.  Before a drug may be 
 94.1   considered for prior authorization at the request of the 
 94.2   commissioner:  
 94.3      (1) the drug formulary committee must develop criteria to 
 94.4   be used for identifying drugs; the development of these criteria 
 94.5   is not subject to the requirements of chapter 14, but the 
 94.6   formulary committee shall provide opportunity for public input 
 94.7   in developing criteria; 
 94.8      (2) the drug formulary committee must hold a public forum 
 94.9   and receive public comment for an additional 15 days; and 
 94.10     (3) the commissioner must provide information to the 
 94.11  formulary committee on the impact that placing the drug on prior 
 94.12  authorization will have on the quality of patient care and 
 94.13  information regarding whether the drug is subject to clinical 
 94.14  abuse or misuse.  Prior authorization may be required by the 
 94.15  commissioner before certain formulary drugs are eligible for 
 94.16  payment.  The formulary shall not include:  
 94.17     (i) drugs or products for which there is no federal 
 94.18  funding; 
 94.19     (ii) over-the-counter drugs, except for antacids, 
 94.20  acetaminophen, family planning products, aspirin, insulin, 
 94.21  products for the treatment of lice, vitamins for adults with 
 94.22  documented vitamin deficiencies, vitamins for children under the 
 94.23  age of seven and pregnant or nursing women, and any other 
 94.24  over-the-counter drug identified by the commissioner, in 
 94.25  consultation with the drug formulary committee, as necessary, 
 94.26  appropriate, and cost-effective for the treatment of certain 
 94.27  specified chronic diseases, conditions or disorders, and this 
 94.28  determination shall not be subject to the requirements of 
 94.29  chapter 14; 
 94.30     (iii) anorectics, except that medically necessary 
 94.31  anorectics shall be covered for a recipient previously diagnosed 
 94.32  as having pickwickian syndrome and currently diagnosed as having 
 94.33  diabetes and being morbidly obese; 
 94.34     (iv) drugs for which medical value has not been 
 94.35  established; and 
 94.36     (v) drugs from manufacturers who have not signed a rebate 
 95.1   agreement with the Department of Health and Human Services 
 95.2   pursuant to section 1927 of title XIX of the Social Security Act.
 95.3      The commissioner shall publish conditions for prohibiting 
 95.4   payment for specific drugs after considering the formulary 
 95.5   committee's recommendations.  An honorarium of $100 per meeting 
 95.6   and reimbursement for mileage shall be paid to each committee 
 95.7   member in attendance.  
 95.8      (c) The basis for determining the amount of payment shall 
 95.9   be the lower of the actual acquisition costs of the drugs plus a 
 95.10  fixed dispensing fee; the maximum allowable cost set by the 
 95.11  federal government or by the commissioner plus the fixed 
 95.12  dispensing fee; or the usual and customary price charged to the 
 95.13  public.  The pharmacy dispensing fee shall be $3.65, except that 
 95.14  the dispensing fee for intravenous solutions which must be 
 95.15  compounded by the pharmacist shall be $8 per bag, $14 per bag 
 95.16  for cancer chemotherapy products, and $30 per bag for total 
 95.17  parenteral nutritional products dispensed in one liter 
 95.18  quantities, or $44 per bag for total parenteral nutritional 
 95.19  products dispensed in quantities greater than one liter.  Actual 
 95.20  acquisition cost includes quantity and other special discounts 
 95.21  except time and cash discounts.  The actual acquisition cost of 
 95.22  a drug shall be estimated by the commissioner, at average 
 95.23  wholesale price minus nine percent, except that where a drug has 
 95.24  had its wholesale price reduced as a result of the actions of 
 95.25  the National Association of Medicaid Fraud Control Units, the 
 95.26  estimated actual acquisition cost shall be the reduced average 
 95.27  wholesale price, without the nine percent deduction.  The 
 95.28  maximum allowable cost of a multisource drug may be set by the 
 95.29  commissioner and it shall be comparable to, but no higher than, 
 95.30  the maximum amount paid by other third-party payors in this 
 95.31  state who have maximum allowable cost programs.  The 
 95.32  commissioner shall set maximum allowable costs for multisource 
 95.33  drugs that are not on the federal upper limit list as described 
 95.34  in United States Code, title 42, chapter 7, section 1396r-8(e), 
 95.35  the Social Security Act, and Code of Federal Regulations, title 
 95.36  42, part 447, section 447.332.  Establishment of the amount of 
 96.1   payment for drugs shall not be subject to the requirements of 
 96.2   the Administrative Procedure Act.  An additional dispensing fee 
 96.3   of $.30 may be added to the dispensing fee paid to pharmacists 
 96.4   for legend drug prescriptions dispensed to residents of 
 96.5   long-term care facilities when a unit dose blister card system, 
 96.6   approved by the department, is used.  Under this type of 
 96.7   dispensing system, the pharmacist must dispense a 30-day supply 
 96.8   of drug.  The National Drug Code (NDC) from the drug container 
 96.9   used to fill the blister card must be identified on the claim to 
 96.10  the department.  The unit dose blister card containing the drug 
 96.11  must meet the packaging standards set forth in Minnesota Rules, 
 96.12  part 6800.2700, that govern the return of unused drugs to the 
 96.13  pharmacy for reuse.  The pharmacy provider will be required to 
 96.14  credit the department for the actual acquisition cost of all 
 96.15  unused drugs that are eligible for reuse.  Over-the-counter 
 96.16  medications must be dispensed in the manufacturer's unopened 
 96.17  package.  The commissioner may permit the drug clozapine to be 
 96.18  dispensed in a quantity that is less than a 30-day supply.  
 96.19  Whenever a generically equivalent product is available, payment 
 96.20  shall be on the basis of the actual acquisition cost of the 
 96.21  generic drug, unless the prescriber specifically indicates 
 96.22  "dispense as written - brand necessary" on the prescription as 
 96.23  required by section 151.21, subdivision 2. 
 96.24     (d) For purposes of this subdivision, "multisource drugs" 
 96.25  means covered outpatient drugs, excluding innovator multisource 
 96.26  drugs for which there are two or more drug products, which: 
 96.27     (1) are related as therapeutically equivalent under the 
 96.28  Food and Drug Administration's most recent publication of 
 96.29  "Approved Drug Products with Therapeutic Equivalence 
 96.30  Evaluations"; 
 96.31     (2) are pharmaceutically equivalent and bioequivalent as 
 96.32  determined by the Food and Drug Administration; and 
 96.33     (3) are sold or marketed in Minnesota. 
 96.34  "Innovator multisource drug" means a multisource drug that was 
 96.35  originally marketed under an original new drug application 
 96.36  approved by the Food and Drug Administration. 
 97.1      (e) The basis for determining the amount of payment for 
 97.2   drugs administered in an outpatient setting shall be the lower 
 97.3   of the usual and customary cost submitted by the provider; the 
 97.4   average wholesale price minus five percent; or the maximum 
 97.5   allowable cost set by the federal government under United States 
 97.6   Code, title 42, chapter 7, section 1396r-8(e) and Code of 
 97.7   Federal Regulations, title 42, section 447.332, or by the 
 97.8   commissioner under paragraph (c). 
 97.9      Sec. 19.  Minnesota Statutes 2000, section 256B.0625, 
 97.10  subdivision 13a, is amended to read: 
 97.11     Subd. 13a.  [DRUG UTILIZATION REVIEW BOARD.] A nine-member 
 97.12  drug utilization review board is established.  The board is 
 97.13  comprised of at least three but no more than four licensed 
 97.14  physicians actively engaged in the practice of medicine in 
 97.15  Minnesota; at least three licensed pharmacists actively engaged 
 97.16  in the practice of pharmacy in Minnesota; and one consumer 
 97.17  representative; the remainder to be made up of health care 
 97.18  professionals who are licensed in their field and have 
 97.19  recognized knowledge in the clinically appropriate prescribing, 
 97.20  dispensing, and monitoring of covered outpatient drugs.  The 
 97.21  board shall be staffed by an employee of the department who 
 97.22  shall serve as an ex officio nonvoting member of the board.  The 
 97.23  members of the board shall be appointed by the commissioner and 
 97.24  shall serve three-year terms.  The members shall be selected 
 97.25  from lists submitted by professional associations.  The 
 97.26  commissioner shall appoint the initial members of the board for 
 97.27  terms expiring as follows:  three members for terms expiring 
 97.28  June 30, 1996; three members for terms expiring June 30, 1997; 
 97.29  and three members for terms expiring June 30, 1998.  Members may 
 97.30  be reappointed once.  The board shall annually elect a chair 
 97.31  from among the members. 
 97.32     The commissioner shall, with the advice of the board: 
 97.33     (1) implement a medical assistance retrospective and 
 97.34  prospective drug utilization review program as required by 
 97.35  United States Code, title 42, section 1396r-8(g)(3); 
 97.36     (2) develop and implement the predetermined criteria and 
 98.1   practice parameters for appropriate prescribing to be used in 
 98.2   retrospective and prospective drug utilization review; 
 98.3      (3) develop, select, implement, and assess interventions 
 98.4   for physicians, pharmacists, and patients that are educational 
 98.5   and not punitive in nature; 
 98.6      (4) establish a grievance and appeals process for 
 98.7   physicians and pharmacists under this section; 
 98.8      (5) publish and disseminate educational information to 
 98.9   physicians and pharmacists regarding the board and the review 
 98.10  program; 
 98.11     (6) adopt and implement procedures designed to ensure the 
 98.12  confidentiality of any information collected, stored, retrieved, 
 98.13  assessed, or analyzed by the board, staff to the board, or 
 98.14  contractors to the review program that identifies individual 
 98.15  physicians, pharmacists, or recipients; 
 98.16     (7) establish and implement an ongoing process to (i) 
 98.17  receive public comment regarding drug utilization review 
 98.18  criteria and standards, and (ii) consider the comments along 
 98.19  with other scientific and clinical information in order to 
 98.20  revise criteria and standards on a timely basis; and 
 98.21     (8) adopt any rules necessary to carry out this section. 
 98.22     The board may establish advisory committees.  The 
 98.23  commissioner may contract with appropriate organizations to 
 98.24  assist the board in carrying out the board's duties.  The 
 98.25  commissioner may enter into contracts for services to develop 
 98.26  and implement a retrospective and prospective review program. 
 98.27     The board shall report to the commissioner annually on the 
 98.28  date the Drug Utilization Review Annual Report is due to the 
 98.29  Health Care Financing Administration.  This report is to cover 
 98.30  the preceding federal fiscal year.  The commissioner shall make 
 98.31  the report available to the public upon request.  The report 
 98.32  must include information on the activities of the board and the 
 98.33  program; the effectiveness of implemented interventions; 
 98.34  administrative costs; and any fiscal impact resulting from the 
 98.35  program.  An honorarium of $50 $100 per meeting and 
 98.36  reimbursement for mileage shall be paid to each board member in 
 99.1   attendance. 
 99.2      Sec. 20.  Minnesota Statutes 2000, section 256B.0625, 
 99.3   subdivision 17, is amended to read: 
 99.4      Subd. 17.  [TRANSPORTATION COSTS.] (a) Medical assistance 
 99.5   covers transportation costs incurred solely for obtaining 
 99.6   emergency medical care or transportation costs incurred by 
 99.7   nonambulatory persons in obtaining emergency or nonemergency 
 99.8   medical care when paid directly to an ambulance company, common 
 99.9   carrier, or other recognized providers of transportation 
 99.10  services.  For the purpose of this subdivision, a person who is 
 99.11  incapable of transport by taxicab or bus shall be considered to 
 99.12  be nonambulatory. 
 99.13     (b) Medical assistance covers special transportation, as 
 99.14  defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 
 99.15  if the provider receives and maintains a current physician's 
 99.16  order by the recipient's attending physician certifying that the 
 99.17  recipient has a physical or mental impairment that would 
 99.18  prohibit the recipient from safely accessing and using a bus, 
 99.19  taxi, other commercial transportation, or private automobile.  
 99.20  Special transportation includes driver-assisted service to 
 99.21  eligible individuals.  Driver-assisted service includes 
 99.22  passenger pickup at and return to the individual's residence or 
 99.23  place of business, assistance with admittance of the individual 
 99.24  to the medical facility, and assistance in passenger securement 
 99.25  or in securing of wheelchairs or stretchers in the vehicle.  The 
 99.26  commissioner shall establish maximum medical assistance 
 99.27  reimbursement rates for special transportation services for 
 99.28  persons who need a wheelchair lift accessible van or 
 99.29  stretcher-equipped vehicle and for those who do not need a 
 99.30  wheelchair lift accessible van or stretcher-equipped vehicle.  
 99.31  The average of these two rates per trip must not exceed $15 for 
 99.32  the base rate and $1.20 $1.50 per mile.  Special transportation 
 99.33  provided to nonambulatory ambulatory persons who do not need a 
 99.34  wheelchair lift van or stretcher-equipped vehicle, may be 
 99.35  reimbursed at a lower rate than special transportation provided 
 99.36  to persons who need a wheelchair lift van or stretcher-equipped 
100.1   vehicle. 
100.2      Sec. 21.  Minnesota Statutes 2000, section 256B.0625, 
100.3   subdivision 17a, is amended to read: 
100.4      Subd. 17a.  [PAYMENT FOR AMBULANCE SERVICES.] Effective for 
100.5   services rendered on or after July 1, 1999 2001, medical 
100.6   assistance payments for ambulance services shall be increased by 
100.7   five percent paid at the greater of:  (1) the medical assistance 
100.8   reimbursement rate in effect on June 30, 2000; or (2) the 
100.9   current Medicare reimbursement rate for ambulance services. 
100.10     Sec. 22.  Minnesota Statutes 2000, section 256B.0625, 
100.11  subdivision 18a, is amended to read: 
100.12     Subd. 18a.  [PAYMENT FOR MEALS AND LODGING ACCESS TO 
100.13  MEDICAL SERVICES.] (a) Medical assistance reimbursement for 
100.14  meals for persons traveling to receive medical care may not 
100.15  exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner. 
100.16     (b) Medical assistance reimbursement for lodging for 
100.17  persons traveling to receive medical care may not exceed $50 per 
100.18  day unless prior authorized by the local agency. 
100.19     (c) Medical assistance direct mileage reimbursement to the 
100.20  eligible person or the eligible person's driver may not exceed 
100.21  20 cents per mile. 
100.22     (d) Medical assistance covers oral language interpreter 
100.23  services when provided by an enrolled health care provider 
100.24  during the course of providing a direct, person-to-person 
100.25  covered health care service to an enrolled recipient with 
100.26  limited English proficiency. 
100.27     Sec. 23.  Minnesota Statutes 2000, section 256B.0625, 
100.28  subdivision 30, is amended to read: 
100.29     Subd. 30.  [OTHER CLINIC SERVICES.] (a) Medical assistance 
100.30  covers rural health clinic services, federally qualified health 
100.31  center services, nonprofit community health clinic services, 
100.32  public health clinic services, and the services of a clinic 
100.33  meeting the criteria established in rule by the commissioner.  
100.34  Rural health clinic services and federally qualified health 
100.35  center services mean services defined in United States Code, 
100.36  title 42, section 1396d(a)(2)(B) and (C).  Payment for rural 
101.1   health clinic and federally qualified health center services 
101.2   shall be made according to applicable federal law and regulation.
101.3      (b) A federally qualified health center that is beginning 
101.4   initial operation shall submit an estimate of budgeted costs and 
101.5   visits for the initial reporting period in the form and detail 
101.6   required by the commissioner.  A federally qualified health 
101.7   center that is already in operation shall submit an initial 
101.8   report using actual costs and visits for the initial reporting 
101.9   period.  Within 90 days of the end of its reporting period, a 
101.10  federally qualified health center shall submit, in the form and 
101.11  detail required by the commissioner, a report of its operations, 
101.12  including allowable costs actually incurred for the period and 
101.13  the actual number of visits for services furnished during the 
101.14  period, and other information required by the commissioner.  
101.15  Federally qualified health centers that file Medicare cost 
101.16  reports shall provide the commissioner with a copy of the most 
101.17  recent Medicare cost report filed with the Medicare program 
101.18  intermediary for the reporting year which support the costs 
101.19  claimed on their cost report to the state. 
101.20     (c) In order to continue cost-based payment under the 
101.21  medical assistance program according to paragraphs (a) and (b), 
101.22  a federally qualified health center or rural health clinic must 
101.23  apply for designation as an essential community provider within 
101.24  six months of final adoption of rules by the department of 
101.25  health according to section 62Q.19, subdivision 7.  For those 
101.26  federally qualified health centers and rural health clinics that 
101.27  have applied for essential community provider status within the 
101.28  six-month time prescribed, medical assistance payments will 
101.29  continue to be made according to paragraphs (a) and (b) for the 
101.30  first three years after application.  For federally qualified 
101.31  health centers and rural health clinics that either do not apply 
101.32  within the time specified above or who have had essential 
101.33  community provider status for three years, medical assistance 
101.34  payments for health services provided by these entities shall be 
101.35  according to the same rates and conditions applicable to the 
101.36  same service provided by health care providers that are not 
102.1   federally qualified health centers or rural health clinics.  
102.2      (d) Effective July 1, 1999, the provisions of paragraph (c) 
102.3   requiring a federally qualified health center or a rural health 
102.4   clinic to make application for an essential community provider 
102.5   designation in order to have cost-based payments made according 
102.6   to paragraphs (a) and (b) no longer apply. 
102.7      (e) Effective January 1, 2000, payments made according to 
102.8   paragraphs (a) and (b) shall be limited to the cost phase-out 
102.9   schedule of the Balanced Budget Act of 1997. 
102.10     (f) Effective January 1, 2001, each federally qualified 
102.11  health center and rural health clinic may elect to be paid 
102.12  either under the prospective payment system established in 
102.13  United States Code, title 42, section 1396a, paragraph (a) or 
102.14  under an alternative payment methodology consistent with the 
102.15  requirements of United States Code, title 42, section 1392a, 
102.16  paragraph (a) and approved by the health care financing 
102.17  administration.  The alternative payment methodology shall be 
102.18  100 percent of cost as determined according to Medicare cost 
102.19  principles. 
102.20     Sec. 24.  Minnesota Statutes 2000, section 256B.0625, 
102.21  subdivision 34, is amended to read: 
102.22     Subd. 34.  [INDIAN HEALTH SERVICES FACILITIES.] Medical 
102.23  assistance payments and MinnesotaCare payments to facilities of 
102.24  the Indian health service and facilities operated by a tribe or 
102.25  tribal organization under funding authorized by United States 
102.26  Code, title 25, sections 450f to 450n, or title III of the 
102.27  Indian Self-Determination and Education Assistance Act, Public 
102.28  Law Number 93-638, for enrollees who are eligible for federal 
102.29  financial participation, shall be at the option of the facility 
102.30  in accordance with the rate published by the United States 
102.31  Assistant Secretary for Health under the authority of United 
102.32  States Code, title 42, sections 248(a) and 249(b).  General 
102.33  assistance medical care payments to facilities of the Indian 
102.34  health services and facilities operated by a tribe or tribal 
102.35  organization for the provision of outpatient medical care 
102.36  services billed after June 30, 1990, must be in accordance with 
103.1   the general assistance medical care rates paid for the same 
103.2   services when provided in a facility other than a facility of 
103.3   the Indian health service or a facility operated by a tribe or 
103.4   tribal organization.  MinnesotaCare payments for enrollees who 
103.5   are not eligible for federal financial participation at 
103.6   facilities of the Indian Health Service and facilities operated 
103.7   by a tribe or tribal organization for the provision of 
103.8   outpatient medical services must be in accordance with the 
103.9   medical assistance rates paid for the same services when 
103.10  provided in a facility other than a facility of the Indian 
103.11  Health Service or a facility operated by a tribe or tribal 
103.12  organization. 
103.13     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
103.14  following final enactment. 
103.15     Sec. 25.  Minnesota Statutes 2000, section 256B.0635, 
103.16  subdivision 1, is amended to read: 
103.17     Subdivision 1.  [INCREASED EMPLOYMENT.] Beginning January 
103.18  1, 1998 (a) Until June 30, 2002, medical assistance may be paid 
103.19  for persons who received MFIP-S or medical assistance for 
103.20  families and children in at least three of six months preceding 
103.21  the month in which the person became ineligible for MFIP-S or 
103.22  medical assistance, if the ineligibility was due to an increase 
103.23  in hours of employment or employment income or due to the loss 
103.24  of an earned income disregard.  In addition, to receive 
103.25  continued assistance under this section, persons who received 
103.26  medical assistance for families and children but did not receive 
103.27  MFIP-S must have had income less than or equal to the assistance 
103.28  standard for their family size under the state's AFDC plan in 
103.29  effect as of July 16, 1996, as required by the Personal 
103.30  Responsibility and Work Opportunity Reconciliation Act of 1996 
103.31  (PRWORA), Public Law Number 104-193, increased by three percent 
103.32  effective July 1, 2000, at the time medical assistance 
103.33  eligibility began.  A person who is eligible for extended 
103.34  medical assistance is entitled to six months of assistance 
103.35  without reapplication, unless the assistance unit ceases to 
103.36  include a dependent child.  For a person under 21 years of age, 
104.1   medical assistance may not be discontinued within the six-month 
104.2   period of extended eligibility until it has been determined that 
104.3   the person is not otherwise eligible for medical assistance.  
104.4   Medical assistance may be continued for an additional six months 
104.5   if the person meets all requirements for the additional six 
104.6   months, according to title XIX of the Social Security Act, as 
104.7   amended by section 303 of the Family Support Act of 1988, Public 
104.8   Law Number 100-485. 
104.9      (b) Beginning July 1, 2002, medical assistance for families 
104.10  and children may be paid for persons who were eligible under 
104.11  section 256B.055, subdivision 3a, paragraph (b), in at least 
104.12  three of six months preceding the month in which the person 
104.13  became ineligible under that section if the ineligibility was 
104.14  due to an increase in hours of employment or employment income 
104.15  or due to the loss of an earned income disregard.  A person who 
104.16  is eligible for extended medical assistance is entitled to six 
104.17  months of assistance without reapplication, unless the 
104.18  assistance unit ceases to include a dependent child, except 
104.19  medical assistance may not be discontinued for that dependent 
104.20  child under 21 years of age within the six-month period of 
104.21  extended eligibility until it has been determined that the 
104.22  person is not otherwise eligible for medical assistance.  
104.23  Medical assistance may be continued for an additional six months 
104.24  if the person meets all requirements for the additional six 
104.25  months, according to title XIX of the Social Security Act, as 
104.26  amended by section 303 of the Family Support Act of 1988, Public 
104.27  Law Number 100-485. 
104.28     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
104.29     Sec. 26.  Minnesota Statutes 2000, section 256B.0635, 
104.30  subdivision 2, is amended to read: 
104.31     Subd. 2.  [INCREASED CHILD OR SPOUSAL SUPPORT.] Beginning 
104.32  January 1, 1998 (a) Until June 30, 2002, medical assistance may 
104.33  be paid for persons who received MFIP-S or medical assistance 
104.34  for families and children in at least three of the six months 
104.35  preceding the month in which the person became ineligible for 
104.36  MFIP-S or medical assistance, if the ineligibility was the 
105.1   result of the collection of child or spousal support under part 
105.2   D of title IV of the Social Security Act.  In addition, to 
105.3   receive continued assistance under this section, persons who 
105.4   received medical assistance for families and children but did 
105.5   not receive MFIP-S must have had income less than or equal to 
105.6   the assistance standard for their family size under the state's 
105.7   AFDC plan in effect as of July 16, 1996, as required by the 
105.8   Personal Responsibility and Work Opportunity Reconciliation Act 
105.9   of 1996 (PRWORA), Public Law Number 104-193 increased by three 
105.10  percent effective July 1, 2000, at the time medical assistance 
105.11  eligibility began.  A person who is eligible for extended 
105.12  medical assistance under this subdivision is entitled to four 
105.13  months of assistance without reapplication, unless the 
105.14  assistance unit ceases to include a dependent child.  For a 
105.15  person under 21 years of age, except medical assistance may not 
105.16  be discontinued for that dependent child under 21 years of age 
105.17  within the four-month period of extended eligibility until it 
105.18  has been determined that the person is not otherwise eligible 
105.19  for medical assistance. 
105.20     (b) Beginning July 1, 2002, medical assistance for families 
105.21  and children may be paid for persons who were eligible under 
105.22  section 256B.055, subdivision 3a, paragraph (b), in at least 
105.23  three of the six months preceding the month in which the person 
105.24  became ineligible under that section if the ineligibility was 
105.25  the result of the collection of child or spousal support under 
105.26  part D of title IV of the Social Security Act.  A person who is 
105.27  eligible for extended medical assistance under this subdivision 
105.28  is entitled to four months of assistance without reapplication, 
105.29  unless the assistance unit ceases to include a dependent child, 
105.30  except medical assistance may not be discontinued for that 
105.31  dependent child under 21 years of age within the four-month 
105.32  period of extended eligibility until it has been determined that 
105.33  the person is not otherwise eligible for medical assistance. 
105.34     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
105.35     Sec. 27.  [256B.0637] [PRESUMPTIVE ELIGIBILITY FOR CERTAIN 
105.36  PERSONS NEEDING TREATMENT FOR BREAST OR CERVICAL CANCER.] 
106.1      Medical assistance is available during a presumptive 
106.2   eligibility period for persons who meet the criteria in section 
106.3   256B.057, subdivision 10.  For purposes of this section, the 
106.4   presumptive eligibility period begins on the date on which an 
106.5   entity designated by the commissioner determines, based on 
106.6   preliminary information, that the person meets the criteria in 
106.7   section 256B.057, subdivision 10.  The presumptive eligibility 
106.8   period ends on the day on which a determination is made as to 
106.9   the person's eligibility, except that if an application is not 
106.10  submitted by the last day of the month following the month 
106.11  during which the determination based on preliminary information 
106.12  is made, the presumptive eligibility period ends on that last 
106.13  day of the month. 
106.14     Sec. 28.  [256B.195] [HEALTH CARE SAFETY NET PRESERVATION.] 
106.15     Subdivision 1.  [INTERGOVERNMENTAL TRANSFERS AND RELATED 
106.16  PAYMENTS.] (a) This section is contingent on federal approval of 
106.17  the intergovernmental transfers and payments to safety net 
106.18  hospitals authorized under this section. 
106.19     (b) In addition to the percentage contribution paid by a 
106.20  county under section 256B.19, subdivision 1, the governmental 
106.21  units designated in this subdivision shall be responsible for an 
106.22  additional portion of the nonfederal share of medical assistance 
106.23  costs attributable to them.  For purposes of this section, 
106.24  "designated governmental unit" means Hennepin county, Ramsey 
106.25  county, or the University of Minnesota.  For purposes of this 
106.26  section, "nonstate, government hospital" means Hennepin County 
106.27  Medical Center, the successor or assignee to St. Paul-Ramsey 
106.28  Medical Center as described in section 383A.91, or Fairview 
106.29  University Medical Center. 
106.30     (c) Effective July 1, 2001, the governmental units 
106.31  designated in paragraph (a) shall in total transfer $2,833,333 
106.32  on a monthly basis to the state Medicaid agency.  The 
106.33  commissioner shall allocate this assessment between the 
106.34  governmental units based on the proportion of the Medicare upper 
106.35  payment limit for each nonstate, government hospital located 
106.36  within the governmental unit to the total Medicare upper payment 
107.1   limit of all participating hospitals in paragraph (b).  
107.2      (d) The commissioner shall distribute the proceeds of this 
107.3   intergovernmental transfer, including the federal Medicaid 
107.4   match, as follows: 
107.5      (1) Proceeds may be no less than the amount of the 
107.6   intergovernmental transfer in paragraph (c) multiplied by 1.75. 
107.7      (2) The remaining proceeds provide funding for hospital 
107.8   charity care aid under section 144.585.  The commissioner of 
107.9   human services shall work with the commissioner of health to 
107.10  assure that hospital charity care aid payments are administered 
107.11  in a manner that generates Medicaid matching funds.  
107.12     (e) The successor or assignee to St. Paul-Ramsey Medical 
107.13  Center shall transfer on a monthly basis to Ramsey county an 
107.14  amount equal to the county assessment under paragraph (c). 
107.15     Subd. 2.  [DETERMINATION OF INTERGOVERNMENTAL TRANSFER 
107.16  AMOUNTS.] Medicaid rate changes, including those required to 
107.17  obtain federal financial participation under section 62J.692, 
107.18  subdivision 8, enacted prior to the effective date of this 
107.19  legislation, shall precede the determination of 
107.20  intergovernmental transfer amounts determined in this section.  
107.21  Participation in the intergovernmental transfer program shall 
107.22  not result in the offset of any nonstate, government hospital's 
107.23  receipt of Medicaid payment increases. 
107.24     Subd. 3.  [STATE PLAN AMENDMENTS.] The commissioner shall 
107.25  amend the state Medicaid plan as necessary to implement this 
107.26  section. 
107.27     Subd. 4.  [PROPORTIONATE ADJUSTMENTS.] (a) The commissioner 
107.28  shall adjust the intergovernmental transfers under subdivision 
107.29  1, paragraph (c), and the payments under subdivision 1, 
107.30  paragraph (d), upon the approval of the designated governmental 
107.31  unit named in subdivision 1, paragraph (b), based on the 
107.32  commissioner's determination of Medicare upper payment limits, 
107.33  hospital-specific federal limitations on disproportionate share 
107.34  payments or to maximize additional federal reimbursements. 
107.35     (b) In the event that:  (i) federal approval is not 
107.36  received for the total intergovernmental transfer amount 
108.1   specified in subdivision 1, paragraph (d), or, (ii) federal 
108.2   rules regarding the establishment of the 150 percent Medicare 
108.3   upper payment limit, section 1102 of the Social Security Act, 
108.4   United States Code, title 42, section 1302, enacted on March 13, 
108.5   2001, are rescinded or, (iii) the federal 150 percent Medicare 
108.6   upper payment limit is reduced to 100 percent, the amount of the 
108.7   intergovernmental transfers and Medicaid payments to the 
108.8   nonstate, government hospitals named in subdivision 1, paragraph 
108.9   (b), shall be adjusted for each hospital based on the proportion 
108.10  of each hospital's Medicaid inpatient hospital days to the total 
108.11  Medicaid inpatient hospital days provided by all participating 
108.12  hospitals.  
108.13     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
108.14     Sec. 29.  Minnesota Statutes 2000, section 256B.69, 
108.15  subdivision 4, is amended to read: 
108.16     Subd. 4.  [LIMITATION OF CHOICE.] The commissioner shall 
108.17  develop criteria to determine when limitation of choice may be 
108.18  implemented in the experimental counties.  The criteria shall 
108.19  ensure that all eligible individuals in the county have 
108.20  continuing access to the full range of medical assistance 
108.21  services as specified in subdivision 6.  The commissioner shall 
108.22  exempt the following persons from participation in the project, 
108.23  in addition to those who do not meet the criteria for limitation 
108.24  of choice:  
108.25     (1) persons eligible for medical assistance according to 
108.26  section 256B.055, subdivision 1; 
108.27     (2) persons eligible for medical assistance due to 
108.28  blindness or disability as determined by the social security 
108.29  administration or the state medical review team, unless:  
108.30     (i) they are 65 years of age or older,; or 
108.31     (ii) they reside in Itasca county or they reside in a 
108.32  county in which the commissioner conducts a pilot project under 
108.33  a waiver granted pursuant to section 1115 of the Social Security 
108.34  Act; 
108.35     (3) recipients who currently have private coverage through 
108.36  a health maintenance organization; 
109.1      (4) recipients who are eligible for medical assistance by 
109.2   spending down excess income for medical expenses other than the 
109.3   nursing facility per diem expense; 
109.4      (5) recipients who receive benefits under the Refugee 
109.5   Assistance Program, established under United States Code, title 
109.6   8, section 1522(e); 
109.7      (6) children who are both determined to be severely 
109.8   emotionally disturbed and receiving case management services 
109.9   according to section 256B.0625, subdivision 20; and 
109.10     (7) adults who are both determined to be seriously and 
109.11  persistently mentally ill and received case management services 
109.12  according to section 256B.0625, subdivision 20; and 
109.13     (8) persons eligible for medical assistance according to 
109.14  section 256B.057, subdivision 10.  
109.15  Children under age 21 who are in foster placement may enroll in 
109.16  the project on an elective basis.  Individuals excluded under 
109.17  clauses (6) and (7) may choose to enroll on an elective basis.  
109.18  The commissioner may allow persons with a one-month spenddown 
109.19  who are otherwise eligible to enroll to voluntarily enroll or 
109.20  remain enrolled, if they elect to prepay their monthly spenddown 
109.21  to the state.  Beginning on or after July 1, 1997, The 
109.22  commissioner may require those individuals to enroll in the 
109.23  prepaid medical assistance program who otherwise would have been 
109.24  excluded under clauses (1) and, (3), and (8), and under 
109.25  Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L.  
109.26  Before limitation of choice is implemented, eligible individuals 
109.27  shall be notified and after notification, shall be allowed to 
109.28  choose only among demonstration providers.  The commissioner may 
109.29  assign an individual with private coverage through a health 
109.30  maintenance organization, to the same health maintenance 
109.31  organization for medical assistance coverage, if the health 
109.32  maintenance organization is under contract for medical 
109.33  assistance in the individual's county of residence.  After 
109.34  initially choosing a provider, the recipient is allowed to 
109.35  change that choice only at specified times as allowed by the 
109.36  commissioner.  If a demonstration provider ends participation in 
110.1   the project for any reason, a recipient enrolled with that 
110.2   provider must select a new provider but may change providers 
110.3   without cause once more within the first 60 days after 
110.4   enrollment with the second provider. 
110.5      Sec. 30.  Minnesota Statutes 2000, section 256B.69, 
110.6   subdivision 5, is amended to read: 
110.7      Subd. 5.  [PROSPECTIVE PER CAPITA PAYMENT.] The 
110.8   commissioner shall establish the method and amount of payments 
110.9   for services.  The commissioner shall annually contract with 
110.10  demonstration providers to provide services consistent with 
110.11  these established methods and amounts for payment.  Payment 
110.12  rates established by the commissioner must be within the limits 
110.13  of available appropriations.  
110.14     If allowed by the commissioner, a demonstration provider 
110.15  may contract with an insurer, health care provider, nonprofit 
110.16  health service plan corporation, or the commissioner, to provide 
110.17  insurance or similar protection against the cost of care 
110.18  provided by the demonstration provider or to provide coverage 
110.19  against the risks incurred by demonstration providers under this 
110.20  section.  The recipients enrolled with a demonstration provider 
110.21  are a permissible group under group insurance laws and chapter 
110.22  62C, the Nonprofit Health Service Plan Corporations Act.  Under 
110.23  this type of contract, the insurer or corporation may make 
110.24  benefit payments to a demonstration provider for services 
110.25  rendered or to be rendered to a recipient.  Any insurer or 
110.26  nonprofit health service plan corporation licensed to do 
110.27  business in this state is authorized to provide this insurance 
110.28  or similar protection.  
110.29     Payments to providers participating in the project are 
110.30  exempt from the requirements of sections 256.966 and 256B.03, 
110.31  subdivision 2.  The commissioner shall complete development of 
110.32  capitation rates for payments before delivery of services under 
110.33  this section is begun.  For payments made during calendar year 
110.34  1990 and later years, the commissioner shall contract with an 
110.35  independent actuary to establish prepayment rates. 
110.36     By January 15, 1996, the commissioner shall report to the 
111.1   legislature on the methodology used to allocate to participating 
111.2   counties available administrative reimbursement for advocacy and 
111.3   enrollment costs.  The report shall reflect the commissioner's 
111.4   judgment as to the adequacy of the funds made available and of 
111.5   the methodology for equitable distribution of the funds.  The 
111.6   commissioner must involve participating counties in the 
111.7   development of the report. 
111.8      Sec. 31.  Minnesota Statutes 2000, section 256B.69, 
111.9   subdivision 5b, is amended to read: 
111.10     Subd. 5b.  [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 
111.11  prepaid medical assistance and general assistance medical care 
111.12  program contract rates set by the commissioner under subdivision 
111.13  5 and effective on or after January 1, 1998, capitation rates 
111.14  for nonmetropolitan counties shall on a weighted average be no 
111.15  less than 88 percent of the capitation rates for metropolitan 
111.16  counties, excluding Hennepin county.  The commissioner shall 
111.17  make a pro rata adjustment in capitation rates paid to counties 
111.18  other than nonmetropolitan counties in order to make this 
111.19  provision budget neutral.  
111.20     (b) For prepaid medical assistance program contract rates 
111.21  set by the commissioner under subdivision 5 and effective on or 
111.22  after January 1, 2001 2002, capitation rates for nonmetropolitan 
111.23  counties shall, on a weighted average, be no less than 89 95 
111.24  percent of the capitation rates for metropolitan counties, 
111.25  excluding Hennepin county.  The commissioner shall make a pro 
111.26  rata adjustment in capitation rates paid to Hennepin county in 
111.27  order to make the portion of the increase between 89 and 95 
111.28  percent budget neutral. 
111.29     (c) This subdivision shall not affect the nongeographically 
111.30  based risk adjusted rates established under section 62Q.03, 
111.31  subdivision 5a, paragraph (f). 
111.32     (d) The commissioner shall require prepaid health plans to 
111.33  use all revenue received from the increase in capitation rates 
111.34  for nonmetropolitan counties from 89 to no less than 95 percent 
111.35  of the capitation rate for metropolitan counties, excluding 
111.36  Hennepin county, to increase reimbursement rates, effective 
112.1   January 1, 2002, for providers under contract with the prepaid 
112.2   health plan to serve enrollees from nonmetropolitan counties. 
112.3      Sec. 32.  Minnesota Statutes 2000, section 256B.69, is 
112.4   amended by adding a subdivision to read: 
112.5      Subd. 6c.  [DENTAL SERVICES DEMONSTRATION PROJECT.] The 
112.6   commissioner shall establish a dental services demonstration 
112.7   project in Crow Wing, Todd, Morrison, Wadena, and Cass counties 
112.8   for provision of dental services to medical assistance, general 
112.9   assistance medical care, and MinnesotaCare recipients.  The 
112.10  commissioner may contract on a prospective per capita payment 
112.11  basis for these dental services with an organization licensed 
112.12  under chapter 62C, 62D, or 62N in accordance with section 
112.13  256B.037 or may establish and administer a fee-for-service 
112.14  system for the reimbursement of dental services.  
112.15     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
112.16     Sec. 33.  Minnesota Statutes 2000, section 256B.75, is 
112.17  amended to read: 
112.18     256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 
112.19     (a) For outpatient hospital facility fee payments for 
112.20  services rendered on or after October 1, 1992, the commissioner 
112.21  of human services shall pay the lower of (1) submitted charge, 
112.22  or (2) 32 percent above the rate in effect on June 30, 1992, 
112.23  except for those services for which there is a federal maximum 
112.24  allowable payment.  Effective for services rendered on or after 
112.25  January 1, 2000, payment rates for nonsurgical outpatient 
112.26  hospital facility fees and emergency room facility fees shall be 
112.27  increased by eight percent over the rates in effect on December 
112.28  31, 1999, except for those services for which there is a federal 
112.29  maximum allowable payment.  Services for which there is a 
112.30  federal maximum allowable payment shall be paid at the lower of 
112.31  (1) submitted charge, or (2) the federal maximum allowable 
112.32  payment.  Total aggregate payment for outpatient hospital 
112.33  facility fee services shall not exceed the Medicare upper 
112.34  limit.  If it is determined that a provision of this section 
112.35  conflicts with existing or future requirements of the United 
112.36  States government with respect to federal financial 
113.1   participation in medical assistance, the federal requirements 
113.2   prevail.  The commissioner may, in the aggregate, prospectively 
113.3   reduce payment rates to avoid reduced federal financial 
113.4   participation resulting from rates that are in excess of the 
113.5   Medicare upper limitations. 
113.6      (b) Notwithstanding paragraph (a), payment for outpatient, 
113.7   emergency, and ambulatory surgery hospital facility fee services 
113.8   for critical access hospitals designated under section 144.1483, 
113.9   clause (11), shall be paid on a cost-based payment system that 
113.10  is based on the cost-finding methods and allowable costs of the 
113.11  Medicare program. 
113.12     (c) Effective for services provided on or after July 1, 
113.13  2002, rates that are based on the Medicare outpatient 
113.14  prospective payment system shall be replaced by a budget neutral 
113.15  prospective payment system that is derived using medical 
113.16  assistance data.  The department shall provide a proposal to the 
113.17  2002 legislature to define and implement this provision. 
113.18     Sec. 34.  Minnesota Statutes 2000, section 256B.76, is 
113.19  amended to read: 
113.20     256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
113.21     (a) Effective for services rendered on or after October 1, 
113.22  1992, the commissioner shall make payments for physician 
113.23  services as follows: 
113.24     (1) payment for level one Health Care Finance 
113.25  Administration's common procedural coding system (HCPCS) codes 
113.26  titled "office and other outpatient services," "preventive 
113.27  medicine new and established patient," "delivery, antepartum, 
113.28  and postpartum care," "critical care," Caesarean cesarean 
113.29  delivery and pharmacologic management provided to psychiatric 
113.30  patients, and HCPCS level three codes for enhanced services for 
113.31  prenatal high risk, shall be paid at the lower of (i) submitted 
113.32  charges, or (ii) 25 percent above the rate in effect on June 30, 
113.33  1992.  If the rate on any procedure code within these categories 
113.34  is different than the rate that would have been paid under the 
113.35  methodology in section 256B.74, subdivision 2, then the larger 
113.36  rate shall be paid; 
114.1      (2) payments for all other services shall be paid at the 
114.2   lower of (i) submitted charges, or (ii) 15.4 percent above the 
114.3   rate in effect on June 30, 1992; 
114.4      (3) all physician rates shall be converted from the 50th 
114.5   percentile of 1982 to the 50th percentile of 1989, less the 
114.6   percent in aggregate necessary to equal the above increases 
114.7   except that payment rates for home health agency services shall 
114.8   be the rates in effect on September 30, 1992; 
114.9      (4) effective for services rendered on or after January 1, 
114.10  2000, payment rates for physician and professional services 
114.11  shall be increased by three percent over the rates in effect on 
114.12  December 31, 1999, except for home health agency and family 
114.13  planning agency services; and 
114.14     (5) the increases in clause (4) shall be implemented 
114.15  January 1, 2000, for managed care. 
114.16     (b) Effective for services rendered on or after October 1, 
114.17  1992, the commissioner shall make payments for dental services 
114.18  as follows: 
114.19     (1) dental services shall be paid at the lower of (i) 
114.20  submitted charges, or (ii) 25 percent above the rate in effect 
114.21  on June 30, 1992; 
114.22     (2) dental rates shall be converted from the 50th 
114.23  percentile of 1982 to the 50th percentile of 1989, less the 
114.24  percent in aggregate necessary to equal the above increases; 
114.25     (3) effective for services rendered on or after January 1, 
114.26  2000, payment rates for dental services shall be increased by 
114.27  three percent over the rates in effect on December 31, 1999; 
114.28     (4) the commissioner shall award grants to community 
114.29  clinics or other nonprofit community organizations, political 
114.30  subdivisions, professional associations, or other organizations 
114.31  that demonstrate the ability to provide dental services 
114.32  effectively to public program recipients.  Grants may be used to 
114.33  fund the costs related to coordinating access for recipients, 
114.34  developing and implementing patient care criteria, upgrading or 
114.35  establishing new facilities, acquiring furnishings or equipment, 
114.36  recruiting new providers, or other development costs that will 
115.1   improve access to dental care in a region.  In awarding grants, 
115.2   the commissioner shall give priority to applicants that plan to 
115.3   serve areas of the state in which the number of dental providers 
115.4   is not currently sufficient to meet the needs of recipients of 
115.5   public programs or uninsured individuals.  The commissioner 
115.6   shall consider the following in awarding the grants:  (i) 
115.7   potential to successfully increase access to an underserved 
115.8   population; (ii) the ability to raise matching funds; (iii) the 
115.9   long-term viability of the project to improve access beyond the 
115.10  period of initial funding; (iv) the efficiency in the use of the 
115.11  funding; and (v) the experience of the proposers in providing 
115.12  services to the target population. 
115.13     The commissioner shall monitor the grants and may terminate 
115.14  a grant if the grantee does not increase dental access for 
115.15  public program recipients.  The commissioner shall consider 
115.16  grants for the following: 
115.17     (i) implementation of new programs or continued expansion 
115.18  of current access programs that have demonstrated success in 
115.19  providing dental services in underserved areas; 
115.20     (ii) a pilot program for utilizing hygienists outside of a 
115.21  traditional dental office to provide dental hygiene services; 
115.22  and 
115.23     (iii) a program that organizes a network of volunteer 
115.24  dentists, establishes a system to refer eligible individuals to 
115.25  volunteer dentists, and through that network provides donated 
115.26  dental care services to public program recipients or uninsured 
115.27  individuals. 
115.28     (5) beginning October 1, 1999, the payment for tooth 
115.29  sealants and fluoride treatments shall be the lower of (i) 
115.30  submitted charge, or (ii) 80 percent of median 1997 charges; and 
115.31     (6) the increases listed in clauses (3) and (5) shall be 
115.32  implemented January 1, 2000, for managed care; and 
115.33     (7) effective for services provided on or after October 1, 
115.34  2001, payment for diagnostic examinations and dental x-rays 
115.35  provided to children under age 21 shall be the lower of (i) the 
115.36  submitted charge, or (ii) 85 percent of median 1999 charges.  
116.1      (c) Effective for dental services rendered on or after July 
116.2   1, 2001, the commissioner may increase reimbursements to 
116.3   dentists and dental clinics deemed by the commissioner to be 
116.4   critical access dental providers.  Reimbursement to a critical 
116.5   access dental provider may be increased by not more than 50 
116.6   percent above the reimbursement rate that would otherwise be 
116.7   paid to the provider.  Payments to health plan companies shall 
116.8   be adjusted to reflect increased reimbursements to critical 
116.9   access dental providers as approved by the commissioner.  In 
116.10  determining which dentists and dental clinics shall be deemed 
116.11  critical access dental providers, the commissioner shall review: 
116.12     (1) the utilization rate in the service area in which the 
116.13  dentist or dental clinic operates for dental services to 
116.14  patients covered by medical assistance, general assistance 
116.15  medical care, or MinnesotaCare as their primary source of 
116.16  coverage; 
116.17     (2) the level of services provided by the dentist or dental 
116.18  clinic to patients covered by medical assistance, general 
116.19  assistance medical care, or MinnesotaCare as their primary 
116.20  source of coverage; and 
116.21     (3) whether the level of services provided by the dentist 
116.22  or dental clinic is critical to maintaining adequate levels of 
116.23  patient access within the service area. 
116.24  In the absence of a critical access dental provider in a service 
116.25  area, the commissioner may designate a dentist or dental clinic 
116.26  as a critical access dental provider if the dentist or dental 
116.27  clinic is willing to provide care to patients covered by medical 
116.28  assistance, general assistance medical care, or MinnesotaCare at 
116.29  a level which significantly increases access to dental care in 
116.30  the service area. 
116.31     (d) An entity that operates both a Medicare certified 
116.32  comprehensive outpatient rehabilitation facility and a facility 
116.33  which was certified prior to January 1, 1993, that is licensed 
116.34  under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
116.35  whom at least 33 percent of the clients receiving rehabilitation 
116.36  services in the most recent calendar year are medical assistance 
117.1   recipients, shall be reimbursed by the commissioner for 
117.2   rehabilitation services at rates that are 38 percent greater 
117.3   than the maximum reimbursement rate allowed under paragraph (a), 
117.4   clause (2), when those services are (1) provided within the 
117.5   comprehensive outpatient rehabilitation facility and (2) 
117.6   provided to residents of nursing facilities owned by the entity. 
117.7      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
117.8   following final enactment. 
117.9      Sec. 35.  [256B.78] [MEDICAL ASSISTANCE DEMONSTRATION 
117.10  PROJECT FOR FAMILY PLANNING SERVICES.] 
117.11     (a) The commissioner of human services shall establish a 
117.12  medical assistance demonstration project to determine whether 
117.13  improved access to coverage of prepregnancy family planning 
117.14  services reduces medical assistance and MFIP costs. 
117.15     (b) This section is effective upon federal approval of the 
117.16  demonstration project. 
117.17     Sec. 36.  Minnesota Statutes 2000, section 256D.03, 
117.18  subdivision 3, is amended to read: 
117.19     Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
117.20  (a) General assistance medical care may be paid for any person 
117.21  who is not eligible for medical assistance under chapter 256B, 
117.22  including eligibility for medical assistance based on a 
117.23  spenddown of excess income according to section 256B.056, 
117.24  subdivision 5, or MinnesotaCare as defined in paragraph (b), 
117.25  except as provided in paragraph (c); and: 
117.26     (1) who is receiving assistance under section 256D.05, 
117.27  except for families with children who are eligible under 
117.28  Minnesota family investment program-statewide (MFIP-S), who is 
117.29  having a payment made on the person's behalf under sections 
117.30  256I.01 to 256I.06, or who resides in group residential housing 
117.31  as defined in chapter 256I and can meet a spenddown using the 
117.32  cost of remedial services received through group residential 
117.33  housing; or 
117.34     (2)(i) who is a resident of Minnesota; and whose equity in 
117.35  assets is not in excess of $1,000 per assistance unit.  Exempt 
117.36  assets, the reduction of excess assets, and the waiver of excess 
118.1   assets must conform to the medical assistance program in chapter 
118.2   256B, with the following exception:  the maximum amount of 
118.3   undistributed funds in a trust that could be distributed to or 
118.4   on behalf of the beneficiary by the trustee, assuming the full 
118.5   exercise of the trustee's discretion under the terms of the 
118.6   trust, must be applied toward the asset maximum; and 
118.7      (ii) who has countable income not in excess of the 
118.8   assistance standards established in section 256B.056, 
118.9   subdivision 4 that does not exceed 133 and 1/3 percent of the 
118.10  AFDC income standard in effect under the July 16, 1996, AFDC 
118.11  state plan, increased by three percent, or whose excess income 
118.12  is spent down according to section 256B.056, subdivision 5, 
118.13  using a six-month budget period.  The method for calculating 
118.14  earned income disregards and deductions for a person who resides 
118.15  with a dependent child under age 21 shall follow section 
118.16  256B.056, subdivision 1a.  However, if a disregard of $30 and 
118.17  one-third of the remainder has been applied to the wage earner's 
118.18  income, the disregard shall not be applied again until the wage 
118.19  earner's income has not been considered in an eligibility 
118.20  determination for general assistance, general assistance medical 
118.21  care, medical assistance, or MFIP-S for 12 consecutive months.  
118.22  The earned income and work expense deductions for a person who 
118.23  does not reside with a dependent child under age 21 shall be the 
118.24  same as the method used to determine eligibility for a person 
118.25  under section 256D.06, subdivision 1, except the disregard of 
118.26  the first $50 of earned income is not allowed; 
118.27     (3) who would be eligible for medical assistance except 
118.28  that the person resides in a facility that is determined by the 
118.29  commissioner or the federal Health Care Financing Administration 
118.30  to be an institution for mental diseases; or 
118.31     (4) who is ineligible for medical assistance under chapter 
118.32  256B or general assistance medical care under any other 
118.33  provision of this section, and is receiving care and 
118.34  rehabilitation services from a nonprofit center established to 
118.35  serve victims of torture.  These individuals are eligible for 
118.36  general assistance medical care only for the period during which 
119.1   they are receiving services from the center.  During this period 
119.2   of eligibility, individuals eligible under this clause shall not 
119.3   be required to participate in prepaid general assistance medical 
119.4   care.  
119.5      (b) Beginning January 1, 2000, applicants or recipients who 
119.6   meet all eligibility requirements of MinnesotaCare as defined in 
119.7   sections 256L.01 to 256L.16, and are: 
119.8      (i) adults with dependent children under 21 whose gross 
119.9   family income is equal to or less than 275 percent of the 
119.10  federal poverty guidelines; or 
119.11     (ii) adults without children with earned income and whose 
119.12  family gross income is between 75 percent of the federal poverty 
119.13  guidelines and the amount set by section 256L.04, subdivision 7, 
119.14  shall be terminated from general assistance medical care upon 
119.15  enrollment in MinnesotaCare. 
119.16     (c) For services rendered on or after July 1, 1997, 
119.17  eligibility is limited to one month prior to application if the 
119.18  person is determined eligible in the prior month.  A 
119.19  redetermination of eligibility must occur every 12 months.  
119.20  Beginning January 1, 2000, Minnesota health care program 
119.21  applications completed by recipients and applicants who are 
119.22  persons described in paragraph (b), may be returned to the 
119.23  county agency to be forwarded to the department of human 
119.24  services or sent directly to the department of human services 
119.25  for enrollment in MinnesotaCare.  If all other eligibility 
119.26  requirements of this subdivision are met, eligibility for 
119.27  general assistance medical care shall be available in any month 
119.28  during which a MinnesotaCare eligibility determination and 
119.29  enrollment are pending.  Upon notification of eligibility for 
119.30  MinnesotaCare, notice of termination for eligibility for general 
119.31  assistance medical care shall be sent to an applicant or 
119.32  recipient.  If all other eligibility requirements of this 
119.33  subdivision are met, eligibility for general assistance medical 
119.34  care shall be available until enrollment in MinnesotaCare 
119.35  subject to the provisions of paragraph (e). 
119.36     (d) The date of an initial Minnesota health care program 
120.1   application necessary to begin a determination of eligibility 
120.2   shall be the date the applicant has provided a name, address, 
120.3   and social security number, signed and dated, to the county 
120.4   agency or the department of human services.  If the applicant is 
120.5   unable to provide an initial application when health care is 
120.6   delivered due to a medical condition or disability, a health 
120.7   care provider may act on the person's behalf to complete the 
120.8   initial application.  The applicant must complete the remainder 
120.9   of the application and provide necessary verification before 
120.10  eligibility can be determined.  The county agency must assist 
120.11  the applicant in obtaining verification if necessary.  On the 
120.12  basis of information provided on the completed application, an 
120.13  applicant who meets the following criteria shall be determined 
120.14  eligible beginning in the month of application: 
120.15     (1) has gross income less than 90 percent of the applicable 
120.16  income standard; 
120.17     (2) has liquid assets that total within $300 of the asset 
120.18  standard; 
120.19     (3) does not reside in a long-term care facility; and 
120.20     (4) meets all other eligibility requirements. 
120.21  The applicant must provide all required verifications within 30 
120.22  days' notice of the eligibility determination or eligibility 
120.23  shall be terminated. 
120.24     (e) County agencies are authorized to use all automated 
120.25  databases containing information regarding recipients' or 
120.26  applicants' income in order to determine eligibility for general 
120.27  assistance medical care or MinnesotaCare.  Such use shall be 
120.28  considered sufficient in order to determine eligibility and 
120.29  premium payments by the county agency. 
120.30     (f) General assistance medical care is not available for a 
120.31  person in a correctional facility unless the person is detained 
120.32  by law for less than one year in a county correctional or 
120.33  detention facility as a person accused or convicted of a crime, 
120.34  or admitted as an inpatient to a hospital on a criminal hold 
120.35  order, and the person is a recipient of general assistance 
120.36  medical care at the time the person is detained by law or 
121.1   admitted on a criminal hold order and as long as the person 
121.2   continues to meet other eligibility requirements of this 
121.3   subdivision.  
121.4      (g) General assistance medical care is not available for 
121.5   applicants or recipients who do not cooperate with the county 
121.6   agency to meet the requirements of medical assistance.  General 
121.7   assistance medical care is limited to payment of emergency 
121.8   services only for applicants or recipients as described in 
121.9   paragraph (b), whose MinnesotaCare coverage is denied or 
121.10  terminated for nonpayment of premiums as required by sections 
121.11  256L.06 and 256L.07.  
121.12     (h) In determining the amount of assets of an individual, 
121.13  there shall be included any asset or interest in an asset, 
121.14  including an asset excluded under paragraph (a), that was given 
121.15  away, sold, or disposed of for less than fair market value 
121.16  within the 60 months preceding application for general 
121.17  assistance medical care or during the period of eligibility.  
121.18  Any transfer described in this paragraph shall be presumed to 
121.19  have been for the purpose of establishing eligibility for 
121.20  general assistance medical care, unless the individual furnishes 
121.21  convincing evidence to establish that the transaction was 
121.22  exclusively for another purpose.  For purposes of this 
121.23  paragraph, the value of the asset or interest shall be the fair 
121.24  market value at the time it was given away, sold, or disposed 
121.25  of, less the amount of compensation received.  For any 
121.26  uncompensated transfer, the number of months of ineligibility, 
121.27  including partial months, shall be calculated by dividing the 
121.28  uncompensated transfer amount by the average monthly per person 
121.29  payment made by the medical assistance program to skilled 
121.30  nursing facilities for the previous calendar year.  The 
121.31  individual shall remain ineligible until this fixed period has 
121.32  expired.  The period of ineligibility may exceed 30 months, and 
121.33  a reapplication for benefits after 30 months from the date of 
121.34  the transfer shall not result in eligibility unless and until 
121.35  the period of ineligibility has expired.  The period of 
121.36  ineligibility begins in the month the transfer was reported to 
122.1   the county agency, or if the transfer was not reported, the 
122.2   month in which the county agency discovered the transfer, 
122.3   whichever comes first.  For applicants, the period of 
122.4   ineligibility begins on the date of the first approved 
122.5   application. 
122.6      (i) When determining eligibility for any state benefits 
122.7   under this subdivision, the income and resources of all 
122.8   noncitizens shall be deemed to include their sponsor's income 
122.9   and resources as defined in the Personal Responsibility and Work 
122.10  Opportunity Reconciliation Act of 1996, title IV, Public Law 
122.11  Number 104-193, sections 421 and 422, and subsequently set out 
122.12  in federal rules. 
122.13     (j)(1) An undocumented noncitizen or a nonimmigrant is 
122.14  ineligible for general assistance medical care other than 
122.15  emergency services.  For purposes of this subdivision, a 
122.16  nonimmigrant is an individual in one or more of the classes 
122.17  listed in United States Code, title 8, section 1101(a)(15), and 
122.18  an undocumented noncitizen is an individual who resides in the 
122.19  United States without the approval or acquiescence of the 
122.20  Immigration and Naturalization Service. 
122.21     (2) This paragraph does not apply to a child under age 18, 
122.22  to a Cuban or Haitian entrant as defined in Public Law Number 
122.23  96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 
122.24  aged, blind, or disabled as defined in Code of Federal 
122.25  Regulations, title 42, sections 435.520, 435.530, 435.531, 
122.26  435.540, and 435.541, or effective October 1, 1998, to an 
122.27  individual eligible for general assistance medical care under 
122.28  paragraph (a), clause (4), who cooperates with the Immigration 
122.29  and Naturalization Service to pursue any applicable immigration 
122.30  status, including citizenship, that would qualify the individual 
122.31  for medical assistance with federal financial participation. 
122.32     (k) For purposes of paragraphs (g) and (j), "emergency 
122.33  services" has the meaning given in Code of Federal Regulations, 
122.34  title 42, section 440.255(b)(1), except that it also means 
122.35  services rendered because of suspected or actual pesticide 
122.36  poisoning. 
123.1      (l) Notwithstanding any other provision of law, a 
123.2   noncitizen who is ineligible for medical assistance due to the 
123.3   deeming of a sponsor's income and resources, is ineligible for 
123.4   general assistance medical care. 
123.5      Sec. 37.  Minnesota Statutes 2000, section 256D.03, 
123.6   subdivision 4, is amended to read: 
123.7      Subd. 4.  [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 
123.8   For a person who is eligible under subdivision 3, paragraph (a), 
123.9   clause (3), general assistance medical care covers, except as 
123.10  provided in paragraph (c): 
123.11     (1) inpatient hospital services; 
123.12     (2) outpatient hospital services; 
123.13     (3) services provided by Medicare certified rehabilitation 
123.14  agencies; 
123.15     (4) prescription drugs and other products recommended 
123.16  through the process established in section 256B.0625, 
123.17  subdivision 13; 
123.18     (5) equipment necessary to administer insulin and 
123.19  diagnostic supplies and equipment for diabetics to monitor blood 
123.20  sugar level; 
123.21     (6) eyeglasses and eye examinations provided by a physician 
123.22  or optometrist; 
123.23     (7) hearing aids; 
123.24     (8) prosthetic devices; 
123.25     (9) laboratory and X-ray services; 
123.26     (10) physician's services; 
123.27     (11) medical transportation; 
123.28     (12) chiropractic services as covered under the medical 
123.29  assistance program; 
123.30     (13) podiatric services; 
123.31     (14) dental services; 
123.32     (15) outpatient services provided by a mental health center 
123.33  or clinic that is under contract with the county board and is 
123.34  established under section 245.62; 
123.35     (16) day treatment services for mental illness provided 
123.36  under contract with the county board; 
124.1      (17) prescribed medications for persons who have been 
124.2   diagnosed as mentally ill as necessary to prevent more 
124.3   restrictive institutionalization; 
124.4      (18) psychological services, medical supplies and 
124.5   equipment, and Medicare premiums, coinsurance and deductible 
124.6   payments; 
124.7      (19) medical equipment not specifically listed in this 
124.8   paragraph when the use of the equipment will prevent the need 
124.9   for costlier services that are reimbursable under this 
124.10  subdivision; 
124.11     (20) services performed by a certified pediatric nurse 
124.12  practitioner, a certified family nurse practitioner, a certified 
124.13  adult nurse practitioner, a certified obstetric/gynecological 
124.14  nurse practitioner, a certified neonatal nurse practitioner, or 
124.15  a certified geriatric nurse practitioner in independent 
124.16  practice, if (1) the service is otherwise covered under this 
124.17  chapter as a physician service, (2) the service provided on an 
124.18  inpatient basis is not included as part of the cost for 
124.19  inpatient services included in the operating payment rate, and 
124.20  (3) the service is within the scope of practice of the nurse 
124.21  practitioner's license as a registered nurse, as defined in 
124.22  section 148.171; 
124.23     (21) services of a certified public health nurse or a 
124.24  registered nurse practicing in a public health nursing clinic 
124.25  that is a department of, or that operates under the direct 
124.26  authority of, a unit of government, if the service is within the 
124.27  scope of practice of the public health nurse's license as a 
124.28  registered nurse, as defined in section 148.171; and 
124.29     (22) telemedicine consultations, to the extent they are 
124.30  covered under section 256B.0625, subdivision 3b.  
124.31     (b) Except as provided in paragraph (c), for a recipient 
124.32  who is eligible under subdivision 3, paragraph (a), clause (1) 
124.33  or (2), general assistance medical care covers the services 
124.34  listed in paragraph (a) with the exception of special 
124.35  transportation services. 
124.36     (c) Gender reassignment surgery and related services are 
125.1   not covered services under this subdivision unless the 
125.2   individual began receiving gender reassignment services prior to 
125.3   July 1, 1995.  
125.4      (d) In order to contain costs, the commissioner of human 
125.5   services shall select vendors of medical care who can provide 
125.6   the most economical care consistent with high medical standards 
125.7   and shall where possible contract with organizations on a 
125.8   prepaid capitation basis to provide these services.  The 
125.9   commissioner shall consider proposals by counties and vendors 
125.10  for prepaid health plans, competitive bidding programs, block 
125.11  grants, or other vendor payment mechanisms designed to provide 
125.12  services in an economical manner or to control utilization, with 
125.13  safeguards to ensure that necessary services are provided.  
125.14  Before implementing prepaid programs in counties with a county 
125.15  operated or affiliated public teaching hospital or a hospital or 
125.16  clinic operated by the University of Minnesota, the commissioner 
125.17  shall consider the risks the prepaid program creates for the 
125.18  hospital and allow the county or hospital the opportunity to 
125.19  participate in the program in a manner that reflects the risk of 
125.20  adverse selection and the nature of the patients served by the 
125.21  hospital, provided the terms of participation in the program are 
125.22  competitive with the terms of other participants considering the 
125.23  nature of the population served.  Payment for services provided 
125.24  pursuant to this subdivision shall be as provided to medical 
125.25  assistance vendors of these services under sections 256B.02, 
125.26  subdivision 8, and 256B.0625.  For payments made during fiscal 
125.27  year 1990 and later years, the commissioner shall consult with 
125.28  an independent actuary in establishing prepayment rates, but 
125.29  shall retain final control over the rate methodology.  Payment 
125.30  rates established by the commissioner must be within the limits 
125.31  of available appropriations.  Notwithstanding the provisions of 
125.32  subdivision 3, an individual who becomes ineligible for general 
125.33  assistance medical care because of failure to submit income 
125.34  reports or recertification forms in a timely manner, shall 
125.35  remain enrolled in the prepaid health plan and shall remain 
125.36  eligible for general assistance medical care coverage through 
126.1   the last day of the month in which the enrollee became 
126.2   ineligible for general assistance medical care. 
126.3      (e) There shall be no copayment required of any recipient 
126.4   of benefits for any services provided under this subdivision.  A 
126.5   hospital receiving a reduced payment as a result of this section 
126.6   may apply the unpaid balance toward satisfaction of the 
126.7   hospital's bad debts. 
126.8      (f) Any county may, from its own resources, provide medical 
126.9   payments for which state payments are not made. 
126.10     (g) Chemical dependency services that are reimbursed under 
126.11  chapter 254B must not be reimbursed under general assistance 
126.12  medical care. 
126.13     (h) The maximum payment for new vendors enrolled in the 
126.14  general assistance medical care program after the base year 
126.15  shall be determined from the average usual and customary charge 
126.16  of the same vendor type enrolled in the base year. 
126.17     (i) The conditions of payment for services under this 
126.18  subdivision are the same as the conditions specified in rules 
126.19  adopted under chapter 256B governing the medical assistance 
126.20  program, unless otherwise provided by statute or rule. 
126.21     Sec. 38.  Minnesota Statutes 2000, section 256J.31, 
126.22  subdivision 12, is amended to read: 
126.23     Subd. 12.  [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 
126.24  participant who is not in vendor payment status may discontinue 
126.25  receipt of the cash assistance portion of the MFIP assistance 
126.26  grant and retain eligibility for child care assistance under 
126.27  section 119B.05 and for medical assistance under sections 
126.28  256B.055, subdivision 3a, and 256B.0635.  For the months a 
126.29  participant chooses to discontinue the receipt of the cash 
126.30  portion of the MFIP grant, the assistance unit accrues months of 
126.31  eligibility to be applied toward eligibility for child care 
126.32  under section 119B.05 and for medical assistance under sections 
126.33  256B.055, subdivision 3a, and 256B.0635. 
126.34     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002. 
126.35     Sec. 39.  Minnesota Statutes 2000, section 256K.03, 
126.36  subdivision 1, is amended to read: 
127.1      Subdivision 1.  [NOTIFICATION OF PROGRAM.] Except for the 
127.2   provisions in this section, the provisions for the MFIP 
127.3   application process shall be followed.  Within two days after 
127.4   receipt of a completed combined application form, the county 
127.5   agency must refer to the provider the applicant who meets the 
127.6   conditions under section 256K.02, and notify the applicant in 
127.7   writing of the program including the following provisions: 
127.8      (1) notification that, as part of the application process, 
127.9   applicants are required to attend orientation, to be followed 
127.10  immediately by a job search; 
127.11     (2) the program provider, the date, time, and location of 
127.12  the scheduled program orientation; 
127.13     (3) the procedures for qualifying for and receiving 
127.14  benefits under the program; 
127.15     (4) the immediate availability of supportive services, 
127.16  including, but not limited to, child care, transportation, 
127.17  medical assistance, and other work-related aid; and 
127.18     (5) the rights, responsibilities, and obligations of 
127.19  participants in the program, including, but not limited to, the 
127.20  grounds for exemptions and deferrals, the consequences for 
127.21  refusing or failing to participate fully, and the appeal process.
127.22     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002. 
127.23     Sec. 40.  Minnesota Statutes 2000, section 256K.07, is 
127.24  amended to read: 
127.25     256K.07 [ELIGIBILITY FOR FOOD STAMPS, MEDICAL ASSISTANCE, 
127.26  AND CHILD CARE.] 
127.27     The participant shall be treated as an MFIP recipient for 
127.28  food stamps, medical assistance, and child care eligibility 
127.29  purposes.  The participant who leaves the program as a result of 
127.30  increased earnings from employment shall be eligible for 
127.31  transitional medical assistance and child care without regard to 
127.32  MFIP receipt in three of the six months preceding ineligibility. 
127.33     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002. 
127.34     Sec. 41.  Minnesota Statutes 2000, section 256L.06, 
127.35  subdivision 3, is amended to read: 
127.36     Subd. 3.  [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 
128.1   Premiums are dedicated to the commissioner for MinnesotaCare. 
128.2      (b) The commissioner shall develop and implement procedures 
128.3   to:  (1) require enrollees to report changes in income; (2) 
128.4   adjust sliding scale premium payments, based upon changes in 
128.5   enrollee income; and (3) disenroll enrollees from MinnesotaCare 
128.6   for failure to pay required premiums.  Failure to pay includes 
128.7   payment with a dishonored check, a returned automatic bank 
128.8   withdrawal, or a refused credit card or debit card payment.  The 
128.9   commissioner may demand a guaranteed form of payment, including 
128.10  a cashier's check or a money order, as the only means to replace 
128.11  a dishonored, returned, or refused payment. 
128.12     (c) Premiums are calculated on a calendar month basis and 
128.13  may be paid on a monthly, quarterly, or annual basis, with the 
128.14  first payment due upon notice from the commissioner of the 
128.15  premium amount required.  The commissioner shall inform 
128.16  applicants and enrollees of these premium payment options. 
128.17  Premium payment is required before enrollment is complete and to 
128.18  maintain eligibility in MinnesotaCare.  
128.19     (d) Nonpayment of the premium will result in disenrollment 
128.20  from the plan within one calendar month after the due date 
128.21  effective for the calendar month for which the premium was due.  
128.22  Persons disenrolled for nonpayment or who voluntarily terminate 
128.23  coverage from the program may not reenroll until four calendar 
128.24  months have elapsed.  Persons disenrolled for nonpayment who pay 
128.25  all past due premiums as well as current premiums due, including 
128.26  premiums due for the period of disenrollment, within 20 days of 
128.27  disenrollment, shall be reenrolled retroactively to the first 
128.28  day of disenrollment.  Persons disenrolled for nonpayment or who 
128.29  voluntarily terminate coverage from the program may not reenroll 
128.30  for four calendar months unless the person demonstrates good 
128.31  cause for nonpayment.  Good cause does not exist if a person 
128.32  chooses to pay other family expenses instead of the premium.  
128.33  The commissioner shall define good cause in rule. 
128.34     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002. 
128.35     Sec. 42.  Minnesota Statutes 2000, section 256L.12, 
128.36  subdivision 9, is amended to read: 
129.1      Subd. 9.  [RATE SETTING.] Rates will be prospective, per 
129.2   capita, where possible.  The commissioner may allow health plans 
129.3   to arrange for inpatient hospital services on a risk or nonrisk 
129.4   basis.  The commissioner shall consult with an independent 
129.5   actuary to determine appropriate rates.  Rates established by 
129.6   the commissioner must be within the limits of available 
129.7   appropriations. 
129.8      Sec. 43.  Minnesota Statutes 2000, section 256L.12, is 
129.9   amended by adding a subdivision to read: 
129.10     Subd. 11.  [COVERAGE AT INDIAN HEALTH SERVICE 
129.11  FACILITIES.] For American Indian enrollees of MinnesotaCare, 
129.12  MinnesotaCare shall cover health care services provided at 
129.13  Indian Health Service facilities and facilities operated by a 
129.14  tribe or tribal organization under funding authorized by United 
129.15  States Code, title 25, sections 450f to 450n, or title III of 
129.16  the Indian Self-Determination and Education Act, Public Law 
129.17  Number 93-638, if those services would otherwise be covered 
129.18  under section 256L.03.  Payments for services provided under 
129.19  this subdivision shall be made on a fee-for-service basis, and 
129.20  may, at the option of the tribe or organization, be made at the 
129.21  rates authorized under sections 256.969, subdivision 16, and 
129.22  256B.0625, subdivision 34, for those MinnesotaCare enrollees 
129.23  eligible for coverage at medical assistance rates.  For purposes 
129.24  of this subdivision, "American Indian" has the meaning given to 
129.25  persons to whom services will be provided for in the Code of 
129.26  Federal Regulations, title 42, section 36.12. 
129.27     Sec. 44.  Minnesota Statutes 2000, section 256L.16, is 
129.28  amended to read: 
129.29     256L.16 [PAYMENT RATES; SERVICES FOR FAMILIES AND CHILDREN 
129.30  UNDER THE MINNESOTACARE HEALTH CARE REFORM WAIVER.] 
129.31     Section 256L.11, subdivision 2, shall not apply to services 
129.32  provided to children families with children who are eligible to 
129.33  receive expanded services according to section 256L.03, 
129.34  subdivision 1a 256L.04, subdivision 1, paragraph (a). 
129.35     Sec. 45.  Laws 1995, chapter 178, article 2, section 36, is 
129.36  amended to read: 
130.1      Sec. 36.  [EMPOWERMENT ZONES; ADMINISTRATIVE SIMPLIFICATION 
130.2   OF WELFARE LAWS.] 
130.3      (a) The commissioner of human services shall make 
130.4   recommendations to effectuate the changes in federal laws and 
130.5   regulations, state laws and rules, and the state plan to improve 
130.6   the administrative efficiency of the aid to families with 
130.7   dependent children, general assistance, work readiness, family 
130.8   general assistance, medical assistance, general assistance 
130.9   medical care, and food stamp programs.  At a minimum, the 
130.10  following administrative standards and procedures must be 
130.11  changed. 
130.12     The commissioner shall: 
130.13     (1) require income or eligibility reviews no more 
130.14  frequently than annually for cases in which income is normally 
130.15  invariant, as in aid to families with dependent children cases 
130.16  where the only source of household income is Supplemental Social 
130.17  Security Income; 
130.18     (2) permit households to report income annually when the 
130.19  source of income is excluded, such as a minor's earnings; 
130.20     (3) require income or eligibility reviews no more 
130.21  frequently than annually for extended medical assistance cases; 
130.22     (4) require income or eligibility reviews no more 
130.23  frequently than annually for a medical assistance postpartum 
130.24  client, where the client previously had eligibility under a 
130.25  different basis prior to pregnancy or if other household members 
130.26  have eligibility with the same income/basis that applies to the 
130.27  client; 
130.28     (5) (4) permit all income or eligibility reviews for foster 
130.29  care medical assistance cases to use the short application form; 
130.30  and 
130.31     (6) (5) make dependent care expenses declaratory for 
130.32  medical assistance; and 
130.33     (7) permit households to only report gifts worth $100 or 
130.34  more per month. 
130.35     (b) The county's administrative savings resulting from 
130.36  these changes may be allocated to fund any lawful purpose. 
131.1      (c) The recommendations must be provided in a report to the 
131.2   chairs of the appropriate legislative committees by August 1, 
131.3   1995.  The recommendations must include a list of the 
131.4   administrative standards and procedures that require approval by 
131.5   the federal government before implementation, and also which 
131.6   administrative simplification standards and procedures may be 
131.7   implemented by a county prior to receiving a federal waiver. 
131.8      (d) The commissioner shall seek the necessary waivers from 
131.9   the federal government as soon as possible to implement the 
131.10  administrative simplification standards and procedures. 
131.11     Sec. 46.  Laws 1999, chapter 245, article 4, section 110, 
131.12  is amended to read: 
131.13     Sec. 110.  [PROGRAMS FOR SENIOR CITIZENS.] 
131.14     The commissioner of human services shall study the 
131.15  eligibility criteria of and benefits provided to persons age 65 
131.16  and over through the array of cash assistance and health care 
131.17  programs administered by the department, and the extent to which 
131.18  these programs can be combined, simplified, or coordinated to 
131.19  reduce administrative costs and improve access.  The 
131.20  commissioner shall also study potential barriers to enrollment 
131.21  for low-income seniors who would otherwise deplete resources 
131.22  necessary to maintain independent community living.  At a 
131.23  minimum, the study must include an evaluation of asset 
131.24  requirements and enrollment sites.  The commissioner shall 
131.25  report study findings and recommendations to the legislature by 
131.26  June September 30, 2001. 
131.27     Sec. 47.  [NOTICE OF NEW PREMIUM SCHEDULE.] 
131.28     The commissioner of human services shall provide medical 
131.29  assistance enrollees subject to premiums as employed persons 
131.30  with disabilities with prior notice of the new premium schedule 
131.31  established under the section 13 amendment to section 256B.057, 
131.32  subdivision 9, paragraph (c).  This notice must be provided at 
131.33  least two months before the month in which the first premium 
131.34  payment under the new schedule is due. 
131.35     Sec. 48.  [MEDICATION THERAPY MANAGEMENT PILOT PROGRAM.] 
131.36     Subdivision 1.  [ESTABLISHMENT.] The commissioner of human 
132.1   services, in consultation with the advisory committee 
132.2   established under subdivision 2, shall implement, beginning July 
132.3   1, 2001, a two-year medication therapy management pilot program 
132.4   for medical assistance enrollees.  Medication therapy management 
132.5   must be provided by teams of physicians and pharmacists working 
132.6   in collaborative practice, as defined in Minnesota Statutes, 
132.7   section 151.01, subdivision 27, clause (5), to help patients use 
132.8   medications safely and effectively.  The commissioner may enroll 
132.9   individual pharmacists who participate in the pilot program as 
132.10  medical assistance providers and shall seek to ensure that 
132.11  participating pharmacists represent all geographic regions of 
132.12  the state. 
132.13     Subd. 2.  [ADVISORY COMMITTEE.] The commissioner shall 
132.14  establish a ten-member medication therapy management advisory 
132.15  committee, to advise the commissioner in the implementation and 
132.16  administration of the program and the development of eligibility 
132.17  criteria for enrollees and providers and requirements for 
132.18  collaborative practice agreements.  The committee shall be 
132.19  comprised of:  two licensed physicians; two licensed 
132.20  pharmacists; two consumer representatives; three members with 
132.21  expertise in the area of medication therapy management, who may 
132.22  be licensed physicians or licensed pharmacists; and a 
132.23  representative of the commissioner, who shall serve as an 
132.24  ex-officio nonvoting member.  In appointing members who are not 
132.25  consumer representatives, the commissioner shall consider 
132.26  recommendations of associations representing pharmacy and 
132.27  medical practitioners.  The committee is governed by section 
132.28  15.059, except that committee members do not receive 
132.29  compensation or reimbursement for expenses. 
132.30     Subd. 3.  [EVALUATION.] The commissioner shall evaluate the 
132.31  cost-effectiveness of the pilot program and its effect on 
132.32  patient outcomes and quality of care, and shall report to the 
132.33  legislature by December 15, 2003.  The commissioner may contract 
132.34  with a vendor to conduct the evaluation. 
132.35     Sec. 49.  [REGULATORY SIMPLIFICATION FOR STATE HEALTH CARE 
132.36  PROGRAM PROVIDERS.] 
133.1      The commissioner of human services, in consultation with 
133.2   providers participating in state health care programs, shall 
133.3   identify nonfinancial barriers to increased provider enrollment 
133.4   and provider retention in state health care programs, and shall 
133.5   implement procedures to address these barriers.  Areas to be 
133.6   examined by the commissioner shall include, but are not limited 
133.7   to, regulatory complexity and inconsistencies between state 
133.8   health care programs, provider requirements, provision of 
133.9   technical assistance to providers, responsiveness to provider 
133.10  inquiries and complaints, claims processing turnaround times, 
133.11  and policies for rejecting provider claims.  The commissioner 
133.12  shall report to the legislature by February 15, 2002, on any 
133.13  changes to the administration of state health care programs that 
133.14  will be implemented as a result of the study, and present 
133.15  recommendations for any necessary changes in state law. 
133.16     Sec. 50.  [REPEALER.] 
133.17     (a) Minnesota Statutes 2000, section 256B.037, subdivision 
133.18  5, is repealed effective January 1, 2002. 
133.19     (b) Minnesota Statutes 2000, section 256B.0635, subdivision 
133.20  3, is repealed effective July 1, 2002. 
133.21                             ARTICLE 3 
133.22                   CONTINUING CARE AND HOME CARE 
133.23     Section 1.  Minnesota Statutes 2000, section 245A.13, 
133.24  subdivision 7, is amended to read: 
133.25     Subd. 7.  [RATE RECOMMENDATION.] The commissioner of human 
133.26  services may review rates of a residential program participating 
133.27  in the medical assistance program which is in receivership and 
133.28  that has needs or deficiencies documented by the department of 
133.29  health or the department of human services.  If the commissioner 
133.30  of human services determines that a review of the rate 
133.31  established under section 256B.501 sections 256B.5012 and 
133.32  256B.5013 is needed, the commissioner shall: 
133.33     (1) review the order or determination that cites the 
133.34  deficiencies or needs; and 
133.35     (2) determine the need for additional staff, additional 
133.36  annual hours by type of employee, and additional consultants, 
134.1   services, supplies, equipment, repairs, or capital assets 
134.2   necessary to satisfy the needs or deficiencies. 
134.3      Sec. 2.  Minnesota Statutes 2000, section 245A.13, 
134.4   subdivision 8, is amended to read: 
134.5      Subd. 8.  [ADJUSTMENT TO THE RATE.] Upon review of rates 
134.6   under subdivision 7, the commissioner may adjust the residential 
134.7   program's payment rate.  The commissioner shall review the 
134.8   circumstances, together with the residential program cost report 
134.9   program's most recent income and expense report, to determine 
134.10  whether or not the deficiencies or needs can be corrected or met 
134.11  by reallocating residential program staff, costs, revenues, 
134.12  or any other resources including any investments, efficiency 
134.13  incentives, or allowances.  If the commissioner determines that 
134.14  any deficiency cannot be corrected or the need cannot be met 
134.15  with the payment rate currently being paid, the commissioner 
134.16  shall determine the payment rate adjustment by dividing the 
134.17  additional annual costs established during the commissioner's 
134.18  review by the residential program's actual resident days from 
134.19  the most recent desk-audited cost income and expense report or 
134.20  the estimated resident days in the projected receivership 
134.21  period.  The payment rate adjustment must meet the conditions in 
134.22  Minnesota Rules, parts 9553.0010 to 9553.0080, and remains in 
134.23  effect during the period of the receivership or until another 
134.24  date set by the commissioner.  Upon the subsequent sale, 
134.25  closure, or transfer of the residential program, the 
134.26  commissioner may recover amounts that were paid as payment rate 
134.27  adjustments under this subdivision.  This recovery shall be 
134.28  determined through a review of actual costs and resident days in 
134.29  the receivership period.  The costs the commissioner finds to be 
134.30  allowable shall be divided by the actual resident days for the 
134.31  receivership period.  This rate shall be compared to the rate 
134.32  paid throughout the receivership period, with the difference, 
134.33  multiplied by resident days, being the amount to be repaid to 
134.34  the commissioner.  Allowable costs shall be determined by the 
134.35  commissioner as those ordinary, necessary, and related to 
134.36  resident care by prudent and cost-conscious management.  The 
135.1   buyer or transferee shall repay this amount to the commissioner 
135.2   within 60 days after the commissioner notifies the buyer or 
135.3   transferee of the obligation to repay.  This provision does not 
135.4   limit the liability of the seller to the commissioner pursuant 
135.5   to section 256B.0641. 
135.6      Sec. 3.  Minnesota Statutes 2000, section 252.275, 
135.7   subdivision 4b, is amended to read: 
135.8      Subd. 4b.  [GUARANTEED FLOOR.] Each county with an original 
135.9   allocation for the preceding year that is equal to or less than 
135.10  the guaranteed floor minimum index shall have a guaranteed floor 
135.11  equal to its original allocation for the preceding year.  Each 
135.12  county with an original allocation for the preceding year that 
135.13  is greater than the guaranteed floor minimum index shall have a 
135.14  guaranteed floor equal to the lesser of clause (1) or (2): 
135.15     (1) the county's original allocation for the preceding 
135.16  year; or 
135.17     (2) 70 percent of the county's reported expenditures 
135.18  eligible for reimbursement during the 12 months ending on June 
135.19  30 of the preceding calendar year. 
135.20     For calendar year 1993, the guaranteed floor minimum index 
135.21  shall be $20,000.  For each subsequent year, the index shall be 
135.22  adjusted by the projected change in the average value in the 
135.23  United States Department of Labor Bureau of Labor Statistics 
135.24  consumer price index (all urban) for that year. 
135.25     Notwithstanding this subdivision, no county shall be 
135.26  allocated a guaranteed floor of less than $1,000. 
135.27     When the amount of funds available for allocation is less 
135.28  than the amount available in the previous year, each county's 
135.29  previous year allocation shall be reduced in proportion to the 
135.30  reduction in the statewide funding, to establish each county's 
135.31  guaranteed floor. 
135.32     Sec. 4.  Minnesota Statutes 2000, section 254B.02, 
135.33  subdivision 3, is amended to read: 
135.34     Subd. 3.  [RESERVE ACCOUNT.] The commissioner shall 
135.35  allocate money from the reserve account to counties that, during 
135.36  the current fiscal year, have met or exceeded the base level of 
136.1   expenditures for eligible chemical dependency services from 
136.2   local money.  The commissioner shall establish the base level 
136.3   for fiscal year 1988 as the amount of local money used for 
136.4   eligible services in calendar year 1986.  In later years, the 
136.5   base level must be increased in the same proportion as state 
136.6   appropriations to implement Laws 1986, chapter 394, sections 8 
136.7   to 20, are increased.  The base level must be decreased if the 
136.8   fund balance from which allocations are made under section 
136.9   254B.02, subdivision 1, is decreased in later years.  The local 
136.10  match rate for the reserve account is the same rate as applied 
136.11  to the initial allocation.  Reserve account payments must not be 
136.12  included when calculating the county adjustments made according 
136.13  to subdivision 2.  For counties providing medical assistance or 
136.14  general assistance medical care through managed care plans on 
136.15  January 1, 1996, the base year is fiscal year 1995.  For 
136.16  counties beginning provision of managed care after January 1, 
136.17  1996, the base year is the most recent fiscal year before 
136.18  enrollment in managed care begins.  For counties providing 
136.19  managed care, the base level will be increased or decreased in 
136.20  proportion to changes in the fund balance from which allocations 
136.21  are made under subdivision 2, but will be additionally increased 
136.22  or decreased in proportion to the change in county adjusted 
136.23  population made in subdivision 1, paragraphs (b) and 
136.24  (c).  Effective July 1, 2001, funds deposited in the reserve 
136.25  account in excess of those needed to meet obligations for 
136.26  services provided during the biennium under this section and 
136.27  sections 254B.06 and 254B.09 shall cancel to the general fund. 
136.28     Sec. 5.  Minnesota Statutes 2000, section 254B.03, 
136.29  subdivision 1, is amended to read: 
136.30     Subdivision 1.  [LOCAL AGENCY DUTIES.] (a) Every local 
136.31  agency shall provide chemical dependency services to persons 
136.32  residing within its jurisdiction who meet criteria established 
136.33  by the commissioner for placement in a chemical dependency 
136.34  residential or nonresidential treatment service.  Chemical 
136.35  dependency money must be administered by the local agencies 
136.36  according to law and rules adopted by the commissioner under 
137.1   sections 14.001 to 14.69. 
137.2      (b) In order to contain costs, the county board shall, with 
137.3   the approval of the commissioner of human services, select 
137.4   eligible vendors of chemical dependency services who can provide 
137.5   economical and appropriate treatment.  Unless the local agency 
137.6   is a social services department directly administered by a 
137.7   county or human services board, the local agency shall not be an 
137.8   eligible vendor under section 254B.05.  The commissioner may 
137.9   approve proposals from county boards to provide services in an 
137.10  economical manner or to control utilization, with safeguards to 
137.11  ensure that necessary services are provided.  If a county 
137.12  implements a demonstration or experimental medical services 
137.13  funding plan, the commissioner shall transfer the money as 
137.14  appropriate.  If a county selects a vendor located in another 
137.15  state, the county shall ensure that the vendor is in compliance 
137.16  with the rules governing licensure of programs located in the 
137.17  state. 
137.18     (c) The calendar year 1998 2002 rate for vendors may not 
137.19  increase more than three two percent above the rate approved in 
137.20  effect on January 1, 1997 2001.  The calendar year 1999 2003 
137.21  rate for vendors may not increase more than three two percent 
137.22  above the rate in effect on January 1, 1998 2002.  The calendar 
137.23  years 2004 and 2005 rates may not exceed the rate in effect on 
137.24  January 1, 2003. 
137.25     (d) A culturally specific vendor that provides assessments 
137.26  under a variance under Minnesota Rules, part 9530.6610, shall be 
137.27  allowed to provide assessment services to persons not covered by 
137.28  the variance. 
137.29     Sec. 6.  Minnesota Statutes 2000, section 254B.04, 
137.30  subdivision 1, is amended to read: 
137.31     Subdivision 1.  [ELIGIBILITY.] (a) Persons eligible for 
137.32  benefits under Code of Federal Regulations, title 25, part 20, 
137.33  persons eligible for medical assistance benefits under sections 
137.34  256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, 
137.35  or who meet the income standards of section 256B.056, 
137.36  subdivision 4, and persons eligible for general assistance 
138.1   medical care under section 256D.03, subdivision 3, are entitled 
138.2   to chemical dependency fund services.  State money appropriated 
138.3   for this paragraph must be placed in a separate account 
138.4   established for this purpose.  
138.5      Persons with dependent children who are determined to be in 
138.6   need of chemical dependency treatment pursuant to an assessment 
138.7   under section 626.556, subdivision 10, or a case plan under 
138.8   section 260C.201, subdivision 6, or 260C.212, shall be assisted 
138.9   by the local agency to access needed treatment services.  
138.10  Treatment services must be appropriate for the individual or 
138.11  family, which may include long-term care treatment or treatment 
138.12  in a facility that allows the dependent children to stay in the 
138.13  treatment facility.  The county shall pay for out-of-home 
138.14  placement costs, if applicable. 
138.15     (b) A person not entitled to services under paragraph (a), 
138.16  but with family income that is less than the 1997 federal 
138.17  poverty guidelines equivalent of 60 percent of the state median 
138.18  income for a family of like size and composition, shall be 
138.19  eligible to receive chemical dependency fund services within the 
138.20  limit of funds available after persons entitled to services 
138.21  under paragraph (a) have been served appropriated for this group 
138.22  for the fiscal year.  If notified by the state agency of limited 
138.23  funds, a county must give preferential treatment to persons with 
138.24  dependent children who are in need of chemical dependency 
138.25  treatment pursuant to an assessment under section 626.556, 
138.26  subdivision 10, or a case plan under section 260C.201, 
138.27  subdivision 6, or 260C.212.  A county may spend money from its 
138.28  own sources to serve persons under this paragraph.  State money 
138.29  appropriated for this paragraph must be placed in a separate 
138.30  account established for this purpose. 
138.31     (c) Persons whose income is between the 1997 federal 
138.32  poverty guidelines equivalent of 60 percent and 115 percent of 
138.33  the state median income shall be eligible for chemical 
138.34  dependency services on a sliding fee basis, within the limit of 
138.35  funds available, after persons entitled to services under 
138.36  paragraph (a) and persons eligible for services under paragraph 
139.1   (b) have been served appropriated for this group for the fiscal 
139.2   year.  Persons eligible under this paragraph must contribute to 
139.3   the cost of services according to the sliding fee scale 
139.4   established under subdivision 3.  A county may spend money from 
139.5   its own sources to provide services to persons under this 
139.6   paragraph.  State money appropriated for this paragraph must be 
139.7   placed in a separate account established for this purpose. 
139.8      Sec. 7.  Minnesota Statutes 2000, section 254B.09, is 
139.9   amended by adding a subdivision to read: 
139.10     Subd. 8.  [PAYMENTS TO IMPROVE SERVICES TO AMERICAN 
139.11  INDIANS.] The commissioner may set rates for chemical dependency 
139.12  services according to the American Indian Health Improvement 
139.13  Act, Public Law Number 94-437, for eligible vendors.  These 
139.14  rates shall supersede rates set in county purchase of service 
139.15  agreements when payments are made on behalf of clients eligible 
139.16  according to Public Law Number 94-437. 
139.17     Sec. 8.  Minnesota Statutes 2000, section 256.01, is 
139.18  amended by adding a subdivision to read: 
139.19     Subd. 19.  [GRANTS FOR CASE MANAGEMENT SERVICES TO PERSONS 
139.20  WITH HIV OR AIDS.] The commissioner may award grants to eligible 
139.21  vendors for the development, implementation, and evaluation of 
139.22  case management services for individuals infected with the human 
139.23  immunodeficiency virus.  HIV/AIDs case management services will 
139.24  be provided to increase access to cost effective health care 
139.25  services, to reduce the risk of HIV transmission, to ensure that 
139.26  basic client needs are met, and to increase client access to 
139.27  needed community supports or services. 
139.28     Sec. 9.  Minnesota Statutes 2000, section 256.476, 
139.29  subdivision 1, is amended to read: 
139.30     Subdivision 1.  [PURPOSE AND GOALS.] The commissioner of 
139.31  human services shall establish a consumer support grant 
139.32  program to assist for individuals with functional limitations 
139.33  and their families in purchasing and securing supports which the 
139.34  individuals need to live as independently and productively in 
139.35  the community as possible who wish to purchase and secure their 
139.36  own supports.  The commissioner and local agencies shall jointly 
140.1   develop an implementation plan which must include a way to 
140.2   resolve the issues related to county liability.  The program 
140.3   shall: 
140.4      (1) make support grants available to individuals or 
140.5   families as an effective alternative to existing programs and 
140.6   services, such as the developmental disability family support 
140.7   program, the alternative care program, personal care attendant 
140.8   services, home health aide services, and private duty nursing 
140.9   facility services; 
140.10     (2) provide consumers more control, flexibility, and 
140.11  responsibility over the needed supports their services and 
140.12  supports; 
140.13     (3) promote local program management and decision making; 
140.14  and 
140.15     (4) encourage the use of informal and typical community 
140.16  supports. 
140.17     Sec. 10.  Minnesota Statutes 2000, section 256.476, 
140.18  subdivision 2, is amended to read: 
140.19     Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
140.20  following terms have the meanings given them: 
140.21     (a) "County board" means the county board of commissioners 
140.22  for the county of financial responsibility as defined in section 
140.23  256G.02, subdivision 4, or its designated representative.  When 
140.24  a human services board has been established under sections 
140.25  402.01 to 402.10, it shall be considered the county board for 
140.26  the purposes of this section. 
140.27     (b) "Family" means the person's birth parents, adoptive 
140.28  parents or stepparents, siblings or stepsiblings, children or 
140.29  stepchildren, grandparents, grandchildren, niece, nephew, aunt, 
140.30  uncle, or spouse.  For the purposes of this section, a family 
140.31  member is at least 18 years of age. 
140.32     (c) "Functional limitations" means the long-term inability 
140.33  to perform an activity or task in one or more areas of major 
140.34  life activity, including self-care, understanding and use of 
140.35  language, learning, mobility, self-direction, and capacity for 
140.36  independent living.  For the purpose of this section, the 
141.1   inability to perform an activity or task results from a mental, 
141.2   emotional, psychological, sensory, or physical disability, 
141.3   condition, or illness. 
141.4      (d) "Informed choice" means a voluntary decision made by 
141.5   the person or the person's legal representative, after becoming 
141.6   familiarized with the alternatives to: 
141.7      (1) select a preferred alternative from a number of 
141.8   feasible alternatives; 
141.9      (2) select an alternative which may be developed in the 
141.10  future; and 
141.11     (3) refuse any or all alternatives. 
141.12     (e) "Local agency" means the local agency authorized by the 
141.13  county board to carry out the provisions of this section. 
141.14     (f) "Person" or "persons" means a person or persons meeting 
141.15  the eligibility criteria in subdivision 3. 
141.16     (g) "Authorized representative" means an individual 
141.17  designated by the person or their legal representative to act on 
141.18  their behalf.  This individual may be a family member, guardian, 
141.19  representative payee, or other individual designated by the 
141.20  person or their legal representative, if any, to assist in 
141.21  purchasing and arranging for supports.  For the purposes of this 
141.22  section, an authorized representative is at least 18 years of 
141.23  age. 
141.24     (h) "Screening" means the screening of a person's service 
141.25  needs under sections 256B.0911 and 256B.092. 
141.26     (i) "Supports" means services, care, aids, home 
141.27  environmental modifications, or assistance purchased by the 
141.28  person or the person's family.  Examples of supports include 
141.29  respite care, assistance with daily living, and adaptive aids 
141.30  assistive technology.  For the purpose of this section, 
141.31  notwithstanding the provisions of section 144A.43, supports 
141.32  purchased under the consumer support program are not considered 
141.33  home care services. 
141.34     (j) "Program of origination" means the program the 
141.35  individual transferred from when approved for the consumer 
141.36  support grant program. 
142.1      Sec. 11.  Minnesota Statutes 2000, section 256.476, 
142.2   subdivision 3, is amended to read: 
142.3      Subd. 3.  [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 
142.4   is eligible to apply for a consumer support grant if the person 
142.5   meets all of the following criteria: 
142.6      (1) the person is eligible for and has been approved to 
142.7   receive services under medical assistance as determined under 
142.8   sections 256B.055 and 256B.056 or the person is eligible for and 
142.9   has been approved to receive services under alternative care 
142.10  services as determined under section 256B.0913 or the person has 
142.11  been approved to receive a grant under the developmental 
142.12  disability family support program under section 252.32; 
142.13     (2) the person is able to direct and purchase the person's 
142.14  own care and supports, or the person has a family member, legal 
142.15  representative, or other authorized representative who can 
142.16  purchase and arrange supports on the person's behalf; 
142.17     (3) the person has functional limitations, requires ongoing 
142.18  supports to live in the community, and is at risk of or would 
142.19  continue institutionalization without such supports; and 
142.20     (4) the person will live in a home.  For the purpose of 
142.21  this section, "home" means the person's own home or home of a 
142.22  person's family member.  These homes are natural home settings 
142.23  and are not licensed by the department of health or human 
142.24  services. 
142.25     (b) Persons may not concurrently receive a consumer support 
142.26  grant if they are: 
142.27     (1) receiving home and community-based services under 
142.28  United States Code, title 42, section 1396h(c); personal care 
142.29  attendant and home health aide services under section 256B.0625; 
142.30  a developmental disability family support grant; or alternative 
142.31  care services under section 256B.0913; or 
142.32     (2) residing in an institutional or congregate care setting.
142.33     (c) A person or person's family receiving a consumer 
142.34  support grant shall not be charged a fee or premium by a local 
142.35  agency for participating in the program.  
142.36     (d) The commissioner may limit the participation of nursing 
143.1   facility residents, residents of intermediate care facilities 
143.2   for persons with mental retardation, and the recipients of 
143.3   services from federal waiver programs in the consumer support 
143.4   grant program if the participation of these individuals will 
143.5   result in an increase in the cost to the state. 
143.6      (e) The commissioner shall establish a budgeted 
143.7   appropriation each fiscal year for the consumer support grant 
143.8   program.  The number of individuals participating in the program 
143.9   will be adjusted so the total amount allocated to counties does 
143.10  not exceed the amount of the budgeted appropriation.  The 
143.11  budgeted appropriation will be adjusted annually to accommodate 
143.12  changes in demand for the consumer support grants. 
143.13     Sec. 12.  Minnesota Statutes 2000, section 256.476, 
143.14  subdivision 4, is amended to read: 
143.15     Subd. 4.  [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 
143.16  county board may choose to participate in the consumer support 
143.17  grant program.  If a county board chooses to participate in the 
143.18  program, the local agency shall establish written procedures and 
143.19  criteria to determine the amount and use of support grants.  
143.20  These procedures must include, at least, the availability of 
143.21  respite care, assistance with daily living, and adaptive aids.  
143.22  The local agency may establish monthly or annual maximum amounts 
143.23  for grants and procedures where exceptional resources may be 
143.24  required to meet the health and safety needs of the person on a 
143.25  time-limited basis, however, the total amount awarded to each 
143.26  individual may not exceed the limits established in subdivision 
143.27  5, paragraph (f). 
143.28     (b) Support grants to a person or a person's family will be 
143.29  provided through a monthly subsidy payment and be in the form of 
143.30  cash, voucher, or direct county payment to vendor.  Support 
143.31  grant amounts must be determined by the local agency.  Each 
143.32  service and item purchased with a support grant must meet all of 
143.33  the following criteria:  
143.34     (1) it must be over and above the normal cost of caring for 
143.35  the person if the person did not have functional limitations; 
143.36     (2) it must be directly attributable to the person's 
144.1   functional limitations; 
144.2      (3) it must enable the person or the person's family to 
144.3   delay or prevent out-of-home placement of the person; and 
144.4      (4) it must be consistent with the needs identified in the 
144.5   service plan, when applicable. 
144.6      (c) Items and services purchased with support grants must 
144.7   be those for which there are no other public or private funds 
144.8   available to the person or the person's family.  Fees assessed 
144.9   to the person or the person's family for health and human 
144.10  services are not reimbursable through the grant. 
144.11     (d) In approving or denying applications, the local agency 
144.12  shall consider the following factors:  
144.13     (1) the extent and areas of the person's functional 
144.14  limitations; 
144.15     (2) the degree of need in the home environment for 
144.16  additional support; and 
144.17     (3) the potential effectiveness of the grant to maintain 
144.18  and support the person in the family environment or the person's 
144.19  own home. 
144.20     (e) At the time of application to the program or screening 
144.21  for other services, the person or the person's family shall be 
144.22  provided sufficient information to ensure an informed choice of 
144.23  alternatives by the person, the person's legal representative, 
144.24  if any, or the person's family.  The application shall be made 
144.25  to the local agency and shall specify the needs of the person 
144.26  and family, the form and amount of grant requested, the items 
144.27  and services to be reimbursed, and evidence of eligibility for 
144.28  medical assistance or alternative care program. 
144.29     (f) Upon approval of an application by the local agency and 
144.30  agreement on a support plan for the person or person's family, 
144.31  the local agency shall make grants to the person or the person's 
144.32  family.  The grant shall be in an amount for the direct costs of 
144.33  the services or supports outlined in the service agreement.  
144.34     (g) Reimbursable costs shall not include costs for 
144.35  resources already available, such as special education classes, 
144.36  day training and habilitation, case management, other services 
145.1   to which the person is entitled, medical costs covered by 
145.2   insurance or other health programs, or other resources usually 
145.3   available at no cost to the person or the person's family. 
145.4      (h) The state of Minnesota, the county boards participating 
145.5   in the consumer support grant program, or the agencies acting on 
145.6   behalf of the county boards in the implementation and 
145.7   administration of the consumer support grant program shall not 
145.8   be liable for damages, injuries, or liabilities sustained 
145.9   through the purchase of support by the individual, the 
145.10  individual's family, or the authorized representative under this 
145.11  section with funds received through the consumer support grant 
145.12  program.  Liabilities include but are not limited to:  workers' 
145.13  compensation liability, the Federal Insurance Contributions Act 
145.14  (FICA), or the Federal Unemployment Tax Act (FUTA).  For 
145.15  purposes of this section, participating county boards and 
145.16  agencies acting on behalf of county boards are exempt from the 
145.17  provisions of section 268.04. 
145.18     Sec. 13.  Minnesota Statutes 2000, section 256.476, 
145.19  subdivision 5, is amended to read: 
145.20     Subd. 5.  [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 
145.21  For the purpose of transferring persons to the consumer support 
145.22  grant program from specific programs or services, such as the 
145.23  developmental disability family support program and alternative 
145.24  care program, personal care attendant assistant services, home 
145.25  health aide services, or nursing facility private duty nursing 
145.26  services, the amount of funds transferred by the commissioner 
145.27  between the developmental disability family support program 
145.28  account, the alternative care account, the medical assistance 
145.29  account, or the consumer support grant account shall be based on 
145.30  each county's participation in transferring persons to the 
145.31  consumer support grant program from those programs and services. 
145.32     (b) At the beginning of each fiscal year, county 
145.33  allocations for consumer support grants shall be based on: 
145.34     (1) the number of persons to whom the county board expects 
145.35  to provide consumer supports grants; 
145.36     (2) their eligibility for current program and services; 
146.1      (3) the amount of nonfederal dollars expended on those 
146.2   individuals for those programs and services or, in situations 
146.3   where an individual is unable to obtain the support needed from 
146.4   the program of origination due to the unavailability of service 
146.5   providers at the time or the location where the supports are 
146.6   needed, the allocation will be based on the county's best 
146.7   estimate of the nonfederal dollars that would have been expended 
146.8   if the services had been available; and 
146.9      (4) projected dates when persons will start receiving 
146.10  grants.  County allocations shall be adjusted periodically by 
146.11  the commissioner based on the actual transfer of persons or 
146.12  service openings, and the nonfederal dollars associated with 
146.13  those persons or service openings, to the consumer support grant 
146.14  program. 
146.15     (c) The amount of funds transferred by the commissioner 
146.16  from the alternative care account and the medical assistance 
146.17  account for an individual may be changed if it is determined by 
146.18  the county or its agent that the individual's need for support 
146.19  has changed. 
146.20     (d) The authority to utilize funds transferred to the 
146.21  consumer support grant account for the purposes of implementing 
146.22  and administering the consumer support grant program will not be 
146.23  limited or constrained by the spending authority provided to the 
146.24  program of origination. 
146.25     (e) The commissioner shall may use up to five percent of 
146.26  each county's allocation, as adjusted, for payments to that 
146.27  county for administrative expenses, to be paid as a 
146.28  proportionate addition to reported direct service expenditures. 
146.29     (f) Except as provided in this paragraph, the county 
146.30  allocation for each individual or individual's family cannot 
146.31  exceed 80 percent of the total nonfederal dollars expended on 
146.32  the individual by the program of origination except for the 
146.33  developmental disabilities family support grant program which 
146.34  can be approved up to 100 percent of the nonfederal dollars and 
146.35  in situations as described in paragraph (b), clause (3).  In 
146.36  situations where exceptional need exists or the individual's 
147.1   need for support increases, up to 100 percent of the nonfederal 
147.2   dollars expended by the consumer's program of origination may be 
147.3   allocated to the county.  Allocations that exceed 80 percent of 
147.4   the nonfederal dollars expended on the individual by the program 
147.5   of origination must be approved by the commissioner.  The 
147.6   remainder of the amount expended on the individual by the 
147.7   program of origination will be used in the following 
147.8   proportions:  half will be made available to the consumer 
147.9   support grant program and participating counties for consumer 
147.10  training, resource development, and other costs, and half will 
147.11  be returned to the state general fund. 
147.12     (g) The commissioner may recover, suspend, or withhold 
147.13  payments if the county board, local agency, or grantee does not 
147.14  comply with the requirements of this section. 
147.15     (h) Grant funds unexpended by consumers shall return to the 
147.16  state once a year.  The annual return of unexpended grant funds 
147.17  shall occur in the quarter following the end of the state fiscal 
147.18  year. 
147.19     Sec. 14.  Minnesota Statutes 2000, section 256.476, 
147.20  subdivision 8, is amended to read: 
147.21     Subd. 8.  [COMMISSIONER RESPONSIBILITIES.] The commissioner 
147.22  shall: 
147.23     (1) transfer and allocate funds pursuant to this section; 
147.24     (2) determine allocations based on projected and actual 
147.25  local agency use; 
147.26     (3) monitor and oversee overall program spending; 
147.27     (4) evaluate the effectiveness of the program; 
147.28     (5) provide training and technical assistance for local 
147.29  agencies and consumers to help identify potential applicants to 
147.30  the program; and 
147.31     (6) develop guidelines for local agency program 
147.32  administration and consumer information; and.  
147.33     (7) apply for a federal waiver or take any other action 
147.34  necessary to maximize federal funding for the program by 
147.35  September 1, 1999. 
147.36     Sec. 15.  Minnesota Statutes 2000, section 256B.0625, 
148.1   subdivision 7, is amended to read: 
148.2      Subd. 7.  [PRIVATE DUTY NURSING.] Medical assistance covers 
148.3   private duty nursing services in a recipient's home.  Recipients 
148.4   who are authorized to receive private duty nursing services in 
148.5   their home may use approved hours outside of the home during 
148.6   hours when normal life activities take them outside of their 
148.7   home and when, without the provision of private duty nursing, 
148.8   their health and safety would be jeopardized.  To use private 
148.9   duty nursing services at school, the recipient or responsible 
148.10  party must provide written authorization in the care plan 
148.11  identifying the chosen provider and the daily amount of services 
148.12  to be used at school.  Medical assistance does not cover private 
148.13  duty nursing services for residents of a hospital, nursing 
148.14  facility, intermediate care facility, or a health care facility 
148.15  licensed by the commissioner of health, except as authorized in 
148.16  section 256B.64 for ventilator-dependent recipients in hospitals 
148.17  or unless a resident who is otherwise eligible is on leave from 
148.18  the facility and the facility either pays for the private duty 
148.19  nursing services or forgoes the facility per diem for the leave 
148.20  days that private duty nursing services are used.  Total hours 
148.21  of service and payment allowed for services outside the home 
148.22  cannot exceed that which is otherwise allowed in an in-home 
148.23  setting according to section 256B.0627.  All private duty 
148.24  nursing services must be provided according to the limits 
148.25  established under section 256B.0627.  Private duty nursing 
148.26  services may not be reimbursed if the nurse is the spouse of the 
148.27  recipient or the parent or foster care provider of a recipient 
148.28  who is under age 18, or the recipient's legal guardian. 
148.29     Sec. 16.  Minnesota Statutes 2000, section 256B.0625, 
148.30  subdivision 19a, is amended to read: 
148.31     Subd. 19a.  [PERSONAL CARE ASSISTANT SERVICES.] Medical 
148.32  assistance covers personal care assistant services in a 
148.33  recipient's home.  To qualify for personal care assistant 
148.34  services, recipients or responsible parties must be able to 
148.35  identify the recipient's needs, direct and evaluate task 
148.36  accomplishment, and provide for health and safety.  Approved 
149.1   hours may be used outside the home when normal life activities 
149.2   take them outside the home and when, without the provision of 
149.3   personal care, their health and safety would be jeopardized.  To 
149.4   use personal care assistant services at school, the recipient or 
149.5   responsible party must provide written authorization in the care 
149.6   plan identifying the chosen provider and the daily amount of 
149.7   services to be used at school.  Total hours for services, 
149.8   whether actually performed inside or outside the recipient's 
149.9   home, cannot exceed that which is otherwise allowed for personal 
149.10  care assistant services in an in-home setting according to 
149.11  section 256B.0627.  Medical assistance does not cover personal 
149.12  care assistant services for residents of a hospital, nursing 
149.13  facility, intermediate care facility, health care facility 
149.14  licensed by the commissioner of health, or unless a resident who 
149.15  is otherwise eligible is on leave from the facility and the 
149.16  facility either pays for the personal care assistant services or 
149.17  forgoes the facility per diem for the leave days that personal 
149.18  care assistant services are used.  All personal care services 
149.19  must be provided according to section 256B.0627.  Personal 
149.20  care assistant services may not be reimbursed if the personal 
149.21  care assistant is the spouse or legal guardian of the recipient 
149.22  or the parent of a recipient under age 18, or the responsible 
149.23  party or the foster care provider of a recipient who cannot 
149.24  direct the recipient's own care unless, in the case of a foster 
149.25  care provider, a county or state case manager visits the 
149.26  recipient as needed, but not less than every six months, to 
149.27  monitor the health and safety of the recipient and to ensure the 
149.28  goals of the care plan are met.  Parents of adult recipients, 
149.29  adult children of the recipient or adult siblings of the 
149.30  recipient may be reimbursed for personal care assistant services 
149.31  if they are not the recipient's legal guardian and, if they are 
149.32  granted a waiver under section 256B.0627.  Until July 1, 2001, 
149.33  and Notwithstanding the provisions of section 256B.0627, 
149.34  subdivision 4, paragraph (b), clause (4), the noncorporate legal 
149.35  guardian or conservator of an adult, who is not the responsible 
149.36  party and not the personal care provider organization, may be 
150.1   granted a hardship waiver under section 256B.0627, to be 
150.2   reimbursed to provide personal care assistant services to the 
150.3   recipient, and shall not be considered to have a service 
150.4   provider interest for purposes of participation on the screening 
150.5   team under section 256B.092, subdivision 7. 
150.6      Sec. 17.  Minnesota Statutes 2000, section 256B.0625, 
150.7   subdivision 19c, is amended to read: 
150.8      Subd. 19c.  [PERSONAL CARE.] Medical assistance covers 
150.9   personal care assistant services provided by an individual who 
150.10  is qualified to provide the services according to subdivision 
150.11  19a and section 256B.0627, where the services are prescribed by 
150.12  a physician in accordance with a plan of treatment and are 
150.13  supervised by the recipient under the fiscal agent option 
150.14  according to section 256B.0627, subdivision 10, or a qualified 
150.15  professional.  "Qualified professional" means a mental health 
150.16  professional as defined in section 245.462, subdivision 18, or 
150.17  245.4871, subdivision 27; or a registered nurse as defined in 
150.18  sections 148.171 to 148.285.  As part of the assessment, the 
150.19  county public health nurse will consult with assist the 
150.20  recipient or responsible party and to identify the most 
150.21  appropriate person to provide supervision of the personal care 
150.22  assistant.  The qualified professional shall perform the duties 
150.23  described in Minnesota Rules, part 9505.0335, subpart 4.  
150.24     Sec. 18.  Minnesota Statutes 2000, section 256B.0625, 
150.25  subdivision 20, is amended to read: 
150.26     Subd. 20.  [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 
150.27  extent authorized by rule of the state agency, medical 
150.28  assistance covers case management services to persons with 
150.29  serious and persistent mental illness and children with severe 
150.30  emotional disturbance.  Services provided under this section 
150.31  must meet the relevant standards in sections 245.461 to 
150.32  245.4888, the Comprehensive Adult and Children's Mental Health 
150.33  Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 
150.34  9505.0322, excluding subpart 10. 
150.35     (b) Entities meeting program standards set out in rules 
150.36  governing family community support services as defined in 
151.1   section 245.4871, subdivision 17, are eligible for medical 
151.2   assistance reimbursement for case management services for 
151.3   children with severe emotional disturbance when these services 
151.4   meet the program standards in Minnesota Rules, parts 9520.0900 
151.5   to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 
151.6      (c) Medical assistance and MinnesotaCare payment for mental 
151.7   health case management shall be made on a monthly basis.  In 
151.8   order to receive payment for an eligible child, the provider 
151.9   must document at least a face-to-face contact with the child, 
151.10  the child's parents, or the child's legal representative.  To 
151.11  receive payment for an eligible adult, the provider must 
151.12  document: 
151.13     (1) at least a face-to-face contact with the adult or the 
151.14  adult's legal representative; or 
151.15     (2) at least a telephone contact with the adult or the 
151.16  adult's legal representative and document a face-to-face contact 
151.17  with the adult or the adult's legal representative within the 
151.18  preceding two months. 
151.19     (d) Payment for mental health case management provided by 
151.20  county or state staff shall be based on the monthly rate 
151.21  methodology under section 256B.094, subdivision 6, paragraph 
151.22  (b), with separate rates calculated for child welfare and mental 
151.23  health, and within mental health, separate rates for children 
151.24  and adults. 
151.25     (e) Payment for mental health case management provided by 
151.26  county-contracted vendors shall be based on a monthly rate 
151.27  negotiated by the host county.  The negotiated rate must not 
151.28  exceed the rate charged by the vendor for the same service to 
151.29  other payers.  If the service is provided by a team of 
151.30  contracted vendors, the county may negotiate a team rate with a 
151.31  vendor who is a member of the team.  The team shall determine 
151.32  how to distribute the rate among its members.  No reimbursement 
151.33  received by contracted vendors shall be returned to the county, 
151.34  except to reimburse the county for advance funding provided by 
151.35  the county to the vendor. 
151.36     (f) If the service is provided by a team which includes 
152.1   contracted vendors and county or state staff, the costs for 
152.2   county or state staff participation in the team shall be 
152.3   included in the rate for county-provided services.  In this 
152.4   case, the contracted vendor and the county may each receive 
152.5   separate payment for services provided by each entity in the 
152.6   same month.  In order to prevent duplication of services, the 
152.7   county must document, in the recipient's file, the need for team 
152.8   case management and a description of the roles of the team 
152.9   members. 
152.10     (g) The commissioner shall calculate the nonfederal share 
152.11  of actual medical assistance and general assistance medical care 
152.12  payments for each county, based on the higher of calendar year 
152.13  1995 or 1996, by service date, project that amount forward to 
152.14  1999, and transfer one-half of the result from medical 
152.15  assistance and general assistance medical care to each county's 
152.16  mental health grants under sections 245.4886 and 256E.12 for 
152.17  calendar year 1999.  The annualized minimum amount added to each 
152.18  county's mental health grant shall be $3,000 per year for 
152.19  children and $5,000 per year for adults.  The commissioner may 
152.20  reduce the statewide growth factor in order to fund these 
152.21  minimums.  The annualized total amount transferred shall become 
152.22  part of the base for future mental health grants for each county.
152.23     (h) Any net increase in revenue to the county as a result 
152.24  of the change in this section must be used to provide expanded 
152.25  mental health services as defined in sections 245.461 to 
152.26  245.4888, the Comprehensive Adult and Children's Mental Health 
152.27  Acts, excluding inpatient and residential treatment.  For 
152.28  adults, increased revenue may also be used for services and 
152.29  consumer supports which are part of adult mental health projects 
152.30  approved under Laws 1997, chapter 203, article 7, section 25.  
152.31  For children, increased revenue may also be used for respite 
152.32  care and nonresidential individualized rehabilitation services 
152.33  as defined in section 245.492, subdivisions 17 and 23.  
152.34  "Increased revenue" has the meaning given in Minnesota Rules, 
152.35  part 9520.0903, subpart 3.  
152.36     (i) Notwithstanding section 256B.19, subdivision 1, the 
153.1   nonfederal share of costs for mental health case management 
153.2   shall be provided by the recipient's county of responsibility, 
153.3   as defined in sections 256G.01 to 256G.12, from sources other 
153.4   than federal funds or funds used to match other federal funds.  
153.5      (j) The commissioner may suspend, reduce, or terminate the 
153.6   reimbursement to a provider that does not meet the reporting or 
153.7   other requirements of this section.  The county of 
153.8   responsibility, as defined in sections 256G.01 to 256G.12, is 
153.9   responsible for any federal disallowances.  The county may share 
153.10  this responsibility with its contracted vendors.  
153.11     (k) The commissioner shall set aside a portion of the 
153.12  federal funds earned under this section to repay the special 
153.13  revenue maximization account under section 256.01, subdivision 
153.14  2, clause (15).  The repayment is limited to: 
153.15     (1) the costs of developing and implementing this section; 
153.16  and 
153.17     (2) programming the information systems. 
153.18     (l) Notwithstanding section 256.025, subdivision 2, 
153.19  payments to counties for case management expenditures under this 
153.20  section shall only be made from federal earnings from services 
153.21  provided under this section.  Payments to contracted vendors 
153.22  shall include both the federal earnings and the county share. 
153.23     (m) Notwithstanding section 256B.041, county payments for 
153.24  the cost of mental health case management services provided by 
153.25  county or state staff shall not be made to the state treasurer.  
153.26  For the purposes of mental health case management services 
153.27  provided by county or state staff under this section, the 
153.28  centralized disbursement of payments to counties under section 
153.29  256B.041 consists only of federal earnings from services 
153.30  provided under this section. 
153.31     (n) Case management services under this subdivision do not 
153.32  include therapy, treatment, legal, or outreach services. 
153.33     (o) If the recipient is a resident of a nursing facility, 
153.34  intermediate care facility, or hospital, and the recipient's 
153.35  institutional care is paid by medical assistance, payment for 
153.36  case management services under this subdivision is limited to 
154.1   the last 30 180 days of the recipient's residency in that 
154.2   facility and may not exceed more than two six months in a 
154.3   calendar year. 
154.4      (p) Payment for case management services under this 
154.5   subdivision shall not duplicate payments made under other 
154.6   program authorities for the same purpose. 
154.7      (q) By July 1, 2000, the commissioner shall evaluate the 
154.8   effectiveness of the changes required by this section, including 
154.9   changes in number of persons receiving mental health case 
154.10  management, changes in hours of service per person, and changes 
154.11  in caseload size. 
154.12     (r) For each calendar year beginning with the calendar year 
154.13  2001, the annualized amount of state funds for each county 
154.14  determined under paragraph (g) shall be adjusted by the county's 
154.15  percentage change in the average number of clients per month who 
154.16  received case management under this section during the fiscal 
154.17  year that ended six months prior to the calendar year in 
154.18  question, in comparison to the prior fiscal year. 
154.19     (s) For counties receiving the minimum allocation of $3,000 
154.20  or $5,000 described in paragraph (g), the adjustment in 
154.21  paragraph (r) shall be determined so that the county receives 
154.22  the higher of the following amounts: 
154.23     (1) a continuation of the minimum allocation in paragraph 
154.24  (g); or 
154.25     (2) an amount based on that county's average number of 
154.26  clients per month who received case management under this 
154.27  section during the fiscal year that ended six months prior to 
154.28  the calendar year in question, in comparison to the prior fiscal 
154.29  year, times the average statewide grant per person per month for 
154.30  counties not receiving the minimum allocation. 
154.31     (t) The adjustments in paragraphs (r) and (s) shall be 
154.32  calculated separately for children and adults. 
154.33     Sec. 19.  Minnesota Statutes 2000, section 256B.0625, is 
154.34  amended by adding a subdivision to read: 
154.35     Subd. 43.  [TARGETED CASE MANAGEMENT.] For purposes of 
154.36  subdivisions 43a to 43h, the following terms have the meanings 
155.1   given them: 
155.2      (1) "Home care service recipients" means those individuals 
155.3   receiving the following services under section 256B.0627:  
155.4   skilled nursing visits, home health aide visits, private duty 
155.5   nursing, personal care assistants, or therapies provided through 
155.6   a home health agency. 
155.7      (2) "Home care targeted case management" means the 
155.8   provision of targeted case management services for the purpose 
155.9   of assisting home care service recipients to gain access to 
155.10  needed services and supports so that they may remain in the 
155.11  community. 
155.12     (3) "Institutions" means hospitals, consistent with Code of 
155.13  Federal Regulations, title 42, section 440.10; regional 
155.14  treatment center inpatient services, consistent with section 
155.15  245.474; nursing facilities; and intermediate care facilities 
155.16  for persons with mental retardation. 
155.17     (4) "Relocation targeted case management" means the 
155.18  provision of targeted case management services for the purpose 
155.19  of assisting recipients to gain access to needed services and 
155.20  supports if they choose to move from an institution to the 
155.21  community.  Relocation targeted case management may be provided 
155.22  during the last 180 consecutive days of an eligible recipient's 
155.23  institutional stay. 
155.24     (5) "Targeted case management" means case management 
155.25  services provided to help recipients gain access to needed 
155.26  medical, social, educational, and other services and supports. 
155.27     Sec. 20.  Minnesota Statutes 2000, section 256B.0625, is 
155.28  amended by adding a subdivision to read: 
155.29     Subd. 43a.  [ELIGIBILITY.] The following persons are 
155.30  eligible for relocation targeted case management or home care 
155.31  targeted case management: 
155.32     (1) medical assistance eligible persons residing in 
155.33  institutions who choose to move into the community are eligible 
155.34  for relocation targeted case management services; and 
155.35     (2) medical assistance eligible persons receiving home care 
155.36  services, who are not eligible for any other medical assistance 
156.1   reimbursable case management service, are eligible for home care 
156.2   targeted case management services beginning January 1, 2003.  
156.3      Sec. 21.  Minnesota Statutes 2000, section 256B.0625, is 
156.4   amended by adding a subdivision to read: 
156.5      Subd. 43b.  [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 
156.6   QUALIFICATIONS.] The following qualifications and certification 
156.7   standards must be met by providers of relocation targeted case 
156.8   management: 
156.9      (a) The commissioner must certify each provider of 
156.10  relocation targeted case management before enrollment.  The 
156.11  certification process shall examine the provider's ability to 
156.12  meet the requirements in this subdivision and other federal and 
156.13  state requirements of this service.  A certified relocation 
156.14  targeted case management provider may subcontract with another 
156.15  provider to deliver relocation targeted case management 
156.16  services.  Subcontracted providers must demonstrate the ability 
156.17  to provide the services outlined in subdivision 43d. 
156.18     (b) A relocation targeted case management provider is an 
156.19  enrolled medical assistance provider who is determined by the 
156.20  commissioner to have all of the following characteristics: 
156.21     (1) the legal authority to provide public welfare under 
156.22  sections 393.01, subdivision 7; and 393.07, or a federally 
156.23  recognized Indian tribe; 
156.24     (2) the demonstrated capacity and experience to provide the 
156.25  components of case management to coordinate and link community 
156.26  resources needed by the eligible population; 
156.27     (3) the administrative capacity and experience to serve the 
156.28  target population for whom it will provide services and ensure 
156.29  quality of services under state and federal requirements; 
156.30     (4) the legal authority to provide complete investigative 
156.31  and protective services under section 626.556, subdivision 10, 
156.32  and child welfare and foster care services under section 393.07, 
156.33  subdivisions 1 and 2, or a federally recognized Indian tribe; 
156.34     (5) a financial management system that provides accurate 
156.35  documentation of services and costs under state and federal 
156.36  requirements; and 
157.1      (6) the capacity to document and maintain individual case 
157.2   records under state and federal requirements. 
157.3   A provider of targeted case management under subdivision 20 may 
157.4   be deemed a certified provider of relocation targeted case 
157.5   management. 
157.6      Sec. 22. Minnesota Statutes 2000, section 256B.0625, is 
157.7   amended by adding a subdivision to read: 
157.8      Subd. 43c.  [HOME CARE TARGETED CASE MANAGEMENT PROVIDER 
157.9   QUALIFICATIONS.] The following qualifications and certification 
157.10  standards must be met by providers of home care targeted case 
157.11  management. 
157.12     (a) The commissioner must certify each provider of home 
157.13  care targeted case management before enrollment.  The 
157.14  certification process shall examine the provider's ability to 
157.15  meet the requirements in this subdivision and other state and 
157.16  federal requirements of this service. 
157.17     (b) A home care targeted case management provider is an 
157.18  enrolled medical assistance provider who has a minimum of a 
157.19  bachelor's degree or a license in a health or human services 
157.20  field, and is determined by the commissioner to have all of the 
157.21  following characteristics: 
157.22     (1) the demonstrated capacity and experience to provide the 
157.23  components of case management to coordinate and link community 
157.24  resources needed by the eligible population; 
157.25     (2) the administrative capacity and experience to serve the 
157.26  target population for whom it will provide services and ensure 
157.27  quality of services under state and federal requirements; 
157.28     (3) a financial management system that provides accurate 
157.29  documentation of services and costs under state and federal 
157.30  requirements; 
157.31     (4) the capacity to document and maintain individual case 
157.32  records under state and federal requirements; and 
157.33     (5) the capacity to coordinate with county administrative 
157.34  functions. 
157.35     Sec. 23.  Minnesota Statutes 2000, section 256B.0625, is 
157.36  amended by adding a subdivision to read: 
158.1      Subd. 43d.  [ELIGIBLE SERVICES.] Services eligible for 
158.2   medical assistance reimbursement as targeted case management 
158.3   include: 
158.4      (1) assessment of the recipient's need for targeted case 
158.5   management services; 
158.6      (2) development, completion, and regular review of a 
158.7   written individual service plan, which is based upon the 
158.8   assessment of the recipient's needs and choices, and which will 
158.9   ensure access to medical, social, educational, and other related 
158.10  services and supports; 
158.11     (3) routine contact or communication with the recipient, 
158.12  recipient's family, primary caregiver, legal representative, 
158.13  substitute care provider, service providers, or other relevant 
158.14  persons identified as necessary to the development or 
158.15  implementation of the goals of the individual service plan; 
158.16     (4) coordinating referrals for, and the provision of, case 
158.17  management services for the recipient with appropriate service 
158.18  providers, consistent with section 1902(a)(23) of the Social 
158.19  Security Act; 
158.20     (5) coordinating and monitoring the overall service 
158.21  delivery to ensure quality of services, appropriateness, and 
158.22  continued need; 
158.23     (6) completing and maintaining necessary documentation that 
158.24  supports and verifies the activities in this subdivision; 
158.25     (7) traveling to conduct a visit with the recipient or 
158.26  other relevant person necessary to develop or implement the 
158.27  goals of the individual service plan; and 
158.28     (8) coordinating with the institution discharge planner in 
158.29  the 180-day period before the recipient's discharge. 
158.30     Sec. 24.  Minnesota Statutes 2000, section 256B.0625, is 
158.31  amended by adding a subdivision to read: 
158.32     Subd. 43e.  [TIME LINES.] The following time lines must be 
158.33  met for assigning a case manager: 
158.34     (1) for relocation targeted case management, an eligible 
158.35  recipient must be assigned a case manager who visits the person 
158.36  within 20 working days of requesting a case manager from their 
159.1   county of financial responsibility as determined under chapter 
159.2   256G.  If a county agency does not provide case management 
159.3   services as required, the recipient may, after written notice to 
159.4   the county agency, obtain targeted relocation case management 
159.5   services from a home care targeted case management provider, as 
159.6   defined in subdivision 43c; and 
159.7      (2) for home care targeted case management, an eligible 
159.8   recipient must be assigned a case manager within 20 working days 
159.9   of requesting a case manager from a home care targeted case 
159.10  management provider, as defined in subdivision 43c. 
159.11     Sec. 25.  Minnesota Statutes 2000, section 256B.0625, is 
159.12  amended by adding a subdivision to read: 
159.13     Subd. 43f.  [EVALUATION.] The commissioner shall evaluate 
159.14  the delivery of targeted case management, including, but not 
159.15  limited to, access to case management services, consumer 
159.16  satisfaction with case management services, and quality of case 
159.17  management services. 
159.18     Sec. 26.  Minnesota Statutes 2000, section 256B.0625, is 
159.19  amended by adding a subdivision to read: 
159.20     Subd. 43g.  [CONTACT DOCUMENTATION.] The case manager must 
159.21  document each face-to-face and telephone contact with the 
159.22  recipient and others involved in the recipient's individual 
159.23  service plan. 
159.24     Sec. 27.  Minnesota Statutes 2000, section 256B.0625, is 
159.25  amended by adding a subdivision to read: 
159.26     Subd. 43h.  [PAYMENT RATES.] The commissioner shall set 
159.27  payment rates for targeted case management under this 
159.28  subdivision.  Case managers may bill according to the following 
159.29  criteria: 
159.30     (1) for relocation targeted case management, case managers 
159.31  may bill for direct case management activities, including 
159.32  face-to-face and telephone contacts, in the 180 days preceding 
159.33  an eligible recipient's discharge from an institution; 
159.34     (2) for home care targeted case management, case managers 
159.35  may bill for direct case management activities, including 
159.36  face-to-face and telephone contacts; and 
160.1      (3) billings for targeted case management services under 
160.2   this subdivision shall not duplicate payments made under other 
160.3   program authorities for the same purpose. 
160.4      Sec. 28.  Minnesota Statutes 2000, section 256B.0627, 
160.5   subdivision 1, is amended to read: 
160.6      Subdivision 1.  [DEFINITION.] (a) "Activities of daily 
160.7   living" includes eating, toileting, grooming, dressing, bathing, 
160.8   transferring, mobility, and positioning.  
160.9      (b) "Assessment" means a review and evaluation of a 
160.10  recipient's need for home care services conducted in person.  
160.11  Assessments for private duty nursing shall be conducted by a 
160.12  registered private duty nurse.  Assessments for home health 
160.13  agency services shall be conducted by a home health agency 
160.14  nurse.  Assessments for personal care assistant services shall 
160.15  be conducted by the county public health nurse or a certified 
160.16  public health nurse under contract with the county.  A 
160.17  face-to-face assessment must include:  documentation of health 
160.18  status, determination of need, evaluation of service 
160.19  effectiveness, identification of appropriate services, service 
160.20  plan development or modification, coordination of services, 
160.21  referrals and follow-up to appropriate payers and community 
160.22  resources, completion of required reports, recommendation of 
160.23  service authorization, and consumer education.  Once the need 
160.24  for personal care assistant services is determined under this 
160.25  section, the county public health nurse or certified public 
160.26  health nurse under contract with the county is responsible for 
160.27  communicating this recommendation to the commissioner and the 
160.28  recipient.  A face-to-face assessment for personal 
160.29  care assistant services is conducted on those recipients who 
160.30  have never had a county public health nurse assessment.  A 
160.31  face-to-face assessment must occur at least annually or when 
160.32  there is a significant change in the recipient's condition or 
160.33  when there is a change in the need for personal care assistant 
160.34  services.  A service update may substitute for the annual 
160.35  face-to-face assessment when there is not a significant change 
160.36  in recipient condition or a change in the need for personal care 
161.1   assistant service.  A service update or review for temporary 
161.2   increase includes a review of initial baseline data, evaluation 
161.3   of service effectiveness, redetermination of service need, 
161.4   modification of service plan and appropriate referrals, update 
161.5   of initial forms, obtaining service authorization, and on going 
161.6   consumer education.  Assessments for medical assistance home 
161.7   care services for mental retardation or related conditions and 
161.8   alternative care services for developmentally disabled home and 
161.9   community-based waivered recipients may be conducted by the 
161.10  county public health nurse to ensure coordination and avoid 
161.11  duplication.  Assessments must be completed on forms provided by 
161.12  the commissioner within 30 days of a request for home care 
161.13  services by a recipient or responsible party. 
161.14     (b) (c) "Care plan" means a written description of personal 
161.15  care assistant services developed by the qualified 
161.16  professional or the recipient's physician with the recipient or 
161.17  responsible party to be used by the personal care assistant with 
161.18  a copy provided to the recipient or responsible party. 
161.19     (d) "Complex and regular private duty nursing care" means, 
161.20  effective July 1, 2001:  
161.21     (1) complex care is private duty nursing provided to 
161.22  recipients who are ventilator dependent or for whom a physician 
161.23  has certified that were it not for private duty nursing the 
161.24  recipient would meet the criteria for inpatient hospital 
161.25  intensive care unit (ICU) level of care; and 
161.26     (2) regular care is private duty nursing provided to all 
161.27  other recipients. 
161.28     (e) "Health-related functions" means functions that can be 
161.29  delegated or assigned by a licensed health care professional 
161.30  under state law to be performed by a personal care attendant. 
161.31     (c) (f) "Home care services" means a health service, 
161.32  determined by the commissioner as medically necessary, that is 
161.33  ordered by a physician and documented in a service plan that is 
161.34  reviewed by the physician at least once every 62 60 days for the 
161.35  provision of home health services, or private duty nursing, or 
161.36  at least once every 365 days for personal care.  Home care 
162.1   services are provided to the recipient at the recipient's 
162.2   residence that is a place other than a hospital or long-term 
162.3   care facility or as specified in section 256B.0625.  
162.4      (g) "Instrumental activities of daily living" includes meal 
162.5   planning and preparation, managing finances, shopping for food, 
162.6   clothing, and other essential items, performing essential 
162.7   household chores, communication by telephone and other media, 
162.8   and getting around and participating in the community. 
162.9      (d) (h) "Medically necessary" has the meaning given in 
162.10  Minnesota Rules, parts 9505.0170 to 9505.0475.  
162.11     (e) (i) "Personal care assistant" means a person who:  
162.12     (1) is at least 18 years old, except for persons 16 to 18 
162.13  years of age who participated in a related school-based job 
162.14  training program or have completed a certified home health aide 
162.15  competency evaluation; 
162.16     (2) is able to effectively communicate with the recipient 
162.17  and personal care provider organization; 
162.18     (3) effective July 1, 1996, has completed one of the 
162.19  training requirements as specified in Minnesota Rules, part 
162.20  9505.0335, subpart 3, items A to D; 
162.21     (4) has the ability to, and provides covered personal care 
162.22  assistant services according to the recipient's care plan, 
162.23  responds appropriately to recipient needs, and reports changes 
162.24  in the recipient's condition to the supervising qualified 
162.25  professional or physician; 
162.26     (5) is not a consumer of personal care assistant services; 
162.27  and 
162.28     (6) is subject to criminal background checks and procedures 
162.29  specified in section 245A.04.  
162.30     (f) (j) "Personal care provider organization" means an 
162.31  organization enrolled to provide personal care assistant 
162.32  services under the medical assistance program that complies with 
162.33  the following:  (1) owners who have a five percent interest or 
162.34  more, and managerial officials are subject to a background study 
162.35  as provided in section 245A.04.  This applies to currently 
162.36  enrolled personal care provider organizations and those agencies 
163.1   seeking enrollment as a personal care provider organization.  An 
163.2   organization will be barred from enrollment if an owner or 
163.3   managerial official of the organization has been convicted of a 
163.4   crime specified in section 245A.04, or a comparable crime in 
163.5   another jurisdiction, unless the owner or managerial official 
163.6   meets the reconsideration criteria specified in section 245A.04; 
163.7   (2) the organization must maintain a surety bond and liability 
163.8   insurance throughout the duration of enrollment and provides 
163.9   proof thereof.  The insurer must notify the department of human 
163.10  services of the cancellation or lapse of policy; and (3) the 
163.11  organization must maintain documentation of services as 
163.12  specified in Minnesota Rules, part 9505.2175, subpart 7, as well 
163.13  as evidence of compliance with personal care assistant training 
163.14  requirements. 
163.15     (g) (k) "Responsible party" means an individual residing 
163.16  with a recipient of personal care assistant services who is 
163.17  capable of providing the supportive care necessary to assist the 
163.18  recipient to live in the community, is at least 18 years old, 
163.19  and is not a personal care assistant.  Responsible parties who 
163.20  are parents of minors or guardians of minors or incapacitated 
163.21  persons may delegate the responsibility to another adult during 
163.22  a temporary absence of at least 24 hours but not more than six 
163.23  months.  The person delegated as a responsible party must be 
163.24  able to meet the definition of responsible party, except that 
163.25  the delegated responsible party is required to reside with the 
163.26  recipient only while serving as the responsible party.  Foster 
163.27  care license holders may be designated the responsible party for 
163.28  residents of the foster care home if case management is provided 
163.29  as required in section 256B.0625, subdivision 19a.  For persons 
163.30  who, as of April 1, 1992, are sharing personal care assistant 
163.31  services in order to obtain the availability of 24-hour 
163.32  coverage, an employee of the personal care provider organization 
163.33  may be designated as the responsible party if case management is 
163.34  provided as required in section 256B.0625, subdivision 19a. 
163.35     (h) (l) "Service plan" means a written description of the 
163.36  services needed based on the assessment developed by the nurse 
164.1   who conducts the assessment together with the recipient or 
164.2   responsible party.  The service plan shall include a description 
164.3   of the covered home care services, frequency and duration of 
164.4   services, and expected outcomes and goals.  The recipient and 
164.5   the provider chosen by the recipient or responsible party must 
164.6   be given a copy of the completed service plan within 30 calendar 
164.7   days of the request for home care services by the recipient or 
164.8   responsible party. 
164.9      (i) (m) "Skilled nurse visits" are provided in a 
164.10  recipient's residence under a plan of care or service plan that 
164.11  specifies a level of care which the nurse is qualified to 
164.12  provide.  These services are: 
164.13     (1) nursing services according to the written plan of care 
164.14  or service plan and accepted standards of medical and nursing 
164.15  practice in accordance with chapter 148; 
164.16     (2) services which due to the recipient's medical condition 
164.17  may only be safely and effectively provided by a registered 
164.18  nurse or a licensed practical nurse; 
164.19     (3) assessments performed only by a registered nurse; and 
164.20     (4) teaching and training the recipient, the recipient's 
164.21  family, or other caregivers requiring the skills of a registered 
164.22  nurse or licensed practical nurse. 
164.23     (n) "Telehomecare" means the use of telecommunications 
164.24  technology by a home health care professional to deliver home 
164.25  health care services, within the professional's scope of 
164.26  practice, to a patient located at a site other than the site 
164.27  where the practitioner is located. 
164.28     Sec. 29.  Minnesota Statutes 2000, section 256B.0627, 
164.29  subdivision 2, is amended to read: 
164.30     Subd. 2.  [SERVICES COVERED.] Home care services covered 
164.31  under this section include:  
164.32     (1) nursing services under section 256B.0625, subdivision 
164.33  6a; 
164.34     (2) private duty nursing services under section 256B.0625, 
164.35  subdivision 7; 
164.36     (3) home health aide services under section 256B.0625, 
165.1   subdivision 6a; 
165.2      (4) personal care assistant services under section 
165.3   256B.0625, subdivision 19a; 
165.4      (5) supervision of personal care assistant services 
165.5   provided by a qualified professional under section 256B.0625, 
165.6   subdivision 19a; 
165.7      (6) consulting qualified professional of personal care 
165.8   assistant services under the fiscal agent intermediary option as 
165.9   specified in subdivision 10; 
165.10     (7) face-to-face assessments by county public health nurses 
165.11  for services under section 256B.0625, subdivision 19a; and 
165.12     (8) service updates and review of temporary increases for 
165.13  personal care assistant services by the county public health 
165.14  nurse for services under section 256B.0625, subdivision 19a. 
165.15     Sec. 30.  Minnesota Statutes 2000, section 256B.0627, 
165.16  subdivision 4, is amended to read: 
165.17     Subd. 4.  [PERSONAL CARE ASSISTANT SERVICES.] (a) The 
165.18  personal care assistant services that are eligible for payment 
165.19  are the following: services and supports furnished to an 
165.20  individual, as needed, to assist in accomplishing activities of 
165.21  daily living; instrumental activities of daily living; 
165.22  health-related functions through hands-on assistance, 
165.23  supervision, and cuing; and redirection and intervention for 
165.24  behavior including observation and monitoring.  
165.25     (b) Payment for services will be made within the limits 
165.26  approved using the prior authorized process established in 
165.27  subdivision 5. 
165.28     (c) The amount and type of services authorized shall be 
165.29  based on an assessment of the recipient's needs in these areas: 
165.30     (1) bowel and bladder care; 
165.31     (2) skin care to maintain the health of the skin; 
165.32     (3) repetitive maintenance range of motion, muscle 
165.33  strengthening exercises, and other tasks specific to maintaining 
165.34  a recipient's optimal level of function; 
165.35     (4) respiratory assistance; 
165.36     (5) transfers and ambulation; 
166.1      (6) bathing, grooming, and hairwashing necessary for 
166.2   personal hygiene; 
166.3      (7) turning and positioning; 
166.4      (8) assistance with furnishing medication that is 
166.5   self-administered; 
166.6      (9) application and maintenance of prosthetics and 
166.7   orthotics; 
166.8      (10) cleaning medical equipment; 
166.9      (11) dressing or undressing; 
166.10     (12) assistance with eating and meal preparation and 
166.11  necessary grocery shopping; 
166.12     (13) accompanying a recipient to obtain medical diagnosis 
166.13  or treatment; 
166.14     (14) assisting, monitoring, or prompting the recipient to 
166.15  complete the services in clauses (1) to (13); 
166.16     (15) redirection, monitoring, and observation that are 
166.17  medically necessary and an integral part of completing the 
166.18  personal care assistant services described in clauses (1) to 
166.19  (14); 
166.20     (16) redirection and intervention for behavior, including 
166.21  observation and monitoring; 
166.22     (17) interventions for seizure disorders, including 
166.23  monitoring and observation if the recipient has had a seizure 
166.24  that requires intervention within the past three months; 
166.25     (18) tracheostomy suctioning using a clean procedure if the 
166.26  procedure is properly delegated by a registered nurse.  Before 
166.27  this procedure can be delegated to a personal care assistant, a 
166.28  registered nurse must determine that the tracheostomy suctioning 
166.29  can be accomplished utilizing a clean rather than a sterile 
166.30  procedure and must ensure that the personal care assistant has 
166.31  been taught the proper procedure; and 
166.32     (19) incidental household services that are an integral 
166.33  part of a personal care service described in clauses (1) to (18).
166.34  For purposes of this subdivision, monitoring and observation 
166.35  means watching for outward visible signs that are likely to 
166.36  occur and for which there is a covered personal care service or 
167.1   an appropriate personal care intervention.  For purposes of this 
167.2   subdivision, a clean procedure refers to a procedure that 
167.3   reduces the numbers of microorganisms or prevents or reduces the 
167.4   transmission of microorganisms from one person or place to 
167.5   another.  A clean procedure may be used beginning 14 days after 
167.6   insertion. 
167.7      (b) (d) The personal care assistant services that are not 
167.8   eligible for payment are the following:  
167.9      (1) services not ordered by the physician; 
167.10     (2) assessments by personal care assistant provider 
167.11  organizations or by independently enrolled registered nurses; 
167.12     (3) services that are not in the service plan; 
167.13     (4) services provided by the recipient's spouse, legal 
167.14  guardian for an adult or child recipient, or parent of a 
167.15  recipient under age 18; 
167.16     (5) services provided by a foster care provider of a 
167.17  recipient who cannot direct the recipient's own care, unless 
167.18  monitored by a county or state case manager under section 
167.19  256B.0625, subdivision 19a; 
167.20     (6) services provided by the residential or program license 
167.21  holder in a residence for more than four persons; 
167.22     (7) services that are the responsibility of a residential 
167.23  or program license holder under the terms of a service agreement 
167.24  and administrative rules; 
167.25     (8) sterile procedures; 
167.26     (9) injections of fluids into veins, muscles, or skin; 
167.27     (10) services provided by parents of adult recipients, 
167.28  adult children, or siblings of the recipient, unless these 
167.29  relatives meet one of the following hardship criteria and the 
167.30  commissioner waives this requirement: 
167.31     (i) the relative resigns from a part-time or full-time job 
167.32  to provide personal care for the recipient; 
167.33     (ii) the relative goes from a full-time to a part-time job 
167.34  with less compensation to provide personal care for the 
167.35  recipient; 
167.36     (iii) the relative takes a leave of absence without pay to 
168.1   provide personal care for the recipient; 
168.2      (iv) the relative incurs substantial expenses by providing 
168.3   personal care for the recipient; or 
168.4      (v) because of labor conditions, special language needs, or 
168.5   intermittent hours of care needed, the relative is needed in 
168.6   order to provide an adequate number of qualified personal care 
168.7   assistants to meet the medical needs of the recipient; 
168.8      (11) homemaker services that are not an integral part of a 
168.9   personal care assistant services; 
168.10     (12) home maintenance, or chore services; 
168.11     (13) services not specified under paragraph (a); and 
168.12     (14) services not authorized by the commissioner or the 
168.13  commissioner's designee. 
168.14     (e) The recipient or responsible party may choose to 
168.15  supervise the personal care assistant or to have a qualified 
168.16  professional, as defined in section 256B.0625, subdivision 19c, 
168.17  provide the supervision.  As required under section 256B.0625, 
168.18  subdivision 19c, the county public health nurse, as a part of 
168.19  the assessment, will assist the recipient or responsible party 
168.20  to identify the most appropriate person to provide supervision 
168.21  of the personal care assistant.  Health-related delegated tasks 
168.22  performed by the personal care assistant will be under the 
168.23  supervision of a qualified professional or the direction of the 
168.24  recipient's physician.  If the recipient has a qualified 
168.25  professional, Minnesota Rules, part 9505.0335, subpart 4, 
168.26  applies. 
168.27     Sec. 31.  Minnesota Statutes 2000, section 256B.0627, 
168.28  subdivision 5, is amended to read: 
168.29     Subd. 5.  [LIMITATION ON PAYMENTS.] Medical assistance 
168.30  payments for home care services shall be limited according to 
168.31  this subdivision.  
168.32     (a)  [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 
168.33  recipient may receive the following home care services during a 
168.34  calendar year: 
168.35     (1) up to two face-to-face assessments to determine a 
168.36  recipient's need for personal care assistant services; 
169.1      (2) one service update done to determine a recipient's need 
169.2   for personal care assistant services; and 
169.3      (3) up to five nine skilled nurse visits.  
169.4      (b)  [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 
169.5   services above the limits in paragraph (a) must receive the 
169.6   commissioner's prior authorization, except when: 
169.7      (1) the home care services were required to treat an 
169.8   emergency medical condition that if not immediately treated 
169.9   could cause a recipient serious physical or mental disability, 
169.10  continuation of severe pain, or death.  The provider must 
169.11  request retroactive authorization no later than five working 
169.12  days after giving the initial service.  The provider must be 
169.13  able to substantiate the emergency by documentation such as 
169.14  reports, notes, and admission or discharge histories; 
169.15     (2) the home care services were provided on or after the 
169.16  date on which the recipient's eligibility began, but before the 
169.17  date on which the recipient was notified that the case was 
169.18  opened.  Authorization will be considered if the request is 
169.19  submitted by the provider within 20 working days of the date the 
169.20  recipient was notified that the case was opened; 
169.21     (3) a third-party payor for home care services has denied 
169.22  or adjusted a payment.  Authorization requests must be submitted 
169.23  by the provider within 20 working days of the notice of denial 
169.24  or adjustment.  A copy of the notice must be included with the 
169.25  request; 
169.26     (4) the commissioner has determined that a county or state 
169.27  human services agency has made an error; or 
169.28     (5) the professional nurse determines an immediate need for 
169.29  up to 40 skilled nursing or home health aide visits per calendar 
169.30  year and submits a request for authorization within 20 working 
169.31  days of the initial service date, and medical assistance is 
169.32  determined to be the appropriate payer. 
169.33     (c)  [RETROACTIVE AUTHORIZATION.] A request for retroactive 
169.34  authorization will be evaluated according to the same criteria 
169.35  applied to prior authorization requests.  
169.36     (d)  [ASSESSMENT AND SERVICE PLAN.] Assessments under 
170.1   section 256B.0627, subdivision 1, paragraph (a), shall be 
170.2   conducted initially, and at least annually thereafter, in person 
170.3   with the recipient and result in a completed service plan using 
170.4   forms specified by the commissioner.  Within 30 days of 
170.5   recipient or responsible party request for home care services, 
170.6   the assessment, the service plan, and other information 
170.7   necessary to determine medical necessity such as diagnostic or 
170.8   testing information, social or medical histories, and hospital 
170.9   or facility discharge summaries shall be submitted to the 
170.10  commissioner.  For personal care assistant services: 
170.11     (1) The amount and type of service authorized based upon 
170.12  the assessment and service plan will follow the recipient if the 
170.13  recipient chooses to change providers.  
170.14     (2) If the recipient's medical need changes, the 
170.15  recipient's provider may assess the need for a change in service 
170.16  authorization and request the change from the county public 
170.17  health nurse.  Within 30 days of the request, the public health 
170.18  nurse will determine whether to request the change in services 
170.19  based upon the provider assessment, or conduct a home visit to 
170.20  assess the need and determine whether the change is appropriate. 
170.21     (3) To continue to receive personal care assistant services 
170.22  after the first year, the recipient or the responsible party, in 
170.23  conjunction with the public health nurse, may complete a service 
170.24  update on forms developed by the commissioner according to 
170.25  criteria and procedures in subdivision 1.  
170.26     (e)  [PRIOR AUTHORIZATION.] The commissioner, or the 
170.27  commissioner's designee, shall review the assessment, service 
170.28  update, request for temporary services, service plan, and any 
170.29  additional information that is submitted.  The commissioner 
170.30  shall, within 30 days after receiving a complete request, 
170.31  assessment, and service plan, authorize home care services as 
170.32  follows:  
170.33     (1)  [HOME HEALTH SERVICES.] All home health services 
170.34  provided by a licensed nurse or a home health aide must be prior 
170.35  authorized by the commissioner or the commissioner's designee.  
170.36  Prior authorization must be based on medical necessity and 
171.1   cost-effectiveness when compared with other care options.  When 
171.2   home health services are used in combination with personal care 
171.3   and private duty nursing, the cost of all home care services 
171.4   shall be considered for cost-effectiveness.  The commissioner 
171.5   shall limit nurse and home health aide visits to no more than 
171.6   one visit each per day.  The commissioner, or the commissioner's 
171.7   designee, may authorize up to two skilled nurse visits per day. 
171.8      (2)  [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal 
171.9   care assistant services and supervision by a qualified 
171.10  professional, if requested by the recipient, must be prior 
171.11  authorized by the commissioner or the commissioner's designee 
171.12  except for the assessments established in paragraph (a).  The 
171.13  amount of personal care assistant services authorized must be 
171.14  based on the recipient's home care rating.  A child may not be 
171.15  found to be dependent in an activity of daily living if because 
171.16  of the child's age an adult would either perform the activity 
171.17  for the child or assist the child with the activity and the 
171.18  amount of assistance needed is similar to the assistance 
171.19  appropriate for a typical child of the same age.  Based on 
171.20  medical necessity, the commissioner may authorize: 
171.21     (A) up to two times the average number of direct care hours 
171.22  provided in nursing facilities for the recipient's comparable 
171.23  case mix level; or 
171.24     (B) up to three times the average number of direct care 
171.25  hours provided in nursing facilities for recipients who have 
171.26  complex medical needs or are dependent in at least seven 
171.27  activities of daily living and need physical assistance with 
171.28  eating or have a neurological diagnosis; or 
171.29     (C) up to 60 percent of the average reimbursement rate, as 
171.30  of July 1, 1991, for care provided in a regional treatment 
171.31  center for recipients who have Level I behavior, plus any 
171.32  inflation adjustment as provided by the legislature for personal 
171.33  care service; or 
171.34     (D) up to the amount the commissioner would pay, as of July 
171.35  1, 1991, plus any inflation adjustment provided for home care 
171.36  services, for care provided in a regional treatment center for 
172.1   recipients referred to the commissioner by a regional treatment 
172.2   center preadmission evaluation team.  For purposes of this 
172.3   clause, home care services means all services provided in the 
172.4   home or community that would be included in the payment to a 
172.5   regional treatment center; or 
172.6      (E) up to the amount medical assistance would reimburse for 
172.7   facility care for recipients referred to the commissioner by a 
172.8   preadmission screening team established under section 256B.0911 
172.9   or 256B.092; and 
172.10     (F) a reasonable amount of time for the provision of 
172.11  supervision by a qualified professional of personal 
172.12  care assistant services, if a qualified professional is 
172.13  requested by the recipient or responsible party.  
172.14     (ii) The number of direct care hours shall be determined 
172.15  according to the annual cost report submitted to the department 
172.16  by nursing facilities.  The average number of direct care hours, 
172.17  as established by May 1, 1992, shall be calculated and 
172.18  incorporated into the home care limits on July 1, 1992.  These 
172.19  limits shall be calculated to the nearest quarter hour. 
172.20     (iii) The home care rating shall be determined by the 
172.21  commissioner or the commissioner's designee based on information 
172.22  submitted to the commissioner by the county public health nurse 
172.23  on forms specified by the commissioner.  The home care rating 
172.24  shall be a combination of current assessment tools developed 
172.25  under sections 256B.0911 and 256B.501 with an addition for 
172.26  seizure activity that will assess the frequency and severity of 
172.27  seizure activity and with adjustments, additions, and 
172.28  clarifications that are necessary to reflect the needs and 
172.29  conditions of recipients who need home care including children 
172.30  and adults under 65 years of age.  The commissioner shall 
172.31  establish these forms and protocols under this section and shall 
172.32  use an advisory group, including representatives of recipients, 
172.33  providers, and counties, for consultation in establishing and 
172.34  revising the forms and protocols. 
172.35     (iv) A recipient shall qualify as having complex medical 
172.36  needs if the care required is difficult to perform and because 
173.1   of recipient's medical condition requires more time than 
173.2   community-based standards allow or requires more skill than 
173.3   would ordinarily be required and the recipient needs or has one 
173.4   or more of the following: 
173.5      (A) daily tube feedings; 
173.6      (B) daily parenteral therapy; 
173.7      (C) wound or decubiti care; 
173.8      (D) postural drainage, percussion, nebulizer treatments, 
173.9   suctioning, tracheotomy care, oxygen, mechanical ventilation; 
173.10     (E) catheterization; 
173.11     (F) ostomy care; 
173.12     (G) quadriplegia; or 
173.13     (H) other comparable medical conditions or treatments the 
173.14  commissioner determines would otherwise require institutional 
173.15  care.  
173.16     (v) A recipient shall qualify as having Level I behavior if 
173.17  there is reasonable supporting evidence that the recipient 
173.18  exhibits, or that without supervision, observation, or 
173.19  redirection would exhibit, one or more of the following 
173.20  behaviors that cause, or have the potential to cause: 
173.21     (A) injury to the recipient's own body; 
173.22     (B) physical injury to other people; or 
173.23     (C) destruction of property. 
173.24     (vi) Time authorized for personal care relating to Level I 
173.25  behavior in subclause (v), items (A) to (C), shall be based on 
173.26  the predictability, frequency, and amount of intervention 
173.27  required. 
173.28     (vii) A recipient shall qualify as having Level II behavior 
173.29  if the recipient exhibits on a daily basis one or more of the 
173.30  following behaviors that interfere with the completion of 
173.31  personal care assistant services under subdivision 4, paragraph 
173.32  (a): 
173.33     (A) unusual or repetitive habits; 
173.34     (B) withdrawn behavior; or 
173.35     (C) offensive behavior. 
173.36     (viii) A recipient with a home care rating of Level II 
174.1   behavior in subclause (vii), items (A) to (C), shall be rated as 
174.2   comparable to a recipient with complex medical needs under 
174.3   subclause (iv).  If a recipient has both complex medical needs 
174.4   and Level II behavior, the home care rating shall be the next 
174.5   complex category up to the maximum rating under subclause (i), 
174.6   item (B). 
174.7      (3)  [PRIVATE DUTY NURSING SERVICES.] All private duty 
174.8   nursing services shall be prior authorized by the commissioner 
174.9   or the commissioner's designee.  Prior authorization for private 
174.10  duty nursing services shall be based on medical necessity and 
174.11  cost-effectiveness when compared with alternative care options.  
174.12  The commissioner may authorize medically necessary private duty 
174.13  nursing services in quarter-hour units when: 
174.14     (i) the recipient requires more individual and continuous 
174.15  care than can be provided during a nurse visit; or 
174.16     (ii) the cares are outside of the scope of services that 
174.17  can be provided by a home health aide or personal care assistant.
174.18     The commissioner may authorize: 
174.19     (A) up to two times the average amount of direct care hours 
174.20  provided in nursing facilities statewide for case mix 
174.21  classification "K" as established by the annual cost report 
174.22  submitted to the department by nursing facilities in May 1992; 
174.23     (B) private duty nursing in combination with other home 
174.24  care services up to the total cost allowed under clause (2); 
174.25     (C) up to 16 hours per day if the recipient requires more 
174.26  nursing than the maximum number of direct care hours as 
174.27  established in item (A) and the recipient meets the hospital 
174.28  admission criteria established under Minnesota Rules, parts 
174.29  9505.0500 9505.0501 to 9505.0540.  
174.30     The commissioner may authorize up to 16 hours per day of 
174.31  medically necessary private duty nursing services or up to 24 
174.32  hours per day of medically necessary private duty nursing 
174.33  services until such time as the commissioner is able to make a 
174.34  determination of eligibility for recipients who are 
174.35  cooperatively applying for home care services under the 
174.36  community alternative care program developed under section 
175.1   256B.49, or until it is determined by the appropriate regulatory 
175.2   agency that a health benefit plan is or is not required to pay 
175.3   for appropriate medically necessary health care services.  
175.4   Recipients or their representatives must cooperatively assist 
175.5   the commissioner in obtaining this determination.  Recipients 
175.6   who are eligible for the community alternative care program may 
175.7   not receive more hours of nursing under this section than would 
175.8   otherwise be authorized under section 256B.49.  
175.9      Beginning July 1, 2001, private duty nursing services shall 
175.10  be authorized for complex and regular care according to 
175.11  subdivision 1. 
175.12     (4)  [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 
175.13  ventilator-dependent, the monthly medical assistance 
175.14  authorization for home care services shall not exceed what the 
175.15  commissioner would pay for care at the highest cost hospital 
175.16  designated as a long-term hospital under the Medicare program.  
175.17  For purposes of this clause, home care services means all 
175.18  services provided in the home that would be included in the 
175.19  payment for care at the long-term hospital.  
175.20  "Ventilator-dependent" means an individual who receives 
175.21  mechanical ventilation for life support at least six hours per 
175.22  day and is expected to be or has been dependent for at least 30 
175.23  consecutive days.  
175.24     (f)  [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 
175.25  or the commissioner's designee shall determine the time period 
175.26  for which a prior authorization shall be effective.  If the 
175.27  recipient continues to require home care services beyond the 
175.28  duration of the prior authorization, the home care provider must 
175.29  request a new prior authorization.  Under no circumstances, 
175.30  other than the exceptions in paragraph (b), shall a prior 
175.31  authorization be valid prior to the date the commissioner 
175.32  receives the request or for more than 12 months.  A recipient 
175.33  who appeals a reduction in previously authorized home care 
175.34  services may continue previously authorized services, other than 
175.35  temporary services under paragraph (h), pending an appeal under 
175.36  section 256.045.  The commissioner must provide a detailed 
176.1   explanation of why the authorized services are reduced in amount 
176.2   from those requested by the home care provider.  
176.3      (g)  [APPROVAL OF HOME CARE SERVICES.] The commissioner or 
176.4   the commissioner's designee shall determine the medical 
176.5   necessity of home care services, the level of caregiver 
176.6   according to subdivision 2, and the institutional comparison 
176.7   according to this subdivision, the cost-effectiveness of 
176.8   services, and the amount, scope, and duration of home care 
176.9   services reimbursable by medical assistance, based on the 
176.10  assessment, primary payer coverage determination information as 
176.11  required, the service plan, the recipient's age, the cost of 
176.12  services, the recipient's medical condition, and diagnosis or 
176.13  disability.  The commissioner may publish additional criteria 
176.14  for determining medical necessity according to section 256B.04. 
176.15     (h)  [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 
176.16  The agency nurse, the independently enrolled private duty nurse, 
176.17  or county public health nurse may request a temporary 
176.18  authorization for home care services by telephone.  The 
176.19  commissioner may approve a temporary level of home care services 
176.20  based on the assessment, and service or care plan information, 
176.21  and primary payer coverage determination information as required.
176.22  Authorization for a temporary level of home care services 
176.23  including nurse supervision is limited to the time specified by 
176.24  the commissioner, but shall not exceed 45 days, unless extended 
176.25  because the county public health nurse has not completed the 
176.26  required assessment and service plan, or the commissioner's 
176.27  determination has not been made.  The level of services 
176.28  authorized under this provision shall have no bearing on a 
176.29  future prior authorization. 
176.30     (i)  [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 
176.31  Home care services provided in an adult or child foster care 
176.32  setting must receive prior authorization by the department 
176.33  according to the limits established in paragraph (a). 
176.34     The commissioner may not authorize: 
176.35     (1) home care services that are the responsibility of the 
176.36  foster care provider under the terms of the foster care 
177.1   placement agreement and administrative rules; 
177.2      (2) personal care assistant services when the foster care 
177.3   license holder is also the personal care provider or personal 
177.4   care assistant unless the recipient can direct the recipient's 
177.5   own care, or case management is provided as required in section 
177.6   256B.0625, subdivision 19a; 
177.7      (3) personal care assistant services when the responsible 
177.8   party is an employee of, or under contract with, or has any 
177.9   direct or indirect financial relationship with the personal care 
177.10  provider or personal care assistant, unless case management is 
177.11  provided as required in section 256B.0625, subdivision 19a; or 
177.12     (4) personal care assistant and private duty nursing 
177.13  services when the number of foster care residents is greater 
177.14  than four unless the county responsible for the recipient's 
177.15  foster placement made the placement prior to April 1, 1992, 
177.16  requests that personal care assistant and private duty nursing 
177.17  services be provided, and case management is provided as 
177.18  required in section 256B.0625, subdivision 19a. 
177.19     Sec. 32.  Minnesota Statutes 2000, section 256B.0627, 
177.20  subdivision 7, is amended to read: 
177.21     Subd. 7.  [NONCOVERED HOME CARE SERVICES.] The following 
177.22  home care services are not eligible for payment under medical 
177.23  assistance:  
177.24     (1) skilled nurse visits for the sole purpose of 
177.25  supervision of the home health aide; 
177.26     (2) a skilled nursing visit: 
177.27     (i) only for the purpose of monitoring medication 
177.28  compliance with an established medication program for a 
177.29  recipient; or 
177.30     (ii) to administer or assist with medication 
177.31  administration, including injections, prefilling syringes for 
177.32  injections, or oral medication set-up of an adult recipient, 
177.33  when as determined and documented by the registered nurse, the 
177.34  need can be met by an available pharmacy or the recipient is 
177.35  physically and mentally able to self-administer or prefill a 
177.36  medication; 
178.1      (3) home care services to a recipient who is eligible for 
178.2   covered services including hospice, if elected by the recipient, 
178.3   under the Medicare program or any other insurance held by the 
178.4   recipient; 
178.5      (4) services to other members of the recipient's household; 
178.6      (5) a visit made by a skilled nurse solely to train other 
178.7   home health agency workers; 
178.8      (6) any home care service included in the daily rate of the 
178.9   community-based residential facility where the recipient is 
178.10  residing; 
178.11     (7) nursing and rehabilitation therapy services that are 
178.12  reasonably accessible to a recipient outside the recipient's 
178.13  place of residence, excluding the assessment, counseling and 
178.14  education, and personal assistant care; 
178.15     (8) any home health agency service, excluding personal care 
178.16  assistant services and private duty nursing services, which are 
178.17  performed in a place other than the recipient's residence; and 
178.18     (9) Medicare evaluation or administrative nursing visits on 
178.19  dual-eligible recipients that do not qualify for Medicare visit 
178.20  billing. 
178.21     Sec. 33.  Minnesota Statutes 2000, section 256B.0627, 
178.22  subdivision 8, is amended to read: 
178.23     Subd. 8.  [SHARED PERSONAL CARE ASSISTANT SERVICES.] (a) 
178.24  Medical assistance payments for shared personal care assistance 
178.25  services shall be limited according to this subdivision. 
178.26     (b) Recipients of personal care assistant services may 
178.27  share staff and the commissioner shall provide a rate system for 
178.28  shared personal care assistant services.  For two persons 
178.29  sharing services, the rate paid to a provider shall not exceed 
178.30  1-1/2 times the rate paid for serving a single individual, and 
178.31  for three persons sharing services, the rate paid to a provider 
178.32  shall not exceed twice the rate paid for serving a single 
178.33  individual.  These rates apply only to situations in which all 
178.34  recipients were present and received shared services on the date 
178.35  for which the service is billed.  No more than three persons may 
178.36  receive shared services from a personal care assistant in a 
179.1   single setting. 
179.2      (c) Shared service is the provision of personal 
179.3   care assistant services by a personal care assistant to two or 
179.4   three recipients at the same time and in the same setting.  For 
179.5   the purposes of this subdivision, "setting" means: 
179.6      (1) the home or foster care home of one of the individual 
179.7   recipients; or 
179.8      (2) a child care program in which all recipients served by 
179.9   one personal care assistant are participating, which is licensed 
179.10  under chapter 245A or operated by a local school district or 
179.11  private school; or 
179.12     (3) outside the home or foster care home of one of the 
179.13  recipients when normal life activities take the recipients 
179.14  outside the home.  
179.15     The provisions of this subdivision do not apply when a 
179.16  personal care assistant is caring for multiple recipients in 
179.17  more than one setting. 
179.18     (d) The recipient or the recipient's responsible party, in 
179.19  conjunction with the county public health nurse, shall determine:
179.20     (1) whether shared personal care assistant services is an 
179.21  appropriate option based on the individual needs and preferences 
179.22  of the recipient; and 
179.23     (2) the amount of shared services allocated as part of the 
179.24  overall authorization of personal care assistant services. 
179.25     The recipient or the responsible party, in conjunction with 
179.26  the supervising qualified professional, if a qualified 
179.27  professional is requested by any one of the recipients or 
179.28  responsible parties, shall arrange the setting and grouping of 
179.29  shared services based on the individual needs and preferences of 
179.30  the recipients.  Decisions on the selection of recipients to 
179.31  share services must be based on the ages of the recipients, 
179.32  compatibility, and coordination of their care needs. 
179.33     (e) The following items must be considered by the recipient 
179.34  or the responsible party and the supervising qualified 
179.35  professional, if a qualified professional has been requested by 
179.36  any one of the recipients or responsible parties, and documented 
180.1   in the recipient's health service record: 
180.2      (1) the additional qualifications needed by the personal 
180.3   care assistant to provide care to several recipients in the same 
180.4   setting; 
180.5      (2) the additional training and supervision needed by the 
180.6   personal care assistant to ensure that the needs of the 
180.7   recipient are met appropriately and safely.  The provider must 
180.8   provide on-site supervision by a qualified professional within 
180.9   the first 14 days of shared services, and monthly thereafter, if 
180.10  supervision by a qualified provider has been requested by any 
180.11  one of the recipients or responsible parties; 
180.12     (3) the setting in which the shared services will be 
180.13  provided; 
180.14     (4) the ongoing monitoring and evaluation of the 
180.15  effectiveness and appropriateness of the service and process 
180.16  used to make changes in service or setting; and 
180.17     (5) a contingency plan which accounts for absence of the 
180.18  recipient in a shared services setting due to illness or other 
180.19  circumstances and staffing contingencies. 
180.20     (f) The provider must offer the recipient or the 
180.21  responsible party the option of shared or one-on-one personal 
180.22  care assistant services.  The recipient or the responsible party 
180.23  can withdraw from participating in a shared services arrangement 
180.24  at any time. 
180.25     (g) In addition to documentation requirements under 
180.26  Minnesota Rules, part 9505.2175, a personal care provider must 
180.27  meet documentation requirements for shared personal care 
180.28  assistant services and must document the following in the health 
180.29  service record for each individual recipient sharing services: 
180.30     (1) permission by the recipient or the recipient's 
180.31  responsible party, if any, for the maximum number of shared 
180.32  services hours per week chosen by the recipient; 
180.33     (2) permission by the recipient or the recipient's 
180.34  responsible party, if any, for personal care assistant services 
180.35  provided outside the recipient's residence; 
180.36     (3) permission by the recipient or the recipient's 
181.1   responsible party, if any, for others to receive shared services 
181.2   in the recipient's residence; 
181.3      (4) revocation by the recipient or the recipient's 
181.4   responsible party, if any, of the shared service authorization, 
181.5   or the shared service to be provided to others in the 
181.6   recipient's residence, or the shared service to be provided 
181.7   outside the recipient's residence; 
181.8      (5) supervision of the shared personal care assistant 
181.9   services by the qualified professional, if a qualified 
181.10  professional is requested by one of the recipients or 
181.11  responsible parties, including the date, time of day, number of 
181.12  hours spent supervising the provision of shared services, 
181.13  whether the supervision was face-to-face or another method of 
181.14  supervision, changes in the recipient's condition, shared 
181.15  services scheduling issues and recommendations; 
181.16     (6) documentation by the qualified professional, if a 
181.17  qualified professional is requested by one of the recipients or 
181.18  responsible parties, of telephone calls or other discussions 
181.19  with the personal care assistant regarding services being 
181.20  provided to the recipient who has requested the supervision; and 
181.21     (7) daily documentation of the shared services provided by 
181.22  each identified personal care assistant including: 
181.23     (i) the names of each recipient receiving shared services 
181.24  together; 
181.25     (ii) the setting for the shared services, including the 
181.26  starting and ending times that the recipient received shared 
181.27  services; and 
181.28     (iii) notes by the personal care assistant regarding 
181.29  changes in the recipient's condition, problems that may arise 
181.30  from the sharing of services, scheduling issues, care issues, 
181.31  and other notes as required by the qualified professional, if a 
181.32  qualified professional is requested by one of the recipients or 
181.33  responsible parties. 
181.34     (h) Unless otherwise provided in this subdivision, all 
181.35  other statutory and regulatory provisions relating to personal 
181.36  care assistant services apply to shared services. 
182.1      (i) In the event that supervision by a qualified 
182.2   professional has been requested by one or more recipients, but 
182.3   not by all of the recipients, the supervision duties of the 
182.4   qualified professional shall be limited to only those recipients 
182.5   who have requested the supervision. 
182.6      Nothing in this subdivision shall be construed to reduce 
182.7   the total number of hours authorized for an individual recipient.
182.8      Sec. 34.  Minnesota Statutes 2000, section 256B.0627, 
182.9   subdivision 10, is amended to read: 
182.10     Subd. 10.  [FISCAL AGENT INTERMEDIARY OPTION AVAILABLE FOR 
182.11  PERSONAL CARE ASSISTANT SERVICES.] (a) "Fiscal agent option" is 
182.12  an option that allows the recipient to: 
182.13     (1) use a fiscal agent instead of a personal care provider 
182.14  organization; 
182.15     (2) supervise the personal care assistant; and 
182.16     (3) use a consulting professional. 
182.17     The commissioner may allow a recipient of personal care 
182.18  assistant services to use a fiscal agent intermediary to assist 
182.19  the recipient in paying and accounting for medically necessary 
182.20  covered personal care assistant services authorized in 
182.21  subdivision 4 and within the payment parameters of subdivision 
182.22  5.  Unless otherwise provided in this subdivision, all other 
182.23  statutory and regulatory provisions relating to personal care 
182.24  assistant services apply to a recipient using the fiscal agent 
182.25  intermediary option. 
182.26     (b) The recipient or responsible party shall: 
182.27     (1) hire, and terminate the personal care assistant and 
182.28  consulting professional, with the fiscal agent recruit, hire, 
182.29  and terminate a qualified professional, if a qualified 
182.30  professional is requested by the recipient or responsible party; 
182.31     (2) recruit the personal care assistant and consulting 
182.32  professional and orient and train the personal care assistant in 
182.33  areas that do not require professional delegation as determined 
182.34  by the county public health nurse verify and document the 
182.35  credentials of the qualified professional, if a qualified 
182.36  professional is requested by the recipient or responsible party; 
183.1      (3) supervise and evaluate the personal care assistant in 
183.2   areas that do not require professional delegation as determined 
183.3   in the assessment; 
183.4      (4) cooperate with a consulting develop a service plan 
183.5   based on physician orders and public health nurse assessment 
183.6   with the assistance of a qualified professional and implement 
183.7   recommendations pertaining to the health and safety of the 
183.8   recipient, if a qualified professional is requested by the 
183.9   recipient or responsible party, that addresses the health and 
183.10  safety of the recipient; 
183.11     (5) hire a qualified professional to train and supervise 
183.12  the performance of delegated tasks done by (4) recruit, hire, 
183.13  and terminate the personal care assistant; 
183.14     (6) monitor services and verify in writing the hours worked 
183.15  by the personal care assistant and the consulting (5) orient and 
183.16  train the personal care assistant with assistance as needed from 
183.17  the qualified professional; 
183.18     (7) develop and revise a care plan with assistance from a 
183.19  consulting (6) supervise and evaluate the personal care 
183.20  assistant with assistance as needed from the recipient's 
183.21  physician or the qualified professional; 
183.22     (8) verify and document the credentials of the consulting 
183.23  (7) monitor and verify in writing and report to the fiscal 
183.24  intermediary the number of hours worked by the personal care 
183.25  assistant and the qualified professional; and 
183.26     (9) (8) enter into a written agreement, as specified in 
183.27  paragraph (f). 
183.28     (c) The duties of the fiscal agent intermediary shall be to:
183.29     (1) bill the medical assistance program for personal care 
183.30  assistant and consulting qualified professional services; 
183.31     (2) request and secure background checks on personal care 
183.32  assistants and consulting qualified professionals according to 
183.33  section 245A.04; 
183.34     (3) pay the personal care assistant and consulting 
183.35  qualified professional based on actual hours of services 
183.36  provided; 
184.1      (4) withhold and pay all applicable federal and state 
184.2   taxes; 
184.3      (5) verify and document keep records of hours worked by the 
184.4   personal care assistant and consulting qualified professional; 
184.5      (6) make the arrangements and pay unemployment insurance, 
184.6   taxes, workers' compensation, liability insurance, and other 
184.7   benefits, if any; 
184.8      (7) enroll in the medical assistance program as a fiscal 
184.9   agent intermediary; and 
184.10     (8) enter into a written agreement as specified in 
184.11  paragraph (f) before services are provided. 
184.12     (d) The fiscal agent intermediary: 
184.13     (1) may not be related to the recipient, consulting 
184.14  qualified professional, or the personal care assistant; 
184.15     (2) must ensure arm's length transactions with the 
184.16  recipient and personal care assistant; and 
184.17     (3) shall be considered a joint employer of the personal 
184.18  care assistant and consulting qualified professional to the 
184.19  extent specified in this section. 
184.20     The fiscal agent intermediary or owners of the entity that 
184.21  provides fiscal agent intermediary services under this 
184.22  subdivision must pass a criminal background check as required in 
184.23  section 256B.0627, subdivision 1, paragraph (e). 
184.24     (e) If the recipient or responsible party requests a 
184.25  qualified professional, the consulting qualified professional 
184.26  providing assistance to the recipient shall meet the 
184.27  qualifications specified in section 256B.0625, subdivision 19c.  
184.28  The consulting qualified professional shall assist the recipient 
184.29  in developing and revising a plan to meet the 
184.30  recipient's assessed needs, and supervise the performance of 
184.31  delegated tasks, as determined by the public health nurse as 
184.32  assessed by the public health nurse.  In performing this 
184.33  function, the consulting qualified professional must visit the 
184.34  recipient in the recipient's home at least once annually.  
184.35  The consulting qualified professional must report to the local 
184.36  county public health nurse concerns relating to the health and 
185.1   safety of the recipient, and any suspected abuse, neglect, or 
185.2   financial exploitation of the recipient to the appropriate 
185.3   authorities.  
185.4      (f) The fiscal agent intermediary, recipient or responsible 
185.5   party, personal care assistant, and consulting qualified 
185.6   professional shall enter into a written agreement before 
185.7   services are started.  The agreement shall include: 
185.8      (1) the duties of the recipient, qualified professional, 
185.9   personal care assistant, and fiscal agent based on paragraphs 
185.10  (a) to (e); 
185.11     (2) the salary and benefits for the personal care assistant 
185.12  and those providing professional consultation the qualified 
185.13  professional; 
185.14     (3) the administrative fee of the fiscal agent intermediary 
185.15  and services paid for with that fee, including background check 
185.16  fees; 
185.17     (4) procedures to respond to billing or payment complaints; 
185.18  and 
185.19     (5) procedures for hiring and terminating the personal care 
185.20  assistant and those providing professional consultation the 
185.21  qualified professional. 
185.22     (g) The rates paid for personal care assistant services, 
185.23  qualified professional assistance services, and fiscal agency 
185.24  intermediary services under this subdivision shall be the same 
185.25  rates paid for personal care assistant services and qualified 
185.26  professional services under subdivision 2 respectively.  Except 
185.27  for the administrative fee of the fiscal agent intermediary 
185.28  specified in paragraph (f), the remainder of the rates paid to 
185.29  the fiscal agent intermediary must be used to pay for the salary 
185.30  and benefits for the personal care assistant or those providing 
185.31  professional consultation the qualified professional. 
185.32     (h) As part of the assessment defined in subdivision 1, the 
185.33  following conditions must be met to use or continue use of a 
185.34  fiscal agent intermediary: 
185.35     (1) the recipient must be able to direct the recipient's 
185.36  own care, or the responsible party for the recipient must be 
186.1   readily available to direct the care of the personal care 
186.2   assistant; 
186.3      (2) the recipient or responsible party must be 
186.4   knowledgeable of the health care needs of the recipient and be 
186.5   able to effectively communicate those needs; 
186.6      (3) a face-to-face assessment must be conducted by the 
186.7   local county public health nurse at least annually, or when 
186.8   there is a significant change in the recipient's condition or 
186.9   change in the need for personal care assistant services.  The 
186.10  county public health nurse shall determine the services that 
186.11  require professional delegation, if any, and the amount and 
186.12  frequency of related supervision; 
186.13     (4) the recipient cannot select the shared services option 
186.14  as specified in subdivision 8; and 
186.15     (5) parties must be in compliance with the written 
186.16  agreement specified in paragraph (f). 
186.17     (i) The commissioner shall deny, revoke, or suspend the 
186.18  authorization to use the fiscal agent intermediary option if: 
186.19     (1) it has been determined by the consulting qualified 
186.20  professional or local county public health nurse that the use of 
186.21  this option jeopardizes the recipient's health and safety; 
186.22     (2) the parties have failed to comply with the written 
186.23  agreement specified in paragraph (f); or 
186.24     (3) the use of the option has led to abusive or fraudulent 
186.25  billing for personal care assistant services.  
186.26     The recipient or responsible party may appeal the 
186.27  commissioner's action according to section 256.045.  The denial, 
186.28  revocation, or suspension to use the fiscal agent intermediary 
186.29  option shall not affect the recipient's authorized level of 
186.30  personal care assistant services as determined in subdivision 5. 
186.31     Sec. 35.  Minnesota Statutes 2000, section 256B.0627, 
186.32  subdivision 11, is amended to read: 
186.33     Subd. 11.  [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 
186.34  Medical assistance payments for shared private duty nursing 
186.35  services by a private duty nurse shall be limited according to 
186.36  this subdivision.  For the purposes of this section, "private 
187.1   duty nursing agency" means an agency licensed under chapter 144A 
187.2   to provide private duty nursing services. 
187.3      (b) Recipients of private duty nursing services may share 
187.4   nursing staff and the commissioner shall provide a rate 
187.5   methodology for shared private duty nursing.  For two persons 
187.6   sharing nursing care, the rate paid to a provider shall not 
187.7   exceed 1.5 times the nonwaivered regular private duty nursing 
187.8   rates paid for serving a single individual who is not ventilator 
187.9   dependent, by a registered nurse or licensed practical nurse.  
187.10  These rates apply only to situations in which both recipients 
187.11  are present and receive shared private duty nursing care on the 
187.12  date for which the service is billed.  No more than two persons 
187.13  may receive shared private duty nursing services from a private 
187.14  duty nurse in a single setting. 
187.15     (c) Shared private duty nursing care is the provision of 
187.16  nursing services by a private duty nurse to two recipients at 
187.17  the same time and in the same setting.  For the purposes of this 
187.18  subdivision, "setting" means: 
187.19     (1) the home or foster care home of one of the individual 
187.20  recipients; or 
187.21     (2) a child care program licensed under chapter 245A or 
187.22  operated by a local school district or private school; or 
187.23     (3) an adult day care service licensed under chapter 245A; 
187.24  or 
187.25     (4) outside the home or foster care home of one of the 
187.26  recipients when normal life activities take the recipients 
187.27  outside the home.  
187.28     This subdivision does not apply when a private duty nurse 
187.29  is caring for multiple recipients in more than one setting. 
187.30     (d) The recipient or the recipient's legal representative, 
187.31  and the recipient's physician, in conjunction with the home 
187.32  health care agency, shall determine: 
187.33     (1) whether shared private duty nursing care is an 
187.34  appropriate option based on the individual needs and preferences 
187.35  of the recipient; and 
187.36     (2) the amount of shared private duty nursing services 
188.1   authorized as part of the overall authorization of nursing 
188.2   services. 
188.3      (e) The recipient or the recipient's legal representative, 
188.4   in conjunction with the private duty nursing agency, shall 
188.5   approve the setting, grouping, and arrangement of shared private 
188.6   duty nursing care based on the individual needs and preferences 
188.7   of the recipients.  Decisions on the selection of recipients to 
188.8   share services must be based on the ages of the recipients, 
188.9   compatibility, and coordination of their care needs. 
188.10     (f) The following items must be considered by the recipient 
188.11  or the recipient's legal representative and the private duty 
188.12  nursing agency, and documented in the recipient's health service 
188.13  record: 
188.14     (1) the additional training needed by the private duty 
188.15  nurse to provide care to two recipients in the same setting and 
188.16  to ensure that the needs of the recipients are met appropriately 
188.17  and safely; 
188.18     (2) the setting in which the shared private duty nursing 
188.19  care will be provided; 
188.20     (3) the ongoing monitoring and evaluation of the 
188.21  effectiveness and appropriateness of the service and process 
188.22  used to make changes in service or setting; 
188.23     (4) a contingency plan which accounts for absence of the 
188.24  recipient in a shared private duty nursing setting due to 
188.25  illness or other circumstances; 
188.26     (5) staffing backup contingencies in the event of employee 
188.27  illness or absence; and 
188.28     (6) arrangements for additional assistance to respond to 
188.29  urgent or emergency care needs of the recipients. 
188.30     (g) The provider must offer the recipient or responsible 
188.31  party the option of shared or one-on-one private duty nursing 
188.32  services.  The recipient or responsible party can withdraw from 
188.33  participating in a shared service arrangement at any time. 
188.34     (h) The private duty nursing agency must document the 
188.35  following in the health service record for each individual 
188.36  recipient sharing private duty nursing care: 
189.1      (1) permission by the recipient or the recipient's legal 
189.2   representative for the maximum number of shared nursing care 
189.3   hours per week chosen by the recipient; 
189.4      (2) permission by the recipient or the recipient's legal 
189.5   representative for shared private duty nursing services provided 
189.6   outside the recipient's residence; 
189.7      (3) permission by the recipient or the recipient's legal 
189.8   representative for others to receive shared private duty nursing 
189.9   services in the recipient's residence; 
189.10     (4) revocation by the recipient or the recipient's legal 
189.11  representative of the shared private duty nursing care 
189.12  authorization, or the shared care to be provided to others in 
189.13  the recipient's residence, or the shared private duty nursing 
189.14  services to be provided outside the recipient's residence; and 
189.15     (5) daily documentation of the shared private duty nursing 
189.16  services provided by each identified private duty nurse, 
189.17  including: 
189.18     (i) the names of each recipient receiving shared private 
189.19  duty nursing services together; 
189.20     (ii) the setting for the shared services, including the 
189.21  starting and ending times that the recipient received shared 
189.22  private duty nursing care; and 
189.23     (iii) notes by the private duty nurse regarding changes in 
189.24  the recipient's condition, problems that may arise from the 
189.25  sharing of private duty nursing services, and scheduling and 
189.26  care issues. 
189.27     (i) Unless otherwise provided in this subdivision, all 
189.28  other statutory and regulatory provisions relating to private 
189.29  duty nursing services apply to shared private duty nursing 
189.30  services. 
189.31     Nothing in this subdivision shall be construed to reduce 
189.32  the total number of private duty nursing hours authorized for an 
189.33  individual recipient under subdivision 5. 
189.34     Sec. 36.  Minnesota Statutes 2000, section 256B.0627, is 
189.35  amended by adding a subdivision to read: 
189.36     Subd. 13.  [CONSUMER-DIRECTED HOME CARE DEMONSTRATION 
190.1   PROJECT.] (a) Upon the receipt of federal waiver authority, the 
190.2   commissioner shall implement a consumer-directed home care 
190.3   demonstration project.  The consumer-directed home care 
190.4   demonstration project must demonstrate and evaluate the outcomes 
190.5   of a consumer-directed service delivery alternative to improve 
190.6   access, increase consumer control and accountability over 
190.7   available resources, and enable the use of supports that are 
190.8   more individualized and cost-effective for eligible medical 
190.9   assistance recipients receiving certain medical assistance home 
190.10  care services.  The consumer-directed home care demonstration 
190.11  project will be administered locally by county agencies, tribal 
190.12  governments, or administrative entities under contract with the 
190.13  state in regions where counties choose not to provide this 
190.14  service. 
190.15     (b) Grant awards for persons who have been receiving 
190.16  medical assistance covered personal care, home health aide, or 
190.17  private duty nursing services for a period of 12 consecutive 
190.18  months or more prior to enrollment in the consumer-directed home 
190.19  care demonstration project will be established on a case-by-case 
190.20  basis using historical service expenditure data.  An average 
190.21  monthly expenditure for each continuing enrollee will be 
190.22  calculated based on historical expenditures made on behalf of 
190.23  the enrollee for personal care, home health aide, or private 
190.24  duty nursing services during the 12 month period directly prior 
190.25  to enrollment in the project.  The grant award will equal 90 
190.26  percent of the average monthly expenditure. 
190.27     (c) Grant awards for project enrollees who have been 
190.28  receiving medical assistance covered personal care, home health 
190.29  aide, or private duty nursing services for a period of less than 
190.30  12 consecutive months prior to project enrollment will be 
190.31  calculated on a case-by-case basis using the service 
190.32  authorization in place at the time of enrollment.  The total 
190.33  number of units of personal care, home health aide, or private 
190.34  duty nursing services the enrollee has been authorized to 
190.35  receive will be converted to the total cost of the authorized 
190.36  services in a given month using the statewide average service 
191.1   payment rates.  To determine an estimated monthly expenditure, 
191.2   the total authorized monthly personal care, home health aide or 
191.3   private duty nursing service costs will be reduced by a 
191.4   percentage rate equivalent to the difference between the 
191.5   statewide average service authorization and the statewide 
191.6   average utilization rate for each of the services by medical 
191.7   assistance eligibles during the most recent fiscal year for 
191.8   which 12 months of data is available.  The grant award will 
191.9   equal 90 percent of the estimated monthly expenditure. 
191.10     (d) The state of Minnesota, county agencies, tribal 
191.11  governments, or administrative entities under contract with the 
191.12  state that participate in the implementation and administration 
191.13  of the consumer-directed home care demonstration project, shall 
191.14  not be liable for damages, injuries, or liabilities sustained 
191.15  through the purchase of support by the individual, the 
191.16  individual's family, or the authorized representative under this 
191.17  section with funds received through the consumer-directed home 
191.18  care demonstration project.  Liabilities include but are not 
191.19  limited to:  workers' compensation liability, the Federal 
191.20  Insurance Contributions Act (FICA), or the Federal Unemployment 
191.21  Tax Act (FUTA). 
191.22     Sec. 37.  Minnesota Statutes 2000, section 256B.0627, is 
191.23  amended by adding a subdivision to read: 
191.24     Subd. 14.  [TELEHOMECARE; SKILLED NURSE VISITS.] Medical 
191.25  assistance covers skilled nurse visits according to section 
191.26  256B.0625, subdivision 6a, provided via telehomecare, for 
191.27  services which do not require hands-on care between the home 
191.28  care nurse and recipient.  The provision of telehomecare must be 
191.29  made via live, two-way interactive audiovisual technology and 
191.30  may be augmented by utilizing store-and-forward technologies.  
191.31  Store-and-forward technology includes telehomecare services that 
191.32  do not occur in real time via synchronous transmissions, and 
191.33  that do not require a face-to-face encounter with the recipient 
191.34  for all or any part of any such telehomecare visit.  A 
191.35  communication between the home care nurse and recipient that 
191.36  consists solely of a telephone conversation, facsimile, 
192.1   electronic mail, or a consultation between two health care 
192.2   practitioners, is not to be considered a telehomecare visit.  
192.3   Multiple daily skilled nurse visits provided via telehomecare 
192.4   are allowed.  Coverage of telehomecare is limited to two visits 
192.5   per day.  All skilled nurse visits provided via telehomecare 
192.6   must be prior authorized by the commissioner or the 
192.7   commissioner's designee and will be covered at the same 
192.8   allowable rate as skilled nurse visits provided in-person. 
192.9      Sec. 38.  Minnesota Statutes 2000, section 256B.0627, is 
192.10  amended by adding a subdivision to read: 
192.11     Subd. 15.  [THERAPIES THROUGH HOME HEALTH AGENCIES.] (a)  
192.12  [PHYSICAL THERAPY.] Medical assistance covers physical therapy 
192.13  and related services, including specialized maintenance 
192.14  therapy.  Services provided by a physical therapy assistant 
192.15  shall be reimbursed at the same rate as services performed by a 
192.16  physical therapist when the services of the physical therapy 
192.17  assistant are provided under the direction of a physical 
192.18  therapist who is on the premises.  Services provided by a 
192.19  physical therapy assistant that are provided under the direction 
192.20  of a physical therapist who is not on the premises shall be 
192.21  reimbursed at 65 percent of the physical therapist rate.  
192.22  Direction of the physical therapy assistant must be provided by 
192.23  the physical therapist as described in Minnesota Rules, part 
192.24  9505.0390, subpart 1, item B.  The physical therapist and 
192.25  physical therapist assistant may not both bill for services 
192.26  provided to a recipient on the same day. 
192.27     (b)  [OCCUPATIONAL THERAPY.] Medical assistance covers 
192.28  occupational therapy and related services, including specialized 
192.29  maintenance therapy.  Services provided by an occupational 
192.30  therapy assistant shall be reimbursed at the same rate as 
192.31  services performed by an occupational therapist when the 
192.32  services of the occupational therapy assistant are provided 
192.33  under the direction of the occupational therapist who is on the 
192.34  premises.  Services provided by an occupational therapy 
192.35  assistant under the direction of an occupational therapist who 
192.36  is not on the premises shall be reimbursed at 65 percent of the 
193.1   occupational therapist rate.  Direction of the occupational 
193.2   therapy assistant must be provided by the occupational therapist 
193.3   as described in Minnesota Rules, part 9505.0390, subpart 1, item 
193.4   B.  The occupational therapist and occupational therapist 
193.5   assistant may not both bill for services provided to a recipient 
193.6   on the same day. 
193.7      Sec. 39.  Minnesota Statutes 2000, section 256B.0627, is 
193.8   amended by adding a subdivision to read: 
193.9      Subd. 16.  [HARDSHIP CRITERIA; PRIVATE DUTY NURSING.] (a) 
193.10  Payment is allowed for extraordinary services that require 
193.11  specialized nursing skills and are provided by parents of minor 
193.12  children, spouses, and legal guardians who are providing private 
193.13  duty nursing care under the following conditions: 
193.14     (1) the provision of these services is not legally required 
193.15  of the parents, spouses, or legal guardians; 
193.16     (2) the services are necessary to prevent hospitalization 
193.17  of the recipient; and 
193.18     (3) the recipient is eligible for state plan home care or a 
193.19  home and community-based waiver and one of the following 
193.20  hardship criteria are met: 
193.21     (i) the parent, spouse, or legal guardian resigns from a 
193.22  part-time or full-time job to provide nursing care for the 
193.23  recipient; or 
193.24     (ii) the parent, spouse, or legal guardian goes from a 
193.25  full-time to a part-time job with less compensation to provide 
193.26  nursing care for the recipient; or 
193.27     (iii) the parent, spouse, or legal guardian takes a leave 
193.28  of absence without pay to provide nursing care for the 
193.29  recipient; or 
193.30     (iv) because of labor conditions, special language needs, 
193.31  or intermittent hours of care needed, the parent, spouse, or 
193.32  legal guardian is needed in order to provide adequate private 
193.33  duty nursing services to meet the medical needs of the recipient.
193.34     (b) Private duty nursing may be provided by a parent, 
193.35  spouse, or legal guardian who is a nurse licensed in Minnesota.  
193.36  Private duty nursing services provided by a parent, spouse, or 
194.1   legal guardian cannot be used in lieu of nursing services 
194.2   covered and available under liable third-party payers, including 
194.3   Medicare.  The private duty nursing provided by a parent, 
194.4   spouse, or legal guardian must be included in the service plan.  
194.5   Authorized skilled nursing services provided by the parent, 
194.6   spouse, or legal guardian may not exceed 50 percent of the total 
194.7   approved nursing hours, or eight hours per day, whichever is 
194.8   less, up to a maximum of 40 hours per week.  Nothing in this 
194.9   subdivision precludes the parent's, spouse's, or legal 
194.10  guardian's obligation of assuming the nonreimbursed family 
194.11  responsibilities of emergency backup caregiver and primary 
194.12  caregiver. 
194.13     (c) A parent or a spouse may not be paid to provide private 
194.14  duty nursing care if the parent or spouse fails to pass a 
194.15  criminal background check according to section 245A.04, or if it 
194.16  has been determined by the home health agency, the case manager, 
194.17  or the physician that the private duty nursing care provided by 
194.18  the parent, spouse, or legal guardian is unsafe. 
194.19     Sec. 40.  Minnesota Statutes 2000, section 256B.0627, is 
194.20  amended by adding a subdivision to read: 
194.21     Subd. 17.  [QUALITY ASSURANCE PLAN FOR PERSONAL CARE 
194.22  ASSISTANT SERVICES.] The commissioner shall establish a quality 
194.23  assurance plan for personal care assistant services that 
194.24  includes: 
194.25     (1) performance-based provider agreements; 
194.26     (2) meaningful consumer input, which may include consumer 
194.27  surveys, that measure the extent to which participants receive 
194.28  the services and supports described in the individual plan and 
194.29  participant satisfaction with such services and supports; 
194.30     (3) ongoing monitoring of the health and well-being of 
194.31  consumers; and 
194.32     (4) an ongoing public process for development, 
194.33  implementation, and review of the quality assurance plan.  
194.34     Sec. 41.  Minnesota Statutes 2000, section 256B.0911, is 
194.35  amended by adding a subdivision to read: 
194.36     Subd. 4a.  [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 
195.1   YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 
195.2   ensure that individuals with disabilities or chronic illness are 
195.3   served in the most integrated setting appropriate to their needs 
195.4   and have the necessary information to make informed choices 
195.5   about home and community-based service options. 
195.6      (b) Individuals under 65 years of age who are admitted to a 
195.7   nursing facility from a hospital must be screened prior to 
195.8   admission as outlined in subdivision 4. 
195.9      (c) Individuals under 65 years of age who are admitted to 
195.10  nursing facilities with only a telephone screening must receive 
195.11  a face-to-face assessment from the long-term care consultation 
195.12  team member of the county in which the facility is located or 
195.13  from the recipient's county case manager within 20 working days 
195.14  of admission. 
195.15     (d) At the face-to-face assessment, the long-term care 
195.16  consultation team member or county case manager must perform the 
195.17  activities required under subdivision 3. 
195.18     (e) For individuals under 21 years of age, the screening or 
195.19  assessment which recommends nursing facility admission must be 
195.20  approved by the commissioner before the individual is admitted 
195.21  to the nursing facility. 
195.22     (f) In the event that an individual under 65 years of age 
195.23  is admitted to a nursing facility on an emergency basis, the 
195.24  county must be notified of the admission on the next working 
195.25  day, and a face-to-face assessment as described in paragraph (c) 
195.26  must be conducted within 20 working days of admission. 
195.27     (g) At the face-to-face assessment, the long-term care 
195.28  consultation team member or the case manager must present 
195.29  information about home and community-based options so the 
195.30  individual can make informed choices.  If the individual chooses 
195.31  home and community-based services, the long-term care 
195.32  consultation team member or case manager must complete a written 
195.33  relocation plan within 20 working days of the visit.  The plan 
195.34  shall describe the services needed to move out of the facility 
195.35  and a time line for the move which is designed to ensure a 
195.36  smooth transition to the individual's home and community. 
196.1      (h) An individual under 65 years of age residing in a 
196.2   nursing facility shall receive a face-to-face assessment at 
196.3   least every 12 months to review the person's service choices and 
196.4   available alternatives unless the individual indicates, in 
196.5   writing, that annual visits are not desired.  In this case, the 
196.6   individual must receive a face-to-face assessment at least once 
196.7   every 36 months for the same purposes. 
196.8      (i) Notwithstanding the provisions of subdivision 6, the 
196.9   commissioner may pay county agencies directly for face-to-face 
196.10  assessments for individuals who are eligible for medical 
196.11  assistance, under 65 years of age, and being considered for 
196.12  placement or residing in a nursing facility. 
196.13     Sec. 42.  Minnesota Statutes 2000, section 256B.0916, 
196.14  subdivision 1, is amended to read: 
196.15     Subdivision 1.  [REDUCTION OF WAITING LIST.] (a) The 
196.16  legislature recognizes that as of January 1, 1999, 3,300 persons 
196.17  with mental retardation or related conditions have been screened 
196.18  and determined eligible for the home and community-based waiver 
196.19  services program for persons with mental retardation or related 
196.20  conditions.  Many wait for several years before receiving 
196.21  service. 
196.22     (b) The waiting list for this program shall be reduced or 
196.23  eliminated by June 30, 2003.  In order to reduce the number of 
196.24  eligible persons waiting for identified services provided 
196.25  through the home and community-based waiver for persons with 
196.26  mental retardation or related conditions, during the period from 
196.27  July 1, 1999, to June 30, 2003, funding shall be increased to 
196.28  add 100 additional eligible persons each year beyond the 
196.29  February 1999 medical assistance forecast. 
196.30     (c) The commissioner shall allocate resources in such a 
196.31  manner as to use all resources budgeted during a biennium for 
196.32  the home and community-based waiver for persons with mental 
196.33  retardation or related conditions according to the priorities 
196.34  listed in subdivision 2, paragraph (b), and then to serve other 
196.35  persons on the waiting list.  Resources allocated for a fiscal 
196.36  year to serve persons affected by public and private sector 
197.1   ICF/MR closures, but not expected to be expended for that 
197.2   purpose, must be reallocated within that fiscal year to serve 
197.3   other persons on the waiting list, and the number of waiver 
197.4   diversion slots shall be adjusted accordingly. 
197.5      (d) For fiscal year 2001, at least one-half of the increase 
197.6   in funding over the previous year provided in the February 1999 
197.7   medical assistance forecast for the home and community-based 
197.8   waiver for persons with mental retardation and related 
197.9   conditions, including changes made by the 1999 legislature, must 
197.10  be used to serve persons who are not affected by public and 
197.11  private sector ICF/MR closures. 
197.12     (e) The commissioner of finance shall not reduce the 
197.13  expenditure forecast for a biennium for which appropriations 
197.14  have been made, if at the time of the forecast there is a 
197.15  waiting list for waiver services for persons with mental 
197.16  retardation or related conditions who need services within the 
197.17  next 30 months.  Funds that would have resulted from a projected 
197.18  reduction in expenditures must be used by the commissioner of 
197.19  human services to serve persons with developmental disabilities 
197.20  through the home and community-based waiver for persons with 
197.21  mental retardation or related conditions. 
197.22     Sec. 43.  Minnesota Statutes 2000, section 256B.0916, is 
197.23  amended by adding a subdivision to read: 
197.24     Subd. 6a.  [STATEWIDE AVAILABILITY OF CONSUMER-DIRECTED 
197.25  COMMUNITY SUPPORT SERVICES.] (a) The commissioner shall submit 
197.26  to the federal Health Care Financing Administration by August 1, 
197.27  2001, an amendment to the home and community-based waiver for 
197.28  persons with mental retardation or related conditions to make 
197.29  consumer-directed community support services available in every 
197.30  county of the state by January 1, 2002. 
197.31     (b) If a county declines to meet the requirements for 
197.32  provision of consumer-directed community supports, the 
197.33  commissioner shall contract with another county, a group of 
197.34  counties, or a private agency to plan for and administer 
197.35  consumer-directed community supports in that county. 
197.36     (c) The state of Minnesota, county agencies, tribal 
198.1   governments, or administrative entities under contract to 
198.2   participate in the implementation and administration of the home 
198.3   and community-based waiver for persons with mental retardation 
198.4   or a related condition, shall not be liable for damages, 
198.5   injuries, or liabilities sustained through the purchase of 
198.6   support by the individual, the individual's family, or the 
198.7   authorized representative with funds received through the 
198.8   consumer-directed community support service under this section.  
198.9   Liabilities include but are not limited to:  workers' 
198.10  compensation liability, the Federal Insurance Contributions Act 
198.11  (FICA), or the Federal Unemployment Tax Act (FUTA). 
198.12     Sec. 44.  Minnesota Statutes 2000, section 256B.0916, 
198.13  subdivision 7, is amended to read: 
198.14     Subd. 7.  [ANNUAL REPORT BY COMMISSIONER.] Beginning 
198.15  October 1, 1999, and each October 1 November 1, 2001, and each 
198.16  November 1 thereafter, the commissioner shall issue an annual 
198.17  report on county and state use of available resources for the 
198.18  home and community-based waiver for persons with mental 
198.19  retardation or related conditions.  For each county or county 
198.20  partnership, the report shall include: 
198.21     (1) the amount of funds allocated but not used; 
198.22     (2) the county specific allowed reserve amount approved and 
198.23  used; 
198.24     (3) the number, ages, and living situations of individuals 
198.25  screened and waiting for services; 
198.26     (4) the urgency of need for services to begin within one, 
198.27  two, or more than two years for each individual; 
198.28     (5) the services needed; 
198.29     (6) the number of additional persons served by approval of 
198.30  increased capacity within existing allocations; 
198.31     (7) results of action by the commissioner to streamline 
198.32  administrative requirements and improve county resource 
198.33  management; and 
198.34     (8) additional action that would decrease the number of 
198.35  those eligible and waiting for waivered services. 
198.36  The commissioner shall specify intended outcomes for the program 
199.1   and the degree to which these specified outcomes are attained. 
199.2      Sec. 45.  Minnesota Statutes 2000, section 256B.0916, 
199.3   subdivision 9, is amended to read: 
199.4      Subd. 9.  [LEGAL REPRESENTATIVE PARTICIPATION EXCEPTION.] 
199.5   The commissioner, in cooperation with representatives of 
199.6   counties, service providers, service recipients, family members, 
199.7   legal representatives and advocates, shall develop criteria to 
199.8   allow legal representatives to be reimbursed for providing 
199.9   specific support services to meet the person's needs when a plan 
199.10  which assures health and safety has been agreed upon and carried 
199.11  out by the legal representative, the person, and the county.  
199.12  Legal representatives providing support under consumer-directed 
199.13  community support services pursuant to section 256B.092, 
199.14  subdivision 4, the home and community-based waiver for persons 
199.15  with mental retardation or related conditions or the consumer 
199.16  support grant program pursuant to section 256B.092, subdivision 
199.17  7 256.476, shall not be considered to have a direct or indirect 
199.18  service provider interest under section 256B.092, subdivision 7, 
199.19  if a health and safety plan which meets the criteria established 
199.20  has been agreed upon and implemented.  By October 1, 1999 August 
199.21  1, 2001, the commissioner shall submit, for federal approval, 
199.22  amendments to allow legal representatives to provide support and 
199.23  receive reimbursement under the consumer-directed community 
199.24  support services section of the home and community-based waiver 
199.25  plan. 
199.26     Sec. 46.  Minnesota Statutes 2000, section 256B.092, 
199.27  subdivision 2a, is amended to read: 
199.28     Subd. 2a.  [MEDICAL ASSISTANCE FOR CASE MANAGEMENT 
199.29  ACTIVITIES UNDER THE STATE PLAN MEDICAID OPTION.] (a) Upon 
199.30  receipt of federal approval, the commissioner shall make 
199.31  payments to approved vendors counties, private individuals, and 
199.32  agencies enrolled as providers of case management services 
199.33  participating in the medical assistance program to reimburse 
199.34  costs for providing case management service activities to 
199.35  medical assistance eligible persons with mental retardation or a 
199.36  related condition, in accordance with the state Medicaid plan, 
200.1   the home and community-based waiver for persons with mental 
200.2   retardation and related conditions plan, and federal 
200.3   requirements and limitations.  
200.4      (b) The commissioner shall ensure that each eligible person 
200.5   is given a choice of county and private agency case management 
200.6   service providers.  Case management service providers are 
200.7   prohibited from providing any other service to the person 
200.8   receiving case management services. 
200.9      Sec. 47.  Minnesota Statutes 2000, section 256B.092, 
200.10  subdivision 5, is amended to read: 
200.11     Subd. 5.  [FEDERAL WAIVERS.] (a) The commissioner shall 
200.12  apply for any federal waivers necessary to secure, to the extent 
200.13  allowed by law, federal financial participation under United 
200.14  States Code, title 42, sections 1396 et seq., as amended, for 
200.15  the provision of services to persons who, in the absence of the 
200.16  services, would need the level of care provided in a regional 
200.17  treatment center or a community intermediate care facility for 
200.18  persons with mental retardation or related conditions.  The 
200.19  commissioner may seek amendments to the waivers or apply for 
200.20  additional waivers under United States Code, title 42, sections 
200.21  1396 et seq., as amended, to contain costs.  The commissioner 
200.22  shall ensure that payment for the cost of providing home and 
200.23  community-based alternative services under the federal waiver 
200.24  plan shall not exceed the cost of intermediate care services 
200.25  including day training and habilitation services that would have 
200.26  been provided without the waivered services.  
200.27     (b) The commissioner, in administering home and 
200.28  community-based waivers for persons with mental retardation and 
200.29  related conditions, shall ensure that day services for eligible 
200.30  persons are not provided by the person's residential service 
200.31  provider, unless the person or the person's legal representative 
200.32  is offered a choice of providers and agrees in writing to 
200.33  provision of day services by the residential service provider.  
200.34  The individual service plan for individuals who choose to have 
200.35  their residential service provider provide their day services 
200.36  must describe how health, safety, and protection needs will be 
201.1   met by frequent and regular contact with persons other than the 
201.2   residential service provider. 
201.3      Sec. 48.  Minnesota Statutes 2000, section 256B.093, 
201.4   subdivision 3, is amended to read: 
201.5      Subd. 3.  [TRAUMATIC BRAIN INJURY PROGRAM DUTIES.] The 
201.6   department shall fund administrative case management under this 
201.7   subdivision using medical assistance administrative funds.  The 
201.8   traumatic brain injury program duties include: 
201.9      (1) recommending to the commissioner in consultation with 
201.10  the medical review agent according to Minnesota Rules, parts 
201.11  9505.0500 to 9505.0540, the approval or denial of medical 
201.12  assistance funds to pay for out-of-state placements for 
201.13  traumatic brain injury services and in-state traumatic brain 
201.14  injury services provided by designated Medicare long-term care 
201.15  hospitals; 
201.16     (2) coordinating the traumatic brain injury home and 
201.17  community-based waiver; 
201.18     (3) approving traumatic brain injury waiver eligibility or 
201.19  care plans or both; 
201.20     (4) providing ongoing technical assistance and consultation 
201.21  to county and facility case managers to facilitate care plan 
201.22  development for appropriate, accessible, and cost-effective 
201.23  medical assistance services; 
201.24     (5) (4) providing technical assistance to promote statewide 
201.25  development of appropriate, accessible, and cost-effective 
201.26  medical assistance services and related policy; 
201.27     (6) (5) providing training and outreach to facilitate 
201.28  access to appropriate home and community-based services to 
201.29  prevent institutionalization; 
201.30     (7) (6) facilitating appropriate admissions, continued stay 
201.31  review, discharges, and utilization review for neurobehavioral 
201.32  hospitals and other specialized institutions; 
201.33     (8) (7) providing technical assistance on the use of prior 
201.34  authorization of home care services and coordination of these 
201.35  services with other medical assistance services; 
201.36     (9) (8) developing a system for identification of nursing 
202.1   facility and hospital residents with traumatic brain injury to 
202.2   assist in long-term planning for medical assistance services.  
202.3   Factors will include, but are not limited to, number of 
202.4   individuals served, length of stay, services received, and 
202.5   barriers to community placement; and 
202.6      (10) (9) providing information, referral, and case 
202.7   consultation to access medical assistance services for 
202.8   recipients without a county or facility case manager.  Direct 
202.9   access to this assistance may be limited due to the structure of 
202.10  the program. 
202.11     Sec. 49.  Minnesota Statutes 2000, section 256B.095, is 
202.12  amended to read: 
202.13     256B.095 [THREE-YEAR QUALITY ASSURANCE PILOT PROJECT 
202.14  ESTABLISHED.] 
202.15     Effective July 1, 1998, an alternative quality assurance 
202.16  licensing system pilot project for programs for persons with 
202.17  developmental disabilities is established in Dodge, Fillmore, 
202.18  Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, 
202.19  Wabasha, and Winona counties for the purpose of improving the 
202.20  quality of services provided to persons with developmental 
202.21  disabilities.  A county, at its option, may choose to have all 
202.22  programs for persons with developmental disabilities located 
202.23  within the county licensed under chapter 245A using standards 
202.24  determined under the alternative quality assurance licensing 
202.25  system pilot project or may continue regulation of these 
202.26  programs under the licensing system operated by the 
202.27  commissioner.  The pilot project expires on June 30, 2001 2005. 
202.28     Sec. 50.  Minnesota Statutes 2000, section 256B.0951, 
202.29  subdivision 1, is amended to read: 
202.30     Subdivision 1.  [MEMBERSHIP.] The region 10 quality 
202.31  assurance commission is established.  The commission consists of 
202.32  at least 14 but not more than 21 members as follows:  at least 
202.33  three but not more than five members representing advocacy 
202.34  organizations; at least three but not more than five members 
202.35  representing consumers, families, and their legal 
202.36  representatives; at least three but not more than five members 
203.1   representing service providers; at least three but not more than 
203.2   five members representing counties; and the commissioner of 
203.3   human services or the commissioner's designee.  Initial 
203.4   membership of the commission shall be recruited and approved by 
203.5   the region 10 stakeholders group.  Prior to approving the 
203.6   commission's membership, the stakeholders group shall provide to 
203.7   the commissioner a list of the membership in the stakeholders 
203.8   group, as of February 1, 1997, a brief summary of meetings held 
203.9   by the group since July 1, 1996, and copies of any materials 
203.10  prepared by the group for public distribution.  The first 
203.11  commission shall establish membership guidelines for the 
203.12  transition and recruitment of membership for the commission's 
203.13  ongoing existence.  Members of the commission who do not receive 
203.14  a salary or wages from an employer for time spent on commission 
203.15  duties may receive a per diem payment when performing commission 
203.16  duties and functions.  All members may be reimbursed for 
203.17  expenses related to commission activities.  Notwithstanding the 
203.18  provisions of section 15.059, subdivision 5, the commission 
203.19  expires on June 30, 2001 2005. 
203.20     Sec. 51.  Minnesota Statutes 2000, section 256B.0951, 
203.21  subdivision 3, is amended to read: 
203.22     Subd. 3.  [COMMISSION DUTIES.] (a) By October 1, 1997, the 
203.23  commission, in cooperation with the commissioners of human 
203.24  services and health, shall do the following:  (1) approve an 
203.25  alternative quality assurance licensing system based on the 
203.26  evaluation of outcomes; (2) approve measurable outcomes in the 
203.27  areas of health and safety, consumer evaluation, education and 
203.28  training, providers, and systems that shall be evaluated during 
203.29  the alternative licensing process; and (3) establish variable 
203.30  licensure periods not to exceed three years based on outcomes 
203.31  achieved.  For purposes of this subdivision, "outcome" means the 
203.32  behavior, action, or status of a person that can be observed or 
203.33  measured and can be reliably and validly determined. 
203.34     (b) By January 15, 1998, the commission shall approve, in 
203.35  cooperation with the commissioner of human services, a training 
203.36  program for members of the quality assurance teams established 
204.1   under section 256B.0952, subdivision 4. 
204.2      (c) The commission and the commissioner shall establish an 
204.3   ongoing review process for the alternative quality assurance 
204.4   licensing system.  The review shall take into account the 
204.5   comprehensive nature of the alternative system, which is 
204.6   designed to evaluate the broad spectrum of licensed and 
204.7   unlicensed entities that provide services to clients, as 
204.8   compared to the current licensing system.  
204.9      (d) The commission shall contract with an independent 
204.10  entity to conduct a financial review of the alternative quality 
204.11  assurance pilot project.  The review shall take into account the 
204.12  comprehensive nature of the alternative system, which is 
204.13  designed to evaluate the broad spectrum of licensed and 
204.14  unlicensed entities that provide services to clients, as 
204.15  compared to the current licensing system.  The review shall 
204.16  include an evaluation of possible budgetary savings within the 
204.17  department of human services as a result of implementation of 
204.18  the alternative quality assurance pilot project.  If a federal 
204.19  waiver is approved under subdivision 7, the financial review 
204.20  shall also evaluate possible savings within the department of 
204.21  health.  This review must be completed by December 15, 2000. 
204.22     (e) The commission shall submit a report to the legislature 
204.23  by January 15, 2001, on the results of the review process for 
204.24  the alternative quality assurance pilot project, a summary of 
204.25  the results of the independent financial review, and a 
204.26  recommendation on whether the pilot project should be extended 
204.27  beyond June 30, 2001. 
204.28     (f) The commissioner, in consultation with the commission, 
204.29  shall examine the feasibility of expanding the project to other 
204.30  populations or geographic areas and identify barriers to 
204.31  expansion.  The commissioner shall report findings and 
204.32  recommendations to the legislature by December 15, 2004. 
204.33     Sec. 52.  Minnesota Statutes 2000, section 256B.0951, 
204.34  subdivision 4, is amended to read: 
204.35     Subd. 4.  [COMMISSION'S AUTHORITY TO RECOMMEND VARIANCES OF 
204.36  LICENSING STANDARDS.] The commission may recommend to the 
205.1   commissioners of human services and health variances from the 
205.2   standards governing licensure of programs for persons with 
205.3   developmental disabilities in order to improve the quality of 
205.4   services by implementing an alternative developmental 
205.5   disabilities licensing system if the commission determines that 
205.6   the alternative licensing system does not adversely affect the 
205.7   health or safety of persons being served by the licensed program 
205.8   nor compromise the qualifications of staff to provide services. 
205.9      Sec. 53.  Minnesota Statutes 2000, section 256B.0951, 
205.10  subdivision 5, is amended to read: 
205.11     Subd. 5.  [VARIANCE OF CERTAIN STANDARDS PROHIBITED.] The 
205.12  safety standards, rights, or procedural protections under 
205.13  sections 245.825; 245.91 to 245.97; 245A.04, subdivisions 3, 3a, 
205.14  3b, and 3c; 245A.09, subdivision 2, paragraph (c), clauses (2) 
205.15  and (5); 245A.12; 245A.13; 252.41, subdivision 9; 256B.092, 
205.16  subdivisions 1b, clause (7), and 10; 626.556; 626.557, and 
205.17  procedures for the monitoring of psychotropic medications shall 
205.18  not be varied under the alternative licensing system pilot 
205.19  project.  The commission may make recommendations to the 
205.20  commissioners of human services and health or to the legislature 
205.21  regarding alternatives to or modifications of the rules and 
205.22  procedures referenced in this subdivision. 
205.23     Sec. 54.  Minnesota Statutes 2000, section 256B.0951, 
205.24  subdivision 7, is amended to read: 
205.25     Subd. 7.  [WAIVER OF RULES.] The commissioner of health may 
205.26  exempt residents of intermediate care facilities for persons 
205.27  with mental retardation (ICFs/MR) who participate in the 
205.28  three-year quality assurance pilot project established in 
205.29  section 256B.095 from the requirements of Minnesota Rules, 
205.30  chapter 4665, upon approval by the federal government of a 
205.31  waiver of federal certification requirements for ICFs/MR.  The 
205.32  commissioners of health and human services shall apply for any 
205.33  necessary waivers as soon as practicable and shall submit the 
205.34  concept paper to the federal government by June 1, 1998.  
205.35     Sec. 55.  Minnesota Statutes 2000, section 256B.0951, is 
205.36  amended by adding a subdivision to read: 
206.1      Subd. 8.  [FEDERAL WAIVER.] The commissioner of human 
206.2   services shall seek federal authority to waive provisions of 
206.3   intermediate care facilities for persons with mental retardation 
206.4   (ICFs/MR) regulations to enable the demonstration and evaluation 
206.5   of the alternative quality assurance system for ICFs/MR under 
206.6   the project.  The commissioner of human services shall apply for 
206.7   any necessary waivers as soon as practicable. 
206.8      Sec. 56.  Minnesota Statutes 2000, section 256B.0951, is 
206.9   amended by adding a subdivision to read: 
206.10     Subd. 9.  [EVALUATION.] The commission, in consultation 
206.11  with the commissioner of human services, shall conduct an 
206.12  evaluation of the alternative quality assurance system, and 
206.13  present a report to the commissioner by June 30, 2004. 
206.14     Sec. 57.  Minnesota Statutes 2000, section 256B.0952, 
206.15  subdivision 1, is amended to read: 
206.16     Subdivision 1.  [NOTIFICATION.] By January 15, 1998, each 
206.17  affected county shall notify the commission and the 
206.18  commissioners of human services and health as to whether it 
206.19  chooses to implement on July 1, 1998, the alternative licensing 
206.20  system for the pilot project.  A county that does not implement 
206.21  the alternative licensing system on July 1, 1998, may give 
206.22  notice to the commission and the commissioners by January 15, 
206.23  1999, or January 15, 2000, that it will implement the 
206.24  alternative licensing system on the following July 1.  A county 
206.25  that implements the alternative licensing system commits to 
206.26  participate until June 30, 2001.  For each year of the project, 
206.27  region 10 counties shall give notice to the commission and 
206.28  commissioners of human services and health by March 15 of intent 
206.29  to join the quality assurance alternative licensing system, 
206.30  effective July 1 of that year.  A county choosing to participate 
206.31  in the alternative licensing system commits to participate until 
206.32  June 30, 2005.  Counties participating in the quality assurance 
206.33  alternative licensing system as of January 1, 2001, shall notify 
206.34  the commission and the commissioners of human services and 
206.35  health by March 15, 2001, of intent to continue participation.  
206.36  Counties that elect to continue participation must participate 
207.1   in the alternative licensing system until June 30, 2005. 
207.2      Sec. 58.  Minnesota Statutes 2000, section 256B.0952, 
207.3   subdivision 4, is amended to read: 
207.4      Subd. 4.  [APPOINTMENT OF QUALITY ASSURANCE MANAGER.] (a) A 
207.5   county or group of counties that chooses to participate in the 
207.6   alternative licensing system shall designate a quality assurance 
207.7   manager and shall establish quality assurance teams in 
207.8   accordance with subdivision 5.  The manager shall recruit, 
207.9   train, and assign duties to the quality assurance team members.  
207.10  In assigning team members to conduct the quality assurance 
207.11  process at a facility, program, or service, the manager shall 
207.12  take into account the size of the service provider, the number 
207.13  of services to be reviewed, the skills necessary for team 
207.14  members to complete the process, and other relevant factors.  
207.15  The manager shall ensure that no team member has a financial, 
207.16  personal, or family relationship with the facility, program, or 
207.17  service being reviewed or with any clients of the facility, 
207.18  program, or service. 
207.19     (b) Quality assurance teams shall report the findings of 
207.20  their quality assurance reviews to the quality assurance manager.
207.21  The quality assurance manager shall provide the report from the 
207.22  quality assurance team to the county and, upon request, to the 
207.23  commissioners of human services and health, and shall provide a 
207.24  summary of the report to the quality assurance review council.  
207.25     Sec. 59.  Minnesota Statutes 2000, section 256B.49, is 
207.26  amended by adding a subdivision to read: 
207.27     Subd. 11.  [AUTHORITY.] (a) The commissioner is authorized 
207.28  to apply for home and community-based service waivers, as 
207.29  authorized under section 1915(c) of the Social Security Act to 
207.30  serve persons under the age of 65 who are determined to require 
207.31  the level of care provided in a nursing home and persons who 
207.32  require the level of care provided in a hospital.  The 
207.33  commissioner shall apply for the home and community-based 
207.34  waivers in order to:  (i) promote the support of persons with 
207.35  disabilities in the most integrated settings; (ii) expand the 
207.36  availability of services for persons who are eligible for 
208.1   medical assistance; (iii) promote cost-effective options to 
208.2   institutional care; and (iv) obtain federal financial 
208.3   participation.  
208.4      (b) The provision of waivered services to medical 
208.5   assistance recipients with disabilities shall comply with the 
208.6   requirements outlined in the federally approved applications for 
208.7   home and community-based services and subsequent amendments, 
208.8   including provision of services according to a service plan 
208.9   designed to meet the needs of the individual.  For purposes of 
208.10  this section, the approved home and community-based application 
208.11  is considered the necessary federal requirement. 
208.12     (c) The commissioner shall provide interested persons 
208.13  serving on agency advisory committees and task forces, and 
208.14  others upon request, with notice of, and an opportunity to 
208.15  comment on, any changes or amendments to the federally approved 
208.16  applications for home and community-based waivers, prior to 
208.17  their submission to the federal health care financing 
208.18  administration. 
208.19     (d) The commissioner shall seek approval, as authorized 
208.20  under section 1915(c) of the Social Security Act, to allow 
208.21  medical assistance eligibility under this section for children 
208.22  under age 21 without deeming of parental income or assets. 
208.23     (e) The commissioner shall seek approval, as authorized 
208.24  under section 1915(c) of the Social Act, to allow medical 
208.25  assistance eligibility under this section for individuals under 
208.26  age 65 without deeming the spouse's income or assets. 
208.27     Sec. 60.  Minnesota Statutes 2000, section 256B.49, is 
208.28  amended by adding a subdivision to read: 
208.29     Subd. 12.  [INFORMED CHOICE.] Persons who are determined 
208.30  likely to require the level of care provided in a nursing 
208.31  facility or hospital shall be informed of the home and 
208.32  community-based support alternatives to the provision of 
208.33  inpatient hospital services or nursing facility services.  Each 
208.34  person must be given the choice of either institutional or home 
208.35  and community-based services, using the provisions described in 
208.36  section 256B.77, subdivision 2, paragraph (p). 
209.1      Sec. 61.  Minnesota Statutes 2000, section 256B.49, is 
209.2   amended by adding a subdivision to read: 
209.3      Subd. 13.  [CASE MANAGEMENT.] (a) Each recipient of a home 
209.4   and community-based waiver shall be provided case management 
209.5   services by qualified vendors as described in the federally 
209.6   approved waiver application.  The case management service 
209.7   activities provided will include: 
209.8      (1) assessing the needs of the individual within 20 working 
209.9   days of a recipient's request; 
209.10     (2) developing the written individual service plan within 
209.11  ten working days after the assessment is completed; 
209.12     (3) informing the recipient or the recipient's legal 
209.13  guardian or conservator of service options; 
209.14     (4) assisting the recipient in the identification of 
209.15  potential service providers; 
209.16     (5) assisting the recipient to access services; 
209.17     (6) coordinating, evaluating, and monitoring of the 
209.18  services identified in the service plan; 
209.19     (7) completing the annual reviews of the service plan; and 
209.20     (8) informing the recipient or legal representative of the 
209.21  right to have assessments completed and service plans developed 
209.22  within specified time periods, and to appeal county action or 
209.23  inaction under section 256.045, subdivision 3. 
209.24     (b) The case manager may delegate certain aspects of the 
209.25  case management service activities to another individual 
209.26  provided there is oversight by the case manager.  The case 
209.27  manager may not delegate those aspects which require 
209.28  professional judgment including assessments, reassessments, and 
209.29  care plan development. 
209.30     Sec. 62.  Minnesota Statutes 2000, section 256B.49, is 
209.31  amended by adding a subdivision to read: 
209.32     Subd. 14.  [ASSESSMENT AND REASSESSMENT.] (a) Assessments 
209.33  of each recipient's strengths, informal support systems, and 
209.34  need for services shall be completed within 20 working days of 
209.35  the recipient's request.  Reassessment of each recipient's 
209.36  strengths, support systems, and need for services shall be 
210.1   conducted at least every 12 months and at other times when there 
210.2   has been a significant change in the recipient's functioning. 
210.3      (b) Persons with mental retardation or a related condition 
210.4   who apply for services under the nursing facility level waiver 
210.5   programs shall be screened for the appropriate level of care 
210.6   according to section 256B.092. 
210.7      (c) Recipients who are found eligible for home and 
210.8   community-based services under this section before their 65th 
210.9   birthday may remain eligible for these services after their 65th 
210.10  birthday if they continue to meet all other eligibility factors. 
210.11     Sec. 63.  Minnesota Statutes 2000, section 256B.49, is 
210.12  amended by adding a subdivision to read: 
210.13     Subd. 15.  [INDIVIDUALIZED SERVICE PLAN.] Each recipient of 
210.14  home and community-based waivered services shall be provided a 
210.15  copy of the written service plan which: 
210.16     (1) is developed and signed by the recipient within ten 
210.17  working days of the completion of the assessment; 
210.18     (2) meets the assessed needs of the recipient; 
210.19     (3) reasonably ensures the health and safety of the 
210.20  recipient; 
210.21     (4) promotes independence; 
210.22     (5) allows for services to be provided in the most 
210.23  integrated settings; and 
210.24     (6) provides for an informed choice, as defined in section 
210.25  256B.77, subdivision 2, paragraph (p), of service and support 
210.26  providers. 
210.27     Sec. 64.  Minnesota Statutes 2000, section 256B.49, is 
210.28  amended by adding a subdivision to read: 
210.29     Subd. 16.  [SERVICES AND SUPPORTS.] (a) Services and 
210.30  supports included in the home and community-based waivers for 
210.31  persons with disabilities shall meet the requirements set out in 
210.32  United States Code, title 42, section 1396n.  The services and 
210.33  supports, which are offered as alternatives to institutional 
210.34  care, shall promote consumer choice, community inclusion, 
210.35  self-sufficiency, and self-determination. 
210.36     (b) Beginning January 1, 2003, the commissioner shall 
211.1   simplify and improve access to home and community-based waivered 
211.2   services, to the extent possible, through the establishment of a 
211.3   common service menu that is available to eligible recipients 
211.4   regardless of age, disability type, or waiver program. 
211.5      (c) Consumer directed community support services shall be 
211.6   offered as an option to all persons eligible for services under 
211.7   section 256B.49, subdivision 11, by January 1, 2002. 
211.8      (d) Services and supports shall be arranged and provided 
211.9   consistent with individualized written plans of care for 
211.10  eligible waiver recipients. 
211.11     (e) The state of Minnesota and county agencies that 
211.12  administer home and community-based waivered services for 
211.13  persons with disabilities, shall not be liable for damages, 
211.14  injuries, or liabilities sustained through the purchase of 
211.15  supports by the individual, the individual's family, or the 
211.16  authorized representative with funds received through the 
211.17  consumer-directed community support service under this section.  
211.18  Liabilities include but are not limited to:  workers' 
211.19  compensation liability, the Federal Insurance Contributions Act 
211.20  (FICA), or the Federal Unemployment Tax Act (FUTA). 
211.21     Sec. 65.  Minnesota Statutes 2000, section 256B.49, is 
211.22  amended by adding a subdivision to read: 
211.23     Subd. 17.  [COST OF SERVICES AND SUPPORTS.] (a) The 
211.24  commissioner shall ensure that the average per capita 
211.25  expenditures estimated in any fiscal year for home and 
211.26  community-based waiver recipients does not exceed the average 
211.27  per capita expenditures that would have been made to provide 
211.28  institutional services for recipients in the absence of the 
211.29  waiver. 
211.30     (b) The commissioner shall implement on January 1, 2002, 
211.31  one or more aggregate, need-based methods for allocating to 
211.32  local agencies the home and community-based waivered service 
211.33  resources available to support recipients with disabilities in 
211.34  need of the level of care provided in a nursing facility or a 
211.35  hospital.  The commissioner shall allocate resources to single 
211.36  counties and county partnerships in a manner that reflects 
212.1   consideration of: 
212.2      (1) an incentive-based payment process for achieving 
212.3   outcomes; 
212.4      (2) the need for a state-level risk pool; 
212.5      (3) the need for retention of management responsibility at 
212.6   the state agency level; and 
212.7      (4) a phase-in strategy as appropriate. 
212.8      (c) Until the allocation methods described in paragraph (b) 
212.9   are implemented, the annual allowable reimbursement level of 
212.10  home and community-based waiver services shall be the greater of:
212.11     (1) the statewide average payment amount which the 
212.12  recipient is assigned under the waiver reimbursement system in 
212.13  place on June 30, 2001, modified by the percentage of any 
212.14  provider rate increase appropriated for home and community-based 
212.15  services; or 
212.16     (2) an amount approved by the commissioner based on the 
212.17  recipient's extraordinary needs that cannot be met within the 
212.18  current allowable reimbursement level.  The increased 
212.19  reimbursement level must be necessary to allow the recipient to 
212.20  be discharged from an institution or to prevent imminent 
212.21  placement in an institution.  The additional reimbursement may 
212.22  be used to secure environmental modifications; assistive 
212.23  technology and equipment; and increased costs for supervision, 
212.24  training, and support services necessary to address the 
212.25  recipient's extraordinary needs.  The commissioner may approve 
212.26  an increased reimbursement level for up to one year of the 
212.27  recipient's relocation from an institution or up to six months 
212.28  of a determination that a current waiver recipient is at 
212.29  imminent risk of being placed in an institution. 
212.30     (d) Beginning July 1, 2001, medically necessary private 
212.31  duty nursing services will be authorized under this section as 
212.32  complex and regular care according to section 256B.0627. 
212.33     Sec. 66.  Minnesota Statutes 2000, section 256B.49, is 
212.34  amended by adding a subdivision to read: 
212.35     Subd. 18.  [PAYMENTS.] The commissioner shall reimburse 
212.36  approved vendors from the medical assistance account for the 
213.1   costs of providing home and community-based services to eligible 
213.2   recipients using the invoice processing procedures of the 
213.3   Medicaid management information system (MMIS).  Recipients will 
213.4   be screened and authorized for services according to the 
213.5   federally approved waiver application and its subsequent 
213.6   amendments. 
213.7      Sec. 67.  Minnesota Statutes 2000, section 256B.49, is 
213.8   amended by adding a subdivision to read: 
213.9      Subd. 19.  [HEALTH AND WELFARE.] The commissioner of human 
213.10  services shall take the necessary safeguards to protect the 
213.11  health and welfare of individuals provided services under the 
213.12  waiver. 
213.13     Sec. 68.  Minnesota Statutes 2000, section 256B.49, is 
213.14  amended by adding a subdivision to read: 
213.15     Subd. 20.  [TRAUMATIC BRAIN INJURY AND RELATED CONDITIONS.] 
213.16  The commissioner shall seek to amend the traumatic brain injury 
213.17  waiver to include, as eligible persons, individuals with an 
213.18  acquired or degenerative disease diagnosis where cognitive 
213.19  impairment is present, such as multiple sclerosis. 
213.20     Sec. 69.  Minnesota Statutes 2000, section 256B.69, 
213.21  subdivision 23, is amended to read: 
213.22     Subd. 23.  [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES; 
213.23  ELDERLY AND DISABLED PERSONS.] (a) The commissioner may 
213.24  implement demonstration projects to create alternative 
213.25  integrated delivery systems for acute and long-term care 
213.26  services to elderly persons and persons with disabilities as 
213.27  defined in section 256B.77, subdivision 7a, that provide 
213.28  increased coordination, improve access to quality services, and 
213.29  mitigate future cost increases.  The commissioner may seek 
213.30  federal authority to combine Medicare and Medicaid capitation 
213.31  payments for the purpose of such demonstrations.  Medicare funds 
213.32  and services shall be administered according to the terms and 
213.33  conditions of the federal waiver and demonstration provisions.  
213.34  For the purpose of administering medical assistance funds, 
213.35  demonstrations under this subdivision are subject to 
213.36  subdivisions 1 to 22.  The provisions of Minnesota Rules, parts 
214.1   9500.1450 to 9500.1464, apply to these demonstrations, with the 
214.2   exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, 
214.3   subpart 1, items B and C, which do not apply to persons 
214.4   enrolling in demonstrations under this section.  An initial open 
214.5   enrollment period may be provided.  Persons who disenroll from 
214.6   demonstrations under this subdivision remain subject to 
214.7   Minnesota Rules, parts 9500.1450 to 9500.1464.  When a person is 
214.8   enrolled in a health plan under these demonstrations and the 
214.9   health plan's participation is subsequently terminated for any 
214.10  reason, the person shall be provided an opportunity to select a 
214.11  new health plan and shall have the right to change health plans 
214.12  within the first 60 days of enrollment in the second health 
214.13  plan.  Persons required to participate in health plans under 
214.14  this section who fail to make a choice of health plan shall not 
214.15  be randomly assigned to health plans under these demonstrations. 
214.16  Notwithstanding section 256L.12, subdivision 5, and Minnesota 
214.17  Rules, part 9505.5220, subpart 1, item A, if adopted, for the 
214.18  purpose of demonstrations under this subdivision, the 
214.19  commissioner may contract with managed care organizations, 
214.20  including counties, to serve only elderly persons eligible for 
214.21  medical assistance, elderly and disabled persons, or disabled 
214.22  persons only.  For persons with primary diagnoses of mental 
214.23  retardation or a related condition, serious and persistent 
214.24  mental illness, or serious emotional disturbance, the 
214.25  commissioner must ensure that the county authority has approved 
214.26  the demonstration and contracting design.  Enrollment in these 
214.27  projects for persons with disabilities shall be voluntary until 
214.28  July 1, 2001.  The commissioner shall not implement any 
214.29  demonstration project under this subdivision for persons with 
214.30  primary diagnoses of mental retardation or a related condition, 
214.31  serious and persistent mental illness, or serious emotional 
214.32  disturbance, without approval of the county board of the county 
214.33  in which the demonstration is being implemented. 
214.34     Before implementation of a demonstration project for 
214.35  disabled persons, the commissioner must provide information to 
214.36  appropriate committees of the house of representatives and 
215.1   senate and must involve representatives of affected disability 
215.2   groups in the design of the demonstration projects. 
215.3      (b) A nursing facility reimbursed under the alternative 
215.4   reimbursement methodology in section 256B.434 may, in 
215.5   collaboration with a hospital, clinic, or other health care 
215.6   entity provide services under paragraph (a).  The commissioner 
215.7   shall amend the state plan and seek any federal waivers 
215.8   necessary to implement this paragraph. 
215.9      Sec. 70.  Minnesota Statutes 2000, section 256D.35, is 
215.10  amended by adding a subdivision to read: 
215.11     Subd. 11a.  [INSTITUTION.] "Institution" means:  a 
215.12  hospital, consistent with Code of Federal Regulations, title 42, 
215.13  section 440.10; regional treatment center inpatient services; a 
215.14  nursing facility; and an intermediate care facility for persons 
215.15  with mental retardation. 
215.16     Sec. 71.  Minnesota Statutes 2000, section 256D.35, is 
215.17  amended by adding a subdivision to read: 
215.18     Subd. 18a.  [SHELTER COSTS.] "Shelter costs" means:  rent, 
215.19  manufactured home lot rentals; monthly principal, interest, 
215.20  insurance premiums, and property taxes due for mortgages or 
215.21  contract for deed costs; costs for utilities, including heating, 
215.22  cooling, electricity, water, and sewerage; garbage collection 
215.23  fees; and the basic service fee for one telephone. 
215.24     Sec. 72.  Minnesota Statutes 2000, section 256D.44, 
215.25  subdivision 5, is amended to read: 
215.26     Subd. 5.  [SPECIAL NEEDS.] In addition to the state 
215.27  standards of assistance established in subdivisions 1 to 4, 
215.28  payments are allowed for the following special needs of 
215.29  recipients of Minnesota supplemental aid who are not residents 
215.30  of a nursing home, a regional treatment center, or a group 
215.31  residential housing facility. 
215.32     (a) The county agency shall pay a monthly allowance for 
215.33  medically prescribed diets payable under the Minnesota family 
215.34  investment program if the cost of those additional dietary needs 
215.35  cannot be met through some other maintenance benefit.  
215.36     (b) Payment for nonrecurring special needs must be allowed 
216.1   for necessary home repairs or necessary repairs or replacement 
216.2   of household furniture and appliances using the payment standard 
216.3   of the AFDC program in effect on July 16, 1996, for these 
216.4   expenses, as long as other funding sources are not available.  
216.5      (c) A fee for guardian or conservator service is allowed at 
216.6   a reasonable rate negotiated by the county or approved by the 
216.7   court.  This rate shall not exceed five percent of the 
216.8   assistance unit's gross monthly income up to a maximum of $100 
216.9   per month.  If the guardian or conservator is a member of the 
216.10  county agency staff, no fee is allowed. 
216.11     (d) The county agency shall continue to pay a monthly 
216.12  allowance of $68 for restaurant meals for a person who was 
216.13  receiving a restaurant meal allowance on June 1, 1990, and who 
216.14  eats two or more meals in a restaurant daily.  The allowance 
216.15  must continue until the person has not received Minnesota 
216.16  supplemental aid for one full calendar month or until the 
216.17  person's living arrangement changes and the person no longer 
216.18  meets the criteria for the restaurant meal allowance, whichever 
216.19  occurs first. 
216.20     (e) A fee of ten percent of the recipient's gross income or 
216.21  $25, whichever is less, is allowed for representative payee 
216.22  services provided by an agency that meets the requirements under 
216.23  SSI regulations to charge a fee for representative payee 
216.24  services.  This special need is available to all recipients of 
216.25  Minnesota supplemental aid regardless of their living 
216.26  arrangement.  
216.27     (f) Notwithstanding the language in this subdivision, an 
216.28  amount equal to the maximum allotment authorized by the federal 
216.29  Food Stamp Program for a single individual which is in effect on 
216.30  the first day of January of the previous year will be added to 
216.31  the standards of assistance established in subdivisions 1 to 4 
216.32  for individuals under the age of 65 who are relocating from an 
216.33  institution and who are shelter needy.  An eligible individual 
216.34  who receives this benefit prior to age 65 may continue to 
216.35  receive the benefit after the age of 65. 
216.36     "Shelter needy" means that the assistance unit incurs 
217.1   monthly shelter costs that exceed 40 percent of the assistance 
217.2   unit's gross income before the application of this special needs 
217.3   standard.  "Gross income" for the purposes of this section is 
217.4   the applicant's or recipient's income as defined in section 
217.5   256D.35, subdivision 10, or the standard specified in 
217.6   subdivision 3, whichever is greater.  A recipient of a federal 
217.7   or state housing subsidy, that limits shelter costs to a 
217.8   percentage of gross income, shall not be considered shelter 
217.9   needy for purposes of this paragraph. 
217.10     Sec. 73.  Minnesota Statutes 2000, section 256I.05, 
217.11  subdivision 1e, is amended to read: 
217.12     Subd. 1e.  [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.] 
217.13  Notwithstanding the provisions of subdivisions 1a and 1c, 
217.14  beginning July 1, 1999 2001, a county agency shall negotiate a 
217.15  supplementary rate in addition to the rate specified in 
217.16  subdivision 1, equal to 25 125 percent of the amount specified 
217.17  in subdivision 1a, including any legislatively authorized 
217.18  inflationary adjustments, for a group residential housing 
217.19  provider that: 
217.20     (1) is located in Hennepin county and has had a group 
217.21  residential housing contract with the county since June 1996; 
217.22     (2) operates in three separate locations a 56-bed 71-bed 
217.23  facility, a and two 40-bed facility, and a 30-bed facility 
217.24  facilities; and 
217.25     (3) serves a chemically dependent clientele, providing 24 
217.26  hours per day supervision and limiting a resident's maximum 
217.27  length of stay to 13 months out of a consecutive 24-month period.
217.28     Sec. 74.  [256I.07] [RESPITE CARE PILOT PROJECT FOR FAMILY 
217.29  ADULT FOSTER CARE PROVIDERS.] 
217.30     Subdivision 1.  [PROGRAM ESTABLISHED.] The state recognizes 
217.31  the importance of developing and maintaining quality family 
217.32  foster care resources.  In order to accomplish that goal, the 
217.33  commissioner shall establish a two-year respite care pilot 
217.34  project for family adult foster care providers in three 
217.35  counties.  This pilot project is intended to provide support to 
217.36  caregivers of adult foster care residents.  The commissioner 
218.1   shall establish a pilot project to accomplish the provisions in 
218.2   subdivisions 2 to 4. 
218.3      Subd. 2.  [ELIGIBILITY.] A family adult foster care home 
218.4   provider as defined under section 144D.01, subdivision 7, who 
218.5   has been licensed for six months is eligible for 30 days of 
218.6   respite care per calendar year.  In cases of emergency, a county 
218.7   social services agency may waive the six-month licensing 
218.8   requirement.  In order to be eligible to receive respite payment 
218.9   from group residential housing and alternative care, a provider 
218.10  must take time off away from their foster care residents.  
218.11     Subd. 3.  [PAYMENT STRUCTURE.] (a) The payment for respite 
218.12  care for an adult foster care resident eligible for only group 
218.13  residential housing shall be based on the current monthly group 
218.14  residential housing base room and board rate and the current 
218.15  maximum monthly group residential housing difficulty of care 
218.16  rate. 
218.17     (b) The payment for respite care for an adult foster care 
218.18  resident eligible for alternative care funds shall be based on 
218.19  the resident's alternative care foster care rate. 
218.20     (c) The payment for respite care for an adult foster care 
218.21  resident eligible for Medicaid home and community-based services 
218.22  waiver funds shall be based on the group residential housing 
218.23  base room and board rate. 
218.24     (d) The total amount available to pay for respite care for 
218.25  a family adult foster care provider shall be based on the number 
218.26  of residents currently served in the foster care home and the 
218.27  source of funding used to pay for each resident's foster care.  
218.28  Respite care must be paid for on a per diem basis and for a full 
218.29  day. 
218.30     Subd. 4.  [PRIVATE PAY RESIDENTS.] Payment for respite care 
218.31  for private pay foster care residents must be arranged between 
218.32  the provider and the resident or the resident's family. 
218.33     Sec. 75.  Laws 1999, chapter 152, section 1, is amended to 
218.34  read: 
218.35     Section 1.  [TASK FORCE.] 
218.36     A day training and habilitation task force is established.  
219.1   Task force membership shall consist of representatives of the 
219.2   commissioner of human services, counties, service consumers, and 
219.3   vendors of day training and habilitation as defined in Minnesota 
219.4   Statutes, section 252.41, subdivision 9, including at least one 
219.5   representative from each association representing day training 
219.6   and habilitation vendors.  Appointments to the task force shall 
219.7   be made by the commissioner of human services and technical 
219.8   assistance shall be provided by the department of human services.
219.9      Sec. 76.  Laws 1999, chapter 152, section 4, is amended to 
219.10  read: 
219.11     Sec. 4.  [REPORT.] 
219.12     The task force shall present a report recommending a new 
219.13  payment rate structure to the legislature by January 15, 2000, 
219.14  and shall make recommendations to the commissioner of human 
219.15  services regarding the implementation of the pilot project for 
219.16  the individualized payment rate structure, so the pilot project 
219.17  can be implemented by July 1, 2002, as required in section 3.  
219.18  The task force expires on March 15, 2000 December 30, 2003. 
219.19     Sec. 77.  [DAY TRAINING AND HABILITATION PAYMENT STRUCTURE 
219.20  PILOT PROJECT.] 
219.21     Subdivision 1.  [INDIVIDUALIZED PAYMENT RATE 
219.22  STRUCTURE.] Notwithstanding Minnesota Statutes, sections 
219.23  252.451, subdivision 5; and 252.46; and Minnesota Rules, part 
219.24  9525.1290, subpart 1, items A and B, the commissioner of human 
219.25  services shall initiate a pilot project and phase-in for the 
219.26  individualized payment rate structure described in this section 
219.27  and section 74.  The pilot project shall include actual 
219.28  transfers of funds, not simulated transfers.  The pilot project 
219.29  may include all or some of the vendors in up to eight counties, 
219.30  with no more than two counties from the seven-county 
219.31  Minneapolis-St. Paul metropolitan area.  Following initiation of 
219.32  the pilot project, the commissioner shall phase in 
219.33  implementation of the individualized payment rate structure to 
219.34  the remaining counties and vendors according to the 
219.35  implementation plan developed by the task force.  The pilot and 
219.36  phase-in shall not extend over more than 18 months and shall be 
220.1   completed by December 31, 2003.  
220.2      Subd. 2.  [SUNSET.] The pilot project shall sunset upon 
220.3   implementation of a new statewide rate structure according to 
220.4   the implementation plan developed by the task force described in 
220.5   subdivision 3, in its report to the legislature on December 1, 
220.6   2001.  The rates of vendors participating in the pilot project 
220.7   must be modified to be consistent with the new statewide rate 
220.8   structure, as implemented. 
220.9      Subd. 3.  [TASK FORCE RESPONSIBILITIES.] The day training 
220.10  and habilitation task force established under Laws 1999, chapter 
220.11  152, section 4, shall evaluate the pilot project authorized 
220.12  under subdivision 1, and by December 1, 2001, shall report to 
220.13  the legislature with an implementation plan, which shall address 
220.14  how and when the pilot project individualized payment rate 
220.15  structure will be implemented statewide, shall ensure that 
220.16  vendors that wish to maintain their current per diem rate may do 
220.17  so within the new payment system, and shall identify criteria 
220.18  that would halt statewide implementation if vendors or clients 
220.19  were adversely affected by the new payment rate structure, and 
220.20  with recommendations for any amendments that should be made 
220.21  before statewide implementation.  These recommendations shall be 
220.22  made in a report to the chairs of the house health and human 
220.23  services policy and finance committees and the senate health and 
220.24  family security committee and finance division. 
220.25     Subd. 4.  [RATE SETTING.] (a) The rate structure under this 
220.26  section is intended to allow a county to authorize an individual 
220.27  rate for each client in the vendor's program based on the needs 
220.28  and expected outcomes of the individual client.  Rates shall be 
220.29  based on an authorized package of services for each individual 
220.30  over a typical time frame.  Rates may be established across 
220.31  multiple sites run by a single vendor. 
220.32     (b) With county concurrence, a vendor shall establish up to 
220.33  four levels of service, A through D, based on the intensity of 
220.34  services provided to an individual client of day training and 
220.35  habilitation services.  Service level A shall be the highest 
220.36  intensity of services, marked primarily, but not exclusively, by 
221.1   a one-to-one client-to-staff ratio.  Service level D shall be 
221.2   the lowest intensity of services.  The county shall document the 
221.3   vendor's description of the type and amount of services 
221.4   associated with each service level. 
221.5      (c) For each vendor, a county board shall establish a 
221.6   dollar value for one hour of service at each of the service 
221.7   levels defined in paragraph (b).  In establishing these values 
221.8   for existing vendors transitioning from the payment rate 
221.9   structure under Minnesota Statutes, section 252.46, subdivision 
221.10  1, the county board shall follow the formula and guidelines 
221.11  developed by the day training and habilitation task force under 
221.12  paragraph (e). 
221.13     (d) A vendor may elect to maintain a single transportation 
221.14  rate or may elect to establish up to five types of 
221.15  transportation services:  public transportation, public special 
221.16  transportation, nonambulatory transportation, out-of-service 
221.17  area transportation, and ambulatory transportation.  For vendors 
221.18  that elect to establish multiple transportation services, the 
221.19  county board shall establish a dollar value for a round trip on 
221.20  each type of transportation service offered through the vendor.  
221.21  With vendor concurrence, the county may also establish a uniform 
221.22  one-way trip value for some or all of the transportation service 
221.23  types. 
221.24     (e) The county board shall ensure that the vendor 
221.25  translates the vendor's existing program and transportation 
221.26  rates to the rates and values in the pilot project by using the 
221.27  conversion calculations for services and transportation approved 
221.28  by the day training and habilitation task force established 
221.29  under Laws 1999, chapter 152, and included in the task force's 
221.30  recommendations to the legislature.  The conversion calculation 
221.31  may be amended by the task force with the approval of the 
221.32  commissioner and any amendments shall become effective upon 
221.33  notification to the pilot project counties from the 
221.34  commissioner.  The calculation shall take the total 
221.35  reimbursement dollars available to the vendor and divide by the 
221.36  units of service expected at each service level and of each 
222.1   transportation type.  In determining the total reimbursement 
222.2   dollars available to a vendor, the vendor shall multiply the 
222.3   vendor's current per diem rate for both services and 
222.4   transportation, including any new rate increases, by the 
222.5   vendor's actual utilization for the year prior to implementation 
222.6   of the pilot project.  Vendors shall be allowed to allocate 
222.7   available reimbursement dollars between service and 
222.8   transportation before the vendor's service level and 
222.9   transportation values are calculated.  After translating its 
222.10  existing service and transportation rates to the service level 
222.11  and transportation values under the pilot, the vendor shall 
222.12  project its expected reimbursement income using the expected 
222.13  service and transportation packages for its existing clients, 
222.14  based on current service authorizations.  If the projected 
222.15  reimbursement income is less than the vendor would have received 
222.16  under the payment structure of Minnesota Statutes, section 
222.17  252.46, the vendor and the county, with the approval of the 
222.18  commissioner, shall adjust the vendor's service level and 
222.19  transportation values to eliminate the shortfall.  The 
222.20  commissioner shall report all adjustments to the day training 
222.21  and habilitation task force for consideration of possible 
222.22  modifications to the pilot project individualized payment rate 
222.23  structure.  
222.24     Subd. 5.  [INDIVIDUAL RATE AUTHORIZATION.] (a) As part of 
222.25  its annual authorization of services for each client under 
222.26  Minnesota Statutes, section 252.44, paragraph (a), clause (1), 
222.27  and Minnesota Rules, part 9525.0016, subpart 12, the county 
222.28  shall authorize and document a service package and a 
222.29  transportation package as follows: 
222.30     (1) the service package shall include the amount and type 
222.31  of services at each applicable service level to be provided to 
222.32  the client over a package period.  An individual client may 
222.33  receive services at multiple service levels over the course of 
222.34  the package period.  The service package rate shall be the sum 
222.35  of the amount of services at each level over the package period, 
222.36  multiplied by the dollar value for each service level; 
223.1      (2) the transportation package shall include the amount and 
223.2   type of transportation services to be provided to the client 
223.3   over the package period.  The transportation package rate shall 
223.4   be the sum of the amount of transportation services, multiplied 
223.5   by the dollar value associated with the type of transportation 
223.6   service authorized for the client; 
223.7      (3) the package period shall be established by the county, 
223.8   and may be one week, two weeks, or one month; and 
223.9      (4) the individual rate authorization may be reviewed and 
223.10  modified by the county at any time and must be reviewed and 
223.11  reauthorized by the county at least annually. 
223.12     (b) For vendors with rates established under this section, 
223.13  a service day under Minnesota Statutes, sections 245B.06 and 
223.14  252.44, includes any day in which a client receives any 
223.15  reimbursable service from a vendor or attends employment 
223.16  arranged by the vendor. 
223.17     Subd. 6.  [BILLING FOR SERVICES.] The vendor shall bill 
223.18  for, and shall be reimbursed for, the service package rate and 
223.19  transportation package rate for the package period as authorized 
223.20  by the county for each client in the vendor's program.  The 
223.21  length of the package period shall not affect the timing or 
223.22  frequency of vendors' submissions of claims for payment under 
223.23  the Medicaid Management Information System II (MMIS) or its 
223.24  successors. 
223.25     Subd. 7.  [NOTIFICATION OF CHANGE IN CLIENT NEEDS.] The 
223.26  vendor shall notify an individual client's case manager if the 
223.27  vendor has knowledge of a material change in the client's needs 
223.28  that may indicate a need for a change in service authorization.  
223.29  Factors that would require such notice include, but are not 
223.30  limited to, significant changes in medical status, residential 
223.31  placement, attendance patterns, behavioral needs, or skill 
223.32  functioning.  The vendor shall notify the case manager as soon 
223.33  as possible but no later than 30 calendar days after becoming 
223.34  aware of the change in needs.  The service authorization for the 
223.35  client shall not change until the county authorizes a new 
223.36  service and transportation package for the client in accordance 
224.1   with the provisions in Minnesota Statutes, section 256B.092. 
224.2      Sec. 78.  [COUNTY BOARD RESPONSIBILITIES.] 
224.3      For each vendor with rates established under section 73, 
224.4   the county board shall document the vendor's description of the 
224.5   type and amount of services associated with each service level, 
224.6   the vendor's service level values, the vendor's transportation 
224.7   values, and the package period that will be used to determine 
224.8   the rate for each individual client.  The county shall establish 
224.9   a package period of one week, two weeks, or one month. 
224.10     Sec. 79.  [STUDY OF DAY TRAINING AND HABILITATION VENDOR 
224.11  RATES.] 
224.12     The commissioner shall identify the vendors with the lowest 
224.13  rates or underfunded programs in the state and make 
224.14  recommendations to reconcile the discrepancies prior to the 
224.15  implementation of the individualized payment rate structure 
224.16  described in sections 73 and 74. 
224.17     Sec. 80.  [FEDERAL APPROVAL.] 
224.18     The commissioner shall seek any amendments to the state 
224.19  Medicaid plan and any waivers necessary to permit implementation 
224.20  of section 74 within the timelines specified. 
224.21     Sec. 81.  [SEMI-INDEPENDENT LIVING SERVICES (SILS) STUDY.] 
224.22     The commissioner of human services, in consultation with 
224.23  county representatives and other interested persons, shall 
224.24  develop recommendations revising the funding methodology for 
224.25  SILS as defined in Minnesota Statutes, section 252.275, 
224.26  subdivisions 3, 4, 4a, 4b, and 4c, and report by January 15, 
224.27  2002, to the chair of the house of representatives health and 
224.28  human services finance committee and the chairs of the senate 
224.29  health, human services, and corrections budget division. 
224.30     Sec. 82.  [WAIVER REQUEST REGARDING SPOUSAL INCOME.] 
224.31     By September 1, 2001, the commissioner of human services 
224.32  shall seek federal approval to allow recipients of home and 
224.33  community-based waivers authorized under Minnesota Statutes, 
224.34  section 256B.49, to choose either a waiver of deeming of spousal 
224.35  income or the spousal impoverishment protections authorized 
224.36  under United States Code, title 42, section 1396r-5, with the 
225.1   addition of the group residential housing rate set according to 
225.2   Minnesota Statutes, section 256I.03, subdivision 5, to the 
225.3   personal needs allowance authorized by Minnesota Statutes, 
225.4   section 256B.0575. 
225.5      Sec. 83.  [PROGRAM OPTIONS FOR CERTAIN PERSONS WITH 
225.6   DEVELOPMENTAL DISABILITIES.] 
225.7      (a) The commissioner of human services shall ensure that 
225.8   services continue to be available to persons with developmental 
225.9   disabilities who were covered by social services supplemental 
225.10  grants prior to July 1, 2001.  Services shall be provided in 
225.11  priority order as follows: 
225.12     (1) to the extent possible, the commissioner shall 
225.13  establish for these persons targeted slots under the home and 
225.14  community-based waivered services program for persons with 
225.15  mental retardation or related conditions; 
225.16     (2) persons accommodated under clause (1) shall, if 
225.17  eligible, receive room and board services through group 
225.18  residential housing under Minnesota Statutes, chapter 256I; and 
225.19     (3) any remaining persons shall continue to receive 
225.20  services through community social services supplemental grants 
225.21  to the affected counties. 
225.22     (b) This section applies only to individuals receiving 
225.23  services under social services supplemental grants as of June 
225.24  30, 2001. 
225.25     Sec. 84.  [FEDERAL APPROVAL.] 
225.26     The commissioner of human services, by September 1, 2001, 
225.27  shall request any federal approval and plan amendments necessary 
225.28  to implement the choice of case manager provision in section 
225.29  256B.092, subdivision 2a, paragraph (b). 
225.30     Sec. 85.  [FEDERAL WAIVER REQUESTS.] 
225.31     The commissioner of human services shall submit to the 
225.32  federal Health Care Financing Administration by September 1, 
225.33  2001, a request for a home and community-based services waiver 
225.34  for day services, including:  community inclusion, supported 
225.35  employment, and day training and habilitation services defined 
225.36  in Minnesota Statutes, section 252.41, subdivision 3, clause 
226.1   (1), for persons eligible for the waiver under Minnesota 
226.2   Statutes, section 256B.092. 
226.3      Sec. 86. [REPEALER.] 
226.4      (a) Minnesota Statutes 2000, sections 256B.0951, 
226.5   subdivision 6; and 256E.06, subdivision 2b, are repealed. 
226.6      (b) Minnesota Statutes 2000, sections 145.9245; 256.476, 
226.7   subdivision 7; 256B.0912; 256B.0915, subdivisions 3a, 3b, and 
226.8   3c; and 256B.49, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10, 
226.9   are repealed. 
226.10     (c) Laws 1995, chapter 178, article 2, section 48, 
226.11  subdivision 6, is repealed. 
226.12     (d) Minnesota Rules, parts 9505.2455; 9505.2458; 9505.2460; 
226.13  9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 
226.14  9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 
226.15  9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 
226.16  9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 
226.17  9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 
226.18  9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 
226.19  9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 
226.20  9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 
226.21  9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 
226.22  9505.3660; and 9505.3670, are repealed. 
226.23                             ARTICLE 4 
226.24                CONSUMER INFORMATION AND ASSISTANCE 
226.25                      AND COMMUNITY-BASED CARE 
226.26     Section 1.  [144A.35] [EXPANSION OF BED DISTRIBUTION STUDY 
226.27  AND CREATION OF CRITICAL ACCESS SITES.] 
226.28     Subdivision 1.  [OLDER ADULT SERVICES DISTRIBUTION 
226.29  STUDY.] The commissioner of health, in coordination with the 
226.30  commissioner of human services, shall monitor and analyze the 
226.31  distribution of older adult services, including, but not limited 
226.32  to, nursing home beds, senior housing, housing with services 
226.33  units, and home and community-based services in the different 
226.34  geographic areas of the state.  The study shall include an 
226.35  analysis of the impact of amendments to the nursing home 
226.36  moratorium law which would allow for transfers of nursing home 
227.1   beds within the state.  The commissioner of health shall submit 
227.2   to the legislature, beginning January 15, 2002, and each January 
227.3   15 thereafter, an assessment of the distribution of long-term 
227.4   health care services by geographic area, with particular 
227.5   attention to service deficits or problems, the designation of 
227.6   critical access service sites, and corrective action plans. 
227.7      Subd. 2.  [CRITICAL ACCESS SERVICE SITE.] "Critical access 
227.8   service site" shall include nursing homes, senior housing, 
227.9   housing with services, and home and community-based services 
227.10  that are certified by the state as necessary providers of health 
227.11  care services to a specific geographic area.  For purposes of 
227.12  this requirement, a "necessary provider of health care services" 
227.13  is a provider that is: 
227.14     (1) located more than 20 miles, defined as official mileage 
227.15  as reported by the Minnesota department of transportation, from 
227.16  the next nearest long-term health care provider; 
227.17     (2) the sole long-term health care provider in the county; 
227.18  or 
227.19     (3) a long-term health care provider located in a medically 
227.20  underserved area or health professional shortage area. 
227.21     Subd. 3.  [IDENTIFICATION OF CRITICAL ACCESS SERVICE 
227.22  SITES.] Based on the results of the analysis completed in 
227.23  subdivision 1, the commissioners of health and human services 
227.24  shall identify and designate long-term health care providers as 
227.25  critical access service sites. 
227.26     Subd. 4.  [CRITICAL ACCESS SERVICE SITES.] The commissioner 
227.27  of health, in consultation with the commissioner of human 
227.28  services, shall: 
227.29     (1) develop and implement specific waivers to regulations 
227.30  governing health care personnel scope of duties, physical plant 
227.31  requirements, and location of community-based services, to 
227.32  address critical access service site older adult service needs; 
227.33     (2) identify payment barriers to the continued operation of 
227.34  older adult services in critical access service sites, and 
227.35  provide recommendations on changes to reimbursement rates to 
227.36  facilitate the continued operation of these services. 
228.1      Sec. 2.  Minnesota Statutes 2000, section 256.973, is 
228.2   amended by adding a subdivision to read: 
228.3      Subd. 6.  [GRANTS FOR HOME-SHARING PROGRAMS.] Grants 
228.4   awarded for home-sharing programs under this section shall be 
228.5   awarded through a request for proposals process every two years 
228.6   according to criteria developed by the commissioner.  In 
228.7   awarding grants, the commissioner shall not give priority to an 
228.8   applicant solely because the applicant has previously received a 
228.9   grant under this section.  Nothing under this subdivision shall 
228.10  prohibit the commissioner from evaluating the performance of a 
228.11  home-sharing program receiving a grant under this section and 
228.12  allocating funds based on the evaluation. 
228.13     Sec. 3.  Minnesota Statutes 2000, section 256.975, is 
228.14  amended by adding a subdivision to read: 
228.15     Subd. 7.  [CONSUMER INFORMATION AND ASSISTANCE; SENIOR 
228.16  LINKAGE.] (a) The Minnesota board on aging shall operate a 
228.17  statewide information and assistance service to aid older 
228.18  Minnesotans and their families in making informed choices about 
228.19  long-term care options and health care benefits.  Language 
228.20  services to persons with limited English language skills may be 
228.21  made available.  The service, known as Senior LinkAge Line, must 
228.22  be available during business hours through a statewide toll-free 
228.23  number and must also be available through the Internet. 
228.24     (b) The service must assist older adults, caregivers, and 
228.25  providers in accessing information about choices in long-term 
228.26  care services that are purchased through private providers or 
228.27  available through public options.  The service must: 
228.28     (1) develop a comprehensive database that includes detailed 
228.29  listings in both consumer- and provider-oriented formats; 
228.30     (2) make the database accessible on the Internet and 
228.31  through other telecommunication and media-related tools; 
228.32     (3) link callers to interactive long-term care screening 
228.33  tools and make these tools available through the Internet by 
228.34  integrating the tools with the database; 
228.35     (4) develop community education materials with a focus on 
228.36  planning for long-term care and evaluating independent living, 
229.1   housing, and service options; 
229.2      (5) conduct an outreach campaign to assist older adults and 
229.3   their caregivers in finding information on the Internet and 
229.4   through other means of communication; 
229.5      (6) implement a messaging system for overflow callers and 
229.6   respond to these callers by the next business day; 
229.7      (7) link callers with county human services and other 
229.8   providers to receive more in-depth assistance and consultation 
229.9   related to long-term care options; and 
229.10     (8) link callers with quality profiles for nursing 
229.11  facilities and other providers developed by the commissioner of 
229.12  health. 
229.13     (c) The Minnesota board on aging shall conduct an 
229.14  evaluation of the effectiveness of the statewide information and 
229.15  assistance, and submit this evaluation to the legislature by 
229.16  December 1, 2002.  The evaluation must include an analysis of 
229.17  funding adequacy, gaps in service delivery, continuity in 
229.18  information between the service and identified linkages, and 
229.19  potential use of private funding to enhance the service. 
229.20     Sec. 4.  [256.9754] [COMMUNITY SERVICES DEVELOPMENT GRANTS 
229.21  PROGRAM.] 
229.22     Subdivision 1.  [DEFINITIONS.] For purposes of this 
229.23  section, the following terms have the meanings given. 
229.24     (a) "Community" means a town, township, city, or targeted 
229.25  neighborhood within a city, or a consortium of towns, townships, 
229.26  cities, or targeted neighborhoods within cities. 
229.27     (b) "Older adult services" means any services available 
229.28  under the elderly waiver program or alternative care grant 
229.29  programs; nursing facility services; transportation services; 
229.30  respite services; and other community-based services identified 
229.31  as necessary either to maintain lifestyle choices for older 
229.32  Minnesotans, or to promote independence. 
229.33     (c) "Older adult" refers to individuals 65 years of age and 
229.34  older. 
229.35     Subd. 2.  [CREATION.] The community services development 
229.36  grants program is created under the administration of the 
230.1   commissioner of human services.  
230.2      Subd. 3.  [PROVISION OF GRANTS.] The commissioner shall 
230.3   make grants available to communities, providers of older adult 
230.4   services identified in subdivision 1, or to a consortium of 
230.5   providers of older adult services, to establish older adult 
230.6   services.  Grants may be provided for capital and other costs 
230.7   including, but not limited to, start-up and training costs, 
230.8   equipment, and supplies related to older adult services or other 
230.9   residential or service alternatives to nursing facility care.  
230.10  Grants may also be made to renovate current buildings, provide 
230.11  transportation services, fund programs that would allow older 
230.12  adults or disabled individuals to stay in their own homes by 
230.13  sharing a home, fund programs that coordinate and manage formal 
230.14  and informal services to older adults in their homes to enable 
230.15  them to live as independently as possible in their own homes as 
230.16  an alternative to nursing home care, or expand state-funded 
230.17  programs in the area. 
230.18     Subd. 4.  [ELIGIBILITY.] Grants may be awarded only to 
230.19  communities and providers or to a consortium of providers that 
230.20  have a local match of 50 percent of the costs for the project in 
230.21  the form of donations, local tax dollars, in-kind donations, 
230.22  fundraising, or other local matches. 
230.23     Subd. 5.  [GRANT PREFERENCE.] The commissioner of human 
230.24  services may award grants to the extent grant funds are 
230.25  available and to the extent applications are approved by the 
230.26  commissioner.  Denial of approval of an application in one year 
230.27  does not preclude submission of an application in a subsequent 
230.28  year.  The maximum grant amount is limited to $750,000. 
230.29     Sec. 5.  Minnesota Statutes 2000, section 256B.0911, 
230.30  subdivision 1, is amended to read: 
230.31     Subdivision 1.  [PURPOSE AND GOAL.] (a) The purpose of the 
230.32  preadmission screening program long-term care consultation 
230.33  services is to assist persons with long-term or chronic care 
230.34  needs in making long-term care decisions and selecting options 
230.35  that meet their needs and reflect their preferences.  The 
230.36  availability of, and access to, information and other types of 
231.1   assistance is also intended to prevent or delay certified 
231.2   nursing facility placements by assessing applicants and 
231.3   residents and offering cost-effective alternatives appropriate 
231.4   for the person's needs and to provide transition assistance 
231.5   after admission.  Further, the goal of the program these 
231.6   services is to contain costs associated with unnecessary 
231.7   certified nursing facility admissions.  The commissioners of 
231.8   human services and health shall seek to maximize use of 
231.9   available federal and state funds and establish the broadest 
231.10  program possible within the funding available. 
231.11     (b) These services must be coordinated with services 
231.12  provided under sections 256.975, subdivision 7, and 256.9772, 
231.13  and with services provided by other public and private agencies 
231.14  in the community to offer a variety of cost-effective 
231.15  alternatives to persons with disabilities and elderly persons.  
231.16  The county agency providing long-term care consultation services 
231.17  shall encourage the use of volunteers from families, religious 
231.18  organizations, social clubs, and similar civic and service 
231.19  organizations to provide community-based services. 
231.20     Sec. 6.  Minnesota Statutes 2000, section 256B.0911, is 
231.21  amended by adding a subdivision to read: 
231.22     Subd. 1a.  [DEFINITIONS.] For purposes of this section, the 
231.23  following definitions apply: 
231.24     (a) "Long-term care consultation services" means: 
231.25     (1) providing information and education to the general 
231.26  public regarding availability of the services authorized under 
231.27  this section; 
231.28     (2) an intake process that provides access to the services 
231.29  described in this section; 
231.30     (3) assessment of the health, psychological, and social 
231.31  needs of referred individuals; 
231.32     (4) assistance in identifying services needed to maintain 
231.33  an individual in the least restrictive environment; 
231.34     (5) providing recommendations on cost-effective community 
231.35  services that are available to the individual; 
231.36     (6) development of an individual's community support plan; 
232.1      (7) providing information regarding eligibility for 
232.2   Minnesota health care programs; 
232.3      (8) preadmission screening to determine the need for a 
232.4   nursing facility level of care; 
232.5      (9) preliminary determination of Minnesota health care 
232.6   programs eligibility for individuals who need a nursing facility 
232.7   level of care, with appropriate referrals for final 
232.8   determination; 
232.9      (10) providing recommendations for nursing facility 
232.10  placement when there are no cost-effective community services 
232.11  available; and 
232.12     (11) assistance to transition people back to community 
232.13  settings after facility admission. 
232.14     (b) "Minnesota health care programs" means the medical 
232.15  assistance program under chapter 256B, the alternative care 
232.16  program under section 256B.0913, and the prescription drug 
232.17  program under section 256.955. 
232.18     Sec. 7.  Minnesota Statutes 2000, section 256B.0911, 
232.19  subdivision 3, is amended to read: 
232.20     Subd. 3.  [PERSONS RESPONSIBLE FOR CONDUCTING THE 
232.21  PREADMISSION SCREENING LONG-TERM CARE CONSULTATION TEAM.] (a) A 
232.22  local screening long-term care consultation team shall be 
232.23  established by the county board of commissioners.  Each local 
232.24  screening consultation team shall consist of screeners who are a 
232.25  at least one social worker and a at least one public health 
232.26  nurse from their respective county agencies.  The board may 
232.27  designate public health or social services as the lead agency 
232.28  for long-term care consultation services.  If a county does not 
232.29  have a public health nurse available, it may request approval 
232.30  from the commissioner to assign a county registered nurse with 
232.31  at least one year experience in home care to participate on the 
232.32  team.  The screening team members must confer regarding the most 
232.33  appropriate care for each individual screened.  Two or more 
232.34  counties may collaborate to establish a joint local screening 
232.35  consultation team or teams. 
232.36     (b) In assessing a person's needs, screeners shall have a 
233.1   physician available for consultation and shall consider the 
233.2   assessment of the individual's attending physician, if any.  The 
233.3   individual's physician shall be included if the physician 
233.4   chooses to participate.  Other personnel may be included on the 
233.5   team as deemed appropriate by the county agencies.  The team is 
233.6   responsible for providing long-term care consultation services 
233.7   to all persons located in the county who request the services, 
233.8   regardless of eligibility for Minnesota health care programs. 
233.9      Sec. 8.  Minnesota Statutes 2000, section 256B.0911, is 
233.10  amended by adding a subdivision to read: 
233.11     Subd. 3a.  [ASSESSMENT AND SUPPORT PLANNING.] (a) Persons 
233.12  requesting assessment, services planning, or other assistance 
233.13  intended to support community-based living must be visited by a 
233.14  long-term care consultation team within ten working days after 
233.15  the date on which an assessment was requested or recommended.  
233.16  Assessments must be conducted according to paragraphs (b) to (g).
233.17     (b) The county may utilize a team of either the social 
233.18  worker or public health nurse, or both, to conduct the 
233.19  assessment in a face-to-face interview.  The consultation team 
233.20  members must confer regarding the most appropriate care for each 
233.21  individual screened or assessed. 
233.22     (c) The long-term care consultation team must assess the 
233.23  health and social needs of the person, using an assessment form 
233.24  provided by the commissioner of human services. 
233.25     (d) The team must conduct the assessment in a face-to-face 
233.26  interview with the person being assessed and the person's legal 
233.27  representative, if applicable. 
233.28     (e) The team must provide the person, or the person's legal 
233.29  representative, with written recommendations for facility- or 
233.30  community-based services.  The team must document that the most 
233.31  cost-effective alternatives available were offered to the 
233.32  individual.  For purposes of this requirement, "cost-effective 
233.33  alternatives" means community services and living arrangements 
233.34  that cost the same as or less than nursing facility care. 
233.35     (f) If the person chooses to use community-based services, 
233.36  the team must provide the person or the person's legal 
234.1   representative with a written community support plan, regardless 
234.2   of whether the individual is eligible for Minnesota health care 
234.3   programs.  The person may request assistance in developing a 
234.4   community support plan without participating in a complete 
234.5   assessment. 
234.6      (g) The team must give the person receiving assessment or 
234.7   support planning, or the person's legal representative, 
234.8   materials supplied by the commissioner of human services 
234.9   containing the following information: 
234.10     (1) the purpose of preadmission screening and assessment; 
234.11     (2) information about Minnesota health care programs; 
234.12     (3) the person's freedom to accept or reject the 
234.13  recommendations of the team; 
234.14     (4) the person's right to confidentiality under the 
234.15  Minnesota Government Data Practices Act, chapter 13; and 
234.16     (5) the person's right to appeal the decision regarding the 
234.17  need for nursing facility level of care or the county's final 
234.18  decisions regarding public programs eligibility according to 
234.19  section 256.045, subdivision 3. 
234.20     Sec. 9.  Minnesota Statutes 2000, section 256B.0911, is 
234.21  amended by adding a subdivision to read: 
234.22     Subd. 3b.  [TRANSITION ASSISTANCE.] (a) A long-term care 
234.23  consultation team shall provide assistance to persons residing 
234.24  in a nursing facility, hospital, regional treatment center, or 
234.25  intermediate care facility for persons with mental retardation 
234.26  who request or are referred for such assistance.  Transition 
234.27  assistance must include assessment, community support plan 
234.28  development, referrals to Minnesota health care programs, and 
234.29  referrals to programs that provide assistance with housing. 
234.30     (b) The county shall develop transition processes with 
234.31  institutional social workers and discharge planners to ensure 
234.32  that: 
234.33     (1) persons admitted to facilities receive information 
234.34  about transition assistance that is available; 
234.35     (2) the assessment is completed for persons within ten 
234.36  working days of the date of request or recommendation for 
235.1   assessment; and 
235.2      (3) there is a plan for transition and follow-up for the 
235.3   individual's return to the community.  The plan must require 
235.4   notification of other local agencies when a person who may 
235.5   require assistance is screened by one county for admission to a 
235.6   facility located in another county. 
235.7      (c) If a person who is eligible for a Minnesota health care 
235.8   program is admitted to a nursing facility, the nursing facility 
235.9   must include a consultation team member or the case manager in 
235.10  the discharge planning process. 
235.11     Sec. 10.  Minnesota Statutes 2000, section 256B.0911, is 
235.12  amended by adding a subdivision to read: 
235.13     Subd. 4a.  [PREADMISSION SCREENING ACTIVITIES RELATED TO 
235.14  NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid 
235.15  certified nursing facilities, including certified boarding care 
235.16  facilities, must be screened prior to admission regardless of 
235.17  income, assets, or funding sources for nursing facility care, 
235.18  except as described in subdivision 4b.  The purpose of the 
235.19  screening is to determine the need for nursing facility level of 
235.20  care as described in paragraph (d) and to complete activities 
235.21  required under federal law related to mental illness and mental 
235.22  retardation as outlined in paragraph (b). 
235.23     (b) A person who has a diagnosis or possible diagnosis of 
235.24  mental illness, mental retardation, or a related condition must 
235.25  receive a preadmission screening before admission regardless of 
235.26  the exemptions outlined in subdivision 4b, paragraph (b), to 
235.27  identify the need for further evaluation and specialized 
235.28  services, unless the admission prior to screening is authorized 
235.29  by the local mental health authority or the local developmental 
235.30  disabilities case manager, or unless authorized by the county 
235.31  agency according to Public Law Number 100-508.  
235.32     The following criteria apply to the preadmission screening: 
235.33     (1) the county must use forms and criteria developed by the 
235.34  commissioner of human services to identify persons who require 
235.35  referral for further evaluation and determination of the need 
235.36  for specialized services; and 
236.1      (2) the evaluation and determination of the need for 
236.2   specialized services must be done by: 
236.3      (i) a qualified independent mental health professional, for 
236.4   persons with a primary or secondary diagnosis of a serious 
236.5   mental illness; or 
236.6      (ii) a qualified mental retardation professional, for 
236.7   persons with a primary or secondary diagnosis of mental 
236.8   retardation or related conditions.  For purposes of this 
236.9   requirement, a qualified mental retardation professional must 
236.10  meet the standards for a qualified mental retardation 
236.11  professional under Code of Federal Regulations, title 42, 
236.12  section 483.430. 
236.13     (c) The local county mental health authority or the state 
236.14  mental retardation authority under Public Laws Numbers 100-203 
236.15  and 101-508 may prohibit admission to a nursing facility if the 
236.16  individual does not meet the nursing facility level of care 
236.17  criteria or needs specialized services as defined in Public Laws 
236.18  Numbers 100-203 and 101-508.  For purposes of this section, 
236.19  "specialized services" for a person with mental retardation or a 
236.20  related condition means active treatment as that term is defined 
236.21  under Code of Federal Regulations, title 42, section 483.440, 
236.22  paragraph (a), clause (1). 
236.23     (d) The determination of the need for nursing facility 
236.24  level of care must be made according to criteria developed by 
236.25  the commissioner of human services.  In assessing a person's 
236.26  needs, consultation team members shall have a physician 
236.27  available for consultation and shall consider the assessment of 
236.28  the individual's attending physician, if any.  The individual's 
236.29  physician must be included if the physician chooses to 
236.30  participate.  Other personnel may be included on the team as 
236.31  deemed appropriate by the county. 
236.32     Sec. 11.  Minnesota Statutes 2000, section 256B.0911, is 
236.33  amended by adding a subdivision to read: 
236.34     Subd. 4b.  [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 
236.35  Exemptions from the federal screening requirements outlined in 
236.36  subdivision 4a, paragraphs (b) and (c), are limited to: 
237.1      (1) a person who, having entered an acute care facility 
237.2   from a certified nursing facility, is returning to a certified 
237.3   nursing facility; and 
237.4      (2) a person transferring from one certified nursing 
237.5   facility in Minnesota to another certified nursing facility in 
237.6   Minnesota. 
237.7      (b) Persons who are exempt from preadmission screening for 
237.8   purposes of level of care determination include: 
237.9      (1) persons described in paragraph (a); 
237.10     (2) an individual who has a contractual right to have 
237.11  nursing facility care paid for indefinitely by the veterans' 
237.12  administration; 
237.13     (3) an individual enrolled in a demonstration project under 
237.14  section 256B.69, subdivision 8, at the time of application to a 
237.15  nursing facility; 
237.16     (4) an individual currently being served under the 
237.17  alternative care program or under a home and community-based 
237.18  services waiver authorized under section 1915(c) of the federal 
237.19  Social Security Act; and 
237.20     (5) individuals admitted to a certified nursing facility 
237.21  for a short-term stay, which is expected to be 14 days or less 
237.22  in duration based upon a physician's certification, and who have 
237.23  been assessed and approved for nursing facility admission within 
237.24  the previous six months.  This exemption applies only if the 
237.25  consultation team member determines at the time of the initial 
237.26  assessment of the six-month period that it is appropriate to use 
237.27  the nursing facility for short-term stays and that there is an 
237.28  adequate plan of care for return to the home or community-based 
237.29  setting.  If a stay exceeds 14 days, the individual must be 
237.30  referred no later than the first county working day following 
237.31  the 14th resident day for a screening, which must be completed 
237.32  within five working days of the referral.  The payment 
237.33  limitations in subdivision 7 apply to an individual found at 
237.34  screening to not meet the level of care criteria for admission 
237.35  to a certified nursing facility. 
237.36     (c) Persons admitted to a Medicaid-certified nursing 
238.1   facility from the community on an emergency basis as described 
238.2   in paragraph (d) or from an acute care facility on a nonworking 
238.3   day must be screened the first working day after admission. 
238.4      (d) Emergency admission to a nursing facility prior to 
238.5   screening is permitted when all of the following conditions are 
238.6   met: 
238.7      (1) a person is admitted from the community to a certified 
238.8   nursing or certified boarding care facility during county 
238.9   nonworking hours; 
238.10     (2) a physician has determined that delaying admission 
238.11  until preadmission screening is completed would adversely affect 
238.12  the person's health and safety; 
238.13     (3) there is a recent precipitating event that precludes 
238.14  the client from living safely in the community, such as 
238.15  sustaining an injury, sudden onset of acute illness, or a 
238.16  caregiver's inability to continue to provide care; 
238.17     (4) the attending physician has authorized the emergency 
238.18  placement and has documented the reason that the emergency 
238.19  placement is recommended; and 
238.20     (5) the county is contacted on the first working day 
238.21  following the emergency admission. 
238.22  Transfer of a patient from an acute care hospital to a nursing 
238.23  facility is not considered an emergency except for a person who 
238.24  has received hospital services in the following situations: 
238.25  hospital admission for observation, care in an emergency room 
238.26  without hospital admission, or following hospital 24-hour bed 
238.27  care. 
238.28     Sec. 12.  Minnesota Statutes 2000, section 256B.0911, is 
238.29  amended by adding a subdivision to read: 
238.30     Subd. 4c.  [SCREENING REQUIREMENTS.] (a) A person may be 
238.31  screened for nursing facility admission by telephone or in a 
238.32  face-to-face screening interview.  Consultation team members 
238.33  shall identify each individual's needs using the following 
238.34  categories: 
238.35     (1) the person needs no face-to-face screening interview to 
238.36  determine the need for nursing facility level of care based on 
239.1   information obtained from other health care professionals; 
239.2      (2) the person needs an immediate face-to-face screening 
239.3   interview to determine the need for nursing facility level of 
239.4   care and complete activities required under subdivision 4a; or 
239.5      (3) the person may be exempt from screening requirements as 
239.6   outlined in subdivision 4b, but will need transitional 
239.7   assistance after admission or in-person follow-along after a 
239.8   return home. 
239.9      (b) Persons admitted on a nonemergency basis to a 
239.10  Medicaid-certified nursing facility must be screened prior to 
239.11  admission. 
239.12     (c) The long-term care consultation team shall recommend a 
239.13  case mix classification for persons admitted to a certified 
239.14  nursing facility when sufficient information is received to make 
239.15  that classification.  The nursing facility is authorized to 
239.16  conduct all case mix assessments for persons who have been 
239.17  screened prior to admission for whom the county did not 
239.18  recommend a case mix classification.  The nursing facility is 
239.19  authorized to conduct all case mix assessments for persons 
239.20  admitted to the facility prior to a preadmission screening.  The 
239.21  county retains the responsibility of distributing appropriate 
239.22  case mix forms to the nursing facility. 
239.23     (d) The county screening or intake activity must include 
239.24  processes to identify persons who may require transition 
239.25  assistance as described in subdivision 3b. 
239.26     Sec. 13.  Minnesota Statutes 2000, section 256B.0911, 
239.27  subdivision 5, is amended to read: 
239.28     Subd. 5.  [SIMPLIFICATION OF FORMS ADMINISTRATIVE 
239.29  ACTIVITY.] The commissioner shall minimize the number of forms 
239.30  required in the preadmission screening process provision of 
239.31  long-term care consultation services and shall limit the 
239.32  screening document to items necessary for care community support 
239.33  plan approval, reimbursement, program planning, evaluation, and 
239.34  policy development. 
239.35     Sec. 14.  Minnesota Statutes 2000, section 256B.0911, 
239.36  subdivision 6, is amended to read: 
240.1      Subd. 6.  [PAYMENT FOR PREADMISSION SCREENING LONG-TERM 
240.2   CARE CONSULTATION SERVICES.] (a) The total screening payment for 
240.3   each county must be paid monthly by certified nursing facilities 
240.4   in the county.  The monthly amount to be paid by each nursing 
240.5   facility for each fiscal year must be determined by dividing the 
240.6   county's annual allocation for screenings long-term care 
240.7   consultation services by 12 to determine the monthly payment and 
240.8   allocating the monthly payment to each nursing facility based on 
240.9   the number of licensed beds in the nursing facility.  Payments 
240.10  to counties in which there is no certified nursing facility must 
240.11  be made by increasing the payment rate of the two facilities 
240.12  located nearest to the county seat. 
240.13     (b) The commissioner shall include the total annual payment 
240.14  for screening determined under paragraph (a) for each nursing 
240.15  facility according to section 256B.431, subdivision 2b, 
240.16  paragraph (g), 256B.434, or 256B.435. 
240.17     (c) Payments for screening activities long-term care 
240.18  consultation services are available to the county or counties to 
240.19  cover staff salaries and expenses to provide the screening 
240.20  function services described in subdivision 1a.  The lead agency 
240.21  county shall employ, or contract with other agencies to employ, 
240.22  within the limits of available funding, sufficient personnel 
240.23  to conduct the preadmission screening activity provide long-term 
240.24  care consultation services while meeting the state's long-term 
240.25  care outcomes and objectives as defined in section 256B.0917, 
240.26  subdivision 1.  The local agency county shall be accountable for 
240.27  meeting local objectives as approved by the commissioner in the 
240.28  CSSA biennial plan. 
240.29     (d) Notwithstanding section 256B.0641, overpayments 
240.30  attributable to payment of the screening costs under the medical 
240.31  assistance program may not be recovered from a facility.  
240.32     (e) The commissioner of human services shall amend the 
240.33  Minnesota medical assistance plan to include reimbursement for 
240.34  the local screening consultation teams. 
240.35     (f) The county may bill, as case management services, 
240.36  assessments, support planning, and follow-along provided to 
241.1   persons determined to be eligible for case management under 
241.2   Minnesota health care programs.  No individual or family member 
241.3   shall be charged for an initial assessment or initial support 
241.4   plan development provided under subdivision 3a or 3b. 
241.5      Sec. 15.  Minnesota Statutes 2000, section 256B.0911, 
241.6   subdivision 7, is amended to read: 
241.7      Subd. 7.  [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 
241.8   (a) Medical assistance reimbursement for nursing facilities 
241.9   shall be authorized for a medical assistance recipient only if a 
241.10  preadmission screening has been conducted prior to admission or 
241.11  the local county agency has authorized an exemption.  Medical 
241.12  assistance reimbursement for nursing facilities shall not be 
241.13  provided for any recipient who the local screener has determined 
241.14  does not meet the level of care criteria for nursing facility 
241.15  placement or, if indicated, has not had a level II PASARR OBRA 
241.16  evaluation as required under the federal Omnibus Reconciliation 
241.17  Act of 1987 completed unless an admission for a recipient with 
241.18  mental illness is approved by the local mental health authority 
241.19  or an admission for a recipient with mental retardation or 
241.20  related condition is approved by the state mental retardation 
241.21  authority. 
241.22     (b) The nursing facility must not bill a person who is not 
241.23  a medical assistance recipient for resident days that preceded 
241.24  the date of completion of screening activities as required under 
241.25  subdivisions 4a, 4b, and 4c.  The nursing facility must include 
241.26  unreimbursed resident days in the nursing facility resident day 
241.27  totals reported to the commissioner. 
241.28     (c) The commissioner shall make a request to the health 
241.29  care financing administration for a waiver allowing screening 
241.30  team approval of Medicaid payments for certified nursing 
241.31  facility care.  An individual has a choice and makes the final 
241.32  decision between nursing facility placement and community 
241.33  placement after the screening team's recommendation, except as 
241.34  provided in paragraphs (b) and (c) subdivision 4a, paragraph (c).
241.35     (c) The local county mental health authority or the state 
241.36  mental retardation authority under Public Law Numbers 100-203 
242.1   and 101-508 may prohibit admission to a nursing facility, if the 
242.2   individual does not meet the nursing facility level of care 
242.3   criteria or needs specialized services as defined in Public Law 
242.4   Numbers 100-203 and 101-508.  For purposes of this section, 
242.5   "specialized services" for a person with mental retardation or a 
242.6   related condition means "active treatment" as that term is 
242.7   defined in Code of Federal Regulations, title 42, section 
242.8   483.440(a)(1). 
242.9      (e) Appeals from the screening team's recommendation or the 
242.10  county agency's final decision shall be made according to 
242.11  section 256.045, subdivision 3. 
242.12     Sec. 16.  Minnesota Statutes 2000, section 256B.0913, 
242.13  subdivision 1, is amended to read: 
242.14     Subdivision 1.  [PURPOSE AND GOALS.] The purpose of the 
242.15  alternative care program is to provide funding for or access to 
242.16  home and community-based services for frail elderly persons, in 
242.17  order to limit nursing facility placements.  The program is 
242.18  designed to support frail elderly persons in their desire to 
242.19  remain in the community as independently and as long as possible 
242.20  and to support informal caregivers in their efforts to provide 
242.21  care for frail elderly people.  Further, the goals of the 
242.22  program are: 
242.23     (1) to contain medical assistance expenditures by providing 
242.24  funding care in the community at a cost the same or less than 
242.25  nursing facility costs; and 
242.26     (2) to maintain the moratorium on new construction of 
242.27  nursing home beds. 
242.28     Sec. 17.  Minnesota Statutes 2000, section 256B.0913, 
242.29  subdivision 2, is amended to read: 
242.30     Subd. 2.  [ELIGIBILITY FOR SERVICES.] Alternative care 
242.31  services are available to all frail older Minnesotans.  This 
242.32  includes: 
242.33     (1) persons who are receiving medical assistance and served 
242.34  under the medical assistance program or the Medicaid waiver 
242.35  program; 
242.36     (2) persons age 65 or older who are not eligible for 
243.1   medical assistance without a spenddown or waiver obligation but 
243.2   who would be eligible for medical assistance within 180 days of 
243.3   admission to a nursing facility and served under subject to 
243.4   subdivisions 4 to 13; and 
243.5      (3) persons who are paying for their services out-of-pocket.
243.6      Sec. 18.  Minnesota Statutes 2000, section 256B.0913, 
243.7   subdivision 4, is amended to read: 
243.8      Subd. 4.  [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 
243.9   NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 
243.10  under the alternative care program is available to persons who 
243.11  meet the following criteria: 
243.12     (1) the person has been screened by the county screening 
243.13  team or, if previously screened and served under the alternative 
243.14  care program, assessed by the local county social worker or 
243.15  public health nurse determined by a community assessment under 
243.16  section 256B.0911, to be a person who would require the level of 
243.17  care provided in a nursing facility, but for the provision of 
243.18  services under the alternative care program; 
243.19     (2) the person is age 65 or older; 
243.20     (3) the person would be financially eligible for medical 
243.21  assistance within 180 days of admission to a nursing facility; 
243.22     (4) the person meets the asset transfer requirements of is 
243.23  not ineligible for the medical assistance program due to an 
243.24  asset transfer penalty; 
243.25     (5) the screening team would recommend nursing facility 
243.26  admission or continued stay for the person if alternative care 
243.27  services were not available; 
243.28     (6) the person needs services that are not available at 
243.29  that time in the county funded through other county, state, or 
243.30  federal funding sources; and 
243.31     (7) (6) the monthly cost of the alternative care services 
243.32  funded by the program for this person does not exceed 75 percent 
243.33  of the statewide average monthly medical assistance payment for 
243.34  nursing facility care at the individual's case mix 
243.35  classification weighted average monthly nursing facility rate of 
243.36  the case mix resident class to which the individual alternative 
244.1   care client would be assigned under Minnesota Rules, parts 
244.2   9549.0050 to 9549.0059, less the recipient's maintenance needs 
244.3   allowance as described in section 256B.0915, subdivision 1d, 
244.4   paragraph (a), until the first day of the state fiscal year in 
244.5   which the resident assessment system, under section 256B.437, 
244.6   for nursing home rate determination is implemented.  Effective 
244.7   on the first day of the state fiscal year in which a resident 
244.8   assessment system, under section 256B.437, for nursing home rate 
244.9   determination is implemented and the first day of each 
244.10  subsequent state fiscal year, the monthly cost of alternative 
244.11  care services for this person shall not exceed the alternative 
244.12  care monthly cap for the case mix resident class to which the 
244.13  alternative care client would be assigned under Minnesota Rules, 
244.14  parts 9549.0050 to 9549.0059, which was in effect on the last 
244.15  day of the previous state fiscal year, and adjusted by the 
244.16  greater of any legislatively adopted home and community-based 
244.17  services cost-of-living percentage increase or any legislatively 
244.18  adopted statewide percent rate increase for nursing facilities.  
244.19  This monthly limit does not prohibit the alternative care client 
244.20  from payment for additional services, but in no case may the 
244.21  cost of additional services purchased under this section exceed 
244.22  the difference between the client's monthly service limit 
244.23  defined under section 256B.0915, subdivision 3, and the 
244.24  alternative care program monthly service limit defined in this 
244.25  paragraph.  If medical supplies and equipment or adaptations 
244.26  environmental modifications are or will be purchased for an 
244.27  alternative care services recipient, the costs may be prorated 
244.28  on a monthly basis throughout the year in which they are 
244.29  purchased for up to 12 consecutive months beginning with the 
244.30  month of purchase.  If the monthly cost of a recipient's other 
244.31  alternative care services exceeds the monthly limit established 
244.32  in this paragraph, the annual cost of the alternative care 
244.33  services shall be determined.  In this event, the annual cost of 
244.34  alternative care services shall not exceed 12 times the monthly 
244.35  limit calculated described in this paragraph. 
244.36     (b) Individuals who meet the criteria in paragraph (a) and 
245.1   who have been approved for alternative care funding are called 
245.2   180-day eligible clients. 
245.3      (c) The statewide average payment for nursing facility care 
245.4   is the statewide average monthly nursing facility rate in effect 
245.5   on July 1 of the fiscal year in which the cost is incurred, less 
245.6   the statewide average monthly income of nursing facility 
245.7   residents who are age 65 or older and who are medical assistance 
245.8   recipients in the month of March of the previous fiscal year.  
245.9   This monthly limit does not prohibit the 180-day eligible client 
245.10  from paying for additional services needed or desired.  
245.11     (d) In determining the total costs of alternative care 
245.12  services for one month, the costs of all services funded by the 
245.13  alternative care program, including supplies and equipment, must 
245.14  be included. 
245.15     (e) Alternative care funding under this subdivision is not 
245.16  available for a person who is a medical assistance recipient or 
245.17  who would be eligible for medical assistance without a 
245.18  spenddown, unless authorized by the commissioner or waiver 
245.19  obligation.  A person whose initial application for medical 
245.20  assistance is being processed may be served under the 
245.21  alternative care program for a period up to 60 days.  If the 
245.22  individual is found to be eligible for medical assistance, the 
245.23  county must bill medical assistance must be billed for services 
245.24  payable under the federally approved elderly waiver plan and 
245.25  delivered from the date the individual was found eligible 
245.26  for services reimbursable under the federally approved elderly 
245.27  waiver program plan.  Notwithstanding this provision, upon 
245.28  federal approval, alternative care funds may not be used to pay 
245.29  for any service the cost of which is payable by medical 
245.30  assistance or which is used by a recipient to meet a medical 
245.31  assistance income spenddown or waiver obligation.  
245.32     (f) (c) Alternative care funding is not available for a 
245.33  person who resides in a licensed nursing home or, certified 
245.34  boarding care home, hospital, or intermediate care facility, 
245.35  except for case management services which are being provided in 
245.36  support of the discharge planning process to a nursing home 
246.1   resident or certified boarding care home resident who is 
246.2   ineligible for case management funded by medical assistance. 
246.3      Sec. 19.  Minnesota Statutes 2000, section 256B.0913, 
246.4   subdivision 5, is amended to read: 
246.5      Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
246.6   Alternative care funding may be used for payment of costs of: 
246.7      (1) adult foster care; 
246.8      (2) adult day care; 
246.9      (3) home health aide; 
246.10     (4) homemaker services; 
246.11     (5) personal care; 
246.12     (6) case management; 
246.13     (7) respite care; 
246.14     (8) assisted living; 
246.15     (9) residential care services; 
246.16     (10) care-related supplies and equipment; 
246.17     (11) meals delivered to the home; 
246.18     (12) transportation; 
246.19     (13) skilled nursing; 
246.20     (14) chore services; 
246.21     (15) companion services; 
246.22     (16) nutrition services; 
246.23     (17) training for direct informal caregivers; 
246.24     (18) telemedicine devices to monitor recipients in their 
246.25  own homes as an alternative to hospital care, nursing home care, 
246.26  or home visits; and 
246.27     (19) other services including which includes discretionary 
246.28  funds and direct cash payments to clients, approved by the 
246.29  county agency following approval by the commissioner, subject to 
246.30  the provisions of paragraph (m) (j).  Total annual payments for "
246.31  other services" for all clients within a county may not exceed 
246.32  either ten percent of that county's annual alternative care 
246.33  program base allocation or $5,000, whichever is greater.  In no 
246.34  case shall this amount exceed the county's total annual 
246.35  alternative care program base allocation; and 
246.36     (20) environmental modifications. 
247.1      (b) The county agency must ensure that the funds are not 
247.2   used only to supplement and not to supplant services available 
247.3   through other public assistance or services programs. 
247.4      (c) Unless specified in statute, the service definitions 
247.5   and standards for alternative care services shall be the same as 
247.6   the service definitions and standards defined specified in the 
247.7   federally approved elderly waiver plan.  Except for the county 
247.8   agencies' approval of direct cash payments to clients as 
247.9   described in paragraph (j) or for a provider of supplies and 
247.10  equipment when the monthly cost of the supplies and equipment is 
247.11  less than $250, persons or agencies must be employed by or under 
247.12  a contract with the county agency or the public health nursing 
247.13  agency of the local board of health in order to receive funding 
247.14  under the alternative care program.  Supplies and equipment may 
247.15  be purchased from a non-Medicaid certified vendor if the cost 
247.16  for the item is less than that of a Medicaid vendor.  
247.17     (d) The adult foster care rate shall be considered a 
247.18  difficulty of care payment and shall not include room and 
247.19  board.  The adult foster care daily rate shall be negotiated 
247.20  between the county agency and the foster care provider.  The 
247.21  rate established under this section shall not exceed 75 percent 
247.22  of the state average monthly nursing home payment for the case 
247.23  mix classification to which the individual receiving foster care 
247.24  is assigned, and it must allow for other alternative care 
247.25  services to be authorized by the case manager.  The alternative 
247.26  care payment for the foster care service in combination with the 
247.27  payment for other alternative care services, including case 
247.28  management, must not exceed the limit specified in subdivision 
247.29  4, paragraph (a), clause (6). 
247.30     (e) Personal care services may be provided by a personal 
247.31  care provider organization. must meet the service standards 
247.32  defined in the federally approved elderly waiver plan, except 
247.33  that a county agency may contract with a client's relative of 
247.34  the client who meets the relative hardship waiver requirement as 
247.35  defined in section 256B.0627, subdivision 4, paragraph (b), 
247.36  clause (10), to provide personal care services, but must ensure 
248.1   nursing if the county agency ensures supervision of this service 
248.2   by a registered nurse or mental health practitioner.  Covered 
248.3   personal care services defined in section 256B.0627, subdivision 
248.4   4, must meet applicable standards in Minnesota Rules, part 
248.5   9505.0335. 
248.6      (f) A county may use alternative care funds to purchase 
248.7   medical supplies and equipment without prior approval from the 
248.8   commissioner when:  (1) there is no other funding source; (2) 
248.9   the supplies and equipment are specified in the individual's 
248.10  care plan as medically necessary to enable the individual to 
248.11  remain in the community according to the criteria in Minnesota 
248.12  Rules, part 9505.0210, item A; and (3) the supplies and 
248.13  equipment represent an effective and appropriate use of 
248.14  alternative care funds.  A county may use alternative care funds 
248.15  to purchase supplies and equipment from a non-Medicaid certified 
248.16  vendor if the cost for the items is less than that of a Medicaid 
248.17  vendor.  A county is not required to contract with a provider of 
248.18  supplies and equipment if the monthly cost of the supplies and 
248.19  equipment is less than $250.  
248.20     (g) For purposes of this section, residential care services 
248.21  are services which are provided to individuals living in 
248.22  residential care homes.  Residential care homes are currently 
248.23  licensed as board and lodging establishments and are registered 
248.24  with the department of health as providing special 
248.25  services under section 157.17 and are not subject to 
248.26  registration under chapter 144D.  Residential care services are 
248.27  defined as "supportive services" and "health-related services."  
248.28  "Supportive services" means the provision of up to 24-hour 
248.29  supervision and oversight.  Supportive services includes:  (1) 
248.30  transportation, when provided by the residential care center 
248.31  home only; (2) socialization, when socialization is part of the 
248.32  plan of care, has specific goals and outcomes established, and 
248.33  is not diversional or recreational in nature; (3) assisting 
248.34  clients in setting up meetings and appointments; (4) assisting 
248.35  clients in setting up medical and social services; (5) providing 
248.36  assistance with personal laundry, such as carrying the client's 
249.1   laundry to the laundry room.  Assistance with personal laundry 
249.2   does not include any laundry, such as bed linen, that is 
249.3   included in the room and board rate.  "Health-related services" 
249.4   are limited to minimal assistance with dressing, grooming, and 
249.5   bathing and providing reminders to residents to take medications 
249.6   that are self-administered or providing storage for medications, 
249.7   if requested.  Individuals receiving residential care services 
249.8   cannot receive homemaking services funded under this section.  
249.9      (h) (g) For the purposes of this section, "assisted living" 
249.10  refers to supportive services provided by a single vendor to 
249.11  clients who reside in the same apartment building of three or 
249.12  more units which are not subject to registration under chapter 
249.13  144D and are licensed by the department of health as a class A 
249.14  home care provider or a class E home care provider.  Assisted 
249.15  living services are defined as up to 24-hour supervision, and 
249.16  oversight, supportive services as defined in clause (1), 
249.17  individualized home care aide tasks as defined in clause (2), 
249.18  and individualized home management tasks as defined in clause 
249.19  (3) provided to residents of a residential center living in 
249.20  their units or apartments with a full kitchen and bathroom.  A 
249.21  full kitchen includes a stove, oven, refrigerator, food 
249.22  preparation counter space, and a kitchen utensil storage 
249.23  compartment.  Assisted living services must be provided by the 
249.24  management of the residential center or by providers under 
249.25  contract with the management or with the county. 
249.26     (1) Supportive services include:  
249.27     (i) socialization, when socialization is part of the plan 
249.28  of care, has specific goals and outcomes established, and is not 
249.29  diversional or recreational in nature; 
249.30     (ii) assisting clients in setting up meetings and 
249.31  appointments; and 
249.32     (iii) providing transportation, when provided by the 
249.33  residential center only.  
249.34     Individuals receiving assisted living services will not 
249.35  receive both assisted living services and homemaking services.  
249.36  Individualized means services are chosen and designed 
250.1   specifically for each resident's needs, rather than provided or 
250.2   offered to all residents regardless of their illnesses, 
250.3   disabilities, or physical conditions.  
250.4      (2) Home care aide tasks means:  
250.5      (i) preparing modified diets, such as diabetic or low 
250.6   sodium diets; 
250.7      (ii) reminding residents to take regularly scheduled 
250.8   medications or to perform exercises; 
250.9      (iii) household chores in the presence of technically 
250.10  sophisticated medical equipment or episodes of acute illness or 
250.11  infectious disease; 
250.12     (iv) household chores when the resident's care requires the 
250.13  prevention of exposure to infectious disease or containment of 
250.14  infectious disease; and 
250.15     (v) assisting with dressing, oral hygiene, hair care, 
250.16  grooming, and bathing, if the resident is ambulatory, and if the 
250.17  resident has no serious acute illness or infectious disease.  
250.18  Oral hygiene means care of teeth, gums, and oral prosthetic 
250.19  devices.  
250.20     (3) Home management tasks means:  
250.21     (i) housekeeping; 
250.22     (ii) laundry; 
250.23     (iii) preparation of regular snacks and meals; and 
250.24     (iv) shopping.  
250.25     Individuals receiving assisted living services shall not 
250.26  receive both assisted living services and homemaking services.  
250.27  Individualized means services are chosen and designed 
250.28  specifically for each resident's needs, rather than provided or 
250.29  offered to all residents regardless of their illnesses, 
250.30  disabilities, or physical conditions.  Assisted living services 
250.31  as defined in this section shall not be authorized in boarding 
250.32  and lodging establishments licensed according to sections 
250.33  157.011 and 157.15 to 157.22. 
250.34     (i) (h) For establishments registered under chapter 144D, 
250.35  assisted living services under this section means either the 
250.36  services described and licensed in paragraph (g) and delivered 
251.1   by a class E home care provider licensed by the department of 
251.2   health or the services described under section 144A.4605 and 
251.3   delivered by an assisted living home care provider or a class A 
251.4   home care provider licensed by the commissioner of health. 
251.5      (j) For the purposes of this section, reimbursement (i) 
251.6   Payment for assisted living services and residential care 
251.7   services shall be a monthly rate negotiated and authorized by 
251.8   the county agency based on an individualized service plan for 
251.9   each resident and may not cover direct rent or food costs.  The 
251.10  rate 
251.11     (1) The individualized monthly negotiated payment for 
251.12  assisted living services as described in paragraph (g) or (h), 
251.13  and residential care services as described in paragraph (f), 
251.14  shall not exceed the nonfederal share in effect on July 1 of the 
251.15  state fiscal year for which the rate limit is being calculated 
251.16  of the greater of either the statewide or any of the geographic 
251.17  groups' weighted average monthly medical assistance nursing 
251.18  facility payment rate of the case mix resident class to which 
251.19  the 180-day alternative care eligible client would be assigned 
251.20  under Minnesota Rules, parts 9549.0050 to 9549.0059, unless the 
251.21  less the maintenance needs allowance as described in subdivision 
251.22  1d, paragraph (a), until the first day of the state fiscal year 
251.23  in which a resident assessment system, under section 256B.437, 
251.24  of nursing home rate determination is implemented.  Effective on 
251.25  the first day of the state fiscal year in which a resident 
251.26  assessment system, under section 256B.437, of nursing home rate 
251.27  determination is implemented and the first day of each 
251.28  subsequent state fiscal year, the individualized monthly 
251.29  negotiated payment for the services described in this clause 
251.30  shall not exceed the limit described in this clause which was in 
251.31  effect on the last day of the previous state fiscal year and 
251.32  which has been adjusted by the greater of any legislatively 
251.33  adopted home and community-based services cost-of-living 
251.34  percentage increase or any legislatively adopted statewide 
251.35  percent rate increase for nursing facilities. 
251.36     (2) The individualized monthly negotiated payment for 
252.1   assisted living services are provided by a home care described 
252.2   under section 144A.4605 and delivered by a provider licensed by 
252.3   the department of health as a class A home care provider or an 
252.4   assisted living home care provider and are provided in a 
252.5   building that is registered as a housing with services 
252.6   establishment under chapter 144D and that provides 24-hour 
252.7   supervision in combination with the payment for other 
252.8   alternative care services, including case management, must not 
252.9   exceed the limit specified in subdivision 4, paragraph (a), 
252.10  clause (6). 
252.11     (k) For purposes of this section, companion services are 
252.12  defined as nonmedical care, supervision and oversight, provided 
252.13  to a functionally impaired adult.  Companions may assist the 
252.14  individual with such tasks as meal preparation, laundry and 
252.15  shopping, but do not perform these activities as discrete 
252.16  services.  The provision of companion services does not entail 
252.17  hands-on medical care.  Providers may also perform light 
252.18  housekeeping tasks which are incidental to the care and 
252.19  supervision of the recipient.  This service must be approved by 
252.20  the case manager as part of the care plan.  Companion services 
252.21  must be provided by individuals or organizations who are under 
252.22  contract with the local agency to provide the service.  Any 
252.23  person related to the waiver recipient by blood, marriage or 
252.24  adoption cannot be reimbursed under this service.  Persons 
252.25  providing companion services will be monitored by the case 
252.26  manager. 
252.27     (l) For purposes of this section, training for direct 
252.28  informal caregivers is defined as a classroom or home course of 
252.29  instruction which may include:  transfer and lifting skills, 
252.30  nutrition, personal and physical cares, home safety in a home 
252.31  environment, stress reduction and management, behavioral 
252.32  management, long-term care decision making, care coordination 
252.33  and family dynamics.  The training is provided to an informal 
252.34  unpaid caregiver of a 180-day eligible client which enables the 
252.35  caregiver to deliver care in a home setting with high levels of 
252.36  quality.  The training must be approved by the case manager as 
253.1   part of the individual care plan.  Individuals, agencies, and 
253.2   educational facilities which provide caregiver training and 
253.3   education will be monitored by the case manager. 
253.4      (m) (j) A county agency may make payment from their 
253.5   alternative care program allocation for "other services" 
253.6   provided to an alternative care program recipient if those 
253.7   services prevent, shorten, or delay institutionalization.  These 
253.8   services may which include use of "discretionary funds" for 
253.9   services that are not otherwise defined in this section and 
253.10  direct cash payments to the recipient client for the purpose of 
253.11  purchasing the recipient's services.  The following provisions 
253.12  apply to payments under this paragraph: 
253.13     (1) a cash payment to a client under this provision cannot 
253.14  exceed 80 percent of the monthly payment limit for that client 
253.15  as specified in subdivision 4, paragraph (a), clause (7) (6); 
253.16     (2) a county may not approve any cash payment for a client 
253.17  who meets either of the following: 
253.18     (i) has been assessed as having a dependency in 
253.19  orientation, unless the client has an authorized 
253.20  representative under section 256.476, subdivision 2, paragraph 
253.21  (g), or for a client who.  An "authorized representative" means 
253.22  an individual who is at least 18 years of age and is designated 
253.23  by the person or the person's legal representative to act on the 
253.24  person's behalf.  This individual may be a family member, 
253.25  guardian, representative payee, or other individual designated 
253.26  by the person or the person's legal representative, if any, to 
253.27  assist in purchasing and arranging for supports; or 
253.28     (ii) is concurrently receiving adult foster care, 
253.29  residential care, or assisted living services; 
253.30     (3) any service approved under this section must be a 
253.31  service which meets the purpose and goals of the program as 
253.32  listed in subdivision 1; 
253.33     (4) cash payments must also meet the criteria of and are 
253.34  governed by the procedures and liability protection established 
253.35  in section 256.476, subdivision 4, paragraphs (b) through (h), 
253.36  and recipients of cash grants must meet the requirements in 
254.1   section 256.476, subdivision 10; and cash payments to a person 
254.2   or a person's family will be provided through a monthly payment 
254.3   and be in the form of cash, voucher, or direct county payment to 
254.4   vendor.  Fees or premiums assessed to the person for eligibility 
254.5   for health and human services are not reimbursable through this 
254.6   service option.  Services and goods purchased through cash 
254.7   payments must be identified in the person's individualized care 
254.8   plan and must meet all of the following criteria: 
254.9      (i) they must be over and above the normal cost of caring 
254.10  for the person if the person did not have functional 
254.11  limitations; 
254.12     (ii) they must be directly attributable to the person's 
254.13  functional limitations; 
254.14     (iii) they must have the potential to be effective at 
254.15  meeting the goals of the program; 
254.16     (iv) they must be consistent with the needs identified in 
254.17  the individualized service plan.  The service plan shall specify 
254.18  the needs of the person and family, the form and amount of 
254.19  payment, the items and services to be reimbursed, and the 
254.20  arrangements for management of the individual grant; and 
254.21     (v) the person, the person's family, or the legal 
254.22  representative shall be provided sufficient information to 
254.23  ensure an informed choice of alternatives.  The local agency 
254.24  shall document this information in the person's care plan, 
254.25  including the type and level of expenditures to be reimbursed; 
254.26     (4) the county, lead agency under contract, or tribal 
254.27  government under contract to administer the alternative care 
254.28  program shall not be liable for damages, injuries, or 
254.29  liabilities sustained through the purchase of direct supports or 
254.30  goods by the person, the person's family, or the authorized 
254.31  representative with funds received through the cash payments 
254.32  under this section.  Liabilities include, but are not limited 
254.33  to, workers' compensation, the Federal Insurance Contributions 
254.34  Act (FICA), or the Federal Unemployment Tax Act (FUTA); 
254.35     (5) persons receiving grants under this section shall have 
254.36  the following responsibilities: 
255.1      (i) spend the grant money in a manner consistent with their 
255.2   individualized service plan with the local agency; 
255.3      (ii) notify the local agency of any necessary changes in 
255.4   the grant-expenditures; 
255.5      (iii) arrange and pay for supports; and 
255.6      (iv) inform the local agency of areas where they have 
255.7   experienced difficulty securing or maintaining supports; and 
255.8      (5) (6) the county shall report client outcomes, services, 
255.9   and costs under this paragraph in a manner prescribed by the 
255.10  commissioner. 
255.11     (k) Upon implementation of direct cash payments to clients 
255.12  under this section, any person determined eligible for the 
255.13  alternative care program who chooses a cash payment approved by 
255.14  the county agency shall receive the cash payment under this 
255.15  section and not under section 256.476 unless the person was 
255.16  receiving a consumer support grant under section 256.476 before 
255.17  implementation of direct cash payments under this section. 
255.18     Sec. 20.  Minnesota Statutes 2000, section 256B.0913, 
255.19  subdivision 6, is amended to read: 
255.20     Subd. 6.  [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] The 
255.21  alternative care program is administered by the county agency.  
255.22  This agency is the lead agency responsible for the local 
255.23  administration of the alternative care program as described in 
255.24  this section.  However, it may contract with the public health 
255.25  nursing service to be the lead agency.  The commissioner may 
255.26  contract with federally recognized Indian tribes with a 
255.27  reservation in Minnesota to serve as the lead agency responsible 
255.28  for the local administration of the alternative care program as 
255.29  described in the contract. 
255.30     Sec. 21.  Minnesota Statutes 2000, section 256B.0913, 
255.31  subdivision 7, is amended to read: 
255.32     Subd. 7.  [CASE MANAGEMENT.] Providers of case management 
255.33  services for persons receiving services funded by the 
255.34  alternative care program must meet the qualification 
255.35  requirements and standards specified in section 256B.0915, 
255.36  subdivision 1b.  The case manager must ensure the health and 
256.1   safety of the individual client and not approve alternative care 
256.2   funding for a client in any setting in which the case manager 
256.3   cannot reasonably ensure the client's health and safety.  The 
256.4   case manager is responsible for the cost-effectiveness of the 
256.5   alternative care individual care plan and must not approve any 
256.6   care plan in which the cost of services funded by alternative 
256.7   care and client contributions exceeds the limit specified in 
256.8   section 256B.0915, subdivision 3, paragraph (b).  The county may 
256.9   allow a case manager employed by the county to delegate certain 
256.10  aspects of the case management activity to another individual 
256.11  employed by the county provided there is oversight of the 
256.12  individual by the case manager.  The case manager may not 
256.13  delegate those aspects which require professional judgment 
256.14  including assessments, reassessments, and care plan development. 
256.15     Sec. 22.  Minnesota Statutes 2000, section 256B.0913, 
256.16  subdivision 8, is amended to read: 
256.17     Subd. 8.  [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 
256.18  case manager shall implement the plan of care for each 180-day 
256.19  eligible alternative care client and ensure that a client's 
256.20  service needs and eligibility are reassessed at least every 12 
256.21  months.  The plan shall include any services prescribed by the 
256.22  individual's attending physician as necessary to allow the 
256.23  individual to remain in a community setting.  In developing the 
256.24  individual's care plan, the case manager should include the use 
256.25  of volunteers from families and neighbors, religious 
256.26  organizations, social clubs, and civic and service organizations 
256.27  to support the formal home care services.  The county shall be 
256.28  held harmless for damages or injuries sustained through the use 
256.29  of volunteers under this subdivision including workers' 
256.30  compensation liability.  The lead agency shall provide 
256.31  documentation to the commissioner verifying that the 
256.32  individual's alternative care is not available at that time 
256.33  through any other public assistance or service program.  The 
256.34  lead agency shall provide documentation in each individual's 
256.35  plan of care and, if requested, to the commissioner that the 
256.36  most cost-effective alternatives available have been offered to 
257.1   the individual and that the individual was free to choose among 
257.2   available qualified providers, both public and private.  The 
257.3   case manager must give the individual a ten-day written notice 
257.4   of any decrease in or termination of alternative care services. 
257.5      (b) If the county administering alternative care services 
257.6   is different than the county of financial responsibility, the 
257.7   care plan may be implemented without the approval of the county 
257.8   of financial responsibility. 
257.9      Sec. 23.  Minnesota Statutes 2000, section 256B.0913, 
257.10  subdivision 9, is amended to read: 
257.11     Subd. 9.  [CONTRACTING PROVISIONS FOR PROVIDERS.] The lead 
257.12  agency shall document to the commissioner that the agency made 
257.13  reasonable efforts to inform potential providers of the 
257.14  anticipated need for services under the alternative care program 
257.15  or waiver programs under sections 256B.0915 and 256B.49, 
257.16  including a minimum of 14 days' written advance notice of the 
257.17  opportunity to be selected as a service provider and an annual 
257.18  public meeting with providers to explain and review the criteria 
257.19  for selection.  The lead agency shall also document to the 
257.20  commissioner that the agency allowed potential providers an 
257.21  opportunity to be selected to contract with the county agency.  
257.22  Funds reimbursed to counties under this subdivision Alternative 
257.23  care funds paid to service providers are subject to audit by the 
257.24  commissioner for fiscal and utilization control.  
257.25     The lead agency must select providers for contracts or 
257.26  agreements using the following criteria and other criteria 
257.27  established by the county: 
257.28     (1) the need for the particular services offered by the 
257.29  provider; 
257.30     (2) the population to be served, including the number of 
257.31  clients, the length of time services will be provided, and the 
257.32  medical condition of clients; 
257.33     (3) the geographic area to be served; 
257.34     (4) quality assurance methods, including appropriate 
257.35  licensure, certification, or standards, and supervision of 
257.36  employees when needed; 
258.1      (5) rates for each service and unit of service exclusive of 
258.2   county administrative costs; 
258.3      (6) evaluation of services previously delivered by the 
258.4   provider; and 
258.5      (7) contract or agreement conditions, including billing 
258.6   requirements, cancellation, and indemnification. 
258.7      The county must evaluate its own agency services under the 
258.8   criteria established for other providers.  The county shall 
258.9   provide a written statement of the reasons for not selecting 
258.10  providers. 
258.11     Sec. 24.  Minnesota Statutes 2000, section 256B.0913, 
258.12  subdivision 10, is amended to read: 
258.13     Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
258.14  appropriation for fiscal years 1992 and beyond shall cover 
258.15  only 180-day alternative care eligible clients.  Prior to July 1 
258.16  of each year, the commissioner shall allocate to county agencies 
258.17  the state funds available for alternative care for persons 
258.18  eligible under subdivision 2. 
258.19     (b) Prior to July 1 of each year, the commissioner shall 
258.20  allocate to county agencies the state funds available for 
258.21  alternative care for persons eligible under subdivision 2.  The 
258.22  allocation for fiscal year 1992 shall be calculated using a base 
258.23  that is adjusted to exclude the medical assistance share of 
258.24  alternative care expenditures.  The adjusted base is calculated 
258.25  by multiplying each county's allocation for fiscal year 1991 by 
258.26  the percentage of county alternative care expenditures for 
258.27  180-day eligible clients.  The percentage is determined based on 
258.28  expenditures for services rendered in fiscal year 1989 or 
258.29  calendar year 1989, whichever is greater.  The adjusted base for 
258.30  each county is the county's current fiscal year base allocation 
258.31  plus any targeted funds approved during the current fiscal 
258.32  year.  Calculations for paragraphs (c) and (d) are to be made as 
258.33  follows:  for each county, the determination of alternative care 
258.34  program expenditures shall be based on payments for services 
258.35  rendered from April 1 through March 31 in the base year, to the 
258.36  extent that claims have been submitted and paid by June 1 of 
259.1   that year.  
259.2      (c) If the county alternative care program expenditures for 
259.3   180-day eligible clients as defined in paragraph (b) are 95 
259.4   percent or more of its the county's adjusted base allocation, 
259.5   the allocation for the next fiscal year is 100 percent of the 
259.6   adjusted base, plus inflation to the extent that inflation is 
259.7   included in the state budget. 
259.8      (d) If the county alternative care program expenditures for 
259.9   180-day eligible clients as defined in paragraph (b) are less 
259.10  than 95 percent of its the county's adjusted base allocation, 
259.11  the allocation for the next fiscal year is the adjusted base 
259.12  allocation less the amount of unspent funds below the 95 percent 
259.13  level. 
259.14     (e) For fiscal year 1992 only, a county may receive an 
259.15  increased allocation if annualized service costs for the month 
259.16  of May 1991 for 180-day eligible clients are greater than the 
259.17  allocation otherwise determined.  A county may apply for this 
259.18  increase by reporting projected expenditures for May to the 
259.19  commissioner by June 1, 1991.  The amount of the allocation may 
259.20  exceed the amount calculated in paragraph (b).  The projected 
259.21  expenditures for May must be based on actual 180-day eligible 
259.22  client caseload and the individual cost of clients' care plans.  
259.23  If a county does not report its expenditures for May, the amount 
259.24  in paragraph (c) or (d) shall be used. 
259.25     (f) Calculations for paragraphs (c) and (d) are to be made 
259.26  as follows:  for each county, the determination of expenditures 
259.27  shall be based on payments for services rendered from April 1 
259.28  through March 31 in the base year, to the extent that claims 
259.29  have been submitted by June 1 of that year.  Calculations for 
259.30  paragraphs (c) and (d) must also include the funds transferred 
259.31  to the consumer support grant program for clients who have 
259.32  transferred to that program from April 1 through March 31 in the 
259.33  base year.  
259.34     (g) For the biennium ending June 30, 2001, the allocation 
259.35  of state funds to county agencies shall be calculated as 
259.36  described in paragraphs (c) and (d).  If the annual legislative 
260.1   appropriation for the alternative care program is inadequate to 
260.2   fund the combined county allocations for fiscal year 2000 or 
260.3   2001 a biennium, the commissioner shall distribute to each 
260.4   county the entire annual appropriation as that county's 
260.5   percentage of the computed base as calculated in paragraph 
260.6   (f) paragraphs (c) and (d). 
260.7      Sec. 25.  Minnesota Statutes 2000, section 256B.0913, 
260.8   subdivision 11, is amended to read: 
260.9      Subd. 11.  [TARGETED FUNDING.] (a) The purpose of targeted 
260.10  funding is to make additional money available to counties with 
260.11  the greatest need.  Targeted funds are not intended to be 
260.12  distributed equitably among all counties, but rather, allocated 
260.13  to those with long-term care strategies that meet state goals. 
260.14     (b) The funds available for targeted funding shall be the 
260.15  total appropriation for each fiscal year minus county 
260.16  allocations determined under subdivision 10 as adjusted for any 
260.17  inflation increases provided in appropriations for the biennium. 
260.18     (c) The commissioner shall allocate targeted funds to 
260.19  counties that demonstrate to the satisfaction of the 
260.20  commissioner that they have developed feasible plans to increase 
260.21  alternative care spending.  In making targeted funding 
260.22  allocations, the commissioner shall use the following priorities:
260.23     (1) counties that received a lower allocation in fiscal 
260.24  year 1991 than in fiscal year 1990.  Counties remain in this 
260.25  priority until they have been restored to their fiscal year 1990 
260.26  level plus inflation; 
260.27     (2) counties that sustain a base allocation reduction for 
260.28  failure to spend 95 percent of the allocation if they 
260.29  demonstrate that the base reduction should be restored; 
260.30     (3) counties that propose projects to divert community 
260.31  residents from nursing home placement or convert nursing home 
260.32  residents to community living; and 
260.33     (4) counties that can otherwise justify program growth by 
260.34  demonstrating the existence of waiting lists, demographically 
260.35  justified needs, or other unmet needs. 
260.36     (d) Counties that would receive targeted funds according to 
261.1   paragraph (c) must demonstrate to the commissioner's 
261.2   satisfaction that the funds would be appropriately spent by 
261.3   showing how the funds would be used to further the state's 
261.4   alternative care goals as described in subdivision 1, and that 
261.5   the county has the administrative and service delivery 
261.6   capability to use them.  
261.7      (e) The commissioner shall request applications by June 1 
261.8   each year, for county agencies to apply for targeted funds by 
261.9   November 1 of each year.  The counties selected for targeted 
261.10  funds shall be notified of the amount of their additional 
261.11  funding by August 1 of each year.  Targeted funds allocated to a 
261.12  county agency in one year shall be treated as part of the 
261.13  county's base allocation for that year in determining 
261.14  allocations for subsequent years.  No reallocations between 
261.15  counties shall be made. 
261.16     (f) The allocation for each year after fiscal year 1992 
261.17  shall be determined using the previous fiscal year's allocation, 
261.18  including any targeted funds, as the base and then applying the 
261.19  criteria under subdivision 10, paragraphs (c), (d), and (f), to 
261.20  the current year's expenditures. 
261.21     Sec. 26.  Minnesota Statutes 2000, section 256B.0913, 
261.22  subdivision 12, is amended to read: 
261.23     Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
261.24  all 180-day alternative care eligible clients to help pay for 
261.25  the cost of participating in the program.  The amount of the 
261.26  premium for the alternative care client shall be determined as 
261.27  follows: 
261.28     (1) when the alternative care client's income less 
261.29  recurring and predictable medical expenses is greater than the 
261.30  medical assistance income standard recipient's maintenance needs 
261.31  allowance as defined in section 256B.0915, subdivision 1d, 
261.32  paragraph (a), but less than 150 percent of the federal poverty 
261.33  guideline effective on July 1 of the state fiscal year in which 
261.34  the premium is being computed, and total assets are less than 
261.35  $10,000, the fee is zero; 
261.36     (2) when the alternative care client's income less 
262.1   recurring and predictable medical expenses is greater than 150 
262.2   percent of the federal poverty guideline effective on July 1 of 
262.3   the state fiscal year in which the premium is being computed, 
262.4   and total assets are less than $10,000, the fee is 25 percent of 
262.5   the cost of alternative care services or the difference between 
262.6   150 percent of the federal poverty guideline effective on July 1 
262.7   of the state fiscal year in which the premium is being computed 
262.8   and the client's income less recurring and predictable medical 
262.9   expenses, whichever is less; and 
262.10     (3) when the alternative care client's total assets are 
262.11  greater than $10,000, the fee is 25 percent of the cost of 
262.12  alternative care services.  
262.13     For married persons, total assets are defined as the total 
262.14  marital assets less the estimated community spouse asset 
262.15  allowance, under section 256B.059, if applicable.  For married 
262.16  persons, total income is defined as the client's income less the 
262.17  monthly spousal allotment, under section 256B.058. 
262.18     All alternative care services except case management shall 
262.19  be included in the estimated costs for the purpose of 
262.20  determining 25 percent of the costs. 
262.21     The monthly premium shall be calculated based on the cost 
262.22  of the first full month of alternative care services and shall 
262.23  continue unaltered until the next reassessment is completed or 
262.24  at the end of 12 months, whichever comes first.  Premiums are 
262.25  due and payable each month alternative care services are 
262.26  received unless the actual cost of the services is less than the 
262.27  premium. 
262.28     (b) The fee shall be waived by the commissioner when: 
262.29     (1) a person who is residing in a nursing facility is 
262.30  receiving case management only; 
262.31     (2) a person is applying for medical assistance; 
262.32     (3) a married couple is requesting an asset assessment 
262.33  under the spousal impoverishment provisions; 
262.34     (4) a person is a medical assistance recipient, but has 
262.35  been approved for alternative care-funded assisted living 
262.36  services; 
263.1      (5) a person is found eligible for alternative care, but is 
263.2   not yet receiving alternative care services; or 
263.3      (6) (5) a person's fee under paragraph (a) is less than $25.
263.4      (c) The county agency must record in the state's receivable 
263.5   system the client's assessed premium amount or the reason the 
263.6   premium has been waived.  The commissioner will bill and collect 
263.7   the premium from the client and forward the amounts collected to 
263.8   the commissioner in the manner and at the times prescribed by 
263.9   the commissioner.  Money collected must be deposited in the 
263.10  general fund and is appropriated to the commissioner for the 
263.11  alternative care program.  The client must supply the county 
263.12  with the client's social security number at the time of 
263.13  application.  If a client fails or refuses to pay the premium 
263.14  due, The county shall supply the commissioner with the client's 
263.15  social security number and other information the commissioner 
263.16  requires to collect the premium from the client.  The 
263.17  commissioner shall collect unpaid premiums using the Revenue 
263.18  Recapture Act in chapter 270A and other methods available to the 
263.19  commissioner.  The commissioner may require counties to inform 
263.20  clients of the collection procedures that may be used by the 
263.21  state if a premium is not paid.  
263.22     (d) The commissioner shall begin to adopt emergency or 
263.23  permanent rules governing client premiums within 30 days after 
263.24  July 1, 1991, including criteria for determining when services 
263.25  to a client must be terminated due to failure to pay a premium.  
263.26     Sec. 27.  Minnesota Statutes 2000, section 256B.0913, 
263.27  subdivision 13, is amended to read: 
263.28     Subd. 13.  [COUNTY BIENNIAL PLAN.] The county biennial plan 
263.29  for the preadmission screening program long-term care 
263.30  consultation under section 256B.0911, the alternative care 
263.31  program under this section, and waivers for the elderly under 
263.32  section 256B.0915, and waivers for the disabled under section 
263.33  256B.49, shall be incorporated into the biennial Community 
263.34  Social Services Act plan and shall meet the regulations and 
263.35  timelines of that plan.  This county biennial plan shall include:
263.36     (1) information on the administration of the preadmission 
264.1   screening program; 
264.2      (2) information on the administration of the home and 
264.3   community-based services waivers for the elderly under section 
264.4   256B.0915, and for the disabled under section 256B.49; and 
264.5      (3) information on the administration of the alternative 
264.6   care program. 
264.7      Sec. 28.  Minnesota Statutes 2000, section 256B.0913, 
264.8   subdivision 14, is amended to read: 
264.9      Subd. 14.  [REIMBURSEMENT PAYMENT AND RATE ADJUSTMENTS.] (a)
264.10  Reimbursement Payment for expenditures for the provided 
264.11  alternative care services as approved by the client's case 
264.12  manager shall be through the invoice processing procedures of 
264.13  the department's Medicaid Management Information System (MMIS).  
264.14  To receive reimbursement payment, the county or vendor must 
264.15  submit invoices within 12 months following the date of service.  
264.16  The county agency and its vendors under contract shall not be 
264.17  reimbursed for services which exceed the county allocation. 
264.18     (b) If a county collects less than 50 percent of the client 
264.19  premiums due under subdivision 12, the commissioner may withhold 
264.20  up to three percent of the county's final alternative care 
264.21  program allocation determined under subdivisions 10 and 11. 
264.22     (c) The county shall negotiate individual rates with 
264.23  vendors and may be reimbursed authorize service payment for 
264.24  actual costs up to the greater of the county's current approved 
264.25  rate or 60 percent of the maximum rate in fiscal year 1994 and 
264.26  65 percent of the maximum rate in fiscal year 1995 for each 
264.27  alternative care service.  Notwithstanding any other rule or 
264.28  statutory provision to the contrary, the commissioner shall not 
264.29  be authorized to increase rates by an annual inflation factor, 
264.30  unless so authorized by the legislature. 
264.31     (d) (c) On July 1, 1993, the commissioner shall increase 
264.32  the maximum rate for home delivered meals to $4.50 per meal.  To 
264.33  improve access to community services and eliminate payment 
264.34  disparities between the alternative care program and the elderly 
264.35  waiver program, the commissioner shall establish statewide 
264.36  maximum service rate limits and eliminate county-specific 
265.1   service rate limits. 
265.2      (1) Effective July 1, 2001, for service rate limits, except 
265.3   those in subdivision 5, paragraphs (d) and (j), the rate limit 
265.4   for each service shall be the greater of the alternative care 
265.5   statewide maximum rate or the elderly waiver statewide maximum 
265.6   rate. 
265.7      (2) Counties may negotiate individual service rates with 
265.8   vendors for actual costs up to the statewide maximum service 
265.9   rate limit. 
265.10     Sec. 29.  Minnesota Statutes 2000, section 256B.0915, 
265.11  subdivision 1d, is amended to read: 
265.12     Subd. 1d.  [POSTELIGIBILITY TREATMENT OF INCOME AND 
265.13  RESOURCES FOR ELDERLY WAIVER.] (a) Notwithstanding the 
265.14  provisions of section 256B.056, the commissioner shall make the 
265.15  following amendment to the medical assistance elderly waiver 
265.16  program effective July 1, 1999, or upon federal approval, 
265.17  whichever is later. 
265.18     A recipient's maintenance needs will be an amount equal to 
265.19  the Minnesota supplemental aid equivalent rate as defined in 
265.20  section 256I.03, subdivision 5, plus the medical assistance 
265.21  personal needs allowance as defined in section 256B.35, 
265.22  subdivision 1, paragraph (a), when applying posteligibility 
265.23  treatment of income rules to the gross income of elderly waiver 
265.24  recipients, except for individuals whose income is in excess of 
265.25  the special income standard according to Code of Federal 
265.26  Regulations, title 42, section 435.236.  Recipient maintenance 
265.27  needs shall be adjusted under this provision each July 1. 
265.28     (b) The commissioner of human services shall secure 
265.29  approval of additional elderly waiver slots sufficient to serve 
265.30  persons who will qualify under the revised income standard 
265.31  described in paragraph (a) before implementing section 
265.32  256B.0913, subdivision 16. 
265.33     (c) In implementing this subdivision, the commissioner 
265.34  shall consider allowing persons who would otherwise be eligible 
265.35  for the alternative care program but would qualify for the 
265.36  elderly waiver with a spenddown to remain on the alternative 
266.1   care program. 
266.2      Sec. 30.  Minnesota Statutes 2000, section 256B.0915, 
266.3   subdivision 3, is amended to read: 
266.4      Subd. 3.  [LIMITS OF CASES, RATES, REIMBURSEMENT PAYMENTS, 
266.5   AND FORECASTING.] (a) The number of medical assistance waiver 
266.6   recipients that a county may serve must be allocated according 
266.7   to the number of medical assistance waiver cases open on July 1 
266.8   of each fiscal year.  Additional recipients may be served with 
266.9   the approval of the commissioner. 
266.10     (b) The monthly limit for the cost of waivered services to 
266.11  an individual elderly waiver client shall be the statewide 
266.12  average payment weighted average monthly nursing facility rate 
266.13  of the case mix resident class to which the elderly waiver 
266.14  client would be assigned under the medical assistance case mix 
266.15  reimbursement system.  Minnesota Rules, parts 9549.0050 to 
266.16  9549.0059, less the recipient's maintenance needs allowance as 
266.17  described in subdivision 1d, paragraph (a), until the first day 
266.18  of the state fiscal year in which the resident assessment system 
266.19  as described in section 256B.437 for nursing home rate 
266.20  determination is implemented.  Effective on the first day of the 
266.21  state fiscal year in which the resident assessment system as 
266.22  described in section 256B.437 for nursing home rate 
266.23  determination is implemented and the first day of each 
266.24  subsequent state fiscal year, the monthly limit for the cost of 
266.25  waivered services to an individual elderly waiver client shall 
266.26  be the rate of the case mix resident class to which the waiver 
266.27  client would be assigned under Minnesota Rules, parts 9549.0050 
266.28  to 9549.0059, in effect on the last day of the previous state 
266.29  fiscal year, adjusted by the greater of any legislatively 
266.30  adopted home and community-based services cost-of-living 
266.31  percentage increase or any legislatively adopted statewide 
266.32  percent rate increase for nursing facilities. 
266.33     (c) If extended medical supplies and equipment or 
266.34  adaptations environmental modifications are or will be purchased 
266.35  for an elderly waiver services recipient client, the costs may 
266.36  be prorated on a monthly basis throughout the year in which they 
267.1   are purchased for up to 12 consecutive months beginning with the 
267.2   month of purchase.  If the monthly cost of a recipient's other 
267.3   waivered services exceeds the monthly limit established in this 
267.4   paragraph (b), the annual cost of the all waivered services 
267.5   shall be determined.  In this event, the annual cost of all 
267.6   waivered services shall not exceed 12 times the monthly 
267.7   limit calculated in this paragraph.  The statewide average 
267.8   payment rate is calculated by determining the statewide average 
267.9   monthly nursing home rate, effective July 1 of the fiscal year 
267.10  in which the cost is incurred, less the statewide average 
267.11  monthly income of nursing home residents who are age 65 or 
267.12  older, and who are medical assistance recipients in the month of 
267.13  March of the previous state fiscal year.  The annual cost 
267.14  divided by 12 of elderly or disabled waivered services of 
267.15  waivered services as described in paragraph (b).  
267.16     (d) For a person who is a nursing facility resident at the 
267.17  time of requesting a determination of eligibility for elderly or 
267.18  disabled waivered services shall be the greater of the monthly 
267.19  payment for:  (i), a monthly conversion limit for the cost of 
267.20  elderly waivered services may be requested.  The monthly 
267.21  conversion limit for the cost of elderly waiver services shall 
267.22  be the resident class assigned under Minnesota Rules, parts 
267.23  9549.0050 to 9549.0059, for that resident in the nursing 
267.24  facility where the resident currently resides; or (ii) the 
267.25  statewide average payment of the case mix resident class to 
267.26  which the resident would be assigned under the medical 
267.27  assistance case mix reimbursement system, provided that until 
267.28  July 1 of the state fiscal year in which the resident assessment 
267.29  system as described in section 256B.437 for nursing home rate 
267.30  determination is implemented.  Effective on July 1 of the state 
267.31  fiscal year in which the resident assessment system as described 
267.32  in section 256B.437 for nursing home rate determination is 
267.33  implemented, the monthly conversion limit for the cost of 
267.34  elderly waiver services shall be the per diem nursing facility 
267.35  rate as determined by the resident assessment system as 
267.36  described in section 256B.437 for that resident in the nursing 
268.1   facility where the resident currently resides multiplied by 365 
268.2   and divided by 12, less the recipient's maintenance needs 
268.3   allowance as described in subdivision 1d.  The limit under this 
268.4   clause only applies to persons discharged from a nursing 
268.5   facility after a minimum 30-day stay and found eligible for 
268.6   waivered services on or after July 1, 1997.  The following costs 
268.7   must be included in determining the total monthly costs for the 
268.8   waiver client: 
268.9      (1) cost of all waivered services, including extended 
268.10  medical supplies and equipment and environmental modifications; 
268.11  and 
268.12     (2) cost of skilled nursing, home health aide, and personal 
268.13  care services reimbursable by medical assistance.  
268.14     (c) (e) Medical assistance funding for skilled nursing 
268.15  services, private duty nursing, home health aide, and personal 
268.16  care services for waiver recipients must be approved by the case 
268.17  manager and included in the individual care plan. 
268.18     (d) For both the elderly waiver and the nursing facility 
268.19  disabled waiver, a county may purchase extended supplies and 
268.20  equipment without prior approval from the commissioner when 
268.21  there is no other funding source and the supplies and equipment 
268.22  are specified in the individual's care plan as medically 
268.23  necessary to enable the individual to remain in the community 
268.24  according to the criteria in Minnesota Rules, part 9505.0210, 
268.25  items A and B.  (f) A county is not required to contract with a 
268.26  provider of supplies and equipment if the monthly cost of the 
268.27  supplies and equipment is less than $250.  
268.28     (e) (g) The adult foster care daily rate for the elderly 
268.29  and disabled waivers shall be considered a difficulty of care 
268.30  payment and shall not include room and board.  The adult foster 
268.31  care service rate shall be negotiated between the county agency 
268.32  and the foster care provider.  The rate established under this 
268.33  section shall not exceed the state average monthly nursing home 
268.34  payment for the case mix classification to which the individual 
268.35  receiving foster care is assigned; the rate must allow for other 
268.36  waiver and medical assistance home care services to be 
269.1   authorized by the case manager.  The elderly waiver payment for 
269.2   the foster care service in combination with the payment for all 
269.3   other elderly waiver services, including case management, must 
269.4   not exceed the limit specified in paragraph (b). 
269.5      (f) The assisted living and residential care service rates 
269.6   for elderly and community alternatives for disabled individuals 
269.7   (CADI) waivers shall be made to the vendor as a monthly rate 
269.8   negotiated with the county agency based on an individualized 
269.9   service plan for each resident.  The rate shall not exceed the 
269.10  nonfederal share of the greater of either the statewide or any 
269.11  of the geographic groups' weighted average monthly medical 
269.12  assistance nursing facility payment rate of the case mix 
269.13  resident class to which the elderly or disabled client would be 
269.14  assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 
269.15  unless the services are provided by a home care provider 
269.16  licensed by the department of health and are provided in a 
269.17  building that is registered as a housing with services 
269.18  establishment under chapter 144D and that provides 24-hour 
269.19  supervision.  For alternative care assisted living projects 
269.20  established under Laws 1988, chapter 689, article 2, section 
269.21  256, monthly rates may not exceed 65 percent of the greater of 
269.22  either the statewide or any of the geographic groups' weighted 
269.23  average monthly medical assistance nursing facility payment rate 
269.24  for the case mix resident class to which the elderly or disabled 
269.25  client would be assigned under Minnesota Rules, parts 9549.0050 
269.26  to 9549.0059.  The rate may not cover direct rent or food costs. 
269.27     (h) Payment for assisted living service shall be a monthly 
269.28  rate negotiated and authorized by the county agency based on an 
269.29  individualized service plan for each resident and may not cover 
269.30  direct rent or food costs. 
269.31     (1) The individualized monthly negotiated payment for 
269.32  assisted living services as described in section 256B.0913, 
269.33  subdivision 5, paragraph (g) or (h), and residential care 
269.34  services as described in section 256B.0913, subdivision 5, 
269.35  paragraph (f), shall not exceed the nonfederal share, in effect 
269.36  on July 1 of the state fiscal year for which the rate limit is 
270.1   being calculated, of the greater of either the statewide or any 
270.2   of the geographic groups' weighted average monthly nursing 
270.3   facility rate of the case mix resident class to which the 
270.4   elderly waiver eligible client would be assigned under Minnesota 
270.5   Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 
270.6   allowance as described in subdivision 1d, paragraph (a), until 
270.7   the July 1 of the state fiscal year in which the resident 
270.8   assessment system as described in section 256B.437 for nursing 
270.9   home rate determination is implemented.  Effective on July 1 of 
270.10  the state fiscal year in which the resident assessment system as 
270.11  described in section 256B.437 for nursing home rate 
270.12  determination is implemented and July 1 of each subsequent state 
270.13  fiscal year, the individualized monthly negotiated payment for 
270.14  the services described in this clause shall not exceed the limit 
270.15  described in this clause which was in effect on June 30 of the 
270.16  previous state fiscal year and which has been adjusted by the 
270.17  greater of any legislatively adopted home and community-based 
270.18  services cost-of-living percentage increase or any legislatively 
270.19  adopted statewide percent rate increase for nursing facilities. 
270.20     (2) The individualized monthly negotiated payment for 
270.21  assisted living services described in section 144A.4605 and 
270.22  delivered by a provider licensed by the department of health as 
270.23  a class A home care provider or an assisted living home care 
270.24  provider and provided in a building that is registered as a 
270.25  housing with services establishment under chapter 144D and that 
270.26  provides 24-hour supervision in combination with the payment for 
270.27  other elderly waiver services, including case management, must 
270.28  not exceed the limit specified in paragraph (b). 
270.29     (g) (i) The county shall negotiate individual service rates 
270.30  with vendors and may be reimbursed authorize payment for actual 
270.31  costs up to the greater of the county's current approved rate or 
270.32  60 percent of the maximum rate in fiscal year 1994 and 65 
270.33  percent of the maximum rate in fiscal year 1995 for each service 
270.34  within each program.  Persons or agencies must be employed by or 
270.35  under a contract with the county agency or the public health 
270.36  nursing agency of the local board of health in order to receive 
271.1   funding under the elderly waiver program, except as a provider 
271.2   of supplies and equipment when the monthly cost of the supplies 
271.3   and equipment is less than $250.  
271.4      (h) On July 1, 1993, the commissioner shall increase the 
271.5   maximum rate for home-delivered meals to $4.50 per meal. 
271.6      (i) (j) Reimbursement for the medical assistance recipients 
271.7   under the approved waiver shall be made from the medical 
271.8   assistance account through the invoice processing procedures of 
271.9   the department's Medicaid Management Information System (MMIS), 
271.10  only with the approval of the client's case manager.  The budget 
271.11  for the state share of the Medicaid expenditures shall be 
271.12  forecasted with the medical assistance budget, and shall be 
271.13  consistent with the approved waiver.  
271.14     (k) To improve access to community services and eliminate 
271.15  payment disparities between the alternative care program and the 
271.16  elderly waiver, the commissioner shall establish statewide 
271.17  maximum service rate limits and eliminate county-specific 
271.18  service rate limits. 
271.19     (1) Effective July 1, 2001, for service rate limits, except 
271.20  those described or defined in paragraphs (g) and (h), the rate 
271.21  limit for each service shall be the greater of the alternative 
271.22  care statewide maximum rate or the elderly waiver statewide 
271.23  maximum rate. 
271.24     (2) Counties may negotiate individual service rates with 
271.25  vendors for actual costs up to the statewide maximum service 
271.26  rate limit. 
271.27     (j) (l) Beginning July 1, 1991, the state shall reimburse 
271.28  counties according to the payment schedule in section 256.025 
271.29  for the county share of costs incurred under this subdivision on 
271.30  or after January 1, 1991, for individuals who are receiving 
271.31  medical assistance. 
271.32     (k) For the community alternatives for disabled individuals 
271.33  waiver, and nursing facility disabled waivers, county may use 
271.34  waiver funds for the cost of minor adaptations to a client's 
271.35  residence or vehicle without prior approval from the 
271.36  commissioner if there is no other source of funding and the 
272.1   adaptation: 
272.2      (1) is necessary to avoid institutionalization; 
272.3      (2) has no utility apart from the needs of the client; and 
272.4      (3) meets the criteria in Minnesota Rules, part 9505.0210, 
272.5   items A and B.  
272.6   For purposes of this subdivision, "residence" means the client's 
272.7   own home, the client's family residence, or a family foster 
272.8   home.  For purposes of this subdivision, "vehicle" means the 
272.9   client's vehicle, the client's family vehicle, or the client's 
272.10  family foster home vehicle. 
272.11     (l) The commissioner shall establish a maximum rate unit 
272.12  for baths provided by an adult day care provider that are not 
272.13  included in the provider's contractual daily or hourly rate. 
272.14  This maximum rate must equal the home health aide extended rate 
272.15  and shall be paid for baths provided to clients served under the 
272.16  elderly and disabled waivers. 
272.17     Sec. 31.  Minnesota Statutes 2000, section 256B.0915, 
272.18  subdivision 5, is amended to read: 
272.19     Subd. 5.  [REASSESSMENTS FOR WAIVER CLIENTS.] A 
272.20  reassessment of a client served under the elderly or disabled 
272.21  waiver must be conducted at least every 12 months and at other 
272.22  times when the case manager determines that there has been 
272.23  significant change in the client's functioning.  This may 
272.24  include instances where the client is discharged from the 
272.25  hospital.  
272.26     Sec. 32.  Minnesota Statutes 2000, section 256B.0917, 
272.27  subdivision 7, is amended to read: 
272.28     Subd. 7.  [CONTRACT.] (a) The commissioner of human 
272.29  services shall execute a contract with Living at Home/Block 
272.30  Nurse Program, Inc. (LAH/BN, Inc.).  The contract shall require 
272.31  LAH/BN, Inc. to: 
272.32     (1) develop criteria for and award grants to establish 
272.33  community-based organizations that will implement 
272.34  living-at-home/block nurse programs throughout the state; 
272.35     (2) award grants to enable current living-at-home/block 
272.36  nurse programs to continue to implement the combined 
273.1   living-at-home/block nurse program model; 
273.2      (3) serve as a state technical assistance center to assist 
273.3   and coordinate the living-at-home/block nurse programs 
273.4   established; and 
273.5      (4) manage contracts with individual living-at-home/block 
273.6   nurse programs. 
273.7      (b) The contract shall be effective July 1, 1997, and 
273.8   section 16B.17 shall not apply. 
273.9      Sec. 33.  [256B.0918] [DEVELOPMENT AND PURPOSE OF MEDICAL 
273.10  ASSISTANCE PILOT PROJECT ON SENIOR SERVICES.] 
273.11     Subdivision 1.  [DEVELOPMENT AND PURPOSE.] The commissioner 
273.12  of human services shall develop a medical assistance pilot 
273.13  project on senior services to determine how converting the 
273.14  delivery of housing, supportive services, and health care for 
273.15  seniors into a flexible voucher program will impact public 
273.16  expenditures for older adult service care and provide an 
273.17  alternative way to purchase services based on consumer choice. 
273.18     Subd. 2.  [FEDERAL WAIVER AUTHORITY.] The commissioner 
273.19  shall apply for any necessary federal waivers or approvals to 
273.20  implement this pilot project.  The commissioner shall submit the 
273.21  waiver request no later than April 15, 2002.  
273.22     Subd. 3.  [REPORT.] The commissioner shall report to the 
273.23  legislature by January 15, 2003, on approval of waivers 
273.24  requested.  Upon federal approval, the commissioner shall seek 
273.25  legislative authorization to implement the pilot project.  Once 
273.26  the pilot project is implemented, participating communities and 
273.27  the commissioner of human services shall collaborate to prepare 
273.28  and issue an annual report each December 1 to the appropriate 
273.29  committee chairs in the senate and house on:  (1) the use of 
273.30  state resources, including other funds leveraged for this 
273.31  initiative; (2) the status of individuals being served in the 
273.32  pilot project; and (3) the cost-effectiveness of the pilot 
273.33  project.  The commissioner shall provide data that may be needed 
273.34  to evaluate the pilot project to communities that request the 
273.35  data. 
273.36     Subd. 4.  [SUNSET.] This section sunsets June 30, 2008. 
274.1      Sec. 34.  [SERVICE ACCESS STUDY.] 
274.2      By February 15, 2002, the commissioner of human services 
274.3   shall submit to the legislature recommendations for creating 
274.4   coordinated service access at the county agency level for both 
274.5   publicly subsidized and nonsubsidized long-term care services 
274.6   and housing options.  The report must: 
274.7      (1) include a plan to coordinate public funding streams to 
274.8   allow low-income, privately paying consumers to purchase 
274.9   services through a sliding fee scale; and 
274.10     (2) evaluate the feasibility of statewide implementation, 
274.11  based upon an evaluation of public cost, consumer preferences 
274.12  and satisfaction, and other relevant factors. 
274.13     Sec. 35.  [RESPITE CARE.] 
274.14     The Minnesota board on aging shall report to the 
274.15  legislature by February 1, 2002, on the provision of in-home and 
274.16  out-of-home respite care services on a sliding scale basis under 
274.17  the federal Older Americans Act. 
274.18     Sec. 36.  [REPEALER.] 
274.19     Minnesota Statutes 2000, sections 256B.0911, subdivisions 
274.20  2, 2a, 4, 8, and 9; and 256B.0913, subdivisions 3, 15a, 15b, 
274.21  15c, and 16; Minnesota Rules, parts 9505.2390; 9505.2395; 
274.22  9505.2396; 9505.2400; 9505.2405; 9505.2410; 9505.2413; 
274.23  9505.2415; 9505.2420; 9505.2425; 9505.2426; 9505.2430; 
274.24  9505.2435; 9505.2440; 9505.2445; 9505.2450; 9505.2455; 
274.25  9505.2458; 9505.2460; 9505.2465; 9505.2470; 9505.2473; 
274.26  9505.2475; 9505.2480; 9505.2485; 9505.2486; 9505.2490; 
274.27  9505.2495; 9505.2496; and 9505.2500, are repealed. 
274.28                             ARTICLE 5 
274.29              LONG-TERM CARE REFORM AND REIMBURSEMENT 
274.30     Section 1.  [144.0724] [RESIDENT REIMBURSEMENT 
274.31  CLASSIFICATION.] 
274.32     Subdivision 1.  [RESIDENT REIMBURSEMENT 
274.33  CLASSIFICATIONS.] The commissioner of health shall establish 
274.34  resident reimbursement classifications based upon the 
274.35  assessments of residents of nursing homes and boarding care 
274.36  homes conducted under this section and according to section 
275.1   256B.437.  The reimbursement classifications established under 
275.2   this section shall be implemented after June 30, 2002, but no 
275.3   later than January 1, 2003. 
275.4      Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
275.5   following terms have the meanings given. 
275.6      (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 
275.7   date" means the last day of the minimum data set observation 
275.8   period.  The date sets the designated endpoint of the common 
275.9   observation period, and all minimum data set items refer back in 
275.10  time from that point. 
275.11     (b) [CASE MIX INDEX.] "Case mix index" means the weighting 
275.12  factors assigned to the RUG-III classifications. 
275.13     (c) [INDEX MAXIMIZATION.] "Index maximization" means 
275.14  classifying a resident who could be assigned to more than one 
275.15  category, to the category with the highest case mix index. 
275.16     (d) [MINIMUM DATA SET.] "Minimum data set" means the 
275.17  assessment instrument specified by the Health Care Financing 
275.18  Administration and designated by the Minnesota department of 
275.19  health. 
275.20     (e) [REPRESENTATIVE.] "Representative" means a person who 
275.21  is the resident's guardian or conservator, the person authorized 
275.22  to pay the nursing home expenses of the resident, a 
275.23  representative of the nursing home ombudsman's office whose 
275.24  assistance has been requested, or any other individual 
275.25  designated by the resident. 
275.26     (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 
275.27  utilization groups" or "RUG" means the system for grouping a 
275.28  nursing facility's residents according to their clinical and 
275.29  functional status identified in data supplied by the facility's 
275.30  minimum data set. 
275.31     Subd. 3.  [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] (a) 
275.32  Resident reimbursement classifications shall be based on the 
275.33  minimum data set, version 2.0 assessment instrument, or its 
275.34  successor version mandated by the Health Care Financing 
275.35  Administration that nursing facilities are required to complete 
275.36  for all residents.  The commissioner of health shall establish 
276.1   resident classes according to the 34 group, resource utilization 
276.2   groups, version III or RUG-III model.  Resident classes must be 
276.3   established based on the individual items on the minimum data 
276.4   set and must be completed according to the facility manual for 
276.5   case mix classification issued by the Minnesota department of 
276.6   health.  The facility manual for case mix classification shall 
276.7   be drafted by the Minnesota department of health and presented 
276.8   to the chairs of health and human services legislative 
276.9   committees by December 31, 2001. 
276.10     (b) Each resident must be classified based on the 
276.11  information from the minimum data set according to general 
276.12  domains in clauses (1) to (7): 
276.13     (1) extensive services where a resident requires 
276.14  intravenous feeding or medications, suctioning, tracheostomy 
276.15  care, or is on a ventilator or respirator; 
276.16     (2) rehabilitation where a resident requires physical, 
276.17  occupational, or speech therapy; 
276.18     (3) special care where a resident has cerebral palsy; 
276.19  quadriplegia; multiple sclerosis; pressure ulcers; fever with 
276.20  vomiting, weight loss, or dehydration; tube feeding and aphasia; 
276.21  or is receiving radiation therapy; 
276.22     (4) clinically complex status where a resident has burns, 
276.23  coma, septicemia, pneumonia, internal bleeding, chemotherapy, 
276.24  wounds, kidney failure, urinary tract infections, oxygen, or 
276.25  transfusions; 
276.26     (5) impaired cognition where a resident has poor cognitive 
276.27  performance; 
276.28     (6) behavior problems where a resident exhibits wandering, 
276.29  has hallucinations, or is physically or verbally abusive toward 
276.30  others, unless the resident's other condition would place the 
276.31  resident in other categories; and 
276.32     (7) reduced physical functioning where a resident has no 
276.33  special clinical conditions. 
276.34     (c) The commissioner of health shall establish resident 
276.35  classification according to a 34 group model based on the 
276.36  information on the minimum data set and within the general 
277.1   domains listed in paragraph (b), clauses (1) to (7).  Detailed 
277.2   descriptions of each resource utilization group shall be defined 
277.3   in the facility manual for case mix classification issued by the 
277.4   Minnesota department of health.  The 34 groups are described as 
277.5   follows: 
277.6      (1) SE3:  requires four or five extensive services; 
277.7      (2) SE2:  requires two or three extensive services; 
277.8      (3) SE1:  requires one extensive service; 
277.9      (4) RAD:  requires rehabilitation services and is dependent 
277.10  in activity of daily living (ADL) at a count of 17 or 18; 
277.11     (5) RAC:  requires rehabilitation services and ADL count is 
277.12  14 to 16; 
277.13     (6) RAB:  requires rehabilitation services and ADL count is 
277.14  ten to 13; 
277.15     (7) RAA:  requires rehabilitation services and ADL count is 
277.16  four to nine; 
277.17     (8) SSC:  requires special care and ADL count is 17 or 18; 
277.18     (9) SSB:  requires special care and ADL count is 15 or 16; 
277.19     (10) SSA:  requires special care and ADL count is seven to 
277.20  14; 
277.21     (11) CC2:  clinically complex with depression and ADL count 
277.22  is 17 or 18; 
277.23     (12) CC1:  clinically complex with no depression and ADL 
277.24  count is 17 or 18; 
277.25     (13) CB2:  clinically complex with depression and ADL count 
277.26  is 12 to 16; 
277.27     (14) CB1:  clinically complex with no depression and ADL 
277.28  count is 12 to 16; 
277.29     (15) CA2:  clinically complex with depression and ADL count 
277.30  is four to 11; 
277.31     (16) CA1:  clinically complex with no depression and ADL 
277.32  count is four to 11; 
277.33     (17) IB2:  impaired cognition with nursing rehabilitation 
277.34  and ADL count is six to ten; 
277.35     (18) IB1:  impaired cognition with no nursing 
277.36  rehabilitation and ADL count is six to ten; 
278.1      (19) IA2:  impaired cognition with nursing rehabilitation 
278.2   and ADL count is four or five; 
278.3      (20) IA1:  impaired cognition with no nursing 
278.4   rehabilitation and ADL count is four or five; 
278.5      (21) BB2:  behavior problems with nursing rehabilitation 
278.6   and ADL count is six to ten; 
278.7      (22) BB1:  behavior problems with no nursing rehabilitation 
278.8   and ADL count is six to ten; 
278.9      (23) BA2:  behavior problems with nursing rehabilitation 
278.10  and ADL count is four to five; 
278.11     (24) BA1:  behavior problems with no nursing rehabilitation 
278.12  and ADL count is four to five; 
278.13     (25) PE2:  reduced physical functioning with nursing 
278.14  rehabilitation and ADL count is 16 to 18; 
278.15     (26) PE1:  reduced physical functioning with no nursing 
278.16  rehabilitation and ADL count is 16 to 18; 
278.17     (27) PD2:  reduced physical functioning with nursing 
278.18  rehabilitation and ADL count is 11 to 15; 
278.19     (28) PD1:  reduced physical functioning with no nursing 
278.20  rehabilitation and ADL count is 11 to 15; 
278.21     (29) PC2:  reduced physical functioning with nursing 
278.22  rehabilitation and ADL count is nine or ten; 
278.23     (30) PC1:  reduced physical functioning with no nursing 
278.24  rehabilitation and ADL count is nine or ten; 
278.25     (31) PB2:  reduced physical functioning with nursing 
278.26  rehabilitation and ADL count is six to eight; 
278.27     (32) PB1:  reduced physical functioning with no nursing 
278.28  rehabilitation and ADL count is six to eight; 
278.29     (33) PA2:  reduced physical functioning with nursing 
278.30  rehabilitation and ADL count is four or five; and 
278.31     (34) PA1:  reduced physical functioning with no nursing 
278.32  rehabilitation and ADL count is four or five. 
278.33     Subd. 4.  [RESIDENT ASSESSMENT SCHEDULE.] (a) A facility 
278.34  must conduct and electronically submit to the commissioner of 
278.35  health case mix assessments that conform with the assessment 
278.36  schedule defined by the Code of Federal Regulations, title 42, 
279.1   section 483.20, and published by the United States Department of 
279.2   Health and Human Services, Health Care Financing Administration, 
279.3   in the Long Term Care Assessment Instrument User's Manual, 
279.4   version 2.0, October 1995, and subsequent clarifications made in 
279.5   the Long-Term Care Assessment Instrument Questions and Answers, 
279.6   version 2.0, August 1996.  The commissioner of health may 
279.7   substitute successor manuals or question and answer documents 
279.8   published by the United States Department of Health and Human 
279.9   Services, Health Care Financing Administration, to replace or 
279.10  supplement the current version of the manual or document. 
279.11     (b) The assessments used to determine a case mix 
279.12  classification for reimbursement include the following: 
279.13     (1) a new admission assessment must be completed by day 14 
279.14  following admission; 
279.15     (2) an annual assessment must be completed within 366 days 
279.16  of the last comprehensive assessment; 
279.17     (3) a significant change assessment must be completed 
279.18  within 14 days of the identification of a significant change; 
279.19  and 
279.20     (4) the second quarterly assessment following either a new 
279.21  admission assessment, an annual assessment, or a significant 
279.22  change assessment.  Each quarterly assessment must be completed 
279.23  within 92 days of the previous assessment. 
279.24     Subd. 5.  [SHORT STAYS.] (a) A facility must submit to the 
279.25  commissioner of health an initial admission assessment for all 
279.26  residents who stay in the facility less than 14 days. 
279.27     (b) Notwithstanding the admission assessment requirements 
279.28  of paragraph (a), a facility may elect to accept a default rate 
279.29  with a case mix index of 1.0 for all facility residents who stay 
279.30  less than 14 days in lieu of submitting an initial assessment.  
279.31  Facilities may make this election to be effective on the day of 
279.32  implementation of the revised case mix system. 
279.33     (c) After implementation of the revised case mix system, 
279.34  nursing facilities must elect one of the options described in 
279.35  paragraphs (a) and (b) on the annual report to the commissioner 
279.36  of human services filed for each report year ending September 
280.1   30.  The election shall be effective on the following July 1. 
280.2      (d) For residents who are admitted or readmitted and leave 
280.3   the facility on a frequent basis and for whom readmission is 
280.4   expected, the resident may be discharged on an extended leave 
280.5   status.  This status does not require reassessment each time the 
280.6   resident returns to the facility unless a significant change in 
280.7   the resident's status has occurred since the last assessment.  
280.8   The case mix classification for these residents is determined by 
280.9   the facility election made in paragraphs (a) and (b). 
280.10     Subd. 6.  [PENALTIES FOR LATE OR NONSUBMISSION.] A facility 
280.11  that fails to complete or submit an assessment for a RUG-III 
280.12  classification within seven days of the time requirements in 
280.13  subdivisions 4 and 5 is subject to a reduced rate for that 
280.14  resident.  The reduced rate shall be the lowest rate for that 
280.15  facility.  The reduced rate is effective on the day of admission 
280.16  for new admission assessments or on the day that the assessment 
280.17  was due for all other assessments and continues in effect until 
280.18  the first day of the month following the date of submission of 
280.19  the resident's assessment. 
280.20     Subd. 7.  [NOTICE OF RESIDENT REIMBURSEMENT 
280.21  CLASSIFICATION.] (a) A facility must elect between the options 
280.22  in clauses (1) and (2) to provide notice to a resident of the 
280.23  resident's case mix classification. 
280.24     (1) The commissioner of health shall provide to a nursing 
280.25  facility a notice for each resident of the reimbursement 
280.26  classification established under subdivision 1.  The notice must 
280.27  inform the resident of the classification that was assigned, the 
280.28  opportunity to review the documentation supporting the 
280.29  classification, the opportunity to obtain clarification from the 
280.30  commissioner, and the opportunity to request a reconsideration 
280.31  of the classification.  The commissioner must send notice of 
280.32  resident classification by first class mail.  A nursing facility 
280.33  is responsible for the distribution of the notice to each 
280.34  resident, to the person responsible for the payment of the 
280.35  resident's nursing home expenses, or to another person 
280.36  designated by the resident.  This notice must be distributed 
281.1   within three working days after the facility's receipt of the 
281.2   notice from the commissioner of health. 
281.3      (2) A facility may choose to provide a classification 
281.4   notice, as prescribed by the commissioner of health, to a 
281.5   resident upon receipt of the confirmation of the case mix 
281.6   classification calculated by a facility or a corrected case mix 
281.7   classification as indicated on the final validation report from 
281.8   the commissioner.  A nursing facility is responsible for the 
281.9   distribution of the notice to each resident, to the person 
281.10  responsible for the payment of the resident's nursing home 
281.11  expenses, or to another person designated by the resident.  This 
281.12  notice must be distributed within three working days after the 
281.13  facility's receipt of the validation report from the 
281.14  commissioner.  If a facility elects this option, the 
281.15  commissioner of health shall provide the facility with a list of 
281.16  residents and their case mix classifications as determined by 
281.17  the commissioner.  A nursing facility may make this election to 
281.18  be effective on the day of implementation of the revised case 
281.19  mix system. 
281.20     (3) After implementation of the revised case mix system, a 
281.21  nursing facility shall elect a notice of resident reimbursement 
281.22  classification procedure as described in clause (1) or (2) on 
281.23  the annual report to the commissioner of human services filed 
281.24  for each report year ending September 30.  The election will be 
281.25  effective the following July 1. 
281.26     (b) If a facility submits a correction to an assessment 
281.27  conducted under subdivision 3 that results in a change in case 
281.28  mix classification, the facility shall give written notice to 
281.29  the resident or the resident's representative about the item 
281.30  that was corrected and the reason for the correction.  The 
281.31  notice of corrected assessment may be provided at the same time 
281.32  that the resident or resident's representative is provided the 
281.33  resident's corrected notice of classification. 
281.34     Subd. 8.  [REQUEST FOR RECONSIDERATION OF RESIDENT 
281.35  CLASSIFICATIONS.] (a) The resident, or resident's 
281.36  representative, or the nursing facility or boarding care home 
282.1   may request that the commissioner of health reconsider the 
282.2   assigned reimbursement classification.  The request for 
282.3   reconsideration must be submitted in writing to the commissioner 
282.4   within 30 days of the day the resident or the resident's 
282.5   representative receives the resident classification notice.  The 
282.6   request for reconsideration must include the name of the 
282.7   resident, the name and address of the facility in which the 
282.8   resident resides, the reasons for the reconsideration, the 
282.9   requested classification changes, and documentation supporting 
282.10  the requested classification.  The documentation accompanying 
282.11  the reconsideration request is limited to documentation which 
282.12  establishes that the needs of the resident at the time of the 
282.13  assessment justify a classification which is different than the 
282.14  classification established by the commissioner of health. 
282.15     (b) Upon request, the nursing facility must give the 
282.16  resident or the resident's representative a copy of the 
282.17  assessment form and the other documentation that was given to 
282.18  the commissioner of health to support the assessment findings.  
282.19  The nursing facility shall also provide access to and a copy of 
282.20  other information from the resident's record that has been 
282.21  requested by or on behalf of the resident to support a 
282.22  resident's reconsideration request.  A copy of any requested 
282.23  material must be provided within three working days of receipt 
282.24  of a written request for the information.  If a facility fails 
282.25  to provide the material within this time, it is subject to the 
282.26  issuance of a correction order and penalty assessment under 
282.27  sections 144.653 and 144A.10.  Notwithstanding those sections, 
282.28  any correction order issued under this subdivision must require 
282.29  that the nursing facility immediately comply with the request 
282.30  for information and that as of the date of the issuance of the 
282.31  correction order, the facility shall forfeit to the state a $100 
282.32  fine for the first day of noncompliance, and an increase in the 
282.33  $100 fine by $50 increments for each day the noncompliance 
282.34  continues. 
282.35     (c) In addition to the information required under 
282.36  paragraphs (a) and (b), a reconsideration request from a nursing 
283.1   facility must contain the following information:  (i) the date 
283.2   the reimbursement classification notices were received by the 
283.3   facility; (ii) the date the classification notices were 
283.4   distributed to the resident or the resident's representative; 
283.5   and (iii) a copy of a notice sent to the resident or to the 
283.6   resident's representative.  This notice must inform the resident 
283.7   or the resident's representative that a reconsideration of the 
283.8   resident's classification is being requested, the reason for the 
283.9   request, that the resident's rate will change if the request is 
283.10  approved by the commissioner, the extent of the change, that 
283.11  copies of the facility's request and supporting documentation 
283.12  are available for review, and that the resident also has the 
283.13  right to request a reconsideration.  If the facility fails to 
283.14  provide the required information with the reconsideration 
283.15  request, the request must be denied, and the facility may not 
283.16  make further reconsideration requests on that specific 
283.17  reimbursement classification. 
283.18     (d) Reconsideration by the commissioner must be made by 
283.19  individuals not involved in reviewing the assessment, audit, or 
283.20  reconsideration that established the disputed classification.  
283.21  The reconsideration must be based upon the initial assessment 
283.22  and upon the information provided to the commissioner under 
283.23  paragraphs (a) and (b).  If necessary for evaluating the 
283.24  reconsideration request, the commissioner may conduct on-site 
283.25  reviews.  Within 15 working days of receiving the request for 
283.26  reconsideration, the commissioner shall affirm or modify the 
283.27  original resident classification.  The original classification 
283.28  must be modified if the commissioner determines that the 
283.29  assessment resulting in the classification did not accurately 
283.30  reflect the needs or assessment characteristics of the resident 
283.31  at the time of the assessment.  The resident and the nursing 
283.32  facility or boarding care home shall be notified within five 
283.33  working days after the decision is made.  A decision by the 
283.34  commissioner under this subdivision is the final administrative 
283.35  decision of the agency for the party requesting reconsideration. 
283.36     (e) The resident classification established by the 
284.1   commissioner shall be the classification that applies to the 
284.2   resident while the request for reconsideration is pending. 
284.3      (f) The commissioner may request additional documentation 
284.4   regarding a reconsideration necessary to make an accurate 
284.5   reconsideration determination. 
284.6      Subd. 9.  [AUDIT AUTHORITY.] (a) The commissioner shall 
284.7   audit the accuracy of resident assessments performed under 
284.8   section 256B.437 through desk audits, on-site review of 
284.9   residents and their records, and interviews with staff and 
284.10  families.  The commissioner shall reclassify a resident if the 
284.11  commissioner determines that the resident was incorrectly 
284.12  classified. 
284.13     (b) The commissioner is authorized to conduct on-site 
284.14  audits on an unannounced basis. 
284.15     (c) A facility must grant the commissioner access to 
284.16  examine the medical records relating to the resident assessments 
284.17  selected for audit under this subdivision.  The commissioner may 
284.18  also observe and speak to facility staff and residents. 
284.19     (d) The commissioner shall consider documentation under the 
284.20  time frames for coding items on the minimum data set as set out 
284.21  in the Resident Assessment Instrument Manual published by the 
284.22  Health Care Financing Administration. 
284.23     (e) The commissioner shall develop an audit selection 
284.24  procedure that includes the following factors: 
284.25     (1) The commissioner may target facilities that demonstrate 
284.26  an atypical pattern of scoring minimum data set items, 
284.27  nonsubmission of assessments, late submission of assessments, or 
284.28  a previous history of audit changes of greater than 35 percent.  
284.29  The commissioner shall select at least 20 percent of the most 
284.30  current assessments submitted to the state for audit.  Audits of 
284.31  assessments selected in the targeted facilities must focus on 
284.32  the factors leading to the audit.  If the number of targeted 
284.33  assessments selected does not meet the threshold of 20 percent 
284.34  of the facility residents, then a stratified sample of the 
284.35  remainder of assessments shall be drawn to meet the quota.  If 
284.36  the total change exceeds 35 percent, the commissioner may 
285.1   conduct an expanded audit up to 100 percent of the remaining 
285.2   current assessments. 
285.3      (2) Facilities that are not a part of the targeted group 
285.4   shall be placed in a general pool from which facilities will be 
285.5   selected on a random basis for audit.  Every facility shall be 
285.6   audited annually.  If a facility has two successive audits in 
285.7   which the percentage of change is five percent or less and the 
285.8   facility has not been the subject of a targeted audit in the 
285.9   past 36 months, the facility may be audited biannually.  A 
285.10  stratified sample of 15 percent of the most current assessments 
285.11  shall be selected for audit.  If more than 20 percent of the 
285.12  RUGS-III classifications after the audit are changed, the audit 
285.13  shall be expanded to a second 15 percent sample.  If the total 
285.14  change between the first and second samples exceed 35 percent, 
285.15  the commissioner may expand the audit to all of the remaining 
285.16  assessments. 
285.17     (3) If a facility qualifies for an expanded audit, the 
285.18  commissioner may audit the facility again within six months.  If 
285.19  a facility has two expanded audits within a 24-month period, 
285.20  that facility will be audited at least every six months for the 
285.21  next 18 months. 
285.22     (4) The commissioner may conduct special audits if the 
285.23  commissioner determines that circumstances exist that could 
285.24  alter or affect the validity of case mix classifications of 
285.25  residents.  These circumstances include, but are not limited to, 
285.26  the following:  
285.27     (i) frequent changes in the administration or management of 
285.28  the facility; 
285.29     (ii) an unusually high percentage of residents in a 
285.30  specific case mix classification; 
285.31     (iii) a high frequency in the number of reconsideration 
285.32  requests received from a facility; 
285.33     (iv) frequent adjustments of case mix classifications as 
285.34  the result of reconsiderations or audits; 
285.35     (v) a criminal indictment alleging provider fraud; or 
285.36     (vi) other similar factors that relate to a facility's 
286.1   ability to conduct accurate assessments. 
286.2      (f) Within 15 working days of completing the audit process, 
286.3   the commissioner shall mail the written results of the audit to 
286.4   the facility, along with a written notice for each resident 
286.5   affected to be forwarded by the facility.  The notice must 
286.6   contain the resident's classification and a statement informing 
286.7   the resident, the resident's authorized representative, and the 
286.8   facility of their right to review the commissioner's documents 
286.9   supporting the classification and to request a reconsideration 
286.10  of the classification.  This notice must also include the 
286.11  address and telephone number of the area nursing home ombudsman. 
286.12     Subd. 10.  [TRANSITION.] After implementation of this 
286.13  section, reconsiderations requested for classifications made 
286.14  under section 144.0722, subdivision 1, shall be determined under 
286.15  section 144.0722, subdivision 3. 
286.16     Sec. 2.  Minnesota Statutes 2000, section 144A.071, 
286.17  subdivision 1, is amended to read: 
286.18     Subdivision 1.  [FINDINGS.] The legislature declares that a 
286.19  moratorium on the licensure and medical assistance certification 
286.20  of new nursing home beds and construction projects that 
286.21  exceed $750,000 $1,000,000 is necessary to control nursing home 
286.22  expenditure growth and enable the state to meet the needs of its 
286.23  elderly by providing high quality services in the most 
286.24  appropriate manner along a continuum of care.  
286.25     Sec. 3.  Minnesota Statutes 2000, section 144A.071, 
286.26  subdivision 1a, is amended to read: 
286.27     Subd. 1a.  [DEFINITIONS.] For purposes of sections 144A.071 
286.28  to 144A.073, the following terms have the meanings given them: 
286.29     (a) "attached fixtures" has the meaning given in Minnesota 
286.30  Rules, part 9549.0020, subpart 6. 
286.31     (b) "buildings" has the meaning given in Minnesota Rules, 
286.32  part 9549.0020, subpart 7. 
286.33     (c) "capital assets" has the meaning given in section 
286.34  256B.421, subdivision 16. 
286.35     (d) "commenced construction" means that all of the 
286.36  following conditions were met:  the final working drawings and 
287.1   specifications were approved by the commissioner of health; the 
287.2   construction contracts were let; a timely construction schedule 
287.3   was developed, stipulating dates for beginning, achieving 
287.4   various stages, and completing construction; and all zoning and 
287.5   building permits were applied for. 
287.6      (e) "completion date" means the date on which a certificate 
287.7   of occupancy is issued for a construction project, or if a 
287.8   certificate of occupancy is not required, the date on which the 
287.9   construction project is available for facility use. 
287.10     (f) "construction" means any erection, building, 
287.11  alteration, reconstruction, modernization, or improvement 
287.12  necessary to comply with the nursing home licensure rules. 
287.13     (g) "construction project" means: 
287.14     (1) a capital asset addition to, or replacement of a 
287.15  nursing home or certified boarding care home that results in new 
287.16  space or the remodeling of or renovations to existing facility 
287.17  space; 
287.18     (2) the remodeling or renovation of existing facility space 
287.19  the use of which is modified as a result of the project 
287.20  described in clause (1).  This existing space and the project 
287.21  described in clause (1) must be used for the functions as 
287.22  designated on the construction plans on completion of the 
287.23  project described in clause (1) for a period of not less than 24 
287.24  months; or 
287.25     (3) capital asset additions or replacements that are 
287.26  completed within 12 months before or after the completion date 
287.27  of the project described in clause (1). 
287.28     (h) "new licensed" or "new certified beds" means: 
287.29     (1) newly constructed beds in a facility or the 
287.30  construction of a new facility that would increase the total 
287.31  number of licensed nursing home beds or certified boarding care 
287.32  or nursing home beds in the state; or 
287.33     (2) newly licensed nursing home beds or newly certified 
287.34  boarding care or nursing home beds that result from remodeling 
287.35  of the facility that involves relocation of beds but does not 
287.36  result in an increase in the total number of beds, except when 
288.1   the project involves the upgrade of boarding care beds to 
288.2   nursing home beds, as defined in section 144A.073, subdivision 
288.3   1.  "Remodeling" includes any of the type of conversion, 
288.4   renovation, replacement, or upgrading projects as defined in 
288.5   section 144A.073, subdivision 1. 
288.6      (i) "project construction costs" means the cost of the 
288.7   facility capital asset additions, replacements, renovations, or 
288.8   remodeling projects, construction site preparation costs, and 
288.9   related soft costs.  Project construction costs also include the 
288.10  cost of any remodeling or renovation of existing facility space 
288.11  which is modified as a result of the construction 
288.12  project.  Project construction costs also includes the cost of 
288.13  new technology implemented as part of the construction project. 
288.14     (j) "technology" means information systems or devices that 
288.15  make documentation, charting, and staff time more efficient or 
288.16  encourage and allow for care through alternative settings 
288.17  including, but not limited to, touch screens, monitors, 
288.18  hand-helds, swipe cards, motion detectors, pagers, telemedicine, 
288.19  medication dispensers, and equipment to monitor vital signs and 
288.20  self-injections, and to observe skin and other conditions. 
288.21     Sec. 4.  Minnesota Statutes 2000, section 144A.071, 
288.22  subdivision 2, is amended to read: 
288.23     Subd. 2.  [MORATORIUM.] The commissioner of health, in 
288.24  coordination with the commissioner of human services, shall deny 
288.25  each request for new licensed or certified nursing home or 
288.26  certified boarding care beds except as provided in subdivision 3 
288.27  or 4a, or section 144A.073.  "Certified bed" means a nursing 
288.28  home bed or a boarding care bed certified by the commissioner of 
288.29  health for the purposes of the medical assistance program, under 
288.30  United States Code, title 42, sections 1396 et seq.  
288.31     The commissioner of human services, in coordination with 
288.32  the commissioner of health, shall deny any request to issue a 
288.33  license under section 252.28 and chapter 245A to a nursing home 
288.34  or boarding care home, if that license would result in an 
288.35  increase in the medical assistance reimbursement amount.  
288.36     In addition, the commissioner of health must not approve 
289.1   any construction project whose cost exceeds $750,000 $1,000,000 
289.2   unless: 
289.3      (a) any construction costs exceeding $750,000 $1,000,000 
289.4   are not added to the facility's appraised value and are not 
289.5   included in the facility's payment rate for reimbursement under 
289.6   the medical assistance program; or 
289.7      (b) the project: 
289.8      (1) has been approved through the process described in 
289.9   section 144A.073; 
289.10     (2) meets an exception in subdivision 3 or 4a; 
289.11     (3) is necessary to correct violations of state or federal 
289.12  law issued by the commissioner of health; 
289.13     (4) is necessary to repair or replace a portion of the 
289.14  facility that was damaged by fire, lightning, groundshifts, or 
289.15  other such hazards, including environmental hazards, provided 
289.16  that the provisions of subdivision 4a, clause (a), are met; 
289.17     (5) as of May 1, 1992, the facility has submitted to the 
289.18  commissioner of health written documentation evidencing that the 
289.19  facility meets the "commenced construction" definition as 
289.20  specified in subdivision 1a, clause (d), or that substantial 
289.21  steps have been taken prior to April 1, 1992, relating to the 
289.22  construction project.  "Substantial steps" require that the 
289.23  facility has made arrangements with outside parties relating to 
289.24  the construction project and include the hiring of an architect 
289.25  or construction firm, submission of preliminary plans to the 
289.26  department of health or documentation from a financial 
289.27  institution that financing arrangements for the construction 
289.28  project have been made; or 
289.29     (6) is being proposed by a licensed nursing facility that 
289.30  is not certified to participate in the medical assistance 
289.31  program and will not result in new licensed or certified beds. 
289.32     Prior to the final plan approval of any construction 
289.33  project, the commissioner of health shall be provided with an 
289.34  itemized cost estimate for the project construction costs.  If a 
289.35  construction project is anticipated to be completed in phases, 
289.36  the total estimated cost of all phases of the project shall be 
290.1   submitted to the commissioner and shall be considered as one 
290.2   construction project.  Once the construction project is 
290.3   completed and prior to the final clearance by the commissioner, 
290.4   the total project construction costs for the construction 
290.5   project shall be submitted to the commissioner.  If the final 
290.6   project construction cost exceeds the dollar threshold in this 
290.7   subdivision, the commissioner of human services shall not 
290.8   recognize any of the project construction costs or the related 
290.9   financing costs in excess of this threshold in establishing the 
290.10  facility's property-related payment rate. 
290.11     The dollar thresholds for construction projects are as 
290.12  follows:  for construction projects other than those authorized 
290.13  in clauses (1) to (6), the dollar threshold 
290.14  is $750,000 $1,000,000.  For projects authorized after July 1, 
290.15  1993, under clause (1), the dollar threshold is the cost 
290.16  estimate submitted with a proposal for an exception under 
290.17  section 144A.073, plus inflation as calculated according to 
290.18  section 256B.431, subdivision 3f, paragraph (a).  For projects 
290.19  authorized under clauses (2) to (4), the dollar threshold is the 
290.20  itemized estimate project construction costs submitted to the 
290.21  commissioner of health at the time of final plan approval, plus 
290.22  inflation as calculated according to section 256B.431, 
290.23  subdivision 3f, paragraph (a). 
290.24     The commissioner of health shall adopt rules to implement 
290.25  this section or to amend the emergency rules for granting 
290.26  exceptions to the moratorium on nursing homes under section 
290.27  144A.073.  
290.28     Sec. 5.  Minnesota Statutes 2000, section 144A.071, 
290.29  subdivision 4a, is amended to read: 
290.30     Subd. 4a.  [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 
290.31  best interest of the state to ensure that nursing homes and 
290.32  boarding care homes continue to meet the physical plant 
290.33  licensing and certification requirements by permitting certain 
290.34  construction projects.  Facilities should be maintained in 
290.35  condition to satisfy the physical and emotional needs of 
290.36  residents while allowing the state to maintain control over 
291.1   nursing home expenditure growth. 
291.2      The commissioner of health in coordination with the 
291.3   commissioner of human services, may approve the renovation, 
291.4   replacement, upgrading, or relocation of a nursing home or 
291.5   boarding care home, under the following conditions: 
291.6      (a) to license or certify beds in a new facility 
291.7   constructed to replace a facility or to make repairs in an 
291.8   existing facility that was destroyed or damaged after June 30, 
291.9   1987, by fire, lightning, or other hazard provided:  
291.10     (i) destruction was not caused by the intentional act of or 
291.11  at the direction of a controlling person of the facility; 
291.12     (ii) at the time the facility was destroyed or damaged the 
291.13  controlling persons of the facility maintained insurance 
291.14  coverage for the type of hazard that occurred in an amount that 
291.15  a reasonable person would conclude was adequate; 
291.16     (iii) the net proceeds from an insurance settlement for the 
291.17  damages caused by the hazard are applied to the cost of the new 
291.18  facility or repairs; 
291.19     (iv) the new facility is constructed on the same site as 
291.20  the destroyed facility or on another site subject to the 
291.21  restrictions in section 144A.073, subdivision 5; 
291.22     (v) the number of licensed and certified beds in the new 
291.23  facility does not exceed the number of licensed and certified 
291.24  beds in the destroyed facility; and 
291.25     (vi) the commissioner determines that the replacement beds 
291.26  are needed to prevent an inadequate supply of beds. 
291.27  Project construction costs incurred for repairs authorized under 
291.28  this clause shall not be considered in the dollar threshold 
291.29  amount defined in subdivision 2; 
291.30     (b) to license or certify beds that are moved from one 
291.31  location to another within a nursing home facility, provided the 
291.32  total costs of remodeling performed in conjunction with the 
291.33  relocation of beds does not exceed $750,000 $1,000,000; 
291.34     (c) to license or certify beds in a project recommended for 
291.35  approval under section 144A.073; 
291.36     (d) to license or certify beds that are moved from an 
292.1   existing state nursing home to a different state facility, 
292.2   provided there is no net increase in the number of state nursing 
292.3   home beds; 
292.4      (e) to certify and license as nursing home beds boarding 
292.5   care beds in a certified boarding care facility if the beds meet 
292.6   the standards for nursing home licensure, or in a facility that 
292.7   was granted an exception to the moratorium under section 
292.8   144A.073, and if the cost of any remodeling of the facility does 
292.9   not exceed $750,000 $1,000,000.  If boarding care beds are 
292.10  licensed as nursing home beds, the number of boarding care beds 
292.11  in the facility must not increase beyond the number remaining at 
292.12  the time of the upgrade in licensure.  The provisions contained 
292.13  in section 144A.073 regarding the upgrading of the facilities do 
292.14  not apply to facilities that satisfy these requirements; 
292.15     (f) to license and certify up to 40 beds transferred from 
292.16  an existing facility owned and operated by the Amherst H. Wilder 
292.17  Foundation in the city of St. Paul to a new unit at the same 
292.18  location as the existing facility that will serve persons with 
292.19  Alzheimer's disease and other related disorders.  The transfer 
292.20  of beds may occur gradually or in stages, provided the total 
292.21  number of beds transferred does not exceed 40.  At the time of 
292.22  licensure and certification of a bed or beds in the new unit, 
292.23  the commissioner of health shall delicense and decertify the 
292.24  same number of beds in the existing facility.  As a condition of 
292.25  receiving a license or certification under this clause, the 
292.26  facility must make a written commitment to the commissioner of 
292.27  human services that it will not seek to receive an increase in 
292.28  its property-related payment rate as a result of the transfers 
292.29  allowed under this paragraph; 
292.30     (g) to license and certify nursing home beds to replace 
292.31  currently licensed and certified boarding care beds which may be 
292.32  located either in a remodeled or renovated boarding care or 
292.33  nursing home facility or in a remodeled, renovated, newly 
292.34  constructed, or replacement nursing home facility within the 
292.35  identifiable complex of health care facilities in which the 
292.36  currently licensed boarding care beds are presently located, 
293.1   provided that the number of boarding care beds in the facility 
293.2   or complex are decreased by the number to be licensed as nursing 
293.3   home beds and further provided that, if the total costs of new 
293.4   construction, replacement, remodeling, or renovation exceed ten 
293.5   percent of the appraised value of the facility or $200,000, 
293.6   whichever is less, the facility makes a written commitment to 
293.7   the commissioner of human services that it will not seek to 
293.8   receive an increase in its property-related payment rate by 
293.9   reason of the new construction, replacement, remodeling, or 
293.10  renovation.  The provisions contained in section 144A.073 
293.11  regarding the upgrading of facilities do not apply to facilities 
293.12  that satisfy these requirements; 
293.13     (h) to license as a nursing home and certify as a nursing 
293.14  facility a facility that is licensed as a boarding care facility 
293.15  but not certified under the medical assistance program, but only 
293.16  if the commissioner of human services certifies to the 
293.17  commissioner of health that licensing the facility as a nursing 
293.18  home and certifying the facility as a nursing facility will 
293.19  result in a net annual savings to the state general fund of 
293.20  $200,000 or more; 
293.21     (i) to certify, after September 30, 1992, and prior to July 
293.22  1, 1993, existing nursing home beds in a facility that was 
293.23  licensed and in operation prior to January 1, 1992; 
293.24     (j) to license and certify new nursing home beds to replace 
293.25  beds in a facility acquired by the Minneapolis community 
293.26  development agency as part of redevelopment activities in a city 
293.27  of the first class, provided the new facility is located within 
293.28  three miles of the site of the old facility.  Operating and 
293.29  property costs for the new facility must be determined and 
293.30  allowed under section 256B.431 or 256B.434; 
293.31     (k) to license and certify up to 20 new nursing home beds 
293.32  in a community-operated hospital and attached convalescent and 
293.33  nursing care facility with 40 beds on April 21, 1991, that 
293.34  suspended operation of the hospital in April 1986.  The 
293.35  commissioner of human services shall provide the facility with 
293.36  the same per diem property-related payment rate for each 
294.1   additional licensed and certified bed as it will receive for its 
294.2   existing 40 beds; 
294.3      (l) to license or certify beds in renovation, replacement, 
294.4   or upgrading projects as defined in section 144A.073, 
294.5   subdivision 1, so long as the cumulative total costs of the 
294.6   facility's remodeling projects do not 
294.7   exceed $750,000 $1,000,000; 
294.8      (m) to license and certify beds that are moved from one 
294.9   location to another for the purposes of converting up to five 
294.10  four-bed wards to single or double occupancy rooms in a nursing 
294.11  home that, as of January 1, 1993, was county-owned and had a 
294.12  licensed capacity of 115 beds; 
294.13     (n) to allow a facility that on April 16, 1993, was a 
294.14  106-bed licensed and certified nursing facility located in 
294.15  Minneapolis to layaway all of its licensed and certified nursing 
294.16  home beds.  These beds may be relicensed and recertified in a 
294.17  newly-constructed teaching nursing home facility affiliated with 
294.18  a teaching hospital upon approval by the legislature.  The 
294.19  proposal must be developed in consultation with the interagency 
294.20  committee on long-term care planning.  The beds on layaway 
294.21  status shall have the same status as voluntarily delicensed and 
294.22  decertified beds, except that beds on layaway status remain 
294.23  subject to the surcharge in section 256.9657.  This layaway 
294.24  provision expires July 1, 1998; 
294.25     (o) to allow a project which will be completed in 
294.26  conjunction with an approved moratorium exception project for a 
294.27  nursing home in southern Cass county and which is directly 
294.28  related to that portion of the facility that must be repaired, 
294.29  renovated, or replaced, to correct an emergency plumbing problem 
294.30  for which a state correction order has been issued and which 
294.31  must be corrected by August 31, 1993; 
294.32     (p) to allow a facility that on April 16, 1993, was a 
294.33  368-bed licensed and certified nursing facility located in 
294.34  Minneapolis to layaway, upon 30 days prior written notice to the 
294.35  commissioner, up to 30 of the facility's licensed and certified 
294.36  beds by converting three-bed wards to single or double 
295.1   occupancy.  Beds on layaway status shall have the same status as 
295.2   voluntarily delicensed and decertified beds except that beds on 
295.3   layaway status remain subject to the surcharge in section 
295.4   256.9657, remain subject to the license application and renewal 
295.5   fees under section 144A.07 and shall be subject to a $100 per 
295.6   bed reactivation fee.  In addition, at any time within three 
295.7   years of the effective date of the layaway, the beds on layaway 
295.8   status may be: 
295.9      (1) relicensed and recertified upon relocation and 
295.10  reactivation of some or all of the beds to an existing licensed 
295.11  and certified facility or facilities located in Pine River, 
295.12  Brainerd, or International Falls; provided that the total 
295.13  project construction costs related to the relocation of beds 
295.14  from layaway status for any facility receiving relocated beds 
295.15  may not exceed the dollar threshold provided in subdivision 2 
295.16  unless the construction project has been approved through the 
295.17  moratorium exception process under section 144A.073; 
295.18     (2) relicensed and recertified, upon reactivation of some 
295.19  or all of the beds within the facility which placed the beds in 
295.20  layaway status, if the commissioner has determined a need for 
295.21  the reactivation of the beds on layaway status. 
295.22     The property-related payment rate of a facility placing 
295.23  beds on layaway status must be adjusted by the incremental 
295.24  change in its rental per diem after recalculating the rental per 
295.25  diem as provided in section 256B.431, subdivision 3a, paragraph 
295.26  (c).  The property-related payment rate for a facility 
295.27  relicensing and recertifying beds from layaway status must be 
295.28  adjusted by the incremental change in its rental per diem after 
295.29  recalculating its rental per diem using the number of beds after 
295.30  the relicensing to establish the facility's capacity day 
295.31  divisor, which shall be effective the first day of the month 
295.32  following the month in which the relicensing and recertification 
295.33  became effective.  Any beds remaining on layaway status more 
295.34  than three years after the date the layaway status became 
295.35  effective must be removed from layaway status and immediately 
295.36  delicensed and decertified; 
296.1      (q) to license and certify beds in a renovation and 
296.2   remodeling project to convert 12 four-bed wards into 24 two-bed 
296.3   rooms, expand space, and add improvements in a nursing home 
296.4   that, as of January 1, 1994, met the following conditions:  the 
296.5   nursing home was located in Ramsey county; had a licensed 
296.6   capacity of 154 beds; and had been ranked among the top 15 
296.7   applicants by the 1993 moratorium exceptions advisory review 
296.8   panel.  The total project construction cost estimate for this 
296.9   project must not exceed the cost estimate submitted in 
296.10  connection with the 1993 moratorium exception process; 
296.11     (r) to license and certify up to 117 beds that are 
296.12  relocated from a licensed and certified 138-bed nursing facility 
296.13  located in St. Paul to a hospital with 130 licensed hospital 
296.14  beds located in South St. Paul, provided that the nursing 
296.15  facility and hospital are owned by the same or a related 
296.16  organization and that prior to the date the relocation is 
296.17  completed the hospital ceases operation of its inpatient 
296.18  hospital services at that hospital.  After relocation, the 
296.19  nursing facility's status under section 256B.431, subdivision 
296.20  2j, shall be the same as it was prior to relocation.  The 
296.21  nursing facility's property-related payment rate resulting from 
296.22  the project authorized in this paragraph shall become effective 
296.23  no earlier than April 1, 1996.  For purposes of calculating the 
296.24  incremental change in the facility's rental per diem resulting 
296.25  from this project, the allowable appraised value of the nursing 
296.26  facility portion of the existing health care facility physical 
296.27  plant prior to the renovation and relocation may not exceed 
296.28  $2,490,000; 
296.29     (s) to license and certify two beds in a facility to 
296.30  replace beds that were voluntarily delicensed and decertified on 
296.31  June 28, 1991; 
296.32     (t) to allow 16 licensed and certified beds located on July 
296.33  1, 1994, in a 142-bed nursing home and 21-bed boarding care home 
296.34  facility in Minneapolis, notwithstanding the licensure and 
296.35  certification after July 1, 1995, of the Minneapolis facility as 
296.36  a 147-bed nursing home facility after completion of a 
297.1   construction project approved in 1993 under section 144A.073, to 
297.2   be laid away upon 30 days' prior written notice to the 
297.3   commissioner.  Beds on layaway status shall have the same status 
297.4   as voluntarily delicensed or decertified beds except that they 
297.5   shall remain subject to the surcharge in section 256.9657.  The 
297.6   16 beds on layaway status may be relicensed as nursing home beds 
297.7   and recertified at any time within five years of the effective 
297.8   date of the layaway upon relocation of some or all of the beds 
297.9   to a licensed and certified facility located in Watertown, 
297.10  provided that the total project construction costs related to 
297.11  the relocation of beds from layaway status for the Watertown 
297.12  facility may not exceed the dollar threshold provided in 
297.13  subdivision 2 unless the construction project has been approved 
297.14  through the moratorium exception process under section 144A.073. 
297.15     The property-related payment rate of the facility placing 
297.16  beds on layaway status must be adjusted by the incremental 
297.17  change in its rental per diem after recalculating the rental per 
297.18  diem as provided in section 256B.431, subdivision 3a, paragraph 
297.19  (c).  The property-related payment rate for the facility 
297.20  relicensing and recertifying beds from layaway status must be 
297.21  adjusted by the incremental change in its rental per diem after 
297.22  recalculating its rental per diem using the number of beds after 
297.23  the relicensing to establish the facility's capacity day 
297.24  divisor, which shall be effective the first day of the month 
297.25  following the month in which the relicensing and recertification 
297.26  became effective.  Any beds remaining on layaway status more 
297.27  than five years after the date the layaway status became 
297.28  effective must be removed from layaway status and immediately 
297.29  delicensed and decertified; 
297.30     (u) to license and certify beds that are moved within an 
297.31  existing area of a facility or to a newly constructed addition 
297.32  which is built for the purpose of eliminating three- and 
297.33  four-bed rooms and adding space for dining, lounge areas, 
297.34  bathing rooms, and ancillary service areas in a nursing home 
297.35  that, as of January 1, 1995, was located in Fridley and had a 
297.36  licensed capacity of 129 beds; 
298.1      (v) to relocate 36 beds in Crow Wing county and four beds 
298.2   from Hennepin county to a 160-bed facility in Crow Wing county, 
298.3   provided all the affected beds are under common ownership; 
298.4      (w) to license and certify a total replacement project of 
298.5   up to 49 beds located in Norman county that are relocated from a 
298.6   nursing home destroyed by flood and whose residents were 
298.7   relocated to other nursing homes.  The operating cost payment 
298.8   rates for the new nursing facility shall be determined based on 
298.9   the interim and settle-up payment provisions of Minnesota Rules, 
298.10  part 9549.0057, and the reimbursement provisions of section 
298.11  256B.431, except that subdivision 26, paragraphs (a) and (b), 
298.12  shall not apply until the second rate year after the settle-up 
298.13  cost report is filed.  Property-related reimbursement rates 
298.14  shall be determined under section 256B.431, taking into account 
298.15  any federal or state flood-related loans or grants provided to 
298.16  the facility; 
298.17     (x) to license and certify a total replacement project of 
298.18  up to 129 beds located in Polk county that are relocated from a 
298.19  nursing home destroyed by flood and whose residents were 
298.20  relocated to other nursing homes.  The operating cost payment 
298.21  rates for the new nursing facility shall be determined based on 
298.22  the interim and settle-up payment provisions of Minnesota Rules, 
298.23  part 9549.0057, and the reimbursement provisions of section 
298.24  256B.431, except that subdivision 26, paragraphs (a) and (b), 
298.25  shall not apply until the second rate year after the settle-up 
298.26  cost report is filed.  Property-related reimbursement rates 
298.27  shall be determined under section 256B.431, taking into account 
298.28  any federal or state flood-related loans or grants provided to 
298.29  the facility; 
298.30     (y) to license and certify beds in a renovation and 
298.31  remodeling project to convert 13 three-bed wards into 13 two-bed 
298.32  rooms and 13 single-bed rooms, expand space, and add 
298.33  improvements in a nursing home that, as of January 1, 1994, met 
298.34  the following conditions:  the nursing home was located in 
298.35  Ramsey county, was not owned by a hospital corporation, had a 
298.36  licensed capacity of 64 beds, and had been ranked among the top 
299.1   15 applicants by the 1993 moratorium exceptions advisory review 
299.2   panel.  The total project construction cost estimate for this 
299.3   project must not exceed the cost estimate submitted in 
299.4   connection with the 1993 moratorium exception process; 
299.5      (z) to license and certify up to 150 nursing home beds to 
299.6   replace an existing 285 bed nursing facility located in St. 
299.7   Paul.  The replacement project shall include both the renovation 
299.8   of existing buildings and the construction of new facilities at 
299.9   the existing site.  The reduction in the licensed capacity of 
299.10  the existing facility shall occur during the construction 
299.11  project as beds are taken out of service due to the construction 
299.12  process.  Prior to the start of the construction process, the 
299.13  facility shall provide written information to the commissioner 
299.14  of health describing the process for bed reduction, plans for 
299.15  the relocation of residents, and the estimated construction 
299.16  schedule.  The relocation of residents shall be in accordance 
299.17  with the provisions of law and rule; 
299.18     (aa) to allow the commissioner of human services to license 
299.19  an additional 36 beds to provide residential services for the 
299.20  physically handicapped under Minnesota Rules, parts 9570.2000 to 
299.21  9570.3400, in a 198-bed nursing home located in Red Wing, 
299.22  provided that the total number of licensed and certified beds at 
299.23  the facility does not increase; 
299.24     (bb) to license and certify a new facility in St. Louis 
299.25  county with 44 beds constructed to replace an existing facility 
299.26  in St. Louis county with 31 beds, which has resident rooms on 
299.27  two separate floors and an antiquated elevator that creates 
299.28  safety concerns for residents and prevents nonambulatory 
299.29  residents from residing on the second floor.  The project shall 
299.30  include the elimination of three- and four-bed rooms; 
299.31     (cc) to license and certify four beds in a 16-bed certified 
299.32  boarding care home in Minneapolis to replace beds that were 
299.33  voluntarily delicensed and decertified on or before March 31, 
299.34  1992.  The licensure and certification is conditional upon the 
299.35  facility periodically assessing and adjusting its resident mix 
299.36  and other factors which may contribute to a potential 
300.1   institution for mental disease declaration.  The commissioner of 
300.2   human services shall retain the authority to audit the facility 
300.3   at any time and shall require the facility to comply with any 
300.4   requirements necessary to prevent an institution for mental 
300.5   disease declaration, including delicensure and decertification 
300.6   of beds, if necessary; or 
300.7      (dd) to license and certify 72 beds in an existing facility 
300.8   in Mille Lacs county with 80 beds as part of a renovation 
300.9   project.  The renovation must include construction of an 
300.10  addition to accommodate ten residents with beginning and 
300.11  midstage dementia in a self-contained living unit; creation of 
300.12  three resident households where dining, activities, and support 
300.13  spaces are located near resident living quarters; designation of 
300.14  four beds for rehabilitation in a self-contained area; 
300.15  designation of 30 private rooms; and other improvements.; 
300.16     (ee) to license and certify beds in a facility that has 
300.17  undergone replacement or remodeling as part of a planned closure 
300.18  under section 256B.437; 
300.19     (ff) to license and certify a total replacement project of 
300.20  up to 124 beds located in Wilkin county that are in need of 
300.21  relocation from a nursing home substantially destroyed by 
300.22  flood.  The operating cost payment rates for the new nursing 
300.23  facility shall be determined based on the interim and settle-up 
300.24  payment provisions of Minnesota Rules, part 9549.0057, and the 
300.25  reimbursement provisions of section 256B.431, except that 
300.26  section 256B.431, subdivision 26, paragraphs (a) and (b), shall 
300.27  not apply until the second rate year after the settle-up cost 
300.28  report is filed.  Property-related reimbursement rates shall be 
300.29  determined under section 256B.431, taking into account any 
300.30  federal or state flood-related loans or grants provided to the 
300.31  facility; 
300.32     (gg) to allow the commissioner of human services to license 
300.33  an additional nine beds to provide residential services for the 
300.34  physically handicapped under Minnesota Rules, parts 9570.2000 to 
300.35  9570.3400, in a 215-bed nursing home located in Duluth, provided 
300.36  that the total number of licensed and certified beds at the 
301.1   facility does not increase; 
301.2      (hh) to license and certify up to 120 new nursing facility 
301.3   beds to replace beds in a facility in Anoka county, which was 
301.4   licensed for 98 beds as of July 1, 2000, provided the new 
301.5   facility is located within four miles of the existing facility 
301.6   and is in Anoka county.  Operating and property rates shall be 
301.7   determined and allowed under section 256B.431 and Minnesota 
301.8   Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 
301.9   256B.435.  The provisions of section 256B.431, subdivision 26, 
301.10  paragraphs (a) and (b), do not apply until the second rate year 
301.11  following settle-up; or 
301.12     (ii) to transfer up to 98 beds of a 129-licensed bed 
301.13  facility located in Anoka county that, as of March 25, 2001, is 
301.14  in the active process of closing, to a 122-licensed bed 
301.15  nonprofit nursing facility located in the city of Columbia 
301.16  Heights or its affiliate.  The transfer is effective when the 
301.17  receiving facility notifies the commissioner in writing of the 
301.18  number of beds accepted.  The commissioner shall place all 
301.19  transferred beds on layaway status held in the name of the 
301.20  receiving facility.  The layaway adjustment provisions of 
301.21  section 256B.431, subdivision 30, do not apply to this layaway.  
301.22  The receiving facility may only remove the beds from layaway for 
301.23  recertification and relicensure at the receiving facility's 
301.24  current site, or at a newly constructed facility located in 
301.25  Anoka county.  The receiving facility must receive statutory 
301.26  authorization before removing these beds from layaway. 
301.27     Sec. 6.  Minnesota Statutes 2000, section 144A.073, 
301.28  subdivision 2, is amended to read: 
301.29     Subd. 2.  [REQUEST FOR PROPOSALS.] At the authorization by 
301.30  the legislature of additional medical assistance expenditures 
301.31  for exceptions to the moratorium on nursing homes, the 
301.32  interagency committee shall publish in the State Register a 
301.33  request for proposals for nursing home projects to be licensed 
301.34  or certified under section 144A.071, subdivision 4a, clause 
301.35  (c).  The public notice of this funding and the request for 
301.36  proposals must specify how the approval criteria will be 
302.1   prioritized by the advisory review panel, the interagency 
302.2   long-term care planning committee, and the commissioner.  The 
302.3   notice must describe the information that must accompany a 
302.4   request and state that proposals must be submitted to the 
302.5   interagency committee within 90 days of the date of 
302.6   publication.  The notice must include the amount of the 
302.7   legislative appropriation available for the additional costs to 
302.8   the medical assistance program of projects approved under this 
302.9   section.  If no money is appropriated for a year, the 
302.10  interagency committee shall publish a notice to that effect, and 
302.11  no proposals shall be requested.  If money is appropriated, the 
302.12  interagency committee shall initiate the application and review 
302.13  process described in this section at least twice each biennium 
302.14  and up to four times each biennium, according to dates 
302.15  established by rule.  Authorized funds shall be allocated 
302.16  proportionally to the number of processes.  Funds not encumbered 
302.17  by an earlier process within a biennium shall carry forward to 
302.18  subsequent iterations of the process.  Authorization for 
302.19  expenditures does not carry forward into the following 
302.20  biennium.  To be considered for approval, a proposal must 
302.21  include the following information: 
302.22     (1) whether the request is for renovation, replacement, 
302.23  upgrading, conversion, or relocation; 
302.24     (2) a description of the problem the project is designed to 
302.25  address; 
302.26     (3) a description of the proposed project; 
302.27     (4) an analysis of projected costs of the nursing facility 
302.28  proposal, which are not required to exceed the cost threshold 
302.29  referred to in section 144A.071, subdivision 1, to be considered 
302.30  under this section, including initial construction and 
302.31  remodeling costs; site preparation costs; technology costs; 
302.32  financing costs, including the current estimated long-term 
302.33  financing costs of the proposal, which consists of estimates of 
302.34  the amount and sources of money, reserves if required under the 
302.35  proposed funding mechanism, annual payments schedule, interest 
302.36  rates, length of term, closing costs and fees, insurance costs, 
303.1   and any completed marketing study or underwriting review; and 
303.2   estimated operating costs during the first two years after 
303.3   completion of the project; 
303.4      (5) for proposals involving replacement of all or part of a 
303.5   facility, the proposed location of the replacement facility and 
303.6   an estimate of the cost of addressing the problem through 
303.7   renovation; 
303.8      (6) for proposals involving renovation, an estimate of the 
303.9   cost of addressing the problem through replacement; 
303.10     (7) the proposed timetable for commencing construction and 
303.11  completing the project; 
303.12     (8) a statement of any licensure or certification issues, 
303.13  such as certification survey deficiencies; 
303.14     (9) the proposed relocation plan for current residents if 
303.15  beds are to be closed so that the department of human services 
303.16  can estimate the total costs of a proposal; and 
303.17     (10) other information required by permanent rule of the 
303.18  commissioner of health in accordance with subdivisions 4 and 8. 
303.19     Sec. 7.  Minnesota Statutes 2000, section 144A.073, 
303.20  subdivision 4, is amended to read: 
303.21     Subd. 4.  [CRITERIA FOR REVIEW.] The following criteria 
303.22  shall be used in a consistent manner to compare, evaluate, and 
303.23  rank all proposals submitted.  Except for the criteria specified 
303.24  in clause (3), the application of criteria listed under this 
303.25  subdivision shall not reflect any distinction based on the 
303.26  geographic location of the proposed project: 
303.27     (1) the extent to which the proposal furthers state 
303.28  long-term care goals, including the goals stated in section 
303.29  144A.31, and including the goal of enhancing the availability 
303.30  and use of alternative care services and the goal of reducing 
303.31  the number of long-term care resident rooms with more than two 
303.32  beds; 
303.33     (2) the proposal's long-term effects on state costs 
303.34  including the cost estimate of the project according to section 
303.35  144A.071, subdivision 5a; 
303.36     (3) the extent to which the proposal promotes equitable 
304.1   access to long-term care services in nursing homes through 
304.2   redistribution of the nursing home bed supply, as measured by 
304.3   the number of beds relative to the population 85 or older, 
304.4   projected to the year 2000 by the state demographer, and 
304.5   according to items (i) to (iv): 
304.6      (i) reduce beds in counties where the supply is high, 
304.7   relative to the statewide mean, and increase beds in counties 
304.8   where the supply is low, relative to the statewide mean; 
304.9      (ii) adjust the bed supply so as to create the greatest 
304.10  benefits in improving the distribution of beds; 
304.11     (iii) adjust the existing bed supply in counties so that 
304.12  the bed supply in a county moves toward the statewide mean; and 
304.13     (iv) adjust the existing bed supply so that the 
304.14  distribution of beds as projected for the year 2020 would be 
304.15  consistent with projected need, based on the methodology 
304.16  outlined in the interagency long-term care committee's 1993 
304.17  nursing home bed distribution study; 
304.18     (4) the extent to which the project improves conditions 
304.19  that affect the health or safety of residents, such as narrow 
304.20  corridors, narrow door frames, unenclosed fire exits, and wood 
304.21  frame construction, and similar provisions contained in fire and 
304.22  life safety codes and licensure and certification rules; 
304.23     (5) the extent to which the project improves conditions 
304.24  that affect the comfort or quality of life of residents in a 
304.25  facility or the ability of the facility to provide efficient 
304.26  care, such as a relatively high number of residents in a room; 
304.27  inadequate lighting or ventilation; poor access to bathing or 
304.28  toilet facilities; a lack of available ancillary space for 
304.29  dining rooms, day rooms, or rooms used for other activities; 
304.30  problems relating to heating, cooling, or energy efficiency; 
304.31  inefficient location of nursing stations; narrow corridors; or 
304.32  other provisions contained in the licensure and certification 
304.33  rules; 
304.34     (6) the extent to which the applicant demonstrates the 
304.35  delivery of quality care, as defined in state and federal 
304.36  statutes and rules, to residents as evidenced by the two most 
305.1   recent state agency certification surveys and the applicants' 
305.2   response to those surveys; 
305.3      (7) the extent to which the project removes the need for 
305.4   waivers or variances previously granted by either the licensing 
305.5   agency, certifying agency, fire marshal, or local government 
305.6   entity; and 
305.7      (8) the extent to which the project increases the number of 
305.8   private or single bed rooms; and 
305.9      (9) other factors that may be developed in permanent rule 
305.10  by the commissioner of health that evaluate and assess how the 
305.11  proposed project will further promote or protect the health, 
305.12  safety, comfort, treatment, or well-being of the facility's 
305.13  residents. 
305.14     Sec. 8.  [144A.185] [DEFINITIONS.] 
305.15     Subdivision 1.  [APPLICABILITY.] For purposes of sections 
305.16  144A.185 to 144A.1887, the terms defined in this section have 
305.17  the meanings given them.  
305.18     Subd. 2.  [CLOSURE.] "Closure" means the cessation of 
305.19  operations of a nursing home and the delicensure or 
305.20  decertification of all beds within the facility.  
305.21     Subd. 3.  [CURTAILMENT, REDUCTION, OR CHANGE IN 
305.22  OPERATIONS.] "Curtailment, reduction, or change in operations" 
305.23  means any change in operations or services that would result in 
305.24  or encourage the relocation of residents. 
305.25     Subd. 4.  [FACILITY.] "Facility" means a licensed nursing 
305.26  home or a certified boarding care home licensed according to 
305.27  sections 144.50 to 144.56. 
305.28     Subd. 5.  [LICENSEE.] "Licensee" means the owner of the 
305.29  facility or the owner's designee or the commissioner of health 
305.30  for a facility in receivership. 
305.31     Subd. 6.  [LOCAL AGENCY.] "Local agency" means a county or 
305.32  a multicounty social service agency authorized under section 
305.33  393.01 as the agency responsible for providing social services 
305.34  for the county in which the facility is located.  
305.35     Subd. 7.  [PLAN.] "Plan" means a process developed under 
305.36  section 144A.186 for the closure or curtailment, reduction, or 
306.1   change in operations of a facility and for the subsequent 
306.2   relocation of residents.  
306.3      Subd. 8.  [RELOCATION.] "Relocation" means the discharge of 
306.4   a resident and movement of the resident to another facility or 
306.5   living arrangement as a result of a closure or curtailment, 
306.6   reduction, or change in operations of a facility. 
306.7      Sec. 9.  [144A.1855] [INITIAL NOTICE.] 
306.8      Subdivision 1.  [NOTIFICATION; PARTIES.] A licensee shall 
306.9   notify the following parties in writing when there is an intent 
306.10  to close or curtail, reduce, or change operations which would 
306.11  result in or encourage the relocation of residents:  
306.12     (1) the commissioner of health; 
306.13     (2) the commissioner of human services; 
306.14     (3) the local agency; 
306.15     (4) the office of the ombudsman for older Minnesotans; and 
306.16     (5) the office of the ombudsman for mental health and 
306.17  mental retardation.  
306.18     Subd. 2.  [NOTICE REQUIREMENTS.] The written notice shall 
306.19  include the names, telephone numbers, fax numbers, and e-mail 
306.20  addresses of the persons in the facility who are responsible for 
306.21  coordinating the facility's efforts in the planning process and 
306.22  the number of residents potentially affected by the closure or 
306.23  curtailment, reduction, or change in operations.  
306.24     Sec. 10.  [144A.186] [PLANNING PROCESS.] 
306.25     Subdivision 1.  [LOCAL AGENCY REQUIREMENTS.] (a) A local 
306.26  agency, within five working days of receiving an initial notice 
306.27  from a licensee according to section 144A.1855, shall provide 
306.28  all parties identified in section 144A.1855, subdivision 1, with 
306.29  the names, telephone numbers, fax numbers, and e-mail addresses 
306.30  of those persons who are responsible for coordinating local 
306.31  agency efforts in the planning process. 
306.32     (b) Within ten working days of receipt of the notice under 
306.33  paragraph (a), the local agency and licensee shall meet to 
306.34  develop the relocation plan under subdivision 2.  The local 
306.35  agency shall inform the departments of health and human 
306.36  services, the office of the ombudsman for older Minnesotans, and 
307.1   the office of the ombudsman for mental health and mental 
307.2   retardation of the date, time, and location of the meeting so 
307.3   that their representatives may attend.  The relocation plan must 
307.4   be completed within 45 days, but may be completed earlier 
307.5   according to a schedule agreed to by all parties. 
307.6      Subd. 2.  [RELOCATION PLAN.] (a) The plan shall: 
307.7      (1) identify the expected date of closure or curtailment, 
307.8   reduction, or change in operations; 
307.9      (2) outline the process for public notification of the 
307.10  closure or curtailment, reduction, or change in operations; 
307.11     (3) outline the process to ensure 60-day advance written 
307.12  notice to residents, family members, and designated 
307.13  representatives of residents; 
307.14     (4) present an aggregate description of the resident 
307.15  population remaining to be relocated and the population's needs; 
307.16     (5) outline the individual resident assessment process to 
307.17  be used; 
307.18     (6) identify an inventory of available relocation options, 
307.19  including home and community-based services; 
307.20     (7) identify a timeline for submission of the list required 
307.21  under section 144A.1865, subdivision 3; and 
307.22     (8) identify a schedule for each element of the plan.  
307.23     (b) All parties to the plan shall refrain from any public 
307.24  notification of the intent to close or curtail, reduce, or 
307.25  change operations until a relocation plan has been established.  
307.26     Sec. 11.  [144A.1865] [REQUIREMENTS OF LICENSEE.] 
307.27     Subdivision 1.  [RELOCATION.] The licensee shall provide 
307.28  for the safe, orderly, and appropriate relocation of residents.  
307.29  The licensee and facility staff shall cooperate with 
307.30  representatives from the local agency, the departments of health 
307.31  and human services, the office of the ombudsman for older 
307.32  Minnesotans, and the office of the ombudsman for mental health 
307.33  and mental retardation in planning for and implementing the 
307.34  relocation of residents.  
307.35     Subd. 2.  [INTERDISCIPLINARY TEAM.] The licensee shall 
307.36  establish an interdisciplinary team responsible for coordinating 
308.1   and implementing the plan under section 144A.186, subdivision 
308.2   2.  The interdisciplinary team shall include representatives 
308.3   from the local agency, the office of the ombudsman for older 
308.4   Minnesotans, facility staff who provide direct care services to 
308.5   the residents, and the facility administration.  
308.6      Subd. 3.  [RESIDENT LISTS.] The licensee shall provide a 
308.7   list to the local agency that includes the following information 
308.8   on each resident to be relocated:  
308.9      (1) name; 
308.10     (2) date of birth; 
308.11     (3) social security number; 
308.12     (4) medical assistance ID number; 
308.13     (5) all diagnoses; and 
308.14     (6) name of and contact information for the resident's 
308.15  family or other designated representative.  
308.16     Subd. 4.  [CONSULTATION WITH LOCAL AGENCY.] The licensee 
308.17  shall consult with the local agency on the availability and 
308.18  development of resources and in the resident relocation process. 
308.19     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
308.20  following final enactment. 
308.21     Sec. 12.  [144A.187] [RESIDENT AND PHYSICIAN NOTICE.] 
308.22     Subdivision 1.  [RESIDENT NOTICE REQUIRED.] (a) At least 60 
308.23  days before the proposed date of closure or curtailment, 
308.24  reduction, or change in operations as agreed to in the plan 
308.25  under section 144A.186, the licensee shall send a written notice 
308.26  of closure or curtailment, reduction, or change in operations to 
308.27  each resident being relocated, the resident's family member or 
308.28  designated representative, and the resident's attending 
308.29  physician. 
308.30     (b) The notice must include: 
308.31     (1) the date of the proposed closure or curtailment, 
308.32  reduction, or change in operations; 
308.33     (2) the name, address, telephone number, fax number, and 
308.34  e-mail address of the individuals in the facility responsible 
308.35  for providing assistance and information; 
308.36     (3) a notice of upcoming meetings for residents, families 
309.1   and designated representatives, and resident and family councils 
309.2   to discuss the relocation of residents; 
309.3      (4) the name, address, and telephone number of the local 
309.4   agency contact person; 
309.5      (5) the name, address, and telephone number of the office 
309.6   of the ombudsman for older Minnesotans and the office of the 
309.7   ombudsman for mental health and mental retardation; and 
309.8      (6) a notice of resident rights during discharge and 
309.9   relocation. 
309.10     (c) The notice to residents must comply with all applicable 
309.11  state and federal requirements for notice of transfer or 
309.12  discharge of nursing home residents.  
309.13     Subd. 2.  [MEDICAL INFORMATION REQUEST.] The licensee shall 
309.14  request the attending physician to furnish the licensee with, or 
309.15  arrange for the release of, any medical information needed to 
309.16  update a resident's medical records and to prepare transfer 
309.17  forms and discharge summaries.  
309.18     Sec. 13.  [144A.1875] [RELOCATION OF RESIDENTS.] 
309.19     Subdivision 1.  [PREPARATION; PLACEMENT INFORMATION.] A 
309.20  licensee shall provide sufficient preparation to residents to 
309.21  ensure safe, orderly, and appropriate discharge and relocation.  
309.22  The facility is responsible for assisting residents in finding 
309.23  placement within the resident's desired geographic location 
309.24  using the Senior LinkAge database of the department of human 
309.25  services.  By January 1, 2002, Senior LinkAge line shall make 
309.26  available via a Web site the name, address, and telephone and 
309.27  fax numbers of each facility with available beds, the 
309.28  certification level of the available beds, the types of services 
309.29  available, and the number of beds that are available as updated 
309.30  daily by the licensee.  The Web site shall include the 
309.31  information required by section 256.975, subdivision 7, 
309.32  paragraph (b), clause (1), and home and community-based services 
309.33  and other options for individuals with special needs.  The 
309.34  licensee must provide residents, their families or designated 
309.35  representatives, the office of the ombudsman for older 
309.36  Minnesotans, the office of the ombudsman for mental health and 
310.1   mental retardation, and the local agency with the toll-free 
310.2   number and Web site address for the Senior LinkAge line.  
310.3      Subd. 2.  [RESIDENT AND FAMILY MEETINGS.] After preparing 
310.4   the plan according to section 144A.186, the licensee shall 
310.5   conduct meetings with residents, families and designated 
310.6   representatives, and resident and family councils to notify them 
310.7   of the process for resident relocation.  Representatives from 
310.8   the local agency, the office of the ombudsman for older 
310.9   Minnesotans, the office of the ombudsman for mental health and 
310.10  mental retardation, the departments of health and human services 
310.11  shall receive advance notice of these meetings. 
310.12     Subd. 3.  [PERSONAL PROPERTY.] (a) The licensee shall 
310.13  update the inventory of residents' personal possessions and 
310.14  provide a copy of the final inventory to each resident and the 
310.15  resident's family or designated representative prior to the 
310.16  relocation of the resident.  The licensee is responsible for the 
310.17  timely transfer of a resident's possessions for all relocations 
310.18  within the state and within a 50-mile radius of the facility for 
310.19  relocations outside the state. 
310.20     (b) The licensee shall complete a final accounting of 
310.21  personal funds held in trust by the licensee and provide a copy 
310.22  of the accounting to each resident and the resident's family or 
310.23  designated representative.  The licensee is responsible for the 
310.24  timely transfer of all personal funds held in trust by the 
310.25  licensee. 
310.26     Subd. 4.  [SITE VISITS.] The licensee is responsible for 
310.27  assisting residents desiring to make site visits to facilities 
310.28  or other placements to which the resident may be relocated, 
310.29  unless it is medically inadvisable, as documented by the 
310.30  attending physician in the resident's care record.  The licensee 
310.31  shall provide, or make arrangements for, transportation for site 
310.32  visits to facilities or other placements within a 50-mile radius.
310.33     Subd. 5.  [FINAL NOTICE OF RELOCATION.] (a) Before 
310.34  relocating a resident, the licensee shall provide a final 
310.35  written notice to the resident, the resident's family or 
310.36  designated representative, and the resident's attending 
311.1   physician. 
311.2      (b) The final written notice shall: 
311.3      (1) be provided seven days before the relocation of a 
311.4   resident, unless the resident agrees to waive the resident's 
311.5   right to advance notice; and 
311.6      (2) identify the date of the anticipated relocation and the 
311.7   location to which the resident is being relocated.  
311.8      Subd. 6.  [ADMINISTRATIVE DUTIES.] (a) All administrative 
311.9   duties of the licensee under subdivisions 1, 2, 4, and 5 must be 
311.10  completed before relocation of a resident.  
311.11     (b) The licensee is responsible for providing the receiving 
311.12  facility or other health, housing, or care entity with a 
311.13  complete and accurate resident record, including information on 
311.14  family members, designated representatives, guardians, social 
311.15  service caseworkers, and other contact information.  The record 
311.16  must also include all information necessary to provide 
311.17  appropriate medical care and social services, including, but not 
311.18  limited to, information on preadmission screening, Level I and 
311.19  Level II screening, minimum data set and all other assessments, 
311.20  resident diagnosis, behavior, and medication.  
311.21     (c) For residents with special care needs, the licensee 
311.22  shall consult with the receiving facility or other placement 
311.23  entity and provide staff training or other preparation as needed 
311.24  to assist in providing for the special needs.  
311.25     (d) The licensee shall assist residents with the transfer 
311.26  or reconnection of telephone service.  The licensee shall bear 
311.27  all costs associated with reestablishing telephone service.  
311.28     Subd. 7.  [TRANSPORTATION; CONTINUITY OF CARE.] The 
311.29  licensee shall make arrangements or provide for the 
311.30  transportation of residents to the new facility or placement 
311.31  within the state or within a 50-mile radius for relocations 
311.32  outside the state.  The licensee shall provide a staff person to 
311.33  accompany the resident during transportation, upon request of 
311.34  the resident, the resident's family, or designated 
311.35  representative.  The discharge and relocation of residents must 
311.36  comply with all applicable state and federal requirements and 
312.1   must be conducted in a safe, orderly, and appropriate manner.  
312.2   The licensee must ensure that there is no disruption in 
312.3   providing meals, medications, or treatments of a resident during 
312.4   the relocation process.  
312.5      Sec. 14.  [144A.1885] [RELOCATION REPORTS.] 
312.6      (a) Beginning the week following development of the initial 
312.7   relocation plan under section 144A.186, the licensee shall 
312.8   submit weekly status reports to the commissioners of health and 
312.9   human services, or their designees, and to the local agency. 
312.10     (b) The first status report must identify the relocation 
312.11  plan developed under section 144A.186, the interdisciplinary 
312.12  team members, and the number of residents to be relocated.  
312.13     (c) Subsequent status reports must note any modifications 
312.14  to the relocation plan, any change of interdisciplinary team 
312.15  members or number of residents relocated, the placement 
312.16  destination to which residents have been relocated, and the 
312.17  number of residents remaining to be relocated.  Subsequent 
312.18  status reports must also identify issues or problems encountered 
312.19  during the relocation process and the resolution of these issues.
312.20     Sec. 15.  [144A.1886] [REQUIREMENTS OF LOCAL AGENCY.] 
312.21     Subdivision 1.  [MEETING; REPRESENTATION.] (a) The local 
312.22  agency with the licensee shall convene a meeting to develop a 
312.23  plan according to section 144A.186, subdivision 1, paragraph (b).
312.24     (b) The local agency shall designate a representative to 
312.25  the interdisciplinary team established by the licensee 
312.26  responsible for coordinating the relocation efforts.  
312.27     Subd. 2.  [RESOURCE.] (a) The local agency shall serve as a 
312.28  resource in the relocation process.  
312.29     (b) Concurrent with the notice sent to residents from the 
312.30  licensee according to section 144A.187, subdivision 1, the local 
312.31  agency shall provide written notice to residents, family 
312.32  members, and designated representatives describing: 
312.33     (1) the local agency's role in the relocation process and 
312.34  in the follow-up to relocation; 
312.35     (2) a local agency contact name, address, and telephone 
312.36  number; and 
313.1      (3) the name, address, and telephone number of the office 
313.2   of the ombudsman for older Minnesotans and the office of the 
313.3   ombudsman for mental health and mental retardation.  
313.4      (c) The local agency is responsible for the safe and 
313.5   orderly relocation of residents in cases where an emergent need 
313.6   arises or when the licensee has abrogated the licensee's 
313.7   responsibilities under the relocation plan.  
313.8      Subd. 3.  [COORDINATION; OVERSIGHT.] (a) The local agency 
313.9   shall meet with appropriate facility staff to coordinate any 
313.10  assistance.  Coordination shall include participating in group 
313.11  meetings with residents, family members, and designated 
313.12  representatives to explain the transfer or relocation process.  
313.13     (b) The local agency shall monitor compliance with all 
313.14  components of the relocation plan.  When the licensee is not in 
313.15  compliance, the local agency shall notify the commissioners of 
313.16  health and human services.  
313.17     (c) Except as requested by the resident, family member, or 
313.18  designated representative and within the parameters of the 
313.19  Vulnerable Adults Act, the local agency may halt a relocation 
313.20  that it deems inappropriate or dangerous to the health or safety 
313.21  of a resident. 
313.22     Subd. 4.  [FOLLOW-UP REVIEW.] (a) A member of the local 
313.23  agency staff shall visit residents relocated within 100 miles of 
313.24  the county within 30 days after a relocation.  Local agency 
313.25  staff shall interview the resident and family member or 
313.26  designated representative or shall observe the resident on-site, 
313.27  or both, and review and discuss pertinent medical or social 
313.28  records with appropriate facility staff to assess the adjustment 
313.29  of the resident to the new placement, recommend services or 
313.30  methods to meet any special needs of the resident, and identify 
313.31  residents at risk.  
313.32     (b) The local agency may conduct subsequent follow-up 
313.33  visits in cases where the adjustment of the resident to the new 
313.34  placement is in question.  
313.35     (c) Within 60 days of the completion of the follow-up 
313.36  visits, the local agency shall submit a written summary of the 
314.1   follow-up work to the commissioners of health and human 
314.2   services, in a manner approved by the commissioners.  
314.3      (d) The local agency shall submit a report of any issues 
314.4   that may require further review or monitoring to the 
314.5   commissioner of health. 
314.6      Sec. 16.  [144A.1887] [FUNDING.] 
314.7      (a) Within 60 days of a nursing home ceasing operations, 
314.8   the commissioner of human services shall reimburse nursing homes 
314.9   that are reimbursed under sections 256B.431, 256B.434, and 
314.10  256B.435 for operating costs incurred by the nursing home during 
314.11  the closure process.  The amount to be reimbursed to the nursing 
314.12  home shall be determined by applying paragraphs (b) to (f). 
314.13     (b) The facility shall provide the commissioner of human 
314.14  services with the nursing home's operating costs for the time 
314.15  period of 30 days prior to the notice specified under section 
314.16  144A.16, to 30 days after the nursing home's closure. 
314.17     (c) The nursing home shall provide the commissioner of 
314.18  human services with the number of medical assistance, Medicare, 
314.19  private pay, and other resident days for the period referenced 
314.20  in paragraph (b) by the 11 case mix categories. 
314.21     (d) The commissioner of human services shall calculate a 
314.22  nursing home closure rate by dividing the facility operating 
314.23  costs in paragraph (b) by the total resident days in paragraph 
314.24  (c). 
314.25     (e) The total closure costs attributable to medical 
314.26  assistance shall be determined by multiplying the nursing home 
314.27  closure rate in paragraph (d) by the medical assistance days 
314.28  provided by the nursing facility in paragraph (c). 
314.29     (f) The amount to be reimbursed to the nursing home is 
314.30  equal to the total closure costs in paragraph (e) minus the sum 
314.31  of the nursing facility's 11 operating rates times their 
314.32  respective number of medical assistance days by case mix as 
314.33  referenced in paragraph (c). 
314.34     Sec. 17.  [144A.36] [TRANSITION PLANNING GRANTS.] 
314.35     Subdivision 1.  [DEFINITIONS.] "Eligible nursing home" 
314.36  means any nursing home licensed under sections 144A.01 to 
315.1   144A.16 and certified by the appropriate authority under United 
315.2   States Code, title 42, sections 1396-1396p, to participate as a 
315.3   vendor in the medical assistance program established under 
315.4   chapter 256B. 
315.5      Subd. 2.  [GRANTS AUTHORIZED.] (a) The commissioner shall 
315.6   establish a program of transition planning grants to assist 
315.7   eligible nursing homes in implementing the provisions in 
315.8   paragraphs (b) and (c).  
315.9      (b) Transition planning grants may be used by nursing homes 
315.10  to develop strategic plans which identify the appropriate 
315.11  institutional and noninstitutional settings necessary to meet 
315.12  the older adult service needs of the community.  
315.13     (c) At a minimum, a strategic plan must consist of: 
315.14     (1) a needs assessment to determine what older adult 
315.15  services are needed and desired by the community; 
315.16     (2) an assessment of the appropriate settings in which to 
315.17  provide needed older adult services; 
315.18     (3) an assessment identifying currently available services 
315.19  and their settings in the community; and 
315.20     (4) a transition plan to achieve the needed outcome 
315.21  identified by the assessment. 
315.22     Subd. 3.  [ALLOCATION OF GRANTS.] (a) Eligible nursing 
315.23  homes must apply to the commissioner no later than September 1 
315.24  of each fiscal year for grants awarded in that fiscal year.  A 
315.25  grant shall be awarded upon signing of a grant contract. 
315.26     (b) The commissioner must make a final decision on the 
315.27  funding of each application within 60 days of the deadline for 
315.28  receiving applications. 
315.29     Subd. 4.  [EVALUATION.] The commissioner shall evaluate the 
315.30  overall effectiveness of the grant program.  The commissioner 
315.31  may collect, from the nursing homes receiving grants, the 
315.32  information necessary to evaluate the grant program.  
315.33  Information related to the financial condition of individual 
315.34  nursing homes shall be classified as nonpublic data. 
315.35     Sec. 18.  [144A.37] [ALTERNATIVE NURSING HOME SURVEY 
315.36  PROCESS.] 
316.1      Subdivision 1.  [ALTERNATIVE NURSING HOME SURVEY 
316.2   SCHEDULES.] (a) The commissioner of health shall implement 
316.3   alternative procedures for the nursing home survey process as 
316.4   authorized under this section.  
316.5      (b) These alternative survey process procedures seek to:  
316.6   (1) use department resources more effectively and efficiently to 
316.7   target problem areas; (2) use other existing or new mechanisms 
316.8   to provide objective assessments of quality and to measure 
316.9   quality improvement; (3) provide for frequent collaborative 
316.10  interaction of facility staff and surveyors rather than a 
316.11  punitive approach; and (4) reward a nursing home that has 
316.12  performed very well by extending intervals between full surveys. 
316.13     (c) The commissioner shall pursue changes in federal law 
316.14  necessary to accomplish this process and shall apply for any 
316.15  necessary federal waivers or approval.  If a federal waiver is 
316.16  approved, the commissioner shall promptly submit, to the house 
316.17  and senate committees with jurisdiction over health and human 
316.18  services policy and finance, fiscal estimates for implementing 
316.19  the alternative survey process waiver.  The commissioner shall 
316.20  also pursue any necessary federal law changes during the 107th 
316.21  Congress. 
316.22     (d) The alternative nursing home survey schedule and 
316.23  related educational activities shall not be implemented until 
316.24  funding is appropriated by the legislature. 
316.25     Subd. 2.  [SURVEY INTERVALS.] The commissioner of health 
316.26  must extend the time period between standard surveys up to 30 
316.27  months based on the criteria established in subdivision 4.  In 
316.28  using the alternative survey schedule, the requirement for the 
316.29  statewide average to not exceed 12 months does not apply. 
316.30     Subd. 3.  [COMPLIANCE HISTORY.] The commissioner shall 
316.31  develop a process for identifying the survey cycles for skilled 
316.32  nursing facilities based upon the compliance history of the 
316.33  facility.  This process can use a range of months for survey 
316.34  intervals.  At a minimum, the process must be based on 
316.35  information from the last two survey cycles and shall take into 
316.36  consideration any deficiencies issued as the result of a survey 
317.1   or a complaint investigation during the interval.  A skilled 
317.2   nursing facility with a finding of substandard quality of care 
317.3   or a finding of immediate jeopardy is not entitled to a survey 
317.4   interval greater than 12 months.  The commissioner shall alter 
317.5   the survey cycle for a specific skilled nursing facility based 
317.6   on findings identified through the completion of a survey, a 
317.7   monitoring visit, or a complaint investigation.  The 
317.8   commissioner must also take into consideration information other 
317.9   than the facility's compliance history. 
317.10     Subd. 4.  [CRITERIA FOR SURVEY INTERVAL 
317.11  CLASSIFICATION.] (a) The commissioner shall provide public 
317.12  notice of the classification process and shall identify the 
317.13  selected survey cycles for each skilled nursing facility.  The 
317.14  classification system must be based on an analysis of the 
317.15  findings made during the past two standard survey intervals, but 
317.16  it only takes one survey or complaint finding to modify the 
317.17  interval. 
317.18     (b) The commissioner shall also take into consideration 
317.19  information obtained from residents and family members in each 
317.20  skilled nursing facility and from other sources such as 
317.21  employees and ombudsmen in determining the appropriate survey 
317.22  intervals for facilities. 
317.23     Subd. 5.  [REQUIRED MONITORING.] (a) The commissioner shall 
317.24  conduct at least one monitoring visit on an annual basis for 
317.25  every skilled nursing facility which has been selected for a 
317.26  survey cycle greater than 12 months.  The commissioner shall 
317.27  develop protocols for the monitoring visits which shall be less 
317.28  extensive than the requirements for a standard survey.  The 
317.29  commissioner shall use the criteria in paragraph (b) to 
317.30  determine whether additional monitoring visits to a facility 
317.31  will be required.  
317.32     (b) The criteria shall include, but not be limited to, the 
317.33  following: 
317.34     (1) changes in ownership, administration of the facility, 
317.35  or direction of the facility's nursing service; 
317.36     (2) changes in the facility's quality indicators which 
318.1   might evidence a decline in the facility's quality of care; 
318.2      (3) reductions in staffing or an increase in the 
318.3   utilization of temporary nursing personnel; and 
318.4      (4) complaint information or other information that 
318.5   identifies potential concerns for the quality of the care and 
318.6   services provided in the skilled nursing facility. 
318.7      Subd. 6.  [SURVEY REQUIREMENTS FOR FACILITIES NOT APPROVED 
318.8   FOR EXTENDED SURVEY INTERVALS.] The commissioner shall establish 
318.9   a process for surveying and monitoring of facilities which 
318.10  require a survey interval of less than 15 months.  This 
318.11  information shall identify the steps that the commissioner must 
318.12  take to monitor the facility in addition to the standard survey. 
318.13     Subd. 7.  [IMPACT ON SURVEY AGENCY'S BUDGET.] The 
318.14  implementation of an alternative survey process for the state 
318.15  must not result in any reduction of funding that would have been 
318.16  provided to the state survey agency for survey and enforcement 
318.17  activity based upon the completion of full standard surveys for 
318.18  each skilled nursing facility in the state. 
318.19     Subd. 8.  [EDUCATIONAL ACTIVITIES.] The commissioner shall 
318.20  expand the state survey agency's ability to conduct training and 
318.21  educational efforts for skilled nursing facilities, residents 
318.22  and family members, residents and family councils, long-term 
318.23  care ombudsman programs, and the general public. 
318.24     Subd. 9.  [EVALUATION.] The commissioner shall develop a 
318.25  process for the evaluation of the effectiveness of an 
318.26  alternative survey process conducted under this section. 
318.27     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
318.28  following final enactment. 
318.29     Sec. 19.  [144A.38] [INNOVATIONS IN QUALITY DEMONSTRATION 
318.30  GRANTS.] 
318.31     Subdivision 1.  [PROGRAM ESTABLISHED.] The commissioner of 
318.32  health and the commissioner of human services shall establish a 
318.33  long-term care grant program that demonstrates best practices 
318.34  and innovation for long-term care service delivery and housing.  
318.35  The grants must fund demonstrations that create new means and 
318.36  models for serving the elderly or demonstrate creativity in 
319.1   service provision through the scope of their program or service. 
319.2      Subd. 2.  [ELIGIBILITY.] Grants may only be made to those 
319.3   who provide direct service or housing to the elderly within the 
319.4   state.  Grants may only be made for projects that show 
319.5   innovations and measurable improvement in resident care, quality 
319.6   of life, use of technology, or customer satisfaction. 
319.7      Subd. 3.  [AWARDING OF GRANTS.] (a) Applications for grants 
319.8   must be made to the commissioners on forms prescribed by the 
319.9   commissioners. 
319.10     (b) The commissioners shall review applications and award 
319.11  grants based on the following criteria: 
319.12     (1) improvement in direct care to residents; 
319.13     (2) increase in efficiency through the use of technology; 
319.14     (3) increase in quality of care through the use of 
319.15  technology; 
319.16     (4) increase in the access and delivery of service; 
319.17     (5) enhancement of nursing staff training; 
319.18     (6) the effectiveness of the project as a demonstration; 
319.19  and 
319.20     (7) the immediate transferability of the project to scale. 
319.21     (c) In reviewing applications and awarding grants, the 
319.22  commissioners shall consult with long-term care providers, 
319.23  consumers of long-term care, long-term care researchers, and 
319.24  staff of other state agencies. 
319.25     (d) Grants for eligible projects may not exceed $100,000. 
319.26     Sec. 20.  [144A.39] [LONG-TERM CARE QUALITY PROFILES.] 
319.27     Subdivision l.  [DEVELOPMENT AND IMPLEMENTATION OF QUALITY 
319.28  PROFILES.] (a) The commissioner of health and the commissioner 
319.29  of human services shall develop and implement a quality profile 
319.30  system for nursing facilities and, beginning not later than July 
319.31  1, 2003, other providers of long-term care services, except when 
319.32  the quality profile system would duplicate requirements under 
319.33  sections 256B.5011 and 256B.5013.  The system must be developed 
319.34  and implemented to the extent possible without the collection of 
319.35  new data.  To the extent possible, the system must incorporate 
319.36  or be coordinated with information on quality maintained by area 
320.1   agencies on aging, long-term care trade associations, and other 
320.2   entities.  The system must be designed to provide information on 
320.3   quality: 
320.4      (1) to consumers and their families to facilitate informed 
320.5   choices of service providers; 
320.6      (2) to providers to enable them to measure the results of 
320.7   their quality improvement efforts and compare quality 
320.8   achievements with other service providers; and 
320.9      (3) to public and private purchasers of long-term care 
320.10  services to enable them to purchase high-quality care. 
320.11     (b) The system must be developed in consultation with the 
320.12  long-term care task force, area agencies on aging, and 
320.13  representatives of consumers, providers, and labor unions.  
320.14  Within the limits of available appropriations, the commissioners 
320.15  may employ consultants to assist with this project. 
320.16     Subd. 2.  [QUALITY MEASUREMENT TOOLS.] The commissioners 
320.17  shall identify and apply existing quality measurement tools to: 
320.18     (1) emphasize quality of care and its relationship to 
320.19  quality of life; and 
320.20     (2) address the needs of various users of long-term care 
320.21  services, including, but not limited to, short-stay residents, 
320.22  persons with behavioral problems, persons with dementia, and 
320.23  persons who are members of minority groups. 
320.24  The tools must be identified and applied, to the extent 
320.25  possible, without requiring providers to supply information 
320.26  beyond current state and federal requirements. 
320.27     Subd. 3.  [CONSUMER SURVEYS.] Following identification of 
320.28  the quality measurement tool, the commissioners shall conduct 
320.29  surveys of long-term care service consumers to develop quality 
320.30  profiles of providers.  To the extent possible, surveys must be 
320.31  conducted face-to-face by state employees or contractors.  At 
320.32  the discretion of the commissioners, surveys may be conducted by 
320.33  telephone or by provider staff.  Surveys must be conducted 
320.34  periodically to update quality profiles of individual service 
320.35  providers. 
320.36     Subd. 4.  [DISSEMINATION OF QUALITY PROFILES.] By July 1, 
321.1   2002, the commissioners shall implement a system to disseminate 
321.2   the quality profiles developed from consumer surveys using the 
321.3   quality measurement tool.  Profiles must be disseminated to the 
321.4   Senior LinkAge line and to consumers, providers, and purchasers 
321.5   of long-term care services through all feasible printed and 
321.6   electronic outlets.  The commissioners shall conduct a public 
321.7   awareness campaign to inform potential users regarding profile 
321.8   contents and potential uses. 
321.9      Sec. 21.  Minnesota Statutes 2000, section 256B.431, 
321.10  subdivision 17, is amended to read: 
321.11     Subd. 17.  [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.] 
321.12  (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3, 
321.13  for rate periods beginning on October 1, 1992, and for rate 
321.14  years beginning after June 30, 1993, a nursing facility that (1) 
321.15  has completed a construction project approved under section 
321.16  144A.071, subdivision 4a, clause (m); (2) has completed a 
321.17  construction project approved under section 144A.071, 
321.18  subdivision 4a, and effective after June 30, 1995; or (3) has 
321.19  completed a renovation, replacement, or upgrading project 
321.20  approved under the moratorium exception process in section 
321.21  144A.073 shall be reimbursed for costs directly identified to 
321.22  that project as provided in subdivision 16 and this subdivision. 
321.23     (b) Notwithstanding Minnesota Rules, part 9549.0060, 
321.24  subparts 5, item A, subitems (1) and (3), and 7, item D, 
321.25  allowable interest expense on debt shall include: 
321.26     (1) interest expense on debt related to the cost of 
321.27  purchasing or replacing depreciable equipment, excluding 
321.28  vehicles, not to exceed six percent of the total historical cost 
321.29  of the project; and 
321.30     (2) interest expense on debt related to financing or 
321.31  refinancing costs, including costs related to points, loan 
321.32  origination fees, financing charges, legal fees, and title 
321.33  searches; and issuance costs including bond discounts, bond 
321.34  counsel, underwriter's counsel, corporate counsel, printing, and 
321.35  financial forecasts.  Allowable debt related to items in this 
321.36  clause shall not exceed seven percent of the total historical 
322.1   cost of the project.  To the extent these costs are financed, 
322.2   the straight-line amortization of the costs in this clause is 
322.3   not an allowable cost; and 
322.4      (3) interest on debt incurred for the establishment of a 
322.5   debt reserve fund, net of the interest earned on the debt 
322.6   reserve fund. 
322.7      (c) Debt incurred for costs under paragraph (b) is not 
322.8   subject to Minnesota Rules, part 9549.0060, subpart 5, item A, 
322.9   subitem (5) or (6). 
322.10     (d) The incremental increase in a nursing facility's rental 
322.11  rate, determined under Minnesota Rules, parts 9549.0010 to 
322.12  9549.0080, and this section, resulting from the acquisition of 
322.13  allowable capital assets, and allowable debt and interest 
322.14  expense under this subdivision shall be added to its 
322.15  property-related payment rate and shall be effective on the 
322.16  first day of the month following the month in which the 
322.17  moratorium project was completed. 
322.18     (e) Notwithstanding subdivision 3f, paragraph (a), for rate 
322.19  periods beginning on October 1, 1992, and for rate years 
322.20  beginning after June 30, 1993, the replacement-costs-new per bed 
322.21  limit to be used in Minnesota Rules, part 9549.0060, subpart 4, 
322.22  item B, for a nursing facility that has completed a renovation, 
322.23  replacement, or upgrading project that has been approved under 
322.24  the moratorium exception process in section 144A.073, or that 
322.25  has completed an addition to or replacement of buildings, 
322.26  attached fixtures, or land improvements for which the total 
322.27  historical cost exceeds the lesser of $150,000 or ten percent of 
322.28  the most recent appraised value, must be $47,500 per licensed 
322.29  bed in multiple-bed rooms and $71,250 per licensed bed in a 
322.30  single-bed room.  These amounts must be adjusted annually as 
322.31  specified in subdivision 3f, paragraph (a), beginning January 1, 
322.32  1993. 
322.33     (f) For purposes of this paragraph, a total replacement 
322.34  means the complete replacement of the nursing facility's 
322.35  physical plant through the construction of a new physical plant, 
322.36  the transfer of the nursing facility's license from one physical 
323.1   plant location to another, or a new building addition to 
323.2   relocate beds from three- and four-bed wards.  For total 
323.3   replacement projects completed on or after July 1, 1992, the 
323.4   commissioner shall compute the incremental change in the nursing 
323.5   facility's rental per diem, for rate years beginning on or after 
323.6   July 1, 1995, by replacing its appraised value, including the 
323.7   historical capital asset costs, and the capital debt and 
323.8   interest costs with the new nursing facility's allowable capital 
323.9   asset costs and the related allowable capital debt and interest 
323.10  costs.  If the new nursing facility has decreased its licensed 
323.11  capacity, the aggregate investment per bed limit in subdivision 
323.12  3a, paragraph (c), shall apply.  If the new nursing facility has 
323.13  retained a portion of the original physical plant for nursing 
323.14  facility usage, then a portion of the appraised value prior to 
323.15  the replacement must be retained and included in the calculation 
323.16  of the incremental change in the nursing facility's rental per 
323.17  diem.  For purposes of this part, the original nursing facility 
323.18  means the nursing facility prior to the total replacement 
323.19  project.  The portion of the appraised value to be retained 
323.20  shall be calculated according to clauses (1) to (3): 
323.21     (1) The numerator of the allocation ratio shall be the 
323.22  square footage of the area in the original physical plant which 
323.23  is being retained for nursing facility usage. 
323.24     (2) The denominator of the allocation ratio shall be the 
323.25  total square footage of the original nursing facility physical 
323.26  plant. 
323.27     (3) Each component of the nursing facility's allowable 
323.28  appraised value prior to the total replacement project shall be 
323.29  multiplied by the allocation ratio developed by dividing clause 
323.30  (1) by clause (2). 
323.31     In the case of either type of total replacement as 
323.32  authorized under section 144A.071 or 144A.073, the provisions of 
323.33  this subdivision shall also apply.  For purposes of the 
323.34  moratorium exception authorized under section 144A.071, 
323.35  subdivision 4a, paragraph (s), if the total replacement involves 
323.36  the renovation and use of an existing health care facility 
324.1   physical plant, the new allowable capital asset costs and 
324.2   related debt and interest costs shall include first the 
324.3   allowable capital asset costs and related debt and interest 
324.4   costs of the renovation, to which shall be added the allowable 
324.5   capital asset costs of the existing physical plant prior to the 
324.6   renovation, and if reported by the facility, the related 
324.7   allowable capital debt and interest costs. 
324.8      (g) Notwithstanding Minnesota Rules, part 9549.0060, 
324.9   subpart 11, item C, subitem (2), for a total replacement, as 
324.10  defined in paragraph (f), authorized under section 144A.071 or 
324.11  144A.073 after July 1, 1999, or any building project that is a 
324.12  relocation, renovation, upgrading, or conversion authorized 
324.13  under section 144A.073, completed on or after July 1, 2001, the 
324.14  replacement-costs-new per bed limit shall be $74,280 per 
324.15  licensed bed in multiple-bed rooms, $92,850 per licensed bed in 
324.16  semiprivate rooms with a fixed partition separating the resident 
324.17  beds, and $111,420 per licensed bed in single rooms.  Minnesota 
324.18  Rules, part 9549.0060, subpart 11, item C, subitem (2), does not 
324.19  apply.  These amounts must be adjusted annually as specified in 
324.20  subdivision 3f, paragraph (a), beginning January 1, 2000.  
324.21     (h) For a total replacement, as defined in paragraph (f), 
324.22  authorized under section 144A.073 for a 96-bed nursing home in 
324.23  Carlton county, the replacement-costs-new per bed limit shall be 
324.24  $74,280 per licensed bed in multiple-bed rooms, $92,850 per 
324.25  licensed bed in semiprivate rooms with a fixed partition 
324.26  separating the resident's beds, and $111,420 per licensed bed in 
324.27  a single room.  Minnesota Rules, part 9549.0060, subpart 11, 
324.28  item C, subitem (2), does not apply.  The resulting maximum 
324.29  allowable replacement-costs-new multiplied by 1.25 shall 
324.30  constitute the project's dollar threshold for purposes of 
324.31  application of the limit set forth in section 144A.071, 
324.32  subdivision 2.  The commissioner of health may waive the 
324.33  requirements of section 144A.073, subdivision 3b, paragraph (b), 
324.34  clause (2), on the condition that the other requirements of that 
324.35  paragraph are met. 
324.36     (i) For a renovation authorized under section 144A.073 for 
325.1   a 65-bed nursing home in St. Louis county, the incremental 
325.2   increase in rental rate for purposes of paragraph (d) shall be 
325.3   $8.16, and the total replacement cost, allowable appraised 
325.4   value, allowable debt, and allowable interest shall be increased 
325.5   according to the incremental increase. 
325.6      (j) For a total replacement, as defined in paragraph (f), 
325.7   authorized under section 144A.073 involving a new building 
325.8   addition that relocates beds from three-bed wards for an 80-bed 
325.9   nursing home in Redwood county, the replacement-costs-new per 
325.10  bed limit shall be $74,280 per licensed bed for multiple-bed 
325.11  rooms; $92,850 per licensed bed for semiprivate rooms with a 
325.12  fixed partition separating the beds; and $111,420 per licensed 
325.13  bed for single rooms.  These amounts shall be adjusted annually, 
325.14  beginning January 1, 2001.  Minnesota Rules, part 9549.0060, 
325.15  subpart 11, item C, subitem (2), does not apply.  The resulting 
325.16  maximum allowable replacement-costs-new multiplied by 1.25 shall 
325.17  constitute the project's dollar threshold for purposes of 
325.18  application of the limit set forth in section 144A.071, 
325.19  subdivision 2.  The commissioner of health may waive the 
325.20  requirements of section 144A.073, subdivision 3b, paragraph (b), 
325.21  clause (2), on the condition that the other requirements of that 
325.22  paragraph are met. 
325.23     Sec. 22.  Minnesota Statutes 2000, section 256B.431, is 
325.24  amended by adding a subdivision to read: 
325.25     Subd. 31.  [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 
325.26  years beginning on or after July 1, 2001, the total payment rate 
325.27  for a facility reimbursed under this section, section 256B.434, 
325.28  or any other section for the first 90 days after admission shall 
325.29  be: 
325.30     (1) for the first 30 paid days, the rate shall be 120 
325.31  percent of the facility's medical assistance rate for each case 
325.32  mix class; and 
325.33     (2) for the next 60 days after the first 30 paid days, the 
325.34  rate shall be 110 percent of the facility's medical assistance 
325.35  rate for each case mix class. 
325.36     (b) Beginning with the 91st paid day after admission, the 
326.1   payment rate shall be the rate otherwise determined under this 
326.2   section, section 256B.434, or any other section. 
326.3      (c) This subdivision applies to admissions occurring on or 
326.4   after July 1, 2001. 
326.5      Sec. 23.  Minnesota Statutes 2000, section 256B.431, is 
326.6   amended by adding a subdivision to read: 
326.7      Subd. 32.  [NURSING FACILITY RATE INCREASES BEGINNING JULY 
326.8   1, 2001, AND JULY 1, 2002.] For the rate years beginning July 1, 
326.9   2001, and July 1, 2002, the commissioner shall make available to 
326.10  each nursing facility reimbursed under this section or section 
326.11  256B.434 an adjustment equal to 3.0 percent of the total 
326.12  operating payment rate.  The operating payment rates in effect 
326.13  on June 30, 2001, and June 30, 2002, respectively, shall include 
326.14  the adjustment in subdivision 2i, paragraph (c). 
326.15     Sec. 24.  Minnesota Statutes 2000, section 256B.431, is 
326.16  amended by adding a subdivision to read: 
326.17     Subd. 33.  [ADDITIONAL INCREASES FOR LOW RATE METROPOLITAN 
326.18  AREA FACILITIES.] After the calculation of the increase for the 
326.19  rate year beginning July 1, 2001, in subdivision 31, the 
326.20  commissioner must provide for special increases to facilities 
326.21  determined to be the lowest rate facilities in state development 
326.22  region 11, as defined in section 462.385.  Within this region, 
326.23  the commissioner shall identify the median nursing facility rate 
326.24  by case mix category for all nursing facilities under section 
326.25  256B.431 or 256B.434.  Nursing home rates that are below the 
326.26  median for case mix class A must be adjusted to the set of case 
326.27  mix rates for the facility at the median for case mix class A.  
326.28     Sec. 25.  Minnesota Statutes 2000, section 256B.431, is 
326.29  amended by adding a subdivision to read: 
326.30     Subd. 34.  [RATE FLOOR FOR FACILITIES LOCATED OUTSIDE THE 
326.31  METROPOLITAN AREA.] (a) For the rate year beginning July 1, 
326.32  2001, the commissioner shall adjust operating costs per diem for 
326.33  nursing facilities located outside of state development region 
326.34  11, as defined in section 462.385, reimbursed under this section 
326.35  and sections 256B.434 and 256B.435, as provided in this 
326.36  subdivision. 
327.1      (b) For each nursing facility, the commissioner shall 
327.2   compare the operating costs per diem listed in this paragraph to 
327.3   the operating costs per diem the facility would otherwise 
327.4   receive for the July 1, 2001, rate year after provision of any 
327.5   other rate increases required by this chapter. 
327.6        Case mix classification     Operating costs per diem
327.7                  A                         $ 67.02
327.8                  B                         $ 73.00
327.9                  C                         $ 79.77
327.10                 D                         $ 85.94
327.11                 E                         $ 92.32
327.12                 F                         $ 92.72
327.13                 G                         $ 98.13
327.14                 H                         $108.40
327.15                 I                         $112.03
327.16                 J                         $117.67
327.17                 K                         $129.55
327.18     (c) If a facility's total reimbursement for operating 
327.19  costs, using the case mix classification operating costs per 
327.20  diem listed in paragraph (b), is greater than the total 
327.21  reimbursement for operating costs the facility would otherwise 
327.22  receive, the commissioner shall calculate operating costs per 
327.23  diem for that facility for the rate year beginning July 1, 2001, 
327.24  using the case mix classification operating costs per diem 
327.25  listed in paragraph (b). 
327.26     (d) If a facility's total reimbursement for operating 
327.27  costs, using the case mix classification costs per diem listed 
327.28  in paragraph (b), is less than the total reimbursement for 
327.29  operating costs the facility would otherwise receive, the 
327.30  commissioner shall reimburse that facility for the rate year 
327.31  beginning July 1, 2001, as provided in this section, section 
327.32  256B.434, or 256B.435, whichever is applicable, and shall not 
327.33  calculate operating costs per diem for that facility using the 
327.34  case mix classification operating costs per diem listed in 
327.35  paragraph (b). 
327.36     Sec. 26.  Minnesota Statutes 2000, section 256B.431, is 
328.1   amended by adding a subdivision to read: 
328.2      Subd. 35.  [EXCLUSION OF RAW FOOD COST ADJUSTMENT.] For 
328.3   rate years beginning on or after July 1, 2001, in calculating a 
328.4   nursing facility's operating cost per diem for the purposes of 
328.5   constructing an array of nursing facility payment rates to be 
328.6   used to determine future rate increases under this section, 
328.7   section 256B.434, or any other section, the commissioner shall 
328.8   exclude adjustments for raw food costs under subdivision 2b, 
328.9   paragraph (h), that are related to providing special diets based 
328.10  on religious beliefs. 
328.11     Sec. 27.  Minnesota Statutes 2000, section 256B.434, 
328.12  subdivision 4, is amended to read: 
328.13     Subd. 4.  [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 
328.14  nursing facilities which have their payment rates determined 
328.15  under this section rather than section 256B.431, the 
328.16  commissioner shall establish a rate under this subdivision.  The 
328.17  nursing facility must enter into a written contract with the 
328.18  commissioner. 
328.19     (b) A nursing facility's case mix payment rate for the 
328.20  first rate year of a facility's contract under this section is 
328.21  the payment rate the facility would have received under section 
328.22  256B.431. 
328.23     (c) A nursing facility's case mix payment rates for the 
328.24  second and subsequent years of a facility's contract under this 
328.25  section are the previous rate year's contract payment rates plus 
328.26  an inflation adjustment and an adjustment to include the cost of 
328.27  any increase in health department licensing fees for the 
328.28  facility taking effect on or after July 1, 2001.  The index for 
328.29  the inflation adjustment must be based on the change in the 
328.30  Consumer Price Index-All Items (United States City average) 
328.31  (CPI-U) forecasted by Data Resources, Inc., as forecasted in the 
328.32  fourth quarter of the calendar year preceding the rate year.  
328.33  The inflation adjustment must be based on the 12-month period 
328.34  from the midpoint of the previous rate year to the midpoint of 
328.35  the rate year for which the rate is being determined.  For the 
328.36  rate years beginning on July 1, 1999, and July 1, 2000, July 1, 
329.1   2001, and July 1, 2002, this paragraph shall apply only to the 
329.2   property-related payment rate, except that adjustments to 
329.3   include the cost of any increase in health department licensing 
329.4   fees taking effect on or after July 1, 2001, shall be provided.  
329.5   In determining the amount of the property-related payment rate 
329.6   adjustment under this paragraph, the commissioner shall 
329.7   determine the proportion of the facility's rates that are 
329.8   property-related based on the facility's most recent cost report.
329.9      (d) The commissioner shall develop additional 
329.10  incentive-based payments of up to five percent above the 
329.11  standard contract rate for achieving outcomes specified in each 
329.12  contract.  The specified facility-specific outcomes must be 
329.13  measurable and approved by the commissioner.  The commissioner 
329.14  may establish, for each contract, various levels of achievement 
329.15  within an outcome.  After the outcomes have been specified the 
329.16  commissioner shall assign various levels of payment associated 
329.17  with achieving the outcome.  Any incentive-based payment cancels 
329.18  if there is a termination of the contract.  In establishing the 
329.19  specified outcomes and related criteria the commissioner shall 
329.20  consider the following state policy objectives: 
329.21     (1) improved cost effectiveness and quality of life as 
329.22  measured by improved clinical outcomes; 
329.23     (2) successful diversion or discharge to community 
329.24  alternatives; 
329.25     (3) decreased acute care costs; 
329.26     (4) improved consumer satisfaction; 
329.27     (5) the achievement of quality; or 
329.28     (6) any additional outcomes proposed by a nursing facility 
329.29  that the commissioner finds desirable. 
329.30     Sec. 28.  Minnesota Statutes 2000, section 256B.434, is 
329.31  amended by adding a subdivision to read: 
329.32     Subd. 4c.  [FACILITY RATE INCREASES EFFECTIVE JANUARY 1, 
329.33  2002.] For the rate period beginning January 1, 2002, and for 
329.34  the rate year beginning July 1, 2002, a nursing facility in 
329.35  Morrison county licensed for 83 beds shall receive an increase 
329.36  of $2.54 in each case mix payment rate to offset property tax 
330.1   payments due as a result of the facility's conversion from 
330.2   nonprofit to for-profit status.  The increases under this 
330.3   subdivision shall be added following the determination under 
330.4   this chapter of the payment rate for the rate year beginning 
330.5   July 1, 2001, and shall be included in the facility's total 
330.6   payment rates for the purposes of determining future rates under 
330.7   this section or any other section. 
330.8      Sec. 29.  Minnesota Statutes 2000, section 256B.434, is 
330.9   amended by adding a subdivision to read: 
330.10     Subd. 4d.  [FACILITY RATE INCREASES EFFECTIVE JULY 1, 
330.11  2001.] For the rate year beginning July 1, 2001, a nursing 
330.12  facility in Hennepin county licensed for 302 beds shall receive 
330.13  an increase of 29 cents in each case mix payment rate to correct 
330.14  an error in the cost-reporting system that occurred prior to the 
330.15  date that the facility entered the alternative payment 
330.16  demonstration project.  The increases under this subdivision 
330.17  shall be added following the determination under this chapter of 
330.18  the payment rate for the rate year beginning July 1, 2001, and 
330.19  shall be included in the facility's total payment rates for the 
330.20  purposes of determining future rates under this section or any 
330.21  other section. 
330.22     Sec. 30.  Minnesota Statutes 2000, section 256B.434, is 
330.23  amended by adding a subdivision to read: 
330.24     Subd. 4e.  [RATE INCREASE EFFECTIVE JULY 1, 2001.] A 
330.25  nursing facility in Anoka county licensed for 98 beds as of July 
330.26  1, 2000, shall receive an increase of $10 in each case mix rate 
330.27  for the rate year beginning July 1, 2001.  This increase shall 
330.28  be included in the facility's total payment rate for purposes of 
330.29  determining future rates under this section or any other section 
330.30  through June 30, 2004. 
330.31     Sec. 31.  Minnesota Statutes 2000, section 256B.434, 
330.32  subdivision 10, is amended to read: 
330.33     Subd. 10.  [EXEMPTIONS.] (a) To the extent permitted by 
330.34  federal law, (1) a facility that has entered into a contract 
330.35  under this section is not required to file a cost report, as 
330.36  defined in Minnesota Rules, part 9549.0020, subpart 13, for any 
331.1   year after the base year that is the basis for the calculation 
331.2   of the contract payment rate for the first rate year of the 
331.3   alternative payment demonstration project contract; and (2) a 
331.4   facility under contract is not subject to audits of historical 
331.5   costs or revenues, or paybacks or retroactive adjustments based 
331.6   on these costs or revenues, except audits, paybacks, or 
331.7   adjustments relating to the cost report that is the basis for 
331.8   calculation of the first rate year under the contract. 
331.9      (b) A facility that is under contract with the commissioner 
331.10  under this section is not subject to the moratorium on licensure 
331.11  or certification of new nursing home beds in section 144A.071, 
331.12  unless the project results in a net increase in bed capacity or 
331.13  involves relocation of beds from one site to another.  Contract 
331.14  payment rates must not be adjusted to reflect any additional 
331.15  costs that a nursing facility incurs as a result of a 
331.16  construction project undertaken under this paragraph.  In 
331.17  addition, as a condition of entering into a contract under this 
331.18  section, a nursing facility must agree that any future medical 
331.19  assistance payments for nursing facility services will not 
331.20  reflect any additional costs attributable to the sale of a 
331.21  nursing facility under this section and to construction 
331.22  undertaken under this paragraph that otherwise would not be 
331.23  authorized under the moratorium in section 144A.073.  Nothing in 
331.24  this section prevents a nursing facility participating in the 
331.25  alternative payment demonstration project under this section 
331.26  from seeking approval of an exception to the moratorium through 
331.27  the process established in section 144A.073, and if approved the 
331.28  facility's rates shall be adjusted to reflect the cost of the 
331.29  project.  Nothing in this section prevents a nursing facility 
331.30  participating in the alternative payment demonstration project 
331.31  from seeking legislative approval of an exception to the 
331.32  moratorium under section 144A.071, and, if enacted, the 
331.33  facility's rates shall be adjusted to reflect the cost of the 
331.34  project. 
331.35     (c) Notwithstanding section 256B.48, subdivision 6, 
331.36  paragraphs (c), (d), and (e), and pursuant to any terms and 
332.1   conditions contained in the facility's contract, a nursing 
332.2   facility that is under contract with the commissioner under this 
332.3   section is in compliance with section 256B.48, subdivision 6, 
332.4   paragraph (b), if the facility is Medicare certified. 
332.5      (d) (c) Notwithstanding paragraph (a), if by April 1, 1996, 
332.6   the health care financing administration has not approved a 
332.7   required waiver, or the health care financing administration 
332.8   otherwise requires cost reports to be filed prior to the 
332.9   waiver's approval, the commissioner shall require a cost report 
332.10  for the rate year. 
332.11     (e) (d) A facility that is under contract with the 
332.12  commissioner under this section shall be allowed to change 
332.13  therapy arrangements from an unrelated vendor to a related 
332.14  vendor during the term of the contract.  The commissioner may 
332.15  develop reasonable requirements designed to prevent an increase 
332.16  in therapy utilization for residents enrolled in the medical 
332.17  assistance program. 
332.18     Sec. 32.  [256B.437] [IMPLEMENTATION OF A CASE MIX SYSTEM 
332.19  FOR NURSING FACILITIES BASED ON THE MINIMUM DATA SET.] 
332.20     Subdivision 1.  [SCOPE.] This section establishes the 
332.21  method and criteria used to determine resident reimbursement 
332.22  classifications based upon the assessments of residents of 
332.23  nursing homes and boarding care homes whose payment rates are 
332.24  established under section 256B.431, 256B.434, or 256B.435.  
332.25  Resident reimbursement classifications shall be established 
332.26  according to the 34 group, resource utilization groups, version 
332.27  III or RUG-III model as described in section 144.0724.  
332.28  Reimbursement classifications established under this section 
332.29  shall be implemented after June 30, 2002, but no later than 
332.30  January 1, 2003. 
332.31     Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
332.32  following terms have the meanings given. 
332.33     (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 
332.34  date" has the meaning given in section 144.0724, subdivision 2, 
332.35  paragraph (a). 
332.36     (b) [CASE MIX INDEX.] "Case mix index" has the meaning 
333.1   given in section 144.0724, subdivision 2, paragraph (b). 
333.2      (c) [INDEX MAXIMIZATION.] "Index maximization" has the 
333.3   meaning given in section 144.0724, subdivision 2, paragraph (c). 
333.4      (d) [MINIMUM DATA SET.] "Minimum data set" has the meaning 
333.5   given in section 144.0724, subdivision 2, paragraph (d). 
333.6      (e) [REPRESENTATIVE.] "Representative" has the meaning 
333.7   given in section 144.0724, subdivision 2, paragraph (e). 
333.8      (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 
333.9   utilization groups" or "RUG" has the meaning given in section 
333.10  144.0724, subdivision 2, paragraph (f). 
333.11     Subd. 3.  [CASE MIX INDICES.] (a) The commissioner of human 
333.12  services shall assign a case mix index to each resident class 
333.13  based on the Health Care Financing Administration's staff time 
333.14  measurement study and adjusted for Minnesota-specific wage 
333.15  indices.  The case mix indices assigned to each resident class 
333.16  shall be published in the Minnesota State Register at least 120 
333.17  days prior to the implementation of the 34 group, RUG-III 
333.18  resident classification system. 
333.19     (b) An index maximization approach shall be used to 
333.20  classify residents. 
333.21     (c) After implementation of the revised case mix system, 
333.22  the commissioner of human services may annually rebase case mix 
333.23  indices and base rates using more current data on average wage 
333.24  rates and staff time measurement studies.  This rebasing shall 
333.25  be calculated under subdivision 7, paragraph (b).  The 
333.26  commissioner shall publish in the Minnesota State Register 
333.27  adjusted case mix indices at least 45 days prior to the 
333.28  effective date of the adjusted case mix indices. 
333.29     Subd. 4.  [RESIDENT ASSESSMENT SCHEDULE.] (a) Nursing 
333.30  facilities shall conduct and submit case mix assessments 
333.31  according to the schedule established by the commissioner of 
333.32  health under section 144.0724, subdivisions 4 and 5. 
333.33     (b) The resident reimbursement classifications established 
333.34  under section 144.0724, subdivision 3, shall be effective the 
333.35  day of admission for new admission assessments.  The effective 
333.36  date for significant change assessments shall be the assessment 
334.1   reference date.  The effective date for annual and second 
334.2   quarterly assessments shall be the first day of the month 
334.3   following assessment reference date. 
334.4      Subd. 5.  [NOTICE OF RESIDENT REIMBURSEMENT 
334.5   CLASSIFICATION.] Nursing facilities shall provide notice to a 
334.6   resident of the resident's case mix classification according to 
334.7   procedures established by the commissioner of health under 
334.8   section 144.0724, subdivision 7. 
334.9      Subd. 6.  [RECONSIDERATION OF RESIDENT CLASSIFICATION.] Any 
334.10  request for reconsideration of a resident classification must be 
334.11  made under section 144.0724, subdivision 8. 
334.12     Subd. 7.  [RATE DETERMINATION UPON TRANSITION TO RUG-III 
334.13  PAYMENT RATES.] (a) The commissioner of human services shall 
334.14  determine payment rates at the time of transition to the RUG 
334.15  based payment model in a facility-specific, budget-neutral 
334.16  manner.  The case mix indices as defined in subdivision 3 shall 
334.17  be used to allocate the case mix adjusted component of total 
334.18  payment across all case mix groups.  To transition from the 
334.19  current calculation methodology to the RUG based methodology, 
334.20  the commissioner of health shall report to the commissioner of 
334.21  human services the resident days classified according to the 
334.22  categories defined in subdivision 3 for the 12-month reporting 
334.23  period ending September 30, 2001, for each nursing facility.  
334.24  The commissioner of human services shall use this data to 
334.25  compute the standardized days for the reporting period under the 
334.26  RUG system. 
334.27     (b) The commissioner of human services shall determine the 
334.28  case mix adjusted component of the rate as follows: 
334.29     (1) determine the case mix portion of the 11 case mix rates 
334.30  in effect on June 30, 2002, or the 34 case mix rates in effect 
334.31  on or after June 30, 2003; 
334.32     (2) multiply each amount in clause (1) by the number of 
334.33  resident days assigned to each group for the reporting period 
334.34  ending September 30, 2001, or the most recent year for which 
334.35  data is available; 
334.36     (3) compute the sum of the amounts in clause (2); 
335.1      (4) determine the total RUG standardized days for the 
335.2   reporting period ending September 30, 2001, or the most recent 
335.3   year for which data is available using new indices calculated 
335.4   under subdivision 3, paragraph (c); 
335.5      (5) divide the amount in clause (3) by the amount in clause 
335.6   (4) which shall be the average case mix adjusted component of 
335.7   the rate under the RUG method; and 
335.8      (6) multiply this average rate by the case mix weight in 
335.9   subdivision 3 for each RUG group. 
335.10     (c) The noncase mix component will be allocated to each RUG 
335.11  group as a constant amount to determine the transition payment 
335.12  rate.  Any other rate adjustments that are effective on or after 
335.13  July 1, 2002, shall be applied to the transition rates 
335.14  determined under this section. 
335.15     Sec. 33.  [256B.4371] [NURSING FACILITY VOLUNTARY CLOSURES 
335.16  AND PLANNING AND DEVELOPMENT OF COMMUNITY-BASED ALTERNATIVES.] 
335.17     Subdivision 1.  [DEFINITIONS.] (a) The definitions in this 
335.18  subdivision apply to subdivisions 2 to 9. 
335.19     (b) "Closure" means the cessation of operations of a 
335.20  nursing facility and delicensure and decertification of all beds 
335.21  within the facility. 
335.22     (c) "Commencement of closure" means the date on which 
335.23  residents and designated representatives are notified of a 
335.24  planned closure according to sections 144A.185 to 144A.1887 as 
335.25  part of an approved closure plan. 
335.26     (d) "Completion of closure" means the date on which the 
335.27  final resident of the nursing facility or nursing facilities 
335.28  designated for closure in an approved closure plan is discharged 
335.29  from the facility or facilities. 
335.30     (e) "Closure plan" means a plan to close a nursing facility 
335.31  and reallocate the resulting savings to provide planned closure 
335.32  rate adjustments at other facilities. 
335.33     (f) "Partial closure" means the delicensure and 
335.34  decertification of a portion of the beds within the facility. 
335.35     (g) "Planned closure rate adjustment" means an increase in 
335.36  a nursing facility's operating rates resulting from a partial 
336.1   planned closure of a facility or a planned closure of another 
336.2   facility.  
336.3      Subd. 2.  [PLANNING AND DEVELOPMENT OF COMMUNITY BASED 
336.4   SERVICES.] 
336.5      (a) The commissioner of human services shall establish a 
336.6   process to adjust the capacity and distribution of long-term 
336.7   care services to equalize the supply and demand for different 
336.8   types of services.  This process must include community 
336.9   planning, expansion or establishment of needed services, and 
336.10  analysis of voluntary nursing facility closures. 
336.11     (b) The purpose of this process is to support the planning 
336.12  and development of community-based services.  This process must 
336.13  support early intervention, advocacy, and consumer protection 
336.14  while providing resources and incentives for expanded county 
336.15  planning and for nursing facilities to transition to meet 
336.16  community needs. 
336.17     (c) The process shall support and facilitate expansion of 
336.18  community-based services under the county-administered 
336.19  alternative care program under section 256B.0913 and waivers for 
336.20  elderly under section 256B.0915, including the development of 
336.21  supportive services such as housing and transportation.  The 
336.22  process shall utilize community assessments and planning 
336.23  developed for the community health services plan and plan update 
336.24  and for the community social services act plan. 
336.25     (d) The addendum to the biennial plan shall be submitted 
336.26  annually, beginning in 2001, and shall include recommendations 
336.27  for development of community-based services.  Both planning and 
336.28  implementation shall be implemented within the amount of funding 
336.29  made available to the county board for these purposes. 
336.30     (e) The commissioner of health and the commissioner of 
336.31  human services, as appropriate, shall provide available data 
336.32  necessary for the county, including but not limited to data on 
336.33  nursing facility bed distribution, housing with services 
336.34  options, the closure of nursing facilities that occur outside of 
336.35  the planned closure process, and approval of planned closures in 
336.36  the county and contiguous counties. 
337.1      (f) The plan, within the funding allocated, shall: 
337.2      (1) identify the need for services based on demographic 
337.3   data, service availability, caseload information, and provider 
337.4   information; 
337.5      (2) involve providers, consumers, cities, townships, 
337.6   businesses, and area agencies on aging in the planning process; 
337.7      (3) address the availability of alternative care and 
337.8   elderly waiver services for eligible recipients; 
337.9      (4) address the development of other supportive services, 
337.10  such as transit, housing, and workforce and economic 
337.11  development; and 
337.12     (5) estimate the cost and timelines for development. 
337.13     (g) The biennial plan addendum shall be coordinated with 
337.14  the county mental health plan for inclusion in the community 
337.15  health services plan and included as an addendum to the 
337.16  community social services plan. 
337.17     (h) The county board having financial responsibility for 
337.18  persons present in another county shall cooperate with that 
337.19  county for planning and development of services. 
337.20     (i) The county board shall cooperate in planning and 
337.21  development of community based services with other counties, as 
337.22  necessary, and coordinate planning for long-term care services 
337.23  that involve more than one county, within the funding allocated 
337.24  for these purposes. 
337.25     (j) The commissioners of health and human services, in 
337.26  cooperation with county boards, shall report to the legislature 
337.27  by February 1 of each year, beginning February 1, 2002, 
337.28  regarding the development of community based services, 
337.29  transition or closure of nursing facilities, and consumer 
337.30  outcomes achieved, as documented by each county and reported to 
337.31  the commissioner by December 31 of each year. 
337.32     (k) The process established by the commissioner of human 
337.33  services shall ensure: 
337.34     (1) that counties consider multicounty service areas in 
337.35  developing services that may impact delivery efficiencies; and 
337.36     (2) review and comment by the area agencies on aging, 
338.1   regional development commissions, where they exist, and other 
338.2   planning agencies of the biennial plan addendum. 
338.3      Subd. 3.  [REQUEST FOR APPLICATIONS FOR PLANNED CLOSURE OF 
338.4   NURSING FACILITIES.] (a) By July 15, 2001, the commissioner of 
338.5   human services shall implement and announce a program for 
338.6   closure or partial closure of nursing facilities.  Names and 
338.7   identifying information provided in response to the announcement 
338.8   shall remain private unless approved, according to the timelines 
338.9   established in the plan.  The announcement must specify: 
338.10     (1) the criteria that will be used by the interagency 
338.11  long-term care planning committee established under section 
338.12  144A.31 and the commissioner to approve or reject applications; 
338.13     (2) a requirement for the submission of a letter of intent 
338.14  before the submission of an application; 
338.15     (3) the information that must accompany an application; 
338.16     (4) a schedule for letters of intent, applications, and 
338.17  consideration of applications for a minimum of four review 
338.18  processes to be conducted before June 30, 2003; and 
338.19     (5) that applications may combine planned closure rate 
338.20  adjustments with moratorium exception funding, in which case a 
338.21  single application may serve both purposes. 
338.22  Between October 1, 2001, and June 30, 2003, the commissioner 
338.23  shall approve planned closures of at least 5,140 nursing 
338.24  facility beds, with no more than 2,070 approved for closure 
338.25  prior to July 1, 2002, less the number of licensed beds in 
338.26  facilities that close during the same time period without 
338.27  approved closure plans or have notified the commissioner of 
338.28  health of their intent to close without an approved closure plan.
338.29     (b) A facility or facilities reimbursed under section 
338.30  256B.431, 256B.434, or 256B.435 with a closure plan approved by 
338.31  the commissioner under subdivision 6 may assign a planned 
338.32  closure rate adjustment to another facility that is not closing 
338.33  or facilities that are not closing, or in the case of a partial 
338.34  closure, to the facility undertaking the partial closure.  A 
338.35  facility may also elect to have a planned closure rate 
338.36  adjustment shared equally by the five nursing facilities with 
339.1   the lowest total operating payment rates in the state 
339.2   development region, designated under section 462.385, in which 
339.3   the facility receiving the planned closure rate adjustment is 
339.4   located.  The planned closure rate adjustment must be calculated 
339.5   under subdivision 7.  A planned closure rate adjustment under 
339.6   this section is effective on the first day of the month 
339.7   following completion of closure of all facilities designated for 
339.8   closure in the application and becomes part of the nursing 
339.9   facility's total operating payment rate. 
339.10     Applicants may use the planned closure rate adjustment to 
339.11  allow for a property payment for a new nursing facility or an 
339.12  addition to an existing nursing facility.  Applications approved 
339.13  under this paragraph are exempt from other requirements for 
339.14  moratorium exceptions under section 144A.073, subdivisions 2 and 
339.15  3.  
339.16     Facilities without a closure plan, or whose closure plan is 
339.17  not approved by the commissioner, are not eligible for a planned 
339.18  closure rate adjustment under subdivision 7.  However, the 
339.19  commissioner shall calculate the amount the facility would have 
339.20  received under subdivision 7 and shall use this amount to 
339.21  provide equal rate adjustments to the five nursing facilities 
339.22  with the lowest total operating payment rates in the state 
339.23  development region, designated under section 462.385, in which 
339.24  the facility is located. 
339.25     (c) To be considered for approval, an application must 
339.26  include: 
339.27     (1) a description of the proposed closure plan, which must 
339.28  include identification of the facility or facilities to receive 
339.29  a planned closure rate adjustment and the amount and timing of a 
339.30  planned closure rate adjustment proposed for each facility; 
339.31     (2) the proposed timetable for any proposed closure, 
339.32  including the proposed dates for announcement to residents, 
339.33  commencement of closure, and completion of closure; 
339.34     (3) the proposed relocation plan for current residents of 
339.35  any facility designated for closure.  The proposed relocation 
339.36  plan must be designed to comply with all applicable state and 
340.1   federal statutes and regulations, including, but not limited to, 
340.2   section 144A.16 and Minnesota Rules, parts 4655.6810 to 
340.3   4655.6830, 4658.1600 to 4658.1690, and 9546.0010 to 9546.0060; 
340.4      (4) a description of the relationship between the nursing 
340.5   facility that is proposed for closure and the nursing facility 
340.6   or facilities proposed to receive the planned closure rate 
340.7   adjustment.  If these facilities are not under common ownership, 
340.8   copies of any contracts, purchase agreements, or other documents 
340.9   establishing a relationship or proposed relationship must be 
340.10  provided; 
340.11     (5) documentation, in a format approved by the 
340.12  commissioner, that all the nursing facilities receiving a 
340.13  planned closure rate adjustment under the plan have accepted 
340.14  joint and several liability for recovery of overpayments under 
340.15  section 256B.0641, subdivision 2, for the facilities designated 
340.16  for closure under the plan; and 
340.17     (6) an explanation of how the application coordinates with 
340.18  planning efforts under subdivision 2. 
340.19     (d) The application must address the criteria listed in 
340.20  subdivision 4. 
340.21     Subd. 4.  [CRITERIA FOR REVIEW OF APPLICATION.] In 
340.22  reviewing and approving closure proposals, the commissioner 
340.23  shall consider, but not be limited to, the following criteria: 
340.24     (1) improved quality of care and quality of life for 
340.25  consumers; 
340.26     (2) closure of a nursing facility that has a poor physical 
340.27  plant; 
340.28     (3) the existence of excess nursing facility beds, measured 
340.29  in terms of beds per thousand persons aged 85 or older.  The 
340.30  excess must be measured in reference to: 
340.31     (i) the county in which the facility is located; 
340.32     (ii) the county and all contiguous counties; 
340.33     (iii) the region in which the facility is located; or 
340.34     (iv) the facility's service area. 
340.35  The facility shall indicate in its proposal the area it believes 
340.36  is appropriate for this measurement.  A facility in a county 
341.1   that is in the lowest quartile of counties with reference to 
341.2   beds per thousand persons aged 85 or older is not in an area of 
341.3   excess capacity; 
341.4      (4) low-occupancy rates, provided that the unoccupied beds 
341.5   are not the result of a personnel shortage.  In analyzing 
341.6   occupancy rates, the commissioner shall examine waiting lists in 
341.7   the applicant facility and at facilities in the surrounding 
341.8   area, as determined under clause (3); 
341.9      (5) evidence of a community planning process to determine 
341.10  what services are needed and ensure that needed services are 
341.11  established; 
341.12     (6) innovative use of reinvestment funds; 
341.13     (7) innovative use planned for the closed facility's 
341.14  physical plant; 
341.15     (8) evidence that the proposal serves the interests of the 
341.16  state; and 
341.17     (9) evidence of other factors that affect the viability of 
341.18  the facility, including excessive nursing pool costs. 
341.19     Subd. 5.  [REVIEW AND APPROVAL OF PROPOSALS.] (a) The 
341.20  interagency long-term care planning committee may recommend that 
341.21  the commissioner of human services grant approval, within the 
341.22  limits established in subdivision 3, paragraph (a), to 
341.23  applications that satisfy the requirements of this section.  The 
341.24  interagency committee may appoint an advisory review panel 
341.25  composed of representatives of counties, SAIL projects, 
341.26  consumers, and providers to review proposals and provide 
341.27  comments and recommendations to the committee.  The 
341.28  commissioners of human services and health shall provide staff 
341.29  and technical assistance to the committee for the review and 
341.30  analysis of proposals.  The commissioners of human services and 
341.31  health shall jointly approve or disapprove an application within 
341.32  30 days after receiving the committee's recommendations. 
341.33     (b) Approval of a planned closure expires 18 months after 
341.34  approval by the commissioner of human services, unless 
341.35  commencement of closure has begun. 
341.36     (c) The commissioner of human services may change any 
342.1   provision of the application to which all parties agree. 
342.2      Subd. 6.  [PLANNED CLOSURE RATE ADJUSTMENT.] The 
342.3   commissioner of human services shall calculate the amount of the 
342.4   planned closure rate adjustment available under subdivision 3, 
342.5   paragraph (b), according to clauses (1) to (4): 
342.6      (1) the amount available is the net reduction of nursing 
342.7   facility beds multiplied by $2,080; 
342.8      (2) the total number of beds in the nursing facility 
342.9   receiving the planned closure rate adjustment must be 
342.10  identified; 
342.11     (3) capacity days are determined by multiplying the number 
342.12  determined under clause (2) by 365; and 
342.13     (4) the planned closure rate adjustment is the amount 
342.14  available in clause (1), divided by capacity days determined 
342.15  under clause (3). 
342.16     Subd. 7.  [OTHER RATE ADJUSTMENTS.] Facilities receiving 
342.17  planned closure rate adjustments remain eligible for any 
342.18  applicable rate adjustments provided under section 256B.431, 
342.19  256B.434, or any other section. 
342.20     Subd. 8.  [COUNTY COSTS.] The commissioner of human 
342.21  services shall allocate up to $500 per nursing facility bed that 
342.22  is closing, within the limits of the appropriation specified for 
342.23  this purpose, to be used for relocation costs incurred by 
342.24  counties for planned closures under this section or resident 
342.25  relocation under sections 144A.185 to 144A.1887.  To be eligible 
342.26  for this allocation, a county in which a nursing facility closes 
342.27  must provide to the commissioner a detailed statement in a form 
342.28  provided by the commissioner of additional costs, not to exceed 
342.29  $500 per bed closed, that are directly incurred related to the 
342.30  county's required role in the relocation process. 
342.31     Sec. 34.  Minnesota Statutes 2000, section 256B.501, is 
342.32  amended by adding a subdivision to read: 
342.33     Subd. 14.  [ICF/MR RATE INCREASES BEGINNING JULY 1, 2001, 
342.34  AND JULY 1, 2002.] (a) For the rate periods beginning July 1, 
342.35  2001, and July 1, 2002, the commissioner shall make available to 
342.36  each facility reimbursed under this section, section 256B.5011, 
343.1   and Laws 1993, First Special Session chapter 1, article 4, 
343.2   section 11, an adjustment to the total operating payment rate of 
343.3   3.0 percent. 
343.4      (b) For each facility, the commissioner shall determine the 
343.5   payment rate adjustment using the percentage specified in 
343.6   paragraph (a) multiplied by the total operating payment rate in 
343.7   effect on the last day of the prior rate year, and dividing the 
343.8   resulting amount by the facility's actual resident days.  The 
343.9   total operating payment rate shall include the adjustment 
343.10  provided in subdivision 12. 
343.11     (c) Any facility whose payment rates are governed by 
343.12  closure agreements, receivership agreements, or Minnesota Rules, 
343.13  part 9553.0075, is not eligible for an adjustment otherwise 
343.14  granted under this subdivision.  
343.15     Sec. 35.  Minnesota Statutes 2000, section 256B.76, is 
343.16  amended to read: 
343.17     256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
343.18     (a) Effective for services rendered on or after October 1, 
343.19  1992, the commissioner shall make payments for physician 
343.20  services as follows: 
343.21     (1) payment for level one Health Care Finance 
343.22  Administration's common procedural coding system (HCPCS) codes 
343.23  titled "office and other outpatient services," "preventive 
343.24  medicine new and established patient," "delivery, antepartum, 
343.25  and postpartum care," "critical care," Caesarean cesarean 
343.26  delivery and pharmacologic management provided to psychiatric 
343.27  patients, and HCPCS level three codes for enhanced services for 
343.28  prenatal high risk, shall be paid at the lower of (i) submitted 
343.29  charges, or (ii) 25 percent above the rate in effect on June 30, 
343.30  1992.  If the rate on any procedure code within these categories 
343.31  is different than the rate that would have been paid under the 
343.32  methodology in section 256B.74, subdivision 2, then the larger 
343.33  rate shall be paid; 
343.34     (2) payments for all other services shall be paid at the 
343.35  lower of (i) submitted charges, or (ii) 15.4 percent above the 
343.36  rate in effect on June 30, 1992; 
344.1      (3) all physician rates shall be converted from the 50th 
344.2   percentile of 1982 to the 50th percentile of 1989, less the 
344.3   percent in aggregate necessary to equal the above increases 
344.4   except that payment rates for home health agency services shall 
344.5   be the rates in effect on September 30, 1992; 
344.6      (4) effective for services rendered on or after January 1, 
344.7   2000, payment rates for physician and professional services 
344.8   shall be increased by three percent over the rates in effect on 
344.9   December 31, 1999, except for home health agency and family 
344.10  planning agency services; and 
344.11     (5) the increases in clause (4) shall be implemented 
344.12  January 1, 2000, for managed care. 
344.13     (b) Effective for services rendered on or after October 1, 
344.14  1992, the commissioner shall make payments for dental services 
344.15  as follows: 
344.16     (1) dental services shall be paid at the lower of (i) 
344.17  submitted charges, or (ii) 25 percent above the rate in effect 
344.18  on June 30, 1992; 
344.19     (2) dental rates shall be converted from the 50th 
344.20  percentile of 1982 to the 50th percentile of 1989, less the 
344.21  percent in aggregate necessary to equal the above increases; 
344.22     (3) effective for services rendered on or after January 1, 
344.23  2000, payment rates for dental services shall be increased by 
344.24  three percent over the rates in effect on December 31, 1999; 
344.25     (4) the commissioner shall award grants to community 
344.26  clinics or other nonprofit community organizations, political 
344.27  subdivisions, professional associations, or other organizations 
344.28  that demonstrate the ability to provide dental services 
344.29  effectively to public program recipients.  Grants may be used to 
344.30  fund the costs related to coordinating access for recipients, 
344.31  developing and implementing patient care criteria, upgrading or 
344.32  establishing new facilities, acquiring furnishings or equipment, 
344.33  recruiting new providers, or other development costs that will 
344.34  improve access to dental care in a region.  In awarding grants, 
344.35  the commissioner shall give priority to applicants that plan to 
344.36  serve areas of the state in which the number of dental providers 
345.1   is not currently sufficient to meet the needs of recipients of 
345.2   public programs or uninsured individuals.  The commissioner 
345.3   shall consider the following in awarding the grants:  (i) 
345.4   potential to successfully increase access to an underserved 
345.5   population; (ii) the ability to raise matching funds; (iii) the 
345.6   long-term viability of the project to improve access beyond the 
345.7   period of initial funding; (iv) the efficiency in the use of the 
345.8   funding; and (v) the experience of the proposers in providing 
345.9   services to the target population. 
345.10     The commissioner shall monitor the grants and may terminate 
345.11  a grant if the grantee does not increase dental access for 
345.12  public program recipients.  The commissioner shall consider 
345.13  grants for the following: 
345.14     (i) implementation of new programs or continued expansion 
345.15  of current access programs that have demonstrated success in 
345.16  providing dental services in underserved areas; 
345.17     (ii) a pilot program for utilizing hygienists outside of a 
345.18  traditional dental office to provide dental hygiene services; 
345.19  and 
345.20     (iii) a program that organizes a network of volunteer 
345.21  dentists, establishes a system to refer eligible individuals to 
345.22  volunteer dentists, and through that network provides donated 
345.23  dental care services to public program recipients or uninsured 
345.24  individuals. 
345.25     (5) beginning October 1, 1999, the payment for tooth 
345.26  sealants and fluoride treatments shall be the lower of (i) 
345.27  submitted charge, or (ii) 80 percent of median 1997 charges; and 
345.28     (6) the increases listed in clauses (3) and (5) shall be 
345.29  implemented January 1, 2000, for managed care. 
345.30     (c) An entity that operates both a Medicare certified 
345.31  comprehensive outpatient rehabilitation facility and a facility 
345.32  which was certified prior to January 1, 1993, that is licensed 
345.33  under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
345.34  whom at least 33 percent of the clients receiving rehabilitation 
345.35  services and mental health services in the most recent calendar 
345.36  year are medical assistance recipients, shall be reimbursed by 
346.1   the commissioner for rehabilitation services and mental health 
346.2   services at rates that are 38 percent greater than the maximum 
346.3   reimbursement rate allowed under paragraph (a), clause (2), when 
346.4   those services are (1) provided within the comprehensive 
346.5   outpatient rehabilitation facility and (2) provided to residents 
346.6   of nursing facilities owned by the entity. 
346.7      Sec. 36.  Laws 1995, chapter 207, article 3, section 21, as 
346.8   amended by Laws 1999, chapter 245, article 3, section 43, is 
346.9   amended to read:  
346.10     Sec. 21.  [FACILITY CERTIFICATION.] 
346.11     (a) Notwithstanding Minnesota Statutes, section 252.291, 
346.12  subdivisions 1 and 2, the commissioner of health shall inspect 
346.13  to certify a large community-based facility currently licensed 
346.14  under Minnesota Rules, parts 9525.0215 to 9525.0355, for more 
346.15  than 16 beds and located in Northfield.  The facility may be 
346.16  certified for up to 44 beds.  The commissioner of health must 
346.17  inspect to certify the facility as soon as possible after the 
346.18  effective date of this section.  The commissioner of human 
346.19  services shall work with the facility and affected counties to 
346.20  relocate any current residents of the facility who do not meet 
346.21  the admission criteria for an ICF/MR.  Until January 1, 1999, in 
346.22  order to fund the ICF/MR services and relocations of current 
346.23  residents authorized, the commissioner of human services may 
346.24  transfer on a quarterly basis to the medical assistance account 
346.25  from each affected county's community social service allocation, 
346.26  an amount equal to the state share of medical assistance 
346.27  reimbursement for the residential and day habilitation services 
346.28  funded by medical assistance and provided to clients for whom 
346.29  the county is financially responsible.  
346.30     (b) After January 1, 1999, the commissioner of human 
346.31  services shall fund the services under the state medical 
346.32  assistance program and may transfer on a quarterly basis to the 
346.33  medical assistance account from each affected county's community 
346.34  social service allocation, an amount equal to one-half of the 
346.35  state share of medical assistance reimbursement for the 
346.36  residential and day habilitation services funded by medical 
347.1   assistance and provided to clients for whom the county is 
347.2   financially responsible.  
347.3      (c) Effective July 1, 2001, the commissioner of human 
347.4   services shall fund the entire state share of medical assistance 
347.5   reimbursement for the residential and day habilitation services 
347.6   funded by medical assistance and provided to clients for whom 
347.7   counties are financially responsible from the medical assistance 
347.8   account, and shall not make any transfer from the community 
347.9   social service allocations of affected counties.  
347.10     (d) For nonresidents of Minnesota seeking admission to the 
347.11  facility, Rice county shall be notified in order to assure that 
347.12  appropriate funding is guaranteed from their state or country of 
347.13  residence. 
347.14     Sec. 37.  Laws 1999, chapter 245, article 3, section 45, as 
347.15  amended by Laws 2000, chapter 312, section 3, is amended to read:
347.16     Sec. 45.  [STATE LICENSURE CONFLICTS WITH FEDERAL 
347.17  REGULATIONS.] 
347.18     (a) Notwithstanding the provisions of Minnesota Rules, part 
347.19  4658.0520, an incontinent resident must be checked according to 
347.20  a specific time interval written in the resident's care plan.  
347.21  The resident's attending physician must authorize in writing any 
347.22  interval longer than two hours unless the resident, if 
347.23  competent, or a family member or legally appointed conservator, 
347.24  guardian, or health care agent of a resident who is not 
347.25  competent, agrees in writing to waive physician involvement in 
347.26  determining this interval. 
347.27     (b) This section expires July 1, 2001 2003. 
347.28     Sec. 38.  [DEVELOPMENT OF NEW NURSING FACILITY 
347.29  REIMBURSEMENT SYSTEM.] 
347.30     (a) The commissioner of human services shall develop and 
347.31  report to the legislature by January 15, 2003, a system to 
347.32  replace the current nursing facility reimbursement system 
347.33  established under Minnesota Statutes, sections 256B.431, 
347.34  256B.434, and 256B.435. 
347.35     (b) The system must be developed in consultation with the 
347.36  long-term care task force and with representatives of consumers, 
348.1   providers, and labor unions.  Within the limits of available 
348.2   appropriations, the commissioner may employ consultants to 
348.3   assist with this project. 
348.4      (c) The new reimbursement system must: 
348.5      (1) provide incentives to enhance quality of life and 
348.6   quality of care; 
348.7      (2) recognize cost differences in the care of different 
348.8   types of populations, including subacute care and dementia care; 
348.9      (3) establish rates that are sufficient without being 
348.10  excessive; 
348.11     (4) be affordable for the state and for private-pay 
348.12  residents; 
348.13     (5) be sensitive to changing conditions in the long-term 
348.14  care environment; 
348.15     (6) avoid creating access problems related to insufficient 
348.16  funding; 
348.17     (7) allow providers maximum flexibility in their business 
348.18  operations; 
348.19     (8) recognize the need for capital investment to improve 
348.20  physical plants; and 
348.21     (9) provide incentives for the development and use of 
348.22  private rooms. 
348.23     (d) Notwithstanding Minnesota Statutes, section 256B.435, 
348.24  the commissioner must not implement a performance-based 
348.25  contracting system for nursing facilities prior to July 1, 2003. 
348.26  The commissioner shall continue to reimburse nursing facilities 
348.27  under Minnesota Statutes, section 256B.431 or 256B.434, until 
348.28  otherwise directed by law. 
348.29     (e) The commissioner of human services, in consultation 
348.30  with the commissioner of health, shall conduct or contract for a 
348.31  time study to determine staff time being spent on various case 
348.32  mix categories; recommend adjustments to the case mix weights 
348.33  based on the time study data; and determine whether current 
348.34  staffing standards are adequate for providing quality care based 
348.35  on professional best practice and consumer experience.  If the 
348.36  commissioner determines the current standards are inadequate, 
349.1   the commissioner shall determine an appropriate staffing 
349.2   standard for the various case mix categories and the financial 
349.3   implications of phasing into this standard over the next four 
349.4   years. 
349.5      Sec. 39.  [REPORT ON STANDARDS FOR SUBACUTE CARE FACILITY 
349.6   LICENSURE.] 
349.7      By January 15, 2003, the commissioner of health shall 
349.8   submit a report to the legislature on implementation of a 
349.9   licensure program for subacute care.  This report must include: 
349.10     (1) definitions of subacute care and applicability of the 
349.11  proposed licensure program to various types of licensed 
349.12  facilities; 
349.13     (2) an analysis of whether specific standards for subacute 
349.14  levels of care need to be developed and the potential for 
349.15  increased costs for existing providers of subacute care; 
349.16     (3) recommendations on the applicability of the nursing 
349.17  home moratorium law to the licensure of subacute care facilities 
349.18  or programs; 
349.19     (4) identification of federal regulations guiding the 
349.20  provision of subacute care and whether further state standards 
349.21  are needed; and 
349.22     (5) identification of current and potential reimbursement 
349.23  for subacute care under Medicare, Medicaid, or managed care 
349.24  programs. 
349.25     Sec. 40.  [REGULATORY FLEXIBILITY.] 
349.26     (a) By July 1, 2001, the commissioners of health and human 
349.27  services shall: 
349.28     (1) develop a summary of federal nursing facility and 
349.29  community long-term care regulations that hamper state 
349.30  flexibility and place burdens on the goal of achieving 
349.31  high-quality care and optimum outcomes for consumers of 
349.32  services; and 
349.33     (2) share this summary with the legislature, other states, 
349.34  national groups that advocate for state interests with Congress, 
349.35  and the Minnesota congressional delegation. 
349.36     (b) The commissioners shall conduct ongoing follow-up with 
350.1   the entities to which this summary is provided and with the 
350.2   health care financing administration to achieve maximum 
350.3   regulatory flexibility, including the possibility of pilot 
350.4   projects to demonstrate regulatory flexibility on less than a 
350.5   statewide basis. 
350.6      Sec. 41.  [REPORT.] 
350.7      By January 15, 2003, the commissioner of health and the 
350.8   commissioner of human services shall report to the senate health 
350.9   and family security committee and the house health and human 
350.10  services policy committee on the number of closures that have 
350.11  taken place under Minnesota Statutes, section 256B.437, and any 
350.12  other nursing facility closures that may have taken place, 
350.13  alternatives to nursing facility care that have been developed, 
350.14  any problems with access to long-term care services that have 
350.15  resulted, and any recommendations for continuation of the 
350.16  regional long-term care planning process and the closure process 
350.17  after June 30, 2003. 
350.18     Sec. 42.  [NURSING ASSISTANT; HOME HEALTH AIDE CURRICULUM.] 
350.19     By January 1, 2003, the commissioner of health, in 
350.20  consultation with long-term care consumers, advocates, unions, 
350.21  and trade associations, shall present to the chairs of the 
350.22  legislative committees dealing with health care policy 
350.23  recommendations for updating the nursing assistant and home 
350.24  health aide curriculum (1998 edition) to help students learn 
350.25  front-line survival skills that support job motivation and 
350.26  satisfaction.  These skills include, but are not limited to, 
350.27  working with challenging behaviors, communication skills, stress 
350.28  management including the impact of personal life stress in the 
350.29  work setting, building relationships with families, cultural 
350.30  competencies, and working with death and dying. 
350.31     Sec. 43.  [EVALUATION OF REPORTING REQUIREMENTS.] 
350.32     The commissioners of human services and health, in 
350.33  consultation with interested parties, shall evaluate long-term 
350.34  care provider reporting requirements, balancing the need for 
350.35  public accountability with the need to reduce unnecessary 
350.36  paperwork, and shall eliminate unnecessary reporting 
351.1   requirements, seeking any necessary changes in federal and state 
351.2   law.  The commissioners shall present a progress report by 
351.3   February 1, 2002, to the chairs of the house and senate 
351.4   committees with jurisdiction over health and human services 
351.5   policy and finance. 
351.6      Sec. 44.  [NURSING FACILITY MULTIPLE SCLEROSIS PILOT 
351.7   PROJECT.] 
351.8      (a) For the period from July 1, 2001, to June 30, 2003, the 
351.9   commissioner of human services shall establish and implement a 
351.10  pilot project to contract with nursing facilities eligible to 
351.11  receive medical assistance payments that, at the time of 
351.12  enrollment in the pilot project, serve ten or more persons with 
351.13  a diagnosis of multiple sclerosis.  The commissioner shall 
351.14  negotiate a payment rate with eligible facilities to provide 
351.15  services to persons with multiple sclerosis that must not exceed 
351.16  150 percent of the person's case mix classification payment rate 
351.17  for that facility.  The commissioner may contract with up to six 
351.18  nursing facilities. 
351.19     (b) Facilities may enroll in the pilot project between July 
351.20  1, 2001, and December 31, 2001. 
351.21     (c) The commissioner shall evaluate the additional payments 
351.22  made under the pilot project to determine if the adjustment 
351.23  enables participating facilities to adequately meet the needs 
351.24  for individual care and specialized programming, including 
351.25  programs to meet psychosocial, physiological, and case 
351.26  management needs, without incurring financial losses.  The 
351.27  commissioner of human services, in consultation with the 
351.28  commissioner of health, shall report to the legislature by 
351.29  January 15, 2003, on the results of the project and with a 
351.30  recommendation on whether the project should be made permanent. 
351.31     (d) The negotiated adjustment shall not affect the payment 
351.32  rate charged to private paying residents under the provisions of 
351.33  Minnesota Statutes, section 256B.48, subdivision 1. 
351.34     Sec. 45.  [MINIMUM STAFFING STANDARDS REPORT.] 
351.35     By January 15, 2002, the commissioner of health and the 
351.36  commissioner of human services shall report to the legislature 
352.1   on whether they should translate the minimum nurse staffing 
352.2   requirement in Minnesota Statutes, section 144A.04, subdivision 
352.3   7, paragraph (a), upon the transition to the RUG-III 
352.4   classification system, or whether they should establish 
352.5   different time-based standards, and how to accomplish either. 
352.6      Sec. 46.  [REPEALER.] 
352.7      Minnesota Statutes 2000, sections 144.0721, subdivision 1, 
352.8   and 256B.434, subdivision 5, are repealed. 
352.9                              ARTICLE 6 
352.10                             WORK FORCE 
352.11     Section 1.  Minnesota Statutes 2000, section 144.1464, is 
352.12  amended to read: 
352.13     144.1464 [SUMMER HEALTH CARE INTERNS.] 
352.14     Subdivision 1.  [SUMMER INTERNSHIPS.] The commissioner of 
352.15  health, through a contract with a nonprofit organization as 
352.16  required by subdivision 4, shall award grants to hospitals and, 
352.17  clinics, nursing facilities, and home care providers to 
352.18  establish a secondary and post-secondary summer health care 
352.19  intern program.  The purpose of the program is to expose 
352.20  interested secondary and post-secondary pupils to various 
352.21  careers within the health care profession. 
352.22     Subd. 2.  [CRITERIA.] (a) The commissioner, through the 
352.23  organization under contract, shall award grants to 
352.24  hospitals and, clinics, nursing facilities, and home care 
352.25  providers that agree to:  
352.26     (1) provide secondary and post-secondary summer health care 
352.27  interns with formal exposure to the health care profession; 
352.28     (2) provide an orientation for the secondary and 
352.29  post-secondary summer health care interns; 
352.30     (3) pay one-half the costs of employing the secondary and 
352.31  post-secondary summer health care intern, based on an overall 
352.32  hourly wage that is at least the minimum wage but does not 
352.33  exceed $6 an hour; 
352.34     (4) interview and hire secondary and post-secondary pupils 
352.35  for a minimum of six weeks and a maximum of 12 weeks; and 
352.36     (5) employ at least one secondary student for each 
353.1   post-secondary student employed, to the extent that there are 
353.2   sufficient qualifying secondary student applicants. 
353.3      (b) In order to be eligible to be hired as a secondary 
353.4   summer health intern by a hospital or, clinic, nursing facility, 
353.5   or home care provider, a pupil must: 
353.6      (1) intend to complete high school graduation requirements 
353.7   and be between the junior and senior year of high school; and 
353.8      (2) be from a school district in proximity to the facility; 
353.9   and 
353.10     (3) provide the facility with a letter of recommendation 
353.11  from a health occupations or science educator. 
353.12     (c) In order to be eligible to be hired as a post-secondary 
353.13  summer health care intern by a hospital or clinic, a pupil must: 
353.14     (1) intend to complete a health care training program or a 
353.15  two-year or four-year degree program and be planning on 
353.16  enrolling in or be enrolled in that training program or degree 
353.17  program; and 
353.18     (2) be enrolled in a Minnesota educational institution or 
353.19  be a resident of the state of Minnesota; priority must be given 
353.20  to applicants from a school district or an educational 
353.21  institution in proximity to the facility; and 
353.22     (3) provide the facility with a letter of recommendation 
353.23  from a health occupations or science educator. 
353.24     (d) Hospitals and, clinics, nursing facilities, and home 
353.25  care providers awarded grants may employ pupils as secondary and 
353.26  post-secondary summer health care interns beginning on or after 
353.27  June 15, 1993, if they agree to pay the intern, during the 
353.28  period before disbursement of state grant money, with money 
353.29  designated as the facility's 50 percent contribution towards 
353.30  internship costs.  
353.31     Subd. 3.  [GRANTS.] The commissioner, through the 
353.32  organization under contract, shall award separate grants to 
353.33  hospitals and, clinics, nursing facilities, and home care 
353.34  providers meeting the requirements of subdivision 2.  The grants 
353.35  must be used to pay one-half of the costs of employing secondary 
353.36  and post-secondary pupils in a hospital or, clinic, nursing 
354.1   facility, or home care setting during the course of the 
354.2   program.  No more than 50 percent of the participants may be 
354.3   post-secondary students, unless the program does not receive 
354.4   enough qualified secondary applicants per fiscal year.  No more 
354.5   than five pupils may be selected from any secondary or 
354.6   post-secondary institution to participate in the program and no 
354.7   more than one-half of the number of pupils selected may be from 
354.8   the seven-county metropolitan area. 
354.9      Subd. 4.  [CONTRACT.] The commissioner shall contract with 
354.10  a statewide, nonprofit organization representing facilities at 
354.11  which secondary and post-secondary summer health care interns 
354.12  will serve, to administer the grant program established by this 
354.13  section.  Grant funds that are not used in one fiscal year may 
354.14  be carried over to the next fiscal year.  The organization 
354.15  awarded the grant shall provide the commissioner with any 
354.16  information needed by the commissioner to evaluate the program, 
354.17  in the form and at the times specified by the commissioner. 
354.18     Sec. 2.  [144.1499] [PROMOTION OF HEALTH CARE AND LONG-TERM 
354.19  CARE CAREERS.] 
354.20     The commissioner of health, in consultation with an 
354.21  organization representing health care employers, long-term care 
354.22  employers, and educational institutions, may make grants to 
354.23  qualifying consortia as defined in section 116L.11, subdivision 
354.24  4, for intergenerational programs to encourage middle and high 
354.25  school students to work and volunteer in health care and 
354.26  long-term care settings.  To qualify for a grant under this 
354.27  section, a consortium shall: 
354.28     (1) develop a health and long-term care careers curriculum 
354.29  that provides career exploration and training in national skill 
354.30  standards for health care and long-term care and that is 
354.31  consistent with Minnesota graduation standards and other related 
354.32  requirements; 
354.33     (2) offer programs for high school students that provide 
354.34  training in health and long-term care careers with credits that 
354.35  articulate into post-secondary programs; and 
354.36     (3) provide technical support to the participating health 
355.1   care and long-term care employer to enable the use of the 
355.2   employer's facilities and programs for K-12 health and long-term 
355.3   care careers education. 
355.4      Sec. 3.  Minnesota Statutes 2000, section 144A.62, 
355.5   subdivision 1, is amended to read: 
355.6      Subdivision 1.  [ASSISTANCE WITH EATING AND DRINKING.] (a) 
355.7   Upon federal approval, a nursing home may employ resident 
355.8   attendants to assist with the activities authorized under 
355.9   subdivision 2.  The resident attendant will not shall be counted 
355.10  in the minimum staffing requirements under section 144A.04, 
355.11  subdivision 7. 
355.12     (b) The commissioner shall submit by May July 15, 2000 
355.13  2001, a new request for a federal waiver necessary to implement 
355.14  this section. 
355.15     Sec. 4.  Minnesota Statutes 2000, section 144A.62, 
355.16  subdivision 2, is amended to read: 
355.17     Subd. 2.  [DEFINITION.] (a) "Resident attendant" means an 
355.18  individual who assists residents in a nursing home with the one 
355.19  or more of the following activities of eating and drinking: 
355.20     (1) eating and drinking; and 
355.21     (2) transporting. 
355.22     (b) A resident attendant does not include an individual who:
355.23     (1) is a licensed health professional or a registered 
355.24  dietitian; 
355.25     (2) volunteers without monetary compensation; or 
355.26     (3) is a registered nursing assistant. 
355.27     Sec. 5.  Minnesota Statutes 2000, section 144A.62, 
355.28  subdivision 3, is amended to read: 
355.29     Subd. 3.  [REQUIREMENTS.] (a) A nursing home may not use on 
355.30  a full-time or other paid basis any individual as a resident 
355.31  attendant in the nursing home unless the individual: 
355.32     (1) has completed a training and competency evaluation 
355.33  program encompassing the tasks activities in subdivision 2 that 
355.34  the individual provides; 
355.35     (2) is competent to provide feeding and hydration services 
355.36  those activities; and 
356.1      (3) is under the supervision of the director of nursing. 
356.2      (b) A nursing home may not use a current employee as a 
356.3   resident attendant unless the employee satisfies the 
356.4   requirements of paragraph (a) and volunteers to be used in that 
356.5   capacity. 
356.6      Sec. 6.  Minnesota Statutes 2000, section 144A.62, 
356.7   subdivision 4, is amended to read: 
356.8      Subd. 4.  [EVALUATION.] The training and competency 
356.9   evaluation program may be facility based.  It must include, at a 
356.10  minimum, the training and competency standards for eating and 
356.11  drinking assistance the specific activities the attendant will 
356.12  be conducting contained in the nursing assistant training 
356.13  curriculum. 
356.14     Sec. 7.  Minnesota Statutes 2000, section 148.212, is 
356.15  amended to read: 
356.16     148.212 [TEMPORARY PERMIT.] 
356.17     Upon receipt of the applicable licensure or reregistration 
356.18  fee and permit fee, and in accordance with rules of the board, 
356.19  the board may issue a nonrenewable temporary permit to practice 
356.20  professional or practical nursing to an applicant for licensure 
356.21  or reregistration who is not the subject of a pending 
356.22  investigation or disciplinary action, nor disqualified for any 
356.23  other reason, under the following circumstances: 
356.24     (a) The applicant for licensure by examination under 
356.25  section 148.211, subdivision 1, has graduated from an approved 
356.26  nursing program within the 60 days preceding board receipt of an 
356.27  affidavit of graduation or transcript and has been authorized by 
356.28  the board to write the licensure examination for the first time 
356.29  in the United States.  The permit holder must practice 
356.30  professional or practical nursing under the direct supervision 
356.31  of a registered nurse.  The permit is valid from the date of 
356.32  issue until the date the board takes action on the application 
356.33  or for 60 days whichever occurs first. 
356.34     (b) The applicant for licensure by endorsement under 
356.35  section 148.211, subdivision 2, is currently licensed to 
356.36  practice professional or practical nursing in another state, 
357.1   territory, or Canadian province.  The permit is valid from 
357.2   submission of a proper request until the date of board action on 
357.3   the application. 
357.4      (c) The applicant for licensure by endorsement under 
357.5   section 148.211, subdivision 2, or for reregistration under 
357.6   section 148.231, subdivision 5, is currently registered in a 
357.7   formal, structured refresher course or its equivalent for nurses 
357.8   that includes clinical practice. 
357.9      (d) The applicant for licensure by examination under 
357.10  section 148.211, subdivision 1, as a registered nurse has been 
357.11  issued a commission on graduates of foreign nurse schools 
357.12  certificate, has completed all requirements for licensure except 
357.13  the licensing examination, and has been authorized by the board 
357.14  to write the licensure examination for the first time in the 
357.15  United States.  The permit holder must practice professional 
357.16  nursing under the direct supervision of a registered nurse.  The 
357.17  permit is valid from the date of issue until the date the board 
357.18  takes action on the application or for 60 days, whichever occurs 
357.19  first. 
357.20                             ARTICLE 7 
357.21                     REGULATION OF SUPPLEMENTAL 
357.22                     NURSING SERVICES AGENCIES
357.23     Section 1.  [144A.70] [REGISTRATION OF SUPPLEMENTAL NURSING 
357.24  SERVICES AGENCIES; DEFINITIONS.] 
357.25     Subdivision 1.  [SCOPE.] As used in sections 144A.70 to 
357.26  144A.74, the terms defined in this section have the meanings 
357.27  given them. 
357.28     Subd. 2.  [COMMISSIONER.] "Commissioner" means the 
357.29  commissioner of health. 
357.30     Subd. 3.  [CONTROLLING PERSON.] "Controlling person" means 
357.31  a business entity, officer, program administrator, or director 
357.32  whose responsibilities include the direction of the management 
357.33  or policies of a supplemental nursing services agency.  
357.34  Controlling person also means an individual who, directly or 
357.35  indirectly, beneficially owns an interest in a corporation, 
357.36  partnership, or other business association that is a controlling 
358.1   person. 
358.2      Subd. 4.  [HEALTH CARE FACILITY.] "Health care facility" 
358.3   means a hospital, boarding care home, or outpatient surgical 
358.4   center licensed under sections 144.50 to 144.58, a nursing home 
358.5   or home care agency licensed under this chapter, a residential 
358.6   care home, or a board and lodging establishment that is 
358.7   registered to provide supportive or health supervision services 
358.8   under section 157.17. 
358.9      Subd. 5.  [PERSON.] "Person" includes an individual, firm, 
358.10  corporation, partnership, or association. 
358.11     Subd. 6.  [SUPPLEMENTAL NURSING SERVICES 
358.12  AGENCY.] "Supplemental nursing services agency" means a person, 
358.13  firm, corporation, partnership, or association engaged for hire 
358.14  in the business of providing or procuring temporary employment 
358.15  in health care facilities for nurses, nursing assistants, nurse 
358.16  aides, and orderlies.  Supplemental nursing services agency does 
358.17  not include an individual who only engages in providing the 
358.18  individual's services on a temporary basis to health care 
358.19  facilities.  Supplemental nursing services agency also does not 
358.20  include any nursing services agency that is limited to providing 
358.21  temporary nursing personnel solely to one or more health care 
358.22  facilities owned or operated by the same person, firm, 
358.23  corporation, or partnership. 
358.24     Sec. 2.  [144A.71] [SUPPLEMENTAL NURSING SERVICES AGENCY 
358.25  REGISTRATION.] 
358.26     Subdivision 1.  [DUTY TO REGISTER.] A person who operates a 
358.27  supplemental nursing services agency shall register the agency 
358.28  with the commissioner.  Each separate location of the business 
358.29  of a supplemental nursing services agency shall register the 
358.30  agency with the commissioner.  Each separate location of the 
358.31  business of a supplemental nursing services agency shall have a 
358.32  separate registration. 
358.33     Subd. 2.  [APPLICATION INFORMATION AND FEE.] The 
358.34  commissioner shall establish forms and procedures for processing 
358.35  each supplemental nursing services agency registration 
358.36  application.  An application for a supplemental nursing services 
359.1   agency registration must include at least the following: 
359.2      (1) the names and addresses of the owner or owners of the 
359.3   supplemental nursing services agency; 
359.4      (2) if the owner is a corporation, copies of its articles 
359.5   of incorporation and current bylaws, together with the names and 
359.6   addresses of its officers and directors; 
359.7      (3) any other relevant information that the commissioner 
359.8   determines is necessary to properly evaluate an application for 
359.9   registration; and 
359.10     (4) the annual registration fee for a supplemental nursing 
359.11  services agency, which is $891. 
359.12     Subd. 3.  [REGISTRATION NOT TRANSFERABLE.] A registration 
359.13  issued by the commissioner according to this section is 
359.14  effective for a period of one year from the date of its issuance 
359.15  unless the registration is revoked or suspended under section 
359.16  144A.72, subdivision 2, or unless the supplemental nursing 
359.17  services agency is sold or ownership or management is 
359.18  transferred.  When a supplemental nursing services agency is 
359.19  sold or ownership or management is transferred, the registration 
359.20  of the agency must be voided and the new owner or operator may 
359.21  apply for a new registration. 
359.22     Sec. 3.  [144A.72] [REGISTRATION REQUIREMENTS.] 
359.23     The commissioner shall require that, as a condition of 
359.24  registration: 
359.25     (1) the supplemental nursing services agency shall document 
359.26  that each temporary employee provided to health care facilities 
359.27  currently meets the minimum licensing, training, and continuing 
359.28  education standards for the position in which the employee will 
359.29  be working; 
359.30     (2) the supplemental nursing services agency shall comply 
359.31  with all pertinent requirements relating to the health and other 
359.32  qualifications of personnel employed in health care facilities; 
359.33     (3) the supplemental nursing services agency must not 
359.34  restrict in any manner the employment opportunities of its 
359.35  employees; 
359.36     (4) the supplemental nursing services agency, when 
360.1   supplying temporary employees to a health care facility, and 
360.2   when requested by the facility to do so, shall agree that at 
360.3   least 30 percent of the total personnel hours supplied are 
360.4   during night, holiday, or weekend shifts; 
360.5      (5) the supplemental nursing services agency shall carry 
360.6   medical malpractice insurance to insure against the loss, 
360.7   damage, or expense incident to a claim arising out of the death 
360.8   or injury of any person as the result of negligence or 
360.9   malpractice in the provision of health care services by the 
360.10  supplemental nursing services agency or by any employee of the 
360.11  agency; and 
360.12     (6) the supplemental nursing services agency must not, in 
360.13  any contract with any employee or health care facility, require 
360.14  the payment of liquidated damages, employment fees, or other 
360.15  compensation should the employee be hired as a permanent 
360.16  employee of a health care facility. 
360.17     Sec. 4.  [144A.73] [COMPLAINT SYSTEM.] 
360.18     The commissioner shall establish a system for reporting 
360.19  complaints against a supplemental nursing services agency or its 
360.20  employees.  Complaints may be made by any member of the public.  
360.21  Written complaints must be forwarded to the employer of each 
360.22  person against whom a complaint is made.  The employer shall 
360.23  promptly report to the commissioner any corrective action taken. 
360.24     Sec. 5.  [144A.74] [MAXIMUM CHARGES.] 
360.25     A supplemental nursing services agency must not bill or 
360.26  receive payments from a nursing home licensed under this chapter 
360.27  at a rate higher than 150 percent of the weighted average wage 
360.28  rate for the applicable employee classification for the 
360.29  geographic group to which the nursing home is assigned under 
360.30  chapter 256B.  The weighted average wage rates must be 
360.31  determined by the commissioner of human services and reported to 
360.32  the commissioner of health on an annual basis.  Facilities shall 
360.33  provide information necessary to determine weighted average wage 
360.34  rates to the commissioner of human services in a format 
360.35  requested by the commissioner.  The maximum rate must include 
360.36  all charges for administrative fees, contract fees, or other 
361.1   special charges in addition to the hourly rates for the 
361.2   temporary nursing pool personnel supplied to a nursing home. 
361.3      Sec. 6.  Minnesota Statutes 2000, section 245A.04, 
361.4   subdivision 3, is amended to read: 
361.5      Subd. 3.  [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 
361.6   (a) Before the commissioner issues a license, the commissioner 
361.7   shall conduct a study of the individuals specified in paragraph 
361.8   (c) (d), clauses (1) to (5), according to rules of the 
361.9   commissioner. 
361.10     Beginning January 1, 1997, the commissioner shall also 
361.11  conduct a study of employees providing direct contact services 
361.12  for nonlicensed personal care provider organizations described 
361.13  in paragraph (c) (d), clause (5). 
361.14     The commissioner shall recover the cost of these background 
361.15  studies through a fee of no more than $12 per study charged to 
361.16  the personal care provider organization.  The fees collected 
361.17  under this paragraph are appropriated to the commissioner for 
361.18  the purpose of conducting background studies. 
361.19     Beginning August 1, 1997, the commissioner shall conduct 
361.20  all background studies required under this chapter for adult 
361.21  foster care providers who are licensed by the commissioner of 
361.22  human services and registered under chapter 144D.  The 
361.23  commissioner shall conduct these background studies in 
361.24  accordance with this chapter.  The commissioner shall initiate a 
361.25  pilot project to conduct up to 5,000 background studies under 
361.26  this chapter in programs with joint licensure as home and 
361.27  community-based services and adult foster care for people with 
361.28  developmental disabilities when the license holder does not 
361.29  reside in the foster care residence. 
361.30     (b) Beginning July 1, 1998, the commissioner shall conduct 
361.31  a background study on individuals specified in 
361.32  paragraph (c) (d), clauses (1) to (5), who perform direct 
361.33  contact services in a nursing home or a home care agency 
361.34  licensed under chapter 144A or a boarding care home licensed 
361.35  under sections 144.50 to 144.58, when the subject of the study 
361.36  resides outside Minnesota; the study must be at least as 
362.1   comprehensive as that of a Minnesota resident and include a 
362.2   search of information from the criminal justice data 
362.3   communications network in the state where the subject of the 
362.4   study resides. 
362.5      (c) Beginning August 1, 2001, the commissioner shall 
362.6   conduct all background studies required under this chapter and 
362.7   initiated by supplemental nursing services agencies registered 
362.8   under chapter 144A.  Studies for the agencies must be initiated 
362.9   annually by each agency.  The commissioner shall conduct the 
362.10  background studies according to this chapter.  The commissioner 
362.11  shall recover the cost of the background studies through a fee 
362.12  of no more than $8 per study, charged to the supplemental 
362.13  nursing services agency.  The fees collected under this 
362.14  paragraph are appropriated to the commissioner for the purpose 
362.15  of conducting background studies. 
362.16     (d) The applicant, license holder, the registrant, bureau 
362.17  of criminal apprehension, the commissioner of health, and county 
362.18  agencies, after written notice to the individual who is the 
362.19  subject of the study, shall help with the study by giving the 
362.20  commissioner criminal conviction data and reports about the 
362.21  maltreatment of adults substantiated under section 626.557 and 
362.22  the maltreatment of minors in licensed programs substantiated 
362.23  under section 626.556.  The individuals to be studied shall 
362.24  include: 
362.25     (1) the applicant; 
362.26     (2) persons over the age of 13 living in the household 
362.27  where the licensed program will be provided; 
362.28     (3) current employees or contractors of the applicant who 
362.29  will have direct contact with persons served by the facility, 
362.30  agency, or program; 
362.31     (4) volunteers or student volunteers who have direct 
362.32  contact with persons served by the program to provide program 
362.33  services, if the contact is not directly supervised by the 
362.34  individuals listed in clause (1) or (3); and 
362.35     (5) any person who, as an individual or as a member of an 
362.36  organization, exclusively offers, provides, or arranges for 
363.1   personal care assistant services under the medical assistance 
363.2   program as authorized under sections 256B.04, subdivision 16, 
363.3   and 256B.0625, subdivision 19a. 
363.4      The juvenile courts shall also help with the study by 
363.5   giving the commissioner existing juvenile court records on 
363.6   individuals described in clause (2) relating to delinquency 
363.7   proceedings held within either the five years immediately 
363.8   preceding the application or the five years immediately 
363.9   preceding the individual's 18th birthday, whichever time period 
363.10  is longer.  The commissioner shall destroy juvenile records 
363.11  obtained pursuant to this subdivision when the subject of the 
363.12  records reaches age 23.  
363.13     For purposes of this section and Minnesota Rules, part 
363.14  9543.3070, a finding that a delinquency petition is proven in 
363.15  juvenile court shall be considered a conviction in state 
363.16  district court. 
363.17     For purposes of this subdivision, "direct contact" means 
363.18  providing face-to-face care, training, supervision, counseling, 
363.19  consultation, or medication assistance to persons served by a 
363.20  program.  For purposes of this subdivision, "directly supervised"
363.21  means an individual listed in clause (1), (3), or (5) is within 
363.22  sight or hearing of a volunteer to the extent that the 
363.23  individual listed in clause (1), (3), or (5) is capable at all 
363.24  times of intervening to protect the health and safety of the 
363.25  persons served by the program who have direct contact with the 
363.26  volunteer. 
363.27     A study of an individual in clauses (1) to (5) shall be 
363.28  conducted at least upon application for initial license or 
363.29  registration and reapplication for a license or registration.  
363.30  The commissioner is not required to conduct a study of an 
363.31  individual at the time of reapplication for a license or if the 
363.32  individual has been continuously affiliated with a foster care 
363.33  provider licensed by the commissioner of human services and 
363.34  registered under chapter 144D, other than a family day care or 
363.35  foster care license, if:  (i) a study of the individual was 
363.36  conducted either at the time of initial licensure or when the 
364.1   individual became affiliated with the license holder; (ii) the 
364.2   individual has been continuously affiliated with the license 
364.3   holder since the last study was conducted; and (iii) the 
364.4   procedure described in paragraph (d) (e) has been implemented 
364.5   and was in effect continuously since the last study was 
364.6   conducted.  For the purposes of this section, a physician 
364.7   licensed under chapter 147 is considered to be continuously 
364.8   affiliated upon the license holder's receipt from the 
364.9   commissioner of health or human services of the physician's 
364.10  background study results.  For individuals who are required to 
364.11  have background studies under clauses (1) to (5) and who have 
364.12  been continuously affiliated with a foster care provider that is 
364.13  licensed in more than one county, criminal conviction data may 
364.14  be shared among those counties in which the foster care programs 
364.15  are licensed.  A county agency's receipt of criminal conviction 
364.16  data from another county agency shall meet the criminal data 
364.17  background study requirements of this section. 
364.18     The commissioner may also conduct studies on individuals 
364.19  specified in clauses (3) and (4) when the studies are initiated 
364.20  by: 
364.21     (i) personnel pool agencies; 
364.22     (ii) temporary personnel agencies; 
364.23     (iii) educational programs that train persons by providing 
364.24  direct contact services in licensed programs; and 
364.25     (iv) professional services agencies that are not licensed 
364.26  and which contract with licensed programs to provide direct 
364.27  contact services or individuals who provide direct contact 
364.28  services. 
364.29     Studies on individuals in items (i) to (iv) must be 
364.30  initiated annually by these agencies, programs, and 
364.31  individuals.  Except for personal care provider 
364.32  organizations and supplemental nursing services agencies, no 
364.33  applicant, license holder, or individual who is the subject of 
364.34  the study shall pay any fees required to conduct the study. 
364.35     (1) At the option of the licensed facility, rather than 
364.36  initiating another background study on an individual required to 
365.1   be studied who has indicated to the licensed facility that a 
365.2   background study by the commissioner was previously completed, 
365.3   the facility may make a request to the commissioner for 
365.4   documentation of the individual's background study status, 
365.5   provided that: 
365.6      (i) the facility makes this request using a form provided 
365.7   by the commissioner; 
365.8      (ii) in making the request the facility informs the 
365.9   commissioner that either: 
365.10     (A) the individual has been continuously affiliated with a 
365.11  licensed facility since the individual's previous background 
365.12  study was completed, or since October 1, 1995, whichever is 
365.13  shorter; or 
365.14     (B) the individual is affiliated only with a personnel pool 
365.15  agency, a temporary personnel agency, an educational program 
365.16  that trains persons by providing direct contact services in 
365.17  licensed programs, or a professional services agency that is not 
365.18  licensed and which contracts with licensed programs to provide 
365.19  direct contact services or individuals who provide direct 
365.20  contact services; and 
365.21     (iii) the facility provides notices to the individual as 
365.22  required in paragraphs (a) to (d) (e), and that the facility is 
365.23  requesting written notification of the individual's background 
365.24  study status from the commissioner.  
365.25     (2) The commissioner shall respond to each request under 
365.26  paragraph (1) with a written or electronic notice to the 
365.27  facility and the study subject.  If the commissioner determines 
365.28  that a background study is necessary, the study shall be 
365.29  completed without further request from a licensed agency or 
365.30  notifications to the study subject.  
365.31     (3) When a background study is being initiated by a 
365.32  licensed facility or a foster care provider that is also 
365.33  registered under chapter 144D, a study subject affiliated with 
365.34  multiple licensed facilities may attach to the background study 
365.35  form a cover letter indicating the additional facilities' names, 
365.36  addresses, and background study identification numbers.  When 
366.1   the commissioner receives such notices, each facility identified 
366.2   by the background study subject shall be notified of the study 
366.3   results.  The background study notice sent to the subsequent 
366.4   agencies shall satisfy those facilities' responsibilities for 
366.5   initiating a background study on that individual. 
366.6      (d) (e) If an individual who is affiliated with a program 
366.7   or facility regulated by the department of human services or 
366.8   department of health or who is affiliated with a nonlicensed 
366.9   personal care provider organization, is convicted of a crime 
366.10  constituting a disqualification under subdivision 3d, the 
366.11  probation officer or corrections agent shall notify the 
366.12  commissioner of the conviction.  The commissioner, in 
366.13  consultation with the commissioner of corrections, shall develop 
366.14  forms and information necessary to implement this paragraph and 
366.15  shall provide the forms and information to the commissioner of 
366.16  corrections for distribution to local probation officers and 
366.17  corrections agents.  The commissioner shall inform individuals 
366.18  subject to a background study that criminal convictions for 
366.19  disqualifying crimes will be reported to the commissioner by the 
366.20  corrections system.  A probation officer, corrections agent, or 
366.21  corrections agency is not civilly or criminally liable for 
366.22  disclosing or failing to disclose the information required by 
366.23  this paragraph.  Upon receipt of disqualifying information, the 
366.24  commissioner shall provide the notifications required in 
366.25  subdivision 3a, as appropriate to agencies on record as having 
366.26  initiated a background study or making a request for 
366.27  documentation of the background study status of the individual.  
366.28  This paragraph does not apply to family day care and child 
366.29  foster care programs. 
366.30     (e) (f) The individual who is the subject of the study must 
366.31  provide the applicant or license holder with sufficient 
366.32  information to ensure an accurate study including the 
366.33  individual's first, middle, and last name; home address, city, 
366.34  county, and state of residence for the past five years; zip 
366.35  code; sex; date of birth; and driver's license number.  The 
366.36  applicant or license holder shall provide this information about 
367.1   an individual in paragraph (c) (d), clauses (1) to (5), on forms 
367.2   prescribed by the commissioner.  By January 1, 2000, for 
367.3   background studies conducted by the department of human 
367.4   services, the commissioner shall implement a system for the 
367.5   electronic transmission of:  (1) background study information to 
367.6   the commissioner; and (2) background study results to the 
367.7   license holder.  The commissioner may request additional 
367.8   information of the individual, which shall be optional for the 
367.9   individual to provide, such as the individual's social security 
367.10  number or race. 
367.11     (f) (g) Except for child foster care, adult foster care, 
367.12  and family day care homes, a study must include information 
367.13  related to names of substantiated perpetrators of maltreatment 
367.14  of vulnerable adults that has been received by the commissioner 
367.15  as required under section 626.557, subdivision 9c, paragraph 
367.16  (i), and the commissioner's records relating to the maltreatment 
367.17  of minors in licensed programs, information from juvenile courts 
367.18  as required in paragraph (c) (d) for persons listed in paragraph 
367.19  (c) (d), clause (2), and information from the bureau of criminal 
367.20  apprehension.  For child foster care, adult foster care, and 
367.21  family day care homes, the study must include information from 
367.22  the county agency's record of substantiated maltreatment of 
367.23  adults, and the maltreatment of minors, information from 
367.24  juvenile courts as required in paragraph (c) (d) for persons 
367.25  listed in paragraph (c) (d), clause (2), and information from 
367.26  the bureau of criminal apprehension.  The commissioner may also 
367.27  review arrest and investigative information from the bureau of 
367.28  criminal apprehension, the commissioner of health, a county 
367.29  attorney, county sheriff, county agency, local chief of police, 
367.30  other states, the courts, or the Federal Bureau of Investigation 
367.31  if the commissioner has reasonable cause to believe the 
367.32  information is pertinent to the disqualification of an 
367.33  individual listed in paragraph (c) (d), clauses (1) to (5).  The 
367.34  commissioner is not required to conduct more than one review of 
367.35  a subject's records from the Federal Bureau of Investigation if 
367.36  a review of the subject's criminal history with the Federal 
368.1   Bureau of Investigation has already been completed by the 
368.2   commissioner and there has been no break in the subject's 
368.3   affiliation with the license holder who initiated the background 
368.4   studies. 
368.5      When the commissioner has reasonable cause to believe that 
368.6   further pertinent information may exist on the subject, the 
368.7   subject shall provide a set of classifiable fingerprints 
368.8   obtained from an authorized law enforcement agency.  For 
368.9   purposes of requiring fingerprints, the commissioner shall be 
368.10  considered to have reasonable cause under, but not limited to, 
368.11  the following circumstances: 
368.12     (1) information from the bureau of criminal apprehension 
368.13  indicates that the subject is a multistate offender; 
368.14     (2) information from the bureau of criminal apprehension 
368.15  indicates that multistate offender status is undetermined; or 
368.16     (3) the commissioner has received a report from the subject 
368.17  or a third party indicating that the subject has a criminal 
368.18  history in a jurisdiction other than Minnesota. 
368.19     (g) (h) An applicant's or, license holder's, or 
368.20  registrant's failure or refusal to cooperate with the 
368.21  commissioner is reasonable cause to disqualify a subject, deny a 
368.22  license application or immediately suspend, suspend, or revoke a 
368.23  license or registration.  Failure or refusal of an individual to 
368.24  cooperate with the study is just cause for denying or 
368.25  terminating employment of the individual if the individual's 
368.26  failure or refusal to cooperate could cause the applicant's 
368.27  application to be denied or the license holder's license to be 
368.28  immediately suspended, suspended, or revoked. 
368.29     (h) (i) The commissioner shall not consider an application 
368.30  to be complete until all of the information required to be 
368.31  provided under this subdivision has been received.  
368.32     (i) (j) No person in paragraph (c) (d), clause (1), (2), 
368.33  (3), (4), or (5), who is disqualified as a result of this 
368.34  section may be retained by the agency in a position involving 
368.35  direct contact with persons served by the program. 
368.36     (j) (k) Termination of persons in paragraph (c) (d), clause 
369.1   (1), (2), (3), (4), or (5), made in good faith reliance on a 
369.2   notice of disqualification provided by the commissioner shall 
369.3   not subject the applicant or license holder to civil liability. 
369.4      (k) (l) The commissioner may establish records to fulfill 
369.5   the requirements of this section. 
369.6      (l) (m) The commissioner may not disqualify an individual 
369.7   subject to a study under this section because that person has, 
369.8   or has had, a mental illness as defined in section 245.462, 
369.9   subdivision 20. 
369.10     (m) (n) An individual subject to disqualification under 
369.11  this subdivision has the applicable rights in subdivision 3a, 
369.12  3b, or 3c. 
369.13     (n) (o) For the purposes of background studies completed by 
369.14  tribal organizations performing licensing activities otherwise 
369.15  required of the commissioner under this chapter, after obtaining 
369.16  consent from the background study subject, tribal licensing 
369.17  agencies shall have access to criminal history data in the same 
369.18  manner as county licensing agencies and private licensing 
369.19  agencies under this chapter. 
369.20     Sec. 7.  [REPORT ON SUPPLEMENTAL NURSING SERVICES AGENCY 
369.21  USE.] 
369.22     Beginning July 1, 2001, through June 30, 2003, the 
369.23  commissioner of human services shall require nursing facilities 
369.24  and other providers of long-term care services to report 
369.25  semiannually on the use of supplemental nursing services, in the 
369.26  form and manner specified by the commissioner.  The information 
369.27  reported must include, but is not limited to: 
369.28     (1) number of hours worked by supplemental nursing services 
369.29  personnel, by job classification, for each month; 
369.30     (2) payments to supplemental nursing services agencies, on 
369.31  a per hour worked basis, by job classification, for each month; 
369.32  and 
369.33     (3) percentage of total monthly work hours provided by 
369.34  supplemental nursing services agency personnel, by job 
369.35  classification, for each shift and for weekdays and weekends. 
369.36                             ARTICLE 8 
370.1                       LONG-TERM CARE INSURANCE 
370.2      Section 1.  Minnesota Statutes 2000, section 62A.48, 
370.3   subdivision 4, is amended to read: 
370.4      Subd. 4.  [LOSS RATIO.] The anticipated loss ratio for 
370.5   long-term care policies must not be less than 65 percent for 
370.6   policies issued on a group basis or 60 percent for policies 
370.7   issued on an individual or mass-market basis.  This subdivision 
370.8   does not apply to policies issued on or after January 1, 2002, 
370.9   that comply with sections 62S.021 and 62S.081. 
370.10     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
370.11  following final enactment. 
370.12     Sec. 2.  Minnesota Statutes 2000, section 62A.48, is 
370.13  amended by adding a subdivision to read: 
370.14     Subd. 10.  [REGULATION OF PREMIUMS AND PREMIUM 
370.15  INCREASES.] Policies issued under sections 62A.46 to 62A.56 on 
370.16  or after January 1, 2002, must comply with sections 62S.021, 
370.17  62S.081, 62S.265, and 62S.266 to the same extent as policies 
370.18  issued under chapter 62S. 
370.19     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
370.20  following final enactment. 
370.21     Sec. 3.  Minnesota Statutes 2000, section 62A.48, is 
370.22  amended by adding a subdivision to read: 
370.23     Subd. 11.  [NONFORFEITURE BENEFITS.] Policies issued under 
370.24  sections 62A.46 to 62A.56 on or after January 1, 2002, must 
370.25  comply with section 62S.02, subdivision 2, to the same extent as 
370.26  policies issued under chapter 62S. 
370.27     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
370.28  following final enactment. 
370.29     Sec. 4.  Minnesota Statutes 2000, section 62S.01, is 
370.30  amended by adding a subdivision to read: 
370.31     Subd. 13a.  [EXCEPTIONAL INCREASE.] (a) "Exceptional 
370.32  increase" means only those premium rate increases filed by an 
370.33  insurer as exceptional for which the commissioner determines 
370.34  that the need for the premium rate increase is justified due to 
370.35  changes in laws or rules applicable to long-term care coverage 
370.36  in this state, or due to increased and unexpected utilization 
371.1   that affects the majority of insurers of similar products. 
371.2      (b) Except as provided in section 62S.265, exceptional 
371.3   increases are subject to the same requirements as other premium 
371.4   rate schedule increases.  The commissioner may request a review 
371.5   by an independent actuary or a professional actuarial body of 
371.6   the basis for a request that an increase be considered an 
371.7   exceptional increase.  The commissioner, in determining that the 
371.8   necessary basis for an exceptional increase exists, shall also 
371.9   determine any potential offsets to higher claims costs. 
371.10     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
371.11  following final enactment. 
371.12     Sec. 5.  Minnesota Statutes 2000, section 62S.01, is 
371.13  amended by adding a subdivision to read: 
371.14     Subd. 17a.  [INCIDENTAL.] "Incidental," as used in section 
371.15  62S.265, subdivision 10, means that the value of the long-term 
371.16  care benefits provided is less than ten percent of the total 
371.17  value of the benefits provided over the life of the policy.  
371.18  These values must be measured as of the date of issue. 
371.19     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
371.20  following final enactment. 
371.21     Sec. 6.  Minnesota Statutes 2000, section 62S.01, is 
371.22  amended by adding a subdivision to read: 
371.23     Subd. 23a.  [QUALIFIED ACTUARY.] "Qualified actuary" means 
371.24  a member in good standing of the American Academy of Actuaries. 
371.25     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
371.26  following final enactment. 
371.27     Sec. 7.  Minnesota Statutes 2000, section 62S.01, is 
371.28  amended by adding a subdivision to read: 
371.29     Subd. 25a.  [SIMILAR POLICY FORMS.] "Similar policy forms" 
371.30  means all of the long-term care insurance policies and 
371.31  certificates issued by an insurer in the same long-term care 
371.32  benefit classification as the policy form being considered.  
371.33  Certificates of groups that meet the definition in section 
371.34  62S.01, subdivision 15, clause (1), are not considered similar 
371.35  to certificates or policies otherwise issued as long-term care 
371.36  insurance, but are similar to other comparable certificates with 
372.1   the same long-term care benefit classifications.  For purposes 
372.2   of determining similar policy forms, long-term care benefit 
372.3   classifications are defined as follows:  institutional long-term 
372.4   care benefits only, noninstitutional long-term care benefits 
372.5   only, or comprehensive long-term care benefits. 
372.6      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
372.7   following final enactment. 
372.8      Sec. 8.  [62S.021] [LONG-TERM CARE INSURANCE; INITIAL 
372.9   FILING.] 
372.10     Subdivision 1.  [APPLICABILITY.] This section applies to 
372.11  any long-term care policy issued in this state on or after 
372.12  January 1, 2002, under this chapter or sections 62A.46 to 62A.56.
372.13     Subd. 2.  [REQUIRED SUBMISSION TO COMMISSIONER.] An insurer 
372.14  shall provide the following information to the commissioner 30 
372.15  days prior to making a long-term care insurance form available 
372.16  for sale: 
372.17     (1) a copy of the disclosure documents required in section 
372.18  62S.081; and 
372.19     (2) an actuarial certification consisting of at least the 
372.20  following: 
372.21     (i) a statement that the initial premium rate schedule is 
372.22  sufficient to cover anticipated costs under moderately adverse 
372.23  experience and that the premium rate schedule is reasonably 
372.24  expected to be sustainable over the life of the form with no 
372.25  future premium increases anticipated; 
372.26     (ii) a statement that the policy design and coverage 
372.27  provided have been reviewed and taken into consideration; 
372.28     (iii) a statement that the underwriting and claims 
372.29  adjudication processes have been reviewed and taken into 
372.30  consideration; and 
372.31     (iv) a complete description of the basis for contract 
372.32  reserves that are anticipated to be held under the form, to 
372.33  include: 
372.34     (A) sufficient detail or sample calculations provided so as 
372.35  to have a complete depiction of the reserve amounts to be held; 
372.36     (B) a statement that the assumptions used for reserves 
373.1   contain reasonable margins for adverse experience; 
373.2      (C) a statement that the net valuation premium for renewal 
373.3   years does not increase, except for attained-age rating where 
373.4   permitted; 
373.5      (D) a statement that the difference between the gross 
373.6   premium and the net valuation premium for renewal years is 
373.7   sufficient to cover expected renewal expenses, or if such a 
373.8   statement cannot be made, a complete description of the 
373.9   situations in which this does not occur.  An aggregate 
373.10  distribution of anticipated issues may be used as long as the 
373.11  underlying gross premiums maintain a reasonably consistent 
373.12  relationship.  If the gross premiums for certain age groups 
373.13  appear to be inconsistent with this requirement, the 
373.14  commissioner may request a demonstration under item (i) based on 
373.15  a standard age distribution; and 
373.16     (E) either a statement that the premium rate schedule is 
373.17  not less than the premium rate schedule for existing similar 
373.18  policy forms also available from the insurer except for 
373.19  reasonable differences attributable to benefits, or a comparison 
373.20  of the premium schedules for similar policy forms that are 
373.21  currently available from the insurer with an explanation of the 
373.22  differences. 
373.23     Subd. 3.  [ACTUARIAL DEMONSTRATION.] The commissioner may 
373.24  request an actuarial demonstration that benefits are reasonable 
373.25  in relation to premiums.  The actuarial demonstration must 
373.26  include either premium and claim experience on similar policy 
373.27  forms, adjusted for any premium or benefit differences, relevant 
373.28  and credible data from other studies, or both.  If the 
373.29  commissioner asks for additional information under this 
373.30  subdivision, the 30-day time limit in subdivision 2 does not 
373.31  include the time during which the insurer is preparing the 
373.32  requested information. 
373.33     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
373.34  following final enactment. 
373.35     Sec. 9.  [62S.081] [REQUIRED DISCLOSURE OF RATING PRACTICES 
373.36  TO CONSUMERS.] 
374.1      Subdivision 1.  [APPLICATION.] This section applies as 
374.2   follows: 
374.3      (a) Except as provided in paragraph (b), this section 
374.4   applies to any long-term care policy or certificate issued in 
374.5   this state on or after January 1, 2002. 
374.6      (b) For certificates issued on or after the effective date 
374.7   of this section under a policy of group long-term care insurance 
374.8   as defined in section 62S.01, subdivision 15, that was in force 
374.9   on the effective date of this section, this section applies on 
374.10  the policy anniversary following June 30, 2002. 
374.11     Subd. 2.  [REQUIRED DISCLOSURES.] Other than policies for 
374.12  which no applicable premium rate or rate schedule increases can 
374.13  be made, insurers shall provide all of the information listed in 
374.14  this subdivision to the applicant at the time of application or 
374.15  enrollment, unless the method of application does not allow for 
374.16  delivery at that time; in this case, an insurer shall provide 
374.17  all of the information listed in this subdivision to the 
374.18  applicant no later than at the time of delivery of the policy or 
374.19  certificate: 
374.20     (1) a statement that the policy may be subject to rate 
374.21  increases in the future; 
374.22     (2) an explanation of potential future premium rate 
374.23  revisions and the policyholder's or certificate holder's option 
374.24  in the event of a premium rate revision; 
374.25     (3) the premium rate or rate schedules applicable to the 
374.26  applicant that will be in effect until a request is made for an 
374.27  increase; 
374.28     (4) a general explanation of applying premium rate or rate 
374.29  schedule adjustments that must include: 
374.30     (i) a description of when premium rate or rate schedule 
374.31  adjustments will be effective, for example the next anniversary 
374.32  date or the next billing date; and 
374.33     (ii) the right to a revised premium rate or rate schedule 
374.34  as provided in clause (3) if the premium rate or rate schedule 
374.35  is changed; and 
374.36     (5)(i) information regarding each premium rate increase on 
375.1   this policy form or similar policy forms over the past ten years 
375.2   for this state or any other state that, at a minimum, identifies:
375.3      (A) the policy forms for which premium rates have been 
375.4   increased; 
375.5      (B) the calendar years when the form was available for 
375.6   purchase; and 
375.7      (C) the amount or percent of each increase.  The percentage 
375.8   may be expressed as a percentage of the premium rate prior to 
375.9   the increase and may also be expressed as minimum and maximum 
375.10  percentages if the rate increase is variable by rating 
375.11  characteristics; 
375.12     (ii) the insurer may, in a fair manner, provide additional 
375.13  explanatory information related to the rate increases; 
375.14     (iii) an insurer has the right to exclude from the 
375.15  disclosure premium rate increases that apply only to blocks of 
375.16  business acquired from other nonaffiliated insurers or the 
375.17  long-term care policies acquired from other nonaffiliated 
375.18  insurers when those increases occurred prior to the acquisition; 
375.19     (iv) if an acquiring insurer files for a rate increase on a 
375.20  long-term care policy form acquired from nonaffiliated insurers 
375.21  or a block of policy forms acquired from nonaffiliated insurers 
375.22  on or before the later of the effective date of this section, or 
375.23  the end of a 24-month period following the acquisition of the 
375.24  block of policies, the acquiring insurer may exclude that rate 
375.25  increase from the disclosure.  However, the nonaffiliated 
375.26  selling company must include the disclosure of that rate 
375.27  increase according to item (i); and 
375.28     (v) if the acquiring insurer in item (iv) files for a 
375.29  subsequent rate increase, even within the 24-month period, on 
375.30  the same policy form acquired from nonaffiliated insurers or 
375.31  block of policy forms acquired from nonaffiliated insurers 
375.32  referenced in item (iv), the acquiring insurer shall make all 
375.33  disclosures required by this subdivision, including disclosure 
375.34  of the earlier rate increase referenced in item (iv). 
375.35     Subd. 3.  [ACKNOWLEDGMENT.] An applicant shall sign an 
375.36  acknowledgment at the time of application, unless the method of 
376.1   application does not allow for signature at that time, that the 
376.2   insurer made the disclosure required under subdivision 2.  If, 
376.3   due to the method of application, the applicant cannot sign an 
376.4   acknowledgment at the time of application, the applicant shall 
376.5   sign no later than at the time of delivery of the policy or 
376.6   certificate. 
376.7      Subd. 4.  [FORMS.] An insurer shall use the forms in 
376.8   Appendices B and F of the Long-term Care Insurance Model 
376.9   Regulation adopted by the National Association of Insurance 
376.10  Commissioners to comply with the requirements of subdivisions 1 
376.11  and 2. 
376.12     Subd. 5.  [NOTICE OF INCREASE.] An insurer shall provide 
376.13  notice of an upcoming premium rate schedule increase, after the 
376.14  increase has been approved by the commissioner, to all 
376.15  policyholders or certificate holders, if applicable, at least 45 
376.16  days prior to the implementation of the premium rate schedule 
376.17  increase by the insurer.  The notice must include the 
376.18  information required by subdivision 2 when the rate increase is 
376.19  implemented. 
376.20     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
376.21  following final enactment. 
376.22     Sec. 10.  Minnesota Statutes 2000, section 62S.26, is 
376.23  amended to read: 
376.24     62S.26 [LOSS RATIO.] 
376.25     (a) The minimum loss ratio must be at least 60 percent, 
376.26  calculated in a manner which provides for adequate reserving of 
376.27  the long-term care insurance risk.  In evaluating the expected 
376.28  loss ratio, the commissioner shall give consideration to all 
376.29  relevant factors, including: 
376.30     (1) statistical credibility of incurred claims experience 
376.31  and earned premiums; 
376.32     (2) the period for which rates are computed to provide 
376.33  coverage; 
376.34     (3) experienced and projected trends; 
376.35     (4) concentration of experience within early policy 
376.36  duration; 
377.1      (5) expected claim fluctuation; 
377.2      (6) experience refunds, adjustments, or dividends; 
377.3      (7) renewability features; 
377.4      (8) all appropriate expense factors; 
377.5      (9) interest; 
377.6      (10) experimental nature of the coverage; 
377.7      (11) policy reserves; 
377.8      (12) mix of business by risk classification; and 
377.9      (13) product features such as long elimination periods, 
377.10  high deductibles, and high maximum limits. 
377.11     (b) This section does not apply to policies or certificates 
377.12  that are subject to sections 62S.021, 62S.081, and 62S.265, and 
377.13  that comply with those sections. 
377.14     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
377.15  following final enactment. 
377.16     Sec. 11.  [62S.265] [PREMIUM RATE SCHEDULE INCREASES.] 
377.17     Subdivision 1.  [APPLICABILITY.] (a) Except as provided in 
377.18  paragraph (b), this section applies to any long-term care policy 
377.19  or certificate issued in this state on or after January 1, 2002, 
377.20  under this chapter or sections 62A.46 to 62A.56. 
377.21     (b) For certificates issued on or after the effective date 
377.22  of this section under a group long-term care insurance policy as 
377.23  defined in section 62S.01, subdivision 15, issued under this 
377.24  chapter, that was in force on the effective date of this 
377.25  section, this section applies on the policy anniversary 
377.26  following June 30, 2002. 
377.27     Subd. 2.  [NOTICE.] An insurer shall file a requested 
377.28  premium rate schedule increase, including an exceptional 
377.29  increase, to the commissioner for prior approval at least 60 
377.30  days prior to the notice to the policyholders and shall include: 
377.31     (1) all information required by section 62S.081; 
377.32     (2) certification by a qualified actuary that: 
377.33     (i) if the requested premium rate schedule increase is 
377.34  implemented and the underlying assumptions, which reflect 
377.35  moderately adverse conditions, are realized, no further premium 
377.36  rate schedule increases are anticipated; and 
378.1      (ii) the premium rate filing complies with this section; 
378.2      (3) an actuarial memorandum justifying the rate schedule 
378.3   change request that includes: 
378.4      (i) lifetime projections of earned premiums and incurred 
378.5   claims based on the filed premium rate schedule increase and the 
378.6   method and assumptions used in determining the projected values, 
378.7   including reflection of any assumptions that deviate from those 
378.8   used for pricing other forms currently available for sale; 
378.9      (A) annual values for the five years preceding and the 
378.10  three years following the valuation date must be provided 
378.11  separately; 
378.12     (B) the projections must include the development of the 
378.13  lifetime loss ratio, unless the rate increase is an exceptional 
378.14  increase; 
378.15     (C) the projections must demonstrate compliance with 
378.16  subdivision 3; and 
378.17     (D) for exceptional increases, the projected experience 
378.18  must be limited to the increases in claims expenses attributable 
378.19  to the approved reasons for the exceptional increase and, if the 
378.20  commissioner determines that offsets to higher claim costs may 
378.21  exist, the insurer shall use appropriate net projected 
378.22  experience; 
378.23     (ii) disclosure of how reserves have been incorporated in 
378.24  this rate increase whenever the rate increase will trigger 
378.25  contingent benefit upon lapse; 
378.26     (iii) disclosure of the analysis performed to determine why 
378.27  a rate adjustment is necessary, which pricing assumptions were 
378.28  not realized and why, and what other actions taken by the 
378.29  company have been relied upon by the actuary; 
378.30     (iv) a statement that policy design, underwriting, and 
378.31  claims adjudication practices have been taken into 
378.32  consideration; and 
378.33     (v) if it is necessary to maintain consistent premium rates 
378.34  for new certificates and certificates receiving a rate increase, 
378.35  the insurer shall file composite rates reflecting projections of 
378.36  new certificates; 
379.1      (4) a statement that renewal premium rate schedules are not 
379.2   greater than new business premium rate schedules except for 
379.3   differences attributable to benefits, unless sufficient 
379.4   justification is provided to the commissioner; and 
379.5      (5) sufficient information for review and approval of the 
379.6   premium rate schedule increase by the commissioner. 
379.7      Subd. 3.  [REQUIREMENTS PERTAINING TO RATE INCREASES.] All 
379.8   premium rate schedule increases must be determined according to 
379.9   the following requirements: 
379.10     (1) exceptional increases must provide that 70 percent of 
379.11  the present value of projected additional premiums from the 
379.12  exceptional increase will be returned to policyholders in 
379.13  benefits; 
379.14     (2) premium rate schedule increases must be calculated so 
379.15  that the sum of the accumulated value of incurred claims, 
379.16  without the inclusion of active life reserves, and the present 
379.17  value of future projected incurred claims, without the inclusion 
379.18  of active life reserves, will not be less than the sum of the 
379.19  following: 
379.20     (i) the accumulated value of the initial earned premium 
379.21  times 58 percent; 
379.22     (ii) 85 percent of the accumulated value of prior premium 
379.23  rate schedule increases on an earned basis; 
379.24     (iii) the present value of future projected initial earned 
379.25  premiums times 58 percent; and 
379.26     (iv) 85 percent of the present value of future projected 
379.27  premiums not in item (iii) on an earned basis; 
379.28     (3) if a policy form has both exceptional and other 
379.29  increases, the values in clause (2), items (ii) and (iv), must 
379.30  also include 70 percent for exceptional rate increase amounts; 
379.31  and 
379.32     (4) all present and accumulated values used to determine 
379.33  rate increases must use the maximum valuation interest rate for 
379.34  contract reserves permitted for valuation of whole life 
379.35  insurance policies issued in this state on the same date.  The 
379.36  actuary shall disclose as part of the actuarial memorandum the 
380.1   use of any appropriate averages. 
380.2      Subd. 4.  [PROJECTIONS.] For each rate increase that is 
380.3   implemented, the insurer shall file for approval by the 
380.4   commissioner updated projections, as described in subdivision 2, 
380.5   clause (3), item (i), annually for the next three years and 
380.6   include a comparison of actual results to projected values.  The 
380.7   commissioner may extend the period to greater than three years 
380.8   if actual results are not consistent with projected values from 
380.9   prior projections.  For group insurance policies that meet the 
380.10  conditions in subdivision 11, the projections required by this 
380.11  subdivision must be provided to the policyholder in lieu of 
380.12  filing with the commissioner. 
380.13     Subd. 5.  [LIFETIME PROJECTIONS.] If any premium rate in 
380.14  the revised premium rate schedule is greater than 200 percent of 
380.15  the comparable rate in the initial premium schedule, lifetime 
380.16  projections, as described in subdivision 2, clause (3), item 
380.17  (i), must be filed for approval by the commissioner every five 
380.18  years following the end of the required period in subdivision 
380.19  4.  For group insurance policies that meet the conditions in 
380.20  subdivision 11, the projections required by this subdivision 
380.21  must be provided to the policyholder in lieu of filing with the 
380.22  commissioner. 
380.23     Subd. 6.  [EFFECT OF ACTUAL EXPERIENCE.] (a) If the 
380.24  commissioner has determined that the actual experience following 
380.25  a rate increase does not adequately match the projected 
380.26  experience and that the current projections under moderately 
380.27  adverse conditions demonstrate that incurred claims will not 
380.28  exceed proportions of premiums specified in subdivision 3, the 
380.29  commissioner may require the insurer to implement any of the 
380.30  following: 
380.31     (1) premium rate schedule adjustments; or 
380.32     (2) other measures to reduce the difference between the 
380.33  projected and actual experience. 
380.34     (b) In determining whether the actual experience adequately 
380.35  matches the projected experience, consideration must be given to 
380.36  subdivision 2, clause (3), item (v), if applicable. 
381.1      Subd. 7.  [CONTINGENT BENEFIT UPON LAPSE.] If the majority 
381.2   of the policies or certificates to which the increase is 
381.3   applicable are eligible for the contingent benefit upon lapse, 
381.4   the insurer shall file: 
381.5      (1) a plan, subject to commissioner approval, for improved 
381.6   administration or claims processing designed to eliminate the 
381.7   potential for further deterioration of the policy form requiring 
381.8   further premium rate schedule increases, or both, or a 
381.9   demonstration that appropriate administration and claims 
381.10  processing have been implemented or are in effect; otherwise, 
381.11  the commissioner may impose the condition in subdivision 8, 
381.12  paragraph (b); and 
381.13     (2) the original anticipated lifetime loss ratio, and the 
381.14  premium rate schedule increase that would have been calculated 
381.15  according to subdivision 3 had the greater of the original 
381.16  anticipated lifetime loss ratio or 58 percent been used in the 
381.17  calculations described in subdivision 3, clause (2), items (i) 
381.18  and (iii). 
381.19     Subd. 8.  [PROJECTED LAPSE RATES.] (a) For a rate increase 
381.20  filing that meets the following criteria, the commissioner shall 
381.21  review, for all policies included in the filing, the projected 
381.22  lapse rates and past lapse rates during the 12 months following 
381.23  each increase to determine if significant adverse lapsation has 
381.24  occurred or is anticipated: 
381.25     (1) the rate increase is not the first rate increase 
381.26  requested for the specific policy form or forms; 
381.27     (2) the rate increase is not an exceptional increase; and 
381.28     (3) the majority of the policies or certificates to which 
381.29  the increase is applicable are eligible for the contingent 
381.30  benefit upon lapse. 
381.31     (b) If significant adverse lapsation has occurred, is 
381.32  anticipated in the filing, or is evidenced in the actual results 
381.33  as presented in the updated projections provided by the insurer 
381.34  following the requested rate increase, the commissioner may 
381.35  determine that a rate spiral exists.  Following the 
381.36  determination that a rate spiral exists, the commissioner may 
382.1   require the insurer to offer, without underwriting, to all 
382.2   in-force insureds subject to the rate increase, the option to 
382.3   replace existing coverage with one or more reasonably comparable 
382.4   products being offered by the insurer or its affiliates.  The 
382.5   offer must: 
382.6      (1) be subject to the approval of the commissioner; 
382.7      (2) be based upon actuarially sound principles, but not be 
382.8   based upon attained age; and 
382.9      (3) provide that maximum benefits under any new policy 
382.10  accepted by an insured will be reduced by comparable benefits 
382.11  already paid under the existing policy. 
382.12     (c) The insurer shall maintain the experience of all the 
382.13  replacement insureds separate from the experience of insureds 
382.14  originally issued the policy forms.  In the event of a request 
382.15  for a rate increase on the policy form, the rate increase must 
382.16  be limited to the lesser of the maximum rate increase determined 
382.17  based on the combined experience and the maximum rate increase 
382.18  determined based only upon the experience of the insureds 
382.19  originally issued the form plus ten percent. 
382.20     Subd. 9.  [PERSISTENT PRACTICE OF INADEQUATE INITIAL 
382.21  RATES.] If the commissioner determines that the insurer has 
382.22  exhibited a persistent practice of filing inadequate initial 
382.23  premium rates for long-term care insurance, the commissioner 
382.24  may, in addition to the provisions of subdivision 8, take either 
382.25  of the following actions: 
382.26     (1) prohibit the insurer from filing and marketing 
382.27  comparable coverage for a period of up to five years; or 
382.28     (2) prohibit the insurer from offering all other similar 
382.29  coverages and limit the insurer's marketing of new applications 
382.30  for the products that are subject to recent premium rate 
382.31  schedule increases. 
382.32     Subd. 10.  [INCIDENTAL LONG-TERM CARE 
382.33  BENEFITS.] Subdivisions 1 to 9 do not apply to policies for 
382.34  which the long-term care benefits provided by the policy are 
382.35  incidental, as defined in section 62S.01, subdivision 17a, if 
382.36  the policy complies with all of the following provisions: 
383.1      (1) the interest credited internally to determine cash 
383.2   value accumulations, including long-term care, if any, are 
383.3   guaranteed not to be less than the minimum guaranteed interest 
383.4   rate for cash value accumulations without long-term care set 
383.5   forth in the policy; 
383.6      (2) the portion of the policy that provides insurance 
383.7   benefits other than long-term care coverage meets the 
383.8   nonforfeiture requirements as applicable in any of the following:
383.9      (i) for life insurance, section 61A.25; 
383.10     (ii) for individual deferred annuities, section 61A.245; 
383.11  and 
383.12     (iii) for variable annuities, section 61A.21; 
383.13     (3) the policy meets the disclosure requirements of 
383.14  sections 62S.10 and 62S.11 if the policy is governed by chapter 
383.15  62S and of section 62A.50 if the policy is governed by sections 
383.16  62A.46 to 62A.56; 
383.17     (4) the portion of the policy that provides insurance 
383.18  benefits other than long-term care coverage meets the 
383.19  requirements as applicable in the following: 
383.20     (i) policy illustrations to the extent required by state 
383.21  law applicable to life insurance; 
383.22     (ii) disclosure requirements in state law applicable to 
383.23  annuities; and 
383.24     (iii) disclosure requirements applicable to variable 
383.25  annuities; and 
383.26     (5) an actuarial memorandum is filed with the commissioner 
383.27  that includes: 
383.28     (i) a description of the basis on which the long-term care 
383.29  rates were determined; 
383.30     (ii) a description of the basis for the reserves; 
383.31     (iii) a summary of the type of policy, benefits, 
383.32  renewability, general marketing method, and limits on ages of 
383.33  issuance; 
383.34     (iv) a description and a table of each actuarial assumption 
383.35  used.  For expenses, an insurer must include percent of premium 
383.36  dollars per policy and dollars per unit of benefits, if any; 
384.1      (v) a description and a table of the anticipated policy 
384.2   reserves and additional reserves to be held in each future year 
384.3   for active lives; 
384.4      (vi) the estimated average annual premium per policy and 
384.5   the average issue age; 
384.6      (vii) a statement as to whether underwriting is performed 
384.7   at the time of application.  The statement must indicate whether 
384.8   underwriting is used and, if used, the statement must include a 
384.9   description of the type or types of underwriting used, such as 
384.10  medical underwriting or functional assessment underwriting.  
384.11  Concerning a group policy, the statement must indicate whether 
384.12  the enrollee or any dependent will be underwritten and when 
384.13  underwriting occurs; and 
384.14     (viii) a description of the effect of the long-term care 
384.15  policy provision on the required premiums, nonforfeiture values, 
384.16  and reserves on the underlying insurance policy, both for active 
384.17  lives and those in long-term care claim status. 
384.18     Subd. 11.  [LARGE GROUP POLICIES.] Subdivisions 6 and 9 do 
384.19  not apply to group long-term care insurance policies as defined 
384.20  in section 62S.01, subdivision 15, where: 
384.21     (1) the policies insure 250 or more persons, and the 
384.22  policyholder has 5,000 or more eligible employees of a single 
384.23  employer; or 
384.24     (2) the policyholder, and not the certificate holders, pays 
384.25  a material portion of the premium, which is not less than 20 
384.26  percent of the total premium for the group in the calendar year 
384.27  prior to the year in which a rate increase is filed. 
384.28     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
384.29  following final enactment. 
384.30     Sec. 12.  [62S.266] [NONFORFEITURE BENEFIT REQUIREMENT.] 
384.31     Subdivision 1.  [APPLICABILITY.] This section does not 
384.32  apply to life insurance policies or riders containing 
384.33  accelerated long-term care benefits. 
384.34     Subd. 2.  [REQUIREMENT.] An insurer must offer each 
384.35  prospective policyholder a nonforfeiture benefit in compliance 
384.36  with the following requirements: 
385.1      (1) a policy or certificate offered with nonforfeiture 
385.2   benefits must have coverage elements, eligibility, benefit 
385.3   triggers, and benefit length that are the same as coverage to be 
385.4   issued without nonforfeiture benefits.  The nonforfeiture 
385.5   benefit included in the offer must be the benefit described in 
385.6   subdivision 5; and 
385.7      (2) the offer must be in writing if the nonforfeiture 
385.8   benefit is not otherwise described in the outline of coverage or 
385.9   other materials given to the prospective policyholder. 
385.10     Subd. 3.  [EFFECT OF REJECTION OF OFFER.] If the offer 
385.11  required to be made under subdivision 2 is rejected, the insurer 
385.12  shall provide the contingent benefit upon lapse described in 
385.13  this section. 
385.14     Subd. 4.  [CONTINGENT BENEFIT UPON LAPSE.] (a) After 
385.15  rejection of the offer required under subdivision 2, for 
385.16  individual and group policies without nonforfeiture benefits 
385.17  issued after the effective date of this section, the insurer 
385.18  shall provide a contingent benefit upon lapse. 
385.19     (b) If a group policyholder elects to make the 
385.20  nonforfeiture benefit an option to the certificate holder, a 
385.21  certificate shall provide either the nonforfeiture benefit or 
385.22  the contingent benefit upon lapse. 
385.23     (c) The contingent benefit on lapse must be triggered every 
385.24  time an insurer increases the premium rates to a level which 
385.25  results in a cumulative increase of the annual premium equal to 
385.26  or exceeding the percentage of the insured's initial annual 
385.27  premium based on the insured's issue age provided in this 
385.28  paragraph, and the policy or certificate lapses within 120 days 
385.29  of the due date of the premium increase.  Unless otherwise 
385.30  required, policyholders shall be notified at least 30 days prior 
385.31  to the due date of the premium reflecting the rate increase. 
385.32           Triggers for a Substantial Premium Increase 
385.33                      Percent Increase
385.34       Issue Age      Over Initial Premium
385.35       29 and Under            200
385.36          30-34                190
386.1           35-39                170
386.2           40-44                150
386.3           45-49                130
386.4           50-54                110
386.5           55-59                 90
386.6              60                 70
386.7              61                 66
386.8              62                 62
386.9              63                 58
386.10             64                 54
386.11             65                 50
386.12             66                 48
386.13             67                 46
386.14             68                 44
386.15             69                 42
386.16             70                 40
386.17             71                 38
386.18             72                 36
386.19             73                 34
386.20             74                 32
386.21             75                 30
386.22             76                 28
386.23             77                 26
386.24             78                 24
386.25             79                 22
386.26             80                 20
386.27             81                 19
386.28             82                 18
386.29             83                 17
386.30             84                 16
386.31             85                 15
386.32             86                 14
386.33             87                 13
386.34             88                 12
386.35             89                 11
386.36         90 and over            10
387.1      (d) On or before the effective date of a substantial 
387.2   premium increase as defined in paragraph (c), the insurer shall: 
387.3      (1) offer to reduce policy benefits provided by the current 
387.4   coverage without the requirement of additional underwriting so 
387.5   that required premium payments are not increased; 
387.6      (2) offer to convert the coverage to a paid-up status with 
387.7   a shortened benefit period according to the terms of subdivision 
387.8   5.  This option may be elected at any time during the 120-day 
387.9   period referenced in paragraph (c); and 
387.10     (3) notify the policyholder or certificate holder that a 
387.11  default or lapse at any time during the 120-day period 
387.12  referenced in paragraph (c) is deemed to be the election of the 
387.13  offer to convert in clause (2). 
387.14     Subd. 5.  [NONFORFEITURE BENEFITS; REQUIREMENTS.] (a) 
387.15  Benefits continued as nonforfeiture benefits, including 
387.16  contingent benefits upon lapse, must be as described in this 
387.17  subdivision. 
387.18     (b) For purposes of this subdivision, "attained age rating" 
387.19  is defined as a schedule of premiums starting from the issue 
387.20  date which increases with age at least one percent per year 
387.21  prior to age 50, and at least three percent per year beyond age 
387.22  50. 
387.23     (c) For purposes of this subdivision, the nonforfeiture 
387.24  benefit must be of a shortened benefit period providing paid-up, 
387.25  long-term care insurance coverage after lapse.  The same 
387.26  benefits, amounts, and frequency in effect at the time of lapse, 
387.27  but not increased thereafter, will be payable for a qualifying 
387.28  claim, but the lifetime maximum dollars or days of benefits must 
387.29  be determined as specified in paragraph (d). 
387.30     (d) The standard nonforfeiture credit is equal to 100 
387.31  percent of the sum of all premiums paid, including the premiums 
387.32  paid prior to any changes in benefits.  The insurer may offer 
387.33  additional shortened benefit period options, so long as the 
387.34  benefits for each duration equal or exceed the standard 
387.35  nonforfeiture credit for that duration.  However, the minimum 
387.36  nonforfeiture credit must not be less than 30 times the daily 
388.1   nursing home benefit at the time of lapse.  In either event, the 
388.2   calculation of the nonforfeiture credit is subject to the 
388.3   limitation of this subdivision. 
388.4      (e) The nonforfeiture benefit must begin not later than the 
388.5   end of the third year following the policy or certificate issue 
388.6   date.  The contingent benefit upon lapse must be effective 
388.7   during the first three years as well as thereafter. 
388.8      (f) Notwithstanding paragraph (e), for a policy or 
388.9   certificate with attained age rating, the nonforfeiture benefit 
388.10  must begin on the earlier of: 
388.11     (1) the end of the tenth year following the policy or 
388.12  certificate issue date; or 
388.13     (2) the end of the second year following the date the 
388.14  policy or certificate is no longer subject to attained age 
388.15  rating. 
388.16     (g) Nonforfeiture credits may be used for all care and 
388.17  services qualifying for benefits under the terms of the policy 
388.18  or certificate, up to the limits specified in the policy or 
388.19  certificate. 
388.20     Subd. 6.  [BENEFIT LIMIT.] All benefits paid by the insurer 
388.21  while the policy or certificate is in premium-paying status and 
388.22  in the paid-up status will not exceed the maximum benefits which 
388.23  would be payable if the policy or certificate had remained in 
388.24  premium-paying status. 
388.25     Subd. 7.  [MINIMUM BENEFITS; INDIVIDUAL AND GROUP 
388.26  POLICIES.] There must be no difference in the minimum 
388.27  nonforfeiture benefits as required under this section for group 
388.28  and individual policies. 
388.29     Subd. 8.  [APPLICATION; EFFECTIVE DATES.] This section 
388.30  becomes effective January 1, 2002, and applies as follows: 
388.31     (a) Except as provided in paragraph (b), this section 
388.32  applies to any long-term care policy issued in this state on or 
388.33  after the effective date of this section. 
388.34     (b) For certificates issued on or after the effective date 
388.35  of this section, under a group long-term care insurance policy 
388.36  that was in force on the effective date of this section, the 
389.1   provisions of this section do not apply. 
389.2      Subd. 9.  [EFFECT ON LOSS RATIO.] Premiums charged for a 
389.3   policy or certificate containing nonforfeiture benefits or a 
389.4   contingent benefit on lapse are subject to the loss ratio 
389.5   requirements of section 62A.48, subdivision 4, or 62S.26, 
389.6   treating the policy as a whole, except for policies or 
389.7   certificates that are subject to sections 62S.021, 62S.081, and 
389.8   62S.265 and that comply with those sections. 
389.9      Subd. 10.  [PURCHASED BLOCKS OF BUSINESS.] To determine 
389.10  whether contingent nonforfeiture upon lapse provisions are 
389.11  triggered under subdivision 4, paragraph (c), a replacing 
389.12  insurer that purchased or otherwise assumed a block or blocks of 
389.13  long-term care insurance policies from another insurer shall 
389.14  calculate the percentage increase based on the initial annual 
389.15  premium paid by the insured when the policy was first purchased 
389.16  from the original insurer. 
389.17     Subd. 11.  [LEVEL PREMIUM CONTRACTS.] A nonforfeiture 
389.18  benefit for qualified long-term care insurance contracts that 
389.19  are level premium contracts must be offered that meets the 
389.20  following requirements: 
389.21     (1) the nonforfeiture provision must be appropriately 
389.22  captioned; 
389.23     (2) the nonforfeiture provision must provide a benefit 
389.24  available in the event of a default in the payment of any 
389.25  premiums and must state that the amount of the benefit may be 
389.26  adjusted subsequent to being initially granted only as necessary 
389.27  to reflect changes in claims, persistency, and interest as 
389.28  reflected in changes in rates for premium paying contracts 
389.29  approved by the commissioner for the same contract form; and 
389.30     (3) the nonforfeiture provision must provide at least one 
389.31  of the following: 
389.32     (i) reduced paid-up insurance; 
389.33     (ii) extended term insurance; 
389.34     (iii) shortened benefit period; or 
389.35     (iv) other similar offerings approved by the commissioner. 
389.36     <b>[EFFECTIVE DATE.]</b> This section is effective the day 
390.1   following final enactment. 
390.2      Sec. 13.  Minnesota Statutes 2000, section 256.975, is 
390.3   amended by adding a subdivision to read: 
390.4      Subd. 8.  [PROMOTION OF LONG-TERM CARE INSURANCE.] The 
390.5   Minnesota board on aging, either directly or through contract, 
390.6   shall promote the provision of employer-sponsored, long-term 
390.7   care insurance.  The board shall encourage private and public 
390.8   sector employers to make long-term care insurance available to 
390.9   employees, provide interested employers with information on the 
390.10  long-term care insurance product offered to state employees, and 
390.11  provide technical assistance to employers in designing long-term 
390.12  care insurance products and contacting companies offering 
390.13  long-term care insurance products. 
390.14     Sec. 14.  [256B.0571] [LONG-TERM CARE PARTNERSHIP.] 
390.15     Subdivision 1.  [DEFINITIONS.] For purposes of this 
390.16  section, the following terms have the meanings given them. 
390.17     (a) "Home care service" means care described in section 
390.18  144A.43. 
390.19     (b) "Long-term care insurance" means a policy described in 
390.20  section 62S.01. 
390.21     (c) "Medical assistance" means the program of medical 
390.22  assistance established under section 256B.01. 
390.23     (d) "Nursing home" means nursing home as described in 
390.24  section 144A.01. 
390.25     (e) "Partnership policy" means a long-term care insurance 
390.26  policy that meets the requirements under chapter 62S. 
390.27     (f) "Partnership program" means the Minnesota partnership 
390.28  for long-term care program established under this section. 
390.29     Subd. 2.  [PARTNERSHIP PROGRAM.] (a) Subject to federal 
390.30  waiver approval, the commissioner of human services, along with 
390.31  the commissioner of commerce, shall establish the Minnesota 
390.32  partnership for long-term care program to provide for the 
390.33  financing of long-term care through a combination of private 
390.34  insurance and medical assistance. 
390.35     (b) An individual who meets the requirements in paragraph 
390.36  (c) is eligible to participate in the partnership program. 
391.1      (c) The individual must: 
391.2      (1) be a Minnesota resident; 
391.3      (2) purchase a partnership policy that is delivered, issued 
391.4   for delivery, or renewed on or after the effective date of this 
391.5   section, and maintains the partnership policy in effect 
391.6   throughout the period of participation in the partnership 
391.7   program; and 
391.8      (3) exhaust the minimum benefits under the partnership 
391.9   policy as described in this section.  Benefits received under a 
391.10  long-term care insurance policy before the effective date of 
391.11  this section do not count toward the exhaustion of benefits 
391.12  required in this subdivision. 
391.13     Subd. 3.  [MEDICAL ASSISTANCE ELIGIBILITY.] (a) Upon 
391.14  application of an individual who meets the requirements 
391.15  described in subdivision 2, the commissioner of human services 
391.16  shall determine the individual's eligibility for medical 
391.17  assistance according to paragraphs (b) and (c). 
391.18     (b) After disregarding financial assets exempted under 
391.19  medical assistance eligibility requirements, the department 
391.20  shall disregard an additional amount of financial assets equal 
391.21  to the dollar amount of coverage under the partnership policy.  
391.22     (c) The department shall consider the individual's income 
391.23  according to medical assistance eligibility requirements. 
391.24     Subd. 4.  [FEDERAL APPROVAL.] (a) The commissioner of human 
391.25  services shall seek appropriate amendments to the medical 
391.26  assistance state plan and shall apply for any necessary waiver 
391.27  of medical assistance requirements by the federal Health Care 
391.28  Financing Administration to implement the partnership program.  
391.29  The state shall not implement the partnership program unless the 
391.30  provisions in paragraphs (b) and (c) apply. 
391.31     (b) The commissioner shall seek any necessary federal 
391.32  waiver of medical assistance requirements. 
391.33     (c) Individuals who receive medical assistance under this 
391.34  section are exempt from estate recovery requirements under 
391.35  section 1917, title XIX of the federal Social Security Act, 
391.36  United States Code, title 42, section 1396p. 
392.1      Subd. 5.  [APPROVED POLICIES.] (a) A partnership policy 
392.2   must meet all of the requirements in paragraphs (b) to (h). 
392.3      (b) Minimum coverage shall be for a period of not less than 
392.4   three years and for a dollar amount equal to 36 months of 
392.5   nursing home care at the minimum daily benefit rate determined 
392.6   and adjusted under paragraph (c).  The policy shall provide for 
392.7   home health care benefits to be substituted for nursing home 
392.8   care benefits on the basis of two home health care days for one 
392.9   nursing home care day. 
392.10     (c) Minimum daily benefits shall be $130 for nursing home 
392.11  care or $65 for home care.  These minimum daily benefit amounts 
392.12  shall be adjusted by the department on October 1 of each year, 
392.13  based on the health care index used under medical assistance for 
392.14  nursing home rate setting.  Adjusted minimum daily benefit 
392.15  amounts shall be rounded to the nearest whole dollar. 
392.16     (d) The insured shall be entitled to designate a third 
392.17  party to receive notice if the policy is about to lapse for 
392.18  nonpayment of premium, and an additional 30-day grace period for 
392.19  payment of premium shall be granted following notification to 
392.20  that person. 
392.21     (e) The policy must cover all of the following services: 
392.22     (1) nursing home stay; 
392.23     (2) home care service; 
392.24     (3) care management; and 
392.25     (4) up to 14 days of nursing care in a hospital while the 
392.26  individual is waiting for long-term care placement.  
392.27     (f) Payment for service under paragraph (e), clause (4), 
392.28  must not exceed the daily benefit amount for nursing home care. 
392.29     (g) A partnership policy must offer both options in 
392.30  paragraph (h) for an adjusted premium. 
392.31     (h) The options are: 
392.32     (1) an elimination period of not more than 100 days; and 
392.33     (2) nonforfeiture benefits for applicants between the ages 
392.34  of 18 and 75. 
392.35                             ARTICLE 9
392.36                 MENTAL HEALTH AND CIVIL COMMITMENT
393.1      Section 1.  [145.56] [SUICIDE PREVENTION.] 
393.2      Subdivision 1.  [PUBLIC HEALTH GOAL; SUICIDE PREVENTION 
393.3   PLAN.] The commissioner of health shall make suicide prevention 
393.4   an important public health goal of the state and shall conduct 
393.5   suicide prevention activities to accomplish that goal using an 
393.6   evidence-based, public health approach focused on prevention.  
393.7   The commissioner shall refine, coordinate, and implement the 
393.8   state's suicide prevention plan, in collaboration with assigned 
393.9   staff from the department of human services; the department of 
393.10  public safety; the department of children, families, and 
393.11  learning; and appropriate agencies, organizations, and 
393.12  institutions in the community. 
393.13     Subd. 2.  [COMMUNITY-BASED PROGRAMS.] (a) The commissioner 
393.14  shall establish a grant program consistent with the policy goals 
393.15  of this section to fund: 
393.16     (1) community-based programs to provide education, 
393.17  outreach, and advocacy services to populations who may be at 
393.18  risk for suicide; 
393.19     (2) community-based programs that educate natural community 
393.20  helpers and gatekeepers, such as family members, spiritual 
393.21  leaders, coaches, and business owners, employers, and coworkers, 
393.22  on how to prevent suicide by encouraging help-seeking behaviors; 
393.23  and 
393.24     (3) community-based programs to provide evidence-based 
393.25  suicide prevention and intervention education to school staff, 
393.26  parents, and students in kindergarten through grade 12. 
393.27     (b) Education to populations at risk for suicide and to 
393.28  community helpers and gatekeepers must include information on 
393.29  the symptoms of depression and other psychiatric illnesses, the 
393.30  warning signs of suicide, skills for preventing suicides, and 
393.31  making or seeking effective referrals to intervention and 
393.32  community resources. 
393.33     Subd. 3.  [WORKPLACE AND PROFESSIONAL EDUCATION.] (a) The 
393.34  commissioner shall promote the use of employee assistance and 
393.35  workplace programs to support employees with depression and 
393.36  other psychiatric illnesses and substance abuse disorders, and 
394.1   refer them to services.  In promoting these programs, the 
394.2   commissioner shall collaborate with employer and professional 
394.3   associations, unions, and safety councils. 
394.4      (b) The commissioner shall provide training and technical 
394.5   assistance to local public health and other community-based 
394.6   professionals to provide for integrated implementation of best 
394.7   practices for preventing suicides. 
394.8      Subd. 4. [COLLECTING AND REPORTING SUICIDE DATA.] The 
394.9   commissioner shall coordinate with federal, regional, local, and 
394.10  other state agencies to collect, analyze, and annually issue a 
394.11  public report on Minnesota-specific data on suicide and suicidal 
394.12  behaviors. 
394.13     Subd. 5.  [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The 
394.14  commissioner shall conduct periodic evaluations of the impact of 
394.15  and outcomes from implementation of the state's suicide 
394.16  prevention plan and each of the activities specified in this 
394.17  section.  By July 1, 2002, and July 1 of each even-numbered year 
394.18  thereafter, the commissioner shall report the results of these 
394.19  evaluations to the chairs of the policy and finance committees 
394.20  in the house and senate with jurisdiction over health and human 
394.21  services issues. 
394.22     Sec. 2.  Minnesota Statutes 2000, section 245.462, 
394.23  subdivision 8, is amended to read: 
394.24     Subd. 8.  [DAY TREATMENT SERVICES.] "Day treatment," "day 
394.25  treatment services," or "day treatment program" means a 
394.26  structured program of treatment and care provided to an adult in 
394.27  or by:  (1) a hospital accredited by the joint commission on 
394.28  accreditation of health organizations and licensed under 
394.29  sections 144.50 to 144.55; (2) a community mental health center 
394.30  under section 245.62; or (3) an entity that is under contract 
394.31  with the county board to operate a program that meets the 
394.32  requirements of section 245.4712, subdivision 2, and Minnesota 
394.33  Rules, parts 9505.0170 to 9505.0475.  Day treatment consists of 
394.34  group psychotherapy and other intensive therapeutic services 
394.35  that are provided at least one day a week by a multidisciplinary 
394.36  staff under the clinical supervision of a mental health 
395.1   professional.  Day treatment may include education and 
395.2   consultation provided to families and other individuals as part 
395.3   of the treatment process.  The services are aimed at stabilizing 
395.4   the adult's mental health status, providing mental health 
395.5   services, and developing and improving the adult's independent 
395.6   living and socialization skills.  The goal of day treatment is 
395.7   to reduce or relieve mental illness and to enable the adult to 
395.8   live in the community.  Day treatment services are not a part of 
395.9   inpatient or residential treatment services.  Day treatment 
395.10  services are distinguished from day care by their structured 
395.11  therapeutic program of psychotherapy services.  The commissioner 
395.12  may limit medical assistance reimbursement for day treatment to 
395.13  15 hours per week per person instead of the three hours per day 
395.14  per person specified in Minnesota Rules, part 9505.0323, subpart 
395.15  15. 
395.16     Sec. 3.  Minnesota Statutes 2000, section 245.462, 
395.17  subdivision 18, is amended to read: 
395.18     Subd. 18.  [MENTAL HEALTH PROFESSIONAL.] "Mental health 
395.19  professional" means a person providing clinical services in the 
395.20  treatment of mental illness who is qualified in at least one of 
395.21  the following ways:  
395.22     (1) in psychiatric nursing:  a registered nurse who is 
395.23  licensed under sections 148.171 to 148.285, and who is certified 
395.24  as a clinical specialist in adult psychiatric and mental health 
395.25  nursing by a national nurse certification organization or who 
395.26  has a master's degree in nursing or one of the behavioral 
395.27  sciences or related fields from an accredited college or 
395.28  university or its equivalent, with at least 4,000 hours of 
395.29  post-master's supervised experience in the delivery of clinical 
395.30  services in the treatment of mental illness; 
395.31     (2) in clinical social work:  a person licensed as an 
395.32  independent clinical social worker under section 148B.21, 
395.33  subdivision 6, or a person with a master's degree in social work 
395.34  from an accredited college or university, with at least 4,000 
395.35  hours of post-master's supervised experience in the delivery of 
395.36  clinical services in the treatment of mental illness; 
396.1      (3) in psychology:  a psychologist an individual licensed 
396.2   by the board of psychology under sections 148.88 to 148.98 who 
396.3   has stated to the board of psychology competencies in the 
396.4   diagnosis and treatment of mental illness; 
396.5      (4) in psychiatry:  a physician licensed under chapter 147 
396.6   and certified by the American board of psychiatry and neurology 
396.7   or eligible for board certification in psychiatry; 
396.8      (5) in marriage and family therapy:  the mental health 
396.9   professional must be a marriage and family therapist licensed 
396.10  under sections 148B.29 to 148B.39 with at least two years of 
396.11  post-master's supervised experience in the delivery of clinical 
396.12  services in the treatment of mental illness; or 
396.13     (6) in allied fields:  a person with a master's degree from 
396.14  an accredited college or university in one of the behavioral 
396.15  sciences or related fields, with at least 4,000 hours of 
396.16  post-master's supervised experience in the delivery of clinical 
396.17  services in the treatment of mental illness.  
396.18     Sec. 4.  Minnesota Statutes 2000, section 245.462, is 
396.19  amended by adding a subdivision to read: 
396.20     Subd. 25a.  [SIGNIFICANT IMPAIRMENT IN FUNCTIONING.] 
396.21  "Significant impairment in functioning" means a condition, 
396.22  including significant suicidal ideation or thoughts of harming 
396.23  self or others, which harmfully affects, recurrently or 
396.24  consistently, a person's activities of daily living in 
396.25  employment, housing, family, and social relationships, or 
396.26  education. 
396.27     Sec. 5.  Minnesota Statutes 2000, section 245.4871, 
396.28  subdivision 10, is amended to read: 
396.29     Subd. 10.  [DAY TREATMENT SERVICES.] "Day treatment," "day 
396.30  treatment services," or "day treatment program" means a 
396.31  structured program of treatment and care provided to a child in: 
396.32     (1) an outpatient hospital accredited by the joint 
396.33  commission on accreditation of health organizations and licensed 
396.34  under sections 144.50 to 144.55; 
396.35     (2) a community mental health center under section 245.62; 
396.36     (3) an entity that is under contract with the county board 
397.1   to operate a program that meets the requirements of section 
397.2   245.4884, subdivision 2, and Minnesota Rules, parts 9505.0170 to 
397.3   9505.0475; or 
397.4      (4) an entity that operates a program that meets the 
397.5   requirements of section 245.4884, subdivision 2, and Minnesota 
397.6   Rules, parts 9505.0170 to 9505.0475, that is under contract with 
397.7   an entity that is under contract with a county board. 
397.8      Day treatment consists of group psychotherapy and other 
397.9   intensive therapeutic services that are provided for a minimum 
397.10  three-hour time block by a multidisciplinary staff under the 
397.11  clinical supervision of a mental health professional.  Day 
397.12  treatment may include education and consultation provided to 
397.13  families and other individuals as an extension of the treatment 
397.14  process.  The services are aimed at stabilizing the child's 
397.15  mental health status, and developing and improving the child's 
397.16  daily independent living and socialization skills.  Day 
397.17  treatment services are distinguished from day care by their 
397.18  structured therapeutic program of psychotherapy services.  Day 
397.19  treatment services are not a part of inpatient hospital or 
397.20  residential treatment services.  Day treatment services for a 
397.21  child are an integrated set of education, therapy, and family 
397.22  interventions. 
397.23     A day treatment service must be available to a child at 
397.24  least five days a week throughout the year and must be 
397.25  coordinated with, integrated with, or part of an education 
397.26  program offered by the child's school. 
397.27     Sec. 6.  Minnesota Statutes 2000, section 245.4871, 
397.28  subdivision 27, is amended to read: 
397.29     Subd. 27.  [MENTAL HEALTH PROFESSIONAL.] "Mental health 
397.30  professional" means a person providing clinical services in the 
397.31  diagnosis and treatment of children's emotional disorders.  A 
397.32  mental health professional must have training and experience in 
397.33  working with children consistent with the age group to which the 
397.34  mental health professional is assigned.  A mental health 
397.35  professional must be qualified in at least one of the following 
397.36  ways:  
398.1      (1) in psychiatric nursing, the mental health professional 
398.2   must be a registered nurse who is licensed under sections 
398.3   148.171 to 148.285 and who is certified as a clinical specialist 
398.4   in child and adolescent psychiatric or mental health nursing by 
398.5   a national nurse certification organization or who has a 
398.6   master's degree in nursing or one of the behavioral sciences or 
398.7   related fields from an accredited college or university or its 
398.8   equivalent, with at least 4,000 hours of post-master's 
398.9   supervised experience in the delivery of clinical services in 
398.10  the treatment of mental illness; 
398.11     (2) in clinical social work, the mental health professional 
398.12  must be a person licensed as an independent clinical social 
398.13  worker under section 148B.21, subdivision 6, or a person with a 
398.14  master's degree in social work from an accredited college or 
398.15  university, with at least 4,000 hours of post-master's 
398.16  supervised experience in the delivery of clinical services in 
398.17  the treatment of mental disorders; 
398.18     (3) in psychology, the mental health professional must be a 
398.19  psychologist an individual licensed by the board of psychology 
398.20  under sections 148.88 to 148.98 who has stated to the board of 
398.21  psychology competencies in the diagnosis and treatment of mental 
398.22  disorders; 
398.23     (4) in psychiatry, the mental health professional must be a 
398.24  physician licensed under chapter 147 and certified by the 
398.25  American board of psychiatry and neurology or eligible for board 
398.26  certification in psychiatry; 
398.27     (5) in marriage and family therapy, the mental health 
398.28  professional must be a marriage and family therapist licensed 
398.29  under sections 148B.29 to 148B.39 with at least two years of 
398.30  post-master's supervised experience in the delivery of clinical 
398.31  services in the treatment of mental disorders or emotional 
398.32  disturbances; or 
398.33     (6) in allied fields, the mental health professional must 
398.34  be a person with a master's degree from an accredited college or 
398.35  university in one of the behavioral sciences or related fields, 
398.36  with at least 4,000 hours of post-master's supervised experience 
399.1   in the delivery of clinical services in the treatment of 
399.2   emotional disturbances. 
399.3      Sec. 7.  Minnesota Statutes 2000, section 245.4876, 
399.4   subdivision 1, is amended to read: 
399.5      Subdivision 1.  [CRITERIA.] Children's mental health 
399.6   services required by sections 245.487 to 245.4888 must be:  
399.7      (1) based, when feasible, on research findings; 
399.8      (2) based on individual clinical, cultural, and ethnic 
399.9   needs, and other special needs of the children being served; 
399.10     (3) delivered in a manner that improves family functioning 
399.11  when clinically appropriate; 
399.12     (4) provided in the most appropriate, least restrictive 
399.13  setting that meets the requirements in subdivision 1a, and that 
399.14  is available to the county board to meet the child's treatment 
399.15  needs; 
399.16     (5) accessible to all age groups of children; 
399.17     (6) appropriate to the developmental age of the child being 
399.18  served; 
399.19     (7) delivered in a manner that provides accountability to 
399.20  the child for the quality of service delivered and continuity of 
399.21  services to the child during the years the child needs services 
399.22  from the local system of care; 
399.23     (8) provided by qualified individuals as required in 
399.24  sections 245.487 to 245.4888; 
399.25     (9) coordinated with children's mental health services 
399.26  offered by other providers; 
399.27     (10) provided under conditions that protect the rights and 
399.28  dignity of the individuals being served; and 
399.29     (11) provided in a manner and setting most likely to 
399.30  facilitate progress toward treatment goals. 
399.31     Sec. 8.  Minnesota Statutes 2000, section 245.4876, is 
399.32  amended by adding a subdivision to read: 
399.33     Subd. 1a.  [APPROPRIATE SETTING TO RECEIVE SERVICES.] A 
399.34  child must be provided with mental health services in the least 
399.35  restrictive setting that is appropriate to the needs and current 
399.36  condition of the individual child.  For a child to receive 
400.1   mental health services in a residential treatment or acute care 
400.2   hospital inpatient setting, the family may not be required to 
400.3   demonstrate that services were first provided in a less 
400.4   restrictive setting and that the child failed to make progress 
400.5   toward or meet treatment goals in the less restrictive setting. 
400.6      Sec. 9.  Minnesota Statutes 2000, section 245.4885, 
400.7   subdivision 1, is amended to read: 
400.8      Subdivision 1.  [SCREENING REQUIRED.] The county board 
400.9   shall, prior to admission, except in the case of emergency 
400.10  admission, screen all children referred for treatment of severe 
400.11  emotional disturbance to a residential treatment facility or 
400.12  informally admitted to a regional treatment center if public 
400.13  funds are used to pay for the services.  The county board shall 
400.14  also screen all children admitted to an acute care hospital for 
400.15  treatment of severe emotional disturbance if public funds other 
400.16  than reimbursement under chapters 256B and 256D are used to pay 
400.17  for the services.  If a child is admitted to a residential 
400.18  treatment facility or acute care hospital for emergency 
400.19  treatment or held for emergency care by a regional treatment 
400.20  center under section 253B.05, subdivision 1, screening must 
400.21  occur within three working days of admission.  Screening shall 
400.22  determine whether the proposed treatment:  
400.23     (1) is necessary; 
400.24     (2) is appropriate to the child's individual treatment 
400.25  needs; 
400.26     (3) cannot be effectively provided in the child's home; and 
400.27     (4) provides a length of stay as short as possible 
400.28  consistent with the individual child's need. 
400.29     When a screening is conducted, the county board may not 
400.30  determine that referral or admission to a residential treatment 
400.31  facility or acute care hospital is not appropriate solely 
400.32  because services were not first provided to the child in a less 
400.33  restrictive setting and the child failed to make progress toward 
400.34  or meet treatment goals in the less restrictive setting.  
400.35  Screening shall include both a diagnostic assessment and a 
400.36  functional assessment which evaluates family, school, and 
401.1   community living situations.  If a diagnostic assessment or 
401.2   functional assessment has been completed by a mental health 
401.3   professional within 180 days, a new diagnostic or functional 
401.4   assessment need not be completed unless in the opinion of the 
401.5   current treating mental health professional the child's mental 
401.6   health status has changed markedly since the assessment was 
401.7   completed.  The child's parent shall be notified if an 
401.8   assessment will not be completed and of the reasons.  A copy of 
401.9   the notice shall be placed in the child's file.  Recommendations 
401.10  developed as part of the screening process shall include 
401.11  specific community services needed by the child and, if 
401.12  appropriate, the child's family, and shall indicate whether or 
401.13  not these services are available and accessible to the child and 
401.14  family.  
401.15     During the screening process, the child, child's family, or 
401.16  child's legal representative, as appropriate, must be informed 
401.17  of the child's eligibility for case management services and 
401.18  family community support services and that an individual family 
401.19  community support plan is being developed by the case manager, 
401.20  if assigned.  
401.21     Screening shall be in compliance with section 256F.07 or 
401.22  260C.212, whichever applies.  Wherever possible, the parent 
401.23  shall be consulted in the screening process, unless clinically 
401.24  inappropriate.  
401.25     The screening process, and placement decision, and 
401.26  recommendations for mental health services must be documented in 
401.27  the child's record.  
401.28     An alternate review process may be approved by the 
401.29  commissioner if the county board demonstrates that an alternate 
401.30  review process has been established by the county board and the 
401.31  times of review, persons responsible for the review, and review 
401.32  criteria are comparable to the standards in clauses (1) to (4). 
401.33     Sec. 10.  Minnesota Statutes 2000, section 245.4886, 
401.34  subdivision 1, is amended to read: 
401.35     Subdivision 1.  [STATEWIDE PROGRAM; ESTABLISHMENT.] The 
401.36  commissioner shall establish a statewide program to assist 
402.1   counties in providing services to children with severe emotional 
402.2   disturbance as defined in section 245.4871, subdivision 15, and 
402.3   their families; and to young adults meeting the criteria for 
402.4   transition services in section 245.4875, subdivision 8, and 
402.5   their families.  Services must be designed to help each child to 
402.6   function and remain with the child's family in the community.  
402.7   Transition services to eligible young adults must be designed to 
402.8   foster independent living in the community.  The commissioner 
402.9   shall make grants to counties to establish, operate, or contract 
402.10  with private providers to provide the following services in the 
402.11  following order of priority when these cannot be reimbursed 
402.12  under section 256B.0625: 
402.13     (1) family community support services including crisis 
402.14  placement and crisis respite care as specified in section 
402.15  245.4871, subdivision 17; 
402.16     (2) case management services as specified in section 
402.17  245.4871, subdivision 3; 
402.18     (3) day treatment services as specified in section 
402.19  245.4871, subdivision 10; 
402.20     (4) professional home-based family treatment as specified 
402.21  in section 245.4871, subdivision 31; and 
402.22     (5) therapeutic support of foster care as specified in 
402.23  section 245.4871, subdivision 34. 
402.24     Funding appropriated beginning July 1, 1991, must be used 
402.25  by county boards to provide family community support services 
402.26  and case management services.  Additional services shall be 
402.27  provided in the order of priority as identified in this 
402.28  subdivision. 
402.29     Sec. 11.  Minnesota Statutes 2000, section 245.99, 
402.30  subdivision 4, is amended to read: 
402.31     Subd. 4.  [ADMINISTRATION OF CRISIS HOUSING ASSISTANCE.] 
402.32  The commissioner may contract with organizations or government 
402.33  units experienced in housing assistance to operate the program 
402.34  under this section.  This program is not an entitlement.  The 
402.35  commissioner may take any of the following steps whenever the 
402.36  commissioner projects that funds will be inadequate to meet 
403.1   demand in a given fiscal year: 
403.2      (1) transfer funds from mental health grants in the same 
403.3   appropriation; and 
403.4      (2) impose statewide restrictions as to the type and amount 
403.5   of assistance available to each recipient under this program 
403.6   including reducing the income eligibility level, limiting 
403.7   reimbursement to a percentage of each recipient's costs, 
403.8   limiting housing assistance to 60 days per recipient, or closing 
403.9   the program for the remainder of the fiscal year. 
403.10     Sec. 12.  Minnesota Statutes 2000, section 256.969, 
403.11  subdivision 3a, is amended to read: 
403.12     Subd. 3a.  [PAYMENTS.] Acute care hospital billings under 
403.13  the medical assistance program must not be submitted until the 
403.14  recipient is discharged.  However, the commissioner shall 
403.15  establish monthly interim payments for inpatient hospitals that 
403.16  have individual patient lengths of stay over 30 days regardless 
403.17  of diagnostic category.  Except as provided in section 256.9693, 
403.18  medical assistance reimbursement for treatment of mental illness 
403.19  shall be reimbursed based on diagnostic classifications.  The 
403.20  commissioner may selectively contract with hospitals for 
403.21  services within the diagnostic categories relating to mental 
403.22  illness and chemical dependency under competitive bidding when 
403.23  reasonable geographic access by recipients can be assured.  No 
403.24  physician shall be denied the privilege of treating a recipient 
403.25  required to use a hospital under contract with the commissioner, 
403.26  as long as the physician meets credentialing standards of the 
403.27  individual hospital.  Individual hospital payments established 
403.28  under this section and sections 256.9685, 256.9686, and 
403.29  256.9695, in addition to third party and recipient liability, 
403.30  for discharges occurring during the rate year shall not exceed, 
403.31  in aggregate, the charges for the medical assistance covered 
403.32  inpatient services paid for the same period of time to the 
403.33  hospital.  This payment limitation shall be calculated 
403.34  separately for medical assistance and general assistance medical 
403.35  care services.  The limitation on general assistance medical 
403.36  care shall be effective for admissions occurring on or after 
404.1   July 1, 1991.  Services that have rates established under 
404.2   subdivision 11 or 12, must be limited separately from other 
404.3   services.  After consulting with the affected hospitals, the 
404.4   commissioner may consider related hospitals one entity and may 
404.5   merge the payment rates while maintaining separate provider 
404.6   numbers.  The operating and property base rates per admission or 
404.7   per day shall be derived from the best Medicare and claims data 
404.8   available when rates are established.  The commissioner shall 
404.9   determine the best Medicare and claims data, taking into 
404.10  consideration variables of recency of the data, audit 
404.11  disposition, settlement status, and the ability to set rates in 
404.12  a timely manner.  The commissioner shall notify hospitals of 
404.13  payment rates by December 1 of the year preceding the rate 
404.14  year.  The rate setting data must reflect the admissions data 
404.15  used to establish relative values.  Base year changes from 1981 
404.16  to the base year established for the rate year beginning January 
404.17  1, 1991, and for subsequent rate years, shall not be limited to 
404.18  the limits ending June 30, 1987, on the maximum rate of increase 
404.19  under subdivision 1.  The commissioner may adjust base year 
404.20  cost, relative value, and case mix index data to exclude the 
404.21  costs of services that have been discontinued by the October 1 
404.22  of the year preceding the rate year or that are paid separately 
404.23  from inpatient services.  Inpatient stays that encompass 
404.24  portions of two or more rate years shall have payments 
404.25  established based on payment rates in effect at the time of 
404.26  admission unless the date of admission preceded the rate year in 
404.27  effect by six months or more.  In this case, operating payment 
404.28  rates for services rendered during the rate year in effect and 
404.29  established based on the date of admission shall be adjusted to 
404.30  the rate year in effect by the hospital cost index. 
404.31     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002. 
404.32     Sec. 13.  [256.9693] [CONTINUING CARE PROGRAM FOR PERSONS 
404.33  WITH MENTAL ILLNESS.] 
404.34     The commissioner shall establish a continuing care benefit 
404.35  program for persons with mental illness, in which persons with 
404.36  mental illness may obtain acute care hospital inpatient 
405.1   treatment for mental illness for up to 45 days beyond that 
405.2   allowed by section 256.969.  Persons with mental illness who are 
405.3   eligible for medical assistance may obtain inpatient treatment 
405.4   under this program in hospital beds for which the commissioner 
405.5   contracts under this section.  The commissioner may selectively 
405.6   contract with hospitals to provide this benefit through 
405.7   competitive bidding when reasonable geographic access by 
405.8   recipients can be assured.  Payments under this section shall 
405.9   not affect payments under section 256.969.  The commissioner may 
405.10  contract externally with a utilization review organization to 
405.11  authorize persons with mental illness to access the continuing 
405.12  care benefit program.  The commissioner, as part of the 
405.13  contracts with hospitals, shall establish admission criteria to 
405.14  allow persons with mental illness to access the continuing care 
405.15  benefit program.  If a court orders acute care hospital 
405.16  inpatient treatment for mental illness for a person, the person 
405.17  may obtain the treatment under the continuing care benefit 
405.18  program.  The commissioner shall not require, as part of the 
405.19  admission criteria, any commitment or petition under chapter 
405.20  253B as a condition of accessing the program.  This benefit is 
405.21  not available for people who are also eligible for Medicare and 
405.22  who have not exhausted their annual or lifetime inpatient 
405.23  psychiatric benefit under Medicare.  If a recipient is enrolled 
405.24  in a prepaid plan, this program is included in the plan's 
405.25  coverage.  
405.26     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002. 
405.27     Sec. 14.  [256B.0623] [ADULT REHABILITATIVE MENTAL HEALTH 
405.28  SERVICES.] 
405.29     Subdivision 1.  [SCOPE.] Medical assistance covers adult 
405.30  rehabilitative mental health services as defined in subdivision 
405.31  2, subject to federal approval, if provided to recipients as 
405.32  defined in subdivision 3 and provided by a qualified provider 
405.33  entity meeting the standards in this section and by a qualified 
405.34  individual provider working within the provider's scope of 
405.35  practice and identified in the recipient's individual treatment 
405.36  plan as defined in section 245.462, subdivision 14, and if 
406.1   determined to be medically necessary according to section 62Q.53.
406.2      Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
406.3   following terms have the meanings given them. 
406.4      (a) "Adult rehabilitative mental health services" means 
406.5   mental health services which are rehabilitative and enable the 
406.6   recipient to develop and enhance psychiatric stability, social 
406.7   competencies, personal and emotional adjustment, and independent 
406.8   living and community skills, when these abilities are impaired 
406.9   by the symptoms of mental illness.  Adult rehabilitative mental 
406.10  health services are also appropriate when provided to enable a 
406.11  recipient to retain stability and functioning, if the recipient 
406.12  would be at risk of significant functional decompensation or 
406.13  more restrictive service settings without these services. 
406.14     (1) Adult rehabilitative mental health services instruct, 
406.15  assist, and support the recipient in areas such as:  
406.16  interpersonal communication skills, community resource 
406.17  utilization and integration skills, crisis assistance, relapse 
406.18  prevention skills, health care directives, budgeting and 
406.19  shopping skills, healthy lifestyle skills and practices, cooking 
406.20  and nutrition skills, transportation skills, medication 
406.21  education and monitoring, mental illness symptom management 
406.22  skills, household management skills, employment-related skills, 
406.23  and transition to community living services. 
406.24     (2) These services shall be provided to the recipient on a 
406.25  one-to-one basis in the recipient's home or another community 
406.26  setting or in groups. 
406.27     (b) "Medication education services" means services provided 
406.28  individually or in groups which focus on educating the recipient 
406.29  about mental illness and symptoms; the role and effects of 
406.30  medications in treating symptoms of mental illness; and the side 
406.31  effects of medications.  Medication education is coordinated 
406.32  with medication management services, and does not duplicate it.  
406.33  Medication education services are provided by physicians, 
406.34  pharmacists, or registered nurses. 
406.35     (c) "Transition to community living services" means 
406.36  services which maintain continuity of contact between the 
407.1   rehabilitation services provider and the recipient and which 
407.2   facilitate discharge from a hospital, residential treatment 
407.3   program under Minnesota Rules, chapter 9505, board and lodging 
407.4   facility, or nursing home. Transition to community living 
407.5   services are not intended to provide other areas of adult 
407.6   rehabilitative mental health services.  
407.7      Subd. 3.  [ELIGIBILITY.] An eligible recipient is an 
407.8   individual who: 
407.9      (1) is age 18 or older; 
407.10     (2) is diagnosed with a medical condition, such as mental 
407.11  illness or traumatic brain injury, for which adult 
407.12  rehabilitative mental health services are needed; 
407.13     (3) has substantial disability and functional impairment in 
407.14  three or more of the areas listed in section 245.462, 
407.15  subdivision 11a, so that self-sufficiency is markedly reduced; 
407.16  and 
407.17     (4) has had a recent diagnostic assessment by a qualified 
407.18  professional that documents adult rehabilitative mental health 
407.19  services are medically necessary to address identified 
407.20  disability and functional impairments and individual recipient 
407.21  goals. 
407.22     Subd. 4.  [PROVIDER ENTITY STANDARDS.] (a) The provider 
407.23  entity must be: 
407.24     (1) a county operated entity certified by the state; or 
407.25     (2) a noncounty entity certified by the entity's host 
407.26  county. 
407.27     (b) The certification process is a determination as to 
407.28  whether the entity meets the standards in this subdivision.  The 
407.29  certification must specify which adult rehabilitative mental 
407.30  health services the entity is qualified to provide. 
407.31     (c) If an entity seeks to provide services outside its host 
407.32  county, it must obtain additional certification from each county 
407.33  in which it will provide services.  The additional certification 
407.34  must be based on the adequacy of the entity's knowledge of that 
407.35  county's local health and human service system, and the ability 
407.36  of the entity to coordinate its services with the other services 
408.1   available in that county. 
408.2      (d) Recertification must occur at least every two years. 
408.3      (e) The commissioner may intervene at any time and 
408.4   decertify providers with cause.  The decertification is subject 
408.5   to appeal to the state.  A county board may recommend that the 
408.6   state decertify a provider for cause. 
408.7      (f) The adult rehabilitative mental health services 
408.8   provider entity must meet the following standards: 
408.9      (1) have capacity to recruit, hire, manage, and train 
408.10  mental health professionals, mental health practitioners, and 
408.11  mental health rehabilitation workers; 
408.12     (2) have adequate administrative ability to ensure 
408.13  availability of services; 
408.14     (3) ensure adequate preservice and inservice training for 
408.15  staff; 
408.16     (4) ensure that mental health professionals, mental health 
408.17  practitioners, and mental health rehabilitation workers are 
408.18  skilled in the delivery of the specific adult rehabilitative 
408.19  mental health services provided to the individual eligible 
408.20  recipient; 
408.21     (5) ensure that staff is capable of implementing culturally 
408.22  specific services that are culturally competent and appropriate 
408.23  as determined by the recipient's culture, beliefs, values, and 
408.24  language as identified in the individual treatment plan; 
408.25     (6) ensure enough flexibility in service delivery to 
408.26  respond to the changing and intermittent care needs of a 
408.27  recipient as identified by the recipient and the individual 
408.28  treatment plan; 
408.29     (7) ensure that the mental health professional or mental 
408.30  health practitioner, who is under the clinical supervision of a 
408.31  mental health professional, involved in a recipient's services 
408.32  participates in the development of the individual treatment 
408.33  plan; 
408.34     (8) assist the recipient in arranging needed crisis 
408.35  assessment, intervention, and stabilization services; 
408.36     (9) ensure that services are coordinated with other 
409.1   recipient mental health services providers and the county mental 
409.2   health authority and the federally recognized American Indian 
409.3   authority and necessary others after obtaining the consent of 
409.4   the recipient.  Services must also be coordinated with the 
409.5   recipient's case manager or care coordinator, if the recipient 
409.6   is receiving case management or care coordination services; 
409.7      (10) develop and maintain recipient files, individual 
409.8   treatment plans, and contact charting; 
409.9      (11) develop and maintain staff training and personnel 
409.10  files; 
409.11     (12) submit information as required by the state; 
409.12     (13) establish and maintain a quality assurance plan to 
409.13  evaluate the outcome of services provided; 
409.14     (14) keep all necessary records required by law; 
409.15     (15) deliver services as required by section 245.461; 
409.16     (16) comply with all applicable laws; 
409.17     (17) be an enrolled Medicaid provider; 
409.18     (18) maintain a quality assurance plan to determine 
409.19  specific service outcomes and the recipient's satisfaction with 
409.20  services; and 
409.21     (19) develop and maintain written policies and procedures 
409.22  regarding service provision and administration of the provider 
409.23  entity. 
409.24     (g) The commissioner shall develop statewide procedures for 
409.25  provider certification, including timelines for counties to 
409.26  certify qualified providers. 
409.27     Subd. 5.  [QUALIFICATIONS OF PROVIDER STAFF.] Adult 
409.28  rehabilitative mental health services must be provided by 
409.29  qualified individual provider staff of a certified provider 
409.30  entity.  Individual provider staff must be qualified under one 
409.31  of the following criteria: 
409.32     (1) a mental health professional as defined in section 
409.33  245.462, subdivision 18, clauses (1) to (5); 
409.34     (2) a mental health practitioner as defined in section 
409.35  245.462, subdivision 17.  The mental health practitioner must 
409.36  work under the clinical supervision of a mental health 
410.1   professional; or 
410.2      (3) a mental health rehabilitation worker.  A mental health 
410.3   rehabilitation worker means a staff person working under the 
410.4   direction of a mental health practitioner or mental health 
410.5   professional, and under the clinical supervision of a mental 
410.6   health professional in the implementation of rehabilitative 
410.7   mental health services as identified in the recipient's 
410.8   individual treatment plan; and who: 
410.9      (i) is at least 21 years of age; 
410.10     (ii) has a high school diploma or equivalent; 
410.11     (iii) has successfully completed 30 hours of training 
410.12  during the past two years in all of the following areas:  
410.13  recipient rights, recipient-centered individual treatment 
410.14  planning, behavioral terminology, mental illness, co-occurring 
410.15  mental illness and substance abuse, psychotropic medications and 
410.16  side effects, functional assessment, local community resources, 
410.17  adult vulnerability, recipient confidentiality; and 
410.18     (iv) meets the qualifications in (A) or (B): 
410.19     (A) has an associate of arts degree in one of the 
410.20  behavioral sciences or human services, or is a registered nurse 
410.21  without a bachelor's degree, or who within the previous ten 
410.22  years has:  
410.23     (1) three years of personal life experience with serious 
410.24  and persistent mental illness; 
410.25     (2) three years of life experience as a primary caregiver 
410.26  to an adult with a serious mental illness or traumatic brain 
410.27  injury; or 
410.28     (3) 4,000 hours of supervised paid work experience in the 
410.29  delivery of mental health services to adults with a serious 
410.30  mental illness or traumatic brain injury; or 
410.31     (B)(1) be fluent in the non-English language or competent 
410.32  in the culture of the ethnic group to which at least 50 percent 
410.33  of the mental health rehabilitation worker's clients belong; 
410.34     (2) receives during the first 2,000 hours of work, monthly 
410.35  documented individual clinical supervision by a mental health 
410.36  professional; 
411.1      (3) has 18 hours of documented field supervision by a 
411.2   mental health professional or practitioner during the first 160 
411.3   hours of contact work with recipients, and at least six hours of 
411.4   field supervision quarterly during the following year; 
411.5      (4) has review and cosignature of charting of recipient 
411.6   contacts during field supervision by a mental health 
411.7   professional or practitioner; and 
411.8      (5) has 40 hours of additional continuing education on 
411.9   mental health topics during the first year of employment. 
411.10     Subd. 6.  [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 
411.11  health rehabilitation workers must receive ongoing continuing 
411.12  education training of at least 30 hours every two years in areas 
411.13  of mental illness and mental health services and other areas 
411.14  specific to the population being served.  Mental health 
411.15  rehabilitation workers must also be subject to the ongoing 
411.16  direction and clinical supervision standards in paragraphs (c) 
411.17  and (d). 
411.18     (b) Mental health practitioners must receive ongoing 
411.19  continuing education training as required by their professional 
411.20  license; or if the practitioner is not licensed, the 
411.21  practitioner must receive ongoing continuing education training 
411.22  of at least 30 hours every two years in areas of mental illness 
411.23  and mental health services.  Mental health practitioners must 
411.24  meet the ongoing clinical supervision standards in paragraph (c).
411.25     (c) A mental health professional providing clinical 
411.26  supervision of staff delivering adult rehabilitative mental 
411.27  health services must provide the following guidance: 
411.28     (1) review the information in the recipient's file; 
411.29     (2) review and approve initial and updates of individual 
411.30  treatment plans; 
411.31     (3) meet with mental health rehabilitation workers and 
411.32  practitioners, individually or in small groups, at least monthly 
411.33  to discuss treatment topics of interest to the workers and 
411.34  practitioners; 
411.35     (4) meet with mental health rehabilitation workers and 
411.36  practitioners, individually or in small groups, at least monthly 
412.1   to discuss treatment plans of recipients, and approve by 
412.2   signature and document in the recipient's file any resulting 
412.3   plan updates; 
412.4      (5) meet at least twice a month with the directing mental 
412.5   health practitioner, if there is one, to review needs of the 
412.6   adult rehabilitative mental health services program, review 
412.7   staff on-site observations and evaluate mental health 
412.8   rehabilitation workers, plan staff training, review program 
412.9   evaluation and development, and consult with the directing 
412.10  practitioner; 
412.11     (6) be available for urgent consultation as the individual 
412.12  recipient needs or the situation necessitates; and 
412.13     (7) provide clinical supervision by full- or part-time 
412.14  mental health professionals employed by or under contract with 
412.15  the provider entity. 
412.16     (d) An adult rehabilitative mental health services provider 
412.17  entity must have a treatment director who is a mental health 
412.18  practitioner or mental health professional.  The treatment 
412.19  director must ensure the following: 
412.20     (1) while delivering direct services to recipients, a newly 
412.21  hired mental health rehabilitation worker must be directly 
412.22  observed delivering services to recipients by the mental health 
412.23  practitioner or mental health professional for at least six 
412.24  hours per 40 hours worked during the first 160 hours that the 
412.25  mental health rehabilitation worker works; 
412.26     (2) the mental health rehabilitation worker must receive 
412.27  ongoing on-site direct service observation by a mental health 
412.28  professional or mental health practitioner for at least six 
412.29  hours for every six months of employment; 
412.30     (3) progress notes are reviewed from on-site service 
412.31  observation prepared by the mental health rehabilitation worker 
412.32  and mental health practitioner for accuracy and consistency with 
412.33  actual recipient contact and the individual treatment plan and 
412.34  goals; 
412.35     (4) immediate availability by phone or in person for 
412.36  consultation by a mental health professional or a mental health 
413.1   practitioner to the mental health rehabilitation services worker 
413.2   during service provision; 
413.3      (5) oversee the identification of changes in individual 
413.4   recipient treatment strategies, revise the plan and communicate 
413.5   treatment instructions and methodologies as appropriate to 
413.6   ensure that treatment is implemented correctly; 
413.7      (6) model service practices which:  respect the recipient, 
413.8   include the recipient in planning and implementation of the 
413.9   individual treatment plan, recognize the recipient's strengths, 
413.10  collaborate and coordinate with other involved parties and 
413.11  providers; 
413.12     (7) ensure that mental health practitioners and mental 
413.13  health rehabilitation workers are able to effectively 
413.14  communicate with the recipients, significant others, and 
413.15  providers; and 
413.16     (8) oversee the record of the results of on-site 
413.17  observation and charting evaluation and corrective actions taken 
413.18  to modify the work of the mental health practitioners and mental 
413.19  health rehabilitation workers. 
413.20     (e) A mental health practitioner who is providing treatment 
413.21  direction for a provider entity must receive supervision at 
413.22  least monthly from a mental health professional to: 
413.23     (1) identify and plan for general needs of the recipient 
413.24  population served; 
413.25     (2) identify and plan to address provider entity program 
413.26  needs and effectiveness; 
413.27     (3) identify and plan provider entity staff training and 
413.28  personnel needs and issues; and 
413.29     (4) plan, implement, and evaluate provider entity quality 
413.30  improvement programs.  
413.31     Subd. 7.  [PERSONNEL FILE.] The adult rehabilitative mental 
413.32  health services provider entity must maintain a personnel file 
413.33  on each staff.  Each file must contain: 
413.34     (1) an annual performance review; 
413.35     (2) a summary of on-site service observations and charting 
413.36  review; 
414.1      (3) a criminal background check of all direct service 
414.2   staff; 
414.3      (4) evidence of academic degree and qualifications; 
414.4      (5) a copy of professional license; 
414.5      (6) any job performance recognition and disciplinary 
414.6   actions; 
414.7      (7) any individual staff written input into own personnel 
414.8   file; 
414.9      (8) all clinical supervision provided; and 
414.10     (9) documentation of compliance with continuing education 
414.11  requirements. 
414.12     Subd. 8.  [DIAGNOSTIC ASSESSMENT.] Providers of adult 
414.13  rehabilitative mental health services must complete a diagnostic 
414.14  assessment as defined in section 245.462, subdivision 9, within 
414.15  five days after the recipient's second visit or within 30 days 
414.16  after intake, whichever occurs first.  In cases where a 
414.17  diagnostic assessment is available that reflects the recipient's 
414.18  current status, and has been completed within 180 days preceding 
414.19  admission, an update must be completed.  An update shall include 
414.20  a written summary by a mental health professional of the 
414.21  recipient's current mental health status and service needs.  If 
414.22  the recipient's mental health status has changed significantly 
414.23  since the adult's most recent diagnostic assessment, a new 
414.24  diagnostic assessment is required. 
414.25     Subd. 9.  [FUNCTIONAL ASSESSMENT.] Providers of adult 
414.26  rehabilitative mental health services must complete a written 
414.27  functional assessment as defined in section 245.462, subdivision 
414.28  11a, for each recipient.  The functional assessment must be 
414.29  completed within 30 days of intake, and reviewed and updated at 
414.30  least every six months after it is developed, unless there is a 
414.31  significant change in the functioning of the recipient.  If 
414.32  there is a significant change in functioning, the assessment 
414.33  must be updated.  A single functional assessment can meet case 
414.34  management and adult rehabilitative mental health services 
414.35  requirements, if agreed to by the recipient.  Unless the 
414.36  recipient refuses, the recipient must have significant 
415.1   participation in the development of the functional assessment. 
415.2      Subd. 10.  [INDIVIDUAL TREATMENT PLAN.] All providers of 
415.3   adult rehabilitative mental health services must develop and 
415.4   implement an individual treatment plan for each recipient.  The 
415.5   provisions in clauses (1) and (2) apply: 
415.6      (1) Individual treatment plan means a plan of intervention, 
415.7   treatment, and services for an individual recipient written by a 
415.8   mental health professional or by a mental health practitioner 
415.9   under the clinical supervision of a mental health professional.  
415.10  The individual treatment plan must be based on diagnostic and 
415.11  functional assessments.  To the extent possible, the development 
415.12  and implementation of a treatment plan must be a collaborative 
415.13  process involving the recipient, and with the permission of the 
415.14  recipient, the recipient's family and others in the recipient's 
415.15  support system.  Providers of adult rehabilitative mental health 
415.16  services must develop the individual treatment plan within 30 
415.17  calendar days of intake.  The treatment plan must be updated at 
415.18  least every six months thereafter, or more often when there is 
415.19  significant change in the recipient's situation or functioning, 
415.20  or in services or service methods to be used, or at the request 
415.21  of the recipient or the recipient's legal guardian. 
415.22     (2) The individual treatment plan must include: 
415.23     (i) a list of problems identified in the assessment; 
415.24     (ii) the recipient's strengths and resources; 
415.25     (iii) concrete, measurable goals to be achieved, including 
415.26  time frames for achievement; 
415.27     (iv) specific objectives directed toward the achievement of 
415.28  each one of the goals; 
415.29     (v) documentation of participants in the treatment planning.
415.30  The recipient, if possible, must be a participant.  The 
415.31  recipient or the recipient's legal guardian must sign the 
415.32  treatment plan, or documentation must be provided why this was 
415.33  not possible.  A copy of the plan must be given to the recipient 
415.34  or legal guardian.  Referral to formal services must be 
415.35  arranged, including specific providers where applicable; 
415.36     (vi) cultural considerations, resources, and needs of the 
416.1   recipient must be included; 
416.2      (vii) planned frequency and type of services must be 
416.3   initiated; and 
416.4      (viii) clear progress notes on outcome of goals. 
416.5      (3) The individual community support plan defined in 
416.6   section 245.462, subdivision 12, may serve as the individual 
416.7   treatment plan if there is involvement of a mental health case 
416.8   manager, and with the approval of the recipient.  The individual 
416.9   community support plan must include the criteria in clause (2). 
416.10     Subd. 11.  [RECIPIENT FILE.] Providers of adult 
416.11  rehabilitative mental health services must maintain a file for 
416.12  each recipient that contains the following information: 
416.13     (1) diagnostic assessment or verification of its location, 
416.14  that is current and that was reviewed by a mental health 
416.15  professional who is employed by or under contract with the 
416.16  provider entity; 
416.17     (2) functional assessments; 
416.18     (3) individual treatment plans signed by the recipient and 
416.19  the mental health professional, or if the recipient refused to 
416.20  sign the plan, the date and reason stated by the recipient as to 
416.21  why the recipient would not sign the plan; 
416.22     (4) recipient history; 
416.23     (5) signed release forms; 
416.24     (6) recipient health information and current medications; 
416.25     (7) emergency contacts for the recipient; 
416.26     (8) case records which document the date of service, the 
416.27  place of service delivery, signature of the person providing the 
416.28  service, nature, extent and units of service, and place of 
416.29  service delivery; 
416.30     (9) contacts, direct or by telephone, with recipient's 
416.31  family or others, other providers, or other resources for 
416.32  service coordination; 
416.33     (10) summary of recipient case reviews by staff; and 
416.34     (11) written information by the recipient that the 
416.35  recipient requests be included in the file. 
416.36     Subd. 12.  [ADDITIONAL REQUIREMENTS.] (a) Providers of 
417.1   adult rehabilitative mental health services must comply with the 
417.2   requirements relating to referrals for case management in 
417.3   section 245.467, subdivision 4. 
417.4      (b) Adult rehabilitative mental health services are 
417.5   provided for most recipients in the recipient's home and 
417.6   community.  Services may also be provided at the home of a 
417.7   relative or significant other, job site, psychosocial clubhouse, 
417.8   drop-in center, social setting, classroom, or other places in 
417.9   the community.  Except for "transition to community services," 
417.10  the place of service does not include a regional treatment 
417.11  center, nursing home, residential treatment facility licensed 
417.12  under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36), 
417.13  or an acute care hospital. 
417.14     (c) Adult rehabilitative mental health services may be 
417.15  provided in group settings if appropriate to each participating 
417.16  recipient's needs and treatment plan.  A group is defined as two 
417.17  to ten clients, at least one of whom is a recipient, who is 
417.18  concurrently receiving a service which is identified in this 
417.19  section.  The service and group must be specified in the 
417.20  recipient's treatment plan.  No more than two qualified staff 
417.21  may bill Medicaid for services provided to the same group of 
417.22  recipients.  If two adult rehabilitative mental health workers 
417.23  bill for recipients in the same group session, they must each 
417.24  bill for different recipients. 
417.25     Subd. 13.  [EXCLUDED SERVICES.] The following services are 
417.26  excluded from reimbursement as adult rehabilitative mental 
417.27  health services: 
417.28     (1) recipient transportation services; 
417.29     (2) a service provided and billed by a provider who is not 
417.30  enrolled to provide adult rehabilitative mental health service; 
417.31     (3) adult rehabilitative mental health services performed 
417.32  by volunteers; 
417.33     (4) provider performance of household tasks, chores, or 
417.34  related activities, such as laundering clothes, moving the 
417.35  recipient's household, housekeeping, and grocery shopping for 
417.36  the recipient; 
418.1      (5) direct billing of time spent "on call" when not 
418.2   delivering services to recipients; 
418.3      (6) activities which are primarily social or recreational 
418.4   in nature, rather than rehabilitative, for the individual 
418.5   recipient, as determined by the individual's needs and treatment 
418.6   plan; 
418.7      (7) job-specific skills services, such as on-the-job 
418.8   training; 
418.9      (8) provider service time included in case management 
418.10  reimbursement; 
418.11     (9) outreach services to potential recipients; 
418.12     (10) a mental health service that is not medically 
418.13  necessary; and 
418.14     (11) any services provided by a hospital, board and 
418.15  lodging, or residential facility to an individual who is a 
418.16  patient in or resident of that facility. 
418.17     Subd. 14.  [BILLING WHEN SERVICES ARE PROVIDED BY QUALIFIED 
418.18  STATE STAFF.] When rehabilitative services are provided by 
418.19  qualified state staff who are assigned to pilot projects under 
418.20  section 245.4661, the county or other local entity to which the 
418.21  qualified state staff are assigned may consider these staff part 
418.22  of the local provider entity for which certification is sought 
418.23  under this section, and may bill the medical assistance program 
418.24  for qualifying services provided by the qualified state staff.  
418.25  Notwithstanding section 256.025, subdivision 2, payments for 
418.26  services provided by state staff who are assigned to adult 
418.27  mental health initiatives shall only be made from federal funds. 
418.28     Sec. 15.  [256B.0624] [ADULT MENTAL HEALTH CRISIS RESPONSE 
418.29  SERVICES.] 
418.30     Subdivision 1.  [SCOPE.] Medical assistance covers adult 
418.31  mental health crisis response services as defined in subdivision 
418.32  2, paragraphs (c) to (e), subject to federal approval, if 
418.33  provided to a recipient as defined in subdivision 3 and provided 
418.34  by a qualified provider entity as defined in this section and by 
418.35  a qualified individual provider working within the provider's 
418.36  scope of practice and as defined in this subdivision and 
419.1   identified in the recipient's individual crisis treatment plan 
419.2   as defined in subdivision 10 and if determined to be medically 
419.3   necessary.  
419.4      Subd. 2.  [DEFINITIONS.] For purposes of this section, the 
419.5   following terms have the meanings given them. 
419.6      (a) "Mental health crisis" is an adult behavioral, 
419.7   emotional, or psychiatric situation which, but for the provision 
419.8   of crisis response services, would likely result in 
419.9   significantly reduced levels of functioning in primary 
419.10  activities of daily living, or in an emergency situation, or in 
419.11  the placement of the recipient in a more restrictive setting, 
419.12  including, but not limited to, inpatient hospitalization.  
419.13     (b) "Mental health emergency" is an adult behavioral, 
419.14  emotional, or psychiatric situation which causes an immediate 
419.15  need for mental health services and is consistent with section 
419.16  62Q.55. 
419.17     A mental health crisis or emergency is determined for 
419.18  medical assistance service reimbursement by a physician, a 
419.19  mental health professional, or crisis mental health practitioner 
419.20  with input from the recipient whenever possible. 
419.21     (c) "Mental health crisis assessment" means an immediate 
419.22  face-to-face assessment by a physician, a mental health 
419.23  professional, or mental health practitioner under the clinical 
419.24  supervision of a mental health professional, following a 
419.25  screening that suggests that the adult may be experiencing a 
419.26  mental health crisis or mental health emergency situation. 
419.27     (d) "Mental health mobile crisis intervention services" 
419.28  means face-to-face, short-term intensive mental health services 
419.29  initiated during a mental health crisis or mental health 
419.30  emergency to help the recipient cope with immediate stressors, 
419.31  identify and utilize available resources and strengths, and 
419.32  begin to return to the recipient's baseline level of functioning.
419.33     (1) This service is provided on-site by a mobile crisis 
419.34  intervention team outside of an inpatient hospital setting.  
419.35  Mental health mobile crisis intervention services must be 
419.36  available 24 hours a day, seven days a week.  
420.1      (2) The initial screening must consider other available 
420.2   services to determine which service intervention would best 
420.3   address the recipient's needs and circumstances.  
420.4      (3) The mobile crisis intervention team must be available 
420.5   to meet promptly face-to-face with a person in mental health 
420.6   crisis or emergency in a community setting.  
420.7      (4) The intervention must consist of a mental health crisis 
420.8   assessment and a crisis treatment plan.  
420.9      (5) The treatment plan must include recommendations for any 
420.10  needed crisis stabilization services for the recipient. 
420.11     (e) "Mental health crisis stabilization services" means 
420.12  individualized mental health services provided to a recipient 
420.13  following crisis intervention services which are designed to 
420.14  restore the recipient to the recipient's prior functional 
420.15  level.  Mental health crisis stabilization services may be 
420.16  provided in the recipient's home, the home of a family member or 
420.17  friend of the recipient, another community setting, or a 
420.18  short-term supervised, licensed residential program.  Mental 
420.19  health crisis stabilization does not include partial 
420.20  hospitalization or day treatment. 
420.21     Subd. 3.  [ELIGIBILITY.] An eligible recipient is an 
420.22  individual who: 
420.23     (1) is age 18 or older; 
420.24     (2) is screened as possibly experiencing a mental health 
420.25  crisis or emergency where a mental health crisis assessment is 
420.26  needed; and 
420.27     (3) is assessed as experiencing a mental health crisis or 
420.28  emergency, and mental health crisis intervention or crisis 
420.29  intervention and stabilization services are determined to be 
420.30  medically necessary.  
420.31     Subd. 4.  [PROVIDER ENTITY STANDARDS.] (a) A provider 
420.32  entity is an entity that meets the standards listed in paragraph 
420.33  (b) and: 
420.34     (1) is a county board operated entity; or 
420.35     (2) is a provider entity that is under contract with the 
420.36  county board in the county where the potential crisis or 
421.1   emergency is occurring.  To provide services under this section, 
421.2   the provider entity must directly provide the services; or if 
421.3   services are subcontracted, the provider entity must maintain 
421.4   responsibility for services and billing. 
421.5      (b) The adult mental health crisis response services 
421.6   provider entity must meet the following standards: 
421.7      (1) has the capacity to recruit, hire, and manage and train 
421.8   mental health professionals, practitioners, and rehabilitation 
421.9   workers; 
421.10     (2) has adequate administrative ability to ensure 
421.11  availability of services; 
421.12     (3) is able to ensure adequate preservice and in-service 
421.13  training; 
421.14     (4) is able to ensure that staff providing these services 
421.15  are skilled in the delivery of mental health crisis response 
421.16  services to recipients; 
421.17     (5) is able to ensure that staff are capable of 
421.18  implementing culturally specific treatment identified in the 
421.19  individual treatment plan that is meaningful and appropriate as 
421.20  determined by the recipient's culture, beliefs, values, and 
421.21  language; 
421.22     (6) is able to ensure enough flexibility to respond to the 
421.23  changing intervention and care needs of a recipient as 
421.24  identified by the recipient during the service partnership 
421.25  between the recipient and providers; 
421.26     (7) is able to ensure that mental health professionals and 
421.27  mental health practitioners have the communication tools and 
421.28  procedures to communicate and consult promptly about crisis 
421.29  assessment and interventions as services occur; 
421.30     (8) is able to coordinate these services with county 
421.31  emergency services and mental health crisis services; 
421.32     (9) is able to ensure that mental health crisis assessment 
421.33  and mobile crisis intervention services are available 24 hours a 
421.34  day, seven days a week; 
421.35     (10) is able to ensure that services are coordinated with 
421.36  other mental health service providers, county mental health 
422.1   authorities, or federally recognized American Indian authorities 
422.2   and others as necessary, with the consent of the adult.  
422.3   Services must also be coordinated with the recipient's case 
422.4   manager if the adult is receiving case management services; 
422.5      (11) is able to ensure that crisis intervention services 
422.6   are provided in a manner consistent with sections 245.461 to 
422.7   245.486; 
422.8      (12) is able to submit information as required by the 
422.9   state; 
422.10     (13) maintains staff training and personnel files; 
422.11     (14) is able to establish and maintain a quality assurance 
422.12  and evaluation plan to evaluate the outcomes of services and 
422.13  recipient satisfaction; 
422.14     (15) is able to keep records as required by applicable 
422.15  laws; 
422.16     (16) is able to comply with all applicable laws and 
422.17  statutes; 
422.18     (17) is an enrolled medical assistance provider; and 
422.19     (18) develops and maintains written policies and procedures 
422.20  regarding service provision and administration of the provider 
422.21  entity including safety of staff and recipients in high risk 
422.22  situations.  
422.23     Subd. 5.  [MOBILE CRISIS INTERVENTION STAFF 
422.24  QUALIFICATIONS.] For provision of adult mental health mobile 
422.25  crisis intervention services, a mobile crisis intervention team 
422.26  is comprised of at least two mental health professionals as 
422.27  defined in section 245.462, subdivision 18, clauses (1) to (5), 
422.28  or a combination of at least one mental health professional and 
422.29  one mental health practitioner as defined in section 245.462, 
422.30  subdivision 17, with the required mental health crisis training 
422.31  and under the clinical supervision of a mental health 
422.32  professional on the team.  The team must have at least two 
422.33  people with at least one member providing on-site crisis 
422.34  intervention services when needed.  Team members must be 
422.35  experienced in mental health assessment, crisis intervention 
422.36  techniques, and clinical decision-making under emergency 
423.1   conditions and have knowledge of local services and resources.  
423.2   The team must recommend and coordinate the team's services with 
423.3   appropriate local resources such as the county social services 
423.4   agency, mental health services, and local law enforcement when 
423.5   necessary. 
423.6      Subd. 6.  [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 
423.7   INTERVENTION TREATMENT PLANNING.] (a) Prior to initiating mobile 
423.8   crisis intervention services, a screening of the potential 
423.9   crisis situation must be conducted.  The screening may use the 
423.10  resources of crisis assistance and emergency services as defined 
423.11  in sections 245.462, subdivision 6, and 245.469, subdivisions 1 
423.12  and 2.  The screening must gather information, determine whether 
423.13  a crisis situation exists, identify parties involved, and 
423.14  determine an appropriate response. 
423.15     (b) If a crisis exists, a crisis assessment must be 
423.16  completed.  A crisis assessment evaluates any immediate needs 
423.17  for which emergency services are needed and, as time permits, 
423.18  the recipient's current life situation, sources of stress, 
423.19  mental health problems and symptoms, strengths, cultural 
423.20  considerations, support network, vulnerabilities, and current 
423.21  functioning. 
423.22     (c) If the crisis assessment determines mobile crisis 
423.23  intervention services are needed, the intervention services must 
423.24  be provided promptly.  As opportunity presents during the 
423.25  intervention, at least two members of the mobile crisis 
423.26  intervention team must confer directly or by telephone about the 
423.27  assessment, treatment plan, and actions taken and needed.  At 
423.28  least one of the team members must be on-site providing crisis 
423.29  intervention services.  If providing on-site crisis intervention 
423.30  services, a mental health practitioner must seek clinical 
423.31  supervision as required in subdivision 8. 
423.32     (d) The mobile crisis intervention team must develop an 
423.33  initial, brief crisis treatment plan as soon as appropriate but 
423.34  no later than 24 hours after the initial face-to-face 
423.35  intervention.  The plan must address the needs and problems 
423.36  noted in the crisis assessment and include measurable short-term 
424.1   goals, cultural considerations, and frequency and type of 
424.2   services to be provided to achieve the goals and reduce or 
424.3   eliminate the crisis.  The treatment plan must be updated as 
424.4   needed to reflect current goals and services. 
424.5      (e) The team must document which short-term goals have been 
424.6   met, and when no further crisis intervention services are 
424.7   required. 
424.8      (f) If the recipient's crisis is stabilized, but the 
424.9   recipient needs a referral to other services, the team must 
424.10  provide referrals to these services.  If the recipient has a 
424.11  case manager, planning for other services must be coordinated 
424.12  with the case manager. 
424.13     Subd. 7.  [CRISIS STABILIZATION SERVICES.] (a) Crisis 
424.14  stabilization services must be provided by qualified staff of a 
424.15  crisis stabilization services provider entity and must meet the 
424.16  following standards: 
424.17     (1) a crisis stabilization treatment plan must be developed 
424.18  which meets the criteria in subdivision 11; 
424.19     (2) staff must be qualified as defined in subdivision 8; 
424.20  and 
424.21     (3) services must be delivered according to the treatment 
424.22  plan and include face-to-face contact with the recipient by 
424.23  qualified staff for further assessment, help with referrals, 
424.24  updating of the crisis stabilization treatment plan, supportive 
424.25  counseling, skills training, and collaboration with other 
424.26  service providers in the community. 
424.27     (b) If crisis stabilization services are provided in a 
424.28  supervised, licensed residential setting, the recipient must be 
424.29  contacted face-to-face daily by a qualified mental health 
424.30  practitioner or mental health professional.  The program must 
424.31  have 24-hour-a-day residential staffing which may include staff 
424.32  who do not meet the qualifications in subdivision 8.  The 
424.33  residential staff must have 24-hour-a-day immediate direct or 
424.34  telephone access to a qualified mental health professional or 
424.35  practitioner. 
424.36     (c) If crisis stabilization services are provided in a 
425.1   supervised, licensed residential setting that serves no more 
425.2   than four adult residents, and no more than two are recipients 
425.3   of crisis stabilization services, the residential staff must 
425.4   include, for at least eight hours per day, at least one 
425.5   individual who meets the qualifications in subdivision 8. 
425.6      (d) If crisis stabilization services are provided in a 
425.7   supervised, licensed residential setting that serves more than 
425.8   four adult residents, and one or more are recipients of crisis 
425.9   stabilization services, the residential staff must include, for 
425.10  24 hours a day, at least one individual who meets the 
425.11  qualifications in subdivision 8.  During the first 48 hours that 
425.12  a recipient is in the residential program, the residential 
425.13  program must have at least two staff working 24 hours a day.  
425.14  Staffing levels may be adjusted thereafter according to the 
425.15  needs of the recipient as specified in the crisis stabilization 
425.16  treatment plan. 
425.17     Subd. 8.  [ADULT CRISIS STABILIZATION STAFF 
425.18  QUALIFICATIONS.] (a) Adult mental health crisis stabilization 
425.19  services must be provided by qualified individual staff of a 
425.20  qualified provider entity.  Individual provider staff must have 
425.21  the following qualifications: 
425.22     (1) be a mental health professional as defined in section 
425.23  245.462, subdivision 18, clauses (1) to (5); 
425.24     (2) be a mental health practitioner as defined in section 
425.25  245.462, subdivision 17.  The mental health practitioner must 
425.26  work under the clinical supervision of a mental health 
425.27  professional; or 
425.28     (3) be a mental health rehabilitation worker who meets the 
425.29  criteria in section 256B.0623, subdivision 5, clause (3); works 
425.30  under the direction of a mental health practitioner as defined 
425.31  in section 245.462, subdivision 17, or under direction of a 
425.32  mental health professional; and works under the clinical 
425.33  supervision of a mental health professional. 
425.34     (b) Mental health practitioners and mental health 
425.35  rehabilitation workers must have completed at least 30 hours of 
425.36  training in crisis intervention and stabilization during the 
426.1   past two years. 
426.2      Subd. 9.  [SUPERVISION.] Mental health practitioners may 
426.3   provide crisis assessment and mobile crisis intervention 
426.4   services if the following clinical supervision requirements are 
426.5   met: 
426.6      (1) the mental health provider entity must accept full 
426.7   responsibility for the services provided; 
426.8      (2) the mental health professional of the provider entity, 
426.9   who is an employee or under contract with the provider entity, 
426.10  must be available by phone or in person for clinical 
426.11  supervision; 
426.12     (3) the mental health professional is consulted, in person 
426.13  or by phone, during the first three hours when a mental health 
426.14  practitioner provides on-site service; 
426.15     (4) the mental health professional must: 
426.16     (i) review and approve of the tentative crisis assessment 
426.17  and crisis treatment plan; 
426.18     (ii) document the consultation; and 
426.19     (iii) sign the crisis assessment and treatment plan within 
426.20  the next business day; 
426.21     (5) if the mobile crisis intervention services continue 
426.22  into a second calendar day, a mental health professional must 
426.23  contact the recipient face-to-face on the second day to provide 
426.24  services and update the crisis treatment plan; and 
426.25     (6) the on-site observation must be documented in the 
426.26  recipient's record and signed by the mental health professional. 
426.27     Subd. 10.  [RECIPIENT FILE.] Providers of mobile crisis 
426.28  intervention or crisis stabilization services must maintain a 
426.29  file for each recipient containing the following information: 
426.30     (1) individual crisis treatment plans signed by the 
426.31  recipient, mental health professional, and mental health 
426.32  practitioner who developed the crisis treatment plan, or if the 
426.33  recipient refused to sign the plan, the date and reason stated 
426.34  by the recipient as to why the recipient would not sign the 
426.35  plan; 
426.36     (2) signed release forms; 
427.1      (3) recipient health information and current medications; 
427.2      (4) emergency contacts for the recipient; 
427.3      (5) case records which document the date of service, place 
427.4   of service delivery, signature of the person providing the 
427.5   service, and the nature, extent, and units of service.  Direct 
427.6   or telephone contact with the recipient's family or others 
427.7   should be documented; 
427.8      (6) required clinical supervision by mental health 
427.9   professionals; 
427.10     (7) summary of the recipient's case reviews by staff; and 
427.11     (8) any written information by the recipient that the 
427.12  recipient wants in the file. 
427.13  Documentation in the file must comply with all requirements of 
427.14  the commissioner. 
427.15     Subd. 11.  [TREATMENT PLAN.] The individual crisis 
427.16  stabilization treatment plan must include, at a minimum: 
427.17     (1) a list of problems identified in the assessment; 
427.18     (2) a list of the recipient's strengths and resources; 
427.19     (3) concrete, measurable short-term goals and tasks to be 
427.20  achieved, including time frames for achievement; 
427.21     (4) specific objectives directed toward the achievement of 
427.22  each one of the goals; 
427.23     (5) documentation of the participants involved in the 
427.24  service planning.  The recipient, if possible, must be a 
427.25  participant.  The recipient or the recipient's legal guardian 
427.26  must sign the service plan or documentation must be provided why 
427.27  this was not possible.  A copy of the plan must be given to the 
427.28  recipient and the recipient's legal guardian.  The plan should 
427.29  include services arranged, including specific providers where 
427.30  applicable; 
427.31     (6) planned frequency and type of services initiated; 
427.32     (7) a crisis response action plan if a crisis should occur; 
427.33     (8) clear progress notes on outcome of goals; 
427.34     (9) a written plan must be completed within 24 hours of 
427.35  beginning services with the recipient; and 
427.36     (10) a treatment plan must be developed by a mental health 
428.1   professional or mental health practitioner under the clinical 
428.2   supervision of a mental health professional.  The mental health 
428.3   professional must approve and sign all treatment plans. 
428.4      Subd. 12.  [EXCLUDED SERVICES.] The following services are 
428.5   excluded from reimbursement under this section: 
428.6      (1) room and board services; 
428.7      (2) services delivered to a recipient while admitted to an 
428.8   inpatient hospital; 
428.9      (3) recipient transportation costs may be covered under 
428.10  other medical assistance provisions, but transportation services 
428.11  are not an adult mental health crisis response service; 
428.12     (4) services provided and billed by a provider who is not 
428.13  enrolled under medical assistance to provide adult mental health 
428.14  crisis response services; 
428.15     (5) services performed by volunteers; 
428.16     (6) direct billing of time spent "on call" when not 
428.17  delivering services to a recipient; 
428.18     (7) provider service time included in case management 
428.19  reimbursement.  When a provider is eligible to provide more than 
428.20  one type of medical assistance service, the recipient must have 
428.21  a choice of provider for each service, unless otherwise provided 
428.22  for by law; 
428.23     (8) outreach services to potential recipients; and 
428.24     (9) a mental health service that is not medically necessary.
428.25     Sec. 16.  Minnesota Statutes 2000, section 256B.0625, 
428.26  subdivision 20, is amended to read: 
428.27     Subd. 20.  [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 
428.28  extent authorized by rule of the state agency, medical 
428.29  assistance covers case management services to persons with 
428.30  serious and persistent mental illness and children with severe 
428.31  emotional disturbance.  Services provided under this section 
428.32  must meet the relevant standards in sections 245.461 to 
428.33  245.4888, the Comprehensive Adult and Children's Mental Health 
428.34  Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 
428.35  9505.0322, excluding subpart 10. 
428.36     (b) Entities meeting program standards set out in rules 
429.1   governing family community support services as defined in 
429.2   section 245.4871, subdivision 17, are eligible for medical 
429.3   assistance reimbursement for case management services for 
429.4   children with severe emotional disturbance when these services 
429.5   meet the program standards in Minnesota Rules, parts 9520.0900 
429.6   to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 
429.7      (c) Medical assistance and MinnesotaCare payment for mental 
429.8   health case management shall be made on a monthly basis.  In 
429.9   order to receive payment for an eligible child, the provider 
429.10  must document at least a face-to-face contact with the child, 
429.11  the child's parents, or the child's legal representative.  To 
429.12  receive payment for an eligible adult, the provider must 
429.13  document: 
429.14     (1) at least a face-to-face contact with the adult or the 
429.15  adult's legal representative; or 
429.16     (2) at least a telephone contact with the adult or the 
429.17  adult's legal representative and document a face-to-face contact 
429.18  with the adult or the adult's legal representative within the 
429.19  preceding two months. 
429.20     (d) Payment for mental health case management provided by 
429.21  county or state staff shall be based on the monthly rate 
429.22  methodology under section 256B.094, subdivision 6, paragraph 
429.23  (b), with separate rates calculated for child welfare and mental 
429.24  health, and within mental health, separate rates for children 
429.25  and adults. 
429.26     (e) Payment for mental health case management provided by 
429.27  Indian health services or by agencies operated by Indian tribes 
429.28  may be made according to this section or other relevant 
429.29  federally approved rate setting methodology. 
429.30     (f) Payment for mental health case management provided by 
429.31  county-contracted vendors who contract with a county or Indian 
429.32  tribe shall be based on a monthly rate negotiated by the host 
429.33  county or tribe.  The negotiated rate must not exceed the rate 
429.34  charged by the vendor for the same service to other payers.  If 
429.35  the service is provided by a team of contracted vendors, the 
429.36  county or tribe may negotiate a team rate with a vendor who is a 
430.1   member of the team.  The team shall determine how to distribute 
430.2   the rate among its members.  No reimbursement received by 
430.3   contracted vendors shall be returned to the county or tribe, 
430.4   except to reimburse the county or tribe for advance funding 
430.5   provided by the county or tribe to the vendor. 
430.6      (f) (g) If the service is provided by a team which includes 
430.7   contracted vendors, tribal staff, and county or state staff, the 
430.8   costs for county or state staff participation in the team shall 
430.9   be included in the rate for county-provided services.  In this 
430.10  case, the contracted vendor, the tribal agency, and the county 
430.11  may each receive separate payment for services provided by each 
430.12  entity in the same month.  In order to prevent duplication of 
430.13  services, the county each entity must document, in the 
430.14  recipient's file, the need for team case management and a 
430.15  description of the roles of the team members. 
430.16     (g) (h) The commissioner shall calculate the nonfederal 
430.17  share of actual medical assistance and general assistance 
430.18  medical care payments for each county, based on the higher of 
430.19  calendar year 1995 or 1996, by service date, project that amount 
430.20  forward to 1999, and transfer one-half of the result from 
430.21  medical assistance and general assistance medical care to each 
430.22  county's mental health grants under sections 245.4886 and 
430.23  256E.12 for calendar year 1999.  The annualized minimum amount 
430.24  added to each county's mental health grant shall be $3,000 per 
430.25  year for children and $5,000 per year for adults.  The 
430.26  commissioner may reduce the statewide growth factor in order to 
430.27  fund these minimums.  The annualized total amount transferred 
430.28  shall become part of the base for future mental health grants 
430.29  for each county. 
430.30     (h) (i) Any net increase in revenue to the county or tribe 
430.31  as a result of the change in this section must be used to 
430.32  provide expanded mental health services as defined in sections 
430.33  245.461 to 245.4888, the Comprehensive Adult and Children's 
430.34  Mental Health Acts, excluding inpatient and residential 
430.35  treatment.  For adults, increased revenue may also be used for 
430.36  services and consumer supports which are part of adult mental 
431.1   health projects approved under Laws 1997, chapter 203, article 
431.2   7, section 25.  For children, increased revenue may also be used 
431.3   for respite care and nonresidential individualized 
431.4   rehabilitation services as defined in section 245.492, 
431.5   subdivisions 17 and 23.  "Increased revenue" has the meaning 
431.6   given in Minnesota Rules, part 9520.0903, subpart 3.  
431.7      (i) (j) Notwithstanding section 256B.19, subdivision 1, the 
431.8   nonfederal share of costs for mental health case management 
431.9   shall be provided by the recipient's county of responsibility, 
431.10  as defined in sections 256G.01 to 256G.12, from sources other 
431.11  than federal funds or funds used to match other federal 
431.12  funds.  If the service is provided by a tribal agency, the 
431.13  nonfederal share, if any, shall be provided by the recipient's 
431.14  tribe.  
431.15     (j) (k) The commissioner may suspend, reduce, or terminate 
431.16  the reimbursement to a provider that does not meet the reporting 
431.17  or other requirements of this section.  The county of 
431.18  responsibility, as defined in sections 256G.01 to 256G.12, or, 
431.19  if applicable, the tribal agency, is responsible for any federal 
431.20  disallowances.  The county or tribe may share this 
431.21  responsibility with its contracted vendors.  
431.22     (k) (l) The commissioner shall set aside a portion of the 
431.23  federal funds earned under this section to repay the special 
431.24  revenue maximization account under section 256.01, subdivision 
431.25  2, clause (15).  The repayment is limited to: 
431.26     (1) the costs of developing and implementing this section; 
431.27  and 
431.28     (2) programming the information systems. 
431.29     (l) (m) Notwithstanding section 256.025, subdivision 2, 
431.30  payments to counties and tribal agencies for case management 
431.31  expenditures under this section shall only be made from federal 
431.32  earnings from services provided under this section.  Payments to 
431.33  contracted county-contracted vendors shall include both the 
431.34  federal earnings and the county share. 
431.35     (m) (n) Notwithstanding section 256B.041, county payments 
431.36  for the cost of mental health case management services provided 
432.1   by county or state staff shall not be made to the state 
432.2   treasurer.  For the purposes of mental health case management 
432.3   services provided by county or state staff under this section, 
432.4   the centralized disbursement of payments to counties under 
432.5   section 256B.041 consists only of federal earnings from services 
432.6   provided under this section. 
432.7      (n) (o) Case management services under this subdivision do 
432.8   not include therapy, treatment, legal, or outreach services. 
432.9      (o) (p) If the recipient is a resident of a nursing 
432.10  facility, intermediate care facility, or hospital, and the 
432.11  recipient's institutional care is paid by medical assistance, 
432.12  payment for case management services under this subdivision is 
432.13  limited to the last 30 days of the recipient's residency in that 
432.14  facility and may not exceed more than two months in a calendar 
432.15  year. 
432.16     (p) (q) Payment for case management services under this 
432.17  subdivision shall not duplicate payments made under other 
432.18  program authorities for the same purpose. 
432.19     (q) (r) By July 1, 2000, the commissioner shall evaluate 
432.20  the effectiveness of the changes required by this section, 
432.21  including changes in number of persons receiving mental health 
432.22  case management, changes in hours of service per person, and 
432.23  changes in caseload size. 
432.24     (r) (s) For each calendar year beginning with the calendar 
432.25  year 2001, the annualized amount of state funds for each county 
432.26  determined under paragraph (g) (h) shall be adjusted by the 
432.27  county's percentage change in the average number of clients per 
432.28  month who received case management under this section during the 
432.29  fiscal year that ended six months prior to the calendar year in 
432.30  question, in comparison to the prior fiscal year. 
432.31     (s) (t) For counties receiving the minimum allocation of 
432.32  $3,000 or $5,000 described in paragraph (g) (h), the adjustment 
432.33  in paragraph (r) (s) shall be determined so that the county 
432.34  receives the higher of the following amounts: 
432.35     (1) a continuation of the minimum allocation in paragraph 
432.36  (g) (h); or 
433.1      (2) an amount based on that county's average number of 
433.2   clients per month who received case management under this 
433.3   section during the fiscal year that ended six months prior to 
433.4   the calendar year in question, in comparison to the prior fiscal 
433.5   year, times the average statewide grant per person per month for 
433.6   counties not receiving the minimum allocation. 
433.7      (t) (u) The adjustments in paragraphs (r) and (s) and (t) 
433.8   shall be calculated separately for children and adults. 
433.9      Sec. 17.  Minnesota Statutes 2000, section 256B.0625, is 
433.10  amended by adding a subdivision to read: 
433.11     Subd. 43.  [APPEAL PROCESS.] If a county contract or 
433.12  certification is required to enroll as an authorized provider of 
433.13  mental health services under medical assistance, and if a county 
433.14  refuses to grant the necessary contract or certification, the 
433.15  provider may appeal the county decision to the commissioner.  A 
433.16  recipient may initiate an appeal on behalf of a provider who has 
433.17  been denied certification.  The commissioner shall determine 
433.18  whether the provider meets applicable standards under state laws 
433.19  and rules based on an independent review of the facts, including 
433.20  comments from the county review.  If the commissioner finds that 
433.21  the provider meets the applicable standards, the commissioner 
433.22  shall enroll the provider as an authorized provider.  The 
433.23  commissioner shall develop procedures for providers and 
433.24  recipients to appeal a county decision to refuse to enroll a 
433.25  provider.  After the commissioner makes a decision regarding an 
433.26  appeal, the county, provider, or recipient may request that the 
433.27  commissioner reconsider the commissioner's initial decision. The 
433.28  commissioner's reconsideration decision is final and not subject 
433.29  to further appeal. 
433.30     Sec. 18.  Minnesota Statutes 2000, section 256B.0625, is 
433.31  amended by adding a subdivision to read: 
433.32     Subd. 44.  [MENTAL HEALTH PROVIDER TRAVEL TIME.] Medical 
433.33  assistance covers provider travel time if a recipient's 
433.34  individual treatment plan requires the provision of mental 
433.35  health services outside of the provider's normal place of 
433.36  business.  This does not include any travel time which is 
434.1   included in other billable services, and is only covered when 
434.2   the mental health service being provided to a recipient is 
434.3   covered under medical assistance. 
434.4      Sec. 19.  [256B.761] [REIMBURSEMENT FOR MENTAL HEALTH 
434.5   SERVICES.] 
434.6      Payment for medication management provided to psychiatric 
434.7   patients, outpatient mental health services, day treatment 
434.8   services, home-based mental health services, and family 
434.9   community support services shall be paid at: 
434.10     (1) for services rendered on or after July 1, 2001, and 
434.11  before July 1, 2002, the lower of (i) submitted charges, or (ii) 
434.12  the 73rd percentile of the 50th percentile of 1999 charges; and 
434.13     (2) for services rendered on or after July 1, 2002, the 
434.14  lower of (i) submitted charges, or (ii) the 75th percentile of 
434.15  the 50th percentile of 1999 charges. 
434.16     Sec. 20.  [299A.76] [SUICIDE STATISTICS.] 
434.17     (a) The commissioner of public safety shall not: 
434.18     (1) include any statistics on committing suicide or 
434.19  attempting suicide in any compilation of crime statistics 
434.20  published by the commissioner; or 
434.21     (2) label as a crime statistic, any data on committing 
434.22  suicide or attempting suicide. 
434.23     (b) This section does not apply to the crimes of aiding 
434.24  suicide under section 609.215, subdivision 1, or aiding 
434.25  attempted suicide under section 609.215, subdivision 2, or to 
434.26  statistics directly related to the commission of a crime. 
434.27     Sec. 21.  [NOTICE REGARDING ESTABLISHMENT OF CONTINUING 
434.28  CARE BENEFIT PROGRAM.] 
434.29     When the continuing care benefit program for persons with 
434.30  mental illness under Minnesota Statutes, section 256.9693 is 
434.31  established, the commissioner of human services shall notify 
434.32  counties, health plan companies with prepaid medical assistance 
434.33  contracts, health care providers, and enrollees of the benefit 
434.34  program through bulletins, workshops, and other meetings. 
434.35     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2002. 
434.36     Sec. 22.  [STUDY; LENGTH OF STAY FOR MEDICARE-ELIGIBLE 
435.1   PERSONS.] 
435.2      The commissioner of human services shall study and make 
435.3   recommendations on how Medicare-eligible persons with mental 
435.4   illness may obtain acute care hospital inpatient treatment for 
435.5   mental illness for a length of stay beyond that allowed by the 
435.6   diagnostic classifications for mental illness according to 
435.7   Minnesota Statutes, section 256.969, subdivision 3a.  The study 
435.8   and recommendations shall be reported to the legislature by 
435.9   January 15, 2002. 
435.10     Sec. 23.  [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT 
435.11  RESIDENTIAL SERVICES GRANTS.] 
435.12     The commissioner of human services shall review funding 
435.13  methods for adult residential services grants under Minnesota 
435.14  Rules, parts 9535.2000 to 9535.3000, and shall develop a payment 
435.15  system that takes into account client difficulty of care as 
435.16  manifested by client physical, mental, or behavioral 
435.17  conditions.  The payment system must provide reimbursement for 
435.18  education, consultation, and support services provided to 
435.19  families and other individuals as an extension of the treatment 
435.20  process.  The commissioner shall present recommendations and 
435.21  draft legislation for an adult residential services payment 
435.22  system to the legislature by January 15, 2002.  The 
435.23  recommendations must address whether additional funding for 
435.24  adult residential services grants is necessary for the provision 
435.25  of high quality services under a payment reimbursement system. 
435.26                             ARTICLE 10 
435.27                        ASSISTANCE PROGRAMS 
435.28     Section 1.  Minnesota Statutes 2000, section 256.01, 
435.29  subdivision 18, is amended to read: 
435.30     Subd. 18.  [IMMIGRATION STATUS VERIFICATIONS.] (a) 
435.31  Notwithstanding any waiver of this requirement by the secretary 
435.32  of the United States Department of Health and Human Services, 
435.33  effective July 1, 2001, the commissioner shall utilize the 
435.34  Systematic Alien Verification for Entitlements (SAVE) program to 
435.35  conduct immigration status verifications: 
435.36     (1) as required under United States Code, title 8, section 
436.1   1642; 
436.2      (2) for all applicants for food assistance benefits, 
436.3   whether under the federal food stamp program, the MFIP or work 
436.4   first program, or the Minnesota food assistance program; 
436.5      (3) for all applicants for general assistance medical care, 
436.6   except assistance for an emergency medical condition, for 
436.7   immunization with respect to an immunizable disease, or for 
436.8   testing and treatment of symptoms of a communicable disease; and 
436.9      (4) for all applicants for general assistance, Minnesota 
436.10  supplemental aid, MinnesotaCare, or group residential housing, 
436.11  when the benefits provided by these programs would fall under 
436.12  the definition of "federal public benefit" under United States 
436.13  Code, title 8, section 1642, if federal funds were used to pay 
436.14  for all or part of the benefits.  
436.15     The commissioner shall report to the Immigration and 
436.16  Naturalization Service all undocumented persons who have been 
436.17  identified through application verification procedures or by the 
436.18  self-admission of an applicant for assistance.  Reports made 
436.19  under this subdivision must comply with the requirements of 
436.20  section 411A of the Social Security Act, as amended, and United 
436.21  States Code, title 8, section 1644. 
436.22     (b) The commissioner shall comply with the reporting 
436.23  requirements under United States Code, title 42, section 611a, 
436.24  and any federal regulation or guidance adopted under that law. 
436.25     Sec. 2.  Minnesota Statutes 2000, section 256D.053, 
436.26  subdivision 1, is amended to read: 
436.27     Subdivision 1.  [PROGRAM ESTABLISHED.] The Minnesota food 
436.28  assistance program is established to provide food assistance to 
436.29  legal noncitizens residing in this state who are ineligible to 
436.30  participate in the federal Food Stamp Program solely due to the 
436.31  provisions of section 402 or 403 of Public Law Number 104-193, 
436.32  as authorized by Title VII of the 1997 Emergency Supplemental 
436.33  Appropriations Act, Public Law Number 105-18, and as amended by 
436.34  Public Law Number 105-185. 
436.35     Beginning July 1, 2002 2003, the Minnesota food assistance 
436.36  program is limited to those noncitizens described in this 
437.1   subdivision who are 50 years of age or older. 
437.2      Sec. 3.  [256J.021] [SEPARATE STATE PROGRAM FOR USE OF 
437.3   STATE MONEY.] 
437.4      Beginning October 1, 2001, and each year thereafter, the 
437.5   commissioner of human services must treat financial assistance 
437.6   expenditures made to or on behalf of any minor child under 
437.7   section 256J.02, subdivision 2, clause (1), who is a resident of 
437.8   this state under section 256J.12, and who is part of a 
437.9   two-parent eligible household as expenditures under a separately 
437.10  funded state program and report those expenditures to the 
437.11  federal Department of Health and Human Services as separate 
437.12  state program expenditures under Code of Federal Regulations, 
437.13  title 45, section 263.5. 
437.14     Sec. 4.  Minnesota Statutes 2000, section 256J.09, 
437.15  subdivision 1, is amended to read: 
437.16     Subdivision 1.  [WHERE TO APPLY.] To apply for assistance a 
437.17  person must apply for assistance at submit a signed application 
437.18  to the county agency in the county where that person lives. 
437.19     Sec. 5.  Minnesota Statutes 2000, section 256J.09, 
437.20  subdivision 2, is amended to read: 
437.21     Subd. 2.  [COUNTY AGENCY RESPONSIBILITY TO PROVIDE 
437.22  INFORMATION.] When a person inquires about assistance, a county 
437.23  agency must inform a person who inquires about assistance about: 
437.24     (1) explain the eligibility requirements for assistance of, 
437.25  and how to apply for, diversionary assistance, including 
437.26  diversionary assistance and as provided in section 256J.47; 
437.27  emergency assistance. as provided in section 256J.48; MFIP as 
437.28  provided in section 256J.10; or any other assistance for which 
437.29  the person may be eligible; and 
437.30     A county agency must (2) offer the person brochures 
437.31  developed or approved by the commissioner that describe how to 
437.32  apply for assistance. 
437.33     Sec. 6.  Minnesota Statutes 2000, section 256J.09, 
437.34  subdivision 3, is amended to read: 
437.35     Subd. 3.  [SUBMITTING THE APPLICATION FORM.] (a) A county 
437.36  agency must offer, in person or by mail, the application forms 
438.1   prescribed by the commissioner as soon as a person makes a 
438.2   written or oral inquiry.  At that time, the county agency must: 
438.3      (1) inform the person that assistance begins with the date 
438.4   the signed application is received by the county agency or the 
438.5   date all eligibility criteria are met, whichever is later.  The 
438.6   county agency must; 
438.7      (2) inform the applicant person that any delay in 
438.8   submitting the application will reduce the amount of assistance 
438.9   paid for the month of application.  A county agency must; 
438.10     (3) inform a person that the person may submit the 
438.11  application before an interview appointment.  To apply for 
438.12  assistance, a person must submit a signed application to the 
438.13  county agency.; 
438.14     (4) explain the information that will be verified during 
438.15  the application process by the county agency as provided in 
438.16  section 256J.32; 
438.17     (5) inform a person about the county agency's average 
438.18  application processing time and explain how the application will 
438.19  be processed under subdivision 5; 
438.20     (6) explain how to contact the county agency if a person's 
438.21  application information changes and how to withdraw the 
438.22  application; 
438.23     (7) inform a person that the next step in the application 
438.24  process is an interview and what a person must do if the 
438.25  application is approved including, but not limited to, attending 
438.26  orientation under section 256J.45 and complying with employment 
438.27  and training services requirements in sections 256J.52 to 
438.28  256J.55; 
438.29     (8) explain the child care and transportation services that 
438.30  are available under paragraph (c) to enable caregivers to attend 
438.31  the interview, screening, and orientation; and 
438.32     (9) identify any language barriers and arrange for 
438.33  translation assistance during appointments, including, but not 
438.34  limited to, screening under subdivision 3a, orientation under 
438.35  section 256J.45, and the initial assessment under section 
438.36  256J.52.  
439.1      (b) Upon receipt of a signed application, the county agency 
439.2   must stamp the date of receipt on the face of the application.  
439.3   The county agency must process the application within the time 
439.4   period required under subdivision 5.  An applicant may withdraw 
439.5   the application at any time by giving written or oral notice to 
439.6   the county agency.  The county agency must issue a written 
439.7   notice confirming the withdrawal.  The notice must inform the 
439.8   applicant of the county agency's understanding that the 
439.9   applicant has withdrawn the application and no longer wants to 
439.10  pursue it.  When, within ten days of the date of the agency's 
439.11  notice, an applicant informs a county agency, in writing, that 
439.12  the applicant does not wish to withdraw the application, the 
439.13  county agency must reinstate the application and finish 
439.14  processing the application. 
439.15     (c) Upon a participant's request, the county agency must 
439.16  arrange for transportation and child care or reimburse the 
439.17  participant for transportation and child care expenses necessary 
439.18  to enable participants to attend the screening under subdivision 
439.19  3a and orientation under section 256J.45.  
439.20     Sec. 7.  Minnesota Statutes 2000, section 256J.09, is 
439.21  amended by adding a subdivision to read: 
439.22     Subd. 3a.  [SCREENING.] The county agency, or at county 
439.23  option, the county's employment and training service provider as 
439.24  defined in section 256J.49, must screen each applicant to 
439.25  determine immediate needs and to determine if the applicant may 
439.26  be eligible for: 
439.27     (1) another program that is not partially funded through 
439.28  the federal temporary assistance to needy families block grant 
439.29  under Title I of Public Law Number 104-193, including the 
439.30  expedited issuance of food stamps under section 256J.28, 
439.31  subdivision 1.  If the applicant may be eligible for another 
439.32  program, a county caseworker must provide the appropriate 
439.33  referral to the program; 
439.34     (2) the diversionary assistance program under section 
439.35  256J.47; or 
439.36     (3) the emergency assistance program under section 256J.48. 
440.1      Sec. 8.  Minnesota Statutes 2000, section 256J.09, is 
440.2   amended by adding a subdivision to read: 
440.3      Subd. 3b.  [INTERVIEW TO DETERMINE REFERRALS AND SERVICES.] 
440.4   If the applicant is not diverted from applying for MFIP, and if 
440.5   the applicant meets the MFIP eligibility requirements, then a 
440.6   county agency must: 
440.7      (1) identify an applicant who is under the age of 20 and 
440.8   explain to the applicant the assessment procedures and 
440.9   employment plan requirements for minor parents under section 
440.10  256J.54; 
440.11     (2) explain to the applicant the eligibility criteria for 
440.12  an exemption under the family violence provisions in section 
440.13  256J.52, subdivision 6, and explain what an applicant should do 
440.14  to develop an alternative employment plan; 
440.15     (3) determine if an applicant qualifies for an exemption 
440.16  under section 256J.56 from employment and training services 
440.17  requirements, explain how a person should report to the county 
440.18  agency any status changes, and explain that an applicant who is 
440.19  exempt may volunteer to participate in employment and training 
440.20  services; 
440.21     (4) for applicants who are not exempt from the requirement 
440.22  to attend orientation, arrange for an orientation under section 
440.23  256J.45 and an initial assessment under section 256J.52; 
440.24     (5) inform an applicant who is not exempt from the 
440.25  requirement to attend orientation that failure to attend the 
440.26  orientation is considered an occurrence of noncompliance with 
440.27  program requirements and will result in an imposition of a 
440.28  sanction under section 256J.46; and 
440.29     (6) explain how to contact the county agency if an 
440.30  applicant has questions about compliance with program 
440.31  requirements. 
440.32     Sec. 9.  Minnesota Statutes 2000, section 256J.15, is 
440.33  amended by adding a subdivision to read: 
440.34     Subd. 3.  [ELIGIBILITY AFTER DISQUALIFICATION DUE TO 
440.35  NONCOMPLIANCE.] (a) An applicant who is a member of an 
440.36  assistance unit that was disqualified from receiving MFIP under 
441.1   section 256J.46, subdivision 1, paragraph (d), clause (3), and 
441.2   who applies for MFIP assistance within six months of the date of 
441.3   the disqualification is considered to be a new applicant for 
441.4   purposes of the property limitations under section 256J.20 and, 
441.5   at county option, the payment of assistance provisions under 
441.6   section 256J.24, subdivision 8.  The county agency must also use 
441.7   the initial income test under section 256J.21, subdivision 3, in 
441.8   determining the applicant's eligibility for assistance. 
441.9      (b) Notwithstanding section 256J.24, subdivisions 5 to 7 
441.10  and 9, for an applicant who is eligible for MFIP under this 
441.11  subdivision, the residual amount of the grant, after making any 
441.12  applicable vendor payments for shelter and utility costs, if 
441.13  any, must be reduced by ten percent of the applicable MFIP 
441.14  standard of need for an assistance unit of the same size for 
441.15  each of the first six months on MFIP before the residual amount 
441.16  of the grant is paid to the assistance unit. 
441.17     (c) A participant who is disqualified from MFIP a second or 
441.18  subsequent time and who is eligible for MFIP under this 
441.19  subdivision is considered to have a third occurrence of 
441.20  noncompliance and must be sanctioned under section 256J.46, 
441.21  subdivision 1, paragraph (d), clause (2), for the first six 
441.22  months on MFIP under this subdivision. 
441.23     Sec. 10.  Minnesota Statutes 2000, section 256J.24, 
441.24  subdivision 10, is amended to read: 
441.25     Subd. 10.  [MFIP EXIT LEVEL.] (a) In state fiscal years 
441.26  2000 and 2001, The commissioner shall adjust the MFIP earned 
441.27  income disregard to ensure that most participants do not lose 
441.28  eligibility for MFIP until their income reaches at least 120 
441.29  percent of the federal poverty guidelines in effect in October 
441.30  of each fiscal year.  The adjustment to the disregard shall be 
441.31  based on a household size of three, and the resulting earned 
441.32  income disregard percentage must be applied to all household 
441.33  sizes.  The adjustment under this subdivision must be 
441.34  implemented at the same time as the October food stamp 
441.35  cost-of-living adjustment is reflected in the food portion of 
441.36  MFIP transitional standard as required under subdivision 5a. 
442.1      (b) In state fiscal year 2002 and thereafter, the earned 
442.2   income disregard percentage must be the same as the percentage 
442.3   implemented in October 2000. 
442.4      Sec. 11.  Minnesota Statutes 2000, section 256J.26, 
442.5   subdivision 1, is amended to read: 
442.6      Subdivision 1.  [PERSON CONVICTED OF DRUG OFFENSES.] (a) 
442.7   Applicants or participants who have been convicted of a drug 
442.8   offense committed after July 1, 1997, may, if otherwise 
442.9   eligible, receive MFIP benefits subject to the following 
442.10  conditions: 
442.11     (1) Benefits for the entire assistance unit must be paid in 
442.12  vendor form for shelter and utilities during any time the 
442.13  applicant is part of the assistance unit. 
442.14     (2) The convicted applicant or participant shall be subject 
442.15  to random drug testing as a condition of continued eligibility 
442.16  and following any positive test for an illegal controlled 
442.17  substance is subject to the following sanctions: 
442.18     (i) for failing a drug test the first time, the 
442.19  participant's grant shall be reduced by ten percent of the MFIP 
442.20  standard of need, prior to making vendor payments for shelter 
442.21  and utility costs; or 
442.22     (ii) for failing a drug test two or more times, the 
442.23  residual amount of the participant's grant after making vendor 
442.24  payments for shelter and utility costs, if any, must be reduced 
442.25  by an amount equal to 30 percent of the MFIP standard of 
442.26  need for an assistance unit of the same size.  When a sanction 
442.27  under this subdivision is in effect, the job counselor must 
442.28  attempt to meet with the person face-to-face.  During the 
442.29  face-to-face meeting, the job counselor must explain the 
442.30  consequences of a subsequent drug test failure and inform the 
442.31  participant of the right to appeal the sanction under section 
442.32  256J.40.  If a face-to-face meeting is not possible, the county 
442.33  agency must send the participant a notice of adverse action as 
442.34  provided in section 256J.31, subdivisions 4 and 5, and must 
442.35  include the information required in the face-to-face meeting; or 
442.36     (ii) for failing a drug test two times, the participant is 
443.1   permanently disqualified from receiving MFIP assistance, both 
443.2   the cash and food portions.  The assistance unit's MFIP grant 
443.3   must be reduced by the amount which would have otherwise been 
443.4   made available to the disqualified participant.  
443.5   Disqualification under this item does not make a participant 
443.6   ineligible for food stamps.  Before a disqualification under 
443.7   this provision is imposed, the job counselor must attempt to 
443.8   meet with the participant face-to-face.  During the face-to-face 
443.9   meeting, the job counselor must identify other resources that 
443.10  may be available to the participant to meet the needs of the 
443.11  family and inform the participant of the right to appeal the 
443.12  disqualification under section 256J.40.  If a face-to-face 
443.13  meeting is not possible, the county agency must send the 
443.14  participant a notice of adverse action as provided in section 
443.15  256J.31, subdivisions 4 and 5, and must include the information 
443.16  required in the face-to-face meeting. 
443.17     (3) A participant who fails an initial a drug test the 
443.18  first time and is under a sanction due to other MFIP program 
443.19  requirements is considered to have more than one occurrence of 
443.20  noncompliance and is subject to the applicable level of sanction 
443.21  in clause (2)(ii) as specified under section 256J.46, 
443.22  subdivision 1, paragraph (d). 
443.23     (b) Applicants requesting only food stamps or participants 
443.24  receiving only food stamps, who have been convicted of a drug 
443.25  offense that occurred after July 1, 1997, may, if otherwise 
443.26  eligible, receive food stamps if the convicted applicant or 
443.27  participant is subject to random drug testing as a condition of 
443.28  continued eligibility.  Following a positive test for an illegal 
443.29  controlled substance, the applicant is subject to the following 
443.30  sanctions: 
443.31     (1) for failing a drug test the first time, food stamps 
443.32  shall be reduced by ten percent of the applicable food stamp 
443.33  allotment; and 
443.34     (2) for failing a drug test two or more times, food stamps 
443.35  shall be reduced by an amount equal to 30 percent of the 
443.36  applicable food stamp allotment.  When a sanction under this 
444.1   clause is in effect, a job counselor must attempt to meet with 
444.2   the person face-to-face.  During the face-to-face meeting, a job 
444.3   counselor must explain the consequences of a subsequent drug 
444.4   test failure and inform the participant of the right to appeal 
444.5   the sanction under section 256J.40.  If a face-to-face meeting 
444.6   is not possible, a county agency must send the participant a 
444.7   notice of adverse action as provided in section 256J.31, 
444.8   subdivisions 4 and 5, and must include the information required 
444.9   in the face-to-face meeting; and 
444.10     (2) for failing a drug test two times, the participant is 
444.11  permanently disqualified from receiving food stamps.  Before a 
444.12  disqualification under this provision is imposed, a job 
444.13  counselor must attempt to meet with the participant 
444.14  face-to-face.  During the face-to-face meeting, the job 
444.15  counselor must identify other resources that may be available to 
444.16  the participant to meet the needs of the family and inform the 
444.17  participant of the right to appeal the disqualification under 
444.18  section 256J.40.  If a face-to-face meeting is not possible, a 
444.19  county agency must send the participant a notice of adverse 
444.20  action as provided in section 256J.31, subdivisions 4 and 5, and 
444.21  must include the information required in the face-to-face 
444.22  meeting. 
444.23     (c) For the purposes of this subdivision, "drug offense" 
444.24  means an offense that occurred after July 1, 1997, of sections 
444.25  152.021 to 152.025, 152.0261, or 152.096.  Drug offense also 
444.26  means a conviction in another jurisdiction of the possession, 
444.27  use, or distribution of a controlled substance, or conspiracy to 
444.28  commit any of these offenses, if the offense occurred after July 
444.29  1, 1997, and the conviction is a felony offense in that 
444.30  jurisdiction, or in the case of New Jersey, a high misdemeanor. 
444.31     Sec. 12.  Minnesota Statutes 2000, section 256J.31, 
444.32  subdivision 4, is amended to read: 
444.33     Subd. 4.  [PARTICIPANT'S RIGHT TO NOTICE.] A county agency 
444.34  must give a participant written notice of all adverse actions 
444.35  affecting the participant including payment reductions, 
444.36  suspensions, terminations, and use of protective, vendor, or 
445.1   two-party payments.  The notice of adverse action must be on a 
445.2   form prescribed or approved by the commissioner, must be 
445.3   understandable at a seventh grade reading level, and must be 
445.4   mailed to the last known mailing address provided by the 
445.5   participant.  A notice written in English must include the 
445.6   department of human services language block and must be sent to 
445.7   every applicable participant.  The county agency must state on 
445.8   the notice of adverse action the action it intends to take, the 
445.9   reasons for the action, the participant's right to appeal the 
445.10  action, the conditions under which assistance can be continued 
445.11  pending an appeal decision, and the related consequences of the 
445.12  action. 
445.13     Sec. 13.  Minnesota Statutes 2000, section 256J.32, 
445.14  subdivision 7a, is amended to read: 
445.15     Subd. 7a.  [REQUIREMENT TO REPORT TO IMMIGRATION AND 
445.16  NATURALIZATION SERVICES.] Notwithstanding subdivision 7, 
445.17  effective July 1, 2001, the commissioner shall report to the 
445.18  Immigration and Naturalization Services all undocumented persons 
445.19  who have been identified through application verification 
445.20  procedures or by the self-admission of an applicant for 
445.21  assistance.  Reports made under this subdivision must comply 
445.22  with the requirements of section 411A of the Social Security 
445.23  Act, as amended, and United States Code, title 8, section 1644.  
445.24  The commissioner shall comply with the reporting requirements 
445.25  under United States Code, title 42, section 611a, and any 
445.26  federal regulation or guidance adopted under that law. 
445.27     Sec. 14.  Minnesota Statutes 2000, section 256J.42, is 
445.28  amended by adding a subdivision to read: 
445.29     Subd. 6.  [CASE REVIEW.] (a) Within 180 days before the end 
445.30  of the participant's 60th month on MFIP, the county agency or 
445.31  job counselor must review the participant's case to determine if 
445.32  the employment plan is still appropriate, or if the participant 
445.33  is exempt under section 256J.56 from the employment and training 
445.34  services component, and attempt to meet with the participant 
445.35  face-to-face. 
445.36     (b) During the face-to-face meeting, a county agency or the 
446.1   job counselor must: 
446.2      (1) inform the participant how many months of counted 
446.3   assistance the participant has accrued and when the participant 
446.4   is expected to reach the 60th month; 
446.5      (2) explain the hardship extension criteria under section 
446.6   256J.425 and what the participant should do if the participant 
446.7   thinks a hardship extension applies; 
446.8      (3) identify other resources that may be available to the 
446.9   participant to meet the needs of the family; and 
446.10     (4) inform the participant of the right to appeal the case 
446.11  closure under section 256J.40. 
446.12     (c) If a face-to-face meeting is not possible, the county 
446.13  agency must send the participant a notice of adverse action as 
446.14  provided in section 256J.31, subdivisions 4 and 5. 
446.15     (d) Before a participant's case is closed under this 
446.16  section, the county must ensure that: 
446.17     (1) the case has been reviewed by the job counselor's 
446.18  supervisor or the review team designated in the county's 
446.19  approved local service unit plan to determine if the criteria 
446.20  for a hardship extension, if requested, were applied 
446.21  appropriately; and 
446.22     (2) the county agency or the job counselor attempted to 
446.23  meet with the participant face-to-face. 
446.24     Sec. 15.  [256J.425] [HARDSHIP EXTENSIONS.] 
446.25     Subdivision 1.  [ELIGIBILITY.] An assistance unit subject 
446.26  to the time limit under section 256J.42, subdivision 1, in which 
446.27  any participant has received 60 counted months of assistance is 
446.28  not eligible to receive months of assistance beyond the first 60 
446.29  months under a hardship extension, if the participant is not in 
446.30  compliance.  If there is more than one participant in the 
446.31  household, each participant must be in compliance to be eligible 
446.32  for a hardship extension.  For purposes of determining 
446.33  eligibility for a hardship extension, a participant is in 
446.34  compliance in any month that the participant has not been 
446.35  sanctioned under section 256J.46, subdivision 1, or under 
446.36  256J.26, subdivision 1. 
447.1      Subd. 2.  [ILL OR INCAPACITATED PARTICIPANTS; DEPENDENT 
447.2   HOUSEHOLD MEMBER.] (a) An assistance unit subject to the time 
447.3   limit in section 256J.42, subdivision 1, in which any 
447.4   participant has received 60 counted months of assistance, is 
447.5   eligible to receive months of assistance under a hardship 
447.6   extension if the participant belongs to any of the following 
447.7   groups: 
447.8      (1) participants who are suffering from a professionally 
447.9   certified illness, injury, or incapacity which is expected to 
447.10  continue for more than 30 days and which prevents the person 
447.11  from obtaining or retaining employment and who are following the 
447.12  treatment recommendations of the health care provider certifying 
447.13  the illness, injury, or incapacity; 
447.14     (2) participants whose presence in the home is required 
447.15  because of the professionally certified illness or incapacity of 
447.16  another member in the assistance unit, a relative in the 
447.17  household, or a foster child in the household and the illness or 
447.18  incapacity is expected to continue for more than 30 days; or 
447.19     (3) caregivers with a child or an adult in the household 
447.20  who meets the disability or medical criteria for home care 
447.21  services under section 256B.0627, subdivision 1, paragraph (c), 
447.22  or a home and community-based waiver services program under 
447.23  chapter 256B, or meets the criteria for severe emotional 
447.24  disturbance under section 245.4871, subdivision 6, or for 
447.25  serious and persistent mental illness under section 245.462, 
447.26  subdivision 20, paragraph (c).  Caregivers in this category are 
447.27  presumed to be prevented from obtaining or retaining employment. 
447.28     (b) An assistance unit receiving assistance under a 
447.29  hardship extension under this subdivision may continue to 
447.30  receive assistance under MFIP as long as the participant meets 
447.31  the criteria in paragraph (a), clause (1), (2), or (3).  A 
447.32  county agency or job counselor must, on a quarterly basis, 
447.33  review the case file of an assistance unit receiving assistance 
447.34  under this subdivision to determine if the participant still 
447.35  meets the criteria in paragraph (a), clause (1), (2), or (3). 
447.36     Subd. 3.  [CERTAIN HARD-TO-EMPLOY PARTICIPANTS.] (a) An 
448.1   assistance unit subject to the time limit in section 256J.42, 
448.2   subdivision 1, in which any participant has received 60 counted 
448.3   months of assistance, is eligible to receive months of 
448.4   assistance under a hardship extension if the participant belongs 
448.5   to any of the following groups: 
448.6      (1) a person who is diagnosed by a licensed physician, 
448.7   psychological practitioner, or other qualified professional, as 
448.8   mentally retarded or mentally ill, and that condition prevents 
448.9   the person from obtaining or retaining employment; 
448.10     (2) a person who has been assessed by a vocational 
448.11  specialist, job counselor, or the county agency to be 
448.12  unemployable for purposes of this subdivision; a person is 
448.13  considered employable if positions of employment in the local 
448.14  labor market exist, regardless of the current availability of 
448.15  openings for those positions, that the person is capable of 
448.16  performing.  The person's eligibility under this category must 
448.17  be reassessed at least annually; or 
448.18     (3) a person who is determined by the county agency, 
448.19  according to Minnesota Rules, part 9500.1251, subpart 2, item I, 
448.20  to be learning disabled, provided that if a rehabilitation plan 
448.21  for the person is developed or approved by the county agency, 
448.22  the person is following the plan.  A rehabilitation plan does 
448.23  not replace the requirement to develop and comply with an 
448.24  employment plan under section 256J.52. 
448.25     (b) An assistance unit receiving assistance under a 
448.26  hardship extension under this subdivision may continue to 
448.27  receive assistance under MFIP as long as the participant meets 
448.28  the criteria in paragraph (a), clause (1), (2), or (3), and all 
448.29  participants in the assistance unit remain in compliance with, 
448.30  or are exempt from, the employment and training services 
448.31  requirements in sections 256J.52 to 256J.55. 
448.32     Subd. 4.  [VICTIMS OF FAMILY VIOLENCE.] A participant who 
448.33  received TANF assistance that counted towards the federal 
448.34  60-month time limit while the participant complied with a safety 
448.35  plan or, after October 1, 2001, an alternative employment plan 
448.36  under the MFIP employment and training component is eligible for 
449.1   assistance under a hardship extension for a period of time equal 
449.2   to the number of months that were counted toward the federal 
449.3   60-month time limit while the participant complied with a safety 
449.4   plan or, after October 1, 2001, an alternative employment plan 
449.5   under the MFIP employment and training component. 
449.6      Subd. 5.  [ACCRUAL OF CERTAIN EXEMPT MONTHS.] (a) A 
449.7   participant who received TANF assistance that counted towards 
449.8   the federal 60-month time limit while the participant was or 
449.9   would have been exempt under section 256J.56, paragraph (a), 
449.10  clause (7), from employment and training services requirements 
449.11  and who is no longer eligible for assistance under a hardship 
449.12  extension under subdivision 2, paragraph (a), clause (3), is 
449.13  eligible for assistance under a hardship extension for a period 
449.14  of time equal to the number of months that were counted toward 
449.15  the federal 60-month time limit while the participant was or 
449.16  would have been exempt under section 256J.56, paragraph (a), 
449.17  clause (7), from the employment and training services 
449.18  requirements. 
449.19     (b) A participant who received TANF assistance that counted 
449.20  towards the federal 60-month time limit while the participant 
449.21  met the state time limit exemption criteria under section 
449.22  256J.42, subdivision 5, is eligible for assistance under a 
449.23  hardship extension for a period of time equal to the number of 
449.24  months that were counted toward the federal 60-month time limit 
449.25  while the participant met the state time limit exemption 
449.26  criteria under section 256J.42, subdivision 5. 
449.27     Sec. 16.  Minnesota Statutes 2000, section 256J.45, 
449.28  subdivision 1, is amended to read: 
449.29     Subdivision 1.  [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 
449.30  county agency must provide a face-to-face orientation to each 
449.31  MFIP caregiver who is not exempt under section 256J.56, 
449.32  paragraph (a), clause (6) or (8), with a face-to-face 
449.33  orientation unless the caregiver is: 
449.34     (1) a single parent, or one parent in a two-parent family, 
449.35  employed at least 35 hours per week; or 
449.36     (2) a second parent in a two-parent family who is employed 
450.1   for 20 or more hours per week provided the first parent is 
450.2   employed at least 35 hours per week. 
450.3   The county agency must inform caregivers who are not exempt 
450.4   under section 256J.56, paragraph (a), clause (6) or (8), clause 
450.5   (1) or (2) that failure to attend the orientation is considered 
450.6   an occurrence of noncompliance with program requirements, and 
450.7   will result in the imposition of a sanction under section 
450.8   256J.46.  If the client complies with the orientation 
450.9   requirement prior to the first day of the month in which the 
450.10  grant reduction is proposed to occur, the orientation sanction 
450.11  shall be lifted. 
450.12     Sec. 17.  Minnesota Statutes 2000, section 256J.46, 
450.13  subdivision 1, is amended to read: 
450.14     Subdivision 1.  [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 
450.15  WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 
450.16  good cause to comply with the requirements of this chapter, and 
450.17  who is not subject to a sanction under subdivision 2, shall be 
450.18  subject to a sanction as provided in this subdivision.  Prior to 
450.19  the imposition of a sanction, a county agency shall provide a 
450.20  notice of intent to sanction under section 256J.57, subdivision 
450.21  2, and, when applicable, a notice of adverse action as provided 
450.22  in section 256J.31. 
450.23     (b) A participant who fails to comply with an alternative 
450.24  employment plan must have the plan reviewed by a person trained 
450.25  in domestic violence and a job counselor to determine if 
450.26  components of the alternative employment plan are still 
450.27  appropriate.  If the activities are no longer appropriate, the 
450.28  plan must be revised with a person trained in domestic violence 
450.29  and approved by a job counselor.  A participant who fails to 
450.30  comply with a plan that is determined not to need revision will 
450.31  lose their exemption and be required to comply with regular 
450.32  employment services activities.  
450.33     (c) A sanction under this subdivision becomes effective the 
450.34  month following the month in which a required notice is given.  
450.35  A sanction must not be imposed when a participant comes into 
450.36  compliance with the requirements for orientation under section 
451.1   256J.45 or third-party liability for medical services under 
451.2   section 256J.30, subdivision 10, prior to the effective date of 
451.3   the sanction.  A sanction must not be imposed when a participant 
451.4   comes into compliance with the requirements for employment and 
451.5   training services under sections 256J.49 to 256J.72 256J.55 ten 
451.6   days prior to the effective date of the sanction.  For purposes 
451.7   of this subdivision, each month that a participant fails to 
451.8   comply with a requirement of this chapter shall be considered a 
451.9   separate occurrence of noncompliance.  A participant who has had 
451.10  one or more sanctions imposed must remain in compliance with the 
451.11  provisions of this chapter for six months in order for a 
451.12  subsequent occurrence of noncompliance to be considered a first 
451.13  occurrence.  
451.14     (b) (d) Sanctions for noncompliance shall be imposed as 
451.15  follows: 
451.16     (1) For the first occurrence of noncompliance by a 
451.17  participant in a single-parent household or by one participant 
451.18  in a two-parent household an assistance unit, the assistance 
451.19  unit's grant shall be reduced by ten percent of the MFIP 
451.20  standard of need for an assistance unit of the same size with 
451.21  the residual grant paid to the participant.  The reduction in 
451.22  the grant amount must be in effect for a minimum of one month 
451.23  and shall be removed in the month following the month that the 
451.24  participant returns to compliance.  
451.25     (2) For a second or subsequent and third occurrence of 
451.26  noncompliance by a participant in an assistance unit, or 
451.27  when both each of the participants in a two-parent household are 
451.28  out of compliance assistance unit have a first occurrence of 
451.29  noncompliance at the same time, the assistance unit's shelter 
451.30  costs shall be vendor paid up to the amount of the cash portion 
451.31  of the MFIP grant for which the participant's assistance unit is 
451.32  eligible.  At county option, the assistance unit's utilities may 
451.33  also be vendor paid up to the amount of the cash portion of the 
451.34  MFIP grant remaining after vendor payment of the assistance 
451.35  unit's shelter costs.  The residual amount of the grant after 
451.36  vendor payment, if any, must be reduced by an amount equal to 30 
452.1   percent of the MFIP standard of need for an assistance unit of 
452.2   the same size before the residual grant is paid to the 
452.3   assistance unit.  The reduction in the grant amount must be in 
452.4   effect for a minimum of one month and shall be removed in the 
452.5   month following the month that a the participant in a one-parent 
452.6   household assistance unit returns to compliance.  In a 
452.7   two-parent household assistance unit, the grant reduction must 
452.8   be in effect for a minimum of one month and shall be removed in 
452.9   the month following the month both participants return to 
452.10  compliance.  The vendor payment of shelter costs and, if 
452.11  applicable, utilities shall be removed six months after the 
452.12  month in which the participant or participants return to 
452.13  compliance.  If an assistance unit is sanctioned under this 
452.14  clause, the participant's case file must be reviewed as required 
452.15  under paragraph (e). 
452.16     (3) For a fourth occurrence of noncompliance, the 
452.17  assistance unit is disqualified from receiving MFIP assistance, 
452.18  both the cash and food portions.  This disqualification must be 
452.19  in effect for a minimum of one full month.  Disqualification 
452.20  under this clause does not make a participant ineligible for 
452.21  food stamps.  Before an assistance unit is disqualified under 
452.22  this clause, the county must ensure that: 
452.23     (i) the case has been reviewed by the job counselor's 
452.24  supervisor or the review team designated in the county's 
452.25  approved local service unit plan to determine if the review 
452.26  required under paragraph (e) has occurred; and 
452.27     (ii) the job counselor attempted to meet with the 
452.28  participant face-to-face. 
452.29     (c) No later than during the second month that (e) When a 
452.30  sanction under paragraph (b) (d), clause (2), is in effect due 
452.31  to noncompliance with employment services, the participant's 
452.32  case file must be reviewed to determine if, the county agency or 
452.33  job counselor must review the participant's case to determine if 
452.34  the employment plan is still appropriate and attempt to meet 
452.35  with the participant face-to-face.  If a face-to-face meeting is 
452.36  not possible, the county agency must send the participant a 
453.1   notice of adverse action as provided in section 256J.31, 
453.2   subdivisions 4 and 5. 
453.3      (1) During the face-to-face meeting, the job counselor must:
453.4      (i) determine whether the continued noncompliance can be 
453.5   explained and mitigated by providing a needed preemployment 
453.6   activity, as defined in section 256J.49, subdivision 13, clause 
453.7   (16), or services under a local intervention grant for 
453.8   self-sufficiency under section 256J.625; 
453.9      (ii) determine whether the participant qualifies for a good 
453.10  cause exception under section 256J.57; or 
453.11     (iii) determine whether the participant qualifies for an 
453.12  exemption under section 256J.56; 
453.13     (iv) determine whether the participant qualifies for an 
453.14  exemption for victims of family violence under section 256J.52, 
453.15  subdivision 6; 
453.16     (v) inform the participant of the participant's sanction 
453.17  status and explain the consequences of continuing noncompliance; 
453.18     (vi) identify other resources that may be available to the 
453.19  participant to meet the needs of the family if the participant 
453.20  is sanctioned and disqualified from MFIP under paragraph (d), 
453.21  clause (3); and 
453.22     (vii) inform the participant of the right to appeal under 
453.23  section 256J.40. 
453.24     (2) If the lack of an identified activity can explain the 
453.25  noncompliance, the county must work with the participant to 
453.26  provide the identified activity, and the county must restore the 
453.27  participant's grant amount to the full amount for which the 
453.28  assistance unit is eligible.  The grant must be restored 
453.29  retroactively to the first day of the month in which the 
453.30  participant was found to lack preemployment activities or to 
453.31  qualify for an exemption or under section 256J.56, a good cause 
453.32  exception under section 256J.57, or an exemption for victims of 
453.33  family violence under section 256J.52, subdivision 6. 
453.34     (3) If the participant is found to qualify for a good cause 
453.35  exception or an exemption, the county must restore the 
453.36  participant's grant to the full amount for which the assistance 
454.1   unit is eligible.  
454.2      <b>[EFFECTIVE DATE.]</b> The family violence provisions in 
454.3   paragraph (e) are effective October 1, 2001, if the alternative 
454.4   employment plan and family violence provisions in section 
454.5   256J.52, subdivision 6, are enacted during the 2001 session. 
454.6      Sec. 18.  Minnesota Statutes 2000, section 256J.46, 
454.7   subdivision 2a, is amended to read: 
454.8      Subd. 2a.  [DUAL SANCTIONS.] (a) Notwithstanding the 
454.9   provisions of subdivisions 1 and 2, for a participant subject to 
454.10  a sanction for refusal to comply with child support requirements 
454.11  under subdivision 2 and subject to a concurrent sanction for 
454.12  refusal to cooperate with other program requirements under 
454.13  subdivision 1, sanctions shall be imposed in the manner 
454.14  prescribed in this subdivision. 
454.15     A participant who has had one or more sanctions imposed 
454.16  under this subdivision must remain in compliance with the 
454.17  provisions of this chapter for six months in order for a 
454.18  subsequent occurrence of noncompliance to be considered a first 
454.19  occurrence.  Any vendor payment of shelter costs or utilities 
454.20  under this subdivision must remain in effect for six months 
454.21  after the month in which the participant is no longer subject to 
454.22  sanction under subdivision 1. 
454.23     (b) If the participant was subject to sanction for: 
454.24     (i) noncompliance under subdivision 1 before being subject 
454.25  to sanction for noncooperation under subdivision 2; or 
454.26     (ii) noncooperation under subdivision 2 before being 
454.27  subject to sanction for noncompliance under subdivision 1; under 
454.28  subdivision 1 or 2 before being subject to sanction under the 
454.29  other of those subdivisions, the participant shall be sanctioned 
454.30  as provided in subdivision 1, paragraph (b) (d), clause 
454.31  clauses (2) and (3), and the requirement that the county conduct 
454.32  a review as specified in subdivision 1, paragraph (c) (e), 
454.33  remains in effect. 
454.34     (c) A participant who first becomes subject to sanction 
454.35  under both subdivisions 1 and 2 in the same month is subject to 
454.36  sanction as follows: 
455.1      (i) in the first month of noncompliance and noncooperation, 
455.2   the participant's grant must be reduced by 25 percent of the 
455.3   applicable MFIP standard of need, with any residual amount paid 
455.4   to the participant; 
455.5      (ii) in the second and subsequent months of noncompliance 
455.6   and noncooperation, the participant shall be sanctioned as 
455.7   provided in subdivision 1, paragraph (b) (d), clause clauses (2) 
455.8   and (3). 
455.9      The requirement that the county conduct a review as 
455.10  specified in subdivision 1, paragraph (c) (e), remains in effect.
455.11     (d) A participant remains subject to sanction under 
455.12  subdivision 2 if the participant: 
455.13     (i) returns to compliance and is no longer subject to 
455.14  sanction under subdivision 1; or 
455.15     (ii) has the sanction under subdivision 1, 
455.16  paragraph (b) (d), removed upon completion of the review under 
455.17  subdivision 1, paragraph (c) (e). 
455.18     A participant remains subject to sanction under subdivision 
455.19  1, paragraph (b) (d), if the participant cooperates and is no 
455.20  longer subject to sanction under subdivision 2. 
455.21     Sec. 19.  Minnesota Statutes 2000, section 256J.46, is 
455.22  amended by adding a subdivision to read: 
455.23     Subd. 3.  [SANCTION STATUS AFTER DISQUALIFICATION.] An 
455.24  applicant who is a member of an assistance unit that was 
455.25  disqualified from receiving MFIP under subdivision 1, paragraph 
455.26  (d), clause (3), who applies for MFIP assistance within six 
455.27  months of the date of the disqualification, and who is 
455.28  determined to be eligible for MFIP assistance, is considered to 
455.29  have a first occurrence of noncompliance.  An applicant who is a 
455.30  member of an assistance unit that was disqualified from MFIP 
455.31  under subdivision 1, paragraph (d), clause (3), a second or 
455.32  subsequent time, who applies for assistance within six months of 
455.33  the date of disqualification, and who is determined to be 
455.34  eligible for MFIP assistance, is considered to have a third 
455.35  occurrence of noncompliance.  The applicant must remain in 
455.36  compliance with the provisions of this chapter for six months in 
456.1   order for a subsequent occurrence of noncompliance to be 
456.2   considered a first occurrence. 
456.3      Sec. 20.  Minnesota Statutes 2000, section 256J.50, 
456.4   subdivision 1, is amended to read: 
456.5      Subdivision 1.  [EMPLOYMENT AND TRAINING SERVICES COMPONENT 
456.6   OF MFIP.] (a) By January 1, 1998, each county must develop and 
456.7   implement an employment and training services component of MFIP 
456.8   which is designed to put participants on the most direct path to 
456.9   unsubsidized employment.  Participation in these services is 
456.10  mandatory for all MFIP caregivers, unless the caregiver is 
456.11  exempt under section 256J.56. 
456.12     (b) A county must provide employment and training services 
456.13  under sections 256J.515 to 256J.74 within 30 days after the 
456.14  caregiver's participation becomes mandatory under subdivision 
456.15  5 or within 30 days of receipt of a request for services from a 
456.16  caregiver who under section 256J.42 is no longer eligible to 
456.17  receive MFIP but whose income is below 120 percent of the 
456.18  federal poverty guidelines for a family of the same size.  The 
456.19  request must be made within 12 months of the date the 
456.20  caregivers' MFIP case was closed. 
456.21     Sec. 21.  Minnesota Statutes 2000, section 256J.50, 
456.22  subdivision 7, is amended to read: 
456.23     Subd. 7.  [LOCAL SERVICE UNIT PLAN.] (a) Each local or 
456.24  county service unit shall prepare and submit a plan as specified 
456.25  in section 268.88. 
456.26     (b) The plan must include a description of how projects 
456.27  funded under the local intervention grants for self-sufficiency 
456.28  in section 256J.625, subdivisions 2 and 3, operate in the local 
456.29  service unit, including: 
456.30     (1) the target populations of hard-to-employ participants 
456.31  and, working participants in need of job retention and wage 
456.32  advancement services, and caregivers who, within the last 12 
456.33  months, have been determined under section 256J.42 to no longer 
456.34  be eligible to receive MFIP and whose income is below 120 
456.35  percent of the federal poverty guidelines for a family of the 
456.36  same size, with a description of how individual participant 
457.1   needs will be met; 
457.2      (2) services that will be provided which may include paid 
457.3   work experience, enhanced mental health services, outreach to 
457.4   sanctioned families and to caregivers who, within the last 12 
457.5   months, have been determined under section 256J.42 to no longer 
457.6   be eligible to receive MFIP but whose income is below 120 
457.7   percent of the federal poverty guidelines for a family of the 
457.8   same size, child care for social services, child care transition 
457.9   year set-aside, homeless and housing advocacy, and 
457.10  transportation; 
457.11     (3) projected expenditures by activity; 
457.12     (4) anticipated program outcomes including the anticipated 
457.13  impact the intervention efforts will have on performance 
457.14  measures under section 256J.751 and on reducing the number of 
457.15  MFIP participants expected to reach their 60-month time limit; 
457.16  and 
457.17     (5) a description of services that are provided or will be 
457.18  provided to MFIP participants affected by chemical dependency, 
457.19  mental health issues, learning disabilities, or family violence. 
457.20     Each plan must demonstrate how the county or tribe is 
457.21  working within its organization and with other organizations in 
457.22  the community to serve hard-to-employ populations, including how 
457.23  organizations in the community were engaged in planning for use 
457.24  of these funds, services other entities will provide under the 
457.25  plan, and whether multicounty or regional strategies are being 
457.26  implemented as part of this plan. 
457.27     (c) Activities and expenditures in the plan must enhance or 
457.28  supplement MFIP activities without supplanting existing 
457.29  activities and expenditures.  However, this paragraph does not 
457.30  require a county to maintain either:  
457.31     (1) its current provision of child care assistance to MFIP 
457.32  families through the expenditure of county resources under 
457.33  chapter 256E for social services child care assistance if funds 
457.34  are appropriated by another law for an MFIP social services 
457.35  child care pool; 
457.36     (2) its current provision of transition-year child care 
458.1   assistance through the expenditure of county resources if funds 
458.2   are appropriated by another law for this purpose; or 
458.3      (3) its current provision of intensive ESL programs through 
458.4   the expenditure of county resources if funds are appropriated by 
458.5   another law for intensive ESL grants. 
458.6      (d) The plan required under this subdivision must be 
458.7   approved before the local or county service unit is eligible to 
458.8   receive funds under section 256J.625, subdivisions 2 and 3. 
458.9      Sec. 22.  Minnesota Statutes 2000, section 256J.56, is 
458.10  amended to read: 
458.11     256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 
458.12  EXEMPTIONS.] 
458.13     (a) An MFIP caregiver participant is exempt from the 
458.14  requirements of sections 256J.52 to 256J.55 if the caregiver 
458.15  participant belongs to any of the following groups: 
458.16     (1) individuals participants who are age 60 or older; 
458.17     (2) individuals participants who are suffering from a 
458.18  professionally certified permanent or temporary illness, injury, 
458.19  or incapacity which is expected to continue for more than 30 
458.20  days and which prevents the person from obtaining or retaining 
458.21  employment.  Persons in this category with a temporary illness, 
458.22  injury, or incapacity must be reevaluated at least quarterly; 
458.23     (3) caregivers participants whose presence in the home is 
458.24  required because of the professionally certified illness or 
458.25  incapacity of another member in the assistance unit, a relative 
458.26  in the household, or a foster child in the household and the 
458.27  illness or incapacity is expected to continue for more than 30 
458.28  days; 
458.29     (4) women who are pregnant, if the pregnancy has resulted 
458.30  in a professionally certified incapacity that prevents the woman 
458.31  from obtaining or retaining employment; 
458.32     (5) caregivers of a child under the age of one year who 
458.33  personally provide full-time care for the child.  This exemption 
458.34  may be used for only 12 months in a lifetime.  In two-parent 
458.35  households, only one parent or other relative may qualify for 
458.36  this exemption; 
459.1      (6) individuals who are single parents, or one parent in a 
459.2   two-parent family, employed at least 35 hours per week; 
459.3      (7) individuals (6) participants experiencing a personal or 
459.4   family crisis that makes them incapable of participating in the 
459.5   program, as determined by the county agency.  If the participant 
459.6   does not agree with the county agency's determination, the 
459.7   participant may seek professional certification, as defined in 
459.8   section 256J.08, that the participant is incapable of 
459.9   participating in the program. 
459.10     Persons in this exemption category must be reevaluated 
459.11  every 60 days; or 
459.12     (8) second parents in two-parent families employed for 20 
459.13  or more hours per week, provided the first parent is employed at 
459.14  least 35 hours per week; or 
459.15     (9) (7) caregivers with a child or an adult in the 
459.16  household who meets the disability or medical criteria for home 
459.17  care services under section 256B.0627, subdivision 1, paragraph 
459.18  (c), or a home and community-based waiver services program under 
459.19  chapter 256B, or meets the criteria for severe emotional 
459.20  disturbance under section 245.4871, subdivision 6, or for 
459.21  serious and persistent mental illness under section 245.462, 
459.22  subdivision 20, paragraph (c).  Caregivers in this exemption 
459.23  category are presumed to be prevented from obtaining or 
459.24  retaining employment. 
459.25     A caregiver who is exempt under clause (5) must enroll in 
459.26  and attend an early childhood and family education class, a 
459.27  parenting class, or some similar activity, if available, during 
459.28  the period of time the caregiver is exempt under this section.  
459.29  Notwithstanding section 256J.46, failure to attend the required 
459.30  activity shall not result in the imposition of a sanction. 
459.31     (b) The county agency must provide employment and training 
459.32  services to MFIP caregivers participants who are exempt under 
459.33  this section, but who volunteer to participate.  Exempt 
459.34  volunteers may request approval for any work activity under 
459.35  section 256J.49, subdivision 13.  The hourly participation 
459.36  requirements for nonexempt caregivers participants under section 
460.1   256J.50, subdivision 5, do not apply to exempt caregivers 
460.2   participants who volunteer to participate. 
460.3      Sec. 23.  Minnesota Statutes 2000, section 256J.57, 
460.4   subdivision 2, is amended to read: 
460.5      Subd. 2.  [NOTICE OF INTENT TO SANCTION.] (a) When a 
460.6   participant fails without good cause to comply with the 
460.7   requirements of sections 256J.52 to 256J.55, the job counselor 
460.8   or the county agency must provide a notice of intent to sanction 
460.9   to the participant specifying the program requirements that were 
460.10  not complied with, informing the participant that the county 
460.11  agency will impose the sanctions specified in section 256J.46, 
460.12  and informing the participant of the opportunity to request a 
460.13  conciliation conference as specified in paragraph (b).  The 
460.14  notice must also state that the participant's continuing 
460.15  noncompliance with the specified requirements will result in 
460.16  additional sanctions under section 256J.46, without the need for 
460.17  additional notices or conciliation conferences under this 
460.18  subdivision.  The notice, written in English, must include the 
460.19  department of human services language block, and must be sent to 
460.20  every applicable participant.  If the participant does not 
460.21  request a conciliation conference within ten calendar days of 
460.22  the mailing of the notice of intent to sanction, the job 
460.23  counselor must notify the county agency that the assistance 
460.24  payment should be reduced.  The county must then send a notice 
460.25  of adverse action to the participant informing the participant 
460.26  of the sanction that will be imposed, the reasons for the 
460.27  sanction, the effective date of the sanction, and the 
460.28  participant's right to have a fair hearing under section 256J.40.
460.29     (b) The participant may request a conciliation conference 
460.30  by sending a written request, by making a telephone request, or 
460.31  by making an in-person request.  The request must be received 
460.32  within ten calendar days of the date the county agency mailed 
460.33  the ten-day notice of intent to sanction.  If a timely request 
460.34  for a conciliation is received, the county agency's service 
460.35  provider must conduct the conference within five days of the 
460.36  request.  The job counselor's supervisor, or a designee of the 
461.1   supervisor, must review the outcome of the conciliation 
461.2   conference.  If the conciliation conference resolves the 
461.3   noncompliance, the job counselor must promptly inform the county 
461.4   agency and request withdrawal of the sanction notice. 
461.5      (c) Upon receiving a sanction notice, the participant may 
461.6   request a fair hearing under section 256J.40, without exercising 
461.7   the option of a conciliation conference.  In such cases, the 
461.8   county agency shall not require the participant to engage in a 
461.9   conciliation conference prior to the fair hearing. 
461.10     (d) If the participant requests a fair hearing or a 
461.11  conciliation conference, sanctions will not be imposed until 
461.12  there is a determination of noncompliance.  Sanctions must be 
461.13  imposed as provided in section 256J.46. 
461.14     Sec. 24.  Minnesota Statutes 2000, section 256J.62, 
461.15  subdivision 9, is amended to read: 
461.16     Subd. 9.  [CONTINUATION OF CERTAIN SERVICES.] At the 
461.17  request of the caregiver participant, the county may continue to 
461.18  provide case management, counseling, or other support services 
461.19  to a participant following the participant's achievement of: 
461.20     (a) who has achieved the employment goal,; or 
461.21     (b) who under section 256J.42 is no longer eligible to 
461.22  receive MFIP. 
461.23     These services may be provided for up to 12 months 
461.24  following termination of the participant's eligibility for MFIP. 
461.25     A county may expend funds for a specific employment and 
461.26  training service for the duration of that service to a 
461.27  participant if the funds are obligated or expended prior to the 
461.28  participant losing MFIP eligibility. 
461.29     Sec. 25.  Minnesota Statutes 2000, section 256J.625, 
461.30  subdivision 1, is amended to read: 
461.31     Subdivision 1.  [ESTABLISHMENT; GUARANTEED MINIMUM 
461.32  ALLOCATION.] (a) The commissioner shall make grants under this 
461.33  subdivision to assist county and tribal TANF programs to more 
461.34  effectively serve hard-to-employ MFIP participants and 
461.35  participants who, within the last 12 months, have been 
461.36  determined under section 256J.42 to no longer be eligible to 
462.1   receive MFIP but whose income is below 120 percent of the 
462.2   federal poverty guidelines for a family of the same size.  Funds 
462.3   appropriated for local intervention grants for self-sufficiency 
462.4   must be allocated first in amounts equal to the guaranteed 
462.5   minimum in paragraph (b), and second according to the provisions 
462.6   of subdivision 2.  Any remaining funds must be allocated 
462.7   according to the formula in subdivision 3.  Counties or tribes 
462.8   must have an approved local service unit plan under section 
462.9   256J.50, subdivision 7, paragraph (b), in order to receive and 
462.10  expend funds under subdivisions 2 and 3.  
462.11     (b) Each county or tribal program shall receive a 
462.12  guaranteed minimum annual allocation of $25,000. 
462.13     Sec. 26.  Minnesota Statutes 2000, section 256J.625, 
462.14  subdivision 2, is amended to read: 
462.15     Subd. 2.  [SET-ASIDE FUNDS.] (a) Of the funds appropriated 
462.16  for grants under this section, after the allocation in 
462.17  subdivision 1, paragraph (b), is made, 20 percent of the 
462.18  remaining funds each year shall be retained by the commissioner 
462.19  and awarded to counties or tribes whose approved plans 
462.20  demonstrate additional need based on their identification of 
462.21  hard-to-employ families and, working participants in need of job 
462.22  retention and wage advancement services, and participants who 
462.23  within the last 12 months, have been determined under section 
462.24  256J.42 to no longer be eligible to receive MFIP but whose 
462.25  income is below 120 percent of the federal poverty guidelines 
462.26  for a family of same size, strong anticipated outcomes for 
462.27  families and an effective plan for monitoring performance, or, 
462.28  use of a multicounty, multi-entity or regional approach to serve 
462.29  hard-to-employ families and, working participants in need of job 
462.30  retention and wage advancement services, and participants who, 
462.31  within the last 12 months, have been determined under section 
462.32  256J.42 to no longer be eligible to receive MFIP but whose 
462.33  income is below 120 percent of the federal poverty guidelines 
462.34  for a family of the same size, who are identified as a target 
462.35  population to be served in the plan submitted under section 
462.36  256J.50, subdivision 7, paragraph (b).  In distributing funds 
463.1   under this paragraph, the commissioner must achieve a geographic 
463.2   balance.  The commissioner may award funds under this paragraph 
463.3   to other public, private, or nonprofit entities to deliver 
463.4   services in a county or region where the entity or entities 
463.5   submit a plan that demonstrates a strong capability to fulfill 
463.6   the terms of the plan and where the plan shows an innovative or 
463.7   multi-entity approach. 
463.8      (b) For fiscal year 2001 only, of the funds available under 
463.9   this subdivision the commissioner must allocate funding in the 
463.10  amounts specified in article 1, section 2, subdivision 7, for an 
463.11  intensive intervention transitional employment training project 
463.12  and for nontraditional career assistance and training programs.  
463.13  These allocations must occur before any set-aside funds are 
463.14  allocated under paragraph (a). 
463.15     Sec. 27.  Minnesota Statutes 2000, section 256J.625, 
463.16  subdivision 4, is amended to read: 
463.17     Subd. 4.  [USE OF FUNDS.] (a) A county or tribal program 
463.18  may use funds allocated under this subdivision to provide 
463.19  services to MFIP participants who are hard-to-employ and their 
463.20  families.  Services provided must be intended to reduce the 
463.21  number of MFIP participants who are expected to reach the 
463.22  60-month time limit under section 256J.42.  Counties, tribes, 
463.23  and other entities receiving funds under subdivision 2 or 3 must 
463.24  submit semiannual progress reports to the commissioner which 
463.25  detail program outcomes. 
463.26     (b) Funds allocated under this section may not be used to 
463.27  provide benefits that are defined as "assistance" in Code of 
463.28  Federal Regulations, title 45, section 260.31, to an assistance 
463.29  unit that is only receiving the food portion of MFIP benefits or 
463.30  under section 256J.42 is no longer eligible to receive MFIP. 
463.31     (c) A county may use funds allocated under this section for 
463.32  that part of the match for federal access to jobs transportation 
463.33  funds that is TANF-eligible.  A county may also use funds 
463.34  allocated under this section to enhance transportation choices 
463.35  for eligible recipients up to 150 percent of the federal poverty 
463.36  guidelines. 
464.1      Sec. 28.  Minnesota Statutes 2000, section 256J.751, is 
464.2   amended to read: 
464.3      256J.751 [COUNTY PERFORMANCE MANAGEMENT.] 
464.4      (a) Subdivision 1.  [QUARTERLY COUNTY CASELOAD REPORT.] The 
464.5   commissioner shall report quarterly to all counties each county 
464.6   on the county's performance on the following measures: 
464.7      (1) percent of MFIP caseload working in paid employment; 
464.8      (2) percent number of MFIP caseload cases receiving only 
464.9   the food portion of assistance; 
464.10     (2) number of child-only cases; 
464.11     (3) number of minor caregivers; 
464.12     (4) number of cases that are exempt from the 60-month time 
464.13  limit by the exemption category under section 256J.42; 
464.14     (5) number of participants who are exempt from employment 
464.15  and training services requirements by the exemption category 
464.16  under section 256J.56; 
464.17     (6) number of assistance units receiving assistance under a 
464.18  hardship extension under section 256J.425; 
464.19     (7) number of participants and number of months spent in 
464.20  each level of sanction under section 256J.46, subdivision 1; 
464.21     (3) (8) number of MFIP cases that have left assistance; 
464.22     (4) (9) federal participation requirements as specified in 
464.23  title 1 of Public Law Number 104-193; and 
464.24     (5) (10) median placement wage rate.; and 
464.25     (b) (11) of each county's total MFIP caseload less the 
464.26  number of cases in clauses (1) to (6): 
464.27     (i) number of one-parent cases; 
464.28     (ii) number of two-parent cases; 
464.29     (iii) percent of one-parent cases that are working more 
464.30  than 20 hours per week; 
464.31     (iv) percent of two-parent cases that are working more than 
464.32  20 hours per week; and 
464.33     (v) percent of cases that have received more than 36 months 
464.34  of assistance. 
464.35     Subd. 2.  [QUARTERLY COMPARISON REPORT.] The commissioner 
464.36  shall report quarterly to all counties on each county's 
465.1   performance on the following measures: 
465.2      (1) percent of MFIP caseload working in paid employment; 
465.3      (2) percent of MFIP caseload receiving only the food 
465.4   portion of assistance; 
465.5      (3) number of MFIP cases that have left assistance; 
465.6      (4) federal participation requirements as specified in 
465.7   Title 1 of Public Law Number 104-193; 
465.8      (5) median placement wage rate; and 
465.9      (6) caseload by months of TANF assistance. 
465.10     Subd. 3.  [ANNUAL REPORT.] The commissioner must report to 
465.11  all counties and to the legislature on each county's annual 
465.12  performance on the measures required under subdivision 1 by 
465.13  racial and ethnic group and, to the extent consistent with state 
465.14  and federal law, must include each county's performance on: 
465.15     (1) the number of out-of-wedlock births and births to teen 
465.16  mothers; and 
465.17     (2) number of cases by racial and ethnic group. 
465.18     The report must be completed by January 1, 2002, and 
465.19  January 1 of each year thereafter and must comply with sections 
465.20  3.195 and 3.197. 
465.21     Subd. 4.  [DEVELOPMENT OF PERFORMANCE MEASURES.] By January 
465.22  1, 2002, the commissioner shall, in consultation with counties, 
465.23  develop measures for county performance in addition to those in 
465.24  paragraph (a) subdivision 1 and 2.  In developing these 
465.25  measures, the commissioner must consider: 
465.26     (1) a measure for MFIP cases that leave assistance due to 
465.27  employment; 
465.28     (2) job retention after participants leave MFIP; and 
465.29     (3) participant's earnings at a follow-up point after the 
465.30  participant has left MFIP; and 
465.31     (4) the appropriateness of services provided to minority 
465.32  groups. 
465.33     (c) Subd. 5.  [FAILURE TO MEET FEDERAL PERFORMANCE 
465.34  STANDARDS.] (a) If sanctions occur for failure to meet the 
465.35  performance standards specified in title 1 of Public Law Number 
465.36  104-193 of the Personal Responsibility and Work Opportunity Act 
466.1   of 1996, the state shall pay 88 percent of the sanction.  The 
466.2   remaining 12 percent of the sanction will be paid by the 
466.3   counties.  The county portion of the sanction will be 
466.4   distributed across all counties in proportion to each county's 
466.5   percentage of the MFIP average monthly caseload during the 
466.6   period for which the sanction was applied. 
466.7      (d) (b) If a county fails to meet the performance standards 
466.8   specified in title 1 of Public Law Number 104-193 of the 
466.9   Personal Responsibility and Work Opportunity Act of 1996 for any 
466.10  year, the commissioner shall work with counties to organize a 
466.11  joint state-county technical assistance team to work with the 
466.12  county.  The commissioner shall coordinate any technical 
466.13  assistance with other departments and agencies including the 
466.14  departments of economic security and children, families, and 
466.15  learning as necessary to achieve the purpose of this paragraph. 
466.16     Sec. 29.  Minnesota Statutes 2000, section 256K.25, 
466.17  subdivision 1, is amended to read: 
466.18     Subdivision 1.  [ESTABLISHMENT AND PURPOSE.] (a) The 
466.19  commissioner shall establish a supportive housing and managed 
466.20  care pilot project in two counties, one within the seven-county 
466.21  metropolitan area and one outside of that area, to determine 
466.22  whether the integrated delivery of employment services, 
466.23  supportive services, housing, and health care into a single, 
466.24  flexible program will: 
466.25     (1) reduce public expenditures on homeless families with 
466.26  minor children, homeless noncustodial parents, and other 
466.27  homeless individuals; 
466.28     (2) increase the employment rates of these persons; and 
466.29     (3) provide a new alternative to providing services to this 
466.30  hard-to-serve population. 
466.31     (b) The commissioner shall create a program for counties 
466.32  for the purpose of providing integrated intensive and 
466.33  individualized case management services, employment services, 
466.34  health care services, rent subsidies or other short- or 
466.35  medium-term housing assistance, and other supportive services to 
466.36  eligible families and individuals.  Minimum project and 
467.1   application requirements shall be developed by the commissioner 
467.2   in cooperation with counties and their nonprofit partners with 
467.3   the goal to provide the maximum flexibility in program design. 
467.4      (c) Services available under this project must be 
467.5   coordinated with available health care services for an eligible 
467.6   project participant. 
467.7      Sec. 30.  Minnesota Statutes 2000, section 256K.25, 
467.8   subdivision 3, is amended to read: 
467.9      Subd. 3.  [COUNTY ELIGIBILITY.] (a) A county may request 
467.10  funding under this pilot project if the county: 
467.11     (1) agrees to develop, in cooperation with nonprofit 
467.12  partners, a supportive housing and managed care pilot project 
467.13  that integrates the delivery of employment services, supportive 
467.14  services, housing and health care for eligible families and 
467.15  individuals, or agrees to contract with an existing integrated 
467.16  program; 
467.17     (2) for eligible participants who are also MFIP recipients, 
467.18  agrees to develop, in cooperation with nonprofit partners, 
467.19  procedures to ensure that the services provided under the pilot 
467.20  project are closely coordinated with the services provided under 
467.21  MFIP; and 
467.22     (3) develops a method for evaluating the quality of the 
467.23  integrated services provided and the amount of any resulting 
467.24  cost savings to the county and state.; and 
467.25     (4) addresses in the pilot design the prevalence in the 
467.26  homeless population served those individuals with mental 
467.27  illness, a history of substance abuse, or HIV. 
467.28     (b) Preference may be given to counties that cooperate with 
467.29  other counties participating in the pilot project for purposes 
467.30  of evaluation and counties that provide additional funding. 
467.31     Sec. 31.  Minnesota Statutes 2000, section 256K.25, 
467.32  subdivision 4, is amended to read: 
467.33     Subd. 4.  [PARTICIPANT ELIGIBILITY.] (a) In order to be 
467.34  eligible meet initial eligibility criteria for the pilot 
467.35  project, the county must determine that a participant is 
467.36  homeless or is at risk of homelessness; has a mental illness, a 
468.1   history of substance abuse, or HIV; and is a family that meets 
468.2   the criteria in paragraph (b) or is an individual who meets the 
468.3   criteria in paragraph (c). 
468.4      (b) An eligible family must include a minor child or a 
468.5   pregnant woman, and: 
468.6      (1) be receiving or be eligible for MFIP assistance under 
468.7   chapter 256J; or 
468.8      (2) include an adult caregiver who is employed or is 
468.9   receiving employment and training services, and have household 
468.10  income below the MFIP exit level in section 256J.24, subdivision 
468.11  10.  
468.12     (c) An eligible individual must: 
468.13     (1) meet the eligibility requirements of the group 
468.14  residential housing program under section 256I.04, subdivision 
468.15  1; or 
468.16     (2) be a noncustodial parent who is employed or is 
468.17  receiving employment and training services, and have household 
468.18  income below the MFIP exit level in section 256J.24, subdivision 
468.19  10.  
468.20     (d) Counties participating in the pilot project may develop 
468.21  and initiate disenrollment criteria, subject to approval by the 
468.22  commissioner of human services. 
468.23     Sec. 32.  Minnesota Statutes 2000, section 256K.25, 
468.24  subdivision 5, is amended to read: 
468.25     Subd. 5.  [FUNDING.] A county may request funding from the 
468.26  commissioner for a specified number of TANF-eligible project 
468.27  participants.  The commissioner shall review the request for 
468.28  compliance with subdivisions 1 to 4 and may approve or 
468.29  disapprove the request.  If other funds are available, the 
468.30  commissioner may allocate funding for project participants who 
468.31  meet the eligibility requirements of subdivision 4, paragraph 
468.32  (c).  The commissioner may also redirect funds to the pilot 
468.33  project. 
468.34     Sec. 33.  Minnesota Statutes 2000, section 256K.25, 
468.35  subdivision 6, is amended to read: 
468.36     Subd. 6.  [REPORT.] Participating counties and the 
469.1   commissioner shall collaborate to prepare and issue an annual 
469.2   report, beginning December 1, 2001, to the chairs of the 
469.3   appropriate legislative committees on the pilot project's use of 
469.4   public resources, including other funds leveraged for this 
469.5   initiative, and an assessment of the feasibility of financing 
469.6   the pilot through other health and human services programs, the 
469.7   employment and housing status of the families and individuals 
469.8   served in the project, and the cost-effectiveness of the 
469.9   project.  The annual report must also evaluate the pilot project 
469.10  with respect to the following project goals:  that participants 
469.11  will lead more productive, healthier, more stable and better 
469.12  quality lives; that the teams created under the project to 
469.13  deliver services for each project participant will be 
469.14  accountable for ensuring that services are more appropriate, 
469.15  cost-effective and well-coordinated; and that the system-wide 
469.16  costs of serving this population, and the inappropriate use of 
469.17  emergency, crisis-oriented or institutional services, will be 
469.18  materially reduced.  The commissioner shall provide data that 
469.19  may be needed to evaluate the project to participating counties 
469.20  that request the data. 
469.21     Sec. 34.  Minnesota Statutes 2000, section 268.0122, 
469.22  subdivision 2, is amended to read: 
469.23     Subd. 2.  [SPECIFIC POWERS.] The commissioner of economic 
469.24  security shall: 
469.25     (1) administer and supervise all forms of unemployment 
469.26  benefits provided for under federal and state laws that are 
469.27  vested in the commissioner, including make investigations and 
469.28  audits, secure and transmit information, and make available 
469.29  services and facilities as the commissioner considers necessary 
469.30  or appropriate to facilitate the administration of any other 
469.31  states, or the federal Economic Security Law, and accept and use 
469.32  information, services, and facilities made available by other 
469.33  states or the federal government; 
469.34     (2) administer and supervise all employment and training 
469.35  services assigned to the department under federal or state law; 
469.36     (3) review and comment on local service unit plans and 
470.1   community investment program plans and approve or disapprove the 
470.2   plans; 
470.3      (4) establish and maintain administrative units necessary 
470.4   to perform administrative functions common to all divisions of 
470.5   the department; 
470.6      (5) supervise the county boards of commissioners, local 
470.7   service units, and any other units of government designated in 
470.8   federal or state law as responsible for employment and training 
470.9   programs; 
470.10     (6) establish administrative standards and payment 
470.11  conditions for providers of employment and training services; 
470.12     (7) act as the agent of, and cooperate with, the federal 
470.13  government in matters of mutual concern, including the 
470.14  administration of any federal funds granted to the state to aid 
470.15  in the performance of functions of the commissioner; 
470.16     (8) obtain reports from local service units and service 
470.17  providers for the purpose of evaluating the performance of 
470.18  employment and training services; and 
470.19     (9) review and comment on plans for Indian tribe employment 
470.20  and training services and approve or disapprove the plans; and 
470.21     (10) require all general employment and training programs 
470.22  that receive state funds to make available information about 
470.23  opportunities for women in nontraditional careers in the trades 
470.24  and technical occupations. 
470.25     Sec. 35.  Laws 1997, chapter 203, article 9, section 21, as 
470.26  amended by Laws 1998, chapter 407, article 6, section 111, and 
470.27  Laws 2000, chapter 488, article 10, section 28, is amended to 
470.28  read: 
470.29     Sec. 21.  [INELIGIBILITY FOR STATE FUNDED PROGRAMS.] 
470.30     (a) Effective on the date specified, the following persons 
470.31  will be ineligible for general assistance and general assistance 
470.32  medical care under Minnesota Statutes, chapter 256D, group 
470.33  residential housing under Minnesota Statutes, chapter 256I, and 
470.34  MFIP assistance under Minnesota Statutes, chapter 256J, funded 
470.35  with state money: 
470.36     (1) Beginning July 1, 2002, persons who are terminated from 
471.1   or denied Supplemental Security Income due to the 1996 changes 
471.2   in the federal law making persons whose alcohol or drug 
471.3   addiction is a material factor contributing to the person's 
471.4   disability ineligible for Supplemental Security Income, and are 
471.5   eligible for general assistance under Minnesota Statutes, 
471.6   section 256D.05, subdivision 1, paragraph (a), clause (15), 
471.7   general assistance medical care under Minnesota Statutes, 
471.8   chapter 256D, or group residential housing under Minnesota 
471.9   Statutes, chapter 256I; 
471.10     (2) Beginning July 1, 2002, legal noncitizens who are 
471.11  ineligible for Supplemental Security Income due to the 1996 
471.12  changes in federal law making certain noncitizens ineligible for 
471.13  these programs due to their noncitizen status; and 
471.14     (3) Beginning July 1, 2001 2002, legal noncitizens who are 
471.15  eligible for MFIP assistance, either the cash assistance portion 
471.16  or the food assistance portion, funded entirely with state money.
471.17     (b) State money that remains unspent due to changes in 
471.18  federal law enacted after May 12, 1997, that reduce state 
471.19  spending for legal noncitizens or for persons whose alcohol or 
471.20  drug addiction is a material factor contributing to the person's 
471.21  disability, or enacted after February 1, 1998, that reduce state 
471.22  spending for food benefits for legal noncitizens shall not 
471.23  cancel and shall be deposited in the TANF reserve account. 
471.24     Sec. 36.  [REPORT ON ASSESSMENT OF COUNTY PERFORMANCE.] 
471.25     By January 15, 2003, the commissioner, in consultation with 
471.26  counties, must report to the chairs of the house and senate 
471.27  committees having jurisdiction over human services, on a 
471.28  proposal for assessing county performance using a methodology 
471.29  that controls for demographic, economic, and other variables 
471.30  that may impact county achievement of MFIP performance 
471.31  outcomes.  The proposal must recommend how state and federal 
471.32  funds may be allocated to counties to encourage and reward high 
471.33  performance. 
471.34     Sec. 37.  [REPEALER.] 
471.35     Minnesota Statutes 2000, sections 256J.42, subdivision 4; 
471.36  256J.44; and 256J.46, subdivision 1a, are repealed. 
472.1                              ARTICLE 11
472.2                            DHS LICENSING
472.3      Section 1.  Minnesota Statutes 2000, section 13.46, 
472.4   subdivision 4, is amended to read: 
472.5      Subd. 4.  [LICENSING DATA.] (a) As used in this subdivision:
472.6      (1) "licensing data" means all data collected, maintained, 
472.7   used, or disseminated by the welfare system pertaining to 
472.8   persons licensed or registered or who apply for licensure or 
472.9   registration or who formerly were licensed or registered under 
472.10  the authority of the commissioner of human services; 
472.11     (2) "client" means a person who is receiving services from 
472.12  a licensee or from an applicant for licensure; and 
472.13     (3) "personal and personal financial data" means social 
472.14  security numbers, identity of and letters of reference, 
472.15  insurance information, reports from the bureau of criminal 
472.16  apprehension, health examination reports, and social/home 
472.17  studies. 
472.18     (b)(1) Except as provided in paragraph (c), the following 
472.19  data on current and former licensees are public:  name, address, 
472.20  telephone number of licensees, licensed capacity, type of client 
472.21  preferred, variances granted, type of dwelling, name and 
472.22  relationship of other family members, previous license history, 
472.23  class of license, and the existence and status of complaints.  
472.24  When disciplinary action has been taken against a licensee or 
472.25  the complaint is resolved, the following data are public:  the 
472.26  substance of the complaint, the findings of the investigation of 
472.27  the complaint, the record of informal resolution of a licensing 
472.28  violation, orders of hearing, findings of fact, conclusions of 
472.29  law, and specifications of the final disciplinary action 
472.30  contained in the record of disciplinary action.  
472.31     (2) The following data on persons subject to 
472.32  disqualification under section 245A.04 in connection with a 
472.33  license to provide family day care for children, child care 
472.34  center services, foster care for children in the provider's 
472.35  home, or foster care or day care services for adults in the 
472.36  provider's home, are public:  the nature of any disqualification 
473.1   set aside under section 245A.04, subdivision 3b, and the reasons 
473.2   for setting aside the disqualification; and the reasons for 
473.3   granting any variance under section 245A.04, subdivision 9. 
473.4      (3) When maltreatment is substantiated under section 
473.5   626.556 or 626.557 and the victim and the substantiated 
473.6   perpetrator are affiliated with a program licensed under chapter 
473.7   245A, the commissioner of human services, local social services 
473.8   agency, or county welfare agency may inform the license holder 
473.9   where the maltreatment occurred of the identity of the 
473.10  substantiated perpetrator and the victim. 
473.11     (c) The following are private data on individuals under 
473.12  section 13.02, subdivision 12, or nonpublic data under section 
473.13  13.02, subdivision 9:  personal and personal financial data on 
473.14  family day care program and family foster care program 
473.15  applicants and licensees and their family members who provide 
473.16  services under the license. 
473.17     (d) The following are private data on individuals:  the 
473.18  identity of persons who have made reports concerning licensees 
473.19  or applicants that appear in inactive investigative data, and 
473.20  the records of clients or employees of the licensee or applicant 
473.21  for licensure whose records are received by the licensing agency 
473.22  for purposes of review or in anticipation of a contested 
473.23  matter.  The names of reporters under sections 626.556 and 
473.24  626.557 may be disclosed only as provided in section 626.556, 
473.25  subdivision 11, or 626.557, subdivision 12b. 
473.26     (e) Data classified as private, confidential, nonpublic, or 
473.27  protected nonpublic under this subdivision become public data if 
473.28  submitted to a court or administrative law judge as part of a 
473.29  disciplinary proceeding in which there is a public hearing 
473.30  concerning the disciplinary action. 
473.31     (f) Data generated in the course of licensing 
473.32  investigations that relate to an alleged violation of law are 
473.33  investigative data under subdivision 3. 
473.34     (g) Data that are not public data collected, maintained, 
473.35  used, or disseminated under this subdivision that relate to or 
473.36  are derived from a report as defined in section 626.556, 
474.1   subdivision 2, are subject to the destruction provisions of 
474.2   section 626.556, subdivision 11.  
474.3      (h) Upon request, not public data collected, maintained, 
474.4   used, or disseminated under this subdivision that relate to or 
474.5   are derived from a report of substantiated maltreatment as 
474.6   defined in section 626.556 or 626.557 may be exchanged with the 
474.7   department of health for purposes of completing background 
474.8   studies pursuant to section 144.057. 
474.9      (i) Data on individuals collected according to licensing 
474.10  activities under chapter 245A, and data on individuals collected 
474.11  by the commissioner of human services according to maltreatment 
474.12  investigations under sections 626.556 and 626.557, may be shared 
474.13  with the department of human rights, the department of health, 
474.14  the department of corrections, the ombudsman for mental health 
474.15  and retardation, and the individual's professional regulatory 
474.16  board when there is reason to believe that laws or standards 
474.17  under the jurisdiction of those agencies may have been violated. 
474.18     (j) In addition to the notice of determinations required 
474.19  under section 626.556, subdivision 10f, if the commissioner or 
474.20  the local social services agency has determined that an 
474.21  individual is a substantiated perpetrator of maltreatment of a 
474.22  child based on sexual abuse, as defined in section 626.556, 
474.23  subdivision 2, and the commissioner or local social services 
474.24  agency knows that the individual is a person responsible for a 
474.25  child's care in another facility, the commissioner or local 
474.26  social services agency shall notify the head of that facility of 
474.27  this determination.  The notification must include an 
474.28  explanation of the individual's available appeal rights and the 
474.29  status of any appeal.  If a notice is given under this 
474.30  paragraph, the government entity making the notification shall 
474.31  provide a copy of the notice to the individual who is the 
474.32  subject of the notice. 
474.33     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
474.34     Sec. 2.  Minnesota Statutes 2000, section 144.057, is 
474.35  amended to read: 
474.36     144.057 [BACKGROUND STUDIES ON LICENSEES AND SUPPLEMENTAL 
475.1   NURSING SERVICES AGENCY PERSONNEL.] 
475.2      Subdivision 1.  [BACKGROUND STUDIES REQUIRED.] The 
475.3   commissioner of health shall contract with the commissioner of 
475.4   human services to conduct background studies of: 
475.5      (1) individuals providing services which have direct 
475.6   contact, as defined under section 245A.04, subdivision 3, with 
475.7   patients and residents in hospitals, boarding care homes, 
475.8   outpatient surgical centers licensed under sections 144.50 to 
475.9   144.58; nursing homes and home care agencies licensed under 
475.10  chapter 144A; residential care homes licensed under chapter 
475.11  144B, and board and lodging establishments that are registered 
475.12  to provide supportive or health supervision services under 
475.13  section 157.17; and 
475.14     (2) beginning July 1, 1999, all other employees in nursing 
475.15  homes licensed under chapter 144A, and boarding care homes 
475.16  licensed under sections 144.50 to 144.58.  A disqualification of 
475.17  an individual in this section shall disqualify the individual 
475.18  from positions allowing direct contact or access to patients or 
475.19  residents receiving services; 
475.20     (3) individuals employed by a supplemental nursing services 
475.21  agency, as defined under section 144A.70, who are providing 
475.22  services in health care facilities; and 
475.23     (4) controlling persons of a supplemental nursing services 
475.24  agency, as defined under section 144A.70. 
475.25     If a facility or program is licensed by the department of 
475.26  human services and subject to the background study provisions of 
475.27  chapter 245A and is also licensed by the department of health, 
475.28  the department of human services is solely responsible for the 
475.29  background studies of individuals in the jointly licensed 
475.30  programs. 
475.31     Subd. 2.  [RESPONSIBILITIES OF DEPARTMENT OF HUMAN 
475.32  SERVICES.] The department of human services shall conduct the 
475.33  background studies required by subdivision 1 in compliance with 
475.34  the provisions of chapter 245A and Minnesota Rules, parts 
475.35  9543.3000 to 9543.3090.  For the purpose of this section, the 
475.36  term "residential program" shall include all facilities 
476.1   described in subdivision 1.  The department of human services 
476.2   shall provide necessary forms and instructions, shall conduct 
476.3   the necessary background studies of individuals, and shall 
476.4   provide notification of the results of the studies to the 
476.5   facilities, supplemental nursing services agencies, individuals, 
476.6   and the commissioner of health.  Individuals shall be 
476.7   disqualified under the provisions of chapter 245A and Minnesota 
476.8   Rules, parts 9543.3000 to 9543.3090.  If an individual is 
476.9   disqualified, the department of human services shall notify the 
476.10  facility, the supplemental nursing services agency, and the 
476.11  individual and shall inform the individual of the right to 
476.12  request a reconsideration of the disqualification by submitting 
476.13  the request to the department of health. 
476.14     Subd. 3.  [RECONSIDERATIONS.] The commissioner of health 
476.15  shall review and decide reconsideration requests, including the 
476.16  granting of variances, in accordance with the procedures and 
476.17  criteria contained in chapter 245A and Minnesota Rules, parts 
476.18  9543.3000 to 9543.3090.  The commissioner's decision shall be 
476.19  provided to the individual and to the department of human 
476.20  services.  The commissioner's decision to grant or deny a 
476.21  reconsideration of disqualification is the final administrative 
476.22  agency action, except for the provisions under section 245A.04, 
476.23  subdivisions 3b, paragraphs (e) and (f); and 3c, paragraph (a). 
476.24     <b>[EFFECTIVE DATE.]</b> This subdivision is effective January 1, 
476.25  2002. 
476.26     Subd. 4.  [RESPONSIBILITIES OF FACILITIES AND AGENCIES.] 
476.27  Facilities and agencies described in subdivision 1 shall be 
476.28  responsible for cooperating with the departments in implementing 
476.29  the provisions of this section.  The responsibilities imposed on 
476.30  applicants and licensees under chapter 245A and Minnesota Rules, 
476.31  parts 9543.3000 to 9543.3090, shall apply to these 
476.32  facilities and supplemental nursing services agencies.  The 
476.33  provision of section 245A.04, subdivision 3, paragraph (e), 
476.34  shall apply to applicants, licensees, registrants, or an 
476.35  individual's refusal to cooperate with the completion of the 
476.36  background studies.  Supplemental nursing services agencies 
477.1   subject to the registration requirements in section 144A.71 must 
477.2   maintain records verifying compliance with the background study 
477.3   requirements under this section. 
477.4      Sec. 3.  Minnesota Statutes 2000, section 214.104, is 
477.5   amended to read: 
477.6      214.104 [HEALTH-RELATED LICENSING BOARDS; DETERMINATIONS 
477.7   REGARDING DISQUALIFICATIONS FOR MALTREATMENT.] 
477.8      (a) A health-related licensing board shall make 
477.9   determinations as to whether licensees regulated persons who are 
477.10  under the board's jurisdiction should be disqualified under 
477.11  section 245A.04, subdivision 3d, from positions allowing direct 
477.12  contact with persons receiving services the subject of 
477.13  disciplinary or corrective action because of substantiated 
477.14  maltreatment under section 626.556 or 626.557.  A determination 
477.15  under this section may be done as part of an investigation under 
477.16  section 214.103.  The board shall make a determination within 90 
477.17  days of upon receipt, and after the review, of an investigation 
477.18  memorandum or other notice of substantiated maltreatment under 
477.19  section 626.556 or 626.557, or of a notice from the commissioner 
477.20  of human services that a background study of a licensee 
477.21  regulated person shows substantiated maltreatment.  The board 
477.22  shall also make a determination under this section upon 
477.23  consideration of the licensure of an individual who was subject 
477.24  to disqualification before licensure because of substantiated 
477.25  maltreatment. 
477.26     (b) In making a determination under this section, the board 
477.27  shall consider the nature and extent of any injury or harm 
477.28  resulting from the conduct that would constitute grounds for 
477.29  disqualification, the seriousness of the misconduct, the extent 
477.30  that disqualification is necessary to protect persons receiving 
477.31  services or the public, and other factors specified in section 
477.32  245A.04, subdivision 3b, paragraph (b). 
477.33     (c) The board shall determine the duration and extent of 
477.34  the disqualification or may establish conditions under which the 
477.35  licensee may hold a position allowing direct contact with 
477.36  persons receiving services or in a licensed facility.  
478.1      (b) Upon completion of its review of a report of 
478.2   substantiated maltreatment, the board shall notify the 
478.3   commissioner of human services and the lead agency that 
478.4   conducted an investigation under section 626.556 or 626.557, as 
478.5   applicable, of its determination.  The board shall notify the 
478.6   commissioner of human services if, following a review of the 
478.7   report of substantiated maltreatment, the board determines that 
478.8   it does not have jurisdiction in the matter and the commissioner 
478.9   shall make the appropriate disqualification decision regarding 
478.10  the regulated person as otherwise provided in chapter 245A.  The 
478.11  board shall also notify the commissioner of health or the 
478.12  commissioner of human services immediately upon receipt of 
478.13  knowledge of a facility or program allowing a regulated person 
478.14  to provide direct contact services at the facility or program 
478.15  while not complying with requirements placed on the regulated 
478.16  person. 
478.17     (c) In addition to any other remedy provided by law, the 
478.18  board may, through its designated board member, temporarily 
478.19  suspend the license of a licensee; deny a credential to an 
478.20  applicant; or require the regulated person to be continuously 
478.21  supervised, if the board finds there is probable cause to 
478.22  believe the regulated person referred to the board according to 
478.23  paragraph (a) poses an immediate risk of harm to vulnerable 
478.24  persons.  The board shall consider all relevant information 
478.25  available, which may include but is not limited to: 
478.26     (1) the extent the action is needed to protect persons 
478.27  receiving services or the public; 
478.28     (2) the recency of the maltreatment; 
478.29     (3) the number of incidents of maltreatment; 
478.30     (4) the intrusiveness or violence of the maltreatment; and 
478.31     (5) the vulnerability of the victim of maltreatment.  
478.32  The action shall take effect upon written notice to the 
478.33  regulated person, served by certified mail, specifying the 
478.34  statute violated.  The board shall notify the commissioner of 
478.35  health or the commissioner of human services of the suspension 
478.36  or denial of a credential.  The action shall remain in effect 
479.1   until the board issues a temporary stay or a final order in the 
479.2   matter after a hearing or upon agreement between the board and 
479.3   the regulated person.  At the time the board issues the notice, 
479.4   the regulated person shall inform the board of all settings in 
479.5   which the regulated person is employed or practices and the 
479.6   board shall inform all known employment and practice settings of 
479.7   the board action and schedule a disciplinary hearing to be held 
479.8   under chapter 14.  The board shall provide the regulated person 
479.9   with at least 30 days' notice of the hearing, unless the parties 
479.10  agree to a hearing date that provides less than 30 days notice, 
479.11  and shall schedule the hearing to begin no later than 90 days 
479.12  after issuance of the notice of hearing. 
479.13     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
479.14     Sec. 4.  Minnesota Statutes 2000, section 245A.03, 
479.15  subdivision 2b, is amended to read: 
479.16     Subd. 2b.  [EXCEPTION.] The provision in subdivision 2, 
479.17  clause (2), does not apply to: 
479.18     (1) a child care provider who as an applicant for licensure 
479.19  or as a license holder has received a license denial under 
479.20  section 245A.05, a fine conditional license under section 
479.21  245A.06, or a sanction under section 245A.07 from the 
479.22  commissioner that has not been reversed on appeal; or 
479.23     (2) a child care provider, or a child care provider who has 
479.24  a household member who, as a result of a licensing process, has 
479.25  a disqualification under this chapter that has not been set 
479.26  aside by the commissioner. 
479.27     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
479.28     Sec. 5.  Minnesota Statutes 2000, section 245A.04, 
479.29  subdivision 3a, is amended to read: 
479.30     Subd. 3a.  [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 
479.31  STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 
479.32  commissioner shall notify the applicant or, license holder, or 
479.33  registrant and the individual who is the subject of the study, 
479.34  in writing or by electronic transmission, of the results of the 
479.35  study.  When the study is completed, a notice that the study was 
479.36  undertaken and completed shall be maintained in the personnel 
480.1   files of the program.  For studies on individuals pertaining to 
480.2   a license to provide family day care or group family day care, 
480.3   foster care for children in the provider's own home, or foster 
480.4   care or day care services for adults in the provider's own home, 
480.5   the commissioner is not required to provide a separate notice of 
480.6   the background study results to the individual who is the 
480.7   subject of the study unless the study results in a 
480.8   disqualification of the individual. 
480.9      The commissioner shall notify the individual studied if the 
480.10  information in the study indicates the individual is 
480.11  disqualified from direct contact with persons served by the 
480.12  program.  The commissioner shall disclose the information 
480.13  causing disqualification and instructions on how to request a 
480.14  reconsideration of the disqualification to the individual 
480.15  studied.  An applicant or license holder who is not the subject 
480.16  of the study shall be informed that the commissioner has found 
480.17  information that disqualifies the subject from direct contact 
480.18  with persons served by the program.  However, only the 
480.19  individual studied must be informed of the information contained 
480.20  in the subject's background study unless the only basis for the 
480.21  disqualification is failure to cooperate, substantiated 
480.22  maltreatment under section 626.556 or 626.557, the Data 
480.23  Practices Act provides for release of the information, or the 
480.24  individual studied authorizes the release of the 
480.25  information.  When a disqualification is based on the subject's 
480.26  failure to cooperate with the background study or substantiated 
480.27  maltreatment under section 626.556 or 626.557, the agency that 
480.28  initiated the study shall be informed by the commissioner of the 
480.29  reason for the disqualification. 
480.30     (b) Except as provided in subdivision 3d, paragraph (b), if 
480.31  the commissioner determines that the individual studied has a 
480.32  disqualifying characteristic, the commissioner shall review the 
480.33  information immediately available and make a determination as to 
480.34  the subject's immediate risk of harm to persons served by the 
480.35  program where the individual studied will have direct contact.  
480.36  The commissioner shall consider all relevant information 
481.1   available, including the following factors in determining the 
481.2   immediate risk of harm:  the recency of the disqualifying 
481.3   characteristic; the recency of discharge from probation for the 
481.4   crimes; the number of disqualifying characteristics; the 
481.5   intrusiveness or violence of the disqualifying characteristic; 
481.6   the vulnerability of the victim involved in the disqualifying 
481.7   characteristic; and the similarity of the victim to the persons 
481.8   served by the program where the individual studied will have 
481.9   direct contact.  The commissioner may determine that the 
481.10  evaluation of the information immediately available gives the 
481.11  commissioner reason to believe one of the following: 
481.12     (1) The individual poses an imminent risk of harm to 
481.13  persons served by the program where the individual studied will 
481.14  have direct contact.  If the commissioner determines that an 
481.15  individual studied poses an imminent risk of harm to persons 
481.16  served by the program where the individual studied will have 
481.17  direct contact, the individual and the license holder must be 
481.18  sent a notice of disqualification.  The commissioner shall order 
481.19  the license holder to immediately remove the individual studied 
481.20  from direct contact.  The notice to the individual studied must 
481.21  include an explanation of the basis of this determination. 
481.22     (2) The individual poses a risk of harm requiring 
481.23  continuous supervision while providing direct contact services 
481.24  during the period in which the subject may request a 
481.25  reconsideration.  If the commissioner determines that an 
481.26  individual studied poses a risk of harm that requires continuous 
481.27  supervision, the individual and the license holder must be sent 
481.28  a notice of disqualification.  The commissioner shall order the 
481.29  license holder to immediately remove the individual studied from 
481.30  direct contact services or assure that the individual studied is 
481.31  within sight or hearing of another staff person when providing 
481.32  direct contact services during the period in which the 
481.33  individual may request a reconsideration of the 
481.34  disqualification.  If the individual studied does not submit a 
481.35  timely request for reconsideration, or the individual submits a 
481.36  timely request for reconsideration, but the disqualification is 
482.1   not set aside for that license holder, the license holder will 
482.2   be notified of the disqualification and ordered to immediately 
482.3   remove the individual from any position allowing direct contact 
482.4   with persons receiving services from the license holder. 
482.5      (3) The individual does not pose an imminent risk of harm 
482.6   or a risk of harm requiring continuous supervision while 
482.7   providing direct contact services during the period in which the 
482.8   subject may request a reconsideration.  If the commissioner 
482.9   determines that an individual studied does not pose a risk of 
482.10  harm that requires continuous supervision, only the individual 
482.11  must be sent a notice of disqualification.  The license holder 
482.12  must be sent a notice that more time is needed to complete the 
482.13  individual's background study.  If the individual studied 
482.14  submits a timely request for reconsideration, and if the 
482.15  disqualification is set aside for that license holder, the 
482.16  license holder will receive the same notification received by 
482.17  license holders in cases where the individual studied has no 
482.18  disqualifying characteristic.  If the individual studied does 
482.19  not submit a timely request for reconsideration, or the 
482.20  individual submits a timely request for reconsideration, but the 
482.21  disqualification is not set aside for that license holder, the 
482.22  license holder will be notified of the disqualification and 
482.23  ordered to immediately remove the individual from any position 
482.24  allowing direct contact with persons receiving services from the 
482.25  license holder.  
482.26     (c) County licensing agencies performing duties under this 
482.27  subdivision may develop an alternative system for determining 
482.28  the subject's immediate risk of harm to persons served by the 
482.29  program, providing the notices under paragraph (b), and 
482.30  documenting the action taken by the county licensing agency.  
482.31  Each county licensing agency's implementation of the alternative 
482.32  system is subject to approval by the commissioner.  
482.33  Notwithstanding this alternative system, county licensing 
482.34  agencies shall complete the requirements of paragraph (a). 
482.35     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
482.36     Sec. 6.  Minnesota Statutes 2000, section 245A.04, 
483.1   subdivision 3b, is amended to read: 
483.2      Subd. 3b.  [RECONSIDERATION OF DISQUALIFICATION.] (a) The 
483.3   individual who is the subject of the disqualification may 
483.4   request a reconsideration of the disqualification.  
483.5      The individual must submit the request for reconsideration 
483.6   to the commissioner in writing.  A request for reconsideration 
483.7   for an individual who has been sent a notice of disqualification 
483.8   under subdivision 3a, paragraph (b), clause (1) or (2), must be 
483.9   submitted within 30 calendar days of the disqualified 
483.10  individual's receipt of the notice of disqualification.  A 
483.11  request for reconsideration for an individual who has been sent 
483.12  a notice of disqualification under subdivision 3a, paragraph 
483.13  (b), clause (3), must be submitted within 15 calendar days of 
483.14  the disqualified individual's receipt of the notice of 
483.15  disqualification.  An individual who was determined to have 
483.16  maltreated a child under section 626.556 or a vulnerable adult 
483.17  under section 626.557, and who was disqualified under this 
483.18  section on the basis of serious or recurring maltreatment, may 
483.19  request reconsideration of both the maltreatment and the 
483.20  disqualification determinations.  The request for 
483.21  reconsideration of the maltreatment determination and the 
483.22  disqualification must be submitted within 30 calendar days of 
483.23  the individual's receipt of the notice of disqualification.  
483.24  Removal of a disqualified individual from direct contact shall 
483.25  be ordered if the individual does not request reconsideration 
483.26  within the prescribed time, and for an individual who submits a 
483.27  timely request for reconsideration, if the disqualification is 
483.28  not set aside.  The individual must present information showing 
483.29  that: 
483.30     (1) the information the commissioner relied upon is 
483.31  incorrect or inaccurate.  If the basis of a reconsideration 
483.32  request is that a maltreatment determination or disposition 
483.33  under section 626.556 or 626.557 is incorrect, and the 
483.34  commissioner has issued a final order in an appeal of that 
483.35  determination or disposition under section 256.045 or 245A.08, 
483.36  subdivision 5, the commissioner's order is conclusive on the 
484.1   issue of maltreatment.  If the individual did not request 
484.2   reconsideration of the maltreatment determination, the 
484.3   maltreatment determination is deemed conclusive; or 
484.4      (2) the subject of the study does not pose a risk of harm 
484.5   to any person served by the applicant or, license holder, or 
484.6   registrant. 
484.7      (b) The commissioner shall rescind the disqualification if 
484.8   the commissioner finds that the information relied on to 
484.9   disqualify the subject is incorrect.  The commissioner may set 
484.10  aside the disqualification under this section if the 
484.11  commissioner finds that the information the commissioner relied 
484.12  upon is incorrect or the individual does not pose a risk of harm 
484.13  to any person served by the applicant or, license holder, or 
484.14  registrant.  In determining that an individual does not pose a 
484.15  risk of harm, the commissioner shall consider the consequences 
484.16  of the event or events that lead to disqualification, whether 
484.17  there is more than one disqualifying event, the vulnerability of 
484.18  the victim at the time of the event, the time elapsed without a 
484.19  repeat of the same or similar event, documentation of successful 
484.20  completion by the individual studied of training or 
484.21  rehabilitation pertinent to the event, and any other information 
484.22  relevant to reconsideration.  In reviewing a disqualification 
484.23  under this section, the commissioner shall give preeminent 
484.24  weight to the safety of each person to be served by the license 
484.25  holder or, applicant, or registrant over the interests of the 
484.26  license holder or, applicant, or registrant. 
484.27     (c) Unless the information the commissioner relied on in 
484.28  disqualifying an individual is incorrect, the commissioner may 
484.29  not set aside the disqualification of an individual in 
484.30  connection with a license to provide family day care for 
484.31  children, foster care for children in the provider's own home, 
484.32  or foster care or day care services for adults in the provider's 
484.33  own home if: 
484.34     (1) less than ten years have passed since the discharge of 
484.35  the sentence imposed for the offense; and the individual has 
484.36  been convicted of a violation of any offense listed in sections 
485.1   609.20 (manslaughter in the first degree), 609.205 (manslaughter 
485.2   in the second degree), criminal vehicular homicide under 609.21 
485.3   (criminal vehicular homicide and injury), 609.215 (aiding 
485.4   suicide or aiding attempted suicide), felony violations under 
485.5   609.221 to 609.2231 (assault in the first, second, third, or 
485.6   fourth degree), 609.713 (terroristic threats), 609.235 (use of 
485.7   drugs to injure or to facilitate crime), 609.24 (simple 
485.8   robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 
485.9   609.255 (false imprisonment), 609.561 or 609.562 (arson in the 
485.10  first or second degree), 609.71 (riot), burglary in the first or 
485.11  second degree under 609.582 (burglary), 609.66 (dangerous 
485.12  weapon), 609.665 (spring guns), 609.67 (machine guns and 
485.13  short-barreled shotguns), 609.749 (harassment; stalking), 
485.14  152.021 or 152.022 (controlled substance crime in the first or 
485.15  second degree), 152.023, subdivision 1, clause (3) or (4), or 
485.16  subdivision 2, clause (4) (controlled substance crime in the 
485.17  third degree), 152.024, subdivision 1, clause (2), (3), or (4) 
485.18  (controlled substance crime in the fourth degree), 609.224, 
485.19  subdivision 2, paragraph (c) (fifth-degree assault by a 
485.20  caregiver against a vulnerable adult), 609.228 (great bodily 
485.21  harm caused by distribution of drugs), 609.23 (mistreatment of 
485.22  persons confined), 609.231 (mistreatment of residents or 
485.23  patients), 609.2325 (criminal abuse of a vulnerable adult), 
485.24  609.233 (criminal neglect of a vulnerable adult), 609.2335 
485.25  (financial exploitation of a vulnerable adult), 609.234 (failure 
485.26  to report), 609.265 (abduction), 609.2664 to 609.2665 
485.27  (manslaughter of an unborn child in the first or second degree), 
485.28  609.267 to 609.2672 (assault of an unborn child in the first, 
485.29  second, or third degree), 609.268 (injury or death of an unborn 
485.30  child in the commission of a crime), 617.293 (disseminating or 
485.31  displaying harmful material to minors), a gross misdemeanor 
485.32  offense under 609.324, subdivision 1 (other prohibited acts), a 
485.33  gross misdemeanor offense under 609.378 (neglect or endangerment 
485.34  of a child), a gross misdemeanor offense under 609.377 
485.35  (malicious punishment of a child), 609.72, subdivision 3 
485.36  (disorderly conduct against a vulnerable adult); or an attempt 
486.1   or conspiracy to commit any of these offenses, as each of these 
486.2   offenses is defined in Minnesota Statutes; or an offense in any 
486.3   other state, the elements of which are substantially similar to 
486.4   the elements of any of the foregoing offenses; 
486.5      (2) regardless of how much time has passed since the 
486.6   discharge of the sentence imposed for the offense, the 
486.7   individual was convicted of a violation of any offense listed in 
486.8   sections 609.185 to 609.195 (murder in the first, second, or 
486.9   third degree), 609.2661 to 609.2663 (murder of an unborn child 
486.10  in the first, second, or third degree), a felony offense under 
486.11  609.377 (malicious punishment of a child), a felony offense 
486.12  under 609.324, subdivision 1 (other prohibited acts), a felony 
486.13  offense under 609.378 (neglect or endangerment of a child), 
486.14  609.322 (solicitation, inducement, and promotion of 
486.15  prostitution), 609.342 to 609.345 (criminal sexual conduct in 
486.16  the first, second, third, or fourth degree), 609.352 
486.17  (solicitation of children to engage in sexual conduct), 617.246 
486.18  (use of minors in a sexual performance), 617.247 (possession of 
486.19  pictorial representations of a minor), 609.365 (incest), a 
486.20  felony offense under sections 609.2242 and 609.2243 (domestic 
486.21  assault), a felony offense of spousal abuse, a felony offense of 
486.22  child abuse or neglect, a felony offense of a crime against 
486.23  children, or an attempt or conspiracy to commit any of these 
486.24  offenses as defined in Minnesota Statutes, or an offense in any 
486.25  other state, the elements of which are substantially similar to 
486.26  any of the foregoing offenses; 
486.27     (3) within the seven years preceding the study, the 
486.28  individual committed an act that constitutes maltreatment of a 
486.29  child under section 626.556, subdivision 10e, and that resulted 
486.30  in substantial bodily harm as defined in section 609.02, 
486.31  subdivision 7a, or substantial mental or emotional harm as 
486.32  supported by competent psychological or psychiatric evidence; or 
486.33     (4) within the seven years preceding the study, the 
486.34  individual was determined under section 626.557 to be the 
486.35  perpetrator of a substantiated incident of maltreatment of a 
486.36  vulnerable adult that resulted in substantial bodily harm as 
487.1   defined in section 609.02, subdivision 7a, or substantial mental 
487.2   or emotional harm as supported by competent psychological or 
487.3   psychiatric evidence. 
487.4      In the case of any ground for disqualification under 
487.5   clauses (1) to (4), if the act was committed by an individual 
487.6   other than the applicant or, license holder, or registrant 
487.7   residing in the applicant's or, license holder's, or 
487.8   registrant's home, the applicant or, license holder, or 
487.9   registrant may seek reconsideration when the individual who 
487.10  committed the act no longer resides in the home.  
487.11     The disqualification periods provided under clauses (1), 
487.12  (3), and (4) are the minimum applicable disqualification 
487.13  periods.  The commissioner may determine that an individual 
487.14  should continue to be disqualified from licensure or 
487.15  registration because the license holder or, applicant, or 
487.16  registrant poses a risk of harm to a person served by that 
487.17  individual after the minimum disqualification period has passed. 
487.18     (d) The commissioner shall respond in writing or by 
487.19  electronic transmission to all reconsideration requests for 
487.20  which the basis for the request is that the information relied 
487.21  upon by the commissioner to disqualify is incorrect or 
487.22  inaccurate within 30 working days of receipt of a request and 
487.23  all relevant information.  If the basis for the request is that 
487.24  the individual does not pose a risk of harm, the commissioner 
487.25  shall respond to the request within 15 working days after 
487.26  receiving the request for reconsideration and all relevant 
487.27  information.  If the request is based on both the correctness or 
487.28  accuracy of the information relied on to disqualify the 
487.29  individual and the risk of harm, the commissioner shall respond 
487.30  to the request within 45 working days after receiving the 
487.31  request for reconsideration and all relevant information.  If 
487.32  the disqualification is set aside, the commissioner shall notify 
487.33  the applicant or license holder in writing or by electronic 
487.34  transmission of the decision. 
487.35     (e) Except as provided in subdivision 3c, the 
487.36  commissioner's decision to disqualify an individual, including 
488.1   the decision to grant or deny a rescission or set aside a 
488.2   disqualification under this section, is the final administrative 
488.3   agency action and shall not be subject to further review in a 
488.4   contested case under chapter 14 involving a negative licensing 
488.5   appeal taken in response to the disqualification or involving an 
488.6   accuracy and completeness appeal under section 13.04. if a 
488.7   disqualification is not set aside or is not rescinded, an 
488.8   individual who was disqualified on the basis of a preponderance 
488.9   of evidence that the individual committed an act or acts that 
488.10  meet the definition of any of the crimes lists in subdivision 
488.11  3d, paragraph (a), clauses (1) to (4); or for failure to make 
488.12  required reports under section 626.556, subdivision 3, or 
488.13  626.557, subdivision 3, pursuant to subdivision 3d, paragraph 
488.14  (a), clause (4), may request a fair hearing under section 
488.15  256.045.  Except as provided under subdivision 3c, the 
488.16  commissioner's final order for an individual under this 
488.17  paragraph is conclusive on the issue of disqualification, 
488.18  including for purposes of subsequent studies conducted under 
488.19  section 245A.04, subdivision 3, and is the only administrative 
488.20  appeal of the final agency determination, specifically, 
488.21  including a challenge to the accuracy and completeness of data 
488.22  under section 13.04. 
488.23     (f) Except as provided under subdivision 3c, if an 
488.24  individual was disqualified on the basis of a determination of 
488.25  maltreatment under section 626.556 or 626.557, which was serious 
488.26  or recurring, and the individual has requested reconsideration 
488.27  of the maltreatment determination under section 626.556, 
488.28  subdivision 10i, or 626.557, subdivision 9d, and also requested 
488.29  reconsideration of the disqualification under this subdivision, 
488.30  reconsideration of the maltreatment determination and 
488.31  reconsideration of the disqualification shall be consolidated 
488.32  into a single reconsideration.  For maltreatment and 
488.33  disqualification determinations made by county agencies, the 
488.34  consolidated reconsideration shall be conducted by the county 
488.35  agency.  Except as provided under subdivision 3c, if an 
488.36  individual who was disqualified on the basis of serious or 
489.1   recurring maltreatment requests a fair hearing on the 
489.2   maltreatment determination under section 626.556, subdivision 
489.3   10i, or 626.557, subdivision 9d, the scope of the fair hearing 
489.4   under section 256.045 shall include the maltreatment 
489.5   determination and the disqualification.  Except as provided 
489.6   under subdivision 3c, the commissioner's final order for an 
489.7   individual under this paragraph is conclusive on the issue of 
489.8   maltreatment and disqualification, including for purposes of 
489.9   subsequent studies conducted under subdivision 3, and is the 
489.10  only administrative appeal of the final agency determination, 
489.11  specifically, including a challenge to the accuracy and 
489.12  completeness of data under section 13.04. 
489.13     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
489.14     Sec. 7.  Minnesota Statutes 2000, section 245A.04, 
489.15  subdivision 3c, is amended to read: 
489.16     Subd. 3c.  [CONTESTED CASE.] (a) Notwithstanding 
489.17  subdivision 3b, paragraphs (e) and (f), if a disqualification is 
489.18  not set aside, a person who is an employee of an employer, as 
489.19  defined in section 179A.03, subdivision 15, may request a 
489.20  contested case hearing under chapter 14.  If the 
489.21  disqualification which was not set aside or was not rescinded 
489.22  was based on a maltreatment determination, the scope of the 
489.23  contested case hearing shall include the maltreatment 
489.24  determination and the disqualification.  In such cases, a fair 
489.25  hearing shall not be conducted under section 256.045.  Rules 
489.26  adopted under this chapter may not preclude an employee in a 
489.27  contested case hearing for disqualification from submitting 
489.28  evidence concerning information gathered under subdivision 3, 
489.29  paragraph (e). 
489.30     (b) If a disqualification for which reconsideration was 
489.31  requested and which was not set aside or was not rescinded under 
489.32  subdivision 3b is the basis for a denial of a license under 
489.33  section 245A.05 or a licensing sanction under section 245A.07, 
489.34  the license holder has the right to a contested case hearing 
489.35  under chapter 14 and Minnesota Rules, parts 1400.8510 to 
489.36  1400.8612 and successor rules.  The appeal must be submitted in 
490.1   accordance with section 245A.05 or 245A.07, subdivision 3.  As 
490.2   provided for under section 245A.08, subdivision 2a, the scope of 
490.3   the consolidated contested case hearing shall include the 
490.4   disqualification and the licensing sanction or denial of a 
490.5   license.  If the disqualification was based on a determination 
490.6   of substantiated serious or recurring maltreatment under section 
490.7   626.556 or 626.557, the appeal must be submitted in accordance 
490.8   with sections 245A.07, subdivision 3, and 626.556, subdivision 
490.9   10i, or 626.557, subdivision 9d.  As provided for under section 
490.10  245A.08, subdivision 2a, the scope of the contested case hearing 
490.11  shall include the maltreatment determination, the 
490.12  disqualification, and the licensing sanction or denial of a 
490.13  license.  In such cases, a fair hearing shall not be conducted 
490.14  under section 256.045. 
490.15     (c) If a maltreatment determination or disqualification, 
490.16  which was not set aside or was not rescinded under subdivision 
490.17  3b, is the basis for a denial of a license under section 245A.05 
490.18  or a licensing sanction under section 245A.07, and the 
490.19  disqualified subject is an individual other than the license 
490.20  holder and upon whom a background study must be conducted under 
490.21  subdivision 3, the hearing of all parties may be consolidated 
490.22  into a single contested case hearing upon consent of all parties 
490.23  and the administrative law judge.  
490.24     (d) The commissioner's final order under section 245A.08, 
490.25  subdivision 5, is conclusive on the issue of maltreatment and 
490.26  disqualification, including for purposes of subsequent 
490.27  background studies.  The contested case hearing under this 
490.28  subdivision is the only administrative appeal of the final 
490.29  agency determination, specifically, including a challenge to the 
490.30  accuracy and completeness of data under section 13.04. 
490.31     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
490.32     Sec. 8.  Minnesota Statutes 2000, section 245A.04, 
490.33  subdivision 3d, is amended to read: 
490.34     Subd. 3d.  [DISQUALIFICATION.] (a) Except as provided in 
490.35  paragraph (b), when a background study completed under 
490.36  subdivision 3 shows any of the following:  a conviction of one 
491.1   or more crimes listed in clauses (1) to (4); the individual has 
491.2   admitted to or a preponderance of the evidence indicates the 
491.3   individual has committed an act or acts that meet the definition 
491.4   of any of the crimes listed in clauses (1) to (4); or an 
491.5   investigation results in an administrative determination listed 
491.6   under clause (4), the individual shall be disqualified from any 
491.7   position allowing direct contact with persons receiving services 
491.8   from the license holder, registrant and for individuals studied 
491.9   under section 245A.04, subdivision 3, paragraph (c), clauses 
491.10  (2), (6), and (7), in H.F. 1381, if enacted, the individual 
491.11  shall also be disqualified from access to persons receiving 
491.12  services from the license holder: 
491.13     (1) regardless of how much time has passed since the 
491.14  discharge of the sentence imposed for the offense, and unless 
491.15  otherwise specified, regardless of the level of the conviction, 
491.16  the individual was convicted of any of the following offenses:  
491.17  sections 609.185 (murder in the first degree); 609.19 (murder in 
491.18  the second degree); 609.195 (murder in the third degree); 
491.19  609.2661 (murder of an unborn child in the first degree); 
491.20  609.2662 (murder of an unborn child in the second degree); 
491.21  609.2663 (murder of an unborn child in the third degree); 
491.22  609.322 (solicitation, inducement, and promotion of 
491.23  prostitution); 609.342 (criminal sexual conduct in the first 
491.24  degree); 609.343 (criminal sexual conduct in the second degree); 
491.25  609.344 (criminal sexual conduct in the third degree); 609.345 
491.26  (criminal sexual conduct in the fourth degree); 609.352 
491.27  (solicitation of children to engage in sexual conduct); 609.365 
491.28  (incest); felony offense under 609.377 (malicious punishment of 
491.29  a child); a felony offense under 609.378 (neglect or 
491.30  endangerment of a child); a felony offense under 609.324, 
491.31  subdivision 1 (other prohibited acts); 617.246 (use of minors in 
491.32  sexual performance prohibited); 617.247 (possession of pictorial 
491.33  representations of minors); a felony offense under sections 
491.34  609.2242 and 609.2243 (domestic assault), a felony offense of 
491.35  spousal abuse, a felony offense of child abuse or neglect, a 
491.36  felony offense of a crime against children; or attempt or 
492.1   conspiracy to commit any of these offenses as defined in 
492.2   Minnesota Statutes, or an offense in any other state or country, 
492.3   where the elements are substantially similar to any of the 
492.4   offenses listed in this clause; 
492.5      (2) if less than 15 years have passed since the discharge 
492.6   of the sentence imposed for the offense; and the individual has 
492.7   received a felony conviction for a violation of any of these 
492.8   offenses:  sections 609.20 (manslaughter in the first degree); 
492.9   609.205 (manslaughter in the second degree); 609.21 (criminal 
492.10  vehicular homicide and injury); 609.215 (suicide); 609.221 to 
492.11  609.2231 (assault in the first, second, third, or fourth 
492.12  degree); repeat offenses under 609.224 (assault in the fifth 
492.13  degree); repeat offenses under 609.3451 (criminal sexual conduct 
492.14  in the fifth degree); 609.713 (terroristic threats); 609.235 
492.15  (use of drugs to injure or facilitate crime); 609.24 (simple 
492.16  robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 
492.17  609.255 (false imprisonment); 609.561 (arson in the first 
492.18  degree); 609.562 (arson in the second degree); 609.563 (arson in 
492.19  the third degree); repeat offenses under 617.23 (indecent 
492.20  exposure; penalties); repeat offenses under 617.241 (obscene 
492.21  materials and performances; distribution and exhibition 
492.22  prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 
492.23  609.67 (machine guns and short-barreled shotguns); 609.749 
492.24  (harassment; stalking; penalties); 609.228 (great bodily harm 
492.25  caused by distribution of drugs); 609.2325 (criminal abuse of a 
492.26  vulnerable adult); 609.2664 (manslaughter of an unborn child in 
492.27  the first degree); 609.2665 (manslaughter of an unborn child in 
492.28  the second degree); 609.267 (assault of an unborn child in the 
492.29  first degree); 609.2671 (assault of an unborn child in the 
492.30  second degree); 609.268 (injury or death of an unborn child in 
492.31  the commission of a crime); 609.52 (theft); 609.2335 (financial 
492.32  exploitation of a vulnerable adult); 609.521 (possession of 
492.33  shoplifting gear); 609.582 (burglary); 609.625 (aggravated 
492.34  forgery); 609.63 (forgery); 609.631 (check forgery; offering a 
492.35  forged check); 609.635 (obtaining signature by false pretense); 
492.36  609.27 (coercion); 609.275 (attempt to coerce); 609.687 
493.1   (adulteration); 260C.301 (grounds for termination of parental 
493.2   rights); and chapter 152 (drugs; controlled substance).  An 
493.3   attempt or conspiracy to commit any of these offenses, as each 
493.4   of these offenses is defined in Minnesota Statutes; or an 
493.5   offense in any other state or country, the elements of which are 
493.6   substantially similar to the elements of the offenses in this 
493.7   clause.  If the individual studied is convicted of one of the 
493.8   felonies listed in this clause, but the sentence is a gross 
493.9   misdemeanor or misdemeanor disposition, the lookback period for 
493.10  the conviction is the period applicable to the disposition, that 
493.11  is the period for gross misdemeanors or misdemeanors; 
493.12     (3) if less than ten years have passed since the discharge 
493.13  of the sentence imposed for the offense; and the individual has 
493.14  received a gross misdemeanor conviction for a violation of any 
493.15  of the following offenses:  sections 609.224 (assault in the 
493.16  fifth degree); 609.2242 and 609.2243 (domestic assault); 
493.17  violation of an order for protection under 518B.01, subdivision 
493.18  14; 609.3451 (criminal sexual conduct in the fifth degree); 
493.19  repeat offenses under 609.746 (interference with privacy); 
493.20  repeat offenses under 617.23 (indecent exposure); 617.241 
493.21  (obscene materials and performances); 617.243 (indecent 
493.22  literature, distribution); 617.293 (harmful materials; 
493.23  dissemination and display to minors prohibited); 609.71 (riot); 
493.24  609.66 (dangerous weapons); 609.749 (harassment; stalking; 
493.25  penalties); 609.224, subdivision 2, paragraph (c) (assault in 
493.26  the fifth degree by a caregiver against a vulnerable adult); 
493.27  609.23 (mistreatment of persons confined); 609.231 (mistreatment 
493.28  of residents or patients); 609.2325 (criminal abuse of a 
493.29  vulnerable adult); 609.233 (criminal neglect of a vulnerable 
493.30  adult); 609.2335 (financial exploitation of a vulnerable adult); 
493.31  609.234 (failure to report maltreatment of a vulnerable adult); 
493.32  609.72, subdivision 3 (disorderly conduct against a vulnerable 
493.33  adult); 609.265 (abduction); 609.378 (neglect or endangerment of 
493.34  a child); 609.377 (malicious punishment of a child); 609.324, 
493.35  subdivision 1a (other prohibited acts; minor engaged in 
493.36  prostitution); 609.33 (disorderly house); 609.52 (theft); 
494.1   609.582 (burglary); 609.631 (check forgery; offering a forged 
494.2   check); 609.275 (attempt to coerce); or an attempt or conspiracy 
494.3   to commit any of these offenses, as each of these offenses is 
494.4   defined in Minnesota Statutes; or an offense in any other state 
494.5   or country, the elements of which are substantially similar to 
494.6   the elements of any of the offenses listed in this clause.  If 
494.7   the defendant is convicted of one of the gross misdemeanors 
494.8   listed in this clause, but the sentence is a misdemeanor 
494.9   disposition, the lookback period for the conviction is the 
494.10  period applicable to misdemeanors; or 
494.11     (4) if less than seven years have passed since the 
494.12  discharge of the sentence imposed for the offense; and the 
494.13  individual has received a misdemeanor conviction for a violation 
494.14  of any of the following offenses:  sections 609.224 (assault in 
494.15  the fifth degree); 609.2242 (domestic assault); violation of an 
494.16  order for protection under 518B.01 (Domestic Abuse Act); 
494.17  violation of an order for protection under 609.3232 (protective 
494.18  order authorized; procedures; penalties); 609.746 (interference 
494.19  with privacy); 609.79 (obscene or harassing phone calls); 
494.20  609.795 (letter, telegram, or package; opening; harassment); 
494.21  617.23 (indecent exposure; penalties); 609.2672 (assault of an 
494.22  unborn child in the third degree); 617.293 (harmful materials; 
494.23  dissemination and display to minors prohibited); 609.66 
494.24  (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 
494.25  exploitation of a vulnerable adult); 609.234 (failure to report 
494.26  maltreatment of a vulnerable adult); 609.52 (theft); 609.27 
494.27  (coercion); or an attempt or conspiracy to commit any of these 
494.28  offenses, as each of these offenses is defined in Minnesota 
494.29  Statutes; or an offense in any other state or country, the 
494.30  elements of which are substantially similar to the elements of 
494.31  any of the offenses listed in this clause; failure to make 
494.32  required reports under section 626.556, subdivision 3, or 
494.33  626.557, subdivision 3, for incidents in which:  (i) the final 
494.34  disposition under section 626.556 or 626.557 was substantiated 
494.35  maltreatment, and (ii) the maltreatment was recurring or 
494.36  serious; or substantiated serious or recurring maltreatment of a 
495.1   minor under section 626.556 or of a vulnerable adult under 
495.2   section 626.557 for which there is a preponderance of evidence 
495.3   that the maltreatment occurred, and that the subject was 
495.4   responsible for the maltreatment. 
495.5      For the purposes of this section, "serious maltreatment" 
495.6   means sexual abuse; maltreatment resulting in death; or 
495.7   maltreatment resulting in serious injury which reasonably 
495.8   requires the care of a physician whether or not the care of a 
495.9   physician was sought; or abuse resulting in serious injury.  For 
495.10  purposes of this section, "abuse resulting in serious injury" 
495.11  means:  bruises, bites, skin laceration or tissue damage; 
495.12  fractures; dislocations; evidence of internal injuries; head 
495.13  injuries with loss of consciousness; extensive second-degree or 
495.14  third-degree burns and other burns for which complications are 
495.15  present; extensive second-degree or third-degree frostbite, and 
495.16  others for which complications are present; irreversible 
495.17  mobility or avulsion of teeth; injuries to the eyeball; 
495.18  ingestion of foreign substances and objects that are harmful; 
495.19  near drowning; and heat exhaustion or sunstroke.  For purposes 
495.20  of this section, "care of a physician" is treatment received or 
495.21  ordered by a physician, but does not include diagnostic testing, 
495.22  assessment, or observation.  For the purposes of this section, 
495.23  "recurring maltreatment" means more than one incident of 
495.24  maltreatment for which there is a preponderance of evidence that 
495.25  the maltreatment occurred, and that the subject was responsible 
495.26  for the maltreatment.  For purposes of this section, "access" 
495.27  means physical access to an individual receiving services or the 
495.28  individual's personal property without continuous, direct 
495.29  supervision as defined in section 245A.04, subdivision 3.  
495.30     (b) If Except for background studies related to child 
495.31  foster care, adult foster care, or family child care licensure, 
495.32  when the subject of a background study is licensed regulated by 
495.33  a health-related licensing board as defined in chapter 214, and 
495.34  the regulated person has been determined to have been 
495.35  responsible for substantiated maltreatment under section 626.556 
495.36  or 626.557, instead of the commissioner making a decision 
496.1   regarding disqualification, the board shall make the a 
496.2   determination regarding a disqualification under this 
496.3   subdivision based on a finding of substantiated maltreatment 
496.4   under section 626.556 or 626.557.  The commissioner shall notify 
496.5   the health-related licensing board if a background study shows 
496.6   that a licensee would be disqualified because of substantiated 
496.7   maltreatment and the board shall make a determination under 
496.8   section 214.104. whether to impose disciplinary or corrective 
496.9   action under chapter 214. 
496.10     (1) The commissioner shall notify the health-related 
496.11  licensing board: 
496.12     (i) upon completion of a background study that produces a 
496.13  record showing that the individual was determined to have been 
496.14  responsible for substantiated maltreatment; 
496.15     (ii) upon the commissioner's completion of an investigation 
496.16  that determined the individual was responsible for substantiated 
496.17  maltreatment; or 
496.18     (iii) upon receipt from another agency of a finding of 
496.19  substantiated maltreatment for which the individual was 
496.20  responsible. 
496.21     (2) The commissioner's notice shall indicate whether the 
496.22  individual would have been disqualified by the commissioner for 
496.23  the substantiated maltreatment if the individual were not 
496.24  regulated by the board.  The commissioner shall concurrently 
496.25  send a copy of this notice to the individual.  
496.26     (3) Notwithstanding the exclusion from this subdivision for 
496.27  individuals who provide child foster care, adult foster care, or 
496.28  family child care, when the commissioner or a local agency has 
496.29  reason to believe that the direct contact services provided by 
496.30  the individual may fall within the jurisdiction of a 
496.31  health-related licensing board, a referral shall be made to the 
496.32  board as provided in this section. 
496.33     (4) If, upon review of the information provided by the 
496.34  commissioner, a health-related licensing board informs the 
496.35  commissioner that the board does not have jurisdiction to take 
496.36  disciplinary or corrective action, the commissioner shall make 
497.1   the appropriate disqualification decision regarding the 
497.2   individual as otherwise provided in this chapter. 
497.3      (5) The commissioner has the authority to monitor the 
497.4   facility's compliance with any requirements that the 
497.5   health-related licensing board places on regulated persons 
497.6   practicing in a facility either during the period pending a 
497.7   final decision on a disciplinary or corrective action or as a 
497.8   result of a disciplinary or corrective action.  The commissioner 
497.9   has the authority to order the immediate removal of a regulated 
497.10  person from direct contact or access when a board issues an 
497.11  order of temporary suspension based on a determination that the 
497.12  regulated person poses an immediate risk of harm to persons 
497.13  receiving services in a licensed facility. 
497.14     (6) A facility that allows a regulated person to provide 
497.15  direct contact services while not complying with the 
497.16  requirements imposed by the health-related licensing board is 
497.17  subject to action by the commissioner as specified under 
497.18  sections 245A.06 and 245A.07. 
497.19     (7) The commissioner shall notify a health-related 
497.20  licensing board immediately upon receipt of knowledge of 
497.21  noncompliance with requirements placed on a facility or upon a 
497.22  person regulated by the board. 
497.23     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
497.24     Sec. 9.  Minnesota Statutes 2000, section 245A.05, is 
497.25  amended to read: 
497.26     245A.05 [DENIAL OF APPLICATION.] 
497.27     The commissioner may deny a license if an applicant fails 
497.28  to comply with applicable laws or rules, or knowingly withholds 
497.29  relevant information from or gives false or misleading 
497.30  information to the commissioner in connection with an 
497.31  application for a license or during an investigation.  An 
497.32  applicant whose application has been denied by the commissioner 
497.33  must be given notice of the denial.  Notice must be given by 
497.34  certified mail.  The notice must state the reasons the 
497.35  application was denied and must inform the applicant of the 
497.36  right to a contested case hearing under chapter 14 and Minnesota 
498.1   Rules, parts 1400.8510 to 1400.8612 and successor rules.  The 
498.2   applicant may appeal the denial by notifying the commissioner in 
498.3   writing by certified mail within 20 calendar days after 
498.4   receiving notice that the application was denied.  Section 
498.5   245A.08 applies to hearings held to appeal the commissioner's 
498.6   denial of an application. 
498.7      <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
498.8      Sec. 10.  Minnesota Statutes 2000, section 245A.06, is 
498.9   amended to read: 
498.10     245A.06 [CORRECTION ORDER AND FINES CONDITIONAL LICENSE.] 
498.11     Subdivision 1.  [CONTENTS OF CORRECTION ORDERS OR FINES AND 
498.12  CONDITIONAL LICENSES.] (a) If the commissioner finds that the 
498.13  applicant or license holder has failed to comply with an 
498.14  applicable law or rule and this failure does not imminently 
498.15  endanger the health, safety, or rights of the persons served by 
498.16  the program, the commissioner may issue a correction order and 
498.17  an order of conditional license to or impose a fine on the 
498.18  applicant or license holder.  When issuing a conditional 
498.19  license, the commissioner shall consider the nature, chronicity, 
498.20  or severity of the violation of law or rule and the effect of 
498.21  the violation on the health, safety, or rights of persons served 
498.22  by the program.  The correction order or fine conditional 
498.23  license must state: 
498.24     (1) the conditions that constitute a violation of the law 
498.25  or rule; 
498.26     (2) the specific law or rule violated; 
498.27     (3) the time allowed to correct each violation; and 
498.28     (4) if a fine is imposed, the amount of the fine license is 
498.29  made conditional, the length and terms of the conditional 
498.30  license. 
498.31     (b) Nothing in this section prohibits the commissioner from 
498.32  proposing a sanction as specified in section 245A.07, prior to 
498.33  issuing a correction order or fine conditional license. 
498.34     Subd. 2.  [RECONSIDERATION OF CORRECTION ORDERS.] If the 
498.35  applicant or license holder believes that the contents of the 
498.36  commissioner's correction order are in error, the applicant or 
499.1   license holder may ask the department of human services to 
499.2   reconsider the parts of the correction order that are alleged to 
499.3   be in error.  The request for reconsideration must be in writing 
499.4   and received by the commissioner within 20 calendar days after 
499.5   receipt of the correction order by the applicant or license 
499.6   holder, and: 
499.7      (1) specify the parts of the correction order that are 
499.8   alleged to be in error; 
499.9      (2) explain why they are in error; and 
499.10     (3) include documentation to support the allegation of 
499.11  error. 
499.12     A request for reconsideration does not stay any provisions 
499.13  or requirements of the correction order.  The commissioner's 
499.14  disposition of a request for reconsideration is final and not 
499.15  subject to appeal under chapter 14. 
499.16     Subd. 3.  [FAILURE TO COMPLY.] If the commissioner finds 
499.17  that the applicant or license holder has not corrected the 
499.18  violations specified in the correction order or conditional 
499.19  license, the commissioner may impose a fine and order other 
499.20  licensing sanctions pursuant to section 245A.07.  If a fine was 
499.21  imposed and the violation was not corrected, the commissioner 
499.22  may impose an additional fine.  This section does not prohibit 
499.23  the commissioner from seeking a court order, denying an 
499.24  application, or suspending, revoking, or making conditional the 
499.25  license in addition to imposing a fine. 
499.26     Subd. 4.  [NOTICE OF FINE CONDITIONAL LICENSE; 
499.27  RECONSIDERATION OF FINE CONDITIONAL LICENSE.] A license holder 
499.28  who is ordered to pay a fine If a license is made conditional, 
499.29  the license holder must be notified of the order by certified 
499.30  mail.  The notice must be mailed to the address shown on the 
499.31  application or the last known address of the license holder.  
499.32  The notice must state the reasons the fine conditional license 
499.33  was ordered and must inform the license holder of the 
499.34  responsibility for payment of fines in subdivision 7 and the 
499.35  right to request reconsideration of the fine conditional license 
499.36  by the commissioner.  The license holder may request 
500.1   reconsideration of the order to forfeit a fine of conditional 
500.2   license by notifying the commissioner by certified mail within 
500.3   20 calendar days after receiving the order.  The request must be 
500.4   in writing and must be received by the commissioner within ten 
500.5   calendar days after the license holder received the order.  The 
500.6   license holder may submit with the request for reconsideration 
500.7   written argument or evidence in support of the request for 
500.8   reconsideration.  A timely request for reconsideration shall 
500.9   stay forfeiture of the fine imposition of the terms of the 
500.10  conditional license until the commissioner issues a decision on 
500.11  the request for reconsideration.  The request for 
500.12  reconsideration must be in writing and: 
500.13     (1) specify the parts of the violation that are alleged to 
500.14  be in error; 
500.15     (2) explain why they are in error; 
500.16     (3) include documentation to support the allegation of 
500.17  error; and 
500.18     (4) any other information relevant to the fine or the 
500.19  amount of the fine. 
500.20     The commissioner's disposition of a request for 
500.21  reconsideration is final and not subject to appeal under chapter 
500.22  14. 
500.23     Subd. 5.  [FORFEITURE OF FINES.] The license holder shall 
500.24  pay the fines assessed on or before the payment date specified 
500.25  in the commissioner's order.  If the license holder fails to 
500.26  fully comply with the order, the commissioner shall issue a 
500.27  second fine or suspend the license until the license holder 
500.28  complies.  If the license holder receives state funds, the 
500.29  state, county, or municipal agencies or departments responsible 
500.30  for administering the funds shall withhold payments and recover 
500.31  any payments made while the license is suspended for failure to 
500.32  pay a fine.  
500.33     Subd. 5a.  [ACCRUAL OF FINES.] A license holder shall 
500.34  promptly notify the commissioner of human services, in writing, 
500.35  when a violation specified in an order to forfeit is corrected.  
500.36  If upon reinspection the commissioner determines that a 
501.1   violation has not been corrected as indicated by the order to 
501.2   forfeit, the commissioner may issue a second fine.  The 
501.3   commissioner shall notify the license holder by certified mail 
501.4   that a second fine has been assessed.  The license holder may 
501.5   request reconsideration of the second fine under the provisions 
501.6   of subdivision 4. 
501.7      Subd. 6.  [AMOUNT OF FINES.] Fines shall be assessed as 
501.8   follows: 
501.9      (1) the license holder shall forfeit $1,000 for each 
501.10  occurrence of violation of law or rule prohibiting the 
501.11  maltreatment of children or the maltreatment of vulnerable 
501.12  adults, including but not limited to corporal punishment, 
501.13  illegal or unauthorized use of physical, mechanical, or chemical 
501.14  restraints, and illegal or unauthorized use of aversive or 
501.15  deprivation procedures; 
501.16     (2) the license holder shall forfeit $200 for each 
501.17  occurrence of a violation of law or rule governing matters of 
501.18  health, safety, or supervision, including but not limited to the 
501.19  provision of adequate staff to child or adult ratios; and 
501.20     (3) the license holder shall forfeit $100 for each 
501.21  occurrence of a violation of law or rule other than those 
501.22  included in clauses (1) and (2). 
501.23     For the purposes of this section, "occurrence" means each 
501.24  violation identified in the commissioner's forfeiture order. 
501.25     Subd. 7.  [RESPONSIBILITY FOR PAYMENT OF FINES.] When a 
501.26  fine has been assessed, the license holder may not avoid payment 
501.27  by closing, selling, or otherwise transferring the licensed 
501.28  program to a third party.  In such an event, the license holder 
501.29  will be personally liable for payment.  In the case of a 
501.30  corporation, each controlling individual is personally and 
501.31  jointly liable for payment. 
501.32     Fines for child care centers must be assessed according to 
501.33  this section. 
501.34     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
501.35     Sec. 11.  Minnesota Statutes 2000, section 245A.07, is 
501.36  amended to read: 
502.1      245A.07 [SANCTIONS.] 
502.2      Subdivision 1.  [SANCTIONS AVAILABLE.] In addition to 
502.3   ordering forfeiture of fines making a license conditional under 
502.4   section 245A.06, the commissioner may propose to suspend, or 
502.5   revoke, or make conditional the license, impose a fine, or 
502.6   secure an injunction against the continuing operation of the 
502.7   program of a license holder who does not comply with applicable 
502.8   law or rule.  When applying sanctions authorized under this 
502.9   section, the commissioner shall consider the nature, chronicity, 
502.10  or severity of the violation of law or rule and the effect of 
502.11  the violation on the health, safety, or rights of persons served 
502.12  by the program. 
502.13     Subd. 2.  [IMMEDIATE SUSPENSION IN CASES OF IMMINENT DANGER 
502.14  TO HEALTH, SAFETY, OR RIGHTS TEMPORARY IMMEDIATE SUSPENSION.] (a)
502.15  If the license holder's actions or failure to comply with 
502.16  applicable law or rule has placed poses an imminent risk of harm 
502.17  to the health, safety, or rights of persons served by the 
502.18  program in imminent danger, the commissioner shall act 
502.19  immediately to temporarily suspend the license.  No state funds 
502.20  shall be made available or be expended by any agency or 
502.21  department of state, county, or municipal government for use by 
502.22  a license holder regulated under this chapter while a license is 
502.23  under immediate suspension.  A notice stating the reasons for 
502.24  the immediate suspension and informing the license holder of the 
502.25  right to a contested case an expedited hearing under chapter 
502.26  14 and Minnesota Rules, parts 1400.8510 to 1400.8612 and 
502.27  successor rules, must be delivered by personal service to the 
502.28  address shown on the application or the last known address of 
502.29  the license holder.  The license holder may appeal an order 
502.30  immediately suspending a license.  The appeal of an order 
502.31  immediately suspending a license must be made in writing by 
502.32  certified mail and must be received by the commissioner within 
502.33  five calendar days after the license holder receives notice that 
502.34  the license has been immediately suspended.  A license holder 
502.35  and any controlling individual shall discontinue operation of 
502.36  the program upon receipt of the commissioner's order to 
503.1   immediately suspend the license. 
503.2      (b) The commissioner is liable to the license holder for 
503.3   actual damages for days of lost service in an amount not more 
503.4   than $50,000 when: 
503.5      (1) the commissioner immediately suspends a license under 
503.6   paragraph (a); and 
503.7      (2) the administrative law judge recommends, after a review 
503.8   of the facts in an expedited hearing under chapter 14 and 
503.9   Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 
503.10  rules, that reasonable cause did not exist at the time the 
503.11  commissioner issued the immediate suspension.  
503.12     (c) If the commissioner immediately suspends a license 
503.13  under paragraph (a) and the administrative law judge recommends 
503.14  that reasonable cause exists for the immediate suspension, the 
503.15  commissioner is not liable to the license holder. 
503.16     Subd. 2a.  [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 
503.17  Within five working days of receipt of the license holder's 
503.18  timely appeal, the commissioner shall request assignment of an 
503.19  administrative law judge.  The request must include a proposed 
503.20  date, time, and place of a hearing.  A hearing must be conducted 
503.21  by an administrative law judge within 30 calendar days of the 
503.22  request for assignment, unless an extension is requested by 
503.23  either party and granted by the administrative law judge for 
503.24  good cause.  The commissioner shall issue a notice of hearing by 
503.25  certified mail at least ten working days before the hearing.  
503.26  The scope of the hearing shall be limited solely to the issue of 
503.27  whether the temporary immediate suspension should remain in 
503.28  effect pending the commissioner's final order under section 
503.29  245A.08, regarding a licensing sanction issued under subdivision 
503.30  3 following the immediate suspension.  The burden of proof in 
503.31  expedited hearings under this subdivision shall be limited to 
503.32  the commissioner's demonstration that reasonable cause exists to 
503.33  believe that the license holder's actions or failure to comply 
503.34  with applicable law or rule poses an imminent risk of harm to 
503.35  the health, safety, or rights of persons served by the program.  
503.36     (b) The administrative law judge shall issue findings of 
504.1   fact, conclusions, and a recommendation within ten working days 
504.2   from the date of hearing.  The commissioner's final order shall 
504.3   be issued within ten working days from receipt of the 
504.4   recommendation of the administrative law judge.  Within 90 
504.5   calendar days after a final order affirming an immediate 
504.6   suspension, the commissioner shall make a determination 
504.7   regarding whether a final licensing sanction shall be issued 
504.8   under subdivision 3.  The license holder shall continue to be 
504.9   prohibited from operation of the program during this 90-day 
504.10  period. 
504.11     Subd. 3.  [LICENSE SUSPENSION, REVOCATION, DENIAL OR 
504.12  CONDITIONAL LICENSE FINE.] The commissioner may suspend, or 
504.13  revoke, make conditional, or deny a license, or impose a fine if 
504.14  an applicant or a license holder fails to comply fully with 
504.15  applicable laws or rules, or knowingly withholds relevant 
504.16  information from or gives false or misleading information to the 
504.17  commissioner in connection with an application for a license or 
504.18  during an investigation.  A license holder who has had a license 
504.19  suspended, revoked, or made conditional has been ordered to pay 
504.20  a fine must be given notice of the action by certified mail.  
504.21  The notice must be mailed to the address shown on the 
504.22  application or the last known address of the license holder.  
504.23  The notice must state the reasons the license was suspended, 
504.24  revoked, or made conditional a fine was ordered. 
504.25     (a) If the license was suspended or revoked, the notice 
504.26  must inform the license holder of the right to a contested case 
504.27  hearing under chapter 14 and Minnesota Rules, parts 1400.8510 to 
504.28  1400.8612 and successor rules.  The license holder may appeal an 
504.29  order suspending or revoking a license.  The appeal of an order 
504.30  suspending or revoking a license must be made in writing by 
504.31  certified mail and must be received by the commissioner within 
504.32  ten calendar days after the license holder receives notice that 
504.33  the license has been suspended or revoked.  
504.34     (b) If the license was made conditional, the notice must 
504.35  inform the license holder of the right to request a 
504.36  reconsideration by the commissioner.  The request for 
505.1   reconsideration must be made in writing by certified mail and 
505.2   must be received by the commissioner within ten calendar days 
505.3   after the license holder receives notice that the license has 
505.4   been made conditional.  The license holder may submit with the 
505.5   request for reconsideration written argument or evidence in 
505.6   support of the request for reconsideration.  The commissioner's 
505.7   disposition of a request for reconsideration is final and is not 
505.8   subject to appeal under chapter 14. (1) If the license holder 
505.9   was ordered to pay a fine, the notice must inform the license 
505.10  holder of the responsibility for payment of fines and the right 
505.11  to a contested case hearing under chapter 14 and Minnesota 
505.12  Rules, parts 1400.8510 to 1400.8612 and successor rules.  The 
505.13  appeal of an order to pay a fine must be made in writing by 
505.14  certified mail and must be received by the commissioner within 
505.15  ten calendar days after the license holder receives notice that 
505.16  the fine has been ordered.  
505.17     (2) The license holder shall pay the fines assessed on or 
505.18  before the payment date specified.  If the license holder fails 
505.19  to fully comply with the order, the commissioner may issue a 
505.20  second fine or suspend the license until the license holder 
505.21  complies.  If the license holder receives state funds, the 
505.22  state, county, or municipal agencies or departments responsible 
505.23  for administering the funds shall withhold payments and recover 
505.24  any payments made while the license is suspended for failure to 
505.25  pay a fine.  A timely appeal shall stay payment of the fine 
505.26  until the commissioner issues a final order.  
505.27     (3) A license holder shall promptly notify the commissioner 
505.28  of human services, in writing, when a violation specified in the 
505.29  order to forfeit a fine is corrected.  If upon reinspection the 
505.30  commissioner determines that a violation has not been corrected 
505.31  as indicated by the order to forfeit a fine, the commissioner 
505.32  may issue a second fine.  The commissioner shall notify the 
505.33  license holder by certified mail that a second fine has been 
505.34  assessed.  The license holder may appeal the second fine as 
505.35  provided under this subdivision. 
505.36     (4) Fines shall be assessed as follows:  the license holder 
506.1   shall forfeit $1,000 for each determination of maltreatment of a 
506.2   child under section 626.556 or the maltreatment of a vulnerable 
506.3   adult under section 626.557; the license holder shall forfeit 
506.4   $200 for each occurrence of a violation of law or rule governing 
506.5   matters of health, safety, or supervision, including but not 
506.6   limited to the provision of adequate staff to child or adult 
506.7   ratios, and failure to submit a background study; and the 
506.8   license holder shall forfeit $100 for each occurrence of a 
506.9   violation of law or rule other than those subject to a $1,000 or 
506.10  $200 fine above.  For purposes of this section, "occurrence" 
506.11  means each violation identified in the commissioner's fine order.
506.12     (5) When a fine has been assessed, the license holder may 
506.13  not avoid payment by closing, selling, or otherwise transferring 
506.14  the licensed program to a third party.  In such an event, the 
506.15  license holder will be personally liable for payment.  In the 
506.16  case of a corporation, each controlling individual is personally 
506.17  and jointly liable for payment. 
506.18     Subd. 4.  [ADOPTION AGENCY VIOLATIONS.] If a license holder 
506.19  licensed to place children for adoption fails to provide 
506.20  services as described in the disclosure form required by section 
506.21  259.37, subdivision 2, the sanctions under this section may be 
506.22  imposed. 
506.23     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
506.24     Sec. 12.  Minnesota Statutes 2000, section 245A.08, is 
506.25  amended to read: 
506.26     245A.08 [HEARINGS.] 
506.27     Subdivision 1.  [RECEIPT OF APPEAL; CONDUCT OF HEARING.] 
506.28  Upon receiving a timely appeal or petition pursuant to 
506.29  section 245A.04, subdivision 3c, 245A.05, or 245A.07, 
506.30  subdivision 3, the commissioner shall issue a notice of and 
506.31  order for hearing to the appellant under chapter 14 and 
506.32  Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 
506.33  rules. 
506.34     Subd. 2.  [CONDUCT OF HEARINGS.] At any hearing provided 
506.35  for by section 245A.04, subdivision 3c, 245A.05, or 245A.07, 
506.36  subdivision 3, the appellant may be represented by counsel and 
507.1   has the right to call, examine, and cross-examine witnesses.  
507.2   The administrative law judge may require the presence of 
507.3   witnesses and evidence by subpoena on behalf of any party.  
507.4      Subd. 2a.  [CONSOLIDATED CONTESTED CASE HEARINGS FOR 
507.5   SANCTIONS BASED ON MALTREATMENT DETERMINATIONS AND 
507.6   DISQUALIFICATIONS.] (a) When a denial of a license under section 
507.7   245A.05 or a licensing sanction under section 245A.07, 
507.8   subdivision 3, is based on a disqualification for which 
507.9   reconsideration was requested and which was not set aside or was 
507.10  not rescinded under section 245A.04, subdivision 3b, the scope 
507.11  of the contested case hearing shall include the disqualification 
507.12  and the licensing sanction or denial of a license.  When the 
507.13  licensing sanction or denial of a license is based on a 
507.14  determination of maltreatment under section 626.556 or 626.557, 
507.15  or a disqualification for serious or recurring maltreatment 
507.16  which was not set aside or was not rescinded, the scope of the 
507.17  contested case hearing shall include the maltreatment 
507.18  determination, disqualification, and the licensing sanction or 
507.19  denial of a license.  In such cases, a fair hearing under 
507.20  section 256.045 shall not be conducted as provided for in 
507.21  sections 626.556, subdivision 10i, and 626.557, subdivision 9d. 
507.22     (b) In consolidated contested case hearings regarding 
507.23  sanctions issued in family child care, child foster care, and 
507.24  adult foster care, the county attorney shall defend the 
507.25  commissioner's orders in accordance with section 245A.16, 
507.26  subdivision 4. 
507.27     (c) The commissioner's final order under subdivision 5 is 
507.28  the final agency action on the issue of maltreatment and 
507.29  disqualification, including for purposes of subsequent 
507.30  background studies under section 245A.04, subdivision 3, and is 
507.31  the only administrative appeal of the final agency 
507.32  determination, specifically, including a challenge to the 
507.33  accuracy and completeness of data under section 13.04. 
507.34     (d) When consolidated hearings under this subdivision 
507.35  involve a licensing sanction based on a previous maltreatment 
507.36  determination for which the commissioner has issued a final 
508.1   order in an appeal of that determination under section 256.045, 
508.2   or the individual failed to exercise the right to appeal the 
508.3   previous maltreatment determination under section 626.556, 
508.4   subdivision 10i, or 626.557, subdivision 9d, the commissioner's 
508.5   order is conclusive on the issue of maltreatment.  In such 
508.6   cases, the scope of the administrative law judge's review shall 
508.7   be limited to the disqualification and the licensing sanction or 
508.8   denial of a license.  In the case of a denial of a license or a 
508.9   licensing sanction issued to a facility based on a maltreatment 
508.10  determination regarding an individual who is not the license 
508.11  holder or a household member, the scope of the administrative 
508.12  law judge's review includes the maltreatment determination. 
508.13     (e) If a maltreatment determination or disqualification, 
508.14  which was not set aside or was not rescinded under section 
508.15  245A.04, subdivision 3b, is the basis for a denial of a license 
508.16  under section 245A.05 or a licensing sanction under section 
508.17  245A.07, and the disqualified subject is an individual other 
508.18  than the license holder and upon whom a background study must be 
508.19  conducted under section 245A.04, subdivision 3, the hearings of 
508.20  all parties may be consolidated into a single contested case 
508.21  hearing upon consent of all parties and the administrative law 
508.22  judge.  
508.23     Subd. 3.  [BURDEN OF PROOF.] (a) At a hearing regarding 
508.24  suspension, immediate suspension, or revocation of a license for 
508.25  family day care or foster care a licensing sanction under 
508.26  section 245A.07, including consolidated hearings under 
508.27  subdivision 2a, the commissioner may demonstrate reasonable 
508.28  cause for action taken by submitting statements, reports, or 
508.29  affidavits to substantiate the allegations that the license 
508.30  holder failed to comply fully with applicable law or rule.  If 
508.31  the commissioner demonstrates that reasonable cause existed, the 
508.32  burden of proof in hearings involving suspension, immediate 
508.33  suspension, or revocation of a family day care or foster care 
508.34  license shifts to the license holder to demonstrate by a 
508.35  preponderance of the evidence that the license holder was in 
508.36  full compliance with those laws or rules that the commissioner 
509.1   alleges the license holder violated, at the time that the 
509.2   commissioner alleges the violations of law or rules occurred. 
509.3      (b) At a hearing on denial of an application, the applicant 
509.4   bears the burden of proof to demonstrate by a preponderance of 
509.5   the evidence that the appellant has complied fully with sections 
509.6   245A.01 to 245A.15 this chapter and other applicable law or rule 
509.7   and that the application should be approved and a license 
509.8   granted. 
509.9      (c) At all other hearings under this section, the 
509.10  commissioner bears the burden of proof to demonstrate, by a 
509.11  preponderance of the evidence, that the violations of law or 
509.12  rule alleged by the commissioner occurred. 
509.13     Subd. 4.  [RECOMMENDATION OF ADMINISTRATIVE LAW JUDGE.] The 
509.14  administrative law judge shall recommend whether or not the 
509.15  commissioner's order should be affirmed.  The recommendations 
509.16  must be consistent with this chapter and the rules of the 
509.17  commissioner.  The recommendations must be in writing and 
509.18  accompanied by findings of fact and conclusions and must be 
509.19  mailed to the parties by certified mail to their last known 
509.20  addresses as shown on the license or application. 
509.21     Subd. 5.  [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 
509.22  considering the findings of fact, conclusions, and 
509.23  recommendations of the administrative law judge, the 
509.24  commissioner shall issue a final order.  The commissioner shall 
509.25  consider, but shall not be bound by, the recommendations of the 
509.26  administrative law judge.  The appellant must be notified of the 
509.27  commissioner's final order as required by chapter 14 and 
509.28  Minnesota Rules, parts 1400.8510 to 1400.8612 and successor 
509.29  rules.  The notice must also contain information about the 
509.30  appellant's rights under chapter 14 and Minnesota Rules, parts 
509.31  1400.8510 to 1400.8612 and successor rules.  The institution of 
509.32  proceedings for judicial review of the commissioner's final 
509.33  order shall not stay the enforcement of the final order except 
509.34  as provided in section 14.65.  A license holder and each 
509.35  controlling individual of a license holder whose license has 
509.36  been revoked because of noncompliance with applicable law or 
510.1   rule must not be granted a license for five years following the 
510.2   revocation.  An applicant whose application was denied must not 
510.3   be granted a license for two years following a denial, unless 
510.4   the applicant's subsequent application contains new information 
510.5   which constitutes a substantial change in the conditions that 
510.6   caused the previous denial. 
510.7      <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
510.8      Sec. 13.  Minnesota Statutes 2000, section 245A.16, 
510.9   subdivision 1, is amended to read: 
510.10     Subdivision 1.  [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 
510.11  County agencies and private agencies that have been designated 
510.12  or licensed by the commissioner to perform licensing functions 
510.13  and activities under section 245A.04, to recommend denial of 
510.14  applicants under section 245A.05, to issue correction orders, to 
510.15  issue variances, and recommend fines a conditional license under 
510.16  section 245A.06, or to recommend suspending, or revoking, and 
510.17  making licenses probationary a license or issuing a fine under 
510.18  section 245A.07, shall comply with rules and directives of the 
510.19  commissioner governing those functions and with this section. 
510.20     (b) For family day care programs, the commissioner may 
510.21  authorize licensing reviews every two years after a licensee has 
510.22  had at least one annual review. 
510.23     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
510.24     Sec. 14.  Minnesota Statutes 2000, section 245B.08, 
510.25  subdivision 3, is amended to read: 
510.26     Subd. 3.  [SANCTIONS AVAILABLE.] Nothing in this 
510.27  subdivision shall be construed to limit the commissioner's 
510.28  authority to suspend, or revoke a license, or make conditional 
510.29  issue a fine at any time a license under section 245A.07; make 
510.30  correction orders and require fines make a license conditional 
510.31  for failure to comply with applicable laws or rules under 
510.32  section 245A.06; or deny an application for license under 
510.33  section 245A.05. 
510.34     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
510.35     Sec. 15.  Minnesota Statutes 2000, section 256.045, 
510.36  subdivision 3, is amended to read: 
511.1      Subd. 3.  [STATE AGENCY HEARINGS.] (a) State agency 
511.2   hearings are available for the following:  (1) any person 
511.3   applying for, receiving or having received public assistance, 
511.4   medical care, or a program of social services granted by the 
511.5   state agency or a county agency or the federal Food Stamp Act 
511.6   whose application for assistance is denied, not acted upon with 
511.7   reasonable promptness, or whose assistance is suspended, 
511.8   reduced, terminated, or claimed to have been incorrectly paid; 
511.9   (2) any patient or relative aggrieved by an order of the 
511.10  commissioner under section 252.27; (3) a party aggrieved by a 
511.11  ruling of a prepaid health plan; (4) except as provided under 
511.12  chapter 245A, any individual or facility determined by a lead 
511.13  agency to have maltreated a vulnerable adult under section 
511.14  626.557 after they have exercised their right to administrative 
511.15  reconsideration under section 626.557; (5) any person whose 
511.16  claim for foster care payment according to a placement of the 
511.17  child resulting from a child protection assessment under section 
511.18  626.556 is denied or not acted upon with reasonable promptness, 
511.19  regardless of funding source; (6) any person to whom a right of 
511.20  appeal according to this section is given by other provision of 
511.21  law; (7) an applicant aggrieved by an adverse decision to an 
511.22  application for a hardship waiver under section 
511.23  256B.15; or (8) except as provided under chapter 245A, an 
511.24  individual or facility determined to have maltreated a minor 
511.25  under section 626.556, after the individual or facility has 
511.26  exercised the right to administrative reconsideration under 
511.27  section 626.556; or (9) except as provided under chapter 245A, 
511.28  an individual disqualified under section 245A.04, subdivision 
511.29  3d, on the basis of serious or recurring maltreatment; a 
511.30  preponderance of the evidence that the individual has committed 
511.31  an act or acts that meet the definition of any of the crimes 
511.32  listed in section 245A.04, subdivision 3d, paragraph (a), 
511.33  clauses (1) to (4); or for failing to make reports required 
511.34  under section 626.556, subdivision 3, or 626.557, subdivision 
511.35  3.  Hearings regarding a maltreatment determination under clause 
511.36  (4) or (8) and a disqualification under this clause in which the 
512.1   basis for a disqualification is serious or recurring 
512.2   maltreatment, which has not been set aside or rescinded under 
512.3   section 245A.04, subdivision 3b, shall be consolidated into a 
512.4   single fair hearing.  In such cases, the scope of review by the 
512.5   human services referee shall include both the maltreatment 
512.6   determination and the disqualification.  The failure to exercise 
512.7   the right to an administrative reconsideration shall not be a 
512.8   bar to a hearing under this section if federal law provides an 
512.9   individual the right to a hearing to dispute a finding of 
512.10  maltreatment.  Individuals and organizations specified in this 
512.11  section may contest the specified action, decision, or final 
512.12  disposition before the state agency by submitting a written 
512.13  request for a hearing to the state agency within 30 days after 
512.14  receiving written notice of the action, decision, or final 
512.15  disposition, or within 90 days of such written notice if the 
512.16  applicant, recipient, patient, or relative shows good cause why 
512.17  the request was not submitted within the 30-day time limit. 
512.18     The hearing for an individual or facility under clause 
512.19  (4) or, (8), or (9) is the only administrative appeal to the 
512.20  final agency determination specifically, including a challenge 
512.21  to the accuracy and completeness of data under section 13.04.  
512.22  Hearings requested under clause (4) apply only to incidents of 
512.23  maltreatment that occur on or after October 1, 1995.  Hearings 
512.24  requested by nursing assistants in nursing homes alleged to have 
512.25  maltreated a resident prior to October 1, 1995, shall be held as 
512.26  a contested case proceeding under the provisions of chapter 14.  
512.27  Hearings requested under clause (8) apply only to incidents of 
512.28  maltreatment that occur on or after July 1, 1997.  A hearing for 
512.29  an individual or facility under clause (8) is only available 
512.30  when there is no juvenile court or adult criminal action 
512.31  pending.  If such action is filed in either court while an 
512.32  administrative review is pending, the administrative review must 
512.33  be suspended until the judicial actions are completed.  If the 
512.34  juvenile court action or criminal charge is dismissed or the 
512.35  criminal action overturned, the matter may be considered in an 
512.36  administrative hearing. 
513.1      For purposes of this section, bargaining unit grievance 
513.2   procedures are not an administrative appeal. 
513.3      The scope of hearings involving claims to foster care 
513.4   payments under clause (5) shall be limited to the issue of 
513.5   whether the county is legally responsible for a child's 
513.6   placement under court order or voluntary placement agreement 
513.7   and, if so, the correct amount of foster care payment to be made 
513.8   on the child's behalf and shall not include review of the 
513.9   propriety of the county's child protection determination or 
513.10  child placement decision. 
513.11     (b) A vendor of medical care as defined in section 256B.02, 
513.12  subdivision 7, or a vendor under contract with a county agency 
513.13  to provide social services under section 256E.08, subdivision 4, 
513.14  is not a party and may not request a hearing under this section, 
513.15  except if assisting a recipient as provided in subdivision 4. 
513.16     (c) An applicant or recipient is not entitled to receive 
513.17  social services beyond the services included in the amended 
513.18  community social services plan developed under section 256E.081, 
513.19  subdivision 3, if the county agency has met the requirements in 
513.20  section 256E.081. 
513.21     (d) The commissioner may summarily affirm the county or 
513.22  state agency's proposed action without a hearing when the sole 
513.23  issue is an automatic change due to a change in state or federal 
513.24  law. 
513.25     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
513.26     Sec. 16.  Minnesota Statutes 2000, section 256.045, 
513.27  subdivision 3b, is amended to read: 
513.28     Subd. 3b.  [STANDARD OF EVIDENCE FOR MALTREATMENT AND 
513.29  DISQUALIFICATION HEARINGS.] The state human services referee 
513.30  shall determine that maltreatment has occurred if a 
513.31  preponderance of evidence exists to support the final 
513.32  disposition under sections 626.556 and 626.557.  For purposes of 
513.33  hearings regarding disqualification, the state human services 
513.34  referee shall affirm the proposed disqualification in an appeal 
513.35  under subdivision 3, paragraph (a), clause (9), if a 
513.36  preponderance of the evidence shows the individual has:  
514.1      (1) committed maltreatment under section 626.556 or 
514.2   626.557, which is serious or recurring; 
514.3      (2) committed an act or acts meeting the definition of any 
514.4   of the crimes listed in section 245A.04, subdivision 3d, 
514.5   paragraph (a), clauses (1) to (4); or 
514.6      (3) failed to make required reports under section 626.556 
514.7   or 626.557 for incidents in which:  
514.8      (i) the final disposition under section 626.556 or 626.557 
514.9   was substantiated maltreatment; and 
514.10     (ii) the maltreatment was recurring or serious; or 
514.11  substantiated serious or recurring maltreatment of a minor under 
514.12  section 626.556 or of a vulnerable adult under section 626.557 
514.13  for which there is a preponderance of evidence that the 
514.14  maltreatment occurred, and that the subject was responsible for 
514.15  the maltreatment.  If the disqualification is affirmed, the 
514.16  state human services referee shall determine whether the 
514.17  individual poses a risk of harm in accordance with the 
514.18  requirements of section 245A.04, subdivision 3b. 
514.19     The state human services referee shall recommend an order 
514.20  to the commissioner of health or human services, as applicable, 
514.21  who shall issue a final order.  The commissioner shall affirm, 
514.22  reverse, or modify the final disposition.  Any order of the 
514.23  commissioner issued in accordance with this subdivision is 
514.24  conclusive upon the parties unless appeal is taken in the manner 
514.25  provided in subdivision 7.  Except as provided under section 
514.26  245A.04, subdivisions 3b, paragraphs (e) and (f); and 3c, in any 
514.27  licensing appeal under chapter 245A and sections 144.50 to 
514.28  144.58 and 144A.02 to 144A.46, the commissioner's determination 
514.29  as to maltreatment is conclusive. 
514.30     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
514.31     Sec. 17.  Minnesota Statutes 2000, section 256.045, 
514.32  subdivision 4, is amended to read: 
514.33     Subd. 4.  [CONDUCT OF HEARINGS.] (a) All hearings held 
514.34  pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 
514.35  according to the provisions of the federal Social Security Act 
514.36  and the regulations implemented in accordance with that act to 
515.1   enable this state to qualify for federal grants-in-aid, and 
515.2   according to the rules and written policies of the commissioner 
515.3   of human services.  County agencies shall install equipment 
515.4   necessary to conduct telephone hearings.  A state human services 
515.5   referee may schedule a telephone conference hearing when the 
515.6   distance or time required to travel to the county agency offices 
515.7   will cause a delay in the issuance of an order, or to promote 
515.8   efficiency, or at the mutual request of the parties.  Hearings 
515.9   may be conducted by telephone conferences unless the applicant, 
515.10  recipient, former recipient, person, or facility contesting 
515.11  maltreatment objects.  The hearing shall not be held earlier 
515.12  than five days after filing of the required notice with the 
515.13  county or state agency.  The state human services referee shall 
515.14  notify all interested persons of the time, date, and location of 
515.15  the hearing at least five days before the date of the hearing.  
515.16  Interested persons may be represented by legal counsel or other 
515.17  representative of their choice, including a provider of therapy 
515.18  services, at the hearing and may appear personally, testify and 
515.19  offer evidence, and examine and cross-examine witnesses.  The 
515.20  applicant, recipient, former recipient, person, or facility 
515.21  contesting maltreatment shall have the opportunity to examine 
515.22  the contents of the case file and all documents and records to 
515.23  be used by the county or state agency at the hearing at a 
515.24  reasonable time before the date of the hearing and during the 
515.25  hearing.  In hearings under subdivision 3, paragraph (a), 
515.26  clauses (4) and, (8), and (9), either party may subpoena the 
515.27  private data relating to the investigation prepared by the 
515.28  agency under section 626.556 or 626.557 that is not otherwise 
515.29  accessible under section 13.04, provided the identity of the 
515.30  reporter may not be disclosed. 
515.31     (b) The private data obtained by subpoena in a hearing 
515.32  under subdivision 3, paragraph (a), clause (4) or, (8), or (9), 
515.33  must be subject to a protective order which prohibits its 
515.34  disclosure for any other purpose outside the hearing provided 
515.35  for in this section without prior order of the district court.  
515.36  Disclosure without court order is punishable by a sentence of 
516.1   not more than 90 days imprisonment or a fine of not more than 
516.2   $700, or both.  These restrictions on the use of private data do 
516.3   not prohibit access to the data under section 13.03, subdivision 
516.4   6.  Except for appeals under subdivision 3, paragraph (a), 
516.5   clauses (4), (5), and (8), and (9), upon request, the county 
516.6   agency shall provide reimbursement for transportation, child 
516.7   care, photocopying, medical assessment, witness fee, and other 
516.8   necessary and reasonable costs incurred by the applicant, 
516.9   recipient, or former recipient in connection with the appeal.  
516.10  All evidence, except that privileged by law, commonly accepted 
516.11  by reasonable people in the conduct of their affairs as having 
516.12  probative value with respect to the issues shall be submitted at 
516.13  the hearing and such hearing shall not be "a contested case" 
516.14  within the meaning of section 14.02, subdivision 3.  The agency 
516.15  must present its evidence prior to or at the hearing, and may 
516.16  not submit evidence after the hearing except by agreement of the 
516.17  parties at the hearing, provided the petitioner has the 
516.18  opportunity to respond. 
516.19     <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
516.20     Sec. 18.  Minnesota Statutes 2000, section 626.556, 
516.21  subdivision 3, is amended to read: 
516.22     Subd. 3.  [PERSONS MANDATED TO REPORT.] (a) A person who 
516.23  knows or has reason to believe a child is being neglected or 
516.24  physically or sexually abused, as defined in subdivision 2, or 
516.25  has been neglected or physically or sexually abused within the 
516.26  preceding three years, shall immediately report the information 
516.27  to the local welfare agency, agency responsible for assessing or 
516.28  investigating the report, police department, or the county 
516.29  sheriff if the person is:  
516.30     (1) a professional or professional's delegate who is 
516.31  engaged in the practice of the healing arts, social services, 
516.32  hospital administration, psychological or psychiatric treatment, 
516.33  child care, education, or law enforcement; or 
516.34     (2) employed as a member of the clergy and received the 
516.35  information while engaged in ministerial duties, provided that a 
516.36  member of the clergy is not required by this subdivision to 
517.1   report information that is otherwise privileged under section 
517.2   595.02, subdivision 1, paragraph (c).  
517.3      The police department or the county sheriff, upon receiving 
517.4   a report, shall immediately notify the local welfare agency or 
517.5   agency responsible for assessing or investigating the report, 
517.6   orally and in writing.  The local welfare agency, or agency 
517.7   responsible for assessing or investigating the report, upon 
517.8   receiving a report, shall immediately notify the local police 
517.9   department or the county sheriff orally and in writing.  The 
517.10  county sheriff and the head of every local welfare agency, 
517.11  agency responsible for assessing or investigating reports, and 
517.12  police department shall each designate a person within their 
517.13  agency, department, or office who is responsible for ensuring 
517.14  that the notification duties of this paragraph and paragraph (b) 
517.15  are carried out.  Nothing in this subdivision shall be construed 
517.16  to require more than one report from any institution, facility, 
517.17  school, or agency. 
517.18     (b) Any person may voluntarily report to the local welfare 
517.19  agency, agency responsible for assessing or investigating the 
517.20  report, police department, or the county sheriff if the person 
517.21  knows, has reason to believe, or suspects a child is being or 
517.22  has been neglected or subjected to physical or sexual abuse.  
517.23  The police department or the county sheriff, upon receiving a 
517.24  report, shall immediately notify the local welfare agency or 
517.25  agency responsible for assessing or investigating the report, 
517.26  orally and in writing.  The local welfare agency or agency 
517.27  responsible for assessing or investigating the report, upon 
517.28  receiving a report, shall immediately notify the local police 
517.29  department or the county sheriff orally and in writing. 
517.30     (c) A person mandated to report physical or sexual child 
517.31  abuse or neglect occurring within a licensed facility shall 
517.32  report the information to the agency specified under 
517.33  subdivisions 3b and 3c as responsible for licensing 
517.34  the assessing or investigating a facility licensed under 
517.35  sections 144.50 to 144.58; a facility licensed under section 
517.36  241.021; 245A.01 to 245A.16; or 245B, or a facility licensed 
518.1   under chapter 245A; a school as defined in sections section 
518.2   120A.05, subdivisions 9, 11, and 13; and, or section 124D.10; or 
518.3   a nonlicensed personal care provider organization as defined 
518.4   in sections section 256B.04, subdivision 16; and, or section 
518.5   256B.0625, subdivision 19.  A health or corrections An agency 
518.6   receiving a report may request the local welfare agency to 
518.7   provide assistance pursuant to subdivisions 10, 10a, and 10b. 
518.8      (d) Any person mandated to report shall receive a summary 
518.9   of the disposition of any report made by that reporter, 
518.10  including whether the case has been opened for child protection 
518.11  or other services, or if a referral has been made to a community 
518.12  organization, unless release would be detrimental to the best 
518.13  interests of the child.  Any person who is not mandated to 
518.14  report shall, upon request to the local welfare agency, receive 
518.15  a concise summary of the disposition of any report made by that 
518.16  reporter, unless release would be detrimental to the best 
518.17  interests of the child. 
518.18     (e) For purposes of this subdivision, "immediately" means 
518.19  as soon as possible but in no event longer than 24 hours. 
518.20     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
518.21     Sec. 19.  Minnesota Statutes 2000, section 626.556, 
518.22  subdivision 3c, is amended to read: 
518.23     Subd. 3c.  [AGENCY RESPONSIBLE FOR ASSESSING OR 
518.24  INVESTIGATING REPORTS OF MALTREATMENT.] The following agencies 
518.25  are the administrative agencies responsible for assessing or 
518.26  investigating reports of alleged child maltreatment in 
518.27  facilities made under this section: 
518.28     (1) the county local welfare agency is the agency 
518.29  responsible for assessing or investigating allegations of 
518.30  maltreatment in child foster care, family child care, and 
518.31  legally unlicensed child care and; 
518.32     (2) the department of human services is the agency 
518.33  responsible for assessing or investigating allegations of 
518.34  maltreatment in juvenile correctional facilities licensed under 
518.35  section 241.021 located in the local welfare agency's county; 
518.36     (2) (3) the department of human services is the agency 
519.1   responsible for assessing or investigating allegations of 
519.2   maltreatment in facilities licensed under chapters 245A and 
519.3   245B, except for child foster care and family child care; and 
519.4      (3) (4) the department of health is the agency responsible 
519.5   for assessing or investigating allegations of child maltreatment 
519.6   in facilities licensed under sections 144.50 to 144.58, and in 
519.7   unlicensed home health care. 
519.8      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
519.9      Sec. 20.  Minnesota Statutes 2000, section 626.556, 
519.10  subdivision 10b, is amended to read: 
519.11     Subd. 10b.  [DUTIES OF COMMISSIONER; NEGLECT OR ABUSE IN 
519.12  FACILITY.] (a) This section applies to the commissioners of 
519.13  human services, health, and children, families, and learning.  
519.14  The commissioner of the agency responsible for assessing or 
519.15  investigating the report shall immediately investigate if the 
519.16  report alleges that: 
519.17     (1) a child who is in the care of a facility as defined in 
519.18  subdivision 2 is neglected, physically abused, or sexually 
519.19  abused by an individual in that facility, or has been so 
519.20  neglected or abused by an individual in that facility within the 
519.21  three years preceding the report; or 
519.22     (2) a child was neglected, physically abused, or sexually 
519.23  abused by an individual in a facility defined in subdivision 2, 
519.24  while in the care of that facility within the three years 
519.25  preceding the report.  
519.26     The commissioner of the agency responsible for assessing or 
519.27  investigating the report shall arrange for the transmittal to 
519.28  the commissioner of reports received by local agencies and may 
519.29  delegate to a local welfare agency the duty to investigate 
519.30  reports.  In conducting an investigation under this section, the 
519.31  commissioner has the powers and duties specified for local 
519.32  welfare agencies under this section.  The commissioner of the 
519.33  agency responsible for assessing or investigating the report or 
519.34  local welfare agency may interview any children who are or have 
519.35  been in the care of a facility under investigation and their 
519.36  parents, guardians, or legal custodians. 
520.1      (b) Prior to any interview, the commissioner of the agency 
520.2   responsible for assessing or investigating the report or local 
520.3   welfare agency shall notify the parent, guardian, or legal 
520.4   custodian of a child who will be interviewed in the manner 
520.5   provided for in subdivision 10d, paragraph (a).  If reasonable 
520.6   efforts to reach the parent, guardian, or legal custodian of a 
520.7   child in an out-of-home placement have failed, the child may be 
520.8   interviewed if there is reason to believe the interview is 
520.9   necessary to protect the child or other children in the 
520.10  facility.  The commissioner of the agency responsible for 
520.11  assessing or investigating the report or local agency must 
520.12  provide the information required in this subdivision to the 
520.13  parent, guardian, or legal custodian of a child interviewed 
520.14  without parental notification as soon as possible after the 
520.15  interview.  When the investigation is completed, any parent, 
520.16  guardian, or legal custodian notified under this subdivision 
520.17  shall receive the written memorandum provided for in subdivision 
520.18  10d, paragraph (c). 
520.19     (c) In conducting investigations under this subdivision the 
520.20  commissioner or local welfare agency responsible for assessing 
520.21  or investigating the report shall obtain be given access to 
520.22  information consistent with subdivision 10, paragraphs (g), (h), 
520.23  (i), and (j), and shall be granted the same access to the 
520.24  facility as the facility's licensing agency under the 
520.25  corresponding facility licensing statute.  A facility that 
520.26  denies the investigating agency access to this information shall 
520.27  be subject to a negative licensing action by the appropriate 
520.28  licensing agency.  When the agency responsible for assessing or 
520.29  investigating a report under this section and the licensing 
520.30  agency for the facility involved are not the same agency, the 
520.31  investigating agency and the licensing agency may share not 
520.32  public data as necessary to complete the investigation or to 
520.33  determine appropriate licensing action. 
520.34     (d) Except for foster care and family child care, the 
520.35  commissioner has the primary responsibility for the 
520.36  investigations and notifications required under subdivisions 10d 
521.1   and 10f for reports that allege maltreatment related to the care 
521.2   provided by or in facilities licensed by the commissioner.  The 
521.3   commissioner may request assistance from the local social 
521.4   services agency. 
521.5      <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
521.6      Sec. 21.  Minnesota Statutes 2000, section 626.556, 
521.7   subdivision 10i, is amended to read: 
521.8      Subd. 10i.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
521.9   DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 
521.10  SERIOUS OR RECURRING MALTREATMENT.] (a) Except as provided under 
521.11  paragraph (e), an individual or facility that the commissioner 
521.12  or a local social service agency determines has maltreated a 
521.13  child, or the child's designee, regardless of the determination, 
521.14  who contests the investigating agency's final determination 
521.15  regarding maltreatment, may request the investigating agency to 
521.16  reconsider its final determination regarding maltreatment.  The 
521.17  request for reconsideration must be submitted in writing to the 
521.18  investigating agency within 15 calendar days after receipt of 
521.19  notice of the final determination regarding maltreatment.  An 
521.20  individual who was determined to have maltreated a child under 
521.21  this section and who was disqualified on the basis of serious or 
521.22  recurring maltreatment under section 245A.04, subdivision 3d, 
521.23  may request reconsideration of the maltreatment determination 
521.24  and the disqualification.  The request for reconsideration of 
521.25  the maltreatment determination and the disqualification must be 
521.26  submitted within 30 calendar days of the individual's receipt of 
521.27  the notice of disqualification under section 245A.04, 
521.28  subdivision 3a. 
521.29     (b) Except as provided under paragraphs (e) and (f), if the 
521.30  investigating agency denies the request or fails to act upon the 
521.31  request within 15 calendar days after receiving the request for 
521.32  reconsideration, the person or facility entitled to a fair 
521.33  hearing under section 256.045 may submit to the commissioner of 
521.34  human services a written request for a hearing under that 
521.35  section. 
521.36     (c) If, as a result of the reconsideration, the 
522.1   investigating agency changes the final determination of 
522.2   maltreatment, that agency shall notify the parties specified in 
522.3   subdivisions 10b, 10d, and 10f. 
522.4      (d) Except as provided under paragraph (f), if an 
522.5   individual or facility contests the investigating agency's final 
522.6   determination regarding maltreatment by requesting a fair 
522.7   hearing under section 256.045, the commissioner of human 
522.8   services shall assure that the hearing is conducted and a 
522.9   decision is reached within 90 days of receipt of the request for 
522.10  a hearing.  The time for action on the decision may be extended 
522.11  for as many days as the hearing is postponed or the record is 
522.12  held open for the benefit of either party. 
522.13     (e) If an individual was disqualified under section 
522.14  245A.04, subdivision 3d, on the basis of a determination of 
522.15  maltreatment, which was serious or recurring, and the individual 
522.16  has requested reconsideration of the maltreatment determination 
522.17  under paragraph (a) and requested reconsideration of the 
522.18  disqualification under section 245A.04, subdivision 3b, 
522.19  reconsideration of the maltreatment determination and 
522.20  reconsideration of the disqualification shall be consolidated 
522.21  into a single reconsideration.  If an individual disqualified on 
522.22  the basis of a determination of maltreatment, which was serious 
522.23  or recurring requests a fair hearing under paragraph (b), the 
522.24  scope of the fair hearing shall include the maltreatment 
522.25  determination and the disqualification. 
522.26     (f) If a maltreatment determination or a disqualification 
522.27  based on serious or recurring maltreatment is the basis for a 
522.28  denial of a license under section 245A.05 or a licensing 
522.29  sanction under section 245A.07, the license holder has the right 
522.30  to a contested case hearing under chapter 14 and Minnesota 
522.31  Rules, parts 1400.8510 to 1400.8612 and successor rules.  As 
522.32  provided for under section 245A.08, subdivision 2a, the scope of 
522.33  the contested case hearing shall include the maltreatment 
522.34  determination, disqualification, and licensing sanction or 
522.35  denial of a license.  In such cases, a fair hearing regarding 
522.36  the maltreatment determination shall not be conducted under 
523.1   paragraph (b).  If the disqualified subject is an individual 
523.2   other than the license holder and upon whom a background study 
523.3   must be conducted under section 245A.04, subdivision 3, the 
523.4   hearings of all parties may be consolidated into a single 
523.5   contested case hearing upon consent of all parties and the 
523.6   administrative law judge. 
523.7      <b>[EFFECTIVE DATE.]</b> This section is effective January 1, 2002.
523.8      Sec. 22.  Minnesota Statutes 2000, section 626.557, 
523.9   subdivision 3, is amended to read: 
523.10     Subd. 3.  [TIMING OF REPORT.] (a) A mandated reporter who 
523.11  has reason to believe that a vulnerable adult is being or has 
523.12  been maltreated, or who has knowledge that a vulnerable adult 
523.13  has sustained a physical injury which is not reasonably 
523.14  explained shall immediately report the information to the common 
523.15  entry point.  If an individual is a vulnerable adult solely 
523.16  because the individual is admitted to a facility, a mandated 
523.17  reporter is not required to report suspected maltreatment of the 
523.18  individual that occurred prior to admission, unless: 
523.19     (1) the individual was admitted to the facility from 
523.20  another facility and the reporter has reason to believe the 
523.21  vulnerable adult was maltreated in the previous facility; or 
523.22     (2) the reporter knows or has reason to believe that the 
523.23  individual is a vulnerable adult as defined in section 626.5572, 
523.24  subdivision 21, clause (4).  
523.25     (b) A person not required to report under the provisions of 
523.26  this section may voluntarily report as described above.  
523.27     (c) Nothing in this section requires a report of known or 
523.28  suspected maltreatment, if the reporter knows or has reason to 
523.29  know that a report has been made to the common entry point. 
523.30     (d) Nothing in this section shall preclude a reporter from 
523.31  also reporting to a law enforcement agency.  
523.32     (e) A mandated reporter who knows or has reason to believe 
523.33  that an error under section 626.5572, subdivision 17, paragraph 
523.34  (c), clause (5), occurred must make a report under this 
523.35  subdivision.  If the reporter or a facility, at any time 
523.36  believes that an investigation by a lead agency will determine 
524.1   or should determine that the reported error was not neglect 
524.2   according to the criteria under section 626.5572, subdivision 
524.3   17, paragraph (c), clause (5), the reporter or facility may 
524.4   provide to the common entry point or directly to the lead agency 
524.5   information explaining how the event meets the criteria under 
524.6   section 626.5572, subdivision 17, paragraph (c), clause (5).  
524.7   The lead agency shall consider this information when making an 
524.8   initial disposition of the report under subdivision 9c. 
524.9      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
524.10  following final enactment. 
524.11     Sec. 23.  Minnesota Statutes 2000, section 626.557, 
524.12  subdivision 9d, is amended to read: 
524.13     Subd. 9d.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
524.14  DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 
524.15  SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 
524.16  provided under paragraph (e), any individual or facility which a 
524.17  lead agency determines has maltreated a vulnerable adult, or the 
524.18  vulnerable adult or an interested person acting on behalf of the 
524.19  vulnerable adult, regardless of the lead agency's determination, 
524.20  who contests the lead agency's final disposition of an 
524.21  allegation of maltreatment, may request the lead agency to 
524.22  reconsider its final disposition.  The request for 
524.23  reconsideration must be submitted in writing to the lead agency 
524.24  within 15 calendar days after receipt of notice of final 
524.25  disposition or, if the request is made by an interested person 
524.26  who is not entitled to notice, within 15 days after receipt of 
524.27  the notice by the vulnerable adult or the vulnerable adult's 
524.28  legal guardian.  An individual who was determined to have 
524.29  maltreated a vulnerable adult under this section and who was 
524.30  disqualified on the basis of serious or recurring maltreatment 
524.31  under section 245A.04, subdivision 3d, may request 
524.32  reconsideration of the maltreatment determination and the 
524.33  disqualification.  The request for reconsideration of the 
524.34  maltreatment determination and the disqualification must be 
524.35  submitted within 30 calendar days of the individual's receipt of 
524.36  the notice of disqualification under section 245A.04, 
525.1   subdivision 3a. 
525.2      (b) Except as provided under paragraphs (e) and (f), if the 
525.3   lead agency denies the request or fails to act upon the request 
525.4   within 15 calendar days after receiving the request for 
525.5   reconsideration, the person or facility entitled to a fair 
525.6   hearing under section 256.045, may submit to the commissioner of 
525.7   human services a written request for a hearing under that 
525.8   statute.  The vulnerable adult, or an interested person acting 
525.9   on behalf of the vulnerable adult, may request a review by the 
525.10  vulnerable adult maltreatment review panel under section 256.021 
525.11  if the lead agency denies the request or fails to act upon the 
525.12  request, or if the vulnerable adult or interested person 
525.13  contests a reconsidered disposition.  The lead agency shall 
525.14  notify persons who request reconsideration of their rights under 
525.15  this paragraph.  The request must be submitted in writing to the 
525.16  review panel and a copy sent to the lead agency within 30 
525.17  calendar days of receipt of notice of a denial of a request for 
525.18  reconsideration or of a reconsidered disposition.  The request 
525.19  must specifically identify the aspects of the agency 
525.20  determination with which the person is dissatisfied.  
525.21     (c) If, as a result of a reconsideration or review, the 
525.22  lead agency changes the final disposition, it shall notify the 
525.23  parties specified in subdivision 9c, paragraph (d). 
525.24     (d) For purposes of this subdivision, "interested person 
525.25  acting on behalf of the vulnerable adult" means a person 
525.26  designated in writing by the vulnerable adult to act on behalf 
525.27  of the vulnerable adult, or a legal guardian or conservator or 
525.28  other legal representative, a proxy or health care agent 
525.29  appointed under chapter 145B or 145C, or an individual who is 
525.30  related to the vulnerable adult, as defined in section 245A.02, 
525.31  subdivision 13. 
525.32     (e) If an individual was disqualified under section 
525.33  245A.04, subdivision 3d, on the basis of a determination of 
525.34  maltreatment, which was serious or recurring, and the individual 
525.35  has requested reconsideration of the maltreatment determination 
525.36  under paragraph (a) and reconsideration of the disqualification 
526.1   under section 245A.04, subdivision 3b, reconsideration of the 
526.2   maltreatment determination and requested reconsideration of the 
526.3   disqualification shall be consolidated into a single 
526.4   reconsideration.  If an individual who was disqualified on the 
526.5   basis of serious or recurring maltreatment requests a fair 
526.6   hearing under paragraph (b), the scope of the fair hearing shall 
526.7   include the maltreatment determination and the disqualification. 
526.8      (f) If a maltreatment determination or a disqualification 
526.9   based on serious or recurring maltreatment is the basis for a 
526.10  denial of a license under section 245A.05 or a licensing 
526.11  sanction under section 245A.07, the license holder has the right 
526.12  to a contested case hearing under chapter 14 and Minnesota 
526.13  Rules, parts 1400.8510 to 1400.8612 and successor rules.  As 
526.14  provided for under section 245A.08, the scope of the contested 
526.15  case hearing shall include the maltreatment determination, 
526.16  disqualification, and licensing sanction or denial of a 
526.17  license.  In such cases, a fair hearing shall not be conducted 
526.18  under paragraph (b).  If the disqualified subject is an 
526.19  individual other than the license holder and upon whom a 
526.20  background study must be conducted under section 245A.04, 
526.21  subdivision 3, the hearings of all parties may be consolidated 
526.22  into a single contested case hearing upon consent of all parties 
526.23  and the administrative law judge. 
526.24     (g) Until August 1, 2002, an individual or facility that 
526.25  was determined by the commissioner of human services or the 
526.26  commissioner of health to be responsible for neglect under 
526.27  section 626.5572, subdivision 17, after October 1, 1995, and 
526.28  before August 1, 2001, that believes that the finding of neglect 
526.29  does not meet an amended definition of neglect may request a 
526.30  reconsideration of the determination of neglect.  The 
526.31  commissioner of human services or the commissioner of health 
526.32  shall mail a notice to the last known address of individuals who 
526.33  are eligible to seek this reconsideration.  The request for 
526.34  reconsideration must state how the established findings no 
526.35  longer meet the elements of the definition of neglect.  The 
526.36  commissioner shall review the request for reconsideration and 
527.1   make a determination within 15 calendar days.  The 
527.2   commissioner's decision on this reconsideration is the final 
527.3   agency action. 
527.4      (1) For purposes of compliance with the data destruction 
527.5   schedule under subdivision 12b, paragraph (d), when a finding of 
527.6   substantiated maltreatment has been changed as a result of a 
527.7   reconsideration under this paragraph, the date of the original 
527.8   finding of a substantiated maltreatment must be used to 
527.9   calculate the destruction date. 
527.10     (2) For purposes of any background studies under section 
527.11  245A.04, when a determination of substantiated maltreatment has 
527.12  been changed as a result of a reconsideration under this 
527.13  paragraph, any prior disqualification of the individual under 
527.14  section 245A.04 that was based on this determination of 
527.15  maltreatment shall be rescinded, and for future background 
527.16  studies under section 245A.04 the commissioner must not use the 
527.17  previous determination of substantiated maltreatment as a basis 
527.18  for disqualification or as a basis for referring the 
527.19  individual's maltreatment history to a health-related licensing 
527.20  board under section 245A.04, subdivision 3d, paragraph (b). 
527.21     <b>[EFFECTIVE DATE.]</b> Paragraph (g) of this section is 
527.22  effective the day following final enactment.  Paragraphs (a), 
527.23  (b), (e), and (f) are effective January 1, 2002. 
527.24     Sec. 24.  Minnesota Statutes 2000, section 626.5572, 
527.25  subdivision 17, is amended to read: 
527.26     Subd. 17.  [NEGLECT.] "Neglect" means:  
527.27     (a) The failure or omission by a caregiver to supply a 
527.28  vulnerable adult with care or services, including but not 
527.29  limited to, food, clothing, shelter, health care, or supervision 
527.30  which is: 
527.31     (1) reasonable and necessary to obtain or maintain the 
527.32  vulnerable adult's physical or mental health or safety, 
527.33  considering the physical and mental capacity or dysfunction of 
527.34  the vulnerable adult; and 
527.35     (2) which is not the result of an accident or therapeutic 
527.36  conduct. 
528.1      (b) The absence or likelihood of absence of care or 
528.2   services, including but not limited to, food, clothing, shelter, 
528.3   health care, or supervision necessary to maintain the physical 
528.4   and mental health of the vulnerable adult which a reasonable 
528.5   person would deem essential to obtain or maintain the vulnerable 
528.6   adult's health, safety, or comfort considering the physical or 
528.7   mental capacity or dysfunction of the vulnerable adult. 
528.8      (c) For purposes of this section, a vulnerable adult is not 
528.9   neglected for the sole reason that: 
528.10     (1) the vulnerable adult or a person with authority to make 
528.11  health care decisions for the vulnerable adult under sections 
528.12  144.651, 144A.44, chapter 145B, 145C, or 252A, or section 
528.13  253B.03, or 525.539 to 525.6199, refuses consent or withdraws 
528.14  consent, consistent with that authority and within the boundary 
528.15  of reasonable medical practice, to any therapeutic conduct, 
528.16  including any care, service, or procedure to diagnose, maintain, 
528.17  or treat the physical or mental condition of the vulnerable 
528.18  adult, or, where permitted under law, to provide nutrition and 
528.19  hydration parenterally or through intubation; this paragraph 
528.20  does not enlarge or diminish rights otherwise held under law by: 
528.21     (i) a vulnerable adult or a person acting on behalf of a 
528.22  vulnerable adult, including an involved family member, to 
528.23  consent to or refuse consent for therapeutic conduct; or 
528.24     (ii) a caregiver to offer or provide or refuse to offer or 
528.25  provide therapeutic conduct; or 
528.26     (2) the vulnerable adult, a person with authority to make 
528.27  health care decisions for the vulnerable adult, or a caregiver 
528.28  in good faith selects and depends upon spiritual means or prayer 
528.29  for treatment or care of disease or remedial care of the 
528.30  vulnerable adult in lieu of medical care, provided that this is 
528.31  consistent with the prior practice or belief of the vulnerable 
528.32  adult or with the expressed intentions of the vulnerable adult; 
528.33     (3) the vulnerable adult, who is not impaired in judgment 
528.34  or capacity by mental or emotional dysfunction or undue 
528.35  influence, engages in sexual contact with:  
528.36     (i) a person including a facility staff person when a 
529.1   consensual sexual personal relationship existed prior to the 
529.2   caregiving relationship; or 
529.3      (ii) a personal care attendant, regardless of whether the 
529.4   consensual sexual personal relationship existed prior to the 
529.5   caregiving relationship; or 
529.6      (4) an individual makes an error in the provision of 
529.7   therapeutic conduct to a vulnerable adult which:  (i) does not 
529.8   result in injury or harm which reasonably requires medical or 
529.9   mental health care; or, if it reasonably requires care, 
529.10     (5) an individual makes an error in the provision of 
529.11  therapeutic conduct to a vulnerable adult that results in injury 
529.12  or harm which reasonably requires the care of a physician; and: 
529.13     (i) the necessary care is sought and provided in a timely 
529.14  fashion as dictated by the condition of the vulnerable adult; 
529.15  and (ii) the injury or harm that required care does not result 
529.16  in substantial acute, or chronic injury or illness, or permanent 
529.17  disability above and beyond the vulnerable adult's preexisting 
529.18  condition; 
529.19     (ii) is (iii) the error is not part of a pattern of errors 
529.20  by the individual; 
529.21     (iv) if in a facility, the error is immediately reported as 
529.22  required under section 626.557, and recorded internally by the 
529.23  employee or person providing services in the facility in order 
529.24  to evaluate and identify corrective action; 
529.25     (v) if in a facility, the facility identifies and takes 
529.26  corrective action and implements measures designed to reduce the 
529.27  risk of further occurrence of this error and similar errors; and 
529.28     (iii) is (vi) if in a facility, the actions required under 
529.29  items (iv) and (v) are sufficiently documented for review and 
529.30  evaluation by the facility and any applicable licensing, 
529.31  certification, and ombudsman agency; and. 
529.32     (iv) is not part of a pattern of errors by the individual. 
529.33     (d) Nothing in this definition requires a caregiver, if 
529.34  regulated, to provide services in excess of those required by 
529.35  the caregiver's license, certification, registration, or other 
529.36  regulation. 
530.1      (e) If the findings of an investigation by a lead agency 
530.2   result in a determination of substantiated maltreatment for the 
530.3   sole reason that the actions required of a facility under 
530.4   paragraph (c), clause (5), item (iv), (v), or (vi), were not 
530.5   taken, then the facility is subject to a correction order.  This 
530.6   must not alter the lead agency's determination of mitigating 
530.7   factors under section 626.557, subdivision 9c, paragraph (c). 
530.8      <b>[EFFECTIVE DATE.]</b> This section is effective the day 
530.9   following final enactment. 
530.10     Sec. 25.  [FEDERAL LAW CHANGE REQUEST OR WAIVER.] 
530.11     The commissioner of health or human services, whichever is 
530.12  appropriate, shall pursue changes to federal law necessary to 
530.13  allow greater discretion on disciplinary activities of 
530.14  unlicensed health care workers and apply for necessary federal 
530.15  waivers or approval that would allow for a set-aside process 
530.16  related to disqualifications for nurse aides in nursing homes by 
530.17  July 1, 2002. 
530.18     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
530.19     Sec. 26.  [WAIVER FROM FEDERAL RULES AND REGULATIONS.] 
530.20     By January 2002, the commissioner of health shall work with 
530.21  providers to examine federal rules and regulations prohibiting 
530.22  neglect, abuse, and financial exploitation of residents in 
530.23  licensed nursing facilities and shall apply for federal waivers 
530.24  to: 
530.25     (1) allow the use of Minnesota Statutes, section 626.5572, 
530.26  to control the identification and prevention of maltreatment of 
530.27  residents in licensed nursing facilities, rather than the 
530.28  definitions under federal rules and regulations; and 
530.29     (2) allow the use of Minnesota Statutes, sections 214.104, 
530.30  245A.04, and 626.557 to control the disqualification or 
530.31  discipline of any persons providing services to residents in 
530.32  licensed nursing facilities, rather than the nurse aide registry 
530.33  or other exclusionary provisions of federal rules and 
530.34  regulations. 
530.35     <b>[EFFECTIVE DATE.]</b> This section is effective July 1, 2001. 
530.36                             ARTICLE 12 
531.1                            MISCELLANEOUS 
531.2      Section 1.  Minnesota Statutes 2000, section 144.1222, is 
531.3   amended by adding a subdivision to read: 
531.4      Subd. 2a.  [POOLS AT FAMILY DAY CARE OR GROUP FAMILY DAY 
531.5   CARE HOMES.] Notwithstanding Minnesota Rules, part 4717.0250, 
531.6   subpart 8, a pool that is located at a family day care or group 
531.7   family day care home licensed under Minnesota Rules, chapter 
531.8   9502, shall not be considered a public pool, and is exempt from 
531.9   the requirements for public pools in Minnesota Rules, parts 
531.10  4717.0150 to 4717.3975.  If the provider chooses to allow 
531.11  children cared for at the family day care or group family day 
531.12  care home to use the pool located at the home, the provider must 
531.13  satisfy the requirements in section 245A.14, subdivision 10.  
531.14     Sec. 2.  Minnesota Statutes 2000, section 148B.21, 
531.15  subdivision 6a, is amended to read: 
531.16     Subd. 6a.  [BACKGROUND CHECKS.] The board shall request a 
531.17  criminal history background check from the superintendent of the 
531.18  bureau of criminal apprehension on all applicants for initial 
531.19  licensure.  An application for a license under this section must 
531.20  be accompanied by an executed criminal history consent form and 
531.21  the fee for conducting the criminal history background 
531.22  check.  The board shall deposit all fees paid by applicants for 
531.23  criminal history background checks under this subdivision into 
531.24  the miscellaneous special revenue fund and shall reimburse the 
531.25  bureau of criminal apprehension for the cost of the background 
531.26  checks upon their completion. 
531.27     Sec. 3.  Minnesota Statutes 2000, section 148B.22, 
531.28  subdivision 3, is amended to read: 
531.29     Subd. 3.  [BACKGROUND CHECKS.] The board shall request a 
531.30  criminal history background check from the superintendent of the 
531.31  bureau of criminal apprehension on all licensees under its 
531.32  jurisdiction who did not complete a criminal history background 
531.33  check as part of an application for initial licensure.  This 
531.34  background check is a one-time requirement.  An application for 
531.35  a license under this section must be accompanied by an executed 
531.36  criminal history consent form and the fee for conducting the 
532.1   criminal history background check.  The board shall deposit all 
532.2   fees paid by licensees for criminal history background checks 
532.3   under this subdivision into the miscellaneous special revenue 
532.4   fund and shall reimburse the bureau of criminal apprehension for 
532.5   the cost of the background checks upon their completion. 
532.6      Sec. 4.  Minnesota Statutes 2000, section 245A.14, is 
532.7   amended by adding a subdivision to read: 
532.8      Subd. 10.  [SWIMMING POOLS; FAMILY DAY CARE AND GROUP 
532.9   FAMILY DAY CARE PROVIDERS.] (a) This subdivision governs pools 
532.10  located at family day care or group family day care homes 
532.11  licensed under Minnesota Rules, chapter 9502.  This subdivision 
532.12  does not apply to portable wading pools or whirlpools located at 
532.13  family day care or group family day care homes licensed under 
532.14  Minnesota Rules, chapter 9502.  For a provider to be eligible to 
532.15  allow a child cared for at the family day care or group family 
532.16  day care home to use the pool located at the home, the provider 
532.17  must not have had a licensing sanction under section 245A.07 or 
532.18  a correction order or fine under section 245A.06 relating to the 
532.19  supervision or health and safety of children substantiated by 
532.20  the county agency during the prior 24 months, and must satisfy 
532.21  the following requirements: 
532.22     (1) obtain written consent from a child's parent or legal 
532.23  guardian allowing the child to use the pool, and renew the 
532.24  parent's or legal guardian's written consent at least annually.  
532.25  The written consent must include a statement that the parent or 
532.26  legal guardian has received and read materials provided by the 
532.27  department of health to the department of human services for 
532.28  distribution to all family day care or group family day care 
532.29  homes related to the risk of disease transmission as well as 
532.30  other health risks associated with swimming pools.  The written 
532.31  consent must also include a statement that the department of 
532.32  health and county agency will not monitor or inspect the 
532.33  provider's swimming pool to ensure compliance with the 
532.34  requirements in this subdivision; 
532.35     (2) enter into a written contract with a child's parent or 
532.36  legal guardian, and renew the written contract annually.  The 
533.1   terms of the written contract must specify that the provider 
533.2   agrees to perform all of the requirements in this subdivision; 
533.3      (3) attend and successfully complete a pool operator 
533.4   training course once every five years.  Acceptable training 
533.5   courses are: 
533.6      (i) the National Swimming Pool Foundation Certified Pool 
533.7   Operator course; 
533.8      (ii) the National Spa and Pool Institute Tech I and Tech II 
533.9   courses (both required); or 
533.10     (iii) the National Recreation and Park Association Aquatic 
533.11  Facility Operator course; 
533.12     (4) require a caregiver trained in first aid and adult and 
533.13  child cardiopulmonary resuscitation to supervise and be present 
533.14  at the pool with any children in the pool; 
533.15     (5) toilet all potty-trained children before they enter the 
533.16  pool; 
533.17     (6) require all children who are not potty-trained to wear 
533.18  swim diapers while in the pool; 
533.19     (7) if fecal material enters the pool water, add three 
533.20  times the normal shock treatment to the pool water to raise the 
533.21  chlorine level to at least 20 parts per million, and close the 
533.22  pool to swimming for the 24 hours following the entrance of 
533.23  fecal material into the water or until the water pH and 
533.24  disinfectant concentration levels have returned to the standards 
533.25  specified in clause (9), whichever is later; 
533.26     (8) prevent any child from entering the pool who has an 
533.27  open wound or any child who has or is suspected of having a 
533.28  communicable disease; 
533.29     (9) maintain the pool water at a pH of not less than 7.2 
533.30  and not more than 8.0, maintain the disinfectant concentration 
533.31  between two and five parts per million for chlorine or between 
533.32  2.3 and 4.5 parts per million for bromine, and maintain a daily 
533.33  record of the pool's operation with pH and disinfectant 
533.34  concentration readings on days when children cared for at the 
533.35  family day care or group family day care home are present; 
533.36     (10) have a disinfectant feeder or feeders; 
534.1      (11) have a recirculation system that will clarify and 
534.2   disinfect the pool volume of water in ten hours or less; 
534.3      (12) maintain the pool's water clarity so that an object on 
534.4   the pool floor at the pool's deepest point is easily visible; 
534.5      (13) have two or more suction lines in the pool; 
534.6      (14) have in place and enforce written safety rules and 
534.7   pool policies; 
534.8      (15) prohibit diving; 
534.9      (16) prohibit pushing or rough play in the pool area; 
534.10     (17) have in place at all times a safety rope that divides 
534.11  the shallow and deep portions of the pool; 
534.12     (18) satisfy any existing local ordinances regarding pool 
534.13  installation, decks, and fencing; 
534.14     (19) maintain a water temperature of not more than 104 
534.15  degrees Fahrenheit and not less than 70 degrees Fahrenheit; and 
534.16     (20) for lifesaving equipment, have a United States Coast 
534.17  Guard-approved life ring attached to a rope, an exit ladder, and 
534.18  a shepherd's hook available at all times to the caregiver 
534.19  supervising the pool. 
534.20     (b) A violation of this subdivision is grounds for a 
534.21  sanction under section 245A.07, or a correction order or fine 
534.22  under section 245A.06.  If a provider under this subdivision 
534.23  receives a licensing sanction or a correction order or fine 
534.24  relating to the supervision or health and safety of children, 
534.25  the provider is prohibited from allowing a child cared for at 
534.26  the family day care or group family day care home to continue to 
534.27  use the pool located at the home. 
534.28     Sec. 5.  Minnesota Statutes 2000, section 246.57, is 
534.29  amended by adding a subdivision to read: 
534.30     Subd. 7.  [SHARED SERVICES ACCOUNT.] Notwithstanding 
534.31  subdivision 1, beginning July 1, 2001, $6,000,000 each biennium 
534.32  is transferred from the shared services account into which 
534.33  receipts for shared services under subdivision 1 are deposited 
534.34  to the general fund.  This subdivision expires June 30, 2005. 
534.35     Sec. 6.  Minnesota Statutes 2000, section 252A.02, is 
534.36  amended by adding a subdivision to read: 
535.1      Subd. 3a.  [GUARDIANSHIP SERVICE PROVIDERS.] "Guardianship 
535.2   service providers" are individuals or agencies that meet the 
535.3   ethical conduct and best practice standards of the National 
535.4   Guardianship Association, meet the criminal background check 
535.5   requirements of section 245A.04, and do not provide any other 
535.6   services to the individuals for whom guardianship services are 
535.7   provided. 
535.8      Sec. 7.  Minnesota Statutes 2000, section 252A.02, 
535.9   subdivision 12, is amended to read: 
535.10     Subd. 12.  [COMPREHENSIVE EVALUATION.] "Comprehensive 
535.11  evaluation" shall consist of: 
535.12     (1) a medical report on the health status and physical 
535.13  condition of the proposed ward, prepared under the direction of 
535.14  a licensed physician; 
535.15     (2) a report on the proposed ward's intellectual capacity 
535.16  and functional abilities, specifying the tests and other data 
535.17  used in reaching its conclusions, prepared by a psychologist who 
535.18  is qualified in the diagnosis of mental retardation; and 
535.19     (3) a report from the case manager that includes: 
535.20     (i) the most current assessment of individual service needs 
535.21  as described in rules of the commissioner; 
535.22     (ii) the most current individual service plan as described 
535.23  in rules of the commissioner under section 256B.092, subdivision 
535.24  1b; and 
535.25     (iii) a description of contacts with and responses of near 
535.26  relatives of the proposed ward notifying them that a nomination 
535.27  for public guardianship has been made and advising them that 
535.28  they may seek private guardianship.  
535.29     Each report shall contain recommendations as to the amount 
535.30  of assistance and supervision required by the proposed ward to 
535.31  function as independently as possible in society.  To be 
535.32  considered part of the comprehensive evaluation, reports must be 
535.33  completed no more than one year before filing the petition under 
535.34  section 252A.05.  
535.35     Sec. 8.  Minnesota Statutes 2000, section 252A.02, 
535.36  subdivision 13, is amended to read: 
536.1      Subd. 13.  [CASE MANAGER.] "Case manager" means the person 
536.2   designated by the county board under rules of the commissioner 
536.3   to provide case management services under section 256B.092. 
536.4      Sec. 9.  Minnesota Statutes 2000, section 252A.111, 
536.5   subdivision 6, is amended to read: 
536.6      Subd. 6.  [SPECIAL DUTIES.] In exercising powers and duties 
536.7   under this chapter, the commissioner shall: 
536.8      (1) maintain close contact with the ward, visiting at least 
536.9   twice a year; 
536.10     (2) prohibit filming a ward in any way that would reveal 
536.11  the identity of the ward unless the commissioner determines the 
536.12  filming to be in the best interests of the ward.  The 
536.13  commissioner may give written consent for filming of the ward 
536.14  after permitting and encouraging input by the nearest relative 
536.15  protect and exercise the legal rights of the ward; 
536.16     (3) take actions and make decisions on behalf of the ward 
536.17  that encourage and allow the maximum level of independent 
536.18  functioning in a manner least restrictive of the ward's personal 
536.19  freedom consistent with the need for supervision and protection; 
536.20  and 
536.21     (4) permit and encourage maximum self-reliance on the part 
536.22  of the ward and permit and encourage input by the nearest 
536.23  relative of the ward in planning and decision making on behalf 
536.24  of the ward. 
536.25     Sec. 10.  Minnesota Statutes 2000, section 252A.16, 
536.26  subdivision 1, is amended to read: 
536.27     Subdivision 1.  [REVIEW REQUIRED.] The commissioner 
536.28  shall provide require an annual review of the physical, mental, 
536.29  and social adjustment and progress of every ward and 
536.30  conservatee.  A copy of this review shall be kept on file at the 
536.31  department of human services and may be inspected by the ward or 
536.32  conservatee, the ward's or conservatee's parents, spouse, or 
536.33  relatives and other persons who receive the permission of the 
536.34  commissioner.  The review shall contain information required 
536.35  under rules of the commissioner Minnesota Rules, part 9525.3065, 
536.36  subpart 1.  
537.1      Sec. 11.  Minnesota Statutes 2000, section 252A.19, 
537.2   subdivision 2, is amended to read: 
537.3      Subd. 2.  [PETITION.] The commissioner, ward, or any 
537.4   interested person may petition the appointing court or the court 
537.5   to which venue has been transferred for an order to remove the 
537.6   guardianship or to limit or expand the powers of the 
537.7   conservatorship or to appoint a guardian or conservator under 
537.8   sections 525.539 to 525.705 or to restore the ward or 
537.9   conservatee to full legal capacity or to review de novo any 
537.10  decision made by the public guardian or public conservator for 
537.11  or on behalf of a ward or conservatee or for any other order as 
537.12  the court may deem just and equitable.  Section 525.61, 
537.13  subdivision 3, does not apply to a petition to remove a public 
537.14  guardian. 
537.15     Sec. 12.  Minnesota Statutes 2000, section 252A.20, 
537.16  subdivision 1, is amended to read: 
537.17     Subdivision 1.  [WITNESS AND ATTORNEY FEES.] In each 
537.18  proceeding under sections 252A.01 to 252A.21, the court shall 
537.19  allow and order paid to each witness subpoenaed the fees and 
537.20  mileage prescribed by law; to each physician, psychologist, or 
537.21  social worker who assists in the preparation of the 
537.22  comprehensive evaluation and who is not in the employ of the 
537.23  local agency, or the state department of human services, or area 
537.24  mental health-mental retardation board, a reasonable sum for 
537.25  services and for travel; and to the ward's counsel, when 
537.26  appointed by the court, a reasonable sum for travel and for each 
537.27  day or portion of a day actually employed in court or actually 
537.28  consumed in preparing for the hearing.  Upon order the county 
537.29  auditor shall issue a warrant on the county treasurer for 
537.30  payment of the amount allowed. 
537.31     Sec. 13.  Minnesota Statutes 2000, section 256.482, 
537.32  subdivision 8, is amended to read: 
537.33     Subd. 8.  [SUNSET.] Notwithstanding section 15.059, 
537.34  subdivision 5, the council on disability shall not sunset until 
537.35  June 30, 2001 2005. 
537.36     Sec. 14.  [PUBLIC GUARDIANSHIP ALTERNATIVES.] 
538.1      The commissioner of human services shall provide county 
538.2   agencies with funds up to the amount appropriated for public 
538.3   guardianship alternatives based on proposals by the counties to 
538.4   establish private alternatives.  
538.5      Sec. 15.  [AUTOMATIC DEFIBRILLATOR STUDY.] 
538.6      The emergency medical services regulatory board, in 
538.7   consultation with the department of public safety, shall study 
538.8   and report to the legislature by December 15, 2002, regarding 
538.9   the availability of automatic defibrillators outside the 
538.10  seven-county metropolitan area.  The report shall include 
538.11  recommendations to make these devices accessible within a 
538.12  reasonable distance throughout the nonmetropolitan area, 
538.13  including recommendations for funding their acquisition and 
538.14  distribution. 
538.15     Sec. 16.  [REPEALER.] 
538.16     Minnesota Statutes 2000, section 252A.111, subdivision 3, 
538.17  is repealed. 
538.18                             ARTICLE 13 
538.19                           APPROPRIATIONS 
538.20  Section 1.  [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 
538.21     The sums shown in the columns marked "APPROPRIATIONS" are 
538.22  appropriated from the general fund, or any other named fund, to 
538.23  the agencies and for the purposes specified in the following 
538.24  sections of this article, to be available for the fiscal years 
538.25  indicated for each purpose.  The figures "2002" and "2003" where 
538.26  used in this article, mean that the appropriation or 
538.27  appropriations listed under them are available for the fiscal 
538.28  year ending June 30, 2002, or June 30, 2003, respectively.  
538.29  Where a dollar amount appears in parentheses, it means a 
538.30  reduction of an appropriation.  
538.31                          SUMMARY BY FUND 
538.32  APPROPRIATIONS                                      BIENNIAL
538.33                            2002          2003           TOTAL
538.34  General          $3,083,417,000 $3,390,915,000 $6,474,332,000
538.35  State Government
538.36  Special Revenue      35,451,000     37,127,000     72,578,000
538.37  Health Care
539.1   Access              214,712,000    269,923,000    484,635,000
539.2   Federal TANF        318,103,000    277,420,000    595,523,000
539.3   Lottery Cash Flow     1,300,000      1,300,000      2,600,000
539.4   TOTAL            $3,652,983,000 $3,976,685,000 $7,629,668,000
539.5                                              APPROPRIATIONS 
539.6                                          Available for the Year 
539.7                                              Ending June 30 
539.8                                             2002         2003 
539.9   Sec. 2.  COMMISSIONER OF 
539.10  HUMAN SERVICES 
539.11  Subdivision 1.  Total 
539.12  Appropriation                     $3,467,982,000 $3,792,993,000
539.13                Summary by Fund
539.14  General           2,960,188,000 3,270,671,000
539.15  State Government
539.16  Special Revenue         507,000       507,000
539.17  Health Care 
539.18  Access              207,884,000   263,095,000
539.19  Federal TANF        298,103,000   257,420,000
539.20  Lottery Cash Flow     1,300,000     1,300,000
539.21  [APPROPRIATION FOR COURT-ORDERED MENTAL 
539.22  HEALTH TREATMENT.] Of the general fund 
539.23  appropriation, $2,289,000 in fiscal 
539.24  year 2002 and $2,289,000 in fiscal year 
539.25  2003 are for the cost of implementing 
539.26  H.F. 560, if enacted.  This 
539.27  appropriation is available only if H.F. 
539.28  560 is enacted. 
539.29  [APPROPRIATIONS FOR CIVIL COMMITMENT.] 
539.30  (a) Of the general fund appropriation, 
539.31  $3,386,000 in fiscal year 2003 is for 
539.32  the cost of implementing H.F. 281, if 
539.33  enacted.  This appropriation is 
539.34  available only if H.F. 281 is enacted. 
539.35  (b) Of the general fund appropriation, 
539.36  $155,000 in fiscal year 2003 is 
539.37  appropriated to the commissioner to be 
539.38  transferred to the Minnesota supreme 
539.39  court for costs associated with 
539.40  petitions filed for judicial 
539.41  commitment.  This appropriation is 
539.42  available only if H.F. 281 is enacted. 
539.43  [APPROPRIATIONS FOR CHILD SUPPORT.] (1) 
539.44  Of the general fund appropriation, 
539.45  $32,000 in fiscal year 2002 and $32,000 
539.46  in fiscal year 2003 are for the cost of 
539.47  implementing H.F. 1807, if enacted.  
539.48  This appropriation is available only if 
539.49  H.F. 1807 is enacted. 
539.50  (2) Of the general fund appropriation, 
539.51  $435,000 in fiscal year 2002 is for the 
539.52  cost of implementing H.F. 1446, if 
539.53  enacted.  This appropriation is 
539.54  available only if H.F. 1446 is enacted. 
540.1   [APPROPRIATION FOR PATIENT 
540.2   PROTECTIONS.] (a) Of the general fund 
540.3   appropriation, $248,000 in fiscal year 
540.4   2002 and $591,000 in fiscal year 2003 
540.5   are for the cost of implementing the 
540.6   patient protection provisions in H.F. 
540.7   560, if enacted.  This appropriation is 
540.8   available only if H.F. 560 is enacted. 
540.9   (b) Of the health care access fund 
540.10  appropriation, $106,000 in fiscal year 
540.11  2002 and $255,000 in fiscal year 2003 
540.12  are for the cost of implementing H.F. 
540.13  560, if enacted.  This appropriation is 
540.14  available only if H.F. 560 is enacted. 
540.15  [RECEIPTS FOR SYSTEMS PROJECTS.] 
540.16  Appropriations and federal receipts for 
540.17  information system projects for MAXIS, 
540.18  PRISM, MMIS, and SSIS must be deposited 
540.19  in the state system account authorized 
540.20  in Minnesota Statutes, section 
540.21  256.014.  Money appropriated for 
540.22  computer projects approved by the 
540.23  Minnesota office of technology, funded 
540.24  by the legislature, and approved by the 
540.25  commissioner of finance may be 
540.26  transferred from one project to another 
540.27  and from development to operations as 
540.28  the commissioner of human services 
540.29  considers necessary.  Any unexpended 
540.30  balance in the appropriation for these 
540.31  projects does not cancel but is 
540.32  available for ongoing development and 
540.33  operations. 
540.34  [GIFTS.] Notwithstanding Minnesota 
540.35  Statutes, chapter 7, the commissioner 
540.36  may accept on behalf of the state 
540.37  additional funding from sources other 
540.38  than state funds for the purpose of 
540.39  financing the cost of assistance 
540.40  program grants or nongrant 
540.41  administration.  All additional funding 
540.42  is appropriated to the commissioner for 
540.43  use as designated by the grantor of 
540.44  funding. 
540.45  [SYSTEMS CONTINUITY.] In the event of 
540.46  disruption of technical systems or 
540.47  computer operations, the commissioner 
540.48  may use available grant appropriations 
540.49  to ensure continuity of payments for 
540.50  maintaining the health, safety, and 
540.51  well-being of clients served by 
540.52  programs administered by the department 
540.53  of human services.  Grant funds must be 
540.54  used in a manner consistent with the 
540.55  original intent of the appropriation. 
540.56  [SPECIAL REVENUE FUND INFORMATION.] On 
540.57  December 1, 2001, and December 1, 2002, 
540.58  the commissioner shall provide the 
540.59  chairs of the house health and human 
540.60  services finance committee and the 
540.61  senate health, human services, and 
540.62  corrections budget division with 
540.63  detailed fund balance information for 
540.64  each special revenue fund account.  
540.65  [FEDERAL ADMINISTRATIVE REIMBURSEMENT.] 
541.1   Federal administrative reimbursement 
541.2   resulting from MinnesotaCare outreach 
541.3   grants and the Minnesota senior health 
541.4   options project are appropriated to the 
541.5   commissioner for these activities.  Any 
541.6   balance from this appropriation 
541.7   remaining at the end of the biennium 
541.8   shall be transferred to the general 
541.9   fund. 
541.10  [NONFEDERAL SHARE TRANSFERS.] The 
541.11  nonfederal share of activities for 
541.12  which federal administrative 
541.13  reimbursement is appropriated to the 
541.14  commissioner may be transferred to the 
541.15  special revenue fund.  Any balance from 
541.16  this appropriation remaining at the end 
541.17  of the biennium shall be transferred to 
541.18  the general fund. 
541.19  [MAJOR SYSTEMS TRANSFER.] (1) 
541.20  $21,550,000 of funds available in the 
541.21  state systems account authorized in 
541.22  Minnesota Statutes, section 256.014, is 
541.23  transferred to the general fund for the 
541.24  biennium ending June 30, 2003. 
541.25  (2) $2,450,000 of funds available in 
541.26  the state systems account authorized in 
541.27  Minnesota Statutes, section 256.014, is 
541.28  transferred to the general fund for the 
541.29  biennium ending June 30, 2005.  
541.30  Notwithstanding section 13 of this 
541.31  article, this rider does not expire on 
541.32  June 30, 2003. 
541.33  [TANF FUNDS APPROPRIATED TO OTHER 
541.34  ENTITIES.] Any expenditures from the 
541.35  TANF block grant shall be expended in 
541.36  accordance with the requirements and 
541.37  limitations of part A of title IV of 
541.38  the Social Security Act, as amended, 
541.39  and any other applicable federal 
541.40  requirement or limitation.  Prior to 
541.41  any expenditure of these funds, the 
541.42  commissioner shall assure that funds 
541.43  are expended in compliance with the 
541.44  requirements and limitations of federal 
541.45  law and that any reporting requirements 
541.46  of federal law are met.  It shall be 
541.47  the responsibility of any entity to 
541.48  which these funds are appropriated to 
541.49  implement a memorandum of understanding 
541.50  with the commissioner that provides the 
541.51  necessary assurance of compliance prior 
541.52  to any expenditure of funds.  The 
541.53  commissioner shall receipt TANF funds 
541.54  appropriated to other state agencies 
541.55  and coordinate all related interagency 
541.56  accounting transactions necessary to 
541.57  implement these appropriations.  
541.58  Unexpended TANF funds appropriated to 
541.59  any state, local, or nonprofit entity 
541.60  cancel at the end of the state fiscal 
541.61  year unless appropriating language 
541.62  permits otherwise. 
541.63  [TANF FUNDS TRANSFERRED TO OTHER 
541.64  FEDERAL GRANTS.] The commissioner must 
541.65  authorize transfers from TANF to other 
541.66  federal block grants so that funds are 
542.1   available to meet the annual 
542.2   expenditure needs as appropriated.  
542.3   Transfers may be authorized prior to 
542.4   the expenditure year with the agreement 
542.5   of the receiving entity.  Transferred 
542.6   funds must be expended in the year for 
542.7   which the funds were appropriated 
542.8   unless appropriation language permits 
542.9   otherwise.  In accelerating transfer 
542.10  authorizations, the commissioner must 
542.11  aim to preserve the future potential 
542.12  transfer capacity from TANF to other 
542.13  block grants. 
542.14  [TANF MAINTENANCE OF EFFORT.] (a) In 
542.15  order to meet the basic maintenance of 
542.16  effort (MOE) requirements of the TANF 
542.17  block grant specified under Code of 
542.18  Federal Regulations, title 45, section 
542.19  263.1, the commissioner may only report 
542.20  nonfederal money expended for allowable 
542.21  activities listed in the following 
542.22  clauses as TANF MOE expenditures: 
542.23  (1) MFIP cash and food assistance 
542.24  benefits under Minnesota Statutes, 
542.25  chapter 256J; 
542.26  (2) the child care assistance programs 
542.27  under Minnesota Statutes, sections 
542.28  119B.03 and 119B.05, and county child 
542.29  care administrative costs under 
542.30  Minnesota Statutes, section 119B.15; 
542.31  (3) state and county MFIP 
542.32  administrative costs under Minnesota 
542.33  Statutes, chapters 256J and 256K; 
542.34  (4) state, county, and tribal MFIP 
542.35  employment services under Minnesota 
542.36  Statutes, chapters 256J and 256K; and 
542.37  (5) expenditures made on behalf of 
542.38  noncitizen MFIP recipients who qualify 
542.39  for the medical assistance without 
542.40  federal financial participation program 
542.41  under Minnesota Statutes, section 
542.42  256B.06, subdivision 4, paragraphs (d), 
542.43  (e), and (j). 
542.44  (b) The commissioner shall ensure that 
542.45  sufficient qualified nonfederal 
542.46  expenditures are made each year to meet 
542.47  the state's TANF MOE requirements.  For 
542.48  the activities listed in paragraph (a), 
542.49  clauses (2) to (5), the commissioner 
542.50  may only report expenditures that are 
542.51  excluded from the definition of 
542.52  assistance under Code of Federal 
542.53  Regulations, title 45, section 260.31. 
542.54  (c) If nonfederal expenditures for the 
542.55  programs and purposes listed in 
542.56  paragraph (a) are insufficient to meet 
542.57  the state's TANF MOE requirements, the 
542.58  commissioner shall recommend additional 
542.59  allowable sources of nonfederal 
542.60  expenditures to the legislature, if the 
542.61  legislature is or will be in session to 
542.62  take action to specify additional 
542.63  sources of nonfederal expenditures for 
543.1   TANF MOE before a federal penalty is 
543.2   imposed.  The commissioner shall 
543.3   otherwise provide notice to the 
543.4   legislative commission on planning and 
543.5   fiscal policy under paragraph (e). 
543.6   (d) If the commissioner uses authority 
543.7   granted under Laws 1999, chapter 245, 
543.8   article 1, section 10, or similar 
543.9   authority granted by a subsequent 
543.10  legislature, to meet the state's TANF 
543.11  MOE requirements in a reporting period, 
543.12  the commissioner shall inform the 
543.13  chairs of the appropriate legislative 
543.14  committees about all transfers made 
543.15  under that authority for this purpose.  
543.16  (e) If the commissioner determines that 
543.17  nonfederal expenditures under paragraph 
543.18  (a) are insufficient to meet TANF MOE 
543.19  expenditure requirements, and if the 
543.20  legislature is not or will not be in 
543.21  session to take timely action to avoid 
543.22  a federal penalty, the commissioner may 
543.23  report nonfederal expenditures from 
543.24  other allowable sources as TANF MOE 
543.25  expenditures after the requirements of 
543.26  this paragraph are met.  The 
543.27  commissioner may report nonfederal 
543.28  expenditures in addition to those 
543.29  specified under paragraph (a) as 
543.30  nonfederal TANF MOE expenditures, but 
543.31  only ten days after the commissioner of 
543.32  finance has first submitted the 
543.33  commissioner's recommendations for 
543.34  additional allowable sources of 
543.35  nonfederal TANF MOE expenditures to the 
543.36  members of the legislative commission 
543.37  on planning and fiscal policy for their 
543.38  review. 
543.39  (f) The commissioner of finance shall 
543.40  not incorporate any changes in federal 
543.41  TANF expenditures or nonfederal 
543.42  expenditures for TANF MOE that may 
543.43  result from reporting additional 
543.44  allowable sources of nonfederal TANF 
543.45  MOE expenditures under the interim 
543.46  procedures in paragraph (e) into the 
543.47  February or November forecasts required 
543.48  under Minnesota Statutes, section 
543.49  16A.103, unless the commissioner of 
543.50  finance has approved the additional 
543.51  sources of expenditures under paragraph 
543.52  (e). 
543.53  (g) The provisions of Minnesota 
543.54  Statutes, section 256.011, subdivision 
543.55  3, which require that federal grants or 
543.56  aids secured or obtained under that 
543.57  subdivision be used to reduce any 
543.58  direct appropriations provided by law, 
543.59  do not apply if the grants or aids are 
543.60  federal TANF funds. 
543.61  (h) Notwithstanding section 14 of this 
543.62  article, paragraphs (a) to (h) expire 
543.63  June 30, 2005. 
543.64  Subd. 2.  Agency Management 
544.1   General              34,500,000    32,971,000
544.2   State Government
544.3   Special Revenue         392,000       392,000
544.4   Health Care 
544.5   Access                3,591,000     3,602,000
544.6   Federal TANF            546,000       454,000
544.7   The amounts that may be spent from the 
544.8   appropriation for each purpose are as 
544.9   follows: 
544.10  (a) Financial Operations 
544.11  General               6,708,000     6,708,000
544.12  Health Care
544.13  Access                  803,000       803,000
544.14  Federal TANF            546,000       454,000
544.15  (b) Legal and Regulation Operations 
544.16  General               8,682,000     8,305,000
544.17  State Government
544.18  Special Revenue         392,000       392,000
544.19  Health Care
544.20  Access                  233,000       244,000
544.21  [CORE LICENSING ACTIVITIES.] Of the 
544.22  general fund appropriation, $1,138,000 
544.23  in fiscal year 2002 and $923,000 in 
544.24  fiscal year 2003 is to support 14 new 
544.25  licensor positions.  Of this amount, 
544.26  $72,000 in fiscal year 2002 and 
544.27  $107,000 in fiscal year 2003 is to 
544.28  cover maintenance and operational costs 
544.29  for a new computer system, which will 
544.30  provide public access to licensing 
544.31  information. In order to receive 
544.32  continued appropriations for these 
544.33  purposes, by January 1, 2003, the 
544.34  commissioner shall: 
544.35  (1) reduce the average length of time 
544.36  to complete investigations of licensing 
544.37  complaints within 75 days; 
544.38  (2) complete all licensing reviews 
544.39  within the one-year and two-year 
544.40  intervals set forth in statutes; and 
544.41  (3) complete negative licensing action 
544.42  decisions within 45 days of county 
544.43  recommendations. 
544.44  [EXPEDITED MALTREATMENT 
544.45  INVESTIGATIONS.] Of the general fund 
544.46  appropriation, $359,000 in fiscal year 
544.47  2002 and $277,000 in fiscal year 2003 
544.48  are for one senior investigator 
544.49  position, three investigator positions, 
544.50  and one-half of a clerical position to 
544.51  achieve the goals for expedited 
544.52  maltreatment investigations.  In order 
544.53  to receive continued appropriations for 
544.54  this purpose, by January 1, 2003, the 
545.1   commissioner shall reduce the average 
545.2   length of time to complete maltreatment 
545.3   investigations to 60 days. 
545.4   [PUBLIC GUARDIANSHIP INCENTIVES.] Of 
545.5   the general fund appropriation, 
545.6   $250,000 in fiscal year 2002 and 
545.7   $250,000 in fiscal year 2003 is to be 
545.8   used for the purposes of providing 
545.9   fiscal incentives to encourage counties 
545.10  to establish private alternatives. 
545.11  (c) Management Operations 
545.12  General              19,110,000    17,958,000
545.13  Health Care
545.14  Access                2,555,000     2,555,000
545.15  Subd. 3.  Administrative Reimbursement/
545.16  Pass Through
545.17  Federal TANF                               60,565         51,992
545.18  Subd. 4.  Children's Services Grants 
545.19  General              59,320,000    59,833,000
545.20  Federal TANF          6,290,000     6,290,000
545.21  [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 
545.22  Federal funds available during fiscal 
545.23  year 2002 and fiscal year 2003, for 
545.24  adoption incentive grants are 
545.25  appropriated to the commissioner for 
545.26  these purposes. 
545.27  [TANF TRANSFER TO SOCIAL SERVICES.] 
545.28  $4,650,000 is appropriated to the 
545.29  commissioner in fiscal year 2002 and in 
545.30  fiscal year 2003 for purposes of 
545.31  increasing services for families with 
545.32  children whose incomes are at or below 
545.33  200 percent of the federal poverty 
545.34  guidelines.  The commissioner shall 
545.35  authorize a sufficient transfer of 
545.36  funds from the state's federal TANF 
545.37  block grant to the state's federal 
545.38  social services block grant to meet 
545.39  this appropriation. 
545.40  [SOCIAL SERVICES BLOCK GRANT FUNDS FOR 
545.41  CONCURRENT PERMANENCY PLANNING.] 
545.42  Notwithstanding Minnesota Statutes, 
545.43  section 256E.07, $4,650,000 in fiscal 
545.44  year 2002 and $4,650,000 in fiscal year 
545.45  2003 in social services block grant 
545.46  funds allocated to the commissioner 
545.47  under title XX of the Social Security 
545.48  Act are available for distribution to 
545.49  counties under the formula in Minnesota 
545.50  Statutes, section 260C.213, for the 
545.51  purposes of concurrent permanency 
545.52  planning. 
545.53  Subd. 5.  Children's Services Management
545.54  General               5,487,000     5,487,000
545.55  Subd. 6.  Basic Health Care Grants
546.1                 Summary by Fund
546.2   General           1,114,020,000 1,317,641,000
546.3   Health Care
546.4   Access              189,392,000   244,592,000
546.5   The amounts that may be spent from this 
546.6   appropriation for each purpose are as 
546.7   follows: 
546.8   (a) MinnesotaCare Grants  
546.9   Health Care
546.10  Access              188,642,000   243,842,000
546.11  [MINNESOTACARE FEDERAL RECEIPTS.] 
546.12  Receipts received as a result of 
546.13  federal participation pertaining to 
546.14  administrative costs of the Minnesota 
546.15  health care reform waiver shall be 
546.16  deposited as nondedicated revenue in 
546.17  the health care access fund.  Receipts 
546.18  received as a result of federal 
546.19  participation pertaining to grants 
546.20  shall be deposited in the federal fund 
546.21  and shall offset health care access 
546.22  funds for payments to providers. 
546.23  [MINNESOTACARE FUNDING.] The 
546.24  commissioner may expend money 
546.25  appropriated from the health care 
546.26  access fund for MinnesotaCare in either 
546.27  fiscal year of the biennium. 
546.28  (b) MA Basic Health Care Grants -
546.29  Families and Children
546.30  General             433,298,000   517,563,000
546.31  (c) MA Basic Health Care Grants - 
546.32  Elderly and Disabled
546.33  General             511,946,000   604,451,000
546.34  [MEDICALLY NEEDY STANDARD AND FEDERAL 
546.35  AUTHORIZATION.] If federal 
546.36  authorization to use the medical 
546.37  assistance income standard in Minnesota 
546.38  Statutes, section 256B.056, subdivision 
546.39  4, as the medically needy standard is 
546.40  not obtained, the commissioner shall 
546.41  use all resulting savings to provide 
546.42  services under the home and 
546.43  community-based waiver for persons with 
546.44  mental retardation and related 
546.45  conditions. 
546.46  (d) General Assistance Medical Care
546.47  General             155,744,000   176,748,000
546.48  (e) Health Care Grants - Other Assistance  
546.49  General              13,032,000    18,879,000
546.50  Health Care             
546.51  Access                 750,000       750,000 
546.52  [PURCHASING ALLIANCE STOP-LOSS 
546.53  FUNDING.] Of the general fund 
547.1   appropriation, $150,000 in fiscal year 
547.2   2002 and $500,000 in fiscal year 2003 
547.3   are appropriated to the commissioner 
547.4   for the cost of establishing the 
547.5   Purchasing Alliance Stop-loss fund 
547.6   under Minnesota Statutes, section 
547.7   256.956. 
547.8   Subd. 7.  Basic Health Care Management
547.9   General              20,730,000    20,715,000
547.10  Health Care
547.11  Access               13,583,000    13,583,000
547.12  The amounts that may be spent from this 
547.13  appropriation for each purpose are as 
547.14  follows: 
547.15  (a) Health Care Policy Administration
547.16  General               2,822,000     2,862,000
547.17  Health Care 
547.18  Access                  562,000       562,000
547.19  (b) Health Care Operations
547.20  General              17,908,000    17,853,000
547.21  Health Care
547.22  Access               13,021,000    13,021,000
547.23  [PREPAID MEDICAL PROGRAMS.] The 
547.24  nonfederal share of the prepaid medical 
547.25  assistance program fund, which has been 
547.26  appropriated to fund county managed 
547.27  care advocacy and enrollment operating 
547.28  costs, shall be disbursed as grants 
547.29  using either a reimbursement or block 
547.30  grant mechanism. 
547.31  Subd. 8.  State-Operated Services
547.32  General             205,868,000   199,287,000
547.33  The amounts that may be spent from this 
547.34  appropriation for each purpose are as 
547.35  follows: 
547.36  [MITIGATION RELATED TO STATE-OPERATED 
547.37  SERVICES RESTRUCTURING.] Money 
547.38  appropriated to finance mitigation 
547.39  expenses related to restructuring 
547.40  state-operated services programs and 
547.41  administrative services may be 
547.42  transferred between fiscal years within 
547.43  the biennium. 
547.44  [STATE-OPERATED SERVICES CHEMICAL 
547.45  DEPENDENCY PROGRAMS.] When the 
547.46  operations of the state-operated 
547.47  services chemical dependency fund 
547.48  created in Minnesota Statutes, section 
547.49  246.18, subdivision 2, are impeded by 
547.50  projected cash deficiencies resulting 
547.51  from delays in the receipt of grants, 
547.52  dedicated income, or other similar 
547.53  receivables, and when the deficiencies 
547.54  would be corrected within the budget 
547.55  period involved, the commissioner of 
548.1   finance may transfer general fund cash 
548.2   reserves into this account as necessary 
548.3   to meet cash demands.  The cash flow 
548.4   transfers must be returned to the 
548.5   general fund in the fiscal year that 
548.6   the transfer was made.  Any interest 
548.7   earned on general fund cash flow 
548.8   transfers accrues to the general fund 
548.9   and not the state-operated services 
548.10  chemical dependency fund. 
548.11  [STATE-OPERATED SERVICES 
548.12  RESTRUCTURING.] For purposes of 
548.13  restructuring state-operated services, 
548.14  any state-operated services employee 
548.15  whose position is to be eliminated 
548.16  shall be afforded the options provided 
548.17  in applicable collective bargaining 
548.18  agreements.  All salary and mitigation 
548.19  allocations from fiscal year 2002 shall 
548.20  be carried forward into fiscal year 
548.21  2003.  Provided there is no conflict 
548.22  with any collective bargaining 
548.23  agreement, any state-operated services 
548.24  position reduction must only be 
548.25  accomplished through mitigation, 
548.26  attrition, transfer, and other measures 
548.27  as provided in state or applicable 
548.28  collective bargaining agreements and in 
548.29  Minnesota Statutes, section 252.50, 
548.30  subdivision 11, and not through layoff. 
548.31  [REPAIRS AND BETTERMENTS.] The 
548.32  commissioner may transfer unencumbered 
548.33  appropriation balances between fiscal 
548.34  years within the biennium for the state 
548.35  residential facilities repairs and 
548.36  betterments account and special 
548.37  equipment. 
548.38  Subd. 9.  Continuing Care Grants 
548.39  General           1,366,856,000 1,483,268,000
548.40  Lottery Cash Flow     1,158,000     1,158,000
548.41  The amounts that may be spent from this 
548.42  appropriation for each purpose are as 
548.43  follows: 
548.44  (a) Community Social Services
548.45  Block Grants
548.46      48,718,000     49,695,000 
548.47  [CSSA TRADITIONAL APPROPRIATION.] 
548.48  Notwithstanding Minnesota Statutes, 
548.49  section 256E.06, subdivisions 1 and 2, 
548.50  the appropriations available under that 
548.51  section in fiscal years 2002 and 2003 
548.52  must be distributed to each county 
548.53  proportionately to the aid received by 
548.54  the county in calendar year 2000.  
548.55  (b) Aging Adult Service Grants
548.56      10,300,000     10,532,000 
548.57  [COUNTY PLANNING AND SERVICE 
548.58  DEVELOPMENT.] Of this appropriation, 
548.59  $1,200,000 in fiscal year 2002 and 
549.1   $1,600,000 in fiscal year 2003 are for 
549.2   distribution to county boards for 
549.3   planning and development of community 
549.4   services for the elderly as required 
549.5   under Minnesota Statutes, section 
549.6   256B.437, subdivision 2.  For Phase I 
549.7   funding to develop the initial biennial 
549.8   plan addendum, the commissioner shall 
549.9   distribute a minimum of $10,000 to each 
549.10  county on July 1, 2001.  In a county 
549.11  with more than 10,000 persons over 65 
549.12  years, the funding allocation shall be 
549.13  $15,000; with more than 30,000 persons 
549.14  over 65 years - $20,000; with more than 
549.15  50,000 persons over 65 years - $25,000; 
549.16  and with more than 100,000 persons over 
549.17  65 years - $30,000.  Upon submission of 
549.18  the completed biennial plan addendum, 
549.19  the commissioner shall distribute Phase 
549.20  II funding to each county for 
549.21  development of community-based services 
549.22  no later than January 1, 2002.  For 
549.23  counties with less than 4,500 persons 
549.24  under 65 years, the Phase II allocation 
549.25  shall be $10,000.  For counties with 
549.26  more than 4,500 persons over 65 years, 
549.27  the Phase II allocation shall be $2.23 
549.28  per person over 65 years.  Any 
549.29  remaining funds shall be available as 
549.30  targeted funds distributed to counties 
549.31  with designated critical access sites.  
549.32  Phase I funding may be carried over by 
549.33  the county into 2002 and 2003 for the 
549.34  development of services. 
549.35  (c) Deaf and Hard-of-Hearing 
549.36  Services Grants
549.37       1,923,000      1,825,000 
549.38  [SERVICES TO DEAF PERSONS WITH MENTAL 
549.39  ILLNESS.] Of this appropriation, 
549.40  $100,000 in fiscal year 2002 and 
549.41  $100,000 in fiscal year 2003 is for a 
549.42  grant to a nonprofit agency that 
549.43  currently serves deaf and 
549.44  hard-of-hearing adults with mental 
549.45  illness through residential programs 
549.46  and supportive housing outreach 
549.47  activities.  The grant must be used to 
549.48  continue and maintain community support 
549.49  services for deaf and hard-of-hearing 
549.50  adults with mental illness who use or 
549.51  wish to use sign language as their 
549.52  primary means of communication. 
549.53  (d) Mental Health Grants 
549.54  General              50,014,000    51,525,000
549.55  Lottery Cash Flow     1,158,000     1,158,000
549.56  (e) Community Support Grants
549.57      12,698,000     12,920,000 
549.58  (f) Medical Assistance Long-Term 
549.59  Care Waivers and Home Care
549.60     452,689,000    533,489,000 
550.1   [PROVIDER RATE INCREASES.] (1) The 
550.2   commissioner shall increase 
550.3   reimbursement rates by 3.0 percent the 
550.4   first year of the biennium and by 3.0 
550.5   percent the second year for the 
550.6   providers listed in paragraph (2).  The 
550.7   increases shall be effective for 
550.8   services rendered on or after July 1 of 
550.9   each year. 
550.10  (2) The rate increases described in 
550.11  this section shall be provided to home 
550.12  and community-based waivered services 
550.13  for persons with mental retardation or 
550.14  related conditions under Minnesota 
550.15  Statutes, section 256B.501; home and 
550.16  community-based waivered services for 
550.17  the elderly under Minnesota Statutes, 
550.18  section 256B.0915; waivered services 
550.19  under community alternatives for 
550.20  disabled individuals under Minnesota 
550.21  Statutes, section 256B.49; community 
550.22  alternative care waivered services 
550.23  under Minnesota Statutes, section 
550.24  256B.49; traumatic brain injury 
550.25  waivered services under Minnesota 
550.26  Statutes, section 256B.49; nursing 
550.27  services and home health services under 
550.28  Minnesota Statutes, section 256B.0625, 
550.29  subdivision 6a; personal care services 
550.30  and nursing supervision of personal 
550.31  care services under Minnesota Statutes, 
550.32  section 256B.0625, subdivision 19a; 
550.33  private-duty nursing services under 
550.34  Minnesota Statutes, section 256B.0625, 
550.35  subdivision 7; day training and 
550.36  habilitation services for adults with 
550.37  mental retardation or related 
550.38  conditions under Minnesota Statutes, 
550.39  sections 252.40 to 252.46; alternative 
550.40  care services under Minnesota Statutes, 
550.41  section 256B.0913; adult residential 
550.42  program grants under Minnesota Rules, 
550.43  parts 9535.2000 to 9535.3000; adult and 
550.44  family community support grants under 
550.45  Minnesota Rules, parts 9535.1700 to 
550.46  9535.1760; semi-independent living 
550.47  services under Minnesota Statutes, 
550.48  section 252.275, including SILS funding 
550.49  under county social services grants 
550.50  formerly funded under Minnesota 
550.51  Statutes, chapter 256I; community 
550.52  support services for deaf and 
550.53  hard-of-hearing adults with mental 
550.54  illness who use or wish to use sign 
550.55  language as their primary means of 
550.56  communication; and living skills 
550.57  training programs for persons with 
550.58  intractable epilepsy who need 
550.59  assistance in the transition to 
550.60  independent living; and group 
550.61  residential housing supplementary 
550.62  service rate under Minnesota Statutes, 
550.63  section 256I.05, subdivision 1a. 
550.64  (g) Medical Assistance Long-Term 
550.65  Care Facilities
550.66     590,638,000    599,866,000 
550.67  [MORATORIUM EXCEPTIONS.] During each 
551.1   year of the biennium beginning July 1, 
551.2   2001, the commissioner of health may 
551.3   approve moratorium exception projects 
551.4   under Minnesota Statutes, section 
551.5   144A.073, for which the full annualized 
551.6   state share of medical assistance costs 
551.7   does not exceed $2,000,000. 
551.8   [NURSING FACILITY OPERATED BY THE RED 
551.9   LAKE BAND OF CHIPPEWA INDIANS.] (1) The 
551.10  medical assistance payment rates for 
551.11  the 47-bed nursing facility operated by 
551.12  the Red Lake Band of Chippewa Indians 
551.13  must be calculated according to 
551.14  allowable reimbursement costs under the 
551.15  medical assistance program, as 
551.16  specified in Minnesota Statutes, 
551.17  section 246.50, and are subject to the 
551.18  facility-specific Medicare upper limits.
551.19  (2) In addition, the commissioner shall 
551.20  make available rate adjustments for the 
551.21  biennium beginning July 1, 2001, on the 
551.22  same basis as the adjustments provided 
551.23  to nursing facilities under Minnesota 
551.24  Statutes, section 256B.431.  The 
551.25  commissioner must use the facility's 
551.26  final 2000 and 2001 Medicare cost 
551.27  reports to calculate the adjustments.  
551.28  This rate increase shall become part of 
551.29  the facility's base rate for future 
551.30  rate years. 
551.31  [ICF/MR DISALLOWANCES.] Of this 
551.32  appropriation, $65,000 in each fiscal 
551.33  year is to reimburse a four-bed ICF/MR 
551.34  in Ramsey county for disallowance 
551.35  resulting from field audit findings. 
551.36  The commissioner shall exempt these 
551.37  facilities from the provisions of 
551.38  Minnesota Statutes, section 256B.501, 
551.39  subdivision 5b, paragraph (d), clause 
551.40  (6), for the rate years beginning 
551.41  October 1, 1996, and October 1, 1997. 
551.42  [COMMUNITY SERVICES DEVELOPMENT GRANTS 
551.43  PROGRAM.] Of this appropriation, 
551.44  $18,000,000 for the biennium ending 
551.45  June 30, 2003, is to the commissioner 
551.46  for grants under Minnesota Statutes, 
551.47  section 256.9754.  Unexpended 
551.48  appropriations in fiscal year 2002 do 
551.49  not cancel but are available to the 
551.50  commissioner for these purposes in 
551.51  fiscal year 2003.  This is a one-time 
551.52  appropriation and shall not become part 
551.53  of the base-level funding for the 
551.54  2004-2005 biennium. 
551.55  [LONG-TERM CARE CONSULTATION SERVICES.] 
551.56  Long-term care consultation services 
551.57  payments to all counties shall continue 
551.58  at the payment amount in effect for 
551.59  preadmission screening in fiscal year 
551.60  2001. 
551.61  (h) Alternative Care Grants  
551.62  General              75,764,000    89,646,000
551.63  [ALTERNATIVE CARE TRANSFER.] Any money 
552.1   allocated to the alternative care 
552.2   program that is not spent for the 
552.3   purposes indicated does not cancel but 
552.4   shall be transferred to the medical 
552.5   assistance account. 
552.6   [ALTERNATIVE CARE APPROPRIATION.] The 
552.7   commissioner may expend the money 
552.8   appropriated for the alternative care 
552.9   program for that purpose in either year 
552.10  of the biennium. 
552.11  (i) Group Residential Housing
552.12  General              78,712,000    86,807,000
552.13  (j) Chemical Dependency
552.14  Entitlement Grants
552.15  General              39,459,000    41,045,000
552.16  (k) Chemical Dependency 
552.17  Nonentitlement Grants
552.18  General               5,941,000     5,918,000
552.19  [CONSOLIDATED CHEMICAL DEPENDENCY 
552.20  TREATMENT FUND ONE-TIME TRANSFER.] 
552.21  $9,367,000 of funds available in the 
552.22  consolidated chemical dependency 
552.23  treatment fund general reserve account 
552.24  is transferred in fiscal year 2002 to 
552.25  the general fund. 
552.26  Subd. 10.  Continuing Care Management
552.27  General              24,546,000    23,928,000
552.28  State Government
552.29  Special Revenue         115,000       115,000
552.30  Lottery Cash Flow       142,000       142,000
552.31  [COUNTY INVOLVEMENT COSTS.] Of this 
552.32  appropriation, up to $481,000 in fiscal 
552.33  year 2002 and up to $642,000 in fiscal 
552.34  year 2003 are for the commissioner to 
552.35  allocate to counties for resident 
552.36  relocation costs resulting from planned 
552.37  closures under Minnesota Statutes, 
552.38  section 256B.437, and resident 
552.39  relocations under Minnesota Statutes, 
552.40  section 144A.161.  Unexpended funds for 
552.41  fiscal year 2002 do not cancel but are 
552.42  available to the commissioner for this 
552.43  purpose in fiscal year 2003. 
552.44  [REGION 10 QUALITY ASSURANCE 
552.45  COMMISSION.] (1) Of the appropriation 
552.46  from the general fund for the biennium 
552.47  ending June 30, 2003, $548,000 is to 
552.48  the commissioner of human services to 
552.49  be allocated to the region 10 quality 
552.50  assurance commission for operating 
552.51  costs of the alternative quality 
552.52  assurance licensing project and for 
552.53  grants to counties participating in 
552.54  that project. 
552.55  (2) $50,000 is appropriated from the 
552.56  general fund to the commissioner of 
553.1   human services for the biennium ending 
553.2   June 30, 2003, for the region 10 
553.3   quality assurance commission to conduct 
553.4   the evaluation required under Minnesota 
553.5   Statutes, section 256B.0951, 
553.6   subdivision 9. 
553.7   (3) $150,000 is appropriated from the 
553.8   general fund to the commissioner of 
553.9   human services for the biennium ending 
553.10  June 30, 2003, for the commissioner to 
553.11  conduct the project evaluation required 
553.12  for the federal 1115 waiver of ICF/MR 
553.13  regulations. 
553.14  Subd. 11.  Economic Support Grants
553.15  General              91,086,000    90,136,000
553.16  Federal TANF        228,209,000   197,741,000
553.17  The amounts that may be spent from this 
553.18  appropriation for each purpose are as 
553.19  follows: 
553.20  (a) Assistance to Families Grants
553.21  General              25,237,000    21,821,000
553.22  Federal TANF        164,745,000   133,553,000
553.23  (b) Work Grants              
553.24  General               9,844,000     9,844,000
553.25  Federal TANF         62,203,000    61,403,000
553.26  [NONTRADITIONAL CAREER ASSISTANCE.] Of 
553.27  the federal TANF appropriation, 
553.28  $500,000 for fiscal year 2002 and 
553.29  $500,000 for fiscal year 2003 is for 
553.30  grants for nontraditional career 
553.31  assistance training programs under 
553.32  Minnesota Statutes, section 256K.30. 
553.33  This is a one-time appropriation and 
553.34  shall not be added to the base-level 
553.35  funding in the 2004-2005 biennium. 
553.36  [SUPPORTIVE HOUSING AND MANAGED CARE 
553.37  PILOT PROJECT.] Of the general fund 
553.38  appropriation, $2,000,000 in fiscal 
553.39  year 2002 and $5,000,000 in fiscal year 
553.40  2003 is for the supportive housing and 
553.41  managed care pilot project under 
553.42  Minnesota Statutes, section 256K.25. 
553.43  This appropriation may be transferred 
553.44  between fiscal years within the 
553.45  biennium. 
553.46  [INTENSIVE INTERVENTION TRANSITIONAL 
553.47  EMPLOYMENT TRAINING PROJECT.] Of the 
553.48  federal TANF appropriation, $800,000 
553.49  for the biennium ending June 30, 2003, 
553.50  is for the Southeast Asian 
553.51  collaborative in Hennepin county for an 
553.52  intensive intervention transitional 
553.53  employment training project, which 
553.54  serves TANF-eligible recipients, and 
553.55  which moves refugee and immigrant 
553.56  welfare recipients into unsubsidized 
553.57  employment leading to 
554.1   self-sufficiency.  The commissioner 
554.2   must select one of the five partners in 
554.3   the collaborative as the fiscal agent 
554.4   for the project.  The primary effort of 
554.5   the project must be on intensive 
554.6   employment skills training, including 
554.7   workplace English and overcoming 
554.8   cultural barriers, and on specialized 
554.9   training in fields of work which 
554.10  involve a credit-based curriculum.  For 
554.11  recipients without a high school 
554.12  diploma or a GED, extra effort shall be 
554.13  made to help the recipient meet the 
554.14  "ability to benefit test" so the 
554.15  recipient can receive financial aid for 
554.16  further training.  During the 
554.17  specialized training, efforts should be 
554.18  made to involve the recipients with an 
554.19  internship program and retention 
554.20  specialist.  A minor amount of the 
554.21  grant may be used for other efforts to 
554.22  make the recipient families more 
554.23  self-sufficient as provided within TANF 
554.24  rules.  This is a one-time 
554.25  appropriation and shall not be added to 
554.26  the base-level funding for the 
554.27  2004-2005 biennium. 
554.28  [LOCAL INTERVENTION GRANTS FOR 
554.29  SELF-SUFFICIENCY CARRYFORWARD.] 
554.30  Unexpended funds appropriated for local 
554.31  intervention grants under Minnesota 
554.32  Statutes, section 256J.625, for fiscal 
554.33  year 2002 do not cancel but are 
554.34  available to the commissioner for these 
554.35  purposes in fiscal year 2003. 
554.36  (c) Economic Support Grants -      
554.37  Other Assistance
554.38  General               4,682,000     6,931,000
554.39  Federal TANF          1,001,000     2,525,000
554.40  [TANF TRANSFER TO CHILD CARE AND 
554.41  DEVELOPMENT BLOCK GRANT.] $1,526,000 
554.42  for fiscal year 2003 is appropriated to 
554.43  the commissioner of children, families, 
554.44  and learning for the purposes of 
554.45  Minnesota Statutes, section 119B.05.  
554.46  The commissioner of human services 
554.47  shall authorize a sufficient transfer 
554.48  of funds from the state's federal TANF 
554.49  block grant to the state's child care 
554.50  and development fund block grant to 
554.51  meet this appropriation. 
554.52  [WORKING FAMILY TAX CREDITS.] (1) On a 
554.53  regular basis, the commissioner of 
554.54  revenue, with the assistance of the 
554.55  commissioner of human services, shall 
554.56  calculate the value of the refundable 
554.57  portion of the Minnesota working family 
554.58  credits provided under Minnesota 
554.59  Statutes, section 290.0671, that 
554.60  qualifies for federal reimbursement 
554.61  from the temporary assistance for needy 
554.62  families block grant.  The commissioner 
554.63  of revenue shall provide the 
554.64  commissioner of human services with 
554.65  such expenditure records and 
555.1   information as are necessary to support 
555.2   draws of federal funds.  
555.3   (2) Federal TANF funds, as specified in 
555.4   this paragraph, are appropriated to the 
555.5   commissioner of human services based on 
555.6   calculations under paragraph (a) of 
555.7   working family tax credit expenditures 
555.8   that qualify for reimbursement from the 
555.9   TANF block grant for income tax refunds 
555.10  payable in federal fiscal years 
555.11  beginning October 1, 2001.  The draws 
555.12  of federal TANF funds shall be made on 
555.13  a regular basis based on calculations 
555.14  of credit expenditures by the 
555.15  commissioner of revenue.  Up to the 
555.16  following amounts of federal TANF draws 
555.17  are appropriated to the commissioner of 
555.18  human services to deposit in the 
555.19  general fund:  in fiscal year 2002, 
555.20  $25,000,000; and in fiscal year 2003, 
555.21  $16,000,000. 
555.22  (d) Child Support Enforcement
555.23  General               4,239,000     4,239,000
555.24  Federal TANF            260,000       260,000
555.25  [CHILD SUPPORT PAYMENT CENTER.] 
555.26  Payments to the commissioner from other 
555.27  governmental units, private 
555.28  enterprises, and individuals for 
555.29  services performed by the child support 
555.30  payment center must be deposited in the 
555.31  state systems account authorized under 
555.32  Minnesota Statutes, section 256.014.  
555.33  These payments are appropriated to the 
555.34  commissioner for the operation of the 
555.35  child support payment center or system, 
555.36  according to Minnesota Statutes, 
555.37  section 256.014. 
555.38  (e) General Assistance
555.39  General              17,156,000    15,700,000
555.40  [GENERAL ASSISTANCE STANDARD.] The 
555.41  commissioner shall set the monthly 
555.42  standard of assistance for general 
555.43  assistance units consisting of an adult 
555.44  recipient who is childless and 
555.45  unmarried or living apart from his or 
555.46  her parents or a legal guardian at 
555.47  $203.  The commissioner may reduce this 
555.48  amount in accordance with Laws 1997, 
555.49  chapter 85, article 3, section 54. 
555.50  (f) Minnesota Supplemental Aid
555.51  General              29,678,000    31,351,000
555.52  (g) Refugee Services         
555.53  General                 250,000       250,000
555.54  Subd. 12.  Economic Support  
555.55  Management
555.56  General              37,775,000    37,405,000
556.1   Health Care
556.2   Access                1,318,000     1,318,000
556.3   Federal TANF          2,493,000       943,000
556.4   The amounts that may be spent from this 
556.5   appropriation for each purpose are as 
556.6   follows: 
556.7   (a) Economic Support Policy  
556.8   Administration
556.9   General               6,528,000     6,191,000
556.10  Federal TANF          2,493,000       943,000
556.11  [FOOD STAMP ADMINISTRATIVE 
556.12  REIMBURSEMENT.] The commissioner shall 
556.13  reduce quarterly food stamp 
556.14  administrative reimbursement to 
556.15  counties in fiscal years 2002 and 2003 
556.16  by the amount that the United States 
556.17  Department of Health and Human Services 
556.18  determines to be the county random 
556.19  moment study share of the food stamp 
556.20  adjustment under Public Law Number 
556.21  105-185.  The reductions shall be 
556.22  allocated to each county in proportion 
556.23  to each county's contribution, if any, 
556.24  to the amount of the adjustment.  Any 
556.25  adjustment to medical assistance 
556.26  administrative reimbursement that is 
556.27  based on the United States Department 
556.28  of Health and Human Services' 
556.29  determinations under Public Law Number 
556.30  105-185 shall be distributed to 
556.31  counties in the same manner.  
556.32  [EMPLOYMENT SERVICES TRACKING SYSTEM.] 
556.33  Of the federal TANF appropriation, 
556.34  $1,750,000 in fiscal year 2002 and 
556.35  $200,000 in fiscal year 2003 are for 
556.36  development of an employment tracking 
556.37  system in collaboration with the 
556.38  department of economic security.  
556.39  Unexpended funds in fiscal year 2002 do 
556.40  not cancel but are available to the 
556.41  commissioner for these purposes in 
556.42  fiscal year 2003.  This is a one-time 
556.43  appropriation and shall not be added to 
556.44  the base-level funding for the 
556.45  2004-2005 biennium. 
556.46  (b) Economic Support Operations 
556.47  General              31,247,000    31,214,000
556.48  Health Care 
556.49  Access                1,318,000     1,318,000
556.50  Federal TANF        ...,-0-,...   ...,-0-,...
556.51  [SPENDING AUTHORITY FOR FOOD STAMP 
556.52  ENHANCED FUNDING.] In the event that 
556.53  Minnesota qualifies for United States 
556.54  Department of Agriculture Food and 
556.55  Nutrition Services Food Stamp Program 
556.56  enhanced funding beginning in federal 
556.57  fiscal year 1998, the money is 
556.58  appropriated to the commissioner for 
556.59  the purposes of the program.  The 
557.1   commissioner shall retain 25 percent of 
557.2   the enhanced funding for the Minnesota 
557.3   food assistance program, with the 
557.4   remaining 75 percent divided among the 
557.5   counties according to a formula that 
557.6   takes into account each county's impact 
557.7   on the statewide food stamp error rate. 
557.8   [FINANCIAL INSTITUTION DATA MATCH AND 
557.9   PAYMENT OF FEES.] The commissioner is 
557.10  authorized to allocate up to $310,000 
557.11  each year in fiscal year 2002 and 
557.12  fiscal year 2003 from the PRISM special 
557.13  revenue account to make payments to 
557.14  financial institutions in exchange for 
557.15  performing data matches between account 
557.16  information held by financial 
557.17  institutions and the public authority's 
557.18  database of child support obligors as 
557.19  authorized by Minnesota Statutes, 
557.20  section 13B.06, subdivision 7. 
557.21  Sec. 3.  COMMISSIONER OF HEALTH 
557.22  Subdivision 1.  Total 
557.23  Appropriation                        138,591,000    138,716,000
557.24                Summary by Fund
557.25  General              87,619,000    86,160,000 
557.26  State Government 
557.27  Special Revenue      24,144,000    25,728,000 
557.28  Health Care 
557.29  Access                6,828,000     6,828,000 
557.30  Federal TANF         20,000,000    20,000,000 
557.31  Subd. 2.  Family and 
557.32  Community Health                      72,535,000     72,847,000 
557.33                Summary by Fund
557.34  General              47,943,000    47,256,000
557.35  State Government 
557.36  Special Revenue         936,000     1,935,000 
557.37  Health Care 
557.38  Access                3,656,000     3,656,000 
557.39  Federal TANF         20,000,000    20,000,000 
557.40  [ELIMINATING HEALTH DISPARITIES.] Of 
557.41  the general fund appropriation, 
557.42  $6,000,000 each year is for reducing 
557.43  health disparities.  Of the amounts 
557.44  available: 
557.45  (1) $1,500,000 each year is for 
557.46  competitive grants under Minnesota 
557.47  Statutes, section 145.928, subdivision 
557.48  7, to eligible applicants to reduce 
557.49  health disparities in infant mortality 
557.50  rates and adult and child immunization 
557.51  rates. 
557.52  (2) $2,000,000 each year is for 
557.53  competitive grants under Minnesota 
557.54  Statutes, section 145.928, subdivision 
558.1   8, to eligible applicants to reduce 
558.2   health disparities in breast and 
558.3   cervical cancer screening rates, 
558.4   HIV/AIDS and sexually transmitted 
558.5   infection rates, cardiovascular disease 
558.6   rates, diabetes rates, and rates of 
558.7   accidental injuries and violence. 
558.8   (3) $500,000 each year is for grants 
558.9   under Minnesota Statutes, section 
558.10  145.928, subdivision 9, to community 
558.11  health boards as defined in Minnesota 
558.12  Statutes, section 145A.02, to improve 
558.13  access to health screening and 
558.14  follow-up services for refugee 
558.15  populations. 
558.16  (4) $2,000,000 each year is for grants 
558.17  to community health boards as defined 
558.18  in Minnesota Statutes, section 145A.02, 
558.19  according to the formula in Minnesota 
558.20  Statutes, section 145.882, subdivision 
558.21  4a, to provide services targeted at 
558.22  reducing maternal and child health 
558.23  disparities. 
558.24  [TEEN PREGNANCY PREVENTION.] 
558.25  $20,000,000 from the TANF fund for the 
558.26  2002-2003 biennium is appropriated to 
558.27  the commissioner of health for a teen 
558.28  pregnancy prevention program.  Of the 
558.29  amounts available: 
558.30  (1) $3,500,000 in fiscal year 2002 and 
558.31  $5,000,000 in fiscal year 2003 are for 
558.32  teen pregnancy prevention disparity 
558.33  grants under Minnesota Statutes, 
558.34  section 145.9257, subdivision 6. 
558.35  (2) $3,000,000 in fiscal year 2002 and 
558.36  $3,000,000 in fiscal year 2003 are for 
558.37  high-risk community teen pregnancy 
558.38  prevention grants under Minnesota 
558.39  Statutes, section 145.9257, subdivision 
558.40  7. 
558.41  (3) $2,000,000 in fiscal year 2002 and 
558.42  $2,000,000 in fiscal year 2003 are for 
558.43  transfer to the commissioner of 
558.44  children, families, and learning to 
558.45  increase the number of adolescent 
558.46  parenting grants. 
558.47  (4) $1,500,000 in fiscal year 2002 is 
558.48  for one-time grants to public school 
558.49  districts to implement an abstinence 
558.50  until marriage curriculum and to train 
558.51  staff to implement the curriculum.  The 
558.52  curriculum shall educate adolescents 
558.53  that abstinence from sexual activity 
558.54  outside of marriage is the expected 
558.55  standard and that sexual activity 
558.56  outside the context of marriage is 
558.57  likely to have harmful emotional, 
558.58  physical, and social effects; and shall 
558.59  provide an explanation of the value of 
558.60  the institution of marriage and a 
558.61  discussion of the historical purpose 
558.62  and significance of marriage.  The 
558.63  commissioner of health, in consultation 
558.64  with the commissioner of children, 
559.1   families, and learning, shall make 
559.2   school districts aware of the 
559.3   availability of funds for this 
559.4   purpose.  This appropriation shall not 
559.5   become part of the base-level funding 
559.6   for this activity. 
559.7   [POISON INFORMATION SYSTEM.] Of the 
559.8   general fund appropriation, $1,360,000 
559.9   each fiscal year is for poison control 
559.10  system grants under Minnesota Statutes, 
559.11  section 145.93.  This is a one-time 
559.12  appropriation that shall not become 
559.13  part of base-level funding in 2004-2005.
559.14  [SUICIDE PREVENTION.] Of the general 
559.15  fund appropriation, $1,100,000 each 
559.16  fiscal year is for suicide prevention 
559.17  activities under Minnesota Statutes, 
559.18  section 145.56.  Of the amounts 
559.19  available: 
559.20  (1) $275,000 each fiscal year is for 
559.21  refining, coordinating, and 
559.22  implementing the suicide prevention 
559.23  plan according to Minnesota Statutes, 
559.24  section 145.56, subdivisions 1, 3, 4, 
559.25  and 5. 
559.26  (2) $825,000 each fiscal year is to 
559.27  fund community-based programs under 
559.28  Minnesota Statutes, section 145.56, 
559.29  subdivision 2. 
559.30  [TANF HOME VISITING PROGRAM.] Of the 
559.31  federal TANF appropriation, $10,000,000 
559.32  in fiscal year 2002 and $10,000,000 in 
559.33  fiscal year 2003 are for family home 
559.34  visiting programs under Minnesota 
559.35  Statutes, section 145A.17.  These 
559.36  amounts include $7,000,000 in fiscal 
559.37  year 2002 and $7,000,000 in fiscal year 
559.38  2003 of appropriations to the 
559.39  commissioner of human services for 
559.40  transfer to the commissioner of health 
559.41  authorized in Laws 2000, chapter 488, 
559.42  article 13, section 15, subdivision 6, 
559.43  clause (3), as amended by Laws 2000, 
559.44  chapter 499, sections 22 and 39. 
559.45  [TANF HOME VISITING CARRYFORWARD.] Any 
559.46  unexpended balance of the TANF funds 
559.47  appropriated for family home visiting 
559.48  in the first year of the biennium does 
559.49  not cancel but is available for the 
559.50  second year. 
559.51  [TEEN PREGNANCY PREVENTION 
559.52  CARRYFORWARD.] Any unexpended balance 
559.53  of the TANF funds appropriated for teen 
559.54  pregnancy prevention in the first 
559.55  fiscal year of the biennium does not 
559.56  cancel but is available for the second 
559.57  year. 
559.58  [WIC TRANSFERS.] The general fund 
559.59  appropriation for the women, infants, 
559.60  and children (WIC) food supplement 
559.61  program is available for either year of 
559.62  the biennium.  Transfers of these funds 
559.63  between fiscal years must be either to 
560.1   maximize federal funds or to minimize 
560.2   fluctuations in the number of program 
560.3   participants. 
560.4   [MINNESOTA CHILDREN WITH SPECIAL HEALTH 
560.5   NEEDS CARRYFORWARD.] General fund 
560.6   appropriations for treatment services 
560.7   in the services for Minnesota children 
560.8   with special health needs program are 
560.9   available for either year of the 
560.10  biennium. 
560.11  [ONE-TIME REDUCTION FOR FAMILY PLANNING 
560.12  SPECIAL PROJECT GRANTS.] For fiscal 
560.13  year 2003, base-level funding for the 
560.14  Family Planning Special Project Grants 
560.15  under Minnesota Statutes, section 
560.16  145.925, shall be reduced by $690,000. 
560.17  Subd. 3.  Access and Quality 
560.18  Improvement                           31,284,000     30,268,000 
560.19                Summary by Fund
560.20  General              21,160,000    20,194,000 
560.21  State Government 
560.22  Special Revenue       6,952,000     6,902,000 
560.23  Health Care 
560.24  Access                3,172,000     3,172,000 
560.25  [HEALTH CARE SAFETY NET.] (1) Of the 
560.26  general fund appropriation, $5,000,000 
560.27  each year is for a grant program to aid 
560.28  safety net community clinics. 
560.29  (2) $5,000,000 each year is for a grant 
560.30  program to provide rural hospital 
560.31  capital improvement grants described in 
560.32  Minnesota Statutes, section 144.148.  
560.33  Subd. 4.  Health Protection           29,808,000     30,639,000 
560.34                Summary by Fund 
560.35  General              13,699,000    13,895,000 
560.36  State Government 
560.37  Special Revenue      16,109,000    16,744,000 
560.38  [EMERGING HEALTH THREATS.] (a) Of the 
560.39  general fund appropriation, $2,200,000 
560.40  in the first year and $2,400,000 in the 
560.41  second year are to increase the state 
560.42  capacity to identify and respond to 
560.43  emerging health threats.  
560.44  (b) Of these amounts, $1,900,000 in the 
560.45  first year and $2,100,000 in the second 
560.46  year are to expand state laboratory 
560.47  capacity to identify infectious disease 
560.48  organisms, evaluate environmental 
560.49  contaminants, develop new analytical 
560.50  techniques, provide emergency response, 
560.51  and support local government by 
560.52  training health care system workers to 
560.53  deal with biological and chemical 
560.54  health threats.  
560.55  (c) $300,000 each year is to train, 
561.1   consult, and otherwise assist local 
561.2   officials responding to clandestine 
561.3   drug laboratories and minimizing health 
561.4   risks to responders and the public.  
561.5   Subd. 5.  Management and 
561.6   Support Services                       4,964,000      4,962,000 
561.7                 Summary by Fund
561.8   General               4,817,000     4,815,000 
561.9   State Government 
561.10  Special Revenue         147,000       147,000 
561.11  Sec. 4.  VETERANS NURSING   
561.12  HOMES BOARD                           30,336,000     28,784,000 
561.13  [VETERANS HOMES SPECIAL REVENUE 
561.14  ACCOUNT.] The general fund 
561.15  appropriations made to the board may be 
561.16  transferred to a veterans homes special 
561.17  revenue account in the special revenue 
561.18  fund in the same manner as other 
561.19  receipts are deposited according to 
561.20  Minnesota Statutes, section 198.34, and 
561.21  are appropriated to the board for the 
561.22  operation of board facilities and 
561.23  programs. 
561.24  [SETTING COST OF CARE.] The cost of 
561.25  care for the domiciliary residents at 
561.26  the Minneapolis veterans home for 
561.27  fiscal year 2002 and fiscal year 2003 
561.28  shall be calculated based on 100 
561.29  percent occupancy at each facility. 
561.30  [DEFICIENCY FUNDING.] Of the general 
561.31  fund appropriation in fiscal year 2002, 
561.32  $2,000,000 is available with the 
561.33  approval of the commissioner of 
561.34  finance.  Approval of the commissioner 
561.35  of finance is contingent upon review of 
561.36  the board's submittal of a report 
561.37  outlining the following: 
561.38  (1) a long-term revenue outlook for the 
561.39  homes; 
561.40  (2) a review and recommendation of 
561.41  alternative funding sources for the 
561.42  homes' operations; and 
561.43  (3) administrative and service options 
561.44  to bring cost growth in line with 
561.45  revenues. 
561.46  Sec. 5.  HEALTH-RELATED BOARDS 
561.47  Subdivision 1.  Total       
561.48  Appropriation                         10,800,000     10,892,000 
561.49  [STATE GOVERNMENT SPECIAL REVENUE 
561.50  FUND.] The appropriations in this 
561.51  section are from the state government 
561.52  special revenue fund. 
561.53  [NO SPENDING IN EXCESS OF REVENUES.] 
561.54  The commissioner of finance shall not 
561.55  permit the allotment, encumbrance, or 
561.56  expenditure of money appropriated in 
562.1   this section in excess of the 
562.2   anticipated biennial revenues or 
562.3   accumulated surplus revenues from fees 
562.4   collected by the boards.  Neither this 
562.5   provision nor Minnesota Statutes, 
562.6   section 214.06, applies to transfers 
562.7   from the general contingent account. 
562.8   Subd. 2.  Board of Chiropractic 
562.9   Examiners                                361,000        361,000
562.10  Subd. 3.  Board of Dentistry             806,000        806,000
562.11  Subd. 4.  Board of Dietetic
562.12  and Nutrition Practice                    95,000         95,000
562.13  Subd. 5.  Board of Marriage and 
562.14  Family Therapy                           111,000        111,000
562.15  Subd. 6.  Board of Medical  
562.16  Practice                               3,270,000      3,270,000
562.17  Subd. 7.  Board of Nursing             2,704,000      2,772,000
562.18  [HEALTH PROFESSIONAL SERVICES 
562.19  ACTIVITY.] Of these appropriations, 
562.20  $534,000 in fiscal year 2002 and 
562.21  $566,000 in fiscal year 2003 are for 
562.22  the Health Professional Services 
562.23  Activity. 
562.24  Subd. 8.  Board of Nursing 
562.25  Home Administrators                      194,000        186,000
562.26  Subd. 9.  Board of Optometry              90,000         90,000
562.27  Subd. 10.  Board of Pharmacy           1,301,000      1,316,000
562.28  [ADMINISTRATIVE SERVICES UNIT.] Of this 
562.29  appropriation, $433,000 the first year 
562.30  and $441,000 the second year are for 
562.31  the health boards administrative 
562.32  services unit.  The administrative 
562.33  services unit may receive and expend 
562.34  reimbursements for services performed 
562.35  for other agencies. 
562.36  Subd. 11.  Board of Physical Therapy     185,000        185,000
562.37  Subd. 12.  Board of Podiatry              52,000         42,000
562.38  Subd. 13.  Board of Psychology           653,000        647,000
562.39  Subd. 14.  Board of Social Work          825,000        832,000
562.40  Subd. 15.  Board of Veterinary 
562.41  Medicine                                 153,000        179,000
562.42  Sec. 6.  EMERGENCY MEDICAL
562.43  SERVICES BOARD                         3,033,000      3,037,000 
562.44                Summary by Fund
562.45  General               3,033,000     3,037,000
562.46  [COMPREHENSIVE ADVANCED LIFE SUPPORT 
562.47  (CALS).] $500,000 in fiscal year 2002 
562.48  and $500,000 in fiscal year 2003 are 
562.49  for the comprehensive advanced life 
562.50  support educational program under 
562.51  Minnesota Statutes, section 144E.37. 
563.1   Sec. 7.  COUNCIL ON DISABILITY           692,000        714,000
563.2   Sec. 8.  OMBUDSMAN FOR MENTAL 
563.3   HEALTH AND MENTAL RETARDATION          1,378,000      1,378,000
563.4   Sec. 9.  OMBUDSMAN
563.5   FOR FAMILIES                             171,000        171,000
563.6   Sec. 10.  TRANSFERS 
563.7   Subdivision 1.  Grants
563.8   The commissioner of human services, 
563.9   with the approval of the commissioner 
563.10  of finance, and after notification of 
563.11  the chair of the senate health and 
563.12  family security budget division and the 
563.13  chair of the house health and human 
563.14  services finance committee, may 
563.15  transfer unencumbered appropriation 
563.16  balances for the biennium ending June 
563.17  30, 2003, within fiscal years among the 
563.18  MFIP, general assistance, general 
563.19  assistance medical care, medical 
563.20  assistance, Minnesota supplemental aid, 
563.21  and group residential housing programs, 
563.22  and the entitlement portion of the 
563.23  chemical dependency consolidated 
563.24  treatment fund, and between fiscal 
563.25  years of the biennium. 
563.26  Subd. 2.  Administration
563.27  Positions, salary money, and nonsalary 
563.28  administrative money may be transferred 
563.29  within the departments of human 
563.30  services and health and within the 
563.31  programs operated by the veterans 
563.32  nursing homes board as the 
563.33  commissioners and the board consider 
563.34  necessary, with the advance approval of 
563.35  the commissioner of finance.  The 
563.36  commissioner or the board shall inform 
563.37  the chairs of the house health and 
563.38  human services finance committee and 
563.39  the senate health and family security 
563.40  budget division quarterly about 
563.41  transfers made under this provision. 
563.42  Sec. 11.  INDIRECT COSTS NOT TO
563.43  FUND PROGRAMS.
563.44  The commissioners of health and of 
563.45  human services shall not use indirect 
563.46  cost allocations to pay for the 
563.47  operational costs of any program for 
563.48  which they are responsible. 
563.49  Sec. 12.  CARRYOVER LIMITATION 
563.50  None of the appropriations in this 
563.51  article which are allowed to be carried 
563.52  forward from fiscal year 2002 to fiscal 
563.53  year 2003 shall become part of the base 
563.54  level funding for the 2004-2005 
563.55  biennial budget, unless specifically 
563.56  directed by the legislature. 
563.57  Sec. 13.  SUNSET OF UNCODIFIED LANGUAGE
563.58  All uncodified language contained in 
564.1   this article expires on June 30, 2003, 
564.2   unless a different expiration date is 
564.3   explicit. 
564.4      Sec. 14.  [246.141] [PROJECT LABOR.] 
564.5      Wages for project labor may be paid by the commissioner out 
564.6   of repairs and betterments money if the individual is to be 
564.7   engaged in a construction project or a repair project of 
564.8   short-term and nonrecurring nature.  Compensation for project 
564.9   labor shall be based on the prevailing wage rates, as defined in 
564.10  section 177.42, subdivision 6.  Project laborers are excluded 
564.11  from the provisions of sections 43A.22 to 43A.30, and shall not 
564.12  be eligible for state-paid insurance and benefits.