1.1                          A bill for an act
  1.2             relating to health; including persons with fetal 
  1.3             alcohol syndrome in the definitions of child with a 
  1.4             disability and related condition; establishing a fetal 
  1.5             alcohol syndrome advisory committee; establishing 
  1.6             state responsibility for the cost of care outside the 
  1.7             home of a child with fetal alcohol syndrome; amending 
  1.8             Minnesota Statutes 2000, sections 125A.02, subdivision 
  1.9             1; 145.9266, by adding a subdivision; and 252.27, 
  1.10            subdivisions 1, 1a, 2a, and 2b, and by adding a 
  1.11            subdivision. 
  1.12  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.13     Section 1.  Minnesota Statutes 2000, section 125A.02, 
  1.14  subdivision 1, is amended to read: 
  1.15     Subdivision 1.  [CHILD WITH A DISABILITY.] Every child who 
  1.16  has a hearing impairment, visual disability, speech or language 
  1.17  impairment, physical handicap, other health impairment, mental 
  1.18  handicap, emotional/behavioral disorder, specific learning 
  1.19  disability, autism, fetal alcohol syndrome, traumatic brain 
  1.20  injury, multiple disabilities, or deaf/blind disability and 
  1.21  needs special instruction and services, as determined by the 
  1.22  standards of the commissioner, is a child with a disability.  In 
  1.23  addition, every child under age three, and at local district 
  1.24  discretion from age three to age seven, who needs special 
  1.25  instruction and services, as determined by the standards of the 
  1.26  commissioner, because the child has a substantial delay or has 
  1.27  an identifiable physical or mental condition known to hinder 
  1.28  normal development is a child with a disability. 
  2.1      Sec. 2.  Minnesota Statutes 2000, section 145.9266, is 
  2.2   amended by adding a subdivision to read: 
  2.3      Subd. 6a.  [ADVISORY COMMITTEE.] (a) A fetal alcohol 
  2.4   syndrome advisory committee is established to advise the 
  2.5   Minnesota organization on fetal alcohol syndrome on the 
  2.6   operation of pilot programs and its other activities related to 
  2.7   fetal alcohol syndrome. 
  2.8      (b) Membership on the advisory committee shall consist of: 
  2.9      (1) the commissioners of health; human services; 
  2.10  corrections; public safety; economic security; and children, 
  2.11  families, and learning; or their designees; 
  2.12     (2) the director of the office of strategic and long-range 
  2.13  planning, or a designee; 
  2.14     (3) the chairperson of the maternal and child health 
  2.15  advisory task force established in section 145.881, or a 
  2.16  designee; 
  2.17     (4) one representative of the University of Minnesota 
  2.18  academic health center, appointed by the provost; 
  2.19     (5) five members of the general public appointed by the 
  2.20  governor, at least one of whom must be a family member of an 
  2.21  individual with fetal alcohol syndrome or fetal alcohol effect; 
  2.22     (6) one member from the judiciary appointed by the chief 
  2.23  justice of the supreme court; 
  2.24     (7) one representative of the Indian affairs council 
  2.25  established under section 3.922; and 
  2.26     (8) two members of the Minnesota house of representatives, 
  2.27  appointed by the speaker of the house, and two members of the 
  2.28  Minnesota senate, appointed by the subcommittee on committees of 
  2.29  the committee on rules and legislative administration. 
  2.30     (c) Terms, compensation, and removal of members are 
  2.31  governed by section 15.059.  The advisory committee expires June 
  2.32  30, 2005. 
  2.33     Sec. 3.  Minnesota Statutes 2000, section 252.27, 
  2.34  subdivision 1, is amended to read: 
  2.35     Subdivision 1.  [COUNTY OF FINANCIAL RESPONSIBILITY.] 
  2.36  Whenever any child who has mental retardation or a related 
  3.1   condition other than fetal alcohol syndrome, or a physical 
  3.2   disability or emotional disturbance is in 24-hour care outside 
  3.3   the home including respite care, in a facility licensed by the 
  3.4   commissioner of human services, the cost of services shall be 
  3.5   paid by the county of financial responsibility determined 
  3.6   pursuant to chapter 256G.  If the child's parents or guardians 
  3.7   do not reside in this state, the cost shall be paid by the 
  3.8   responsible governmental agency in the state from which the 
  3.9   child came, by the parents or guardians of the child if they are 
  3.10  financially able, or, if no other payment source is available, 
  3.11  by the commissioner of human services. 
  3.12     Sec. 4.  Minnesota Statutes 2000, section 252.27, 
  3.13  subdivision 1a, is amended to read: 
  3.14     Subd. 1a.  [DEFINITIONS.] A "related condition" is a 
  3.15  condition that is found to be closely related to mental 
  3.16  retardation, including, but not limited to, cerebral palsy, 
  3.17  epilepsy, autism, fetal alcohol syndrome, and Prader-Willi 
  3.18  syndrome and that meets all of the following criteria: 
  3.19     (a) is severe and chronic; 
  3.20     (b) results in impairment of general intellectual 
  3.21  functioning or adaptive behavior similar to that of persons with 
  3.22  mental retardation; 
  3.23     (c) requires treatment or services similar to those 
  3.24  required for persons with mental retardation; 
  3.25     (d) is manifested before the person reaches 22 years of 
  3.26  age; 
  3.27     (e) is likely to continue indefinitely; 
  3.28     (f) results in substantial functional limitations in three 
  3.29  or more of the following areas of major life activity:  (1) 
  3.30  self-care, (2) understanding and use of language, (3) learning, 
  3.31  (4) mobility, (5) self-direction, (6) capacity for independent 
  3.32  living; and 
  3.33     (g) is not attributable to mental illness as defined in 
  3.34  section 245.462, subdivision 20, or an emotional disturbance as 
  3.35  defined in section 245.4871, subdivision 15. 
  3.36  For purposes of paragraph (g), notwithstanding section 245.462, 
  4.1   subdivision 20, or 245.4871, subdivision 15, "mental illness" 
  4.2   does not include autism or other pervasive developmental 
  4.3   disorders. 
  4.4      Sec. 5.  Minnesota Statutes 2000, section 252.27, is 
  4.5   amended by adding a subdivision to read: 
  4.6      Subd. 1b.  [FINANCIAL RESPONSIBILITY OF STATE.] Whenever 
  4.7   any child who has fetal alcohol syndrome is in 24-hour care 
  4.8   outside the home, including respite care, in a facility licensed 
  4.9   by the commissioner of human services, the cost of the services 
  4.10  shall be paid by the commissioner of human services, except that 
  4.11  if the child's parents or guardians do not reside in this state, 
  4.12  the cost shall be paid by the responsible government agency in 
  4.13  the state from which the child came or by the parents or 
  4.14  guardians of the child if they are financially able. 
  4.15     Sec. 6.  Minnesota Statutes 2000, section 252.27, 
  4.16  subdivision 2a, is amended to read: 
  4.17     Subd. 2a.  [CONTRIBUTION AMOUNT.] (a) The natural or 
  4.18  adoptive parents of a minor child, including a child determined 
  4.19  eligible for medical assistance without consideration of 
  4.20  parental income, must contribute monthly to the cost of 
  4.21  services, unless the child is married or has been married, 
  4.22  parental rights have been terminated, or the child's adoption is 
  4.23  subsidized according to section 259.67 or through title IV-E of 
  4.24  the Social Security Act. 
  4.25     (b) The parental contribution shall be the greater of a 
  4.26  minimum monthly fee of $25 for households with adjusted gross 
  4.27  income of $30,000 and over, or an amount to be computed by 
  4.28  applying to the adjusted gross income of the natural or adoptive 
  4.29  parents that exceeds 150 percent of the federal poverty 
  4.30  guidelines for the applicable household size, the following 
  4.31  schedule of rates: 
  4.32     (1) on the amount of adjusted gross income over 150 percent 
  4.33  of poverty, but not over $50,000, ten percent; 
  4.34     (2) on the amount of adjusted gross income over 150 percent 
  4.35  of poverty and over $50,000 but not over $60,000, 12 percent; 
  4.36     (3) on the amount of adjusted gross income over 150 percent 
  5.1   of poverty, and over $60,000 but not over $75,000, 14 percent; 
  5.2   and 
  5.3      (4) on all adjusted gross income amounts over 150 percent 
  5.4   of poverty, and over $75,000, 15 percent. 
  5.5      If the child lives with the parent, the parental 
  5.6   contribution is reduced by $200, except that the parent must pay 
  5.7   the minimum monthly $25 fee under this paragraph.  If the child 
  5.8   resides in an institution specified in section 256B.35, the 
  5.9   parent is responsible for the personal needs allowance specified 
  5.10  under that section in addition to the parental contribution 
  5.11  determined under this section.  The parental contribution is 
  5.12  reduced by any amount required to be paid directly to the child 
  5.13  pursuant to a court order, but only if actually paid. 
  5.14     (c) The household size to be used in determining the amount 
  5.15  of contribution under paragraph (b) includes natural and 
  5.16  adoptive parents and their dependents under age 21, including 
  5.17  the child receiving services.  Adjustments in the contribution 
  5.18  amount due to annual changes in the federal poverty guidelines 
  5.19  shall be implemented on the first day of July following 
  5.20  publication of the changes. 
  5.21     (d) For purposes of paragraph (b), "income" means the 
  5.22  adjusted gross income of the natural or adoptive parents 
  5.23  determined according to the previous year's federal tax form. 
  5.24     (e) The contribution shall be explained in writing to the 
  5.25  parents at the time eligibility for services is being 
  5.26  determined.  The contribution shall be made on a monthly basis 
  5.27  effective with the first month in which the child receives 
  5.28  services.  Annually upon redetermination or at termination of 
  5.29  eligibility, if the contribution exceeded the cost of services 
  5.30  provided, the local agency or the state shall reimburse that 
  5.31  excess amount to the parents, either by direct reimbursement if 
  5.32  the parent is no longer required to pay a contribution, or by a 
  5.33  reduction in or waiver of parental fees until the excess amount 
  5.34  is exhausted. 
  5.35     (f) The monthly contribution amount must be reviewed at 
  5.36  least every 12 months; when there is a change in household size; 
  6.1   and when there is a loss of or gain in income from one month to 
  6.2   another in excess of ten percent.  The local agency, or the 
  6.3   commissioner of human services for a child described in 
  6.4   subdivision 1b, shall mail a written notice 30 days in advance 
  6.5   of the effective date of a change in the contribution amount.  A 
  6.6   decrease in the contribution amount is effective in the month 
  6.7   that the parent verifies a reduction in income or change in 
  6.8   household size. 
  6.9      (g) Parents of a minor child who do not live with each 
  6.10  other shall each pay the contribution required under paragraph 
  6.11  (a), except that a court-ordered child support payment actually 
  6.12  paid on behalf of the child receiving services shall be deducted 
  6.13  from the contribution of the parent making the payment. 
  6.14     (h) The contribution under paragraph (b) shall be increased 
  6.15  by an additional five percent if the local agency, or the 
  6.16  commissioner of human services for a child described in 
  6.17  subdivision 1b, determines that insurance coverage is available 
  6.18  but not obtained for the child.  For purposes of this section, 
  6.19  "available" means the insurance is a benefit of employment for a 
  6.20  family member at an annual cost of no more than five percent of 
  6.21  the family's annual income.  For purposes of this section, 
  6.22  "insurance" means health and accident insurance coverage, 
  6.23  enrollment in a nonprofit health service plan, health 
  6.24  maintenance organization, self-insured plan, or preferred 
  6.25  provider organization. 
  6.26     Parents who have more than one child receiving services 
  6.27  shall not be required to pay more than the amount for the child 
  6.28  with the highest expenditures.  There shall be no resource 
  6.29  contribution from the parents.  The parent shall not be required 
  6.30  to pay a contribution in excess of the cost of the services 
  6.31  provided to the child, not counting payments made to school 
  6.32  districts for education-related services.  Notice of an increase 
  6.33  in fee payment must be given at least 30 days before the 
  6.34  increased fee is due.  
  6.35     (i) The contribution under paragraph (b) shall be reduced 
  6.36  by $300 per fiscal year if, in the 12 months prior to July 1: 
  7.1      (1) the parent applied for insurance for the child; 
  7.2      (2) the insurer denied insurance; 
  7.3      (3) the parents submitted a complaint or appeal, in writing 
  7.4   to the insurer, submitted a complaint or appeal, in writing, to 
  7.5   the commissioner of health or the commissioner of commerce, or 
  7.6   litigated the complaint or appeal; and 
  7.7      (4) as a result of the dispute, the insurer reversed its 
  7.8   decision and granted insurance. 
  7.9      For purposes of this section, "insurance" has the meaning 
  7.10  given in paragraph (h). 
  7.11     A parent who has requested a reduction in the contribution 
  7.12  amount under this paragraph shall submit proof in the form and 
  7.13  manner prescribed by the commissioner or county agency, 
  7.14  including, but not limited to, the insurer's denial of 
  7.15  insurance, the written letter or complaint of the parents, court 
  7.16  documents, and the written response of the insurer approving 
  7.17  insurance.  The determinations of the commissioner or county 
  7.18  agency under this paragraph are not rules subject to chapter 14. 
  7.19     Sec. 7.  Minnesota Statutes 2000, section 252.27, 
  7.20  subdivision 2b, is amended to read: 
  7.21     Subd. 2b.  [CHILD'S RESPONSIBILITY.] Responsibility of the 
  7.22  child for the cost of care shall be up to the maximum amount of 
  7.23  the total income and resources attributed to the child except 
  7.24  for the clothing and personal needs allowance as provided in 
  7.25  section 256B.35, subdivision 1.  Reimbursement by the parents 
  7.26  and child shall be made to the county making any payments for 
  7.27  services, or to the commissioner of human services for a child 
  7.28  described in subdivision 1b.  The county board, or the 
  7.29  commissioner of human services for children described in 
  7.30  subdivision 1b, may require payment of the full cost of caring 
  7.31  for children whose parents or guardians do not reside in this 
  7.32  state. 
  7.33     To the extent that a child described in subdivision 1 is 
  7.34  eligible for benefits under chapter 62A, 62C, 62D, 62E, or 64B, 
  7.35  the county is not liable for the cost of services.  To the 
  7.36  extent that a child described in subdivision 1b is eligible for 
  8.1   benefits under chapter 62A, 62C, 62D, 62E, or 64B, the 
  8.2   commissioner of human services is not liable for the cost of 
  8.3   services.